Grant Application Instructions for Sponsoring Institutions and Teaching Programs Data year: Fiscal Year 2017 Clinical Training Application deadline: October 31, 2018 Estimated distribution: April 30, 2019 For more information: http://www.health.state.mn.us/divs/hpsc/hep/merc/index.html MERC Grant Applications Minnesota Department of Health Attention: MERC Staff, 2nd Floor Golden Rule Building 85 East Seventh Place, Suite 220 St. Paul, MN 55101 health.merc@state.mn.us (651)-201-3566
Contents Background... 1 Eligibility... 1 Sponsors... 1 Teaching Program... 1 Clinical Training Site... 2 The Application Process... 3 Reporting Period... 3 Due Date... 3 MERC Funding... 4 Grant Determination... 4 Grant Payments and Grant Verification Reporting... 4 Communication... 4 MERC Staff... 4 Sponsoring Institution Online Application... 5 Setting up Usernames and Passwords for Teaching Programs (Optional)... 5 A. Part I Sponsoring Institution Data... 7 1. Sponsoring Institution Address... 7 2. Contact Responsible for Grant... 7 3. Program Types Applying... 8 Certification by Officer... 8 B. Part II Teaching Program Data... 9 Updating Existing Programs... 9 Deleting Existing Programs... 9 Adding New Programs... 9 1. Program Name and Address... 10 2. Program Type... 10 3. Contact Responsible for Grant... 10 4. Program s Fiscal Year 2017... 10 5. Program Specialty... 11 6. Accreditation... 11 7(a). FTE Summary... 12 C. Training Site Data... 13 Provider Identification Numbers... 13 National Provider Identification Number (NPI)... 13
Minnesota Health Care Program Enrollment (MHCP)... 13 Federal Tax ID Number (FEIN)... 13 Collecting Training Site Applications... 13 7(b). Training Site List... 14 Deleting Training Sites... 14 Modifying Training Sites... 14 Adding Training Sites... 14 7(b). Training Site Details... 15 MHCP Facility Name and Address... 15 CEO/CFO or Authorized Representative... 15 Practice Setting... 15 Hospital Subparts/Group Members... 16 Grantee Pay-To Billing Address... 16 Eligible FTEs... 16 Submitting the Application... 17 Check Missing Fields... 17 Final Submit... 17 Printing the Application... 17 Mailing the Application... 18
Background The MERC grant was established in 1996, and funded for the first time in 1997. Its purpose is to provide support for certain medical education activities in Minnesota that historically were supported in significant part by patient care revenues. Due to Minnesota s competitive health care market, payers became increasingly unwilling to pay the extra costs associated with the purchase of services at teaching facilities. Teaching facilities are forced to compete with non-teaching facilities, which results in greater difficulty in funding teaching activities. The Commissioner of Health has been responsible for administering the MERC grant since 1998. Eligibility Sponsors A hospital, school, or consortium located in Minnesota that sponsors and maintains primary organizational and financial responsibility for a clinical medical education program in Minnesota and which is accountable to the accrediting body. Minnesota Statute 62J.692, subdivision 1(d). Teaching Program Located in Minnesota. Students/Residents in clinical training during fiscal year 2017. Clinical training that is funded in part by patient care revenues and occurs in either an inpatient or ambulatory patient care training site. Program accredited at the time of training and ongoing by an organization recognized by the Department of Education, the Centers for Medicare and Medicaid Services, or another national body that reviews the accrediting organizations for multiple disciplines. Program trains eligible provider types: * Advanced Practice Nurses: Certified Nurse Midwives Certified Registered Nurse Anesthetists Clinical Nurse Specialists Doctor of N ursing Practice Nurse Practitioners Clinical Social Workers Community Health Workers Community Paramedics Dental Students or Residents Dental Therapists or Advanced Dental Therapists Doctor of Chiropractic Students Doctor of P harmacy Students or Residents Medical Students or Residents Physician Assistant Students Psychologists * Training programs for Advanced Practice Nursing must be sponsored by the University of Minnesota Academic Health Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges and Universities System or members of the Minnesota Private College Council. Page 1
Clinical Training Site Located in Minnesota. The training site is the facility at a given practice address where clinical training occurred. o Individual preceptors or departments within a facility should not be listed as the training site. o If the training site is a physician owned clinic, the training site is defined as the clinic and not the physician. o The facility where clinical training occurred should be listed as the training site even if the preceptor that provided the training has moved to another facility. Training that occurs in a nursing facility is not eligible. Site must have a National Provider Identification (NPI) Number actively enrolled in the Minnesota Health Care Program (MHCP). Site must have fiscal year 2017 Medical Assistance/Prepaid Medical Assistance Program (MA/PMAP) claims reimbursements in Minnesota. Training site must host a combined 0.1 FTE minimum. o Sites can meet the FTE minimum by hosting multiple teaching programs and provider types eligible for MERC funding. o Programs are encouraged to submit applications for all clinical training sites regardless of FTE count. o Minimum FTE determination made by MDH. The use of funds are limited to expenses related to clinical training program costs for eligible programs. o MDH will collect clinical training expenses from training facilities after review of the initial application. Page 2
