With the recent enactment of the Patient Protection and Affordable Care Act (PPACA,commonly referred to as health care reform), many Partnership members and Community Action leaders have asked for useful information on the Act, especially as it pertains to the vulnerable populations served by Community Action Agencies (CAAs) and how it might affect the health care plans CAAs provide for their staff.

The Partnership staff in DC is active with several groups that focus primarily on health care reform implementation and policy such as Families USA, Trust for America’s Health/Advocates for a Healthier America, Divided We Fail/AARP, and others. We also receive information and attend briefings from our collegial advocacy groups that have health reform as a part of their respective agendas, e.g. Generations United, Jobs for America Now!, the federal Centers for Disease Control and Prevention, and the Rural Family Economic Success (RuFES) Network/Casey Foundation & Aspen Institute.

In response to your requests for understandable, useful information that helps decipher the complexity of the new law, our e news will periodically carry briefing memos, web site links, and other information on health care reform. Our first two resources appear below. The first is from RuFES and it describes some of the impact on rural communities. Following that is some information on Medicare reform provided by Richard Hamburg of Trust For America’s Health.

A Health Care Opportunity is a Comin' to Your Community

What this Alert contains:

• A brief list of key provisions in the Healthcare Reform Act
• Three parts of the Act with big effects in Rural America:

• Health Care Tax Credit for small business
• Expansion and support for School-Based Health Centers
• Access to rural health care

In March 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (PPACA). Many Americans simply referred to it as Healthcare Reform. While the public remains sharply divided over the benefits of this legislation, just about everyone agrees that this was the most important piece of health care legislation since Medicare in the 1960s.

As the heat from the debate cools, and a growing number of PPACA's provisions go into effect, we think it is time to highlight some parts of the Act that will have particular impact in rural America.

This bill has many parts, but the central Keep It purpose of the legislation, is to increase access to affordable, reliable health care. One of the biggest challenges is how to explain just what the bill is supposed to accomplish and how.

Some people are still scratching their heads, and understandably so. We know we have trouble keeping it all straight. Would you like to see a good, brief overview of the PPACA? Try this YouTube video summary from the Center on American Progress

Some of the key provisions in the PPACA:

• Expands Medicare eligibility
• Subsidizes healthcare premiums
• Provides incentives for businesses to provide health care benefits
• Permits dependent children to remain on their parents' health care plan until the age of 26
• Bars insurers from dropping their policy holders when they get sick
• Restricts insurer's ability to enforce annual spending caps and eliminates these caps completely by 2014
• Prohibits insurers from denying coverage or charging higher fees to individuals based on pre-existing conditions
• Establishes health care exchanges and subsidizes insurance premiums for individuals earning up to 400% of the poverty line

While each of these measures will help low- and moderate-income rural working families, there are a few items within the Patient Protection and Affordable Care Act that will have a particular effect on rural communities. You should be aware of the following three special opportunities presented by the new law.

Rural Effects of Healthcare Reform

Healthcare Tax Credit for Small Business

Small businesses are the engine of the American economy in general, and they have a special importance in rural America. Rural advocates may want to take note of the Patient Protection and Affordable Care Act's special provision for small business owners.

Contrary to popular belief, under the PPACA, businesses with fewer than 50 employees, are NOT compelled to provide health care to their employees. Since 95 percent of all US businesses have fewer than 50 employees, that exempts most American businesses. But if these business owners do choose to provide health insurance to their employees, the PPACA provides a Small Business Tax Credit, designed to make health insurance more affordable. The credit will provide businesses with anywhere from a 25%-50% credit on their insurance premiums. This will be no small relief to small businesses which on average spend 18 percent more than large businesses on health care policies.

To be eligible for this credit, small businesses must:

• Have fewer than 25 employees
• Average wages of less than $50,000 per year
• Purchase health insurance for employees
• Contribute at least 50% of the cost of the premium

For more information, and to see a chart that illustrates how the tax credits will work, please see this short piece from the Center for Rural Affairs.

Expansion and Support of School-Based Health Centers

School-Based Health Centers (SBHCs) provide free, comprehensive health services to students during school hours. Most schools have a nurse on duty at least on a part-time basis, but SBHC's provide most health services including primary, dental and visual care, as well as mental health and nutrition services. SBHCs are usually located in medically underserved areas. About one-third of the 2,000 SBHCs are located in rural areas.
In addition to the obvious health benefits of these services, educators feel that these centers give teachers and administrators more access to students with high needs. SBHC's tend to create more parental involvement and higher academic achievement from their students. With the mental health services involved, SBHC schools report fewer disciplinary issues and high-risk behaviors. Studies show that SBHC users are more likely to graduate from high school than nonusers.

