1

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

I

2

OPR Regional Divisions

Kansas City

Denver

Seattle

I

Boston

New York

Dallas

San Francisco

Atlanta

Chicago PhiladelphiaRockville

Puerto Rico

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

PerformanceAnalysis

4

Action Plan

1

PerformanceReview

Measures

3

PerformanceReport

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

13

14

15

16

17