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
November 3, 2014




(1) 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.

Transformational Call (*bi-weekly) 
November 4th; 10 am - 11 am
1-866-740-1260 Access Code: 4319483

To get on call listserv, email

Audience: MD and DE  Member FQHC Leadership

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


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

November 12th, 12 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.
Click here to register


(4) Outreach Team Call (*biweekly)

To get on call listserv, email

Audience: MD and DE Outreach staff

Topic: Discuss State and FQHC updates, trends, best practices, obstacles and issues. These dicusssions are recorded for HRSA reports  These topics are included in MACHC's advocacy efforts on behalf of FQHCs. This call also entails discussing ongoing CHC advocacy campaigns for CHC participation.


(5) 2014 Uniform Data System (UDS) Training

December 17th, 2014 8:00 AM -  4:30 PM

The Uniform Data System (UDS) in-person training is a full day program covering the preparation of the 2014 UDS Report.  The training addresses each of the report's tables, including a discussion of the changes that have been made and the definitions necessary to complete the Report. The UDS training is aimed at those who are responsible for gathering and reporting the data elements included in the UDS Report, as well as management and clinical staff who need to understand the definitions and concepts used.

Monday, January 5, 2015
Federal Tort Claims Act Training
brought to you by MACHC. This TA will be facilitated by Feldesman Tucker. 
Cost: There will be a nominal fee for non-members
Look out in this section for more info in the coming weeks!


  • (1)  
  •  CMS Offers Webinar on Health Insurance Options for Immigrant Families

    The Centers for Medicare & Medicaid Services (CMS) is hosting a webinar next week, in Spanish, on the health insurance options for immigrant families.   

    • When:   November 3, 2014 at 3pm ET
    • Webinar Link: join 5 minutes early (No registration is required)
    • Audio-conference line: 1-877-267-1577
    • Meeting number: 997 683 698
    •  Meeting ID: Not required- Press #

    Questions should be directed to

    (2) 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

    (3) 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.


    (4) Emerging Technologies to Improve Glycemic Control among Persons with Diabetes: A Healthy People 2020 Spotlight on Health Webinar, Thursday, November 13, 2014, 12:00pm - 1:30pm, ET. HHS is hosting this webinar highlighting free evidence-based and emerging mobile technologies designed to improve glycemic control and the health of people with diabetes. Click here to register

    (5) Health Centers Serving Individuals and Families Experiencing Homelessness Enrichment Webinar, Tuesday, November 18, 2014, 2:00pm - 3:00pm, ET.
    This webinar will provide health centers with an overview of current health trends, and will address the needs of individuals and families experiencing homelessness.
    View the webinar the day of the session. Connect to the audio line using 1-888-946-9422; Participate Code: 2654950.

    (6) Social Determinants of Education Series
    November 19, 2015
    The Social Determinants of Education Seminar Series focuses on answering the question of what it would really take to improve education for all urban students. Come and join us on Wednesday, November 19th for the third seminar of the Social Determinants of Health Series. The seminar will be held at the Johns Hopkins University, School of Education, located at 2800 N. Charles Street Baltimore, MD 21218, Room 219 from 12:00- 1:30 pm. The guest speaker will be Leticia Smith-Evans, Interim Director, Education Practice NAACP Legal Defense & Educational Fund, Inc.RSVP:



    (7) HRSA's Electronic Handbook (EHB) Login Change 

    November 20, 2014 at 8:00pm, ET 

    External EHBs login credentials will change from an User ID to an email address. This update will make it easier for users to remember their usernames. All external EHB users should have received email correspondence with instructions to update User IDs to email addresses. Questions should be directed to the HRSA Contact Center at 1-877-464-4772.


    (8) 2015 NACHC Policy & Issues Forum

    Marriott Wardman Park Hotel, Washington, DC

    March 18-22, 2015


    Emergency Preparedness Events: 



    Question: On the Public Health and Healthcare Systems Emergency Planners Ebola Update conference call, there was a discussion regarding reimbursement for expenses incurred for Ebola.  Reimbursement is for devoted time to Ebola.  Discussion was directed to hospitals and Departments of Health.  Is there is any reimbursement for FQHC's/health centers because a few of our health centers have devoted much time, money and effort towards ebola training? Should this reimbursement come from the State or does it have to come out of the HPP Funds provided to the PCA?


