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 13, 2015
MACHC created a Funding Cliff

Hill Update: At this point Senate leaders have indicated that H.R. 2 will be one of the first things on the agenda when the Senate reconvenes tomorrow. The bill is expected to be considered tomorrow (Tuesday). Both Democratic and Republican lawmakers have indicated an interest in offering amendments to the bill, with potential changes including a longer timeline (4 years vs 2 years) for the Children's Health Insurance Program funding extension, as well as measures to require that the full cost of the bill be paid for - the House bill only required that about $70 billion of the total $214 billion cost be paid for.


Amendments have not yet been finalized, and we know many offices have been reluctant to commit to a position without knowing what amendments will be offered. .


Advocacy Update: The outreach you all have been doing to your Senate offices over the past two weeks has been extremely helpful, thank you. 


Media templates (Letter to the Editor, OpEd & Press Release): Reminder, MACHC has spoken to MD and DE leadership to get local media pieces published in as many Congressional Districts possible - to access templates click here: media templates. 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 passage. If you are successful in publishing in local media, please indicate on the MACHC Tracking Tool (below) and inform us so we can track and record your efforts.

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



(3) 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
(4) June 18-19, 2015

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


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

April 17, 2015
Conference Call 
11 am - 1pm

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

September 18-19, 2015
Board Retreat
Turf Valley

  • (1) NACHC Webinar: Medicaid Waiver Activity: Implications for Essential Hospitals and Health Centers
    Wednesday, April 15, 2:00 - 3:00 pm ET
    Description:  Experts from the National Association of Community Health Centers and America's Essential Hospitals will highlight the different types of Section 1115 waivers currently being implemented across the country, including those that have been recently approved or submitted, as well as waiver trends found across the United States. Presenters will explore Medicaid expansion waivers and the Centers for Medicare & Medicaid Services' action in this area. Participants will also learn about the implications of Medicaid waivers for essential hospitals and health centers.

    (2) Ten Essential Services of Community Health Workers (CHW) in Public Health Webinar - Wednesday, April 15, 2015, 1:00pm - 2:00pm, ET This Migrant Clinicians Network (MCN) webinar is targeted to Spanish speaking CHWs and will highlight the ten Essential Public Health Services and examples of real life experiences of CHWs in the community. This webinar will be conducted in Spanish only. Presentation materials will be available in English on MCN's webpage.
    View more information and register for this webinar

    (3) 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.

    (4) 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)


    (5) First Ever Trauma-Informed Primary Care Initiative

    The National Council for Behavioral Health, in partnership with and sponsored by Kaiser Permanente Community Benefit, is pleased to announce an exciting 9-month learning community for primary care organizations to explore how adopting trauma-sensitive screening, assessment and treatment practices will support their efforts to successfully treat patients with challenging medical, mental health and addiction treatment needs.

    Ongoing research demonstrates that adverse life experiences (trauma) in childhood and adulthood significantly increases the likelihood of persisting physical health, mental health and addiction problems.

    Organizations selected for this pioneering learning community will engage in a critical first effort to examine trauma-informed care's effect on health outcomes for patients with significant exposure to traumatic life events. Through your participation, you will play a significant role in shaping our future health care system - one that accelerates the health and wellness of primary care patients.

    Apply by Friday, April 24th, 2015. Learn more here. Questions? Contact Jordan Winn at


    (6) 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

    (7) 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

    (8) 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



    (9) 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
    (10) 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:

    Senate to Take up SGR, CHIP and Primary Care Cliff Fix Legislation --The U.S. Senate will take up HR 2, the Medicare Access and CHIP Reauthorization Act of 2015, on its return from recess this week.  The bill, a bipartisan compromise that passed the House 392-37 last month, calls for a permanent repeal of the failed Medicare physician payment formula known as the SGR, and includes two years of continued funding for CHIP and two years of continued mandatory funding for Community Health Centers, the NHSC and Teaching Health Centers, and it would make permanent a temporary program to help low-income seniors pay their Medicare premiums. The deal is partially paid for by additional means testing for high-income seniors and the elimination of first-dollar coverage in Medigap plans.  NACHC strongly supports Senate passage of HR 2 and has urged advocates to call their Senators in support of the bill. 

