The Critical Nature of Educating Candidates & Newly Elected Members of Congress About the Health Center Program and the HC Funding Cliff

The November 2014 election is just around the corner. In few short weeks, 36 seats in the Senate and all 435 seats in the House of Representatives will be up for grabs. While the thousands of petitions gathered by Health Center advocates and the legislative signatures collected on the “Dear Colleague” Congressional letter were powerful steps in the effort to avert the Health Center Funding Cliff, this busy election season presents Health Center advocates with a unique opportunity to make the case for the restoration of Health Center funding directly with the candidates – incumbents and challengers alike – who are campaigning in their home districts.

While it may seem counterintuitive to put time and effort into reaching out to all of those running for office, some of whom will inevitably not be victorious, reaching out to all the candidates in these races strengthens Health Center’s relationships with current officials and helps sows the seeds for new connections with future leaders.

NACHC Director of National Advocacy  and Civic Engagement

NACHC Director of National Advocacy and Civic Engagement Amanda Pears Kelly

“Today, as candidates are eager to learn about the local organizations that most support those in need in the community, and after the election this November, as newly elected officials consider the most important providers in their state and districts – Health Center Advocates must take every opportunity to provide a personal introduction to Health Centers and begin cultivating an important and lasting relationship,” said Amanda Pears Kelly, NACHC’s Director of National Advocacy and Civic Engagement. “Being able to demonstrate both the success and value of the Health Center model for candidates and newly elected officials will leave a lasting impression,” she continued, “especially as they consider healthcare issues in their official capacity and contemplate how resources should be used to support various programs in the future.”

These personal introductions are a sterling opportunity for your Health Centers to put itself on center stage and show candidates the amazing work and high quality services that your center provides to their constituents.

NACHC Director of Federal Affairs John Sawyer

NACHC Director of Federal Affairs John Sawyer

“A fundamental reason Health Centers have been so successful in the policy arena is that key decision-makers know who we are and understand what we do. Members of Congress need to feel a personal connection to our work at the community level in order to translate that into action at the national level,” said John Sawyer, NACHC’s Director of Federal Affairs. “This has never been more important – we need to be educating candidates, taking them on tours of Health Centers, explaining to them not only what we bring to the table, but what would happen if our federal support were to be cut. No matter who wins an election, doing proactive education with all candidates will pay dividends for health centers down the road.”

Thus, it is time for Health Centers to seize the moment! Reach out and invite candidates in your district to visit your Health Center so they can see first hand what makes Health Centers unique among health care providers. Be determined to make every “newly elected Member of Congress that arrives in Washington into a Health Center Champion – fully aware of the invaluable role Health Centers play in the community and to the health care system overall, fully aware of what is at stake relative to the Health Center Funding Cliff, and committed to take swift action to fix the Health Center Funding Cliff upon arriving in DC,” said Pears Kelly.

For more information about how to invite an elected official and/or candidates to your Health Center, how to prepare for and communicate effectively during these meetings, and more helpful resources, please check the Working with Elected Officials section on the website. If you do schedule a meeting with an elected official and/or candidates, please be sure to let us know by filling out this simple online form.

Michael Nicastro: October 2014 Outstanding Advocate

mnicastroNACHC’s advocacy team is excited to announce the Outstanding Advocate for October 2014, Michael Nicastro, Director of Community Outreach at East Boston Neighborhood Health Center!

Michael Nicastro has dedicated his career to serving the underserved at East Boston Neighborhood Health Center (EBNHC). For the past 37 years, he has worn many hats at EBNHC- from his start as a lab technician, to working on the development of safety programs, to his current position as the Director of Community Outreach.

Michael’s efforts to engage various populations and bring them into the Health Center fold gets right to the heart of grassroots advocacy and the meaning of community. “One of my main duties is to reach the underserved and disenfranchised individuals who live in the communities of our catchment area,” he said. With so much unmet need in this country, reducing barriers to care is one of the most important ways Health Centers can improve and increase access to primary medical care. Michael leads the charge for East Boston by engaging those who are most in need. “I hold outreach events at schools and non-profit organizations. I go to churches of every denomination, as well as mosques. [I] reach out to those who are poor, undocumented, homeless, and have substance abuse problems.”

