10/2/2015 NACHC FEDERAL POLICY UPDATE

Transcription

1 NACHC FEDERAL POLICY UPDATE Jana Eubank Associate Vice President National Association of Community Health Centers Tennessee Primary Care Association October 2,

2 TODAY S AGENDA LEGISLATIVE UPDATES REGULATORY UPDATES STATE UPDATES ADVOCACY UPDATES CONTACT INFO & QUESTIONS National Association of Community Health Centers Public Policy and Research Division Dan Hawkins Senior Vice President Luke Ertle Program Associate Jana Eubank Associate Vice President Carla Devoe Office Manager John Sawyer Director, Federal Affairs Dawn McKinney Director, State Affairs Michelle Proser Director, Research Amanda Pears Kelly Director, National Advocacy Colleen Meiman Director, Regulatory Affairs Abigail Pinkele Deputy Director, Federal Affairs Jennifer Taylor Deputy Director, Federal Affairs Heidi Emerson Deputy Director, State Affairs Michelle Jester Manager, Research Alex Harris Manager, Advocacy Special Populations Susan Sumrell Deputy Director, Regulatory Vacant Manager, Federal Affairs Alyssa Shinto Program Associate, Federal Affairs Kersten Burns Lausch Manager, State Affairs Caitlin Crowley Policy Associate, Research Elizabeth Kwasnik Manager, Grassroots Advocacy Dorian Wanzer Manager, Advocacy Communications Federal Affairs State Affairs Research Advocacy Regulatory 2

3 THE ENVIRONMENT FOR HEALTH CENTERS The Environment in Washington the BAD Congress not productive - must-pass bills pass, but not much else Limiting budget caps and future funding uncertainty Crowded agenda breaking through the noise is harder than ever ACA and health care remain politically polarizing New members to educate THE ENVIRONMENT FOR HEALTH CENTERS The Environment in Washington the GOOD Bipartisan support for Health Centers mission as we celebrate 50 years Both sides are looking for solutions in the health care arena Health Centers are at the center of the conversation Health Centers in 98% of Congressional Districts (425/435) New members to educate 3

4 HEALTH CENTER FUNDING STREAMS Health Ctrs Fund Required spending, unless Congress changes the law Special 5-year Trust Fund created in ACA to boost Health Center Capacity Currently $3.6 billion (FY15) Mandatory Annual Annual, up to Congress to determine amount Prior to ACA, the only funding for CHC program Cut several times, backfilled with mandatory funds Currently $1.5 billion (FY14) Discretionary HEALTH CENTERS FUNDING CLIFF Health Centers mandatory Fund was set to expire at the end of FY15 Without action by Congress, would have meant up to 70% cut to Health Center grants NHSC, THCs were in same position (though ALL mandatory) 4

5 PRIMARY CARE CLIFF AVERTED! H.R. 2, the Medicare and CHIP Reauthorization Act of 2015 (MACRA) CHCs: 2 add l years at $3.6 billion/year. NHSC: 2 add l years at $310 million/year. THCGME: 2 add l years at$60m/year House vote of , and Senate by 92-8! Permanent Medicare SGR Doc Fix 2-year extension of CHIP funding CURRENT FUNDING SITUATION Mandatory funding through H.R. 2/MACRA Solved problem for 2 years, however need to continue to fight for sustainable funding 5

6 HOW DID THIS HAPPEN? Advocacy Access is the Answer Campaign Key Contacts Program Broad smart grassroots Bipartisanship Only way to get things done in current environment Breadth led to depth Connections Members know/see what you do We remind them often THANK YOU!!! As past of the Access is the Answer Campaign, Tennessee made: Over 325 calls (out of 25,000 nationally) Over 3,100 petitions signatures (out of 202,000 nationally) Over 10 local support letters (out of 4,300 nationally) Thank you for your hard work and dedication to the health centers!! 6

7 ARE WE DONE YET? FY16 Appropriations Funding at Risk After big investments in mandatory funding, Congress may cut back on discretionary funding need to advocate louder than ever to maintain $1.5 billion In September, Congress averted a shutdown and extended all gov t funding until December 11 th. Very unclear after that. OTHER LEGISLATIVE ACTIVITY? Medicaid changes being discussed: - As part of ACA alternative proposals, budget negotiations and entitlement program discussions - Options include block grants and percapita caps - Unlikely to pass this fall 340B Drug Discount Program - First-ever hearing held in March - Flurry of potential activity in May 7

8 OUTLOOK FOR THE FALL Congress has a long list of to-do s - Appropriations possible omnibus or CR need by October 1, or shutdown - Other Deadlines highway trust fund, debt limit, FAA, expiring budget deal, export-import bank - Mental Health Legislation House E&C - 21 st Century Cures passed House - Medical Innovation Senate HELP - Chronic Care Legislation Senate Finance HRSA POLICY FY15 FUNDING $5.1 billion in FY15 - $1.4 billion more than FY14. HRSA has spent or is committed to spend the following: Award Type Date (expected) # Awards Amount Behavioral Health Integration November $51m Quality Improvement December ,113 $ 99m New Access Points (Round 1) May $101m New Access Points (Round 2) August $169m National Cooperative Agreement June $ 3m Expanded Services September ,184 $350m Health Infrastructure Improvement September $150m Base Adjustments September ,280 $165m Substance Abuse Service Exp. September $100m Sequestration (across-the-board) N/A N/A $90m Total $1.278b 8

