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Health Center Controlled Network Frequently Asked Questions

The fiscal year (FY) 2023 Health Center Controlled Network (HCCN) Non-Competing Continuation (NCC) Progress Report instructions are available on the HCCN TA webpage.

These are common questions and corresponding answers for the FY 2023 HCCN NCC Progress Report.

Funding

How will the funding mechanism change from a grant to cooperative agreement impact how I use HCCN funds?  

The change in funding mechanism will allow more flexibility in how HCCN funds are used. With input and agreement from HRSA, you will be able to make changes to your Project Work Plan activities and budget allocations more easily during the budget period, to respond to emerging national priorities and/or your PHCs’ needs. As a cooperative agreement, there will be substantial involvement from HRSA/BPHC and HCCN awardees to further maximize the effectiveness and impact of HCCN awards. For instance, HRSA may add new objectives throughout the period of performance to better respond to emerging national priorities.

Many features of the U86 cooperative agreement, such as the annual non-competing continuation progress report, are similar to the FY 2019 H2Q grant. However, as a cooperative agreement, you will use the Project Work Plan modification process within the EHBs to update your project work plan during the year.

(Updated: 3/1/2023)

What kinds of equipment and supplies may be allowable for HCCNs to purchase for PHCs?

HCCN funding may be utilized for equipment or supplies that directly support achieving the HCCN objectives. Equipment and supplies must be available to all PHCs in an HCCN. You must demonstrate in your budget narrative that the equipment or supplies you are proposing to purchase:

  • Directly helps PHCs access and efficiently use digital health tools such as Electronic Health Records (EHRs), telehealth, patient portals, and electronic registries, along with virtual care platforms that support their integration, and
  • Supports PHCs with translating robust clinical and population data into quality improvement and culturally competent, patient-centered care using, in part, data collected through digital health tools.

If, for example, you identify a significant need across your network for specific data collection and reporting software to support data standardization and integration, and then made this software available to all your PHCs, this may be an allowable cost.

Note that allowable costs for equipment and supplies excludes general office, medical or diagnostic items for use at the PHC level. 

(Updated: 3/1/2023)

Will the executive salary cap be applied to FY 2023 HCCN funding?

Yes, the executive salary cap will be applied to FY 2023 HCCN funding and subsequent fiscal years during the period of performance. HCCN funds may not be used to pay the salary of an individual at a rate in excess of Federal Executive Level II of the Federal Executive Pay scale, which is $212,100 as of January 2022. This amount may change so you should verify each year you submit your budget.

(Updated: 3/1/2023)

My HCCN has had turnover in key staffing (e.g., quality improvement and data analytics staff), can we contract for key technical skills and consulting from external subject experts?

Yes, you may engage external subject experts and consultants through contracts. You will provide information about contracted staff in your Project Narrative Update, Budget Narrative, and Attachment 6: Summary of Contracts and Agreements.

(Updated: 3/1/2023)

Will PHCs have to submit a new Staffing Plan if a new staff member joined the project?

Yes, an updated Staffing Plan will need to be added to reflect the new staff member. The updated plan should include all the requested information detailed in the instructions.  

(Added: 3/1/2023)

Do PHCs have to expend the additional one-time supplemental funding by the end of the budget period (7/31/23)?

One-time supplemental funds generally must be used by the end of the specified budget period unless a carryover request is made. 

(Added: 3/1/2023)

Participating Health Centers

How do HCCNs benefit their PHC?

HCCNs will support PHCs with health information technology (IT) and data needs with a specific focus on improvements in clinical quality, patient-centered care, and provider and staff well-being. HCCNs will support their PHCs individually and collectively to address clinical and operational needs that include strengthening care coordination, reducing administrative burden through improved workflows, utilizing digital health tools, and facilitating data exchange with local, state/territory, and national public health bodies. HCCNs provide specialized training and technical assistance to leverage economies of scale, such as group purchasing power, shared resources and training, and data analytics to support quality measurement and improvement. In addition, HCCNs will assist health centers with implementing the transition to UDS+ for the 2023 UDS cycle. 

