ARRA Health Center Quarterly Report HCQR Reporting Period 3 Overview Quarter Ending 12312009

1
ARRA Health Center Quarterly Report(HCQR)Reporti
ng Period 3 Overview(Quarter Ending 12/31/2009)

• Technical Assistance Call
• December 30, 2009

2
Agenda

• HCQR Reporting Overview
• HCQR Reporting Definitions
• HCQR Reporting Using HRSAs EHB System
• ARRA Federal Reporting update www.federalreporting
  .gov

3
When will HCQR reports be submitted?
In July 2009, grantees reported HCQR Report 1 for

• New Access Point (H8A) grants

• Increased Demand for Services (H8B) grants

In October 2009, grantees reported HCQR Report 2
with additional data elements for their Capital
Improvement Program (CIP-C81) grants
In January 2010, grantees will report HCQR Report
3 including data on their Facility Investment
Program (FIP-C80) grants
4
Who will be reporting the HCQR?

• Health center grantees who received support under
  the American Recovery and Reinvestment Act (ARRA)
  will submit the HCQR report
• ARRA New Access Points (NAPs H8A grants) 3/09
• Increased Demand for Services (IDS H8B grants)
  3/09
• Capital Improvement Program (CIP C81 grants)
  6/09
• Facility Investment Program (FIP C80 grants)
  12/09
• HCQR data is reported by Grant Type (e.g., NAP,
  IDS, CIP, FIP) and will be summarized into a
  universal report by the HCQR system
• For each grant type, you will report data on
• Patients (New, Uninsured, By Service Type)
• Visits (follows UDS table 5 categories)
• Staffing by categories (new and retained
  combined into one column)
• Jobs (number of jobs created or retained) New
  Calculation Method for FTEs
• For CIP and/or FIP Projects, you will report
  Project Status
• There will be a project narrative and optional
  section to attach additional ARRA-relevant
  information

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HCQR Reporting Process
1 10 days after end of Quarter
11 29 days after end of Quarter
30 days after end of Quarter
90 days after end of Quarter
Grantees Enter HCQR Reporting Data
Reports are finalized
BPHC Reviews Data
BPHC Communicates to Grantees
3
1
5
Granteesbegincollectingnext Quarterdata
Initial Submission
Grantees Make Final Corrections
2
10 days after end of Quarter
4
6
BPHC Reviews HCQR Data
Grantees Adjust Reports
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HCQR Report Period 3

• 3rd HCQR Report (January 1 January 15, 2010)
  Data Elements to be reported
• NAP and IDS Awards
• SF-PPR Page 1 Cumulative New Patients,
  Cumulative New Uninsured Patients, award
  narrative, optional attachments
• SF-PPR Page 2 Quarterly FTEs Cumulative Visits
  and Patients
• CIP and FIP Awards
• SF-PPR Page 1 You will report Total New Patients
  and New Uninsured Patients only when you complete
  all of your CIP and/or FIP Projects
• Award Narrative
• Optional Attachments
• SF-PPR Page 2  One Page 2 for each CIP and FIP
  Award
• You will report only the Administrative and
  Construction Staff data cells
• As in reporting period 2, line 35 is for
  Construction Related Staff
• SF-PPR Page 3 CIP/FIP Project Report One Page
  3 for each CIP and/or FIP Project
• System will pre-populate the Project Number,
  Project Title and Project Type
• Select Project Status (e.g., Not Started, lt50
  Complete, gt50 and lt100 Complete, Completed)
• Project Narrative for reporting progress and
  Optional Attachments (e.g., pictures, news
  articles)
• SF-PPR Page 4 CIP and FIP Project Closeout
  Report

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Definitions New PatientsReported on SF-PPR
Page 1

• Cumulative Unduplicated Patients
• Total new patients served in the ARRA program
• A cumulative number including everyone since the
  start
• Total new uninsured served in the program
• Also a cumulative number
• Total new patients by service type
• Total new medical
• Total new dental
• Total new mental health
• Total new substance abuse
• Total new other health
• Total new enabling services
• Patients are unduplicated within each category,
  but can be counted in more than one category

