Policy & Advocacy Newsletter – January 2022

On January 10, California Governor Newsom presented his preliminary FY2022-23 state budget plan. As is customary, Momentum staff and disability stakeholders throughout the state are reviewing it to assess its impact on people with disabilities and providers of disability supports are developing an advocacy plan to work for a spending plan that supports quality, honors choice, and creates sustainable service rates

What is not customary is the policy landscape in which this budget has been released. The Federal Government recently approved California’s request to significantly expand CalAIM, the state’s Medicaid managed care plan, as well as approve a $3 billion spending plan to address Home and Community-Based Services (HCBS) needs related to the COVID-19 pandemic. In addition, the federal HCBS settings rule must be fully implemented by states in 14 months.

With all this activity, it has never been more important for all stakeholders to stay informed on program changes and opportunities that impact people with disabilities. I strongly encourage you to take advantage of the free webinars found in this newsletter to learn more about the disability policy initiatives that will be rolled out in 2022. 

And visit Momentum’s Voter Voice advocacy page to add your voice to our collective efforts to positively impact disability policy at the local, state, and federal levels.  

Lori Anderson, President and CEO

Momentum’s VoterVoice Advocacy Center

Advocacy Contacts

Governor Gavin Newsom
Phone: (916) 445-2841
Fax: (916) 558-3160

Internet Contact Form Access – Here

Twitters: @GavinNewsom
@CAgovernor

Find Your Representatives
Use the links below to identify your representatives and let your opinion be heard.

U.S. House of Representatives

U.S. Senate

California State Legislature

National News

U.S. Administration for Community Living Announces Webinar to Provide Status on Home and Community-Based Services Settings Rule

The U.S. Administration for Community Living (ACL) and Centers for Medicare and Medicaid Services (CMS) are inviting people with disabilities, their families, and advocates to a webinar in the Promising Practices Series titled The Home and Community-Based Services Settings Regulation: Where Are We Now and Where Are We Going. The free webinar will be held on Thursday, January 27 from 1:00 PM PST – 2:30 PM PST.

The Home and Community-Based Services (HCBS) settings rule is a result of a 2014 CMS directive that requires HCBS to prioritize person-centered supports including, but not limited to, residential, employment and day services, and is intended to ensure individuals receiving services through Medicaid-funded programs have full access to the benefits of community living in the most integrated settings. After several extensions, the HCBS settings rule must be fully implemented by March 17, 2023.

This webinar will include an overview of the criteria for home and community-based settings and the heightened scrutiny process, as well as what is required of states to comply with the rule. It will also explore how ACL and CMS are collaborating to ensure successful implementation of the rule and how ACL is supporting our networks and encouraging engagement as states work toward implementation and beyond.

The presentation will be led by Alison Barkoff, Principal Deputy Administrator of the ACL, and Melissa Harris, Deputy Director, Division of Long-Term Services and Supports, for the Disabled and Elderly Health Programs Group at CMS. Click here to register for the free webinar. 

On January 12, 2022, CMS released the Medicaid LTSS Annual Expenditures Report for Federal Fiscal Year (FFY) 2019. This report discusses the LTSS rebalancing trends and growth in expenditures for home and community-based services as compared to institutional spending during the period reviewed. 

Internal Revenue Service Announces Increase in CalABLE Account Limits

The U.S. Internal Revenue Service (IRS) has announced that the federal gift tax exclusion has increased from $15,000 to $16,000 annually for CalABLE accounts. The increase in the contribution for CalABLE accounts, a savings vehicle for Californians with disabilities, is the first since 2018 and is a result of the current rate of inflation.

CalABLE accounts, which were created under a 2014 law, allow individuals with disabilities to save up to $100,000 without risking eligibility for Social Security and other government benefits. Medicaid can be retained no matter how much is in the accounts.

Interest earned on funds in ABLE accounts is tax-free and money saved can be used to pay for qualified disability expenses including education, health care, transportation, and housing. Annual deposits in ABLE accounts are generally limited to the value of the IRS’s gift tax exclusion.

However, people with disabilities who are employed can also save some of their earnings in the accounts above and beyond the gift tax amount. For people in California, that means up to an additional $12,880 this year. To be eligible for the accounts, individuals must have a disability that occurred before age 26. To learn more about CalABLE accounts visit CalABLE.ca.gov.

HHS Extends the COVID Public Health Emergency 

U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra announced an extension of the public health emergency (PHE) declaration, which was set to expire on January 16, 2022. This extension is effective for another 90 days from the announcement on January 14.

