HomeMy WebLinkAbout20252099.tiffResolution
Approve Intergovernmental Agreement for 2025-2026 County Incentives Program
and Authorize Chair to Sign
Whereas, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
Whereas, the Board has been presented with an Intergovernmental Agreement for the
2025-20Q6 County Incentives Program 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 the Colorado Department of Health Care Policy and
Financing, commencing upon full execution of signatures, and ending June 30, 2026, with
further terns 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 Intergovernmental Agreement for the 2025-2026 County Incentives
Program 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 the Colorado Department of Health Care Policy and Financing, 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 23rd day of July, A.D., 2025:
Perry L. Buck, Chair: Aye
Scott K. James, Pro -Tern: Aye
Jason S. Maxey: Aye
Lynette Peppier: Aye
Kevin D. Ross: Aye
Approved as to Form:
Bruce Barker, County Attorney
Attest:
Esther E. Gesick, Clerk to the Board
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ff/o6/25
2025-2099
H R0097
Confva cf- L 744
BOARD OF COUNTY COMMISSIONERS
PASS AROUND REVIEW
PASS -AROUND TITLE: State of Colorado Intergovernmental Agreement for Fiscal Year 2026
County Incentives
DEPARTMENT: Human Services DATE: July 15, 2025
PERSON REQUESTING: Jamie Ulrich, Director, Human Services
Brief description of the problemlissue: The Colorado Department of Health Care Policy and
Financing (HCPF) has issued an Intergovernmental Agreement (IGA) for the period of performance
ending June 30, 2026. The purpose of this IGA is to create performance -based benchmarks and
deliverables for County Departments of Human/Social Services to achieve certain performance
standards related to County Administration, Medical Assistance Eligibility and cooperation with other
Medical Assistance -related entities.
For Fiscal Year 2026, Weld County may earn incentives totaling up to $489,071.24 if benchmarks are
met.
What options exist for the Board?
Approval of the State of Colorado IGA for FY 2026 County Incentives.
Deny approval of the State of Colorado IGA for FY 2026 County Incentives.
Consequences: The Department will not receive the SFY 2026 County Incentives funding.
Impacts: The Department will not have the funding to achieve the performance standards
related to County Administration, Medical Assistance and Eligibility Medical
Assistance -related entities.
Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years):
• Total Contract Amount = $489,071.24
• Funded through Colorado Department of Health Care Policy and Financing.
• Term: July 1, 2025 through June 30, 2026
Pass -Around Memorandum; July 15, 2025 - CMS ID 9744
2025-2099
/Z3
RV -600(i
Recommendation:
• Approval of this Intergovernmental Agreement and authorize the Chair to sign.
Support Recommendation Schedule
Place on BOCC Mende Work Session Other/Comments:
Perry L. Buck
Scott K. James
Jason S. Maxey
Lynette Peppier
Kevin D. Ross
.27-114
4''
If.,
Pass -Around Memorandum; July 15, 2025 - CMS ID 9744
State Agency
Department of Health Care Policy and Financing
Contractor
Weld County
Contract Number
26-198149
Contract Performance Beginning Date
The later of the Effective Date or July 1, 2025
STATE OF COLORADO INTERGOVERNMENTAL AGREEMENT
COVER PAGE
Contract Maximum Amount
Initial Term
State Fiscal Year 2026:
Extension Term
State Fiscal Year 2027:
State Fiscal Year 2028:
State Fiscal Year 2029:
State Fiscal Year 2030:
Total for All State Fiscal Years:
$489,071.24
$0.00
$0.00
$0.00
$0.00
$489,071.24
Initial Contract Expiration Date
June 30, 2026
Contract Authority
Authority to enter into this Contract exists in C.R.S. §25.5-1-101, et. seq. and 10 CCR 2505-5 et. seq.
Contract Purpose
The purpose of this Contract is to create performance -based benchmarks and deliverables for county
departments of human/social services to achieve certain performance standards related to County
Administration, Medical Assistance Eligibility and cooperation with other Medical Assistance -related entities.
Exhibits and Order of Precedence
The following Exhibits and attachments are included with this Contract:
1. Exhibit A — Statement of Work 5. Exhibit E — Small, Medium, and Large
2. Exhibit B — Rates County List
3. Exhibit C — Terminology 6. Exhibit F — Sample Option Letter
4. Exhibit D — Review Sample Size
Exemption Process Flow
In the event of a conflict or inconsistency between this Contract and any Exhibit or attachment, such conflict or
inconsistency shall be resolved by reference to the documents in the following order of priority:
1. Colorado Special Provisions in §17 of the 5. Exhibit D — Review Sample Size
main body of this Contract
2. The provisions of the other sections of the
main body of this Contract
3. Exhibit A — Statement of Work
4. Exhibit B — Rates
Principal Representatives
For the State:
Arturo Serrano
Health Care Policy and Financing
303 17`x' Ave, 11' Floor
Denver, CO 801203
Exemption Process Flow
6. Exhibit E — Small, Medium, and Large
County List
7. Exhibit C — Terminology
8. Exhibit F — Sample Option Letter
For Contractor:
Weld County
Board of County Commissioners
Perry L. Buck, Board Chair
315 N 11th Ave
Greeley, CO 80631-2014
ulrichjj@weldgov.com
Agreement Number: 26-198149
Page 1 of 2 Version 12.1.2024
SIGNATURE PAGE
THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT
Each person signing this Contract represents and warrants that he or she is duly authorized to execute this
Contract and to bind the Party authorizing his or her signature.
CONTRACTOR STATE OF COLORADO
Weld County Jared S. Polis, Governor
Board of County Commissioners Department of Health Care Policy and Financing
Kim Bimestefer, Executive Director
Signed by: p DocuSigned by:
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07/23/2025 I 10:18 MDT
Date:
2"d State or Contractor Signature if Needed
Date:
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07/23/2025 I 17:42 MDT
Date:
LEGAL REVIEW
Philip J. Weiser, Attorney General
N/A
By: Assistant Attorney General
Date:
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
Department of Health Care Policy and Financing
Jerrod Cotosman, Controller
p-DocuSigneddby:
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07/24/2025 I 08:56 MDT
Effective Date:
In accordance with §24-30-202, C.R.S., this Contract is not valid until signed and dated above by the State
Controller or an authrorized delegate.
Agreement Number: 26-198149
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TABLE OF CONTENTS
TABLE OF CONTENTS 1
1. PARTIES 2
2. TERM AND EFFECTIVE DATE 2
3. DEFINITIONS 3
4. STATEMENT OF WORK 5
5. PAYMENTS TO CONTRACTOR 5
6. REPORTING - NOTIFICATION 7
7. CONTRACTOR RECORDS 7
8. CONFIDENTIAL INFORMATION -STATE RECORDS 8
9. CONFLICTS OF INTEREST 9
10. INSURANCE 10
11. BREACH OF CONTRACT 11
12. REMEDIES 11
13. DISPUTE RESOLUTION 13
14. NOTICES AND REPRESENTATIVES 13
15. RIGHTS IN WORK PRODUCT AND OTHER INFORMATION 14
16. GENERAL PROVISIONS 14
17. COLORADO SPECIAL PROVISIONS (COLORADO FISCAL RULE 3-3) 17
EXHIBIT A, STATEMENT OF WORK 1
EXHIBIT B, RATES 1
EXHIBIT C, TERMINOLOGY 1
EXHIBIT D, REVIEW SAMPLE SIZE EXEMPTION PROCERSS FLOW 1
EXHIBIT E, SMALL, MEDIUM, AND LARGE COUNTY LIST 1
EXHIBIT F, SAMPLE OPTION LETTER 1
Agreement Number: 26-198149
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1. PARTIES
This Contract is entered into by and between Contractor named on the Cover Page for this Contract
("Contractor") and the STATE OF COLORADO acting by and through the State agency named
on the Cover Page for this Contract (the "State," the "Department," or "HCPF"). Contractor and
the State agree to the terms and conditions in this Contract.
2. TERM AND EFFECTIVE DATE
A. Effective Date
This Contract shall not be valid or enforceable until the Effective Date. The State shall not
be bound by any provision of this Contract before the Effective Date and shall have no
obligation to pay Contractor for any Work performed or expense incurred before the Effective
Date or after the expiration or sooner termination of this Contract.
B. Initial Term
The Parties' respective performances under this Contract shall commence on the Contract
Performance Beginning Date shown on the Cover Page for this Contract and shall terminate
on the Initial Contract Expiration Date shown on the Cover Page for this Contract (the "Initial
Term") unless sooner terminated or further extended in accordance with the terms of this
Contract.
C. Extension Terms - State's Option
The State, at its discretion, shall have the option to extend the performance under this
Contract beyond the Initial Term for a period, or for successive periods, of one year or less
at the same rates and under the same terms specified in the Contract (each such period an
"Extension Term"). In order to exercise this option, the State shall provide written notice to
Contractor in a form substantially equivalent to the Sample Option Letter attached to this
Contract. Except as stated in §2.D, the total duration of this Contract, including the exercise
of any options to extend, shall not exceed five years from its Effective Date absent prior
approval from the State Purchasing Director in accordance with the Colorado Procurement
Code.
D. End of Term Extension
If this Contract approaches the end of its Initial Term, or any Extension Term then in place,
the State, at its discretion, upon written notice to Contractor as provided in §14, may
unilaterally extend such Initial Term or Extension Term for a period not to exceed two months
(an "End of Term Extension"), regardless of whether additional Extension Terms are
available or not. The provisions of this Contract in effect when such notice is given shall
remain in effect during the End of Term Extension. The End of Term Extension shall
automatically terminate upon execution of a replacement contract or modification extending
the total term of this Contract.
E. Early Termination in the Public Interest
The State is entering into this Contract to serve the public interest of the State of Colorado as
determined by its Governor, General Assembly, or Courts. If this Contract ceases to further
the public interest of the State, the State, in its discretion, may terminate this Contract in
whole or in part. A determination that this Contract should be terminated in the public interest
shall not be equivalent to a State right to terminate for convenience. This subsection shall not
apply to a termination of this Contract by the State for breach by Contractor, which shall be
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governed by §12.A.i.
Method and Content
The State shall notify Contractor of such termination in accordance with §14. The
notice shall specify the effective date of the termination and whether it affects all or a
portion of this Contract, and shall include, to the extent practicable, the public interest
justification for the termination.
ii. Obligations and Rights
Upon receipt of a termination notice for termination in the public interest, Contractor
shall be subject to the rights and obligations set forth in §12.A.i.a.
iii. Payments
If the State terminates this Contract in the public interest, the State shall pay Contractor
an amount equal to the percentage of the total reimbursement payable under this
Contract that corresponds to the percentage of Work satisfactorily completed and
accepted, as determined by the State, less payments previously made. Additionally, if
this Contract is less than 60% completed, as determined by the State, the State may
reimburse Contractor for a portion of actual out-of-pocket expenses, not otherwise
reimbursed under this Contract, incurred by Contractor which are directly attributable
to the uncompleted portion of Contractor's obligations, provided that the sum of any
and all reimbursement shall not exceed the maximum amount payable to Contractor
hereunder.
3. DEFINITIONS
The following terms shall be construed and interpreted as follows:
A. "Breach of Contract" means the failure of a Party to perform any of its obligations in
accordance with this Contract, in whole or in part or in a timely or satisfactory manner. If
Contractor is debarred or suspended under §24-109-105, C.R.S. at any time during the term
of this Contract, then such debarment or suspension shall constitute a breach.
B. "Business Day" means any day in which the State is open and conducting business, but shall
not include Saturday, Sunday or any day on which the State observes one of the holidays
listed in §24-11-101(1), C.R.S.
C. "Chief Procurement Officer" means the individual to whom the Executive Director has
delegated his or her authority, pursuant to §24-102-202, C.R.S. to procure or supervise the
procurement of all supplies and services needed by the State.
D. "Contract" means this agreement, including all attached Exhibits, all documents
incorporated by reference, all referenced statutes, rules and cited authorities, and any future
modifications thereto.
E. "Contract Funds" means the funds that have been appropriated, designated, encumbered, or
otherwise made available for payment by the State under this Contract.
F. "CORA" means the Colorado Open Records Act, §§24-72-200.1, et. seq., C.R.S.
G. "Effective Date" means the date on which this Contract is approved and signed by the
Colorado State Controller or designee, as shown on the Signature Page for this Contract. If
this Contract is for a Major Information Technology Project, as defined in §24-37.5-102(2.6),
C.R.S., then the Effective Date of this Contract shall be the later of the date on which this
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Contract is approved and signed by the State's Chief Information Officer or authorized
delegate or the date on which this Contract is approved and signed by the State Controller or
authorized delegate, as shown on the Signature Page for this Contract.
H. "End of Term Extension" means the time period defined in §2.D.
I. "Exhibits" means the exhibits and attachments included with this Contract as shown on the
Cover Page for this Contract.
J. "Extension Term" means the time period defined in §2.C
K. "Goods" means any movable material acquired, produced, or delivered by Contractor as set
forth in this Contract and shall include any movable material acquired, produced, or delivered
by Contractor in connection with the Services.
L. "Incident" means any accidental or deliberate event that results in or constitutes an imminent
threat of the unauthorized access, loss, disclosure, modification, disruption, or destruction of
any communications or information resources of the State, which are included as part of the
Work, as described in §§24-37.5-401 et. seq. C.R.S. Incidents include, without limitation (i)
successful attempts to gain unauthorized access to a State system or State Information
regardless of where such information is located; (ii) unwanted disruption or denial of service;
(iii) the unauthorized use of a State system for the processing or storage of data; or (iv)
changes to State system hardware, firmware, or software characteristics without the State's
knowledge, instruction, or consent.
M. "Initial Term" means the time period defined in §2.B.
N. "Party" means the State or Contractor, and "Parties" means both the State and Contractor.
O. "PHI" means any protected health information, including, without limitation 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. PHI includes, but is not limited to, any
information defined as Individually Identifiable Health Information by the federal Health
Insurance Portability and Accountability Act.
P. "PII" means personally identifiable information including, without limitation, any
information maintained by the State about an individual that can be used to distinguish or
trace an individual's identity, such as name, social security number, date and place of birth,
mother's maiden name, or biometric records; and any other information that is linked or
linkable to an individual, such as medical, educational, financial, and employment
information. PII includes, but is not limited to, all information defined as personally
identifiable information in §§24-72-501 and 24-73-101, C.R.S. "PII" shall also mean
"personal identifying information" as set forth at § 24-74-102, et. seq., C.R.S.
"Services" means the services to be performed by Contractor as set forth in this Contract,
and shall include any services to be rendered by Contractor in connection with the Goods.
R. "State Confidential Information" means any and all State Records not subject to disclosure
under CORA. State Confidential Information shall include, but is not limited to, PII, PHI,
and State personnel records not subject to disclosure under CORA. State Confidential
Information shall not include information or data concerning individuals that is not deemed
confidential but nevertheless belongs to the State, which has been communicated, furnished,
Q.
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or disclosed by the State to Contractor which (i) is subject to disclosure pursuant to CORA;
(ii) is already known to Contractor without restrictions at the time of its disclosure to
Contractor; (iii) is or subsequently becomes publicly available without breach of any
obligation owed by Contractor to the State; (iv) is disclosed to Contractor, without
confidentiality obligations, by a third party who has the right to disclose such information; or
(v) was independently developed without reliance on any State Confidential Information.
S. "State Fiscal Rules" means the fiscal rules promulgated by the Colorado State Controller
pursuant to §24-30-202(13)(a), C.R.S.
T. "State Fiscal Year (SFY)" means a 12 -month period beginning on July 1 of each calendar
year and ending on June 30 of the following calendar year. If a single calendar year follows
the term, then it means the State Fiscal Year ending in that calendar year.
U. "State Records" means any and all State data, information, and records, regardless of
physical form, including, but not limited to, information subject to disclosure under CORA.
V. "Subcontractor" means third -parties, if any, engaged by Contractor to aid in performance
of the Work.
W. "Work" means the Goods delivered and Services performed pursuant to this Contract.
X. "Work Product" means the tangible and intangible results of the Work, whether finished or
unfinished, including drafts. Work Product includes, but is not limited to, documents, text,
software (including source code), research, reports, proposals, specifications, plans, notes,
studies, data, images, photographs, negatives, pictures, drawings, designs, models, surveys,
maps, materials, ideas, concepts, know-how, and any other results of the Work. "Work
Product" does not include any material that was developed prior to the Effective Date that is
used, without modification, in the performance of the Work.
Any other term used in this Contract that is defined in an Exhibit shall be construed and interpreted
as defined in that Exhibit, including the terminology in Exhibit C.
