FQHC Policy
The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, is the primary Federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable.

Comprising six bureaus and 13 offices, HRSA provides leadership and financial support to health care providers in every state and U.S. territory.

The main agency of the six agencies under HRSA that is associated with federal FQHC policy is the Bureau of Primary Health Care (BPHC). The BPHC provides Health Center specifications on legislation and program expectations; updates for current issues such as Federal Tort Claims Insurance and the 340 drug program; and funding opportunities and the Health Center initiative itself.

Uniform Data System (UDS)

The Uniform Data System (UDS) is a standardized set of core information established and collected annually by the federal Health Resources and Services Administration (HRSA) for the purpose of reviewing the operation and performance of health centers. Every year, IPHCA hosts a training session on the changes to UDS reporting requirements. Links to online documentation and technical support for the UDS submission process are also provided.

HRSA Roll-up Reports

What is the UDS?

A core set of information appropriate for reviewing the operation and performance of health centers.
 
What Data Are Collected?
The Uniform Data System (UDS) tracks a variety of information, including patient demographics, services provided, staffing, clinical indicators, utilization rates, costs, and revenues. UDS data are collected from grantees and reported at the grantee, state, and national levels.

Who Reports UDS Data?
The UDS is a reporting requirement for grantees of the following HRSA primary care programs, as defined in the Public Health Service Act:
  • Community Health Center, Section 330 (e)
  • Migrant Health Center, Section 330 (g)
  • Health Care for the Homeless, Section 330 (h)
  • Public Housing Primary Care, Section 330 (i)
All new grantees that receive Health Center grant awards and are operational by October of the reporting year are required to submit UDS reports.

When Are Data Reported?

Data are reported annually in the first quarter of the year. The UDS submission deadline was March 31, 2012.
 
This is the 16th edition of the Bureau of Primary Health Care’s User’s Manual: Uniform Data System. It is designed for use in submitting Calendar Year 2011 UDS Data, and updates all instructions and modifications issued since the first UDS reporting year (1996). This Manual supersedes all previous manuals, including instructions provided on the BPHC Web site prior to December 13, 2011.
 
The Manual includes a brief introduction to the Uniform Data System, definitions of terms as they are used in the UDS, instructions for completing each of the tables, and information on submission of UDS to the Bureau of Primary Health Care (BPHC) through HRSA’s Electronic Handbook (EHB) system. Table-specific instructions also include a set of “Questions and Answers,” addressing issues that are frequently raised when completing the tables and highlighting changes to the table that may have been implemented during the year. Five appendices are included which: (A) list personnel by category and designation of personnel as providers who can produce countable “visits” for the purpose of the UDS; (B) describe how to report issues which have impact on multiple tables; (C) provide sampling methodologies for selecting charts for clinical reviews; (D) explain the reporting of Electronic Health Record (EHR) system capabilities; and (E) explain reporting differences for FQHC Look-Alike Designees.
 
The Uniform Data System (UDS) contains the annual reporting requirements for the cluster of primary care grantees funded by the Health Resources and Services Administration (HRSA). The UDS includes reporting requirements for grantees of the following primary care programs:
 
  • Community Health Center, as defined in section 330(e) of the Consolidated Health Centers Act as amended;
  • Migrant Health Center, as defined in section 330(g) of the Act;
  • Health Care for the Homeless, as defined in section 330(h) of the Act;
  • Public Housing Primary Care, as defined in section 330(i) of the Act, and
  • Other grantees under Section 330
 
The authorizing statute is section 330 of the Public Health Service Act, as amended. FQHC Look-Alikes do not receive grant funds, but report certain UDS data to HRSA in order to permit monitoring of their performance. American Recovery and Reinvestment Act (ARRA) and Affordable Care Act (ACA) funded activities are also reported in the UDS, since activities (patients, visits, income, and expenses) which have been and/or are being supported by one or more element of the ARRA and the ACA are integrated with other section 330 funded activities. (NOTE: Grantees are also required to report ARRA funded activities to BPHC in a separate Health Center Quarterly Report (HCQR). These instructions are included in a separate HCQR Reporting Manual available on the BPHC Web site and are not addressed in this manual.)
 
