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

Next Enrollment Period starts
 November 15, 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
April 4, 2014 
Saying Thank you...
On Thursday, April 3rd, the CEO of Mid-Atlantic Association of Community Health Centers, Duane Taylor, presented a crystal clock to DHMH Deputy Secretary of Healthcare Financing, Chuck Mulligan, at the All FQHC meeting at DHMH. The award presented to Chuck was to thank him for his ongoing support and guidance for our health centers.
On behalf of all Maryland FQHCs, we thank you, Chuck

MACHC Website Under Construction..... 


New Website COMING SOON!!!!


Technical Assistance Request Form 
---to be submitted prior to receiving any TA from MACHC---
Update on the Access Campaign:

Health Centers Collect Over 80,000 Access is the Answer Petition Signatures!

Health Center Advocates across the country kicked off the Access is the Answer campaign by successfully collecting over 80,000 petition signatures in the month of March! This tremendous outpouring of support is a crucial first step in making the case to Congress and the President that the time to fix the Health Centers funding cliff and ensure ongoing access to affordable, quality primary health care for 22 million Health Center patients and millions more who still lack access to care is NOW!

Join the Access is the Answer Campaign and advocate for CHC Funding!

Health Centers are facing an unprecedented threat and a unique opportunity in 2014. Like every year, Health Centers will have to fight to secure annual funding from Washington. But unlike any year in Health Center history, this year we face a looming Health Center funding cliff - a potential 70% reduction in Health Center program funding scheduled to take effect in 2016. As Health Center Advocates we will also have to make sure that programs, like Medicaid, that are essential to our survival remain intact and strong in the face of efforts to save money.

These are threats to Health Centers AND to the more than 22 million patients Health Centers currently serve and the millions more that Health Centers will need to grow to serve in our communities. Your advocacy through the Access is the Answer campaign is essential if we are to ensure that Health Centers will be there for everyone who needs access to health care.

What can YOU do?

To make the Access is the Answer campaign a success, commit to taking 3 easy action steps:

Number 1: Sign the Access is the Answer petition. 

Number 2: Work with your Health Center leadership to collect Access is the Answer support letters from local elected officials

Number 3:  Work with your Health Center leadership to collect community support letters. 

The value of advocacy:

All politics is local. Congress and the President do really pay attention to the voices of those back home in the community. That means the most effective advocacy has to come from YOU back home.

The Access is the Answer Campaign will be asking Advocates to weigh in on many issues as the campaign goes forward, but if YOU and tens of thousands of Advocates take the 3 steps, we will be laying the foundation for success in a fight neither Health Centers nor our patients can afford to lose. Thanks for joining the Access is the Answer campaign and building the power of Health Center Advocacy.  

MACHC Happenings

"Healthcare Reform: The Impact on Behavioral Health"   

Wednesday, April 9, 2014 ~ Baltimore Convention Center  

This year's highlights:

PLENARY: What's New and Why? The New ASAM Criteria for the Treatment of Addictive, Substance-Related, and Co-Occurring Conditions

David Mee-Lee, MD, is a board-certified psychiatrist, and is certified by the American Board of Addiction Medicine (ABAM). Dr. Mee-Lee has led the development of the ASAM Criteria for the Treatment of Substance-Related Disorders since the late 1980's.

The ASAM Criteria are the most widely used guidelines for assessment, service planning, placement, continued stay and discharge of patients with addictive disorders. A new edition was released in October 2013. This presentation will update participants on what is new since the last edition ASAM PPC-2R, 2001. It will highlight compatibility with DSM-5 and new sections on older adults, criminal justice clients,

PLENARY: Addiction and the Gift of Adversity 

Norman Rosenthal, MD, Clinical Professor of Psychiatry, Georgetown University School of Medicine 

The presenter will expand on Nietzsche's famous quote, "What doesn't kill us makes us stronger." Adversity undoubtedly can be extremely destructive -- and this applies in the case of addictions as much as or more than in many other spheres of life. However, if a person is able to deal effectively with adversity, then there is the chance that such a person can emerge stronger, wiser and more resilient. The purpose of this session is to understand the adversity of addiction in particular, how to help the addicted client find the gifts in the adversity and to use this knowledge to build self-esteem and promote gratitude.

