HomeMy WebLinkAbout970266.tiffRESOLUTION
RE: APPROVE FAMILY CARING NETWORK CASE MANAGEMENT AGREEMENT WITH
LIFEPLANS, INC., 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 Family Caring Network Case
Management Agreement 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 LifePlans, Inc., commencing March 1, 1997, and ending
February 28, 1999, 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, that the Family Caring Network Case Management Agreement
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 LifePlans, Inc., 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 10th day of February, A.D., 1997.
Deputy Clerk to the Board
unty Attorney k
APPRO
S TO FORM:
(2/1: f/5; Lf4,o%ns, 2r
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COkORADO
{/ / -7y
George EtBaxter, Chair
1/' 2 - - Ate/ (/ 1
Instance L. Harb P Tem
Dale K. Hall
FXCI ISFf) nATE C)F SIrNINC;
Barbara,l. Kirkmeyer
W. H. Webster
(AYE)
970266
HR0068
nu
LIFEPLANS
FAMILY CARING NETWORK CASE MANAGEMENT
AGREEMENT
This Agreement is made as of the 1OTH day of FEBRUARY 19 97 ,
between Family Caring Network, Inc. (FCN), a subsidiary of LifePlans, Inc. and
WELD COUNTY DIVISION OF HUMAN SERVICES AREA AGENCY ON AGTNG (Provider).
BACKGROUND
The Family Caring Network provides a full range of risk management services to long
term care insurers and their applicants/claimants. FCN wishes to make use of
Provider's services and Provider is willing to make such services available as set forth
in this Agreement.
Therefore, the parties agree as follows:
1. Right to Use Materials. Products and Trademarks
FCN hereby grants to Provider the right to utilize, on an exclusive basis, the materials
developed for use by FCN and all products and trademarks related thereto (Materials),
including, but not limited to, all forms, manuals, assessment instruments, training
materials, documentation and other systems used or useful in fulfilling Provider's
obligations under this Agreement. The Materials shall be used solely for the purpose
of performing Case Management activities in strict accordance with this Agreement, as
amended from time to time, from the commencement until the end of the term hereof,
unless sooner terminated. No materials other than FCN approved Materials shall be
used by Provider in carrying out services under this agreement. Provider
brochures/materials may not be distributed to applicants except, when required, during
the benefit determination & care management process.
All rights, title and interest in the Materials, including any intellectual property rights
associated with the Materials, under any applicable federal or state statutory or
common law shall at all times remain vested in LifePlans. Inc. or one or more of its
affiliates. FCN disclaims any express or implied warranty that the materials or their
use will be free from claims of interference or infringement of the patents, copyrights
or other proprietary rights of any third party or claims of impermissible use of
proprietary information of any third party or any warranty, express or implied, of the
accuracy, reliability, technological or commercial value. comprehensives or
merchantability of the Materials.
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2. Definitions
2.1 Case Management. The term Case Management as it relates to FCN means
specifically Long -Term Care Case Management. Long -Term Care Case
Management is a service with three distinct components which collectively
make up Case Management as defined for purposes of this Agreement.
(a) Underwriting and Benefit Determination Assessment - Is a face to face
evaluation utilizing a standardized assessment tool to determine the
individual's needs and resources. The assessment provides some or all
of the following information regarding the individual:
(1) functional level;
(2) cognitive status;
(3) health status;
(4) current living arrangement;
(5) use of formal and informal support systems.
(b) Care Planning - Determining with the individual the appropriate and
available mix of formal and informal services and resources to meet the
individual's long-term care needs, and developing a Plan of Care to meet
those needs;
(c) Ongoing Care Management - Is the monitoring, reassessment, and
discharge or termination component of case management. More
specifically this includes:
(1) monitoring the service delivery, quality of care provided and
status of the individual;
(2) reassessing the individual's cognitive status, health status, and
functional level as they relate to the care provided and making
appropriate changes as needed, and;
(3) closing the case once an individual no longer requires case
management due to depletion of insurance coverage, death, or
improved health, whereby case management services are no
longer required.
Provider has the right to reveal its findings, plans and recommendations; only at
the time of claim, to the client regardless of the company's final decision
regarding client eligibility and/or services provided.
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2.2. competitor. Any Network agency or organization providing, offering or seeking
to provide or offer Long Term Care Insurance Assessment services in more than one
state, either directly or through coordinating activities, management agreements,
affiliation or contracting with organizations or individuals shall notify FCN (Exhibit A)
3. Confidentiality
As part of your working relationship with LifePlans, Inc. and the Family Caring
Network (FCN) you will be furnished with materials developed by LifePlans which are
confidential and non-public. With respect to these materials; you and your staff agree
to: keep secret and not disclose, reproduce or remove from your or our premises, nor
use for your benefit or the benefit of others, any confidential or proprietary materials
unless expressly authorized in writing by one of our executive officers.
