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

Enrollment Period ends
 February 15, 2015!!!
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
December 15, 2014



Dates changed to accommodate for holidays and attendance of the maximum number of participants on call.

(2) Transformational Call (*bi-weekly) 

December 18th; 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) 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.

Sliding Fee Scale Workshop 
by Feldesman Tucker's Marcie Zakheim (registration combined with FTCA registration)
Monday January 5, 2015
Time: 10:30 am - 12:30 pm
Place:  BECO Conference Center
10461 Mill Run Circle
Suite 110
Owings MillsMD 21117
  • Key requirements and optional components of HRSA's SFDP policy (e.g., fee and sliding fee discount schedules, nominal fees, eligibility verification policies, and billing and collection policies), which was issued September 2014, and how they differ from previous policies / requirements.
  • Fundamental legal and operational implications, and the board's role in approval, of the SFDP
    Real-life scenarios and strategies for developing and implementing the SFDP that complies with the requirements and balances the dual purposes of ensuring access to care and maximizing revenue.
    Registration coming soon. Please SAVE THE DATE!
Federal Tort Claims Act Training by Feldesman Tucker's Martin Bree
Monday, January 5, 2015
Time: 1 pm - 3pm

With FTCA Application deadline in March, 2015 just around the corner, MACHC brings you a comprehensive FTCA Training for member health centers and partners. During the TA, Marty Bree from Feldesman Tucker Leifer Fidell, LLP, will respond to questions related to the FTCA Program including, but not limited to, what the program covers, deeming process, gap insurance, etc...

The participants will:       
*Understand the underlying legal foundation of the health center FTCA program
*Be able to identify the significant gaps in coverage and how to overcome them
*Learn the options available to respond to denial of coverage
Price: MACHC Members: FREE
MACHC Non-Members: $125
Owings Mills BECO Conference Center
10461 Mill Run Circle
Suite 110
Owings MillsMD 21117

  • (1) Preparing for Tax Season: What HRSA Grantees Need to Know About Premium Tax Credits and the Reconciliation Process Webcast - Tuesday, December 16, 2014, 1:30pm - 3:30pm, ET. 
    Preparing for Tax Season: What HRSA Grantees Need to Know About Premium Tax Credits and the Reconciliation Process Webcast - Tuesday, December 16, 2014, 1:30pm - 3:30pm, ET.  HRSA and the Internal Revenue Service (IRS) are hosting this webcast about the tax implications of the Affordable Care Act. The IRS will provide HRSA grantees and staff with important information on premium tax credits, the reconciliation process for advanced premium tax credits, individual shared responsibility payments and navigating new and updated IRS tax forms. 

    (2) Health Centers Serving Residents of Public Housing Enrichment Webinar - Tuesday, December 16, 2014, 2:00pm - 3:00pm, ET.
    BPHC is hosting this webinar to provide an overview of housing authorities and strategies for improving collaboration between housing authorities and health centers. The webinar will also describe effective methods for recording patients who are residents of public housing.
    Connect to the audio line using 1-877-918-3033; Participant Code: 6755526

    Fiscal Year 2015 Health Center Quality Improvement Awards - On December 9, 2014, HHS Secretary Sylvia Burwell announced $36.3 million in Affordable Care Act funding to 1,113 health centers in all 50 states, the District of Columbia, and seven U.S. Territories to recognize health center quality improvement achievements and invest in ongoing quality improvement activities. 


    (3) BPHC will host a technical assistance webinar for award winners on Thursday, December 18, 2014, 1:00pm - 2:00pm, ET. 
     View the webinar the day of the session. Connect to the audio line using 1-800-857-9632; Participant Code: 8512229.
     View more information on the awards.
    View a list of health centers receiving awards.


    (4) Medical Redesign: Creating High Functioning Team-Based Care

    Dec 18, 2014 at 1:00 PM EST. 

    Register now! Join us for a Free Webinar on Thursday December 18, 2014.

    Key objectives:
    Understand differences between traditional models vs. team based models.
    Create a model that incorporates system-wide improvements in work efficiencies and effectiveness.
    Identify ways to optimize staff performance using the right staff, at the right time, doing the right thing approach.



    Registration is now open!

