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In this issue:
Primary Intelligence
Member News
Outreach and Enrollment
Advocacy
NC Tracks
State Updates
Federal Updates
Healthcare Headlines
Workforce Development
Funding Opportunities
Group Purchasing
Events and Training





 

Primary Intelligence

 
Notice of Funding Opportunity for Rural Providers: Small Health Care Provider Quality Improvement Program
Applications are due by Monday, April 22.
HRSA recently released a notice of funding opportunity that will support up to 32 public or private nonprofit health care providers located in rural areas to improve patient care in their communities. HRSA expects to invest approximately $6.4 million for this program, which aims to improve the quality of rural health care through an evidence-based approach to primary care that has proven effective in rural areas.
Previously funded organizations under this program designed and carried out projects focused on coordinated care for patients, chronic disease management, integrated care delivery systems, and reduced admissions for emergency rooms and hospitals, among other issues for rural providers. Objectives for this program, which is competitive every three years, include improved health outcomes, better engagement of patients and their caregivers, and continuous improvement to chronic disease management. Grantees also are encouraged to implement quality improvement activities that measure value by outcomes, establish and maintain PCMHs, and integrate behavioral health into the primary care setting.
View the announcement on Grants.gov to learn more.


2019 Patient Target EHBs Notification to Health Centers
Beginning this week, HRSA is sending a tailored email from the Electronic Handbooks (EHBs) to each Health Center Program award recipient with a direct link to the patient target in EHBs. The Program Director should review the patient target and take appropriate action in EHBs by Friday, April 19. Email BPHCPatientTargets@hrsa.gov with questions. A recorded walk-through of the EHBs Patient Target Management Module and Patient Target Frequently Asked Questions are available on the Service Area Competition Technical Assistance (TA) website.


 

Outreach and Enrollment

April SNAP Benefits
NC DHHS continues to work towards getting SNAP households back on their normal benefit issuance schedule, which was disrupted by the federal shutdown earlier this year. Households that receive SNAP benefits between the 1st-11th of the month will receive their April SNAP benefits on their normal cycle. Households that receive benefits between the 12th-21st of the month will receive them on April 12. The regular issuance schedule will resume in May. Help spread the word by posting this flyer (available in English and Spanish) throughout your health center. Please note that SNAP is referred to as Food & Nutrition Services (FNS) in North Carolina.
 
Remind Consumers to Reconcile APTCs
Enrollment assisters should remind consumers to reconcile advanced premium tax credits (APTCs) received in 2018 when they file their taxes. Consumers can reconcile APTCs by using the information provided on Form 1095-A to complete Form 8962. If a consumer has not received Form 1095-A for their 2018 Marketplace coverage, they can log-in to their Marketplace account or call the Marketplace Call Center (1-800-318-2596) to obtain a copy. Consumers who fail to file a 2018 tax return and reconcile APTCs received in 2018 will not be issued PTCs for plan year 2020 until they take action.
 
Penalty Still Applies for Consumers Who Were Uninsured in 2018
Individuals who were uninsured for all or part of 2018 will be subject to a penalty when they complete their 2018 tax return, unless they qualify for an exemption. The penalty amount is a percentage of household income or a flat dollar amount, whichever is greater (see table below and the Tax Year 2018 Reference Guide).
 
Percent of Household Income Flat Dollar Amount
2.5% of income above tax filing threshold $695/adult; $347.50/child
Capped at annual cost of average premium of bronze level plan Capped at $2,085
 
Enrollment assisters can review exemptions individuals may be eligible for, possibly helping them avoid the penalty. The Exemptions Tool on Healthcare.gov, as well as this exemptions worksheet, can be used to assess possible exemptions an individual may be able to claim. The current tax season represents the last year uninsured individuals will be assessed the individual mandate penalty.

 

Member and NCCHCA News

Triad Adult and Pediatric Medicine’s (TAPM) - 2nd Annual Friends of TAPM Brunch featuring Merle Green, Director of Guilford County Department of Public Health as our Keynote Speaker and the inaugural Dr. Stewart and Betty Rogers Award. Thursday, April 25, 2019 | 8:30am-11:00am | The Conference Center at GTCC – Oak Ridge Room| 7908 Leabourne Road, Colfax, NC, 27235.  For more information go to friendsoftapmbrunch.eventbrite.com
 
The Seventh Annual Lincoln Community Health Center Foundation Legacy Award Luncheon Honoring Dr. Oveta McIntosh-Vick and Dr. Veronica Ray, Friday May 10, 2019 at the Washington Duke Inn and Golf Club, Durham, NC. Lincolnchcf.org

 

Advocacy

Take Action! Ask Congress to Support Health Center Funding
Thank you for being a supporter of North Carolina's Community Health Centers.
Did you know all the federal funding for CHCs (24% of our budgets) expires on September 30, 2019? Federal funding enables health centers to provide primary care and other services to uninsured and underinsured people across North Carolina. Our CHCs need YOU to contact your member of Congress and ask them to reauthorize our funding.
 
