1. DEEMING REQUIREMENTS AND APPLICATION PROCESS FOR FTCA MEDICAL MALPRACTICE COVERAGE Health Resources and Services Administration Bureau of Primary Health Care Office of Quality and Data

2. Today’s Call 1. Purpose 2. Program Updates 3. Types of Applications 4. New Application Requirements 5. Existing Application Requirements 6. FTCA Module in EHB 7. Sub-Recipient Applications 8. Paper Waiver Request 9. Resources 2 06/01/11

3. Purpose To provide information on Federal Tort Claims Act (FTCA) initial and redeeming application processes and requirements To review Program Assistance Letter (PAL) 20011-05: “New Requirements for Medical Malpractice Coverage Deeming under the Federally Supported Health Centers Assistance Act for Calendar Year 2012” http://bphc.hrsa.gov/policiesregulations/policies/pal201 105.pdf http://bphc.hrsa.gov/policiesregulations/policies/pal201 105.pdf 3 06/01/11

4. Purpose (continued) General Program Information & Requirements  Applicants must be a Section 330 organization  Applicants must be currently funded under the Health Center Program  Health centers must reapply each year for deeming status using the EHB FTCA Module 4 06/01/11

5. Program Updates FTCA Branch  New branch within OQD  10 staff members  Focus on FTCA policies, procedures, and program development for Health Centers and Free Clinics New FTCA Website  http://www.bphc.hrsa.gov/ftca/ http://www.bphc.hrsa.gov/ftca/ FTCA Policy Manual (PIN 2011-01)  http://bphc.hrsa.gov/policiesregulations/policies/pdfs/pi n201101manual.pdf http://bphc.hrsa.gov/policiesregulations/policies/pdfs/pi n201101manual.pdf 5 06/01/11

6. Program Updates (Continued) Focus on implementation  Creation of policies and procedures  Implementation of policies and procedures  Reevaluation of policies and procedures Site Visits  Education  Technical Assistance  Verification of Implementation 6 06/01/11

7. Types of Applications There are two types of applications for FTCA coverage:  INITIAL DEEMING APPLICATION May be submitted at any time during the year using the EHB FTCA Module Will be acted upon by HRSA within 30 days after receipt of a completed application  ANNUAL REDEEMING APPLICATION All currently deemed health centers must file a renewal deeming application no later than July 11, 2011 in order to be deemed for CY 2012 7 6/01/2011

8. New Application Requirements Minutes from last six QI/QA committee meetings  Remove patient names and other identifiers Minutes from the last six Board meetings that reflect Board approval of QI/QA activities  Remove all information not related to QI/QA activity Board-approved Credentialing and Privileging policies  Must be signed and dated by the Board 8 06/01/11

9. New Application Requirements (continued) Clinical policies and procedures for the following activities: Referral Tracking Hospitalization Tracking X-Ray Tracking Lab Result Tracking 9 06/01/11

10. Additional Application Requirements A complete initial or redeeming application must include: 1.An Application Form completed in EHB 2.An approved Quality Improvement/Quality Assurance Plan, including governing board signature and approval date 3.Summary of professional liability history for cases filed or closed within the last 5 years, if applicable  Name of provider(s) involved  Area of practice/Specialty  Date of Occurrence  Summary of allegations  Status and outcome of claim 10 06/01/11

11. Additional Application Requirements (continued) A complete initial or redeeming application must include: 4.Explanation of any “NO” responses 5.Deeming applications for any sub-recipients (as documented on the organization’s most recent approved scope from FORM 5B - see “sub-recipient submission instructions.”) 11 06/01/11

12. Additional Application Requirements (continued) 6.Credentialing list (in an Excel spreadsheet) of all licensed and/or certified health care personnel employed and/or contracted by the health center, with the following information: Name & Professional Designation (e.g., MD/DO, RN, CNM, DDS) Title/Position Specialty Employment Status (full-time employee, part-time employee, contractor, volunteer) Date of Hire Initial Credentialing Date (the first time the individual was credentialed by your organization) Most Recent Credentialing Date Next Expected Credentialing Date 12 06/01/11

