for Sponsoring Institutions and Teaching Programs Data year: Fiscal Year 2016 Clinical Training Application deadline: October 31, 2017 Estimated distribution: April 30, 2018 For more information: http://www.health.state.mn.us/divs/hpsc/hep/merc/index.html MERC Grant Applications Minnesota Department of Health Attention: Diane Reger, 2nd Floor Golden Rule Building 85 East Seventh Place, Suite 220 St. Paul, MN 55101 diane.reger@state.mn.us (651)-201-3566
Contents Background... 1 Eligibility... 1 Online Application... 2 Setting up Usernames and Passwords for Programs (Optional)... 2 The Application Process... 4 Reporting Period... 4 Due Date... 4 MERC Funding... 5 Grant Determination... 5 Grant Payments... 5 Communication... 5 MERC Staff... 5 A. Part I Sponsoring Institution Data... 6 1. Sponsoring Institution Address... 6 2. Contact Responsible for Grant... 6 3. Program Types Applying... 7 Certification by Officer... 7 B. Part II Teaching Program Data... 8 Deleting Existing Programs... 8 Adding New Programs... 8 Updating Existing Programs... 8 1. Program Name and Address... 9 2. Program Type... 9 3. Contact Responsible for Grant... 9 4. Program s Fiscal Year 2016... 9 5. Program Specialty... 10 6. Accreditation... 10 7(a). FTE Summary... 11 C. Training Site Data... 12 Provider Identification Numbers... 12 National Provider Identification Number (NPI)... 12 Minnesota Health Care Program Enrollment (MHCP)... 12 Collecting Training Site Applications... 12 7(b). Training Site List... 13
Adding Training Sites... 13 MHCP Facility Name and Addresses... 14 Deleting Training Sites... 14 Modifying Training Sites... 14 7(b). Training Site Details... 15 CEO/CFO or Authorized Representative... 15 Practice Setting... 15 Subparts/Group Members... 15 Grantee Pay-To Billing Address... 15 Eligible FTEs... 16 Submitting the Application... 16 Check Missing Fields... 16 Final Submit... 16 Printing the Application... 16 Mailing the Application... 16
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 Accredited medical education programs are eligible for funding through the MERC grant if they meet additional criteria, as required by the MERC legislation: 1) The sponsoring institution, program and site of training must all be in Minnesota. The training site must also have a National Provider Identification (NPI) number currently active medical assistance enrollment status in Minnesota along with fiscal year 2016 MA/PMAP claims reimbursements in Minnesota. 2) The training program must provide clinical training to one of the following designated provider types: * Advanced Practice Nurses: Dental Students or Residents Certified Nurse Midwives Dental Therapists or Advanced Dental Therapists Certified Registered Nurse Anesthetists Doctor of Chiropractic Students Clinical Nurse Specialists Doctor of P harmacy Students or Residents Doctor of N ursing Practice Nurse Practitioners Medical Students or Residents Clinical Social Workers Physician Assistant Students Community Health Workers Psychologists Community Paramedics * 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. 3) The training program must provide accredited clinical training that is funded in part by patient care revenues, and that occurs in either an inpatient or ambulatory patient care training site. All training programs must be accredited by an organization that is 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. 4) The training site is the facility at a given practice address where clinical training occurred. Individual preceptors or departments within a facility should not be listed as the training site. If the training site is a physician owned clinic, the training site is defined as the clinic and not the physician. 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. Page 1
5) Training that occurs in a nursing facility setting is not eligible. 6) Training sites must host a combined 0.1 FTE minimum across all teaching programs and provider types in fiscal year 2016 to be eligible for MERC funding. Programs may submit applications for sites hosting fewer than 0.1 FTE at a program level if the program is uncertain if the training site meets this minimum. The determination will be made when grant applications are reviewed by MDH. 7) The use of funds are limited to expenses related to clinical training program costs for eligible programs. MDH will collect clinical training expenses from training facilities after review of the initial application. Online Application https://merc.health.state.mn.us/merc/index.html Grant applications are submitted electronically Figure 1 using an online application available to sponsoring institutions by password. Instructions for navigating the online application are found on the left menu bar throughout the application. Please contact Diane Reger at diane.reger@state.mn.us if you are new sponsoring institution and require initial access. If you have applied in the past, your existing username and password can be used. If you have forgotten your password, please contact MERC staff to have it reset. Usernames and passwords are case sensitive. Attention: The application will remain active on the screen for 20 minutes without activity. If inactive, any unsaved data will be lost. Data is saved by changing screens or using the SAVE button on the left menu Setting up Usernames and Passwords for Programs (Optional) A sponsoring institution may designate one representative to complete the entire application on behalf of all teaching programs. Or, they may place the responsibility for completing the teaching program s grant application on a representative of the teaching program(s). The sponsoring institution representative will continue to oversee the entire application. To grant additional 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 2
