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Home My WebLink About20172634.tiffr rep 149$(6. PRIVILEGED AND CONFIDENTIAL MEMORANDUM DATE: June 19, 2018 TO: Board of County Commissioners — Pass -Around FR: Judy A. Griego, Director, Human Services RE: Fiscal Year 2018-19 Purchase of Service Agreement Amendments for the Area Agency on Aging In -Home Voucher Program Partners Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Fiscal Year 2018-19 Purchase of Service Agreement Amendments for the Area Agency on Aging In -Home Voucher Program Partners. The Weld County Area Agency on Aging In -Home Services Voucher Program provides assistance to eligible Weld County residents 60 years of age and older who require assistance with personal care and homemaking services. Personal care services include, but are not limited to, bathing, dressing, mobility, and hygiene assistance. Homemaking services include, but are not limited to, laundry assistance, dusting, vacuuming, and bathroom cleaning. Program participants can choose a provider of their choice from the list of contracted agencies at a rate of $25 per hour for up to three (3) hours per week per participant. On a case -by -case basis, some participants may receive additional hours, if funds are available, to ensure their safety. The term for all agreements is July 1, 2018, through June 30, 2019. All vendors have been previous In -Home Voucher Program partners. CMS ID VENDOR '1906 A Little R & R Care A Caring Hand, Inc. DBA All Valley Home Care -A 907 1908 Altitude Home Care 1909 Andrea's Angels, Inc. MCC Corp dba Caring Senior Service e 1910 1911 I Livefully, Inc. DBA First Light Home Care 191.3 Mile High Seniors, Inc. DBA Home Helpers and Direct Link Caregivers, Inc. DBA Homewatch Caregivers 1914 Compassionate Connection, LLC DBA Seniors Helping Seniors 1915 1916 Visiting Angels Living Assistance Services of Windsor Pass -Around Memorandum; June 19, 2018 —Var s enAa--eitt 7. 30 -/� M,! -- -/g Page 1 02o/ 7--al‘03its m PRIVILEGED AND CONFIDENTIAL I do not recommend a Work Session I recommend approval of these amendments and authorize the Director and Chair to sign. Sean P. Conway Julie A Cozad Mike Freeman Barbara Kirkmeyer, Pro-Tem Steve Moreno, Chair Approve Schedule Recommendation Work Session Other/Comments: Pass -Around Memorandum, June 19, 2018 — ID (Various) Page 2 PURCHASE SERVICE AGREEMENT AMENDMENT BETWEEN T E WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND A LITTLE R & R HOME CARE This Agreement Amendrnei t, made and en tyre into (. day L " 2018, by and between the Board of Weld County Commissione s, on behalf of the b eld County Department of Human Services, Area Agency on Aging, hereinafter referr d to as the "AAA", arf d A little R & R Home Care. WHEREAS the parties ente d into an Agreement to purchase and deliver home delivered meal services (the "Original Agreement") identifie by the Weld County Clerk to the Board of County Commissioners as document No. 2017.2634, approve on July 1, 2017. WHEREAS the parties here y agree to amend the term(s) of the Original Agreement in accordance with the terms of the Original Agreemen and the previous amendment, which are incorporated by reference herein, as well as the terms provided herein NOW THEREFORE, in consicjeration of the premipes, the parties hereto covenant and agree as follows: • The terms of this agreement ill extend from July 4, 2018 through June 30, 2019. This amendment will terminate immediately in t e event of lo$s of fu jding. • All other terms and conditions of the Original A eement remain unchanged. IN WITNESS WHEREOF, the parties h eto have duly executed the Agreement as of the day, month and year first above written ATTEST: Weld County Clerk to the Board B eputy Cler Jado; COUpTY: E3OAkD OF COUNTY COMMISSIONERS WELs COUNTY COLORDO C) Stevp Moreno, Chair JULA3 0 1018 CONTRACTOR: A Little R & R Home Care 196q W 15'h Street, Suite 6 Loveand, CO 80538 eidf Rizzotto, Administrator I Dat ( s' ow I - ?to sq RESOLUTION RE: APPROVE ELEVEN (11) AGREEMENTS FOR PURCHASES OF IN -HOME SERVICES WITH VARIOUS PROVIDERS 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 eleven (11) Agreements for Purchases of In -Home Services 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, Area Agency on Aging, and the various providers, as follows commencing upon full execution of signatures and ending June 30, 2018, with further terms and conditions being as stated in said agreements, and 1. A Little R & R Home Care 2. A Caring Hand, Inc., dba All Valley Home Care 3. Altitude Home Care 4. Andrea's Angels, Inc. 5. Caring Senior Service 6. Britin, LLC, dba First Light Home Care 7. Caregivers, Inc., dba Homewatch Caregivers of Northern Colorado 8. Compassionate Connection, LLC, dba Seniors Helping Seniors 9. Mile High Seniors, Inc., dba Home Helpers and Direct Link 10. Rehabilitation and Visiting Nurse Association, LLC 11. Visiting Angels Living Assistance Services of Windsor WHEREAS, after review, the Board deems it advisable to approve said agreements, copies of which is attached hereto and incorporated herein by reference. Cc -ti -)S0 Co nt ract Orl o orm rte+ -/17/I-7 2017-2634 thru 2644 HR0088 RE: ELEVEN AGREEMENTS FOR PURCHASE OF IN -HOME SERVICES WITH VARIOUS PROVIDERS PAGE 2 NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the eleven (11) Agreements for Purchases of In -Home Services 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, Area Agency on Aging, and the various providers as listed above be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said agreements. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 31st day of July, A.D., 2016. BOARD OF COUNTY COMMISSIONERS WELD CONTY, COLORADO ATTEST: dotite4) jdai:gok Weld County Clerk to the Board BY: C210,a-ej aJ• puty Clerk to the Board APP ounty Attorney Date of signature: cal IS( Th /au Julie A,Cozad, Chair Steve Moreno, Pro-Tem EXCUSED Sean P. Conway ike Freeman j. rbara Kirkmeyer 2017-2634 thru 2644 HR0088 b;rafc\d- L9.9 PURCHASE OF SERVICE AGREEMENT THIS AGREEMENT, made and entered into this July 1. 201' by and between the County of Weld. State of Colorado. by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Human Services" Area Agency on Aging. hereinafter referred to as "WCAAA" or County and A Little R & R Home Care, hereinafter referred to as "A Little R & R Home Care" or Provider agency. WITNFSSFTII: WHEREAS. In -Home Services for older adults, as defined by the 12 CCR 2510-1, Colorado Older Americans Act. Volume 10. are widely recognized as valued services that assist individuals who experience difficulty performing activities of daily living to remain in their homes and to live independently. WHEREAS. WCAAA serves as the advocate and focal point for older persons with the greatest economic and social need. and WHIEREAS..A Little R & R Home Care is an organization existing for the purpose of providing homemaker and personal care services to residents of Weld County. and WHEREAS. WCAAA desires to purchase homemaker and personal care services for low-income seniors from A Little R & R Home Care. NOW THEREFORE. it is mutually agreed: 1. The WCAAA hereby agrees to reimburse Provider agency for services at the rate of S25.00 per unit of service (1 unit of service= 1 hour of personal care and'or homemaker services). ?. Provider agency agrees to commence services within thirty (30) days after the signing of the Agreement and assure completion of all services required hereunder by June 30. 2018. 3. Provider agency will not accept donations related to the services provided in this agreement. All donations received related to the services provided under this agreement must be referred back to WCAAA. 4. Provider agency understands that WCAAA is required to conduct an on -site evaluation of the activities conducted under this Agreement and to monitor on an ongoing basis the performance of Provider agency to insure that the funds made available by the Agreement are expended in keeping with the purposes for which they were awarded: and Provider agency accordingly agrees to cooperate fully with the WCAAA in the conduct of such evaluation and monitoring. including the keeping and supplying of such information. and providing access to documents and records to the WCAAA for the purpose of audit: and further agrees to do all things necessary to enable W CA A A to fulfill its obligation to the State ot Co?orado and the I nited States Government. Any changes, including any increase or decrea_ie in the amoum of Provider agency "s eoinpensat+:vn, and ncluding changes in budget allocations v,hich are mutually agreed upon by and betueen'he WCAAA and Provider agency shall ^e incorporated in vv'lttc'n amendments in this :Agreement and in appropriate rev''o the _rant 6 Pros'.dcr .tgen:.. undery anJ and g:-ee: that :r.c tuil,r.Fine leions are part of appilcation and its sudh become hindlnkt upon corrunenientent ot the protect. 2017-2634 a. This Agreement and the provisions of services hereunder shall be subject to the laws of Colorado and be in accordance with the policies, procedures, and practices of the County. the Older Americans Act, the policies and procedures established by the State Unit on Aging, and the terms and conditions of the project application approved by WCAAA. b. This award is made for the initial term stated in this Agreement. This Agreement in no way implies that further funding beyond the initial term is available. Funding for future term is contingent upon the availability of finds and approval of future project applications. Agrees to keep records and make reports on the forms required by the WCAAA and in accordance with guidelines issued by the State of Colorado and the Administration on Aging, specifically Provider agency agrees, i. To submit financial reports to the WCAAA at a minimum monthly; ii. To submit other reports to the WCAAA as requested; iii. fa maintain intemet access in order to transfer all required data to the WCAAA. d. Agrees to advise the WCAAA of needed program and financial changes and await approval from the WCAAA prior to change implementation. e. Agrees to have policies and procedures for complaint appeal tracking. timely disposition of complaints/appeals and documentation of such processes that includes all information in Exhibit C. A complaint log shall be kept on file and shall be available for WCAAA review as requested. Recipients must also be provided the WCAAA complaints and appeal process. f. Agrees to have a client grievance policy, which will address any alleged infractions of any federal, state or local laws by Provider agency against recipients of or applicants for services. g. Agrees to perform background checks of all employees, volunteers or subcontractors pursuant to C.R.S. 27-1-110 and in accordance with the policy of WCAAA and the State Unit on Aging. h. Agrees to be licensed by the State of Colorado to perform the services provided. Agrees to follow all policies of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regarding privacy of records. j. WCAAA reserves the right to conduct an investigation on a compliant received by a consumer. 