PLENARY: How to Make it Work? Leveraging the Affordable Care Act and Parity to Achieve Recovery from Mental and Substance Use Disorders

Carol McDaid, BA Principal & Co-founder of Capitol Decisions,

a Washington, DC-based government relations firm that represents business and non-profit interests in the health industry including addiction treatment providers, alcohol and other drug advocacy organizations, hospitals and other health care providers. This session will arm participants with the tools to better advocate for those with mental and substance use disorders by informing attendees of new rights and benefits under MHPAEA and ACA. Participants will learn when and how to appeal denied claims, tools for filing state and federal complaints and other tactics to help individuals and families receive benefits entitled under these laws. 


(2) 2014 UDS Changes Webinar  
Wednesday, April 9, 2014, 2:00 pm - 4:00 pm, ET. 
On this webinar, BPHC will review and discuss changes to 2014 UDS reporting, including patient characteristics (Table 4), patient counts (Table 6A), reportable services (Table 6B and 7), quality of care measures (Table 6B), health outcomes and disparities measures (Table 7), and EHR capabilities and quality recognition.   View this webinar the day of the session 

(3) FTCA Application Technical Assistance (TA) and Deeming Process Webinar Series:  

April 9, and 10, 2014

 BPHC's Office of Quality and Data is hosting TA webinars for health centers who will be submitting Federal Tort Claims Act (FTCA) redeeming or initial deeming applications. Each webcast will focus on a different application section.  All webcasts will be recorded and posted on the FTCA website, but health centers are strongly encouraged to attend the live sessions. 

o First Webinar: Archived Topics: Application Logistics/Credentialing

o Second Webinar: April 9, 2014, 2:00 pm-3:30 pm, ET.
Topics: Application Logistics/Risk Management & Tracking

o Third Webinar: April 10, 2014, 2:00 pm-3:00 pm, ET.
Topics: Application Logistics/Quality Improvement & Quality Assurance  


Outreach Phone Call
Friday, April 4, 2014   I   2 PM- 3 PM
Discuss what happens Post Enrollment?!
Dial: 1-866-740-1260 Access Code: 4319483
(5) Transformational Call 
Tuesday, April 8, 2014,  10 AM - 11 AM
Dial: 1-866-740-1260 Access Code: 4319483

Grants Management Training 

When: Tuesday, April 23, 2014

Time: 9:00am- 4:30pm EST

Location: The Conference Center at the Maritime Institute

692 Maritime Boulevard

Linthicum Heights, MD 21090



(6)  Grants Management Training

When: Tuesday, April 23, 2014

Time: 9:00am- 4:30pm EST

Location: The Conference Center at the Maritime Institute

692 Maritime Boulevard

Linthicum Heights, MD 21090 

Please join the Mid-Atlantic Association of Community Health Centers (MACHC) as we welcome Edward (Ted) Waters of Feldesman Tucker Leifer Fidell, LLP for an important session on the Supercircular/Omnicircular and what grantees need to know. 

Grantees and sub-grantees should begin to understand the ins and outs of the new "common rules" for grants administration, Cost Principles, and Audit Requirements so that you can come into compliance quickly.

Click here to register

(7) ACA Moving Forward - Webinar
Friday, May 2, 2014   I   10 AM- 11 AM

Guest Speaker: Matthew Molloy, Maryland State Director - Doctors for America 

The first open enrollment period for qualified health plans has come to a close.  How did Maryland do?  What's next? This webinar will review the successes and challenges of the first open enrollment period in Maryland and provide the numbers covered to date through the Maryland Health Connection and Medicaid expansion.  It will also take a look forward into the rest of 2014 and beyond to discuss the ways that the ACA will continue to impact patients, including the continued closing of the Medicare donut hole, the individual mandate, and how patients can qualify to enroll in qualified health plans before the next enrollment period in November.  The webinar will also discuss challenges, including issues of network adequacy and educating patients on how to use their health coverage.

* Check this column next week for registration link.


