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
October 6, 2014

***Attention- Please note that MACHC is providing Outreach & Enrollment funds (for MD & DE Health Centers only) towards the new Enrollment Period through a Clear Channel Ad Initiative. Each member Health Center may participate in the Campaign or opt out and use the allocated funds towards their own O&E efforts. Please fill out the doodle sent to you or email for receiving the doodle which will determine the mutually convenient time to discuss the campaign and decisions. One Representative per health center must be on the call or respond back by the call date to be eligible to participate.
Thank you! 


(1) Transformational Call -- CANCELLED *for MHBE meeting

October 7th; 10 am - 11 am

Bi-weekly calls to resume as scheduled starting October 7th.

To get on call listserv, email

Audience: MD MACHC Leadership

Topic: Discuss State and FQHC updates, trends, best practices, obstacles and issues. These are discussed and issues are brought to the respective official's attention. These topics are included in MACHC's advocacy efforts on behalf of FQHCs.


(2) Title: Outreach 2.0: Applying Lessons Learned When Connecting With Specific Uninsured Communities

Date/Time: Wednesday, October 8, 2014, at 2:00 p.m. ET


Description: Join this webinar during the #Ready4OE2 series as we walk through data-informed outreach and in-reach strategies to engage young adult, Latino, and African American populations.


(3National TeleForum Introducing Phase Two of the Access is the Answer Campaign to Take Place Tuesday, October 14th 

Health Center Advocates are invited to this important call on Tuesday, October 14th at 2PM ET regarding second phase of the Access is the Answer campaign. Join the call on the 14th to get the latest updates on Access is the Answer and learn what steps you can take this fall to ensure the continued success of the Health Centers Program. Click here to sign-up to receive the call on Tuesday, October 14th at 2PM ET, or join directly by dialing 1-877-229-8493 and entering PIN: 15035.


(4) Outreach Team: Engage Faith-Based Communities in your Outreach Efforts

October 17, 2014

Please join us to hear from the national nonprofit, Enroll America, about things you can do right now to effectively partner with faith based groups to get the word out about your program and connect people to coverage. With the start of Open Enrollment, faith institutions will again play a critical role in reaching the uninsured. Places of worship will be significant locations for enrollment events and points of reference for information. There are many lessons learned to be shared and tools and tips to apply when reaching multiple faith based groups, some of which have been captured in these toolkits. During this hour long webinar you will hear practical suggestions that you can run with now to amplify your reach in the community and leverage existing partnerships by including communities of faith.  

Speaker: Reverend Doctor Derrick Harkins Is the National Director for Faith Initiatives and African American Engagement for Enroll America. 

1.  Please join my meeting.

2.  Use your microphone and speakers (VoIP) - a headset is recommended.  Or, call in using your telephone.

United States: +1 (224) 649-0001

United States (toll-free): 1 877 309 2073

Access Code: 157-700-118

Audio PIN: Shown after joining the meeting

Meeting ID: 157-700-118


(5) Family Health Centers of Baltimore brings you Breast Cancer Screening & Lunch Event
October 25, 8:30 am - 4pm 
Please join Family Health Center's for their October;s Breast Cancer Awareness Event in light of Breast Cancer Awareness month--the event will include breast cancer screening, lunch and entertainment. For more information, find the attached flyer.


(6) Outreach Team: Creating an Earned Media Strategy: Simple Ways to Engage the Ethnic Media

October 31, 2014

Please join us to hear from the national nonprofit, Enroll America, about simple things you can do to engage the media in your efforts to get the word out about your program and connect people to coverage. This webinar will present the benefits of working with local radio, television, and print media outlets to get the word out. This will be an opportunity for you to hear about how this strategy can be effective in engaging non-English speaking individuals and minority groups in general, free of charge. You will learn about ways you can engage local media and use this powerful tool to educate and motivate consumers to take action. There are many lessons learned to be shared and tools and tips to apply when amplifying your reach, some of which have been captured in this outreach toolkit. During this hour long webinar you will hear practical suggestions that you can run with now to make the most of your time and outreach efforts.

Speaker: Dayanne Leal, Deputy Director of the Best Practices Institute at Enroll America

1.  Please join my meeting.

2.  Use your microphone and speakers (VoIP) - a headset is recommended.  Or, call in using your telephone.

United States: +1 (213) 493-0008

United States (toll-free): 1 877 309 2070

Access Code: 596-817-486

Audio PIN: Shown after joining the meeting

Meeting ID: 596-817-486

    (1) Supporting Homeless LGBTQ Youth through Better Access to Care Webinar, Wednesday, October 8, 2014 2:00pm - 3:00pm, ET -
    The National LGBT Health Education Center is hosting this webinar to raise awareness of the challenges experienced by lesbian, gay, bisexual, transgender, or queer (LGBTQ) youth. This webinar will discuss ways that health care providers can help facilitate access to culturally responsive care and resources.

    (2) 2014 Mid Atlantic Medical Neighborhood Forum -The Gaylord National Resort and Convention Center
    National Harbor, MD  October 3 -4, 2014

     The Mid Atlantic Medical Neighborhood Forum is the second event in a series of local and regional forums to advance collaboration among all community healthcare stakeholders.  Dr Paul Grundy, Founder and President of the Patient Centered Primary Care Collaborative (PCPCC), is confirmed as the keynote for the first day of the two-day event.  On the second day, we will host the Inaugural Mid Atlantic Medical Neighborhood Golf Tournament and Awards Luncheon at the Andrews AFB.  

    Event details and registration here.


    (3) Mark your calendars for these flu clinics in Delaware

    DPH plans three large flu immunization clinics this fall. Two flu clinics will be held at the New Castle Farmers Market, 101 N. DuPont Hwy., New Castle, DE 19720:
     Oct.10, 2014, 3:00 p.m. - 6:30 p.m.; and
     Oct. 24, 2014, 3:00 p.m. - 6:00 p.m.
    One flu clinic will be held at the Blades Fire Hall, 200 East 5th St., Blades, DE 19973:
     Oct. 23, 2014, 3:30 p.m. - 7:00 p.m.
    Visit or call 800-282-8672 for the complete schedule.