7. Performance Measures a. As part of the State's Unit on Aging performance -based requirement. the WCAAA will survey recipients in the month of February. During this time. provider agencies will not be allowed to survey clients. This month is subject to change each fiscal year. 8. Scope of Work a. Definitions (Volume 10 Older Americans Act State Unit on Aging Policy and Procedure Manual 2 1 2016) "Frail" means an older adult who is determined to be functionally impaired due to inability to perform at least two Activities of Daily Living without substantial human 2 assistance. including verbal reminding, physical cueing. or supervision: or. a cognitive or other mental impairment. requiring substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to self or others. ii. "Homemaker Services" means providing assistance to persons who meet the eligibility requirements for in -home services and who are unable to perform two or more of the following Instrumental Activities of Daily Living: preparing meals. laundry. shopping for personal items, managing money. using the telephone or doing light housework. iii. "Homemaker eligibility" is restricted to those persons who are unable to perform at least two Instrumental Activities of Daily Living without substantial human assistance. including verbal reminding, physical cueing, or supervision: or due to a cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. Instrumental Activities of Daily Living (IADL) shall include: a. Meal Preparation: b. Housework: c. Laundry: d. Shopping: e. Medication Management: f. Appointment Management: g. Money Management: h. Accessing Resources.'Transportation: and i. Telephone. iv. "Personal Care" means providing personal assistance. stand-by assistance, supervision or cues for persons who meet the requirements for in -home services. v. "Personal Care Eligibility" is restricted to those persons who fit the definition of "frail" within the Older Americans Act. Activities of Daily Living (ADL) shall include: a. Mobility: b. Transfers; c. Bladder Care: d. Bowel Care: e. Bathing: t. Dressing: Eating: and h. hly giene \ll ;;Id County aduit., age snh. and oiler asho meet the necessary •teilnitions in thl. zectk n .hall he eligible ti>r sere ices. If resources are not 44aitable to serve .ill eli�gihie older tds:lts +silo reque..t ser, ices, r. ferencc and pri nrit, shall be etven to •ho•,e e!iuihle r.,rti.lii. ,<t '.zreate\t ;octal and e.onotr e need Nah part s..:l.ir .attention to itn+s 't1��n Ild older *hits and older adults res:dune; :0 rural areas In -h=are .ers'ce" .hall be 'tiad; .is:ulahht to indisidual> ssith lizhein er's disease and related !i'order, or sith neurological and organic brain ,.1>st inction and their family '. 3 b. General Guidelines i. Upon referral to the WCAAA recipients will be assessed by the Community Services and Support Coordinator using the standard Title III NAPIS Intake form at the time of the initial enrollment and each six month period thereafter. In the event the coordinator is not available, assessments may be completed by authorized WCAAA staff. ii. Recipients must he 60 years of age or older and live in Weld County. iii. Recipients must meet criteria for homemaker/personal care services as outlined in regulations. WCAAA will follow Older Americans Act and target populations with greatest economic need; greatest social need: low-income: minority: frail: older individuals residing in rural areas. iv. Vouchers w ill he awarded on a first -come. first -served basis contingent on funding. Funding for this program is based on a fiscal year of July I to June 30. v. If funding is not available at time of request. the applicant will be placed on a wait list for the next funding cycle or referred to other resources if waiting list is full. vi. Recipients are required to use a home health care provider from the list of agencies contracted with WCAAA for in -home services. If the recipient does not indicate a preference, WCAAA staff will assign a Provider agency based on a rotating schedule to assure equal distribution of hours and units of services. If Provider agency selected is not able to meet the need, staff will choose next agency on the list. vii. Any homemaker or personal care costs incurred prior to receipt of a voucher or after voucher expires will not be covered by the In -Home Services Voucher Program. viii. Vouchers will be submitted by Provider agency to the WCAAA for payment (see Exhibit B ). ix. Only approved services listed on the award voucher will be honored. Any costs or services incurred above and beyond the authorized services and hours/units will be the responsibility of the recipient. x. Concerns or complaints about vervices should be reported to the WCAAA. All recipients will be made aware of the WCAAA grievance procedures at time of enrollment (see Exhibit C). Please refer to Volume 10 and the State Unit on Aging Policy and Procedures for regulation guidance. xi. If homemaker or personal care services are not used for a sixty (60) day period, the voucher may be withdrawn with notice by the WCAAA and assigned to another recipient. xii. Any unused hours/units of authorized services cannot be carried over into the next funding cycle. xiii. Assigned providers must contact WCAAA Community Services and Support Coordinator immediately upon any changes in status of assigned recipients (i.e. fall; hospitalization. 4 move; death) or to request additional hours due to change in recipient status or a termination of services. xis. Recipients and their assigned provider agencies will need to track the hours/units of service they receive to avoid exceeding authorized hoursiunits of service. Recipients will he given information regarding donations at time of enrollment. All donations for in -Home Services Voucher Program will be sent to WCAAA and used by the program for service delivery . xv i. Applicants on Long -Term Care Medicaid are not eligible for the In -Home Services Voucher Program: however. pending applicants may be eligible until approval is granted. xv. c. Referral. Assessment and Follow-up Guideline i. Referrals may be accepted from other agencies. caseworkers. providers, professionals. self -referral, and family members of applicants. All referrals for the in -Home Services Voucher Program will be processed by the WCAAA. The Community Services and Support Coordinator will obtain basic recipient information such as name, contact information, age. general care needs, housing situation and other programs or agencies involved. As appropriate. the Community Services and Support Coordinator will schedule a home visit to complete a full assessment using the Title III NAPIS intake. ii. Upon approval or denial of application. the Community Services and Support Coordinator skill notify applicant via United States Postal Services of the eligibility status and include hours/units of service information, guidelines and instructions. The Community Services and Support Coordinator will notify assigned Provider agency by electronically sending or faxing recipient Assessment. Task Sheet, Release of Information, and Voucher including assigned hoursrunits. The Community Services and Support Coordinator will follow up with agency andior recipient to assure services begin within one week. Community Services and Support Coordinator will be available to problem solve as needed. d. Reimbursement for Services i. Reimbursement for services will be monthly. See Exhibit B for complete instructions. All questions and concerns regarding reimbursements will be directed to the Community Services and Support Coordinator. ii. Only approved services listed on the award voucher will be honored. Any costs or services incurred above and beyond the authorized hours units will not be reimbursed and ,kill he the responsibility of the recipient t.ssigned agency. Pros ider agency may not request reimbursement for services :Inlets services have been rendered: if a client is not home ,i. the scheduled time, the cost !s not reimbursable frasel time to the recipient's fesldence is not a reimbursable sers ice Noy:r. i nl'; \r ri emits .lualitV 1n. tor ;he In-11.O11c ler.cs Votiche' Proerim will he limited maximum amount of ''.ours r units of ser\ ice. `wCAAA .kill re+mhurse the Pro ider agency for sers ices at the rate of S_25.00 per unit of service tone unit of service = ! hour of S personal care or homemaker services). WCAAA is not guaranteeing a minimum number of units or recipients. Travel will not be reimbursed. The general guidelines for homemaker and;or personal care services are a total of 12 hourstunits of service per month based on funding availability and need. Exceptions to these guidelines will be reviewed on a case by case basis. f. Chances in Services or Hours i. All changes to services or hours units must be approved by the Community Services and Support Coordinator and a new voucher will he generated that reflects the changes. ii. Provider agency will not be paid for any changes in services or hourslunits unless prior approval is received by the Community Services and Support Coordinator and a new voucher is issued iii. Payment for any services provided upon the request of the recipient. which are in addition to the services or hours;units approved by the W'CAA.A. will he the responsibility, of the recipient. g. W ithdrawal of Service Request i. A recipient may withdraw a request for homemaker and`or personal care services. A request to end services must be reported by the recipient or their legal representative by contacting the WCAAA. h. Denial or Termination ofa Service Request i. WCAAA makes every effort to be fair to both recipients and service providers and meet the needs of older adults who need homemaker or personal care services. The following rules for denial or termination were developed as guidelines for receiving services with the In -Home Services Voucher Program. ii. When the WCAAA or Provider agency determines that the In -Home Services Voucher Program cannot meet the needs of the recipient requesting homemaker or personal care services. the WCAAA must be notified by the Provider agency within two (2) business days of the last day of services being offered. if services cannot be provided and why. Reasons for Denial or termination of Sen ices i. The WCAAA or Provider agency has determined that the recipient no longer meets the program eligibility requirements (Age 60Y. deficit in 2 LADLs or 2 ADLs. with a focus on recipients with greatest economic need; greatest social need; low-income; minority: frail: older individuals residing in rural areas as defined in Volume 10). ii. The recipient is unavailable for scheduled appointments (same day and time) and is requesting a variable schedule that creates undue hardship for service providers. iii. The recipient is not home for scheduled appointments on two (2) or more occasions. and has failed to notify the Provider agency 24 hours in advance. 