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

Thank you for your participation and support during the hill visits. What next? 
Read the SGR Update under National News!
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 

April 6, 2015
-P&I Hill Visits-
MACHC wanted to take the opportunity to THANK all of you and our membership who came out to P&I's Hill Day Visits to meet your Senators - the day was successful and the HR 2 would not have received outstanding bipartisan support without your advocacy help! 
Here is a glimpse of the day:
* Pictured above: Dr. Allen Bennett, CEO of PartWest Health Systems handing an award to Congressman Cummings

*Pictured above: Family Health Centers, ParkWest and MACHC mambers at the Capitol Hill Visits.

*Pictured above: Board members and Health Center leadership at the MACHC lunch on Capitol Hill. 
What a wonderful time catching up with all of you!

-MACHC Finance/IT Conference-
Last week, MACHC hosted the Finance/IT Conference at Turf Valley Conference Center & Golf Resort in Ellicot City, MD. 
Thank you so very much for attending and making the conference successful. We hope you found the sessions both informative and enjoyable. MACHC's CEO, Duane Taylor, will be sharing evaluations of the event with MACHC member leadership. Please have a look at some of the captures from the conference below:




What To Do for Your Health Center the next week until April 13, 2015: 

Senate Outreach: Over the course of this week and next Health Centers need to pin down and confirm positions on HR 2 among each Member of the Senate. If you have not done so already, please follow up with your Senate offices to ask how the Senator will vote and whether they have any issues with the bill. At this stage they have all had an opportunity to review the language and make determinations about how they will vote, please inform us & NACHC once you have received feedback.  In addition, please take advantage of the recess to seek out opportunities to meet with your Senators to have these discussions in person. If they plan to make public appearances and you/your HC members can attend, OR, if you are able to schedule a meeting at a HC or in state offices, please do so and let us know once something has been scheduled. 

Media templates (Letter to the Editor, OpEd & Press Release) attached: as a reminder, we are asking for your help to work with HC CEOs to get these placed in as many Congressional Districts possible. The intent of the message is to publicly thank House members for voting yes to pass HR 2, outlining the implications of what that/the cliff would mean at home and that HR 2 helps move toward a solution, and finally urging Senators to follow suit with a yes vote when they return on the 13th. If you are successful in publishing in local media, please send us a link so we can track and record your efforts.

Email Advocacy Campaigns: NACHC has set up two email campaigns for the broad advocacy network - the first is targeted to Senate offices requesting they vote YES on HR 2 to support Health Centers, the second is a 'Thank You' email to House members for voting to pass HR 2. Please encourage advocates to send messages using the accompanying links.

Grassroots Performance Report: please find attached performance report breaking out call in activity, HC letter results and potential.

Let's keep the pressure and success going in the Senate!


MACHC created a Funding Cliff
Work Plan Tracking Tool (click here). The fight towards the 70% cut in Health Center funding and ensuring continuing Health Center Trust Fund is now more important than ever. 

MACHC has discussed the Funding Cliff Work Plan with MD & DE FQHC Leadership so that collectively we can make a greater impact. Please have your Point of Contact for your health center, complete the sheet and turn it in to Aneeqa Chowdhury ( every week. 

A Factsheet has been created for MD & DE FQHCs depicting the Funding Cliff impact. In order to receive this, please email Aneeqa Chowdhury.


MACHC Announces its Newly Launched Provider Credentialing Services

For a subscription cost, MACHC will provide initial and re-credentialing services to our members.

For more information please contact Bernadette Johnson at



(1) MACHC's Funding Cliff Call (*bi-weekly) 

April 6, 2015
10 am - 10:30 am/11am
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.


(2) MACHC Legislative Call

April 6, 2015 

1-866-740-1260 and the passcode is 5770097
Audience: FQHC health advocates & FQHC leadership. 


(3) Maryland's New Quality Improvement Organization
April 7th, 2015 12:30 PM   through   1:30 PM
This webinar will focus on key quality improvement and clinical priorities for FHQCs in Maryland
Sheila McLean, Program Director for Maryland, and Peggy Oehlmann, Improvement Consultant, of VHQC, will give an overview of VHQC and its role as the CMS-designated Quality Improvement Organization for Maryland and Virginia. As the CMS-designated Quality Improvement Organization for Maryland and Virginia, VHQC is actively reaching out to key stakeholders and providers interested in participating in various quality improvement activities, such as:


