Advocacy: Governmental Issues Impacting Our Members 

National Focus

In 2010, our focus has remained on the opportunities and challenges afforded through the American Recovery and Reinvestment Act (ARRA), specifically The Health Information Technology for Economic and Clinical Health Act (HITECH) provisions of the law and the EHR Adoption Incentive program sponsored and funded through the Centers for Medicare and Medicaid (CMS).  Following reviews of these programs, providers, organizations, and congressional representatives have identified areas that are not aligned with all facets of the healthcare environment.

• Oct. 18, 2010:  Health centers across the country could receive nearly a billion dollars from the Medicaid HIT adoption incentive program. Unfortunately, based on the current program as enacted, accessing the payments could be cumbersome for health centers as the payments are scheduled to go to individual providers rather than to the health center who has invested in the technology. According to the National Association of Community Health Centers (NACHC), Senators Debbie Stabenow (D-MI) and Olympia Snowe (R-ME) have written and begun circulating a “Dear Colleague Letter” asking Senators to join them in supporting the Medicaid HIT fix for health centers this year.  Senators can do this by cosigning the letter. Read more about NACHC's plan by clicking here.

• Sept. 10, 2010:  H.R. 6072, the Electronic Health Records Incentives for Multi-Campus Hospitals Act of 2010 - The Florida Hospital Association has calculated that CMS' existing EHR adoption incentive program failed to allow for multi-campus hospitals using the same Medicare number would negatively impact 50 Florida hospitals, for a total of $85 Million in incentives that Florida will not be able to access. 

• April 14, 2010: H.R. 5025 -- HITECH Extension for Behavioral Health Services Act of 2010; would amend the Public Health Service Act and the Social Security Act to extend health information technology assistance eligibility to behavioral health, mental health, and substance abuse professionals and facilities, and for other purposes. Status: Referred to the Subcommittee on Health.

While these efforts may bring more of Florida's heathcare safety net support for technology adoption, there are other key providers within our member systems that are so far not included in these efforts. For example, though Pharmacists within FQHCs are playing a larger and larger role on the clinical care team and offering additional patients services, such as Medication Therapy Management (MTM), “pharmacists are not eligible professionals for the EHR incentive programs” under the legislation passed by congress (CMS-0033-F).   

CHCA supports the advocacy efforts of our members and community colleagues to continue to strive for parity in the availability of funds to support Meaningful Use of health information technology throughout the entire continuum of patient care.

State and Local Issues

April 30, 2010, marked the end of 2010 Florida regular legislative session.  The House adjourned Sine Die* just before 7 PM and the Senate finally completed its work at 8:47 PM.  The Sine Die ceremony was called, because the Governor left town and the House finished its business early.

The FY 2010 – 11 General Appropriations Act includes the following:

• The final budget for FY 10-11 is $70.4 billion.
• The budget contains $1.4 billion in reserves. 
• $2.3 billion of stimulus dollars are used.
• $230 million was spent on non-ongoing program and recurring expenses on an "if-received" basis.  That’s less than a quarter of the potential Federal Medical Assistance Percentages (FMAP) dollars, receipt of which was purported to be increasingly unlikely.
• $507 million was transferred from trust funds.

* Sine Die: Latin, literally "adjournment without a day." The final adjournment of a legislative session, meaning no further business may come before the assembly. Any bill not passed out of the legislature by this date is null and void,and must be resubmitted in future sessions to be enacted.

National Focus 2009

The American Recovery and Reinvestment Act (ARRA), an unprecedented effort to jumpstart the economy and create or save millions of jobs, is an extraordinary response to a crisis unlike any since the Great Depression. Community Health Centers (CHCs) are a key in the plan's commitment to healthcare. The first announcement of funding under ARRA included New Access Point grants to CHCs across the country, including CHCA member Bond Community Health Center. All CHCA members are also eligible for Increased Demand for Services (IDS) funding in fiscal year 2009 to support existing operations. IDS grant funding will be provided under a 2-year project period and is based upon the following formula: $100,000 base, with additional $6 for each patient served in 2008, and an additional $19 per uninsured patient served during that period. The IDS project is intended to increase service to the uninsured during this economic crisis through expanded hours of operation and/or new providers hired to increase the capacity of each health center organization to serve more patients. To follow the progress of the ARRA, visit: www.recovery.gov.

The National Association of Community Health Centers (NACHC) leads the national effort to gain attention to CHC efforts and the need for greater access to primary and preventive health care across the country.  CHCA is proud to work with NACHC on behalf of its members in all matters related to advocacy on a national level.

One way NACHC helps get attention to the needs of community health centers is an annual week-long event that brings together elected officials and others to celebrate accomplishments and create interest in progress and healthcare needs of the uninsured and underinsured throughout the nation. In 2008, Florida Governor Charlie Crist demonstrated his support with an executive order endorsing the celebration statewide. "Community health centers empower communities to address unmet health needs, reduce health disparities and reduce preventable deaths, costly disabilities, and communicable diseases... and ensure quality health care."  Read the full proclamation by clicking here.