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The Compliance Manual is the principal resource to assist health centers in understanding and demonstrating compliance with Health Center Program requirements. View Frequently Asked Questions. The Health Center Program uses a library of standard conditions that follow its Progressive Action policy and process, which fully aligns with the Health Center Program Compliance Manual. View the Progressive Action Conditions Library. The SVP is designed to provide HRSA the information necessary to perform its oversight responsibilities using a standard and transparent methodology that aligns with the Compliance Manual. View the Site Visit Protocol. Written comments were accepted through November 22, 2016. Individuals and groups submitted more than 700 comments. After thorough review and consideration of all comments, HRSA made a substantial number of revisions to the Compliance Manual to incorporate suggestions and requests for further clarification. Because the Compliance Manual has been revised since the issuance of this summary, comments and response summaries marked with an asterisk and in italics no longer reflect current Compliance Manual language. Sign-up to receive the newsletter each week in your inbox. Ask it Now. Look-alikes do not receive Federal funding under section 330 of the PHS Act; however, to receive look-alike designation and associated Federal benefits, look-alikes must meet the Health Center Program requirements. 3 For the purposes of this document, the term “health center” refers to entities that apply for or receive a Federal award under section 330 of the PHS Act (including section 330 (e), (g), (h) and (i)), section 330 subrecipients, and organizations designated as look-alikes. The Compliance Manual also addresses HRSA’s approach to determining eligibility for and exercising oversight over the Health Center Program and details the requirements for obtaining deemed PHS employee status under section 224 (g)-(n) and (q) of the PHS Act.
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5 The Compliance Manual does not provide guidance on requirements in areas beyond Health Center Program requirements or outside HRSA’s oversight authority. In addition, the Compliance Manual is not intended to address best or promising practices or performance improvement strategies that may support effective operations or organizational excellence. With the exception of these policies, the Compliance Manual supersedes other previous Health Center Program non-regulatory policy issuances (Policy Information Notices (PINs), Program Assistance Letters (PALs), Regional Office Memoranda, Regional Program Guidance memoranda, and other non-regulatory materials) related to Health Center Program compliance or eligibility requirements. Previously published issuances that are superseded by this Manual include, but are not limited to: HRSA will update or amend the Compliance Manual as needed to provide further policy clarification with respect to demonstrating compliance with Health Center Program requirements. In responding to such conditions, health centers could demonstrate their compliance to HRSA either by submitting documentation as described in the Demonstrating Compliance sections of the Manual or by the health center proposing an alternative means of demonstrating compliance with the specified Requirements, which would include submitting an explanation and documentation that explicitly demonstrate compliance. All responses to conditions are subject to review and approval by HRSA (see Chapter 2: Health Center Program Oversight ). When specific examples are provided, they are not intended to be an all-inclusive list. All related considerations are offered with the understanding that health center decision-making and implementation are consistent with all applicable statutory, regulatory, and policy requirements.
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As such, the Compliance Manual does not constitute an exhaustive listing of all requirements that may be included in terms and conditions stated in NOFOs, NoAs, and other applicable laws, regulations, and policies. In fulfilling all of these oversight and compliance responsibilities, a health center may wish to consult its private legal counsel. Health centers may also direct questions to the designated points of contact for these programs. See Appendix A for additional policy issuances which remain in effect. See for more information. Ask it Now. See the Site Visit Protocol and other tools HRSA uses for conducting site visits of health centers, primary care associations (PCAs), and health center controlled networks (HCCNs). These tools can be used to help organizations prepare for site visits. See this page for documents and resources to understand scope for project and for guidance on making scope-related changes. Conditions are applied when a health center does not demonstrate compliance with Health Center Program requirements and include clear descriptions of the specific actions needed to remove the conditions. Operational Site Visits (OSVs) provide an objective assessment and verification of the status of each Health Center Program awardee's or look-alike’s compliance with the statutory and regulatory requirements of the Health Center Program. In addition, HRSA conducts site visits to assess and verify look-alike initial designation applicants for compliance with Health Center Program requirements to inform initial designation determinations. The SVP is designed to provide HRSA the information necessary to perform its oversight responsibilities using a standard and transparent methodology that aligns with the Health Center Program Compliance Manual (Compliance Manual). View Frequently Asked Questions. This includes ensuring that health centers comply with applicable statutory and regulatory requirements for the Health Center Program.
