HomeMy WebLinkAbout20231825.tiffRESOLUTION
RE: APPROVE AMENDMENT #2 TO INTERGOVERNMENTAL AGREEMENT FOR AGING
AND DISABILITY RESOURCES FOR COLORADO (ADRC) TRANSITION -RELATED
REFERRALS AND OPTIONS COUNSELING AND AUTHORIZE CHAIR PRO-TEM TO
SIGN AND 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 Amendment #2 to the Intergovernmental
Agreement for Aging and Disability Resources for Colorado (ADRC) Transition -Related Referrals
and Options Counseling 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 July 1, 2019,
and ending June 30, 2024, with further terms and conditions being as stated in said amendment,
and
WHEREAS, after review, the Board deems it advisable to approve said amendment, 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 Amendment #2 to the Intergovernmental Agreement for Aging and
Disability Resources for Colorado (ADRC) Transition -Related Referrals and Options Counseling
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 Pro-Tem be, and hereby is,
authorized to electronically sign and submit said amendment.
cc:NSD
e -7/2o /23
2023-1825
HR0095
AMENDMENT #2 TO INTERGOVERNMENTAL AGREEMENT FOR AGING AND DISABILITY
RESOURCES FOR COLORADO (ADRC) TRANSITION -RELATED REFERRALS AND
OPTIONS COUNSELING
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 28th day of June, A.D., 2023, nunc pro tunc July 1, 2019.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: dda,„ igc
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Weld County Clerk to the Board
C•un Att��'"y
Date of signature: O1/ti /2
2023-1825
HR0095
Con-fra c# ' O 11' -I I a '3
PRIVILEGED AND CONFIDENTIAL
MEMORANDUM
DATE: June 20, 2023
TO: Board of County Commissioners — Pass -Around
FR: Jamie Ulrich, Director, Human Services
RE: Aging and Disability Resources for Colorado (ADRC)
Contract Amendment #2 between Region 2B Weld
County Area Agency on Aging and the Colorado
Department of Health Care Policy and Financing
(HCPF)
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 Aging and Disability Resources for Colorado
(ADRC) Contract Amendment #2 between Region 2B Weld County Area Agency on Aging and the
Colorado Department of Health Care Policy and Financing (HCPF). The Department entered into an
Intergovernmental Agreement (IGA) with the Colorado Department of Health Care Policy and Finance
(HCPF), identified as Tyler ID 2019-2177. The purpose of this agreement is to expand the capacity of
Aging and Disability Resources for Colorado (ADRC) to enable an ADRC Site to respond to Minimum
Data Set (MDS) 3.0 Section Q Referrals, and to provide Options Counseling. Options Counseling will be
provided to individuals in nursing homes, Intermediate Care Facilities or Regional Centers who have
formally indicated, through the process, a desire to leave the facility and relocate to a community setting.
HCPF is now amending this IGA for a second time to make the following changes:
• Extend the term date through June 30, 2024.
• Update the current contract maximum to include State Fiscal Funding of $12,700.18.
• Amend Exhibit B, revising the Statement of Work.
I do not recommend a Work Session. I recommend approval of this Amendment and authorize the Chair
to sign via DocuSign.
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; June 20, 2023 - CMS ID 7123
Page 1
2023-1825
1-1 R o oeI 5
Karla Ford
From:
Sent:
To:
Subject
Approve
Mike Freeman
Tuesday, June 20, 2023 12:33 PM
Karla Ford
Re: Please Reply - PA FOR ROUTING: 062023 AAA ADRC Amend #2 (CMS 7123)
Sent from my iPhone
On Jun 20, 2023, at 11:53 AM, Karla Ford <kford@weld.gov>wrote:
Please advise if you approve recommendation. Thank you.
Karla Ford
Office Manager, Board of Weld County Commissioners
1150 0 Street, P.O. Box 758, Greeley, Colorado 80632
970.336-7204 :: kford(caweldgov.com :: www.weldgov.com
**Please note my working hours are Monday -Thursday 7:00a.m.-5:tgp.m.**
<image002,jpg>
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: Lesley Cobb <cobbxxlk@weld.gov>
Sent: Tuesday, June 20, 2023 11:46 AM
To: Karla Ford <kford@weld.gov>
Cc: Bruce Barker <bbarker@weld.gov>; Cheryl Pattelli <cpattelli@weld.gov>; Chris D'Ovidio
<cdovidio@weld.gov>; Esther Gesick <egesick@weld.gov>; Lennie Bottorff <bottorll@weld.gov>; HS -
Contract Management<HS-ContractManagement@co.weld.co.us>
Subject: PA FOR ROUTING: 062023 AAA ADRC Amend #2 (CMS 7123)
Good morning Karla,
Please see the attached PA approved for routing: 062023 AAA ADRC Amend #2 (CMS 7123).
Thank you!
Lesley Cobb
Contract Management and Compliance Supervisor
Weld Courtly Dept. of Human Services
315 N. 11th Ave., Bldg A
PO Box A
Greeley, CO 80632
^r1 (970) 400-6512
8 (970) 353-5212
coblexxik@weld.gov
DocuSign Envelope ID: 1BE27EEC-BCC2-41FA-9C13-3DB54B211933
CONTRACT AMENDMENT #2
SIGNATURE AND COVER PAGE
State Agency
Department of Health Care Policy and Financing
Original Contract Number
20-139139
Contractor
Amendment Contract Number
Weld County Area Agency on Aging
20-139139A2
Current Contract Maximum Amount
Contract Performance Beginning Date
Initial Term
July 1, 2019
State Fiscal Year 2020 $12,700.18
Extension Terms
Current Contract Expiration Date
State Fiscal Year 2021 $12,700.18
June 30, 2024
State Fiscal Year 2022 $12,700.18
State Fiscal Year 2023 $12,700.18
State Fiscal Year 2024 $12,700.18
Total for All State Fiscal Years $63,500.90
THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT
Each person signing this Amendment represents and warrants that he or she is duly authorized to execute this Amendment
and to bind the Party authorizing his or her signature.
By:
CONTRACTOR
Weld County Area Agency on Aging
Date:
C7 DS.
DocuSigned bb, I''
c.
D063D44A1...
6/30/2023 I 07:19 PDT
By:
STATE OF COLORADO
Jared S. Polls, Governor
Department of Health Care Policy and Financing
Kim Bimestefer, Executive Director
Date:
DocuSigned by:
N4 fnti
o86A84797EA84s3...
6/30/2023 I 17:38 PDT
In accordance with §24-30-202 C.R.S., this Amendment is not valid until signed and dated below by the State Controller or an
authorized delegate.
