HomeMy WebLinkAbout20042170.tiff RESOLUTION
RE: APPROVE SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT FOR CHILD
WELFARE CLIENTS AND AUTHORIZE CHAIR TO SIGN - SIGNAL BEHAVIORAL
HEALTH NETWORK
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Substance Abuse Treatment Service
Agreement for Child Welfare Clients between the County of Weld,State of Colorado, by and through
the Board of County Commissioners of Weld County, on behalf of the Department of Social
Services, and Signal Behavioral Health Network, commencing July 1, 2004, and ending June 30,
2005, with further terms and conditions being as stated in said agreement, and
WHEREAS,after review,the Board deems it advisable to approve said agreement,a copy
of which is attached hereto and incorporated herein by reference.
NOW,THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County,Colorado,ex-officio Board of Social Services,that the Substance Abuse Treatment Service
Agreement for Child Welfare Clients between the County of Weld,State of Colorado, by and through
the Board of County Commissioners of Weld County, on behalf of the Department of Social
Services, and Signal Behavioral Health Network be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said agreement.
The above and foregoing Resolution was,on motion duly made and seconded, adopted by
the following vote on the 28th day of July, A.D., 2004, nunc pro tunc July 1, 2004.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
EXCUSED
Robert D. Masden, Chair
86i ,.' ; u erk to the Board
r
1 • William H. ''r'e, Pro-Tem
-..J _.®-•: (Clerk to e Board — �
x..`w M. . eile
AP V AS TO l �_
Davi• E. Long I
ounty ttor ey
EXCUSED
/ Glenn Vaad
Date of signature: _ ���1 1
/ 2004-2170
SS0031
(0 ; SSC> g) OS-/o -ny
DEPARTMENT OF SOCIAL SERVICES
P.O.BOX A
GREELEY,CO.80632
Webslte:www.coweld.co•us
II ill Admnnistradoo and Public Assistance(970)352-1551
Child Support(970)3524933
Co
COLORADO
MEMORANDUM
TO: Robert D. Masden, Chair Date: July 26, 2004
Board of County Commissioners
FR: Judy A. Griego, Director, Social Services • et +i)
RE: Additional Family Services (AFS) Funding greement between
the Weld County Department of Social Services and Signal
Behavioral Health Network
Enclosed for Board approval is an Additional Family Services (AFS) Funding Agreement
between the Weld County Department of Social Services (Department) and Signal
Behavioral Health Network (Signal). This Agreement was reviewed at the Board's Work
Session of May 3, 2004.
The major provisions of the Agreement are as follows:
1. The term of the Agreement is from July 1, 2004 through June 30, 2005.
2. Signal is the recipient of Colorado Department of Human Services funding. A
portion of the total funding to Signal was set aside by Signal for Weld County's
child welfare clients. Signal's funding to Weld County is $89,707.20 for alcohol
and drug treatment and at fee charges set by Signal.
3. The Agreement establishes a working relationship with Signal and provides the
mechanism to access these funds by the Department on behalf of the
Department's child welfare clients.
If you have any questions, please telephone me at extension 6510.
2004-2170
RECEIVED BY
JUL 2 6 2004 REn hatin BY
SIGNAL BEHAVIORAL� �} T'
JUL
l/ 2004
WELD COUNTY DEPARTM CI I;J CES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT VVCLU L.uuty r Y DEPT.
CHILD WELFARE CLIENTS-AFS SERVICE FUNDING OF SOCIAL SERVICES
This Agreement is between the Weld County Department of Social Services,hereinafter referred
to as "WCDSS"and Signal Behavioral Health Network,hereinafter referred to as "Signal".
WHEREAS, the Weld County Department of Social Services requires the services of a substance
abuse treatment provider to assist the County in delivering substance abuse treatment services to child
welfare clients, and Signal is willing and able to provide such services; and
WHEREAS, Signal is a Colorado non-profit corporation organized for the purpose of managing
and coordinating high quality,cost efficient, integrated chemical dependency and related behavioral
health care services in the State of Colorado.
NOW,THEREFORE, it is mutually agreed as follows:
SERVICES:
A. Responsibilities of Signal:
1. Signal agrees and desires to participate as the service coordinator for WCDSS qualified
child welfare clients under the definition set forth in the Child Welfare Lawsuit
Settlement Agreement(David Littman vs. State of Colorado).
2. Signal will maintain a high quality of clinical care to clients in a delivery system of
limited resources and public funding. The full continuum of care(Outpatient, Intensive
Outpatient,Transitional Residential, Intensive Residential, Therapeutic Community,or
comparable alternatives as mutually agreed upon)will be available to clients. The
client's clinical needs will determine the level of care Signal is to provide and Signal will
meet those needs regardless of"modality."