    (4) Save the Date: 2014 N.C. Rural Assembly
    Empowering North Carolina's Rural Communities

    Thursday, October 30, 2014
    DoubleTree by Hilton Hotel Raleigh - Brownstone - University1707 Hillsborough Street, Raleigh, North Carolina 27605

    Hosted by the North Carolina Rural Economic Development Center. The Rural Center's signature event will return this October, with a new name, a new venue and a new strategic action plan for addressing the future of rural economic development. 

    (5) 2015 NACHC Policy & Issues Forum

    Marriott Wardman Park Hotel, Washington, DC

    March 18-22, 2015


    Emergency Preparedness Events: 

    DHMH Response to Ebola Outbreak: Update


    DHMH continues to monitor the situation surrounding the current Ebola outbreak in West Africa. There are currently no known cases of EVD in Maryland, and EVD poses little risk to the U.S. general population at this time. However, healthcare workers are advised to be alert for signs and symptoms of EVD in patients with compatible illness who have a recent (within 21 days) travel history to countries where the outbreak is occurring, and should consider isolation of those patients meeting these criteria, pending diagnostic testing. Maryland clinicians who suspect Ebola virus in a traveler should contact their local public health department immediately.


    See the attached letter from Lucy Wilson, MD, ScM, Chief of the Center for Surveillance, Infection Prevention and Outbreak Response at DHMH. It contains guidance on epidemiology and identification of potential Ebola virus disease (EVD) cases and web links for additional information. Additional guidance for clinicians can be found at the CDC's Clinician Outreach and Communication Activity (COCA) website [ ].


    For specific information regarding infection control recommendations and other healthcare-related resources, go to [ ] and scroll down to the Additional Resources section.



    A folder has been created on the Maryland Health Alert Network (HAN) website where new and updated information will be posted. To access the folder, log in to HAN, click on the Documents tab, and select the folder "Ebola Virus". We recommend that you "watch" this folder in order to receive automatic notifications when new content has been added. (Simply select the folder and click the "Watch" link by the star icon in the panel on the right.)

     Pediatric Disaster Preparedness and Planning Program (TEEX)

    Mon, 01/12/2015 - 8:00am - Tue, 01/13/2015 - 5:00pm
    Thu, 01/15/2015 - 8:00am - Fri, 01/16/2015 - 5:00pm

    Enrollment is through the Commonwealth of Virginia Knowledge Center (KC). There are two options for enrollment (please see below).

    * For students who are comfortable using the Knowledge Center: If you have an existing account with any state agency, click here  for enrollment procedures. For students who do not already have an existing KC account, click here  for enrollment procedures.

    * For those who do not feel comfortable using the Knowledge Center, you may access an online enrollment form at this link. Our Help Desk will use the form to verify/create your account and enroll you in the course.

    This course, taught by the Texas Engineering and Extension Service, is a two day performance level course that addresses pediatric emergency planning and medical response considerations. The course addresses the need for emergency responders, first receivers, and emergency management personnel to increase their effectiveness in responding to pediatric patients and their unique needs/considerations. This course provides participants with skills and knowledge necessary to make pediatric considerations/accommodations while planning and preparing for community all-hazards events. Those who should attend include hospital staff and planners, public health, school administrators, American Red Cross, fire service, law enforcement, emergency management, military personnel and others that deal with children on a daily basis.

    Individuals who need an accommodation of a functional or access need to attend the training should contact the LMS Help Desk via telephone at 804-897-9995 or via email at

    . at least two weeks prior to the course start date.

    DatesTimesLocationEnrollment Deadline
    Jan 12-13, 20158:00-5:00FairfaxDec 30, 2014
    Jan 15-16, 20158:00-5:00RoanokeDec 30, 2014



    2014 HPP-PHEP Fall Regional Preparedness Conferences

    DHMH has scheduled this year's round of Fall conferences. The dates and locations are:


    Regions I and II

    October 10, 2014 / Wisp Resort Conference Center (McHenry, MD)


    Region III

    October 3, 2014 / Maryland Department of Transportation Headquarters (Hanover, MD)


    Region IV

    October 17, 2014 / Tidewater Inn (Easton, MD)


    Region V

    October 24, 2014 / Universities at Shady Grove Conference Center (Rockville, MD)   


    MSAT Satellite Phone Maintenance Check-up Visits Underway


    MSAT preventive maintenance visits to health departments and healthcare organizations are now underway. For detailed information to assist you in preparing for your facility's visit, see the attached handout: "MSAT Satellite Phone Preventive Maintenance Visits".


    We thank you in advance for your cooperation as we work to ensure that all of our state partners have functional redundant communications capabilities.



    HPP Facility Inventory Assessment Project Update


    The Facility Inventory Assessment sponsored by OP&R is now underway. Multiple vendors are assisting with this project. A goal has been set to complete the inventory assessment of all HPP-funded supplies and materials by December 31, 2014. HPP Regional Coordinators are contacting each facility to schedule inventory assessment visits.


    To ensure an efficient and effective inventory process, please notify all appropriate personnel at your facilities. It is essential that the vendor has safe access to all relevant HPP supplies and materials during the assessment visit.


    Preparedness News



    Governor's Cabinet-Level Tabletop Exercise Addresses Ebola Virus


    Governor O'Malley convened several state agencies, including the Maryland Department of Health and Mental Hygiene (DHMH) in partnership with the Governor's Office of Homeland Security, to participate in a Cabinet-level tabletop exercise (TTX). The goal of the exercise was to test Maryland's operational readiness for preparing and responding to a significant public health crisis impacting the broad community of emergency responders, stakeholders, partners and residents. A variety of capabilities were tested during this exercise, including information sharing across several governmental levels and disciplines, public messaging and notification protocols, law enforcement operations in support of public health interventions, and biosurveillance.