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Definitions New PatientsReported on SF-PPR
Page 1

• A new patient is one who
• Has never been seen for any reportable service or
  counted for a UDS report prior to 2/17/09
• Has now been seen one or more times since 2/17/09
  for a reportable service
• This includes all patients who were reported at
  the end of the second quarter
• Also includes all new patients seen for the first
  time during the third quarter
• NAP New Start grantees will include all
  patients seen within the scope of their new HRSA
  grant
• NAP Satellite Expansion grantees will include
  only patients seen at the new site that were not
  previously served at any other grantee sites

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Definitions New UninsuredPatients on SF-PPR
Page 1

• An uninsured ARRA patient is one who
• Is a new ARRA patient who was uninsured at the
  time they were first seen or
• Is a new ARRA patient who was insured when first
  seen, but subsequently became uninsured or
• Is an existing patient who lost their insurance
  after 2/17/09
• Includes new uninsured patients reported in the
  first quarter
• NOTE A patient may have been a new patient in
  HCQR Reporting Period 1 or 2 and been insured.
  If they lost their insurance eligibility between
  October 1 and December 31, 2009 they will now be
  counted as anew uninsured patient.

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HCQR Cumulative Reporting

• The count of uninsured patients is cumulative.
  Once a patient is reported as uninsured they
  continue to be included in the count of uninsured
  patients.
• Therefore, a new patient who was uninsured when
  you first saw her in June whom you helped to
  obtain Medicaid coverage, will still be included
  in the count of New Uninsured Patients.

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Key Concept in HCQR Reporting

• HCQR Reports are cumulative, with the exception
  of FTEs
• In your 01/15/2010 HCQR report, you will report
  all of your ARRA project activities from the
  beginning of your ARRA grant to 12/31/2009
• For example, if you reported 20 new patients in
  your HCQR Report 1 and 10 new patients in your
  HCQR Report 2, you will report those same 30 new
  patients plus any new patients (e.g., 10 new
  patients) seen in period 3 for a cumulative total
  of 40 New Patients in your HCQR Report 3

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Definitions Patients by ServiceType Reported on
SF-PPR Page 2

• For each HCQR service, provide a cumulative
  unduplicated count of the patients who have
  accessed that particular service
• A new medical patient is either
• a new ARRA patient who has been seen one or more
  times for reportable medical services or
• An existing patient who never received medical
  services before and who is now able to do so
  because of new ARRA funded services
• Count a patient only once in each category of
  service
• Therefore, a patient may be counted as an ARRA
  medical patient and as an ARRA dental patient.

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Definitions Patients by ServiceType Reported on
SF-PPR Page 2

• On SF-PPR Page 2, the definition of new
  (medical/dental/ mental health/etc.) patients may
  include patients who are not counted on SF-PPR
  Page 1 as New ARRA patients.
• On SF-PPR Page 2, you may include an existing
  patient who, for the first time, obtains a new
  service which is supported by the ARRA program.
• For example, an existing medical patient who is
  seen in an ARRA supported substance abuse program
  for the first time may be counted as a new
  substance abuse patient for purposes of the HCQR.
• In this example, the patient would not be counted
  as a new medical patient.

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Definitions Cumulative Patientsby Service Type

• A new patient who was counted as a new medical
  patient in HCQR Period 1 or 2 will continue to be
  counted as a new patient in HCQR Period 3
• If they received additional medical care
• If they received no additional medical care but
  received dental care
• If they were never seen during the quarter

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Definitions Visits Reported onSF-PPR Page 2

• Visits are reported using the same definitions
  that are used for all other BPHC reporting
• Specifically,
• Face to face
• With a licensed or credentialed provider
• Working independently
• Providing professional judgment
• And charting the visit
• See Appendix A in the HCQR Manual

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Definitions Visits Reported onSF-PPR Page 2

• Visits are reported by Type (e.g., medical,
  dental, mental health, substance abuse, other
  health, or enabling services)
• Limits on visits include
• Only one per type per day
• But can have one of each type in a day
• One visit can be reported as only one type of
  service
• Report Visits at the type level (medical, dental,
  etc.), not the provider level (FP, NP, PA, etc.)

