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 20, 2014



(1 Transformational Call (*bi-weekly)

October 21st; 10 am - 11 am

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) 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. 

To register:


(3) 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.


(4) 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

To register: 

(5) Delaware Outreach & Enrollment (O&E) Event

Monday November 3, 2014  ;  1:00-4:00pm

Location: Currently have Edgehill Training Center in Dover reserved. (Look under this section for updates)

Email should you have any questions.


(6) Maryland Department on Aging Living Well Program - Diabetes 

November 12th, 12:00 PM - 1:30 PM
Pam Toomey, Master Trainer of Standford's Living Well Program, will explain how this evidence based, self-management workshop that is available in your community is available for your patients. This 6 week workshop is led by trained facilitators throughout Maryland and administered by the Maryland Department of Aging. This program teaches participants how to manage their chronic conditions like diabetes as well as improve their quality of life. Participants who partake in the program see improvements in exercise, cognitive symptom management, communication with physicians, health distress, fatigue and social limitations.

  • (1) Preparing Your Healthcare System for Ebola Call - Monday, October 20, 2014, 1:00pm - 2:00pm, ET.

    Leaders across HHS are hosting this conference call for hospital executives, hospital emergency management directors, and safety officers to describe how to prepare healthcare systems to protect health and safety should an Ebola patient be present at the facility. Stay tuned for call-in information.


    (2) Navigating the Outreach and Enrollment Landscape Webinar Series

    Session #3: Income Determination and Taxes: What Health Centers Need to Know
    Wednesday, October 22, 2014
    1:00 - 2:00 PM ET

     This webinar is the third in the NACHC series "Sign Me Up!" Navigating the Outreach and Enrollment Landscape.

    This webinar is the third in the NACHC series "Sign Me Up!" Navigating the Outreach and Enrollment Landscape. 

    Enrollment assisters at health centers face increasingly complex questions related to household composition and income rules when helping to enroll consumers in Medicaid or the insurance exchange. The questions get tougher in states that didn't expand Medicaid and where consumers can fall into coverage gaps. How consumers answers these questions during enrollment will have a significant impact next year when they file their taxes.
    This webinar, tailored specifically for a health center audience, will feature a health policy expert from the Center on Budget and Policy Priorities to discuss household and income determinations, PTC eligibility, exemptions, paying the fine, and other time sensitive issues. The webinar will also highlight effective partnerships and strategies implemented at the health center level to respond to tax issues both during tax filing season and beyond.


    (3) Save the Date: BPHC All-Programs Webcast - Thursday, October 23, 2014, 2:00pm - 3:00pm, ET

    BPHC is hosting this quarterly webcast to provide all BPHC programs (Grantees, Look-Alikes, Cooperatives Agreement Partners - NCAs, PCAs, and BPHC Staff) with updates on current BPHC activities and future plans for Fiscal Year 2015. Look for more details in the next edition of the Digest.


    (4) 340B Audit Readiness Webinar Series: Confirming and Documenting Eligibility - Wednesday, October 29, 2014, 2:00pm - 3:00pm, ET

    HRSA is hosting a series of webinars focused on audit readiness.  The first webinar will present a systematic approach to verifying, documenting and maintaining covered-entity eligibility for participation in the 340B program.  

    Register here.


    (5) AHRQ Co-Sponsors ECRI Conference On Care For "New" Complex Patients November 6-7

    ECRI Institute's 21st Annual Conference on the Use of Evidence in Policy and Practice will be held November 6-7 in the nation's capital. The title of the free conference, co-hosted by AHRQ, is "The 'New' Complex Patient: The Shifting Locus of Care and Cost." The purpose is to explore how America's health care system is changing to care for complex patients, how this care is being financed and how and where this care takes place. The conference will be held at the National Academy of Sciences, 2101 Constitution Ave. NW, Washington, D.C. Continuing education (CE) credits will be available to participants at no cost. Registration is open.


    (6) 2015 NACHC Policy & Issues Forum

    Marriott Wardman Park Hotel, Washington, DC

    March 18-22, 2015


    Emergency Preparedness Events: 


    The Centers for Disease Control and Prevention (CDC) is ramping up efforts to ensure that providers are prepared in case more cases of the Ebola virus are detected.  A second healthcare worker at the Texas Presbyterian Hospital has now tested positive for the virus after coming into contact with a patient who died from Ebola. CDC and its partners are taking precautions to prevent the spread of Ebola within the United States.  Among the resources coming out from CDC is a resource/checklist for Outpatient/ Ambulatory Care Settings.   Representatives from the Department of Health and Human Services are also hosting a conference call for hospital executives, hospital emergency management directors, and safety officers to describe how to prepare healthcare systems to protect health and safety should an Ebola patient be present at the facility on Monday, October 20th at 1 pm, ET. We will post the call information as soon as its available.

