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HomeMy WebLinkAboutC17-292 Colorado Department of Health Care Policy and FinancingDepartment of Health Care Policy and Financing
Agreement Routing Number 2015CMIP037A3
AGREEMENT AMENDMENT NO.3
Original Agreement Routing Number 2015CMIP037A3
1. PARTIES
This Amendment to the above -referenced Original Agreement (hereinafter called the
"Agreement") is entered into by and between 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."), and the Eagle County (hereinafter called
"Contractor").
1. 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 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.
2. FACTUAL RECITALS
The Parties entered into the Agreement to create performance -related benchmarks for county
departments ofhuman/social services that achieve certain Incentive Performance Standards related
to determining and redetermining Medicaid eligibility, those populations currently enrolled in
Medicaid and cooperation with other Medicaid -related entities. The purpose of this Amendment
is to add exhibits and update the Incentives Performance Standards.
3. 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.
4. LIMITS OF EFFECT
This Amendment is incorporated by reference into the Agreement, and the Agreement and all prior
amendments thereto, if any, remain in full force and effect except as specifically modified herein.
5. MODIFICATIONS
The Agreement 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
with the following:
A. Initial Term
C 17-292
The Parties' respective performances under this Contract shall commence on the Inter of
the Effective Date or January 1, 2015_ This Contract shall expire June 30, 2018, unless
sooner terminated or further extended as specified elsewhere herein_
B. Section 4, Definitions, Subsection B is hereby deleted in its entirety and replaced with the
fol lowing:
B. Exhibits and other Attachments. The following documents are attached hereto and
incorporated by reference herein.-
Exhibit
erein:
Exhibit A-3, Statement of Work
Exhibit B, Rates
Exhibit C, Sample Option Letter
Exhibit D, List of CDHS programs for Training Performance Incentive
Exhibit E. Small, Medium, Large County List
Exhibit F, List of Mandatory Trainings for Training Performance Incentive
C. Section 7, Payments to Contractor, Subsection A, Maximum Amount, is hereby deleted in
its entirety and replaced with the following:
A. Maximum Amount
The maximum amount payable under this Contract to Contractor by the Department
is shown in the following table, as desermined by the Department from available funds_
Payments to the Contractor are limited to the unpaid obligated balance of the Contract
at the rates set forth in Exhibit B. The maximum amount payable by the Department
to the Contractor is:
State Fiscal Year 2014-15
$36,078.09
State Fiscal Year 2015-16
$35,811.14
State Fiscal Year 2016-17
$31,932.92
State Fiscal Year 2017-18
$31,627.61
Total for All State Fiscal Years
$135,449.76
D. Section 10, Confidential Information, Subsection B, Health Insurance Portability &
Accountability Act of 1996 ("HIPAA"), Paragraph ii, Business Associate Contract is
hereby deleted in its entirety,
E. Section 16, Notices and Representatives is hereby deleted in its entirety and replaced with
the following:
16. NOTICES AND REPRESENTATIVES
Each individual identified below is the principal representative of the designating
Party. All notices required to be given hereunder shall be hand delivered with
receipt required or sent by certified or registered mail to such Party's principal
representative at the address set forth below. In addition to, but not in lieu of, a
hard -copy notice, notice also may be sent by e-mail to the e-mail addresses, if
any, set forth below. Either Party may from time to time designate by written
Page 2 of 19
notice substitute addresses or persons to whom such notices shall be sent. Unless
otherwise provided herein, all notices shall be effective upon receipt.
For the State: Joshua Montoya
Department of Health Care Policy and Financing
1570 Grant Street
Denver, CO 80203
Joshua. Montoyacr hcpf.state.co.us
For the Contractor: The Contractor shall provide the Department with
the name and address of its principal representative.
In the event that the Contractor does not provide
this infonnation to the Department, all notices
required to be given hereunder shall be delivered to
the attention of the Contractor's director of human
services or director of social services, at the general
address on file with the Department.
F. Section 19, General Provisions, Subsection I, Order of Precedence, Paragraph ii, HIPAA
Business Associate Addendum is hereby deleted in its entirety.