    Answer: The reimbursement is not a sure thing at this time. This will only happen if there is a federally declared emergency which will activate the Stafford Act. We are just encouraging our partners to track expenses in the event that there is a  federally declared emergency due to Ebola response.  Please refer to the link below to learn more about the Stafford Act. 



    I.  Ebola Preparedness Update

    DHMH continues to collaborate closely with ASPR and CDC to assist Maryland hospitals and healthcare coalitions in preparing for potential Ebola virus disease (EVD) and similar threats. To access and download DHMH's weekly Ebola Virus Disease Situation Update, as well as additional information related to Ebola, log on to the Maryland Health Alert Network (HAN) website, click on the Documents tab, select the folder titled "Emerging Infectious Diseases", and select the "Ebola Virus" sub-folder.


    Healthcare partners are strongly encouraged to monitor the CDC's Ebola website frequently for access the most up-to-date information:



    DHMH Secretary's Directive and Order Regarding Ebola. (see attached)

    On October 8, 2014, DHMH Secretary Joshua M. Sharfstein issued a special directive and order regarding the reporting of Ebola case information and measures to prevent potential spread of the disease. The order contains provisions that are applicable to healthcare facilities, healthcare providers, local health departments and law enforcement. To review the full text of the Secretary's Directive and Order,


    Ebola Preparedness Assessment for Hospitals (survey).

    DHMH, OP&R is currently developing an online Ebola preparedness survey that will be disseminated to Maryland healthcare facilities. The responses that our healthcare partners provide to this survey will allow DHMH to better understand and evaluate the capabilities of Maryland's healthcare system to respond to Ebola. Additional information and a link to complete the survey will be distributed via email in the coming days.


    Checklists and Resources.

    It is important for healthcare providers, facilities, and coalitions to remain vigilant and take steps to be as prepared as possible to protect our communities from all emerging infectious diseases, including Ebola. In support of these efforts, ASPR and CDC have released guidance to assist healthcare system partners with Ebola preparedness.


    Checklist for Patients Being Evaluated for Ebola Virus Disease in the U.S. (hospitals): see attached


    Detailed Hospital Checklist for Ebola Preparedness: provides practical and specific suggestions to ensure your hospital is able to detect possible EVD cases, protect employees, and respond appropriately.

    Checklist for Healthcare Coalitions for Ebola Preparedness: highlights key areas for healthcare coalitions to review in preparing to care for patients possibly infected with the Ebola virus. The checklist provides practical and specific suggestions to ensure healthcare coalition members are able to detect possible Ebola cases, protect employees, and respond appropriately.



    Detailed Emergency Medical Services (EMS) Checklist for Ebola Preparedness: highlights key areas for EMS personnel to review in preparation for encountering and providing medical care to a person with Ebola.




    II.  Preparedness News

    Flu Season Begins: Time to Get Vaccinated!


    September 28, 2014, marked the official beginning of the 2014-2015 influenza surveillance season for Maryland and for the rest of the United States. Though no influenza cases have been confirmed yet in Maryland, the Department of Health and Mental Hygiene (DHMH) reminds all Maryland residents that now is the time to get vaccinated against the flu.


    While it is expected that influenza activity will begin to increase in the coming weeks and months, it is important to remember that there are other respiratory viruses already circulating that might cause symptoms similar to those of influenza. "We know that Marylanders have been paying attention to respiratory viruses recently, including enterovirus D68," said DHMH Secretary Dr. Joshua M. Sharfstein. "One respiratory virus that leads to hospitalizations and deaths every year in Maryland is influenza. Protect yourself and your family and friends by getting vaccinated."


