Site Visit Protocol Update, Oral Health Initiative, and More! HRSA PHC Digest

A Newsletter from the Health Resources & Services Administration (HRSA)

HRSA BPHC Primary Health Care Digest

March 26, 2019

News

2019 Site Visit Protocol Update Now Available for Preview
HRSA has updated the Site Visit Protocol (SVP) in response to feedback from stakeholders, including health centers, strategic partners, site visit team reviewers, and HRSA staff. No changes were made to the Compliance Manual or to Health Center Program requirements.

The 2019 SVP Update is now available for public preview. It will go into effect for site visits that start after Thursday, April 18.

As part of HRSA’s commitment to continuous quality improvement, the updated SVP increases clarity and continues to provide HRSA the information necessary to perform its oversight responsibilities using a standard and transparent methodology that aligns with the Compliance Manual. Check out the summary of the changes and 2019 SVP Update Frequently Asked Questions.


Dental Chair

New Funding Opportunity: Oral Health Infrastructure
On Friday, March 22, HRSA announced the availability of $76 million in one-time supplemental funding for Oral Health Infrastructure (OHI) to support health center infrastructure enhancements. These investments will increase access to new or enhanced high-quality, integrated oral health services, including those provided via telehealth and virtual dentistry.

Applications are due in Grants.gov by Monday, April 22 (11:59 p.m. ET) and HRSA’s Electronic Handbooks (EHBs) by Tuesday, May 21 (5:00 p.m. ET).

For more information:

If you have questions, contact the OHI TA team.


Service Area Competition-Additional Area for Pago Pago, American Samoa
Applications for HRSA-19-110, the Service Area Competition-Additional Area (SAC-AA) funding opportunity for the Pago Pago, American Samoa service area, are due in Grants.gov by 11:59 p.m. ET on Thursday, April 11, and in EHBs by 5:00 p.m. ET on Thursday, May 9. TA materials are available on the SAC-AA TA website.


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Jump To:  Substance Use Disorder & Behavioral Health  |  HIV  |  Diabetes  |  Workforce  | 
                Oral Health  |  Additional Resources


What's New 

Visit HRSA Booth 513

Meet Us at the NACHC P&I Forum!
If you’re attending the National Association of Community Health Centers (NACHC) P&I Forum, please stop by the HRSA booth on Friday, March 29—booth 513 on the back wall of the exhibit hall. Health Center Program Support staff and representatives from our Loan Guarantee Program will be there to answer your questions.

Staff from the National Practitioner Data Bank will be at booth 506 to share this valuable tool that prevents providers from moving across state lines without disclosure or discovery of previous damaging performance.

HRSA Administrator George Sigounas, MS, Ph.D., will provide the Federal Update on Friday, March 29. HRSA Associate Administrator Jim Macrae and Health Center Program senior staff will provide updates on policy and quality developments, as well as what’s new with operational site visits. Check out the full conference schedule for more information.


NACHC P&I Session: Could the HRSA Loan Guarantee Program Benefit Your Health Center?
We encourage those attending the NACHC P&I Forum to come hear the details regarding the HRSA Health Center Facility Loan Guarantee Program, a newly-launched, greatly expanded program to assist health centers with their capital needs. Capital Link, a HRSA-funded National Cooperative Agreement (NCA), will host two informal sessions:

Thursday, March 28
9:00-10:00 a.m. ET
Park Tower Room 8210
Presenter: Allison Coleman, CEO Capital Link

Thursday, March 28
3:00-4:00 p.m. ET
Park Tower Room 8210
Presenter: Jonathan Chapman, Director of CHC Advisory Services, Capital Link


2019 Uniform Data System Approved Program Assistance Letter Released
HRSA has released the Program Assistance Letter (PAL) to highlight approved changes to the Uniform Data System (UDS) for calendar year 2019. The approved changes in this PAL include:

  • Updating quality of care measures to align with CMS electronic-specified clinical quality measures (eCQMs)
  • Adding mental health and substance use disorder tables by provider
  • Adding a column in Table 5: Staffing and utilization to capture virtual visits
  • Removing Table 5A: Tenure for health center staff
  • Replacing coronary artery disease measure with statin therapy for the prevention and treatment of cardiovascular disease
  • Revising Appendix D: Health center electronic health record capabilities and quality recognition
  • Adding Appendix F: Workforce

Health Center Program awardees and look-alikes will use the reporting changes detailed in the PAL for reporting data beginning January 1, 2020. The 2019 UDS Manual, which we expect to release this spring, will include additional details regarding these changes.