The Application Process The sponsoring institution must submit the online application for a MERC grant on behalf of one or more teaching programs. A sponsoring institution may be a hospital, school, or consortium located in Minnesota that sponsors and maintains primary organizational and financial responsibility for a clinical medical education program in Minnesota and which is accountable to the accrediting body. The sponsoring institution is designated as the applicant because, in some cases, programs are not prepared to handle funding directly, but rely on the sponsoring institution or consortium for those functions. This system also reduces the administrative complexity in the event that more than one program at a given institution is receiving funding because the application and reporting process can be coordinated at a higher level. In some cases, the sponsoring institution, the teaching program and the training site will be three different entities. However, because other models also exist, the sponsoring institution may be the same as both the program and training site. The online application consists of two parts: Part I requests information on the sponsoring institution and basic summary data regarding the teaching programs included in the sponsoring institution s application. For each application there will be only one Part I submitted. Part II requests information on teaching program(s). For sponsoring institutions applying on behalf of more than one teaching program, multiple Part IIs must be completed, one for each teaching program included in the application. Only accredited teaching programs located in Minnesota should be included in the application. Reporting Period With the exception of names and addresses, the grant application must reflect clinical training during fiscal year 2017. Due Date The MERC application has a statutory deadline. Signed applications will be accepted until October 31, 2018, as indicated by a date stamp placed on the application by the Minnesota Department of Health receptionist at the following location: Minnesota Department of Health MERC Grant Applications Attn: ORHPC, 2nd Floor Golden Rule Building 85 East Seventh Place, Suite 220 St. Paul, MN 55101 Page 3
MERC Funding While the data in the application is based on training that took place in fiscal year 2017, the grant is funded by state fiscal year 2019. Funding comes from multiple sources including a carve-out on the Prepaid Medical Assistance Program (PMAP) rates, an appropriation from the Minnesota cigarette tax, federal matching funds, the general fund, and the health care access fund. The estimated state fiscal year 2019 grant pool is $59 million. Grant Determination Grant are awarded based on the eligibility criteria and legislative formula found in Minnesota Statute 62J.692 Grant Payments and Grant Verification Reporting The estimated distribution date is April 30, 2019. Sponsoring institutions will receive payments from the Minnesota Department of Health along with reports and instructions indicating the amount awarded to each clinical training site. Sponsoring institutions are required to forward the funds to the training sites within 60- days of receipt. Legislation requires the sponsoring institution to complete a Grant Verification Report (GVR) verifying that the sponsoring institution distributed the MERC grants consistent with the award materials from the Minnesota Department of Health. If the sponsoring institution fails to submit the GVR by the deadline stated in the letter, the sponsoring institution must return the full amount of the grant to MERC staff within 30 days of receiving notice from the Commissioner. Communication Subscribe to MERC updates using the GovDelivery link located on the right menu bar throughout the MERC website http://www.health.state.mn.us/divs/hpsc/hep/merc/index.html. MERC Staff If you have questions regarding the MERC grant, please visit the MERC website or contact: Diane Reger, MERC Grant Coordinator (651)-201-3566 Cirrie Byrnes, Grant Verification Reporting (651)-201-3844 Shared Email: health.merc@state.mn.us Page 4