    How to register:

    2. Fill out a  paper Registration Form

    Questions regarding registration?

    Please contact Monica Gordon at 301-347-0400


    (6) 2015 NACHC Policy & Issues Forum

    Marriott Wardman Park Hotel, Washington, DC

    March 18-22, 2015


    Emergency Preparedness Events: 


    SAVE THE DATE: Assisting two FQHCs with Planning for Onsite Drill/Exercise in February 5th & 6th, 2015. The FQHC sites are Community Clinic Inc in Silver Spring, MD (2/5/15) and Family Health Centers of Baltimore in Baltimore, MD (2/6/15) from 8 am - 1 pm.  


    FDA updates on saline drug shortage

    0.9% sodium chloride injection (normal saline), B. Braun Medical Inc. of Bethlehem, Pa., will temporarily distribute normal saline in the United States from its manufacturing facility in Germany. FDA is temporarily exercising its discretion regarding the distribution of B. Braun's saline product from Germany, in addition to Baxter's saline product from Spain and Fresenius Kabi's saline product from Norway, to help address this critical shortage, which poses a serious threat to patients.

    FDA inspected B. Braun's facility in Melsungen, Germany where its normal saline product is made to ensure the facility currently meets FDA standards. FDA asks that health care professionals contact B. Braun directly to obtain the product. 

    In addition to this source of normal saline as well as B.Braun's normal saline that is manufactured in the U.S. , FDA will continue working with Baxter Healthcare Corp., Fresenius Kabi USA, LLC., and Hospira Inc. while they continue distributing their respective saline products and  seek to restore their supply of normal saline for U.S. hospitals and health clinics.

    While the shipments described above continue to help reduce current disruptions, they will not resolve the current shortage of 0.9% sodium chloride injection.  Preventing drug shortages

    is a top priority for the FDA, and we are doing everything within our authority to alleviate this and other drug shortages.


    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. 


    BPHC All-Programs Webcast Recording and Ebola Presentation

    The All Programs webcast recording is now available for viewing. The webcast provided updates to all BPHC programs (Grantees, Look-Alikes, Cooperative Agreement Partners - NCAs, PCAs, and BPHC Staff) on current BPHC activities and future plans for Fiscal Year 2015. The Ebola Presentation featured speakers from other federal agencies who presented on current Ebola response activities.


    Updated Health Care Resources for Suspected Cases of Ebola Virus Disease 

    HHS' Centers for Disease Control and Prevention (CDC), HRSA, and the Office of the Assistant Secretary for Preparedness and Response (ASPR) continue to work with other U.S. government agencies, the World Health Organization (WHO), and other domestic and international partners in an international response to the current Ebola outbreak in West Africa. The following Ebola resources, among others, are also available for use: 


  • Timeline of What's New 
  • Latest CDC Outbreak Information
  • Determining Risk of Ebola Transmission in Healthcare and Community Settings
  • Video & Slides: What you REALLY needs to Know about Ebola
  • Factsheet: Why Ebola is Not Likely to Become Airborne (pdf)
  • Top 10 Things You Really Need to Know about Ebola (pdf)
  • Audio Replays and Transcripts of Ebola past Calls and Webinars.
  • View all CDC Ebola updates and resources.
  • View all ASPR Ebola updates and resources





    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. SAVE THE DATE: Assisting two FQHCs with Planning for Onsite Drill/Exercise in February 5th & 6th, 2015. The FQHC sites are Community Clinic Inc in Silver Spring, MD (2/5/15) and Family Health Centers of Baltimore in Baltimore, MD (2/6/15) from 8 am - 1 pm. 
    N95 Masks POD (training) are in the horizon after the drill and release of After Action Report.

    6. Quality Improvement and Ebola webinar was Dec 2nd. How did you feel about it? Please send comments/suggestions to Judy Litchy-Hess.
    *** Look for the latest EP related updates RIGHT HERE!


    Three Lower Counties Community Services, Inc.


    on NCQA Level III status!


    Access is the Answer Phase Two Continues

    Health Center Advocates should begin reaching out to newly elected Members of Congress and continue strengthening relationships with current Members in the months to come. Take these three simple action steps as part of phase two of Access is the Answer to demonstrate to your Members the outpouring of support for Health Centers and to help secure a fix to the Health Center Funding Cliff: 

    1) Collect Local Support Letters from state and local elected officials and community partners.

