Texas Primary Care Office FQHC Open Enrollment Training Fiscal Year (FY) 2010 Texas Primary Care...

Texas Primary Care OfficeTexas Primary Care Office

FQHC Open Enrollment FQHC Open Enrollment TrainingTraining

Fiscal Year (FY) 2010 Fiscal Year (FY) 2010

Texas Primary Care Office (TPCO)

Federally Qualified Health Clinic (FQHC) Incubator Program

July 27, 2009

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AgendaAgenda

TX Primary Care Office BerryFQHC Incubator Program Open Enrollment

Application Martin

Program Information, Application Requirements & Contractor’s Procedure Manual Program Requirements Soper Performance Measures/Monitoring Key Deliverables Defined & Completed Gibbons

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AgendaAgenda

General Provisions YoungClient Services Contracting Unit WalkContractor’s Financial COS

Procedures Manual

Questions and Answers

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Introduction/Introduction/TPCO OverviewTPCO Overview

Introduce TPCO programs-Connie Berry, TPCO Manager

81st Legislative OverviewFQHC Incubator Program

Successes Future-Primary and Behavioral Health Care Special Initiative

Introduce FQHC Incubator Program StaffReview Agenda

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Application Application

Purpose and Overview Expansion of FQHCs eligible to submit a competitive HRSA/BPHC

application for medical or service expansion Certification as FQHC Look Alike Submittal of competitive HRSA/BPHC application Organizational compliance with HRSA/BPHC PIN 98-23

Program Funding $4.85 Including Primary & Behavioral Hlth Integration Special Initiative Supports TA, organizational development, capital improvements, and

management & clinical salary support

Payment Contract will have specific set of deliverables and a maximum about is

set

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Application/Application/EligibilityEligibility

Category 1-FQHCs Category 2-FQHC Look AlikesCategory 3 health care organization 501(c)(3) &

PIN 98-23 compliant MUA/MUP Articles of Incorporation By-laws Mission Statement Board of Directors Roster (indicate consumers)

Category 4 501(c)(3) or Public Entity

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Application/Application/Program Program LimitationsLimitations

Public entity or 501(c)(3) nonprofit organizationDSHS Performance MeasuresRequested amount not guaranteedNo supplantationFunds used for purpose of FQHC Incubator

ProgramFunds to open new primary care health clinic &

meet program expectations of defined in PIN 98-23

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Application/Application/Program Program LimitationsLimitations

Apply for HRSA/BPHC funding “first available opportunity” or FQHC Look Alike certification when eligible.

Leverage funds & use other funds if deliverable exceeds allowable contracted amount.

Re-negotiate or change deliverables to: Expand services Reduce funding when deliverables are not satisfactorily attained Eliminate supplantation when contractor has bee designated an FQHC

An approved Change of Scope with Open Enrollment Application

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Application/Application/Process & Process & ProceduresProcedures

Read FQHC Incubator Program Information Application Requirements & Contractor’s Procedures Manual.

60 calendar days to process application

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Application Application //FormsForms/Attachments/Attachments

Form A Face PageForm B Table of ContentsForm C 1, C 2, C 3, or C 4

Technical Assistance Deliverables Development Deliverables Capital Improvements (renovations & equipment) Salary Support

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Application Application /Forms//Forms/AttachmentsAttachments

Category 1 FQHCs-NGA and Update on Conditions

Category 2 FQHC LAs-Letter of Certification from BPHC

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Application Application /Forms//Forms/AttachmentsAttachments

Category 3 health care organization 501(c)(3) & PIN 98-23 compliant and Category 4 501(c)(3) or Public Entity IRS 501(c) (3) or other document that indicates organization is a

public entity MUA/MUP Articles of Incorporation By-laws (Category 3 PIN 98-23 Compliant) Mission Statement (refer to PIN 98-23) Board of Directors (Category 3 PIN 98-23 Compliant-51%

consumer representation)

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Form C Technical Assistance Deliverables Brief description of how funding will expand organizational goals,

meeting staff and board of directors’ members in meeting educational need

Identify specific training events On-site technical assistance funding may be considered, must

be discussed with TPCO prior to application submittal

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Form C Development Deliverables Brief description of how development funding will expand

organizational goals Include DSHS approved contract for consulting services

• Service description (business plan)• Timeline• Payment schedule• Resume• Writing sample• List of three references

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Form C Capital Improvement Renovations Lease Signed contract or bid

• Legal description of property to be renovated• Renovation schedule, detailed budget• Development and construction documents• Permits• Est. cost per sq ft• Floor plan (8 ½ by 11 inches)• Etc.

