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HomeMy WebLinkAbout20101357.tiff RESOLUTION RE: APPROVE CONTRACT TO PERFORM FUNCTIONS OF A SINGLE ENTRY POINT AGENCY FOR HOME CARE ALLOWANCE AND ADULT FOSTER CARE CLIENTS 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 a Contract to perform the functions of a Single Entry Point Agency for Home Care Allowance and Adult Foster Care clients 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 Human Services, commencing July 1, 2010, 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 the Contract to perform the functions of a Single Entry Point Agency for Home Care Allowance and Adult Foster Care clients 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 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 23rd day of June, A.D., 2010. BOARD OF COUNTY COMMISSIONERS LD CO. ' , •LORADO Zia ATTEST: .ro,-.• � _ 1S61 ( �:�.la- ademac -r, air Weld County Clerk to the B• rd ��} - Y A �l( � �� rbara Kirkmeyer, ro Tem fA De Clerk o the Board Sean P. Con APP A RM: •am F. Garcia ounty rney (`)C1 David E. Long Date of signature: X0-6010 bn j• t SGnd Iluscl CC .. \-l5 2010-1357 AAA Lr-a3-l0 (NS) --1 - t5 - 1u HR0081 MEMORANDUM , a'1SDATE: June 21, 2010 (ese "ilk 1'�� TO: Douglas Rademacher, Chair, Board ofC�ounty Co issioners FROM: Judy A. Griego, Director, Human rvi es pa tT COLORADO RE: Home Care Allowance Contract between the Weld County Department of Human Services and the Colorado Department of Human Services Enclosed for Board approval is a Contract between the Department and the Colorado Department of Human Services. This Contract was presented at the Board's June 21, 2010. Work Session. The Contract allows the Area Agency on Aging to continue to provide case management services for all Home Care Allowance clients. The contract amount is$38,781.01 for the period of July 1, 2010 through June 30, 2011. If you have questions, please give me a call at extension 6510. 2010-1357 STATE_OF COLORADO cdhster Colorado Department of Human Services t876 people who help people 2 't �,; ;;. ' ` v v gave OFFICE OF SELF SUFFICIENCY AND INDEPENDENCE Bill Ritter,Jr. PAULINE BURTON,DEPUTY EXECUTIVE DIRECTOR Governor DIVISION OF AGING AND ADULT SERVICES Karen L.Beye 1575 Sherman SL,10"Floor Executive Director Denver,Colorado 80203 Phone 303-866-2800 TDD 303-866-2850 FAX 303-866-2696 viw v.cdhsstate.co.us Peggy Rogers Interim Director July 29, 2010 Eva Jewell Weld County Area Agency on Aging 315 C. N. 11th Ave. Bldg. C Greeley, CO 80631 Dear Eva Jewell: Enclosed is your executed contract between Colorado Department of Human Services and Weld County Area Agency on Aging. This contract is to perform the functions of a Single Entry Point Agency for Home Care Allowance and Adult Foster Care clients. This contract is effective July 1, ZQ10 and will end on June 30, 2011. -0 If you have any questions, please contact Lauren Ishida at lauren.ishida@state.co.us or b&phone at (303) 866-2717. Sincerely, ki(itleer auren Ishida Division of Aging and Adult Services Enclosures cc: Peggy Rogers, Interim Director Cheryl Duncan, Manager Financial and Data Systems Our Mission is to Design and Deliver Quality Human Services that Improve the Safety and Independence of the People of Colorado DEPARTMENT OF HUMAN SERVICES ROUTING NO. 11 IH:A 18055 CONTRACT This contract is made and entered into by and between the named parties. In accordance with the purposes stated herein, it is hereby agreed as follows: STATE: CONTRACTOR: Weld County,Colorado Weld County Department of Human Services State of Colorado for the use&benefit of the Area Agency on Aging Department of Human Services 315 C. N. 11th Ave.Bldg. C Division of Aging and Adult Services Greeley,CO 80631 1575 Sherman St. 10th Floor Denver, CO 80203 CONTRACT MADE DATE: CONTRACTOR'S ENTITY TYPE: 07/01/2010 4trelivialaw1 Ges,,}g-v\r .,CuU CONTRACTOR'S STATE OF INCORPORATION: PO/SC ENCUMBRANCE NUMBER. PO IHA BILLING STATEMENTS RECEIVED. TERM: Monthly This contract shall be effective upon approval STATUTORY AUTHORITY: by the State Controller,or designee, or on CRS. 26-1-111 07/01/2010,whichever is later. The contract CONTRACT PRICE NOT TO EXCEED. shall end on 06/30/2011. $38,781.01 MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR PROCUREMENT METHOD: FY 11: $38,781.01 Law Specified`Tendon C1�2JM BID/RFP/LIST PRICE AGREEMENT NUMBER Not Applicable O LAW SPECIFIED VENDOR STATUTE. PRICE STRUCTURE. Not Applicable Fixed Price 13 FUND SOURCE-NAME OF FEDERAL PROGRAM/GRANT AND FUNDS ID# STATE REPRESENTATIVE: CONTRACTOR REPRESENTATIVE'. Lrw f Cy. `rjk:i(i,Q_. Eva Jewell Division of Aging and Adult Services Weld County Area Agency on Aging 1575 Sherman St. 10th Floor 315 C. N. 11th Ave. Bldg. C Denver, CO 80203 Greeley, CO 80631 SCOPE OF WORK- In accordance with the provisions of this contract and its exhibits and attachments, the Contractor shall: Perform the functions of a Single Entry Point Agency for Home Care Allowance and Adult Foster Care clients For Contract Wizard Version 3.10 Page 1 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management alio — /357 • • EXHIBITS: The following exhibits are hereby incorporated: Exhibit A- Program 1 xplanation, Definitions and Statement of Work Exhibit B- HIPAA Business Associates Addendum Exhibit C- Sample Option Letter COORDINATION: The State warrants that required approval, clearance and coordination has been accomplished from and with appropriate agencies. APPROVAL: In no event shall this contract be deemed valid until it shall have been approved by the State Controller or his/her designee. PROCUREMENT: This contractor has been selected in accordance with the requirements of the Colorado Procurement Code. PRICE PROVISIONS: Payments pursuant to this contract shall be made as earned, in whole or in part, from available funds, encumbered for the purchase of the described services and/or deliverables. The liability of the State at any time for such payments shall be limited to the encumbered amount remaining of such funds. • Authority exists in the laws and funds have been budgeted, appropriated and otherwise made available, and a sufficient unencumbered balance thereof remains available for payment. Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. The Contractor understands and agrees that the State shall not be liable for payment for work or services or for costs or expenses incurred by the Contractor prior to the proper execution and State Controller approval of this contract. For Contract Wizard Version 3.9 Page 2 of 25 Revised 12/31/08 Colorado Department of I Inman Services Contract Management GENERAL PROVISIONS The following clauses apply to this contract: documents in the following order of priority: I) the Special Provisions of this contract shall always be A. Governmental Immunity/Limitation of Liability: controlling over other provisions in the contract or Notwithstanding anything herein to the contrary, amendments; 2) the contract"cover"pages; 3) the no term or condition of this contract shall be exhibits to this contract 4) the General Provisions construed or interpreted as a waiver, express or of this contract. implied, of any of the immunities,rights, benefits, protection, or other provisions of the "Colorado E. Notice and Representatives: For the purposes of this Governmental Immunity Act", C.R.S. §24-10-101, contract, the representative for each party is as et seq., as now or hereinafter amended. The parties designated herein. Any notice required or permitted understand and agree that the liability of the State may be delivered in person or sent by registered or for claims for injuries to persons or property certified mail,return receipt requested,to the party at arising out of negligence of the State of Colorado, the address provided, and if sent by mail it is its departments, institutions, agencies, boards, effective when posted in a U.S. Mail Depository officials and employees is controlled and limited with sufficient postage attached thereto. Notice of by the provisions of C.R.S. §24-10-101, et seq., as change of address or change or representative shall now or hereafter amended and the risk be treated as any other notice. management statutes, C.R.S. §24-30-1501, et seq., as now or hereafter amended. Any liability of the F. Contractor Representations: State created under any other provision of this 1. Licenses and Certifications: The Contractor contract, whether or not incorporated herein by certifies that, at the time of entering into this reference, shall be controlled by, limited to, and contract, it and its agents have currently in otherwise modified so as to conform with, the effect all necessary licenses, certifications, above cited laws. approvals, insurance, etc. required to properly provide the services and/or supplies covered B. Federal Funds Contingency: Payment pursuant to by this contract in the state of Colorado. Proof this contract, if in federal funds, whether in whole of such licenses, certifications-2 approvals, or in part, is subject to and contingent upon the insurance, etc. shall be provided upon the continuing availability of federal funds for the State's request. Any revocation, Withdrawal or purposes hereof. In the event that said funds, or nonrenewal of necessary license,,tertification, any part thereof, become unavailable, as approval, insurance, etc. requEd for the determined by the State, the State may Contractor to properly perform `t this contract, immediately terminate this contract or amend it shall be grounds for terminafUl of this accordingly. contract by the State. 2. Qualification: Contractor certifies'that it is C. Billing Procedures: The State shall establish billing qualified to perform such servicer provide procedures and requirements for payment due the such deliverables as delineated in this contract. Contractor in providing performance pursuant to this 3. Debarment and Suspension: The Contractor contract. The Contractor shall comply with the certifies to the best of its knowledge and belief established billing procedures and requirements for that the Contractor,its principals and authorized submission of billing statements. The State shall subcontractors are not presently debarred, comply with CRS 24-30-202(24) when paying suspended, proposed for debarment, declared vendors upon receipt of a correct notice of the ineligible, or voluntarily excluded from amount due for goods or services provided participation in this transaction by any federal hereunder. department or agency. 