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June 27, 2024 | Volume 28, No. 5 | Archives
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While Awaiting SCOTUS, Health Care Guidance and Funding Are Issued
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| In This Issue:
- Want to Write this Mobilizer? We’re Hiring!
- FY2025 Budget
- Congressional Recess Coming Up: Book Site Visits Now
- Medicaid Unwinding: 23 Million Now Disenrolled, Waivers Extended
- CLOSER LOOK: CRUEL AND UNUSUAL PUNISHMENT, PART 3
- Two Medicaid Managed Care Rules Finalized
- Medicaid Guidance on Homelessness and Peer Supports
- More Medicaid in the News
- HHS Re-instates Rule on Non-Discrimination Protections
- Substance Use Disorder Funding and News
- New Resources from our Partners
- What (Else) We’re Reading
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| Want to Write this Mobilizer? We're Hiring!
Do you know someone who is passionate about social justice, has experience with legislative advocacy, and would make a great addition to the National Health Care for the Homeless Council’s Policy Team? We’re hiring for a Senior Policy Manager and want to ensure we get the word out. More details are in the job description, but this person will staff our Policy Committee, represent us on Capitol Hill, and manage our policy and advocacy agenda (and yes, write this exciting newsletter!).
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- Decreasing HRSA’s budget by nearly $650 million (though level-funding for health centers specifically)
- Eliminating funding for Title X Family Planning grants
- Cutting $190 million from Ryan White HIV/AIDS program and eliminating funding for the Ending the HIV Epidemic initiative
- Eliminating funding for firearms research, opioid overdose prevention and surveillance, rape prevention, and suicide prevention (among others)
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| Congressional Recess Coming Up: Book Site Visits Now
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| Legislators will be home for summer break soon — so it’s a great time to schedule a site visit to your program! This is an opportunity to illustrate the vital importance of the services you provide to unhoused people so policymakers can return to D.C. and advance the funding and policies we need to end homelessness and provide high-quality care. It can be as simple as a tour of your program and a conversation with leadership, staff and clients about the impact of homelessness on heath, health outcomes, and the larger health care system. Emphasize how important it is for them to increase funding for housing and health care programs, as well as fight attempts to attach harmful policy requirements into the appropriations process.
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| Take Action on Congress
Contact your legislators today and get on their calendar for a site visit! Tell them to OPPOSE budget cuts and instead make stronger investments in existing programs.
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Medicaid Unwinding: 23 Million Now Disenrolled, Waivers Extended
As of June 14, just over 23 million people have been disenrolled from Medicaid — 69% for procedural reasons not involving eligibility. Of those terminated, Nevada is currently at the highest rate of procedural disenrollments (93%) while Maine is at the lowest (24%).
To support states continued efforts to conduct redeterminations, CMS is extending the flexibilities states have to verify eligibility through June 30, 2025 (e.g., such as states that use SNAP benefits or permit ex-parte income determinations for very low income individuals as part of the renewal process). (See an informative slide deck here.)
CMS is also reminding states of 10 renewal practices that are not permitted under federal rules, which include not conducting renewals at the household level, providing less than 30 days for a response on a renewal form, and not determining eligibility for other programs prior to disenrollment.
Related reading from Kaiser Health News:
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| Take Action on Medicaid
- Continue making all efforts to prevent coverage loss and help ensure redetermination for clients.
- Ensure your state is not engaging in any prohibited practices (listed above).
- Promote enrollment retention by advocating for more streamlined enrollment practices that screen people into the program.
- See our unwinding policy brief for more possible actions at both the program and policy level.
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| Cruel and Unusual Punishment, Part 3
By Barbara DiPietro, Senior Director of Policy
This month’s blog post is forthcoming! We are still awaiting a decision from the Supreme Court on the Johnson v. Grants Pass case — and whether local jurisdictions can punish unhoused people for sleeping outside when there are no shelter beds available. Refresh your memory on this case with our prior posts on Cruel and Unusual Punishment (Part 1 and Part 2). We anticipate the Court will rule any day now. When they do, we'll send a special Mobilizer with updates!
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| Two Medicaid Managed Care Rules Finalized
At the end of April, CMS released two final rules related to Medicaid managed care:
Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality (full rule here, fact sheet here, chart with implementation dates here): This rule enhances wait time standards, strengthens quality measures and fiscal integrity standards for state-directed payments, and specifies the scope of in lieu of services to better address health-related social needs.
Ensuring Access to Medicaid Services (full rule here, fact sheet here, chart with implementation dates here): This rule ensures transparency in fee-for-service rates, protects FQHCs from state actions to restructure or lower reimbursement rates, and includes FQHCs as an option to participate in the Medicaid Advisory Committee.
Related reading
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| Medicaid Guidance on Homelessness and Peer Supports
Informational Bulletin on Homelessness: On May 10, the Centers for Medicaid and CHIP Services (CMCS) released an informational bulletin outlining strategies states can take to increase access to Medicaid-funded mental health and substance use disorder (SUD) services for people experiencing homelessness. The bulletin discusses the certified community behavioral health clinic demonstration, services for those re-entering the community from incarceration, health-related social needs, 1115 SUD and mental health demonstrations, as well as additional resources that link to the breadth of policy options available to states to increase care for unhoused people.
FAQ for Peer Supports: On June 5, CMCS released an FAQ to discuss its position encouraging states to enhance peer support services as part of a broader effort to integrate lived experience into the treatment for individuals with mental health and substance use disorders. CMS encourages states to bolster peer support services through a variety of strategies, to include allowing coverage in emergency room and inpatient settings. CMS also encourages states to ensure that payment rates for peer support services are sufficient to support a living wage for these critical members of the care team. The FAQ also covers action steps needed at the state level, training requirements, and oversight/supervision.
More Medicaid in the News
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| HRSA Releases 2025 New Access Point Opportunity
For the first time in a while, HRSA opened up a funding opportunity for new access points (NAPs)! They anticipate awarding $50 million for 77 NAPs to increase access to primary care. Applications are due by August 15, 2024, in grants.gov. Apply now to expand your services at a new location!
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| HHS Reinstates Rule on Non-Discrimination Protections
In June 2020, the prior administration weakened anti-discrimination clauses in Section 1557 of the Affordable Care Act. On April 26, HHS issued a final rule restoring civil rights and protections against discrimination in health care (fact sheet here). Among other provisions, this rule:
- Requires covered health care providers, insurers, grantees, and others, to proactively let people know that language assistance services are available at no cost to patients.
- Requires covered health care providers, insurers, grantees, and others to let people know that accessibility services are available to patients at no cost.
- Clarifies that covered health programs and activities offered via telehealth must also be accessible to individuals with limited English proficiency, and individuals with disabilities.
- Protects against discrimination by codifying that Section 1557’s prohibition against discrimination based on sex includes LGTBQI+ patients.
- Respects the clinical judgment of health care providers.
- Clarifies that nondiscrimination in health programs and activities continues to apply to the use of AI, clinical algorithms, predictive analytics, and other tools.
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| Substance Use Disorder Funding and News
Related reading
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| New Resources from Our Partners
Our partners have published a range of new reports recently:
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What (Else) We're Reading
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This publication and all HCH advocacy are funded by dues from Organizational Members of the Council and by private donations. Consider joining the Council or donating to support this work.
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