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

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
February 28, 2014 
Community Health Center Spotlight
The Board of Trustees of People's Community Health Centers (PCHC), Inc. announced the appointment of Ms. Stacy C. Fruhling as the Interim CEO. She has assumed the responsibilities of the office starting February 24, 2014. Ms. Fruhling will succeed Ms. Patricia S. Cassatt who is no longer with the organization.
Ms. Fruhling had been with PCHC for four years, serving most recently the Chief Administrative Officer. Her work and supervision of several departments within the organization has contributed the continued success and growth of the organization, fostering new partnerships and collaborations within the healthcare community. Ms. Fruhling is very pleased to have this opportunity and is eager to lead the organization through the ever changing landscape of healthcare, to continue to provide quality care to the patients served by PCHC. Please join MACHC in welcome Ms. Stacy Fruhling into our membership and wish her continued success in her current role as CEO of PCHC!
MACHC Website Under Construction..... 


New Website COMING SOON!!!!


Technical Assistance Request Form 
(to be submitted prior to receiving any TA from MACHC)

NACHC's "Access is the Answer" Campaign

"Access is the Answer", NACHC's new policy and advocacy campaign designed to communicate the critical importance of providing Health Centers with the resrouces and tools they need to help solve America's health care challenges, was launched earlier this month. As we move forward with the campaign, it is crucial that you get involved! Get started today! Sign the Access is the Answer petition. 

Take action today to send a critical message to  Congress and the President about the importance of supporting America's Health Centers. We are asking every Health Center to collect AT LEAST 500 signatures by the end of March - access the template petition and other resources on the Campaign for America's Health Centers website to get started. Take action: sign the petition and work with your Health Center leadership to organize a petition drive locally today!
MACHC Happenings

Maryland Health Connection and our consumer assistance organizations (Connectors) are hosting a series of free enrollment health fairs throughout the state in March to help you get covered before the March 31 deadline. 

Come to a free HealthConnect NOW event near you, where you'll get in-person to select and enroll in health coverage that fits
your needs and budget. Insurance carriers and brokers will
also be on hand to answer your questions. Free health screenings, healthy living demos, food & fun!

  • We'll help you shop, select and enroll in health coverage that fits your needs and your budget  
  • Find out if you qualify for Medicaid  
  • Determine your eligibility for tax credits and cost-sharing reductions to reduce your insurance premiums  
Meet with navigators and authorized insurance brokers to complete your enrollment 
(1) Community Health Center Essentials: FREE 2-Part Webinar Series!!!


B'More Healthy Expo
10 am - 5 pm
Baltimore Convention Center
HCAM Enrollment Ctr., Level 3
1 W. Pratt Street
Baltimore, MD 21201



Waldorf Jaycees Hall
2 - 8 pm
3090 Crain Highway
Waldorf, MD 20601



Wicomico Youth & Civic Center
10 am - 2 pm
500 Glen Avenue
Salisbury, MD 21804



Harford Co. Library - Bel Air
1 - 5 pm
100 E. Pennsylvania Ave
Bel Air, MD 21014



Healthy Howard/
Howard Co. Health Dept.
10 am - 2 pm
Ascend One Building
8930 Stanford Blvd.
Columbia, MD 21045



Southern Regional Technology
and Recreation Complex
9 am - 3 pm
7007 Bock Road
Fort Washington, MD 20744


(2) Enroll America Webinar: How to Engage Faith Communities in Outreach

Are you interested in deepening or initiating relationships with faith communities but unsure how or where to start? Enroll America has built a multi-cultural, interfaith coalition of churches, organizations, and faith-based providers that are engaging their members in outreach and enrollment. On March 3, from 4:00 - 5:00 pm, Enroll America will host, How to Engage Faith Communities in Outreach.  Join and hear useful strategies to kick-start your outreach and help you move your engagement to the next level. Click here to register.


(3) In effort to provide CHC staff with the tools and training necessary to successfully navigate the transformed healthcare environment, NACHC is pleased to present our upcoming 2-part Webinar Series:  Community Health Center Essentials. The purpose of this series of webinars is to help CHC staff develop a better understanding of those managed care and financial concepts that are vital to CHC business operations.

Session I:  Managed Care 101:"The Basics" 

Thursday, March 6th 2:00pm-3:30pm

Register here by March 4th!  


Session II: Key Financial Concepts for Clinicians 
Thursday, March 13th 2:00pm-3:30pm


Register here by March 11th!

Session I: Managed Care 101: "The Basics"

Description:  What is managed care?  What is a PPO? These topics and many others will be addressed during the course of this 90-minute webinar.  This session is designed to educate CHC staff on the basics of managed care, its principles, concepts and the role of CHCs. To those new to the healthcare industry, it is imperative they develop a basic understanding of the managed care Industry, how it functions and the role of the provider organization in the delivery of care.

Key learning objectives include:

  • The Evolution of Managed Care and Population Health Management
  • Gaining Familiarity with Managed Care Principles
  • Increased knowledge of Managed Care Products & Networks
  • Provide an overview of key reimbursement mechanisms and contracting strategies
  • The Role of the Community Health Center in a Managed Care Environment  
Duration: 90 Minutes
Discussion Lead:  Monica Powell-Gerald, MHSA, Director, Innovative Care Networks

Target Audience:  CHC Staff

Click here to register for Session 1: Managed Care 101



Session II: Key Financial Concepts for Clinicians

Description: Health care delivery continues to evolve and today's providers must develop business skills as well as have an understanding of reimbursement and financial statements than ever before.  This session is designed to educate CHC clinical staff on key financial concepts important to the delivery of care.  As clinician responsibilities have evolved, it is critical that CHC clinical leaders become familiar with those key indicators impacting the financial health of provider organizations. Likewise, these skills will allow clinicians to become knowledgeable contributors to conversations related to organizational viability operational effectiveness and managed care contracting.