4. Schedule of Services To Be Provided
4.1. Services Provided by FCN. FCN will provide national coordination,
operational management and network development services.
4.2. Services Provided by Provider. Provider is responsible for providing Case
Management services using FCN approved protocols as specified in agreements
with insurance clients including, without limitation, when specified:
(a) Assessments conducted in conjunction with an individual's
application for Insurance;
(b) Assessments conducted in conjunction with an insured's filing of a claim for
insurance benefits;
(c) Care Planning and Plan of Care;
(d) Ongoing care management
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Term
The Term of this Agreement shall begin as of the date hereof and continue in force for
twelve months unless otherwise terminated pursuant to the terms of this Agreement.
At the expiration of each term, this Agreement will automatically renew for an
additional twelve month period unless a party sends written notice of termination via
receipted mail to the other party sixty (60) days prior to the expiration of the then
current term.
6. Territory
The Network Provider's Territory shall be a geographical area described in Fxhibit B
which is attached to this Agreement and incorporated herein by reference, in which the
Provider has the right to use the FCN Materials, and in which the Provider agrees to
provide Case Management and related services as a designated representative of the
Network, either directly or through sub -contracts.
7. Service Referrals
7.1. General. FCN is responsible for making available the services of the Provider
organizations to individuals and groups such as national and regional insurance
companies, employers, and unions. FCN or LifePlans, Inc. will develop and manage
the group contracts for Case Management services, and all referrals will be coordinated
through a centralized national intake center which receives calls, collects identifying
and accounting information, conducts a preliminary needs screen and makes referrals to
the appropriate Provider organization.
7.2. Overlapping Territories. In the event Territories overlap, or if there are multiple
Providers within a Territory, referrals will be made as determined by FCN, on the
basis of the following criteria:
(a) Prior affiliation of the individual with a specific Provider;
(b) Individual preference for Provider with specific mutual affiliation;
(c) Geographic proximity;
(d) Cost of service.
8. Fees and Payments
8.1 Fees. Fees shall be as set forth in EXHIBIT C attached to this Agreement.
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8.2 Payments
8.2.1. Billing. Providers will be responsible for maintaining separate service
documentation and accounting for all individuals referred to the Provider
by FCN. Providers will use FCN forms and procedures to submit the
required service documentation and accounting information on a monthly
basis.
8.2.2. Payments. The Provider will submit the billing to FCN for payment and
FCN will pay the Provider for all services rendered and documented
according to the requirements specified. Payment will be made within 30
days of receipt of accurate billing.
8.2.3. Documentation and Record Keening. FCN will develop the necessary
documentation and reporting systems and supports (e.g. forms, etc.) to
implement the billing system. The Provider will be responsible for
maintaining all service documentation in accordance with the terms of
any Agreement. Individual billing records shall be kept for a minimum
of five (5) years, and FCN, having given reasonable notice, shall have
the right at any time during that period to audit, at its own expense, the
service records and all related accounting records for individuals
referred to the Provider by the Network.
9. Default and Termination
9.1. By Provider. The Provider may terminate this Agreement, on the first day of the
month following at least 60 days written notice of termination, via receipted
mail.
9.2. By FCN. FCN may terminate the Agreement on the first day of the month
following written notice, via receipted mail. FCN may terminate for any of the
following:
(a) If Provider fails to follow agreed upon protocols in provision of Case
Management services;
(b) If Provider fails to meet agreed upon standards of excellence in provision of
Case Management services;
(c) If Provider shall abandon Case Management activities in any part of the
Territory;
(d) If Provider shall attempt to assign this Agreement or otherwise sell, assign,
transfer or encumber the Materials without the written consent of FCN as herein
above provided;
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(e) If Provider or any of its employees fails to conduct the Provider's activities in
substantial compliance with any applicable law or regulation, local or national;
(f) If Provider or a person or entity controlling, controlled by, or under common
control with Provider becomes insolvent (as revealed by its records or
otherwise); or if an involuntary petition is filed against it and such petition is
not dismissed within thirty (30) days, or if it shall make an assignment for the
benefit of creditors; or if a receiver or trustee in bankruptcy or similar officer,
temporary or permanent, be appointed to take charge of any of its affairs or any
of its property; or if dissolution is commenced;
(g) If Provider, by the conduct of its activities materially impairs the value of the
Materials, in the reasonable judgment of FCN.
10. Liability: Indemnity
The relationship between LifePlans, Family Caring Network and the Provider is that of
independent contractors, and neither shall be considered an agent or representative of
the other for any purpose. Each party shall be responsible for action and services
separately attributable to itself and to its employees and staff. This paragraph shall
survive termination of this agreement. At all times the Provider shall keep in force a
general liability insurance policy issued by a company authorized to transact business in
the providers state of business. Limits of liability shall be in the amount of $1,000,000
per incident $3,000,000 aggregate. The Provider agrees to indemnify and hold
harmless FCN and its insurance company customers, employees and agents for any
losses or damages resulting from the wrongful acts, omissions or negligence of the
Provider, its employees, or agents under this Agreement.