Now Available: New Access Points Application TA Videos
New TA videos are available to help you complete your New Access Points (NAP) application forms—SF-424, Form 1A, Form 1B, and Performance Measures. Also available is an animated video demonstrating how to use the Unmet Need Score Workbook. NAP applications are due in EHBs by Thursday, April 11 (5:00 p.m. ET). See the NAP TA webpage for additional TA resources.

NAP TA Webinars

2019 Patient Target EHBs Notification to Health Centers
Last week, HRSA began sending a tailored email from EHBs to each Health Center Program award recipient with a direct link to the patient target in EHBs. The Program Director should review the patient target and take appropriate action in EHBs by Friday, April 19. Email BPHCPatientTargets@hrsa.gov with questions. A recorded walk-through of the EHBs Patient Target Management Module and Patient Target Frequently Asked Questions are available on the SAC TA web site.


Quarterly 340B Program Registration
Quarterly 340B Program site registration is open from April 1 to 15. Health centers are still able to register a site that has been verified as implemented and with a site status reflected as “active” in EHBs Form 5B through Friday, May 24, after which the system will close to prepare for the July 1 start. Email the 340B call center or call 888-340-2787 (Monday-Friday, 9:00 a.m.-6:00 p.m. ET) to register a new site or ask questions.

You will need to provide the following information when calling:

  • Health center name,
  • Site/clinic name,
  • Site IDs for all sites,
  • HRSA/BPHC grant number,
  • Contact name and email address, and
  • Authorizing official name and email address.

The authorizing official will receive an email message that the account is unlocked and a registration may be submitted.


Million Hearts Hypertension Control Challenge Now Open

Final Week – Become a 2019 Million Hearts® Hypertension Control Champion
Next Monday, April 1, is the deadline for applications to the Million Hearts® Hypertension Control Champion Challenge. We encourage all eligible health centers to complete the application.

The Million Hearts® Hypertension Control Challenge is a competition to identify clinicians, practices, and health systems that have demonstrated exceptional achievements in working with their patients to control hypertension. Champions will have achieved at least 80% blood pressure control (blood pressure reading <140 mmHg/<90 mmHg) among their hypertensive population aged 18 to 85.

Last month HRSA hosted a webinar featuring three 2018 Million Hearts® Hypertension Control Champions sharing their best practices. Watch it now to learn how they did it.


Patient Safety Pictures

Health Centers Keep Patients Safe By…
March 10-16 was Patient Safety Week. As part of the observance, HRSA asked health center staff to think about how they keep patients safe and snap a photo of themselves holding a sign reflecting their thoughts. This collage is just a handful of the many photo submissions we received. You can view all the photos on Flickr (not supported in Internet Explorer). Thank you to all who participated!


SUD-MH Tri-Annual Progress Reporting TA Office Hours
If you received fiscal year (FY) 2018 Substance Use Disorder and Mental Health (SUD-MH) Services supplemental funding, HRSA will hold SUD-MH Progress Reporting TA office hours to provide updates and reminders for the next report submission and answer questions about reporting requirements. Visit the TA website for other resources.

Wednesday, April 10
2:00-3:30 p.m. ET
Join the webcast the day of the session
Call-in: 888-233-9404
Passcode: 3415759


Review Process for SAC or Renewal of Designation Applications
A few months ago, HRSA created this graphic, which illustrates what to expect after submitting a SAC or Renewal of Designation (RD) application to HRSA. Take a look to learn more about the updated HRSA review process.

A new quick reference guide explains how SAC and RD applicants should manage correspondence requests from HRSA about their application. It will help you respond quickly to the EHBs correspondence request within the 14-day turnaround time.

