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HomeMy WebLinkAbout20021941.tiff RESOLUTION RE: APPROVE SINGLE ENTRY POINT AGENCY CONTRACT 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 Single Entry Point Agency Contract 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 of said contract, and ending June 30, 2003, 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 Single Entry Point Agency Contract between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, Area Agency on Aging, and the Colorado Department of Health Care Policy and Financing be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said contract. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 22nd day of July, A.D., 2002. BOARD OF COUNTY COMMISSIONERS WELD OUNTY, OLO DO ATTEST: LEO Lai Glenn Vaadad, Chair Weld County Clerk to th-`;oa � gap EXCUSED 1861 Q David E. L g, Pro-Tem BY: Deputy Clerk to the B -rd 9i.j am- o.1--2) M. J. Geile AFT_ DA OF M: I </ •' � �y illiam H. J� ke ounty Attor Robert D. Mas en Date of signature: 02-1941 (1-0 I ie 20HR007 /��'� HR0073 Approved Waivered Form Agency or Department Name Health Care Policy&Financing Department or Agency Number UHA Contract Routin°Number 02303 -1.3? y SINGLE ENTRY POINT AGENCY CONTRACT THIS CONTRACT,made this 30th day of June,2002 by and between the State of Colorado for the use and benefit of the Department of Health Care Policy and Financing, 1575 Sherman Street, Denver, Colorado 80203-1714 hereinafter referred to as the State or the Department and Weld County Division of Human Services'Area Agency on Aging by and through the Weld County Board of Commissioners, 1551 North 17th Avenue, P. O. Box 1805, Greeley, CO 80631, hereinafter referred to as the contractor. 'WHEREAS, authority exists in the Law and Funds have been budgeted, appropriated and otherwise made available and a sufficient unencumbered balance thereof remains available for payment in Contract Encumbrance number` .(L#4 03o3-13'74and for the Single Entry Point program, COFR's codes: Fund 100, Agency UHA, Appropriation Code 175;and WHEREAS, required approval, clearance and coordination has been accomplished from and with appropriate agencies;and WHEREAS,the contractor was selected in accordance with State law;and WHEREAS, the Department is the designated single Colorado agency responsible for the administration of the Medicaid program,pursuant to 26-4-104,Colorado Revised Statutes(C.R.S.),as amended;and WHEREAS, the State has established a Colorado Medical Assistance Program in order to participate in Title XIX of the Social Security Act(Medicaid);and WHEREAS,the Department is authorized, pursuant to Sections 26-1-103(7) and 26-4-521, et. seq., C.R.S. as amended, to contract with designated Single Entry Point agencies to serve as independent Contractors for the administration of long term care programs;and WHEREAS, Section 26-4-522, C.R.S., as amended, provides that the Single Entry Point agency shall be recommended by the Board of County Commissioners, and considered for approval by the Department in accordance with the authorizing legislation;and WHEREAS, the Board(s) of County Commissioners of Weld has (have) designated the Contractor to be the district Single Entry Point agency;and WHEREAS,the Department has approved certification of the Contractor as a Single Entry Point agency;and WHEREAS,the Department desires to enter into this Contract with the Contractor herein for the administration of the Single Entry Point program,as set forth in greater detail below; and 'WHEREAS, as of the date of the execution of this Contract, the Contractor meets all statutory and regulatory requirements for entering into this Contract;and Page 1 of 17 020002-/9y/ NOW THEREFORE,it is hereby agreed that: 2(a) Scope of Work A. Contractor shall perform the functions of Single Entry Point agencies as defined by sections 26-4-507 and 26-4-522, C.R.S., as amended, and the rules and regulations applicable to the Department and the Single Entry Point system (hereafter referred to as "state regulations"). These state regulations may be found in the Code of Colorado Regulations (C.C.R.)at 10 C.C.R. §2505-10, and may also be found in Volume 8 of the staff manual titled Medical Assistance. B. Contractor shall perform its obligations hereunder in conformity with the provisions of Title XIX of the Social Security Act, other relevant federal and state laws and all pertinent federal and state regulations promulgated pursuant thereto; including, without limitation, the Colorado Human Services Code, Section 26-1-101, et. seq., C.R.S., as amended, and those applicable portions of the Staff Manuals of the Colorado Department of Human Services and the Colorado Department of Health Care Policy and Financing: Volume 3, entitled "Income Maintenance," 9 C.C.R. §2503-I; Volume 5, entitled "Finance and Accounting," 11 C.C.R. §2508-I; Volume 8, entitled "Medical Assistance," 10 C.C.R. §2505-10; and Volume 10, entitled "Services for the Aging," 12 C.C.R. §2510-1,as all the foregoing provide on the date this Contract is executed,and as they may later be amended. C. Contractor shall perform the functions of case management for eligible persons as defined in the state statutes and regulations, including but not limited to intake/screening/referral, assessment of client need, development and implementation of a care plan,on-going case management,monitoring of clients,reassessment,and case closure. D. Contractor shall perform all necessary administrative functions for the operation of Single Entry Point agencies, as defined in the state statutes and regulations,including but not limited to such matters as the following: (1) establishing a community advisory committee for the purpose of providing public input and guidance for Single Entry Point agency operation; (2) administering a personnel system for recruiting,hiring,evaluating,and terminating employees; (3) performing accounting tasks in compliance with all rules and regulations for accounting practices set forth by the Department; (4) maintaining adequate liability insurance to meet the Department's minimum requirements for contract agencies; (5) information management: collecting and reporting of summary and client-specific data pertaining to information and referral services provided by the agency,program eligibility determination, financial eligibility determination,care planning,service authorization,resource development,and fiscal accountability; (6) record keeping: maintaining client records in accordance with program requirements, including the documentation of all case activities,the monitoring of service delivery,and service effectiveness; (7) resource development: facilitating the development of local resources to meet the long term care needs of individuals who reside within the Single Entry Point district served by the Contractor; (8) protecting the confidentiality of all applicant and recipient records;and (9) protecting the client's rights as defined by the Department under applicable programs. E. Contractor shall comply with the standards as outlined in the state statutes and regulations, staff manual Volume 8: sections 8.390 through 8.539,for the operation of the Single Entry Point agency which include,but are not limited to the following: Page 2 of 17 (1) Contractor shall afford appropriate and timely access to services for all clients and shall facilitate the application process for potentially eligible individuals and respond in a timely manner to all referrals of eligible clients; (2) Contractor shall provide thorough assessments of care needs and resources to assure the most appropriate targeting of all private and public long term care resources to the needs of the clients. Such targeting shall not supplant but shall support self care, family care and other informal community care. Contractor shall assure through the prior authorization review process that long-term care clients, who receive case management services under the contractor, receive types and amounts of Medicaid-funded skilled and non-skilled Community-Based Services that do not exceed the types and amounts medically and/or functionally required by each client and in compliance with Medicaid rules. (3) Contractor shall review prior authorization requests for Medicaid funded Home Health Services for Single Entry Point clients, except for clients enrolled in Medicaid HMOs. Contractor shall determine compliance with Medicaid rules, and shall approve, deny or return the Prior Authorization Request to the Home Health Agency for additional information. Contractor shall maintain a database that meets Department requirements. The database shall be kept timely and accurate to within 14 days for all Prior Authorization Reviews(PARs) for clients who receive skilled care approved by the contractor. The contractor shall inform the Department of any significant increases in skilled services. (4) Prior to March 31, 2003, the Department shall monitor a representative sample of Single Entry Point clients who are receiving Home and Community-Based Services non-skilled care services and those receiving Home Health Services, except for clients enrolled in Medicaid HMOs. Based on standards set by the Department and communicated to the contractor in training materials, the Department shall monitor this sample to ascertain that clients are being approved by the contractor to receive only those types and amounts of Medicaid-funded Home Health services and Home and Community-Based services that do not exceed the types and amounts medically and/or functionally required by each client and in compliance with Medicaid rules. (5) Contractor shall process paperwork in a timely and accurate manner to promote timely service to clients; (6) Contractor shall provide accurate and timely documentation of client and agency activities; and (7) Contractor shall not provide direct services unless a waiver is approved by the Department based on criteria set forth in the state regulations for Single Entry Point agencies. F. Contractor shall certify adult foster care facilities within the Single Entry Point district in accordance with the Department rules for adult foster care(staff manual volume 8,section 8.483). G. Contractor shall provide case management functions to recipients of publicly funded long term care programs, including, but not limited to Medicaid nursing facility care, Home and Community-Based Services for the Elderly, Blind and Disabled (HCBS-EBD), Home and Community-Based Services for Persons Living with AIDS (HCBS- PLWA), Home and Community-Based Services for Persons with Brain Injury (HCBS-B1), Home Care Allowance, Adult Foster Care, Consumer Directed Attendant Support(CDAS), and certain in-home services available under the federal "Older Americans Act of 1965, as amended". The authorization and administration of services through a publicly funded program shall be in accordance with the program's eligibility criteria, as defined by applicable state and federal statutes and regulations, as they exist on the date this Contract is executed, and as they may later be amended. Contractor shall cooperate with the Department and the community center boards in the admission of clients with developmental disabilities to the Home and Community-Based Services for the Elderly, Blind and Disabled Program. H. In accordance with staff manual section 8.392.4, entitled "PRIVATE PAY CLIENTS," the contractor shall provide case management services to persons able to pay privately for such services within two years of contractor implementation. I. Contractor shall develop procedures for the transfer of clients from one county to another within the Single Entry Point district and from one district to another in accordance with the state statutes and regulations. Page 3 of 17 J. Contractor shall provide staff who meet the qualifications set forth in the state statutes and regulations,to perform the following functions: administrative/supervisory,and case management. K. 