New York DSRIP 1115 Quarterly Report
October 1, 2014 – December 30, 2014
- Third Quarter Report also available in Portable Document Format (PDF)
New York State Department of Health
Office of Health Insurance Programs
Albany, New York
www.health.ny.gov/dsrip
New York DSRIP
Section 1115 Quarterly Report
Introduction
On April 14, 2014, New York finalized terms and conditions with the Centers for Medicare and Medicaid Services (CMS) for a groundbreaking amendment that will allow the state to reinvest $8 billion in federal savings generated by Medicaid Redesign Team (MRT) reforms. The MRT waiver amendment amends New York´s Section 1115 Demonstration, the Partnership Plan, and will transform the state´s health care system, bend the Medicaid cost curve, and ensure access to quality care for all Medicaid members. The agreement authorizes funding through the current demonstration end date of December 31, 2014, with an additional three months through March 31, 2015, and will continue upon agreement of the demonstration´s renewal from January 1, 2015 through December 31, 2019.
The Medicaid 1115 waiver amendment will enable New York to fully implement the MRT action plan, facilitate innovation, lower health care costs over the long term, and save scores of essential safety net providers from financial ruin. The waiver allows the state to reinvest over a five–year period $8 billion of the $17.1 billion in federal savings generated by MRT reforms.
The waiver amendment dollars will address critical issues throughout the state and allow for comprehensive reform through a Delivery System Reform Incentive Payment (DSRIP) program. The DSRIP program will promote community–level collaborations and focus on system reform, with a primary goal to achieve a 25 percent reduction in avoidable hospital use over five years. Safety net providers will be required to collaborate to implement innovative projects focusing on system transformation, clinical improvement and population health improvement. Single providers will be ineligible to apply. All DSRIP funds will be based on performance linked to achievement of project milestones.
The $8 billion reinvestment will be allocated in the following ways:
- $500 Million for the Interim Access Assurance Fund – temporary, time limited funding to ensure current trusted and viable Medicaid safety net providers can fully participate in the DSRIP transformation without disruption to the delivery of key health services
- $6.42 Billion for Delivery System Reform Incentive Payments (DSRIP) – including DSRIP Planning Grants, DSRIP Provider Incentive Payments, and DSRIP Administrative costs
- $1.08 Billion for other Medicaid Redesign purposes – this funding will support Health Home development, and investments in long term care, workforce and enhanced behavioral health services
In addition, the special terms and conditions also commit the state to comprehensive payment reform and continuing New York´s effort to effectively manage its Medicaid program within the confines of the Medicaid Global Spending Cap.
|top of page|Year 0 Focus
This report summarizes the activities from October 1, 2014 through December 31, 2014, the third quarter of Year 0. The agreement between New York and CMS includes a pre–implementation year, known as Year 0, which is the period between April 14, 2014 and March 31, 2015. Stakeholder education and engagement, planning activities, procurement of DSRIP contractors and development of key DSRIP policies and procedures are the main areas of focus during Year 1. An extensive DSRIP website was launched on April 14, 2014 and is available here. A high–level Year 0 timeline outlining key activities is available on the website and included with this report. (Attachment A).
Key Accomplishments for the Quarter:
This quarterly report summarizes the program development and implementation activities for the DSRIP program for the period from October 1, 2014 through December 31, 2014. Highlights of the quarter that are further described in the report are:
- Development and finalization of Project Plan Application incorporating public comments
- Twenty–five (25) PPS Project Plan Applications submitted on December 22, 2014
- Capital Restructuring Financing Program ($1.2 billion in NYS dollars) to support DSRIP projects request for applications (RFA) issued on November 18, 2014 with deadline of Feb. 20, 2015
- Intensive activities for stakeholder engagement and to support PPS entities in the application process
Stakeholder Engagement Activities, Transparency, and Public Forums
The period covering October 1, 2014 through December 31, 2014 included extensive stakeholder engagement activity conducted by DOH and by its selected vendors for the DSRIP Support Team and DSRIP Independent Assessor.
- DOH, with the Independent Assessor, released the Draft DSRIP Project Plan Application, Project Milestones and Metrics, and Scoring Guide for public comment on September 29, 2014. Public comments on the Draft DSRIP Project Plan were due by October 29, 2014.
- The DSRIP Independent Assessor provided a webinar on the Draft DSRIP Project Plan Application, Project Milestones and Metrics, and Scoring Guide on October 3, 2014.
