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HomeMy WebLinkAbout20192177.tiffRESOLUTION RE: APPROVE INTERGOVERNMENTAL AGREEMENT FOR AGING AND DISABILITY RESOURCE OF COLORADO (ADRC) TRANSITION -RELATED REFERRALS AND OPTIONS COUNSELING AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with an Intergovernmental Agreement for Aging and Disability Resource of 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, Region 2B Weld County Area Agency on Aging, and the Colorado Department of Health Care Policy and Financing, commencing July 1, 2019, and ending June 30, 2020, with further terms and conditions being as stated in said intergovernmental agreement, and WHEREAS, after review, the Board deems it advisable to approve said intergovernmental agreement, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Intergovernmental Agreement for Aging and Disability Resource of 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, Region 2B Weld County Area Agency on Aging, and the Colorado Department of Health Care Policy and Financing, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said intergovernmental agreement. cc={—tSO IOf( (l9 2019-2177 H R0090 RE: INTERGOVERNMENTAL AGREEMENT FOR AGING AND DISABILITY RESOURCE OF 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 12th day of June, A.D., 2019. BOARD OF COUNTY COMMISSIONERS W COUNTY, COLORADO ATTEST: dititvo jC ; ok Weld County Clerk to the Board Mike Freeman, Pro-Tem Deputy Clerk to eunty A''orney Date of signature: if ?..)%! q 2019-2177 HR0090 COYl+rctc1- g-7CoCo PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: June 5, 2019 TO: Board of County Commissioners — Pass -Around FR: Judy A. Griego, Director, Human Services RE: Weld County Department of Human Services' ADRC-Transition Related Referrals and Options Counseling Contract 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 Departments' ADRC-Transition Related Referrals and Options Counseling Contract. The State has issued a new contract between Aging and Disability Resource of Colorado (ADRC) Region 2 B Weld County Area Agency on Aging and the Colorado Department of Health Care Policy and Financing (HCPF). The ADRC is a program that exists within the Area Agency on Aging. The purpose of this contract is to expand the capacity of ADRC to enable an ADRC site to respond to Minimum Data Set (MDS) 3.0 Section Q referrals and provide Options Counseling. Options Counseling will be provided to residents in nursing homes who have formally indicated through the process a desire to leave the nursing home and relocate to a community setting. The contract is due to the State by June 14, 2019. The initial contract term is July 1, 2019, through June 30, 2020, with a maximum amount of $12,700.18. I do not recommend a Work Session. I recommend approval of this Contract and authorize the Chair to sign. Sean P. Conway Mike Freeman, Pro -Tern Scott James Barbara Kirkmeyer, Chair Steve Moreno Approve Schedule Recommendation Work Session NLr Other/Comments: Pass -Around Memorandum; June 5, 2019 — CMS 2766 Page 1 2019-2177 I -I ROOG O STATE OF COLORADO INTERGOVERNMENTAL AGREEMENT COVER PAGE State Agency Department of Health Care Policy and Financing Contract Number 20-139139 Contractor Region 2B Weld County Area Agency on Aging Contract Performance Beginning Date The later of the Effective Date or July 1, 2019 Contract Maximum Amount Initial Term State Fiscal Year 2020 $12,700.18 Total for All State Fiscal Years $12,700.18 Initial Contract Expiration Date June 30, 2020 Contract Authority Authority to enter into this Contract exists in Colorado Revised Statutes (CRS) at §25.5-6-106, et seq. Contract Purpose The purpose of this Contract 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 to those nursing home Members referred. This Contract is exempt from the Colorado Procurement Code pursuant to the exemption in 24-101-105(1)(a)(XII). Exhibits and Order of Precedence The following Exhibits and attachments are included with this Contract: 1. Exhibit A — HIPAA Business Associates Addendum 2. Exhibit B — Statement of Work 3. Exhibit C — Rates 4. Exhibit D — Sample Option Letter 5. Exhibit E — Information Technology Provisions 6. Exhibit F — CMS — R-0235 Addendum In the event of a conflict or inconsistency between this Contract and any Exhibit or attachment, such conflict or inconsistency shall be resolved by reference to the documents in the following order of priority: 1. Colorado Special Provisions in §17 of the main body of this Contract. 2. The provisions of the other sections of the main body of this Contract. 3. Exhibit A, HIPAA Business Associates Addendum. 4. Exhibit E, Information Technology Provisions. 5. Exhibit B, Statement of Work. 6. Exhibit C, Rates. 7. Exhibit D, Sample Option Letter. 8. Exhibit F, CMS - R-0235 Addendum. Principal Representatives For the State: For Contractor: Katy Barnett Kelly Morrison Department of Health Care Policy and Financing Region 2B 1570 Grant Street 311 N 11 `h Ave Denver, CO 80203 Greeley, CO 80632 katy.barnett@hcpf.state.co.us kmorrison@weldgov.com Contract Number: 20-139139 Page 1 of 22 0619-x177(1) SIGNATURE PAGE THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT Each person signing this Contract represents and warrants that the signer is duly authorized to execute this Contract and to bind the Party authorizing such signature. CONTRACTOR Region 2B Weld County Area Agency on Aging Department Kim STATE OF COLORADO Jared S. Polis, Governor of Health Care Policy and Financing Bim ste xeeutive Director 74.,By: Barbara Kirkmeye , Weld Coun Commissioner Date: JUN 12 2019 By: Kim Date: Bimestefer, Execut ve rector Co . 2A-- _ 6) LEGAL REVIEW Phil Weiser, Attorney General By: M/J Date: Assistant Attorney General In accordance with §24-30-202, C.R.S., this Contract STAT Ro By: is not valid until signed and dated below by the State Controller or an authorized delegate. CONTROLLER , A, l�'[BA, JD Departm'n Effective H . lth are Policy and Financing Date: [U_/30 6 Contract Numbcr: 20-139139 Page 2 of 22 -ao la- Q111 (3) TABLE OF CONTENTS 1. PARTIES 4 2. TERM AND EFFECTIVE DATE 4 3. DEFINITIONS 5 4. STATEMENT OF WORK 8 5. PAYMENTS TO CONTRACTOR 8 6. REPORTING - NOTIFICATION 9 7. CONTRACTOR RECORDS 9 8. CONFIDENTIAL INFORMATION -STATE RECORDS 10 9. CONFLICTS OF INTEREST 12 10. INSURANCE 12 11. BREACH OF CONTRACT 14 12. REMEDIES 14 13. DISPUTE RESOLUTION 16 14. NOTICES AND REPRESENTATIVES 17 15. RIGHTS IN WORK PRODUCT AND OTHER INFORMATION 17 16. GENERAL PROVISIONS 18 17. COLORADO SPECIAL PROVISIONS (COLORADO FISCAL RULE 3-1) 20 EXHIBIT A, HIPAA BUSINESS ASSOCIATES ADDENDUM 1 EXHIBIT B, STATEMENT OF WORK 1 EXHIBIT C, RATES 1 EXHIBIT D, SAMPLE OPTION LETTER 1 EXHIBIT E, INFORMATION TECHNOLOGY PROVISIONS 1 EXHIBIT F, CMS - R-0235 ADDENDUM 1 Contract Number: 20-139139 Page 3 of 22 1. PARTIES This Contract is entered into by and between Contractor named on the Cover Page for this Contract (the "Contractor"), and the STATE OF COLORADO acting by and through the State agency named on the Cover Page for this Contract (the "State"). Contractor and the State agree to the terms and conditions in this Contract. 2. TERM AND EFFECTIVE DATE A. Effective Date This Contract shall not be valid or enforceable until the Effective Date. The State shall not be bound by any provision of this Contract before the Effective Date and shall have no obligation to pay Contractor for any Work performed or expense incurred before the Effective Date or after the expiration or sooner termination of this Contract. B. Initial Term The Parties' respective performances under this Contract shall commence on the Contract Performance Beginning Date shown on the Cover Page for this Contract and shall terminate on the Initial Contract Expiration Date shown on the Cover Page for this Contract (the "Initial Term") unless sooner terminated or further extended in accordance with the terms of this Contract. C. Extension Terms - State's Option The State, at its discretion, shall have the option to extend the performance under this Contract beyond the Initial Term for a period, or for successive periods, of one (1) year or less at the same rates and under the same terms specified in the Contract (each such period an "Extension Term"). In order to exercise this option, the State shall provide written notice to Contractor in a form substantially equivalent to the Sample Option Letter attached to this Contract. Except as stated in §2.D, the total duration of this Contract, including the exercise of any options to extend, shall not exceed five (5) years from its Effective Date absent prior approval from the State Purchasing Director in accordance with the Colorado Procurement Code. The rates shown in Exhibit C, rates are determined by Department methodology. The State, at its discretion, shall have the option to increase or decrease the rates shown in Exhibit C, Rates, as the State determines is necessary to account for inflation or legislative changes. In order to exercise this option, the State shall provide written notice to Contractor in a form substantially equivalent to Exhibit D, Sample Option Letter, and any new rates table or exhibit shall be effective as of the effective date of that notice unless the notice provides for a different date. D. End of Term Extension If this Contract approaches the end of its Initial Term, or any Extension Term then in place, the State, at its discretion, upon written notice to Contractor as provided in §14, may unilaterally extend such Initial Term or Extension Term for a period not to exceed two (2) months (an "End of Term Extension"), regardless of whether additional Extension Terms are available or not. The provisions of this Contract in effect when such notice is given shall remain in effect during the End of Term Extension. The End of Term Extension shall automatically terminate upon execution of a replacement contract or modification extending the total term of this Contract. Contract Number: 20-139139 Page 4 of 22 E. Early Termination in the Public Interest The State is entering into this Contract to serve the public interest of the State of Colorado as determined by its Governor, General Assembly, or Courts. If this Contract ceases to further the public interest of the State, the State, in its discretion, may terminate this Contract in whole or in part. A determination that this Contract should be terminated in the public interest shall not be equivalent to a State right to terminate for convenience. This subsection shall not apply to a termination of this Contract by the State for breach by Contractor, which shall be governed by §12. i. Method and Content The State shall notify Contractor of such termination in accordance with §14. The notice shall specify the effective date of the termination and whether it affects all or a portion of this Contract, and shall include, to the extent practicable, the public interest justification for the termination. ii. Obligations and Rights Upon receipt of a termination notice for termination in the public interest, Contractor shall be subject to the rights and obligations set forth in §12. iii. Payments If the State terminates this Contract in the public interest, the State shall pay Contractor an amount equal to the percentage of the total reimbursement payable under this Contract that corresponds to the percentage of Work satisfactorily completed and accepted, as determined by the State, less payments previously made. Additionally, if this Contract is less than sixty percent (60%) completed, as determined by the State, the State may reimburse Contractor for a portion of actual out-of-pocket expenses, not otherwise reimbursed under this Contract, incurred by Contractor that are directly attributable to the uncompleted portion of Contractor's obligations, provided that the sum of any and all reimbursement shall not exceed the maximum amount payable to Contractor hereunder. 3. DEFINITIONS The following terms shall be construed and interpreted as follows: A. "Breach of Contract" means the failure of a Party to perform any of its obligations in accordance with this Contract, in whole or in part or in a timely or satisfactory manner. If Contractor is debarred or suspended under §24-109-105, C.R.S. at any time during the term of this Contract, then such debarment or suspension shall constitute a breach. B. "Business Day" means any day in which the State is open and conducting business, but shall not include Saturday, Sunday, or any day which the State observes one of the holidays listed in C.R.S. §24-11-101(1). C. "Chief Procurement Officer" means the individual to whom the Executive Director has delegated his or her authority pursuant to C.R.S. §24-102-202 to procure or supervise the procurement of all supplies and services needed by the state. D. "Colorado Open Records Act (CORA)" means C.R.S. §24-72-200.1, et. seq. E. "Contract" means this agreement, including all attached Exhibits, all documents incorporated by reference, all referenced statutes, rules and cited authorities, and any future Contract Number: 20-139139 Page 5 of 22 modifications thereto. F. "Contract Funds" means the funds that have been appropriated, designated, encumbered, or otherwise made available for payment by the State under this Contract. G. "Criminal Justice Information (CJI)" means criminal justice information collected by criminal justice agencies needed for the performance of their authorized functions, including, without limitation, all information defined as criminal justice information by the U.S. Department of Justice, Federal Bureau of Investigation, Criminal Justice Information Services Security Policy, as amended and all Criminal Justice Records as defined under C.R.S. §24-72-302. H. "Effective Date" means the date on which this Contract is approved and signed by the Colorado State Controller or designee, as shown on the Cover Page for this Contract. I. "End of Term Extension" means the time period defined in §2.D J. "Exhibits" means the following exhibits attached to this Contract: i. Exhibit A, HIPAA Business Associates Addendum ii. Exhibit B, Statement of Work iii. Exhibit C, Rates iv. Exhibit D, Sample Option Letter v. Exhibit E, Information Technology Provisions vi. Exhibit F, CMS — R-0235 Addendum K. "Extension Term" means the time period defined in §2.C L. "Goods" means any movable material acquired, produced, or delivered by Contractor as set forth in this Contract and shall include any movable material acquired, produced, or delivered by Contractor in connection with the Services. M. "Incident" means any accidental or deliberate event that results in or constitutes an imminent threat of the unauthorized access, loss, disclosure, modification, disruption, or destruction of any communications or information resources of the State, which are