G. Attachment A, HIPAA Business Associate Addendum, is hereby deleted in its entirety.
H. Exhibit A-2, Statement of Work, is hereby deleted in its entirety and replaced with Exhibit
A-3, Statement of Work, attached hereto and incorporated by reference into the Agreement.
All references within the Agreement to Exhibit A, Exhibit A-1, or Exhibit A-2 shall be
deemed to reference to Exhibit A-3.
I. Exhibit B, Rates, Section 1.3., SFY 2017-18 Incentives Payment Table, is hereby added as
follows:
1.3. SFY 2017-18 Incentives Payment Table
Incentive Payment Name
% of Funding
Payment Amount
Eligibility Timeliness and Backlog
35°-0
$8,302.25
Performance Incentive Payment
Collaboration Performance Incentive
20%
$4,744.14
Payment
Long Term Services and Supports
10%
$2,372.07
LTSS Performance Incentive Payment
Training Performance Incentive
15%
$3,558.11
Child Welfare Performance Incentive
20%
$4,744.14
Payment
Total Maximum
$23,720.70
Available for all
Incentive Payments
Page 3of19
A. Exhibit B, Rates, Section 2.3., SFY 2017-I8 Pool Maximum County Share Table, is hereby
added as follows:
2.3. SFY 2017-18 Pool Maximum County Share Table
Pool Name
Pool Maximum Distribution
Amount
Total Maximum Available for
$7,906.90
all Pool Distributions
6. START DATE
This Amendment shall take effect on its Effective Date.
7. ORDER OF PRECEDENCE
In the event of any conflict, inconsistency, variance, or contradiction between the provisions of
this Amendment and any of the provisions of the Agreement, the provisions of this Amendment
steal C in all respects supersede, govern, and control.
8. 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 HCPF by the federal
government, state government and/or grantor.
REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK
Page 4 of 19
Amendment Routing Number 2015CMIP037A3
THE PARTIES HERETO HAVE EXECUTED THIS INTERAGENCY AGREEMENT
Persons signing for Parties hereby swear and affirm that they are authorized to act on behalf of
their respective Party and acknowledge that the other Party is relying on their representations to
that effect.
STATE OF COLORADO
John W. Hickenlooper, Governor
Eagle County Department of Health Care Policy and
} Fin ncing
By: By:
Susan E. Birch, MBA, BSN, RN
Executive Director
i
Date; Date:
-6-l
ALL AGREEMEN'T'S REQUIRE APPROVAL BY THE STATE CONTROLLER
E CONTROLLER
ros, CPA, MBA, JD
Un
Department of Health Care Micy and Finaincing INSERT -Name of Agency or THE
Date: OL11-2
Page 5 of 19
EXHIBIT A-3, STATEMENT OF WORK
I. TERMINOLOGY
1.1. The following list is provided to assist the reader in understanding; acronyms, abbreviations
and terminology used throughout this document.
1,1.1. Accountable Care Collaborative (ACC) — the Department's program for care
coordination and cost containment for Medicaid members in all sixty-four (64) of
Colorado's counties.
1.1.2. Applicant — An individual for whom the Contractor is performing a Determination.
1.1.3. Behavioral Health Organization (BHO) - An organization that arranges for enrolled
Clients to get medically necessary behavioral health services. For a list of BHOs,
please see the County Incentive Program Guide.
1.1.4. Backlogged Determination — Any Untimely Determination that was not completed by
the timeliness requirements as set in Section 1.1.11.
1.1.5. Backlogged Redetermination —Any Untimely Redetermination that was not completed
by the timeliness requirements as set in Section 1.1.12.
3.1.6. COGNOS/Decision Support System 01 (DSSO l) — the Department's data reporting;
systems that use information from the Colorado Benefits Management System
(CBMS).
1.1.7. Colorado Benefits Management System (CBMS) — the State's eligibility determination
system.
1.1.5. Colorado interChange (interChange) — the State's claims payment system and related
subsystems that utilize eligibility information from CBMS to pay providers for medical
and.'or other claims. The system and related subsystems also collects and analyzes data
related to those payments.
