Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA)

1. Federal Tort Claims Act (FTCA) Coverage for Individuals at Free ClinicsTechnical Assistance CallPAL 2011-09 Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) Bureau of Primary Health Care (BPHC) Office of Quality & Data (OQD) August 16, 2011

2. Today’s Call • Purpose • Overview of FTCA Coverage • Requirements for Free Clinic FTCA Coverage • Eligible Individuals • Revised Application • Dates and Important Information • Resources and Contact Information

3. II. Overview ofFTCA Coverage • Established by Section 194 of HIPAA adding section 224(o) of the Public Health Service Act, covering volunteer health professionals • Expanded by the Affordable Care Act in 2010 to include board members, officers, employees, and individual contractors

4. II. Overview of FTCA Coverage • Provides Medical Malpractice Coverage for deemed individuals providing medical, surgical, or dental services • Eligible Individuals must be sponsored by a Free Clinic • Free Clinic entity is NOT covered by FTCA • NOT general liability coverage

5. II. Overview of FTCA Coverage • FTCA coverage is similar to an occurrence policy – coverage is for any incidents that occur during time the individual is covered under FTCA • No specific coverage limit • Punitive damages not allowed • Cases defended by the United States in Federal court

6. III. Requirements Sponsoring Clinics: • Must be a nonprofit organization • Cannot accept third party reimbursement • May not impose charges on patients • May accept donations • Are licensed or certified in accordance with applicable state law

7. III. Requirements Major Requirements for Deeming: • Credentialing and Privileging System • Risk Management System • Patient Notification of Limited Liability • Medical Malpractice Claims Review • Data Reporting

8. III. Requirements Risk Management • Quality Improvement/Quality Assurance Plan (QI/QA Plan) • Identifies Free Clinic’s plan to mitigate risk and improve quality care for patients • Should map out plan for identification and evaluation of concerns, education plan for staff members, and responsibilities of management • Also include Free Clinic’s credentialing and privileging processes

9. III. Requirements Review of Medical Malpractice Claims • Used to ensure appropriate policies and procedures are in place to reduce risk of medical malpractice • Report any medical malpractice claim or disciplinary action taken by licensing board • Report for past ten years for new applicants • Report from past five years for renewal applicants

10. III. Requirements Annual Data Reporting • Occurs the first quarter of each year • Examples of information requested: • Number of visits per clinic by covered individuals • Number of patients per clinic by covered individuals

11. IV. Eligible Individuals Eligible Individuals: • Volunteer Health Professionals • Board Members • Officers • Employees • Individual Contractors • Must have individual contract between individual and clinic

12. V. Application • New Application now in Excel • Can save application in progress unlike previous fillable PDF • Email entire application IN EXCEL to freeclinicsFTCA@hrsa.gov

13. V. Application • Each section of application has its own “worksheet” • Five worksheets in total • Click tabs on bottom of page to move between worksheets

14. V. Application First Worksheet: Contact Information • Free Clinic organizational information • FTCA Contact Person(s) • Free Clinic Sites • Update sites or address here

15. V. Application Second Worksheet: Sponsoring Free Clinic • Confirm eligibility • Click button for “yes” or “no” • Explain all “no” answers

16. V. Application Third Worksheet: Credentialing and Privileging • Answer questions regarding credentialing and privileging processes • Click “yes” or “no” • Explain all “no” answers

17. V. Application Fourth Worksheet: Risk Management Systems • Answer questions about Risk Management and QI/QA plan • Also attach QI/QA Plan WITH board signature • Explain all “no” answers

18. V. Application Fifth Worksheet: Individuals’ Information • List name of EACH individual seeking deeming status • Including board members, officers, employees, and contractors • HRSA will only consider those listed on the application

19. V. Application Fifth Worksheet: Individuals’ Information (continued) • Credentialing and Privileging should be done every two (2) years • Credentialing/Privileging date listed should be the date conducted by your organization (or CVO) • Answer “yes” or “no” if there has been a medical malpractice or disciplinary action against any individual • Attach explanation of all claims

20. V. Application Adding more fields • If more lines needed for people, sites, etc. • Highlight rows (click on numbers on left) • Right Click • Choose “Insert” • Repeat as necessary

21. V. Application • Important Information • Send one (1) email. Email should include EXCEL application form, QI/QA Plan, an explanation of medical malpractice claims, and signature page. Include FC number • QI/QA Plan must be signed and dated by an authorized member of the board indicating approval • Please do not have hidden cells on individuals spreadsheet. It interferes with the synching of our database • Include ALL individuals

22. VI. Dates and Important Information • Deeming Applications due September 16, 2011 for 2012 coverage • Include all renewals and new individuals on application form. Please do not attach separate spreadsheet • Board members and officers do not need same credentialing/privileging as providers • Use renewal application to update sites

23. Questions? Questions and Answers Thank you for your continued interest in our programs

24. VII. Resources and Contact Information For more information on the Free Clinic deeming application or FTCA coverage, please contact the Bureau of Primary Health Care (BPHC) • 877-974-BPHC (877-974-2742) • The Helpline is available 8:30 AM to 5:00 PM (ET) business days • FreeclinicsFTCA@hrsa.gov • http://bphc.hrsa.gov/ftca/freeclinics/