Washington DC Update 10/15/14 - submitted Washington DC Update {Don’t forget to check out the Family Voices/NCFPP ACA webpage and the most recent NCFPP blog post on coverage of children “aging out” of Medicaid.} February 10, 2016 Did you know that ONE in FIVE families has at least one child with special health care needs? Join the Family Voices One-in-Five Awareness Campaign. Don’t forget to check out the Family Voices/NCFPP ACA webpage and the latest Family Voices ACA blog post. Greetings from Washington! Yesterday, the White House released the President’s budget request for federal FY 2017, which begins on October 1. As explained below, his budget is simply a request to Congress, but it can help to push certain issues to the forefront. In his final budget, President Obama proposes to spend $755 million to help fund the "Moonshot” initiative to cure cancer, which he announced in his State of the Union address. He also proposes to give states three years of full federal funding for a Medicaid expansion, regardless of when they choose to expand the program. (Under the ACA, the 100 percent federal match is available only through FY 2016.) Read about the federal budget process and more in this week’s Update. To read about an email scam aimed at Social Security beneficiaries, see below under “Other News and Information.” If you are curious about the Zika virus, see the CDC’s Zika virus homepage. {NOTE: Some of the webinars below are taking place within the next few days.} UPCOMING WEBINARS AND CALLS [NOTE: Events are listed in chronological order, by the first event in a series, where applicable.] National Council on Disability Quarterly Meeting (phone participation available) Thursday, February 11, 9:00-4:30 pm ET Friday, February 12, 8:30 am–12:15 pm ET At its next quarterly meeting, the National Council on Disability (NCD), an independent federal advisory agency, will hear policy presentations on the topics of mental health services in higher education; guardianship; updates since the release of NCD’s “Breaking the School to Prison Pipeline” report last fall; Medicaid managed care and the direct care workforce; and emerging technology in employment and education. The Council will also receive reports from its standing committees and receive public comment on the topics of mental health services in higher education; guardianship; challenges of the direct care workforce; and emerging technology. Interested parties are welcome to join in person or by phone in a listening-only capacity (other than the period allotted for public comment.) Comments can be emailed to [email protected] or people call-in with their comments during the meeting, although priority will be given to those who attend in-person. CALL-IN INFORMATION: Number: 888-505-4369; Conference ID: 382979; Conference Title: NCD Meeting; Host Name: Clyde Terry. For more information and the full agenda, click here. Improving Health Care Quality for Children in Medicaid and CHIP Family Voices, Inc. Mailing Address: P.O. Box 37188, Albuquerque, NM 87176 Physical Address: 3701 San Mateo Blvd NE, Suite 103, Albuquerque, NM 87110 Phone: 505-872-4774 Toll Free: 888-835-5669 Fax: 505-872-4780 Website: www.familyvoices.org 1 February 11, 2:00-3:30 pm ET The Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS) will be holding this webinar, “Amplify Your Impact on Child Health Quality: Learning from the CHIPRA Quality Demonstration Grant Program.” Speakers will highlight promising practices and key lessons learned from the 5-year grant program to improve health care quality for children in Medicaid and CHIP. They will also talk about a new opportunity for technical assistance and peer-to-peer learning aimed at States that did not participate in the demonstration, so they can benefit from the experiences of the 18 States that did. Advance registration is encouraged, but not required. For more information and a link to register or join the event without registering, click here. Sustainable Financing for Community Health Workers: Exploring Medicaid Opportunities Thursday, February 11, 2:00-3:30 pm ET Sponsored by the Public Health Institute Community Health Workers (CHWs) have gained increased recognition and awareness since the passage of the Affordable Care Act. Many states that were funded through Centers of Medicare and Medicaid Innovation Center (CMMI) Health Care Innovation Awards (HCIA) and State Innovation Model (SIM) awards are turning to CHWs to help transform the delivery of health care. CHW’s historically have been supported through grant funding, but now states are looking for sustainable financing strategies, including Medicaid. This webinar will feature speakers from state agencies in Connecticut, Michigan, Minnesota, and Pennsylvania who will provide valuable insight into how they have approached sustainable financing sources for CHWs, such as the recent preventive service rule change, managed care