Public Policy

The NAFC is dedicated to educating the public, the press, Congress, Federal and state agencies, pharmaceutical companies and other corporations about Free and Charitable Clinics and the important service they provide to America’s un- and under-insured.

The NAFC monitors proposed rules and regulations, legislation and other important issues to keep a finger on the pulse of the issues that may be important to Free and Charitable Clinics and to the medically underserved.

The NAFC believes that when discussing health care access and reform it is necessary for Congress to take into account the following overarching points. Without addressing these points in their entirety, it is the position of the NAFC that more work will need to be done on any health care reform efforts.

  • Access to Affordable Health Care should be a right and not a privilege.
  • In the interest of public health, all individuals should have access to affordable quality health care.
  • Affordability, accessibility and portability of health care are issues that remain critical to the uninsured in this country.

 


 

Below, please find the NAFC 2021 Public Policy Objectives.  

 


 

BACKGROUND

 

The National Association of Free & Charitable Clinics (NAFC) is dedicated to ensuring that America’s medically underserved have access to affordable, quality health care. 

Annually, 2 million people (through 6.9 million patient visits) receive health care at America’s 1,400 Free and Charitable Clinics and Charitable Pharmacies. This is accomplished through the work of dedicated staff and over 207,600 volunteers, including approximately 106,500 medical volunteers. 

Free and Charitable Clinics and Charitable Pharmacies focus on the overall needs of patients by providing medical, dental, pharmaceutical, behavioral health, vision, and health education services and ensuring that uninsured and underinsured people throughout the country have a medical home.

Our members exemplify the concept of private/public partnerships at its finest and showcase that health care starts by building healthy communities, one person at a time. 

 


 

ANNUAL FUNDING PRIORITIES SUBJECT TO APPROPRIATIONS

 

To better address the health care needs of individuals, including the uninsured and medically underserved, adequate funding for key programs must continue to be allocated each year through the appropriations process.

 

HEALTH CARE ACCESS AND AFFORDABILITY PROGRAM FUNDING

The NAFC supports funding for all critical Federal safety-net programs at appropriate levels to allow for affordable health care access, including:

  • The Breast and Cervical Cancer Screening Program under Title X

  • The Children’s Health Insurance Program (CHIP)

  • Medicaid 

  • Medicare

 

WORKFORCE DEVELOPMENT PROGRAM FUNDING

The NAFC supports funding that strengthens America’s medical professional and volunteer workforce through the appropriations process for the following programs:

  • Federal Tort Claims Act (FTCA) – Protect the current funding level for the Free Clinic Medical Malpractice Program under the Federal Tort Claims Act (FTCA).

  • Nurse Corps Loan Repayment – Protect the current funding level for the Nurse Corps Loan Repayment program. 

  • National Health Service Corps – Protect the current funding level for the National Health Service Corps.

  • Corporation for National and Community Service – Protect the current funding level for the Corporation for National and Community Service.

 


 

STRATEGIC AND MISSION FOCUSED PUBLIC POLICY OBJECTIVES

 

HEALTH CARE ACCESS AND AFFORDABILITY PUBLIC POLICY OBJECTIVES

To increase our ability to address the health care needs of individuals, including the uninsured and medically underserved, the NAFC supports: 

  • Legislative language to improve access for the uninsured and underinsured to affordable, accessible, and portable health insurance.
  • Legislative language to promote the development of policies that stabilize the health insurance market.
  • The creation of a Medically Underserved Population and Health Professional Shortage Areas automatic designation for Free and Charitable Clinics and Charitable Pharmacies.

 

MEDICATION ACCESS AND AFFORDABILITY PUBLIC POLICY OBJECTIVES

The unaffordability and inaccessibility of medication impacts all Americans, including the uninsured and underinsured. Therefore, the NAFC supports:

  • The inclusion of eligible Free and Charitable Clinics and Charitable Pharmacies as authorized entities for participation in the 340B Drug Pricing Program.
  • Legislative language and/or regulatory action to support increased access to affordable branded and generic FDA approved medications for the uninsured and medically underserved.

