Regional Update from HHS Regional Director Susan Johnson

Region 10 - Alaska, Idaho, Oregon, and Washington

Dear Colleagues-

As you read this, we will be nearly halfway through the second Open

Enrollment Period. As a reminder, Open Enrollment ends on February

15, 2015. Over the last year, I’ve visited all of the states in the region.

I’ve talked to people whose lives are impacted by the Affordable Care

Act (ACA), and seen the difference it makes in their lives.

This holiday season, the most important card any of us can receive is a

health insurance card, along with the security and peace of mind that

quality, affordable coverage brings with it. We are all just one accident

or unexpected diagnosis away from needing health insurance. Yet, for

generations, millions of Americans have found that quality coverage is

out of reach … until now. Quality health coverage is available, thanks

to the Affordable Care Act and the Health Insurance Marketplaces.

Whether you’re renewing your coverage from the last Open

Enrollment or signing up for the first time, you may be surprised at

what you can find. Open Enrollment runs through February 15, 2015.

So give the gift of health insurance and peace of mind to your family.

As a reminder, by law you are required to have health insurance

unless you qualify for an exemption. For 2015, the penalties increase

substantially. Many of you may not have filed your taxes by the time

Open Enrollment ends, and may not realize that you owe a tax penalty

this year. Take a look at the penalties that will be in place for 2015

which are shown in this newsletter.

Go enroll. Tell your family and friends to enroll. You only have until

February 15! Have a safe holiday season!

Regards,

Susan

DECEMBER 2014

Individual Shared Responsibility Provision Under the Individual Shared Responsibility Provision, everyone is required to have minimum essential health coverage

(known as minimum essential coverage) for each month, qualify for an exemption (including members of Federally-

recognized Indian Tribes), or make a payment when filing his or her federal income tax return.

The fee in 2015

If you don’t have coverage in 2015, you’ll pay the higher of these two amounts:

2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for

an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze

plan.

$325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is

$975.

The fee for not having coverage in 2014

If you didn’t have coverage in 2014, you’ll pay the higher of these two amounts when you file your 2014 federal tax return:

1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for

an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze

plan.

$95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.

The fee after 2015

The penalty increases every year. In 2016 it’s 2.5% of income or $695 per person. After that it's adjusted for inflation.

How Do I Enroll Myself and My Family in Health Insurance? Open Enrollment is November 15, 2014, to February 15, 2015.

While you can get to any state’s site through Healthcare.gov, there may be a more direct way to enroll in your state.

State Health Insurance Website/Contact

Alaska Healthcare.gov (https://www.healthcare.gov/) or call 2-1-1

Idaho Your Health Idaho (http://www.yourhealthidaho.org/)

Oregon Healthcare.gov (https://www.healthcare.gov/)

Washington Washington Healthplanfinder (https://www.wahealthplanfinder.org/)

Flu Shots and Other Vaccinations Flu shots and other recommended vaccinations are among the free preventive services offered by Qualified Health Plans sold

on the Health Insurance Marketplaces. Certain people are at greater risk for serious complications if they get the flu. This

includes older people, young children, pregnant women and people with certain health conditions (such as asthma, diabetes,

or heart disease). Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and

worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

Flu seasons are unpredictable and can be severe. Over a period of 30 years, between 1976 and 2006, estimates of flu-

associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people.

While you’re in for your flu shot, make sure your other vaccinations are up to date, including your tetanus booster (which

includes pertussis or whooping cough) and your MMR vaccine. Your immunity to these “childhood diseases” wears off over

time and these illnesses can cause serious problems, especially for pregnant women, older people, and those with certain

health conditions. Give yourself a present of continuing health by keeping your vaccines up to date.

Key Dates for the Health Insurance Marketplace Are you ready for the next Health Insurance Marketplace Open Enrollment Period? Open Enrollment is the time when you can

apply for a new Marketplace plan, keep your current plan, or pick a new one.

4 key dates you should know:

•November 15, 2014. Open Enrollment begins. Apply for, keep, or change your coverage.

