Accessible Locations and Hours of Operation

Primary Reviewer: Governance/Administrative Expert

Secondary Reviewer: Clinical Expert

Authority: Section 330(k)(3)(A) of the Public Health Service (PHS) Act; and 42 CFR 51c.303(a) and 42 CFR 56.303(a)

Health Center Program Compliance Manual Related Considerations

Document Checklist for Health Center Staff

  • List of health center sites, including site addresses, hours of operation by site, and information on what general services (for example, medical, oral health, behavioral health) are offered at each service site.

    Note: These may be presented in separate documents or as references to health center websites.

  • Uniform Data System (UDS) Mapper Service Area Map (if updated since last application submission to HRSA).
  • Patient satisfaction surveys or other forms of patient input.
  • Needs assessment(s) or related studies or resources.

Demonstrating Compliance

Select each element below for the corresponding text of the element, site visit team methodology, and site visit finding questions.

The health center’s service site(s) are accessible to the patient population relative to where this population lives or works (for example, in areas immediately accessible to public housing for health centers targeting public housing residents, or in shelters for health centers targeting individuals experiencing homelessness, or at migrant camps for health centers targeting agricultural workers). Specifically, the health center considers the following factors to ensure the accessibility of its sites:

  • Access barriers (for example, barriers resulting from the area's physical characteristics, residential patterns, or economic and social groupings); and
  • Distance and time taken for patients to travel to or between service sites in order to access the health center’s full range of in-scope services.

Site Visit Team Methodology

  • Review Service Area Map.
  • Review needs assessment(s) or related studies or resources.
  • Review status of any special populations funding or designation.
  • Interview health center staff and board members, walking through considerations either for one to two sites already in scope OR a site added to scope within the past 12 months.

Site Visit Findings

  1. Does the health center take the following factors, including those specific to special population(s) (if applicable), into consideration in determining where to locate its sites:
    • Access barriers (for example, the health center has considered the ways patients access health center sites)?

      Response is either: Yes or No

    • Distance and time taken for patients to travel to or between service sites in order to access the health center’s full range of in-scope services (for example, if some in-scope services are located only at certain sites, the health center facilitates access to these services for the entire patient population)?

      Response is either: Yes or No

    If No was selected for any of the above, an explanation is required.

The health center’s total number and scheduled hours of operation across its service sites are responsive to patient needs by facilitating the ability to schedule appointments and access the health center’s full range of services within the HRSA-approved scope of project1 (for example, a health center service site might offer extended evening hours 3 days a week based on input or feedback from patients who cannot miss work for appointments during normal business hours).

Site Visit Team Methodology

  • Review health center’s Form 5B to assess overall range of hours of operation and addresses of sites.
  • Review needs assessment(s) or related studies or resources.
  • Review patient satisfaction surveys or other forms of patient input.
  • Interview relevant health center staff and board members to have them provide one to two examples of how hours are responsive to patient need.

Site Visit Findings

  1. Has the health center taken patient needs into consideration in setting the hours of operation of its sites (for example, within available resources, the hours correspond to most requested appointment times or align with the most in-demand services)?

    Response is either: Yes or No

    If No, an explanation is required.

The health center accurately records the sites in its HRSA-approved scope of project2 on its Form 5B: Service Sites in HRSA’s Electronic Handbooks (EHBs).

Site Visit Team Methodology

  • Review health center’s Form 5B.
  • Review latest list of site addresses provided by health center and compare to those sites listed on the most current Form 5B in the EHBs.
  • Interview relevant health center staff.

Note

The primary focus of this portion of the site visit is to validate the active service sites of the health center, noting any inaccuracy(ies) on Form 5B accordingly in the site visit finding question.

Site Visit Findings

  1. Does the health center’s Form 5B need to have any site(s) added or removed?

    Response is either: Yes or No

  2. IF YES: Has the health center submitted a Change in Scope request(s) to HRSA to correct Form 5B?

    Response is either: Yes or No

    If Yes OR No, specify the inconsistency(ies) observed and whether the relevant Change in Scope request(s) has been submitted to HRSA to correct Form 5B.

 

Footnotes:

  • 1. Services provided by a health center are defined at the awardee/designee level, not by individual site. Thus, not all services must be available at every health center service site; rather, health center patients must have reasonable access to the full complement of services offered by the center as a whole, either directly or through formal written established arrangements. Visit the Scope of Project website for further details, including services and column descriptors listed on Form 5A: Services Provided.
  • 2. In accordance with 45 CFR 75.308(c)(1)(i), health centers must request prior approval from HRSA for a “Change in the scope or the objective of the project or program (even if there is no associated budget revision requiring prior written approval).” This prior approval requirement applies to the addition or deletion of a service site. These changes require prior approval from HRSA and must be submitted by the health center as a formal Change in Scope request. Visit the Scope of Project website for further details.