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HomeMy WebLinkAbout20232329.tiffRESOLUTION RE: APPROVE APPLICATION AND STATEMENT OF ASSURANCE FORM FOR CASE MANAGEMENT AGENCY TRANSITION SUPPORT START-UP GRANT, AND AUTHORIZE DEPARTMENT OF HUMAN SERVICES TO SUBMIT ELECTRONICALLY 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 Application and Statement of Assurance Form for the Case Management Agency Transition Support Start -Up Grant from 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, to the Colorado Department Health Care Policy and Financing, with further terms and conditions being as stated in said application and form, and WHEREAS, after review, the Board deems it advisable to approve said application and form, 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 Application and Statement of Assurance Form for the Case Management Agency Transition Support Start -Up Grant from 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, to the Colorado Department Health Care Policy and Financing, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that Karina Amaya-Ragland, Department of Human Services, be, and hereby is, authorized to electronically submit said application and form. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 9th day of August, A.D., 2023. ATTEST: d ) Weld County Clerk to the Board �•C� BY. Deputy Clerk to the Board APP' e ED A O FORM: County ttorney I I Date of signature: S 15{2 BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Mike man, Chair rr L. ck, Pro-Tem Sc•tt K. James D. Ro§s aine 2023-2329 HR0095 cc.. HSD, ACT(cp/cc) oV 1-7/2.3 PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: August 1, 2023 TO: Board of County Commissioners — Pass -Around FR: Jamie Ulrich, Director, Human Services RE: Colorado Department of Health Care Policy and Financing (HCPF) Case Management Agency Start Up Grant Application Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Colorado Department of Health Care Policy and Financing (HCPF) Case Management Agency Start Up Grant Application. The Weld County Area Agency on Aging (WCAAA) is requesting to submit a grant application to the Colorado Department of Health Care Policy and Financing (HCPF) for the Case Management Agency Start Up Grant in the amount of $200,000.00. On June 12, 2023, HCPF awarded a contract to the WCAAA for Case Management Agency (CMA) Activities and State General Fund Program Services. HCPF is now offering a grant to support agencies who have been awarded a contract to assist with start up costs of the new program. If awarded, the Department will use these funds to assist with office set up costs, construction build outs of office space, and/or other allowable general startup cost expenses. Grant applications are due Thursday, August 10, 2023, by 5:00 PM MST. The project time frame will be from September 1, 2023 to September 30, 2024. I do not recommend a Work Session. I recommend approval of this Grant Application and authorize the Department to submit electronically by Thursday, August 10, 2023. Approve Recommendation Perry L. Buck, Pro-Tem Mike Freeman, Chair Scott K. James Kevin D. Ross Lori Saine Schedule Work Session Other/Comments: Pass -Around Memorandum; August 1, 2023 - CMS ID (Not in CMS) Page 1 2023-2329 3/9 11-120CF15 Karla Ford From: Sent: To: Subject: yes Lori Saine Weld County Commissioner, District 3 1150 O Street PO Box 758 Greeley CO 80632 Phone: 970-400-4205 Fax: 970-336-7233 Email: Isaine@weldgov.com Website: www.co.weld.co.us In God We Trust Lori Saine Tuesday, August 1, 2023 2:32 PM Karla Ford RE: Please Reply - DHS #4 PA FOR ROUTING: 080123 AAA Case Management Agency Start Up Grant App (Not in CMS) Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Karla Ford <kford@weld.gov> Sent: Tuesday, August 1, 2023 12:34 PM To: Lori Saine <Isaine@weld.gov> Subject: Please Reply - DHS #4 PA FOR ROUTING: 080123 AAA Case Management Agency Start Up Grant App (Not in CMS) Importance: High Please advise if you approve recommendation. Thank you. Karla Ford A 1 Case Management Agency Transition Support Start Up Grant Application and Statement of Assurance Form The purpose of the start up grant payments being offered are to provide support to CMAs to implement CMRD, transition, change management, strategic and organizational planning, capacity and ensuring member access to a CMA, including developing an infrastructure for a learning collaborative so that CMAs have access to individual resources relevant to their change management needs. kelly.r.morrison65@gmail.com Switch account * Indicates required question Email kmorrison@weld.gov General Application Questions Please carefully review