1. 1 FQHC Look-Alike Program Uniform Data System Technical Assistance Call November 16, 2011

2. 2 Goals and Objectives Goal To provide technical assistance to support FQHC Look Alike electronic data reporting for the CY2011 reporting period Objectives At the end of the call, participants will be able to: Describe the importance of the Uniform Data System reporting Summarize the required UDS data tables for FQHC Look Alike data reporting Describe the process for completing and submitting the UDS report Understand the key steps and procedures in the reporting process Identify additional resources available UDS Overview

3. 3 Agenda Overview of UDS data reporting and related resources Overview of EHB access to UDS and related resources Questions and answers

4. 4 UDS Overview for FQHC Look-Alikes (LALs) Importance of the UDS Critical dates in the UDS process Available Assistance Introduction to UDS Tables and Definitions For detailed instructions attend regional training or download online training modules

5. 5 Uniform Data System (UDS) Standardized set of data reported by: Section 330 Grantees – CHC, HCH, MHC, and PHPC (for over 15 years) FQHC Look-Alikes (effective this year) Reported for calendar year January 1- December 31

6. 6 Importance of the UDS UDS data is used by HRSA to: Ensure compliance with legislative and regulatory requirements; Improve health center performance; and Report overall program performance

7. 7 Content of the UDS Number of the patients served and their socio-demographic characteristics Types and quantities of services provided Types of staff who provide these services Quality of care provided to patients Cost and efficiency of delivering services Sources and amounts of income

8. 8 Critical Dates in the UDS Process Complete report due February 15 Submitted online through the HRSA “Electronic Handbook” (EHB) https://grants.hrsa.gov/webexternal/login.asp Data entry is subject to testing Math is verified and inter-table consistency checked

9. 9 Available Assistance Regional trainings hosted by PCAs On-line training modules, manual, and fact sheets available at http://bphcdata.net/html/bphctraining.html Telephone help line (866-UDS-HELP) E-mail help udshelp330@bphcdata.netudshelp330@bphcdata.net EHB Support HRSA Call Center 877-464-4772 BPHC Help Desk 301-443-7356

10. UDS Tables and Definitions

11. 11 Patient Profile Number of patients served and their socio- demographic characteristics Patients by Zip Code Table 3A – Patients by Age and Gender Table 3B – Patients by Race/Ethnicity/Language Table 4 – Other Patient Characteristics Income, insurance, special populations

12. 12 Patients - Defined An individual who has one or more visit that was reported on Table 5 during the calendar year Medical, dental, behavioral health, vision, other professional, and selected enabling services (More on “visit” in a while) An individual counts once and only once regardless of the number of visits

13. 13 Provider and Utilization Profile Types and quantities of services provided and staff who provide these services Table 5 – Staffing and Utilization FTEs, visits, and patients by service

14. 14 Staff FTEs - Defined Includes all paid, salary, and volunteer workers at any approved site FTE is actual for the year, not as of last day Based on hours paid including vacation, sick, continuing education, etc. Full time is defined by LAL – may be 40 hours/week or 36 or different for each type

15. 15 Visits - Defined Face to face, 1:1 between patient and provider Except for behavioral health* Only one visit / day / provider / type Unless 2 different providers at 2 different sites Count paid referral, nursing home, and hospital visits and visits provided by volunteers and contracted staff Exclude group* visits, screenings, immunization, or lab only, visits

16. 16 Patients by Service - Defined An individual who receives one or more documented “visit” of any specific service type: – Medical– Dental – Mental Health– Substance Abuse – Other Professional– Vision – Enabling

17. 17 Clinical Profile Quality of care and outcome indicators Table 6A – Selected Diagnoses and Services (not required for LALs) Table 6B – “Quality of Care” Indicators Table 7 – Health Outcomes and Disparities Electronic Health Record (EHR) Addendum Series of questions on the adoption of EHRs, certification of systems and how widely adopted the system is throughout the health center’s providers

18. 18 Quality of Care Indicators “Process measures” - If patients receive timely routine and preventive care, then we can expect improved health Early entry into prenatal care (All prenatal patients) Childhood immunizations (children age 2) Pap tests (Women aged 21-64) Weight Assessment, nutrition counseling, and counseling on activities for children (Children and adolescents aged 2 – 17)

19. 19 Quality of Care Indicators “Process measures” - If patients receive timely routine and preventive care, then we can expect improved health Adult Weight Assessment (Adults aged 18+) Tobacco Use Assessment (Adults aged 18+) Tobacco Cessation Intervention (Tobacco users aged 18+) Asthma Intervention (Patients aged 5-40 diagnosed with persistent asthma)