Today, please ask your member of Congress to sign a "Dear Colleague" letter--a letter from members of Congress to committee leaders--to Chairwoman Rosa DeLauro and Ranking Member Tom Cole urging the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies to provide robust funding for the Health Center Program in Fiscal Year 2020.
Click here to ask our Senators to cosponsor Community Health Center legislation



Join NCCHCA for Capitol Hill Visits on March 28!
More than 70% of Community Health Center funding expires on September 30, 2019. Be sure your Congressional delegation is aware of what that will mean and the actions they need to take to prevent health centers from losing funding Join NCCHCA for Capitol Hill Visit Day (March 28, 2019). Come talk with our elected officials about the important services you are providing to your communities and explain why Congress should renew mandatory Community Health Center funding. Please fill out this form to let us know which staff/board members/patients from your health center will be joining us for the preparation meeting on March 27th at 5:45pm and the visits on March 28th.



 

NC Tracks

Is It Time for Your Re-verification Application? 
It's already been five years since the implementation of NCTracks, which means there are many providers who will need to complete re-verification over the next few months. If you haven't received a re-verification notification in your Message Center Inbox yet, you may be seeing it soon. To find your re-verification date, go to the NC Division of Medical Assistance (DMA)'s list of the providers who are due for re-verification in 2018 under 'Recredentialing' on the DMA Provider Enrollment webpage
 
Be sure to check your email and NCTracks Provider Portal for reminders on useful resources and tips for completing your application. To learn more, visit the Re-verification/Re-credentialing FAQs page today.

NCTracks Provider Announcement and Newsletters
Join NCTracks’ Email List

 

State Updates

North Carolina Medicaid Special Bulletin
Provider Transition to NC Medicaid Managed Care 101
Thursday, March 28, 2019 12 – 1 pm.
NC Medicaid will launch a webinar series to support providers and practices during their transition to NC Medicaid Managed Care. “General” webinars are overviews of significant changes and features of the managed care program. “Topical” webinars are in-depth reviews of specific managed care topics. The first webinar in this series, Provider Transition to NC Medicaid Managed Care 101, is an overview of the state’s transition efforts and includes the vision and background for the transition to a managed care system, an overview of key initiatives, and a closer look at managed care and engagement from a provider perspective.
Registration is required. A recording of each webinar, including a summary of the questions and answers shared during the session, will be posted to the Medicaid website.

Office of Rural Health Stakeholders Meetings on NC J-1 Visa Waiver and Provider Loan Repayment & Incentive Programs.
The NC Office of Rural Health (ORH) is hosting several stakeholder meetings across NC to gather Stakeholder input regarding our J-1 Visa Waiver program and NC’s Loan Repayment and Incentive Programs. They need your help in shaping ORH programs to recruit and retain medical providers for rural and underserved areas in NC.  ORH’s Loan Repayment programs include the NC Loan Repayment (NCLRP) and the State Loan Repayment (SLRP) programs. ORH incentive program includes the High Needs Service Bonus (HNSB). ORH administers each of these programs. At the meetings, ORH will review key priorities and requirements for each program.  The purpose of the stakeholder meetings is to gather information and feedback regarding the current processes and possible program modifications to ensure maximum benefits to rural NC communities. Attendance is welcome to any or multiple meetings regardless of location.
Remaining meetings include:
March 28 Thursday Anson Community Hospital
Wadesboro, Anson County
1:00 PM – 4:30 PM
April 4 Thursday Madison County NC Cooperative Extension, Marshall, Madison County 1:00 PM – 4:30 PM
 
Registration for the meeting is requested. Please register attendee names(s) to: Karen Gliarmis, ORH Recruiter at karen.gliarmis@dhhs.nc.gov or call 919-527-6452 for more information.
 
Did you Miss the NC Medicaid Managed Care FQHC/RHC Payment Guidelines Webinar?
Email Kristen Dubay if you missed this webinar focused on how federal protections for FQHC/RHC PPS payments will be maintained under North Carolina Medicaid managed care. Slides and a webinar recording are available.

