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Public Comments - Bureau of Health Workforce (BHW)

General Comments

American Optometric Association, Alexandria, VA

The BHW has an important role to play in supporting a health care workforce that can effectively and efficiently care for the health needs of all Americans. However, despite the number and variety of workforce programs, the BHW falls short when it comes to ensuring an adequate and well-distributed eye care workforce. Because doctors of optometry have been excluded from the National Health Service Corps, the largest and most significant of the workforce programs, would-be and current eye doctors with a passion to care for the underserved have been forced to cobble together financial support from the few, small BHW scholarship programs that are open to them. With average student loan debt of $138,358 upon graduation, many new doctors of optometry cannot afford to work in the communities with greatest need.[https://optometriceducation.org/wp-content/uploads/2018/05/ASCO-Student-Data-Report-2017-18.pdf hrsa exit disclaimer] Allowing doctors of optometry to participate in the National Health Service Corps would significantly simplify the workforce program participation by optometrists and remove the financial barriers preventing them from practicing in underserved settings, especially in light of the fact that the Administration proposed eliminating the other various workforce programs in its most recent budget proposal.

RFI section D.1

AIDS United, Washington, DC (Legacy Community Health)

Legacy appreciates HRSA's request for feedback on how to collect data more effectively- in particular, if there are data points and/or documents that BHW requests as part of the application process that are particularly burdensome to applicants. We recommend BHW streamline the application process by asking questions consistently among applicants. We have found in many instances that application questions have been inconsistent, and you often cannot move to the next step of the application process until the unfamiliar question is answered appropriately. We encourage BHW to create a routine application processes to avoid unnecessary confusion. We also encourage BHW to adopt and employ consistent use of job titles and descriptions throughout the application process to avoid confusion.

Alabama Department of Public Health, Montgomery, AL

The Application and Program Guidance provides three paragraphs related to participant service – those who leave an approved site prior to the completion of their service commitment, those who transfer to another NHSC approved service site and, those who become unemployed during their service obligation. This information addresses actions initiated at the preference of the participant, or in the case of termination, an action initiated through the participant's actions or work performance. Although it is inferred through these paragraphs, it is not clear how the participant should proceed should the approved NHSC site cease operations, leaving the participant potentially in default of the contract through no fault of their own.

ALTURA Centers for Health, Tulare, CA

It would be helpful to know the minimum HPSA score needed to qualify for loan repayment. Our providers are very disappointed to have spent a considerable amount of time applying for the Loan Repayment program, only to find that our HPSA score was not high enough to allow them to receive the funding.

Community Clinic Association of Los Angeles County (CCALAC), Los Angeles, CA

The NHSC application process can be time consuming and cumbersome. To reduce the burden of determining eligibility and applying, we recommend:

  • Developing a minimum qualifications screening tool so that candidates can quickly ascertain whether they do or do not meet the criteria.
  • Creating a quick reference guide or providing access to one-on-one technical assistance to advise applicants on the specific steps to apply to each program.
  • Allowing for the electronic submission of applications and verification of enrollment.
  • Reducing the required essays from three to one.

One of the most significant barriers is the lack of transparency in the actual HPSA score that community health centers need for providers to receive an award in the Loan Repayment Programs. Health centers report spending a lot of time applying only to find out they were not selected due to their HPSA score being too low for the current loan process. To reduce the burden in this area we recommend HRSA publish the HPSA scores that will be eligible.

California Primary Care Association (CPCA), Sacramento, CA

CA health centers find the NHSC application process to be extremely time consuming and cumbersome. To reduce the burden, we recommend:

  • Allowing for the electronic submission of applications and verification of enrollment
  • CPCA members have also recommended a short quick reference guide, or coaches, be made available that could quickly advise applicants on the available programs, and provide clear instructions on what needs to be done to submit for that specific program.
  • It would greatly assist applicants if a minimum qualifications screening via an internet tool was created so that candidates who don’t meet the minimum qualifications could be quickly given that information and move on.
  • The application process could be improved by reducing required essays from three down to one.

Finally, one of the greatest barriers is the lack of transparency in the actual HPSA score that community health centers need for providers to receive an award in the Loan Repayment Programs. Health centers report spending a lot of time applying only to find out they haven’t been selected due to their HPSA score being too low for the current loan process. We recommend that HRSA publish the HPSA scores that will be eligible to employ providers receiving an award in the loan repayment programs.