The Patient Protection and Affordable Care Act provides $200 million in additional grant funds over the next four years to SBHCs. The grants are limited to facilities expenditures—such as the acquisition or improvement of land, construction costs, equipment and similar expenditures. The regulations for these funds are likely to be released this month. The US Department of Health and Human Services will also soon decide which agency within the department will coordinate these activities.

For more information on the SBHC provision in the PPACA bill, please visit the National Assembly on School-Based Health Care

Access to Rural Health Care

Rural people face significant challenges when they need to access health care. They usually have to travel farther than urban and suburban dwellers. Moreover, rural health care facilities have fewer doctors serving more people. While only nine percent of American doctors work in rural America, over 20 percent of all Americans live in rural areas. Certainly this leaves rural America with a deficit in coverage. One reason—beyond simple geography—for this discrepancy in service is a difference in how much rural health care providers are paid. The PPACA improves this situation in three ways:

• First, it provides a 10% pay incentive for primary care doctors operating in rural areas
• Secondly, it closes part of the gap between what federal programs pay rural and urban doctors
• Finally, the PPACA extends the enhanced payments to rural health care facilities in the Medicare Modernization Act

The Ways and Means Committee of the House of Representatives has prepared a user-friendly information sheet on the ways the PPACA has increased health care access in rural communities. Please click here to view.

We hope these Action Alerts energize your RuFES deeds and aspirations. Help us spark more RuFES action! How? Simply contact us with any news, ideas or opportunities that can help your RuFES colleagues across the nation.

Friday, June 25, 2010

Statement from Secretary Sebelius on Proposed CMS Rule to Expand Medicare Preventive Services and Expand Access to Primary Care

Today, the Centers for Medicare & Medicaid Services (CMS) took another important step to help improve the health status of Medicare beneficiaries. The proposed regulation will implement the new preventive health benefits created under the Affordable Care Act for the seniors and persons with disabilities who rely on Medicare for their health care coverage.

The new rule proposes to make two significant improvements to preventive care benefits under Medicare: Beginning January 1, 2011, Medicare will cover annual wellness visits so that doctors and patients can develop a personalized prevention plan that takes a comprehensive approach to improving the patient’s health. Also beginning January 1, 2011, Medicare beneficiaries will no longer have to pay any out-of-pocket costs for most preventive services – including that annual wellness visit.

To help make sure that Medicare beneficiaries have access to primary care doctors, the rule would also boost payments for primary care services. The proposed regulation would also increase access to services by creating payment incentives for general surgeons as well as expand access to other types of health care providers.

Improving access to preventive services and primary care is a top priority for HHS. The proposed rule is just one part of a broader effort we are making to improve the health status of Medicare beneficiaries – and all Americans. We recently announced the allocation of $500 million from the Prevention and Public Health Fund – created by the Affordable Care Act – to invest in the training and development of primary care professionals as well as preventive care activities and public health infrastructure.

With these new benefits under Medicare, and investments in our health care system, the Affordable Care Act is continuing the Obama Administration’s historic work to promote wellness and reduce chronic disease.

Danny Pouladian of Blue Line Media (formerly known as Bluline Media) in Los Angeles, CA, has reached out to the Partnership again, this time to offer CAAs discounted advertising rates for ad space on municipal buses in the available markets.

As a nationwide outdoor advertising company, Blue Line Media periodically offers government and nonprofit discounted advertising rates to CAAs as part of its pro bono efforts. Check out their website, www.bluelinemedia.com/transitadvertisingmedia for examples of their work. Also see the Spring 2010 magazine for CAA testimonials on this service.

Although Blue Line is no longer able to provide free ad space on the buses as it has done for CAAs in the past, they are able to offer CAAs the discounted government and nonprofit rates. CAAs would be responsible for the costs of the ad space and providing Blue Line Media with the artwork for the ads. Blue Line will then work with the municipal bus companies to place the ads, which would run on buses from October-December 2010.

This is a great opportunity for your CAA to promote Head Start, job training, housing, and other programs to a wide audience. If you are interested, please contact Danny for full details and pricing information at
310-729-5190 or dannyp@bluelinemedia.com. The deadline is August 9, 2010.

 

Thanks to our hardworking, always vigilant colleagues at the Coalition on Human Needs, the Partnership joined with over 1,100 national, state and community-based organizations in support of extending the child tax credit, EITC improvement, and the tax credit for low-income college students. Our special thanks to the dozens of Community Action Agencies and CA State Associations who signed on. Visit http://www.chn.org/pdf/2010/TaxCreditsLetter6-21-10.pdf to see the complete list of signers to the letter below.

