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Natalia Cales Regional Outreach Specialist U.S.

Department of Health and Human Services Region IV

Mission:
At the Department of Health and Human Services, our mission is to help provide the building blocks that Americans need to live healthy, successful lives.

Strategic Initiatives 1.Transform health care 2.Implement the Affordable Care Act 3.Implement the Recovery Act 4.Promote Early Childhood Health and Development 5.Help Americans achieve and maintain healthy weight

Strategic Initiatives 6.Prevent and reduce tobacco use 7.Protect the health and safety of Americans in public health emergencies 8.Accelerate the process of scientific discovery to improve patient care 9.Implement a 21st century food safety program 10. nsure program integrity and responsible E stewardship
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Region IV States Alabama Florida Georgia Kentucky Mississippi North Carolina South Carolina Tennessee
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Role of the Regional Director


Implementation of health care reform (priority #1). Represent & communicate health care policies with federal, state, local, tribal, and territorial government officials and key nongovernmental external stakeholders. Serve as a conduit with stakeholders on their priorities for policies, operations issues and partner on activities and events.

Anton J. Gunn, M.S.W. Regional Director Region IV

Department/Agency Collaboration
Work across regional office and among all regions to collaborate and coordinate on key issues.
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After a year of striving, after a year of debate, after a historic vote, Health Care Reform is no longer an unmet promise. It is the law of the land.
- President Barack Obama
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Title I -

Quality, Affordable Health Care for All Americans Title II - The Role of Public Programs Title III - Improving the Quality and Efficiency of Health Care Title IV - Prevention of Chronic Disease and Improving Public Health Title V - Health Care Workforce
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Title VI - Transparency and Program Integrity Title VII - Improving Access to Innovative Medical Therapies Title VIII - Community Living Assistance Services and Supports Act (CLASS Act) Title IX - Revenue Provisions Title X - Reauthorization of the Indian Health Care Improvement Act
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1. 2.

Expands Coverage Offers New Consumer Protections and Consumer Choice Makes Health Care More Affordable Improves Quality Improves Prevention and Public Health
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3.

4. 5.

2010

2011

2012

2013

2014

TIMELINE

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Quick Glance :
Banned discrimination against children with pre-existing conditions Eliminated lifetime limits on insurance coverage Extended coverage to young adults (up to 26 years old) Reinsurance extended to early retirees (55-64 years old) Provided relief to nearly 4 million seniors - Medicare donut hole $250 rebate checks Cracked down on health care fraud - $4 billion recovered Created HealthCare.gov internet web portal to provide plan choices and other helpful information for consumers
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Quick Glance :
Discounts on Medicare prescription drug 50% off of brand name drugs and annual wellness visit are free. Expands community health centers and increases access to health services at home. Adds transparency, strengthens State premium oversight, Medical Loss Ratio (MLR) review. Provides additional resources to enhance states Health Information Technology (HIT) capabilities. Increases Medicaid payments for primary care services.

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Quick Glance: Expands Coverage to 32 million in 2014


(92% of non-elderly population)

Will establish state-based Exchanges, creating new competitive health insurance marketplace
- These exchanges will offer individuals and small businesses a choice of affordable, quality plans

Medicaid Expansion to 133% of FPL = $29K, family of 4 Bridge Programs to 2014


- Pre-Existing Condition Insurance Plan (PCIP) - Early Retiree Reinsurance Program (ERRP) - Small Business Health Insurance Tax Credits
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Planning for Health Insurance Exchanges


2010 2011 2012 2013 2014

Exchange planning grants, IT systems & federal policymaking. States enact legislation & federal rules issued. States notify HHS of intent to run exchanges and begin to qualify plans. Exchanges bring IT systems online and ensure operation before enrollment. Exchange-provided coverage is in effect, tax credits begin (1/1/2014).

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Affordable Insurance Exchanges will create: Lower Costs: The Exchanges will increase competition among private insurance plans.

One-Stop Shopping: The Exchanges will make purchasing health insurance easier. Greater Benefits and Protections: The Exchanges will create a health insurance marketplace with a variety of high quality plans for employers, individuals, and families.

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Tennessee $168.9 million

Alabama $16.8 million

Florida $110.4 million

S. Carolina $16.8 million

SE Region $512.2 million

Georgia $36.9 million

N. Carolina $81.1 million

Kentucky

Mississippi $45.5 million

$35.9 million

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Limited List Highlighted Below

Medicare Rebate Checks CAP

PCIP

ERRP

ACA
Healthcare Professional Expansion

Tax Credits

Community Health Centers

Public Health Prevention Fund


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Since enactment of the Affordable Care Act (ACA) on March 23, 2010, the Department of Health and Human Services has awarded $16.8 million in new grant funding in Alabama, and helped many residents and employers take more control of their health care from new patient protections to new coverage options.*

*The following information is a selection of programs funded by the Affordable Care Act and does not add up to the total Affordable Care Act funding for the State of Tennessee.