    In the meantime NACHC is also urging health centers to work directly with local public health departments to ensure an effective and coordinated response.   NACHC is advising health centers to ramp up their front desk/scheduling operations to ensure appropriate screening of patients.  If a patient is concerned that they are exhibiting symptoms of Ebola, the protocol for telephone screening should first and foremost rule out whether the patient has traveled to any of the countries affected by the Ebola Virus Disease.   If appropriate, the patient should be referred to a facility that is equipped and prepared to handle such cases without presenting to the health center and possibly exposing others.  Call ahead of time to alert the facility that a suspected case will be presenting, so that they can prepare for their arrival.

    NACHC's Chief Medical Officer Ron Yee, MD, also offers some cautionary advice:  "While we are greatly concerned about the protection of our communities, patients and staff from the Ebola virus, taking the appropriate measures, we need to make sure that we are also protecting our populations from influenza and addressing enterovirus cases.  These conditions will affect a great number of individuals and are also very important, from a public health standpoint.  We should not let the fear of Ebola distract us from the important work of prevention.  While taking the proper steps to address Ebola, make sure you and your loved ones get vaccinated, wash your hands frequently, and cover your coughs.  These are things everyone can do now to stay healthy."

    Finally, don't forget to include communications in your response planning.  The primary goal is to educate and to allay fears about Ebola and emphasize to the community and patients that staff are trained and prepared to deal with public health threats.



    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:



    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!

                              Access is the Answer 

          Campaign to Fix Health Center Funding Cliff

    This week, the national Modern Healthcare news service outlined the funding cliff facing Community Health Centers in the 2016 federal Fiscal Year.  The following article also highlights that NACHC will initiate an advocacy effort in the "lame duck session" following the election to urge Congress to take legislative action to circumvent the financial calamity facing health centers. Health centers should expect to begin outreach initiatives to our congressional delegation as early as October 27. If you haven't already, please join the Campaign for America's Health Centers for regular updates.

    Have you checked out the NEW MACHC website?
    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

    Fiscal Year (FY) 2015 Service Area Competition (SAC) for HRSA-15-015 HRSA released SAC-AA funding opportunity announcement (FOA) HRSA-15-015 on October 15, 2014 covering service areas with a May 31, 2015 project period end date.
    Technical assistance materials for SAC applicants, including transcripts, recording and slides are available on the SAC TA Webpage. Questions should be directed to the Office of Policy and Program Development at

    HHS has developed a primer to describe strategies for using Medicaid to meet the needs of  individuals experiencing homelessness and tenants in permanent supportive housing.  While focused on these vulnerable populations, this Primer can be used to serve  individuals who might require supportive services to maintain stability. 
    The U.S. Health Workforce: State Profiles
    The State Profiles provide data on 35 types of health workers as companion documents to the U.S. Health Workforce Chartbook. The State Profiles and were developed to make data on the U.S. health workforce more readily available to diverse users
    Updated Health Care Resources for Suspected Cases of Ebola Virus Disease
    The Centers for Disease Control and Prevention (CDC) is working with other U.S. government agencies and has activated its Emergency Operations Center to help coordinate technical assistance and control activities with partners about the Ebola Virus Disease outbreak. CDC has  updated key messages and resources about the outbreak. The following CDC resources, among others, are available for use:

    Treating Ebola Patients in the US, Lessons Learned Presentation
     The Infectious Diseases Society of America has released a summary of a presentation on caring for Ebola patients in the US.
    Read the summary of the presentation.

    Spike in ER, Hospitalization Use Short-Lived After Medicaid Expansion
    While the Medicaid expansion may lead to a dramatic rise in emergency room use and hospitalizations for previously uninsured people, that increase is largely temporary and should not lead to a dramatic impact on state budgets, according to an analysis from the UCLA Center for Health Policy Research released Wednesday.