    TTX participants included DHMH; the Governor's Office of Homeland Security (GOHS); Maryland Institute for Emergency Medical Services Systems (MIEMSS); Maryland Emergency Management Agency (MEMA); US Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response (ASPR); and the CDC's Division of Global Migration and Quarantine.

    For additional details, visit:


    Preparedness Training, Exercises and Events


    September is National Preparedness Month!


    September is 2014 National Preparedness Month! Throughout September, activities to promote emergency preparedness will be taking place across the country. National Preparedness Month is a time to prepare yourself and those in your care for emergencies and disasters, both large scale and smaller local events. For additional information and to find out how you can get involved, visit


    Upcoming Training Opportunities  ------------- 


    Community Psychological First Aid.

    The MD Responds MRC is pleased to announce Psychological First Aid training opportunities to be held on multiple dates and locations throughout Maryland. Take this free, half-day training and learn about how to improve your mental health! In Coping in Today's World-Community Psychological First Aid, the Red Cross will provide information about mental health and emergencies, including about how to prepare, respond, and recover from trauma. Participants will also receive information on community resources for coping with stress.


    Intended Audience: this course is open to the general community (healthcare background not required). Bring your friends or neighbors!


    For additional information and registration details, see the attached flyer.


    Preparedness Resources


    Guidance for Infection Prevention and Respiratory Protection.

    1. The Association for Professionals in Infection Control and Epidemiology (APIC) has released a guidance document containing CSC guidance for respirators. This document, titled "Infection Prevention for Ambulatory Care Centers During Disasters," has been posted to the ASPR Communities of Interest (COI) website. To download, visit scroll down to the "Tools" section.



    2. The California Department of Public Health (CDPH), Occupational Health Branch (OHB) has developed a useful guide and template for healthcare organizations to employ in developing and implementing effective respiratory protection programs, with an emphasis on protecting healthcare workers from aerosol transmissible diseases. The template is not copyright protected; rather, it is intended to be modified and tailored by the end user to suit their individual facility's needs. The CDPH guide and templateare included here.




    FEMA National Incident Management System (NIMS) Online Training Courses.

    FEMA's Emergency Management Institute (EMI) offers a variety of interactive, web-based NIMS training courses. For additional information and access to these free online courses, visit:





    ATTENTION MD FQHCS - Thank you for joining the MACHC Emergency Preparedness & Management Call on Wednesday, July 23rd at 10 AM. 


    1. MACHC's Table Top Exercise (see slides attached) After Action Report Improvement Plan (AARIP). Please find AARIP attached here. Additionally, the Situational Manual discussed during the discussion is attached here


    2. DHMH Satellite Phone Recall FQHCs that still have the satellite phones distributed by DHMH 4 years ago, please send them back to: 
    L. Kay Webster, MPH

    Office of Preparedness & Response

    Maryland Department of Health and Mental Hygiene

    300 W. Preston Street, Ste. 202

    Baltimore, MD  21201 

    3. Please get in touch with your Regional Coordinators if you have not already done so and be more active in your Regional Coalition. You should already have their contacts in emails I have sent within this year numerous times. Please find them below: 


    Regions I and II Health Care Coalition 

    [Allegany, Frederick, Garrett and Washington Counties]

    Alison Robinson

    Allegany County Health Department

    12501 Willowbrook Road
    Cumberland, MD  21502
    301-759-5238 (Office)

    443-934-2232 (Mobile)

    301-777-2069 (Fax) 


    Region III  Health and Medical Task Force


    [Baltimore City; Anne Arundel, Baltimore, Carroll, Harford and Howard Counties]

    Edward Johnson

    Harford County Health Department

    120 S. Hays Street, Suite 230
    Bel Air, MD  21014 
    410-877-1031 (Office)

    443-388-6290 (Mobile)

    410-420-3448 (Fax)


    Region IV -

    [Caroline, Cecil, Dorchester, Kent, Queen Anne's, Somerset, Talbot, Wicomico and Worcester Counties]

    Aniket Telang

    Kent County Health Department

    A.F. Whitsitt Center

    300 Scheeler Road

    P.O. Box 229
    Chestertown, MD  21620

    410-778-4861 (Office)

    443-690-3091 (Mobile)


    Region V  Emergency Preparedness Coalition

    [Calvert, Charles, Montgomery, Prince George's and St. Mary's Counties]

    Kamelah Jefferson

    Prince George's County Health Department

    9201 Basil Court, Suite 318

    Largo, MD  20774


    443-462-0230 (Mobile) 



    4. Find ATTACHED (Please click here) the guide was developed to provide hospitals in California with a useful tool for developing and implementing effective respiratory protection programs, with an emphasis on protecting health care workers from aerosol transmissible diseases. It was prepared by the Occupational Health Branch (OHB) of the California Department of Public Health (CDPH) with funding from the National Institute for Occupational Safety and Health (NIOS H) National Personal Protective Technology Laboratory (NPPTL).  It sure looks like something that we can perhaps modify for Maryland.  
    Also attached, you will find the template for setting up a respiratory protection program in hospitals.  

    5. Upcoming: Assisting two FQHCs with Planning for Onsite Drill/Exercise in October 2014. The FQHC sites will be announced in the coming weeks. MACHC INVITES ALL FQHCS to participate during both or at least one of the drills as observers to take notes back to your own shop.
    N95 Masks POD (training) are in the horizon after the drill and release of After Action Report.
    Please look for the latest EP related updates RIGHT HERE!
    Greater Baden Medical Services on the PCMH NCQA Level 3 
    Three Lower Counties on the PCMH 
    Level 2
    Choptank Community Health System on PCMH 
    Level 3

    NEW MACHC Website  is LIVE
    Technical Assistance Request Form 
    ---to be submitted prior to receiving any TA from MACHC--- 

    ***If there are any job openings at any of MD or DE health centers, please email them to us at to be posted on our website.
    Policy, Advocacy and Legislation
    National News
    Please note that there are several critical administrative actions you must take to ensure your HRSA grant applications can be submitted successfully. First, your organization must have an active registration at the time of application submission. You can check your registration at any time. If you do not have an active registration, your application will not be accepted through Second, you must have an active AOR (Authorized Organization Representative) in that is approved to submit an application. You can check to make sure you are an AOR at the website.  Lastly, your DUNS number remains an important part of your registration.  Your DUNS number is linked to the name of your organization and should be consistent in, on your grant application, and in EHB on your Notice of Award.  In accordance with HHS grants policy, without a current registration and a registered AOR, your application will be rejected in  For questions, please access the information found at and or contact the HRSA Contact Center at, 1-877-464-4772.   