contracting, and health homes. For more information and to register, click here. Connecting Kids to Coverage Thursday, February 11, 3:00-4:00 pm ET Sponsored by the Centers for Medicare and Medicaid Services (CMS) Children and teenagers, and their parents, may qualify for free or low-cost health insurance coverage through Medicaid or the Children’s Health Insurance Program (CHIP). Learn about the nationwide effort to identify children and youth eligible for Medicaid and CHIP and get them enrolled. Click here to register. Managing Care for Students with Chronic Conditions: Shared Use of Electronic Health Records by Health Systems and Schools Thursday, February 18, 2:00-3:00 pm ET This webinar highlights the importance of health informatics and how the adoption of electronic health records (EHR) can improve delivery of health care and help meet the needs of children with chronic conditions. It will introduce EHR use in clinical settings serving children and the opportunity to share data with schools in an effort to strengthen care coordination and improve health and education outcomes. Panelists from Wisconsin, Delaware, and Oregon will describe their approaches to increase the inclusion of school nurses as part of the health care team, with a focus on how they promote school nurse access to view EHR. These examples will feature key partnerships and collaborations and additional ingredients for success to assist state health departments and other stakeholders wishing to move forward in this area. Register here. Debriefing on Enrollment Efforts Thursday, February 18, 2:00-3:00 pm ET Families USA will be holding this webinar to help outreach and enrollment assisters plan and conduct constructive meetings to debrief on their efforts during the recent open enrollment period. Key topics will include examples of ways to engage staff and partners, capture past experiences and brainstorm new ideas, as well as plan for the future. Read more and register here. Managed Care for People with I/DD: Lessons Learned Family Voices, Inc. Mailing Address: P.O. Box 37188, Albuquerque, NM 87176 Physical Address: 3701 San Mateo Blvd NE, Suite 103, Albuquerque, NM 87110 Phone: 505-872-4774 Toll Free: 888-835-5669 Fax: 505-872-4780 Website: www.familyvoices.org 2 Thursday, February 18, 3:00-4:00 pm ET This webinar, sponsored by The Arc as part of its HealthMeet project, will present results from a four-year evaluation of an integrated care program in which people with intellectual or developmental disabilities (I/DD) were transferred from fee-for-service Medicaid to managed health care. It will include innovative ways to assess the views of people with I/DD regarding their health and healthcare, outcomes of the transition, and strategies resulting in better health care outcomes. Lessons learned will address the role of continuity of care, care coordination, consumer choice, and family involvement in meeting the health care needs of people with I/DD and ways to improve these aspects. For more information and to register, click here. Special Enrollment Periods Thursday, March 3, 2:00-3:30 pm ET Sponsored by the Center on Budget and Policy Priorities This Health Reform: Beyond the Basics webinar will address the circumstances that trigger a special enrollment period and will review the timing of coverage effective dates for different triggering events. It will also clarify changes and updates to the circumstances that trigger a special enrollment period. Register here. Community Health Worker Call Series #1: Certification and Licensure Thursday, March 3, 3:30-5:00 pm ET Sponsored by the Association of State and Territorial Health Officials (ASTHO) Integrating Community Health Workers (CHWs) into the healthcare workforce is a growing strategy for increasing access and improving population health, while decreasing cost. ASTHO, with funding from HRSA, will host an interactive panel discussion to highlight issues related to CHW certification and licensure. This webinar will provide an overview of state legislative activity related to certification and licensure of CHWs, describe the Community Health Worker Core Consensus (C3) Project, and discuss the pros and cons to certification through facilitated Q&A among panelists and participants. Register here. THE ADMINISTRATION President’s FY 2017 Budget Released February 9 Each year in early February the President reveals his budget for the next federal fiscal year, which begins the following October 1. The President’s budget is really just a proposal to Congress, (despite some press reports that make it sound like the proposals will really take effect). It includes proposed funding levels for existing appropriated programs (e.g., the Maternal and Child Health Block Grant), along with proposals for legislative changes to existing entitlements (e.g., Medicare and Medicaid), and proposals for new programs or initiatives. The submission of the presidential budget