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The Health Center Program: Program Assistance Letter 2009-02, Uniform Data System Changes for Calendar Year 2009

 

 

I. Background

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) 2009. These changes include:

  • modifications to certain UDS tables and data elements; and
  • clarification of the specifications for the Pap test, diabetes, and blood pressure control clinical measures.

HRSA collects data annually from section 330 funded health centers through the UDS. The data are reviewed to ensure compliance with legislative and regulatory requirements, improve health center performance and operations, and report overall program accomplishments. The data help to 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 look at differences between the U.S. population at large and those individuals and families who rely on the health care safety net for primary care. UDS data also inform Health Center Program grantees, partners, and communities about Health Centers and their patients.

II. Changes for CY 2009 UDS Reporting

While most changes 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 collect the required data for 2009. Beginning with the CY 2009 UDS report submitted February 19, 2010, the following changes will be implemented:

Table 3B - Patients by Race, Ethnicity, Language (see attached table): The table is reformatted and lines are renumbered. The number of patients by race is listed on the left hand side of the table, and the Hispanic/Non-Hispanic breakdowns are shown in columns on the right hand side of the table. Unreported/refused to report and total patients line and columns are also shown. The number of patients best served in a language other than English is not changed.

Table 6A - Selected Diagnoses and Services Rendered (see attached table): Two new services have been added, childhood lead test screening (9 to 72 months of age) as line 26A, and Screening, Brief Intervention and Referral to Treatment (SBIRT) for substance abuse as line 26B. The CPT codes for these items are provided.

Table 6B - Quality of Care Indicators (see attached table): In order to align with the revised National Quality Forum measure, the numerator and denominator for the Pap test measure are changed from female patients age 21 to 64 years old to female patients age 24 to 64 years old. The look back period—during the measurement year or two years prior—is not changed. Section D, line 11 is changed to read: Number of women 21-64 years of age who received one or more Pap tests to screen for cervical cancer. (Technical note: Women age 21 to 64 years old is correct because the look back period for 24 year olds captures women that were 21 years old when they received Pap tests 2 years prior.) Column a is changed to: total number of female patients 24 to 64 years of age.

Table 7 - Health Outcomes and Disparities (see attached table): There are two changes to this table:

  1. adult age ranges are specified for the blood pressure control and diabetes measures; and
  2. ethnicity columns are revised to coincide with categories for Hispanic and Non- Hispanic as specified in Table 3B.

    Clinical Measures
    The following specifications are made to align the blood pressure control and diabetes measures with those of the National Quality Forum.
  • Blood pressure control (hypertension): Changed from adults 18+ to adults age 18 to 85 years old (Section B line 6)
  • Diabetes: Changed from adults 18+ to adults age 18 to 75 years old (Section C line 9)

Ethnicity/Race
Ethnicity and Race are combined into a single table. The race categories are unchanged and are reported separately for Hispanic/Non-Hispanic. Sections D, E, and F are eliminated because this information is now reported in Sections A, B, and C.

Appendix A: Listing of Personnel: The lines shown for categories of mental health and substance abuse providers are changed to coincide with the line numbers in Table 5, Staffing and Utilization.

The revised tables and Appendix are attached for your information. These will be included in the 2009 UDS Reporting Manual to be posted on the web at http://bphc.hrsa.gov/uds/.

III. 2009 UDS Technical Assistance and Training

During 2009, HRSA will provide ongoing support to Health Center Program grantees regarding the CY 2009 UDS reporting requirements through the UDS Help Line (udshelp330@jsi.com and 1-866-837-4357). In addition, HRSA in conjunction with Primary Care Associations will be offering UDS trainings starting in the fall of 2009. The training schedules will be posted on the UDS web site at http://www.bphc.hrsa.gov/uds late summer 2009.

 

James Macrae
Associate Administrator for Primary Care

Attachment

TABLE 3B – PATIENTS BY RACE, ETHNICITY, LANGUAGE

Patients by race

HISPANIC

NON- HISPANIC

UNREPORTED/REFUSED TO REPORT

TOTAL

number of  patients
1. Asian

 

 

 

 
2a. Native Hawaiian

 

 

 

 
2b. Other Pacific Islander

 

 

 

 
2.

