AAHD Legislative Agenda

AAHD 2022 Public Policy Priorities:

1.Expand Medicaid Home and Community Based Services (HCBS) and Address the Medicaid Institutional Bias including making Home and Community Based Services (HCBS) a mandatory Medicaid benefit and expanding & strengthening HCBS Infrastructure.

2. Provide for more comprehensive coverage through the Affordable Care Act marketplaces by doing the following:

2.1 Continue education and outreach, including supporting navigators;

2.2 Limit use of plans that do not provide comprehensive coverage, including rescinding the short-term limited duration plan and association health plan rules;

2.3 Strengthen requirements for essential health benefits (EHBs), specifically reverse ability to benchmark EHBs from another state.

2.4 Strengthen federal network adequacy standards in ACA Marketplace plans, Medicaid managed care plans including managed LTSS plans, in Medicaid HCBS programs, and Medicare Advantage plans.

3. Reduce health disparities and promote health and wellness in people with disabilities, including women’s health, access to healthcare providers and health care facilities, and training of health care providers, including maintenance of existing protections through the Americans with Disabilities Act. Support federal government efforts to identify and reduce Social Determinants of Health (SDOH) and better align federal and state health programs to reduce disparities and increase equity.

4. Support inclusive healthy communities and full accessibility, including maintenance of existing protections through the Americans with Disabilities Act.

5. Promote Quality and Performance Measurement, including appropriate self-directed, home and community-based services targeted to persons with disabilities

6. Promote Self-Management and Self-Direction in Health Promotion and Wellness

7. Expand the patient/consumer centered health (medical) home and promote the bi-directional integration of behavioral health, general health, and primary care.

8. Collect, Analyze, and Publicly Report – Appropriate agencies of the federal government in all COVID-19 testing, cases, and deaths, in all settings and by setting, should collect, analyze, and regularly publicly report COVID-19 and co-occurring demographic factors including disability status, race, ethnicity, sex, age, primary language, sexual orientation, gender identity, and socio-economic status. Ideally, the data system analysis should be able to cross-walk between these various precise demographic factors; for example, disability status and race. This COVID-19 disability status data template should serve for use in all public health and health funded programs.

Medicaid and Disability – AAHD Presentation To the CMS Administrator

On April 7, AAHD joined a by invitation CMS Administrator listening session. Available here is AAHD’s issue brief on five issues discussed by AAHD at the CMS Administrator Listening Session: (1) Medicaid Home-and-Community-Based Services (HCBS); (2)  Medicaid Home-and-Community-Based Services (HCBS) – Core Quality Measure Set (3) More Effective Coordination (Ultimately Integration) For Persons Dually Eligible for Medicare and Medicaid; (4) System Silos and Barriers To Serving Persons with Co-Occurring Conditions; and (5) Integrating Behavioral Health-General Health-Primary Care. The issue brief also identifies our work with the Lakeshore Foundation.

AAHD to/on the HHS Draft Strategic Plan:

AAHD and Lakeshore Foundation November 2021 submitted comments on the HHS draft strategic plan are here: (PDF)

The American Association on Health and Disability and the Lakeshore Foundation provide comments on the HHS draft strategic plan. Our comments are consistent with those submitted by the Consortium for Citizens with Disabilities (CCD), and we support the CCD statement. We go beyond the CCD statement detailing quality measurement approaches; focusing on the need for effective integration for persons dually eligible for Medicare and Medicaid; endorsing “bi-directional” behavioral health-general health-primary care integration; focusing on the particular and complex challenges faced by a variety of persons with co-occurring disabilities and chronic conditions; and grappling with the search for consistency in disability and related demographic data collection, analysis, and public reporting/transparency.

Barriers to Effective Treatments for Mental Illness and Substance Use Disorder:

AAHD and Lakeshore Foundation November 2021 submitted comments to the Senate Committee on Finance RFI on Mental Illness and SUD treatment are here: PDF.

AAHD, as a member, has endorsed the submitted comments of the Mental Health Liaison Group (MHLG). The Committee’s RFI has generated discussion in disability coalitions.

Our letter here addresses several issues not addressed by the MHLG – focusing on the need for effective integration for persons dually eligible for Medicare and Medicaid; endorsing “bi-directional” behavioral health-general health-primary care integration; focusing on the particular and complex challenges faced by a variety of persons with co-occurring disabilities and chronic conditions; quality measurement approaches; and, “peer support” and “community health workers” as reinforcing community supports. Our colleague organization – No Health without Mental Health (NHMH) – recently submitted comments to the Committee documenting best practices and need for revised payment policies to promote “bi-directional” behavioral health-general health-primary care integration. We signed the NHMH letter.

To identify and contact your congressional representative: click here.

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