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
, -DocuSigned by:
20440etedr .,.
By: \-76,695,1272.3.
6/30/2023 I 17:59 PDT
Amendment Effective Date:
Amendment Contract Number: 20-139139A2
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
I. PARTIES
This Amendment (the "Amendment") to the Original Contract shown on the Signature and Cover
Page for this Amendment (the "Contract") is entered into by and between the Contractor and the
State.
2. TERMINOLOGY
Except as specifically modified by this Amendment, all terms used in this Amendment that are
defined in the Contract shall be construed and interpreted in accordance with the Contract.
3. AMENDMENT EFFECTIVE DATE AND TERM
A. Amendment Effective Date
This Amendment shall not be valid or enforceable until the Amendment Effective Date
shown on the Signature and Cover Page for this Amendment. The State shall not be bound
by any provision of this Amendment before that Amendment Effective Date, and shall have
no obligation to pay Contractor for any Work performed or expense incurred under this
Amendment either before or after of the Amendment term shown in §3.B of this Amendment.
B. Amendment Term
The Parties' respective performances under this Amendment and the changes to the Contract
contained herein shall commence on the Amendment Effective Date shown on the Signature
and Cover Page for this Amendment or July 1, 2023, whichever is later and shall terminate
on the termination of the Contract or June 30, 2024, whichever is earlier.
4. PURPOSE
The purpose of the Original Contract is to edit the Report Term and other Statements of Work in
order to provide appreciated Work. Also, extend the Contract for SFY2024.
5. MODIFICATIONS
The Contract and all prior amendments thereto, if any, are modified as follows:
A. The Contract Initial Contract Expiration Date on the Contract's Signature and Cover Page is
hereby deleted and replaced with the Current Contract Expiration Date shown on the
Signature and Cover Page for this Amendment.
B. 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 on the
Signature and Cover Page for this Amendment.
C. Exhibit B-1, Statement of Work, is deleted in its entirety and replaced with Exhibit B-2,
Statement of Work, attached hereto and incorporated by reference into the Contract. Any
reference to Exhibit B and Exhibit B-1 shall now be deemed to reference Exhibit B-2.
6. LIMITS OF EFFECT AND ORDER OF PRECEDENCE
This Amendment is incorporated by reference into the Contract, and the Contract and all prior
amendments or other modifications to the Contract, if any, remain in full force and effect except
as specifically modified in this Amendment. Except for the Special Provisions contained in the
Contract, in the event of any conflict, inconsistency, variance, or contradiction between the
provisions of this Amendment and any of the provisions of the Contract or any prior modification
to the Contract, the provisions of this Amendment shall in all respects supersede, govern, and
Amendment Contract Number: 20-139139A2
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
control. The provisions of this Amendment shall only supersede, govern, and control over the
Special Provisions contained in the Contract to the extent that this Amendment specifically
modifies those Special Provisions.
Amendment Contract Number: 20-139139A2
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-6588-A2A8DE7E8DC1
EXHIBIT B-2, STATEMENT OF WORK
1. TERMINOLOGY
1.1. In addition to the terms defined in §Error! Reference source not found. of this Contract, acronyms
and abbreviations are defined at their first occurrence in this Exhibit B, Statement of Work. The
following list of terms shall be construed and interpreted as follows:
1.1.1. Aging and Disability Resources for Colorado (ADRC) — The Colorado Adult Resources for
Care and Help Program which provides a coordinated and streamlined access point to long
term services and support for adults age 60 and over, or age 18 and over living with a
disability, and their caregivers.
1.1.2. ADRC Policy and Procedure Manual — The manual maintained by the State Unit on Aging
which outlines the policies and procedures for operating an ADRC Site in Colorado.
1.1.3. ADRC Site — An ADRC operating agency.
1.1.4. Authorization for Release of Information Form — A form signed by an individual authorizing
the ADRC to release and/or obtain verbal, electronic or written information regarding the
individual with the service providers and agencies for the purpose of making Referrals for
services and coordination in support of a transition to the community.
1.1.5. 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.
1.1.6. Case Management Agency (CMAs) — A public or private not -for-profit or for-profit agency
that meets all applicable state and federal requirements and is certified by the Department to
provide case management services for Home and Community Based Services waivers and
pursuant to a provider participation agreement with the state department.
1.1.7. Case Managers (CMs) — An individual employed by a CMA who is qualified to perform case
management activities.
1.1.8. Closeout Period — The period beginning on the earlier of ninety (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.
1.1.9. Colorado Revised Statutes (C.R.S.) — The legal code of Colorado; the legal codified general
and permanent statutes of the Colorado General Assembly.
1.1.10. Contractor — The individual or entity selected to complete the Work contained in the Contract.
1.1.11. Data — State Confidential Information and other State information resources transferred to
the Contractor for the purpose of completing a task or project assigned in the Statement of
Work.
1.1.12. 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.
1.1.13. Department — The Colorado Department of Health Care Policy and Financing.
1.1.14. Disaster — An event that makes it impossible for Contractor to perform the Work out of its
Page 1 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-6588-A2A8DE7E8DC1
regular facility or facilities, and may include, but is not limited to, natural disasters, fire or
terrorist attacks.
1.1.15. Health First Colorado — Colorado's Medicaid Program.
1.1.16. Health Insurance Portability and Accountability Act (HIPAA) — The Health Insurance
Portability and Accountability Act of 1996, as amended.
1.1.17. Independent Living Center (ILC) — A consumer -controlled, community -based, cross -
disability, non-residential private nonprofit agency that is designed and operated within a
local community by individuals with disabilities to provide an array of independent living
services to disabled individuals.
1.1.18. Key Personnel — The position or positions that are specifically designated as such in this
Contract.
1.1.19. Local Contact Agencies (LCAs) — An ADRC designated as a Local Contact Agency (LCA)
by the Colorado Department of Health Care Policy and Financing (HCPF) under the
Minimum Data Set (MDS) 3.0, Section Q protocol.
1.1.20. Member — Any individual enrolled in the Colorado Medicaid program, Colorado's CHP+
program or the Colorado Indigent Care Program, as determined by the Department.
1.1.21. Nursing Facility — a Nursing Facility in which a Member resides.
1.1.22. Nursing Facility Staff— The staff members of a Nursing Facility in which a Member resides.
1.1.23. Operational Start Date — When the Department authorizes Contractor to begin fulfilling its
obligations under the Contract.
1.1.24. Options Counseling — A person -centered approach to helping individuals gain an
understanding of the benefits and limitations of long-term services and support options, and
the knowledge to access these resources, in order to empower them to make choices that
reflect their unique needs, values and circumstances.