    The Centers for Disease Control and Prevention (CDC) is working with domestic and international partners in an international response to the current Ebola outbreak in West Africa. CDC has developed key messages about the outbreak and responses to cases of the Ebola Virus Disease.

    Patient Being Tested for Ebola at D.C.'s Howard University Hospital

    A patient with Ebola-like symptoms is being treated at Howard University Hospital in Washington, D.C., a hospital spokesperson confirmed late Friday morning.

    The patient had traveled to Nigeria recently.

    That person has been admitted to the hospital in stable condition, and is being isolated and tested. The medical team is working with the CDC to determine whether the patient has Ebola.

    "In an abundance of caution, we have activated the appropriate infection control protocols, including isolating the patient," said hospital spokesperson Kerry-Ann Hamilton in a statement. "Our medical team continues to evaluate and monitor progress in close collaboration with the CDC and the Department of Health."

    The federal government has shelved plans to transfer the insurance website to a new hosting service for the coming enrollment period, delaying a move that was supposed to fix reliability problems. The Centers for Medicare and Medicaid Services signed a contract last year to replace Verizon Communications Inc. with Hewlett-Packard Co. the host of, the site used by most people to obtain plans under the Affordable Care Act. The Verizon platform had a series of outages last year that shut the site and affected the federal data hub on which all states rely to transmit information about enrollees' identity and income.
    Exactly one year ago, the Obamacare insurance exchanges stumbled into existence. Consumers struggled to sign up for its online marketplace - and the Obama administration was pummeled. Eventually,'s problems were mostly fixed, and two weeks ago, the administration announced 7.3 million people have bought insurance through it so far this year. So, was the health exchanges' first year a success - or something less? 
    The Balanced Budget Act of 1997 (BBA) directed the Centers for Medicare & Medicaid Services (CMS) to develop regulations and terminate certification for Rural Health Clinics (RHCs) that are no longer located in rural areas with a shortage of health care providers. The Health & Human Services Office of Inspector General (OIG) recently issued a report calling on the CMS to develop and issue regulations to determine "essential-provider" RHCs that meet two location requirements: (1) census-defined rural area and (2) a geographic or population HPSA, a Medically Underserved Area (MUA), or a state-designated shortage area.  Prior to the enactment of the BBA, RHCs retained their certification indefinitely.  The OIG report stated that as of 2013, about 12 percent of RHCs no longer meet the location requirements for certification. In the report, CMS neither agreed nor disagreed with the OIG recommendation.

    Primary Care Rate Increase:  Considerations Beyond 2014

    The Medicaid primary care rate increase, enacted under the Affordable Care Act (ACA), requires Medicaid programs to reimburse qualified primary care services at Medicare levels in 2013 and 2014. Funded entirely by the federal government, the rate increase was designed to increase access to Medicaid primary care services. Federal funding for the increase will cease as of December 31, 2014, raising questions about next steps for states. Prior to the rate increase's implementation, Medicaid programs paid, on average, 66 percent of Medicare rates for all services and just 58 percent of Medicare rates for primary care services.  A new brief from the Centers for Health Care Strategies looks at the impact of the increase in PCP payment, recommendations to improve the program should states elect to continue it, and more.  

    Poor interoperability is a significant hurdle for accountable care organizations (ACOs), according to a survey from Premier and the eHealth Initiative. All 62 ACOs responding reported access to data from external sources was a challenge for their organization and interoperability of disparate systems was reported as a significant challenge for 95 percent. 

    Rep. John Sarbanes (D-Md.) wants to use retrained physicians returning to the work force to ameliorate the nation's primary care physician shortage. He has introduced the Primary Care Physician Reentry Act, which would provide training and financial assistance to these returning doctors.  In return for this assistance, the physicians would serve at Community Health Centers , VA medical centers or school-based health centers to help fill the shortage of primary care doctors. The legislation would establish a grant program for medical schools, hospitals and non-profit organizations to create or expand their physician reentry programs that give physicians a streamlined process for credentialing and continuing medical education to return to medical practice after an absence. Rep. Sarbanes in an online interview said he will reintroduce the bill in the new 2015-16 Congress and that he expects bipartisan support. .

    Fiscal Year 2015 Affordable Care Act New Access Point (NAP) Grants (HRSA-15-016)

    NAP applications are due in HRSA's Electronic Handbook (EHB) by Tuesday, October 7, 2014, 8:00pm, ET. New FAQs and technical assistance resources have been posted on the NAP TA Webpage.
    The Department of Housing and Urban Development eligible applicants to apply for a Promise Zone designation. In Promise Zones, the federal government will partner with and invest in communities to create jobs, leverage private investment, increase economic activity, expand educational opportunities, and reduce violent crime to ensure that all communities continue to share in the country's economic growth. Applications are due by Friday, November 21, 2014, 5:00pm, ET in  Three webcasts geared to various audiences will be archived on the Promise Zone website. Additional questions on how to apply should be directed to      
    2014 Million Hearts Hypertension Control Challenge
    Million Hearts is an initiative that brings together communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke. The Million Hearts Hypertension Control Challenge  recognizesclinicians, practices, and health systems that achieve blood pressure control for greater than 70% of their patients with hypertension. The deadline to apply to is Wednesday, October 10, 2014, 11:59pm, ET.. . Questions about the Challenge should be directed to
    with "Challenge" in the subject line. 