So far, his efforts have been very successful in bringing more and more people to the Health Center. EBNHC’s CEO, Manny Lopes, says of Michael, “[he] has done an excellent job advocating for many in our service areas, and often has been instrumental in helping community members access much-needed care.”

In addition to reaching out to individuals who might benefit from the many services EBNHC provides, he is always looking for ways to partner with other organizations, making good health and positive well-being a collaborative, group effort—not just something EBNHC tries to achieve on its own. One example of such partnership is the work Michael has done to facilitate a relationship between EBNHC and Cradles to Crayons, an organization that provides clothing, school supplies, and other essentials to children living in low-income households, poverty, or who are homeless. Another example, from his time working on safety programs at EBNHC, is operating a child safety seat distribution program at the Health Center in conjunction with the Massachusetts Department of Public Health.

Whether he is working with the homeless or another local-non-profit, Michael truly puts the “community” in Community Health Center.

As far as efforts on NACHC’s Access is the Answer campaign, Michael collected over 13,000 petition signatures from EBNHC and surrounding communities. His efforts to collect local support letters also proved fruitful, as he was able to secure copies from area mayors and city councilors as well as state-level representatives and senators. Local support letters are a crucial part of the Access campaign, as they demonstrate to Congress a broad base of support back home for Community Health Centers, and Michael’s tireless efforts on behalf of EBNHC certainly paid off—both of MA’s US Senators and Reps. Capuano and Clark (whose districts are served by EBNHC) recently signed on to letters calling for a fix to the Health Center Funding Cliff.

Congratulations, Michael, on being our October 2014 Outstanding Advocate!


Do you know an Outstanding Advocate who deserves this recognition? Let us know! Email Elizabeth Kwasnik at

Celebrating Hispanic Heritage Month in America’s Health Centers

HispanicHeritageMonthCesar Chavez said, “Preservation of one’s own culture does not require contempt or disrespect for other cultures.” As Hispanic Heritage Month, September 15th-October 15th, comes to a close, we celebrate the unique cultural contributions of over 50 million Hispanic Americans and over 7 million Hispanic American Health Center patients.

Health Centers across the country serve patients of all backgrounds, ethnicities, races, languages, dialects, and cultures. They hire providers and staff from the community, and are run by Boards with a majority of patients. They treat their patients with dignity, making sure they leave the Health Center feeling healthy and confident.

The Campaign for America’s Health Centers is proud of the culturally competent care Health Centers work hard to deliver, and we support and encourage the role Health Centers play in encouraging their patients to be Advocates for themselves, their Health Centers, and their communities.  To support this role, we distribute a weekly Spanish newsletter via email to keep Spanish-speaking Advocates informed on important Health Center Advocacy updates and calls to action. In addition, to make staying engaged as easy as possible we offer a mobile advocacy network from which we send text messages in Spanish with advocacy information and easy ways to take action.  To be successful we follow a model in which we work directly with Health Centers to collect best practices and resources. This is in recognition of the Health Center model to engage and recognize the unique needs and priorities of various cultures and ethnicities.

The Campaign for America’s Health Centers celebrates the unique contributions Hispanic Americans bring to our country every day, and we applaud the Health Centers that promote the health and wellbeing of all of their patients through culturally and linguistically competent care. Thank you for respecting and honoring the cultures of all Americans.3

To learn more about the work the Campaign for America’s Health Centers is doing to encourage Hispanic Health Center patients to become Advocates, take a look at our website, featuring a new video in Spanish speaking to the importance of being an Advocate. To signup for the Campaign for America’s Health Centers weekly Spanish newsletter and/or text messages, click here.

Advocacy During an Election Year: Best Practices and Pitfalls to Avoid


Marc Wetherhorn, NACHC’s former Senior Director of Advocacy and Civic Engagement and current Project Director of Community Health Vote

With the Health Center Funding Cliff looming on the horizon and the election only a few weeks away, this is an ideal time for advocates to ramp up their efforts to make the case for continued support and funding of Health Centers. However, because there is an election underway, it is important for health center to be aware of what they can and cannot do as 501c3 non-profit organizations. The IRS has long-standing restrictions on the advocacy and political activity of 501(c)(3) nonprofit corporations.

To provide some insight into these issues, we’ve invited Marc Wetherhorn, NACHC’s former Senior Director of Advocacy and Civic Engagement and current Project Director of Community Health Vote, to weigh in on some frequently asked questions related to Health Center advocacy in an election environment.