included as part of the Work, as described in C.R.S. §24-37.5-401, et. seq. Incidents include, without limitation, (i) successful attempts to gain unauthorized access to a State system or State Information regardless of where such information is located; (ii) unwanted disruption or denial of service; (iii) the unauthorized use of a State system for the processing or storage of data; or (iv) changes to State system hardware, firmware, or software characteristics without the State's knowledge, instruction, or consent. N. "Initial Term" means the time period defined in §2.B O. "Party" means the State or Contractor, and "Parties" means both the State and Contractor. P. "Payment Card Information (PCI)" means payment card information including any data related to credit card holders' names, credit card numbers, or the other credit card information as may be protected by state or federal law. "Personal Health Information (PHI)" means any protected health information, including, without limitation any information whether oral or recorded in any form or medium: (i) that relates to the past, present or future physical or mental condition of an individual; the provision of health care to an individual; or the past, present or future payment for the Q. Contract Number: 20-139139 Page 6 of 22 provision of health care to an individual; and (ii) that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual. PHI includes, but is not limited to, any information defined as Individually Identifiable Health Information by the federal Health Insurance Portability and Accountability Act. R. "Personally Identifiable Information (PII)" means personally identifiable information including, without limitation, any information maintained by the State about an individual that can be used to distinguish or trace an individual's identity, such as name, social security number, date and place of birth, mother's maiden name, or biometric records; and any other information that is linked or linkable to an individual, such as medical, educational, financial, and employment information. PII includes, but is not limited to, all information defined as personally identifiable information in C.R.S. §24-72-501. S. "Services" means the services to be performed by Contractor as set forth in this Contract, and shall include any services to be rendered by Contractor in connection with the Goods. T. "State Confidential Information" means any and all State Records not subject to disclosure under CORA. State Confidential Information shall include, but is not limited to, PII, PHI, PCI, Tax Information, CJI, and State personnel records not subject to disclosure under CORA. State Confidential Information shall not include information or data concerning individuals that is not deemed confidential but nevertheless belongs to the State, which has been communicated, furnished, or disclosed by the State to Contractor which (i) is subject to disclosure pursuant to CORA; (ii) is already known to Contractor without restrictions at the time of its disclosure to Contractor; (iii) is or subsequently becomes publicly available without breach of any obligation owed by Contractor to the State; (iv) is disclosed to Contractor, without confidentiality obligations, by a third party who has the right to disclose such information; or (v) was independently developed without reliance on any State Confidential Information. U. "State Fiscal Rules" means the fiscal rules promulgated by the Colorado State Controller pursuant to C.R.S. §24-30-202(13)(a). V. "State Fiscal Year" means a twelve-month period beginning on July 1 of each calendar year and ending on June 30 of the following calendar year. If a single calendar year follows the term, then it means the State Fiscal Year ending in that calendar year. W. "State Records" means any and all State data, information, and records, regardless of physical form, including, but not limited to, information subject to disclosure under CORA. X. "Subcontractor" means third -parties, if any, engaged by Contractor to aid in performance of the Work. Y. "Tax Information" means federal and State of Colorado tax information including, without limitation, federal and State tax returns, return information, and such other tax -related information as may be protected by federal and State law and regulation. Tax Information includes, but is not limited to all information defined as federal tax information in Internal Revenue Service Publication 1075. Z. "Work" means the Goods delivered and Services performed pursuant to this Contract. AA. "Work Product" means the tangible and intangible results of the Work, whether finished or unfinished, including drafts. Work Product includes, but is not limited to, documents, text, software (including source code), research, reports, proposals, specifications, plans, notes, Contract Number: 20-139139 Page 7 of 22 studies, data, images, photographs, negatives, pictures, drawings, designs, models, surveys, maps, materials, ideas, concepts, know-how, and any other results of the Work. "Work Product" does not include any material that was developed prior to the Effective Date that is used, without modification, in the performance of the Work. Any other term used in this Contract that is defined in an Exhibit shall be construed and interpreted as defined in that Exhibit. 4. STATEMENT OF WORK Contractor shall complete the Work as described in this Contract and in accordance with the provisions of Exhibit B. The State shall have no liability to compensate Contractor for the delivery of any goods or the performance of any services that are not specifically set forth in this Contract. 5. PAYMENTS TO CONTRACTOR A. Maximum Amount Payments to Contractor are limited to the unpaid, obligated balance of the Contract Funds. The State shall not pay Contractor any amount under this Contract that exceeds the Contract Maximum for that State Fiscal Year shown on the Cover Page for this Contract. B. Payment Procedures i. Invoices and Payment a. The State shall pay Contractor in the amounts and in accordance with the schedule and other conditions set forth in Exhibit C. b. Contractor shall initiate payment requests by invoice to the State, in a form and manner approved by the State. c. The State shall pay each invoice within forty-five (45) days following the State's receipt of that invoice, so long as the amount invoiced correctly represents Work completed by Contractor and previously accepted by the State during the term that the invoice covers. If the State determines that the amount of any invoice is not correct, then Contractor shall make all changes necessary to correct that invoice. d. The acceptance of an invoice shall not constitute acceptance of any Work performed or deliverables provided under this Contract. ii. Interest Amounts not paid by the State within forty-five (45) days of the State's acceptance of the invoice shall bear interest on the unpaid balance beginning on the forty-fifth (45th) day at the rate of one percent (1%) per month, as required by C.R.S. §24-30-202(24)(a), until paid in full; provided, however, that interest shall not accrue on unpaid amounts that the State disputes in writing. Contractor shall invoice the State separately for accrued interest on delinquent amounts, and the invoice shall reference the delinquent payment, the number of day's interest to be paid and the interest rate. iii. Payment Disputes If Contractor disputes any calculation, determination or amount of any payment, Contractor shall notify the State in writing of its dispute within thirty (30) days following the earlier to occur of Contractor's receipt of the payment or notification of the determination or calculation of the payment by the State. The State will review the information presented by Contractor and may make changes to its determination based Contract Number: 20-139139 Page 8 of 22 on this review. The calculation, determination or payment amount that results from the State's review shall not be subject to additional dispute under this subsection. No payment subject to a dispute under this subsection shall be due until after the State has concluded its review, and the State shall not pay any interest on any amount during the period it is subject to dispute under this subsection. iv. Available Funds -Contingency -Termination The State is prohibited by law from making commitments beyond the term of the current State Fiscal Year. Payment to Contractor beyond the current State Fiscal Year is contingent on the appropriation and continuing availability of Contract Funds in any subsequent year (as provided in the Colorado Special Provisions). If federal funds or funds from any other non -State funds constitute all or some of the Contract Funds, the State's obligation to pay Contractor shall be contingent upon such non -State funding continuing to be made available for payment. Payments to be made pursuant to this Contract shall be made only from Contract Funds, and the State's liability for such payments shall be limited to the amount remaining of such Contract Funds. If State, federal or other funds are not appropriated, or otherwise become unavailable to fund this Contract, the State may, upon written notice, terminate this Contract, in whole or in part, without incurring further liability. The State shall, however, remain obligated to pay for Services and Goods that are delivered and accepted prior to the effective date of notice of termination, and this termination shall otherwise be treated as if this Contract were terminated in the public interest as described in §2.E. 6. REPORTING - NOTIFICATION A. Litigation Reporting If Contractor is served with a pleading or other document in connection with an action before a court or other administrative decision -making body, and such pleading or document relates to this Contract or may affect Contractor's ability to perform its obligations under this Contract, Contractor shall, within ten (10) days after being served, notify the State of such action and deliver copies of such pleading or document to the State's principal representative identified in §14. C. Performance Outside the State of Colorado or the United States, C.R.S. §24-102-206. To the extent not previously disclosed in accordance with C.R.S. §24-102-206, Contractor shall provide written notice to the State, in accordance with §14, within twenty (20) days following the earlier to occur of Contractor's decision to perform Services outside of the State of Colorado or the United States, or its execution of an agreement with a Subcontractor to perform Services outside the State of Colorado or the United States. Such notice shall specify the type of Services to be performed outside the State of Colorado or the United States and the reason why it is necessary or advantageous to perform such Services at such location or locations, and such notice shall be a public record. Knowing failure by Contractor to provide notice to the State under this section shall constitute a breach of this Contract. This section shall not apply if the Contract Funds include any federal funds. 7. CONTRACTOR RECORDS A. Maintenance Contractor shall maintain a file of all documents, records, communications, notes and other materials relating to the Work (the "Contractor Records"). Contractor Records shall include Contract Number: 20-139139 Page 9 of 22 all documents, records, communications, notes and other materials maintained by Contractor that relate to any Work performed by Subcontractors, and Contractor shall maintain all records related to the Work performed by Subcontractors required to ensure proper performance of that Work. Contractor shall maintain Contractor Records until the last to occur of: (i) the date three (3) years after the date this Contract expires or is terminated, (ii) final payment under this Contract is made, (iii) the resolution of any pending Contract matters, or (iv) if an audit is occurring, or Contractor has received notice that an audit is pending, the date such audit is completed and its findings have been resolved (the "Record Retention Period"). B. Inspection Contractor shall permit the State to audit, inspect, examine, excerpt, copy and transcribe Contractor Records during the Record Retention Period. Contractor shall make Contractor Records available during normal business hours at Contractor's office or place of business, or at other mutually agreed upon times or locations, upon no fewer than two (2) Business Days' notice from the State, unless the State determines that a shorter period of notice, or no notice, is necessary to protect the interests of the State. C. Monitoring The State, in its discretion, may monitor Contractor's performance of its obligations under this Contract using procedures as determined by the State. The State shall monitor Contractor's performance in a manner that does not unduly interfere with Contractor's performance of the Work. D. Final Audit Report Contractor shall promptly submit to the State a copy of any final audit report of an audit performed on Contractor's records that relates to or affects this Contract or the Work, whether the audit is conducted by Contractor or a third party. 