begins a long process in Congress, which will, theoretically but not always in reality, adopt a budget resolution to guide its subsequent appropriations and budget-related policy decisions. This resolution does not require presidential approval and does not have the force of law. Even if Congress does not adopt a budget resolution, it must pass appropriations bills to keep federal agencies operating in the next fiscal year. For more information on the budget process, see the website of the House Budget Committee. The President's budget includes $5 million in funding for Family-to-Family Health Information Centers (F2Fs), as expected, since funding for this program is set in statute through FY 2017. (The F2F program does not need an appropriation from Congress.) The President also proposes that the Maternal and Child Health Block Grant be funded at the same level as last year, $638 million. (The Association of Maternal and Child Health Programs is proposing that Congress fund the program at $650 million this year.) Family Voices, Inc. Mailing Address: P.O. Box 37188, Albuquerque, NM 87176 Physical Address: 3701 San Mateo Blvd NE, Suite 103, Albuquerque, NM 87110 Phone: 505-872-4774 Toll Free: 888-835-5669 Fax: 505-872-4780 Website: www.familyvoices.org 3 CONGRESS House Mental Health Bill Introduced On February 2, Representative Gene Green (D-TX), Ranking Member of the House Energy & Commerce Health Subcommittee, along with five other Democrats on the Committee, introduced the Comprehensive Behavioral Health Reform and Recovery Act of 2016 (H.R. 4435). The bill would increase funding for services across the spectrum of mental health care - from prevention, through treatment and recovery - with an aim to “transform our system from the ground up.” See this press release. Among other things, the bill includes measures to revise Medicaid benefits to promote home and community-based mental health services; clarify what can and cannot be shared under the federal health privacy (HIPAA) law; expand mental health grants to states; improve the integration of primary and mental health care; prevent adult suicide; and address racial, ethnic, sexual, and gender minority behavioral health disparities. For a one-page summary of the bill, click here. For a section-bysection summary of the bill, click here. For the text of the bill, click here. As noted in previous Updates, there is also a very controversial bill moving through the House, the Helping Families in Mental Health Crisis Act (H.R. 2646), sponsored by Rep. Tim Murphy (R-PA). The Senate is also considering mental health legislation, so this is an issue that has “traction” in Congress. ACA NEWS AND INFORMATION ACA Open Enrollment Results On January 31, Open Enrollment for 2016 health insurance coverage ended. The Centers for Medicare and Medicaid Services (CMS) has reported that about 12.7 million plan selections were made through the Health Insurance Marketplaces. This is an increase from the 11.7 million plan selections last year. Of these 12.7 million consumers, over 9.6 million came through the HealthCare.gov platform and 3.1 million consumers selected a plan through State-based Marketplaces. Of the 9.6 million consumers who got coverage through the HealthCare.gov platform, about 4.0 million were new consumers, meaning that about 42 percent of all plan selections through the federal Marketplace were from new consumers. About 3.9 million of the 9.6 million were returning Marketplace consumers who actively selected a plan, and about 1.7 million were automatically enrolled by the Marketplace. Click here for more details and state information. As reported in this article from The Hill, the Centers for Disease Control and Prevention last year found that 16.3 million people had gained coverage due to the Affordable Care Act (ACA) since 2013, through both state Medicaid expansions and the purchase of private insurance coverage through the federal and state Marketplaces. The country's uninsured rate has fallen to a record low of 9 percent since the passage of the ACA. Nevertheless, there remain about 30 million uninsured individuals. DoD Health Insurance Form for 2015 Federal Taxes The Defense Department (DoD) has announced that civilian and military personnel will begin receiving Internal Revenue Service Form 1095 to help them complete health coverage questions on their 2015 federal tax returns. The form already is available via MyPay for those who receive their tax forms electronically. The 1095 form attests to the IRS that the DoD employee has received “minimum essential coverage” for purposes of the requirement that individuals have insurance coverage or pay a penalty with their taxes. For more detailed information on how to get this important form, click here. The DoD announcement notes that service members who plan to separate from the military in the next year – but not retire – will be responsible for obtaining