NOTE: This blog is presented for informational purposes only. Please contact a licensed attorney if you have any specific questions or concerns about the political activity at your health center.


Question 1:

As a 501c.3, can I invite candidates to tour our Health Center and meet our staff and patients? Can I invite just the incumbent running for office? Just his/her opposition? Do I have to invite every candidate, even those from “fringe groups”?

501(c)(3) organizations can host candidates or have a legislative breakfast in which politicians come to discuss pertinent policy issues with Health Center staff and board. These candidate appearances are permitted as long as the organization provides equal opportunity to all political candidates seeking office and provides a fair, non-partisan forum. Generally speaking, organizations should extend invitations to all candidates seeking the same office.

Question 2:

How should these invitations be sent out (phone/email)? How much advance should be give? Does it matter?

It does not matter how the invitations are issued; however, it is always wise to have something in writing to describe the event and to document the invitation. Most elected officials and candidates have pretty full schedules, so the more time they are given to try to work your activity into their schedule the better.

Question 3:

Can candidates speak publicly at my Health Center, if for example the press is present? Can s/he talk about the Health Center Funding Cliff? 

Candidates can speak to your staff, board and others and answer questions about their views as part of a visit to educate them about the center and issues important to the center and its patients, but they cannot campaign and shouldn’t be allowed to make a public speech. If the press is present, they can cover the visit and what the candidate says but shouldn’t be allowed to ask questions during the visit.  It should be made clear to the candidate and the press that the visit is only to educate the candidate.

Question 4:

Can our Health Center support or oppose and candidates? Similarly, by being present at our Health Center, does this count as an endorsement of a particular individual running for office particularly if only one candidate makes a personal visit?

No. The IRS completely prohibits all partisan political activity. This means that a Health Center cannot directly, or indirectly, participate in, or intervene in, any political campaign on behalf of or in opposition to any candidate for public office.

Candidate appearances are permitted as long as the Health Center provides equal opportunity to all political candidates seeking office and provides fair, non-partisan forum.  Whether this activity constitutes political intervention will be determined by the surrounding facts and circumstances.

Question 5:

Are candidates allowed to fundraise or distribute campaign literature while at our Health Center? Can we have a policy in place regarding fundraising that we can share with candidates in advance?

No. The same “non-intervention” rules apply as in the previous question. Certainly your center can establish it’s own rules prohibiting this type of activity but they would simply be restating the law.

 Question 7:

What can I, as a Health Center staff/volunteer/board member/volunteer, do on my own time when it comes to endorsing or campaigning for a candidate? How do I distinguish personal conduct from actions undertaken on behalf of the Health Center?

The prohibition on partisan political campaign activity does not apply to the activities of officers, directors, or employees acting in their individual capacity. Staff may work on political campaigns outside work hours, or using their available leave time. However, leaders and volunteers may not use the facilities, equipment, personnel, or other resources of the organization to provide support or oppose a candidate or campaign.

Health Centers would be wise to protect themselves by:

1. Requiring officers or employees acting as individuals engaged in partisan political activity to clearly state that they are acting in their individual capacity, not on behalf of the Health Center, and that any reference to their work for the Health Center is made only for identification purposes.

2. Notifying employees of their limitation on use of their staff time and office facilities. Time sheets should reflect that an employee took leave to participate in partisan activity.

3. Disavowing any partisan actions of officials or employees that appear to be authorized by the organization, taking steps to ensure such actions are not repeated. Such a disavowal should be in writing and done in a timely manner.

Question 7:

What are the rules regarding voter registration at Health Centers?

A Health Center can engage in voter registration activities provided that voter registration is handled in a completely nonpartisan manner. In fact, Health Centers that have out-stationed Medicaid eligibility workers on site (either public employees or Health Center employees with delegated authority) may be required to do voter registration under the National Voter Registration Act, also known as “Motor Voter.”

Question 8: Where can health centers find more information about the rules for engaging in advocacy and political activity?

Health centers looking of more detailed information can go to

Community Health Vote

Nonprofit Vote 

Internal Revenue Service

Getting to Yes: Recruiting Your Legislators to Sign The Health Center Funding Cliff Letter

With Health Centers facing a 70% reduction to Program funding in FY 2016, a small group of Senators and Congressional Representatives stepped up to lead a bipartisan “Dear Colleague” Senate and House letter to address this Health Center Funding Cliff. The letters are addressed to Congressional Leadership and by co-signing, Members of Congress publicly state their support for the Health Centers and the need to fix the Health Center Funding Cliff. The House and Senate letters are currently circulating for signatures in Congress.