8. CONFIDENTIAL INFORMATION -STATE RECORDS A. Confidentiality Contractor shall keep confidential, and cause all Subcontractors to keep confidential, all State Records, unless those State Records are publicly available. Contractor shall not, without prior written approval of the State, use, publish, copy, disclose to any third party, or permit the use by any third party of any State Records, except as otherwise stated in this Contract, permitted by law or approved in Writing by the State. Contractor shall provide for the security of all State Confidential Information in accordance with all policies promulgated by the Colorado Office of Information Security and all applicable laws, rules, policies, publications, and guidelines. If Contractor or any of its Subcontractors will or may receive the following types of data, Contractor or its Subcontractors shall provide for the security of such data according to the following: (i) the most recently promulgated IRS Publication 1075 for all Tax Information and in accordance with the Safeguarding Requirements for Federal Tax Information attached to this Contract as an Exhibit, if applicable, (ii) the most recently updated PCI Data Security Standard from the PCI Security Standards Council for all PCI, (iii) the most recently issued version of the U.S. Department of Justice, Federal Bureau of Investigation, Criminal Justice Information Services Security Policy for all CJI, and (iv) the federal Health Insurance Portability and Accountability Act for all PHI and the HIPAA Business Associate Agreement attached to this Contract, if applicable. Contractor shall Contract Number: 20-139139 Page 10 of 22 immediately forward any request or demand for State Records to the State's principal representative. B. Other Entity Access and Nondisclosure Agreements Contractor may provide State Records to its agents, employees, assigns and Subcontractors as necessary to perform the Work, but shall restrict access to State Confidential Information to those agents, employees, assigns and Subcontractors who require access to perform their obligations under this Contract. Contractor shall ensure all such agents, employees, assigns, and Subcontractors sign agreements containing nondisclosure provisions at least as protective as those in this Contract, and that the nondisclosure provisions are in force at all times the agent, employee, assign or Subcontractor has access to any State Confidential Information. Contractor shall provide copies of those signed nondisclosure provisions to the State upon execution of the nondisclosure provisions. C. Use, Security, and Retention Contractor shall use, hold and maintain State Confidential Information in compliance with any and all applicable laws and regulations in facilities located within the United States, and shall maintain a secure environment that ensures confidentiality of all State Confidential Information wherever located. Contractor shall provide the State with access, subject to Contractor's reasonable security requirements, for purposes of inspecting and monitoring access and use of State Confidential Information and evaluating security control effectiveness. Upon the expiration or termination of this Contract, Contractor shall return State Records provided to Contractor or destroy such State Records and certify to the State that it has done so, as directed by the State. If Contractor is prevented by law or regulation from returning or destroying State Confidential Information, Contractor warrants it will guarantee the confidentiality of, and cease to use, such State Confidential Information. D. Incident Notice and Remediation If Contractor becomes aware of any Incident, it shall notify the State immediately and cooperate with the State regarding recovery, remediation, and the necessity to involve law enforcement, as determined by the State. Unless Contractor can establish that none of Contractor or any of its agents, employees, assigns or Subcontractors are the cause or source of the Incident, Contractor shall be responsible for the cost of notifying each person who may have been impacted by the Incident. After an Incident, Contractor shall take steps to reduce the risk of incurring a similar type of Incident in the future as directed by the State, which may include, but is not limited to, developing and implementing a remediation plan that is approved by the State at no additional cost to the State. The State may, in its sole discretion and at Contractor's sole expense, require Contractor to engage the services of an independent, qualified, State -approved third party to conduct a security audit. Contractor shall provide the State with the results of such audit and evidence of Contractor's planned remediation in response to any negative findings. Contract Number: 20-139139 Page 11 of 22 E. Data Protection and Handling Contractor shall ensure that all State Records and Work Product in the possession of Contractor or any Subcontractors are protected and handled in accordance with the requirements of this Contract, including the requirements of any Exhibits hereto, at all times. F. Safeguarding PII If Contractor or any of its Subcontractors will or may receive PII under this Contract, Contractor shall provide for the security of such PII, in a manner and form acceptable to the State, including, without limitation, State non -disclosure requirements, use of appropriate technology, security practices, computer access security, data access security, data storage encryption, data transmission encryption, security inspections, and audits. Contractor shall be a "Third -Party Service Provider" as defined in §24-73-103(1)(i), C.R.S. and shall maintain security procedures and practices consistent with §§24-73-101 et seq., C.R.S. 9. CONFLICTS OF INTEREST A. Actual Conflicts of Interest Contractor shall not engage in any business or activities, or maintain any relationships that conflict in any way with the full performance of the obligations of Contractor under this Contract. Such a conflict of interest would arise when a Contractor's or Subcontractor's employee, officer or agent were to offer or provide any tangible personal benefit to an employee of the State, or any member of his or her immediate family or his or her partner, related to the award of, entry into or management or oversight of this Contract. B. Apparent Conflicts of Interest Contractor acknowledges that, with respect to this Contract, even the appearance of a conflict of interest shall be harmful to the State's interests. Absent the State's prior written approval, Contractor shall refrain from any practices, activities or relationships that reasonably appear to be in conflict with the full performance of Contractor's obligations under this Contract. C. Disclosure to the State If a conflict or the appearance of a conflict arises, or if Contractor is uncertain whether a conflict or the appearance of a conflict has arisen, Contractor shall submit to the State a disclosure statement setting forth the relevant details for the State's consideration. Failure to promptly submit a disclosure statement or to follow the State's direction in regard to the actual or apparent conflict constitutes a breach of this Contract. 10. INSURANCE Contractor shall obtain and maintain, and ensure that each Subcontractor shall obtain and maintain, insurance as specified in this section at all times during the term of this Contract. All insurance policies required by this Contract that are not provided through self-insurance shall be issued by insurance companies as approved by the state. A. Contractor Insurance The Contractor is a "public entity" within the meaning of the Colorado Governmental Immunity Act, §24-10-101, et seq., C.R.S. (the "GIA") and shall maintain at all times during the term of this Contract such liability insurance, by commercial policy or self-insurance, as is necessary to meet its liabilities under the GIA. B. Subcontractor Requirements Contract Number: 20-139139 Page 12 of 22 Contractor shall ensure that each Subcontractor that is a public entity within the meaning of the GIA, maintains at all times during the terms of this Contract, such liability insurance, by commercial policy or self-insurance, as is necessary to meet the Subcontractor's obligations under the GIA. Contractor shall ensure that each Subcontractor that is not a public entity within the meaning of the GIA, maintains at all times during the terms of this Contract all of the following insurance policies: i. Workers' Compensation Workers' compensation insurance as required by state statute, and employers' liability insurance covering all Contractor or Subcontractor employees acting within the course and scope of their employment. ii. General Liability Commercial general liability insurance covering premises operations, fire damage, independent contractors, products and completed operations, blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: a. $1,000,000 each occurrence; b. $1,000,000 general aggregate; c. $1,000,000 products and completed operations aggregate; and d. $50,000 any 1 fire. iii. Automobile Liability Automobile liability insurance covering any auto (including owned, hired and non - owned autos) with a minimum limit of $1,000,000 each accident combined single limit. iv. Protected Information Liability insurance covering all loss of State Confidential Information, such as PII, PHI, PCI, Tax Information, and CJI, and claims based on alleged violations of privacy rights through improper use or disclosure of protected information with minimum limits as follows: a. $1,000,000 each occurrence; and b. $2,000,000 general aggregate. v. Professional Liability Insurance Professional liability insurance covering any damages caused by an error, omission or any negligent act with minimum limits as follows: a. $1,000,000 each occurrence; and b. $1,000,000 general aggregate. vi. Crime Insurance Crime insurance including employee dishonesty coverage with minimum limits as follows: a. $1,000,000 each occurrence; and b. $1,000,000 general aggregate. C. Additional Insured Contract Number: 20-139139 Page 13 of 22 The State shall be named as additional insured on all commercial general liability policies (leases and construction contracts require additional insured coverage for completed operations) required of Contractor and Subcontractors. D. Primacy of Coverage Coverage required of Contractor and each Subcontractor shall be primary over any insurance or self-insurance program carried by Contractor or the State. E. Cancellation All commercial insurance policies shall include provisions preventing cancellation or non - renewal, except for cancellation based on non-payment of premiums, without at least 30 days prior notice to Contractor and Contractor shall forward such notice to the State in accordance with §14 within 7 days of Contractor's receipt of such notice. F. Subrogation Waiver All commercial insurance policies secured or maintained by Contractor or its Subcontractors in relation to this Contract shall include clauses stating that each carrier shall waive all rights of recovery under subrogation or otherwise against Contractor or the State, its agencies, institutions, organizations, officers, agents, employees, and volunteers. G. Certificates For each commercial insurance plan provided by Contractor under this Contract, Contractor shall provide to the State certificates evidencing Contractor's insurance coverage required in this Contract within 7 Business Days following the Effective Date. Contractor shall provide to the State certificates evidencing Subcontractor insurance coverage required under this Contract within 7 Business Days following the Effective Date, except that, if Contractor's subcontract is not in effect as of the Effective Date, Contractor shall provide to the State certificates showing Subcontractor insurance coverage required under this Contract within 7 Business Days following Contractor's execution of the subcontract. No later than 15 days before the expiration date of Contractor's or any Subcontractor's coverage, Contractor shall deliver to the State certificates of insurance evidencing renewals of coverage. At any other time during the term of this Contract, upon request by the State, Contractor shall, within 7 Business Days following the request by the State, supply to the State evidence satisfactory to the State of compliance with the provisions of this §10. 11. BREACH OF CONTRACT In the event of a Breach of Contract, the aggrieved Party shall give written notice of breach to the other Party. If the notified Party does not cure the Breach of Contract, at its sole expense, within 30 days after the delivery of written notice, the Party may exercise any of the remedies as described in §12 for that Party. Notwithstanding any provision of this Contract to the contrary, the State, in its discretion, need not provide notice or a cure period and may immediately terminate this Contract in whole or in part or institute any other remedy in this Contract in order to protect the public interest of the State; or if Contractor is debarred or suspended under §24-109-105, C.R.S., the State, in its discretion, need not provide notice or cure period and may terminate this Contract in whole or in part or institute any other remedy in this Contract as of the date that the debarment or suspension takes effect. 12. REMEDIES A. State's Remedies Contract Number: 20-139139 Page 14 of 22 If Contractor is in breach under any provision of this Contract and fails to cure such breach, the State, following the notice and cure period set forth in §11, shall have all of the remedies listed in this section. in addition to all other remedies set forth in this Contract or at law. The State may exercise any or all of the remedies available to it, in its discretion, concurrently or consecutively. i. Termination for Breach In the event of Contractor's uncured breach, the State may terminate this entire Contract or any part of this Contract. Contractor shall continue performance of this Contract to the extent not terminated, if any. a. Obligations and Rights To the extent specified in any termination notice, Contractor shall not incur further obligations or render further performance past the effective date of such notice, and shall terminate outstanding orders and subcontracts with third parties. However, Contractor shall complete and deliver to the State all Work not cancelled by the termination notice, and may incur obligations as necessary to do so within this Contract's terms. At the request of the State, Contractor shall assign to the State all of Contractor's rights, title, and interest in and to such terminated orders or subcontracts. Upon termination, Contractor shall take timely, reasonable and necessary action to protect and preserve property in the possession of Contractor but in which the State has an interest. At the State's request, Contractor shall return materials owned by the State in Contractor's possession at the time of any termination. Contractor shall deliver all completed Work Product and all Work Product that was in the process of completion to the State at the State's request. b. Payments Notwithstanding anything to the contrary, the State shall only pay Contractor for accepted Work received as of the date of termination. If, after termination by the State, the State agrees that Contractor was not in breach or that Contractor's action or inaction was excusable, such termination shall be treated as a termination in the public interest, and the rights and obligations of the Parties shall be as if this Contract had been terminated in the public interest under §2.E. c. Damages and Withholding Notwithstanding any other remedial action by the State, Contractor shall remain liable to the State for any damages sustained by the State in connection with any breach by Contractor, and the State may withhold payment to Contractor for the purpose of mitigating the State's damages until such time as the exact amount of damages due to the State from Contractor is determined. The State may withhold any amount that may be due Contractor as the State deems necessary to protect the State against loss including, without limitation, loss as a result of outstanding liens and excess costs incurred by the State in procuring from third parties replacement Work as cover. ii. Remedies Not Involving Termination The State, in its discretion, may exercise one or more of the following additional remedies: Contract Number: 20-139139 Page 15 of 22 a. Suspend Performance Suspend Contractor's performance with respect to all or any portion of the Work pending corrective action as specified by the State without entitling Contractor to an adjustment in price or cost or an adjustment in the performance schedule. Contractor shall promptly cease performing Work and incurring costs in accordance with the State's directive, and the State shall not be liable for costs incurred by Contractor after the suspension of performance. b. Withhold Payment Withhold payment to Contractor until Contractor corrects its Work. c. Deny Payment Deny payment for Work not performed, or that due to Contractor's actions or inactions, cannot be performed or if they were performed are reasonably of no value to the state; provided, that any denial of payment shall be equal to the value of the obligations not performed. d. Removal Demand immediate removal of any of Contractor's employees, agents, or Subcontractors from the Work whom the State deems incompetent, careless, insubordinate, unsuitable, or otherwise unacceptable or whose continued relation to this Contract is deemed by the State to be contrary to the public interest or the State's best interest. e. Intellectual Property If any Work infringes, or if the State in its sole discretion determines that any Work is likely to infringe, a patent, copyright, trademark, trade secret or other intellectual property right, Contractor shall, as approved by the State (i) secure that right to use such Work for the State and Contractor; (ii) replace the Work with noninfringing Work or modify the Work so that it becomes noninfringing; or, (iii) remove any infringing Work and refund the amount paid for such Work to the State. B. Contractor's Remedies If the State is in breach of any provision of this Contract and does not cure such breach, Contractor, following the notice and cure period in §11 and the dispute resolution process in §13 shall have all remedies available at law and equity. 