Section 2: Frequently Asked Questions (FINAL)

Transcription

1 The Delta Center for a Thriving Safety Net Letter of Intent Instructions Addendum #1 Issued February 26, 2018 The following shall be incorporated as part of the Letter of Intent Instructions: Section 1 Revised Submission Instructions Section 2 Frequently Asked Questions (FINAL) All other requirements, terms, and conditions remain unchanged. Section 1: Revised Submission Instructions The process for submitting Letters of Intent (LOIs) has been modified. Applicants should NOT submit LOIs through . Letters of intent should be submitted online using the Submit LOI web form provided on the Delta Center Grant Program web page: Section 2: Frequently Asked Questions (FINAL) The LOI Question & Answer period has closed. The following pages provide the final set of questions and responses.

2 Page 1 The Delta Center for a Thriving Safety Net Frequently Asked Questions (FINAL) February 26, 2018 New Questions A. Eligibility and Selection Criteria: 8-10 B. Award Amount and Use: 5 C. Program: 8-13 A. Eligibility and Selection Criteria 1. Are county and/or regional associations eligible to apply from large states with multiple primary care and/or behavioral health state associations or consortia? Answer: County and/or regional networks or consortia may apply as partners to a primary care association or behavioral health state association. However, the primary care association or behavioral health state association would need to be the lead entity. 2. Will there be a requirement in the grant for primary care associations to engage with the behavioral health state association counterpart in their state, or vice versa, if the other does not apply? Answer: It is not a requirement that primary care associations and behavioral health state associations apply as co-applicants. We are looking for organizations that are open to advancing partnerships with their behavioral health or primary care association counterparts beyond what they are doing today. Creative collaboration between behavioral health and primary care is encouraged. 3. If a state-level behavioral health program for Medicaid is in transition (and still TBD), is that an opportunity or a barrier for this application? Answer: We would ask that you describe how your association views the transition and how participation in the Delta Center would further your ability to influence the transitioning program. 4. If a state has a behavioral health state association and primary care association that share numerous members, would it be possible for one of the associations to take the lead and to have a joint-partnership application within a state? Answer: Yes, as long as one of the associations serves as the lead entity. 5. If we don't have a behavioral health state association in our state, can a primary care association still qualify? Answer: A primary care association may apply on its own. We do ask that the primary care association describe how the organization would work with behavioral health leaders at the state level beyond the

3 Page 2 current status quo as part of the LOI. The National Council for Behavioral Health s website provides a list of active members. 6. Can you go back to the examples of states with significant value-based payment opportunities? Maryland's all-payer waiver is driving a value-based payment approach, and I'm trying to figure out whether it meets your criteria or not. Answer: As long as you can describe how the all-payer waiver is creating a policy environment that is pushing providers toward HCP-LAN categories 3 and 4, it would meet the criteria. 7. Is there a specific region of the country that is a priority for the Delta Center? Answer: No, there is no one specific region of the country that is a priority for the Delta Center. Our intent in offering 10 awards is to achieve geographic diversity while also making sure that we have state associations that are well prepared to address the needs of both their urban and rural providers. 8. I am with an association of free and charitable clinics. We have many clinics accepting Medicaid for dental and behavioral health services, and some hybrid clinics accepting general insurance. How can free and charitable clinics that accept Medicaid and insurance and the associations that support them become a part of the Delta Center? Answer: In order to be eligible, applicants must be state or regional primary care associations affiliated with the National Association of Community Health Centers (if applicant is a PCA) or behavioral health state associations that are active members of the National Council for Behavioral Health (if applicant is a BHSA). We encourage interested organizations that do not meet these criteria to consider partnering with a PCA or BHSA in their state. In addition, we encourage you to visit the Delta Center website periodically. We expect to share resources and policy insight papers based on best practices/lessons learned over the next two years. Please let us know if you would like to be added to a mailing list for Delta Center announcements. 9. If the primary care association and the state behavioral health association from the same state each submit separate LOIs, will only one be invited to submit a full application? Would two separate applications be viewed as a weakness/unfavorably? Answer: We are looking for organizations that are open to advancing partnerships with their counterparts. Primary care associations and behavioral health state associations are encouraged to collaborate, and the nature of the primary care/behavioral health partnership will be taken into consideration when LOIs are scored. However, it is not a requirement that associations from the same state apply as co-applicants. As such, it is possible (although unlikely) that both associations could be invited to submit a full proposal. Ultimately, only one award will be made per state. 10. The instructions indicate that we should include a letter of support (LOS) from one clinic or provider organization. We are planning to apply in partnership with our counterpart behavioral health state association. Since one of us, as the provider organization, will serve as the lead applicant, should that LOS come from the other organization to indicate our commitment to the partnership? Can we include