13. Application Requirements (continued) Incomplete applications will not be processed until all components are submitted through the EHB FTCA Module  Application review can not be completed  Deeming decision can not be finalized  Deeming Notification Letter may be delayed Checklist  A comprehensive application checklist is included in the PAL and should be utilized to ensure completion 13 06/01/11

14. FTCA Module in EHB Accessing the FTCA Module:  Users are required to navigate to the section 330 grant portfolio in EHB to access, and begin working on the FTCA application 14 06/01/11

15. FTCA Module in EHB (continued) Accessing the FTCA Module:  The current section 330 grant project director (PD) will be given default access to read, complete, edit, and submit the application  The PD can provide access to the relevant members of the organization to enable them to work on the FTCA application  New users must register with EHB before access to the application can be provided 15 06/01/11 Start here

16. FTCA Module in EHB (continued) Accessing the FTCA Module:  Click Work on My FTCA Application  To create an application, click the Go button  To return to an application in progress, click Edit Application 16 06/01/11

17. 17 FTCA Module in EHB (continued) Begin Application Data Entry:  The system will label the organization’s FTCA application as “Initial” or “Redeeming” based on the grantee’s current deeming status  If you believe your application is incorrectly labeled, you can change the system default (e.g., from “Initial” to “Redeeming”)  You must provide an explanation for the change 17 06/01/11

18. FTCA Module in EHB (continued) 18 06/01/11 Application Data Entry (continued): Each grantee must complete all the sections of the application Each section requires users to provide both structured and unstructured (attachments) information The system has many validation and business rules included in each section to ensure that all the relevant data elements are populated in the system

19. FTCA Module in EHB (continued) 19 Application Data Entry (continued): The system does not validate the content of the attachments that are uploaded–grantees are expected to upload and submit the correct attachments based on the PAL 2011-05 The system will mark each section as complete when all the requirements and validations for that section are met. A user can submit the application when all sections are marked as complete. 06/01/11

20. FTCA Module in EHB (continued) Application Data Entry (continued) The system is closely integrated with the grantee scope data and will pre-populate grantee profile information based on the latest information available in the EHB system 20 06/01/11

21. FTCA Module in EHB (continued) Application Data Entry (continued) The system will allow users to:  View the latest approved grant scope (Forms 5A, 5B, & 5C)  Select contact information from a list of existing contacts or provide new/updated contact information for the deeming application  Easily access programmatic resources like the PAL, FAQ’s on the BPHC home page, and the FTCA system user guide 21 06/01/11

22. Sub-Recipient Applications Grantees with Sub-recipients: The system will identify existing sub-recipient organization data based on the information provided by grantees on the approved scope of project (Form 5B).  The system will display the sub-recipient section in EHB only if the grantee has identified one or more sub- recipients on their current Form 5B.  The system will validate the grantee scope at the time of application submission. 22 06/01/11

23. Sub-Recipient Applications (continued) Grantees with Sub-recipients: Health centers must indicate whether FTCA coverage is being sought for each sub-recipient listed on their most recent Form 5B.  For sub-recipients that decline FTCA coverage, the grantee is required to provide an explanation or upload any appropriate attachments that support the decision to decline coverage. 23 06/01/11

24. Sub-Recipient Applications (continued) Health centers must submit a separate deeming application on behalf of each sub-recipient seeking FTCA coverage  A single application package that includes the grantee and all appropriate sub-recipient applications should be submitted. Each sub-recipient application will be collected as an attachment in the system. The system will provide a downloadable template which the grantee can send to sub-recipients to complete and return to the grantee 24 06/01/11