The extension of the PHE extends the availability of the 6% federal matching rate increase to certain state Medicaid programs authorized by the Families First Coronavirus Response Act (FFCRA). The temporary matching increase is the federal share of Medicaid supports in California and all other states. The FFCRA states that the 6% Federal Medical Assistance Percentage (FMAP) increase is available through the last day of the calendar quarter in which the PHE is declared. With the latest 90-day extension of the PHE, the 6% FAMP increase is available until June 30, 2022.

CMS Approves California Waiver Expanding Scope of CalAIM

On December 29, 2021, the Centers for Medicare and Medicaid Services (CMS) approved the California Department of Health Care Services’s (DHCS) request for a five-year extension of its Medicaid section 1115 demonstration and a five-year extension of its Medicaid managed care section 1915(b) waiver. 

The stated intentions of the approved waiver provisions, named “California Advancing and Innovating Medi-Cal” (CalAIM), are expansion of home and community-based services (HCBS) for underserved communities and improved access to care for vulnerable Californians, including those with disabilities.

CalAIM will provide $4.3 billion in total funding for the state’s HCBS program with the stated goal of reducing the likelihood of service disruptions for people who need HCBS to stay healthy and safe. The CalAIM managed care 1915(b) waiver attempts to improve network adequacy and strengthen access to medically necessary services including primary care services, specialty care, and behavioral health services. The goal of these initiatives is to yield greater accountability, improve data, and expand transparency around network adequacy and timely access.

Stakeholders in the California disability support system will be following the full implementation of the CalAIM waiver to advocate for a system that honors choice and establishes rates that allow for high quality and responsive services and supports. You can learn about opportunities for advocacy engagement in CalAIM implementation in future newsletters.

California to Receive $3 Billion Additional Federal Funds Under the American Rescue Plan Act

On January 4, 2022, the Centers for Medicare and Medicaid Services (CMS) approved on a conditional basis California’s Home and Community-Based Services (HCBS) Spending Plan, as revised on October 27, 2021. The revised HCBS spending plan provides a blueprint for the $3 billion California will receive from the federal government that was authorized under the federal American Rescue Plan Act (ARPA), one of several bills passed by Congress to address the COVID-19 pandemic.  

The HCBS Spending Plan includes initiatives that cover several health and human services departments, including people receiving services and supports under the California Department of Aging (CDA), Department of Developmental Services (DDS), California Department of Social Services (CDSS), Department of Rehabilitation (DOR), and Department of Health Care Services (DHCS). Funding for the HCBS Spending Plan for California and all the other states is one-time additional funding. States can choose to continue certain initiatives in their HCBS Spending Plans with their own state funding – that could be matched by their normal level of Medicaid matching funds. 

The California spending plan covers five broad categories of disability services supporting 28 unique initiatives, many of which were included in the state FY 2021-2022 budget. The five functional areas include retention and building a network of HCBS direct care workforce, HCBS navigation, HCBS transitions, enhancing HCBS capacity and models of care, and HCBS infrastructure and support.

Advocacy Events

White House Office of Public Engagement, Disabled Stakeholder Call February 17, 2022, at 11:00 am PST

All people with disabilities, their families, and advocates are invited to join Emily Voorde, the White House Liaison to Disabled Americans, for a 30-minute community update call. This call is open registration, closed to the press, and will provide updates for the disability community. Click here to register for this free call.

2022 Disability Policy Seminar, March 28–30, 2022, at the Renaissance Downtown Hotel, Washington, D.C.

Registration has opened for the 2022 Disability Policy Seminar, an annual three-day federal legislative conference. This year, the conference will be a hybrid event providing attendees with the option of participating in person in Washington, DC or online.

The conference, sponsored in part by United Cerebral Palsy, strengthens federal disability advocacy efforts by having people from across the country come to Washington, DC to receive training and updates and visit their Members of Congress. The Disability Policy Seminar promotes unity and movement building and amplifies the concerns of people with IDD before Congress. For more information on the conference and to register click here.

National Council on Disability Quarterly Meeting January 27, 2022, 9:00 am to 1:00 pm, PST via Zoom

The agenda for the National Council on Disability (NCD) meeting includes a public comment period exclusively designated for receiving information for NCDs upcoming project that examines the state of the nation’s home and community-based services (HCBS) prior to and during the COVID-19 pandemic. Click here to register for this free online event.

California Virtual Developmental Disabilities Public Policy Conference, April 26–28, 2022

The 15th annual Developmental Disabilities Public Policy Conference, “Back to Our Future,” will refocus the disability advocacy community beyond the pandemic and back to the opportunities and important decisions ahead. 

The conference is presented by The Arc of California, Easterseals and United Cerebral Palsy and features nationally known speakers who have been trailblazers for promoting policies that improve the disability system — enabling people with I/DD to live inclusively in their communities.