These FAQs are for the REGIONAL QUALITY IMPROVEMENT HUB PROPOSAL
Additional questions regarding this Request for Proposals may be emailed to: Crystal Phommasathit and Allison Lorenz.
Questions will be accepted for 15 days after the RFP release date, August 1, 2022, 5:00 PM (EST). Answers will be posted on the FAQ page.
Administrative Questions
- Will each CoM have a defined region to serve for this initiative?
CoM applying to the RFP are not required to identify a region(s) where they will focus their efforts. Once funded, the GRC will work with each CoM to coordinate the selection of practices that they serve.
- Will ODM provide information to better understand which providers serve patients enrolled in Medicaid?
ODM will work with CoMs to better understand which providers and practices serve a high volume of Medicaid patients.
- Will this initiative impact existing quality improvement (QI) programs funded by the Ohio Department of Medicaid (ODM)?
This initiative will not impact existing QI programs funded by ODM. If your institution receives funding for QI programs outside of the QI HUB, continued funding decisions fall outside of the scope of the QI HUB work. QI HUB will not duplicate funding of other QI activities/programs the COMs participate in. The intent is for the QI HUB to enhance QI activities across the state of Ohio.
- Will the Ohio Colleges of Medicine Government Resource Center (GRC) support a learning collaborative approach among all institutions even though chosen topics will vary across the state?
The GRC will support a peer-to-peer learning network across institutions, identifying and collaborating with all of Ohio’s Colleges of Medicine (CoMs) to share learning and best practices across QI projects, focusing on creating an all-teach—all learn environment for capacity building, and data driven results. Best practices may not always exist and may instead be developed as part of the QI project. This learning network is not the goal/focus of the QI Hub, but a strengthening component. Workgroups will be created by GRC for each selected QI topic to ensure appropriate learning opportunities are available to all CoMs.
- Are there any metrics for number of health systems or providers?
Since the number of existing partnerships will vary by institution, specific metrics will not be provided in Year 1. However, ODM and GRC will work with each funded CoM to identify metrics for Year 2 to be accomplished based on QI topic area.
Budget Questions
- How much internal staff support is needed to efficiently partner with GRC to utilize the QI dashboard and support data extraction needs across multiple sites that use multiple EHR systems?
GRC will build and support data dashboards for the selected CoM QI topics. COMs will need staff (QI coaches) to help practices interpret and utilize dashboards. They may also require a small amount of IT support to help practices build and implement EHR queries, but resources for other data collection and data analysis needs will be minimal. The data dashboards will support pre-determined process and outcome measures, as agreed upon by ODM, GRC and the selected CoM.
- Should the CoM allocate staff or budget a contract expense for the affiliated health system to support a QI leader with site engagement?
Each CoM should allocate staff or budget a contract expense for a QI leader who will participate in all learning collaborative and coaching opportunities, coordinate activities with GRC, and help build internal capacity within their CoM.
- Are there factors that could impact the maximum funding amount in either SFY23 or SFY24?
The MedTAPP funding model consists of a combination of Federal funding (FFP) and non-federal funding (State and Institution). The majority of non-federal funding is contributed by ODM (General Revenue Funds (GRF)). Institutions can also provide cost share to leverage additional Federal funding. Institutional cost share typically consists of faculty time the institution provides as an in-kind contribution. If your institution is providing in-kind match, it should be clearly delineated as match in your budget.
- Are there any budgetary restrictions for health professions students?
Stipends and/or tuition for health professions students is considered a non-allowable cost. While students may not receive a stipend, the QI initiative can be a part of their learning experience. Including FTE for faculty to manage students would be considered allowable.
- Is funding for support staff at health systems an allowable cost?
Yes, a Fixed Site Participation Fee to help offset costs associated with site participation is allowed to support participating health systems for the staff time and data submission activities required when implementing QI activities. This fee should only be proposed if the CoM intends to actively implement QI activities at the clinic level in Year 1- which is currently beyond the required scope of work outlined in year 1 (capacity building). Revised 7/29/2022
Medicaid Managed Care Organizations (MCOs)
- What is the role of Managed Care Organizations in this initiative and how will they support each CoM?
CoMs should benefit from engaging managed care entities as well as other health plans in this initiative. It is up to the discretion of CoMs and such partners as to how they collaborate to pursue shared goals.
- What is the relationship to other structures with Medicaid (Buckeye Health, Partners for Kids) and how does this fit into the process?
Other Ohio Medicaid population health initiatives are synergistic with the envisioned implementation of this RFP. Serving as a CoM hub for regional quality improvement should generate valuable opportunities, in part through stronger coordination of various structures related to population health or alternative payment models.
Submitted Questions
- The RFP states that in SFY23 between $300,000 to $500,000 has been allocated for Regional QI Hub planning and implementation activities. Are these funds per applicant or the pool for all applicants?
- Is there any budget range estimate for the Project Year 2 and beyond at this time?
The funding available for Year 1 ($300K-$500K) is per applicant. Future years amounts will be dependent upon available funds. We do not have funding estimates that can be shared at this time.
- In reviewing the RFP and the budget template it does not appear that this award requires any matching dollars from the applicant. Is that correct?
- If there is no match required for Year 1 is that going to remain true for the following years?
Matching dollars are not a requirement in Year 1. Future matching amounts will be dependent upon the funding source(s) that ODM uses. However, we do not anticipate requiring match in future year funding.
- What is the anticipated project start date for SFY23?
We anticipate notifying awardees by end of September with an anticipated start date of October 1st.
- On page 8: item 5 “Using the budget form provided in Appendix IV of this document and budget justification narrative (Appendix D - not included in the page count) for SFY23” I do not see a template for the budget justification narrative. If there is not a template, what would you need to see in the budget narrative?