Sponsoring Institution Online Application https://merc.health.state.mn.us/merc/index.html Grant applications are submitted electronically using an online application available to sponsoring institutions by password. If the sponsoring institution has applied in the past, existing username and password can be used. Please contact health.merc@state.mn.us if you are new sponsoring institution and require initial access or if you need your existing password reset. Instructions for navigating the online application are found on the left menu bar throughout the application. Figure 1 Attention: Usernames and passwords are case sensitive. Data is saved by changing screens or pressing the SAVE button on the left menu. The application will remain active for 20 minutes without activity. If left inactive, any unsaved data will be lost. Setting up Usernames and Passwords for Teaching Programs (Optional) A sponsoring institution may designate one representative to complete the entire application on behalf of all teaching programs. Alternatively, they may place the responsibility for completing the teaching program s grant application on a representative of the teaching program. The sponsoring institution representative will continue to oversee the entire application. To grant access for program representatives, return to this section after completing Part I of the application and entering the program name under Part II, Step #1. Page 5
To assign a new username and password for an individual program: Figure 2 1. On the left menu, click the ADMINISTRATION button. 2. Under the ADMINISTRATION menu, click USER ADMINISTRATION (See Figure 2). 3. At the top of the screen, click the ADD NEW USER button. 4. Select a username and password for the program administrator (See Figure 3.) Passwords are case sensitive and limited to 30 characters. 5. Click MODIFY USER INFORMATION. To assign programs to an individual (See Figure 2 Teaching Programs Available ): Figure 3 1. Locate the program to assign to the program representative 2. With the program name highlighted, click the right arrow located in the center of the page. This assigns the program to the user. If one individual administers multiple programs, select the next program name and the right arrow again. To remove a program from a user: 1. Locate the program to assign to the program representative 2. With the program name highlighted, click the left arrow located in the center of the page. This removes the program from the user. Repeat steps in Figures 2 and 3 for additional users. If you are finished, click SAVE or move to another button on the left menu bar. Page 6
A. Part I Sponsoring Institution Data MERC grant applications must be submitted through the sponsoring institution. Part I requests information about the sponsoring institution, which is defined in statute as a hospital, school, or consortium located in Minnesota that sponsors and maintains primary organizational and financial responsibility for a clinical medical education program in Minnesota and which is accountable to the accrediting body. Minnesota Statute 62J.692, subdivision 1(d). Sign into the application (see Page 6). Highlight the sponsoring institution name. Click the left menu bar to complete the sections below. 1. Sponsoring Institution Address Enter the name and address of the sponsoring institution submitting this application. Figure 4 2. Contact Responsible for Grant Enter the name and mailing address of the person responsible for managing grant money received from the MERC grant. Figure 5 If entering information for the first time, or if the contact person has changed, click the arrow next to the name field and select ADD NEW. Enter the new contact and press SAVE PERSON INFO. Page 7
3. Program Types Applying No data entry occurs on this screen. A summary of fiscal year 2017 programs and trainee FTEs contained in the application will be updated automatically as information is entered into the applications. Users can refer back to this screen after teaching programs and clinical training sites have been entered. Figure 6 Certification by Officer Once the online application is submitted, an officer authorized by the sponsoring institution must sign a hard copy. (See Submitting the Application.) Page 8
B. Part II Teaching Program Data Complete a separate Part II for each teaching program for fiscal year 2017. Part II may be completed by the teaching program representative * or by the sponsoring institution representative. Regardless of who enters the program s data, the sponsoring institution representative will have final signoff. *Refer to Setting up Usernames and Passwords for Programs (Page 6-7). Figure 7 Teaching programs submitted on the prior grant application will appear in a list. Using the left menu bar, complete each section under the Teaching Program dropdown. Updating Existing Programs To update programs that has applied in the past: 2. Detailed instructions for completing the TEACHING PROGRAM and the TRAINING SITE sections are on the following pages. 3. After the entire program and all the training sites under that program are completed, return to the TEACHING PROGRAM button to begin the next program. Deleting Existing Programs 1. Before deleting a program, training sites listed under the program must first be deleted. (See the section on Deleting Training Sites before proceeding.) 2. After the training sites associated with the program have been deleted, delete the program by click on the program name and then the DELETE SELECTED button located below the program list. Adding New Programs To add a program applying for the first time: 1. Click the ADD NEW button at the bottom of the teaching program list. 2. Scroll through the alphabetical list of teaching programs and click SELECT when the program name is located. If the teaching program is not in the drop down list provided, click the ADD NEW button. Enter the program name in uppercase in the field titled New Program Name, then click CREATE NEW PROGRAM. 1. Select the first program in the alphabetical list and complete each step found under TEACHING PROGRAM and TRAINING SITE on the left menu bar. Page 9
