INTERIOR WITHDRAWS ANNUAL CONFERENCE LEARN WHAT THE FRACKING RULE PG. 3 WORKSHOP REPORT PG. 4 CONFERENCE SPEAKERS HAD TO SAY PG. 8 NATIONAL ASSOCIATION of COUNTIES VOL. 49, NO. 16 AUGUST 7, 2017 Brooks takes the lead New NACo Executive Team By Beverly Schlotterbeck executive editor Tarrant County, Texas Com- missioner Roy Charles Brooks took over the reins as NACo’s new president at the 2017 Annu- al Business Meeting in Franklin County, Ohio July 24. Douglas County, Neb. Commissioner Mary Ann Borgeson won the slot as the association’s new second vice president, round- ing out the 2017-2018 executive team of Brooks, Second Vice President Greg Cox, San Diego County, Calif. supervisor, and Immediate Past President Bry- an Desloge, Leon County, Fla. commissioner. In his acceptance speech, Brooks spotlighted poverty and economic opportunity as the twin pillars of his presidential initiative with a special focus See ANNUAL page 16 NACo Immediate Past President Bryan Desloge of Leon County, Fla. (left), Second Vice President Mary Ann Borgeson, of Douglas Coun- ty, Neb., President Roy Charles Brooks of Tarrant County, Texas and First Vice President Greg Cox of San Diego County, Calif. pause for a photo July 24 at the association’s Annual Conference in Franklin County, Ohio. Photo by David Hathcox ANALYSIS After the Senate blinked, what’s next for health care? By Brian Bowden ly be rolled into one piece of ever, unlike the recent effort (MIECHV) Program, Commu- associate legislative director legislation, providing Congress to pass major health reforms nity Health Center funding and with another opportunity to under budget reconciliation, Disproportionate Share Hospi- As the wait continues to de- advance its health priorities. 60 votes in the Senate will be tal (DSH) reductions. termine what Congress may do The stakes will be high as necessary and would require next in relation to the Afford- Congress will only have 12 the support of at least eight The Children’s Health able Care Act (ACA), a series of legislative days to craft and Democrats. Insurance Program health programs must be reau- pass bills before these series of Programs of most relevance The Children’s Health In- thorized by Congress through health programs expire. These to counties that need reautho- surance Program (CHIP) is a regular congressional process programs represent another rization include the Children’s federal-state program that pro- before the end of this fiscal legislative vehicle in which Health Insurance Program vides health insurance to chil- year (Sept. 30). Congress could attach other (CHIP), the Maternal, Infant, All of the programs will like- health-related policies. How- Early Childhood Home Visiting See HEALTH CARE page 2 2 AUGUST 7, 2017 NATIONAL ASSOCIATION of COUNTIES COUNTY NEWS Stakes high as Congress turns to reauthorizing health care programs From HEALTH CARE page 1 states to maintain their CHIP The Maternal, Infant, serve mdically underserved Hospital (DSH) payments. The programs in the absence of Early Childhood, areas, or MUAs, which include Affordable Care Act reduced dren in families with incomes federal funding certainty. Home Visiting areas where people have lit- federal DSH allotments to ac- that are modest but too high to Without a guarantee that Program tle access to primary health count for decreases in uncom- qualify for Medicaid. CHIP funding will be extended, The Maternal, Infant, Ear- care and individuals who are pensated care anticipated as a First enacted in 1997, CHIP states may take action to limit ly Childhood, Home Visiting uninsured, underinsured or result of Medicaid expansion. was last reauthorized through enrollment, impose lock-outs (MIECHV) Program provides low-income. However, not all states expand- the Medicare Access and CHIP and waiting periods, or wind resources and support for preg- The Health Center Program ed Medicaid and there are still Reauthorization Act (MACRA) down their programs altogether. nant women, families and at- is administered by the Health 28 million uninsured. of 2015 which provided feder- A recent report by the Medic- risk parents of children under Resources and Services Ad- Since the implementation al funding to the program for aid and CHIP Payment and Ac- the age of five. Families partic- ministration within the De- of the ACA, several laws have FY2016 and FY2017 at $19.3 cess Commission (MACPAC) ipate voluntarily in home visits partment of Health and Hu- amended the ACA to delay the billion and $20.4 billion, re- indicates that at least four spectively. states (Arizona, California, For now, repeal and replace efforts in Congress appear unlikely as lawmakers The program now covers Minnesota, North Carolina) turn their attention to other urgent budgetary and policy priorities. over 8 million children and and the District of Columbia along with Medicaid — which will completely exhaust funds conducted by nurses, mental man Services, which award Medicaid DSH reductions to covers over 30 million children for CHIP by the end of the year health clinicians, social work- grants to outpatient health prevent funding cuts to these — has led to a 95 percent in- if Congress does not act. More ers and others with special- care facilities. hospitals that serve a large sured rate for U.S. children. than half of all states will ex- ized training. In FY2015, the The Community Health Cen- proportion of uninsured and State budget cycles and reg- haust their funds by March program supported more than ters Fund, which was first es- Medicaid beneficiaries. Most ulations make it difficult for 2018. 