ADVOCACY LEADERS PLN

February 9, 2021

ROLL CALL Favorite Valentine's Day candy?

Agenda■ Federal Updates

– COVID19 Relief Package– Updates– 340B– Financial Impact

■ State Updates– COVID vaccination– State Legislative Agenda– Governor Budget teasers– State COVID relief bill

■ Advocacy Opportunities– Advocacy Days– NACHC P&I

■ CHC Share Out – Eva Scheppa, Family Health Center of Marshfield

FEDERALPOLICY UPDATES

COVID19 Relief Legislation■ President Joe Biden acknowledged his final coronavirus stimulus bill will probably look

different from his $1.9 trillion opening bid

■ Negotiating:– $15 minimum wage (likely won't be in the bill)– Threshold for individuals receiving stimulus checks ($75k or below)– $1400 stimulus Check– Unemployment Insurance ($400 v $300 per week/ thru Sept/June)– Rental Assistance– Child Care– Behavioral Health– Aid to Local Governments

■ Democrats took a first step toward doing an end run around Republicans on Friday, starting down the path of using the complicated budget reconciliation process. It will likely take a few weeks, but when all the hurdles are jumped, Democrats would need just a majority ofthe Senate to pass the package.

Reconciliation Bill

■ The first Reconciliation package should provide CHCs with $7.6 billion in general COVID relief funds, and $800 million for grants to develop their workforce; however, NACHC is hearing from Hill staff that the $4.4 billion that the Administration requested for service expansion may be in the second package.

– NACHC requesting $1B for National Health Service Corps

General Hill Updates• Reconciliation I –It is Congress’ hope to have the first Reconciliation completed by March 14,

when the current Pandemic Unemployment Assistance program ends.

• Reconciliation II – Senior Senator tells NACHC that the second package could be ready by April or May, although many factors could cause this to change.

• FY22 Appropriations – Congress will not start work on this until after the first Reconciliation bill is passed. Earmarks are still “on the table” (but we’ve heard this before). In the meantime, we are gathering deadline dates, and Chairwoman DeLauro staff told NACHC that forms will be created soon. Once the forms are available, we will fill them out and submit them on CHC’s behalf.

• Atmosphere – Although Impeachment is impacting the mood and cross-aisle communications, it is generally agreed that Appropriators on LHHSE expect better interaction than media may indicate.

Updates■ On Thursday, President Biden signed an Executive Order (EO) establishing a new Special

Enrollment Period (SEP) for the Affordable Care Act (ACA) Marketplaces. During the SEP, which will run from Feb. 15 through May 15, people will be able to apply for coverage without needing to demonstrate that they have had a “qualifying event.”

– the Biden administration plans to spend $50 million on outreach, with "a mix of tactics to increase awareness, including advertisements on broadcast, digital, and an earned media.“

■ HHS plans to continue Public Health Emergency (PHE) through all of 2021, and will give 60 days’ notice of its conclusion.

■ NACHC Requests for Medicare/Medicaid reimbursement for administering COVID vaccines:– Medicare: Require Medicare to make interim payments to FQHCs for COVID vaccine

administration, based on fee schedule rates, so that CHCs do not have to wait between 6 and 18 months to receive any reimbursement for these costs.

– Medicaid: Require states to reimburse FQHCs directly for the cost of administering COVID vaccines. Current status in WI: FQHCs can bill FFS rate.

340BUpdates

■ NACHC/ FTLF lawsuit and Administrative Dispute Resolution (ADR) claim filed on contract pharmacy restrictions.

– Original NACHC lawsuit: “paused”– NACHC claim through ADR process filed on 1/13/21. Panel

to assess the claim currently being appointed by the new Administration.

– Claim request: cease current actions, no future actions, comply with 340B as intended. Does not include monetary compensation but could occur for future drug manufacturer actions. Result would be a legally binding opinion.

– Unknown: timeline for ADR process.– In the meantime, several lawsuits over the contract pharmacy issue

continue to work their way through the courts. For example, three drug makers have filed suits in different jurisdictions claiming that the contract pharmacy model is invalid. AHA and Ryan White lawsuits also continue.

All CHC must “recertify” for 340B during February – or be removed from the program.

Richelle reaching out to MOCs to sign on to 340B letter holding drug manufacturers responsible – issue refunds.

Financial Impact Report■ Financial Impact of COVID-19 on FQHCs -

New National Report– Capital Link just released a new

report that provides a national picture of health center revenue loss, COVID-19-related expenses, influx of relief funds through 2020, and the estimated gap in needed funds, based on the 15-month period from April 2020 through June 2021.

STATEPOLICY UPDATES

COVID Vaccines■ WPHCA sent letter to DHS outlining recommendations from more equitable

distribution.

■ SDMAC included agricultural workers in Phase 1B. DHS is anticipating 1B beginning in March. SDMAC postponed indefinitely as DHS works with Biden administration.

■ Public Registration portal launching in 15 communities Feb 15- have not heard much from the state.

■ DHS released a recent update included some new changes -->– Planned fulfillment of all CHC requests– Upcoming process to focus on two weeks of requests with subsequent allocations

for a two-week period.

■ Federal partners have indicated that plans/direction for direct ship to CHCs will be released in the next few weeks.

■ Biden goal of 9 million vaccines in 100 days.

