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

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

2. UDS Overview 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

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

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. 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. 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. 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. 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. 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.net • EHB Support • HRSA Call Center 877-464-4772 • BPHC Help Desk 301-443-7356

10. UDS Tables and Definitions

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. 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. 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. 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. 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. 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. 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. 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. 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. Health Outcomes and Disparities • “Intermediate outcome measures”- Ifthis 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. 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. 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. 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. 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. 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. Overview of EHB Access to UDS • Process Overview • Prerequisites • EHBs Notes • Walkthrough of UDS Forms • Resources

28. Process Overview • HRSA will make the UDS report available in the HRSA Electronic Handbooks (EHB) on January 1, 2012. • Designees will login to the EHB, navigate to the UDS report, complete and submit it. • Completing the UDS report is a three-step process: • Complete and validate tables • Resolve Data Audit checks • Review and submit report • 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. 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

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. Prerequisites (Project Director) • Project director must grant users permission to view, edit or submit the UDS report • UDS is a “performance report”

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

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

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

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

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

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

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.

40. Schedule Status Schedule Status: Describes the lifecycle of the UDS report.

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.

42. Start Report Click Start Report.

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

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

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

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

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

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