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Definitions Visits Reported onSF-PPR Page 2

• Visits are reported in the HCQR on a cumulative
  basis for the entire period of the ARRA grant
• Each HCQR Reporting Period will report a greater
  or, occasionally, equal number of visits when
  compared to the prior HCQR Reporting Period
• The HCQR report will not re-set to zero at any
  time during the project period of the ARRA grant

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Definitions Staff Reported onSF-PPR Page 2

• Staff may be impacted in any number of ways by
  the ARRA NAP, IDS, CIP, and FIP grants
• HRSA is measuring the direct impact on employment
  in the HCQR reports
• Only one category of staff will be reported for
  the quarter
• Number of FTEs (Combines Created and Retained
  staff)
• Created and Retained FTEs will no longer be
  reported separately

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Definitions FTEs

• New FTEs are defined as staff who
• Were not employed by the grantee prior to the
  ARRA grant
• Were employed by the grantee during the quarterly
  reporting period
• Whose position is covered in whole or in part by
  ARRA grant funds
• Retained FTEs are defined as staff
• Who were employed by the grantee the quarterly
  reporting period and
• Whose position would have been eliminated in
  whole or in part were it not for ARRA-supported
  grant funds

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FTE Calculation
December 2009
20
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Examples of FTE Calculations

• ARRA funds and another targeted grant. Grantee
  receives a separate grant to hire an outreach
  worker to support its new IDS program. The
  outreach worker is not reported on the HCQR.
  Other staff FTEs are not affected.
• ARRA funds and another general grant.
  Grantee receives general revenue support from the
  County (or any other form of unrestricted
  support) to help provide expanded services. ARRA
  support for the IDS program is 400,000 and the
  other grant is 100,000. Grantee will report 80
  of all FTEs in the program as ARRA supported on
  the HCQR and will not report the other 20 at
  all.

December 2009
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Examples of FTE Calculations (cont.)

• ARRA funds and patient service revenues.
  Grantee receives 600,000 in ARRA funds of which
  400,000 supports the medical program. The
  medical program receives a total of 200,000
  from patients, Medicare, Medicaid and other third
  party payors for medical services related to the
  ARRA program. Two-thirds of each ARRA employees
  time is allocated to the ARRA program and
  reported on the HCQR. The other one-third,
  supported by first and third party payors, is not
  reported.

23
Examples of FTE Calculations (cont.)

• Time limited other support. Grantee
  receives full support for two outreach workers.
  The funding began May 1 and ended on October 31.
  When the outside support ended on October 31, the
  workers were then paid by ARRA grant funds from
  November 1 through December 31. The grantee will
  report the two workers for two-thirds of the
  reporting quarter or 1.35 FTEs. The reporting
  quarter is October 1 December 31.

December 2009
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Examples of FTE Calculations (cont.)

• On September 1, a grantee hired two full-time
  employees and one half-time employee working half
  days using ARRA funds. They worked for the
  grantee for the entire quarter. To convert paid
  hours to the number of FTEs for the quarterly
  report, the grantee must aggregate all hours paid
  to these employees through the reporting quarter
  and divide by the number of hours in a full time
  schedule in this case, 520 hours. Note that
  only the hours paid from October 1 to December 31
  are counted.

December 2009
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Definitions Construction StaffReported on
SF-PPR Page 2

• All construction-related staff that are supported
  using ARRA funds are reported on SF-PPR Page 2
  line 35 - Construction Related Staff FTEs for
  both CIP and FIP Projects
• Grantees will obtain total construction worker
  hours from their contractors and use this as the
  numerator in the FTE equation

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Example of FTE Calculation
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Definitions CIP Project StatusReported on
SF-PPR Page 3

• You will report a separate SF-PPR Page 3 for each
  approved CIP and FIP Project
• For each project, you will report a Project
  Status