13. DISPUTE RESOLUTION A. Initial Resolution Except as herein specifically provided otherwise, disputes concerning the performance of this Contract which cannot be resolved by the designated Contract representatives shall be referred in writing to a senior departmental management staff member designated by the State and a senior manager designated by Contractor for resolution. B. Resolution of Controversies If the initial resolution described in §13.A fails to resolve the dispute within 10 Business Days, Contractor shall submit any alleged breach of this Contract by the State to the Procurement Official of the State Agency named on the Cover Page of this Contract as Contract Number: 20-139139 Page 16 of 22 described in §24-101-301(30), C.R.S. for resolution in accordance with the provisions of §§24-106-109, and 24-109-101.1 through 24-109-505, C.R.S., (the "Resolution Statutes"), except that if Contractor wishes to challenge any decision rendered by the Procurement Official, Contractor's challenge shall be an appeal to the executive director of the Department of Personnel and Administration, or their delegate, under the Resolution Statutes before Contractor pursues any further action as permitted by such statutes. Except as otherwise stated in this Section, all requirements of the Resolution Statutes shall apply including, without limitation, time limitations. 14. NOTICES AND REPRESENTATIVES Each individual identified as a Principal Representative on the Cover Page for this Contract shall be the principal representative of the designating Party. All notices required or permitted to be given under this Contract shall be in writing, and shall be delivered (A) by hand with receipt required, (B) by certified or registered mail to such Party's principal representative at the address set forth below or (C) as an email with read receipt requested to the principal representative at the email address, if any, set forth on the Cover Page for this Contract. If a Party delivers a notice to another through email and the email is undeliverable, then, unless the Party has been provided with an alternate email contact, the Party delivering the notice shall deliver the notice by hand with receipt required or by certified or registered mail to such Party's principal representative at the address set forth on the Cover Page for this Contract. Either Party may change its principal representative or principal representative contact information, or may designate specific other individuals to receive certain types of notices in addition to or in lieu of a principal representative by notice submitted in accordance with this section without a formal amendment to this Contract. 15. RIGHTS IN WORK PRODUCT AND OTHER INFORMATION A. Work Product Contractor assigns to the State and its successors and assigns, the entire right, title, and interest in and to all causes of action, either in law or in equity, for past, present, or future infringement of intellectual property rights related to the Work Product and all works based on, derived from, or incorporating the Work Product. Whether or not Contractor is under contract with the State at the time, Contractor shall execute applications, assignments, and other documents, and shall render all other reasonable assistance requested by the State, to enable the State to secure patents, copyrights, licenses and other intellectual property rights related to the Work Product. To the extent that Work Product would fall under the definition of "works made for hire" under 17 U.S.C.S. §101, the Parties intend the Work Product to be a work made for hire. Copyrights To the extent that the Work Product (or any portion of the Work Product) would not be considered a work made for hire under applicable law, Contractor hereby assigns to the State, the entire right, title, and interest in and to copyrights in all Work Product and all works based upon, derived from, or incorporating the Work Product; all copyright applications, registrations, extensions, or renewals relating to all Work Product and all works based upon, derived from, or incorporating the Work Product; and all moral rights or similar rights with respect to the Work Product throughout the world. To the extent that Contractor cannot make any of the assignments required by this section, Contractor hereby grants to the State a perpetual, irrevocable, royalty -free license to use, modify, copy, publish, display, perform, transfer, distribute, sell, and create derivative works of the Work Product and all works based upon, derived from, or Contract Number: 20-139139 Page 17 of 22 incorporating the Work Product by all means and methods and in any format now known or invented in the future. The State may assign and license its rights under this license. B. Exclusive Property of the State Except to the extent specifically provided elsewhere in this Contract, any pre-existing State Records, State software, research, reports, studies, photographs, negatives or other documents, drawings, models, materials, data and information shall be the exclusive property of the State (collectively, "State Materials"). Contractor shall not use, willingly allow, cause or permit Work Product or State Materials to be used for any purpose other than the performance of Contractor's obligations in this Contract without the prior written consent of the State. Upon termination of this Contract for any reason, Contractor shall provide all Work Product and State Materials to the State in a form and manner as directed by the State. C. Exclusive Property of Contractor Contractor retains the exclusive rights, title, and ownership to any and all pre-existing materials owned or licensed to Contractor including, but not limited to, all pre-existing software, licensed products, associated source code, machine code, text images, audio and/or video, and third -party materials, delivered by Contractor under the Contract, whether incorporated in a Deliverable or necessary to use a Deliverable (collectively, "Contractor Property"). Contractor Property shall be licensed to the State as set forth in this Contract or a State approved license agreement: (i) entered into as exhibits to this Contract; (ii) obtained by the State from the applicable third -party vendor; or (iii) in the case of open source software, the license terms set forth in the applicable open source license agreement. 16. GENERAL PROVISIONS A. Assignment Contractor's rights and obligations under this Contract are personal and may not be transferred or assigned without the prior, written consent of the State. Any attempt at assignment or transfer without such consent shall be void. Any assignment or transfer of Contractor's rights and obligations approved by the State shall be subject to the provisions of this Contract B. Subcontracts Contractor shall not enter into any subcontract in connection with its obligations under this Contract without the prior, written approval of the State. Contractor shall submit to the State a copy of each such subcontract upon request by the State. All subcontracts entered into by Contractor in connection with this Contract shall comply with all applicable federal and state laws and regulations, shall provide that they are governed by the laws of the State of Colorado, and shall be subject to all provisions of this Contract. C. Binding Effect Except as otherwise provided in §16.A., all provisions of this Contract, including the benefits and burdens, shall extend to and be binding upon the Parties' respective successors and assigns. D. Authority Each Party represents and warrants to the other that the execution and delivery of this Contract and the performance of such Party's obligations have been duly authorized. Contract Number: 20-139139 Page 18 of 22 E. Captions and References The captions and headings in this Contract are for convenience of reference only, and shall not be used to interpret, define, or limit its provisions. All references in this Contract to sections (whether spelled out or using the § symbol), subsections, exhibits or other attachments, are references to sections, subsections, exhibits or other attachments contained herein or incorporated as a part hereof, unless otherwise noted. F. Counterparts This Contract may be executed in multiple, identical, original counterparts, each of which shall be deemed to be an original, but all of which, taken together, shall constitute one and the same agreement. G. Entire Understanding This Contract represents the complete integration of all understandings between the Parties related to the Work, and all prior representations and understandings related to the Work, oral or written, are merged into this Contract. Prior or contemporaneous additions, deletions, or other changes to this Contract shall not have any force or effect whatsoever, unless embodied herein. H. Digital Signatures If any signatory signs this agreement using a digital signature in accordance with the Colorado State Controller Contract, Grant and Purchase Order Policies regarding the use of digital signatures issued under the State Fiscal Rules, then any agreement or consent to use digital signatures within the electronic system through which that signatory signed shall be incorporated into this Contract by reference. I. Modification Except as otherwise provided in this Contract, any modification to this Contract shall only be effective if agreed to in a formal amendment to this Contract, properly executed and approved in accordance with applicable Colorado State law and State Fiscal Rules. Modifications permitted under this Contract, other than contract amendments, shall conform to the policies issued by the Colorado State Controller. J. Statutes, Regulations, Fiscal Rules, and Other Authority. Any reference in this Contract to a statute, regulation, State Fiscal Rule, fiscal policy or other authority shall be interpreted to refer to such authority then current, as may have been changed or amended since the Effective Date of this Contract. K. Severability The invalidity or unenforceability of any provision of this Contract shall not affect the validity or enforceability of any other provision of this Contract, which shall remain in full force and effect, provided that the Parties can continue to perform their obligations under this Contract in accordance with the intent of this Contract. L. Survival of Certain Contract Terms Any provision of this Contract that imposes an obligation on a Party after termination or expiration of this Contract shall survive the termination or expiration of this Contract and shall be enforceable by the other Party. M. Taxes Contract Number: 20-139139 Page 19 of 22 The State is exempt from federal excise taxes under I.R.C. Chapter 32 (26 U.S.C., Subtitle D, Ch. 32) (Federal Excise Tax Exemption Certificate of Registry No. 84-730123K) and from State and local government sales and use taxes under §§39-26-704(1), et seq., C.R.S. (Colorado Sales Tax Exemption Identification Number 98-02565). The State shall not be liable for the payment of any excise, sales, or use taxes, regardless of whether any political subdivision of the state imposes such taxes on Contractor. Contractor shall be solely responsible for any exemptions from the collection of excise, sales or use taxes that Contractor may wish to have in place in connection with this Contract. N. Third Party Beneficiaries Except for the Parties' respective successors and assigns described in §16.A., this Contract does not and is not intended to confer any rights or remedies upon any person or entity other than the Parties. Enforcement of this Contract and all rights and obligations hereunder are reserved solely to the Parties. Any services or benefits which third parties receive as a result of this Contract are incidental to this Contract, and do not create any rights for such third parties. O. Waiver A Party's failure or delay in exercising any right, power, or privilege under this Contract, whether explicit or by lack of enforcement, shall not operate as a waiver, nor shall any single or partial exercise of any right, power, or privilege preclude any other or further exercise of such right, power, or privilege. P. CORA Disclosure To the extent not prohibited by federal law, this Contract and the performance measures and standards required under C.R.S. §24-106-107, if any, are subject to public release through the CORA. Q. Standard and Manner of Performance Contractor shall perform its obligations under this Contract in accordance with the highest standards of care, skill and diligence in Contractor's industry, trade, or profession. R. Licenses, Permits, and Other Authorizations. Contractor shall secure, prior to the Effective Date, and maintain at all times during the term of this Contract, at its sole expense, all licenses, certifications, permits, and other authorizations required to perform its obligations under this Contract, and shall ensure that all employees, agents and Subcontractors secure and maintain at all times during the term of their employment, agency or subcontract, all license, certifications, permits and other authorizations required to perform their obligations in relation to this Contract. 