Community Health Systems, Inc., Moreno Valley, CA

Documentation is necessary; however three essays can be reduced to one or two. HRSA can expand its eligibility by eliminating the restriction on US citizens or nationals who attend schools beyond the geographic boundaries stated in the application guide.

Eastern Aleutian Tribes (EAT), Anchorage, AK

EAT manages eight community health clinics that qualify for this program. It has been difficult to complete the additional work in the BHW portal that we are required to do every time a provider provides coverage at a different clinic. BHW should streamline this process. As long as a provider is at one of our clinics that should be good enough. We should not to complete requests to change sites every time.

Family Health Centers of San Diego, San Diego, CA

Family Health Centers of San Diego has several recommendations in this area. First, it would greatly assist applicants if a minimum qualifications screening via an internet tool was created so that candidates who don't meet the minimum qualifications could be part of the National Health quickly given that information and move on. We recommend adding US geographic area Service Corps application feedback as something that could be easily accessed. The process is extremely time consuming and cumbersome. If a short quick reference guide, or coaches, were made available that could quickly advise applicants on the available programs, and the provide clear instructions on what needs to be done to submit for that specific program, it would allow more applicants to take part in the program and further assist health centers in meeting their workforce needs.

Health Center Partners of Southern California, San Diego, CA

The online application and instruction provided therein is already very helpful for applicants. We have found that the essay questions don’t always identify providers with a passion for community health in underserved areas but, rather, a desire for loan repayment.

Legacy Community Health, Houston, TX

Legacy appreciates HRSA's request for feedback on how to collect data more effectively – in particular, if there are data points and/or documents that BHW requests as part of the application process that are particularly burdensome to applicants. We recommend BHW streamline the application process by asking questions consistently among applicants. We have found in many instances that application questions have been inconsistent, and you often cannot move to the next step of the application process until the unfamiliar question is answered appropriately. We encourage BHW to create a routine application processes to avoid unnecessary confusion. We also encourage BHW to adopt and employ consistent use of job titles and descriptions throughout the application process to avoid confusion.

Mendocino Community Health Clinic (MCHC), Ukiah, CA

MCHC finds the NHSC application process to be extremely time consuming and cumbersome. To reduce the burden, we recommend:

  • Allowing for the electronic submission of applications and verification of enrollment
  • Development of a short quick reference guide, or coaches, be made available that could quickly advise applicants on the available programs, and provide clear instructions on what needs to be done to submit for that specific program.
  • It would greatly assist applicants if a minimum qualifications screening via an internet tool was created so that candidates who don't meet the minimum qualifications could be quickly given that information and move on.
  • The application process could be improved by reducing required essays from three down to one.

Finally, one of the greatest barriers is the lack of transparency in the actual HPSA score that community health centers need for providers to receive an award in the Loan Repayment Programs. Health centers report spending a lot of time applying only to find out they haven't been selected due to their HPSA score being too low for the current loan process. We recommend that HRSA publish the HPSA scores that will be eligible employ providers receiving an award in the loan repayment programs.

Neighborhood Healthcare (NHcare), Escondido, CA

NHcare finds the NHSC application process to be extremely time consuming and cumbersome. To reduce the burden, we recommend:

  • Allowing for the electronic submission of applications and verification of enrollment
  • A short quick reference guide, or coaches, be made available that could quickly advise applicants on the available programs, and provide clear instructions on what needs to be done to submit for that specific program.
  • It would greatly assist applicants if a minimum qualifications screening via an internet tool was created so that candidates who don't meet the minimum qualifications could be quickly given that information and move on.
  • The application process could be improved by reducing required essays from three down to one.

Finally, one of the greatest barriers is the lack of transparency in the actual HPSA score that community health centers need for providers to receive an award in the Loan Repayment Programs. Health centers report spending a lot of time applying only to find out they haven't been selected due to their HPSA score being too low for the current loan process. We recommend that HRSA publish the HPSA scores that will be eligible employ providers receiving an award in the loan repayment programs.

Wayne County Health Department, Goldsboro, NC

I think the Nurse Corps program is a good recruitment tool especially for nursing/provider shortage areas. Even though Wayne County has a shortage of nurses, I have not seen any nurses at the health department that have benefited from the loan repayment program. I was initially involved when Wayne County applied to be a loan repayment site. I think the webinars mentioned to help applicants understand requirements would be a great idea. I also think something similar for personnel staff to help encourage potential applicants to apply and to market this as a benefit would be good too. Thank you.

