Weekly E-Blast:  
Voicing the latest news on Communities in Need
In This Issue

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Dec 23,2013 
for insurance starting on Jan 1, 2014 
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Let's Stay Connected
December 13, 2013 
Community Health Center Spotlight
Collage from La Red's Ribbon Cutting Ceremony, November 21, 2013)


National Rural Health Center Day & Hearty Congratulations La Red Health Center


November 21st marked National Rural Health Center Day. The third Thursday in November has been set aside to highlight rural communities as wonderful places to live and work, increase awareness of rural health-related issues, and promote the efforts of State Offices of Rural Health and the National Organization of State Offices of Rural Health in addressing these issues. Mid-Atlantic Association of Community Health Centers wants to recognize and is proud of all the wonderful work of our Health Centers that serve rural populations in both Maryland and Delaware -Henrietta Johnson Medical Center, La Red Health Center, Choptank Community Health Center, Three Lower Counties Community Services, Tri State Community Health Center, Owensville Primary Care, Walnut Street Community Health Center and West Cecil Community Health Center.



In celebration of National Rural Health Center Day, La Red Center hosted their Ribbon Cutting Ceremony today. LRHC's previous 1,400 square foot facility in Seaford was home to LRHC's Family Practice Services for Western Sussex County since 2010. The facility provided LRHC with a turn-key operation that allowed LRHC to begin offering much needed primary care and preventative health care services. LRHC's patient volume grew steadily to the point where it was providing 40 hours of weekly primary patient care and seeing as many as 20 -35 patients per day. 

In recognition of growth, and the need to provide even more services to the community, LRHC was awarded a federal grant from the U.S. Department of Health and Social Services Administration, (HRSA) in June of 2011 to further expand patient care in Western Sussex County and to hire additional practitioners.  Accordingly, LRHC sought to increase its physical capacity by purchasing a newly renovated 8,900 square foot building that will become its new Western Sussex County ambulatory health care facility. 


The  renovated 8,900 square-foot, two-story building is strategically located on a signalized corner at the intersection of High and Cannon Streets which will provide easy access for patients who walk from the surrounding neighborhoods, as well for patients who drive and want to access LRHC's two private parking lots located directly behind the building. The location is ideally situated to enhance LRHC's visibility and create awareness of its presence in the community. The major renovations to the building include the addition of an elevator as well as a generator of sufficient size to handle 25% of the building. The additional space will allow LRHC to expand its existing primary care and preventive health services, and to begin offering critically needed mental health services to the community


MACHC Happenings
(1) MACHC Emergency Preparedness Call
December 17th, 2013 10:00 AM - 
:00 PM
Call in- 1-866-740-1260  Access code: 4319483 

(2) DHMH HPP Emergency Preparedness Call

 December 19th, 2013 10:30 AM - 11:30 AM

Dial in from your phone:

Meeting ID: 6455

Dial in Number: 410-225-5300


(3) Maryland Health Benefit Exchange - Implementation Advisory Board Meeting

When: December 19th, 2 PM - 5 PM

Where: UMBC Tech Center

1450 S. Rolling Road,

Baltimore, MD, 21229



(4) NACHC, NNOHA Offer Free Webinar on Contracting with Private Dentists

When: Tuesday, January 7, 2014 

Time: 11:00 am - 12:30 pm, PST/2:00 pm - 3:30 pm, ET

Registration: Click here

Credits: 1.5 CDE credit

The National Association of Community Health Centers (NACHC) and the National Network for Oral Health Access (NNOHA) are hosting a free webinar, "Contracting with Private Practice Dentists: Partnerships for Access." 

 Target Audience:  Health center CEOs, CFOs, COOs, CIOs, system administrators, EHR managers, IT staff, clinicians, primary care associations and health center controlled networks

The webinar will provide an overview of contracting practice, a discussion of the parameters to be negotiated, examples of contracts and will highlight successes and challenges from actual FQHCs.

