1. Support Implementation of Voter-Approved Medicaid Expansion: The highest priority of Maine’s Community Health Centers (CHCs) is implementing the November 2017 voter-approved ballot initiative to expand Medicaid coverage in Maine, enabling approximately 70,000 individuals to gain access to care. Carrying out the full Medicaid expansion will create greater access to health care services for those in need and will strengthen the CHCs, as well as the overall state economy. Moreover, such expansion is linked to higher likelihood of individuals remaining in the work force.
  2. Promote Policies that Increase Access to Telehealth Services: Telehealth is a cost-effective way to allow patients to access services closer to home and to increase provider productivity across CHC sites. With recent rulemaking that supports adequate and consistent reimbursement for telehealth services, Maine’s CHCs have an opportunity to leverage this health care delivery method for greater impact. For many Mainers, lack of transportation is the #1 barrier to accessing affordable, high quality health care services. The difficulty in recruiting and retaining medical, behavioral health and dental providers adds to this access problem. Community Health Centers are poised to expand access to telehealth services as a means to address this challenge.
  3. Maintain and Expand Maine’s Commitment to Supporting Community Health Centers through Direct State Investments and Adequate Reimbursement: Until 2016, Maine was the only state in the Northeast—and in the minority of states across the country—in which no direct state funding was invested in community health centers. While the latest appropriation of $500,000 by the Legislature is an important initial step, it is insufficient to meet escalating demand for services. Maine’s CHCs operate on narrow margins, while producing some of the best quality outcomes in the country. Maine must maintain and expand the modest state investment for the CHCs, as well as ensure adequate reimbursement through the federally-required Prospective Payment System (PPS) rates which help the CHCs to provide access to critical services for rural and underserved communities.
  4. Continue to Support Legislation that Improves Access to Alcohol and Substance Use Disorder Recovery and Support Services: Mainers who struggle with alcohol or substance use disorder need affordable and ready access to treatment, recovery and support services. Currently, there are not enough access points to serve this population due to many factors - chief among them is insufficient funding to cover the costs of such care, especially for uninsured patients. In order for this crisis to be addressed adequately, Maine needs to make significant investments in these services, as well as enact legislation aligning with the recommendations of the Maine Opiate Collaborative. Additionally, efforts to support these services must include a genuine focus on the social determinants of health that help to drive the current substance use disorder crisis we face in our state.
  5. Create a Preventive Dental Benefit under MaineCare for all Adults: Every year, Maine’s CHCs provide millions of dollars in uncompensated dental care to adults throughout the state for their preventive and restorative needs. This care results in cost savings from avoidable visits to the Emergency Department for oral health diseases and other conditions. However, there is currently no preventive and restorative MaineCare benefit (reimbursement) in place for adults (including pregnant women) to offset the rising burden that these costs are having on health center operations. MPCA currently has a carryover bill, LD 1301, which includes an annual comprehensive oral examination along with preventive services, oral hygiene instruction, behavior management and smoking cessation counseling as means to expand preventive dental care and save the health care system from unnecessary expense.
  6. Continue to Address Maine’s Primary Care Provider Recruitment Issues by 1.) Maintaining Support for the Primary Care Professionals Tax Credit Program, and 2.) Investing in Additional Programs that Strengthen Maine’s Ability to Attract and Retain Primary Care Providers: By far the biggest factor limiting the CHC’s ability to serve additional patients is the challenge they face in recruiting and retaining qualified, culturally-competent and mission-driven providers. Maine’s CHCs struggle to attract and retain these providers due, in part, to flaws in the National Health Service Corps’ methodology and because neighboring states have expansive programs such as state-funded loan repayment programs to make them much more competitive. The Legislature passed a law creating the Primary Care Professionals Tax Credit Program to help address this issue. In order for Maine to compete with other states in the region and across the country, funding must be appropriated in the state budget to sustain the program. If it is not, our CHCs will continue to have providers decline job offers in favor of positions in other states where these benefits are guaranteed. LD 1287 aims to extend the tax credit for eligible dentists and expand the number of primary care professionals who can be certified for the tax credit. Additionally, continued state investment in health centers must go hand-in-hand with other incentives to support a strong clinical workforce in Maine’s underserved areas. Specifically, the State should consider ways to increase the number of training programs that support recruitment, succession planning, and other innovative and sustainable work force initiatives in community-based primary care settings.
  7. Conduct Administrative Advocacy and Policy Analysis in Support of Robust Primary Care and Public Health Services across the State:
    • Immunization Policy: Through its facilitation of the Maine Immunization Coalition (MIC), MPCA supports evidence-based policies that result in improved immunization rates for children and adults. This may include (but is not limited to) assessing school entry requirements, policies for non-medical exemptions or the dedication of resources to provide vaccines to vulnerable and underserved populations.
    • Strengthen and Broaden Community Health Worker (CHW) Network: MPCA supports the expansion and professionalization of the CHW role, as it provides a critical link between the medical model and the various culture and community elements that impact a person’s ability to maintain health. We will explore expansion efforts through training, research and policy analysis.
    • Strengthen Relationships with Key State Agencies: We commit to seeking partnerships with the Maine CDC, Medicaid, Maine’s Primary Care Office and other key stakeholders. We will participate in the MaineCare Advisory Committee and the Office of Family Independence (OFI) to ensure coordination and alignment among programs and affiliated partners.