Contract Lists and Supporting Documentation

Clarifying which contracts to select for Chapter 12

Do they really want to see my sanitation contract?

When it comes to Chapter 12 of the HRSA Site Visit Protocol (SVP), so many of us get stopped in our tracks. For the rest of us, we just assume the documents we selected for Form 5A are sufficient. Neither response is correct. With a review of the details in the Site Visit Protocol for Chapter 12: Contracts and Subawards, along with the HRSA Compliance Manual, we can nail down with certainty what reviewers need for compliance and why.

In this blog post, we will review what documents are required, what questions are being answered, and why those questions are being asked. We’ll turn to the Site Visit Protocol for the first two points, and the revert back to the Compliance Manual for the last point.

What Documents are Required

Here’s what happens: a health center gets a hold of the Consolidated Documents Checklist from their OSV Review Team. They get down to Chapter 12: Contracts and Subawards, and they read that they need to provide a list of contracts. This is usually when we get an email asking “What are the reviewers looking for?” There are 3 key parts:

1. A list

2. Federally-Supported Contracts and Procurement Support

3. Non-Federally-Supported Contracts.

Let’s tale a look at these together!

The List

Provide a complete list of health center contracts that support the HRSA-approved scope of project, including contracts for health center clinical services or other goods and services (for example, tech support, janitorial, payroll). Specifically, include all active contracts and all contracts that had a period of performance that ended less than 3 years ago. In the list, include all of the following information for each contract:

• Whether the health center uses federal award funds to pay in whole or in part for the contract (not applicable to Look-Alikes);

• Contractor/contract organization;

• Value of the contract (if there is a federal share, state the federal share amount);

• Brief description of the goods or services provided;

• Period of performance/timeframe (for example, ongoing contractual relationship, specific duration); and

• Whether the contract supports substantive programmatic work.

We can simplify these three steps: 1) Include the right contracts, 2) filter by timeframe, and 3) select the right columns.

Step 1 – Include the right contracts – all of them. The verbiage here makes it clear that it is any contract that is used to support the HRSA-approved scope of project. For clarity, this means any contract for the health center, unless, the health center maintains certain services out-of-scope and the contracts exclusively support those activities or services. It does not mean only contracts that relate to Form 5A: Services. We know that because the request explicitly states examples to include “tech support, janitorial, payroll” services.

Step 2 – Filter for timeframe – keep active contracts and those ending less than 3 years ago. Any other contracts that ended more than 3 years ago are beyond the scope of this compliance assessment, and you can (and should) remove them from your list.

Step 3 – Select the right columns – use your accounts payable system or vendor list to develop a simple table that includes all the required elements. The table may look like:

Example contract table.

You may want to rearrange the columns based on the way the data is structured in your system and how it makes sense to manage. The key is to make sure all of the required items are present. Notice that the description does not have to be long, and the timeframe needs to be detailed to the relevant point – is it ongoing or did it end less than 3 years ago? Substantive work is rare and is only included if the organization has received prior HRSA approval to contract for a majority of its Form 5A services. This point is beyond this blog article.

Federally-Supported Contracts

Based on the list of contracts that support the HRSA-approved scope of project:

• Five contracts AND related supporting procurement documentation for actions that use federal award funds. Choose the contracts that use the largest amounts of federal award funds.

Notice here that the Site Visit Protocol is saying to use the list that was created above to filter those that use the largest amounts of federal award. That means sorting the list above by Federal Share from largest to smallest and taking the top 5. You then need to provide the final contract and the procurement support used for this purchase. This means you should include any of the documentation required by your procurement procedures that guide the procurement with federal funds – solicitation of bids, multiple bids, selection rationale, final contract, and pricing terms.

Non-Federally-Supported Contracts

Based on the list of contracts that support the HRSA-approved scope of project:

• Sample of five contracts that do NOT use federal award funds.

Here the list above is to be filtered for any “N” to Federal Funds and the health center is allowed to select from that group. Notice that the health center only has to provide the contract and not the procurement support. This particular selection is used in Chapter 12 Element f where both the federally supported and non-federally-supported contracts are reviewed for the required contract language.

What Questions are Answered?

To avoid reprinting the Site Visit Protocol in detail here, we will point to the main questions that the documents above are used to answer.

Chapter 12 Element b

In this element, the list is used to answer if the health center has any active contracts that ended less than 3 years ago that use federal awards. In some cases, health centers answer “no” to this because they use the majority of their federal funding for salaries. However, with the influx of COVID-related federal dollars, many health centers now have to answer “yes”.

If that answer is yes, then contracts and procurement support are reviewed to make sure that the rationale, contract type, contractor, and basis for price are all evident.

As a best practice, health centers may have a procurement checklist or coversheet that walks staff members through: clarifying what the purchase amount is, based on the amount the type of procurement support that is needed, a place for multiple vendors to quote amounts, and a rationale location for final selection information.

Chapter 12 Element c

This element reviews the final contracts to ensure that they are fully executed. Make sure that you are retaining the signed and counter-signed contracts for all agreements – especially those supported by federal awards.

Chapter 12 Element f

Skipping ahead here, Element f reviews both sets of contracts. These questions focus on the health center’s ability to hold contractors accountable for the services they agreed to provide. Namely, the questions make sure the health center has contracts that: 1) specify what the contractor will do, 2) how performance will be monitored (Continuous HRSA Compliance: Contract Program Monitoring), 3) getting needed data, and 4) record retention.

The rationale here is that if HRSA is designating the health center as meeting all of the federal requirements to be a Federally Qualified Health Center (FQHC), then the FQHC needs to ensure that its contractors are meeting those same standards. The FQHC needs to ensure the contractor’s services are clear and that it has a way to hold that contractor accountable. It needs to ensure that any relevant data needed for UDS or other grant reporting will be provided promptly. Finally, because money is changing hands, the FQHC needs to know that the contractor will keep its own records in the case of an audit that requires such documentation.

Why are these questions being asked?

The Site Visit Protocol bases these questions on the Compliance Manual, which spells out the statutory requirements for the Health Center Program. These requirements are meant to ensure that the vast resources that American taxpayers are investing in the Health Center Program are producing the intended results of providing accessible, high-quality care to communities across the country.

To summarize the points, the HRSA Compliance Manual outlines that health centers must:

• Use procurement procedures

• Conduct a cost analysis

• Ensure full and open competition

• Clarify rates and payment method

• Monitor contractor performance

• Retain records for at least 3 years

As you look back at the HRSA Site Visit Protocol documents and questions above, you can see why these are provided to satisfy the requirements laid out by the Compliance Manual.

How to Use RegLantern

RegLantern provides a straightforward way to upload documents for the required list, contracts, and procurement documentation. In addition, RegLantern’s Organizations and Agreements and Form 5A modules provide a complete location to keep track of all of your contracts, the overall value, the federal share, term dates, and which Form 5A services they support. With features like automated reminders and document tagging, RegLantern makes navigating these complex matters a breeze. Contact us today to schedule a demo with us or let us know how we can help you with your compliance needs.