10/14/2013. County Commissioners and Managers: What Public Policy Leaders Should Know & Do. Presentation Overview. About NACo.

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1 County Commissioners and Managers: What Public Policy Leaders Should Know & Do NCACC Affordable Care Act Seminar Orange County/Chapel Hill October 15, 2013 Presentation Overview About NACo Why health reform? How did we end up with the ACA? County policy options under the ACA Coverage expansion Medicaid & the Safety Net Public Health: Disease Prevention & Health Promotion Jail Health MAY 2013 About NACo The National Association of Counties (NACo) assists America's counties in pursuing excellence in public service by advancing sound public policies, promoting county solutions and innovations, fostering intergovernmental and publicprivate collaboration and providing value-added services to save counties and taxpayers money Founded in 1935, NACo provides the elected and appointed leaders from the nation's 3,069 counties with the knowledge, skills and tools necessary to provide fiscally-responsible, quality-driven, and results-oriented policies and services for healthy, vibrant, safe and resilient counties MAY

2 Counties: Where the Rubber Meets the Road Unique Role of Counties: Providers, Payers, Purchasers Highly polarized political debate MAY

3 3

4 NACo and Health Reform 2008 NACo President appoints Health System Reform Working Group Working Group holds three hearings around the country Working Group drafts a White Paper proposing NACo priorities in health reform The White Paper is debated, amended and approved by the NACo Health Steering Committee, NACo Board and NACo Membership Coverage expansion Individual mandate Define role for county agencies Community leadership role Employer mandate Set county employee health benefit policy If continuing to offer coverage, design benefit to comply with ACA Consider workplace wellness incentives Medicaid & the Safety Net Medicaid for all up to 133% FPL state option Pass through for counties required to contribute to nonfederal share $14.1 billion cuts to DSH , cuts extended into out years New requirements for NFP hospitals 4

5 Public Health: Disease Prevention & Health Promotion Prevention & Public Health Fund: to provide for expanded and sustained national investment in prevention and public health programs to improve health and help restrain the rate of growth in private and public sector health care costs Source: Sarah Kliff Workblog.washingtonpost Public Health: Disease Prevention & Health Promotion, cont d. Community Transformation Grants (CTG) Public Health Workforce Public Health Improvement Initiative (PHII) Section 317 Immunization Program Epidemiology and Lab Capacity (ELC) Grant Program Jail Health Persons in custody pending disposition of charges retain eligibility for QHP coverage on the exchanges Screen inmates for eligibility? Enroll? Pursue billing for services? Medicaid? We re working on it 5

6 Questions? Contact Us! For questions or more information, feel free to contact us Matthew Chase, NACo Executive Director Deborah Cox: Legislative Director or Paul Beddoe: Deputy Legislative Director/Health or Michael Belarmino: Finance & Intergovernmental Affairs or Daria Daniel: Community and Economic Development or Bob Fogel: Transportation or Arlandis Rush: Justice and Public Safety or Arthur Scott : Agriculture and Rural Affairs ascott@naco.org or Ryan Yates: Public Lands ryates@naco.org or Julie Ufner: Environment, Energy & Land Use jufner@naco.org or Yejin Jang: Telecommunications and Technology yjang@naco.org or NACo was named one of nine remarkable associations in the United States after a four-year study conducted by the American Society of Association Executives and The Center for Association Leadership because of its commitment to members and purpose 6

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