July 02, 2014

July 2 Washington DC Update

July 2 Washington DC Update

 Washington DC Update 7/2/14 

{Don’t forget to check out the Family Voices/NCFPP ACA webpage, and the latest blog post: Why Oral Health is Important for Children with Special Needs & How to Access It, at http://www.fv-ncfpp.org/blog/.}

[Please note that the first webinar listed below takes place today, Wednesday, at 4:00 pm ET.]

Greetings from Washington!  The big news this week comes from the Supreme Court, which announced Monday its rulings in cases that affect contraception coverage under the Affordable Care Act and whether health care providers paid by Medicaid are required to pay union dues.  In addition, the House of Representatives passed a bill to reauthorize federal autism efforts, and the FDA approved the first “exoskeleton” to aid paraplegics. Read more on these and other topics below, and find new resources for applicants for Navigator grants. 

EXTRA:  See Family Voices Director of Strategic Partnerships Lynda Honberg’s blog post about the Family Voices “One-in-Five” Campaign in the latest issue of the Lucile Packard Foundation’s newsletter.


Got Coverage? Next Steps in Using Your Health Insurance

Wednesday, July 2, 4:00-5:00 pm ET

Sponsored by the HHS Center for Faith-based and Neighborhood Partnerships; aimed at consumers who may not be familiar with using health insurance.

To join by phone only, dial 1-480-297-0021, and enter Access Code: 580-591-872. Pin Number is the # key.  Or register here.

Organizational Considerations for Successful Implementation of Peer Support Services 

Friday, July 11, 3:00 pm ET

Sponsored by the National Federation of Families for Children’s Mental Health.

In May, 2013, the Centers for Medicare and Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) released a joint informational bulletin that clarified the definition of "Peer" to include adults, families, and youth. Many organizations are working with their states to expand current peer services accordingly. This webinar will look at the growth of Peer Support and the organizational considerations necessary for successful implementation of its different types.  For more information, and instructions on joining the webinar, click here.  To join by phone only, dial 1-888-727-2247 and enter the conference ID number 5433540#.  If you have any questions, contact Kelle Masten at kelle.masten@nasmhpd.org or at 703-682-5187.

Innovative State and Local Crisis Response Systems

Tuesday, July 15, 2-3:30 p.m. (ET)

The Substance Abuse and Mental Health Service Administration (SAMHSA) is hosting a series of webinars on how to expand community-based crisis response services and systems. The series began on May 7, 2014 and will run every two weeks through July 15. The webinars describe new and emerging crisis response practices across a continuum of need that includes pre-crisis planning, early intervention, crisis stabilization, and post-crisis support. In addition, the webinar series explores the types of outcomes sought for different approaches, how these approaches are financed, and provide State and local examples. Click here to register.

Special Enrollment Periods and Resources for the Uninsured

Wednesday, July 16, 1:00-2:00 pm ET

Sponsored by the HHS Center for Faith-based and Neighborhood Partnerships.

Submit questions to ACA101@hhs.gov by July 15 at 12 pm ET.

To join by phone only, dial 1-646-307-1721, and enter Access Code: 270-706-869. Pin Number is the # key.  Or register here.

Partnering with Patients, Families, & Communities to Link Interprofessional Practice and Education

Tuesday, July 22, 1:00-2:00 pm ET

The Macy Foundation will hold a web conference to discuss moving beyond what is typically thought of as “patient engagement” efforts to integrate patients and families as partners throughout the health professions education and delivery system. The webinar will address recommendations in a new report – Partnering with Patients, Families, and Communities: An Urgent Imperative for Health Caredeveloped from an April 2014 meeting of leaders in health professions education and practice, and consumer organizations. Register here.

Medical Diagnosis and Health Care Justice
Wednesday, July 30, 2:00 pm ET

Sponsored by The Arc, this webinar will discuss medical diagnostics and healthcare justice, with leaders from the US Access Board and the Disability Rights Education & Defense Fund. Attendees will learn updates on the current medical diagnostics rule as well as how to educate others in their communities about health care provider misconceptions and stereotypes. Register here.


On Monday, the last day of the Supreme Court’s term, the court announced its rulings in two important cases.  In Burwell v. Hobby Lobby, the Court held, in a 5-4 decision, that the Religious Freedom Restoration Act allows a privately owned employer to exclude from its health insurance plans contraceptives that violate the owner’s religious beliefs (the “morning after pill” and IUDs).  See this very readable explanation from NPR/Kaiser Health News, which notes that the majority opinion’s author, Justice Alito, explicitly limited the scope of the decision:  "This decision concerns only the contraceptive mandate and should not be understood to hold that all insurance-coverage mandates, e.g. for vaccinations or blood transfusions, must necessarily fall if they conflict with an employer's religious beliefs." 