the instructions in the Request for Application (RFA) document found on the ARPA HCBS Grants, Incentives, Pilots, and Community Funding web page before completing this application. Also, please note that you will be asked to attach a budget worksheet (template in RFA document) and project workplan (instructions in RFA document). Legal Business Name: The County of Weld Authorized Representatives Name and Title: Kelly Morrison FULL Business Address & Phone Number: 1150 O St Greeley, CO 80632 Name the Counties Served? Weld County Please identify if your organization fits one or more of the following categories Small business (500 or fewer employees) Minority -owned business Woman -owned business Veteran -owned business Business that employs people with disabilities (employs any Home and Community -Based Services Waiver member in Competitive Integrated Employment (CIE)) How many members will your case management agency serve? approximately 3000 What is the total dollar amount of the funds requested? $284091.00 What is your SAM number. If you have not yet completed this, please type "in process" M KKXT9U9MTV5 Please explain in detail how the grant funds requested are supplementing and not supplanting existing dollars. Funding will be to used for equipment for incoming staff and itmes for all staff that are not currently provided such as a stylus for the laptops. Start up funds are for transition related costs or items for new staff that existing staff already have or items need for CMA work by all staff not already provided such as the cell phones CMA Start Up Costs ARPA 5.01 Questions: CMA transition start up costs maximum are capped at $200,000 per CMA. Please note, agencies may request for up to $200,000 but award amounts will vary by individual CMA application review. The following list of items are eligible for this portion of the application: Operational transition costs to include set up and first month costs, not to include any ongoing service costs Renting work space Utilities Phone Service Internet and cable Paper record transfer costs such as moving truck rental or other transportation support Internet and cable Paper record transfer costs such as moving truck rental or other transportation support Marketing costs Costs for advertising of positions Website design Digital advertising Promotional supplies including mailers, brochures, and flyers Postage Booth rentals at conventions/fairs/festivals for community engagement etc. Training facilitator/strategic planner fee Technology fee Venue fee Office set up costs Office phones, headsets, or cell phones Desks/desk mats Chairs/ chair mats Shredders Cubicles Tables, refrigerator, microwave, coffee maker, plates, cups, cutlery, etc Chairs or couches, end tables, brochure holders, TV etc. in reception areas and common areas so that the office is welcoming and comfortable General Office Supplies/Operating Supplies Copy Machines (Rental) set up or first month Construction build outs of office space including signage In addition to completing the "Start Up Costs" portion of the budget workbook, please answer the questions below. For each of the responses, please respond in no more than one paragraph. (4-6 sentences) Has your organization applied for any other ARPA funding, if yes, what project (name/number) and for what type of expenditure? The Single Entry Point/CMA has not applied for or received other ARPA funding. How will these funds provide continuity of care for members? These funds will allow Weld CMA to supply staff with the equipment needed to provide, as close to a seamless transition as possible. It will also be used to communicate with members to keep them informed of changes, allow for improved ongoing communication with a CMA website and CMs cell phones for both providers and individuals we serve. Has your organization been awarded Single Entry Point funding subject to subrecipient monitoring? Yes Do you currently have any unexpended or deferred revenue that is subject to subrecipient monitoring? If so please explain the amount, source and how this grant will not supplant the use of those funds. Yes, we do have unexpended funds to date in the amount of 294000.00. These funds are from the SEP contract over the last few years and are largely due to vacancy savings throughout those years. However these funds have been earmarked for hiring some positions now to place the program in the best possible position when the CMA becomes effective, cover current expenses as we ended FY22 overspent, increase in currents staff time on the CMA work vs other units within the division, purchasing a client tracking system and cell phones for existing CM staff. This totals over 306000.00, completely depleting the current deferred revenue prior to the CMA start date of 3/1/2024. Device ARPA 6.08 Questions: Care and Case Management Compatible Devices maximum award: variable; refer to Exhibit B in the RFA document for per -Designated Service Area maximums. In addition to completing the "Devices" portion of the budget workbook, please answer the questions below. For each of the responses, please respond in no more than one paragraph (4-6 sentences). 