Key Learning Objectives Include:

  • Exposure to basic financial reports and key indicators
  • Improved understanding of CHC impact on total cost of care
  • Increased  ability to comfortably engage in conversations related to organizational finances
  • Creating a holistic approach to understanding how the basic financial indicators impact care delivery and the impact on  total cost of care


Duration: 90 minutes
Discussion Leader: Dr. Ron Yee, Chief Medical Officer, NACHC

Target Audience: CHC Clinicians (but appropriate for all staff)

Click here to register for Session II: Key Fininancial Concepts for Clinicians.



(4) NHSC Loan Repayment Program Application Conference Call 
Wednesday, March 5, 2014 
8:00 - 9:30 p.m. ET 
Dial-in Number: 1-877-917-6902 
Participant Passcode: 5854645

Do you have additional questions about the application process for the National Health Service Corps (NHSC) Loan Repayment Program? Please join us on our conference call, where NHSC staff will be on hand to provide helpful answers about the application process.

Prospective applicants are also encouraged to view the recorded NHSC Loan Repayment Application and Program Guidelines Webcast and the helpful application checklist


(5) The Health Resources & Services Administration (HRSA) is offering a webinar series, Integrating Oral Health Care in HIV Primary Care Settings: A Guide to Oral Health Care for People Living with HIV/AIDS. This is a curriculum designed to assist primary care providers with the information they need to recognize and manage oral health and disease for people living with HIV/AIDS. The curriculum is composed of five chapters: oral health and oral screening, oral diseases, dental emergencies, dental management and patient education.


Part 1: Introduction to Oral Health: Oral Screening and Dental Management
Friday, March 7

2:00 - 4:00 pm, ET
Conference Line Number: 1-888-603-9693
Participant code: 9116383 


Part 2: Oral Diseases, Dental Emergencies, and Patient Education 
Friday, March 28

2:00 pm - 4:00 pm, ET 
Conference Number: 1-888-603-9693

Participant code: 9116383 


When connecting to the webinar, please enter as a guest.


(6) NACHC Policy & Issues Forum 
Please remember that NACHC's Policy & Issues Forum is scheduled for March 19 through 23 in Washington, D.C. We encourage all health centers to participate and schedule appointments with your Congressional delegation for Thursday, March 20. More details are forthcoming from NACHC.



(7) NACHC Offers Training for New Medical Directors

NACHC will host Training for New Medical Directors on March 22-23 in Washington, DC. For more information, click here.



(8) SAVE THE DATEWebinar coming in April!

ACA: How to Enroll and Help Consumers Eroll

Do you want to know more about the Affordable Care Act and its impact on patients?  Doctors for America has a free one-hour workshop that will teach you the basics of the ACA.  This includes changes that impact all Americans, including those who already have insurance, and the new options for getting access to quality, affordable health care in Maryland.  Please join us to learn more about the details of the changes, important dates, and what you can do to help get your patients connected.



:  Cultural Competency 

Where: Doverdown, Dover, DE

When: May 8th - May 9th (attend 1 of the two 1/2 day sessions for the conference)

The training will consist of didactic training and panel discussion and will offer:

*   Discussions on cultural competency techniques

*   Importance of utilizing culturally sensitive language and behavior

*   Strategies for health entities to foster greater engagement with clients and co-workers 

*   Excellent networking opportunity   

*   Continuing Education Credits for Nurses have been applied for 



MACHC's Annual Conference
When: Thursday, September 18th - Friday, September 19th, 2014 
Where: Dover Downs Hotel, Dover, DE 




MACHC's Emergency Preparedness Exercise & Drill Workshop 
April 2014
Please check back next week for the Workshop Date.
*FQHC EP Coordinators MUST attend this important workshop
DHMH HPP Program 2014 Timeline of Events:

Final Draft of ESF-8 Communications Plan Posted to HAN

DHMH, OP&R has just released a final draft of the ESF-8 Communications Plan, which has been published to the Maryland Health Alert Network (HAN) website along with a comment form. We are requesting partner feedback in order to finalize this plan. Please see the attached memo from Sherry Adams providing background information on the processes utilized to draft the plan, instructions for submitting your feedback, and the actions that OP&R will take to follow up.


The ESF-8 Communications Plan and comment form can be accessed by logging on to HAN and selecting the following folders: Documents/Communications/ESF-8 Communications Plan.


Please use the following email inbox to submit your comments form: Comments are due no later than February 28, 2014.


For questions or additional information about the ESF-8 Communications Plan, contact Alicia McClelland, DHMH Communications [W: 410-767-4493].


Statewide Inventory Assessment Project

DHMH, OP&R will be undertaking a statewide inventory assessment of all supplies and materials purchased with Hospital Preparedness Program (HPP) funds. This will involve visiting every facility that has purchased or received items funded by HPP. In preparation


 the assessment, OP&R staff will


 Inventory Management Forms submitted with End of Year Reports dated from FY08 to FY12 (BP1). Data collected from these reports will serve as the minimal items that will be captured during the inventory process.


Over the next few weeks we will be making contact with facilities to follow up on missing or incomplete Inventory Management Forms.

Integrated Public Health and Medical Preparedness Forum (IPHMPF)

Healthcare coalition partners are encouraged to join us for the next Integrated Preparedness Forum, to be held on February 24, 2014. The featured presenters will be Lisa Skolnick and Reanee Murriell of the Federal Bureau of Investigation (FBI). They will be speaking on the FBI Office of Victim Assistance's Response to Criminal Mass Casualty Events.

Save the Date: HPP Budget Period 3 Pre-Application Meeting

The Pre-Application Meeting for HPP Budget Period (BP) 3 has been scheduled for May 21, 2014 at the Maritime Institute Conference Center. A meeting agenda will be provided in the coming months.

Reminder: New Bimonthly Schedule for HPP Healthcare Systems Conference Calls

The HPP Healthcare Systems Partner Conference Calls have moved to a new bimonthly schedule. The first call of the year was held on January 16, 2014. Going forward, these calls will still be held on third Thursdays at 10:30am; however, they will take place on a bimonthly basis. Additional conference calls are scheduled for March 20, May 15, July 17, September 18, and November 20. Appointment notices will be sent out by Bonita Winchester-Bey.

