April 10, 2014

April 9 Washington DC Update

April 9 Washington DC Update

Washington DC Update 4/9/14

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

Greetings from Washington!  Administration officials are breathing a sigh of relief, and probably “high-fiving” each other, about the final numbers of people who enrolled in health insurance through the Exchanges – about 7.1 million – and an increase in those enrolling in Medicaid and CHIP. Now we’ll see how it all works out….


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. Registration is required. Register here. You will receive webinar link and call-in details after you register.

Engaging Patients to Improve Health and Health Care  Tuesday, April 15, 2:30-3:30 ET.  The Robert Wood Johnson Foundation is sponsoring this webinar to explore lessons and insights about how hospitals, primary care providers, and patients are working together to improve care and empower patients. The webinar includes case studies outlining how one organization developed a framework to more actively engage patients across all levels of the delivery spectrum, and how another program embedded “patient partners” in primary care practices to assist in quality improvement efforts.  Register here.

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 this webinar to provide information to assist family caregivers in developing both a personal preparedness plan and a plan for individuals they support. Presenters will discuss preparedness for caretakers of children with special health care needs, and elderly individuals who are medically fragile or have dementia. For more information see http://www.phe.gov/Preparedness/planning/abc/Pages/caregiver-webinar.aspx. [Hit cancel if asked for username.]  Note that Peg Kinsell, of the NJ Statewide Parents Advocacy Network – a Family Voices SAO and the state’s F2F - will be one of the presenters.

Hear the presentation by phone and see the slides on-line:

Toll Free Number: 888-325-0345

Participant passcode: 813-1392 (required)

Restrictions may exist when accessing freephone/toll free numbers using a mobile telephone. 

Live Meeting™ Net Conference Access Information for Participants

URL: https://www.mymeetings.com/nc/join/

Conference number: PW4462938

Audience passcode: 8131392

Participants can join the event directly at: https://www.mymeetings.com/nc/join.php?i=PW4462938&p=8131392&t=c

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.  

State Innovations: Updates from the Minnesota Health Care Home Initiative. Thursday, April 17, 11:00-12:00 ET. The National Academy of State Health Policy is sponsoring this webinar on Minnesota's Health Care Home (HCH) initiative, which includes 322 certified Health Care Homes, and has lowered costs for Medicaid enrollees by more than 9% since the program began in 2010. This webinar will provide an overview of Minnesota's Health Care Home initiative, a review of key findings of the 2014 HCH Evaluation Report to the Minnesota State Legislature. Register here.

Autism Spectrum Disorder: From Numbers to Know-How. Tuesday, April 22, 1:00-2:00 ET. The CDC has announced its first-ever Public Health Grand Rounds on autism spectrum disorder, featuring presentations on autism etiology, surveillance, early identification and screening, and evidence-based intervention. CDC asks that this information be shared widely. You can receive free training and continuing education opportunities/contact hours for watching Grand Rounds. Visit http://www.cdc.gov/about/grand-rounds/index.htm to register.

There are two ways to attend:

  1. A live webcast will be available. Visit http://www.cdc.gov/about/grand-rounds/ to watch the event. OR
  2. Attend in person at in Atlanta. This requires having prior security clearance and a U.S. state-issued photo ID. Please send your request to attend in person to the CDC Grand Rounds Team. (International visitors are required to submit a copy of passport and U.S. state-issued photo ID 10 days prior to the session for clearance.)

Starting and Supporting Family Advisory Groups. Thursday, April 24, 12:00-1:00 ET. Hosted by the National Center for Medical Home Implementation and the American Academy of Pediatrics, this webinar will define the term “family advisory group” and explain its potential effectiveness as part of a family-centered medical home approach to providing care. Additionally, it will describe strategies for implementation and provide examples of family advisory groups within actual pediatric practices. Register here. This webinar is part of a series Fostering Partnership and Teamwork in the Pediatric Medical Home (past webinars available on this website).

