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News from VAFCC VAFCC Staff

MARCH 2013

Linda D. Wilkinson, MPA CEO

VAFCC 2013 Conferences

Judy Griffin Director of Resource Development

ED Conference - March 14-17 Fredericksburg - Hospitality House You can still register...but time is running out! Registration closes Friday, March 8, 2013.

Rob Bradley, LCSW Director of Membership Support

Linda Pretlow Business Manager

Melanie Hofe Administrative Assistant

ROOMS: Our host hotel is completely booked, but rooms are available at the Homewood Suites (5 minutes away). Call 540-786-9700 to make a reservation. Tell them you are with VAFCC. Rate is $109/night COST: $150/person CLICK HERE to register Limited scholarships of $100 are Linda Wilkinson

Annual Conference - November 17-19 Inside this issue:

Roanoke - Hotel Roanoke

State Funds


Definition Change


Fundraising Tips


VA Healthcare Innovators




VA Risk 2


E H R Update


Community Platform Site


We are excited to hold another joint conference with the Virginia Rural Health Association. The Conference Planning Committee has already started planning a first class event! Thanks to the members of the VAFCC serving on this committee: ~Diane Kelly, Roanoke Valley Mental Health Care Collaborative ~Carla Santos, Bradley Free Clinic ~April Taylor, Orange County Free Clinic ~Helen Ferguson, Rescue Mission Ministries ~Kathryn Sims Cross, Charlottesville Free Clinic Registration for the conference will be available by late July. A dedicated webpage for the Hotel Roanoke will be set up for room reservations. To help you budget attending, please note that the combined cost of rooms & conference registration will be close to 2012.

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News from VAFCC

Anticipated State Funds Reports & Distribution Based on our current contract with the Virginia Department of Health, we anticipate the following deadlines for funding reports for FY2012-2013 and quarterly disbursements:


3-15-13 4-12-13


Management Fees due from Second Quarter FY201213 Third Quarter FY2012-13 report due to VAFCC


Third Quarter FY2012-13 sent to clinics


Management Fees due from Third Quarter FY2012-13


11 month report for VDH due to VAFCC for FY2012-13


Annual report for FY2012-13 for VDH due to VAFCC

7-25-13 8-15-13

Approximate Disbursement

Final Fourth Quarter FY2012-13 sent to clinics Management Fees due from Fourth Quarter FY2012-13

Please note that report deadlines and disbursement schedules are subject to change depending on VDH. VAFCC cannot release quarterly funding to clinics that have not paid their previous quarter’s Management Fees or satisfactorily completed the required VDH report. Reports should be typed and emailed to Contact VAFCC staff if you have questions about reports.

Effective July 1, 2014, the Board of Directors has approved the following modification to the State Funds Funding Formula: “… The allocation methodology shall not permit disbursement of State Funds to any member whose disbursement would represent more than 50% of their annual operating budget for the clinic.” It is the hope of the VAFCC that member clinics will create and foster diverse, sustainable funding to support on-going costs at the clinics. VAFCC is committed to providing support and technical assistance to member clinics in the area of resource development. • For information or questions about resource development, please contact Judy Griffin, Director of Resource Development, • For information about State Funds distributions, please contact Linda Wilkinson at or phone 804-340-3434.

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State Funds Reporting - Teleconference How to accurately and simply complete the quarterly reports for VAFCC and VDH Friday, March 29, 2013 9am-10am Conference #1-877-484-2089, code 8043403435# No RSVP required

REPORTS - State Funds & COPN Because there are so many member clinics reporting on state funds and COPN distributions, it is very helpful to VAFCC staff if reports are typed so we can read the information, but also the data can be cut and pasted into final documents submitted to VDH. This will also minimize errors in transcribing numbers. Thank you for typing all responses on reports.

