HomeMy WebLinkAbout20250682.tiffResolution
Approve Case Management Agency (CMA) Service Agreement Terms and
Conditions, and Authorize Chair to Sign — Support, LLC, dba Support, Inc.
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 Case Management Agency (CMA) Service
Agreement Terms and Conditions 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, and Support, LLC, dba Support, Inc., commencing March 1, 2025,
and ending June 30, 2025, 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 Case Management Agency (CMA) Service Agreement Terms and
Conditions 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,
and Support, LLC, dba Support, 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 Board of County Commissioners of Weld County, Colorado, approved the above
and foregoing Resolution, on motion duly made and seconded, by the following vote on
the 12th day of March, A.D., 2025, nunc pro tunc March 1, 2025:
Perry L. Buck, Chair: Aye
Scott K. James, Pro-Tem: Aye
Jason S. Maxey: Aye
Lynette Peppler: Aye
Kevin D. Ross: Aye
Approved as to Form:
Bruce Barker, County Attorney
Attest:
Esther E. Gesick, Clerk to the Board
cc: HSD
03/26/2,5
2025-0682
H R0097
C�r1hcad- [to I
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
PASS -AROUND TITLE: Case Management Agency Service Agreement with Support, LLC dba
Support, Inc.
DEPARTMENT: Human Services DATE: March 4, 2025
PERSON REQUESTING: Jamie Ulrich, Director, Human Services
Brief description of the problem/issue: On March 1, 2024, the Weld County Department of Human
Services began serving as the region's Case Management Agency (CMA) as a result of an awarded
Request for Proposal (RFP) through the Colorado Department of Health Care Policy & Financing
(HCPF). In order to offer services to clients as the CMA, the Department is requesting approval of a
CMA Service Agreement with the Provider listed below.
The Service Agreement and Exhibit A have been approved by Legal (B. Howell) and reflect a term date
of March 1, 2025 through June 30, 2025 and may be extended upon written agreement by both parties.
CMS ID
Provider
Location
Rate
Approved Services
9161
Support, LLC dba
Support, Inc.
Aurora, Colorado
Approved
State Rate
Behavioral Consultation
Behavioral Counseling for
Individual/Group
Behavioral Line Staff
Respite Individual/Group
Transportation Mileage
Day Habilitation
Behavioral Assessment
Group Overnight (Camp)
What options exist for the Board?
Approval of the Case Management Agency Service Agreement.
Deny approval of the Case Management Agency Service Agreement.
Consequences: WCDHS will not have a contract with this provider.
Impacts: WCDHS will not be able to serve the individuals on our caseload.
Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years):
Total cost = State approved rates for services.
Pass-thru funding from the Colorado Department of Health Care Policy & Financing (HCPF).
Pass -Around Memorandum; March 4, 2025 - CMS ID 9161
3/( Z
2025-0682
Recommendation:
• Approval of the Case Management Agency Service Agreement and authorize the Chair to sign.
Support Recommendation Schedule
Place on BOCC Agenda Work Session Other/Comments:
Perry L. Buck 07
Scott K. James Uta 1,r utt1
Jason S. Maxey ___Al
Peppier Jr
Kevin D. Ross \RD. -{,KQ4,07
Pass -Around Memorandum; March 4, 2025 - CMS ID 9161
Karla Ford
From:
Sent"
To:
Subject:
Approve
** Sent from my iPhone **
Scott.:{Jaines
Tuesday, March 4, 2025 12:14 PM
Karla Ford
Re: Please Reply - PA FOR ROUTING: HCS CMA Service Agreement - Support, Inc. (CMS
9161)
Scott K. James
Weld County Commissioner, District 2
1150 O Street, P.O. Box 758, Greeley, Colorado 80632
970.336.7204 (Office)
970.381.7496 (Cell)
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended
only for the person or entity to which it is addressed and may contain information that is privileged, confidential or
otherwise protected from disclosure. If you have received this communication in error, please immediately notify
sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any
action concerning the contents of this communication or any attachments by anyone other than the named
recipient is strictly prohibited.
On Mar 4, 2025, at 11:13 AM, Karla Ford <kford@weld.gov>wrote:
Please advise if you support recommendation and to have department place on the agenda.
<image002.png>
Karla Ford
Office Manager & Executive Assistant
Board of Weld County Commissioners
Desk: 970-400-4200/970-400-4228
P.O. Box 758, 1150 O St., Greeley, CO 80632
Karla Ford
From:
Sent:
To:
Subject:
Approve
Kevin Ross
Kevin Ross
Tuesday, March 4, 2025 12:25 PM
Karla Ford; Scott James
Re: Please Reply - PA IS ROUTING: HCS CMA Service Agreement Support, Inc.(CMS
9161)
From: Karla Ford <kford@weld.gov>
Sent: Tuesday, March 4, 2025 2:13:37 PM
To: Kevin Ross <kross@weld.gov>; Scott James <sjames@weld.gov>
Subject: Please Reply - PA FOR ROUTING: HCS CMA Service Agreement - Support, Inc. (CMS 9161)
Please advise if you support recommendation and to have department place on the agenda.
w, if'..'.
COUNTY, CO
Karla Ford
Office Manager & Executive Assistant
Board of Weld County Commissioners
Desk: 970-400-4200/970-400-4228
P.O. Box 758, 1150 O St., Greeley, CO 80632
00000
Join Our Team
IMPORTANT: This electronic transmission and any attached documents or other writings are intended only for the
person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by
return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action
concerning the contents of this communication or any attachments by anyone other than the named recipient is
strictly prohibited.