    The Obama administration began notifying consumers on Wednesday that they should return to the federal health insurance marketplace to renew coverage for next year. In addition, the officials said, consumers should update information on their income and family size and should compare their current insurance with alternatives, which could offer better coverage at a lower cost

    Study Finds Savings Low For Employers Capping Their Payments For Treatments; Burwell Meets The Press: Managing Expectations On Ebola,, ACA Year 2

    Julie Appleby reports on a study about capping payments: "In an effort to slow health care spending, more employers are looking at capping what they pay for certain procedures - like joint replacements - and requiring insured workers who choose hospitals or medical facilities that exceed the cap to pay the difference themselves. But a study out Thursday finds employers might be disappointed with the overall savings. While the idea, known as "reference pricing," does highlight the huge variation in what hospitals and other medical providers charge for the same services, the report says, it does little to lower overall health care spending" 
    Also on the blog, Mary Agnes Carey opens up her notebook and reports on comments from Health and Human Services Secretary Sylvia Mathews Burwell: "We're working on it. No matter what the topic - from improving consumers' experience with, the health law's Medicaid expansion, narrow networks and even Ebola - Department of Health and Human Services Secretary Sylvia Mathews Burwell told reporters Thursday her agency is on it. During a breakfast with reporters sponsored by Kaiser Health News and the health policy journal Health Affairs, Burwell tried to manage expectations about the health law's next open enrollment season and declined to make a prediction about how many people would enroll this time around. She also cautioned that we are likely to see the number of Ebola cases rise before the crisis subsides"

    ACA Costs Much Lower than Projected

    According to data released by the Congressional Budget Office this week, the cost of expanding insurance coverage under the Affordable Care Act (ACA) in fiscal 2014--the year during which the main coverage expansions went into effect--was far lower than budget experts predicted when the law was enacted four years ago. CBO originally projected that federal Medicaid spending would total between $320 billion and $335 billion in fiscal 2014. Its latest numbers show the tally to be $302 billion.  Medicaid spending grew 13.6 percent and Medicare spending a more modest 2.7 percent. The Medicare total was $509 billion, about $100 billion less than CBO thought it would be in 2010.

    Upcoming UDS Webinars

    The Bureau of Primary Health Care (BPHC) is hosting several technical assistance webinars to provide UDS training opportunities to health centers completing a 2014 UDS report. Each webcast will focus on a different UDS objective. All webinars will be recorded and posted on the UDS Reporting webpage, but health centers are also strongly encouraged to attend a live training session.

    • Introduction to UDS Clinical Measures, October 20, 2014, 2:00 pm - 4:30 pm, ET.  To participate in this session, use the link: UDSOctober20. Connect to the audio line using 1-800-857-5012; Participant Code: 9413383.
    • Introduction to UDS for Look-Alikes, October 22, 2014, 1:30 pm - 3:00 pm, ET.  To participate in this session, use the link: UDSOctober22. Connect to the audio line using 1-800-857-5012; Participant Code: 9413383.
    Kaiser Permanente was the only HMO to earn a top four-star rating for providing recommended care, according to California's latest report card on insurers and medical groups. The scores issued Wednesday focus on California's 10 largest HMOs, the six biggest preferred-provider organization plans and more than 200 physician groups covering 16 million consumers. Anthem Blue Cross, the state's largest for-profit insurer, and Cigna Corp. led the way among PPO plans with three-star ratings. The data is drawn from claims data and patient surveys in 2013 
    Consumers Whose Income Drops Below Poverty Get Break On Subsidy Payback
    Right about now, some low-income people who just barely qualified for subsidies on the health insurance marketplace are starting to worry: What if my income for the year ends up below the poverty level? Will I have to pay back the premium tax credits I received? A couple of readers have posed this question in recent weeks

    Insurance consultants were shocked recently to learn that Obama administration rules allow large companies to offer 2015 worker health plans that don't include hospital benefits. Now the administration is concerned too. Treasury Department officials are preparing to reverse course on an official calculator that permits plans without hospital coverage to pass the health law's strictest standard for large employers, said industry lawyers who have spoken to them. These sources expect the administration to disallow such coverage by the end of the year

    State News
    Community unites to break down English-Spanish language barrier
    Hertiage Month spans from Sept. 15 to Oct. 15. In Sussex County, the month gives residents with a Hispanic background an opportunity to take pride in their heritage, while also recognize the unique challenges they face, particularly the language barrier.
    Georgetown's La Red Health Center is another key local organization. Forty-eight percent of its patient base is Hispanic, so they work to ensure that language does not affect the accessibility of suitable health care.