- DOH released the DSRIP Measure Specification and Reporting Manual for public comment on October 10, 2014. The public comment period was open for 30 days.
- The DSRIP Independent Assessor hosted an operator assisted call on the DSRIP Project Plan Application materials on October 28, 2014.
- DOH and the DSRIP Support Team released a ´How To´ guide and webinar on PPS Governance on October 28, 2014.
- DOH and the DSRIP Support Team launched the MRT Innovation eXchange (MIX) on October 29, 2014. The MIX was created to centrally manage the development of an interactive public discussion platform for sharing ideas and insights into the DSRIP program specifically and Medicaid reform more generally.
- The final DSRIP PPS Lead & PPS Lead Financial Stability Test was released for PPS Lead completion on October 30, 2014 and completed tests were due on November 10, 2014.
- An updated DSRIP Project Plan application along with redline versions of the DSRIP Project Plan application materials, following public comments, were posted to the web on November 14, 2014.
- DOH and the DSRIP Independent Assessor published a summary of the public comments received on the DSRIP Project Plan application materials with responses to those comments as well as a complete listing of all public comments received on November 14, 2014.
- DOH, with the DSRIP Independent Assessor and the DSRIP Support Team, released a DSRIP Project Plan Application prototype with scoring on November 14, 2014.
- A DSRIP Project Plan Application Prototype Guide was released on November 18, 2014 to provide further insights to the various sections of the application and highlight key priorities and concerns of the DSRIP Independent Assessor.
- DOH and the DSRIP Support Team released webinars on Flow of Funds and Community Needs on November 19, 2014.
- DOH released updated DSRIP FAQs on November 20, 2014.
- The DSRIP PPS Lead & PPS Lead Financial Stability Test results were released on November 20, 2014.
- DOH and the DSRIP Support Team hosted an operated assisted call on November 20, 2014 to provide an overview of DSRIP updates and allow for a question and answer session with the public.
- DOH and the DSRIP Support Team released a webinar on Data Sharing and Confidentiality on November 20, 2014.
- The DSRIP Support Team IT Tiger Team and DOH IT vendor Salient provided 3 training sessions during the month of November 2014 and supported PPS staff in using the SIM tool to estimate their target populations at the project level.
- New York State Medicaid Director Jason Helgerson hosted a NYS DSRIP Whiteboard webinar on November 17, 2014 related to Project Plan Scale and Speed of Implementation.
- The DSRIP Project Plan Application Tool (Sections 1–9, except Section 4) was published and made available for PPS completion in MAPP on December 2, 2014.
- DOH and the DSRIP Support Team released webinars on Rapid Cycle Evaluation: Performance Management and on Behavioral Health on December 2, 2014.
- DOH and the DSRIP Support Team released webinars on Value Based Payments and Part II of Population Health Management on December 5, 2014.
- DOH released FAQs on COPA/ACO applications on December 8, 2014. Updated FAQs were released on December 23, 2014.
- DOH and the Center for Health Care Strategies (CHCS) presented on December 11, 2014 a live webinar and slide presentation on New York´s DSRIP program to a national audience. The webinar provided timely information to states pursuing their own DSRIP programs for reforming Medicaid health care delivery.
- New York State Medicaid Director hosted a NYS DSRIP Whiteboard webinar on December 11, 2014 that provided the Final Tips before the December 22, 2014 PPS Application Due Date. The webinar presented recommendations for perfecting scale and speed, engaging the entire network, demonstrating a thoughtful process for including workforce and cultural competence strategies, and integrating behavioral health and primary care.
- DOH released a slide deck on December 17, 2014 to provide additional guidance for the completion of the Patient Engagement Speed and Scale tables of the DSRIP Project Plan Application.
- The DSRIP Project Plan Application Tool (Sections 4, 10, 11) was released for PPS completion on December 17, 2014.
- Completed DSRIP Project Plan applications were due from the PPSs on December 22, 2014. Twenty–five completed Project Plan applications were received by the DOH and the DSRIP Independent Assessor.