Medicaid Tool Available for Free Clinics On the January 18 Road to Reform webinar, Community Health Solutions (Dr. Steve Horan) introduced a concept for a Medicaid revenue tool to assist clinics with a cost-benefit analysis for accepting Medicaid payments. The tool is now posted in the Road to Reform Community (see 2013 Medicaid Revenue Tool in the Knowledge & Tools space). To access the tool upon login, click this link: Community Health Solutions can assist if you have any questions or suggestions related to the tool: Dr. Stephen Horan, Community Health Solutions Phone 804.673.0166 or

VAFCC and the VHCF are pleased to continue the Road to Reform initiative for the benefit of member clinics.

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News from VAFCC

Recommended Definition Change At the January 25, 2013 meeting of the Board of Directors, the Board voted unanimously to present the following Definition of a Free Clinic to the members for consideration at the Executive Director Conference on March 14, 2013, 3:30p.m.: Free and charitable clinics are safety-net health care organizations that utilize a volunteer/ staff model to provide a range of medical, dental, pharmacy, vision and/or behavioral health services to economically disadvantaged individuals. Such clinics are 501(c)(3) tax-exempt organizations, or operate as a program component or affiliate of a 501(c)(3) organization. Entities that otherwise meet the above definition, but charge a nominal/sliding fee to patients, may still be considered free or charitable clinics provided essential services are delivered regardless of the patient's ability to pay. Free or charitable clinics restrict eligibility for their services to individuals who are uninsured, underinsured and/or have limited or no access to primary, specialty or prescription health care. (Adopted by the NAFCC in 2011) The VAFCC current definition of a Free Clinic is: Free clinics are volunteer-based, safety net health care organizations that provide a range of medical, dental, pharmacy, and/or behavioral health services to economically disadvantaged individuals who are predominately uninsured. Free clinics are 501(c)(3) tax-exempt organizations, or operate as a program component or affiliate of a 501(c)(3) organization. Entities that otherwise meet the above definition, but charge a nominal fee to patients, may still be considered free clinics provided essential services are delivered regardless of the patient's ability to pay. (Adopted 4/2011) The VAFCC Board of Directors is proposing this change to better reflect the change in current, and possibly future, members, and to recognize the evolution of the health care delivery system in our communities. A change in the Definition of Clinic must be approved by a 2/3 majority vote of voting members per the Bylaws, Article XI. This proposed definition change will be presented at the March 14, 2013 Executive Director Conference.

Nominations for the Board of Directors The VAFCC Board of Directors is eager to receive clinic Executive Director candidate and community leader nominations to the Board. Please contact Linda Wilkinson at VAFCC and/or Cathy Lewis, Board Development Chair, for information about board terms, responsibilities, and qualifications needed. Linda can be reached at VAFCC, phone 804-340-3434 or and Cathy can be reached at

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Citizens of the Year!

Golden Bethune-Hill and Charlie Hill, co-founders of the Community Free Clinic of Newport News, are the Daily Press Citizens of the Year. Congratulations to both of them! Click here to read the full story.

Top 10 Fundraising Tips 1. Stage a Board Member Thank-a-Thon 2. Never Apply for a Grant Without Contacting the Foundation First 3. Make Specific and Direct Asks for Money 4. Map Donations to Impact 5 Make Your Donation Button Shine 6. Create and Tap Your Social Network 7. Pursue In-Kind Donations, Contributed Media, and Technical Expertise 8. Apply for a Google Grant 9. Create a Winning Budget 10. Understand the Social Capital Market

Read the entire article here!

Estelle Avner, of the Bradley Free Clinic wants to begin a discussion with other clinics about Patients’ Responsibilities. Please visit the Road to Reform Support Community to read her thoughts and join the conversation.

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News from VAFCC

Group Health Insurance...Are You In?

VAFCC is actively working on offering our member clinics an opportunity to form a group, specifically for the purpose of obtaining affordable health care insurance for clinic staff. We need to first get an idea of the interest level of the member clinics. If you are interested in possibly participating, please contact Linda Pretlow at Please respond no later than Monday, March 11th. More details will be provided at our ED Conference in Fredericksburg. Thank you.

Please review the VA Poverty Law Center’s Medicaid Expansion Policy webinar slides on the online Road to Reform Support Community (see page 14 for login instructions)

AMA Foundation Healthy Communities

Flu Vaccine 2013 - 2014

The AMA Foundation Announces 2013-14 Healthy Communities/Healthy America Grant Funds for diabetes management & education for free clinics.

