Fiscal Year (FY) 2013 State and Regional Primary Care Association (PCA) Non-Competing Continuation Progress Report (NCC) HRSA 5-U

Technical Assistance Call Date: Thursday, December 20, 2012 Time: 1 PM EST Dial-In Number: Participant Passcode: Web Meeting Link: A replay will be posted within one week of the call at 2

FY 2013 PCA NCC Overview Submission Process Standard Form SF-PPR Budget (Forms & Justification/Narrative) Program Narrative Update Project Work Plan Resources TA Contacts 3

Overview PCAs applying for FY 2013 non-competing continuation funding must submit a progress report in the Electronic Handbooks (EHB) FY 2013 begins April 1, 2013 and ends March 31, 2014 Instructions for completing the progress report are available in EHB and on the PCA TA webpage Progress reports must be submitted in EHB by 5 PM ET on January 23, 2013 Progress reports may not exceed 40 pages 4

Submission Process System-generated notifications that the progress report is available in EHB were sent December 19, 2012 to PCA Project Directors and others individuals who have non-competing continuation edit and submit privileges in EHB 5

NCC Components REQUIRED: Standard Form SF-PPR Standard Form SF-PPR2 Budget Information: Budget Details Form Budget Narrative Project Work Plan Attachment 1: Program Narrative Update As Applicable: Attachment 2: Staffing Plan Attachment 3: Position Descriptions for Key Personnel Attachment 4: Biographical Sketches for Key Personnel Attachment 5: Summary of Contracts/Agreements Attachment 6: Other Relevant Documents 6

Budget Forms Section A: Budget Summary The PCA grant request in the federal column is pre-populated and cannot be edited (this figure should correspond with the recommended future support figure (Line 13) on the most recent Notice of Award) Section B: Budget Categories Provide a breakdown of the budgeted funds by object class category (e.g., Personnel, Fringe Benefits) Refer to SF-424A submitted with the most recent PCA application as a reference point, noting that the total value for each Object Class Category may be different from year to year based on programmatic changes Section C: Non-Federal Resources It is not necessary to provide other sources of funding PCAs will complete these sections of the budget form for each remaining year in the project period. 7

Budget Justification/Narrative Provide a detailed line-item budget that explains each cost for the upcoming budget period (April 1, 2013 through March 31, 2014) Additional narrative for the budget justification should describe each cost element and explain how each contributes to meeting the project’s objectives Line items: Personnel Costs Fringe Benefits Travel Equipment Supplies Contracts Other Indirect Costs 8

Project Work Plan EHB will pre-populate the Project Work Plan recently negotiated with the PO An abbreviated sample Project Work Plan is available at apply/assistance/pca/ apply/assistance/pca/ Project Work Plan Fields: Goal Projected Goal Percentage Key Factors T/TA Focus Areas Activity Person Area Responsible Time Frame Expected Outcome Comments Progress Report 9

Project Work Plan – 4 Sections The 12-month work plan should address: ONLY the activities to be supported under the cooperative agreement Short-term and long-term T/TA needs of potential and existing health centers in the state/region Projected target goals for the end of the project period 10 Requirement 1: Statewide/Regional Health Center T/TA Activities Section A – T/TA in Fiscal and Program Management (Program Requirements) Section B1 – T/TA in Performance Improvement (Clinical) Section B2 – T/TA in Performance Improvement (Financial) Requirement 2: Statewide/Regional Program Assistance Section C – Statewide/Regional Program Assistance

Alternative Text for Slide 10 Requirement 1: Statewide/Regional Health Center T/TA Activities Section A – T/TA in Fiscal and Program Management (Program Requirements) Section B1 – T/TA in Performance Improvement (Clinical) Requirement 2: Statewide/Regional Program Assistance Section C – Statewide/Regional Program Assistance 11

State Performance Profile Metrics and Definitions 12 Goal: Health Center Program Requirements A1 XX% of Health Center Program grantees with no program conditions on their Notice of Awards (NoAs). This metric provides the number and percentage of currently funded H80 grantees that do not have any active 30 day program conditions in the last 12 months. Program conditions relate to compliance with the 19 program requirements which can be found at Note: Goal percentages are for the end of the project period. Do not change these percentages without prior discussion with your Project Officer.

Alternative Text for Slide 12 Goal A1: XX% of Health Center Program grantees with no program conditions on their Notice of Awards (NoAs). Definition: This metric provides the number and percentage of currently funded H80 grantees that do not have any active 30 day program conditions in the last 12 months. Program conditions relate to compliance with the 19 program requirements which can be found at

State Performance Profile Metrics and Definitions 14 Note: Goal percentages are for the end of the project period. Do not change these percentages without prior discussion with your Project Officer. Goals: Performance Improvement (Clinical) B1.a XX% of Health Center Program grantees in the state/region that meet or exceed performance on one or more Healthy People 2020 performance measure goal(s). This metric provides the number and percentage of grantees that have met or exceeded the Healthy People (HP) 2020 performance measure goals on at least one of the clinical measures. This metric applies to the total number of grantees who submitted UDS data. B1.b XX% of Health Center Program grantees with Patient-Centered Medical Home (PCMH) recognition. This metric provides the number and percentage of grantees that currently have PCMH recognition for at least one site. Only sites recognized within the past 3 years will be considered to be PCMH recognized. Data includes PCMH Recognition through NCQA, The Joint Commission, and AAAHC. This metric applies to the total number of grantees who submitted UDS data.

