Category: Advocacy

On Thursday, President Biden signed into law the most recent broad COVID relief legislative package, known as the “American Rescue Plan.”  While the legislation does not fully address our key priorities, it does improve on previous law, and includes a number of provisions that will impact our member network which we have outlined below. Significantly, the law expands eligibility for the Paycheck Protection Program to organizations with 500 or more employees across multiple locations, but with no more than 500 employees at a single one of those locations. Applications must be submitted to lenders by March 31.

Key Provisions of H.R. 1319

Paycheck Protection Program

• Additional funding of $7.25 billion, increasing the total program level to $813.7 billion.
• The program is still set to expire on March 31.
• Eligibility expanded to nonprofit organizations with 500 or more employees across multiple locations, but with no more than 500 employees at a single one of those locations.
  • If your organization will only become eligible under this expansion, it is especially important to prepare immediately to be able to apply quickly, given the short timeframe between enactment of the law and the program’s expiration.
  • The Small Business Administration which runs this program has not yet indicated whether there will be a new or different application form or additional required supporting documents for this new group of eligible applicants, so we recommend you review the current application form and related information, available on our website and on the SBA website, and that you talk with your lender.
• Other loan types still available:
• “First Draw” loans for entities with fewer than 500 employees total who have not already received funding
• “Second Draw” loans for entities that:
  • have already received and spent an initial PPP loan
  • have no more than 300 employees, and
  • can demonstrate a 25% reduction in gross receipts.
• For more information about this program and application requirements, including possible required documentation, please check our website and contact your lender.

Unemployment Insurance Relief for Reimbursing Employers

• Extends the subsidy for costs incurred by employers who provide unemployment benefits on a reimbursable basis, rather than via tax contributions, through September 6, 2021.
• Increases the subsidy from 50% to 75% for weeks beginning after March 31.

Payments to Rural Medicare or Medicaid Providers

• $8.5 billion for payments to rural Medicare or Medicaid providers who provide diagnoses, testing, or care for individuals with possible or actual cases of COVID–19, for health care related expenses and lost revenues that are attributable to COVID–19 and are not otherwise reimbursable.
• We anticipate further details about this funding once the Department of Health and Human Services begins shaping the program.

FMAP Increase for HCBS

• A one-year increase of 10% of the Federal Medical Assistance Percentage (FMAP) for Medicaid providers for home and community-based services (HCBS) for states that implement one or more activities to enhance, expand or strengthen these services.  (We anticipate that CMS will determine what these activities are.) This is an increase from the 7.35% from the original bill.
• This is in addition to the 6.2% FMAP increase for Medicaid overall which will continue through the public health emergency.

Skilled Nursing Facility Support

• $200 million for Quality Improvement Organizations to provide support with infection control and vaccine uptake.
• $250 million for allocation among the states to establish strike teams that will be deployed to skilled nursing facilities with diagnosed or suspected cases of COVID–19 among residents or staff for the purposes of assisting with clinical care, infection control, or staffing.

Older Americans Act Programs

• An additional $1.4 billion including $460 million for efforts related to vaccination outreach and prevention and mitigation activities related to COVID–19 focused on addressing extended social isolation among older individuals.

Medicaid Expansion Incentive

• A 5% base FMAP rate increase for two years to states who had not previously expanded Medicaid under the Affordable Care Act but do so now.

Housing

• $21.55 billion more for the emergency rental assistance program originally authorized in the Consolidated Appropriations Act of 2021 in December.
• $5 billion in homeless assistance and supportive services funding that will flow through the HOME Investment Partnerships program to states and localities.

Child Care Stabilization

• $24 billion to Child Care and Development Block lead agencies, to award subgrants to qualified child care providers that are either open and available to provide services or closed for reasons related to COVID19.

State, Local, and Tribal Government Support

• $362 billion to be used for responding to the COVID-19 public health emergency, to offset revenue losses, bolster economic recovery and to provide premium pay for essential workers.
  • Among the allowable uses of these funds, up to $13 per hour extra may be paid to workers “needed to maintain continuity of operations of essential critical infrastructure sectors and additional sectors” as designated by a governor or tribal government.
  • We anticipate further details about this program will be forthcoming once states begin shaping their own programs.

Expanded Unemployment Benefits

• Benefits extended through September 6, 2021, with an additional weekly payment of $300 (reduced from the $400 in the original version of the bill.)

Not Included in this Legislation

• A phased increase in the federal minimum wage from the current $7.25 per hour to $15 per hour by 2025.