    Influenza activity typically starts to increase in October. Stay up-to-date on influenza activity in Maryland by visiting for weekly updates. For more information about the seriousness of influenza and the benefits of vaccination, visit the following websites:






    Coming Soon: New Emergency Department at UMSMC-Chestertown


    On September 16, 2014, University of Maryland Shore Medical Center at Chestertown held a ribbon-cutting ceremony and Community Open House to celebrate their new, $4.3 million Emergency Department. The renovation increased the size of the ED from roughly 4,500 square feet to nearly 8,000 square feet. Upgrades include an enclosed ambulance bay; a larger lobby and waiting room; a separate walk-in entrance that provides convenience for emergency patients and added security for the entire hospital; and private, specialized treatment rooms designated for behavioral health, pediatrics, trauma, and women's health.


    The new ED will serve 15,000 patients a year. UMSMC-Chestertown hopes to move into the 8,000 sq. ft., 18-bed space by the end of September.


    III.  Upcoming Training Opportunities   

    UASI Active Assailant Seminar 2014.

    The Baltimore Urban Area Security Initiative will be hosting a free one-day Active Assailant training seminar on November 20, 2014 at Goucher College in the Kraushaar Auditorium (8:00am - 3:30pm). This event will allow participants to hear about active assailant incidents from individuals who have experienced them first-hand. The seminar will cover pre-incident planning, response, recovery, and lessons learned. For additional details and registration instructions:




    MGT431: Pediatric Disaster Preparedness and Planning Course.  

    The Virginia Department of Emergency Management and the Fairfax County Office of Emergency Management are pleased to announce the offering of MGT431: Pediatric Disaster Preparedness and Planning, which will be held January 12-13, 2015 at the Fairfax County Government Center. There is no cost to attend.


    MGT 431 is a two-day performance level course that focuses on 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. The course will be taught by the Texas Engineering and Extension Service (TEEX).


    The target audience includes: hospital staff and planners, public health, school administrators, American Red Cross, law enforcement, emergency management, fire service, military personnel, and others that deal with children on a daily basis.


    For additional information and registration instructions:


    Note: this course will fill up quickly. Those interested in attending should register as soon as possible at the address link provided.


    IV. Preparedness Resources

    Be Prepared: New OP&R Fact Sheets Available Online in Multiple Languages.

    DHMH/OP&R has released several new preparedness fact sheets. The following have been translated into Chinese, French, Haitian-Creole, Korean, Russian, Spanish, Tagalog and Vietnamese:


    -  Emergency Supply Kit Checklist

    -  Cold Weather Health Issues and Concerns

    -  Frostbite

    -  Driving Tips for Extreme Cold Weather

    -  Pandemic and Seasonal Flu: What You Need to Know to Be Prepared

    -  Ricin


    These new fact sheets (along with previously translated fact sheets on general emergency preparedness, extreme heat, and hurricanes/storms/floods) are available online at [To download, navigate to the site and click the desired language on the right sidebar.]



    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:






    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.

    6. Quality Improvement and Infectious Disease series of webinars TBA
    Please look for the latest EP related updates RIGHT HERE!

    Outreach Luncheon - Date: TBA

    The Affordable Care Act (ACA) has increased requirements not only for community health centers (CHC) but for health departments.  These requirements have resulted in a need for a greater level of partnership as needs have converged.  As a result, many health departments are reaching out to CHCs to find ways to lessen the burden for all and to investigate the best way to meet the goals in partnership.

    For example, the Baltimore City Health Department (BCHD) will host decisions makers from the CHCs that serve the citizens of Baltimore City at its first planning meeting on Monday, December 8, at the Radisson Hotel at Cross Keys.  Representatives from the CHCs will meet with counterparts from the BCHD to discuss how to partner with the BCHD to address considerations that affect:

    • Clinical services;
    • Clinical protocols;
    • Budget issues; and,
    • Reporting to agencies that fund and/or certify the clinic, as well as, required reports to the Health Department.

    As part of the team, the BCHD invited the Federal Training Center Consortium, Atlantic Region (FTCCAR) to describe programs that support medical management, prevention services and quality assurance; the Maryland Department of Health and Mental Hygiene; and, a representative from the Mid/Atlantic Association of Community Health Centers (MACHC). 

