Editor’s Note: This information is accurate as of today, 4/28/2020. These policies are continuing to evolve at the federal level, as well as at the state levels, and they may change, so please check back here on the MomsRising blog regularly for updated information.

All policies addressing this pandemic should center the growing racial disparity in COVID-19 morbidity throughout each issue area. Shocking new data has emerged that show African American and Latinx peoples are dying at rates markedly higher than white Americans. Our elected leaders must develop and implement health equity interventions across all components of coronavirus response legislation, collect national health outcomes data by race, and ensure that all new policies urgently address these racial and ethnic disparities.

Specifically, elected leaders must:

1. Address the needs of families requiring child care, as well as the needs of early childhood educators, like child care providers;

2. Ensure all workers receive paid sick days and paid leave. The Families First Act expanded this coverage to 87 million workers, but we need to make sure everyone, regardless of the size of their employers, gets access to paid sick days and we need to make sure every working person gets access to paid medical leave too;

3. Secure health care for all those who need it, regardless of immigration status or ability to pay, and including those who are newly unemployed. This includes testing, treatment, medical exams, vaccinations, and wage replacement during isolation/quarantine. We also need to ensure that our frontline health care providers have all the assistance and medical supplies they need so they can continue showing up for us in a safe manner. Ensure that meeting health care needs does not lead to financial ruin. 

4. Continue to support and improve on the unemployment insurance (UI) system and make sure struggling families have the tools they need to make ends meet, including direct payments, nutrition assistance, UI tied to economic indicators, and a moratorium on rent/mortgage payments and utilities for those who need it;

5. Give guidance to the Edward Byrne Memorial Justice Assistance Grant and other criminal justice grants that encourage and incentivize decarceration in states by releasing from jails, prisons, and detention centers people who do not pose a public safety risk, such as families held by ICE (Immigration and Customs Enforcement), elderly people, and those housed in pre-trial detention and who are rehabilitated; 

6. Protect immigrant families;

7. Implement measures across the nation that will allow all eligible voters to cast their ballots, while prioritizing the public health of our communities.

DETAILS:

1.     Early Education and Care:

o   Protections for parents: No job loss because of lack of child care and waive child care fees for families to “save spots,” and help subsidize so providers don’t go under. Make payments to programs so they can continue to serve children when parents or caregivers experience an inability to make co-payments or pay tuition.

o   A $50 billion minimum investment in flexible funding, including but not limited to:

o   Pay providers to cover their ongoing operating costs when they are closed so their financial security – and the security of educators they employ – is not threatened. This must include centers as well as home-based providers, such as family child care homes and family, friend, and neighbor care.

o   Eliminate copayments or tuition for families during this crisis and ensure that providers are still paid the full amount for that enrolled slot.

o   Provide paid leave for educators and fund providers to fully cover this cost.

o   Find and pay for substitute educators, where needed and available.

o   Provide higher levels of compensation – hazard pay – for child care providers and educators serving children of frontline workers or operating for longer hours.

o   Help state and local agencies and organizations keep track of child care programs that are closing and those that have available slots, in order to identify child care providers that may need assistance and to match supply and demand.

o   Purchase materials for providers that cannot afford or find supplies on their own (especially sanitation supplies).

o   Provide training and medical support for child care providers on health and safety practices in response to the virus, available in all relevant languages.

o   Direct assistance to providers based on enrollment, not attendance (part of this could potentially be waiving parent fees - covering those costs).

o   Payments to programs and workers in the case of COVID-19 related closures, including back-up care.

o   Design paid leave, housing assistance, grants for small businesses, and other supports so that all child care providers, whether centers, family child care homes, or family, friend, and neighbor care providers, can participate and take advantage of the benefits.

o   Double the Child Tax Credit, which will especially help families caring for young children.