17. COLORADO SPECIAL PROVISIONS (COLORADO FISCAL RULE 3-1) These Special Provisions apply to all contracts except where noted in italics. A. STATUTORY APPROVAL. C.R.S. §24-30-202(1) This Contract shall not be valid until it has been approved by the Colorado State Controller or designee. If this Contract is for a Major Information Technology Project, as defined in §24-37.5-102(2.6), then this Contract shall not be valid until it has been approved by the State's Chief Information Officer or designee. B. FUND AVAILABILITY. C.R.S. §24-30-202(5.5) Contract Number: 20-139139 Page 20 of 22 Financial obligations of the State payable after the current State Fiscal Year are contingent upon funds for that purpose being appropriated, budgeted, and otherwise made available. C. GOVERNMENTAL IMMUNITY. Liability for claims for injuries to persons or property arising from the negligence of the Parties, its departments, boards, commissions committees, bureaus, offices, employees and officials shall be controlled and limited by the provisions of the Colorado Governmental Immunity Act, §24-10-101, et seq., C.R.S.; the Federal Tort Claims Act, 28 U.S.C. Pt. VI, Ch. 171 and 28 U.S.C. 1346(b), and the State's risk management statutes, §§24-30-1501, et seq. C.R.S. No term or condition of this Contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections, or other provisions, contained in these statutes. D. INDEPENDENT CONTRACTOR. Contractor shall perform its duties hereunder as an independent contractor and not as an employee. Neither Contractor nor any agent or employee of Contractor shall be deemed to be an agent or employee of the State. Contractor shall not have authorization, express or implied, to bind the State to any agreement, liability or understanding, except as expressly set forth herein. Contractor and its employees and agents are not entitled to unemployment insurance or workers compensation benefits through the State and the State shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes incurred pursuant to this Contract. Contractor shall (i) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, (ii) provide proof thereof when requested by the State, and (iii) be solely responsible for its acts and those of its employees and agents. E. COMPLIANCE WITH LAW. Contractor shall strictly comply with all applicable federal and State laws, rules, and regulations in effect or hereafter established, including, without limitation, laws applicable to discrimination and unfair employment practices. F. CHOICE OF LAW, JURISDICTION, AND VENUE. Colorado law, and rules and regulations issued pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Contract. Any provision included or incorporated herein by reference which conflicts with said laws, rules, and regulations shall be null and void. All suits or actions related to this Contract shall be filed and proceedings held in the State of Colorado and exclusive venue shall be in the City and County of Denver. G. PROHIBITED TERMS. Any term included in this Contract that requires the State to indemnify or hold Contractor harmless; requires the State to agree to binding arbitration; limits Contractor's liability for damages resulting from death, bodily injury, or damage to tangible property; or that conflicts with this provision in any way shall be void ab initio. Nothing in this Contract shall be construed as a waiver of any provision of §24-106-109 C.R.S. Any term included in this Contract that limits Contractor's liability that is not void under this section shall apply only Contract Number: 20-139139 Page 21 of 22 in excess of any insurance to be maintained under this Contract, and no insurance policy shall be interpreted as being subject to any limitations of liability of this Contract. H. SOFTWARE PIRACY PROHIBITION. State or other public funds payable under this Contract shall not be used for the acquisition, operation, or maintenance of computer software in violation of federal copyright laws or applicable licensing restrictions. Contractor hereby certifies and warrants that, during the term of this Contract and any extensions, Contractor has and shall maintain in place appropriate systems and controls to prevent such improper use of public funds. If the State determines that Contractor is in violation of this provision, the State may exercise any remedy available at law or in equity or under this Contract, including, without limitation, immediate termination of this Contract and any remedy consistent with federal copyright laws or applicable licensing restrictions. I. EMPLOYEE FINANCIAL INTEREST/CONFLICT OF INTEREST. C.R.S. §§24-18- 201 and 24-50-507 The signatories aver that to their knowledge, no employee of the State has any personal or beneficial interest whatsoever in the service or property described in this Contract. Contractor has no interest and shall not acquire any interest, direct or indirect, that would conflict in any manner or degree with the performance of Contractor's services and Contractor shall not employ any person having such known interests. Contract Number: 20-139139 Page 22 of 22 EXHIBIT A, HIPAA BUSINESS ASSOCIATES ADDENDUM This HIPAA Business Associate Agreement ("Agreement") between the State and Contractor is agreed to in connection with, and as an exhibit to, the Contract. For purposes of this Agreement, the State is referred to as "Covered Entity" and the Contractor is referred to as "Business Associate". Unless the context clearly requires a distinction between the Contract and this Agreement, all references to "Contract" shall include this Agreement. 1. PURPOSE Covered Entity wishes to disclose information to Business Associate, which may include Protected Health Information ("PHI"). The Parties intend to protect the privacy and security of the disclosed PHI in compliance with the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), Pub. L. No. 104-191 (1996) as amended by the Health Information Technology for Economic and Clinical Health Act ("HITECH Act") enacted under the American Recovery and Reinvestment Act of 2009 ("ARRA") Pub. L. No. 111-5 (2009), implementing regulations promulgated by the U.S. Department of Health and Human Services at 45 C.F.R. Parts 160, 162 and 164 (the "HIPAA Rules") and other applicable laws, as amended. Prior to the disclosure of PHI, Covered Entity is required to enter into an agreement with Business Associate containing specific requirements as set forth in, but not limited to, Title 45, Sections 160.103, 164.502(e) and 164.504(e) of the Code of Federal Regulations ("C.F.R.") and all other applicable laws and regulations, all as may be amended. 2. DEFINITIONS The following terms used in this Agreement shall have the same meanings as in the HIPAA Rules: Breach, Data Aggregation, Designated Record Set, Disclosure, Health Care Operations, Individual, Minimum Necessary, Notice of Privacy Practices, Protected Health Information, Required by Law, Secretary, Security Incident, Subcontractor, Unsecured Protected Health Information, and Use. The following terms used in this Agreement shall have the meanings set forth below: a. Business Associate. "Business Associate" shall have the same meaning as the term "business associate" at 45 C.F.R. 160.103, and shall refer to Contractor. b. Covered Entity. "Covered Entity" shall have the same meaning as the term "covered entity" at 45 C.F.R. 160.103, and shall refer to the State. c. Information Technology and Information Security. "Information Technology" and "Information Security" shall have the same meanings as the terms "information technology" and "information security", respectively, in §24-37.5-102, C.R.S. Capitalized terms used herein and not otherwise defined herein or in the HIPAA Rules shall have the meanings ascribed to them in the Contract. Exhibit A, HIPAA BAA Page 1 of 9 Revised 8/18 3. OBLIGATIONS AND ACTIVITIES OF BUSINESS ASSOCIATE a. Permitted Uses and Disclosures. i. Business Associate shall use and disclose PHI only to accomplish Business Associate's obligations under the Contract. i. To the extent Business Associate carries out one or more of Covered Entity's obligations under Subpart E of 45 C.F.R. Part 164, Business Associate shall comply with any and all requirements of Subpart E that apply to Covered Entity in the performance of such obligation. ii. Business Associate may disclose PHI to carry out the legal responsibilities of Business Associate, provided, that the disclosure is Required by Law or Business Associate obtains reasonable assurances from the person to whom the information is disclosed that: A. the information will remain confidential and will be used or disclosed only as Required by Law or for the purpose for which Business Associate originally disclosed the information to that person, and; B. the person notifies Business Associate of any Breach involving PHI of which it is aware. iii. Business Associate may provide Data Aggregation services relating to the Health Care Operations of Covered Entity. Business Associate may de -identify any or all PHI created or received by Business Associate under this Agreement, provided the de - identification conforms to the requirements of the HIPAA Rules. d. Minimum Necessary. Business Associate, its Subcontractors and agents, shall access, use, and disclose only the minimum amount of PHI necessary to accomplish the objectives of the Contract, in accordance with the Minimum Necessary Requirements of the HIPAA Rules including, but not limited to, 45 C.F.R. 164.502(b) and 164.514(d). e. Impermissible Uses and Disclosures. i. Business Associate shall not disclose the PHI of Covered Entity to another covered entity without the written authorization of Covered Entity. ii. Business Associate shall not share, use, disclose or make available any Covered Entity PHI in any form via any medium with or to any person or entity beyond the boundaries or jurisdiction of the United States without express written authorization from Covered Entity. f. Business Associate's Subcontractors. i. Business Associate shall, in accordance with 45 C.F.R. 164.502(e)(1)(ii) and 164.308(b)(2), ensure that any Subcontractors who create, receive, maintain, or Exhibit A, HIPAA BAA Page 2 of 9 Revised 8/18 transmit PHI on behalf of Business Associate agree in writing to the same restrictions, conditions, and requirements that apply to Business Associate with respect to safeguarding PHI. ii. Business Associate shall provide to Covered Entity, on Covered Entity's request, a list of Subcontractors who have entered into any such agreement with Business Associate. iii. Business Associate shall provide to Covered Entity, on Covered Entity's request, copies of any such agreements Business Associate has entered into with Subcontractors. g. Access to System. If Business Associate needs access to a Covered Entity Information Technology system to comply with its obligations under the Contract or this Agreement, Business Associate shall request, review, and comply with any and all policies applicable to Covered Entity regarding such system including, but not limited to, any policies promulgated by the Office of Information Technology and available at http://oit.state.co.us/about/policies. h. Access to PHI. Business Associate shall, within ten days of receiving a written request from Covered Entity, make available PHI in a Designated Record Set to Covered Entity as necessary to satisfy Covered Entity's obligations under 45 C.F.R. 164.524. i. Amendment of PHI. J. i. Business Associate shall within ten days of receiving a written request from Covered Entity make any amendment to PHI in a Designated Record Set as directed by or agreed to by Covered Entity pursuant to 45 C.F.R. 164.526, or take other measures as necessary to satisfy Covered Entity's obligations under 45 C.F.R. 164.526. ii. Business Associate shall promptly forward to Covered Entity any request for amendment of PHI that Business Associate receives directly from an Individual. Accounting Rights. Business Associate shall, within ten days of receiving a written request from Covered Entity, maintain and make available to Covered Entity the information necessary for Covered Entity to satisfy its obligations to provide an accounting of Disclosure under 45 C.F.R. 164.528. k. Restrictions and Confidential Communications. i. Business Associate shall restrict the Use or Disclosure of an Individual's PHI within ten days of notice from Covered Entity of: A. a restriction on Use or Disclosure of PHI pursuant to 45 C.F.R. 164.522; or B. a request for confidential communication of PHI pursuant to 45 C.F.R. 164.522. ii. Business Associate shall not respond directly to an Individual's requests to restrict the Use or Disclosure of PHI or to send all communication of PHI to an alternate address. Exhibit A, HIPAA BAA Page 3 of 9 Revised 8/18 iii. Business Associate shall refer such requests to Covered Entity so that Covered Entity can coordinate and prepare a timely response to the requesting Individual and provide direction to Business Associate. 