1. A Federal Policy Agenda for SBHCs Linda Juszczak, Executive Director NASBHC December12, 2009

2. NASBHC’s Federal Policy Agenda Create a federal grant program for SBHCs Support reimbursement opportunities for SBHCs Position SBHCs to receive support in federal legislation and in governmental agencies

3. The History of SBHC Legislation The Healthy Schools Act of 2007 –25 cosponsors in 110 th Congress The School-Based Health Clinic Act of 2007 –49 cosponsors in 110 th Congress

4. SBHC HRC Principles Quality of Care-Emphasis on quality care has primarily focused on adult care. There is a need to improve the quality of care for children and adolescents, particularly related to well-child services and care for chronically ill children. Medical Home- Public health resources must be invested in SBHCs that provide access to patients without a medical home and toward SBHCs delivering ancillary care with the patient’s medical home. SBHCs must be included in the health information technology network.

5. SBHC HRC Principles Inter-Agency Collaboration-Senior department leadership should coordinate relationships with other federal agencies to align related programs.

6. Health Care Reform Process House of Representatives “Tri-Committee” Bill developed jointly by –Education and Labor –Energy and Commerce –Ways and Means Result – America’s Affordable Health Care Choices Act (H.R. 3200)

7. Health Care Reform Process House of Representatives Affordable Health Care for America Act (H.R. 3962) Passed on November 7, 2009 Includes: Authorization of federal grant program Reimbursement for services covered under Medicaid and CHIP Cost-based reimbursement for SBHCs funded under the new grant program

8. Health Care Reform Process Senate Two separate bills –Health, Education, Labor, and Pensions (H.E.L.P.) Committee –Finance Committee Result : The Patient Protection and Affordable Care Act

9. Health Care Reform Process Senate Patient Protection and Affordable Care Act Debate beginning today, vote likely by end of Dec. Includes: Authorization of federal grant program Short-term appropriation for facilities and equipment Reimbursement NOT in the bill as introduced, but expected as floor amendment.

10. Compare the bills AS OF 11/24/09 Authorization of Federal SBHC Grant Program Reimbursement through Public Insurance Programs Cost-Based Reimbursement Short-term Appropriation H OUSE B ILL H.R. 3962 S ENATE B ILL Bill Number TBA Not in current bill, but expected to be introduced as amendment on Senate floor

11. Health Care Reform Process After Senate passage… …Conference Committee: Representatives from House and Senate Reconcile differences in House and Senate bills Then, back to each Chamber for passage of same bill. Finally, President’s signature. Deadline: State of the Union Address

12. After Passage… Appropriations: Advocate for $ for SBHC programs Regulations: Work with HHS to design grant program

13. Other Opportunities The White House The Agencies and Interagency Collaboration Colleague Organizations CHIPRA Coming up: Education Policy

14. Challenges we are facing Health care reform process Challenges regarding reproductive health Misunderstandings regarding parental rights Where SBHCs fit in the medical home concept

15. WE NEED YOU!!! Write letters, make phone calls, contribute to local media (interviews, op/eds and LTEs) Get your Reps to a SBHC (again) Communicate with LEAs and principals Join NASBHC and get involved in its work