1. Please refer to Exhibit B or C in the RFA. Describe how your agency will use the purchased devices (including peripherals) to support the person -centered roll out of the Care and Case Management System? What business needs will be met and who will use the devices? All CMA staff completing assessments will be given a touchscreen laptop that can fold into a tablet for ease of use. A compatible stylus and backup battery pack and cell phone with hot spot will also be provided for case manager's field work and will allow the CMs to complete assessments in the field and will allow members the opportunity to sign documents at the time of the visit having the chance to ask questions as necessary. Headsets and wireless devices allow for ease of communication between CMA staff and members. Dual monitors will allow the CMs to have more than one window open on their computer at a time decreasing the amount of time to complete data entry work. 2. Please refer to Exhibit B or C in the RFA. Should the devices your CMA qualifies for not be sufficient to meet your agency's needs as described in Question 1, please identify the number of additional devices needed along with a justification for their purchase in the workbook. Go to the linked WORKBOOK under 'Devices Budget' tab to enter in those details. I DO need additional devices and included the details in the workbook. I DO NOT need additional devices. 3. While the grant is designed to provide devices to case managers, the Department is also willing to consider reimbursement of up to $300.00 per device for the costs of peripherals and accessories to expand the ability of and help protect and maintain the device. This allotment of funds is displayed in Exhibit A Supplanting vs. Supplementing below. I DO need additional devices and included the details in the workbook. I DO NOT need additional devices. 4. If your agency is requesting funding for leased devices, please explain how you plan to sustain these costs following the use of the grant funds. N/A EHR ARPA 6.06 Questions: Upgrade or adopt a new Electronic Health Record (EHR) maximum award: $100,000 per CMA (up to $2,000,000 total for 20 redesigned CMAs). In addition to completing the "EHR" portion of the budget workbook, please answer the questions below. For each of the responses, please respond in no more than one paragraph (4-6 sentences): 1. Why is your CMA agency requesting funding for an Electronic Health Record (EHR) upgrade or new implementation? N/A 2. Approximately how long will this EHR project take? (Please note this information is also required in your project work plan). N/A 3. Will the EHR be used for HCBS client data only or other lines of business at your agency? N/A 4. How will your agency balance an EHR upgrade at the same time as implementing the Care and Case Management tool? N/A 5. Other supporting information for an EHR upgrade N/A ATTESTATION STATEMENT: Please check/mark each statement of assurance below to be considered for ARPA grant funding. The applicant organization listed above hereby accepts the conditions of the Case Management Retention grant program and agrees to the following assurances: The startup grant funds requested in the application will be administered and distributed in accordance with all applicable statutes, regulations, program plans, and requirements delineated in this application. The applicant meets all eligibility requirements of the grant as outlined in the Case Management Agencies Start Up Request for Applications (RFA). Applicants must have this form approved by the Department to be eligible for reimbursement. Applicant understands that the funds requested in this application are likely the maximum amount that can be paid, the Department will not have additional funds available for costs invoiced above the requested amount. The applicant will cooperate with any examination of records with respect to such Colorado Department of Healthcare Policy and Financing (the Department), the Office of eHealth Innovation (OeHl), the State of Colorado, or any auditors on its behalf; or (ii) any other state agency, commission, or department in the lawful exercise