1.1.25. Options Counseling Assessment — The process of evaluating an individual's status and needs
in order to identify the appropriate service or combination of services required.
1.1.26. Options Counseling Referral Information Form — The document required by the Department
for any Options Counseling under this contract. This must be signed by the individual
receiving Options Counseling.
1.1.27. Options Counseling Referral Log — The monthly log created and required by the Department
identifying individuals referred to Options Counseling.
1.1.28. Options Counselor — Individual employed by an ADRC to conduct Options Counseling.
1.1.29. Other Personnel — Individuals and Subcontractors, in addition to Key Personnel, assigned to
positions to complete tasks associated with the Work.
1.1.30. Pre -Admission Screening and Resident Review (PASRR) Level II — The purpose of the
PASRR Level II evaluation is to evaluate and determine whether nursing facility services
are needed, whether an individual has mental illness or intellectual or developmental
disability and whether specialized mental health or intellectual or developmental disability
services are needed. After admission to a nursing facility, Level II Evaluation is also
required promptly following any significant change in the resident's condition.
1.1.31. Provider — Any health care professional or entity that has been accepted as a provider in the
Page 2 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
Colorado Medicaid program, Colorado's CHP+ program or the Colorado Indigent Care
Program, as determined by the Department.
1.1.32. Referral — the request of a Member for Options Counseling.
1.1.33. Section Q — The Section which addresses community Referrals on the Minimum Data Set
(MDS) 3.0, a federally mandated clinical assessment of all Members in Medicaid certified
nursing homes.
1.1.34. State — The State of Colorado, acting by and through any State agency.
1.1.35. State Fiscal Quarter — The quarterly period of a State Fiscal Year in which Contractor's
performance is measured.
1.1.36. State Unit on Aging — The unit in the State, designated to administer the Colorado State Plan
on Aging, including Older Americans Act and Older Coloradans Act programs. In Colorado,
this agency is within the Colorado Department of Human Services, Division of Aging and
Adult Services.
1.1.37. Transition Coordination Agency (TCAs) — A public or private not -for-profit or for-profit
agency that is enrolled as a provider and is certified by the Department to provide transition
coordination pursuant to a provider participation agreement with the state department.
1.1.38. Transition Coordination Referral Log — The monthly log created and required by the
Department identifying individuals referred to and accepted by Transition Coordination
Agencies.
1.1.39. Transition Coordination Pending Referral List — The monthly list created and required by the
Department identifying individuals who have not been accepted by a Transition Coordination
Agency.
1.1.40. Transition Coordinators — A person who provides transition coordination services and meets
all regulatory requirements for a transition coordinator.
2. CONTRACTOR'S GENERAL REQUIREMENTS
2.1. Contractor may be privy to internal policy discussions, contractual issues, price negotiations,
confidential medical information, Department financial information, advance knowledge of
legislation and other Confidential Information. In addition to all other confidentiality
requirements of the Contract, the Contractor shall also consider and treat any such information
as Confidential Information and shall only disclose it in accordance with the terms of the
Contract.
2.2. The Contractor shall work cooperatively with Department staff and, if applicable, the staff of
other State contractors to ensure the completion of the Work. The Department may, in its sole
discretion, use other contractors to perform activities related to the Work that are not contained
in the Contract or to perform any of the Department's responsibilities. In the event of a conflict
between Contractor and any other State contractor, the State will resolve the conflict and
Contractor shall abide by the resolution provided by the State.
2.3. The Contractor shall inform the Department on current trends and issues in the healthcare
marketplace and provide information on new technologies in use that may impact the
Contractor's responsibilities under this Contract.
2.4. The Contractor shall maintain complete and detailed records of all meetings, system development
life cycle documents, presentations, project artifacts, and any other interactions or Deliverables
Page 3 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
related to the Work described in the Contract. The Contractor shall make such records available
to the Department upon request throughout the term of the Contract.
2.5. Deliverables
2.5.1. All Deliverables shall meet Department -approved format and content requirements. The
Department will specify the number of copies and media for each Deliverable.
2.5.1.1. Contractor shall submit each Deliverable to the Department for review and approval and
shall adhere to the following Deliverable process such for any documentation creation,
review, and acceptable cycle, the Contractor shall:
2.5.1.1.1. Gather and document requirements for the Deliverable.
2.5.1.1.2. Create a draft in the Department -approved format for the individual Deliverable.
2.5.1.1.3. Perform internal quality control review(s) of the Deliverable, including, but not
limited to:
2.5.1.1.3.1. Readability.
2.5.1.1.3.2. Spelling.
2.5.1.1.3.3. Grammar.
2.5.1.1.3.4. Completion.
2.5.1.1.4. Adhere to all required templates or development of templates.
2.5.1.1.5. Perform modifications that include version control and tracked changes.
2.5.1.2. The Department will review the Deliverable and may direct Contractor to make changes
to the Deliverable. Contractor shall make all changes within five (5) Business Days
following the Department's direction to make the change unless the Department provides
a longer period in writing.
2.5.1.2.1. Changes the Department direct include, but are not limited to, modifying portions of
the Deliverable, requiring new pages or portions of the Deliverable, requiring
resubmission of the Deliverable or requiring inclusion of information or components
that were left out of the Deliverable.
2.5.1.2.2. The Department may also direct Contractor to provide clarification or provide a
walkthrough of any Deliverable to assist the Department in its review. Contractor
shall provide the clarification or walkthrough as directed by the Department.
2.5.1.3. Once the Department has received an acceptable version of the deliverable, the
Department will submit the invoice for payment.
2.5.2. Contractor shall employ an internal quality control process to ensure that all Deliverables are
complete, accurate, easy to understand and of high quality, as described herein. Contractor
shall provide Deliverables that, at a minimum, are responsive to the specific requirements for
that Deliverable, organized into a logical order, contain accurate spelling and grammar, are
formatted uniformly, and contain accurate information and correct calculations. Contractor
shall retain all draft and marked -up documents and checklists utilized in reviewing
Deliverables for reference as directed by the Department.
2.5.3. In the event any due date for a Deliverable falls on a day that is not a Business Day, the due
date shall be automatically extended to the next Business Day, unless otherwise directed by
the Department.
Page 4 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
2.5.4. All due dates or timelines that reference a period of days, months or quarters shall be
measured in calendar days, months and quarters unless specifically stated as being measured
in Business Days or otherwise. All times stated in the Contract shall be considered to be in
Mountain Time, adjusted for Daylight Saving Time as appropriate, unless specifically stated
otherwise.
2.5.5. No Deliverable, report, data, procedure or system created by Contractor for the Department
that is necessary to fulfilling Contractor's responsibilities under the Contract, as determined
by the Department, shall be considered proprietary.