(5) MACHC Outreach Team Call
  January 10th, 2013 11:00 AM - 12:00 PM
Call in- 1-866-740-1260  Access code: 4319483  


Strategic Planning Committee Meeting
When: February 20th - 21st, 2014
Where: Turf Valley, Maryland
Policy, Advocacy and Legislation
National News
HHS announces Affordable Care Act mental health services funding


$50 million from the health care law will expand mental health and substance use disorder services in approximately 200 Community Health Centers nationwide

The U.S. Department of Health and Human Services (HHS) today announced that it plans to issue a $50 million funding opportunity announcement to help Community Health Centers establish or expand behavioral health services for people living with mental illness, and drug and alcohol problems. Community Health Centers will be able to use these new funds, made available through the Affordable Care Act, for efforts such as hiring new mental health and substance use disorder professionals, adding mental health and substance use disorder services, and employing team-based models of care.

"Most behavioral health conditions are treatable, yet too many Americans are not able to get needed treatment," said Health Resources and Services Administration (HRSA) Administrator Mary K. Wakefield, Ph.D., R.N. "These new Affordable Care Act funds will expand the capacity of our network of community health centers to respond to the mental health needs in their communities."

"These new funds will further the Department's work to develop integrated primary and behavioral health care services to better meet the needs of people with mental health and substance use conditions," said Substance Abuse and Mental Health Services Administration Administrator, Pamela S. Hyde.

It is estimated these awards will support behavioral health expansion in approximately 200 existing health centers nationwide.

Over the past year the Obama administration has taken a number of steps to reduce the barriers that too often prevent people from getting the help they need for behavioral health problems.

The Affordable Care Act expands mental health and substance use disorder benefits and parity protections for approximately 60 million Americans.

The President's Fiscal Year 2014 Budget includes a new $130 million initiative to help teachers recognize signs of mental illness in students and refer them to services, support innovative state-based programs to improve mental health outcomes for young people ages, and train 5,000 more mental health professionals. For more information please visit:

The Administration has also finalized rules under the Mental Health Parity and Addiction Equity Act. Because of these parity protections, many insurance plans will now include coverage for mental health and substance use conditions that is comparable to their medical and surgical coverage.

The Administration also launched a new website featuring easy-to-understand information about basic signs of mental health problems, how to talk about mental health, and how to find help.

The expiring insurance program for sick Americans who've been refused coverage by private carriers will be extended for one month, as the U.S. government continues to fix the Obamacare health exchange intended as an alternative.

The federal government's Pre-existing Condition Insurance Plan was due to expire on Dec. 31. People in the program who haven't yet obtained new coverage will be able to stay through the end of January, Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services said today in an e-mail.

Congress Moves Closer To Changing How Medicare Pays Doctors

Key House and Senate committees approved legislation Thursday to repeal the Sustainable Growth Rate, the formula officials use to pay doctors who treat Medicare patients.
Promises To Fix Mental Health System Still Unfulfilled
The shooting at Sandy Hook Elementary School in Newtown, Conn., one year ago sparked a national conversation about the country's troubled mental health system. Politicians convened task forces and promised additional funding and new laws. But despite those promises, one year later, patients and advocates say treatment for mental health is still in shambles.
The government asked insurers to grant people extra time to buy health insurance to gain coverage by Jan. 1. "There's still ample time for folks to research their options, talk things over with their families and select a plan," Health and Human Services Secretary Kathleen Sebelius said Thursday. People may sign up until Dec. 23 for Jan. 1 coverage. "We're recommending that insurers extend this deadline further," she said
As enrollments lag around the U.S., Fran Drescher and Kal Penn are among the Hollywood faces being enlisted for the "Tell a Friend Get Covered" campaign, which will urge friends, family members and neighbors around the country to talk to each other about the health care law. The hope is that familiar faces can do something Obama, thus far, has not achieved - getting millions of healthy, younger adults to enroll for coverage  
Marketplace Plans Networks Are Very Small, Study Finds
To keep premium prices down for individuals and small businesses buying coverage through new online marketplaces, insurers have created smaller networks of hospitals. But consumers and policy experts have wondered, just how small? Turns out, many are very small
After a sweeping vote by conservative Republicans controlling the House and President Barack Obama's Democratic allies, a bipartisan budget pact is in the hands of the Senate, where it will encounter stronger but probably futile resistance from Republicans. ... It leaves in place the bulk of $1 trillion or so in automatic cuts slamming the Pentagon, domestic agencies and Medicare providers through 2021 but eases an especially harsh set of cuts for 2014 and 2015

A new survey examining how U.S. hospitals are addressing the Centers for Medicare & Medicaid Services 30-day readmission penalties found that most facilities agree on what core strategies work the best for reducing preventable readmissions.