1. Program Name and Address Provide the name and address of the teaching program and the date the program began teaching activities. Figure 8 3. Contact Responsible for Grant Identify the name and mailing address of the person responsible for handling financial aspects of the program, including managing funds that may be awarded from the MERC grant. Figure 10 2. Program Type Check one radio button to identify the type of training provided. Figure 9 4. Program s Fiscal Year 2017 Provide the program s 2017 fiscal year dates. Figure 11 Page 10
5. Program Specialty Scroll through the available options and highlight the program s specialty (e.g. clinical nurse specialist, pediatric dentistry, internal medicine). If the accrediting body is not in the existing list, email a PDF of the program s accreditation letter to MERC staff at health.merc@state.mn.us. Figure 13 If the specialty is not listed, select ADD NEW located in the drop down list. Add the specialty using uppercase. Figure 12 6. Accreditation Teaching programs applying for a MERC grant must be accredited through an organization recognized by the U.S. Department of Education ( Current List of Nationally Recognized Accrediting Agencies and the Criteria for Recognition by the U.S. Secretary of Education. U.S. Department of Education Office of Postsecondary Education, September 1998), the Centers for Medicare and Medicaid Services (42 C.F.R. 413.85, 413.86) or another national body who reviews the accrediting organizations for multiple disciplines and whose standards for recognizing accrediting organizations are reviewed and approved by the Commissioner of Health. Programs applying for the first time can select from a list of accreditation bodies by clicking on the right arrow and scrolling. Select one of the three options: Initial: Programs recently accredited or those applying for the MERC grant for the first time. Continued: Programs who have applied for the MERC grant in the past who have ongoing accredited programs. Other: Any other status along with a short description. Effective During: Enter the date the program s accreditation first started and the date the current accreditation will be up for renewal. Accredited programs are required to submit documentation, such as a letter from the accrediting body, verifying the program s accreditation status and effective dates. An officer who has personal knowledge of the program s accreditation status must attest to the accreditation. Depending on the circumstances, this may be an officer of the teaching program or the sponsoring institution. If the program s accreditation status changes, MERC staff must be notified in writing. Page 11
7(a). FTE Summary Report the total number of non-eligible trainees for the teaching program according to the categories below. Enter 0 for those with no FTEs in fiscal year 2017. i. Clinical Training FTEs at Sites Located Outside of Minnesota Report the total number of clinical trainee FTEs training sites outside of Minnesota. ii. Didactic/classroom (non-patient care) FTEs Report the total number of didactic/classroom FTEs. For example, if trainees spend half of their time in didactic/classroom activities, then half of the total student/resident FTEs should be reported here. Figure 14 FTE is defined as a full-time equivalent. Full-time is considered a minimum of 2,080 hours, 52 weeks, or 260 days. One person cannot exceed one FTE. ((Student/Resident * Weeks in Rotation) * Hours per Week) = Clinical Training Hours / 2,080 = FTE Count iii. iv. Other Non-Eligible Trainee FTEs - Report all other non-eligible trainee FTEs. Examples of other noneligible trainees include trainees in sites not enrolled in the Minnesota Health Care Program (MHCP), trainees in nursing homes or VA/federal facilities, or training sites in school-based clinics not supported by patient care revenues. Total Non-Eligible Trainee FTEs - A total of items i, ii, and iii are automatically calculated by the system. v. Eligible Total - This field is automatically calculated as trainee counts are entered in the training site section. Note: A program can be defined to exclude students who do not participate in clinical training, (for example, year one medical students whose time is all spent in didactic training). The definition of the teaching program should be consistent throughout the application. vi. FTE Total - This field is automatically calculated as non-eligible and eligible trainee counts are entered. Page 12