of its jurisdiction and authority. All information contained in this application is true and accurate. The applicant attests that no funds will be used to supplant their organizations existing costs. End of application: By adding your name on this Statement of Assurances document, the applicant attests that all information indicated in this document is accurate and true. The applicant agrees and acknowledges that by printing their name here it represents their signature in order for the application to be valid. Kelly Morrison A copy of your responses will be emailed to the address you provided. Never submit passwords through Google Forms. reCAPTCHA Privacy Terms This form was created inside of State.co.us Executive Branch. Report Abuse Google Forms Deices Budget Summary Device Description, quantity, cost per device Number Devices Referenced in Exhibit B Number of Devices Requested CalendarCalendar Year 2023Year 2024 ' Total Narrative/Description (Justification for requested funds, including if there is a variance from the number of devices outlined in RFA Exhibit B and the number of devices requested) Current SEP caseload is 1705- CCB in Weld is 943. and 8`_� from Larimer CCB and we have been told we will receive approximately 215 CHCBS individuals totaling 2948 requiring 46 cue managers for a 1:65 caseload computer bag 40.00 38 40 SI60.00 51.440.00 51,600.00 Computer bogs for all new staff completing assessments Dell Latitude TnuchScreen laptop 1599,41 28 40 56,397.77 $57,579.48 $63,977.20 staff *includes new leads and supervisors that will do assessments when necessary power cord for monitors 10.00 x2-20,00; per staff 38 40 580.00 5720.00 $800.00 additional cost for laptop cords for all new computers monitors x7. , 141.59 'each wok space total 283.14!staff 38 40 51,132.56 510.193.04 S11.325.60 2 -monitor setup for all workspaces to allow for multiple program to be viewed at of wireless mouse and wireless keyboard 50.00 38 40 5200.00 $1,800.00 S2.000.00 witreless mouse and keyboard combo Stylus for Laptops 100.00 38 69 5300.00 56,600.00 $6.900.00 for current and new staff completing assessments Total Costs S8,270.28 $78,332.52 $86,602.80 ie time Devices Budget Summary EHR Description Calendar Year 2023 Calendar Year 2024 Total Narrative/Description (Justification for Requested Fundsl SO Total Direct Costs $0 $0 $0 1 Transitions Cost Budget Description Calendar 'rear 2023 Calendar Year 2024 Total Narrative/Description (Justification for Requested Funds) Multi function copyrpnnt.Maxrscan ill 5''d aO_ S10400 tun additional machines to accomodate the increased stag' Standing Desk Mat 50.00 S200 S2 100 S2 300 each cubicle has a high'tow desk and is provided a standing mat This is requres for ail new staff Chair Mat 50 00 S200 52 100 52 300 chair mats for all new staff Construction build out of office space 550000 550,000 S100.000 additional consturction to add additional cubicles and office space to accomodate the additional staff Promotional Supplies brochures. flyers, stakeholder meetings S3.000 $2 000 55 000 provide communication to stakeholders and community partners cord for headset 40.00 160 1 660 $1,640 00 heads seticords for all new staff to allow for ease of cornmurucation with members Headset for phone 419 00 1 676 17 598 S19 274 00 heads set'cords for aU new staff to allow for ease of communtcation with members docking station 246 74 987 10 363 S11..350 04 all new staff to allow for dual monitor use Desk phone 350 GO 1.400 14 700 S16.100 00 desk phones for new staff to allow for d rect access between memebe-s and CMs first months activation:desk phone 18 00 72 756 5828.00 This is a new item for all staff to provide protection for their device when using them in the field Computer protective case 50.00 1 350 1.600 S2.950 00 Cell Phone 29 99 90 1.260 51,34958 70 staff excluding case aides to allow for streamlined communication with members farnflies and providers external power pack for laptop 150 GO 4 050 5 100 $9,150 00 This power pack will afiow for extended laptop use inthe field Rebranding Division name 8 Website design 50000 50000 100 000 We would like to rebrand the Area Agency on Aging Division to be more inclusive of all memebers we will serve Stakeholder meetings 300 200 500 hosting and snacks for stakeholder meetings to proive communication with the community,families and providers Grant Budget Summary Budget Category Devices Software EHR Transition Total Direct Costs Calendar Year 2023 Calendar Year 2024 $8,270 $78,333 $0 SO $113,485 5169,857 $121,755 $248, 189 Total Narrative/Description (Justification for Requested Funds) 586,603 So $283,342 $ 369.944 Indirect l_ostt3) S3o,955 