Waiver FAQ

Waiver FAQ
Date posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	Who is actually responsible for the report? Was it developed by JPS Staff members or authored by an unnamed 3rd party consulting firm?
Response:	The assembling of the Region 10 plan is a joint effort of many individuals and organizations. Those providing significant content include JPS as the anchor organization, participating performing providers, and subject matter experts (waiver subject matter experts and legal) as needs were determined by each performing provider

Waiver FAQ
Date Posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	How much did it cost to prepare this report?
Response:	The cost for all performing providers in the region is unknown. JPS’s external cost to complete the plan was approximately $2.5 million. These costs are funded through DSRIP funds.

Waiver FAQ
Date Posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	Starting on page 16, there are 20 pages of Category 1-2 projects. What were the criteria used to select these projects versus (other than an apparent healthcare institution’s wish list)?
Response:	The criteria for project selection were driven from a menu of projects spelled out by the Center for Medicare and Medicaid Services (CMS) and Texas Health and Human Services Commission (HHSC). The requirements can be found in the RHP Planning Protocol and Program and Funding Mechanics Protocol documents located on HHSC’s website. These requirements can be found at: http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml. Performing providers were then allowed to select projects within the parameters of these guidelines where the provider could demonstrate a need through a community needs analysis.

Waiver FAQ
Date Posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	There are enormous technology requirements underlying these 20 pages of projects. These include: a. IT infrastructure (in-house, host, cloud) b. Networks / communications (telephony, mobility, BYOD) c. Applications (clinical, patient billing, electronic health records, analytics, etc.); and, d. Systems integration underlies these 20 pages of projects. e. What is RHS overall strategic IT plan for all these requirements to ensure the projects’ successful outcomes and timely implementation, and minimize redundancy and cost overruns, etc.?
Response:	HHSC and the performing providers are currently assessing IT needs and requirements. Final determination of those requirements cannot occur until after final plan approval by CMS which is targeted for May 1, 2013.

Waiver FAQ
Date Posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	Who is responsible for the preparation for this strategic IT plan?
Response:	Strategic planning is a joint function of the Board of Managers and Senior Leadership.

Waiver FAQ
Date Posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	Are these technologies costs included in the budget numbers on the right side of the page? If so, what amount of these budgets is allocated to address the technology requirements?
Response:	The waiver does not permit a cost passthrough approach. All project valuations are based on the estimated economic impact that a particular project has on a defined population of patients through an associated intervention. Final valuation amounts will be determined by CMS in the final approved plan.

Waiver FAQ
Date Posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	If they are not included in these budgets, then what are the technology budget numbers?
Response:	The preforming providers are currently developing long term business plans and projections of cost needed to fully implement the plans. Final determinations will be made once CMS provides full plan approval.

Waiver FAQ
Date Posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	What is the difference between the anticipated revenue and costs of these projects, the difference which will have to be made up by the Counties (and specifically Tarrant County as the largest county in the RPS)?
Response:	As per question #7, the net differential of project revenue and costs is currently being assessed and final determinations will occur after CMS provides final plan approval. If a project cost more than the available funds, a performing provider will have to choose from multiple options including: discontinuing the project, subsidizing the project from gains on other projects, or subsidizing the project from other operating funds, reserves, or efficiency gains.

Waiver FAQ
Date Posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	What are the Counties plan to address these revenue gaps?
Response:	Not fully known at this time. All performing providers are developing implementation and business plans as the Region 10 plan is being reviewed by CMS.

Waiver FAQ
Date Posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	What is being done to integrate the RHS technology strategy with the Counties planned technology strategies to minimize redundancies and duplicate costs? How can these technology strategies combine to save money and improve service?
Response:	We understand that HHSC has an RFP underway to develop an information database system to support the reporting requirements of the DSRIP projects beginning in DY3 of the Waiver (October 1, 2013). The anchors have been advised that they will be notified of these requirements by HHSC once the RFP selection has been completed.

Waiver FAQ
Date Posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	What is the best, most effective strategy(ies) to procure these technologies, especially concerning the short timeline to comply to the Texas HHS requirements?
Response:	JPS has been evaluating how to best provide the reporting of milestones and metrics with newly installed EPIC system and with other internal systems infrastructure. The SVP for Quality and IT leadership (CIO) are currently assessing alternative project management programs to support DSRIP project owners in the implementation of DSRIP projects. IT Infrastructure needs by non-JPS entities are unknown at this time by JPS.

Waiver FAQ
Date Posted:	March 19, 2013	Requestor:	Dan Fernandez
Question:	How will the structural infrastructure be procured (e.g. additions to JPS and other medical institutions)?
Response:	IT infrastructure for JPS will be procured through the standard JPS procurement processes. Non-JPS infrastructure will be secured directly by the performing providers.

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