Form 1 OMB Passback PIMS Measures-CLEAN 11-10-16

HRSA-15-068

Rural Network Allied Health Training Program

Performance Measures

Grant Program:

The purpose of this grant program is to support the development of formal rural health networks that focus on activities that strengthen the rural health care system. Such activities include those that improve the quality of essential health services and those that facilitate efficient, accessible, and coordinated health care. This project will meet its goal through the recruitment, clinical training, and retention of allied health professionals.

The Importance of Measuring Performance:

The Performance Improvement Measurement System (PIMS) is used to develop grantee baseline measurements, track progress, and develop an evidence base for effective rural health interventions. A robust set of performance measures is an important evaluation component that helps the Federal Office of Rural Health Policy (FORHP) determine the effectiveness of Rural Network Allied Health Training Program grantees’ efforts to meet overall project goals. In addition, it is important to have high quality data for grantees to use in self-evaluation. The data reported into the PIMS system allows FORHP to determine if grantees are meeting the health workforce needs of their network members while also addressing the broader goals of the 330A grant program. In turn, these data enable FORHP to document the impacts of its investment in rural communities through the Allied Health Program. Grantees may also use the PIMS data in developing and conducting evaluations of their own programs to measure the extent to which goals and objectives are met. FORHP will share aggregate PIMS data reports so that individual grantees can compare their performance against peers (benchmarking). FORHP has learned through the evolution of PIMS that sharing PIMS data with grantees enhances the quality and consistency of grantees’ PIMS data, supports grantee performance improvement activities, and results in high quality program outcomes.

Tables/Categories:

1. Network Member Service Area

2. Population Demographics

3. Network Description

4. Sustainability of Network and Program

5. Student Access to Education

6. Student Education and Training

7. Workforce Recruitment and Retention

Performance Measures:

Table 1: Network Member Service Area

Instructions:

Information collected in this table provides an aggregate count of the number of counties within the service area that network partners serve, which may or may not be the total population residing within the service area. In the third column, please enter a numerical figure or DK for don’t know, if applicable.

Number of counties

• End of the budget year number is the number of counties served by the end of the budget year.

• Denotes the number of counties served through the program, which is defined as the number of counties the network members’ serve. Please include entire the county served through the grant program, for example, if your project is serving only a fraction of a county; please count that as one (1) county.

1	Number of counties: (If you serve a sub-county area please count this as (1)	Number of counties at the end of budget year (count sub-county areas as “1” county)
	Total number of counties served by your network members
	Number of counties providing students for the program

Table 2: Population Demographics

Instructions:

Please provide the number of people in your service area population by race, ethnicity, and veteran status. The number of people is defined as the total potential trainee population targeted for the Rural Network Allied Health Training Program. The number of people in the target population would be the total number of trainees the network organization has access to as well as the total number of trainees enrolled in the educational programs and institutions where the network is actively recruiting.

If the number of people is zero (0), please put zero (0) in the appropriate section; do not leave any sections blank. There should not be a N/A (not applicable) response since all measures are applicable.

Number of people served through program by defined ethnicity of Hispanic or Latino where Hispanic or Latino origin includes Mexican, Mexican American, Chicano, Puerto Rican, Cuban and other Hispanic, Latino or Spanish origin, such as, Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard etc.

Population Demographics		Number
2	Number in target population by ethnicity:
	Hispanic or Latino
	Not Hispanic or Latino
	Unknown
3	Number in target population by race:
	American Indian/Alaska Native
	Asian
	Black or African American
	Native Hawaiian/Other Pacific Islander
	White
	More than one race
	Unknown
4	Number of military persons in target population
	Active Service Person
	Veteran
	Non-military persons

Table 3: Network Description

Instructions:

Please identify the total number of formal member organizations in the consortium or network, as well as the types of member organizations by non-profit and for-profit status and organization type. Please indicate a number for each category.

Network Size		Number
7	Type of member organizations in the consortium or network	Number
	Area Health Education Center (AHEC)
	Community College
	Community Health Center
	Community Mental Health Center (CMHC)
	Critical Access Hospital
	Faith-Based Organization
	Federally Qualified Health Center (FQHC)
	Health Center Controlled Network (HCCN)
	Health Department
	Migrant Health Center
	Private Practice
	Quality Improvement Organization
	Regional Extension Center
	Rural Acute Care General Hospital
	Rural Health Clinic
	School District
	Social Services Organization
	Technical School
	University/College
	Urban Acute Care General Hospital
	Other – Specify Type:

Table 4: Sustainability of Network and Program

Instructions:

Please provide the following funding/revenue amounts:

• The amount of additional funding secured to sustain the Rural Network Allied Health Training Program. Please indicate if you have a sustainability plan and select your sustainability activities.

If the total amount of additional funding secured is zero (0), please put zero in the appropriate section. Do not leave any sections blank.

