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.CSV File

.csv is a file extension that stands for "Comma Separated Values." It is a common format to share data and can be opened in most spreadsheet and statistical packages like Microsoft Excel.



Bureau of Primary Health Care (BPHC)

The Bureau of Primary Health Care (BPHC) is part of the Health Resources and Services Administration of the US Department of Health and Human Services. BPHC administers the Health Center Program for which the UDS Mapper was built to serve.



Centers for Medicare & Medicaid Services (CMS)

The Centers for Medicare & Medicaid Services (CMS) is part of the Department of Health and Human Services (HHS). They administer Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace.



Centroid

A centroid is the geometric center of a feature. In the UDS Mapper ZIP Codes are mapped to the ZCTA that best fits its location based on the ZIP Code centroids.



County Subdivisions

County Subdivisions are the primary divisions of counties and equivalent entities. They include census county divisions, census subareas, minor civil divisions, and unorganized territories and can be classified as either legal or statistical. Minor civil divisions (MCDs) are the primary governmental or administrative divisions of a county in many states (parishes in Louisiana) and the county equivalents in Puerto Rico and the Island Areas. Census county divisions (CCDs) are areas delineated by the Census Bureau in cooperation with state, tribal, and local officials for statistical purposes. CCDs have no legal function and are not governmental units. CCDs often exist where there are no legally established MCDs. Census subareas are statistical subdivisions of boroughs, city and boroughs, municipalities, and census areas, all of which are statistically equivalent entities for counties in Alaska.



Dominant Health Center

The dominant health center is the health center with the highest number, and therefore highest share of patients, of health center patients in a ZCTA.



Extended Care Site (also called Community Living Centers (CLCs)) (Stand-Alone)

Extended care is defined by encounters between Veterans and providers within the VHA health care system in VA institutional care. Extended care services is defined in 38 U.S.C. 1710B as including geriatric evaluation, nursing home care, domiciliary services, adult day health care, other non-institutional alternatives to nursing home care, and respite care. Each point of service receives an extended care rating within the VHA site classifications based on the services provided at that location. VA Institutional Extended Care Sites (also called CLCs) provide care in beds associated with overnight institutional extended care programs. VA institutional extended care beds are defined by the treating specialty. There are three subtypes of institutional extended care beds: community living center (CLC) short-stay, CLC long-stay, and CLC hospice. The VHA site classification uses the sum of the BDOC of all three subtypes to calculate the total CLC BDOC. Note: These sites are stand-alone, and do not include the CLC programs co-located within a VAMC.



Facility/Point HPSA

A facility HPSA designation, as defined by the Public Health Service Act, is given to FQHCs and RHCs that meet the requirement of providing access to care regardless of ability to pay. FQHC in this definition includes all types of FQHCs: Health Center Program (HCP) grantees, HCP look-alikes, and outpatient health programs/facilities operated by tribal organizations (under the Indian Self-Determination Act) or urban Indian organizations (under the Indian Health Care Improvement Act).

Point HPSAs are only applicable to Alaskan Native and Native American Tribal populations. The Federally Recognized Native American Tribes and Alaskan Natives receive automatic population HPSAs. These HPSAs are represented as a point which is placed at a provider location/ facility within the tribal area.



Federal Poverty Level (FPL)

The Census Bureau uses a set of money income thresholds that vary by family size and composition to determine who is in poverty. If a family's total income is less than the family's threshold, then that family and every individual in it is considered in poverty. The official poverty thresholds do not vary geographically, but they are updated for inflation using the Consumer Price Index (CPI-U). The official poverty definition uses money income before taxes and does not include capital gains or noncash benefits (such as public housing, Medicaid, and food stamps). For more information, see: https://www.census.gov/topics/income-poverty/poverty/guidance/poverty-measures.html.



Federally Qualified Health Centers (FQHCs)

A Federally Qualified Health Center (FQHC) is a public or private, non-profit health care organization that meets certain criteria under the Medicare and Medicaid Programs (respectively, Sections 1861(aa)(4) and 1905(l)(2)(B) of the Social Security Act.) An organization that meets these criteria is eligible to apply for Health Center Program grant funding from the Health Resources and Services Administration's Bureau of Primary Health Care. Not all FQHC's receive this grant funding.



Geocode

In order to represent things like street addresses on a map, they must be geocoded. A geocode is a spatial representation of a descriptive locational reference (like street address.) Geocoding is the computational process of transforming a postal address description to a location on the Earth's surface (spatial representation in numerical coordinates).



Geographic Information Systems (GIS)

A geographic information system (GIS) integrates hardware, software, and data for capturing, managing, analyzing, and displaying all forms of geographically referenced information. GIS allows visualization, understanding, questioning, and interpretation of data in many ways that reveal relationships, patterns, and trends in the form of maps, globes, reports, and charts. For more information see: http://researchguides.library.wisc.edu/GIS



Health Care Center (HCC)

A HCC is a VA-owned, VA-leased, or contract clinic operated at least 5 days per week that provides primary care, mental health care, on site specialty services, and performs ambulatory surgery and/or invasive procedures which may require moderate sedation or general anesthesia.



