Connected Communities Implementation Grant Program

Connected Communities Implementation Grant Program

(Solicitation No. 2015-MeHI-05)

Questions and Answers

New questions added as of June 22, 2015 (new questions start at line 43)

1. / May organizations who received awards under the eQIP Grant apply for the Connected Communities Grant Program? / Organizations that are grantees under the eQIP Grant may apply for the Connected Communities Grant, so long as the intended use case for the Communities Grant is different than the use case for the eQIP Grant.
2. / May an organization participate in more than one Connected Communities Grant? / An organization may participate in more than one Connected Communities Grant, but the same organization cannot receive more than one grant. The organization could be a grantee on one grant, and a collaborator on another grant. In such case, the use cases for the two grants must be different.
3. / Do both care coordination scenarios – care transitions and care management – need to be proposed in the application? / Yes, at a minimum, two use cases with a related measure(s) each must be proposed in the application.
4. / When does MeHI pay the planning payment? / MeHI will make the planning payment of 10% of the contract value (up to $25,000) upon contract execution. Please see Section 2.1 of the Solicitation document for more details.
5. / Can an application be represented by organizations that span MeHI’s defined communities? / Yes. Collaborating organizations may be from different communities and different regions.
6. / Is there a page limit to the Full Application? / There is a 12-page limit to the Proposal Narrative that must be included with the Full Application. Please see Section 5.4 of the Solicitation for more details.
7. / May long term care centers as well as Federally Qualified Health Centers (FQHCs) act as collaborators on one grant? / Yes, both may be collaborators on one grant. They may also be a lead/applying organization.
8. / In the pre-application, does Att. D count against the 3 page limit? / No.
9. / What is a TPO-type organization? / A TPO organization is one that is involved in patient treatment, payment or healthcare operations. Examples include medical practices, health plans, and hospitals.
Please see Section 5.5 of the Solicitation for the TPO definition and more details.
10. / Would it be acceptable to include a middleware appliance to facilitate information sharing among different EHRs and with non-TPOs as appropriate? / If the middleware appliance in reference is a LAND box, or some integration engine, then it would be acceptable to include it.
11. / What is the minimum number of collaborating partners allowed for the project? / There is no defined minimum number of collaborators. As stated in Section 3.1 of the Solicitation, MeHI encourages between 4 to 8 TPO-type unaffiliated collaborators, with 8 or more total collaborators.
12. / Can a behavioral health organization serve as a Lead Agency? / Yes.
13. / Is there an expected outline and format for the pre-application document? / Yes. Please see Section 5.4 of the Solicitation for the expected outline and documentation for the pre-application.
14. / How is this grant different from the SIM grant/e-referral process? Can we build on this? / MeHI encourages organizations to integrate with or extend other state and federally funded investments in health IT, including SIM (the State Innovation Model program funded through CMS). We ask that you highlight your participation in the SIM program in your application, and how you intend to build on your SIM program activities. While proposed efforts may be complementary to what you are doing under SIM, they should not be duplicative.
15. / $100,000 only goes so far – would that be a reason for minimizing collaborators? / The maximum grant award value is $500,000. Applications may propose a budget of less than $500,000. It is at the discretion of the applicants to decide how the award would be distributed among grant collaborators. Funding may be used to hire personnel to facilitate the grant, or to fund existing staff.
16. / If four TPOs within a certain region apply separately, would you recommend to each organization that they combine their efforts into one application? / That is up to the discretion of the applicants. If the efforts of the four TPOs are related, then combining into one application makes would be acceptable. If the four TPOs have different aims, then separate applications would be more appropriate.
17. / May existing use cases be expanded to help support the efforts of other communities invited to complete the full application? / Yes. With the Connected Communities Grant we are looking to expand and strengthen existing use cases, and to bring on more trading partners. We also encourage new use cases.
18. / Where is the pre-application located in the Solicitation? / The pre-application guidelines are located in Section 5.4 of the Solicitation.
19. / Some organizations have trouble establishing what the legal medical record is when providers from different organizations document and manage the care of patients in an application which may be owned by one of the organizations. How is this handled under the Communities Grant? / Under this grant, it is up to the grantee and collaborators to determine the best method to share information among the grant team to meet the proposed use case and related measure targets.
