In this section:
Primary Reviewer: Governance/Administrative Expert
Secondary Reviewer: Clinical Expert
Authority: Section 330(k)(3)(B) of the Public Health Service (PHS) Act; and 42 CFR 51c.303(n), 42 CFR 56.303(n), and 42 CFR 51c.305(h)
Health Center Program Compliance Manual Related Considerations
Documents the Health Center Provides
- Documentation of established collaboration with other providers and organizations in the health center service area to provide access to services not available through the health center, including:
- Local hospitals;
- Specialty providers;
- Social service organizations; and
- Organizations that serve special populations.
Examples of documentation may include memoranda of agreement (MOAs), memoranda of understanding (MOUs), letters, evidence of membership in a city-wide community health planning council, or evidence of participation in an emergency room diversion program.
- Documentation of coordination with other federally-funded, as well as state and local, health services delivery projects and programs serving similar patient populations in the service area.
- If coordination is not established, documentation of efforts to establish coordination.
- Documentation must include one or more health centers in the service area.
- Examples of documentation may include minutes or agendas from meetings, emails, or other correspondence.
- Uniform Data System (UDS) Mapper documentation showing other health centers with sites in the service area.
Compliance Assessment
Select each element below for the corresponding text of the element, site visit team methodology, and site visit finding questions.
The health center documents its efforts to collaborate with other providers or programs in the service area, including local hospitals, specialty providers, and social service organizations (including those that serve special populations), to provide access to services not available through the health center in order to support:
- Reductions in the non-urgent use of hospital emergency departments;
- Continuity of care across community providers; and
- Access to other health or community services that impact the patient population.
Site Visit Team Methodology
- Interview Project Director/CEO about collaboration activities, including examples of how the health center’s collaborative relationships support each of the following:
- Reductions in the non-urgent use of hospital emergency departments;
- Continuity of care across community providers; and
- Access to other health or community services that impact the patient population.
- Review the Collaboration section and any relevant attachments in all recent competitive (any Service Area Competition and New Access Point) or designation (Initial Designation or Renewal of Designation) applications.
- Review the sample of MOUs, MOAs, or any other documentation of collaboration with other providers or programs, including:
- Local hospitals;
- Specialty providers;
- Social service organizations; and
- Organizations that serve special populations.
Note: The health center determines how to document collaboration or coordination with providers and organizations in its service area.
Site Visit Findings
- Does the health center have documentation of its efforts to collaborate with other providers or programs in the service area to provide access to services not available through the health center? Other providers or programs include local hospitals, specialty providers, social service organizations, and organizations that serve special populations.
Response is either: Yes or No
If No, an explanation is required.
- Did the health center provide at least one documented example of how its collaborative relationships support each of the following:
- Reductions in the non-urgent use of hospital emergency departments;
- Continuity of care across community providers; and
- Access to other health or community services that impact the patient population?
Response is either: Yes or No
If No, an explanation is required.
The health center documents its efforts to coordinate and integrate activities with other federally-funded, as well as state and local, health services delivery projects and programs serving similar patient populations in the service area (at a minimum, this would include establishing and maintaining relationships with other health centers in the service area).
Site Visit Team Methodology
- Review the Uniform Data System (UDS) Mapper to identify other health centers with sites in the service area.
- Interview health center Project Director/CEO about coordination with other federally-funded, as well as state and local, health service delivery projects and programs serving similar patient populations in the service area (at a minimum, other health centers in the service area).
- Review the relevant documentation of coordination with other federally-funded, as well as state and local, health services delivery projects and programs serving similar patient populations in the service area.
- If coordination is not established, review documentation of efforts to establish coordination.
- Documentation must include one or more health centers in the service area.
- Examples of documentation may include minutes or agendas from meetings, emails, or other correspondence.
Note: The health center determines how to document collaboration or coordination with providers and organizations in its service area.
Site Visit Findings
- Does the health center have documentation of its efforts to establish relationships with at least one health center in the service area?
Note: Only select “Not Applicable” if there are no other health centers in the service area.
Response is: Yes, No, or Not Applicable
If No OR Not Applicable, an explanation is required. If Not Applicable, state if the UDS Mapper documentation shows there are no other health centers in the service area.
- Does the health center have documentation of its efforts to coordinate and integrate activities with other federally-funded, state, and local health service delivery projects and programs serving similar patient populations in the service area?
Response is either: Yes or No
If No, an explanation is required, including stating if there are no other federally-funded, state, or local health services delivery projects or programs serving similar patient populations in the service area.
If the health center expands1,2 its HRSA-approved scope of project:
- The health center obtains letters or other appropriate documents specific to the request or application that describe areas of coordination or collaboration with health care providers serving similar patient populations in the service area (health centers, rural health clinics, local hospitals including critical access hospitals, health departments, other providers including specialty providers, as applicable); or
- If such letters or documents cannot be obtained from these providers, the health center documents its attempts to coordinate or collaborate with these health care providers (health centers, rural health clinics, local hospitals including critical access hospitals, health departments, other providers including specialty providers, as applicable) on the specific request or application proposal.
Site Visit Team Methodology
N/A – HRSA does not review health center compliance with this element during the site visit. HRSA assesses compliance with this element during its review of the health center’s Change in Scope requests and competing continuation application (SAC or RD).
Site Visit Findings
N/A – HRSA does not review health center compliance with this element during the site visit. HRSA assesses compliance with this element during its review of the health center’s Change in Scope requests and competing continuation application (SAC or RD).
Footnotes
1. Expanding the HRSA-approved scope of project may occur by adding sites or services through Change in Scope requests, New Access Point competitive applications, or other supplemental funding applications.
2. Additional requirements for documented collaboration may apply based on specific Notices of Funding Opportunity (NOFOs), Notices of Award (NOAs), look-alike designation instructions, or other federal statutes, regulations, or policies.