April 02, 2014

April 2 Washington DC Update

Washington DC Update 4/1/14

{Don’t forget to check out the Family Voices/NCFPP ACA webpage!}

Greetings from Washington!  Happy day after April Fools Day!  This is no joke, though:  On Monday two eventful things occurred – the ACA’s open enrollment period ended, and Congress provided another $5 million in funding for Family-to-Family Health Information Centers (F2Fs)! Read more below.


Strategies for Building Cultural Competence. Wednesday, April 2, 1:00 - 2:30 ET. The Institute for Diversity in Health Management will conduct this interactive webinar to present practical proven strategies for developing action plans that will help organizations evaluate their existing cultural competence programs. Register here

Qualified Health Plan Selection: The Keys to Choosing the Right Option. Wednesday, April 2, 2:00-3:00 ET. This is the last in a series offered by health care consulting firm Manatt Health Solutions. Register here.

E3Enrolling Eligible Children & Teens in Medicaid and CHIP Year Round. Thursday, April 3, 2:00-3:15 ET. The Connecting Kids to Coverage National Campaign is hosting this webinar to raise awareness that individuals who are eligible for Medicaid and CHIP can enroll at any time. This webinar is also an opportunity to learn about the Connecting Kids to Coverage spring outreach campaign, and new enrollment messages. Register here.

Integrating Behavioral Health Competency within Disability-Competent Care Teams and Individualized Plans of Care. Tuesday, April 8, 2:00-3:00 ET. The CMS Medicare-Medicaid Coordination Office is conducting one more webinar in the Disability-Competent Care Webinar Roundtable Series. This webinar will help participants understand the prevalence and importance of addressing participant behavioral health needs and discuss strategies to facilitate timely communication and collaboration between behavioral health providers and disability-competent care teams. Though open to all, the target audience of this webinar is individuals who work with persons with disabilities, particularly behavioral health providers. Registration is required to participate. Click here to register.

Achieving Bright Futures A New Resource from the AAP/Bright Futures. Wednesday, April 9, 1:00-2:00 ET/12:00 - 1:00 PM Central Time. This American Academy of Pediatrics (AAP)/Bright Futures webinar will discuss the new publication, Achieving Bright Futures, to help AAP chapters, pediatric councils, and pediatricians obtain coverage of—and payment for—all Bright Futures screenings, assessments, and services. It should also assist AAP state chapters and other stakeholders in advocating for payment for all of the services provided in the Bright Futures periodicity schedule. Space is limited. Register here.

Health Disparities and Prevention. Wednesday, April 9, 2:00 to 3:00 ET. The Centers for Medicare and Medicaid Services, Office of Minority Health will hold a webinar in honor of Minority Health Month. Speakers will discuss CMS’ ongoing efforts to reduce and eliminate health disparities, and its work encouraging newly insured consumers to use preventive services and primary care. To register visit: http://cmsomhwebinar492014.eventbrite.com. Registration is required. You will receive webinar link and call in details after you register.

Disaster Preparedness Planning for Family Caregivers. Wednesday, April 16, 2:00-3:30 ET. The HHS/Office of the Assistant Secretary for Preparedness and Response and the Administration for Community Living will offer a Caregiver Webinar. Register here

Inclusive Health Promotion Strategies. Wednesday, April 16, 2:00-3:00 ET. This webinar, sponsored by The Arc, will provide attendees with updates on health promotion and health education efforts that are inclusive of people with intellectual and developmental disabilities from the perspective of three different University Centers of Excellence in Developmental Disabilities. Attendees will learn about current health promotion resources, strategies for influencing medical school curricula, and the new HealthMeet resource, Understanding Health and Health Promotion for People with ID (www.iddhealthtraining.org). Register here!  

Starting and Supporting Family Advisory Groups. Thursday, April 24, 12:00-1:00 ET. Part of a series – Fostering Partnership and Teamwork in the Pediatric Medical Home - hosted   by the National Center for Medical Home Implementation and the American Academy of Pediatrics. Register here.


F2F Funding Extended!

On Monday evening, the Senate approved H.R. 4302, the Protecting Access to Medicare Act of 2014 (a.k.a. the “doc fix” or “SGR” bill), which had already passed the House. The bill includes a provision to extend F2F funding for another year from now, providing $2.5 million for the remainder of FY 2014 plus $2.5 million for the first six months of FY 2015. Pursuant to a unanimous consent agreement, the bill required 60 votes for passage. The final vote was 64 in favor and 35 opposed. (See how your Senators voted here.) The president signed the bill on Tuesday.