Cultural Competency 

Where: Dover down, 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 

Register HERE  



(9) SAVE THE DATE ----Recent Hypertension Guidelines

May 7th   I   12:30 - 1:30


Target Audience:  Physicians, Nurse Practitioners & Nurses

This webinar will provide an overview of new guidelines including the 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report from the Panel Members Appointed to the Eighth Joint National Committee (JNC 8).  Featuring Dr. Lawrence Fine, Eighth Joint National Committee Panel Member, the webinar will also offer considerations for health care providers and public health practitioners when selecting and supporting implementation of hypertension guidelines.
Lawrence J. Fine, MD, DrPH, FAHA, National Heart Lung and Blood Institute, National Institutes of Health, Member of Panel Appointed to the Eighth Joint National Committee 

Registration details to be posted soon.



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




(11) Maryland Rural Health Association

Call for Proposals The Call for Proposals is now open. The conference will gather rural health leaders in the public, private, and non-profit sectors to discuss the major issues facing rural Maryland. Past conference attendees have pointed toward the value of illustrating best public health and community level practices as most useful to participants. Additionally, the conference planning committee is hoping to illustrate how recent statewide programs and policies have been implemented or are impacting rural Maryland both in terms of health and the economy. Examples include, but are not limited to the following: behavioral health, CMS Waiver implementation, Community Transformation Grant, the Affordable Care Act, oral health. Every proposal will be given consideration by the Rural Health Conference Planning Committee and presenters will be notified by June 13, 2014.

Please submit proposals online at Call For Proposals Due Date May 23, 2014.  





MACHC's Emergency Preparedness Exercise & Drill Workshop 
April 24, 2014--- 9 am - 5 pm
*FQHC EP Coordinators MUST attend this important workshop
Outlook invites to all FQHC Emergency Preparedness & Response staff has been sent out. If you are supposed to be a point of EP&R contact and have not received an Outlook invite, please reach out to Aneeqa Chowdhury at ASAP.
DHMH HPP Program Events below.
DHMH HPP Program 2014 Timeline of Events:



I. 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 for the assessment, OP&R staff will review 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.

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


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
For some states, like California, things have gone well. But the rollout in states like Maryland and Oregon has been rocky. Mary Agnes Carey and CQ Roll Call's Emily Ethridge discuss what we've learned about why some did better than others. 
"MARY AGNES CAREY:  Were there different ways that they picked their vendors?  Several of the states that had a problem, did they hire the same vendor that had the same technological issues?

EMILY ETHRIDGE: Now Maryland is adopting the same IT platform and vendor used by Connecticut, because Connecticut's exchange has worked really well. Maryland says they can do something similar, so they're just really switching their entire IT platform over to this one that Connecticut used." [Read or listen to the whole conversation by clicking the title]

House and Senate Health Center FY15 Funding Support Letter Update

The House FY15 Health Center funding support letter led by Rep. Bilirakis (R-FL) and Rep. Pallone (D-NJ) closed on Monday with a total of 216 signatures. We expect a few last minute additions, but the list of signers as of Tuesday morning can be viewed here. A final letter and cosigner list will be posted as soon as we have it.

The Senate FY15 Health Center funding support letter led by Sen. Stabenow (D-MI) and Rep. Wicker (R-MS) closes today. As of Tuesday morning, there are a total of 39 cosigners. Additional signers will be added throughout the day as we receive confirmation from our Senate leads. The list of cosigners can be viewed here or through the NACHC website here.  

These letters are crucial as the FY15 appropriations process moves forward, and Advocates' efforts have been instrumental in securing as many House and Senate cosigners as possible this year. 

New NACHC resource for Insurance Expansion as well as Outreach/Enrollment Efforts  - Helpful for ALL States! 

NACHC has released  new state maps that identify high concentrations of low-income, uninsured residents inside and outside of Health Center service areas. Created in collaboration with the Robert Graham Center, these maps guide health outreach and enrollment efforts by highlighting the populations that are newly eligible for insurance under the Affordable Care Act (ACA), identifying areas that may need new Health Centers, and documenting the community impact in states that do not expand insurance. 

House & Senate Pass Short-Term Health Care Legislation

On Monday evening the U.S. Senate passed a 12-month extension to the scheduled Medicare Sustainable Growth Rate (SGR) physician cuts-otherwise known as the "doc fix". The House passed the bill last week, and it easily passed the Senate with a vote of 64 to 35 though it is only a short-term fix rather than the permanent solution that some Senators and Representatives had advocated for.