    Need for Feedback

    The NACHC Payment Reform Monitoring Tool is now live and ready for state data to be entered.  Please take a moment to read over the instructions we have prepared on how to download Dropbox as well as how to edit the spreadsheet.  If you have any questions or concerns, please contact Luke Ertle (  Please fill out your state's information by April 30, 2015 and update later as needed 

    NHSC New Site application cycle

    The 2015 NHSC New Site application cycle is now open for eligible health care sites.  The application cycle will close on June 2, 2015, at 7:30 p.m. ET.  Interested sites are encouraged to read the 2015 NHSC Site Reference Guide for all program requirements.
    Eligible sites include health care facilities that provide outpatient, ambulatory and primary health care services (medical, dental, and behavioral) to populations residing in high-need urban and rural areas. Critical Access Hospitals (CAHs) are the only eligible inpatient facilities and must be affiliated with an NHSC-approved outpatient clinic.

    Applicants are encouraged to participate in any of these upcoming events, which will offer application help and technical assistance to those applying to become an NHSC Site.


    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

    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, an application submitted without these items 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. 
    The federal Mental Health Parity Act of 2008 was supposed to ensure that when patients had insurance benefits for mental health and addiction treatment, the coverage was on par with what they received for medical and surgical care. But until now, the government had only spelled out how the law applied to commercial plans.  This week, with release of a long-awaited rule proposing how the parity law should also protect those insured through Medicaid and CHIP programs, that changed. Under the proposal, plans no longer could have hard limits on coverage such as a certain number of mental health visits in a year. And if a patient were to be denied treatment for a mental health or substance use disorder, the insurer would have to explain why.  In the short term, the rule is expected to cost state Medicaid programs $150 million in additional behavioral health costs

    The Robert Wood Johnson Foundation has released their new county health rankings report.  County Health Rankings & Roadmaps measures the health of nearly every county in the nation.  The report provides a revealing snapshot of how health is influenced by where we live, learn, work and play a starting point for change in communities. 

    The National Association of Community Health Centers released a new website to celebrate America's Health Centers and 50 years of success in expanding access to quality and affordable primary and preventive healthcare services to millions of uninsured and medically underserved people nationwide. The website highlights the important past, present and future role of health centers in the nation's healthcare system.
    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.

    Democrats Propose Minimum Wage Increase

    State Rep. Patty Kim (D-Dauphin) has reintroduced legislation to increase the state's minimum wage, which would help struggling families pay their bills and reduce their reliance on government assistance programs. Kim's bill, House Bill 250, would increase the minimum wage from the current $7.25 per hour to $9 per hour and then to $10.10 per hour a year later. A similar bill, Senate Bill 196, has been introduced by Sen. Christine Tartaglione (D-Philadelphia). Gov. Tom Wolf has voiced support of a $10.10 minimum wage but any increase faces an uphill climb in the Republican controlled General Assembly.

    Who Can Enter Orders to Meet CPOE Meaningful Use?

    For the Computerized Provider Order Entry (CPOE) meaningful use measure, can anyone enter medication orders into an EHR system?

    According to the Centers for Medicare & Medicaid Services (CMS)

    FAQ #2851"Any licensed healthcare professional can enter orders into the medical record for purposes of including the order in the numerator for the measure of the CPOE objective if they can enter the order per state, local, and professional guidelines. The order must be entered by someone who could exercise clinical judgment in the case that the entry generates any alerts about possible interactions or other clinical decision support aides."

    EHR intelligence reports a key issue that concerns providers is the difficulty of increasing patient engagement and the use of patient portals.  For Stage 2 Meaningful Use, providers need to ensure that more than five percent of their patients access their data through patient portals and utilize secure messaging tools to speak with their provider. Ensuring a portal is user-friendly and engaging is vital.  When developing a patient portal, it is useful to have interactive features that are relevant to patient needs. A portal should go beyond scheduling appointments and displaying lab results. Incorporating proactive and engaging features as well as promoting portal use and secure messaging capabilities will increase the regular use of patient portals.  Often, the older population may not be as "tech-savvy" with regard to accessing their health data through a patient portal and training these patients to use the tools and services available through a portal may be necessary. There are a variety of benefits providers gain from portals such as efficient and effective communication with patients, greater self-care initiative from patients, and higher patient satisfaction.  In order to assist providers in meeting these requirements, the Office of the National Coordinator for Health IT (ONC) provides a fact sheet to assist in the implementation of patient portals.
    State News

    The prospect of spending 12 hours developing health care policy would send most college students running for a case of beer.

