In this Policy Round-Up:
- Coming soon: Proposed rule to improve online accessibility.
- Comments due Monday: Increasing access to school-based Medicaid services: The U.S. Department of Health and Human Services and the U.S. Department of Education are working together to increase access to school-based Medicaid services for children. To that end, the following aim to reduce key administrative barriers schools face in providing these services:
- Proposed rule to increase access to school-based services for children with disabilities.
- CMS Guidance on Delivering School-Based Medicaid Services.
- EEOC Update to COVID-19 Technical Assistance.
- New CDC Indoor Air Quality Standards.
- Updates to CDC’s webpage to address the end of the public health emergency.
- Updates to CMS’ Strategic Plan Webpage.
Coming Soon: DOJ Rule to Establish Accessibility Standards for State and Local Government Online Tools
The Department of Justice (DOJ) is proposing a new rule that would establish accessibility standards for state and local governments’ web and mobile app-based services. This proposed rule will better enable state and local governments to meet their ADA obligation to provide equal access to their services, programs, and activities for people with disabilities. It suggests clear technical standards, like including text descriptions of images so people using screen readers can understand the content, providing captions on videos, and enabling navigation through use of a keyboard instead of a mouse for those with limited use of their hands. Clearer standards will both ensure that people with disabilities can access vital services and make it easier for states and localities to understand their ADA obligations. The proposed rule will be published in the Federal Register soon — we will provide more information as soon as it’s available.
Comments Due Monday: Proposed Rule to Increase Access to School-based Services for Children with Disabilities
The Department of Education is seeking input on a proposed rule that would improve access to services provided under the Individuals with Disabilities Education Act by making it easier for schools to access federal funding to pay for them.
Specifically, the proposed rule would remove the requirement for public agencies to obtain parental consent before billing Medicaid for services provided through a student’s individualized education program (IEP). No similar requirement exists for using Medicaid to pay for services provided at school to students without disabilities.
Many children with disabilities who have IEPs, which can include both education and health care related services, are also enrolled in Medicaid. The proposed rule would make it easier for schools to provide the Medicaid-covered services those students need.
It is important to note that the proposed rule does not change:
- Critical parental consent provisions required in federal education laws.
- The requirement that IEP services must be delivered at no cost to the child’s family.
- The requirement that IEP services cannot reduce other Medicaid-reimbursable services.
Comments can be submitted online until August 1.
CMS Guidance on Delivering School-based Medicaid Services
The Centers for Medicare & Medicaid Services (CMS) recently published a guide that offers new flexibilities and combines existing guidance, making it easier for all schools, no matter their size or the resources available to them, to receive payment for delivering Medicaid-covered services.
Access to school-based health care services has been shown to improve health and academic outcomes and Medicaid and CHIP provide health coverage for over half of all children in the U.S., making coverage of Medicaid and CHIP services in school an important tool to improve educational equity.
Examples of care that can be provided in schools include:
- Preventive care
- Behavioral health
- Physical and occupational therapy
- Disease management
The guide outlines important new billing flexibilities, like allowing states to provide higher fee schedule rates for services offered in schools. Providing services in schools can be more expensive than providing them in the general community, so allowing that flexibility will make it easier for schools to be able to provide services. It also covers best practices, including best practices to help states and schools enroll qualified health care providers to participate in Medicaid within school settings.
Along with the guide, CMS has released a fact sheet and an informational bulletin to help explain these new changes.
EEOC Releases Update to COVID-19 Technical Assistance
The Equal Employment Opportunity Commission (EEOC) has made a number of updates to its COVID-19 resource “What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws.” This resource helps employers, employees, and job applicants understand COVID-19-related issues that may arise in the workplace.
Key updates include:
- Clarifying that the end of the public health emergency does not mean pandemic-related reasonable accommodations can automatically terminated.
- Note, however, those accommodations may be reevaluated on an individualized basis.
- Providing common examples of possible reasonable accommodations for people with Long COVID.
- Providing tips for employers about remaining alert for COVID-related harassment of applicants or employees with a disability-related need to continue wearing a face mask or take other COVID-19 precautions at work.
New CDC Indoor Air Quality Standards
The Centers for Disease Control and Prevention (CDC) updated its COVID-19 building ventilation standards to include a specific ventilation target, an update the disability community has been advocating for throughout the pandemic.
The new standards recommend at least five air changes per hour of clean air in occupied spaces. While this change won’t eliminate risk of transmission of the virus that causes COVID-19, it will do a lot to make indoor spaces safer for people at high risk from COVID-19 and other respiratory illnesses.
CDC Updates to Address the End of the Public Health Emergency
The CDC has updated its website to address changes due to the end of the COVID-19 public health emergency (PHE).
The changes emphasize that although the PHE has ended, COVID-19 vaccines and treatments remain available. However, treatment will only remain free while supplies last. After that, the price will depend on your health insurance coverage. The end of the PHE also means insurance providers are no longer required to provide free COVID-19 tests or to waive costs for them. However, CDC does have a No Cost COVID-19 Testing Locator to help people find free testing.
The end of the PHE has also brought changes to CDC’s COVID-19 data collection and reporting. In some cases, sources of data or frequency of reporting has changed, but the CDC will continue to provide data to inform decision making, including data on:
- Hospital admissions.
- COVID-19 deaths (as a percentage of all deaths reported to the National Vital Statistics System).
- Emergency room visits with diagnosed COVID-19.
- Regional-level COVID-19 test positivity from more than 450 labs that voluntarily submit data.
- Wastewater surveillance and genomic surveillance, which allows CDC to track transmission and how the virus is mutating.
- Vaccines administered (for jurisdictions that continue to submit data).
The CDC has removed the following data with the end of the PHE:
- National, county-level test positivity data from COVID-19 Electronic Reporting (CELR).
- The V-safe tracking system for health check-ins after vaccination health check-ins.
- COVID-19 case and death data are no longer highlighted on COVID Data Tracker.
Updates to CMS’ Strategic Plan Webpage
CMS’ Strategic Plan webpage includes several updates of note:
- A new Cross Cutting Initiative (CCI): Oral Health. CMS will use this CCI to implement policy changes and consider opportunities through existing authorities to expand access to oral health coverage, including in Medicare and Medicaid.
- Updates to the Health Equity Pillar fact sheet that detail key actions undertaken by CMS centers and offices to advance health equity.
- A new fact sheet with updates to the Integrating the 3Ms (Medicare, Medicaid, and Marketplace) CCI that outlines how CMS has begun to develop approaches to promote alignment and consistency across programs.