*         Working with physicians to promote more effective treatment to patients at risk for heart attack and stroke, especially in underserved populations
*         Working with providers across the continuum of care to reduce healthcare associated infections and spread evidence-based practices for infection prevention and reduction.
*         Promoting prevention and treatment of chronic disease by working with providers to reduce disparities for underserved patients with heart disease or diabetes.
*         Improving prevention coordination through Meaningful Use of HIT and provider education on PQRS and the Value Modifier incentive program. 
Cultural Competency Conference
(4) Cultural Competency in Practice:
Using CLAS and Health Equity in your everyday Practice
April 30 or May 1, 2015
(April 30, 2015, 11:00 a.m. - 4:30 p.m. or
May 1, 2015 8:00 a.m. - 1:30 p.m.) Register here
(This workshop is being repeated, participants need only attend one day)
Dover Downs Conference Center, Dover, DE
This competency training will help you and your staff build awareness, knowledge, and skills through a variety of teaching methods including direct instruction, role playing, case studies, facilitated group discussions, and technology/media.
All healthcare professionals, including physicians, nurses, social workers, front office staff, facility managers, supervisors, etc., are encouraged to attend!
This free training will offer:
  • Better understanding of  your patient's culture and yours
  • Knowledge and skills for navigating the dynamics of difference
  • Strategies for healthcare organizations to foster greater engagement with clients and co-workers
  • Excellent networking opportunities
(5) June 19-20, 2015

(6) September 18, 2015 
Operations Leadership
Turf Valley Conf. Ctr.


Board of Directors Meetings:
(Third Friday @ 11:00 a.m.)

April 17, 2015
Face to face
11 am - 1pm

June 19, 2015
Face to face
11 am - 1pm

September 18-19, 2015
Board Retreat
Turf Valley

  • (1) NACHC's Practice Operations Management, 
    Level I (POM I) Seminar

    April 22-23, 2015 - Bally's Las Vegas

    Las Vegas, Nevada
    Online registration ends April 15.
     Register here.

    (2) Take Steps Today, Avoid Penalties Tomorrow (online)

    Wednesday April 22, 2015 from 12:00 PM to 1:00 PM EDT       Register Now

    Are you concerned about the impact of the CMS value-modifier on your practice's bottom line? Join VHQC on Wednesday, April 22 at noon to hear from

    Patrick Hamilton, Health Insurance Specialist/Rural Health Coordinator for the Centers for Medicare & Medicaid Services. During the webinar, Mr. Hamilton will share:

    1. A general overview of the value modifier and 2015 quality reporting
    2. Relationship between the physician quality reporting system (PQRS) and value modifier
    3. The quality and cost components of value-modifier
    4. Timeline for value modifier and when groups of various sizes will be affected 

      Accessing and understanding your Physician Quality and Resource Use Reports (QRUR)

    (3) 2015 NHSC Site Application Technical Assistance Webinar

    Thursday, April 30 from 12:00 - 1:30 p.m. ET
    Access link:

    Dial-in Number: 1-888-996-4919
    Passcode: 8392355
    * To participate in the webinar, you will need to use both the access link and the dial-in number.
    NHSC Site Application Technical Assistance Conference Call 

    Wednesday, May 13 from 12:00-2:00 p.m. ET

    Dial-in Number: 1-888-790-1868
    Passcode: 8788160

    (3) Accountable Care Academy: Moving from Volume to Value and from Theoretical to Practical Application
    May 13 - 14, 2015
    Charlotte, North Carolina
    Online registration ends May 6
    NACHC is pleased to offer a new training designed to bring together the key leaders (CEO, CMO, CFO, COO, and CIO) of Health Centers, PCAs, and HCCNs to focus on the critical elements for successful participation in both informal and formal Accountable Care Organizations (managed care).
    Latino Health Conference - May 12

    (4) The Urban Health Institute and the Johns Hopkins Centro SOL announce the
    Latino Health Conference
    "Land of Opportunity? Latino Immigrants and the Affordable Care Act (ACA)" on Tuesday, May 12, in Feinstone Hall. This day-long event will provide a dynamic forum for speakers and attendees to discuss challenges and opportunities associated with changes in the healthcare system and the rapid growth of the Latino community in Maryland. The conference will bring together scholars, policy experts, clinicians, and community advocates interested in improving access and quality of healthcare for Latino immigrants and their families.
    Please join us in a dynamic conversation with health policy experts, clinicians, community partners, public health officials, and academics. Our plenary speaker will be
    Dr. Benjamin D. Sommers of the Department of Health Policy & Management at the Harvard T.H. Chan School of Public Health, Harvard Medical School. 
    Tuesday May 12, 8 a.m. to  5 p.m.
    Feinstone Hall, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Baltimore, MD 21224

    Register TODAY



    (5) Managing Ambulatory Health Care I (MAHC I): Introductory Course for Clinicians in
    Community Health Centers       
    June 15-18, 2015 - Portland, Oregon
    EARLY BIRD DEADLINE: June 1         Apply here.

    The Managing Ambulatory Health Care I (MAHC I) course is an exciting collaboration between the National Association of Community Health Centers (NACHC) and Northwest Regional Primary Care Association (NWRPCA). 

    This four-day course goes beyond the basics of being a new clinical director in a FQHC. This course focuses on skills that are essential in the community health center environment. You will learn specific management skills that are essential in the community health center environment:

    • Financial management
    • The enhanced role of the medical director (dental, behavioral health, etc.)
    • Clinical operations
    • Productivity management
    • Performance compensation
    (6) Save the Date for the Maryland Chronic Disease Conference

    On September 8-9, 2015 in Baltimore, Maryland, DHMH will be hosting the Inaugural Chronic Disease Conference.  The Maryland Chronic Disease Conference aims to explore challenges and opportunities in public health as well as approaches to prevent and control chronic diseases and associated risk factors. The conference will identify best practices, examine existing barriers, and develop a roadmap for future programs in Maryland. The core focus of the Conference will be the four CDC Chronic Disease Domains-Epidemiology/Surveillance; Environmental Approaches; Health Care System Interventions and Community Programs Linked to Clinical Services.

