Annual Review of Service Area (Chapter 3 Element a)

Updating your service area is a crucial step for community health centers aiming to align services with community needs. It’s also required. Chapter 3 of HRSA’s Site Visit Protocol asks if the health center uses the most recent Uniform Data System (UDS) to update the zip codes on HRSA’s Form 5B-Service Sites annually. Here's a quick guide on what to consider and how to make this happen.

1. Schedule an Annual Review

Schedule an annual review of the service area after the UDS is submitted each February. The month of March is a great time to conduct this review, as it allows you to analyze recent data and plan accordingly.

2. Find Your Most Recent Form 5B

Locate your most recent Form 5B from the HRSA Electronic Handbooks (EHBs). Create a list of the ZIP codes included, ensuring that there are no duplicates. This provides a clear picture of your current service area.

3. Compare Patient Data

Compare the number of patients coming from ZIP codes listed on Form 5B to your total patient population. You can use tools like the HCP GeoCare Navigator or udsdata.com to complete this step. Ensure that at least 75% of your patients are coming from the ZIP codes listed on Form 5B.

4. Consider Unmet Needs Score

As you determine your service area, you may also want to look at the Unmet Needs Score to ensure the selected ZIP codes still match the highest needs in your community (https://data.hrsa.gov/topics/health-centers/sanam, https://data.hrsa.gov/topics/health-centers/sanam).

5. Identify Potential Overlap with Other Health Centers

If you make changes to your service area, identify any new ZIP codes that may overlap with another health center. Adding a new ZIP code may require a letter of support and evidence of collaboration in future applications. Be proactive in reaching out to other health centers to establish partnerships and secure necessary documentation.

6. Check Board Member Connections

If you remove any ZIP codes, check to see if any board members no longer live or work in the service area. If you proceed with removing a ZIP code, that board member will need to demonstrate a meaningful connection to the service area and submit that information to the board.

7. Get any changes approved by the board

The Board has ultimate authority over the health center’s Form 5B. Consider showing a map of the current service area and the recommended changes. Provide a short explanation and be prepared to explain why the changes are necessary. 

8. Update in the EHBs through a Scope Adjustment (easier version of Change in Scope)

Make it official by submitting Scope Adjustments through the EHBs. Changes in ZIP codes are Scope Adjustments, but they do require some attention to detail. Find someone else to help you enter the data and provide a second set of eyes when you’re typing them into the EHBs.

Conclusion

Knowing your community and defining your service area is a crucial part of defining the scope of project. Communities change. Leaders do well to be responsive to the realities facing the community and creating a regular rhythm to revisit the community keeps us informed and making better decisions for our organizations.