2.5.6. If any Deliverable contains ongoing responsibilities or requirements for the Contractor, such
as Deliverables that are plans, policies or procedures, then Contractor shall comply with all
requirements of the most recently approved version of that Deliverable. Contractor shall not
implement any version of any such Deliverable prior to receipt of the Department's written
approval of that version of that Deliverable. Once a version of any Deliverable described in
this subsection is approved by the Department, all requirements, milestones and other
Deliverables contained within that Deliverable shall be considered to be requirements,
milestones and Deliverables of this Contract.
2.5.6.1. Any Deliverable described as an update of another Deliverable shall be considered a
version of the original Deliverable for the purposes of this subsection.
2.6. Stated Deliverables and Performance Standards
2.6.1. Any section within this Statement of Work headed with or including the term
"DELIVERABLE" or "PERFORMANCE STANDARD" is intended to highlight a
Deliverable or performance standard contained in this Statement of Work and provide a clear
due date for the Deliverables. The sections with these headings are for ease of reference not
intended to expand or limit the requirements or responsibilities related to any Deliverable or
performance standard, except to provide the due date for the Deliverables.
2.7. Communication with the Department
2.7.1. The Contractor shall enable all Contractor staff to exchange documents and electronic files
with the Department staff in formats compatible with the Department's systems. The
Department currently uses Microsoft Office 2016 and/or Microsoft Office 365 for PC. If the
Contractor uses a compatible program, then the Contractor shall ensure that all documents or
files delivered to the Department are completely transferrable and reviewable, without error,
on the Department's systems.
2.7.2. The Department will use a transmittal process to provide the Contractor with official direction
within the scope of the Contract. The Contractor shall comply with all direction contained
within a completed transmittal. For a transmittal to be considered complete, it must include,
at a minimum, all of the following:
2.7.2.1.
2.7.2.2.
2.7.2.3.
2.7.2.4.
2.7.2.4.1.
The date the transmittal will be effective.
Direction to the Contractor regarding performance under the Contract.
A due date or timeline by which the Contractor shall comply with the direction contained
in the transmittal.
The signature of the Department employee who has been designated to sign transmittals.
The Department will provide the Contractor with the name of the person it has
designated to sign transmittals on behalf of the Department, who will be the
Page 5 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
Department's primary designee. The Department will also provide the Contractor
with a list of backups who may sign a transmittal on behalf of the Department if the
primary designee is unavailable. The Department may change any of its designees
from time to time by providing notice to the Contractor through a transmittal.
2.7.3. The Department may deliver a completed transmittal to the Contractor in hard copy, as a
scanned attachment to an email or through a dedicated communication system, if such a
system is available.
2.7.3.1. If a transmittal is delivered through a dedicated communication system or other electronic
system, then the Department may use an electronic signature to sign that transmittal.
2.7.4. If the Contractor receives conflicting transmittals, the Contractor shall contact the
Department's primary designee, or backup designees if the primary designee is unavailable,
to obtain direction. If the Department does not provide direction otherwise, then the
transmittal with the latest effective date shall control.
2.7.5. In the event that the Contractor receives direction from the Department outside of the
transmittal process, it shall contact the Department's primary designee, or backup designees
if the primary designee is unavailable, and have the Department confirm that direction
through a transmittal prior to complying with that direction.
2.7.6. Transmittals may not be used in place of an amendment, and may not, under any
circumstances be used to modify the term of the Contract or any compensation under the
Contract. Transmittals are not intended to be the sole means of communication between the
Department and the Contractor, and the Department may provide day-to-day communication
to the Contractor without using a transmittal.
2.7.7. The Contractor shall retain all transmittals for reference and shall provide copies of any
received transmittals upon request by the Department.
2.8. Data Use Addendum
2.8.1. The Contractor shall agree to and provide signatures for Exhibit F, CMS -R-0235 Addendum
to receive MDS identifiable data to support Options Counseling and Referral Services as
described in Exhibit F. The Contractor shall ensure that all Subcontractors agree to and
provide signatures for Exhibit F, CMS -R-0235 Addendum.
2.8.1.1. Exhibit F, CMS -R-0235 Addendum may be modified or amended by the mutual written
agreement of the Parties, without amendment of this Agreement. Any modified or
amended Exhibit F, CMS -R-0235 Addendum agreed to in writing by the Parties shall
supersede and replace any prior version of Exhibit F, CMS -R-0235 Addendum.
2.9.
2.9.1.
2.9.1.1.
Closeout Period
During the Closeout Period, the Contractor shall complete all of the following:
Provide to the Department, or any other contractor at the Department's direction, all
reports, data, systems, Deliverables and other information reasonably necessary for a
transition as determined by the Department.
2.9.1.2. Ensure that all responsibilities under the Contract have been transferred to the
Department, or to another contractor at the Department's direction, without significant
interruption.
Page 6 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
2.9.1.3. Notify any Subcontractors of the termination of the Contract, as directed by the
Department.
2.9.1.4. Continue meeting each requirement of the Contract until the Department determines that
specific requirement is being performed by the Department or another contractor,
whichever is sooner. The Department will determine when any specific requirement is
being performed by the Department or another Contractor, and will notify the Contractor
of this determination for that requirement.
2.9.1.5. The Closeout Period may extend past the termination of the Contract. The Department
will perform a closeout review to ensure that Contractor has completed all requirements
of the Closeout Period. If Contractor has not completed all of the requirements of the
Closeout Period by the date of the termination of the Contract, then any incomplete
requirements shall survive termination of the Contract.
2.10. Federal Financial Participation Related Intellectual Property Ownership
2.10.1. In addition to the intellectual property ownership rights specified in the Contract, the
following subsections enumerate the intellectual property ownership requirements the
Contractor shall meet during the term of the Contract in relation to federal financial
participation under 42 CFR §433.112 and 45 CFR §95.617.
2.10.1.1. The Contractor shall notify the State before designing, developing, creating or installing
any new data, new software or modification of a software using Contract Funds. The
Contractor shall not proceed with such designing, development, creation or installation
of data or software without express written approval from the State.
2.10.1.2. If the Contractor uses Contract Funds to develop necessary materials, including, but not
limited to, programs, products, procedures, data and software to fulfill its obligations
under the Contract, the Contractor shall document all Contract Funds used in the
development of the Work Product, including, but not limited to the materials, programs,
procedures, and any data, software or software modifications.
2.10.1.2.1. The terms of this Contract will encompass sole payment for any and all Work Product
and intellectual property produced by the Contractor for the State. The Contractor
shall not receive any additional payments for licenses, subscriptions, or to remove a
restriction on any intellectual property Work Product related to or developed under
the terms of this Contract.
