1. Federally Qualified Health Center Look-Alike Program Implementation of Electronic Annual Data Reporting Program Assistance Letter (PAL) 2011-10 Look-Alike Technical Assistance (TA) Page: http://bphc.hrsa.gov/about/lookalike/index.htmlhttp://bphc.hrsa.gov/about/lookalike/index.html

2. Overview In an effort to enhance the Federally Qualified Health Center (FQHC) Look-Alike Program, HRSA is establishing electronic application and data reporting processes. Program Assistance Letter (PAL) 2011-08 has been issued to communicate important information and upcoming dates related to these processes. Beginning in January 2012 FQHC Look-Alikes will be required to submit certain data to HRSA through the HRSA Electronic Handbooks (EHB) rather than through paper applications. 2

3. Benefits One centralized system for monitoring, tracking performance, and recording Program changes. Streamlined and simplified data reporting processes through integration into the HRSA EHB. Reporting requirements will be similar to existing data requirements in the current Look-Alike application guidance. 3

4. Agenda Data Requirements Data Submission Timelines Data Reporting Manual Technical Assistance Information Question & Answer Session 4

5. Data Requirements Zip code Patients by Age and Gender Patients by Race Ethnicity/Language Selected Patient Characteristics Staffing and Utilization Quality of Care Indicators Health Outcomes and Disparities Financial Costs Patient Related Revenue Other Revenues Electronic Health Records Information 5 Types of data collected:

6. Example 1: Paper-to-Electronic Reporting This form reported the number of total patients by appropriate categories for age and gender. This form is an electronic version of the paper form and reports the number of patients by appropriate categories for age and gender. 6 Paper Application Table 3AElectronic Table 3A

7. Example 2: Paper-to-Electronic Reporting The form projected program income, by source, for the first year of the project period. These tables collect information on charges, collections, retroactive settlements, allowances, self-pay sliding discounts, and self-pay bad debt write-off. Look-Alikes will only report selected total patient revenues, grants and contracts. 7 Paper Application Form 3Electronic Tables 9D & 9E

8. Data Submission Timelines FQHC Look-Alikes will be required to report data for calendar year (CY) 2011 commencing in January 2012. From January 1, 2012 through February 15, 2012, FQHC Look-Alikes will be able to enter and make changes as needed to this data. 8

9. Data Reporting Manual HRSA will issue a FQHC Look-Alike electronic data reporting manual in fall 2011 as an addendum to the manual created for the CY 2011 UDS data reporting under the Health Center Program. FQHC Look-Alike data submission will be similar to the Health Center Program’s Uniform Data System (UDS) reporting within HRSA’s EHB. 9

10. Technical Assistance HRSA will conduct technical assistance conference calls to discuss trainings specific to data requirements, the EHB reporting system, and reporting processes. Visit the FQHC Look-Alike Program technical assistance (TA) webpage at http://bphc.hrsa.gov/about/lookalike for announcements of upcoming conference calls and TA materials.http://bphc.hrsa.gov/about/lookalike Visit the Reporting and Technical Assistance webpage at http://bphc.hrsa.gov/healthcenterdatastatistics/reporting/for more details on the data and the electronic system currently used for the Health Center Program. http://bphc.hrsa.gov/healthcenterdatastatistics/reporting/ 10

11. Technical Assistance Program Contacts –Nicole Amado –FQHCLAL@hrsa.gov or 301-594-4300FQHCLAL@hrsa.gov FQHC Look-Alike Program TA Webpage –http://bphc.hrsa.gov/about/lookalike/index.htmlhttp://bphc.hrsa.gov/about/lookalike/index.html 11

12. Question & Answer Session Please note: HRSA will hold technical assistance conference calls in the near future to discuss detailed elements of the FQHC Look-Alike data reporting instructions and processes. Please reserve questions related to those topics for those specific conference calls. Thank you! 12