“These letters are vitally important in setting the stage for continued funding for Health Centers into the future,” said NACHC’s Director of Federal Affairs John Sawyer. “We have seen over and over again that it’s outreach from back home that makes the difference and turns a member from ‘no’ to ‘yes’,” noted Sawyer.

So far, 55 senators and 219 representatives have added their names to the letter. Health Center advocates from across the nation have been advocating hard and employing different advocacy strategies to bring their legislators to the table and get them to commit to co-sign the Health Center Cliff Letter.


Seferino Montaño, Chief Executive Officer of La Casa Family Health Center in Portales, NM

For Seferino Montaño, the Chief Executive Officer of La Casa Family Health Center in Portales, NM, the key to enlisting Representative Steve Pearce (R) as a co-signer to the Health Center Funding Cliff Letter was “constantly educating him and keeping him involved in the issues facing Health Centers. We continually tried to frame the issue through a rural perspective.In the Pearce’s district, which covers nearly half the state of New Mexico, Health Centers like ours are, for much of the population, the only source of health care that is both accessible and available,” said Montaño. Through emails, personal correspondence, phone calls, and in person visits “we continually made the case for the current and growing need for the services that we provide and the consequences for his constituents should funding for Health Centers be cut.” All these efforts helped create a strong relationship with the Representative that resulted in Pearce signing the “Dear Colleague” letter after being contacted by Montaño. “When I’m in DC for the Policy and Issues Forum next Spring, I plan to personally visit Representative Pearce on the Hill and thank him for his support,” said Montaño.

David D'Amato

David D’Amato, Senior Health Policy Director of the Alaska Primary Care Association

In Alaska, David D’Amato, Senior Health Policy Director with the Alaska Primary Care Association, noted that “Community Health Centers are so central to our way of life that, in absence of these health care homes, there would literally be no health services available to a large number of residents.” Both Senators Begich (D) and Murkowski (R), who also serve on the pivotal Appropriations Committee, “reallynities,” said D’Amato. It is this understanding on behalf of Alaskan lawmakers, as well as the personal relationships that have been formed with Begich and Murkowski and Health Centers across the state, that has helped create a strong, responsive relationship enabling the Alaska PCA and Health Center Advocates to reach out and secure signatures from both senators and their Representative to the letter. “Health Cent seem to understand that the consequence of the Health Center Funding Cliff to Alaska is that, if underfunding the Health Centers causes a CHC to close on the Alaska frontier, there is literally nowhere else for their constituents to go for health care in many of their commuers in Alaska are like a marriage vow: they are there for people in richness and poverty, and we’re blessed with a federal delegation who gets this,” he said.

John Silva, Chief Executive Officer of Morton Comprehensive Health Services

John Silva, Chief Executive Officer of Morton Comprehensive Health Services in Tulsa, Oklahoma

For John Silva, Chief Executive Officer at Morton Comprehensive Health Services in Tulsa, Oklahoma, the political environment around issues related to health care in Oklahoma has been exceptionally challenging in a Republican dominated state. “In large part, the conversation in Oklahoma has been an economic one when it comes to the Health Center Funding Cliff. So, we make sure to highlight the number of patients that we serve and the professionals that we employ,” said Silva. To help make the case for the continued funding of Health Centers, Silva and his colleagues have “shown up for everything: at collaborative partnerships, small meetings, and gatherings of the Tulsa Chamber of Commerce – a relationship that we have worked to foster over the last three to four years. We also started a monthly speaker series, inviting our elected officials, foundations, and the community at large, to come and learn about the issues facing the Health Centers.” Said Silva, “Speaking out on behalf of our Health Center is something we continually do year-round.” As a result of efforts like these, Senator James M. Inhofe (R) and Representative Tom Cole (R) have signed onto the “Dear Colleague” letter and other legislators “who have been reluctant to go near anything related to health care, have been quietly working with us on the sidelines, helping to set up meetings and open important doors,” noted Silva. In some ways “we were the little engine that could,” he said.