2.10.1.3.
2.10.1.4.
2.10.1.4.1.
The Contractor shall provide the State comprehensive and exclusive access to and
disclose all details of the Work Product produced using Contract Funds.
The Contractor shall hereby assign to the State, without further consideration, all right,
interest, title, ownership and ownership rights in all work product and deliverables
prepared and developed by the Contractor for the State, either alone or jointly, under this
Contract, including, but not limited to, data, software and software modifications
designed, developed, created or installed using Contract Funds, as allowable in the United
States under 17 U.S.C.S. §201 and §204 and in any foreign jurisdictions.
Such assigned rights include, but are not limited to, all rights granted under 17
U.S.C.S §106, the right to use, sell, license or otherwise transfer or exploit the Work
Product and the right to make such changes to the Work Product as determined by the
State.
Page 7 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
2.10.1.4.2. This assignment shall also encompass any and all rights under 17 U.S.C.S §106A,
also referred to as the Visual Artists Rights Act of 1990 (VARA), and any and all
moral rights to the Work Product.
2.10.1.4.3. The Contractor shall require its employees and agents to, proniptly sign and deliver
any documents and take any action the State reasonably requests to establish and
perfect the rights assigned to the State or its designees under these provisions.
2.10.1.4.4. The Contractor shall execute the assignment referenced herein immediately upon the
creation of the Work Product pursuant to the terms of this Contract.
2.10.1.5. The State claims sole ownership and all ownership rights in all copyrightable software
designed, developed, created or installed under this contract, including, but not limited
to:
2.10.1.5.1. Data and software, or modifications thereof created, designed or developed using
Contract Funds.
2.10.1.5.2. Associated documentation and procedures designed and developed to produce any
systems, programs, reports and documentation.
2.10.1.5.3. All other Work Products or documents created, designed, purchased, or developed by
the Contractor and funded using Contract Funds.
2.10.1.6. All ownership and ownership rights pertaining to Work Product created in the
performance of this Contract will vest with the State, regardless of whether the Work
Product was developed by the Contractor or any Subcontractor.
2.10.1.7. The Contractor shall fully assist in and allow without dispute, both during the term of this
Contract and after its expiration, registration by the State of any and all copyrights and
other intellectual property protections and registrations in data, software, software
modifications or any other Work Product created, designed or developed using Contract
Funds.
2.10.1.8. The State reserves a royalty -free, non-exclusive and irrevocable license to produce,
publish or otherwise use such software, modifications, documentation and procedures
created using Contract Funds on behalf of the State, the Federal Department of Health
and Human Services (HHS) and its contractors. Such data and software include, but are
not limited to, the following:
2.10.1.8.1. All computer software and programs, which have been designed or developed for the
State, or acquired by the Contractor on behalf of the State, which are used in
performance of the Contract.
2.10.1.8.2. All internal system software and programs developed by the Contractor or
subcontractor, including all source codes, which result from the performance of the
Contract; excluding commercial software packages purchased under the Contractor's
own license.
2.10.1.8.3. All necessary data files.
2.10.1.8.4. User and operation manuals and other documentation.
2.10.1.8.5. System and program documentation in the form specified by the State.
2.10.1.8.6. Training materials developed for State staff, agents or designated representatives in
the operation and maintenance of this software.
Page 8 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-6588-A2A8DE7E8DC1
2.11. Renewal Options and Extensions
2.11.1. The Department may, within its sole discretion, choose to not exercise any renewal option in
the Contract for any reason. If the Department chooses to not exercise an option, it may re -
procure the performance of the Work in its sole discretion.
2.11.2. The Parties may amend the Contract to extend beyond five (5) years, in accordance with the
Colorado Procurement Code and its implementing rules, in the event that the Department
determines the extension is necessary to align the Contract with other Department contracts,
to address state or federal programmatic or policy changes related to the Contract, or to
provide sufficient time to transition the Work.
2.11.3. The limitation on the annual maximum compensation in this Contract shall not include
increases made specifically as compensation for additional Work added to the Contract.
2.12. State of Colorado Information Technology Requirements
2.12.1. The Contractor shall adhere to all State of Colorado Information Technology Security and
Privacy requirements that are relevant to the Contract outlined in Exhibit E, Information
Technology Provisions.
3. PERSONNEL AND MEETING REQUIREMENTS
3.1. Key Personnel
3.1.1. Contractor shall designate an individual to hold the following Key Personnel positions:
3.1.1.1. Project Lead
3.1.1.1.1. The Project Lead shall be responsible for all of the following:
3.1.1.1.1.1. Serving as Contractor's primary point of contact for the Department.
3.1.1.1.1.2. Ensuring the completion of all Work in accordance with the Contract's
requirements. This includes, but is not limited to, ensuring the accuracy,
timeliness and completeness of all work.
3.1.1.1.1.3. Overseeing all other Key Personnel and Other Personnel and ensuring proper
staffing levels throughout the term of the Contract
3.2. Other Personnel Responsibilities
3.2.1. Contractor shall use its discretion to determine the number of Other Personnel necessary to
perform the Work in accordance with the requirements of this Contract. If the Department
determines that Contractor has not provided sufficient Other Personnel to perform the Work
in accordance with the requirements of this Contract, Contractor shall provide all additional
Other Personnel necessary to perform the Work in accordance with the requirements of this
Contract at no additional cost to the Department.
3.2.2. Contractor shall ensure that all Other Personnel have sufficient training and experience to
complete all portions of the Work assigned to them. Contractor shall provide all necessary
training to its Other Personnel, except for State -provided training specifically described in
this Contract.
3.3. Department Staff
3.3.1. Department Staff from both the State Unit on Aging and the Department of Health Care
Policy and Financing (HCPF) will coordinate communications with the Contractor's Aging
Page 9 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
and Disability Resources for Colorado (ADRC) staff; including staff from a sub -contracted
Independent Living Center (ILC), to ensure proper uniformity with the project.
3.4. Meeting Requirements
3.4.1. The Contractor shall attend transition coordination meetings scheduled by the Department
for Transition Coordinators (TCs), Case Managers (CMs), Option Counselors and
Ombudsman scheduled by the Department to coordinate and plan Referral and transition
activities and to discuss processes impacting Members, consumers and long-term care facility
staff. The Contractor shall ensure that it provides all necessary attendees as requested by the
Department for these meetings, including, but not limited to, the ADRC Site, Options
Counselors and sub -contracted ILCs.