Total Project Costs $133,931 $273,008 $406,939 oFof sa6Kiscs/04( Cheryl Hoffman From: Sent: To: Subject: Kelly Morrison Wednesday, August 9, 2023 10:03 PM Lesley Cobb FW: Case Management Agency Transition Support Start Up Grant Application and Statement of Assurance Form Here you go. In case you notice, the question about what category we fit in for business type would not allow me to not check any of the boxes so I picked the small business and when I sent the workbook and one page document I made sure to add a comment that the application would not allow me to submit without picking one area so they understand why picked one. Kelly From: Google Forms <forms-receipts-noreply@google.com> Sent: Wednesday, August 9, 2023 9:48 PM To: Kelly Morrison <kmorrison@weld.gov> Subject: Case Management Agency Transition Support Start Up Grant Application and Statement of Assurance Form Caution: This email originated from outside of Weld County Government. Do not click links or open attachments unless you recognize the sender and know the content is safe. Thanks for filling out Case Management Agency Transition Support Start Up Grant Application and Statement of Assurance Form Here's what was received. Case Management Agency Transition Support Start Up Grant Application and Statement of Assurance Form The purpose of the start up grant payments being offered are to provide support to CMAs to implement CMRD, transition, change management, strategic and organizational planning, capacity and ensuring member access to a CMA, including developing an infrastructure for a learning collaborative so that CMAs have access to individual resources relevant to their change management needs. Email kmorrison@weld.gov General Application Questions Please carefully review the instructions in the Request for Application (RFA) document found on the ARPA HCBS Grants. Incentives, Pilots, and Community Funding web page before completing this application. Also, please note that you will be asked to attach a budget worksheet (template in RFA document) and project workplan (instructions in RFA document). Legal Business Name: The County of Weld Authorized Representatives Name and Title: Kelly Morrison FULL Business Address & Phone Number: 1150 0 St Greeley, CO 80632 Name the Counties Served? Weld County Please identify if your organization fits one or more of the following categories Small business (500 or fewer employees) Minority -owned business 2 Woman -owned business Veteran -owned business Business that employs people with disabilities (employs any Home and Community -Based Services Waiver member in Competitive Integrated Employment (CIE)) How many members will your case management agency serve'? approximately 3000 What is the total dollar amount of the funds requested'? * $371,664 00 What is your SAM number If you have not yet completed this, please type "in process" MKKXT9U9MTV5 Please explain in detail how the grant funds requested are supplementing and not supplanting existing dollars * Funding will be to used for equipment for incoming staff and items for all staff that are not currently provided such as a stylus for the laptops Startup funds are for transition related costs or items for new staff that existing staff already have or items need for CMA work by all staff not already provided such as the cell phones I , CMA Start Up Costs ARPA 5.01 Questions: CMA transition start up costs maximum are capped at $200,000 per CMA Please note, agencies may request for up to $200,000 but award amounts will vary by individual CMA application review The following list of items are eligible for this portion of the application 3 • Operational transition costs to include set up and first month costs, not to include any ongoing service costs • Renting work space • Utilities • Phone Service • Internet and cable • Paper record transfer costs such as moving truck rental or other transportation support • Internet and cable • Paper record transfer costs such as moving truck rental or other transportation support • Marketing costs • Costs for advertising of positions • Website design • Digital advertising • Promotional supplies including mailers, brochures, and flyers • Postage • Booth rentals at conventions/fairs/festivals for community engagement etc • Training facilitator/strategic planner fee • Technology fee • Venue fee • Office set up costs • Office phones, headsets, or cell phones • Desks/desk mats • Chairs/ chair mats • Shredders • Cubicles • Tables, refrigerator, microwave, coffee maker, plates, cups, cutlery, etc • Chairs or couches, end tables, brochure holders, TV etc in reception areas and common areas so that the office