Recent Efforts to Address the Issue of
Health Center Funding
UPDATED: Friday, February 8, 2019 at 12:00PM
In case you missed it, last Tuesday the Senate HELP Committee
held a hearing entitled "Access to Care: Health Centers and
Providers in Underserved Communities". Four health center witnesses
spoke to the importance of extending and stabilizing funding for
health centers, the National Health Service Corps, and the Teaching
Health Centers program. Their testimony underscored the value of
federal grant funding, as well as workforce programs that are vital
to health centers across the country.
We also wanted to share that in addition to the two bills
already introduced in the Senate (
S. 106 and
S. 192), we are expecting a third bill to be introduced next
week by Senator Bernie Sanders (I- VT). While the details are still
being ironed out, we expect this bill to include a five-year
extension with increases in funding for Community Health Centers
and other key programs. As we've said over the past few weeks, all
of this action and showing of support so early in the new Congress
is truly a testament to the extraordinary work of health center
advocates over the past several years.
GET READY- next week, we'll be sending a Call to Action to ask
you to reach out to your Senators and urge their co-sponsorship of
at least one of these bills. We will provide background information
and a pre-written email; all you have to do is click send!
Click here to read NACHC's Press Release about the Senate
Click here to access the hearing recording, as well as a
copy of the witness testimony.
Click here to read an op-ed by Sen. Lamar Alexander
entitled "Community health centers vital to Tennessee"
UPDATED: Tuesday, January 22, 2019 at 12:00PM
Good afternoon advocates,
We have more good news to share! In addition to the CHIME Act
introduced in the Senate earlier this month (read below
for the original blog post with more information), last week
Senate HELP Committee Chairman Lamar Alexander (R-TN) and Ranking
Member Patty Murray (D-WA) introduced legislation to extend health
center funding, as well as several other health-related programs,
for an additional five years.
What does the Senate HELP bill (
S. 192) mean for health center funding?
Specifically, the bill provides five years of level funding for
each of the following programs:
- Community Health Centers Fund,
- National Health Service Corps,
- Teaching Health Centers Graduate Medical Education
- Special Diabetes Program at the National Institutes of Health,
- Special Diabetes Program for Indians.
As you may know, the Senate HELP Committee has jurisdiction over
the health center program in the Senate, meaning that they will
play a key role in determining what will happen with our mandatory
funding this year. This legislation is a strong showing of support
for the need to extend health center funding well before its
expiration on September 30, 2019, and we're grateful to Senators
Alexander and Murray for their support.
Upcoming Senate HELP committee hearing on health
Next Tuesday, January 29th at 10:00AM ET, the Senate HELP
Committee is holding a hearing entitled "Access to Care: Health
Centers and Providers in Underserved Communities". The hearing will
include four health center witnesses who will speak to the
importance of extended funding for health centers, the National
Health Service Corps, and the Teaching Health Center program.
Given all of these exciting developments, we're putting the
final touches on materials that will allow you to most effectively
connect with your Members of Congress and rally your networks to do
the same. All of this action and showing of support so early in the
new Congress is truly a testament to the extraordinary work of
health center advocates over the past several years.
THANK YOU for all your hard work, and get ready to take action.
We'll be in touch very soon with next steps!
Confidentiality and Medical Records: Do
Special Protections Apply?
Since the 1970s, the Federal Government has required that the
medical records of patients who receive treatment for substance use
disorder (SUD) be given extra protections to ensure
confidentiality. These federal rules - commonly known as 42
CFR Part 2 - have recently been revised, and are more extensive
than the standard protections required under HIPAA.
Given the Health Resources and Services Administration's
(HRSA) recent announcement of the
availability of funds to expand access to substance use disorder
(SUD) and mental health services, health centers are reportedly
concerned about complying with the revised confidentiality rules
that impact medical records for SUD treatment.
First, health centers should note that the 42 CFR Part 2 rules
do not apply to all SUD records; rather, whether they apply depends
on the characteristics of the health
care provider who provided the
SUD services. In general terms, only records generated by
providers who are publicly identified as offering SUD treatment
services are subject to 42 CFR Part 2. According to
the final rule issued in January 2017, health center
providers generally are not
subject to these requirements, as they are viewed as providing
"general medical care."
However, there are two important exceptions: health center
providers (and the SUD treatment records they
generate) are subject to 42 CFR rules
if the provider meets either of the following criteria:
- They "work in an identified unit within [the health
center] that holds itself out as providing, and
provides, substance use disorder diagnosis, treatment or referral
- "the primary function of the provider is substance use disorder
diagnosis, treatment or referral for treatment and they are
identified as providers of such services."
In other words, if a health center provider is publicly
identifiable as a provider of SUD services, either by the unit they
work in or individually, then the medical records they generate are
subject to the 42 CFR protections. This means these providers
are required to obtain patient consent before sharing information
about SUD diagnosis and treatment. Click
here for more information on which health center providers
are subject to 42 CFR Part 2.
The 42 CFR requirements can complicate efforts to coordinate
care for patients who are dealing with SUD. To help address
those problems, the recent revisions made some simplifications to
the consent process; for example, patients can now consent to
sharing with their records with all providers within a specified
group, as opposed to having to name each provider
individually. In addition, some states and providers are
adopting innovative approaches to support ensuring care
coordination while maintaining appropriate confidentiality.
For example, see this
case study of how a community has implemented a standard consent
form. More information on coordinating care for patients
with SUD while adhering to 42 CFR protections is available from
HRSA/ SAMSHA Center for Integrated Health Solutions.
project was supported by the Health Resources and Services
Administration (HRSA) of the U.S. Department of Health and Human
Services (HHS) under cooperative agreement number U30CS16089,
Technical Assistance to Community and Migrant Health Centers and
Homeless for $6,375,000.00. This information or content and
conclusions are those of the author and should not be construed as
the official position or policy of, nor should any
endorsements be inferred by HRSA, HHS or the U.S.
Fact Sheet Highlights the Cost Savings
Health Centers Generate for Medicaid
May 18, 2018
We've always known that
health centers and Medicaid are ideal partners in the effort to cut
health care costs. A host of independent studies, both
statewide and national, have confirmed those findings over the
course of many years. Now a new NACHC
fact sheet based on 2016 federal data showcases
those findings and takes a closer look at the costs of caring for a
large Medicaid population.
Health centers provide care to one in every 6 Medicaid
beneficiaries, but Medicaid payments to health centers make up only
just under two percent of total Medicaid spending.
Meanwhile, health centers are providing affordable access to
preventive care for a large portion of the Medicaid population,
reducing costly visits to hospital emergency rooms. In
fact, health centers save the Medicaid program $6 billion
annually. And a previous landmark study [
see press release] found that in 13 states, health
centers save, on average, $2,371 (or 24 percent) per Medicaid
patient when compared to other providers. In communities
fortunate enough to have a health center, there are lower rates of
hospital utilization among Medicaid beneficiaries who are health
center patients because having a usual source of care ensures they
don't delay getting care until they are very sick.
Caring for Medicaid patients does have its challenges, though.
Nearly half of health center patients (49 percent) rely on
Medicaid, but the amount of Medicaid revenue collected in 2016 only
covered 80 percent of the cost associated with caring for that
population, which puts health centers in a tight financial
squeeze. Adequate Medicaid reimbursement is a key issue for
health centers, as is a strong and robust Medicaid program.