RFI section D.2

American Association of Nurse Practitioners, Alexandria, VA

HRSA asked how the National Health Services Corps (NHSC) can support their priorities of increasing access to telehealth and substance abuse disorder treatment, particularly regarding data that can be collected from its sites and participants:

For telehealth, HRSA can collect data regarding the prevalence of telehealth usage, a site/participant’s telehealth needs, and barriers to adoption of telehealth by nurse practitioners. This information would help HRSA, other federal agencies, and states target funding and other resources in an appropriate and efficient manner to implement telehealth adoption in the neediest areas. It is also important that all practitioners that desire to use telehealth, including nurse practitioners, have access to technical assistance and funding resources. HRSA can obtain provider specific data to ensure that nurse practitioners and all clinicians have access to these funds and resources.

As you know with the passage of CARA in 2016, NPs were authorized to provide medication assisted treatment (MAT) to patients suffering from addiction, after taking the necessary training and obtaining a DEA waiver. Since NPs became eligible to obtain MAT-waivers in February of 2017, almost 6,000 NPs have obtained their waiver. Surveying HRSA sites to determine where MAT-waived NPs and other providers are practicing can help assist state and federal governments in allocating resources for MAT training.

SAMHSA currently collects data regarding locations where MAT-waived providers are practicing, but the database does not yet identify the areas most in need of MAT-waived providers. HRSA can add to this database by surveying the number of MAT-waived providers in HRSA sites, and combine this information with HRSA provider shortage area databases to provide a comprehensive assessment of a community’s need for substance abuse providers.

California Primary Care Association (CPCA), Sacramento, CA

HRSA must first understand the impact of state policy on the utilization of telehealth and substance use disorder services. California has many reimbursement restrictions that serve as barriers for the uptake of telemedicine, and for mental health and substance abuse services.

To measure efficacy of work in this area, CPCA recommends that level of service and compliance with requirements be measured by reporting:

  1. Number of unique patients served,
  2. Whether clients return for a first, second, third treatment,
  3. Whether a patient tested clean at each encounter; and
  4. Total number of encounters.

We also recommend that HRSA consider talking to providers about state-level policy barriers to gain a qualitative understanding of how policy can support the increased use of telemedicine and provision of substance use disorder services.

Community Clinic Association of Los Angeles County (CCALAC), Los Angeles, CA

California has reimbursement restrictions in place that serve as barriers for the uptake of telemedicine, and for mental health and substance abuse services. Determining level of service and compliance with requirements in these areas requires an understanding of the impact of state policies on the utilization of telehealth and substance use disorder services.

To measure efficacy of work in this area, health centers recommend that level of service and compliance with requirements be measured by reporting:

  • Hours of service
  • Number of unique patients served
  • Whether clients return for a first, second, third treatment
  • Whether patient tests clean at each encounter
  • Total number of encounters

Reporting would be aided by clear definitions around level of services and compliance. For example, members recommend additional clarity around required versus additional dental services and what services and provider types are considered primary care and what is considered specialty.

Eastern Aleutian Tribes (EAT), Anchorage, AK

While EAT supports the desire of HRSA’s Bureau of Health Workforce (BHW) for their National Health Service Corp (NHSC) clinicians to support the priorities on telehealth and substance use disorder, just adding more data collection requirements does not necessarily result in a positive impact. It would be a better idea for BHW to offer an increase in the loan repayment amount for NHSC clinicians that actually engage in telehealth to serve patients with substance abuse disorder. If you were offering additional amounts of loan repayment for these much needed services, then it would make sense to increase the data collection requirements to ensure compliance and determine the actual volume of service provided by the clinicians.

Family Health Centers of San Diego, San Diego, CA

Family Health Centers of San Diego believes that the best way to measure level of service and compliance with requirements is for grantees to report, 1. Hours of Service, 2. Number of unique patients served, and 3. Total number of encounters. Additionally, should the bureau desire to better judge the effectiveness of the training environment, simple pre- and post- knowledge and comfort of those participating would be relatively simple to implement.

Medical University of South Carolina

As someone with over 15 years working with database systems, data collection, and data analysis, AND, who has worked with HRSA's Electronic Handbooks system (EHBs) since it began, I think HRSA's system could be streamlined very easily. Instead of defining the reports you want from grantees, define the datasets you want. In other words, don't collect summaries of the data, collect the data itself.