Additional Resources

• Legislative summaries of the law:
  • Section-by-section
  • Changes from the original House version
• Link to bill itself
• As more information about the rollout of these provisions becomes available, we will share it on our website.

Lutheran Services in America appreciates our members’ work on the frontlines of the pandemic caring for people while taking extraordinary steps to protect their staff and people served. We intend to continue our aggressive call for additional Congressional legislation to support members’ business continuity and services during this difficult time.

Join us to ensure our faith-based advocacy voice is heard by lawmakers. Your voice is more important now than ever before.

By Sarah Dobson, Director of Public Policy and Advocacy

Following President Biden’s decision to end on-going discussions with Senator Shelley Moore Capito (R-WV) aimed at crafting a bipartisan Senate proposal to move forward his infrastructure proposal (the American Jobs Plan), he continues to eye bipartisan alternatives even as House and Senate Democratic leaders prepare their own version of the package that would need to pass via the budget reconciliation process.

Fundamental disagreements remain between the President and Republicans on the scope and size of the package, as well as how to pay for it. While a group of five Republican and five Democratic Senate centrists have offered a $1 trillion alternative, it would need the support of both Senate Majority Leader Chuck Schumer and Minority Leader Mitch McConnell, and they have not indicated that at this time.

In the evenly split Senate, key to success in passing any package are the votes of moderate Democrats Joe Manchin (WV) and Kyrsten Sinema (AZ), who continue to support a centrist, bipartisan package and have expressed reluctance to back a reconciliation bill, which would require the support of all 50 Democrats. While the President has made concessions on his desire to raise the corporate tax rate to pay for the package, he does not appear to have agreed to reduce or eliminate the major $400 billion investment in home and community-based services (HCBS) for aging adults and persons with disabilities included in his original proposal.  However, due to the size of the investment, the provision could still be scaled back or eliminated.

Lutheran Services in America has been advocating in support of key provisions of the American Jobs Plan, particularly the $400 billion HCBS investment and a provision for $213 billion for affordable housing and homelessness services, and is urging the inclusion of the WORK NOW Act legislation (S. 740) to provide nonprofit health and human services organizations funding to pay wages, salaries, and benefits to retain staff and meet services’ demand.

Join us in this effort through our advocacy alert calling for inclusion of these key initiatives in the package.

By Sarah Dobson, Director of Public Policy and Advocacy

Senate Passes Traditional Infrastructure Bill, Budget Resolution

On Tuesday, the Senate completed its consideration of the $550 billion “traditional infrastructure” legislation that a bipartisan group of senators negotiated for weeks, passing the bill on a bipartisan vote of 69 to 30. The final version totaled $29 billion lower than the version originally negotiated in June.

Senators next turned their attention to the budget resolution, passing the bill Wednesday through a party-line vote of 50 to 49, as expected, before adjourning for the August recess. The resolution contains topline dollar figures and instructions for the $3.5 trillion reconciliation package to follow. That bill will enact many of the “human infrastructure” provisions included in President Biden’s American Jobs Plan and American Families Plan, including the proposed expansion of home- and community-based services (HCBS) with $400 billion in funding. Under the reconciliation procedure, the success of the vote depends on the support of all 50 Democrats; Sens. Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ) continue to state that they will not support the package at its current cost, so negotiations continue on the content of the package.

The House, which had already adjourned for its August recess, now plans to return on August 23 to pass the budget resolution. Both chambers will wait until the fall for consideration of the “human infrastructure” package itself. The House will also wait until the fall to move forward on the traditional infrastructure bill.

Federal Reserve Seeks Input on Pandemic Impacts on Nonprofits, Communities

The Federal Reserve is conducting a broad survey—closing August 24—of the pandemic’s impacts on nonprofits and the communities they serve, both nationwide and in the individual states. This will likely be the most comprehensive national survey of its kind conducted by a government entity. The results will be a powerful advocacy tool for nonprofits like our network in informing policymakers at every level of government about the challenges faced this past year and a half and helping secure further financial relief. The survey should take no more than 15 minutes to complete.

Federal Agencies Issue Guidance on “Long COVID” and Disability Rights

The Office for Civil Rights of the Department of Health and Human Services and the Civil Rights Division of the Department of Justice issued new guidance on July 26, explaining that “Long COVID” can be a disability under Titles II (state and local government) and III (public accommodations) of the Americans with Disabilities Act, Section 504 of the Rehabilitation Act of 1973, and Section 1557 of the Patient Protection and Affordable Care Act. The Department of Labor also has guidance for employers and employees related to Long COVID, given that people with disabilities due to Long COVID may be eligible for temporary or permanent accommodations in the workplace (if they have the required level of impairment.)