Alternative Text for Slide 14 Goal B1.a: XX% of Health Center Program grantees in the state/region that meet or exceed performance on one or more Healthy People 2020 performance measure goal(s). Definition: This metric provides the number and percentage of grantees that have met or exceeded the Healthy People (HP) 2020 performance measure goals on at least one of the clinical measures. This metric applies to the total number of grantees who submitted UDS data. Goal B1.b: XX% of Health Center Program grantees with Patient-Centered Medical Home (PCMH) recognition. Definition: This metric provides the number and percentage of grantees that currently have PCMH recognition for at least one site. Only sites recognized within the past 3 years will be considered to be PCMH recognized. Data includes PCMH Recognition through NCQA, The Joint Commission, and AAAHC. This metric applies to the total number of grantees who submitted UDS data. 15

State Performance Profile Metrics and Definitions 16 Note: Goal percentages are for the end of the project period. Do not change these percentages without prior discussion with your Project Officer. Goals: Performance Improvement (Financial) B2.a XX% of Health Center Program grantees with cost increase less than National average. This metric provides the number and percent of grantees whose percent increase in cost per patient is less than the CMS National Health Expenditure rate (NHE). The CMS NHE is 4.81% (which was derived from the total health expenditure data published by CMS at the following webpage: HealthAccountsProjected.asp#TopOfPagehttp:// HealthAccountsProjected.asp#TopOfPage). This metric applies to the total number of grantees who submitted UDS data. B2.b XX% of Health Center Program grantees without going concern issues. This metric provides the number and percentage of grantees that currently have no going concern issues identified in their most recent audit.

Alternative Text for Slide 16 Goal B2.a: XX% of Health Center Program grantees with cost increase less than National average. Definition: This metric provides the number and percent of grantees whose percent increase in cost per patient is less than the CMS National Health Expenditure rate (NHE). The CMS NHE is 4.81% (which was derived from the total health expenditure data published by CMS at the following webpage: Projected.asp#TopOfPage). This metric applies to the total number of grantees who submitted UDS data. Projected.asp#TopOfPage Goal B2.b: XX% of Health Center Program grantees without going concern issues. Definition: This metric provides the number and percentage of grantees that currently have no going concern issues identified in their most recent audit. 17

Overview State Performance Profile A.Health Center Program Requirement Goal B.Clinical Performance Improvement Goals B2. Financial Performance Improvement Goals 18

Health Center Program Requirement Goal Metric: % of Health Center Program grantees with no program conditions on their Notice of Awards (NoAs) Definition: Currently funded H80 Grantees that do not have any active 30 day program conditions issued in the current or previous calendar years. –Program conditions relate to compliance with the 19 key program requirements ( 19

Clinical Performance Improvement Goals Metric: % of Health Center Program grantees in the state/region that meet or exceed performance on one or more Healthy People (HP) 2020 performance measure goal(s) Definition: Met or exceeded the ‘Healthy People (HP) 2020’ performance measure goals on at least one of the seven clinical measures Formula: 20

Clinical Performance Improvement Goals (cont’d) Metric: % Diabetic Patients with HbA1c less than or equal to 9% is 85.4% or higher Definition: Met or exceeded the HP 2020 performance measure goal(s) of 85.4% or higher for ‘% Diabetic Patients with HbA1c less than or equal to 9%’ clinical measure in the 2011 UDS Formula: 21

Clinical Performance Improvement Goals (cont’d) Metric: % Female Patients with PAP Test is 93.0% or higher Definition: Met or exceeded the HP 2020 performance measure goal(s) of 93.0% or higher for ‘% Female Patients with PAP Test’ clinical measure in the 2011 UDS Formula: 22

Clinical Performance Improvement Goals (cont’d) Metric: % Hypertensive Patients with BP less than 140/90 is 61.2% or higher Definition: Met or exceeded the HP 2020 performance measure goal(s) of 61.2% or higher for ‘% Hypertensive Patients with BP less than 140/90’ clinical measure in the 2011 UDS Formula: 23

Clinical Performance Improvement Goals (cont’d) Metric: % Low Birth Weight is 7.8% or lower Definition: Met or exceeded the HP 2020 performance measure goal(s) of 7.8% or lower for ‘% Low Birth Weight’ clinical measure in the 2011 UDS Formula: 24

Clinical Performance Improvement Goals (cont’d) Metric: % Prenatal Patients Served in the 1st Trimester is 77.9% or higher Definition: Met or exceeded the HP 2020 performance measure goal(s) of 77.9% or higher for ‘% Prenatal Patients Served in the 1st Trimester’ clinical measure in the 2011 UDS Formula: 25

Clinical Performance Improvement Goals (cont’d) Metric: % of Adults Assessed for Tobacco Use is 68.6% or higher Definition: Met or exceeded the HP 2020 performance measure goal(s) of 68.6% or higher for ‘% of Adults Assessed for Tobacco Use’ clinical measure in the 2011 UDS Formula: 26

