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8 | Page <br /> <br />13. InCK Model Beneficiary Needs Assessment and Service Integration Level (SIL) <br />Stratification. The InCK Model NOFO (Section F.51.1., Table 1 InCK Model Operational <br />Milestones ) outlines the requirement that Recipients provide an “aggregate count of : unique <br />attributed children assessed for SIL eligibility, unique attributed children found to be <br />eligible for SIL 2 and SIL 3, and unique attributed children who received services under <br />SIL 2 and SIL 3.” <br /> <br />A. Beneficiary data submission: The Recipient is required to provide to CMS beneficiary- <br />level information documenting the results of each beneficiary’s screening within a SIL <br />Data Elements Workbook on a quarterly basis, beginning 30 Days following the last day <br />of Quarter 1 in MY3 (April 30, 2022). The workbook, completed for each beneficiary <br />screened, includes an overall tab with the assigned SIL and 12 individual tabs for each <br />assessment area. Recipients must populate these tabs as separate files with beneficiary- <br />level data. When completed, the workbook must be submitted by award recipients <br />through the InCK Reusable Framework. <br />B. Flexibility for total beneficiaries screened in MY3 : Section F.5.1.1 of the NOFO states <br />that Recipients are required to report a set of Performance Measure Milestones to CMS <br />covering at least 80 percent of their attributed population. In MY2, CMS provide d <br />Recipients with updated guidance for how to submit needs assessment (screening) and <br />SIL stratification data on attributed beneficiaries and flexibility for working toward the <br />minimum 80 percent screening threshold in MY3. CMS does not plan to take corrective <br />action based solely on missing the 80 percent screening threshold in 2022. CMS may still <br />initiate corrective action, funding restrictions, or termination for not making progress <br />towards meeting the 80 percent threshold or for not meeting other model requireme nts <br />outlin ed in the Cooperative Agreement Notice of Award, Terms and Conditions of <br />Award, or other federal award documentation. Recipients should anticipate that CMS will <br />monitor their progress in 2022 by measuring the Recipient’s trend toward the 80 percent <br />screening threshold. <br />14. Monitoring. CMS will primarily monitor awards through data collection and reporting; <br />Recipient documentation; and communications with the PO, Grants Management Specialist, <br />and the model’s I mplementation & Monitoring (I&M) contractor. See Section 20 of this <br />document (Implementation and Monitoring) for more details on the I&M contractor. <br />Recipient shall participate in model monitoring activities that include, but are not limited to: <br />1) routine tele phone calls and correspondence between the Recipient and the PO and Grants <br />Management Specialist; 2) submission and review of QPRs, annual progress reports <br />(APRs), quarterly cash transactions reports , and annual expenditure reports ; 3) prior- <br />approval requests to use funding; 4) attendance and participation in Learning System events; <br />5) provision of data for audit and validation; 6) document review; 7) virtual or in -person site <br />visits; and 8) other activities necessary to provide monitoring-related information and data <br />to CMS and its contractor(s). <br /> <br />A. Communications . The Recipient shall inform the PO and Grants Management Specialist <br />of the activities and tasks performed under this Cooperative Agreement. In addition, the <br />Recipient shall establish lines of communication among all of the individuals and entities <br />DocuSign Envelope ID: 7832B0E4-F34E-430E-A3C2-1A6A14F29307