Friday, January 13, 2017

Call to Action


By Rylin Rodgers, Director, Board of Directors
I want to take a minute to talk to you parent to parent. I know you’re busy. I know you have a lot on your plate. I know you feel like you can’t do one more thing. But, I need you to do something. I need you to speak up on behalf of your child and other children.

There are several threats to programs for our children at the federal level, primarily the ACA and Medicaid.

Many of you depend on the provisions of the Affordable Care Act:
  • No exclusions of pre-exisiting conditions
  • No cap on lifetime limits
  • A prohibition against rescinding coverage when someone gets sick
  • ABA and other services provided by marketplace plans
The plan is to repeal the Affordable Care Act. I know it’s not perfect, but we have very few details about what the replacement would be, if anything. If the ACA matters to your family, you need to share your story with your Representative and Senators. They need to know why it’s important to you.
Here’s a basic script and you can add your own story:

Main message I am a constituent whose child has special health care needs. My child and family and others like mine benefit greatly from the Affordable Care Act (ACA).Therefore, I urge you to vote against any bill that would repeal the ACA (even with a delayed effective date) before replacing it with another law that will maintain or improve access to affordable and comprehensive health insurance and services.

Many of you rely on Medicaid, often through the waiver program. But, the proposed Medicaid block grants will most likely result in
  • Cuts to funding
  • Changes to eligibility
  • Changes to benefits
You probably use Medicaid for things like equipment, prescriptions, home care, transportation, etc. Those are guaranteed right now under EPSDT. Changes to Medicaid could mean those benefits are optional, if you even qualify in the future. If you need that coverage, you need to act to protect Medicaid.
You need to call your Representative and Senators and tell them how important Medicaid is to you. If there are indeed changes at the federal level, you’ll need to advocate at the state level to make our children a priority.

At the end of the day, no matter what the result, I always want to be able to look my children in the eye and say “Mom tried her best.” I know you want to be able to say that, too.

Find and contact your Representative:

Contact your Senators:
Senator Todd Young
(202) 224-5623

Senator Joe Donnelly
(202) 224-4814

Follow our BLOG for up-to-date information on federal and state legislation

If you need help or information, feel free to contact Family Voices Indiana.
844 F2F INFO

IN Legislative Session: Policy Updates

From Indiana Association of United Ways:

At the Statehouse
The 2017 legislative session is underwayState Capitol
The Indiana General Assembly has begun, and committee meetings are being scheduled. The last day for bills to get filed is today, and more than 840 bills have already been filed.  This session is a "long session" where lawmakers will decide the state's next two-year budget which is typically about $30 billion.  Legislators will make tough funding decisions on state government services including education, infrastructure and public safety. 

Links to help you follow are below: 
At the StatehouseGovernor Holcomb prioritizes economy and the workforce, infrastructure and attacking the drug epidemic
The newly inaugurated Governor Holcomb recently released his Next Level Legislative Agenda.  The agenda tells us more about the new administration's funding and policy priorities for the future.  The agenda includes five key priority areas:
  • Cultivate a strong and diverse economy by growing Indiana as a magnet for jobs:  pass an honestly balanced budget, make Indiana an innovation hub, continue the Regional Cities program and create entrepreneurship grants.
  • Create a 20-year plan to fund roads and bridges:  maintain current roads and invest in the future, incentivize more direct flights, double track the south shore line in northwest Indiana, leverage Federal dollars for local projects.
  • Develop a 21st century skilled and ready workforce:  double the state's investment in pre-k, increase incentives for adult credential/certificate programs, appoint a Secretary of Education, align STEM efforts through K-12 education.
  • Attack the drug epidemic:  local authority to establish syringe exchange programs, limit the amount of controlled substances prescriptions and refills, enhance penalties for pharmacy robberies.
  • Deliver great government service: modernize the Department of Revenue computer system, expand the nurse family partnership to combat infant mortality, update the Indiana State Police labs.
Many of the Governor's priorities are reflected in legislation that has been filed by the Indiana General Assembly. We will know more about how they fare as the session continues.
At the Statehouse - Take Action
Register now for January 30 legislative update webinar
IaUW partners with the Indiana Coalition for Human Services to bring you updates during the legislative session.  The first update webinar will take place on Monday, January 30 at 2pmET. We will share an update about the progress with legislation affecting working Hoosiers, children, seniors and people with disabilities. Register now to watch the webinar live.  The recorded version will be posted on our website if you are not able to watch the live recording.  Additional legislative update webinars will be recorded on March 10 and May 5.

