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In this Program Assistance Letter, the Health
Resources and Services Administration (HRSA)
is providing information on the changes to the
Uniform Data System (UDS) for calendar year
(CY) 2008. These changes include:
- modifications to UDS tables and data elements;
- the addition of a limited set of clinical
measures to be reported by Health Center Program
grantees;
- a new process for the electronic submission
of UDS reports; and
- an updated schedule of training sessions
on UDS clinical measures and administrative
and system components.
HRSA collects data annually from section 330
funded health centers through the UDS. The data
are analyzed to ensure compliance with legislative
mandates and report program accomplishments.
The data identify trends over time, enabling
HRSA to establish or expand targeted programs
and identify effective services and interventions
to improve the health of underserved communities
and vulnerable populations. UDS data are compared
with national data to examine differences between
the U.S. population at large and those individuals
and families who rely on the health center safety
net for primary care services. UDS data also
inform Health Center Program grantees, partners
and communities about health centers and their
patients.
Beginning with the CY 2008 UDS report submitted
March 2, 2009, the following changes will be
implemented. While most involve reporting on
data that grantees are already collecting, grantees
should check their information systems against
this list to ensure that they will be able to
report the required data in 2009.
- Cover Sheet. Health Center/Grantee Profile:
The vast majority of the data from the cover
sheet will no longer be collected through
the CY 2008 UDS. By the time of submission
in March 2009, all site information will be
recorded in the Electronic Hand Books (EHBs)
and changes will be noted through the formal
change in scope process. The patient origin
zip code data, previously collected with the
cover sheet, will continue to be collected
as a part of the annual UDS filing, in an
EHB location to be identified.
- Table 2. Services Offered and Delivery
Method: Table 2 is eliminated in the CY 2008
UDS submission. The data previously collected
on Table 2 have been made a part of the EHB
through the annual competing/non-competing
grant application and will be modified when
necessary through a variety of mechanisms.
- Table 3A. Patients by Age and Gender: No
changes for the CY 2008 UDS submission.
- Table 3B. Patients by Race/Ethnicity, Linguistic
Preference: Row labels in the table are changed
and renumbered. For the CY 2008 UDS, report
Total Hawaiian/Pacific Islander (Sum lines
5a and 5b) and Asian on line 5d.
- Table 4. Socioeconomic Characteristics:
A new variable, “Veterans,” has
been added for the CY 2008 UDS submission.
All grantees are expected to ascertain from
patients whether or not they have completed
service in the Uniformed Services of the United
States. The number of veterans served is to
be reported on line 25 (new). In addition,
member months data from Table 9C are transferred
to lines 13a, 13b, and 13c and collected as
a part of the information on insurance status.
- Table 5. Staffing and Utilization: Line
1, “Family Practitioners,” has
been changed to “Family Physicians.”
In addition, the following two changes have
been made for the CY 2008 UDS submission in
order to provide more detailed information
on grantee staff:
- “Licensed Mental Health Providers
(Other Than Psychiatrists)” has
been divided into three categories: Licensed
Clinical Psychologists, Licensed Clinical
Social Workers, and Other Licensed Mental
Health Workers. The latter category will
be used for mental health workers with
appropriate Masters degrees (with different
titles in different States including,
but not limited to Marriage and Family
Therapists, Marriage, Family and Child
Counselors, and Licensed Educational Counselors),
as well as for Mental Health Nurse Practitioners.
- “Administrative staff” has
been divided into three categories: Management
and Support Staff, Fiscal and Billing
Staff, and Information Technology Staff.
- Table 6. Selected Diagnoses and Services
Rendered: Table 6 is re-numbered as Table
6A in the CY 2008 UDS. No changes are proposed,
however CPT and ICD codes may change as a
result of annual updates to these coding systems.
Changes will be noted in materials provided
prior to January 2009.
- Table 6B. Quality of Care Indicators: This
is a new table for the CY 2008 UDS submission
to collect clinical quality data on three
variables: trimester of entry into prenatal
care, immunization of two-year olds, and Pap
tests for women aged 21 – 64 years old.
The first indicator, trimester of entry into
prenatal care, is taken from the previous
Table 7 and remains unchanged. Details on
the other two indicators are contained in
the 2008 Reporting Manual on the Bureau of
Primary Health Care (BPHC) UDS web site and
will be discussed in detail in training sessions
to be held later this spring/summer.
- Table 7 (Previous). Perinatal Profile:
All of the previous Table 7 will be eliminated
in the CY 2008 UDS except for the sections
transferred to the new Tables 6B and 7 including
age of patient and number of HIV positive
perinatal care patients.
- Table 7 (New). Health Outcomes and Disparities:
This is a new table for the CY 2008 UDS submission
to collect clinical outcome data on three
variables:
- deliveries and birth weight of infants;
- clinical control of hypertension; and
- clinical control of diabetes.
The first variable, deliveries and birth weight
of infants, is taken from the previous Table
7 and remains unchanged. Details on the other
two variables are contained in the 2008 Reporting
Manual on the BPHC web site and will be discussed
in detail in training sessions to be held later
this spring/summer.
- Table 8A. Financial Costs: All of the lines
on the previous Table 8A will be retained.
In addition, lines 11a through 11g are added
to further detail line 11 (enabling services)
and collect the data which were previously
collected on Table 8B.
- Table 8B. Mental Health, Substance Abuse,
and Enabling Services: Table 8B has been eliminated
for the CY 2008 UDS submission.
- Table 9C. Managed Care Revenues and Expenses:
Lines 8, 8a, and 8b (member months) are transferred
to Table 4 in the CY 2008 UDS. The remainder
of Table 9C is eliminated.
- Table 9D. Patient Related Revenue: No changes
for the CY 2008 UDS submission.
- Table 9E. Other Revenues: No changes for
the CY 2008 UDS submission.
All Health Center Program grantees will submit
electronic UDS reports via the web. In lieu
of the CD-Rom software used in the past, these
reports will be submitted through each grantee’s
EHB. All necessary reporting materials will
be available on the UDS
Web site.
Two sets of trainings will be provided to
Health Center Program grantees throughout CY
2008.
- Clinical Measures --- Forty-two (42) training
sessions will be held for clinicians and health
center staff responsible for clinical data
reporting during the late spring and early
summer. These trainings will address the use
of electronic health records and medical charts
to report measures, specifications for the
new clinical measures, and records sampling
requirements and methods.
- Administrative and System Components ---
More than 40 training sessions will be held
during the fall for health center staff responsible
for UDS reporting. Detailed discussion of
the UDS tables and data elements will be included
in these trainings, along with the new requirements
for web-based reporting.
Training schedules will be posted on the UDS
Web site. In April 2008, Primary Care Associations
(PCAs) will announce trainings for health centers
on the specifics of reporting clinical measures
and trainings on the administrative/systems
components of UDS. Grantees are encouraged to
contact their PCA for the schedule of upcoming
trainings.
During 2008, HRSA will provide ongoing support
to Health Center Program grantees regarding
the CY 2008 UDS reporting requirements through
the UDS Help Line (udshelp330@jsi.com
and 1-866-837-4357). Please contact Angela Damiano-Holder,
Chief, Data Branch, Office of Quality and Data
at (301) 594-4184 or adamiano@hrsa.gov
if you have any questions or concerns.
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