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HomeMy WebLinkAbout20101790 RESOLUTION RE: APPROVE CONTRACT TO PERFORM FUNCTIONS OF A SINGLE ENTRY POINT AGENCY FOR MEDICAID LONG TERM CARE AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Contract to perform the functions of a Single Entry Point Agency for Medicaid Long Term Care between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, Area Agency on Aging, and the Colorado Department of Health Care Policy and Financing, commencing upon full execution,and ending June 30, 2011,with further terms and conditions being as stated in said contract, and WHEREAS, after review, the Board deems it advisable to approve said contract, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Contract to perform the functions of a Single Entry Point Agency for Medicaid Long Term Care between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Health Care Policy and Financing, Area Agency on Aging, and the Colorado Department of Human Services be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said contract. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 9th day of August, A.D., 2010. BOARD OF COUNTY COMMISSIONERS WELD CO 1N Y, COLORADO ATTEST: .�*� IZ/�1 ATTEST:., �r• ou as Rad mach r, air Weld County Clerk to the :.ar. fr 4 1851 r 9s�:r.�g�1 u.:arbara Kirkmeye , Pro-Tem Deputy Clerk to the Boa"/ j & ciaC 21 unty A torney cAni I 11-1 David E. Long Date of signature: ®.Zs J' orte., \o Eva.. 2010-1790 ci" 9-IL) HR0081 MEMORANDUM 4$40tA DATE: August 5, 2010 ID TO: Douglas Rademacher, Chair, Board of C mm' Toners / II O�•FROM Jud A. Gie o Director H an Se ices De ent COLORADO y r g ' SUBJECT: Single Entry Point Contract etween the Weld County Department of Human Services' Area Agency on Aging and the Colorado Department of Health Care Policy and Financing for Fiscal Year 2011 Enclosed for Board approval is the Fiscal Year 2011 Single Entry Point Contract between the Weld County Department of Human Services' Area Agency on Aging and the Department of Health Care Policy and Financing. This Contract was presented at the Board's June 21, 2010, Work Session. The Department's Area Agency on Aging provides case management services for Medicaid clients who fall under the responsibility of the Single Entry Point. The contact amount is $1,030,958.63. The effective dates of the Contract are September 1, 2010 through June 30, 2011. If you have any questions, give me a call at extension 6510. 2010-1790 Contract Routing Number 3011-1322 STATE OF COLORADO Department of Health Care Policy and Financing Contract with Weld County Department of Human Services by and through the Weld County Board of Commissioners For Single Entry Point Case Management and Utilization Review for Medicaid Home and Community Based Services Waiver and Long Term Home Health Clients and Applicants TABLE OF CONTENTS 1. PARTIES 2 2. EFFECTIVE DATE AND NOTICE OF NONLIABILITY 2 3. RECITALS 2 4. DEFINITIONS 3 5. TERM AND EARLY TERMINATION 4 6. STATEMENT OF WORK 4 7. PAYMENTS TO CONTRACTOR 5 8. REPORTING-NOTIFICATION 6 9. CONTRACTOR RECORDS 7 10. CONFIDENTIAL INFORMATION 8 11. CONFLICTS OF INTEREST 10 12. REPRESENTATIONS AND WARRANTIES I 1 13. INSURANCE 12 14. BREACH 14 15. REMEDIES 15 16. NOTICES AND REPRESENTATIVES 18 17. RIGHTS IN DATA, DOCUMENTS, AND COMPUTER SOFTWARE 18 18. GOVERNMENTAL IMMUNITY . 19 19. NOT USED 19 20. GENERAL PROVISIONS 19 21. ADDITONAL GENERAL PROVISIONS 22 HIPAA BUSINESS ASSOCIATE ADDENDUM EXHIBIT A, STATEMENT OF WORK EXHIBIT B, CASE MANAGEMENT AGENCY (CMA) ADMINISTRATIVE REVIEW TOOL EXHIBIT C, STATEMENT OF OPERATING EXPENSES EXHIBIT D, CASE MANAGER TRAINING REPORT TEMPLATE EXHIBIT E, COMPLAINT TRENDS/REMEDIAL ACTION REPORT TEMPLATE EXHIBIT F, CRITICAL INCIDENT TRENDS/REMEDIAL ACTION REPORT TEMPLATE 1. PARTIES This Contract(hereinafter called "Contract") is entered into by and between Weld County Department of Human Services by and through the Weld County Board of Commissioners located at PO Box 1805, Greeley, Colorado 80632 (hereinafter called "Contractor"), and the STATE OF COLORADO acting by and through the Department of Health Care Policy and Financing, 1570 Grant Street, Denver, Colorado 80203 (hereinafter called the "State" or "Department"). Contractor and the State hereby agree to the following terms and conditions. 2. EFFECTIVE DATE AND NOTICE OF NONLIABILITY This Contract shall not be effective or enforceable until it is approved and signed by the Colorado State Controller or designee (hereinafter called the "Effective Date"). The State shall not be liable to pay or reimburse Contractor for any performance hereunder including, but not limited to, costs or expenses incurred, or be bound by any provision hereof prior to the Effective Date. 3. RECITALS A. Authority, Appropriation, and Approval Authority to enter into this Contract exists in C.R.S. 25.5-6-105 and C.R.S. 25.5- 6-106 and funds have been budgeted, appropriated and otherwise made available pursuant to C.R.S. 25.5-6-107, C.R.S. 26-1-122 and C.R.S. 26-2-114 and a sufficient unencumbered balance thereof remains available for payment. Required approvals, clearance and coordination have been accomplished from and with appropriate agencies. B. Consideration The Parties acknowledge that the mutual promises and covenants contained herein and other good and valuable consideration are sufficient and adequate to support this Contract. C. Purpose The purpose of this Contract is to secure home and community-based waiver and long term home health case management and associated utilization review services for applicants and clients of Medicaid Long Term Care. D. References All references in this Contract to sections (whether spelled out or using the § symbol), subsections, exhibits or other attachments, are references to sections, Page 2 of 29 subsections, exhibits or other attachments contained herein or incorporated as a part hereof; unless otherwise noted. 4. DEFINITIONS The following terms as used herein shall be construed and interpreted as follows: A. "Contract" means this Contract, its terms and conditions, attached addenda, exhibits, documents incorporated by reference under the terms of this Contract, and any future modifying agreements, exhibits, attachments or references incorporated herein pursuant to Colorado State law, Fiscal Rules, and State Controller Policies. B. Exhibits and other Attachments: The following documents are attached hereto and incorporated by reference herein: HIPAA Business Associate Addendum Exhibit A, Statement of Work Exhibit B, Case Management Agency(CMA) Administrative Review Tool Exhibit C, Statement of Operating Expenses Exhibit D, Case Manager Training Report Template Exhibit E, Complaint Trends/Remedial Action Report Template Exhibit F, Critical Incident Trends/Remedial Action Report Template C. "Goods" means tangible material acquired, produced, or delivered by Contractor either separately or in conjunction with the Services Contractor renders hereunder. D. "Party" means the State or Contractor and Parties means both the State and Contractor. E. "Review" means examining Contractor's Work to ensure that it is adequate, accurate, correct and in accordance with the standards described in this Contract. F. "Services" means the required services to be performed by Contractor pursuant to this Contract. G. "Subcontractor" means third parties, if any, engaged by Contractor to aid in performance of its obligations. H. "Work" means the tasks and activities Contractor is required to perform to fulfill its obligations under this Contract, including the performance of the Services and delivery of the Goods. L "Work Product" means the tangible or intangible results of Contractor's Work, including, but not limited to, software, research, reports, studies, data, Page 3 of 29 photographs, negatives or other finished or unfinished documents, drawings, models, surveys, maps, materials, or work product of any type, including drafts. 5. TERM AND EARLY TERMINATION A. Initial Term-Work Commencement The contract shall be effective upon approval by the State Controller, or designee. The Parties' respective performances under this Contract shall commence on the Effective Date. This Contract shall expire on June 30, 2011, unless sooner terminated or further extended as specified elsewhere herein. B. Two Month Extension The State, at its sole discretion, upon written notice to Contractor as provided in §16, may unilaterally extend the term of this Contract for a period not to exceed two months if the Parties desire to continue the services and a replacement Contract has not been fully executed by the expiration of any initial term or renewal term. The provisions of this Contract in effect when such notice is given, including, but not limited to, prices, rates and delivery requirements, shall remain in effect during the two month extension. The two month extension shall immediately terminate when and if a replacement contract is approved and signed by the Colorado State Controller or an authorized designee, or at the end of two months, whichever is earlier. C. Extension Amendments The State may require continued performance for a period of one year at the same rates and same terms specified in the Contract, unless modified by the extension amendment. Such extension shall be made by contract amendment. An extension amendment is not effective until approved and signed by the Colorado State Controller or an authorized designee. The extended contract shall be considered to include this renewal provision. The total duration of this Contract, including any extension amendments under this clause, shall not exceed five years. 6. STATEMENT OF WORK A. Completion Contractor shall complete the Work and its other obligations as described in this Contract on or before June 30, 2011. The State shall not be liable to compensate Contractor for any Work performed prior to the Effective Date or after the expiration or termination of this Contract. B. Goods and Services Page 4 of 29 Contractor shall procure Goods and Services necessary to complete the Work. Such procurement shall not increase the maximum amount payable hereunder by the State. C. Independent Contractor All persons employed by Contractor or Subcontractors to perform Work under this Contract shall be Contractor's or Subcontractors' employee(s) for all purposes hereunder and shall not be employees of the State for any purpose as a result of this Contract. 