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 prior authorization for SEP clients. L. Contractor shall be considered for certification by the Department in accordance with standards and requirements set forth in the state statutes and regulations. Decisions about certification shall be based upon but not limited to on-site visits and other evaluation of agency performance in the following areas: quality of services provided; compliance with program requirements, including case management standards adopted by the Department; timeliness; performance of administrative functions, including reasonable cost per client, timely responses, managing programs in one consolidated unit, on-site visits to clients, community coordination and outreach, and client monitoring; targeting of populations served;and financial accountability. M. In accordance with procedures set forth in applicable state statutes and regulations, Contractor performance shall be reviewed by the Department or its designee on an ongoing basis. Contractor shall be notified within 30 days of the outcome of such reviews, which may result in approval, provisional approval, denial, or termination of certification. For the purpose of monitoring the Contractor and making certification recommendations, the Department may designate an agent such as(but not limited to)the Colorado Department of Human Services. 2(b) Scope of Work in Regard to Deinstitutionalization Activities: A. Contractor shall show a good faith effort to identify appropriate State clients who may be deinstitutionalized from nursing facilities and who are determined to be appropriate to be served under community-based care. B. Contractor shall perform the following activities and functions as required under the Deinstitutionalization Project: (I) From among eligible clients housed in nursing facilities, and who shall be designated by the State, contractor shall select clients for whom they determine a reasonable potential for Deinstitutionalization from the nursing facility and into the community. (2) Contractor shall conduct on-site visits to selected residents and/or families of residents of nursing facilities in order to provide information regarding community-based services and to assess the appropriateness of relocation from the nursing facility into community based options. (3) If the client elects to leave the nursing facility and enter the community, contractor shall guide the client and/or client's family and facilitate completion of the administrative and programmatic requirements to enter community-based care. (4) In a form and manner to be selected by the State, contractor shall collect and report summary and client specific data and information sufficient to enable the Department to complete research requirements under this project. This shall entail collection of data and information in regard to: a. clients to whom informational visits are made in nursing facilities;and b. clients who elect not to leave the nursing facility;and c. clients who elect to leave the nursing facility. Page 4 of 17 C. Contractor agrees to perform its obligations hereunder in conformity with the provisions of Title XIX of the Social Security Act, other relevant federal and state laws and all pertinent federal and state regulations promulgated pursuant thereto; including, without limitation, the Colorado Human Services Code, Section 26-1-101, et. seq., C.R.S., as amended, and those applicable portions of the Staff Manuals of the Colorado Department of Human Services and the Colorado Department of Health Care Policy and Financing: Volume 3, entitled "Income Maintenance," 9 C.C.R. §2503-1; Volume 5, entitled "Finance and Accounting," 11 C.C.R. §2508-1; Volume 8, entitled "Medical Assistance," 10 C.C.R. §2505-10; and Volume 10, entitled "Services for the Aging," 12 C.C.R. §2510-I,as all the foregoing provide on the date this Contract is executed,and as they may later be amended. 3. Performance Period The contract shall be effective upon approval by the State Controller, or designee, or on July 1, 2002, whichever is later. The contract performance contemplated herein shall commence as soon as practicable after the effective date of this contract and shall be undertaken and performed in the sequence and manner set forth in the scope of work identified in paragraph 2 and extend through June 30,2003. 4. Price/Cost The State shall reimburse the contractor's reasonable, allowable costs, as defined herein, not exceeding $393,525 for work associated with the Scope of Work described under paragraph 2(a) above. Payment to the contractor for activities associated with deinstitutionalization, described under paragraph 2(b) above is described and established for the contractor in Exhibit B, hereby made a part of this contract. The statewide liability of the Department for payment associated with deinstitutionalization, described under paragraph 2(b) above is limited to the unspent amount remaining of$81,527 during the term of this contract. Payment to the Contractor for activities associated with Consumer Directed Attendant Support (CDAS), is described and established for the Contractor in Exhibit C, hereby made a part of this contract. The statewide liability of the Department for payment associated with CDAS, is limited to the unspent amount remaining of$149,250 during the term of this contract. Payment pursuant to this Contract shall be made as earned, in whole or in part, from available state and federal finds encumbered in an amount not to exceed $393,525 for the purchase of the within-described services described under paragraph 2(a) above during the period, July 1, 2001 through June 30, 2002. The specific methodology for calculating the payment to the contractor is described in Exhibit A and Exhibit E which are attached to this contract and incorporated herein by reference. The liability of the State, at any time, for such payments shall be limited to the unspent amount remaining of such encumbered funds. 5. Payment Terms The Department shall pay reasonable, allocable, allowable costs of performance as provided in Exhibit A, Exhibit B, Exhibit C and Exhibit E to this contract. Unless otherwise provided,and where appropriate: A. The State shall establish billing procedures and pay the contractor the reasonable, allocable, and allowable costs for work performed under this contract, based on the submission of monthly statements in the format prescribed by the State. To be considered for payment, billings for payment pursuant to this contract must be received within 30 days after the period for which payment is being requested and final billings on the contract must be received by the State within 30 days after the end of the contract term. All goods and services purchased under this Single Entry Point contract shall be received by the contractor by the last day of the contract period, 24-75-102 C.R.S., or as required by State policies and regulations. B. Payments pursuant to this contract shall be made as earned, in whole or in part, from available funds encumbered for the purchase of the described services. The liability of the State, at any time, for such payments shall be limited to the amount remaining of such encumbered funds. C. In the event this contract is terminated, final payment to the contractor may be withheld at the discretion of the State until completion of final audit. Page 5 of 17 D. Incorrect payments to the contractor due to omission, error, fraud, or defalcation shall be recovered from the contractor by deduction from subsequent payment under this contract or other contracts between the State and the contractor, or by the State as a debt due to the State. The contractor shall submit requests for reimbursement monthly, stating in the invoice a detailed description of the amounts of services performed and description of reimbursable expenses. The Uniform Administrative Requirements for Grants and Cooperative agreements to State and Local Governments (the "Common Rule"), and the applicable Office of Management and Budget (OMB) Circulars cited therein, shall govern the allowability and allocability of costs under this contract. The State and federal government reserves the right to audit the contractor's books and records for a period of three years after contract expiration or termination in order to validate the allowability of costs paid under this contract, and any costs not allowable under the State procurement rules shall be reimbursed by the contractor, or offset against current obligations due by the State to the contractor, at the State's election. If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the three(3)year period,or if audit findings have not been resolved after a three(3)year period,the materials shall be retained until the resolution of the audit findings. Contractors and sub-contractors shall retain automated and manual records in a condition and manner which shall enable transfer or transmission to other organizations. In the eventuality that a contract and/or sub-contract are terminated, the contractor and/or sub-contractors shall cooperate with the Department in the transmission or transferring of records as necessary to a designated organization. E. Contractor is subject to and agrees to honor and abide by Single Entry Point regulations in regard to settlement required of differences between payments by the Department to the contractor and allowed expenditures incurred by the contractor for the contractor's operation of the Single Entry Point contract. F. The State shall establish billing procedures and reimburse the Contractor in such amounts as may from time to time be specified by the State pursuant to applicable federal and state statutes and regulations, including the Colorado Medical Assistance Act Section 26-4-101 et. seq., C.R.S., as amended, and the State Rules for the Long Term Care Single Entry Point System, as such statutes and ntles currently exist or may hereafter be amended. State funds shall be allocated to each Single Entry Point agency based on the number of counties in a district and the average number of clients served in community-based care programs in that district during each quarter of the contract term. The specific methodology for calculating the payment to the contractor is described in Exhibit A and Exhibit E which are attached to this contract and incorporated herein by reference. F. The contractor shall submit monthly expenditure statements,using forms,procedures and within time frames prescribed by the State. Failure to submit the expenditure statements or to enter expenditures in the County Fiscal Management System (CFMS)within the time frames established by the Department may result in the withholding of payments