At the Statehouse - Take Action
Check out our Third House / Meet Your Legislator event calendar
IaUW is tracking Third House Sessions and "meet your legislator" events across the state.  These meetings are opportunities for constituents to talk to their legislators and learn about bills they are working on at the statehouse.  It is important that legislators hear input from their constituents, and these events are a great way for you to connect and share your thoughts.  View our Third House Calendar that will be updated regularly throughout the legislative session.  Check back often for new events as they are posted.  Upcoming events include:
  • Carroll County - January 27 at 12:00pm
  • Elkhart County - January 21 at 10:00am
  • Greater Lafayette - January 21 at 7:30am
  • Howard County - January 27 at 4:00pm
  • Shelby County - January 27 at 11:30am
  • St. Joseph County - January 27 at 12:00pm
If you attend, drop us a note to share a little about your experience.

Transitioning from ABA to School

The Institute’s Indiana Resource Center for Autism has developed a checklist that focuses on student transition from ABA programs to school programs. Factors for a successful transition include skills the child/student has gained, how they were prepared for the transition process, the relationships between the ABA program/provider and the school district, and how the school is prepared to receive the child.

Transition Checklist: Moving From ABA Programs to School Programs builds upon the information from the article entitled Transitioning from ABA Programs to School Programs and to provide some additional guidance.

Thursday, January 12, 2017

Protect Mental Health Care

Take Action!

Last night, the Senate took the first step towards repeal of health care reform. Health care reform, otherwise known as the Affordable Care Act (ACA) and/or Obamacare, made several changes to federal laws which have especially benefited people with mental health and addiction needs.
These changes include:
  1. Made mental health and addiction treatment a benefit that all insurance plans must fully cover
  2. Required insurance companies to cover people with pre-existing conditions
  3. Allowed young people to stay on their parents’ family insurance plan until 26 years old
  4. Increased access to individuals who previously were not able to access coverage, through the exchange, Medicaid
  5. Improved coordination of mental, behavioral, and physical medical care for people
The House is poised to take similar action tomorrow.
Any changes to the Affordable Care Act must keep these priorities in place.
Right now, more than ever, we need you to contact your Member of Congress and tell them you want to protect mental health. We encourage you to make sure that your Representative knows that you don’t want to lose coverage for you or loved ones – you don’t want them to repeal without a replacement, and you want the replacement to maintain existing coverage.

Senate Passes Budget Resolution: Focus on ACA repeal

from Community Catalyst:

Early this morning, the Senate voted 51-48 mostly along party lines to pass the budget resolution that includes instructions to repeal major parts of the Affordable Care Act (ACA). This completes the first step in the process to repeal and delay, which would strip health care coverage away from 30 million people and consumer protections from millions more. (See our recent alert for a refresher on the process.)

While this new development moves them closer to a vote on repeal, our message is working. Over the past two weeks, we have seen several Republicans speak publicly about concerns regarding repeal that does not include a simultaneous plan for replacement. In response, and in order to keep up the momentum we have gained so far, we must continue to generate as much noise as possible through earned media, social media and high-visibility public events.

Additionally, we know that the public and Congress are watching the enrollment numbers this open enrollment period. With only a few weeks left in this open enrollment period your work enrolling consumers in health insurance is critically important. Thank you for all you are doing to help bolster the case against repeal. 

Here are the latest resources that Community Catalyst has pulled together to help you: 
  1. Senate Votes: Find out how your senators voted here. It is important that those senators who opposed repeal by voting "Nay" on the resolution hear from as many constituents thanking them for their support as possible over the next few days. Find your Senators' phone numbers here.
  2. Talking Points: Please continue to use these general talking points when communicating the impact of repeal and delay.
  3. Social Media Content: Continue to use our What’s At Stake infographic to spread the word through social media and get people to take action, as well as these new posts which can be tailored based on how your senators voted.
  4. Organizational Statement: Community Catalyst issued a statement on today’s vote. Please feel free to use ours as an example to create your own.