C. Training Site Data Training facilities must be located in Minnesota and the practice address where training occurred must be actively enrolled as Medicaid providers in the Minnesota Health Care Program (MHCP). Facilities with multiple practice locations must complete an application for each training facility. Provider Identification Numbers The site where clinical training occurred must provide the practice location s identification number used for Medicaid billing. The identification number is essential in determining the Medical Assistance (MA/PMAP) revenue for the grant formula. National Provider Identification Number (NPI): The Centers for Medicare and Medicaid Services (CMS) requires all health care providers to apply for a National Provider Identification (NPI) Number. Minnesota Health Care Program Enrollment (MHCP): Each practice location must be actively enrolled in the MHCP to apply for the MERC grant. The address where training took place must match MHCP enrollment. Federal Tax ID Number (FEIN): Sites must provide the FEIN on record with the MHCP. Collecting Training Site Applications: Teaching programs need to collect paper applications from their clinical training sites to complete the training site data. When requesting applications, please provide the information below to the clinical training site. Primary preceptors and student/resident names are not mandatory this year; however, the teaching program should be able to provide this data to the training site if requested. Application Materials Instructions for Clinical Training Facilities (http://www.health.state.mn.us/divs/hpsc/hep/merc/2018instrclinical.pdf) Application for Clinical Training Facilities (http://www.health.state.mn.us/divs/hpsc/hep/merc/2018ctfgapp.pdf) Application Process Date the application is due to the sponsor/program. Contact information for sponsor/program requesting the training site application. How to send (pdf, mail, fax, etc.). Program Data Sponsoring institution name. Teaching program name. Type of trainee (provider type). Site Data Training site name and address where training occurred. Primary preceptor(s). Student/Resident name(s). Dates of clinical training. Clinical trainee FTE count Clinical training hours/2,080 hours = * FTE Count (*One person cannot exceed one FTE.) Upon receipt, the program representative enters the data into the online application under the corresponding program. If the teaching program or training site applied in the previous fiscal year, the information from the previous application (with the exception of FTEs) is available as a starting point. All training site information must match for the fiscal year 2017 training site application. Page 13
Medical Education and Research Cost (MERC) 7(b). Training Site List Complete this section using the Clinical Training Site Grant Application provided by the clinical training facility. Figure 15 Deleting Training Sites Click the site name and DELETE SELECTED button. Modifying Training Sites Click the site name and press the TRAINING SITE INFORMATION button located on the left menu. Adding Training Sites 1. Press the ADD NEW button located at the bottom of the site list. 2. In the search field, enter the NPI Figure 16 number provided on the clinical training site s grant application. 3. Click the radio button to search by NPI number. 4. Click FIND. 5. Highlight the location where training took place, and click Select. Use caution when selecting the correct location. It will affect the grant amount. The grant formula is based on MA/PMAP claims specific to the training location. Contact health.merc@state.mn.us for assistance. Title the email: Site Application site s NPI # site s name FY2017 Training Example: Site Application 123456789 Name - FY2017 Training (Site name and NPI are found on the site s application.) Attach a PDF copy of the Clinical Training Site Grant Application. If the name or address on the grant application is not consistent with the training site s enrollment in the MHCP, the grant application cannot be processed. If this situation occurs, contact the facility and inform them that the grant application is not consistent with their enrollment in the MHCP under the NPI number they provided. If they recently moved, they must contact the MHCP to update their MHCP enrollment. (See references under provider identification numbers.) The Department of Human Services administers the Minnesota Health Care Program (MHCP). Medicaid enrollment changes must be processed through the MHCP. Providers must contact the MHCP within 30-days of a change in their enrollment. Refer training sites to MHCP Provider Change Form or at 800/366-5411 or 651/431-2700. Page 14
Medical Education and Research Cost (MERC) 7(b). Training Site Details When the training site identification numbers are entered and location selected, the address will populate 7b based on the facility s MHCP enrollment. Figure 17 1. With the facility name highlighted, click TRAINING SITE INFORMATION located on the left menu bar. MHCP Facility Name and Address: The site name and address must be consistent with the provider s MHCP provider enrollment records. The site name and address fields cannot be changed. If the address does not match the Clinical Training Site Grant Application, verify that the correct facility and facility location were selected. Figure 18 CEO/CFO or Authorized Representative: The facility must designate one representative who is responsible for completing all aspects of the grant application. This representative must have sufficient information about the facility s Medicaid enrollment, training activities, and clinical training costs. 2. Enter the representative s contact information. Valid email addresses are required and will be used by MERC staff. Practice Setting: The practice setting the training took place in. Options include inpatient, ambulatory, or both. 3. Select the practice setting using the dropdown menu. Click the SAVE button on the left before continuing. Page 15
