An Update on the American Recovery & Reinvestment Act (ARRA)

Is Your North Carolina Community Ready to be a Beacon Community?
On December 2 the Office of the National Coordinator for Health IT (ONC) announced the Beacon Communities program. This $10 - $20 million per community Cooperative Agreement funding announcement has already caught the attention of many NC communities. If your community is interested in applying, the NCHICA Development Committee is supporting submission of one or more successful applications from NC. Please contact Andrew Weniger at andrew@nchica.org if your community is ready to pursue an application or if your organization can contribute to the success of NC. Following are some highlights of the funding opportunity announcement:

• The goal is to accelerate a community's use of health IT to achieve measurable improvements in health outcomes.
• Eligible applicants are non-profit organizations or government entities representing geographical communities where those communities are already national leaders in the advancement of health IT, workflow redesign and care coordination, or quality monitoring and feedback.
• Funds can be used for health IT and exchange infrastructure improvements, training, patient engagement, quality reporting repositories and other functions that do not duplicate other Federal funding efforts and that advance the community's population health goals.
• At least five communities are expected to be located in or include substantial rural areas.
• A mandatory Letter of Intent is due on January 8, applications are due on February 1, and the award period is over 36 months.

According to National Coordinator for Health IT Dr. David Blumenthal: "The core goal of the Beacon Community Program is to advance specific health improvement goals through interoperable health IT and standards-based information exchange within and among providers, hospitals, and populations. In other words, Beacon Communities are designed to be the proving ground for meaningful use of EHRs and health information exchange, where we test the proposition that health IT adoption as envisioned does actually improve health care in measurable ways, and in different types of health communities. These communities will also show that safeguards for the privacy and security of sensitive health information are both feasible and effective. The Beacon Community entities ultimately selected for participation in this program will be diverse and representative - large and small, urban and rural, prosperous and underserved. But they will have two things in common: they will all be well above-average users of health IT, and they will be fully committed to employing health information exchange within their communities."

Click here to read the funding announcement, and click here for comments by Dr. Blumenthal.

ARRA Section 3012 Regional Extension Centers
North Carolina's application for a statewide Regional Extension Center was submitted to ONC by the AHEC team, and remains under review. If the currently announced schedule remains in place, the program could begin in the second half of January.

Meaningful Use
Announcement of the NPRM on the requirements for meaningful use is expected to be published by HHS this month. NCHICA plans to submit comments on the proposed rule - please email Tara Waechter at tara@nchica.org if you'd like to be on the comment team, and put "meaningful use comments" in the subject line.

ARRA Section 3013 State-wide HIE - Work Groups for NC Operational Plan
The NC Health and Wellness Trust Fund is continuing to prepare elements of the Operational Plan through regularly scheduled NC HIT Collaborative and associated Work Group meetings. NCHICA continues to assist in whatever ways possible to increase the likelihood of success for North Carolina. To be notified of the schedule for these meetings or to join one of the Work Groups, please send your contact information to: Kortney Smith, kortney.smith@healthwellnc.com, Special Projects/Executive Assistant, NC Health and Wellness Trust Fund,
Woodoak Building, 1100 Navaho Drive, Suite 203, Raleigh, NC 27609, (919)-855-6882.

Work Groups include:

• GOVERNANCE
  Purpose: Convening health care stakeholders to create trust and consensus on an approach for statewide health IT and to provide oversight and accountability of health IT to protect the public interest. One of the primary purposes of a governance entity it to develop and maintain a multi-stakeholder process to ensure health IT among providers is in compliance with applicable policies and laws.
• TECHNICAL INFRASTRUCTURE (next meeting NC HWTF, 12/14, 10:00 am - 1:00 pm)
  Purpose: This domain includes the architecture, hardware, software, applications, network configurations and other technological aspects that physically enable the technical services for health IT in a secure and appropriate manner.
• LEGAL AGREEMENTS & POLICY
  Purpose: The mechanisms and structures that address legal and policy barriers and enablers related to HIE which include: policy frameworks, privacy and security requirements and use, data sharing agreements, laws, regulations, and multi-state policy harmonization activities.
• COMMUNITY HIE DEVELOPMENT/ HIE SERVICE DELIVERY (next meeting NC HWTF, 12/14, 10:00 am - 1:00 pm)
  Purpose: A model for organizing and convening a domain specific or geography-based community for the purpose of HIE which includes building stakeholder collaboration, creating governance structures and a policy framework.
• HIE SUSTAINABILITY
  Purpose: Develop a framework for implementation and sustainability of health IT and HIE.

