FQHC EP Attestation Process Requirement- updated May 18, 2018:

As you may or may not be aware, the emergency preparedness regulations addressed in the Code of Federal Regulations at 42 CFR Part 491.12,  became effective November 15th, 2017.  Federally Qualified Health Centers (FQHCs) are one of the 17 provider types subject to this regulation.   For your convenience, the regulations may be reviewed via the following link:




In response to these regulations, the Health Standards Section of the Louisiana Department of Health,  as the monitoring entity for Federal requirements, has instituted an annual attestation process that is now required for all affected Federally certified provider types (see attached memo published earlier this year).  The Certification Attestation Addendum Forms were mailed out to 42 FQHC clinics March 1st.   Responses to the mail out have been very slow to come in.  This is a new process and we understand that staff may not have been aware of the importance of the document and it may have been lost in the shuffle.   Perhaps, the address on file with the Centers for Medicare and Medicaid Services (CMS) is not the clinic’s most current address and the document was never received.   


In order to optimize the efficiency of the attestation process for all parties involved, the Health Standards Section obtained a list of FQHC clinics from the LDH Bureau of Primary Care and Rural Health that included email addresses. FQHC providers will now be receiving the attestation forms annually via email.  A current copy of the electronic form is attached for your review.  The form should be completed electronically and submitted via email to Emergency Preparedness Program Management Staff via email at Oklynn.Broussard@LA.Gov and Libby.Gonzales@LA.Gov.  The forms will be emailed out as close to the 1st of the month as possible with an expected return date no later than the 5th of the following month.  Due to the large volume of FQHC providers, we will notify providers via email quarterly as their turn for response comes up.  Failure to respond to the request and return the completed form may result in an onsite complaint investigation and the citation of a condition level deficiency.