From: Sara Adams <sadams@weld.gov>
Sent: Tuesday, March 4, 2025 11:59 AM
To: Karla Ford <kford@weld.gov>
Cc: HS -Contract Management<HS-ContractManagement@co.weld.co.us>; Bruce Barker <bbarker@weld.gov>; Cheryl
Pattelli <cpatteili@weld.gov>; Chris D'Ovidio <cdovidio@weld.gov>; Esther Gesick <egesick@weld.gov>; Jill Scott
<jscott@weld.gov>; Lennie Bottorff <bottorll@weld.gov>; Tanya Geiser <tgeiser@weld.gov>; Rusty Williams
Case Management Agency (CMA)
Service Agreement Terms and Conditions
This Service Agreement (SA) is made this day M(yl1/ Oh I Z, ( ?,(�ZS , by and between
Weld County Department of Human Services, hereinafter referred to as "CMA", having its principal
place of business at 315 North 11"' Avenue, Greeley, Colorado 80631, and Support, LLC dba
Support, Inc., hereinafter referred to as the "VENDOR," whose business address is 15591 East
Centretech Parkway, Aurora, Colorado 80011. NOW THEREFORE, in consideration of the
promises and covenants contained herein, the parties agree as follows:
I. Work and Payment
The VENDOR should not commence services under this Agreement until Services have been
approved in the individual's Service Plan. Services to be provided are detailed in the Individual's
State Supported Living Services (SLS) or OBRA Service Plan which dictates the type of service as
well as timing and frequency of service to be performed. Rates paid for State SLS and OBRA
services can be found on the State Health Care Policy and Financing Website
https://hcpf.colorado.gov/provider-rates-fee-schedule see State General Fund Programs Direct
Service Rates Fee Schedule. Reimbursement for all supplies and equipment will be provided
based on the actual purchase price of the item. The VENDOR shall include in their monthly
invoice the date and duration of services performed.
Specific work performance expectations that are deemed appropriate and necessary in order to
receive compensation for the work must meet specified State Regulations. Services covered in this'
agreement are listed in Exhibit B, Scope of Services and Rates. The VENDOR affirms the following
requirements are met, as defined by the State of Colorado:
The service to be delivered shall meet all applicable state licensing requirements for the
performance of the support or service being provided.
Certificate: The service to be delivered shall meet all applicable state certification requirements
for the performance of the support or service being provided and program approval.
Electronic Visit Verification (EVV) is not a requirement for billing State SLS / OBRA services. More
information can be found on the HCPF website https://hcpf.colorado.gov/electronic-visit-
verification-program-manual#coEVVX
II. Intent of the Parties:
It is the expressed intent of the parties that the Contractor is a VENDOR and not the agent,
employee, or servant of CMA and that:
a. The VENDOR does not have the express or implied authority to act for CMA or to bind CMA to
any agreements, liability, or understanding except as expressly set forth herein.
b. The VENDOR shall be accountable to CMA for the ultimate results of its actions but shall not
be subject to direction and control of CMA herein.
c. Neither the VENDOR nor any agent or employee of the VENDOR shall be or shall be deemed
to be an agent or employee of CMA.
d. The VENDOR shall pay when due all required employment taxes and Income Tax
Withholdings, including all Federal and State Income Tax and Local Tax on any monies paid
pursuant to this service authorization.
e. The VENDOR acknowledges that the VENDOR and its employees are not entitled to
unemployment insurance benefits unless the VENDOR, or a Third Party provides such
coverage, and that CMA does not pay for or otherwise provide such coverage.
f. The VENDOR shall provide and keep in force Worker's Compensation and show proof of such
insurance; and unemployment compensation insurance in the amounts required by law and
shall be solely and entirely responsible for the acts of the VENDOR, its employees, and agents.
The VENDOR shall fumish CMA with written certification of the existence of such coverage
prior to the finalization of service authorization provisions.
III. VENDOR Responsibilities:
a. COMPLIANCE WITH THE LAW: The VENDOR agrees to perform its duties and obligations
hereunder in strict conformity with relevant federal law, all pertinent federal regulations
promulgated pursuant to federal law, the Home and Community -Based Services for Persons
with Developmental Disabilities Act; 10 Code of Colorado Regulations (CCR) 2505-10 8.500;
10 CCR 2505-10 8.600 Colorado Revised Statute (CRS); Title 25.5 Article 10 et seq., relevant
State law, and all pertinent regulations of the Colorado Department of Human Services,
Colorado Department of Health Care Policy and Financing, and Colorado Department of Public
Health and Environment, as they currently exist or may hereafter be amended.
b. LICENSES AND CERTIFICATIONS: The VENDOR represents and warrants to CMA that it
and its employees have the requisite training, skills, experience, qualifications, all necessary
provider numbers, licenses, certifications, approvals, etc. required to properly provide the
services or goods covered by this authorization.
c. RECORDS: The VENDOR shall maintain a complete file of all records, communications,
documents, and other written materials that pertain to the operation of programs or the delivery
of services under this SA and shall maintain such records for a period of six (6) years after the
date of termination of this SA as per State requirements, or for such further period as may be
necessary to resolve any matters which may be pending. All files shall be kept at the
VENDOR's place of business, and the VENDOR shall fumish copies of such files, or portions
thereof, as requested by CMA or its designee.
d. INSPECTIONS AND PERFORMANCE MONITORING: The VENDOR shall permit CMA, the
State of Colorado, the Colorado Department of Health Care Policy and Financing, the U.S.
