HomeMy WebLinkAbout20161867.tiffDate of signature
RESOLUTION
RE: APPROVE 2016-2017 HEALTHY COMMUNITIES CONTINUATION CONTRACT
AMENDMENT #1 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 the 2016-2017 Health Communities
Continuation Contract Amendment #1 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 Public Health and Environment, and the Colorado Department of Public Health
and Environment, Health Care Policy and Financing, commencing July 1, 2016, and ending
June 30, 2017, with further terms and conditions being as stated in said contract amendment, and
WHEREAS, after review, the Board deems it advisable to approve said contract
conditional upon the deletion of paragraph 4.1.3., 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 2016-2017 Health Communities Continuation Contract Amendment #1
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 Public Health and
Environment, and the Colorado Department of Public Health and Environment, Health Care Policy
and Financing, be and hereby is, approved, as modified.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said contract amendment.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 20th day of June, A.D., 2016.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: d m00%t� 1
Weld County Clerk to the Board
Attorney
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CG: I-iL (ST)
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Mike Freeman, Chair
Sean P. C.nway, Pro-Tem
Steve Moreno
2016-1867
HL0048
/D�
Memorandum
TO: Mike Freeman, Chair
Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH
Executive Director
Department of Public Health & Environment
DATE: June 16, 2016
SUBJECT: 2016-2017 Healthy Communities
Continuation Contract with Health Care
Policy & Financing
For the Board's approval is a contract amendment between the Colorado Department of Health
Care Policy and Financing and the Board of County Commissioners of Weld County. This contract
amendment allows the Weld County Department of Public Health and Environment to continue
providing Healthy Communities services in Weld County.
Funding for this contract will be used to provide Early and Periodic Screening, Diagnosis &
Treatment (EPSTD) services including health care case management, outreach and support
services for children and pregnant women who are enrolled in Health First Colorado, Colorado's
Medicaid program, and Child Health Plan (Plus) (CHP+). Emphasis is on educating families about
age appropriate well child services and helping them utilize these services available in the
community. In addition, this program provides outreach to non -enrolled individuals and
community based organizations to bring awareness of the Healthy Communities program.
In the interest of executing this contract in a timely manner, pursuant to the direction of the
Health Department's Commissioner Coordinator, Sean Conway, we have struck -through one item
within the contract, paragraph 4.1.3, under Section 4.0, Personnel General Requirements. This
section would have required the Health Department to provide additional staff at no cost to the
State upon the State's determination that we didn't have adequate staffing to perform the work
in accordance with the requirements of the contract. No other sections of the contract were
modified.
The term of the contract is from July 1, 2016, through June 30, 2017. Funding for this renewal
period will not exceed $137,000. No new FTE will be required to perform the work as outlined in
the contract.
This contract was approved for placement on the Board's agenda via pass -around dated June 8,
2016. I recommend approval of this Healthy Communities continuation contract with Health Care
Policy & Financing, as modified.
2016-1867
Contract Number 20160000000000000029A1
CONTRACT AMENDMENT NO. 1
Original Contract Number 20160000000000000029
1. PARTIES
This Amendment to the above -referenced Original Contract (hereinafter called the "Contract") is entered
into by and between Board of County Commissioners of Weld County, 1555 N. 17th Ave., Greeley, CO
80631, (hereinafter called "Contractor"), and the STATE OF COLORADO, acting by and through the
Department of Health Care Policy and Financing, 1570 Grant Street, Denver, Colorado 80203 (hereinafter
called "Department" or "State.")
2. EFFECTIVE DATE AND ENFORCEABILITY
This Amendment shall not be effective or enforceable until it is approved and signed by the Colorado State
Controller or designee (hereinafter called the "Effective Date.") The Department shall not be liable to pay
or reimburse Contractor for any performance hereunder, including, but not limited to, costs or expenses
incurred, or be bound by any provision hereof prior to the Effective Date.
3. FACTUAL RECITALS
The Parties entered into the Contract to provide Early and Periodic Screening, Diagnosis and Treatment
(EPSDT) services for Weld County. The purpose of this Amendment is to make changes to the Statement
of Work, add money to this Contract, and extend this Contract for an additional year.
4. CONSIDERATION
The Parties acknowledge that the mutual promises and covenants contained herein and other good and
valuable consideration are sufficient and adequate to support this Amendment.
5. LIMITS OF EFFECT
This Amendment is incorporated by reference into the Contract, and the Contract and all prior amendments
thereto, if any, remain in full force and effect except as specifically modified herein.
6. MODIFICATIONS
The Contract and all prior amendments thereto, if any, are modified as follows:
A. Section 5, Term, Subsection A, Initial Term, is hereby deleted in its entirety and replaced as
follows:
A. Initial Term
The Parties' respective performances under this Contract shall commence on the later of July 1,
2015 or the Effective Date. This Contract shall expire June 30, 2017, unless sooner terminated
or further extended as specified elsewhere herein.