•December 15, 2014. If you use HealthCare.gov, enroll by the 15th if you want new coverage that begins on January 1, 2015.

If your plan is changing or you want to change plans, enroll by the 15th to avoid a lapse in coverage. State marketplaces may

choose another date for coverage effective January 1, 2015. (In Idaho, you must enroll by December 20, 2014.)

•December 31, 2014. Coverage ends for 2014 plans. Coverage for 2015 plans can start as soon as January 1st.

•February 15, 2015. This is the last day you can apply for 2015 coverage before the end of Open Enrollment.

To buy Marketplace insurance outside of Open Enrollment, you must qualify for a Special Enrollment Period (SEP) because of a

Qualifying Life Event like marriage, birth or adoption of a child, or loss of other health coverage. Watch this video about SEPs

or visit the screener tool to see if you could qualify to enroll outside Open Enrollment.

As a reminder, you can enroll in Medicaid at any time. AIANs can enroll in Marketplace plans at any time and can change plans

as often as once a month.

Recent Events and Visits

HHS Regional Director Susan Johnson; Don Berwick, M.D., former Administrator of CMS; and Sean Kolmer, Governor Kitzhaber’s

Health Policy Advisor discuss the achievements of the Coordinated Care Models at the CCO Summit in Portland on December 3. Photo

courtesy of Jonnaliz Corbett, Oregon Health Authority, Transformation Center.

Moderator, Carol Backstrom, with the National Governors’ Association, Susan Mende with the Robert Wood Johnson Foundation,

Piper Su with The Advisory Board Company, and HHS Regional Director Susan Johnson share views of delivery system innovation

occurring across the United States at the CCO Summit in Portland, December 4. Photo courtesy of Jonnaliz Corbett, Oregon Health

Authority, Transformation Center.

Visiting with the successful Your Health Idaho conversion to a

State Based Marketplace:(L to R) Jody Olson, Director of

Communications, YHI; Susan Johnson, Regional Director, HHS

Region 10; Idaho H&W Director Dick Armstrong; Pat Kelly,

Executive Director, YHI.

Visit to SeaTac CDC Quarantine Station: Pictured Than Lerner,

Quarantine Public Health Officer, and Keysha Ross, Officer-in-

Charge.

December Observances National Impaired Driving Prevention Month President Obama’s Proclamation begins, “All Americans deserve to live long and full lives, and every child should have the

chance to seize his or her future. But throughout our Nation, too many lives are tragically cut short in traffic crashes involving

drunk, drugged, or distracted driving. Impaired driving not only puts the driver at risk -- it threatens the lives of passengers

and all others who share the road, and every year it causes the deaths of thousands of loved ones. This month, and especially

during the holiday season, we dedicate ourselves to driving safely and responsibly, and to promoting these behaviors among

our family and friends.” He later continues, “My Administration is striving to increase awareness of the dangers and

devastating consequences of impaired driving in all its forms, especially the growing, but often overlooked, problem of

drugged driving. Illegal drugs, as well as prescription and over-the-counter medications, can be just as deadly on the road as

alcohol, and preventing drugged driving is a public health imperative… Reducing impaired driving and keeping our roadways

safe is everyone's responsibility. Parents and other caring adults can play an important role in educating young Americans

about the dangers of impaired driving; adults can model good practices while driving and can help new drivers develop safe

habits. This holiday season, all Americans can drive responsibly and encourage their loved ones to do the same, including by

designating a sober driver or making alternative transportation arrangements.”

Reminders for the holiday season and beyond:

Designate a sober driver before any festivities

Read medication labels—over the counter and prescription drugs can cause drowsiness or other impairment o Some drugs can interact with each other or alcohol causing impairment o Don’t drive until you know how a new medication affects you

If you are a host, don’t let your guests drive impaired—call a cab, find a sober driver to drive them, or invite your guest to stay and sober up.

o Offer non-alcoholic alternatives for those who choose not to drink.