1. Governmental Access to Records. Business Associate shall make its facilities, internal practices, books, records, and other sources of information, including PHI, available to the Secretary for purposes of determining compliance with the HIPAA Rules in accordance with 45 C.F.R. 160.310. m. Audit, Inspection and Enforcement. i. Business Associate shall obtain and update at least annually a written assessment performed by an independent third party reasonably acceptable to Covered Entity, which evaluates the Information Security of the applications, infrastructure, and processes that interact with the Covered Entity data Business Associate receives, manipulates, stores and distributes. Upon request by Covered Entity, Business Associate shall provide to Covered Entity the executive summary of the assessment. ii. Business Associate, upon the request of Covered Entity, shall fully cooperate with Covered Entity's efforts to audit Business Associate's compliance with applicable HIPAA Rules. If, through audit or inspection, Covered Entity determines that Business Associate's conduct would result in violation of the HIPAA Rules or is in violation of the Contract or this Agreement, Business Associate shall promptly remedy any such violation and shall certify completion of its remedy in writing to Covered Entity. n. Appropriate Safeguards. i. Business Associate shall use appropriate safeguards and comply with Subpart C of 45 C.F.R. Part 164 with respect to electronic PHI to prevent use or disclosure of PHI other than as provided in this Agreement. ii. Business Associate shall safeguard the PHI from tampering and unauthorized disclosures. iii. Business Associate shall maintain the confidentiality of passwords and other data required for accessing this information. iv. Business Associate shall extend protection beyond the initial information obtained from Covered Entity to any databases or collections of PHI containing information derived from the PHI. The provisions of this section shall be in force unless PHI is de - identified in conformance to the requirements of the HIPAA Rules. o. Safeguard During Transmission. i. Business Associate shall use reasonable and appropriate safeguards including, without limitation, Information Security measures to ensure that all transmissions of PHI are Exhibit A, HIPAA BAA Page 4 of 9 Revised 8/18 authorized and to prevent use or disclosure of PHI other than as provided for by this Agreement. ii. Business Associate shall not transmit PHI over the internet or any other insecure or open communication channel unless the PHI is encrypted or otherwise safeguarded with a FIPS-compliant encryption algorithm. P. q. Reporting of Improper Use or Disclosure and Notification of Breach. Business Associate shall, as soon as reasonably possible, but immediately after discovery of a Breach, notify Covered Entity of any use or disclosure of PHI not provided for by this Agreement, including a Breach of Unsecured Protected Health Information as such notice is required by 45 C.F.R. 164.410 or a breach for which notice is required under §24-73-103, C.R.S. ii. Such notice shall include the identification of each Individual whose Unsecured Protected Health Information has been, or is reasonably believed by Business Associate to have been, accessed, acquired, or disclosed during such Breach. iii. Business Associate shall, as soon as reasonably possible, but immediately after discovery of any Security Incident that does not constitute a Breach, notify Covered Entity of such incident. iv. Business Associate shall have the burden of demonstrating that all notifications were made as required, including evidence demonstrating the necessity of any delay. Business Associate's Insurance and Notification Costs. i. Business Associate shall bear all costs of a Breach response including, without limitation, notifications, and shall maintain insurance to cover: A. loss of PHI data; B. Breach notification requirements specified in HIPAA Rules and in §24-73- 103, C.R.S.; and C. claims based upon alleged violations of privacy rights through improper use or disclosure of PHI. ii. All such policies shall meet or exceed the minimum insurance requirements of the Contract or otherwise as may be approved by Covered Entity (e.g., occurrence basis, combined single dollar limits, annual aggregate dollar limits, additional insured status, and notice of cancellation). iii. Business Associate shall provide Covered Entity a point of contact who possesses relevant Information Security knowledge and is accessible 24 hours per day, 7 days per week to assist with incident handling. Exhibit A, HIPAA BAA Page 5 of 9 Revised 8/18 iv. Business Associate, to the extent practicable, shall mitigate any harmful effect known to Business Associate of a Use or Disclosure of PHI by Business Associate in violation of this Agreement. r. Subcontractors and Breaches. i. Business Associate shall enter into a written agreement with each of its Subcontractors and agents, who create, receive, maintain, or transmit PHI on behalf of Business Associate. The agreements shall require such Subcontractors and agents to report to Business Associate any use or disclosure of PHI not provided for by this Agreement, including Security Incidents and Breaches of Unsecured Protected Health Information, on the first day such Subcontractor or agent knows or should have known of the Breach as required by 45 C.F.R. 164.410. ii. Business Associate shall notify Covered Entity of any such report and shall provide copies of any such agreements to Covered Entity on request. s. Data Ownership. i. Business Associate acknowledges that Business Associate has no ownership rights with respect to the PHI. ii. Upon request by Covered Entity, Business Associate immediately shall provide Covered Entity with any keys to decrypt information that the Business Association has encrypted and maintains in encrypted form, or shall provide such information in unencrypted usable form. t. Retention of PHI. Except upon termination of this Agreement as provided in Section 5 below, Business Associate and its Subcontractors or agents shall retain all PHI throughout the term of this Agreement, and shall continue to maintain the accounting of disclosures required under Section 1.j above, for a period of six years. 4. OBLIGATIONS OF COVERED ENTITY a. Safeguards During Transmission. Covered Entity shall be responsible for using appropriate safeguards including encryption of PHI, to maintain and ensure the confidentiality, integrity, and security of PHI transmitted pursuant to this Agreement, in accordance with the standards and requirements of the HIPAA Rules. b. Notice of Changes. i. Covered Entity maintains a copy of its Notice of Privacy Practices on its website. Covered Entity shall provide Business Associate with any changes in, or revocation of, permission to use or disclose PHI, to the extent that it may affect Business Associate's permitted or required uses or disclosures. Exhibit A, HIPAA BAA Page 6 of 9 Revised 8/18 ii. Covered Entity shall notify Business Associate of any restriction on the use or disclosure of PHI to which Covered Entity has agreed in accordance with 45 C.F.R. 164.522, to the extent that it may affect Business Associate's permitted use or disclosure of PHI. 5. TERMINATION a. Breach. i. In addition to any Contract provision regarding remedies for breach, Covered Entity shall have the right, in the event of a breach by Business Associate of any provision of this Agreement, to terminate immediately the Contract, or this Agreement, or both. ii. Subject to any directions from Covered Entity, upon termination of the Contract, this Agreement, or both, Business Associate shall take timely, reasonable, and necessary action to protect and preserve property in the possession of Business Associate in which Covered Entity has an interest. u. Effect of Termination. i. Upon termination of this Agreement for any reason, Business Associate, at the option of Covered Entity, shall return or destroy all PHI that Business Associate, its agents, or its Subcontractors maintain in any form, and shall not retain any copies of such PHI. ii. If Covered Entity directs Business Associate to destroy the PHI, Business Associate shall certify in writing to Covered Entity that such PHI has been destroyed. iii. If Business Associate believes that returning or destroying the PHI is not feasible, Business Associate shall promptly provide Covered Entity with notice of the conditions making return or destruction infeasible. Business Associate shall continue to extend the protections of Section 3 of this Agreement to such PHI, and shall limit further use of such PHI to those purposes that make the return or destruction of such PHI infeasible. 6. INJUNCTIVE RELIEF Covered Entity and Business Associate agree that irreparable damage would occur in the event Business Associate or any of its Subcontractors or agents use or disclosure of PHI in violation of this Agreement, the HIPAA Rules or any applicable law. Covered Entity and Business Associate further agree that money damages would not provide an adequate remedy for such Breach. Accordingly, Covered Entity and Business Associate agree that Covered Entity shall be entitled to injunctive relief, specific performance, and other equitable relief to prevent or restrain any Breach or threatened Breach of and to enforce specifically the terms and provisions of this Agreement. Exhibit A, HIPAA BAA Page 7 of 9 Revised 8/18 7. LIMITATION OF LIABILITY Any provision in the Contract limiting Contractor's liability shall not apply to Business Associate's liability under this Agreement, which shall not be limited. This requirement shall not be interpreted to create any indemnification obligation on behalf of Contractor. 8. DISCLAIMER Covered Entity makes no warranty or representation that compliance by Business Associate with this Agreement or the HIPAA Rules will be adequate or satisfactory for Business Associate's own purposes. Business Associate is solely responsible for all decisions made and actions taken by Business Associate regarding the safeguarding of PHI. 9. CERTIFICATION Covered Entity has a legal obligation under HIPAA Rules to certify as to Business Associate's Information Security practices. Covered Entity or its authorized agent or contractor shall have the right to examine Business Associate's facilities, systems, procedures, and records, at Covered Entity's expense, if Covered Entity determines that examination is necessary to certify that Business Associate's Information Security safeguards comply with the HIPAA Rules or this Agreement. 10. AMENDMENT a. Amendment to Comply with Law. The Parties acknowledge that state and federal laws and regulations relating to data security and privacy are rapidly evolving and that amendment of this Agreement may be required to provide procedures to ensure compliance with such developments. i. In the event of any change to state or federal laws and regulations relating to data security and privacy affecting this Agreement, the Parties shall take such action as is necessary to implement the changes to the standards and requirements of HIPAA, the HIPAA Rules and other applicable rules relating to the confidentiality, integrity, availability and security of PHI with respect to this Agreement. ii. Business Associate shall provide to Covered Entity written assurance satisfactory to Covered Entity that Business Associate shall adequately safeguard all PHI, and obtain written assurance satisfactory to Covered Entity from Business Associate's Subcontractors and agents that they shall adequately safeguard all PHI. iii. Upon the request of either Party, the other Party promptly shall negotiate in good faith the terms of an amendment to the Contract embodying written assurances consistent with the standards and requirements of HIPAA, the HIPAA Rules, or other applicable rules. iv. Covered Entity may terminate this Agreement upon 30 days' prior written notice in the event that: Exhibit A, HIPAA BAA Page 8 of 9 Revised 8/18 A. Business Associate does not promptly enter into negotiations to amend the Contract and this Agreement when requested by Covered Entity pursuant to this Section; or B. Business Associate does not enter into an amendment to the Contract and this Agreement, which provides assurances regarding the safeguarding of PHI sufficient, in Covered Entity's sole discretion, to satisfy the standards and requirements of the HIPAA, the HIPAA Rules and applicable law. v. Amendment of Appendix. The Appendix to this Agreement may be modified or amended by the mutual written agreement of the Parties, without amendment of this Agreement. Any modified or amended Appendix agreed to in writing by the Parties shall supersede and replace any prior version of the Appendix. 11. ASSISTANCE IN LITIGATION OR ADMINISTRATIVE PROCEEDINGS Covered Entity shall provide written notice to Business Associate if litigation or administrative proceeding is commenced against Covered Entity, its directors, officers, or employees, based on a claimed violation by Business Associate of HIPAA, the HIPAA Rules or other laws relating to security and privacy or PHI. Upon receipt of such notice and to the extent requested by Covered Entity, Business Associate shall, and shall cause its employees, Subcontractors, or agents assisting Business Associate in the performance of its obligations under the Contract to, assist Covered Entity in the defense of such litigation or proceedings. Business Associate shall, and shall cause its employees, Subcontractor's and agents to, provide assistance, to Covered Entity, which may include testifying as a witness at such proceedings. Business Associate or any of its employees, Subcontractors or agents shall not be required to provide such assistance if Business Associate is a named adverse party. 12. INTERPRETATION AND ORDER OF PRECEDENCE Any ambiguity in this Agreement shall be resolved in favor of a meaning that complies and is consistent with the HIPAA Rules. In the event of an inconsistency between the Contract and this Agreement, this Agreement shall control. This Agreement supersedes and replaces any previous, separately executed HIPAA business associate agreement between the Parties. 13. SURVIVAL Provisions of this Agreement requiring continued performance, compliance, or effect after termination shall survive termination of this contract or this agreement and shall be enforceable by Covered Entity. Exhibit A, HIPAA BAA Page 9 of 9 Revised 8/18 APPENDIX TO HIPAA BUSINESS ASSOCIATE AGREEMENT This Appendix ("Appendix") to the HIPAA Business Associate Agreement ("Agreement") is an appendix to the Contract and the Agreement. For the purposes of this Appendix, defined terms shall have the meanings ascribed to them in the Agreement and the Contract. Unless the context clearly requires a distinction between the Contract, the Agreement, and this Appendix, all references to "Contract" or "Agreement" shall include this Appendix. 1. PURPOSE This Appendix sets forth additional terms to the Agreement. Any sub -section of this Appendix marked as "Reserved" shall be construed as setting forth no additional terms. 2. ADDITIONAL TERMS b. Additional Permitted Uses. In addition to those purposes set forth in the Agreement, Business Associate may use PHI for the following additional purposes: i. Reserved. c. Additional Permitted Disclosures. In addition to those purposes set forth in the Agreement, Business Associate may disclose PHI for the following additional purposes: i. Reserved. c. Approved Subcontractors. Covered Entity agrees that the following Subcontractors or agents of Business Associate may receive PHI under the Agreement: i. Reserved. d. Definition of Receipt of PHI. Business Associate's receipt of PHI under this Contract shall be deemed to occur, and Business Associate's obligations under the Agreement shall commence, as follows: i. Upon receipt of PHI from the Department. e. Additional Restrictions on Business Associate. Business Associate agrees to comply with the following additional restrictions on Business Associate's use and disclosure of PHI under the Contract: i. Reserved. f. Additional Terms. Business Associate agrees to comply with the following additional terms under the Agreement: i. Reserved. Exhibit A, HIPAA BAA, APPENDIX A Page 1 of 1 Revised 8/18 EXHIBIT B, STATEMENT OF WORK 1. TERMINOLOGY 1.1. In addition to the terms defined in §3 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 Exhibit B, SOW Page 1 of 17 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. Provider — Any health care professional or entity that has been accepted as a provider in the Colorado Medicaid program, Colorado's CHP+ program or the Colorado Indigent Care Program, as determined by the Department. 