Congress Comes Home Part II- To Iowa, California, Minnesota, and Washington

Since our last  “Congress Comes Home”  blog, we have had more and more health centers share stories of their recent Member visit(s). HUGE thank yous to those who’ve already shared their stories! Inviting a Member of Congress for an in-person visit is a great advocacy tool and a great way to strengthen a relationship that could potentially last for decades. Keep in mind that next week, from May 30th to June 3rd, both House and Senate will be out of session so right now is a great time to reach out. Here are short excerpts from a few health center experiences so far this year:


In mid- February, Congressman Rod Blum (R-IA) visited Eastern Iowa Health Center and Congressman David Loebsack (D-IA) visited both Community Health Centers of Southeastern Iowa and River Hills Community Health Center. These visits were scheduled when the House was out of session. To coordinate efforts, the health centers notified the Iowa Primary Care Association of the visits who then relayed the information to NACHC.

Tip #1 and #2: Be sure to let NACHC and your state’s PCA know about the health center visit ahead of time. They can provide you with background information on the Member as well as help compile any statistics or information needed to illustrate your concerns. Feel free to email federalaffairs@nachc.org for some up-to-the-minute insight.  Also, check the 2016 Congressional calendar to see when your Member is likely to be back home in the district. Friendly reminder that the next recess is May 30th to June 3rd. Don’t forget 2016 health center visits by your Rep., Senator, and/or delegate are one criteria used to determine 2017 NACHC Congressional Awards.


In April, Congresswoman Betty McCollum (D-MN) organized a roundtable discussion with various community leaders regarding health disparities within the Asian American and Pacific Islander community at United Family Medicine in St. Paul, Minnesota. Participants involved included the Minnesota Association of Community Health Centers, MN Department of Health, St. Paul-Ramsey County Public Health, and Council of Asian Pacific Minnesotans. The discussion was featured in Congresswoman McCollum’s newsletter as well as posted on her Twitter account.

Rep. McCollum with United Family Medicine and other community partners to discuss health equity.

Rep. McCollum with United Family Medicine and other community partners to discuss health equity.

Tip #3 and #4: Inviting a member to your health center doesn’t always have to mean you conduct a tour. It can also include community events, like this roundtable discussion with stakeholders. This is an opportunity to address your concerns or current issues or barriers impacting your community’s access to healthcare. However, make sure to work with the Member’s office to ensure an appropriate amount of time for the event. If possible, coordinate with the Member’s communications staff when posting on social media (Twitter, Facebook, etc.).


On April 28th, Family HealthCare Network (FHCN) celebrated the opening of their newest Community Health Center in Traver, CA. In attendance were local government and school leaders, a field representative from Congressman Devin Nunes’ office (R-CA), FHCN board and staff, and Traver community members. Not only did they celebrate with a ribbon cutting but also conducted guided tours of the new health center, and had live entertainment on hand from students of Traver Elementary School’s band and folkloric dance team. Sounds like a fun time!

FHCN Traver Grand Opening Ceremony

FHCN Traver Grand Opening Ceremony. Photo courtesy of Family HealthCare Network.

Tip #5, #6 and #7: There are elected officials at multiple levels of government who have a stake in the healthcare system so it is beneficial to make an effort to build relationships with all elected officials. The more the merrier. In addition, add some fun activities to the schedule and demonstrate how essential your health center is to the surrounding community. Also, create and publicize a press release of the event to attract more attention from local media and community members.


Earlier this month, Senator Maria Cantwell (D-WA) visited Community Health Association of Spokane’s (CHAS) Health’s Maple Street Clinic where she held a press conference with a fellow WA state representative to urge Washington to implement the Federal Basic Health Plan and afterwards toured the facility. Combined CHAS and Senator Cantwell’s office did a fantastic job of disseminating the event via Facebook, Twitter, press releases, and blogs. To keep the conversation flowing, CHAS staff made sure to invite Senator Cantwell and her staff to visit again in the near future, especially during the August recess and National Health Center Week (NHCW).

CHAS Health's blog post on Senator Cantwell's visit. Photo courtesy of CHAS Health.

CHAS Health’s blog post on Senator Cantwell’s visit. Photo courtesy of CHAS Health.

Tip #8 and #9: Do your best in promoting the visit(s) via social media, blogs, press releases etc. If you would like some technical support, please feel free to reach out to us at NACHC. We have lots of helpful resources at your fingertips. Invite your member to visit in August, particularly during National Health Center Week  (August 7th through 13th). Friendly reminder that the whole month of August, both chambers will be out of session meaning they should be back in their states and districts. This year’s theme is “Celebrating America’s Health Centers: Innovators in Community Health.” Time to shine and show off the innovative programs and services your health center provides in order to meet the unique needs of your community. Sky’s the limit!