alternative coverage, particularly if their new employer does not offer health care insurance. See “If you Lose TRICARE Coverage.” [Sign up for TRICARE e-mail updates at www.tricare.mil/subscriptions.] Family Voices, Inc. Mailing Address: P.O. Box 37188, Albuquerque, NM 87176 Physical Address: 3701 San Mateo Blvd NE, Suite 103, Albuquerque, NM 87110 Phone: 505-872-4774 Toll Free: 888-835-5669 Fax: 505-872-4780 Website: www.familyvoices.org 4 National Council on Disability Report on ACA Monitoring and Enforcement On February 2, the National Council on Disability (NCD) announced the release of the last in a series of three reports on the Affordable Care Act (ACA) and people with disabilities. The new report, “Monitoring and Enforcing the Affordable Care Act for People with Disabilities,” examines key legal safeguards in ACA regulations that can help people with disabilities secure essential care and supports. The report also outlines legal duties; identifies the parties responsible for fulfilling those duties; and in some instances, explores potential avenues for redress where applicable. The first report in the series focused on ACA implementation; the second report focused on how ACA’s changes are affecting Americans with disabilities. WORTH REPEATING: IRS Alert about Insurance Penalty Tax Scam Through a consumer alert issued last week, the Internal Revenue Service (IRS) is warning consumers about tax scams in which tax preparers are telling consumers to pay penalties for not having health insurance to the preparer, who then keeps the money. Most people do not owe such a penalty, but if they might, the IRS reminds them to pay it directly to the IRS with their tax return or in response to a letter from the agency, never to an individual or tax preparer. ACA RESOURCES Updated Poverty Levels – Effect on Eligibility for Medicaid and ACA Subsidies As reported in last week’s Update, the Department of Health and Human Services issued its annual update of the HHS Poverty Guidelines, on January 27. A recent blog post from the Georgetown Center on Children and Families discusses the impact of the new poverty levels on eligibility for Medicaid and ACA subsidies. ACA Resources from the Center for Budget and Policy Priorities Here are some new ACA resources from the Center for Budget and Policy Priorities (CBPP): Determining Household Size for Medicaid and CHIP Determining Household Size for Premium Tax Credits Tax Preparer's Guide to the ACA (Download PDF) Income Definitions for Marketplace and Medicaid Coverage Key Facts and Webinar on Immigrant Eligibility for Coverage Programs View key facts / View webinar Webinar: Preventing and Resolving Data-Matching Issues in the FFM Download the slide deck PDF / View webinar To view video recordings of past Health Reform: Beyond the Basics webinars and to access additional resources, please visit Health Reform: Beyond the Basics. For information and registration details on upcoming webinars, please visit our Upcoming Webinars page. Worth Repeating: Getting Ready for Tax Season Many people are now preparing their tax returns and may be confused about how to reconcile or claim their premium tax credits. This page from HealthCare.gov will help consumers figure out how do so. Also check out a new blog post (in English or Spanish) from Marketplace CEO Kevin Counihan, which addresses what people with different health coverage situations need to know as they prepare for the tax season. Click here to view the IRS Q&A that offers more about new tax forms related to the health care law, including when consumers will receive these forms, how they should use them, and who will provide them. Family Voices, Inc. Mailing Address: P.O. Box 37188, Albuquerque, NM 87176 Physical Address: 3701 San Mateo Blvd NE, Suite 103, Albuquerque, NM 87110 Phone: 505-872-4774 Toll Free: 888-835-5669 Fax: 505-872-4780 Website: www.familyvoices.org 5 More detail. Consumers who received advanced premium tax credits (APTCs), will get a Form 1095-A from the Marketplace. (CMS recently updated its translation of the Spanish Form 1095-A and instructions for using the form.) Consumers must use this form to complete Form 8962 when they file their taxes. These forms allow consumers to reconcile the total APTC they received during 2015 with the amount of premium tax credit (PTC) for which they are eligible based on their final 2015 income and household information. Consumers expecting to receive a Form 1095-A should wait to file their 2015 income tax return until they receive that form. This page will help consumers figure out the premium tax credit they were entitled to, which is based on the second-lowest-cost Silver plan available to them. That page will also help them figure out whether they qualify for an affordability exemption from the requirement to have health coverage. In order to determine eligibility for an exemption, they will need to complete IRS Form 8965, which