April 27, 2012

April 27 Washington Update

Greetings from Washington.  It was great to have all the F2Fs here in our nation's capital, and especially to have them visiting their Members of Congress to explain how well federal grant dollars are being spent by F2Fs to serve CYSHCN and their families. 

There are several things to report this week about goings-on in Congress and the Administration.

F2F funding bills

As always, we open with an update on the legislation introduced in February by Senator Robert Menendez (D-NJ) and Representative Frank Pallone (D-NJ) to extend funding for F2FS beyond the current fiscal year (S. 2123/H.R. 4083).  There have been no new cosponsors this week, but we expect that some will join the bill soon, now that they have been further educated by grantees about the value of F2Fs to children and families. 

If you visited the Hill, please remember to follow up with the staffers with whom you met to thank them for the meeting and to send them any additional information that might enhance their understanding of your work, such as other family stories and/or a video like those shown at the end of the grantee meeting.  If you gave them hard copies of state data, etc., you may want to send them electronic copies.  Please copy or blind copy Brooke and me when you correspond with the Hill staffers. 

As always, we remind you to thank your Senator(s) and Representative have cosponsored the legislation, if you haven't already. You can find their contact information by clicking on their names on the list of cosponsors at the end of this update.

If your Members of Congress have not yet cosponsored the legislation, please contact them to ask that they do so.  See guidance at the end of this update or click here now to send a pre-drafted letter to your Representative.  Attached to this update are some materials about the bill you can send to congressional staffers.

Prevention and Public Health Fund.  The Affordable Care Act (ACA) included significant funding for a broad range of public health activities.  This pot of money has been threatened by a bill passed by the House today.  The bill would take money from the prevention/public health fund to pay for the cost of reducing the interest rates of student loans.  The Senate, where Senator Tom Harkin (D-IA) is a staunch supporter of the fund -- is expected to take up the bill in the coming weeks, without that "pay-for."  The administration has threatened to veto the student loan legislation if it would reduce the prevention/public health fund.

Regulations on community-based care.   Historically, states had to get a federal waiver to provide home and community-based services within the Medicaid program.  The ACA included a provision, the Community First Choice state plan option, that would allow states to provide these services as a Medicaid state option instead, which means they would not need to show that the services would be "budget neutral." States electing this option would receive an enhanced federal match.  The services would be available to individuals who would otherwise need an institutional level of care.  The law directs that they be provided only in a "home or community" setting. 

This week, the administration issued a final rule to implement this provision of the ACA. The final rule issued this week does not, however, finalize language regarding the definition for
"home or community-based setting."   Instead, the Department of Health and Human Services (HHS) decided to seek additional comment on that issue, and issued another proposed rule to do so.  That proposed rule also addresses the Home and Community-Based Services State plan benefit, otherwise known as the "1915(i)" benefit, which permits States to offer home and community-based services without the use of a waiver, and does not require that an individual meet an institutional level of care in order to receive these services.  States would be permitted to design targeted benefits to meet the needs of individuals with specific conditions.

A bulletin on the final and proposed rules can be found at http://content.govdelivery.com/attachments/USCMS/2012/04/26/file_attachments/109408/CIB-04-26-12.pdf.

Waiver transparency.  Today the Centers for Medicare and Medicaid Services (CMS) finalized rules that will allow for greater public oversight of state waiver proposals.  A summary of the rules was prepared by the Kaiser Family Foundation and Georgetown Center for Children and Families.  CMS also unveiled a new website that provides a comprehensive list of all waivers by state.  The Department will be holding a conference call on the regulation and website on Thursday, May 3, 3:30 PM - 4:30 PM (Eastern).  Call in Information:  Participants: (800) 603-1774; Confirmation Number: 76839817.

Cost of insurance under the ACA.  As you know, the ACA would require most Americans to purchase health insurance as of 2014 or pay a fine, under the so-called "individual mandate."  Plans will be available at different cost-sharing levels.  Under the minimum coverage plan, the "Bronze" plan, the insurance plan will pay for 60 percent of health care costs on average while the individual enrolled will pay the remaining 40 percent in deductibles, copays and coinsurance.   A new study by the Kaiser Family Foundation predicts what the out-of-pocket costs would be under the Bronze and Silver plans, finding that the Bronze plan would provide coverage mainly for catastrophic for medical expenses.  The 5-page report also provides a good explanation of how the different cost-sharing options would work.


As always, please feel free to contact us with any questions. 

Brooke Lehmann, MSW, Esq.

Janis Guerney, Esq.

NOTE:  Past issues of the Washington update can be found on the Family Voices home page by scrolling down in the "News Feed" section.

Cosponsors of House F2F funding bill, H.R. 4083, sponsored by Rep. Frank Pallone (D-NJ):

Rep Langevin, James R. [RI-2] - 2/17/2012
Rep Norton, Eleanor Holmes [DC] - 2/17/2012
Rep Pingree, Chellie [ME-1] - 2/17/2012
Rep Cicilline, David N. [RI-1] - 2/17/2012
Rep Michaud, Michael H. [ME-2] - 2/17/2012
Rep Engel, Eliot L. [NY-17] - 2/17/2012
Rep Green, Gene [TX-29] - 3/5/2012
Rep Rangel, Charles B. [NY-15] - 3/8/2012
Rep Roybal-Allard, Lucille [CA-34] - 3/20/2012

Cosponsors of Senate F2F funding bill, S. 2123, sponsored by Senator Robert Menendez:

Sen Bingaman, Jeff [NM] - 2/17/2012
Sen Conrad, Kent [ND] - 2/17/2012
Sen Snowe, Olympia J. [ME] - 2/17/2012
Sen Whitehouse, Sheldon [RI] - 2/17/2012
Sen Lautenberg, Frank R. [NJ] - 2/17/2012
Sen Kerry, John F. [MA] - 3/13/2012

Contacting your Members of Congress about F2F funding bills

All of you who are concerned about the future of F2Fs should contact your Members of Congress to urge that they cosponsor the Menendez or Pallone bill. You can call them through the Capitol switchboard at 202-224-3121.  (To find the names of your Members of Congress, go to http://www.congressmerge.com/onlinedb/index.htm.)  When you speak to the receptionist, state that you are a constituent and ask to speak to the staff person who handles health issues.  If that person is not available to talk, you can leave a BRIEF message identifying yourself as a constituent who has a child with special health care needs (if applicable) and asking that the Representative/Senator cosponsor a bill that would extend funding for Family-to-Family Health Information Centers.  Refer to the appropriate bill number and sponsor - in the Senate, S. 2123, sponsored by Senator Menendez; in the House, H.R. 4083, sponsored by Rep. Pallone.  Leave your phone number and email address. (Remember to use your personal contact information, not that of your F2F.)

You can also write to your Representative (even if you call) via the "Advocacy" section of the Family Voices website, where you will find a pre-written letter that you fill in with your personal information.  (You do not need to know the name of your Representative.)  Please ask families you have worked with, friends, and relatives to write their Representatives through the Family Voices website also.  The URL is http://www.familyvoices.org/action/advocate.   At this time, the website is not configured to automatically send the letter to Senators, but simple instructions about how to contact your Senators, and text to copy and paste, can also be found on that page.  (You do not need to know the names of your Senators.)

Remember:  Federal resources may not be used for lobbying activities.

Please feel free to call Brooke or Janis (contact information above) if you have any questions.