To assign a username and password for an individual program, first press the ADMINISTRATION button on the left menu, then press the USER ADMINISTRATION menu button. Figure 2 At the top section of the screen under User Administration, click ADD NEW USER. Select a username and password for the program administrator (limited to 30 characters and case sensitive). Press MODIFY USER INFORMATION. Next, to assign programs to the user, refer again to Figure 2. Located mid-page, under the section titled Teaching Programs Available, click on the program name to assign to the program representative then click the right arrow button located in the center of the page. This assigns the program to the user. If one person administers multiple programs, select the next program name and the right arrow button again. Figure 3 To remove a program from a user, select the program name located under the section titled Teaching Programs Assigned and click the left arrow button. To set up additional users for another program, repeat the steps above. If you are finished, click SAVE or move to another button on the left menu bar. Page 3
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 2016. Due Date The MERC application has a statutory deadline. Signed applications will be accepted until 4 p.m. on October 31, 2017, as indicated by a date/time stamp placed on the application by the Minnesota Department of Health receptionist at the following location: Minnesota Department of Health MERC Grant Applications Attn: Diane Reger, 2nd Floor Golden Rule Building 85 East Seventh Place, Suite 220 St. Paul, MN 55101 Page 4
MERC Funding While the data in the application is based on training that took place in fiscal year 2016, the grant is funded by state fiscal year 2018. 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 2018 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 The estimated distribution date is April 30, 2018. 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 diane.reger@state.mn.us (651)-201-3566 Darwin Flores Trujillo darwin.flores.trujillo@state.mn.us (651)-201-3850 Page 5
A. Part I Sponsoring Institution Data MERC grant applications must be submitted online by the sponsoring institution on behalf of the teaching program. 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). In some cases, the sponsoring institution will be the same as the teaching program; in other cases, the two will be separate. After signing into the application. Click on the sponsoring institution name. Then, using the left menu bar, complete each section under the Sponsoring Institution button. 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 6
3. Program Types Applying This is a summary of fiscal year 2016 programs and trainee FTEs contained in the application. This screen will be calculated automatically as information is entered into program applications. After programs and sites have been entered, refer back to this screen for verification. Figure 6 Certification by Officer This will not appear on the screens; however, once the online application is submitted, the printed copy must be signed by an officer authorized by the sponsoring institution. This signature verifies that the information contained in all parts of the application is true and correct to the best knowledge of the officer. Page 7
B. Part II Teaching Program Data Complete a separate Part II for each teaching program for fiscal year 2016. Using the left menu bar, complete each section under the Teaching Program drop-down. Part II may be completed online by the teaching program* or by the sponsoring institution on behalf of a teaching program. Regardless of who enters the program s data, the sponsoring institution will have final signoff. *Refer to Setting up Usernames and Passwords for Programs on at the beginning of the instructions. All teaching programs previously submitted on the prior grant application will appear in a list. Figure 7 button located below the program list. Adding New Programs To add a program applying for the first time, click the ADD NEW button at the bottom of the teaching program list. Scroll through the alphabetical list of teaching programs and click SELECT when the program name is located. If the teaching program does not currently exist in the drop down list provided, click the ADD NEW button. Next enter the program name in uppercase in the field titled New Program Name, then click CREATE NEW PROGRAM. Updating Existing Programs To update programs that has applied in the past, select the first program in the alphabetical list and complete each screen under the dropdown buttons for the TEACHING PROGRAM and the TRAINING SITE sections. 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. Information on entering training sites can be found in the coming steps. Deleting Existing Programs Before a program can be deleted, all training sites must first be deleted from that program. See the section on Deleting Training Sites before proceeding. 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 Page 8
1. Program Name and Address Provide the name and address of the teaching program and the date the program was established and 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 which 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 2016 Provide the program s 2016 fiscal year dates. Figure 11 Page 9