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The Compliance Manual is the principal resource to assist health centers in understanding and demonstrating compliance with Health Center Program requirements. View the Health Center Program Compliance Manual. The uses a library of standard conditions that follows its Progressive Action policy and process, which fully aligns with the Compliance Manual. View the Progressive Action Conditions Library. View a summary of the 2019 SVP updates (PDF - 5.9 MB). Submit a request through Health Center Program Support, and select Issue Type: “Compliance Manual.”. Any consultant interested in participating on these visits are required to participate in the Look-A-Like Designation Applicant Training webinar posted on the MSCG website. This is a pre-recorded training. The webinar is intended to provide consultants with an overview of the Look-A-Like designation review process. Please note that this webinar is only required for consultants interested in participating on the Look-A-Like designation site visits. This requirement also includes consultants interested in Look-A-Like site visits who may have previously conducted such visits.The purpose of the training is to provide consultants with insights and strategies on the following:This training is only open to consultants with extensive PCA experience.It will include an overview of the structure and effective dates of the HHS Uniform Guidance (45 CFR 75) and changes of note for HAB grant and cooperative agreement recipients. Changes in vocabulary, procurement thresholds, indirect costs, sub recipient monitoring, select items of cost, and audit requirements will be highlighted. Specifically, attendees to the training learned how to effectively assess compliance and report findings based on administrative practices required by legislation. Specifically, attendees to the training learned how to effectively assess compliance and report findings based on fiscal practices required by legislation and policy.
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Specifically, attendees to the training learned how to effectively assess compliance and report findings based on clinical requirements required by legislation and policy. With a rapidly changing healthcare environment, increasing requirements for oversight of subrecipients (including contractors performing programmatic activities), and required coordination across other federal, state, and local funding streams, RWHAP recipients have new and additional administrative costs. These additional activities coupled with current policies have resulted in unreimbursed administrative costs for RWHAP recipients and less flexibility in the use of HRSA funds to administer their grant(s). This training focuses on changes with regard to administrative costs that better enable recipients and subrecipients to provide core medical and support services to eligible clients while ensuring that the RWHAP is the payer of last resort. With a rapidly changing healthcare environment, increasing requirements for oversight of subrecipients (including contractors performing programmatic activities), and required coordination across other federal, state, and local funding streams, RWHAP recipients have new and additional administrative costs. These additional activities coupled with current policies have resulted in unreimbursed administrative costs for RWHAP recipients and less flexibility in the use of HRSA funds to administer their grant(s). This training focuses on changes with regard to administrative costs that better enable recipients and subrecipients to provide core medical and support services to eligible clients while ensuring that the RWHAP is the payer of last resort. HIV Care Continuum and Clinical Site Visit Tool Training - Clinical Site Visit Training The key objectives included understanding the Project Officer and Consultant Roles within the Ryan White Part B Program site visit.
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Becoming familiar with the most common Ryan White Part B Program site visit type: The Comprehensive Site Visit and understanding the consultant requirements when conducting site visits on behalf of the Ryan White Part B Program.The training focused on the rostering process, logistics process including information on how a consultant is selected for task orders and the consultant responsibility after receiving an assignment. In addition the training focused on the consultant report requirements, consultant evaluations and the payment process. FQHCs are outpatientThey includeHealth centers provide a comprehensive set of health services includingMost awards provideFQHCs include Health Center Program awardees andCMS provides aA 2017 Medicaid and CHIP Payment and AccessHealth centers must still review and sign the NHSC site agreement. Learn more aboutTo receive coverage, awardeesNote that FTCA coverage is available only to Health CenterBenefits toThe NAP notice of funding opportunity (NOFO) is posted onHealth CenterOnce they receive the awards, they become responsible for serving the generalAdditional information on Medicare enrollment for FQHCs canIt provides additional details on health center service areas, high need and servicesFor those working through the process, it may be helpful to separate the steps ofThe key aspects of developing a grant proposal for a Section 330 PHS Act Health CenterSee the MUA Find tool.
