HomeMy WebLinkAbout20072149.tiff RESOLUTION
RE: APPROVE SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT FOR CHILD
WELFARE CLIENTS AND AUTHORIZE CHAIR TO SIGN - SIGNAL BEHAVIORAL
HEALTH NETWORK
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 Substance Abuse Treatment Service
Agreement for Child Welfare Clients between the County of Weld, State of Colorado, by and
through the Board of County Commissioners of Weld County,on behalf of the Department of Social
Services, and Signal Behavioral Health Network, commencing July 1, 2007, and ending
June 30, 2008, with further terms and conditions being as stated in said agreement, and
WHEREAS,after review,the Board deems it advisable to approve said agreement, 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,ex-officio Board of Social Services,that the Substance Abuse Treatment Service
Agreement for Child Welfare Clients between the County of Weld, State of Colorado, by and
through the Board of County Commissioners of Weld County,on behalf of the Department of Social
Services, and Signal Behavioral Health Network be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be,and hereby is, authorized to
sign said agreement.
The above and foregoing Resolution was,on motion duly made and seconded,adopted by
the following vote on the 30th day of July, A.D., 2007, nunc pro tunc July 1, 2007.
BOARD OF COUNTY COMMISSIONERS
W:i�COUNTY, COLORADO
ATTEST: lE
?= E. Long, Chair
Weld County Clerk to the Boar'p 86i
C rke Pro-Tem
BY:
Deputy Cler to the Board
U
APP AS M:
Robert D. Masden
ount Attorney re-
Douglas R demacher
9-15'0'1
Date of signature:
2007-2149
SS00 4
Ico F ssCt D ofglistio7
d DEPARTMENT OF SOCIAL SERVICES
P.O. BOX A
GREELEY, CO. 80632
Website: www.co.weld.co.us
ig Administration and Public Assistance(970)352-1551
Child Support(970)352-6933
III
COLORADO
MEMORANDUM
TO: David E. Long, Chair Date: July 26, 2007
Board of County Commissioners "F
FR: Judy A. Griego, Director, Social Services..<,,CN.Aol (Kt( CI
1/4
RE: Substance Abuse Treatment Service Agreement under AFS Service Funding
between Signal Behavioral Health Network and the Weld County Department of
Social Services
Enclosed for Board approval is a Substance Abuse Treatment Service Agreement under AFS
Service Funding between Signal Behavioral Health Network(Signal) and the Weld County
Department of Social Services (Department). This Agreement was reviewed at the Board's Work
Session held on July 23, 2007.
The major provisions of the Agreement are as follows:
1. The term of the Agreement is July 1, 2007 through June 30, 2008.
2. Signal will contribute $115,126.04 from designated ADAD Additional Family Service
(AFS) funds on behalf of families and adolescents receiving child welfare services
through the Department. Signal will retain $4,271.43 in administrative fees.
3. Signal will provide assessments, monitored sobriety services, and treatment according to
Signal's fee schedule and through their provider, Island Grove Regional Treatment
Center.
4. The Department will refer to Signal those families and adolescents involved in the chil�
welfare system and who are in need of substance abuse services. r C)
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If you have any questions, please telephone me at extension 6510. Cr-
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2007-2149
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT
CHILD WELFARE CLIENTS-AFS SERVICE FUNDING
Fiscal Year July 1'2007 through June 30'h 2008
This Agreement is between the Weld County Department of Social Services, hereinafter referred
to as "WCDSS" and Signal Behavioral Health Network,hereinafter referred to as "Signal".
WHEREAS,the Weld County Department of Social Services requires the services of a substance
abuse treatment provider to assist the County in delivering substance abuse treatment services to child
welfare clients, and Signal is willing and able to provide such services; and
WHEREAS, Signal is a Colorado non-profit corporation organized for the purpose of managing
and coordinating high quality, cost efficient, integrated chemical dependency and related behavioral
health care services in the State of Colorado.
NOW, THEREFORE, it is mutually agreed as follows:
SERVICES:
A. Responsibilities of Signal:
1. Signal agrees and desires to participate as the service coordinator for WCDSS qualified
child welfare clients under the definition set forth in the Child Welfare Lawsuit
Settlement Agreement(David Littman vs. State of Colorado).