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HRSA EHBs Notes

• HRSA EHBs allows you to work on your report in
  parts, save it online, and return to complete it
  later.
• Multiple users can work on the report at the same
  time.
• EHB sessions time out after 30 minutes of
  inactivity (you must key either the Save or Save
  and Continue buttons or navigate to a new page
  within 30 minutes. EHB does not interpret
  keying/entering text as activity).
• Only the Authorizing Official (AO) can submit
  the report to HRSA
• The AO will receive an email confirming that the
  report was submitted to HRSA

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Navigating to the HCQR ReportsWelcome Page
ClickView Portfolioto view your grant portfolio
30
Navigating to the HCQR ReportsGrant Portfolio
1. Locate your H80 Health Center Cluster
grant in the Grants List
2. ClickOpen Grant Handbook
HCQR Reports are in the H80 grant handbook for
theprimary Health Center Cluster grant. Do
not select the New Access Point or Increased
Demand for Services grant.
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Navigating to the HCQR ReportsGrant Handbook
This is the handbook for the H80 Health Center
Cluster grant
HCQR Reports are performance reports.Click
Performance Reports
or Click on Performance Reports
32
Performance Reports List Page
HCQR and other Performance Reportsare listed on
the Performance Report page.
01/10/2010
01/01/2010
10/01/2009 12/31/2009

• Third reporting period ends 01/10/2010.
• The report is available for filing one day after
  the end of a reporting period.
• The report is due 10 days after it is available.

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Submission Status andStarting the HCQR Report
Submission Status Describes the status of the
HCQR Report while it is being prepared, reviewed,
or revised, either originally or in response to a
request for changes.
01/10/2010
10/01/2009 12/31/2009
ClickStart Report
It will say Edit Report if data entry has already
been started.
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Status Overview Page
Helpful instructions appear at the top of every
page.
Observe your progress through the three steps to
completing the report here.
Gray Not Started Blue In Progress Green
Complete
Use the side menu to jump to any section of the
report.
35
Status Overview Page
The Status page shows all the sections of the
report
One line for each grant award (e.g., if you only
have a NAP grant, only the NAP line will appear)
Click Update to open a page for editing.
and the completion status of each section.
You can update any page, even those marked
Completed. Doing so may cause the status to
revert toIn Progress.
36
Contact Information
You must provide a designated HCQR Point of
Contact for each Type of Grant.This is the
person to whom the reviewer will contact if there
are questions about the data.
37
SF-PPR Page 1
You can access SF-PPR Page 1 from the side
navigation menu.
SF-PPR Page 1 is the same for NAP, IDS, and
CIP. This tab tells you which one you are on.
Use the list to jump to other pages.
C80CS0123 ARRA Facility Improvement Program
(FIP)
A link to your grantapplication
Required fields are marked with an
38
SF-PPR Page 2
You will report these forNAP and IDS grants only
Construction Related Staff for CIP and FIP
Projects
39
SF-PPR Page 2
For CIP and FIP Grants, you will only reportNew
and Retained Administrative FTEsandNew
Construction Staff
40
SF-PPR Page 3CIP and FIP Project Report
SF-PPR Page 3 reports progress on CIP and FIP
Projects by Project
41
SF-PPR Page 3CIP and FIP Project Report
SF-PPR Page 3 record for each CIP and FIP Project
You will also report close out data when you
complete a CIP or FIP Project on SF-PPR Page 4
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SF-PPR Page 3CIP and FIP Project Report
SF-PPR Page 3 Project Information Details
Project Status
When you mark the CIP Project as Completed here,
you will then seeSF-PPR Page 4for this CIP
Project(FIP Projects will work the same way)
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SF-PPR Page 4CIP and FIP Project Close Out
Data fields are specific to the CIP or FIP
Project Type
For A/R/R projects, this shows only2.
Square Footage Improved
For Construction projects, this will
show both1. Square Footage
Increased and2. Square Footage Improved
For EHR projects, this will
show 3a. Number of Clinicians with
EHR 3b. Number of Other Staff with
EHR3c. Number of Patients with an EHR
44
Data Audit Report Screen
45
Review Page
Use this button to print all the forms in the
report
Click View to open a printable (HTML format)
version of any section of the report.
46
Submit Page
Once all sections are Complete, click the Proceed
to Submit button to access the submit page, where
users with permission can sign and submit the
HCQR Report.
47
Submitting the HCQR Report
The grantees Authorizing Official (AO) should
complete and submit the HCQR reports.
48
Post-Submission

• BPHC will review your report.
• BPHC will initially contact the HCQR Point of
  Contact person with questions and/or comments.
• BPHC will work with you to resolve any errors or
  discrepancies in your HCQR Report. You will use
  the EHBs system to make any changes to your
  report.
• You will always be able to view your submission
  in read-only format.