 

2.     Paid Sick Days and Paid Leave:

 As Congress begins to negotiate additional relief packages, leaders must guarantee comprehensive paid sick days and paid family and medical leave to every working person in this country during this emergency and lay the groundwork for permanent protections. Fixes needed to paid sick/paid leave laws:

o   Include private-sector employers with 500 or more employees under the emergency paid sick days and emergency paid leave provisions.

o   Prevent the DOL from excluding small businesses with fewer than 50 employees from certain emergency paid sick days requirements and the emergency paid leave provision.

o   Prevent DOL and employers from excluding health care providers and emergency responders from the emergency paid sick days and emergency paid leave provisions.

o   Expand emergency paid leave to include paid medical leave for an employee who is seriously ill with the coronavirus, and paid caregiving leave for an employee to care for a family member who is seriously ill with the coronavirus.

o   Ensure that employees receive the same wage replacement for any uses of emergency paid sick days, rather than a lower wage replacement for family caregiving.

o   Include caregiving for adults with disabilities whose personal care attendant is no longer available in the reasons employees can take emergency paid sick days and emergency paid leave.

o   Include “chosen family” in the definition of family for which employees can take emergency paid leave.

o   Include absences related to domestic violence, sexual assault, or stalking in the purposes for which employees may take emergency paid sick days.

o   Require employers of independent contractors to also provide those workers with emergency paid sick days and emergency paid leave.

o   Clarify that workers may take emergency paid sick days and emergency paid leave intermittently.

o   Clarify the definition of quarantine and self-isolation to include federal, state, and local shelter-in-place orders.

o   Clarify that employees who have already taken FMLA leave for other purposes are still eligible to receive emergency paid leave within the same year. And clarify that employees who take emergency paid leave are still eligible later in the same year to take FMLA leave for other purposes.

o   Provide additional funding to the DOL for outreach, education, and enforcement of the emergency paid sick days and emergency paid leave provisions.

o   Make the emergency paid sick days and emergency paid leave provisions permanent, as specified by the P.A.I.D. Leave Act.

o   Make accrued paid sick days permanent, as specified by the Healthy Families Act.

o   Make paid family and medical leave funded through employer and employee payroll taxes permanent, as specified in the FAMILY Act.

 

3.     Health Care:

o   Secure health care for all who need it, regardless of immigration status or ability to pay:

o   Eliminate all cost-sharing for COVID-19 testing, treatment, and a future vaccine, whether it is done at in-network providers, urgent care, or ERs, through all public and private insurers, including with short-term limited duration plans.

o   Open a special enrollment period on HealthCare.gov for everyone and fund advertising to let people know about their enrollment options during this health and economic crisis.

o   Allow for insurance premium non-payment during the crisis.

o   Ban the practice of surprise medical bills to protect families.

o   Help people who lose their jobs transition to the marketplace by increasing Affordable Care Act (ACA) premium tax credits.

o   Medicaid:

o   Temporary (Federal Medical Assistance Percentages) FMAP increase of at least 12% to ensure patients are cared for based on need and not cost, and tie the duration of the increase to state-specific economic indicators.

o   Include funding for home- and community-based services, with a focus on the home care and direct support workforce.

o   Prohibit work requirements and ban cost-sharing.

o   Allow telehealth flexibility for Medicaid beneficiaries, including mental health telephone and video calls.

o   Permit Medicaid portability to allow people’s services to move with them as needed during the pandemic (DRMA https://reaadi.com/wp-content/uploads/2019/05/DRMA-One-Pager.pdf)

o   Allow for presumptive eligibility and fast track Medicaid waivers to accommodate states with large influxes of low-income patients.

o   Disability Community and Emergency Management:

o   FEMA should increase the number of disability immigration coordinators to pre-Trump administration levels, to ensure services and supports are available to people with disabilities. (REAADI Act https://reaadi.com/what-is-reaadi/)

o   Centers for independent living and other disability community-based organizations should be eligible for funds targeting emergency services during a pandemic for service delivery. REAADI Act https://reaadi.com/what-is-reaadi/)

o   All information provided by the federal government must be provided with the necessary reasonable accommodations under law.

o   Fix the paid leave provisions in the Families First bill to cover having to step in to provide care for an adult with a disability or senior if their program closes or if their care worker is sick or unavailable.

o   Ensure people with complex medical needs and disabilities are not discriminated against in accessing medical care.

o   Prescriptions:

o   Make the future coronavirus vaccine free via preventive services coverage and to all who are uninsured.

o   Prohibit pandemic profiteering on treatments, medical supplies, and a future vaccine through anti-price-gouging measures.

o   Require all payers (Medicare, Medicaid, ERISA, non-ERISA, marketplace, VA, etc.) to cover an additional 90-day supply of all medications and supplies, including prescribed controlled substances.

o   Medication-based treatment for opioid use disorder must not be interrupted.

o   Require all payers (including Medicaid) to permit the use of mail-order pharmacies for home delivery of medications.