2. Signal will maintain a high quality of clinical care to clients in a delivery system of
limited resources and public funding. The full continuum of care(Outpatient, Intensive
Outpatient,Transitional Residential, Intensive Residential,Therapeutic Community, or
comparable alternatives as mutually agreed upon)will be available to clients. The
client's clinical needs will determine the level of care Signal is to provide and Signal will
meet those needs regardless of"modality."
3. Signal will assure that all eligible child welfare clients referred by WCDSS in need of
treatment will receive such in accordance with ASAM PPC-II R level of care, as
reimbursed by the State of Colorado,Alcohol and Drug Abuse Division.
5. Signal will serve child welfare clients (parents and children)on a priority basis who
comply with the following criteria as WCDSS refers:
• Case is active on TRAILS, and
• Case meets the State DHS program category criteria 4, 5, or 6, and
• Case meets the definition of"imminent risk for out-of-home placement/reunification"
set forth by the State of Colorado.
6. Signal will include the following provisions in all subcontracts with providers:
• The Provider shall submit a treatment plan to WCDSS within 30 days
• The Provider shall enter monthly progress reports into the Signal system no later than
the 10'h calendar day of the month following the month during in which the service
was rendered. Services submitted without monthly progress reports will be pended
for official billing and utilization against AFS funds until such reports are submitted.
• Signal, or their designee, agrees to provide Social Services monitoring results(UA,
BA, patch,tox trap)by faxing said results to Social Services at(970)346-7698 no
later than 72 hours after the day of service.
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• Signal agrees to make available Core and AFS Utilization Reports to WCDSS each
month by the 3'd Wednesday of each month.
• Signal agrees to cooperate with WCDSS to resolve any duplicated fees and/or errors
identified by the WCDSS billing review process.
7. Signal will utilize AFS monies to pay for services in cooperation with designated WCDSS
staff. Island Grove's AFS allocation will be reduced by 50%this year and there shall be no
provider AFS allocation effective July 1, 2008. The balance of this year's AFS shall be made
available to WCDSS to be reimbursed by Signal on a fee-for-service basis. All such AFS
funds shall be utilized in the Signal network.
8. Signal will assure that the providers in its network give timely notice of cancelled
appointments to the clients and will reschedule such appointments as soon as practical.
9. Signal will provide access to monthly progress reports for each WCDSS client in treatment
via the Signal service management website.
10. Signal will provide training and technical support, as necessary and as resources allow, for
WCDSS staff in accessing data reports and on the use of the child welfare referral system.
11. Signal shall reconcile all treatment providers' complete claims to AFS funds within 120
days from the date the service was rendered. Services with dates beyond 120 days will
be denied reimbursement.
B. Responsibilities of WCDSS:
1. WCDSS will work cooperatively with Signal and its Providers to deliver quality, efficient
and cost-effective substance abuse treatment services to WCDSS qualified clients.
2. WCDSS will make every effort to inform Signal and its Providers in a timely manner of
system issues, developments, and complications so that Signal and the Provider can make
informed choices in its role as the managed service organization and treatment agency
respectively.
3. WCDSS will assure that all referrals under this contract meet the eligibility criteria
expressed in Section I(A)(6) above.
4. WCDSS agrees to provide Signal with the name of a primary contact person who will be
responsible for interacting with Signal's accounting and information systems
departments.
5. WCDSS, or its authorized designee(s), will be responsible for electronically authorizing
services to various providers.
6. WCDSS will review monthly AFS Actual reports and determine any duplicate charges
pursuant to Core or other previously paid services. WCDSS will report monthly any
discrepancies in duplication and/or errors to Signal, and in cooperation with Signal,work
with Signal to resolve any conflicts of billed services or fees.
7. WCDSS will complete the Signal remittance advice and return to Signal within 5 business days of
completion of each month's TRAILS payroll date. Each remittance advice shall detail reasons for
denial of any and all services. WCDSS shall work with Signal and other counties to develop
standard claims denial criteria. WCDSS shall reimburse Signal for all complete services invoiced
within 45 calendar days from the date of receipt of Signal's invoice.
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8. WCDSS shall inform Signal of the county primary contacts along with contact information.
WCDSS shall provide such contact information for all contract,data and billing related matters.
II. PERIOD OF PERFORMANCE
The Signal Additional Family Service period of performance under this Agreement shall be for
the 12-month period beginning July 1, 2007 through June 30, 2008, unless sooner terminated.
As a condition of continuing to render services under this Agreement, it is understood that Signal
will report any limitation or restriction of their license or insurance or the ability to perform the
services covered by this Agreement under any condition of impairment.