    This is a first step to developing a stronger partnership that will assist both the CHCs and the health departments as the ACA is more fully implemented.  If you are interested in learning more about this outreach, contact M. Terry Hogan at  


    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?

    ***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

    HRSA EHB Login Changing

    Beginning Thursday, November 20, 2014 at 8:00 pm ET, Health Resources & Services Administration (HRSA) external electronic handbook (EHB) login credentials will change from a User ID to an email address. The update is designed to make it easier for users to remember their usernames. All external EHB users should have received email correspondence with instructions to update User IDs to email addresses. Questions should be directed to the HRSA Contact Center at 1-877-464-4772.

    Health and Human Services Secretary Sylvia M. Burwell announced today that more than $2.2 billion in grants was awarded in fiscal year (FY) 2014 to cities, states and local community-based organizations, funded through the Ryan White HIV/AIDS Program. This funding will ensure that more than half a million people living with and affected by HIV infection continue to have access to critical HIV health care, support services, and medications that are insufficiently covered by other forms of health care insurance. 

    Key Messages - Ebola Virus Disease 

    ASPR continues to provide Ebola information for healthcare professionals and healthcare settings on its website.  Information is organized for EMS providers, clinicians and healthcare professionals, hospitals and healthcare facilities, and healthcare coalitions.  Audio replays and transcripts from recent Ebola webinars and national calls for healthcare professionals and healthcare settings are also available here and updated as additional information comes available.  
    Additionally, on October 24th, the CDC published Interim Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public Safety Answering Points (PSAPs) for Management of Patients with Known or Suspected Ebola Virus Disease in the United States. It can be found at:
    On October 24th, the Interagency Board published Recommendations on the Selection and Use of Personal Protective Equipment for First Responders Against Ebola Exposure Hazards.  It can be found at:

    Making Medication-Assisted Treatment (MAT) a Routine Part of Addictions Care Blog 
    Read this week's  ATTC/NIATx Service Improvement Blog to learn about how communities can move forward in implementing MAT as a routine part of care.  The blog also provides information on a year-long project with safety-net providers about MAT by the SAMHSA-HRSA Center for Integrated Health Solutions

    HRSA Hosts Lobbying Presentation for Grantees

    This week HRSA held a webinar to discuss lobbying and aspects that HRSA grantees should be aware of for reporting and best practices.  The slides from the presentation are available.  One point that should be noted is that new lobbying rules are expected to be made available via a "super circular" on December 26 and will highlight any changes or prohibitions for HRSA grantees moving forward into 2015.

    CMS Releases New Renewal Notices and Resources for Enrollment Assisters

    The Centers for Medicare & Medicaid Services (CMS) has released model redetermination and renewal notices for the FFM (in English and Spanish). There are six sample notices for the following groups of consumers:
    • Enrolled without tax credits
    • Eligible but not enrolled
    • Those with income that appears too high for tax credits
    • Those with income that appears to have changed significantly
    • Those with income that has not changed
    • Consumers who did not allow the Marketplace to check their tax return.
    CMS has also released a short fact sheet, 5 Steps to Staying Covered, to help consumers and assisters during renewal

    CMS Releases Guidelines on Renewals for 2015

    The Centers for Medicare & Medicaid Services (CMS) has released guidelines on the renewal process for 2015. These guidelines, Renewal and Re-enrollment Basics for 2015, are available online.

