HomeMy WebLinkAbout20130365.tiffRESOLUTION
RE: APPROVE AMENDMENT #4 TO CONTRACT TO PERFORM FUNCTIONS OF A SINGLE
ENTRY POINT AGENCY FOR MEDICAID LONG TERM CARE AND AUTHORIZE CHAIR
TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with Amendment #4 to the Contract to perform
the functions of a Single Entry Point Agency for Medicaid Long Term Care between the County of
Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on
behalf of the Department of Human Services, Area Agency on Aging, and the Colorado Department
of Health Care Policy and Financing, commencing upon full execution, with further terms and
conditions being as stated in said contract amendment, and
WHEREAS, after review, the Board deems it advisable to approve said contract amendment,
a copy of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that Amendment #4 to the Contract to perform the functions of a Single Entry
Point Agency for Medicaid Long Term Care between the County of Weld, State of Colorado, by and
through the Board of County Commissioners of Weld County, on behalf of the Department of
Human Services, Area Agency on Aging, and the Colorado Department of Health Care Policy and
Financing be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said contract amendment.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 4th day of February, A.D., 2013.
BOARD OF COUNTY COMMISSIONERS
WELD CQUIVTY, COLORADO
ATTEST"
Weld County Clerk to the Board
BY:
Deputy Cler
APPROVED A
PCounty Attorney
Date of signature:MAR 1 2 2013
/C ((2
William F. arcia, Chair
o uglasRade aches, Pro-Tem
an P. Conway
adLet—
Freeman
CC'
2013-0365
HR0084
MEMORANDUM
DATE: January 31, 2013
TO: William F. Garcia, Chair, Board of County Commissioners
FROM: Judy A. Griego, Director, Department of Huttiai e
RE: Contract Amendment No. 04 to the Weld County
Department of Human Services' Area Agency on
Aging Single Entry Point (SEP) Contract with the
State of Colorado Acting by and through the
Department of Health Care Policy and Financing
Enclosed for Board approval is a Contract Amendment No. 04 to the Weld County
Department of Human Services' Area Agency on Aging Single Entry Point (SEP) Contract
with the State of Colorado Acting by and through the Department of Health Care Policy and
Financing. This Contract Amendment was reviewed under the Board's Pass -Around
Memorandum dated January 25, 2013, and approved for placement on the Board's Agenda.
This document amends the original SEP Contract that was effective 7/2010 (County
tracking number 2010-1790).
This amendment requires the SEPs to complete an aspect of the Money Follows the Person/
Colorado Choice Transitions (CCT) program called the Quality of Life Interview. Once a
client has been identified as a potential nursing home diversion client, a Quality of Life
Interview must take place several times over the period of 24 months. The first interview
must take place in the nursing home, the second takes place 11 months after discharge and
the last one 24 months after discharge.
The reimbursement to the Department from the Department of Health Care Policy and
Financing will be $100.00 per interview.
If you have additional questions, please contact me at extension 6510.
Department of Health Care Policy and Financing
Contract Routing Number 13-51581
CONTRACT AMENDMENT NO. 04
Original Contract Routing Number 3011-1322, CMS 20517
1. PARTIES
This Amendment to the above -referenced Original Contract (hereinafter called the "Contract") is entered
into by and between Weld County Department of Human Services, by and through the Weld County
Board of Commissioners, PO Box 1805, Greeley, Colorado 80632 (hereinafter called "Contractor"), and
the STATE OF COLORADO, acting by and through the Department of Health Care Policy and Financing,
1570 Grant Street, Denver, Colorado 80203 (hereinafter called "Department" or "State.")
2. EFFECTIVE DATE AND ENFORCEABILITY
This Amendment shall not be effective or enforceable until it is approved and signed by the Colorado
State Controller or designee (hereinafter called the "Effective Date.") The Department shall not be liable
to pay or reimburse Contractor for any performance hereunder, including, but not limited to, costs or
expenses incurred, or be bound by any provision hereof prior to the Effective Date.