(Updated: 3/1/2023)

What do PHCs commit to by signing an HCCN’s MOA?

A PHC should commit to work with the HCCN for the entire, or remainder of the three-year period of performance, to address each objective, and provide annual data. If a PHC has already met an objective measure requirement, they only need to provide data for that objective and are not required to take part in related activities. It is important for PHCs to work closely with their HCCN to develop a beneficial and productive individual work plan so they can receive health IT and data support specific to their needs.

(Updated: 3/1/2023)

How should I update the “Number Of Sites (Baseline)” field on the Progress Report Table?

If the PHC was in your network and submitted with your FY22 application, this field will be prepopulated with information submitted to HRSA in that application, and should not be edited. 

If you added the PHC after your FY22 application was submitted, this field will be blank. You must enter the number of sites at the time the PHC was added to your network. This field is a required field, and Progress Report Table  can’t be submitted if the field is left blank.

(Added: 3/1/2023)

Is it possible for a PHC to report data on the Progress Report Table for a calendar year as opposed to the 8/1/22 start date currently in place?

PHCs must report data as of 8/1/2022 because that is the beginning of the period of performance and when the HCCN funding mechanism changed from a grant to a cooperative agreement. Reporting progress on or after 8/1/2022 allows HCCNs to accurately track how their PHCs are working towards achieving targeted objectives in alignment with the HCCN budget period.

(Added: 3/1/2023)

Is the 40-page limit for the Progress Report listed in the instructions required, and what is included in the page count?

The 40-page limit is suggested to give HCCNs a guide to depict the level of detail HRSA expects to receive in progress report submissions. This page count would include all attachments specified in the instructions. Any EHBs forms would not count towards the page limit. 

(Added: 3/1/2023)

Objective 1 – Patient Engagement

What are integrated digital health tools and how often should they be used to count towards the objective measure?

There are various integrated digital health tools that PHCs can use for patient engagement; these may include, but are not limited to, electronic messages sent through patient portals to providers, telehealth visits, and reporting remote monitoring device data. If a patient has used integrated digital health tools at least once during the reporting period between in-person visits to communicate health information with the PHC, this will count towards the "80% of patients" requirement for this objective. The communication must be two-way; for example, a Population Health Management Tool may be acceptable but one-way texting tools may not.

For the FY 2023 HCCN NCC progress report, the reporting period is from 8/1/2022 through 1/31/2023.

(Updated: 3/1/2023)

Does the patient engagement numerator exclude the use of surveys?

Yes, the patient engagement numerator does exclude the use of survey data.

(Added: 3/1/2023)

Objective 2 – Patient Privacy and Cybersecurity

What does "closed loop" referral mean?

Closed loop referrals are digital mechanisms that allow PHCs to electronically send a consultation request and other pertinent background information to a specialist or Community Based Organization and then receive a consultation summary and any other relevant information back following the completion of any tests or care coordination, without leaving the workflow of the Electronic Health Record (EHR). The goal of a closed loop referral is the transfer of relevant clinical information in both directions to track outcomes. Closed loop referrals can often address social risk factors.

(Added: 1/4/2022)

For the Progress Report Table: Can a PHC include patient privacy and cybersecurity practices it had implemented prior to 8/1/2022 in its response?

A PHC can include previously implemented practices if they were reviewed or modified since 8/1/2022. Please reach out to your project officer for further clarification. 

(Added: 3/1/2023)

For the Progress Report Table: What secure health information practices that protect patient privacy should be included?

PHCs can include any health information practices reviewed, revised and newly implemented since 8/1/2022. The practices listed can include any Administrative, Physical and Technical options that may tie back to the HIPAA Safeguards that are currently in place. 

Additional Health IT and cybersecurity resources are available on the NCC TA webpage, including the newly added: Reassessing Your Security Practices in a Health IT Environment: A Guide for Small Health Care Practices (PDF - 74 KB).