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See page 11 of So You Want to Start a HealthSee page 16 of So You Want to Start a Health Center, PhysicalThese entities are funded by HRSA to provide training and technicalIn addition, onceIf the existing awardee would like to continue receiving the award, they mustAdditional services of this programThey provide comprehensive healthcare services that includeOften these services are provided on the public housing premises or withinSBHCs in rural areas are more likely to serve other populations in addition toSchool-BasedTwenty Years of School-Based HealthThe Evidence on School-Based Health Centers: AGeneral tips provided include:This could include establishment of a SchoolWho is your target audience and what are their primary unmetWhat services will you provide. Where? With what staff?School-Based Health Centers: AThe School-BasedStrategizingThe board must include a majority (at least 51)For detailed information about board development and management, see Chapter 20:The Health Center ResourceHealth centers must be located in or serveMigrant and Seasonal AgriculturalHealth centers must maintain aAdditional information about clinical staffing and demonstrating complianceFor example:Each health center is responsible for ensuring that itHealth centers may offer a full discount orFor individuals with incomes above 100 and at or below 200 FPG, partialThe NHSC loan repayment program is not limited to primary careThe NHSC scholarship program will pay for a variety of schoolThis manual includesCase Studies ofAccording to a 2018 NACHC publication, The HealthMACs also support and work with FQHCs by enrollingOrganizations can also use the online Provider Enrollment,For more information, please see the CMSTo access a CMS Medicare Administrative Contractor within your state, seeThese grants are posted on HRSA's Capital Development GrantOther funders may support capital projects and can be found listed on theAny information, content, or conclusions on this website are.
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This includes logistical support, advocacy and education to assist individuals in navigating the healthcare system and activities that help recipients gain access necessary to manage their physical and behavioral health conditions. Individuals who are deemed clinically eligible for BPHC may become eligible for Medicaid due to BPHC financial eligibility standards and therefore eligible to receive all Medicaid covered services for which they qualify to meet their complex needs. Community mental health centers will provide services such as help in scheduling appointments with doctors, coaching on communicating more effectively with doctors and following instructions on medications or other doctor recommendations. In addition, BPHC includes: direct assistance in gaining access to services, coordination of care within and across systems, oversight of the entire case, and linkage to appropriate services: needs based assessment of the eligible recipient to identify service needs; development of an individualized integrated care plan; referral and related activities to help the recipient obtain needed services; monitoring and follow-up; and evaluation. Each setting must be assessed independently to determine if an applicant resides in a community-based setting. These income limits are updated annually when the federal government releases the new FPL standards. They are typically published in late January and become effective for Indiana Medicaid eligibility determinations in March or April. There are certain income disregards that may be applied that may lower countable income. There is no asset limit for the program. Determination of financial eligibility is conducted by the Division of Family Resources. It also highlights foundational knowledge and core competencies you need to be an effective board member. The BPHC Compliance Manual, issued August 2017, indicates where PINS, PALs and other program guidance are now superseded or subsumed by the BPHC Compliance Manual.
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See. These include low income populations, the uninsured, and those with limited English proficiency. Health Center Program grantees are organizations that receive grants under the Health Center Program as authorized under Section 330 of the Public Health Service Act, as amended. There are 19 Key Program Requirements that fall under 4 main categories: Need; Services; Management and Finance, and; Governance. Please click Health Center Program Requirements for the complete listing. Find MUAs and MUPs More about health center governance Health centers may also use this Guide as a self-assessment resource as it provides a series of prompting questions for both program requirements and performance improvement. Please click Health Center Site Visit Guide to be directed to the document. Policy Information Notices (PINs) define and clarify policies and procedures that grantees funded under Section 330 must follow. Please click PINs and PALs to be directed to the complete listing of policies. As part of the federal government’s War on Poverty, funding was made available for communities to establish primary care centers to provide comprehensive health services, regardless of ability to pay. Although there have been many changes in the Community Health Center program over the years, its foundation remains the same—to provide high-quality primary and preventive health care to people in rural and urban medically underserved areas. Principal employment for both migrant and seasonal farmworkers must be in agriculture. In 1996, Congress joined the Health Care for the Homeless program to the Community, Migrant, and Public Housing Primary Health Care programs under a single authority called the Consolidated Health Center Program.