Total Hawaiian/Pacific Islander   (Sum Lines 2a + 2B)

 

 

 

 
3. Black/African American

 

 

 

 
4. American Indian/Alaska Native

 

 

 

 
5. White

 

 

 

 
6. More than one race

 

 

 

 
7. Unreported / Refused to

 

 

 

 
8.

Total Patients  (Sum Lines 1+2 + 3 to 7)

 

 

 

 

 

PATIENTS by Language

Number
(a)

number of  patients
9.

Patients Best Served in a Language Other Than English

 

TABLE 6A – SELECTED DIAGNOSES AND SERVICES RENDERED

 Service Category Applicable ICD-9-CM or CPT-4 code(s) Number of Encounters(A) Number of Patients(B)
Selected Diagnostic Tests/Screening/Preventive Services
21. HIV test CPT-4: 86689; 86701-86703; 87390-87391    
22. Mammogram CPT-4: 77055-77057 OR ICD-9: V76.11; V76.12    
23. Pap test CPT-4: 88141-88155; 88164-88167 OR ICD-9: V72.3; V72.31; V76.2    
24.  Selected Immunizations: Hepatitis A, Hemophilus Influenza B (HiB), Influenza virus, Pneumococcal, Diptheria, Tetanus, Pertussis (DTaP) (DTP) (DT), Mumps, Measles, Rubella, Poliovirus, Varicella, Hepatitis B Child)  CPT-4: 90633-90634, 90645 – 90648;90657 – 90660; 90669; 90700 – 90702;90704 – 90716; 90718; 90720-90721, 90723;90743 – 90744; 90748    
25. Contraceptive management ICD-9: V25.xx    
26. Health supervision of infant or child (ages 0 through 11) CPT-4: 99391-99393;99381-99383;99431-99433ORICD-9: V20.xx; V29.xx    
26 a.  Childhood lead test screening (9 to 72 months)       CPT-4: 83655    
26 b. Screening, Brief Intervention, and Referral (SBIRT) CPT-4: 99408-99409    
Selected Dental Services
27. I. Emergency Services ADA : D9110    
28. II. Oral Exams ADA : D0120, D0140, DO145 ,D0150, D0160, D0170, D0180    
29. Prophylaxis – adult or child ADA : D1110, D1120,    
30. Sealants ADA : D1351    
31. Fluoride treatment – adult or child ADA : D1203, D1204, D1206    
32. III. Restorative Services ADA : D21xx, D23xx, D27xx    
33. IV. Oral Surgery (extractions and other surgical procedures) ADA : D7111, D7140, D7210, D7220, D7230, D7240, D7241, D7250, D7260, D7261, D7270, D7272, D7280    


TABLE 6B – QUALITY OF CARE INDICATORS

(No prenatal care provided?  Check here:  )

Section A: Age Categories for Prenatal Patients
(GRANTEES WHO PROVIDE PRENATAL CARE ONLY)

DEMOGRAPHIC CHARACTERISTICS OF PRENATAL CARE PATIENTS

AGE

NUMBER OF PATIENTS    ( a )

1

Less than 15 years

 

2

Ages 15-19

 

3

Ages 20-24

 

4

Ages 25-44

 

5

Ages 45 and Over

 

6

Total Patients   (Sum lines 1 – 5)

 

Section B – Trimester of Entry Into Prenatal Care

Trimester of First Known Visit for Women Receiving Prenatal Care During Reporting Year

Women Having First Visit with Grantee
( a )

Women Having First Visit with Another Provider

7

First Trimester

 

 

8

Second Trimester

 

 

9

Third Trimester

 

 

Section C – Childhood Immunization

Childhood Immunization

Total Number patients with 2nd birthday during measurement year
( a )

Number Charts Sampled or EHR total

( b )

Number of Patients Immunized

( c )

10

Number of children who have received age appropriate vaccines who had their 2nd birthday during measurement year (on or prior to 31 December)

 

 

 

Section D – Pap Tests

Pap Tests

Total number of Female Patients 
24-64 years of Age
( a )

Number Charts Sampled or EHR total
( b )

Number of Patients Tested

( c )

11

Number of female patients aged 21-64 who received one or more Pap tests to screen for cervical cancer