II. Program Updates and Deliverables

National Healthcare Coalition Resource Center (NHCRC) Monthly Follow Up for Strategic Planning

NHCRC faculty will continue to engage in monthly follow-up to support healthcare coalitions with implementation of the priorities identified in the workshops. Partners are encouraged to attend and actively participate in these follow-up sessions in order to meet their coalition's goals and objectives. Contact your respective HPP Regional Coordinator


information about


 meeting times for your regional coalition.

III. Preparedness News

Proposed Rule: Emergency Preparedness Requirements for End Stage Renal Disease (ESRD) Facilities

The Centers for Medicare and Medicaid Services (CMS) has released a new rule that would establish national emergency preparedness requirements for Medicare- and Medicaid-participating providers and suppliers. This would include hospitals, ambulatory surgical centers, hospices, long-term care facilities, home health agencies, critical access hospitals, organ procurement organizations, and End Stage Renal Disease (ESRD) facilities, among others. The intent of the rule is to ensure that these organizations adequately plan for both natural and man-made disasters, and coordinate with federal, state, tribal, regional, and local emergency preparedness systems. It would also ensure that they are adequately prepared to meet the needs of patients, residents, clients, and participants during disasters and emergency situations.

The proposed rule would add additional requirements to the Conditions for Coverage for ESRD facilities and relocate the emergency preparedness Conditions for Coverage requirement established in the April 2008 Final Rule "Conditions for Coverage for End-Stage Renal Disease Facilities; Final Rule." An overview of the proposed rule's requirements is available at Comments on the proposed rule are due by 2/25/2014.

IV. Preparedness Trainings, Exercises and Events

DHMH MSAT G2 Satellite Phone Webinar Training and Drill Schedule

DHMH OP&R has scheduled two webinars to provide preparedness partners with up-to-date, hands-on training before quarterly MSAT testing begins in March. See the attached announcement for specific information regarding the training.

Webinar Schedule:

Regions I, II & V: February 18, 10:30-11:30am  [Calendar appointments have been sent to designated primary healthcare emergency planners.]

Regions III & IV: March 6, 1:30-2:30pm  [Calendar appointments have been sent to designated primary healthcare emergency planners.]

DHMH, in partnership with local health departments, state facilities and acute care hospitals, will begin quarterly testing of the MSAT wall-mounted satellite phones in March 2014. The objective of quarterly tests is to ensure that all agencies equipped with an MSAT are familiar with the use and functionality of the device.

March MSAT Drill Schedule

Regions I-II: March 11 (1-2pm)  

Region III: March 17 (10-11am)

Region IV: March 19 (2-3pm)

Region V: March 12 (11am-12pm)

A full testing schedule that includes test times has been posted to the HAN website and can be accessed by logging in to HAN, clicking the Documents tab, and selecting Communications folder/Appendix A/Statewide Quarterly Testing Calendar. For specific questions regarding testing of the MSAT satellite phone, please contact your HPP Regional Coordinator or Alicia McClelland at DHMH Communications [W: 410-767-4493].

Region III Alternate Care Site Cache Deployment Tabletop Exercise

Date: March 6, 2014

Time: 8:30am - 12:30pm

Location: MedStar Harbor Hospital [3001 S. Hanover Street, Baltimore, MD 21225]


The purpose of this exercise is to test the newly drafted Region III Maryland Alternate Care Site (ACS) Equipment and Supply Cache Activation Plan, which impacts hospitals, public health and other responders across Region III. The Plan outlines the process for activation, deployment and return of cache equipment and supplies located at the USAR warehouse. The exercise will provide participants an overview of the Plan and address stakeholder roles and responsibilities. For more information and to register, see the attached flyer.

Preparedness Trainings   -------------

ICS 400: Advanced ICS.

In coordination with the Department of Health and Mental Hygiene (DHMH), the Maryland Emergency Management Agency (MEMA), Active Learning and Exercise Branch invites you to participate in the ICS 400: Advanced ICS training course.


Dates: February 19-20, 2014

Time: 8:30am - 4:30pm

Location: Baltimore Public Safety Training Academy, Room 200 (3500 W. Northern Parkway, Baltimore, MD 21215)


Registration closes on February 12, 2014. For additional information and registration instructions, see the attached flyer.




MEMA Community Cybersecurity Courses

AWR 136: Essentials of Community Cybersecurity. This course provides individuals, community leaders, and first responders with information on how cyber attacks can impact, prevent, and/or stop operations and emergency responses in a community. The course also provides a cursory introduction to cybersecurity vulnerabilities, risks, threats, and countermeasures. It explains vulnerabilities of computer systems and networks and how these vulnerabilities can affect communities, organizations, and daily workplace operations.


Date: March 4, 2014

Time: 8:00am - 12:00pm

Location: James N. Robey Public Safety Training Center, 2200 Scott Wheeler Drive, Marriottsville, MD 21104


To register:


MGT 384: The EOC's Role in Community Cybersecurity. This course provides an awareness of how cyber events can impact communities. Participants will learn (1) the roles and responsibilities needed to detect, prevent and respond to cybersecurity incidents; (2) how the EOC and community can plan for and manage information needed for a cyber event; and (3) how cyber attacks can be used to affect, disrupt and/or complicate emergency responses.

Dates: March 4-5, 2014

Times: 1:00pm - 5:00pm (March 4), 8:00am - 5:00pm (March 5)

Location: James N. Robey Public Safety Training Center, 2200 Scott Wheeler Drive, Marriottsville, MD 21104


To register:




Active Shooter in a Healthcare Setting.

In coordination with the Department of Health and Mental Hygiene (DHMH), the Maryland Emergency Management Agency (MEMA), Active Learning and Exercise Branch invites you to participate in the Active Shooter in a Healthcare Setting training course.