1.1.31. Referral — the request of a Member for Options Counseling. 1.1.32. 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 Exhibit B, SOW Page 2 of 17 nursing homes. 1.1.33. State — The State of Colorado, acting by and through any State agency. 1.1.34. State Fiscal Quarter — The quarterly period of a State Fiscal Year in which Contractor's performance is measured. 1.1.35. 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. 1.1.36. 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. 1.1.37. Transition Coordination Referral Log — The monthly log created and required by the Department identifying individuals referred to and accepted by Transition Coordination Agencies. 1.1.38. 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. 1.1.39. 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 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. Exhibit B, SOW Page 3 of 17 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, including all changes directed by the Department, the Department will notify Contractor of its acceptance of the Deliverable in writing. A Deliverable shall not be deemed accepted prior to the Department's notice to Contractor of its acceptance of that Deliverable. 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. 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 Exhibit B, SOW Page 4 of 17 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 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 Exhibit B, SOW Page 5 of 17 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. Closeout Period 2.9.1. During the Closeout Period, the Contractor shall complete all of the following: 2.9.1.1. 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. 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, Exhibit B, SOW Page 6 of 17 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. 2.10.1.4.2. 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. 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. Exhibit B, SOW Page 7 of 17 2.10.1.4.3. 2.10.1.4.4. 2.10.1.5. The Contractor shall require its employees and agents to, promptly 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. The Contractor shall execute the assignment referenced herein immediately upon the creation of the Work Product pursuant to the terms of this Contract. 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. 2.10.1.8.1. 2.10.1.8.2. 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 includes, but is not limited to, the following: 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. 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. 2.11. Renewal Options and Extensions 2.11.1. The Department may, within its sole discretion, choose to not exercise any renewal option in Exhibit B, SOW Page 8 of 17 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 and Disability Resources for Colorado (ADRC) staff, including staff from a sub -contracted Independent Living Center (ILC), to ensure proper uniformity with the project. Exhibit B, SOW Page 9 of 17 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 monthly 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. 4.2. 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 and the State Unit on Aging, to facilitate the Referral process and Referrals to the Transition Coordination program. Exhibit B, SOW Page 10 of 17 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 Department. 5.2.3.3. Members using Medicaid referred through self -Referrals. 5.2.3.4. Members using Medicaid referred through service providers, advocates and/or family Members. 5.2.3.5. All Members identified in MDS data made available to the Contractor by the Department. 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 meet the referred Members in the Member's nursing home within ten (10) Business Days of the Referral. 5.2.5.1. The Contractor shall document in the Member's case file and on the monthly Options Counseling Referral Log how many attempts were made to reach the Member and any reason the Member could not be reached within ten (10) Business Days. 5.2.5.2. 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. 5.2.6. The Contractor shall transfer a Referral to a Subcontractor, when applicable, within two (2) Business Days after receiving the Member Referral for Options Counseling. 5.2.7. 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. 5.2.7.1. The Contactor shall ensure all Subcontractors adhere to all Nursing Facility rules and regulations, including those pertaining to visitors in the facility. 5.2.8. The Contractor shall provide Options Counseling to Members who are enrolled in the Long - Term Care Medicaid program and who wish to transition to the community. 5.2.8.1. The Contractor shall provide Members with the option to choose from any of the following programs through Medicaid: 5.2.8.1.1. Home and Community Based Waiver Programs (HCBS); 5.2.8.1.2. State Plan Long Term Care Benefits including Transition Coordination. 5.2.9. The Contractor shall explain and describe the programs available to the Member or their legal guardian. 5.2.10. The Contractor shall make a Referral to a local Transition Coordination Agency if the Member wishes to proceed with the transition process. 5.2.10.1. The Contractor shall not screen out a Member for transition services. Exhibit B, SOW Page 11 of 17 5.2.10.2. 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. 5.2.10.3. The Contractor shall provide written 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. 5.2.10.3.1. 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. 5.2.10.4. 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. 5.2.10.5. 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: 5.2.10.5.1. Completed Options Counseling Referral Information Form; and 5.2.10.5.2. Options Counseling Assessment. 5.2.10.6. If the chosen TCA does not have capacity, the Contractor shall add the Member to the Contractor's Transition Coordination Pending Referral List. 5.2.10.7. 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: 5.2.10.7.1. Completed Options Counseling Referral Information Form; and 5.2.10.7.2. Options Counseling Assessment. 5.2.10.8. The Contractor shall confirm that the chosen TCA accepted the Referral by notifying the Medicaid Member and the Nursing Facility, with the following information: 5.2.10.8.1. TCA name, phone number, and email address; and 5.2.10.8.2. Assigned TC name, phone number, and email address. 5.2.10.9. The Contractor shall inform a Member of alternative options if the Member is not an appropriate candidate for transition coordination through Medicaid. 5.2.10.9.1. The Contractor shall make proper Referrals based on the Member's status. 5.2.10.10. The Contractor shall ensure that Medicaid Members referred through Section Q and/or identified in the MDS data receives Options Counseling. The data includes: 5.2.10.10.1. MDS Section Q0500B "yes" and Q0600 "yes -referral made" Medicaid Member responses. 5.2.10.10.2. MDS Section Q0500B "yes" and Q0600 "no -referral is or may be needed" Medicaid Member responses. 5.2.10.10.3. MDS Section Q0500B "yes" and Q0600 "no -referral not needed" Medicaid Member responses. 5.2.10.10.4. Departmental Referrals from the Department's Principal Representative. Exhibit B, SOW Page 12 of 17 5.2.10.11. The Contractor shall ensure that its Options Counseling follows the ADRC Policy and Procedure Manual for Options Counseling. 5.2.10.12. The Contractor shall ensure that transition coordination eligible Members who desire to continue with transitioning are referred to a local TCA. 5.2.10.13. The Contractor shall 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. 5.2.10.14. The Contractor shall attend and participate in regional Transition Coordination 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; 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. The Regional Outreach Plan shall include all of the following: Exhibit B, SOW Page 13 of 17 5.4.1.1.1. 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. 5.4.1.1.2. All performance standards, timelines and milestones the Contractor will meet related to regional outreach, as well as any Deliverables the Contractor will submit. 5.4.1.2. The Contractor shall deliver the Regional Outreach Plan to the Department for review and approval. 5.4.1.2.1. DELIVERABLE: Regional Outreach Plan 5.4.1.2.2. DUE: No later than sixty (60) days after Effective Date, and annually thereafter 5.4.1.3. The Contractor shall update the Regional Outreach Plan annually and deliver a copy to the Department for review and approval. 5.4.1.3.1. The Contractor shall update the Regional Outreach Plan to include the following: 5.4.1.3.1.1. A list of all outreach activities completed by the Contractor. 5.4.1.3.1.2. A description of the results from the completed outreach activities. 5.4.1.3.1.2.1. Results include, but are not limited to, the following: 5.4.1.3.1.2.1.1. Number of outreach/education meetings held with family/guardians of Nursing Facility residents. 5.4.1.3.1.2.1.2. Number of presentations to Resident Council Meetings. 5.4.1.3.1.2.1.3. Number of informational meetings held with landlords. 5.4.1.3.1.2.1.4. Number of MDS Section Q referral process outreach/training sessions for Nursing Facility Staff. 5.4.1.3.1.2.1.5. Number of community meetings attended and presentations given. 5.4.1.3.1.2.1.6. Development and dissemination of outreach materials. 5.4.1.3.2. DELIVERABLE: Updated Regional Outreach Plan 5.4.1.3.3. DUE: At least three (3) Business Days before the start 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. Exhibit B, SOW Page 14 of 17 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. 6.2. Monthly Referral Logs 6.2.1. The Contractor shall complete Monthly Referral Logs, as provided by the Department, that cover the previous month's activity. The Monthly Referral Logs 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 Monthly Referral Logs to the Department for review and approval. 6.2.2.1. DELIVERABLE: Monthly Referral Logs 6.2.2.2. DUE: Fifteen (15) Calendar Days following the last day of the month that the logs cover Exhibit B, SOW Page 15 of 17 6.3. Quarterly Report 6.3.1. The Contractor shall complete a Quarterly Report that covers the previous State Fiscal Quarter's activity. The Quarterly Report shall include, at a minimum, the following: 6.3.1.1. The ADRC Data report required by the State Unit on Aging. 6.3.1.2. A written report specifying progress made for each specified performance measure and standard in this Contract. The written report shall be in accordance with the procedures developed and prescribed by the State. 6.3.2. The Contractor shall deliver the Quarterly Report to the Department for review and approval. 6.3.2.1. DELIVERABLE: Quarterly Report 6.3.2.2. DUE: Fifteen (15) Calendar Days following the last day of the State Fiscal Quarter that the Quarterly Report covers 7. OUTREACH INCENTIVE PAYMENT 7.1. The Contractor may earn an Outreach Incentive Payment in the last quarter of the State Fiscal Year if the Contractor meets the performance standards and milestones contained in the most recent Department approved Updated Regional Outreach Plan. 7.1.1. The Department may, at its sole discretion, reduce outreach activities if the Contractor submits a written request to the Department's Principal Representative. 7.2. The Department will maintain one Outreach Incentive Pool for each State Fiscal Year. The Outreach Incentive Pool shall include the following: 7.2.1. Any Quarterly Payment not earned by any ADRC Contractors under Section 8.1.1.1. 7.2.2. The total amount of all Quarterly Payments allocated to any ADRC Contractor that did not participate in the Section Q Options Counseling for that State Fiscal Year. 7.3. The amount of an Outreach Incentive Payment for each State Fiscal Year will be determined by the Department. The Department will maintain an Outreach Incentive Pool and distribute a portion of the Outreach Incentive Pool to the Contractor as follows: 7.3.1. The Department will determine the Outreach Incentive Payment that each ADRC Contractor receives from the Outreach Incentive Pool for a State Fiscal Year using the same pricing methodology that the Department uses to calculate ADRC Contractor base Quarterly Payments. 7.4. If the Outreach Incentive Pool is zero dollars ($0.00) for any State Fiscal Year, the Contractor shall not receive an Outreach Incentive Payment for that State Fiscal Year. 8. COMPENSATION AND INVOICING 8.1. Compensation 8.1.1. The compensation under this Contract shall consist of a base Quarterly Payment as described in Exhibit C, Rates, and any Outreach Incentive Payment earned by the Contractor under Section 7. 8.1.1.1. Quarterly Payment Exhibit B, SOW Page 16 of 17 8.1.1.1.1. 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 Monthly Referral Logs and Quarterly Report to the Department. 8.1.1.1.2. 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. 8.2. Detailed Invoicing and Payment Procedures 8.2.1. The Contractor shall invoice the Department on a quarterly basis, by the fifteenth (15t) 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. 8.2.1.1. Quarterly invoices for payment shall use the standardized template provided by the Department. 8.2.2. 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. 8.2.3. 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 the Department's review shall be final. No disputed payment shall be due until after the Department has concluded its review. 8.3. Closeout Payments 8.3.1. 