B. Section 7, Payments to Contractors, Subsection G, Maximum Amount, is hereby deleted in its
entirety and replaced as follows:
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c:2O/—/o6/ `l)
G. Maximum Amount
The maximum amount payable under this Contract to Contractor by the Department is shown
in the following table, as determined by the Department from available funds. Payments to
Contractor are limited to the unpaid obligated balance of the Contract. The maximum amount
payable by the Department to Contractor is:
State Fiscal Year 2015-2016
$135,000.00
State Fiscal Year 2016-2017
$137,000.00
Total for All State Fiscal Years
$272,000.00
C. Exhibit A, Statement of Work, is hereby deleted in its entirety and replaced with Exhibit AI,
Statement of Work, attached hereto and incorporated by reference into the Contract. All
references within the Contract to Exhibit A, shall be deemed to reference to Exhibit Al.
7. START DATE
This Amendment shall take effect on its Effective Date.
8. ORDER OF PRECEDENCE
Except for the Special Provisions and the HIPAA Business Associates Addendum, in the event of any
conflict, inconsistency, variance, or contradiction between the provisions of this Amendment and any of the
provisions of the Contract, the provisions of this Amendment shall in all respects supersede, govern, and
control. The most recent version of the Special Provisions incorporated into the Contract or any amendment
shall always control other provisions in the Contract or any amendments.
9. AVAILABLE FUNDS
Financial obligations of the state payable after the current fiscal year are contingent upon funds for that
purpose being appropriated, budgeted, or otherwise made available to the Department by the federal
government, state government and/or grantor.
REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK
Page 2 of 17
Contract Number 201 60000000000000029
THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT
Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's behalf
and acknowledge that the State is relying on their representations to that effect.
CONTRACTOR:
Board of County Commissioners of Weld
County
By:
Signature of Authorized Officer
Date: JUN 2 0 2016
By:
Date:
STATE OF COLORADO:
John W. Hickenlooper, Governor
Susan F. Birch, MBA, BSN, RN
Executive Director
Department of 1 lealth Care Policy and
Financing
Mike Freeman LEGAL REVIEW:
Printed Name of Authorized Officer Cynthia H. Coffman. Attorney General
By:
Chair
Printed Title of Authorized Officer Date:
ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER
CRS §24-30-202 requires the State Controller to approve all State Contracts. This Contract is not valid until
signed and dated below by the State Controller or delegate. Contractor is not authorized to begin
performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not
obligated to pay Contractor for such performance or for any goods and/or services provided hereunder.
By:
Dc
Date:
STA E CONTROLLER:
aros, CPA, MBA, JD
re Policy and Financing
Page 3 of 17
02 0/4 -/g 1 (a
Contract Routing Number 20160000000000000029A1
EXHIBIT Al, STATEMENT OF WORK
SECTION 1.0 PROGRAM PURPOSE
1.1.
The purpose of the Healthy Communities program is to ensure that children and pregnant women
enrolled in Health First Colorado — Colorado's Medicaid Program and Child Health Plan (Plus)
receive the best possible start with respect to utilizing the health care services and supports available
to them.
1.1.1. Toward that end, the Contractor:
1.1.1.1. Provides outreach to non -enrolled individuals and community based organizations to bring
awareness of the Healthy Communities program.
1.1.1.2. Provides outreach and administrative case management to clients newly enrolled into Health
First Colorado or CHP+.
1.1.1.3. Directs clients to primary and specialty medical providers as needed.
1.1.1.4. Directs clients to community based organizations and agencies for non -medical services.
1.1.1.5. Coordinates with community based organizations, the Department and other Department
contractors to assist them in improving overall health outcomes as determined by the
Department.
1.1.1.5.1. Specifically, the Contractor's work helps the Department attain its goal to increase the number
of well child and oral health visits as counted on the Centers for Medicare and Medicaid
Services Early and Periodic Screening, Diagnostic and Treatment (CMS EPSDT) 416 report
to eighty percent (80%) and to increase oral health visits by ten percentage points over the
2010 CMS EPSDT 416 report.
SECTION 2.0 ACRONYMS, ABBREVIATIONS AND OTHER TERMINOLOGY
2.1 Acronyms, abbreviations and other terminology are defined at their first occurrence in this Statement
of Work. The following list is provided to assist the reader in understanding acronyms, abbreviations
and terminology used throughout this document.
2.1.1. Administrative Case Management — assisting clients and their family representatives to navigate
Colorado's public health care system to address concerns regarding eligibility and enrollment in
their respective Medical Assistance Program including application assistance as necessary.
2.1.2. Business Day - Any day in which the Department is open and conducting business, but shall not
include weekend days or any day on which the Department observes one ofthe following holidays:
2.1.2.1. New Year's Day.
2.1.2.2. Martin Luther King, Jr. Day.
2.1.2.3. Washington -Lincoln Day (also referred to as President's Day).
2.1.2.4. Memorial Day.
2.1.2.5. Independence Day.
2.1.2.6. Labor Day.
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2.1.2.7.
2.1.2.8.
2.1.2.9.
2.1.2.10.
2.1.3.
2.1.4.
Columbus Day.
Veterans' Day.