4. Work Performed Outside the United States or D. Exhibits- Interpretation: Unless otherwise stated, all Colorado,pursuant to C.R.S. §24-102-206: The referenced exhibits are incorporated herein and made Contractor certifies all work performed under a part of this contract. And,unless otherwise stated, this Contract, including any subcontracts, is in the event of conflicts or inconsistencies between anticipated to be and will be performed within this contract and its exhibits or attachments, such the United States or Colorado,unless otherwise conflicts shall be resolved by reference to the specified in the Statement of Work. If work For Contract Wizard Version 3.10 Page 3 of 27 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management 5. under this Contract is anticipated to be or will a. $1,000,000 each occurrence; be performed outside the United States or b. $1,000,000 general aggregate; Colorado, the countries and/or states where c. $1,000,000 products and completed work will be performed, and the reasons it is operations aggregate; and necessary or advantageous to go outside the d. $50,000 any one fire. United States or Colorado to perform the work are also specified in the Statement of Work. If any aggregate limit is reduced below $1,000,000 because of claims made or paid, G. Legal Authority: The Contractor warrants that it the contractor shall immediately obtain possesses the legal authority to enter into this additional insurance to restore the full contract and that it has taken all actions required aggregate limit and furnish to the State a by its procedures, by-laws, and/or applicable law certificate or other document satisfactory to to exercise that authority, and to lawfully authorize the State showing compliance with this its undersigned signatory to execute this contract provision. and bind the Contractor to its terms. The person(s) executing this contract on behalf of the Contractor e. Automobile Liability Insurance covering warrant(s) that such person(s) have full any auto (including owned, hired and authorization to execute this contract. non-owned autos) with a minimum limit as follows: $1,000,000 each accident H. Indemnification Contractor shall indemnify, combined single limit. save, and hold harmless the State, its employees f. Professional liability insurance with and agents, against any and all claims, damages, minimum limits of liability of not less liability and court awards including costs, than$1,000,000. expenses, and attorney fees and related costs, 3. The State of Colorado shall be named as incurred as a result of any act or omission by additional insured on the Commercial General Contractor, or its employees, agents, Liability and Automobile Liability Insurance subcontractors, or assignees pursuant to the terms policies(leases and construction contracts will of this contract. require the additional insured coverage for completed operations on endorsements CG /Applicable Only to Intergovernmental 2010 11/85, CG 2037, or equivalent). Contracts] No term or condition of this contract Coverage required of the contract will be shall be construed or interpreted as a waiver, primary over any insurance or self-insurance express or implied, of any of the immunities, program carried by the State of Colorado. rights, benefits, protection, or other provisions, of 4. The Insurance shall include provisions the Colorado Governmental Immunity Act, CRS preventing cancellation or non-renewal §24-10-101 et seq., or the Federal Tort Claims without at least 45 days prior notice to the Act, 28 U.S.C. 2671 et seq., as applicable,as now State by certified mail. or hereafter amended. 5. The contractor will require all insurance policies in any way related to the contract and I. Insurance - Contractor: The contractor shall secured and maintained by the contractor to obtain, and maintain at all times during the term of include clauses stating that each carrier will this contract, insurance in the following kinds and waive all rights of recovery, under amounts: subrogation or otherwise, against the State of 1. Workers' Compensation Insurance as required Colorado, its agencies, institutions, by state statute, and Employer's Liability organizations, officers, agents, employees and Insurance covering all of contractor's volunteers. employees acting within the course and scope 6. All policies evidencing the insurance of their employment. coverages required hereunder shall be issued 2. Commercial General Liability Insurance by insurance companies satisfactory to the written on ISO occurrence form CG 00 01 State. 10/93 or equivalent, covering premises 7. The contractor shall provide certificates operations, fire damage, independent showing insurance coverage required by this contractors, products and completed contract to the State within 7 business days of operations, blanket contractual liability, the effective date of the contract, but in no personal injury, and advertising liability with event later than the commencement of the minimum limits as follows: services or delivery of the goods under the For Contract Wizard Version 3.10 Page 4 of 25 Revised 02/08/10 Colorado Department of I Inman Services Division of Contract Management 8. contract. No later than 15 days prior to the accompanying the intellectual property or expiration date of any such coverage, the otherwise, shall comply with the State contractor shall deliver the State certificates of requirements which include but is not limited to all insurance evidencing renewals thereof. At documentation being in a paper, human readable any time during the term of this contract, the format which is useable by one who is reasonably State may request in writing, and the proficient in the given subject area. contractor shall thereupon within 10 days supply to the State, evidence satisfactory to L. Proprietary Information: Proprietary information for the State of compliance with the provisions of the purpose of this contract is information relating to this section. a party's research, development, trade secrets, 9. Notwithstanding subsection A of this section, business affairs,internal operations and management if the contractor is a "public entity" within the procedures and those of its customers, clients or meaning of the Colorado Governmental affiliates, but does not include information lawfully Immunity Act CRS 24-10-101, et seq., as obtained by third parties, which is in the public amended ("Act'), the contractor shall at all domain,or which is developed independently. times during the term of this contract maintain only such liability insurance, by commercial Neither party shall use or disclose directly or policy or self-insurance, as is necessary to indirectly without prior written authorization any meet its liabilities under the Act. Upon request proprietary information concerning the other party by the State, the contractor shall show proof obtained as a result of this contract. Any proprietary of such insurance satisfactory to the State. information removed from the State's site by the Contractor in the course of providing services under J. Disaster Planning and Pandemic Outbreaks:The this contract will be accorded at least the same State may require the Contractor to submit a precautions as are employed by the Contractor for Disaster Response Plan(Plan) to ensure the similar information in the course of its own business. delivery hereunder of essential government services during a disaster, declared emergency, M. Records Maintenance, Performance Monitoring & and/or pandemic outbreak. The Plan would take Audits: The Contractor shall maintain a complete precedence over and nullify any contractual file of all records, documents, communications, provision relating to force majeure or"Acts of and other materials that pertain to the operation of God."Accordingly,should the work performed by the program/project or the deliverya of services the Contractor under this contract include the under this contract. Such files shall iiepsufficient to provision of any essential government services,the properly reflect all direct and indirect costs of State may request a Plan from the Contractor, and, labor, materials, equipment, supplier&I' d services, upon such request,the Contractor shall forthwith and other costs of whatever nature-Mr which a submit a Plan, and the Contractor shall be bound to contract payment was made. These records shall perform hereunder in accordance therewith. be maintained according to genera'O accepted accounting principles and shall be easily separable K. Rights in Data, Documents and Computer from other Contractor records. • Software or Other Intellectual Property: All intellectual property including without The Contractor shall protect the confidentiality of limitation, databases, software, documents, all records and other materials containing research, programs and codes, as well as all, personally identifying information that are reports, studies, data, photographs, negatives or maintained in accordance with this contract. other documents, drawings or materials prepared Except as provided by law, no information in by the contractor in the performance of its possession of the Contractor about any individual obligations under this contract shall be the constituent shall be disclosed in a form including exclusive property of the State. Unless otherwise identifying information without the prior written stated, all such materials shall be delivered to the consent of the person in interest, a minor's parent, State by the contractor upon completion, guardian, or the State. The Contractor shall have termination, or cancellation of this contract. written policies governing access to, duplication Contractor shall not use, willingly allow or cause and dissemination of, all such information and to have such materials used for any purpose other advise its agents, if any, that they are subject to than the performance of the contractor's these confidentiality requirements. The Contractor obligations under this contract without a prior shall provide its agents, if any, with a copy or written consent of the State. All documentation, For Contract Wizard Version 3.10 Page 5 of 25 Revised 02/08/10 Colorado Department of I Inman Services Division of Contract Management • written explanation of these confidentiality O. Conflict of Interest: During the term of this requirements before access to confidential data is contract, the Contractor shall not engage in any permitted. business or personal activities or practices or maintain any relationships which conflict in any The Contractor authorizes the State, the federal way with the Contractor fully performing his/her government or their designee, to perform audits obligations under this contract. and/or inspections of its records, at any reasonable time, to assure compliance with the state or federal Additionally, the Contractor acknowledges that, in government's terms and/or to evaluate the governmental contracting, even the appearance of Contractor's performance. Any amounts the State a conflict of interest is harmful to the interests of paid improperly shall be immediately returned to the State. Thus, the Contractor agrees to refrain the State or may be recovered in accordance with from any practices, activities or relationships other remedies. which could reasonably be considered to be in conflict with the Contractor's fully performing All such records,documents, communications,and his/her obligations to the State under the terms of other materials shall be the property of the State this contract, without the prior written approval of unless otherwise specified herein and shall be the State. maintained by the Contractor,for a period of three (3) years from the date of final payment or In the event that the Contractor is uncertain submission of the final federal expenditure report whether the appearance of a conflict of interest under this contract, unless the State requests that may reasonably exist, the Contractor shall submit the records be retained for a longer period, or until to the State a full disclosure statement setting forth an audit has been completed with the following the relevant details for the State's consideration qualification If an audit by or on behalf of the and direction. Failure to promptly submit a federal and/or state government has begun but is disclosure statement or to follow the State's not completed at the end of the three (3) year direction in regard to the apparent conflict shall be period, or if audit findings have not been resolved grounds for termination of the contract. after a three (3) year period, the materials shall be retained until the resolution of the audit findings. Further, the Contractor shall maintain a written code of standards governing the performance of its The Contractor shall permit the State, any other agent(s) engaged in the award and administration governmental agency authorized by law, or an of contracts. Neither the Contractor nor its authorized designee thereof, in its sole discretion, agent(s) shall participate in the selection, or in the to monitor all activities conducted by the award or administration of al_sontract or Contractor pursuant to the terms of this contract. subcontract supported by Federal: funds if a Monitoring may consist of internal evaluation conflict of interest, real or apparent, would be procedures, reexamination of program data,special involved. Such a conflict would arise when: analyses, on-site verification, formal