145,000 individual parents and tablished under the Affordable recently, MACRA delayed DSH children, and conducted over Care Act and later extended reductions by one year, by 900,000 home visits. through the Medicare Access eliminating the FY2017 DSH Although states are the pri- and CHIP Reauthorization Act reductions. mary recipient of home vis- of 2015, now provides $3.6 bil- However, without addition- itation program funding — lion annually, or more than 70 al delays DSH cuts will begin which currently totals about percent of federal funding, for in FY2018 and extend through $400 million annually — re- the health centers. These funds FY2025 — and would total $43 sources are typically passed have been used for a range of billion. on from states to counties health center activities includ- For now, repeal and replace to operate local programs. ing funding new health centers, efforts in Congress appear un- Counties often employ public increasing services provided at likely as lawmakers turn their health nurses to conduct visits existing health centers, and im- attention to other urgent bud- or contract with local social plementing care coordination getary and policy priorities be- service nonprofits to provide initiatives. fore Sept. 30. these services. In addition, the fund supports Although President Trump MIECHV is critical to help- the National Health Service can still act without Congress ing counties improve maternal Corps, a scholarship and loan to alter certain ACA provi- SNAP STATS and child health, prevent child repayment program that places sions, such as enforcing the abuse and neglect, encourage providers in underserved areas individual mandate, the White THE TOP 10 HAPPIEST positive parenting and pro- including at health centers. House is under pressure to de- U.S. COUNTIES (2016) mote child development and liver on major tax reform and school readiness. Disproportionate infrastructure packages that Rank Share Hospital they hope to advance quickly 1. Loudoun County, Va. 6. Morris County, N. J. Community Health Payments through Congress this year. 2. Fairfax County, Va. 7. Howard County, Md. Centers Many of the approximately NACo will continue to mon- 3. Carver County, Minn. 8. Douglas County, Colo. Community Health Cen- 900 county-supported hospi- itor legislative and budgetary 4. Chester County, Pa. 9. Somerset County, N. J. ters provide primary health tals across the country receive developments on these im- services for over 25 million partial compensation from the portant health programs and 5. Hunterdon County, N. J. 10. Ozaukee County, Wis. people in counties across the U.S. government for treating ensure that county interests country. The 1,200 neighbor- indigent patients in the form are represented in any upcom- Source: SmartAsset.com, financial assets planning company hood health centers generally of Disproportionate Share ing legislation. President Executive Editor ADVERTISING STAFF Published biweekly except August by: The appearance of paid advertisements in County POSTMASTER: send address changes to Roy Charles Beverly Anne Job Market/Classifieds National Association of Counties News in no way implies support or endorsement County News, 660 N. Capitol Street, N.W. Brooks Schlotterbeck by the National Association of Counties for any of representative Research Foundation, Inc. STE. 400, Washington, D.C. 20001 Publisher Senior Staff Writer 660 N. Capitol Street, N.W. STE. 400, the products, services or messages advertised. National Accounts (USPS 704-620) n (ISSN: 0744-9798) Matthew Chase Charlie Ban Washington, D.C. 20001 Periodicals postage paid at Washington D.C. and © National Association of Counties representative 202.393.6226 | FAX 866.752.1573 other offices. Public Affairs Senior Staff Writer Research Foundation, Inc. Director Mary Ann Barton Beverly Schlotterbeck E-mail [email protected] Mail subscriptions are $100 per year for non-mem- (202) 393-6226 bers. $60 per year for non-members purchasing Brian Namey Design Director Online address www.countynews.org Leon Lawrence III FAX (866) 752-1573 multiple copies. Educational institution rate, $50 per year. Member county supplemental subscrip- tions are $20 each. Send payment with order and address changes to NACo, 660 N. Capitol Street, We are commited to getting County News on your desktop ASAP. Send your address corrections to [email protected]. N.W. STE. 400, Washington, D.C. 20001. COUNTY NEWS NATIONAL ASSOCIATION of COUNTIES AUGUST 7, 2017 3 Changes coming to NACo County Explorer Tadas Pack full list of relevant maps.