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Monthly Legislative Wrap Up from D.C.
Thursday, June 23, 2016
Welcome to AJFCA's Monthly Legislative Wrap Up Newsletter. Below you will find updates on recent developments regarding OAA Reauthorization Holocaust survivor guidance, mental health legislation currently being debated in Congress, and two public policy proposals that AJFCA believes would hurt the very clients our agencies serve.

As Congress is scheduled to recess after the second week of July and will not return until September, we encourage agencies to consider reaching out to their representatives and senators for meetings or agency site visits. Next month, in addition to legislative updates, we will provide recommendations for ways agencies can interact with their legislators during the long summer recess. 

Is there a topic you would like us to touch on? A question about public policy you would like us to try and answer? We would love to hear from you! Please do not hesitate to email AJFCA's Director of Government Affairs, Liz Leibowitz, with any questions, comments, or ideas. 
Draft Federal Guidance on Serving Holocaust Survivors Unveiled - Next Steps

As you are likely aware, the Older Americans Act (OAA) Reauthorization Act was signed into law earlier this year. One of the changes made to the OAA in this reauthorization was the addition of a new section, advocated for by JFNA and AJFCA, known as "Section 10 - Guidance on Serving Holocaust Survivors." This new portion of the law instructs the Assistant Secretary for Aging to issue guidance to states on serving the unique needs of Holocaust survivors and, in developing this guidance, to consult with experts and organizations that serve survivors. 

Following the law's passage, JFNA and AJFCA held meetings with representatives from the U.S. Administration on Community Living (ACL) and Administration on Aging (AoA) who explained that draft guidance on serving Holocaust survivors would be included in their pre-drafted but not-yet-published Program Instruction (PI) entitled Guidance for the Development and Submission of State Plans on Aging, State Plan Amendments and the Interstate Funding Formula. Once published, this PI would be made available for public comments for 60 days. All submitted comments will be considered for inclusion in the finalized PI.

On June 21, ACL published a notice in the Federal Register that it is seeking comments by August 22 on the PI, specifically requesting comments on whether the guidance provided on targeting two new communities - Holocaust survivors and lesbian, gay, bisexual, or transgender older adults - was sufficient. You can view the draft PI here (references to survivors can be found on pages 5-6 and 10).  

In light of this, JFNA and AJFCA, in coordination with experts within and outside of our network, plan to submit official comments that will provide recommendations for specific guidance that we believe will sufficiently enable states to successfully serve Holocaust survivors. We also plan to create a comments template for agencies and communities that would like to submit official comments on behalf of individual entities. 

In the coming weeks, please keep your eyes open for an email from AJFCA that will provide agencies with an opportunity to share ideas and thoughts on what recommendations should be included. We will continue to provide you with more information on this evolving issue.

Update: Congressional Action on Mental Health Legislation
On June 15, the House Energy and Commerce Committee unanimously approved a substantially reworked version of the Helping Families in Mental Health Crisis Act (H.R.2646). The bill must now be brought to a vote before the full House of Representatives. Recent reports have indicated that the bill will be brought for a vote in July before Congress goes into recess until September. A similar, but not identical mental health bill (S.2680) already was approved by a Senate committee in April, and now awaits action by the full Senate as well.

"This legislation is a major step forward in improving our nation's fragmented mental healthcare system, and is long overdue," said William Daroff, Senior Vice President for Public Policy & Director of the Washington Office for JFNA. "The bill will help children and adults with mental disorders, their families and the behavioral health providers who care for them."

The House bill contains a number of important changes:
  • IMD Exclusion - Codifies limited Medicaid Managed Care coverage for inpatient mental health care at inpatient facilities, known as Institutions for Mental Diseases.
  • Same-Day Billing - Allows same-day billing of mental health and physical health services under Medicaid.
  • Patient Privacy - Directs the Department of Health and Human Services (HHS) to clarify patient privacy protections under the Health Information Portability Accountability Act.
  • Parity - Requires a study of federal oversight of parity in group health plans - including Medicaid managed care plans - to ensure that these plans are providing mental health coverage that equals the benefits for physical health care coverage.
  • Grant Programs - Reauthorizes suicide intervention and prevention programs.
  • Assisted Outpatient Treatment (AOT) - Extends an assisted outpatient grant program for individuals with serious mental illness through 2020.
  • SAMHSA Strategic Plan - Requires the Substance Abuse and Mental Health Services Administration (SAMHSA) to create a strategic plan in coordination with the National Institutes of Mental Health, a new Assistant Secretary of Mental Health, and the HHS Secretary.
JFNA and AJFCA are disappointed that the committee-approved version of the House bill failed to include federal funding for adoption of health information technology (HIT) by behavioral health providers. JFNA and AJFCA will continue to push for inclusion of HIT resources for behavioral health providers, while exploring alternative resources being made available through the Medicaid program that may help behavioral health providers make the transition to interoperable electronic health records. The committee-approved bill also failed to expand the Excellence in Mental Health Act program, which provides federal funds to certified community behavioral health clinics under a small but popular demonstration program.

AJFCA Opposes Legislative Proposals That Would Harm Low-Income Children, Older Adults, and People with Disabilities 

AJFCA has come out in opposition to two recently introduced policy proposals because of the potential devastating effects each policy would have on the low-income children, older adults, and people with disabilities. You will find more information below on each proposal. Should you or your agency wish to take action in opposition to either of these proposals, please do not hesitate to be in touch. 

Proposal to Eliminate SHIP
The Senate Appropriations Committee recently approved the Fiscal Year (FY) 2017 Labor, HHS, Education Appropriations bill. While this bill contains proposals that AJFCA supports, we were dismayed by the bill's proposal to cut $52.1 million in funding for the Medicare State Health Insurance Assistance Program (SHIP), effectively eliminating the program. 

SHIP provides free, in-depth, and personalized counseling to seniors and people with disabilities who need help understanding the complexities of Medicare coverage. SHIPs also help with fraud and abuse issues, billing problems, appeal rights, and enrollment in low-income protection programs. Just last year, SHIPs served 7 million Medicare beneficiaries. You can learn more about SHIPs from the National Council on Aging.  

AJFCA has joined a letter of national organizations expressing opposition to this proposal. We will circulate opportunities for local organizations to express their opposition as we learn of them. 

Proposal to Block Grant School Meal Program 
The House and Senate are working to reauthorize the Child Nutrition Program by the end of the 114th Congress. The House's bill, the Improving Child Nutrition and Education Act (H.R.5003), has received strong opposition due to its inclusion of a block grant proposal that would allow up to three states to opt for a capped funding stream instead of the current federal funding reimbursement they receive for school meal programs. 

This proposal would result in fewer meals for fewer low-income children by enabling states to only guarantee one "affordable" meal a day for students, to create more restrictive eligibility standards, and to weaken the program's nutritional standards. If the funding available to a state through the block grant runs out, there would be no guarantee that low-income children would be able to receive free school meals. Furthermore, the block grant would allow states to divert federal resources they currently must use for school meals to other purposes, as long as state legislators conclude that school-aged children's nutritional needs were being met.  

AJFCA and JFNA have both joined the Food Research & Action Center's letter in opposition to this proposal. Interested agencies can still sign onto the letter here