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June 21, 2010

Dear Senator/Representative:

You have an opportunity to help low-income working families withstand the loss of income from the recession, prevent millions from slipping into poverty, and sustain economic growth, now and for years to come. These vital goals can be achieved by continuing and building upon the refundable tax credits now in place to assist children and their working parents.

The undersigned are organizations in every state in the nation, representing people of faith, providers of essential services, policy experts, and national, state, and community leaders. We come together to urge the speedy renewal and improvement of the refundable Child Tax Credit, Earned Income Tax Credit, and American Opportunity Tax Credit.

Improve and Preserve the Refundable Child Tax Credit. A family with two children working full-time at the minimum wage currently receives a Child Tax Credit of about $1,750. If Congress does not act to extend the current levels, the same family will receive only $250, a loss of $1,500. This loss occurs because earnings of $3,000 or more count in calculating the Credit under current law, but only earnings higher than about $12,850 would count if improvements in the Child Tax Credit made since 2001 are allowed to expire.

If the current Child Tax Credit improvements expire 8 million children would lose their credit entirely, and an additional 10 million children would lose some of it, according to the Tax Policy Center. The poverty figures are equally staggering — if CTC improvements expire, 600,000 more children will become poor and 4 million already poor children will fall into deeper poverty, according to the Center on Budget and Policy Priorities. Economists at the Economic Policy Institute have estimated that fully one in four children were poor in 2009. It would be reckless to make these shocking statistics even worse.

We strongly urge you to prevent this harm to children, and help low-income working families further by counting the 15 percent credit from the first dollar of earnings, as passed in December by the House in its Jobs for Main Street legislation. This strong work incentive and family support would provide the family working full-time at the minimum wage with a credit of $2,000 – reducing poverty instead of allowing it to deepen.

Retain Help for Families with Three or more Children and Reduce the “Marriage Penalty” in the Earned Income Tax Credit. In 2009, Congress improved upon the EITC by increasing the amount available to families with three or more children and reducing the “marriage penalty” in the EITC by increasing the amount received by married couples. In 2009, the maximum EITC for a family with three or more children was increased to $5,657, or $629 over the amount available to families with two children. The increase is important because it responds both to the increased costs of raising more children and to the greater likelihood of poverty in larger families. These two EITC changes prevented three million people from falling into poverty in 2009, according to an analysis by the Center on Budget and Policy Priorities, and increased the help to 7 million people. Please vote to preserve these improvements.

Help Low-Income Students Afford to Go to College through the American Opportunity Tax Credit: The 2009 changes to this credit (formerly known as the Hope tax credit) could benefit 3.8 million low-income prospective college students by providing up to $1,000 in a refundable credit to help pay for college costs. (The full tax credit was increased to $2,500, with up to 40 percent available to students among the millions of those who do not owe federal income taxes, although they are likely to pay significant amounts for payroll and other taxes.) Before this improvement, families with students saw little to no benefit from the non-refundable Hope tax credit, and a married couple with one child in college and another younger child would be ineligible for the credit if their income were below $26,000. Similarly, low-income single adults attending college can receive at least a partial credit. In this time of high unemployment (with one in four 16-19 year-olds unemployed), it makes sense for youth and adults alike to upgrade their skills and prepare for jobs with career potential. Most federal tax assistance for college study is primarily helpful to households with incomes of $100,000 - $200,000. The American Opportunity Tax Credit deserves your support because it will make it possible for millions of lowincomestudents who would otherwise be excluded to afford higher education.

Preserving and building upon these tax credits will prevent millions of children in working families from becoming poor or more deeply poor. They help parents whose earnings have dropped in the recession, and help children, families and the economy by preventing disastrous reductions in purchases of food and other necessities. These credits also provide significant help to families just over the poverty line, easing their daily struggle to make ends meet.

Please remember these children, students, and families by supporting the improvements in the Child Tax Credit, Earned Income Tax Credit, and American Opportunity Tax Credit as you consider tax legislation this year.

 

Community Workforce Agreements (CWAs), also known as Project Labor Agreements or Project Stabilization Agreements are project-specific, pre-hire collective bargaining agreements that set out the terms and conditions of employment (often with public funds). CWAs are intended, in part, to assure that stakeholders such as residents in low-income communities where the projects are/will be are included and involved.

