Federally Qualified Health Center Look-Alike Application Instructions for Calendar Year 2011/2012

1. Federally Qualified Health Center Look-Alike Application Instructions for Calendar Year 2011/2012 Renewal of Designation and Annual Certification Applications

2. Call Overview • FQHC Definition, Benefits, and Eligibility • Application Types, Components, and Content Overview • Application Submission Information • Review Timelines • Tips for Preparing a Successful Application • Technical Assistance Resources

3. What is an FQHC? Medicare and Medicaid statutes define a provider type: “Federally Qualified Health Center” (FQHC) • Respectively, Social Security Act §1861(aa)(4) and §1905(l)(2)(B) • Entity that receives a grant under section 330 of the Public Health Service Act – Health Center Program. • Entity that is determined by DHHS to meet requirements to receive funding without actually receiving a grant (i.e., FQHC Look-Alike). • Entities that are outpatient health programs or facilities operated by a tribe or tribal organization under the Indian Self-Determination Act or by an Indian organization receiving funds under Title V of the Indian Health Care Improvement Act.

4. Fundamental Principles • Private non-profit or public entities that serve a high-need community or population • Governed by a community board of which at least a majority are health center patients who represent the patient population served • Provide comprehensive primary care and enabling and supporting services • Services are available to all, with fees adjusted based upon ability to pay • Meet all performance and accountability requirements for administrative, clinical, and financial operations

5. Benefits

6. Eligibility • Must be a private, charitable, tax-exempt nonprofit organization, OR public entity • Must serve a medically underserved area (MUA) or medically underserved population (MUP) designated by DHHS • Must NOT be owned, controlled, or operated by another entity • Must be operational and providing primary care services at the time of application submission

7. FQHC Look-Alike Application Types

8. Application Components • Program Narrative • Forms • Attachments

9. Program Narrative • Need • Response • Collaboration (New!) • Evaluative Measures • Impact (Annual Certification application only) • Resources/Capabilities • Governance

10. Forms

11. Forms

12. Attachments

13. Attachments

14. Key Differences Between PIN 2009-06 & the New Instructions • All applications must be submitted through HRSA Electronic Handbooks (EHB). Renewal of Designation and Annual Certification applications will be submitted according to existing designation periods. • Data will now be reported separately from the Annual Certification application through the Uniform Data System (UDS) in the EHB. This data will be reported on a calendar year (CY) basis. Data reported in the EHB will no longer be included in the Annual Certification application.

15. Key Differences Between PIN 2009-06 & the New Instructions • Contracts for required services will be summarized in an attachment rather than attached in full, except for contracts that constitute a substantial scope of the project. • A budget form (Form 3A) has been added to the application requirements. • The Change in Scope process is unchanged from and can still be found in PIN 2009-06.

16. Application Submission RENEWAL OF DESIGNATION • Applications must be submitted through the HRSA EHB • Refer to HRSA’s Electronic Submission User Guide, available online at http://bphc.hrsa.gov/about/lookalike/index.htmlfor detailed application and submission instructions. • Once the Renewal of Designation application process is started in the EHB system, it must be completed and submitted in a maximum of 90 calendar days. • Applications that are ineligible or not completed within 90 days will not be considered for designation. Failure to submit the Renewal of Designation application could result in termination of the FQHC Look-Alike designation and all corresponding benefits.

17. Application Submission ANNUAL CERTIFICATION • Applications must be submitted through the HRSA EHB • Refer to HRSA’s Electronic Submission User Guide, available online at http://bphc.hrsa.gov/about/lookalike/index.htmlfor detailed application and submission instructions. • Once the Annual Certification application process is started in the EHB system, it must be completed and submitted in a maximum of 60 calendar days. • Applications that are ineligible or not completed within 60 days will not be considered for designation. Failure to submit the application could result in termination of the FQHC Look-Alike designation and all corresponding benefits.

18. Estimated Timelines RENEWAL OF DESIGNATION APPLICATION

19. Estimated Timelines ANNUAL CERTIFICATION APPLICATION

20. Preparing for a Successful Application • Perform a thorough needs assessment early • Request technical assistance from your PCA/PCO or other experienced health centers • Ensure that the organization is operating in full compliance with each program requirement, including active involvement and oversight of a governing board • Ensure that all application forms, attachments, and program narrative provide consistent information

21. Key Resources for Application Development • FQHC Look-Alike Application Instructions 2011-2012 and EHB System User Guides: http://bphc.hrsa.gov/about/lookalike/index.html • Service Area Overlap: Policy and Process (PIN 2007-09) for guidance on preparing a service area overlap analysis • Health Center Program Requirements: http://bphc.hrsa.gov/about/requirements/index.html • FQHC Look-Alike Application Resources document under “Application Help” on the TA page

22. Technical Assistance Program Contacts: • Jennifer Joseph; Chief, Strategic Operations Branch • Nicole Amado; Public Health Analyst • Telephone: 301-594-4300 • Email: FQHCLAL@hrsa.gov Look-Alike Program TA Webpage: • http://bphc.hrsa.gov/about/lookalike/index.html

23. Question & Answer Session