Q & A 19-444-26-1757-01 Opioid Use Disorder (OUD) MAT in Federally Qualified Health Centers (FQHC)

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Q & A 19-444-26-1757-01 Opioid Use Disorder (OUD) MAT in Federally Qualified Health Centers (FQHC)

Supplemental Documents

SUPR FQHC-NOFO Bidder's Conference (pptx)

DEFINITIONS RSS SERVICES (pdf)

RECOVERY SUPPORT SERVICE RATES (pdf)

MAT Deserts Map (pdf)

Q1: Is the narrative page limit 10 pages or 12 pages?

A1: The narrative page limit is 12 pages. It was misstated within the NOFO and has been corrected. The previous statement said, "The page limit for the Proposal Narrative is 12 pages. Any narrative information that exceeds the 10-page limit will be discarded and excluded from the review process." The new statement says, "The page limit for the Proposal Narrative is 12 pages. Any narrative information that exceeds the 12-page limit will be discarded and excluded from the review process."

Q2: Is the LOI required or optional?

A2: The Letter of Intent is optional, but strongly encouraged.

Q3: Is it required to be able to provide all three approved medications for OUD? How should methadone be addressed?

A3: If Methadone is used for the MAT, the applicant must have a referral agreement with a licensed SUPR organization and ensure that the MAT service is coordinated with the outpatient service delivered by the FQHC.

Q4: Can an applicant request less than $500,000?

A4: Yes. An applicant can request less than $500,000

Q5: Can you describe the SUPR reporting requirements or direct us to a location to learn more about those obligations.

A5: Prior to implementation of the program SUPR will provide the applicable state manuals and our DARTs software and or a record layout for inclusion in the EHR. Training and technical assistance will also be provided regarding the use of the manual and Software.

Q6: Is this PowerPoint going to be made available online to download?

A6: Yes the PowerPoint is available online.

Q7: May more than one FQHC work together for this funding opportunity? And if so would the max still be $1million

A7: We will not accept an application from two entities. If two entities want to partner they would have to submit separate applications and explain how they will work together.

Q8: I thought we couldn't see Medicaid patients.

A8:You can use this money to cover Medicaid patients for services that are not billable through the encounter rate.

Q9: If an organization is awarded, are they awarded a fixed grant amount or awarded the ability to bill and receive payment up to the grant amount, based on volume of care provided?

A9: FQHC's are able to receive payment up to the grant amount based on the volume of care provided.

Q10: Is the funding ONLY to be used for individuals with a diagnosed OUD who is uninsured or underinsured, not Medicaid eligible?

A10: The targeted population is any individual with a diagnosed OUD who is uninsured or underinsured, not Medicaid eligible and who meets the income guidelines established by SUPR as defined in the IDHS/SUPR Contractual Policy Manual FY 2019 .

Q11: I didn't understand the answer to the SUPR requirement question. Does DARTS directly work with our EHR to upload data to SUPR or will we need to document in the DARTS system separately? Thanks.

A11: Prior to implementation of the program SUPR will provide the applicable state manuals and our DARTs software and or a record layout for inclusion in the EHR. Training and technical assistance will also be provided regarding the use of the manual and Software. It will be your choice to either use the DARTs software independently from their EHR or use the money to integrate your two systems.

Q12: IS GPRA reporting also required? I suggest mentioning this again.

A12: Applicants will be responsible for administration of the baseline version of the SAMHSA/CSAT GPRA data collection to each person admitted to these expanded Recovery Home services. The baseline version of this tool shall be administered within 7 calendar days of the admission or opening date in DARTS. The funded organization will be responsible for completion of the abbreviated version of the SAMHSA/CSAT GPRA tool that is completed at time of discharge from the expanded Recovery Home services. IDHS/SUPR will provide training on the administration and completion of these SAMHSA/CSAT GPRA tool versions, along with instructions for the submission of completed tools. Six-month follow-up interviews will be conducted by a third party contracted by SUPR. The applicant will also be responsible for assisting the third party in the scheduling of telephone interviews for the six-month follow ups.

Q13: Can you give guidance on the section of the NOFO that says "priority will be given to proposed service areas with limited or no readily available resident access to OUD MAT services." I know a MAT map was released for 19-444-26-1693-01 Access to Medication Assisted Treatment (MAT) Pilot Grant, in which counties that were considered MAT deserts were the only eligible areas. Is that MAT map desert a good guide for eligibility?

A13: Services can be delivered statewide, but priority will be given to proposed service areas with limited or no readily available resident access to OUD MAT services. This should not however, limit or disqualify any proposal that is not a desert area.

Q14: Can we use these funds to support provider salaries, who will provide SUD services to everyone (Medicaid eligible, underinsured, and undocumented)?

A14: The SFY2019 agreements for successful applicants will contain fixed-rate budgets. Services are reimbursed via an established rate and are not based upon budget amounts. Revenue from fee for service reimbursement can be used by the applicant for any expense that is not prohibited by state or federal law.

Q15: If it is a fee for service contract then how would the budget look? Are we to project our billable services or program cost?

A15: Yes

Q16: How can an applicant determine how much the State reimburses for each SUD service, given that the award is actually an award to bill up to the awarded amount of funding.

A16: The Recovery Support Services Rates and definitions are attached.

Q17: If this is a reimbursement-based service how do the funds for the EHR compatibility become available to the grantee?

A17: If the FQHC is using funds to upgrade their EHR, the expense will be manually billed to SUPR.

