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Transcript of PPS Operator Assisted Call on July 17, 2015

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THE STATE OF NEW YORK
Moderator: Jason Helgerson
07-17-15/12:30 p.m. Et
Confirmation #83070360

THE STATE OF NEW YORK

Moderator: Jason Helgerson
July 17. 2015
12:30 p.m. ET

Operator:

This is Conference ID # 83070360.

Good afternoon. My name is (Shelly). And I will be your conference operator today.

At this time, I would like to welcome everyone to the DSRIP PPS call.

All lines have been placed on mute to prevent any background noise. After the speakers remarks, there will be a question and answer session. If you would like to ask a question during this time simply press star then the number one on your telephone keypad. If you would like to withdraw your question, press the pound key. Thank you.

Jason Helgerson, you may begin your conference.

Jason Helgerson:

Thank you very much. Good afternoon, everyone. And I want thank everyone for taking time out of their Friday afternoons to participate in this operator assisted call.

Today´s call is really with schedules in lieu of a face-to-face meeting at the request of the PPS is we decided that for this month, for the month of July we would forgo a face-to-face meeting explicitly to sort of give the PPSs more time to work on some of the key deliverables that are still outstanding. And sort of try to, you know, respect that and give all of you sufficient time to do what you need to do.

But at the same time, we know we put out a considerable amount of additional new material including things fairly recently. So what we want to do is schedule this call to give everyone opportunities to bring their questions to the table. We have here around us and participating not only staff from Department of Health including (Payee Chan and Greg Allen) but others also from the health department.

In addition to that, representatives from the public consulting group, our independent assessor are also here available to also answer questions considering much of the new material that´s been put out - was developed by them. So hopefully, we have the people in the room that can answer the questions that arise. If, for whatever reason we can´t we promise to get back to everyone on the call and throughout to all the PSSs any questions that we are unable to answer but hopefully we can. We hope that - hopefully quite a folks in the room and hopefully we will be able to provide you with the direction and clarifications that you need.

So we are set up here to be here from 12:30 to 3:30 if that is in fact necessary. We will see how it goes. My hope is to try to take every questions that comes to the floor. I hope everyone has the agenda of the particular items that have been identified. What we would to do it (inaudible) possible stick to the -a lot of time for each item. But if we exhaust questions, we will move on to the next items which should sort of give us potentially more time for those additional items.

If we finish early, great. Happy to give people time back in their busy days at the Friday in July. But that said, fully purged day here at 3:30 if there are questions that need to be answered.

So with that, what I would like to do is begin with the first item which is scheduled for a time slot of 12:45 to 1:30 so we have roughly 45 minutes for this topic. And the topic is implementation plans and first quarterly progress reporting. And I don´t know, (PCG), do you have anything you want to open with or should we just go straight to question?

All right. Why don´t we go straight to questions, we are on time at the moment. So operator, do you want to take the first in queue?

Operator:

Certainly. Your first question comes from the line of (Michelle Mercery), your line is now open.

(Jamie Bono):

Sorry, I was on mute. This is actually (Jamie Bono) from Millennium. We have a couple - I will just tart with one question but in terms of the implementation plan in the risk communication sections that have already been completed, we are trying to include the feedback from the independent assessor. And now, we are limited to 3,900 characters. Are we going to have to reduce the size of our overall risk communications for each work stream?

(Michael):

The current accounts are limited to that. Yes, they would have to be reduced in that area.

(Jamie Bono):

So then my (inaudible).....

(Michael):

Sorry. This is (Michael) (inaudible) company group.

DSRIP TEAM:

Sorry, this is Shilpa from PCG. You can edit your content up until 3,900 characters and anything else that your copy, pasting in will get truncated at that. And you can edit any of those point any of those boxes up until you submit your report.

(Jamie Bono):

Thank you very much.

Jason Helgerson:

Excellent.

Operator:

Again, if you like to ask a telephone questions please press star then the number one. And your next question comes from the lien of (Courtney Casiraghi), your line is now open.

(Courtney Casiraghi):

Hi. So we heard from (KPMG and PCG) that we do not need to fill out the provider ramp up tables and that zeros would be sufficient for the quarter one submission. Can you confirm that that´s true?

DSRIP TEAM:

So that is not accurate. This is Shilpa from (PCG) again.

(Amie Vankapen):

Right. I guess - so have had the domain one desert project requirement milestones and metric document for some time but it wasn´t clear to us until we saw the entry format of the map tool that you were actually looking for a quarterly number for each of those provider level requirements. And not only were you looking for quarterly - then today you are clarifying that you are not just looking for quarterly progress due date but you are looking for projected speed and scale for each one of those. That was not made clear in the domain one desert projects requirement metrics and milestones.

So I just wanted to clarify that in fact that that is analysis we ask to complete and turn within the next couple of days.

DSRIP TEAM:

Correct.

(Amie Vankapen):

Fantastic. Thanks.

DSRIP TEAM:

All right.

Operator:

And your next question comes from the line of (Janneth King). Your line is now open.

(Chris Bell):

Hi. Good afternoon. This is (Chris Bell) with the (COAs) performance provider system.

I have a question around module two of the integrated delivery system to (AI) project. Previously we haven´t been asked to submit expectation of provider commitments for this project. And so I wanted to: A - confirm that that was a purposeful inclusion for the 31st submission.

DSRIP TEAM:

Yes. So, even at the point of the project plan applications, speed and scale submissions in January provider speed and scale commitments and safety net provider, speed and scale commitment were submitted. And those correlate to these project implementation speed module in map.

(Chris Bell):

Great. Follow up question to that is around the numbers that are total committed in that column there. These numbers for us differ from our January table. And in January we were given the detail of each provider type. Will we get that level of detail again so we know exactly who is coming in these numbers?

DSRIP TEAM:

Yes. That´s on - there is a couple of efforts going on there but within the actual map and implementation tool there is the expectation for the next release, the quarterly report which will go it live in October. There will be that drill down capability to understand where providers fit in the various classification consistent with the table for speed and scale.

(Greg Allen):

Yes. This is (Greg Allen). And those as we have been discussing in our previous meetings, those tables are being greatly cleaned up and updated, and addressing some of the feedback that we received from the providers in the (PPS).

Your next question comes from the line of (Lauren Winerhong). Your line is now open.

(Lauren Winerhong):

Thank you very much. This actually piggy backs nicely of that previous question so we very much appreciate any flexibility that you guys are able to extend when we get cleaned up provider type categories that may reduce our numbers.

I guess my biggest concern is the fact that our partner organizations have until October to really fully commit to the project so that would really impact the provider ramp-up tables. And I think a lot of us are going to be doing a lot of what could end up being duplicative work to make those tables accurate between now and the end of the month when we are going to be getting a lot of new information, and partners will have time to technically pull out a project if they have decided to.

So, I guess I´m just asking beyond some kind of margin for changes based on categories, what level of flexibility will you give given the fact that partner still have some time to make decisions about what they are willing to commit to.