7. PAYMENTS TO CONTRAC'T'OR The State shall, in accordance with the provisions of this § 7 and Exhibit A, Statement of Work, pay Contractor in the amounts and using the methods set forth below: A. Maximum Amount The maximum amount payable under this Contract to Contractor by the State for Work performed, including the Holdover period is: State Fiscal Year 2010-11 51,030,958.63 B. Payment Payment pursuant to this Contract will be made as earned. Any advance payments allowed under this Contract shall comply with State Fiscal Rules and be made in accordance with the provisions of this Contract. Contractor shall initiate any payment requests by submitting invoices to the State in the form and manner prescribed by the State. C. Interest The State shall fully pay each invoice within forty-five (45) days of receipt thereof if the amount invoiced represents peformance by Contractor previously accepted by the State. Uncontested amounts not paid by the State within forty-five (45) days shall bear interest on the unpaid balance beginning on the forty-sixth (46") day at a rate not to exceed one percent (1%) per month until paid in full; provided, however, that interest shall not accrue on unpaid amounts that are subject to a good faith dispute. Contractor shall invoice the State separately for accrued interest on delinquent amounts. The billing shall reference the delinquent payment, the number of days' interest to be paid and the interest rate. D. Available Funds-Contingency-Termination Page 5 of 29 The State is prohibited by law from making commitments beyond the term of the State's current fiscal year. Therefore, Contractor's compensation beyond the State's current fiscal year is contingent upon the continuing availability of State appropriations as provided in the Colorado Special Provisions, set forth below. If federal funds are used to fund this Contract, in whole or in part, the State's performance hereunder is contingent upon the continuing availability of such funds. Payments pursuant to this Contract shall be made only from available funds and the State's liability for such payments shall be limited to the amount remaining of such available funds. If State or federal funds are not appropriated, or otherwise become unavailable to fund this Contract, the State may terminate this Contract immediately, in whole or in part, without further liability notwithstanding any notice and cure period in § 14.B. E. Erroneous Payments At the State's sole discretion, payments made to Contractor in error for any reason, including, but not limited to, overpayments or improper payments, may be recovered from Contractor by deduction from subsequent payments under this Contract or other contracts, grants or agreements between the State and Contractor or by other appropriate methods and collected as a debt due to the State. Such funds shall not be paid to any party other than the State. 8. REPORTING— NOTIFICATION Reports required under this Contract shall be in accordance with the procedures and in such form as prescribed by the State. A. Quarterly Reports The Contractor shall submit to the Department by the end of each quarter (September 30, December 31, March 31 and June 15 (for final quarter reporting purposes) of each year), all quarterly reports as documented in Section 5 of Exhibit A. B. Monthly Reports The Contractor shall provide to the Department on a monthly basis, a written program report specifying the number and type of Medicaid Long Term Care clients and applicants served and the specific services provided. Such written reports shall be in accordance with the procedures developed and prescribed by the Department. Required reports shall be submitted to the Department not later than the 30111 day of each subsequent calendar month, or at such time as otherwise specified. The Contractor shall provide to the Department on a monthly basis, a written program report identifying the monthly operating expenses incurred by the Page 6 of 29 Contractor in the satisfaction of the terms and conditions of this Contract. Such written reports shall be in accordance with the procedures developed and prescribed by the Department in the format as provided in Exhibit C Statement of Operating Expenses. Reports shall be submitted to the Department not later than the 30th day of each subsequent calendar month, or at such time as otherwise specified. C. Litigation Reporting Within ten (10) days after being served with any pleading in a legal action filed with a court or administrative agency, related to this Contract or which may affect Contractor's ability to perform its obligations hereunder, Contractor shall notify the State of such action and deliver copies of such pleadings to the State's principal representative as identified herein. If the State's principal representative is not then serving, such notice and copies shall be delivered to the Executive Director of the Department. D. Noncompliance Contractor's failure to provide reports and notify the State in a timely manner in accordance with this § 8 may result in the delay of payment of funds and/or termination as provided under this Contract. 9. CONTRACTOR RECORDS A. Maintenance Contractor shall make, keep, maintain, and allow inspection and monitoring by the State of a complete file of all records, documents, communications, notes and other written materials, electronic media files and electronic communications, pertaining in any manner to the Work or the delivery of Services or Goods hereunder. Contractor shall maintain such records until the last to occur of: (i) a period of six (6) years after the date this Contract expires or is sooner terminated, or (ii) a period of six (6) years after final payment is made hereunder, or (iii) a period of six (6) years after the resolution of any pending Contract matters, or(iv) if an audit is occuring, or Contractor has received notice that an audit is pending, until such audit has been completed and its findings have been resolved (collectively, the "Record Retention Period"). All such records, documents, communications and other materials shall be the property of the State, and shall be maintained by the Contractor in a central location and the Contractor shall be custodian on behalf of the State. B. Inspection Contractor shall permit the State, the federal government and any other duly authorized agent of a governmental agency to audit, inspect, examine, excerpt, Page 7 of 29 copy and/or transcribe Contractor's records related to this Contract during the Record Retention Period, to assure compliance with the terms hereof or to evaluate performance hereunder. The State reserves the right to inspect the Work at all reasonable times and places during the term of this Contract, including any extensions or renewals. If the Work fails to conform with the requirements of this Contract, the State may require Contractor promptly to bring the Work into conformity with Contract requirements, at Contractor's sole expense. If the Work cannot be brought into conformance by re-performance or other corrective measures, the State may require Contractor to take necessary action to ensure that future performance conforms to Contract requirements and exercise the remedies available under this Contract, at law or in equity, in lieu of or in conjunction with such corrective measures. C. Monitoring Contractor shall permit the State, the federal government and any other duty authorized agent of a government agency, in their sole discretion, to monitor all activities conducted by Contractor pursuant to the terms of this Contract using any reasonable procedure, including, but not limited to: internal evaluation procedures, examination of program data, special analyses, on-site checking, formal audit examinations, or any other procedure. All monitoring controlled by the State shall be performed in a manner that shall not unduly interfere with Contractor's performance hereunder. D. Final Audit Report If an audit is performed on Contractor's records for any fiscal year covering a portion of the term of this Contract, Contractor shall submit a copy of the final audit report to the State or its principal representative at the address specified herein. 10. CONFIDENTIAL INFORMATION Contractor shall comply with the provisions of this § 10 if it becomes privy to confidential information in connection with its performance hereunder. Confidential information includes, but is not necessarily limited to, any state records, personnel records, and information concerning individuals. Such information shall not include information required to be disclosed pursuant to the Colorado Open Records Act, CRS §24-72-101, et seq. A. Confidentiality Contractor shall keep all State records and information confidential at all times and comply with all laws and regulations concerning confidentiality of information. Any request or demand by a third party for State records and Page 8 of 29 information in the possession of Contractor shall be immediately forwarded to the State's principal representative. B. Health Insurance Portability&Accountability Act of 1996 ("HIPAA") Federal Law and Regulations Pursuant to federal law and regulations governing the privacy of certain health information, the Contractor, to the extent applicable, shall comply 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. ii. Business Associate Contract Federal law and regulations governing the privacy of certain health information requires a "Business Associate Contract" between the State and the Contractor. 45 C.F.R. Section 164.504(e). Attached and incorporated herein by reference and agreed to by the parties is a HIPAA Business Associate Addendum ("Addendum") for HIPAA compliance. Terms of the Addendum shall be considered binding upon execution of this Contract and shall remain in effect during the term of the Contract including any extensions. iii. Confidentiality of Records Whether or not an Addendum is attached to this Contract, the Contractor shall protect the confidentiality of all records and other materials containing personally identifying information that are maintained in accordance with the Contract and comply with HIPAA rules and regulations. Except as provided by law, no information in possession of the Contractor about any individual constituent shall be disclosed in a form including identifying information without the prior written consent of the person in interest, a minor's parent, or guardian. The Contractor shall have written policies governing access to, duplication and dissemination of, all such information. The Contractor shall advise its employees, agents and subcontractors, if any, that they are subject to these confidentiality requirements. The Contractor shall provide its employees, agents and subcontractors, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. No confidentiality requirements contained in this Contract shall negate or supersede the provisions of the federal Health Insurance Portability and Accountability Act of 1996. Page 9 of 29 C. Notification Contractor shall notify its agents, employees, Subcontractors and assigns who may come into contact with State records or other confidential information that each is subject to the confidentiality requirements set forth herein, and shall provide each with a written explanation of such requirements before permitting them to access such records and information. D. Use, Security, and Retention Confidential information of any kind shall not be distributed or sold to any third party or used by Contractor or its agents in any way, except as authorized by this Contract or approved in writing by the State. Contractor shall provide and maintain a secure environment that ensures confidentiality of all State records and other confidential information wherever located. Confidential information shall not be retained in any files or otherwise by Contractor or its agents, except as permitted in this Contract or approved in writing by the State. E. Disclosure-Liability Disclosure of State records or other confidential information by Contractor for any reason may be cause for legal action by third parties against Contractor, the State or their respective agents. Contractor shall indemnify, save, and hold harmless the State, its employees and agents, against any and all claims, damages, liability and court awards including costs, expenses, and attorney fees and related costs, incurred as a result of any act or omission by Contractor, or its employees, agents, Subcontractors, or assignees pursuant to this § 10. 