HomeMy WebLinkAbout20111245 RESOLUTION
RE: APPROVE AMENDMENT#1 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#1 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, and ending June 30, 2011,
with further terms and conditions being as stated in said contract, and
WHEREAS, after review, the Board deems it advisable to approve said contract, 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 #1 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 Health
Care Policy and Financing, Area Agency on Aging, and the Colorado Department of Human
Services be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said contract.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 18th day of May, A.D., 2011.
BOARD OF COUNTY COMMISSIONERS
WELD OUNTY, CO ORADO
ATTEST:/ 4
�� �-� •`• a •ara Kirkmey „Chair
Weld County Clerk to the e;�§K• .�"'y• .�' _
/�}�BY:nuna A,4ean P. •n ' ay, Pro-Tem
Deputy Clerk to the Boar Io kit
Wi F. Garcia
AP ED FORM: • 11
o nty Attorney vivild E. Long—�
r i)O3 less` er ' v �2.t/�
Douglas Rademacher
Date of signature: 3/26 '
�
3 Orui � cmv � Cc,'• !-'SiJ 2011-1245
�J lES I I S- 15. 11 HR0082
MEMORANDUM
1861 - 2011
DATE: May 2, 2011
W E L0' 0 N T Y TO: Barbara Kirkmeyer, Chair, Board of Count Co m. sioners
FR: Judy A. Griego, Director, Departme of u an Se ices
RE: Amendment to the Single Entry Point Contract between
the Weld County Department of Human Services' Area
Agency on Aging and the Colorado Department of Health
Care Policy and Financing
Enclosed for Board approval is the Amendment to the Single Entry Point Contract betweenthe
Weld County Department of Human Services' Area Agency on Aging and the Colorado
Department of Health Care Policy and Financing. This Amendment to the Single Entry Point
Contract was reviewed under the Board's Pass-Around Memorandum dated March 21, 2011, and
approved for placement on the Board's Agenda.
This document is an amendment to the FY11 (September 1, 2010 through June 30, 2011) contract
which formally states that the Colorado Department of Health Care Policy and Financing can
execute an option letter annually, up to a total of four years after the execution of the original
contract, before a new full contract must be completed.
The option letter is included as Exhibit H. In addition, Exhibit G was added to the contract via the
amendment to outline how the Weld County Area Agency on Aging is being funded under the
Options for Long Term Care contract. There were no changes in the funding level or general
scope of work.
If you have any questions, please contact me at extension 6510.
2011-1245
O DEP&r
OQPO 41%,
ca gn COLORADO DEPARTMENT OF HEALTH CARE POLICY & FINANCING
m z 1570 Grant Street, Denver,CO 80203-1818 •(303)866-2993• (303)866-4411 Fax
p John W.Hickenlooper,Governor • Susan E.Birch MBA,BSN,RN,Executive Director
F C,gktP0LIC•
V
c
July 18, 2011 rs,
c
Ms. Eva Jewell
SEP Administrator cc)
Weld County Area Agency on Aging
CO
P.O. Box 1805
Greeley, CO 80632
Ms. Jewell:
Enclosed is an executed original contract amendment and option letter. Please forward these
documents to the appropriate person(s) within your organization.
Thanks for all you and staff do for our most fragile populations.
Sincer-ly,
W. Sean Bryan
Contracts and Perform ce 'gmt Unit Supervisor
"The mission of the Department of Health Care Policy&Financing is to improve access to cost-effective,quality health care services for Coloradans"
colorado.gov/hcpf
i
OPTION LETTER
Date: Original Contract Routing No. Option Letter No. Contract Routing No.
June 24, 2011 3011-1322 01 3012-9074
CMS #20517 CMS #33661
1. OPTIONS:
Level of service change in conjunction with renewal for additional term.
2. REQUIRED PROVISIONS:
In accordance with Section 5, Term and Early Termination, Subsection C, Option to Extend of the Original
Contract between the State of Colorado, Department of Health Care Policy and Financing, and Weld County
Department of Human Services, covering the term August 26, 2010 through June 30, 2011, the State hereby
exercises its option for an additional term beginning July 1, 2011, and ending on June 30, 2012, and for
an increase in the amount of services under the Contract at the same rates as specified in Exhibit G-1, Rate
Schedule, attached hereto and incorporated herein.
