application process

0293 process.doc

Free Clinics FTCA Program Application

application process

OMB: 0915-0293

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HRSA Review Process for Free Clinic FTCA Initial Deeming Applications

Free clinic submits FTCA deeming application to HRSA/BPHC staff

BPHC staff note receipt of application in tracking database (and FTCA file created if not already established)

BPHC staff or contractor performs initial application screening to determine completeness

BPHC staff sends communication noting the application deficiencies


Application passes initial screening

BPHC staff or contractor completes a thorough review of the application

BPHC staff recommend approval of FTCA application

Free clinic receives letter stating the effective date of FTCA coverage for its sponsored volunteer health care professionals and the due date for the annual renewal application

Application does not pass initial screening


Free clinic does not resubmit the application

Free clinic resubmits the application


Application does not pass through review

Application passes thorough review

BPHC staff prepare FTCA deeming letter for signature by HRSA’s Associate Administrator for Primary Care (date of letter noted in tracking database). BPHC staff confirm that all application materials and correspondence are included in FTCA file.

Minor and/or easily resolved deficiency: BPHC staff or contractor contact free clinic by phone or e-mail to discuss and establish plan for resolution

Significant deficiency: BPHC staff or contractor contact free clinic by phone to discuss and establish plan for resolution

BPHC or contractor staff confirm that free clinic has resolved deficiency


File Typeapplication/msword
AuthorSSMITH
Last Modified ByHRSA
File Modified2008-07-29
File Created2008-07-29

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