 

4.     Frontline and Essential Workers: Assure the safety of health care workers caring for patients with coronavirus and other essential workers (like child care workers) by requiring OSHA to issue an Emergency Temporary Standard that prescribes specific protections. There are currently little or no specific enforceable OSHA requirements to ensure that frontline health care workers and other at-risk workers are protected from coronavirus. We must protect our health care workers, child care workers, and other essential workers and assure that employers are implementing all guidance from the CDC and providing workers with the training, protective equipment, and other protective measures they need.

 

5.     Unemployment Insurance: With an estimated 20 million unemployed workers or more being laid off or furloughed by July, we need to continue to improve and strengthen our UI Insurance program. Including,

o   At least $30 billion investment for state UI administration and updating technology.

o   Set up a tiered system of UI benefits (similar to what was done during the Great Recession). Triggers should be related to the status of the economy, rather than ending on particular dates.

o   Implement structural UI reform, including mandatory 26 weeks of benefits for each state; mandatory wage replacement rates; mandatory work sharing; and fixing the Emergency Benefits program.

Expand work-sharing including:

Removing the federal cap of 60% reduction on hours for participating businesses

• Removing the 50% employer cost-share in states without work share laws to incentivize participation
• Encouraging states to expand eligibility to all businesses, regardless of the number of employees

 

6.     People Incarcerated in Jails, Prisons, and Detention Centers:

o   Give guidance to Byrne JAG and other criminal justice grants that encourage and incentivize decarceration in states by releasing from jails, prisons, and detention centers people who do not pose a public safety risk, such as families held by ICE, elderly people, and those housed in pre-trial detention and who are rehabilitated.

o   Ask prison and detention authorities to reveal what plans there are to prevent and tackle any outbreaks. Provide education and training to incarcerated people, staff, and visitors in order to inform about the risks and help them understand the measures needed to minimize risk of contracting and spreading virus.

o   Release  people in jails and detention centers who do not pose a public safety risk, such as families held by ICE, those housed in pre-trial detention, and rehabilitated people. Elderly incarcerated people often pose little public safety risk but disproportionately suffer from chronic medical conditions and thus are at the highest risk of dying from COVID-19. Many ICE detainees have no criminal records.

o   Should authorities suspect and/or confirm cases among people in detention, they must move swiftly to provide appropriate testing and health care, including:

o   Create plans to house people exposed to or infected with the virus.

o   Bar use of solitary confinement or lockdowns, which would only put more individuals at risk of mental harm or which could put incarcerated people in fear of isolation and therefore delay notification of medical staff should symptoms arise..

o   Restrict transfer and reprogramming of funds for immigration enforcement and border wall construction. No supplemental funds for ICE or CBP.

 

7.     Immigrant Families: Solutions to combat the coronavirus must include protections and programs that all families can access, regardless of immigration status. Up until this point, many immigrant families--especially mixed status families--have been left out of the health and economic policies Congress has passed. Protecting all of our families means:

o   Addressing the Health Care Needs of Immigrants:

o   Provide no-cost testing and treatment for all, including immigrant communities and ensure that testing and treatment for COVID-19 is covered under emergency Medicaid.

o   Guarantee no immigration enforcement activities at hospitals, clinics, and other sensitive locations, and suspend immigration checkpoints that interfere with border communities’ ability to access medical care.

o    Elected and health officials must ensure that communications, press statements, guidance to access essential services, and all other materials are accessible in multiple languages.

o   Effective public health responses have to include welcoming messages for EVERYONE to seek the care they need, and that means everyone regardless of immigration status, insurance coverage, or income.

o   In order to reduce the chilling effect and lift all barriers to accessing care, including fear, implementation of the public charge rule in the United States and abroad must be immediately and permanently halted.

o   Make sure immigrant families are able to access the programs needed to assist their families during an economic downturn:

o   Provide cash payments to individuals who file taxes with an ITIN and create a process for those who are not required to file taxes but are otherwise eligible.

o   Include more measures to protect workers, including automatic extension of work authorization.