According to the CDC, people with long COVID have a range of new or ongoing symptoms that can last weeks or months after they are infected with the virus that causes COVID-19 and that can worsen with physical or mental activity. An individualized assessment is necessary to determine whether a specific person’s long COVID condition or any of its symptoms substantially limits a major life activity. A specific diagnosis is not needed to qualify for the protections offered by law. What is important is that a physical or mental impairment of a certain severity exists. The Equal Employment Opportunity Commission offers information on the impact of COVID-19 for employers on its website, while the Department of Labor funds the Job Accommodation Network website (askjan.org) which offers additional information for both employers and employees on this issue.

New PPP Portal Launched in Effort to Finish Loan Forgiveness

The Small Business Administration (SBA) launched a new forgiveness portal on its website where borrowers of $150,000 or less from the Paycheck Protection Program (PPP) whose lenders are participating are able to apply directly for loan forgiveness, rather than having to begin the process with their lenders. While lending institutions will still have a say in whether specific loans should be forgiven, the intent of the program is to reduce the time and effort needed for the process; the SBA estimates that the new application will take borrowers just a few minutes to complete. The SBA has also lifted the requirement for certain borrowers who received second PPP loans of $150,000 or less that documentation proving a 25 percent revenue reduction in 2020 be supplied.

By Sarah Dobson, Director of Public Policy and Advocacy

On Tuesday, as part of a larger piece of legislation, the House approved the budget resolution that will enable lawmakers to move forward with writing the broad “human infrastructure” package to enact much of President Biden’s American Jobs and American Families Plans. The 220–212 party-line vote came after days of delays, with a small group of moderate Democrats threatening to vote against the budget resolution if the House did not first vote on the traditional infrastructure package passed by the Senate earlier this month. House Speaker Nancy Pelosi (D-CA) ultimately brokered a compromise including a commitment that the House would consider the infrastructure bill by September 27, following passage of the budget resolution and substantive work on the human infrastructure package itself. That legislative package, which will need to pass the Senate with just the votes of the 50 Democratic senators under the “budget reconciliation” process, is expected to include the proposed expansion of home- and community-based services (HCBS) with $400 billion in funding and currently has an overall cost of $3.5 billion. However, because Sens. Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ) continue to state that they will not support the package at its current cost, negotiations continue on the cost and content of the package. Finalizing the bill is expected to take several more weeks at least.

Lutheran Services in America continues to advocate for the inclusion of key provisions of the President’s proposals in the reconciliation package, particularly the $400 billion HCBS investment (which is outlined in the Better Care Better Jobs Act, S. 2210/H.R. 4131) and a provision for $213 billion for affordable housing and homelessness services, and is urging the inclusion of the WORK NOW Act legislation (S. 740) to provide nonprofit health and human services organizations funding to pay wages, salaries, and benefits to retain staff and meet services’ demand. Please join us in this effort through our advocacy alert calling for inclusion of these key initiatives in the package.

By Sarah Dobson, Director of Public Policy and Advocacy

As part of our mission to transform lives, our network is committed to honoring all with dignity and respect, recognizing the diversity of people and communities. We uphold this principle for everyone in this country, no matter their background. It should then come as no surprise that Lutheran Services in America members have been actively engaged in the humanitarian effort to resettle refugees from Afghanistan here in the United States following our nation’s withdrawal.

Ascentria Care Alliance in Worcester, Massachusetts, is focused on assisting Afghan families by expanding access to housing and affordable legal assistance and providing living essentials. With the help of the local community, Ascentria aims at resettling families across Massachusetts and New Hampshire.

As part of its effort to help evacuees, Ascentria is calling on Gov. Charlie Baker and state lawmakers to make funds from the American Rescue Plan and the state’s budget surplus available for allocation toward services for Afghans seeking relocation. Current funds from the federal government are not enough to completely cover the cost of resettlement in Massachusetts where affordable housing is harder to come by, said Aimee Mitchell, chief of community service for Ascentria, in an interview with NBC Boston.

Ascentria has successfully resettled 330 refugees from Afghanistan over the past seven years. We applaud the team at Ascentria for their conviction—their commitment is needed now more than ever.

Ascentria Care Alliance is a member of Lutheran Services in America, a network of 300 health and human service organizations located in more than 1,400 communities across the United States. Together, the network makes a difference in the lives of one in 50 Americans every year.

Learn more about Ascentria Care Alliance and help support their efforts.