Letter of Inquiry is due by March 15, 2013 Click on their logo for information.

The Virginia Department of Health has agreed to provide FREE flu vaccine to VAFCC member clinics for 2013-14. A form to place your order will be emailed out to every clinic in early March. Please note that the deadline to return this form is April 5, 2013, end of business day. After that, requests will no longer be accepted.

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2013 Virginia Healthcare Innovators Awards Presented by Virginia Healthcare Innovators Council, Inc. Sponsored by Virginia Chamber of Commerce CALL FOR NOMINATIONS The 2013 Virginia Healthcare Innovators Awards honor Virginia providers and organizations/ entities that have developed innovative ways to improve quality and/or efficiency. The Virginia Chamber of Commerce will once again host the awards event at its Virginia Health Care Conference on June 6, 2013. We're pleased to announce that enhancements have been made to this year's program. Finalists will be featured in a printed booklet distributed at the awards event. All non-winning finalists will also receive a certificate plaque memorializing their achievement in their category. As in the past, winners will be presented with an award during the event program. Nominations are now underway, and until March 22, 2013, will be accepted via an online form, which can be found at Please consider nominating organizations/ entities that you feel have developed breakthrough products, processes or services with the potential to revolutionize healthcare in Virginia. We permit self-nominations and repeat prior nominations, even of previous winners. Prior nominees are eligible, however, only if the innovation has demonstrated success/significant external validation since January 1, 2012 (e.g., improved patient outcomes, cost savings, improved access to care, successful clinical trial, regulatory approval, obtained funding, etc.). Leadership, demonstrated through excellence in innovation, will be judged in each of the following categories:

Patient Care

Medical Product or Device

Health Information Technology

Employee Health

A panel of judges, comprising representatives of the member organizations and other healthcare professionals, will review the nominations and select the winners. We invite you to be a part of this exciting way to recognize Virginia organizations/entities that dedicate themselves to improving quality and enhancing the efficiency of healthcare delivery to the Commonwealth's citizens. For more information, please visit

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News from VAFCC

Calling all Superheroes! Come and reveal your true “Superhero” identity at the VAFCC After Dinner ED’s Social – Thursday, March 14, 2013. Please join other superheroes in fighting for the uninsured by day and painting the town by night. Guaranteed to be a FUN evening. Be sure to bring & wear your costume for this event! By Wikipedia Definition: “A superhero (sometimes rendered super -hero or super hero) is a type of stock character possessing "extraordinary or superhuman powers" and dedicated to protecting the public. By most definitions, characters do not strictly require actual superhuman powers to be deemed superheroes, although terms such as costumed crime fighters or masked vigilantes are sometimes used to refer to those such as Batman and Green Arrow without such powers who share other common superhero traits.” Normally, superheroes use their powers to counter day-to-day crime while also combating threats against humanity by supervillains, their criminal counterparts. Come and share some of your very own secret superpowers in fighting healthcare with the other fellow supporting cast of characters. Please bring your wrapped gift valued at $20 for our crazy gift exchange. Your Partners in Fighting Healthcare, Vicki McClelland & Donna DeJarnette P.S. All ED’s and their guests are invited to this event!

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Trip to Washington D.C. for National Prayer Breakfast

Helen Scott, Executive Director of Healing Hands Health Center was invited to be a guest at the National Prayer Breakfast. Click here to read the entire story of her experience.

Show Your Love With a Cupcake

Donated cupcakes delivered for Valentine’s Day is a growing fundraiser for the Healing Hands Health Center in Bristol. Their volunteers make it happen. Read more!

Teresa Gardner

Celebrating 20 Years! VAFCC 20th Anniversary Gala Tuesday, September 24, 2013 The Westin Richmond at West Broad and I-64 This black tie event will be a celebration of the VAFCC as the oldest free clinic association in the country. Mark your calendars now and plan to join us for this very special evening.