If your Community Action Agency has been part of, signed on to a CWA, Don Mathis at the Partnership is very interested in learning about your experience. Don will be participating in a series of meetings, starting on July 7th at which CWAs will be on the agendas. Please either e-mail dmathis@communityactionpartnership.com or phone him, 202-449-9774. Your input and experience will be very important.

mmm

The Partnership’s Certified Community Action Professional (CCAP) program is a peer-driven, structured, self-paced certification and recognition program for current or emerging Community Action leaders and managers. Applicants apply by submitting a Candidate Data Form by the third Wednesday in January, and if accepted into the CCAP program, begin by developing their Executive Skills Portfolio. To learn more about CCAP, visit our website www.communityactionpartnership.com

Following days of rigorous scoring and analysis, the Partnership’s CCAP Commission (see photo) determined that 50 candidates in this year’s pool completed all their CCAP requirements and earned their CCAP. Congratulations to our new CCAPs below, and if you know or work with any of these new CCAPs, please offer them your appreciation for helping strengthen our Community Action Movement.

FROM LEFT: Paul Dole (KY), Janice Reilly (SC), Janice Daku (ME), Winston Ross (NY), Bill Breidinger (NY),
Charles McCann (MO), Lois Carson (CA), and Jim Lopresti from the Partnership

Cyndi Astley, CCAP
Mid-Willmette Valley CAA
Salem, Oregon

Carrie Blackham, CCAP
Audubon Area Com
Owensboro, Kentucky

Sheri Boelter, CCAP
District & Human Resources Development Council
Billings, Montana

Jennifer Brooks-Smith, CCAP KCEOC
Barbourville, Kentucky

Denise Caldwell, CCAP
KCEOC
Barbourville, Kentucky

Melissa Canady-Alderton, CCAP
KCEOC
Barbourville, Kentucky

Marilyn Coffey, CCAP
KCEOC
Barbourville, Kentucky

Tish Coldiron, CCAP
KCEOC
Barbourville, Kentucky

Anika Coney, CCAP
Hillsborough County Health & Social Services
Tampa, Florida

Robin Corak, CCAP
Multi Service Center
Federal Way, Washington

Stephanie Davis, CCAP
Community Action Council
Lexington, Kentucky

Jay Doman, CCAP
Eastern Idaho Community Action Partnership
Idaho Falls, Idaho

John Edwards, Jr., CCAP
NE Florida CAA
Jacksonville, Florida

Miles Estes, CCAP
KCEOC
Barbourville, Kentucky

DeLisa Lynn Estes, CCAP
KCEOC
Barbourville, Kentucky

Paul Fessler, CCAP
Project NOW, Inc
Rock Island, Illinois

Theodore Foster, Jr., CCAP
Human Development Corporation of St. Louis
St Louis, Missouri

Karla Mulkey, CCAP
Eastern Idaho Community Action Partnership
Slamon, Idaho

Dianna Moore, CCAP
Central Missouri Community Action
Columbia , Missouri

Shaunda Noah, CCAP
Ki-Bois Community Action
Stigler, Oklahoma

Lana Ross, CCAP
Iowa Community Action Association
Des Moines, Iowa

Donna Jean Sample, CCAP
Kankakee County Community Services
Kankakee IL

Naimah Sierra, CCAP
Action for a Better Community Rochester , New York

Dick Sievers, CCAP
Mid Sioux Opporunities, Inc
Remsen, Iowa

Tiffany Smith-Keimig, CCAP
Iowa Community Action Association
Des Moines, Iowa

Denise Stahura, CCAP
CAP of Ramsey and Washington Counties
St. Paul, Minnesota

Brenda Stegeman, CCAP
Missouri Association of Community Action
Jefferson City, Missouri

Laura Traum, CCAP
Ogden Weber Community Action Partnership
Layton, Utah

Karla Underwood, CCAP
Community Action Council
Lexington, Kentucky

Aaron Wicks, CCAP
Action for a Better Community Rochester, New York

Trisha Wilkins, CCAP
NE Iowa CAC
Decorah, Iowa

Tina Zerbian, CCAP
Cattaraugus Community Action Salamanca, New York

 

Pay tribute to Community Action with an ad in the 2010 Annual Convention program book!

Celebrate your role in America’s poverty fighting network and
Community Action: The Power of Partnerships by sending special greetings to
your colleagues, honoring your CAA's partners, and highlighting the unique history of your CAA.

Ad deadline is July 12. Click here for the ad registration form and prices.

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To view or download the 2010 Annual Convention Brochure or the Registration form, click here. Hotel rooms are selling quickly at the Boston Marriott Copley Place. Click here to reserve online and assure your reservation is confirmed at the convention rate of $189.00 single or double.

Okay, so maybe Bill Gates made it without spending time at the Partnership. The great news is that our intern from last summer, Stephanie Gilmour, Penn State Class of 2010, has been hired by Big Brothers/Big Sisters in Philadelphia to do “matches’ of youth with their BB/BS. Congratulations to Steph who’s maintained her values of caring and helping others. So, the big question is, after Steph has arranged her first dozen matches with Big Sisters, are these young females the new “Gilmour Girls?"