This funding is enough to provide F2F grants through the first half of the grant cycle that begins on June 1, 2015, i.e., through November 2015. The Maternal and Child Health Bureau will determine when and how these grant funds will be distributed.

To get this funding in the budget-cutting environment of Washington at this time indicates that the program’s champions – Senator Robert Menendez (D-NJ) and Rep. Frank Pallone (D-NJ), with the support of House Energy and Commerce Committee Ranking Member Henry Waxman (D-CA) – really went to bat for F2Fs, and were able to persuade the leadership of the key committees – Senate Finance Committee Chairman Ron Wyden (D-OR), House Energy and Commerce (E & C) Committee Chairman Fred Upton (R-MI), and E & C Health Subcommittee Chairman Joe Pitts (R-PA) – of the program’s importance.

The F2F provision was included in legislation that will maintain the current Medicare physician payment method and levels for another year. A permanent change in the payment formula had been developed and agreed to on a bipartisan basis by the House and Senate, and was supported by physician groups. But there was no agreement on how to pay for the change. The Senate version of that permanent SGR fix, written by Senate Finance Committee Chairman Ron Wyden (D-OR), included a provision to provide F2F funding for another five years (through FY 2018), at $6 million per year, and to allow grants to be given in US territories. At some point, legislation to make a permanent doc-fix might be taken up again, with or without the more generous F2F provision.

ACA NEWS and INFORMATION  [See below for ACA resources.] 

Enrollment period ended. Four years, one week, and one day after enactment of the Affordable Care Act (ACA), the first year’s open-enrollment period closed on Monday. How many people signed up for plans?   The administration reports that over 6 million people signed up for health insurance through the Exchanges (Marketplaces) since October 1. According to this article from the Los Angeles Times, at least 9.5 million previously uninsured people have gained coverage -- through the Marketplaces, private insurers, and Medicaid.

What happens if someone fails to have insurance coverage this year?  See this FAQ article from Kaiser Health News.

The next open-enrollment period, for coverage beginning in 2015, will run from November 15, 2014–February 15, 2015. See this article from Kaiser Health News and USA Today on how to assess the impact of the law so far, and what to expect next.

But, there is extra time to enroll in health plans for certain people. The Administration announced last week that consumers “in line” on HealthCare.gov by the March 31st deadline to complete enrollment, will be able to complete enrollment after March 31. In addition, people in certain other circumstances will be allowed extra time to enroll. These include consumers who were found ineligible for Medicaid, but whose accounts were not transferred to the Marketplace in a timely way before March 31. Extra time is also allowed for individuals who are victims of domestic abuse (See http://www.treasury.gov/press-center/press-releases/Pages/jl2334.aspx). See below for resources on these exceptions.


President’s Early Childhood Initiative. Last week, the administration announced the “Birth to 5: Watch Me Thrive!” initiative. The initiative is joint effort of the Department of Health and Human Services and the Department of Education, in collaboration with other federal partners, to encourage developmental and behavioral screening for children to support the families and providers who care for them. Birth to 5: Watch Me Thrive! resources include:

  • A list of research-based developmental screening tools appropriate for use across a wide range of settings;
  • Guides on how to use the screeners for a variety of audiences, from early learning teachers to doctors, social workers, and families;
  • Toolkits with resources and tip sheets;
  • Guidance on finding help at the local level; and
  • A screening passport that allows families to track a child's screening history and results.

New autism prevalence data from the CDC. New data from the Autism and Developmental Disabilities Monitoring (ADDM) Network of the National Center for Birth Defects and Developmental Disabilities (NCBDDD), Centers for Disease Control and Prevention (CDC), show that the estimated number of children identified with autism spectrum disorder (ASD) continues to rise, and the picture of ASD in communities has changed. Last week, CDC’s Morbidity and Mortality Weekly Report Surveillance Summaries released the findings in a report titled, “Prevalence of Autism Spectrum Disorder among Children Aged 8 Years – Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2010,” which found that one in 68 children were identified with autism spectrum disorder. Read the full report. Read 10 Things You Need To Know About New Autism Data.