While the SGR itself does not impact Health Centers directly, there are a number of interesting provisions included in the one-year bill that are important. A complete summary of the legislation can be found here, though most notably it includes a one-year delay of ICD-10; extension of Transitional Medical Assistance (TMA), which provides Medicaid coverage for families transitioning from welfare to work; extension of Medicaid and CHIP "Express Lane" enrollment; and an eight-state demonstration program for "Certified Community Behavioral Health Clinics" with a Medicaid payment system similar to Health Centers' unique PPS methodology. NACHC is neutral on the Behavioral Health Clinic provision and has not taken a formal position on the comprehensive legislative package.


A new analysis finds that many people who signed up for a Covered California health insurance exchange plan are likely to drop the coverage for a good reason: They found insurance elsewhere.

Researchers at the U.C. Berkeley Labor Center released estimates Wednesday showing that about 20 percent of Covered California enrollees are expected to leave the program because they found a job that offers health insurance. Another 20 percent will see their incomes fall and become eligible for Medi-Cal, the state's insurance program for people who are low income.

The Commonwealth Fund Releases Interactive Map on the Cost of Not Expanding Medicaid

The Commonwealth Fund's new interactive map displays, by state, the loss of federal dollars and the number of individuals who fall into the coverage gap (those adults under 100% of the federal poverty level not currently eligible for Medicaid and not eligible for assistance on the exchanges).  View the Commonwealth Fund's accompanying report regarding alternative approaches to Medicaid expansion here.

What Happens Next On The Health Law? Just because open enrollment for people who buy their own health insurance formally closes March 31 doesn't mean debate over the health law will take a hiatus. After more than four years of strident rhetoric, evidence about how the law is actually working is starting to trickle in. Click on the title to find seven things to watch before the next enrollment period begins in November.

As Insurance Enrollment Exceeds 7M, Obama Says Health Law Here To Stay

The Obama administration took a victory lap Tuesday as enrollment through the health law's exchanges topped 7 million, a goal previously thought untouchable when the website sputtered and crashed as sign-ups began last fall.

In a statement in the Rose Garden, President Barack Obama, said, "The debate over repealing this law is over. The Affordable Care Act is here to stay."

The names of the big health insurance companies are familiar - Blue Cross, Aetna, United Healthcare. But what about CoOportunity Health, or Health Republic Insurance of New York? These are among 23 new health insurance companies that started under the Affordable Care Act. They're all nonprofit, member-owned cooperatives, and the aim is to create more competition and drive prices down. 
5 Questions About Obamacare's 7 Million Enrollees
What does the 7 million mark mean for the health law? It tells us the final days of enrollment attracted a surge of consumers and that the sometimes-panicked rush by the Obama administration to fix after a disastrous launch largely paid off. What the politically crucial milestone doesn't reveal, however, is much about whether the law will work. For instance, we still don't know whether the new marketplaces will make much of a dent in the number of uninsured people, or if the business will prove sustainable for insurers.
State News
Check out the Delaware ACA Toolkit right here!
Despair Not, Delawareans!

If you were "in line" trying to enroll on Delaware's Health Insurance Marketplace by the March 31 enrollment deadline and did not finish, we may still be able to help you get covered.

* Log in to your online Marketplace application on and finish the enrollment process 
  - you'll need to confirm online that you were still trying to enroll on March 31.

* Or contact the Marketplace Call Center at 1-800-318-2596. The Call Center can help you complete your enrollment over the phone. TTY users should call 1-855-889-4325.  
* Or contact a Delaware marketplace guide with contact numbers here at
Be sure to tell the customer service representative that you have been trying to enroll.



