California School Health Centers Association

Federal Health Care Reform
An update on health care reform and SBHCs will be provided by NASBHC on May 6th from 12:00-1:00 (CA time). Please stay tuned and save the date!

In the meantime, here is a summary of what was passed in health care reform (click here for text of the bill) and what comes next:

1. SBHC Authorization (Sec. 4101(b))
As a movement, SBHCs have realized a great victory in passing legislation to authorize a federal program for SBHCs. However, an authorization does not guarantee funding, it simply creates an official program in federal statute. So we are now launching into the next phase of our campaign, to get the newly authorized program actually funded through the appropriations process.

We are facing a difficult battle for three reasons: 1) The Labor, Health and Human Services appropriations bill is one of the most competitive appropriations bill in Congress, 2) this is a difficult budgetary year, and 3) misconceptions remain among members of Congress that SBHCs are supported by 330 funds (which is true in a few cases but not in many others).

CSHC will be working closely with NASBHC to advocate for an appropriation by reaching to California champions in Congress and members of the Appropriations Committee.

NASBHC is working on FQHC eligibility to apply for funding through the authorization (when it gets funded). Congress wants to avoid duplication or overlap of federal funding; therefore sponsoring agencies that receive 330 funds to run a SBHC program will not be eligible for additional funding for the same SBHC program. These are issues that will be addressed in regulations which will not be written until an appropriation is allocated to the authorization program.

2. Emergency Funding for SBHCs (Sec. 4101(a))

The second provision included in the Affordable Care Act mandates $200 million over four years ($50 million/year) for SBHCs. Unfortunately, the original intent of the provision to provide funding for operations was amended by Senate appropriators in closed-door negotiations.

The funds are restricted to expenditures for facilities (construction, expansion, improvements, equipment) and can not be used for operations. Appropriators made these changes because of a misconception that operations are supported through 330 funds.

NASBHC continues to work with staff and members to expand the use of these funds to include operations, however they estimate the likelihood of success as slim.

However, the funding is mandated and the guidance for the funds is due in June. It is clear that these funds will be allocated through a competitive grant cycle. NASBHC is investigating who is responsible for writing the guidance so the field can be involved. In the meantime, we encourage programs to think creatively about ways to use these funds if they are restricted for capital. FQHCs will be eligible for capital funds for SBHCs.