FY 17 Flex Non-Competing Continuation

Transcription

1 FY 17 Flex Non-Competing Continuation HRSA: 5-H Technical Assistance Call March 23, 2017 Sarah Young, Flex Program Coordinator Yvonne Chow, MBQIP Coordinator Federal Office of Rural Health Policy (FORHP) Health Resources and Services Administration (HRSA) Release of NCC: March 21, 2017 Due Date of NCC: May 16, 2017

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3 Agenda What is a Non Competing Continuation? Flex Program Direction Population Health and EMS Integration MBQIP Updates NCC in Detail Where is the NCC? Components of the NCC Attachments Reporting Requirements Reminders Questions

4 What is a Non-Competing Continuation (NCC)? A Progress Report and Performance Narrative that provides HRSA with: a summary of grant activities and progress since the last report, expected progress for the remainder of the current budget year, and project plans for continuation of funds next budget year (FY 2017) The NCC is an opportunity to update, readjust, and refine

5 NCC Progress Reports PIMS Reports Applications Financial Reports Flex Timeline

6 Flex Direction The FY 2015 Flex FOA describes a three-year project period FY 2017 EMS clarification FY 2017 MBQIP update

7 7 MBQIP Update Agenda Approach to MBQIP criteria NCC 2017: Building Capacity for HAI and ED-1 and ED-2 measures Review of FY2016 and FY2017 MBQIP Participation results Potentially ineligible CAHs Waivers and Frequently Asked Questions Next Steps and Resources

8 Medicare Beneficiary Quality Improvement Program: MBQIP Goals Reporting common, rural-relevant CMS measures Measuring outcomes and demonstrating improvements Sharing best practices

9 NCC 2017: Building Capacity for HAI and ED-1 and ED-2 Measures 9

10 Additional MBQIP Measures 10

11 Review of FY16 and FY17 MBQIP participation

12 12 Flex Funding Opportunity Announcement Project Period 09/01/2015 8/31/2018 (FY ) through the Medicare Beneficiary Quality Improvement Project (MBQIP) within the Quality Improvement program area, many CAHs signed on to voluntarily participate in quality reporting and improvement initiatives. With this iteration of the program to align with the focus on quality measurement and outcomes across health care payment systems, CAHs that wish to participate in any Flex activity will be required to participate in reporting MBQIP core quality measures.

13 13 MBQIP Eligibility Criteria for Flex Participation FY Building Capacity FY 2016: CAHs required to report at least one measure in any domain FY 2017: CAHs required to report at least one measure in 2 domains FY 2018: TBD FY 20XX: Reporting all measures

14 4Q11 1Q12 2Q12 3Q12 4Q12 1Q13 2Q13 3Q13 4Q13 1Q14 2Q14 3Q14 4Q14 1Q15 2Q15 3Q15 4Q15 1Q16 2Q16 3Q16 4Q16 Percentage of CAHs reporting Reporting Percentages (1340 CAHs) % 90.00% 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% Patient Safety Outpatient Patient Engagement (HCAHPS) Care Transitions Reporting Quarters 14

15 Reporting Rates for FY16 MBQIP Requirements % 90.00% 80.00% Patient Engagement 70.00% 60.00% Outpatient Care Transitions 50.00% Patient Safety 40.00% 30.00% 2Q14 3Q14 4Q14 1Q15 2Q15 3Q15 4Q15 Patient Safety Patient Engagement Care Transitions Outpatient 15

16 FY 2016 MBQIP Participation Rates 98% 96% Submitted data on MBQIP measures for at least one quarter for at least one Signed Memorandum of measure in at least one of Understanding with SORH the four quality domains within a certain reporting period 16

17 17 FY 2017 MBQIP Requirements Budget period: FY 2017, September 1, 2017 August 31, 2018 CAHs must meet two criteria to be eligible for FY 2017 Flexfunded activities: 1. A signed MOU to submit and share MBQIP data 2. Reported data on at least one MBQIP Core measure, for at least one quarter, in at least two of the four quality domains. Patient Safety IMM-2: 3Q15 2Q16 OP-27: The facility is registered through NHSN Patient Engagement (HCAHPS): 3Q15-2Q16 Care Transitions (EDTC): 1Q16 4Q16 Outpatient (OP-1-5, OP-18, 20-22): 3Q15 2Q16

18 4Q11 1Q12 2Q12 3Q12 4Q12 1Q13 2Q13 3Q13 4Q13 1Q14 2Q14 3Q14 4Q14 1Q15 2Q15 3Q15 4Q15 1Q16 2Q16 3Q16 4Q16 Percentage of CAHs reporting Reporting Percentages (1340 CAHs) % 90.00% 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% Patient Safety Outpatient Patient Engagement (HCAHPS) Care Transitions Reporting Quarters 18

19 FY 2017 MBQIP Participation Rates 99% 93.5% Signed Submitted data on MBQIP measures for at least one Memorandum of quarter for at least one Understanding with measure in at least two of SORH the four quality domains within a certain reporting period 1330 MOUs 1343 certified CAHs 19