4. STATEMENT OF WORK
Contractor shall complete the Work as described in this Contract and in accordance with the
provisions of Exhibit A. The State shall have no liability to compensate Contractor for the delivery
of any goods or the performance of any services that are not specifically set forth in this Contract.
The State, at its discretion, shall have the option to increase or decrease the statewide quantity of
Goods and Services based upon rates established in this Contract, and increase the maximum
amount payable accordingly. In order to exercise this option, the State shall provide written notice
to Contractor in a form substantially equivalent to the Sample Option Letter attached to this
contract. Delivery of Goods and performance of Services shall continue at the same rates and terms
as described in this Contract.
5. PAYMENTS TO CONTRACTOR
A. Maximum Amount
Payments to Contractor are limited to the unpaid, obligated balance of the Contract Funds.
The State shall not pay Contractor any amount under this Contract that exceeds the Contract
Maximum for that State Fiscal Year shown on the Cover Page for this Contract.
B. Payment Procedures
i. Invoices and Payment
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a. The State shall pay Contractor in the amounts and in accordance with the schedule
and other conditions set forth in Exhibit A, Statement of Work and Exhibit B,
Rates.
b. Contractor shall initiate payment requests by invoice to the State, in a form and
manner approved by the State.
c. The State shall pay each invoice within 45 days following the State's receipt of
that invoice, so long as the amount invoiced correctly represents Work completed
by Contractor . and previously accepted by the State during the term that the
invoice covers. If the State determines that the amount of any invoice is not
correct, then Contractor shall make all changes necessary to correct that invoice.
d. The acceptance of an invoice shall not constitute acceptance of any Work
performed or deliverables provided under this Contract.
ii. Interest
Amounts not paid by the State within 45 days after the State's acceptance of the invoice
shall bear interest on the unpaid balance beginning on the 45th day at the rate of one
percent per month, as required by §24-30-202(24)(a), C.R.S., until paid in full;
provided, however, that interest shall not accrue on unpaid amounts that the State
disputes in writing. Contractor shall invoice the State separately for accrued interest on
delinquent amounts, and the invoice shall reference the delinquent payment, the number
of day's interest to be paid and the interest rate.
iii. Payment Disputes
If Contractor disputes any calculation, determination or amount of any payment,
Contractor shall notify the. State in writing of its dispute within 30 days following the
earlier to occur of Contractor's receipt of the payment or notification of the
determination or calculation of the payment by the State. The State will review the
information presented by Contractor and may make changes to its determination based
on this review. The calculation, determination or payment amount that results from the
State's review shall not be subject to additional dispute under this subsection. No
payment subject to a dispute under this subsection shall be due until after the State has
concluded its review, and the State shall not pay any interest on any amount during the
period it is subject to dispute under this subsection.
iv. Available Funds -Contingency -Termination
The State is prohibited by law from making commitments beyond the term of the
current State Fiscal Year. Payment to Contractor beyond the current State Fiscal Year
is contingent on the appropriation and continuing availability of Contract Funds in any
subsequent year (as provided in the Colorado Special Provisions). If federal funds or
funds from any other non -State funds constitute all or some of the Contract Funds, the
State's obligation to pay Contractor shall be contingent upon such non -State funding
continuing to be made available for payment. Payments to be made pursuant to this
Contract shall be made only from Contract Funds, and the State's liability for such
payments shall be limited to the amount remaining of such Contract Funds. If State,
federal or other funds are not appropriated, or otherwise become unavailable to fund
this Contract, the State may, upon written notice, terminate this Contract, in whole or
in part, without incurring further liability. The State shall, however, remain obligated
to pay for Services and Goods that are delivered and accepted prior to the effective date
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of notice of termination, and this termination shall otherwise be treated as if this
Contract were terminated in the public interest as described in §2.E.
6. REPORTING - NOTIFICATION
A. Written Reports.
In addition to any reports required pursuant to this Contract or pursuant to any other Exhibit,
for any contract having a term longer than three months, Contractor shall submit, upon
request of the State, a written report specifying progress made for each specified performance
measure and standard in this Contract. Such progress report shall be in accordance with the
procedures developed and prescribed by the State. Progress reports shall be submitted to the
State not later than 5 Business Days following the State's request or at such time as otherwise
specified by the State.
B. Litigation Reporting
If Contractor is served with a pleading or other document in connection with an action before
a court or other administrative decision -making body, and such pleading or document relates
to this Contract or may affect Contractor's ability to perform its obligations under this
Contract, Contractor shall, within 10 days after being served, notify the State of such action
and deliver copies of such pleading or document to the State's principal representative
identified on the Cover Page of this Contract.
C. Performance Outside the State of Colorado or the United States, §24-102-206, C.R.S.
To the extent not previously disclosed in accordance with §24-102-206, C.R.S., Contractor
shall provide written notice to the State, in accordance with §14 and in a form designated by
the State, within 20 days following the earlier to occur of Contractor's decision to perform
Services outside of the State of Colorado or the United States, or its execution of an
agreement with a Subcontractor to perform, Services outside the State of Colorado or the
United States. Such notice shall specify the type of Services to be performed outside the State
of Colorado or the United States and the reason why it is necessary or advantageous to
perform such Services at such location or locations, and such notice shall be a public record.
Knowing failure by Contractor to provide notice to the State under this section shall constitute
a breach of this Contract. This section shall not apply if the Contract Funds include any
federal funds.
7. CONTRACTOR RECORDS
A. Maintenance
Contractor shall maintain a file of all documents, records, communications, notes and other
materials relating to the Work (the "Contractor Records"). Contractor Records shall include
all documents, records, communications, notes and other materials maintained by Contractor
that relate to any Work performed by Subcontractors, and Contractor shall maintain all
records related to the Work performed by Subcontractors required to ensure proper
performance of that Work. Contractor shall maintain Contractor Records until the last to
occur of: (i) the date three years after the date this Contract expires or is terminated, (ii) final
payment under this Contract is made, (iii) the resolution of any pending Contract matters, or
(iv) if an audit is occurring, or Contractor has received notice that an audit is pending, the
date such audit is completed and its findings have been resolved (the "Record Retention
Period").
B. Inspection
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Contractor shall permit the State to audit, inspect, examine, excerpt, copy and transcribe
Contractor Records during the Record Retention Period. Contractor shall make Contractor
Records available during normal business hours at Contractor's office or place of business,
or at other mutually agreed upon times or locations, upon no fewer than two Business Days'
notice from the State, unless the State determines that a shorter period of notice, or no notice,
is necessary to protect the interests of the State.
C. Monitoring
The State, in its discretion, may monitor Contractor's performance of its obligations under
this Contract using procedures as determined by the State. The State shall monitor
Contractor's performance in a manner that does not unduly interfere with Contractor's
performance of the Work.
D. Final Audit Report
Contractor shall promptly submit to the State a copy of any final audit report of an audit
performed on Contractor's records that relates to or affects this Contract or the Work, whether
the audit is conducted by Contractor or a third party.
8. CONFIDENTIAL INFORMATION -STATE RECORDS
A. Confidentiality
Contractor shall keep confidential, and cause all Subcontractors to keep confidential, all State
Records, unless those State Records are publicly available. Contractor shall not, without prior
written approval of the State, use, publish, copy, disclose to any third party, or permit the use
by any third party of any State Records, except as otherwise stated in this Contract, permitted
by law or approved in Writing by the State. Contractor shall provide for the security of all
State Confidential Information in accordance with all policies promulgated by the Colorado
Office of Information Security and all applicable laws, rules, policies, publications, and
guidelines. Contractor shall immediately forward any request or demand for State Records to
the State's principal representative.
B. Other Entity Access and Nondisclosure Agreements
Contractor may provide State Records to its agents, employees, assigns and Subcontractors
as necessary to perform the Work, but shall restrict access to State Confidential Information
to those agents, employees, assigns and Subcontractors who require access to perform their
obligations under this Contract. Contractor shall ensure all such agents, employees, assigns,
and Subcontractors sign agreements containing nondisclosure provisions at least as protective
as those in this Contract, and that the nondisclosure provisions are in force at all times the
agent, employee, assign or Subcontractor has access to any State Confidential Information.
Contractor shall provide copies of those signed nondisclosure provisions to the State upon
execution of the nondisclosure provisions.
C. Use, Security, and Retention
Contractor shall use, hold and maintain State Confidential Information in compliance with
any and all applicable laws and regulations in facilities located within the United States, and
shall maintain a secure environment that ensures confidentiality of all State Confidential
Information wherever located. Contractor shall provide the State with access, subject to
Contractor's reasonable security requirements, for purposes of inspecting and monitoring
access and use of State Confidential Information and evaluating security control
effectiveness. Upon the expiration or termination of this Contract, Contractor shall return
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State Records provided to Contractor or destroy such State Records and certify to the State
that it has done so, as directed by the State. If Contractor is prevented by law or regulation
from returning or destroying State Confidential Information, Contractor warrants it will
guarantee the confidentiality of, and cease to use, such State Confidential Information.
D. Incident Notice and Remediation
If Contractor becomes aware of any Incident, it shall notify the State immediately and
cooperate with the State regarding recovery, remediation, and the necessity to involve law
enforcement, as determined by the State. Unless Contractor can establish that none of
Contractor or any of its agents, employees, assigns or Subcontractors are the cause or source
of the Incident, Contractor shall be responsible for the cost of notifying each person who may
have been impacted by the Incident. After an Incident, Contractor shall take steps to reduce
the risk of incurring a similar type of Incident in the future as directed by the State, which
may include, but is not limited to, developing and implementing a remediation plan that is
approved by the State at no additional cost to the State. The State may, in its sole discretion
and at Contractor's sole expense, require Contractor to engage the services of an independent,
qualified, State -approved third party to conduct a security audit. Contractor shall provide the
State with results of such audit and evidence of Contractor's planned remediation in response
to any negative findings.
E. Data Protection and Handling
Contractor shall ensure that all State Records and Work Product in the possession of
Contractor or any Subcontractors are protected and handled in accordance with the
requirements of this Contract, including the requirements of any Exhibits hereto, at all times.
F. Safeguarding PII
If Contractor or any of its Subcontractors will or may receive PII under this Contract,
Contractor shall provide for the security of such PII, in a manner and form acceptable to the
State, including, without limitation, State non -disclosure requirements, use of appropriate
technology, security practices, computer access security, data access security, data storage
encryption, data transmission encryption, security inspections, and audits. Contractor shall
be a "Third -Party Service Provider" as defined in §24-73-103(1)(i), C.R.S. and shall maintain
security procedures and practices consistent with §§24-73-101 et seq., C.R.S.
9. CONFLICTS OF INTEREST
A. Actual Conflicts of Interest
Contractor shall not engage in any business or activities or maintain any relationships that
conflict in any way with the full performance of the obligations of Contractor under this
Contract. Such a conflict of interest would arise when a Contractor's or Subcontractor's
employee, officer or agent were to offer or provide any tangible personal benefit to an
employee of the State, or any member of his or her immediate family or his or her partner,
related to the award of, entry into or management or oversight of this Contract.
B. Apparent Conflicts of Interest
Contractor acknowledges that, with respect to this Contract, even the appearance of a conflict
of interest shall be harmful to the State's interests. Absent the State's prior written approval,
Contractor shall refrain from any practices, activities or relationships that reasonably appear
to be in conflict with the full performance of Contractor's obligations under this Contract.
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C. Disclosure to the State
If a conflict or the appearance of a conflict arises, or if Contractor is uncertain whether a
conflict or the appearance of a conflict has arisen, Contractor shall submit to the State a
disclosure statement setting forth the relevant details for the State's consideration. Failure to
promptly submit a disclosure statement or to follow the State's direction in regard to the
actual or apparent conflict constitutes a breach of this Contract.
D. Acknowledgment
Contractor acknowledges that all State employees are subject to the ethical principles
described in §24-18-105, C.R.S. Contractor further acknowledges that State employees may
be subject to the requirements of §24-18-105, C.R.S. with regard to this Contract
10. INSURANCE
Contractor shall obtain and maintain, and ensure that each Subcontractor shall obtain and maintain,
insurance as specified in this section at all times during the term of this Contract. All insurance
policies required by this Contract that are not provided through self-insurance shall be issued by
insurance companies as approved by the State.
A. Contractor Insurance
Contractor is a "public entity" within the meaning of the Colorado Governmental Immunity
Act, §24-10-101, et seg., C.R.S. (the "GIA") and shall maintain at all times during the term
of this Contract such liability insurance, by commercial policy or self-insurance, as is
necessary to meet its liabilities under the GIA.
B. Additional Insured
The State shall be named as additional insured on all commercial general liability policies
(leases and construction contracts require additional insured coverage for completed
operations) required of Contractor and Subcontractors.
C. Primacy of Coverage
Coverage required of Contractor and each Subcontractor shall be primary over any insurance
or self-insurance program carried by Contractor or the State.
D. Cancellation
All commercial insurance policies shall include provisions preventing cancellation or non -
renewal, except for cancellation based on non-payment of premiums, without at least 30 days
prior notice to Contractor and Contractor shall forward such notice to the State in accordance
with §14 within seven days of Contractor's receipt of such notice.
E. Subrogation Waiver
All commercial insurance policies secured or maintained by Contractor or its Subcontractors
in relation to this Contract shall include clauses stating that each carrier shall waive all rights
of recovery under subrogation or otherwise against Contractor or the State, its agencies,
institutions, organizations, officers, agents, employees, and volunteers.
F. Certificates
For each commercial insurance plan provided by Contractor under this Contract, Contractor
shall provide to the State certificates evidencing Contractor's insurance coverage required in
this Contract within seven Business Days following the Effective Date. Contractor shall
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provide to the State certificates evidencing Subcontractor insurance coverage required under
this Contract within seven Business Days following the Effective Date, except that, if
Contractor's subcontract is not in effect as of the Effective Date, Contractor shall provide to
the State certificates showing Subcontractor insurance coverage required under this Contract
within seven Business Days following Contractor's execution of the subcontract. No later
than 15 days before the expiration date of Contractor's or any Subcontractor's coverage,
Contractor shall deliver to the State certificates of insurance evidencing renewals of coverage.
At any other time during the term of this Contract, upon request by the State, Contractor shall,
within seven Business Days following the request by the State, supply to the State evidence
satisfactory to the State of compliance with the provisions of this §10.
11. BREACH OF CONTRACT
In the event of a Breach of Contract, the aggrieved Party shall give written notice of breach to the
other Party. If the notified Party does not cure the Breach of Contract, at its sole expense, within
30 days after the delivery of written notice, the Party may exercise any of the remedies as described
in §12 for that Party. Notwithstanding any provision of this Contract to the contrary, the State, in
its discretion, need not provide notice or a cure period and may immediately terminate this Contract
in whole or in part or institute any other remedy in this Contract in order to protect the public
interest of the State; or if Contractor is debarred or suspended under §24-109-105, C.R.S., the State,
in its discretion, need not provide notice or cure period and may terminate this Contract in whole
or in part or institute any other remedy in this Contract as of the date that the debarment or
suspension takes effect.
12. REMEDIES
A. State's Remedies
If Contractor is in breach under any provision of this Contract and fails to cure such breach,
the State, following the notice and cure period set forth in §11, shall have all of the remedies
listed in this section in addition to all other remedies set forth in this Contract or at law. The
State may exercise any or all of the remedies available to it, in its discretion, concurrently or
consecutively.
i. Termination for Breach
In the event of Contractor's uncured breach, the State may terminate this entire Contract
or any part of this Contract. Contractor shall continue performance of this Contract to
the extent not terminated, if any.
a. Obligations and Rights
To the extent specified in any termination notice, Contractor shall not incur further
obligations or render further performance past the effective date of such notice,
and shall terminate outstanding orders and subcontracts with third parties.
However, Contractor shall complete and deliver to the State all Work not
cancelled by the termination notice and may incur obligations as necessary to do
so within this Contract's terms. At the request of the State, Contractor shall assign
to the State all of Contractor's rights, title, and interest in and to such terminated
orders or subcontracts. Upon termination, Contractor shall take timely, reasonable
and necessary action to protect and preserve property in the possession of
Contractor but in which the State has an interest. At the State's request, Contractor
shall return materials owned by the State in Contractor's possession at the time of
any termination. Contractor shall deliver all completed Work Product and all
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Work Product that was in the process of completion to the State at the State's
request.
b. Payments
Notwithstanding anything to the contrary, the State shall only pay Contractor for
accepted Work received as of the date of termination. If, after termination by the
State, the State agrees that Contractor was not in breach or that Contractor's action
or inaction was excusable, such termination shall be treated as a termination in
the public interest, and the rights and obligations of the Parties shall be as if this
Contract had been terminated in the public interest under §2.E.
c. Damages and Withholding
Notwithstanding any other remedial action by the State, Contractor shall remain
liable to the State for any damages sustained by the State in connection with any
breach by Contractor, and the State may withhold payment to Contractor for the
purpose of mitigating the State's damages until such time as the exact amount of
damages due to the State from Contractor is determined. The State may withhold
any amount that may be due Contractor as the State deems necessary to protect
the State against loss including, without limitation, loss as a result of outstanding
liens and excess costs incurred by the State in procuring from third parties
replacement Work as cover.
ii. Remedies Not Involving Termination
The State, in its discretion, may exercise one or more of the following additional
remedies:
a. Suspend Performance
Suspend Contractor's performance with respect to all or any portion of the Work
pending corrective action as specified by the State without entitling Contractor to
an adjustment in price or cost or an adjustment in the performance schedule.