Any grantee that has any clue about data collection knows that in order to generate the required reports in the EHB system, you first need to generate the base dataset. For example, in order to know how many white female students we worked with, you first have to have a list of all students you worked with and the gender and race attributes for each. Instead of sending HRSA the summary statistics (i.e. 26 female white, 13 male white), why not just collect the underlying list that the summary is based on? There are several huge advantages to this approach:

  1. It would save a lot of extra work on the grantee's part by not having to run complicated queries against the underlying dataset.
  2. It would make the data more useful. HRSA could analyze the data in whatever ways they wanted instead of being stuck with the few reports that are submitted. (Don't take my word for it…ask any data analyst if they would rather work with the raw data or arbitrary summaries of the data.)
  3. It would make grantee data more easily combinable for national level analysis.
  4. It would make it easier to audit a grantee because individual cases could be investigated more easily.
  5. It would be easier for the BHW program to implement data collection changes because it could simply add another field to a spreadsheet definition.

I anticipate that some grantees would resist this change:

Potential Objection 1. What about the privacy of the participants?
Response 1: Datasets could be submitted without the personally identifying information of the participants. HRSA is already doing this on a small scale with the AHEC Scholars system. The same approach could easily be expanded to all the data.

Potential Objection 2. It's more work to enter individual level data.
Response : This is true…IF you're using the EHB's. The EHB's are a magnificent achievement, but, honestly, the way they are structured makes reporting harder than it has to be. A simple spreadsheet upload is all we would really need, if we were collecting the data in spreadsheet form. The data could still be validated, it just wouldn’t require hours and hours of tedious data entry by the grantees. In this day and age, all grantees should have some type of data system that can spit data out in spreadsheet form. From a technical standpoint, it’s not a lot to ask.

Potential Objection 3. It's too hard to manage large datasets.
Response : This might have been true 15 years ago, but now even a regular desktop computer can handle far more data than HRSA programs can generate.

Mendocino Community Health Clinic (MCHC), Ukiah, CA

HRSA must first understand the impact of state policy on the utilization of telehealth and substance use disorder services. California has many reimbursement restrictions that serve as barriers for the uptake of telemedicine, and for mental health and substance abuse services.

To measure efficacy of work in this area, MCHC recommends that level of substance use prevention and treatment services and compliance with requirements be measured by reporting:

  1. Number of unique patients served,
  2. Number of encounters provided,
  3. Number of telehealth encounters provided, and
  4. Number of unique patients provided case management.

Neighborhood Healthcare (NHcare), Escondido, CA

NHcare finds the NHSC application process to be extremely time consuming and cumbersome. To reduce the burden, we recommend:

  1. Allowing for the electronic submission of applications and verification of enrollment
  2. A short quick reference guide, or coaches, be made available that could quickly advise applicants on the available programs, and provide clear instructions on what needs to be done to submit for that specific program.
  3. It would greatly assist applicants if a minimum qualifications screening via an internet tool was created so that candidates who don’t meet the minimum qualifications could be quickly given that information and move on.
  4. The application process could be improved by reducing required essays from three down to one.

Finally, one of the greatest barriers is the lack of transparency in the actual HPSA score that community health centers need for providers to receive an award in the Loan Repayment Programs. Health centers report spending a lot of time applying only to find out they haven’t been selected due to their HPSA score being too low for the current loan process. We recommend that HRSA publish the HPSA scores that will be eligible employ providers receiving an award in the loan repayment programs.

RFI section D.3

American Association of Nurse Practitioners, Alexandria, VA

Nurse practitioners are heavily involved in HRSA programs to increase access to care in health professional shortage areas and medically underserved communities. A recent study in Health Affairs found that 25% of primary care in rural communities is now provided by nurse practitioners. [Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners hrsa exit disclaimer, Hilary Barnes, Michael R. Richards, Matthew D. McHugh, and Grant Martsolf, Health Affairs 2018 37:6, 908-914.] However, the authors of the study were only able to evaluate the number of NPs practicing in physician practices because there is currently no publicly available data set for the number of NP-owned or managed practices or clinics. [Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners hrsa exit disclaimer, Hilary Barnes, Michael R. Richards, Matthew D. McHugh, and Grant Martsolf, Health Affairs 2018 37:6, 909.] NPs comprise an increasingly large portion of the healthcare workforce. The number of NPs in the workforce has grown by almost 100,000 since HRSA last surveyed NPs in 2012. [https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/npsurveyhighlights.pdf.] It would be helpful if HRSA can enhance their workforce data by assessing NPs who manage or own their own clinics, helping to obtain a more complete picture of the health care workforce.

