DMH CPTT/MHSA Meeting Notes, 041508

Here are my notes from the CPTT/MHSA meeting on Tuesday! My notes are only as good as the speed to which I can take them and my comprehension of the topic. Please be sure to double check and validate your understanding on this topic.

Bob Greenless hosted a CPTT meeting on April 15th, to update the contract providers on the MHSA Technology Project allocations and reimbursement process. The Contractor Technology Assessment Report forms / Budget Planning Request Package was just redistributed today.

• It was agreed that the deadline for contract provider's to submit the initial project proposal forms will be delayed to May 15th.
  
• The SLT meeting Friday resulted in a 70/30 split rather than 60/40, so providers will see their allocation amounts increase; this is an SLT recommendation to go to the board and has not been officially approved. I.e. for the $345M MHSA funding estimate, this results in a $7.8M increase. Karen will distribute the new allocation sheets.
  
• The State shared $449M at CIMH as the likely total rather than $345M, but the plan is still held at $345M; Bob proposes we send a second round request to the state when the number is finalized, rather than waiting for the final allocation. So, contract providers should only complete the initial Level 1/$345M column on the forms and may optionally fill in the $449M amount. Karen to send out updated Contractor Technology Assessment Report forms / Budget Planning Request Package .
  
• Bob will also have Karen revise the Technology Assessment Report forms (this was sent out today) to reflect that the amount requested is not the total project “budget” amt., but the “requested” amount. They will ask providers to also indicate the total project budget amount, if different from the requested amount and each agency’s ability to fund their entire project.
  
• Bob confirmed that the Criteria page is mis-worded and there is no necessity to implement EDI to the IS, only to the IBHIS, they will change wording. (this was corrected on forms sent today)
  
• No further definitions of the project categories on the forms and guidelines will be forth coming. Suggestion was made to define them yourself and keep in your files.
  
• You can ignore the word “Describe” on the Contractor Technology Assessment Report form, it will also be removed. Only need to select the project category for now.(this was corrected on forms sent today)
  
• Is/when is a phase or progress payment considered supplantation? No clarity was given in the meeting. We need the County to circulate a definition of supplantation that is relevant to this topic, with examples. I found this DMH MHSA definition online: http://www.comresearch.org/docs/DMH%20letter%20on%20non-supplantation%20Policy%2005-04.pdf
  
• Bob suggested that you can specify phases of the overall EHR-S project and submit these phases for reimbursement, as long as you avoid supplantation and the work does not begin until your project is approved.
  
• Bob indicated we can submit staffing costs for the project being submitted, even if the staff exists prior to project approval, provided the costs being requested for reimbursement are the hours spent on the approved project and for work commenced after approval. It is the allocation of their time spent on the approved project that is being reimbursed.
  
• The EHR-S user training lab question is still open, i.e can this be a project we submit for reimbursement if it is required for EHR-S implementation? Bob was concerned if it were to be used as a general lab, rather than EHR-S only. No clarity was given in the meeting.
  
• Can we submit progress payments for work that has not yet begun, even if the EHR-S contract was signed prior to the agency’s approved MHSA project? Bob indicated Yes, as long as work associated with the payment had not commenced prior to the approval date and it is not supplantation. This is significant clarification for anyone who has already signed an EHRS- agreement.
  
• The Jan 09 decision date is not the defining moment, it is the agency’s project approval by CIOB that deems funding release. When will contract providers’ project proposals get approved? If Bob gets delegated authority, then could be weeks to approve agency proposals, otherwise could be months.
  
• The detailed budget/plan documents agencies will submit for CIOB project approval are coming next and will be due in October/Nov tbd. The forms will be developed by the MHSA committee.
  
• These projects will require a separate contract with each contract provider. You will not start expensing the MHSA costs until you have these separate contracts.
  
• The project expenditures must be included on the cost reports, along with the Mental Health expenditures, as a separate line item, tracked separately. DMH Finance was represented by Winnie Suen who works with the providers on the cost report. Winnie agreed to add this to the training usually held in June for cost reports.
  

Some project examples come to mind for those who have already signed an EHR-S contract and for those that have already implemented one, but I am seeking some clarification whether they meet the guidelines, timing, and avoid supplantation issues.

DMH CPTT Minutes won’t come quickly for this meeting,……………….so please be sure to read them when they do come out, to assure they agree with what I captured here.

by Keely McGeehan, Sahara Management Solutions, Inc.