Contractor shall promptly cease performing Work and incurring costs in
accordance with the State's directive, and the State shall not be liable for costs
incurred by Contractor after the suspension of performance.
b. Withhold Payment
Withhold payment to Contractor until Contractor corrects its Work.
c. Deny Payment
Deny payment for Work not performed, or that due to Contractor's actions or
inactions, cannot be performed or if they were performed are reasonably of no
value to the state; provided, that any denial of payment shall be equal to the value
of the obligations not performed.
d. Removal
Demand immediate removal of any of Contractor's employees, agents, or
Subcontractors from the Work whom the State deems incompetent, careless,
insubordinate, unsuitable, or otherwise unacceptable or whose continued relation
to this Contract is deemed by the State to be contrary to the public interest or the
State's best interest.
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e. Intellectual Property
If any Work infringes, or if the State in its sole discretion determines that any
Work is likely to infringe, a patent, copyright, trademark, trade secret or other
intellectual property right, Contractor shall, as approved by the State (i) secure
that right to use such Work for the State and Contractor; (ii) replace the Work
with noninfringing Work or modify the Work so that it becomes noninfringing;
or, (iii) remove any infringing Work and refund the amount paid for such Work
to the State.
B. Contractor's Remedies
If the State is in breach of any provision of this Contract and does not cure such breach,
Contractor, following the notice and cure period in §11 and the dispute resolution process in
§Error! Reference source not found. shall have all remedies available at law and equity.
13. DISPUTE RESOLUTION
A. Initial Resolution
Except as herein specifically provided otherwise, disputes concerning the performance of this
Contract which cannot be resolved by the designated Contract representatives shall be
referred in writing to a senior departmental management staff member designated by the State
and a senior manager designated by Contractor for resolution.
B. Resolution of Controversies
If the initial resolution described in §13.A fails to resolve the dispute within 10 Business
Days, Contractor shall submit any alleged breach of this Contract by the State to the
Procurement Official of the State Agency named on the Cover Page of this Contract as
described in §24-102-202(3), C.R.S. for resolution in accordance with the provisions of §§24-
106-109, and 24-109-101.1 through 24-109-505, C.R.S., (the "Resolution Statutes"), except
that if Contractor wishes to challenge any decision rendered by the Procurement Official,
Contractor's challenge shall be an appeal to the executive director of the Department of
Personnel and Administration, or their delegate, under the Resolution Statutes before
Contractor pursues any further action as permitted by such statutes. Except as otherwise
stated in this Section, all requirements of the Resolution Statutes shall apply including,
without limitation, time limitations.
14. NOTICES AND REPRESENTATIVES
Each individual identified as a Principal Representative on the Cover Page for this Contract shall
be the principal representative of the designating Party. All notices required or permitted to be
given under this Contract shall be in writing, and shall be delivered (A) by hand with receipt
required, (B) by certified or registered mail to such Party's principal representative at the address
set forth on the Cover Page of this Contract or (C) as an email with read receipt requested to the
principal representative at the email address, if any, set forth on the Cover Page of this Contract. If
a Party delivers a notice to another through email and the email is undeliverable, then, unless the
Party has been provided with an alternate email contact, the Party delivering the notice shall deliver
the notice by hand with receipt required or by certified or registered mail to such Party's principal
representative at the address set forth on the Cover Page for this Contract. Either Party may change
its principal representative or principal representative contact information, or may designate
specific other individuals to receive certain types of notices in addition to or in lieu of a principal
representative by notice submitted in accordance with this section without a formal amendment to
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this Contract. Unless otherwise provided in this Contract, notices shall be effective upon delivery
of the written notice.
15. RIGHTS IN WORK PRODUCT AND OTHER INFORMATION
A. Work Product
Contractor assigns to the State and its successors and assigns, the entire right, title, and
interest in and to all causes of action, either in law or in equity, for past, present, or future
infringement of intellectual property rights related to the Work Product and all works based
on, derived from, or incorporating the Work Product. Whether or not Contractor is under
contract with the State at the time, Contractor shall execute applications, assignments, and
other documents, and shall render all other reasonable assistance requested by the State, to
enable the State to secure patents, copyrights, licenses and other intellectual property rights
related to the Work Product. To the extent that Work Product would fall under the definition
of "works made for hire" under 17 U.S.C.S. §101, the Parties intend the Work Product to be
a work made for hire.
B. Exclusive Property of the State
Except to the extent specifically provided elsewhere in this Contract, any pre-existing State
Records, State software, research, reports, studies, photographs, negatives or other
documents, drawings, models, materials, data and information shall be the exclusive property
of the State (collectively, "State Materials"). Contractor shall not use, willingly allow, cause
or permit Work Product or State Materials to be used for any purpose other than the
performance of Contractor's obligations in this Contract without the prior written consent of
the State. Upon termination of this Contract for any reason, Contractor shall provide all Work
Product and State Materials to the State in a form and manner as directed by the State.
C. Exclusive Property of Contractor
Contractor retains the exclusiverights, title, and ownership to any and all pre-existing
materials owned or licensed to Contractor including, but not limited to, all pre-existing
software, licensed products, associated source code, machine code, text images, audio and/or
video, and third -party materials, delivered by Contractor under the Contract, whether
incorporated in a Deliverable or necessary to use a Deliverable (collectively, "Contractor
Property"). Contractor Property shall be licensed to the State as set forth in this Contract or a
State approved license agreement: (i) entered into as exhibits to this Contract; (ii) obtained
by the State from the applicable third -party vendor; or (iii) in the case of open source
software, the license terms set forth in the applicable open source license agreement.
16. GENERAL PROVISIONS
A. Assignment
Contractor's rights and obligations under this Contract are personal and may not be
transferred or assigned without the prior, written consent of the State. Any attempt at
assignment or transfer without such consent shall be void. Any assignment or transfer of
Contractor's rights and obligations approved by the State shall be subject to the provisions of
this Contract
B. Subcontracts
Contractor shall not enter into any subcontract in connection with its obligations under this
contract without providing notice to the State. The State may reject any such subcontract,
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and Contractor shall terminate any subcontract that is rejected by the State and shall not allow
any Subcontractor to perform any work after that Subcontractor's subcontract has been
rejected by the State. Contractor shall submit to the State a copy of each such subcontract
upon request by the State. All subcontracts entered into by Contractor in connection with this
Contract shall comply with all applicable federal and state laws and regulations, shall provide
that they are governed by the laws of the State of Colorado, and shall be subject to all
provisions of this Contract.
C. Binding Effect
Except as otherwise provided in §16.A., all provisions of this Contract, including the benefits
and burdens, shall extend to and be binding upon the Parties' respective successors and
assigns.
D. Authority
Each Party represents and warrants to the other that the execution and delivery of this
Contract and the performance of such Party's obligations have been duly authorized.
E. Captions and References
The captions and headings in this Contract are for convenience of reference only, and shall
not be used to interpret, define, or limit its provisions. All references in this Contract to
sections (whether spelled out or using the § symbol), subsections, exhibits or other
attachments, are references to sections, subsections, exhibits or other attachments contained
herein or incorporated as a part hereof, unless otherwise noted.
F. Counterparts
This Contract may be executed in multiple, identical, original counterparts, each of which
shall be deemed to be an original, but all of which, taken together, shall constitute one and
the same agreement.
G. Entire Understanding
This Contract represents the complete integration of all understandings between the Parties
related to the Work, and all prior representations and understandings related to the Work, oral
or written, are merged into this Contract. Prior or contemporaneous additions, deletions, or
other changes to this Contract shall not have any force or effect whatsoever, unless embodied
herein.
H. Digital Signatures
If any signatory signs this agreement using a digital signature in accordance with the
Colorado State Controller Contract, Grant and Purchase Order Policies regarding the use of
digital signatures issued under the State Fiscal Rules, then any agreement or consent to use
digital signatures within the electronic system through which that signatory signed shall be
incorporated into this Contract by reference.
I. Modification
Except as otherwise provided in this Contract, any modification to this Contract shall only be
effective if agreed to in a formal amendment to this Contract, properly executed and approved
in accordance with applicable Colorado State law and State Fiscal Rules. Modifications
permitted under this Contract, other than contract amendments, shall conform to the policies
issued by the Colorado State Controller.
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J. Statutes, Regulations, Fiscal Rules, and Other Authority.
Any reference in this Contract to a statute, regulation, State Fiscal Rule, fiscal policy or other
authority shall be interpreted to refer to such authority then current, as may have been
changed or amended since the Effective Date of this Contract.
K. External Terms and Conditions
Notwithstanding anything to the contrary herein, the State shall not be subject to any
provision included in any terms, conditions, or agreements appearing on Contractor's or a
Subcontractor's website or any provision incorporated into any click -through or online
agreements related to the Work unless that provision is specifically referenced in this
Contract.
L. Severability
The invalidity or unenforceability of any provision of this Contract shall not affect the validity
or enforceability of any other provision of this Contract, which shall remain in full force and
effect, provided that the Parties can continue to perform their obligations under this Contract
in accordance with the intent of this Contract.
M. Survival of Certain Contract Terms
Any provision of this Contract that imposes an obligation on a Party after termination or
expiration of this Contract shall survive the termination or expiration of this Contract and
shall be enforceable by the other Party.
N. Taxes
The State is exempt from federal excise taxes under I.R.C. Chapter 32 (26 U.S.C., Subtitle
D, Ch. 32) (Federal Excise Tax Exemption Certificate of Registry No. 84-730123K) and from
State and local government sales and use taxes under §§39-26-704(1), et seq., C.R.S.
(Colorado Sales Tax Exemption Identification Number 98-02565). The State shall not be
liable for the payment of any excise, sales, or use taxes, regardless of whether any political
subdivision of the state imposes such taxes on Contractor. Contractor shall be solely
responsible for any exemptions from the collection of excise, sales or use taxes that
Contractor may wish to have in place in connection with this Contract.
O. Third Party Beneficiaries
Except for the Parties' respective successors and assigns described in §16.A., this Contract
does not and is not intended to confer any rights or remedies upon any person or entity other
than the Parties. Enforcement of this Contract and all rights and obligations hereunder are
reserved solely to the Parties. Any services or benefits which third parties receive as a result
of this Contract are incidental to this Contract, and do not create any rights for such third
parties.
P. Waiver
A Party's failure or delay in exercising any right, power, or privilege under this Contract,
whether explicit or by lack of enforcement, shall not operate as a waiver, nor shall any single
or partial exercise of any right, power, or privilege preclude any other or further exercise of
such right, power, or privilege.
CORA Disclosure
To the extent not prohibited by federal law, this Contract and the performance measures and
Q.
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standards required under §24-106-107, C.R.S., if any, are subject to public release through
the CORA.
R. Standard and Manner of Performance
Contractor shall perform its obligations under this Contract in accordance with the highest
standards of care, skill and diligence in Contractor's industry, trade, or profession.
S. Licenses, Permits, and Other Authorizations.
Contractor shall secure, prior to the Effective Date, and maintain at all times during the term
of this Contract, at its sole expense, all licenses, certifications, permits, and other
authorizations required to perform its obligations under this Contract, and shall ensure that
all employees, agents and Subcontractors secure and maintain at all times during the term of
their employment, agency or subcontract, all license, certifications, permits and other
authorizations required to perform their obligations in relation to this Contract.
T. Accessibility
i. Contractor shall comply with and the Work Product provided under this Contract shall
be in compliance with all applicable provisions of §§24-85-101, et seq., C.R.S., and
the Accessibility Standards for Individuals with a Disability, as established by OIT
pursuant to Section §24-85-103 (2.5), C.R.S. Contractor shall also comply with all State
of Colorado technology standards related to technology accessibility and with Level
AA of the most current version of the Web Content Accessibility Guidelines (WCAG),
incorporated in the State of Colorado technology standards.
ii. The State may require Contractor's compliance to the State's Accessibility Standards
to be determined by a third party selected by the State to attest to Contractor's Work
Product and software is in compliance with §§24-85-101, et seq., C.R.S., and
the Accessibility Standards for Individuals with a Disability as established by OIT
pursuant to Section §24-85-103 (2.5), C.R.S.
17. COLORADO SPECIAL PROVISIONS (COLORADO FISCAL RULE 3-3)
These Special Provisions apply to all contracts except where noted in italics.
A. STATUTORY APPROVAL. §24-30-202(1), C.R.S.
This Contract shall not be valid until it has been approved by the Colorado State Controller
or designee. If this Contract is for a Major Information Technology Project, as defined in
§24-37.5-102(2.6), C.R.S., then this Contract shall not be valid until it has been approved by
the State's Chief Information Officer or designee.
B. FUND AVAILABILITY. §24-30-202(5.5), C.R.S.
Financial obligations of the State payable after the current State Fiscal Year are contingent
upon funds for that purpose being appropriated, budgeted, and otherwise made available.
C. GOVERNMENTAL IMMUNITY.
Liability for claims for injuries to persons or property arising from the negligence of the
Parties, their departments, boards, commissions committees, bureaus, offices, employees and
officials shall be controlled and limited by the provisions of the Colorado Governmental
Immunity Act, §24-10-101, et seq., C.R.S.; the Federal Tort Claims Act, 28 U.S.C. Pt. VI,
Ch. 171 and 28 U.S.C. 1346(b), and the State's risk management statutes, §§24-30-1501, et
seq. C.R.S. No term or condition of this Contract shall be construed or interpreted as a waiver,
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express or implied, of any of the immunities, rights, benefits, protections, or other provisions,
contained in these statutes.
D. INDEPENDENT CONTRACTOR.
Contractor shall perform its duties hereunder as an independent contractor and not as an
employee. Neither Contractor nor any agent or employee of Contractor shall be deemed to
be an agent or employee of the State. Contractor shall not have authorization, express or
implied, to bind the State to any agreement, liability or understanding, except as expressly
set forth herein. Contractor and its employees and agents are not entitled to
unemployment insurance or workers compensation benefits through the State and the
State shall not pay for or otherwise provide such coverage for Contractor or any of its
agents or employees. Contractor shall pay when due all applicable employment taxes
and income taxes and local head taxes incurred pursuant to this Contract. Contractor
shall (i) provide and keep in force workers' compensation and unemployment
compensation insurance in the amounts required by law, (ii) provide proof thereof when
requested by the State, and (iii) be solely responsible for its acts and those of its
employees and agents.
E. COMPLIANCE WITH LAW.
Contractor shall comply with all applicable federal and State laws, rules, and regulations in
effect ` or hereafter established, including, without limitation, laws applicable to
discrimination and unfair employment practices.
CHOICE OF LAW, JURISDICTION, AND VENUE.
Colorado law, and rules and regulations issued pursuant thereto, shall be applied in the
interpretation, execution, and enforcement of this Contract. Any provision included or
incorporated herein by reference which conflicts with said laws, rules, and regulations shall
be null and void. All suits or actions related to this Contract shall be filed and proceedings
held in the State of Colorado and exclusive venue shall be in the City and County of Denver.
G. PROHIBITED TERMS.
Any term included in this Contract that requires the State to indemnify or hold Contractor
harmless; requires the State to agree to binding arbitration; limits Contractor's liability for
damages resulting from death, bodily injury, or damage to tangible property; or that conflicts
with this provision in any way shall be void ab initio. Nothing in this Contract shall be
construed as a waiver of any provision of §24-106-109 C.R.S.
H. SOFTWARE PIRACY PROHIBITION.
State or other public funds payable under this Contract shall not be used for the acquisition,
operation, or maintenance of computer software in violation of federal copyright laws or
applicable licensing restrictions. Contractor hereby certifies and warrants that, during the
term of this Contract and any extensions, Contractor has and shall maintain in place
appropriate systems and controls to prevent such improper use of public funds. If the State
determines that Contractor is in violation of this provision, the State may exercise any remedy
available at law or in equity or under this Contract, including, without limitation, immediate
termination of this Contract and any remedy consistent with federal copyright laws or
applicable licensing restrictions.