Safe Toys and Gifts Month This holiday season (and beyond), please consider the following guidelines for choosing safe toys for all ages:

•Inspect all toys before purchasing. The toy should have no sharp edges or points and should be sturdy enough to withstand

impact without breaking, being crushed, or being pulled apart easily.

•When purchasing toys for children with special needs try to:

o Choose toys that may appeal to different senses such as sound, movement, and texture; o Consider interactive toys to allow the child to play with others; o Think about the size of the toy and the position a child would need to be in to play with it.

•Be diligent about inspecting toys your child has received. Check them for age, skill level, and developmental appropriateness

before allowing them to be played with.

•Look for labels that assure you the toys have passed a safety inspection – “ATSM” means the toy has met the American

Society for Testing and Materials standards.

•Gifts of sports equipment should always be accompanied by protective gear (give a helmet with the skateboard)

•Keep kids safe from lead in toys by:

o Educating yourself about lead exposure from toys, symptoms of lead poisoning, and what kinds of toys have been recalled;

o Being aware that old toys may be more likely to contain lead in the paint; o Having your children wash their hands frequently and calling your doctor if you suspect your child has been exposed

to lead. •Do NOT give toys with small parts (including magnets and “button” batteries which can cause serious injury or death if

ingested) to young children as they tend to put things in their mouths, increasing the risk of choking. If the piece can fit inside

a toilet paper roll, it is not appropriate for kids under age three.

•Do NOT give toys with ropes and cords or heating elements

•Do NOT give crayons and markers unless they are labeled “nontoxic”.

Grant Opportunities Evaluating Structural, Economic, Environmental, or Policy Primary Prevention Strategies for Intimate Partner Violence and

Sexual Violence – CDC offers this announcement to support research to rigorously evaluate structural, economic,

environmental, or policy strategies for the primary prevention of intimate partner violence and/or sexual violence (IPV and/or

SV). The proposed research will add to the limited knowledge base on effective strategies for IPV and/or SV prevention by

evaluating the use of community-level approaches that change one or more of the social, economic, behavioral, or

environmental characteristics of a community in order to prevent and reduce rates of IPV and/or SV perpetration,

victimization or both perpetration and victimization. Eligible applicants include: State, County, City or township, or Special

district governments; Independent school districts; Private and Public or State controlled institutions of higher education;

Native American tribal governments (Federally recognized and non-recognized); Public housing authorities/Indian housing

authorities; Native American tribal organizations (other than Federally recognized tribal governments); Nonprofits with or

without a 501(c)(3) status with the IRS, other than institutions of higher education; For profit organizations; Faith-based or

Community-based Organizations; and Regional Organizations Closing date: March 5, 2015. Read full announcement.

OSERS: OSEP: Training and Information for Parents of Children with Disabilities: Parent Training and Information Centers

CFDA – Funding is offered by the Department of Education. The purpose of this program is to ensure that parents of children

with disabilities receive training and information to help improve results for their children. Eligible Applicants: Parent

organizations (Alaska and Oregon only in Region 10). Closing date: February 9, 2015. Read full announcement.

American Apprenticeship Initiative - The Employment and Training Administration (ETA), U.S. Department of Labor (DOL),

announces the availability of approximately $100 million in grant funds for the American Apprenticeship Initiative. This

initiative is intended to provide a catalyst in supporting a uniquely American Apprenticeship system that meets our country’s

particular economic, industry and workforce needs. American Apprenticeships (also referred to as Registered Apprenticeships)

are innovative work-based learning and post-secondary earn-and- learn models that meet national standards for registration

with the U.S. Department of Labor (or federally recognized State Apprenticeship Agencies). To be eligible for consideration,

applications must include a partnership of private and public sector entities. The Department seeks a diversity of partners and

partnership structures to support innovation and seed diverse approaches. To be eligible for consideration, applications must

include at least one entity from: (1) the private sector; i.e. a business, a consortium of businesses, business-related nonprofit

organization, or a private organization functioning as a workforce intermediary for the express purpose of serving the needs of

businesses; and (2) the public sector; i.e. the workforce investment system; public education or training provider; or DOL-

recognized State Apprenticeship Agency. A lead applicant must be a public or non-profit organization. Closing date: April 30,

