1. Texas Primary Care Office FQHC Open Enrollment Training Fiscal Year (FY) 2010 Texas Primary Care Office (TPCO) Federally Qualified Health Clinic (FQHC) Incubator Program July 27, 2009

2. Texas Primary Care Office 2 Agenda TX Primary Care OfficeBerry FQHC Incubator Program Open Enrollment ApplicationMartin Program Information, Application Requirements & Contractors Procedure Manual Program RequirementsSoper Performance Measures/MonitoringKey Deliverables Defined & CompletedGibbons

3. Texas Primary Care Office 3 Agenda General ProvisionsYoung Client Services Contracting Unit Walk Contractors Financial COS Procedures Manual Questions and Answers

4. Texas Primary Care Office 4 Introduction/ TPCO Overview Introduce TPCO programs-Connie Berry, TPCO Manager 81 st Legislative Overview FQHC Incubator Program Successes Future-Primary and Behavioral Health Care Special Initiative Introduce FQHC Incubator Program Staff Review Agenda

5. Texas Primary Care Office 5 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

6. Texas Primary Care Office 6 Application/Eligibility Category 1-FQHCs Category 2-FQHC Look Alikes Category 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

7. Texas Primary Care Office 7 Application/Program Limitations Public entity or 501(c)(3) nonprofit organization DSHS Performance Measures Requested amount not guaranteed No supplantation Funds used for purpose of FQHC Incubator Program Funds to open new primary care health clinic & meet program expectations of defined in PIN 98- 23

8. Texas Primary Care Office 8 Application/Program Limitations 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

9. Texas Primary Care Office 9 Application/Process & Procedures Read FQHC Incubator Program Information Application Requirements & Contractors Procedures Manual. 60 calendar days to process application

10. Texas Primary Care Office 10 Application /Forms/Attachments Form A Face Page Form B Table of Contents Form C 1, C 2, C 3, or C 4 Technical Assistance Deliverables Development Deliverables Capital Improvements (renovations & equipment) Salary Support

11. Texas Primary Care Office 11 Application /Forms/Attachments Category 1 FQHCs-NGA and Update on Conditions Category 2 FQHC LAs-Letter of Certification from BPHC

12. Texas Primary Care Office 12 Application /Forms/Attachments 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)

13. Texas Primary Care Office 13 Application /Forms/Attachments 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

14. Texas Primary Care Office 14 Application /Forms/Attachments 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

15. Texas Primary Care Office 15 Application /Forms/Attachments 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.

16. Texas Primary Care Office 16 Application /Forms/Attachments 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.

17. Texas Primary Care Office 17 Application /Forms/Attachments 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.

18. Texas Primary Care Office 18 Application 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 49 th St P.O. Box 149347 Austin, TX 78714-9347

19. Texas Primary Care Office 19 Program Information/Application Requirements/Contractors Procedure Manual I FQHC Incubator Program Requirements

20. Texas Primary Care Office 20 Program Information/Application Requirements/Contractors Procedure Manual Submission of new HRSA/BPHC Grant Application During 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.

21. Texas Primary Care Office 21 Program Information/Application Requirements/Contractors Procedure Manual 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.

22. Texas Primary Care Office 22 Program Information/Application Requirements/Contractors Procedure Manual 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).

23. Texas Primary Care Office 23 Program Information/Application Requirements/Contractors Procedure Manual 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.

24. Texas Primary Care Office 24 Program Information/Application Requirements/Contractors Procedure Manual 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.

25. Texas Primary Care Office 25 Program Information/Application Requirements/Contractors Procedure Manual III Performance Measures/Monitoring

26. Texas Primary Care Office 26 Program Information/Application Requirements/Contractors 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 contractors 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.

27. Texas Primary Care Office 27 Program Information/Application Requirements/Contractors Procedure Manual IV Deliverables Defined & Standards of Evidence of Completed Deliverables

28. Texas Primary Care Office 28 Program Information/Application Requirements/Contractors Procedure Manual Receipts Contracts 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

29. Texas Primary Care Office 29 Application/Process & Procedures Questions and Answers