DSRIP TEAM:

Right. So, I´m glad you raised that question but it´s important to point out.

We are prepared to again be flexible when it comes to the fact that if we re- character - re-categorize providers and as a result there is a change in the actual number providers in your network in a particular category. We aren´t going to hold you accountable if you committed to a number and the total number available here in your (PPS) in that (sort) of category went down for whatever reason, we will make adjustments for that.

That said, assuming, let´s say for instance for you as the (PPS) there is no adjustments, right? And the providers you have by category remained the same, I mean theoretical example you are still held accountable for what you committed to an application.

There is not in anticipation of us being quote flexible around your those kind of commitments because at the end of the day the amount of points you received in the application was a direct reflection on your commitments around scale and speed. So there is not going to be flexibility in that regard.

What we are saying is that for whatever reason because of this re- characterization of the file that we would do in order to basically clean that up, we are not going to - when that clean up occurs and if there are changes that affect you we are not going to have those changes negatively affect you.

DSRIP TEAM:

But I also think it´s important to say that the point at which you are selecting the actual providers because you are using an example of an individual provider, you (will) not selecting those individual providers until that next quarterly report when we put that drop down capability upright in October. And that would be based on the new categorization with a new master list that we would be, you know, maintaining through the life of the project.

So - and your new targets, we would be recalibrating in advance of that selection you would be cognizant of the target, you would be getting a new set of providers and you would be selecting at that point. So there is some time here to be thinking about which providers they partner with.

DSRIP TEAM:

And I think that´s the thing too is that, you know, and we said this before that at various points in time we could open networks to allow (PPSs) to add providers. And if necessary, we could explore the possibility and the run up to, you know, sort of October time frame. It looks like (PPSS) need to add providers specific types meaning they weren´t in your initial network.

We could potentially explore that as a way to help you ensure that you can meet your speed and scale. This has only been anticipated that providers could joint (PPSS) at later point but the opposite was not the case which was providers could, in essence, leave with the exception of the structural changes which are going to be allowed at the midpoint set.

(Lauren Winerhong):

OK. Thank you very much.

DSRIP TEAM:

Thank you. Next question.

Operator:

Your next question comes from the line of (Kuan Lilly). Your line is now open.

(Kuan Lilly):

Hi. Thanks for taking my question. So, for the July 31st quarterly report in the budget and funds for our table, it appears that the waiver revenue line has been pre-populated, and it seems to reflect only net project evaluation.

So, in some cases this is different than (announced) that (PPSS) had filled in for the June 1st implementation plan. Could you give us all some guidance on how you prefer as modify our budget and funds for the table to reflect any differences in what waiver revenue?

(Kuan Lilly):

Great. Thank you so much for the insight.

Operator:

And your next question is from the line of (George Clifford). Your line is now open. From the Albany Medical.

(Christy Mcintire):

(Caroline Cross):

Hi. This is (Caroline Cross). I´m sitting with (Shelly). We have a few questions for you.

The first is for pre-completion reporting, from June it sounded like we are only doing pre-completion reporting for organizational section. The first question is, are we required to submit pre-completion reporting for the July 31st reporting period or only subsequent periods?

DSRIP TEAM:

So, for organizational milestones adhering to the 421 domain one achievement values webinar, pre-completion reporting is required for all pertinent organizational prescribed milestone.

Hi. This is (Elisa Coreilli) sitting here with (Joseph Lamentia) and our team. Just having a few questions, I will start just piggybacking off of the discussion about pre-completion reporting. Can you just validate that we should be populating those updates in the narrative boxes tied to each milestone?

DSRIP TEAM:

Right. So for whatever pre-completion reporting that goes above and beyond the visible field that should be using either the narrative or the file upload functionality.

(Elisa Coreilli):

OK. Thank you.

And is the description fields required for every task if we do a sufficient job describing the task within the task box?

(Mike):

So, this is (Mike) from (PCG).

So, we would expect for those partners requirements that were identified as project level that the (PPS) would report as a project wide data source or project wide evidence whereas the provider requirements, provider unit level reporting would be through the individual providers as demonstrated or identified in the domain one milestones and metrics document.

(Elisa Coreilli):

OK. All right. My next question is in regards to project to (DI), you have (PAM) provider as a unit level for us to identify a spread. Can you confirm that our training requirement is the (PAM) provider?

DSRIP TEAM:

So I will start...this (Mike) from (PCG) and (inaudible) chime in.

So in the application submitted in January, (PPS) has identified how many individuals will be trained in (PAM) active - patient engagement technique to the life of the project or by the time they said they would. So we expect that ramp-up to be consistent with the totals that the (PPS) is committed in the January projects application.

(Elisa Coreilli):

OK. So I will take that as our training commitments.

DSRIP TEAM:

Correct.

DSRIP TEAM:

Yes.

(Elisa Coreilli):

Your next question comes from the line of (Kelly Owens). Your line is now open.

(Kayleen Florio):

This is (Kalyeen Florio) actually at around (Adirondack) Health Institute. And my question is with regards to domain four projects, I understand that we will submit that milestones at our (PPS) pre-defined specifically in our own December project plan application.

Operator:

Your next question comes from the line of (Ariel Gulfinmat). Your line is now open.

(Pia):

Hi. This is (inaudible) Medical Center. My question is also related to provider ramp-up. So for those projects where in the detailed milestones we have certain provider types listed. And then in the module two which is the higher level, this is for roll-up or the meeting all project milestone.

So, how would we be measured on meeting all project milestones by the time it didn´t exist in the lower levels, in the milestone level? What kind of evidence would be have to provide?

(Mike):

Sure. This is (Mike) from (PCG). So the project wide requirements often deal with training protocols or (EXR) certification that are (PPS) project wide, policy and procedures, governance, things like that so that´s where we would want to see the independent assessor would request.

Evidence of the training were conducted across all relevant partners included in the project where the policies and procedures have been adapted, things like that at the, what we are calling the project wide level whereas the provider level would be a list of (PCPs) achieving patients and medical home level pre- certification or other types of more specific project requirements to provider unit.

(Pia):

Great. (Mike), thank you.

And for the second question is, if we have let´s say a (PCP) type provider and we have multiple milestones that relate to (PCPs) for instance. We have only one place for (PCP) in the higher level so we just provide that ramp-up that is the most aggressive in that level?

DSRIP TEAM:

So the project implementation speed module were just sort of the higher level should reflect your ramp-up accurate to your original speed and scale commitment. And for anything that needs to be more aggressive that should be aligned within the project requirements module, that should be aligned with the appropriate requirement that have a more aggressive timeline.

(Pia):

Got it. So the higher level should match the speed and scale, and then milestones should be based on whatever we believe is the ramp-up, appropriate ramp-up?

DSRIP TEAM:

Yes.

(Pia):

Thank you.

DSRIP TEAM:

Excellent. Next question.

Operator:

And your next question comes from the line of (Maureen Dorin). Your line is now open.