20. 20 Health Outcomes and Disparities “Intermediate outcome measures” - If this measurable intermediate outcome is improved, then later negative health outcomes will be less likely. Normal Birthweight (All live infants born to prenatal patients) Controlled Hypertension (Adults aged 18-85 with a history of hypertension) Controlled Diabetes (Adults aged 18-75 with a history of diabetes)

21. 21 Options for Reporting Report Universe – All patients who meet the reporting criteria Must report universe when: Universe has fewer than 70 patients who meet the criteria Reporting Prenatal Care and Delivery Outcome variables Report Sample – A random sample of 70 charts from the Universe Must report sample when: Unable to verify all aspects of compliance on entire universe

22. 22 Financial Profile Cost and efficiency of delivering services and sources and amounts of income Table 8A – Costs Table 9D – Income from patient services Table 9E – Other revenues Grants, contracts, and other income not generated by patient services

23. 23 Costs and Revenues - Defined Costs on Table 8A are reported as accrued costs including depreciation and excluding bad debt Patient and other revenues on Tables 9D and 9E are reported on a cash basis Grants and contract revenues are reported using the “last party rule” i.e., “last party” to handle funds before you receive them

24. 24 Differences between LAL and 330 UDS UDS Tables are identical to simplify reporting, training, and data analysis Selected UDS Tables have simplified reporting by LALs Table 4: Delete managed care data and details on homeless and/or farmworker patients Table 6A: Deleted from LAL reporting

25. 25 Differences between LAL and 330 UDS Selected UDS Tables have simplified reporting by LALs Table 7: Delete race and ethnicity data for clinical measures Table 9D: Delete detail data on managed vs. non- managed care and on retroactive payments Table 9E: Delete data on 330 grant funds as well as ARRA grant funds from BPHC

26. Contact Information Susan Friedrich John Snow, Inc. (JSI) UDS Helpline: 866-UDS-HELP

27. 27 Overview of EHB Access to UDS Process Overview Prerequisites EHBs Notes Walkthrough of UDS Forms Resources

28. 28 Process Overview 1.HRSA will make the UDS report available in the HRSA Electronic Handbooks (EHB) on January 1, 2012. 2.Designees will login to the EHB, navigate to the UDS report, complete and submit it. 3.Completing the UDS report is a three-step process: a.Complete and validate tables b.Resolve Data Audit checks c.Review and submit report 4.HRSA may request changes to the report. If this is the case, the report will be made available to the FQHC Look Alike so that it can be changed and resubmitted.

29. 29 Prerequisites (All Users) All users who wish to work on the UDS report must register in the HRSA EHB If you have registered before, you do not have to register again. Use the same username and password. Contact the HRSA Call Center if you do not remember your username or password. Go to https://grants.hrsa.gov/webexternal/login.asp https://grants.hrsa.gov/webexternal/login.asp

30. 30 Prerequisites (All Users) All users must add the designation to their portfolio If you are the project director, you will be given immediate access to the designation; otherwise, you will get access to the designation when the project director gives it to you

31. 31 Prerequisites (Project Director) Project director must grant users permission to view, edit or submit the UDS report UDS is a “performance report” PrivilegePermissions View Access the read-only version of the entire report for the current year Access the submitted read-only version of the entire report for all previous years* Edit All permissions associated with the “View” privilege, plus Enter and save the data in the electronic forms for all the report tables Perform edit checks on the data and validate the data in the report View the UDS reviewer change requests and comments Submit All permissions associated with the “Edit” privilege, plus Submit the report once the data has been entered and validated

32. 32 HRSA EHB Notes HRSA EHB allows you to work on your report in parts, save it online and return to complete it later Multiple users can work on the report at the same time Multiple users can work on different tables at the same time Multiple users can work on different sections of the same table at the same time (e.g., User A can work on one part of Table 7 while User B works on another part of it) HRSA EHB has two views: one for data entry and one for review The view for “review” appears just like the printed form The view for “data entry” is set up for user-friendly data entry

33. 33 Logging In https://grants.hrsa.gov/webexternal/login.asp

34. 34 Navigation to UDS Report: Welcome Page Click FQHC LA Home.

35. 35 Navigation to UDS Report: FQHC LAL Home Page Click View Portfolio to view your designation portfolio.

