Issues

2017 NAFC Public Policy Priorities – This document details the NAFC 2017 Public Policy priorities for the organization and its members. Below are some highlights from this document on the NAFC's Federal Policy objectives.


BACKGROUND

Annually, 1.7 million people through 5.9 million patient visits receive health care at America’s 1,200 Free and Charitable Clinics.. This is accomplished by dedicated staff and over 160,000 volunteers, including 30,000 medical providers, 21,000 nurses and almost 71,000 non-medical volunteers. Free and Charitable Clinics focus on the overall needs of patients by providing medical, dental, pharmaceutical, behavioral health, vision, and health education services and ensuring that uninsured and underinsured Americans have a medical home.  


SERVING THE UNINSURED AND THE MEDICALLY UNDERSERVED

We need to do a better job as a nation of addressing the health care gaps and we need the federal government to acknowledge Free and Charitable Clinics as a valuable member of America’s safety net.  For any health care reform policy to be successful, it is imperative for policy makers to understand that America’s safety net is broader than just the federally funded health centers. While millions of people received access to health insurance over the past 7 years, there are as many as 29 million people who have not yet been able to access health insurance or care. 83% of individuals who access care from Free and Charitable Clinics come from a working household, 75% of our clinics are reporting that newly insured individuals are returning to our clinics for care because they can’t afford the high cost of premiums.   As Congress develops a health care reform plan, it is critical that the uninsured, working poor, medically underserved and those members of the safety net that are not federally funded who serve them are not forgotten or left out of conversations.

Specific Requests

  • A commitment from every policy maker that, as conversations continue about health care reform, Free and Charitable Clinics have a seat at the table and are recognized for the critical work they do as members of the safety net.
  • Ensure that Free and Charitable Clinics are named as recognized sites to provide health care for Medicaid patients.
  • Ensure that discussions about a Medicaid Block Grant consider availability, accessibility and affordability for both state and patients
  • Create an automatic designation for Free and Charitable Clinics as Medically Underserved Population and Health Professional Shortage Areas (similar to the designation in current law for Community Health Centers)
  • Allow insurance to be purchased across state lines
  • Urge health-related federal agencies to broaden eligibility for competitive federal grant opportunities to groups like ours who are serving as a valuable part of the health care safety net instead of limiting eligibility only to federally funding centers.

ACCESS TO AFFORDABLE MEDICATION

We need to make medication more affordable.  The unaffordability and inaccessibility of medication impacts all Americans, however among the working poor and the middle class, the impact is even more astounding. Many of our patients are not able to afford a $4 medication. In addition to purchasing medications, we rely on the donated products we receive from our supply chain distribution partners Americares, Direct Relief and Heart to Heart International as well as the Patient Assistance Programs that are available through pharmaceutical companies.  However, even with these programs, our clinics spend $15 million annually on pharmaceutical medications for our patients. Ironically, while 46% of our clinics have an operating budget of under $100,000 and are serving the poorest of the poor, we are not eligible to participate in the 340b discounted drug pricing program.

Specific Requests

  • Expand the 340B program to include Free & Charitable Clinics
  • Protect the $4 formulary
  • Make generic medications more available and affordable

VOLUNTEERISM

We need to encourage volunteerism.  Free and Charitable Clinics currently have 160,000 volunteers including 30,000 medical providers, 21,000 nurses and almost 71,000 non-medical volunteers who are serving our nation’s most vulnerable patients at clinics around the country. This dedication in giving back to communities should be celebrated and encouraged. Unfortunately, there are currently barriers in place that if removed would allow our clinics and charitable pharmacies to increase our pool of volunteers dramatically, therefore increasing our ability to provide health care access.

Specific Requests

  • Protect the National Health Service Corps designation for Free Clinics
  • Expand the National Health Service Corps Designation to include Charitable Clinics
  • Expand IRS regulations to allow licensed medical professionals to claim their volunteer hours at a Free or Charitable Clinic as a tax write off
  • Allow licensed medical professionals to use their hours at Free and Charitable Clinics to offset Continuing Education Units
  • Expand the Federal Tort Claims Act to include entity coverage for Free Clinics
  • Expand the Federal Tort Claims Act to include Charitable Clinics, the Charitable Clinic entity, the Charitable Clinic volunteers, staff and board

TAX PROVISIONS/CHARITABLE GIVING

We need to ensure that a tax reform package protects positive tax provisions that encourage donations to charitable organizations, like the IRA Charitable Rollover. Free and Charitable Clinics do not receive dedicated federal funding like Federally Qualified Health Centers/Community Health Centers. Instead, our clinics rely heavily on private donations from individual donors, foundations, grants and volunteers, which allow them to keep their doors open and to deliver health care to those who need it the most. 

Specific Request

  • Protect and support tax programs that encourage charitable donations, including the IRA Charitable Rollover

PUBLIC - PRIVATE PARTNERSHIPS

We are very proud of our recently received Robert Wood Johnson Foundation (RWJF) Award for Health Equity.  We also have a strong partnership with CVS Health Foundation who has made a multi-year, multi-million-dollar commitment to helping our clinics provide coordinated health care in communities across the country. Free and Charitable Clinics are on the front lines every day providing affordable and accessible health care to low-income patients in their local communities. Our clinics are truly the communities’ response to health care needs and we are grassroots medicine at its finest. Our on-the-ground connection to the medically underserved and uninsured is considered a benefit to private sector groups who are trying to make our country healthier and more health care cost-conscious.  We look forward to working more closely with the federal government to ensure that all American’s have access to quality, affordable healthcare.

Specific Request

  • Expand and establish opportunities for growth in private public partnerships through grant programs and tax credits

To learn more, please see the full 2017 NAFC Public Policy Priorities document – READ MORE