Medical Home Implementation and Innovation at the State Level. Thursday, April 24, 1:00-2:00 ET. The National Academy of State Health Policy will present a webinar on the innovative medical-home efforts in Vermont and Philadelphia, and their impact on cost and quality outcomes. Register here.

Navigating Insurance Issues. April 30, 1:00 pm ET. This webinar will focus on how health insurance coverage for patients with rare diseases has undergone significant changes in recent years, including changes arising from the Affordable Care Act. Different types of health insurance and emerging trends in benefit design and affordability for individuals will be discussed, along with ways to determine how to evaluate plans to meet needs of rare disease patients or caregivers. Register here.


Other Child Health Programs Funded in “Doc Fix” Law (in addition to F2Fs)

As reported in last week’s Washington DC Update, the Protecting Access to Medicare Act of 2014 (a.k.a. the “doc fix” or “SGR” bill), was approved by the Senate on March 31. This legislation, subsequently signed by the president (and now Public Law 113-93), includes a provision to extend F2F funding for another year, providing $2.5 million for the remainder of FY 2014 plus $2.5 million for the first six months of FY 2015.

This law also included several other Medicaid, CHIP, and other provisions important to children’s health and well-being, including an extension of “Express-Lane Eligibility” for enrollment in Medicaid and CHIP; additional funding for pediatric quality centers of excellence (seven research centers focused on developing and refining quality measures for children’s and pregnant women’s care); and an extension of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program at full funding until March 31, 2015. This program facilitates evidence-based, voluntary, community-run home visiting programs for vulnerable children and families in 50 states, six territories, and numerous tribes and tribal organizations. See this article from First Focus for more details about these programs.

Graduate Medical Education Funding for Children’s Hospitals (CHGME)

On April 1, 2014, the House passed the Children's Hospitals GME Support Act of 2013 by a voice vote. The bill reauthorizes CHGME through 2018. Since it had been passed by the Senate in November 2013, the bill was then ready to send to the president for his signature. The CHGME program provides federal support for the training of pediatricians and pediatric specialists at independent children’s teaching hospitals across the country.

Children’s Health Research

On April 3, the President signed the Gabriella Miller Kids First Research Act (Public Law 113-94), which had been passed by the House in December and by the Senate in March. The law transfers public funds allocated for political conventions to a 10-Year Pediatric Research Initiative Fund, making $12.6 million per year available for National Institutes of Health grants for research into pediatric cancer and other pediatric diseases and disorders. See this Washington Post article about Gabriella Miller, who died in October at the age of 10. She became a well-known advocate for pediatric cancer research after she developed a brain tumor about a year before her death.

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

ACA Enrollment Success

According to an April 4 blog post from Secretary of Health and Human Services Kathleen Seblius, 7.1 million people signed up for private health insurance plans created under the ACA, as of March 31. In addition, the Centers for Medicare and Medicaid Services (CMS) has reported that enrollment in Medicaid and the Children's Health Insurance Program (CHIP) rose by more than 3 million people from the average enrollment level between the beginning of open enrollment for “Obamacare” on October 1, 2013, and the end of February 2014. Enrollment in states that adopted the Medicaid coverage expansion increased five-fold compared to states that did not expand Medicaid. See this article from the Commonwealth Fund for more detailed information.

Enrollment Grace Periods and Special Exceptions

Although the open-enrollment period for “ObamaCare” ended on March 31, the administration is allowing consumers who were “in line” on HealthCare.gov by March 31 to complete enrollment late. 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 below for resources on these exceptions, including new resources made available this week.

Some states running their own exchanges are also providing grace periods for people who were unable to enroll before the March 31 deadline. Some, like the federal Exchange, have not set a specific deadline for those who need extra time, and/or are not requiring proof of an earlier attempt to enroll. Some others have set a deadline of April 15, and/or require evidence of an attempt to enroll by March 31. See https://www.healthcare.gov/marketplace/b/welcome/.