Date: March 25, 2014

Time: 8:30am - 4:30pm

Location: Springfield Hospital Center, Central Conference Room, 6655 Sykesville Road, Sykesville, MD 21784


Overview: Active Shooter training for healthcare professionals which will give strategies for responding to a shooting situation. Guest speakers from Johns Hopkins will discuss a shooting incident that occurred at their facility. MEMA/MSP staff will provide training on developing plans within facilities.


Register: Registration closes on March 18, 2014, at 8:30am. To register, visit


For more information, see the attached flyer.




Free CDC Crisis and Emergency Risk Communication (CERC) Training on March 27


Who: You!

What:CDC Crisis and Emergency Risk Communication Training [sponsored by Fairfax County and the National Public Health Information Coalition]

Where: Fairfax County Government Center, 12000 Government Center Parkway, Fairfax, VA 22035

When: Thursday, March 27, 9 a.m. to 4 p.m.

Cost: Free!



About This Training: CERC training is a fast-paced, interactive course that gives participants essential knowledge and tools to navigate the harsh realities of communicating to the public, media, partners and stakeholders during an intense public health emergency. CERC sessions are presented across the U.S. and internationally to offer helpful guidance for communicating with people when the unthinkable happens to them, their family, their community or the nation. This rare in-person CERC training is the first to be conducted in the National Capital Region in several years. This session will be taught by Richard Sheehe, National Public Health Information Coalition CERC Project Manager and Senior Research Fellow at George Mason University's Center for Health and Risk Communication. More CERC information is available at:  and


Target Audience: Public information officers; federal, state, and local public health professionals; health care professionals; emergency medical services professionals; preparedness partners; and civic and community leaders 


Training Goals: Share communication strategies that will help to effectively prepare for and respond to public health emergencies; review and disseminate current crisis and emergency risk communication training curricula and tools; and train communicators in how to systematically plan, develop, implement, and evaluate crisis and emergency risk communication training activities.




Emergency Management of Radiation Accident Victims (REAC/TS) Training Course Rescheduled


The course has been successfully rescheduled for April 22-23, 2014.  For more information and to register, see the attached flyer




The United States Army Medical Research Institute of Chemical Defense (USAMRICD) and the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) are advertising the following training opportunities for 2014.

Medical Management of Chemical and Biological Casualties (MCBC) Course.  Dates: multiple dates in 2014

Field Management of Chemical and Biological Casualties (FCBC) Course.  Dates: multiple dates in 2014

CE, CME, CEH credits are available for these courses. See the attached flyers for additional details and registration information.

Policy, Advocacy and Legislation
National News
Wolozin is a volunteer for the Northwest Neighbors Village in Washington, D.C., one of the more than 200 'villages' across the United States. These neighborhood membership organizations provide volunteers and other resources to help with everything from transportation and snow shoveling to hanging curtains and solving computer glitches. But as many of the Northwest Neighbors' 210 dues-paying members 'age in place' - the village movement's top goal -- some need more than just a ride to the doctor, said executive director Marianna Blagburn. So the group is expanding its services this year with 16 newly trained 'medical note takers' who will accompany members into the doctor's office armed with questions prepared in advance and take notes.
Health Plans Rush To Size Up New Clients
Insurers are rushing to gather health information from the new customers they won on public marketplaces in a high-stakes outreach effort crucial to their hopes of profiting from the health-care law. Health plans need to know the health status of those signing up for coverage so they can project whether the costs are likely to outrun the premiums coming in. That information will be critical in figuring out prices for next year, among other things. But, under the law's new rules, enrollees don't have to disclose pre-existing conditions to buy insurance 

ACA Co-ops Doing Surprisingly Well

Kaiser Health News reports that the 23 nonprofit co-op health plans developed as part of the Affordable Care Act (ACA), "which see themselves as the rebel alliance battling established insurers," have signed nearly 300,000 members and are set to expand into three new states next year. Some, like Maine Community Health Options, did incredibly well. Competing against Anthem BlueCross BlueShield, Maine Community Health Options cornered 80 percent of the market in that state for plans offered through an online exchange to individuals and small businesses. Another surprise is that in many cases co-ops are selling high-benefit platinum plans, even to younger consumers, rather than the less-expensive bronze or silver policies that most were expected to choose. So far co-ops are estimated to have won between 15 and 20 percent of the total signups in the 23 states.
States that have experienced technical problems running their own health care enrollment websites are getting some help from the Obama administration. The administration quietly issued a health law fix Thursday to help those states. Several Democratic-led states, including Oregon, Maryland, Massachusetts and Hawaii, are still trying to solve website problems that have eclipsed those experienced earlier by the federal site, now largely repaired.  
Maryland Begins To Put A Price Tag On Health-Care Exchange Debacle
The cost to taxpayers of flaws in Maryland's online health insurance exchange is coming into focus, with officials estimating at least $30.5 million in unnecessary Medicaid spending and conceding that they have no idea how much it will take to get a system that works. The state has paid $65.4 million to the contractor hired to build the system and fired this week because of the protracted problems. Costs are likely to keep rising as Maryland figures out how to fix or replace the system. 
Washington Wire: GOP Targets Hillary Clinton With Obamacare Attacks Republicans see the Affordable Care Act as prime ammunition in the midterm elections. But party strategists are bent on getting mileage out of President Barack Obama's biggest domestic initiative long after the battle for control of congress ends in November. The Republican National Committee is signaling that one line of attack against Hillary Clinton, should she run for president in 2016, will be her stance on health care 

U.S. hospitals are coping better with ongoing shortages of hundreds of medications, but a new survey indicates that obtaining drugs from alternate sources is costing them a lot of money they can't spare. Premier Inc., the hospital group that did the survey, conservatively estimates that cost at $230 million a year for the country's 5,000 hospitals, on average, from 2011 through 2013.

