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ANCOR Urges All Members to Take the Following Action:

The Ask: Use our action tool to insist that your members of Congress fully fund the $400 billion investment in Medicaid Home and Community-Based Services (HCBS) in the budget reconciliation package.

The Details: Congress is currently negotiating its budget reconciliation bill, which could include an investment of billions of dollars in the HCBS program. The House version of the bill included $190 billion in the HCBS program, falling far short of the promise President Biden made in his American Jobs Plan to invest $400 billion in HCBS and failing to meet the funding level outlined in the Better Care Better Jobs Act.

While we celebrate this historic investment in the HCBS program, the level of financing is insufficient to sustain access and stabilize the direct care workforce. The dire conditions facing our nation’s direct care workforce demand a greater investment.

Why It Matters: A $400 billion investment in dedicated support for HCBS is essential for building a sustainable HCBS infrastructure that can begin addressing the magnitude of unmet need in our communities, and frankly, increased funding for HCBS can’t wait any longer. Not only does investing in this program enjoy wide bipartisan support—81% of voters want to see this funding in the reconciliation bill—but ANCOR’s recent research shows how badly community services need resources to stabilize a workforce in crisis.

Our new report, The State of America’s Direct Support Workforce Crisis 2021, reveals deep concerns from our providers, including:

  • 92% of providers report that the pandemic continues to inhibit their ability to recruit and retain workers; the majority of these respondents point to the fact that industries that previously paid comparable wages now pay employees more than they can afford to do.
  • 77% of providers have had to stop accepting new referrals due to high turnover or lack of staff.
  • 58% of providers have had to discontinue programs or services due to high turnover or lack of staff.
  • 84% of providers have had to delay the launch of new programs or the opening of new homes due to high turnover or lack of staff.
  • 81% of providers report difficulties achieving required quality standards due to high turnover or lack of staff.

The findings of this survey reveal the significant need for an immediate federal response. As the House and Senate continue to move this historic legislation and enter negotiations on the final package, it’s essential that every member of Congress hears from you now.

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Capitol hill building in the morning with colorful cloud , Washington DC.

Message from ANCOR: 

Dear ANCOR Members,

The to-do list for Congress this week is quite massive and hugely significant. Speaker Pelosi’s list includes passing the bipartisan infrastructure package, the reconciliation, and a continuing resolution (CR) to fund the government. We wanted to give you a Monday overview of what we are following, planning and how you can help in the coming days!

First up, the Continuing Resolution or CR: If you’ll recall, the House did pass a CR, but it included provisions to raise the debt limit, disaster relief funding and Afghanistan refugee resettlement funding. The Senate is not going to pass the CR with all of that attached. There should be a party line vote today, primarily with Republicans refusing to raise the debt limit. (This is a drama that plays out in Congress all the time, no matter the party in power…haven’t we all seen this movie before?) Once that Senate vote fails today, both chambers will need to go back to the drawing board in order to pass a “clean” CR that can be signed by President Biden by midnight on September 30 to avoid a government shutdown.

Next up, the Bipartisan (hard) Infrastructure Package: Speaker Pelosi announced the House will vote on this package Thursday, September 30. Originally the date was set for a vote on both this package and the human infrastructure package TODAY in hopes of keeping both the progressive and moderate sides of her caucus satisfied, but things haven’t gone exactly to plan. The risk for Speaker Pelosi is that the progressive caucus has threatened to vote no on the bipartisan infrastructure package without significant progress toward the reconciliation package (where our HCBS funding lives). Speaker Pelosi has promised a “framework” for the reconciliation package in hopes that will be enough to bring the progressives on board to pass the bipartisan package first, but the vote is anything but certain.

Last but not least, the Human Infrastructure Package/Reconciliation: On Sunday, the House Budget Committee (after the markups) packaged the reconciliation bill and moved it to the House Rules Committee. As expected House and Senate Democrats are actively negotiating to develop an overarching framework and legislative text. Leadership is developing a reconciliation package for a potential vote on Thursday in hopes of moving the progressive Democrats to vote on the bipartisan package (see above).  Needless to say, this is a tall order to get this done by Thursday with so many disagreements among Democrats on what should and shouldn’t be included. One thing for sure, whatever happens this week with the reconciliation will not be the last step. There will still be plenty of time for change.

LASTLY, WHAT CAN WE DO TO HELP?

  • Recent polling shows over 80% of Americans support the HCBS provisions of the bill, even if they don’t agree with other parts of it.
  • Congress is hearing from a LOT of their constituents back home supporting HCBS. Keep it up! This is clearly not a partisan issue.
  • Tell your stories!
  • Take Action Alerts!

On Wednesday, ahead of the vote(s) in the House…we will be releasing a summary brief of our recent Workforce Impact Survey, along with a NEW Action Alert. Please be on the lookout for that, rally your groups and prepare for this important DAY OF ACTION. 

Thank you, everyone! Happy Monday!
——————————
Shannon McCracken
Vice President of Government Relations
ANCOR
606.271.3555
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Message from Centers for Medicare and Medicaid Services (CMS):

Coverage without cost-sharing available for eligible people with Medicare, Medicaid, CHIP, and Most Commercial Health Insurance Coverage.

Following the FDA’s recent action that authorized a booster dose of the Pfizer COVID-19 vaccine for certain high-risk populations and a recommendation from the CDC, CMS will continue to provide coverage for this critical protection from the virus, including booster doses, without cost sharing.