Health Center Program (HCP) Grantee

A public or private non-profit health care organization that meets certain criteria under the Medicare and Medicaid Programs (respectively, Sections 1861(aa)(4) and 1905(l)(2)(B) of the Social Security Act AND receives funds under the Health Center Program (Section 330 of the Public Health Service Act) (i.e., Community Health Centers, Migrant Health Centers, Healthcare for the Homeless Programs, and Public Housing Primary Care Programs). A detailed explanation of health center program terminology (http://bphc.hrsa.gov/technicalassistance/health_center_terminology_sheet.pdf) is available from the HRSA website.



Health Center Program (HCP) Look-Alike

An FQHC that meets all of the eligibility requirements of an organization that receives a Health Center Program grant, but does not receive Health Center Program grant funding.



Health Professional Shortage Area (HPSA)

A Health Professional Shortage Area is an urban or rural area, population group, or medical or other public facility which has received federal designation as having a shortage of health care providers. Each year, the Department of Health and Human Services (HHS) evaluates HPSA designations and awards them through state Primary Care Offices (PCO). There are separate designations for Primary Care, Dental Care, and Mental Health Care. All federally qualified health centers facilities receive automatic facility HPSA designation, while Rural Health Clinics must request facility HPSA designation. More information can be found here: https://bhw.hrsa.gov/shortage-designation/hpsas.



Health Resources and Services Administration (HRSA)

The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services, is the primary Federal agency for improving health care to people who are geographically isolated, economically or medically vulnerable.



Medically Underserved Area/Population (MUA/P)

A medically underserved area (MUA) may be a whole county or a group of contiguous counties, a group of county or civil divisions or a group of urban census tracts that the Department of Health and Human Services (HHS) has designated as having a shortage of health services for residents. Designations are based on the qualifications outlined in the Index of Medical Underservice (IMU), published in the Federal Register on October 15, 1976.
A medically underserved population (MUP) may include groups of persons who face economic, cultural or linguistic barriers to health care. Designations are also based on the qualifications outlined in the Index of Medical Underservice (IMU), and exceptional MUP designations are based on the provisions of Public Law 99-280, enacted in 1986.
A Governor designated MUA/P is an exceptional designation given by HRSA at the request of a state Governor or other chief executive officer and local health official.



Multi-Specialty Community Based Outpatient Clinic (MS CBOC)

A multi-specialty CBOC is a VA-owned, VA-leased, mobile, or contract clinic that offers both primary and mental health care and two or more specialty services physically on site. Access to additional specialty services may be offered by referral or telehealth. These clinics may offer support services, such as pharmacy, laboratory, and x-ray. The clinic may be operational from 1 to 7 days per week. These clinics are permitted to provide invasive procedures with local anesthesia or minimal sedation, but not with moderate sedation or general anesthesia (see VHA Directive 2006-023). The establishment of a new multi-specialty CBOC can only be approved by the Secretary, with Congressional notification consistent with 38 U.S.C. 8119(b) (2), (3), and (4).



National Health Service Corps (NHSC)

The NHSC program aids organizations in HPSAs in attracting the necessary medical, dental and mental health providers to meet the health care needs of the shortage area. The scholarship and loan repayment programs are awarded to providers who fulfill an obligation to serve a HPSA with a sufficiently high shortage. The Bureau of Health Workforce (BHW) oversees the program for the Health Resources and Services Administration (HRSA). For more information see: http://nhsc.hrsa.gov/about/.



Other Outpatient Services (OOS) Sites

Other Outpatient Services Sites are sites in which Veterans receive services that do not meet the criteria listed above to be classified as a CBOC or HCC. Many of the services provided at these sites are contacts made by VA or VHA personnel to provide information, social services, homelessness outreach services, activities to increase Veteran awareness of benefits and services, and support services, such as those provided in Vet Centers. Other services could be more clinical in nature, in which clinical services are provided to remote areas through a Telehealth clinic or other arrangement. If any other services are provided in this venue (external to a VA clinic or facility), they must be associated with, attached to, and coordinated by a health care delivery site located in a clinic or facility.



Penetration Rate

The ratio of patients (from health centers with 11 or more patients in that ZCTA) to a matching sub-population (such as the total population or low-income population). For example, for each ZCTA the number of reported health center patients is divided by the number of low-income or total residents. Note: Because the UDS does not distinguish the income of health center patients at the ZIP Code level, this measure is not perfect, particularly when dividing the number of health center patients by the number of low-income (as not all health center patients are low-income below 200% FPL). But because it is known that approximately 92.2% of health center patients nationally are low-income, the basic utility of the calculation in assessing the role of health centers in serving the community is not changed. Such penetration rate measures should be considered the starting point for exploring potential unmet need, not the final answer.