20. / My organization is officially connected to the Mass HIway by webmail. However, is that sufficient to be considered ‘health IT’ since it is essentially just a secure email system? / Yes, HIway webmail is a suitable technology to exchange information with collaborators under this grant.
21. / What is the cost of the interface for a Health Center? / The Mass. HIway rates are located on this webpage: http://www.masshiway.net/HPP/HowtoJoin/Rates/index.htm
22. / If the collaborating entities are part of a single large system, does each entity count as a trading partner? / Yes. There is an expectation that the TPO-type collaborators are unaffiliated, per Section 3.1 of the Solicitation. Please also see Section 5.5 for the definition of ‘affiliated’.
It is acceptable for multiple entities within one system to be collaborators, but alone it is insufficient to meet the intent of this grant.
23. / Are the funds okay to be used in conjunction with related tasks being performed under Partnership for Community Health population health grants? / We encourage you to integrate efforts under the Communities grant with other funded efforts. While MeHI has an interest in all efforts, we specifically want to ensure these funds are needed and are not duplicative to other State and Federally funded efforts.
24. / Can community collaborators be organizations that do not have electronic medical records? / While there is no requirement to have an EHR under this grant, organizations are required to have the ability to exchange information digitally.
25. / Is there a limit to how many grants will be issued? Will there be a limit to grants by community and/or region? / MeHI anticipates awarding between 5 and 8 grants. There is no limit on grants awarded within a specific community or region.
26. / Can Grant funds be used to hire contractors/consultants to support the Grant and be used by collaborators? Can the funds be used for additional staff? / Yes. Grant funds may be used to hire external contractors/consultants to support the Grant, and the Grant collaborators. The Grant funds may also be used for existing staff, or to hire new staff.
27. / Can this Grant be used in conjunction with the e-referral requirement in PWTF to integrate care with community based organizations such as the visiting nurse association and the YMCA? / Integrating with ongoing efforts from other state agencies is encouraged. If there is a way to leverage the e-referral work for the Connected Communities Grant in a non-duplicative manner, then that would be acceptable.
28. / If we already have many physician practices and at least one hospital involved and connected, do those sites have to be included as specific collaborators rather than the proposed new connected organizations? / Organizations included on the grant as collaborators are expected to contribute to meeting the outcomes/measures identified in the grant application. Further, organizations listed as collaborators under the grant may have requirements they need to meet under the grant agreement in order for the grantee to achieve a milestone. Simply adding collaborators without the expectation of what they need to contribute may jeopardize milestone achievement.
29. / Can a community health center be a lead agency? / Yes.
30. / Are there a minimum and a maximum number of collaborating organizations that may comprise the applicant team? / The Grant should include the participation of multiple unaffiliated collaborating organizations that includes at a minimum a Behavioral Health or a Long-Term/Post-Acute Care organization. While the Solicitation does not specify the number of collaborating organizations, roughly 4 to 8 TPO-type unaffiliated collaborators would be expected, with 8 or more total collaborators (i.e., affiliated, unaffiliated; TPO, non-TPO) encouraged.
Please see Section 3.1 for more details.
31. / What is the maximum amount of money, per year, for a team? / Payments per year for a team will vary depending on how quickly the team achieves each milestone. While individual incentive payments will vary, we anticipate payments to range between approximately $50,000 and $125,000 per milestone, up to a maximum of $500,000 per award for the planning payment and all four milestones.
32. / Are third and fourth year renewals of the Grant possible? / At this time, MeHI does not anticipate renewing the Grant for third or fourth years.
33. / Our organization uses e-referrals with several health centers, and is also connected to a HIE. How will the Connected Communities Grant apply for our organization that already has these capabilities in place? / Many organizations may have a connection to exchange information digitally. The degree to which the organizations are leveraging the health information exchange has been low. The Connected Communities Grant encourages building and/or strengthening the exchange of health information with new trading partners, to interconnect more organizations to improve patient care.
34. / Do you have an expectation or vision for the types of documentation that may be shared between a TPO and civic organization? / We see much opportunity to work with civic/municipal-type organizations. Two examples that would be highly valued by MeHI include:
1)  Addressing the opioid epidemic in MA. Opioid addiction is a problem across MA that is hitting many communities hard. Schools, law-enforcement, local governments and the healthcare system have an opportunity to work together to address this problem. In this scenario, the sharing of PHI may or may not be required. The referrals could come from the community to the healthcare organization, as an example.