requires finding out the premiums for both: the lowest cost Bronze plan available to their family the second lowest cost Silver plan available to their family This year, some consumers who have health coverage through the Marketplace will also receive a Form 1095-B or 1095-C, if they or members of their household had coverage in 2015 through other programs or plans outside of the Marketplace. It is not necessary to wait for Forms 1095-B or 1095-C in order to file their taxes. Individuals who have questions about a Form 1095-B or 1095-C should contact the entity that provided them with the form. Tax-Related Resources for Assisters A December 18, 2015, assister webinar included a presentation on Form 1095-A and how assisters can help consumers during the 2016 tax season. Click here to view the slides from webinar. These slides and other resources on helping consumers during the tax season are available on the tax information page of Marketplace.CMS.gov. See also the “Affordable Care Act Tax Provisions” section of the IRS website. [Note: Assisters may not provide assistance with filing taxes, unless they are licensed tax preparers.] Penalties for Lack of Insurance. See this Q&A from Kaiser Health News about penalty amounts, what qualifies as coverage, exemptions from coverage requirement, and related questions. Worth Repeating: Little Known Provision Keeps Kids from Slipping Through Cracks Due to Differences in Eligibility Rules For the most part, the Affordable Care Act aligns the way that Medicaid determines eligibility based on the same Modified Adjusted Gross Income (MAGI) rules used to determine eligibility for financial assistance in the Marketplace. But, there are exceptions in Medicaid, as outlined in this 2015 blog post. The differences can mean that an individual is denied both Medicaid and premium tax credits to purchase a qualified health plan in the Marketplace. But, as explained in this new blog post from the Georgetown Center on Children and Families, an obscure rule keeps children from slipping through the cracks. OTHER NEWS AND INFORMATION “Get Protected” Social Security Email Scam The Social Security Administration (SSA) and the Federal Trade Commission (FTC) are alerting the public about an email scam that may have in the subject line "Get Protected.” This email appears to be from the SSA and discusses new features that claim to monitor unauthorized use of one's Social Security number. It even cites the IRS and the official-sounding “S.A.F.E. Act 2015.” Yet it is entirely bogus. SSA advises consumers not to open to the link or any of the attachments. If you should receive this email, report it to [email protected]. For more information on protecting yourself from fraud, and how to verify the authenticity of anyone claiming to be from Family Voices, Inc. Mailing Address: P.O. Box 37188, Albuquerque, NM 87176 Physical Address: 3701 San Mateo Blvd NE, Suite 103, Albuquerque, NM 87110 Phone: 505-872-4774 Toll Free: 888-835-5669 Fax: 505-872-4780 Website: www.familyvoices.org 6 the SSA, see this SSA webpage and this SSA webpage about online “phishing” and another Social Security scam. Additional information about protecting yourself from online fraud can be found on this webpage of the FTC website. FDA Pediatric Advisory Committee to Recommend Labeling for Pediatric Opioid Use On February 4, the Food and Drug Administration (FDA) announced a plan to address the problem of opioid abuse. Under the plan, the FDA will convene a meeting of its standing Pediatric Advisory Committee to make recommendations regarding a framework for pediatric opioid labeling and use of opioid pain medications in the pediatric population. (Last year, the FDA approved labeling for OxyContin to include children ages 11-16.) The Pediatric Advisory Committee will make recommendations regarding a framework for pediatric opioid labeling before any new labeling is approved for these drugs. In its press release, the FDA noted that drug overdose deaths, driven largely by overdose from prescription opioids and illicit drugs like heroin and illegally-made fentanyl, are now the leading cause of injury death in the United States – surpassing motor vehicle crashes. See also this FDA Fact Sheet. Technical Assistance Available for States on Home and Community-Based Services Advocates might find it useful to know that the Centers for Medicare and Medicaid Services (CMS) is offering free technical assistance and training to any state agency that is developing or improving home and communitybased services (HCBS) under Sections 1915(c) waivers or Sections 1915(i), 1915(j), or 1915(k) State Plan Amendments. Click here to view more details. OTHER RESOURCES Newly Redesigned Child Health Data Website The Child and Adolescent Health Measurement Initiative (CAHMI) has partnered with Title V and family leaders to create an updated look and feel for the Data Resource Center website (http://childhealthdata.org). In