- During the third quarter, the DSRIP Support Team regional teams directly engaged PPSs to assist them with their project plan application throughout the DSRIP Project Plan applications process. Their activities included: answering DSRIP related questions (instantly or through DST PMO); clarifying DSRIP related documentation and requirements; providing SME support; notifying PPSs of upcoming releases (i.e., tools, guides, webinars, other communications); evaluating PPS approaches and reporting risks and issues to DOH if necessary; ensuring that PPSs were appropriately equipped to meet DSRIP deadlines; facilitating project workgroup discussions; and reviewing drafts of PPS submissions including application sections, financial stress tests, MOUs, and governance models.
For more information visit the DSRIP website
|top of page|Interim Access Assurance Fund
The purpose of the Interim Access Assurance Fund (IAAF), part of the DSRIP program, is to assist safety net hospitals in severe financial distress and major public hospital systems.
Five hundred million dollars in temporary funding is available in Year 0 through the IAAF, to enable recipient hospitals to work toward sustainable operations and, to maintain critical services to their community as they work with other partner providers to develop integrated PPSs eligible for DSRIP funding.
In accordance with the waiver amendment Special Terms & Conditions (STCs) the State is required to, within 10 days of initiating IAAF payments, submit a report to CMS that states the total amount of the payment or payments, the amount of FFP that the state will claim, the source of the non–Federal share of the payments, and documentation of the needs and purposes of the funds to assure CMS of non–duplication. The report must include all other Medicaid payments (e.g. base, supplemental, VAP, DSH) the provider receives to demonstrate that existing payments are not sufficient to meet the financial needs of the providers.
IAAF payments for Large Public Providers began on June 18, 2014 while IAAF payments for Safety Net providers began June 27, 2014. All of the IAAF payment reports submitted to CMS are included as Attachment B.
More information is also available on the IAAF web page.
|top of page|DSRIP Project Design Grants
The State made funding available to emerging PPSs to develop comprehensive DSRIP Project Plans. Forty–nine applications for the DSRIP Project Design Grants were received on June 26, 2014
The DOH announced awards on August 6, 2014, with 42 of the 49 applicants receiving awards. The DOH included conditions with awards to certain applicants including considerations for merging or partnering with other PPSs and for geographic overlap with other PPSs.
In October 2014, progress reports were due from Design Grant awardees and in November 2014, final grant payments were made to awardees (50% Safety Net). In addition, during the third quarter requests for additional Supplemental Design Grant (PDG) funding were submitted to the DOH from several emerging PPSs; the requests were considered on a case by case basis and additional funds were provided. Attachment C includes a summary of the DSRIP Project Design Grant award and supplemental award payments made in November 2014.
In December 2014, additional Design Grant funding requests were evaluated by DOH with the intent to distribute remaining design grant funds. The goal was to have the additional awards process approved and notices sent to PPSs in January 2015.
The regional map and a schedule of the DSRIP Design Grant Awards are available here.
|top of page|DSRIP Safety Net and Vital Access Providers
The Vital Access Provider (VAP) Exception process opened on September 29, 2014 and ended on October 24, 2014 for all Medicaid providers that did not qualify by the Safety Net Definition by calculation or by appeal. If the exception is granted, then the applicant will be qualified and can fully participate in the DSRIP program. Non–qualifying facilities are limited; they may only receive up to 5% (as a group) of their PPSs award.
On November 3, 2014 NYS submitted safety exemption recommendations to CMS and posted safety nets to the web for a 30–day public comment period. NYS recommended that CMS approve all 503 providers for DSRIP safety net status through the VAP Exception process. If these providers are not approved, it could directly impair the ability of the individual PPSs and the statewide DSRIP program to be successful.
As per the STCs, the VAP exception appeals were posted for public comment for 30 days. On December 3, 2014, the public comment period ended; a total of 28 comments were received through the BVAPR email account. DOH leadership considered all public comments prior to providing recommendations to CMS for provider safety net status. On December 5, 2014, NYS submitted 503 exception appeals to CMS.
This link contains the VAP Exception appeals submitted to CMS, including the summary list of providers, the criteria used to determine safety net status (both through the original appeals and the VAP Exception), the Public comment listing and the backup lists by provider specific listings of exceptions received.
The approval of these exception appeals is contingent upon obtaining final approval from CMS. Once approval is received from CMS, the safety net lists will be updated and posted to the web.
|top of page|DSRIP Project Plan Application
The DOH, with the Independent Assessor, developed a revised DSRIP Project Plan application based upon feedback received from the public comment period in November 2014. The final DSRIP Project Plan Application Tool (Sections 1–9, except Section 4) was published and made available for PPS completion in MAPP on December 2, 2014. The DSRIP Project Plan Application Tool (Sections 4, 10, 11) was released for PPS completion on December 17, 2014. Completed DSRIP Project Plan applications were due from the PPSs on December 22, 2014. DSRIP Project Plan applications were received from 25 PPSs.