1.1.9. County Incentives Program Guide — A supplemental document, provided by the
Department to each Contractor, that defines the expectations of the Department for the
County Incentives Program. This includes lists supporting documentation for the Child
Welfare Incentive and Training; Incentive, Collaboration Incentive partner information,
required forms and templates and other relevant materials.
3.1.10. Determination The act of determining if an Applicant is eligible for the Colorado
Medical Assistance Program based on information submitted on a new application.
1.1.11. DSS1 — A two-way communication form between the financial eligibility worker and
the case management agency that can include the ULTC 100.2 certification and the
financial eligibility determination.
1.1.I2. Member —An individual who is eligible for the Colorado Medical Assistance Program,
also known as a client.
1.1. I3. Regional Care Collaborative Organization (RCCO) — contracted entities of the
Department that are responsible for carrying out the goals of the Accountable Care
Collaborative,
1.1.14. Reporting Period — The period of time for each performance standard used to measure
whether the Contractor met that standard.
Page 6 of 19
1.1.14.1. The First Reporting Period for a SFY shall begin on July 1 of that SFY and end on
December 31 of that SFY.
1.1.14.2. The Second Reporting Period for a SFY shall begin on January I of that SFY and
end on June 30 of that SFY.
1.1.15. Redetermination — A Determination as defined under 10 C.C.R. 2505-8.100.3.P.
1.1.16. Small, Medium and Large County ._ The size of the county is determined by the case -
and workload of Medical Assistance enrollment.
1.1.17, State Fiscal Year (SFY) —The period beginning July 1 of each calendar year and ending
on June 30 of the following calendar year.
1.1.18. Timely Determination — Any Determination that is completed within the timeliness
requirements set forth in 10 C.C.R. 2505-8.100.3.D.
1.1.19. Timely Redetermination — Any Redetermination that is completed by the Iast day of
the month prior to the month in which the client's new annual enrollment period begins.
1.1.20. Untimely Determination — Any Determination that is not completed within the
timeliness requirements set forth in 10 C.C.R. 2505-8.100.3.D.
1.1.21. Untimely Redetermination — Any Redetermination that is not completed by the last day
of the month prior to the month in which the client's new annual enrollment period
begins. This is based on the CBMS RRR Due Date.
2. COUNTY DETERMINATIONS
2.1. The Contractor shall perform all Medicaid eligibility -related work within the Contractor's
county, required under C.R.S. §25.5-1-101 et. seg. The Department and the Contractor
share the costs of this work performed by the Contractor as defined in those statutes and
this Contract shall not impact the allocated amount of that cost sharing.
3. SYSTEMS USED TO DETERMINE COMPLIANCE WITH INCENTIVES
PERFORMANCE STANDARDS
3.1. To determine whether the Contractor met any or all of the Incentives Performance
Standards when completing determinations and redeterminations within the Contractor's
county, the Department will utilize the COGN0S:`DSS01 systems to pull the following
reports:
3.1.1. Weekly Timeliness.
3.1.2. Detailed Timely Processing of Medical Applicant Determinations/Redeterminations.
3.1.3. Mass Update Case Error Details.
3.1.4. Non -MAGI Redeterminations Due.
3.1.5. Redeterminations Due for Self-employment and individuals without a Social Security
Number.
3.1.6. Verifications Due.
3.2. To determine whether the Contractor met any or all of the Incentives Performance
Standards when working with Medicaid populations within the Contractor's county, the
Department may utilize data from the Colorado interChange system.
Page 7 of 19
3.3. The above list of systems and reports is not all-inclusive and the Department will, at its
discretion, utilize additional data and reports from the COGNOS `DSSOI, interChange,
and/or other systems to determine whether the Contractor met any or all of the Incentives
Performance Standards_
3.4. The date the data or reports will be pulled from the COGNOS.'DSS01, interChange, or
other systems will be defined in each applicable Incentives Performance Standard.
3.5. The Contractor shall utilize Section 3, Determining Compliance with Incentives
Performance Standards, and information in the County Incentives Program Guide, to assist
with pulling applicable data and reports to determine the Contractor's compliance with any
or all of the Incentives Performance Standards.