The survey, conducted in September 2013 by home healthcare delivery provider Amedisys Inc. and HealthLeaders Media Intelligence Unit, also revealed that many hospital leaders agreed on the major reasons behind preventable readmissions.

According to the survey of 106 senior leaders at 44 U.S. health systems, 73 percent of those polled cited a lack of preventative care and monitoring of patients with chronic conditions as a major cause of preventable readmissions. Additionally, 67 percent cited a lack of coordination between hospital discharge and physician follow-up, and 57 percent cited poor accountability for who is responsible for patient follow-up as major reasons driving readmissions.

State News
Check out the Delaware ACA Toolkit right here!

Use the Subsidy Calculator

Use the subsidy calculator on to get an estimate of the tax subsidy you might be eligible for when you buy coverage on Delaware's health insurance marketplace. 


Maryland Health Connection Mobile Updates:
Text "Connected" to 96000 to get the latest SMS updates on Maryland Health Connection right on your phone. 

O'Malley Confident Health Exchange Will Meet Goal

Despite a rocky start with health care reform, Gov. Martin O'Malley said Thursday he is still aiming to meet the goal of enrolling 260,000 people in private insurance and Medicaid through the state's health care exchange by the end of March. O'Malley, outlining how the state is addressing challenges to enrolling people, said most of the problems with the exchange's website have been addressed. He said a computer glitch relating to tax credits should be fixed this week. A more stubborn problem involves screens freezing, and O'Malley says progress has been made diagnosing the matter 





Finance & Business

Since the founding of Medicare in 1965, the government has subsidized the training of physicians; these subsidies come directly out of the Medicare program. The original theory was that this ensured that there would always be enough doctors to care for the older population.

In 2012, Medicare spent close to $10 billion on Graduate Medical Education. Despite this taxpayer subsidy, very little is spent on training doctors in the nuances of caring for older people. In the end, Medicare is spending our taxpayer dollars to assure that young physicians ARE NOT trained to care for Medicare beneficiaries.

About 100,000 Iowans newly eligible for Medicaid are set to get private insurance coverage through a demonstration project approved by the federal government, the second Medicaid "private option" okayed this year.The Centers for Medicare & Medicaid Services largely met Iowa Governor Terry Branstad halfway on his proposal to expand Medicaid under the Affordable Care Act through the state-federal partnership insurance exchange.The Iowa Health and Wellness Plan, brokered by Branstad, a Republican, and a Democratic legislature, was originally designed to have non-medically frail beneficiaries earning between 50 percent and 133 percent of the federal poverty level pay sliding-scale premiums to enroll in HIX health plans.Unwilling to go that far, CMS is allowing those earning between 100 percent and 133 percent FPL to enroll in private plans and pay small premiums. (That in itself is somewhat precedent-setting; the Arkansas waiver approved earlier this year for a similar Medicaid-expansion-via-HIX does not include premiums for beneficiaries selecting qualified health plans.)According to conditions CMS approved, those premiums, limited to 2 percent of beneficiaries incomes, won't be applied until the second year of the demonstration, running through the end of 2016. The premiums also won't applied at all if beneficiaries participate in a prevention and healthy behaviors incentive program - one of several policies the demonstration is testing, to see if waived costs for wellness is a significant motivator for Medicaid populations.
The Latest News on ACA
What's the LATEST 
on the ACA this week?


Q. My wife and I are retired, and we're both under 65. We have health insurance through my previous employer's retiree-only plan. In 2014, the premium for our coverage will double, to 13.3 percent of our income. But since coverage for me alone would "only" cost 6.7 percent of our income, we won't qualify for subsidies on the exchange. Is there any way that one or both of us can opt out of my retiree-only plan and get subsidized insurance on the exchange?

A. The short answer is yes, you can opt out of your retiree-only plan and shop for subsidized coverage on the health insurance marketplace.

In general, people who have employer-sponsored insurance that meets the definition of "minimum essential coverage" are eligible for exchange subsidies only if the employer plan is considered unaffordable or inadequate under the health law. It's inadequate if it pays for less than 60 percent of covered medical expenses, and it's unaffordable if the premium for self-only coverage costs more than 9.5 percent of family income. That affordability standard is where many people run into trouble: As long as coverage for one person doesn't exceed 9.5 percent of family income, the plan is considered affordable, even if the premium for family coverage exceeds that threshold. Since the plan is affordable, employer-insured workers generally can't qualify for subsidies on the marketplace.

