Value-Based Medical Student Education Training Program

Health Resources and Services Administration
Academic Year: 2025-2026

Bureau of Health Workforce
OMB Number: 0906-0086

Annual Performance Report
OMB Expiration Date: 03/31/2027

EXP-1: Training Site Setup

EXP-1 - Entering Site Name

Site Name
(1) Block 1

Figure 1. EXP-1 - Entering Site Name

Site Name:

Enter the name of any new sites used to train individuals during the current reporting period in the row labeled, “Enter the Site’s Name.” Next, click the “Add Record” button. New sites will be listed at the bottom of the data table, beneath all previously used sites (i.e., prior records). Repeat this process as necessary to enter the names of each NEW site used during the current reporting period.

Warning
Only enter new sites if they were active during the current reporting period.

Note

There is an option to delete both new and prior records on EXP-1. This option should only be used if the clinical sites will not be used in the future, or were erroneously entered. The delete option is not reversible (i.e. if the site was erroneously deleted, it will need to be re-entered again).

EXP-1 - Selecting Whether the Site was Used in the Current Period

Select Whether the Site was Used in the Current Reporting Period
(2)

Figure 2. EXP-1 - Selecting Whether the Site was Used in the Current Period

Select Whether the Site was Used in the Current Reporting Period: Select whether each site was used during the current reporting period by clicking on the drop-down menu and choosing one of the following options:

Warning
For NEW sites, you must select "Yes" in Column 2.

Note
If the clinical site was used in the current reporting period, then you must enter or update information for all subsequent columns in that row. If the clinical site was NOT used in the current reporting period, then the remaining columns are not required.

Note
If a clinical site was NOT used in the current reporting period, then it will not appear on EXP-2 as a dropdown option in Column 1.

EXP-1 - Selecting Type of Site Used

Select Type of Site Used
(3) Block 1a

Figure 3. EXP-1 - Selecting Type of Site Used

Select Type of Site Used: Select the type of sites used to train residents or fellows during the annual reporting period by clicking on the drop-down menu under Column 3 (Block 1a) and choosing from one of the following options.

Academic institution
Acute Care for the Elderly (ACE) Units
Acute care services
Aerospace operations setting
Ambulatory practice sites
Assisted Living Community
Certified Community Behavioral Health Clinic (CCBHC)
Community Care Programs for Elderly Mentally Challenged Individuals
Community-based Organization
Critical Access Hospital
Day and Home Care Programs (e.g. Home Health)
Dentist Office
Emergency Room
Federal and State Bureau of Prisons
Federal Government - Other
FQHC or look-alike
Geriatric Ambulatory Care and Comprehensive Units
Geriatric Behavioral or Mental Health Units
Geriatric Consultation Services
Hospice
Hospital
Independent Living Facility
Indian Health Service (IHS) Site
International Nonprofit/Nongovernmental Organization
Local Government Office or Agency
Local Health Department
Long-Term Care Facility
Mobile Clinic/Site
National Health Association or Affiliate
Nurse Managed Health Clinics
Nursing Home
Other
Other Community Health Center (e.g. free clinic)
Other Oral Health Facility
Physician Office
Program of All Inclusive Care for the Elderly
Residential Living Facility
Rural Health Clinic
School-based Clinic
Senior Centers
Specialty Clinics (e.g. mental health practice/rehabilitation/substance abuse clinic)
State Government Office or Agency
State Health Department
Tribal Government
Tribal Health Department
Tribal Organization
Veterans Affairs Hospital or Clinic

EXP-1 - Selecting Type of Setting Where the Site was Located

Select Type of Setting Where the Site was Located
(4) Block 2

Figure 4. EXP-1 - Selecting Type of Setting Where the Site was Located

Select Type of Setting Where the Site was Located: Select whether each site used to train students during the annual reporting period was located in designated settings by clicking on the drop-down menu under Column 4 (Block 2) and choosing all that apply from the following options.

Medically underserved community
Primary Care Setting
Rural area
None of the above

Warning
“None of the above” cannot be selected in combination with any other option.

Note
Review the glossary definition to determine if a site is in a medically underserved community -https://bhw.hrsa.gov/glossary#m

Note
Use the Rural Health Grants Eligibility Analyzer to determine whether the Federal Office of Rural Health Policy considers a geographical area rural.

EXP-1 - Selecting Site Certifications/Designations

Select Site Certifications/Designations
(4a)

Figure 5. EXP-1 - Selecting Site Certifications/Designations

Select Site Certifications/Designations:

Critical Shortage Facility
National Health Service Corps (NHSC)-Approved Site
None of the Above
N/A

Warning
You cannot select "none of the above" in combination with other options.

