1. PA Legislative and Regulatory Issues

2. Legislative Activity to Date Purely Public Charities (non-profit local property taxes) Senate Bill 4 has been enacted as Joint Resolution 2; however as a constitutional amendment, we must pass identical legislation again in 2015 Currently, 4 Community Health Center sites have been affected; 1 YMCA and 1 hospital Creation of the Community-Based Health Care Fund Senate Bill 5, now Act 10, received an appropriation of $4 million in this year’s budget and is currently considering applications of eligible grantees The Department of Health’s Pennsylvania Community Primary Care Challenge Grants has been paused for this fiscal year

3. Legislative Activity to Date, continued State oversight of insurance marketplace navigators The sponsor of House Bill 1522 and House Republicans are still considering this legislation and moved it out of the House Rules Committee in September

4. Healthy PA Initiative Medicaid/Medical Assistance Changes Currently eligible: Consolidation of benefits packages to now have 2 options Move to monthly premiums with a maximum of $25 Premium reductions for participation in wellness/healthy behavior programs Work search requirements for able adults Newly eligible (100 – 133% FPL): Draw down ACA funds for individuals to shop for coverage in the insurance marketplace

5. Healthy PA Initiative, continued Medicaid/Medical Assistance Concerns This is a loosely formed proposal that the Corbett administration has offered to HHS to begin negotiations. A formal conversation has taken place and the Corbett administration is in the process of following up on that meeting with a letter Few details are available as the administration is still forming all aspects of Healthy PA, MA included HHS must approve the actual proposal that will be submitted and items such as work search requirements are questionable Preservation of PPS for the newly eligible in the marketplace!!!

6. Healthy PA Initiative, continued Primary Care Expansion CHIP Increase efforts to move from 95% coverage to 100% Eliminate 6-month waiting period CHIP reauthorization, House Bill 108, was passed unanimously by the Senate and awaits House action Workforce Development Increased support and funding for loan repayment programs Increased use of information technology Reform of medical liability in Pennsylvania Medicaid reforms

7. Healthy PA Initiative, continued Primary Care Expansion, continued Additional Federal Funding The Corbett administration will petition HHS to receive additional federal dollars for Harrisburg to distribute under its own direction This additional federal funding may include 330-grant funding from Community Health Centers

8. Healthy PA Initiative Action Steps Be mindful that the Healthy PA proposal is just that and a negotiating point with HHS. However, at the same time, the Corbett administration is in the process of developing its 2014-15 budget proposal and these items are likely to resurface in that proposal if not addressed now Use the calculator designed by NACHC to determine what Medicaid expansion under the ACA means to your health center and community. Share that with stakeholders, legislators and media Educate the same parties mentioned above to explain the purposes of your 330-grant and the services you provide. Be sure to add that the state provides NO direct state funding support or relief from uncompensated care Be prepared for a legislative action alert to respond to any adverse impact that Healthy PA may have on health centers

9. Healthy PA Initiative Action Steps, continued Educate the legislators, media and community partners to explain the purposes of your 330-grant and the services you provide. Be sure to add that the state provides NO direct state funding support or relief from uncompensated care Be prepared for a legislative action alert to respond to any adverse impact that Healthy PA may have on health centers

10. Regulatory Activity to Date Mobile Dentistry Regulations Last year, the Board of Dentistry proposed onerous rule-making for how to oversee mobile dentistry practices in the state Due to the engagement of stakeholders such as PACHC and the PA Dental Association, the Board rescinded its proposal and revised it. In September, they made this new version publicly available with substantive changes

11. Questions

12. Jim Willshier (717) 761-6443, extension 206 jim@pachc.com