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News from VAFCC

VAFCC Risk Management Teleconference with Don Lemond, Director of Risk Management, Virginia Dept. of the Treasury Risk Management/Malpractice in Medicaid Billing NOTES – Q&A prepared by Linda Wilkinson Wednesday, February 27, 2013, 9am Question? Would a free clinic that enrolls in Virginia Medicaid and accepts payment for certain covered services from DMAS/MCOs continue to qualify for coverage under Va. Code 2.2-1839 as an entity engaged in the “delivery of health care services without charge?” Answer Yes, as long as the charges to the patient are “either free or reasonable/minimal fee is charged to cover administrative cost.” (§2.2-1839) Reasonable fees should be determined by individual clinic; “double digit” fees may receive scrutiny, but typical Medicaid co-payments or co-insurance would not preclude coverage under VaRisk or VaRisk2. Question? Would a free clinic that establishes a wholly-owned subsidiary that enrolls in Virginia Medicaid and accepts payment for certain covered services from DMAS continue to qualify for coverage under Va. Code 2.2-1839 as an entity engaged in the “delivery of health care services without charge?” Answer Yes, see Question above Question? Are all volunteer providers covered under VaRisk? Answer All volunteer licensed health providers (e.g. physicians, NPs, RNs, LCSWs, LPCs, etc.) are covered for liability under the Division of Risk Management program (Virginia Code §54.1-106) at no cost. Medical malpractice insurance is provided to registered volunteer providers regardless if the clinic itself covered through the Division of Risk Management. Paid providers can be insured, for a fee, under VARisk2 (Virginia Code §2.2-1839). The VaRisk2 plan provides coverage for tort liability, errors and omissions, and medical malpractice. Question? Are the benefits the same under VaRisk for volunteers as they are under VaRisk2 for paid providers? Answer ~No, the free liability coverage for volunteer health care practitioners working in/for a free clinic includes only malpractice (see for more information). ~VaRisk2 for paid providers includes tort liability, errors & omissions, and medical malpractice (for more information about VaRisk2 see


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TELECONFERENCE Q&A Continued: Question? Are volunteer providers who treat free clinic patients covered under VaRisk (Virginia Code §54.1-106)? Answer ~Yes, if they are REGISTERED with the Department of Treasury/Division of Risk Management. According to the Dept. of Treasury, “coverage is NOT effective (for volunteers) unless the clinic at which the volunteer serves has registered him or her with the Division of Risk Management.” To register volunteer providers (including retired physicians), follow the instructions for Civitas: (You will need license # for provider) ~If volunteer providers treating patients at their offices are not registered with DRM, their private/commercial malpractice would have to cover them for any/all malpractice claims. This could adversely impact volunteers not only from a cost perspective, but also their willingness to voluntarily treat patients. Free Clinics should evaluate the benefits of registering ALL volunteer providers with their legal counsel and board of directors and volunteer providers. Question? How do you register a hospital with the Division of Risk Management (DRM)? Answer DRM will accept a written agreement between the hospital and free clinic for In-patient and Out-Patient services provided by volunteer physicians. Lackey and GloucesterMathews will share their agreements with VAFCC for distribution. Question? How long are providers covered by the Division of Risk Management if they are registered by a free clinic? Answer Indefinitely; they receive lifetime coverage for incidents occurring while they are providing services for the clinic. Coverage is provided on an Occurrence Basis. The provider’s license must be current while working for a free clinic. Question? Will the Medicaid Managed Care Organizations (MCOs) accept VaRisk and/or VaRisk2? Answer Uncertain at this time other than a response from Anthem (below). VAFCC will verify with MCOs and report back to members. Linda Wilkinson has contacted the Virginia Association of health Plans. According to Anthem’s Corporate Credentialing, the CSBs use VaRisk & VaRisk2 for malpractice coverage. A certificate of coverage needs to be attached to Medicaid Provider Application. VAFCC will report back to members as soon as definitive information is available from other MCOs. Question? Is a wellness program covered by DRM under either VaRisk or VaRisk2? Answer Yes, it would be covered under the VaRisk2 program covering the clinic. PLEASE GO TO THE NEXT PAGE FOR ADDITIONAL RESOURCES ON RISK MANAGEMENT.