    State News

    Gearing up for Marketplace Open Enrollment


    Choose Health Delaware is the state's official program for health care reform and the Health Insurance Marketplace and is focused on reaching the uninsured and underinsured to increase their access to high-quality, affordable health care.


    Through August, more than 22,000 Delawareans had enrolled in health care coverage either through private coverage purchased on the Marketplace or through the state's expanded Medicaid program. The Marketplace's next open-enrollment period, for coverage in 2015, starts November 15 and ends February 15, 2015.  If you've recently moved, gotten married, had a child or experienced a similar life-changing event, you might qualify to enroll in coverage before November 15.  And qualified applicants can enroll in coverage through Medicaid and the Children's Health Insurance Program (CHIP) throughout the year.


    There are many reasons to get covered through the Health Insurance Marketplace:


    • Free checkups. Annual checkups and preventive care, including mammograms, vaccinations and screenings, are all covered - without a co-pay. That means free.
    • Prescription drugs, emergency services, maternity and newborn care, mental health and substance abuse services are all covered, too.
    • Health insurance companies compete for business, so consumers can compare offers and choose the best plan for them.
    • You are prepared if a crisis hits. Having health insurance means you're prepared for any health crisis - from a car-accident injury to a sudden illness or unexpected health condition. Health insurance can also help you avoid health issues before they become major problems.
    • Financial help. People with moderate and low incomes can get financial help to offset the cost of premiums and out-of-pocket expenses.
    • It's the law. If you or your dependents don't have insurance that qualifies as minimum essential coverage you'll pay a penalty.  The penalty for being uninsured in 2015 will be whichever of these amounts is higher: 2% of your yearly household income(only the amount of income above the tax filing threshold, $10,150 for an individual, is used to calculate the penalty) or $325 per person ($162.50 per child under 18).  You'll pay the fee on your 2015 federal income tax return. Most people will file this return in 2016.

    All 2014 Marketplace health plans will come up for renewal in 2015. Those who signed up for coverage in 2014 will receive notices from the Marketplace shortly before November 15, explaining the automatic enrollment process and how they can return to the Marketplace to see if they qualify for additional financial assistance and shop for plans. Consumers will also receive notices from their insurance company about their new 2015 premium and the amount they may save on their monthly bill with a premium tax credit.  

    Generally, if consumers do nothing, they will be automatically enrolled in the same plan with the same premium tax credit and other financial assistance, if applicable, as their 2014 plan.  


    Getting covered has already made a difference for many Delawareans. "My life has improved a lot," says Felipe Hernandez, a 25-year-old machine operator from Wilmington and a married father of a toddler. He's used his new coverage to pay for prescriptions and get a physical exam and other preventive care. "I feel less stress and more hopeful about the future for me and my family," Felipe says. "I want to buy a house, and having health insurance will help keep me out of debt."


    The state's Marketplace Guides, who are trained and certified to educate residents about their health insurance options and to help them enroll, are available to provide free in-person assistance throughout the state.  Visit for a list of where Marketplace Guides will be available and for more information on the Health Insurance Marketplace and Delaware's expanded Medicaid program.



    Nearly 458,000 Marylanders have enrolled in quality and affordable coverage under the Affordable Care Act in 2014. Of these, more than 80,000 have enrolled in private coverage through Maryland Health Connection. 

    As of Sept. 20, 81,091 individuals have enrolled in qualified health plans.

    As of Sept. 29, 376,850 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014, to full Medicaid coverage. Compared to August, the September figure represents an increase of 21,569 people enrolled in Medicaid and 2,425 individuals enrolled in qualified health plans in Maryland.

    The net increase in Medicaid enrollment as of Sept. 29, 2014, is 262,979, compared to Dec. 31, 2013. This figure takes into account that some individuals who were enrolled in Medicaid later became ineligible due to changes in household, age and income, as well as redeterminations.

    Open enrollment for health coverage under the Affordable Care Act for 2015 begins next month. Starting Nov. 9, Marylanders can browse plans at to see new plans and costs for the coming calendar year. Starting Nov. 15, consumers can get help enrolling in-person, and starting Nov. 19, Marylanders can go online and sign up from home using a new, easier-to-use website at

    The open enrollment period for private health coverage in 2015 runs through Feb. 15. Medicaid enrollment continues year-round.

    All Marylanders interested in financial help with a plan in 2015 who would like coverage starting Jan. 1, 2015, should visit by Dec. 18. Those who received a health plan through Maryland Health Connection in 2014 should visit the website to retain financial assistance, and to shop and compare new plans and costs.


    Finance & Business
    Commonwealth Fund survey: ACA plans seen as affordable

    Seventy percent of the people getting health coverage through the ACA insurance exchanges believe they could now afford care if they get sick, according to a Commonwealth Fund survey released Thursday. Generally, the people in the exchanges find premiums affordable, although that's particularly true of lower-income people who are more heavily subsidized. "The subsidies are doing what they were designed to do - make comprehensive coverage attainable for low- and moderate-income families without employer-based health insurance," Sara Collins, Commonwealth Fund vice president for health care coverage and access, said in a statement. The report finds that 65 percent of people making less than $28,725 (or 250 percent of the federal poverty level) said their premiums were affordable. More than two-thirds pay less than $125 a month for individual coverage, and about 40 percent had deductibles of less than $500. That's all comparable to employer-sponsored coverage at this income level.

    Underinsured ACA Enrollees Strain Community Health Centers
    Modern Healthcare reports that individuals who purchased health insurance coverage through state and federal health insurance marketplaces are straining the finances of community health centers around the country, according to some health center leaders. The issue is that many lower-income patients with this coverage bought bronze-tier plans with lower premiums but high deductibles, coinsurance and copayments and no federal cost-sharing subsidies. When these patients face high out-of-pocket costs for care that falls below the deductible, they can't afford it. They then  turn to health centers that subsidize care by offering means-tested sliding-scale fees. When the health centers, which are not allowed to turn away patients for inability to pay, try to get the insurers to pay, the claims are usually denied, and the centers have to write it off as uncompensated care. 

