ACEP Public Policy Grants Support Advocacy Efforts

ACEP News
November 2009

By Christie L. Carter
ACEP News Contributing Writer

In early 2007, Gwen Harry, executive director of the Virginia College of Emergency Physicians, filled out an application for ACEP's State Public Policy Grant Program. The goal was simple: to obtain funding to assist the chapter in its efforts to enforce insurer compliance with current Virginia code protecting patient access to emergency services.

The chapter's reward? Funding in the amount of $12,500 to further the chapter's extraordinary efforts.

The key word in that sentence, said Craig Price, ACEP's director of chapter and state relations, is "extraordinary."

"This grant program is for extraordinary state advocacy efforts that go above and beyond what a chapter would normally be engaged in and that are tied to a national priority objective," he said. "ACEP wants to help chapters with major concerns that they're trying to address."

ACEP has budgeted $50,000 for the grant program each of the past several years, and the maximum amount of grant funds available for any single state public policy initiative cannot exceed one-fourth of that amount. To qualify for the program, chapters must also commit their own funds, totaling at least a dollar-for-dollar match of the funds requested from ACEP.

The grant money has made all the difference for VACEP, which, along with other emergency medicine groups and key stakeholders, challenged a change announced by Anthem HMO that affected patients receiving care from nonparticipating physicians.

The change resulted in Anthem reimbursement at its internal fee schedule, far below the costs associated with the care provided--leaving the patient with the potential for a balance bill from a nonparticipating physician that was formerly covered in full by the insurer. In addition, physicians were often not reimbursed for the care they were obligated to provide under EMTALA.

"Because quality emergency care for our patients requires fair reimbursement, and because we work under the unfunded and underfunded mandate of EMTALA for about 60% of our patients, it's imperative that commercial insurance reimbursement be fair and adhere to state patient protection laws," said Todd L. Vanden Hoek, M.D., MBA, of Chesapeake Emergency Physicians. A member of VACEP's board of directors, Dr. Vanden Hoek led the effort challenging Anthem's reimbursement practices.

"We used the ACEP grant funds to enforce insurer compliance with current Virginia code protecting patients' access to emergency services, as well as to properly define with the Bureau of Insurance what we do for patients under EMTALA," Dr. Vanden Hoek continued. "A proper definition will ensure access to quality emergency care in Virginia, and will set an important precedent for the rest of the nation."

NJ-ACEP Educates State Legislators

Beverly Lynch, executive director of the New Jersey College of Emergency Physicians (NJ-ACEP), has applied for and received two ACEP State Public Policy Grants on behalf of her chapter. Ms. Lynch, whose contract association management firm manages multiple health care associations, commends ACEP for its efforts to help state chapters.

"ACEP does this better than any other medical specialty I've had the privilege to work with. They totally get the fact that things happen at the state level--various projects and initiatives bubble up from the states, and ACEP is more than willing to help state chapters fund these initiatives and ideas," she said. "They really put their money where their mouth is."

While both of NJ-ACEP's grants were used to benefit projects that were already under way, Ms. Lynch said the additional funding gave both the extra edge they needed to truly make a difference at the state level.

One previous project, a mini-internship program for legislators, health care press, and anyone else impacting health care legislation in New Jersey, was "wildly successful" years before, but proved a logistical nightmare when it came to coordinating schedules and other similar activities. When Ms. Lynch heard about ACEP's State Public Policy Grant Program in 2007, the New Jersey chapter board members thought the time had come to resurrect the internship program.

"We have so many issues that we need to educate key legislators and other stakeholders about, and what better way to do that than to have them shadow an emergency physician for a few hours?" said Ms. Lynch. "This grant from ACEP allowed us to put new resources into the project to expand it much more so than we were able to do before."

The chapter used the grant money to launch an extensive mini-internship program, recruiting many policymakers and other key stakeholders in a record amount of time--further deepening their understanding of the challenges that emergency physicians face on a daily basis.

"It's not a difficult program to administer--it's just a lot of work, from thousands of e-mails and phone calls, to an introduction letter to an evaluation letter at the end," said Ms. Lynch. "The ACEP grant even allowed us to order participants white coats, which is a nice touch to make them feel part of the team."

NJ-ACEP applied for and received another grant in 2008, this time to help the chapter in its efforts to generate support for a legislative package aimed at alleviating the problem of boarding psychiatric patients in the emergency department.

"Previously, we just didn't have the money we needed to generate the proper kind of public relations support we needed to further this effort," Ms. Lynch said. "The grant allowed us to retain a small PR firm, and with their help, our three bills have passed the New Jersey State Assembly. Now, as they move through the Senate, we'll reactivate the PR campaign and support it on that side."

Grant recipients are asked to inform ACEP of their process on a regular basis, as well as provide a report on their accomplishments for ACEP's State Legislative/Regulatory Committee, including lessons learned and any documentation produced from which other chapters could benefit.

Ms. Lynch encouraged all state chapters to consider applying for a grant.

"Every board should take a good look at the opportunities before them and brainstorm on ways to use the money to advance emergency medicine," she suggested. "It's a relatively easy process that has gone a long way toward advancing our advocacy agenda."

For more information, go to www.acep.org/advocacy, for the "State Public Policy Grant Program." 

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