I. EMPLOYEE FINANCIAL INTEREST/CONFLICT OF INTEREST. §§24-18-201 and
24-50-507, C.R.S.
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The signatories aver that to their knowledge, no employee of the State has any personal or
beneficial interest whatsoever in the service or property described in this Contract. Contractor
has no interest and shall not acquire any interest, direct or indirect, that would conflict in any
manner or degree with the performance of Contractor's services and Contractor shall not
employ any person having such known interests.
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EXHIBIT A, STATEMENT OF WORK
1. PROJECT SPECIFIC TERMINOLOGY
1.1.
The following list is provided to assist the reader in understanding project specific acronyms,
abbreviations, and terminology used throughout this document. See Exhibit C, Terminology for
additional definitions.
1.1.1. Applicant — An individual for whom Contractor is performing a Medical Assistance
Eligibility Determination.
1.1.2. Average Speed to Answer (ASA) — A key Call Center metric measuring the average amount
of time it takes to answer a phone call from a customer, from the point of call connection to
being connected to a live agent, including the time waiting in queue. ASA does not include
calls that can be answered through automated means and does not require a live agent.
1.1.3. Business Day — Any day in which the State is open and conducting business, but shall not
include Saturday, Sunday, or any day which the State of Colorado observes one of the
holidays listed in C.R.S. §24-11-101(1).
1.1.4. Call Center — A Call Center is defined as having one dedicated line for contacting Contractor;
when Members and individuals call in, they are automatically assigned to the next available
Contractor agent. This dedicated line should also have technology in place to provide data,
at a minimum, on the number of calls received, the average wait -time and the number of
abandoned calls. Call Centers can be as small as one Contractor staff and as large as 100 or
more Contractor staff answering calls.
1.1.5. Compliance Measures — Performance measures tied to contracts to ensure Colorado does not
fall below expected federal or state performance standards.
1.1.6. COGNOS/Decision Support System 01 (DSS01) — The Department's data reporting systems
that use information from the Colorado Benefits Management System (CBMS).
1.1.7. Colorado Benefits Management System (CBMS) — The State's eligibility determination
system.
1.1.8. Colorado interChange (interChange) — The State's claims payment system and related
subsystems that utilize eligibility information from CBMS to pay providers for medical
and/or other claims. The system and related subsystems also collect and analyze data related
to those payments.
1.1.9. Corrective Action Plan (CAP) — A formal plan submitted by Contractor and in collaboration
with the Department who will provide technical assistance to address non-compliance and/or
performance in accordance with 10 CCR 2505-5 1.020.11.
1.1.10. County Administration website — The Department's public -facing website where contract
documentation is kept for the County Incentives Program
(http://www.colorado.gov/hcpf/county-admin).
1.1.11. County Financial Management System (CFMS) — The accounting system utilized by
Contractor to record expenditures against county administration funding for Colorado's
Medical Assistance Program. The system is also used to issue Performance Incentive
Payments to eligible Contractors.
1.1.12. County Incentives Program — A program that provides specific funding to county
departments of human/social services for meeting Medicaid -related Performance Incentive
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Standards in their counties. Also referenced as Performance Incentive Standard Program
throughout this Contract.
1.1.13. Determination — The act of using CBMS to determine if an Applicant is eligible for the
Colorado Medical Assistance Program based on information submitted on a new application,
a redetermination or a change in Member circumstance.
1.1.14. Disenroll or Disenrollment — The act of processing a change in circumstance that affects a
Member's eligibility and makes them ineligible for coverage within Health First Colorado or
Child Health Plan Plus.
1.1.15. Eligibility Quality Assurance (EQA) Program — EQA conducts monthly case reviews to
monitor the accuracy and timeliness of eligibility determinations for Medical Assistance
made by Contractor, with cases pulled monthly for quality review. Results of the EQA
reviews are displayed on the MAP Accuracy Dashboard.
1.1.16. Exception — A contract action the Department will take action on its own, without needing
any input or steps from Contractor, that will assist Contractor in meeting and/or exceeding
performance targets and deliverables.
1.1.17. Exemption — A contract action the Department takes upon receiving a formal request from
Contractor to grant an exemption, and that request is backed up by data or other
documentation that is submitted by Contractor to the Department.
1.1.18. HCPF Memo Series — The Department's policy, operational and informational
communications that are utilized to provide contract clarifications, provide data and
operational guidance and share information pertaining to the County Incentives Program
(https://hcpf.colorado.gov/memo-series).
1.1.19. Home and Community -Based Services (HCBS) - HCBS waiver programs provide additional
benefits and services to eligible populations in addition to the standard benefit package
offered to all Members.
1.1.20. Improvement Action Plan (lAP) — An informal plan submitted by Contractor to address non-
compliance and/or performance in accordance with 10 CCR 2505-5 1.020.11.
1.1.21. Key Performance Indicator — KPI, a specific, measurable and quantifiable measure of
performance metrics used to track progress over time toward a specific objective or goal. Call
Center KPIs definitions and terminology were shared with Tier 1 counties in FY 2023-24 and
will be issued as an attachment in the HCPF Memo Series.
1.1.22. Long Term Care (LTC) — Long -Term Care is a Medical Assistance program that provides
nursing home care, home -health care, personal or adult day care for individuals of any age
with a chronic or disabling condition.
1.1.23. Management Decision Letter (MDL) — A formal notification issued by the Department,
through a letter that details areas and findings of noncompliance by Contractor. An MDL can
be issued for not meeting performance targets on the MAP Dashboard.
1.1.24. MCC — Health First Colorado Member Contact Center.
1.1.25. Medical Assistance Performance (MAP) Dashboards — A graphic representation of essential
information regarding performance measures, targets and Contractor's actual performance.
The MAP Dashboards highlight each county's performance and quality.
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1.1.26. Performance Measure — A quantification that provides objective evidence of the degree to
which a performance result (goal) is occurring over time.
1.1.27. Performance Coaching Workbook — A tool provided by the Department to support Eligibility
Sites with understanding of the key performance indicators for Colorado Human Service
Offices and MA/EAP Sites.
1.1.28. Program for the All -Inclusive Care for the Elderly (PACE) — Program provides
comprehensive medical and social support services to certain frail individuals 55 years of age
and over. The goal of PACE is to keep individuals in their homes and communities through
comprehensive care coordination.
1.1.29. PuMP — A Performance Measurement Process developed by Stacey Barr.
1.1.30. Reporting Period — The period of time for each performance standard used to measure
whether Contractor is meeting the requirements of each specific Performance Incentive
Standard, including performance targets and/or deliverables.
1.1.30.1. The First Reporting Period for a SFY shall begin on July 1 of that SFY and end on
December 31 of that SFY.
1.1.30.2. The Second Reporting Period for a SFY shall begin on January 1 of that SFY and end on
June 30 of that SFY.
1.1.31. Redetermination — A Determination as defined under 10 C.C.R. 2505-10 8.100.3.P.
1.1.32. State Fiscal Year (SFY) — The period beginning July 1 of each calendar year and ending on
June 30 of the following calendar year.
1.1.33. Status Report — A communication to Contractor that details which Performance Incentive
Standards were met for each Reporting Period.
1.1.34. Tableau — An interactive data visualization software focused on business intelligence;
provides a graphic representation, of essential information regarding performance measures,
targets and Contractor's actual performance.
1.1.35. Target — A specific goal or standard that the Department aims to achieve. It represents the
desired level of performance or outcome that is used to evaluate success. Degree of
performance we are continuously striving to achieve (i.e., 95% Timeliness).
1.1.36. Timely Determination — Any initial Determination that is completed within the timeliness
requirements set forth in 10 C.C.R. 2505-10 8.100.3.D.
1.1.37. Timely Disenrollment — Processing a change in a Member's circumstance resulting in
disenrollment within 15 Calendar Days.
1.1.38. Timely Renewal — A renewal is considered timely if it is completed by the last day of the due
month when the packet is received before the 15th. If the packet is received on or after the
15th, you'll have 30 Calendar Days from the packet received date to complete the renewal to
keep it timely. Also, any renewals received during the 90 -day reconsideration period will
have 30 Calendar Days from the date the packet is received to be completed.
1.1.39. Untimely Determination — Any initial Determination that is not completed within the
timeliness requirements set forth in 10 C.C.R. 2505-10 8.100.3.D.
1.1.40. Untimely Renewal — If the renewal packet is received before the 15th of the due month, you
have until the end of that month to complete it, if not completed is considered untimely. If
the packet is received on or after the 15th, you'll get 30 Calendar Days from the packet
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received date. If the renewal isn't completed within those 30 Calendar Days, it will be marked
as late. Additionally, if a renewal is received during the 90 -day reconsideration period, you
will have 30 Calendar Days from when the packet is received to complete it. Any renewal
completed after that 30 -day period will also be considered late.
1.1.41. Voice of the Customer — Voice of the Customer (VoC) is a series of different methods that is
used to collect customer feedback. A VoC program can help Contractor capture how
customers feel about the experience of accessing services at Contractor and can produce
insights that can help Contractor create a stronger customer experience.
2. COUNTY DETERMINATIONS
2.1. Contractor shall perform all Medicaid eligibility -related work within Contractor's County,
required under C.R.S. §25.5-1-101 et seq. The Department and Contractor share the costs of this
work performed by Contractor as defined in those statutes and this Contract shall not impact the
allocated amount of that cost sharing.
3. SYSTEMS USED TO DETERMINE COMPLIANCE WITH PERFORMANCE
INCENTIVES STANDARDS
3.1. Systems Utilized to Determine Compliance
3.1.1. To determine whether Contractor met any or all the Performance Incentives Standards when
completing determinations and redeterminations within Contractor's County, the Department
will utilize the COGNOS/DSSO1 and MAP Dashboard systems to pull data tracking and
reports that track Contractor's compliance with certain Performance Incentive Standards.
This data will be visualized on each county's MAP Dashboards.
3.1.2. To determine whether Contractor met any or all the Performance Incentives Standards when
working with Medicaid populations within Contractor's County, the Department may utilize
data from the Colorado interChange system.
3.1.3. The list of systems in Sections 3.1.1. and 3.1.2. is not all-inclusive, and the Department will,
at its discretion, utilize additional data and reports from the COGNOS/DSS01, interChange,
and/or other systems to determine whether Contractor met any or all the Performance
Incentives Standards.
3.1.4. The date the data or reports will be pulled from the COGNOS/DSS01, interChange, and/or
other systems published on the MAP Dashboard will be defined in each applicable
Performance Incentive Standard and/or the PuMP template for those performance measures.
3.1.5. Contractor shall utilize policy, operational, and informational guidance provided in this
Statement of Work, the County Incentives Program Guide, and through the HCPF Memo
Series for each Performance Incentives Standard to assist with implementing the Performance
Incentives Standard and pulling applicable data and reports to determine Contractor's
compliance with any or all the Performance Incentives Standards.
3.1.6. To determine whether Contractor met any or all the Call Center Performance Standards, the
Department will review county Call Center systems data for tracking and reports that track
Contractor's compliance with Customer Service Performance Incentive Standard.
3.2. Communications Utilized to Determine Compliance
3.2.1. Contractor shall utilize and comply with guidance issued through the HCPF Memo Series
and shall fulfill the requirements in the Statement of Work, thereby enabling Contractor to
earn a Performance Incentive Payment.
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3.2.2. Contractor shall utilize the HCPF Memo Series to find any forms, templates, program
contacts, or additional information needed to operationalize the Performance Incentives
Standard Program referenced throughout this Contract.
3.2.3. If additional guidance or contract clarification is needed, the Department may release
additional guidance to Contractor through the HCPF Memo Series.
3.2.4. The Department reserves the right to request written documentation from Contractor
including, but not limited to, the following:
3.2.4.1. Any and all documentation generated by various software and/or systems.
3.2.4.2. Written policies and procedures.
3.2.4.3. Standard operating procedures.
3.2.4.4. Internal directives and/or communications to staff related to processing or performance
guidelines
3.2.4.5. If the Department requests any documentation outlined in Section 3.2.4, Contractor shall
respond within five Business Days commencing the day following the issuance date of
the request. If, for reasons outside of Contractor's control, Contractor is unable to respond
within the five Business Days, Contractor will notify the Department immediately and
request an extension. The request for an extension must be received by the Department
within the five -calendar day timeframe as outlined above. Contractor must provide a
reason for the extension. If the request for the delay is not received within the five -
calendar day timeline, the request will be denied.
3.2.4.6. The Department reserves the right to extend the deadline or to deny the request for an
extension.
4. MEDICAID COUNTY PERFORMANCE STANDARDS PROGRAM
4.1. In State Fiscal Year (SFY) 2025-2026, the Medicaid County Performance Standards Program
shall be divided into three incentive categories: the Performance Compliance Performance
Incentive Standard, the Customer Service Performance Incentive Standard, and the County
Collaboration Incentive Standard.
4.2. Each of these standards is assigned a specific percentage, which collectively represent 100% of
the total Eligible Earnings available to each Contractor under the Program.
4.3. The following sections provide a detailed breakdown of the percentage weight assigned to each
standard, as well as the associated performance targets and deliverables required to achieve the
corresponding portion of the Eligible Earnings:
4.3.1. Performance Compliance Performance Incentives Standard
4.3.1.1.
4.3.1.2.
4.3.1.2.1.
Contractor has the ability to earn Performance Compliance Performance Incentive
Standard Payments to reimburse a portion of cost sharing as described in Section 2,
County Determinations, by meeting targets, and/or deliverables as outlined in each
Performance Compliance Performance Incentive Standard.
Performance Compliance Performance Incentive Standard
Contractor shall be eligible to earn the Performance Compliance Performance
Incentive Payment upon meeting the Performance Compliance and Accuracy targets
at the conclusion of the First and Second Reporting Periods.
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4.3.1.2.2. Contractor may earn a Performance Compliance Performance Incentive Payment in
Reporting Period when Contractor meets at least four out of six following Targets:
4.3.1.2.2.1. Application Timeliness of Determinations: 45 Calendar Days
4.3.1.2.2.2. Application Timeliness of Determinations: 90 Calendar Days
4.3.1.2.2.3. Pending Exceeding Processing Guidelines (EPG): 45 Determinations
4.3.1.2.2.4. Pending Exceeding Processing Guidelines (EPG): 90 Determinations
4.3.1.2.2.5. Renewal Timeliness: NON-LTSS (Non -Long -Term Service and Support)
4.3.1.2.2.6. Pending Exceeding Processing Guidelines (EPG): Renewals NON-LTSS
4.3.1.2.3. Contractor may earn a Performance Compliance Performance Incentive Payment in
Reporting Period 2 when Contractor meets six out of the eight of the following
Targets:
4.3.1.2.3.1. Application Timeliness of Determinations: 45 Calendar Days
4.3.1.2.3.2. Application Timeliness of Determinations: 90 Calendar Days
4.3.1.2.3.3. Pending Exceeding Processing Guidelines (EPG): 45 Determinations
4.3.1.2.3.4. Pending Exceeding Processing Guidelines (EPG): 90 Determinations
4.3.1.2.3.5. Renewal Timeliness: NON-LTSS
4.3.1.2.3.6. Pending Exceeding Processing Guidelines (EPG): Renewals NON-LTSS
4.3.1.2.3.7. Incorrect Eligibility Determination Rate
4.3.1.2.3.8. Errors That Did Not Impact Eligibility Rate
4.3.1.3. Department Monitoring of MAP Dashboards
4.3.1.3.1. The Department updates the MAP Dashboards monthly, which are accessible to
Contractor through the MAP Dashboard Tableau site, MAP Tableau.
4.3.1.3.2. If the Department determines that Contractor has not met specific performance
targets, a Management Decision Letter (MDL) will be issued. The MDL will require
Contractor to create an Improvement Action Plan (IAP) or Corrective Action Plan
(CAP) that will be monitored by the Department to ensure Contractor's performance
is improved.
4.3.1.3.3. Contractor shall refer to I-ICPF OM 21-078 for guidance on MDLs, IAPs and CAPs,
or whichever later Operational Memo supersedes HCPF OM 21-078.
4.3.1.4. Contractor Monitoring of MAP Dashboards
4.3.1.4.1. Contractor shall monitor the monthly published MAP Dashboards to ensure targets
are met. The Department will utilize the MAP Applications Dashboard to determine
compliance with timeliness targets.
4.3.1.4.2. The MAP Applications Dashboard data will be updated on the 3rd of each month and
after the end of the First and Second Reporting Periods to determine Contractor's
performance over the entire six-month Reporting Period.