Florida lawmakers backing expansion of the state's Medicaid program plan to mount a new argument this legislative session: That voting against extending the program would deprive low-income U.S. citizens of access to insurance that's available to some legal immigrants.
HHS Outlines Marketplace Exemptions Related to Health Sharing Ministries

The Department of Health & Human Services (HHS) recently addressed the issue of whether the Amish population is a member of a recognized health care sharing ministry. HHS clarified that exemptions in the case of health sharing ministries are not granted to an entire category of individuals, but on a case-by-case basis. The rule is written to provide a choice for individuals in this category of health sharing ministries (and two others - the incarcerated, and members of federally recognized Indian tribes). Keep in mind, the Amish don't have social security numbers and page 3 of the exemption form states that a SSN is not needed to get the exemption certificate. For further clarification on exemptions, see the  CMS fact sheet. A article on the subject is also helpful.

The finding comes from a government study considered a gold standard to measure public-health trends. Researchers found that just over 8 percent of children 2 to 5 were obese in 2011-2012, down from nearly 14 percent in 2003-2004. Although the drop was significant, federal health officials noted that obesity rates for the broader population remain unchanged, and for women older than 60, obesity rates rose about 21 percent during that period. 
State News
Check out the Delaware ACA Toolkit right here!
In this testimonial, Jenna from #NewarkDE talks about how health insurance is more affordable than you may think.

Listen to more Delawareans talk about what they think about the Health Insurance Marketplace by visiting  #ChooseHealthDE #GetCovered #Delaware





Maryland begins to put a price on health-care exchange debacle

The cost to taxpayers of flaws in Maryland's online health insurance exchange is coming into focus, with officials estimating at least $30.5 million in unnecessary Medicaid spending and conceding that they have no idea how much it will take to get a system that works.

The state has paid $65.4 million to the contractor hired to build the system and fired this week because of the protracted problems. Costs are likely to keep rising as Maryland figures out how to fix or replace the system.

Finance & Business

Federally funded health centers brace for financial loss

Federally funded health care centers, already straining to makes ends meet, now are fighting to block a 70% cut in their funding next year.

The more than 9,000 health clinic centers, which serve 22 million mostly poor patients, were supposed to be big beneficiaries when an estimated 7 million more people were enrolled in health insurance under the Affordable Care Act . So while losing $3.6 billion a year in federal funding in October 2015 would be a steep reduction in support, it hadn't seemed as problematic when the law passed four years ago as it does now.

Next year's funding loss will hit far harder than expected for three reasons:

*Medicaid has not been expanded in about half of the states. The ACA assumed people under 138% of the federal poverty limit would be on Medicaid, but a Supreme Court decision last year let states decide whether to expand Medicaid to cover the poorest of the poor. So, in many states, the sickest patients with the least ability to pay are still using their local clinics for health care.

*Enrollment in ACA exchange plans is well below expectations. At La Clinica Del Pueblo, a Washington, D.C., center that serves about 80 patients a day, little has changed since the Jan. 1 deadline to sign up for insurance, when centers hoped newly enrolled consumers would start showing up. "The enrollment process has been so arduous that we haven't seen an influx of patients," said Alicia Wilson, executive director of the center,

*Insurance is still seen as too costly by many. Some uninsured patients don't believe they need health insurance because they are able to receive low-cost health care from these clinics. This makes outreach and education far more important. La Clinica and Unity Health Care center, also in D.C., both received grants to hire new staff for outreach, education and enrollment, which will help combat some of the misconceptions.

The Latest News on ACA
What's the LATEST 
on the ACA this week




Is Your Health Center Prepared for a Late Rush of Enrollment Requests?

As the March 31 open enrollment deadline approaches, expect increased Obama administration and media communication on the deadline.  A recent Kaiser poll found that three quarters of the uninsured are not aware of the impending deadline, so a ramp up of communication could result in a surge of individuals seeking enrollment assistance. Health centers should prepare to expand phone coverage to handle an increased volume of inquiries as well as prepare to respond to a surge in demand with extended hours as the deadline approaches.

Social Media content:
If you have not already, check out this Enrollment Buzzfeed by the Maryland Health Connection: 
and disseminate on your health center's social media accounts!!!


Resources from Enroll America for Outreach staff helping to enroll!!!

  1. Enroll America's Outreach Webinar on effective strategies of enrollment is finally online!! (see link below):
  2. REPORT on importance of consumers remaining in coverage. This report speaks to Medicaid and qualifying event enrollments, which are ongoing:
  3. Get Covered Guide for insurance terms, which is also available in Spanish, found on the outreach resources page:


Update: Submitting Supporting Documents - ID Proofing v. Application Inconsistencies



It's important for assisters to know the difference between the types of supporting documentation that consumers may be asked to submit. This is because one type of documentation request may delay a consumer's ability to go forward with an eligibility determination and plan selection without the supporting documentation, while the other type of documentation request will not prevent a consumer from going forward and enrolling in a plan if the documents have not been supplied.

There are two main reasons a consumer might be asked to submit supporting documentation: (1) ID proofing, and (2) application inconsistencies. If a consumer is asked to provide supporting documentation for application inconsistencies, the consumer can still get subsidies and enroll in a plan.

1.       ID proofing  

ID proofing is used to verify a consumer's identity when they are creating their MyAccount on ID proofing is accomplished by asking a series of questions based on the consumer's personal and financial history (e.g. current and past residences, auto ownership, employment history, loan history). This process is meant to prevent an unauthorized person from creating an account and applying for health coverage in someone else's name without their knowledge.

If the Marketplace tells a consumer that their identity couldn't be verified, the consumer will need to take additional steps before they can complete their online application for coverage, such as calling the Experian Help Desk at 1-866-578-5409, or uploading or mailing documentation to the Marketplace for review. Consumers should expect their ID proofing paperwork to be processed and turned around quickly, typically within 7-10 business days from when the Marketplace receives the documentation, if not sooner.