 

Federal Updates

Emergencies Happen: What Health Centers Need to Know
Recent severe weather across the U.S. is a reminder that emergencies can impact health centers at any time. Health centers and NCCHCA, a PCA, play a critical role in providing services and resources before, during, and after emergency events. During emergencies, NCCHCA gathers critical health center information and report the status of service delivery sites to HRSA. For health centers in impacted areas, HRSA asks that you report site-level status to your NCCHCA as soon as you are able. Project Officers are available if health center staff have questions about program requirements or scope of project. Please also visit the HRSA Health Center Program Emergency Preparedness and Recovery Resources website for information about change in scope for temporary sites, 340B program enrollment under emergency declarations, and FTCA coverage during emergencies.
 
Information on Auto-HPSA updates available on NACHC and HRSA websites:  The auto-HPSA Update Preview 4 Report was sent to health centers last week.  If you have concerns about the accuracy of data used in the scoring contact Mark Snuggs at the NC Office of Rural Health mark.snuggs@dhhs.nc.gov. Once finalized, these new scores will become effective for the 2020 NHSC recruiting year. Both NACHC and HRSA have information on their websites about how and why the scores are being updated, and how to interpret preliminary estimates.  The NACHC Shortage Designation website contains FAQs, a background memo, and a recording of a NACHC webinar discussing the auto-HPSA changes.  The HRSA website contains general information about the Shortage Designation Modernization Project.  The NC Office of Rural Health is the immediate contact regarding preliminary HPSA scores however NCCHCA can facilitate with the process of collecting correct data for your county/area.  You may direct your general questions about the process to Sharon Brown-Singleton at NCCHCA.
 
New FTCA Site Visit Protocol
FTCA-deemed health centers are already familiar with FTCA site visits. Now we have streamlined the process into one document, the FTCA Site Visit Protocol, to help you find the information you need.

 

Healthcare Headlines

State

Medicaid expansion: The pros and cons
About one in six Randolph County residents under the age of 65 have no health insurance, according to a study from the Robert Wood Johnson Foundation. The care of those uninsured individuals strains resources People without insurance also go to MERCE Family Healthcare in Asheboro. MERCE provides medical and dental services regardless of a patient’s ability to pay. Copays are charged based on income. “For uninsured patients in Randolph County, there are very few resources,” MERCE CEO Teresa Shackleford said. “We serve the working poor of Randolph County. There’s a misperception out there.” The majority of MERCE’s uninsured patients, Shackleford said, would qualify for government insurance if Medicaid, which covers many low-income residents, was expanded in North Carolina.

For NC Poor, High Housing Cost Puts Healthy Lifestyle Out Of Reach
A lack of affordable housing drives down health and keeps North Carolinians in poverty, according to the latest annual County Health Rankings & Roadmaps, released today by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Among North Carolina children living in poverty, 49 percent were living in a household that spends more than half of its income on housing, according to the report, which makes other healthy lifestyles out of reach.

National
Why The Promise Of Electronic Health Records Has Gone Unfulfilled
A decade ago, the U.S. government claimed that ditching paper medical charts for electronic records would make health care better, safer and cheaper. Ten years and $36 billion later, the digital revolution has gone awry, an investigation by Kaiser Health News and Fortune magazine has found.

1 big thing: Work requirements aren't boosting work
When Arkansas became the first state to enforce work requirements in its Medicaid program, thousands lost their coverage. Most of those people haven't found jobs, according to an analysis of state data by the Center on Budget and Policy Priorities, and are still uninsured.

Health Plans For State Employees Use Medicare’s Hammer On Hospital Bills
States. They’re just as perplexed as the rest of us over the ever-rising cost of health care premiums. Now some states are moving to control costs of state employee health plans. And it’s triggering alarm from the hospital industry. The strategy: Use Medicare reimbursement rates to recalibrate how they pay hospitals.  If the gamble pays off, more private-sector employers could start doing the same thing. “Government workers will get it first, then everyone else will see the savings and demand it,” said Glenn Melnick, a hospital finance expert and professor at the University of Southern California. “This is the camel’s nose. It will just grow and grow.”




 

Funding Opportunities

RFP to increase physician awareness and practices to prevent, detect, and control hypertension among priority populations
Proposals due March 30th, 2019.
The American College of Preventive Medicine (ACPM) will fund up to six health care organizations/practices to develop and implement protocols to prevent, detect, and control hypertension among African-American men ages 35-64 using data. Awards will begin in the spring of 2019 and have the opportunity to last for up to 3 years dependent on federal funding and successful completion of initial work. These demonstrations projects are funded by a grant from the Division of Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention. More information can be found here: https://www.acpm.org/page/hypertensionawardproposals

SAMHSA: Substance Use Disorder Treatment for Minorities at High Risk for HIV/AIDS
April 22.  The Substance Abuse and Mental Health Services Administration (SAMSHA) will make 24 awards of up to $500,000 each to increase engagement in care for racial and ethnic minority individuals with substance use disorders, and/or co-occurring substance use and mental disorders, who are at risk for HIV or are receiving HIV services and treatment.  Eligible applicants include state, local and tribal governments, public and private universities and colleges, and community- and faith-based organizations.  Racial and ethnic minority populations make up only 15 percent of the rural population, but approximately 62 percent of people living with HIV/AIDS in rural areas are minorities.

