Policy 101: What exactly happens in that Policy 101: What exactly happens in that Capitol Building and what does it mean for Capitol Building and what does it mean for my health center?!my health center?!

Connie Parker, Executive Director, North Carolina School-Community Health AllianceKristin Curran, Deputy Director, California School Health Centers

National School Based Health Care ConventionJune 26, 2008

GoalsGoals

Review the basic process of moving from an idea to a bill and then to a law

Understand the steps taken and strategies used by NASBHC in pursuit of an authorization bill in Congress

Learn strategies and prepare to be an advocate for school-based health centers at the federal level!

Federal Gov’t Role in Child HealthFederal Gov’t Role in Child Health

Health services programPublicly financed health insuranceHealth promotion & disease

controlEducationCommercial insurance

Public Spending by Political Public Spending by Political JurisdictionJurisdiction

Education

Health Care

Federal

State

Local

SBHC Policy DomainsSBHC Policy Domains

“Every community that wants a school-based health center will have one.”

4 million served by 2012

Public health services and disease prevention programs and resources dedicated to SBHCs

Medicaid and SCHIP programs recognize SBHCs as provider type; reimburse for full value of services

Education policies/resources recognize and support importance of on-site health/mental health services

Commercial insurers recognize SBHCs as viable health services partner

Federal Policy ArenaFederal Policy Arena

StrategyStrategy

“Every community that wants a school-based health center will have one.”

4 million served by 2012

“Grasstops” Advocacy

Grassroots mobilizing

Partnerships w/ policy and advocacy

communities

Policy vision and

monitoring

A convenient and strategic model to organize your A convenient and strategic model to organize your advocacy planadvocacy plan

GoalsGoals Organizational Organizational

ConsiderationsConsiderations

Constituents, Constituents, Allies & Allies & OpponentsOpponents

Decision MakerDecision Maker TacticsTactics

Long Term:Long Term:

Intermediate:Intermediate:

Short Term:Short Term:

What do you What do you have?have?

What do you What do you want?want?

Internal Internal ProblemsProblems

Constituents:Constituents:

Allies:Allies:

Opponents:Opponents:

Primary Primary Decision Maker:Decision Maker:

Secondary Secondary Decision Decision Maker(s):Maker(s):

Model from Midwest Academy; www.midwestacademy.com

Political process on Capitol HillPolitical process on Capitol Hill

http://www.youtube.com/watch?v=mEJL2Uuv-oQ

AuthorizationAuthorization

A statutory provision that obligates funding for a program or agency.

May be effective for one year, a fixed number of years, or an indefinite period.

May be for a definite amount of money or for "such sums as may be necessary."

The formal federal spending process consists of two sequential steps: authorization and then appropriation.

AppropriationAppropriation

The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes.

RegulationRegulation

…is the next phase through which a primary piece of legislation is implemented … through which the administrative agency dictates exactly how to achieve the purposes set out by the primary piece of legislation.

Additional TermsAdditional Terms

Committee, subcommittee Senate: HELP (Health, Education, Labor

and Pensions) House: Energy and Commerce Sponsor, Co-Sponsor Mark up 110th, 111th Congress– cycles of Congresses Ranking member Earmark, line item

S600/HR4230: The School-Based S600/HR4230: The School-Based Health Clinic Establishment ActHealth Clinic Establishment Act

Introduced in the Senate on February 14, 2007 by Senators Dodd (D-CT) and Smith (R-OR). Introduced in the House on November 17, 2007 by Congresswomen Hooley (D-OR) and Capito (R-WV)

Authorize a federal SBHC program Provide competitive grants to SBHC providers to help

start new SBHCs or support already existing SBHCs. S600 was discussed in the Senate HELP committee

in the fall and resulted in a study by the General Accounting Office (GAO).

HR 4230 received a hearing on December 4, 2007. Movement is not likely until the 111th Congress in 2009.

S1669/HR2870: S1669/HR2870: Healthy Schools Act of 2007 Healthy Schools Act of 2007

Senate: Stabenow (D-MI); June 13, 2007 House: Rep Towns (D-NY); June 28, 2007 Ensure procedures for payment under Medicaid and

SCHIP for services provided by SBHCs Require State to certify to HHS Secretary that State has

implemented procedures to pay for SCHIP and Medicaid provided health care in SBHC

Define “primary health services” : core group of services offered by a SBHC, including comprehensive health and mental health assessments, intervention and treatment, as well as oral health, social, and health education services.

SBHCs included in final SCHIP bill with language that did not prohibit states from reimbursing SBHCs.

President vetoed twice

What to look for in 2008-2009?What to look for in 2008-2009?

School-based health centers included as a part of SCHIP reauthorization

Integrate school health centers in federal and state health care reform efforts/dialogue

Continue to move forward with authorization

Take Action!Take Action!

Check the NASBHC website to see if your Representative and Senators are co-sponsors.

Visit district offices.Host a site visit.Stay up-to-date and join the NASBHC

Action Center by visiting www.nasbhc.org (where you can also download advocacy resources).

QuestionsQuestions