 

 

 

TABLE 7 – HEALTH OUTCOMES AND DISPARITIES

 

Hispanic

Non- Hispanic

Unreported/
Refused to Report

Total

Asian
(a)

 

Native Hawaiian
( b1 )

Pacific Islander
( b2 )

Black/
African American
(c)

 

 

 

 

American Indian/ Alaska  Native
( d )

White
(e)

More than one race
(f)

Asian
( a )

Native Hawaiian
( b1 )

Pacific Islander
( b2 )

Black / African
American
(c)

 

 

 

 

 

 

American Indian/ Alaska Native
( d )

White
( e )

More than one race
( f  )

 

 

HIV Positive Pregnant Women

 

 

(No prenatal care provided?  Check here:  )

Section A:  Deliveries and Low Birth Weight by Race

Deliveries and Babies by birth weight

1

Prenatal care patients who delivered during the year

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

Deliveries performed by Grantee Provider

 

 

3

Live Births
< 1500 grams

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

Live Births
1500 – 2499 grams

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Live Births
³ 2500

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section B:  Hypertension By Race

Patients diagnosed with hypertension whose last blood pressure was less than 140 / 90

6

Total patients aged 18 to 85 years with hypertension

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

Charts sampled or  EHR total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

Patients with controlled blood pressure

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section C:  Diabetes by Race  

Patients diagnosed with Type I or Type II diabetes:  Most recent test results

9

Total patients aged 18 to 75 years with Type I or II diabetes

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

Charts sampled or
EHR total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

Patients with
HBA1c < 7%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

Patients with
7% < HBA1c  <  9%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

Patients with
HBA1c > 9%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IV. APPENDIX A: LISTING OF PERSONNEL
(All Line numbers in the following table refer to Table 5)

 

Personnel By Major Service Category

Provider

Non-Provider

Physicians
  • Family Practitioners (Line 1)

X

 
  • General Practitioners (Line 2)

X

 
  • Internists (Line 3)

X

 
  • Obstetrician/Gynecologists (Line 4)

X

 
  • Pediatrician (Line 5)

X

 

Other Specialist Physicians (Line 7)

  • Allergists

X

 
  • Cardiologists

X

 
  • Dermatologists

X

 
  • Ophthalmologists

X

 
  • Orthopedists

X

 
  • Surgeons

X

 
  • Urologists

X

 
  • Other Specialists And Sub-Specialists

X

 

Nurse Practitioners (Line 9a)

X

 

Physicians Assistants (Line 9b)

X

 

Certified Nurse Midwives (Line 10)

X

 

Nurses (Line 11)
  • Clinical Nurse Specialists

X

 
  • Public Health Nurses

X

 
  • Home Health Nurses

X

 
  • Visiting Nurses

X

 
  • Registered Nurse

X

 
  • Licensed Practical Or Vocational Nurse

X

 

Other Medical Personnel (Line 12)
  • Nurse Aide/Assistant (Certified And Uncertified)

 

X
  • Clinic Aide/Medical Assistant (Certified And Uncertified Medical Technologists)

 

X

Laboratory Personnel (Line 13)
  • Pathologists

 

X
  • Medical Technologists

 

X
  • Laboratory Technicians

 

X
  • Laboratory Assistants

 

X
  • Phlebotomists

 

X

X-Ray Personnel (Line 14)
  • Radiologists

 

X
  • X-Ray Technologists

 

X
  • X-Ray Technician

 

X

Dentists (Line 16)
  • General Practitioners

X

 
  • Oral Surgeons

X

 
  • Periodontists

X

 
  • Endodontists

X

 

Other Dental

  • Dental Hygienists (Line 17)

X

 
  • Dental Assistant (Line 18)

 

X
  • Dental Technician (Line 18)

 

X
  • Dental Aide (Line 18)

 

X

Mental Health (Line 20)  & Substance Abuse (Line 21)
  • Psychiatrists (Line 20a)

X

 
  • Psychologists (Line 20a1 or 20c or 21)

X

 
  • Social Workers  -  Clinical  and Psychiatric (Line 20a2 or 20c or 21)

X

 
  • Nurses - Psychiatric And Mental Health  (Line 20b or 21)

