Screening/Diagnostic RFA - Request for Clarification on quality-assurance indicators and MOUs

Question 1: Can you provide additional clarification regarding the requirement for Screening/Diagnostic grantees to have an MOU with a treatment provider? This question was asked during the training webinar but the answer provided in the Q&A left some questions. On page 16 of the training powerpoint it states there is a NEW requirement for screening/diagnostic grantees to provide an "MOU with a treatment provider that will accept Komen-eligible patients". This requirement is not listed anywhere in the RFA - the RFA only indicates in 5a of the Project Description that MOUs are required only with partners further than 60 miles from the screening site; this reflects the answer given in the Q&A. If the applicant only provides certain services (ie. CBEs) onsite and then refers out to a partner provider for imaging and diagnostic workup, then it makes sense that an MOU or agreement would need to be in place since the grantee reimburses the partner provider for those services. Is a MOU with a cancer treatment provider truly required as indicated in the powerpoint? Or is "treatment" in the powerpoint referring to diagnostic workup? If a MOU is required, how can applicants know which providers will have a Komen treatment award for the 2015-2016 grant cycle to be able to request a MOU?

Question 2: In the Organization Capacity narrative section, questions 4c and 4d contain new quality-assurance indicators. What if the applicant does not currently track those metrics for any patients outside of WWC and does not have a method to collect that data due to using paper records and not EHR? This applicant does provide individual case management and follow up for abnormal results to guide patients to diagnosis, but we do not track or aggregate data regarding outcomes or timelines. Additionally, will grantees be required to report out on these indicators on any reports for the 2015-2016 grant year?

1. MOUs with treatment providers are not required for screening/diagnostic applicants. However, applicants in this category should explain how Komen-eligible individuals who are diagnosed with breast cancer are referred to treatment provider(s) because Komen-eligible patients who are uninsured or do not have insurance-guided networks. The affiliate understands that some screening/diagnostic applicants that only provide CBEs may not have the same referral relationships with providers as the imaging/biopsy facilit(ies) where you refer for tests in the event of an abnormal CBE, but strong applications will explain to grant reviewers what the process is to minimize the likelihood that Komen-eligible patients aren't lost due to an inability to navigate the continuum of care.

2. By the end of the 2015-16 grant cycle, grantees will be expected to report out on the quality-assurance indicators to enable Komen to better understand how its provision of grant funds helps to close the gap among medically underserved Coloradans compared to others with a different source of payment. If an applicant organization does not currently collect these data for Komen-eligible populations, strong grant applications would explain how the organization tracks breast health outcomes for Komen-eligible populations served by the organization and refines its internal policies to reduce patients who "fall through the cracks." The intent of Komen's asking this question, and gathering this data through reporting, is to supplement WWC's tracking indicators to get a broader picture of breast health care for women other than those who are WWC-eligible. This will be important as fewer women are WWC-eligible due to Medicaid expansion.