Health Center Application Process
2016 FTCA Deeming Application Technical Assistance:
The 2017 application process and guidance for submitting deeming applications for Federal Tort Claims Act (FTCA) medical malpractice coverage is detailed within Program Assistance Letter (PAL) 2016-03. The information found on this page is meant as a guide to applicants; download the PAL (PDF - 430 KB) for complete details.
Submitting FTCA Applications
To be considered complete, an initial or renewal application must contain all of the following documentation within EHB.
- Quality Improvement/Quality Assurance (QI/QA) Plan, with clear documentation that the Board reviewed and approved the plan within 3 years of the date of submission to HRSA (i.e., on or after April 1, 2013, for a renewal application). Details in PAL 2016-03 Section VIII page 6, item 1 (PDF - 430 KB).
- Minutes from any six QI/QA committee meetings that took place between April 1, 2015, and the submission date of the application. Details in PAL 2016-03 page 7, item 2 (PDF - 430 KB).
- In addition to the minutes noted above, the health center may also submit health center committee reports that further evidence QI/QA activities. Details in PAL 2016-03 page 7, item 2 (PDF - 430 KB).
- Minutes from any six Board meetings evidencing oversight of QI/QA activities that took place between April 1, 2015, and the submission date of the application. Details in PAL 2016-03 page 7, item 3 (PDF - 430 KB).
- Credentialing and privileging policies. Details in PAL 2016-03 page 7, item 4 (PDF - 430 KB).
- A list of all licensed and certified staff members providing services at all health center sites and their current credentialing/privileging status. Details in PAL 2016-03 page 7, item 4 (PDF - 430 KB).
- The credentialing list must be in an Excel Spreadsheet compatible with EHB.
- The Excel Spreadsheet must include the following information for all licensed and certified staff members:
- Name and Professional Designation (e.g., MD/DO, RN, CNM, DDS, LPN, PA, MA, NP, etc.);
- Employment Status (full-time employee, part-time employee, contractor or volunteer);
- Hire Date;
- Current Credentialing Date (must be within past 2 years); and
- Next Expected Credentialing Date. Details in PAL 2016-03 page 7, item 4 (PDF - 430 KB).
- Board approved health center policies for the following:
- Referral tracking;
- Hospitalization tracking;
- Diagnostic tracking (Note that the FTCA deeming application no longer requires separate clinical policies for x-ray and labs, where these activities are addressed by the diagnostic tracking policies). Details in PAL 2016-03 page 8, item 5 (PDF - 430 KB).
- Statement verifying whether or not there were any medical malpractice claims or allegations presented during the past 5 years, that any such claims or allegations were internally analyzed, and that appropriate actions were implemented as needed in response to such claims or allegations. Details in PAL 2016-03 page 8, item 6 (PDF - 430 KB).
- Electronic signature of the Executive Director certifying the contents of the application. Details in PAL 2016-03 page 9, item 7 (PDF - 430 KB).
- Deeming applications for any subrecipient(s) that appear on the health center’s most recent Form 5B, who are requesting FTCA coverage. Details in PAL 2016-03 page 9, item 8 (PDF - 430 KB).
HRSA periodically will update this section to include presentations and resources that will focus on the application preparation, submission, and deeming process.