Department of Health and Human Services, and any other duly authorized agent or
govemmental agency (including the Medicaid Fraud Control Unit) to monitor all activities
authorized under this SA. Such monitoring may consist of intemal evaluation procedures,
examination of data, formal audit, on -site checking, or any other reasonable procedure. Any
amounts which have been paid by CMA, and which are found to be improper in accordance
with the terms of this SA shall be immediately retumed to CMA or may be withheld from future
payments. Services rendered through State SLS are subject to inspection and recovery by the
Department pursuant to 10 C.C.R. 2505-10 Section 8.076.
e. ASSIGNMENT/DELEGATION/SUBCONTRACTORS: The VENDOR shall not assign,
delegate, nor subcontract services in this SA without the express prior written consent of CMA.
f. INSURANCE:
i. The VENDOR agrees that it will keep in force an insurance policy or policies, issued by a
company authorized to do business in Colorado, in the kinds and minimum amounts
specified below unless specifically waived herein. In the event of cancellation of any such
coverage, the VENDOR shall immediately notify CMA of such cancellation.
ii. The VENDOR shall have CMA and State of Colorado Health Care Policy and Financing
listed as "Additional Insured" on VENDOR's insurance policies.
iii. Standard Worker's Compensation and Employers' Liability as required by State statute,
including occupational disease, covering all employees on or off the work site acting within
the course and scope of their employment.
iv. General, Personal Injury, Professional, Automobile Liability (including bodily injury,
personal injury, and property damage) minimum coverages:
v. Occurrence basis policy: combined single limit of $1,000,000 or Claims -Made policy:
combined single limit of $1,000,000; plus, an endorsement, certificate, or other evidence
that extends coverage two years beyond the performance period of the service
authorization.
vi. Annual Aggregate Limit policy: Not less than $1,000,000 plus an agreement that the IC
will purchase additional insurance to replenish the limit to $1,000,000 if claims reduce the
annual aggregate below $1,000,000.
vii. The insurance shall include provisions preventing cancellation without thirty (30) calendar
days prior written notice to CMA by certified mail.
viii. The VENDOR shall provide certificates of adequate insurance coverage to CMA within ten
(10) days of receipt of this service authorization.
Iv. Payment for Services and Term:
a. This contract shall be for a term commencing March 1, 2025 thrqugh June 30, 2025, and may
be extended upon written agreement of both parties.
b. Monthly Invoicing for Services: The VENDOR shall invoice CMA within four (4) working days of
the end of the month in which the services were performed, except at the end of the fiscal year
when invoices are due two (2) working days from the end of the fiscal year. Invoices received
within this time frame will be paid Net 30 unless otherwise noted on the invoice. Invoices may
be sent via email to wccmabilling(a)weld.gov
c. Vendor must include the following detail on invoices in order to be paid for services:
i. Name of individual in services
ii. Dates of Service
iii. For services paid in 15 -minute increments, invoice must show the amount of time services
were provided in hours or 15 -minute increment
iv. Rate per 15 -minute increment or Rate per hour (per State General Fund fee schedule)
v. Total Amount Due
vi. "No shows" are not billable to Medicaid and will not be reimbursed. Do not include "No
shows" in your billing ("No shows" include family cancelling or provider cancelling)
d. Invoicing for Supplies/Equipment: The VENDOR shall invoice CMA within sixty (60) days of the
end of the month in which the client received the supplies/equipment, except at the end of the
fiscal year when invoices are due two (2) working days from the end of the fiscal year for all
State General Fund invoices. Invoices received within this time frame will be paid Net 30 unless
otherwise noted on the invoice. Invoices may be sent via email to wccmabilling(c�weld.gov
e. Vendor must include the following detail on invoices in order to be paid for services:
i. Name of individual in services
ii. Dates of Supply delivery/pickup
iii. Total Amount Due
f. In order to comply with HCPF State General Funds reporting requirements, no invoices
received from the VENDOR after July 3, 2025, for Fiscal Year July 1, 2024 thru June 30, 2025
will be accepted or paid by CMA, the date of July 3, 2025 is subject to change pending Fiscal
Year 24-25 holiday schedule.
g. Services may be increased or decreased during the term of this agreement by either party due
to increased or decreased State funding levels or adjustments to service levels, with the
agreement by both parties.
h. In the event that overpayments are made by CMA due to the VENDOR's omission, error, fraud,
or defalcation; or in the event that the State or Federal govemment seeks to recover from CMA
any sums of money based upon a claim on behalf of the VENDOR after said funds have been
paid to the VENDOR, the VENDOR shall immediately reimburse such funds to CMA as allowed
by law. The parties understand and agree that CMA shall have the right to offset against
payments due to the VENDOR hereunder, or by other legal means recover any debts owed by
the VENDOR to CMA or to the State.
v. General Terns and Conditions:
a. TERMINATION: Except as otherwise agreed in Section I, if the VENDOR refuses or fails to
perform any of the provisions of this SA in a timely manner, CMA may notify the VENDOR in
writing of nonperformance and may terminate VENDOR's right to proceed with the SA. In
addition, either party shall have the right to terminate this SA, without cause, by giving the other
party 30 days written notice. If notice is so given, this SA 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.
b. COMPLETE SERVICE AUTHORIZATION: This SA contains the entire agreement of the
parties.
c. INDEMNIFICATION: To the extent authorized by law, the VENDOR shall indemnify, save, and
hold harmless CMA, its employees, and agents against any and all claims, damages, liability,
and court awards including costs, expenses, and attomey fees incurred as a result of any act or
omission by the VENDOR or its employees, agents, subcontractors, or assignees pursuant to
the terms of this SA.