2015. Read full announcement.

Desalination and Water Purification Research and Development (DWPR) - Through this Funding Opportunity Announcement

(FOA), the U.S. Department of the Interior (DOI), Bureau of Reclamation (Reclamation), is accepting applications for projects

to be funded by the Desalination and Water Purification Research and Development Program (DWPR). Through this program,

Reclamation is forming partnerships with private industry, universities, water utilities, and others to address a broad range of

desalting and water purification needs. Eligible applicants: Individuals, institutions of higher education, commercial or

industrial organizations, private entities, public entities (including state and local), and Indian Tribal Governments. Closing

date: Apr 27, 2015; Phase I applications are due February 16, 2015 by 4:00PM MST. Phase II applications are due April 27,

2015 by 4:00PM MST. Read full announcement.

Public Transportation on Indian Reservations Program; Tribal Transit Program - The primary purpose of these competitively

selected grants is to support planning, capital, and, in limited circumstances, operating assistance for tribal public transit

services. Funds distributed to Indian tribes under the TTP should NOT replace or reduce funds that Indian tribes receive from

States through FTA’s Section 5311 program. Priority consideration will be given to eligible projects that help to expand ladders

of opportunity. Examples could include enhancing access to work, educational, and other training opportunities, and

supporting partnerships that expand access to other governmental, health, medical, education, social, human service, and

transportation providers to improve coordinated delivery of services. Eligible applicants: Federally-recognized Indian tribes or

Alaska Native villages, groups, or communities as identified by the U.S. Department of Interior (DOI), Bureau of Indian

Affairs (BIA). Closing date: February 18, 2015. Read full announcement.

ENVIRONMENTAL WORKFORCE DEVELOPMENT AND JOB TRAINING (EWDJT) GRANTS - This notice announces the availability

of funds and solicits proposals from eligible entities, including nonprofit organizations, to deliver environmental workforce

development and job training programs that recruit, train, and place local, unemployed and under-employed residents with

the skills needed to secure full-time employment in the environmental field, with a focus on solid and hazardous waste

remediation, environmental health and safety, and wastewater-related training. Eligible applicants: General Purpose Unit of

Local Government; Land Clearance Authority or other quasi-governmental entity that operates under the supervision and

control of, or as an agent of, a general purpose unit of local government; Government entity created by State Legislature;

Regional Council or group of General Purpose Units of Local Government; Redevelopment Agency that is chartered or

otherwise sanctioned by a State; State; Indian Tribe other than in Alaska. (The exclusion of Alaskan tribes from grant

eligibility is statutory at CERCLA §104(k)(1).) Intertribal Consortia are eligible for funding in accordance with EPA’s policy for

funding intertribal consortia published in the Federal Register on November 4, 2002, at 67 Fed. Reg. 67181. (This policy also

may be obtained from your EPA Regional Job Training Coordinator listed in Section VII.); Alaskan Native Regional

Corporation, Alaska Native Village Corporation and the Metlakatla Indian Community. (Alaskan Native Regional

Corporation and Alaska Native Village Corporation as those terms are defined in the Alaska Native Claims Settlement Act

(43 U.S.C. 1601 and following).); Nonprofit organizations. For purposes of this grant program, the term “nonprofit

organization” means any corporation, trust, association, cooperative, or other organization that is operated mainly for

scientific, educational, service, charitable, or similar purpose in the public interest; is not organized primarily for profit; and

uses net proceeds to maintain, improve, or expand the operation of the organization. Workforce Investment Boards and

organized Labor Unions that meet these criteria may be eligible nonprofit organizations. Closing date: February 3, 2015. Read

full announcement.