4.3.1.4.3. Contractor shall designate Contractor staff to be MAP Dashboard performance
owners. Performance owners will have access to the MAP Dashboards and follow the
Standard Operating Procedure (SOP) or HCPF Memo Series guidance. Contractor
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shall use the MAP Dashboard to ensure performance targets are met and to take the
necessary action(s) to mitigate ongoing errors when necessary.
4.3.1.4.4. Contractor shall review and investigate the root causes for not achieving the
performance target(s) and, if issued an MDL, shall submit the requested IAP or CAP
by the required due date listed on the MDL.
4.3.1.5. Determining Compliance with Performance Compliance Performance Incentives
Standard
4.3.1.5.1.
4.3.1.5.1.1.
4.3.1.5.1.1.1.
4.3.1.5.1.1.2.
4.3.1.5.1.2.
4.3.1.5.1.2.1.
4.3.1.5.1.2.2.
4.3.1.5.2.
4.3.1.5.2.1.
4.3.1.5.2.2.
4.3.1.5.2.3.
4.3.1.5.2.4.
4.3.1.5.3.
4.3.1.5.3.1.
Timeliness of Determinations
Application Timeliness of Determinations, 45 Calendar Days
Contractor shall complete at least 95% of Application Timeliness of
Determinations 45 Calendar Days, as Timely Determinations.
The Department will total all Timely Determinations Contractor completed
within the First and Second Reporting Periods and divide that by the total
number of Determinations Contractor completed during each Reporting
Period to determine the timeliness percent for status reports one and two. The
Department will round these calculated percentages to two decimal places.
Application Timeliness of Determinations, 90 Calendar Days
Contractor shall Complete at least 95% of all Application Timeliness of
Determinations 90 Calendar Days as Timely Determinations.
The Department will total all Timely Determinations for Application
Timeliness of Determinations 90 Calendar Days, Contractor completed within
the First and Second Reporting Periods and divide that by the total number of
Application Timeliness of Determinations, 90 Calendar Days completed
during each Reporting Period to determine timeliness percent for status
reports one and two. The Department will round these calculated percentages
to two decimal places.
Timeliness of Renewals
Contractor shall complete at least 95% of Renewals Non-LTSS as Timely
Renewals as defined in Section 1.1.38.
The Department will total all Timely Non-LTSS Renewals Contractor completed
within the First and Second Reporting Periods and divide that by the total number
of Determinations Contractor completed during each Reporting Period to
determine the timeliness percent for status report one and two. The Department
will round these calculated percentages to two decimal places.
The Department will utilize the MAP Renewals Dashboards to determine
compliance with timeliness targets.
The MAP Renewals Dashboards data will be pulled on the 3rd of each month and
after the First and Second Reporting Periods to determine Contractor's
performance over the entire six-month Reporting Period.
Pending Exceeding Processing Guidelines (EPG) Determinations and Renewals
Contractor's pending EPG Determinations and EPG Renewal average will be
calculated by taking the total number of Pending EPG Determinations and EPG
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Renewals for the First and Second Reporting Periods and dividing that total by
the number of months in the Reporting Period. Renewal EPG targets will be
applicable for the Second Reporting Period. Contractor must be at or below the
targets specified below:
4.3.1.5.3.1.1. Contractor Targets Pending EPG Table
County Size
App EPG 45 Target
Large
≤ 25
Medium
≤ 5
Small
≤ 3
County Size
App EPG 90 Target
Large
≤ 10
Medium
<3
Small
≤ 1
County Size
Renewal EPG Non-LTSS Target
Large
< 130
Medium
≤ 20
Small
≤ 3
4.3.1.5.3.1.2.
4.3.1.5.3.1.3.
4.3.1.5.3.1.4.
4.3.1.5.4.
4.3.1.5.4.1.
4.3.1.5.4.2.
To determine the Pending EPG Determinations and EPG Renewal average,
the Department will total the Pending EPG Determinations and EPG
Renewals for the First and Second Reporting Periods and divide by the
number of months in the Reporting Period.
The MAP Dashboard will be used to determine Contractor's amount of
Pending EPG 45, EPG 90, and EPG Renewal Non-LTSS for the First
Reporting Period. The MAP Dashboard will be used to determine Contractor's
amount of Pending EPG 45, EPG 90, and EPG Renewal Non-LTSS for the
Second Reporting Period.
The Department will round the Pending EPG 45, EPG 90, and EPG Renewal
Non-LTSS averages to the nearest whole number.
Small County and Sample Size Exceptions
If Contractor processes a total of 100 or fewer 45 -Day Determinations, Contractor
shall be deemed to have met the timeliness percentage target so long as they had
10 or fewer Untimely Determinations during that Reporting Period.
If Contractor processes a total of 10 or fewer 90 -Day Determinations, per
Reporting Period, Contractor shall be deemed to have met the 90 -Day
Determinations percentage target so long as they had four or fewer Untimely
Determinations during that Reporting Period.
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4.3.1.5.4.3.
4.3.1.5.5.
4.3.1.5.5.1.
There are no Small County or Sample Size Exceptions for either Pending EPG
45, Pending EPG 90, and EPG Renewal Non-LTSS measures.
Accuracy Compliance and Targets
Accuracy targets are set based on the county size of Contractor. There are two
tiers.
4.3.1.5.5.2. Tier 1 target percentage: Contractors with 20 or more cumulative quality
assurance case reviews conducted over a 12 -month period. This is the target
reported on the MAP Accuracy Dashboard.
4.3.1.5.5.3. Tier 2 target percentage: Contractors with fewer than 20 cumulative quality
assurance case reviews conducted over a 12 -month period. This is not reported on
the MAP Accuracy Dashboard and used for County Incentives purposes only.
4.3.1.5.5.4. Based on EQA sampling, large Contractors will exceed 20 cumulative quality
assurance reviews over the 12 -month period, resulting in no Tier 2 target for large
counties.
4.3.1.5.5.5. The Inaccurate Eligibility Determination Rate target is used to determine how
many individuals in the sample had an incorrect determination.
4.3.1.5.5.5.1. The Inaccurate Eligibility Determination Rate is calculated as the number of
individuals who were incorrectly approved, denied, or terminated divided by
the total number of individuals in the sample percent, monthly (includes
applications, redeterminations, and case changes).
4.3.1.5.5.5.2. Target Percentages for Incorrect Eligibility Determination Rate
County Size
Tier 1 Target %
Tier 2 Target %
Large
5.5%
N/A
Medium
6.6%
13.2%
Small
7.3%
14.6%
4.3.1.5.5.6. The Errors That Did Not Impact Eligibility target is used to determine how many
individuals in the sample had a correct determination with errors that did not
impact eligibility (procedural errors).
4.3.1.5.5.6.1. The Errors That Did Not Impact Eligibility is calculated as the number of
individuals with error(s) that did not impact eligibility divided by number of
individuals in the sample, monthly (includes applications, changes,
redeterminations).
4.3.1.5.5.6.2. Target Percentages for the Errors That Did Not Impact Eligibility Rate
County Size
Tier 1 Target %
Tier 2 Target %
Large
17.9%
NA
Medium
20.9%
23.2%
Small
23.2%
27.2%
4.3.1.5.6. HCPF Eligibility Quality Assurance (EQA) Program and Medical Assistance
Performance (MAP) Accuracy Dashboard.
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Exhibit A, Statement of Work
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4.3.1.5.6.1.
4.3.1.5.6.1.1.1.
4.3.1.5.6.1.1.2.
4.3.1.5.6.1.1.3.
4.3.1.5.6.1.1.4.
4.3.1.5.6.1.1.5.
4.3.1.5.7.
4.3.1.5.7.1.
4.3.1.5.7.2.
Contractor shall comply with the HCPF Eligibility Quality Assurance Program,
per 10 CCR 2505-5 1.020.10.2 and HCPF Operational Memo (OM) 21-057, or
whichever later Operational Memo supersedes OM 21-057, which specifies
Contractor's role in the state quality assurance (QA) case review process.
The EQA case review process is to monitor the accuracy and quality of
eligibility determinations for Medical Assistance made by Contractor, and
EQA case reviews occur monthly.
Contractor must respond to documentation requests and error findings
within 10 Business Days of the request to ensure EQA case reviews are
completed in a timely manner.
Contractor must respond to the Department's EQA case review error
findings by using one of two options: 1) Agree/Concur or 2)
Disagree/Rebut within 10 Business Days.
If additional or revised guidance relative to the HCPF EQA process is
issued through the HCPF Memo Series, Contractor shall disregard the
previous guidance and comply with the new guidance offered through the
HCPF Memo Series.
The Department will utilize the Medical Assistance Performance (MAP)
Accuracy Dashboard to publish the results of the quality assurance case
review findings each month, send the results to the County Directors, and
may be sent to the Board of County Commissioners, at the Department's
discretion.
Determining Compliance with the Accuracy portion of the Performance Compliance
Performance Incentives Standards
The MAP Accuracy Dashboard will be available monthly to Contractor to
determine Contractor's performance over the State Fiscal Year (SFY). To
determine compliance with the Accuracy Performance Incentive, the Department
will utilize the most recent 12 consecutive months of cumulative MAP Accuracy
Dashboard data, to determine whether Contractor met or exceeded the specified
Accuracy target. The 12 consecutive months of MAP Accuracy data may extend
outside of the timeframe of this amendment.
The Department will use Contractor's final actual performance on the MAP
Accuracy Dashboard in comparison to Contractor's Accuracy targets at the end
of the SFY to determine if Contractor's actual performance has met and/or
exceeded the Accuracy targets to earn an Accuracy Performance Incentive
Payment. The percentage calculation has one decimal place and will not be
rounded.
4.3.1.6. Review Sample Size Exemptions
4.3.1.6.1.1. If Contractor has a review sample size, as defined in Section 4.3.1.6.1.2.,
performed by HCPF EQA, Contractor maybe eligible for the Review Sample Size
Exemption.
4.3.1.6.1.2. Definition of Review Sample Size
Agreement Number: 26-198149
Page 10 of 26 Exhibit A, Statement of Work
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
4.3.1.6.1.2.1.
4.3.1.6.1.3.
4.3.1.6.1.3.1.
4.3.1.6.1.3.1.1.
4.3.1.6.1.3.1.2.
4.3.1.6.1.3.2.
4.3.1.6.1.3.2.1.
4.3.1.6.1.3.3.
4.3.1.6.1.3.3.1.
4.3.1.6.1.3.3.2.
4.3.1.6.1.3.3.3.
4.3.1.6.1.3.4.
4.3.1.6.1.3.4.1.
4.3.1.6.1.3.4.2.
4.3.1.6.1.3.4.3.
Contractor with 20 or fewer quality assurance case reviews in the 12
consecutive months of MAP Accuracy data would qualify for a Review
Sample Size Exemption. Contractor with a review sample size that does not
meet one, or both, of the Accuracy Incentive targets as defined in Section
4.3.1.5.5. may be eligible for the Review Sample Size Exemption: (i)
Inaccurate Eligibility Rate and/or, (ii) Errors That Did Not Impact Eligibility.
Determining Targets Percentage for Potential Review Sample Size Exemptions
The Department will have two separate tiers with different target percentages
for the Accuracy Targets:
Tier 1 target percentage: Contractor with 20 or more quality assurance
case reviews completed with the most recent 12 consecutive months of
cumulative MAP Accuracy Dashboard.
Tier 2 target percentage: Contractor with fewer than 20 quality assurance
case reviews completed with the most recent 12 consecutive months of
cumulative MAP Accuracy Dashboard.
Review Sample Size Exemption Process
The Department will follow Exhibit D, Review Sample Size Exemption
Process Flow.
Definition of Similar Error(s)
The MAP Accuracy Dashboard identifies the accuracy rates for each
Contractor; HCPF EQA provides Contractor with those errors caused by
Contractor that impact accuracy rates. This allows Contractor to address
the root cause of errors to prevent similar errors going forward. If errors
are not addressed by Contractor and the same errors repeat in future
months, the errors will be considered Similar Errors.
If Contractor meets only one target with less than 20 reviews within the
most recent 12 consecutive months of cumulative MAP Accuracy
Dashboard, the Review Sample Size Exemption Process will be applied
only to the one target not met by Contractor.
Contractor that does not meet both targets with less than 20 reviews within
the most recent 12 consecutive months of cumulative MAP Accuracy
Dashboard, exemption will be applied to both targets.
Notification of Review Sample Size Exemption
If Contractor does not meet the Accuracy Incentive Targets per Sections
4.3.1.5.5.5.2. and 4.3.1.5.5.6.2., Contractor will be notified through the
Status Report of the Second Reporting Period.
Contractor that does not meet the Accuracy Incentive Targets but qualifies
for the exemption process per Section 4.3.1.6., Contractor will be notified
through the Status Report of the Second Reporting Period.
If Contractor qualifies for the Review Sample Size Exemption Process,
the Department will review previously submitted documentation from
Agreement Number: 26-198149
Page 11 of 26 Exhibit A, Statement of Work
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
Contractor based on their MAP Accuracy Dashboard and may request
additional documentation as specified in Section 4.3.1.6.1.3.2.
4.3.1.6.1.3.4.4. Contractor shall submit any additional documentation requested for the
exemption process, using the MAP exemption process, following Status
Report Period 2. Review Sample Size Exemption Process and Accuracy
Performance Incentive Payment.
4.3.1.6.1.3.4.5. TARGET: four out of the following six targets are met for Reporting
Period 1.
4.3.1.6.1.3.4.5.1. > 95% timeliness average over the First Reporting Period for
Application Timeliness of Determinations, 45 Days.
4.3.1.6.1.3.4.5.2. > 95% timeliness average over the First Reporting Period for
Application Timeliness of Determinations, 90 Days.
4.3.1.6.1.3.4.5.3. < Pending EPG 45 determinations must average at or below the target
level during Reporting Period 1, taking into account the size of the
County.
4.3.1.6.1.3.4.5.4. Applications 45 Days
County Size
App EPG 45 Target
Large
< 25
Medium
< 5
Small
<3
4.3.1.6.1.3.4.5.5. < Pending EPG 90 determinations must average at or below the target
level during Reporting Period 1, taking into account the size of the
County.
4.3.1.6.1.3.4.5.6. Applications 90 days
County Size
App EPG 90 Target
Large
< 10
Medium
< 3
Small
< 1
4.3.1.6.1.3.4.5.7.
4.3.1.6.1.3.4.6.
4.3.1.6.1.3.4.6.1.
Renewals Non-LTSS
County Size
Renewal EPG Non-LTSS Target
Large
< 130
Medium
< 20
Small
<3
TARGET: six out of the following eight targets are met in the Second
Reporting Period:
> 95% timeliness average over the Second Reporting Period for
Application Timeliness of Determinations, 45 Days.
Agreement Number: 26-198149
Page 12 of 26 Exhibit A, Statement of Work
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
4.3.1.6.1.3.4.6.2. > 95% timeliness average over the Second Reporting Period for
Application Timeliness of Determinations, 90 Days.
4.3.1.6.1.3.4.6.3. > 95% timeliness average over the Second Reporting Period for
Renewal Non-LTSS Timeliness.
4.3.1.6.1.3.4.6.4. < Pending EPG 45 determinations must average at or below the target
level during Reporting Period 2, taking into account the size of the
County.
4.3.1.6.1.3.4.6.5. Applications 45 Days
County Size
App EPG 45 Target
Large
< 25
Medium
< 5
Small
< 3
4.3.1.6.1.3.4.6.6. < Pending EPG 90 determinations must average at or below the target
level during Reporting Period 2, taking into account the size of the
County.
4.3.1.6.1.3.4.6.7. Applications 90 Days
County Size
App EPG 90 Target
Large
< 10
Medium
<3
Small
< 1
4.3.1.6.1.3.4.6.8.
Pending EPG Renewal Non-LTSS must average at or below the
target level during Reporting Period 2, taking into account the size of
Contractor.
4.3.1.6.1.3.4.6.9. Renewals Non-LTSS
County Size
Renewal EPG Non-LTSS Target
Large
< 130
Medium
< 20
Small
< 3
4.3.1.6.1.3.4.6.10. Accuracy Target Percentages for Incorrect Eligibility Determination
Rate
County Size
Tier 1 Target %
Tier 2 Target %
Large
5.5%
N/A
Medium
6.6%
13.2%
Small
7.3%
14.6%
4.3.1.6.1.3.4.6.11. Accuracy Target Percentages for the Errors That Did Not Impact
Eligibility Rate
Agreement Number: 26-198149
Page 13 of 26
Exhibit A, Statement of Work
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
County Size
Tier 1 Target %
Tier 2 Target %
Large
5.5%
N/A
Medium
6.6%
13.2%
Small
7.3%
14.6%
4.3.1.6.1.3.4.6.12.
4.3.1.6.1.3.4.6.13.
