• Attachment is also available in Portable Document Format (PDF)


To ensure that the state is operating its program according to the requirements of the Special Terms and Conditions (STCs) governing its Section 1115 demonstration and consistent with Medicaid requirements, this attachment identifies the expectation of the state´s efforts towards monitoring the implementation of the DSRIP program under demonstration. Through monitoring we expect to: (1) recognize and resolve operational barriers immediately (2) quickly identify states´ needs for technical assistance; and (3) assure program integrity and accountability.

The New York DSRIP is comprised of three phases as described further in the STCs, including:
1) Interim Access Assurance Fund; 2) DSRIP Design Grant; and 3) DSRIP Fund. The operational protocol will cover all three phases of the project and implementation monitoring will be required in all three phases. The state will be required to submit for approval a new operational protocol during each phase of the DSRIP.

If there are changes outside of the phases of the DSRIP, or if any of the criteria set within this set of STCs is changed, the state will submit an update to its operational protocol.


  1. Executive Summary
    Provide a brief overview of what´s in the protocol, giving just a few sentences about each topic. This section is usually no longer than 2 or 3 pages.
  2. Activities Overview
    1. This section should highlight any activities or events that occurred or will occur to implement the most recent phase of the demonstration. Issues would be included here even if they might ordinarily be covered elsewhere if events were extraordinary or have attracted unusual attention. The implementation and operational activities of the following should be addressed:
      • Goals, processes and activities
      • Key personnel
      • Role details
      • Administrative structures to address functions,
      • Mechanisms to assure and oversee quality
      • Partnership Agreements
      • Contracting
      • Travel, training, outreach and engagement of stakeholders
      • IT infrastructure to accommodate the reporting requirement
    2. This section should also include problems or other issues that the state wishes to raise. It would include a discussion of key challenges that the State expects as well as solutions the state devised to deal with them.
    3. Transition and implementation activities including the development of data usage agreements and creation of infrastructure to receive provider information for purposes of this demonstration.
    4. How operational and performance concerns, appeals, lawsuits, Legislative developments and audits will be handled.
  3. Provider Requirements
    1. Report of infrastructure created to ensure providers have met the criteria to qualify including methodology for review.
    2. How providers who have met the criteria will receive a payment.
    3. How submissions to the state from providers will occur.
    4. How the state will monitor provider compliance including soliciting comments from the public.
    5. Plan for ongoing compliance with monitoring provider compliance with requirements; including describing the frequency with which aggregate reports will be submitted.
  4. Evaluation and Statewide Accountability
    1. Report on progress towards assignment or procurement of an independent evaluator.
    2. If procuring a contractor to have an independent evaluator or administer the evaluation and write the reports, submit as an attachment to the operational protocol, the statement of work that will be used in the request for proposal for contractor recruitment.
    3. Report on interim progress for development of the draft evaluation design, including proposed data that state will use to evaluate DSRIP.
    4. Public notice process used for seeking and incorporating public comments to incorporate into draft evaluation design.
    5. Draft research questions and hypotheses for the draft evaluation design.
  5. Detailed Timeline of Activities Related to the Execution of the Operational

Partnership Plan – Approval Period: August 1, 2011 – December 31, 2014; as Amended April