3.4.2. The Contractor's ADRC Site, CMAs, ILCs and Transition Coordination Agency (TCAs)
shall work to establish a standard meeting schedule based on the local needs of the Contractor.
3.4.3. The Contractor's ADRC Site, sub -contracted ILCs, CMAs, and TCAs may meet regularly
outside of the scheduled meeting at the Contractor's discretion for the purposes of
coordinating efforts and resolving issues at a local level.
4. DEPARTMENT SUPPORT AND RESPONSIBILITIES
4.1. The Department will financially support the infrastructure of the ADRC network to enable it to
conduct outreach activities to inform local stakeholders and the general public about transition
coordination and other transition services, to respond to all Minimum Data Set (MDS) Section
Q Medicaid Referrals and provide Options Counseling to Members in the ADRC coverage area.
4.1.1. The Department will provide outreach and options counseling to any referrals that come
through the online referral form.
4.2. The Department will designate ADRC Sites as the Local Contact Agencies (LCAs).
4.3. The Department will inform all nursing facilities and Transition Coordinators in the coverage
area that the ADRC in the Contractor's coverage area shall serve as the LCA.
4.4. The Department will make available an online MDS Section Q training for Options Counselors,
Nursing Facility Staff and Transition Coordinators.
4.5. The Department will provide ongoing technical assistance regarding outreach activities and the
Referral and transition processes to the ADRC Sites, sub -contracted ILCs, TCAs, and CMAs
through Transition Coordination meetings and technical assistance calls.
4.6. The Department shall make available relevant MDS data to the Contractor to support ADRC
planning and activities in response to Section Q Referrals.
5. PROJECT SPECIFIC STATEMENT OF WORK
5.1. ADRC Coverage Area
5.1.1. The Contractor shall manage all Referrals locally from nursing homes in the following
counties: Weld
5.2. Options Counseling Responsibilities
5.2.1. The Contractor shall provide Options Counseling following the requirements included in this
section.
5.2.2. The Contractor shall use Options Counseling procedures identified in the ADRC Policy and
Procedure Manual, Options Counseling Training and Webinars provided by the Department
Page 10 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
and the State Unit on Aging, to facilitate the Referral process and Referrals to the Transition
Coordination program.
5.2.2.1. The Contractor shall use the ADRC Policy and Procedure Manual, Options Counseling
Training and Webinars to determine the minimum qualifications for Options Counseling
for ADRC staff and sub -contractors.
5.2.3. The Contractor shall provide Options Counseling to the following groups:
5.2.3.1. Members using Medicaid referred through the MDS Section Q process.
5.2.3.2. Members using Medicaid referred through the PASRR Level II process.
5.2.3.3. Members using Medicaid referred through the Department.
5.2.3.4. Members using Medicaid referred through self -Referrals.
5.2.3.5. Members using Medicaid referred through service providers, advocates and/or family
Members.
5.2.3.6. All Members identified in MDS data made available to the Contractor by the Department.
5.2.3.7. All Members identified shall referred through the online Google Form.
5.2.4. The Contractor shall assign an Options Counselor for Members. All Options Counselors
shall be assigned within six (6) months of the Effective Date of this Contract.
5.2.5. The Contractor shall work to avoid any staffing conflicts of interests including utilizing
Ombudsman to conduct options counseling in facilities they oversee.
5.2.5.1. If the Contractor foresees any conflict of interest for any staff during the contracting
period, the contractor will submit a plan to mitigate these conflicts to the Department
Representative for review and approval prior to the staff member starting work.
5.2.6. The Contractor shall meet the referred Members in the Member's nursing home within ten
(10) Business Days of the Referral.
5.2.6.1. The Contractor shall document in the Member's case file and on the quarterly reporting
spreadsheet in the event if the Member could not be reached within (10) Business Days.
5.2.6.2. The Contractor shall adhere to all Nursing Facility rules and regulations when meeting
with a Member in their Nursing Facility, including, but not limited to, rules and
regulations pertaining to vendors in the facility.
5.2.7. The Contractor shall transfer a Referral to a Subcontractor, when applicable, within two (2)
Business Days after receiving the Member Referral for Options Counseling.
5.2.8. The Contractor shall ensure that a Subcontractor responds to the referred Member in the
Member's Nursing Facility within eight (8) Business Days after receiving the transferred
Referral from the Contractor.
5.2.8.1. The Contactor shall ensure all Subcontractors adhere to all Nursing Facility rules and
regulations, including those pertaining to visitors in the facility.
5.2.9. The Contractor shall provide Options Counseling:
5.2.9.1. Medicaid recipients who are eligible for Home and Community Based Services, reside in
a nursing home or, Intermediate Care Facility for Individuals with Intellectual and
Developmental Disabilities (ICF-IID), or Regional Center, and are willing to participate
and have expressed interest in moving to a home and community -based setting.
Page 11 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
5.2.9.2. Members may also be Medicaid recipients receiving Home and Community Based
Services provided by the State operated Regional Centers who want to transition to a
private Home and Community Based Services Provider.
5.2.9.3. Excluded are children under the age of 18.
5.2.10. The Contractor shall provide Members with the option to choose from any of the following
programs through Medicaid:
5.2.10.1. Home and Community Based Waiver Programs (HCBS);
5.2.10.2. State Plan Long Term Care Benefits including Transition Coordination.
5.2.11. The Contractor shall explain and describe the programs available to the Member or their legal
guardian.
5.2.12. The Contractor shall make a Referral to a local Transition Coordination Agency if the
Member wishes to proceed with the transition process. Including the Contractor shall make
the Referral to a Transition Coordination Agency outside of their region if there is not
available in their area.
5.2.12.1.
5.2.12.2.
5.2.12.3.
5.2.12.3.1.
5.2.12.4.
5.2.12.5.
5.2.12.5.1.
5.2.12.5.2.
5.2.12.6.
5.2.12.7.
5.2.12.7.1.
5.2.12.7.2.
The Contractor shall not screen out a Member for transition services.
The Contractor shall obtain a signed Authorization for Release of Information Form from
the Member before sending any information to the Member's chosen TCA.
The Contractor shall provide information about each TCA in the local area that can work
with the Member to determine if a transition is feasible. The Contractor shall provide
support as necessary to the Member in choosing a TCA.
Regardless of a Member's preference, the Contractor shall use the tools and resources
at their disposal to help Members to make an informed choice about a local TCA prior
to signing the Options Counseling Referral Information Form.
The Contractor shall leave the appropriate contact information of the chosen TCA, as
well as contact information for the Options Counselor, for each Member or designated
individual.