25. Sub-Recipient Applications (continued)  It is recommended that the grantee download the template from the system and send it to all the sub- recipients that are requesting coverage and participating in the program as soon as they begin working on their own application  The grantee is required to upload the sub-recipient application within the system once they have received it from the appropriate sub-recipients 25 06/01/11

26. Paper Waiver Requests Limited only to applicants unable to submit electronically These applicants must submit:  Waiver Justification Letter (that should provide a detailed explanation regarding their inability to submit through EHB)  Completed application packet Mailing address  HRSA Health Center FTCA Program Attn: FTCA Branch Chief Bureau of Primary Health Care, HRSA 5600 Fishers Lane, Mailstop 15C-26 Rockville, MD 20857 Fax: 301-594-5224 Waiver justifications are subject to review and approval by HRSA 26 06/01/11

27. Resources Resource Page, Quality Improvement: https://members2.ecri.org/Components/HRSA/Pages/QI.aspx https://members2.ecri.org/Components/HRSA/Pages/QI.aspx Risk Management Plan: https://members2.ecri.org/Components/HRSA/Pages/RMPlan. aspx https://members2.ecri.org/Components/HRSA/Pages/RMPlan. aspx Event Reporting Toolkit: https://members2.ecri.org/Components/HRSA/Pages/EventRe portToolkit.aspx https://members2.ecri.org/Components/HRSA/Pages/EventRe portToolkit.aspx Webinars https://members2.ecri.org/Components/HRSA/Pages/Webinar _Audioconf_Archive.aspx: https://members2.ecri.org/Components/HRSA/Pages/Webinar _Audioconf_Archive.aspx  Clinical Risk Management Basics Part I  Developing a Risk Management Plan 27 06/01/11

28. Resources Sample Risk Management Policy: Physician Office Practice https://members2.ecri.org/Components/HRSA/Pages/PSRMP ol3.aspx https://members2.ecri.org/Components/HRSA/Pages/PSRMP ol3.aspx Patient Satisfaction Questionnaire https://members2.ecri.org/Components/HRSA/Pages/PSRMP ol2.aspx https://members2.ecri.org/Components/HRSA/Pages/PSRMP ol2.aspx Anecdotal Note for Patient Concerns https://members2.ecri.org/Components/HRSA/Pages/OAPol4. aspx https://members2.ecri.org/Components/HRSA/Pages/OAPol4. aspx Handling Patient Complaints https://members2.ecri.org/Components/HRSA/Pages/OAPol3. aspx https://members2.ecri.org/Components/HRSA/Pages/OAPol3. aspx Safety Attitudes Questionnaire (Ambulatory Version) https://members2.ecri.org/Components/HRSA/Pages/PSRMP ol1.aspx https://members2.ecri.org/Components/HRSA/Pages/PSRMP ol1.aspx 28 06/01/11

29. ECRI Institute Login For more information or to login:  Go to http://www.ecri.org/clinical_rm_programhttp://www.ecri.org/clinical_rm_program  Enter your user ID and password on the left-hand side To access online CME courses:  Go to http://ecrilearning.ecri.orghttp://ecrilearning.ecri.org  Register using your health center’s course keys Need a user ID or course keys?  E-mail clinical_rm_program@ecri.org or call 610-825-6000, ext. 5200clinical_rm_program@ecri.org  Include your full name and facility name 29

30. Resources FTCA Website: http://www.bphc.hrsa.gov/ftcahttp://www.bphc.hrsa.gov/ftca Call Replay available until December 31, 2011: 800-337-5610  No passcode required FTCA/BPHC Help Line: 1-877-974-BPHC (877-974-2742) or BPHChelpline@hrsa.gov BPHChelpline@hrsa.gov  9:00AM to 5:30 PM (ET)  For information on the FTCA Program and the deeming application HRSA Call Center: 1-877-464-4772 or CallCenter@hrsa.govCallCenter@hrsa.gov  Monday-Friday (except federal holidays) 9:00AM to 5:30PM (ET)  For EHB technical support (e.g., registration, username and password) 30 06/01/11