audit 1. The employee, officer or agent; examinations, or any other procedures as deemed 2. Any member of the employee's-epmediate reasonable and relevant. All such monitoring shall family; be performed in a manner that will not unduly 3. The employee's partner; or interfere with contract work. 4. An organization which employees, °It&about to employ,any of the above, N. Taxes: The State, as purchaser, is exempt from all has a financial or other interest in the firm selected federal excise taxes under Chapter 32 of the for award. Neither the Contractor nor its agent(s) Internal Revenue Code [No. 84-730123K] and will solicit nor accept gratuities, favors, or from all state and local government use taxes anything of monetary value from Contractor's [C.R.S. §39- 26-114(a) and 203, as amended]. The potential contractors, or parties to subagreements. contractor is hereby notified that when materials are purchased for the benefit of the State, such P. Conformance with Law: The Contractor and its exemptions apply except that in certain political agent(s) shall at all times during the term of this subdivisions the vendor may be required to pay contract strictly adhere to all applicable federal sales or use taxes even though the ultimate product laws, state laws, Executive Orders and or service is provided to the State. These sales or implementing regulations as they currently exist use taxes will not be reimbursed by the State. and may hereafter be amended. Without limitation, these federal laws and regulations include: For Contract Wizard Version 3.10 Page 6 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management • Age Discrimination Act of 1975, 42 U.S.C. Q. Restrictions on Public Benefits: Pursuant to House Section 6101 et seq. and its implementing Bill 06S-1023,as codified at C.R.S. § 24-76.5-101 et regulation,45 C.F.R.Part 91; seq., except as otherwise provided therein or where • Age Discrimination in Employment Act of exempt by federal law,the State is required to verify 1967,29 U.S.C.621 et seq.; the lawful presence in the United States of each • Americans with Disabilities Act of 1990 natural person 18 years of age or older who applies (ADA),42 U.S.C. 12101 et seq.; for state or local public benefits or for federal public • The Drug Free Workplace Act of 1988, 41 benefits for the applicant. Accordingly, should the U.S.C.701 et seq.; work performed by the Contractor under this • Equal Pay Act of 1963,29 U.S.C.206; contract include the provision of any of said benefits • Health Insurance Portability and to any natural person 18 years of age or older who Accountability Act of 1996, 42 U.S.C. applies therefore for the applicant, the Contractor § 1320d et seq. and implementing regulations, shall follow the requirements of said law in the 45 C.F.R. Parts 160 and 164; provision of said benefits as if it were the State. The • Immigration Reform and Control Act of 1986,8 State will provide the Contractor with specific U.S.C. 1324b; instruction on the identification documentation • Pro-Children Act of 1994, 20 U.S.C. 6081 et required and the process to be followed by the Contractor to properly comply with the law if the seq.; work done under this contract is subject to these • Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794, as amended, and implementing requirements. regulation 45 C.F.R.Part 84; R. Statewide Contract Management System: • Titles VI &VII of the Civil Rights Act of 1964, If the maximum amount payable to Contractor 42 U.S.C.2000(d)&(e); under this Contract is$100,000 or greater,either • The Personal Responsibility and Work on the Effective Date or at anytime thereafter,this Opportunity Reconciliation Act of 1996, 42 provision applies. USC 604a, PL 104-193. See also State Executive Order D 015 00; Contractor agrees to be governed, and to abide,by • Title IX of the Education Amendments of 1972, the provisions of CRS §24-102-205, §24-102-206, 20 U.S.C. 1681 et seq.; §24-103-601, §24-103.5-101 and§24-105-102 • The Uniform Administrative Requirements for concerning the monitoring of vendor performance Grants and Cooperative Agreements to State on state contracts and inclusion of contract and Local Governments (Common Rule), at 45 performance information in a statewide contract CFR,Part 92; management system. • The Uniform Administrative Requirements for Awards and Subawards to Institutions of Higher Contractor's performance shall be subject to Education, Hospitals, Other Non-Profit Evaluation and Review in accordance with the Organizations, and Commercial Organizations terms and conditions of this Contract, State law (Common Rule),at 2 CFR 215; (including without limitation CRS §24-103.5-101), • Office of Management and Budget Circulars A- and State Fiscal Rules,Policies and Guidance. 87, A-21 or A-122, and A-102 or A-110, Evaluation and Review of Contractor's whichever is applicable. performance shall be part of the normal contract • The Hatch Act (5 USC 1501-1508) and Civil administration process and Contractor's Service Reform Act, Public Law 95-454 performance will be systematically recorded in the Section 4728. statewide Contract Management System. Areas of • Departments of Labor, Health and Human Evaluation and Review shall include without Services, and Education and Related Agencies limitation quality, cost and timeliness. Collection Appropriations Act, 1990, PL 101-166, Section of information relevant to the performance of 511. Contractor's obligations under this Contract shall • 45 CFR Subtitle A, Department of Health and be determined by the specific requirements of such Human Services regulations. obligations and shall include factors tailored to • The Single Audit Act Amendments of 1996, 31 match the requirements of Contractor's obligations USC 7501,Public Law 104-156, OMB Circular hereunder. Such performance information shall be A-133,and 45 CRF 74.26. entered into the statewide Contract Management System at intervals during the term hereof determined appropriate by the State, and a final For Contract Wizard Version 3.10 Page 7 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management Evaluation, Review and Rating shall be rendered 2. report any arrests, charges,or summonses for by the State within 30 days of the end of the any disqualifying offense as specified by Contract temi. Contractor shall be notified C.R.S. §27-1-110 to the State. following each performance Evaluation and Any Contractor or its agent(s), who does not Review,and shall address or correct any identified comply with C.R.S. §27-1-110 and DHS Policy problem in a timely manner and maintain work VI-2.4, may, at the sole discretion of the State, be progress. suspended or terminated. Should the final performance Evaluation and U. Litigation: The Contractor shall within five (5) Review determine that Contractor demonstrated a calendar days after being served with a summons, gross failure to meet the performance measures complaint, or other pleading which has been filed established hereunder, the Executive Director of in any federal or state court or administrative the Colorado Department of Personnel and agency notify the State that it is a party defendant Administration (Executive Director), upon request in a case which involves services provided under by the Department of Human Services, for good this contract. The Contractor shall deliver copies cause shown, may debar Contractor and prohibit of such document(s) to the State's Executive Contractor from bidding on future contracts. Director. The term "litigation" includes an Contractor may contest the final Evaluation and assignment for the benefit of creditors, and filings Review and Rating by: (a) filing rebuttal in bankruptcy, reorganization and/or foreclosure. statement(s), which may result in either removal or correction of the evaluation (CRS §24-105- V. Disputes: Except as herein specifically provided 102(6)), or (b) under CRS §24-105-102(6), otherwise, disputes concerning the performance of exercising the debarment protest and appeal rights this contract which cannot be resolved by the provided in CRS §§24-109-106, 107, 201 or 202, designated contract representatives shall be which may result in the reversal of the debarment referred in writing to a senior departmental and reinstatement of Contractor by the Executive management staff designated by the department Director upon showing of good cause. and a senior manager designated by the Contractor. Failing resolution at that level, S. Discrimination: The Contractor during the disputes shall be presented in writing to the performance of this contract shall: Executive Director and the Contractor's chief 1. not discriminate against any person on the basis executive officer for resolution. This process is of race, color, national origin, age, sex,religion not intended to supersede any other process for the and handicap, including Acquired Immune resolution of controversies provided by law. Deficiency Syndrome (AIDS) or AIDS related conditions. W. Remedies: Acceptance is dependent upon 2. not exclude from participation in, or deny completion of all applicable inspection procedures. benefits to any qualified individual with a The State reserves the right to inspect the goods disability,by reason of such disability. and/or services provided under this contract at all Any person who thinks he/she has been reasonable times and places. The Executive discriminated against as related to the performance Director of the State or her/his designee may of this contract has the right to assert a claim, exercise the following remedial actions should s/he Colorado Civil Rights Division, C.R.S. §24-34- find the Contractor substantially failed to satisfy 302,et seq. the scope of work found in this contract. Substantial failure to satisfy the scope of work T. Criminal Background Check: Pursuant to C.R.S. shall be defined to mean substantially insufficient, §27-1-110 and Department of Human Services incorrect or improper activities or inaction by the Policy VI-2.4, any independent contractor, and its Contractor. Without limitation, the State has the agent(s), who is designated by the Executive right to: Director or the Executive Director's designee to be a contracting employee under C.R.S. §27-1-110, 1. withhold payment until performance is cured, who has direct contact with vulnerable persons in a 2. require the vendor to take necessary action to state-operated facility, or who provides state- ensure that the future performance conforms funded services that involve direct contact with to contract requirements, vulnerable persons in the vulnerable person's home 3. request removal of a Contractor's agent from or residence, shall: contract work, 1. submit to a criminal background check, and For Contract Wizard Version 3.10 Page 8 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management • 4. equitably reduce the payment due the vendor State may immediately terminate this contract to reflect the reduced value of the services upon verifying that the Contractor has performed, engaged in or is about to participate in 5. recover payment for work that due to the fraudulent or other illegal acts. Contractor cannot be performed or would be 4. Termination for Financial Exigency: The State of no value to the State, shall have the right to terminate this contract 6. modify or recover payments (from payments for financial exigency by giving the under this contract or other contracts between Contractor at least thirty (30) days prior the State and the vendor as a debt due to the written notice. For the purposes of this State) to correct an error due to omission, provision, a financial exigency shall be a error, fraud and/or defalcation, determination made by the Colorado 7. terminate the contract. legislature or its Joint Budget Committee that the financial circumstances of the State are These remedies in no way limit the remedies such that it is in the best interest of the State to available to the State in the termination provisions of terminate