Rural Communities Opioid Response Program-Implementation (RCORP-Implementation)
May 6.  The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy (FORHP) will be making approximately 75 awards of up to $1 million each to rural communities to enhance service delivery for substance use disorder, including opioid use disorder. Over the course of a three-year period of performance, grant recipients will implement a set of core prevention, treatment, and recovery activities that align with the U.S. Department of Health and Human Services’ Five-Point Strategy to Combat the Opioid Crisis.  Award recipients are strongly encouraged to leverage workforce recruitment and retention programs such as the National Health Service Corps (NHSC).  All domestic public and private entities, nonprofit and for-profit, are eligible to apply and all services must be provided in HRSA-designated rural areas (as defined by the Rural Health Grants Eligibility Analyzer).  The applicant organization must be part of an established network or consortium that includes at least three other separately-owned entities.  At least two of these entities must be located in a HRSA-designated rural area.  FORHP will hold a 90-minute webinar for applicants on Wednesday, March 27, 2019 from 11:30-1:00 pm ET.  A recording will be made available for those who cannot attend.  For the webinar dial-in and playback information,  please reference page (ii) in the Notice of Funding Opportunity on Grants.gov.  (Click “Preview” on the Package tab, and then “Download Instructions”.)  Contact ruralopioidresponse@hrsa.gov with questions.
 
 
All other funding opportunities are listed on our website, here.

 

Workforce Development

STAR² CENTER SELF-PACED COURSES
The STAR² Center has added new interactive self-paced online courses to our growing catalogue of resources and training opportunities for health center workforce teams looking to enhance their recruitment and retention efforts. Take some time today to  set up your learner account and review our new "Administrative Strategies for Increasing Retention" course.  Click here to view a brief overview of how to access and register to complete these courses and be sure to reach out to Mariah Blake with any questions.


Become a Vital Part of North Carolina’s Safety Net!
Community Health Centers are a unique, growing area of the health care industry. Community Health Centers offer many dynamic career opportunities for dedicated individuals who want to make a difference in their communities. You will also find postings for careers within the North Carolina Community Health Center Association (NCCHCA) whose mission is to promote and support patient-governed community health care organizations and the populations they serve. Visit our website to see open positions and to post opportunities.


 

NCCHCA Group Purchasing Organization


The NCCHCA Group Purchasing Organization provides a shared savings model for NC Community Health Centers. NCCHCA members may participate at no cost and can save a significant amount of money on items, such as medical/dental supplies and equipment. Thank you to our current partners: LabCorp, Toshiba Business Solutions, and Community Health Ventures (VIP). Contact Chris Shank for more information.
 

Events and Training

2019 Convergence Telehealth Summit, March 31 - April 2, 2019
The Mid-Atlantic Telehealth Resource Center (MATRC) is offering free pre-sessions on Sunday, March 31st which may be of interest to Community Health Centers. Topics for 3/31 include:
  • 2:00-4:15pm, Telehealth in Community Health Centers
  • 3:00-6:00pm,
  • 4:30-5:30pm, Post-Acute Care Management and Remote Patient Monitoring 101
Williamsburg Lodge, Williamsburg, VA, http://matrcsummit.org/

Coming Together for Rural Resiliency
The NC Agromedicine Institute is partnering with NC Cooperative Extension to conduct a one day workshop "Coming Together for Rural Resiliency" in 4 locations across the state. We invite anyone who is interested in working together to address farm stress to come learn more and help us best respond to this important public issue.  Workshops and lunch are all provided at no cost. If you are a community organization that provides behavioral health or other support to farming and rural communities and you would like to have a table to share resources with participants, please let us know. More details on the attached flier.
  • learn about causes & effects of escalating farm & rural stress
  • share or learn about existing resources to support farm families & other rural residents experiencing stress
  • share your ideas as to what strategies are needed to address farm & rural stress
  • participate in ‘Talk Saves Lives’: A presentation that covers the general scope of suicide, the research on prevention, and what people can do to fight suicide
Dates and locations:
  • April 8, 2019: Edenton Baptist Church, 200 S Granville Street, Edenton, NC 27932
  • April 11, 2019: NC Cooperative Extension–Duplin County Center (Lois Britt Agriculture Service Center), 165 Agriculture Drive, Kenansville, NC 28349
  • April 15, 2019: Mountain Horticultural Crops Research and Extension Center, 455 Research Drive, Mills River, NC 28759
  • April 29, 2019: NC Cooperative Extension – Forsyth County Center, 1450 Fairchild Road, Winston Salem, NC 27105
Registration is free. To register: call the NC Agromedicine Institute at 252.744.1008 or email agromedicine@ecu.edu . Be sure to indicate the date and location of the meeting you plan to attend.