Thanksgiving Day.
Christmas Day.
Business Interruption - Any event that disrupts the 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.
CHP+ - The Colorado Child Health Plan Plus program.
2.1.5. Client - Any individual who is eligible for EPSDT Medicaid, a pregnant woman on Medicaid or
any person on the Child Health Plan Plus (CHP+) program.
2.1.6. Closeout Period - The period beginning on the earlier of ninety (90) days prior to the end of the
last renewal year of the Contract or notice by the Department of non -renewal and ending on the
day that the Department has accepted the final deliverable for the Closeout Period and has
determined that the final transition is complete.
2.1.7. Community Partner - any individual or organization who may provide additional services or
general assistance to Clients.
2.1.8. Disaster - An event that makes it impossible for the Contractor to perform the Work out of its
regular facility, and may include, but is not limited to, natural disasters, fire or terrorist attacks.
2.1.9. EBNE - Eligible but not enrolled.
2.1.9.1. EBNE Outreach — To actively generate awareness and provide education to women and children
currently not enrolled in the Healthy Communities Program but who may be eligible.
2.1.10. Health First Colorado (HFC) — The name of Colorado's Medicaid program beginning in May
2016.
2.1.11. Operational Start Date - The later of July 1, 2015 or when the Department authorizes the
Contractor to begin fulfilling its obligations under the Contract.
2.1.12. PHI - Protected Health Information.
2.1.13. Provider - any entity that submits claims under Colorado Medical Assistance Programs for
services rendered.
2.1.14. RCCO - Regional Care Collaborative Organization.
2.1.15. Refer - to offer to a Client or his/her representative the contact information for an individual or
list of Community Partners and/or Providers in order to help meet the Client's individual needs.
SECTION 3.0 CONTRACTOR'S GENERAL REQUIREMENTS
3.1 The Department will contract with only one (1) organization, the Contractor, and will work solely
with that organization with respect to all tasks and deliverables to be completed, services to be
rendered and performance standards to be met.
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3.2. The Contractor may be privy to internal policy discussions, contractual issues, price negotiations,
confidential medical information, Department financial information, and advance knowledge of
legislation. In addition to all other confidentiality requirements of the Contract, the Contractor shall
also consider and treat any such information as confidential and shall only disclose it in accordance
with the terms of the Contract.
3.3. The Contractor shall work cooperatively with key Department staff and, if applicable, the staff of
other Department contractors or other State agencies 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 the Contractor and any other Department contractor, the Department will
resolve the conflict and the Contractor shall abide by the resolution provided by the Department.
3.4. The Contractor shall inform the Department, upon request, on current trends and provide information
on new technologies in use that may impact the Contractor's responsibilities under this Contract.
3.5. Deliverables
3.5.1. All deliverables shall meet Department -approved format and content requirements. The
Department will specify the number of copies and media for each deliverable.
3.5.2. Each deliverable will follow the deliverable submission process as follows:
3.5.2.1. The Contractor shall submit each deliverable to the Department for review and approval.
3.5.2.2. The Department will review the deliverable and may direct the Contractor to make changes to
the deliverable. The Contractor shall make all changes within ten (10) Business Days following
the Department's direction to make the change unless the Department provides a longer period
in writing.
3.5.2.2.1. Changes the Department may 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 that was left out of the deliverable.
3.5.2.3. The Department may also direct the Contractor to provide clarification or provide a walkthrough
of each deliverable to assist the Department in its review. The Contractor shall provide the
clarification or walkthrough as directed by the Department.
3.5.2.4. Once the Department has received an acceptable version of the deliverable, including all
changes directed by the Department, the Department will notify the Contractor of its acceptance
of the deliverable in writing. A deliverable shall not be deemed accepted prior to the
Department's notice to the Contractor of its acceptance of that deliverable.
3.5.3. The Contractor shall employ an internal quality control process to ensure that all deliverables,
documents and calculations are complete, accurate, easy to understand and of high quality. The
Contractor shall provide deliverables that, at a minimum, are responsive to the specific
requirements for that deliverable, organized into a logical order, contain no spelling or
grammatical errors, are formatted uniformly and contain accurate information and correct
calculations. The Contractor shall retain all draft and marked -up documents and checklists utilized
in reviewing deliverables for reference as directed by the Department.
3.5.4. In the event that any due date for a deliverable falls on a day that is not a Business Day, then the
due date shall be automatically extended to the next Business Day, unless otherwise directed by
the Department.
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3.5.5. All due dates or timelines that reference a period of days, months or quarters shall be measured in
calendar days, months and quarters unless specifically stated as being measured in Business Days
or otherwise. All times stated in the Contract shall be considered to be in Mountain Time, adjusted
for Daylight Saving Time as appropriate, unless specifically stated otherwise.
3.5.6. No deliverable, report, data, procedure or system created by the Contractor for the Department
that is necessary to fulfilling the Contractor's responsibilities under the Contract, as determined by
the Department, shall be considered proprietary.
