HRSA Announcement: Increased Demand for Services (HRSA-09-218) - Clarification of Application Instruction Form 14R - Proposed Staffing and Utilization

Listserv message sent 03/10/2009

We would like to thank all of those grantees and other Health Center Program partners for the overwhelming participation on the Increased Demand for Services (IDS) technical assistance conference call this afternoon.

There have been numerous questions raised prior to and during the call regarding the definitions of new jobs and retained jobs, and the appropriate manner in which to project new and retained FTEs in the IDS application. As a result, we would like to provide clarification on the expectations related to Form 14R - Proposed Staffing and Utilization.

As a reminder, consistent with the overall purposes of the American Recovery and Reinvestment Act, health centers are expected to demonstrate new jobs created and/or retained as well as new patients, including uninsured patients, to be served as a result of the awarding of the IDS funding. As your projections in these areas will be reported both to HRSA and the general public, we encourage you to carefully consider projects to be supported with these funds that will result in the greatest benefit to your community and those most impacted by the recession.

As stated on page four of the IDS Application Announcement:

For the purposes of the IDS funding under the Recovery Act, the following definitions will be used:

• New jobs include new positions created and filled or previously existing unfilled positions that are filled as a result of IDS funding.
• Retained jobs include those positions preserved from layoffs or terminations and those restored to full-time as a result of IDS funding.
• New and retained FTEs include both direct hire and contractual staff.

CLARIFICATION:

The numbers for health center FTEs to be entered in column (a) on form 14R should reflect both new jobs created and jobs retained with IDS funding over the 2-year project period. It is important to note that a new or retained FTE (whole or partial) can be counted only once over the entire 2-year project period. To provide further clarification, the header for column (a) has been modified to read "New and Retained FTEs." Also as a reminder, the total number of health center FTEs retained should be entered on Form 13R - Use of Funds, under 5.c, Total Jobs Retained.

Below are some examples of how an applicant might calculate an appropriate FTE figure on Form 14R of the IDS application:

1. ABC Health Center proposes to create two new internist positions in July 2009 using IDS funding. It also plans to employ the two internists for the remaining portion of the 2-year project period. The appropriate FTE number placed in row three, column (a) on Form 14R is 2 (for the two internists). If no other staff are anticipated to be hired or retained using IDS funds, the total number of new and retained FTEs for this application is 2.
   
2. BCD Health Center will use IDS funding to create one pediatrician position in May 2009, and a nurse practitioner position in April 2010. The appropriate FTE number placed in row 5, column (a) is 1 (for the one pediatrician), and the appropriate FTE number placed in row 9a, column (a) is 1 (for one nurse practitioner). If no other staff are anticipated to be hired or retained using IDS funds, the total number of new and retained FTEs for this application is 2.
   
3. CDE Health Center reduced an existing physician assistant position from full time to .5 FTE in December 2008. The center proposes to use IDS funding to restore this position to 1.0 FTE immediately following receipt of the IDS award, and continue supporting the FTE through the 2-year project period. The appropriate FTE number placed in row 9b, column (a) is .5 (for the restored physician assistant). If no other staff are anticipated to be hired or retained using IDS funds, the total number of new and retained FTEs for this application is .5. Additionally, the .5 FTE should be reflected in the total reported on line 5.c. of Form 13R (Total Jobs Retained).
   
4. DEF Health Center proposes to create two new ob/gyn positions, each at .75 FTE. In addition, the center will use IDS funding to avoid laying off 2 nurses, each currently employed at .5 FTE. The appropriate FTE number placed in row 4, column (a) is 1.5 (for the two ob/gyn positions, each at .75 FTE). The appropriate number placed in row 11, column (a) is 1.0 (for the two nursing positions, each at .5 FTE). If no other staff are anticipated to be hired or retained using IDS funds, the total number of new and retained FTEs for this application is 2.5. Additionally, 1.0 FTE should be reflected on line 5.c. of Form 13R (Total Jobs Retained).

Additional technical assistance resources related to IDS funding are scheduled to be posted shortly at The Health Center Program: Recovery Act Grants.

James Macrae
Associate Administrator for Primary Health Care
Health Resources and Services Administration