    For more information please visit: Maryland Chronic Disease Conference 

    Emergency Preparedness Events: 


    How Prepared Is Your Community for an Emergency? 


    Download the kit checklist: 


    Family communication and evacuation plan: 




    DATE:   WEDNESDAY, JUNE 3, 2015


    9:00 AM TO 5:00 PM - WORKSHOP



    Corrected Registration Phone#: 301-474-1485









    Fun New Emergency Preparedness Challenge YOU can take part in TODAY!


     MEMA is holding a pet preparedness challenge. See info below. If anyone would like to participate, you can send 

    Sara Luell (  your pet preparedness picture and she will post to the OP&R Facebook and Twitter.



    Starting tomorrow, April 1st-May 8th, share a pet selfie with DHMH (HPP Program) of you and your pet taking action and preparing for any emergency. The action can be simple as;
    1. Downloading a Pet Preparedness App
    2. Building a Pet Emergency Supply Kit
    3. ID-ing your pet w/ a collar & tag (or consider micro chipping)
    4. Practicing your evacuation plan in the car or determining where you both would shelter-in-place.
    5. Creating a buddy-system with a relative or friend to help each other's pets if one of you is away from home during an emergency.

    Whatever your action is, Office of Preparedness & Response (OP&R) wants to see it! Once the action is complete, take a picture (or selfie) of your #petpared and share, tweet, or Instagram the picture to them (email provided above or use social media) and include the hashtag #Petpared to help spread the word. You will feature you/ your pet ON the OP&R Facebook, Twitter, and Instagram page.



    Hospital Ebola Preparedness Assessment Survey: Preliminary Results


    In January, DHMH/OP&R disseminated the DHMH Hospital Ebola Preparedness Assessment to Maryland acute care hospitals and other healthcare partners. The survey was intended to assess whether hospitals are ready and capable of properly identifying, isolating and treating a potential Ebola patient. The assessment was sent to 46 acute care hospitals; 95.7 percent provided responses. Hospitals across all 5 regions were represented among the respondents.


    Analysis of the survey data is still in progress; however, an initial review indicates that Maryland hospitals have done a great deal of work to prepare for a potential Ebola patient. Preliminary results indicate the need in some areas for additional training and PPE, as well as additional planning around the healthcare system/EMS interface. DHMH will continue to support healthcare system partners in their efforts to enhance preparedness for Ebola and other emerging infectious diseases. 





    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]


    Kristin McMenamin

    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)

    410-778-4862 (Fax) 



    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. MACHC conducted two FQHCs with Planning for Onsite Drill/Exercise in February 5th & 6th, 2015. The follow up call with ALL MACHC member health centers and partners was held Thursday, March 12th. Due to the large file size of Active Shooter documents, an email to all attendees and FQHC POIs was sent out. Please alert Aneeqa Chowdhury ( if you have not received the link.

    *** Look for the latest EP related updates RIGHT HERE!
    Policy, Advocacy and Legislation
    National News

    SGR Update:

    I know all of you are anxious for the very latest information from the Hill after of what can only be called an incredible show of bipartisan support in the House and a cluster known as the "vote-a-rama" into the wee hours of this morning in the Senate.

    Last week, the House voted overwhelmingly to pass H.R. 2, which includes vital 2-year extensions of funding for Health Centers, the National Health Service Corps and Teaching Health Centers. NACHC Statement on passage of the bill. As I'm sure you've read in the news, the Senate adjourned very early this morning before taking up H.R. 2 and will not return to Washington until April 13th. Because of procedural rules in the Senate requiring that all Senators be in favor in order to expedite passage of a bill, the Senate failed to act on the legislation before leaving on a two-week recess.


    Senate leaders Reid and McConnell have publicly committed to the bill being considered very quickly when the Senate reconvenes April 13. Majority Leader McConnell said he has ""every reason to believe [the bill] is going to pass the Senate by a very large majority."  Senator Reid said "We were hoping to get this done... I'm disappointed that we may not be able to get it done tonight, I sure wish we could."


    We know that there are Senators that will oppose this bill and moreover, two weeks is a long time in politics for folks to reconsider and shift their position. Over the course of the next two weeks we'll be asking for your help, along with HC Key Contacts to solidify support and ask for their commitment to vote to pass H.R. 2 among every member of the Senate.  We will be holding an SLC Policy & Advocacy Call on Monday, 3/30 at 2PM ET (Call In: 1-866-939-8416 ID: 9941078) to walk through outcomes and next steps to do everything we can to ensure final passage of H.R. 2 when Congress returns on the 13th. If you cannot join us for the call Monday, please let me know so I can arrange access to a call recording.