The Contractor shall make a Referral to a local TCA by sending the following forms,
provided by the Department and State Unit on Aging, to a local TCA of the Member's
choosing within two (2) Business Days upon Member signature on the Referral form:
Completed Options Counseling Referral Information Form; and
Options Counseling Assessment.
If the chosen TCA does not have capacity, the Contractor shall add the Member to the
Contractor's Transition Coordination Pending Referral List or refer them to another TCA
outside of their region.
The Contractor shall send the following completed forms to the Department's Principal
Representative listed on the Cover Page of this Agreement within two (2) Business Days
upon Member signature on the form:
Completed Options Counseling Referral Information Form; and
Options Counseling Assessment.
Page 12 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
5.2.12.8. The Contractor shall confirm that the chosen TCA accepted the Referral by notifying the
Medicaid Member and the Nursing Facility, with the following information:
5.2.12.8.1. TCA name, phone number, and email address; and
5.2.12.8.2. Assigned TC name, phone number, and email address.
5.2.12.9. The Contractor shall inform a Member of alternative options if the Member is not an
appropriate candidate for transition coordination through Medicaid.
5.2.12.9.1. The Contractor shall make proper Referrals based on the Member's status.
5.2.12.10. The Contractor shall ensure that Medicaid Members referred through Section Q and/or
identified in the MDS data receives Options Counseling. The data includes:
5.2.12.10.1. MDS Section Q0500B "yes" and Q0600 "yes -referral made" Medicaid Member
responses.
5.2.12.10.2. MDS Section Q0500B "yes" and Q0600 "no -referral is or may be needed" Medicaid
Member responses.
5.2.12.10.3. MDS Section Q0500B "yes" and Q0600 "no -referral not needed" Medicaid Member
responses.
5.2.12.10.4. Departmental Referrals from the Department's Principal Representative.
5.2.12.11. The Contractor shall ensure that its Options Counseling follows the ADRC Policy and
Procedure Manual for Options Counseling.
5.2.12.12. The Contractor shall ensure that transition coordination eligible Members who desire to
continue with transitioning are referred to a local TCA.
5.2.12.13. The Contractor may participate in a statewide Quarterly Technical Assistance Conference
Call for all ADRC Sites, hosted by the Department, to troubleshoot common issues and
share best practices in the Referral and transition process.
5.2.12.14. The Contractor shall attend and participate in regional Transition Coordination Meetings
or Options Counseling Meetings, hosted by the Department, to improve the candidate
identification, Referral, and transition functions, and to problem solve local or Member -
specific issues with the Referral transition process.
5.3. Regional Transition Coordination
5.3.1. The Contractor may utilize already established ADRC Advisory Councils, as outlined in the
ADRC Policy and Procedure Manual provided by the State Unit on Aging to either convene
and facilitate conversations about transition coordination with partners or create a separate
transition coordination council/committee.
5.3.2. Target Membership of the ADRC Advisory Council or separate transition coordination
council/committee shall include, but is not limited to, representatives from the following
perspectives:
5.3.2.1. ADRC Site;
5.3.2.2. Members/Families;
5.3.2.3. Community Centered Boards;
5.3.2.4. Community Providers;
Page 13 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
5.3.2.5. Landlords;
5.3.2.6. Local Housing Authorities;
5.3.2.7. Nursing Facilities;
5.3.2.8. Local Businesses;
5.3.2.9. Local Government;
5.3.2.10. Ombudsmen;
5.3.2.11. Single Entry Points; and
5.3.2.12. Transition Coordination Agencies.
5.3.3. PERFORMANCE STANDARD: Contractor shall notify the Department's Principal
Representative how they plan to structure Regional Transition Coordination within 60
Calendar Days following the Effective Date of this Agreement.
5.4. ADRC Outreach Responsibilities
5.4.1. The Contractor shall develop and submit a Regional Outreach Plan to the Department for
review.
5.4.1.1.
5.4.1.1.1.
5.4.1.1.2.
5.4.1.2.
5.4.1.2.1.
5.4.1.2.2.
5.4.1.3.
5.4.1.3.1.
5.4.1.3.1.1.
5.4.1.3.1.2.
5.4.1.3.1.2.1.
5.4.1.3.1.2.1.1.
5.4.1.3.1.2.1.2.
5.4.1.3.1.2.1.3.
5.4.1.3.1.2.1.4.
5.4.1.3.2.
The Regional Outreach Plan shall include all of the following:
An outline of the Contractor's proposed efforts to increase Referrals for Options
Counseling and community transitions. The Contractor may include any outreach
activity approved by the Department. The Department will provide a list of potential
outreach activities to the Contractor.
All performance standards, timelines and milestones the Contractor will meet related
to regional outreach, as well as any Deliverables the Contractor will submit.
The Contractor shall deliver the Regional Outreach Plan to the Department for review
and approval.
DELIVERABLE: Regional Outreach Plan
DUE: No later than sixty (60) days after Effective Date, and annually thereafter
The Contractor shall update the Regional Outreach Plan annually and deliver a copy to
the Department for review and approval.
The Contractor shall update the Regional Outreach Plan to include the following:
A list of all outreach activities completed by the Contractor.
A description of the results from the completed outreach activities.
Results include, but are not limited to, the following:
Number of outreach/education meetings held with family/guardians of
Nursing Facility residents.
Number of presentations to Resident Council Meetings.
Number of community meetings attended and presentations given.
Development and dissemination of outreach materials.
DELIVERABLE: Updated Regional Outreach Plan
Page 14 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-6588-A2A8DE7E8DC1
5.4.1.3.3. DUE: At least three (3) Business Days before the end of the fourth (4th) quarter of the
State Fiscal Year
5.4.1.4. Target audiences for outreach activities shall include, but are not limited to:
5.4.1.4.1. Potential Members;
5.4.1.4.2. Families/Guardians;
5.4.1.4.3. Nursing Facility Staff;
5.4.1.4.4. Housing Authorities;
5.4.1.4.5. Landlords;
5.4.1.4.6. Local businesses;
5.4.1.4.7. Local government; and
5.4.1.4.8. General Members of the public.
5.4.1.5. The Contractor shall provide ongoing Section Q Referral process outreach, training and
education to Nursing Facility Staff.
5.5. Sub -Contracting with Independent Living Centers
5.5.1. The Contractor may subcontract with an Independent Living Center (ILC) to support
outreach activities and Options Counseling to nursing home Members if an ILC is established
in the Contractor's coverage area.
5.5.2. If the Contractor subcontracts with an ILC, the ILC shall provide Options Counseling in
accordance with the established ADRC policies and procedures and state standards.
5.5.3. The Contractor shall include the ILC performance data in the required reports identified in
Section 6.