11. CONFLICTS OF INTEREST A. Contractor shall not engage in any business or personal activities or practices or maintain any relationships which conflict in any way with the full performance of Contractor's obligations hereunder. Contractor acknowledges that with respect to this Contract, even the appearance of a conflict of interest is harmful to the State's interests. Absent the State's prior written approval, Contractor shall refrain from any practices, activities or relationships that reasonably appear to be in conflict with the full performance of Contractor's obligations to the State hereunder. If a conflict or appearance exists, or if Contractor is uncertain whether a conflict or the appearance of a conflict of interest exists, Contractor shall submit to the State a disclosure statement setting forth the relevant details for the State's consideration. Failure to promptly submit a disclosure statement or to follow the State's direction in regard to the apparent conflict constitutes a breach of this Contract. B. The Contractor (and Subcontractors or subgrantees permitted under the terms of this Contract) shall maintain a written code of standards governing the Page I 0 of 29 performance of its employees engaged in the award and administration of contracts. No employee, officer or agent of the Contractor, Subcontractor or subgrantee shall participate in the selection, or in the award or administration of a contract or subcontract supported by federal funds if a conflict of interest, real or apparent, would be involved. Such a conflict would arise when: i. The employee, officer or agent; Any member of the employee's immediate family; The employee's partner; or iv. An organization which employs, or is about to employ, any of the above, has a financial or other interest in the firm selected for award. The Contractor's, Subcontractor's, or subgrantee's officers, employees, or agents will neither solicit nor accept gratuities, favors, or anything of monetary value from Contractors, potential Contractors, or parties to subagreements. 12. REPRESENTATIONS AND WARRANTIES Contractor makes the following specific representations and warranties, each of which was relied on by the State in entering into this Contract. A. Standard and Manner of Performance Contractor shall perform its obligations hereunder in accordance with the highest standards of care, skill and diligence in Contractor's industry, trade, or profession and in the sequence and manner set forth in this Contract. B. Legal Authority—Contractor Signatory Contractor warrants that it possesses the legal authority to enter into this Contract and that it has taken all actions required by its procedures, and bylaws, and/or applicable laws to exercise that authority, and to lawfully authorize its undersigned signatory to execute this Contract, or any part thereof, and to bind Contractor to its terms. If requested by the State, Contractor shall provide the State with proof of Contractor's authority to enter into this Contract within five (5) days of receiving such request. C. Licenses, Pennits, Etc. Contractor represents and warrants that as of the Effective Date it has, and that at all times during the term hereof it shall have and maintain, at its sole expense, all licenses, certifications, approvals, insurance, permits and other authorizations required by law to perform its obligations hereunder. Contractor warrants that it shall maintain all necessary licenses, certifications, approvals, insurance, permits, and other authorizations required to properly perform this Contract, without reimbursement by the State or other adjustment in the Contract. Additionally, all Page I I of 29 employees, agents, and Subcontractors of Contractor performing Services under this Contract shall hold all required licenses or certifications, if any, to perform their responsibilities. Contractor, if a foreign corporation or other foreign entity transacting business in the State of Colorado, further warrants that it currently has obtained and shall maintain any applicable certificate of authority to transact business in the State of Colorado and has designated a registered agent in Colorado to accept service of process. Any revocation, withdrawal or non-renewal of licenses, certifications, approvals, insurance, permits or any such similar requirements necessary for Contractor to properly perform the terms of this Contract is a material breach by Contractor and constitutes grounds for termination of this Contract. 13. INSURANCE Contractor and its Subcontractors shall obtain and maintain insurance as specified in this section at all times during the term of this Contract. All policies evidencing the insurance coverage required hereunder shall be issued by insurance companies satisfactory to Contractor and the State. A. Contractor Public Entities If Contractor is a "public entity" within the meaning of the Colorado Governmental Immunity Act, CRS §24-10-101, et seq., as amended (the "GIA"), then Contractor shall maintain at all times during the term of this Contract such liability insurance, by commercial policy or self-insurance, as is necessary to meet its liabilities under the GIA. Contractor shall show proof of such insurance satisfactory to the State, if requested by the State. Contractor shall require each contract with a Subcontractor that is a public entity, to include the insurance requirements necessary to meet such Subcontractor's liabilities under the GIA. Non-Public Entities If Contractor is not a "public entity" within the meaning of the GIA, Contractor shall obtain and maintain during the term of this Contract insurance coverage and policies meeting the requirements set forth in § 13.B. B. Contractors—Subcontractors Contractor shall require each contract with Subcontractors other than those that are public entities, providing Goods or Services in connection with this Contract, to include insurance requirements substantially similar to the following: Page 12 of 29 Worker's Compensation Worker's Compensation Insurance as required by State statute, and Employer's Liability Insurance covering all of Contractor's or Subcontractor's employees acting within the course and scope of their employment. General Liability Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent, covering premises operations, fire damage, independent contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: a. S1,000,000 each occurrence; b. 51,000,000 general aggregate; c. S 1,000,000 products and completed operations aggregate; and d. S50,000 any one fire. If any aggregate limit is reduced below SI,000,000 because of claims made or paid, Subcontractor shall immediately obtain additional insurance to restore the full aggregate limit and furnish to Contractor a certificate or other document satisfactory to Contractor showing compliance with this provision. iii. Automobile Liability Automobile Liability Insurance covering any auto (including owned, hired and non-owned autos) with a minimum limit of S1,000,000 each accident combined single limit. iv. Additional Insured The State shall be named as additional insured on all Commercial General Liability and Automobile Liability Insurance policies (leases and construction contracts require additional insured coverage for completed operations on endorsements CG 2010 11/85, CG 2037, or equivalent) required of Contractor and any Subcontractors hereunder. v. Primacy of Coverage Coverage required of Contractor and Subcontractor shall be primary over any insurance or self-insurance program carried by Contractor or the State. vi. Cancellation Page 13 of 29 The above insurance policies shall include provisions preventing cancellation or non-renewal without at least thirty (30) days prior notice to Contractor and the State by certified mail and in accordance with § 16. vii. Subrogation Waiver All insurance policies in any way related to this Contract and secured and maintained by Contractor or its Subcontractors as required herein shall include clauses stating that each carrier shall waive all rights of recovery, under subrogation or otherwise, against Contractor or the State, its agencies, institutions, organizations, officers, agents, employees, and volunteers. C. Certificates Contractor and all Subcontractors shall provide certificates showing insurance coverage required hereunder to the State within seven (7) business days of the Effective Date of this Contract. No later than fifteen (15) days prior to the expiration date of any such coverage, Contractor and each Subcontractor shall deliver to the State or Contractor certificates of insurance evidencing renewals thereof. In addition, upon request by the State at any other time during the term of this Contract or any subcontract, Contractor and each Subcontractor shall, within ten (10) days of such request, supply to the State evidence satisfactory to the State of compliance with the provisions of this § 13. 14. BREACH A. Defined In addition to any breaches specified in other sections of this Contract, the failure of the Contractor to perform any of its material obligations hereunder in whole or in part or in a timely or satisfactory manner, constitutes a breach. The institution of proceedings under any bankruptcy, insolvency, reorganization or similar law, by or against Contractor, or the appointment of a receiver or similar officer for Contractor or any of its property, which is not vacated or fully stayed within twenty (20) days after the institution or occurrence thereof, shall also constitute a breach. B. Notice and Cure Period In the event of a breach, the State shall notify the Contractor of such in writing in the manner provided in § 16. If such breach is not cured within ten (10) days of receipt of written notice, the State may exercise any of the remedies set forth in § 15. Notwithstanding anything to the contrary herein, the State, in its sole discretion, need not provide advance notice or a cure period and may immediately Page 14 of 29 terminate this Contract in whole or in part if reasonably necessary to preserve public safety or to prevent immediate public crisis. 