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Policy Updates for City/Local, State, and Federal.

Policy Updates: City/Local

1. Board of Supervisors Budget and Finance Committee Restores $30 Million in Proposed City General Fund Health and Human Services Cuts – Including $440,000 for SFCCC Member Clinics’ and Other “Primary Care Services”

In a marathon committee meeting ending at 4 am, June 27, the BOS Budget/ Finance Committee voted to restore $30 million in health and human services cuts that had been included in the Mayor’s budget proposal. Significant cuts to behavioral health, homeless, HIV/AIDS services were restored as well as $440,000 to clinic “primary care services.”

I personally want to thank Brenda Storey, Laura Guzman, Maritza Panegos, and Julie Leadbetter of Mission Neighborhood Health Center and David Knego of Curry Senior Center for visiting supervisors’ offices with me and participating in the hearings to explain the impacts and urge the committee to restore what would have been devastating cuts to many essential community services.

The full BOS will vote on the final budget on July 22. SFCCC will continue to monitor the situation through the final vote.

2.”Healthy San Francisco” A Major Priority of the DPH Budget for 2008-2009 – With SFCCC Member Clinics Slated to Receive $2.9 Million (Up From $1.2 Million Last Year)

HSF’s budget for 2008-2009 is expected to increase significantly while many other SFDPH programs have been reduced or will stay the same. In addition to the $2.9 million, SFCCC is working with HSF to secure approximately $200,000 from a special fund for IT support development.

3. SFCCC Secures No-Cost Bridge Loan Funding from the San Francisco Health Plan (SFHP) for SFCCC Member Clinics Facing Delayed Med-Cal and Other State Payments

Four of SFCCC’s ten member clinic organizations have expressed an interest in bridge loans to help them with potential cash flow problems resulting from the State’s Medi-Cal checkwrite delay policy (now, 5 weeks of delayed Medi-Cal payments) plus the anticipated delay in finalization of the State budget – which could delay all State payments (e.g., EAPC, etc. as well as Medi-Cal). Accordingly, SFCCC has secured a commitment from SFHP for no-cost loans to member clinics to cover the delayed State payments.

Initially, loans will be for a 3 month period. For further information, please contact Allen Meyer at 415 355-2226/ ameyer@sfcccc.org.

4. “Healthy San Francisco” (HSF) Enrollments Now Exceed 23,780 and Growing; SFCCC Clinics Continue To Be Medical Homes to 39% of Enrollees; Re-Enrollment for initial Enrollees Has Now Begun

HSF – the City’s program to provide access to health care for all uninsured San Franciscans – continues to grow steadily and is popular with SF residents – the City’s 311 information service reports that 40% of calls are inquiries regarding how to enroll in HSF. Despite some monthly participation fees and point-of-service charges for those above 100% FPL, the program has reported few drop-outs.

For additional information about SFCCC health centers’ participation in “Healthy San Francisco,” please contact Allen Meyer (ameyer@sfccc.org/ 415 355-2226).

5. SFCCC and Several Other California Consortia Receive Funds Through the California Primary Care Association (CPCA) to Promote Voter Registration in Clinics and Voter Education on State Health Care Reform/ Universal Health Care Issues

Although the Governor and Legislature were not able to achieve State health care reform/ universal health care last year, these continue to be high priorities for many legislators and California voters. The grant from CPCA will support voter registration, materials development and distribution and local public forums on health care reform/ universal health care.

For additional information, please contact Dick Hodgson at 415 355-2230/ rhodgson@sfccc.org.

6. SFCCC’s Assessment of Clinics’ Impacts on San Francisco Shows That SFCCC’s 10 Member Clinic Organizations Now Have 17 Clinic Sites Serving Over 72,000 San Franciscans Per Year ( 9% of the City’s Population)

SFCCC member clinics also have over 900 clinic/corporate employees, 114 medical/ dental/ allied providers, 280 volunteers serving in a variety of capacities and over 100 community members/ patients serving on clinic boards of directors. In addition, member clinics bring over $59 million per year into the City to support health care for low-income underserved and uninsured communities.

7. SFCCC Releases 2007 Health Center Profiles Report

SFCCC’s 2007 Health Center Profiles report is a compendium of information on the basics of SFCCC’s 10 member health center organizations – e.g., patient demographics, services utilization, providers, etc.

For additional copies and/ or further information, please contact Dick Hodgson at 415 355-2230/rhodgson@sfccc.org.