(Maureen Dorin):

Yes. Hi. Thank you. This Westchester Medical Center, (PPS). So I have a couple of questions that may seem mundane but they get to know the actual entry of items within the portal.

First, they know that we had a question asking about the description text box. The description text box was not in the original template for the earlier sections that we submitted June 1st. We went through remediation process and we received our feedback from the (IA) which would indicate to me that the steps we have submitted at that time had been reviewed. And like in our case, most of them were accepted. We were not asked to add too many more steps.

Therefore, having the required description box seems to me a little bit after the point and the answer that you can just copy a step and put it in. If you are the person doing this work for July 31st, I timed myself on the actual minutes that will (crone) to hours, actually into a couple of full days that I would lose just with having to do that because we are talking hundreds of steps.

I have left that box blank and I have saved, and I´ve not got an error message so I guess choose and reporting, and what I want to share as my other (PPS) colleagues, I mean, why couldn´t we leave that test box blank if we have already been through the remediation to those sections and we are not remediating most of our steps.

DSRIP TEAM:

So the description, the description field is a required field. And the distinction between the description field and the original, the sort of first field that appears, is that the first column is the name column. So the idea was that they weren´t necessarily containing the same information. At this point, they are required field.

And if you are in with...if you are within a module that allows you to save as a draft you will be able to save. But once you get to the point of submitting your report you will not be able to hit save and continue, and actually attach and submit your report if those description fields are blank.

(Maureen Dorin):

OK. But I guess, let me make this clearer, I´m just (inaudible) to consider why now have a requirement for this description text boxes on sections that we submitted June 1st that the assessor already reviewed and commented on so he/she must have had enough understanding if I didn´t get pushed on almost most of my milestones and the steps that I submitted which are now called task.

And the answer that (PCG) gave to one of the earlier question on this was, well if you don´t have anything else to add just simply copy that first box, your task box into the description. Now, I have to tell you that that´s not a really good use of your time and that´s very time consuming on hundreds and hundreds of these tasks because we don´t have the description boxes and we don´t feel like we should be making them now after the fact after our entire sections have been already reviewed. And we are found in large part to be accessible other than what I have to do for remediation.

So, I´m just asking you think about it from a work process flow from a (PPS). You can take it away and think about it but I think making that a required field after the fact just doesn´t seem to make a lot of sense.

And my next question is on the dates, if you are in the system for all of your tasks that have not yet begun, you know, you have three options as you know. So if you put the on-hold because I have reviewed the webinar you sent, and unless I misunderstood if I have task that begin, let´s say (DY 1) Q3, they are on-hold, they are not in progress.

When I put the on-hold that wipes out my start and end dates in the system. So, how will I be able to communicate my dates to the assessor because they get wiped out. I mean I keep them in and then I go to save, you know, and I have the on-hold and the system wipes those dates out.

DSRIP TEAM:

Right. If you are selecting the in-progress status that will allow you to choose future dates. So if you already know the planned date of the activity in the future for (DY) 1 Q3 then select the in-progress status and you can save with the dates that you are keying in.

DSRIP TEAM:

The on-hold status.

DSRIP TEAM:

Yes, does wipe out your - wipe out any (PPS) under dates and include just before 1 2015 as the start and 331 2020 as the end date because that´s an overall - that´s a more sort of rigid indication to the (IA) that the activity is planned maybe a couple years down the road or sort of there is a blocker to actually completing the activity right now.

[Crosstalk]

(Maureen Dorin):

Yes. Can you be clearer because now you are redefining what in-progress means versus on-hold? So in-progress to me is I have already begun, I am in- progress working on the task. Understand that if it doesn´t - I´m not using a salacious lead to indicate, you know, this isn´t two years out so you can´t redefine that.

So if I put on-hold which is what I have done now for anything beyond (DY) 1 Q3 that´s not started which means when I submit July 31st you are not going to have my start and end dates in which originally we were asked for, for almost the entire implementation plan because obviously we are only in (DY) 1 Q2. I mean I have to promise that personally, you have saved me a lot of data entry time but I didn´t know that at first. So, you know, I put in the entire section and went back and said, "These aren´t in progress, put on-hold and save." And I was wiped out.

So I´m OK with that but understand that´s what you are going to get.

DSRIP TEAM:

Sure. That´s the (PPS) (inaudible) on-hold status, we will review the report as is right now. And then when the activity does come to pass sort of it needs to be reported then in future reports (PPS) will need to change those dates and sort of provide an explanation for the...

(Maureen Dorin):

That´s fair. So, to my other fellow (PPS) who is listening to this that that´s going to save you a big risk on playing with the start and end dates, and your projects because it´s been a very demanding process.

We appreciate the issue. I think we´ve got you, we have heard you. We will (pick) and look at it.

(Maureen Dorin):

OK. Thank you.

DSRIP TEAM:

Operator, next caller, please.

Operator:

Your next question comes from the lien of (Courtney Casiraghi). Your line is now open.

(Courtney Casiraghi):

Hi, again. Just a couple of questions. So what time does the map portal officially close on July 31st? Is it going to be 5:00 P.M. or 11:59 like it´s been previously?

DSRIP TEAM:

11:59.

(Courtney Casiraghi):

OK. My other question is, is there going to be like a real-time quality support or contact person that (PPSS) can contact for like almost immediate support in the map portal because as the previous call was mentioning, it´s extremely tedious and time, you know, it takes a lot of time.

And what we have experienced so far is that the map portal can be extremely slow particularly in the days leading up to the official submission. And so, you know, we just want to know who we can contact. We were previously told that the (CMA) help desk is a good person to contact. But we contacted them like three days ago and we still haven´t heard anything.

DSRIP TEAM:

That´s good feedback for us to get. If you can document that for us and send it up through your (PCG) folks will follow up with that with (CMA). (CMA) has been adding a bandwidth resources to map and separately provisioning out various portions to the system. We have previously been running this on the Medicaid (day) warehouse full back on. They have added servers and process, and capability.

So we are hoping that those sets of action including some very recent ones will include - improve the performance when we´ve got sort of key usage times. And we do track that and we have been looking at that. And we have performance issues that are resulting in your - in a uniform submission problem, we will address that at that time.

But we would encourage everybody to get this done as really as possible recognizing that, you know, it´s summer and you´ve got swing resources working on this. But waiting to the 11th hour is, you know, likely to cause the system to run slower so the fewer (PPSS) that do the better off it´s going to be on the system side.

(Courtney Casiraghi):

OK. Thank you.

And then last question, in our budget and fund flow module, we have realized that the budget categories don´t match up with the budget categories that we have submitted in the implementation plan. And so, when we raised this with our (KPMG) representative earlier this week they mentioned that a crosswalk document is coming to kind of explain some of the discrepancies and the terminology used between the map and the implementation plan.

So when does that documents going to be released?

DSRIP TEAM:

So, unfortunately I don´t think any of us in the room are aware of a crosswalk document that is to be released. I will drop my head though, the budget categories do align. There are two additional categories that we sort of work with DOH to include with your cost of non-covered services and other.