4. INCENTIVES PERFORMANCE STANDARD PROGRAM
4.1. The Contractor may earn an incentive payment to reimburse it for a portion of its cost
sharing as described in Section 3.
4.1.1. To fulfill the requirements in Exhibit A-3 Statement of Work and earn an incentive
payment, the Contractor shall utilize and comply with the County Incentives Program
Guide.
4.1.1.1. The Contractor shall utilize the County Incentives Program Guide to find any
forms, templates, program contacts or additional information needed to
operationalize the Incentives Performance Standard Program referenced
throughout this Agreement.
4.2. Eligibility Timeliness and Backlog Performance Incentive Standard
4.2.1. The Contractor may earn an Eligibility Timeliness and Backlog Performance Incentive
Payment for each Reporting Period in which the Contractor:
4.2.1.1. Completes at least ninety-five percent (95%) of all Determinations and
Redeterminations as Timely Determinations and Timely Redeterminations and,
4.2.1.2_ The Backlogged Detenninations average and Backlogged Redeterminations
average at the end of each Reporting Period is within the limits described in the
following table:
4.2.1.2.1. County Backlog Table
Page 8 of 19
County Size
Limit
New Applications
Large
< 100
Medium
< 15
Small
< 5
Redeterminations
.49
Large
<360
Medium
Small
X36
X12
Page 8 of 19
4.2. 1.3. To determine the Backlogged Determinations average, the Department will total
the Backlogged Determinations of each month of the Reporting Period and divide
by the number of months in the Reporting Period.
4.2.1.3.1. The Court Order Based Timeliness Report's Weekly Backlog by County Report
of the first week of each month will be used to determine the Contractor's
amount of Backlogged Determinations.
4.2.1.4. To determine the Backlogged Redeterminations average, the Department will total
the Backlogged Redeterminations of each month of the Reporting Period and divide
by the number of months in the Reporting Period.
4.2. l .4.1. The Court Order Based Timeliness Report's Weekly Backlog by County Report
of the first week of each month will be used to determine the Contractor's
number of Backlogged Redeterminations.
4.2.1.5. The Department will round both the Backlogged Determinations average and
Backlogged Redeterminations average to a whole number.
4.2.1.6. To determine the timeliness percent for this Performance Standard, the Department
shall total up all Timely Determinations and Timely Redeterminations the
Contractor completed within the Reporting Period and divide that by the total
number of Determinations and Redeterminations the Contractor completed during
that Reporting Period. The Department shall round these calculated percentages to
two (2) decimal places.
4.2.1.7. If the Contractor processes a total of two -hundred and forty (240) or fewer
Determinations and two -hundred and forty (240) or fewer Redeterminations per
month, the Contractor shall be deemed to have met the timeliness percentage of this
performance standard so long as they had eighteen (18) or fewer Untimely
Determinations/Redeterminations during that Reporting Period.
4.2.1.8. The Department will not include any Untimely Determinations/Untimely
Redeterminations and/or Backlogged Determinations/Backlogged
Redeterminations in its calculation of this Performance Standard if the Department
has approved those Untimely Determinations:Untimely Redeterminations and/or
Backlogged Determinations/Redeterminations as being untimely andfor
backlogged because of unusual circumstances as specified in Section 4,
Exemptions.
4.2.1.8.1. The Contractor shall submit documentation with the semi-annual report to
request the Department's approval of that Determination or Redetermination as
being untimely and/or backlogged because of unusual circumstances. The
Contractor shall use the exemption request form in the County Incentives
Program Guide for documentation.
4.2.1.8.2. The Department may approve or reject any request for exemption due to
unusual circumstances and may Iimit the total number of exemption requests.
4.2.1.9. The Department will determine the Contractor's compliance with the Eligibility
Timeliness and Backlog Performance Incentive Standard during each Reporting
Period as specified in Section 3, Determining Compliance with Performance
Incentive Standards.
Page 9 of 19
4.2.1.9.1. Timeliness data and reports for the Eligibility Timeliness and Backlog
Performance Incentive will be pulled the first working day after the end of each
Reporting Period.