The maximum amount payable for the current State Fiscal Year 2011-12 is increased by $1,082,604.46 to a new
total including all previous amendments, option letters, etc. for all State Fiscal Years of $2,113,563.09 as
consideration for services ordered under the Contract. Section 7, Payments to Contractor, Subsection A,
Maximum Amount is hereby modified:
State Fiscal Year 2010-11 $1,030,958.63
State Fiscal Year 2011-12 $1,082,604.46
Total for all State Fiscal Years $2,113,563.09
3. EFFECTIVE DATE:
The effective date of this Option Letter is upon approval of the State Controller or June 30, 2011, whichever is
later.
STATE OF COLORADO
John W. Hickenlooper, GOVERNOR
Department of He�Policy and Financing
By: Susan E. Birch, MBA, BSN, RN
Executive Director
Date: 1 11
ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER
CRS§24-30-202 requires the State Controller to approve all State Contracts.This Contracts 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.
STAT CON Rrmott CPA
R
i D . M rmott, C
By:
Depart th a e olicyynd Financing
Date: gilt
Page 1 of 1
Contract Routing Number 3012-9074
EXHIBIT G-1
RATE SCHEDULE
SEP Case Management Rate Table
Services Unit Quantity Rate Total
Base Rate each 918.50 $ 974.00 $ 894,619.00
Appeals each 918.50 $ 39.75 $ 36,510.38
Long-term Home Health (LTHH) PAR each 918.50 $ 39.75 $ 36,510.38
Multiple County (per county for SEPs with 2 or more per
0 $ 8,000.00 $
counties) county
Mental Illness (MI) Differential each 70.67 $ 75.00 $ 5,300.25
Comsumer Directed Attendant Support Services
(CDASS) Differential each 142.83 $ 200.00 $ 28,566.00
Assessments (initial only) each 768.00 $ 75.00 $ 57,600.00
Community Transition Services (CTS) each 2.00 $ 75.00 $ 150.00
Total Based on Forecasted Services Calculation-275 $ 1,059,256.01
Services/Appropriation 160
Utilization Review (UR) each I 918.50 $ 75.00 $ 68,887.50
Total Based on Forecasted Services Calculation-160 $ 68,887.50
Total Calculation-All Appropriations $ 1,128,143.51
SEP Case Management Appropriation Percentage Calculation
Total Appropriation-275 SFY 2011-12 $ 26,333,984.00
Percentage of Appropriation 275 4.39%
Amount of Appropriation 275 by Percentage $ 1,155,664.66
°total Appropriation-160 SFY 2011-12 $ 524,974.00
Percentage of Appropriation 160 4.45%
Amount of Appropriation 160 by Percentage $ 23,348.45
Total Amount of All Appropriations by Percentage $ 1,179,013.11
Contract Allocations based on Forcasted Services/ Fee Base Month 1-11 Month 12
SFY 2011-12 Monthly Fee Calculation-Appropriation 275 $ 1,059,256.01 $ 88,271.33 $ 88,271.38
SFY 2011-12 Monthly Fee Calculation-Appropriation 160 $ 23,348.45 $ 1,945.70 $ 1,945.75
SFY 2011-12 Monthly Fee Calculation-All Appropriations $ 1,082,604.46 $ 90,217.03 $ 90,217.13
Exhibit G-1 Page 1 of 1
Department of Health Care Policy and Financing
Contract Routing Number
3011-9191
CMS # 30077
CONTRACT AMENDMENT NO. 1
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, P.O. 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 add Contract
maximum amount and annual reconciliation language to the Contract; add Exhibit G, Rate
Schedule, to identify the calculation used to set the annual maximum value of the Contract; and
Exhibit H, Sample Option Letter, as the modification tool to extend the contract term and
change the statewide quantity of services.
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, Definition 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
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
Exhibit H, Sample Option Letter
B. Section 5, Term and Early Termination, Subsection C, Extension Amendments is hereby
deleted in its entirety and replaced with:
C. Option to Extend
The Department may require continued performance for a period of one (1) year
at the same rates and same terms specified in the Contract. If the Department
exercises this option, it shall provide written notice to Contractor at least 30 days
prior to the end of the current Contract term in form substantially equivalent to
Exhibit H. If exercised, the provisions of the Option Letter shall become part of
and be incorporated into this Contract. The total duration of this Contract,
including the exercise of any options under this clause, shall not exceed five (5)
years.
C. Section 6, Statement of Work, Subsection A, Completion is hereby deleted in its entirety
and replaced with:
A. Completion
Contractor shall complete the Work and its other obligations as described in this
Contract on or before the end of the term of this Contract. The State shall not be
liable to compensate Contractor for any Work performed prior to the Effective
Date or after the expiration or termination of this Contract.