American Optometric Association, Alexandria, VA

The National Center for Health Workforce Analysis provides valuable research and analytic support to everyone interested in health care workforce issues. However, the U.S. Health Workforce Chartbook's information on doctors of optometry suggests that for over half the states, the workforce data should be used with caution because of large sampling error and a lack of reliability. [https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/chartbookpart2.pdf] The BHW has a responsibility to work to improve this data and the underlying reporting systems in order to provide a more accurate picture of the health workforce resources and needs in each state.

AT Still University (ATSU), Kirksville, MO

ATSU appreciates the opportunity to report the training activities offered in partnership with CHCs in the EXP tables. As CHC's are increasingly the "front line" to primary care and population health, perhaps a stand alone question (similar to the newly added IPE/IPP) would be beneficial to determine how many training activities are occurring exclusively at CHC sites.

In relation to performance measure data, it would be helpful to receive advance notice of new performance measures/questions to be reported. Many grantees track the performance data through the year and learning of new requirements 6 weeks prior to the due date for the Annual Performance Report creates significant reporting difficulties as the data must be collected, validated, and reported in a very short time frame.

California Primary Care Association (CPCA), Sacramento, CA

The current process that requires an entirely separate UDS submission for BHW grants is extremely burdensome. We recommend that the Bureau work to integrate this reporting with the BPHC UDS reporting as a separate population within the same report, similar to how Healthcare for the Homeless and Public Housing Primary Care are now subpopulations.

Additionally, we recommend HRSA solicit/collect training resources, webinars and presentations in all required areas of training for all health centers (by State), and create a depository for use/download by all health centers.

These training resources should be easily uploaded into each organization’s learning management system (LMS) and come with suggested assessments to test knowledge; this setup would enable organizations to deliver, track and report by employee, by site, and course.

Chicago Family Health Center, Chicago, IL

BPHC has a great responsibility to push the propagation and expansion of the primary care workforce, and the NHSC program works. I would like to see ongoing data gathering around NHSC Clinicians, and feel the NPI would be the best primary identifier for a particular clinician. I would also like to see more recognition of the program, and educational and marketing efforts to make participants feel "special" in their commitment to the underserved. The goal of this would be to increase future service, rather than losing clinicians to mainstream medicine after their loan repayment period ends. These clinicians should have some form of "veteran" status, which might push them to continue to make a conscious choice to serve communities in need.

Community Clinic Association of Los Angeles County (CCALAC), Los Angeles, CA

The current process, which requires an entirely separate UDS submission for Bureau of Healthcare Workforce (BHW) grants, is extremely burdensome. Health centers recommend that the Bureau work to integrate this reporting with the BPHC UDS reporting as a separate population within the same report, similar to how Healthcare for the Homeless and Public Housing Primary Care are now subpopulations.

Additionally, we recommend HRSA compile, by state, training resources, webinars and presentations in all required areas of training and create a resource library where health centers can access and download them. Training resources should be uploadable into health centers' learning management systems (LMS) and come with suggested assessments to test knowledge. This would enable organizations to more easily deliver, track and report on training.

Eastern Aleutian Tribes (EAT), Anchorage, AK

In general, EAT does NOT support requiring additional performance measure data, because each addition adds more staff time to our already lengthy data collection requirements. EAT does not have specific comments on which performance measures could be streamlined, because we do not currently receive any grants for training programs from BHW.

Family Health Centers of San Diego, San Diego, CA

The current process that requires an entirely separate UDS submission for BHW grants is extremely burdensome. Family Health Centers of San Diego would recommend that the bureau work to integrate this reporting with the BPHC UDS reporting as a separate population within the same report, similar to how Healthcare of the Homeless and Public Housing Primary Care are now subpopulations of the Universe.

Mendocino Community Health Clinic (MCHC), Ukiah, CA

MCHC recommends HRSA solicit/collect training resources, webinars and presentations in all required areas of training for all health centers (by State), and create a depository for use/download by all health centers.

These training resources should be easily uploaded into each organization's learning management system (LMS) and come with suggested assessments to test knowledge; this setup would enable organizations to deliver, track and report by employee, by site, and course.

RFI section D.4

Alabama Department of Public Health, Montgomery, AL

RFI section D.4 i. The call center has a reputation for being unaware of at least components of the National Health Service Corps program. The call center has inappropriately referred callers to the Primary Care Office when the Division of Regional Operations or some other entity/person within the BHW should have responded to the question. This is particularly confusing to candidates, and adds wasteful steps in responding to inquiries.