The board of Maryland's health-insurance exchange voted Tuesday to hire Deloitte Consulting to replace most of the state's troubled online marketplace with technology that has successfully worked in Connecticut. The change is expected to cost between $40 million and $50 million to implement, plus some hardware and software costs, according to Isabel FitzGerald, Maryland's secretary of information technology. Fitzgerald told board members that Maryland would adopt Connecticut's system, which has run as smoothly as any in the country, largely as is, with little retrofitting
Finance & Business
The 99-page plan is Ryan's last manifesto on government austerity as head of the Budget Committee. He has emerged as the GOP's leading light on fiscal policy in recent years, but he is term-limited as head of the budget panel and vying to become chairman of the tax-writing Ways and Means Committee next year while considering a 2016 presidential bid. 
The decision by lawmakers to delay implementation of ICD-10 by a year will give hospitals extra time to get ready for the transition, but will have a negative financial impact.
The Latest News on ACA




Thanks to the Affordable Care Act (ACA),more than 7 million Americans have enrolled in private health coverage in the Health Insurance Marketplace. Read personal stories of how the Marketplace has helped people across the country.



Post March 31st Enrollment period, all in-person assisters, including Navigators and Certified Application Counselors (CACs) will continue many of their existing functions. 

1. To find out about post enrollment responsibilities of Outreach staff, please click here.

2. Find out how to Connect the Newly Insured to the Healthcare System, click here.

3. HRSA QPR reports will continue to be collected. Supplemental Grantees will be reporting their QPR 4 from April 1 - June 30. For additional information on the QPR, see HRSA slides on QPR 4.


4. If you have additional questions regarding Outreach & Enrollment Assistane, check out the HRSA - Bureau of Primary Healthcare (BPHC) FAQs here.

Any questions on O/E QPR not answered on the FAQ page can be emailed to



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

Transformational Team Talk & Outreach Upates

Health Center Outreach and Enrollment (O/E) Quarterly Reporting (QPR):

O/E grantees have from Tuesday, April 1, 2014 untilThursday, April 10, 2014 to complete and submit the Quarter 3 QPR in EHB. 

Post Open Enrollment, QPR 4 reporting period is April 1 - June 30, 2014. (see ACA section above for more)


Exchange Updates:

[I].  CAC Certifications are currently being mailed out. Look out for them in a day or two if you have not received them yet.

[II.]  More CAC ceritification dates and times will be released in the coming weeks. Check back on the CAC website for details.

[III.]  CAC Consent Forms RELEASED

[IV.]  ALL CACs need to have this form completed anytime they are assisting a consumer in creating an account on Maryland Health Connection. This form is to be retained by you, the Entity for documentation purposes.

[V.]  Exchange Standing Committee 

The Exchange Board selected the members of the Committee; however, no representative for FQHCs were picked. Duane Taylor, MACHC's CEO, is reaching out to the leadership to ensure FQHC representation on the board. Once there is a resolution, you will find the information here.

[VI.]  CACs cannot assist Medicaid/CHIP eligible consumers select an MCO. They are supposed to hand those consumers off to Navigators, Call-Centers, Department of Health or Social Services.

[VII.]  Medicaid re-verification barrier

During the last Exchange ACSE phone call held on Monday, March 24th, attendees posed the clear barrier of consumers having to seek assistance from Case Managers for re-verification of documents after already working with a in-person assister, CAC or Navigator. The Exchange has this topic on the table for discussion.



Exchange Updates for ACSE (CACs):

For those application counselors that could not complete the previously scheduled Webinars, they will need to get in touch with to unenroll in order to be notified of future Webinar training.


Exchange Call with ACSE:

The Exchange has sent ACSE's an email around monthly webinar/calls with all to discuss the CAC Program and Maryland's Marketplace progress. The webinar.calls would take place every 4th Monday of the month and this will allow CHCs a platform to discuss success, obstacles and make suggestions for improvement. The first of these webinars/calls took place on March 24 at 10 am - 11:30 am. Slides from the webinar can be found here. 

The NEXT call will take place on Monday, April 28th. 

Grants & Funding Opportunities

  • Federal Funding: 

    • Service Area Competition-Additional Area (SAC-AA) Funding Opportunity Announcement (FOA) - BPHC will release the Fiscal Year (FY) 2014 SAC-AA (HRSA-14-136) funding opportunity for Warrenton, GA.

      The SAC-AA FOA is available at  Applications are due to no later than Wednesday, April 30, 2014, 11:59 PM ET. Supplemental materials are due in HRSA's Electronic Handbook (EHB) no later than Wednesday, May 14, 2014, 5:00 PM ET.