    CMS Guidance on When to Complete a Security Risk Analysis

    To meet the "Protect Electronic Health Information" core objective for Stage 1, eligible professionals (EP) must conduct or review a security risk analysis and implement security updates as necessary and correct identified security deficiencies as part of the provider's risk management process.  In Stage 2, in addition to the same security risk analysis requirements, EPs also need to address the encryption and security of data stored in the certified EHR technology (CEHRT). A security risk analysis must be conducted or reviewed during each program year for Stage 1 and Stage 2. The analysis may be completed outside or during the EHR reporting period timeframe, but must take place no earlier than the start of the reporting year and no later than the end of the reporting year.  For example, an EP who is reporting for a 90-day EHR reporting period in 2014 may complete the security risk analysis requirements any time between January 1 and December 31, 2014. For more information, read the new FAQ.  Providers in small-to-medium sized offices may also use ONC's Security Risk Assessment (SRA) tool to conduct risk assessments of their organizations. The tool also produces a report that can be provided to auditors.  An assessment tool user guide and tutorial video are also available.
    Hoping to bolster the status of primary care providers across the country, the newly formed Family Medicine for America's Health coalition has launched a five-year, $20 million campaign to fight for increased reimbursement rates, create new incentives for medical school students considering primary care and promote the patient-centered medical home model for care.  
    With open enrollment set to launch in less than three weeks, HHS Secretary Sylvia M. Burwell met with 12 insurance executives to reaffirm "her commitment to continue to work with issuers on implementing the Affordable Care Act to make health care more affordable, accessible, and of a higher quality."
    Faced with another outbreak of viral meningitis, this time on the University of Maryland Campus, the U.S. Food and Drug Administration has approved a new vaccine designed to combat the deadly disease.  Trumenba, which protects against the serogroup B form of meningitis, received final FDA approval on Wednesday, well ahead of schedule. 

    Hoping to slow the spread of Ebola, a bipartisan team of senators is drafting legislation to speed the development of treatments and vaccines.  Democratic Senator Tom Harkin of Iowa and Republican Senator Lamar Alexander of Tennessee said their bill would add Ebola to the Food and Drug Administration's priority review "voucher" program, which is designed to incentivize the development of new drugs for certain tropical diseases.

    State News

    PCC welcomes new leadership 

    Leslie Graham has been hired by the Primary Care Coalition (PCC) as their new President and Chief Executive Officer, effective November 17, 2014. Ms. Graham is taking over the position from Steve Galen who served as PCC's CEO for 18 years. Mr. Galen will continue to work with PCC as a Strategic Advisor in the coming months.

    Ms. Graham comes to the PCC from the Delmarva Foundation for Medical Care where she developed a roll out strategy for the Health Benefits Exchange assistor program for the State of Delaware. In the past, she served as the PCC's Chief Operating Officer. 

    A meningitis outbreak at the University of Maryland may be related to another virus that has swept across the country during recent months, though further testing is being conducted to determine the possibility. 

    If the tests are positive, it would mean that yet another manifestation of enterovirus-68 has occurred.

    In Maryland, the state public health lab is conducting a broad range of testing on specimens submitted to the agency, state epidemiologist Dr. David Blythe says. Agency officials would not specify whether testing for EV-68 was occurring and did not confirm whether samples had been sent to the Centers for Disease Control and Prevention. County health officials say that testing will occur at either the state level or be performed by the CDC.
    Finance & Business

    Medicare Prospective Payment System (PPS) on the Billing Process.

    New Patient is defined:

    •          A new patient is one who has not received any professional medical or mental health services from any sites within the FQHC within the past three years.
    •          If a new patient is also receiving a mental visit on the same day, the patient is considered "new" for only one of these visits.

    New Patient FAQs (These questions were asked to and answers were provided by CMS):

    •          Q1. If an established patient sees a specialist in the FQHC for the first time, will we get the new patient adjustment?
    •          A1. No. The new patient adjustment is only for patients that have not received services from any practitioner in the FQHC organization within the last 3 years.
      •          Q2. If a patient was seen in a satellite of the FQHC but not in the main location, would they be a new patient?
      •          A2. No. If a patient was seen in any location of the FQHC by any provider within the last 3 years they would not be considered a new patient.
      •          Q3. If a patient received only behavioral health services and then had a medical visit, would they be a new patient?
      •          A3. No, because the patient is not new to the FQHC.
      •          Q4. If a patient was seen in another FQHC that is not affiliated with my FQHC, would they be a new patient?
      •          A4. Yes, because they would be new to your FQHC.
      •          Q5. If a patient was seen in the hospital that we are affiliated with and then came to the FQHC for follow-up, would they be a new patient?
      •          A5. Yes. FQHCs are not authorized to furnish hospital services (inpatient and outpatient), so if the patient has not been seen in the FQHC within the past 3 years he/she would be a new patient.
      •          Q6. When does the 34% increase for IPPE, AWV, and new patients begin?
      •          A6. It will begin for claims submitted under the PPS, which is determined based on when your cost reporting period begins.
      •          Q7. Does the new patient, IPPE, AWV adjustment vary by region?
      •          A7. No. The 34% increase is the same for all FQHCs.
      •          Q8. If a medical visit, mental health visit, and subsequent illness/injury are reported on the same day can we bill for 3 visits.
      •          A8. Yes, although we would not expect that to be a common occurrence. 