3. Signal encourages Agencies and clients/consumers/referral agencies to resolve any
complaint or grievance or appeal at the level closest to the situation. Should WCDSS
and/or Signal and its Provider fail to agree upon the level of care offered by Signal, they
may appeal the case directly to Bill Wendt, Signal Behavioral Health Network for
resolution. Signal, its Provider(s)and WCDSS will have an opportunity to provide
Signal with consultation and documentation regarding the appeal. Signal's Medical
Director and Clinical Director may also be consulted. Appeals are to be resolved within
72 working-day hours,unless good cause justifies an extension. In the interim of the
appeal, Signal is expected to continue providing services to the client.
4. Signal will assure that all eligible child welfare clients referred by WCDSS in need of
treatment will receive such in accordance with ASAM PPC-II R level of care,as
reimbursed by the State of Colorado,Alcohol and Drug Abuse Division.
5. Signal will serve child welfare clients(parents and children) on a priority basis who
comply with the following criteria as WCDSS refers:
• Case is active on TRAILS, and
• Case meets the State DHS program category criteria 4, 5, or 6, and
• Case meets the definition of"imminent risk for out-of-home placement/reunification"
set forth by the State of Colorado.
6. Signal will include the following provisions in all subcontracts with providers:
1
• The Provider shall submit a treatment plan for the client within 30 days
• The Provider shall submit Signal monthly progress reports to the assigned
caseworker.
• Signal,or their designee,agrees to provide Social Services monitoring results(UA,
BA,patch,tox trap)by faxing said results to Social Services at 970.346.7698 no later
than 72 hours after the day of service.
• Signal agrees to send AFS Actual Reports to Social Services each month by the 25th
day of the month following the service. Additionally, Signal agrees to include in the
AFS Actual Reports all AFS funded services for the month the services were
provided.
• Signal agrees to cooperate with the Social Services billing review process by
supplying AFS Actual Reports for current month services for the purpose of the
WCDSS review process.
• Signal agrees to cooperate with Social Services to resolve any duplicated fees and/or
errors identified by the WCDSS billing review process.
7. Signal will utilize AFS monies to pay for services in cooperation with designated
WCDSS staff.
8. Signal will assure that the providers in its network give timely notice of cancelled
appointments to the clients and will reschedule such appointments as soon as practical.
9. Signal will provide monthly reports showing the amount of AFS and Core spent on
treatment. Signal will also provide monthly progress reports for each WCDSS client in
treatment.
10. Signal will provide training and technical support, as necessary, for WCDSS staff in
accessing data reports and on the use of the child welfare referral system.
11. Signal shall reconcile all treatment providers' claims to AFS funds within 180 days
from the date of service delivery or will release those funds back to the county to be
used for additional treatment services.
B. Responsibilities of WCDSS:
1. WCDSS will work cooperatively with Signal and its Providers to deliver quality,efficient
and cost-effective substance abuse treatment services to WCDSS qualified clients.
2. WCDSS will make every effort to inform Signal and its Providers in a timely manner of
system issues, developments,and complications so that Signal and the Provider can make
informed choices in its role as the managed service organization and treatment agency
respectively.
3. WCDSS will assure that all referrals under this contract meet the eligibility criteria
expressed in Section I(A)(6)above.
4. WCDSS agrees to provide Signal with the name of a primary contact person who will be
responsible for interacting with Signal's data system.
5. WCDSS, or its authorized designee(s), will be responsible for electronically authorizing
services to various providers.
2
6. WCDSS will review monthly AFS Actual reports and determine any duplicate charges
pursuant to Core or other previously paid services. WCDSS will report monthly any
discrepancies in duplication and/or errors to Signal, and in cooperation with Signal,work
with Signal to resolve any conflicts of billed services or fees.
II. PERIOD OF PERFORMANCE
The Signal Additional Family Service period of performance under this Agreement shall be for
the 12-month period beginning July 1,2004 through June 30, 2005,unless sooner terminated.
As a condition of continuing to render services under this Agreement, it is understood that Signal
will report any limitation or restriction of their license or insurance or the ability to perform the
services covered by this Agreement under any condition of impairment.
Either party may terminate this Agreement or any part herein at any time by giving not less than
45 days advance written notice to the other party.
In the absence of any formal agreement beyond the term of this agreement, Signal agrees to
continue providing treatment,under the terms of this agreement, for clients that are in treatment
or referred by WCDSS for treatment. This is with the further understanding that service delivery
and payment are subject to the termination terms mentioned above.