6 iv. The recipient has cancelled three t3) or more consecutive appointments without due cause (i.e. hospitalization. temporary out -of -home placement. illness). v. I -he recipient is verbally or physically abusive to provider_ vi. Provider agency has the right to refuse sery ice to recipients when provider health or safety is deemed to be at risk and the recipient home is unsafe. Training for Staff i. Homemaker pros der agencies shall document that all homemakers have received a minimum of eight hours of training or have passed a skills validation test prior to delivery of services in the provision of Homemaker Services, to include at a minimum the following: I. Basic techniques in light housecleaning including, but not limited to dusting. vacuuming. mopping. and cleaning of bathroom and kitchen areas: ?. Basic nutritional requirements including shopping. meal preparation, and proper food handling and storage techniques: 3. Dishwashing. bed making. and laundry: 4. Basic techniques of identify ing and correcting potential safety hazards in the home: First aid and emergency procedures and basic infection control techniques. including universal precautions: and 6. Screening for situations requiring assistance. ii_ A person. who at a minimum, has received the eight (8) hours of training listed herein or passed the skills validation test required of homemakers, shall be considered qualified to supervise other employees. Supervision shall include, but not be limited to: I . Arrangement and documentation of training; 2. Informing statT of policies concerning advance directives and emergency procedures; 3. Oversight of scheduling and notiticat:on to clients of -changes: 4 Meet nt;'. and ccnterence': w!th .tat" 3s neccssar.: rm. esti_.ition of cornplah t,. n2. A nth +t.ti' .iii .1 ';C t;i' C:l.es, and nnotent .t;k dam erou: .livaEi.�n�. ( ominuolcation, ivit`7 —Ise managers a. ne.t's.ar.v 8. Oversight of record keeping by staff and 7 9. Supervisory visits shall be made to the participant's home at least every six months or more often as necessary for problem resolution, skills validation of staff, observation of the home's condition. and assessment of participant's satisfaction with services. iii. Personal Care provider agencies shall document that all staff rendering personal care services to older adults shall receive at least 20 hours of training or pass a skills validation test prior to service delivery in the following: I. Basic personal care procedures. including bathing, skin care, hair care, nail care. mouth care, shaving, dressing, and feeding; 2. Assistance with ambulation, exercises, and transfers; 3. Bowel and bladder care: 4. Medication: 5. Homemaking and protective oversight: 6. Basic nutritional requirements. including meal planning. shopping and food storage; 7. Basic first aid, training in infection control, and emergency procedures; 8. Basic techniques of identifying and correcting potential safety hazards in the home; and 9. Techniques in lifting. iv. A person who, at a minimum, has received the 20 hours of training listed herein or passed the skills validation test required of personal care staff shall be considered qualified to supervise all employees giving personal care. Supervision shall include, but is not limited to: I. Orientation of staff to agency policies and procedures: 2. Arrangement and documentation of training; 3. Informing staff of policies concerning advance directives and emergency procedures: 4. Oversight of scheduling, and notification to clients of changes; or close communication with scheduling staff; 5. Written assignment of duties on a client -specific basis: 6. Meetings and conferences with staff as necessary: 'r. Investigation of complaints and critical incidents; 8 8. Counseling with staff on difficult cases, and potentially dangerous situations: 9. Communication with case managers. the physicians, and other providers on the 5eryice plan. as necessary to assure appropriate and effective care: and 10. Superb isory visits shall he made to the participant's home at least every three months or more often as necessary, for problem resolution. skills validation of staff. participant specific or procedure -specific training of staff, observation of the participant's condition and care. and assessment of satisfaction with services. At least one of the assigned personal staff shall be present at supervisory y isits. 9, Term a. The term ot'this Agreement begins upon the date of the execution of this Agreement by County. and shall continue through June 30. 2018. This contract may be renewed for additional one ( I ) year terms at the discretion of the WCAAA and the Weld County Board of County Commissioners. Both of the parties to this Agreement understand and agree that the laws of the State of Colorado prohibit County from entering into Agreements which bind the County for periods longer than one year. Therefore. within the thirty (30) days preceding June 30 of each year. County shall notify Provider agency, in writing if it wishes to renew this Contract for another term. 10. Termination a. Either party has the right to terminate this Agreement, with or without cause on thirty (30) days written notice. Furthermore. this Agreement may be terminated at any time without prior notice upon notice of a material breach of the terms of the Agreement. b. Upon termination of this Agreement, Provider agency shall have no claim of any kind whatsoever against the County by reason of such termination or by reason of any act incidental thereto. except for compensation for work satisfactorily performed and/or materials described herein properly delivered. I I. Extension or Modification Any amendments or modifications to this agreement shall be in writing signed by both parties. No additional services or work performed by Provider agency shall be the basis for additional compensation unless and until Provider agency has obtained written authorization and acknowledgement by County for such additional services. !2 Compensation contract Amount a. In no e.ent snail Cot,.lt. be required to pa: Pros der agency more than the available grant :undo mtcll�plated in this Agreement. nor mare than that itnount stated in paragraph I Provider .t eney .:._knov', ledges no pa:. mem 111 eyLess of that amount u, ill he nade by C aunty unless 3 "ehanoe ilyder' aut;,or!li!"1 such .idditi .t: pat.Me".n has been speLilltiall_' approved b• \5e C our'tA or h\ t 'rnlal rvsoh .' on 0t 'he N eid County qeard L t Count:. G. ommis _Friers. a', requir i pursuant to the V .Id Ctii_any Code. 9 h. Provider agency shall provide invoices to County on a monthly basis. County shall pay all such invoices. unless in dispute. within 30 days of receipt. c. County will not yyithhold any taxes from monies paid to the Provider agency hereunder and Provider agency agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to the terms of this Agreement. d The Parties understand that this Agreement is wholly funded by State and Federal funds, and the County shall have no obligation to expend any funds not appropriated by the State for purposes related to this Agreement. 13. Independent Contractor a. Provider agency agrees that it is an independent Contractor and that its officers, agents or employees will not become employees of County. nor entitled to any employee benefits from County as a result of the execution of this Agreement. Provider agency shall perform its duties hereunder as an independent Contractor. Provider agency shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Provider agency, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. 14. Subcontractors a. Provider agency acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of agency . Provider agency shall not enter into any subcontractor agreements for performance under this agreement without County's prior written consent. which may be withheld in County's sole discretion. 15. Ownership a. All work and information obtained by Provider agency under this Agreement shall become or remain (as applicable), the property of County, 16. Confidentiality a. Provider agency agrees to keep confidential all of County's confidential information. Provider agency agrees not to sell, assign, distribute, or disclose any such confidential information to any other person or entity without seeking written permission from the County. Provider agency agrees to advise its employees, agents, and consultants, of the confidential and proprietary nature of this confidential information and of the restrictions imposed by this agreement. 17. Warranty a. Provider agency warrants that the services performed under this Agreement will be performed in a manner consistent with the standards governing such services and the provisions of this Agreement. Provider agency further represents and warrants that all services shall be performed by qualified personnel in a professional and workmanlike manner, consistent with industry standards, and that all services will conform to applicable specifications. 10 18. Acceptance of Services Not a Vs aiyer a. In no event shall any action by County hereunder constitute or be construed to be a waiver by County of any breach of this Agreement or default which may then exist on the part of Provider agency. Acceptance by the County of, or pay ment for. the services completed under this Agreement shall not be construed as a waiver of any of the County's rights under this Agreement or under the law generally . 