1. Creating and Maintaining a Successful Health Clinic under the Affordable Care Act What the Affordable Care Act means for health clinics and how to plan for their success through financial and legal considerations. Aamer Hayat CEO AWC Management, Inc COO Avecinia Wellness Center Wasif Ali Khan, JD, LLM (Health Law) LaDonna Waugh, MD, JD FACS MAY 9, 2015 (CHICAGO, IL)

2. FINANCIAL CONSIDERATIONS AND BUSINESS PLANNING

3. Financial Considerations/Business Planning 1)Understand your market Who are you serving? What resources are currently available to that population? What is your clinics value proposition? 2)Understand your resources Will you be using grants? Fundraising? Medicaid? Which community groups can be partners? 3)Understand your costs What will be your most significant costs: Salary (Administrative, Professional Fees) Rent Supplies

4. Financial Considerations/Business Planning 1)Understand your market Who are you serving? Medicaid Population Indigent – Uninsured Immigrant - Uninsured What resources are currently available to that population? Local Health Clinics Homeless Shelters Islamic Centers/Churches/Synagogues What is your clinics value proposition? What difference are you try to make? What are alternatives to creating a clinic?

5. Financial Considerations/Business Planning 1)Understand your resources Will you be using grants? Fundraising? Medicaid? Medicaid or other federal health resources may be restrictive in who can be Grants Which community groups/businesses can be partners? Can pooling you resources achieve better results? Can local businesses or resources provide for costs?

6. Financial Considerations/Business Planning 1)Understand your costs What will be your most significant costs: Salary (Administrative, Professional Fees) Hire a good lawyer (Asbahi Law) Not For Profit Status, Etc Hire a good accountant Cash Flow & Income Statement Hire a good “manager” Organizational management Rent What are your most cost efficient options Free spaces Shared spaces Insurance Malpractice – Volunteer programs Supplies Administrative/Medical Supplies Medicines

7. LEGAL ELEMENTS OF NON-PROFIT CLINIC OPERATIONS

8. Legal Elements of Non-profit Clinic Operations 1)Forming the Legal Entity Formation of Entity (Not for Profit Corporation) Internal Documents (Bylaws, Policies & Procedures) Form 1023-Application for Tax Exemption State Registrations Registration with Attorney General State Solicitation Statutes Tax and Employment Security Offices 2)Business Contracts and Agreements Vendor Agreement Commercial Leases Employment/Independent Contractor Agreements

9. Legal Elements of Non-profit Clinic Operations 3)Relationships w/ Health Professionals Prohibition on corporate practice of medicine If you will be paying for staff physicians/dentist must be independent contractor & maintain independent judgment Preference for volunteers Volunteer Protection Act State Protections for Physicians and Dentists 4)Insurance Malpractice concerns for Physicians/Dentists General Business Liability Insurance Directors & Officers Insurance

10. Legal Elements of Non-profit Clinic Operations 5)Compliance with Health Care Laws and Regulations Some compliance efforts dependent on equipment (use of X-Rays, MRI’s, etc.) HIPAA & Privacy Laws Personal Information Protection Act Medical Patient Rights Act HIPAA-generally not applicable to non-profit clinics 6)General Recommendations Well-thought out and proper documentation at the start prevents headaches Operate the free-clinic like a clinic, not like a “free” clinic Maintain proper board governance as you grow (transition from operation to governing board) Fiduciary obligations for Board of Directors Duties of Care, Loyalty and Obedience

11. The Future of ACA: What We Still Don’t Know about Healthcare Reform in America in Twenty Minutes or Less LaDonna Waugh, MD, JD, FACS American Muslim Healthcare Conference 9 May 2015

14. 2.5-2.9 x 10 7

19. Will the Affordable Care Act Survive 2015? Congress, the Supreme Court and Political Reality

39. 4.5-4.9 x 10 7