Appendix: Archive of out-of-date questions

Interim Access Assurance Fund (IAAF)

1. Q: What is IAAF?

A: IAAF stands for "Interim Access Assurance Fund". This is temporary funding to be awarded to select Medicaid providers to protect against degradation of current access to key health care services, limit unproductive disruption, and avoid gaps in the health delivery system until DSRIP is implemented. The IAAF is available to provide supplemental payments that exceed upper payment limits, DSH limitations, or state plan payments, to ensure that certain current Medicaid safety net providers remain viable so they can more fully participate in DSRIP.

2. Q: Is there a time and dollar amount limit on IAAF funding?

A: New York may expend up to $500 million in FFP for Interim Access Assurance payments for the period of the date of approval of the IAAF expenditure authority until March 31, 2015.

3. Q: Who qualified to receive IAAF funding?

A: Please visit the IAAF website for a detailed description of the IAAF guidelines.

4. Q: Do you need to submit an application to receive IAAF funding? If so, how long will providers have to do so (deadline to submit application)?

A: Final IAAF applications were due on May 30, 2014 and $462 million of these funds have been awarded. More information on awards.

5. Q. Can a non-hospital based provider apply for IAAF?

A. No. IAAF funding was only made available to hospital based providers. Non-hospital based providers in need of funding to protect against degradation of current access to key health care services are encouraged to apply for funding through the Vital Access/Safety Net Provider Program (VAP).

6. Q. How does the IAAF funding affect the ability to apply for DSRIP funding?

A. Any applicant who applied and received IAAF funding must subsequently become part of a DSRIP Performing Provider System that submits a DSRIP Project Plan application. Receipt of IAAF funding does not limit eligibility for DSRIP Project Design Grants. However receipt of IAAF funding does limit ability to serve as a lead applicant.

7. Q. How does IAAF funding affect a PPS´s applicant status?

A. In certain instances, receipt of IAAF funding does impact an organization´s ability to serve as a lead applicant. Only public hospitals are able to receive IAAF funding and also serve as lead applicant. Any non-public recipient of IAAF funding may not serve as a PPS lead applicant.

8. Q. What happens to my IAAF grant if my PPS merges and I am no longer the lead?

A. Any applicant who applied and received IAAF funding must subsequently become part of a DSRIP Performing Provider System that submits a DSRIP Project Plan application. IAAF recipients that merge with other entities, will still keep their IAAF award as long as they are still participating in a DSRIP PPS.

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Performing Provider Systems

1. Q: As a partnering provider, what happens if the emerging PPS I choose to join did not receive approval to operate a PPS? Am I going to be left out of DSRIP? (Revised 8/28/2015)

A: The State has worked proactively to provide planning resources to PPS so that they had a thorough understanding of what was expected in, as well as the means to create, a thorough/approvable Project Plan Application. These resources included, but were not limited to, the state´s launch of a DSRIP Support Team in addition to planning funds via DSRIP Design Grants. Furthermore, the State published a draft of the applicant scoring tool in September 2014, so applicants could see the metrics which their application will be scored against.

The state also built several "rounds" into the DSRIP application process to ensure, to the best of its ability, that the most viable applicants were building partner networks. That being said, there was no way for the State to ensure that every emerging PPS entity will make it through the entire DSRIP application process. While applicants have been approved to proceed through other rounds of the DSRIP application process, in the end, if their PPS Project Plan application does not meet the standards set forth in the application scoring tool, the emerging PPS will not be approved as an official PPS entity to participate in the DSRIP program.

However, from the experience of other DSRIP application rounds, if a provider is a member of an emerging PPS that does not receive approval for a DSRIP Project Plan application, more likely than not, the non-approved PPS (and its provider network), will join and be merged with another PPS that is serving counties in close proximity.

Therefore, in choosing which emerging PPS network to join, a provider should focus on aligning with the emerging PPS they have the most clinical relationships with to maintain continuity of care for their patients, rather than worrying about partnering with multiple emerging PPS networks in fear of being left out of the DSRIP Program.

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PPS Project Advisory Committee

1. Q: How should Project Advisory Committee representatives chosen?

A: PAC Representatives should be determined using the following process:

  1. Organizational representatives:
    1. Emerging PPS partners with more than 50 employees are required to have an organizational (managerial) representative participate in the PAC.
    2. Emerging PPS partners with less than 50 employees have the option of selecting an organizational (managerial) representative to participate in the PAC.
  2. Worker representatives:
    1. Partner organizations that are not unionized and have over 50 employees must develop a process to elect a worker (non-managerial employee) representative to participate in the PAC.
    2. For non-unionized partner organizations with less than 50 employees, the employees have the option of electing a worker (non-managerial employee) representative to participate in the PAC if they so choose.
  3. Union Representatives:
    1. Partner organizations that are unionized and have over 50 employees must designate a union representative to participate in the PAC. If a particular union represents workers from multiple emerging PPS partners, one representative from that union is sufficient to satisfy PAC requirements.
    2. For unionized partner organizations with less than 50 employees, the union has the option of designating a union representative to participate in the PAC if they so choose.

2. Q: Is there any flexibility in Project Advisory Committee membership composition?

A: While there is no set minimum/maximum number regarding PAC members, the State understands that it may become impracticable to require larger emerging PPS to have all the partner, union and worker representatives included in the PAC, while expect the committee to be efficient and effective. For an emerging PPS with over 20 partnering organizations, a qualifying PPS may propose an alternative PAC committee structure that will allow for a leaner committee, as long as the proposed structure is still representative of all key parties within the PPS.

Finalized alternative PAC proposals must be submitted to the state as a DSRIP Project Design Grant award mid-point deliverable. The state will approve Final PPS PACs after reviewing the final submissions.