19_ Insurance and Indemnification a. General Requirements: Provider agency must secure. at or before the time of execution of any agreement or commencement of any work. the following insurance covering all operations. goods or services provided pursuant to this request. Provider agencies shall keep the required insurance coverage in three at all times during the term of the Agreement. or any extension thereof, and during any warranty period. h. The insurance coverage's specified in this Agreement are the minimum requirements. and these requirements do not decrease or limit the liability of Provider agency. The County in no way warrants that the minimum limits contained herein are sufficient to protect the Provider agency from liabilities that might arise out of the performance of the work under this Contract by the Provider agency. its agents. representatives. employees, or subcontractors. c. The Provider agency stipulates that it has met the insurance requirements identified herein. The Contractor shall be responsible for the professional quality, technical accuracy. and quantity of all services provided, the timely delivery of said sery ices. and the coordination of all services rendered by the agency and shall, without additional compensation. promptly remedy and correct any errors. omissions, or other deficiencies. d. INDEMNITY: The Provider agency shall defend, indemnify and hold harmless the State of Colorado and Weld County. its officers, agents. and employees, from and against injury, loss damage. liability, suits, actions, or claims of any type or character arising out of the work done in fulfillment of the terms of this Contract or on account of any act. claim or amount arising or recovered under workers' compensation law or arising out of the failure of the Provider agency to conform to any statutes. ordinances. regulation. law or court decree. The Provider agency shall be fully responsible and liable for any and all injuries or damage received or sustained by any person. persons. or property on account of its performance under this Agreement or its failure to comply with the provisions of the Agreement, This paragraph shall survive expiration or termination hereof. e Types of Insurance: The Provider agency shall obtain, and maintain at all times during the term of air Agreement. insurance in the following kinds and amounts: v�.trker,' Compcnsatiun insurtnce a.• rcguird by st.tte'.tatut.. and f ntnkoyer'., t iahiiity insurance uo%ering an of the Pr us der agency's employees acting w ithtn the course and • cope dt !heir entpho: trent, ct'titattr a wary er or serf" roeatton ali,unst the I ount. I'tis "e•autrernent shall not apply when a Prut ider atenc% or iuhcontractar Is eV tupt under t+`�otado Vkorkers ( t!n'per>sation act., A'vi) ,s hen such Provider agency or subt.ontr U.: D.tr yCi iitc' 'he approprtJte sol: proprietor vy a`1 t r firm it Commercial Uc''cral Liability Insurance with the mininr_on limits as ro!iow,• S1,000.000 each occurrence. 11 S1,000.000 general aggregate; 51.000.000 products and completed operations aggregate: and $50,000 any one fire. iii. Professional Liability: Professional liability insurance with minimum limits of liability of not less than $1.000.000. unless waived by the State. iy. Privacy, Insurance: If this Contract includes a HIPAA Associates Addendum exhibit. Provider agency shall obtain and maintained during the term of this Contract liability insurance covering all loss of Protected Health Information data and claims based upon alleged violations of privacy rights through improper use or disclosure of Protected Health Information (Pill) with a minimum annual limit of S 1,000.000. y. Automobile Liability: Provider agency shall maintain limits of $1.000,000 for bodily injury per person. S 1.000.000 for bodily injury for each accident, and $1,000.000 for property damage applicable to all vehicles operating both on County property and elsewhere. for vehicles owned. hired. and non -owned vehicles used in the performance of this Contract. Provider agency shall secure and deliver to the County at or before the time of execution of this Agreement. and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided, a commercial general liability insurance policy, including public liability and property damage. in form and company acceptable to and approved by said Administrator, covering all operations hereunder set forth in the related Bid or Request for Proposal. g. Proof of Insurance: County reserves the right to require the Provider agency to provide a certificate of insurance, a policy, or other proof of insurance as required by the County's Risk Administrator in his sole discretion. h. Additional Insureds. For general liability. excess, umbrella liability, pollution legal liability. liquor liability, and inland marine. Provider agency insurer shall name County as an additional insured. Waiver of Subrogation: For all coverages. Provider agency insurer shall waive subrogation rights against County. Subcontractors: All subcontractors, subcontractors, independent Contractors, sub -vendors. suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverage's required of Provider agency. Provider agency shall include all such subcontractors, independent Contractors. sub -vendors suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Provider agency agrees to provide proof of insurance for all such subcontractors, independent Contractors, sub -vendors suppliers or other entities upon request by the County. 20, Non -Assignment a. Provider agency ma not assign or transfer this Agreement or any interest therein or claim thereunder, without the prior written approval of County. Any attempts by Provider agency to assign or transfer its rights hereunder without such prior approval by County shall, at the option 12 of County. automatically terminate this Agreement and all rights of Provider agency hereunder. Such consent may be granted or denied at the sole and absolute discretion of County . 21. Examination of Records a. To the extent required by law, the Pros ider agency agrees that a duly authorized representatis e of County, including the County Auditor. shall have access to and the right to examine and audit any books. documents, papers and records of Provider agency. involving all matters and'or transactions related to this Agreement. irhe Provider agency agrees to maintain these documents for three years from the date of the last payment received. 22. Interruptions a. Neither party to this Agreement shall be liable to the other for delays in delivery or failure to deliver or otherwise to perform any obligation under this Agreement. where such failure is due to any cause beyond its reasonable control. including but not limited to Acts of God, tires, strikes. war. flood, earthquakes or Governmental actions. 23. Notices a. County may designate. prior to commencement of work, its project representative ("County Representative") who shall make, within the scope of his or her authority. all necessary and proper decisions with reference to the project. All requests for contract interpretations, change orders. and other clarification or instruction shall be directed to County Representative. The County Representative for purposes of this Agreement is hereby identified as. Eva M. Jewell. All notices or other communications (including annual maintenance made by one party to the other concerning the terms and conditions of this contract shall he deemed delivered under the following circumstances) I. personal service by a reputable courier service requiring signature for receipt; or ii. five (5) days following delivery to the United States Postal Service, postage prepaid addressed to a party at the address set forth in this contract: or iii. electronic transmission via email at the address set forth below, where a receipt or acknowledgment is required by the sending party; or iv. transmission via facsimile, at the number set forth below. where a receipt or acknowledgment is required by the sending party. h. hither part: ma: L hance its notice address by written notice to the other. Not iticat on IntOrnauon Ilrov der agency • 4ttn: 11dres lddres: Email: A Little R . R Home Care 1 eid Ritlotto 1960 44 I s `' Street_ Siiite e i.o:eland. CO Stt5ix i leidl'.riziot'o it aliti c'rrhoineL.ire Loin 13 Counts: Name: Position: Address: Address: Email: Facsimile: 24. Compliance with Law Eva Jewell Weld County Area Agency on Aging Division I -lead 313 North 1 1 °i Ave Building C or P.O. Box 1805 Greeley CO 80631 ejewell a-weldgos.com 9"9-346-69ci a. Provider agency 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. 25 Non -Exclusive Agreement a. This Agreement is nonexclusive and WCAAA may engage or use other Provider agencies or persons to perform services of the same or similar nature. 26. Entire Agreement/Modifications a. This Agreement including the Exhibits attached hereto and incorporated herein, contains the entire agreement between the parties with respect to the subject matter contained in this Agreement. This instrument supersedes all prior negotiations, representations, and understandings or agreements with respect to the subject matter contained in this Agreement. This Agreement may be changed or supplemented only by a written instrument signed by both parties. 27. Fund Availability a. Financial obligations of WCAAA payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. Execution of this Agreement by WCAAA does not create an obligation on the part of County to expend funds not otherwise appropriated in each succeeding year. 28. Employee Financial Interest/Conflict of Interest —C.R.S. §§24-18-201 et seq. and §24-50-507 a. The signatories to this Agreement state that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. County has no interest and shall not acquire any interest direct or indirect, that would in any manner or degree interfere with the performance of Provider agency's services and Provider agency shall not employ any person having such known interests. During the term of this Agreement. Provider agency shall not engage in any business or personal activities or practices or maintain any relationships which actually conflicts with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by Provider agency to ensure compliance with this provision may result, in County's sole discretion, in immediate termination of this Agreement. No employee of Pros ider agency nor any member of Provider agency's family shall serve on a County Board, committee or hold any such position which either by rule, practice or action nominates, recommends. supervises Provider agency's operations, or authorizes funding to Provider agency. 14 29. Seserability a. It any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall he construed and enforced without such provision. to the extent that this Agreement is then capable of execution within the original intent of the parties. 30. Governmental Immunity a. 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. of the Colorado Governmental Immunity Act s's',24-10-101 et seq., as applicable now or hereafter amended. 