1. Health Information Technology Request for Grant Applications Applicants Conference November 21, 2006 10:00am - 1:00pm

2. Conference Panelists Bill Schroth - Moderator Anna Colello - Evaluation Co-Chair Ellen Flink - Evaluation Co-Chair Marybeth Hefner-DOH - GrantsAdministrator Janice Dee – DOH – HEAL NY Bob Veino - DOH - Legal Tracy Raleigh - DASNY - Finance Sara Richards - DASNY - Legal

3. HEAL NY - Phase III Support Federal Strategic HIT Plan Broad definition of Clinical Data Information Sharing Projects Principle: Large public interest in building clinical data sharing infrastructure Majority of funds to existing stakeholders Show community benefit and support

4. Financial Issues Funding for capital costs - Statutory 60% match funds required –Leverage grants –“Skin in the game” –Reduce to 50% in certain circumstances Financial viability –Real implementation, not temporary –Encourage payer involvement

5. Multi-stakeholders/Community Buy-in Across corporate/stakeholder boundaries Minimum requirements The more the merrier Openness to new stakeholders CAUTION: Make sure applicant is “eligible”

6. Technology Interoperability Existing standards, certification for EHRs Choice of platforms/vendors Prescriptive standards for e-Imaging and eRx Requirements Recommendations

7. Three Project Categories e-Imaging$10MM Public Health$10MM Clinical data sharing$32.875+ Million Increase proportionally if total Phase 3 amount increased

8. 1- e-Imaging: Interoperable Sharing of Imaging Data across a Community Imaging is the fastest growing medical expense Digital imaging increases diagnostic capability: resolution, contrast, historical images Opportunity to avoid duplication & unnecessary images Advanced technical standards Four (4) Requirements Decision/Recommendations Financial support from payers, possibly vendors Required: 20% funding from Payers Higher scores for larger payer and/or vendor financing Only 50% match required for projects utilizing existing PACS

9. 2 – Public Health Projects with specific public health functionality: Clinical laboratory data Medical records Connect with the clinical Detailed specifications and standards

10. 3 – Clinical Data Sharing – Provider infrastructure & connecting software for various projects E H R, eRX, and other Connect others to existing projects Connect Existing projects Projects in Geographic Areas where none exist E H R Certification eRX standards 3 Requirements Recommendations/Discussion

11. Regional Allocations Evaluation combines project quality and category with geographic distribution Right to alter grant/project size – hope not to use Three steps: Fill e-Imaging & public health categories Geographic distribution to specific 6 regions Remainder to highest scores statewide

12. 0 2 4 6 8 10 12 14 16 18 20 Western Northern NY Example: Step One - e-Imaging & Public Health Hudson Valley LICentral MILLIONSMILLIONS $ 5MM $2MM $0 $4MM

13. 0 2 4 6 8 10 12 14 16 18 20 Western NorthernNY e-Imaging & PHGeographic Quotas Example: Step Two – Geographic Quotas MILLIONSMILLIONS LIHudson Valley Central $5MM $2MM $4MM $3.1MM $11MM 0 2 4 6 8 10 12 14 16 18 20 Western NorthernNY e-Imaging & PHGeographic Quotas Example: Step Two – Geographic Quotas MILLIONSMILLIONS LIHudson Valley Central $5MM $2MM $4MM $3.1MM $11MM

14. $0 $4 $8 $12 $16 $20 Western Northern NYC e-Imaging & PHGeographicHighest Remaining Scores Example: Step Three – Highest Remaining Scores LI Hudson Valley Central $5MM $8MM $4MM $9MM $20MM $7MM MILLIONSMILLIONS

15. Capital Costs and Matching Funds Project Phases –Preliminary design phase –Software development phase –Post-implementation/operational phase

16. Preliminary Design Phase Costs apply only to matching costs Direct costs only Must be incurred 10/1/06 or later

17. Software Development Phase Costs can apply to match or be reimbursable Direct costs only If used for match, must be incurred 10/1/06 or later If used for reimbursement, must be incurred after contract start

18. Post-Implementation/Operational Phase Costs apply only to matching costs Direct costs only Must be incurred after contract start date

19. Examples of Allowed Costs Payroll for staff directly involved Payroll related costs (employee benefits) Travel for direct staff Hardware Software purchase - specific to project Software development by third party

20. Eligible Applicants Legally existing corporation licensed to operate entity Section 3.2 in NYS of RGA May be an eligible applicant for only one application, but may be a stakeholder in one or more applications May be Clinical Information Data Exchange made up of Section 3.2 entities and must exchange data with stakeholder of a different category

21. Stakeholders Same entities as eligible applicants with the addition of adult homes with assisted living programs, hospices, payers, pharmacies and labs Must be medical entity to qualify and the more appropriate organizations that partner the better May be part of multiple applications

22. Requirement to Certify that:  I will make every effort to ensure that the applicant will be consistent with the goals and recommendations, when available, of the Commission on Health Care Facilities in the Twenty-First Century, as established pursuant to Section 31 of Part E of Chapter 63 of the Laws of 2005.  I will make every effort to ensure that the applicant will design a project which is interoperable and adheres to the national standards for their type of Project.  I certify that the work covered by the Grant Disbursement Agreements (“GDAs”) shall be deemed “public work” subject to and in accordance with Articles 8, 9 and 10 of the Labor Law, if applicable.  I certify that the applicant will collaborate with other grant recipients in their region and with the Department of Health on the development of statewide standards.  I certify that the information contained in this application and attached materials are accurate and true.  I certify that the funds received pursuant to subdivision 1 of section 2818 of the Public Health Law will be expended solely for the purposes for which the monies were awarded under the RGA for __________________________________. Attachment 6 (Name of Facility)

24. Evaluation Criteria The Technical component is worth 70% and the Financial component is worth 30% Minimum score of 65 to be eligible for consideration Within the technical component, the areas of most importance are: quality, technology and community buy-in/commitment The technical component and financial component will be reviewed by separate teams An awards committee will make the final award determinations

25. Evaluation Criteria Project Description-40 points Technology-20 points Project Evaluation / Monitoring -10 points Financial - 30 points Cost effectiveness Financial viability

26. Review Teams Program Teams Technology Teams Financial Teams

27. Award Criteria Considerations Strength and scope of overall Project Availability of funds Responsiveness to the goals and objectives of HEAL NY and RGA Evidence of substantial applicant organizational capability, support, and commitment Financial commitment and viability

28. Submitting the Application Applications must be prepared using the forms on the website, including the budget and certification. Attachments can be found at: http://www.nyhealth.gov. /funding/rfa/0610100951/index.htm Applications should be submitted to: Robert Schmidt Director, HEAL NY Implementation Team New York State Department of Health Hedley Building, 6th floor Troy, NY 12180

29. Questions due by November 27, 2006 Questions & Answers will be posted December 1, 2006 at http://www.nyhealth.gov/funding/rfa/06101009 51/index.htm Application due date - January 8, 2007 Anticipated Award Date - Spring 2007 Key Dates