Please identify the types of sustainability activities that the network/consortium engaged in during the respective budget year; please check all that apply.

8	Funding/Revenue:	Dollar Amount * If the total amount of additional funding secured is zero (0), please put zero in the appropriate section. Do not leave any sections blank.
	Additional funding secured to assist in sustaining the Rural Network Allied Health Training program (e.g. value of in-kind services, additional grants, cash, etc.)
9	Type(s) of sources of funding for sustainability:	Mark “X” for all that apply.
	Tuition
	Network Business Revenue
	In-Kind Contributions	Y/N
	Specify types: (such as Financial Endowments, staffing, etc.)
	Project Member Dues
	Fundraising
	Other Grants
	Specify type of other grants,: such as, foundation, state, federal
	Contractual Services
	Other – Specify Type:

Table 5: Student Access to Education

Instructions: Please provide the following information about individuals enrolled in the program. In question11A please indicate the total number of individuals in the program. In subsequent columns where indicated, the total number should equal the same for the total number of individuals in the program. In question 17 ividuals may fall into more than one category. *Note: For a definition of disadvantaged, please go to http://www.hrsa.gov/loanscholarships/scholarships/disadvantaged.html

	Performance Measure	Number
11A	Insert the total number of individuals in the program	Total Number:
11 B	Indicate the number of individuals enrolled in the program by type (select all that apply):	Number
	Full- time employed individuals
	Part-time employed individuals
	unemployed individuals
		Total Number:
11 C	Indicate the number of individuals enrolled in the program by type (select all that apply)
	current health care staff
	local displaced workers
	underrepresented Minorities and/or from Disadvantaged Backgrounds*
		Total Number:
11D	Indicate the number of individuals enrolled in the program by type:
	rural residents
	non-rural residents
		Total Number:
12	Indicate the number of individuals enrolled that currently have an Associates level degree or higher	Number:

Table 6: Student Education and Training

Instructions: Please provide the following information about individuals enrolled in the program

that have completed the training, and those that permanently left the program. In questions 20, 22, 24, 26 and 28 individuals may fall into more than one category. *Note: For a definition of disadvantaged, please go to http://www.hrsa.gov/loanscholarships/scholarships/disadvantaged.html

13	Indicate the total number of individuals who completed the training (results in certification, such as EMT)	Total Number
14	Indicate the number of individuals who completed the training or educational program (e.g., associate degree) by type:
	full time employed individuals
	part-time employed individuals
	unemployed individuals
		Total Number
14A	Indicate the number of individuals who completed the training or educational program by type (an individual may fit more than one category):
	current health care staff
	local displaced workers
	underrepresented Minorities and/or from Disadvantaged Backgrounds*
		Total Number
15	Indicate the number of individuals who completed the training or educational program by type:
	veterans
	non-veterans
		Total Number
16	Indicate the number of individuals who completed the training or educational program by type:
	rural residents
	non-rural residents
		Total Number
15A	Indicate the number of individuals who permanently left the program before completion by type:
	full time employed individuals
	part-time employed individuals
	unemployed individuals
		Total Number
15 B	Indicate the number of individuals who permanently left the program before completion by type:
	current health care staff
	local displaced workers
	underrepresented Minorities and/or from Disadvantaged Backgrounds*
		Total Number
15 C	Indicate the number of individuals who permanently left the program before completion by type:
	veterans
	non-veterans
		Total Number
15 D	Indicate the number of individuals who permanently left the program before completion by type:
	rural residents
	non-rural residents
		Total Number

Table 7: Workforce Recruitment and Retention

Instructions: Please provide the following information about individuals that have completed* the program and are now considered part of the Allied Health Professional workforce. **Those have completed the Program are defined as individuals who have completed the education or training.

15 D	Indicate the number of targeted vacant Allied Health positions located within the rural community.	Number
16	Indicate the number of individuals who completed the program that are currently employed in the Allied Health field by setting:	Number
	critical access hospital
	rural clinic
	rural hospital
	rural Veteran’s Administration facility
	Health Center Controlled Network
	Other (Please specify)
17	Select the disciplines of Allied Health Professionals hired as a result of the FORHP funded program,: (indicate the number for all that apply)	Number
	Behavioral health technicians Specify: (psychiatric/mental/substance abuse)	Number
	Certified nursing assistants (CNA)	Number
	Dental hygienists	Number
	Emergency medical technicians (EMT)	Number
	Medical/clinical laboratory technicians	Number
	Technologists and technicians Specify: (diagnostic imaging technologists, sonography, radiology, etc.)	Number
	Paramedics or community paramedics	Number
	Pharmacy technicians	Number
	Other (please specify)	Number
18	How many program completers** who were placed in a permanent rural position are still employed in a rural Allied Health position?	Number

*Note: For a definition of disadvantaged, please go to http://www.hrsa.gov/loanscholarships/scholarships/disadvantaged.html

**Program completers are individuals who have completed the education, and training programs.

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