    2) Place an editorial in a local media outlet regarding the cliff and its impact in your community.

    3) Meet with Members of Congress and educate new Members about Health Centers and the cliff.

    If you missed the national TeleForum launching Phase Two of Access is the Answer, check out the transcript and recording of the call. You can find more information on the Campaign for America's Health Centers website


    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 Clarifies Sliding Fee Discount Program Policy with FAQs

    Recently the Health Resources & Services Administration (HRSA) issued Frequently Asked Questions (FAQs) to clarify certain aspects of PIN 2014-02: Sliding Fee Discount and Related Billing and Collections Program Requirements. Included in the FAQs are several important clarifications regarding the extent of board approval, eligibility assessment, the definitions of income and family size, and discounts on service-related supplies and materials.
    REMINDER: Please note that there are several critical administrative actions you must take to ensure your HRSA grant applications can be submitted successfully. First, your organization must have an active registration at the time of application submission. You can check your registration at any time. If you do not have an active registration, your application will not be accepted through Second, you must have an active AOR (Authorized Organization Representative) in that is approved to submit an application. You can check to make sure you are an AOR at the website.  Lastly, your DUNS number remains an important part of your registration.  Your DUNS number is linked to the name of your organization and should be consistent in, on your grant application, and in EHB on your Notice of Award.  In accordance with HHS grants policy, without a current registration and a registered AOR, your application will not be accepted in  For questions, please access the information found at and or contact the HRSA Contact Center at, 1-877-464-4772. 

    HRSA Issues Revised Site Visit Guide to Include Requirements from New Policies

    Last week HRSA issued a revisedHealth Center Program Site Visit Guide, effective as of Monday. The new Guide incorporates revisions and clarifications that were initially included in Policy Information Notice (PIN) 2014-01: Health Center Program Governance and PIN 2014-02: Sliding Fee Discount and Related Billing and Collections Program Requirements. These changes impact several program requirements including required and additional services, sliding fee discounts, financial management and control policies, billing and collections, and board authority. For additional information on these revisions to the Guide.
    The medical record, from an Ebola case, made for grim reading, but Dr. Ian Crozier could not put it down. Within days of the first symptom, a headache, the patient was fighting for his life. He became delirious, his heartbeat grew ragged, his blood teemed with the virus, and his lungs, liver and kidneys began to fail.

    New ICD-10 Resources Also Provide CME & CE

    The Centers for Medicare & Medicaid Services (CMS) has released three new resources to help physician practices prepare for ICD-10. These resources also provide continuing medical education (CME) and continuing education (CE) credits to health care professionals who complete the learning modules, and anyone who takes them will earn a certificate of completion. You will need to create a free account to access these resources if this is your first time using Medscape.

    Hospitals are experimenting with a novel way to improve American health care - they're treating fewer patients.

    Consider Boston Children's Hospital, which recently invested $5.6 million in community health efforts after deciding it could do more to advance kids  ' health by keeping them out of the hospital. For every dollar spent on its Community Asthma Initiative, Boston Children's has trimmed $1.50 from its overall health costs.

    More than 70 percent of people who currently have insurance through the health law's federal online marketplace could pay less for comparable coverage if they are willing to switch plans, officials said Thursday. With a Dec. 15 deadline looming for coverage that would begin Jan. 1, current policy holders should come back to to see if they can get a better deal, the officials said. They'll find more plans available and nearly 8 in 10 current enrollees can find coverage for $100 or less a month, with subsidies covering the rest of the cost.

    Based on a new study published in the New England Journal of Medicine, disparities in the rates at which white people versus black people are given medical treatment in hospitals have decreased considerably.  However, when it comes to preventive care, racial disparities continue to persist. Real thought needs to be given on how to incentivize safety net providers in a way that supports improved health outcomes without penalizing them with requirements that don't account for the social determinants of health and other differences in the patients they serve.  