    But the University of Delaware students participating in this year's all-night Healthcare Hackathon were right at home.

    Divided into groups of three or four, the students had to pitch a policy to university staff and experts in the health field addressing real world policy concerns ranging from issues related to chronic disease, patient accountability, technology and community health with help from mentors at Christiana Care and the state health department among others.

    "People of this age are going to push us to do things in a new way," said policy mentor Emily Knearl, section chief of Health and Risk Communication in the Delaware Division of Public Health as the hackathon kicked off Thursday evening.


    The countdown to the end of the Maryland General Assembly's session can now be measured in hours.

    Lawmakers have until midnight on Monday to pass legislation and finalize the state budget, which has been the prime focus of this year's 90-day legislative session. As of Sunday evening, Maryland Gov. Larry Hogan (R) was still not satisfied with the budget or the status of legislation that he introduced - and legislators expect that negotiating on both will continue up to the deadline.

    Finance & Business
    The CVS Health Foundation announced 55 new grant recipients as part of its multi-year, $5 million commitment to increase access to health care in communities nationwide. The grants were awarded through the CVS Health Foundation's partnerships with the National Association of Community Health Centers and other organizations. 

    We have written extensively on this blog about the cost-savings that Community Health  Centers produce for U.S. healthcare system ($24 billion a year, by the way).  Now comes a new report from the Massachusetts League of Community Health Centers which shows that the Commonwealth's 49 health centers generate annual savings of more than $1 billon for Massachusetts. The $1.1 billion in savings is tied directly with the impact health centers have in reducing emergency room visits, hospital stays and the need for higher-cost specialty care among patients.  Also, the more health centers expand to meet growing demand for their services (they have added more than 295,000 patients since 2006 thanks to federal and state health reform), the bigger their economic punch as employers and economic engines that produce tax revenue for the state.

    "This report demonstrates that health centers provide significant value far beyond just the communities in which they are located," said James W. Hunt, Jr., president and CEO of the Massachusetts League of Community Health Centers. "For the first time, we are able to quantify the critical role health centers play in the economic health of Massachusetts. At a time when state leaders are looking for savings and wise investments, Community Health Centers can demonstrate that they are powerful economic drivers." The analysis was conducted by Capital Link.   

    Resources and Publications for your Health Center:

    Latest News on ACA


    Supplemental Webinar: "Taxes & Health Care" Hosted by Young Invincibles

    Next Tuesday, April 14, Young Invincibles, an organization dedicated to representing the interests of individuals 18-34 years old, will host a webinar on how the health care law may affect consumers' taxes, and how consumers can sign up for coverage if they qualify for the Tax Penalty SEP.   Click to register for the Tuesday, April 14, 7:00 pm EDT webinar.

    Connecting Kids to Coverage Webinar

    On April 22 at 3:00 pm, the Connecting Kids to Coverage National Campaign is hosting a webinar, Helping Newly Enrolled Families Understand and Use their Medicaid and CHIP Coverage. Please click on the link to register.

    Take action: Special Enrollment Period

    If you owe a fee with your taxes for not having health coverage in 2014 and don't yet have health coverage for 2015, you may still be able to get coverage for 2015.

    The Health Insurance Marketplace is providing individuals and families who need to pay the fee when they file their 2014 taxes with one last chance to get covered for 2015.

    This is too important to put off. If you don't have coverage for the remainder of 2015 you'll risk having to pay the fee again next year for the portion of this year that you don't have coverage. The fee for people who don't have coverage increases in 2015 to $325 per person or 2% of your household income - whichever is higher.

    States Expanding Medicaid See Significant Budget Savings and Revenue Gains
    States expanding Medicaid under Obamacare are seeing large budget savings without reducing services, according to a report released last week.  The report, "States Expanding Medicaid See Significant Budget Savings and Revenue Gains," prepared for the Robert Wood Johnson Foundation, anticipates $1.8 billion in budget savings and revenue gains across eight states - Arkansas, Colorado, Kentucky, Michigan, New Mexico, Oregon, Washington and West Virginia - by the end of 2015.