5. Program Specialty Select the program specialty (e.g. clinical nurse specialist, pediatric dentistry, internal medicine) by scrolling through the available options. To select, click on the specialty name. If you cannot find the specialty in the existing list, select ADD NEW located in the drop down list then, using all caps, enter and save the newly added specialty. Next select ACCREDITATION on the left menu bar. Figure 12 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 current list of accreditation bodies by clicking on the right arrow and scrolling. If the accrediting body is not in the available list, email a PDF of the program s accreditation letter to MERC staff. Figure 13 6. Accreditation All 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 There are three choices to indicate current accreditation status: 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: Provide the date the program was originally accredited along with 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. The accreditation must be attested to by an officer who has personal knowledge of the program s accreditation status. 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 10
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 2016. 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. 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 as training sites. An 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 Figure 14 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 11
C. Training Site Data Training facilities must be located in Minnesota and actively enrolled as Medicaid providers in the Minnesota Health Care Program (MHCP). Facilities with multiple locations cannot combine their applications. They must complete separate applications based on where the actual training occurred. Each facility location must be enrolled in the MHCP. Only those sites that had trainees and whose practice location are enrolled with the MHCP can apply for MERC funding. Provider Identification Numbers The authorized representative of the clinical training site must complete a MERC grant application which will include the facility s identification number used for Medicaid billing by the location where training occurred. Medical Assistance (MA/PMAP) revenue on record with the Minnesota Department of Human Services (DHS) will be used to calculate the MERC grant. Individual preceptors or departments within a facility should not be listed as the applicant. 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. This number must be reported on the MERC application. Minnesota Health Care Program Enrollment (MHCP): Only NPIs enrolled in Minnesota have MAID/Legacy IDs. IDs are specific to the location enrolled. If the training location is not enrolled in Minnesota, the site cannot apply for the MERC grant. If the training site has a consolidated NPI shared across many locations, each location must enroll in the MHCP regardless of shared NPI status. If the address where training took place does not match MHCP enrollment, the facility may not qualify. Collecting Training Site Applications: Provide the following information to the 2016 clinical training sites: Dates of clinical training. Sponsoring institution name. Teaching program name. Training site name and address where training occurred. Type of trainee (provider type). Clinical trainee FTE count. Date the application is due to the sponsor/program and the collection method preferred. Contact information for sponsor/program requesting the training site application. Instructions for Clinical Training Facilities (http://www.health.state.mn.us/divs/hpsc/hep/merc/sitememo.pdf) Application for Clinical Training Facilities (http://www.health.state.mn.us/divs/hpsc/hep/merc/siteapp.pdf) Upon receipt, the program representative will enter 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 information must be brought up-to-date and match the fiscal year 2016 training site application. Page 12
7(b). Training Site List Complete this section using the Clinical Training Site Grant Application provided by the clinical training facility. Adding Training Sites To add a training site, press the ADD NEW button located at the bottom of the site list. Figure 15 In the search field, enter the NPI number provided on the clinical training site grant application, click the radio button to search by NPI number, then click FIND. Figure 16 The next screen contains a list of facilities currently enrolled in the Minnesota Health Care Program (MHCP). If the provider has more than one location under a consolidated NPI, there will be multiple records listed. Compare the paper application to the screen and select the location where training took place and click the SELECT button Grants are based on a formula that uses Medical Assistance (MA/PMAP) claims specific to the location. Use caution when selecting the correct location as it will affect the grant. Locations not enrolled in the MHCP will not be found and are not eligible. If you encounter problems entering the site on the online application, contact Diane Reger via email for further assistance. Attach a PDF copy of the Clinical Training Site Grant Application and indicate the site name and NPI in the subject line of the email. Page 13