So there is a total of five categories in this July report compared to the three from the June report. And that´s the only discrepancy per say that you should be seeing.

(Courtney Casiraghi):

OK. Well, we will just erase that again with our (KPMG) representative. Thank you.

DSRIP TEAM:

All right. thanks very much. Next up?

Operator:

Your next question comes from the line of (Janneth King). Your line is now open.

(Janneth King):

Hi. Thanks for taking our call. This is (Janneth).

OK. I´m sorry. So, my understanding based on how the question was -- responded to earlier is that for this submission we not only provide all of the milestones and steps so we also have to...we also required to report on progress for anything that is pre-completion. Are you saying that what do not need to do that in this initial baseline submission?

DSRIP TEAM:

So I think we are - confusing two different terms, so if there are - if the (PPS) is further along in - and works steps for a particular milestone in terms of (EHR) meaningful use development then the independent assessor would like to be - would like that information included in the July 31st implementation plan.

I know some of the comments came back between the original implementation plans whether a view has came out with more information was needed. And some of the (PPS) (inaudible) further along, you know, meet all these steps because we are - we have already embarked on the project in these project requirements.

So the independent assessor in the next implantation plan would like to see, you know, those that may have been completed already to understand why you are at the place where you are at which is a little different I think than the term pre-completion documentation that´s been used in various other webinars.

(David Rosales):

DSRIP TEAM:

All right. Thanks. Move on to the next.

And so, we are over the allotted time for this topic but given the fact that we have deliverable due dates to the 31st, I think it make sense to continue on with questions. We have seven in the queue so, and many of (key) customers which we are always glad to have repeat customers.

That said, particularly for those of you who are repeat customers if you could try to keep your questions sort of, you know, short and distinct. We want to try to make sure we have time to get everybody as well as the rest of agenda.

So next up?

Operator:

Your next question comes from the line of (inaudible). Your line is now open.

DSRIP TEAM:

Hi. Thank you. I guess my question is for the project specific reporting requirements where you have to make provide number commitment or roll-out commitments. There are number of requirements that you are committing that don´t really have in the (phases) and they are more binary achievements.

So things like (Rio) or (Shiny) connectivity or (PCMH) recognitions, those are sort of binary and may happen all at once for a large group of providers because they all, you know, participate in one group practice or something like that.

Earlier in, you know, maybe two months ago when the implementation plan first came out, we were given the guidance that weren´t allowed to put, you know, continuous quarters of zeros for provider level commitments. Is that still the guidance even for the things that, you know, it is possible that 100 doctors or (PCPs) would come online at once for (Rio) connectivity or (PCMH) certification?

(Michael):

Yes. This is (Michael) from (PCG).

Yes, you can - your understanding of the guidance is correct which is why we instituted the idea of work steps and sub-steps within each milestone. So a (PPS) can, and we understand can wait until a certain point of (for your) time to make all the medical villages turn their lights on all at the same time.

However, the work steps associated with those part of requirements must demonstrate a logical and appropriate fast forward in terms of meeting those requirements.

[Crosstalk]

(Amie Vankapen):

DSRIP TEAM:

I will give you a simple example. If we had a template - it has been brought up already - if we had a template that we could fill out in Excel and then upload, it would make our whole process much different, including on boarding staff and allocating resources.

Hi. This is (Alyssa), again. I just had a point of, for future reference. It was mentioned earlier that for task that we would be able to put on hold on a project plan, the project side of things, not the (orc) side, that there would be an opportunity to write in a description that that particular task is on hold and why. But there is not an option for a narrative or a description on task on the project side.

So, maybe, in the future, you want to consider that anticipating that some of our task that we put in for July 31st may become on hold.

DSRIP TEAM:

Right. So, throughout the application, organizational or project side, any information detailed that needs to be clarified in a narrative or with uploading documents regarding tasks, should be communicated at the milestone level.

The narratives and the upload functionality exist at the milestone level.

DSRIP TEAM:

OK. And then the other piece around patient engagement, I also wanted to highlight, there has been a lot of planning on our part in regards to taking with this state has given us the DOH patient engagement definition and turning into something that we can operationalize it based on the many different partners that we are looking to engage in the project.

And providing technical guidance, mid-August, I think we will wind up probably kind of throwing it for a loop in term so of all the planning that has to go into this. So, if there is any way that (PCG) or (KPMG) can at least begin to consider answering our questions around patient engagement in a more timely fashion, it will be helpful for us so that we do not put ourselves in a position to get technical guidance mid-August, which kind of deters what we are organizing today.

DSRIP TEAM:

I think that is a great suggestion. We will take it back and we will see what we can expedite. Thank you very much.

Operator:

Your next questions comes from the line of (Joan Child). Your line is open.

(Joan Child):

However, if something still goes through that sort of has (junk state over) is blank, then we do have the - after the 30 days of IA review, the PPS does have 15 days for remediation of that report if further information does need to be included or something was accidentally admitted.

(Lauren Waterhorn):

OK. Thank you for that. And this is - this may not be high priority, given the fact that you have all of these request on the map tool, but back on June 1st or prior to that, I think it might have been the IA, they gave us a check list for thinking about sections that needed to be completed.

What should we have as relative to (2DI) patient activation? And just for clarification purposes here, that in terms of activating our patients, administering the PAM, scoring them, and of course, then engaging the patient into primary care community care services and the like, the follow up and the reassessment of these patients in terms of reporting and the like, do I understand it that it is not necessary to report on a (re-PAM)?

But in terms of overall activation, as part of the overall performance, we can just simply report where we believe that patient is within our system a year, two years, three years down the road?

DSRIP TEAM:

Hi, Michael, this is (Betty). No, I think, you know, as we, as according to the CMS and to the (2DI) description, what we are really looking is that there is an ongoing engagement with these patients.

And you know, when the PAM, when the Patient Activation Measure assessment is done, it is actually (voted) into a database. You are doing it on the insignia tool; it is automatically scoring, it is (voted) into your database, as well as the large insignia database.

That is the information that we will be using for measurement, and we will be looking for that measurement over time, (one to two accordingly). We will be looking at these, you know, what we have to report to CMS, is again, that level of engagement and that change in activation score.

So, this is not sort of a one-time outreach by any means. It is - this is really about people, community health workers and such types of folks being out in the community and regularly working with the folks that they encounter and, yeah, helping them whether it is accessing services or talking about how you are doing on, you know, on the various sort of disease knowledge, other health behaviors and other connections to community health resources.

(Michael Gaddle):

OK.

DSRIP TEAM:

I will be working with you further. You know, we are in touch with the Greater New York Hospital Association. We realized, you know, we were all kind of parallel tracks when we were kind of align in our efforts to be all involved with all the PPSs working on (2DI), and we will discuss this further.

(Michael Gaddle):

All right. Very good. Thank you.

DSRIP TEAM:

Thank you. Next up?

