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July 2009 Policy Updates for City/Local, State, and Federal.

Policy Updates: City/Local

1.  Board of Supervisors Restores $44 Million in City General Fund Cuts; $4 Million Reduction to Behavioral Health RFPs Restored   
Per the Human Services Network –
The following link is to the final Board of Supervisors budget restoration list.  One SFCCC’s clinics GF cut was restored in addition to several behavioral health cuts. 

2. DPH Has Selected Mathematica as the Evaluator for the “Healthy San Francisco” Program/ HSF Enrollments Are At Just Under 44,000 With 44% Enrolled in SFCCC Medical Homes  

The evaluation will begin in August. The evaluator plans to attend some of the HSF Provider Work Group meetings along with others, yet to be determined.  The specific role of SFCCC in the evaluation and the assessment of the community providers’ participation is being determined 

Here’s the link to their website: http://www.mathematica-mpr.com/about%20us/

For questions re HSF, please contact Allen Meyer (ameyer@sfccc.org).  

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Policy Updates: State

1. State “Big 5” Leaders Again Express Optimism About A Budget Deal; Additional Major Cuts Expected  

Per CPCA – Lawmakers continued to warn that severe cuts to state programs (including health) remained unavoidable but said they hoped to reach a compromise within the next several days.  Rumors had circulated last week that a deal might not be reached until August. 
Weekend discussions focused on Schwarzenegger’s reform proposals which have to do with finding cost savings and ending abuse in welfare, in-home support and health care programs.  The Governor’s office claims that his reform proposals could save California up to $1.7 billion this fiscal year; the savings could be used to make up for some cuts that have been made, or proposed, in other programs. 
CPCA staff continues to closely monitor budget negotiations and proposed cuts.  Please look for CPCA Budget Alert emails for timely information on the state budget, as well as important clinic advocacy requests.  For additional information related to the state budget please contact Alison Ramey (aramey@cpca.org) or Serena Kirk (skirk@cpca.org).  

2. CPCA Develops Contingency Planning Q and A to Answer Clinic Questions on the Impacts of the Elimination of Medi-Cal Optional Benefits (including Adult Dental Services

The Q and A is attached.

For questions, please contact molly Brassil (mbrassil@cpca.org).    

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Policy Updates: Federal

Per NACHC:

Early this week, Speaker of the House Nancy Pelosi toured the Mission Neighborhood Health Center giving staff, patients, and the media her perspective on community health centers’ role in health reform.
In her public remarks, Speaker Pelosi made the case for community health centers in reform. She highlighted investments in community health centers funded by the American Reinvestment and Recovery Act (ARRA), saying these investments are just the beginning of Congress’ work to expand Americans’ access to quality, comprehensive care.
Speaker Pelosi described the integral part community health centers will play moving forward, with an expanded role and guaranteed participation in our reformed health system. She emphasized health centers’ critical importance providing primary care in low-income neighborhoods and pledged Congress would ensure health centers expand into more communities and receive reimbursement for almost all families they serve.
The Speaker assured the assembled press and health center staff that Congress would be working all through July to have something to the President by the end of this year, as he has requested.
“We will not fail. Our long-run fiscal health, our economy and most importantly, the health of all Americans is at stake.”

Last Friday, the House Subcommittee on Labor-HHS Appropriations voted to send the FY2010 Appropriations bill to full committee and the bill provides no new funding for the Health Centers program. Committee staff have indicated that because the Subcommittee received an overall funding allocation amounting to less than the President’s budget request, they were forced to cut a number of programs and level fund others, like Health Centers, that received Recovery Act (ARRA) dollars.
As for next steps, the bill will be considered by the full Appropriations Committee this coming Friday, and will be on the House floor possibly later this month. The Senate Subcommittee on Labor-HHS Appropriations is expected to take up its FY2010 bill towards the end of the month as well. 
A number of folks have inquired what this funding level will mean to health centers if it becomes law (which is still a ways off). The answer is that while health centers would still have some of their ARRA funds through FY2010 since it is two year money, there would be no new funding for health centers until FY2011 at the earliest if this level funding becomes law. This would mean no base grant adjustments, expanded medical capacity grants, or dental, mental health, or pharmacy grants. There would also be no new opportunities to apply for new access points for all of 2010. 

While disappointing, this is not the final word in the Appropriations process. Health Centers will continue to work to secure an increase in the Senate Labor-HHS bill, and in whatever bill becomes law at the end of the day.

With just under a month left before Congress adjourns for the August Recess (and National Health Center Week!), Congressional leaders and President Obama spent the weekend doubling down on their ambitious timeline:  passage of health reform bills by both House and Senate before that break.
So where do things stand?

1. In the House, after last-minute cold feet by conservative “Blue Dog” Democrats, things are back on track and the revised version of legislation is set to be unveiled today.  The three Committees of jurisdiction will begin marking up bills Wednesday, and the Chamber is aiming to pass their bill before leaving town July 31.
2. In the Senate, the HELP Committee enters its third week of marking up legislation, while the Finance Committee is scheduled to release a bill this week.  Finance Committee leaders have been trying to straddle the line between accommodating Committee Republicans and not losing the Democratic base of support, in the quest for 60 votes.  The Senate leaves DC a week later than the House, on August 7th.
3. With regard to health centers, NACHC has posted a new side-by-side on the health center related provisions in the various reform bills.  It can be found under the “Fact Sheets” section of our health reform hub.

The timelines are ambitious to be sure, and conventional wisdom here in town is that while the House will likely meet its deadline, there’s little likelihood a Senate bill will be done by August.  That makes for a busy fall on health care, as one of the only things both sides agree on is that should this debate slip until next year, there’s little chance anything will get done.

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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