Funding Opportunity for a Cooperative Agreement -- The Affordable Care Act and What It Means for People with Disabilities

The National Council on Disability (NCD) is an independent federal agency charged with advising the President, Congress, and other federal agencies regarding policies, programs, practices, and procedures that affect people with disabilities. The NCD recently announced a funding opportunity – a cooperative agreement to study the Affordable Care Act and what it means for people with disabilities. The proposal is due on April 29, 2014, by 5:00 PM ET.

The purpose of this project – for which $135,000 is available over a period of 12 months -- is to assess the current status of implementation of ACA provisions impacting people with disabilities. The NDC notes that many aspects of ACA implementation have yet to be determined, such as the definition of Essential Health Benefits; enforcement of non-discrimination requirements in benefit design; minimum "habilitative services" requirements for health plans; how Qualified Health Plans on the exchanges may be allowed to interact with or complement Medicaid; states’ decisions about whether to expand Medicaid; and the impact of implementing the new Community First Choice state option. See the Funding Opportunity Announcement at http://www.ncd.gov/newsroom/research/04012014.


New ACA Blog from the National Center for Family/Professional Partnerships!

Check out the latest ACA blog post from the National Center for Family/Professional Partnerships, about what families should do if they experience changes in their family structure, income, or other circumstances that might necessitate changes in their insurance coverage (such as the birth of a child, change in employer coverage), change their eligibility for or amount of ACA subsidies, and/or affect family members’ eligibility for Medicaid or CHIP.

HHS and Treasury Department Information about Extended-Enrollment Circumstances (See above explanation in the ACA News section.)

See https://www.healthcare.gov/marketplace/b/welcome/, for information on enrollment grace periods and special exceptions.

CMS also updated the following links on healthcare.gov:

 “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.

Health Insurance for Immigrant Families: ACA Review and Update 2014

On February 20, 2014, the  Center for Children and Families at Georgetown University and the National Immigration Law Center co-presented a webinar that provided an overview of eligibility for Medicaid and the Children's Health Insurance Program (CHIP), Marketplace coverage, barriers to enrollment, and strategies for overcoming those barriers for immigrant families. Download the webinar slides.

Request for Information. What's your state doing to promote health insurance equity for low-income and immigrant children with special health care needs? Please share innovative strategies your state is using to promote health insurance equity. E-mail Kasey Wilson, Catalyst Center Research Assistant, at wilsonka@bu.edu or call 617-638-1925.

National Disability Navigator Resource Collaborative Resources

The National Disability Navigator Resource Collaborative (NDNRC) Guide to Disability for Healthcare Insurance Marketplace Navigators  provides information to help those assisting people with disabilities to select the most appropriate health plan and navigate the new health insurance landscape. Additionally, the NDNRC has ten Fact Sheets and two draft Fact Sheets that address a variety of topics in greater detail. The following Fact Sheets are available here.

  1. Comparing Health Plan’s Benefits and Coverage Summaries 
  2. Getting and Using Health Plan Evidence of Coverage 
  3. Using Health Plan Customer Service 
  4. Rehabilitation and Habilitation Services and Devices 
  5. Prescription Medication Benefits 
  6. Supporting Collaborations between Navigators, Connectors and Assisters, and Local Disability and Affinity Organizations 
  7. Mental Health and Substance Abuse Parity
  8. Medically Frail Status as an Exemption to Receiving Medicaid Alternative Benefit Plan with Essential Health Benefits 
  9. Streamlined Marketplace Application Process 
  10. Medical Supplies Benefits

In addition, two fact sheets are still in draft form:

  1. Civil Rights of People with Disabilities under the Americans with Disabilities Act and Section 504 and Section 508 of the Rehabilitation Act 
  2. Process for Medicaid eligibility

More fact sheets are expected to be released in the near future. The entire list of fact sheets (along with upcoming fact sheets) is also available here.


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.

Mental Health Parity

The Mental Health Parity Act issue brief, from the National Health Law Program, explains how the 2008 law interacts with the Affordable Care Act, CHIP, and Medicaid.