    Find out what the latest on Dealware's State Health Care Innovation Plan
    Anthony Brown, Larry Hogan Trade Attacks In 2nd Maryland Gubernatorial Debate
    Democrat Anthony G. Brown and Republican Larry Hogan on Monday sharply questioned each other's credibility on economic issues and managing state spending, part of a gubernatorial debate that also included attacks on gun laws, funding for pre-kindergarten and Maryland's troubled health insurance exchange. ... The candidates also sparred over Brown's role in Maryland's botched rollout of its online health insurance exchange. The issue was not mentioned when the men debated in Baltimore last week, prompting Hogan to complain about the moderators 


    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

    Could Your Health Center be at Risk of Failure?

    Capital Link and Community Health Center Capital Fund (Capital Fund) have announced the release of Identifying the Risks of Health Center Failure,the newest report in the Community Health Center Financial Perspectives series sponsored by the Citi Foundation. Based on an analysis of the financial and operational performance of 29 health centers over a four-year period leading up to the centers' demise, this report examines the differences between failed or failing health centers and their more successful counterparts. The report contains two issues: one written to address an audience of community health center leaders and another directed toward lenders and investors. Key findings can be found in an infographic. The complete report contains detailed financial and operational data.

    Wal-Mart Drops Health Coverage for Part-Timers

    Wal-Mart, the nation's largest private employer, has announced it will stop offering health benefits effective January 2015 to employees who work fewer than 30 hours per week. The move is significant both because of the size of the Wal-Mart workforce as well as the impact the decision might have on other employers.

    Program Information Notice (PIN) 2014-02
    Sliding Fee Discount and Related Billing and Collections Program Requirements Webinar Recording
    -This recorded webinar provides an overview of PIN 2014-02, information on next steps BPHC is taking, and who to contact with additional questions. View the webinar recording.

    Introduction to UDS Clinical Measures, October 20, 2014, 2:00pm - 4:30pm, ET. 
    Objectives: Review Table 6B and 7 clinical measures (including prenatal) and discuss strategies for evaluating reported data.  
    To participate in this session, use the following link: UDSOctober20. Connect to the audio line using 1-800-857-5012; Participant Code: 9413383.  

    Introduction to UDS for Look-Alikes, October 22, 2014, 1:30pm - 3:00pm, ET.
    Objectives: Review reporting requirements and overview of review process.  
    To participate in this session, use the following link: UDSOctober22. Connect to the audio line using 1-800-857-5012; Participant Code: 9413383.  

    UDS Sampling Methods, including, November 6, 2014, 1:30pm - 3:00pm, ET. 
    Objectives: Review purpose of random sample and correct methods for generating random sample and chart substitutions.  
    To participate in this session, use the following link: UDSNovember6. Connect to the audio line using 1-800-857-5012; Participant Code: 9413383.
    Latest News on ACA


    The health care overhaul makes renewing insurance so easy you don't have to do a thing. However, there are many reasons to resist this temptation. More than 7 million people signed up for coverage through the overhaul's public insurance exchanges after the first annual open enrollment window started last fall. Open enrollment returns starting Nov. 15, and experts say it brings with it the perfect chance to take stock in your insurance coverage, even if you like the plan you have this year. That coverage - or the cost of it - may change for 2015. Plus, new and better options also could be available in your market 


    Even With Insurance, Language Barriers Could Undermine Asian Americans Access To Care

    Efforts to enroll Asian Americans in the health law's marketplace plans have generally been touted as a success, but because coverage details are provided primarily in English or Spanish, those who depend on their native languages have encountered roadblocks as they try to use this new insurance


    New From Coverage to Care Materials Available in Spanish


    From Coverage to Care (C2C), an initiative of the Centers for Medicare & Medicaid Services (CMS) designed to help people with new health coverage understand their benefits and connect to primary care and preventive services, now has resources in Spanish available to download, print and order. Available resources include:
    • A Roadmap to Better Care and a Healthier You (Una Guía para Un Mejor Cuidado y Una Vida Más Saludable) that includes 8 steps to explain what health coverage is, and how to use it to get needed care
    • Consumer tools including a sample insurance card and a sample explanation of benefits
    • An 11-part video series that helps explain the information covered in the Roadmap 


    CMS October Webinar Schedule:

    • 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


    The Obama administration seems pretty confident that can avoid punch-line status again when Obamacare enrollment reopens next month. Administration officials this week showed off improvements to the enrollment Web site that are supposed to be much more consumer-friendly - things like new smartphone capabilities, a shorter application process and the ability to actually use the "back" button while filling out the online application. As new Health and Human Services Secretary Sylvia Mathews Burwell talked with reporters Thursday about plans and expectations for Obamacare's second year, there are still some big question marks about the landscape for the health-care law when enrollment opens again Nov. 15



    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


    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

    Maryland Health Connection Update

    for LHD and LDSS Caseworkers, Call Center representatives and Connector Entities


    Effective October 18, 2014, in preparation for the new open enrollment period, the current HIX will not process new Medicaid/ MCHP applications or changes. PLEASE follow the INTERIM procedures listed below:     

    October 18th  - November 18th

    •          If a new Medicaid/MCHP application or eligibility change is added to the HIX after October 17th, the system will still show a Medicaid or MCHP determination, but it WILL NOT be sent to MMIS and the enrollment will never be completed.

    o   Call Center and Connector Entities must submit New Medicaid/MCHP applications via SAIL at  LHD and LDSS caseworkers will continue to process all applications in CARES. 

    o   If a navigator or call center representative does not have access to CARES and a customer is requesting a status update on their SAIL application, they should be referred to the DHR Constituent Services hotline: 1-800-332-6347.

    Beginning November 18th

    •          All new MAGI Medicaid/MCHP applications must be submitted via the new Maryland Health Connection (HBX). 

    Questions this week that may help you:

    Q:  Can MACHC help with the state's current decision to not allow our CACs to directly enroll patients in Medicaid? The CACs receive the same training as the Navigators, but are required to refer folks to the health department or DSS offices for enrollment.  This seems incredibly inefficient and clearly creates barriers.
    A:  .  MACHC has advocated for this position all of last year.  You may recall that it is the legislature that gave approval for the Navigators and Assistors and we had to petition the legislature last year to even get the CACs qualified in the manner that they are presently.  We have continued to push the issue, however, the law would have to be changed to allow for such a change to occur.   We will continue to appeal for this but it may be next to impossible to change the current state for this upcoming enrollment period.  

    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:

    REMINDER: Complete Training!

    Remember to take MD HBX online tutorials located on the LMS ("The HUB") . The training helps users gain familiarity with the system. You can also register for classroom training through the LMS.

    If you are having any difficulty accessing the training or have questions, please email Producers may use


    Final Exams

    We are currently testing the HBX system's performance communicating with insurance carriers and other state databases, as well as testing true-to-life scenarios to prepare for when the system is available to the public.


    Preparing Our People

    We have held meetings with leaders from across the user community to answer questions, provide updates, and describe how the system will affect existing business operations. We also held a meeting exclusively for Producers to show them how they will be using the HBX to work with consumers.


    System Sneak-Peek

    The HBX system facilitates two-way communication between consumers and workers through notices that are generated automatically and sent to consumers. Notices are sent to collect missing information or verifications.

    Consumers can choose to receive notices by postal mail or electronically through their Maryland Health Connection account. Consumers may send needed information or upload verifications to their account.

    Frequently Asked Questions

    Question: What credentials are required of a primary applicant?

    Answer: A primary applicant must meet the following criteria to apply for health coverage through Maryland Health Connection:

    1.      Resident of State of Maryland
    2.      18 years or older*
    3.     U.S. citizen, naturalized or eligible immigration status**
    4.      Not deceased (Yes, this does occur.)

    *The primary applicant must be 18 or older to file an application. An emancipated minor who is 16 to 18 may be processed through the Worker Portal. Children younger than 16 must have a Responsible Adult listed on the application to receive an eligibility determination through the system. That Responsible Adult must meet the Primary Applicant criteria listed above.

    **An undocumented immigrant can be the primary applicant on the MD HBX system. Because the primary applicant must be age 18 or older, an undocumented immigrant can include themselves as the primary applicant so that they can apply for their children's health coverage. However, they are ineligible to receive coverage themselves. In order to proceed with their application on behalf of their household, they should indicate that they are not seeking coverage.


    We Want to Hear From You!

    Please send a list of email addresses of your staff who should receive the MHBE updates/ newsletter, as well as your feedback and questions, to

    Grants & Funding Opportunities

    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.

    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. 


