2. Health Center Funding Cliff Webinar/NACHC Policy Update
Elizabeth Kwasnik
Manager of Grassroots Advocacy
National Association of Community Health Centers
April 23, 2015

3. TODAY’S AGENDA The Environment for Health Centers
FUNDING CLIFF/Policy Update
Grassroots Advocacy
Questions?

4. THE ENVIRONMENT FOR HEALTH CENTERS
The Environment in Washington
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
There are Health Centers in 98% of Congressional Districts (425/435)

5. 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, remaining uninsured and underinsured
Federal support, through 330 grant and Medicaid payment, crucial to model of care
We will have to advocate louder than ever

6. FUNDING CLIFF FIX NEXT STEPS – APPROPRIATIONS, MEDICAID, 340B
POLICY UPDATE
FUNDING CLIFF FIX
NEXT STEPS – APPROPRIATIONS, MEDICAID, 340B

7. HEALTH CENTER FUNDING STREAMS
Annual Appropriation
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 (FY15)
“Discretionary”
Health Center Trust 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”

8. RAISING THE NOISE ON THE HILL
Sign-on Letters
Bipartisan letters circulated in both Chambers
Addressed Appropriations Support and Cliff Issue
House: 271 Signers (173 D, 98 R)
Senate: 60 Signers (39 D, 19 R, 2 I)
Member Contacts
Target fly-in with Leadership, Key Committees
Hundreds of visits during P&I Hill Day
Thousands of calls to Congressional Offices

9. RAISING THE NOISE IN MICHIGAN
Sign-on Letters
Cliff sign-on letter (October 2014)
8 Reps. and both Sens.
FY16 Approps letter (March 2015)
9 Reps. and both Sens.

10. Primary Care Cliff Averted!
Congress passed, and the President signed into law, H.R. 2, the Medicare and CHIP Reauthorization Act of 2015
Overwhelming support – passed House by a vote of , and Senate by 92-8!
Permanent Medicare SGR “Doc Fix”
2-year extension of CHIP
**Two years of additional mandatory funding for Community Health Centers, National Health Service Corps, and THC Program – All extended until October 1, 2017**

11. Note About H.R. 2 Funds Senate Human Trafficking Legislation
Use of Health Center funds set aside in H.R. 2 to cover health care-related services for victims
Cost could range from $5mil to $30mil per year (for two years)
Press release/statement available on NACHC website, and we will be sure to update you as we know more

12. Primary Care Cliff Averted!
Health Center Funding Chart

13. HRSA has/will spend this on:
FY15 FUNDING
$5.1 billion in FY15 - $1.4 billion more than FY14, largest amount ever.
HRSA has/will spend this on:
$350M - New Access Points and Expanded Services
$165 - Base Adjustments
$150M – Construction & Capital Improvements
$150M - Outreach and Enrollment
$51M - Behavioral Health Integration
$36M - Quality awards

14. Where Do We Go From Here?
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
Medicaid changes included in ACA alternative proposals, budget negotiations and entitlement program discussions, including block grants, per-capita caps, and increased state waiver flexibility

15. Where Do We Go From Here?
King v. Burwell Supreme Court Decision
Expected in June
Potential to severely undermine insurance exchanges
340B Drug Discount Program
Recent Congressional Hearing
“Mega Guidance” expected this summer

16. Importance of advocacy Access is the Answer Campaign What’s next?
GRASSROOTS ADVOCACY
Importance of advocacy
Access is the Answer Campaign
What’s next?
Key Contact Program

17. MAKE YOUR VOICE HEARD!

18. ACCESS IS THE ANSWER CAMPAIGN
We did it! H.R. 2 signed into law on April 16th
Don’t forget to thank your MOCs!
Direct /call
Media templates available
Health Center advocates made a HUGE difference
BUT, our job isn’t done…

19. ONGOING ADVOCACY NEEDS
Appropriations process– need to protect our discretionary funding!
Federal discussion around Medicaid
King v. Burwell*
Workforce issues
Funding past FY17
We need to be able to adequately respond when issues come up, and be on the offensive moving forward! We cannot afford to lose any ground we’ve gained!

20. Does your Health Center have a Key Contact?
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.

21. A WORD ABOUT MICHIGAN MOCs
Key Contacts and advocacy in Michigan is especially important, given the delegation!
Member Contact
46 s to Reps. and 68 s per Senator on H.R. 2
Cliff Call in Day (March 19): 153 calls
Senate/H.R. 2 Call in Day (April 13): 66 calls

22. 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.

23. Manager of Grassroots Advocacy
CONTACT INFO AND QUESTIONS
Elizabeth Kwasnik
Manager of Grassroots Advocacy
QUESTIONS?