    NACHC Offers Free 340B Internal Audit Webinar

    Health centers participating in the 340B Program must ensure program integrity and maintain accurate records documenting compliance with all 340B Program requirements. Health centers participating in the 340B Program are subject to audit by both the drug manufacturers and the federal government. Find out how to prepare yourself by conducting your own internal audits of your 340B program. Register for the November 13, 2:00 - 3:30 pm webinar and learn:  the key pieces of the program to test for compliance; policies and procedure documentation to support your program; and how to document your internal audit findings and action plans.  A Second free webinar on 340B Inventory Management will be held on November 20.

    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


    Outreach and Enrollment Frequently Asked Questions (FAQ) Update -BPHC has provided clarification for health centers that are considering working with agents or brokers to further enhance the health center's Outreach and Enrollment efforts. For more information, see FAQs 13 and 14.


    In preparation for the Open Enrollment Period beginning November 15, 2014 for the 2015 plan year, CMS updated the Navigator, non-Navigator assistance personnel, and certified application counselor (CAC) training curriculum for the Federally-facilitated Marketplaces, including State Partnership Marketplaces. CMS released the English version of the Assister Training on September 4, 2014. 

    The Assister training curriculum is now available in Spanish, in addition to English, at the Medicare Learning Network® (MLN) Health Insurance Marketplace Learning Management System at

    Please refer to the CMS Enrollment Assister Bulletin: 2014-01’ released August 15, 2014 on the CCIIO website for additional guidance regarding training, certification, and recertification for Navigators, certified application counselors (CACs), and non-Navigator assistance personnel in the Federally-facilitated Marketplaces. 


    Health Insurance Marketplace Four Key Dates You Should Know -Are you ready for the next Health Insurance Marketplace Open Enrollment Period? Open Enrollment is the time when anyone can apply for a new Marketplace plan, keep a current plan, or pick a new plan. Here are four dates everyone should know:


    November 15, 2014 - Marketplace open Enrollment Begins 
    December 1, 2014 - Deadline: Enroll for January 1, 2015 Coverage 
    January 1, 2015 - 2015 Coverage Begins

    February 15, 2015 - Last Day to Enroll for 2015 Coverage

    Get covered in 2015: What you need to know



    On November 15th, millions of Americans will return to to find a new health insurance plan or re-enroll in their current plan.


    Here are 3 things you can do right now to get ready:

    We want to make sure every single American who needs good, affordable health insurance knows how to get it.

    Take a look, mark your calendar, and spread the word!

    The Team  


    Health insurance options for immigrant families

    Please join the Centers for Medicare & Medicaid Services (CMS) for a workshop (in Spanish) on the benefits available to immigrant families through the Health Insurance Marketplace and how to get covered during open enrollment, which will take place November 15-February 15.


    When:                         November 3, 2014 at 3pm ET


    Webinar Link:
    Please join 5 minutes early (No registration is required)


    Audio- conference line: 1-877-267-1577

    Meeting number: 997 683 698
    Meeting ID:
    Not required- Press #

    For questions, please contact



    Seguros de salud para familias inmigrantes

    Los Centros de Servicios de Medicare y Medicaid (CMS) los invita a un seminario en línea (en Español) sobre los beneficios disponible en el Mercado de Seguros Médicos para las familias inmigrantes e información sobre cómo obtener cobertura durante la inscripción abierta- el 15 de noviembre hasta el 15 de febrero.


