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

Enrollment until 
Dec 27,2013 
for insurance starting on Jan 1, 2014 
Have news to share with us? Want to be featured on our next E-Digest? Want to read about something in particular? Please email us at 

Let's Stay Connected
December 20, 2013 
Community Health Center Spotlight


Baltimore Medical Systems on the successful Outreach and Enrollment Event held at Morning Star Baptist Church in Baltimore, Maryland. The event was in collaboration with Enroll America's Constituency Engagement Department and was widely successful. Numerous interested consumers asked questions related to Open Enrollment and were interested in signing up. However, due to the website being down this past weekend, they were unable to sign up but received appointments to come back to BMS and sign up at a later convenient time. 


Kudos to BMS for getting back to MACHC on their interest incollaborating with Enroll America on this wonderful event. 


If your health center is hosting an Outreach and Enrollment event, please reach out to us at


Health Centers are more likely than other providers to accept new patients - just another reason to STOP funding cuts to health centers and #FixTheCliff.
MACHC Happenings

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.

(2) MACHC Outreach Team Call
  Friday, January 10th, 2014 11:00 AM - 12:00 PM
Call in- 1-866-740-1260  Access code: 4319483  


(3) Transformational Leadership Call
  Tuesday, January 14th, 2014 10:00 AM - 11:00 AM
Call in- 1-866-740-1260  Access code: 4319483  


(4) MACHC Emergency Preparedness Call
  Wednesday, January 15th, 2014 10:00 AM - 10:45 AM
Call in- 1-866-740-1260  Access code: 4319483  
(5) DHMH HPP Call
When: Thursday, January 16th, 2014 10:30 AM - 12 PM

Dial in from your phone:

Meeting ID: 6455

Dial in Number: 410-225-5300


Strategic Planning Committee Meeting
When: February 20th - 21st, 2014
Where: Turf Valley, Maryland
Policy, Advocacy and Legislation
National News

HHS Announces Funding Opportunity for Mental Health Service Expansion, Awards Additional Outreach and Enrollment Funding, and Indicates Future New Access Point Funding Possible

Last week, the Department of Health and Human Services (HHS) announced a planned opportunity for $50 million to fund approximately 200 awards to health centers to establish or expand mental health services. HHS also awarded $58 million in Affordable Care Act funding to 1,157 health centers for the continuation of Outreach and Enrollment activities. For more information on these funding activities and possible future funding, read the full update here

White House Media Blitz Garners Attention for Health Centers on Social Media 

Thanks to all Health Center advocates who participated in a Health Center media blitz last Wednesday. The blitz, initiated by the White House, was meant to garner attention for Health Centers' importance to the success of the Affordable Care Act. On Wednesday, there were over 250 tweets with the #FQHC hashtag, and those tweets generated 510,542 impressions on Twitter. Additionally, 11 Members of Congress tweeted about the importance of Health Centers. You can read the White House press release here

MACHC took part advocating and participated during this Health Center media blitz, did you participate, too?!

QHP Contracting Assessment: Last Chance to Participate!

NACHC has emailed all health center and look-alike CEOs with a link to an assessment about contracting issues with Qualified Health Plans (QHPs). The information health centers provide will help inform NACHC advocacy efforts around ensuring best contracting practices for health centers and be used to develop new training/technical assistance for health centers. This brief assessment is co-sponsored by your PCA and NACHC and will close this Friday, December 20. If you did not receive the email or need help accessing the survey, please contact Allison Abayasekara


Obama Administration Extends High-Risk Insurance Pools

Last week, the Obama administration announced that it would extend the temporary high-risk insurance pool program by one month. The insurance pool, otherwise known as the Pre-Existing Condition Insurance Plan, covers over 100,000 people with high-need medical conditions and has been extended through the end of January due to the setbacks in the enrollment process. You can read more about the extension here.


Improvements in the government's insurance Web portal have not translated into stronger public support for the health law, a new poll shows. Nearly half of the public views the law unfavorably this month, while only a third likes it. That's about the same as in November, when public opinion plummeted after the technologically troubled start of the health care marketplaces, according to the poll from the Kaiser Family Foundation. 
The Obama administration has opened a small, but potentially important, hole in a key requirement of the new healthcare law, letting some people who have had insurance policies cancelled avoid the requirement to buy coverage next year. The change, announced Thursday night in a letter that Health and Human Services Secretary Kathleen Sebelius sent to a group of senators, marks the first exception the administration has allowed to the law's so-called individual mandate. 
Insurers pressing for last-minute enrollees under the health-care law say they are running into a worrisome trend: Customers who were put off by the insurance marketplaces' early troubles are proving hard sells. Many people thwarted by the technical problems of are reluctant to try again, citing frustration with the federal site, web-security concerns and the pressure of the holidays, several insurers say 

With Obama Now In Need, Aides Put Off Their Exits
In any White House, the end of the year typically brings staff changes, especially as exhaustion sets in during the later years of an administration. But the Obama team has been as tested as any in decades: by economic calamity, the winding down of two wars, an expansive domestic agenda, various international crises and, lately, the trouble-filled execution of the most ambitious health care program since Medicare. Controversy over the health care law has helped drive Mr. Obama's approval ratings to new lows, a trend that the White House is scrambling to reverse. Longtime aides who stayed with the president into the second term - thinking that they would remain for months or a year to help with the transition - are now feeling pressured to extend their service, officials said. 