The DSRIP Independent Assessor completed an initial completeness review by December 24, 2014 and began the comprehensive evaluation of the DSRIP Project Plan applications on December 26, 2014. The evaluation of the 25 DSRIP Project Plan applications is scheduled to be completed in January 2015.
The completed DSRIP Project Plan applications can be found here.
Additional support materials for the DSRIP Project Plan application are available on DSRIP website.
|top of page|Quarterly expenditures related to IAAF, DSRIP Project Design Grants, and DSRIP Fund
IAAF payments for Large Public Providers began on June 18, 2014 while IAAF payments for Safety Net providers began June 27, 2014. Subsequent IAAF payments were based on three separate categories of providers and made at the following times:
- Large Publics (excluding HHC): December 15, 2014
- Large Publics (HHC only): December 15, 2014
- Safety Net: October 27, 2014; November 24, 2014; December 15, 2014
Attachment B contains all of the IAAF payments made during the October 1, 2014 through December 31, 2014 quarter.
DSRIP Project Design Grant funds were distributed during the month of November 2014.
DSRIP Fund performance payments are scheduled to begin April 1, 2015 for approved DSRIP Project Plan Applications.
|top of page|Requests for Regulatory Waivers
PHL § 2807(20)(e) and (21)(e) authorize the waiver of regulatory requirements for DSRIP projects and capital projects that are associated with DSRIP projects by:
- the Department of Health (DOH),
- the Office of Mental Health (OMH),
- the Office of Alcoholism and Substance Abuse Services (OASAS), and
- the Office for People With Developmental Disabilities (OPWDD)
- the Office of Primary Care and Health Systems Management (OPCHSM)
A waiver may be issued:
- as necessary to allow applicants to avoid duplication of requirements and to allow the efficient implementation of the proposed projects;
- only if the waiver would not jeopardize patient safety; and
- only for the life of the project.
Stakeholder meetings were held on October 21st and 29th, 2014. A system for tracking waiver requests was developed.
New York State received over 400 requests for regulatory waivers within the DSRIP Project Plan Applications from PPSs. DOH began working with the necessary agencies including OMH, OASAS, and OPWDD to complete the reviews of the regulatory waiver requests. Reviews are expected to be completed in February 2015.
Future reports will identify outcomes and waivers granted of the regulatory waivers submitted by PPSs.
For more information refer here.
|top of page|Other New York State DSRIP Program Activity
DSRIP Project Management
DSRIP project management efforts continued into this quarter with the continued use of the successfully established MRT process and work plan format, with key DSRIP staff meeting twice weekly and reporting on progress of DSRIP activity to New York´s Medicaid Director. DSRIP project management meetings have now expanded to include staff from the DSRIP Independent Assessor and the DSRIP Support Team as well as CMA, the vendor tasked with creating the DSRIP Project Plan Application web tool. Meetings will continue through the end of Year 0, and will likely continue through DSRIP Years 1 – 5.
New York has also established additional, separate project management meetings with their vendors for the DSRIP Independent Assessor and the DSRIP Support Team and a joint meeting involving key staff from New York, the DSRIP Independent Assessor, and the DSRIP Support Team. These meetings allow for more in depth reviews of project deliverables with each vendor and to address any policy considerations requiring New York input.
Independent Assessor
New York released a Funding Availability Solicitation (FAS) for the purpose of procuring the services of an entity to serve as the DSRIP Independent Assessor on May 20, 2014. Through the FAS procurement process, New York selected Public Consulting Group (PCG) to serve as the DSRIP Independent Assessor. Notification of the award was made on July 31, 2014 and PCG began work on August 4, 2014.
The DSRIP Independent Assessor´s tasks include, but are not limited to: creating an application and application review tool as well as a process for a transparent and impartial review of all proposed project plans, making project approval recommendations to the state using CMS– approved criteria, assembling an independent review panel chosen by the DOH based on standards set forth in the DSRIP STCs, conducting a transparent and impartial mid–point assessment of project performance during the third year to determine whether the DSRIP project plans merit continued funding or need plan alterations, and assisting with the ongoing monitoring of performance and reporting deliverables for the duration of the DSRIP program. State review of proposals was underway at the close of this quarter and additional detail on the contract award will be provided in future reports.