X

 
  • Alcohol And Drug Abuse Counselors  (Line 20c or 21)

X

 
  • Nurse Counselor  (Line 20b or 21)

X

 

All Other Professional Personnel (Line 22)

 

 
  • Audiologists

X

 
  • Acupuncturists

X

 
  • Chiropractors

X

 
  • Herbalists

X

 
  • Massage Therapists

X

 
  • Naturopaths

X

 
  • Occupational Therapists

X

 
  • Optometrists

X

 
  • Podiatrists

X

 
  • Physical Therapists

X

 
  • Respiratory Therapists

X

 
  • Speech Therapists / Pathologists

X

 
  • Traditional Healers

X

 
  • Nutritionists/Dietitians

X

 

Pharmacy Personnel (Line 23)

 

 
  • Pharmacist, Clinical Pharmacist

 

X
  • Pharmacist Assistant

 

X
  • Pharmacy Clerk

 

X

Enabling Services

 

 

Case Managers  (Line 24)

 

 
  • Case Managers

X

 
  • Social Workers

X

 
  • Public Health Nurses

X

 
  • Home Health Nurses

X

 
  • Visiting Nurses

X

 
  • Registered Nurses

X

 
  • Licensed Practical Nurses

X

 

Health Educators (Line 25)

 

 
  • Family Planning Counselors

X

 
  • Health Educators

X

 
  • Social Workers

X

 
  • Public Health Nurses

X

 
  • Home Health Nurses

X

 
  • Visiting Nurses

X

 
  • Registered Nurses

X

 
  • Licensed Practical Nurses

X

 

Outreach Workers (Line 26)

 

X

Patient Transportation Workers (Line 27)

 

 
  • Patient Transportation Coordinator

 

X
  • Driver

 

X

E ligiblity Assistance Workers (Line 27a)

 

 
  • Benefits Assistance Workers

 

X
  • Eligibility Workers

 

X
  • Registration Clerks

 

X

Interpretation (Line 27b)

 

 
  • Interpreters

 

X
  • Translators

 

X

 Other Enabling Services Personnel (Line 28)

 

X

Other Related Services Staff  (Line 29a)

 

 
  • WIC Workers

 

X
  • Head Start Workers

 

X
  • Housing Assistance Workers

 

X
  • Child Care Workers

 

X
  • Food Bank / Meal Delivery Workers

 

X
  • Employment / Educational Counselors

 

X

Management and Support Staff (Line 30a)

 

 
  • Project Director

 

X
  • Chief Executive Officer/ Executive Director

 

X
  • Chief Financial Officer

 

X
  • Chief Information Officer

 

X
  • Chief Medical Officer

 

X
  • Secretary

 

X
  • Administrator

 

X
  • Director of Planning And Evaluation

 

X
  • Clerk Typist

 

X
  • Personnel Director

 

X
  • Receptionist

 

X
  • Director of Marketing

 

X
  • Marketing Representative

 

X
  • Enrollment/Service Representative

 

X

Fiscal and Billing Staff (Line 30b)

 

 
  • Finance Director

 

X
  • Accountant

 

X
  • Bookkeeper

 

X
  • Billing Clerk

 

X
  • Cashier

 

X
  • Data Entry Clerk

 

X

IT Staff (Line 30c)

 

 
  • Director of Data Processing

 

X
  • Programmer

 

X
  • IT Help Technician

 

X
  • Data Entry Clerk

 

X

Facility (Line 31)

 

 
  • Janitor/Custodian

 

X
  • Security Guard

 

X
  • Groundskeeper

 

X
  • Equipment Maintenance Personnel

 

X
  • Housekeeping Personnel

 

X

Patient Services Support Staff (Line 32)

 

 
  • Medical And Dental Team Clerks

 

X
  • Medical And Dental Team Secretaries

 

X
  • Medical And Dental Appointment Clerks

 

X
  • Medical And Dental Patient Records Clerks

 

X
  • Patient Records Supervisor

 

X
  • Patient Records Technician

 

X
  • Patient Records Clerk

 

X
  • Patient Records Transcriptionist

 

X
  • Registration Clerk

 

X
  • Appointments Clerk

 

X