is welcoming and comfortable • General Office Supplies/Operating Supplies • Copy Machines (Rental) set up or first month • Construction build outs of office space including signage ' In addition to completing the "Start Up Costs" portion of the budget workbook, please answer the questions below For each of the responses, please respond in no more than one paragraph (4-6 sentences) Has your organization applied for any other ARPA funding, if yes, what project (name/number) and for ' what type of expenditure" The Single Entry Point/CMA has not applied for or received other ARPA funding How will these funds provide continuity of care for members" * These funds will allow Weld CMA to supply staff with the equipment needed to provide, as close to a seamless transition as possible It will also be used to communicate with members to keep them informed of changes, allow for improved ongoing communication with a CMA website and CMs cell phones for both providers and individuals we serve 4 , Has your organization been awarded Single Entry Point funding subject to subrecipient monitoring? Yes Do you currently have any unexpended or deferred revenue that is subject to subrecipient monitoring? If so please explain the amount, source and how this grant will not supplant the use of those funds * Yes, we do have unexpended funds to date in the amount of 294000 00 These funds are from the SEP contract over the last few years and are largely due to vacancy savings throughout those years However, these funds have been earmarked for hiring some positions now to place the program in the best possible position when the CMA becomes effective, cover current expenses as we ended FY23 overspent, increase in currents staff time on the CMA work vs other units within the division, purchasing a client tracking system and cell phones for existing CM staff This totals over 306000 00, completely depleting the current deferred revenue prior to the CMA start date of 3/1/2024 Device ARPA 6.08 Questions: Care and Case Management Compatible Devices maximum award variable, refer to Exhibit B in the RFA document for per - Designated Service Area maximums In addition to completing the "Devices" portion of the budget workbook, please answer the questions below For each of the responses, please respond in no more than one paragraph (4-6 sentences) 1 Please refer to Exhibit B or C in the RFA Describe how your agency will use the purchased devices (including peripherals) to support the person -centered roll out of the Care and Case Management System? What business needs will be met and who will use the devices? * All CMA staff completing assessments will be given a touchscreen laptop that can fold into a tablet for ease of use A compatible stylus and backup battery pack and cell phone with hot spot will also be provided for case manager's field work and will allow the CMs to complete assessments in the field and will allow members the opportunity to sign documents at the time of the visit having the chance to ask questions as necessary Headsets and wireless devices allow for ease of communication between CMA staff and members Dual monitors will allow the CMs to have more than one window open on their computer at a time decreasing the amount of time to complete data entry work 2 Please refer to Exhibit B or C in the RFA Should the devices your CMA qualifies for not be sufficient to meet your agency's needs as described in Question 1, please identify the number of additional devices needed along with a justification for their purchase in the workbook. Go to the linked WORKBOOK under 'Devices Budget' tab to enter in those details. I DO need additional devices and included the details in the workbook. I DO NOT need additional devices. 3. While the grant is designed to provide devices to case managers, the Department is also willing to consider reimbursement of up to $300.00 per device for the costs of peripherals and accessories to expand the ability of and help protect and maintain the device. This allotment of funds is displayed in Exhibit A Supplanting vs. Supplementing below. D I DO need additional devices and included the details in the workbook. I DO NOT need additional devices. 