In another 5-4 decision, the court held in Harris v. Quinn that, First Amendment prohibits the mandatory collection of a union agency fee from “personal assistants” paid by the Illinois Medicaid program, since these personal assistants are not full-fledged state employees.  See this explanation from NPR and this piece from the Family Support Network.Top of Form


Autism CARES Act

On June 24, the House of Representatives passed the Autism Collaboration, Accountability, Research, Education and Support Act, or Autism CARES Act, by a voice vote.  The bill (H.R. 4631), which was sponsored by Reps. Chris Smith (R-NJ) and Mike Doyle (D-PA), and has 86 cosponsors, extends and modifies the Combating Autism Act, which expires at the end of September. 

On June 25, the Senate Health, Education, Labor and Pensions Committee approved the corresponding Senate bill (S. 2449), which is sponsored by Senator Robert Menendez (D-NJ) and has 10 cosponsors.  The bill was sent straight to the full Senate under a unanimous consent agreement, but several Senators asked for time to review the bill, delaying a vote.  It is hoped that the Senate will take up the bill after the July 4 recess.

For more information, see this article from Autism Speaks or this article from Disability Scoop.

Trauma Systems and Regionalization of Emergency Care Reauthorization Act

The House, by voice vote, approved the Trauma Systems and Regionalization of Emergency Care Reauthorization Act (H.R. 4080) on June 24.  The bill, sponsored by Rep. Michael Burgess (R-TX), would reauthorize several trauma programs that were established by the Affordable Care Act. These programs provide grants to states for planning, implementing, and developing trauma care systems and establishing pilot projects to design, implement, and evaluate innovative models of regionalized emergency care and trauma systems.  Click here for more information.

ACE Kids Act

Last week, Representatives Joe Barton (R-TX) and Kathy Castor (D-FL) introduced the bipartisan Advancing Care for Exceptional Kids Act of 2014, or ACE Kids Act (H.R. 4930), aimed at improving care coordination for children with complex medical needs enrolled in Medicaid.  Reps. Anna Eshoo (D-CA), Gene Green (D-TX), and Jaime Herrera Beutler (R-WA) joined as original cosponsors.  The legislation, supported by the Children's Hospital Association, would allow for the creation of nationally designated children’s hospital networks for children with medical complexity.  These networks would provide and coordinate the full range of home, primary, ambulatory, acute and post-acute care/providers for the children they cover.  Click here for a summary of the bill.  A similar bipartisan bill may be introduced in the Senate later this year.

Community Integration Act

On June 24, Senator Tom Harkin (D-IA), chairman of the Health, Education, Labor, and Pensions (HELP) Committee, introduced the Community Integration Act (S. 2515), summarized here, which is intended to eliminate the institutional bias in Medicaid by requiring the option of home or community-based services (HCBS) for anyone who requires an "institutional level of care."  On the same day, the HELP Committee held a roundtable hearing on "Moving Toward Greater Inclusion" as part of the activities commemorating the 15th anniversary of the Supreme Court’s Olmstead decision. The bill is based on the recommendations of the HELP Committee's July 2013 report: Separate and Unequal: States Fail to Fulfill the Community Living Promise of the Americans with Disabilities Act. 

Traumatic Brain Injury Bill

On June 26, Senators Orrin Hatch (R-UT) and Bob Casey (D-PA) introduced legislation to reauthorize the Traumatic Brain Injury (TBI) program for another five years (through FY2019) at the current funding levels. The bill (S. 2539) is supported by the Brain Injury Association of America and other national organizations with interest or expertise in brain injury.  The federal TBI program was created in 1996 by Senator Hatch and the late Senator Ted Kennedy (D-MA).  Click here for more information. 

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

2015 Auto-Enrollment in Marketplace Health Insurance Plans

In a proposed rule and guidance it released last week, the U.S. Department of Health and Human Services (HHS) announced that, for 2015, it plans to automatically re-enroll most consumers in the existing insurance plans they purchased through the federal Marketplace unless the consumer chooses to change their coverage during the open-enrollment period.  State-based Marketplaces may take this approach as well, or propose an alternative. The proposed rule is open to public comment for 30 days.

The auto-renewal will apply to people whose income fell below 500 percent of the federal poverty line in 2013, which is expected to be about 95 percent of the people who enrolled in health plans through HealthCare.gov. Under the ACA, individuals with family incomes under 400 percent of the federal poverty line are entitled to premium tax credits.  If a consumer’s updated income information indicates they no longer qualify for a tax credit in 2015, they will still be auto-enrolled in their current health plan, but will not receive the tax credit. Consumers who believe that they still qualify for subsidies will have to send documentation to the marketplace.

The federal Marketplace will not inform consumers what their new premiums will be.  Rather, insurers will be required to do so.  The draft issuer renewal and discontinuance notices are open to public comment and may be viewed here.

For more information, see this article from the Commonwealth Fund.


FDA Approves First “Robotic Legs”

On June 26, the U.S. Food and Drug Administration announced that it approved marketing of the first motorized device intended to act as an exoskeleton for people with lower body paralysis (paraplegia) due to specific types of spinal cord injuries.  The product, ReWalk, is a motorized device worn over the legs and part of the upper body that helps an individual sit, stand, and walk with assistance from a trained companion, such as a spouse or home health aide.  It has been approved for people with paraplegia due to spinal cord injuries at levels T7 (seventh thoracic vertebra) to L5 (fifth lumbar vertebra) when accompanied by a specially trained caregiver.  In addition, it may be used in rehabilitation institutions with people who have spinal cord injuries at levels T4 (fourth thoracic vertebra) to T6 (sixth thoracic vertebra). The device is not intended for sports or climbing stairs.  