15. REMEDIES A. Termination for Cause and/or Breach If Contractor is in breach under any provision of this Contract, the State shall have all of the remedies listed in this § 15 in addition to all other remedies set forth in other sections of this Contract, and without limiting its remedies otherwise available at law or equity, following the notice and cure period set forth in § 14.B. Remedies are cumulative and the State may exercise any or all of the remedies available to it, in its sole discretion, concurrently or consecutively. The State may terminate this entire Contract or any part of this Contract. Exercise by the State of this right shall not be a breach of its obligations hereunder. Obligations and Rights To the extent specified in any termination notice, Contractor shall not incur further obligations or render further performance hereunder past the effective date of such notice, and shall terminate outstanding orders and subcontracts with third parties. However, Contractor shall complete and deliver to the State all Work, Services and Goods not cancelled by the termination notice. Contractor shall continue performance of this Contract up to the effective date of the termination. To the extent the Contract is not terminated, Contractor shall continue performance until the expiration of this Contract. At the sole discretion of the State, Contractor shall assign to the State all of Contractor's right, title, and interest under such terminated orders or subcontracts. Upon termination, Contractor shall take timely, reasonable and necessary action to protect and preserve property in the possession of Contractor in which the State has an interest. All materials owned by the State in the possession of Contractor shall be immediately returned to the State. All Work Product, at the option of the State, shall be delivered by Contractor to the State and shall become the State's property. The Contractor shall be obligated to return any payment advanced under the provisions of this Contract. Payments The State shall reimburse Contractor only for accepted performance up to the effective date of the termination. If, after termination by the State, it is determined that Contractor was not in breach or that Contractor's action or inaction was excusable, such termination shall be treated as a termination in the public interest and the rights and obligations of the Parties shall be the same as if this Contract had been terminated in the public interest, as described herein. Page 15 of 29 Damages and Withholding Notwithstanding any other remedial action by the State, Contractor shall remain liable to the State for any damages sustained by the State by virtue of any breach under this Contract by Contractor and the State may withhold any payment to Contractor for the purpose of mitigating the State's damages, until such time as the exact amount of damages due to the State from Contractor is determined. The State may withhold any amount that may be due Contractor as the State deems necessary to protect the State against loss, including loss as a result of outstanding liens, claims of former lien holders, or for the excess costs incurred in procuring similar goods or services. Contractor shall be liable for excess costs incurred by the State in procuring from third parties replacement Work, Services or substitute Goods as cover. B. Early Termination in the Public Interest The State is entering into this Contract for the purpose of carrying out the public policy of the State of Colorado, as determined by its Governor, General Assembly, and/or courts. If this Contract ceases to further the public policy of the State, the State, in its sole discretion, may terminate this Contract, in whole or in part. Exercise by the State of this right shall not constitute a breach of the State's obligations hereunder. This subsection shall not apply to a termination of this Contract by the State for cause or breach by Contractor, which shall be governed by§ 15.A or as otherwise specifically provided for herein. Method and Content The State shall notify Contractor of such termination in accordance with §16. The notice shall specify the effective date of the termination, which shall be at least twenty(20) days, and whether it affects all or a portion of this Contract. ii. Obligations and Rights Upon receipt of a termination notice, Contractor shall be subject to and comply with the same obligations and rights set forth in § 15.A.i. ii. Payments If this Contract is terminated by the State pursuant to this § 15.B, Contractor shall be paid an amount which bears the same ratio to the total reimbursement under this Contract as Contractor's obligations that were satisfactorily performed bear to the total obligations set forth in this Contract, less payments previously made. Additionally, if this Contract is Page 16 of 29 less than 60% completed upon the effective date of such termination, the State may reimburse Contractor for a portion of actual out-of-pocket expenses (not otherwise reimbursed under this Contract) incurred by Contractor prior to the effective date of the termination in the public interest which are directly attributable to the uncompleted portion of Contractor's obligations hereunder; provided that the sum of any and all reimbursement shall not exceed the maximum amount payable to Contractor hereunder. C. Remedies The State, in its sole discretion, may exercise one or more of the following remedies in addition to other remedies available to it: Suspend Performance Suspend Contractor's performance with respect to all or any portion of this Contract pending necessary corrective action as specified by the State without entitling Contractor to an adjustment in price/cost or performance schedule. Contractor shall promptly cease performance of such portions of the contract. Withhold Payment Withhold payment to Contractor until Contractor's performance or corrections in Contractor's performance are satisfactorily made and completed. Deny/Reduce Payment Deny payment for those obligations not performed in conformance with Contract requirements, that due to Contractor's actions or inactions, cannot be performed or, if performed, would be of no value to the State; provided, that any denial or reduction of payment shall be reasonably related to the value to the State of the obligations not performed. iv. Removal Notwithstanding any other provision herein, the State may demand immediate removal of any of Contractor's employees, agents, or Subcontractors whom the State deems incompetent, careless, insubordinate, unsuitable, or otherwise unacceptable, or whose continued relation to this Contract is deemed to be contrary to the public interest or the State's best interest. v. Intellectual Property Page 17 of 29 If Contractor infringes on a patent, copyright, trademark, trade secret or other intellectual property right while performing its obligations under this Contract, Contractor shall, at the State's option: a. Obtain for the State or Contractor the right to use such products and services; b. Replace any Goods, Services, or other product involved with non- infringing products or modify them so that they become non- infringing; or, c. If neither of the foregoing alternatives are reasonably available, remove any infringing Goods, Services, or products and refund the price paid therefore to the State. 16. NOTICES AND REPRESENTATIVES Each individual identified below is the principal representative of the designating Party. All notices required to be given hereunder shall be hand delivered with receipt required or sent by certified or registered mail to such Party's principal representative at the address set forth below. In addition to, but not in lieu of, a hard-copy notice, notice also may be sent by e-mail to the e-mail addresses, if any, set forth below. Either Party may from time to time designate by written notice substitute addresses or persons to whom such notices shall be sent. Unless otherwise provided herein, all notices shall be effective upon receipt. For the State: W. Sean Bryan Department of Health Care Policy and Financing 1570 Grant Street Denver, Colorado 80203 william.bryan@state.co.us For the Contractor: Eva Jewell SEP Administrator Weld County Department of Human Services by and through the Weld County Board of Commissioners PO Box 1805 Greeley, Colorado 80632 17. RIGHTS IN DATA, DOCUMENTS, AND COMPUTER SOFTWARE Any software, research, reports, studies, data, photographs, negatives or other documents, drawings, models, materials, or Work Product of any type, including drafts, prepared by Page 18 of 29 Contractor in the performance of its obligations under this Contract shall be the exclusive property of the State, and all Work Product shall be delivered to the State by Contractor upon completion or termination hereof The State's exclusive rights in such Work Product shall include, but not be limited to, the right to copy, publish, display, transfer, and prepare derivative works. Contractor shall not use, willingly allow, cause or permit such Work Product to be used for any purpose other than the performance of Contractor's obligations hereunder without the prior written consent of the State. 18. GOVERNMENTAL IMMUNITY Liability for claims for injuries to persons or property arising from the negligence of the State of Colorado, its departments, institutions, agencies, boards, officials, and employees is controlled and limited by the provisions of the Colorado Governmental Immunity Act, CRS §24-10-101, et seq., and the risk management statutes, CRS §24-30-1501, et seq., as now or hereafter amended. 19. NOT USED 20. GENERAL PROVISIONS A. Assignment and Subcontracts Contractor's rights and obligations hereunder are personal and may not be transferred, assigned or subcontracted without the prior, written consent of the State. Any attempt at assignment, transfer or subcontracting without such consent shall be void. All assignments, subcontracts, or Subcontractors are subject to all of the provisions hereof. Contractor shall be solely responsible for all of the Work performed under this Contract, regardless of whether Subcontractors are used and for all aspects of subcontracting arrangements and performance. Copies of any and all subcontracts entered into by Contractor to perform its obligations hereunder shall be in writing and submitted to the State upon request. Any and all subcontracts entered into by Contractor related to its performance hereunder shall require the Subcontractor to perform in accordance with the terms and conditions of this Contract and to comply with all applicable federal and state laws. Any and all subcontracts shall include a provision that such subcontracts are governed by the laws of the State of Colorado. B. Binding Effect Except as otherwise provided in §20.A, all provisions herein contained, including the benefits and burdens, shall extend to and be binding upon the Parties' respective heirs, legal representatives, successors, and assigns. C. Captions Page 19 of 29 The captions and headings in this Contract are for convenience of reference only, and shall not be used to interpret, define, or limit its provisions. D. Counterparts This Contract may be executed in multiple identical original counterparts, all of which shall constitute one agreement. E. Entire Understanding This Contract represents the complete integration of all understandings between the Parties and all prior representations and understandings, oral or written, are merged herein. Prior or contemporaneous additions, deletions, or other changes hereto shall not have any force or effect whatsoever, unless embodied herein. F. Indemnification Contractor shall indemnify, save, and hold harmless the State, its employees and agents, against any and all claims, damages, liability and court awards including costs, expenses, and attorney fees and related costs, incurred as a result of any act or omission by Contractor, or its employees, agents, Subcontractors, or assignees pursuant to the terms of this Contract; however, the provisions hereof shall not 