PC-1 | HRSA EHBs

PC-1 - Selecting Partnerships Developed Using BHW Funds

Select the Primary Purpose of the Grant Partnership(s) Developed or Enhanced using BHW Funding	Select Types of Partner Organizations for the Primary Purpose	Select Secondary Purpose(s) of the Grant Partnership(s)
(5a)	(5b)	(5c)

Figure 1. PC-1 - Selecting Partnerships Developed Using BHW Funds

Select the Primary Purpose of the Grant Partnership(s) Developed or Enhanced using BHW Funding: Select the primary purpose of the partnership used to develop or enhance the training program by clicking on the drop-down menu in column 5a and selecting the most applicable option.

Clinical/experiential training
Community outreach
Curriculum development
Didactic training
Establishing and maintaining apprenticeships
Field placements in medically underserved and/or rural areas
Interprofessional training
Job placement
Matriculation into health professions schools
Mentoring students/trainees
Providing faculty development
Providing faculty/clinical preceptors
Recruitment of trainees
Recruitment of URM/disadvantaged/rural trainees
Technical assistance
None of the above
No partnerships developed or expanded

Select Types of Partner Organizations for the Primary Purpose: Select the type(s) of organizations associated with the primary partnership purpose indicated in question 5a by clicking on the drop-down menu in column 5b and choosing all options that apply.

Academic Institution
Academic Medical Center
Area Health Education Center
Certified Community Behavioral Health Center (CCBHC)
Community Behavioral Health/Mental Health Center
Community Health Center (CHC)
Critical Access Hospital
Federal Government
FQHC or Look-Alike
Health Department (local/state/tribal)
Hospital (non-academic)
Indian Health Service (IHS)/Tribal/Urban Indian Health Center
Nursing Home
Other Clinical Health Setting
Other Community-Based Organization
Other Long-term Care Facility
Other Specialty Clinic
Private Industry
Private Practice
Residential Living Facility (including independent and assisted living)
Rural Health Clinic
School-based Clinic
State or Local Government
US Armed Forces
Veterans Affairs Healthcare (e.g. VA hospital or clinic)
N/A

Select Secondary Purpose(s) of the Grant Partnership(s): Select any additional purpose(s) of the partnerships used to develop or enhance the training program by clicking on the drop-down menu in column 5c and choosing all options that apply.

Clinical/experiential training
Community outreach
Curriculum development
Didactic training
Establishing and maintaining apprenticeships
Field placements in medically underserved and/or rural areas
Interprofessional training
Job placement
Matriculation into health professions schools
Mentoring students/trainees
Providing faculty development
Providing faculty/clinical preceptors
Recruitment of trainees
Recruitment of URM/disadvantaged/rural trainees
Technical assistance
N/A

PC-1 - Entering Enrollment Information

Warning
Multiple steps are required to complete this portion of the subform. Please read instructions carefully.

Enter Total # Enrolled (whether funded by BHW or not)	Enter Total # Enrolled (whether funded by BHW or not)	Enter Total # Enrolled (whether funded by BHW or not)
Total	URM	Disadvantaged Background and not URM
(7) Block 3	(8) Block 3a	(9) Block 3b

Figure 2. PC-1 - Entering Enrollment Information

Enter Total # Enrolled (whether funded by BHW or not): Total:

For Column 7, enter the total number of students who participated in each degree program during the current reporting period. Count all students who participated, regardless of whether the student received a BHW-funded financial award.

Enter Total # Enrolled (whether funded by BHW or not): URM: For Block 3a, enter the number of students enrolled in each certificate program during the current reporting period who were underrepresented minorities. Block 3a is a subset of Block 3.Enter Total # Enrolled (whether funded by BHW or not): Disadvantaged Background and not URM:

For Column 9, enter the number of students from disadvantaged backgrounds who participated in the degree program during the current reporting period but were not underrepresented minorities.