    By all accounts your hard work and the advocacy we saw from our folks over the course of the last few days and weeks was an enormous factor in the results in House yesterday. The House vote is a clear case of the power of advocacy. We are closer to a fix for the funding cliff than ever before - we need to use the next two weeks to pin down each and every member of the Senate.


    I've pasted the latest version of the call report by state so you can share with your HC Members the outcome of their work. We'll also be sending a message out the field later today letting everyone know about the incredible outcome in the House, the need to say THANK YOU to their Representatives, and letting them know the work and commitment to advocacy must continue in the Senate.


    A very big THANK YOU to each of you for your hard work, persistence and support - I've never been more proud of our advocacy and each of you played a critical role in getting us to where we are today. - Amanda Pears Kelly, NACHC

    Health care systems ramp up efforts to assist hardest-to-help patients

    Health systems across the country are realizing that healthcare issues are intricately tied to addiction, homelessness, and poverty. While the line between healthcare systems and these other socio-economic issues begins to blur, Kaiser Permanente is one institution that is pioneering efforts to provide more comprehensive care to curb high healthcare costs in the long-term.  


    Per the Affordable Care Act's tax penalty on individuals who do not obtain coverage, the Internal Revenue Service (IRS) has a new tax to enforce. The timing could not be worse as the agency struggles with a diminishing budget, decreased staff, a new technical system for processing, and a limited ability to provide quality customer service. Despite the agency's request, Congress refused to provide the IRS with funds for additional staff to execute these new responsibilities. In fact, at least one member of Congress chastised the agency for what they claim is a mismanagement of funds. 

    As part of President Barack Obama's new Precision Medicine Initiative, U.S. Department of Health & Human Services Secretary Sylvia Mathews Burwell travelled to the west coast to meet and partner with researchers and other experts of this field. The concept of precision medicine involves delivering the right treatment to the right person at the right time.   

    The House Passes A Bill To Fix Medicare's Doctor Payments. What's In It?
    Just days before the March 31 deadline, the House of Representatives is expected to vote on a proposal that addresses Medicare's physician payment formula, which is based on the outdated sustainable growth rate (SGR). It is believed current negotiations involve payment increases to doctors as Medicare slowly transitions to a new system of quality, value, and accountability. If the issue cannot be resolved, then Congress will likely put forward a temporary fix or request that the Centers for Medicare and Medicaid Services hold their claims to physicians so that doctors do not experience such significant pay cuts. 

    Last week NACHC submitted comments on the Veterans Administration's Interim Final Rule on the establishment of the Veteran's Choice Program. This program was established in the Veteran's Choice Act, passed last summer, and gives veterans an opportunity to seek care in non-VA facilities, including FQHCs. NACHC commented on many aspects of the program, including many issues we have heard from FQHCs regarding the implementation of the program thus far. For more information on the Veterans Choice Program, please see the NACHC fact sheet here.

    Children's Health Insurance Program (CHIP) Funding Push on Capitol Hill

    With CHIP funding slated to expire in September (at the same time as the Primary Care Cliff), Advocates are gearing up on Capitol Hill to pass a funding extension ASAP. Given that a number of state legislatures will have finished their legislative sessions for the year well before September rolls in, there is increasing pressure that Capitol Hill act sometime this month to extend the program. Accordingly, three sets of legislators have proposed legislation to extend the program's funding...albeit each bill is different and neither advocacy groups nor legislators have coalesced around any one particular option.

    NACHC staff are working closely with legislators and other advocacy groups in DC to ensure that whatever bill ultimately passes on dovetails with Health Center priorities
    IRS Deadline Extended For ObamaCare Customers Sent The Wrong Tax Form 
    ObamaCare customers who received the wrong tax form from the federal government this spring will not face penalties if they miss the April 15 deadline, officials announced Friday. Anyone who has not yet been sent corrected tax forms and is "unable to file an accurate tax return" now has until Oct. 15 to file - as long as they request an extension. The government did not say how many people will be given extra time, though officials said in late March that 80,000 people were still waiting on their corrected tax forms.
    40K On Louisiana Medicaid Waiting List For Home Health Care 
    Louisiana may be facing a crisis as its elderly population grows. The state's ability to care for older residents is already stretched: there are 40,000 people on the state's waiting list for home care services funded by Medicaid, according to the state Department of Health and Hospitals. The number is expected to grow as more baby boomers retire and the nursing home industry and home health care providers work in a climate that presents challenges for expanding their business
    The 30,000-plus people who work for Carolinas HealthCare System will have only one option for insurance next year, and it requires them to pay up to $5,600 a year out of pocket. For family coverage that risk rises to $11,200. The move by the Charlotte area's largest employer spotlights a trend that's sweeping the country: As more people get health insurance, more people with insurance face potentially devastating medical bills. 