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 etseq.,or the Federal Tort Claims Act, 28 U.S.C. 2671 et seq., as applicable, as now or hereafter amended. G. Jurisdiction and Venue All suits or actions related to this Contract shall be filed and proceedings held in the State of Colorado and exclusive venue shall be in the City and County of Denver. H. Modification By the Parties Except as specifically provided in this Contract, modifications of this Contract shall not be effective unless agreed to in writing by the Parties in an amendment to this Contract, properly executed and approved in accordance with applicable Colorado State law and State Fiscal Rules. Modifications permitted under this Contract, other than contract amendments, shall conform to the policies of the Office of the State Controller, including, but not limited to, the policy entitled MODIFICATIONS OF CONTRACTS - TOOLS AND FORMS. Page 20 of 29 By Operation of Law This Contract is subject to such modifications as may be required by changes in Federal or Colorado State law, or their implementing regulations. Any such required modification automatically shall be incorporated into and be part of this Contract on the effective date of such change, as if fully set forth herein. Order of Precedence The provisions of this Contract shall govern the relationship of the State and Contractor. In the event of conflicts or inconsistencies between this Contract and its exhibits and attachments, including, but not limited to, those provided by Contractor, such conflicts or inconsistencies shall be resolved by reference to the documents in the following order of priority: Colorado Special Provisions I-IPAA Business Associate Addendum The provisions of the main body of this Contract iv. Exhibit A, Statement of Work v. Exhibit B, Case Management Agency(CMA) Administrative Review Tool vi. Exhibit C, Statement of Operating Expenses vii. Exhibit D, Case Manager Training Report Template viii. Exhibit E, Complaint Trends/Remedial Action Report Template ix. Exhibit F, Critical Incident Trends/Remedial Action Report Template J. Severability Provided this Contract can be executed and performance of the obligations of the Parties accomplished within its intent, the provisions hereof are severable and any provision that is declared invalid or becomes inoperable for any reason shall not affect the validity of any other provision hereof. K. Survival of Certain Contract Terms Notwithstanding anything herein to the contrary, provisions of this Contract requiring continued performance, compliance, or effect after termination hereof, shall survive such termination and shall be enforceable by the State if Contractor fails to perform or comply as required. L. Taxes The State is exempt from all federal excise taxes under IRC Chapter 32 (No. 84- 730123K) and from all State and local government sales and use taxes under CRS §39-26-101 and 201, et seq. Such exemptions apply when materials are purchased Page 21 of 29 or services are rendered to benefit the State; provided, however, that certain political subdivisions (e.g., City of Denver) may require payment of sales or use taxes even though the product or service is provided to the State. Contractor shall be solely liable for paying such taxes as the State is prohibited from paying or reimbursing Contractor for such taxes. M. Third Party Beneficiaries Enforcement of this Contract and all rights and obligations hereunder are reserved solely to the Parties. Any services or benefits which third parties receive as a result of this Contract are incidental to the Contract, and do not create any rights for such third parties. N. Waiver Waiver of any breach under a term, provision, or requirement of this Contract, or any right or remedy hereunder, whether explicitly or by lack of enforcement, shall not be construed or deemed as a waiver of any subsequent breach of such term, provision or requirement, or of any other term, provision, or requirement. 21. ADDITIONAL GENERAL PROVISIONS A. Compliance With Applicable Law The Contractor shall at all times during the execution of this Contract strictly adhere to, and comply with, all applicable federal and state laws, and their implementing regulations, as they currently exist and may hereafter be amended, which are incorporated herein by this reference as terms and conditions of this Contract. The Contractor shall also require compliance with these statutes and regulations in subcontracts and subgrants permitted under this contract. The federal laws and regulations include: Age Discrimination Act of 1975, as 42 U.S.C. 6101, et seq. amended Age Discrimination in Employment Act 29 U.S.C. 621-634 of 1967 Americans with Disabilities Act of 1990 42 U.S.C. 12101, et seq. (ADA) Clean Air Act 42 U.S.C. 7401, et seq. Equal Employment Opportunity E.O. 11246,as amended by E.O. 11375, amending E.O. 11246 and as supplemented by 41 CFR Part 60 Page 22 of 29 Equal Pay Act of 1963 29 U.S.C. 206(d) Federal Water Pollution Control Act, as 33 U.S.C. 1251, et seq. amended Immigration Reform and Control Act of 8 U.S.C. I324b 1986 Section 504 of the Rehabilitation Act of 29 U.S.C. 794 1973, as amended Title VI of the Civil Rights Act of 1964, 42 U.S.C. 2000d, et seq. as amended Title VII of the Civil Rights Act of 1964 42 U.S.C. 2000e Title IX of the Education Amendments of 20 U.S.C. 1681 1972, as amended State laws include: Civil Rights Division Section 24-34-301, CRS, et seq. The Contractor also shall comply with any and all laws and regulations prohibiting discrimination in the specific program(s) which is/are the subject of this Contract. In consideration of and for the purpose of obtaining any and all federal and/or state financial assistance, the Contractor makes the following assurances, upon which the State relies. The Contractor will not discriminate against any person on the basis of race, color, national origin, age, sex, religion or handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS-related conditions, in performance of Work under this Contract. ii. At all times during the performance of this Contract, no qualified individual with a disability shall, by reason of such disability, be excluded from participation in, or denied benefits of the service, programs, or activities performed by the Contractor, or be subjected to any discrimination by the Contractor. The Contractor shall take all necessary affirmative steps, as required by 45 CFR 92.36(e), Colorado Executive Order and Procurement Rules, to assure that small and minority businesses and women's business enterprises are used, when possible, as sources of supplies, equipment, construction, and services purchased under this Contract. Page 23 of 29 B. Federal Audit Provisions Office of Management and Budget (OMB) Circular No. A-133 Audits of States, Local Governments, and Non-Profit Organizations defines audit requirements under the Single Audit Act of 1996 (Public Law 104-156). All state and local governments and non-profit organizations expending $500,000 or more from all sources (direct or from pass-through entities) are required to comply with the provisions of Circular No. A-133. The Circular also requires pass-through entities to monitor the activities of subrecipients and ensure that subrecipients meet the audit requirements. To identify its pass-through responsibilities, the State of Colorado requires all subrecipients to notify the State when expected or actual expenditures of federal assistance from all sources equal or exceed $500,000. C. Debarment and Suspension If this is a covered transaction or the Contract amount exceeds $100,000, the Contractor certifies to the best of its knowledge and belief that it and its principals and Subcontractors are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency. ii. This certification is a material representation of fact upon which reliance was placed when the State determined to enter into this transaction. If it is later determined that the Contractor knowingly rendered an erroneous certification, in addition to other remedies available at law or by contract, the State may terminate this Contract for default. The Contractor shall provide immediate written notice to the State if it has been debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded by any Federal department or agency. iv. The terms "covered transaction," "debarment," "suspension," "ineligible," "lower tier covered transaction," "principal," and "voluntarily excluded," as used in this paragraph, have the meanings set out in 2 CFR Parts 180 and 376. v. The Contractor agrees that it will include this certification in all lower tier covered transactions and subcontracts that exceed S100,000. D. Force Majeure Neither the Contractor nor the State shall be liable to the other for any delay in, or failure of performance of, any covenant or promise contained in this Contract, nor shall any delay or failure constitute default or give rise to any liability for Page 24 of 29 damages if, and only to the extent that, such delay or failure is caused by "force majeure." As used in this Contract, "force majeure" means acts of God; acts of the public enemy; acts of the state and any govennnental entity in its sovereign or contractual capacity; fires; floods; epidemics; quarantine restrictions; strikes or other labor disputes; freight embargoes; or unusually severe weather. E. Disputes Except as herein specifically provided otherwise, disputes concerning the performance of this Contract which cannot be resolved by the designated Contract representatives shall be referred in writing to a senior departmental management staff designated by the State and a senior manager designated by the Contractor. Failing resolution at that level, disputes shall be presented in writing to the Executive Director of the State and the Contractor's Chief Executive Officer for resolution. This process is not intended to supersede any other process for the resolution of controversies provided by law. F. Lobbying Contractor certifies, to the best of his or her knowledge and belief, that: No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative Contract, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative Contract. ii. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an office or employee of any agency, a Member of Congress, an office or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative Contract, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The undersigned shall require that the language of this certification be included in the award documents for all sub awards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative Contracts) and that all subrecipients shall certify and disclose accordingly. iv. This certification is a material representation of fact upon which reliance was placed when the transaction was made or entered into. Submission of Page 25 of 29 the certification is a requisite for making or entering into transaction imposed by Section 1352, Title 31, U. S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than S10,000 and not more than S100,000 for each such failure. THE REST OF THIS PAGE INTENTIONALLY LEFT BLANK Page 26 of 29 SPECIAL PROVISIONS (The Special Provisions apply to all contracts except where noted in italics.) CON'TROLLER'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 arc 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(6)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 lobe 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 its whole or in part shall not he 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. 