Signal reserves the right to suspend services to clients if funding is no longer available. WCDSS
acknowledges financial responsibility for all services authorized and performed before the
effective date of termination.
III. COMPENSATION
Signal agrees to contribute a maximum of eighty-nine thousand seven hundred seven dollars and
twenty cents($89,707.20)annually from designated ADAD Additional Family Service(AFS)
funds to serve eligible clients in accordance with the terms herein. Of this amount, Signal shall
retain four thousand two hundred seventy-one dollars and seventy-seven cents($4,271.77)or five
percent of the service fees, salaries,and other authorized costs that are actually incurred in the
delivery of the treatment services authorized in this Agreement.
IV. CLIENT FEES OR CO-PAYS
Neither Signal nor their network providers shall assess a client fee or co-pay to child welfare
clients served under this contract,unless the client is required to pay for any positive urine screen
as a condition of their treatment plan or through court order for monitored sobriety and/or
treatment as a condition of their treatment plan.
V. ATTACHMENTS
Signal and WCDSS agree to adopt herein the attached fee-for-service Exhibit A.
VI. INDEPENDENT CONTRACTOR
Signal and its providers shall be providing services hereunder as an independent contractor and
the relationship of employer and employee does not exist between WCDSS and Signal.
VII. NON-DISCRIMINATION
It is the policy of Signal to provide equal opportunity without discrimination based on race,color,
sex,religion, age, sexual orientation,national origin,veteran status, or individual handicap in any
aspect of employment, training or services offered. All Signal programs, activities, and services
are administered on a non-discriminatory basis subject to the provisions of:
3
Title VI and VII of the Civil Rights Act of 1964
Executive Order 11246,as amended
Title VII and VIII of the Public Health Services Act
Rehabilitation Act of 1973 (Section 503 and 504)
Equal Pay Act of 1963, as amended
Title IX of the Education Amendments of 1972
Vietnam Era Veteran's Readjustment Assistance Act of 1974
Age Discrimination in Employment Act of 1967
Age Discrimination Act of 1975
Non-Discrimination Laws of the State of Colorado.
VIII. ACCESS TO RECORDS
Signal and WCDSS agree to make available in a timely manner all books, documents, and
records pertinent to this contract for the purpose of billing for services, audit, and compliance
with requirements and regulations of federal and state agencies and commercial insurance
carriers.
Signal acknowledges that in reviewing, storing,processing, or otherwise dealing with any client
records dealing with any client seen by a Signal provider or the on-site substance abuse counselor
is bound by the confidentiality provisions of 42 CFR Part 2. If necessary, Signal shall resist in
judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR
Part 2. WCDSS and Signal shall sign a Qualified Service Organization Agreement in compliance
with 42 CFR,Part 2.
IX. OBLIGATIONS
Obligations of WCDSS and Signal are contingent upon funds for that purpose being appropriated,
budgeted and otherwise made available.
X. PROVISIONS
This Agreement may be amended only by written agreement signed by each of the parties hereto.
This Agreement shall be binding upon, and shall inure to the benefit of the respective parties
hereto and shall not be assigned without the consent of all parties hereto.
XI. NOTICES:
Any notice required to be given pursuant to the terms and provisions hereof shall be in writing
and shall be sent by certified mail,return receipt requested;
To Signal at: To Weld County at:
Bill Wendt, Chief Executive Officer Judy A. Griego,Director
Signal Behavioral Health Network Weld County Department of Social Services
1391 Speer Blvd., Suite 300 P.O. Box A
Denver, CO 80204 Greeley, CO 80632
XII. DISPUTE RESOLUTION
It is the desire of all parties to resolve conflicts at the Signal/Provider/County level through
cooperation. Internally,the County Director(s)and the Signal Chief Executive Officer shall
attempt to resolve all conflicts and disputes. If the issue cannot be resolved, either party may
request that the State intervene and mediate the situation(by DHS Child Welfare and ADAD).
4
Any further unresolved issues may be submitted to George Kawamura,Office of Health and
Rehabilitation Services or his designee(s) for case presentation and review.
Should the above efforts fail, Signal, its Providers and WCDSS hereby agree to submit all
unresolved controversies,claims, and disputes arising out of this Agreement to mediation in
Denver County, Colorado, according to the commercial rules and practices of the American
Arbitration Association then in force, or pursuant to other rules or procedures as to which the
parties may agree. Regardless of the outcome, each party agrees to fund their own litigation
expenses.
This Agreement shall be governed by and construed in accordance with the laws of the State of
Colorado.