3.5.7. If any deliverable contains ongoing responsibilities or requirements for the Contractor, such as
deliverables that are plans, policies or procedures, then the Contractor shall comply with all
requirements of the most recently approved version of that deliverable. The 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.
3.5.8. Any deliverable described as an update of another deliverable shall be considered a version of the
original deliverable for the purposes of this subsection.
3.6. Stated Deliverables and Performance Standards
3.6.1. 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 deliverables. The
sections with these headings are not intended to expand or limit the requirements or
responsibilities related to any deliverable or performance standard.
3.7. Communication Requirements
3.7.1. Communication with the Department
3.7.1.1. 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 2013 and/or Microsoft Office 365 for PC. If the Contractor
uses a compatible program that is not the system used by the Department, 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.
3.7.2. Communication with Clients, Providers and Other Entities
3.7.2.1. The Contractor shall use e-mail and letter templates stored in the Healthy Communities Client
Relationship Management Database for all written Client communications unless otherwise
inappropriate to use them.
3.7.2.2. The Contractor shall create a Communication Plan that includes, but is not limited to, all of the
following:
3.7.2.2.1. A description of how the Contractor will communicate to Clients any changes to the services
those Clients will receive or how those Clients will receive the services.
3.7.2.2.2. A description of the communication methods, including things such as email lists, newsletters
and other methods, the Contractor will use to communicate with Providers and
Subcontractors.
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3.7.2.2.3.
3.7.2.2.4.
3.7.2.2.5.
3.7.2.2.5.1.
3.7.2.2.5.2.
3.7.2.2.5.3.
3.7.2.2.6.
3.7.2.2.6.1.
3.7.2.2.6.2.
The specific means of immediate communication with Clients and a method for accelerating
the internal approval and communication process to address urgent communications or crisis
situations.
A general plan for how the Contractor will address communication deficiencies or crisis
situations, including how the Contractor will increase staff, contact hours or other steps the
Contractor will take if existing communication methods for Clients or Providers are
insufficient.
A listing of the following individuals within the Contractor's organization, that includes cell
phone numbers and email addresses:
An individual who is authorized to speak on the record regarding the Work, the Contract
or any issues that arise that are related to the Work.
An individual who is responsible for any website or marketing related to the Work.
Back-up communication staff that can respond in the event that the other individuals listed
are unavailable.
The Contractor shall deliver the Communication Plan to the Department for review and
approval.
DELIVERABLE: Communication Plan
DUE: Within forty-five (45) Business Days after the Effective Date
3.7.3. The Contractor shall review its Communication Plan on an annual basis and determine if any
changes are required to account for any changes in the Work, in the Department's processes and
procedures or in the Contractor's processes and procedures. The Contractor shall submit an
Annual Communication Plan Update that contains all changes from the most recently approved
prior Communication Plan, Annual Communication Plan Update or Interim Communication Plan
Update or shall note that there were no changes.
3.7.3.1. DELIVERABLE: Annual Communication Plan Update
3.7.3.2. DUE: Annually, by September 30th of each year
3.7.4. The Department may request a change to the Communication Plan at any time to account for any
changes in the Work, in the Department's processes and procedures or in the Contractor's
processes and procedures, or to address any communication related deficiencies determined by
the Department. The Contractor shall modify the Communication Plan as directed by the
Department and submit an Interim Communication Plan Update containing all changes directed
by the Department.
3.7.4.1. DELIVERABLE: Communication Plan Update
3.7.4.2. DUE: Within thirty (30) Business Days following the receipt of the request from the
Department, unless the Department allows for a longer time in writing
3.8. Business Continuity
3.8.1. The Contractor shall create a Business Continuity Plan that the Contractor will follow in order to
continue operations after a Disaster or a Business Interruption. The Business Continuity Plan shall
include, but is not limited to, all of the following:
3.8.1.1. How the Contractor will replace staff that has been lost or is unavailable during or after a
Business Interruption so that the Work is performed in accordance with the Contract.
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3.8.1.2. How the Contractor will back-up all information necessary to continue performing the Work,
so that no information is lost because of a Business Interruption.
3.8.1.3. In the event of a Disaster, the plan shall also include how the Contractor will make all
information available at its back-up facilities.
3.8.1.4. How the Contractor will minimize the effects on Clients of any Business Interruption.
3.8.1.5. How the Contractor will communicate with the Department during the Business Interruption
and points of contact within the Contractor's organization the Department can contact in the
event of a Business Interruption.
3.8.1.6. Planned long-term back-up facilities out of which the Contractor can continue operations after
a Disaster.
3.8.1.7. The time period it will take to transition all activities from the Contractor's regular facilities to
the back-up facilities after a Disaster.
3.8.2. The Contractor shall deliver the Business Continuity Plan to the Department for review and
approval.
3.8.2.1. DELIVERABLE: Business Continuity Plan
3.8.2.2. DUE: Within forty-five (45) Business days after the Effective Date
3.8.3. The Contractor shall review its Business Continuity Plan at least semi-annually and update the
plan as appropriate to account for any changes in the Contractor's processes, procedures or
circumstances. The Contractor shall submit an Updated Business Continuity Plan that contains
all changes from the most recently approved prior Business Continuity Plan or Updated Business
Continuity Plan or shall note that there were no changes.