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. 

Gansler, a Democratic candidate for governor, has been highly critical of the role played by his rival, Lt. Gov. Anthony G. Brown (D), in overseeing the implementation of the federal health care law in Maryland. Brown co-chairs a council that has guided reforms in the state but has said he was not involved in the day-to-day operations of the exchange  





Finance & Business

 Budget Deal Expected to Pass Final Vote

A bipartisan budget deal was unveiled last week by House and Senate Budget Committee Chairs Paul Ryan and Patty Murray. The Bipartisan Budget Act of 2013 went on to pass the House by a vote of 332-94 and yesterday cleared a procedural vote of 67-33 in the Senate. The legislation will now proceed to a final Senate vote which is set to occur today, clearing the way for the President's signature. Read more here.


If you're one of the 150 million Americans who get health insurance through your job, prepare to pay more. The new year will likely bring higher deductibles and co-payments, penalties for not joining wellness programs and smaller employer contributions toward family coverage. While some workers and employers blame the federal health law for those changes, benefit experts say the law is mainly accelerating trends that predate it.
The Latest News on ACA
What's the LATEST 
on the ACA this week


Update: HRSA Funding

  • Last week, the Health Resources and Services Administration (HRSA) announced approximately $58 million in awards made available through the Community Health Center Fund in the Affordable Care Act (ACA). These awards will support 1,157 health centers across the nation currently working to enroll uninsured Americans in new health insurance coverage options made available by the ACA.  With these funds, health centers will be able to expand their enrollment assistance efforts as more Americans enroll into affordable health insurance coverage. More specifically, this will help health centers to meet immediate needs, including expanding the hours of their existing Outreach and Enrollment assistance workers, and hiring new or temporary Outreach and Enrollment assistance workers.

    Eligible applicants were Health Center Program grantees who received outreach and enrollment funding from HRSA in FY 2013.

    Press Release: Health Centers to Help Uninsured Americans Gain Affordable Health Insurance Coverage 

    List of health centers receiving this funding: Outreach & Enrollment Assistance Awards to Health Centers 

    To learn more about HRSA‚€™s Health Center Program: What is a Health Center?


    Grab Bag FAQs

    Q:  It looks like some people who have received their eligibility results can't reset their application and start over, but other people can.  Why is this happening?

    A:  You are right, currently the option to remove an application is not enabled for individuals who have already enrolled in a QHP, and also is not enabled for individuals who have already received affirmative eligibility determinations for Medicaid and CHIP.  This is because the information about applicants who have already enrolled has been sent to the insurance company, and information about applicants who are Medicaid or CHIP eligible has already been queued for sending to the state Medicaid and CHIP agencies.  If the Medicaid or CHIP agency finds that the individual is not eligible, the state agency will transfer the account back to the Marketplace and the applicant will have an opportunity to get APTC at that time. 

    This is something we are still working on, because we know some consumers are questioning their eligibility determinations.  We are working on some strategies to help people who think they may have received an incorrect determination for Medicaid and CHIP, especially if their application was submitted early in the open enrollment period.  We will be in touch to let you know if the option to reset the application becomes available for more consumers.  In the meantime, the fact that these types of consumers can't remove their applications from the website is not a defect. 

    Q:  If an applicant who has not been assessed eligible for Medicaid asks to have a full determination for Medicaid (e.g., they check the box next to their name on the results page and press the "Send to Medicaid" button), does the rest of the application process stop and wait for an answer from the Medicaid agency?

    A:  No.  An applicant who has been determined eligible to enroll in a QHP and/or to get a premium tax credit, may continue to plan selection and enrollment even if they choose to send their information to the state for the state Medicaid agency to do their own check on the individual's eligibility.  If the applicant ends up being Medicaid-eligible, the Medicaid agency will let the Marketplace know, so the Marketplace can terminate the premium tax credit if necessary.  Applicants who choose to get a full determination by the Medicaid agency, or whose information is sent to the Medicaid agency because the individual has a disability, can still enroll in a plan through the Marketplace to be sure they have coverage on January 1st.

    Q:  How should consumers respond to the question about tobacco use that is part of the Plan Compare feature?