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The Health Care for the Homeless program provides federal grants to non-profit organizations to deliver The Health Care for the Homeless Program is a major source of primary health care and substance abuse services to homeless individuals and families in the United States, serving patients that live on the street, in shelters, or in transitional housing. Public The Public Housing Primary Care Program provides residents of public housing with increased access to comprehensive primary health care services through the direct provision of health promotion, disease prevention, and primary health care services. Services are provided on the premises of public housing developments or at other locations immediately accessible to residents. Look-Alikes are certified by the Centers for Medicare and Medicaid Services (CMS) and operate and provide services consistent with all statutory, regulatory, and policy requirements that apply to section 330-funded health centers, but do not receive funding under section 330. FQHC-LAs are eligible for cost-based reimbursement through CMS, participation in the 340B federal drug pricing program. Both Health Center Program grantees and look-alikes are essential to the success of the program. The Health Center Program Update and Initial Designation Application Instructions for 2013. The guide “So You Want to Start a Health Center” is a great resource for communities and organizations to use as they begin the process. The views and opinions expressed in any referenced document do not necessarily state or reflect those of the Ohio Association of Community Health Centers. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov. Health Center Program grantees, which receive federal funding, and Federally Qualified Health Center Look-Alikes (FQHC LAs), which do not, must meet a set of requirements.
The Bureau of Primary Health Care (BPHC), within the Health Resources and Services Administration (HRSA), administers the Health Center Program and provides ongoing oversight of both Health Center Program grantees and FQHC Look-Alikes. Included in the program requirements are clinical expectations that guide both the types of services offered, as well as the quality of those services. While the intent of these requirements is to assure quality service to health center patients, many organizations struggle to understand how to design and manage their sites to meet the requirements. In this section of our website you will find information about clinical performance measures. Please explore our resources page, our tool box, and technical assistance services offered by MCN that will help you better manage your organization. If you do not find what you need on this page, you may contact Theressa Lyons, Senior Program Manager, Training and Technical Assistance Coordinator for further guidance. Information about the Clinical Performance Measures If you are associated with a Health Center grantee receiving funding to serve a migrant farmworker population, you may have some familiarity with the performance measures introduced in 2008 by the Bureau of Primary Health Care (BPHC). Grantees must report annually into the Uniform Data System (UDS) on a set of clinical and financial performance measures in an effort to collect data that will allow for the evaluation of individual and collective performance trends over time. The required measures are described here. Health centers that meet or exceed quality improvement measures in their annual Uniform Data System reports can receive quality improvement award payments that reward their achievements and support further improvement.
Migrant-Specific Performance Measures Many Health Center Program grantees that serve large migrant populations are interested in developing measures that reflect the unique features of both the migrant population itself and the service delivery modalities used by Migrant Health Centers. MCN was asked by BPHC in 2009 to coordinate a work group to respond to this need, and that group developed a set of recommended migrant-specific performance measures. The conclusions of that work are presented here. The process of developing migrant-specific measures included consideration of the following questions: What’s already out there. What’s the evidence. What do our experts say. What is most relevant to migrant farmworkers and Migrant Health Centers. Unlike the required performance measures, these measures are not mandatory for Health Center Program grantees. Their adoption, however, has been estimated by MCN’s work group to provide significant benefit to health centers serving migrant populations. This measure would monitor the effectiveness of enabling services by documenting the identification of patients outside of the clinic setting with uncontrolled hypertension who are entered into care. “Successfully referred” means the patient is referred and the resulting clinic visit is documented. Additional Enabling Services Measures include: Percent of migrant women who have documented screening for sexual violence during the measurement year Percent of migrant patients who are 12-years old or older who have documented tobacco use status during the measurement year Preferred Environmental and Occupational Health Measure: Percent of registered farmworker patients who receive pesticide prevention education. This measure would document how many farmworker patients receive education regarding the prevention of pesticide exposure, such as the use of personal protective equipment (PPE), proper storage and handling of pesticides, etc.