During the October 1, 2014 through December 31, 2014 quarter the DSRIP Independent Assessor performed many tasks vital to the eventual awarding of DSRIP funding to PPSs. These activities include:
DSRIP Project Plan Application and Review Tool
The Independent Assessor, developed an application process with the aid of DOH. The criteria for evaluating the application – Project Metrics and Milestones, Scoring Guide, PPS Lead Financial Stability Test – were made publically available on the DSRIP website. Public comment was collected on the application and updates and revisions were made to the application. The application was built by CMA in a web portal for PPSs to complete their submission. The Independent Assessor and DOH accepted applications from 25 PPSs through December 22, 2014.
DSRIP PPS Lead & PPS Lead Financial Stability Test
The Independent Assessor, with DOH, released the DSRIP PPS Lead & PPS Lead Financial Stability Test on October 27, 2014 with a revised response template released on October 30, 2014. The DSRIP PPS Lead & PPS Lead Financial Stability Test was intended to assess the financial stability of the proposed PPS Lead entities. PPS Lead entities were required to submit the completed DSRIP PPS Lead & PPS Lead Financial Stability Test by November 10, 2014. The Independent Assessor completed a review and validation of the DSRIP PPS Lead & PPS Lead Financial Stability Test submissions and final results were released on November 20, 2014.
DSRIP Project Application Portal
The Independent Assessor assisted DOH and CMA in the development of the DSRIP Project Plan application functionality in MAPP. The Independent Assessor developed technical requirements to convert the DSRIP Project Plan application from a Microsoft Word document to a web based portal. The Independent Assessor also completed testing on the portal prior to its release to the PPSs for submission of their DSRIP Project Plan applications.
Evaluation of DSRIP Project Plan Applications
Upon the submission of the 25 DSRIP Project Plan applications the Independent Assessor completed an initial completeness review to ensure all of the required information was included in the Project Plan applications. Following the completeness review the Project Plan applications were provided to the team of six non–conflicted evaluators who would be responsible for conducting the evaluation and scoring of the applications. The evaluators began scoring on December 26, 2014 and are expected to complete all evaluations and scoring by January 26, 2015.
DSRIP Project Approval and Oversight Panel (PAOP)
The DSRIP program requirements outlined by CMS, required the DOH and the Independent Assessor to convene the DSRIP Project Approval and Oversight Panel (PAOP) to review DSRIP Project Plan applications scored by the Independent Assessor and to advise the Commissioner of Health whether to accept, reject or modify those recommendations. The Panel will play an important role in approving DSRIP Project Plans from all areas of the state and will serve as advisors and reviewers of PPSs status and project performance during the 5–year DSRIP duration.
The DOH and the Independent Assessor began coordinating training and outreach efforts for the Panel in December. These efforts included the development of a comprehensive training program and the scheduling of a public meeting to conduct the Panel training. The DOH also completed outreach efforts to establish the list of participating Panel members. The training for the Panel is scheduled to be completed in January 2015 with the formal presentation of Independent Assessor recommendations to the Panel scheduled for February 2015.
Implementation Plan
The Independent Assessor began work with the DSRIP Support Team and DOH on the development of a comprehensive implementation plan that will outline the PPSs approach to meeting organizational and project specific implementation milestones. This effort will continue in to the next quarter when the implementation plan template will be released for the PPSs to complete.
COPA/ACO
Public Health Law (PHL) Article 29–F sets forth the State´s policy of encouraging appropriate collaborative arrangements among health care providers who might otherwise be competitors. The statute requires DOH to establish a regulatory structure allowing it to engage in appropriate state supervision as necessary to promote state action immunity under state and federal antitrust laws. The regulations establish a process for providers to apply for a Certificate of Public Advantage (COPA) for their collaborative arrangements such as mergers and clinical integration agreements. The Department will consult with the Office of the Attorney General and, if appropriate, with the OMH, OASAS, and OPWDD. In addition, the Department will consult with and receive a recommendation from the Public Health and Health Planning Council before granting a COPA.
Pursuant to Article 29–F, the Department has issued regulations establishing a process for the issuance of a Certificate of Public Advantage. Public comment was collected on COPA/ACO regulations. COPA and ACO regulations were published in the State Register and became effective December 17th and 30th, 2014 respectively
For more information refer here.