Though these Health Centers and the Alaska PCA operate in regions with distinct political and social differences, all were able to successfully reach out and recruit their Members of Congress to sign the “Dear Colleague” letter based in large part upon the relationships they had built-up with their members over time. With a small window left in this year’s Congressional session, Health Center advocates must press on and actively reach out to their Members of Congress. Only by having a large number of bipartisan co-singers, will we send the unmistakable message to Congressional leadership and the President that support for Health Centers is strong and that the Health Center Funding Cliff must be fixed.

Take action today:

  1. Call the NACHC Advocacy Hotline at 866-456-3949 to contact your Members’ offices directly and ask that they co-sign the Health Center funding cliff letters.
  2. Email your Senators and Representative and ask them to co-sign the Health Center Funding Cliff letter (send your email through the Grassroots Action Center by entering your zip code here).
  3. Share any feedback you receive by emailing

A copy of each letter can be found here along with updated lists of congressional signers and talking points.

“We can’t write anyone off in this effort, and we’ll need the action and leadership of every advocate in the country to get this done. The deadlines for signatures are fast approaching, so take action now,” said Sawyer.


Stephanie Wiersma, Rebecca Shaw, and LCH&D Staff: September 2014 Outstanding Advocates

(Photo courtesy of Lorain County Health & Dentistry)

NACHC’s advocacy team is excited to announce the Outstanding Advocate for September 2014. This month, we are recognizing not just one person, but a team— the staff at Lorain County Health & Dentistry in Lorain, OH.

Each August, Health Centers across the country observe National Health Center Week (NHCW). It’s a time to celebrate the work of and incredible care provided by Health Centers in their communities. NHCW is more than just a time to celebrate; it’s also a tool to help Health Centers showcase their services and the value they bring to the community, as well as advocate on a local and national level for continued support of the Health Center Program. True to the theme of NHCW 2014, CHCs really are “local engines for healthier communities.”

One Ohio Health Center embraced both the theme and the purpose of NHCW in a special way: Lorain Country Health & Dentistry (LCH&D) in Lorain, OH. Led by CEO Stephanie Wiersma and Outreach & Volunteer Coordinator Rebecca Shaw, the team at LCH&D took advantage of every opportunity to turn the energy and excitement around their NHCW events into action!

Beginning on August 11 and continuing throughout the week, LCH&D held health fairs at each of their locations, including two new sites in Elyria, OH. The health fairs provided the opportunity to showcase not only the sites themselves and the services provided, but also the numerous partnerships that LCH&D has with other community organizations and businesses. At the two Elyria sites in particular, the health fairs served as a way for LCH&D to introduce themselves to the community and begin to build new relationships – a factor they view as key to their success in caring for the community.

CEO Stephanie Wiersma (2nd from right) joins in on the fun of Spirit Week on Tiki Tuesday! (Photo courtesy of Lorain County Health & Dentistry)

In addition to the health fairs, Stephanie and Rebecca wanted to engage the Health Center staff- not just patients and community members. According to Stephanie’s philosophy, “when there’s an opportunity to have a little fun, we take advantage of it!” This led to the implementation of “spirit week”, where the staff dressed according to a different theme each day. Even bigger than the fun of each day’s theme, the activities that took place at LCH&D during NHCW had a deeper meaning. Rebecca remembers colleagues using their wacky outfits as an opportunity to educate and advocate, saying to patients and visitors, “yes I know my shoes don’t match- let me tell you why…” and continuing the conversation about Community Health Centers and why they are so vital to local communities.

This year, for the first time, LCH&D entered NACHC’s NHCW Video Contest. In promoting their submission and encouraging colleagues and patients to vote in the contest, they could never have imagined the outpouring of support they’ve received from the community, both for their video and for the Health Center in general. Stephanie was featured in a radio interview, and a local newspaper- The Morning Journal- even ran an article about the contest! Beyond staff and patients encouraging their family and friends to vote, Stephanie and Rebecca have seen an increase of awareness in the community around the care and services provided at LCH&D. Rebecca noted that just by telling others about the contest, and therefore, the Health Center, all of these people “are being advocates and they don’t even realize it!”

All in all, National Health Center Week was a huge success at LCH&D. Stephanie and Rebecca agreed that it brought the staff closer and got everyone more engaged, and all of the hype and publicity around the contest has helped get their name out in the community. At the time of this writing, the contest was in its final days, and the winner had not yet been decided. Stephanie reflected on the outcome, saying that even if their video didn’t get the most votes, “we’ve already won. We’ve made health care fun.”