Increases in service levels per patient may result in increased “average cost per patient,” while increases in the total number of patients served within the same staffing and cost structure will result in lower “average cost per patient,” indicating improved efficiency. They are intended only as suggested supplemental measures. The Health Resources and Services Administration (HRSA), one of the divisions of the PHS, is responsible for the administration and funding of Federally Qualified Health Centers (FQHCs) throughout the United States. What is a Federally Qualified Health Center? FQHCs play a significant role in the delivery of ambulatory healthcare in the United States.Subsequently, the BPHC revised its Site Visit Protocol in September 2018 to align with the statutory changes. Therefore, it is critical that FQHC-based compliance officers conduct a gap analysis to determine whether any enhancements or other modifications may be warranted for their Health Center’s annual compliance work plan. Please log in or become a member. SCCE supports our members' work with education, news, and discussion forums. We are a community of leaders, defining and shaping the corporate compliance environment across a wide range of industries and geographic regions. In developing and maintaining effective ethics and compliance programs, our members strengthen and protect their companies. HCCA was established in 1996 and is headquartered in Minneapolis, MN. We provide training, certification, and other resources to over 10,000 members. Our members include compliance officers and staff from a wide range of organizations, including hospitals, research facilities, clinics and technology service providers. Your use of this site to is subject to our Terms Of Use and Privacy Statement. This newsletter or articles therein may not be reproduced in any form without the express written permission of the publisher. We’ve made big changes to make the eCFR easier to use.
Be sure to leave feedback using the 'Help' button on the bottom right of each page!The Public Inspection page may alsoWhile every effort has been made to ensure thatUntil the ACFR grants it official status, the XMLCounts are subject to sampling, reprocessing and revision (up or down) throughout the day. These can be usefulOnly official editions of theUse the PDF linked in the document sidebar for the official electronic format. The purpose of the Compliance Manual is to provide a consolidated web-based resource to assist current and prospective health centers in understanding and demonstrating compliance with requirements of the Health Center Program, a HRSA-administered program authorized under 42 U.S.C. 254 b. The Compliance Manual identifies requirements found in the Health Center Program's authorizing legislation and implementing regulations, as well as certain applicable grant regulations. The Compliance Manual also addresses HRSA's approach to determining eligibility for and oversight of the Health Center Program. In addition, the Compliance Manual includes the requirements for obtaining deemed Public Health Service (PHS) employee status under the Federally Supported Health Centers Assistance Acts of 1992 and 1995, for purposes of Federal Tort Claims Act (FTCA) liability protections for the performance of medical, surgical, dental, and related functions within the scope of deemed PHS employment. HRSA also designates eligible applicants under the Health Center Look-Alike Program ( see Sections 1861(aa)(4)(B) and 1905(l)(2)(B) of the Social Security Act). Look-Alikes do not receive Health Center Program funding but must meet the Health Center Program statutory and regulatory requirements. Note that for the purposes of the Compliance Manual, the term “health center” refers to entities that receive a federal award under section 330 of the PHS Act, as amended, subrecipients, and organizations designated as look-alikes, unless otherwise stated.
Section 224(g)-(n) of the PHS Act ( 42 U.S.C. 233 (g)-(n)) authorizes the FTCA Program and affords eligibility for FTCA coverage as the exclusive civil remedy for acts or omissions arising from the performance of medical, surgical, dental, or related functions within the scope of such employment by deemed health centers and by any officers, governing board members, employees, and certain individual contractors of these entities. A favorable FTCA deeming determination requires submission of an application by the Health Center Program awardee in the form and manner specified by HRSA. Organizations receiving Health Center Program federal awards, including subrecipients, are also subject to all requirements incorporated within documents such as Funding Opportunity Announcements and Notices of Award. The Compliance Manual specifies Health Center Program non-regulatory policy issuances that would be superseded, as well as those that would remain in effect. The chapter also describes organizational eligibility requirements that apply only to look-alikes. In addition, the Compliance Manual supersedes other Health Center Program policy issuances including PIN 2014-01: Health Center Program Governance and PIN 2014-02: Sliding Fee Discount and Related Billing and Collections Program Requirements. Once final, the Compliance Manual will be the definitive guidance for eligibility and compliance-related determinations and review processes for the Health Center program. However, if you have an OSV scheduled, it is recommended that you thoroughly read the draft Compliance Manual. Operational Site Visits (OSVs) provide an objective assessment and verification of the status of each Health Center Program awardee or Page(s) Purpose, Responsibility and Scope 1-2 Medication Dispensing Errors Page(s) Purpose, Responsibility and Scope 1-2 Medication Dispensing Errors Sample Performance Improvement Plan.