49
HCQR Support
50
ARRA Federal Reporting (Section 1512 Reports)
51
ARRA Federal Reporting

• Who must submit reports?
• All recipients of ARRA grants (H8A, H8B, C81,
  C80) are required by law to submit reports to the
  central Federal government-wide reporting system
  (www.FederalReporting.gov)
• This reporting is SEPARATE from Health Center
  Quarterly Reporting (HCQR)
• Federal Reporting is based on the grant received,
  whereas HCQR is by project
• Submit ONE report for each ARRA grant received
  please do not combine information from multiple
  grants into one report or include H80 grants
• What data will recipients submit?
• Number of Jobs (New and Retained FTEs) New
  Calculation Method
• Spent/Obligated
• Percentage of Project Completed
• Narrative Update
• Payments to Vendors

52
ARRA Federal Reporting

• How will recipients submit reports?
• Recipients will register at and submit reports
  through the Federal Reporting website at
  www.federalreporting.gov
• 3 methods to submit data
• Data Entry Form (on Federal Reporting website)
• Excel Spreadsheet (download from
  www.federalreporting.gov)
• XML Schema (download from www.federalreporting.gov
  )
• Note Please ensure that the report has been
  submitted and not merely saved as a draft.

53
Federal Reporting Timeline
54
Federal Reporting Process Changes

• New Agency Comment Period Recipient Report
  Adjustment
• Reports will be available for corrections by
  grantees 33 90 days after the end of the most
  recent quarter. For example, from February 2,
  2010 through March 31, 2010, recipients will have
  the ability to correct data for the quarter
  ending December 31, 2009.
• Reports from prior quarters (e.g., the quarter
  ending September 30, 2009) will not be open for
  corrections. However, grantees are instructed to
  maintain information on any and all necessary
  corrections to prior quarter data with their
  administrative records.
• Grantees will be required to submit corrected
  information from a prior quarter to the Federal
  government at a time and process to be specified
  in the future.

55
Recipient Report Submission

• Recipient Report Submission Period January 1
  15
• Data for the second report is cumulative, except
  for number of jobs, and is due January 15, 2010.
  The report covers all project activity from the
  beginning of the ARRA grant up to 12/31/2009.
• Federal Reporting will be locked at midnight PST
  on January 15th. No exceptions or waivers.
  Recipients who did not submit a report will be
  considered in noncompliance with their grant
  agreement.
• Initial submission reports may be available for
  public view at Recovery.gov beginning Monday,
  January 16, 2010.

56
Recipient Editing

• Recipient Editing Period January 16 22, 2010
• Federal Agency View Only
• HRSA will be viewing reports during this time and
  contacting grantees with questions or issues
  regarding their reports.
• Recipient reports will be locked from recipient
  editing at 12 am on January 22nd.
• Resources and tools HRSA will use to validate
  grantee reports
• Electronic Handbooks (EHB)
• Payment Management System
• TAGGS
• Project Officers (for narrative reviews)

57
Jobs Reporting Changes

• The calculation to estimate the number of jobs
  created or retained has been changed to a
  quarterly basis it no longer is based on
  cumulative quarters.
• Jobs created or retained are defined as those
  funded in the quarter by an ARRA grant.
• Jobs funded with non-ARRA grant funds will not be
  counted unless they will be reimbursed by ARRA
  grant funds.
• Jobs funded partially with ARRA grant funds will
  only be counted based on the proportion funded by
  the ARRA grant.
• Note Grantees are not required to re-calculate
  and/or correct job estimate totals for the
  quarter ending September 30, 2009.