    HHS Awards $36.3 Million for Health Center Quality Improvement

    Last Tuesday HHS Secretary Burwell announced the release of over $36 million in ACA money to reward Health Centers with achievements in chronic disease management, preventive care, and EHR use to report quality data. The funding will go to 1,113 Health Centers in all 50 states.
    FY 2015 Appropriations Package Released

    With the current short-term Continuing Resolution (CR) set to expire at midnight tonight, Congressional negoiators released a FY 2015 spending package Tuesday night. The bill, known in DC as the "CRomnibus", includes 11 of the 12 full spending bills for FY 2015 with the exception of the Department of Homeland Security, which would be funded through February 27th on a short-term basis. The spending bill includes NACHC's requested $1.4 billion increase in funding through the Health Center Fund. In FY 2015, $5.1 billion in funding will be available for the Health Centers Program. However, the longer term shortfall known as the "Primary Care Cliff" was not addressed as part of the package and will have to be addressed next year. NACHC's statement on the legislation can be viewed here, and a more detailed rundown of what's in it and prospects for passage can be found here.

    35 U.S. Hospitals Designated as Ebola Treatment Centers
    CDC and state health officials have identified and designated 35 hospitals as Ebola treatment centers, with more expected in the coming weeks. Ebola treatment centers have been assessed to have current proficiencies, training and resources to provide the complex treatment necessary to care for a person with Ebola while minimizing risk to health care workers.

    Scope Alignment Validation Update

    BPHC has completed the last phase of administrative changes to Form 5A: Services, consistent with the actions and the timeline described in the Scope Alignment Validation Follow-up Actions document (pdf) on the  BPHC Scope of Project webpage. Some health centers will need to take further action to make corrections to their Forms 5A and/or 5B in cases where BPHC was not able to make a requested change. 
    State News

    Office of Drinking Water ensures safe drinking water for Delaware 

    The Delaware Division of Public Health's (DPH) Office of Drinking Water (ODW) enforces the Safe Drinking Water Act and regulates about 490 public water systems, ranging from community water systems that serve cities, towns, and developed areas, to small day care facilities, schools, and convenience stores served by private wells.
    Most community water systems collect their own water samples and report the results to ODW monthly. DPH staff review all reported sample results to determine if water systems are in compliance.
    If a water system exceeds a regulated maximum contaminant level, it must notify its customers about the violation. The notification must identify potential health risks, recommend consumer action, describe corrective efforts, and provide a contact's name and phone number.
    For more information, visit the ODW website at


    Flu vaccine may not work; 'severe' season expected

    With word that this year's flu vaccine won't protect people from one of the strains out there, Delaware health officials are urging everyone to take extra precautions.

    The Centers for Disease Control and Prevention said Wednesday a mutated form of the H3N2 virus has been reported in almost all states, and the flu vaccine on the market does not prevent it from spreading.

    There have been seven hospitalizations so far this flu season in Delaware. Of the 168 confirmed flu cases, Division of Public Health officials estimate that about 85 were caused by H3N2. They aren't sure Friday whether the hospitalizations were related to the mutated strain.

    As of Dec. 4, a total of 51,796 Marylanders have enrolled in quality, affordable health coverage for calendar year 2015 since the 90-day open enrollment period began Nov. 15. This includes 29,543 individuals enrolled in private Qualified Health Plans and 22,253 individuals enrolled in Medicaid. From Nov. 15 to Dec. 4...

    Finance & Business

    Healthcare Spending Growth Hits 53-Year Low

    U.S. healthcare spending grew more slowly last year than at any time in the past half-century, a federal estimate shows. As a percentage of the economy, health spending last year remained at 17.4% of the gross domestic product. Last year's slowdown can be traced to the recession, changes in health benefits and the Affordable Care Act, federal officials who produced the latest estimate wrote in the journal Health Affairs, which published the snapshot of 2013 spending. For more, see related Modern Healthcare article.

    Latest News on ACA


    Assister Winter Webinar Schedule

    Below is a list of dates for upcoming assister webinars.  Additionally, please note that there are no webinars scheduled for Friday, December 26, 2014 (the day after Christmas) and for Friday, January 2, 2015 (the day after New Year's Day).