by the Department until the statements are received. Total compensation to the Contractor under this contract shall not exceed the limitation contained in the General Provision entitled"Price/Cost". H. The contractor shall receive state and federal funds in monthly payments from the State. Allowable agency expenditures are set forth by Federal rules, CFR Title 45, Part 74, Appendix G; Office of Management and Budget Circular A-87 or A-I22, whichever is applicable; and the U.S. Department of Health and Welfare, December 1976, Cost Principles and Procedures for Establishing Cost Allocation Plans and Indirect Cost Rates for Grants and Contracts with the Federal Government as indicated presently or amended in the future. I. The contractor shall be reimbursed an amount to equal the"annual rate"per client calculated as specified in Exhibits A and E for each client for whom assessment has occurred, and who selects and is enrolled in the Total Long Term Care program. This shall be achieved by the Contractor continuing to include the referred client in their monthly client count through the remainder of the Performance Period of the contract year in which the referral is made. 6. Legal Authority The contractor warrants that it possesses the legal authority to enter into this contract and that it has taken all actions required by its procedures, by-laws, and/or applicable law to exercise that authority, and to lawfully authorize its undersigned signatory to execute this contract and to bind the contractor to its terms. The person(s) executing this contract on behalf of the contractor warrant(s)that such person(s)have full authorization to execute this contract. Page 6 of 17 7. Inspection and Acceptance (Services) The State reserves the right to inspect services provided under this contract at all reasonable times and places during the term of the contract. "Services" as used in this clause includes services performed or tangible material produced or delivered in the performance of services. If any of the services do not conform with contract requirements, the State may require the contractor to perform the services again in conformity with contract requirements, with no additional payment. When defects in the quality or quantity of service cannot be corrected by reperformance, the State may (I) require the contractor to take necessary action to ensure that the future performance conforms to contract requirements and (2) equitably reduce the payment due the contractor to reflect the reduced value of the services performed. These remedies in no way limit the remedies available to the State in the termination provisions of this contract, or remedies otherwise available at law. 8. Confidentiality of Records In the event the contractor shall obtain access to any records or files of the State in connection with agreement, or in connection with the performance of its obligations under this agreement, the contractor shall keep such records and information confidential and shall comply with Section 8-72-107, CRS, Section 24-72-201 et. seq. and all other laws and regulations concerning the confidentiality of such records to the same extent as such laws and regulations apply to the State. The contractor shall notify its employees, agents and sub-contractors that they are subject to the confidentiality requirements as set forth above, and shall provide each employee with a written explanation of the confidentiality requirements before the employee is permitted access to confidential data. 9. Remedies In addition to any other remedies provided for in this contract, and without limiting its remedies otherwise available at law,the State may exercise the following remedial actions if the contractor substantially fails to satisfy or perform the duties and obligation in this contract. Substantial failure to satisfy the duties and obligations shall be defined to mean significant insufficient, incorrect or improper performance, activities, or inaction by contractor. These remedial actions are as follows: A. Suspend contractor's performance pending necessary corrective action as specified by the State without contractor's entitlement to adjustment in price/cost or schedule;and/or B. Withhold payment to contractor until the necessary services or corrections in performance are satisfactorily completed;and/or C. Request the removal from work on the contract of employees or agents of contractor whom the State justifies as being incompetent, careless, insubordinate, unsuitable, or otherwise unacceptable, or whose continued employment on the contract the State deems to be contrary to the public interest or not in the best interest of the State; and/or D. Deny payment for those services or obligations which have not been performed and which due to circumstances caused by contractor cannot be performed. Denial of the amount of payment must be reasonably related to the value of work or performance lost to the State. E. Terminate the contract for default. The above remedies are cumulative and the State, in its sole discretion, may exercise any or all of them individually or simultaneously. 10. Termination for Convenience The State may terminate this contract at any time the State determines that the purposes of the distribution of State moneys under the contract would no longer be served by completion of the project. The State shall effect such termination by giving written notice of termination to the contractor and specifying the effective date thereof, at least sixty (60) days before the effective date of such termination. Either party may terminate this contract by giving the other party sixty(60)days written notice of its intent to terminate the Contract. In that event, all finished or unfinished documents, data, studies, and reports or other material prepared by the contractor under this contract shall, at the option of the State, become its property,and the contractor shall be entitled to receive just and equitable compensation for any satisfactory services and supplies delivered. Page 7 of 17 If the contract is terminated by either party as provided by Paragraph 10 of this agreement,the contractor will be paid for those services that were satisfactorily performed prior to the date of termination, less any payments that were previously made for services not completed. However, if the contract is terminated, and if less than sixty percent (60%) of the services covered by this contract have been performed upon the effective date of such termination, the contractor shall be reimbursed for that portion of the actual out-of-pocket expenses that are not otherwise reimbursed under this contract incurred by the contractor during the contract period which are directly attributable to the uncompleted portion of the services covered by this contract. In no event shall reimbursement under this clause exceed the contract amount. If this contract is terminated for cause, or due to the fault of the contractor, the Termination for Cause or Default provision shall apply. 11. Termination for Default/Cause If, through any cause, the contractor shall fail to fulfill, in a timely and proper manner, its obligations under this contract, or if the contractor shall violate any of the covenants, agreements, or stipulations of this contract, the State shall thereupon have the right to terminate this contract for cause by giving written notice to the contractor of its intent to terminate and at least ten (10) days opportunity to cure the default or show cause why termination is otherwise not appropriate. In the event of termination, all finished or unfinished documents, data, studies, and reports or other material prepared by the contractor under this contract shall, at the option of the State, become its property, and the contractor shall be entitled to receive just and equitable compensation for any services and supplies delivered and accepted. The contractor shall be obligated to return any payment advanced under the provisions of this contract not expended for purposes set forth herein. Notwithstanding the above, the contractor shall not be relieved of liability to the State for any damages sustained by the State by virtue of any breach of the contract by the contractor, and the State may withhold any payment to the contractor for the purposes of mitigating its damages until such time as the exact amount of damages due to the State from the contractor is determined. If after such termination it is determined, for any reason, that the contractor was not in default, or that the contractor's action/inaction was excusable, such termination shall be treated as a termination for convenience, and the rights and obligations of the parties shall be the same as if the contract had been terminated for convenience, as described herein. 12. Insurance A. The contractor shall obtain,and maintain at all times during the term of this agreement, insurance in the following kinds and amounts: 1) Standard Worker's Compensation and Employer Liability as required by State statute, including occupational disease, covering all employees on or off the work site, acting within the course and scope of their employment. 2) General, Personal Injury, and Automobile Liability (including bodily injury, personal injury, and property damage)minimum coverage: a) Combined single limit of$600,000 if written on an occurrence basis. b) Any aggregate limit will not be less than$1,000,000. c) Combined single limit of$600,000 for policies written on a claims-made basis. The policy shall include an endorsement, certificate, or other evidence that coverage extends two years beyond the performance period of the contract. d) If anv aggregate limits are reduced below$600,000 because of claims made or paid during the required policy period, the contractor shall immediately obtain additional insurance to restore the full aggregate limit and furnish a certificate or other document showing compliance with this provision. B. The State of Colorado shall be named as additional insured on all liability policies. C. The insurance shall include provisions preventing cancellation without 60 days prior notice to the State by certified mail. Page 8of17 D. The contractor shall provide certificates showing adequate insurance coverage to the State within 7 working days of award or contract execution,unless otherwise provided. E. If the contractor is a "public entity" within the meaning of the Colorado Governmental Immunity Act, CRS 24- 10-101, et seq., as amended("Act"),the contractor shall at all times during the term of this contract maintain such liability insurance, by commercial policy or self-insurance, as is necessary to meet its liabilities under the Act. The contractor shall show proof of such insurance or certify that they are self-insured. 13. Independent Contractor Relationship THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND NOT AS AN EMPLOYEE. NEITHER THE CONTRACTOR NOR ANY AGENT OR EMPLOYEE OF THE CONTRACTOR SHALL BE OR SHALL BE DEEMED TO BE AN AGENT OR EMPLOYEE OF THE STATE. CONTRACTOR SHALL PAY WHEN DUE ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX AND LOCAL HEAD TAX ON ANY MONEYS PAID PURSUANT TO THIS CONTRACT. CONTRACTOR ACKNOWLEDGES THAT THE CONTRACTOR AND ITS EMPLOYEES ARE NOT ENTITLED TO UNEMPLOYMENT INSURANCE BENEFITS UNLESS THE CONTRACTOR OR A THIRD PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE DOES NOT PAY FOR OR OTHERWISE PROVIDE SUCH COVERAGE. CONTRACTOR SHALL HAVE NO AUTHORIZATION, EXPRESS OR IMPLIED, TO BIND THE STATE TO ANY AGREEMENTS, LIABILITY, OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN. CONTRACTOR SHALL PROVIDE AND KEEP IN FORCE WORKER'S COMPENSATION (AND SHOW PROOF OF SUCH INSURANCE) AND UNEMPLOYMENT COMPENSATION INSURANCE IN THE AMOUNTS REQUIRED BY LAW, AND SHALL BE SOLELY RESPONSIBLE FOR THE ACTS OF THE CONTRACTOR, ITS EMPLOYEES AND AGENTS. 