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 initial submission deadline is February 15 of each year for the prior year’s data.  The UDS reviewer identifies and discusses potential data errors and final corrected submissions are due by March 31 of the same year.

The UDS Manual is updated annually and is designed for use in submitting each calendar years data, and updates all instructions and modifications issued since the first UDS reporting year (1996).

Each manual includes a brief introduction to the Uniform Data System, definitions of terms, instructions for completing each of the tables, and information on the submission of the UDS to the Bureau of Primary Health Care (BPHC) through HRSA’s Electronic Handbook (EHB) system. Detailed table-specific instructions follow and include a set of “Questions and Answers,” addressing issues that are frequently raised when completing the tables. The table-specific instructions highlight any changes to the table that may have been implemented for the current year. Five appendices are included:

  • A list of personnel by category and identification of personnel by job title who may be able to produce countable “visits” for the purpose of the UDS
  • A set of tables which describe how to address specific issues which have impact on multiple tables
  • Sampling methodologies for selecting patient charts for clinical reviews
  • Reporting instructions for the form which describes health center’s Electronic Health Record (EHR) system capabilities and Quality Recognition
  • A summary of the few remaining reporting differences between Section 330-grant supported health centers and look-alikes

 

The UDS Manual addresses the annual reporting requirements for recipients of the cluster of primary care grants funded by the Health Resources and Services Administration (HRSA) and other health centers designated as look-alikes and certain health centers funded under the Bureau of Health Workforce (BHW). (The authorizing statute is Section 330 of the Public Health Service Act, as amended.) The UDS Report is required of Health Center Program grantees with the following grants and other health centers which have been designated as look-alikes:

  • 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

 

In addition to the Health Center Program grantees and look-alikes, certain primary care clinics and nurse managed health clinics funded under the HRSA Bureau of Health Workforce (BHW) must also submit a UDS report.

The UDS is a core set of information appropriate for reviewing the operation and performance of health centers. The data are collected and reviewed annually to ensure compliance with legislative and regulatory requirements, improve health center performance and operations, and report overall program accomplishments.

UDS data help to identify trends over time, enabling HRSA to establish or expand targeted programs and identify effective services and interventions to improve the health of underserved communities and vulnerable populations. These data are compared with national data to review differences between the U.S. population at large and those individuals and families served by health centers for primary care. Much of these data as well as analysis of the data are routinely reported back to health centers through the Electronic Handbook (EHB) and to the public through the Bureau’s website at http://bphc.hrsa.gov/datareporting/index.html.

The UDS includes two components: 

The Universal Report, which is completed by all reporting health centers. The Universal report consists of each of the UDS tables, and provides data on patients, services, staffing, and financing across all programs. The data reflect all activities that are considered “in scope” for the reporting agency, and its scope is the same as that which is defined in the health center’s notice of award. The Universal report is the source of unduplicated data on in scope programs.

The Grant Reports, are completed by a sub-set of grantees who receive 330 grants under multiple BPHC Health Center Program funding authorities. Currently, only Section 330 grantees fill out Grant reports. The Grant report consists of one or more additional copies of Tables 3A, 3B, 4, 6A, and part of Table 5. The Grant reports provide comparable data for that portion of the program that falls within the scope of a project funded under a particular funding stream. Separate Grant reports are required for each funding stream when grantees are 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 scope of activities supported by the Community Health Center Section 330(e) grant since reporting is included in the Universal report.

The UDS is comprised of 12 tables designed to yield consistent clinical, operational, and financial data that can be compared with National and State data and trended over time. These tables are:

  • Patient Origin: Patients served reported by ZIP code and by primary third party medical insurance source, if any
  • Table 3A: Patients by age and gender
  • Table 3B: Patients by race, Hispanic/Latino ethnicity, and language barriers
  • Table 4: Patients by income (percent of poverty level) and primary third party medical insurance source; Table 4 also reports the number of “special population” patients receiving services, and managed care member months-
  • Table 5: The annualized full-time equivalent of program staff by position, visits by provider type, and patients by service type
  • Table 5A: Tenure for selected health center staff
  • Table 6A: Selected diagnoses for medical, mental health, and substance abuse visits; and selected medical, mental health, substance abuse, vision, and dental services provided
  • Table 6B: Quality of care measures
  • Table 7: Health outcomes measures by race and ethnicity
  • Table 8A: Direct and indirect expenses by cost center
  • Table 9D: Full charges, collections, and allowances by payer type as well as sliding discounts and patient bad debt
  • Table 9E: Other, non patient-service income

 

In addition to these data collection tables, health centers will report on quality recognition and health information technology (HIT) capabilities, including EHR interoperability. This additional form is included in the EHB along with the other tables and must be completed as part of your UDS report submission.

The UDS report is always a calendar year report. Agencies whose designation or funding begins, either in whole or in part, after the beginning of the year, or whose designation or 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. Similarly, agencies with a fiscal year other than 1/1/15 to 12/31/15 will still report on the calendar year, not on their fiscal year. (Organizations designated or funded for the first time during the calendar year and those which were terminated during the year should discuss any issues with calendar year reporting with their assigned UDS Reviewer.)

 

From http://bphc.hrsa.gov/datareporting/reporting/2015udsmanual.pdf ,accessed 8/11/2016

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

This Manual describes the type of coverage and requirements, procedures deemed grantees must comply with when faced with a medical malpractice claim or suit, and 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.

The FTCA policies for FQHC resource page
FTCA annually publishes a PAL describing the process for applying and reapplying for coverage for the calendar year.

 

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 

IPHCA Springfield Office
500 S. Ninth St., Springfield, IL 62701

IPHCA Chicago Office

542 S. Dearborn St., Suite 300, Chicago, IL  60605