Either party may terminate this Agreement or any part herein at any time by giving not less than
45 days advance written notice to the other party.
In the absence of any formal agreement beyond the term of this agreement, Signal agrees to
continue providing treatment, under the terms of this agreement, for clients that are in treatment
or referred by WCDSS for treatment. This is with the further understanding that service delivery
and payment are subject to the termination terms mentioned above.
Signal reserves the right to suspend services to clients if funding is no longer available. WCDSS
acknowledges financial responsibility for all services authorized and performed before the
effective date of termination.
III. COMPENSATION
Signal agrees to contribute a maximum of one hundred fifteen-thousand one houndred and
tweleve dollars and four cents($115,126.04)annually from designated ADAD Additional
Family Service(AFS)funds to serve eligible clients in accordance with the terms herein. Of this
amount, Signal shall retain four thousand two hundred seventy-one dollars and seventy-seven
cents($4,271.43) or five percent of the service fees, salaries, and other authorized costs that are
actually incurred in the delivery of the treatment services authorized in this Agreement.
IV. CLIENT FEES OR CO-PAYS
Neither Signal nor their network providers shall assess a client fee or co-pay to child welfare
clients served under this contract,unless the client is required to pay for any positive urine screen
as a condition of their treatment plan or through court order for monitored sobriety and/or
treatment as a condition of their treatment plan.Any such client fees or co-pays shall be outside
the scope of this contract, and Signal shall have no responsibility for accounting for such fees and
co-pays.
V. ATTACHMENTS
Signal and WCDSS agree to adopt herein the attached fee-for-service Attachment A.
VI. INDEPENDENT CONTRACTOR
Signal and its providers shall be providing services hereunder as an independent contractor and
the relationship of employer and employee does not exist between WCDSS and Signal.
VII. NON-DISCRIMINATION
It is the policy of Signal to provide equal opportunity without discrimination based on race, color,
sex, religion, age, sexual orientation,national origin, veteran status,or individual handicap in any
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aspect of employment,training or services offered. All Signal programs, activities, and services
are administered on a non-discriminatory basis subject to the provisions of:
Title VI and VII of the Civil Rights Act of 1964
Executive Order 11246,as amended
Title VII and VIII of the Public Health Services Act
Rehabilitation Act of 1973 (Section 503 and 504)
Equal Pay Act of 1963, as amended
Title DC of the Education Amendments of 1972
Vietnam Era Veteran's Readjustment Assistance Act of 1974
Age Discrimination in Employment Act of 1967
Age Discrimination Act of 1975
Non-Discrimination Laws of the State of Colorado.
VIII. ACCESS TO RECORDS
Signal and WCDSS agree to make available in a timely manner all books, documents,and
records pertinent to this contract for the purpose of billing for services, audit, and compliance
with requirements and regulations of federal and state agencies and commercial insurance
carriers.
Signal acknowledges that in reviewing, storing, processing, or otherwise dealing with any client
records dealing with any client seen by a Signal provider or the on-site substance abuse counselor
is bound by the confidentiality provisions of 42 CFR Part 2. If necessary, Signal shall resist in
judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR
Part 2. WCDSS and Signal shall sign a Qualified Service Organization Agreement in compliance
with 42 CFR, Part 2.
IX. OBLIGATIONS
Obligations of WCDSS and Signal are contingent upon funds for that purpose being appropriated,
budgeted and otherwise made available.
X. PROVISIONS
This Agreement may be amended only by written agreement signed by each of the parties hereto.
This Agreement shall be binding upon, and shall inure to the benefit of the respective parties
hereto and shall not be assigned without the consent of all parties hereto.
XL NOTICES:
Any notice required to be given pursuant to the terms and provisions hereof shall be in writing
and shall be sent by certified mail, return receipt requested;
To Signal at: To Weld County at:
Bill Wendt, Chief Executive Officer Judy A. Griego, Director
Signal Behavioral Health Network Weld County Department of Social Services
1391 Speer Blvd., Suite 300 P.O. Box A
Denver, CO 80204 Greeley,CO 80632
XII. DISPUTE RESOLUTION
It is the desire of all parties to resolve disputes at the Signal/County level through shared
decision making. The County and Signal shall attempt to resolve all disputes at the lowest
level possible within each organization. If the parties fail to reach an agreement, the
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issue shall be documented and submitted to Signal's Chief Executive Officer and the
WCDSS Director(or their designee). Such documentation shall include a statement of the
issue(s), position of both parties, and each parties' specific request(s). If Signal and the
WCDSS are unable to resolve the dispute, either party may submit the dispute to the
Colorado Department of Human Services, Child Welfare and Alcohol and Drug Abuse
Division.