addition to a more modern look, the new website is designed to make it even easier to access resources, including: The interactive data query Prepared and customizable data snapshots at the National, State, and Regional levels Special topics portals on topics such as Medical Home, Healthy People 2020, and Systems Improvement Extensive examples of data in action, showcasing the use of child health data in peer-reviewed publications, presentations, and data briefs and reports And…Spanish Translation of Well Visit Planner Toolkit This past spring, CAHMI partnered with Family Voices to create a toolkit to assist families and family advocates in the use of the Well Visit Planner. Spanish translations of most of the documents, including the newsletter, FAQs, flyer, and some of the videos are now available. Respite Care To locate respite care services in your area, see the National Respite Locator from the ARCH National Respite Network and Resource Center. The Lifespan Respite Grantee/Partner Tools Page is frequently updated with products and materials developed by Lifespan Respite grantees and their partners. See also the Lifespan Respite Discussion Forum. If you are operating a respite program, this guide provides detailed information about each of the federal programs that provides or could provide respite funding or support. Finding Medications and Supplies During/After a Disaster Family Voices, Inc. Mailing Address: P.O. Box 37188, Albuquerque, NM 87176 Physical Address: 3701 San Mateo Blvd NE, Suite 103, Albuquerque, NM 87110 Phone: 505-872-4774 Toll Free: 888-835-5669 Fax: 505-872-4780 Website: www.familyvoices.org 7 Healthcare Ready (formerly Rx Response) was established in the aftermath of Hurricane Katrina by the trade associations comprising the bio-pharmaceutical supply chain and the American Red Cross. It serves as a central point of contact to strengthen healthcare supply chains during times of crisis. When a disaster occurs, Healthcare Ready also activates Rx Open maps to help the public and emergency responders see where pharmacies are open and closed in the affected area. Healthcare Ready also works with local, state and federal government agencies and industry partners to develop working relationships in preparation for disasters, including major natural disasters, pandemics or acts of terrorism. Education and Health As reported in last week’s Update, the US Departments of Education and Health and Human Services launched the Healthy Students, Promising Futures initiatives by sending a letter to governors, Chief State School Officers, state health officials, and state Medicaid directors, and issuing a toolkit to suggest practical steps for better connecting health and education services. For additional information about this initiative, see the National Collaborative on Education and Health, which is co-convened by the Healthy Schools Campaign and the Trust for America’s Health. OF POSSIBLE INTEREST Worth Repeating: Information Sought on Air Travel Experiences Paralyzed Veterans of America (PVA) is working with the broader disability community to bring attention to the successes and failures in air travel for passengers with disabilities and is interested in hearing stories about air travel experiences. Stories can be submitted at the PVA “AirAccess30” website or via social media at #ACAA30. Stories will be used to highlight progress and increase advocacy around the Air Carriers Access Act to improve air travel for all people with disabilities. To learn more, please click here. Family Caregiving [From the ARCH Quick News Update, February 2016] The entire Winter 2015-16 issue of the American Society on Aging's journal, Generations, is devoted to the topic of family caregiving. The journal was co-edited by Kathy Kelly, M.P.H., Executive Director of the Family Caregiver Alliance and Jennifer Wolff, Ph.D., Johns Hopkins Bloomberg School of Public Health. Read the co-editors introductory article, Family Caregiving is Finally Gaining Public and Policy Notice. See Generations, Winter 201516 Table of Contents. Articles are free for American Society on Aging members. We would love to hear any suggestions you might have about how to make the Update more useful to you. Does it provide the right amount of information? What parts are helpful and not so helpful? Please let us know! And, as always, please feel free to contact us with any questions. Comments and questions can be directed to [email protected]. Yours truly, The Family Voices Policy Team This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U40MC00149. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. Family Voices, Inc. Mailing Address: P.O. Box 37188, Albuquerque, NM 87176 Physical Address: 3701 San Mateo Blvd NE, Suite 103, Albuquerque, NM 87110 Phone: 505-872-4774 Toll Free: 888-835-5669 Fax: 505-872-4780 Website: www.familyvoices.org 8
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