d. NON-DISCRIMINATION: The VENDOR agrees to comply with the letter and spirit of all
applicable State and federal laws respecting discrimination and unfair employment practices.
e. CONFIDENTIALITY OF RECORDS: The VENDOR shall protect the confidentiality of all
records containing personal identifying information that are maintained in accordance with this
SA. No such information shall be released except for program administration purposes or with
the subject individual's prior written consent.
f. CONFLICT OF INTEREST: The VENDOR shall fully disclose to CMA any relationship(s) it has
with a third party where such relationship is in opposition or conflict to its relationship with CMA
under this SA.
g. Health Insurance Portability & Accountability Act of 1996 ("HIPAA"). Federal law goveming the
privacy of certain health information requires a "Business Associate" service authorization
between CMA and the VENDOR. 45 CFR Section 164.504(e). Attached and incorporated
herein by reference as Exhibit A is a HIPAA Business Associate Addendum for HIPAA
compliance.
h. BACKGROUND CHECKS: As per C.R.S. 27-90-111, the VENDOR shall conduct background
(criminal record) and reference checks prior to hiring staff and volunteers or contracting with
other providers. The VENDOR shall not employ, contract with, or accept volunteer services
from individuals who would have unsupervised contact with or access to persons receiving
services under this service authorization, or their property and who have been convicted of
abuse, neglect, or mistreatment of a child, adult or person receiving services, or of a
misdemeanor or felony involving physical harm or violence to another individual, or distribution
of controlled substances.
i. CONTRACTS FOR SERVICE - ILLEGAL ALIENS: The VENDOR shall not knowingly employ
or contract with illegal aliens to perform work under this service authorization or enter into a
contract with a subcontractor that fails to certify to VENDOR that the subcontractor knowingly
does not employ or contract with illegal aliens to perform work under this service authorization.
The VENDOR, if a natural person eighteen (18) years of age or older, hereby swears or affirms
under penalty of perjury that he or she (i) is a citizen or otherwise lawfully present in the United
States pursuant to federal law, (ii) shall comply with the provisions of CRS 24-76.5-101 et seq.
and (iii) shall produce identification required by CRS 24-76.5-103 prior to the effective date of
this service authorization.
j. If there is a dispute, VENDORs are to follow Section 25.5-10-212 CRS,
k. The VENDOR agrees to abide by the following CMA policies and procedures located on the
CMA website at https://www.weld.gov/Govemment/Departments/Human-Services/Area-
Agency-on-Aging-AAA
i. Critical Incidents
ii. Mistreatment
iii. Human Rights Committee (HRC)
I. FEDERAL FALSE CLAIMS ACT 31 US Code 3729: The VENDOR, its employees,
subcontractors, and agents shall comply with the Federal False Claims Act. Violations of the
False Claims Act such as false claims or attempts to defraud health care programs should be
promptly reported, investigated, and remedied, as appropriate and required by law. Detailed
information regarding the False Claims Act and CMA's policy can be found on the CMA
website.
The parties have caused their duly authorized representatives to sign this Service Authorization
Agreement stated above:
al&
ATTEST:
BY:
BOARD OF COUNTY COMMISSIONERS
Cle. k to the Board WELD COUNTY, CQLORADO
Deputy Clerk to the
uck, Chair
NDOR:
MAR 1 2 2025
upport, LLC dba Support, Inc.
15591 East Centretech Parkway
Aurora, Colorado 80011
By:�
Bentley Smith, Chief Executive Officer
Date: Feb 26, 2025
z oz5-olo132
Exhibit A
CMA
HIPAA BUSINESS ASSOCIATE AGREEMENT
This Business Associate Agreement ("Agreement') is part of federal and state
requirements of CMA For purposes of this Agreement, CMA is referred to as "Covered Entity" or
"CE" and VENDOR is referred to as the "Business Associate" or "Associate." The Associate
performs, or assists in the performance, of a function or activity, or provides services of a type for
CMA that makes the Associate a "Business Associate" for purposes of the HIPAA privacy
regulations.
The CE may disclose protected health information to the Associate in conjunction with the
function, activity, or services performed or provided by the Associate. The CE and the Associate
desire to enter into an agreement as required by the HIPAA privacy regulations to provide
satisfactory assurance to CMA that the Associate will appropriately safeguard that protected
health information (PHI).
RECITALS
A. CE and Associate intend to protect the privacy and provide for the security of PHI disclosed
to Associate pursuant to this Agreement in compliance with the Health Insurance Portability
and Accountability Act of 1996, 42 U.S.C. §1320d — 1320d-8 ("HIPAA"), as amended by
the American Recovery and Reinvestment Act of 2009 ("ARRA")/HITECH Act (P.L. 111-
005), and its implementing regulations promulgated by the U.S. Department of Health and
Human Services, 45 C.F.R. Parts 160, 162 and 164 (the "HIPAA Rules") and other
applicable laws, as amended.
B. As part of the HIPAA Rules, the CE is required to enter into an agreement containing
specific requirements with Associate prior to the disclosure of PHI, as set forth in, but not
limited to, Title 45, Sections 160.103, 164.502(e) and 164.504(e) of the Code of Federal
Regulations ("C.F.R.") and contained in this Agreement.
The parties agree as follows:
1. Term. Except as otherwise provided for herein, this Agreement will continue in full force
and effect through the term of any function, activity, or services performed or provided by the
Associate.