Department of Labor guidance on live-in caretakers. On October 1, 2013, the Department of Labor (DOL) published a Final Rule extending minimum wage and overtime pay protections under the Fair Labor Standards Act (FLSA) to direct care workers providing home based care to older adults and people with disabilities. The DOL received many questions regarding how the rule would affect shared living arrangements such as adult foster care, host home, and paid roommates, where the person receiving services and their direct care worker live together. On March 27, 2014, DOL published an Administrator's Interpretation and fact sheet providing guidance on how FLSA applies to various shared living arrangements. Click here to access the Fact Sheet. Click here to access the Administrator's Interpretation.


HHS and Treasury Department information about extended-enrollment circumstances. (See above explanation.)

“Tip Sheets” for individuals and organizations who are helping people navigate the enrollment process:

HHS guidance for insurance issuers:

Treasury Department information on exception for victims of domestic abuse: http://www.treasury.gov/press-center/press-releases/Pages/jl2334.aspx.

Keeping coverage. Enroll America’s Best Practices Institute has developed this issue brief to  explain the steps consumers need to take to keep coverage, including Medicaid coverage, once they've got it, from reporting changes and qualifying for special enrollment periods to preparing to navigate the renewal process this fall.

Penalties for failing to have coverage. See this FAQ article from Kaiser Health News.

IRS Questions & Answers. The IRS recently updated their website with new public information about the tax provisions in the Affordable Care Act. You can visit the IRS webpage for more information.

Below is a listing of webpages that may be of particular interest:

  • Individual Shared Responsibility


  • Examples of how someone would calculate the payment based on their income


  • Exemptions


  • Minimum Essential Coverage


  • Updated Employer Shared Responsibility information


  • Master Q&A page


The National Disability Navigator Resource Collaborative published five new fact sheets. Remember that, although the open-enrollment period ended on March 31, there are some exceptions (see above), so some of these Marketplace-related resources are still relevant, as is the fact sheet regarding Medicaid Alternative Benefit Plans.

All five of these should be useful follow-ups to prior fact sheets which have addressed issues such as a health plans’ summary of benefits and coverage, rehabilitation and habilitation therapies and devices, and prescription medication benefits. The entire list of fact sheets (along with upcoming fact sheets) is also available here. The NDNRC has also published the “Guide to Disability for Healthcare Insurance Marketplace Navigators” which provides information on special considerations people with disabilities face as they shop for healthcare coverage and it can be found here.


Tools on HCBS Rules. The Centers for Medicare and Medicaid Services (CMS) recently issued new regulations regarding home and community-based services under the Medicaid program. CMS has developed a toolkit to help State Medicaid Agencies, Operating Agencies, and other stakeholders comply with these new requirements. The new regulations and toolkit are available here.  Additional information is available in this Informational Bulletin.

In addition, the National Health Law Program (NHeLP) has developed a Q&A on Home and Community Based Settings, which breaks down recent regulations regarding what types of settings qualify.

Young people and the disability movement. March was Disability Awareness Month, and the U.S. Department of Education celebrated by promoting respect for people with disabilities by increasing awareness of the daily obstacles faced by these individuals and their families. ED held a briefing (video is within the Blog) and OSERS Deputy Assistant Secretary wrote a blog focusing on creating opportunities for young people to learn about the disability movement. 

Check out the Blog and video at  http://www.ed.gov/blog/2014/03/celebrating-a-disability-rights-pioneer/.

To learn more about Ed Roberts and the civil rights movement of people with disabilities please see:

No Pity written by Joseph P. Shapiro

Ed Roberts, Father of Disability Rights written by Diana Pastora Carson


Financial Steps for Caregivers. The Women's Institute for a Secure Retirement has released a new publication entitled “Financial Steps for Caregivers.” This 26-page guide addresses an aspect of caregiving that is often overlooked: the caregiver's own financial security. Studies show that caregivers forgo more than $300,000 in lost wages and reduced Social Security and pension benefits. The publication offers tips on budgeting, saving for retirement, personal care agreements, identifying financial fraud and abuse, sources of financial help for the caregiver and the care recipient, end-of-life planning, and more. Click here to view the publication.

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


Yours truly,




Janis Guerney, Esq.


Brooke Lehmann, MSW, Esq.


Lynda Honberg


NOTE:  Past issues of the Update appears can be found on the home page of the Family Voices website  by scrolling down the "News Feed" items.