3.8.3.1. DELIVERABLE: Updated Business Continuity Plan
3.8.3.2. DUE: Semi-annually, by August 15th and February 15th of each year
3.8.4. In the event of any Business Interruption, the Contractor shall implement its most recently
approved Business Continuity Plan or Updated Business Continuity Plan immediately after the
Contractor becomes aware of the Business Interruption. In that event, the Contractor shall comply
with all requirements, deliverables, timelines and milestones contained in the implemented plan.
3.9. Department System Access
3.9.1. In the event that the Contractor requires access to any Department computer system to complete
the Work, the Contractor shall have and maintain all hardware, software and interfaces necessary
to access the system without requiring any modification to the Department's system. The
Contractor shall follow all Department policies, processes and procedures necessary to gain access
to the Department's systems.
3.10. HIPAA Policies
3.10.1. The Contractor shall develop and deliver a HIPAA Policy to the Department for review and
approval. The HIPAA Policy shall address the Contractor's policies for Protected Health
Information (PHI), technologies in place for protecting PHI, and trainings provided to Contractor
staff.
3.10.1.1. DELIVERABLE: HIPAA Policy
3.10.1.2. DUE: Ten (10) Business Days After the Effective Date
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3.10.2. The Contractor shall update their HIPAA Policy, at least annually, to include any technical,
procedural or other changes and deliver this HIPAA Policy Update to the Department for review
and approval.
3.10.2.1. DELIVERABLE: Updated HIPAA Policy
3.10.2.2. DUE: Annually, by June 30th of each year
SECTION 4.0 PERSONNEL GENERAL REQUIREMENTS
4.1. Personnel General Requirements
4.1.1. The Contractor shall provide qualified personnel as necessary to perform the Work throughout the
term of the Contract. The Contractor shall provide the Department with a final list of personnel
assigned to the Contract.
4.1.1.1. The Contractor shall designate a staff member to serve as Project Lead. The Project Lead shall
monitor all project activities, ensure the completion of all Work in accordance with the
Contract's requirements, and will act as the primary point of contact with the Department for
all communications, tasks and deliverables.
4.1.1.1.1. DELIVERABLE: Final list of names of the personnel assigned to the Contract
4.1.1.1.2. DUE: Within five (5) Business Days following the Effective Date
4.1.2. If any of the Contractor's personnel are required to have and maintain any professional licensure
or certification issued by any federal, state or local government agency, then the Contractor shall
maintain copies of such current licenses and certifications and provide them to the Department
upon request.
4.1.3. The Contractor shall use its discretion to determine the number of personnel necessary to perform
the Work in accordance with the requirements of the Contract.
4.1.4. The Contractor shall ensure that all personnel have sufficient training and experience to complete
all portions of the Work assigned to them. The Contractor shall provide all necessary training to
its personnel, except for Department -provided training specifically described in the Contract.
4.1.5. The Contractor may subcontract to complete Work required by the Contract. The conditions for
using a Subcontractor or Subcontractors are as follows:
4.1.5.1. The Contractor shall provide the organizational name of each Subcontractor and all items to be
worked on by each Subcontractor to the Department.
4.1.5.2. The Contractor shall obtain the Department's prior consent and written approval for any use of
Subcontractor(s).
4.1.5.2.1 DELIVERABLE: Name of each Subcontractor and items on which each Subcontractor will
work
4.1.5.2.2. DUE: The later of thirty (30) days prior to the Subcontractor beginning work or the Effective
Date
4.1.6. The Contractor shall fully cooperate with the scheduling of and participation in an annual site visit
by a Department designee as well as any follow up meetings deemed necessary by the Department
to address specific issues requiring corrective action.
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4.1.7. The Contractor shall have at least one (1) member of its staff attend, in person, via conference call
and/or web conferencing when available, at least ninety percent of all regular Healthy
Communities Family Health Coordinator monthly meetings; and, in the same manner, attend all
annual Healthy Communities statewide meetings, trainings or retreats.
4.1.8. The Contractor shall notify the Department within one (1) Business Day when any employee or
subcontractor leaves employment and within ten (10) Business Days of hiring a new employee.
4.1.9. The Contractor shall ensure all provisions of this Contract will be carried out during such
employment/subcontractor gaps or transitions and shall secure replacements within sixty (60)
days.
SECTION 5.0 PROJECT REQUIREMENTS
5.1 The Contractor shall serve as the Healthy Communities Contractor for the following counties: Weld
County.
5.2. The Contractor shall complete the Work pursuant to the Department's policies including the
Department's Customer Relationship Management procedures. These procedures may be updated
regularly by the Department via a web site. The Contractor shall comply with all updated
procedures.
5.3. Regional Care Collaborative Organization (RCCO) Collaboration
5.3.1. The Contractor shall work collaboratively with its RCCO in providing outreach and administrative
case management to Clients.