[UPDATE 9/15/14: NACHC is thrilled to announce that LCH&D’s video “All Aboard the Healthy Train” was selected as the NHCW 2014 Video Contest Grand Prize Winner!]

Many thanks to Stephanie, Rebecca, and the rest of the staff at LCH&D for all of their hard work during NHCW 2014 and beyond! Congratulations on being our September 2014 Outstanding Advocates!


For more information on how your health center can get more involved in advocacy, email us at Do you know an Outstanding Advocate who deserves this recognition? Let us know! Email Elizabeth Kwasnik at

National Health Center Week 2014 A Huge Success! Thank You & Congratulations!

By Amanda Pears Kelly – NACHC National Advocacy Director

Open Door Family Medical Center

Open Door Family Medical Center

Every year, with an increasing sense of excitement, the planning for National Health Center Week (NHCW) begins months in advance of the actual event. NACHC, State Primary Care Associations, Health Centers and even individuals start brainstorming, about what their NHCW celebrations will entail and how to best showcase the great work of health centers and the critically important role they play in their community. This year was no exception. Despite the usual deadlines, challenges and competing demands for time and resources, health centers from coast to coast planned and delivered some of the best celebrations yet!

Nearly every state in the nation participated in NHCW this year and more than 600 health centers held more than 1500 events during NHCW 2014. The Administration once again helped to kick off NHCW this year, when President Barack Obama issued an official proclamation recognizing August 10th -16th as National Health Center Week 2014. HHS Secretary Sylvia Burwell and HRSA Administrator Dr. Mary Wakefield also helped celebrate NHCW by joining NACHC President & CEO, Tom Van Coverden and Health Center Leaders from around the country for a special NHCW 2014 Teleforum highlighting the countless ways that health centers are leading the nation in providing high quality, accessible care to all those in need. You can access the call transcript and recording on the Health Center Week website.

The NHCW success story goes on: more than thirty states, counties and localities also issued resolutions and proclamations in recognition of this year’s celebration. More than 80 Members of Congress participated in NHCW events, sharing kind words of support and pointing to the critical role health centers play in our communities and to the patients they serve. Hundreds of print, radio and broadcast media pieces also appeared throughout the week covering the wonderful events and celebrations happening around the nation.

We’ve done our best to document the success of NHCW 2014 by adding links to media coverage and posting event photos on the Health Center Week website and CFAHC Facebook page. If you haven’t yet had a chance, checkout the NHCW website to see this year’s NHCW in the News section. NHCW 2014 was also a big hit in the world of social media, garnering posts from dozens of members of Congress, state and local elected officials and partner organizations recognizing the vital role health centers play in the communities they serve. Thousands of NHCW tweets and Facebook posts went out using the #NHCW2014 hashtag, helping to spread the word about health centers and in recognition of NHCW 2014.

As a way to keep the celebration going throughout the month of August we encourage everyone to send us pictures and videos captured during your NCHW event celebrations. You can email them directly to . Also be sure to submit the best images and videos as part of the NHCW Picture & Video Contest . The contest submission period is open through August 29thvisit the contest pages to access rules and submission guidelines. The contest is a great way to gain national visibility for your health center and showcase the great events and celebrations hosted during NHCW. Keep the celebration going and make your submission today!

Year after year we have proudly organized and celebrated National Health Center Week, and there is one thing we know for sure: NHCW is a success because of the tremendous hard work and dedication of the staff, board members and patients at health centers everywhere. We want to take this opportunity to THANK YOU for another wonderful year of celebrations and success and congratulate you on a job extremely well done.

We are already thinking about National Health Center Week 2015 (August 9th – 15th) and we hope you’ll join us next year to raise the bar once again and make NHCW 2015 even bigger and better than each year prior.

Thank You.

The NACHC Advocacy Team

Amanda Pears Kelly – National Advocacy Director

Alexandra Harris – National Advocacy Specialist

Elizabeth Kwasnik – Grassroots Advocacy Manager

Joshua Speiser – Manager of Grassroots Advocacy Outreach & Communications

Yvette Ammerman – Associate Director for Western Operations


Join Together in Celebration of National Health Center Week and Farmworker Health Day

– In recognition of Farmworker Health Day on August 14th during National Health Center Week 2014, we welcome guest contributor Bobbi Ryder, President and CEO of National Center for Farmworker Health, Inc.

