NACHC UPDATE Amanda Pears Kelly National Director, Advocacy & Civic Engagement National Association of Community Health Centers South Carolina Primary Health Care Association Annual Meeting December 5,, 2014 1
TODAY S AGENDA THE ENVIRONMENT FOR HEALTH CENTERS FEDERAL POLICY UPDATE: LEGISLATIVE AND REGULATORY GRASSROOTS ADVOCACY: MAKE YOUR VOICE HEARD! RESOURCES AND FOLLOW-UP QUESTIONS? THE ENVIRONMENT The Environment in Washington the BAD Political Polarization ACA is as divisive as ever Must-pass bills pass, but not much else Heightened scrutiny of federal programs Budget caps and future funding uncertainty 2
THE ENVIRONMENT The Environment in Washington the GOOD Bipartisan support for Health Centers Program, Model and Mission Both sides looking for solutions in the health care arena Health Centers are at the center of the conversation HEALTH CENTERS IN A POST-ACA WORLD Where do we fit? Where do we stand? Access to primary care is vital for cost savings and improved outcomes Unmet need for our services remains enormous 62 million without primary care We expect increased demand, among newly insured and uninsured (MA experience) Federal support, through 330 grant and Medicaid payment, crucial to model of care We will have to advocate louder than ever 3
LEGISLATIVE UPDATE FY15 APPROPRIATIONS HEALTH CENTER FUNDING CLIFF MEDICAID/MEDICARE/CHIP WORKFORCE FY15 APPROPRIATIONS Annual appropriations process determines funding for all of Section 330, other programs like NHSC New funding essential if we want base grant adjustments, expanded capacity, service expansion, new access points Since ACA, funding comes two ways: 4
HEALTH CENTER FUNDING STREAMS Annual Discretionary Funding 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) Health Ctrs Fund Mandatory Funding 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) APPROPRIATIONS OUTLOOK Senate Subcommittee passed full NACHC request - $5.1 billion total Process in final negotiations as we speak Final resolution of this year s funding has implications for funding cliff issue 5
HEALTH CENTERS FUNDING CLIFF Mandatory funding expires at the end of FY15 Without action by Congress, up to 70% cut to Health Center grants NHSC, THCs in same position (though ALL mandatory) FIXING THE CLIFF OUR PLAN Extends, grows mandatory funding $20b over 5 years Grow from current 22m patients to 35m Continue funding for NHSC, Teaching Health Centers Message: Act Now! 6
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: www.nachc.com/cliff RAISING THE DRUMBEAT ON THE HILL Sign-on Letters: Did Your Member Sign On? Bipartisan letters in House and Senate Addressed to Leadership, and emphasize need to address the cliff No dollar figures, timelines, specific prescriptions Record Numbers: 250 House, 66 Senate 7
Congress is currently convened in a lame-duck session. ACTION THIS FALL There is a lot of unfinished business and several must-do items may be moving. The Access is the Answer Campaign is still in full swing. Outcome uncertain, lame duck action tied to larger politics (immigration, etc) MEDICARE/MEDICAID/CHIP For the moment, not on the Congressional radar as much fights are in the States and in the administration Medicare doc fix bill passed in March Included 8 state demo on Certified Community Behavioral Health Clinics NACHC neutral, but monitoring process Current CHIP funding expires in 2015 8
WORKFORCE POLICY National Health Service Corps and Teaching Health Centers GME programs currently 100% funded with ACA funds Funding for both expires in 2015 President proposed extending, expanding NHSC, and building on THCGME Working alongside coalition partners (AAFP, AAMC, ACU, AATHC) to extend REGULATORY UPDATE 9
HRSA POLICY FY14 FUNDING Congress increased Health Centers Funding by $700m in FY14. HRSA has/will spend this on: $110m in Base Adjustments $58m in Outreach and Enrollment $50m in Behavioral Health Integration $150m in New Access Points $300m in Expanded Service $34m PCMH Incentives HRSA POLICY Also newly released or coming down the pike from HRSA: Additional $50+ million in behavioral health grants (FY2015 funding) Quality improvement awards We are keeping a close eye on 340B Mega-Reg was expected summer 2014, now potentially stalled Increased scrutiny in Congress Important that health centers can speak to importance of the program 10
