SEPTEMBER POLICY AND ADVOCACY WEBINAR Fixing the Primary Care Cliff: Landscape, Action Steps and What it Will Take to Succeed

SEPTEMBER POLICY AND ADVOCACY WEBINAR Fixing the Primary Care Cliff: Landscape, Action Steps and What it Will Take to Succeed

Audio today will be provided via computer. Please double check that your speakers on your computer are working and/or plug in a headset to listen. You can adjust the volume of the audio on your computer or by using the Audio Broadcast control box.

This webinar is being recorded. You will be able to access the webinar recording on www.hcadvocacy.org/ pastevents The link to the recording will be distributed in the Washington Update

Questions? Use the chat box to ask your question at any point in the webinar. We want to see all of your questions! We ll try our best to respond to all of them.

In this briefing, we ll cover: Cliff Refresher Current Landscape what we know and what Congress hasn t figured out yet September Advocacy Action Steps What to Expect when Talking to Congress

The Cliff Basics Health Centers Program (Sec. 330) Annual Funding, FY11-FY18 What is it? 2010: ACA created a dedicated 5- year fund for growth in CHCs (red) This was in addition to regular annual funding (blue) Every New Access Point, Service Expansion, Quality Award, Capital Grant, Base Adjustment etc. since 2011 has come from this fund. In 2015, CHC advocates succeeded in getting a 2-year extension (orange)

The Cliff Basics Where do we stand today? Health Centers Program (Sec. 330) Annual Funding, FY11-FY18 CHC Fund Extension expires 9/30. Funding cuts will begin soon after. NHSC and THCGME (also CHIP, MIECHV, DSH, more) expire at the same time. House held hearing on CHIP/CHCs in June Very crowded agenda in Sept., Congress not yet convinced of urgency

Continuing Resolution Doesn t Fix CHC Cliff Continuing Resolution (CR) Maintains Short-Term Funding for Discretionary Programs (Blue Bars on Slides 6 & 7) Prevents Lapse in Funding (Government Shutdown) Required by 9/30/17 if Congress Doesn t Pass 12 Approps Bills (1997) Gives Congress More Time to Pass Spending Bills Health Center Funding Cliff Mandatory Funding is Separate from Discretionary Programs (Orange Bars in Slides 6 & 7) Cliff Can Occur on 9/30/17 Even if CR Passes (Only Discretionary) 20+ Outstanding Mandatory Programs Need Extending (NHSC, THCGME, CHIP, ETC.) Fix COULD be attached to CR not yet the case.

Fresh Data From HRSA What No Fix Means Health Center Program Total Funding Falls to $1.5b Over 9m Patients Lose Access to Care 51,000 Jobs Lost 2,800 Health Center Sites Close $7.5b in Lost Health Center Revenue National Health Service Corps (NHSC) No New Contracts Awarded After 9/30/17 No continuations 5,750 clinicians eligible Current NHSC Participants Fulfill Service Commitments Field Strength Drops (NHSC Exodus for Higher Pay): Currently: 10,400; 2018: 5,000; 2019: 1,600 Teaching Health Centers No New Funds to Make Payments in FY18 All 732 Residents Would Have Academic Year Stopped/Interrupted (Transfers) Likely to Lead to Closure of THC Programs Altogether

A Very Busy September July 28 th : Senate Vote FAILS on Skinny Repeal August 27-29: NACHC CHI Senate Hearings on Market Stabilization, CHIP CHC Fund Expires Hurricane Harvey Relief? THCGME, NHSC Funding Expires CHIP Funding Expires Debt Ceiling? July August September Aug 13-19: Nat l Health Center Week Fly-in/Fly-out CHC Key Contact Meetings w/ EVERY Member Sept 11-15, Sept 18-23 End of Fiscal Year 2017 (CR, Omnibus or Shutdown) MIECHV, DSH, ~12 Other Extenders Expire Sept. 30 FY18 Budget Deal? October 50-vote Rule for ACA Repeal Expires

What Happens Next? We don t know what the a fix could look like because Congress doesn t know what it looks like. Possibilities range from a short (3-month) extension to a 5-yr solution, and everywhere in between. There are a limited number of legislative days left this month Without sufficient pressure from back home, is very possible that Congress will miss the September 30 deadline.

What Really Happens on 10/1/17? Enormous uncertainty for entire CHC System of Care HRSA Begins Disbursing CHC funds on a Month-to-Month Basis w/ no new awards until $$ runs out Health Center Financing/Credit/Recruitment Issues difficulty purchasing equipment, securing bank loans No NHSC Continuations THCGME Program Ends Congress does not yet feel the urgency.