Following the approval by the House of Representatives in late August of the budget resolution containing instructions for writing the broad “human infrastructure” package to enact much of President Biden’s American Jobs and American Families Plans, the various House committees with jurisdiction over portions of the package have moved forward with crafting legislative language, in conjunction with their Senate counterparts. Numerous committees have held sessions this week to consider parts of the bill. A highlight for our network in the legislation in its current form is $1.48 billion to fund strategies to recruit and retain direct care workers, including raising wages and creating training opportunities to help address the direct care workforce shortage. Nonprofits “with experience in aging, disability, supporting the rights and interests of direct care workers, or training or educating direct care workers” would be eligible for the funding.

Democratic party leaders continue to express optimism that the House will vote on a package the last week of September, with relatively quick Senate approval to follow, but the process remains complicated by the continued disagreement within the party on what the final cost of the package should be, and what should be included. Notably, Sens. Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ) continue to state that they will not support the package at its current cost.

We continue to advocate in support of key provisions of the President’s proposals, particularly the $400 billion HCBS investment and a provision for $213 billion for affordable housing and homelessness services, and are urging the inclusion of the WORK NOW Act legislation to provide nonprofit health and human services organizations funding to pay wages, salaries, and benefits to retain staff and meet services’ demand. Please join us in this effort through our advocacy alert calling for inclusion of these key initiatives in the package.

By Sarah Dobson, Director of Public Policy and Advocacy

Congressional Committees Move Forward with Drafting “Human Infrastructure” Package, Path to Passage Remains Challenging

Congressional committees have moved forward with crafting legislative language for the broad “human infrastructure” package. Democratic party leaders are optimistic that the House will vote on a package the last week of September, with relatively quick Senate approval to follow, but the process remains complicated due to continued disagreement within the party on the final cost of the package and what should be included.

A highlight for our network in the legislation in its current form is $1.48 billion to fund strategies to recruit and retain direct care workers, including raising wages and creating training opportunities to help address the direct care workforce shortage. A $190 billion investment in home- and community-based services is also included, falling short of the $400 billion proposed by the President. Congressional champions are continuing to fight for an increase in this funding, and Lutheran Services in America continues to advocate for the higher amount.

Please join us in this effort through our advocacy alert.

HHS to Release Additional $25.5 Billion in COVID-19 Provider Funding

The Department of Health and Human Services announced it will be making available to health care providers affected by the COVID-19 pandemic an additional $25.5 billion: $8.5 billion in American Rescue Plan (ARP) resources for providers who serve rural Medicaid, Children’s Health Insurance Program (CHIP) or Medicare patients, and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document revenue loss and expenses associated with the pandemic. The application portal will open on September 29.

To expedite the application process, providers will apply for both programs in a single application. PRF Phase 4 payments will be based on providers’ lost revenues and expenditures between July 1, 2020, and March 31, 2021. Additionally, PRF Phase 4 will reimburse smaller providers at a higher rate compared to larger providers and will include bonus payments for providers who serve Medicaid, CHIP, and/or Medicare patients. Lutheran Services in America will provide more information, as well as a link to the portal, when it is created.

Biden Administration Expands Proposed Vaccination Mandate to Cover All Medicare/Medicaid Health Care Facilities

The Biden Administration on September 9 announced that previously announced proposed emergency regulations requiring COVID-19 vaccinations for nursing home workers will be expanded to cover all staff within any Medicare- or Medicaid-certified facility. This includes hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others. The Centers for Medicare and Medicaid Services (CMS) is developing an Interim Final Rule and expects to publish it in October with a Public Comment Period. Lutheran Services in America is seeking additional feedback opportunities for affected providers like our members and will issue updates as we receive them, along with more information about how to comment when the rule is published.

Upcoming Congressional Town Hall Meetings

Members of Congress continue to hold virtual town hall meetings to address constituent concerns about coronavirus relief. Here is a look at upcoming sessions (click links below to find out how to join):

By Sarah Dobson, Director of Public Policy and Advocacy

Congress Continues to Finalize “Human Infrastructure” Package, Path to Passage Remains Challenging

Congressional leaders in both the House and the Senate continue their efforts to finalize the broad “human infrastructure” package they will consider under the budget reconciliation process. Democratic party leaders hope to be able to hold a House vote on the package as soon as possible, with relatively quick Senate approval to follow, but the process remains complicated due to continued disagreement within the party on the final cost of the package and what should be included, and the timeline for final passage remains unclear.

Given the ongoing, acute workforce shortage, several provisions which are currently included or are being considered for the package that would help address this crisis are especially important. Lutheran Services in America continues to advocate for the following:

• full funding of the provision permanently incentivizing states to deliver or improve home- and community-based service programs, including through increasing wages and benefits for direct care workers;
• $1.48 billion for a grant program funding strategies to recruit and retain direct care workers; and
• including the provisions of the WORK NOW Act to create a $50 billion grant program supporting nonprofits in paying wages and benefits.

