Chapter 7: Coverage for Medical Emergencies During and After Hours

The following points describe areas where health centers have discretion with respect to decision-making or that may be useful for health centers to consider when implementing these requirements:

• The health center determines the means by which after-hours coverage is provided to health center patients. Examples include: telephone coverage by health center providers, primary care services after hours to address urgent medical conditions on an extended or 24-hour basis at certain service sites, after-hours phone coverage arrangements with other community providers, 6 or “nurse call” lines.
• The health center determines how to make patients aware of the availability of, and procedures for, accessing professional coverage after hours. Examples include after-hours instructions that are: integrated into an automated message on the health center’s main phone line explaining how to access after-hours coverage, posted on the door of all health center service sites, provided as part of the initial patient registration process, posted on the health center’s website, and/or provided as patient brochures or cards.

Footnotes

1. Medical emergencies may, for example, include those related to physical, oral, behavioral, or other emergent health needs.

2. See Chapter 6: Accessible Location and Hours of Operation for more information on hours of operation.

3. See Chapter 12: Contracts and Subawards for more information on oversight over such arrangements.

4. Under Section 602 of Title VI of the Civil Rights Act and the Department of Health and Human Services implementing regulations (45 CFR Section 80.3(b)(2)), recipients of Federal financial assistance, including health centers, must take reasonable steps to ensure meaningful access to their programs, services, and activities by eligible limited English proficiency (LEP) persons. See Office of Civil Rights: Guidance to Federal Financial Assistance Recipients Regarding Title VI and the Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons -Summary for further guidance on translating vital documents for LEP persons.

5. See Chapter 8: Continuity of Care and Hospital Admitting for more information on continuity of care.

6. Health centers that are deemed under the Federal Tort Claims Act (FTCA) should ensure that they are familiar with the applicable restrictions on FTCA coverage for services provided to non-health center patients. Review the FTCA Health Center Policy Manual (PDF - 406 KB) for further information.

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