DSRIP Weekly Update-Oct. 28, 2014

As usual, there is a lot to report regarding the Delivery System Reform Incentive Payment (DSRIP) program this week. In addition to new educational audio conferences, application comments due and website updates, LeadingAge NY met with DOH to discuss our member concerns and priorities with regard to DSRIP.

DSRIP Draft Application Resources and Opportunity to Comment

The DSRIP Independent Assessor, KPMG, will be hosting a conference call open to the public to discuss the Draft DSRIP Performing Provider System (PPS) Plan Application materials on Tues., Oct. 28, 2014 from 3 - 5 p.m. The call will include an overview of the applications, followed by an opportunity for questions and answers. To participate, please dial (888) 892-6166 ten minutes prior to 3 p.m. The conference pass code is 25038265. Click here to view the application materials, which should be reviewed before the call.

To aid in your review of the application, our counsel, Hinman Straub, has developed a summary of the application scoring guide; click here to view. The PPS draft project plan application and scoring guide are available for review here.

LeadingAge NY is developing comments on the application, which are due to DOH by Oct. 29 at: dsripapp@health.ny.gov. We encourage members to consider submitting comments and provide us with input as well.

LeadingAge NY Meeting with DOH on Member DSRIP Issues

LeadingAge NY met with Jason Helgerson last week to discuss our ongoing concerns related to our member’s roles in DSRIP PPSs. We discussed a variety of issues, summarized below:

Safety Net/Vital Access Provider Concerns: We discussed our ongoing concerns regarding new Certified Home Health Agencies (CHHAs) that do not have enough data to demonstrate Safety Net criteria. We urged DOH to set up a different process, as has been done for some other categories of providers. DOH reports that the Safety Net application process is done now, and recommended using the Vital Access Provider as a last opportunity to try and become regarded as a Safety Net provider. It was noted that there will likely be an additional mid-point assessment at which some new Safety Net providers may be included. We reached out to member organizations with new CHHAs, and hope that they submitted the Vital Access Provider application, which was due last week. We do not anticipate any additional opportunity to become a Safety Net provider until the mid-point assessment. It is important to note that being designated as a Safety Net provider does not alone ensure (nor is it a requirement to be) involvement in a PPS. Providers must be engaged with PPSs in order to participate, and should be taking with PPS leads if not yet named as a PPS participant. DOH also affirmed that Safety Net providers named on the publicly posted lists are indeed Safety Net providers, including adult care facilities and licensed home care services agencies.
DSRIP Attribution Methodology: We appreciate that the Department took into consideration the importance of nursing home services in the attribution process; but again encouraged them to include other provider types in the attribution hierarchy, including home care, Assisted Living Program (ALP), Adult Day Health Care (ADHC). Unfortunately, the attribution process has been finalized. DOH has run the first attribution and there was a notable amount of people not attributed to any PPS. While there are several possible reasons, DOH felt that more nursing homes need to be included in PPSs.
Capital: We inquired about the status of capital funds, and the need to ensure that funds will ultimately make their way to our members. DOH is working on the development of that opportunity, and notes that the vast majority of those funds will be available to DSRIP projects. An Applicant Conference regarding the Capital Restructuring Financing Program has been scheduled for Fri., Nov. 21, 2014 from 1 – 4 p.m. at the Empire State Plaza, Concourse Level, Meeting Room 6, Albany. Anyone planning to attend the meeting should send an email to CRFP@health.ny.gov with the subject line: “November 21, 2014 CRFP Meeting Attendance” and provide a list of names attending the conference. The meeting can be viewed via live webcast here. The on-demand webcasts will be available within a week of the conference. A separate capital opportunity is likely to be issued for non-DSRIP participants, but again, most funds will be made available to DSRIP participants.
Technology: During our discussion with DOH, we stressed the needs that long term care and post-acute providers have for capital to reconfigure to meet the needs of consumers in a rapidly changing environment. We noted that health information technology was an area of particular need as our members have not been eligible to benefit from many investments in these areas historically. Such investments will be necessary for many to be successful in Domain 2 DSRIP projects. DOH noted that capital funds and incentive payments can be used for technology investments. In addition, they have seen some PPS leads investing in technology for their PPS partners. For any members engaged in DSRIP PPS Domain 2 projects, this is a key issue to attend to.
Managed Care Alignment with DSRIP: DOH will be working to provide a report to the Centers for Medicare and Medicaid Services (CMS) regarding managed care. and part of the report will focus on how managed care/managed long term care aligns with DSRIP objectives. DOH plans to use the Global Cap Advisory group to work on this aspect of the plan. LeadingAge NY sits on this group and will be at the table for these discussions.

Upcoming Member Educational Programs on DSRIP

LeadingAge NY will be holding an interactive conference for our members that are named as partners in emerging Performing Provider Systems (PPSs), as well as those that are still hoping to get engaged in DSRIP PPSs; A Dialogue on DSRIP:A LeadingAge NY discussion for members that plan to be engaged in DSRIP. The call is scheduled for Tues., Nov. 4 from 11 a.m to 12:30 p.m. During the discussion, we will identify some key considerations and strategies for members. Each issue will have time dedicated for question and answers and input from members regarding their experiences and needs at this time. Click here for more information.

Additionally, on Nov. 10, we will present DSRIP-Legal Issues for Non-Lead Providers, from 10 to 11:30 a.m. Click here for more information. This program will focus on some of the complex legal issues that our members will grapple with in DSRIP. This too is free of charge and for members-only.

Both programs will be recorded to be available at a later date.

Salient DSRIP Dashboards Updated

DOH has updated data dashboards with new information and functionality. Specifically, the Department has added two new dashboards to help with networking; Medicaid Enrollment by Member County and Health Home Enrollment. DOH has also revised the MMIS NPI ID Lookup dashboard to improve exporting functionalities. Click here for more information. For questions regarding the dashboards, contact DOH at DSRIPDashboards@health.ny.gov.

Financial Stability Test Available

The DSRIP PPS Lead & PPS Lead Financial Stability Test is now available for completion by potential PPS Lead organizations here under DSRIP PPS Lead and Financial Stability Test. A potential PPS Lead organization must complete both the DSRIP PPS Lead & PPS Lead Financial Stability Test document and the DSRIP PPS Lead & PPS Lead Financial Stability Test Excel Tool by Nov. 7, 2014. The completed application documents along with all supporting documentation must be submitted to DSRIPApp@health.ny.gov by Nov. 7, 2014. An organization that does not submit the completed application documents by Nov. 7, 2014 will not be eligible to serve as a PPS Lead organization.

As always, we encourage members to let us know how we can help you succeed with your DSRIP projects.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828