Beneficiaries with Medicare pay nothing for COVID-19 vaccines or their administration, and there is no applicable copayment, coinsurance, or deductible. In addition, thanks to the American Rescue Plan Act of 2021, nearly all Medicaid and CHIP beneficiaries must receive coverage of COVID-19 vaccines and their administration, without cost-sharing. COVID-19 vaccines and their administration, including boosters, will also be covered without cost-sharing for eligible consumers of most issuers of health insurance in the commercial market. People can visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby.

“The Biden-Harris Administration has made the safe and effective COVID-19 vaccines accessible and free to people across the country. CMS is ensuring that cost is not a barrier to access, including for boosters,” said CMS Administrator Chiquita Brooks-LaSure. “CMS will pay Medicare vaccine providers who administer approved COVID-19 boosters, enabling people to access these vaccines at no cost.”

CMS continues to explore ways to ensure maximum access to COVID-19 vaccinations. More information regarding the CDC COVID-19 Vaccination Program Provider Requirements and how the COVID-19 vaccine is provided through that program at no cost to recipients is available on the CDC COVID-19 Vaccination Program Provider Requirements and Support webpage and through the CMS COVID-19 Provider Toolkit.

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As your teams begin working on completing the RCPA Work Force Survey, we received a request to have a master list of questions that can be referenced. The Master List of survey questions includes all service line areas, questions on the program operations, and vaccinations.

Again, we thank you for your efforts to complete the survey. Please contact RCPA Children’s Division Director Jim Sharp if you have any questions or concerns.

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The COVID-19 pandemic has created existential challenges for agencies that provide supports and services to individuals who have disabilities and/or health issues. Staffing has been an area that has been significantly affected. Legislative and State Stakeholders have requested RCPA to quantify the impact of the pandemic on our workforce so that we might effectively lobby for the welfare of the agencies that support and serve individuals with disabilities and health issues.

The work force survey will examine work force topics for a diverse range of programs, including Mental Health, IDD/Autism, Brain Injury, Drug & Alcohol, Inpatient Rehabilitation Facilities (IRF), and others. The survey responses seek to gather data related to hiring, retention, vacancy rates, pay structures, vaccinations, and COVID-19 impacts on programs as well as access to care associated with the pandemic.

RCPA is making the survey available to providers across Pennsylvania, not just RCPA members. Please be assured that response data will be de-identified and aggregated for reporting by an independent research entity, and your individual data will be shared with no one. A copy of the results of this survey will be available to all participants at the conclusion of the study. Please follow the link to the survey.

We thank you in advance for your time in completing this survey and would ask that you share this information with your colleagues, fellow leaders, and Human Resources teams. The more information collected, the more we will be able to provide to stakeholders, which will affect not only RCPA members but all providers within the Commonwealth.

If you have any questions, please contact Director of Children’s Services Jim Sharp or your RCPA Policy Director.

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Having a mental health condition such as depression, anxiety, or a substance use disorder (SUD) can negatively impact one’s oral health, and conversely, poor oral health can create or exacerbate problems with mental health, cognitive health, and/or substance use. RCPA President & CEO Richard S. Edley, PhD, along with other members of the OH/BH Integration Technical Expert Panel, have developed an OH/BH Integration Framework, which includes new and innovative care models designed to enable providers and organizations to start wherever they feel comfortable.

No comprehensive set of resources currently exists to help health organizations that may be interested in more coordination or integration across oral, mental health, and substance use treatment services specifically. This toolkit seeks to help oral health and behavioral health providers and organizations increase coordination and integration by offering practical suggestions, resources, strategies, and on-the-ground examples for implementation of new care models across a continuum, ranging from cross-sector provider and patient education to full system integration. It provides innovative examples from leading-edge programs across the country about how to re-engineer traditional care pathways, especially given broader adoption of telehealth.

Please find the final draft of this framework here.

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Leading in 2021: Hoping, Healing, Helping
RCPA Conference Featuring Panel with National Advocacy Experts for Review of the Need for Equity in Service:
National Release of Video

On Thursday, September 30, a video developed by a group of parents of children with severe autism will be “unveiled” publicly and nationally at the RCPA Annual Conference for the first time. Later in the afternoon, a panel addressing these concerns titled “One Size Does Not Fit All — A Review of the Need for Equity in Service Provision and Establishing A Comprehensive Continuum of Care” will include national advocacy experts discussing how the narrow interpretation of the HCBS setting rule and other policies potentially deprive individuals with intense needs choice in where they live, work, and play. Hear from the families on how these policies have impacted their loved ones’ quality of life.

The video contains disturbing images; however, the parents who produced this video felt compelled to share the reality of severe autism in order to combat the increasing claims of the highly vocal and publicly visible advocates and others who have the sole agenda of supporting those of higher functioning in the community.

In contrast, severely autistic individuals and their families are often not publicly visible. They may not be able to safely leave the house, let alone testify in a government hearing, present at a conference, or appear on television alongside other advocates.

But severe autism is real. This is what it looks like. And those affected require a true continuum of care — from the most inclusive options to disability-specific settings — to meet their lifelong support needs, not only to thrive, but to survive. One size does not fit all.

Register today for the RCPA Conference to see this national release.

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