1. Health Reform: Whats In and Whats Out re: CLAS Mara Youdelman, youdelman@healthlaw.orgyoudelman@healthlaw.org Families USA Health Action Conference January 28, 2010 Securing Health Rights for Those in Need

2. NHeLP National non-profit law firm committed to improving healthcare access and quality for low-income individuals Coordinates the National Language Access Advocacy Project, funded by The California Endowment – Includes a national coalition of stakeholders on language access working to improve polices and resources at the federal level

3. Prevention & Wellness Senate – number of references to C&L and R&E subpopulations – Pain care – Oral Health – Community Transformation grants House – Ctr. For Quality Improvement, dissemination of best practices must be done in appropriate formats/languages

4. Workforce Senate – number of references to C&L and R&E subpopulations regarding training grants for healthcare providers (primary care, dentistry, BH & MH, CHW, home health care) House – Cultural and Linguistic Competency Training for healthcare professionals Pipeline to nursing grants can include ESL classes

5. Nondiscrimination – House Includes broad nondiscrimination provision to ensure public health and healthcare and related services are provided without regard to factors that do not relate to the provision of high quality healthcare No cause of action

6. Nondiscrimination – Senate More limited provision, based on statutes in existence (inc. race, national origin, age, sex, disability) Doesnt cover religion and sexual orientation Includes cause of action

7. Office of Minority Health Senate includes reauthorization – Covers 2011-2016 – Puts in direct reporting to HHS Secretary and authorizes Deputy Asst. Sec for Minority Health – Requires creation of OMH offices in CDC, HRSA, SAMHSA, AHRQ, FDA & CMS – Raises NIH Center on minority health/health disparities to Institute

8. Language Access – The Asks Extend enhanced match from CHIP and Medicaid kids to all of Medicaid Initiate reimbursement for language services in Medicare – study & demo Require culturally and linguistically appropriate services for insurance plans participating in the Exchange To switch from VOIP to a telephone connection, call 213-286-1201, access code 435-253-182

9. Language Access – The Senate Nothing on Medicare, Medicaid Exchange req. to provide C&L only re: funding for navigators HHS to develop standards for providing summary of benefits & coverage that must consider C&L Plans must provide notice, in C&L manner, explaining appeals process

10. Language Access – The House Medicare study/demo on language access Medicaid – extends enhanced match to all of Medicaid Grants for reducing hospital readmissions – can use $ to pay for language services

11. Language Access – The House Exchange – Requires C&L appropriate communication and services – Requires plans to use plain language which includes consideration of LEP – Requires plain language and C&L appropriate for outreach/enrollment

12. Data Collection – The Asks Require all HHS programs/activities/surveys to collect r/e/l and by sufficient subpopulations for disaggregation Require collection of r/e/l in Medicare Require Medicaid to use OMB Standards Require CHIP to collect language data

13. Data Collection – Senate Includes broad data collection provision for all HHS programs/activities/surveys – Race, ethnicity, gender, geographic location, socioeconomic status (including education, employment or income), primary language, and, disability and by racial and ethnic subgroups

14. Data Collection – House Creates Asst Sec for Health IT Develop standards which should include, as appropriate, for the collection of accurate data on health and health care by race, ethnicity, primary language, sex, sexual orientation, gender identity, disability, socioeconomic status, rural, urban, or other geographic setting, and any other population or subpopulation determined appropriate by the Secretary