HomeMy WebLinkAbout20041752.tiff RESOLUTION
RE: APPROVE CONTRACT AMENDMENT#1 FOR EARLY AND PERIODIC SCREENING,
DIAGNOSIS, AND TREATMENT SERVICES PROGRAM 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 Contract Amendment#1 for Early and
Periodic Screening, Diagnosis, and Treatment Services Program between the County of Weld,
State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf
of the Weld County Department of Public Health and Environment, and the Colorado Department
of Public Health and Environment,commencing July 1,2004,and ending June 30,2005,with further
terms and conditions being as stated in said amendment, and
WHEREAS,after review,the Board deems it advisable to approve said amendment,a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Contract Amendment#1 for Early and Periodic Screening, Diagnosis,
and Treatment Services Program between the County of Weld, State of Colorado, by and through
the Board of County Commissioners of Weld County, on behalf of the Weld County Department of
Public Health and Environment,and the Colorado Department of Public Health and Environment be,
and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said amendment.
The above and foregoing Resolution was, on motion duly made and seconded,adopted by
the following vote on the 28th day of June, A.D., 2004.
BOARD OF COUNTY COMMISSIONERS
1'\ I /- 4 1 WEW COUN Y, CWOLOORADO
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4 �; ` el Robert D. Masden, Chair
1
r. ;vim' ••I Clerk to the Board
•
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1�� � ir- Ai, C/e William H. rke, Pro-Tem
ti�
Deputy Clerk to the Board
M. ie
P ED AST
David . Long
oUn ttorney
�_ ,�( Glenn Vaad
Date of signature: '`//3F'f
2004-1752
H L0031
('l : LC atii9J 07 -20-Ott
Memorandum
I TO: Robert E. Masden
OBoard of County Commissioners
• From: Mark E. Wallace, MD, MPH, Director
COLORADO Department of Public Health and`���7O (
Environment
DATE: June 24, 2004 / v
SUBJECT: Amendment#1 for the EPSDT Program
Enclosed for Board review and approval is amendment#1 to the contract between the State of
Colorado, Department of Health Care Policy and Financing (HCPF) and Weld County Board of
Commissioners for the Early and Periodic Screening, Diagnosis, and Treatment Services
(EPSDT) Program.
The funding will be used to provide case management, outreach, and support services for
children ages 0 to 21 who are on Medicaid in the northeast region of Colorado. Emphasis is on
educating families about age appropriate well child services and helping them utilize these
services that are available in our community. For these activities, Weld County will be
reimbursed a sum not to exceed $123,317 for the time period July 1, 2004, through June 30,
2005.
I recommend your approval of this contract.
Enclosure
2004-1752
OLIN OCUHAa1C-te. Agency or Department Name
Health Care Policy&Financing
Department or Agency Number
UHA
Contract Routing Number
2105-9018
CONTRACT AMENDMENT #1
THIS AMENDMENT, made this first day of May 2004, by and between the State of Colorado
for the use and benefit of the Department of Health Care Policy and Financing, 1570 Grant
Street, Denver, Colorado 80203 hereinafter referred to as the Department, and Board of County
Commissioners of Weld County, 1555 North 17th Avenue, Greeley, Colorado, 80631,
hereinafter referred to as the Contractor.
FACTUAL RECITALS
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; and
Required approval, clearance, and coordination has been accomplished from and with
appropriate agencies; and
The parties entered into a contract dated July 1, 2003, to provide Early and Periodic, Screening,
Diagnosis and Treatment (EPSDT) outreach and case management services. The purpose of this
amendment is to extend the performance period, change the compensation payable, remove the
five percent indirect costs from reimbursement, specify appropriate items for reimbursement
from Medicaid funds, add billing time limits and replace Exhibit A, Scope of Work.
NOW THEREFORE, it is hereby agreed that:
1. Consideration for this amendment to the original contract, Contract Routing Number
2104-0134, dated July 1, 2003, consists of the payments, which shall be made pursuant to
this amendment and the promises, and agreements herein set forth.
2. It is expressly agreed by the parties that this amendment is supplemental to the original
Contract, which is, by this reference, incorporated herein, that all terms, conditions, and
provisions thereof, unless specifically modified herein, are to apply to this amendment as
though they were expressly rewritten, incorporated, and included herein.