4 Page 3 more than one LOS? We both have very supportive members who are interested in the project and we weren t sure whether we could submit an LOS from one member each. Answer: For this stage in the selection process, there is no requirement for a letter of support confirming partnership from the counterpart association, although we would expect the partnership to be outlined in the LOI. In terms of the clinic/provider letter of support indicating commitment to participate in the TA activities provided by the grantee, the Delta Center will consider more than one letter of support only in the case of joint applications. For joint applicants, the Delta Center would accept one letter of support for the lead applicant and one letter of support for the partnering applicant (total of two letters). B. Award Amount and Use 1. Is the $240,000 for the entire 2-year project period or per year (total $480,000)? Answer: The funding is a total of $240,000 for the two years. 2. If we were to submit a joint application with a behavioral health state association, would the award we'd be eligible for be $240,000 total for both organizations or $240,000 per organization? Answer: The total award money is $240,000, and this will be given to one lead entity. It is up to that lead to determine how to share the total with any co-applicant(s). We also encourage state associations to use this opportunity to solicit local funders, such as local foundations or Medicaid payers, to complement the Delta Center grant with local funding. 3. Can you say more about applying in collaboration with another organization? Would the $240K then be split between the two organizations, or would they each receive $240K? Answer: The funding would be split between the two collaborating organizations (see Question B2 above), and one single organization would serve as the lead organization for grantmaking purposes. 4. Does funding need to cover costs for the in-person convenings? Or are those expenses covered by RWJF outside of the grant funds? Answer: Yes. The expenses for in-person convenings are to be paid using the $240,000 grant. There will be no outside funding from RWJF. Of note, one of the intents of this initiative is to promote local sustainability. One way that sustainability can be demonstrated is when state associations can articulate that they have local funders (e.g., foundations, managed care Medicaid plans who are interested in being ongoing funding partners for the state associations, etc.) for funding ongoing provider training and technical assistance. 5. Can the grant award funds be used for existing staff salary, or to fund a new staff position? Are there any specific expectations or limitations on use of grant funds? Answer: Grant funds are primarily intended to offset costs for participation in the Learning & Action

5 Page 4 Collaborative, such as travel to in-person convenings or staffing to implement capacity-building activities. Staffing may include current staff, new staff, or outside consultants. C. Program 1. What sort of team are you imagining will be needed at each state association to perform successfully in this opportunity? Answer: Organizations will need to commit to identifying select staff who would participate in core program activities (e.g., in-person convenings and evaluation interviews). The team should include: 1) at least one senior leader (i.e., CEO, Medical Director) with decision-making authority to serve as the Executive Sponsor; 2) a day-to-day Program Manager to oversee the activities and reporting requirements of the program; and 3) other individuals who work closely with the providers or local stakeholders on value-based care and payment initiatives (e.g., a quality improvement lead, a support person to champion care transformation training, Executive or Finance Director, and a policy lead to champion policy and payment reform work). Please note that staffing requirements may be met through a combination of primary care association and behavioral health state association staff and support from members, affiliates, or other partners. Given the lean staffing of some associations, we recognize that in some cases, one person may fill multiple roles and/or roles may be held by volunteer/committee leaders rather than staff. 2. What are the requirements /expectations for minimum health center participants in the collaborative? We have a subset of health centers that engage in alternative payment model and valuebased payment work. Not all health centers in our state would be involved in the collaborative. First, to clarify the expectation for the Delta Center-run learning and action collaborative, only state association leaders would be expected to participate. In some cases, state associations may have volunteer provider members who comprise part of the state association team. In other cases, the state association will have association staff be the participants. Second, in terms of the expectation for the on-the-ground learning activities that state associations run for their provider members, there is not a minimum number of provider participants, but we will be looking for state associations that can show they are a trusted training partner and have a good amount of reach with providers within their state, including addressing the needs of both urban and rural providers interested in value-based care and payment and cultivating the practices of learning organizations. 3. If you partner with another state association, must they also attend all of the convenings? It would not be required that another state association partner attend all convenings as long as the lead entity can show that a dedicated team plans to attend all convenings and communicate relevant information/tools from the meetings to partners. We expect that much of the work will occur in between in-person convenings as partners work together to execute action and implementation plans.