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. Exhibit B, SOW Page 17 of 17 EXHIBIT C, RATES 1. QUARTERLY PAYMENT 1.1. The Contractor shall be paid at a base Quarterly Payment, contingent upon the delivery of approved Monthly Referral Logs and Quarterly Reports to the Department and subject to the Contractor's performance of Options Counseling. The applicable Payments are as follows: QUARTER TOTAL State Fiscal Year 2019-2020 Quarter 1 $3,175.05 Quarter 2 $3,175.05 Quarter 3 $3,175.05 Quarter 4 $3,175.03 TOTAL $12,700.18 Total Incentive Pool for All Qualifying Regions State Fiscal Year 2019-2020 $33,219.39 TOTAL $33,219.39 Exhibit C, Rates Page 1 of 1 EXHIBIT D, SAMPLE OPTION LETTER OPTION LETTER State Agency Department of Health Care Policy and Financing Option Letter Number Insert the Option Number (e.g. "1" for the first option) Contractor Insert Contractor's Full Legal Name, including "Inc.", "LLC", etc... Original Contract Number Insert CMS number or Other Contract Number of the Original Contract Current Contract Maximum Amount Initial Term State Fiscal Year 20xx $0.00 Extension Terms State Fiscal Year 20xx $0.00 State Fiscal Year 20xx $0.00 State Fiscal Year 20xx $0.00 State Fiscal Year 20xx $0.00 Total for All State Fiscal Years $0.00 Option Contract Number Insert CMS number or Other Contract Number of this Option Contract Performance Beginning Date The later of the Effective Date or Month Day, Year Current Contract Expiration Date Month Day, Year 1. Options A. Option to extend for an Extension Term. B. Option to change the quantity of Goods under the Contract. C. Option to change the quantity of Services under the Contract. D. Option to modify the Contract rates. E. Option to initiate next phase of the Contract. 2. Required Provisions A. For use with Option 1(A): In accordance with Section(s) Number of the Original Contract referenced above, the State hereby exercises its option for an additional term, beginning Insert start date and ending on the current contract expiration date shown above, at the rates stated in the Original Contract, as amended. B. For use with Options 1(B and C): In accordance with Section(s) Number of the Original Contract referenced above, the State hereby exercises its option to Increase/Decrease the quantity of the Goods/Services or both at the rates stated in the Original Contract, as amended. C. For use with Option 1(D): In accordance with Section(s) Number of the Original Contract referenced above, the State hereby exercises its option to modify the Contract rates specified in Exhibit/Section Number/Letter. The Contract rates attached to this Option Letter replace the rates in the Original Contract as of the Option Effective Date of this Option Letter. D. For use with Option 1(E): In accordance with Section(s) Number of the Original Contract referenced above, the State hereby exercises its option to initiate Phase indicate which Phase: 2, 3, 4, etc., which shall begin on Insert start date and end on Insert ending date at the cost/price specified in Section Number. E. For use with all Options that modify the Contract Maximum Amount: The Contract Maximum Amount table on the Contract's Signature and Cover Page is hereby deleted and replaced with the Current Contract Maximum Amount table shown above. 3. Option Effective Date a. The Effective Date of this Option Letter is upon approval of the State Controller or the Effective Date of this Option Letter, whichever is later. Exhibit D, Sample Option Letter Page 1 of 2 STATE OF COLORADO John W. Hickenlooper, Governor Department of Health Care Policy and Financing Kim Bimestefer, Executive Director By: Kim Bimestefer, Executive Director Date: In accordance with C.R.S. §24-30-202, this Option is not valid until signed and dated below by the State Controller or an authorized delegate. STATE CONTROLLER Robert Jaros, CPA, MBA, JD By: Greg Tanner, Controller; Department of Health Care Policy and Financing Option Effective Date: Exhibit D, Sample Option Letter Page 2 of 2 EXHIBIT E, INFORMATION TECHNOLOGY PROVISIONS This Exhibit regarding Information Technology Provisions (the "Exhibit") is an essential part of the agreement between the State and Contractor as described in the Contract to which this Exhibit is attached. Unless the context clearly requires a distinction between the Contract and this Exhibit, all references to "Contract" shall include this Exhibit. 1. PROTECTION OF SYSTEM DATA A. In addition to the requirements of the main body of this Contract, if Contractor or any Subcontractor is given access to State Records by the State or its agents in connection with Contractor's performance under the Contract, Contractor shall protect all State Records in accordance with this Exhibit. All provisions of this Exhibit that refer to Contractor shall apply equally to any Subcontractor performing work in connection with the Contract. B. For the avoidance of doubt, the terms of this Exhibit shall apply to the extent that any of the following statements is true in regard to Contractor access, use, or disclosure of State Records: i. Contractor provides physical or logical storage of State Records; ii. Contractor creates, uses, processes, discloses, transmits, or disposes of State Records; iii. Contractor is otherwise given physical or logical access to State Records in order to perform Contractor's obligations under this Contract. C. Contractor shall, and shall cause its Subcontractors, to do all of the following: i. Provide physical and logical protection for all hardware, software, applications, and data that meets or exceeds industry standards and the requirements of this Contract. ii. Maintain network, system, and application security, which includes, but is not limited to, network firewalls, intrusion detection (host and network), annual security testing, and improvements or enhancements consistent with evolving industry standards. iii. Comply with State and federal rules and regulations related to overall security, privacy, confidentiality, integrity, availability, and auditing. iv. Provide that security is not compromised by unauthorized access to workspaces, computers, networks, software, databases, or other physical or electronic environments. v. Promptly report all Incidents, including Incidents that do not result in unauthorized disclosure or loss of data integrity, to a designated representative of the State's Office of Information Security ("OIS"). vi. Comply with all rules, policies, procedures, and standards issued by the Exhibit E, Information Technology Provisions Page 1 of 4 Governor's Office of Information Technology ("OIT"), including project lifecycle methodology and governance, technical standards, documentation, and other requirements posted at www.oit.state.co.us/about/policies. D. Subject to Contractor's reasonable access security requirements and upon reasonable prior notice, Contractor shall provide the State with scheduled access for the purpose of inspecting and monitoring access and use of State Records, maintaining State systems, and evaluating physical and logical security control effectiveness. E. Contractor shall perform current background checks in a form reasonably acceptable to the State on all of its respective employees and agents performing services or having access to State Records provided under this Contract, including any Subcontractors or the employees of Subcontractors. A background check performed within 30 days prior to the date such employee or agent begins performance or obtains access to State Records shall be deemed to be current. i. Contractor will provide notice to the Security and Compliance Representative for the State indicating that background checks have been performed. Such notice will inform the State of any action taken in response to such background checks, including any decisions not to take action in response to negative information revealed by a background check. ii. If Contractor will have access to Federal Tax Information under the Contract, Contractor shall agree to the State's requirements regarding Safeguarding Requirements for Federal Tax Information and shall comply with the background check requirements defined in IRS Publication 1075 and §24-50-1002, C.R.S. 2. DATA HANDLING A. The State, in its sole discretion, may securely deliver State Records directly to the facility where such data is used to perform the Work. Contractor may not maintain or forward these State Records to or from any other facility or location, except for the authorized and approved purposes of backup and disaster recovery purposes, without the prior written consent of the State. Contractor may not maintain State Records in any data center or other storage location outside the United States for any purpose without the prior express written consent of OIS. B. Contractor shall not allow remote access to State Records from outside the United States, including access by Contractor's employees or agents, without the prior express written consent of OIS. Contractor shall communicate any request regarding non-U.S. access to State Records to the Security and Compliance Representative for the State. The State shall have sole discretion to grant or deny any such request. Exhibit E, Information Technology Provisions Page 2 of 4 C. Upon request by the State made any time prior to 60 days following the termination of this Contract for any reason, whether or not the Contract is expiring or terminating, Contractor shall make available to the State a complete and secure download file of all data that is encrypted and appropriately authenticated. This download file shall be made available to the State within 10 Business Days of the State's request, and shall contain, without limitation, all State Records, Work Product, and system schema and transformation definitions, or delimited text files with documents, detailed schema definitions along with attachments in its native format. Upon the termination of Contractor's provision of data processing services, Contractor shall, as directed by the State, return all State Records provided by the State to Contractor, and the copies thereof, to the State or destroy all such State Records and certify to the State that it has done so. If legislation imposed upon Contractor prevents it from returning or destroying all or part of the State Records provided by the State to Contractor, Contractor shall guarantee the confidentiality of all State Records provided by the State to Contractor and will not actively process such data anymore. D. The State retains the right to use the established operational services to access and retrieve State Records stored on Contractor's infrastructure at its sole discretion and at any time. If that ability does not exist, it does not need to be created. Upon request of the State or of the supervisory authority, Contractor shall submit its data processing facilities for an audit of the measures referred to in this Exhibit in accordance with the terms of this Contract. 3. COMPLIANCE A. In addition to the compliance obligations imposed by the main body of the Contract, Contractor shall comply with: i. All Colorado Office of Information Security (OIS) policies and procedures which OIS has issued pursuant to §§24-37.5-401 through 406, C.R.S. and 8 CCR §1501-5 and posted at http://oit.state.co.us/ois ii. All information security and privacy obligations imposed by any federal, state, or local statute or regulation, or by any industry standards or guidelines, as applicable based on the classification of the data relevant to Contractor's performance under the Contract. Such obligations may arise from: a. Health Information Portability and Accountability Act (HIPAA) b. IRS Publication 1075 c. Payment Card Industry Data Security Standard (PCI-DSS) d. FBI Criminal Justice Information Service Security Addendum e. CMS Minimum Acceptable Risk Standards for Exchanges f. Electronic Information Exchange Security Requirements and Exhibit E, Information Technology Provisions Page 3 of 4 Procedures For State and Local Agencies Exchanging Electronic Information With The Social Security Administration B. Contractor shall implement and maintain all appropriate administrative, physical, technical, and procedural safeguards necessary and appropriate to ensure compliance with the standards and guidelines applicable to Contractor's performance under the Contract. C. Contractor shall allow the State reasonable access and shall provide the State with information reasonably required to assess Contractor's compliance. Such access and information may include: i. The performance of security audit and penetration tests, as requested by OIS or its designee at any time under this Contract; ii. An annual SOC2 Type II audit including, at a minimum, the Trust Principles of Security, Confidentiality, and Availability, or an alternative audit recommended by OIS. 4. TRANSITION OF SERVICES Upon expiration or earlier termination of this Contract or any Services provided in this Contract, Contractor shall accomplish a complete transition of the Services from Contractor to the State or any replacement provider designated solely by the State without any interruption of or adverse impact on the Services or any other services provided by third parties in this Contract. Contractor shall cooperate fully with the State or such replacement provider and promptly take all steps required to assist in effecting a complete transition of the Services designated by the State. All services related to such transition shall be performed at no additional cost beyond what would be paid for the Services in this Contract. Exhibit E, Information Technology Provisions Page 4 of 4 EXHIBIT F, CMS — R-0235 ADDENDUM DEPARTMENT OF HEA.LTH AND HUMAN SER.,ICE4 Farm Approved CENTERS FOR MEDICARE & MEDICAID SERVICES OMB No. 0 B —F734 DATA USE AGREEMENT (DUA) ADDENDUM for Data Acquired from the CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) The following individuals) requests access to CMS data. Their signature4s1, attest to their agreement with the terms and conditions defined in the original docruneutation for Data Use Agreement (DUA) or for new DUA studrproject name Part A Requester Custodian Subcontractor Recipient Printed Name Phone Ext Ormarii7ation Sweet Address City State Zip E-mail Signature (if applicable) Courier name Account number Part B Requester Custodian Subcontractor Recipient Printed Name Phone Ext Orear,i7ation Street Address City State Zip E-mail Signature (if applicable)) Courier name Account number Contracting Officer Representative iCORI Governtnent Task Lead tGTLI or COLS Privacy Staff Printed Name Signature Organization Please send as an email attachment to DataL-scAgrccrrtcrtr'ZLetus irk s.gor, and see our website at i+"ww.cros.goi'r prii'ac1' Parer..--ri e,_u,.tkm 4. 1 +?: n. r.. ne an: rn .ur-_t: ini.:crrui....r .Tile: t JrsFIat a :41u.1 .ntr-1 jm-:r I o ,Li! (IMF. r:r-1 numh..r I -r thi. in; ,rma:r e Iln. - rs ^+5N is 1 "hc :in. r nr_,_ t i�lr:r �1is ini ma,: -,n , :ih.:h n is t rn:n.c .:.m..�: r r.;F .:. iru..d.: _ thy U,r..: I•. r: irn- inarJ tj n sr -arch ext,tim. Ja!a r., u. _ ., ;ail-. r the 111.1 nn•J•.- anti c m 5.4. ar.J r. c;r rt. e.i-. rrar_- n : JI l:n •n It va ha, : amen1 . c •n.,rn ..p :Mat, urz �:. •f Ib: scantrn; r r rmpm •...h I: •rnr draw erne r \t . __(f. x+untr fk:-rile ar J. 'a. ?7 ..m; l h an„ r1( zr 11m1 '.::.,ot t e ua:::re r M.1. 2.::'11 G3•11'1 CM5-R-0.2._354 iCe_.:121 Exhibit F, CMS — R-0235 Addendum Page 1 of 1 Hello