14. Representatives and Notice A. Representatives. For the purpose of this contract, the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing new or substitute representatives: For the State: Gary Snider Director,Long Term Care Division For the Contractor: Eva Jewell Director, Weld Area Agency on Aging Page 9 of 17 B. Notices. All notices required to be given by the parties hereunder shall be hand delivered or given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing substitute addresses or persons to whom such notices shall be sent. For the State: Gary Snider Long Term Care Division Colorado Department of Health Care Policy and Financing 1575 Sherman Street Denver, Colorado 80203-1714 For the Contractor: Eva Jewell Weld Area Agency on Aging P. O. Box 1805 Greeley, CO 80632 15. Assignment and Successors The contractor agrees not to assign rights or delegate duties under this contract or subcontract any part of the performance required under the contract without the express, written consent of the State. Except as herein otherwise provided, this agreement shall inure to the benefit of and be binding only upon the parties hereto and their respective successors and assigns. 16. Changes The State may prospectively increase or decrease the amount payable under this contract through a "Change Order Letter," approved by the State Controller or his designee, in the form attached hereto as Exhibit D and provided for in Exhibit A, subject to the following conditions. A. The Change Order Letter("Letter")shall include the following: 1) Identification of contract by contract number and affected paragraph number(s); 2) Types of services or programs increased or decreased and the new level of each service or program; 3) Amount of the increase or decrease in the level of funding for each service or program and the total; 4) Intended effective date of the funding change; 5) A provision stating that the change shall not be valid until approved by the State Controller or such assistant as he may designate; B. Upon proper execution and approval, such letter shall become an amendment to this contract and, except for the general terms and conditions and Special Provisions of the contract, the letter shall supersede the contract in the event of a conflict between the two. It is understood and agreed that the letter may be used only for increased or decreased funding, and corresponding adjustments to service levels and any budget line items. The process to increase or decrease the level of funding under this contract is as specified in Exhibit A, Paragraph 11, to this contract. C. Increases or decreases in the level of contractual funding made through the letter process during the term of this contract may be made under the following circumstances: 1) If necessary to fully utilize Colorado State appropriations and/or non-appropriated federal grant awards. Page 10 of 17 2) Adjustments to reflect current year expenditures. 3) Supplemental appropriations or non-appropriated federal funding changes resulting in an increase or decrease in the amounts originally budgeted and available for the purposes of this program. 4) Closure of programs and/or termination of related contracts. 5) Delay or difficulty in implementing new programs or services. 6) Other special circumstances as deemed appropriate by the State. 17. Options: Performance Extension The State may require continued performance for a period of one year of any services within the limits and at the rates specified in the contract. The State may exercise the option by written notice to the contractor deposited in the mail before the end of the performance period of the contract using a form substantially equivalent to Exhibit F. The State shall give the contractor 60 days preliminary written notice of its intent to execute the option. Preliminary notice does not commit the State to an extension. If the State exercises this option, the extended contract shall be considered to include this option provision. The total duration of this contract, including the exercise of any options under this clause, shall not exceed five (5) years. Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted, and otherwise made available. No option shall be effective unless executed by the Contractor. Financial obligations of the Contractor payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. 18. 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 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 fire, explosion, action of the elements, strike, interruption of transportation, rationing, court action, illegality, unusually severe weather, or any other cause which is beyond the control of the party affected and which, by the exercise of reasonable diligence,could not have been prevented by the party affected. 19. Third Party Beneficiaries It is expressly understood and agreed that the enforcement of the terms and conditions of this contract and all rights of action relating to such enforcement, shall be strictly reserved to the State and the named contractor. Nothing contained in this agreement shall give or allow any claim or right of action whatsoever by any other third person. It is the express intention of the State and the contractor that any such person or entity, other than the State or the contractor,receiving services or benefits under this agreement shall be deemed an incidental beneficiary only. 20. Sovereign Immunity Notwithstanding any other provision of this contract to the contrary, 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, Section 24-10-101, et.seq., CRS, as now or hereafter amended. The parties understand and agree that liability for claims for injuries to persons or property arising out of negligence of the State of Colorado or the negligence of Contractor, their departments, institutions, agencies, boards, officials, employees and its political subdivisions is controlled and limited by the provisions of Section 24-10-101, et. seq., CRS, as now or hereafter amended and the risk management statutes, Section 24-30-1501, et. seq., CRS, as now or hereafter amended. 21. Severability To the extent that this contract may be executed and performance of the obligations of the parties may be accomplished within the intent of the contract, the terms of this contract are severable, and should any term or provision hereof be declared invalid or become inoperative for any reason, such invalidity or failure shall not affect the validity of any other term or provision hereof. Page 11 of 17 22. Waiver The waiver of any breach of a term, provision, or requirement of this contract shall not be construed or deemed as waiver of any subsequent breach of such term, provision, or requirement, or of any other term, provision, or requirement. 23. Entire Understanding This contract is intended as the complete integration of all understandings between the parties. No prior or contemporaneous addition, deletion, or other amendment hereto shall have any force or effect whatsoever, unless embodied herein in writing. No subsequent novation, renewal, addition, deletion, or other amendment hereto shall have any force or effect unless embodied in a writing executed and approved pursuant to the State Fiscal Rules. 24. Survival of Certain Contract Terms Notwithstanding anything herein to the contrary, the parties understand and agree that all terms and conditions of this contract and the exhibits and attachments hereto which may require continued performance, compliance, or effect beyond the termination date of the contract shall survive such termination date and shall be enforceable by the State as provided herein in the event of such failure to perform or comply by the contractor. 25. Modification and Amendment This contract is subject to such modifications as may be required by changes in Federal or State law, or their implementing regulations. Any such required modification shall automatically be incorporated into and be part of this contract on the effective date of such change as if fully set forth herein. Except as provided above, no modification of this contract shall be effective unless agreed to in writing by both parties in an amendment to this contract that is properly executed and approved in accordance with applicable law. 26. Federal Funding This contract is subject to and contingent upon the continuing availability of Federal funds for the purposes hereof The parties hereto expressly recognize that the contractor is to be paid, reimbursed, or otherwise compensated with funds provided to the State for the purpose of contracting for the services provided for herein, and therefore, the contractor expressly understands and agrees that all its rights, demands, and claims to compensation arising under this contract are contingent upon receipt of such funds by the State. In the event that such funds or any part thereof are not received by the State, the State may immediately terminate this contract without liability, including liability for termination costs. 27. Litigation Reporting Unless otherwise provided, the contractor shall promptly notify the State in the event that the contractor learns of any actual litigation which is related to the Single Entry Point Program in which it is a party defendant. The contractor, within ten (10) days after being served with a summons, complaint, or other pleading in a case which involves services provided under this contract and which has been filed in any Federal or State court or administrative agency, shall deliver copies of such document to the representative designated in this contract, or in absence of such designation,to the chief executive officer of the department, agency,or institution executing this contract on behalf of the State. 28. Maintenance of Records The contractor shall maintain a complete file of all records, documents, communications, and other written materials which pertain to the operation of programs or the delivery of services under this contract, and shall maintain such records for a period of three (3) years after the date of termination of this contract or final payment hereunder, whichever is later, or for such further period as may be necessary to resolve any matters which may be pending. 