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Policy Priorities

CHAD tracks closely policy and legislative updates, changes and issues at both the federal and state levels and works with Congressional and state officials to ensure that community health centers and their patients are represented throughout the legislative and policy making process.

At the core of CHC policy priorities is protecting access to quality health care for all Dakotans, especially the rural, uninsured and underserved populations. Another core priority is ensuring health coverage for all to foster healthy communities and sustain the overall operations and growth of health centers across the Dakotas.

Federal Advocacy

Legislation and policymaking at the federal level significantly impact community health centers, especially in the areas of funding and program development. That’s why CHAD’s policy team works closely with its member health centers and health care partners across the Dakotas to develop policy priorities and convey those priorities to Congressional leaders and their staff. CHAD connects on a regular basis with Congressional members and their offices to keep them apprised of issues impacting CHCs and their patients and to encourage them to take action on key health care legislation and policies.

Federal Policy Priorities

The Dakota’s community health centers (CHCs) provided primary care, behavioral health services, and dental care to over 113,000 Dakotans in 2020. They demonstrated that communities could improve health, reduce health inequities, generate taxpayer savings, and effectively address a multitude of costly and significant public health problems, including epidemics of flu and coronavirus, HIV/AIDS, substance use disorders, maternal mortality, veterans’ access to care, and natural disasters. 

To continue their important work and mission, CHCs need increased pharmacy access for underserved patients, support for health centers’ telehealth services, investment in workforce, and strong and stable funding. Health centers want to continue to work in partnership with Congress to address the following issues. 

Increasing Pharmacy Access for Underserved Patients

Providing access to a full range of affordable, comprehensive services, including pharmacy services, is a key component of the community health center model. The savings from the 340B program must be reinvested into health center activities and are integral to health centers’ ability to sustain ongoing operations. In fact, many health centers report that due to their slim operating margins, without the savings from the 340B program, they would be severely limited in their ability to support many of their core services and activities for their patients. 

  • Make it explicitly clear that 340B covered entities are entitled to purchase all drug manufacturers’ covered outpatient drugs at 340B pricing for eligible patients through each covered entity’s contract pharmacies. 
  • Cosponsor the PROTECT 340B Act (HR 4390), from Reps. David McKinley (R-WV) and Abigail Spanberger (D-VA) to prohibit pharmaceutical benefit managers (PBMs) and insurers from engaging in discriminatory contracting practices or “pick-pocketing” 340B savings from health centers. 

Expand CHC Telehealth Opportunities

All community health centers in the Dakotas are utilizing telehealth to meet their patients’ needs. Telehealth services help address pandemic, geographic, economic, transportation, and linguistic barriers to health care access. Because CHCs are required to offer comprehensive services in areas of high need, including sparsely populated rural areas, health centers are pioneering the use of telehealth to expand access to quality health care services.  

  • Support legislative and regulatory efforts to ensure an extension of the public health emergency (PHE) telehealth flexibilities, ideally through a permanent policy change or at least two years to provide certainty for health centers. 

  • Support for the CONNECT for Health Act (H.R. 2903/S. 1512) and Protecting Access to Post-COVID-19 Telehealth Act (H.R. 366). These bills modernize Medicare policy by recognizing health centers as “distant sites” and removing “originating site” restrictions, allowing telehealth coverage wherever the patient or provider is located. These bills also allow telehealth services to be reimbursed equally to an in-person visit. 

Workforce

Community health centers depend upon a network of over 255,000 clinicians, providers, and staff to deliver on the promise of affordable and accessible health care. Long-term investments in the nation’s primary care workforce are needed to achieve the cost-savings the country needs and to ensure health centers can keep pace with the growing and changing health needs in their communities. Severe workforce shortages and growing salary gaps make it difficult for health centers to recruit and retain an integrated, multi-disciplinary workforce to provide high-quality care. The National Health Service Corps (NHSC) and other federal workforce programs are critical to our ability to recruit providers to communities that need them. We appreciate the funding provided in the American Rescue Plan Act to address workforce shortages caused by the pandemic. Continued federal investment is essential to broadening the workforce pipelines health centers depend on to provide care to patients.  