It appears more Call Center training and/or guidance is needed on how to handle/route National Health Service Corps/Nurse Corps inquires.

ALTURA Centers for Health, Tulare, CA

Once multiple providers have been stored, but not processed, it is difficult to retrieve the information on the stored providers to submit them to the system. It would be nice if the process could be simplified to retrieve the stored information for submission.

California Primary Care Association (CPCA), Sacramento, CA

CPCA health centers report that entering data to run reports on the NPDB website is very easy and the turnaround time to obtain a report after a report is requested is very fast. When customer service is needed, CPCA health centers report excellent customer service.

CPCA members offer a few recommendations for improving NPDB processes:

  1. Seek electronic integration with Workday, the largest human capital management software;
  2. Eliminate or modify the need to re-enroll each practitioner into the database.
  3. Reduce the input requirements, such as social security and date of birth. At the time of interview, which is when query responses are most utilized, HR departments do not always have access to all of the personal information required from the NPDB to access a query response.
  4. Provide clear direction to HRSA OSV consultants on the requirements for how to use and who must be included in the NPDB queries, as health centers report receiving conflicting guidance.
  5. Lastly, an organization fee to run queries rather than a fee per employee would ease financial burden. If that is not feasible, providing an online payment system or at the very least invoicing for all queries in a month rather a separate invoice for each query would reduce accounting burden.
  6. Training for health center staff on adverse action requirements would be appreciated.

Community Clinic Association of Los Angeles County (CCALAC), Los Angeles, CA

Health centers report that entering data to run reports on the National Practitioner Data Bank (NPDB) website is very easy and the turnaround time to obtain a report is very fast. When customer service is needed, most health centers report excellent customer service.

The following are recommendations for further improving NPDB processes:

  • Eliminate or simplify re-enrolling each practitioner into the database.
  • Reduce the input requirements, such as social security and date of birth. Query responses are most often used at the time of the interview; prior to when a health center would obtain this level of detailed personal information from an applicant.
  • Provide clear direction to HRSA OSV consultants on the requirements for how to use and who must be included in the NPDB queries, as health centers report receiving conflicting guidance.
  • Administrative burden on health centers could be reduced by charging an organization fee (rather than a fee per query), creating an online payment system, or invoicing organizations monthly, rather than a separate invoice for each query.

Family Health Centers of San Diego, San Diego, CA

We would recommend the following two areas where NPDB processes could be streamlined and made more effective. 1. Seek electronic integration with Workday, the largest human capital management software; and 2. Eliminate or modify the need to reenroll each practitioner into the database. Additionally, clearer direction needs to be given to HRSA OSV consultants on the requirements for how to use and who must be included in the NPDB queries as we have received conflicting guidance. Lastly, an organization fee to run queries rather than a fee per employee would ease financial burden, however if not feasible, invoicing for all queries in a month rather a separate invoice for each query would reduce accounting burden.

Health Center Partners of Southern California, San Diego, CA

The NPDB is useful in identifying current issues with provider licenses but can be opaque when considering the physician's full history. If an "additional information" category could be added, the individual site could make the decision if they would like to pursue the candidate knowing the full history.

Mendocino Community Health Clinic (MCHC), Ukiah, CA

MCHC has found that entering data to run reports on the NPDB website is very easy and the turnaround time to obtain a report after a report is requested is very fast. When customer service is needed, MCHC has received excellent customer service.

Recommendations for improving the NPDB processes:

  1. Seek electronic integration with Workday, the largest human capital management software;
  2. Eliminate or modify the need to re-enroll each practitioner into the database.
  3. Reduce the input requirements, such as social security and date of birth. At the time of interview, which is when query responses are most utilized, HR departments do not always have access to all of the personal information required from the NPDB to access a query response.
  4. Provide clear direction to HRSA OSV consultants on the requirements for how to use and who must be included in the NPDB queries, as health centers report receiving conflicting guidance.
  5. Lastly, implementing an organizational fee to run queries rather than a fee per employee would ease financial burden. If that is not feasible, providing an on line payment system or at the very least invoicing for all queries in a month rather a separate invoice for each query would reduce accounting burden.
  6. Training for health center staff on adverse action requirements would be appreciated.

QueensCare Health Centers, Los Angeles, CA

Yes, HRSA should implement system enhancements to improve the querying and reporting workflow processes.

Date Last Reviewed:  October 2018