2018 NAFC Public Policy Priorities – This document details the NAFC 2018 Public Policy priorities for the organization and its members. Below are some highlights from this document on the NAFC's Federal Policy objectives.
Annually, 2 million people receive health care at America’s 1,400 Free and Charitable Clinics and Charitable Pharmacies. This is accomplished through the work of dedicated staff and over 190,000 volunteers, including over 94,000 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 throughout the country have a medical home.
The National Association of Free and Charitable Clinics (NAFC) is dedicated to ensuring that America’s medically underserved have access to affordable quality health care.
HEALTH CARE ACCESS AND AFFORDABILITY
As a nation, we need to do a better job of addressing the health care needs of individuals, including the uninsured and medically underserved. Given that the health care landscape has shifted so dramatically and continues to change, policy makers must recognize the important and critical role Free and Charitable Clinics and Charitable Pharmacies play as members of the safety-net in responding to the needs and health care demands of the working poor, uninsured, and medically underserved. Therefore, the NAFC encourages policy makers to:
- 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).
- Establish Demonstration Projects with federal agencies to address the needs of diabetic and hypertensive patients treated at Free and Charitable Clinics and Charitable Pharmacies.
- Support legislative language to ensure the uninsured and underinsured in our country have access to affordable, accessible, and portable health insurance.
- Support legislative language which ensures the development of policies that stabilize the health insurance market.
- Support federal safety-net programs including the Breast and Cervical Cancer Screening program, CHIP, Medicaid and Medicare and ensure funding at appropriate levels to allow for access.
MEDICATION ACCESS AND AFFORDABILITY
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 patients at Free and Charitable Clinics cannot afford a $4 medication and 83% of our patients have stated that the high cost of medication is a huge barrier to care. Ironically, while 46% of our clinics have an operating budget of under $100,000 and are serving the poorest of the poor, our clinics are left out of the federal discount pricing program that makes medication more affordable for patients. Annually, Free and Charitable Clinics spend $15 million on pharmaceutical medications for our patients. Therefore, the NAFC encourages policy makers to:
- Include eligible Free and Charitable Clinics and Charitable Pharmacies as authorized entities for participation in the 340B drug pricing program.
- Support legislative language to make medications more available and affordable for the uninsured and medically underserved.
As we strengthen America’s medical workforce through training and opportunities, we also need to encourage volunteerism. 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 dramatically increase our pool of volunteers, which in turn would increase our ability to provide health care access. Therefore, the NAFC encourages policy makers to:
- Protect the current funding level for the Free Clinic Medical Malpractice Program under the Federal Torts Claim Act (FTCA).
- Expand the Federal Torts Claim Act to include entity coverage for Free Clinics.
- Pursue legislative language to expand the Federal Torts Claim Act to include Charitable Clinics, Charitable Pharmacies and the entities of both Free Clinics, Charitable Clinics, and Charitable Pharmacies.
- Expand the National Health Service Corps Designation to include Charitable Clinics.
- Expand telehealth programs to Free and Charitable Clinics and Charitable Pharmacies.
NONPROFIT FINANCE AND TAX
Free and Charitable Clinics do not receive dedicated federal funding, so they rely heavily on private donations from individual donors, foundations, grants and volunteers to keep their doors open and deliver health care to those who need it the most. Therefore, the NAFC encourages policy makers to:
- Support the broader efforts of the non-profit community to establish a Universal Tax Deduction for individuals to donate more easily to non-profits.
- Support the broader efforts of the non-profit community to Protect the Johnson Amendment -a provision in the U.S. tax code that prohibits all 501(c)(3) non-profit organizations from endorsing or opposing political candidates.
ENHANCING PUBLIC/PRIVATE PARTNERSHIPS
Free and Charitable Clinics and Charitable Pharmacies have a unique on-the-ground connection to the medically underserved and uninsured that is considered a benefit to private sector groups who are trying to make our country healthier and more health care cost-conscious. Free and Charitable Clinics are leaders in developing cost saving measures through the utilization and expansion of our public/private partnerships. Therefore, the NAFC encourages policy makers to:
- Expand and establish opportunities for growth in public/private partnerships through grant programs and tax credits.
- Urge health-related federal agencies to broaden eligibility for competitive federal grant opportunities to Free and Charitable Clinics and Charitable Pharmacies instead of limiting eligibility to federally funded centers.
- Develop sufficient funding for nonprofit capacity building programs and reforms that expand the availability and range of training opportunities to address the needs of both rural and urban communities.
As a recipient of the Robert Wood Johnson Foundation (RWJF) Award for Health Equity, the National Association of Free and Charitable Clinics, in the interest of public health, believes that all individuals should have access to affordable, quality health care. Therefore, the NAFC encourages policy makers to:
- Expand health care access and affordability to all individuals regardless of their age, sex, income, education, immigration status, ethnicity, color of skin, religion, or sexual orientation.