5.3.2. The Contractor shall meet with its RCCO at least two (2) times per year to create a work plan or
agreement for RCCO and Contractor Collaboration. The Contractor shall share data and
information with the RCCOs for all clients the entities have in common.
5.3.3. The Contractor shall provide to the Department a plan of the outreach, administrative case
management and care coordination that the Contractor agreed to conduct and that the RCCO
agreed to conduct during the SFY.
5.3.3.1. DELIVERABLE: Plan of outreach, administrative case management and care coordination
activities the RCCO and Contractor shall conduct
5.3.3.2. DUE: Within ten (10) Business Days of each coordination meeting
5.4. Client Outreach and Program Education
5.4.1. The Contractor shall conduct, on average throughout the SFY, a minimum of four (4) EBNE
outreach activities per quarter.
5.4.1.1. Outreach may include, but is not limited to, the following events:
5.4.1.1.1. Health fairs.
5.4.1.1.2. Back to school nights.
5.4.1.1.3. Workshops, presentations, in-service announcements, etc., to community based organizations
and agencies who come in contact with the same (enrolled and EBNE) populations served by
Healthy Communities.
5.4.2. The outreach information shall, at a minimum, include the following program information:
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5.4.2.1. Information describing Health First Colorado (Colorado's Medicaid Program) and Child Health
Plan Plus (CHP+) including the basic eligibility requirements for these programs.
5.4.2.2. Information on the services and resources provided by Family Health Coordinators.
5.4.3. The Contractor shall assist Clients in finding or accessing appropriate community resources and
ensure families have access to the programs discussed in Section 4.3.2 Community resources may
include, but are not limited to:
5.4.3.1. Food banks.
5.4.3.2. Shelters.
5.5. Community Outreach and Program Education
5.5.1. The Contractor shall educate the Client regarding the availability of services offered by the
Healthy Communities Program.
5.5.2. The Contractor shall assist Community Partners in understanding the Medicaid and CHP+ medical
assistance programs, program benefits, and program administration.
5.5.3. The Contractor shall plan, manage, and coordinate collaborative efforts and/or activities with
Community Partners to ensure better service delivery and education to the populations served.
5.5.4. The Contractor shall attend relevant meetings, conferences, and other channels of collaboration in
conjunction with Community Partners at no additional cost to the Department.
5.6. Provider Outreach and Program Education
5.6.1. The Contractor shall educate Providers on all services provided by or available through Healthy
Communities Program.
5.6.2. The Contractor shall educate and assist Providers with services covered by Medicaid and CHP+.
5.6.3. The Contractor shall assist Providers with missed appointment follow-up as requested. This
assistance shall include calling Clients, when requested by a Provider, to assist the Client in
attending appointments. This may include providing to the Client resource referrals such as
transportation assistance or child care resources in order to allow the Client to attend an
appointment.
5.7. Administrative Case Management and Program Navigation
5.7.1. The Contractor shall maintain a dedicated phone line to receive calls from Clients with questions
about the Healthy Communities Program.
5.7.2. The Contractor shall maintain an office that Healthy Communities Clients may visit with questions
about the Healthy Communities Program.
5.7.3. The Contractor shall provide the phone number and office location to the Department. In addition,
the Contractor shall publish the office location and phone line on its website, if it has a website,
and on publications so that Clients know where to call and visit for information.
5.7.4. The Contractor shall assist all EBNEs and Clients enrolled in the Healthy Communities Program
with the overall program navigation of the Medicaid and/or CHP+ programs.
5.7.5. The Contractor shall assist EBNEs with the application process, which may include any of the
following:
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5.7.5.1. Assisting the EBNEs with a paper Medicaid application or the Colorado Program Eligibility
and Application Kit (PEAK).
5.7.5.2. Providing on site Presumptive Eligibility (PE) determinations for those who may qualify.
5.7.5.3. Providing an appropriate referral, when necessary, to another application assistance site,
including, but not limited to a local department of human or social services, a Presumptive
Eligibility (PE) site, a Certified Application Assistant Site (CAAS), or a Medicaid Assistance
(MA) site.
5.7.5.4. The Contractor shall perform the following tasks for all individuals who qualify for the Healthy
Communities Program:
5.7.5.4.1. Follow-up with pregnant women, children, families, and EBNEs regarding the status of their
application as requested by the Client.
5.7.5.4.2. Provide Healthy Communities Program Clients with a list of appropriate Medicaid and CHP+
Providers and referrals when appropriate.
5.7.5.4.3. Provide appointment assistance as requested by Medicaid eligible Clients.
5.7.5.4.4. Provide referrals for medical and non -medical programs to Healthy Communities Program
Clients and their family members as requested by the Client.
5.7.5.4.5. Provide missed appointment follow up as requested by physical, oral and mental health
Providers.
5.7.5.4.6.
5.7.5.4.7.
5.7.5.4.8.
Provide follow-up assistance to Clients who have not received services within six (6) months
and/or annually for services defined in the Bright Futures Periodicity Schedule or by the
CHP+ oral health periodicity schedule.