31. No Third Party Beneficiary a. It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement. and all rights of action relating to such enforcement. shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. it is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 32. Board of County Commissioners of Weld County Approval a. This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County. Colorado or its designee. 33. Choice of Law/Jurisdiction a. Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution. and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between,the parties. Provider agency agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 34. Public Contracts for Services C.R.S. $8-17.5-101 a. Pros ider agency certifies. warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract. Provider agency will confirm the employ mert eligibility of all employees who are newly hired for employment in the i 'nited States to perform work under this Agreement. through participation in the 1= -ti erify program or the State of Colorado program established pursuant to !' R i 7 3-'t);4 ` N C i. Pros ider agency stla't not knowittely employ or conlraet ykith an illatii alien to perform ssork under this \t;reenlent or enter into a contract witl, a yu~Lontractor that lai:k to certify %kith Provider agency that the suhcontractor ;ka'1 not k o'.'ngly employ or contract sloth an illegal .i:r.'n to perform work under this \g'reentent. Provider tgencs shalt ni t ase I -y er h Program or State of Colorado program orocednres to undertake pre -employ went screening or joh applu.,tnts o. bile this .Agreement bring pertonnec It' Pros (der agency ,fr,ta+n, actual kook; leJ, e ,hat a subcontractor',)erti,rming .kork ander the public cortraLt for son ic.'s kno'st%tly employs or contracts with an ;Ileu.+l alien Pros ider agency shall noted the subcontractor and County within three t 3 t days that Pros ider 15 agency has actual knowledge that a subcontractor is employing or contracting with an illegal alien and shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three (3) days of receiving notice. Provider agency shall not terminate the contract if within three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. Provider agency shall comply with reasonable requests made in the course of an investigation, undertaken pursuant to C.R.S. §8-17.5-102(5). by the Colorado Department of Labor and Employment. If Pros ider agency participates in the State of Colorado program. Provider agency shall, within twenty days after hiring a new employee to perform work under the contract. affirm that Pros ider agency has examined the legal work status of such employee, retained tile copies of the documents, and not altered or falsified the identification documents for such employees. Provider agency shall deliver to County. a written notarized affirmation that it has examined the legal work status of such employee, and shall comply with all of the other requirements of the State of Colorado program. If Provider agency fails to comply with any requirement of this pros ision or of C.R.S. §8-17.5-101 et seq., County. may terminate this Agreement for breach. and if so terminated, Provider agency shall be liable for actual and consequential damages. b. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-103(3), if Pros ider agency receives federal or state funds under the contract. Provider agency must confirm that an individual natural person eighteen (18) years of age or older is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4). if such individual applies for public benefits pros ided under the contract If Provider agency operates as a sole proprietor, it hereby swears or affirms under penalty of perjury that it: (a) is a citizen of the United States or is otherwise lawfully present in the United States pursuant to federal law. (b) shall produce one of the forms of identification required by C.R.S. § 24-76.5-101. et seq., and (c) shall produce one of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective date of the contract. 35. Acknowledgement a. County and Provider agency acknowledge that each has read this Agreement, understands it and agrees to be bound by its terms. Both parties further agree that this Agreement, including attachment Exhibit A. is the complete and exclusive statement of agreement between the parties and supersedes all proposals or prior agreements, oral or written, and any other communications between the parties relating to the subject matter of this Agreement. 16 IN WITNESS WHEREOF. the parties hereto have signed this Agreement this 1_' day ofJul‘ , 2017. A DIES Weld C. tti Clerk to the Board B Deputy Clerk to t Board Heidi Rizzotto, Administrator WELD COUNTY AREA AGENCY ON AGING WELD COUNTY BOARD OF COUNTY COMMISSIONERS WELD COUNTY. COLORADO Julie A. Cozad. Chair "JUL 3 W 17 CONTRACI OR: A Little R & R Home Care 1966 W 15' Street, Suite 6 Loveland. CO 80538 Date d�d.11 -t- 17 0.20/ ,2-4.5 Exhibit A HIPAA BUSINESS ASSOCIATE ADDENDUM This Business Associate Addendum ("Addendum") is a part of the Contract dated July 1. 2017 between the Department of Human Services Weld County Area Agency on Aging and A Little R & R Home Care. For purposes of this Addendum, the Weld County Department of Human Services Area Agency on Aging is referred to as "Covered Entity" or "CE" and A Little R & R Home Care is referred to as "Associate". Unless the context clearly requires a distinction between the Contract document and this Addendum. all references herein to "the Contract" or "this Contract" include this Addendum. RECITALS A. CE wishes to disclose certain information to Associate pursuant to the terms of the Contract, some of which may constitute Protected Health Information ("PHI") (defined below ). B. CE and Associate intend to protect the privacy and provide for the security of PHI disclosed to Associate pursuant to this Contract in compliance with the Health Insurance Portability and Accountability Act of 1996. 42 U.S.C. §1320d -1320d-8 ("HIPAA") as amended by the American Recovery and Reinvestment Act of 2009 ("ARRA")/I [(TECH Act (P.L. 1 I I-005). and its implementing regulations promulgated by the U.S. Department of Health and Human Services. 45 C F.R. Parts 160. 162 and 164 (the "HIPAA Rules") and other applicable laws. as amended. C. As part of the HIPAA Rules. the CE is required to enter into a written contract containing specific requirements with Associate prior to the disclosure of PHI, as set forth in. but not limited to, Title 45. Sections 160.103. 164.502(e) and I64.504(e) of the Code of Federal Regulations ("C.F.R.") and contained in this Addendum. The parties agree as follows: I. Definitions a. Except as otherwise defined herein, capitalized terms in this Addendum shall have the definitions set forth in the HIPAA Rules at 45 C.F.R. Parts 160. 162 and 164, as amended. In the event of any, conflict between the mandatory provisions of the HIPAA Rules and the provisions of this Contract, the HIPAA Rules shall control. Where the provisions of this Contract differ from those mandated by the HIPAA Rules, but are nonetheless permitted by the HIPAA Rules. the provisions of this Contract shall control. b. "Protected Health Information" or"PHI" means any information, whether oral or recorded in any form or medium: (i) that relates to the past, present or future physical or mental condition of an individual: the provision of health care to an individual: or the past. present or future payment for the provision of health care to an individual: and (ii) that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual, and shall have the meaning given to such term under the HIPAA Rules, including, but not limited to. 45 C.F.R Section 164.501. c. 'Protected Information" shall mean PHI provided by CE to Associate or created received, maintained or transmitted by Associate on CE's behalf. To the extent Associate is a covered entity under HIP AA and creates or obtains its own PHI for treatment, payment and health care operations, Protected Information under this Contract does not include any PHI created or obtained by Associate as a 18 Exhibit A HIPAA BUSINESS ASSOCIATE ADDENDUM This Business Associate Addendum ("Addendum") is a part of the Contract dated July 1. 2017 between the Department of Human Services Weld County Area Agency on Aging and A Little R & R Home Care. For purposes of this Addendum, the Weld County Department of Human Services Area Agency on Aging is referred to as "Covered Entity" or "CE" and A Little R & R Home Care is referred to as "Associate". Unless the context clearly requires a distinction between the Contract document and this Addendum, all references herein to "the Contract" or "this Contract" include this Addendum. RECITALS A. CE yyishes to disclose certain information to Associate pursuant to the terms of the Contract, some of which may constitute Protected Health Information ("PHI") (defined below t. B. CL and Associate intend to protect the privacy and provide for the security of PHI disclosed to Associate pursuant to this Contract in compliance with the Health Insurance Portability and Accountability Act of 1996. 42 U.S.C. §1320d -1320d-8 ("HIPAA") as amended by the American Recovery and Reinvestment Act of 2009 ("ARRA")JHITECH Act (P.L. I 1 1-0051. and its implementing regulations promulgated by the U.S. Department of Health and Human Services, 45 C.F.R. Parts 160, 162 and 164 (the "HIPAA Rules") and other applicable laws, as amended. C. As part of the HIPAA Rules, the CE is required to enter into a written contract containing specific requirements with Associate prior to the disclosure of PHI. as set tbrth 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 contained in this Addendum. The parties agree as follows: Definitions a. Except as otherwise defined herein, capitalized terms in this Addendum shall have the definitions set forth in the HIPAA Rules at 45 C.F.R. Parts 160, 162 and 164. as amended. In the event of any conflict between the mandatory provisions of the HIPAA Rules and the provisions of this Contract, the HIPAA Rules shall control. Where the provisions of this Contract differ from those mandated by the HIPAA Rules. but are nonetheless permitted by the HIPAA Rules, the provisions of this Contract shall control. b. "Protected Health Information" or "PHI" means any information, whether oral or recorded in any form or medium: (i) that relates to the past, present or future physical or mental condition of an individual; the provision of health care to an individual: or the past, present or future payment for the provision of health care to an individual; and (ii) that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual, and shall have the meaning given to such term under the IIIPAA