    Latest News on ACA

    Marketplace Information and Assistance event being  held:

    DATE:            Saturday Oct. 11th

    TIME:             10:00 am - 2:00 pm

    10 - Noon:   Consumer Briefing Session

    Noon - 2:     Marketplace Assister Training


    LOCATION: Tuttleman Learning Center

    Temple University Campus

    1809 North 13th Street

    Philadelphia, PA  19122

    No reservations needed. All are welcome.



    CMS October Webinar Schedule:

    • Friday, October 10 at 2:00 pm EDT
    • Friday, October 17 at 2:00 pm EDT
    • Friday, October 24 at 2:00 pm EDT
    • Friday, October 31at 2:00 pm EDT

    NOTE: The webinar schedule is subject to change in order to deliver late-breaking information



    Last week, HHS Secretary Sylvia Mathews Burwell released a new blog post on gains in health care affordability and access through the Affordable Care Act. The Secretary discussed increased selection for consumers with the 25% increase in the total number of issuers selling health insurance plans in the Marketplace.  She also discussed decreases in provider costs with $5.7 billion in projected savings for hospitals this year due to decreases in uncompensated care costs made possible by increased health insurance coverage. To read more of this blog post and to view other outreach materials provided by HHS and CMS, please see the links below.

    New Blog from the Secretary: The ACA is Working

    New Video: Real Stories, Real Coverage Mash Up

    Get Covered Stories

    Every day Americans share their #GetCovered stories. Check out these stories & get ready to #GetCovered:


    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
    Time Sensitive message from MHBE ( For Maryland FQHCs only):
    Here are the instructions to access the web based training (WBT) and the registration for the instructor led training (ILT) for the new MHC MD HBX system (Please note: this training is for Certified, Permitted or Authorized staff only).  The web based training will serve as a prerequisite to the instructor led training (ILT) sessions that will be held from Oct. 6, 2014 - December 15, 2014. The WBT must be completed in its entirety before you can register for an ILT session.  To access the WBT, please reference the instructions entitled "Non-State WBT". The length of the instructor led training will vary depending on your role (Please make sure you select the correct role during the registration process).   After completion of the WBT, please reference the instructions entitled "Non-State ILT Registration" for instructions on how to register for the ILT.  Also, attached are the listing of sessions that are currently scheduled in Excel for you to cross reference.   If there are any questions regarding registration, please contact

    Maryland Health Benefit Exchange Update:

    What's in a name? A lot! So much so, that we feel compelled to draw a distinction between some of the terms that we have all been using on a regular basis. These distinctions are important for communicating with our colleagues, as well as our consumers.

    • Maryland Health Benefit Exchange (MHBE)- The public corporation and independent unit of Maryland state government that is responsible for the administration of Maryland Health Connection.
    • Maryland Health Connection - Maryland's marketplace at for individuals and families to compare and enroll in health insurance and determine eligibility for Medicaid and other assistance programs, federal tax credits and cost-sharing reductions.
    • MD HBX - The online application/web portal at that consumers will use this fall to enroll in health coverage, and the project supporting the adoption of technology used by Connecticut's health exchange for 2014.


    Enrollment Outreach and Kickoff Week

    We have started direct-outreach to Marylanders enrolled in a qualified health plan in 2014 to apply through Maryland Health Connection by Dec. 18 to keep any financial help they received this year. This is an opportunity for all consumers to see new plans and prices for 2015.

    Emails were sent this week to current QHP-enrollees, and letters will be mailed in early October to make sure these consumers know they need to take action this fall to keep their financial help for 2015. Marylanders can use an online signup form or automated phone system to request enrollment help from authorized insurance brokers or navigators. More information is on our website.

    Kickoff Week for the start of open enrollment in November was announced recently. The week features plan-browsing for consumers starting Nov. 9, and opportunities for in-person enrollment starting Nov. 15. Consumers will be able to enroll online at home starting Nov. 19:

    • Nov. 9 - Anonymous browsing begins on Consumers can use the website to learn about available plans, get an estimate of financial assistance and begin comparing their health insurance options without having to enter personal information.
    • Nov. 15 - The first HealthConnectNow! sign-up event will be held. About 25 sign-up events are being scheduled throughout Maryland. Details about times, dates and locations will be announced in the coming weeks.
    • Nov. 16 - Call center opens to take phone applications at 855-642-8572 (TTY 855-642-8573).
    • Nov. 17 - All authorized insurance brokers (producers) and navigators, and some assisters and certified application counselors are able to complete enrollments through the website and also provide in-person consumer assistance.
    • Nov. 18 - Caseworkers at local health departments and departments of social services begin enrolling consumers through the website. Medicaid applications (currently completed through SAIL) will be directed through
    • Nov. 19 - Self-service enrollment through the website becomes available for the first time to the general public and all consumer assistance staff.


    We Are Making Progress

    Preparing Our People

    We are providing training to make sure that everyone who will be using the system is ready. The training consists of online tutorials and classroom-based training. You will receive an email with step-by-step instructions on how to access online training within "THE HUB."

    Once you have completed each web-based tutorial, "THE HUB" will automatically give you credit and a transcript. You will then be allowed to enroll in classroom-based training.


    We Want Your Feedback

    To help us to achieve our goal, we would like to increase the number of readers of our newsletter and incorporate your feedback and questions.

    We invite you to send a list of email addresses of your staff who should receive the newsletter, as well as your feedback and questions, to

    Grants & Funding Opportunities

    Update: Fiscal Year 2015 New Access Point (NAP) Funding Opportunity (HRSA-15-016) - Webinar recordings are now available from the NAP Applicant Technical Assistance Session and the Cooperative Agreement Partners Briefing which provided an overview of the $100 million announcement to support an estimated 150 NAP grant awards in FY 2015. 