      View SAC-AA TA resources.
    • Public Access to Defibrillation Demonstration Project, HRSA-14-130, FOA - HRSAhas released HRSA-14-130 to support projects that will implement a high quality and sustainable community access defibrillation program in rural areas.  

      Applications are due to by Wednesday, April 30, 2014, 11:59 pm, ET.

      View more information on HRSA-14-130
    • Reduce Hepatitis Infections by Treatment and Integrated Prevention Services (Hepatitis-TIPS) among Non-Urban Young Persons Who Inject Drugs, RFA-PS-14-004, FOA - This cooperative agreement is available for organizations to address the high prevalence of hepatitis C viral (HCV) infection by developing and implementing an integrated approach for detection, prevention, care and treatment of hepatitis C infection among young (18-30 year old), non-urban people who inject drugs.   

      View more information on this FOA 

Patient Centered Medical Home (PCMH) Corner 
HRSA Patient-Centered Medical/Health Home Initiative
Check out the following PCMH presentation by HRSA -

Health Information Technology: Turning the Patient-Centered Medical Home from Concept to Reality

Primary care should stand as the foundation on which our entire health care system rests, but the Nation's primary care infrastructure is under great strain. Millions of Americans lack access to a regular primary care provider, and primary care clinicians are overburdened and, compared with their specialist counterparts, modestly paid. Primary care in the United States can and must do better, and America needs to do better for primary care.

The patient-centered medical home (PCMH) has emerged as a model of care that would restore order to the Nation's primary care system. It reasserts the role of primary care by taking a team approach to health care and placing the patient at the center of that team. Initially conceived in the 1960s, the PCMH model emphasizes the role of primary care practitioners to coordinate their patients' care across multiple locations and settings and over time; creates cost savings by delegating less complex aspects of care (e.g., so that specialists do not spend their time following up on routine chronic diseases); and uses measure-driven incentives to reward the quality of outcomes rather than simply volume of services provided.

Now, decades after the concept was first proposed, the PCMH is no longer a theoretical concept. With Federal encouragement and heavy private sector interest, the PCMH is poised to revitalize primary care.4 This is a promising development, with even greater potential when we are able to combine it with the harnessing of the power of health information technology (IT) to enable rapid quality improvement.

The PCMH is not necessarily a physical place, but rather an organizational model that delivers the core functions of primary health care. AHRQ supports the PCMH by advancing its evidence base and by convening and working with government and private stakeholders to ensure that the best ideas are shared broadly. As AHRQ defines it, the PCMH encompasses five principles:

  1. A patient-centered orientation toward the whole person that requires understanding the patient's and the family's preferences and providing the patient's entire range of care needs.
  2. Comprehensive, team-based care, which relies on a (not necessarily physically co-located) team of providers that might include physicians, nurses, pharmacists, nutritionists, social workers, information technology specialists, and practice managers, in order to meet the patient's care needs.
  3. Care coordinated and/or integrated across all elements of the complex system (both medical and behavioral health care), including specialists, hospitals, and skilled nursing facilities; home health workers; community services and supports; and the panoply of other providers who see the patient.
  4. Continuous access to care, with shorter waits to get appointments, enhanced hours, and alternative methods of communication such as E-mail and telephone.
  5. A systems-based approach to quality and safety, some important aspects of which are: (a) the practice uses evidence-based medicine and clinical decision-support tools to guide decision-making; (b) the practice and patients and families participate in performance measurement and improvement; (c) patient experience and feedback are measured, with data from these measurements acted upon; and (d) the practice participates in population health and management

    *Look for the rest of this piece on next week's E-Blast 
Clinical Quality 
What are the Meaningful Use Stage 1 Clinical Quality Measures?

An important objective set forth in the Meaningful Use Stage 1 final rule is that eligible professionals and hospitals who participate in the program must be able to record, store, and report clinical quality measures (CQM).  In the Meaningful Use Stage 1 final rule, CMS defines CQM as the "processes, experience, and/or outcomes of patient care, observations or treatment that relate to one or more quality aims for health care such as effective, safe, efficient, patient-centered, equitable, and timely care."  

Below is information on how CQM affect various safety net providers found on CMS's Electronic Health Record Incentive Program CQM website.