  • Support $2 billion for the NHSC and $500 million for the Nurse Corps Loan Repayment Program. 
  • Support robust FY22 and FY23 appropriations funding for all primary care workforce programs, including the Title VII Health Professions and Title VIII Nursing Workforce Development programs. 

Support Community Health Centers

We appreciate American Rescue Plan Act funding allocated to health centers to respond to COVID-19 and additional funding for the primary care workforce and vaccine distribution. The COVID-19 pandemic has highlighted the inequities of the health care system for our rural, minority, veteran, senior, and homeless communities. Now more than ever, health centers have been essential stakeholders in the public health system – providing much-needed primary and behavioral health services during the throes of an international pandemic. In 2022, we are looking to Congress to maintain the base funding for CHCs and invest in future growth for the program. 

  • Support at least $2 billion in Health Center Capital Funding for the alternation, renovation, remodeling, expansion, construction, and other capital improvement costs so health centers can continue to meet the health needs of their growing patient populations and the communities they serve.

Protecting Volunteer Health Professionals’ Ability to Serve at Community Health Centers

Volunteer health professionals (VHPs) provide invaluable workforce support to community health centers and their patients. The Federal Tort Claims Act (FTCA) currently provides medical malpractice coverage for these volunteers. However, this protection expires on October 1, 2022. Severe primary care workforce shortages both before and during the COVID-19 pandemic highlight the critical urgency for unpaid medical professional volunteers to receive continued FTCA medical malpractice protection.  

  • Permanently extend the Federal Torts Claim Act (FTCA) coverage for community health center VHPs. The extension is currently included in the bipartisan Senate HELP discussion draft of the Prepare for and Respond to Existing Viruses, Emerging New Threats (PREVENT) Pandemics Act.  

North Dakota Advocacy

Supporting the work and mission of community health centers and protecting access to health care for all North Dakotans are principles at the center of CHAD’s advocacy efforts. Our team works closely with member health centers and health care partners across North Dakota to monitor legislation, develop policy priorities, and engage lawmakers and other state and local officials. CHAD is committed to ensuring that CHCs and their patients are represented throughout the policymaking process.

North Dakota Policy Priorities

North Dakota’s legislature meets every two years in Bismarck. During the 2021 legislative session, CHAD is working to promote policy priorities for community health centers and their patients. Those priorities include support for the continuation of Medicaid Expansion, increasing medical workforce capacity, and expanding dental benefits and primary care management reform.

South Dakota Advocacy

Supporting the work and mission of community health centers and protecting access to health care for all South Dakotans are principles at the center of CHAD’s advocacy efforts. Our team works closely with member health centers and health care partners across South Dakota to monitor legislation, develop policy priorities, and engage lawmakers and other state and local officials. CHAD is committed to ensuring that CHCs and their patients are represented throughout the policymaking process.

South Dakota Policy Priorities

South Dakota’s legislature meets annually in Pierre. The 2021 legislative session will begin on January 12, 2021. During the session, CHAD will monitor health care-related legislation while supporting and promoting three key policy priorities:

Medicaid Expansion in South Dakota

Workforce – Student Loan Repayment

  • Increase funding for the Recruitment Assistance Program by directing the Department of Health to apply for up to $1 million
  • federal matching dollars when they become available in 2022 and giving them the authority to use state funds to provide the
    local match. This could double the reach and impact of the program.
  • Allow automatic qualification for the program for CHCs and increase the size of communities eligible for recruitment support;
  • Reconsider the level of community matching funds required. For many communities they are currently out of reach.
  • Increase the slots for Advanced Practice Providers; and,
  • Consider adding certain behavioral health positions given the shortages the state faces in those areas.

Workforce – Optimal Team Practice Legislation giving Physician’s Assistants more flexibility to practice in our state.