HRSA collects data in the UDS which are used to ensure compliance with legislative and regulatory requirements, improve health center performance and operations, and report overall program accomplishments. To meet these objectives, BPHC requires a core set of data collected annually that is appropriate for monitoring and evaluating performance and reporting on annual trends. The UDS is the vehicle used by BPHC to obtain this information.
The UDS includes two components:
 
  • The Universal Report, completed by all grantees. The Universal Report consists of one copy of each of the UDS reporting tables. This report provides data on patients, services, staffing, and financing across all programs. The Universal Report is the source of unduplicated data on BPHC programs.
  • The Grant Reports, completed by a sub-set of grantees who receive multiple grants from the BPHC health center program. The Grant Report consists of additional copies of only Tables 3A, 3B, 4, 6A, and part of Table 5. The Grant reports provide comparable data for that portion of their program that falls within the scope of a project funded under a particular grant. Separate Grant Reports are required for grantees funded through the Migrant Health Center, Health Care for the Homeless, and Public Housing Primary Care programs unless a grantee is funded under one and only one of these programs. No Grant Report is submitted for the portion of multi-funded grantee’s activities supported by the Community Health Center grant.

The UDS is comprised of 11 tables designed to yield consistent clinical, operational, and financial data that can be compared with other National and State data and trended over time. These tables are:

  • Patient Origin form: Patients served by ZIP code.
  • Table 3A: Patients by age and gender.
  • Table 3B: Patients by race, ethnicity, and language.
  • Table 4: Patients by income (percent of poverty level) and third party medical insurance source. It also reports the number of special population patients receiving services.
  • Table 5: Full-time equivalent staff by position, and visits and patients by provider type and service type.
  • Table 6A: Primary diagnoses for medical and mental health visits and selected medical and dental services provided.
  • Table 6B: Quality of care indicators.
  • Table 7: Health outcomes and health disparities. 
  • Table 8: Direct and indirect expenses by cost center.
  • Table 9D: Full charges, collections, and allowances by payor type as well as sliding discounts and patient bad debt.
  • Table 9E: Non patient-service income.
  • BPHC will continue to collect information on the status of EHR adoption at 330 funded programs. This form will be included in the EHB along with the regular tables and must be completed prior to submitting your UDS report.
 
The UDS report is always a calendar year report. Agencies whose funding begins, either in whole or in part, after the beginning of the year, or whose funding is terminated, again either in whole or in part, before the end of the year, are still required to report on the entire year to the best of their ability.
 
From http://bphc.hrsa.gov/uds/, accessed 10/4/2012

Policy Information Notices (PINs)

Defining Scope of Project and Policy – PIN 2008-01 
This PIN defines the five components of an approved scope of project, and the policy and process for health centers seeking prior approval to make changes in the approved scope of project.

Health Center Site Visit Guide
This guide is a review instrument used by HRSA to assess an organization’s compliance with key section 330 Health Center Program requirements, as well as a resource to assist grantees in identifying areas for performance or operational improvements. 

Federal Tort Claims Act Health Center Policy Manual – PIN 2011-01
This PIN (1) describes the process for applying and reapplying for coverage under the program, (2) describes the type of coverage and requirements, (3) describes the procedures deemed grantees must comply with when faced with a medical malpractice claim or suit, and (4) provides other updated information related to The Federal Tort Claims Act (FTCA) and the Federally Supported Health Centers Assistance Acts (FSHCAA) of 1992 and 1995.

 

Click here to see all PINS issued by the Bureau of Primary Health Care

Program Assistance Letters (PALs)

Dual Eligibles – PAL 2006-01
The purpose of this PAL is to: define dual status, identify situations where dual status occurs, clarify programmatic requirements in the FQHC Look-Alike Program and section 330 of the Public Health Service Act (PHSA), as amended, and convey the Health Resources and Services Administration’s (HRSA) expectations for dual status health centers. 

Click here to see all PALS issued by the Bureau of Primary Health

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