1. FQHC Look-Alike Change in Scope Module for Implementation of Electronic Information Systems August 5, 2010 Esther Paul, Public Health Analyst Anil Bommakanti, Consultant Department of Health and Human Services Health Resources and Services Administration Bureau of Primary Health Care

2. Slide 2 Objectives of this Session  Review the key activities for the integration of FQHC Look-Alike program processes into HRSAs Electronic Handbooks (EHBs)  Review progress so far and next steps  Provide information pertinent to Scope of Project and requesting Change in Scope  Provide technical information for completing a change in scope application electronically  Provide technical assistance resources

3. Slide 3 Key Activities  EHB Registration  Baseline Scope Verification (BSV) Module  Change in Scope Module (CIS)  FQHC Look-Alike Applications Module

4. Slide 4 Progress To Date  In June 2010, all FQHC Look-Alike organizations successfully Registered in EHB  In July 2010, FQHC Look-Alikes completed Baseline Scope Verification in EHB

5. Slide 5 Next Steps - CIS Module  Purpose  To provide FQHC Look-Alikes the opportunity to submit requests for changes in their scope of project electronically through EHB.  Process  In July 2010, the baseline scope verification activity enabled HRSA to establish an electronic baseline scope of project for each FQHC Look-Alike. All future CIS requests will be submitted through EHB.

6. Slide 6 Scope of Project and Change in Scope  CIS Programmatic Considerations  Define Scope of Project  Define Change in Scope  Time frame considerations relevant to requesting a change in scope

7. Slide 7 Defining Scope of Project  The scope of project defines the service sites, services, and service area(s) for the FQHC Look-Alike that have been approved by HRSA at the time of designation as an FQHC Look-Alike or through a subsequent Change in Scope application.

8. Slide 8 Defining Change in Scope  Proposed changes to the previously defined Scope of Project for the FQHC Look-Alike must be approved by HRSA and included in the current scope of project to be eligible for FQHC reimbursement.

9. Slide 9 Prior Approval for Changes in Scope of Project  Prior approval for the implementation of proposed changes is required from HRSA for:  Addition or deletion of services  Addition or deletion of sites  Relocation of a site

10. Slide 10 Time Frame Considerations Relevant to Requesting a Change in Scope  Apply 90 days prior to the proposed date for implementing the change  The effective date of an approved change in scope will be no earlier than the date of receipt of a complete request for prior approval, and will extend to the end of the FQHC Look-Alikes current designation  Approved change must be implemented within 120 days of CMS’ approval of the request

11. Slide 11 Completing a Change in Scope Application Electronically in EHBs Process Overview

12. Slide 12 CIS Application in EHBs - Process Overview  Navigating to CIS Requests in EHB  Adding a new CIS Request  Service Change Requests  Site Change Requests  Other Change Requests  CIS Business Rules

13. Slide 13 Navigating to CIS Requests in EHB  Open the Electronic Handbook  Choose FQHC LA Home from the HRSA Portal menu

14. Slide 14 Navigating to CIS Requests in EHB  Choose New/Existing CIS under Change Scope on the left side menu

15. Slide 15  This is the list page for Change in Scope  Click the Go button if you want to begin a new CIS request  Existing CIS requests are listed on this page  Click the Edit button to open a CIS request that you started previously and want to return to now Navigating to CIS Requests in EHB

16. Slide 16 Adding a New CIS Request in EHB  The first screen that opens when you begin a new CIS request links to Policy Information Notices (PINs) and Program Assistance Letters (PALs) related to Change in Scope  Review the documentation, and then either continue or cancel

17. Slide 17 Adding a New CIS Request  Complete the questionnaire to determine the need to submit a CIS request

18. Slide 18 Adding a New CIS Request  Discuss the results of the evaluation questionnaire with others in your organization  You can print the results, or email them  Regardless of the results, you can create a CIS request or cancel

19. Slide 19 Adding a New CIS Request  The CIS request, when created, will have a tracking number  Use this tracking number in all correspondence with HRSA

20. Slide 20 CIS Request Status Overview  Status page shows all sections of the CIS request, together with their completion status  You must complete all sections before you may submit the request  Start with the Cover Page section  Click Update to open the section for editing

21. Slide 21 CIS Request Cover Page  Specify the change you are requesting on the CIS request Cover Page  You may choose one request type only

22. Slide 22 CIS Request Services Business Rules  Under Change Services, CIS request type shows, for required and existing additional services, what is considered a service “add” and what is considered a service “delete”

23. Slide 23 DELETE ADD CIS Request Services Business Rules  You can only change one service per CIS request  When a FQHC L-A starts paying for a service (e.g., moving from column III to I or II), it is considered an ADD  When a FQHC L-A stops paying for a service (e.g., moving from column I or II to III), it is considered a DELETE  If you start providing a required service that you did not include in BSV, it is considered an ADD

24. Slide 24 Example: Delete a Required Service  After we chose “Delete” under Required Services on the CIS Cover Page, we were taken to the Change Details page  On this page, we click the Pick From List button to choose the service to delete

25. Slide 25 Example: Delete a Required Service  We are allowed to choose only one service  We chose diagnostic laboratory and continued to the next screen

26. Slide 26 Example: Delete a Required Service  Our original record from scope is displayed, showing current modes of service provision  We checked only Column III, indicating that we intend no longer to pay for the service

27. Slide 27 CIS Request Change Sites Business Rules  Under Change Sites, CIS request type shows what is considered a site “add” and what is considered a site “delete”