Assist in resolving any issues or concerns regarding enrollment into Medicaid or CHP+ and/or
eligibility issues, including by, facilitating contact with CHP+ contractors, county
department of social/human services technicians, the Department's Eligibility and Enrollment
Medical Assistance Program contractor, the Department's Enrollment Broker or other
Medical Assistance site as appropriate for the Client's needs.
Assist Clients with scheduling appointments and Non -Emergent Medical Transportation
(NEMT) needs through the Medicaid Transportation Broker or local department of human or
social services.
5.7.5.4.9. Assist Clients to resolve provider issues, including provider demands for payment, collections
issues and/or any additional questions and issues regarding program benefits and/or
navigation, as requested by Clients.
5.8. Client Relationship Management Database
5.8.1. The Contractor shall provide access for employees performing the Work to use the Healthy
Communities Client Relationship Management Database as required.
5.8.2. The Contractor shall assure that all local information needed to assist Clients, such as Providers,
community resources, etc. are added to the Healthy Communities Client Relationship
Management Database as they relate to the Healthy Communities Program in a timely manner to
assure lists are available for use by Clients and Community Partners as needed.
5.8.3. The Contractor shall assure that staff are computer literate and able to use the Healthy
Communities Client Relationship Management Database to its full potential.
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5.8.4. The Contractor shall enter data, according to conventions agreed upon by the collaboration
between the Contractor and Department, recording activities such as outreach events, referrals and
interactions with Clients into the Healthy Communities Client Relationship Management
Database so that the Department may obtain reporting statistics.
5.8.5. The Contractor shall assure the Healthy Communities Client Relationship Management Database
is up to date by the 10th of the month following the reporting month. The Department will pull
reports for monthly contacts, referrals, and outreach activities after the 10th and before the 15th
of the month to meet the monthly reporting requirements.
5.8.5.1. The Contractor shall submit all requests for extensions of the deadline to the Department in
writing no later than the 5th of the month.
5.9. Training
5.9.1. At the Department's request, the Contractor shall attend Departmental training. Departmental
trainings may include, but are not limited to:
5.9.1.1. Training on the Healthy Communities Client Relationship Management Database and access to
the system for all of the Contractor's current employees working with the Healthy Communities
Program.
5.9.1.2. Training on the Healthy Communities Client Relationship Management Database and access to
the system for any new employee hired by the Contractor working with the Healthy
Communities Program.
5.9.1.3. Providing site visits as needed for quality assurance and training.
5.9.1.4. The Department will provide standardized training curriculum to the Contractor and these
materials will be updated at least every six (6) months. Training topics may include:
5.9.1.4.1. Healthy Communities Client Relationship Management Database data entry including data
entry conventions.
5.9.1.4.2. Medicaid and CHP+ benefits.
5.9.1.4.3. Medicaid and CHP+ eligibility.
5.9.1.4.4. CBMS use. Use of PEAK to assist clients.
5.9.1.4.5. Other topics as needed to fulfill the program's purpose.
5.10. Reporting
5.10.1. Monthly Narrative Status Report
5.10.1.1. By the 10th day of each month, the Contractor shall submit a Monthly Narrative Status Report
summarizing, at a minimum, all of the following:
5.10.1.1.1. The activity of the previous month including noteworthy accomplishments, project status,
challenges or barriers to program efforts, and collaborations with community or other agency
partners.
5.10.1.1.2. A description of the outreach activities conducted by the Contractor that month.
5.10.1.1.3. A description of the events and/or activities that the Contractor conducted in order to increase
the number of well child and oral health visits, increase physical health visits, and increase
oral health visits.
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5.10.1.1.3.1.1. DELIVERABLE: Monthly Narrative Status Report.
5.10.1.1.3.1.2. DUE: By the 10th day of each month
5.10.2. Budget Report
5.10.2.1. The Contractor shall submit a detailed Budget Report to the Department within sixty (60) days
of the issuance or renewal of the Contract with the Department. At a minimum, the Budget
Report shall include all anticipated program related expenses for employee(s) and operating
expenses for the entire Contractual period.
5.10.2.1.1. DELIVERABLE: Budget Report.
5.10.2.1.2. DUE: Within sixty (60) days of the issuance or renewal of the Contract with the Department.
5.10.3. Final Report
5.10.3.1. The Contractor shall submit a Final Report to the Department utilizing reporting and
information from the Healthy Communities Client Relationship Management Database.
5.10.3.1.1. The Final Report shall include, at a minimum, all of the following:
5.10.3.1.1.1. An analysis of any successes and challenges faced by the Contractor, based on the
Contractor's individual program and location, related to the Healthy Communities program
during the contracted period;
5.10.3.1.1.2. An analysis of the SFY's activities, outcomes, trends, and results;
5.10.3.1.1.3. An analysis of the Contractor's ability to meet CMS EPSDT requirements for well child,
oral health, and lead testing;
5.10.3.1.1.4. An analysis of the Contractor's ability to meet the oral health periodicity schedule for CHP+
eligible children.