Please join us in this effort through our advocacy alert.

Phase 4 Provider Relief Fund General Distribution and American Rescue Plan Rural Payments Available

The U.S. Department of Health and Human Services (HHS) has announced $25.5 billion in new funding for health care providers impacted by the COVID-19 pandemic. This includes $17 billion in Provider Relief Fund Phase 4 funding for providers who have experienced changes in operating revenues and expenses, as well as $8.5 billion in American Rescue Plan Rural funding for providers who provide Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) services to rural beneficiaries. PRF Phase 4 payments will be based on providers’ lost revenues and expenditures between July 1, 2020, and March 31, 2021. ARP rural payments will be made to providers based on the amount of Medicaid, CHIP and/or Medicare services they provide to patients who live in rural areas as defined by the HHS Federal Office of Rural Health Policy.

Providers may apply for both programs via a single application on the Provider Relief Fund Application and Attestation Portal that opened September 29 through the final deadline of October 26. Read more.

By Sarah Dobson, Director of Public Policy and Advocacy

As I talk with member CEOs across the country, I often hear about acute workforce shortages.

This is not new. But there’s a heightened sense of urgency for many whose direct care workforce shortages are worse now than before—or even during—the height of the pandemic.

CEOs often cite low government reimbursement rates that keep direct care wages low and their concern that policymakers don’t understand the extent of the workforce crisis or the implications for the health and well-being of the one in 50 Americans we care for.

There are two key aspects of the broad “budget reconciliation” bill that is currently being finalized by House lawmakers that relate to workforce:

• $190 billion in home and community-based services for older adults and people with disabilities that includes provisions to increase wages and benefits for direct care workers
• $1.48 billion to fund grants to entities including nonprofits with experience in aging and disability to recruit and retain direct care workers including raising wages and creating training opportunities to address the direct care workforce shortage

In addition, the WORK NOW Act would provide a $50 billion grant program to provide funding for nonprofit health and human services organizations to pay wages, salaries and benefits to retain staff and meet the greatest demand for services.

These provisions won’t solve the workforce crisis. But they provide funding for the workforce and a recognition of the importance of the workforce and connection to government reimbursement rates.

As a faith-based network, our voice, which places people at the center of our advocacy, is an important voice in Washington—one that’s needed now more than ever. With support, we can ensure that the provisions are included in the budget reconciliation package and make a significant difference across the country.

Join us now by sending a message to Congress through our quick and easy advocacy tool.

By Charlotte Haberaecker, President and CEO

Congress Postpones Debt Ceiling Fight, Focuses on Finalizing “Human Infrastructure” Package

Following final Congressional passage earlier this week of a compromise bill increasing the federal debt ceiling until December 3, which President Biden signed Thursday night, lawmakers’ focus again returns to negotiating the final “human infrastructure” package.  Despite pressure from the White House and Congressional leadership, the path to passage remains uncertain. Continued disagreement within the Democratic party over the final cost of the package, what programs should be included, and how long those programs should last remains the primary stumbling block. Lutheran Services in America continues to advocate for key provisions that would help address the acute workforce shortage and expand access to home- and community-based services. Specifically, we are advocating for a final package that includes:

• $250 billion to incentivize states to deliver or improve home- and community-based service programs, including through increasing wages and benefits for direct care workers;
• $1.48 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.

Please join us in this effort through our advocacy alert.

CMS and OSHA Vaccine Rules Expected to be Released By the End of the Month

Following the Biden administration’s September 9 update that previously announced proposed emergency regulations requiring COVID-19 vaccinations for nursing home workers will be expanded to cover all staff within any Medicare- or Medicaid-certified facility, the Centers for Medicare and Medicaid Services (CMS) is developing an Interim Final Rule. Separately, the Department of Labor’s Occupational Safety and Health Administration (OSHA) is also developing a rule that will require all employers with 100 or more employees to ensure their workforce is fully vaccinated or require any workers who remain unvaccinated to produce a negative test result on at least a weekly basis before coming to work. Specific details on implementation and exactly which employees will be subject to the rules will not be available until the regulations are officially released, which is expected by late October. Lutheran Services in America is sharing feedback from our members with these agencies as the rules are being developed, and will issue updates as we receive them, along with more information about any public comment periods.

By Sarah Dobson, Senior Director of Public Policy and Advocacy, and Josh Dubensky, Director of Public Policy and Advocacy for the Lutheran Services in America Disability Network