WIREC

Priority Participant Package

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Download a PDF of these instructions.

During the 2010-2011 project year, primary care practices with 10 or fewer providers may qualify to receive WIREC services at no charge, thanks to Recovery Act funding awarded to WIREC from the US Department of Health and Human Services. There is a limited number of slots available to the Recovery Act-funded participants.

Before we may begin providing technical assistance to a Recovery Act-funded practice, we must receive the following documentation:

1. Memorandum of Understanding, Main Document (WIREC_MOU.doc)

  • Please print this document and have your practice’s authorized representative sign it.
  • For assistance or questions related to the memorandum, contact Elaine Jordshaugen.
  • Keep one copy for your records and send another to Qualis Health, attention Kristin Johnson. You may return it via fax (206) 366-3370, as an e-mail to kristinj@qualishealth.org, or mail to PO Box 33400, Seattle WA 98133-0400.

2. Memorandum of Understanding, Attachments A, B, and C (AttachABC.xls)

  • The DHHS Office of the National Coordinator (WIREC ‘s funding source) requires us to collect the information requested in these attachments. Your organization and practices’ names may be published as being participants in the WIREC project, but all the other data collected here will be kept confidential.
  • E-mail the completed documents to Kristin Johnson.

3. Practice Assessment (Practice_Assessment.pdf)

  • Our consultant team will use the information you provide in this form to tailor our services to your needs. Please type your answers directly into the form.
  • For help related to answering the assessment questions, contact John Hartgraves.

Next Steps
 Two additional documents may be helpful to introduce the WIREC project to other members of your practice:

After we receive your completed paperwork, one of our technical assistance consultants will contact you within two weeks. At that time, we will discuss preliminary ideas for your practice and schedule a group discussion with your team.