DSRIP Support Team
New York released a Funding Availability Solicitation (FAS) for the purpose of procuring the services of a vendor to serve as the DSRIP Support Team (DST) on May 21, 2014. Through the FAS procurement process, New York selected KPMG to serve as the DST. KPMG began work on August 1, 2014.
The DST´s responsibilities include, but are not limited to, under the direction of New York´s DSRIP team, working with providers to strategically think through their potential DSRIP Project Plans to transition to effective and efficient high performing health care delivery systems; developing DSRIP Project Plan prototypes, "how to" guides and other tools to help providers as they prepare their Project Plan applications; and supporting providers from shortly after receipt of their DSRIP Design Grant awards through their final submission of the Project Plan applications.
During the October 1, 2014 through December 31, 2014 quarter, the DST performed a number of key functions in support of the PPSs including:
MRT Innovation eXchange
The MRT Innovation eXchange (MIX) was created to centrally manage the development of an interactive public discussion platform for sharing ideas and insights into the DSRIP program specifically and Medicaid reform more generally. This has proven to be a valuable resource for engaging a wide variety of stakeholders in the DSRIP program and for improving the ultimate outcomes of the projects. An operational version of the MIX platform was launched in October 2014. After launch, activities included promoting the MIX to new users, communicating with existing users, moderating ongoing discussions, and producing weekly newsletters.
Value–Based Payments
The DST Value–Based Payments work stream supported DOH in the strategy and development of the CMS roadmap due spring of 2015. This work included establishing Value–Based Payment subject matter teams that engage stakeholders, including members of the payor community, in the development of the roadmap. Once completed, the roadmap will also be available for public comment to solicit wider feedback.
Project Plan Application Prototype
The goal of the application prototype was to provide PPSs with an example and guidelines for the Project Plan application. The prototype was developed utilizing a variety of subject matter experts. Each section was submitted to DST for review and feedback. Those sections included: 1) the actual prototype content meant for the Independent Assessor to evaluate and score, 2) footnotes that consisted of direct guidance to PPSs to consider their unique demographic and economic circumstances when responding to questions, and 3) feedback to the Independent Assessor on where the Project Plan application could be improved, such as increasing word limits to certain responses, and clarifying the phrasing of several questions. This team is also supporting DOH to develop the implementation plan template.
IT Strategy
The DST IT strategy team held planning sessions for PPSs to increase their understanding of their current and future IT system requirements. These on–site workshops involved discussions of current IT architecture, PPS gap assessment, risk matric, workflow considerations, RHIO analysis and a mock–up of IT architecture future state.
Medicaid Data Requests
The DST Tiger Team worked with Salient to prepare bookmarks/collections in the SIM tool that supported PPSs in their estimations of target populations at the project level under each domain. PPSs also engaged the team to answer data requests that SIM–trained PPS resources (some PPS employees, other PPS consultants/3rd parties) sent to a DST monitored email address. In addition, the team supported Salient and PPSs during three SIM training sessions for the PPSs in November 2014.
Workforce Strategy
The DST workforce strategy team provided PPSs guidance on current and future state workforce needs and how to quantify retraining, redeployment, and hiring needs to support them in achieving project objectives. This guidance was provided to PPSs through templates and on–site workshops. Specifically, the team provided guidance on: training strategies (i.e. best practice methods to achieve desired results); implications of voluntary vs. mandatory training; guidance on considerations to existing HR programs (i.e. certifications, tuition reimbursement, etc.); redeployment strategies and implications; recruitment strategies; infrastructure needed to support large scale recruitment efforts; algorithms to triangulate budget requirements (i.e. as % of total project budget, as multiplier of # of impacted workforce or by population served); how to incorporate programs into overall strategy; change management and application to stakeholder engagement (i.e. communication planning); and how to engage stakeholders during application development process to maximize collaboration.
Financial Strategy
The DST finance team provided assistance to PPSs in the areas of the DSRIP program that require financial management content, or finance function input and perspective. These included, but were not limited to, Sections 2, 4, 5, 8 and 9 of the Application and approaches to funds flow and financial sustainability. This assistance was provided in the form of PPS work group meetings, conference calls and education/workshop sessions. Information and materials or documentation that the Finance Team used was referenced and supported by their understanding of published DSRIP guidance by DOH, and leading practices observed through other engagements.