More From This SeriesInsuring Your Health

However, the law treats people with retiree coverage differently than those in the workforce with job-based insurance, says Timothy Jost, a law professor at Washington and Lee University and an expert on the health law.

"If you are a retiree and you're eligible for retiree coverage but elect not to receive it, you do not have minimum essential coverage and therefore would be able to get through the firewall and apply for premium tax credits," says Jost.

In other words, if you opt out of your retiree plan to choose a policy on the health marketplace instead, you may qualify for premium tax credits that are available to people with incomes between 100 and 400 percent of the federal poverty level ($15,510 to $62,040 for a couple in 2013).

Keep in mind, however, that even though the premiums may be more affordable on the exchange, it's important to carefully compare the benefits in your retiree plan with those in the exchange plans to make sure a new policy provides the coverage you need.


CMS Offers "Follow-Up" Tips for Assisting Consumers

The Centers for Medicare and Medicaid Services (CMS) has offered guidance on what consumers can expect during follow up from the Health Insurance Marketplace if the enrollment application they submitted is missing required information or requires clarification.  When a consumer receives a call from CMS:

  1. The Caller ID may read Health Insurance MP; or 606-260-4191 (Kentucky); 479-877-3203 or (Arkansas); or 636-698-6320 (Missouri); or 580-354-7707 (Oklahoma). 
  2. The agent will ask to speak with the consumer and will identify themselves as calling from the Marketplace regarding the consumer's recent health insurance application. 
  3. The agent will provide their name and agent identification (ID) number, which the consumer should record.
  4. The agent will request information to verify the consumer's identity. If the agent asks for confirmation of the consumer's social security number, it will only be the last 4 digits. 
  5. After identity verification, the agent will ask the consumer for the specific follow up information needed for their submitted application. 
  6. If at any point during the call the consumer decides they would prefer to not provide information over the phone, they can inform the agent of this and CMS will mail a letter to the consumer explaining the next steps to process their application and the options for providing this information.
  7. CMS will attempt to reach the consumer three times via phone, and will leave voicemails each time they are unsuccessful.  If the consumer missed the agent's call, they should not attempt to call back the agent, since they are unable to accept inbound calls.  Instead, they should wait for CMS's next attempt to reach them.  After three attempts to reach the consumer by phone, CMS will mail the consumer a notice explaining what is needed to successfully process the application. 

Caution: CMS wants to remind enrollment assisters that a consumer should never give their personal health information to someone who calls or comes to their home uninvited, even if that person says they are from the Marketplace. Marketplace operators and Call Center agents will never ask for personal health information. A Marketplace operator may ask for income information like wages or salary, but will never ask for information about a consumer's financial institution, such as a bank account number. If the consumer suspects identity theft, or feels like they gave personal information to someone they should not have, they should file a complaint using the Federal Trade Commission's online Complaint Assistant . Consumers can also call the Call Center at 1-800-318-2596, explain what happened, and the Call Center will assist them. Additional resources to protect against fraud are available:


 For other helpful outreach and enrollment resources, please click here.


Grants & Funding Opportunities

Health Centers Can Sign Up for Children's Health Literacy Resource

As you know, health literacy skills start early in life and are an important part 

of caring for and educating children and adolescents. First Book offers a collection of children's books that combine lessons in literacy with lessons on practicing healthy behaviors.  The program works with health professionals like you to ensure low-income kids have access to brand new, high-quality books they need to succeed.  By joining the First Book network, you'll have ongoing access to free and deeply discounted new books for the children you serve. Click here to sign-up. After signing up, keep an eye on your inbox for a welcome email from First Book and instructions on how to start selecting from the wide variety of great titles. Questions may be directed to (866) READ-NOW or by email to  


Community Health Center Executive Fellowship

Application Deadline: Prior to First Session, January 15, 2014

This 11-month distance learning program is sponsored by the University of Kansas Medical Center, Department of Health Policy & Management, in collaboration with the Greater Midwest Association of Primary Health Care and the Kansas Association for the Medically Underserved. The Fellowship is designed to prepare emerging leaders for increasingly responsible management positions in community health centers.  Leveraging interactive online technology, students are able to expand their knowledge and develop the professional skills necessary to respond to the dynamic challenges that exist in the community health environment. The program offers two options:


  • Option 1: By completing all six modules you will received a certificate from the University of Kansas and a lapel pin designating you a "CHC Executive Fellow." Tuition in 2014 is $4,500, plus cost of books, travel/lodging for Capstone in Washington, D.C., plus $150 for meals and transportation.
  • Option 2: Individual module(s) are available for people who may not want (or have time for) the entire curriculum or the CHC Executive Fellow designation, but just want to focus on one or more particular critical areas. Tuition for individual modules is $950 each plus cost of books.  Check the academic calendar on the program's website to see when the module(s) you're interested in are scheduled.


Please email Marsha Killian for more information and/or to begin the application process. 


FY 2014 Rural Health Network Development Planning Grant Program: HRSA-14-043

Application Deadline: January 16, 2014

The Office of Rural Health Policy (ORHP) has announced this funding to assist in the development of an integrated healthcare network.  For the purposes of this grant program, a rural health network is defined as an organizational arrangement among at least three separately owned regional or local health care providers that come together to develop strategies for improving health services delivery systems in a community.  Networks can include a wide range of community partners including social service agencies, faith-based organizations, mental health agencies, charitable organizations, educational institutions, employers, local government agencies or other entities with an interest in a community's health care system. Successful applicants may request up to $85,000 for one year to create a foundation for their infrastructure and form a coordinated plan among members to address important regional or local health needs.  ORHP expects to fund approximately 15 grantees. There will be a technical assistance call on Tuesday, December 3 at 1:00 pm ET:


Meeting Name: Rural Health Network Development 

Planning Program 

Web connection: Click here

Toll-free call-in number: (800) 475-0512

Participant Passcode:  5732913


U.S. Department of Health and Human Services announces new funding opportunities to support the primary care workforce

To help expand and support the nation's supply of primary care practitioners, HHS Secretary Kathleen Sebelius today announced the availability of funds for two programs that receive funding under the Affordable Care Act. 

Robert Wood Johnson Foundation Executive Nurse Fellowship
Application Deadline: January 14, 2014 (3:00 pm ET)  
The Robert Wood Johnson Foundation Executive Nurse Fellows program is a three-year advanced leadership program for nurses who aspire to lead and shape health care locally and nationally. Fellows strengthen and improve their leadership abilities related to improving health and health care. Interested health center nurses should feel free to contact Cheri Rinehart, PACHC President & CEO and a graduate of the program, for more information, including other PA health center alumni of the program.


Debunk the Myths: Grant Application Video Series

Federal grants can be excellent funding opportunities for your project, but not understanding the process can lead to a great deal of frustration. This video series will debunk common myths and assist you with your grant applications.

FY 2014 Service Area Competition (SAC) Technical Assistance

Service Area Competition - New, Competing Continuation, and Supplemental (HRSA-14-021, HRSA-14-022, HRSA14-023, HRSA-14-024, HRSA-14-025, HRSA-14-026, HRSA-14-027, HRSA-14-028)

Through the Service Area Competition (SAC), HRSA will award approximately $468 million in funding to an estimated 310 SAC applicants. A SAC application is a request for Federal financial assistance to support comprehensive primary health care services for a competitively announced underserved area or population. All available service areas (see below) are currently served by Health Center Program grantees whose project periods are ending in FY 2014.

Application Deadlines

Project Period Start DateHRSA Announcement Deadline (11:59 PM ET)HRSA EHB Deadline (5:00 PM ET)
November 1, 2013HRSA-14-021July 24, 2013August 7, 2013
December 1, 2013HRSA-14-022July 31, 2013August 14, 2013
January 1, 2014HRSA-14-023August 14, 2013August 28, 2013
February 1, 2014HRSA-14-024September 11, 2013September 25, 2013
March 1, 2014HRSA-14-025October 9, 2013October 23, 2013
April 1, 2014HRSA-14-026October 30, 2013November 13, 2013
May 1, 2014HRSA-14-027December 4, 2013December 18, 2013
June 1, 2014HRSA-14-028January 8, 2014January 22, 2014

*Please click on the title for more information regarding the various grants. 