The State shall review all documentation regarding the dispute and provide written
findings to the parties. If either party disagrees with the State's findings,the aggrieved
party may pursue additional dispute resolution processes. In this event, Signal and the
WCDSS agree to submit unresolved disputes arising out of the contract to non-binding
mediation/arbitration in Denver, Colorado in accordance with the commercial rules and
practices of the American Arbitration Association then in force or pursuant to such other
rules and procedures as to which the parties may agree. Notwithstanding the above,
nothing herein shall be construed to limit either party's right to resolve any dispute in
court if mediation/arbitration is unsuccessful.
Nothing herein shall be construed as a waiver of any defense or affirmative defense to
any claim.
This Agreement shall be governed by and construed in accordance with the laws of the State of
Colorado.
XIIL MISCELLANEOUS PROVISIONS
12.1 Headings. The headings of the sections and subsections of this Agreement are inserted
solely for ease of reference and shall not in any way affect the meaning or interpretation
of this Agreement.
12.2 Non-Assignment. None of the parties shall have the right to assign the benefits or
delegate the obligations in this Agreement without prior written consent of the other
parties. Subject to the foregoing, this Agreement shall be binding upon and inure to the
benefit of the parties and their respective heirs, successors, legal or personal
representatives and permitted assigns.
12.3 Waiver of Breach. The waiver of any party of a breach or violation of any provision of
this Agreement shall not operate as, or be construed to be, a waiver of any subsequent
breach of the same or any other provision thereof.
12.4 Gender and Number. Whenever the context of this Agreement requires,the gender of all
words shall include the masculine, feminine and neuter, and the number of all words shall
include singular and plural.
12.5 Severability. If any provision of this Agreement is held to be unenforceable for any
reason,the unenforceability thereof shall not affect the remainder of this Agreement,
which shall remain in full force and effect and be enforceable in accordance with its
terms.
12.6 Counterparts. This Agreement may be executed in duplicate originals, each of which
shall be an original instrument but both of which taken together shall constitute one and
the same instrument.
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12.7 Entire Agreement. This Agreement constitutes the entire understanding and agreement
between the parties with respect to its subject matter and supersedes all prior agreements
or understandings, whether written or unwritten,with respect to the same subject matter.
12.8 Hold Harmless. To the extent authorized by law each party shall indemnify, save and
hold harmless the other and the Colorado Department of Human Services, against any
and all claims, damages, liability and court awards including costs, expenses,and
attorney fees incurred as a result of any act or omission by the party's employees, agents,
subcontractors,or assignees, or arising out of any dispute between the WCDSS, Signal,
Network Providers and the State Department of Human Services in connection with the
Agreement.
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SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT
CHILD WELFARE CLIENTS-AFS SERVICE FUNDING
APPROVED BY:
AL BEI 3 VIO ALTH NETWORK
✓g61C^�R� 1-1101
John it Brewster, Board President Da
Signal's Federal tax ID Number: 84-1362495
WELD tn...71
CpC 07/30/2007
By: David E. Long, Chair Date
Board of County Commissioners
WELD C D ARTMENT OF SOCIAL SERVICES y
/ /UN
By: Judy A. riego, I i ector ( to
ELAl IdWeb w uUHnU Or (MUMl
COMMISSIONER SIGNATURES ONLY
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ATTEST: .%:Attt
WE COUNTY CLER TO THE BO
BY: 'd.t. Vaned
PEP CL: K TO THE El ARD