3. It is agreed the original contract is and shall be modified, altered, and changed in the
following respects only:
a. The first sentence of Section III.B., Performance Period, is amended to extend the
performance period through June 30, 2005.
b. Section III.C., Compensation/Maximum Payable, shall be deleted and replaced
with the following:
6tCCy_i 95;;j
Payment pursuant to this contract will be made as earned, in whole or in part,
from available state funds encumbered in an amount not to exceed $121,117.00 in
fiscal year 2003-2004, ending June 30, 2004 and $123,317.00 in fiscal year 2004-
2005, ending June 30, 2005 for the purchase of the within-described services."
c. Add the following new subsection III.E.2.a,Billing/Payment Procedure:
The monthly invoices shall be submitted no later than 60 days after month end. In
compliance with the State Medicaid Manual, Part V, EPSDT Services 5340(B)
Reimbursement, invoices shall not include cost for overhead/indirect or any other
direct or indirect services which do not have a direct impact on the client being
served, including requests such as rent or janitorial costs.
d. Delete section DTI and replace with the following:
I. Remedies
In addition to any other remedies provided for in this contract, and without
limiting its remedies otherwise available at law, the Department may
exercise the following remedial actions if the Contractor substantially fails
to satisfy or perform the duties and obligations 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 the Contractor. These remedial actions are as follows:
1. Suspend Contractor's performance pending necessary corrective
action as specified by the Department without Contractor's
entitlement to adjustment in price/cost or schedule; and/or
2. Withhold payment to Contractor until the necessary services or
corrections in performance are satisfactorily completed; and/or
3. Request the removal from work on the contract of employees or
agents of the Contractor whom the Department justifies as being
incompetent, careless, insubordinate, unsuitable, or otherwise
unacceptable, or whose continued employment on the contract the
Department deems to be contrary to the public interest or not in the
best interest of the Department; and/or
4. Deny payment for those services or obligations which have not
been performed and which, due to circumstances caused by
Contractor, cannot be performed, or if performed would be of no
value to the Department. Denial of the amount of payment must
be reasonably related to the value of work or performance lost to
the Department.
5. Terminate the contract for default.
Page 2 of 4
6. Written Notification from the Department sent to the Contractor's
designated representative. The Contractor shall have 15 days to
reply and/or schedule up to eight hours of training sessions with
the Department. Attendees in the training sessions shall include
the Contractor's EPSDT program manager, regional team leader
and other appropriate staff.
7. If the Contractor has not reached compliance with this contract 15
days following the training session, the Department, may exercise
remedial actions. Remedial actions are as follows:
a. Withholding a percentage of total contract payment from
date of initial compliance request letter. Percentage of
payment will continue to be withheld until the necessary
service or corrections in performance are satisfactorily
completed and the Department has notified the Contractor
in writing;
b. Recovering reimbursements for those services or
deliverables, which have not been performed in compliance
with the contract; and
c. Canceling the contract, giving 30 days notice if the
Contractor cannot meet compliance after 120 days from the
initial deficiency letter.
The above remedies are cumulative and the Department, in its sole
discretion, may exercise any or all of them individually or simultaneously.
e. Exhibit A, Scope of Work from the original contract shall be replaced in its
entirety with the attached Exhibit A, as modified by Amendment 1.
4. The effective date of this amendment is upon approval of the State Controller, or July 1,
2004, whichever is later.
5. Except for the "Special Provisions," in the event of any conflict, inconsistency, variance,
or contradiction between the provisions of this amendment and any of the provisions of
the original contract, the provisions of this amendment shall in all respects supersede,
govern, and control: The "Special Provisions" shall always be controlling over other
provisions in the contract or amendments. The representations in the Special Provisions
concerning the absence of bribery or corrupt influences and personal interest of State
employees are presently reaffirmed.
6. FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT
FISCAL YEAR ARE CONTINGENT UPON FUNDS FOR THAT PURPOSE BEING
APPROPRIATED, BUDGETED, AND OTHERWISE MADE AVAILABLE.
Page 3 of 4
•
IN WITNESS WHEREOF, the parties hereto have executed this amendment on the day first
above written.
Contractor: State of Colorado
Bill Owens, Governor
Board of County Commissioners of Weld By:
County C c r
(Full Legal Name) K en Reinertson
\\nn nn Executive Director
(Signature of Individual) DEPARTMENT OF HEALTH CARE
POLICY AND FINANCING
Robert D. Masden
(Name of Individual) Attorney General,Ken S Tar
---Akkak
Chair (06/28/2004) By: OJN.