Wednesday, January 11, 2017

Agenda for the 115th Congress: Focus on the ACA

from Family Voices, Ntl:

On January 3, the members of the new Congress were sworn into office and the 115thCongress convened for the first of its two, year-long sessions. This Congress includes 53 new Representatives and seven new Senators. Republicans control both chambers, with a 52-48 majority in the Senate and a 241-194 majority in the House.
2017 Agenda
The president-elect and Republican congressional leaders have made repeal of the Affordable Care Act (ACA, or "Obamacare") a top priority for Congress (more below). They have also announced their intention to drastically alter the nature of the Medicaid program by turning it into a block grant or capping federal payments on a per-beneficiary basis. At the end of this fiscal year (September 30, 2017), funding for the Children's Health Insurance Program (CHIP) will expire, as will authorization and funding for the Maternal, Infant and Early Education Home Visiting (MIECHV) program, and Family-to-Family Health Information Centers (F2Fs). Family Voices and other advocates will be working hard to ensure continuation of these programs, to combat structural changes to the Medicaid program, to fight ACA repeal if there is no suitable replacement, and to ensure adequate funding for appropriated programs such as the Maternal and Child Health Block Grant.

ACA Repeal
ACA repeal would be a two-step process. First, both the House and Senate would pass a joint "budget resolution" (which is not signed by the president). This would allow them to take up a "reconciliation" bill that, if enacted, would repeal parts of the ACA, most likely with a delayed effective date so that a replacement can be developed. This is being called the "repeal-and-delay" strategy. Both the budget resolution and reconciliation bill have a special status in the Senate requiring only 51 votes for approval, rather than the 60 votes usually needed to advance legislation to which any Senator objects.
This week - most likely late Wednesday night (early Thursday morning) - the Senate is expected to vote on the budget resolution. The resolution is expected to pass, although only two Republican Senators need to join the Democrats and Independents in voting NO for the budget resolution to fail. (There are 52 Republicans in the Senate; Vice-President Biden can vote to break a tie.) Some of the Senators who have expressed reservations about repealing the ACA without a simultaneous replacement are Senators Lisa Murkowski (AK); Tom Cotton (AR); Jeff Flake and John McCain (AZ); Cory Gardner (CO); Rand Paul (KY); Susan Collins (ME); Rob Portman (OH); Patrick Toomey (PA); Lamar Alexander  and Bob Corker (TN); and Shelley Moore Capito (WV). Once approved by the Senate, the House would approve the resolution.

If adopted by the House and Senate, the budget resolution will direct certain committees in each body to develop legislation to "reconcile" the law with the resolution's budget targets. The committees' legislation would then be combined into a "reconciliation" bill that would effectively repeal the parts of the ACA that have a significant budgetary impact - the individual and employer mandates, the premium tax credit, cost-sharing subsidies, and the Medicaid expansion. The reconciliation bill is likely to delay the repeal of fundamental parts of the ACA (such as premium subsidies) for two to four years, a matter still being debated among Republicans. But, some provisions might go into effect immediately, including a repeal of the maintenance-of-effort (MOE) provision requiring states to maintain their eligibility and enrollment policies for children under Medicaid/CHIP, which could result in loss of coverage for millions of children, according to an Urban Institute analysisOn Tuesday, House Speaker Paul Ryan (R-WI) said that some elements required to replace the ACA could be included in the repeal bill, although he did not go into specifics.
Significantly, Senate rules may prohibit the use of a reconciliation bill to repeal some of the ACA's consumer protections, since they are not primarily budgetary in nature, such as the ban on pre-existing condition exclusions and coverage caps and the provision allowing children to stay on parents' health plans until they are 26. But, there are no black and white rules about this; it will be up to the Senate parliamentarian to decide.
Even with a delay in the repeal date, many analysts expect that an impending repeal will cause many insurers to drop out of the marketplaces, thus causing significant premium increases that could leave millions of Americans without access to affordable health insurance, even before the repeal goes into effect. In fact, the American Academy of Actuaries sent a letter to House leaders explaining that a repeal of the ACA's individual mandate and enrollee subsidies, without enacting a replacement at the same time, could result in significant market disruption, leading to millions of Americans losing their health insurance. Hospital groups and the insurance lobby have also expressed concern about ACA repeal, even a delayed one. The Urban Institute has estimated that the effects on the insurance market could result in loss of health insurance for 30 million people by 2019 if the ACA's individual mandate and insurance subsidies are repealed without repealing the law's consumer protections (such as guaranteed issue to those with pre-existing conditions).
A number of consumer groups have formed the "Protect Our Care Coalition," whose members include Families USA, the Service Employees International Union, MomsRising, the NAACP, and the National Council of La Raza. The coalition plans to educate the public on the potential harms of repealing the ACA "without simultaneously voting on a plan that guarantees people will have health and financial security."
ACA Replacement
Rep. Tom Price, MD (R-GA), the nominee for Secretary of Health and Human Services, previously developed legislation to replace the ACA. Senator Rand Paul (R-KY) recently announced that he is developing replacement legislation as well. House Speaker Paul Ryan (R-WI) and the president-elect have outlined replacement ideas (but not developed legislative language), such as allowing insurance to be sold across state lines and establishing high-risk pools for individuals with expensive medical conditions. House Majority Leader Kevin McCarthy (R-CA), along with the Republican chairs of House committees with jurisdiction over health matters (the Committees on Ways and Mean, Energy and Commerce, and Education and the Workforce), sent a letter on December 2to the governors and insurance commissioners of all the states asking them for input on developing an ACA alternative and posing nine specific questions. Responses were requested by January 6.