    Cuando:          3 de noviembre, 3pm hora del este



    Por favor únanse cinco minutos antes del comienzo (no se necesita registrar antes)


    Número de teléfono: 1-877-267-1577

    Numero de conferencia: 997 683 698
    no se necesita código- oprima #

    ¿Preguntas? Contacte a   


    Transformational Team Talk & Outreach Upates

    MHBE -ACSE Monthly Meeting 

    Here are the list of resources that you may have missed from the webinar:

    1. List of CACs who need a second or third test

    2. ACSE Marketing Strategies

    3. List of Enrollment Fairs

    4. Connector Entity Contact Information (by county)

    5. Plan Services 

    6. 2015 Open Enrollment Plan

    Message from your Maryland Health Benefit Connection

    It's almost spooky to think how close we are to open enrollment!

    We are excited for Kickoff Week, with anonymous browsing starting Nov. 9 and enrollment starting Nov. 15.

    Thank you for completing the online and classroom training to those who did. We are continuing to prepare for go-live.

    If you need support, please use the following tools:

    1) Click here to access useful tools to help you understand the new Maryland Health Connection online application.

    • Repository of helpful training materials, past newsletters, and additional reference materials
    • We'll update with new resources on an ongoing basis
    • Bookmark this site on your web browser!

    2) It's not too late to sign up for online training!

    Online training is available here so you can familiarize yourself with the new system.

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


    REMINDERS for your consumers:

    Dates to Know

    Starting Nov. 9: Compare plans and prices at the all-new

    Starting Nov. 15: Get in-person help enrolling. Look for details soon.

    Starting Nov. 19: Enroll on your own online at

    Dec. 18:  Deadline to apply for financial help with your plan that starts Jan 1. Create a new account and application by Dec. 18 or any financial help you received in 2014 will end, and your coverage will continue at the new, full price. Learn more here.

    (Enrolled in Medicaid? You'll be contacted to renew.)

    Feb. 15: Open enrollment ends for 2015


    5 Steps to Stay Covered

    1) Review: Plans change, people change. Review your coverage and look for a letter from your plan about how your benefits and costs may change next year.

    2) Update: Starting Nov. 19, go to and create a new account and application (even if you had one in 2014). Make sure your household income and other information are up-to-date for next year.

    3) Compare: Compare your current plan with other plans that are available in your area.

    4) Choose: Select the health plan that best fits your budget and health needs.

    5) Enroll: Make sure to apply and choose your plan by Dec. 18 to have any financial help you qualify for start Jan. 1.

    Then be sure to pay your insurance company's bill by the first day of the month you have coverage.




    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). 
    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 
    PCMH Resources

    The Safety Net Medical Home Initiative

    The focus of this initiative is to develop a replicable and sustainable implementation model for medical home transformation in safety net practices. Listed are links to key articles, tools, and resources on patient-centered care, medical home and quality improvement topics. Register for the Medical Home Digest, a quarterly newsletter on updated issues and tools specific to the safety net populations. The November 2012 issue is devoted to vulnerable populations.


    Paying for the Medical Home: Payment Models to Support Patient-Centered Medical Home Transformation in the Safety Net

     Safety Net Medical Home Initiative. Bailit M, Phillips K, Long A.  Bailit Health Purchasing and Qualis Health, Seattle, WA: October 2010. This publication provides an introduction to a series of policy briefs focused on payment reform opportunities to support and sustain the medical home.


    Patient Centered Primary Care Collaborative PCMH Resources

    The Patient Centered Medical Home Purchaser Guide developed by the Patient Centered Primary Care Collaborative (PCPCC) provides insightful overviews of the patient centered medical home including supplemental resources such as detailed case studies, descriptions of pilot programs, and a draft request for information (RFI) and contract language for employers/purchasers to use with their health plans.

    Clinical Quality 
    Study Finds Evidence Lacking on Psychological Harms for Five Screening Guidelines
    An AHRQ-funded study and abstract in the August issue of the Journal of General Internal Medicine revealed that only a small number of studies have addressed the psychological harms of selected screening services. According to the study, more evidence exists on the physical harms of screening services compared with psychological harms, which can include anxiety, distress and reduced quality of life. A team led by researchers at the University of North Carolina, Chapel Hill, examined the literature assessing psychological harms of screening services reviewed by the U.S. Preventive Services Task Force for the following five conditions: prostate and lung cancers, abdominal aortic aneurysm, osteoporosis and carotid artery stenosis. Among the available evidence, only one-third of the studies on psychological harm used both a longitudinal design and included condition-specific measures, which provide the best level of evidence on psychological harm. The authors called on clinicians and guideline panels to use a wider consideration of screening harms in research design. The study is titled, "The Psychological Harms of Screening: the Evidence We Have Versus the Evidence We Need." 