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. If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the three (3) year period, or if audit findings have not been resolved after a three(3)year period,the materials shall be retained until the resolution of the audit findings. Contractors and sub-contractors will retain automated and manual records in a condition and manner which will enable transfer or transmission to other organizations. In the eventuality that a contract and/or sub-contract are terminated,the contractor and/or sub-contractors will cooperate with the state in the transmission or transferring of records as necessary to a designated organization. Page 12 of 17 29. Audit, Inspection of Records, and Monitoring The contractor shall permit the State, Federal Government, or any other duly authorized agent of a governmental agency to audit, inspect, examine, excerpt, copy and/or transcribe contractor's records during the term of this contract and for a period of three (3) years following termination of this contract or final payment hereunder, whichever is later, to assure compliance with the terms hereof, or to evaluate the contractor's performance hereunder. The contractor shall also permit these same described entities to monitor all activities conducted by the contractor pursuant to the terms of this contract. As the monitoring agency may in its sole discretion deem necessary or appropriate,such monitoring may consist of internal evaluation procedures, examination of program data, special analyses, on-site check, or any other reasonable procedure. If an audit by or on behalf of the federal and/or state government has begun but is not completed at the end of the three (3) year period, or if audit findings have not been resolved after a three (3) year period, the materials shall be retained until the resolution of the audit findings. Contractors and sub-contractors will retain automated and manual records in a condition and manner which will enable transfer or transmission to other organizations. In the eventuality that a contract and/or sub-contract are terminated, the contractor and/or sub-contractors will cooperate with the state in the transmission or transferring of records as necessary to a designated organization. 30. Federal Examination of Records Clause Contractor, and its sub-contractors and subgrantees, will give the State, the awarding Federal agency, and the Comptroller General of the United States, through any authorized representatives, access to and the right to examine all records, books, papers, or documents related to the award and contract; and will establish a proper accounting system in accordance with generally accepted accounting standards. 31. Federal Audit Provisions All state and local governments and non-profit organizations receiving more than $300,000 from all funding sources, that are defined as federal financial assistance for single audit purposes, shall comply with the audit requirements of OMB Circular A-I28 (Audits of State and Local Governments) or A-133 (Audits of Institutions of Higher Education and Other Non-profit Organizations),whichever applies. 32. Conflict of Interest The contractor(and subcontractors or subgrantees permitted under the terms of this contract) shall maintain a written code of standards governing the 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; 2) Any member of the employee's immediate family; 3) The employee's partner; or 4) 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, sub-contractor'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 sub-agreements. During the term of this contract, Contractor shall not engage in any business or personal activities or practices or maintain any relationships which conflict in any way with the Contractor fully performing his/her obligations under this contract. Additionally, Contractor acknowledges that, in governmental contracting, even the appearance of a conflict of interest is harmful to the interests of the State. Thus, Contractor agrees to refrain from any practices, activities or relationships which could reasonably be considered to be in conflict with the Contractor's fully performing his/her obligations to the State under the terms of this contract,without the prior written approval of the State. In the event that the Contractor is uncertain whether the appearance of a conflict of interest may reasonably exist, Contractor shall submit to the State a full disclosure statement setting forth the relevant details for the State's consideration and direction. Failure to promptly submit a disclosure statement or to follow the State's direction in regard to the apparent conflict shall be grounds for termination of the contract. Page 13 of 17 33. 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 42 U.S.C. Sections 6101, et seq. - Age Discrimination in Employment 29 U.S.C. 621-634 Act of 1967 - Americans with Disabilities Act 42 U.S.C. 12101,et seq. of 1990 (ADA) - Equal Pay Act of 1963 29 U.S.C.206(d) - Immigration Reform and Control 8 U.S.C. 1324b Act of 1986 - Section 504 of the Rehabilitation 29 U.S.C.794 Act of 1973 - Title VI of the Civil Rights Act 42 U.S.C.2000d of 1964 - Title VII of the Civil Rights Act 42 U.S.C.2000e of 1964 - Title IX of the Education Amendment 20 U.S.C. 1681, et seq. of 1972 - Medicaid Law 42 U.S.C. 1396a Section 24-34-302,et seg., Colorado Revised Statutes 1997,as amended 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. A. The Contractor will not discriminate against any person on the basis of race,color,national origin,age,sex, religion and handicap, including Acquired Immune Deficiency Syndrome (AIDS) or AIDS-related conditions, in performance of work under this Contract. B. 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. C. The Contractor shall take all necessary affirmative steps, as required by 45 CFR 92.36(e) and (Colorado Ex. Order, Procurement Rules), to assure that small and minority businesses and women's business enterprises are used, when practicable, as sources of supplies, equipment, construction, and services purchased under this Contract. Page 14 of 17 34. Drug Free Workplace The undersigned certifies that to the best of his or her knowledge and belief the contractor is in compliance with the requirements of the Drug-Free Workplace Act(Public Law 100-690,Title V,subtitle D,41 USC 701 et seq.). 35. Lobbying The undersigned certifies to the best of his or her knowledge and belief that: 1) 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 agreement, and the extension, continuation, renewal, amendment,or modification of any Federal contract,grant, loan,or cooperative agreement. 2) 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 officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with it instructions. 3) 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 agreements)and that all subrecipients shall certify accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, title 31, United States Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure. By his/her signature to this contract the authorized signatory certifies that the above specified certifications are true. Page 15 of 17 • ,SPECIAL PROVISIONS (For Use Only with Inter-Governmental Contracts) 1. CONTROLLER'S APPROVAL. CRS 24-30-202 (1) This contract shall not be deemed valid until it has been approved by the Controller of the State of Colorado or such assistant as he may designate. 2. FUND AVAILABILITY. CRS 24-30-202 (5.5) Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted, and otherwise made available. 3. INDEMNIFICATION. Indemnity: The contractor shall indemnify, save, and hold harmless the State 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 Contractor, or its employees, agents, subcontractors, or assignees pursuant to the terms of this contract. 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 for the parties, of the Colorado Governmental Immunity Act, Section 24-10-101 et seq. C.R.S. or the Federal Tort Claims Act, 28 U.S.C. 2671 et seq. as applicable, as now or hereafter amended. 4. INDEPENDENT CONTRACTOR. 4 CCR 801-2 THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND NOT AS AN EMPLOYEE. NEITHER THE CONTRACTOR NOR ANY AGENT OR EMPLOYEE OF THE CONTRACTOR SHALL BE OR SHALL BE DEEMED TO BE AN AGENT OR EMPLOYEE OF THE STATE. CONTRACTOR SHALL PAY WHEN DUE ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX AND LOCAL HEAD TAX ON ANY MONIES PAID BY THE STATE PURSUANT TO THIS CONTRACT. CONTRACTOR ACKNOWLEDGES THAT THE CONTRACTOR AND ITS EMPLOYEES ARE NOT ENTITLED TO UNEMPLOYMENT INSURANCE BENEFITS UNLESS THE CONTRACTOR OR THIRD PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE DOES NOT PAY FOR OR OTHERWISE PROVIDE SUCH COVERAGE. CONTRACTOR SHALL HAVE NO AUTHORIZATION, EXPRESS OR IMPLIED, TO BIND THE STATE TO ANY AGREEMENTS, LIABILITY, OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN. CONTRACTOR SHALL PROVIDE AND KEEP IN FORCE WORKERS' COMPENSATION(AND PROVIDE PROOF OF SUCH INSURANCE WHEN REQUESTED BY THE STATE) AND UNEMPLOYMENT COMPENSATION INSURANCE IN THE AMOUNTS REQUIRED BY LAW, AND SHALL BE SOLELY RESPONSIBLE FOR THE ACTS OF THE CONTRACTOR, ITS EMPLOYEES AND AGENTS. 5. NON-DISCRIMINATION. The contractor agrees to comply with the letter and the spirit of all applicable state and federal laws respecting discrimination and unfair employment practices. 6. CHOICE OF LAW. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation, execution, and enforcement of this contract. Any provision of this contract, whether or not incorporated herein by reference, which provides for arbitration by any extra judicial body or person or which is otherwise in conflict with said laws, rules, and regulations shall be considered null and void. Nothing contained in any provision incorporated herein by reference which purports to negate this or any other special provision in whole or in part shall be valid or enforceable or available in any action at law whether by way of complaint, defense, or otherwise. Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this contract to the extent that the contract is capable of execution. At all times during the performance of this contract, the Contractor shall strictly adhere to all applicable federal and state laws, rules, and regulations that have been or may hereafter be established. 