2. Definitions.
a. Except as otherwise defined herein, capitalized terms in this Agreement shall have
the definitions set forth in the HIPAA Rules at 45 C.F.R. Parts 160, 162 and 164, as amended. In
the event of any conflict between the mandatory provisions of the HIPAA Rules and the provisions
of this Agreement, the HIPAA Rules shall control.
b. "Protected Health Information" or "PHI" means any information, whether oral or
recorded in any form or medium: (i) that relates to the past, present, or future physical or mental
condition of an individual; the provision of health care to an individual; or the past, present, or
future payment for the provision of health care to an individual; and (ii) that identifies the individual
or with respect to which there is a reasonable basis to believe the information can be used to
identify the individual and shall have the meaning given to such term under the HIPAA Rules,
including, but not limited to, 45 C.F.R. Section 164.501.
c. "Protected Information" shall mean PHI provided by CE to Associate or created,
received, maintained, or transmitted by Associate on CE's behalf. To the extent Associate is a
covered entity under HIPAA and creates or obtains its own PHI for treatment, payment, and health
care operations, Protected Information under this Agreement does not include any PHI created
or obtained by Associate as a covered entity and Associate shall follow its own policies and
procedures for accounting, access and amendment of Associate's PHI.
3. Obligations of Associate.
a. Permitted Uses. Associate shall not use Protected Information except for the
purpose of performing Associate's obligations as permitted under this Agreement. Further,
Associate shall not use Protected Information in any manner that would constitute a violation of
the HIPAA Rules if so used by CE, except that Associate may use Protected Information: (i) for
the proper management and administration of Associate; (ii) to carry out the legal responsibilities
of Associate; or (iii) for Data Aggregation purposes for the Health Care Operations of CE.
Associate agrees to defend and indemnify the CE against third party claims arising from
Associate's breach of this Agreement.
b. Permitted Disclosures. Associate shall not disclose Protected Information in any
manner that would constitute a violation of the HIPAA Rules if disclosed by CE, except that
Associate may disclose Protected Information: (i) in a manner permitted pursuant to this
Agreement; (ii) for the proper management and administration of Associate; (iii) as required by
law; (iv) for Data Aggregation purposes for the Health Care Operations of CE; or (v) to report
violations of law to appropriate federal or state authorities, consistent with 45 C.F.R. Section
164.5020)(1).
c. Appropriate Safeguards. Associate shall implement appropriate safeguards as are
necessary to prevent the use or disclosure of Protected Information other than as permitted by
this Agreement. Associate shall comply with the requirements of the HIPAA Security Rule at 45
C.F.R. Sections 164.308, 164.310, 164.312, and 164.316. Associate shall maintain a
comprehensive written information privacy and security program that includes administrative,
technical, and physical safeguards appropriate to the size and complexity of the Associate's
operations and the nature and scope of its activities. Associate shall review, modify, and update
documentation of its safeguards as needed to ensure continued provision of reasonable and
appropriate protection of Protected Information.
d. Reporting of Improper Use or Disclosure. Associate shall report to CE in writing
any use or disclosure of Protected Information other than as provided for by this Agreement within
five (5) business days of becoming aware of such use or disclosure.
e. Accounting Rights. Associate and its agents shall make available to CE, within ten
(10) business days of notice by CE, the information required to provide an accounting of
disclosures to enable CE to fulfill its obligations under the HIPAA Rules, including, but not limited
to, 45 C.F.R. Section 164.528. In the event that the request for an accounting is delivered directly
to Associate or its agents, Associate shall within five (5) business days of the receipt of the
request, forward it to CE in writing. It shall be CE's responsibility to prepare and deliver any such
accounting requested. Associate shall not disclose any Protected Information except as set forth
in Section 2(b) of this Agreement.
f. Governmental Access to Records. Associate shall keep records and make its
intemal practices, books and records relating to the use and disclosure of Protected Information
available to the Secretary of the U.S. Department of Health and Human Services (the "Secretary,")
in a time and manner designated by the Secretary, for purposes of determining CE's or
Associate's compliance with the HIPAA Rules. Associate shall provide to CE a copy of any
Protected Information that Associate provides to the Secretary concurrently with providing such
Protected Information to the Secretary when the Secretary is investigating CE. Associate shall
cooperate with the Secretary if the Secretary undertakes an investigation or compliance review of
Associate's policies, procedures or practices to determine whether Associate is complying with
the HIPAA Rules, and permit access by the Secretary during normal business hours to its facilities,
books, records, accounts, and other sources of information, including Protected Information, that
are pertinent to ascertaining compliance.
g. Minimum Necessary. Associate (and its agents) shall only request, use, and
disclose the minimum amount of Protected Information necessary to accomplish the purpose of
the request, use, or disclosure, in accordance with the Minimum Necessary requirements of the
HIPAA Rules, including, but not limited to, 45 C.F.R. Sections 164.502(b) and 164.514(d).
h. Data Ownership. Associate acknowledges that Associate has no ownership rights
with respect to the Protected Information.
i. Retention of Protected Information. Except upon termination of all functions,
activities, or services performed or provided by the Associate, Associate or agents shall retain all
Protected Information and shall continue to maintain the information for a period of six (6) years.
j. Notification of Breach. During the term of this Agreement, Associate shall notify
CE within five (5) business days of any suspected or actual breach of security, intrusion or
unauthorized use or disclosure of Protected Information and/or any actual or suspected use or
disclosure of data in violation of any applicable federal or state laws or regulations. Associate shall
not initiate notification to affected individuals per the HIPAA Rules without prior notification and
approval of CE. Information provided to CE shall include the identification of each individual whose
unsecured PHI has been, or is reasonably believed to have been accessed, acquired or disclosed
during the breach. Associate shall take (i) prompt corrective action to cure any such deficiencies
and (ii) any action pertaining to such unauthorized disclosure required by applicable federal and
state laws and regulations.
k. Safeguards During Transmission. Associate shall be responsible for using
appropriate safeguards, including encryption of PHI, to maintain and ensure the confidentiality,
integrity and security of Protected Information transmitted to CE pursuant to the Agreement, in
accordance with the standards and requirements of the HIPAA Rules.