Operator:

And your last question comes from the line of (Rachel Mark). Your line is now open.

(Rachel Mark):

Sorry about that. Unmute. So, just a functional question about adding tasks in the map. It appears that as you add multiple, it does a reverse, which means that if you start by entering your first sub task or task, it then adds above. Meaning, that when we went to add, it - our first task is now at the bottom of the list and our last is at the top.

Do you need to have that in the correct calendar order or would that be a feature or functionality that you would change in map?

DSRIP TEAM:

As long as the start and end date of the activity reflect the correct chronological implementation of the activity, then you should be fine.

(Rachel Mark):

So, some of them may - some task may start and end in overlapping manner. So, I am just trying to make sure that when the independent assessor looks at those, would it make sense for us to make sure they are represented down the list in chronological order, like with the one, two, three, four, five?

Base on - I am just trying to make sure that when the independent assessor looks at those, that they would not get confused if number nine is at the top of that list and one is at the bottom.

DSRIP TEAM:

Right. So, I mean, that is definitely a great observation. If you would like to number your task within the name itself, that will sort of further clarify for the IA in which order you will be implementing the task.

The other suggestion is, potentially, if you do know how many tasks you will be adding in under the milestone, to just hit the plus button, you know, 10 times for 10 tasks, and then you will have all the 10 rows already there, and you will be able to sort of input all at once and save so they will - you can input as you would like to order them, you know.

But definitely, if you - if there, if they are already out of order and you just sort of enumerate them, that will assist the IA in review.

(Rachel Mark):

OK.

DSRIP TEAM:

But we will look at that as well for future functionality.

DSRIP TEAM:

Very good. Well, thank you very much, everyone. That brings us to the end of the queue for that first topic.

Operator:

Your first question comes from the line of (Rosanna Sasic). Your line is now open.

DSRIP TEAM:

Yes, hi. This is Mark from the Care Compass Network. And we had a question in regards to the previous section where we talked about workforce being delayed until later this year.

We have multiple steps being completed earlier this year, and the question was: If it is not being reported till Q3, would workforce then not be considered as a (waited) factor for the payments based on Q1 and Q2 deliverables?

DSRIP TEAM:

So you are basically indicating that there is a specific (AV) driving milestone for workforce and there is a specific requirement day for that completion but you guys have already completed that or will (stand) by the time the module will be open?

DSRIP TEAM:

If the evaluation for that is not going to be until Q3, which is my understanding from the previous discussion, that the submission of workforce deliverables was not required until Q3.

If we had deliverables due in Q1 and Q2, would they be (waited) during the Q1, Q2 evaluation? I do not know if that could happen.

DSRIP TEAM:

Well, their module will be open for the Q2 report. And I think what we have been trying to communicate, and probably not as clearly, is that the workforce impact analysis, they are looking at how many staff are going to be impacted in the various types of staff across the PPS would not going to be held in terms of the baseline numbers until the Q3 report.

(Jeff Gruffle):

Thank you.

DSRIP TEAM:

All right. Next question?

Operator:

And your next question comes from the line of (Quan Moo). Your line is now open.

(Quan Moo):

Hi. Thanks for taking the question. Really, it is more towards evaluation, I guess, which also, of course, really, payments. Could you give a sense of the final (PMPM) that was used for valuation?

DSRIP TEAM:

The benchmark (PMPM), you mean?

(Quan Moo):

Yes. That is right.

[off mike]

In the meantime, you know, the lead PPS can utilize the data that we provide and can begin doing analysis on that data. On top of the requirements that we have about how to share that data, in the opt out, we do have the security requirements and we have, you know, a policy here that we do not want that data to be passed around without having to (factor) up allocation in a completion of a security assessment, and that we have been, you know, pushing out a lot of information to you, folks, on security assessment in a two factor process.

We know that that presents some technological challenges, but it seems not a day goes by that we do not have, yet, another press story about personal information, health information or otherwise being compromised at some level.

And please recognize that for this, for us, this is, you know, now, you know, potentially the distribution of personal health information for millions of low income New Yorkers, and we take the protection of that very, very seriously.

And even though this is, you know, very burdensome, we will do everything in our power and your power to assure that that data is as secure as we can make it. So, and I know many of you have been concerned about that burden and we have been concern about it too.

But frankly, when you think about what we are going to have at the end of this, we are going to have the capability to administratively share without individual consent, information from a large network of providers down into all of the various partner agencies, simply to an opt out process, which is I think a fairly liberal way to pass a considerable amount of health information.

We are completely behind the (care) integration and the clinical improvement opportunities for that. But we have to be very cautious that we (inaudible) on both, following the confidentiality provisions that have been laid out by our counsel, and also making sure that we follow the security provisions as we have sent them to you.

We do not want to be in breach of either one of those things at any point in the enterprise, and we recognize that it is going to require some patients. And that until we get to the conclusion of the opt out process; you cannot optimally start implementing your projects. But we do think there is a lot of setup analysis that can be done by the lead and advance of that opt out concluding and in advance of you implementing two factor.

The other thing I will say is that we are building map capabilities that will be protected by two factor. So, for those of you that do not have the fast capability to share this (PSI) data among network partners, we are working really fast on building capabilities and map so that map can be the two-factor solution for you.

And again, it will not be optimal in terms of fully integrating claims and encounter data with health record data, et cetera, but it will offer, at least a, you know, crawl-walk-run solution here in terms of getting your network members access to that (PHI) behind the state implemented to factor firewall.

So, we are recognizing the difficulty that you might be, and some of you in implementing that, by trying to build that capability centrally at the state level.

(Jaime Wono):

So, if I am already accessing this Medicaid claims data of the state, provided to factor up (indication) through (CMA) and (inaudible), I already have access to that. What I just need is the mapping between our attributed members and (CIN) so that I can enter those (CIN) of the key.

I guess I do not know. We still do not know how big the data extract is going to be, so it is difficult for us to prepare our infrastructure here to receive it on the 21st. There is just still a lot of unknowns in preparing to get that data and meet the achievement target that we are, you know, being held to.

DSRIP TEAM:

Yes. So we can take back, if you request these on file size, I think you have got file structure information, your request is on file size, we can take that back, try to get it out through PPS.

(Jaime Wono):

Because we got two different pieces of information about file structure as well: One states that there is no PA - there is no actual contact info; and the other is much more liberal, the former being a formal data dictionary.

So, we would appreciate some clarification on that as well.

DSRIP TEAM:

Well, there are also just - remember, there is two files that we are sending: One is a roster file, which is a much more simplified patient, patient ID, and some demographics and contact; and then the other is a much more detailed claims extract file which has, you know, service information, provider information, volume information, et cetera, in it.

On premise, right. And folks can come in and work there and use it, but you cannot, you know, get copies of it, they cannot take it away; it needs to reside there in that initial release until you have done your secure, your identity assurance assessment that prescribes how you are going to share it out to your partners or what the application roles are like, et cetera.