What can YOU do? Take these critical action steps this month and help produce unprecedented activity in your area. hcadvocacy.org

Make the case with advocacy. This month is about volume. Health centers need to GET LOUD and raise the profile of the health center voice. Not only are we asking all Health Center Advocates to take action, we are asking you to generate additional action in your community. All new action steps are on hcadvocacy.org/takeaction

Take action every week this month. 1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 hcadvocacy.org/takeaction Social Media: Tag your Members of Congress and let them know about the services you provide that would be jeopardized. Email: Email your Members of Congress and make sure they know how many jobs are at stake in your community. Phone Calls: Call your Members of Congress and make sure they know how many patients in your community would lose access to care.

hcadvocacy.org/takeaction What are we focused on this week?!? SOCIAL MEDIA Personal Posts: Enter your address at HCAdvocacy to be connected to your Members and prompted with a sample post that will go directly to your Members. Feel free to personalize it a bit! Organization Posts: Post from your Health Center page/account to let your community know what is at stake with the Health Center Funding Cliff should Congress fail to act. Ask them to take action too, by including the link to the action alert. Sample posts available on HC Advocacy.org Elected Official Posts: Ask your elected officials, ESPECIALLY your Members of Congress, to post on their social media accounts expressing their support and commitment to taking action to fix the cliff. Sample posts available on HCAdvocacy.org Resources also in Spanish.

Use HCAdvocacy resources to support your work. Social Media: Enter your address at HCAdvocacy to be connected to your Members and prompted with a sample post that will go directly to your Members. Feel free to personalize it a bit! Email: Enter your address at HCAdvocacy to be connected to your Members of Congress and prompted with a sample email. Feel free to personalize this too, and to contact Congressional staff directly. Phone Calls: Use the HCAdvocacy hotline number to connect to your Members and use the sample script and talking points for your calls. hcadvocacy.org/takeaction Resources also in Spanish.

Keep In Mind.You Can Take Any of These Actions Any Time!! hcadvocacy.org/takeaction There s a reason for why and how we ve scheduled these actions. - Part of our advocacy this month is about VOLUME across social media, email and phone calls!! - The goal is make our voice and engagement BIGGER and LOUDER the further into the month we get - The third & fourth week of September will culminate with multiple call in days Start Getting Prepared NOW! You, Your Health Center/Primary Care Association, SHOULD create your own plan for how you will engage your whole network to turn up the volume throughout the month!

Advocacy Tip Use the Funding Cliff Impact estimator tool Good data leads to stronger advocacy tell a clear story Now Available at hcadvocacy.org/makethecase

Drive advocacy efforts at your health center. This month, volume is the key. - Set goals for your health center - Report your numbers at bit.ly/cliffreporting

Additional resources for advocates New website mobile friendly with all the resources you need Easy to recruit advocates via email and social media with the click of a button View recordings of previous webinars Talking points Cliff chart Funding cliff impact estimator Links to take action and spread the word HCADVOCACY.ORG/MAKETHECASE Didn t find what you need? Email: federalaffairs@nachc.org or grassroots@nachc.org.

You ve taken the action steps And your Member of Congress office has gotten in touch Here s what you might hear back and how you can respond.

The message is simple. It is time for Congress to do its job and act to fix the cliff. The clock is ticking health centers are looking at a uncertain funding situation which puts their business operations in jeopardy. Millions of patients depend on health centers - lives are at stake. The Health Center Advocacy Network is POWERFUL, each advocate is POWERFUL, and we must use our voice and get loud until there is concrete action taken. Hcadvocacy.org

What You Might Hear Back (and How to Respond) Here are a few common responses or questions Advocates can anticipate and how we suggest you respond. I ve heard HRSA can keep funding Health Centers past the October 1 deadline. Don t worry, we ll take care of this by the end of the year We hear HRSA has to make very tough decisions almost immediately without action by 9/30, including shifting to month-to-month operations. This directly harms our ability to operate. As small businesses with a responsibility to our community, we can t wait to plan for the worst. Going past the deadline increases our uncertainty and puts our patients, providers and staff at risk. You need to act now.

What You Might Hear Back (and How to Respond) Here are a few common responses or questions Advocates can anticipate and how we suggest you respond. I ve always supported Health Centers and I do now. But my party isn t in control fixing this is up to the Republicans. This fix will require a bipartisan vote in the Senate, and probably in the House. The agenda is crowded if you tell Congressional Leadership this is a priority and act publicly, it helps us break through. We need you to draw a line in the sand and reject any proposal to cut health centers.

What You Might Hear Back (and How to Respond) Here are a few common responses or questions Advocates can anticipate and how we suggest you respond. How do you propose we pay for this extension? Figuring out exactly how this comes together is up to Congress. We re here to advocate for our patients and communities. BUT, we can tell you that Health Centers save money for the health care system and taxpayer reduced ER use, managing chronic disease. Health centers are a smart investment.

What You Might Hear Back (and How to Respond) Here are a few common responses or questions Advocates can anticipate and how we suggest you respond. I ll speak to Congressional Leadership about this, but I prefer to work on issue like this behind the scenes We are so grateful for your willingness to speak up on this issue. Respectfully, though, given all the other priorities and the deadline being days away, we d like to see that accompanied by a PUBLIC expression of support. We have ideas and templates and want to work with you on this.

My Members want to get more involved - what else can they do? Members showing their support in PUBLIC and ON THE RECORD will be the key to success. Be in touch with us if you hear back from your Member and they want to know how to help. NACHC has a Menu of Options that includes templates for: Press releases/statements Op-Eds and Blog Posts Social Media Individual/Delegation letters to Leadership Short Speeches on the House/Senate Floor

Be Ready to Respond On Short Notice What to expect in September: - MANY Calls to Action - Lots of Twists & Turns What you can do to prepare: - Stay Informed - Have a Plan - Commit to Taking Action EVERY TIME! The Future of the Health Center Program Depends on YOUR Advocacy!

Questions?