7. EMPLOYEE FINANCIAL INTEREST. CRS 24-18-201 & CRS 24-50-507 The signatories aver that to their knowledge, no employee of the State of Colorado has any personal or beneficial interest whatsoever in the service or property described herein. Revised 12/1/01 HCPF LAN VERSION, 12/1/01 Page 16 of 17 SPECIAL PROVISION S THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT CONTRACTOR: STATE OF COLORADO: BILL OWENS,GOVERNOR (� Weld County Division dn Services'Area Commissioners ommiss }t Aging by and through the Weld County Board of Commissioners J\\J Legal Name of Contracting Entity (Or Karen em on,Executive Director Department f Health Care Policy and Financing 84-6000-813 Social Security Nu ber or FEIN LEGAL REVIEW: Signature of Au Offir Ken Salazar, ATTORNEY GENERAL Glenn Vaad. Chair 07/77/02 By Print Name&Title of Authorized Officer CORPORATIONS: ATTEST: (A corporate seal or attestation is required.) "4/ \\ � /` WELD COUNTY CL-RK\T0 THE BOt R �J G2dL/Zic 6 ✓i s� ° , �,BY: � 1861 �• ' % DEPUTY CLERK TO THE BOA t %�:��1 ..i... _r •r. , / \ / \ \``, Attest(Seal)By (Corporate Secretary or Equivalent,or Town/City/County Clerk) ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER CRS 24-30-202 requires that the State Controller approve all state contracts. This contract is not valid until the State Controller, or such assistant as he may delegate, has signed it. The contractor is not authorized to begin performance until the contract is signed and dated below. If performance begins prior to the date below,the State of Colorado may not be obligated to pay for the goods and/or services provided. STATE CONTROLLER: Arthur L.Barnhart Approvals: State Controller By Date nilip J. eed Revised 12/1/01 HCPF LAN VERSION, 12/1/01 Page 17 of 17 Exhibit A Methodology for Calculating Total Compensation and Monthly Payments to Contractor: (1) Total compensation for the one-year term of the contract shall be subject to adjustment in accordance with the average number of community-based clients served by the Contractor during each of the first three quarters of the contract term(7/1/02 -9/30/02, 10/1/02- 12/31/02, and 1/1/03 -3/31/03). Payment to the Contractor shall be made in monthly installments, but the amounts contained in those monthly payments will be subject to adjustment in accordance with the procedures described below. (2) The "average number of community-based clients" shall be calculated as follows: A census of clients will be taken each month by the Department.The categories to be included in this census are: (a) "HCA ONLY(Home Care Allowance Only)", (b) "HCA-KING",(Home Care Allowance, Client sought services due to King lawsuit, (c) "HCA+HCBS"(Home Care Allowance with Home and Community Based Services), (d) " HCA PLUS HCBS -KING" (Home Care Allowance and Home and Community Based Services, client sought services due to the King lawsuit) (e) "AFC ONLY"(Adult Foster Care Only), (f) "AFC+HCBS" (Adult Foster Care with Home and Community-Based Services), (g) "HCBS-EBD ONLY"(Home and Community-Based Services for the Elderly,Blind,and Disabled Only), (h) "HCBS-EBD-KING" (Home and Community Based Services for the Elderly, Blind and Disabled, client sought services due to the King lawsuit) (i) "HCBS-PLWA ONLY"(Home and Community-Based Services for Persons Living with AIDS Only), (j) "HCBS-BI ONLY" (Home and Community-Based Services for Persons with Brain Injury Only),and (k) "CDAS ONLY"(Consumer Directed Attendant Support). (I) Clients referred to the Total Longterm Care Program during the remainder of the first contract year in which the referral is made. These categories are mutually exclusive and each case shall appear in only one category. Cases which may be counted in these categories are those clients who have received at least one service which is eligible for reimbursement under the program indicated,and who have not been terminated from the program. For each quarter of the contract term,the Contractor's "average number of community-based clients" shall be determined by averaging the census for the three months in that quarter. (3) In the event that the average number of community-based clients served by the Contractor during each of the first three quarters of the contract term is between 464, the "Case Loss Threshold", and 488 clients, total compensation to the Contractor for the entire contract term shall be in the amount of$387,960, which shall be known as the"base contract amount." The figure of 488 clients shall be known as the"base client figure." (4) During the first four months of the contract term (7/1/02 - 10/31/02), the Contractor shall be paid $129,320.00, divided into four equal monthly payments. The compensation for the first four months is equal to one-third of the base contract amount and assumes that the average number of community-based clients served by the Contractor during the first quarter will equal the base client figure. (5) Actual compensation to the Contractor during the second, third and fourth quarters of the contract term shall be determined by comparing (1) the actual, average number of community-based clients served during the preceding quarter with (2) the base client figure for the Contractor. Contractor may qualify for additional compensation as indicated in the second paragraph below. (6) If the average number of community-based clients served by the Contractor exceeds the base client figure during any of the first three quarters of the contract term,total compensation to the Contractor shall be increased by$795(Annual Rate) for each additional client beyond the base client figure. Page 1 of3 Exhibit A The following examples illustrate the foregoing principle: (A) If the Contractor's base client figure is 100 and the Contractor's average case count is 103 in each of the first three quarters of the contract term,total compensation shall be increased above the base contract amount by 3 times$795 =$2,385. (B) If the Contractor's base client figure is 100 and the Contractor experiences an average case count of 106, 106, and 108 during the first three contract quarters, total compensation shall be increased above the base contract amount by 8 times$795=$6,360. (C) If the Contractor's base client figure is 100 and the Contractor experiences an average case count of 102, 99, and 105 during the first three contract quarters,total compensation shall be increased above the base contract amount by 5 times$795=$3,975. (7) However, total compensation for the contract term shall not be increased under this mechanism by more than $5,565 above the base contract amount, i.e., to a maximum total compensation of S393,525. The maximum increase above the base contract amount under this mechanism represents 7 clients above the base client figure; the figure of 495 clients shall be known as the"maximum reimbursable client figure." Payment of the additional compensation shall be made in equal installments over the number of months remaining in the contract term. (8) The State has incorporated an adjustment of the payment per client, based upon a performance based payment component to the Single Entry Point payment methodology. Under this payment methodology, if the contractor does not meet the performance objectives as specified in Exhibit E to this contract,the effective rate per client for the period July 1,2003,through June 30,2004,will not include the cost of living increase, if any,appropriated for FY 03-04. (9) In the eventuality of an occurrence which will foreseeably cause rapid growth of the number of clients being served by the Contractor,the State and the Contractor may mutually agree to compensation of the Contractor based on a number of clients which exceeds the present quarterly average and which does not exceed the maximum reimbursable client figure. If the average quarterly number of clients for which the Contractor is paid under this type of agreement is not reached during the first, second or third quarters, the Contractor shall reimburse the State for the difference in compensation between that average client count for which payment has been made and the highest average client count which has occurred during the first, second or third quarters. If the Contractor has not reimbursed the State,the State may also recoup the amount of reimbursement from any payments due under this contract. (10) If the average number of community-based clients served by the Contractor falls below 464 clients during any of the first three quarters of the contract term, payment to the Contractor during the following quarter shall be decreased. The amount of the decrease shall equal $198.75 times the figure obtained by subtracting (1) the average number of community-based clients served during the preceding quarter from(2)the base client figure. (11) After the client counts for the third quarter are reported (i.e., for months through March 2003), no later client counts will be used in calculating the compensation for the contract term. It is possible that, following the third quarter, some additional funds will become available to compensate SEP agencies which have experienced high growth in their client case counts, such that they exceed the "maximum reimbursable client figure", during the first three quarters of the contract term. Such additional funds, if any, would become available if one or more of the SEP agencies does not reach its maximum reimbursable client figure during the first three quarters. In that event, any excess available funds may be proportionately distributed among those SEP agencies which, during any of the first three quarters, have experienced average client counts in excess of the maximum reimbursable client figures stated in their current contracts. As part of its calculations for distributing such excess funds,the State shall compute the largest difference between(a)each agency's average client case count in each of the first three quarters and (b)that agency's maximum reimbursable client figure. Page 2 of 3 Exhibit A For example:consider agency A which has a maximum reimbursable client figure of 115 and experiences average case counts of 110, 115,and 120 during the first three quarters of the contract term; and agency B,which also has a maximum reimbursable client figure of 115 and experiences average case counts of 120, 120 and 120 during the same time period. Each of these agencies would be entitled to the same proportionate share of excess SEP funds, if any, which become available through funds released from agencies which do not reach the maximum reimbursable client figure after the third quarter of the contract term. Notification to the Contractor by the State of changes in the maximum reimbursable client figure and the maximum total compensation under the provisions of this paragraph shall be made to the Contractor by means of a letter of notification of the average number of clients of record at the State during the first three quarters of the contract period. Contractor shall notify the State by a deadline date, not less than fourteen days from the date of notification, set forth in the letter of notification of discrepancies in the number of clients served during the first three quarters and the parties shall set the amended"maximum reimbursable client figure" and the amended"maximum total compensation". Failure to respond to the letter of notification by the deadline date shall constitute agreement by Contractor with the amended "maximum reimbursable client figure" and the amended "maximum total compensation" contained in the letter of notification. Commensurate with this process the State shall issue a change order letter that amends the "maximum reimbursable client figure" and the "maximum total compensation", made part hereof as Exhibit D. Such change order letter shall not be valid until approved by the State Controller or such assistant as he may designate. (12)If adjustments occur in the state and/or federal funds through supplemental funds which are appropriated for this program,the funding available to the contractor for client caseload growth may be adjusted in proportion to the overall change in appropriation. Adjusted funding shall be made available by notification to the Contractor by the Department and shall not require amendment of this contract. (13) The Contractor shall be reimbursed an amount equal to the "Annual Rate" for each client for whom assessment has occurred, and who selects and is enrolled in the Total Long Term Care program. This will be achieved by the Contractor continuing to include the referred client in their monthly client count through the remainder of the Performance Period of the contract year in which the referral is made. (14)The payment to the Contractor of the annual case management fee for clients who are de-institutionalized under Scope of Work Paragraph 2(b)shall be made to the contractor from a separate fund made available to the State in an amount not to exceed$81,527 for all Single Entry Point contractors statewide. (15) The payment to the Contractor of