    National Health Service Corps (NHSC) Students to Service Application Cycle Closes on November 13, 2014 at 7:30pm, ET -NHSC Students to Service Loan Repayment Program is open to medical students (MD and DO) in their final year of school. Medical students can receive an award of up to $120,000 (tax-free) towards their qualifying educational loans.  

    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.

    HRSA PCMH Resources: Comparison Chart
    Clinical Quality 
    New Research Review Looks at Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain
    A new research review from AHRQ's Effective Health Care Program found that while the evidence on the effectiveness and harms of opioid therapy for chronic pain treatment is limited, there is an increased risk of serious harms based on the opioid dose given. The research review assesses observational studies that suggest that use of long-term opioids for chronic pain is associated with increased risk of abuse, overdose, fractures and heart attack, when compared with patients who are not being prescribed opioids. The review noted that more research is needed to understand the long-term benefits, risk of abuse and related outcomes, and effectiveness of different opioid prescribing methods and strategies. The review is titled, "The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain." AHRQ has also released a statistical brief from the Healthcare Cost and Utilization Project titled, "Hospital Inpatient Utilization Related to Opioid Overuse Among Adults, 1993-2012." According to the brief, hospitalization rates for opioid overuse more than doubled from 1993 to 2012 and increased at a faster rate for people age 45 and older. In addition, AHRQ Director Rick Kronick, Ph.D., has published a blog about opioids.

    Prescription Drug Monitoring System Set to Become Law

    This week the House nearly unanimously approved legislation (Senate Bill 1180) that will establish a prescription drug monitoring system in an effort to have a proactive system to detect potential abuse of prescription drugs and also allow law enforcement officials access to the system.  This system would require dispensers and pharmacies to report names of prescribers, prescribers' Drug Enforcement Agency (DEA) registration number (and same for dispenser/pharmacy), dates for prescription being written and dispensed, National Drug Code, day's supply, etc.  Prescribing physicians would be required to access the system as part of the process in prescribing controlled substances to patients.  
    Health Observances This Week


    October is Health Literacy Month

    October is Health Literacy Month. This annual event is a time when organizations and individuals worldwide raise awareness about the importance of understandable health information. Health Literacy Month has been going strong ever since Helen Osborne founded it in 1999.

    Through the years healthcare organizations, community services, health literacy coalitions, government agencies, literacy programs, universities, and others have hosted Health Literacy Month events. These include how-to workshops for professionals, wellness programs for the public, and educational offerings for students at all levels.

    The theme for Health Literacy Month 2014 is "Be a Health Literacy Hero." Health Literacy Heroes are individuals, teams, or organizations who not only identify health literacy problems but also act to solve them. We can all be Health Literacy Heroes. Here are some suggestions about how: 

    • Spread the word. What inspired you to advocate for health literacy? Maybe it was when you attended a health literacy conference, read a research study, or participated in an online training course. Or as often happens, perhaps you were inspired by personal experiences when health communication either went very badly or exceptionally well. Take action this year by sharing stories about why health literacy matters.
    • Communicate health messages in ways that others can easily understand.Our job as health communicators is to clearly communicate important health messages. This job is not complete until we confirm that others can truly comprehend. Take action by focusing your message on just 3 to 5 key points, using words that your audience already knows or clearly explaining terms they need to learn, and supplementing your words with illustrations or interaction.
    • Partner with others. It can sometimes feel like you are a voice of one when it comes to advocating for health literacy. Please know that you are not alone. There are an ever-growing number of health literacy resources and partnerships. One is the excellent online Health Literacy Discussion list. There also are many regional and state-wide health literacy collaborations. A good place to find like-minded folks within the U.S. is at CDC's "Health Literacy Activities by State." Whether you join an existing network or start a new one, be a partner for action.
    • Be a Health Literacy Hero. This means finding health literacy problems and creating long-lasting solutions.
    • Tell the world about how individuals, teams, and organizations are making a difference.

    Become a Health Literacy Hero

    Health Literacy Heroes are individuals, teams, and organizations who identify health literacy problems and act to solve them. There are many ways to do this. Here are examples of what Health Literacy Heroes have done in past years. Follow the links to learn about each story.

    • Raise awareness about why health literacy matters
    • Create materials that are easy to read, understand, and use
    • Partner with communities and colleagues to advance health literacy

    You can help. There are lots of ways:

    • Encourage others to be Health Literacy Heroes
    • Give an award to those you consider Health Literacy Heroes
    • Inspire others to take action
    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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