9 POLICY DEVELOPMENTS- 340B Close scrutiny from Congress, HRSA, & beyond - Important that health centers ensure and document compliance - NACHC is developing tools to assist FQHCs in ensuring compliance. HRSA recently issued a mega-guidance ; now seeking comments - Says FQHC patients can t get 340B Rx for prescriptions written by non-fqhc doctors - Requires annual audits & quarterly reviews of all contract pharmacies. POLICY DEVELOPMENTS CMS Medicare - New format for Cost Report expected soon - Likely to start billing for Chronic Care Management in January Medicaid - Final reg on managed care changes not expected till Getting harder to use 340B Rx for managed care patients Meaningful Use - Reg expected any day, will hopefully loosen rules & timelines Marketplace CMS will ask you to confirm your interest in being listed as an Essential Community Provider. 9

10 POLICY DEVELOPMENTS BPHC COMPLIANCE GUIDE BPHC expected to publish a draft Compliance Guide any day Will consolidate all PINs &PALs in a single document Will explain how to demonstrate compliance NACHC is prepared to do an in-depth analysis and comment New and Improved Reg Affairs website Medicaid expansion MEDICAID EXPANSION: A NATIONAL LANDSCAPE 31 states have expanded Medicaid 6 states have 1115 Waivers for expansion: AR, IA, MI, IN, NH, PA A number of states are actively working on Medicaid expansion (UT, SD, TN, WY) A number of expansion states are currently considering changes (NH, MI, AZ, OH) 10

11 MEDICAID EXPANSION: A NATIONAL LANDSCAPE Alternative payment models for health centers (e.g. CA, OR) Accountable Care Organizations (e.g. MN) National trend toward payment reform e.g. State Innovation Models Initiative, Section 2703 Health Homes PAYMENT REFORM: A NATIONAL LANDSCAPE 11

12 MAKE YOUR VOICE HEARD! WHY ACCESS IS THE ANSWER? High- Quality Costeffective Where will everyone go to receive care? Health Centers already serve as the health care home to more than 24 million patients and prepared to serve millions more with adequate resources. Where will the savings come from to reduce health care spending? Health Centers already save the health care system billions of dollars many times the money invested in the program and can save much more by expanding the model of care. LOCAL How can we maintain local control over our health care and create jobs? As locally owned and operated small businesses, Health Centers have a record of being real local economic engines and creating tens of thousands of jobs leveraging a relatively small investment. 12

13 Access is the Answer Action Steps: What can YOU do right NOW?! 1. Present a Letter of Appreciation from Your Health Center Board Draft & Present to Your MOC - IN PERSON Submit similar Letter to other supporters 2. Host Your MOC at Come Visit your Health Center Invite Your MOC to visit Present Board Appreciation Letter & Make the Case for Continued Funding 3. Submit an OpEd or LTE to Local Media Express your appreciation publicly & continue making the case for continued investment 4. Take the Advocacy Pledge Recommit to Health Center Advocacy & Taking Action EVERY TIME ACCESS IS THE ANSWER: RESOURCES Campaign Website: Templates: English Spanish Letter & Media Templates: Local Elected Officials Community Partners Report Forms Tools to Spread the Word Bilingual Fliers Bilingual Handouts Social Media Tools 13

14 GET READY! NACHC will launch a new set of action steps as part of the Access is the Answer Campaign in early October! Look for Advocacy Webinar Launch Notice coming soon Access new Advocacy Tools & Resources on the website Make sure to report all your advocacy activities thus far to Grassroots@nachc.com NATIONAL HEALTH CENTER WEEK 2015 August 9 th -15 th, 2015 Great success! Over 1,700 events and 70 Member of Congress visits 6 th Consecutive Presidential Proclamation Visit the NHCW website at for more info & get ready for NHCW 2016, August 7 th -13 th 14

15 KEY CONTACT PROGRAM Does your Health Center have a Key Contact? Leverage your relationship with Members of Congress and their staff Be an advocacy leader; Key Contacts are our grasstops and goto folks in the field! Can be anyone at a CHC with a relationship with Member or staff- CEO, O&E, clinician, etc. Will be called to action on timesensitive, critical issues TENNESSEE MEMBERS WITHOUT A KEY CONTACT Each Senator (2) and Representative (9) has a Key Contact! 15

16 LEGISLATIVE & 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. Become a Key Contact WHAT YOU CAN DO? Watch for Washington Update, Advocacy Alerts Support our comments on proposed legislation Plan health center events or visits for Members of Congress Establish advocacy programming at your health center Put us to work, share intelligence 16

17 RESOURCES Campaign for America s Health Centers: NACHC Website: NACHC Blogs (Health Centers on the Hill, the Policy Shop, Health Center News and Happenings, etc.): blogs.nachc.com NACHC MyLearning Center (webinars, conference archives, resources, online communities): mylearning.nachc.com CONTACT INFO AND QUESTIONS Jana Eubank Associate Vice President National Association of Community Health Centers Public Policy and Research Division 1400 Eye St, NW, Suite 910 Washington DC, jeubank@nachc.org QUESTIONS? 17