1. AMCH PPS WCC Monthly Meeting May 12, 2016

2. AMCH PPS WCC: Agenda Items

3. Workforce Compensation and Benefits Analysis Preliminary Summary Findings from Iroquois Health: AMCH invited 177 organizations, more than any other PPS. Participation rate was 37%. May be able to increase that participation rate by incorporating other organizations from neighboring PPSs surveys (Alliance, AHI, and Bassett). 65 organizations participated in the survey. AMCH PPS had the most respondents out of 6 other PPSs who engaged Iroquois Health to conduct the survey. The AMCH survey accounted for 17,278 individuals employed across 65 job titles, with 1,144 position vacancies reported, or an average vacancy rate of 6.62%. The top 8 job titles with the highest position vacancy rates were: Psychiatric Nurse Practitioners LPN Care Coordinators/Case Managers Community Health Workers RN and NP Care Coordinators/Case Managers/Care Transitions Peer Support Worker Coders / Billers Psychologists Psychiatric Aides / Technicians

4. Workforce Strategy Spending Workforce Strategy Budget Funding TypeDY1 Projected SpendDY1 Actual Spend Retraining$613,996$10,250 Redeployment$78,793 Recruiting$59,475$254,565 Other$126,750$526,125 Total $879,014$790,940 (80% and 25% discount) $527,408$790,940 Retraining- Performance Logic ($10,250) Recruiting- PMO Salary ($254,565) Other- Iroquois ($19,125) & Accenture IT ($507K)

5. Spending Commitment Logic Model YearCurrent ValidationValidation DY180% of DY1 spending commitment DY280% of DY2 spending commitment80% of cumulative DY1 + DY2 spending commitment DY385% of DY3 spending commitment85% of DY1 + DY2 + DY3 spending commitment DY490% of total spending commitment *A discount factor” of 25% will be applied to the PPSs’ DY1 workforce spending commitments. This will be reallocated across the remaining DSRIP years.

6. Workforce Policy Guidance Update (04/27/2016) Salaries are not permissible except for those in the PPS whose primary job function is to: Manage the PPS Workforce-related activities. Manage and/or provide training related to DSRIP objectives. Provide DSRIP project management support related to DSRIP workforce or training efforts. PPS can charge a portion of the PMO staff salaries for any PMO staff engaged in the support of DSRIP workforce efforts. PPS will need to establish a reasonable allocation methodology to apportion the PMO staff salary expenses for the purpose of reporting these costs under the Workforce Strategy Spending.

7. Providers in our PPS who already use Health stream for training purposes: Columbia Memorial Health Saratoga Hospital Eddy Visiting Nurse Association Planned Parenthood Mohawk Hudson, Inc. Next Steps: -Site configuration -Import files data collection -Administrator training -Training needs assessment

8. May 12, 2016 DSRIP WORKFORCE STRATEGY MEETING ALBANY MEDICAL CENTER HOSPITAL PERFORMING PROVIDER SYSTEM

9. 9 BDO Consulting AGENDA BDO Team Members & Responsibilities DSRIP Workforce Deliverables & Deadlines Future State Microsimulation Model Overview GAP Analysis Transition Roadmap

10. 10 BDO Consulting BDO TEAM MEMBERS & RESPONSIBILITIES BDO Center for Healthcare Excellence & Innovation Support and ensure overall project execution and the completion of all related DSRIP Workforce Milestones for submission to the Department of Health IHSDevelop future workforce state and transition roadmap analysis through the use of a microsimulation model BDO, along with our partners HIS, have been engaged by the Albany Medical Center Hospital Performing Provider System (AMCH PPS) to support the completion of the DSRIP Workforce Strategy deliverables for the Future State.

11. 11 BDO Consulting DSRIP WORKFORCE DELIVERABLES & DEADLINES Workforce Milestones BDO Project Target Deliverable Date Define Target Workforce StateDraft 6/23/2016 Perform Detailed Gap Analysis Between Current State Assessment (current state assessment report) of Workforce and Projected Target State 8/31/2016 Create Workforce Transition Roadmap for Achieving Defined Target Workforce State 9/30/2016

12. 12 BDO Consulting FUTURE STATE MICROSIMULATION MODEL: METHODOLOGY IHS is developing the target workforce state for the PPS using a microsimulation approach to model workforce demand Key steps in the methodology include: I.Development of a county-level, representative population II.Predicting the use of health care service utilization, by setting and type of provider III.Produce aggregate health care use projections by care setting IV.Translate health care encounters into workforce demands

13. 13 BDO Consulting FUTURE STATE MICROSIMULATION MODEL METHODOLOGY Workforce demands will be impacted by the changing demographics of population served Provides a baseline, and illustrate changes in workforce demand independent of DSRIP Anticipated impact on health care service utilization and in turn providers, per project Ideally, inputs and results from previously executed DSRIP project would be used New staffing patterns as a result of DSRIP projects