4.3.1.6.1.3.4.6.14.
4.3.1.6.2.
4.3.2.
4.3.2.1.
4.3.2.1.1.
4.3.2.1.1.1.
4.3.2.1.2.
4.3.2.1.2.1.
4.3.2.1.2.2.
4.3.2.1.2.3.
4.3.2.1.3.
4.3.2.1.3.1.
Exemptions for Unusual Circumstances
Contractor may request an exemption for unusual circumstances for
failure to meet the Timeliness of Determinations and Renewal targets
and/or failure to meet Pending EPG Determinations and Renewal
targets as described in Section 4.3.1.2.2.
The exemption process for unusual circumstances is described in
Section 6.1.3.
To earn the full Performance Compliance Performance Incentive Standard Payment,
Contractor must meet the targets outlined in both Status Report 1 and Status Report 2
for FY 25-26. Each Status Report achieved will contribute 50% toward the total
earnings. If only one Status Report is met, partial earnings will be distributed
accordingly. Additionally, the Performance Compliance Performance Incentive
Standard Payment will constitute 50% of the total amount available for this Contract
Customer Service Performance Incentive Standard
Contractor may earn one Customer Service Performance Incentive Payment at the end of
the Second Reporting Period in which Contractor meets the target and submits the
required deliverable(s) as outlined for each Contractor Customer Service Tier relating to
improving customer service. These targets demonstrate that Contractor is actively
implementing Rule 10 CCR 2505-5 1.020.3.4, which requires the County Director to have
a documented policy/process outlining the administrative internal controls that ensure
Contractor provides timely, respectful, and culturally appropriate customer service to
Medical Assistance applicants and Members.
Contractor Customer Service Tier
The Department assigned Contractor to a Customer Service Tier during Fiscal
Year 2024-25. The Customer Service Tier determines which customer service
metrics, Targets, and deliverables Contractor must meet and/or submit to earn a
Customer Service Performance Incentive Payment.
Customer Service Tier Reclassification
The Department may, in consultation with Contractor, amend its initial
classification and reclassify Contractor to a different Customer Service Tier.
Any reclassification approved by the Department, in consultation with Contractor,
shall take effect the following Reporting Period.
Contractor reclassifications from Tier 2 to Tier 1 are allowable.
Customer Service Tier 1
If Contractor is assigned to the Customer Service Tier 1 category, the Department
will classify Contractor as Tier 1 to determine what Contractor's required targets
and deliverables are.
Agreement Number: 26-198149
Page 14 of 26 Exhibit A, Statement of Work
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
4.3.2.1.3.2. If Contractor is classified as Tier 1, Contractor is understood to have an active
Call Center operation, which can be as small as one Contractor staff or as large as
100 or more Contractor staff members answering calls, with a dedicated line
which has the technology in place to provide data, at a minimum, on the number
of calls received, the average wait time, and the number of abandoned calls.
4.3.2.1.3.3. If Contractor is classified as Tier 1, Contractor shall complete each of the
following targets and deliverables to earn a Customer Service Performance
Incentive Payment:
4.3.2.1.3.3.1. Submit to the Department monthly Call Center reporting from Contractor's
available data that complies with the Call Center data reporting requirements
determined by the Department.
4.3.2.1.3.3.1.1. Monthly reporting will be due on the 7th of each month and sent
electronically to the County Relations webform:
(http s : //hcpfdev. secure. force. com/HCPFCountyRelations).
4.3.2.1.3.3.1.2. Data elements required to be submitted by Contractor shall be issued via
HCPF Memo Series.
4.3.2.1.3.3.1.2.1. DELIVERABLE: Monthly Call Center Report
4.3.2.1.3.3.1.2.2. DUE: The 7th of each month after the month being reported
4.3.2.1.3.3.2. Meet and/or exceed a service -level performance target for Contractor's Call
Center Average Speed to Answer (ASA) by the Second Semi -Annual Due
Date, June 7th of each SFY.
4.3.2.1.3.3.3. The service -level performance targets for Contractor's Average Speed to
Answer shall be jointly determined by the Department and Contractor at the
beginning of each State Fiscal Year. This joint determination will take place
during the first Technical Assistance Session, scheduled for the first quarter
of each SFY, as mandated for that SFY. The ASA performance targets shall
be calculated as an average over either the six-month period from January to
June of each SFY or the 12 -month period from July to June of each SFY. The
finalized targets will be communicated through the HCPF Memo Series.
4.3.2.1.3.3.4. Attend a minimum of two, half-hour Technical Assistance Sessions (for
learning and support) with the Department's MCC Operations staff before
June 12th of each SFY.
4.3.2.1.3.3.4.1. At a minimum, one Technical Assistance Session will occur during each
of the reporting periods.
4.3.2.1.3.3.4.2. Contractor may request additional support, beyond the required sessions
detailed in Section 4.3.2.1.3.3.4., from the MCC Operations staff to
improve Contractor's ASA performance by submitting the County
Relations webform.
The Department may require additional technical assistance in addition to
the two required Technical Assistance Sessions if Contractor's data
indicates additional support is necessary to meet the ASA targets.
DELIVERABLE: Two Technical Assistance Sessions
4.3.2.1.3.3.4.3.
4.3.2.1.3.3.4.3.1.
Agreement Number: 26-198149
Page 15 of 26 Exhibit A, Statement of Work
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
4.3.2.1.3.3.4.3.2.
4.3.2.1.3.4.
4.3.2.1.4.
4.3.2.1.4.1.
4.3.2.1.4.2.
4.3.2.1.4.3.
4.3.2.1.4.3.1.
4.3.2.1.4.3.1.1.
4.3.2.1.4.3.1.2.
4.3.2.1.4.3.1.3.
DUE: Before June 12th of each SFY.
Contractor assigned to Customer Service Tier 1 must comply with the provisions
in Section 4.3.2.1.3.3.3. to earn a Customer Service Performance Incentive
Payment.
Customer Service Tier 2
If Contractor is assigned to the Customer Service Tier 2 category, the Department
will determine what Contractor's required metrics, targets, and deliverables are.
If Contractor is classified as Tier 2, Contractor is understood to be small enough
in operations and workload where a Call Center is cost -prohibitive or not
supportable under existing funding or staffing allocations.
If Contractor is classified as Tier 2, Contractor shall complete each of the
following targets and deliverables to earn a Customer Service Performance
Incentive Payment:
Implement the Customer Service Survey Outreach Plan submitted by June 30th
of each SFY and submit a report by June 30th of each SFY updating the
Department on the implementation of the Customer Service Survey Outreach
Plan.
If Contractor classified as Tier 2 did not submit a Customer Service
Survey Outreach Plan in SFY 2022-23, SFY 2023-24 or SFY 2024-25,
Contractor is required to submit a Customer Service Survey Outreach Plan
in SFY 2025-26 and to meet all other Tier 2 targets and deliverables to
earn the Customer Service Incentive.
The Customer Service Survey will be managed by the Department.
Contractor is not required to take any action regarding the administration
or implementation of this survey. The Customer Service Survey will be
distributed by the Department to all Members who have a name and email
address submitted and who have opted in to receive communications from
the Department. The survey distribution will occur on a quarterly basis
each calendar year.
Contractor's baseline for Member satisfaction was established at the end
of Fiscal Year 2023-24. This baseline will serve as the reference point for
calculating the percentage increase or decrease in Member satisfaction for
each survey question. Contractor is required to meet the performance
targets issued through the HCPF Memo Series. These targets will outline
the expected levels of Member satisfaction based on the established
baseline.
4.3.2.1.4.3.1.4. The Customer Service Survey Outreach Plan will include Contractor's
methodologies and strategies for increasing applicant and Member
participation in the Department's Customer Service Survey in the
following contract cycle. Requirements of the Customer Service Outreach
Plan must include all elements listed on the corresponding HCPF
Operational Memo.
4.3.2.1.4.3.1.4.1. DELIVERABLE: Customer Service Survey Outreach Plan
Agreement Number: 26-198149
Page 16 of 26 Exhibit A, Statement of Work
Docusign Envelope ID: 297609C1-1A56-45F1-9CB2-3F9E7106C620
4.3.2.1.4.3.1.4.2.
4.3.2.1.4.3.1.4.3.
4.3.2.1.4.3.1.4.4.
4.3.2.1.4.3.2.
DUE: By June 30th of each SFY
DELIVERABLE: Customer Service Survey Outreach Report
DUE: By June 30th of each SFY
Customer Service Performance Incentive Standard Exemptions for Unusual
Circumstances
4.3.2.1.4.3.2.1. Contractor may request an exemption for unusual circumstances for
failure to meet the service -level performance targets as detailed in Section
4.3.2.1.3.3.3., if Contractor was classified by the Department as Customer
Service Tier 1.
4.3.2.1.4.3.2.1.1. No exemptions for unusual circumstances are allowed for deliverables
for each Tier for Contractors classified as Customer Service Tier 1 or
Tier 2. Deliverables include any required plans, reports, data, and
technical assistance.
4.3.2.1.4.3.2.1.2. The exemption process for unusual circumstances is described in
Section 6, Exemptions. Only Contractor exemption requests that
follow the process and meet the requirements as outlined in Section 6
will be considered by the Department.
4.3.2.2. Performance Target:
4.3.2.2.1. Tier 1: Contractor's predetermined, individualized Average Speed to Answer (ASA)
target is set forth in the HCPF Memo Series, which Contractor shall maintain an
average (ASA) at or below for the Reporting Period. Additionally, each Contractor's
individualized ASA target shall not exceed 15 minutes.
4.3.2.2.1.1. The Department may utilize, at its discretion, Contractor's data from the
Reporting Period that best supports Contractor's performance.
4.3.2.2.1.2. Contractor is required to complete all necessary participation in Technical
Assistance Sessions with the MCC as scheduled. Contractor must submit Call
Center reporting data in accordance with the specifications outlined in Section
4.3.2.1.3.3.1.1. of this Contract. Additionally, the Customer Services Incentive
Payment will constitute 30% of the total amount available for this Contract.
4.3.2.2.2. Tier 2: Contractor shall submit a report detailing the implementation of each
Customer Service Plan. The report template will be provided by the Department.
Additionally, Contractor will be required to submit a report that will include data on
the process and/or procedures used by Contractor to address Member calls.
4.3.2.2.2.1. Expectations for completing this report will be provided in the HCPF Memo
Series.
4.3.2.2.2.1.1. DELIVERABLE: Customer Service Plan Report
4.3.2.2.2.1.2. DUE: June 30th of each SFY
4.3.2.2.2.2. Contractor is expected to achieve one of the following targets over the SFY:
4.3.2.2.2.2.1. Submit a Customer Service Tier 2 Inbound/Outbound Call Survey by June 5th
of each SFY and maintain an average of 90% or higher in both percentage of
Members who felt like they were treated with respect, and percentage of
Agreement Number: 26-198149
Page 17 of 26 Exhibit A, Statement of Work
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
4.3.2.2.2.2.1.1.
4.3.2.2.2.2.1.2.
4.3.2.2.2.3.
4.3.2.2.2.4.
Members who felt they received services in a timely manner as well as an
average overall satisfaction score of 3.50 or higher.
DELIVERABLE: Customer Service Tier 2 Inbound/Outbound Call
Survey
DUE: By June 5th of each SFY
If Contractor does not meet the requirements set above, Contractor can increase
their percentage of Members who felt like they were treated with respect, and/or,
increase their percentage of Members who felt they received services in a timely
manner, and/or increase the overall satisfaction score for the site by 3% compared
to their baseline by May 31st of each SFY. If Contractor does not meet the
requirements set above, the Department will determine if Contractor meets an
exception based on county/caseload size fluctuations as a result of the Public
Health Emergency unwind.
If Contractor did not submit a Customer Service Outreach Plan or Customer
Service Improvement Plan (CSIP) in Fiscal Year 2022-23 or FY 2023-24,
Contractor is required to submit such a plan in Fiscal Year 2025-26 to qualify for
the Customer Service Incentive. This requirement is in addition to meeting all
other Tier 2 targets and deliverables. Additionally, the Customer Services
Incentive Payment will constitute 30% of the total amount available for this
Contract.
4.3.2.2.2.4.1. DELIVERABLE: Customer Service Outreach Plan or Customer Service
Improvement Plan (If required as described in Section 4.3.2.2.2.4.)
4.3.2.2.2.4.2. DUE: June 30th of each SFY
4.3.3. County Collaboration Incentive Standard
4.3.3.1. Contractor has the ability to earn County Collaboration Incentive Standard Payments to
reimburse a portion of cost sharing as described in Section 2, County Determinations, by
meeting targets, and/or deliverables as outlined in the County Collaboration Incentive
Standard.
4.3.3.2. County Collaboration Incentive
4.3.3.2.1. Contractor shall be eligible to earn the County Collaboration Incentive Standard
Payment upon the successful submission of the two County Collaboration Incentive
Standard Deliverables involving Nursing Facilities (NFs) and Case Management
Agency(ies) during Reporting Period 2. To qualify for the full County Collaboration
Incentive Standard Payment, Contractor must meet all deliverable requirements as
outlined below.
4.3.3.2.2. To earn the County Collaboration Incentive Payment in Reporting Period 2,
Contractor must:
4.3.3.2.2.1.
Establish collaboration with Nursing Facilities (NFs) and Case Management
Agency(ies) based on the requirements outlined in Rule 1.020.11 County
Department Collaboration with External Entities to Facilitate Eligibility and
Enrollment.
Agreement Number: 26-198149
Page 18 of 26 Exhibit A, Statement of Work
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
4.3.3.2.2.2.
4.3.3.2.2.2.1.
4.3.3.2.2.2.1.1.
4.3.3.2.2.2.1.2.
4.3.3.2.2.2.1.3.
4.3.3.2.2.2.1.4.
4.3.3.2.2.2.1.4.1.
4.3.3.2.2.2.1.4.2.
4.3.3.2.2.2.2.
4.3.3.2.2.2.2.1.
4.3.3.2.2.2.2.2.
4.3.3.2.2.2.2.3.
4.3.3.2.2.2.2.4.
4.3.3.2.2.2.2.4.1.
4.3.3.2.2.2.2.4.2.
4.3.3.2.2.3.
Submit the following two deliverables no later than April 30' 2026. Contractor
will submit these deliverables using the following link: County Collaboration
Incentive Deliverable
Nursing Facilities Deliverable: A minimum of two or more meetings shall be
held with one or more relevant agencies. These meetings shall include, at a
minimum, discussion and documentation of the following information:
A meeting agenda outlining the topics discussed.
A list of attendees, including the name of each individual and the agency
or county they represent, must be provided.
One county may submit this deliverable on behalf of other counties that
attended the meeting. However, all represented counties must be clearly
identified in the list of attendees.
If Contractor does not have any Nursing Facilities (NFs) within the
boundaries of their county, Contractor is exempt from implementing this
deliverable related to Nursing Facilities.
DELIVERABLE: Two or More Nursing Facilities Meetings with One
or More Relevant Agencies
DUE: No later than April 30, 2026
Case Management Agencies Deliverable: A minimum of two or more
meetings shall be held with one or more relevant agencies. These meetings
shall include, at a minimum, discussion and documentation of the following
information:
A meeting agenda outlining the topics discussed
A list of attendees, including the name of each individual and the agency
or county they represent, must be provided.
One county may submit this deliverable on behalf of other counties that
attended the meeting. However, all represented counties must be clearly
identified in the list of attendees.
Contractors acting as Case Management Agencies must submit an internal
control procedure to substitute for this deliverable requirement.
DELIVERABLE: Two or More Case Management Agency Meetings
with One or More Relevant Agencies
DUE: No later than April 30, 2026
To receive the full County Collaboration Incentive Standard Payment, Contractor
must successfully submit both County Incentive deliverables as outlined in
Sections 4.3.3.2.2.2.1. and 4.3.3.2.2.2.2. above. The completion of both
deliverables will contribute 100% toward the total County Collaboration
Incentive Standard Payment. If only one deliverable is submitted, it will
contribute 50% toward the total payment. The County Collaboration Incentive
Standard Payment will represent 20% of the total funds available under this
Contract.
5. SEMI-ANNUAL REPORTING
Agreement Number 26-198149
Page 19 of 26 Exhibit A, Statement of Work
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
5.1. Contractor shall submit documentation to the Department to verify Contractor's compliance with
each Medicaid County Performance Standards Program and will submit such documentation on
a semi-annual basis as required. Contractor must submit documentation to the County Relations
webform (https://hcpfdev.secure.force.com/HCPFCountyRelations) or email
HCPF_CountyRelations@state.co.us, unless otherwise specified through the HCPF Memo
Series.