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. Issued by the Office of the State Controller Date Issued: 7/1/74 Rule 3-1 Page 27 of 29 Date Revised: I/I/09 SPECIAL PROVISIONS (The Special Provisions apply to all contracts except where noted in italics.) II. 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-I 02(5)(e), 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, (c) 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 tenminate 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 (c)has produced one form of identification required by CRS §24-76.5-103 prior to the effective date of this contract. Issued by the Office of the State Controller Date Issued: 7/1l74 Rule 3-1 Page 28 of 29 Date Revised, 111/09 Contract Routing Number 3011-1322 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 Department of Human Services by and through the Weld Bill Ritter, Jr., Governor County Board of Commissioners Legal Name of Contracting Entity By: By: mtc✓ Joa Henneberry, Executive Dire for gnature of uthorized Officer D rtment of Health Care Policy and Financing Douglas Rademacher, Chair Printed Name of Authorized Officer Date: b I L (e. (ID LEGAL REVIEW: Printed Title of Authorized Officer John W. Suthers, Attorney General Date: AUG 0 9 2010 By: /- t A 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: avid J. ermott, CPA By: Date: r (O Page 29 of 29 ao/e- /790 HIPAA BUSINESS ASSOCIATE ADDENDUM This Business Associate Addendum ("Addendum") is part of the Contract between the State of Colorado, Department of Health Care Policy and Financing, and Weld County Department of Human Services by and through the Weld County Board of Commissioners, contract number 3011-1322. For purposes of this Addendum, the State is referred to as "Department", "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 PHl 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 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: I. Definitions. a. Except as otherwise defined herein, capitalized terms 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 fidure 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. HCPF Model BA for New/Amended Contracts Page 1 of9 Revised 10/15/07 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) for 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. 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 HCPF Model BA for New/Amended Contracts Page 2 of 9 Revised 10/15/07 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 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 (10) business 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.P.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 fort 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 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. HCPF Model BA for New/Amended Contracts Page 3 of 9 Revised 10/15/07 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.P.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. L Retention of Protected Information. Except upon termination of the Contract as provided in Section 4(d) of this Addendum, Associate and its agents or subcontractors 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 (2) 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, Inspections 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 HCPF Model BA for New/Amended Contracts Page 4 of 9 Revised 10/I 5/07 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. 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. Section 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 Protected 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 limitation(s) 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 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 HCPF Model BA for New/Amended Contracts Page 5 of 9 Revised 10/15/07 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: (I) 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 4(a), 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 the public interest, and the rights and obligations of the parties shall be the same as if this Contract had been terminated for the public interest, 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. If CE'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. 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 IIIPAA, 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 that Associate or its agents or subcontractors still maintain in any HCPF Model BA for New/Amended Contracts Page 6 of Revised 10/15/07 form, and shall retain no copies of such Protected information. If Associate elects to destroy the PHI, 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 PHI 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 agents or subcontractors 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 24-10-100 et seq. or the Federal Tort Claims Act, 28 U.S.C. 2671 el 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 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 obligation s 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 acknowledge that state and federal laws relating to data security and privacy are rapidly evolving and that amendment of this Addendum may re 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 (Feb 20, 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 HCPF Model BA for New/Amended Contracts Page 7 of 9 Revised 10/15/07 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. 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 thirty (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 supersedes and replaces any previous separately executed fHPAA addendum between the parties. 14. Survival of Certain Contract Terms. Notwithstanding anything herein to the contrary, Associate's obligation sunder 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. HCPF Model BA for New/Amended Contracts Page 8 of 9 Revised 10/15/07 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: W. Sean Bryan Title: Contract and Performance Management Unit Supervisor Department: Department of Health Care Policy and Financing Address: 1570 Grant Street, Denver, CO 80439 Contractor/Business Associate Representative: Name: Eva Jewell Title: SEP Administrator Company: Weld County Department of Human Services by and through the Weld County Board of Commissioners Address: PO Box 1805 Greeley, Colorado 80632 HCPF Model BA for New/Amended Contracts Page 9 of 9 Revised 10/15/07 ATTACHMENT A This Attachment sets forth additional terms to the HIPAA Business Associate Addendum, which is part of the Contract, between the State of Colorado, Department of Health Care Policy and Financing, and Weld County Department of Human Services by and through the Weld County Board of Commissioners, contract number 3011-1322 ("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: No additional permitted uses. 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: No additional permitted disclosures. 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. 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 and disclosure of Protected Information: No additional restrictions on Use of Data. 6. Additional Terms. No additional terms. Page I of I Contract Routing No. 3011-1322 EXHIBIT A STATEMENT OF WORK 1. GENERAL DESCRIPTION Per C.R.S. 25.5-6-104 (2)(k), the Contractor shall serve as a single access or entry point within a local area where a current or potential long-term care client can obtain long-term care information, screening, assessment of need, and referral to appropriate long-term care program and case management services.for all Coloradoans within their designated district seeking access to, or information about long term care. 2. DEFINITIONS A. "Benefits Utilization System(BUS)" means the online data system maintained by the Department for recording case management activities associated with Long Term Care (LTC) services. B. "Case Management Agency (CMA)" means the organization obligated to fulfill the responsibilities and requirements of this Contract. C. "Case Manager" means an individual who meets the qualifications to perform case management activities. D. "Licensed Medical Professional" means the Primary Care Physician (PCP) or licensed medical staff(LPN or RN). E. "Prior Authorization Request (PAR)" means a request authorized by the Department or CMA prior to obtaining certain services, supplies, equipment or other waiver benefit items. F. "Program" means a publicly funded program including, but is not limited to Consumer Directed Attendant Support Services (CDASS), Children's Home and Community Based Services (Children's HCBS), Home and Community-Based Services for Persons with Brain Injury (HCBS-BI), Home and Community-Based Services for the Elderly, Blind and Disabled (HCBS-EBD), Home and Community-Based Services for Persons with Mental Illness (HCBS-MI), Home and Community-Based Services for Persons Living with Acquired Immune Deficiency Syndrome (HCBS-PLWA), Pediatric Hospice Waiver, Long-Term Home Health Services (LTHH), Program of All-Inclusive Care for the Elderly (PACE), Medicaid nursing facility care and case management services funded through 42 U.S.C. Section 3001, et. seq., as amended. Page I of 9 G. "Resource Development" means the analysis and implementation of additional resources or services that extend the capabilities of community-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. H. "Service Plan" means the document developed by the Case Manager with the client and/or legal guardian and, if appropriate, collaterals, to document client choice, establish, and identify the services and supports the client needs to successfully live in the community. The Service Plan shall reflect the full scope of the client's needs and include services from all funding sources including third party and natural supports. The Service Plan shall document the amount, frequency and duration of each service, the type of provider to furnish each service, and the expected outcome of each service. 1. "Single Entry Point (SEP)" means an agency within a local area where a current or potential long-term care client can obtain community-based long-term information, screening, assessment of need and referral to appropriate programs and case management services. J. "Single Entry Point District" means a single county, or two or more counties, designated as a geographic region in which one agency serves as the Single Entry Point. K. "Uniform Long Term Care (ULTC)" Instrument means the Functional Needs Assessment and professional medical information used to determine Functional Eligibility for LTC services. L. "Utilization Review (UR)" means a system for prospective, concurrent, and retrospective review of the necessity and appropriateness in the allocation of supports and services to ensure the proper and efficient administration of Medicaid LTC benefits. 