MHCP Facility Name and Addresses: When the training site identification numbers are entered on the online application, the address will populate 7b based on the facility s MHCP enrollment. If the address on the training site s application does not match MHCP enrollment, either their Medicaid enrollment is not up-to-date or the location that is applying is not enrolled with the ID they provided. If this situation occurs, contact the facility and inform them that the practice noted on the application is not on record with the MHCP. Facilities whose practice location are not enrolled in the MHCP are not eligible for the MERC grant. (See references under provider identification numbers.) Figure 17 Please note: The Department of Human Services administers the Minnesota Health Care Program (MHCP). Providers are required to contact the MHCP within 30-days of a change at 800/366-5411 or 651/431-2700 or at www.dhs.state.mn.us (click on Partners and Providers, then MHCP Enrolled Providers).MERC staff cannot update Medicaid enrollment records. With the facility name highlighted, press the button for TRAINING SITE INFORMATION located on the left menu bar. The training site information screen is where you will enter additional information about the site and the FTEs. Deleting Training Sites If a previously selected site is no longer eligible, click the site name and DELETE SELECTED button. The site is then deleted from the application. Modifying Training Sites To modify a site, highlight the site name and press the TRAINING SITE INFORMATION button located on the left menu. Page 14
7(b). Training Site Details CEO/CFO or Authorized Representative: The facility will designate one representative, who will be responsible for completing the clinical training site grant application regardless of teaching program or sponsoring institution. The representative must have sufficient information about the facility s Medicaid enrollment, training activities, and clinical training costs. After initial review of the application, MERC staff will request clinical training expenditures directly from the representative using the email address provided on the grant application. Figure 18 Enter the contact information for the named representative. Valid email addresses are required for grant administration. The street address is based on the provider s With the exception of the setting type and FTEs, a site s application should be the same regardless of training program. enrollment in the Minnesota Health Care Program. This field cannot be changed. If the address does not match the Clinical Training Site Grant Application, verify that the correct facility was selected. Practice Setting: Enter the practice setting the training took place in. (Options include: inpatient, ambulatory, or both.) Click the SAVE button on the left before continuing. 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. It s important that the hospital is listed as the grant applicant and the hospital departments or provider-based clinics enrolled in the MHCP are captured in the Group Members section. This is an important step! 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. If the information previous reported online is not consistent with the subparts on the current grant application, send an email with the training site name and NPI in the subject line along with a PDF of the hospital s paper application to diane.reger@state.mn.us. In the body of the email explain the requested update. MDH will respond in writing. Grantee Pay-To Billing Address: If the training site indicated that grants should be mailed to the main address on record with the MHCP and there is not an alternate address provided for the Authorized Representative, click on the Billing/Accounting same as above box. The available grant will be mailed to the address on record with DHS Provider Enrollments noted on the top of the form. If the Authorized Representative address is different, do not check the box, but instead enter in the address provided. Page 15
Eligible FTEs: Enter the training site s FTEs at the bottom of the form. After checking the data over, click SAVE and return to the TRAINING SITE button to begin working on the next Training Site. Submitting the Application This section must be completed by the sponsoring institution representative. Check Missing Fields: To verify that all required information has been entered on the application, click SUBMISSION PROCESS on the left menu bar then 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 be directed to the screen where the data can be entered. Enter the information and press SAVE, then 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: After the application has been verified, electronically submit the online application by clicking FINAL SUBMIT on the left menu bar. FINAL SUBMIT will complete the entry process and the application will no longer accept changes. A date stamp will be place in the database noting the date the application was finalized. Although the application was completed online, a signed copy must be submitted to the Minnesota Department of Health. Programs are also required to submit proof of accreditation. FINAL SUBMIT will not work if there are missing fields. Printing the Application: After electronically submitting the application, log back in and print the submitted application. On the left menu bar, click SUBMISSION PROCESS then PRINT. The application will appear in a new browser. To save a copy of the printed application to word processing software, click FILE and SAVE AS located on the internet menu bar at the top of screen. You may choose to print the application from your word processing package or from the web browser itself. To print from the web browser, select FILE and PRINT located on the internet menu bar at the top of the screen. Mailing the Application: Once the application is printed, signed, and the appropriate documentation is attached, mail the application to the Minnesota Department of Health. Submitting the electronic data alone, without a printed and signed application, is not sufficient. Applications must be received by October 31, 2017. Minnesota Department of Health MERC Grant Applications Attn: Diane Reger, 2 nd Floor 85 East Seventh Place, Suite 220 St. Paul, MN 55101 Page 16