I. Restrictions and Confidential Communications. Associate will not respond directly
to an individual's requests to restrict the use or disclosure of Protected Information or to send all
communication of Protected Information to an altemate address. Associate will refer such
requests to the CE so that the CE can coordinate and prepare a timely response to the requesting
individual and provide direction to Associate.
4. Obligations of CE.
a. Safeguards During Transmission. CE shall be responsible for using appropriate
safeguards, including encryption of PHI, to maintain and ensure the confidentiality, integrity and
security of Protected Information transmitted pursuant to this Agreement, in accordance with the
standards and requirements of the HIPAA Rules.
b. Notice of Changes. CE maintains a copy of its Notice of Privacy Practices on its
website. CE shall provide Associate with any changes in, or revocation of, permission to use or
disclose Protected Information, to the extent that it may affect Associate's permitted or required
uses or disclosures. To the extent that it may affect Associate's permitted use or disclosure of
PHI, CE shall notify Associate of any restriction on the use or disclosure of Protected Information
that CE has agreed to in accordance with 45 C.F.R. Section 164.522.
5. Reasonable Steps to Cure Breach.
a. If CE knows of a pattern of activity or practice of Associate that constitutes a
material breach or violation of the Associate's obligations under the provisions of this Agreement
or another arrangement, then CE shall take reasonable steps to cure such breach or end such
violation. If Associate knows of a pattern of activity or practice of an agent that constitutes a
material breach or violation of agent's obligations under the written agreement between Associate
and the agent, Associate shall take reasonable steps to cure such breach or end such violation,
if feasible.
6. Disposition of the PHI upon Termination or Expiration.
a. Upon termination or expiration of any agreement for services between the Parties,
the Associate will either return or destroy, at CE's sole discretion and in accordance with any
instructions by CE, all PHI in the possession or control of the Associate and its agents. However,
if the Associate determines that neither the return nor destruction of the PHI is feasible, the
Associate may retain the PHI provided that the Associate complies with those reasonable
restrictions imposed by the CE.
7. Disclaimer. CE makes no warranty or representation that compliance by Associate with
this Agreement or the HIPAA Rules will be adequate or satisfactory for Associate's own purposes.
Associate is solely responsible for all decisions made by Associate regarding the safeguarding of
PHI.
8. Assistance in Litigation or Administrative Proceedings. Associate shall make itself and any
employees or agents assisting Associate in the performance of its obligations under the
Agreement, available to CE, at no cost to CE, up to a maximum of thirty (30) hours, to testify as
witnesses or otherwise, in the event of litigation or administrative proceedings being commenced
against CE, its directors, officers, or employees based upon a claimed violation of the HIPAA
Rules or other laws relating to security and privacy or PHI, in which the actions of Associate are
at issue, except where Associate or its employee or agent is a named adverse party.
9. Interpretation and Order of Precedence. The provisions of this Agreement shall be
interpreted as broadly as necessary to implement and comply with the HIPAA Rules. The parties
agree that any ambiguity in this Agreement shall be resolved in favor of a meaning that complies
and is consistent with the HIPAA Rules.
10. Survival of Certain Agreement Terms. Notwithstanding anything herein to the contrary,
Associate's obligations under this Agreement shall survive termination of this Agreement and shall
be enforceable by CE as provided herein in the event of such failure to perform or comply by the
Associate.
11. Representatives and Notice. For the purpose of the Agreement, the individuals identified
on Page 1 of 4 Pages of this agreement shall be the representatives of the respective parties. All
required notices shall be hand delivered or given by certified or registered mail to the
representatives at the addresses listed at the top of this form.
Exhibit B
Scope of Services and Rates
1. Scope of Services
a. Services to be provided are detailed in the Individual's State Supported Living Services
(SLS) or OBRA Service Plan which dictates the type of service as well as timing and
frequency of service to be performed.