the annual case management fee for clients who are on the Consumer Directed Attendant Support Program shall be made to the contractor fro a separate fund made available to the State in an amount not to exceed$149,250 for all Single Entry Point contractors statewide. Page 3 of 3 • Exhibit B Payment Methodology for Deinstitutionalization Activities Billing/Payment Procedure (1) The State shall establish billing procedures and reimburse the Contractor in such amounts as may from time to time be specified by the State pursuant to applicable federal and state statutes and regulations Total compensation to the Contractor under this contract shall not exceed the limitation contained in the General Provision entitled "Compensation/Maximum Payable." (2) The Contractor shall receive state and federal funds in monthly payments from the State as set forth in paragraph 3 of this exhibit. Allowable agency expenditures are set forth by Federal rules, CFR Title 45,Part 74, Appendix G; Office of Management and Budget Circular A-87 or A-122,whichever is applicable; and the U.S. Department of Health and Welfare, December 1976, Cost Principles and Procedures for Establishing Cost Allocation Plans and Indirect Cost Rates for Grants and Contracts with the Federal Government as indicated presently or amended in the future. (3) The Contractor shall be reimbursed$270 per client for each nursing facility client for whom Contractor performs an informational interview and a deinstitutionalization potential evaluation. The Contractor shall be reimbursed an additional sum of$200 per client for each client who elects to leave a nursing facility, receive care in a community setting, and for additional required research related to client monitoring and reporting of client specific and summary information as required by the deinstitutionalization project. (4) State payments to Contractor for deinstitutionalization activities are not subject to reimbursement to the State based on contractor cost to provide the services. (5) The Contractor shall be reimbursed as specified in paragraph 3 of this exhibit,as long as funding remains available for this purpose. In the eventuality that the annual funding available for this service has been expended, the state will notify,through the"Dear Administrator Letter"system, all Single Entry Point Contractors that payment will no longer be available. These payments are on a fee for service basis and are not encumbered as a part of this contract. Page 1 of 1 • Exhibit C Payment Methodology for Consumer Directed Attendant Support Program Billing/Payment Procedure (I) The State shall establish billing procedures and reimburse the Contractor in such amounts as may from time to time be specified by the State pursuant to applicable federal and state statutes and regulations Total compensation to the Contractor under this contract shall not exceed the limitation contained in the General Provision entitled "Compensation/Maximum Payable." (2) The Contractor shall receive state and federal funds in monthly payments from the State as set forth in paragraph 3 of this exhibit. Allowable agency expenditures are set forth by Federal rules, CFR Title 45, Part 74, Appendix G; Office of Management and Budget Circular A-87 or A-I22, whichever is applicable; and the U.S. Department of Health and Welfare, December 1976, Cost Principles and Procedures for Establishing Cost Allocation Plans and Indirect Cost Rates for Grants and Contracts with the Federal Government as indicated presently or amended in the future. (3) The Contractor shall be reimbursed a sum of $200 for each newly enrolled participant in Consumer Directed Attendant Support (CDAS). The Contractor shall be reimbursed a sum of$795 per participant per year for case management services. (4) The Contractor shall be reimbursed as specified in paragraph 3 of this exhibit, as long as funding remains available for this purpose. In the eventuality that the annual funding available for this service has been expended, the state will notify, through the"Dear Administrator Letter"system, all Single Entry Point Contractors that payment will no longer be available. These payments are on a fee for service basis and are not encumbered as a part of this contract. Page 1 of 1 Exhibit D SAMPLE BILATERAL CHANGE ORDER LETTER Date: State Fiscal Year: 2003 Bilateral Change Order Letter No. In accordance with Paragraph 16, and Paragraph 11 of Exhibit A, of contract routing number UIIA, between the State of Colorado Department of Health Care Policy and Financing and covering the period of July 1, 2002 through June 30, 2003,the undersigned agree that the supplies/services affected by this change letter are modified as follows: Price/Cost The maximum amount payable by the State for work associated with the Scope of Work described in Paragraph 2(a) is (increased/decreased) by $ to a new total of $ based on the unit pricing schedule in Exhibit A. The first sentence in Paragraph 4, and the first sentence in Paragraph 7 of Exhibit A, are hereby modified accordingly; The total contract value to include all previous amendments, change orders, etc. is $ This change to the contract is intended to be effective as of , or on approval by the State Controller, whichever is later. Please sign, date, and return all copies of this letter on or before 20 Contractor Name: State of Colorado: Bill Owens, Governor By: By: Date: For the Executive Director Name: Colorado Department of Health Care Policy and Financing Title: APPROVALS: By: For [Division] ALL CONTRACTS MUST BE APPROVED BY JUL STATE CONTROLLER CRS 24-30-202 requires that the State Controller approve all state contracts. This contract is not valid until the State Controller, or such assistant as he may delegate, has signed it. The contractor is not authorized to begin performance until the contract is signed and dated below. If performance begins prior to the date below, the State of Colorado may not be obligated to pay for goods and/or services provided. State Controller,Arthur L.Barnhart By: Date: Page 1 of 1 • Exhibit E Performance Based Payment Methodology (1) (a)The contractor will achieve all four performance standards, listed below. Attainment of all performance standards must be achieved and certified by the State by March 31, 2003. (b) If all four performance standards are not achieved and certified by the State by March 31, 2003, the State will withhold the cost of living increase, if any, for clients served throughout the period July 1, 2003,through June 30, 2004, and a compliance issue will be given to the SEP Contractor. If the compliance issue is not remedied during July 1, 2003, to June 30, 2004, to the satisfaction of the State the Contractor may be de- certified for State Fiscal Year 2004-2005. (2) PERFORMANCE STANDARDS AND QUALIFICATION (2A) Obtaining qualifying training for Single Entry Point case management staff: (a) This performance standard is achieved by the Contractor providing at least eight or sixteen hours of training for case management staff based upon length of employment with the Contractor within the period January 1, 2002, through December 31, 2002. Contractor shall submit to the State documentation of all qualified training obtained between January 1, 2002, and December 31, 2002, on a state prescribed form, for credit toward the meeting of this standard. (b) The required training must qualify under the list attached as Attachment 1 to this Exhibit E. (c) Training provided after January 1, 2003, shall become eligible to fulfill training requirements in the contract for July 1,2003, through June 30,2004. (d) Contractor must obtain this training from qualified trainers. (e) Contractor staff who received more hours than those required under the FY 2001-2002 Single Entry Point Contract can carry forward into the FY 2002-2003 contract a credited"beginning balance"of eligible training hours, not to exceed 6 hours. The eligible "beginning balance" shall be calculated by subtracting "Training Hours Required" from "Approved Training Hours Obtained" on the final "Report of Compiled Training Hours" under the FY 2001-2002 contract. Eligible training hours in excess of those required by the training standard under the FY 2001-2002 can be carried forward only into the "beginning balance" under the FY 2002-2003 contract and not into any training requirements in contracts beyond the FY 2002-2003 contract. (1) Qualifying training must be given to training coordinators and all staff who perform as direct case manager supervisors or who interact with clients in a direct case management provision role. This includes case manager supervisors,case managers, and training coordinators.The training requirement for case aides, intake staff, and clerical staff who provide quarterly utilization and review contact shall be one-half of the hours required for case managers, direct supervisors and training coordinators and medical terminology and interviewing courses are recommended. Support staff who only refer clients to direct case management staff have no training hour requirement under this contract. (g) Staff hired by the Contractor prior to December 31, 1999, shall be required to be provided 8 hours of training. Staff hired by the Contractor after December 31, 1999, shall be required to be provided 16 hours of training. Staff hired between July I, 2002, and November 1, 2002, shall have a pro-rated training requirement as follows: • Persons with hiring dates between July 1, 2002, and August 30, 2002, shall be required to be provided 12 hours of training. • Staff hired between September 1, 2002, and October 15, 2002, shall be required to be provided 6 hours of training. • Staff hired after October 15, 2002, shall be required to be provided no hours of training until a new training cycle begins on January 1,2003. (h) The training requirement for part-time staff to meet this standard shall be pro-rated as follows: • Staff who participate in single entry point activities at the level of.01 FTE to .24 FTE shall be provided 4 hours of qualifying training if hired by the Contractor after December 31, 1999, or 2 hours of qualifying training if hired by the Contractor prior to December 31, 1999. • Staff who participate in single entry point activities at the level of.25 FTE to .49 FTE shall be provided with 8 hours of qualifying training if hired by the Contractor after December 31, 1999, or 4 hours of qualifying training if hired by the Contractor prior to December 31, 1999. Page 1 of 2 Exhibit E • Staff who participate in single entry point activities at the level of.50 FTE to .99 FTE shall be provided with 16 hours of qualifying training if hired by the Contractor after December 31, 1999, or 8 hours of qualifying training if hired by the Contractor prior to December 31, 1999. (2 B) Utilization monitoring by the State shall demonstrate that the State determines that at least 90% of monitored client Contractor-approved Prior Authorization Reviews (PARs) do not exceed those appropriate types and amounts of Medicaid-funded Home and Community-Based Non-skilled services that are medically and/or functionally required by each client and in compliance with Medicaid rules. (2C) Utilization monitoring by the State shall demonstrate that the State determines that at least 90% of monitored client Contractor-approved Prior Authorization Reviews (PARs) do not