    As a reminder, applications are due in by Wednesday, August 20, 2014 at 11:59pm, ET and in HRSA's Electronic Handbook (EHB) by Tuesday, October 7, 2014 at 8:00pm, ET.


    FY 2015 SAC Funding Opportunity Announcements (FOA)  

    HRSA has released the next two rounds of FY 2015 SAC FOAs (HRSA-15-012 and HRSA-15-013), covering service areas with March 2015 and April 2015 project period start dates. 
    Contact for questions.


    Verizon Foundation Grants

    Application Deadline:  October 10, 2014

    Grants of $5,000-$10,000 for projects that incorporate technology to improve healthcare and reduce health disparities for women, children, and seniors. Funds can also be used for domestic violence-related programs.


    Healthy Tomorrows Partnership for Children Program

    Application Deadline:  October 14, 2014

    Grants to support community-based child health projects that improve the health status of mothers, infants, children, and adolescents by increasing their access to health services.


    HIV Early Intervention Services Program Existing Geographic Areas

    Application Deadline:  October 15, 2014

    This competition is open to existing and new organizations proposing to provide Part C funded services in the service areas described in Appendix B of the program guidance. New organizations that seek to replace current grantees must demonstrate that they will serve the existing patients, target populations, scope of services, and service areas currently served by the grantee they intend to replace. Community Health Centers and Rural Health Clinics are eligible entities.

    A Rural Community Development Initiative (RCDI) Grants

    Application Deadline:  November 12, 2014

    Awards to provide financial and technical assistance to subrecipients to develop and strengthen their capacity to carry out housing, community facilities and community and economic development projects. Rural communities may be interested in applying for these grants to fund health infrastructure. Recipients must be non-profit organizations, low-income rural communities, or federally recognized tribes. Intermediary organizations are required to provide matching funds at least equal to the RCDI grant. 


    USDA Funding to Promote Healthy Eating Choices

    Application Deadline:  December 15, 2014

    The U.S. Department of Agriculture (USDA), through its National Institute of Food and Agriculture (NIFA), is making up to $31.5 million in funding available to help participants in the Supplemental Nutrition Assistance Program (SNAP) more easily afford healthy foods like fruits and vegetables. The Food Insecurity Nutrition Incentive (FINI) program, a new Farm Bill program, brings together stakeholders from distinct parts of the food system and fosters understanding of how they might improve the nutrition and health status of SNAP households. Under FINI, applicants may propose relatively small pilot projects, multi-year community-based projects, or larger-scale multi-year projects. Funded projects will test community based strategies that could contribute to our understanding of how best to increase the purchase of fruits and vegetables by SNAP participants through incentives at the point of purchase, supported by effective and efficient benefit redemption technologies, that would inform future efforts. 

    HRSA began issuing FY 2014 base adjustments last week for health center grantees in accordance with program statute and the FY 2014 budget as enacted by Congress. Health Center grantees should see new Notice of Awards in EHB in the near future. To compute base adjustments, HRSA is using a base amount for all grantees, and providing additional amounts based on each cCenter's total patient population, uninsured patient population and Patient Centered Medical Home recognition status.


    Reminder: Outreach and Enrollment (O/E) Ongoing Funding 

    Health centers that received O/E grant funds in July 2013 have already received the ongoing O/E funds in their base award to cover the months between July 1, 2014 through the end of their FY 2014 budget period. Health centers should be preparing for the upcoming open enrollment period that begins on November 15, 2014. Contact with any questions or concerns related to O/E.


    Federal Surplus Personal Property Program 

    Application Deadline: None  

    Eligible state and local government agencies and nonprofit organizations, including health centers, can obtain property that the federal government no longer needs through the Federal Surplus Personal Property Donation Program.


    BJ's Charitable Foundation

    Application Deadline: Applications accepted on an ongoing basis
    Funding for hunger prevention, self-sufficiency, healthcare, and education to those who are underserved. 
    Application Deadline: Applications accepted on an ongoing basis
    Provides seed funding to emerging nonprofits, or to new projects of established organizations in the areas of education; environment; health and human services; and hunger and nutrition. Pennsylvania is one of 13 eligible states.
    Application Deadline:  Applications Accepted on an Ongoing Basis
    The Community Response Fund supports organizations, activities, and events that address access to needed oral health care and community resources that improve oral health. Programs that address an immediate response to an urgent issue that impacts access to clinical care, provide short-term access to needed care for the underserved, or sustain organizations experiencing short-term challenges are the focus. A limited number of program concepts that provide longer term solutions or essential services for particularly underserved populations will also be considered. The program will also support Missions of Mercy clinics.
    Patient Centered Medical Home (PCMH) Corner 

    The rapid proliferation of patient-centered medical homes (PCMH) has placed tremendous pressure on hospitals to adapt to the payment and delivery system reforms brought about by these initiatives. Although there has not always been a clear role for hospitals in a PCMH, their absence as a partner can be detrimental to an initiative's success given their place within the medical neighborhood. This briefing, The Role of Hospitals in Medical Home Initiatives and Strategies to Secure their Support and Participation, is made possible through support from The Commonwealth Fund and makes the business case for hospital participation, clarifies roles for hospitals in a PCMH, and offers strategies to successfully secure hospitals' support and participation.

    Patient-centered Medical Home: A Model of Care at Summit Health
    Summit Health has adopted the patient-centered medical home (PCMH) model to provide patients with a comprehensive, coordinated and accessible approach to primary care.

    Rather than a place, the PCMH is an approach to providing primary care that is patient-centered, team-based, and focused on quality and safety. It establishes the patient's primary care physician as the fundamental coordinator of the patient's care.

    As part of the PCMH model, the patient is at the center of care. His or her primary care physician communicates with other providers - such as specialists and subspecialists, pharmacists, and social workers - to integrate and coordinate care. It is a model of achieving primary care excellence by helping patients get the care they need when they need it.