4. If your agency is requesting funding for leased devices, please explain how you plan to sustain these costs following the use of the grant funds. N/A EHR ARPA 6.06 Questions: Upgrade or adopt a new Electronic Health Record (EHR) maximum award: $100,000 per CMA (up to $2,000,000 total for 20 redesigned CMAs). In addition to completing the "EHR' portion of the budget workbook, please answer the questions below. For each of the responses, please respond in no more than one paragraph (4-6 sentences): 1. Why is your CMA agency requesting funding for an Electronic Health Record (EHR) upgrade or new implementation? N/A 6 2 Approximately how long will this EHR project takes (Please note this information is also required in your project work plan) N/A 3 Will the EHR be used for HCBS client data only or other lines of business at your agency' N/A 4 How will your agency balance an EHR upgrade at the same time as implementing the Care and Case Management tool, N/A 5 Other supporting information for an EHR upgrade N/A ATTESTATION STATEMENT: Please check/mark each statement of assurance below to be considered for ARPA grant funding The applicant organization listed above hereby accepts the conditions of the Case Management Retention grant program and agrees to the following assurances is The startup grant funds requested in the application will be administered and distributed in accordance with all applicable statutes, regulations, program plans, and requirements delineated in this application The applicant meets all eligibility requirements of the grant as outlined in the Case Management Agencies Start Up Request for Applications (RFA) Applicants must have this form approved by the Department to be eligible for reimbursement 0 Applicant understands that the funds requested in this application are likely the maximum amount that can be paid, the Department will not have additional funds available for costs invoiced above the requested amount The applicant will cooperate with any examination of records with respect to such Colorado Department of Healthcare Policy and Financing (the Department), the Office of eHealth Innovation (OeHl), the State of Colorado, or any auditors on its behalf, or (ii) any other state agency, commission, or department in the lawful exercise of its jurisdiction and authority All information contained in this application is true and accurate The applicant attests that no funds will be used to supplant their organizations existing costs End of application By adding your name on this Statement of Assurances document, the applicant attests that all Information indicated in this document is accurate and true The applicant agrees and acknowledges that by printing their name here it represents their signature in order for the application to be valid Kelly Morrison Create your own Goole Form Report Abuse 8 Cheryl Hoffman From: Sent: To: Cc: Subject: Attachments: Kelly Morrison Wednesday, August 9, 2023 10 05 PM Nicolette Cordova - HCPF Kelly Morrison, Lesley Cobb Start Up Grant information Start Up Grant Project Work Plan updated 8 9 23 xlsx, CMA Start Up Budget Workbook xlsx Hi Nicolette, I did send you a few questions about this process and haven't heard back so I went with my "best guess" in terms of how to complete the application and workbook Questions I asked in my 8/2 email Can we request funding to implement a client tracking program under startup funds and not the EHR tab or not at all, Can we add the items that we need under the startup costs tab, even if it goes over the 200K and you all will decide what we get/don't get, If we aren't looking for reimbursement for direct costs, can we remove that on the overall budget to bring down our request or leave it and just let you know that we aren't asking font? The member numbers for region 9 are off by a lot The RFA shows 2463 and after confirming with the 2 CCBs and 3 CHCBS providers our total looks to be about 2948 I listed that explanation on the device tab to show why I'm asking for more devices Is that sufficient, We do have some deferred revenue that is already earmarked for costs between now and 3/1/24 Would you like the spreadsheet showing the specifics for that or lust a general paragraph on the application with examples of expenses it will cover, Please find attached the Project workbook and the one -page project work plan(comments to the far right) I did want to point out that when submitting the grant application, there was a group of questions Are you a Small business (500 or fewer employees) Minority owned business Woman -owned business Veteran -owned business Business that employs people with disabilities (employs any Home and Community -Based Services Waiver member in Competitive Integrated Employment (CIE)) I initially did not mark any of these as none fit when thinking of Weld County as a whole however the application would not submit without picking a category I picked the "small business" thinking in terms of the CMA within Weld County that will be under 100 people to allow me to submit the application Please let me know if you have any questions Regards, Kelly Hello