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This Program Assistance Letter (PAL) amends Policy Information Notice (PIN) 2002-23 for guidance on deeming requirements for section 330 grantees (Health Centers) deemed under the Federally Supported Health Centers Assistance Act (FSHCAA) of 1992 and the FSHCAA of 1995. This guidance sets out procedures for deeming for calendar year (CY) 2008 ONLY.
The Federal Tort Claims Act (FTCA) coverage for eligible health centers was initially established through the FSHCAA of 1992 (Public Law 102-501) by amending section 224 of the Public Health Service Act. The eligible entities ("Health Centers") are Community Health Centers , Migrant Health Centers , Health Care for the Homeless, and Public Housing Primary Care grantees. The FSHCAA of 1995, signed into law by the President on December 26, 1995, clarified the 1992 Act and eliminated its sunset provision, making the program permanent.
Effective October 1, 2002, PIN 2002-23 instructed all deemed health centers to reapply for malpractice protection under FSHCAA every year, beginning with budget periods starting on or after October 1, 2002. HRSA's goal is to redesign the deeming process in stages, and this document will address the first stage of this process. The first step is to separate the deeming process from the grant cycle, which will result in some grantees having to re-submit their deeming application in 2007. This process of separating the two applications is consistent with current FTCA statute and will enable us to provide increased technical support and assistance to health center grantees. We regret any inconvenience this may cause you. We also recognize that grantees may have questions while we transition to this new process and encourage the use of the free FTCA help line, 1-866-FTCA-HELP, to answer any questions regarding the new process. This PAL contains the instructions for filing original and renewal deeming applications for calendar year 2008.
The FSHCAA of 1995 requires all health centers to apply for deemed status in order for FTCA coverage to apply. Health centers that have never been deemed can submit their application at any time during the year, and HRSA will act upon the application within 30 days.
In order to be deemed for calendar year 2008, all currently deemed health centers must file a renewal deeming application no later than July 1, 2007. HRSA will announce in future guidance the permanent application process that will come into effect in 2008 for CY 2009 and beyond.
Grantees are strongly encouraged to submit deeming applications (renewal and original) electronically as a PDF file to the following e-mail address bphcftcaredeeming@hrsa.gov . In the e-mail subject line please note whether you are submitting an original deeming application or a redeeming application; UDS number; the State; and whether you are a sub-recipient or co-applicant (when applicable). If not submitting electronically, grantees may also submit deeming applications by Federal Express or certified mail to the following address:
HRSA Health Center FTCA Program
Attn: Redeeming Application Coordinator
Bureau of Primary Health Care, HRSA
5600 Fishers Lane , Mailstop 17C-26
Rockville, MD 20857
Telephone: 301-594-2469
Fax: 301-594-5224
Applications for original deeming and annual renewal must include the following documents:
- Application (Signed by both the Executive Director and Medical Director);
- A copy of your Quality Improvement/Assurance Plan, with a notation indicating when it was approved by the Board of Directors;
- A statement on health center letterhead that is signed by the Executive Director describing any pending medical malpractice claims;
- A staff list which includes all LICENSED or CERTIFIED heath care workers which includes the following (per PIN 2002-22):
- Name and Title
- Professional Designation (e.g., MD, RN, CNM)
- Specialty
- Status (FTE/PTE/Contractor and/or Volunteer)
- Hire Date
- Initial Credentialing Date
- Current Credentialing Date
- Next Expected Credentialing Date; and
- This application must be completed by each sub-recipient and sub-grantee that is currently deemed under FTCA.
If you have any questions, please contact:
1-866-FTCA-HELP (toll free) - 9:00 A.M. to 8:00 P.M. (EST)
866-382-2435
Tritongp@optonline.net
APPLICATION FOR
For Medical/Dental Professional Liability Protection
FEDERAL TORT CLAIMS ACT
SECTION I - APPLICANT INFORMATION |
GRANTEE NAME:
DBA Name (if appropriate):
UDS #: |
Community Health Sub-Grantee
Migrant Health Co-Applicant
Health Care for the Homeless Sub-Recipient
Health Care for Residents of Public Housing
Other - Please Describe
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ADDRESS:
E-mail address:
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TELEPHONE #: FAX #: |
EXECUTIVE DIRECTOR: Telephone Number: |
MEDICAL DIRECTOR: Telephone Number: |
SECTION II - CREDENTIALING SYSTEM |
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Answer YES or NO to the following questions by marking the appropriate box. "NO" answers require explanation on a separate sheet |
YES |
NO |
Is professional educational background and postgraduate training verified? |
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Is primary source verification of licensure, certification, and/or registration performed? |
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Is board certification verified for physicians? |
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Is a copy of current licensure, certification, and/or registration on file? |
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Is a copy of hospital privileges on file, if applicable? |
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Are professional references obtained and reviewed? |
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Is a history of previous malpractice liability claims and adverse actions reviewed? |
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Are health care practitioners required to submit a personal statement or other evidence of health fitness at the time of credentialing? |
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Is the Health Center involved in peer review activities? |
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If Yes, is it a formal process?
(Formal means written procedures on peer review activities are formally adopted by the governing body and provide for adequate notice and opportunity for a fair hearing on any adverse recommendations.) |
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Is the National Practitioner Databank queried in credentialing your health care practitioners? |
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SECTION III - RISK MANAGEMENT POLICIES/PROCEDURES |
Answer Yes or NO to the following questions by marking the appropriate box. NO answers require explanation on a separate sheet. |
YES |
NO |
Are there policies/procedures on the appropriate supervision and back-up of clinical staff? |
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Is a medical record maintained for every patient receiving care at the Health Center ? |
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Are there policies/procedures that address triage, walk-in patients, and telephone triage? |
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Are there clinical protocols that define appropriate treatment and diagnostic procedures for selected medical conditions? |
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Is there a tracking system for patients who require follow-up of specialty referrals, hospitalization, x-ray, and lab results? |
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Are medical records periodically reviewed to determine quality, completeness, and legibility? |
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Is there a written Quality Improvement/Assurance Plan approved by the governing body? If yes, attach a copy of the most recent Quality Improvement/Assurance Plan with the approval date noted. |
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Are quality improvement/assurance findings used to modify policies/procedures in order to improve quality of care? |
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SECTION IV - SERVICES TO NON-HEALTH CENTER PATIENTS |
Are services provided to non Health Center patients? If yes, check all that apply based on the examples listed in the Federal Register Notice (Vol. 60, pages 49417-18) issued September 25, 1995.
COMMUNITY-WIDE INTERVENTIONS
School-based clinics
School-linked clinics
Health Fairs
Immunization Campaign
Outreach
HOSPITAL-RELATED ACTIVITIES
Hospital call as required for privileges
Emergency Room coverage as required for privileges
COVERAGE-RELATED ACTIVITIES
Cross-coverage with community providers
If the services do not appear to fall under the examples cited, then the Health Center should submit a separate request to the Director, BPHC, for a determination of the applicability of FTCA coverage as outlined in Section V of this BPHC PIN.
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SECTION V - SIGNATURES |
Requested Effective Date of FTCA Coverage:
(FOR ORIGINAL DEEMING ONLY) |
EXECUTIVE DIRECTOR NAME:
(Print or Type) |
SIGNATURE:
DATE: |
MEDICAL DIRECTOR NAME:
(Print or Type) |
SIGNATURE:
DATE: |
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