    ALS patients press FDA for quick access to controversial biotech drug

    For people with amyotrophic lateral sclerosis, which attacks the body's motor neurons and renders a person unable to move, swallow or breathe, the search for an effective treatment has been a crushing disappointment. ... Then in the fall, a small California biotech company named Genervon began extolling the benefits of GM604, its new ALS drug. In an early-stage trial with 12 patients, the results were "statistically significant," "very robust" and "dramatic," the company said in news releases. ... Genervon took an even bolder step: It applied to the Food and Drug Administration for "accelerated approval." ... This isn't the first time desperate patients have launched a social media campaign to try to compel the FDA to act. But in this case, the effort also has laid bare stark divisions within the ALS community, where some advocates, patients and researchers - including one who helped lead the clinical trial - have criticized the company's tactics. (Nutt and Dennis, 4/3)

    Meanwhile, the company that invented aspirin is remaking itself and a British investor is pouring $40 million into a Maryland company pursuing vaccine therapies for operable and inoperable cancers.
    State News

    Income inequality is bad for your health

    If the six counties on lower Delmarva were a state of their own, they would have the 13th highest amount of inequality nationwide, according to a Daily Times analysis.

    No wealth, no health.

    Scientifically speaking, the link between income inequality and worse health outcomes isn't as strong as between poverty and health. But study after study, year after year, the case gets stronger.

    And places like Delmarva, where inequality reigns, get sicker.

    Redesigned animal welfare license plate awaits Delaware drivers
    Delaware Health and Social Services Secretary (DHSS) Rita Landgraf unveiled Delaware's new animal welfare license plate in January at the Delaware Society for the Prevention and Cruelty of Animals' (SPCA) Stanton shelter. Wilmington illustrator Andy Lendway, 55, won the Office of Animal Welfare's "First State Paw Draw" art contest with a design of a dog and cat touching noses, on a yellow background with paw prints.
    The plate sells for $50 at the Delaware Division of Motor Vehicles, and $35 of each sale is allocated to the Animal Welfare License Plate Fund. Revenues are used to provide spay and neuter surgeries for community cat colonies or specific breeds, and to offer low-cost or free spay and neuter services, since they are cost prohibitive to some Delawareans.
    To purchase an Animal Welfare License online, visit

    Reduce sugar intake by two-thirds to meet dietary recommendations
    Americans are consuming about 13 percent of their daily calories from added sugars, the World Health Organization announced. Considering that 15 calories are in one teaspoon of sugar, these extra 268 calories are the equivalent to eating 18 teaspoons of sugar every day.
    As the U.S. dietary recommendations limit sugar to only 6-12 teaspoons daily, Americans have to reduce their average sugar intake by about two-thirds. Nutritional labels list sugar under 56 names, including cane sugar, sucrose, maltose, rice syrup, dextrose, sorghum, and maltodextrin.
    Two ways to avoid sugar are to avoid processed foods and choose only non-sweetened beverages, especially water.
    Although Dietary Guidelines do recommend drinking only 100 percent fruit juice, consumers should also be aware that one serving is only ˝ cup. Any more, and all that extra concentrated sugar comes without the added benefit of consuming the fiber with the actual fruit. This can also contribute to overweight and obesity. Who knew nutritional labels had 56+ names for the same ingredient. So, avoid processed foods. Consume at least five fruits and vegetables per day and limit sugary beverages. The 5-2-1-Almost None formula can help you remember how to balance your nutrition and daily physical activity and lead a healthier lifestyle
    Don't miss your chance to have health coverage!
    (Health Centers advertise/communicate the following info)
    If you didn't have health insurance in 2014 and have to pay a tax penalty, there is a new chance to sign up for 2015 health coverage. Enroll through Maryland Health Connection, Maryland's official health insurance marketplace.

    1% of household income or $95 per person
    whichever is greater
    2% of household income or $325 per person
    whichever is greater

    click at the all new
    call 1-855-642-8572
    TTY: 1-855-642-8573
    find free in-person help

    The Office of Inspector General (OIG) found no fault with the use of federal funds by the Maryland Health Benefit Exchange (MHBE) to establish Maryland's health insurance marketplace. We respectfully disagree, however, with its conclusion that MHBE erred in its allocation of costs between Medicaid and grant funds for qualified health plans (QHPs). This conclusion reflects simply the OIG's different interpretation of federal guidance to states regarding cost allocation accounting principles. MHBE believes it followed federal guidance, and working closely with CMS, it passed multiple federal reviews of its processes prior to the OIG audit. MHBE drew from two separate sources of federal funding to develop and begin operating Maryland Health Connection (MHC). Because MHC serves both Medicaid enrollees and Marylanders qualifying for QHPs, the State received both federal Medicaid dollars and QHP grants from the Centers for Medicaid & Medicaid Services Office of Consumer Information and Insurance Oversight (CCIIO). The OIG report contends that MHBE allocated some percentage of costs to its CCIIO grants that should have been allocated to Medicaid instead. Specifically, it contends that MHBE should have more promptly updated its original allocation based on actual enrollment data as it became available, and that MHBE should have gone back and retroactively changed its original allocation because the methodology used to establish its enrollment projections was shown later to have a "material defect." So OIG recommends that MHBE should credit back to the QHP grant side of the ledger $28 million and seek reimbursement from the Medicaid side. This accounting reconciliation would result in the State owing the federal government about $5 million. HBE disagrees. First, in its original cost allocation and all subsequent actions, MHBE worked with CMS and followed its guidance. CMS reviewed and approved MHBE's methodology and cost allocation prior to the OIG audit, and CMS continues to work with MHBE to assess appropriate updates in light of actual marketplace data and enrollment stabilization. Second, the projections on which MHBE relied in its original cost allocations were not defective. The "correction" to which OIG points was simply a clarification of the time period covered by the projections. Acting throughout in good faith, MHBE has done its best to comply with all federal requirements. CMS has been a terrific partner. While we do not agree with the OIG findings, we want to do everything to ensure that MHBE cost allocation methodology and processes are in sync with the expectations and requirements of CMS. As always, MHBE looks forward to continuing work with CMS so that funds are appropriately allocated, allowable and reasonable.
    Finance & Business
    Resources and Publications for your Health Center:

    Latest News on ACA


    Outreach & Enrollment National Update

    NACHC recently conducted a poll of enrollment assisters and staff at Community Health Centers about the second open enrollment (OE2) under the Affordable Care Act (which turns five years old this week).

    A vast majority of the 377 respondents - 84 percent- reported that the second enrollment period (OE2) met or exceeded expectations in terms of total enrollment assists and that there was a reduction in problems overall. Of the 111 respondents from states that participated in the federally facilitated exchange (, nearly 91 percent reported that OE2 met or exceeded their expectations.  On the other hand, the poll also revealed persistent challenges for new enrollees when it comes to accessing care. Nearly 84% of respondents said that the overall cost and affordability of coverage remains a major obstacle that prevents new enrollees from utilizing their benefits and accessing coverage.

    Some key trends have also emerged. During the first open enrollment period, many consumers who were assisted by certified application counselors, navigators, and other staff at health centers were enrolled into the low-premium but high-deductible Bronze plans.  But the trend shifted during the second enrollment period.  Over 71 percent of assisters now say a majority of people enrolled into Silver-level plans or higher due to premium tax credit assistance and/or other factors. Eighty-one percent of respondents in states that did not expand Medicaid reported that a large majority of people enrolled into Silver-level plans or higher and fewer people enrolled into Bronze plans.

    Despite the boost in the numbers of people choosing Silver plans, some assisters reported that the renewal process was problematic and, in some cases, resulted in many people losing coverage.  Also Silver plans were not available in some areas, and even if they were, they were still unaffordable despite the APTCs in some states.

    While cost and affordability were the biggest obstacles for new enrollees in terms of  accessing their care, 56 percent of respondents reported that a lack of understanding of the general healthcare costs covered by insurance posed a significant challenge for new enrollees. Also over half (52.3 percent) reported that many people lack a thorough understanding of insurance terms and how to use insurance.  Other issues cited included password recovery and reset issues, significant technical glitches in several state-based exchanges, and a lack of access to in-network providers.

    In terms of what's next for enrollment, nearly all respondents (93.7 percent) reported that assisting consumers qualifying for a special enrollment is a priority or major priority going forward. The federal government announced a special enrollment period (SEP) for tax season from March 15 - April 30, 2015 in states that utilize Health insurance literacy is also a major focal point of ongoing efforts: 53.6 percent reported that assisting consumers with understanding their coverage is a priority, and an additional 35 percent said it is a major priority. 


    Medicaid Enrollment Update: 11.2 million additional individuals as of January 2015

    KEY TAKEAWAY: Medicaid enrollment continues to increase; assisters can use the new fact sheet to highlight how the Affordable Care Act is helping more consumers enroll in coverage through Medicaid. Remember: If they are eligible, consumers can enroll in Medicaid at any point during the year.

    On Friday, March 20, 2015, the Center for Medicaid and CHIP Services (CMCS) released data showing that Medicaid enrollment increased by approximately 11.2 million individuals  between October 2013 and January 2015 - a 19.3 percent increase over the average monthly enrollment for July through September of 2013, the pre-Marketplace Open Enrollment timeframe. Among states that had implemented the Medicaid expansion and were covering newly eligible adults in January 2015, Medicaid and CHIP enrollment rose by 26.1 percent compared to the July-September 2013 baseline period, while states that did not expand Medicaid during the reporting period showed an increase of 7.8 percent over the same period.

    • To view the full enrollment update,  click here.
    • To view the newly-released Medicaid and CHIP Application, Eligibility Determination, and Enrollment Data, click here.
    • To view a NEW fact sheet on Medicaid/CHIP and the ACA, click here.

    Assister Spring Webinar Schedule
    • Friday, April 10, 2015 at 2:00 pm EST
    • Friday, April 24, 2015 at 2:00 pm EST*

    *Please note that there will NOT be an assister webinar on Friday, April 3 or on Friday, April 17, 2015.


    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 9:00 am-7:00 pm EST. 

