Update on Outreach and Enrollment

Our guest blogger today is Ted Henson, Director of the Robert Wood Johnson Outreach and Enrollment Project, with a progress report on  health center patients and insurance.

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 (Healthcare.gov), 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 Healthcare.gov. 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.

For more information about this poll or NACHC’s ongoing efforts on O&E, contact Ted Henson: thenson@nachc.com



Chicago Health Center Launches Thriving Food Pantry

Volunteers distribute food to community members.

Volunteers distribute food to community members.

When Community Health Centers began 50 years ago, the mission was not only to prevent illness with affordable primary care, but also address the causes.  Confronting  the social determinants of health, meaning factors such as nutrition, homelessness and poverty, is a mission carried out by all health centers even today.  That is what brought us to the south side of Chicago, where TCA Health, Inc. saw a need in the community, and sought to fill it.

Since diet is so often the culprit of ailments such as obesity, diabetes, heart disease and cancer, TCA Health decided to take action by opening the Peter’s Rock Food Pantry just a few blocks from its main clinic site.

“In order to truly build healthy communities, it is critical we address disparities beyond traditional healthcare.  The south side of Chicago is a food desert where healthy choices are extremely limited and in most cases non-existent,” said Mariann Chisum-McGill, Director of Programs. “Regular check-ups and health screenings are excellent preventive measures, however, they are not enough if people are not eating well.  Not only do we educate our constituents on proper nutrition, we opened the food pantry in order to make healthy options more accessible and affordable.”

TCA Health serves 8,500 patients and offers a range of affordable primary care services, such as dental, pediatrics, OB-GYN, and even employment counseling.  But a growing need among patients stretches beyond the walls of the health center.  Stores that sell healthy food are scarce, and for many residents who do not have access to a car, it means trekking several miles to the nearest affordable grocery store for fresh fruits, vegetables and other healthy staples.  On the other hand, establishments that sell processed junk food are plentiful.

TCA Health responded to this barrier by forming the Health & Wellness Collaborative (HWC), an alliance of local community organizations, social service agencies, concerned residents, schools, churches and other stakeholders. The HWC partnered with Peter’s Rock Church of God in Christ to open the food panty on January 30, 2015.  Not just any food pantry, though.  The Peter’s Rock Food Pantry (located inside the church) offers comprehensive nutrition and cooking workshops along with free canned goods, fresh produce and meat.  The pantry serves up to 100 families every Friday from 10 to noon.

TCA Health’s successful efforts to venture beyond the reach of conventional medicine to target specific community needs is part of a legacy that has been in existence for five decades, thanks in part to public support.  Now that support is being imperiled because of the health center funding cliff, which could slash federal funding by up to 70 percent.  If Congress does not act, every health center will be affected.  For TCA Health it means over 1,000  patients could experience reduced access to care.

“The health center funding cliff would deliver a crushing blow to what we are accomplishing on the south side,” said Veronica E. Clarke, CEO.  “TCA Health’s mission is not only dedicated to quality healthcare, we are empowering individuals by improving their quality of life.  We are creating solutions locally, but we need federal investment to continue our work.”

Beyond Washington, a Call to Fix the Funding Cliff

dashcleThe 2500 advocates who gathered at the 2015 NACHC Policy and Issues Forum have long gone home, but they are still burning up the phone lines and writing their leaders in Congress about the importance of fixing the health center funding cliff.   Even though the solution lies with lawmakers, the impact of the funding cliff — which means a federal funding cut of up to 70 percent — will be broadly felt beyond the beltway.  Local news outlets are paying attention about how health centers and patients in their community will be affected.  A case in point is the Fort Bend Star News in Texas, which noted that “local Community Health Center, AccessHealth, served over 16,000 patients last year, with primary care, pediatric care, behavioral health and HIV care, as well as dental services.  If this 70% reduction of funds takes place, AccessHealth stands to lose as much as $875,000 from its annual budget.  AccessHealth has been in existence for 39 years and the Fort Bend community depends on AccessHealth, (formerly Fort Bend Family Health Center), to meet the needs of those uninsured and underinsured.”  