this contract. If notice of such this contract,or remedies otherwise available at law. termination is so given, this contract shall terminate on the expiration of the time period X. Termination: specified in the notice, and the liability of the 1. Termination for Default: The State may parties hereunder for further performance of terminate the contract for cause. If the State the terms of this contract shall thereupon terminates the contract for cause, it will first cease, but the parties shall not be released give ten (10) days prior written notice to the from the duty to perform their obligations up Contractor, stating the reasons for to the date of termination. cancellation, procedures to correct problems, if any, and the date the contract will be In the event that the State terminates this terminated in the event problems have not contract under the Termination for been corrected. In the event this contract is Convenience or Termination for Financial terminated for cause, the State will only Exigency provisions, the Contractor is entitled reimburse the Contractor for accepted work or to submit a termination claim within ten (10) deliverables received up to the date of days of the effective date of termination. The termination. In the event this contract is termination claim shall address and the State terminated for cause, final payment to the shall consider paying the following costs: Contractor may be withheld at the discretion a. the contract price for performance of of the State until completion of final audit. work, which is accepted by the State, up Notwithstanding the above, the Contractor to the effective date of the termination. may be liable to the State for the State's b. reasonable and necessary costs incurred damages. If it is determined that the in preparing to perform the terminated Contractor was not in default then such portion of the contract termination shall be treated as a termination c. reasonable profit on the completed but for convenience as described herein. undelivered work up to the date of 2. Termination for Convenience: The State shall termination have the right to terminate this contract by d. the costs of settling claims arising out of giving the Contractor at least twenty(20) days the termination of subcontracts or orders, prior written notice. If notice is so given, this not to exceed 30 days pay for each contract shall terminate on the expiration of subcontractor the specified time period, and the liability of e. reasonable accounting, legal, clerical,and the parties hereunder for further performance other costs arising out of the termination of the terms of this contract shall thereupon settlement. cease, but the parties shall not be released from the duty to perform their obligations up In no event shall reimbursement under this to the date of termination. clause exceed the contract amount reduced by 3. Immediate Termination: This contract is amounts previously paid by the State to the subject to immediate termination by the State Contractor. in the event that the State determines that the health, safety, or welfare of persons receiving services may be in jeopardy. Additionally,the For Contract Wizard Version 3.10 Page 9 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management • Y. Venue: The parties agree that venue for any action any other term, or the same term upon related to performance of this contract shall be in the subsequent breach. City and County of Denver,Colorado. 5. Survival: The State and the Contractor's obligations under this contract shall survive Z. Understanding of the Parties: following termination or expiration to the extent 1. Complete Understanding: This contract is necessary to give effect to the intent and intended as the complete integration of all understanding of the parties. understandings between the parties. No prior 6. Subcontracting: Except as herein specifically or contemporaneous addition, deletion, or provided otherwise, the duties and obligations other amendment hereto shall have any force of the Contractor arising hereunder cannot be or effect whatsoever, unless embodied herein assigned, delegated, subgranted or in writing. No subsequent novation, renewal, subcontracted except with the express prior addition, deletion, or other amendment hereto written consent of the State. The subgrants shall have any force or effect unless embodied and subcontracts permitted by the State shall in a written contract executed and approved be subject to the requirements of this contract. pursuant to the State Fiscal Rules. Descriptive The Contractor is responsible for all headings as used herein are for convenience subcontracting arrangements, delivery of and shall not control or affect the meaning or services, and performance of any subgrantor construction of any provision of this contract. or subcontractor. The Contractor warrants and 2. Severability: To the extent that this contract agrees that any subgrant or subcontract, may be executed and performance of the resulting from its performance under the terms obligations of the parties may be and conditions of this contract, shall include a accomplished within the intent of the contract, provision that the said subgrantor or the terms of this contract are severable, and subcontractor shall abide by the terms and should any term or provision hereof be conditions hereof. Also, the Contractor declared invalid or become inoperative for any warrants and agrees that all subgrants or reason, such invalidity or failure shall not subcontracts shall include a provision that the affect the validity of any other term or subgrantor or subcontractor shall indemnify provision hereof. and hold harmless the State. The subgrantors 3. Benefit and Right of Action: Except as herein or subcontractors must be certified to work on specifically provided otherwise, it is expressly any equipment for which their services are understood and agreed that this contract shall obtained. inure to the benefit of and be binding upon the parties hereto and their respective successors AA.Holdover: In the event that the State desires to and assigns. All rights of action relating to continue the services provided for in this Contract enforcement of the terms and conditions shall and a replacement contract has not been fully be strictly reserved to the State and the named executed by the expiration date of the Contract, Contractor. Nothing contained in this this Contract may be extended unilaterally by the agreement shall give or allow any claim or State for a period of up to two (2) months upon right of action whatsoever by any other third written notice to the Contractor under the same person. It is the express intention of the State terms and conditions of the original Contract and the Contractor that any such person or including, but not limited to, prices, rates, and entity, other than the State or the Contractor, service delivery requirements. However, this receiving services or benefits under this extension terminates when the replacement agreement shall be deemed an incidental contract becomes effective when signed by the beneficiary only. State Controller or an authorized delegate. 4. Waiver: The waiver of any breach of a term hereof shall not be construed as a waiver of For Contract Wizard Version 3.10 Page 10 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management • These Special Provisions apply to all contracts except where noted in italics. 1. CONTROLLER'S APPROVAL. CRS §24-30-202(1). This contract shall not be valid until it has been approved by the Colorado State Controller or designee. 2. FUND AVAILABILITY. CRS §24-30-202(5.5). Financial obligations of the State payable after the current fiscal year are contingent upon funds for that purpose being appropriated,budgeted,and otherwise made available. 3. GOVERNMENTAL IMMUNITY.No term or condition of this contract shall be construed or interpreted as a waiver,express or implied,of any of the immunities,rights, benefits,protections, or other provisions,of the Colorado Governmental Immunity Act,CRS §24-10-101 et seq., or the Federal Tort Claims Act,28 U.S.C. §§1346(b)and 2671 et seq., as applicable now or hereafter amended. 4. INDEPENDENT CONTRACTOR. Contractor shall perform its duties hereunder as an independent contractor and not as an employee. Neither Contractor nor any agent or employee of Contractor shall be deemed to be an agent or employee of the State. Contractor and its employees and agents are not entitled to unemployment insurance or workers compensation benefits through the State and the State shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Unemployment insurance benefits will be available to Contractor and its employees and agents only if such coverage is made available by Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes incurred pursuant to this contract. Contractor shall not have authorization,express or implied,to bind the State to any agreement, liability or understanding,except as expressly set forth herein. Contractor shall(a)provide and keep in force workers'compensation and unemployment compensation insurance in the amounts required by law,(b)provide proof thereof when requested by the State, and(c)be solely responsible for its acts and those of its employees and agents. 5. COMPLIANCE WITH LAW. Contractor shall strictly comply with all applicable federal and State laws,rules,and regulations in effect or hereafter established,including, without limitation,laws applicable to discrimination and unfair employment practices. 6. CHOICE OF LAW. Colorado law,and rules and regulations issued pursuant thereto, shall be applied in the interpretation,execution,and enforcement of this contract. Any provision included or incorporated herein by reference which conflicts with said laws, rules,and regulations shall be null and void. Any provision incorporated herein by reference which purports to negate this or any other Special Provision in whole or in part shall not be valid or enforceable or available in any action at law,whether by way of complaint,defense, or otherwise. Any provision rendered null and void by the operation of this provision shall not invalidate the remainder of this contract,to the extent capable of execution. 7. BINDING ARBITRATION PROHIBITED.The State of Colorado does not agree to binding arbitration by any extra judicial body or person. Any provision to the contrary in this contact or incorporated herein by reference shall be null and void. 8. SOFTWARE PIRACY PROHIBITION. Governor's Executive Order D 002 00. State or other public funds payable under this contract shall not be used for the acquisition, operation,or maintenance of computer software in violation of federal copyright laws or applicable licensing restrictions. Contractor hereby certifies and warrants that, during the term of this contract and any extensions,Contractor has and shall maintain in place appropriate systems and controls to prevent such improper use of public funds. If the State determines that Contractor is in violation of this provision,the State may exercise any remedy available at law or in equity or under this contract, including,without limitation, immediate termination of this contract and any remedy consistent with federal copyright laws or applicable licensing restrictions. For Contract Wizard Version 3.10 Page 11 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management 9. EMPLOYEE FINANCIAL INTEREST/CONFLICT OF INTEREST. CRS§§24-18-201 and 24-50- 507.The signatories aver that to their knowledge,no employee of the State has any personal or beneficial interest whatsoever in the service or property described in this contract. Contractor has no interest and shall not acquire any interest,direct or indirect,that would conflict in any manner or degree with the performance of Contractor's services and Contractor shall not employ any person having such known interests. 