For more details, check out our FY 2019 SAC and RD application and review award process Frequently Asked Questions.


Rural Communities Opioid Response Program Notice of Funding Opportunity
HRSA released the Rural Communities Opioid Response Program (RCORP) notice of funding opportunity for a new initiative called RCORP-Implementation. HRSA will make approximately 75 awards of up to $1 million each to networks and/or consortia to enhance SUD service delivery in high-risk rural communities, including services for opioid use disorder (OUD). Over a three-year period, RCORP-Implementation grant recipients will implement a set of core SUD/OUD prevention, treatment, and recovery activities that align with HHS’ Five-Point Strategy to Combat the Opioid Crisis. Grant recipients are strongly encouraged to leverage workforce recruitment and retention programs like the National Health Service Corps. Applications are due by Monday, May 6, in Grants.gov.

Learn more at an upcoming webinar:
Wednesday, March 27
11:30 a.m.-1:00 p.m. ET
Join the webcast the day of the session


CMS Strengthens Monitoring and Evaluation Expectations for Medicaid 1115 Demonstrations
CMS recently released new state tools that provide standard monitoring metrics and recommended research methods geared specifically for section 1115 demonstrations that test innovative approaches to Medicaid eligibility and coverage policies.


Substance Use Disorder & Behavioral Health

Improving Opioid Misuse Prevention Literacy Between Older Adults and Health Care Providers
Research suggests that substance use, especially opioid misuse, is a growing public health issue among the nation's older adults. This webinar will feature a discussion regarding effective prevention strategies and approaches for improving understanding and dialogue between older patients and their health care providers about opioid use.

Thursday, March 28
2:00-3:30 p.m. ET
Register here


Opioid Use Disorder: The Role of Adverse Childhood Events and Motivational Interviewing
The detrimental effects of opioid use disorder (OUD) have been well described over the past 10 years, and primary care providers have an important role to play in addressing and treating OUD. HRSA will host a webinar to provide actionable information for all members of the primary care clinic team on adverse childhood events (ACEs), the impact on and association with OUD, and how identifying ACEs provides a foundation for trauma-informed care. Additionally, we will address techniques for motivational interviewing with evidence-based literature supporting approaches for OUD. Finally, we will review case studies derived from practice for discussion of practical interventions.

Thursday, April 4
3:00-4:00 p.m. ET
Register here


FY 2018 SUD-MH Office Hours
See reminder above.


Rural Communities Opioid Response Program Notice of Funding Opportunity
See announcement above.


Opioid Workforce Expansion Program – Professionals and Paraprofessionals
HRSA is accepting applications for the FY 2019 Opioid Workforce Expansion Program (OWEP) Professionals and Paraprofessionals funding opportunities. Apply on Grants.gov by Tuesday, May 7.

The OWEP for Professionals’ purpose is to build upon existing HRSA investments to enhance community-based experiential training focused on OUD and other SUD for students preparing to become behavioral health professionals. The OWEP for Paraprofessionals funds this same training for peer support specialists and other types of behavioral health-related paraprofessionals.

HRSA anticipates awarding $39.3 million for approximately 29 OWEP for Professionals awards and $29.8 million to fund about 33 OWEP for Paraprofessionals awards.


HIV

Nurse Consultant for HRSA’s HIV/AIDS Bureau
The HIV/AIDS Bureau’s Division of Community HIV/AIDS Programs, which works with Part C and D funded clinics, is hiring a Nurse Consultant with experience in clinical HIV care to provide specific focus on advising and consulting in regards to the HIV care and treatment of people living with HIV. Apply by Friday, April 5.


Vital Signs: Ending the HIV Epidemic
CDC’s recent Vital Signs focuses on ending the HIV epidemic, emphasizing how providers can reduce new infections by encouraging testing and conducting prevention education.


Save the Dates: Oral Health and Primary Care Integration for People Living with HIV
HRSA will host a two-part webinar series on oral health and primary care integration to support people living with HIV. The strategies we will cover are designed for all HRSA recipients serving people living with HIV regardless of whether the organizations deliver oral health care directly, refer out for all services, or are somewhere in between. We’ll share registration information when it becomes available.

