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

Policy Updates: City/Local

1. SFCCC President/ CEO Meets with House Speaker Pelosi on Clinics’ Roles in Federal Health Care Reform 

With a small group of national clinic leaders, SFCCC President/ CEO John Gressman will meet this week directly with Speaker Pelosi on proposals for clinics’ roles in health care reform.  This is a critical stage of the reform process as committee bills move toward conference committee reconciliations and floor votes.  A key focus will be the proposed trust fund to expand clinics to be the medical homes for a growing number of people who will now have health coverage under reform options.       

2. “Healthy San Francisco” Evaluation Team (Mathematica) to Meet With SFCCC Senior Managers Next Week  

As part of the evaluation, SFCCC senior managers involved in the “Healthy San Francisco” (HSF) implementation will discuss with the evaluation team the role of community clinics in HSF’s development, HSF enrollee system patient services issues that need to be addressed, long term financial viability and other matters.  The evaluation team will also meet with some participating SFCCC member clinics and other community providers, as well as DPH providers, as part of the assessment.      

3. “Federal Health Care Reform and Clinics” Training Postponed

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Policy Updates: State

1. State Releases Draft Concept Paper for Proposed Section 1115 Waiver to Strengthen the Health Care Safety Net and Potentially Restructure Medi-Cal         

On October 19, the State released the Concept Paper for California’s proposed section 1115 Medicaid waiver [pdf] (see link for the paper). This waiver will replace the current 1115 waiver entitled Medi-Cal Hospital/Uninsured Care Demonstration, which expires on August 31, 2010.

The concept paper presents the State’s goals and strategies for a new waiver. This waiver presents the State’s draft concept for advancing the goals of ABx4 6: strengthen California’s health care safety net; reduce the number of uninsured individuals; optimize opportunities to increase federal financial participation; promote long-term, efficient, and effective use of state and local funds; improve health care quality and outcomes; and promote home and community-based care – without relying on any new general fund spending.

Between November 2009 and August 2010, California will work with CMS to develop, finalize, and secure approval of the new waiver. Aspects of the waiver may change from what is presented in the concept paper to reflect the State’s work with CMS. The final waiver will reflect these changes. During the same time period, the State will meet with a stakeholder committee that will inform the development of a waiver implementation plan and provide ongoing advice to the state during the term of the waiver. Details are available at the Stakeholder Process link [pdf].

The State is interested in our comments and suggestions regarding the concept paper. They will hold a public discussion of the concept paper on Monday, November 2, 2009, from 1 to 4 PM at the Department of Health Care Services’ auditorium at 1500 Capitol Avenue. We may also send questions, comments, and concerns to the waiver renewal e-mail address at waiverrenewal@dhcs.ca.gov .

SFCCC will submit comments upon approval of the Health Policy Committee recommendations in October 21 Board packet consent calendar.  Comments will be submitted in conjunction with CPCA but also directly from SFCCC. SFCCC will participate in the November 2 hearing as well.  

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Policy Updates: Federal

1. Health Centers and Health Reform, By the Numbers

By John Sawyer NACHC)

As Congressional leaders in both the House and Senate hash out final versions of health reform legislation for each chamber to consider next month, health centers are at the heart of proposals to expand access, improve quality and control costs. We thought it would make sense to do a quick run-through of some of the numbers flying around in the current health reform debate (read to the end, the last is most important):
Congressional Committees that have passed health reform bills: 5 out of 5.
Republican votes in favor, so far: 1.
Key Health Center provisions we’re fighting for in the House bill: 5 [pdf].
House “aye” votes needed to pass reform legislation: 218.
Key Health Center provisions we’re fighting for in the Senate bill: Six [pdf].
Senate “aye” votes needed to pass reform legislation: 60.
Largest one-year appropriations increase in the history of the Health Centers program: $207 million.
First year funding increase, on a guaranteed basis, for Health Centers under the new Public Health Investment Fund in the House health reform bill: $1 billion [pdf].
New, guaranteed funding for Health Centers under House Public Health Investment Fund, over 5 years: $12 billion. [pdf]
New patients projected to be served by Health Centers by 2014 under the House proposal: 26 million [pdf]
Current private insurance reimbursement for Health Centers (as a percentage of costs): 58%. [pdf]
Current Medicare reimbursement for Health Centers (as a percentage of costs): 72%. [pdf]
Current Medicaid reimbursement for Health Centers (as a percentage of costs): 85%. [pdf]
Amendments passed by the Finance Committee to bring Medicare and private reimbursement for health centers to Medicaid levels: 2.
Current bills that would require exchange plans to contract with Health Centers: 4 out of 5.
Cosponsors on House Resolution supporting role of Health Centers in health reform: 94. [pdf]
Cosponsors on Senate Resolution supporting role of Health Centers in health reform: 30. [pdf]
U.S. residents without insurance: 46 million.
U.S. residents with nowhere to go for primary care: 60 million. [pdf]
Failed attempts to bring about fundamental health reform in the past century: Five.
Minutes it will take you to call your Representative, and make a difference in bringing meaningful care to millions: Five.

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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