10. VENDOR OFFSET. CRS§§24-30-202 (1)and 24-30-202.4. [Not Applicable to intergovernmental agreements] Subject to CRS §24-30-202.4(3.5),the State Controller may withhold payment under the State's vendor offset intercept system for debts owed to State agencies for: (a) unpaid child support debts or child support arrearages; (b)unpaid balances of tax, accrued interest, or other charges specified in CRS §39-21-101, et seq.; (c)unpaid loans due to the Student Loan Division of the Department of Higher Education; (d) amounts required to be paid to the Unemployment Compensation Fund; and(e)other unpaid debts owing to the State as a result of final agency determination or judicial action. 11. PUBLIC CONTRACTS FOR SERVICES. CRS §8-17.5-101. [Not Applicable to agreements relating to the offer, issuance, or sale of securities, investment advisory services or fund management services, sponsored projects, intergovernmental agreements, or information technology services or products and services] Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract and will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this contract, through participation in the E-Verify Program or the Department program established pursuant to CRS §8-17.5-I02(5)(c), Contractor shall not knowingly employ or contract with an illegal alien to perform work under this contract or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this contract. Contractor(a) shall not use E-Verify Program or Department program procedures to undertake pre-employment screening of job applicants while this contract is being performed, (b) shall notify the subcontractor and the contracting State agency within three days if Contractor has actual knowledge that a subcontractor is employing or contracting with an illegal alien for work under this contract, (e) shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three days of receiving the notice, and(d) shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to CRS §8-17.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in the Department program, Contractor shall deliver to the contracting State agency, Institution of Higher Education or political subdivision a written, notarized affirmation, affirming that Contractor has examined the legal work status of such employee, and shall comply with all of the other requirements of the Department program. If Contractor fails to comply with any requirement of this provision or CRS §8-17.5-101 et seq., the contracting State agency, institution of higher education or political subdivision may terminate this contract for breach and, if so terminated, Contractor shall be liable for damages. 12. PUBLIC CONTRACTS WITH NATURAL PERSONS. CRS §24-76.5-101.Contractor, if a natural person eighteen(18)years of age or older, hereby swears and affirms under penalty of perjury that he or she (a) is a citizen or otherwise lawfully present in the United States pursuant to federal law, (b) shall comply with the provisions of CRS §24-76.5-101 et seq., and (e) has produced one form of identification required by CRS §24-76.5-103 prior to the effective date of this contract. Revised 1-1-09 For Contract Wizard Version 3.10 Page 12 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT *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. CONTRACTOR STATE OF COLORADO Weld County, Colorado Bill Ritter,Jr. GOVERNOR Weld County Department of Human Services Department of Human Services Area Agency on Aging by and through the Karen L. Beye, Executive Director Weld County Board of County Commissioners By: Judy Griego �^ e - , Title: Director C.c u u�tx By: Pauline Burton, Deputy Executive Director �J&[r Date: 7//2//6 Dou as Rademacher, Chair Date: JUN 2 3 2010 2nd Contractor Signature if Needed LEGAL REVIEW By: John W. Suthers, Attorney General Title: By: Signature-Assistant Attorney General *Signature Date: 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. TATEe !ert TROLLER avid t, CPA By: Richard G. aylo /Valri Gimple Date: 7 )7 For Contract Wizard Version 3.10 Page 13 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management QD/e-/i-7 EXHIBIT A DEFINITIONS I. DEFINITIONS: Case Management means the assessment of a client's needs,the development and implementation of a Care Plan for the client,coordination and monitoring of service delivery,the evaluation of service effectiveness and periodic reassessment of the client's needs. Care Planning/Care Plan means the process of identifying goals,client choices for care and services needed, appropriate service providers,and co-payment requirements with the assistance of the client and appropriate collaterals, basedon the client's assessment and knowledge of client and community resources. Program means a publicly funded program, including Adult Foster and Home Care Allowance. Resource Development means the analysis and implementation of additional resources or services that extend the capabilities ofcommunity-based long-term care systems to better serve long-term care clients and those likely to need community-based long-term care in the future. Single Entry Point(SEP)means the availability of an agency within a local area where a current or potential long-term care client can obtain community-based long-term care information, screening, assessment of need,referral to appropriate programs,and case management services. Single Entry Point Agency means the organization selected to provide case management functions to an individual in need of community-based long-term care services within a Single Entry Point District. State/Department as used herein are synonymous. t.J OT V W C O For Contract Wizard Version 3.10 Page 14 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management EXHIBIT A PROGRAM EXPLANATION II. PROGRAM EXPLANATION: A. Home Care Allowance (HCA) is a grant payment for the purpose of securing services for a recipient in his/her home, based on the case manager's assessment. Home Care Allowance is a non-entitlement program. The HCA program is designed to serve those recipients with the lowest functional abilities and the greatest need for paid care. Eligibility for and authorized amounts of the HCA are subject to available appropriations. Services paid for through this grant must be considered non-skilled. These services may include,but are not limited to: I. Assistance with activities of daily living: includes transfers,bladder care,bowel care, mobility, dressing,bathing, hygiene,and eating. 2. Assistance with basic instrumental activities of daily living: includes meal preparation, housework, laundry,and shopping. 3. Supportive service assistance: includes medication management, appointment management, money management,accessing resources, and assistance with telephone use. 4. Electronic Monitoring 5. One time deep cleaning if referral is initiated by Adult Protective Services and can be deemed necessary by the Single Entry Point case manager. B. With regard to this contract the State shall: 1. Monitor and evaluate program performance; 2. Perform program onsite evaluations, as required; 3. Provide training, technical assistance, and consultation,as available; and, 4. Work cooperatively with the Contractor to ensure that State funds are used appropriately and that the State directives to the Contractor are not duplicative or conflicting. a) O C O For Contract Wizard Version 3.10 Page 15 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management • EXHIBIT A STATEMENT OF WORK III. STATEMENT OF WORK A. The Contractor shall perform the functions of a Single Entry Point Agency as defined by Section 26-2-122.3. C.R.S. and the regulations applicable to the Department and the Single Entry Point system at 9 C.C.R. 2503-1, Staff Manual Volume 3, Sections 3.720 et seq. B.The Contractor shall perform its obligations within the provisions of State laws and regulations promulgated pursuant to and including without limitation the Colorado Department of Human Services. C. The Contractor shall perform the functions of case management for eligible persons as defined in the state statutes and regulations, including but not limited to intake/screening/referral, assessment of client need using the Department prescribed form,determination of functional eligibility, development and implementation of a care plan,performance of on-going case management,monitoring of clients, reassessment, and case closure. D.The Contractor shall perform all necessary administrative functions for the operation of a Single Entry Point Agency, as defined in the State statutes and regulations, including but not limited to the following: 1. Providing staff that meets the qualifications set forth in the State statutes and regulations to perform administrative, supervisory, and case management functions. 2. Administering a personnel system for recruiting,hiring, evaluating,and terminating employees. 3. Performing accounting tasks in compliance with all rules and regulations for accounting practices. 4. Establishing and maintaining an information management system that includes collection and reporting of client specific data pertaining to information and referral services provided by the agency,program eligibility determination, care planning, service authorization, resource development, and fiscal accountability. 5. Maintaining client records in accordance with program requirements, including documentation of all case activities and the monitoring of service delivery and service effectiveness. The Contractor shall utilize the Benefits Utilization System(BUS) or the department prescribed data tool for the purpose of client information management. 6. Protecting client's rights in accordance with Department rules and regulations. L-- 7. Providing access to clients,service providers, and others during regular business office hours,Monday tl*oygh Friday, 8:00 a.m. through 5:00 p.m., at a client accessible office. 8. Maintaining staff to operate at least forty(40)hours per week during regular business office hours, Monday`ti��t1 trough Friday, excluding holidays, 8:00 a.m.through 5:00 p.m. C 9. Providing a telephone system and trained staff to ensure timely response to messages,access to telecommunigation devices and/or interpreters for the hearing and vocally impaired,and access to foreign language interpreters, as needed. 10. Conducting a survey of a random sample of clients to determine the level of satisfaction with services provided by the agency to conform to guidelines provided by the Department. 11. Facilitating the application process for potentially eligible individuals,responding in a timely manner to all referrals of eligible clients,and providing appropriate and timely access to services. For Contract Wizard Version 3.10 Page 16 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management 12. Providing a thorough assessment of care needs and resources to assure the most appropriate public and private resources to serve the client's needs. The determination of appropriate resources shall not supplant,but support self- care, family care, and other informal community based resources. The Contractor shall provide a thorough assessment and determine functional eligibility using the Department's prescribed form for all clients requesting Home Care Allowance or Adult Foster Care services. 13. Providing case management functions and establishing a care plan for recipients of publicly funded programs, which include Adult Foster Care and Home Care Allowance. The authorization and administration of services through a publicly funded program shall be in accordance with the program's eligibility criteria as defined by applicable state statutes and regulations as they exist on the date this contract is executed and as they may later be amended. 14. Assuring that a long-term care client who receives case management services receives the type and amount of Home Care Allowance and Adult Foster Care services listed in the care plan or on the client/provider agreement. These services shall not exceed the type and amount of services medically and/or functionally required by each client. 