2.       Application inconsistencies  

When a consumer fills out their application, they enter certain information about themselves and their family (e.g. state of residence, citizenship or immigration status, income). The Marketplace will attempt to match the information provided by the consumer with the Marketplace's data sources. If there is an inconsistency, the Marketplace will still determine the consumer's eligibility based on the information the consumer provided. The consumer's eligibility notice tells them that they can continue to choose and enroll in a health plan, and that more information is needed. They do not have to wait until they receive a notice that their inconsistency has been cleared before enrolling in coverage. This is true even if the date on the eligibility letter is very soon or has already passed.

For more information on resolving inconsistencies please look here:

Assisters should also read the new fact sheet we posted last week regarding Remote Identity Proofing, Remote Identity Proofing Failures and Application Inconsistencies, which can be found here:

4. New Resource: New IRS Tax Tips 

The IRS has released Health Care Tax Tips to help people understand what they need to know for the federal individual income tax returns they are filing this year as well as for future tax returns. This includes information on the Premium Tax Credit and making health care coverage choices.

Assisters can find the new tips here:

5. Grab Bag FAQs  

Q: On the online application, when a consumer includes an apartment or condominium unit number in their street address, a message appears asking the consumer to verify the address without the unit number listed. What should a consumer do in this case?  

A: If the pop-up message suggests a street address but it does not contain the consumer's apartment or condo unit number, the consumer shouldn't select the address suggested by the message box. Instead, the consumer should double-check their typed address for accuracy and select the address with the unit number included. This is especially important for consumers who choose to receive notices from the Marketplace and their issuer through the mail.

Q: If a consumer's dependent has a foreign address, such as a child studying abroad, how should they include the dependent's address on the application?  

A: gives applicants the option to use the same address as they list for themselves when listing their dependents, or to input a different address. Because the system does not accept foreign addresses, an applicant claiming a tax dependent who is living abroad should choose to use the same address for that dependent as they have listed for themselves.

Q: What should a consumer do if they don't have a physical address, such as people experiencing homelessness, members of Tribes living on reservations, or people in rural areas?  

A: An address is needed in order to complete an application through the Marketplace. If a consumer does not have a fixed or recognized address, they can enter any address where they can receive mail, including a PO box. Consumers experiencing homelessness can provide an address of a shelter, friend or relative. Also, the address needs to be a location in the state of application. If the consumer needs additional assistance filling out the application they should contact the Call Center. 

Q: Can I make changes to my application (i.e. change in circumstance) before I have submitted it?  

A: Yes.  Consumers who have not submitted an application can edit their in-progress application as needed.

Q: I used the "report a life change" button to change my name, but it didn't change my name and address in my account profile.  What should I do?  

A: Consumers need to update their name and address in both the application and in their communication preferences.  Consumers should be aware that changing their name in the application doesn't change their name in their account profile. Similarly, changing their name in their account profile will not change their name in the application.

Q: Are appeal forms available in Spanish? If so where?  

A: You can find appeal forms in Spanish here:

6. Common Consumer Situations Related to Qualifying Life Events 

As assisters, you are helping consumers across the spectrum-from young adults who have never had their own insurance policy to aging baby boomers with college age children--and everyone in between.

This section looks at the Marketplace from the consumer's perspective to address common scenarios that may affect the individuals and families you are helping. This information is not intended as the sole source to use when enrolling and assisting consumers. Numerous factors affect eligibility, enrollment, and Marketplace options. These factors include the number of people in the household, immigration status, age, tobacco use, income, and other considerations.  Each application requires consideration of all these factors to make sure that it is accurate and thorough.

 These scenarios provide a starting point to help assisters see how the Marketplace rules and regulations work in real world situations.

Q: I'm newly divorced and need to get health insurance coverage for myself and my son. Am I qualified for an SEP?  

A: We recommend you report life changes, such as marriage or divorce, as soon as possible. If you lost or are losing health coverage as a result of your divorce, you should report the date.  You may select a plan anytime within 60 days of the date you lost or will lose coverage.

Q: I just got married. I'm enrolled in a QHP but my husband and I want to be on the same health plan. Am I able to replace my QHP with one that better meets our needs now that I am married?  

A: Yes. Marriage is a qualifying life event for an SEP and you can change plans.

Q: My daughter just got a new job and I need to drop her from my QHP. Do I have to wait for open enrollment to do this?  

A: No. You should indicate your daughter's new job on your application. Select "Report a Life Change" and review and revise your application answers as necessary. When you complete your application, depending on the results, you will need to confirm your current plan, or may change to a different plan. 

Q: My spouse was just released from prison. Does this qualify him for an SEP so that he may enroll in a QHP?  

A: Yes. Release from incarceration triggers an SEP for the individual and the family.

Q: I just found out that I am expecting a child. Does that qualify me for an SEP?  

A: No. Pregnancy does not trigger an SEP. However, you should report this change to the Marketplace. In some cases, the pregnancy may make you eligible for Medicaid. Remember-under the ACA, your health insurance must now include benefits associated with pregnancy and prenatal care. Once you have the baby, this event will trigger an SEP for you and your family. You should report this life event to the Marketplace.

Q: I'm separated or am otherwise estranged from my spouse and have filed for divorce. If I don't plan to file taxes jointly with my current spouse, how else can I apply and potentially be determined eligible for tax credits and cost-sharing reductions?  

A: You will need to either obtain a divorce or have a legal separation (granted by a court) by the end of the year (for example, by 12/31/2014 for this year's open enrollment period) if you want to file separate taxes and be eligible for tax credits. Another option is to file your taxes as a "head of household" (HOH), which allows for APTCs. To do this, you must have a dependent child or other qualifying person living with you for more than half a year, pay more than half the cost of keeping up the home, and have been living apart from the spouse for the last six months of the tax year.

The Marketplace does not yet recognize the HOH option for "married but filing separate" couples. So you will want to work through the Call Center.

