Today is

Policy Updates for City/Local, State, and Federal.

Policy Updates: City/Local

1. SF Health Commission to Review Up To $40 Million in Additional DPH General Fund Cuts at March 17 Meeting

The Commission is seeking to meet the Mayor’s target of $100 million in DPH General Fund base and contingency cuts for the 2009-2010 budget.  At its most recent meeting, the Commission signed off on $60 million in cuts. 

The Health Commission meeting is at 4 pm; March 17; DPH 101 Grove; Room 300.         

2. Also on March 17, the Health Commission Will Receive Its Annual Update Report on “Healthy San Francisco”

Tangerine Brigham, “Healthy San Francisco” Director, will report on HSF progress to date and outstanding issues.  SFCCC will testify in favor of increased HSF support for SFCCC clinics’ participation and also on any issues related to SFCCC clinics that are brought to the Commission.  Increased support is needed to fund enrollments/ re-enrollments, expanded services (e.g., behavioral health, chronic disease management) needed by enrollees and increasing enrollments resulting from the growing number of uninsured.       

3. President Obama Cites “Healthy San Francisco” As A Model Local initiative to Address the National Crisis of the Growing Number of Uninsured

At the recent U.S Conference of Mayors meeting in D.C., President Obama lauded Mayor Gavin Newsom for taking the lead on addressing a problem that the State and federal government heretofore have not been able to solve.  Mayor Newsom has also received significant recent interest from the media on HSF’s approach and successes. 
   
For additional information about SFCCC health centers’ participation in “Healthy San Francisco,” please contact Allen Meyer (ameyer@sfccc.org/ 415 355-2226).                                          
 
4. DPH Community Programs Budget Planning Committee Moving Toward Integrated Primary Care/ Behavioral Health Model

The Committee – which includes DPH community programs contract administrators and representatives of contracting organizations – is moving towards a model with a medical home at the center.  The medical home would provide or make available both primary care physical health and behavioral health services to clients who are not severely mentally ill.  The medical home would serve as the hub of the health care system for clients – as SFCCC’s primary care medical homes do in HSF.  The Committee is working on the assumption, unfortunately, that there will be a contraction of free-standing outpatient behavioral health resources as a result of the City’s General Fund budget shortfall.       

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Policy Updates: State

1. State Announces That the March Medi-Cal Checkwrite Delay for California’s Providers – Including Clinics – Will Cover Only the Last Two Weeks in March

CPCA was informed by DHCS on the afternoon of March 6 that the Medi-Cal checkwrite delays of March will be postponed for one more week. Thus, only the last two March payments will be delayed into the month of April.

At this point, we expect the four week checkwrite delay in June to take place as planned (it is included in the finalized State budget).    

2. State Finalizes 2009-2010 Budget – But Revenue Measures Must Be Approved by the Voters in a Special Election in May 

Proposed Medi-Cal eligibility cuts – including restriction of Medi-Cal to legal immigrants; reduction of FPL levels for aged, blind and disabled and 1931 (b) Medi-Cal – were restored as a condition of the State receiving federal Medicaid economic stimulus funding.  Optional benefits (e.g., adult dental) restoration is contingent on the State receiving at least $10 billion from federal economic stimulus funds by a certain date – whether this will happen is still being reviewed by the State.

Revenue measures – e.g., Vehicle License Fee and sales tax increases and the re-direction of Prop 10 and Prop 63 (Mental Heath Services Act) funding to base budget support – must be approved by the voters on May 12.  If they are not approved, the budget discussion will be re-opened and there will likely be more cuts.               

3. California’s Family Pact (FPACT) Waiver Included in Labor HHS Appropriations Bill

Advocates – including SFCCC – are seeking a “state option” (rather than a federal mandate) and an “income only” eligibility requirement for FPACT services.  If the waiver does not make it all the way through with the appropriations bill, Speaker Pelosi is expected to attach it to other active legislation.      

4. SFCCC Tracking Economic Stimulus Funding for Clinics’ “Shovel Ready” Capital and IT Projects

SFCCC continues to monitor the roll out of the economic stimulus money – both for 330 e and h grantees and for non-330 clinics.  

5. CPCA Day At the Capitol is April 22 in Sacramento
CPCA members and non-member clinics can participate (with no registration charge) and are urged to do so.  To the extent that providers can be freed-up to participate, that is also encouraged as providers are particularly respected by legislators as advocates on health care issues.    

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Policy Updates: Federal

1. Final Economic Stimulus Package Includes $2 Billion for Community Health Centers’ Capital/ IT Projects and Expanded Services Plus $17 Billion for Electronic Health Record (EHR) Expansion

 The final package includes $1.5 billion for capital and IT projects plus $.5 billion for New Access Points and Expanded Medical Capacity grants to enable clinics to both stimulate the construction/ infrastructure sector and provide increased services for the increasing numbers of uninsured.  In addition, there is a larger HIT electronic health record funding f $17 billion that clinics will have an opportunity to access. Also of note, the legislation includes $500 million over two years for primary care investments, including in Health Professions Training and the National Health Service Corps plus funding for urban Indian facilities.        

2. House FY 2009-2010 Budget Has $125 Million Increase for Health Centers – Including $56 Million for Base Adjustments; Earmarks – Including $500,000 for SFCCC – In the Budget At This Point       

Per NACHC: President Obama presented the outline of his FY2010 budget on Thursday. The $3.55 trillion spending plan proposes a $634 billion fund to help pay for health care reform, which President Obama has indicated remains a top priority for this

year. The fund would be created by cutting subsidies to insurance companies who sponsor Medicare Advantage plans and by raising taxes on individuals with incomes over $250,000 per year. The broad budget outline made little reference to specific programs such as Health Centers. A more detailed, program-by-program budget is expected to be released in April.

In the meantime, the House passed the Omnibus spending bill to fund the government for the remainder of FY2009. This bill includes $2.065 billion for the Health Centers program, a $125 million increase over last year, of which $56 million is identified for base grant adjustments to existing centers.  Earmarks are included at this point.  
 
Click on the NACHC website www.nachc.com for more information.

3. The NACHC Policy and Issues Forum (March 24-29 in Washington, D.C. Hill Visits to San Francisco Legislators Have Been Scheduled 

SFCCC has scheduled the visits with Speaker Pelosi and Congresswoman Speier.  CPCA has scheduled Senator Feinstein and is working on the Senator Boxer meeting. 

For information on the schedule for visits to legislators and other SFCCC-related meetings, please contact Dick Hodgson at 415 355-2230/ rhodgson@sfccc.org

Please call or email Dick Hodgson at 415 355-2230/ rhodgson@sfccc.org if you have questions or need additional information on any of these topics.

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