15. Following the standards set by the Department. These standards include Agency Letters and written documents from Department sanctioned training. 16. Processing accurate information within two business days of receipt of notification regarding client Adult Financial or Supplemental Security Income(SSI)eligibility from the eligibility site.The Contractor shall process accurate information within two business days for a client discharged from a hospital or nursing facility. When information is obtained it shall be evaluated to ensure timely services for a client. 17. Providing accurate and timely documentation of client and agency activities. Timely documentation shall be within two business days. 18.Maintaining all complaints from clients in their file log notes. Complaints regarding quality of care issues against a provider shall be forwarded to the Home Health Hotline or the Colorado Department of Public Health and Environment. 19. Reassessing a client at least annually,or sooner if it is determined that the client's condition has changed and will cause an increase or decrease in services,or as prescribed by program criteria. E.The Contractor shall cooperate with the Department, the Community Center Boards,mental health facilities, and other community organizations in the admission of clients for the Home Care Allowance program or Adult Foster Care program. If inappropriate or ineligible for Adult Foster Care or Home Care Allowance, the client or applicant shall be informed of other resources to appropriately manage their care. F. The Contractor shall contact the SEP and the Department of Human Services technician in each county when transferring a client from one county to another county or from one Single Entry Point District to another district. Arrangements should be made to coordinate the transfer of a case to avoid service disruption to the recipient. G. The Contractor shall have a plan to overcome any geographic barriers within the district, including distance from the agency office, to provide timely assessment and case management services to clients. H. The Contractor shall attend Administrative Law Judge hearings when the Single Entry Point Agency has made a denial or adverse action against a client and the client appeals. The Contractor shall defend their decision as described in 10 C.C.R.2505-10, Sections 8.057 et seq. I. The Contractor shall submit Department required information electronically upon the Department's request. J.The Department or a designee, in accordance with the state statutes and regulations, shall review the performance of the Contractor,which may include but is not limited to,onsite visits,evaluation of agency performance in quality of service provided, compliance with program requirements,case management, timeliness,performance of administrative functions, cost per client, communication with clients, client monitoring, targeting of populations served, community coordination and outreach,and financial accountability. The Contractor shall be notified within 30 days of the outcome of a review. The Department or a designee may monitor and/or make recommendations to the Department of Health Care Policy and Finance following review. For Contract Wizard Version 3.10 Page 17 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management EXHIBIT B HIPAA BUSINESS ASSOCIATE ADDENDUM This Business Associate Addendum ("Addendum") is a part of the Contract dated July 1,2010 between the Department of Human Services and Weld County Area Agency on Aging, contract number 11 IIIA 18055. For purposes of this Addendum, the State is referred to as"Covered Entity"or"CE"and the Contractor is referred to as "Associate". Unless the context clearly requires a distinction between the Contract document and this Addendum,all references herein to"the Contract"or"this Contract"include this Addendum. RECITALS A. CE wishes to disclose certain information to Associate pursuant to the terms of the Contract, some of which may constitute Protected Health Information("PHI") (defined below). B. CE and Associate intend to protect the privacy and provide for the security of PHI disclosed to Associate pursuant to this Contract in compliance with the Health Insurance Portability and Accountability Act of 1996, 42 U.S.C. § 1320d— 1320d-8 ("HIPAA")and its implementing regulations promulgated by the U.S. Department of Health and Human Services,45 C.F.R. Parts 160 and 164(the"Privacy Rule")and other applicable laws, as amended. C. As part of the HIPAA regulations,the Privacy Rule requires CE to enter into a contract containing specific requirements with Associate prior to the disclosure of PHI, as set forth in,but not limited to,Title 45, Sections 160.103, 164.502(e) and 164.504(e)of the Code of Federal Regulations("C.F.R.")and contained in this Addendum. The parties agree as follows: 1. Definitions. a. Except as otherwise defined herein, capitalized teens in this Addendum shall have the definitions set forth in the HIPAA Privacy Rule at 45 C.F.R.Parts 160 and 164, as amended. In the event of any conflict between the mandatory provisions of the Privacy Rule and the provisions of this Contract,the Privacy Rule shall control. Where the provisions of this Contract differ from those mandated by the Privacy Rule,but are nonetheless permitted by the Privacy Rule,the provisions of this Contract shall control. b. "Protected Health Information"or"PHI"means any information,whether oral or recorded in any form or medium: (i)that relates to the past,present or future physical or mental condition of an individual; the provision of health care to an individual; or the past,present or future payment for the provision of health care to an individual; and(ii)that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual, and shall have the meaning given to such term under the Privacy Rule,including,but not limited to,45 C.F.R. Section 164.501. c. "Protected Information"shall mean PHI provided by CE to Associate or created or received by Associate on CE's behalf. To the extent Associate is a covered entity under HIPAA and creates or obtains its own PHI for treatment,payment and health care operations,Protected Information under this Contract does not include any PHI created or obtained by Associate as a covered entity and Associate shall follow its own policies and procedures for accounting,access and amendment of Associate's PHI. 2. Obligations of Associate. a. Permitted Uses. Associate shall not use Protected Information except for the purpose of performing Associate's obligations under this Contract and as permitted under this Addendum. Further,Associate shall not use Protected Information in any manner that would constitute a violation of the Privacy Rule if so used by CE, except that Associate may use Protected Information: (i)for the proper management and administration of Associate; (ii)to carry out the legal responsibilities of Associate; or(iii) &rr Data Aggregation purposes for the Health Care Operations of CE. Additional provisions, if any,governing permitted uses of Protected Information are set forth in Attachment A to this Addendum. For Contract Wizard Version 3.10 Page 18 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract management • b. Permitted Disclosures. Associate shall not disclose Protected Information in any manner that would constitute a violation of the Privacy Rule if disclosed by CE, except that Associate may disclose Protected Information: (i)in a manner permitted pursuant to this Contract; (ii)for the proper management and administration of Associate; (iii) as required by law; (iv) for Data Aggregation purposes for the Health Care Operations of CE; or(v)to report violations of law to appropriate federal or state authorities, consistent with 45 C.F.R. Section 164.502(j)(1). To the extent that Associate discloses Protected Information to a third party,Associate must obtain,prior to making any such disclosure: (i)reasonable assurances from such third party that such Protected Information will be held confidential as provided pursuant to this Addendum and only disclosed as required by law or for the purposes for which it was disclosed to such third party; and(ii)an agreement from such third party to notify Associate within two business days of any breaches of confidentiality of the Protected Information, to the extent it has obtained knowledge of such breach. Additional provisions, if any,governing permitted disclosures of Protected Information are set forth in Attachment A. c. Appropriate Safeguards. Associate shall implement appropriate safeguards as are necessary to prevent the use or disclosure of Protected Information other than as permitted by this Contract. Associate shall maintain a comprehensive written information privacy and security program that includes administrative,technical and physical safeguards appropriate to the size and complexity of the Associate's operations and the nature and scope of its activities. d. Reporting of Improper Use or Disclosure. Associate shall report to CE in writing any use or disclosure of Protected Information other than as provided for by this Contract within five (5)business days of becoming aware of such use or disclosure. e. Associate's Agents. If Associate uses one or more subcontractors or agents to provide services under the Contract,and such subcontractors or agents receive or have access to Protected Information,each subcontractor or agent shall sign an agreement with Associate containing substantially the same provisions as this Addendum and further identifying CE as a third party beneficiary with rights of enforcement and indemnification from such subcontractors or agents in the event of any violation of such subcontractor or agent agreement. Associate shall implement and maintain sanctions against agents and subcontractors that violate such restrictions and conditions and shall mitigate the effects of any such violation. f. Access to Protected Information. Associate shall make Protected Information maintained by Associate or its agents or subcontractors in Designated Record Sets available to CE for inspection and copying within ten(10)business days of a request by CE to enable CE to fulfill its obligations to permit individual access to PHI under the Privacy Rule, including,but not limited to,45 C.F.R. Section 164.524. g. Amendment of PHI. Within ten business(10)days of receipt of a request from CE for an amendment of Protected Information or a record about an individual contained in a Designated Record Set Associate or its agents or subcontractors shall make such Protected Information available to CE for amendment and incorporate any such amendment to enable CE to fulfill its obligations with respect to requests by individuals to amend their PHI under the Privacy Rule, including,but not limited to,45 C.F.R. Section 164.526. If any individual requests an amendment of Protected Information directly from Associate or its agents or subcontractors, Associate must notify CE in writing within five(5)business days of receipt of the request. Any denial of amendment of Protected Information maintained by Associate or its agents or subcontractors shall be the responsibility of CE. h. Accounting Rights. Within ten(10)business days of notice by CE of a request for an accounting of disclosures of Protected Information, Associate and its agents or subcontractors shall make available to CE the information required to provide an accounting of disclosures to enable CE to fulfill its obligations under the Privacy Rule, including,but not limited to,45 C.F.R. Section 164.528. As set forth in, and as limited by,45 C.F.R. Section 164.528,Associate shall not provide an accounting to CE of disclosures: (i)to carry out treatment,payment or health care operations, as set forth in 45 C.F.R. Section 164.506;(ii)to individuals of Protected Information about them as set forth in 45 C.F.R. Section 164.502; (iii)pursuant to an authorization as provided in 45 C.F.R. Section 164.508; (iv)to persons