5.2. For the Second Reporting Period, Contractor shall submit the following documentation:
5.2.1. Any Accuracy Sample Size Exemption Process documentation for the SFY if Contractor
failed to meet specified target(s). Contractor shall only submit documentation upon the
Department's request after the release of the Report Period 2 Status Report.
5.2.2. Any Customer Service Improvement Plan, Customer Service Outreach Plan, reports or other
documents listed as deliverables under this agreement or specified through the HCPF Memo
Series. A due date for any plans not submitted in FY 2025-26 will be provided in HCPF
Memo Series.
6. EXEMPTIONS
6.1. Contractor may request an exemption for unusual circumstances pertaining to specific measures
within this Contract by following the procedure outlined in this section.
6.1.1. Following the Department's review of Contractor's request, a partial payment of the
applicable County Incentive may be made at the Department's sole discretion. Such partial
payment shall not be subject to exemption requests or disputes. The Department's decision
on partial payment is final in addition to any County Incentive Payments made based on the
Department's determination.
6.1.2. Definition of Unusual Circumstances
6.1.2.1. Unusual circumstances are defined as uncommon, rare or sudden events such as
ransomware or other types of cybersecurity attacks, natural disasters, etc. The
circumstance must have been out of Contractor's direct control, and directly result in the
failure to act in accordance with or meet the requirements of the specific Medicaid County
Performance Standards Program.
6.1.2.1.1. Unusual circumstances for which Contractor can request exemption include
circumstances that cause a large, sustained increase in workload.
6.1.2.1.2. Unusual circumstances shall not include situations where Contractor had direct
knowledge of, or control over, the circumstances, including instances where
Contractor's clear and demonstrated failure to act in accordance with, or meet, the
requirements of the specific Medicaid County Performance Standards Program is
evident.
6.1.2.1.3.
The Department's determination of whether Contractor's request for exemption meets
the definition of unusual circumstances is final.
6.1.3. Process for Unusual Circumstances Exemption Requests
6.1.3.1. The process for Contractor to submit an exemption request shall be communicated
through the HCPF Memo Series for each applicable Medicaid County Performance
Standards Program.
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Page 20 of 26 Exhibit A, Statement of Work
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6.1.3.2. Unusual circumstances exemption requests must include thorough supporting
documentation from Contractor clearly outlining what unusual circumstance occurred
and what occurred as a result of the unusual circumstance. Contractor shall be responsible
for timely submission of any additional documentation requested by the Department for
the exemption process determination.
6.1.3.3. General inquiries regarding unusual circumstances exemption requests should be directed
to HCPF_MAPdashboards@state.co.us. To formally submit an exemption request, please
follow the MAP Exemption Request Process available here: Request Exemption
6.1.4. Department Review and Approval of Exemption Requests
6.1.4.1. Based on Contractor's unusual circumstances exemption request and supporting
documentation, the Department will provide Contractor with an approval or denial of the
request on the Final Status Report.
6.1.4.2. If the Department approves Contractor's unusual circumstances exemption request,
Contractor shall receive a partial payment. Such partial payment shall correspond to the
applicable Medicaid County Performance Standards Program for which the exemption
request was approved by the Department.
6.1.4.3. The Department has the sole authority to determine the amount of partial payment, which
is not subject to dispute by Contractor.
6.1.4.4. If partial payment is made based on Contractor's unusual circumstances exemption
request, the Department will provide the actual amount of the partial payment on the Final
Status Report.
6.1.4.5. If the Department denies Contractor's unusual circumstances exemption request, the
applicable County Incentive Payments issued shall be deemed final and shall not be
subject to further dispute or appeal.
6.1.4.6. The Department has the sole discretion to approve or reject any request for unusual
circumstances exceptions and may limit the total number of approved exemptions for all
Medicaid County Performance Standards Program.
6.1.5. Non -Allowable Exemption Reasons
6.1.5.1. The Department will deny unusual circumstances exemption requests that are one or more
of the following:
6.1.5.1.1. Determined to be the fault of Contractor.
6.1.5.1.2. Unusual circumstances that did not exist.
6.1.5.1.3. Any exemption requests based on the following but not limited to the following:
6.1.5.1.3.1. Contractor failed to meet contractually specified requirements relating to the
content of submission of deliverables and the timely submission of deliverables.
6.1.5.1.3.2. Contractor failed to meet the contractually specified requirements related to the
performance targets of an applicable Medicaid County Performance Standards
Program for which an exemption request may be submitted.
6.1.5.1.3.3. Contractor's failure to review and utilize County Administration regulations at 10
CCR 2505-5 1.020 and Medicaid County Performance Standards Program
documentation, including policy, informational, and operational guidance issued
through the HCPF Memo Series, that resulted in Contractor failing to meet
Agreement Number: 26-198149 Page 21 of 26 Exhibit A, Statement of Work
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performance targets and deliverables relating to any Medicaid County
Performance Standards Program.
6.1.5.1.3.4. The Department's final determination regarding Contractor's exemption
request(s) related to the Accuracy Performance Measures under the Performance
Compliance Performance Incentive Standard shall be final.
6.1.5.1.3.5. Contractor's failure to use the MAP Dashboards for the purposes of fulfilling the
purpose of meeting the performance measures outlined in this contract.
6.1.5.1.3.6. Contractor's failure to use EQA case review results for the purposes the purpose
of meeting the performance measures outlined in this contract. The reasons for
denial of an exemption as stated in Section 6 are not all-inclusive and the
Department reserves the right to deny any exemption for reasons not stated in
Section 6.
6.1.5.1.4. Prior to denying an exemption for reasons beyond those stated in Section 6, the
Department may, at its discretion, request further documentation from Contractor to
determine whether the request for exemption meets the exemption standards as stated
in Section 6, Exemptions.
6.1.5.2. Medicaid County Performance Standards Program — Eligibility for Unusual
Circumstances Exemption Requests
6.1.5.2.1. Unusual circumstances exemption requests may be considered for any Medicaid
County Performance Standards Program listed below, subject to the terms and
conditions of this Contract and the applicable guidance issued by the Department.
6.1.5.2.1.1. Performance Compliance Performance Incentive Standard
6.1.5.2.1.2. Customer Service Performance Incentive Standard
6.1.5.2.1.3. County Collaboration Incentive Standard
7. NOTIFICATIONS
7.1. Following each Reporting Period, Contractor shall receive a Status Report from the Department
identifying the applicable County Incentives met, based on the targets or deliverables for that
County Incentive.
7.1.1. Contractor's Reporting Period Status Report shall identify the applicable Medicaid County
Performance Standards Programs that were met and those that were not met during the
relevant Reporting Period. Funding amounts associated with these programs shall not be
disclosed until the conclusion of the SFY.
7.1.2. If Contractor has multiple Reporting Periods within the SFY to meet any County Incentive,
each Reporting Period Status Report shall be evaluated independently. The Final Status
Report shall summarize the estimated final payment and eligible earnings based on
Contractor's performance in meeting the applicable targets or deliverables for each Reporting
Period.
7.1.3. Upon conclusion of the SFY, the Department will issue a Final Status Report to Contractor,
specifying the County Incentives that were met and not met, and detailing the eligible
earnings associated with each incentive earned by Contractor.
7.1.4. The Final Status Report shall be considered final and not subject to dispute. If Contractor
disagreed with the Department's determination of compliance with this Contract for any
Agreement Number: 26-198149
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applicable incentive, such dispute must have been raised in response to the applicable
Reporting Period Status Report.
7.1.5. Each Reporting Period Status Report, as well as the Final Status Report, shall be submitted
by the Department to the County Human/Social Services Director and shall serve as the
official notification of Contractor's compliance with the targets and deliverables outlined in
this Contract for each applicable incentive.
7.1.6. Status Reports for each Reporting Period will be sent within 10 Calendar Days after the Semi -
Annual Reporting due date for each Reporting Period as found in Section 5, Semi -Annual
Reporting. The date on which the Status Report for each Reporting Period is sent to
Contractor will be considered the Status Report Date.
7.1.7. If the Department experiences unusual circumstances resulting in a delay with sending
Contractor's Reporting Period or Final Status Reports, the Department will inform Contractor
of the delay and an anticipated date of resolution during the 10 Calendar Days after the Semi -
Annual Reporting due date for each Reporting Period and provide an updated timeline for
sending Contractor's Reporting Period or Final Status Reports.
7.1.8. ' The Final Status Report will be sent upon the Department's determination of final County
Incentive Payment amounts.
7.1.9. Contractor will have the opportunity to dispute the Status Report results as defined in Section
8.1.
8. DISPUTE RESOLUTION
8.1. Opportunity and Timeframe for Dispute Resolution
8.1.1. In the event Contractor disagrees with the findings of the official notification as found in
Section 7, Notifications, Contractor will have the opportunity to dispute the Reporting Period
Status Report for the Reporting Period in question.
8.1.1.1. The Final Status Report cannot be disputed per Section 7.1.4.
8.1.1.2. Contractor shall have a period of five Calendar Days, commencing the day following the
issuance date of each Reporting Period Status Report, to review the report and raise any
disputes regarding the results.
8.1.1.3. If Contractor fails to dispute the Reporting Period Status Report within five Calendar
Days commencing the day following the issuance date of each Report Period Status
Report, the Status Report results will be deemed final. No further disputes will be
allowed, and compensation will be made per Section 10, Compensation, based on the
results of the non -disputed Status Report.
8.1.2. Allowable Disputes
8.1.2.1. Contractor will be allowed to dispute the results of the Status Report based on the
following reasons:
8.1.2.1.1. If the Department states supporting documentation was omitted in its entirety or if the
Department states the documentation was submitted outside of the time frames
outlined in the Contract and Contractor refutes the claim, Contractor must submit
proof of submission. Contractor must show the documentation was in fact submitted
in a timely manner and in accordance with the contractually required due date.
Agreement Number: 26-198149
Page 23 of 26 Exhibit A, Statement of Work
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8.1.2.1.2. Contractor requests a re -review of Contractor's submitted documentation that was
used to determine compliance with any Medicaid County Performance Standards
Program.
8.1.2.1.3. Contractor has available data, such as systems reports or other tracking
methodologies, that conflict with the Department's available data that will be utilized
to determine compliance with a Medicaid County Performance Standards Program.
8.1.2.1.4. Contractor will be responsible for providing all necessary and relevant data to the
Department for the purposes of determining if Contractor's data in fact conflicts with
the Department's data.
8.1.2.1.5. The Department will make the final determination when a conflict of data occurs and
will make the specific Medicaid County Performance Standards Program Payments
based on its final determination.
8.1.2.1.6. Any and all supporting documentation allowed under this sub -section must be
submitted to the Department within three Calendar Days of said documentation being
determined relevant by the Department. If the documentation is not received by the
Department by the timeframe outlined, it will no longer be considered in the Dispute
Resolution process.
8.1.2.1.7. The Department reserves the right to add additional allowable dispute reasons on a
case -by -case basis based on new and relevant information made available to the
Department from Contractor. The Department's determination of additional
allowable dispute reasons is final and not subject to the Dispute Resolution process
as outlined in Section 8.
8.1.3. Non -Allowable Disputes
8.1.3.1. Contractor will not be allowed to dispute the results of the Status Report based on the
following reasons:
8.1.3.1.1. Contractor failed to meet contractually specified requirements relating to the content
of submission of deliverables and the timely submission of deliverables.
8.1.3.1.2. Contractor failed to meet contractually specified requirements relating to performance
targets of any Medicaid County Performance Standards Program.
8.1.3.1.3. Contractor's failure to review and utilize Medicaid County Performance Standards
Program documentation, including policy, informational, and operational guidance
issued through the Memo Series, that resulted in Contractor failing to meet
performance targets and deliverables relating to any Medicaid County Performance
Standards Program.
8.1.3.2. The Department's final determination of Contractor's exemption request(s) for the
Accuracy Targets within the Performance Compliance Performance Incentive Program.
8.1.3.2.1. The Department reserves the right to deny a Contractor's dispute based on any reason
not included under Section 8.1.3.1. The Department's determination is final and is not
subject to dispute or appeal.
9. DELIVERABLES
9.1. Contractor shall provide the stated deliverables in accordance with the dates stated in the table
below.
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Page 24 of 26 Exhibit A, Statement of Work
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DELIVERABLES
DATE DUE TO THE
DEPARTMENT
Monthly Call Center Report
5th of each month
after the month being reported
Two Technical Assistance Session
Before June 12th of each SFY
Customer Service Survey Outreach Plan
By June 30th of each SFY
Customer Service Survey Outreach Report
By June 30th of each SFY
Customer Service Plan Report
By June 5th of each SFY
Customer Service Tier 2 Inbound/Outbound
Call Survey
By June 5th of each SFY
Customer Service Outreach Plan or
Customer Service Improvement Plan (If
required as described in Section 4.3.2.2.2.4.)
By June 30th of each SFY
Two or More Nursing Facilities Meetings
By April 30, 2026
Two or More Case Management Agency
Meetings
By April 30, 2026
10. COMPENSATION
10.1. County Incentive Payment
10.1.1. The Department will pay Contractor, after the end of the SFY in which the work was
performed, County Incentive Payments for each Medicaid County Performance Standards
Program met during the applicable Reporting Period as follows:
10.1.1.1. The Department will pay Contractor a Performance Compliance Performance Incentive
Standard Payment at the conclusion of the Second Reporting Period if Contractor meets
the requirements for that Performance Compliance Performance Incentive Standard
during the First and Second Reporting Period as defined in Section 4.3.1.2.1.
10.1.1.2. The Department will pay Contractor a Customer Service Performance Incentive Payment
as shown at the conclusion of the Second Reporting Period if Contractor meets the
requirements for this Contract defined in Section 4.3.2.2.
10.1.1.3. The Department will pay Contractor a County Collaboration Incentive Payment at the
conclusion of the Second Reporting Period if Contractor meets the requirements for this
Contract during the First and Second Reporting Periods as defined in Section 4.3.1.2.1.
10.2. Remaining Funds Incentive Pool Payment
10.2.1. The Department will create a Remaining Funds Incentive Pool each SFY.
10.2.2. The Remaining Funds Incentive Pool shall include the following:
10.2.2.1. The total amount of all base County Incentive Payments allocated to any Contractor that
opted out of participation in the Medicaid County Performance Standards Program for
that SFY.
10.2.2.2. Each of the County Incentive Payments that were not earned by Contractor during a
Reporting Period in that SFY.
10.2.3. Contractor shall be eligible for Remaining Funds Incentive Pool payments.
10.2.4. If the Remaining Funds Incentive Pool is zero dollars ($0.00) for any SFY, Contractor shall
not receive a Remaining Funds Incentive Pool Payment for that SFY.
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Page 25 of 26 Exhibit A, Statement of Work
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10.2.5. The Remaining Funds Incentive Pool will be paid as follows:
10.2.5.1. Contractor shall be eligible for payment from the Remaining Funds Incentive Pool based
on the dollar amount of Incentives met during that SFY.
10.2.5.2. Based on the proportion of total Incentive funds that Contractor is eligible to be paid in
each SFY, Contractor shall receive the same proportion of funds from the Remaining
Funds Incentive Pool.
10.2.5.3. Contractor's payment of funds from the Remaining Funds Incentive Pool shall never
exceed the county's share of Medicaid expenditure, as specified in Section 2, County
Determinations.
10.3. Payment Procedures
10.3.1. Contractor shall receive County Incentive Payments at the end of the Second Reporting
Period within 90 Calendar Days following the end of the SFY in which the Medicaid County
Performance Standards Program were met. This allocation will reflect the maximum
Contractor can earn for this Contract per Reporting Period.
10.3.2. If a contractor's county administration line item is over -expended during the county
administration closeout process, Settlement Accounting and the Department may utilize
Contractor's earned County Incentive Payments during the closeout process.
10.3.3. Actual County Incentive Payment maximums are dependent on Contractor's share of
Medicaid county administration expenditure. In no event shall Contractor be paid more than
Contractor's county share of Medicaid county administration expenditure in any Reporting
Period or SFY.
10.3.4. The Department may add any unearned funds from the First Reporting Period into the Second
Reporting Period allocation for any SFY.
10.3.5. Contractor shall be paid the County Incentive Payments through the County Financial
Management System (CFMS).
10.3.6. The Incentive Payment earned is unrestricted, and Contractor may utilize the fund per
Contractor's discretion.