Once you know how you will be your filing taxes, you should update your tax filing status on your application.  Your tax filing status impacts your eligibility for APTC and CSR. To update your application, select "Report a Life Change" and review and revise your application answers as necessary. When you complete your application, depending on the results, you will need to confirm your current plan, or may change to a different plan.

7. Topic of the Week: Enrolling Immigrant Families in the Marketplace 

Navigating the Application Process for Families that Include Immigrants

On Friday February 21, 2014, The Center on Budget and Policy Priorities, the National Immigration Law Center, and the Georgetown University Center for Children and Families gave a presentation on Navigating the Application Process for Families that Include Immigrants.  Accompanying information in the form of a PowerPoint presentation from last Friday's webinar can be found here:

NOTE: The website has links to many other federal agencies, and in a few cases we link to private organizations. You are subject to that site's privacy policy when you leave the site. We are not responsible for Section 508 compliance (accessibility) on other federal or private Web sites.  Reference in this newsletter or on to any specific commercial products, process, service, manufacturer, or company does not constitute its endorsement or recommendation by the U.S. Government or HHS. HHS is not responsible for the contents of any "off-site" web page referenced from this newsletter.

Additionally, CMS presented on attesting to citizenship or immigration status.

Consumers seeking health coverage for themselves must attest on the application for Marketplace coverage to being a U.S. Citizen or U.S. National or in an eligible immigration status. Attestations of eligible immigration status and some attestations of citizenship are verified using the Department of Homeland Security's (DHS) Systematic Alien Verification for Entitlements (SAVE) program.

Attesting to an Eligible Immigration Status

On the application in the Family and Household section, applicants will be asked, "Is [Name of Applicant] a U.S. citizen or U.S. national?" If the applicant checks "No," a box will appear that they can check in order to attest to having an eligible immigration status. There is a link on this section of the application to a page that provides a list of eligible immigration statuses for coverage through the Marketplace. Once a consumer checks this box, a drop-down list will appear with possible document types for a consumer to choose from, depending on what type of immigration document they have that supports their current immigration status. Some may select a Green Card (I-551), or I-766, among others. If consumers have questions about the document type options, there is another link on the application to a page that provides information about the types of documents that can be selected and how to find the requested information on the document.

Some consumers do not have, or have had difficulty, finding all of the document numbers that may be requested for a particular document type, but do have either an Alien Number or an I-94 Number; these consumers can verify their information through another route. These consumers should instead select "Other documents or status types" from the drop down, instead of selecting their specific document type.

They will then be shown a list of other document or status options. Here consumers should select "Other." A field will appear where consumers should describe the type of document they have. For example, if they have a Green Card, they should type Green Card. Consumers should then select whether they have an alien number or I-94 number, and enter the number in the field that appears. Note - If a consumer has immediate access to all of the document numbers, we recommend that they select their specific document in the drop-down list and enter all of the numbers requested. While it is possible to use just one number, the system will produce better verification results if all of the numbers are provided.

The consumer will also be asked if the name as entered on their application for Marketplace coverage is the same name that appears on their immigration documentation. If it differs, they should select "No," and enter in their name as it appears on their immigration documentation. They will also be asked if they've been in the U.S. since 1996.

Naturalized Citizenship Verification

Consumers who are citizens (including those who are naturalized or derived citizens) should attest that they are citizens. The Marketplace will verify their citizenship with the Social Security Administration (SSA), and if it can't verify it with SSA, it will try verifying it with DHS. Naturalized or derived citizens who do not have a Naturalization Certificate or a Certificate of Citizenship can upload a copy of their U.S. Passport or other citizenship documentation if asked to provide more information to the Marketplace. They can do this either through their MyAccount or by mailing it to the Marketplace to be reviewed.

Eligibility and Application Help Resources for Citizens and non-Citizens:  

 8. Partner Resources 

Many of our non-federal government partners have developed tools, tips, materials or training sessions that assisters may consider utilizing.  We are sharing those resources through this weekly newsletter and by posting on  If you would like to recommend helpful resources, please email  We will be limited to sharing resources that are (1) Applicable to assisters facilitating enrollment in the federal Marketplace; (2) Open and accessible to the public; and (3) Reviewed by CMS.

National Disability Navigator Resource Collaborative (NDNRC) 

NDNRC has published two new fact sheets to help assisters answer specific questions that people with disabilities might ask when they are evaluating options in the Marketplace.  "Getting and Using Health Plans' Evidence of Coverage" is designed to help consumers understand a plan's Evidence of Coverage (EOC) document, which describes in detail the covered health care benefits. "Using Health Plan Customer Service" is a tool to help consumers learn about a plan's scope of coverage by using the plan's customer services.

The NDNRC is comprised of seven national disability organizations which represent unique cross-disability experiences. The NDNRC has also published the "Guide to Disability for Healthcare Insurance Marketplace Navigators" which provides information on special considerations that people with disabilities face as they shop for healthcare coverage.

NOTE: The website has links to many other federal agencies, and in a few cases we link to private organizations. You are subject to that site's privacy policy when you leave the site. We are not responsible for Section 508 compliance (accessibility) on other federal or private Web sites.  Reference in this newsletter or on to any specific commercial products, process, service, manufacturer, or company does not constitute its endorsement or recommendation by the U.S. Government or HHS. HHS is not responsible for the contents of any "off-site" web page referenced from this newsletter.



For other helpful outreach and enrollment resources, please click here

For General FAQs on HRSA Health Center Outreach and Enrollment Assistance Supplemental Funding, click here

Grants & Funding Opportunities


* Ryan White HIV/AIDS Program National Training and Technical Assistance Cooperative Agreements -Establishing AIDS Service Organization Service Models and Engaging in Marketplace Insurance Plans under the Affordable Care Act (ACA) (HRSA-14-102) Funding Opportunity Announcement (FOA) - Under the HRSA-14-102 FOA HRSA's HIV/AIDS Bureau will fund two organizations to provide ACA implementation support to grantees, sub-grantees, and people living with HIV/AIDS served by the Ryan White HIV/AIDS Program.

