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Policy and Advocacy

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Policy and Advocacy

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The Coalition OC’s mission highlights the importance of working with health centers, the county’s safety net providers, and key partners to ensure that through working together quality health care is created for the most vulnerable and underserved communities. As health advocates and health centers, we are strongly driven by the belief that health care is a human right, that it should be affordable and accessible to everyone, and that it should be reliable and sustainable.

As such, the Coalition OC endorses, collaborates and advocates for legislation that supports our member health centers, and their patients, which in turn saves thousands of dollars for our county in emergency health services while serving the most vulnerable communities.

As part of this work, we track bills and their progress, help facilitate conversations with legislators either in Washington, D.C., Sacramento, CA, within the County of Orange, or virtually, for member health centers. We also inform member health centers, legislators, and health administrators about developments in state and federal legislation.

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2021 Policy Priorities

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Funding needs at a broader scale:

Infrastructure – Building and Operational
Workforce – Addressing salary inequities, provider shortages, etc.
Funding for Non-FQHCs
Reimbursement Parity for Services Provided
Funding to Address Social Determinants of Health
Equitable Funding Distribution with CHC Input

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Community Health Centers (CHCs) have shown time and time again that they are the most qualified and trusted providers to respond to the COVID-19 pandemic and serve as an integral part of the mitigation strategy. In Orange County, our health centers expanded their testing and vaccination capacity to provide mobile, drive-thru, and walk-in sites, they have partnered with groups that are targeting key demographics in key locations such as schools and shelters, have created key partnerships amongst the health centers, and have collaborated with the Orange County Health Care Agency, CalOptima (the county’s organized health system), local leaders such as the Board of Supervisors, the federal and state government, and community-based organizations. Through these partnerships, and their vast experience with testing and routine vaccinations, they continue to provide COVID-19 tests, vaccines, and case management to ensure their patients receive follow up attention and resources, particularly if they tested positive for COVID-19.

Request:

Continued support for an equitable testing and vaccination strategy through direct distribution of testing supplies, PPE, and vaccine doses to CHCs, proportional to the number of patients served at CHCs.
Recognize the higher burden of the disease in disproportionately impacted communities – including Black, Asian and Pacific Islander, Indigenous, Latinx, and immigrant communities – and place those groups at the center of COVID-19 response and recovery, especially as many of these communities make up the essential workforce and are therefore at greater risk of exposure.
Ensure that funds, coming from the federal government, to the state and county, are distributed in a method that considers health centers, their role and needs.

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In March 2020, when the pandemic and shutdown began, CHCs quickly transitioned much of their provision of care to a virtual model to ensure that their patients continued to receive vital care while limiting the risk of staff and community spread of COVID-19. Most CHCs are still utilizing telehealth, both video and telephonic visits, for over 60% of their patient care. Many patients and providers prefer telehealth, and telehealth appointments result in far fewer missed visits. In Orange County specifically, our membership grew their capacity to provide care through telehealth including preventive, mental and behavioral health, and other specialty care services. Telehealth has emerged as a vital force connecting health centers to their patients during the COVID-19 pandemic. At this point, 98% of health centers nationwide have offered telehealth services, compared to just 43% in 2018. As such, we foresee that telehealth will remain an integral part of health centers operations after the COVID-19 Public Health Emergency ends. We believe that telehealth has the potential to be the great equalizer, eliminating long-standing barriers to care like transportation, childcare, homelessness, and work schedules. To guarantee these innovations continue post-pandemic and can be utilized as part of the long road to an equitable recovery, federal and state action is needed.

Request:

Legislation and administrative action is needed to ensure that CHCs can continue to provide care via both video and telephone visits after the Public Health Emergency is lifted for the same reimbursement rate as in-person visits in both the Medicare and Medicaid programs. Specifically, states must be encouraged to continue telephonic (audio-only) modalities with PPS payment in their Medicaid programs.
As more states, such as California, take action now to continue payment parity and current flexibilities post-pandemic for audio-only modalities, states must be supported by CMS in continuing telephonic (audio-only) modalities with PPS payment in their Medicaid programs.
Congress must also continue to act through bills like the Telemental Health Care Access Act, legislation that would remove barriers to high-quality, virtual mental and behavioral health care for Medicare beneficiaries.
To address the digital divide, new investments in telecommunications infrastructure are sorely needed.

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The COVID-19 pandemic has shined a light on the inequities inherent in our public health system, and CHCs are central to a more equitable system in the future. The last significant federal infrastructure investment in CHCs was in 2009 when CHCs served fewer than 18 million patients. Federal investments in our infrastructure are critical if we are to continue providing high-quality care for this growing patient population. We need increased federal investments to address much-needed construction, renovation, equipment, IT, telehealth, and broadband projects.

Request:

In the next federal budget reconciliation effort or infrastructure package additional action is needed. Funding must include $10 billion for Community Health Center infrastructure.
Continued support to guarantee that final agreements are inclusive of these funds.

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COVID-19 laid bare the nation’s worsening health workforce shortage – that existed before 2020 – and widening gaps for diverse, culturally- and linguistically competent, primary, behavioral, oral, and allied health workers. COVID-19 adversely affects providers’ mental health and safety, accelerates burnout, impedes recruitment and retention, and fuels competition within the health care delivery system for a limited pool of resources. Racial inequities, high costs of education, and debt inhibit a more diverse future workforce from entering the educational pipeline and caring for health center patients, often in areas of unmet medical need.

Request:

In the next budget reconciliation effort or infrastructure package additional action is needed to address the workforce shortage and lack of diversity in pipeline. This includes securing federal investments for frontline staff who are in short supply but vital to the COVID-19 response and vaccine efforts as the Delta, and now Omicron, variants spread.
Support H.R. 3671, the Doctors of Community Act, to permanently authorize and fund the Teaching Health Center Graduate Medical Education and increase new residency programs .
Support H.R. 4285, the COMMUNITIES ACT, that would give full tuition repayment under the NHSC for providers working in medically underserved communities for five years.
With mandatory funding now secured for National Health Service Corp and Teaching Health Centers, congressional workforce investments must expand to acknowledge the full care team. Additional investments in community health workers, behaviorists, and the medical assistant to nursing pipeline that places a priority on racial/ethnic diversity and cultural and linguistic sensitivity are needed.

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Health centers continue to successfully utilize the 340B program, ensuring patients can access medications at affordable prices, and that health centers can reinvest savings into improved quality of care and expanded services. Without the savings from the 340B program, many health centers would be limited in their ability to support many of their core services and activities for their patients. The 340B program is currently under assault on several fronts – and it is crucial that it is protected. Health centers’ reliance on 340B is critical to their financial viability and their ability to provide quality comprehensive low-cost health services, including affordable medications, to their patients.

Request:

Protect the 340B program and ensure the continued use of 340B savings to provide more comprehensive care to more underserved patients. This can be done at the federal level by co-sponsoring the PROTECT 340B (H.R. 4390) Act now, which will ensure that 340B savings remain with CHCs (and other 340B safety net providers), and their medically underserved patients – rather than being taken by PBMs and payers.
Through the state budget, request an additional $50M general fund commitment to strengthen the non-hospital clinic supplemental payment pool and recognize the full costs of the transition on California’s health centers. By increasing the supplemental payment pool, the legislature would ensure that the Medi-Cal pharmacy benefits transition, causes no harm to community health centers, the broader safety-net, or the patients they serve.

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If you’d like to learn more about our 2021 Policy Priorities or any of our Policy and Advocacy efforts, please email us at advocacy@coalitionoc.org.

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