 

8.     Direct Payments: Given the magnitude of the coronavirus crisis, another round of direct assistance is critical to helping families make ends meet and supporting local businesses. All children and families who meet the income guidelines should be able to gain access to the direct payments, including citizen children and ITEN filers. Congress must improve the delivery system for direct payments and offer a variety of different delivery mechanisms so non-filers can access the relief—these are some of the most at-risk people and those most in need of direct funds.

 

9.     Nutrition Needs: Guarantee that anyone who needs nutrition assistance is able to access it and increase benefits to better serve struggling families. This includes:

o   A 15% boost to the maximum benefit nationwide. This should be tied to an economic indicator, not the duration of the pandemic.

o   Raise the minimum benefit to $30/week.

o   Suspend all administrative rules pertaining to SNAP and child nutrition programs in order to remove barriers to access for those in need.

 

10.  Housing and Utilities: A moratorium on foreclosures and evictions to help renters and homeowners remain stably housed during and after a coronavirus outbreak. Provide $3 billion for the creation of an emergency assistance fund to help prevent evictions by providing short-term financial assistance and housing stabilization services, or $3 billion in additional resources for the Homeless Prevention and Rapid Rehousing Program. Issue a nationwide halt to utility shutoffs.

 

11.  Working Family Tax Credits: With projections for the unemployed reaching historic levels and estimated to go well into 2021, Congress must enact the Economic Mobility Act now, so families will have much needed additional assistance in the form of the EITC and Child Tax Credit when they file their taxes next year.

 

12.  Protect Our Democracy: Implement measures across the nation that will allow all eligible voters to cast their ballots, while prioritizing the public health of our communities.

 

13. Supporting Pregnant & Breastfeeding Families: Implement immediate Infant and Young Child Feeding (IYCF) relief for families with an emphasis on trauma-informed support by providing $10 million in additional funding for the CDC Hospitals Promoting Breastfeeding program and equipping multi-systemic emergency interventions by directing the funds as follows:

• $5M to fund a national organization that brings together a multi-sectoral coalition of organizations to work collaboratively to create a landscape of breastfeeding support across the United States, with expertise in providing capacity-building assistance to breastfeeding coalitions and organizations. 
• $2M to fund a national organization that represents the country's local health departments by providing capacity-building assistance to strengthen breastfeeding continuity of care and community support and supporting local health departments as they prepare for and recover from public health emergencies.
• $1.7M to fund a national Tribal organization that supports and represents American Indian and Alaska Native Tribes and Tribal health organizations through health and public health advocacy, policy analysis, communication, and information dissemination; training and capacity building; and research to ensure that the Tribal health system has the resources, workforce, and opportunities to provide for the optimal health of our nation's first peoples. 
• $1.3M to fund a national non-profit membership organization that provides state and national leadership on food and nutrition policy, programs, and services aimed at improving the health of our population, and whose members are public health nutritionists located throughout all 50 states, the District of Columbia, and five U.S. territories.

 

Additional critically needed actions to address infant and young child feeding in emergencies include:

• Expanding the Federal Interagency Breastfeeding Task Force to immediately include the Federal Emergency Management Agency and the CDC Infectious Disease National Centers to collaboratively address IYCF needs in the context of COVID-19.
• Enacting the Fiscal Year 2020 Department of Homeland Security appropriations directive for the Federal Emergency Management Agency to ensure breastfeeding mothers have appropriate breastfeeding services and supplies during a disaster or pandemic.
• Enacting the May 2016 World Health Assembly Resolution 12.6 related to infant and young child feeding in emergencies.

Questions? Drop us a line in the comments!