3. BACKGROUND In 1990, the Legislative Long Term Health Care Task Force developed a legislative proposal, passed in the 1990 session, that required the Department to study the development of a SEP system for accessing long term care services (Senate Bill-9). This study, entitled "Improving Client Access to Long Term Care in Colorado," provided the framework for the legislation passed during the following session in 1991 (House Bill- 1287), which implemented the SEP system for long term care in Colorado. The purpose of this legislation is to improve access to long term care services and to facilitate utilization of appropriate services by long term care clients. The system is to function for both private and publicly funded clients in need of long term care services. Per C.R.S. 25.5-6-104 (1) (a) and (b): "1) (a) The general assembly hereby finds, determines, and declares that there is an increasing strain on long-term care services in the state; that the number of persons in need Page 2 of 9 of long-term care continues to grow; that community-based resources are not integrated into a centralized system for referrals, assessment of needs, development of care plans, and case management; and that persons in need of long-term care services have difficulty accessing and using the current system, which is fragmented and which results in inappropriate placements. (b) The general assembly further finds, determines, and declares that the state is in need of a long-term care system that organizes each long-term care client's entry, assessment of need, and service delivery into a single unified system; and that such system must include, at a minimum, a locally established single entry point administered by a designated entity, a single client assessment instrument and administrative process,targeted case management in order to maximize existing federal, state, and local funding, case management, and an accountability mechanism designed to assure that budget allocations are being effectively managed." 4. CONTRACTOR'S OBLIGATIONS A. The Contractor shall perform the functions of a Single Entry Point Agency as defined by Sections 25.5-6-104 through 25.5-6-106, C.R.S. (2007) and the regulations applicable to the Department and the Single Entry Point system at 10 C.C.R. 2505-10, Sections 8.390 et seq. These functions shall be provided for participants in various long term care Programs including, but not limited to: , Consumer Directed Attendant Support Services (CDASS), Children's Home and Community Based Services (Children's HCBS), Home and Community-Based Services for Persons with Brain Injury (HCBS-BI), Home and Community-Based Services for the Elderly, Blind and Disabled (HCBS-EBD), Home and Community-Based Services for Persons with Mental Illness (HCBS-MI), Home and Community-Based Services for Persons Living with Acquired Immune Deficiency Syndrome (HCBS-PLWA), Pediatric Hospice Waiver, Long-Term Home Health Services (LTHI-I), Program of All- Inclusive Care for the Elderly (PACE), Medicaid nursing facility care and case management services funded through 42 U.S.C. Section 3001, et. seq., as amended. B. The Contractor shall perform its obligations in conformity with the provisions of Title XIX of the Social Security Act and other applicable federal and state laws and regulations. C. The Contractor shall perform the Case Management functions 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 Service Plan, 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: Page 3 of 9 1. Establishing a community advisory committee for the purpose of providing public input and guidance for SEP Agency operation. The committee shall meet at least twice a year or more often as necessary. 2. Establishing a Resource Development committee to facilitate the development of local resources to meet the long-term care needs of individuals who reside within the Single Entry Point District. At least annually, committee updates shall be provided to the Department. Active, on-going participation by key management or administrative staff in area provider or interest group meetings to discuss resource development issues are an acceptable substitute as long as complete documentation of the discussions and progress made in developing relevant solutions is forwarded to the Department at least annually. 3. Providing staff who meet the qualifications set forth in the state statutes and regulations to perform necessary administrative, supervisory, case management and UR functions. 4. Administering a personnel system for recruiting, hiring, evaluating and terminating employees. 5. Performing accounting tasks in compliance with all rules and regulations for accounting practices. 6. Maintaining client records in accordance with Program requirements, including documentation of all case activities, monitoring of service delivery and service effectiveness. The Contractor shall utilize the BUS for the purpose of client information management. All relevant client activities shall be documented in the prescribed system within the timeframes established by the Department. 7. Protecting client's rights as they relate to the responsibilities of SEP agencies as described in this contract. 8. Determining the client's Post Eligibility Treatment of Income (PETI) according to instructions set forth by the Department. 9. Overcoming any geographic barriers within the district, including distance from the agency office to provide timely assessment and case management services to clients. 10. Providing access to its facilities for clients, service providers and others during regular business office hours. Regular business office hours of operation shall be posted and made available to the public and accommodations made available for clients who need assistance or consultation outside regular business office hours. 11. Providing access to a telephone system and trained staff to ensure timely response to messages and telephone calls received after hours. Page 4 of 9 12. Providing access to telecommunication devices and/or interpreters for the hearing and vocally impaired and access to foreign language interpreters as necessary. 13. Distributing an annual survey of a random sample of clients using a Department-prescribed form to determine the level of satisfaction with case management services provided to the client. Survey guidelines and client names for the random sample shall be provided by the Department. 14. Facilitating the Medicaid application process for potentially eligible individuals, responding to all referrals of potentially eligible clients within Department-prescribed timeframes and providing appropriate and timely access to services for all eligible long-term care clients. 15. Providing a thorough assessment of service needs and resources to assure the most appropriate public and private resources are utilized to meet 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 ULTC Instrument for all clients requesting publicly funded long-term care services. 16. Providing case management and UR functions and establishing a Service Plan for recipients of publicly funded long-term care Programs. The authorization and administration of services through a publicly funded Program shall be in accordance with eligibility criteria as defined by applicable state and federal statutes and regulations. 17. Reporting and providing follow-up action to critical incidents using the Department-prescribed system. 18. Assuring that long-term care clients who receive case management services receive the type and amount of skilled and non-skilled community based long-term care services listed in the Service Plan. These services shall not exceed the type and amount of services medically and/or functionally required by each client. 19. Reviewing all PARs. The Contractor shall approve, deny or return a PAR to the provider agency for additional information and notify the Department of any significant increase or decrease in skilled services for a client. 20. Following the standards set by the Department. These standards include Dear Administrator Letters, Dear Agency Letters and written documents from Department-approved training. 21. Processing information regarding client Medicaid eligibility within two business days of receipt from the eligibility site. Page 5 of 9 22. Performing all pertinent information processing within the applicable timeframes specified in Department regulations. 23. Conducting an annual review using the Department prescribed tool(s) to determine compliance with program and administrative requirements. Guidelines for the review and the random sample of clients shall be provided by the Department. Results shall be submitted to the Department or the Department's designee within the prescribed timeframes. 24. Obtaining a waiver annually from the Department to provide direct services based on criteria in applicable Department regulations. SEP agencies granted a waiver to provide services must provide written notification to the client and/or guardian of the potential influence the SEP has on the Service Planning process. The SEP agency must also provide the client and/or guardian with written information about how to file a provider agency and/or SEP agency complaint. Upon client and/or guardian request, the SEP agency must provide an option for the client and/or guardian to request a different entity to develop the Service Plan. The SEP must also provide an option for the Service Plan to be monitored by a different SEP entity or individual. 25. Receiving, documenting and resolving complaints regarding the SEP and/or service provider agencies. Documentation shall include the complaint, the resolution of the complaint and the dates of contact. Periodically analyze complaints for trends and institute corrective actions as appropriate. 26. Verifying that each HCBS client has received at least one waiver service within the timeframes specified in the applicable waiver and/or regulation. If a client does not receive at least one waiver service within the timeframes specified in the applicable waiver and/or regulation, the Contractor shall appropriately notify the client that he/she is ineligible for waiver services and that he/she has the right to appeal. 27. Reassessing a client using the ULTC Instrument annually, when there is a significant change in the client's condition or more often as specific waiver rules or circumstances require. E. The Contractor shall follow 10 C.C.R. 2505-10, Section 8.393.31 when transferring a client from one county to another county or from one Single Entry Point District to another district. F. The Contractor shall employ or contract with a Licensed Medical Professional to be available to staff for consultation regarding medical and diagnostic concerns and Long Term Home Health (LTHH) PARs for SEP clients. G. The Contractor shall attend Administrative Law Judge hearings when the Contractor agency has made a denial or adverse action against a client and the Page 6 of 9 client appeals. The Contractor shall defend their decision as described in 10 C.C.R. 2505-10, Sections 8.057 et seq. H. The Contractor shall submit Department required information electronically upon the Department's request. The Contractor shall assist in the transition of services in the event that the contract shall be transferred to a different entity. Transitional assistance provided by the Contractor shall include the transfer of all hard copy documents maintained by the Contractor and shall be completed no later than ten (10) business days prior to contract termination date. 5. THE DEPARTMENT'S OBLIGATIONS A. The Department or a designee shall review the performance of the Contractor. Performance monitoring may include a review of log notes, service plans, assessments and other documentation relevant to the long term care services provided the client. The Contractor shall be notified within 30 days of the outcome of a review that may result in approval, provisional approval, denial or termination of certification. The Department may appoint a designee to monitor and/or make certification recommendations. B. The Department, in accordance with the state statutes and regulations, shall certify the Contractor. Certification shall be based upon, but not limited to, results of on-site visits, evaluation results of the quality of service provided, compliance with Program requirements, service timeliness, performance of administrative functions, costs per client, communications with clients, client monitoring, targeting populations served, community coordination and outreach and financial accountability. 