36. 36 Navigation to UDS Report: Portfolio (Cont’d) Locate your designation. Click Open Designation Handbook. Locate your designation. Click Open Designation Handbook.

37. 37 Navigation to UDS Report: Designation Handbook Click Performance Reports.

38. 38 Performance Reports Page UDS is on the Performance Reports page.

39. 39 UDS in Performance Report List Click the Search button to search for previous reports. Previous year reports will be available for online viewing starting 2012, when you will have access to the read-only version of the final submitted report for 2011. Click the Search button to search for previous reports. Previous year reports will be available for online viewing starting 2012, when you will have access to the read-only version of the final submitted report for 2011.

40. 40 Schedule Status Schedule Status: Describes the lifecycle of the UDS report. Schedule Status Denotes Who’s Responsible? Not Started This indicates that the report has never been worked on. When the new report is available in the grants handbook it will be in the “Not Started” status. Designee In Progress Clicking the Start Report link changes the status of the report to “In Progress.” Designee SubmittedThis indicates that the report has been submitted. HRSA Change Requested After the report has been submitted, it is sent to the UDS reviewer. If the reviewer determines that changes are needed, the report will be made available to the grantee again for changes. The schedule status will move to “Change Requested.” The report will stay in this status while it is being revised. When the changes are made and the report is re-submitted, the schedule status will revert to “Submitted.” Designee

41. 41 Submission Status Submission Status: Describes the status of the UDS report while it is being prepared, reviewed, or revised, either originally or in response to a request for changes. Submission Status Denotes Data Entry in Progress The report is in this status before it has been submitted. Submitted This indicates that the report has been submitted. Note: More submission statuses will be added in the future.

42. 42 Start Report Click Start Report.

43. 43 UDS Report Window UDS Report opens in a separate window.

44. 44 Process Information Page Click this arrow to show/hide the side menu.

45. 45 Process Information Page Use the side menu to jump to any section of the report.

46. 46 Process Information Page Observe your progress through the three steps to completing the report here. Gray = Not Started Blue = In Progress Green = Complete

47. 47 Process Information Page Links to useful resources are provided under View.

48. 48 Process Information Page Click Show Details to display a list of users with permissions to work on the UDS report.

49. 49 Process Information Page Use the buttons at the bottom of the page to save data entered or, in this case, to proceed to the next page.

50. 50 Status Overview Page The Status Overview page shows all the sections of the report and the completion status of each section.

51. 51 UDS Report Status Table A [+] or [-] appears for Tables 3A, 3B, 4, and 5, and for Table 7, which has three pages.

52. 52 UDS Report Status Table Overall completion status of a table depends on the completion status of the individual reports for that table.

53. 53 UDS Report Status Table StatusDenotes Not Started All the tables are initially in the “Not Started” status. Opening a table from the side menu or by clicking the “Update” link will update the status of the table to “In Progress.” In Progress The table will remain in this status while the data is entered and saved. The data will be saved as long as there are no errors on the page. Complete This status only applies to the individual sections of Table 7. Once you have entered all the and there are no errors in that section, the status is updated to “Complete.” Validated For all tables, the status will change to “Validated” when data entry is complete, the data has been saved, and there are no errors. (For Table 7, the status will change to “Validated” when all three sections are complete.)

54. 54 UDS Report Status Table Click Update to open a section for editing. You can update any section, even those marked “Complete” or “Validated.” Doing so may cause the status to revert to “In Progress.” Click Update to open a section for editing. You can update any section, even those marked “Complete” or “Validated.” Doing so may cause the status to revert to “In Progress.”

55. 55 Contact Information Project Director information is pre- populated from user account information in the EHB.

56. 56 Contact Information You must provide a UDS Contact. This is the person to whom HRSA will turn if there are questions about the data.

57. 57 Contact Information Click Add to enter information for contacts.

58. 58 Patients by ZIP Code Click Add to enter zip codes and patients.

59. 59 Patients by ZIP Code Enter ZIP code and patient data. You can enter up to 20 sets of ZIP code and patient data at a time. Click Save to save the data.

60. 60 Patients by ZIP Code ZIP codes that have been entered appear at the bottom of the screen. Check to ensure there are no duplicates.

61. 61 Patients by ZIP Code Click the Finished Adding ZIP Codes button after you have saved the data and are ready to continue.

62. 62 Patients by ZIP Code Check boxes to select one or more rows and then click the appropriate button to update or delete the data.

63. 63 Patients by ZIP Code For these two rows, enter the data here.