    Upcoming Webinar Schedule:

    • Friday, December 12 at 2:00 pm EST
    • Friday, December 19 at 2:00 pm EST
    • Friday, December 26 - NO WEBINAR SCHEDULED 
    • Friday, January 2 - NO WEBINAR SCHEDULED
    • Friday, January 9 at 2:00 pm EST
    • Friday, January 16 at 2:00 pm EST
    • Friday, January 23 at 2:00 pm EST
    • Friday, January 30 at 2:00 pm EST 


    UPDATES on the Renewal and Re-enrollment Process: Tip on Ensuring Correct Re-enrollment Effective Dates / Tip on Reporting Changes to 2014 Applications / Issuer Guidance and FAQs for Consumers Posted Online / Renewal and Re-enrollment Webinar Recording Available Online

    1.  Re-enrollment Tip: Ensuring Correct Re-enrollment Effective Dates

    As you continue to help consumers re-enroll in coverage, please remember this important tip on ensuring the correct effective dates. Consumers who choose to change plans for 2015 coverage will see a question asking if they lost coverage in the past sixty days. This question is designed for consumers who are losing other types of coverage (e.g., Medicaid or employer-sponsored coverage); it is not required for consumers who are re-enrolling in Marketplace coverage. However, it is important to remember that if consumers re-enrolling in coverage answer this question, they should indicate the last day they will have coverage, rather than the first day they will be without coverage. For example, consumers who are enrolling in a new plan for the 2015 benefit year by the December 15th deadline should enter 12/31/14 as their last day of coverage in order for coverage in their new plan to become effective on January 1, 2015. If a consumer enters 1/1/15, the first day they do not have coverage, instead of 12/31/14, he or she will receive a 2/1/15 effective date. We have recently added help text to the application to this effect.

    2. Re-enrollment Tip: Consumers Must Report Changes to the Information they Provided on their 2014 Applications

    As consumers prepare for 2015 coverage, they should log into their Marketplace accounts as soon as possible and update their 2015 applications. They should report any changes to their income, household size, and any changes in access to other insurance they may have. Consumers should do this to ensure that they receive the most savings they qualify for in 2015 and are enrolled in the plan that best fits their needs. They may find plans that cost less, cover more services important to them, or work better for them and their family. For more information about the kinds of changes consumers must report, and why it's so important to report these changes, visit:

    3.  Issuer Guidance and Consumer FAQs Posted Online

    CMS has released guidance for issuers on the 2015 re-enrollment process in the Federally-facilitated Marketplace, as well as a list of frequently asked questions and answers on re-enrollment (these questions were previously listed in the December 2, 2014 assister newsletter). These resources are now available at the links below:

    4.  Renewal and Re-enrollment Webinar Recording Available Online

    The Thursday, October 2, 2014 assister webinar included a presentation about the renewal and re-enrollment process for 2015, including how assisters can help returning enrollees navigate the process for 2015 coverage and information on the notices that 2014 Marketplace consumers will receive from their issuers and from the Marketplace.  A recording of this webinar is now available at the links listed below. For a summary of this webinar and tips on assisting consumers with plan renewal and re-enrollment, see the October 7, 21, and 28, 2014 assister newsletters. 

    UPDATES on Assisting Immigrant Communities: Helping Immigrants Under 100% FPL Apply for Financial Assistance / Facts about the Affordable Care Act and Immigration Enforcement

    1.  NEW: Targeted Outreach Strategy for Immigrant Applicants Under 100% FPL Who are Eligible for Tax Credits and not Eligible for Medicaid

    Most applicants who have an annual income under 100% of the FPL are not eligible for advance premium tax credits (APTC) or cost sharing reductions (CSR); with one exception. As long as all other eligibility criteria are met, a lawfully present individual whose income is under 100% of the FPL and who is not eligible for Medicaid based on immigration status is eligible for APTC and CSRs.

    Over the last year, CMS has made improvements to to make it easier for certain lawfully present immigrants to get the tax credits they are eligible for through the Marketplace. While the vast majority of eligible immigrants are being appropriately determined eligible for APTC and CSRs, we understand that some applicants have had trouble receiving an accurate eligibility determination. This generally occurs when the Department of Homeland Security's SAVE system is unable to verify their immigration status, or when the consumer is unable to obtain an immigration-specific denial from Medicaid. CMS has identified a group of consumers who, based on our data, may be eligible for APTC and CSRs. CMS is conducting targeted outreach to determine if these individuals are indeed eligible for APTC and CSRs and if so, to facilitate enrollment.