D. Section 7, Payments To Contractor, Subsection G, is hereby added:
G. Option to Increase or Decrease Statewide Quantity of Service
The Department may increase or decrease the statewide quantity of services
described in the Contract based upon the rates established in the Contract. If the
Department exercises the option, it will provide written notice to Contractor in a
Page 2 of 6
form substantially equivalent to Exhibit H. Delivery/performance of services
shall continue at the same rates and terms. If exercised, the provisions of the
Option Letter shall become part of and be incorporated into the original Contract.
E. 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. Colorado Special Provisions
ii. HIPAA Business Associate Addendum
iii. The provisions of the main body of this Contract
iv. Exhibit A, Statement of Work
v. Exhibit B, Case Management Agency (CMA) Administrative Review
Tool
vi. Exhibit C, Statement of Operating Expenses
vii. Exhibit D, Case Manager Training Report Template
viii. Exhibit E, Complaint Trends/Remedial Action Report Template
ix. Exhibit F, Critical Incident Trends/Remedial Action Report Template
x. Exhibit G, Rate Schedule
xi. Exhibit H, Sample Option Letter
F. Attachment A, Statement of work, Section 6, Billing Procedures And Reconciliation, is
hereby deleted in its entirety and replaced with the following:
6. BILLING PROCEDURES AND RECONCILIATION
A. Contract Maximum Amount Calculation
I. The Contract maximum amount shall be calculated using the rates, quantities
or percentages identified on Exhibit G. The maximum amount of the Contract
shall be the lesser of:
a. The total of all SEP projected client and activity counts multiplied by the
rates; or
b. A pro-rata share of Department's total appropriations based on the
percentage of the Contractors projected client and activity counts to the
total of all the Single Entry Points projected client and activity counts.
2. The Department shall apply this contract maximum amount calculation for the
renewal contract year prior the start of that year. The Department shall notify
the Contract of the new contract maximum amount calculation through the
Option Letter in a form substantially equivalent to Exhibit H, Sample Option
Letter, prior to the start of each contract year.
Page 3 of 6
B. Payments
1. At the end of State Fiscal year 2009-10, a Holdover Letter was issued that
extended the prior Contract term through August 31, 2010. Payments for the
Holdover period shall be made to the Contractor in monthly amounts based on
the State Fiscal year 2009-10 Contract amount.
2. Payments to the Contractor for the period September 1, 2010, through June
30, 2011, shall be made in equal monthly payments calculated by the contract
Maximum Amount less the amounts paid to the Contractor for the Holdover
Letter period. The total of all monthly payments for the Holdover period and
the remainder of State Fiscal year shall not exceed the Maximum Amount
stated in paragraph 7.A. of the contract.
3. For subsequent Contract renewal periods, payments to the Contractor shall be
made monthly. Monthly payment amounts shall be calculated by dividing the
Contract maximum amount by the number of months in the Contract term.
The total of all monthly payments made shall not exceed the maximum
amount stated in the Contract.
C. Annual Reconciliation for Potential Overpayment
1. Contractor payments will be reconciled at the end of each contract term to
verify that no overpayment was made to the Contractor. The reconciliation
shall consist of applying the actual client and activity counts multiplied by the
rates in Exhibit G and comparing the total to the total of all monthly
payments paid to the Contractor for the Contract term.
2. If the Contractor's total monthly payments for the Contract term are higher
than the actual client and activity counts multiplied by the rates, the
Contractor will be sent an overpayment recovery notice. The Contractor shall
remit the amount of the overpayment to the Department within 30 days of
receipt of the overpayment recovery notice.
3. In no instance will the reconciliation provide for any additional payments to
the Contractor above the Contract maximum amount for the Contract term.
7. Exhibit G, Rate Schedule is hereby added, attached, and incorporated into the
Contract.
8. Exhibit H, Sample Option Letter, is hereby added, attached, and incorporated into the
Contract.
7. START DATE
This Amendment shall take effect on the later of 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
Page 4 of 6
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.
Page 5 of 6
Contract Routing Number 3011-9191
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.
Board of Weld County Commissioners
on behal .TRACTOR: STATE OF COLORADO:
Weld County Department of Human
Services John W. Hickenlooper, Governor
Le al Name of Contractor
By: .Lt.aAi By: C al,: • c
ignature of Author' ed Officer Susan E. Birch, MBA, BSN, RN
Executive Director
Department of Health Care Policy and
Financing
Date: MAY 1 u 2011 Date: C-4-1.- i I I i
Barbara Kirkmeyer LEGAL REVIEW:
Printed Name of Authorized Officer John W. Suthers, Attorney General
Chair q
Printed Title of Authorized Officer By: 13 ifl
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.