3. FACTUAL RECITALS
The Parties entered into the Contract to secure home and community -based waiver and long-term home
health case management and associated utilization review services for applicants and clients of Medicaid
Long -Term Care. The purpose of this Amendment is to attach Exhibit I to amend the Statement of Work
to add the performance of Money Follows the Person/Colorado Choice Transitions Quality of Life
Interviews.
4. CONSIDERATION
The Parties acknowledge that the mutual promises and covenants contained herein and other good and
valuable consideration are sufficient and adequate to support this Amendment.
5. LIMITS OF EFFECT
This Amendment is incorporated by reference into the Contract, and the Contract and all prior
amendments thereto, if any, remain in full force and effect except as specifically modified herein.
6. MODIFICATIONS
The Contract and all prior amendments thereto, if any, are modified as follows:
A. Section 4, Definitions, Subsection B, Exhibits and Other Attachments, is hereby deleted in its
entirety and replaced with the following:
B. Exhibits and other Attachments. The following documents are attached hereto and incorporated
by reference herein:
HIPAA Business Associate Addendum
Page 1 of 5
Exhibit A, Statement of Work
Exhibit B, Case Management Agency (CMA) Administrative Review Tool
Exhibit C, Statement of Operating Expenses
Exhibit D, Case Manager Training Report Template
Exhibit E, Complaint Trends/Remedial Action Report Template
Exhibit F, Critical Incident Trends/Remedial Action Report Template
Exhibit G, Rate Schedule, SFY 2010-11
Exhibit G-1, Rate Schedule, SFY 2011-12
Exhibit H, Sample Option Letter
Exhibit I, Colorado Choice Transitions Quality of Life Interviews
B. Section 7, Payments to Contractor, Subsection B, Payment, Paragraph 3 is hereby added as
follows:
3. The amount of state and federal funds available for all Work relating to Quality of Life
Interviews is as follows:
Interview Type
Rate Per Completed Interview
Non -Rural Area
$100.00
Rural Area
$120.00
The total compensation for Quality of Life Interviews under this Contract shall not exceed
$20,340.00 for the life of this Contract.
C. Section 20, General Provisions, Subsection I, Order of Precedence, is hereby deleted in its entirety
and replaced with the following:
Order of Precedence
The provisions of this Contract shall govern the relationship of the State and Contractor. In
the event of conflicts or inconsistencies between this Contract and its exhibits and
attachments, including, but not limited to, those provided by Contractor, such conflicts or
inconsistencies shall be resolved by reference to the documents in the following order of
priority:
i. HIPAA Business Associate Addendum
ii. The provisions of the main body of this Contract
iii. Exhibit A, Statement of Work
iv. Exhibit B, Case Management Agency (CMA) Administrative Review Tool
v. Exhibit C, Statement of Operating Expenses
vi. Exhibit D, Case Manager Training Report Template
vii. Exhibit E, Complaint Trends/Remedial Action Report Template
viii. Exhibit F, Critical Incident Trends/Remedial Action Report Template
ix. Exhibit G, Rate Schedule, SFY 2010-11
x. Exhibit G-1, Rate Schedule, SFY 2011-12
xi. Exhibit H, Sample Option Letter
xii. Exhibit I, Colorado Choice Transitions Quality of Life Interviews
Page 2 of 5
D. Exhibit 1, Colorado Choice Transitions Quality of Life Interviews, is hereby added, attached, and
incorporated into the Contract.
7. START DATE
This Amendment shall take effect on its Effective Date.
8. ORDER OF PRECEDENCE
Except for the Special Provisions and the HIPAA Business Associates Addendum, in the event of any
conflict, inconsistency, variance, or contradiction between the provisions of this Amendment and any of
the provisions of the Contract, the provisions of this Amendment shall in all respects supersede, govern,
and control. The most recent version of the Special Provisions incorporated into the Contract or any
amendment shall always control other provisions in the Contract or any amendments.
