The Health Center Funding Cliff: What YOU Can Do to Ensure Congress Acts to Fix the Cliff

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2 The Health Center Funding Cliff: What YOU Can Do to Ensure Congress Acts to Fix the Cliff Amanda Pears Kelly Director of National Advocacy & Civic Engagement National Association of Community Health Centers December 6, 2014

3 HEALTH CENTER FUNDING - A QUICK REFRESHER -

4 Health Center Funding Under the Affordable Care Act The Affordable Care Act (ACA) envisioned CHCs serving as health homes for millions of the newly insured. The ACA provided $11 billion in dedicated mandatory funding (the Health Center Fund) for health center operations and capital for FY 2011 FY $9.5 billion to support health center operations. $1.5 billion for capital needs. Mandatory funding provided through the Health Center Fund ends after FY2015.

5 ACA Planned Funding for Health Centers & Estimated New Patients* Funding in Billions Health Reform Implementation Begins Sources: Data for federally-funded health centers only. FY00-08 are from HRSA s Uniform Data System. FY09-15 are NACHC projected estimates based on new federal funding. NACHC estimates future health center patients as a function of new federal funding. Note: Other factors are difficult to predict and include payer mix, growth in non-federal grant sources, and the costs of care, which may be related to new patients having unmet health needs. Patient growth will be contingent on continuation of federal, state, and local support over the period. * Prior to FY2011 $600 million reduction,

6 FY2015 Appropriations Ask $5.1 billion in total funding - $1.5 billion in discretionary funding (level funding) - $3.6 billion in mandatory funding from the Health Center Fund = capacity to care for 11 million new patients

7 HEALTH CENTER FUNDING STREAMS DISCRETIONARY Annual, up to Congress to determine amount Prior to ACA, the only funding for CHC program Cut in 2011, backfilled with mandatory funds Currently $1.5 billion (FY14) MANDATORY Required spending, unless Congress changes the law Special 5-year Trust Fund created in ACA to boost Health Center Capacity Currently 2.2 billion (FY14) Set to expire in FY2016 (more on that in a moment)

8 The Health Center Funding Cliff Since the creation of the Health Center Fund, the Health Centers program has operated under two streams of funding mandatory and discretionary. Since FY2011, discretionary funding for the program has remained level at approximately $1.6 billion. The Health Center Fund is currently slated to expire in FY2016, leaving only discretionary funding to fund the program s operations. Under current law, assuming that in FY2015, the discretionary side remains at $1.6 billion and the full amount available under the Health Center Fund for that fiscal year is expended, the program faces a nearly 70% reduction for all existing health centers in FY2016.

9 NHSC, THCs in same position (though ALL mandatory) HEALTH CENTERS FUNDING CLIFF Mandatory funding expires at the end of FY15 Without action by Congress, up to 70% cut to Health Center grants

10 The Workforce Cliff The National Health Service Corps will be eligible for $310 million in funding in FY15 and $0 in FY16. The Teaching Health Center Program will go from a total allocation of $230 million in funding to $0 in FY16. Without Congressional intervention, both programs will cease to exist.

11 Changes in Health Center Funding Discretionary to Mandatory ( )

12 THE CLIFF KEY POINTS 1. This is real. Health Centers have broad support, but Congress has to act in order to fix this problem. 2. Estimate the impact. What would a 70% cut to your grant mean in your community, to your patients? 3. Raise the drumbeat for a fix. We have a long fight ahead, but our best hope is the understanding that this is a must-do. 4. Resource Library:

13 Access is the Answer Advocacy Campaign Purpose, Goals & Requirements Action Steps Tools & Resources The Reality

14 MAKE YOUR VOICE HEARD!

15 Access is the Answer Advocacy Campaign To force Washington to fix the Health Center Funding Cliff we have launched Access is the Answer our campaign to organize EVERY HEALTH CENTER ADVOCATE to get Congress & the Administration to fix the Health Center Funding Cliff. The goal of the Access is the Answer Campaign is to demonstrate on a massive scale, the support that local communities have for health centers. To Accomplish this Goal we are asking every Health Center to take 3 Action Steps as part of the Second phase of the Campaign.

16 ACCESS IS THE ANSWER CAMPAIGN What Can YOU Do Right Now? We are asking every Health Center to take 3 Action Steps as part of the second phase of the Campaign. 1. Continue collecting Local Support Letters 2. Submit a letter to the editor/op- Ed to a local media outlet 3. Setup in-person meetings with your Members of Congress grassroots@nachc.com to report your numbers out.cfm

17 HELPFUL RESOURCES TO FIX THE CLIFF Petition templates in English, Spanish, Vietnamese, and Chinese Local Support Letter templates Media templates Fliers and notecards Sample social media posts and images Cliff estimator Cliff graphs Talking points and FAQs State-by-state fact sheets on economic impact

18 ADVOCACY: THE BOTTOM LINE HEALTH CENTERS SUCCESS & OUR COLLECTIVE FUTURE DEPEND ON THE STRENGH OF OUR ADVOCACY. Local connection is the key to policy change build relationships and demonstrate impact over time Advocacy requires ACTION - the key is to develop a sustained culture of advocacy in your center The challenges ahead are huge, as are the opportunities. We have to take them on TOGETHER.

19 Ultimately The only way we will succeed in getting Washington to fix our funding cliff is to organize everyone in our communities elected officials, community organizations and partners, along with tens of thousands of health center advocates, to send a forceful message to Congress and the President that folks back home not only care about making sure the Health Centers Program receives the funding and resources needed to continue providing high quality care in their communities, but that these same folks (health center advocates) reject anything short of real action to make sure that not ONE of the current 22 million health center patients lose access to care, and that millions more who still need access to care will get it. - Dan Hawkins, NACHC Senior Vice President for Policy & Research

20 CONTACT INFO AND QUESTIONS Amanda Pears Kelly Director of National Advocacy & Civic Engagement National Association of Community Health Centers 1400 Eye St. NW, Suite 910 Washington, DC p e. QUESTIONS?