EXP-1 - Selecting Type(s) of Vulnerable Population

Select Type(s) of Vulnerable Population Served at this Site
(7)

Figure 6. EXP-1 - Selecting Type(s) of Vulnerable Population

Select Type(s) of Vulnerable Population Served at this Site: Select the type(s) of vulnerable populations served at each site used to train students during the current reporting period by clicking on the drop-down menu in Column 7 and choosing all that apply from the following options:

Children or adolescents
College students
Health Insurance Marketplace eligible Individuals
Individuals experiencing homelessness
Individuals with chronic illness
Individuals with HIV/AIDS
Individuals with limited English proficiency
Individuals with mental illness or substance use disorders
Low income persons/families
Military and/or military families
Older adults
People with disabilities
Pregnant women and infants
Tribal populations
Unemployed
Uninsured/underinsured persons/families
Veterans
Victims of interpersonal violence abuse or trauma
None of the above

Warning
You may not select "None of the above" in combination with any other option.

EXP-1 - Entering Site's Geographical Data

Street address information is required for each training site location. After saving and validating EXP-1, you will move to a new page which will allow you to standardize the addresses of your active sites.

Street Address 1	Street Address 2	Enter Zip Code	City	State	Four Digit Zip Code Extension
(7a)	(7b)	(8)	(9)	(10)	(11)

Figure 7. EXP-1 - Entering Site's Geographical Data

Street Address 1: Enter line 1 of the Street Address where each training site is located by using the textbox in Column 7a.Street Address 2: If needed, enter line 2 of the Street Address where each training site is located by using the textbox in Column 7b.Zip Code: Enter the zip code where each training site is located by using the textbox in Column 8.City: City will automatically populate after you save and validate this form.State: State will automatically populate after you save and validate this form.Four Digit Zip Code Extension: The Zip Code Extension will automatically populate after you complete the address standardization process.

EXP-1 - Entering Site's Payment Model

Payment Model
(12)

Figure 8. EXP-1 - Entering Site's Payment Model

Payment Model: Select the payment model used by each training site by clicking on the drop-down menu in Column 12 and selecting all that apply from the following options:

ACO
Bundled Payments
Charity Care
CHIP
Dual Eligible (Medicaid & Medicare)
Medicaid
Medicare
Military TRICARE
Other Private Insurance
Other Public
Patient Centered Medical Home
PPO
Self - Pay
Sliding Scale
Uninsured
VA
Workman’s Comp
N/A

EXP-1 - Selecting Whether the Training Site Implements Interprofessional Education and/or Practice

Select whether the training site implements interprofessional education and/or practice
(13)

Figure 9. EXP-1 - Selecting Whether the Training Site Implements Interprofessional Education and/or Practice

Select whether the training site implements interprofessional education and/or practice: Select whether the training site implements interprofessional education and/or practice

EXP-1 - Selecting any HHS Priorities Addressed at this Site

Select any HHS Priorities Addressed at this Site
(14)

Figure 10. EXP-1 - Selecting any HHS Priorities Addressed at this Site

Select any HHS Priorities Addressed at this Site: Select all that apply.

This site offers behavioral health services
This site offers chronic disease services
This site offers integrated behavioral health services in a primary care setting
This site offers medications for opioid use disorder (MOUD)
This site offers nutrition services
None of the above

Warning
You cannot select 'none of the above' in combination with other options.

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.

HRSA Electronic Handbooks

Navigation

Program Manual

Value-Based Medical Student Education Training Program

EXP-1: Training Site Setup

EXP-1 - Entering Site Name

EXP-1 - Entering Site Name

EXP-1 - Selecting Whether the Site was Used in the Current Period

EXP-1 - Selecting Whether the Site was Used in the Current Period

EXP-1 - Selecting Type of Site Used

EXP-1 - Selecting Type of Site Used

EXP-1 - Selecting Type of Setting Where the Site was Located

EXP-1 - Selecting Type of Setting Where the Site was Located

EXP-1 - Selecting Site Certifications/Designations

EXP-1 - Selecting Site Certifications/Designations

EXP-1 - Selecting Type(s) of Vulnerable Population

EXP-1 - Selecting Type(s) of Vulnerable Population

EXP-1 - Entering Site's Geographical Data

EXP-1 - Entering Site's Geographical Data

EXP-1 - Entering Site's Payment Model

EXP-1 - Entering Site's Payment Model

EXP-1 - Selecting Whether the Training Site Implements Interprofessional Education and/or Practice

EXP-1 - Selecting Whether the Training Site Implements Interprofessional Education and/or Practice

EXP-1 - Selecting any HHS Priorities Addressed at this Site

EXP-1 - Selecting any HHS Priorities Addressed at this Site

Footer Information

Tools Panel