ARRA Section 3016 HIT Workforce Development
ONC recently announced new funding opportunities:

• The Community College Consortia to Educate Health Information Technology Professionals in Health Care Program seeks to rapidly create health IT academic programs at Community Colleges. ONC will fund a total of $70 million to five consortia representing five geographical regions. It is expected that by the end of the two-year project period, collectively all of the Community Colleges participating in the program will have established training programs with the capacity to train at least 10,500 students annually to be part of the health IT workforce. Applications are due on January 22, 2010, and the anticipated award date is March 15, 2010. A technical call is scheduled for December 16. For further details click here.
• The Curriculum Development Centers Program will provide $10 million in grants to institutions of higher education (or consortia thereof) to support health IT curriculum development. ONC plans to make up to five grant awards that will support curriculum development to enhance programs of workforce training primarily at the community college level. The materials developed under this program will be used by the member colleges of the five regional consortia as well as be available to institutions of higher education across the country. Applications are due on January 14, 2010, and the anticipated award date is March 18, 2010. For further details click here.
  

ARRA Section 4201 Medicaid Administration of Meaningful Use
NC Division of Medical Assistance (Medicaid) continues to involve NCHICA in the development of Medicaid plans to enable Meaningful Use for any qualified Medicaid provider.

ONC Launches New Blogs
As part of the ongoing communication from the ONC office, two new blogs have been started: Federal Advisory Committee Blog and Health IT Buzz Blog.

ONC Reorganizes to Meet Mission of HITECH Act
On December 1 the Department of Health and Human Services published a notice in the Federal Register about reorganizing the Office of the National Coordinator for Health IT "to more effectively meet the mission outlined by the Health Information Technology for Economic and Clinical Health (HITECH) Act." The reorganization includes adding a Chief Privacy Officer to advise the National Coordinator on "privacy, security, and data stewardship of electronic health information" and coordinate efforts with privacy officers from other federal, state and regional agencies. The original offices under the ONC dealing with health IT adoption, interoperability & standards, programs & coordination and policy & research have been replaced with the offices for Economic Modeling & Analysis, the Chief Scientist, the Deputy National Coordinator for Programs & Policy, the Deputy National Coordinator for Operations, and the Chief Privacy Officer. Click here to read the notice in the Federal Register.

NCHICA Privacy & Security Officials and Legal Workgroups Prepare for HIPAA Changes
NCHICA's Privacy and Security Officials Workgroup has published the HITECH Act Breach Notification Risk Assessment Tool. They developed the tool in response to the DHHS Breach Notification for Unsecured Protected Health Information Interim Final Rule posted in the Federal Register on August 24, 2009. The main objective of the tool is to provide "covered entities" a consistent approach in performing a risk assessment to determine if the breach notifications are required to be implemented as a result of a possible breach of unsecured Protected Health Information. In addition to the risk assessment, a flow chart has been included that addresses the requirements of both the NC Identity Theft Protection Act and the DHHS Breach Notification Interim Final Rule. To access the tool, visit the "What's New" section of the NCHICA home page at http://www.nchica.org/.

The Business Associate Agreement Task Force of the Legal Workgroup, led by Sissy Holloman and including representatives from several law firms, Carolinas Healthcare System, Duke, UNC, Quintiles and others, has been meeting for several months in preparation for the issuance of a revised model BA agreement as soon as the final rule is issued in January. Please click here to view the Briefing Packet to Support the Expected Changes to Business Associate Agreements Mandated by ARRA, which includes a copy of a covered entity and a business associate notice that can be used to communicate this impending change, along with an informational document with more specifics about the HITECH Act changes.

NCHICA members are encouraged to join these groups as your talent guides you - workers on these committees have seen and are using work products weeks before the general public can access them.

NCHICA ARRA UPDATE is only sent to individuals associated with NCHICA member organizations. If you wish to be taken off the e-mail distribution list, contact tara@nchica.org.