    MACHC Conference Call Updates

    MACHC 340B call Wednesday, March 25th

    *If you have any questions regarding 340b, please email MACHC's COO, Judy Lapinski at

    • Changes to Medicaid Reimbursements
    • UHC MCO is limiting their pharmacy network as of April 1, 2015
    • Many community retail pharmacies and also some larger chains are being removed from the network
    • In Maryland, our Director of Maryland Medicaid Pharmacy Program was as surprised as we are at the news
    • Medicaid Reimbursements - lined to actual acquisition costs from Pharmacy, state wants to know true acquisition costs
    • AWP  - reimbursements based on AWP, it's not a real number, worked fine for quite a while (but artificially inflated), state is looking to get away from that (looking to MAC and other different price points)
    • In 2011, CMS surveyed pharmacies to ask for their actual pharmacies for 340B and non-340B. Got a great response rate, used to determine new pricing metric, NADAC ?(couldn't hear)
    • Pharmacy  - prices are made up of cost of drug and dispensing cost
    • In 2013, State surveyed dispensing cost. Mean dispensing cost is $10.49. Statistically different change between chain and independent pharmacies. State met with only independent pharmacies, rather than chains.
    • Example - 1049 only receives $100 from $1000 drug prescribed - 90% rate. Medicaid only has to pay 1.5 million dollars more
    • Ask state for differences between dispensing fees between independent and chain pharmacies. WIN FOR US
    • NADAC - possible to appeal prices - period of time that we can retrobill for better prices!!!
    • If we are serving a drug for $50, and it goes up to $75, but MD won't update its prices daily. So thus, the state will allow us to price the drug at $75 so we don't lose money while the NADAC prices will take time to increase the price.
    • Medicaid has agreed to publish price change list so we can retrobill to make up lost money if the price changes rapidly.
    • Our Members must budget for this - upcoming changes in June and July
    • Recommendation - go to state and be amiable/cooperative to work with them to get what our members want, possibly next week
    • Our members must get financial data related to 340B (340B claims) to Judy L, in 3 weeks time (April 10th)
    • Do MCO claims need to be carved out of 340B claims? MD has not come out with a stance. This is good news. If pharmacies are going to submit a claim, let state know, don't have to submit a rebate then. Most chains don't bother with MCO claims, but our member pharmacies can get additional revenue from it. 
    A message from MHBE's Jody Hartzell


    Important message that was sent out to all applications for CAC's.

    Good Afternoon,

    We have scheduled MHC System training webinar sessions for Application Counselors. These sessions are scheduled and open for registration in The Hub for those who still need to complete this requirement or if you feel you need refresher training on the system.  The webinar sessions are scheduled under the MHC-Application Counselor ILT System Training Event listed in the HUB either on the active or completed tab on your transcript.

    If you have problems with accessing your Hub account, contact our training team at


    Title: MHC-Application Counselor ILT System Training

    Locator Number: 795

    Date: June 25th, 2015

    Time 10:30 am - 1: 30 pm

    Registration close date/time: 6/22/2015 @ 12:00 am


    Requirements for Webinar Completion:


    1.    You must attend the webinar session in their entirety. Participants who miss more
    than 15 minutes of the webinar, as captured by entry and exit times throughout
    the session, will not receive completion status for the training.  For example, if a participant enters the online meeting space after 9:15 am for a webinar start time of 9:00 am, he or she will not receive credit for the training. 

    Participants must participate in the webinar through the Webex Meeting space and by phone for audio. If you are on the phone the entire time, but not signed into the
    WebEx, you will not receive credit for the training.  For this reason, we encourage you to remain logged into the online event during scheduled breaks and Q&A sessions. 

     2.    You must log into the session on an individual computer with a complete and
    accurate last name, first name, and email address. When joining the session, 
    please enter the same name and email address you used when registering for the
    webinar on The Hub.

    Participants who share a computer to attend the webinar will not receive completion status for the training, because their names and email addresses will not be captured
    in the webinar attendance report. 

    3.    Only participants who completed the required prerequisites and registered for the webinar through The Hub, before the registration deadline date and time, and satisfied the attendance requirements listed above will receive credit for completing the webinar.
    4. Only registered participants will receive an email on how to access the webinar, to the email address that was used to register in The Hub, at least 24 hours before the
    start of the webinar. 


    Thank you,



    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.

    Grants & Funding Opportunities

    National Training and Technical Assistance Cooperative Agreements (NCA) Funding Opportunity Announcement (FOA) (HRSA-15-140) - HRSA released the Fiscal Year (FY) 2015 NCA FOA (HRSA-15-140). Approximately $3 million will be available to support 3-4 awards to national organizations that will provide training and technical assistance to potential and existing Health Center Program grantees and look-alikes in the areas of oral health services, health information technology and data, and clinical workforce development.

    Applications are due to by Monday, June 1, 2015. This NCA funding opportunity is a only application.

    A technical assistance (TA) webinar will be held on Friday, April 10, 2015 at 2:00pm, ET. The details for this webinar and FOA TA resources are available on the NCA FOA TA website.


    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.