    The Impact of the Coverage Gap in States not Expanding Medicaid by Race and Ethnicity

    People of color face longstanding and persistent disparities in accessing health coverage that contribute to greater barriers to care and poorer health outcomes. The ACA Medicaid expansion to adults with incomes at or below 138% FPL makes many uninsured adults of color newly eligible for the program, which would help increase their access to care and promote greater health equity. However, in states that do not implement the ACA Medicaid expansion, poor adults fall into a coverage gap and will likely remain uninsured. This new brief, "

    The Impact of the Coverage Gap in States not Expanding Medicaid by Race and Ethnicity

    ," examines the impact of this coverage gap by race and ethnicity and finds that it disproportionately impacts poor uninsured Black adults, which may contribute to widening disparities in health and health care over time.


    Exploring the Feasibility of Including Medicare-Medicaid Enrollees in Medicaid Accountable Care Organizations

    States and the federal government are pursuing new approaches to improve alignment and coordination between Medicare and Medicaid for dually eligible individuals. According to a new CHCS brief, "

    Exploring the Feasibility of Including Medicare-Medicaid Enrollees in Medicaid Accountable Care Organizations," some states are examining Medicaid ACOs as one potential approach to improving outcomes and reducing expenditures for these beneficiaries. However, when deciding whether to include Medicare-Medicaid enrollees in Medicaid ACO programs, states must weigh the feasibility and potential benefits against potential costs and complexities.

     Rural Implications of Medicaid Expansion under ACA

    In order for the ACA Medicaid expansion to effectively meet the needs of rural populations, implementation will need to be based on the underlying differences in rural and urban populations and on the unique needs of rural residents and health systems. According to a recent brief, "Rural Implications of Medicaid Expansion under the Affordable Care Act," missing information that is critical to informing ACA implementation includes: the extent to which prior public health insurance expansions have covered rural populations; whether rural residents who are expected to be newly eligible for Medicaid in 2014 differ from their urban counterparts; the extent to which rural individuals might differentially benefit from the ACA Medicaid expansion in light of the expansion becoming optional; and whether rural enrollees are likely to have adequate access to primary care. This study addresses these knowledge gaps using the 2007-2011 panels of the Medical Expenditure Panel Survey (MEPS), linked with state-level Medicaid policy data and county-level primary care provider data.


    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 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

    *If you have any questions or comments regarding any of the calls conducted by MACHC, please email Aneeqa Chowdhury at


    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

    HRSA Health Infrastructure Investment Program Funding
    Application Deadline: application package by April 21; EHB application by May 21
    HRSA expects to award approximately $150 million in Affordable Care Act funding for the alteration or renovation, expansion or construction of a facility, allowing health centers to provide increased capacity or additional primary and preventive care services. HRSA will hold a call on this announcement on March 24, 2015. For additional information, click here.

    The Geiger Gibson Capstone Fellowship in Health Policy and Leadership

    Program Period: April 20-22, 2015, Washington, D.C.

    This program is offered through a partnership between the Department of Health Policy and the National Association of Community Health Center's Leadership Development Institute.  The program is designed to provide participants with the knowledge needed to understand U.S. health policy trends and their implications for health centers. Special emphasis is placed on current and emerging health reform implementation issues. Program speakers come from senior levels of Washington DC's health policy leadership community.  The program is $750 per participant, not including travel, lodging and meal expenses.

    UCLA/Johnson & Johnson Health Care Executive Program (HCEP)

    Application Deadline:  April 30, 2015

    This program is a unique opportunity for executives of community health centers and AIDS service organizations to participate in an intensive management training program at UCLA Anderson. This leadership and management development program sharpens leaders' skills so they can help their community-based organizations improve and expand care for the people they serve. The program also builds both executive and entrepreneurial management skills. The curriculum consists of practical tools, techniques and approaches to leadership and management relevant to organizations that are adapting to the major changes in health policy, financing and service integration. Participants also engage in a rigorous but relevant curriculum that provides the requisite skills, knowledge and abilities to successfully manage and lead change in their organizations and communities. To learn more about the program, please mark your calendar and register to participate in an online informational webinar scheduled for April 2, 2015 at 12:00 noon ET

    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.


    National Training and Technical Assistance Cooperative Agreement (NCA) Funding Opportunity Announcement (FOA) (HRSA-15-140) - HRSA released Fiscal Year (FY) 2015 NCA FOA (HRSA-15-140)  which will provide approximately $3 million  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. The organizations will provide training 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.