    A:  If a consumer is a regular tobacco user, insurance companies may be allowed to charge that person a higher premium.  The question about tobacco use is very specific. The question asked on the application is this:  Within the past 6 months, have you used tobacco regularly?  Regular tobacco use is defined next to the question as "using tobacco 4 or more times per week on average, excluding religious or ceremonial uses."  This question will be asked for each member of the household who is over the age of 18 and seeking health coverage. 

    When you are assisting consumers, you should tell them to answer this question truthfully.  So, if during the past 6 months, they have used tobacco 4 or more times per week, on average, they should answer yes to the question on whether they use tobacco regularly.  The only exception to this is if they are using tobacco for religious or ceremonial purposes.  Religious or ceremonial use of tobacco does not count as "tobacco use" when determining whether an individual uses tobacco regularly.   

    If a person answers "yes" to the question about regular tobacco use, they will also be asked on the application to provide the date when they last used tobacco regularly.  This question should be answered truthfully for each household member who answered yes to the question about regular tobacco use. 

    Q:  What is acceptable documentation for income?

    A:  The list of acceptable documentation for self-employed income is as follows:

    • Wages and tax statement (W-2)
    • Pay stub
    • Letter from employer
    • Self-employment ledger
    • Cost of living adjustment letter and other benefit verification notices
    • Lease agreement
    • Copy of a check paid to the household member
    • Bank or investment fund statement
    • Document or letter from Social Security Administration (SSA)
    • Form SSA 1099 Social Security benefits statement
    • Letter from government agency for unemployment benefits

    These documents don't necessarily need to be dated for 2014.  For example, consumers can provide recent pay stubs if they don't expect their income to change in 2014.  If consumers expect their income to go up or down in 2014, they can provide other documents, like documents that state when contract work will end.  If any of their income comes from freelance work, they can fill out self-employment ledgers that include their expected income. For more information on income:  What income and household information do I provide when I apply for Marketplace coverage? and Answers to Questions About Income.

    Remember:  On the application, when in doubt, always enter an income source.  As an assister, you should inform consumers about all types of income that should be included on the application. If a consumer informs you that they have income that should be included on their application that they are not including, it is an assister's responsibility to inform the consumer that all income sources should be included. 

    Q:  Can assisters retain a consumer's application ID number in order to assist the consumer with follow up with the Marketplace?

    A:  Yes, as retaining the application ID number is a form of contact information that a consumer can chose to provide to the assister for the purposes of follow up.  An assister may retain a consumer's application ID number with a consumer's consent so long as they protect that information consistent with all other PII as discussed in the next section. 

    An assister can help a consumer follow up with the FFM using the consumer's application ID number if the consumer asks the assister to do so.  However, an assister may not follow up on a consumer's application without the consumer being physically present with the assister, or on the telephone. 


 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!


Practice Requirements

1. What does NCQA Level 1+ and Level 2+ mean? 

Maryland is considering designating "must pass" elements within each of the nine NCQA domains. These elements have been more strongly linked to potential reductions in costs to the purchasers and patients and, as such, are a priority.

2. Will practices be required to pay the NCQA application fee? 

The Maryland Health Care Commission is working to obtain external funding to cover practices' NCQA application fees. At this time, the Commission has not identified a funding source, but will notify Program practices when and if funding becomes available. Fees for first-time applications include a standard $80 for the survey tool license and $450 per physician. If a practice has six or more physicians, the fee is $2,700 for all physicians practicing at the site applying for recognition.

3. Will practices be required to have an operating Electronic Health Record to participate in the Program? 

No, practices will not be required to have an operating EHR to participate in the Program initially. The Program will require practices to have a registry, either as part of an Electronic Health Record, or as a stand-alone program, to meet NCQA Level 1+ recognition. However, to achieve Level 2+, an EHR with decision support is required. Practices need to reach Level 2+ within 18 months of becoming a Program practice.

4. Will practices be required to have NCQA PPC-PCMH Recognition prior to applying for the Program? 

No, the Program requires that practices to apply for NCQA Level 1+ or higher recognition within 6 months of the commencement of the Program on January 4, 2011. Practices must achieve NCQA Level +1 or higher recognition by December 2011 and NCQA Level 2+ or higher recognition within 18 months of the Program commencement. 

Clinical Quality 

1. Will practices be responsible for reporting quality measures during the Program? 

Yes, practices will be responsible for collecting information on their performance as part of NCQA recognition. Practices will be asked to report process measures for at least one of the following conditions: diabetes, heart/stroke management, and asthma control. Reporting requirements will be aligned with Medicare and Medicaid's electronic health records meaningful use definition for bonus payments and with Medicare's PQRI standards, if possible.

2. Will quality measurement affect Program practices' incentive payments? 

Practices earn incentive payments based on meeting quality targets. Practices will also have to meet certain utilization reduction thresholds in order to receive relevant incentive payments from meeting quality targets.

Health Observances This Week
December is 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 | | |
4319 Forbes Blvd. Lanham, MD 20706    |    |    301.577.0097

Copyright © 2013. All Rights Reserved.