Q:  If a private training institution is part of the MiRSA, why are they being excluded?

A:   It has been determined that while the private training institution cannot receive DSH funds directly from the hospital, private schools may partner with publicly funded training institutions and participate in a subcontracting capacity.  These arrangements will need to be reflected in the training agreement with the hospital.

Q:  Does 44% match have to come out of the public training institution’s budget?

A:   Yes.  The match must be a “local” match from the publicly funded training institution or a combination of local matching funds with a private school qualifying match (must not be federal funds or student tuition payment as also stated below for publicly funded applicants).

Q:  Can the 44% match be in-kind or is it required to be a cash match?

A:   The 44% match must be cash.

Q:  Can a training institution’s budgeted funds count towards the match?

A:   Yes.

Q:  When does the 44% match come back to the public training institution?

A:   Once the 44% cash match has been received by the Department of Community Health, the draw down of Medicaid funds by the hospital would occur within one week of receipt of the match.  The training agreement between the hospital and the Michigan publicly funded training institution should articulate a prescribe pay-out by the hospital to cover the 44% match and the balance of the negotiated training program(s) budget.

Q:  Can tuition revenue fund the 44% match?

A:   No.

Q:  Can the students/trainees go out of state to find jobs within the healthcare industry?

A:   We can’t control this.  Training institutions/hospitals should be working with their Michigan Works! Agencies to provide job placement opportunities for trainees.  The proposal should state what efforts would be made to place trainees in the local area after training.  The general idea is that the trainee stay and work within Michigan at the very least.

Q:  As part of the application, do we need to supply our training agreement?

A:   No the signed training agreement(s) will not be required upon submission of the proposal.  The signed training agreement will be required prior to DSH funds being released to the hospital.

Q:  Will the State be reviewing performance outcomes?

A:   The State will be asking for reports.  The initiative covers two separate fiscal years (FYs) (2005 and 2006).  Any performance issues will be addressed prior to the release of funds for fiscal year 2006.

Q:  Can the funds be used to provide clinical opportunities for current students rather than increase the number of new students?

A:    Yes, in some cases where a critical shortage is being addressed.   However, it would be viewed favorably if these clinical opportunities were designed or offered in innovative ways in order to hasten completion of the students’ program. 

Q:  If a training institution needs to increase capacity, there would not be enough time to submit an application to the State Board of Nursing and receive approval prior to the due date of the application.  How will this be addressed?

A:   As long as this is in your application this will not be a problem.  However, there needs to be assurance that the approval would be received in a reasonable amount of time for the project to move forward in a timely way.

Q:  Can a long-term care facility provide clinical rotation space or preceptors?

A:   Yes but preceptors need to be bachelor degreed RN’s as required by the Board of Nursing.

Q:  Can there be more than one training model in the proposal?

A:   Yes.

Q:  If someone is already licensed in a health care field can they provide further training (i.e., incumbent worker training).

A:   The intent is to get new workers into the health care industry.  But, training for incumbent workers can be provided if the need for such training is demonstrated and it is shown that it will create opportunities to backfill slots created by advancement (career laddering).

Q:  The application refers to proposals being developed to meet exclusive needs of the hospital or multiple health industry employers in a region.  What is a region?

A:   The State has not defined regions or geographical boundaries for the purposes of this proposal.  It is expected that the regions will be defined by the participating MiRSAs.

Q:  Where can the labor market information be obtained for shortages in a specific area?

A:    They can be obtained from the Bureau of Labor Market and Strategic Initiatives at http://www.michlmi.org/or by opening the Health Care Workforce Development in Michigan Report link.

Q:  There are four training models used in the application, can other training models be used?

A:   Yes, however the need for training that is identified in the model must clearly demonstrate a critical need.  Also, for nursing programs the minimum level of training must lead directly to an LPN degree.

Q:  Where should proposals be submitted?

A:   The proposal should be submitted to the DLEG – Bureau of Workforce Programs.  (Note:  The address is contained in the application.)

Q:  Who submits the proposal?

A:   The hospital is considered to be the applicant.  The partnering training provider (public university, community college, or consortium of the two) will still need to sign-off on the proposal as well per the application directions.

Q:  When will the proposals be approved?

A:   Grantees will be announced around the first part of June 2005.

Q:  The earlier application showed that the public training institution was the applicant.  Why has that been changed to the hospital?

A:   The reason for the change is the DSH funds are Medicaid funds, which must go directly to the hospitals.

Q:  Why can’t employers supply the match?

A:   Federal regulations do not allow this.

Q:  Is there a listing of what is considered permissible match funds?

A:   There is no listing.  State and local funds can be used as a match.  Federal funds cannot be used toward the match.

Q:  Can general and state funds allocated to the publicly funded training institution be used as a match?

A:   Yes.

Q:  Will non-participation in this initiative jeopardize future DSH payments?

A:   No.

Q:  If a publicly funded training institution and hospital are not part of an existing MiRSA are they eliminated?

A:      Collaboration with a MiRSA is a requirement of the application.  Hospitals and publicly funded training institutions will need to partner with an existing MiRSA

Q:  Is there a listing of which hospitals receive DSH funds and if so, can we receive such a list?

A:    Yes.    Here is the list of hospitals.  Further questions regarding the list should be posted on the web-site.  The questions will be directed to our contact at the Michigan Department of Community Health.