Direct PPS Support
The DST regional teams directly engaged PPSs to assist them with their Project Plan application. The activities included: answering DSRIP related questions (instantly or through DST PMO); clarifying DSRIP related documentation and requirements; providing SME support; notifying PPSs of upcoming releases (tools, guides, webinars, other communications); evaluating each PPS approaches and reporting risks and issues to DOH if necessary; ensuring that PPSs were appropriately equipped to meet DSRIP deadlines; facilitating project workgroup discussions; and reviewing drafts of PPS submissions including application sections, financial stress tests, MOUs, and governance models.
The DST developed a progress reporting tool to monitor and report on PPS progress that involves two types of data collection: PPS entered and DST entered information. PPS data was entered via a bi–weekly survey, while DST data was entered weekly via a form on the progress reporting website. These two inputs were then used to create weekly progress reports provided to the DOH that included regional heatmaps, a PPS status summary, a compliance report, and additional analysis that varied from week to week.
PPSs seeking a COPA or ACO decision by April 2015 were instructed to submit their COPA/ACO applications by December 22, 2014. As of that date, DOH did not received any COPA/ACO applications from PPSs. DOH will continue accepting COPA/ACO applications beyond the December 22, 2014 due date with decisions to be made at a later date.
Future reports will include additional details regarding submitted COPA/ACO applications and the decisions on those applications.
|top of page|Capital Restructuring Finance Program (CRFP) Request for Applications (RFA)
The 2014–15 New York State budget authorized the establishment of the CRFP to allow the DOH and the Dormitory Authority of the State of New York (DASNY), in consultation with the Office of Mental Health (OMH), the Office for People with Developmental Disabilities (OPWDD) and the Office of Alcoholism and Substance Abuse Services (OASAS), to make awards totaling up to $1.2 billion in state funds to support capital projects to help strengthen and promote access to essential health services, including projects to improve infrastructure, promote integrated health systems, and support the development of additional primary care capacity. Awards of CRFP funding may be made to DSRIP participating entities as well as to non–DSRIP participating entities.
The CRFP RFA was posted on the DOH website on November 19, 2014 and applications will be due on February 20, 2015. Additional information regarding the CRFP RFA will be included in subsequent quarterly reports.
Upcoming Activities
Year 0 implementation and planning activities will continue through March 31, 2015. Future reports will also include updates on additional activities as required by the MRT Waiver Amendment and related attachments.
Year 0 implementation and planning activities will continue through March 31, 2015.
- Independent Assessor will complete the scoring of PPS Applications and develop summaries of the results in January 2015.
- Final Scale and Speed Submission completed and submitted by PPS Lead by January 14, 2015.
- DSRIP Project Plan Application PDFs posted to the web, public comment period on Project Plan Applications begins by January 15, 2015.
- Independent Assessor recommendations made public by February 2, 2015.
- Public comment period on Project Plan Applications ends by February 15, 2015.
- Independent Assessor releases the Public Comments received on the Project Plan Applications by February 17, 2015.
- DSRIP Project Approval & Oversight Panel public hearings & meetings to review Independent Assessor recommendations and make final recommendations to state from February 17–20, 2015.
- During the month of March– the Final attribution results will be released.
- Capital Restructuring Financing application due by February 20, 2015.
- Early March DSRIP Project Plan awards made.
- Implementation Plan due from PPSs by April 1, 2015.
- DSRIP Year 1 begins on April 1, 2015.
- First Year 1 Payment to PPS made by Mid–April.
Additional Resources
More information on the New York State DSRIP Program is available here.
Interested parties can sign up to be notified of DSRIP program developments, release of new materials, and opportunities for public comment through the Medicaid Redesign Team listserv. Instructions are available here.
