Congress Prepares for the President’s Budget

March 24, 2022

Congress is only a couple weeks removed from passing the $1.5 trillion government spending bill but is already anticipating the official release of the President’s Fiscal 2023 Budget request next week. The release of the President’s Budget request traditionally kicks off the annual appropriations season on the Hill and although Congress ultimately decides the size and scope of the final bill, it serves as a blueprint to understand the Administration’s policy priorities. With Democrats’ human infrastructure package stalled for the time in Congress, the President’s Budget framework will help set the policy agenda for the rest of the legislative session. Lutheran Services in America will be on the look out to see how much funding the Administration is requesting for home and community-based services and workforce development.

While Congress awaits the President’s Budget framework, other major developments included:

  • The response to Russia’s invasion of Ukraine: President Biden arrived in Europe for an emergency NATO Summit and announced a new round of sanctions.
  • The Senate Judiciary Committee held the Confirmation hearing for Judge Ketanji Brown Jackson to be an Associate Justice on the U.S. Supreme Court.
  • The Administration announced that the U.S. would accept 100,000 Ukrainian refugees through family-based visas and humanitarian parole, as well as some through the U.S. refugee program
  • The Securities and Exchange Commission (SEC) proposed a rule to require companies to report on how their operations affect the climate and the formation of carbon emissions.

As Supreme Court History is Made, Democrats Plan For Another Legislative Push

April 7, 2022

On Thursday, the Senate confirmed Judge Ketanji Jackson Brown to serve as an Associate Justice on the Supreme Court. While the nation watched the historic confirmation of the first Black woman to the Supreme Court, Democrats were also preparing for another push to pass a slimmed down version of the Build Back Better Act. Democratic leaders plan to work closely with Sen. Manchin (D-WV) who has stated he is open to a smaller bill focused on raising taxes on the wealthy and large corporations to offset the cost. The current plan is for half of the money raised through such tax increases to go toward deficit reduction, and the other half to cover climate spending change programs and other social programs. No specific provisions of the legislation have been detailed, however, and significant hurdles remain, including a commitment from Sen. Manchin to support the final bill. Democrats have also not yet gained the approval of another key moderate, Sen. Kyrsten Sinema (D-AZ.)

The confirmation of Ketanji Brown Jackson received the most headlines, but other major developments included:

  • Following new evidence of war crimes committed by Russian in Ukraine, Congress passed legislation to revoke normal trade relations and ban oil imports from Russia.
  • Last Thursday, the House passed the Affordable Insulin Now Act, which would cap insulin prices at either $35 a month or 25% of an insurance plan’s negotiated price — whichever is lower.
  • On Wednesday the Senate unanimously passed the Ukraine Democracy Defense Lend-Lease Act, which would renew the World War II era Lend-Lease program and allow President Biden to more quickly send weapons and supplies to Ukraine.
  • On Wednesday the House to hold two former aides to President Donald Trump in contempt of Congress for refusing to comply with subpoenas related to the investigation into the Jan. 6, 2021, insurrection.
  • Senator Dick Durbin of Illinois and Tom Tillis of North Carolina announced they will restart negotiations to try and bring a bipartisan immigration reform bill to the floor.

Lutheran Services in America Urges CMS to Reconsider Skilled Nursing Facility Initiative

April 19, 2022

Lutheran Services in America Urges CMS to Reconsider Skilled Nursing Facility Initiative, Seeks Member Data

In response to the recently announced plan by the Centers for Medicare & Medicaid Services to establish a minimum staffing requirement that would increase staffing in skilled nursing facilities (without additional funding), along with expanded inspections and increased penalties and enforcement, Lutheran Services in America wrote a letter to CMS administrator Chiquita Brooks-LaSure outlining our concern about the lack of understanding of the workforce shortages facing skilled nursing providers and the result that older adults will not have access to the care they need. We also invited our members and their networks to participate in our advocacy campaign to Brooks-LaSure and members of Congress.

Now, as we prepare for meetings with the Biden administration and lawmakers, we are strengthening our message with more facts and data from the Lutheran Services in America network and invite our SNF members to complete our quick survey.

CMS Updates COVID-Related Rules on Vaccinations, CNA Training

On April 5, CMS issued revisions to its rule mandating COVID-19 vaccination for workers at skilled nursing facilities, stating that staff who have been suspended or are on extended leave won’t count against the providers as “unvaccinated staff.” The agency also clarified that providers who have made “good-faith efforts” to ensure all staff are vaccinated but have not achieved full compliance may receive relief in the form of less severe citations and penalties. The guidance included several examples.

Subsequently, on April 7, CMS also announced that it is restoring training requirements for nurse aides who work at skilled nursing facilities after temporarily waiving them due to COVID-19. Since March 2020, the waiver for nurse aide certifications had allowed SNFs and other nursing facilities to employ aides for longer than four months without the necessary training and certification. While some waivers will still be allowed in cases where training and testing programs are over capacity, the majority will now terminate on June 7.

Eventual End of COVID-19 Public Health Emergency Will Impact Providers, States

The U.S. Department of Health and Human Services declared COVID-19 to be a “public health emergency” (PHE) effective January 27, 2020. This declaration activated certain emergency authority measures and the Department has also subsequently issued several rules and regulations linked to the existence of a PHE. Relief legislation passed by Congress has also tied various provisions offering flexibility on Medicare and Medicaid rules to the PHE. A PHE declaration automatically expires after 90 days, but HHS has issued repeated renewals of the COVID-19 PHE, with the current declaration now running through July 15, 2022.

While the Biden administration has committed to providing states with 60 days’ notice prior to allowing the PHE to terminate, it is expected that the PHE will end at some point this calendar year. States and healthcare providers are encouraged to prepare themselves and those they serve for the consequences of the end of the PHE, so we have compiled a chart outlining the key flexibilities which are currently in effect that will come to an end when the PHE does or shortly thereafter.

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):

Member District Party Format Date & Time Link
Sen. Ron Wyden OR D Virtual (Gilliam County) Apr. 19, 11 am PT More
Sen. Ron Wyden OR D Virtual (Umatilla County) Apr. 19, 4 pm PT More
Rep. Chrissy Houlahan PA-6 D In person (Phoenixville) Apr. 19, 6:30 pm ET More
Rep. Lauren Underwood IL-14 D In person (Huntley) Apr. 19, 5:30 pm CT More
Rep. Byron Donalds FL-19 R In person (Sanibel) Apr. 19, 6 pm ET More
Rep. Elaine Luria VA-2 D In person (Virginia Beach) Apr. 19, 6:30 pm ET More
Sen. Ron Wyden OR D Virtual (Union County) Apr. 20, 10 am PT More
Sen. Ron Wyden OR D Virtual (Wallowa County) Apr. 20, 2:30 pm PT More
Rep. Derek Kilmer WA-6 D Telephone Apr. 20 More
Rep. Ayanna Pressley MA-7 D Virtual Apr. 20, 7 pm ET More
Rep. Lauren Underwood IL-14 D In person (Naperville) Apr. 20, 5:30 pm CT More
Rep. Kim Schrier WA-8 D In person (Wenatchee) Apr. 20, 5 pm PT More
Rep. Tom Cole OK-4 R Telephone Apr. 20, 6 pm CT More
Sen. Ron Wyden OR D Virtual (Morrow County) Apr. 21, 1 pm PT More
Rep. Cathy McMorris Rodgers WA-5 R Telephone April 27, 6 pm PT More