    National Quality Strategy Priorities in Action Features School-Based Health Centers in Connecticut

    The latest edition of the National Quality Strategy Priorities in Action features the Connecticut Association of School Based Health Centers, an advocacy and networking organization committed to increasing access to quality health care for children and adolescents in Connecticut schools. The state's 88 school-based health centers (SBHCs) provide physical, mental and oral health services to more than 44,000 students in 22 Connecticut communities each year and have become a key part of Connecticut's comprehensive coordinated care system for children and adolescents. In the case of children and adolescents insured by Medicaid, each visit to an SBHC saves an estimated $35 in Medicaid costs per child per year. The program's efforts align with National Quality Strategy priorities by promoting the delivery of person- and family-centered care in schools with the most effective prevention and treatment practices for obesity. The SBHCs work with communities to promote wide use of best practices to enable healthy living and make quality care affordable. The National Quality Strategy, first published in March 2011, was mandated by the Patient Protection and Affordable Care Act of 2010. 

    Certified Community Behavioral Health Centers News Again

    Certified community behavioral health centers are back as a topic of discussion again. To learn more plan on attending an upcoming listening session on Wednesday, November 12, 2014, 9:00 am to 5:00 pm ET.  The call will be about criteria development for the Demonstration Program to Improve Community Mental Health Services (Section 223 of the Protecting Access to Medicare Act of 2014).   Section 223 seeks to create certified community behavioral health clinics. The clinics will focus on improving outcomes by increasing access to community-based behavioral health care, expanding the availability and array of services, and improving the quality of care delivered to people with mental and/or substance use disorders. Registration for the listening session is required.  Learn more about Section 223

    A new version of the AHRQ Quality Indicators™ Toolkit for Hospitals is available to help acute-care facilities improve inpatient quality performance. The free toolkit offers hospitals the opportunity to:
    • Improve performance on two sets of AHRQ Quality Indicators, 18 Patient-Safety Indicators and 28 Inpatient Quality Indicators.
    • Measure hospital quality using available inpatient data to assess the quality of care, identify areas that need improvement and track performance over time.
    • Take advantage of "best practices" for 14 Patient-Safety Indicators, including information to determine where gaps exist and suggestions for hospitals regarding improvement, process steps and additional resources.

    Users can also approach quality improvement work from various levels of readiness. Facilities can select any of the 33 tools available to meet their specific hospital quality needs. The tools are designed for multiple audiences, including senior leaders, analysts and multidisciplinary improvement teams.

    Health Observances This Week


    American Diabetes Month

    Diabetes is one of the leading causes of disability and death in the United States. If it's not controlled, diabetes can cause blindness, nerve damage, kidney disease, and other health problems.

    One in 12 Americans has diabetes - that's more than 25 million people. And another 79 million adults in the United States are at high risk of developing type 2 diabetes.

    The good news? People who are at high risk for type 2 diabetes can lower their risk by more than half if they make healthy changes. These changes include: eating healthy, increasing physical activity, and losing weight.

    How can American Diabetes Month make a difference?

    We can use this month to raise awareness about diabetes risk factors and encourage people to make healthy changes.

    Here are just a few ideas:

    • Encourage people to make small changes, like taking the stairs instead of the elevator.
    • Talk to people in your community about getting regular checkups. They can get their blood pressure and cholesterol checked, and ask the doctor about their diabetes risk.
    • Ask doctors and nurses to be leaders in their communities by speaking about the importance of healthy eating and physical activity.

    How can I help spread the word?

    We've made it easier for you to make a difference. This toolkit is full of ideas to help you take action today. For example:

    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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