  1. Eligible Hospitals and Critical Access Hospitals (CAH)

    Below are the Meaningful Use Stage 1 CQM objectives for EPs and hospitals.
  2. Eligible Professionals

    Eligible professionals must report from the table of 44 clinical quality measures which includes, 3 Core, 3 Alternate Core, and 38 additional CQM.
    • Some of the Meaningful Use Stage 1 CQMs for Eligible Professionals are taken from  CMS's Physician Quality Reporting Initiative (PQRI).  
    • Core CQMs - Eligible professionals must report on 3 required core CQMs, and if the denominator of 1 or more of the required core measures is 0, then eligible professionals are permitted to report results for up to 3 alternate core measures.  
    • Eligible Professionals must also select 3 additional CQMs from a set of 38 CQMs (excluding the core/alternate core measures). For these additional measures, it is acceptable to have a '0' denominator provided the EP does not have an applicable population.  

Please refer to the diagram below that shows the process for how EPs select Meaningful Use Stage 1 CQMs


Health Observances This Week

Remember......March is 

National Kidney Month


March is National Kidney Month, and March 13, 2014, is World Kidney Day. DaVita is helping raise awareness about chronic kidney disease (CKD), a condition that one in every 10 adults* (age 20 or older) in the United States has, as well as people with end stage renal disease (ESRD)who need dialysis or a kidney transplant.

Kidney disease develops when kidneys lose their ability to remove waste and maintain fluid and chemical balances in the body. The severity of CKD depends on how well the kidneys filter wastes from the blood.  It can progress quickly or take many years to develop.

Because there are little to no signs of the condition, most people are not even aware that they have kidney disease until it reaches the later stages, including kidney failure.  

Risk factors for chronic kidney disease

High-risk populations include those with diabeteshigh blood pressure, cardiovascular disease and family history of kidney disease. Diabetes is the number one cause of kidney disease and high blood pressure is second leading cause (source: USRDS 2011 Atlas of ESRD); according to the U.S. Centers for Disease Control , 1 in 3 with diabetes and 1 in 5 with high blood pressure have kidney disease.

According to the U.S. Centers for Disease Control, African Americans are nearly 3.5 times more likely to be diagnosed with kidney failure compared to Caucasians. Other high-risk groups include Hispanics, Asian Americans, Pacific Islanders, Native Americans and seniors 65 and older.

Who should be screened for chronic kidney disease?

Anyone 18 years old or older with diabetes, high blood pressure, cardiovascular disease or a family history of kidney disease should be screened for kidney disease. If you live in an area that is offering a free screening, plan to attend. If not, visit your doctor and ask that you be screened for chronic kidney disease.

What is involved in a kidney screening?

Because there are often no symptoms of kidney disease, laboratory tests are critical. When you get a screening, a trained technician will draw blood that will be tested for creatinine, a waste product. If kidney function is abnormal, creatinine levels will increase in the blood, due to decreased excretion of creatinine in the urine. Your glomerular filtration rate (GFR) will then be calculated, which factors in age, gender, creatinine and ethnicity. The GFR indicates the person's stage of chronic kidney disease which provides an evaluation of kidney function. 

How do you treat chronic kidney disease?

In many cases, kidney failure can be prevented or delayed through early detection and proper treatment of underlying diseases, such as diabetes and high blood pressure to slow additional damage to the kidneys. Also helpful are an eating plan with the right amounts of sodium, fluid and protein.  Additionally, one should exercise and avoiding dehydration. Treating diabetes and high blood pressure will slow additional damage to kidneys.

End stage renal disease patients have two treatment options:

  • Dialysis is a treatment that removes wastes and excess fluid from blood when the kidneys are not able to do it on their own. Typically, It is necessary upon development of kidney failure - usually by the time an individual loses about 85-90 percent of kidney function. There are over 380,000 people (including children) in the United States who depend on hemodialysis or peritoneal dialysis (PD) treatments to stay alive.
  • The only other treatment option for people with end stage renal disease is a kidney transplant.

What can you do to raise kidney disease awareness?

Visit and take the steps now to raise awareness about kidney disease. Take the Risk Quiz, make a pledge to get tested and send an E-Card to encourage others to do the same.

*Adults 20 or older. Source: USRDS 2011 Atlas of ESRD.

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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