HomeMy WebLinkAbout20031404.tiff RESOLUTION
RE: APPROVE ADDITION TO OPERATIONS MANUAL, SECTION 3.000, ASSISTANCE
PAYMENTS POLICIES AND PROCEDURES
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 Section 3.000, Assistance Payments
Policies and Procedures for the Weld County Department of Social Services Operations Manual,
and
WHEREAS, after review, the Board deems it advisable to approve said additional section,
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 Section 3.000, Assistance Payments
Policies and Procedures for the Weld County Department of Social Services Operations Manual
be, and hereby are, added and approved.
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 4th day of June, A.D., 2003.
BOARD OF COUNTY COMMISSIONERS
----5:...7,,,, W COUNTY, COLORAD
ATTEST: 7
iliAski ♦ �, F4,
:, , , David E. Long, Chair
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Weld County Clerk to 1 a d rd�C7 "
cp / �, ,. 4� Robert D. sden, Pro-Tem
BY: � i.. G- !' i /A ' \
Deputy Clerk to the Bo V 7/7 42ND
M. J. eil
APPRQV D AS —(
Willis H. Jerk/
ounty Att r y /"D� (6��
Glenn Vaat —�
Date of signature: �'ir
2003-1404
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Assistance Payments Policies and Procedures
3.000 Assistance Payments
Added 6/03
The Weld County Department of Social Services abides by State statutes
and State rules that govern mandated programs under the Colorado
Department of Human Services and the Colorado Department of Health
Care Policy and Financing. The following policies and procedures are in
addition to, or to clarify County policies as they relate to certain mandated
programs, excluding Colorado Works and Child Care program and the
Food Stamp Program, under the Colorado Department of Human Services
and the Colorado Department of Health Care Policy and Financing.
Section 6.000 of the Weld County Department of Social Services
Operations Manual addresses Colorado Works and Child Care mandated
and optional programs. Section 4.000 of the Weld County Department of
Social Services Operations Manual addresses Food Stamp assistance.
3.001 Definition and Legal Basis
Added 6/03
A. Colorado Revised Statutes, Title 26, Article 1, Section 107, created
the State Board of Human Services. The State Board adopts rules
and regulations governing program scope and content,
requirements, obligations, and rights of clients, recipients,
providers, and other persons who may be affected by acts of the
Colorado Department of Human Services.
B. Traditionally, the Department is an arm of the Colorado
Department of Human Services to act as agent of the State for the
administration of public assistance programs and related welfare
activates in the respective counties pursuant to the Social Services
Code, and to carry out the will of the State thereon.
C. The legal basis for Assistance Programs, excluding Colorado
Works and Child Care Programs and Food Stamp Programs, is as
follows:
1. Constitution of Colorado, Article XXIV, Old Age Pensions,
Section 6.
2. Colorado Revised Statutes, Title 26 Article 2, Sections 118,
119, and 120.
3. Constitution of Colorado, Article XXIV, Stabilization Fund
and Health and Medical Care Fund, Section 7, and
Colorado Revised Statutes, Title 26, Article 2, Section 17.
4. Colorado State Rules, Volume III, Income Maintenance
Programs.
5. Colorado State Rules, Volume VIII, Medical Assistance
Programs.
6. "The Weld County Department of Social Services
Operations Manual", as adopted and revised by the Board
Assistance Payments Policies and Procedures
of County Commissioners, as the Board of Social Services,
through resolution.
3.010 Non-emergent Medical Transportation
Added 6/03
The State rules governing this program are found in Colorado State Rules
Section 8.680 and Section 8.681 through 8.688, Volume VIII, Medical
Assistance Programs.
3.011 Definition
Added 6/03
Non-emergent Medical Transportation is transportation for eligible clients
who need transport to or from medical treatment that is not emergent in
nature. The non-emergent medical condition requires urgent or routine
medical attention and which a prudent lay person would not perceive as an
emergency medical condition. Non-emergent care may be scheduled or
unscheduled.
3.012 General Organization
Added 6/03
Non-emergent Medical Transportation involves two major entities:
A. The Weld County Department of Social Services (Department)
B. The Weld County Division of Human Services, on behalf of Mini-
Bus Transportation
3.013 Designation of State Designated Entity for Weld County
Added 6/03
A. Mini-Bus Transportation currently provides Head Start and rural
transportation for eligible Senior Citizens through its own fleet of
vans, has networked with the City of Greeley transportation and
other networks.
B. Colorado Health Care Policy and Financing has established new
rules under Section 8.680, Volume VIII, Medical Assistance
Programs, to establish"State Designated Entity Responsibilities".
C. Given the expertise of Mini-Bus Transportation, the Board of
County Commissioners has designated Mini-Bus Transportation to
provide "State Designated Entity Responsibilities". These
responsibilities include:
1. Contracting with and establishing a network or networks of
transportation providers;
2. Verifying client eligibility;
3. Verifying medical necessity of the transportation;
Assistance Payments Policies and Procedures
4. Identifying and authorizing (prior to) the most cost
effective means of transportation appropriate to the needs
of the client; and
5. Reimbursing clients and transportation providers for
services, as appropriate, pursuant to their contact with a
provider.
3.014 Joint Functions of the Department and Mini-Bus Transportation
Added 6/03
A. The Department and Mini-Bus Transportation agree to develop and
plan the Weld County service delivery system regarding the Non-
emergent Medical Transportation.