Q:  The application refers to increasing retention of trainees.  Can you explain retention?

A:   It is expected that efforts will be made to place or “retain” individuals after the training period for employment in the region, as well as at a specific employment site.

Q:  Can these funds be used for post employment supportive services?

A:   No.  The expectation is that other resources would be drawn upon through the MiRSA partnerships to address some of these support issues.

Q:  Who will be responsible for a single audit?

A:   Upon further research it has been determined that the hospital will be responsible for the audit.  The partnering training institution must be prepared to participate in the audit process and retain all necessary documentation to support the Medicaid funding received from the hospital in payment for contracted services rendered.

Q:  Do trainees have to be retained or placed into employment by the hospital that is receiving the DSH funds?

A:   No, but a job placement, preferably in the region, is the desired outcome.

Q:  Can the funds be carried over from the fiscal year they were received?

A:   Yes.

Q:  Can the DSH funds be used for scholarships?

A:   This issue is under consideration.  Decision to be posted as soon as possible.

Q:  If three hospitals are included in the proposal is there a lead applicant or are all three hospitals considered to be co-applicants?

A:   Only hospitals requesting DSH funds are considered applicants.  The hospitals would be considered co-applicants if all three hospitals were requesting DSH funds in the same proposal.  Three training agreements would be needed for each hospital in this scenario.  If one hospital is requesting DSH funds and the other two hospitals are participating in the project in some other way, the roles of the two hospitals not requesting funds would need to be explained in the proposal and each would need to provide letters of commitment or participation on company letterhead.

Q:  Who is the applicant if more than one applicant is a hospital and all are included in the proposal, but only one of the hospitals received DSH funds?

A:   The application should come from the hospital that receives the DSH funds.

Q:  Do training programs need to start this fall?

A:   No, training can start at anytime after funds are received.

Q:  Can the funds be used for capital equipment?  If yes, is there a percentage limitation?

A:   Yes, with justification, funds can be used for capital equipment such as additional lab equipment needed to expand a nursing program.  The expectation is that equipment costs should be directly related to training individuals and justification for the equipment would be provided in the application.

Q:  Can the funds be used for building modifications or expansion?  If yes, is there percentage limitation?

A:   No.  Funds cannot be used for capital building modifications or expansion.

Q:  There is a proposed CNA to LPN educational track.  Given the overall training provided to medical assistants, could there be a medical assistant to an LPN track?

A:   Yes, other models leading directly to an LPN degree are acceptable.

Q:  Given that we want more RNs as a result of the initiative, would the State consider proposals for an accelerated associates degree in nursing, just as we are looking for proposals on accelerated BSN programs?

A:   Yes, it is fully intended that AD program proposals that look at accelerated strategies would also be considered.

Q:  Since the MiRSAs are an important part of the initiative, could the various proposals being presented include dollars to support the RSA?

A:   No.

Q:  Do we need to submit a separate proposal for each fiscal year?

A:   No.  One proposal should cover two fiscal years with a separate budget included for each fiscal year.  Budget one should cover from the initial award to September 2005.  The second budget should continue from October 2005 through 2006.

Q:  What is the State’s expectation for sustainability?  Does this need to be addressed in the proposal?

A:      Sustainability is not required to be addressed as a part of the proposal.

Q:  Is there any limit to the amount being requested?

A:   No.

Q:  If there is more than one publicly funded training institution partnering in this proposal can the match requirement be split between them?

A:   Yes.

Q:  Can the funds be used for soft skills training?

A:   No, but training entities may partner with the MWA to bring trainees up to speed.

Q:  Is there an indirect cost limit?

A:   No.  Cost should be reasonable, within the 15% to 20% range.

Q:  How long can funds be carried forward?  What is the deadline for expenditure of FY05 and FY06 funds?

A:   No specific time frames have been set for carrying funds forward.  The general expectation is that most of the training activity should be nearing completion by the end of calendar year 2006.  The proposal should clearly state how the funding will be spent and indicate the expected budget expenditure timeline.

Q:  Describe the adjectival rating system to be used during the proposal review.

A:   Rating criteria are included as part of the application packages.  The adjectival rating system will not be published.

Q:  May a post secondary training institute that is currently developing an accelerated training program apply for the DSH funds to help support some sustainability over the next one and half years.

A:   No.  This is not a planning or sustainability initiative.

Q:  What changes were made in the revised application?

A:    Here is the  Change Comparison Chart of the Initiative Revision.

Q:  Will you provide a list of the attendees from the DSH meeting?

A:   No, due to time constraints.  A list will be provided upon written request.

Q:  Will the State ask for clarification of proposal items during the review process?

A:   That is a possibility.

Q:  Can a publicly funded training institution qualify to apply for this initiative by applying to become a MiRSA?

A:   The publicly funded training institution can partner with an existing MiRSA or a hospital that is affiliated with a MiRSA.

Q:  Would you tell me if Michigan Works! in Ypsilanti would be an approved MiRSA partner for the DSH Initiative?

A:   The Washtenaw County Michigan Works! is part of the Southeast Michigan Long Term Care MiRSA.

Q:  Is a public school district eligible to participate as a partnering training provider?

A:   No, public school systems are not eligible to participate in this initiative.