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Policy Updates: State

1. State Revises Medi-Cal Check Write Delay Policy to Release One Additional Check for June

Per the California Primary Care Association (CPCA):

Due to Medi-Cal expenditures coming in under budget, the Administration directed EDS to release one more checkwrite than originally planned. This warrant reflects the paid claims intended for the June 19, 2008 checkwrite date. In addition, Federally Qualified Health Centers and Rural Health Clinics will also be paid for claims intended for the June 26, 2008 checkwrite date. These funds will be released from the State Controller's Office on June 26, 2008, which corresponds with an Electronic Fund Transfer (EFT) date of June 30, 2008. All remaining checkwrites are expected to be released as scheduled on July 2, 2008.

CPCA is has asked EDS to clarify whether or not community clinics are included in the second payment, and will inform members as soon as we know. For more details on the payment delays, visit DHCS’ updated website on the budget at http://files.medi-cal.ca.gov/pubsdoco/newsroom/newsroom_budget_info.asp or contact Jamila Iris Edwards at (916) 440-8170 x.234 or jedwards@cpca.org.

2. State Announces Policy on Medi-Cal Payments While State Budget is Delayed

Per CPCA:

As the State of California has not enacted the Fiscal Year 2008-09 budget by June 30, 2008, the Department of Health Care Services (DHCS) will direct the fiscal intermediary (EDS) to continue to pay to Medi-Cal practitioners per federal mandate and continue to pay Medi-Cal institutional providers through the Medical Providers Interim Payment

(MPIP) fund until the loan is exhausted by the anticipated date of July 17, 2008. After that date, Medi-Cal institutional providers will not receive payment until a budget is enacted, as DHCS has no authority to do so.

After the MPIP Fund is exhausted in approximately mid-July, institutional providers can expect to begin receiving Value of Claim (VOC) letters. Through the new automated VOC process, all Medi-Cal providers whose held payments equal or exceed $5,000.00 will be automatically sent a VOC letter on a weekly basis. This letter will be based on the amount approved for payment (often referred to as the “In Process” amount) each Monday and will be cumulative each week. The letter will also inform providers for which programs payments are owed and how much is owed by program (Healthy Families, Medi-Cal, etc.). This letter will be sent to the “Pay-To” address on file. Providers who have not updated their “Pay-To” address with Provider Enrollment Division (via a Medi-Cal Supplemental Changes DHCS 6209 form, revised 2/08), may not receive this letter. Providers who want this letter but have not received it and have a correct Pay-To address on the Provider Master File, can contact the Telephone Service Center (TSC) after the MPIP loan is exhausted at 1-800-541-5555 and choose option 15, and then option 13.

All providers are asked to continue to render services and submit claims for processing, as this directly feeds the “In Process” amounts the VOC letters will display.

Please continue to monitor the Medi-Cal Web site at www.medi-cal.ca.gov for the latest information regarding the program and the state budget.

CPCA continues to monitor the payment delays and work on loan options to cover periods of non-payment. For any questions on payment delays, please contact Jamila Iris Edwards at jedwards@cpca.org or (916) 440-8170 x. 234. For questions or further information on the loan application process, please contact Kim Dempsey with NCB Capital Impact at kdempsey@ncbcapitalimpact.org or (510) 496-2228. For other questions about CPCA continued efforts to secure loans for clinics during the checkwrite delays, contact Chris Patterson at cpatterson@cpca.org.

3. CPCA Secures 4 Loan Pools for Clinics Impacted by Medi-Cal Checkwrite Delays

At this time, CPCA has secured 4 loan pools to help clinics over the Medi-Cal checkwrite delay period:

Catholic Healthcare West - $5 Million
NCB Capital Impact - $1 Million
Sutter Health – $5 Million
Sisters of Mercy - $300,000

The exact details on the Sutter Health and Sisters of Mercy loan funds are still being worked out and will be sent out at a later date. CPCA is also still in the negotiating process with Untied-PacifiCare and will keep membership apprised as to any new developments.

If you have any questions on loan terms or need further information, please feel free to contact Chris Patterson at cpatterson@cpca.org

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Policy Updates: Federal

1. House Votes Overwhelmingly to Reauthorize Community Health Centers! SFCCC Thanks House Speaker Nancy Pelosi and New Congresswoman Jackie Speier for Their Support of the Bill

In a strong show of support, the full House voted (393 - 24) to PASS H.R. 1343, the Health Centers Renewal Act. The Act retains community majority board requirements for health centers and preserves the integrity of the health center movement.

Speaker Pelosi was instrumental in moving the bill and new Representative Jackie Speier voted for it.

Next steps are Senate approval and signature by the President.

Please call or email Dick Hodgson at 415 355-2230/ rhodgson@sfccc.org if you have questions or need additional information on any of these topics.

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