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�CONNECTING THE DOTS..NEWS YOU CAN USE�NICOLE LAMOUREUX�NAFC CEO AND PRESIDENT�

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NAFC MISSION: To ensure the medically underserved have access to affordable quality health care

NAFC VISION: To be a national voice promoting quality health care for all

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Health insurance doesn’t always equal access

We are health care change agents

We have chosen this challenge

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CONGRESS

PRESIDENT

PATIENTS

PROVIDERS

SAFETY NET ORGANIZATIONS

PHARMA

INSURANCE COMPANIES

REGULATIONS

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CONGRESS

PRESIDENT

PATIENTS

PROVIDERS

SAFETY NET ORGANIZATIONS

PHARMA

INSURANCE COMPANIES

REGULATIONS

TWITTER

FACEBOOK

CONGRESSIONAL HEARINGS

MEDICAID EXPANSION

PATIENTS LOSING MEDICAID

MEDICATION AFFORDABILITY

HOSPITALS

MID-TERM ELECTIONS

SUPREME COURT HEARINGS

24-HOUR NEWS CYCLES

APPROPRIATIONS

The Wall

SHUTDOWN

INVESTIGATIONS

IMMIGRATION

STATE MEDICARE FOR ALL PLANS

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Free Clinic Medical Malpractice/FTCA: $1 million
Title X Family Planning: $286 million
Nurse Loan Repayment Program: $87 million
National Health Service Corps: $105 million
Corporation for National and Community Service: $1,082,958,000

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Medication Access and Affordability

340B
Generic Drug Pricing
Gag Rule

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Immigration - Public Charge

Opioid Crisis

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IMMIGRATION – Public Charge

On September 22, 2018, the Administration announced its long awaited rule that would make changes to “public charge policies.”

The public charge policies allows the federal government to deny an individual entry into the U.S. or adjustment to legal permanent resident (LPR) status (i.e., a green card) if he or she is determined likely to become a public charge.

Whom Would the Proposed Changes Affect?

The proposed changes would primarily affect immigrants applying for a green card through a family-based petition.
The concern is that the proposed rule would likely increase confusion and fear among all legal immigrant families about using public programs, regardless of whether they are directly affected by the policy changes.

Next Steps

The rule was published on Wednesday October 10, 2018 and the open comment period will close December 20, 2018.
The NAFC will draft and submit public comments and we will draft a sample letter for any member organizations that are also interested in submitting comments.

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Medicare For All

Affordable Care Act

Medicaid Expansion

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Medicare For All

The NAFC is actively monitoring H.R. 676, S. 1804 bills that would make a Medicare for all system in the country

Neither House not Senate has made any efforts to push these bills
With the current Administration in power, there isn’t much change of this legislation to pass even if it was heavily amended

ACA

The NAFC is actively monitoring H.R. 5155, H.R. 4666, (not yet introduced) bills that would bolster the health insurance market

No substantive action has been taken on either of these pieces of legislation in the House or the Senate. Most talk has been political posturing for the mid term elections

MEDICAID EXPANSION

Because of term limits, retirements or other issues, 8 of the 17 states that haven’t expanded Medicaid will have new Governors next year.

In 2016, federal funding for Medicaid covered 100 percent of expansion costs. Federal funding for Medicaid expansion drops to 90% in 2020.

Four states are voting on Medicaid expansion in November -- Idaho, Montana, Nebraska and Utah.

Indiana, Kentucky and New Hampshire have also received approval from the Trump administration to impose work requirements for Medicaid. Eight other states — Arizona, Kansas, Maine, Mississippi, Ohio, South Dakota, Utah and Wisconsin — have formally applied for similar waivers.

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ANNUAL FUNDING PRIORITIES SUBJECT TO APPROPRIATIONS

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The Breast and Cervical Cancer Screening program under Title X
The Children’s Health Insurance Program (CHIP)
Medicaid
Medicare
Federal Tort Claims Act (FTCA) (FREE Clinics)
Nurse Corps Loan Repayment
National Health Service Corps
Corporation for National and Community Service

POLICY, PATIENTS AND POLITICS

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STRATEGIC AND MISSION FOCUSED PUBLIC POLICY OBJECTIVES

We believe that all individuals, regardless of their age, sex, income, education, immigration status, ethnicity, color of skin, religion, or sexual orientation should have access to affordable, quality health care

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HEALTH CARE ACCESS AND AFFORDABILITY PUBLIC POLICY OBJECTIVES

To increase our ability to address the health care needs of individuals, including the uninsured and medically underserved, the NAFC supports:

Legislative language to improve access for the uninsured and underinsured to affordable, accessible, and portable health insurance.
Legislative language to promote the development of policies that stabilize the health insurance market.
The creation of a Medically Underserved Population and Health Professional Shortage Areas automatic designation for Free and Charitable Clinics and Charitable Pharmacies.