64. 64 Errors When data entry produces errors, an advisory appears at the top of the page.

65. 65 Errors Fields where errors occur are highlighted.

66. 66 Errors Symbol Denotes Critical Error. This kind of error must be corrected in order for the system to save your data. If one or more errors of this kind appear on the page and are not corrected, the system will not save the data entered after the last successful save. Regular Error. This kind of error will let you save the data, but with these errors existing on the page, the system will not change the status of a page to “Complete.” Exception. This denotes either a discrepancy or an inconsistency in the data entered in the reports. Exceptions in the report will be shown to you when you execute the Data Audit Report. These need to either be corrected or justified. Information. This is a note to alert you to any important information on your report. Success Message. This denotes that a particular process has been executed successfully. This can appear anytime data is successfully saved or submitted.

67. 67 Table 3A: Patients by Age/Gender Helpful instructions that explain what is expected on the page appear at the top of every table. Click Show Full Instruction. Helpful instructions that explain what is expected on the page appear at the top of every table. Click Show Full Instruction.

68. 68 Table 3B: Patients by Race/Ethnicity/Language UDS Overview

69. 69 Table 4: Selected Patient Characteristics

70. 70 Table 5: Staff and Utilization This is a long form. You can click here to expand or collapse individual sections.

71. 71 Table 6B: Quality of Care Indicators Designees who do not provide perinatal/prenatal services should check this box and click Update to disable data entry on the relevant section of the table.

72. 72 Table 7: Health Outcomes and Disparities Designees who do not provide perinatal/prenatal services should check this box and click Update to disable data entry on the relevant section of the table.

73. 73 Table 7: Health Outcomes and Disparities Use this dropdown list to access the other reports for this table. Choose the report from the list and click Go. Use this dropdown list to access the other reports for this table. Choose the report from the list and click Go.

74. 74 Table 7: Health Outcomes and Disparities (Cont’d) Table 7 starts with Deliveries and Low Birth Weight by race and ethnicity…

75. 75 Table 7: Health Outcomes and Disparities (Cont’d) … then moves to Hypertension and Diabetes, again by race and ethnicity.

76. 76 Table 8A: Financial Costs

77. 77 Table 9D: Patient Related Revenue

78. 78 Table 9E: Other Revenues

79. 79 Data Audit Report When data entry is complete and all tables are in “Validated” status, you must run the data audit report. The data audit report is a list of errors that exist between the pages of the different tables in the report and audit exceptions that exist either in a particular page or between multiple pages of a report. Run the Data Audit Report to generate the list of data errors and exceptions (collectively called “Edits”).

80. 80 Data Audit Report You can display all edits, only those pending review, or only those that have been reviewed and explained.

81. 81 Data Audit Report Once an edit in the “Pending” status is justified, its status changes to “Explained.”

82. 82 Data Audit Report Each edit has a unique code. Use this code for communication with the HRSA about your report.

83. 83 Data Audit Status – Error This is an error. It must be corrected. Note that the discrepancy exists between Tables 3A and 4. This is an error. It must be corrected. Note that the discrepancy exists between Tables 3A and 4.

84. 84 Data Audit Status – Error Actual values you have entered in the report are given in ( ) within the error message.

85. 85 Data Audit Status – Error Use the link provided to go to either of the tables to correct the data.

86. 86 Data Audit Status – Exception This is an exception. It may be corrected or explained, as appropriate.

87. 87 Data Audit Status – Exception Use the link provided to open a text entry field to explain this item.

88. 88 Review Page Click View to open a printable (HTML format) version of any section of the report.

89. 89 Submit Page Click Submit to access the submit page, where users with permission sign and submit the UDS report.

90. 90 Post-Submission All electronic interaction will be via the EHB system. You will always be able to view your submission in read-only format.

91. 91 Questions

92. 92 Summary of Available Resources UDS Regional UDS trainings hosted by PCAs On-line training modules, UDS manual, and fact sheets available at http://bphcdata.net/html/bphctraining.html http://bphcdata.net/html/bphctraining.html Helpline (866-UDS-HELP) or udshelp330@bphcdata.netudshelp330@bphcdata.net EHB HRSA Call Center 877-464-4772 BPHC Help Desk 301-443-7356 or BPHCHelpline@hrsa.govBPHCHelpline@hrsa.gov FQHC Look Alike program staff Office of Policy and Program Development 301-594-4300 or FQHCLAL@hrsa.gov FQHCLAL@hrsa.gov