20 Reporting Rates in Each Domain No MOU Signed MOU, No Submission Domain 2 Domains 3 Domains 4 Domains FY2016 FY

21 Potentially Ineligible CAHs = 87 CAHs Status # of CAHs Across # states Notes New MOUs, Newly Converted CAHs Just signed MOU in the last year No MOU of which are enrolled in NHSN Signed MOU, No Submission 8 5 Signed MOU, 1 Domain of which can be eligible if enrolled in NHSN* * Some CAHs may be in the process of enrollment 21

22 22 FY 2017 Waiver Template available on TASC Justifications for a waiver include: CAHs who signed the Memorandum of Understanding between September 2016 thru August 2017 and are building capacity CAHs who received CAH designation within the last year CAHs with other extenuating circumstances Questions on any exceptions not outlined above should be directed to your designated FORHP project officer

23 23 FY 2017 Waiver (cont.) Elements required on a waiver include: CAH s CCN and CAH Name Reason and situations each CAH faces for not being able to submit data on each MBQIP Quality Domain as well as other reasons/situations that do not apply to a particular domain Patient Safety (Imm-2 and OP-27) Patient Engagement (HCAHPS) Care Transitions (EDTC) Outpatient (OP-1-5, OP-18, 20-22) Other reasons Any documents that are relevant to the CAH Flex Coordinators are highly encouraged to include any additional plans of action for helping CAHs meet MBQIP requirements that is not covered in their workplan

24 24 Frequently Asked Questions 1. Every CAH was evaluated based on FY 2017 MBQIP requirements 2. If CAH applied and received waiver last year and is potentially ineligible again, you can apply for a waiver this year 3. CAHs can opt back into MBQIP anytime 4. Any documents that are relevant to the CAH 1. HCAHPS: CAH reports of completed surveys for each quarter 2. NHSN: Documentation the process is underway 5. What happens to waivers not accepted?

25 25 Ineligibility means No access to MBQIP data reports The state Flex Coordinators is not allowed to provide Flex funding to the CAH, including but is not limited to: Any Flex-funded services or activities where the inclusion of the ineligible CAH would increase the costs to the state Flex program Travel assistance or sponsorship/scholarships to activities such as conferences and workshops CAH names will appear on the Notice of Award Reference: FY2016 = 58 potentially ineligible CAHs 42 waivers accepted 16 ineligible CAHs

26 26 Next Steps and Resources Next Steps Your designated Project Officer will provide you a list of potentially ineligible CAHs in your state Will include most up-to-date list of enrollment in NHSN Resources RQITA (Rural Quality Improvement Technical Assistance) Peer Mentoring Program Guide MBQIP Monthly March edition Data: Finding and Using Benchmarking Data

27 Contact Information Yvonne Chow MBQIP Coordinator, Hospital-State Division Federal Office of Rural Health Policy (FORHP) Health Resources and Services Administration (HRSA) Phone: Web: hrsa.gov/ruralhealth/ Twitter: twitter.com/hrsagov Facebook: facebook.com/hhs.hrsa 27

28 NCC In Detail Creative Commons picture from StackExchange

29 Where is the NCC Located? HRSA Electronic Handbooks (EHB) HRSA EHB system on 3/21 You NEED to be a registered grant user in EHB to access If you re a new Flex Coordinator, ensure you have access HRSA NCC User Guide HRSA EHB Knowledge Base The NCC is a submission in EHB

30 NCC Components Content Title Type Required Max. Pages SF-PPR Performance Narrative Appendices SF-PPR Form Yes N/A SF-PPR-2 Form Yes N/A Performance Narrative Document Yes 15 1 Work Plan Data Table Attachment Yes N/A 2 FY 2016 Work Plan (current) Attachment Yes N/A 3 FY 2017 Work Plan (future) Attachment Yes N/A 4 5 FY 2017 Budget Justification Narrative Position Descriptions and Biographical Sketches of New Staff Attachment Yes N/A Attachment Yes if applicable 6 MBQIP Participation Waivers Attachment No N/A N/A

31 What time period does the NCC cover? Your narrative should cover the 12 months of completed activities since the last NCC report March 2016 March 2017

32 SF-PPR and SF-PPR-2 SF-PPR Form page contains basic information about your grantee organization and is the cover page for the progress report. By default, the information will be pre-populated from the information in the last application This is a component of EHB SF-PPR Please refer to pages of the NCC User Guide SF-PPR-2 Please refer to pages of the NCC User Guide

33 Performance Narrative No more than 15 pages, no smaller than 1- inch margins, use a readable 12-point font such Times New Roman May be single spaced or double spaced Document format:.pdf,.doc,.docx Use the Performance Narrative link to upload in EHB Pages of the NCC User Guide

34 Pro Tip #1 Include your state name or postal abbreviation in all file names Confusing: Performance Narrative.docx vs. Clear: TX performance narrative docx

35 Performance Narrative Contents Outlined in NCC The Performance Narrative should include the following sections: 1. Progress on Performance Improvement 2. Activities Completed 3. Current Year (FY 2016) Planned Activities 4. Future Year (FY 2017) Planned Activities 5. Significant Changes, Challenges and Barriers 6. Lessons Learned and/or Best Practices 7. Recommendations for Improving the National Flex Program

36 Performance Narrative Purpose Clearly and concisely describe progress on the goals and objectives of your Flex program Assess the impact of Flex investment in each active Core Area: Quality Improvement MBQIP Financial and Operational Improvement Population Health Management and EMS Integration CAH Conversion Integration of Innovative Care Models Describe what you ve done and what you plan Explain and provide context for your current and future work plans and your outcome data table

37 Pro Tip #2 Use your Narrative to explain and reference your work plan and data table. Save yourself space and effort, you don t need to repeat information that is presented elsewhere such as activities detailed in the work plan.