State Legislative Agenda■ WPHCA is actively involved in identifying avenues to advance our policy priorities

through the budget or legislative action in winter 2021■ WPHCA Priorities

– State Grant – 24 co-sponsors signed on! Senate hearing today!– Health Professions Loan Assistance Program (HPLAP)– Strengthening Medicaid– Expanding Medicaid Coverage for Pregnant Women– Telehealth

■ WPHCA: Other Engagement– Medicaid Re-Entry Act– Oral Health Initiatives -- Are you experiencing any licensing delays/issues?– Pharmacy Policy – 340B protections in Gov’s Budget “teaser”

Save the Date:Governor will release his budget on Feb. 16

Updated State Grant One Pager Available!■ Wphca.org/statepolicy

■ Updated State Grant One Pager

Senate Committee on Health, Hearing today at 1 pm■ SB-003 Pharmacy Benefit Managers (Felzkowski, Mary) Pharmacy benefit managers, prescription drug benefits, and

granting rule-making authority.

■ AB-004 Vaccine Administration(Sanfelippo, Joe) Pharmacy technicians and pharmacy students administering vaccines.

■ SB-060 Vaccine Administration (Kooyenga, Dale) Pharmacy technicians and pharmacy students administering vaccines.

■ SB-013 Vaccine Administration (Bernier, Kathy) Dentists administering certain vaccines.

■ SB-059 Health Center Grants (Testin, Patrick) Community health center grants and making an appropriation.

■ SB-049 Opioid Data System(Testin, Patrick) Opioid and methamphetamine data system and making an appropriation.

■ SB-030 Contraceptive Prescriptions (Felzkowski, Mary) Permitting pharmacists to prescribe certain contraceptives, extending the time limit for emergency rule procedures, providing an exemption from emergency rule procedures, granting rule-making authority, and providing a penalty.

Governor “Teasers”

■ Governor's budget proposal directs more than $140 million over biennium to address childcare quality, affordability, and access, invests more than $600 million in long-term care infrastructure.

■ Governor’s proposal regulates and taxes marijuana much like alcohol, generates more than $165 million annually beginning in Fiscal Year 2023

■ $43 million investment in agricultural industry

■ Plan that will help lower prescription prices by doing things like capping the price of insulin and protect consumers from predatory practices like price gouging.

State COVID Relief Bills

■ AB 1 – Included many controversial and political measures – Some provisions now proposed as standalone bills

■ AB 1 (Amended) – Passed (bipartisan) in the Senate and Governor wanted to sign the bill.

■ Since that point, there were additional amendments (note the “blow-up” over FoodShare funding at risk last week) and the “COVID” bill slammed against the PHE/Mask Mandate Executive Order.

– Assembly looks like they’ll take action today with an amended bill. Then what? – Will the state take action before additional federal relief is available? TBD.– All registered entities opposed (or “other”) on removing the PHE.

Other Updates■ Feb 4th: Gov. Evers today signed statewide public health emergency and requiring face

coverings in public places to protect the health and safety of Wisconsinites.

■ The governor's orders today come as Republicans in the Legislature voted to end the governor's previous public health emergency and relating order requiring face coverings in public places.

■ Feb 5th: Gov. Evers announced he intends to veto AB 1 which will, in part, impose limits on the response to the COVID-19 pandemic.

ADVOCACY UPDATES

Advocacy Days

Registration Now Available: Virtual Programming for WPHCA Advocacy Days All CHC staff and Board members who may participate in virtual legislative visits are encouraged to attend these virtual programming sessions. Note, they will also be recorded and shared with advocates. Legislator visits are currently being scheduled for April 1 and April 2, and will be shared with Advocates as soon as available.

Advocacy 101: Registration now available!Wednesday, March 3, 2021 | 12:00 pm - 1:00 pm via Zoom

This event will provide advocates with a baseline understanding of effective advocacy, featuring discussion with former lawmakers sharing tips and best practices.

Next Level Advocacy: Registration now available!Wednesday, March 10, 2021 | 12:00 pm - 1:00 pm via Zoom

This session will be designed for experienced advocates who want to prepare for tough questions from lawmakers, practice redirecting conversations, and learn from colleagues who have been practicing this skill for years.

The Inside Scoop: Registration now available!Thursday, March 18, 2021 | 12:00 pm - 1:00 pm via Zoom

This training session will provide Health Center advocates with the background and context they need to effectively communicate priorities with Wisconsin legislators, with a featured presentation from Tony Langenohl, Capitol Consultants.

Health Center Legislative Priorities: Registration now available!Wednesday, March 24, 2021 | 12:00 pm - 1:30 pm via Zoom

This training session will provide Health Center advocates current information on each of WPHCA's key legislative priorities and will also provide all the details that advocates need for the logistics of virtual legislator meetings. The last 30 minutes of the session will be reserved for optional breakout sessions for advocates that would like additional support, or for Health Centers to coordinate logistics.

Celebrating Health CentersDate/Time TBD - Stay tuned for more information.

NACHC Policy Issues Forum: March 15-18

■ Wednesday, March 3, 2021 at 2:00 p.m. EST: OPEN TO ALL CHC ADVOCATES: This webinar will cover 2021 Policy Papers, important conference logistics, and advocacy action items. Please promote this with all Members planning to attend the conference. Register here.

■ To learn best practices for virtual meetings and preparing for P&I – watch “The Future of Citizen Engagement: Coronavirus, Congress, and Constituent Communications”. We encourage you to watch it as a primer for the CHC specific webinar next week

Thank you! Thank you for submitting your CHC stories & spotlights! The district profiles are coming together. The quarterly legislative newsletter willbe sent out next week!

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