5.5.4. In the event that an ILC does not wish to subcontract with the Contractor, the Contractor shall
provide documentation to the Department indicating that the ILC has opted out.
5.5.5. The Contractor shall notify the Department if the Contractor establishes a subcontract with
an ILC.
5.5.6. The Contractor may earn an administrative rate for each calendar quarter in which the
Contractor subcontracts with an ILC. For the purposes of this rate, the Contractor shall be
considered to have contracted with an ILC during the quarter if the Contractor has
subcontracted with the ILC for the entire quarter. The Contractor shall provide a copy of the
subcontract to the Department.
5.5.7. Written notification of termination of a subcontract shall be provided to the Department at
least ten (10) Business Days prior to the contract termination unless the Department allows
for a shorter period in writing.
5.5.7.1. PERFORMANCE STANDARD: Subcontracted with an ILC during the calendar quarter
6. REPORTING REQUIREMENTS
6.1. MDS Training Notification
6.1.1. The Contractor shall inform the Department's Principal Representative via email when an
assigned Options Counselor has completed the MDS training, by providing the first and last
name of the Options Counselor.
Page 15 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
6.2. Quarterly Referral Logs
6.2.1. The Contractor shall complete a Quarterly Reporting Spreadsheet, as provided by the
Department, that covers the entire quarters activities. The Quarterly Reporting Spreadsheet
shall include, at a minimum, the following:
6.2.1.1. Options Counseling Referral Logs, including the Transition Coordination Pending
Referral List.
6.2.1.2. TCA Referral Logs, including all Members who received Options Counseling after being
referred to a TCA.
6.2.2. The Contractor shall deliver the completed Quarterly Referral Logs to the Department for
review and approval.
6.2.2.1. DELIVERABLE: Quarterly Referral Logs
6.2.2.2. DUE: Fifteen (15) Calendar Days following the last day of the State Fiscal Quarter that
the Quarterly Report Covers.
7. COMPENSATION AND INVOICING
7.1. Compensation
7.1.1. The Compensation under this Contract shall consist of a base Quarterly Payment as described
in Exhibit C-1, Rates
7.1.1.1. Quarterly Payment
7.1.1.1.1. The Contractor shall receive a quarterly rate for each State Fiscal Quarter, subject to
the Contractor's performance of Options Counseling and delivery of approved
Quarterly Report to the Department.
7.1.1.1.2. If the Contractor does not perform any Options Counseling in a Quarter, the
Contractor shall not receive the Quarterly Payment for that Quarter in which no
Options Counseling occurred.
7.2. Detailed Invoicing and Payment Procedures
7.2.1. The Contractor shall invoice the Department on a quarterly basis, by the fifteenth (15th) of
the month following the last month of the quarter for which the invoice covers. Contractor
shall not invoice the Department for a quarter prior to the last month of that quarter.
7.2.1.1. Quarterly invoices for payment shall use the standardized template provided by the
Department.
7.2.2. The Department shall remit payment to the Contractor within forty-five (45) days of the
Department's acceptance of the monthly and quarterly reports. Acceptance of an invoice
shall not imply the acceptance or sufficiency of any work performed or deliverables
submitted to the Department during the month for which the invoice covers or any other
month. The Department shall not make any payment on an invoice prior to its acceptance of
that invoice.
7.2.3. In the event that the Contractor believes that the calculation or determination of any payment
is incorrect, the Contractor shall notify the Department of the error within thirty (30) days of
receipt of the payment or notification of the determination of the incentive payment, as
appropriate. The Department will review the information presented by the Contractor and
may make changes based on this review. The determination or calculation that results from
Page 16 of 17
Exhibit B-2, Statement Of Work
DocuSign Envelope ID: B45C7CEC-3C86-4CF6-B588-A2A8DE7E8DC1
the Department's review shall be final. No disputed payment shall be due until after the
Department has concluded its review.
7.3. Closeout Payments
7.3.1. Notwithstanding anything to the contrary in this Contract, all payments for the final month
of this Contract shall be paid to Contractor no sooner than ten (10) days after the Department
has determined that Contractor has completed all of the requirements of the Closeout Period.
Page 17 of 17
Exhibit B-2, Statement Of Work
Contract Form
New Contract Request
Entity Information
Entity Name.
COLORADO DEPT OF HEALTH CARE
POLICY & FINANCING
Entity ID*
&00007174
Contract Narne
AGING AND DISABILITY RESOURCE OF COLORADO (ADRC)
AGREEMENT AMENDMENT *2 20-139139A2
Contract Status
CTB REVIEW
Contract ID
7123
Contract Lead.
COBBXXLK.
Ell New Entity?
Parent Contract ID
201921 77
Requires Board Approval.
YES
Contract Lead Email Department Project
cobbxxlk?Pco.weld.ca.us
Contract Description
AGREEMENT AMENDMENT #2 - AGING AND DISABILITY RESOURCE OF COLORADO (ADRC) REGION 28 WELD COUNTY AREA
AGENCY ON AGING AND HCPF. ORIGINAL INTERGOVERNMENTAL AGREEMENT TYLER ID92019-2177. EXTEND TERM DATE TO
JUNE 30, 2024 AND REVISE STATEMENT OF WORK.
Contract Description 2
PA ROUTING THROUGH NORMAL APPROVAL PROCESS. ETA TO CTB 6/22/23. DOCUMENT WILL BE SIGNED VIA DOCUSIGN.
Contract Type.
AMENDMENT
Amount.
$12,700.18
Renewable*
NO
Automatic Renewal
Grant
IGA
Department
HUMAN SERVICES
Department Email
CM -
H umanServtcesWwe Idgov. co
rrr
Department Head Email
CM-HumanServices-
DeptHead,Aa eldcgov°.com
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYATTORNEY WELDG
OV.COM
Requested BOCC Agenda
Date*
06/28/2023
Due Date
06°24/2023
Will a work session with 0OCC be required?*
NO
Does Contract require Purchasing Dept. to be included?
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
Review Date
04, 30.2024
Renewal Date
Termination Notice Period
Contact Information
Contact Info
Contact Name
Purchasing
Purchasing Approver
Approval Process
Department Head
JAMIE ULRICH
OH Approved Date
06,20'2023
Final Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
06;`28,'2023
Originator
COEBXXLK
Committed Delivery Date
Contact Type Contact Email
Finance Approver
CHERYL PATTELLI
Expiration Date.
06;' 2812024
Contact Phone I
Purchasing Approved Date
Legal Counsel
EYRON HOWELL
Contact Phone 2
Finance Approved Date Legal Counsel Approved Date
06,21/2023
Tyler Ref
AG 052823
05,•`22/2023
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