Monday, January 9, 2017

Indiana lawmakers take up wide range of health care legislation

from IBJ:

The Indiana General Assembly is back in session, wading its way through an enormous amount of legislation from road funding to firearms rights.
Of course, there’s a smattering of health care legislation that could add consumer protections for patients, expand insurance coverage to infertile couples and provide hospitals news rights for restraining difficult patients.
At least a dozen bills are winding through each house that would affect patients, insurers, health-care providers or public health officials.
In this issue, we’ll take a look at some bills originating in the House that we’re keeping any eye on. Next time, we’ll look at bills originating in the Senate.
So without further ado:
House Bill 1011 (Rep. Wes Culver): Tired of wondering what you might be charged for a doctor’s visit or a hospital stay? This bill would require health care providers, starting in 2018, to publish and provide patients in advance the charges for procedures, except for those offered in emergencies. The bill would have “indeterminate fiscal impact” on the state, according to a note from the Legislative Services Agency.
“To the extent that providing and discussing charges for procedures, products or services would prompt patients to look for lower cost alternatives, cost savings may occur for the state,” the note said.
About 34 states now require some price disclosure, although it varies widely. Indiana requires hospitals to prepare and submit fiscal reports and patient information reports. Four states (Massachusetts, Minnesota, Nebraska and Nevada) require providers to disclosure information to patients in advance. (Referred to Public Health Committee)

House Bill 1028 (Reps. Ronald Bacon and Robert Heaton): It’s no secret that insurers and providers have occasional scuffles, and this one seeks to un-scuffle an area between insurers and two specialist providers: dentists and optometrists. It would prohibit insurers and HMOs from requiring dentists and optometrists to accept certain payments unless the services are covered under the policy or contract.
It also would prohibit dentists and optometrists from charging for non-covered health care services an amount that exceeds “the usual and customary” charges for health services. According to the state’s fiscal analysts, the bill could increase revenue from penalties assessed against insurers for “unfair and deceptive acts,” as well as optometrists and dentists who charge patients a greater amount than usual and customary. (Referred to Insurance Committee.)
House Bill 1041 (Rep. Jeffrey Thompson): This bill tightens controls on crematories and funeral operations. It requires that a crematory that is registered after July 1, 2017, be supervised by a funeral director. It also requires that a person who operates a cremation chamber receive training and be certified as a crematory operator. Further, it provides for alkaline hydrolysis, or bio-cremation, as a means for dissolution for human remains. A bill allowing bio-cremation in Indiana passed a house committee last year, but failed to advance. (Referred to Public Health Committee.)
House Bill 1059: (Rep. Robin Shackleford): In vitro fertilization is a popular option for infertile couples, and this bill would require health insurers and HMOs that offer pregnancy coverage to offer coverage for in vitro, with religious exemptions. (Referred to Insurance Committee.)
House Bill 1068 (Rep. Ronald Bacon): This bill would require a hospital to ask a patient (or patient’s representative) as soon as possible after an admission whether the patient wants to be a human organ donor. It would also designate the choice on the patient’s medical record. (Referred to Public Health Committee.)
House Bill 1153 (Rep. Dan Leonard): This bill gives more power to health care providers to use mechanical restraints on certain patients. It provides that if a patient has had at least one injury as a result of dementia or related disorder, and the injury could have been prevented if the patient had been restrained, a provider “may use mechanical restraints” on the patient. There is a list of conditions that must be met, and the bill also requires development and review of any guidelines for use of restraints.