Bobbi Ryder

Bobbi Ryder, President and CEO of National Center for Farmworker Health

As we join together in celebration of National Health Center Week and Farmworker Health Day, I would like to encourage you to be bold in your embrace of this population and continue to seek ways to integrate both migratory and seasonal agricultural workers and their families into our care and our communities with the respect and dignity that they deserve. One way to do that is to challenge ourselves to make sure that all agricultural workers who are eligible for the Affordable Care Act (ACA) are enrolled and participating, and to increase the total number of agricultural workers who are able to make their medical home with a Migrant or Community Health Center.

I am confident that you will agree that Migrant and Community Health Centers are, and must remain, the primary points of access to care for the migrant and seasonal farm workers who give so much and ask for so little in return. The enactment of the PHS 329 Migrant Health Act in 1962 was a landmark event that set the stage for what we know of today as the Community Health Center Program, which now includes rural and urban, insured and uninsured, as well as several special population groups. In the ensuing years, we have seen the development of a wealth of high quality health care services across our nation, providing access to individuals in communities who would not otherwise be able to obtain health care services. This legislative act was a key transformational moment in the evolution of health care policy nationwide.

Whether because of migration, multiple employers, day labor or income status, agricultural workers are at risk to be among the residual uninsurable in this nation who will remain outside of the mainstream solutions for improvement of health. To ensure that everyone eligible for coverage does become insured, there is a role for each of us, both individually and collectively, to assure equity for the patients we serve. We must be engaged in our communities, we must engage our patients in articulating their needs and we must assure that they continue to have access to care, even where the ACA does not provide a solution to their continued lack of insurance.

The number of agricultural workers and their family members served in Community and Migrant Health Centers has hovered just under 900,000 for several years, and yet we know that there are significantly more who go unserved. I would like to issue a challenge to you collectively to make a commitment to increase that number in your health center by just 10%. Let us strive collectively to reach and surpass the 1 million mark in the coming years. Do we have the collective enthusiasm to rise to that challenge?

Jim Kim, currently President of the World Bank and formerly a top executive of the World Health Organization and Chair of the Department of Global Health and Social Medicine at Harvard Medical School uses extreme goals to reform the World Bank. Let us take a lesson from his examples.

Examples of Kim’s goals include: assuring that 3 million HIV suffers in developing countries received antiretroviral treatment by 2005. He met that goal in 2007, his current goal as President of the World Bank is to end world poverty by 2030.

What better way for us to recognize the contributions that agricultural workers make to the economic infrastructure of our nation than to make sure that they are able to enjoy the benefits of this most recent change in health care policy?

I encourage you to help us lay the groundwork to assure that migratory and seasonal agricultural workers are able to receive and access the high-quality care provided by our nation’s Health Centers.

My best to you,

Bobbi Ryder, President and CEO, National Center for Farmworker Health

Breaking the Links Between Poor Health and Homelessness

– In recognition of Health Care for the Homeless Day on August 13th during National Health Center Week 2014, we welcome guest contributor Dan Rabbitt, Health Policy Organizer for the National Health Care for the Homeless Council

Dan Rabbitt, Health Policy Organizer for the National Health Care for the Homeless Council

Homelessness is bad for your health – and also bad for your health care. People experiencing homelessness don’t have the basic supports most people take for granted. A safe place to rest and heal, protection from the elements, and a secure place to store medications are all hard to come by without stable housing. The lack of housing—a key social determinant of health– makes people sicker, exacerbates existing illnesses, and makes effective treatment incredibly challenging. It is no wonder those experiencing homelessness die 30 years earlier than their housed counterparts.

Thankfully, the Health Center program, which includes Health Care for the Homeless (HCH) projects, is dedicated to surmounting these challenges, having provided care to more than 1.1 million homeless patients in 2012. For over 30 years, HCH programs have been serving those without stable housing and have learned how to adapt their services for a population with such limited resources. The National HCH Council Clinician’s Network has developed adapted clinical guidelines to treat dozens of medical and behavioral health conditions common among those without homes, and the Health Center model of patient-centered, team-based care effectively delivers care needed to treat the complex health and social needs of individuals and families experiencing homelessness.