 

SOCIAL DETERMINANTS OF HEALTH PUBLIC POLICY OBJECTIVES

We believe that all individuals, regardless of their age, sex, income, education, immigration status, ethnicity, color of skin, religion, or sexual orientation should have access to affordable, quality health care. Therefore, the NAFC supports:

  • Legislative language and/or regulatory action that improve the societal and economic factors that influence people's health.
  • Legislative language and/or regulatory action that protects of all classes of people under the Civil Rights Act.

 

WORKFORCE DEVELOPMENT PUBLIC POLICY OBJECTIVES

To strengthen America’s medical professional and volunteer workforce, the NAFC supports:

  • Legislative language and/or regulatory action that expands the Federal Tort Claims Act to include entity coverage for Free Clinics. 
  • Legislative language and/or regulatory action that clarifies that Free Clinics who are deemed FTCA approved entities under FTCA 42 U.S.C. 233(o) will not lose their status if they receive reimbursement, either through the federal uninsured patient portal or through federal funding that is being administered by the states during any emergency.
  • Legislative language and/or regulatory action that expands the Federal Tort Claims Act to include Charitable Clinics, Charitable Pharmacies and their entities.
  • Legislative language and/or regulatory action that expands the National Health Service Corps to include Charitable Clinics and Charitable Pharmacies.

 

NONPROFIT FINANCE AND TAX PUBLIC POLICY OBJECTIVES

Free and Charitable Clinics and Charitable Pharmacies do not receive dedicated federal funding and have to rely heavily on private donations from individuals and foundations. Therefore, the NAFC supports:

  • Legislative language and/or regulatory action that establishes of a Universal Tax Deduction for individuals to enable them to donate more easily to nonprofits. 

 


 

COVID-19 PUBLIC POLICY OBJECTIVES

 

A $2.8 BILLION FUNDING ALLOCATION THAT WOULD BE DISBURSED DIRECTLY TO FREE AND CHARITABLE CLINICS 

  • The NAFC supports legislative language that provides direct funding to assist free and charitable clinics combat COVID-19, including for the purchase of medical supplies, protective gear, testing equipment, visit and treatment costs, and vaccines. 

 

EXPANSION OF THE FEDERAL TORT CLAIMS ACT (FTCA) TO PERMANENTLY COVER TELEHEALTH SERVICES

  • The NAFC supports legislative language that declares telehealth remains classified as a protected health service under the FTCA once the COVID-19 National Public Health Emergency is lifted. This is critical because without a permanent protection of telehealth services, Free Clinics who are deemed FTCA entities have to wait for HRSA to issue a Determination of Coverage memo to inform providers of protection status, resulting in delays to health care on the frontline. 

 

FTCA COVERAGE FOR FREE CLINICS AND REIMBURSEMENT FOR UNINSURED PATIENT CARE THOUGH COVID-19 PROGRAMS 

  • The NAFC supports legislative language to clarify that Free Clinics who are deemed FTCA approved entities under FTCA 42 U.S.C. 233(o) will not lose their status if they receive reimbursement, either through the federal uninsured patient portal or through federal funding that is being administered by the states.

 

CONTINUED SIMPLIFICATION OF THE PPP LOAN FORGIVENESS APPLICATION 

  • The National Association of Free and Charitable Clinics supports the inclusion of The Paycheck Protection Small Business Forgiveness Act to allow small businesses and non-profits who received a Paycheck Protection Program loan of $150,000 or less to obtain automatic forgiveness after submitting a one-page attestation form.

 

EXPANSION OF COVID-19 TESTING, TREATMENT, AND VACCINES FOR THE UNINSURED 

  • The National Association of Free and Charitable Clinics supports the inclusion of The Stronger Medicaid Response to the COVID–19 Pandemic Act, which would clarify that the scope of emergency services available for individuals who do not meet Medicaid’s citizenship requirements includes vital services.

 

ENHANCING BROADBAND ACCESS PUBLIC POLICY OBJECTIVES

  • Affordable and accessible broadband is a necessity for everyone, regardless of race, income, or geographic location. Communities nationwide are increasingly dependent on reliable internet to access services. And nonprofits are dependent on national information technology and broadband connectivity infrastructure to serve their communities and advance their missions.

  • The National Association of Free and Charitable Clinics supports Congress invest a minimum of $15 billion to ensure underserved communities can fully participate in society.