58
Federal Data Quality Review

• Federal Agency Review Period January 23 29
• Data quality checks all data elements reported
  will be compared with official records.
• Recommend that grantees complete their HCQR
  report for reporting period 3 prior to completing
  the Federal Reporting Quarterly Report. The HCQR
  forms, the calculator feature and audit checks
  will support completion of Federal Reporting data
  fields.
• Data issues that will be flagged for follow-up
• Significant Errors
• Material Omissions Failure to submit a complete
  report on an ARRA grant.

59
Data Quality Review Significant Errors

• The data fields that will be reviewed for
  significant errors have changed as follows
• Award Amount
• Number of Jobs
• Federal Award Number
• Recipient Name

60
Data Quality Review Material Omissions

• HRSA is able to identify reports as ours
  (separate from other Federal agencies) using the
  following data fields in the Section 1512 report
• Awarding Agency Code 7526
• Funding Agency Code 7526
• We identify reports as yours by using the
  following data fields
• Award Type Grant
• Award Number (e.g., C81CS12345)
• CFDA Number 93.703
• DUNS Number
• Please ensure that these data fields are correct
  on your reports.

61
Federal Agency Review

• Federal Agency Review Period January 23 29,
  2010
• HRSA will formally review all recipient reports.
  Any significant errors will be communicated
  through www.FederalReporting.gov to recipients,
  which will unlock reports for corrections by
  recipients.
• HRSA will verify if corrections have been made.
• Federal review status for each grant will be
  posted on www.Recovery.gov
• Not Reviewed by Agency
• Reviewed by Agency with comments
• Reviewed by Agency with no comments

62
Agency Comment Period

• Federal Agency Comment Period February 2 March
  31, 2010
• www.FederalReporting.gov will be open for
  corrections by grantees of all data submitted for
  the quarter ending December 31, 2009.
• Grantees will not be able to correct data
  submitted for the quarter ending September 30,
  2009.
• HRSA will monitor such corrections and will
  communicate to grantees any corrections
  determined to be erroneous.

63
FederalReporting.gov New Features

• FRPIN Communication Enhancement
• FRPIN is now also sent to the FederalReporting.gov
  My Messages Inbox FRPIN
• Copy/Copy Forward Enhancement
• Copy report from current quarter
• Copy Forward report from the previous quarter
• Change Business Key on a Copy Forward and Copy
  report
• Quality Edit Checks
• Validate hard errors and alerts for the following
  data fields and show pick-lists
• Job Number
• Congressional District
• Amounts (award, expended, etc.)
• For more information on new system features,
  visit www.federalreporting.gov

64
Registration

• ARE YOU REGISTERED?
• Pre-Requisites for Registration
• Email address - Users will need to enter their
  valid email address to register.
• DUNS Number - Each Prime Recipient must have a
  DUNS number. A DUNS Number is a unique 9-digit
  number issued by Dun Bradstreet. You can obtain
  the DUNS number from your award document. (If not
  found on the award document, use the DUNS number
  your organization provided on the application for
  award.)
• Central Contractor Registration (CCR)
  Registration - Each Prime Recipient organization
  must be registered with the government in CCR
  (www.ccr.gov). A DUNS number is required to
  register with CCR.
• Please ensure that
• CCR registration is current
• DUNS number is accurate check if it corresponds
  to DUNS number in EHB

65
Supplementary Instructions

The following table contains instructions filling
in certain Section 1512 report fields.
66
Federal Reporting Resources

• The Federal Reporting Service Desk will be
  available 24 hours, 7 days a week during
  reporting period. https//www.federalreporting.gov
  /federalreporting/help.do
• Phone [phone]
• TTY 877-881-5186
• Email Support_at_FederalReporting.gov
• Past Webinars may be accessed at
  http//www.whitehouse.gov/Recovery/WebinarTraining
  Materials/
• For sample NAP, IDS, CIP, and FIP reports, go to
  http//www.hhs.gov/recovery/reports/reportingassis
  tance.html
• HHS Recipient Reporting Tool is available now at
  http//taggs.hhs.gov/ReadinessTool/