HomeMy WebLinkAbout911427.tiff mEmoRAnDum
Kervit
Gordon E. Lacy, Chairman
To Board of County Commissioners Date December 5, 1991 n
COLORADO From Walter J. Speckman, Executive Director, Human Resources O
Contract between the Weld County Division of Human Resources'
Subject:
Area Agency on Aging and Dennis Mohrlang
Enclosed for Board approval is a Contract between the Weld County Division of
Human Resources' Area Agency on Aging and Dennis Mohrlang.
Mr. Mohrlang will be providing a home modification service for the Home and
Community Based Services Program. The cost of the home modification will be paid
by Medicaid. This Contract will expire January 15, 1992.
If you have any questions, please telephone me at 353-3816.
91-142-1
I)f� Cf'���`� I2OAA
CONTRACT FOR INDEPENDENT CONTRACTORS
�L�.C�(./
This Contract made this day of n 19gj by and between the
Weld Board of Commissioners for the use and benefit of thaYivision of Human Resources' Area hereinafter
referred to as the Case Management Agency and Agency On Aging
(Name of independent contractor) Denni s Mohrl ono and Co.
(Address) 1531 4th Ave. Greeley. Co. 80631
hereinafter referred to as the contractor.
Whereas,the State of Colorado has established a program of"Home and Community Based Services for the Elderly.
Blind and Disabled" (HCBS-EBD) tinder the Medicaid program, through the Colorado Department of Social Services; and
Whereas,the Case Management Agency has been duly certified and authorized by the Colorado Department of Sociai
Services to be a case management agency; and
Whereas,the Case Management Agency is authorized to certify for participation and enter into provider agreements
with independent contractors to provide certain HCBS-EBD services as speed in the Colorado Department of Social
Services rules and regulations at Staff Manual Volume VIII, 8.485 et. sec.; and
Whereas, the contractor has been properly certified to providhlome Modi f rat on services as an independent
contractor; and
Whereas, the contractor wishes to enter into a provider agreement with the Case Management agency to provide
Home Modi fi cation services to HCBS-EBD recipients; and
Whereas,as of the date of this contract, contractor meets all other qualification for participation in the HCBS-EBD
program;
Now Therefore, it is hereby agreed that
I. Contractor's Obligations:
A. Contractor agrees to perform the following services
construct a guard rail around a wood burning stove
B Contractor agrees to perform its duties and obligations hereunder in conformance with all pertinent regulations of
the Colorado Department of Social Services and the Case Management Agency as all these regulations are in effect as of the
date of the execution of the contract or as they may later be amended.
C. The Contractor shall provide its services in conformance with all standards of certification as set by the Colorado
Department of Social Services. The contractor shall provide these services in the amount, duration and scope as delineated
in the clients case plan. The contractor shall provide these services in such a professional and ethical manner so as to
safegttard the patients health, safety and rights.
D. Contractor agrees and understands that should its certification lapse or be revoked, this contract shall terminate and
no payment shall be made for services rendered after the certification end date.
E. Contractor agrees and understands that in the event it should fail to comply with any of the provisions of this
contract, certification standards and/or rules and regulations of the HCBS-EBD program, this contract may be terminated
for "good cause" by the case management agency.
F. The contractor shall notify the patient's attending physician and/or case manager whenever a significant health or
living condition change should occur. In case of emergencies the contractor agrees to follow the emergency treatment plan
as established by the case management agency.
Rev.4/91 Page 1 of 3 911427
G. Contractor agrees to accept the Medicaid payment as payment in full and not make any supplemental charees or
claims for payment to the Medicaid client.
H. Contractor agrees to bill the case management agency for all services provided to the Medicaid client in accordance
with the rules and procedures of HCBS-EBD program. Failure to follow these billing procedures may result in a denial of
payment of the contractor.
II. Obligation of the Case Management agency
A. Case Management Agency shall insure that the Contractor is properly qualified and certified to provide the services
covered by the Contract. The Case Management Agency shall present a copy of all the pertinent Colorado Department of
Social Services and Case Management Agency regulations to the Contractor and shall explain the meaning and purpose
behind such regulations. The case management agency shall present a copy of this contract to the contractor.
B. The Case Management Agency shall conduct a program of annual recertification for program participation. Such
annual recertification shall include any subsequent requirements needed by the contractor to stay current with the practice
of its trade, occupation, profession or business and the rules and regulations of the HCBS-EBD program.
C. Case Management Agency shall develop the clients HCBS-EBD case plan and keep the contractors informed of
any changes in the clients health, living status or care needs, if applicable to the provision of services under this contract.