3. Q: Is there any additional guidance for the Alternative Project Advisory Committee (PAC) Structures?

A: The state offers PPS the flexibility to structure its PAC how it sees fit (as long as representativeness among partners and workers/unions is maintained). The state further offers the following suggestions to PPS´ after a thorough review of all submitted alternative PAC structures from the Design Grant, as well as taking public comment into consideration.

Suggested Structure:

  1. To maintain a manageable and effective PAC, the State recommends alternative PAC structures be divided into a smaller Governing Committee that will work in conjunction with unrestricted sub- committees.
  2. Governing and sub-committee members should be selected from within the larger pool of representatives that would have been generated based on the standard PAC formation process.
  3. The Governing Committee should:
    1. consist of no more than 25 members
    2. represent key partners proportional to the number of Medicaid patients they serve
    3. represent key labor organizations proportional to the number of workers represented
    4. be regionally representative
    5. include subject-matter experts
  4. Sub-committees may be organized according to scope of care, project domains, or other method which achieves adequate stakeholder representation, partner collaboration, and comprehensive oversight of DSRIP initiatives.
  5. The PPS must explicate how the Governing and sub-committees will collaborate within the PAC structure.

Further Considerations:

  1. When forming an alternative PAC structure, the PPS should consider the following:
    1. The PAC should include sufficient representation from partners who serve the greatest proportion of the Medicaid population.
    2. The PAC should include sufficient representation from all safety net providers.
    3. The PAC should include sufficient representation from Behavioral Health partner organizations to suitably align with DSRIP goals.
    4. The PAC should be demographically and geographically representative of the community served by the PPS.
    5. The PAC should facilitate engagement with frontline staff and non-partner stakeholders (e.g., community members).
    6. There should be occupational diversity within the PAC (e.g., include both administrators and practitioners).
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Letter of Intent & Project Design Grant

1. Q: How have the Letters of Intent been used to inform application development?

A: The letters of intent served two main purposes:

  1. To help entities interested in participating in DSRIP to become aware of one another. Every letter of intent (including their list of their partners) has been posted online and categorized by region.

    The state hoped that this would not only produce transparency, but also encourage dialogue between providers to form partnerships before the DSRIP Project Design Grant applications were due.
  2. To help the state not only identify interested parties throughout the state, but to also assist the state in seeing areas that might need help to bring providers together to form a DSRIP PPS.

2. Q: Is there funding available to help with ´start-up´ activities?

Funding has been made available through the previously mentioned DSRIP Project Design Grants. These grants will enable providers to develop specific and comprehensive DSRIP Project Plan Applications. The providers and coalitions that receive DSRIP Project Design Grants must use their grant funds to prepare and are required to submit a DSRIP Project Plan application. DSRIP Project Design Grants were announced on August 6, 2014 and a list of awardees is available here.

3. Q: How does my PPS apply for a DSRIP Project Design Grant?

A: DSRIP Project Design Grant applications were due on June 26, 2014. The state is no longer accepting applications for Design Grant awards.

4. Q: Will an emerging Performing Provider System be able to change its list of selected DSRIP projects after the DSRIP Project Design Grant application is submitted?

A: Yes. The DSRIP Project Design Grant´s Project selection was used to gauge PPS Project interest in order for the state to deploy project planning resources accordingly. Final DSRIP Project selection will be made in the submission of the Project Plan application due on December 22, 2014.

5. Q: Does an emerging Performing Provider System need to identify all their partners in their DSRIP Project Design Grant application? Can more partners be added in their DSRIP Project Plan application as projects become more defined?

A: The list of PPS partners submitted in a DSRIP Project Design Grant application was non-binding and can be adjusted as emerging PPS gain a better understanding of the projects they should undertake (and the partners they will need to implement a that project) based on information from their community needs assessment. Finalized PPS partnership rosters are due on December 1, 2014.

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Project Plan & Support Team

1. Q: What is the role of the DSRIP Support Team (DST)?

A: On July 29, 2014, the state announced the award of DSRIP Support Team (DST) funding to KPMG, LLP, contingent upon successful negotiation of a contract. The DSRIP Support Team has been engaged by the Department of Health to support PPSs in the Planning efforts. The DST fulfills 4 specific roles:

  1. Serve as designated contact for any Department of Health-related DSRIP Communications e.g. answer any questions or concerns the PPS may have regarding DSRIP and the Planning Application Process.
  2. Perform periodic reviews of PPS Planning Grant Application as it develops to help the PPS assemble an application that is of high quality and in accordance with DSRIP guidelines and the guidance put forth by the Independent Assessor. The aim is to prevent surprises once the application is submitted on December 22nd and enters the scoring process. The DST will also be putting together a mock application based on the Independent Assessor guidelines once these are published which will allow for detailed guidance in this process.
  3. Provide how-to guides and support materials for all PPSs to use to assist them in the Planning Grant Application process.
  4. If needed and as indicated by the PPS, the DST may also provide on-the-ground support, which may range from basic to intense, in order to assist the PPS in its Planning Grant Application efforts. This may range from weekly check ins to answer key questions to intense workshops with subject matter experts in areas of need to facilitate conversations and help apply DSRIP guiding principles to the PPS application. These options will be discussed in detail with each of the PPS leads during initial kick off meetings to match DST support to need.

To contact the DSRIP Support Team at KPMG, please email: dsrip@health.ny.gov.

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Medicaid Analytics Performance Portal (MAPP) & 2-Factor Authentication (2FA)

Q: Are there any other IDs that will be accepted in lieu of a NYS DMV issued identification?

A: Currently, other means of identification will not be accepted to access MAPP when a 2FA login is deployed. The Department is working to build both a PHI and a non-PHI view; however, a timeline has not been released for this future development.

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