Perinatal and Infant Oral Health Quality Improvement Expansion Grant Program - This funding opportunity announcement

(FOA) solicits applications for the Perinatal and Infant Oral Health Quality Improvement (PIOHQI) Expansion Grant Program,

the second phase of the Perinatal and Infant Oral Health National Initiative. The goal of this grant program, as with this multi-

phase initiative, is to reduce the prevalence of oral disease in both pregnant women and infants through improved access to

quality oral health care. By targeting pregnant women and infants most at risk for disease, during times of increased health

care access, the expected result is improved oral health and oral health care utilization of the mother and her child

throughout their lifespan. Oral health is an essential component in promoting and maintaining overall health during

pregnancy and throughout one’s lifetime. Ultimately, by linking the delivery of oral health with primary care, the overall well-

being of pregnant women and infants will be improved. At the end of this funding period, awardees will have defined and

implemented evidenced-based models used to successfully integrate quality oral health care into perinatal and infant primary

health care delivery systems with statewide reach. These models will: reduce prevalence of oral disease in pregnant women

and infants, ultimately reducing Early Childhood Caries (ECC); increase utilization of preventive dental care by pregnant

women; establish a dental home for infants (by age one); and reduce dental expenditures. Eligible applicants: Any public or

private entity, including an Indian tribe or tribal organization, is eligible to apply for this Federal funding opportunity. If

otherwise eligible, faith-based and community-based organizations are eligible to apply. Closing date: February 27, 2015. Read

full announcement.

Statewide Consumer Network Program - The purpose of this program is to improve mental health service delivery to people

with serious mental illnesses. In so doing, it seeks to enhance statewide mental health consumer-run and -controlled

organizations to promote service system capacity and infrastructure development that is consumer-driven, recovery-focused

and resiliency¬-oriented. The program goals are (1) to increase consumer participation, voice, and empowerment statewide;

(2) emphasize and build consumer leadership within organizations and in the community; and (3) promote activities related

to: partnership development, peer support, service needs related to gender, training and skills development, trauma-

informed peer support, integrated care and wellness, and/or health reform as part of the recovery process for consumers. The

Statewide Consumer Network program also seeks to address the needs of underserved and under-represented consumers,

including those from ethnic, racial, or cultural minority groups, service needs related to gender, veterans, those who have

histories of chronic homelessness, those with co-occurring mental and substance use disorders, young adults, sexual

orientation and gender identity minority individuals, and those who have been involved in the criminal justice system. Eligible

applicants: SAMHSA is limiting eligibility for this program to mental health consumer-controlled organizations only that are

domestic public and private nonprofit entities, tribal and urban Indian organizations, and/or community- and faith-based

organizations. A primary goal of the program is to strengthen the capacity of consumers to act as agents of transformation in

influencing the type and amount of services, so they must be an integral part of an organization that supports individuals with

a serious mental illness or who have received public mental health services, and ensures that their mental health care is

consumer driven with access to recovery support services. Therefore, only organizations controlled and managed by mental

health consumers are eligible to apply. Consumer-controlled organizations must meet the following requirements: • An

applicant organization must complete the Certificate of Eligibility (see Appendix K of the RFA) indicating that the applicant

meets all eligibility requirements. In order to strengthen and expand the impact of this program across the nation and ensure

broad geographic distribution, SAMHSA will make only one award per state, territory, or tribe and is limiting eligibility to

applicants in states, territories, and tribes that do not have a currently funded Statewide Consumer Network grant. See

Appendix L of the RFA for a listing of states, territories, and tribes with a currently funded Statewide Consumer Network grant.

Organizations located in these jurisdictions are not eligible to apply. Tribes, regardless of location, are eligible to apply

providing they do not have a currently funded grant. Closing date: February 2, 2015. Read full announcement.