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Form C Capital Improvements Equipment Discuss with TPCO FQHC Incubator Program staff prior to

submittal Submit application with purchase order that identifies equipment

to be purchased.

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Form C Salary Support Signed employment contract

• Staff credentials• Hours of employment• Location of employment• Description of duties• Line of authority (to whom does position report)• Compensation

• Management positions are considered only for FQHC Look Alikes and Category 3 applicants.

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Application SubmittalApplication Submittal

Mail paper copy to: Dept of State Health Services (DSHS) TX Primary Care Office (TPCO) Mail Code (MC) 1937 Attn: Connie Berry, Manager 1100 West 49th St P.O. Box 149347 Austin, TX 78714-9347

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Program Information/Application Program Information/Application Requirements/Contractor’s Procedure Requirements/Contractor’s Procedure

ManualManual

I FQHC Incubator Program Requirements

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ManualManual

Submission of new HRSA/BPHC Grant ApplicationDuring the term of an Incubator Contract, all contractors (Category 1, 2 & 3) must submit an application to HRSA/BPHC for:

New Access Point (NAP), Expanded Medical Capacity (EMC), and/or Service Expansion (oral, behavioral health, special populations, etc).

If no federal funding opportunity becomes available during the contract period, the FQHC Incubator Program contractor is expected to submit an application the following fiscal year regardless of existing FQHC Incubator Program contract status.

The FQHC Incubator program will offer funding for federal grant writing under another contracting opportunity.

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ManualManual

Category 3 contractors are expected to submit an FQHC Look Alike certification application upon meeting PIN 98-23 program expectations.

The goal of Category 3 funding is to assist the health care organization in meeting PIN 98-23 program expectations during the contract period. A specific date will be negotiated during contract development process.

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ManualManual

After a contractor has submitted a NAP, EMC, Service Expansion, and/or FQHC Look Alike application, DSHS requests that the following information be submitted:

BPHC application review response if not awarded funds; The BPHC request for additional information for FQHC

Look Alike application (see deliverables for more specific timeline information regarding the FQHC Look Alike application).

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ManualManual

If an FQHC Incubator Program contractor does not have an enhanced Medicaid/Medicare number and/or other reimbursement numbers the following information must be submitted to DSHS when asked:

a copy of its Medicare and Medicaid clinic enrollment application and/or enrollment for enhanced reimbursement;

monthly update in board minutes on communications with CMS and TMHP regarding status of application for Medicare and Medicaid.

Please note that DSHS will not approve payment for any deliverables if the requirements described above have not been met.

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ManualManual

Monthly Reporting Requirements All contractors awarded funds for capital improvements

(renovations and/or equipment) and/or salary support must complete and submit from the first month of the contract period until the end of the contract: Monthly Data Report; and, Secretary signed monthly board of directors’ minutes (including

attachments if appropriate) and financial statements.

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ManualManual

III Performance Measures/Monitoring

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Program Information/Application Program Information/Application Requirements/Contractor’s Procedure ManualRequirements/Contractor’s Procedure Manual

DSHS Site Visits and Program Monitoring On Site visits

• to ensure progress towards completion of deliverables• compliance with programmatic and fiscal requirements• contractors’ policies and procedures,• appropriate signage, etc.• review board minutes

TPCO staff will provide follow up documentation of visit findings to the contractor.

Concerns related to the contractor’s performance, specific communications (verbal, email and or hard copy letters) with the contractor will be initiated.

Note: Site visits will be scheduled at a time convenient to the contractor and may occur one or more times during the contract period.

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ManualManual

IV Deliverables Defined & Standards of Evidence of Completed Deliverables

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ManualManual

ReceiptsContracts for Consulting

Submit contract to TPCO for approval-compensation & timeline

Capital Improvements Receipts for equipment purchases & paid invoices for

contractors and Certificate of Occupancy (C of O)

Salary Support Various documents required for Provider, CMO, CEO, CFO and

Health Ctr Development Coordinator Monthly forms required

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Application/Process & Application/Process & ProceduresProcedures

Questions and Answers

Texas Primary Care Office FQHC Open Enrollment Training Fiscal Year (FY) 2010 Texas Primary Care...

Documents

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