1. Office of Performance Review (OPR) U.S. Department of Health and Human Services (DHHS) Health Resources and Services Administration (HRSA) Stephen Dorage Regional Coordinator July 28, 2008

2. 2 Office of Performance Review (OPR)

3. 3 OPR Mission To improve access to quality health care and reduce health disparities by effectively reviewing and enhancing the performance of HRSA-supported programs within communities and States.

4. 4 OPR Core Functions Improve the Performance of HRSA-Funded Programs Work Collaboratively with Grantees and HRSA Bureaus/Offices to Measure Program Performance Identify Effective Strategies and Partnerships to Improve Program Performance, with a Particular Focus on Outcomes Provide Feedback to the Agency about the Impact of HRSA Policies on Program Implementation and Performance within Communities and States.

5. 5 OPR Key Activities Grantee Performance Reviews State and Community Strategic Partnership Sessions Technical assistance Policy and Trends Report Environmental Snapshot

6. 6 Partnering to Serve HRSA Grantees HRSA Grantees OPRBureaus/Offices

7. 7 HRSA Funding HRSA provides over $6 billion in grants or cooperative agreements To over 3,000 organizations Through 80 different programs

8. 8 HRSA Grantees by Organization Type FoundationNational Association State government Local government Hospital University/College Community- based

9. 9 Purpose of Performance Reviews To improve the performance of HRSA-funded programs Provide direct feedback to the agency about the impact of HRSA policies on program implementation and performance

10. 10 Performance Review Benefits Improved grantee performance through: – Facilitated discussions – Sharing best practices – Expert consultation/technical assistance – Performance Improvement Action Plan Cross-Cutting feedback on HRSA policies Environmental surveillance

11. 11 Underlying Assumptions Most grantees are performing well Many solutions to issues/problems exist within an organization, or can be achieved through partnerships with others Working in collaboration with grantees and other HRSA staff will produce better outcomes and results Day-to-day grantee oversight responsibility remains with the Headquarters HRSA project officers and grants officers

12. 12 Performance Review Protocol Two categories of review recognize the diversity of HRSA programs Key Area Discussion captures important information about grantee performance directly or indirectly related to goals, objectives, or performance measures

13. 13 Performance Review: Category 1 Health services delivery activities and professional training programs with measurable data Reviews generally:  focus on the selected performance review measures  assess overall grantee performance

14. 14 Performance Review: Category 2 Professional training and public health infrastructure development grants that have outreach activities as the scope of the project limited project periods may have performance best assessed either by progress toward goals and objectives, or measures Reviews generally:  focus on the selected goals/objectives, priority areas, or measures  assess overall grantee performance

15. 15 Project Officer Role in Review Process Project Officers work collaboratively with OPR review teams throughout the Review Process Project Officer participation may include, but is not limited to:  consulting with review teams during the Pre-Site Preparation  advising on the selection of measures and/or goals and objectives  participating in on-site visit  reviewing Performance Review Report and Action Plan  following up with grantee on progress made on Action Plan

16. 16 Performance Review Components 2 Performance Analysis 4 Action Plan 1 Program Performance 3 Performance Report

17. 17 Performance Review Timeline Week 1-8 - Pre-Site Visit Review of Key Grantee Materials and Pre- Site Consultation with Grantee, HRSA Project Officer(s) and Other Appropriate HRSA Staff Week 9 - Site Visit (scheduled at least 12 weeks in advance) Week 13- Draft Performance Report sent to grantee with request for feedback and an Action Plan Week 15 - Grantee submits Action Plan and feedback on Draft Performance Report to OPR and Project Officer Week 18 – Final Performance Report and approved Action Plan sent to grantee and distributed within HRSA for Follow-up Actions/Technical Assistance

18. 18 Phases of Performance Review Pre-Site Preparation On-Site Visit Post-Site Action Plan Follow-Up

19. 19 Pre-Site Preparation Identify program performance measures, or goals and objectives – Program reporting requirements – Grantee goals/objectives in the grant application – HRSA’s GPRA program measures Determine: – How is the grantee performing on these measures, or goals and objectives? – Is there a gap between current and desired performance?

20. 20 On-Site Visit Average 2 to 3 day site visit with review team of 2-4 members Identify the factors contributing to/restricting performance – Internal systems and processes – External issues, including HRSA policies – Partnerships – critical for most outcome measures Identify best/promising practices Discuss possible Performance Improvement Options and Action Plan development

21. 21 Post-Site Prepare Performance Report and share draft with the grantee, project officer(s), and other HRSA staff for feedback and comments Request Action Plan from grantee that addresses: – Performance Improvement Options – Program Requirements Review the grantee’s Action Plan submission and provides feedback, as appropriate Finalize & disseminate Performance Report and Action Plan

22. 22 Action Plan Follow-Up Program requirement issues will be reviewed by the Project Officer(s) in consultation with the grantee TA requests that support Action Items will be shared with Bureau/Office for concurrence Project Officer(s) and Review Team will follow up with grantee on progress on Action Plan Grantees will include updates on Action Plan progress as part of regular program progress reporting to Project Officer

23. 23 Questions

24. 24 THANK YOU Stephen Dorage Atlanta Regional Division Office of Performance Review sdorage@hrsa.gov or (404) 562-4127 For further information, please view our website: http://www.hrsa.gov/performancereview