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Community Health Centers provide a wide range of services which define their scope. The Scope of Services is most commonly referred to in the health center world as the “Form 5A”. A sample Form 5A can be found HERE . The “Form 5A” provides a list of required services (services a health center MUST provide) and a list of additional services (services that are optional). This form also describes the mode of service provided; in other words, HOW the service will be provided. Will the service be provided by the health center (Direct: W-2 or National Health Service Corp employees), through a formal written contract agreement (also known as Column II, which the Health Center pays for), or through a formal written referral arrangement (also known as Column III, which the Health Center doesn’t pay for)?
Determining which method by which to provide a service is up to the health center; taking into consideration patient needs through patient surveys and focus groups, financial viability or stability, and discussion with key management staff and board members.
In developing a contract or formal written arrangement, known as a Memorandum of Understanding or Agreement (MOU/MOA), it is important to seek legal counsel to determine non-profit requirements, state and local laws, and other contractual obligations required in contracts and MOUs/MOAs.
This article only addresses the requirements set forth by HRSA to determine required language for Column II and Column III obligations. Let’s consider Column II Contracts.
Column II Contracts
Column II contracts are formal written contracts or agreements where the community health center will pay for the service. Based on the Health Center Program Site Visit Protocol, Column II & Column III contracts are reviewed in Chapter 4 (Required and Additional Health Services) , Chapter 5 (Clinical Staffing), Chapter 9 (Sliding Fee Discount Program) and Chapter 12 (Contracts and Subawards). The following questions/comments should be addressed and included in Column II contracts:
The provisions listed above must be addressed in Column II contracts. A community health center is given the ability to choose how and what language to add in order to demonstrate compliance with these requirements within the contract.
Column III Agreements
Column III agreements are usually reflected within MOUs/MOAs. These agreements are considered to be a formal written referral arrangement. The following questions/comments should be addressed within the MOU/MOA:
Development of contracts and agreements should address other language such as, but not limited to termination, confidentiality, terms of agreement, indemnification, and so on. It is important that Health Centers check with local legal counsel, non-profit state laws, and any other regulatory requirements in the development of these types of contracts/agreements.
For more information, please visit: https://bphc.hrsa.gov/sites/default/files/bphc/programrequirements/scope/form-5a-self-assessment-review.pdf