28. Slide 28 Example: Site Convert Admin-Only to Service Site  After we chose “Conversion from Admin-Only” under Change Sites on the CIS Cover Page, we were taken to the Change Details page, where we clicked the Pick From List button to choose the site to terminate (i.e., the site to convert)  On the next page, we chose the site from the list of sites in scope  On the next page, we clicked Update Site to update the information for the site we chose

29. Slide 29 Example: Site Convert Admin-Only to Service Site  We completed the Update Site form, changing “Administrative Site” under Service Site Type to “Service Site”  NOTE: This is a long form; save your work at frequent intervals as you complete it

30. Slide 30 Example: Add a New Site Change Request  Under Change Sites on the CIS Cover Page, we chose “New” under Service Site  We were taken to the Change Details page, where we clicked the Add New Site button to choose the site  The site we wanted to add was already registered with HRSA, so we chose it and clicked the Select This Location button  If the site we wanted to add had not already been registered with HRSA, we would have clicked the Add button to register it  If we had wanted also to change the name of the site, we would have clicked the Update button

31. Slide 31 Example: Add a New Site Change Request  We completed the Site Qualification Criteria questionnaire to verify that the site qualified  We also uploaded justification for adding the site

32. Slide 32 Example: Add a New Site Change Request  Finally, we entered the information for the site on the Update Site page  NOTE: This is a long form; save your work at frequent intervals as you complete it

33. Slide 33 Example: Relocate Site Change Request  Relocating an existing site means terminating the site in its current location and adding it in its new one  For the “From” site, pick the site from the list of your existing ones  For the “To” site:  If you are moving services from one existing site to another, pick the site to be added from the list of your existing sites  If you are moving services to a site not previously in scope, you would click the Add New Site button to add that site.

34. Slide 34 Example: Relocate Site Change Request  If you click “Pick from Existing Sites,” the list of sites already in your scope will open  Pick the site from the list  Some sites may not be selectable for reasons given in footnotes

35. Slide 35 Example: Relocate Site Change Request  If you click “Add New Site,” you must complete the qualification questionnaire and specify whether the site location setting is “Domestic Violence”

36. Slide 36 Example: Relocate Site Change Request  The site you are adding must be pre-registered with HRSA  The list of pre-registered performance sites appears  Pick the site from the list, and then click the Select This Location button  If the site has not been registered with HRSA, click the Register Performance Site button to register it

37. Slide 37 Example: Relocate Site Change Request  After choosing the site from the list of pre-registered performance sites, enter the information for the site on the Update Site page  NOTE: This is a long form; save your work at frequent intervals as you complete it

38. Slide 38 Other Changes -- Business Rules  Adding or deleting an admin-only site is similar to service site add or delete but Assurances and CIS Change/Project Impact Analysis sections are not required

39. Slide 39 Sample CIS Request Assurances Checklist

40. Slide 40 Sample CIS Request Update Checklist  Checklist questions will vary depending on the type of CIS Request

41. Slide 41 CIS Request Download Template Forms  The following CIS request forms require that you download templates  Budget Information  Budget Narrative  Proposed Staff Profile  Income Analysis

42. Slide 42 CIS Request Budget Information Template  Click Download to download the budget information template  Save the template document onto your computer and complete it offline  Click the Attach File button to upload the completed template document to this page

43. Slide 43 Form 5B Business Rules for Site Location Type

44. Slide 44 Form 5B Sites Business Rules  Number of Intermittent/Voucher sites should be more than zero  An update to the number of Intermittent/Voucher sites is permitted as part of the CIS request,  If that update results in the number of Intermittent/Voucher sites becoming zero, it is a CIS-worthy change  … otherwise, a reduction in the number of Intermittent/Voucher sites is NOT a CIS.  Intermittent/Voucher sites cannot be converted to Administrative sites  Only Permanent and Seasonal sites can be converted to Administrative sites  For Permanent sites, Months of Operation should be 12 and Operation Schedule should be Year Round  For Seasonal sites, Months of Operation should be < 12 and Operation Schedule should be Seasonal (cannot be Year Round)

45. Slide 45 Business Rules on CIS Attachments  Attachments are required in order to complete a CIS in all cases except the following:  Addition of Admin-only sites  Termination of Admin-only sites

46. Slide 46 CIS Workflow  After you have submitted your CIS request:  HRSA may request a change for your CIS request. If so you will be notified by email.  HRSA will review your CIS request and may either recommend it for approval to CMS or disapprove it.  If CIS approval recommendation is sent to CMS, CMS will make a decision and communicate it to HRSA.  HRSA will notify you of the CIS approval decision via email.

47. Slide 47 Technical Assistance Resources  EHB website  https://grants.hrsa.gov/webexternal/home.asp https://grants.hrsa.gov/webexternal/home.asp  For technical questions about EHB  Call BPHC Help Desk at (301) 443-7356 or  Send an e-mail to BHCMISYS@hrsa.govBHCMISYS@hrsa.gov  Replay of this technical assistance conference call will be available until January 5, 2011  To access the replay, please call (800) 945-1615 and provide pass code 89323

48. Slide 48 Contact Information Twyla Adams Chief Health Center Systems Branch Office of Policy and Program Development (301) 594-4300 Twyla.Adams@hrsa.hhs.gov

49. Slide 49 Contact Information Esther Paul Public Health Analyst Health Center Systems Branch Office of Policy and Program Development (301) 594-4300 Esther.Paul@hrsa.hhs.gov

50. Slide 50 Questions