Agreement Number: 26-198149
Page 26 of 26 Exhibit A, Statement of Work
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EXHIBIT B, RATES
1. State Fiscal Year 2025-2026 Incentives Payment Table
County Incentive Payment Measures
Percentage of the
Incentive Contract
Performance Compliance Performance
Incentive Payment
50%
Customer Service Performance Incentive
Payment
30%
County Collaboration Incentive Payment
20%
Agreement Number: 26-198149
Page 1 of 1 Exhibit B, Rates
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EXHIBIT C, TERMINOLOGY
1. TERMINOLOGY
1.1. In addition to the terms defined in §3 and Exhibit A, Statement of Work, of this Contract, the
following list of terms shall be construed and interpreted as follows:
1.1.1. Business Interruption — Any event that disrupts Contractor's ability to complete the Work for
a period of time, and may include, but is not limited to a Disaster, power outage, strike, loss
of necessary personnel or computer virus.
1.1.2. Child Health Plan Plus (CHP+) — Colorado's public low-cost health insurance for certain
children and pregnant women. It is for people who earn too much to qualify for Health First
Colorado (Colorado's Medicaid Program), but not enough to pay for private health insurance.
1.1.3. Closeout Period — The period beginning on the earlier of 90 days prior to the end of the last
Extension Term or notice by the Department of its decision to not exercise its option for an
Extension Term, and ending on the day that the Department has accepted the final deliverable
for the Closeout Period, as determined in the Department -approved and updated Closeout
Plan, and has determined that the closeout is complete.
1.1.4. Colorado Revised Statutes (C.R.S.) — The legal code of Colorado; the legal codified general
and permanent statutes of the Colorado General Assembly.
1.1.5. Consumer Price Index- Urban (CPI -U) — The Consumer Price Index for All Urban
Consumers published by the US Department of Labor, Bureau of Labor Statistics.
1.1.6. Data — State Confidential Information and other State information resources transferred to
Contractor for the purpose of completing a task or project assigned in the Statement of Work.
1.1.7. Deliverable — Any tangible or intangible object produced by Contractor as a result of the
work that is intended to be delivered to the Department, regardless of whether the object is
specifically described or called out as a "Deliverable" or not.
1.1.8. Disaster — An event that makes it impossible for Contractor to perform the Work out of its
regular facility or facilities, and may include, but is not limited to, natural disasters, fire or
terrorist attacks.
1.1.9. Fraud — An intentional deception or misrepresentation made by a person with the knowledge
that the deception could result in some unauthorized benefit to that person or some other
person and includes any act that constitutes fraud under any federal or state law.
1.1.10. Health First Colorado — Colorado's Medicaid Program. The Member -facing name for
Colorado's Medical Assistance Program, which includes all programs that use the Modified
Adjusted Gross Income (MAGI) and Non -MAGI Methodology.
1.1.11. Health Insurance Portability and Accountability Act (HIPAA) — The Health Insurance
Portability and Accountability Act of 1996, as amended.
1.1.12. Key Personnel — The position or positions that are specifically designated as such in this
Contract.
1.1.13. Member — Any individual enrolled in the Colorado Medicaid program, Colorado's CHP+
program or the Colorado Indigent Care Program, as determined by the Department.
Sometimes referred to as a "client".
Agreement Number: 26-198149
Page 1 of 3 Exhibit C, Terminology
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1.1.14. Operational Start Date — When the Department authorizes Contractor to begin fulfilling its
obligations under the Contract.
1.1.15. Other Personnel — Individuals and Subcontractors, in addition to Key Personnel, assigned to
positions to complete tasks associated with the Work.
1.1.16. Provider — Any health care professional or entity that has been accepted as a provider in the
Colorado Medicaid program, Colorado's CHP+ program or the Colorado Indigent Care
Program, as determined by the Department.
1.1.17. Start -Up Period — The period starting on the Effective Date and ending on the Operational
Start Date.
2. ACRONYMS AND ABBREVIATIONS
2.1. The following list is provided to assist the reader in understanding certain acronyms and
abbreviations used in this Contract:
2.1.1. ASA — Average Speed to Answer
2.1.2. CAP — Corrective Action Plan
2.1.3. CBMS — Colorado Benefits Management System
2.1.4. CDE — Colorado Department of Education
2.1.5. CDHS — Colorado Department of Human Services
2.1.6. CFMS — County Financial Management System
2.1.7. CFR — Code of Federal Regulations
2.1.8. CHATS — Colorado Child Care Automated Tracking System
2.1.9. CHP+ —Child Health Plan Plus
2.1.10. CICP — Colorado Indigent Care Program
2.1.11. CMS — Centers for Medicare & Medicaid Services
2.1.12. CORA —Colorado Open Records Act, C.R.S. §24-72-200.1, et. seq.
2.1.13. C.R.S. — Colorado Revised Statutes
2.1.14. DOLA — Department of Local Affairs
2.1.15. EBT — Electronic Benefits Transfer
2.1.16. FSR — Financial Status Report
2.1.17. HIPAA — Health Insurance Portability and Accountability Act of 1996, as amended.
2.1.18. MFCU — the Colorado Medicaid Fraud Control Unit in the Colorado Department of Law
2.1.19. MOE — Maintenance of Effort
2.1.20. OEC - Office of Early Childhood
2.1.21. OSA - Office of the State Auditor
2.1.22. PEAK — Program Eligibility and Application Kit
2.1.23. PHI — Protected Health Information
2.1.24. PII — Personally Identifiable Information
Agreement Number: 26-198149
Page 2 of 3 Exhibit C, Terminology
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2.1.25. SFY — State Fiscal Year
2.1.26. SNAP — Supplemental Nutrition Assistance Program
2.1.27. TANF — Temporary Assistance for Needy Families
2.1.28. U.S.C. — United States Code
2.1.29. VARA — Visual Rights Act of 1990
Agreement Number: 26-198149
Page 3 of 3 Exhibit C, Terminology
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EXHIBIT D, REVIEW SAMPLE SIZE EXEMPTION PROCERSS FLOW
1. STEP 1: THE DEPARTMENT PULLS EQA DATA
1.1. Decision A: Did the County complete a minimum of 20 reviews in the fiscal year?
1.1.1. If Yes Proceed to Decision B.
1.1.2. If No (Fewer than 20 reviews completed), proceed to Decision C.
1.2. Decision B: Did the County meet both Accuracy Targets?
1.2.1. If Yes (both targets met), a payment is issued.
1.2.2. If No (one or both targets not met), payment is only issued for the met target(s).
1.3. Decision C: Did the County meet both Accuracy Targets with <20 reviews?
1.3.1. If Yes (both targets met), a payment is issued.
1.3.2. If only one target was met:
1.3.2.1. Apply Exemption Review only to the unmet target.
1.3.2.2. Proceed to Step 2: Exemption Review Process.
1.3.2.3. After exemption review:
1.3.2.3.1. If target is met after exemption Payment issued.
1.3.2.3.2. If not —► Payment denied for that target.
1.3.3. If Neither target met:
1.3.3.1. Apply Exemption Review to both targets.
1.3.3.2. Proceed to Step 2: Exemption Review Process.
1.3.3.3. After exemption review:
1.3.3.3.1. If both targets are met after exemption Payment issued.
1.3.3.3.2. If only one target is met -P Payment issued only for that target.
1.3.3.3.3. If neither target is met —s Payment not issued.
2. STEP 2: EXEMPTION REVIEW PROCESS
2.1. Applied only when:
2.1.1. County has unmet targets on the MAP Accuracy Dashboard.
2.1.2. Less than 20 reviews were completed.
2.2. Review Steps:
2.2.1. Cause Analysis:
2.2.1.1. Use the MAP Dashboard to analyze errors.
2.2.1.2. Determine root causes using short- or long -run performance reports.
2.2.2. Review Submission:
2.2.2.1. The Department reviews submitted justification.
Agreement Number: 26-198149
Page 1 of 3 Exhibit D, Review Sample Size
Exemption Process Flow
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
2.2.3. Request for More Info:
2.2.3.1. If needed, the Department may request additional documentation.
2.2.4. Exemption Approval:
2.2.4.1. If errors are justifiable, exemption is granted.
2.2.4.2. If not, the exemption is denied.
2.3. Final Rule: Payment issued only if the target(s) is met after exemption(s). If not, payment is
denied.
3. ADDITIONAL NOTES
3.1. Errors: MAP Accuracy Dashboard
3.1.1. The dashboard identifies each county's errors.
3.1.2. The Department discusses with counties to prevent similar errors from recurring.
3.1.3. If errors are not addressed and repeated in future months, they will be counted as similar
errors.
3.2. Review Size Rules
3.2.1. Three or fewer errors with no similar errors at the end of the fiscal year, automatic exemption.
3.2.2. More than three errors with no similar errors, exemption may be applied.
3.3. Recalculating Actual Accuracy Performance Based on Exemption
3.3.1. Example:
3.3.1.1. A county's target is 23.2% as reflected on the MAP Dashboard.
3.3.1.2. Reviews Conducted: 12
3.3.1.3. MAP Dashboard Total Reviews: 5
3.3.1.4. Inaccurate Eligibility Determination: 41.7% (5 ± 12 = 41.7%)
3.3.1.5. Exemption Process — The Department creates two tier target percentages based on the
EQA data findings and applies the exemption process on the total county reviews for
qualified counties at the end of the fiscal year.
3.3.1.5.1. Similar Errors: 2 (2 - 12 = 17%, not exempted)
3.3.1.5.2. Not Similar Errors: 3 (3 - 12 = 25%, exempted)
3.3.1.6. Revised Exemption -Adjusted Inaccuracy Eligibility Determination Rate: 16.7% (5
Reviews - 3 Not Similar Errors (exemptions applied) = 2, 2 - 12 = 16.7%)
3.3.1.7. The Department may recalculate this percentage or request additional documentation at
their discretion.
Agreement Number: 26-198149
Page 2 of 3 Exhibit D, Review Sample Size
Exemption Process Flow
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
Exhibit D: Review Sample Size Exemption Process Flow
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eview the tansy's sehmssim tam the short- or bngnrn
�} perfarmanoe.
ti addelonal irgomaaon is need.... Mg s. d
exemption, the Depertmrent may fotow tp wltli dye panty.
d, Aber review of the peNously prided a 1 new
dommaon (root cause analysis), theaxe.Mns wY be
approved a denied.
ecatalatatg ac4al aocuraq perhrmance baud on exemption:
Maowr ti a gib'. detenr.Per. rate at end of F Y= 3 i {acuai pedomance►. Tanga =1596.
atll�ttpp.gpl,�: i. Department eases tiro (2) tlars tarpts petceraage based on Ore QA rmro
rings. Y. App. he emitml ri process m the tool corn. rarMwes for quat(ied oourtries at the end
FY. F�umpM: S roeMas par FY. 3 rot smtiMr errors (exempted) anal 2 settle emws (nor
FY. Eim 4d95 haauraM Etryir ty Datermitaonn mu. Cr i speW a artw (nor exempted) =.25.0
:aerate Etghiti. Draar sae rate. = Theroforo, drs exartpe suet be evaalon against hz w
targets peroeuage, are Department may. evew addtbnel dawmenatbn per the
paMents dame. to =Ma . he parxnuge, tl needed..
Agreement Number: 26-198149
Page 3 of 3
Payment issued a target. are met after exemption(s) are
is spited: d targets) rot met attar exempt. payment
not Issued.
Exhibit D, Review Sample Size
Exemption Process Flow
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
EXHIBIT E, SMALL, MEDIUM, AND LARGE COUNTY LIST
The table below categorizes counties as small, medium, or large for purposes of qualification of exemptions for timeliness
and/or backlog incentives.
Small Counties Medium Counties
Archuleta County Alamosa County
Baca County Broomfield County
Bent County Chaffee County
Cheyenne County Conejos County
Clear Creek County Delta County
Costilla County Douglas County
Crowley County Eagle County
Custer County Elbert County
Dolores County Fremont County
Gilpin County Garfield County
Grand County Gunnison County
Hinsdale County Huerfano County
Jackson County La Plata County
Kiowa County Las Animas County
Kit Carson County Logan County
Lake County Moffat County
Lincoln County Montezuma County
Mineral County Montrose County
Ouray County Morgan County
Phillips County Otero County
Pitkin County Park County
Rio Blanco County Prowers County
San Juan County Rio Grande County
San Miguel County Roan County
Sedgwick County Saguache County
Washington County Summit County
Yuma County Teller County
Agreement Number: 26-198149
Large Counties
Adams County
Arapahoe County
Boulder County
City & County of Denver
El Paso County
Jefferson County
Larimer County
Mesa County
Pueblo County
Weld County
Page 1 of 1 Exhibit E, County List by Size
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
State Agenc
1,010
EXHIBIT F, SAMPLE OPTION LETTER
Contract Performance Beginning Date
Contractor
O tion Letter Number
Ori inal Contract Number
O tion Contract Number
Current Contract Expiration Date
Current Contract Maximum Amount
Initial Term
State Fiscal Year OA:
Extension Terms
State Fiscal Year
State Fiscal Year
State Fiscal Year
State Fiscal Year 2
Total for All State Fiscal Years:
OPTIONS:
A. Option to extend for an Extension Term
B. Option to change the quantity of Goods under the Contract
C. Option to change the quantity of Services under the Contract
D. Option to modify Contract rates
E. Option to initiate next phase of the Contract
1. REQUIRED PROVISIONS:
A. For use with Option 1(A):
In accordance with Sections) "y` of the Original Contract referenced above, the State
hereby exercises its option for an additional term, beginning and ending on
the current contract expiration date shown above, at the rates stated in the Original
Contract, as amended.
B. For use with Options 1(B and C):
In accordance with Section(s) of the Original Contract referenced above, the State
hereby exercises its option to the quantity of the 04414:01414.
at the rates stated in the Original Contract, as amended.
C. For use with Option 1(D):
In accordance with Section(s) Number of the Original Contract referenced above, the State
hereb exercises its option to modify the Contract rates specified in
The Contract rates attached to this Option Letter replace the rates in the
Original Contract as of the Option Effective Date of this Option Letter.
D. For use with Option 1(E):
In accordance with Section(s) of the Ori • final Contract referenced above, the State
hereby exercises its option to initiate Phase .� r s }� , which shall
begin on and end on �:� p § �.,a at the cost/price specified in Section
E. For use with all Options that modify the Contract Maximum Amount:
The Contract Maximum Amount table on the Contract's Signature and Cover Page is
hereby deleted and replaced with the Current Contract Maximum Amount table shown
Agreement Number: 26-198149
Page 1 of 1 Exhibit F, Sample Option Letter
Docusign Envelope ID: 297609C1-1A56-4AF1-9CB2-3F9E7106C620
above.
2. OPTION EFFECTIVE DATE:
The effective date of this Option Letter is upon approval of the State Controller or
whichever is later.
STATE OF COLORADO
Jared S. Polis, Governor
By:
Date:
Agreement Number: 26-198149
STATE CONTROLLER
Robert Jams, CPA, MBA, JD
Option Effective Date:
In accordance with §24-30-202, C.R.S., this
Option is not valid until signed and dated above
by the State Controller or an authorized
delegate
Page 2 of 2 Exhibit F, Sample Option Letter
i n
Entity Information
Entity Name *
COLORADO DEPT OF HEALTH
CARE POLICY & FINANCING
Entity ID*
@00007174
Contract Name *
HEALTH CARE POLICY AND FINANCING
INTERGOVERNMENTAL AGREEMENT COUNTY
INCENTIVES
Contract Status
CTB REVIEW
O New Entity?
Contract ID
9744
Contract Lead *
SADAMS
Contract Lead Email
sadams@weld.gov;cobbx
xlk@weld.gov
Parent Contract ID
Requires Board Approval
YES
Department Project #
Contract Description *
HEALTH CARE POLICY AND FINANCING INTERGOVERNMENTAL AGREEMENT SFY 2026 COUNTY INCENTIVES.
TOTAL CONTRACT AMOUNT $489,071.24. TERM: 07/01/2025 THROUGH 06/30/2026.
Contract Description 2
PA ROUTING THROUGH THE NORMAL PROCESS. ETA TO CTB IS 07/15/2025.
Contract Type* Department Requested BOCC Agenda Due Date
AGREEMENT HUMAN SERVICES Date* 07/19/2025
07/23/2025
Amount* Department Email
$489,071.24 CM- Will a work session with BOCC be required?*
HumanServices@weld.gov NO
Renewable *
NO Department Head Email Does Contract require Purchasing Dept. to be
CM-HumanServices- included?
Automatic Renewal DeptHead@weld.gov
Grant County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
IGA
County Attorney Email
CM-
COUNTYATTORNEY@WEL
RN EY@WEL
D.GOV
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
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 *
04/30/2026
Committed Delivery Date
Renewal Date
Expiration Date*
06/30/2026
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
07/16/2025 07/17/2025 07/17/2025
Final Approval
BOCC Approved Tyler Ref #
AG 072325
BOCC Signed Date Originator
SADAMS
BOCC Agenda Date
07/23/2025
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