Lastly, late last year Congressman Jim Costa (D-CA) visited Livingston Community Health’s (LCH) Hilmar Health Center in Hilmar, California. Rep. Costa congratulated and commended LCH staff on establishing their dental center. LCH has built a strong, positive relationship with Rep. Costa as he visits the three locations often.

Rep. Costa with Hilmar Health Center staff. Photo courtesy of Livingston Community Health.

Rep. Costa with Hilmar Health Center staff. Photo courtesy of Livingston Community Health.

Tip #10: Be flexible with your time requests. Members’ schedules can change, length of recesses differ, and things come up so make sure to allocate more than enough time during the visit. As the visit approaches, keep in contact with Member’s office for any updates or changes with his or her schedule.


For more how-to’s on inviting your Member of Congress and meeting tips, visit our Grassroots Advocacy website or email federalaffairs@nachc.org.  Don’t forget, August 7th through 13th is National Health Center Week (NHCW) and another opportune time to invite your member to tour your health center.

Do you also have a story to share? What tips and tricks have you learned in the process of scheduling and organizing Congressional visits? Do you alert the local press or utilize social media? Let us know by emailing your story, photos if available, and tips for fellow health centers to federalaffairs@nachc.org.

Senate Moving Forward With Zika Package

By: Michaela Keller

Last week, the Senate announced a bipartisan agreement to provide $1.1 billion in emergency funding to combat the Zika virus. This agreement, brokered by Senators Roy Blunt (R-MO) and Patty Murray (D-WA), will be one of three Zika funding amendments offered during debate on an unrelated appropriations bill, scheduled to begin on Tuesday.  The amendment includes several provisions of interest to health centers .

The Senate proposal includes $51 million in resources for HRSA: $40 million for Health Centers in Puerto Rico and other territories; $6 million for National Health Service Corps placements and loan repayment in Puerto Rico and other territories; $5 million for Maternal and Child Health Block Grant funds to Puerto Rico and other territories.

On Monday, the House Appropriations Committee, led by Chairman Hal Rogers (R-KY), introduced legislation to provide $622.1 million to respond to the Zika virus through the duration of the current fiscal year, or until the end of September. The House proposal does not call for funds to HRSA. The funding is offset by repurposing $352.1 million from unobligated and unspent resources left over from the Ebola outbreak in 2014 and $270 million in unused administrative funding within HHS. Floor action on the bill is expected later this week.

Congress Comes Home – to Michigan, Texas, Indiana, and Massachusetts

Throughout the past month, NACHC’s Washington Update has featured a new item called “Congress Comes Home: Health Center Visits with Members of Congress” asking health centers to highlight recent visits by Members of Congress. Below we highlight a few recent visits. Inviting a Member of Congress for an in-person visit is a great advocacy tool and a great way to strengthen a relationship that could potentially last their entire time in Congress. Here are quick excerpts from a few health center experiences so far this year:

In February, Congressman John Conyers Jr. (D-MI) visited Western Wayne Family Health Center (WWFHC) in Inkster, Michigan. As a longtime advocate for community health centers, Rep. Conyers was already aware of the comprehensive services provided at WWFHC, however with the growing opioid epidemic, the Congressman specifically wanted to hear more about what was happening on the ground. WWFHC also hosted a congressional staffer from Senator Debbie Stabenow’s office.

 

Rep. Conyers at Western Wayne Family Health Center in Inkster, Michigan

Rep. Conyers at Western Wayne Family Health Center in Inkster, Michigan

Tip #1 and #2:  Contact the member’s congressional offices (both in DC and district). Inviting and building a relationship with health staffers is very important as they have their member’s ear. Also, know what the hot issues are on the hill. You can do that by visiting this blog or simply email federalaffairs@nachc.org for some up-to-the-minute insight.

On Thursday March 31st and during recess, Congressman Pete Olson (R-TX) visited AccessHealth’s main health center in Richmond, Texas. He spent an hour touring the health center as well as speaking with staff on current projects and concerns about issues affecting FQHCs. Congressman Olson was thanked for signing FY2017 Community Health Center Dear Colleague Letter and for his continued support. AccessHealth made sure to post photos and a quick description of the visit to their Facebook page.

Rep. Olson at AccessHealth in Richmond, Texas

Rep. Olson at AccessHealth in Richmond, Texas

Tip #3 and #4: Make sure you are up to date with your member’s actions. For example, did he or she sign our most recent Dear Colleague letter? You can find that out on our website www.nachc.com/federal or simply by emailing federalaffairs@nachc.org. Also, be sure to promote the visit on your health center’s social media accounts (Twitter, Facebook, etc.). If possible, coordinate coverage with member’s communications staff so they can post on their website too.