  • Assessing Risk and Providing Basic Services at Primary Care Settings
    This webinar will focus on assessing risk and providing basic oral health services for people living with HIV. We’ll also discuss a new HIV Oral Health and Primary Care Toolkit.

    Thursday, May 23
    2:00-3:00 p.m. ET
  • Connecting Clients to Oral Health Services
    We will walk through the components of oral health and primary care integration and will highlight best practices and challenges for developing and maintaining a dental referral network, making referrals, dental patient navigation, and communicating data effectively between primary care and oral health settings.

    Thursday, June 6
    2:00-3:00 p.m. ET

Diabetes

Today is Diabetes Alert Day
Don’t miss this opportunity to improve your health center’s diabetes prevention and testing efforts. Health center staff can play a key role in helping patients prevent diabetes.

An astonishing 7.2 million Americans have diabetes but do not know it. Start by encouraging patients to take a free online diabetes risk test available from NIH.

Health centers can take various approaches to the challenges of undiagnosed diabetes and prediabetes. For example, Health Partners of Western Ohio launched a successful program to identify high-risk patients and offer education and interventions to prevent diabetes. Health centers can also offer diabetes testing at a minimum of annually or more frequently based on patient risk.

HRSA encourages clinicians to become familiar with the American Diabetes Association’s standards of care regarding prevention of type 2 diabetes. The CDC offers fact sheets to help patients learn more about diabetes, its prevention, and management. HRSA’s Diabetes Quality Improvement webpage offers additional resources, promising practices, and information about how to improve patient diabetes control.


Diabetes in Special & Vulnerable Populations: A National Learning Series
Fourteen HRSA-funded NCAs partnered to create a four-part national learning webinar series for health centers, Primary Care Associations (PCAs), and Health Center Controlled Networks (HCCNs). The series’ goal is to increase foundational knowledge of effective strategies to prevent, treat, and manage diabetes among special and vulnerable Health Center Program populations. It focuses on co-morbidities associated with diabetes (e.g., oral health, behavioral health, SUD, obesity, and social risk factors).

The series kicked off last week and this is the next session:

Diabetes Continuum of Care: Using Behavioral Health and Substance Use Disorder Integration to Address Older Adults with Cognitive Impairments and Diabetes
Tuesday, April 9
2:00-3:30 p.m. ET

Learn more and register for individual webinars.


Workforce

Opioid Workforce Expansion Program
See the announcement above.


Oral Health

Save the Dates: Oral Health and Primary Care Integration for People Living with HIV
See information above about this upcoming HRSA webinar series.


Infection Prevention and Control in Dental Settings Webinar Recording
HRSA and CDC recently hosted a webinar focusing on infection prevention and control for dental settings. Watch the recording. Speakers reviewed recent documented transmission of infectious agents in dental settings and discussed the implications, as well as standard precautions (emphasis on sterilization and disinfection of patient care items and devices). They also shared infection prevention and control resources designed to increase adherence with existing recommendations.


Additional Resources

Gordon Schiff

Patient Safety Presentation Available Online
HRSA Bureau of Primary Health Care Associate Administrator Jim Macrae spoke at HRSA's 7th annual Patient Safety Week observance, saying "we take (this) very seriously."

One in 20 primary care patients have a health problem misdiagnosed every year – and 41 percent say in surveys that their clinicians have gotten it wrong at least once – Harvard University expert Dr. Gordon Schiff (pictured) reported last week in an address during Patient Safety Awareness Week.

This, said Dr. Schiff, "means to me from a safety point of view … there's preventable things happening (that) are harder and harder to defend."

View the full event recording.


Cervical Cancer Screening Promising Practices Webinar Recording
Earlier this year, HRSA hosted a webinar highlighting promising practices, challenges, and recommendations to increase cervical cancer screenings from a health center and a HCCN. Speakers shared TA activities targeting health centers' cervical cancer screening quality improvement strategies including patient navigation, care coordination, and data transparency. Access the webinar recording and presentation.