B. The Department and Mini-Bus Transportation agree to prepare and
provide tracking and monitoring of participant, program, goals and
outcomes through monthly reports.
C. The Department and Mini-Bus Transportation agree to provide the
client with the best available transportation to meet their Medicaid
Transportation needs.
3.015 Functions of Mini-Bus Transportation
Added 6/03
A. Mini-Bus Transportation will provide transport of eligible clients
in accordance with Section 8.680, Volume VIII, Medical
Assistance Programs.
B. Mini-Bus Transportation will provide broker functions as provided
under Section 8.680, Volume VIII, Medical Assistance Programs,
including:
1. Evaluating with the assistance of a client's physician any
request for Medicaid transportation.
2. Scheduling all client trips and record the trips in
appropriate manual or computer software.
3. Working with clients who own or have access to private
transportation through mileage reimbursement.
4. Providing bus passes or bus tokens to clients whose need
for Medicaid transportation does not rise to the level of
door-to-door service.
5. Working within a network of providers to arrange the least
costly, most effective means of transportation for every
client whose need required door-to-door service.
Assistance Payments Policies and Procedures
6. Processing invoices from each transportation provider,
verifying each tip and entering the trip costs in the
appropriate computer system.
7. Invoicing the Colorado Department of Health Care Policy
& Financing for reimbursement for all trips taken whether
for mileage, bus token or vendor reimbursement.
8. Obtaining prior authorization and requesting
reimbursement of provider invoices for meals and lodging
from the Colorado Department of Health Care Policy &
Financing, on behalf of clients and/or escorts who meet the
qualifications under Colorado State Rules, Volume VIII,
Medical Assistance Programs, Section 8.685.09, A-J.
9. Billing the Department for reimbursement of trip
administration costs based on an agreed timeframe and
Section 3.018, and according to time usage documentation
by Human Services' broker staff for Non-emergent
Medical Transportation.
3.016 Functions of Department
Added 6/03
A. The Department will provide overall program administration of
Non-emergent Medical Transportation services, as outlined in
Section 8.680, Volume VIII, Medical Assistance Programs.
B. The Department will determine Medicaid eligibility of the clients
and determine their medical necessity for Non-emergent Medical
Transportation services.
C. The Department will refer clients to Mini-Bus Transportation for
services.
D. The Department will provide computer access to Mini-Bus
Transportation through the COIN system for purposes of validating
client eligibility and the reimbursement of providers for
transportation services.
3.017 Client Eligibility
Added 6/03
A client must meet the eligibility criteria as provided in Section 8.681.01,
Volume VIII, Medical Assistance Programs. Generally, the criteria
requires that:
A. A client is Medicaid eligible; and
Assistance Payments Policies and Procedures
B. A client does not have access to transportation or needs a particular
type, more or frequency of services; and
C. A client obtains a non-emergent Medicaid covered service from an
enrolled Medicaid provider or medical facility.
3.018 Reimbursement Transfer
Added 6/03
For a modified State Fiscal Year 2002 through 2003 (September 1, 2002
through June 30, 2003), the Department agrees to transfer a maximum of
$22,200 of County Administration dollars for purposes of an
administrative reimbursement charge. The maximum amount is derived
from what Arapahoe County would have charged us to administer the
program under a 2002 Request for Proposal Bid, sponsored by Denver
Department of Human Services. This amount was based on 12,000 one-
way trips per year times $1.85 per trip. The Department acknowledges
that if the cost to administer the program is greater then $1.85 per one-way
trip and/or the volume of one-way trips are more or less then 12,000 per
year, Human Services is authorized to bill up to $22,200 annually but
expects that anything over this amount will be the responsibility of Human
Services.
f
DEPARTMENT OF SOCIAL SERVICES
P.O. BOX A
GREELEY, CO. 80632
' Website:www.co.weld.co.us
III Administration and Public Assistance(970)352-1551
Child Support(970)352-6933
O
COLORADO MEMORANDUM
T'
TO: David E. Long, Chair Date: May 29, 2003
Board of County Commissioners i
FR: Judy A. Griego, Director, Social Services , ac
RE: Addition of Section 3.000, Assistance Pa ents olicies and Prdcedures;:=
Weld County Department of Social Services Operations Manual
Enclosed for Board approval is an addition of Section 3.000, Assistance Payments Policies and
Procedures,Weld County Department of Social Services Operations Manual. These policies and
procedures were reviewed and discussed at the Board's Work Session of May 28, 2003.
The purposes of Section 3.000 are to:
1. Add or clarify County policies and procedures as they relate to certain mandated
programs under the Colorado Department of Human Services and the Colorado
Department of Health Care Policy and Financing. Reference: Sections 3.000-3.001,
Assistance Payments and Definition and Legal Basis.
2. Specifically add Section 3.010—3.018, which refer to the Non-emergent Medical
Transportation Program, which is a transportation program for eligible clients who
require transport to and from medical treatment that is not emergent in nature. These
policies and procedures outline certain decisions by Weld County regarding the program,
which include:
A. The identification of the Weld County Division of Human Services to provide the
Non-emergent Medical Transportation Broker system in Weld County.
B. The transfer of$22,200 from Social Services to the Weld County Division of
Human Services for the Transportation Broker system. Funding will be from
Social Services' County Administration Funds for the period of September 1,
2002 through June 30, 2003.
Reference: Section 3.010 through Section 3.018,Non-emergent Medical
Transportation.
If you have any questions,please telephone me at extension 6510.
2003-1404
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