Office of Performance Review (OPR)

U.S. Department of Health and Human Services (DHHS)Health Resources and Services Administration (HRSA)

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Stephen DorageRegional CoordinatorJuly 28, 2008

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Office of Performance Review (OPR)

Kansas City

Denver

Seattle

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Boston

New York

Dallas

San Francisco

Atlanta

Chicago PhiladelphiaRockville

Puerto Rico

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OPR Mission

To improve access to quality health care and reduce health disparities by effectively reviewing and enhancing the performance of HRSA-supported programs within communities and States.

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OPR Core Functions

Improve the Performance of HRSA-Funded Programs

Work Collaboratively with Grantees and HRSA Bureaus/Offices to Measure Program Performance

Identify Effective Strategies and Partnerships to Improve Program Performance, with a Particular Focus on Outcomes

Provide Feedback to the Agency about the Impact of HRSA Policies on Program Implementation and Performance within Communities and States.

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OPR Key Activities

Grantee Performance Reviews State and Community Strategic

Partnership Sessions Technical assistance Policy and Trends Report Environmental Snapshot

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Partnering to Serve HRSA Grantees

HRSA Grantees

OPRBureaus/Offices

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HRSA Funding

HRSA provides over $6 billion in grants or cooperative agreements

To over 3,000 organizations

Through 80 different programs

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HRSA Grantees by Organization Type

Community-based

University/College

Hospital

Local government

State government

Association

National

Foundation

FoundationNationalAssociation

State government

Local government

Hospital

University/College

Community-based

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Purpose of Performance Reviews

To improve the performance of HRSA-funded programs

Provide direct feedback to the agency about the impact of HRSA policies on program implementation and performance

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Performance Review Benefits

Improved grantee performance through:– Facilitated discussions– Sharing best practices– Expert consultation/technical assistance– Performance Improvement Action Plan

Cross-Cutting feedback on HRSA policies Environmental surveillance

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Underlying Assumptions

Most grantees are performing well

Many solutions to issues/problems exist within an organization, or can be achieved through partnerships with others

Working in collaboration with grantees and other HRSA staff will produce better outcomes and results

Day-to-day grantee oversight responsibility remains with the Headquarters HRSA project officers and grants officers

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Performance Review Protocol

Two categories of review recognize the diversity of HRSA programs

Key Area Discussion captures important information about grantee performance directly or indirectly related to goals, objectives, or performance measures

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Performance Review: Category 1

Health services delivery activities and professional training programs with measurable data

Reviews generally: focus on the selected performance review

measures assess overall grantee performance

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Performance Review: Category 2

• Professional training and public health infrastructure development grants that have

• outreach activities as the scope of the project• limited project periods• may have performance best assessed either by progress

toward goals and objectives, or measures

• Reviews generally: focus on the selected goals/objectives, priority areas,

or measures assess overall grantee performance

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Project Officer Role in Review Process

Project Officers work collaboratively with OPR review teams throughout the Review Process

Project Officer participation may include, but is not limited to: consulting with review teams during the Pre-Site Preparation advising on the selection of measures and/or goals and

objectives participating in on-site visit reviewing Performance Review Report and Action Plan following up with grantee on progress made on Action Plan

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Performance Review Components

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PerformanceAnalysis

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Action Plan

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Program Performance

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PerformanceReport

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Performance Review Timeline

Week 1-8 - Pre-Site Visit Review of Key Grantee Materials and Pre- Site Consultation with Grantee, HRSA Project Officer(s) and Other Appropriate HRSA Staff

Week 9 - Site Visit (scheduled at least 12 weeks in advance)

Week 13- Draft Performance Report sent to grantee with request for feedback and an Action Plan

Week 15 - Grantee submits Action Plan and feedback on Draft Performance Report to OPR and Project

Officer

Week 18 – Final Performance Report and approved Action Plan sent to grantee and distributed within HRSA for Follow-up

Actions/Technical Assistance

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Phases of Performance Review

Pre-Site Preparation On-Site Visit Post-Site Action Plan Follow-Up

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Pre-Site Preparation

Identify program performance measures, or goals and objectives

– Program reporting requirements– Grantee goals/objectives in the grant application– HRSA’s GPRA program measures

Determine:– How is the grantee performing on these measures, or goals and

objectives?– Is there a gap between current and desired performance?

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On-Site Visit

Average 2 to 3 day site visit with review team of 2-4 members

Identify the factors contributing to/restricting performance– Internal systems and processes– External issues, including HRSA policies– Partnerships – critical for most outcome measures

Identify best/promising practices

Discuss possible Performance Improvement Options and Action Plan development

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Post-Site

Prepare Performance Report and share draft with the grantee, project officer(s), and other HRSA staff for feedback and comments

Request Action Plan from grantee that addresses:– Performance Improvement Options– Program Requirements

Review the grantee’s Action Plan submission and provides feedback, as appropriate

Finalize & disseminate Performance Report and Action Plan

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Action Plan Follow-Up

Program requirement issues will be reviewed by the Project Officer(s) in consultation with the grantee

TA requests that support Action Items will be shared with Bureau/Office for concurrence

Project Officer(s) and Review Team will follow up with grantee on progress on Action Plan

Grantees will include updates on Action Plan progress as part of regular program progress reporting to Project Officer

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Questions

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THANK YOUStephen Dorage

Atlanta Regional DivisionOffice of Performance Review

sdorage@hrsa.gov or (404) 562-4127

For further information, please view our website:http://www.hrsa.gov/performancereview