11. Notices
All notices. requests, demands, and other communications hereunder shall be in writing
and delivered or mailed, with postage prepaid, to the party intended, at its address as
set forth on the signature page of this Agreement or such different address as may be
furnished by written notice.
12. Assignment
This Agreement may not be assigned by either party without the prior written consent
of the other, except that it may be assigned by FCN without Provider's consent to any
corporation affiliated with it by stock ownership or any successor to the operations of
the Network.
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13. Bindino
This Agreement shall inure to and'bind the successors, assigns and representatives of
the parties.
14. Entire Agreement
This Agreement contains the entire agreement between the parties hereto; no
representations, inducements, promises, or agreements, oral or other, between the
parties not embodied herein, shall be of any force or effect.
15. Amendment of Agreement
This Agreement may be amended only by a written instrument signed by the parties
hereto.
16. Headings
The headings used in this Agreement are inserted only as a matter of convenience and
for reference and in no way define, limit, or describe the scope of this Agreement nor
the intent of any provision thereof.
17. Governing Law
This Agreement shall be construed under the laws of The Commonwealth of
Massachusetts.
18. Severability
In the event one or more clauses of this agreement is/are deemed by a court of law to
be unlawful and/or unenforceable all other clauses of this Agreement shall continue in
full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the
day and year first above written.
By:
FAMILY CARING NETWORK
Two University Office Park
51 Sawyer Road, Suite 340
Waltham, MA 02154
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BY: ("6)1C0Q C<
TITLE
By:
99-14
eorge/E. Baxter, Chairman Qa//O/r/
.7.
9702C/3
EXHIBIT A
Competitor Disclosure
(Provider) , provides Long -Term Care
Assessment services with the following organizations:
[7'96) 8
EXHIBIT B - TERRITORY
Please list the counties your agency will cover:
2a -u rrwo ,Cac
ea4
Meat .c c, offs ore a 2.O,^s Gy Caa Acw
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Q'" V
EXHIBIT C.
WORKSHEET: FAMILY CARING NETWORK SERVICE PRICING
Name of Organization: i-dace
CITY:/12alur
7
State: do
All of the rates are per case and inclusive of travel & mileage. FCN agrees to
supply air mailers to be used exclusively for the remittance of completed FCN case
management technologies.
PRICING
Underwriting Assessments
Benefit Determination Assessments
Re -Assessment
Needs Assessment
Care Plan
Ongoing Care Management
Title 1,44 �,/ i tgp9 & Z Lj 4oJ
Sig d �� ! arc_d%h�� Date o3 - •S i7
for Family Caring Network
$80
$110
$110
$50
$50
$125/month
Date ?-v:66; /797
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13. BinLI'
This Agreement shall inure to and bind the successors, assigns and representatives of
the parties.
14. Entire Agreement
This Agreement contains the entire agreement between the parties hereto; no
representations, inducements, promises, or agreements, oral or other, between the
parties not embodied herein, shall be of any force or effect.
15. Amendment9f Agreement
This Agreement may be amended only by a written instrument signed by the parties
hereto.
16. Headings
The headings used in this Agreement are inserted only as a matter of convenience and
for reference and in no way define, limit, or describe the scope of this Agreement nor
the intent of any provision thereof.
17. Governing Law
This Agreement shall be construed under the laws of The Commonwealth of
Massachusetts.
18. Severability
In the event one or more clauses of this agreement is/are deemed by a court of law to
be unlawful and/or unenforceable all other clauses of this Agreement shall continue in
full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the
day and year first above written.
FAMILY CARING NETWORK
Two University Office Park
51 Sawyer Road. Suite 340
Waltham, MA 02154
17/961
By
r/IC�GL�l� , JD..eJci
�&-t QA
n, TITLE
;1
E. Baxter, Chairman Oa/off
7
MEMO
To: Barbara Kirkmeyer, Weld Board of County Commissioners
From: Walter Speckman, Executive Director Weld County Division of Human Services
Subject: Contract between Weld Division of Human Services' Area Agency on Aging and
LifePlans Family Caring Network
Date: February 5, 1997
Enclosed for Board approval is a contract between the Division of Human Services' Area
Agency on Aging and LifePlans Family Caring Network.
The Area on Aging will provide case management services for LifePlans Family Caring Network
clients. Area Agency on Aging will be reimbursed by LifePlans Family Caring Network for
services rendered on a monthly bases. The Area Agency on Aging has had working agreements
with this company since 1990.
The term of this Agreement is from March 1, 1997 through February 28, 1999.
970266
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