    The PCMH model has five main functions:

    • Provide comprehensive care.
    • Be patient-centered.
    • Help coordinate care.
    • Provide accessible services.
    • Commit to improving quality and safety.

    The goal is to improve the quality, effectiveness and efficiency of all care team members so that healthcare decisions are patient-centered and respect the patient's preferences, thus fostering a relationship of trust and encouraging the patient to be actively engaged.

    The primary care physician directs patients to be proactive in their care. The patient collaborates with the physician to establish goals and plans that best meet their healthcare needs and preferences, discusses all of their medications and medical conditions, and more.

    Goals can range from something as simple as exercising twice a week to improve fitness to seeing a specialist for management of a medically complex disease.

    Additionally, the PCMH model brings in the patient's family members as needed to help patients accomplish their goals, such as helping patients remember to take medication as prescribed.

    The objective is to keep all team members - including patients - informed and to develop a treatment plan that meets all of their goals.

    Clinical Quality 

    Which states are showing the most improvement in the quality of health care they deliver to patients and access to services they provide? AHRQ's [[State Snapshots]] answer that question with easy-to-read charts on the strengths, weaknesses and opportunities for improvement in each state and the District of Columbia. State Snapshots data can be analyzed by type of care, treatment setting, clinical condition, insurance status, race and income. State Snapshots data are drawn from the 2013 National Healthcare Quality Report and National Healthcare Disparities Report, which comprise the most complete source of data on the use of health care and health insurance coverage in the nation. Trend data for most measures span from 2000-2002 to 2010-2011.


    New SAMHSA Strategic Plan Released

    The Substance Abuse & Mental Health Services Administration (SAMHSA) has released its new strategic plan, Leading Change 2.0: Advancing the Behavioral Health of the Nation 2015-2018. The plan was developed by SAMHSA's Executive Leadership Team and staff, in partnership with a diverse group of stakeholders and with input from the public.  The plan outlines how SAMHSA through six strategic initiatives will continue to increase awareness and understanding of mental and substance use disorders, expand prevention efforts, promote emotional health and wellness, increase access to effective treatment, and support recovery 

    A study of electronic medical record use in Florida hospitals reveals that adopting all five core meaningful use (MU) medication management elements correlated with large reductions in adverse drug events (ADEs). The study, co-authored by AHRQ's William E. Encinosa, examined 2010 data from hospitals considered early adopters of Stage 1 MU requirements. ADE rates were reduced by MU across the board, even among hospitals challenged with cost barriers, low quality or MU implementation issues. However, the researchers also found that physician buy-in is critical to the success of MU. "Without physician buy-in at the hospital, MU will have no impact on adverse drug events," the study stated

    DEA Releases Final Rule on Disposal of Controlled Substances

    On September 9, 2014, the U.S. Drug Enforcement Administration (DEA) issued a final rule governing the disposal of controlled substances.  Several key provisions provide three additional voluntary options for disposal of controlled substances:

    • Take-back events
    • Mail-back programs
    • Collection receptacles

    The final rule implements the Secure and Responsible Drug Disposal Act of 2010 and goes into effect October 9, 2014.  For more, see Duane Morris Alert on the rule.

    Health Observances This Week


    October 5 - 11, 2014 is Mental Illness Awareness Week (MIAW)


    MIAW is a time for education about mental illness such as depression, bipolar disorder, schizophrenia and other medical conditions that affect a person's thinking, feelings moods, ability to relate to others and daily functioning.

    MIAW includes National Depression Screening Day (Oct. 9.) and World Mental Health Day (Oct. 10) During MIAW everyone should learn symptoms of mental illness and where to find help in case it is needed. It is also a time when community leaders should learn the facts about mental illness for public dialogue about mental health care.

    When an individual or family has a mental health concern, they should discuss it with their doctor, who may refer them to a mental health professional. Information is available from the National Alliance on Mental Illness (NAMI) or its HelpLine at 1-800-950-6264.  NAMI also provides free education classes and support groups.

    NAMI's website provides detailed information about the full range of mental illness diagnoses. Symptoms of depression, bipolar disorder and schizophrenia specifically are listed below.

     In many cases, the conditions have co-occurring substance abuse problems.


    • Changes in sleep
    • Changes in appetite. A person may experience a decrease in appetite and noticeable weight loss. Others may eat more, sometimes resulting in weight gain
    • Poor concentration or ability to make decisions
    • Loss of energy
    • Lack of interest in usual activities.
    • Low self-esteem; dwelling on losses or failures
    • Feelings of hopelessness or guilt-including thoughts of suicide

    Bipolar Disorder

    Bipolar disorder involves alternating, recurring cycles of depression (lows) and mania (highs).During a low cycle, symptoms mirror depression (above). Symptoms of manias include:

    • Anxiety
    • Difficulties with sleep
    • High level of energy and activity
    • Hypersensitivity
    • Irritability
    • Intense imagination
    • Risk-taking; often with poor judgment


    Schizophrenia involves a combination of symptoms falling into three categories: positive, negative and cognitive.

    Positive Symptoms,   also known as "psychotic symptoms," involve a loss of contact with reality. Negative systems "take away" a person's usual ways of interacting with other people. Cognitive symptoms affect thinking, reasoning, memory and perception.

    Positive Symptoms 

    • Delusions-a person believes ideas that are clearly false (e.g. people are reading their thoughts)
    • Hallucinations-images or voices that others cannot see or hear

    Negative Symptoms

    • Emotional flatness 
    • Inability to start or follow through with activities 
    • Lack of content in speech 
    • Inability to experience pleasure

    Cognitive Symptoms

    • Difficulty in organizing thoughts
    • Difficulty in remembering
    • Inability to recognize their illness (anosognosia)

    NAMI thanks Forest Laboratories, LLC, a subsidiary of Actavis, for being the National Sponsor of Mental Illness Awareness Week.

    NAMI is the nation's largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.

    LOGO - http://photos.prnewswire



    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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