b. Approved VENDOR State SLS and OBRA services provided under this agreement:
❑ D2999: State SLS — Dental
❑ G0176: State SLS — Movement Therapy
❑ H1010: CES — Parent Education
® H2019: State SLS — Behavioral Consultation
❑ H2019: DD — Behavioral Counseling Individual
® H2019: SLS — Behavioral Counseling Individual
® H2019: SLS — Behavioral Counseling Group
® H2019: SLS — Behavioral Line Staff
❑ H2019: OBRA — Counseling Individual
❑ H2019: State SLS — Counseling Services Individual
❑ H2021: State SLS - Mentorship
❑ H2023: State SLS - Supp Employment -Job Development
❑ S5130: SLS — Homemaker Basic
❑ S5130: State SLS — Homemaker Basic
❑ S5130: State SLS — Homemaker Enhanced
® S5150: State SLS — Respite Individual per 15 minutes
® S5151: State SLS — Respite Individual Per Day
® S5151: State SLS — Respite Individual - Group
❑ S5160: State SLS — Installation of Personal Emergency
❑ S5161: State SLS — Personal Emergency
❑ S5161: SLS — Personal Emergency Response Services
❑ S5165: CES — Home Accessibility Adaptations
❑ S5199: CES — Adapted Therapeutic Recreational Fees
❑ S8940: CES — Hippotherapy - Individual
❑ S8940: SLS — Hippotherapy - Individual
❑ T1019: State SLS - Personal Care
❑ T1999: CES — Adapted Therapeutic Recreational Equipment
❑ T2003: State SLS — Transportation Mileage
® T2003: State SLS — Transportation Mileage — Non -medical
® T2003: State SLS — Transportation Mileage — Not in Day Program
❑ T2003: SLS — Transportation Mileage Band 1
❑ T2004: State SLS — Transportation Other
❑ T2004: DD — Transportation — Other (Public Conveyance)
❑ T2004: SLS — Transportation — Other (Public Conveyance)
❑ T2019: State SLS — Job Coaching (Individual)
❑ T2019: State SLS - Supportive Employment Individual
❑ T2019: State SLS - Supportive Employment Group
® T2021: State SLS — Day Habilitation Supported Community Connections
❑ T2021: State SLS — Day Habilitation Supported Community Connections per 15
minutes
® T2021: State SLS — Day Habilitation Specialized Habilitation
❑ T2024: State — Behavioral Assessment
❑ T2028: DD - Specialized Medical Supplies — Disposable
❑ T2028: SLS - Specialized Medical Supplies - Disposable
❑ T2029: CES - Specialized Medical Equipment
❑ T2029: DD - Specialized Medical Equipment
❑ T2029: SLS - Specialized Medical Equipment
❑ T2035: CES — Assistive Technology
® T2036: State SLS — Group Ovemight (Camp)
❑ V2799: DD — Vision Services
❑ V2799: SLS — Vision Services
❑ V2799: State SLS — Vision Services
❑ 97124: CES — Massage Therapy
❑ 97124: SLS — Massage Therapy
❑ 10000: State SLS — Acquiring Pest Abatement
2. Provider Rates and Fee Schedule
a. Rates paid for State SLS and OBRA services can be found on the State Health Care
Policy and Financing Website https://hca.colorado.gov/provider-rates-fee-schedule, see
State General Fund Programs Direct Service Rates Fee Schedule.
Terms
1. Home and Community Based Service (HCBS) Provider Agency Billing
a. Claims for HCBS services are payable only if submitted in accordance with the
following procedures:
i. VENDOR shall verify Member eligibility prior to delivering services;
ii. VENDOR shall verify a Prior Authorization Request (PAR) has been
approved for the services in question, prior to service provision and claim
submission;
iii. Claims shall be submitted to the Fiscal Agent in accordance with
Department billing manuals and policies, outlined in 10 C.C.R. 2505-10
Section 8.043;
iv. Claims shall only be submitted for services the VENDOR is enrolled to
provide, including correct HCBS specialties;
v. Claims shall only be submitted for services provided in accordance with all
applicable federal and state statutes, regulations, and other authorities;
vi. Submitted claims shall include all data elements required to complete the
National Uniform Claim Committee Form 1500 (CMS 1500).
b. Payment shall not exceed rate shown in the Health First Colorado Fee Schedule in
effect on the date services are provided.
c. Pursuant to § 25.5-4-301, C.R.S., VENDOR shall not collect copayments or seek
reimbursement from eligible Members for covered services.
2. Personnel
a. Employee and Contractor records
i. The VENDOR shall maintain records documenting the qualifications and
training of employees and Contractors who provide services to Members.
ii. The VENDOR shall maintain a personnel record for each employee or
Contractor. The record shall contain:
■ Documentation of employee/Contractor qualifications.
Documentation of trainings completed.
Documentation of supervision and performance evaluation or contractor
management.
Documentation that the employee/Contractor was informed of all policies
and procedures required by Section 8.7409.
■ Documentation of the employee's/Contractor's job description.
■ Documentation of a criminal background check and a CAPs check.
3. License/Certification
a. The VENDOR shall meet the enrollment requirements for each service it provides
prior to providing services. The VENDOR shall ensure each employee or
independent Contractor maintains the necessary and appropriate license and/or
Certification to render services. The VENDOR shall maintain documentation of
current and valid individual license(s) and Certification(s) in the personnel record.
4. Medication Administration
a. All employees and Contractors, not otherwise authorized by law to administer
medication, who assist and/or monitor Members in the administration of
medications or the filling of medication reminder boxes shall have passed a
"Qualified medication administration person" or "QMAP" competency evaluation
offered by an approved training entity, and shall be listed on the Department's list
of persons who have passed the requisite competency evaluation as defined in 6
CCR 1011-1, Chapter 24. Each facility shall ensure the qualifications of the QMAP
employee or Contractor per 6 CCR 1011-1, Chapter 24, Section 3.
5. Trainings
a. The VENDOR shall have an organized program of orientation and training of
sufficient scope for employees and Contractors to carry out their duties and
responsibilities efficiently, effectively, and competently. Training shall be provided
prior to employees or Contractors having unsupervised contact with Members. The
training program shall, at a minimum, provide for and include:
i. Training related to person -centered practices, the role of the Person -Centered
Support Plan, and the concept of dignity of risk;
ii. Training related to health, safety, and services and supports to be provided
related to the specific needs and diagnoses of Members served;
iii. Training specific to the individual(s) for whom the employees or Contractors will
be providing services and supports which includes medical or behavioral
protocols, supervision, dietary and Activities of Daily Living (ADL) needs, and
Provider agencies' internal policies and procedures.
