Build Back Better continues to advance, but a number of hurdles remain.

Senate Majority Leader Charles Schumer announced he is planning to pass the Build Back Better Act before Christmas, but several hurdles remain. Senate Democrats need to come to agreement on paid family leave, immigration, and clean energy provisions to garner the 50 votes needed for passage. They also need to await a final ruling from the Parliamentarian, who will decide what provisions can be passed through the budget reconciliation process. Finally, there is likely to be a lengthy amendment process that will need to be navigated before the final vote can take place.

We continue to hear that the $150 billion for home and community-based services remains in the package for now, but Lutheran Services in America will continue to advocate to retain key provisions that would help address the acute direct care workforce shortage and expand access to home and community-based services including:

• $150 billion to incentivize states to deliver or improve home- and community-based service programs, including through increasing wages and benefits for direct care workers;
• $1 billion for a grant program funding strategies to recruit and retain direct care workers; and
• the provisions of the WORK NOW Act to create a $50 billion grant program supporting nonprofits in paying wages and benefits.

However, there are two provisions which are problematic for our members providing skilled nursing services which we’re asking Senators to oppose and remove:

•  Mandating a registered nurse on staff 24 hours a day at skilled nursing facilities (from 8 hours/day), a late addition to the House bill and one that doesn’t include additional funding
• Requiring a three-year study of minimum skilled nursing staff levels and that the minimums be met within one year and without additional funding  Please join us in raising our voice to Senators on these issues through our advocacy alert.

CMS Vaccine Mandate Temporarily Halted Nationwide by Courts

On Tuesday, November 30, the U.S. District Court for the Western District of Louisiana granted a preliminary injunction effectively preventing the Centers for Medicare & Medicaid Services (CMS) from enforcing its vaccine mandate rule nationwide.  While the Court’s ruling was based on a lawsuit brought by only 14 states, given the scope of the mandate and the previous injunction granted Monday, November 29, by another District Court preventing enforcement in 10 other states, the Louisiana court indicated that its ruling would cover all remaining states not already under the previous injunction “due to the need for uniformity.”

While the Biden Administration has indicated that it plans to appeal the rulings, as of now, CMS is prevented from requiring compliance with the vaccination mandate’s Dec. 6 deadline for most healthcare workers to have first round shots completed. The final deadline for full vaccinations was set at Jan. 4.

This court ruling follows a three-state (Kentucky, Ohio, and Tennessee) injunction against enforcement of a vaccine mandate for federal contractors and a nationwide injunction on enforcement of the similar mandateissued by The Occupational Safety and Health Administration (OSHA.)  Lutheran Services in America has submitted commentson the OSHA mandate. 

Lutheran Services in America has prepared a summaryof the CMS rule, and will be submitting commentsto CMS sharing questions and concerns from our network members.

 If you have questions about either mandate, please e-mail Sarah Dobson at sdobson@lutheranservices.org and Josh Dubensky at jdubensky@lutheranservices.org.