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57,598 7,302

Medicare Part D Donut Hole $250 Rebate Checks

Medicare beneficiaries of Alabama have already received a free annual wellness visit this year. million Health Insurance Exchange planning grant

$1 $1

million to crack down on Unreasonable Insurance Premium Increases

$3.7

million in Therapeutic Discovery Project Program Tax Credits and Grants from the IRS for Medicare improvements for patients and providers

$961,392

$6.1 $3.9

million investment in Community Health Centers

million from the Prevention and Public Health Fund $3.4 million for community and clinical prevention activities $560,000 to support public health infrastructure

1.5 million for Maternal, Infant and Childhood Home $ Visiting 860,000 for School Based Health Centers, will help clinics $ expand and provide more health care services at schools. 530,000 to support outreach to eligible Medicare $ beneficiaries about their benefits. 790,000 for the Personal Responsibility Education $ Program, which will educate young adults on the prevention of pregnancy and sexually transmitted infections.

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employers enrolled in Early Retiree Reinsurance Program Alabama employers have already received $13.8 million in reimbursement. list of Alabama employers include:

Limited

Decatur Utilities Blue Cross and Blue Shield of Alabama City of Huntsville Utilities City of Huntsville General Activities DCH Healthcare Authority Tombigbee Healthcare Authority Council of the City of Anniston State Employees' Insurance Board Mercedes-Benz U.S. International, Inc. Public Education Employees' Health Insurance Plan

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uninsured Alabama residents enrolled in the Pre-Existing Condition Insurance Plan (PCIP). In Alabama, the PCIP is operated by the Federal government and provides a health coverage option for consumers who have been:

uninsured for at least six months, have a pre-existing condition or have been denied health coverage because of their health condition, and are a U.S. citizen or are residing here legally.
Visit

www.pcip.gov or call 1-866-717-5826 for additional information, application process, and rates.

Summary of 2011 Plan Options & Premium*


(In-network benefits)

Standard Option
Premium range (per
month; varies by age)

Extended Option
$125 - $778 $1,000 $250 $25 $4 for generic $30 for brand 25% for specialty $5,950

HAS Option
$97 - $600 $2,500 Included in medical coverage $25 $4 for generic $30 for brand 25% for specialty $5,950

$93 - $578 $2,000 $500 $25 $4 for generic $40 for brand 25% for specialty

Medical deductible
(per year)

Drug deductible
(per year)

Office Visit (per visit) Drug copay


(per prescription)

Annual out-of-pocket $5,950 limit (in-network)

*For information on coverage, benefits, and premiums by state, visit ww.pcip.gov

Alabama Department of Public Health Office of Minority Health


The

Office of Minority Health (OMH) facilitates local and state level partnerships to address health disparities in Alabama. funds through the Federal Office of Minority Health provides support to the state efforts to improve the health of racial and ethnic minorities. Received $140,000 through the State Partnership Grant

Grant

Alabama OMH provides the following activities:


1. 2. 3. 4. 5.

Health Education Programs

Community & Provider Settings Minority Health Issues Implement Action Plan & Strategy Professional Development & Distance Learning Train-the-Trainer Programs

Cultural Competencies

National Partnership for Action (NPA)

Satellite Conference & Live Webcast

Technical Assistance

Upcoming Satellite Conferences & Live Webcasts


(Potential CEUs are available - http://www.adph.org/alphtn/)
Friday

8/26/2011 1:30 2:30 pm (CST) Reducing Health Disparities by Promoting Health Equity in Alabama 9/14/2011 2:00 3:00 pm (CST) Mental Health Issues in Underserved Youth

Wednesday

Contact Information: Alabama Department of Public Health Office of Minority Health The RSA Tower 201 Monroe Street, Suite 710 P.O. Box 303017 Montgomery, Alabama 36130 Phone: (334) 206-5396 Toll-Free: (800) 255-1992 www.adph.org/minorityhealth

Racial & Ethnic Approaches to Community Health across the U.S.

REACH

REACH U.S. is a CDC project designed to serve as a national clearinghouse and important cornerstone of evidence-based and promising practices to eliminate racial and ethnic health disparities in the United States. The University of Alabama at Birmingham serves as the central coordinating organization for REACH U.S. AL REACH program addresses breast and cervical cancer disparities

AL REACH Legacy Funding


The

REACH U.S. Center of Excellence in Eliminating Disparities (CEED) announces a funding opportunity for organizations to apply for legacy funds each year, usually due in August. are used to: address breast and cervical cancer disparities among African American women using evidencebased strategies and/or promising practices.

Funds

http://mhrc.dopm.uab.edu/REACHUS/grantfunding.html

Contact Information: AL REACH Minority Health & Health Disparities Research Center, University of Alabama at Birmingham (UAB) Dr. Theresa Wynn, PhD Program Director University of Alabama at Birmingham School of Medicine - Division of Preventive Medicine Medical Towers Building 1717 11th Ave. South, Suite 516A Birmingham, AL 35294-4410 Phone: 205-934-6892 Email: twynn@uab.edu Website: www.UABMHRC.com/REACHUS

The Affordable Care Act provides a strong platform for change -- expanding coverage, protecting patients, lowering costs and shifting incentives to reward value over volume.
- Secretary Kathleen Sebelius

November 9, 2010

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Natalia Cales
Regional Outreach Specialist U.S. Department of Health and Human Services (Region IV) 61 Forsyth St., SW Suite 5B95 Atlanta, GA 30303-8909 Region IV - AL, FL, GA, KY, MS, NC, SC, TN Office: (404) 562-7888 Fax: (404) 562-7899 Natalia.Cales@hhs.gov

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