     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

    Shared Services Corner 
    MACHC now offers  a myriad of Shared Services for member convenience. 
    Please check out the attached flier for additional details on the services  offered.
    Clinical Quality 
    Resources To Improve the Integration of Behavior Health and Primary Care
    Two new resources to help reduce fragmentation of care through integration are available on the AHRQ Academy for Integrating Behavioral Health and Primary Care portalA Guidebook of Professional Practices for Behavioral Health and Primary Care Integration identifies key professional practices among exemplary integrated primary care organizations developed to help practices integrate behavioral health care more effectively. Organizations can use this guidebook to work toward a level of integrated care seen in some of the best primary care organizations in the country. The Provider- and Practice-Level Competencies for Integrated Behavioral Health in Primary Care: A Literature Review is a comprehensive set of competencies that practices, providers and staff can use to advance integration efforts. 

    Medication Guide for Treatment of Alcohol Use Disorder

    The Substance Abuse & Mental Health Administration (SAMHSA) has released a new guide for expanding the use of medication in clinical practice for the treatment of alcohol use disorder: Medication for the Treatment of Alcohol Use Disorder-A Brief Guide.  The guide summarizes information on four approved FDA medications to treat alcohol use disorder, prevent relapse to alcohol use, or both and addresses six key topics related to screening a patient for risky alcohol use and treating a patient with co-occurring disorders.  

    Health Observances This Week


    April is STD Awareness Month 

    Know the facts! GYT: Get Yourself Tested

    False assumptions about sexually transmitted diseases (STDs)-how they're spread, treated, and prevented-are everywhere and it can be especially hard for people to get the facts. Here are five you need to know:

    • You can't tell someone has an STD just by looking at them.
    • STD tests aren't always a part of a regular doctor visit.
    • Almost all STDs that can be spread via unprotected vaginal sex can also be spread through unprotected oral and anal sex.
    • Using a condom can take a lot of the worry out of sex, since it can prevent unintended pregnancy and protect you from STDs.
    • STD testing is a basic part of staying healthy.

    Because half of the estimated 20 million STDs that occur in the United States each year are among young people, STD Awareness Month 2015 is focused on this population. This month-long observance provides an opportunity to clear up misperceptions about STD prevention and testing, and confront the unique challenges that young people face when it comes to preventing these infections.

    Know the Facts!
    GYT: Get Yourself Tested

    Know the Facts

    Half of all sexually active young people in the United States will get an STD by the time they're 25-and most won't know it.

    Not having sex is the only way to prevent STDs. This includes vaginal, anal, and oral sex. If you are sexually active, however, you can lower your risk of getting STDs by:

    • Being in a long-term mutually monogamous relationship with a partner who has been tested and does not have STDs.
    • Limiting the number of people you have sex with if you have more than one partner.
    • Using latex condoms and dental dams the right way every time you have sex.
    • Getting an HPV vaccine, which can protect you against diseases (including cancers) caused by the human papillomavirus.
    GYT: Get Yourself Tested

    Getting yourself tested for STDs is one of the most important things you can do to protect your health. Not only is it quick and simple, it's also usually confidential. A 2014 study found that one-third of adolescents didn't talk about sexual health issues with their physicians at all during annual health visits. It is important to be honest with your health care provider about your sexual history so that he or she can provide you with the appropriate STD testing and prevention guidance. If you're not comfortable talking with your regular health care provider about STDs, there are many clinics that provide confidential and free or low-cost testing. It is also important that you find and visit a doctor or other medical provider who stays current on STD and HIV testing recommendations.

    Share the Knowledge

    Now that you know the facts, it's time to spread the word! The GYT: Get Yourself Tested campaign is a youth-oriented, empowering social movement to encourage young people to get tested and treated for STDs and HIV. GYT campaign materials have been developed for doctors, health departments, school administrators, and community-based organizations to help young people increase their knowledge about STD prevention and testing. You can order newly designed GYT posters, stickers, and postcards at CDC-INFO on Demand to display in schools, clinics, community organizations, and health departments.

    GYT is a partnership between the American College Health Association, Kaiser Family Foundation, National Coalition of STD Directors, MTV, and Planned Parenthood Federation of America. Technical consultation for GYT is provided by the U.S. Centers for Disease Control and Prevention.

    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 | | |