MLTC Workforce Q&A Document, June 29, 2017

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Question Answer
Is this program mandatory? This program is NOT mandatory. This is a voluntary program focused on retraining, recruiting and retaining healthcare workers in the long–term care sector.
How will this program reduce Medicaid costs? The money will be spent on initiatives focused on retraining, recruiting and retaining healthcare workers in the long-term care sector to achieve the goals of DSRIP. Goals include reducing avoidable hospital use, ensuring delivery system transformation continues beyond the waiver period, and increased access to quality care for members and long-term delivery reform through managed care payment modification.
Does this program include all MLTC Plans? Yes, all MLTC/FIDA plans are eligible to participate.
What sort of oversight will be in place for the management of funds provided? As part of the ongoing process, DOH will be developing protocols related to oversight, details are forthcoming.
Does this program necessitate amendments to our contracts? No, this will not be reflected in Plan contract language as this is a DSRIP specific initiative.
What about references to Appendix I/J? Appendix I/J refers to 1115 waiver appendices.
Who determines what culturally competent practice is? The definition of cultural competency can be catered to whatever programs the WIOs and decided WDIs are targeting. It is a dynamic process that occurs along a continuum. As referenced in MRT's multi-year action plan, one of the goals of Medicaid redesign is to address disparities through targeted training specific to cultural competency: Cultural competency training should be required to promote care and reduce disparities for all individuals including but not limited to people with disabilities, Lesbian, Gay, Bisexual and Transgender persons, persons with mental illness, substance use disorders and persons at risk of suicide (page 23 of 49).

Furthermore, the widely-used definition of cultural competency is intentionally broad: A set of congruent behaviors, attitudes and policies that come together as a system, that system, agency or those professionals to work effectively in cross-cultural situations. The word "culture" is used because it implies the integrated pattern of human thoughts, communications, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group. The word competence is used because it implies having a capacity to function effectively (Cross et al, 1989). We encourage plans and LTC WIOs to integrate this definition into all aspects of the application process.
The presentation established that DOH will take into consideration the disparities of upstate and downstate regions. What do these disparities look like? We see differences in workforce population, density, resources as well as needs.
How are the LTC WIOs different from the training provided by PPS under DSRIP? There is flexibility throughout the collaborative development of the WDIs. We encourage plans and constituents to curtail these programs to the needs seen in the workforce.
Will all applicants who meet the qualifications be certified as a WIO or is there some other competitive process? All applicants who meet the qualifications set forth will be designated as LTC WIOs and eligible to contract with plans.
What entity will be conducting the annual eligibility of WIOs and how will it be assessed? DOH will determine the annual eligibility based on applications, we are still in the process of developing the application/evaluation procedures which will be available for public comment.
What is the purpose of providing training for providers outside of network? DOH wants the trainings to demonstrate broad accessibility to ensure equal access to healthcare workers. Keep in mind, the aim of this initiative is to benefit direct care workers and the long-term care sector at large, therefore, we do not wish to place limitations on who can attend the trainings.
Why do we need to track trainings? We are looking to maintain records of completion and track the progress of workers who have successfully participated in programs. As we move forward, we are interested in stakeholder input on viable quality assurance metrics.
Will the plans automatically receive funding for participation in the WIOs or will they need to apply? Funds will be received once MLTC/FIDA plans contract with accepted LTC WIOs. The funds will be distributed to MLTC/FIDA plans via increases to the capitation rates and will be reconciled on a quarterly basis.
The methodology includes a built in administrative cost of 5%.
How will this program be sustainable after 2020? This will continue to be explored as we move forward with this process. We will encourage Plans and LTC WIO applicants to work collaboratively and maintain a focus on sustainability for these projects.