6. TRAINING, COMPLAINTS, APPEALS, CRITICAL INCIDENTS AND ADMINISTRATIVE OVERSIGHT REQUIREMENTS A. Training. The Contractor shall, at a minimum, train all case managers hired since the effective date of this contract in the following areas prior to independent case management assignment: I. Long Term Care Eligibility; 2. Intake and Referral; 3. ULTC 100.2 Assessment; 4. Service Plan Development; 5. Notices and Appeals; 6. BUS Documentation; and 7. Home Health. The Contractor shall provide to the Department by the end of each quarter an electronic listing of all case management staff hired since the effective date of this contract and an attendance roster for each training area identified using the Page 7 of 9 reporting template attached to this contract as Exhibit D, Case Manager Training Report Template. All new case management staff shall receive at a minimum basic training and instruction in all of these areas as a prerequisite to independent placement. Documentation of the successful completion of this basic training and instruction shall be included on the Case Manager Training Report Template provided as Exhibit D to this Contract. B. Complaint Process: 1. The Contractor shall document complaints received by the agency; 2. The Contractor shall take appropriate action to address substantiated complaints; 3. The Contractor shall respond to complaints received and document actions taken to resolve and/or mitigate complaints to the extent possible; and 4. The Contractor shall conduct quarterly complaint process trend analyses. The Contractor shall submit to the Department by the end of each quarter, using the reporting template attached to this contract as Exhibit E, Complaint Trends/Remedial Action Report Template, a trend analysis and corrective action report indicating any complaint-oriented trends observed since the effective date of this contract and the remedial actions taken to address them. C. Appeals: 1. In reference to appeals initiated and closed during the contract period, the Contractor shall have represented the Department and worked towards obtaining a favorable decision; 2. The Contractor shall process appeals in accordance with schedules published by the State of Colorado Office of Administrative Courts and rules promulgated by the Department; 3. The Contractor shall represent the Department in accordance with 10 C.C.R. 2505-10, Sections 8.057 etseq and 8.393 et seq; and 4. The Contractor shall submit all exceptions to the Office of Appeals and include required information. D. Critical Incident Reporting: 1. The Contractor shall document critical incidents in the Department- prescribed system; 2. The Contractor shall take appropriate action to address substantiated critical incidents; 3. The Contractor shall respond to critical incidents received and document actions taken to resolve and/or mitigate critical incidents to the extent possible; and Page 8 of 9 4. The Contractor shall perform Critical incident trend analyses at least quarterly. The Contractor shall submit to the Department by the end of each quarter and using the reporting template attached to this contract as Exhibit F, Critical Incident Trends/Remedial Action Report Template, a trend analysis and corrective action report indicating any concerning critical incident-oriented trends observed since the effective date of this contract and the remedial actions taken to address them. E. Administrative Review Tool: The Contractor shall submit to the Department by the end of each quarter the results of the application of the tool attached to this contract as Exhibit B, Case Management Agency(CMA) Administrative Review Tool. 6. BILLING PROCEDURES AND RECONCILIATION A. 1. At the end of State Fiscal year 2009-10 a Holdover Letter was issued that extended the prior contract term through August 31, 2010. Payments for the Holdover period shall be made to the Contractor in monthly amounts based on the State Fiscal year 2009-10 contract amount. 2. Payments to the Contractor for the period September 1, 2010 through June 30, 2011 shall be made in equal monthly payments calculated by the contract Maximum Amount less the amounts paid to the Contractor for the Holdover Letter period. The total of all monthly payments for the Holdover period and the remainder of State Fiscal year shall not exceed the Maximum Amount stated in paragraph 7.A. of the contract. B. For subsequent contract renewal periods, payments to the Contractor shall be made monthly. Monthly payment amounts shall be calculated by dividing the contract Maximum Amount by the number of months of the contract term. The total of all monthly payments made shall not exceed the Maximum Amount stated in the contract. C. Contractor payments will be reconciled to the forecasted amounts used to determine the contract Maximum Amount in accordance with 10 C.C.R. 2505-10, Section 8.392.3.C., as soon as practicable following the contract period. Page 9 of 9 Contract Routing No. 3011-1322 EXHIBIT B tADMINISTRATIVE:MONITORING 700E t' Agency.Name: Reviewed By: +a Review Date: . - 'Assurance:Administrative AUNorRy The Medicaid Agency retains ultimate administrative authority and responsibility for the operation of the waiver program by exercising oversight of the performance o waiver functions by other state and local nonstateagencies(if appropriate)and contracted e tities. 'YoWNo/NIA. PTS 1.Case Managers meet the qualifications as outlined in State regulation 2.Case Managers have been screened (e.g.drug screening,background checks)and are appropriate for employment as defined by the agency 3.Agency administers a personnel system for recruiting.hiring.evaluating,and terminating employees ° 4.If required by the contract,agency staffs a licensed medical professional 5.1f required by the contract,the agency follows standards as set fodh by the Department through DALs and written documents from Department sanctioned lrainings ° 6.Agency completed 015-mandated sample review of cases within required timeframes(Program Tool) 7.If required by the contract,agency has identified provider resource gaps and taken action to address q B.If required by the contract,agency has an established resource development committee and has a summary of activities available 9.Agency has a method ofvenfying that clients have received at least one waiver service each month 10.Agency maintains client records in accordance with program requirements,including documentation of all case activities,the mondodng of service delivery,and service effectiveness 11.The contractor uses the BUS for the purpose of client information management 12.Clients rights are protected as h pertains to the temns of the contract 13.Clients have access to the office during regular business office hours 14.Agency provides a telephone system and trained staff to. a.Timely respond to messages b.Provide access to telecommunication devices and/ar interpreters for the hearing and/or vocally impaired C.Provide access to foreign language interpreters as needed 15.Case management functions are performed according to the contract or provider ageement 16.The agency assisted in the administration of the most recent annual client satisfaction survey 17.Contractor submits Department-required information electronically as scheduled or upon Department's request 0 It.If required by the contract: a.Insurance is maintained in the coned amounts b Workers compensation coverage is available as required by state statute c.Employer's liability insurance as required by state statute d.Commercial general liability with minimum limits as specified in the contract and with the state as an additional insured e.Automobile liability insurance with minimum limits as specified in the contract with the State as an additional insured C Insurance policies include language preventing the cancellation or nonrenewal without at least 45 days prior notice to the Department g.Insurance policies include clauses stating that each tamer will waive all rights of recovery,under subrogation or otherwise,against the State of Colorado,its agencies,institutions,organizations.officers,agents,employees,and volunteers h.The issuing insurance companies have a satisfactory standing wRh the State i.Certificates showing insurance coverage were submitted to the Department vfhin 7 business days of the effective date of the contract 19.In the event that the contractor subcontracts with other entities or organizations to perform duties outlined in the contract,that contractor has 0 secured express w+8ten consent of the Department 20.Contractor complied with the Reporting requirements as specified in the contract 21.Contractor complies with HIPAA 22.If the Contractor received$500,000 or more of Federal Funds from all sources,the contractor has complied with the provisions of OMB Circular No. a 23.1] 23.During the term of this contract,the Contractor did not engage in any rosiness or personal activities orpracticez or maintain any relationships which conflict in any way with the Contractor fully performing his/her obligations under this contract 24.The Contractor refrained from any practices,activities or relationships which could reasonably be considered to be in conflict with the Contractors ability to fury perform the obligations to the Department under the terms of this contrad 25 The Contractor(and subcontractors or subgrantees permitted under the terms of this contract)maintained a written code of standards governing the performance of its employees engaged in the award and administration of contracts 26.If this is a covered transaction as defined by the State Controller or the conrad amount exceeds dstl 10,000,the 0o rased Co d actor certi fiedltified toth best o its knowledge and belief that it and its pincipals and subcontractors are not presently debarred,s p p ° or voluntadly excluded by any Federal Department or agency 1 of 46:$ 1.SS'or2' Grading�Eachquesllon on is worts 278 pis.`Yes'or7WA'(when applicable)rs'wodh 3.77 8 p1s,'No'NwoM gpts.� Pa,v-,nio Page 1 of I Contract Routing No. 3011-1322 EXHIBIT C SINGLE ENTRY POINT AGENCY STATEMENT OF EXPENDITURES SEP AGENCY: MONTH/YEAR: TODAY'S DATE: g ';;r 4):NEXPENSES .':ice,; 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