|top of page|Tentative MRT Waiver/DSRIP Key Dates
|top of page|New York State Medicaid Redesign Team (MRT) Interim Access Assurance Fund (IAAF) Payment Report
|top of page|DSRIP Design Grant Payments
| Provider ID (MMIS #) |
8/22/14 Payment |
11/3/14 Supplemental PDG Award |
11/17/14 Supplemental Award |
11/20/14 Supplemental Award |
|
|---|---|---|---|---|---|
| Public Hospital Design Grant Payments | |||||
| Erie County Medical Center Corporation | 245863 | $1,000,000 | $0 | $0 | $500,000 |
| Nassau University Medical Center | 1962156 | $1,000,000 | $0 | $0 | $0 |
NYC HHC
|
|
$2,000,000
|
$3,000,000
|
$0
|
$0
|
SUNY Central
|
|
$1,000,000
|
$6,000,000
|
$0
|
$0
|
| Westchester Medical Center | 274213 | $1,000,000 | $0 | $0 | $0 |
| Sub‐total | $6,000,000 | $9,000,000 | $0 | $500,000 | |
| Safety Net Design Grant Payments | |||||
| Adirondack Health Institute | 03449974 | $445,500 | $445,500 | $0 | $0 |
| Albany Medical Center Hospital | 03000364 | $350,000 | $350,000 | $0 | $0 |
| Amida Care, Inc. | 02191582 | $250,000 | $250,000 | $0 | $0 |
| Auburn Community Hospital | 00347553 | $184,500 | $184,500 | $0 | $0 |
| AW Medical | 03317604 | $250,000 | $0 | $0 | $250,000 |
| Bronx‐Lebanon Hospital Center | 00476022 | $250,000 | $250,000 | $0 | $0 |
| Cortland Regional Medical Center, Inc. | 00279176 | $248,750 | $248,750 | $0 | $0 |
| Ellis Hospital | 00347562 | $250,000 | $250,000 | $0 | $0 |
| Faxton St. Luke´s Healthcare | 00384309 | $250,000 | $250,000 | $0 | $165,000 |
| HEALTH ALLIANCE HSP BROADWAY CAMPUS | 03000213 | $170,000 | $170,000 | $0 | $0 |
| Long Island Jewish Medical Center | 00243903 | $250,000 | $250,000 | $0 | $0 |
| Lutheran Medical Center | 02996078 | $250,000 | $929,786 | $0 | $0 |
| Maimonides Medical Center | 02998736 | $250,000 | $429,786 | $0 | $0 |
| Mary Imogene Bassett Hospital | 03000593 | $380,000 | $380,000 | $0 | $0 |
| MERCY MEDICAL CENTER | 02996725 | $250,000 | $250,000 | $0 | $0 |
| Montefiore Medical Center | 02998167 | $250,000 | $250,000 | $500,000 | $0 |
| Mount Sinai Hospitals Group | 02998612 | $250,000 | $250,000 | $0 | $0 |
| Niagara Falls Memorial Medical Center | 00354467 | $249,500 | $249,500 | $0 | $0 |
| Refuah Health Center | 01421705 | $250,000 | $250,000 | $0 | $0 |
| Richmond University Medical Center | 00248820 | $125,000 | $125,000 | $0 | $0 |
| Rochester General | 00303315 | $250,000 | $1,250,000 | $0 | $0 |
| Samaritan Medical Center | 03001594 | $250,000 | $250,000 | $0 | $0 |
| Sisters of Charity Hospital of Buffalo | 03001705 | $250,000 | $250,000 | $0 | $0 |
| St. Barnabas Hospital (dba SBH Health System) | 00243361 | $250,000 | $750,000 | $0 | $0 |
| St. Joseph´s Hospital Health Center | 02995893 | $250,000 | $650,000 | $0 | $0 |
| Staten Island University Hospital | 00244202 | $125,000 | $125,000 | $0 | $0 |
| Strong Memorial Hospital‐Univ. Rochester Med. Center | 00279034 | $250,000 | $1,250,000 | $0 | $0 |
| The Jamaica Hospital | 00243852 | $250,000 | $250,000 | $0 | $0 |
| The New York and Presbyterian Hospital | 00243178 | $250,000 | $250,000 | $0 | $0 |
| The New York Hospital Medical Center of Queens | 02998992 | $250,000 | $250,000 | $0 | $0 |
| United Health Services Hospitals, Inc | 03004639 | $247,650 | $747,650 | $0 | $0 |
| Sub‐total | $7,775,900 | $11,785,472 | $500,000 | $415,000 | |
| Grand Total = $35,976,372 | Hospitals in yellow received a supplemental award in addition to their 2nd PDG payment on 11/3/14 | Hospital in blue received a supplemental award | Hospital in blue received a supplemental award | ||
| Allocated Budget | $70,000,000 | ||||
| Remaining PDG Money | $34,023,628 | ||||
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