XIII. MISCELLANEOUS PROVISIONS
12.1 Headings. The headings of the sections and subsections of this Agreement are inserted
solely for ease of reference and shall not in any way affect the meaning or interpretation
of this Agreement.
12.2 Non-Assignment. None of the parties shall have the right to assign the benefits or
delegate the obligations in this Agreement without prior written consent of the other
parties. Subject to the foregoing,this Agreement shall be binding upon and inure to the
benefit of the parties and their respective heirs, successors, legal or personal
representatives and permitted assigns.
12.3 Waiver of Breach. The waiver of any party of a breach or violation of any provision of
this Agreement shall not operate as, or be construed to be, a waiver of any subsequent
breach of the same or any other provision thereof.
12.4 Gender and Number. Whenever the context of this Agreement requires,the gender of all
words shall include the masculine, feminine and neuter, and the number of all words shall
include singular and plural.
12.5 Severability. If any provision of this Agreement is held to be unenforceable for any
reason,the unenforceability thereof shall not affect the remainder of this Agreement,
which shall remain in full force and effect and be enforceable in accordance with its
terms.
12.6 Counterparts. This Agreement may be executed in duplicate originals, each of which
shall be an original instrument but both of which taken together shall constitute one and
the same instrument.
12.7 Entire Agreement. This Agreement constitutes the entire understanding and agreement
between the parties with respect to its subject matter and supersedes all prior agreements
or understandings,whether written or unwritten,with respect to the same subject matter.
12.8 Hold Harmless. To the extent authorized by law each party shall indemnify, save and
hold harmless the other and the Colorado Department of Human Services, against any
and all claims, damages, liability and court awards including costs, expenses, and
attorney fees incurred as a result of any act or omission by the party's employees, agents,
subcontractors, or assignees, or arising out of any dispute between the WCDSS, Signal,
Network Providers and the State Department of Human Services in connection with the
Agreement.
5
SIGNAL BEHAVIORAL HEALTH NETWORK
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE AGREEMENT
CHILD WELFARE CLIENTS-AFS SERVICE FUNDING
APPROVED BY:
SIGNAL BE O � -?�11'WORK
7-,23 -ay
Scott Thoemke, Board President Date
Signal's Federal tax ID Number: 84-1362495
WELD COUNTY ,�t\\ ATTEST:
U 2 8 2004 WELD UNTY CLERK T THE BOARD
William H. Jerke, Ch. r ' .� '�' mate
Board of County Commissioners t r. BY: E UTY C K 0 THE BOA
WELD COUNTY DE TMENT Or SERVICES
k16/°y
By: y A. ego,D' ctor Datuf
6
ac)ti — alie
SIGNAL BEHAVIORAL HEALTH NETWORK and
WELD COUNTY DEPARTMENT OF SOCIAL SERVICES
SUBSTANCE ABUSE TREATMENT SERVICE
Attachment A
Fee-For-Service Reimbursement(for services not provided by the on-site counselor):
Amounts are not to exceed the following:
Service
Description Code Weld County
Provider 5 0"�o AFS/Core Units
Rate Rate
Alcohol (ethanol), breath 82075 $2.00 $0.10 $2.10 Each
Alcohol and/or drug screening; laboratory H0003 $12.00 $0.60 $12.60 Each
analysis of specimens for presence of alcohol
and/or drugs(UA)
Alcohol and/or drug services; acute H0011 $152.00 $7.60 $159.60 Day(s)
detoxification (residential addiction program
inpatient)(Detox)
Alcohol and/or drug services; group H0005 $6.75 $0.34 $7.09 15 Minutes
counseling by a clinician
Alcohol and/or other drug testing, collection H0048:HF $50.00 $2.50 $52.50 Each
and handling only, specimens other than
blood: Substance abuse program (Drug Patch
Monitoring)
Alcohol and/or substance abuse services: T1006 $25.00 $1.25 $26.25 15 Minutes
family/couple counseling
Behavioral health screening to determine H0002 $140.00 $7.00 $147.00 Each
eligibility for admission to treatment program
(Evaluation)
Behavioral health screening to determine H0002:TN $200.00 $10.00 $210.00 Each
eligibility for admission to treatment program:
Rural/out of service area (Off-Site Evaluation)
Behavioral health; long term residential (non- H0019 $93.00 $4.65 $97.65 Day(s)
medical, non-acute care in a residential
treatment program where stay is typically
longer than 30 Day(s)s), without room and
board, per diem (Transitional Residential)
Drug confirmation, each procedure 80102 $35.00 $1.75 $36.75 Each
Individual behavioral health counseling and H0004 $15.00 $0.75 $15.75 15 Minutes
therapy, per 15 min
Medical testimony 99075 $18.75 $0.94 $19.69 15 Minutes
Office or other outpatient visit for the 99214 $60.00 $3.00 $63.00 Each
evaluation and management of a new patient,
which requires these three key components: a
detailed history; a detailed examination; and
medical decision making of low complexity.