Bureau of Primary Health Care Loan Guarantee Program

Application Deadline: Applications accepted on an ongoing basis
Loan program to Section 330 health centers to obtain a loan guarantee for the financing of a medical facility construction, renovation and modernization.
Patient Centered Medical Home (PCMH) Corner 

Weekly Questions and Answers around PCMH to help you!


a)      What is an acceptable manual process to flag when orders (x-rays, lab, etc.) are overdue? There are a number of options you can use, but not limited to the ones mentioned here: 1. Use an Excel spreadsheet that documents what orders were placed and have someone responsible for checking the status of the orders and indicating that status in the spreadsheet. The spreadsheet can indicate the date the order is due and if that order hasn't been received by the due date then follow up needs to occur and the cell with the information can be color coded to show the lateness; or 2. The spreadsheet can be printed off and highlighted with a regular highlighter marker to show which orders need follow up. It is critical, though, that whatever process exists that it is documented.It must include what staff person is responsible for flagging and following up on the overdue orders, how the specific action takes place in the organization, and at what point does the flagging occur, eg., what is the turn around time to receive the results of the order.

b)      In measuring patient experience, how can care coordination/whole person care/self management support be factored in our patient satisfaction questionnaire? 

You may consider the following questions to include on the survey: 1. "Did you receive any reminders about your care between office visits?"; or 2) "Did your provider seem up-to-date about the care that you received outside of the clinic?" - gets to were the results returned, were they provided to the patient's provider, emphasizing that care coordination piece occurring on the back end and affecting the patient's experience within the practice; or 3) "If you had any lab tests during your last visit, did you receive a phone call, email, or letter letting you know what the results of the lab test was?"; for whole person care/self management support, 4. "Did anyone ask during your last visit talk with you about specific goals for your health?" - can also be asked after visit occurs; or 5. Did anyone ask during your last visit if there were things that make it difficult for you to take care of your health?" - Again assessing, is your practice providing that self management support, addressing barriers to care during the visit; or 6. "Did anyone during your last visit ask you about a personal problem, family problem, alcohol us or drug use?" - again, focusing on the whole person care aspect.
Clinical Quality 

Free Prescription Drug Discount Cards Available

SaveonRxDrugs sponsors a Nationwide Outreach Program which provides FREE Discount Prescription Drug Cards to assist people in need with saving money on their prescription medications. The cards are available in quantity to distribute to your patients who are uninsured, under-insured, who have limited or no prescription coverage, as well as those with high deductible policies and co-pays. There is absolutely no cost to you or your patients for the cards, which provide significant savings on prescription drugs at over 80 percent of U.S. pharmacies. Send an email to for a supply of cards or visit the SaveonRxDrugs website for more information.


Learning Module Series Available for Safety Net Dental Directors and Managers

Safety Net Solutions (SNS) is offering a learning module series consisting of seven 30 - 40 minute online learning modules designed for dental directors and dental practice managers. The modules provide an overview of the main components of practice management for a safety net dental program and offer free continuing education credit.

Health Observances This Week
Safe Toys and Celebrations Month 
The holiday season is a time for family, fun, and festivity, but it can also be a time of danger. 
Each year, many people suffer from eye injuries caused by unsafe toys and celebrations. Watch  
those tree branches, chill your champagne bottles, cover the cork while releasing it, and celebrate  
safely. If you experience an eye injury, seek medical attention immediately. For more  
information, contact: Communications Division | American Academy of Ophthalmology |  
415.447.0258 | |
Has your FQHC joined the 
National Branding Campaign?


With more than 43 billion people  eligible to enroll in private insurance starting this October 1, FQHCs strive to create an identifiable unifying identity for themselves. This is where the National Branding Campaign for Our Health Centers comes into place. 

The campaign is a national branding effort to strengthen recognition of our Health Centers as a unified and nationwide network of quality community-based primary care providers.  Initially created at the state level by the Pennsylvania Association of Community Health Centers (PACHC) and its membership, the National Association of Community Health Centers has expanded the campaign nationwide.


The FQHC Brand Components  

MACHC recently hosted a Branding Webinar for MD and DE Health Centers with CEO of PACHC, Cheri Reinhart and Event and Communications Coordinator, Kirsten Keyes, as guest speakers. If you missed the webinar and would like access, please click here.

Mid-Atlantic Association of Community Health Centers | | |
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