After you do that assessment, it will come out to what assurance (level) you need to be at, and that will dictate, you know, do you need (multi factor) of indication or not.

So, you know, in some cases, if you are just giving, you know, analytical views and not actually seeing the actual (PHI), if that is how you are sharing, you are allowing access to it, you might not need two factor.

If in fact the end users see lots of personal health records, could copy them, that jumps up into assurance level three where the two factors are required.

DSRIP TEAM:

OK. Thank you.

DSRIP TEAM:

Thank you very much.

Operator:

Your next question comes from the line of (Tutandra VarMicha). Your line is now open.

(Tutandra VarMicha):

Hi. Good afternoon. I have one comment and two questions. So, my first comment is, it had been over three years (Bronx) receive the (CMA) grant to create (Bronx reason) of informatics center. And as a result, we have created a (Bronx reasonable) analytics data warehouse.

So, in our implementation plan into the planning phases, we were thinking that the (Bronx) view will be our master data management in analytics (vendor), and we have accordingly put them in, as a (vendor) in our (PPSDA) and complying with all the (DUS) specific security requirements.

Now, reading the FAQs, I understand the (Bronx) view can be our vendor, but during the call, we were informed that (Rio) at the moment cannot be a receiver of the Medicaid data as such until December.

So, I needed some clarification on my question number one.

DSRIP TEAM:

I think where you are going is initially, that data can only be received by that PPS until we have completed the opt out period and then we have, you have done the security assessment. And we know that even the (RHIOs) are going to have some upgrading to do on access standards to meet the state access standards here.

So, but, yeah, we cannot share data outside of the lead PPS corporate structure until such time as the opt-out is completed.

(Tutandra VarMicha):

Understood. My second question is, when does Medicaid data answers Medicaid data? For example, with all (malefactors authenticates) process and (active TV) protocol is completed, the derivative of Medicaid data becomes (answered) Medicaid data or they are PPS data?

So, in terms of, for instance, cleaning and documentation, where does Medicaid data answers Medicaid data?

DSRIP TEAM:

We are having trouble understanding the question. Can you repeat it for us, please?

(Tutandra VarMicha):

So, my question is, suppose, with all the security requirements and (SFTP) process, we receive Medicaid data on our encrypted address data servers, or service data base.

Suppose we do that, even the conclusion to our (sequel) query on those member roster or claims file, when does Medicaid data becomes as Medicaid data, or answers Medicaid data? Does that derivative also needs to go through the same (forensic) cleansing and documentation after...?

[crosstalk]

I want to make a couple of statements and just check it: And number one, I think that each data has to be tagged with the consents that were generated for the originating data, right? So we have got...

[Crosstalk]

DSRIP TEAM:

These are opted out. Yes.

DSRIP TEAM:

Right. So, for the (DSRIP) data, we have got a whole set of patients that were opted in for a network that was approve for (DSRIP), right? And we can retain that as the permissions on your medical record data.

Let us say it came in from (Rio) and you had a set of tags on it for which providers could see that clinical data, you have maintain those tags, I guess, in that integrated data set. So you knew not to push out data for which you did not have the proper permissions to the whole network.

And so far these guys are nodding yes to everything I am saying. Is there anything else to say on that in that regard?

DSRIP TEAM:

I think just the other piece was, and this is probably obvious, but just to be sure, that if you get new updates, you got to keep removing the patients´ records to opt it out. So, like, every time you get a refresh, you got to kind of keep it separate.

If you start to mangle everything in databases, that becomes very difficult. So, you want to put some thought ahead of time knowing you have to clean out those records for the ones that opt it out so they do not incidentally share it out.

DSRIP TEAM:

And I will just say this, many of the - in the (CIO) work that we have been doing, the (CIO) has been coming to us and saying that cataloging a permissions is very complicated, and it is something that the PPSs feel, some of them anyway, would be better as a state-wide service.

(John Deondisol):

Are you suggesting that the PPS lead would use the data that we make available to them to do patient outreach? Is that what you are suggesting?

DSRIP TEAM:

Correct.

DSRIP TEAM:

Yes. I think the one issue there is that I think we would caution doing that in advance of the opt-out period. And again, we have had a dialogue internally about this, and then it landed in a position. But just to share with you the concern that has been raised in the policy side is.

If the member has (assertively) not gotten the ability yet to opt out of information sharing, and we give you a file and you use that to outreach to them and offer (DSRIP) services in advance of an assertive effort to have them opt out, we could get (bull) back from them on what is this and why are you using my data in this fashion.

So, while we have not locked on a position yet, our developing opinion here, and Jason can make a ruling right now, is that we are discouraging that specific level of outreach, but we are encouraging the development of an outreach strategy looking at the data that is available so that you could begin to do some hot spotting; figure out where your highest risk members are, develop indexes of those that you want to outreach to first so that when we conclude the opt out period, you are ready go live with that kind of outreach.

(John Deondisol):

OK. That is helpful. Thank you.

Operator:

And your next question comes from the line of (Irene Cohort). Your line is now open.

(Irene Cohort):

Hi. This is (Irene Cohort) on PPS again. So I have two questions on what has already been discussed, and I think I need more clarification. So, the first question is around patient consent.

You know, I think you touched upon recently with one of your answers that there are two sort of separate stage in the patient consent. Right now, you are doing the opt out, which is the part of the PPS situation, and then the other one seems to be on the PPS responsibility side when, you know, we are sort of using care management under or such, or the (Rio) to sort of send information from one provider to the next.

Can you just clarify that because it was not that clear? I know that one of our concerns is, you know, patient can send on that end, can she? Because it is not like they know what providers are part of a PPS. So, they might go to hospital A and say, no, and then the next day, they may go to, like, a clinic in the community and say, yes.

And so, and reason this is critical for is, is that the independent assessor ask for more detail on data security milestone under the (IT) processes and workflow. So, I just, I guess, if you could provide a clarity on that, that would be great, and I can ask my next question after that.

DSRIP TEAM:

So, on the - so there are two forms of consent: One is the (up sell) process that the state will run specifically around the sharing of Medicaid data or Medicaid information by the PPS (link) with their downstream partners. That is a process that we will run; we will mail out six million plus letters over a period of several months. The idea being that we will have completed (that process) by the end of the year.

At that point, you will know from which members you could share information from downstream partners.

The second piece of information sharing, which is also essential, but it is something that is governed by existing state law and regulation, is this process of, in which individuals agree to have their patient records shared amongst providers that see them and have that information available for sharing on an as needed basis amongst providers, you know, that serve them in common.

And that we have, you know, now we have got two outlets where we are already at this state have authorized a, basically, a multiparty consent vehicle. One is the opt out process and (DSRIP) which triggers the administrative transaction: A.) Between the state and the PPS; and B.) Between the PPS and the network partners.

So, that is big, right? And then the second one is health home where a single assertive patient opt in signature triggers information sharing among the care management network.