Note
For the total enrollee count (Block 3), DO include students who went on to graduate from the certificate program in the current reporting period but do NOT include students who discontinued prior to graduation (i.e., attrition). Attrition counts will be captured separately in Block 9.

Reference
Refer to the glossary for a definitions of disadvantaged background.

Example: The John Doe School had 18 paraprofessional students participate during the current annual reporting period. Among the 18 paraprofessional students who participated, 9 were underrepresented minorities. In addition, 3 students were from disadvantaged backgrounds, but were not under-represented minorities.

· In Column 4 (Block 3), the reporting official would enter 18.

· In Column 5 (Block 3a), the reporting official would enter 9.

· In Column 6 (Block 3b), the reporting official would enter 3.

PC-1 - Entering Graduate Information

Enter Total # Graduated/Completed (whether funded by BHW or not)	Enter Total # Graduated/Completed (whether funded by BHW or not)
Total	URM
(10) Block 8	(11) Block 8a

Figure 3. PC-1 - Entering Graduate Information

Enter Total # Graduated/Completed (whether funded by BHW or not): Total: For Block 8, enter the total number of students in each certificate program who graduated during the current reporting period. Block 8 is a subset of Block 3.Enter Total # Graduated/Completed (whether funded by BHW or not): URM: For Block 8a, enter the number students in each certificate program who graduated during the current reporting period and are underrepresented minorities. Block 8a is a subset of Block 8.

Note
Block 8 is a subset of Block 3; Block 8a is a subset of Block 8.

Note
Students who permanently left their programs before completion (i.e. attrition) will be counted separately in Column 9 (Block 9).

Reference

Refer to the glossary for definitions of disadvantaged background and underrepresented minority.

Example: The John Doe School had 18 paraprofessional students participate during the current reporting period. Among the students who participated, 3 completed all their requirements for graduation. Of those who completed their requirements, none were underrepresented minorities.

· In Column 7 (Block 8), the reporting official would enter 3.

· In Column 8 (Block 8a), the reporting official would enter 0.

PC-1 - Entering Attrition Information

Enter Total # Who left the Program Before Completion (whether funded by BHW or not)	Enter Total # Who left the Program Before Completion (whether funded by BHW or not)
Total	URM
(12) Block 9	(13) Block 9a

Figure 4. PC-1 - Entering Attrition Information

Enter Total # Who left the Program Before Completion (whether funded by BHW or not): Total: For Block 9, enter the total number of students who permanently left each certificate program before completion during the current reporting period.Enter Total # Who left the Program Before Completion (whether funded by BHW or not): URM: For Block 9a, enter the number of students who permanently left each certificate program before completion during the current reporting period and are underrepresented minorities. Block 9a is a subset of Block 9.

Note
Block 9a is a subset of Block 9. The total entered in Block 9 is exclusive of the total number of enrollees (Block 3).

Reference
Refer to the glossary for definitions of disadvantaged background and underrepresented minority.

Example: The John Doe School had 18 paraprofessional students participate during the current reporting period. Among the paraprofessional students who participated, 2 left the program before completion. Neither student was an underrepresented minority.

· In Column 9 (Block 9), the reporting official would enter 2.

· In Column 10 (Block 9a), the reporting official would enter 0.

Figure 5. PC-1 - Entering Attrition Information

To Complete the Form: Click on the “Save and Validate” button located on the bottom right corner of your screen. If no errors are found, the BPMH system will automatically route you to the next required subform.

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PC-1: Program Characteristics – Degree/Diploma/Certificate Training Programs

PC-1 - Selecting Partnerships Developed Using BHW Funds

PC-1 - Selecting Partnerships Developed Using BHW Funds

PC-1 - Entering Enrollment Information

PC-1 - Entering Enrollment Information

PC-1 - Entering Graduate Information

PC-1 - Entering Graduate Information

PC-1 - Entering Attrition Information

PC-1 - Entering Attrition Information

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