Apply Now to the SDOH Academy Learning Collaborative: Leveraging Medicaid to Address SDOH
The SDOH Academy is conducting a series of learning collaboratives for small cohorts of health centers, HCCNs, and PCAs. Leveraging Medicaid Policies to Address SDOH is an opportunity to explore how your organization can use emerging Medicaid payment innovations to develop, launch, and sustain activities that address patients’ SDOHs. Apply by 5:00 p.m. ET on Thursday, March 28. As there is limited space, applications will be accepted on a first-come, first-served basis.


AHRQ’s New Question Builder App Helps Patients Prepare for Medical Visits
AHRQ recently launched a new mobile app to help patients be more engaged in their own health care. The Question Builder app, available at no charge for smartphones, tablets, and laptop computers on iTunes and Google Play, helps patients prepare and organize questions and other helpful information prior to medical visits. Learn more.


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Technical Assistance & Training

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Visit the training calendar to learn details about or register for events.

Through April 2

Virtual Training Series - Her Health, Her Housing: Improving Services for Women Experiencing Homelessness
Hosted by The National Health Care for the Homeless Council, a HRSA-funded NCA
Wednesday, March 27,
and Thursday, March 28
1:00-2:00 p.m. ET
**1.0 CME credit** per session
Register here for the series

Improving Opioid Misuse Prevention Literacy Between Older Adults and Health Care Providers
Hosted by SAMHSA
Thursday, March 28
2:00-3:30 p.m. ET
Register here

Migratory and Seasonal Agricultural Worker Registration and UDS Reporting
Hosted by the National Center for Farmworker Health, a HRSA-funded NCA
Thursday, March 28
2:30-3:30 p.m. ET
Register here


UPCOMING

Opioid Use Disorder: The Role of Adverse Childhood Events and Motivational Interviewing
Hosted by HRSA
Thursday, April 4
3:00-4:00 p.m. ET
Register here

Diabetes Continuum of Care: Using Behavioral Health and Substance Use Disorder Integration to Address Older Adults with Cognitive Impairments and Diabetes
Part of the Diabetes in Special & Vulnerable Populations National Learning Series
Hosted by multiple HRSA-funded NCAs
Tuesday, April 9
2:00-3:30 p.m. ET
Register here

SUD-MH Tri-Annual Progress Reporting TA Office Hours
Hosted by HRSA
Wednesday, April 10
2:00-3:30 p.m. ET
Join the webcast the day of the session
Call-in: 888-233-9404
Passcode: 3415759

Fundamentals of Health Center Dental Programs for Non-Clinicians: Financials
Hosted by the National Network for Oral Health Access (NNOHA), a HRSA-funded NCA
Thursday, April 18
1:00-2:00 p.m. ET
Register here
**1.0 CDE credit**

Diabetes Continuum of Care: Using Health Promotion/Behavior Change to Address Childhood and Adult Obesity and Diabetes
Part of the Diabetes in Special & Vulnerable Populations National Learning Series
Hosted by multiple HRSA-funded NCAs
Thursday, April 18
2:00-3:30 p.m. ET
Register here

Diabetes Continuum of Care: Using the CHW and Enabling Services Workforce to Address SDOH and Diabetes
Part of the Diabetes in Special & Vulnerable Populations National Learning Series
Hosted by multiple HRSA-funded NCAs
Tuesday, April 23
2:00-3:30 p.m. ET
Register here

Oral Health for Patients with Developmental Disabilities
Hosted by NNOHA, a HRSA-funded NCA
Tuesday, April 30
4:00-5:00 p.m. ET
Register here
**1.0 CDE credit**

Assessing Risk and Providing Basic Services at Primary Care Settings
Part of HRSA’s Oral Health and Primary Care Integration for People Living with HIV Webinar Series
Thursday, May 23
2:00-3:00 p.m. ET
Registration information coming soon

Connecting Clients to Oral Health Services
Part of HRSA’s Oral Health and Primary Care Integration for People Living with HIV Webinar Series
Thursday, June 6
2:00-3:00 p.m. ET
Registration information coming soon