The FDA reviewed the ReWalk through its de novo classification process, a regulatory pathway for novel, first-of-its-kind medical devices that are generally low-to moderate-risk. See also this article from Bloomberg News. 


The Medicaid “Health Home” Provision of the Affordable Care Act 

The Catalyst Center has developed a new fact sheet about Section 2703 of the Affordable Care, which permits states to create Medicaid Health Homes for the integration of primary care, mental, behavioral, and substance use services for individuals with certain chronic conditions who are enrolled in Medicaid. Read the Catalyst Center fact sheet to learn why Section 2703 matters for kids with special health care needs.

10 Things Immigrant Families Need to Know about the Marketplace

A recent blog post on HealthCare.gov provides information for immigrant families or individuals who have recently had a change in their immigration status.

New Summary Fact Sheets from the National Disability Navigator Resource Collaborative

The National Disability Navigator Resource Collaborative (NDNRC) has issued two new summary fact sheets, meant to provide a quick reference tool for navigators and enrollment specialists to use when they are meeting with consumers and are looking for a quick answer. The first summary fact sheet is for Fact Sheet #10 – “Medical Supplies Benefits.” This fact sheet is intended to help Navigators answer specific questions that people with disabilities might ask about medical supplies benefits when they are considering buying health insurance through the Marketplace. Fact Sheet #10, along with links to PDFs for both the full and summary version, can be found here.

The second summary fact sheet is for Fact Sheet #11 – “The Civil Rights of People with Disabilities under the Americans with Disabilities Act and Section 504 and Section 508 of the Rehabilitation Act.” This fact sheet is to clarify some of the issues that may arise for Navigators when applicants and participants in the Marketplace need reasonable accommodations or policy modifications from Navigators, Assistors, and Certified Application Counselors. Fact Sheet #11, along with links to PDFs for both the full and summary version, can be found here.

The entire list of NDNRC fact sheets is available here. Links to other helpful resources are available here.

Also from the NDNRC:  Answers to questions about the new Marketplace regulations for 2015.  To access this news item, click here.  If you have questions about how these regulations impact restrictions that states have placed on navigator and assister programs, see this news item referencing a new article prepared by Georgetown University’s Health Policy Institute.

The NDNRC is an initiative aimed at providing cross-disability information and support to Navigators and other enrollment specialists thereby ensuring people with disabilities receive accurate information when selecting and enrolling in insurance through the Affordable Care Act Marketplaces. The NDNRC website can be found at: www.nationaldisabilitynavigator.org.


The Lucile Packard Foundation’s “It Takes A Family: An Analysis of Family Participation in Policymaking for Public Programs Serving Children with Special Health Care Needs in California

While specific to California programs, this publication may also be helpful to others interested in promoting family participation in policymaking.

A Triple Aim Approach to Transition from Pediatric to Adult Health Care for Youth with Special Health Care Needs

This publication provides strategies for facilitating the transition to adult medical care that aligns with the Institute for Healthcare Improvement's Triple Aim to improve clinical outcomes; to improve patient, family, and provider experiences of care; and to decrease per capita costs of care. These strategies include helping patients develop self-management skills, supporting the care team, and helping patients and families navigate the transition process.

Pediatric Chronic Fatigue Syndrome

The Center for Disease Control has launched a new Chronic Fatigue Syndrome web page focused on the pediatric population with links to materials for parents, educators, and healthcare providers. It includes information on diagnosis, management, and treatment. Fact sheets are available for health care professionals, parents, and educators.

Info on Applying for a Navigator Grant:

Navigator Grant Applications Due July 10

On June 10, the Centers for Medicare & Medicaid Services (CMS) announced the availability of $60 million in grants to support Navigators in Federally-facilitated and State Partnership Marketplaces in 2014-2015. The funding opportunity announcement is open to eligible individuals, as well as private and public entities, applying to serve as Navigators in states with a Federally-facilitated or State Partnership Marketplace. It is open to new and returning Navigator applicants. Applications are due July 10, 2014.  Additional information about the funding opportunity can be found here, and FAQs are available here. To access the funding opportunity announcement, visit: http://www.grants.gov, and search for CFDA # 93.332. Contact HHSIEA@hhs.gov with questions or concerns.

Last month, CMS finalized regulations that update the requirements applicable to Navigators. Navigators will now be required to maintain a physical presence in the Marketplace service area, so that face-to-face assistance can be provided to consumers. Navigator grant applicants will also be encouraged to perform background checks for all Navigator staff that will be handling sensitive or personally identifiable information (PII). In addition to quarterly and annual reporting, Navigators will be required to submit to CMS weekly and monthly progress reports detailing their progress and activities in their target communities.

Applying for a Navigator Grant – Plan for Success

From Enroll America: http://www.enrollamerica.org/blog/2014/06/applying-for-a-navigator-grant-plan-for-success/