14. 14 BDO Consulting GAP ANALYSIS Current State - Staffing FTEs and headcount Vacancies Current/existing resource shortages Job requirements (education / experience) Use of agency and temporary staff Recruitment resources Current/existing resource shortages Current training and development Current State – Infrastructure & Culture Existing CBAs Current IT systems to support the workforce Cultural competency workforce programming & planning

15. 15 BDO Consulting TRANSITION ROADMAP Staffing Recruitment Training and Development Deployment Retention Development of “New DSRIP Positions” Growth in Certain Care Settings Planned Reduction in Certain Care Settings New Care Delivery Models New Integrated Delivery Systems Expanded Use of Integrated Technology and Sharing of Information Infrastructure Compensation & Benefits Collective Bargaining Agreements & Labor Relations Culture Cultural Competency & Diversity and Inclusion Change Management Employee Engagement

16. About BDO Consulting BDO Consulting, a division of BDO USA, LLP, provides clients with Financial Advisory, Business Advisory and Technology Services in the United States and around the world, leveraging BDO’s global network of over 55,000 professionals. Having a depth of industry expertise, we provide rapid, strategic guidance in the most challenging of environments to achieve exceptional client service. For more information, please visit www.bdoconsulting.com. About BDO BDO is the brand name for BDO USA, LLP, a U.S. professional services firm providing assurance, tax, financial advisory and consulting services to a wide range of publicly traded and privately held companies. For more than 100 years, BDO has provided quality service through the active involvement of experienced and committed professionals. The firm serves clients through 52 offices and more than 400 independent alliance firm locations nationwide. As an independent Member Firm of BDO International Limited, BDO serves multi-national clients through a global network of 1,264 offices in 144 countries. BDO USA, LLP, a Delaware limited liability partnership, is the U.S. member of BDO International Limited, a UK company limited by guarantee, and forms part of the international BDO network of independent member firms. BDO is the brand name for the BDO network and for each of the BDO Member Firms. For more information, please visit www.bdo.com.

17. DY2, Q1 & Q2 Workforce Milestones & Deliverables Milestone 1: Define the Target Workforce State (Milestone due by DY2, Q1) Task: Perform a Future State Staffing Analysis at the project level to assess resources required for project implementation and incorporate into workforce roadmap. Task: Work with individual providers and workforce vendor to assess future state staffing needs by site and incorporate into workforce roadmap. Task: Define Target Workforce State and present to PAC Executive Committee for adoption. Milestone 2: Create a Workforce Transition Roadmap for Achieving the Defined Target Workforce State: Task: In collaboration with the training vendor, analyze gap analysis, workforce survey, CNA, and other resources to determine gaps for each project. The WCC will develop project specific timelines for the retraining, recruitment, and redeployment of workforce. Task: In collaboration with the training vendor, develop strategies to alleviate PPS workforce gaps. These strategies will be outlined in the workforce transition roadmap.

18. DY2, Q1 & Q2 Workforce Milestones & Deliverables Milestone 3: Perform Detailed Gap Analysis between Current State Assessment and Projected Future State: Task: Based on workforce needs, conduct a capacity and workforce shortage assessment to direct the Roadmap to highest areas of need: Task: Expanding on the work product of the previous milestone, create a detailed process for monitoring the gaps identified in the workforce. Milestone 4: Produce a Compensation and Benefits Analysis (Milestone due by DY2, Q1) Task: In collaboration with the workforce vendor and other regional PPSs, contract a third party to conduct an extensive review of compensation for all levels of the workforce. Task: Once aggregated data is received, analyze the aggregate data by position, project, and employment status to determine workforce impact. Task: Collaborate with training vendor to develop retraining and re-deployment strategies to ensure placement for retrained and reassigned workers: Task: Present summary aggregate compensation and benefits analysis report to PAC Executive Committee for review and approval.

19. DY2, Q1 & Q2 Workforce Milestones & Deliverables Milestone 5: Develop a Training Strategy: Task: Conduct an assessment of existing workforce training programs via survey. Task: In collaboration with the training vendor, assess the workforce survey to identify training gaps within the PPS. Submit Baseline for Staff Impact Analysis (Required Documentation for the DOH) Receive aggregated data from Iroquois Health to help the WCC develop the baseline numbers for the impact analysis..

20. Open Forum

21. AMCH PPS Workforce Team Contact Information Zoe Isdell: DSRIP Project Manager IsdellZ@mail.amc.edu (518) 264-5193 Ronald Santiago: DSRIP Project Coordinator santiar@mail.amc.edu (518) 264-4556 Erin McLaughlin: DSRIP Project Coordinator mclauge1@mail.amc.edu (518) 264-4559 AMCH PPS Website: http://www.albanymedpps.org/