CMS POLICY Medicare PPS Rule Issued in May 2014 Eliminates Medicare Cap New, bundled payment rate Transition will take place through 2015 Trainings upcoming in Dec, Jan listed on T&TA page on nachc.com Ongoing State-by-State Medicaid Waiver/Expansions (incl. Private Option ) PA approved, IN & others expected Essential Community Provider Rules Navigator awards issued in September GRASSROOTS ADVOCACY IMPORTANCE OF ADVOCACY ACCESS IS THE ANSWER CAMPAIGN KEY CONTACT PROGRAM NATIONAL HEALTH CENTER WEEK BECOME AN ADVOCATE TODAY! 11
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. MAKE YOUR VOICE HEARD! 12
ACCESS IS THE ANSWER CAMPAIGN Campaign to organize EVERY HEALTH CENTER ADVOCATE to get Congress to fix the Health Center Funding Cliff. Goal is to demonstrate massive support in local communities, among partners, opinion leaders and elected officials for health centers. WHY ACCESS IS THE ANSWER? High- Quality Where will everyone go to receive care? Health Centers already serve as the health care home to more than 22 million patients and prepared to serve millions more with adequate resources. Costeffective 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. 13
ACCESS IS THE ANSWER CAMPAIGN 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 Email grassroots@nachc.com to report your numbers www.saveourchcs.org/ab out.cfm HELPFUL RESOURCES TO FIX THE CLIFF www.saveourchcs.org/about.cfm Petition templates in English, Spanish, Vietnamese, and Chinese Local Support Letter templates Media templates & Instructions Fliers and notecards Sample social media posts and images www.nachc.com/cliff Cliff estimator Cliff graphs Talking points and FAQs State-by-state fact sheets on economic impact 14
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! Can be anyone at a CHC with a relationship with Member or staff- CEO, O&E, clinician, etc. KEY CONTACT PROGRAM Why do we need Key Contacts? Key Contacts are go-to folks in the field who can get Members/staff on the phone, because of an existing personal or working relationship and urge support of CHC issues Their work compliments grassroots efforts, makes a huge difference Will work in coordination with NACHC and PCA to ensure consistent messaging Will be called to action on time-sensitive, critical issues 15
KEY CONTACT PROGRAM Since we began institutionalizing the Key Contact Program in January 2014, we ve achieved over 95% coverage for target Members of Congress (committees of jurisdiction). Our next task is to identify Key Contacts for the remaining Members, to eventually cover all 535 MOCs. As of Fall 2014, we have 57% coverage for all of Congress. It is our goal to have full coverage by the end of the year. If you have an existing relationship with a MOC, and would like to be a Key Contact, let us know at grassroots@nachc.com. NATIONAL HEALTH CENTER WEEK 2015 August 9 th -15 th, 2015 Stay tuned for the 2015 theme It s never too early to start planning! Think about incorporating a bit of history into your events this year in celebration of the 50 th anniversary of the Health Centers Program. 16
BECOME A HEALTH CENTER ADVOCATE TODAY! Join the Campaign for America s Health Centers Weekly Washington Update Action Alerts Spanish-language Advocacy updates Tele-townhall forums with nationa policymakers Send messages to your elected officials in support of Health Centers and the patients they serve. RESOURCES Campaign for America s Health Centers: www.saveourchcs.org NACHC Website: www.nachc.org 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 17
CONTACT INFO AND QUESTIONS Amanda Pears Kelly National Director, Advocacy & Civic Engagement National Association of Community Health Centers p. 202-834-2592 e. apearskelly@nachc.org QUESTIONS? 18