Rules, including, but not limited to. 45 C.F.R. Section 164.501. c. "Protected Information" shall mean PHI provided by CE to Associate or created received, maintained or transmitted by Associate on CE's behalf. To the extent Associate is a covered entity under HIP AA and creates or obtains its own PHI for treatment, payment and health care operations, Protected Information under this Contract does not include any PHI created or obtained by' Associate as a 18 covered entity and Associate shall follow its own policies and procedures for accounting, access and amendment of Associate's PHI_ d. "Subcontractor" shall mean a third party to whom Associate delegates a function. activity, or service that involves CF's Protected Information. in order to carry out the responsibilities of this Agreement. Obligations of Associate a. Permitted Uses. Associate shall not use Protected Information except for the purpose of performing Associate's obligations under this Contract and as permitted under this Addendum. Further. Associate shall not use Protected Information in any manner that would constitute a violation of the HIPAA Rules if so used by CF. except that Associate may use Protected information: (i) for the proper management and administration of Associate: (ii ► to carry out the legal responsibilities of Associate; or t iii) for Data Aggregation purposes for the Health Care Operations of CE. Additional provisions. if any. governing permitted uses of Protected Information are set forth in Attachment A to this Addendum Associate accepts full responsibility for any penalties incurred as a result of Associates breach of the HIPAA Rules. b. Permitted Disclosures. Associate shall not disclose Protected information in any manner that would constitute a violation of the HIPAA Rules if disclosed by CE, except that Associate may disclose Protected Information: (i) in a manner permitted pursuant to this Contract; (ii) for the proper management and administration of Associate: tin) as required by law: (iv) for Data Aggregation purposes for the Health Care Operations of CE; or (v) to report violations of law to appropriate federal or state authorities, consistent with 45 C.F.R. Section 164.502(j)(I ). 1'o the extent that Associate discloses Protected Information to a third party Subcontractor, Associate must obtain, prior to making any such disclosure (i) reasonable assurances through execution of a written agreement with such third party that such Protected Information will be held confidential as provided pursuant to this Addendum and only disclosed as required by law or for the purposes for which it was disclosed to such third party; and that such third party will notify Associate within two (2) business days of any breaches of confidentiality of the Protected Information, to the extent it has obtained knowledge of such breach. Additional provisions. Wally, governing permitted disclosures of Protected Information are set forth in Attachment A. c. Appropriate Safeguards, Associate shall implement appropriate safeguards as are necessary to prevent the use or disclosure of Protected Information other than as permitted by this Contract. Associate shall comply with the requirements of the HIPAA Security Rule at 45 C.F.R. Sections 164.308. 164.310. 164.312. and 164.316. Associate shall maintain a comprehensive written information privacy and security program that includes administrative, technical and physical safeguards appropriate to the size and complexity of the Associate's operations and the nature and scope of its activities. Associate shall rev iew, modify, and update documentation of its safeguards as needed to ensure continued provision of reasonable and appropriate protection of Protected Information_ d Retkirting of impro er I. se or Disclosure. Associate shall report to CV in tinting an use or disclosure of Protected Information other than as pros ided for by this Contract within rise r y s husiness dabs of hecomi ,c .is. are of such use or disclosure. A lent . II :1ssosiate uses one or more Subcontractors or :tents to provide services under the t ontrict. and such Stioci' tractors or agent, rccei'We or has e access to Protected information each Juhcontractor or agent shall sign an agreement with Associate containing the same proslsions .b thhis \ddenduni and further identity ing Ch. as a third part) beneficiary with rights of enforcement and indemnification from such Subcontractors or agents in the event of any violation of such 19 Subcontractor or agent agreement. The Agreement between the Associate and Subcontractor or agent shall emure that the Subcontractor or agent agrees to at least the same restrictions and conditions that apply to Associate with respect to such Protected Information. Associate shall implement and maintain sanctions against agents and Subcontractors that violate such restrictions and conditions and shall mitigate the effects of any such violation. Access to Protected Information. If Associate maintains Protected Information contained within CF's Designated Record Set. Associate shall make Protected Information maintained by Associate or its agents or Subcontractors in such Designated Record Sets available to CE for inspection and copying within ten (10) business days of a request by CE to enable CE to fulfill its obligations to permit individual access to PHI under the HIPAA Rules, including, but not limited to. 45 C.F,R. Section 164.524. if such Protected Information is maintained by Associate in an electronic form or format. Associate must make such Protected Information available to CE in a mutually agreed upon electronic form or format g. Amendment of PHi If Associate maintains Protected information contained within CF's Designated Record Set. Associate or its agents or Subcontractors shall make such Protected Intirrmation available to CE for amendment within ten 10) business days of receipt of a request from CE for an amendment of Protected Information or a record about an individual contained in a Designated Record Set, and shall incorporate any such amendment to enable CE to fulfill its obligations with respect to requests by individuals to amend their PHI under the HIPAA Rules, including, but not limited to, 45 C.F.R. Section 164.526. If any individual requests an amendment of Protected Information directly from Associate or its agents or Subcontractors. Associate must notify CE in writing within five (5) business days of receipt of the request. Any denial of amendment of Protected information maintained by Associate or its agents or Subcontractors shall be the responsibility of CE. h. Accounting Rights. If Associate maintains Protected Information contained within CE's Designated Record Set. Associate and its agents or Subcontractors shall make available to CE within ten (10) business days of notice by CE, the information required to provide an accounting of disclosures to enable CE to fulfill its obligations under the HIPAA Rules, including, but not limited to. 45 C.F R. Section 164.528. in the event that the request for an accounting is delivered directly to Associate or its agents or Subcontractors. Associate shall within five (5) business days of the receipt of the request forward it to CE in writing. It shall be CE's responsibility to prepare and deliver any such accounting requested. Associate shall not disclose any Protected Information except as set forth in Section 2(b) of this Addendum. Governmental Access to Records. Associate shall keep records and make its internal practices, books and records relating to the use and disclosure of Protected Information available to the Secretary of the U.S. Department of Health and Human Services (the "Secretary"), in a time and manner designated by the Secretary. for purposes of determining CE's or Associate's compliance with the HIPAA Rules. Associate shall provide to CE a copy of any Protected information that Associate provides to the Secretary concurrently with providing such Protected Information to the Secretary when the Secretary is investigating CE. Associate shall cooperate with the Secretary if the Secretary undertakes an investigation or compliance review of Associate's policies, procedures or practices to determine whether Associate is complying with the HIPAA Rules, and permit access by the Secretary during normal business hours to its facilities, books, records, accounts, and other sources of information, including Protected Information, that are pertinent to ascertaining compliance. Minimum Necessary. Associate (and its agents or subcontractors) shall only request, use and disclose the minimum amount of Protected Information necessary to accomplish the purpose of'the request, 20 use or disclosure, in accordance with the Minimum Necessary requirements of the HIPAA Rules including. but not limited to 45 C.F.R. Sections 164.s02(b) and 164.514(d). k Data Ownership. Associate acknowledges that Associate has no ownership rights with respect to the Protected Information. I. Retention of Protected Information. Except upon termination of the Contract as provided in Section 4(d) of this Addendum. Associate and its Subcontractors or agents shall retain all Protected Information throughout the term of this Contract and shall continue to maintain the information required under Section 2(h) of this Addendum for a period of six (6) years. m. .Associate's Insurance. Associate shall maintain insurance to cover loss of PNI data and claims based upon alleged violations of privacy rights through improper use or disclosure of PHI. All such policies shall meet or exceed the minimum insurance requirements of the Contract (e.g.. occurrence basis, combined single dollar limits. annual aggregate dollar limits, additional insured status and notice of cancellation). n. Notice of Privacy Practices. Associate shall be responsible for reviewing CE's Notice of Privacy Practices. available on CE's external website, to determine any requirements applicable to Associate per this Contract. o. Notification of Breach. During the term of this Contract, Associate shall notify CE within two (2) business days of any suspected or actual breach of security, intrusion or unauthorized use or disclosure of PHI andtor any actual or suspected use or disclosure of data in violation of any applicable federal or state laws or regulations. Associate shall not initiate notification to affected individuals per the HIPAA Rules without prior notification and approval of CE. Information provided to CE shall include the identification of each individual whose unsecured PHI has been, or is reasonably believed to have been accessed, acquired or disclosed during the breach. Associate shall take (i) prompt