Overview of Performance Review Process

1. I Overview of Performance Review Process U.S. Department of Health and Human Services (DHHS) Health Resources and Services Administration (HRSA) Office of Performance Review (OPR) Chicago Regional Division

2. I Boston Seattle New York Chicago Philadelphia Rockville San Francisco Denver Kansas City Atlanta Dallas Puerto Rico OPR Regional Divisions

3. HRSA Funding • HRSA provides over $7 billion in grants or cooperative agreements • To over 3,000 organizations • Through 80 different programs

4. Purpose of Performance Reviews • Improve the performance of HRSA funded programs • Provide direct feedback to the agency about the impact of HRSA policies on program implementation and performance

5. Steps to Performance Review 2 Performance Analysis 3 Performance Report 1 Performance Review Measures 4 Action Plan

6. Underlying Assumptions • Most grantees are performing well • Performance first  systems support/underlie performance • Many solutions to issues/problems exist within an organization and/or • Can be achieved through partnerships with others • Performance Review Protocol is the framework for our work (Grantee, State, and Community Reviews) • Day-to-day grantee responsibility remains with Headquarters (HRSA project officers and HRSA Division of Grants Management Operations (DGMO) grants officers)

7. Steps to Performance Review:Performance Measures • Identify target population served by each program • Specify services/resources provided • Identify current program performance measures • Program reporting requirements • Grantee goals/objectives in grant application • HRSA’s GPRA program measures

8. Steps to Performance Review:Performance Measures • Select Performance Review Measures with the grantee • Outcome measures – track impact or effectiveness of a program • Effort measures- assess efforts to implement a program • Need a mix of outcome and effort measures • Total of 3 to 5 measures per program

9. Performance Measures • Examples of outcome measures include: • Client results or outcomes (e.g., improved health status, access) • Customer satisfaction (e.g., customer benefit received) • Effectiveness • Examples of effort measures include: • Efficiency (e.g., administrative overhead; unit cost; staffing ratios; staff turnover; waiting time; etc.) • Customer satisfaction (e.g., quality of service provided)

10. Steps to Performance Review: Performance Analysis • Identify factors supporting/hindering performance • Internal systems and processes • External issues, including HRSA policies • Partnerships – critical for most outcome measures • Determine which is the most important to address to improve performance on each measure

11. Steps to Performance Review:Performance Report • Develop Performance Report • Performance Improvement Options • No cost/low cost options • Evidence-based strategies • Partnerships • Requirement issues (if necessary) • Share draft of Performance Report with the grantee, project officer(s), grants officer and OFPO staff for feedback and comments

12. Steps to Performance Review:Action Plan • Finalize Performance Report and request Action Plan from grantee • Grantee Action Plan • Proposed Performance Improvement Actions • Proposed Program Requirements Actions • Review grantee’s Action Plan submission and provide feedback, as appropriate