D. Case Management Agency shall fully describe the contractors role and responsibilities in the case plan. A copy of
the case plan shall also be given to the contractor if applicable to the provision of services under this contract.
E. The Case Management Agency shall pay the contractor such amounts as the agency deems reasonable provided the
amount does not exceed the maximum payment amount established under the Colorado Department of Social Services
regulations and prior authorized by the State or its designee.
F. The Case Management Agency shall pay the contractor within seven(7)days after the agency receives payment from
the State's fiscal intermediary.
III. GENERAL PROVISIONS
A. The contract shall be effective from 19_ and continues in force until
1/15 19 2 and may be subject to renewal, provided the individual satisfies all recertification requirements.
B. The parties of this contract intend that the relationship between them contemplated by this Contract is that of
employer-independent contractor. No agent, employee, or servant of Contractor shall be deemed to be an employee of
Colorado Department Social Services. The Contractor will be solely and entirely responsible for its acts and acts of its agents,
employees, servants and subcontractors, if any, during the performance of this Contract.
C. The Contractor shall at all times during the execution of this Contract strictly adhere to all applicable federal and
state laws and regulations as they currently exist and may hereafter be amended. This includes protection of the
confidentiality of all applicant/recipient records, papers, documents, tapes and any other materials that have been or may
hereafter be established which relate to this Contract. The Contractor acknowledges that the following laws are included:
♦ Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d-1 et seq. and its implementing regulation,45 C.F.R.
Part 80 et seq.; and
♦ Section 504 of the Rehabilitation Act of 1973,29 U.S.C. Section 794 and its implementing regulation,45 C.F.R. Part
84; and
♦ the Age Discrimination Act of 1975, 42 U.S.C. Sections 6101 et seq. and its implementing regulation, 45 C.F.R. Part
91; and
♦ Title VII of the Civil Rights Act of 1964; and
♦ the Age Discrimination in Employment Act of 1967; and
♦ the Equal Pay Act of 1963; and
♦ the Education Amendments of 1972,
♦ Immigration Reform and Control Act of 1986, P.L. 99-603
♦ Waiver of Section 191.5(c) and 1902(a)10 of the Social Security Act;
911427
Rcv.4/91 Page 2 of 3
♦ 26-4.5-101 et seq., C.R.S. 1982, as amended;
♦ CDSS Staff Manual, Volume 8;
♦ 42 CFR 441300-310, 42 CFR 435.726;
♦ 27-1-114 C.R.S. 1982, as amended;
and all other regulations applicable to these laws prohibiting discrimination because of race, religion, color, national
origin, creed, sex, age and handicap. This assurance is given in consideration of and for the purpose of obtaining any and
all federal grants, or other federal financial assistance.
Any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado
Department of Social Services or with the U.S. Department of Health and Human Services, Office for Civil Rights.
D. Contractor agrees to make available, at all reasonable times during the contract period and six (6) years thereafter,
all records and documents pursuant to this agreement for inspection, audit,or reproduction by any authorized representative
of the State or appropriate Federal agencies.
E. Contractor may not assign its rights or duties under this contract.
F. Either party shall have the right to terminate this Contract by giving the other party thirty(30) day notice by registered
mail, return receipt requested. If notice is so given, this Contract shall terminate on the expiration of the thirty (30) days,
and the liability of the parties hereunder for further performance of the terms of this agreement shall thereupon cease, but
the parties shall not be released from the duty to perform their obligations up to the date of termination.
G. This agreement is intended as the complete integration of all understanding 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 written contract executed and approved pursuant to the rules and regulations of the HCBS-EBD
program.
H. To the extent that this contract may be executed and performance of the obligation 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. The waiver of a breach of a term hereof shall not be construed as waiver of any other term.
IN WIT'NFS� the paztie��ve executed this Contract on the day first above written.
Contracto 6/�yn t
(Full Legal Name) Denni s R. Mohrl anq COLORADO DEff��RPMEM'OF SOCIAL SERVICES
EXECUT7tO[SECTOR
1531 4th Ava Graalay (n Rf)fi41 � ✓
By //
Case M agement Agency Director
r
t
Position (Title) Owner i
571-7f-1Ru � `
Social Security Number or Federal ID Number C AG AGENCY "„'/97,37
Gordon E. La , Chairman
Weld County Board of County
(If Corporation:) Commis •oners
Attest (Corporate Seal) ATTEST: Ma,tel?
Weld County Clerk to tie Board
By By: / L�rile
Corporate Secretary,or Equivalent,Town/City/County Clerk Deputy lerk to the arc.
Rev.4/91 Page 3 of 3 911.427
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