6 Page 5 4. Would we start working with our behavioral health state associations during the two-year learning period or following the two-year period? Our expectation is that primary care associations would start working with their behavioral health state association partners to advance the relationship beyond the status quo during the two-year grant period (or vice versa if the lead applicant is a behavioral health state association). 5. Who are some of the examples of the experts that will provide the TA and coaching? In particular, for managed care? Contracting negotiations? Human-centered design? Answer: The Delta Center is building the faculty roster and we will continue to do so as we learn more about the specific needs of the selected grantee cohort. The faculty will include a mix of thought leaders, experts, and practitioners with on-the-ground lived experience in care transformation, policy and payment change, and evidence-based practices of learning organizations that can sustain changes successfully. If there are specific trainers or people you would like to recommend, we welcome the field s input. 6. Will there be technical assistance and experts to assist with setting value-based payment amounts and evaluation of cost savings? Answer: It is likely that TA will include sharing processes used by others for setting value-based payments and evaluating cost savings. However, if an individual state association determines it is in need of specific actuarial analysis, the TA would not cover this level of individualized support. 7. Are the in-person convenings and the capacity building workshops separate events? Answer: They are not separate. Workshops will be built into at least five of the seven in-person convenings. 8. Senior Leader: The description provides CEO or Medical Director as examples. If no CEO is in place, who could serve as the Senior Leader? Could it be the program director? Should we look for a CEO of one of our member organizations? What type of decisions would this person be making? Answer: Yes, other team members can serve as the senior leader on the core team. The team member in this role needs to be able to make decisions, such as decisions about addressing policy opportunities with the state Medicaid agency, directing or soliciting resources to provider trainings, or forging partnerships with other state associations. We do not expect that a CEO of a member organization would serve as the senior leader as the core focus of the work in this initiative is building capacity at the state association level. 9. Support Person: We envision hiring a part-time support person to assist the program manager in day-today and reporting activities, including travel arrangements, and coordinating training events. Please confirm whether such a support staff would be expected to attend the in-person and virtual convenings? Answer: The core team members--a senior leader, program manager, and other select staff (e.g. QI lead, support person, executive or finance director, and/or policy lead)--will be expected to attend the in-

7 Page 6 person convenings. It is at the discretion of the grantee if additional members of the team will attend the in-person convenings. 10. Is there a minimum number of individuals that must be on a team or just specified roles that must be taken on by team members? Answer: The Delta Center requires that teams include at least two individuals, one of whom must be the Program Manager. A core team of at least three to four members is strongly recommended. Across the team, a single team member may fill multiple roles (e.g., a Program Manager who also provides senior leadership); however, the core team must have adequate staffing to fulfill the different roles and complete program requirements. 11. Can you elaborate on the extent of technical assistance and coaching that association team members are expected to directly provide? We are looking for clarification on how much direct TA and coaching would be expected from the team members from member organizations. Answer: It is at the discretion of the grantee who will provide the TA on their behalf. There is no requirement that it be an association staff member versus others they have brought on to their team. 12. More detail about the expected involvement of both primary care providers and behavioral health providers would be appreciated. Is the TA support for providers expected to be distributed equally between behavioral and primary care providers? Are there further expectations around advancing integration of behavioral and primary health care or integrated care team models? Answer: The Learning & Action Collaborative activities will focus on building the capacity of state associations to advance value-based care and payment with their providers. Grantees will be expected to take what they learn from participation in the learning collaborative and develop a technical assistance plan for how they will build the capacity of providers (e.g., through webinars, resources, convenings, etc.). The Delta Center does not have predetermined guidelines for how the technical assistance should be distributed between behavioral health and primary care providers. It is expected that grantees will assess the current state of integration between behavioral health and primary care and develop plans for improving collaboration at both the state association and provider levels. 13. Is the expectation that the Executive or Finance Director role be filled by an association finance director or by a provider finance director? If the inclusion of this role is intended to being the ability to assist in the evaluation and/or design of value-based payment methodologies, an association finance director may not possess the appropriate expertise. In that instance, a provider finance director would be more appropriate. If the intent is to include a role responsible for financial accounting and reporting relative to the grant, an association representative would be appropriate. Answer: The individual in the Executive or Finance Director role is expected to provide vision and leadership around any proposed payment reform and/or policy change initiative (e.g., partnerships with other state associations, discussions with state Medicaid agencies or other payers, etc.). This role is not necessarily responsible for grants management, as that task can be held by another team member (e.g., program manager or support person).the applicant may determine whether the role is filled by a representative from the association or somewhere else.

8 Page 7 D. Housekeeping 1. Will the slide deck be available after the call? Answer: The slide deck is posted to deltacenter.jsi.com. There is also an FAQ, which will be updated on a rolling basis as questions are submitted. 2. Is it possible to get a list of attendees so we will be able to check if our state partners are also interested in this work? Answer: Yes. Please deltacenter@jsi.com to request a list. 3. Please repeat the LOI process. Are only certain primary care associations /behavioral health state associations going to be invited to submit an LOI? Answer: We encourage all organizations who are interested in being considered to be a grantee that meet eligibility criteria to submit a letter of intent (LOI). In order to be considered for funding, an LOI must be submitted. A subset of the LOI applicants will be invited to submit a full proposal.