Statewide Family Network Program - The Statewide Family Network Program builds on the work of SAMHSA’s Center for

Mental Health Services which helped to establish a child and family focus in programs serving children and adolescents with

mental health challenges around the country. Today, nearly every state has active family organizations dedicated to

promoting systems of care that are responsive to the needs of children and adolescents with mental health challenges and

their families. Although significant progress has been made, further support will ensure self-sufficient, empowered networks

that will effectively participate in State and local mental health services planning and health care reform activities related to

improving community-based services for children and adolescents with mental health challenges and their families. Eligibility

for this program is limited to: Eligible applicants are family-controlled* domestic public and private nonprofit organizations in

states, territories, and Tribes. SAMHSA will make one award per state, territory, and tribe and is limiting eligibility to

applicants in states, territories and tribes that do not have a currently funded Statewide Family Network grant. Family-

controlled* organizations must meet the following requirements:• An applicant must complete the Certification of Eligibility

(see Appendix J of the RFA) indicating that the applicant meets all eligibility requirements and include necessary supporting

documentation. *A family-controlled organization is an organization that has a board of directors made up of more than 50%

family members who have primary daily responsibility for the raising of a child, youth, adolescent or young adult with a

serious emotional disturbance up to age 18, or 21 if the adolescent is being served by an Individual Educational Plan (IEP), or

age 26 if the young adult is being served by an Individual Service plan in transition to the adult mental health system. SAMHSA

is limiting eligibility to family-controlled organizations to strengthen the capacity of families with children who have serious

emotional disturbance to act as agents of transformation in influencing the type and amount of services provided to them and

their children and to ensure their mental health care is family driven and youth guided. Closing date: February 2, 2015. Read

full announcement.

Environmental Education Model Grants Program -- Solicitation Notice for 2014 - The purpose of the Environmental

Education Model Grant Program is to support model, replicable projects that increase public awareness and knowledge about

environmental issues and provide the skills that participants in its funded projects need to make informed environmental

decisions and take responsible actions toward the environment. Eligible applicants: local education agency; state education or

environmental agency; college or university; non-profit organization as described in section 501(c)(3) of the Internal Revenue

Code; noncommercial educational broadcasting entity; or tribal education agency (which includes schools and community

colleges controlled by an Indian tribe, band, or nation). Closing date: February 2, 2015. Read full announcement.

Office of Career, Technical, and Adult Education (OCTAE): Performance Partnership Pilots CFDA Number 84.420A - The

Performance Partnership Pilots (P3) program, authorized by the Consolidated Appropriations Act, 2014, Division H, Section

526 (the Act), will enable up to ten pilot sites to test innovative, outcome-focused strategies to achieve significant

improvements in educational, employment, and other key outcomes \1\ for disconnected youth \2\ using new flexibility to

blend \3\ existing Federal funds and to seek waivers \4\ of associated program requirements. P3 pilots will receive start-up

grants to support ongoing planning, streamlined governance, strengthened data infrastructure, improved coordination, and

related activities to help pilots improve outcomes for disconnected youth. Eligible applicants: State, County, City/township, or

Special district governments; Nonprofits with or without 501(c)(3) status with the IRS, other than institutions of higher

education; or Native American tribal governments (Federally recognized). Deadline for Notice of Intent to Apply: January 8,

2015. Note: Submission of a notice of intent to apply is optional. Deadline for Transmittal of Applications: March 4, 2015.

Read full announcement.

Alcohol Education Project Grants (R25) - The over-arching goal of the National Institute on Alcohol Abuse and Alcoholism

(NIAAA) R25 program is to foster a better understanding of biomedical, behavioral and clinical research and its implications.

To accomplish the stated over-arching goal, this FOA will support creative educational activities with a primary focus on

Curriculum or Methods Development and Outreach activities for Health Professionals. Eligible applicants: Native American

tribal governments (Federally recognized); Nonprofits with and without a 501(c)(3) status with the IRS, other than institutions

of higher education; Public/State controlled and Private institutions of higher education; State, County, City/township, Special

district governments; For profit organizations; Independent school districts; Native American tribal organizations (other than

Federally recognized tribal governments); and Public housing authorities/Indian housing authorities. Closing date: January 7,

2018. Read full announcement.

For more grant opportunities, please visit this grant site or Grant Solutions and search by keyword. You can also visit HHS

online and search for grants. You may also wish to receive updates from the Office of Minority Health. You can select to

receive information on funding when you update your preferences.