And as David mentioned, we wanted to get the (RHIOs) to the place where they have all implemented multiparty consent so that this aligns on the administrative transactions at the top of the (trees), and also all the underlying clinical transactions as much as we can.

But until we get to that multiparty consent, a lot of the (RHIOs) are one click at a time; add one provider. But some of them do have list capabilities where you can go down and click an entire list. But we are working with them to try and develop, you know, more multiparty consent.

(Irene Cohort):

OK. Thank you. The second question is a little separate from patient consent. It has to do, and I think you have kind of touched on it already, but I will just reiterate - reask the question with more detail.

So, you guys mentioned that, you know, the new (poll) were not - (RPS) is a new (call) and one of the concerns that we had after the data security webinar was about where that information should reside after, you know, it is received, and we have not had that security (as of today) created.

So, there was, in FAQ, there was sort of, it mentioned that there would be more updates on amendments to the (DEAA) for situation with (new Co.). I mean, what is the status with that and it provides, you know, it is a little difficult right now because we are trying to plan, OK, were is this data going to reside, and we want to make sure that we plan accordingly.

It is an investment to make sure that we have the right servers, or if it is not in our location, which is not necessarily at any other (colleague) location, that is OK for us to have it there.

DSRIP TEAM:

So, maybe I can take a shot at this one. Irene, the guidance that will be sent out was sent out is particularly for NewCo receiving DOH Medicaid data. Since most NewCo are not physical entities with a physical location, the NewCo leads have to decide between the NewCo partners where they will store the data basically. The NewCo guidance/document that will be sent out will allow the PPS to formally designate one of the Co-Lead NewCo partners as the recipient of DOH Medicaid Data.

When the Co-Lead chooses the partner that will be the recipient of DOH Medicaid data, the gatekeeper and the two (IT status) users should come from that one designated NewCo lead partner.

Those are the basics for the information now. Should you need more than that?

(Irene Cohort):

Right. But, yeah, OK. That is a little bit more - you are cutting off a little. Sorry. In terms of the - there was mention of amendments coming down for (new Co.) and I was just wondering what the status of that is.

It was mentioned in the FAQs for the data security webinar.

[off mike]

DSRIP TEAM:

You are right. So the amendments are in draft. I mean, hope to have something out next week. And just to be clear Carlos´ point, which is a great clarification for (new Co.).

The thing is, is that a new (new Co.), if the (new Co.) itself is not in a position, you know, since they are new corporations, they are not often in certain situations where they have the existing infrastructure to host the data, that the option for them is to pick amongst their, you know, sort of owners or the lead organizations within the (new Co.) to pick one of those to be the host for this information, and then that host has to meet the other requirements in order to be (useful).

[crosstalk]

Are you talking about sharing (PAM) results or to administer the (PAM)?

DSRIP TEAM:

Yes. This is (inaudible) talking. If we have to share this information, we have to - with across multiple providers. Because it identifies them, it is when you feel that unethical that we inform the patients that we are sharing this data. So, we have to collect that consent. And remember, this is for both Medicaid and uninsured individuals which will not be covered in that out process.

So, can you comment some stuff...?

DSRIP TEAM:

Yes. Sure. So, your question is, are you - not the administering, because he asked about administering the (PAM), but you are talking about you have administered the (PAM), you did not need a consent to do that, but while you are...

DSRIP TEAM:

No, no, we do.

DSRIP TEAM:

You do.

DSRIP TEAM:

We are saying that before we could even interrupt with this person to collect their demographic data, we need to inform them through the process of consent that their information could potentially be viewed by providers, even outside of those that they are currently being seen as.

[crosstalk]

Last question, not related to (PAM), but it is back with, I guess, the housing of map data. So, if we were to have a kind of a posted solution that maps, you know, identity assures that we set, we use in getting assessed by identity assurance, would that be an acceptable location?

DSRIP TEAM:

Yes, absolutely. Many of the Cloud providers are quite sophisticated with these capabilities. And often, it is economically feasible to have them do it for you; they can do it at lower cost sometimes. But, yeah, as long as they can meet the same requirements and the reference, state policies, and standards around identity assurance; how they do the identity proofing, how they provision the (tokens) and the data being encrypted, yes.

DSRIP TEAM:

Just to - we would like to add just one additional note to ensure that the Cloud provider can ensure the (distraction) of the data, the pre opt data that is required.

DSRIP TEAM:

Right. So, that is the key point, is that you will receive this data file that includes all of the members who are attributed to you. So, once we have completed the (up sell) process, you will be sent an essence updated files, and that will reflect who you can and cannot have access the data for.

(Michael Carlburry):

Is that correct or is it now possible to do that?

[off mike]

DSRIP TEAM:

After the security assessment, you have to complete your security assessment hopefully in that Cloud provider.

DSRIP TEAM:

It will include the Cloud provider and their capabilities in that they can provide those required controls.

(Michael Carlburry):

So, pre-completion of the opt out process, we can use a file provider?

DSRIP TEAM:

Correct. As long as they - as long as you fully pass the security assessment and meet the state´s requirement, you can use the Cloud provider.

DSRIP TEAM:

Yes. If everything has come back and you are head of the curve and you have met all these things and have their capabilities, I think the answer is yes. I think if you are asking before you did that, you know, in the initial, with the (VA), then it says you get the data, have to be within the building for encrypted.

I do not think...

DSRIP TEAM:

You cannot go give it to Cloud provider and access it.

DSRIP TEAM:

Right.

DSRIP TEAM:

We just want to be careful here, though, that if you complete the security assessment pre opt out, you can utilize all the capabilities that your security assessment authorize, but you still cannot share that data downstream with your...

[crosstalk]

DSRIP TEAM:

If you are putting it in the Cloud but only accessing it by the (lead), that is fine, but you cannot put it in the Cloud and open up to access to your network prior to the opt out competing.

So, you got two things, right? You got the - you got to do the confidentially requirements through opt out and you got to complete security assessment.

(Michael Carlburry):

Right. I think I understand. I mean, I guess the transition I missed was when the original concept essentially, it lay inside of a close building all through, (inaudible) operated by the PPS (lead) to the second that we are, you know, we have remote access during this opt out period.

Again, by (inaudible) employees, after we do this security affidavit. But the assumption was it still refer to a data center owned and operated by us, as opposed to a...

[crosstalk]

DSRIP TEAM:

Yes. So the data center owned and operated by you with wired only access is what we are requiring prior to the completion of the security assessment. Be respective of the opt out; you got to do the security assessment and you cannot move the data beyond your data center and your four physical walls and, you know, wires into it kind of thing until you complete the security assessment.

But you cannot share that data, even after you have completed the security assessment with your partners until you complete the opt-out.

(Michael Carlburry):

All right. That is helpful. The way I asked it earlier was treating our Cloud provider as a (inaudible) partner. There are some language that talks about technical partners being essentially (inaudible) partners and treated the same as a (inaudible) and clinical provider.

Where it is obviously a Cloud provider is the same thing, right? So I think I understand now. Thank you.