38 Topics of Interest What are your technical assistance needs? How many CAH site visits have you completed and how many are planned for the remainder of the year? Is your Flex program involved in any technology-enabled collaborative learning models like Project ECHO?

39 Reminder All activities must fit within one of the core areas, consult the FY 2015 Flex Grant Guidance if you are uncertain where/if a project fits: 1. Quality Improvement MBQIP 2. Financial and Operational Improvement 3. Population Health Management and EMS Integration 4. CAH Conversion 5. Integration of Innovative Care Models Significant changes in the objectives, aims, or purposes identified in the approved application require a change of scope.

40 Attachments Pages of the HRSA NCC User Guide describe how to load attachments Each document should include the Grant Number, Project Title, Organization Name, and Primary Contact Name Attach only the components listed in the NCC instructions Submissions will be returned if they re insufficient or missing information

41 Up to Six Attachments 1. Work Plan Data Table 2. FY 2016 Work Plan (current) 3. FY 2017 Work Plan (future) 4. FY 2017 Budget Justification Narrative 5. Position Descriptions and Biographical Sketches of New Staff 6. MBQIP Participation Waivers

42 Pro Tip #3 Include your state name, contact person, and grant number on all documents A header or footer is best

43 Work Plan Data Table Use the template developed by TASC Consolidate your outcome measures from last year in a single place Show trends This is a new format, not new information Outcome Measures (Short-term, Long-term): Must include intended and measurable target. Targets for your proposed outcomes are required page 9, HRSA

44 Current Work Plan The same FY 16 Work Plan submitted with last year s NCC, including Program Area and Goal Objectives Activities Allocated funds Timeline and Responsible Party Process Measures (Outputs) Update as necessary to reflect changes/reality Include approved carryover projects

45 Future Work Plan FY 17 Work Plan (Sept 1, 2017 Aug 31, 2018) Updated template from TASC Be concise The reason for continuing or changing activities in the work plan should be clear from the Performance Narrative

46 Budget Justification Narrative Discuss any significant changes to your FY17 budget relative to FY16. Detail the costs within each object class category. Personnel: For each employee supported by funds from this award include the name of employee; base salary; % FTE on the grant; and amount of Federal funds (wages and fringe) expended for the budget year. This personnel information requirement also applies to sub awards/subcontracts supported by Federal funds from this grant. Travel: List travel costs according to local and long distance travel. Itemize travel estimates. Contracts: Include a clear explanation as to the purpose of each contract, how the costs were estimated, and the specific contract deliverables.

47 Budget Amount Base your budgets on the same award amount as FY 16 Box 13 of the Notice of Award

48 Budget Requirements At least 1.0 FTE Two meetings with out-of-state travel: 2018 Flex Reverse Site Visit and one other regional or national meeting related to the administration of the Flex Grant New Flex staff must attend the Flex Workshop within one year Indirect costs limited to no more than 15% of direct costs (13.04% of total award)

49 Position Descriptions & Bio Sketches Any new staff since the submission of the 2016 NCC Include both the position description and a resume, CV, or biographical sketch for new staff Include a position description for any new positions which are vacant

50 MBQIP Participation Waivers Include waivers for any potentially ineligible CAHs Use the FY 17 Waiver Template

51 Pro Tip #4 Get an editor A set of fresh eyes reading your narrative and updates will ensure everything fits together and tells a compelling story of your program

52 Upcoming Reporting Requirements FY 16 Performance Improvement and Measurement System (PIMS) reports will be available September 1 and due October 31, 2017 FY16 Federal Financial Report (FFR) due January 30, 2018

53 NCC Important Reminders Resources for you: Your Project Officer TASC: Flex grant guidance and templates The Flex Forum Ask questions!

54 EHB Important Reminders Check the HRSA NCC User Guide for help on how to submit this report in EHB Be mindful that EHB times out after 30 minutes of inactivity. Save your work frequently! For assistance with HRSA s EHBs, contact the HRSA Call Center, 8 a.m. to 8 p.m. ET, weekdays (except Federal holidays): Phone: (877) Go4-HRSA or (877) Online request form

55 Questions?

56 Flex Project Officers Sarah Young Yvonne Chow Christy Edwards Owmy Bouloute

57 THE FLEX TEAM Owmy Bouloute FMT Coordinator (301) Christy Edwards EMS Lead (301) Yvonne Chow MBQIP Coordinator (301) Sarah Young Flex Program Coordinator (301) The recording of this webinar, the NCC guidance, templates, and the FY17 MBQIP eligibility criteria are available on the TASC website.