Policy 101: What exactly happens in that Capitol Building and what does it mean for my health center?! Connie Parker, Executive Director, North Carolina School-Community Health Alliance Kristin Curran, Deputy Director, California School Health Centers National School Based Health Care Convention June 26, 2008

Goals 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 Health Health services program Publicly financed health insurance Health promotion & disease control Education Commercial insurance

Public Spending by Political Jurisdiction Education Health Care Federal State Local

SBHC 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 Arena Strategy “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 advocacy plan GoalsOrganizationalConsiderations Constituents, Allies & Opponents Decision Maker Tactics Long Term: Intermediate: Short Term: What do you have? What do you want? Internal Problems Constituents:Allies:Opponents: Primary Decision Maker: Secondary Decision Maker(s): Model from Midwest Academy;

Political process on Capitol Hill

Authorization 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.appropriation

Appropriation 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.

Regulation …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 Terms Committee, subcommittee Senate: HELP (Health, Education, Labor and Pensions) House: Energy and Commerce Sponsor, Co-Sponsor Mark up 110 th, 111 th Congress– cycles of Congresses Ranking member Earmark, line item

S600/HR4230: The School-Based Health 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, Movement is not likely until the 111 th Congress in 2009.

S1669/HR2870: 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 ? 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! 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 (where you can also download advocacy resources).

Questions