Applications are due to no later than Thursday, March 6, 2014, 11:59 pm, ET.
* Affordable Care Act - State Loan Repayment Program (SLRP) (HRSA-14-033) FOA: HRSA's Bureau of Clinician Recruitment and Service has released the
HRSA-14-033 FOA to assist States, the District of Columbia, and U.S. Territories in operating their own state educational loan repayment programs for primary care providers working in Health Professional Shortage Areas (HPSAs).

Applications are due to no later than Tuesday, April 29, 2014, 11:59 pm, ET.
* Safe Infant Sleep Systems Integration Program (SISSI) (HRSA-14-095) FOA - HRSA's Maternal and Child Health Bureau has released the HRSA-14-095 FOA to solicit proposals for the SISSI Program. This program aims to increase the adoption of safe infant sleep behaviors among infant caregivers through the integration of effective programs and policies within service delivery systems that intersect with families.

Applications are due to no later than Wednesday, April 30, 2014, 11:59 pm, ET.

Patient Centered Medical Home (PCMH) Corner 

New PCMH Resources Available to Health Centers

The Safety Net Medical Home Initiative (SNMHI) recently posted new material to their website. Project Recap showcases successes from the Initiative and a series of "Spotlights" highlights practice results in Care Coordination, Enhanced Access, and Team Based Care. 
Clinical Quality 

Free Pediatric Webinars

The National Center for Medical Home Implementation (NCMHI) in the American Academy of Pediatrics (AAP) is hosting a free 3-part webinar series that will provide engaging "how to" presentations focused on several important facets of pediatric care delivery.


 Enhancing Care Partnership Support 
Thursday, March 27
2:00 pm - 3:00 pm, ET


Starting and Supporting Family Advisory Groups
Thursday, April 24
12:00 pm - 1:00 pm, ET

Innovative Approach to Improving Colorectal Screening Rates Shows Promise 

Recent research by the Kaiser Permanente Center for Health Research with community health centers shows a different approach effective in improving colorectal cancer screening rates. Colorectal cancer is the second leading cause of cancer death in the U.S. and screening rates are particularly low among minorities and those who don't have health insurance. When free, simple, colon cancer screening tests were mailed to patients' homes, screening rates increased by nearly 40 percent, based on the pilot study. The federally funded study included 869 patients who use community health centers that serve many Latino patients who live below the poverty level, about half with no health insurance. 

Resources for Population Health Improvement Workshop Video - The Institute of Medicine (IOM) Roundtable on Population Health Improvement held a workshop as part of an effort to advance the integration of primary care and public health. The workshop focused on a wide range of resources to help with population-based interventions and improving population health.

View the Population Health Improvement Workshop Video.

View all BPHC technical assistance resources.

Health Observances This Week

Remember......February is National Eating Disorders Awareness Week



Advocates are currently marking the 14th annual National Eating Disorders Awareness Weekto highlight the psychological and physical toll stemming from the disease. This year's event, which stretches on until March 1, is focused on reaching the families and communities that may fail to realize how disordered eating is impacting the people they know and love. "Everybody knows somebody with an eating disorder," the promotional materials for the awareness campaign point out. Here are five facts to keep in mind about the devastating impact of this issue:

1. Thirty million Americans will suffer from an eating disorder at some point in their lifetime.

According to the National Eating Disorder Association, an estimated 20 million U.S. women and an additional 10 million U.S. men will struggle with a "clinically significant" eating disorder at some point in their life. Eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, or what's defined as an "other specified feeding or eating disorder" (OSFED). Although many Americans incorrectly assume that it's easy to spot an eating disorder, the people who struggle with this condition can actually come in all types of shapes and sizes, and are typically adept at hiding their symptoms.

2. Anorexia is the most fatal mental health issue.

One out of every five people with anorexia eventually dies from causes related to the disease. The rates of suicide among people who suffer from eating disorders are higher than the rates among other psychiatric disorders, largely because anorexia is often accompaniedby depression, anxiety, and substance abuse. A 2003 study found that people with anorexia are 56 times more likely to take their own lives than people who don't suffer from an eating disorder.

3. Disordered eating is on the rise among children.

Disordered eating is an issue that tends to manifests itself in children and young adults. A full95 percent of the Americans who have eating disorders are between the ages of 12 and 25, and the majority of those people report that their unhealthy relationship with food began before they turned 20. Perhaps partly because of the unrealistic body images that are persistently marketed toward kids, this issue is getting worse. According to a recent study, hospitalizations for eating disorders in children under 12 years old increased by a staggering 119 percent between 1999 and 2006. Eighty percent of U.S. girls say they've been on a diet.

4. Eating disorder patients often lack sufficient health coverage.

Despite the fact that disordered eating impacts millions of Americans' lives, and early intervention has been proven to be an effective method of treating the condition, people who struggle with anorexia or bulimia often can't get the medical care they need. Just one in ten eating disorder patients typically receives treatment. That's often because eating disorders are difficult to diagnose and insurers don't always cover the wide range of mental health treatments that can be necessary to address them. Some states have taken their own steps to expand coverage for eating disorders, which isn't considered to be an "essential benefit" under Obamacare's new exchanges. Fortunately, though, the health reform law does prevent insurers from denying coverage to individuals with pre-existing conditions, which includes eating disorders.

5. The government doesn't designate much funding toward eating disorder research.

"Eating disorders are complicated and vexing problems and we don't exactly understand the pathophysiology of them. Certainly there is both a genetic component and an environmental component," Dr. Aaron Krasner, a practicing psychiatrist, explained to Forbes this week. Some eating disorder prevention advocates argue that's because there isn't enough funding designated for research in this area. The National Institute of Health (NIH) allocates just 93 cents in research funding per affected eating disorder patient, compared to $88 per affected autism patient and $81 per affected schizophrenia patient. Figuring out how to address eating disorders would be in the government's best interest, though - one study estimated that hospital costs associated with anorexia and bulimia can top $271 million annually.

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.

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