involved in the individual's care or other notification purposes as set forth in 45 C.F.R. Section 164.510; (v)for national security or intelligence purposes as set forth in 45 C.F.R. Section 164.512(k)(2); (vi)to correctional institutions or law enforcement officials as set forth in 45 C.F.R. Section 164.512(k)(5);(vii) incident to a use or disclosure otherwise permitted by the Privacy Rule; (viii)as part of a limited data set under 45 C.F.R. Section 164.514(e); or(ix) disclosures prior to April 14,2003. Associate agrees to implement a process that allows for an accounting to be collected and maintained by Associate and its agents or subcontractors for at least six(6)years prior to the request,but not before the compliance date of the Privacy Rule. At a minimum, such information shall include: (i)the date of disclosure; (ii) the name of the entity or person who received Protected Information and, if known,the address of the entity or person; (iii)a brief description of Protected Information disclosed; and(iv)a brief statement of purpose of the For Contract Wizard Version 3.10 Page 19 of 25 Revised 02/08/10 Colorado Department of I Inman Services Division of Contract Management • disclosure that reasonably informs the individual of the basis for the disclosure, or a copy of the individual's authorization, or a copy of the written request for disclosure. In the event that the request for an accounting is delivered directly to Associate or its agents or subcontractors, Associate shall within five(5)business days of the receipt of the request forward it to CE in writing. It shall be CE's responsibility to prepare and deliver any such accounting requested. Associate shall not disclose any Protected Information except as set forth in Section 2(b)of this Addendum. i. Governmental Access to Records. Associate shall make its internal practices,books and records relating to the use and disclosure of Protected Information available to the Secretary of the U.S. Department of Health and Human Services(the"Secretary"), in a time and manner designated by the Secretary, for purposes of determining CE's compliance with the Privacy Rule.Associate shall provide to CE a copy of any Protected Information that Associate provides to the Secretary concurrently with providing such Protected Information to the Secretary. J. Minimum Necessary. Associate (and its agents or subcontractors)shall only request,use and disclose the minimum amount of Protected Information necessary to accomplish the purpose of the request, use or disclosure,in accordance with the Minimum Necessary requirements of the Privacy Rule including,but not limited to 45 C.F.R. Sections 164.502(b) and 164.514(d). k. Data Ownership. Associate acknowledges that Associate has no ownership rights with respect to the Protected Information. 1. Retention of Protected Information. Except upon termination of the Contract as provided in Section 4(d)of this Addendum, Associate and its subcontractors or agents shall retain all Protected Information throughout the term of this Contract and shall continue to maintain the information required under Section 2(h)of this Addendum for a period of six(6) years. m. Associate's Insurance. Associate shall maintain casualty and liability insurance to cover loss of PHI data and claims based upon alleged violations of privacy rights through improper use or disclosure of PHI. All such policies shall meet or exceed the minimum insurance requirements of the Contract(e.g.,occurrence basis, combined single dollar limits, annual aggregate dollar limits, additional insured status and notice of cancellation). n. Notification of Breach During the term of this Contract,Associate shall notify CE within two business days of any suspected or actual breach of security, intrusion or unauthorized use or disclosure of PHI and/or any actual or suspected use or disclosure of data in violation of any applicable federal or state laws or regulations. Associate shall take (i)prompt corrective action to cure any such deficiencies and(ii)any action pertaining to such unauthorized disclosure required by applicable federal and state laws and regulations. o. Audits,Inspection and Enforcement. Within ten(10)business days of a written request by CE, Associate and its agents or subcontractors shall allow CE to conduct a reasonable inspection of the facilities, systems, books,records, agreements,policies and procedures relating to the use or disclosure of Protected Information pursuant to this Addendum for the purpose of determining whether Associate has complied with this Addendum;provided, however,that: (i)Associate and CE shall mutually agree in advance upon the scope,timing and location of such an inspection; (ii)CE shall protect the confidentiality of all confidential and proprietary information of Associate to which CE has access during the course of such inspection; and(iii)CE shall execute a nondisclosure agreement,upon terms mutually agreed upon by the parties, if requested by Associate. The fact that CE inspects,or fails to inspect,or has the right to inspect, Associate's facilities, systems,books,records,agreements,policies and procedures does not relieve Associate of its responsibility to comply with this Addendum,nor does CE's(i) failure to detect or(ii)detection,but failure to notify Associate or require Associate's remediation of any unsatisfactory practices, constitute acceptance of such practice or a waiver of CE's enforcement rights under the Contract. p. Safeguards During Transmission. Associate shall be responsible for using appropriate safeguards to maintain and ensure the confidentiality,privacy and security of Protected Information transmitted to CE pursuant to the Contract,in accordance with the standards and requirements of the Privacy Rule,until such Protected Information is received by CE, and in accordance with any specifications set forth in Attachment A. For Contract Wizard Version 3.10 Page 20 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management q. Restrictions and Confidential Communications. Within ten (10) business days of notice by CE of a restriction upon uses or disclosures or request for confidential communications pursuant to 45 C.F.R. 164.522, Associate will restrict the use or disclosure of an individual's Protected Information, provided Associate has agreed to such a restriction. Associate will not respond directly to an individual's requests to restrict the use or disclosure of Protected Information or to send all communication of Protect Information to an alternate address. Associate will refer such requests to the CE so that the CE can coordinate and prepare a timely response to the requesting individual and provide direction to Associate. 3. Obligations of CE. a. Safeguards During Transmission. CE shall be responsible for using appropriate safeguards to maintain and ensure the confidentiality,privacy and security of PHI transmitted to Associate pursuant to this Contract, in accordance with the standards and requirements of the Privacy Rule,until such PHI is received by Associate,and in accordance with any specifications set forth in Attachment A. b. Notice of Changes. CE shall provide Associate with a copy of its notice of privacy practices produced in accordance with 45 C.F.R. Section 164.520, as well as any subsequent changes or limitation(s)to such notice, to the extent such changes or limitations may effect Associate's use or disclosure of Protected Information. CE shall provide Associate with any changes in,or revocation of,permission to use or disclose Protected Information, to the extent it may affect Associate's permitted or required uses or disclosures. To the extent that it may affect Associate's permitted use or disclosure of PHI,CE shall notify Associate of any restriction on the use or disclosure of Protected Information that CE has agreed to in accordance with 45 C.F.R. Section 164.522. CE may effectuate any and all such notices of non-private information via posting on CE's web site. Associate shall review CE's designated web site for notice of changes to CE's HIPAA privacy policies and practices on the last day of each calendar quarter. 4. Termination. a. Material Breach In addition to any other provisions in the Contract regarding breach,a breach by Associate of any provision of this Addendum, as determined by CE, shall constitute a material breach of this Contract and shall provide grounds for immediate termination of this Contract by CE pursuant to the provisions of the Contract covering termination for cause, if any. If the Contract contains no express provisions regarding termination for cause, the following terms and conditions shall apply: (1) Default. If Associate refuses or fails to timely perform any of the provisions of this Contract, CE may notify Associate in writing of the non-performance,and if not promptly corrected within the time specified,CE may terminate this Contract. Associate shall continue performance of this Contract to the extent it is not terminated and shall be liable for excess costs incurred in procuring similar goods or services elsewhere. (2) Associate's Duties. Notwithstanding termination of this Contract,and subject to any directions from CE,Associate shall take timely,reasonable and necessary action to protect and preserve property in the possession of Associate in which CE has an interest. (3) Compensation. Payment for completed supplies delivered and accepted by CE shall be at the Contract price. In the event of a material breach under paragraph 4a,CE may withhold amounts due Associate as CE deems necessary to protect CE against loss from third party claims of improper use or disclosure and to reimburse CE for the excess costs incurred in procuring similar goods and services elsewhere. (4) Erroneous Termination for Default. If after such termination it is determined, for any reason, that Associate was not in default,or that Associate's action/inaction was excusable, such termination shall be treated as a termination for convenience,and the rights and obligations of the parties shall be the same as if this Contract had been terminated for convenience, as described in this Contract. b. Reasonable Steps to Cure Breach. If CE knows of a pattern of activity or practice of Associate that constitutes a material breach or violation of the Associate's obligations under the provisions of this Addendum or another arrangement and does not terminate this Contract pursuant to Section 4(a),then CE shall take reasonable steps to cure such breach or end such violation, as applicable. IfCE's efforts to cure such breach or end such violation are unsuccessful, CE shall either(i)terminate the Contract, if feasible or(ii) if termination of this Contract is not feasible, CE shall report Associate's breach or violation to the Secretary of the Department of Health and Human Services. For Contract Wizard Version 3.10 Page 21 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management c. Judicial or Administrative Proceedings. Either party may terminate the Contract, effective immediately, if(i)the other party is named as a defendant in a criminal proceeding for a violation of HIPAA,the HIPAA Regulations or other security or privacy laws or(ii)a finding or stipulation that the other party has violated any standard or requirement of HIPAA, the HIPAA Regulations or other security or privacy laws is made in any administrative or civil proceeding in which the party has been joined. d. Effect of Termination. (1) Except as provided in paragraph(2)of this subsection,upon termination of this Contract,for any reason, Associate shall return or destroy all Protected Information that Associate or its agents or subcontractors still maintain in any form, and shall retain no copies of such Protected Information. If Associate elects to destroy the Pill, Associate shall certify in writing to CE that such PHI has been destroyed. (2) If Associate believes that returning or destroying the Protected Information is not feasible, Associate shall promptly provide CE notice of the conditions making return or destruction infeasible. Upon mutual agreement of CE and Associate that return or destruction of Protected Information is infeasible, Associate shall continue to extend the protections of Sections 2(a),2(b), 2(c),2(d) and 2(e)of this Addendum to such information,and shall limit further use of such PIII to those purposes that make the return or destruction of such PHI infeasible. 