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
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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.
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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
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Cheryl Hoffman
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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