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SIGNAL BEHAVIORAL HEALTH NETWORK and
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE
Attachment A
Fee-For-Service Reimbursement(for services not provided by the on-site counselor):
Amounts are not to exceed the following:
HIPAA Base Admin Payer
Service Code HIPAA Unit Rate Fee Rate
Antabuse Monitoring H0033 each $2.00 $0.10 $2.10
Antabuse Physical-Existing Client 99214 each $60.00 $3.00 $63.00
Antabuse Physical-New Client 99203 each $60.00 $3.00 $63.00
Breathalyzer 82075 each $2.00 $0.10 $2.10
Case Management H0006 15 minute session(s) N/A N/A N/A
Day Treatment: Adolescent H2012:HA hour(s) $9.87 $0.49 $10.36
Day Treatment: Adult H2012:HB hour(s) $6.90 $0.35 $7.25
Detox—OP H0012 day(s) N/A N/A N/A
Detoxification H0011 day(s) $185.00 $9.25 $194.25
Drug Patch Confirmation H0048 each N/A N/A N/A
Drug Patch Monitoring H0048:HF each $50.00 $2.50 $52.50
Evaluation H0002 15 minute session(s) $11.67 $0.58 $12.25
Evaluation: Rural H0002:TN 15 minute session(s) $16.67 $0.83 $17.50
Family Counseling T1006 15 minute session(s) $25.00 $1.25 $26.25
Group Counseling H0005 15 minute session(s) $6.75 $0.34 $7.09
Hair Testing 84999 each N/A N/A N/A
Individual Counseling 140004 15 minute session(s) $15.00 $0.75 $15.75
Intake T2010 each N/A N/A N/A
Intensive Short-Term Residential: Adolescent H0018:HA day(s) $228.00 $11.40 $239.40
Intensive Short-Term Residential: Adult H0018:HB day(s) $170.00 $8.50 $178.50
Medical testimony 99075 15 minute session(s) $18.75 $0.94 $19.69
Multisystemic therapy for juveniles H2033 15 minute session(s) N/A N/A N/A
Opioid Replacement(Buprenorphine) J0592 month(s) N/A N/A N/A
Opioid Replacement(Methadone) 140020 month(s) $415.00 $20.75 $435.75
Prevention Information Dissemination H0024 15 minute session(s) N/A N/A N/A
Psychiatric Diagnostic Interview Exam 90801 15 minute session(s) N/A N/A N/A
Skills Training and Development H2014 15 minute session(s) N/A N/A N/A
Therapeutic Behavioral Srvc: Preg/Parent H2020:HD day(s) $99.50 $4.98 $104.48
Therapeutic Behavioral Srvcs: Adolescent H2020:HA day(s) $125.00 $6.25 $131.25
Therapeutic Behavioral Srvcs: Adult w/o Infant H2020:HB day(s) $59.00 $2.95 $61.95
Transitional Long-Term Residential H0019 day(s) $93.00 $4.65 $97.65
Transitional Long-Term H0019:HD day(s) $175.00 $8.75 $183.75
Residential:Preg/Parent(NDF)
UA-5 Panel 80101 each $12.00 $0.60 $ 12.60
UA Confirmation 80102 each $35.00 $1.75 $36.75
UA-Dip Stick 81002 each N/A N/A N/A
UA-GC/MS-Quantitative 82542 per drug $18.00 $0.90 $18.90
UA-Oral Swab 82055 each $15.00 $0.75 $15.75
UA-Soma 81099 each N/A N/A N/A
UA w/TX H0003:HF each $12.00 $0.60 $12.60
Vapor inhalations evaluation 94664 each $40.00 $2.00 $42.00
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A GC/MS will automatically be completed without additional WCDSS authorization for all substances that test
positive at initial urine drug screening.
The following services are available exclusively through AFS funds and must be purchased in
conjunction with the residential treatment services described in the fee-for-service schedule above for
both Core and AFS funded residential treatment services:
T2048:HB: Room and Board: Adult
Addition Research and Treatment Services(ARTS) Daily $16.88 $0.84 $17.72
Arapahoe House Daily $45.23 $2.26 $47.49
Crossroads Daily $50.00 $2.50 $52.50
Island Grove Daily $35.00 $1.75 $36.75
Sobriety House Daily $22.00 $1.10 $23.10
T2048:HA: Room and Board:Adolescent
Addition Research and Treatment Services(ARTS) Daily $38.12 $1.91 $40.03
Arapahoe House Daily $36.30 $1.82 $38.12
Crossroads Daily N/A N/A N/A
Island Grove Daily $33.00 $1.65 $34.65
Sobriety House Daily N/A N/A N/A
T2048:HD: Room and Board: Preg/Parent
Addition Research and Treatment Services(ARTS) Daily $16.88 $0.84 $17.72
Arapahoe House Daily $50.17 $2.51 $52.68
Crossroads Daily $75.00 $3.75 $78.75
Island Grove Daily N/A N/A N/A
Sobriety House Daily N/A N/A N/A
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