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Resources for Risk Management Resources: Department of the Treasury, Division of Risk Management P.O. Box 1879 Richmond, VA 23218-1879 DON Lemond, Director Phone 804-225-2142 or 804-225-4620 VaRisk for Volunteer Health Care Providers, ยง54.1-106 VaRisk2 for Paid Health Care Providers, ยง2.2-1839

News from VAFCC

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E H R Update from Rob Bradley Let me take this opportunity to provide a quick overview of the VAFCC Electronic Health Record initiative. As a result of the EHR proposal evaluation, three vendors, of six that submitted proposals, met the requirements: SuccessEHS, AllScripts and NextGEN. The three vendors have been providing several online demos for clinical and administrative staff to become familiar with the various products, with the hope that one of the three will meet your individual clinic needs. On Friday March 15, 2013 from 8:45am to 10am at the Executive Director’s Conference the Electronic Health Record Task Force will provide the membership with a detailed overview of the EHR selection process, funding updates and key next steps. The Task Force (comprised of Dave Baldwin, Karen Dulaney, Kay Bradley, and Rob Marino) has worked extremely hard to get the VAFCC to this point and now respectfully asks that those clinics interested in implementing an Electronic Health Record to please review and sign the Letter of Intent and complete the clinic profile emailed on February 27th by March 21, 2013. This will allow the VAFCC to know how many clinics are possibly interested in each of the three health records’ systems and will help VAFCC negotiate the best possible price and terms with selected vendors. If you know that you are not interested in participating in this initiative, please let me know as soon as possible. Thank you for your support with this matter. Remaining EHR Demos - please encourage Clinical staff to participate in one demo per vendor – please contact Rob Bradley at VAFCC with EHR questions (phone 804-340-3434 or

Option 5 NextGEN EHR (this is the 5th demo for NextGen)


Meeting Number: 577 621 319

Call-in toll-free number:

Meeting Password:

Monday, March 11, 2013 -


1-855-818-9814 vafc_ehr55

To join this meeting 1. Go to 2. If requested, enter your name and email address 3. If a password is required, enter the meeting password: vafc_ehr55

SuccessEHS EHR Demo Dates (choose from one of these dates) March 12th @10am EST March 13th @ Noon EST Each of these overview sessions will last about an hour in duration with questions following each presentation. SuccessEHS can also accommodate individual demonstrations with each group as needed. Please have each member organization email me to register for each session: or call 1-888-879-7302 ext. 1325.

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News from VAFCC

Quick Start Guide for the Road to Reform Support Community

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Virginia Association of Free and Charitable Clinics Mailing Address: P.O. Box 35720 N. Chesterfield, VA 23235 Location: 711 Moorefield Park Dr. Suite C N. Chesterfield, VA 23236

Need the NEW VAFCC Logo? Please contact Judy Griffin at 804-340-3434 or if you need either our 20th Anniversary Logo or our standard logo. She can email them to you in various formats, depending on your needs.

Phone: 804-340-3434 Fax: 804-340-3435

We’re on the web

The mission of the VAFCC is to support, strengthen, and advocate for Free Clinics as they deliver quality health care to Virginia’s low-income, uninsured and underinsured residents.

VAFCC Board of Directors Chair Colin Drozdowski Anthem Blue Cross & Blue Shield Vice-Chair Margaret Hersh Augusta Regional Free Clinic Secretary Darryl J. Pirok, DDS Treasurer M. Caroline Martin Members A. Michelle Brauns, MS, APR Free Clinic of the New River Valley Bill Gayne UVA Health System Cathy Lewis, MPH

Board Committees Jeannie Nelson Northern Neck Free Health Clinic Sean Riley McKesson Medical Erika Viccellio Charlottesville Free Clinic

Audit Board Development Finance

Laura D. Windsor Troutman Sanders LLP

State Funds/ Accreditation/ Membership

Pat Young Community Works


March 2013 - VAFCC Newsletter