Clinical Performance Improvement Goals (cont’d) Metric: % of Tobacco Users who Received Cessation Advice and/or Medication is 21.1% or higher Definition: Met or exceeded the HP 2020 performance measure goal(s) of 21.1% or higher for ‘% of Tobacco Users who Received Cessation Advice and/or Medication’ clinical measure in the 2011 UDS Formula: 27

Clinical Performance Improvement Goals (cont’d) Metric: % of Health Center Program grantees with Patient-Centered Medical Home (PCMH) recognition Definition: Grantees as of October 31, 2012 that currently have PCMH recognition for at least one site. Only sites recognized within the past 3 years will be considered to be PCMH recognized. Data includes PCMH Recognition through NCQA, The Joint Commission, and AAAHC. Formula: 28

Financial Performance Improvement Goals Metric: % of Health Center Program grantees with cost increase less than National average Definition: Grantees whose ‘percent increase in cost per patient’ is less than the CMS National Health Expenditure rate (NHE) –The CMS NHE is 4.81% ( ccountsProjected.asp#TopOfPage) ccountsProjected.asp#TopOfPage Formula: 29

Financial Performance Improvement Goals (cont’d) Metric: % of Health Center Program grantees without going concern issues Definition: Grantees that currently have no going concern issues identified in their audit report for the 2010 submission year and the report has been reviewed as of November 12, 2012 Formula: 30

Project Work Plan: Requirements 31

Alternative Text for Slide 18 Section A may only contain one Goal. Section A must contain a minimum of 3 and a maximum of 5 Key Factors. Section A must contain a minimum of 3 and a maximum of 5 T/TA Focus Areas. Section A must contain a minimum of 2 and a maximum of 5 Activities per each T/TA Focus Area. Section A must contain a minimum of 1 and a maximum of 5 Persons/Areas Responsible, Time Frames, and Expected Outcomes per Activity. Section B Clinical must contain 2 Goals. Section B Clinical must contain a minimum of 3 and a maximum of 5 Key Factors. Section B Clinical must contain a minimum of 1 and a maximum of 3 T/TA Focus Areas. Section B Clinical must contain a minimum of 2 and a maximum of 5 Activities per T/TA Focus Area. Section B Clinical must contain a minimum of 1 and a maximum of 5 Persons/Areas Responsible, Time Frames, and Expected Outcomes per Activity. Section B Financial must contain 2 Goals. Section B Financial must contain a minimum of 3 and a maximum of 5 Key Factors. Section B Financial must contain a minimum of 1 and a maximum of 3 T/TA Focus Areas. Section B Financial must contain a minimum of 2 and a maximum of 5 Activities per T/TA Focus Area. Section B Financial must contain a minimum of 1 and a maximum of 5 Persons/Areas Responsible, Time Frames, and Expected Outcomes per Activity. The Goal and Key Factor fields are not applicable for Section C. Section C must contain a minimum of 7 and a maximum of 9 T/TA Focus Areas. Section C must contain a minimum of 2 and a maximum of 5 Activities per T/TA Focus Area. Section C must contain a minimum of 1 and a maximum of 5 Persons/Areas Responsible, Time Frames, and Expected Outcomes per Activity. The Comments field is an optional field and can be left blank for new activities that are proposed in this NCC or if no changes were made to the field. Comments are required for any edits or deletions made to an activity. This field is limited to 500 characters. The Progress Report field is required and is limited to 1,000 characters. The Narrative for Deletions field is required when pre-populated activities are deleted and is limited to 1,000 characters. The Key Factor field is limited to 500 characters. The T/TA Focus Area, Activity, Person/Area Responsible, Time Frame, and Expected Outcome fields are limited to 200 characters. 32

Program Narrative Update Attachment 1 Discuss broad issues and changes that have impacted the target audiences served and the Primary Care Association, as well as overarching progress on the work plan, since September 1, 2012 Program Narrative Update Items: 1.Any significant progress/proposed changes to the project 2.Any significant changes or outcomes 3.Any significant performance measure changes 4.Any significant changes/updates to linkages or partnerships 5.Any significant changes/updates to the staffing plan 6.Any major expected changes/plans/considerations for activities beyond the upcoming budget period 33

Attachments 2-6 (As Applicable) Attachment 2: Staffing Plan Attachment 3: Position Descriptions for Key Personnel Attachment 4: Biographical Sketches for Key Personnel Attachment 5: Summary of Contracts/Agreements Attachment 6: Other Relevant Documents 34

Important Reminders Progress reports must be submitted in EHB by 5 PM ET on January 23, 2013 Progress reports may not exceed 40 pages Failure to submit the NCC by the established deadline or submission of an incomplete or non-responsive progress report may result in a delay of NoA issuance or a lapse in funding 35

Resources PCA TA Webpage Health Center Program Requirements Performance Measures easures/ easures/ 36

Technical Assistance Contacts Progress report assistance: Beth Levitz or Budget related questions: Angela Wade or EHB related questions: BPHC Helpline or

Questions? 38