DSRIP TEAM:

OK. All right. That is the end of the questions no data security. So, we are on to the initial discussion items. So, I think, Peggy, you wanted to make some remarks before you open it up for some final questions?

DSRIP TEAM:

Right. I mean, again, just - we know that people who have questions regarding what course, you know, as previously said, we have been working with (11/99), with our health workforce folks, as well as talking to the Department of Labor to get a standard definition and standard, or standard job titles that we can then share with you.

I think, you know, we are all - we appreciate that everyone is looking for that kind of job definition consistency that will enable us to really look at these, you know, within a go from each PPS launch (intuitively), as well as across PPS.

You know, there is a larger effort; we do have a DSRIP and shift larger workforce workgroup. These are initiatives from our DSRIP panel, as well as the shift innovation council, and the interest, again, is looking at the workforce transformation over time.

The shift side has been looking at advance primary care with that particular focus as well as you all know, the (DSRIP) side as far as the larger healthcare workforce and the impact of the reductions in avoidable (ED) admissions, and all that we have been striving for.

So, those definitions, again, will be coming out in the next week or two. Additionally, we are working internally to see what else we can standardize and, you know, in collaborating with others to kind of reflect more of a industry approach and to get that out to you.

And as, you know, we said earlier on the (PCG) side, you know, the third, (we have probe with) the first submission, again, is your initial projection is informational; it is really the January 31st, which is the final piece, and we are all cautious and we want to work with you on that.

Yes. It is a great question. I am not saying that there is anything that would - I mean, there is maybe completely permissible. I think it just makes sense for us to check to see if there would be any - I mean, you know, I cannot decide, you know, if it is being done in Medicaid manage care, that is a good chance that it would be allowed on this circumstance.

But I just think it is worthwhile for all of us just to check on that.

Our local (zip) funded entity advised us that they received notice from the DOH that their award, their anticipated award has been reduced by 50 percent.

And that is relevant to us in (DSRIP) because both the Albany med PPS and the Alliance for Better Health, our neighboring PPS, were collaborating with (zip) on workforce issues and some training issues, some prevention agenda issues among other things.

And so, the loss of funding is going to impact our ability to collaborate with them, it is also going to require us to rethink some of our action steps in terms of the deliverables that we have already provided in the organizational section.

So, I am wondering, first of all, if you can confirm that in fact the fifth funding has been cut, and whether you have any suggestions in terms of alternatives.

DSRIP TEAM:

Sure. So, well, I cannot confirm as that the exact amount of reduction. I cannot confirm on top of my head what that reduction was, but there was a reduction off of what was initially anticipated.

The reason for that reduction was that after further consultation with (CMS), we are able to determine that the amount of federal funding available through the initial - through the initiatives that (federal financial) participation was much more limited than hoped.

As a result, we had fixed appropriation available the budget for this purpose, and we are just not going to be able to draw down as much federal money to all support the initiative, and that is what has led to that reduction in the future years, future budgets.

We will be looking to see to potentially supplement those awards, but, yes, the answer is that - now, in terms of it, there is nothing that would stop a PPS or the multiple PPS in the region contracting with the (fifth) to provide those set of services.

And obviously, you would use funds out of your existing award; that would be an appropriate use of (DSRIP) funds to partner and other PPSs, in fact, are using their funds to contract with the (pre-courser) to (fifth), the regional health planning organizations of which, I think is only one remaining, or maybe there is a couple that are remaining, for example, I think also in addition to the (figure length).

And so, those are - and so, I think there is definitely (precedents) out there for how those entities have been brought in as active partners, and it is good to hear that you are partnering, but there would be nothing that would prohibit you from establishing an additional constructional arrangement to help fund activities that are done by the (fifth) on behalf of the PPS in the region.

Any other question? All right. Well, we have come to the end of the question; no one is in the queue. And we have come to closing remarks. So, we are going to end here a little early.

So you will not have the opportunity to listen to it over the weekend, unless you yourselves recorded this. So, but, yes, so we will try to make it no later than Wednesday of next week.

So, with that said, I want to thank everyone for participating. As always, we greatly appreciate all the hard work that is going in to this initiative; so much creativity and effort going on.

We know there is a lot of work to be done up to the 31st with the implementation plans. And obviously, we know that there is continuous to be more information coming out from us and you all have to absorb all that, and it is no easy task. But, you know, as I - I have chances to travel on state and meet with many of you, I am very impressed, we are all very impressed by how much hard work is going into it.

So, thank you everyone. I look forward to your feedback on this as an alternative to in person. I still think (inaudible) has great value, but I also think we were able to answer a lot of questions today, and so I think we definitely would love to use this format in the future for discussions and feedback.

So thank you very much and have a good weekend.

Operator:

This concludes today´s conference call. You may now disconnect.

END

Department of Health

Transcript of PPS Operator Assisted Call on July 17, 2015

THE STATE OF NEW YORK

Moderator: Jason HelgersonJuly 17. 201512:30 p.m. ET

Operator:

Jason Helgerson:

Operator:

(Jamie Bono):

(Michael):

(Jamie Bono):

(Michael):

DSRIP TEAM:

(Jamie Bono):

Jason Helgerson:

Operator:

(Courtney Casiraghi):

DSRIP TEAM:

(Courtney Casiraghi):

DSRIP TEAM:

(Courtney Casiraghi):

DSRIP TEAM:

DSRIP TEAM:

DSRIP TEAM:

DSRIP TEAM:

(Courtney Casiraghi):

DSRIP TEAM:

(Courtney Casiraghi):

DSRIP TEAM:

(Courtney Casiraghi):

DSRIP TEAM:

DSRIP TEAM:

(Courtney Casiraghi):

DSRIP TEAM:

(Courtney Casiraghi):

(Courtney Casiraghi):

DSRIP TEAM:

(Courtney Casiraghi):

DSRIP TEAM:

Operator:

(Amie Vankapen):

DSRIP TEAM:

(Amie Vankapen):

DSRIP TEAM:

(Amie Vankapen):

DSRIP TEAM:

(Amie Vankapen):

DSRIP TEAM:

Operator:

(Chris Bell):

DSRIP TEAM:

(Chris Bell):

DSRIP TEAM:

(Greg Allen):

(Chris Bell):

DSRIP TEAM:

DSRIP TEAM:

DSRIP TEAM:

DSRIP TEAM:

Operator:

(Lauren Winerhong):

DSRIP TEAM:

DSRIP TEAM:

DSRIP TEAM:

(Lauren Winerhong):

DSRIP TEAM:

Operator:

(Kuan Lilly):

DSRIP TEAM:

DSRIP TEAM:

DSRIP TEAM:

(Kuan Lilly):

DSRIP TEAM:

(Kuan Lilly):

Operator:

(Christy Mcintire):

(Mike):

(Christy Mcintire):

(Christy Mcintire):

DSRIP TEAM:

(Christy Mcintire):

Moderator: Jason Helgerson
July 17. 2015
12:30 p.m. ET