corrective action to cure any such deficiencies and (ii) any action pertaining to such unauthorized disclosure required by applicable federal and state laws and regulations. Audits, Inspection and Enforcement. Within ten (10) business days of a written request by Cc, Associate and its agents or subcontractors shall allow CE to conduct a reasonable inspection of the facilities, systems, books, records, agreements, policies and procedures relating to the use or disclosure of Protected Information pursuant to this Addendum for the purpose of determining whether Associate has complied with this .Addendum; provided, however, that: (i) Associate and CE shall mutually agree in advance upon the scope, timing and location of such an inspection: and (ii) CE shall protect the confidentiality of all confidential and proprietary information of Associate to which CE has access during the course of such inspection. The fact that CE inspects, or fails to inspect, or has the right to inspect, Associate's facilities. systems, hooks, records, agreements. policies and procedures does not relieve Associate of its responsibility to comply with this Addendum, nor does i) failure to detect or (iii detection, hut failure to notify Associate or require Associate's remediation of any unsatisfactory practices, constitute acceptance of such practice or a Aatyer of CE's enforcement rights under Inc Conti -Act. q. Safeguards During. transmission. smission. Associate shall he responsible for using appropriate safeguards, rtc!uiing encryption Pill, to maintain and ensure the confidentiality. ittegrity and security of Prt'tew fed Intrirtaauun transmitted pursuant to the ('protract, in accordance ,%ith the standards and requirements of the III)'AA Riles p 21 r. Restrictions and Confidential Communications. Within ten (10) business days of notice by CE of a restriction upon uses or disclosures or request for confidential communications pursuant to 45 C.F.R. Section 164.522, Associate will restrict the use or disclosure of an individual's Protected Information. Associate will not respond directly to an individual's requests to restrict the use or disclosure of Protected Information or to send all communication of Protected Information to an alternate address. Associate will refer such requests to the CE so that the CE can coordinate and prepare a timely response to the requesting individual and provide direction to Associate. Obligations of CE a. Safeguards During Transmission. CE shall be responsible for using appropriate safeguards, including encryption of PHI. to maintain and ensure the confidentiality, integrity and security of Protected Information transmitted pursuant to the Contract. in accordance with the standards and requirements of the HIPAA Rules. b. Notice of Changes. CE maintains a copy of its Notice of Privacy Practices on its website. CE shall provide Associate with any changes in, or revocation of. permission to use or disclose Protected Information, to the extent that it may affect Associate's permitted or required uses or disclosures of PHI. CE shall notify Associate of any restriction on the use or disclosure of Protected Information that CE has agreed to in accordance with 45 C.F.R. Section 164.522. 4. Termination a. Material Breach. In addition to any other provisions in the Contract regarding breach, a breach by Associate of any provision of this Addendum. as determined by CE, shall constitute a material breach of this Contract and shall provide grounds for immediate termination of this Contract by CE pursuant to the provisions of the Contract covering termination for cause, if any. If the Contract contains no express provisions regarding termination for cause. the following terms and conditions shall apply: Default. If Associate refuses or fails to timely perform any of the provisions of this Contract. CE may notify Associate in writing of the non-performance. and if not promptly corrected within the time specified. CE may terminate this Contract. Associate shall continue performance of this Contract to the extent it is not terminated and shall be liable for excess costs incurred in procuring similar goods or services elsewhere. (2) Associate's Duties. Notwithstanding termination of this Contract, and subject to any directions from CE. Associate shall take timely, reasonable and necessary action to protect and preserve property in the possession of Associate in which CE has an interest. (3) Compensation. Payment for completed supplies delivered and accepted by CE shall be at the Contract price. In the event of a material breach under paragraph 4a, CE may withhold amounts due Associate as CE deems necessary to protect CE against loss from third party claims of improper use or disclosure and to reimburse CE for the excess costs incurred in procuring similar goods and services elsewhere. (4) Erroneous Termination for Default. If after such termination it is determined, for any reason. that Associate was not in default, or that Associate's action/inaction was excusable, such termination shall be treated as a termination for convenience, and the rights and obligations of the parties shall be the same as if this Contract had been terminated for convenience, as described in this Contract. 22 b. Reasonable Steps to Cure Breach. If CE, knows of a pattern of activity or practice of Associate that constitutes a material breach or s iolation of the Associate's obligations under the provisions of this Addendum or another arrangement and dues not terminate this Contract pursuant to Section 4(a), then CE shall take reasonable steps to cure such breach or end such violation. If CE's efforts to cure such breach or end such violation are unsuccessful. CE: shall either (i) terminate the Contract. if feasible or t if termination of this Contract is not feasible. CE shall report Associate's breach or violation to the Secretary of the Department of Health and Human Services. if Associate knows of a pattern of activity or practice of a Subcontractor or agent that constitutes a material breach or violation of the Subcontractor's or agent's obligations under the written agreement between Associate and the Subcontractor or agent. Associate shall take reasonable steps to cure such breach or end such s iolation. it' feasible. c. Judicial or Administrative Proceedings. Either party may terminate the Contract, effective immediately, if Li) the other party is named as a defendant in a criminal proceeding for a violation of the HIPAA Rules or other security or privacy laws or (ii) a finding or stipulation that the other party has siolated any standard or requirement of the HIPAA Rules or other security or privacy laws is made in any administrative or civil proceeding in which the party has been joined. d. Effect of Terninption. I 11 Except as provided in paragraph (2) of this subsection, upon termination of this Contract, for any reason, Associate shall return or destroy all Protected Information that Associate or its agents or Subcontractors still maintain in any form, and shall retain no copies of such Protected Information. If Associate elects to destroy the PHI, Associate shall certify in writing to CE that such PHI has been destroyed. (2) if Associate believes that returning or destroying the Protected information is not feasible, Associate shall promptly provide CE notice of the conditions making return or destruction infeasible. Associate shall continue to extend the protections of Sections 2(a), 2(b), 2(c), 2(d) and 2(e) of this Addendum to such Protected Information, and shall limit further use of such PHI to those purposes that make the return or destruction of such PHI infeasible. Injunctive Relief. CE shall have the right to injunctive and other equitable and legal relief against Associate or any of its Subcontractors or agents in the event of any use or disclosure of Protected Information in violation of this Contract or applicable law. 6. No Waiver of Immunit2. 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. protection, or other provisions of the Colorado Governmental Immunity Act, CRS 24-It)-I0l et seq. or the Federal Tort Claims .Act, 28 U.S C. 2671 et seq. as applicable. as now in effect or hereafter amended. t. imitation of Liabiti►v.Any limitation of Associate's liability in the Contract shall be inapplicable to the terms and conditions of this Addendum. 8 9, Disclaimer l_ E makes no warrantv for representation that complianl.e by 1sso.late with this Contractor the HIPA.1 Rules !,\ ill be adequate or satistaciory !or \ssociate's own tuarposes Associate is solely responsible for all decisions made by Associate regarding the safeguarding of PHI. certification. To the extent that I.1.. determines an eyamination is neces>.ary in order to :;amply with CE's legal obligations pursuant to the HIPAA Rules relating to :ertitication of it, security practices. Cl. or its authorized agents or contractors. may. at C l' s expense. examine Associate's facilities, ssstems. 23 procedures and records as may be necessary for such agents or contractors to certity. to CE the extent to which Associate's security safeguards comply with the HIPAA Rules or this Addendum. to. Amendment a. Amendment to Comply with Law. The parties acknowledge that state and federal laws relating to data security and privacy are rapidly evolving and that amendment of this Addendum may be required to provide for procedures to ensure compliance with such developments. The parties specifically agree to take such action as is necessary to implement the standards and requirements of the HIPAA Rules and other applicable laws relating to the confidentiality, integrity, availability and security of PHI. The parties understand and agree that CF must receive satisfactory written assurance from Associate that Associate will adequately safeguard all Protected Information and that it is Associate's responsibility to receive satisfactory written assurances from Associate's Subcontractors and agents. Upon the request of either party, the other party agrees to promptly enter into negotiations concerning the terms of an amendment to this Addendum embodying written assurances consistent with the standards and requirements of the HIPAA Rules or other applicable laws. CE may terminate this Contract upon thirty (30) days written notice in the event (i) Associate does not promptly enter into negotiations to amend this Contract when requested by CE pursuant to this Section, or (ii) Associate does not enter into an amendment to this Contract providing assurances regarding the safeguarding of PHI that CE, in its sole discretion, deems sufficient to satisfy the standards and requirements of the HIPAA Rules. b. Amendment of Attachment A. Attachment A may be modified or amended by mutual agreement of the parties in writing from time to time without formal amendment of this Addendum. I I. Assistance in Litigation or Administrative Proceedings. Associate shall make itself, and any Subcontractors, employees or agents assisting Associate in the performance of its obligations under the Contract, available to CE. at no cost to CE up to a maximum of 30 hours, to testify as witnesses, or otherwise, in the event of litigation or administrative proceedings being commenced against CE, its directors, officers or employees based upon a claimed violation of'the HIPAA Rules or other laws relating to security and privacy or PHI. except where Associate or its Subcontractor. employee or agent is a named adverse party. 