Professional Liability History/Additional Information: Supplemental Information and ECRI Institute Resources

HRSA Clinical Risk Management Resources Homepage

Before You Fill Out the Application… Have the following items with you:  If you’ve had a professional liability claim filed against your center and/or employees within the past 5 years, a document listing and summarizing the allegations  HRSA Program Assistance Letter (PAL) : Calendar Year 2013 Requirements for Federal Tort Claims Act (FTCA) Medical Malpractice Coverage for Health Centers (access at

Components of Application Professional Liability History 1. Confirm whether you have had a professional liability claim filed against your center/employees within past 5 years. Additional Information 1. Specify professional organizations from which you have received accreditation, certification, or recognition. 2. List risk management training/continuing education completed by staff during the past 12 months. 3. Describe plans for risk management training/continuing education for the upcoming year.

Professional Liability History Once a health center reasonably anticipates litigation, it must preserve any documents related to the claimant. If the health center has had a claim filed within the past 5 years, it must attach a separate document listing each claim and including the following information for each claim:  Name of provider(s) involved  Area of practice/specialty  Date of occurrence  Summary of allegations  Status/outcome of claim

Additional Information: Accreditation/Recognition The Joint Commission accreditation for ambulatory care: ealthcare.aspx. ealthcare.aspx Accreditation Association for Ambulatory Health Care: Adjunct Medical Home Chapter (if applicable) National Committee for Quality Assurance Patient Centered Medical Home Accreditation:  See “Resource Page: Patient-Centered Medical Home” on the Clinical Risk Management website:

Additional Information: Training/Continuing Education Patient safety Infection control/hand hygiene Teamwork and communication Medication safety Fall prevention Fire safety Documentation Disaster planning Obstetrics safety

Education and Training Tools Bloodborne Pathogen Communication/Disclosure Hand Hygiene Risk Management/ Patient Safety Sharps Injury Prevention Cross-Contamination from Flexible Endoscopes

ECRI Institute’s e-Learn FTCA deemed health centers and free clinics have free access to e-Learn as part of the Clinical Risk Management Program membership Library of courses for continuing education credit In order to access e-Learn  Go to  Register using your course keys; create a username and password  After initial registration, log-in each time with your username and password

Clinical Risk Management Website Go to: Enter username and password under “Member Login” Don’t have a username and password? Contact us:   (610) x5200

Professional Liability History FAQs Q: How many years does the claims history on the FTCA application need to go back? A: The Health Center should list all claims that occurred within the past five years. This includes FTCA claims and non-FTCA claims. The claims history should include the following for each case: Name of provider(s) involved Area of practice/Specialty Date of occurrence Summary of allegations Status and outcome of claim

Questions on Deeming/Application Process? Contact BPHC helpline at BPHC ( ) or  9:00AM to 5:30PM (ET) FTCA website: For EHB technical support (e.g., registration, username and password), contact HRSA Call Center at or  Monday-Friday (except federal holidays) 9:00AM to 5:30PM (ET)