The Detroit News also put a spotlight on the funding cliff issue in a recent article that described how Michigan’s 35 health centers and their patients — many of them living in rural areas — would be hard hit:

“Michigan’s Community Health Centers serve nearly 700,000 people, and the funding cliff puts many Michigan families at risk of losing access to their physicians, nurse practitioners, dentists and other health providers,” said Kim Sibilsky, CEO of the Michigan Primary Care Association told the reporter.  “This puts their health at risk, but also the health of the communities in which they live and work.”

Local coverage about the funding cliff has stretched from Watertown, NY, [see article in Watertown Daily Times, Stefanik Spotlights Funding Cliff at Coffee Klatch] to Billings, MT, [see article, KTVQ.com, “Riverstone Health Faces Funding Cliff“], but there have also been alarm bells raised by two high profile leaders in Washington.

Former Senate Majority Leader Tom Daschle (D), founder of the Daschle Group, and former Governor  Michael Leavitt (R) jointly penned a call to action in an op-ed published in The Hill last week, writing,

“The 114th Congress took office last month with a pledge to find solutions that work, and to work across the aisle to get things done for the American people.  In the health care arena, investing in access to primary care through Community Health Centers is a logical, non-controversial, pragmatic and cost-saving solution.  Congress should act without delay to see that Community Health Centers continue to serve those in need for the next 50 years.”

Stay tuned to this blog as we keep you updated on the developments related to the funding cliff.   




The NACHC P & I Is Underway in Washington, D.C.

The 2015 NACHC Policy and Issues Forum got off to a rousing start this week with a focus on the 50th anniversary celebration of the Community Health Center Movement and preventing the health center funding cliff from becoming a reality.

Gary Wiltz, M.D. NACHC Chair of the Board and Executive Director/Clinical Director, Teche Action Clinic opened the general session by emphasizing how far the Community Health Center program has come since its early days as a demonstration project under the Office of Economic Opportunity.

“We may have started out as a small demonstration project or, as some people [say], a social experiment but indeed health centers were part of the initial programs of the War on Poverty and look at us now,” said Wiltz. “Just look at all we have accomplished, we are the largest primary care network in the country. We are in every state and territory serving some 23 million people.”

He also added that health centers have only just begun to realize their full potential in helping the nation move towards better healthcare for all. The current numbers support Wiltz’s observation. In fact as health centers celebrate five decades of access to healthcare, they are projected to serve 28 million patients by the end of 2015 in 1,300 sites, in more than 9,200 underserved communities.

Wiltz underscored the importance of fixing the Health Center Funding Cliff, saying, “If we don’t fix the cliff, the cliff will fix us.” If the Health Center Funding Cliff is not addressed by September 30 health centers stand to lose 70 percent of their funding. That means 57,000 jobs lost, 2,000 sites closed and 7.4 million patients would lose access to care.

Wiltz’s comments were followed by a special presentation honoring NACHC’s past presidents, many of whom were in attendance.

e-1CH_0306NACHC P&I attendees were treated to keynote address chock full of historical anecdotes by celebrated Presidential Historian and Author Doris Kearns Goodwin. Goodwin was a White House Fellow in the Lyndon B. Johnson Administration, which also introduced the War on Poverty Legislation that funded the first health centers. Focusing on the histories of Presidents Abraham Lincoln, Teddy Roosevelt, and Franklin Roosevelt, Goodwin gave some insight into how these presidents’ personalities, leadership styles and the political climate influenced them as Presidents.

Goodwin remarked that even though problems change over time there are certain universal traits and patterns held by our most successful Presidents, such as Abraham Lincoln, Theodore Roosevelt and Franklin Delano Roosevelt. For instance, they were able to motivate themselves, withstand adversity, and used their oratory skills to put a human face on an issue and move the public forward.

Goodwin also noted similarities the Community Health Center movement shares with these leaders, such as the  ability to come through adversity.