    Using 2014 application data, CMS has identified immigrant applicants who (1) have a resolved or unresolved QHP immigration data matching issue (2) have requested financial assistance, and (3) have an annual income under 100% of the FPL. Most of these applicants live in non-expansion states. Applicants who meet these three criteria should receive a notice from the Marketplace asking them for immigration documents.

    The notice instructs applicants with an immigration data matching issue to send documentation proving immigration status. Once documentation is submitted, the Marketplace will review this documentation to verify the applicant has a Medicaid-ineligible and a QHP-eligible immigration status. Applicants who send documentation that is insufficient to prove immigration status will receive another letter requesting more specific documentation. Please note that the Marketplace will not send this notice to consumers who have previously submitted sufficient information to resolve their immigration data matching issue.

    If an applicant is found to have QHP-eligible immigration status and Medicaid-ineligible status, based on the submitted documentation, the applicant will receive another notice. This notice will notify applicants of their data matching resolution and encourage the applicants to return to the Marketplace application to answer specific questions to determine if they are eligible for APTC and CSRs. Consumers can login to their account and follow detailed, step-by-step instructions in the notice or contact the Marketplace Call Center and speak to a trained representative. Please note that the Marketplace will send this notice only to applicants who provide sufficient documentation to show that they are potentially immigration-eligible for APTC or CSRs despite being under 100% FPL.

    This outreach strategy will be used on an ongoing basis to help consumers get a correct eligibility determination when they apply for 2015 coverage.


    2.  Facts about the Affordable Care Act and Immigration Enforcement

    The White House recently published a blog in English and Spanish confirming that enrolling in health coverage through the Marketplace - and using the health insurance that this important law extends to eligible individuals - will not prevent individuals who are undocumented from getting a green card in the future or put family members who do not yet have a green card at risk.

    Updated Health Center Outreach and Enrollment Quarterly Progress Report (QPR) Resources 

    Health Center Outreach and Enrollment QPR updates for the 2015 enrollment period were highlighted in BPHC's FY 2015 QPR presentation. BPHC has also updated QPR Frequently Asked Questions. For additional assistance, please visit BPHC's Outreach and Enrollment webpage or email


    Marketplace Eligibility 201

    NEW Reminder: Marketplace Call Center and SHOP Call Center Hours
    • Health Insurance Marketplace Call Center: For customer service support, to start or finish an application, compare plans, enroll or ask a question.
      1-800-318-2596 (TTY: 1-855-889-4325).  Available 24/7. Closed Memorial Day, July 4th, Labor Day, Thanksgiving, and Christmas.
    • SHOP Call Center: For customer service support, including assisting employers and employees apply for and enroll in SHOP.
      1-800-706-7893 (TTY: 711).  Available M-F 9:00am-7:00pm ET.  From November 15, 2014 -December 31, 2014 open on weekends from 9:00am-5:00pm
    Transformational Team Talk & Outreach Upates

    Maryland--Call Center Note:

    Direct Line for Navigators and CAC to MHBE Call Center--Regarding the Call Center # 844-224-6762 It should be noted that: If you need customer assistance from the call center, CAC's should call this number.


    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.

    Grants & Funding Opportunities

    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.

    The next NURSE Corps Loan Repayment Program (LRP) Application Cycle is expected to open in January 2015. To expedite the application review process, potential applicants and facility administrators are encouraged to have the eligibility of their current facility location reviewed for participation in the NURSE Corps LRP Eligible NURSE Corps sites or Critical Shortage Facilities (CSFs) are defined as a health care facility located in, designated as, or serving a mental health or primary medical care Health Professional Shortage Area (HPSA).

    Potential applicants and facility administrators may submit their facility information beginning November 6 through December 2, 2014. Notification of facility eligibility will be confirmed by December 31, 2014 via email.

    When submitting a health care facility to the NURSE Corps LRP for consideration, please provide the following information:

    1. Name of the facility and its specific location (i.e., satellite facility cannot use main facility address)
    2. Full mailing address of the facility  including street address, City, State, and Zip code 
      (Do not use P.O. Box)
    3. Facility profit status; Refer to pages 8-9 of the 2014 NURSE Corps LRP APG for a complete list of eligible facilities.