5.10.3.1.1.4.1. DELIVERABLE: Final Report.
5.10.3.1.1.4.2. DUE: Thirty (30) days after the Contract expires, renews or is terminated.
5.10.4. Ad Hoc Reporting
5.10.4.1. The Contractor shall provide Ad Hoc Reports as requested by the Department.
5.10.4.2. When an Ad Hoc Report is requested, the Contractor shall coordinate with the Department to
confirm its understanding of the request and identify the best method for response.
5.10.4.3. The Contractor shall provide all ad hoc reports within thirty (30) days of the Department's
request at no additional cost to the Department.
SECTION 6.0 CLOSEOUT PERIOD
6.1.1. The Contract shall have a Closeout Period.
6.1.1.1. The Closeout Period shall begin on the earlier of ninety (90) days prior to the end of the last
renewal year of the Contract or notice by the Department of non -renewal. The Closeout Period
shall end 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.
6.1.1.2. This Closeout Period may extend past the termination of the Contract and the requirements of
the Closeout Period shall survive termination of the Contract.
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6.1.2. Closeout Period
6.1.2.1. During the Closeout Period, the Contractor shall complete all of the following:
6.1.2.1.1.
6.1.2.1.2.
6.1.2.1.3.
6.1.2.1.4.
6.1.2.1.5.
6.1.2.1.5.1.
6.1.2.1.5.2.
6.1.2.2.
Implement the most recent Closeout Plan or Closeout Plan Update that has been approved by
the Department, as described in Section 1.10.4.2 and complete all steps, deliverables and
milestones contained in the most recent Closeout Plan or Closeout Plan Update that has been
approved by the Department.
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 or included in the most recent Closeout Plan or Closeout Plan
Update that has been approved by the Department.
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.
Notify any Subcontractors of the termination of the Contract, as directed by the Department.
Notify all Clients that the Contractor will no longer be the Healthy Communities Outreach
and Case Management Contractor. The Contractor shall create these notifications and deliver
them to the Department for approval. Once the Department has approved the notifications,
the Contractor shall deliver these notifications to all Clients, but in no event shall the
Contractor deliver any such notification prior to approval of that notification by the
Department.
DELIVERABLE: Client Notifications
DUE: Thirty (30) days prior to termination of the Contract
Continue meeting each requirement of the Contract as described in the Department -approved
and updated Closeout Plan, or until the Department determines that specific requirement is
being performed by the Department or another contractor, whichever is sooner. The Department
will determine when any specific requirement is being performed by the Department or another
contractor, and will notify the Contractor of this determination for that requirement.
6.1.2.3. The Department will perform a closeout review to ensure that the Contractor has completed all
requirements of the Closeout Period. In the event that the 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.
Closeout Planning
Closeout Plan
The Contractor shall create a Closeout Plan that describes all requirements, steps, timelines,
milestones and deliverables necessary to fully transition the services described in the Contract
from the Contractor to the Department to another contractor selected by the Department to be
the Healthy Communities Outreach and Case Management Contractor after the termination
of the Contract. The Closeout Plan shall also designate an individual to act as a closeout
coordinator, who will ensure that all requirements, steps, timelines, milestones and
deliverables contained in the Closeout Plan are completed and work with the Department and
any other contractor to minimize the impact of the transition on Clients and the Department.
The Contractor shall deliver the Closeout Plan to the Department for review and approval.
6.1.3.1.1.1. DELIVERABLE: Closeout Plan
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6.1.3.1.1.2. DUE: Thirty (30) days following the Effective Date
6.1.3.2. The Contractor shall update the Closeout Plan, at least annually, to include any technical,
procedural or other changes that impact any steps, timelines or milestones contained in the
Closeout Plan, and deliver this Closeout Plan Update to the Department for review and approval.
6.1.3.2.1. DELIVERABLE: Closeout Plan Update
6.1.3.2.2. DUE: Annually, by June 30th of each year
SECTION 7.0 PAYMENT
7.1. The Contractor shall submit a monthly invoice based on the Contractor's actual expenditures for the
period specified. All invoices shall be submitted using the Contract Reimbursement Form, listed as
Exhibit C. The Department, at its discretion, may make edits to the reimbursement form. The
Contractor shall use the most recently updated reimbursement form.
7.2. All invoices shall reference the Contract by the Contract routing number that appears on the first
page of the Contract. Invoice shall be based upon the cost of the Work performed during the term of
this Contract, and, shall be supplemented or accompanied by supporting data and subcontractor
invoices, upon request, covering the Work shown on the invoice.
7.3. Indirect costs shall not exceed five percent (5%) of the Contract Maximum Amount for the SFY.
7.4. Supervision expenses are limited to five percent (5%) of the Contract Maximum Amount for the
SFY.
7.4.1. Supervision shall be defined as work performed by any employee or subcontractor who is not a
regular contributor to the Healthy Communities Program as evidenced by the Contractor's work
recorded (or lack thereof) in the Healthy Communities Client Relations Management Database.
7.5. The total of the invoice submitted by the Contractor for all periods during a SFY shall not exceed
the Contract maximum amount for that year.
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