9. AVAILABLE FUNDS
Financial obligations of the state payable after the current fiscal year are contingent upon funds for that
purpose being appropriated, budgeted, or otherwise made available to the Department by the federal
government, state government and/or grantor.
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Contract Routing Number 13-51581
THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT
Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's
behalf and acknowledge that the State is relying on their representations to that effect.
By:
Date:
CONTRACTOR:
Weld County Department of Human
Services by and through
the Weld `Cc�u—li rty Board of Commissioners
Signature of Authorized Officer
FEB 042013
William F. Garcia
Chair
By:
Date:
STATE OF COLORADO:
John W. Hickenlooper, Governor
Susan E. Birch, MBA, BSN, RN
Executive Director
Department of Health Care Policy and
Financing
MILS
LEGAL REVIEW:
Printed Name of Authorized Officer John W. Suthers, Attorney General
Printed Title of Authorized Officer By:
Date:
ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER
CRS §24-30-202 requires the State Controller to approve all State Contracts. This Contract is not valid
until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin
performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not
obligated to pay Contractor for such performance or for any goods and/or services provided hereunder.
By:
Date:
STAT ?CONTROLLER:
ay. J e e ott, CPA
r
Page 5 of 5
c2013-0365
Contract Routing Number 13-51581
EXHIBIT I
COLORADO CHOICE TRANSITIONS QUALITY OF LIFE INTERVIEWS
1. TERMINOLOGY
1.1. Acronyms, abbreviations and other terminology are defined at their first occurrence in this
document. The following list is provided to assist the reader in understanding acronyms,
abbreviations and terminology used throughout this document.
1.1.1. Assisted Interview — when a third person is present to help the participant answer questions.
1.1.2. Business Day - Any day in which the Department is open and conducting business, but shall
not include weekend days or any day on which one of the Department's holidays are observed.
The Department observes all holidays listed in CRS 24-11-101(1).
1.1.3. CCT — Colorado Choice Transitions, the State program which addresses home and community
based needs for those enrolled.
1.1.4. CMA District or Service Area — Case Management Area assigned area of coverage -
1.1.5. Eligible Person — an individual living in a facility that has been referred to the CCT program
and has signed the program's consent form.
1.1.6. Participant — any eligible person who has signed the consent form and engages in the QL
interview process.
1.1.7. Proxy Respondent — a person who answers the survey questions on the participant's behalf.
1.1.8. QL Interview —Quality of Life Interview
1.1.9. Transition — when an eligible person leaves a hospital or institution to begin to live in a
community setting.
2. GENERAL REQUIREMENTS
2.1. The Contractor shall perform all work in accordance with all applicable Federal and State statutes,
regulations and rules, as now and hereafter amended, and the requirements described in this
Contract.
2.2. The Contractor shall work closely and collaboratively with the Department, discuss suggestions or
issues as they occur and incorporate suggestions or guidance from the Department while
performing the Work described within this Contract.
2.3. The Contractor shall coordinate and prioritize all Work to ensure that all deliverables and
deadlines are met.
2.4. The Contractor shall employ an internal quality control process to ensure that all deliverables are
complete, accurate, easy to understand, and of high quality. The Contractor shall provide
deliverables that, at a minimum, are responsive to the specific requirements, organized into a
logical order, contain no spelling or grammatical errors, formatted uniformly, and contain accurate
information and correct calculations. The Contractor shall retain all work papers generated for
reference through the duration of this Contract. The Contractor shall participate in the review and
revision process, until the Department provides written acceptance of the deliverable.
Page 1 of 3
2.5. The Contractor shall provide copies of any supporting documentation to
request of the Department and without charge.
2.6. The Contractor shall respond to all telephone calls and e-mail inquiries
within one (1) business day.
3. PROJECT REQUIREMENTS: QUALITY OF LIFE INTERVIEWS
3.1. General Requirements
3.1.1. The Contractor shall conduct three (3) interviews for eligible person. These interviews shall
take place at the following intervals:
An initial interview.
