Vital Access Provider Program (VAP)

Table of Contents
I. General
II. Metrics
III. Payments
IV. Strategic Planner

I. General Questions

Question Number Question Answer
1 What expenses should be included in VAP Budgets? Incremental expenses for new VAP projects intended to reconfigure business strategies and clinical services to better meet community health care needs should be included. These operating costs can include both overhead costs and administrative costs. This includes, but is not limited to: utilities, wages, advertising, raw materials, office supplies and consumables.
2 What expenses are disallowed under VAP?
  1. Capital Expenses
  2. Costs that are considered general operations
  3. Salaries/FTEs that cannot be reasonably assigned to the VAP program
  4. Accounts Payable from non VAP related activities incurred before 4/1/13
  5. Operating Losses
  6. Rent and Leases
3 What are major red flags?
  1. VAP Project plan varying from the project described in the approved ´mini-app´ or approved submissions
  2. In kind contributions with no support
  3. Project Budget that does not go cash flow positive past the three year project horizon
  4. Use of funds for operating losses
  5. Capital dollars included
  6. No plan for sustainability
4 Our plan has changed from original plan. How do we handle these changes? If you are significantly modifying your original plan (to meet the same programmatic objectives/goals), you must receive Departmental approval. Your total award has been based on your original application and cannot be repurposed without Department approval. Please contact the Department to discuss.
5 Who should I contact? Contact info: Email:, Please use the following format for the subject Line: VAP - Facility Name.
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II. Metrics Questions

Question Number Question Answer
1 What are the rules regarding Metrics?
  1. Metrics are always numeric.
  2. Metrics should not contain text
  3. Metrics should demonstrate VAP goals and objectives
  4. Metrics should not be milestones
2 What types of metrics should the facility have? It is not necessary to have a metric for each objective; the goal of the metrics attachment is to demonstrate and measure the success of your project. As long as your metrics do this, they will be acceptable. Almost all projects will have multiple metrics in all three areas (Financial, Operating, and Quality); in rare cases quality metrics may not be applicable to the project.
3 What if the baseline metrics need to be determined? If possible, a baseline should be determined. Knowing your baseline also helps you to form your projections. As indicated in the instructions, if the metric is measuring a new initiative and a baseline is not available, a "0" should be entered in this case.
4 Should outcome on time line be verbatim the same on metric? They can be, but are not required to be, as long as we can see how the metric aligns with your objectives and how it measures the success of your program. Please be sure not to put milestones on Schedule E-Metrics
5 Are the benchmarks to measure performance assigned by NYS DOH? If not, do we submitt benchmarks to NYSDOH for approval prior to the submission of the first TMRAA? No, metrics are not assigned by the DOH. Providers are required to submit metrics appropriate to their program on their TMRAA submission.
6 Is there a minimum required number of metrics for each objective Regarding Metrics: must each project have 1 Financial, 1 Operational and 1 Quality metric? Depending on the project, not all categories of metrics would be applicable. There is not a minimum number of metrics; however, enough metrics should be included to demonstrate the success of the program. If not enough acceptable metrics are included, you will be asked to resubmit. It is extremely likely that a project will have multiple metrics in all three categories.
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III. Payment Questions

Question Number Question Answer
1 Will the total amount of the award be paid out quarterly over one year? The total amount of the award will be paid out over the duration of the approved TMRAA, typically one to three years, in quarterly payments.
2 As we submit quarterly reports and they are satisfactory, the full amount that was awarded in the letter will be paid in full prior to the end of CY 2014? Not necessarily, the full amount of the award will be paid out during the duration of the approved TMRAA, in quarterly payments. For example, the full amount of the award would be paid in CY 2014 if the award was just for the CY 2014.
3 Can you discuss the manner by which payments will be made to providers? Payments will be added to providers' Medicaid check in quarterly payments. Future payments will be made once a quarterly report is received and approved.
4 Is payment approved for Medicaid add-on in advance, and subject to changes in Medicaid volume? The VAP /Safety Net Program award is not being added to rates, but is being made in quarterly payments. It is not impacted by volume of claims.
5 Will the Centers for Medicare & Medicaid Services (CMS) approval hold up my payment? Please note that all VAP payments are pending Centers for Medicare & Medicaid Services (CMS) approval. The Department cannot release VAP awards until CMS criteria has been fully met. The Department is continuing to work with CMS staff to resolve issues such as customary charge cap limitations and FQHC approved payment methodology problems.
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IV. Strategic Planner Questions

Question Number Question Answer
1 Can we require the strategic planner to sign confidentiality agreements? Yes it´s possible, but it´s up to each strategic planner. Please discuss your concerns directly with your strategic planner.
2 How do we know if you assigned a strategic planner to our project. When/how will you notify us of that assignment? If our award letter says "may" be assigned strategic planner, are we getting one for sure? Providers are notified in their award letter whether or not they are assigned a Strategic Planner. If your award letter says "will" be assigned a strategic planner, you will be assigned one. The Department reserves the right to assign a strategic planner at any time.
3 Will the strategic planner come on sight? It is extremely likely that your strategic planner will make a site visit; however, this may not happen before the TMRAA is initially submitted.
4 What is the criteria for determining whether a provider needs a strategic planner? Providers receiving large VAP Awards and facilities deemed to need assistance to operate in a financially efficient manner will have a strategic planner (SP). The assigned SP can help guide them through the VAP funding requirements and ensure that funds are used efficiently, effectively and for the intended purposes. Some providers will be assigned strategic planners in the future that were not originally assigned a strategic planner.
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V. TMRAA Questions

Question Number Question Answer
1 What salary costs are appropriate for the VAP program? Salary expense/FTEs for new VAP initiatives or programs, recruitment and retention efforts and sign on bonuses are allowable costs. Please do not include operating losses, regular salaries and raises/increases.
2 We are concerned about being able to complete our TMRAA by the the deadline. Is there an extension period? This due date is firm and necessary in order to pay out awards before State Fiscal Year end. After the TMRAA due date, the Department will have a review period and either approve or ask awardees to resubmit/amend.
3 Should revenue be included in the TMRAA, or just expenses? Expenses should be included in the TMRAA. There are, however, two lines on schedule B for revenue. Provider in-kind contributions can be entered on line 65 of schedule B. This includes contributions other than VAP funds that have been given by either your facility or outside parties for the benefit of your VAP program. Incremental revenue to offset on line 66 should include the increased revenue from the implementation of the added services from your VAP program.
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