Diabetes in Special & Vulnerable Populations: A National Learning Series
Fourteen HRSA-funded National Cooperative Agreements (NCAs) have partnered to create a four-part national learning webinar series for health centers, PCAs, and Health Center Controlled Networks (HCCNs). The series’ goal is to increase foundational knowledge of effective strategies to prevent, treat, and manage diabetes among special and vulnerable Health Center Program populations. It focuses on co-morbidities associated with diabetes (e.g., oral health, behavioral health, SUD, obesity, and social risk factors).
Diabetes Continuum of Care: Using Behavioral Health and Substance Use Disorder Integration to Address Older Adults with Cognitive Impairments and Diabetes
Tuesday, April 9
2:00-3:30 p.m. ET
Learn more and register for individual webinars.
 
2019 NCCHCA Clinical Conference on Quality and Chronic Disease
April 11-12, 2019
Chapel Hill, NC
The Clinical Conference on Quality & Chronic Disease is a professional training opportunity providing continuing education at a low cost. Nationally recognized health care experts share knowledge with safety-net providers on cutting-edge trends and quality improvement methods. Registration open!

Healthy Eating Active Living (HEAL) Convening
May 2-3
Goldsboro, NC
This convening is designed for nonprofit and faith-based organizations who are interested in learning creative ways to develop programming around healthy eating, active living or who want to enhance programming they are already doing. They provide spots for agency representatives as space permits.  Anyone who’s interested can learn more at the event Facebook page at www.facebook.com/resourcefulcommunities.
 
 
 
National Center for Medical-Legal Partnership Summit
Request for Workshop Proposals
Deadline: May 13, 2019
The National Center for Medical-Legal Partnership is accepting workshop proposals for their upcoming Summit, scheduled for September 19-20, 2019 in National Harbor, MD. Individuals do not need to work with a medical-legal partnership in order to present a workshop at the Summit. Preference will be given to proposals that take a layered approach and include a broad range of perspectives. Preference will also be given to proposals that include consumer presenters. Full tuition and travel scholarships are available for consumers who present workshops. Learn more about submitting a workshop proposal.   
 
Registration Open: Federal Tort Claims Act (FTCA) University
May 15-16, 2019
Asheville, NC
Hosted by the North Carolina Community Health Center Association and presented by the Health Resources and Service Administration, the Federal Tort Claims Act University (FTCAU) is an innovative training offered to members of the health center community. FTCAU provides a great opportunity for seasoned quality and risk management professionals and new professionals to learn from experts, leaders, and government officials about FTCA, healthcare quality and risk management, and related subjects. Over the course of two days, attendees will participate in interactive presentations and exercises that are specially geared toward health center grantees. 
Who should attend?
  • Quality Improvement Coordinators
  • Risk Managers
  • Board Members
 
Save the Dates: Oral Health and Primary Care Integration for People Living with HIV
HRSA will host a two-part webinar series on oral health and primary care integration to support people living with HIV. The strategies we will cover are designed for all HRSA recipients serving people living with HIV regardless of whether the organizations deliver oral health care directly, refer out for all services, or are somewhere in between. We’ll share registration information when it becomes available.
  • Assessing Risk and Providing Basic Services at Primary Care Settings
    Thursday, May 23
    2:00-3:00 p.m. ET
  • Connecting Clients to Oral Health Services
    Thursday, June 6
    2:00-3:00 p.m. ET
 
 
Save the Date: 2019 NCCHCA Primary Care Conference
June 26-28, 2019
Renaissance Asheville Hotel
31 Woodfin Street
Asheville, NC 28801
Registration Opening Soon.
 
10th Biennial Childhood Obesity Conference
July 15th - 18th
Anaheim, CA
Click here for more information

Please save the date for the
Fourth Annual John W. Hatch FaithHealth Lecture
December 3, 2019
Shaw University—Raleigh, North Carolina

 
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