Percent Low-Income (Population below 200% FPL)

Label: Pop: Low-Income (%)

Where it's found: Explore Service Area Tool: Data Table, Additional Population Data and Indicators
                        Main Maps Tool: Population Data, Poverty Level
                        Population Indicators

Data source(s):   American Community Survey (ACS) five-year estimates for ZCTAs2011-2015

Next Planned Update: February 2018

Data provider:   John Snow, Inc.

What it shows: Displays the percentage of the population for whom poverty is determined that lives below 200% of the Federal Poverty Level (FPL) (otherwise known as the 'low-income' population).



Primary Care Association (PCA)

A Primary Care Association is a regional, state, or local organization which works in close concert with, and represents the interests of, nonprofit community clinics and health centers and advocates for the health needs of their distinctive populations and geographic areas, most importantly those who face barriers to care due to poverty, language, or geographic isolation.



Primary Care Clinic (PC CBOC)

Primary care CBOCs are VA-owned, VA-leased, mobile, or contract clinics that offer both medical (physically on site) and mental health care (either physically on site or by telehealth) and may offer support services such as pharmacy, laboratory, and x-ray. The clinic may be operational 1 to 7 days per week. Access to specialty care is not provided on site, but may be available through referral or telehealth. A Primary care CBOC often provides home-based primary care (HBPC) and home telehealth to the population it serves to meet the primary care and mental health needs of Veterans who have difficulty accessing clinic-based care. These clinics have access to a higher level of care within a VHA network of care. Primary care in VA includes both medical and mental health care services, as they are inseparable in providing personalized, proactive, patient-centered health care. The establishment of a new primary care CBOC can only be approved by the Secretary of Veterans Affairs, with Congressional notification.



Primary Care Office (PCO)

A Primary Care Office is a state government entity, often under the purview of the state Department of Health, which works to improve access to care for underserved populations. PCOs work with the various bureaus of the Health Resources and Services Administration (HRSA) to promote the health center program, establish HPSA designations and find suitable locations for placement of NHSC scholar and loan repayors.



Public Use Microdata Areas (PUMA)

Public Use Microdata Areas (PUMAs) are statistical geographic areas defined for the dissemination of Public Use Microdata Sample (PUMS) data. They are also used for disseminating American Community Survey (ACS) and Puerto Rico Community Survey period estimates. These files contain records for a sample of housing units with information on the characteristics of each unit and each person in it. While preserving confidentiality (by removing identifiers), these microdata files permit users with special data needs to prepare virtually any tabulation. PUMS files are available from the American Community Survey and the Decennial Census.



Residential Care Site (VA Domiciliary or Mental Health RRTPs) (Stand-Alone)

Residential care is defined as encounters between Veterans and providers within the VA health care system that require an overnight stay in residential bed sections. (1) Each point of service receives a residential care rating within the VHA site classifications based on the services provided at that location; and (2) Although some residential care is also classified as extended care, two programs are specifically classified as “residential care” in the site classification: Residential Rehabilitation and Domiciliary Care (most residential rehabilitation programs are types of domiciliary care). Specifically, a Mental Health Residential Rehabilitation Treatment Program (RRTP) provides residential rehabilitative and clinical care to eligible Veterans who have a wide-range of problems, illnesses, or rehabilitative care needs, which can be medical, psychiatric, SUD, homelessness, vocational, educational, or social services. The term RRTP refers to the bed category and includes the following programs: Domiciliary Residential Rehabilitation Treatment Programs (DRRTP), Domiciliary Care for Homeless Veterans (DCHV), Health Maintenance Domiciliary, Psychosocial Residential Rehabilitation Treatment Programs (PRRTP), PTSD Residential Rehabilitation Treatment Program (PTSD-RRTP), Substance Abuse Residential Rehabilitation Treatment Program (SARRTP), and CWT-Transitional Residence (TR). Note: These sites are stand-alone, and do not include the MHRRTP/DRRTP programs co-located within a VAMC.



Rural Health Clinic (RHC)

The Rural Health Clinic program strives to be the major provider for primary care services for Medicaid and Medicare patients in rural communities which tend to have health disparities due to geographic isolation and low physician density. RHCs can be public, private, or non-profit entities. All RHCs are eligible for facility HPSA designation and the federal funding that comes from that designation, but due to their patient population, RHCs’ main funding sources are enhanced reimbursement rates for providing Medicaid and Medicare services to rural populations. As such, RHCs must be located in underserved rural areas, as designated by HRSA, and must employ nonphysician practitioners (i.e., physician assistants or nurse practitioners) alongside physicians as part of a team-based approach to patient care. For more information, see: https://www.ruralhealthinfo.org/topics/rural-health-clinics.



Share of Patients

The percent of total health center patients from the specified ZCTA that were served by the specified health center.




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