5. Injunctive Relief CE shall have the right to injunctive and other equitable and legal relief against Associate or any of its subcontractors or agents in the event of any use or disclosure of Protected Information in violation of this Contract or applicable law. 6. No Waiver of Immunity. No term or condition of this Contract shall be construed or interpreted as a waiver, express or implied,of any of the immunities,rights,benefits,protection,or other provisions of the Colorado Governmental Immunity Act,CRS 24-10-101 et seq. or the Federal Tort Claims Act,28 U.S.C.2671 et seq. as applicable,as now in effect or hereafter amended. 7. Limitation of Liability. Any limitation of Associate's liability in the Contract shall be inapplicable to the terms and conditions of this Addendum. 8. Disclaimer. CE makes no warranty or representation that compliance by Associate with this Contract,HIPAA or the HIPAA Regulations will be adequate or satisfactory for Associate's own purposes. Associate is solely responsible for all decisions made by Associate regarding the safeguarding of PHI. 9. Certification. To the extent that CE determines an examination is necessary in order to comply with CE's legal obligations pursuant to HIPAA relating to certification of its security practices,CE or its authorized agents or contractors,may, at CE's expense, examine Associate's facilities, systems,procedures and records as may be necessary for such agents or contractors to certify to CE the extent to which Associate's security safeguards comply with HIPAA, the HIPAA Regulations or this Addendum. 10. Amendment. a. Amendment to Comply with Law. The parties aclmowledge that state and federal laws relating to data security and privacy are rapidly evolving and that amendment of this Addendum may be required to provide for procedures to ensure compliance with such developments. The parties specifically agree to take such action as is necessary to implement the standards and requirements of HIPAA,the Privacy Rule,the Final HIPAA Security regulations at 68 Fed. Reg. 8334 (Feb20,2003),45 C.F.R. § 164.314 and other applicable laws relating to the security or privacy of PHI. The parties understand and agree that CE must receive satisfactory written assurance from Associate that Associate will adequately safeguard all Protected Information. Upon the request of either party, the other party agrees to promptly enter into negotiations concerning the terms of an amendment to this Addendum embodying written assurances consistent with the standards and requirements of HIPAA, the Privacy Rule or other applicable laws. CE may terminate this Contract upon thirty(30)days written notice in the event(i)Associate does not promptly enter into negotiations to amend this Contract when requested by CE pursuant to this Section or(ii)Associate does not enter into an amendment to this Contract providing assurances regarding the safeguarding of PHI that CE, in its sole discretion, deems sufficient to satisfy the standards and requirements of HIPAA and the Privacy Rule. b. Amendment of Attachment A. Attachment A may be modified or amended by mutual agreement of the parties in writing from time to time without formal amendment of this Addendum. For Contract Wizard Version 3.10 Page 22 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management • 11. Assistance in Litigation or Administrative Proceedings. Associate shall make itself, and any subcontractors, • employees or agents assisting Associate in the performance of its obligations under the Contract, available to CE,at no cost to CE up to a maximum of 30 hours,to testify as witnesses,or otherwise, in the event of litigation or administrative proceedings being commenced against CE, its directors,officers or employees based upon a claimed violation of HIPAA,the Privacy Rule or other laws relating to security and privacy or PHI, except where Associate or its subcontractor,employee or agent is a named adverse party. 12. No Third Party Beneficiaries. Nothing express or implied in this Contract is intended to confer,nor shall anything herein confer,upon any person other than CE,Associate and their respective successors or assigns, any rights, remedies,obligations or liabilities whatsoever. 13. Interpretation and Order of Precedence. The provisions of this Addendum shall prevail over any provisions in the Contract that may conflict or appear inconsistent with any provision in this Addendum. Together, the Contract and this Addendum shall be interpreted as broadly as necessary to implement and comply with HIPAA and the Privacy Rule. The parties agree that any ambiguity in this Contract shall be resolved in favor of a meaning that complies and is consistent with HIPAA and the Privacy Rule. This Contract supercedes and replaces any previous separately executed HIPAA addendum between the parties. 14. Survival of Certain Contract Terms. Notwithstanding anything herein to the contrary, Associate's obligations under Section 4(d) ("Effect of Termination") and Section 12 ("No Third Party Beneficiaries") shall survive termination of this Contract and shall be enforceable by CE as provided herein in the event of such failure to perform or comply by the Associate. This Addendum shall remain in effect during the term of the Contract including any extensions. 15. Representatives and Notice. a. Representatives. For the purpose of the Contract, the individuals identified elsewhere in this Contract shall be the representatives of the respective parties. If no representatives are identified in the Contract, the individuals listed below are hereby designated as the parties'respective representatives for purposes of this Contract. Either party may from time to time designate in writing new or substitute representatives. b. Notices. All required notices shall be in writing and shall be hand delivered or given by certified or registered mail to the representatives at the addresses set forth below. State/Covered Entity Representative: Name: Pauline Burton Title: Deputy Executive Director Depaitntent and Division: Colorado Department of Human Services, Office of Self Sufficiency and Independence Address: 1575 Sherman 8th Floor Denver, CO 80203 Contractor/Business Associate Representative: Name: Judy Griego Title: Director Department and Division: Weld County Area Agency on Aging Address: 315 C. N. 11th Ave. Bldg. C Greeley, CO 80631 For Contract Wizard Version 3.10 Page 23 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management ATTACHMENT A This Attachment sets forth additional terms to the HIPAA Business Associate Addendum,which is part of the Contract dated July 1,2010,between July 1, 2010 and June 30, 2011,contract number 11 IHA 18055 ("Contract") and is effective as of July 1,2010(the"Attachment Effective Date"). This Attachment may be amended from time to time as provided in Section 10(b)of the Addendum. 1. Additional Permitted Uses. In addition to those purposes set forth in Section 2(a)of the Addendum, Associate may use Protected Information as follows: None except as otherwise directed in writing by the State 2. Additional Permitted Disclosures. In addition to those purposes set forth in Section 2(b)of the Addendum, Associate may disclose Protected Information as follows: None except as otherwise directed in writing by the State 3. Subcontractor(s). The parties acknowledge that the following subcontractors or agents of Associate shall receive Protected Information in the course of assisting Associate in the performance of its obligations under this Contract: None except as otherwise directed in writing by the State 4. Receipt Associate's receipt of Protected Information pursuant to this Contract shall be deemed to occur as follows,and Associate's obligations under the Addendum shall commence with respect to such PHI upon such receipt: Upon Receipt of PHI from the Department 5. Additional Restrictions on Use of Data. CE is a Business Associate of certain other Covered Entities and, pursuant to such obligations of CE,Associate shall comply with the following restrictions on the use wady disclosure of Protected Information: Fr As may be directed in writing by the State 6. Additional Terms. [This section may include specificationsfor disclosure format, method of a mission, use of an intermediary, use ofdigital signatures or Pa,, authentication, additional security of privacy speci tcations, de identification or reidentification of data and other additional terms.] 'Q None C O For Contract Wizard Version 3.10 Page 24 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management • EXHIBIT C r THE STATE MAY REQUIRE CONTINUED PERFORMANCE FOR A PERIOD OF FOUR ONE YEAR TERMS AT THE SAME RATES AND SAME TERMS SPECIFIED IN THE CONTRACT. IF THE STATE EXERCISES THE OPTION, IT WILL PROVIDE WRITTEN NOTICE TO CONTRACTOR AT LEAST 30 DAYS PRIOR TO THE END OF THE CURRENT CONTRACT TERM IN A FORM SUBSTANTIALLY EQUIVALENT TO THE FOLLOWING SAMPLE OPTION LETTER. IF EXERCISED,THE PROVISIONS OF THE OPTION LETTER SHALL BECOME PART OF AND BE INCORPORATED INTO THE ORIGINAL CONTRACT. THE TOTAL DURATION OF THIS CONTRACT, INCLUDING THE EXERCISE OF ANY OPTIONS UNDER THIS CLAUSE,SHALL NOT EXCEED 5 YEARS. SAMPLE OPTION LETTER Date: State Fiscal Year: Option Letter No. CMS Routing tt 1) OPTIONS: Choose all applicable options listed in §1 and in §2 and delete the rest [also delete all yellow highlighted text]. 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 1. Option to initiate next phase of a contract 2) REQUIRED PROVISIONS. All Option Letters shall contain the appropriate provisions set forth below: a. For use with Options 1(a-e): In accordance with Section(s) of the Original Contract routing number between the State of Colorado, Department of Human Services, and Contractor's Name, the State hereby exercises its option for an additional term beginning Insert start date and ending on Insert ending date at a cost/price specified in Section AND/OR an increase/decrease in the amount of goods/services at the same rate(s) as specified in Identify the Section, Schedule, Attachment, Exhibit etc. b.For use with Option 1(f), please use the following: In accordance with Section(s) of the Original Contract routing number between the State of Colorado, Department of Human Services, and Contractor's Name, the State hereby exercises its option to initiate Phase indicate which Phase: 2, 3, 4, etc for the term beginning Insert start date and ending on Insert ending date at the cost/price specified in Section c. For use with all Options: The amount of the current Fiscal Year contract value is increased/decreased by $ amount of change to a new contract value of Insert New $ Amt to as consideration for services/goods ordered under the contract for the current fiscal year indicate Fiscal Year. The first sentence in Section is hereby modified accordingly. The total contract value including all previous aipsndments, option letters, etc. is Insert New $ Amt. 3) Effective Date. The effective date of this Option Letter is upon approval of the Stateontroller or , whichever is later. STATE OF COLORADO Bill Ritter,Jr. GOVERNOR -0 Department of Human Services Karen L. Beye, Executive Director yri By: Pauline Burton, Deputy 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 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. STATE CONTROLLER David J. McDermott,CPA By: Richard G. Taylor/Valri Gimple Date: For Contract Wizard Version 3.10 Page 25 of 25 Revised 02/08/10 Colorado Department of Human Services Division of Contract Management Hello