An eleven (I 1) month interview.
A twenty-four (24) month interview.
Baseline Interviews
3.1.1.1.
3.1.1.2.
3.1.1.3.
3.2.
3.2.1.
the Department upon
from the Department
The Contractor shall complete all Quality of Life (QL) interviews in person. In extreme
circumstances, the Contractor may complete a QL interview via telephone, but may only do so
upon approval by the Department.
3.2.2. The Contractor shall conduct baseline Quality of Life (QL) interviews with all eligible people
who choose to enroll in the Colorado Choice Transitions program.
3.2.3. The Contractor shall complete the QL interview prior to a participant's transition from a long-
term care facility to a home of his/her choice in the community.
3.2.4. The Contractor shall complete the QL interview at least two (2) weeks prior to a person's
scheduled transition.
3.2.5. The Contractor shall, in the case of a participant transition from a nursing home to a
community setting before the baseline QL is completed, conduct the QL interview within ten
(10) days of the transition.
3.2.5.1. The Contractor shall not use any QL survey interview that has taken place later than ten
(10) days after the transition to community living.
3.2.6. The Contractor shall, in the circumstance where either a person does not know an answer, is
not sure of an answer, or is unable to communicate a response, mark the answer to that
question "do not know."
3.2.7. The Contractor shall, when necessary, and dependent upon individual circumstances and the
abilities of the participant, use a proxy respondent to complete the interview or conduct an
assisted interview.
3.3. Follow -Up Interviews
3.3.1. The Contractor shall complete all QL interviews in person. In extreme circumstances, the
Contractor may complete a QL interview via telephone, but may only do so upon approval by
the Department.
3.3.2. The Contractor shall complete follow-up QL interviews only with people who transitioned to
community living through the CCT program and remained enrolled in the program.
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3.3.3. The Contractor shall complete the first follow-up QL interview with an individual eleven (I 1)
months from the initial date of transition to the community, which occurs when the person's
three hundred and sixty-five (365) days of eligibility for CCT-financed home and community -
based services begin.
3.3.4. The Contractor shall complete the second follow-up QL interview with an individual twenty-
four (24) months after transition to the community, which occurs when the person's three
hundred and sixty-five (365) days of eligibility for CCT-financed home and community -based
services begin.
3.3.5. The Contractor shall complete a follow-up QL interview regardless of where a current or prior
CCT participant is living. For CCT participants who transfer between CMA districts or service
areas, the Contractor shall transition follow-up QL responsibilities to the resident CMA.
3.4. Eleven (I 1) and Twenty -Four (24) Month Interviews
3.4.1. The Contractor shall conduct the eleven (I I) month and twenty-four (24) month interview in
the community where the client resides.
3.4.1.1. The Contractor shall, in the event that the client is hospitalized or institutionalized on or
about the time that the eleven (I 1) month or twenty-four (24) month survey shall take
place, conduct the survey in the hospital or institution where the client has been admitted.
3.4.1.2. The Contractor shall, in the event that the client is expected to be discharged back into the
community within five (5) weeks of being admitted, wait to conduct the eleven (I I) month
or twenty-four (24) month survey once the client has returned to the community.
3.4.2. The Contractor shall, in the circumstance where either a person does not know an answer, is
not sure of an answer, or is unable to communicate a response, mark the answer to that
question "do not know."
3.4.3. The Contractor shall, when necessary, and dependent upon individual circumstances and the
abilities of the participant, use a proxy respondent to complete the interview or conduct an
assisted interview.
3.5. Quality of Life Interview Frequency
3.5.1. The Department will determine the exact number of QL interviews that the Contractor shall be
required to complete. There is no guarantee that the Contractor will complete a set number of
interviews, and all compensation will be based on the actual number of interviews the
Contractor completes according to Department standards.
3.5.2. The Department will provide or arrange for training to the interviewers.
3.5.3. The Department will notify the Contractor when pre -transition and post -transition surveys need
to be scheduled with enough advance notice to comply with timelines.
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