On Friday April 1st and during recess, Tulip Tree Family Health Care in Fort Branch Indiana hosted Congressman Larry Bucshon (R-LA). Congressman Bucshon toured the clinic and later discussed healthcare issues with Tulip Tree Leadership and Board Members. Tulip Tree Family Health Care invited both the Princeton Daily Clarion and South Gibson Star Times to help publicize the event.

Rep. Bucshon at Tulip Tree Family Health Care in Fort Branch, Indiana

Rep. Bucshon at Tulip Tree Family Health Care in Fort Branch, Indiana

Tip #5 and #6: Invite local newspapers and/or media for the congressional health center visit. Again if possible, coordinate coverage with the member’s staff. Also, remember to check the Congressional calendar to see when your member is likely to be back home in the district.

On Friday April 8th and during House recess, Congressman Jim McGovern (D-MA) visited Family Health Center of Worcester’s (FHCW) School-based Health Center at South High Community School (SHCS) in Worcester, Massachusetts. He spoke with both the school and clinic staff about how FHCW and SHCS coordinated their efforts. At the health center, students are able to talk with health care providers about issues like mental health, homelessness, and hunger. In response, the school set up a community supported food pantry for students and their families.

Rep. McGovern at Family Health Center of Worcester's School Based Health Center

Rep. McGovern at Family Health Center of Worcester’s School Based Health Center at South High Community School. Photo by MassLive.

Tip #7: Show off your health center’s innovative programs that meet the needs of your community. Each health center is unique so let your Member know!

For more how-to’s on inviting your Member of Congress and meeting tips, visit our Grassroots Advocacy website. For NACHC’s 2016 Congressional Calendar, refer here. Don’t forget August 7-13 is National Health Center Week (NHCW) and an opportune time to invite your member to tour your health center.

HUGE thank yous to those who’ve shared the stories of recent Member visits. Do you also have a story to share? What tips and tricks have you learned in the process of scheduling and organizing Congressional visits? Do you alert the local press or utilize social media? Let us know by emailing your story, photos if available, and tips for fellow health centers to federalaffairs@nachc.org. And don’t forget: 2016 health center visits by your Representative, Delegate, and/or Senator are one criteria used to determine 2017 NACHC Congressional Awards!

House Appropriations Committee Releases LHHS Allocation for FY17

Last week, the Senate Appropriations Committee moved forward with the formal process of considering the Fiscal Year (FY) 2017 appropriations bills by releasing specific funding levels for each of the 12 appropriations bills. Typically, the House and Senate passed budget resolution would establish the total discretionary funding levels for the Appropriations Committee in both the House and Senate. This year, as outlined in a previous blog post here, the House and Senate have been unable to come to agreement and pass a budget resolution. In the absence of a formal budget resolution, both chambers are moving forward with consideration of their FY2017 appropriations bills by using the total discretionary funding level outlined in the two year budget deal, the Bipartisan Budget Act (BBA), Congress passed with President Obama’s approval last year.

The Senate divvied up the total discretionary allocation amongst the 12 appropriations bills including the Labor, Health, Human Services (LHHS) bill that includes annual funding for health centers. The total spending level, known as the 302b allocation, provided for the LHHS bill by the Appropriations Committee is $161.9 billion. In FY2016, the 302b allocation for the LHHS bill was $162.127 making the FY2017 level slightly lower than the previous fiscal year. The House has not yet released their 302b for the LHHS bill.

Health Centers along with all other programs funded out of the LHHS bill will be competing for funding out of the $161.9 billion provided in the Senate in FY2017. Given the funding level is lower than FY2016 and well below pre-sequestration levels, the threat of funding reductions looms.  That’s why our FY2017 health center support letters are so critical to demonstrating support for the program amongst both Senate and House members and we are thankful for the record levels of bipartisan support we received on the Wicker-Stabenow and Green-Bilirakis letters.

As both the Senate and House move forward with the appropriations process, we have submitted written testimony from Dan Hawkins, Senior Vice President for Policy and Research explaining the health center FY2017 appropriations request. This testimony is viewed by the members of the LHHS Subcommittee and their staff and is something they take into consideration when drafting the LHHS bill. Copies of both the House and Senate testimony can be viewed here.

The LHHS bill is often the last bill to move through the process because it is often heavily debated and the most difficult bill to pass. It is possible the Subcommittee may not take up the bill until this summer. As consideration of the FY2017 appropriations process moves forward, we will continue to post updates through both Health Centers on the Hill and the Washington Update.