     BUILD Health Challenge

    Application Deadline:  January 16 for round one; April 10 for round two

    A collaborative initiative of the Kresge Foundation, Advisory Board Company, de Beaumont Foundation and Robert Wood Johnson Foundation offers two kinds of awards - planning and implementation - to strengthen partnerships among hospitals, nonprofits, local health departments, and other community organizations to improve the health of low-income neighborhoods within cities with populations greater than 150,000

    HRSA HIIP (Infrastructure Investment Program) Funding Opportunity: $150 million in support to an estimated 150-175 awardees
    Who: Section 330 grantees
    What: Funding for efforts to increase patient capacity and to provide additional comprehensive primary and preventative health services to medically-underserved populations through the alteration/renovation, expansion or construction of a facility.
    When: due April 21st, 2015 and EHB due May 21st, 2015


    NHSC Scholarship Program Now Open 

    The 2015 National Health Service Corps (NHSC) Scholarship Program application cycle is now open and will close on May 7, 2015 at 7:30pm, ET. Refer to the "Upcoming TA and Training Sessions" section of this Digest for information on a related webinar.
    Eligibility for the program is open to all students who are committed to primary care and are U.S. citizens or nationals and are enrolled in a fully accredited training program for Physicians (MD or DO), Dentists, Nurse Practitioners, Certified Nurse-Midwives or Physician Assistants at a U.S. accredited school. Refer to the 2015 Application and Program Guidance for all of the program requirements.


    CY 2016 Requirements for FTCA Medical Malpractice Coverage for Health Centers- HRSA has issued Program Assistance Letter (PAL) 2015-03 to describe the process for Health Center Program grantees to submit initial and redeeming Federal Tort Claims Act (FTCA) deeming applications for Calendar Year (CY) 2016.
    Applications are due by Tuesday, May 26, 2015, 11:59pm, ET.

    Technical Assistance (TA) Webcasts will be held on April 2 (Risk Management) , April 8 (Credentialing), and April 9 (Professional Liability) from 2:00pm - 3:30pm, ET.
    View more information on this PAL and TA Webcasts

    Patient Centered Medical Home (PCMH) Corner 
     The patient-centered medical home (PCMH) model of primary care is being implemented in a wide variety of socioeconomic contexts, yet there has been little research on whether its effects differ by context. Clinical preventive service use, including cancer screening, is an important outcome to assess the effectiveness of the PCMH within and across socioeconomic contexts.
    Conclusions: The PCMH model was associated with improved cancer screening rates across contexts but may be especially relevant for practices in lower socioeconomic areas. 

    02BPHC released PAL 2015-02 which describes the Accreditation and Patient Centered Medical Home Recognition Initiative, and outlines the process and requirements for applying for ambulatory health care accreditation and/or patient centered medical home (PCMH) recognition in 2015.
    Clinical Quality 

    The Tips Campaign encourages people to quit smoking by highlighting the toll smoking-related illnesses take on smokers and their loved ones. The hard-hitting ads show people living with the real and painful consequences of smoking. Many of the people that are featured in the ads started smoking in their early teens, and some were diagnosed with life-changing diseases before they were age 40. The ads feature suggestions, or "tips," from former smokers on how to get dressed when you have a stoma or artificial limbs; what images of scars from heart surgery look like; and reasons why people have quit smoking.

     2015 County Health Rankings 

    The sixth edition of the County Health Rankings have been released. This year's County Health Rankings provide a health snapshot for nearly every county in all 50 states. See how well your county is doing on 30 factors that influence health, including education, transportations, housing, violent crime, jobs, diet and exercise.

    National Day of Action Targeting Blood Pressure Control: May 7, 2015

    National Day of Action Targeting Blood Pressure Control ask Measure Up/Pressure Down® supporters to roll up their sleeves and join together in their respective communities and participate in at least one action to raise awareness of high blood pressure - to patients, providers, employees, or the general public. These actions can take different forms, based on your audience, capabilities, and resources.

     Maternal and Child Health Mobile App 

    Text4baby is a free mobile health education service that provides pregnant women and new moms with an infant less than one year of age with free, evidence-based, brief health messages. 
    The text messages provide tips on subjects including breastfeeding, car seat safety, and developmental milestones, among many others. The messages also provide 1-800 numbers and other resources to learn more.
     Learn more about Text4baby and similar mobile resources.

    Health Observances This Week

    Drinking too much alcohol increases people's risk of health-related injuries, violence, drowning, liver disease, and some types of cancer.

    The good news? We can all do our part to prevent alcohol misuse or abuse.

    Make a difference: Spread the word about strategies for preventing alcohol misuse or abuse and encourage communities, families, and individuals to get involved.

    How can Alcohol Awareness Month make a difference?

    We can use this month to raise awareness about alcohol abuse and take action to prevent it, both at home and in the community.

    Here are just a few ideas:

    • Encourage friends or family members to make small changes, like keeping track of their drinking and setting drinking limits.
    • Share tips with parents to help them talk with their kids about the risks of alcohol use.
    • Ask doctors and nurses to talk to their patients about the benefits of drinking less or quitting.

    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.

    Mid-Atlantic Association of Community Health Centers | | |