12. No Third Party Beneficiaries. Nothing express or implied in this Contract is intended to confer, nor shall anything herein confer, upon any person other than CE, Associate and their respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever. 13. Interpretation and Order of Precedence. The provisions of this Addendum shall prevail over any provisions in the Contract that may conflict or appear inconsistent with any provision in this Addendum. Together, the Contract and this Addendum shall be interpreted as broadly as necessary to implement and comply with the HIPAA Rules. The parties agree that any ambiguity in this Contract shall be resolved in favor of a meaning that complies and is consistent with the HIPAA Rules. This Contract supersedes and replaces any previous separately executed HIPAA addendum between the parties. 14. Survival of Certain Contract Terms. Notwithstanding anything herein to the contrary, Associate's obligations under Section 4(d) ("Effect ofTermination") and Section 12 ("No Third Party Beneficiaries") shall survive termination of this Contract and shall be enforceable by CE as provided herein in the event of such failure to perform or comply by the Associate. This Addendum shall remain in effect during the term of the Contract including any extensions. 15. Representatives and Notice. 24 a. Representatives. For the purpose of the Contract, the individuals identified elsewhere in this Contract shall he the representatives of the respective parties. If no representatives are identified in the Contract. the individuals listed below are hereby designated as the parties' respective representatives for purposes of this Contract. Either party may from time to time designate in writing new or substitute representatives. b. Notices. All required notices shall he in writing and shall be hand delivered or given by certified or registered mail to the representatives at the addresses set forth below. State'Covered Entity Representative: Name: Eva Jewell Title: Division Head Department and Division: Weld County Department of Human Services Area Agency on Aging Address: 315 North 1 Ith Ave.. Bldg. C or PO Box 1805 Greeley, Colorado 80631 Contractor` Business Associate Representative: Name: Heidi Rizzotto Title: Administrator Department and Division: A Little R & R Home Care Address: 1966 Vr' 15th Street, Suite 6 Loveland, CO 80538 25 ATTACHMENT A This Attachment sets forth additional terms to the HIPAA Business Associate Addendum, which is part of the Contract dated July 1, 2017, between Weld County Department of Human Services Area Agency on Aging and A Little R & R Home Care, ("Contract") and is effective as of July I. 2017 (the "Attachment Effective Date"). This Attachment may be amended from time to time as provided in Section 10(b) of the Addendum. Additional Permitted Uses. In addition to those purposes set forth in Section 2ta) of the Addendum. Associate mas use Protected Information as follows: 2. • Additional Permitted Disclosures, In addition to those purposes set forth in Section 2(h) of the Addendum. Associate may disclose Protected Information as follows: Suhcontractor(s). The parties acknowledge that the following subcontractors or agents of Associate shall receive Protected Information in the course of assisting Associate in the performance of its obligations under this Contract: 4 Receipt. Associate's receipt of Protected Information pursuant to this Contract shall be deemed to occur as follows, and Associate's obligations under the Addendum shall commence with respect to such PHI upon such receipt: 5. Additional Restrictions on Use of Data. CL is a Business Associate of certain other Covered Entities and, pursuant to such obligations of CE, Associate shall comply with the following restrictions on the use and disclosure of Protected Information: 6. Additional Terms. [This section may include specifications for disclosure format, method of transmission, use of an intermediary, use of digital signatures or PKI, authentication, additional security of privacy specifications, de -identification or re -identification of data and other additional terms.] 26 Exhibit B Weld County Area Agency on Aging In -home Services Voucher Program Instructions for completing voucher When a consumer is awarded units/hours of service, the WCAAA will generate a voucher that includes the name and contact information of the consumer. invoice number, date of approval, number of units/hours awarded, and expiration date of the voucher. 2. Vouchers are valid for a six month period of time unless otherwise indicated. At the end of voucher period, the consumer will he reassessed by the WCAAA for the program and if applicable, they will he issued a new voucher for ongoing units of service. 3. Consumers will he notified advising them of the number of units/hours awarded and the expiration date of the voucher. 4. WCAAA will confirm with consumers which Provider agency they have chosen to provide services. WCAAA will contact the Provider agency and provide them with a copy of the voucher. The voucher will be used by providers for reimbursement during that voucher period (expiring every six months during a fiscal year July 1 -June 30. If consumer is approved in September, the voucher will expire December 31 and may he eligible for another six months beginning January I expiring June 30). 5. Provider agency is responsible for obtaining and verifying with the WCAAA that the consumer has a valid voucher before providing services. 6. The Provider agency will need to complete and submit the voucher each month to be reimbursed for units of service rendered. • Vouchers must be received no more than bi-nwnthly and no less than monthly for processing. For services rendered in the month of June, vouchers and invoices shall be received no later than July 5"' of that same year. • In addition to individual vouchers, Provider agency will submit an invoice for the services delivered for the month. invoices shall include the Provider Agency and contact information: name of consumer served, dates) of service: service provided and unit rate for service provided. • The submission of the completed voucher and invoice by the Provider agency is the request for payment. 7 In the event of a program audit. Provider agency must he able to show proof that a visit and services were provided. 8. All information inside the center box of the voucher should be completed by the Provider agency each month, and the voucher must he signed by an authorized agency representative in order for the voucher to be processed for payment. 9. Vouchers with missing information or signatures will be returned to Provider agency to be completed and returned for payment. 10. Payments will be processed and mailed to provider upon receipt of completed vouchers) and invoice generally within three to four weeks. 1 I . Provider agency must track units/hours of service and will not be reimbursed for any services other than those indicated on the Task Sheet without prior approval from the WCAAA. 12. Provider agency will not be reimbursed for any units of service provided that exceeds units/hours of service allocated on the voucher without prior approval from the WCAAA. 13. Only the homemaker/personal care services outlined in the In -Home Services Voucher Program Eligibility Guidelines are reimbursable services. 14. Vouchers may be submitted by email or fax: • Email: mshepard(irweldgov.com • FAX: (970) 346-6951 Ann: Michelle Shepard 27 Exhibit C Weld County Area Agency on Aging (Region 20) Consumer Complaints, Appeals and hearings Procedure Updated December 2015 Consumer Complaint Any older adult, hisiter representative, or caregiver apply ing or receiving services under the Older Americans Act or State Funding for Senior Services by the Weld County Area Agency on Aging t WCAAA), or a contractor of the WCAAA. has the right to submit a complaint. You may tile your complaint in person. by telephone. email, or in writing within thirty (30) days of the action or incident. Complaints shall he forwarded to the appropriate agency for follow-up and resolution. Complaints shall be resolved at the lowest possible level. If the complaint cannot he resolved at the local level, it may he appealed. The direct service provider receiving the complaint shall investigate and resolve the complaint. The direct service pros ider may be the WCAAA or a contractor of the WCAAA. Weld County Area Agency on Aging (970)346-6950 PO Box 1805 Greeley. CO 80632 Written notice of the resolution shall be sent to the complainant within fifteen ( I5) working days from the time the agency receives the complaint. Consumer Appeal At any time the complainant may contact that State Unit on Aging or if the complainant is dissatisfied with the complaint resolution, a written appeal may be filed with the State Unit on Aging Director within ten (10) calendar days of receipt of the decision at: Colorado Department of Human Services. State Unit on Aging 1575 Sherman Street, 10th Floor Denver, CO 80203-1702 (888) 866-4243 (Toll Free) The State Unit on Aging Director or designee shall complete a review of the complaint and resolution of that complaint, including all pertinent documentation or new information that may be available. The State Unit on Aging will provide a written response, including notification of the complainant's rights to an Administrative Law Judge hearing as described in Section 10.507 if he/she is dissatisfied with the resolution of the appeal, to the complainant within thirty (30) calendar days of the receipt of appeal. The appeal procedure may be terminated at any time if the individual and service provider negotiate a written agreement that resolves the issue in question. Upon termination, the complainant shall file with the WCAAA or the State Unit on Aging, whichever is applicable, a written notice stating the reason for the termination. 28 Hello