Taking on the Opioid Epidemic

By: Jennifer Taylor

In our last behavioral health blog post back in November, we filled you in on a few key mental health bills under consideration by Congress, namely H.R. 2646, the Helping Families in Mental Health Crisis Act (Rep. Tim Murphy, R-PA) and S. 1945, the Mental Health Reform Act of 2015 (Sen. Chris Murphy, D-CT and Sen. Bill Cassidy, R-LA). While both bills continue to serve as the foundation for conversations about mental health reform in Washington, Congress has more recently concentrated its efforts on grappling with opioid abuse.

In the last 15 years, deaths from prescription painkillers have quadrupled in America, evidence of a “prescription painkiller overdose epidemic” according to the Centers for Disease Control and Prevention (CDC). Members of Congress are hearing horror stories of opioid overdoses from constituents across the country, and many feel compelled to take action. Since January there have been several hearings in both the House and Senate that explored the topic of opioid addiction, and it seems likely that any final behavioral health reform package that receives a vote in Congress will include proposals related to opioid abuse.

President Obama’s FY17 budget included $1.1 billion to combat the opioid abuse epidemic, and while Congress may not heed much of his budget request, they are exploring similar approaches in the more than 50 opioid-related bills that have been introduced in Congress this session. These bills propose to address the problem from a wide variety of perspectives, including addiction prevention, provider prescribing practices, drug treatment programs, and criminal justice reform.

The Senate acted first, and is expected to pass S. 524, the Comprehensive Addiction and Recovery Act (CARA) (Sen. Sheldon Whitehouse, D-RI and Sen. Rob Portman, R-OH) with strong bipartisan support this week. This bill would redirect about $78 million in existing funding and authorizations for substance abuse prevention and treatment programs to address the opioid epidemic through a combination of prevention, treatment, and recovery efforts. While the bill is widely supported, many Senators expressed concern that it relies on limited existing funding streams and pressed for additional new funding to fight the epidemic. Ultimately the Senate rejected an amendment from Senator Jeanne Shaheen (D-NH) to add $600 million in emergency FY16 supplemental appropriations for the Department of Health and Human Services and the Department of Justice to address heroin and opioid drug abuse. It remains to be seen whether new funding might be included in future bills under consideration later this year.

The Senate’s work on this issue is far from over, with two new draft bills being released just this week and set to be considered in the Senate HELP Committee at a hearing on March 16. On March 7, the first of the two bills was released – a bipartisan discussion draft based on the earlier mental health reform bill released by Senators Murphy and Cassidy. This new version of the bill, the Mental Health Reform Act of 2016, includes provisions designed to improve coordination between federal agencies and evaluations of mental health programs, updates federal block grant funding, promotes evidence-based treatment practices, and targets increased access to mental health care for veterans, women, children, and homeless individuals.

The second new bill set to be released this week will contain additional provisions related to opioid abuse, the details of which have not been shared yet. No matter what that draft bill contains, with so many different ideas being discussed it is likely that Senators will want to offer amendments to try to advance their own legislation. Some Senators are focusing their efforts on bills such as S. 1913, the Stopping Medication Abuse and Protecting Seniors Act (Sen. Pat Toomey, R-PA and Sen. Sherrod Brown, D-OH), which would allow Part D drug plans to implement patient review and restriction (PRR) programs, also known as “lock-in” programs, to lock certain Medicare recipients into one prescriber and one pharmacy to help manage potential addiction. Other widely discussed bills seek to improve the distribution of naloxone, an effective overdose reversal medication, or to change federal restrictions around prescribing for opioid replacement medications used as part of Medication-Assisted Therapy (MAT) for addiction. We’ll keep an eye on all of these bills as the legislative process continues to unfold.

While the Senate is currently driving much of the conversation, House conversations about behavioral health reform are also starting to pivot to opioid abuse. After expressing frustration with the process around mental health reform legislation in the House, Energy and Commerce Democrats led by Representatives Gene Green (D-TX) and Doris Matsui (D-CA), released H.R. 4435, the Comprehensive Behavioral Health Reform and Recovery Act, an alternative to Rep. Tim Murphy’s mental health bill (H.R. 2646), that includes several similar provisions but also makes key changes relative to the structure and function of the Substance Abuse and Mental Health Services Administration (SAMSHA), patient privacy language, and assisted outpatient treatment programs. The Democratic bill carries over several key provisions for health centers, including same-day billing for Medicaid mental and physical health visits and an extension of FTCA medical liability coverage to Health Center volunteer providers, while adding an emphasis on early intervention as well as several provisions to address opioid abuse, including provider prescribing practices.

NACHC is continuing to engage with Members of Congress and their staff on mental and behavioral health reform proposals, including those specific to opioid abuse, as well as to work with health center behavioral health experts to better inform Congressional action in the coming months. We’ll keep you updated on the next steps in Congress, but in the meantime we’d love to hear about innovative work around behavioral health and opioid abuse at your health center – please share your thoughts with NACHC Federal Affairs staff at federalaffairs@nachc.org.