Position(Title) !!ll
84-6000-813 Date: VJ I w I c Y
Social Security Number
or Federal Employer Identification i� Number
Attestation � '� �, '
1 : min.., .,
By: { jait-cife,7aid I'(s
Iprit Clerk to the Board %e PF
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.
St Controller, LESLIE M. SHENEFELT
By:
Date: -53 - z fl a N
WELD COUitiY uLrNn [Vite n Ut
PUBLIC HEALT A NVIR0 NT
Page 4 of 4
BY:
Mark E. Wallace, MU, MPH•Director
dD0 ,/25
EXHIBIT A AS MODIFIED BY AMENDMENT 1
SCOPE OF WORK
The Contractor will act as the prime contractor under this contract and shall develop subcontracts
with the following surrounding counties: Logan, Morgan, Phillips, Sedgwick, Washington
and Yuma ("subcontractors"). The participating counties may be increased or decreased per the
requirements of section III, 13 "Assignment and Successors."
1. The role of the Contractor in directing activities of Logan, Morgan, Phillips,
Sedgwick,Washington and Yuma counties is to:
a. Initiate subcontracts with counties;
b. Complete the contract with the State on behalf of subcontractors;
c. Invoice the State on behalf of subcontractors; and
d. Distribute funds to participating subcontractors.
2. The role of the State in directing activities of Logan, Morgan, Phillips,
Sedgwick,Washington and Yuma counties is to:
a. Track activities of Contractor and subcontractors;
b. Have a state representative notify the prime contractor of any deficient
performance with respect to State tracking of subcontractor's work;
c. Initiate technical direction or inspection of the subcontractor after
agreement with the prime Contractor;
d. Notify the Contractor of any communication with the subcontractor; and
e. Enforce contract deliverables and obligations against the prime Contractor
who has subcontracted out a portion of the work to subcontractors.
The scope of work for this contract cycle shall include the following major projects, all of which
include sub-requirements:
A. Outreach- Target Populations
B. Outreach—Providers
C. Utilization of Reporting/Tracking System
D. Remedial Actions
A. Outreach for Target Populations
Contact newly eligible pregnant women, children and youth to ensure notification of
EPSDT services and benefits with an emphasis on those who have no Medicaid
services/screens in the EPSDT Data Tracking System. Encounter shall include,but is not
limited to:
1. In-depth explanation of EPSDT benefits and the importance of preventive care
and regular medical visits;
2. Assistance with selecting a Primary Care Provider (PCP), Obstetrician/
Gynecologist (OB/GYN) or specialty provider and clarification of the role of the
PCP;
3. Providing information on managed care options available, including phone
number for the Colorado Medicaid Enrollment Broker;
4. Assistance in making appointments with Medicaid providers;
5. Assistance with other services and benefits;
6. Coordinating with county Presumptive Eligibility (PE) sites to receive timely and
appropriate referrals to ensure pregnant woman understand EPSDT benefits and
care options, and to promote the need for regular prenatal care;
7. Efforts to assist parent in obtaining appointment with proper Medicaid providers
in order to bring the child up to date with the AAP recommended periodicity
schedules when the EPSDT Data Tracking System shows the child may be behind
in immunizations, well child checks, dental or vision services.
8. Assistance with contacting community services and benefits including, but not
limited to providing information on Health Care Program for Children with
Special Needs,Part C, WIC, Community Center Boards and Child Find; and
9. Inform parent or guardian of the need to arrange Medicaid care and services with
private Primary Insurance (if enrolled), including assistance in obtaining
additional Medicaid benefits.
B. Outreach to Providers
Provider outreach shall include,but is not limited to:
1. Meeting with Medicaid provider office staff to provide information, which
includes Presumptive Eligibility sites and schedules, mental health centers and
information on EPSDT services. Explain what the ESPDT Outreach coordinators
can offer providers if the provider refers clients to the EPSDT Outreach office;
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2. Making community and Medicaid resource information available to the provider
in written or electronic form;
3. Maintaining lists of current Medicaid providers who are accepting new clients,
including office hours and ages accepted to ensure current and proper referrals;
and
4. Offering assistance to the provider or clinic with EPSDT Medicaid eligible clients
who have excessive missed appointments or need assistance in scheduling
appointments.
C. Utilization of Reporting/Tracking System
The Tracking System uses the Internet to transmit information about client and provider
outreach activities on a statewide basis. The Tracking System includes internal security.