    If you have any questions about this process, you may contact our Customer Care Center at 1-800-221-9393 Monday through Friday (except Federal holidays), 8:00 a.m. to 8:00 p.m. ET.

    Patient Centered Medical Home (PCMH) Corner 

    The VA Releases New Resources

    The Department of Veterans Affairs has been busy working on the implementation of the Veteran's Choice Act, passed into law earlier this summer. It recently released two fact sheets on key programs aimed at providing increased access to primary care: the Veterans Choice Programand thePatient Centered Community Care Program (PC3)


    Report Offers Advice on Behavioral Health Integration in PCMHs

    The SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) recently released Advancing Behavioral Health Integration Within NCQA Recognized Patient-Centered Medical Homes to support safety-net providers across the country in gaining recognition under the National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH) Program. The report details the specific elements of behavioral health required in PCMH recognition.

    Clinical Quality 

    Health Literacy and The "Digital Divide" in Older Adults

    A recent study shows that although patients' ability to interact online with their records is a criterion for meaningful use of electronic health records, "many older American may be unprepared to do this, particularly those with low levels of health literacy," state the authors of a study published online in the Journal of General Internal Medicine.  The study found that among all older adults who were Internet users, those with low health literacy were less likely than those with adequate health literacy to use the internet to get health information. They concluded that, "Web based health interventions targeting older adults must address barriers to substantive use by individuals with low health literacy, or risk esacerbating the digital divide."  In related news, the Agency for Healthcare Research and Quality has published the Short Assessment of Health Literacy, a tool for assessing health literacy in both English and Spanish.  Clinical Risk Management Program users on ECRI can access the guidance article Health Literacy for more on this topic.

    Register Now: Free Online Accredited TeamSTEPPS® Master Trainer Course

    The Agency for Healthcare Research and Quality (AHRQ) is offering TeamSTEPPS Master Training online as an accredited course for health care professionals interested in improving patient safety and health care quality. TeamSTEPPS is an evidence-based teamwork approach to improve communication and teamwork skills among health care professionals.  Registration is free, but space is limited.
    Health Observances This Week

    December is Safe Toys and Celebrations Month


    The holiday season is upon us with friends and family celebrating together, so let's keep it safe and welcome in the holidays and New Year with good health and good eye care as well.  

    The awareness of Safe Toys and Celebration is centered on:

    1) Choosing toys and age-appropriate gifts for children

    * No toys with sharp objects or edges. 
    * Avoid darts, pellet guns and other firearms as gifts, especially to children.  
    * Remember to avoid toys that can be choking hazards especially for children under the age of three.  Remember the rule: If it can fit through an empty toilet paper roll, then avoid it for young children.
    * Avoid hard candy for young children.
    * Remember to avoid toys with strings longer than 12 inches for children less than three years old as it can be a strangulation hazard. 
    * Avoid slingshots or other projectile type of types.  
    * Avoid toys with magnets for young children.  
    * Give children under 10 only toys with batteries and compartments that can only be opened by an adult (such as a screw sealed battery chamber) and don't let them play with batteries.  Plug-in toys should be only for older children.  
    * Buy durable toys that will not break or shatter into pieces or release toxic substances. 
    * Observe video game age-ratings.  They are there for a reason.
    * Read all warning labels carefully on toys and decorations.
    * Remember to supervise your children at all times

    2) Remember safety gear for sports like helmets, googles when gifting for sports related activities and re-visit our sports safety tips

    3) Keep decorations safe by being careful when decorating trees, hanging glass ornaments higher up where children cannot reach them, using only safe electrical lights that do not have damaged wiring and candle/fire safety.  Avoid fire hazards (open flames, heaters).

    4) Remembering our rules about fireworks safety from July 

    5) Opening champagne bottle pointed away from the face, eyes and other people, covering the cork with a towel and turning it slowly with a slight upward motion.  Also make sure your champagne is chilled to at least 45°F for safety reasons.

    6) Remember food allergies and other allergies when gifting items.

    7) Remember to drive safely, have a designated driver if you are drinking, wear your seat belt and restrain children in age and weight appropriate car seats or booster seats. 

    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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