exceed those appropriate types and amounts of Medicaid-funded Home Health Services that are medically and/or functionally required by each client and in compliance with Medicaid rules. (2D) Contractor shall complete a Client Satisfaction Survey using a state prescribed form as follows: (a) Interviewers may be advisory board members, volunteers, SEP Supervisors, student interns for academic credit or another SEP districts case managers,but may not be case management staff of the Contractor. (b) If Contractor has fewer than 200 SEP clients a minimum sample size of 20 SEP clients shall be contacted. If Contractor has between 200 and 1,000 SEP clients a minimum sample size of 10% of all SEP clients shall be contacted. If Contractor has more than 1,000 SEP clients a minimum sample size of 100 SEP clients shall be contacted. (c) The Contractor shall analyze all client responses and submit a written report to the State by February 1, 2003. The report will at a minimum summarize positive findings, concerns, problems and include a corrective action plan explaining how the Contractor plans to resolve those concerns and/or problems. Page 2 of 2 Attachment 1 to Exhibit E Recommended List of Courses for Performance Based Qualification Qualification is sixteen hours per year for most staff(See Exhibit E for specific training requirements) to encompass training as follows: Course description and trainer credentials to teach course must be submitted in advance to the state for qualification. (A)Diabetes Management (B) Progression and Management of Chronic Congestive Heart Failure (C) Progression and Management of Chronic Lung Diseases (D) An Overview of Radiation and Chemotherapy in Respect to the Physical and Emotional Impact on the Client Receiving These Treatment Modalities (E) An Overview of the Normal Aging Process with an Emphasis on Normal Functional Decline (F) Assisting the Younger Disabled Client: • Newly Disabled: Grieving and Adjustment to the Disability • Chronically Disabled: Coping Skills in Regard to the Disability (G) An Overview of Dementia (H) A Brief Overview of the Major Psychiatric Disorders, i.e., Bipolar, Depression, Schizophrenia, Borderline Personality Disorder and How Aging and/or Disability Impacts Them. (I) Functional Evaluation of Cognitive Impairment from Brain Injury--Creating a Care Plan to Address Care Needs (J) Neurobehavioral Consequences of Brain Injury Treatment Planning and Management (K) The Grieving Process including Death and Dying (L) Medical Terminology (M)Interviewing Techniques (N) Common Drug Interactions (0) Utilization of Skilled care vs non-skilled care (P) Skin Care (Q) Infection Control (R) Body Mechanics/Physical Therapy (S) Behavioral Management (T) Oncology Updates (U) CPR/First Aid (Not to exceed 4 credit hours) (V) Topics,to include fraud and abuse training, associated with monitoring of utilization of client Medicaid services. (W) Other topics to be proposed by SEP(s) submitted with course description and trainer credentials to teach the course. Must be approved in advance by the State. Page 1 of 1 .011 Exhibit F SAMPLE OPTION LETTER Date: State Fiscal Year: 2003 Option Letter No. SUBJECT: Option to Renew In accordance with Paragraph 17 of contract routing number , UHA, between the State of Colorado Department of Health Care Policy and Financing( division)and [Contractor] covering the period of July 1, 2002 through June 30,2003,the State hereby exercises the option for an additional one year's performance period at the (cost) (price) specified in Paragraph 4. The maximum amount payable by the State for work associated with the Scope of Work described in Paragraph 2(a) is [increased/decreased] by [$ amount of change] to a new total of[$ ]. The first sentence in Paragraph 4 is hereby modified accordingly. The total contract value to include all previous amendments, option letters, etc. is [$ ]. By: Date: For Division APPROVALS: State of Colorado: Bill Owens, Governor By: Date: For the Executive Director Colorado Department of Health Care Policy and Financing ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER CRS 24-30-202 requires that the State Controller approve all state contracts. This contract is not valid until the State Controller, or such assistant as he may delegate, has signed it. The contractor is not authorized to begin performance until the contract is signed and dated below. If performance begins prior to the date below,the State of Colorado may not be obligated to pay for goods and/or services provided. State Controller,Arthur L.Barnhart By: Date: Page 1 of I MEMORANDUM Atit, DATE: July 12, 2002 ' TO: Glenn Vaad, Chair, Weld County Board of Commissioners FROM: Walter Speckman, Executive Director, Division of Human\ ,k, COLORADO Services SUBJECT: The Weld County Single Entry Point contract for Fiscal Year 2002-2003 Enclosed for Board approval is the Single Entry Point contract for Fiscal Year 2002-2003. The Weld County Area Agency on Aging provides case management services for Medicaid clients who are eligible for Single Entry Point services. The contact period is from July 1, 2002 through June 30, 2003. The contract funding is $387,960. If you have additional questions, please contact Eva Jewell, Director of the Weld County Area Agency on Aging at 353-3800, extension 3331. 2002-1941 Jun 13 02 04:22p NE Cole Assoc oft. Gov 't (9701867-9053 p• 2 STATE OF COLORADO DEPARTMENT OF HEALTH CARE POLICY&FINANCING 17 Ne'f 1497: 1575 Sherman Street I , Ct Denver,CO 80203.1714 (303)866-1993 .111.7t (303!846.4411 FAN _...-- (303)866.3863 TTYBill Owen! t;gvrrno DO NOT DATE STAMP THESE CONTRACTS Karen tshminmtelh URGENT, PLEASE EXPEDITE June 12,2002 Dear OLTC Administrator: Enclosed you will find three copies of your agency's Single Entry Point contract for the period July 1, 2002 through June 30, 2003. (11 your agency does not use the standard, waivered contract that has been pre-approved by the state attorney general, five copies must be signed and returned) We are sending the contact to you to begin the signatory process. Based on current appropriation, the Department's SEP Contract reflects a 7% reduction in the reimbursement rate of$855 per client per year to $795 per client per year. It is the Department's intention to amend this contract as soon as possible based upon a new payment methodology and change in scope of work. You will see three significant changes to the contract relative to Single Entry Point contracts that we have sent in previous years: 1. Changes made as a result of our performance-based payment methodology. All four performance standards must be achieved and certified by the State by March 31, 2003. if all four performance measures are not met in FY02-03,there will be no cost of living increase, if any is available,for FY03-04. Objective#1, obtaining qualifying training for Single Entry Point case management staff,has been reduced to R hours if staff has been employed by the contracted Single Entry Point Agency prior to December 31, 1999. Objective#2 and #3 remain the same. Objective#4 is new and states the Single Entry Point Agency must complete a Client Satisfaction Survey, develop a report summarizing the findings,and send the report to the State by February 1,2003. 2. Single Entry Point Agencies do not need to receive prior written approval for all proposed capital expenditures in excess of over$500 that are made using funds from Single Entry Point_ 3. Consumer Directed Attendant Support(CDAS)case management services have been added. The Single Entry Point Agency will received $200 for new clients to the CDAS program and their regular case management reimbursement of$795 per client per year. Exhibit C explains payment for CDAS. 'The mission of the Department of Health Care Policy&Financing is to purchase cost effective health care fur qualified,low-income Coloradans" http://wwvvichcpistate.co.us us Jun 13 02 04: 22p NE Colo Assoc ofL. Gov 't (9701867-9053 p. 3 As the contract progresses through the signatory process at your agency,please be certain to note the following: o Pages 9 and 10 have been completed for you based upon information received from your agency or last year's contract. o Please see the attached sample page of a correctly completed signatory page,page 17. ✓ Immediately after the word "Contractor" and above the line marked Legal Name of Contracting Entity, the same complete legal identification of your agency that appears in the first paragraph on page 1 must agree and has been entered for your convenience. ✓ On the line marked Social Security Number or FEIN, your agency's correct federal identification number needs to be entered. This should be the same as the federal identification number on W9s submitted by your agency. I The signatory must be a person authorized to legally bind the contractor to performance of the contract. For Single Entry Point agencies, signatories considered eligible to sign a contract, with no accompanying designation, are Presidents or Vice Presidents for corporations or not for profit organizations, and county commissioners for county organizations. If a person other than one of these signs the contract, ynn must submit written documentation,such as a board resolution, authorizing the designee's authority to sign the contract. ✓ Please print or type the name and title of the authorized signatory. ✓ The last required entry is the attestation for your agency for which most agencies have a corporate seal. If you have no seal,write in "No Seal" and complete the attestation. o Change order letters that appear as exhibits arc only examples of documents that may be used later in the contract period. They should not be signed by anyone at this time. ❑ Please be certain to return three completed and signed contracts If the waivered form (the form that is enclosed) is being used with only the completions indicated above. If any alterations occur, the State must receive five completed and signed contracts. If you have questions in regard to this letter or the contracts, please call me at (303) 866-2883 before proceeding. S• Y, s - Peggy Spat ding SEP Administrator Enclosures 2 Jun 13 02 04:22p NE Colo Assoc, ofL. Gov 't (970) 867-9053 p. 4 SPECIAL PROVISIONS THE PARTIES BERETQHAVE EXECUTED THIS CONTRACT CONTRACTOR: STATE OF COLORADO: BILL OWENS,GOVERNOR SEr Agency By Legal Name of Contracting Entity Karen Reincrtson,Executive Director Department or Health Care Policy and Financing t[/ O/.z 3 S/6.- octal Security Number or FEIN LEGAL REVIEW: Siwiaturc of Aut enzed Officer Ken Salazar,ATTORNEY GENERAL P + Pre4fidP_In. By * Print &TIdE of Authorized Officer CORPORATIONS: (A corporate seal or attestation is required) COrrr S.0 a1/4-0 �[LA-0. Q r ° Attest(Seal)By (� /091‘..r (Corporate Secretary or Equiv.lent,or TowuyCity/County Citric) ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER CRS 24-30-202 requires that the State Controller approve all state contracts. This contract is not valid until the State Controller,or such assistant as he may delegate, has signed it. The contractor is not authorized to be?in performance until the contract is signed and dated below. If performance begins prior to the date below,the State of Colorado may not be obligated to pay for the goods and/or services provided. STATE CONTROLLER: Arthur L.Barnhart By Date Raised 12/1/01 HCPF LAN VERSION,12/1/01 Page 17 of 17 Hello