(Added: 3/1/2023)

Objective 4 – Disaggregated, Patient-Level Data

Can you describe the electronic clinical quality measures (eCQM) and UDS+ data fields “test messages” that will be sent using Fast Health Interoperability Resources (FHIR) based application programming interfaces (APIs)?

Test messages are connections via FHIR based APIs to send mock or real eCQM reports or data consistent with UDS+ reporting to the upcoming UDS+ FHIR "sandbox" endpoint OR during other tests such as HL7 FHIR Connectathons in support of data exchange activities that include, but are not limited to, the Da Vinci Data Exchange for Quality Measures (DEQM) or Making EHR Data More available for Research and Public Health (MedMorph) FHIR IGs streams.

(Added: 1/4/2022)

How can I learn about UDS+ system requirements for sending test messages and setting targets?

The UDS Resources and UDS Modernization Initiative webpages will be updated to include UDS+ systems requirements. Updated information about the UDS+FHIR endpoint sandbox was made available in 1/2023. The FHIR-based reporting system will be based on MedMorph and DEQM reference architecture and report content.

(Updated: 3/1/2023)

For the Progress Report Table: Which test messages should be counted for electronic clinical quality measures (eCQM) and UDS+ data fields using Fast Health Interoperability Resources (FHIR) based application programming interfaces (APIs)?

PHCs should include only test messages sent directly by the PHC. They should not include any test messages from EMR vendors.

(Added:3/dd/2023)

Objective 5 – Interoperable Data Exchange and Integration

Can data be integrated into a population health management tool instead of an EHR?

No, to meet the objective requirement, data must be integrated into structured EHR fields. Data integrated from population health management tools will count towards the external clinical and/or non-clinical data sources requirement of the objective.

(Added: 1/4/2022)

Can data, such as laboratory or radiology test results or drug monitoring program information, count towards the objective measure?

Yes, data such as test results or drug monitoring program information integrated into structured EHR fields using a digital health platform will count towards the objective requirement. Information that is entered as free text or as attachments will not.

(Added: 1/4/2022)

Objective 6 – Data Utilization

Are predictive analytics with data visualization, natural language processing, and machine learning use required to meet the advanced data strategies requirement for the objective measure?

No, predictive analytics with data visualization, natural language processing, and machine learning are common but not the only advanced data strategies that will count towards the meeting objective measure requirement.

(Added: 1/4/2022)

Objective 7 – Leveraging Digital Health Tools

For the Progress Report Table: Can the formal trainings that promote proficiency in the use of digital health tools include trainings provided by a vendor or the HCCN?

PHCs can count training provided by a vendor or HCCN if PHC providers and staff are the intended audience.  

(Added: 3/1/2023)

For the Progress Report Table: Can a PHC include a point-to-point interface with a hospital if it was established before 8/1/2022, but is currently receiving regular feeds from that hospital after 8/1/2022?

Yes, you can count the source if the data was received since 8/1/2022, even if the interface existed before then. 

(Added: 3/1/2023)

How does HRSA define the term routine support?

Routine support refers to PHCs making existing resources, such as on-demand reference materials and regular communicated tips or best practices, available to staff to guide their ability to use digital health tools. Routine support would exclude formal training.

(Added: 3/12023)

Publication Plan versus Communication Plan

What is the difference between a Publication Plan and Communication Plan?

The publication plan is part of the cooperative agreement recipient’s post-award responsibilities and is not required as part of your progress report submission. The plan should include each publication’s purpose, target audience, title, publication mode or type, summary description, expected impact/benefit, and projected publication draft date. Contact your project officer for more detailed instructions regarding content and submission of the publication plan.

The communication plan was a required submission component of your FY22 application, and outlined how you intended to maintain ongoing communication with PHCs in your network. An update to the Communication Plan should be included with the progress report if any changes have been made since your application.

(Added: 3/1/2023)

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