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MEDICATION ACCESS AND AFFORDABILITY PUBLIC POLICY OBJECTIVES

The unaffordability and inaccessibility of medication impacts all Americans, including the uninsured and underinsured. Therefore, the NAFC supports:

The inclusion of eligible Free and Charitable Clinics and Charitable Pharmacies as authorized entities for participation in the 340B Drug Pricing Program.
Legislative language to support increased access to affordable medications for the uninsured and medically underserved.

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NONPROFIT FINANCE AND TAX PUBLIC POLICY OBJECTIVES

Free and Charitable Clinics and Charitable Pharmacies do not receive dedicated federal funding and have to rely heavily on private donations from individuals and foundations. Therefore, the NAFC supports:

The establishment of a Universal Tax Deduction for individuals to enable them to donate more easily to non-profit organizations
The protection of the Johnson Amendment – a provision in the U.S. tax code that prohibits all 501(c)(3) non-profit organizations from endorsing or opposing political candidates.

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Membership Feedback Survey Results

NAFC ENDS PRIORITY 1.3

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NAFC ENDS PRIORITY 1.3

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NAFC ENDS PRIORITY 1.3

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4 0 4

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DISCOUNTED REGISTRATION RATE FOR STUDENT RUN FREE CLINICS

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Demonstration Phase – January - December 2018
Assessment Phase – January - December 2019
Implementation Phase – January - December 2020

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If NAFC member organizations are part of a state that has a State Association which has implemented or is implementing standards, that member organization will receive reciprocity.

If a member organization has a PCMH, FTCA or state license certification, the NAFC staff will work closely with the members to identify where those programs overlap with ours so we do not duplicate efforts.

There will be multiple levels of participation, this will be a self-report process.

201 NAFC member organizations will receive an NAFC Standards Seal because they will receive reciprocity because of their State Association Certifications.
30 NAFC member organizations will not receive a NAFC Standards Seal based on their current self-reporting responses.
220 NAFC member organizations will receive some level of the NAFC Standards Seal given their self-reporting. NAFC staff will now begin the process of going through the responses one at a time to see if they achieve an A, AA or AAA rating.

Next Steps

Staff recommends changes to ratings to bronze, silver and gold.
Staff recommends allowing those organizations who have FTCA status, PCMH status or who are licensed by their state governments to operate to receive reciprocity.
Staff will be making a tool kit of sample policies for members to use during the process and it will be launched Winter 2019.

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NAFC Standards Assessment Phase Preliminary Data

NAFC ENDS PRIORITY 1.5

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Better Together

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2

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GROUP PURCHASING POWER:

Access to exclusive NAFC member discounts on products, services, technology, and more!

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PRACTICAL RESOURCES: Access to the members only NAFC resource library with real-world documents you can adopt or adapt.

677

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MEMBERS IN THE NAFC

700

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NEW DISCOUNTED MEMBERSHIPFOR STUDENT RUN FREE CLINICS

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IN GRANTS TO MEMBER ORGANIZATIONS in 2018

3.522 M

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NAFC 2019 GOALS

FREE NAFC Member webinars lead by the CEO on issues of importance.
FREE technical assistance webinars for peer-to-peer virtual learning opportunities with a focus on story-telling and sustainability programs.
NAFC Member letter writing campaigns to policy makers.
Advocacy Reports to members.

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NAFC 2019 GOALS

Visits with Federal Policy Makers

60

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Already committed for grant opportunities to NAFC Member Organizations

2.5M

2019 FUNDING OPPORTUNITIES

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WHAT CAN I DO?

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KNOW YOUR STORY

TELL YOUR STORY

PUT ON YOUR SNEAKERS

STAND UP

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+

WHAT DO I KNOW?

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NAFC CONTACT INFORMATION

National Association of Free & Charitable Clinics

1800 Diagonal Road Suite 600

Alexandria, VA 22314

703-647-7427

info@nafcclinics.org

Nicole Lamoureux, President and CEO

Kerry Thompson, Vice President

Ariana Gordillo, Director of Outreach