Q18: Can we contact Joe if we have budget questions?

A18: Any questions that are submitted will be responded to through the Q&A link and not responded to directly through email.

Q19: What does the State post the determine reimbursement rates?

A19: The Recovery Support Services Rates and definitions are attached. Rates for outpatient services are defined in the IDHS/SUPR Contractual Policy Manual FY 2019.

Q20: Do you have priority geographies you are looking for with this grant?

A20: Services can be delivered statewide, but priority will be given to proposed service areas with limited or no readily available resident access to OUD MAT services. This should not however, limit any proposal that is not a desert area.

Q21: Even though we may add a specific request for EHR upgrades for compliance, are those expenses still to be reimbursed--after they are expended?

A21: If the FQHC is using funds to upgrade their HER, the expense will be manually billed to SUPR.

Q22: Can funding be used to cover medications?

A22: Funding can be used to purchase buprenorphine for uninsured patients. Entities must document that they are working towards insuring uninsured patients. SUPR will reimburse for medication through monthly vouchers. Costs should be itemized on the "other" line in your budget.

Q23: This money is to pay for non-Medicaid patients...so medication would not be paid for as the patient is not covered by Medicaid?

A23: Funding can be used to purchase buprenorphine for uninsured patients. Entities must document that they are working towards insuring uninsured patients. SUPR will reimburse for medication through monthly vouchers. Costs should be itemized on the "other" line in your budget.

Q24: If a second site of the same FQHC is added to the application, does the maximum limit for EHR revisions increase?

A24: As described in Part B, bullet point 3: Each FQHC may submit only one application. A FQHC seeking funding for more than one site, must indicate addresses of the sites in the application and may only request a maximum of $1,000,000 to cover all the sites.

Q25: The FY 2019 Contractual Policy Manual indicates an MAT reimbursement rate of $72.10 per week. Does this reimbursement code cover MAT for all three approved medications for OUD?

A25: No, that rate is only for methadone. We do not have a rate for Buprenorphine. That will be billed through Manual voucher.

Q26: What are the rates and service units for recovery coach / recovery support services? The FAQ document says the RSS rates and definitions are attached, but the link only provides service definitions not reimbursement rates.

A26: The rates are now attached.

Q27 : Can you clarify the Medication Assisted Treatment Weekly rate listed in the policy manual? Can an FQHC bill that weekly case rate all patients receiving MAT or is that restricted to Methadone? Can an FQHC bill that rate including those with Medicaid as the services described on page 13 are outside regular Medicaid encounter rate services?

A27: It is restricted to Methadone. FQHC's interested becoming an OTP can learn more at https://www.samhsa.gov/medication-assisted-treatment/opioid-treatment-programs

Q28: If a second site of the same FQHC is added to the application, does the maximum limit for EHR revisions increase?

A28: As written in Part B, bullet point 3: Each FQHC may submit only one application. A FQHC seeking funding for more than one site, must indicate addresses of the sites in the application and may only request a maximum of $1,000,000 to cover all the sites.

Q29: I am writing to ask about the budget for the OUD MAT Services in FQHCs grant program. Is it possible to ask for any funding for consultation services or training, particularly around the needed technology to report in the DARTS system, but also for any operational matters that would benefit from staff training? Any info you could provide would be greatly appreciated.

A29: IDHS/SUPR will provide DARTs training and technical assistance as described in the NOFO Section C #6. If you feel there are other training needs, you can propose it in your budget narrative. DHS/SUPR will consider what you propose and make a decision about approval.

Q30: Is there a service rate for medical visits for MAT by a DATA-waivered physician for those not covered by Medicaid? If so, what is the rate? None of the rates on page 6 of the 2019 policy manual seem to encompass medical visits by a physician.

A30: No, it's not covered. Medical services are not covered.

Q31: Our organization plans to expand our SUD program from 3 licensed SUPR sites to 5 sites by 2020. Can we license these sites in late 2019 and utilize funds from this SUPR funding?

A31: Yes. After the additional sites are licensed you can utilize the existing funds at those additional sites.

Q32: The rates for employment coaching, employment training, recovery skills, spiritual support and peer coaching are not in line with like services provided by contract providers. Why are they so much lower? A rate of $20.60 per hour doesn't cover the cost to provide the service if it is done in an individual session. If done as a group, the rate is less than the group contractual rate.

A32: These are not treatment services. These are recovery services and should be done by a Certified Peer Recovery Specialist.

Q33: Why is the recovery home rate less than the DASA contractual rate?

A33: That's an error on the attached Recovery Support Services Rates. The correct rate is in the 2019 Contractual Policy Manual, which is $53.48.

Q34: With regards to patient eligibility - can this funding be used for insured patients (who meet the FPL guidelines) who decline to use their current insurance through an employer because they don't want their employer to find out the are accessing SUD/OUD services?

A34: SUD/OUD services are protected under the federal HIPAA Privacy Rule (45 CFR Part 160). An employer does not have access to this information. IDHS/SUPR is the payer of last resort. An individual with insurance would not be eligible.

Q35: In the budget section, Where do I find a list of codes to enter in the Code column?

A35: The Recovery Support Services and Rates are listed on the Q & A 19-444-26-1757-01 The Column "Code" is not required to be completed in the Fixed Rate Budget Template.

Q36: In the budget section, Where do I find a list of codes to enter in the Code column?

A36: The Recovery Support Services and Rates are listed on the Q & A 19-444-26-1757 "Code is not required to be completed in the Fixed Rate Budget Template.