“In many ways your history is one of withstanding adversity and coming through trials of fire as you have defied early on the move from a demonstration project to permanent status. As you faced challenges year after year, and budget wrangles, and despite it all you have come through standing strong against all odds,” said Goodwin.

She ended her address reminding the NACHC P&I participants that even though they may never find their faces on Mount Rushmore they leave their own legacy behind in the work they do and the people they touch.

“I truly honor the work you are doing, work that is even now is creating thousands of stories that will be told and retold in the years to come,” she said.

e-1CH_0387Following Goodwin NACHC presented Former Senate Majority Leader Tom Daschle with the 50th Anniversary Leadership Award. Daschle has long since been a champion of health centers and is Chairing the 50th anniversary committee.

Keeping with the theme of sharing the health center history and the importance of storytelling to the mission, Daschle encouraged health centers to tell their stories about the people in their communities and those who “who step up to the plate to show the kind of leadership that actually saves lives and improves the quality of life for millions of children and men and women and people all over this great land.”

He emphasized that health centers make history every day in ways large and small. “Incredibly serving now nearly 28 million patients, 7 million children, over a quarter of a million veterans, with a local impact of over 26 billion dollars,” said Daschle. “That’s history.”

While health centers should feel proud of their achievements they should also look to the future and to fixing the Health Center Funding Cliff.

“We urgently need to make history this year. We need to persuade Congress that the single, most important health related action they could take this year is to pass a multi-year extension of mandatory funding for the health centers,” said the former Senator.

Noting the heavy lift ahead, he directed health centers to keep it powerful and personal by sharing stories about the real people whose lives they’ve touched. He also reminded them how critical the grassroots efforts are to fixing the Health Center Funding cliff.

“Perhaps the most important history we can make is to ensure we extend mandatory funding for a long time to come,” said Daschel. “In 50 years no fight has ever been more important than this one.”

CHC Advocates Gather in Washington to Press Lawmakers for Funding Cliff Fix

Henry Taylor, President & Chief Executive Officer, Mile Square Health Center, Chicago, Ill, talks about the impact of the funding cliff.

Henry Taylor, President & Chief Executive Officer, Mile Square Health Center, Chicago, Ill, talks about the impact of the funding cliff.

The 2015 NACHC Policy and Issues Forum has kicked off with over 2,500 health center advocates descending on Washington, D.C. to press their leaders in Congress for a solution to the health center funding cliff.  As we’ve written before, much of health centers’ success for the past five decades has depended on consistent federal support, and a major source of federal funding is set to expire on Oct. 1, 2015.  Every health center will be affected with a federal funding cut of up to 70 percent. Health center advocates from all corners of the country will go to Capitol Hill and meet with their Members of Congress and describe how their health center will be affected, whether it is a site closure, staff lay offs, or a reduction of services.

Health center advocates also participated in a news conference [watch live stream recording] where NACHC released a report with news estimates would cause 7.4 million patients to lose access to care at their local health center, and nearly 57,000 clinicians and staff to lose their jobs.

Gary Wiltz, MD, NACHC’s board chair and a physician with Teche Action Clinic, in Franklin, LA, described the funding cliff as the “the cruelest cut of all.. to have that access [to care] and then have that taken from you.”

Also at the news conference was patient Yvonne Davis, who is also a board chair of Health Care Partners of South Carolina, Inc., in Conway, S.C. “When you talk about cutting the funding for Community Health Centers, that’s just almost unheard of. That can’t happen. Community Health Centers give communities like mine and others hope. And we have to keep hope alive for all,” she said.

Already the media is taking notice of the NACHC report, with headlines in U.S. News and World Report, and California Healthline, and the Washington Examiner. But the real audience that counts for health centers are the lawmakers who will decide a large portion their funding future. As the NACHC P & I conference gets underway, state delegations of health center patients, board members, clinicians and professionals are readying their fact sheets and messages to take to Capitol Hill.

Stay tuned to this blog as we keep you updated on #NACHCPI15.