Furthermore, the Health Center program is often the only place people with little or no income can turn for health care besides emergency rooms. Serving everyone regardless of their ability to pay is an essential requirement of the Health Center program and allows very low-income people to access essential primary and preventative care. Many HCH programs have sliding fee scales that charge no copays for those earning less than the federal poverty level, a policy that significantly reduces barriers to care. In turn, these policies save the entire health care system by preventing unnecessary emergency room and inpatient hospital costs.

While access to quality clinical services is critical, housing is the best medicine for individuals and families without homes. Many HCH programs partner with housing providers in their communities to help those they serve obtain stable housing and the supports needed to maintain it. While a wide range of housing programs are available, permanent supportive housing is a particularly successful and cost-effective model for those struggling with significant health care conditions. The National HCH Council and our ally CSH are currently working to promote partnerships between health centers and permanent supportive housing programs, hoping to expand the reach health centers can have to improve the health of those without homes.

The Health Center and HCH program has learned a great deal in the past 30 years and now have more data and better policies to support housing stability for those that need it. In recognition of Health Center Week and HCH Day this year, celebrate the strides made to make homelessness rare and brief and further strengthen your commitment to improve the health of your patients who lack stable housing and need your support more than ever.

Holding Effective Meetings with Your Elected Officials During National Health Center Week

NHCW square1 2014As National Health Center Week 2014 (August 10 -16) approaches, many Health Center advocates have been successful at lining up visits with their Members of Congress onsite at their centers. At time of publication, more than 30 Members of Congress have already confirmed attendance at National Health Center Week events, with event commitments coming in daily.

By introducing Members of Congress and all elected leaders to health center patients, staff, and Boards of Directors, they are able to bear witness to the vital and essential services the health center provides to the community. Furthermore, these visits are a prime opportunity to present your Member of Congress with signed Access is the Answer petitions and letters of Health Center support from elected officials and community supporters. But how can centers take advantage of these visits to make them transformative events that help shift a Member of Congress from a supporter into a true Health Center champion?

Jana Eubank

Jana Eubank, NACHC Associate Vice President for Public Policy and Research

NHCW is arguably the best opportunity Health Centers have each year to educate their members of Congress (as well as state legislators) about the important work of Health Centers in your states. It makes it so much more real for them to see Health Centers in action and observe firsthand the tremendous impact health center staff, clinicians and board members have in communities across the country,” said Jana Eubank, NACHC Associate Vice President for Public Policy and Research. “(Texas) Congresswoman Kay Granger and Senator John Cornyn are great examples of elected officials who have become champions in Congress for the Health Center program and credit their strong support to their direct interaction with Health Centers ‘back home.’ Both members regularly visit health centers and are Co-Chairs of the Community Health Center Caucus in the House and Senate.”

“It’s important to remember that just having an elected official take a tour of the center isn’t always enough to help them truly understand the impact your center has in your community,” she continued. “As a former PCA staffer, I’ve been fortunate to participate in numerous Health Center events with elected officials. Successful events have a couple of common characteristics – members are given time to interact with patients, staff and Board Members and are offered the opportunity to play an active role in the Health Center event. This can be accomplished by setting aside some “quiet time” for them to meet with Board of Directors to discuss issues impacting the Health Center and patients. Or if you are having a health fair or community event put them to work. Let them be a judge in your children’s art contest, assist with food preparation or ask them to help handout school supplies or other items to your patients.”

“Remember, elected officials work hard and also need to have a little bit of fun,” said Eubank. “NHCW is a joyous occasion. Let your member be a part of the celebration and play an active role in your NHCW event this year. You will be amazed at how grateful they will be for being included and how impactful these visits can be in cultivating and strengthening relationships on the ground. A well planned visit can turn your Congressional member from a health center supporter into a health center champion.

As noted by Eubank,the presence of elected officials at Health Centers during National Health Center Week is an extraordinary opportunity. Done well, these visits can lay the groundwork for new relationships with Members of Congress who have little or no history with your Health Center and further strengthen existing connections.

Once confirmed, please let us know about these Congressional visits by emailing and make sure to post your events on the National Health Center Week website Again, be sure to deliver your signed Access is the Answer petitions and letters of Health Center support from elected officials and community supporters at these meetings. For additional resources, including how to communicate effectively and build a relationship with your elected official, check out the Working with Elected Officials page on the Campaign for America’s Health Centers website.