There is not a template for the budget justification narrative. The narrative should justify the expenses (examples of allowable costs are listed in a table under the Funding section) listed in the budget template submitted with the application. Personnel justifications should be limited to one paragraph or less.
- On page 8: Item 3 “Named Regional QI Hub leadership team’s Curriculum Vitaes (Appendix A – not included in the page count)” A question – some of these CVs can be quite lengthy, will you accept a biosketch?
A biosketch (NIH format preferred) will be accepted in place of a CV.
- Will a project that focuses on either hypertension or diabetes which were focus areas in the Case-led QI work be acceptable for this RFP?
Yes, the CoM may select Hypertension or Diabetes as the focus area. Please define in the application how your CoM would build on previous efforts in this area if applicable.
- In regard to FAQ # 3's answer, "...QI HUB will not duplicate funding of other QI activities/programs the COMs participate in. The intent is for the QI HUB to enhance QI activities across the state of Ohio.". Does this mean if the COM is already involved in Cardio or HTN both funded by Medicaid then we shouldn't do these same activities but find another topic (i.e. maternal health or mental health or diabetes) to work on?
The proposed QI topic should not duplicate activities currently funded by ODM for the current state fiscal year. If your institution selects a topic that ODM is already funding (e.g. HTN), ensure that the scope of work being proposed is new and does not overlap with other currently funded activities.
- Can you clarify further on FAQ # 10? For instance, over the last 5 years, we have found that the lost revenue of an hour of patients does have an influence on providers and their nursing staff not wanting to participate in QI initiatives. Does the Fixed Site Participation Fee include paying for the time of clinic staff and doctors to make up for lost revenue when not seeing patients or is it just for pulling data?
The Fixed Site Participation Fee is available to be budgeted by CoMs to support active implementation of QI activities at the clinic level. The amount allocated towards clinic activities would need to be clearly defined, including the name and location of participating clinics prior to expending those dollars.
- Can a QI Hub have Co-PI's (one in GIM or Med - Peds) and one from Family Medicine?
Yes. Applicants with Co-PIs will require a contact PI (PI) and the other will be listed as Co-PI.
- The term regional health care collaborative seems to be used very specifically. Are you referring to existing structures or would this be something we would create? (If they are existing structures, can we have lists of them?)
Regional health care collaboratives will depend on each applicant and their existing partnerships. While some applicants have existing collaborative agreements, some applicants will need to build on new or existing health care collaboratives. The application should provide specific detail for how the applicant will accomplish this in year 1.
- Can you please clarify the data stipend’s intended purpose?
The intended purpose of the data stipend is to ensure there is an outlined process for generating and submitting data used to track QI processes, outcome and balancing measures for the duration of the project.
- How do you want the application submitted?
Proposals may be emailed to: Crystal Phommasathit and Allison Lorenz. Once we receive the application, you will receive a note of confirmation.
- On appendix E (published research and outcomes from previous experience) and appendix F (letter of support from affiliated hospital). Page 8. You state below that appendix A-D are not included in the page count, but do not say that for appendix E and F. Since that section is 2 pages max, should Appendix E and F be included in the page count?
The maximum eight-page, single-sided, single spaced response excludes appendices. Appendix E and F are not included in the page count.
- Given that so much of the project will be infrastructure and build out, although we have a chosen project in mind, until we get more granular in the project design, I think that there will be some budget assumptions that we find might need to change as the project moves along. Will there be some flexibility in year 1 as to change in exact staffing needs, as long as the budgeted amount is not exceeded? Will there be a process for such exceptions?
Funded applicants can make cost-related changes, including re-budgeting of funds, as long as the scope of the project remains the same. To ensure compliance with MedTAPP prior-approval policies, we suggest you send a revised budget and budget justification to GRC Finance for review for any items that may need prior approval.
- What size and type of font do we use for the 8-page proposal?
Times new roman, no smaller than 11 pt. font.
- Can you verify so that we have it in writing that MEDTAPP dollars include federal funds?
The funding for this program comes from General Revenue Funds (GRF) and Federal Financial Participation funds (FFP).
- Can you verify that the indirect/overhead/F&A amount of 10% is inclusive of the total or in addition to the total?
The 10% F&A rate is inclusive of the total.
- Can we reach out to our City's Health Department practices to partner with us on this grant?
You may identify partners that contribute to the overall goal of addressing population health in your region. This may include health systems, local health departments, or providers you have previously partnered with.
- Can we reach out to individual FQHC practices to partner with us on this grant?
You may identify partners that contribute to the overall goal of addressing population health in your region.
- Can we designate and pay staff on the grant to be trained in PI and quality?
You may designate and pay staff to receive training in quality improvement science. Staff identified as Principal Investigators on the project should have experience serving in that role on previous initiatives.
- Can we designate and pay staff on the grant to begin to collect data on the topics in quality our practices want to do?
Each application should identify one topic. Funds may be used to support data collection, though the data must be able to be shared with the Ohio Colleges of Medicine Government Resource Center and the Ohio Department of Medicaid for the purposes of evaluating the impact of the quality improvement program.
Clarification: Year 1 is intended to support both the development of a QI Infrastructure that can be leveraged across QI projects, regardless of the topic, and is sustainable long term. Year 1 is also intended to identify the first QI topic that will be piloted, tested, and spread across multi-year QI effort to address population health. If the CoM does not have a topic identified upon submission of their application, they may use the first three months of funding (October 1-December 31) to identify a topic. GRC is available to support data efforts related to topic identification through Medicaid claims analysis at the regional and state levels. Additional data collection efforts related to topic identification should be minimal, with the majority of funds used to support QI infrastructure development and QI project development for Year 2 activities.
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