4ermoft, A
ON LER:
By:
Date: (N271/
Page 6 of 6
L9(1/-/)II/J
Contract Routing Number 301 1-91 91
EXHIBIT G
RATE SCHEDULE
SEP Case Management Rate Table
Services Unit Quantity Rate Total
Base Rate each 913.67 $ 974.00 $ 889,914.58
Appeals each 913.67 $ 39.75 $ 36,318.38
Long-term Home Health (LTHH) PAR each 913.67 $ 39.75 $ 36,318.38
Multiple County(per county for SEPs with 2 or more per 0 $ 8,000.00 $
counties) county
Mental Illness (MI) Differential each 56.00 $ 75.00 $ 4,200.00
Comsumer Directed Attendant Support Services each 101.33 $ 200.00 $ 20,266.00
(CDASS) Differential
Assessments (initial only) each 680.00 $ 75.00 $ 51,000.00
Community Transition Services(CTS) each 8.00 $ 75.00 $ 600.00
Total Based on Forecasted Services Calculation-275 $ 1,038,617.35
Services/Appropriation 160
Utilization Review(UR) each I 913.67 $ 75.00 $ 68,525,25
Total Based on Forecasted Services Calculation-160 $ 68,525.25
Total Calculation-All Appropriations I $ 1,107,142.60
SEP Case Management Appropriation Percentage Calculation
Total Appropriation-275 SFY 2010-11 $ 24,021,660.00
Percentage of Appropriation 275 4.20%
Amount of Appropriation 275 by Percentage $ 1,008,909.72
Total Appropriation-160 SFY 2010-11 $ 524,974.00
Percentage of Appropriation 160 4.20%
Amount of Appropriation 160 by Percentage $ 22,048.91
Total Amount of All Appropriations by Percentage $ 1,030,958.63
Fee Base Month 1-11 Month 12
SFY 2010-11 Monthly Fee Calculation-Appropriation 275 $ 1,008,909.72 $ 84,075.81 $ 84,075.81
SFY 2010-11 Monthly Fee Calculation-Appropriation 160 $ 22,048.91 $ 1,837.41 $ 1,837.40
SFY 2010-11 Monthly Fee Calculation-All Appropriations $ 1,030,958.63 $ 85,913.22 $ 85,913.21
Exhibit G Page 1 of 1
Contract Routing Number 3011-9191
EXHIBIT H
SAMPLE OPTION LETTER
Date: Original Contract Routing No. Option Letter No. Contract Routing No.
CMS# CMS #
1) OPTIONS: Choose all applicable options listed in§1 and in§2 and delete the rest.
a. Option to renew only (for an additional term).
b.Change in the amount of goods within current term.
c. Change in amount of goods in conjunction with renewal for additional term.
d.Level of service change within current term.
e. Level of service change in conjunction with renewal for additional term.
2) REQUIRED PROVISIONS:
In accordance with Section of the Original Contract between the State of Colorado, Department of Health
Care Policy and Financing, and (Contractor's Name), the State hereby exercises its option for an additional term
beginning and ending on at a (enter cost, price, rate etc) specified in Section , and for
an increase/decrease in the amount of goods/services under the Contract at the same (enter cost, price, rate etc)
as specified in (Identify the Section, Schedule, Attachment, Exhibit etc).
The maximum amount payable for the current State Fiscal Year is increased/decreased by $0.00 to a new total
including all previous amendments, option letters, etc. for all State Fiscal Years of $0.00 as consideration for
goods/services ordered under the Contract for the current State Fiscal Year (indicate Year). Section is
hereby modified:
State Fiscal Year(indicate Year) $0.00
State Fiscal Year(indicate Year) $0.00
Total for all State Fiscal Years $0.00
3) EFFECTIVE DATE:
The effective date of this Option Letter is upon approval of the State Controller or(date), whichever is later.
STATE OF COLORADO
John W. Hickenlooper, GOVERNOR
Department of Health Care Policy and Financing
By: Susan E. Birch, MBA, BSN, RN
Executive Director
Date:
ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER
CRS§24-30-202 requires the State Controller to approve all State Contracts.This Contracts 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.
STATE CONTROLLER
David J. McDermott, CPA
By:
Department of Health Care Policy and Financing
Date:
Exhibit H Page 1 of 1
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