2)  Managing the on-going health of school-aged children, e.g., chronic conditions, behavioral health problems, concussion management, immunization tracking. This is an area where tighter coordination between schools, emergency services, families and the healthcare system could have a powerful impact of the lives of children.
35. / How can an organization become a collaborative partner? / MeHI encourages organizations that have an interest in each other to reach out to one another.
36. / Would an IPA that already runs an HIE qualify as a lead organization? It is involved with quality measurement, contracting, and is connected to an academic network. / The primary requirement of the lead applicant is that they are a TPO-type organization (see Section 5.5 for a definition of TPO).
37. / Will behavioral health organizations be prioritized for funding in this grant? / Behavioral health (“BH”) organizations are a key organization type MeHI is working to integrate into the broader healthcare system. Applicants shall propose a BH or a Long Term Post Acute Care (“LTPAC”) organization as part of their application. BH organizations are encouraged to apply for this grant.
38. / Can a behavioral health EHR vendor be a collaborator on the Grant? / Yes, an EHR vendor may act as a collaborator.
39. / What is the latest start and end date of the Grant? / The Grant period of performance begins upon contract execution. The duration of the Grant is 2 years from the contract execution date.
40. / Could you define what the 15 communities are and their relationship to MEHI? / MeHI suggests visiting the Health Policy Commission’s webpage to learn more about the program and the 15 communities, or region’s as they call them.
http://www.mass.gov/anf/docs/hpc/2013-cost-trends-report-technical-appendix-b3-regions-of-massachusetts.pdf
41. / After we send in the pre-application we will get invited for the final application? / Upon submission of your pre-application you will be part of the pool of applicants. MeHI will conduct a review of all applicants and will invite some of them to submit a full application. The submission of a pre-application does not guarantee selection to submit a full application. It is a competitive process.
42. / After we send in the pre- application, how long after will it take to know if we apply? / MeHI anticipates inviting selected applicants to submit a full application by mid to late July 2015. The turn-around time largely depends on the number of submitted pre-applications.
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43. / Is there a specific definition or an example of “cross-setting care management among inter-organizational care team members? And how does that differ from transitions between different settings of care? / Think a point in time transfer (hospital discharge) compared to on-going care management of a patient.
See also Section 2.2 (p. 5) of the solicitation: “This Grant Program divides care coordination into two parts – 1) care transitions and 2) cross-setting care management. Care transitions is intended to focus on transitions of a patient between different acuity care settings, e.g., from a hospital to a skilled nursing facility (SNF), from a SNF to home health, from a hospital to home health. Cross-setting care management reflects the care for a patient by a care team that spans different care settings, e.g., a care coordinator supporting the integrated care of a high-need patient across inpatient, outpatient, therapy, and in-home care.”
44. / My company intends to submit a proposal for a prehospital communication system that can help hospitals better triage incoming ambulances. Our collaborators may be hospital emergency departments, ambulance companies and the different regions of
Central Medical Emergency Direction (CMED). Could the CMED organization act as the lead collaborator for the Grant? / To be a lead applicant, the organization must be a TPO organization, one that is involved in patient treatment, payment or healthcare operations. Examples include medical practices, health plans, and hospitals.
Please see Section 5.5 of the Solicitation for the TPO definition and more details.
45. / Can a portion of the grant funding be used to help other agencies with technology assistance, purchasing software and other specific changes that will allow intercommunication? / Yes, but the intent is for the Grant to fund “light weight” add-ons where needed to complete the solution and enable the organization’s respective use cases. That said, if such a procurement is modest in cost, but impactful in use, and/or if such a procurement is supplemented with in-kind contributions that would be preferable.
46. / Is there is any information about prior awardees and the types of projects that were funded to make sure that a proposed project is a good fit for the Grant? / This is a new program. There are no prior awardees. Please review the Grant Solicitation carefully to ensure that your pre-application addresses the grant requirements, including Section 2.3.
47. / If a skilled nursing facility (SNF) or Long term care facility has no EMR and wants to get one, can that be included in an organization’s request for the Grant? / Nothing in the Connected Communities Grant precludes buying an EHR, but the intent is for the Grant to fund “light weight” add-ons where needed to complete the solution and enable the organization’s respective use cases. That said, if such a procurement is modest in cost, but impactful in use, and/or if such a procurement is supplemented with in-kind contributions that would be preferable.

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