6. Rendering Services According to the Person -Centered Support Plan
a. The VENDOR shall maintain, on file, copies of the current Person -Centered
Support Plan for all Members they serve. Staff providing direct care to Members
shall have access to or a copy of the support plan Person -Centered Support Plan
and shall render services as required in the support plan Person -Centered Support
Plan.
b. The VENDOR shall render services according to the agreed upon Person -
Centered Support Plan and coordinate with other provider agencies, when
applicable. Members receiving services shall be included in developing the
Person -Centered Support Plan and have the freedom to choose a willing service
vendor.
c. The VENDOR shall not condition a Member's receipt of any service on the
Member's agreement to receive other services from the service vendor.
d. The VENDOR shall not discontinue or refuse to provide agreed upon services to a
Member unless documented efforts have been made to resolve the situation that
triggers such discontinuation or refusal to provide services.
7. Incident Reporting
a. The VENDOR shall complete the timely reporting, recording, and reviewing of
Incidents which shall include, but not be limited to:
■ Death of Member receiving services;
■ Hospitalization of Member receiving services;
■ Medical emergencies, above and beyond first aid, involving Member
receiving services;
■ Allegations of MANE;
■ Injury to Member or illness of Member;
■ Damage or theft of Member's personal property;
■ Errors in medication administration;
■ Lost or missing person receiving services;
■ Criminal activity; and
■ Incidents or reports of actions by Member receiving services that are
unusual and require review.
b. The VENDOR shall submit a verbal or written report of every Incident to the HCBS
Member's Case Management Agency Case Manager within 24 hours of discovery
of the actual or alleged Incident. The report shall include:
■ Name of person reporting;
■ Name of Member who was involved in the Incident;
■ Member's Medicaid identification number;
■ Name of persons involved or witnessing the Incident;
■ Incident type;
■ Date, time, and duration of Incident;
■ Location of Incident;
■ Persons involved;
■ Description of Incident;
■ Description of action taken;
■ Whether the Incident was observed directly or reported to the provider;
■ Name of person notified;
■ Follow-up action taken or where to find documentation of further
follow-up;
■ Name of the person responsible for follow up; and
■ Resolution, if applicable.
c. If any of the above information is not available and reported to the Case
Management Agency Case Manager within 24 hours of the Incident, the VENDOR
must submit follow up information as soon as it is obtained.
d. Additional follow up information may also be requested by the Case Manager, or
the Department. The VENDOR is required to submit all follow up information within
the timeframe specified by the Case Management Agency.
e. VENDOR shall review and analyze information from Incident reports to identify
trends and problematic practices which may be occurring in specific services and
shall take appropriate corrective action to address problematic practices identified.
SIGNATURE REQUESTED: Weld/Support Inc
CMA Service Agreement
Final Audit Report
2025-02-26
Created: 2025-02-26
By: Sara Adams (sadams@weld.gov)
Status: Signed
Transaction ID: CBJCHBCAABAAk_uc-04tpxMWADeRZ9kaJkDUdVagQB7
"SIGNATURE REQUESTED: Weld/Support Inc CMA Service Ag
reement" History
t Document created by Sara Adams (sadams@weld.gov)
2025-02-26 - 9:58:58 PM GMT- IP address: 204.133.39.9
C'y Document emailed to Bentley Smith (bentley.smith@supportinc.com) for signature
2025-02-26 - 9:59:35 PM GMT
t Email viewed by Bentley Smith (bentley.smith@supportinc.com)
2025-02-26 - 10:13:51 PM GMT- IP address: 73.95.211.108
be Document e -signed by Bentley Smith (bentley.smith@supportinc.com)
Signature Date: 2025-02-26 - 10:14:08 PM GMT - Time Source: server- IP address: 73.95.211.108
O Agreement completed.
2025-02-26 - 10:14:08 PM GMT
Pow.. by
Adobe
Acrobat Sign
Contract Form
Entity Information
Entity Name*
SUPPORT INC
Entity ID*
@00049597
Contract Name*
SUPPORT, INC. CASE MANAGEMENT AGENCY (CMA)
SERVICES AGREEMENT
Contract Status
CTB REVIEW
Q New Entity?
Contract ID
9161
Contract Lead*
SADAMS
Contract Lead Email
sadams@weld.gov;cobbx
xlk@weld.gov
Parent Contract ID
Requires Board Approval
YES
Department Project #
Contract Description*
SUPPORT, INC. CASE MANAGEMENT AGENCY (CMA) SERVICES AGREEMENT. TERM 3/1/25 TO 6/30/25.
Contract Description 2
PA ROUTING THROUGH THE NORMAL PROCESS. ETA TO CTB IS 3/4/25.
Contract Type*
AGREEMENT
Amount *
$0.00
Renewable*
NO
Automatic Renewal
Grant
IGA
Department
HUMAN SERVICES
Department Email
CM-
HumanServices@weld.gov
Department Head Email
CM-HumanServices-
DeptHead@weld.gov
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM -
CO U NTYATTO R N EY@W E L
D.GOV
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
Requested BOCC Agenda Due Date
Date* 03/08/2025
03/12/2025
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be
included?
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts
are not in OnBase
Contract Dates
Effective Date
Termination Notice Period
Contact Information
Review Date*
04/30/2025
Committed Delivery Date
Renewal Date
Expiration Date*
06/30/2025
Contact Info
Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2
Purchasing
Purchasing Approver Purchasing Approved Date
Approval Process
Department Head Finance Approver Legal Counsel
JAMIE ULRICH CHERYL PATTELLI BYRON HOWELL
DH Approved Date Finance Approved Date Legal Counsel Approved Date
03/05/2025 03/06/2025 03/06/2025
Final Approval
BOCC Approved Tyler Ref #
AG 031225
BOCC Signed Date Originator
SADAMS
BOCC Agenda Date
03/12/2025
Hello