All users of the Tracking System must be authorized and are required to have separate
user identifiers and passwords. The Tracking System training shall include matters
related to confidentially and approval procedures. The Tracking system will be used to
report the following:
1. Contact with target populations:
a. Contact 90% of Medicaid newly eligible pregnant women and families by
June 30, 2005 to ensure notification of EPSDT benefits and services. The
Department will examine the Tracking System reports on Contractor data
the 10th of each contract month, as well as semi-annually, no later than
January 15, 2005 and July 10, 2005 as final reporting documentation from
the Contractor;
1) Introductory contact shall be within 60 days of client eligibility
notification, unless the pregnant client has been followed from
initial Presumptive Eligibility period;
2) Acceptable contact methods include face-to-face or telephone
contacts. First attempt to contact client shall be by phone or face-
to-face. After initial unsuccessful attempt to locate and inform the
client via face-to-face or phone contact, a letter shall be sent to the
client's last known address. Both attempts must be recorded in the
Tracking System client folder. Outcome shall be included to report
completion of inform process;
3) Encounter shall include assistance in locating a physician within
the available managed care or PCP options, including any primary
insurance options. Included in the recorded encounter must be the
current physician or provider, if known;
iii
4) Encounter shall include appropriate collaborations with and
referrals to the Health Care Program for Children with Special
Needs and local Part C agencies;
5) Encounter shall include immediate assistance to the client in
reporting the birth of the newborn to county technician or other
agency responsible for state ID assignment should the newborn not
yet be reported, utilizing the Add-A—Baby or similar reporting
procedure;
6) Follow-up shall be recorded in the Tracking System client folder
within 60 days of initial notification if client was unable to be
located or declined EPSDT Outreach services at the time of
notification;
7) Follow up shall continue if the client was not using an appropriate
provider at the time the initial outreach was completed. Follow up
shall continue until pregnant client is in a Medical Home, which
includes OB services or OB/GYN provider;
8) Follow-up shall be recorded in the Tracking System client folder as
needed to ensure appropriate and timely medical care; and
9) Plans submitted to The Department shall describe relationships
with partners who are doing EPSDT inform. This plan will include
training provided, including samples of tools used; agreed upon
expectations of the role the partner agency will provide in regards
to the inform process and format in which partner agency will
communicate client contact information with EPSDT. Partner
agency will provide client contact information to EPSDT to allow
for the Tracking System data entry of encounter, concerns,
referrals and outcomes.
b. Physically contact 50% of all current Medicaid physicians performing
primary care, OB/Gyn providers, Dental providers, Vision providers and
Orthodontic providers located within the contract service area at least once
a year, documented in the Tracking system by June 30, 2005. Accurate
list of current Medicaid providers shall be made available to community
partners, providers, child protection, public health, schools and any other
interested party.
1) The Contractor shall document these visits in the Tracking System
in the Community Outreach folder. Documentation shall include,
name of agency or practice, name of person contacted, date, reason
for visit, outcome of visit; and
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2) The Contractor shall notify the Department of all provider changes
within 10 days of provider contact through the Tracking System
Provider Request folder.
c. Maintain an accurate list of local community resources that offer
Medicaid-covered and non-covered services that are provided free or at a
reduced rate. List shall include basic eligibility guideline and program
rules and regulations to ensure appropriate client referrals to client or
provider. The list shall be made available to community partners,
providers, child protection, public health, schools and any other interested
party.
1) The Contractor shall contact 100% of the community resources
one time per year to ensure the accuracy of referrals given to the
client or provider. All contacts shall be recorded in the Tracking
System in the Community Contacts folder and shall include name
of agency or practice, name of person contacted, date, and reason
for visit, outcome of visit, and a brief account;
2) All community referrals given to clients shall be entered into the
Tracking System client folder. The Department shall pull referral
reports no later than January 10, 2005 and July 10, 2005 to ensure
that the Contractor has working relationships with, but not limited
to, the following agencies: Part C, Part B, WIC, School Based
Health Centers, Prenatal Plus, Nurse Home Visitor/Nurse Family
Partnership,Presumptive Eligibility and HCP;
3) All referrals received from the above agencies shall be recorded in
the Tracking System client folder. The Department shall pull
reports no later than January 10th 2005 and July 10, 2005 to ensure
the Contractor has working relationships with community partners.
d. The Department must approve all locally produced publications, letters,
brochures or other types of marketing or outreach materials for the EPSDT
Outreach and Case Management program before distribution.
e. The Contractor shall require local EPSDT Outreach Coordinators and/or
supervisors attend, in person or by phone, at least 6 of 11 monthly EPSDT
Outreach trainings by the Department.
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