Medical Education and Research Cost (MERC) Hospital Subparts/Group Members: Hospitals often have multiple identification numbers enrolled in the MHCP instead of one ID that covers all services of the licensed hospital. The hospital is the grant applicant and the hospital departments or provider-based clinics are captured in the Group Members section. This is an important step for hospitals! The IDs in this section are instrumental in gathering the MA/PMAP claims data used to calculate the hospital s grant. The Group Members section must match Page 2 of the hospital s signed application. Contact health.merc@state.mn.us for assistance. Title the email: Site Application site s NPI # site s name FY2017 Training Example: Site Application 123456789 Name - FY2017 Training (Site name and NPI are found on the site s application.) Attach a PDF copy of the Clinical Training Site Grant Application. Grantee Pay-To Billing Address: The grant will be mailed to this address. 4. Indicate where the grant should be mailed. Click on the Billing/Accounting same as above box if the training site indicated that grants should be mailed to the main address. Enter the alternate address if the training site indicated an alternate address for their business office. Eligible FTEs: FTE is defined as a full-time equivalent. 5. Enter the training site s FTEs at the bottom of the form. After checking the entire page over, click SAVE. Click the TRAINING SITE button on the left menu to enter additional training sites. ((Student/Resident * Weeks in Rotation) * Hours per Week) = Clinical Training Hours Clinical Training Hours / 2,080 = FTE Count FTE = 2,080 hours, 52 weeks, or 260 days. One person cannot exceed one FTE. Page 16
Medical Education and Research Cost (MERC) Submitting the Application The sponsoring institution representative must complete this section. Check Missing Fields: Verify required information is completed. 1. Click SUBMISSION PROCESS on the left menu bar. 2. Click CHECK MISSING FIELDS. A pop-up message will confirm when there are no missing fields. If information is missing, the application will show the missing field in red print. Click on the missing field to complete the missing information. Enter the information and press SAVE. Toggle back to proceed with supplying any further missing information in the same manner. After all data is complete, close that browser tab and press CHECK MISSING FIELDS once again for final verification. Final Submit: Electronically submit the online application to complete the entry process. FINAL SUBMIT will not work if there are missing fields (See Check Missing Fields above). 1. Click FINAL SUBMIT on the left menu bar. The application will no longer accept changes. The application can still be viewed. A date stamp will be place in the database noting the completion. 2. Although the application was completed online, a signed copy must be submitted to the Minnesota Department of Health (See Printing the Application below). 3. Teaching Programs are also required to submit proof of accreditation. Printing the Application: After electronically submitting the application, log back in and print the submitted application. 1. Click SUBMISSION PROCESS on the left menu bar. Click PRINT (the application will appear in a new browser). You may choose to print the application from the web browser itself or from a word processing software. To save a copy and print from a word processing software: Click FILE and SAVE AS located on the internet menu bar at the top of screen. Save the application as Sponsoring Institution Name FY2017 MERC Application. Open the file in the word processing package and print. To print from the web browser, Select FILE and PRINT located on the internet menu bar at the top of the screen. Page 17
Medical Education and Research Cost (MERC) Mailing the Application: Submitting the electronic data alone is not sufficient. 1. Once the online application has been submitted electronically, it must be printed and signed by the sponsoring institution representative and each teaching program representative. 2. Additionally, teaching programs are required to submit proof of accreditation. The accreditation document should span the application s fiscal year of training through the most current accreditation approval. 3. Mail the application to the Minnesota Department of Health at the address noted below. Applications are due no later than October 31, 2018. Minnesota Department of Health MERC Grant Applications Attn: ORHPC, 2 nd Floor 85 East Seventh Place, Suite 220 St. Paul, MN 55101 Page 18