(Antabuse Physical, new patient)
Office or other outpatient visit for the 99203 $60.00 $3.00 $63.00 Each
7
evaluation and management of an established
patient, which requires at least two of these
three key components: a detailed history; a
detailed examination; medical decision
making of moderate complexity. (Antabuse
Physical, established patient)
On-site Staff Services N/A $55.00 $2.75 $57.75 Each
Oral medication administration, direct H0033 $2.00 $0.10 $2.10 Each
observation(Antabuse Monitoring)
Vapor inhalations evaluation 94664 $40.00 $2.00 $42.00 Each
Out of Region One Services
Alcohol and/or drug services; methadone H0020 $415.00 $20.75 $435.75 Month
administration and/or service(provision of the
drug by a licensed program)
Behavioral health day treatment, per hour: H2012:HB $6.90 $0.35 $7.25 Hour(s)
Adult program, non-geriatric(Day Tx--Adult)
Behavioral health day treatment, per hour: H2012:HA $9.87 $0.49 $10.36 Hour(s)
Child/adolescent program (Day Tx--
Adolescent)
Behavioral health; long term residential (non- H0019:HD $175.00 $8.75 $183.75 Day(s)
medical, non-acute care in a residential
treatment program where stay is typically
longer than 30 days), without room and board,
per diem: Pregnant/parenting women's
program (New Directions for Family)
Behavioral health; short-term residential (non H0018:HB $170.00 $8.50 $178.50 Day(s)
hospital residential treatment program)
without room and board, per diem: Adult
program, non-geriatric(Intensive Residential -
-Adult)
Behavioral health; short-term residential (non H0018:HA $228.00 $11.40 $239.40 Day(s)
hospital residential treatment program)
without room and board, per diem:
Child/adolescent program (Intensive
Residential --Adolescent)
Therapeutic behavioral services, per diem: H2020:HB $59.00 $2.95 $61.95 Day(s)
Adult program, non-geriatric(Therapeutic
Community--Adult w/out Infant)
Therapeutic behavioral services, per diem: H2020:HA $125.00 $6.25 $131.25 Day(s)
Child/adolescent program (Therapeutic
Community--Adolescent)
Therapeutic behavioral services, per diem: H2020:HD $99.50 $4.98 $104.48 Day(s)
Pregnant/parenting women's program
(Therapeutic Community --Adult w/ Infant)
Signal in accordance with federal HIPAA regulations, adopted the standard transaction code set
for all treatment services on October 16, 2003. Even though this compliance changed the service
labels and groupings (shown above), the net fees associated with those services have not
changed.
8
The following services are available exclusively through AFS funds and must be purchased in
conjunction with the residential treatment services described in the fee-for-service schedule above for
both Core and AFS funded residential treatment services:
Residential Room and Board: Adult
program, non-geriatric
T2048:HB
Provider Soho AFS Units
Rate Rate
Addiction Research & $16.88 $0.84 $17.72 Day(s)
Treatment Services -ARTS
Arapahoe House $45.23 $2.26 $47.49 Day(s)
Crossroads $50.00 $2.50 $52.50 Day(s)
Island Grove $35.00 $1.75 $36.75 Day(s)
Sobriety House $22.00 $1.10 $23.10 Day(s)
Residential Room and Board:
Child/adolescent program
T2048:HA
Provider 5% Units
Units
Rate Rate
Addiction Research& $22.65 $1.13 $23.78 Day(s)
Treatment Services - ARTS
Arapahoe House $36.30 $1.82 $38.12 Day(s)
Crossroads N/A N/A N/A Day(s)
Island Grove $33.00 $1.65 $34.65 Day(s)
Sobriety House N/A N/A N.A Day(s)
Residential Room and Board:
Pregnant/parenting women's program
T2048:HD
Provider 5% Units
Units
Rate Rate
Addiction Research & $16.88 $0.84 $17.72 Day(s)
Treatment Services - ARTS
Arapahoe House $50.17 $2.51 $52.68 Day(s)
Crossroads $75.00 $3.75 $78.75 Day(s)
Island Grove N/A' N/A N/A Day(s)
Sobriety House N/A N/A N/A Day(s)
9
Hello