4.2.1.9.2. Backlog data and reports for the Eligibility Timeliness and Backlog
Performance Incentive will be pulled the first working Monday of each month
over the entire Reporting Period.
4.2.1.10. A Determination or Redetermination will be considered backlogged for the First
Reporting Period if the due date for the Determination or Redetermination is on or
before December 31 and the Determination or Redetermination was not completed
on or before the due date.
4.2.1.11. A Determination or Redetermination will be considered backlogged for the Second
Reporting Period if the due date for the Determination or Redetermination is on or
before June 30 and the Determination or Redetennination was not completed on or
before the due date.
4.3. Collaboration Performance Incentive Standard
4.3.1. The Contractor may earn a Collaboration Performance Incentive Payment for each
Reporting Period in which it hosted or attended at least one of the types of
Collaboration meetings listed below:
4.3.1.1. Collaborative Vase Conferences - The Contractor will invite the below partner, at
minimum, to participate in at least seventy five percent (75%) of foster care youth
Collaborative Case Conferences and following the below requirements:
4.3.1.1.1. A representative from the county's Regional Care Collaborative Organization
(RCCO).
4.3.1.1.2. Foster care youth are mandatory populations. The Contractor may include
additional child welfare cases, but additional cases will not be included in the
seventy five percent (75%) performance benchmark as specified in Section
4.3.1.1.
4.3.1.1.2.1. The county will provide a template by the semi-annual report due date for
each Reporting Period, found in the County Incentives Program Guide,
attesting to compliance with the seventy five percent (75%) performance
benchmark listed in Section 4.3.1.1.2.
4.3.1.I.2.1.1. The template is subject to audit and any findings that indicate
performance was below the seventy five percent (75%) performance
benchmark will make the Contractor ineligible for a Collaboration
Performance Incentive Payment for the Reporting Period.
4.3.1.1.3. The county and the RCCO must meet at Ieast once per Reporting Period to
establish and evaluate RCCO Collaborative Case Conference participation.
4.3.1.1.3.1. Documentation of the Contractor and RCCO evaluation of Collaborative
Case Conference participation shall be through meeting minutes, agendas,
and sign in sheets attached to the Collaboration Template submitted by the
semi-annual report due date for each Reporting Period.
4.3.1.1.4. If the Contractor has no foster care youth cases to meet the requirements in
4.3.1.1, the Contractor will be deemed to have met the requirements of 4.3.1.1
Page 10 of 19
if the Contractor and Partners meet the requirements of the Alternative
Collaboration listed in 4.3.1.4 and the General Requirements for the
Collaboration Performance Incentive Standard listed in 4.3.1.5.
4.3.1.2. LTSS Collaboration the Contractor will convene with the below partners at least
once per calendar quarter to resolve Long Tenn Care, Home and Community Based
Services (HCBS) and other cases that require additional action beyond a financial
eligibility determination:
4.3.1.2.1. At least one Long Tenn Care Facility that serves Members from the
Contractor's county.
4.3.1.2.2, Single Entry Point (SEP) Agency that serves Members in the Contractor's
county.
4.3.1.2.3. Community Centered Board (CCB) Agency that serves Members in the
Contractor's county.
4.3.1.2.4. The Contractor may include additional partners beyond the mandatory three (3)
partners from those listed in Sections 4.3.1.2.1 through 4.3.1.2.3.
4.3.1.2.5. Documentation of the LTSS Collaboration shall be through meeting minutes,
agendas, and sign in sheets attached to the Collaboration Template submitted
by the semi-annual report due dates for each Reporting Period.
4.3.1.2.5. In the event the Contractor selects the LTSS Collaboration option but has no
complex cases to resolve with the partners mentioned in 4.3.1.2.1 through
4.3.1.2.4, the Contractor will be deemed to have met the requirements of the
LTSS Collaboration so long as the Contractor and Partners meet the
requirements of the Alternative Collaboration listed in 4.3.1.4 and the General
Requirements for the Collaboration Performance Incentive Standard listed in
4.3.1.5.
4.3.1.3. RCCOBHO Collaboration — the county will convene with the below partners at
least once per calendar quarter to better understand the roles and functions of each
partner and improve the relationship between partners to advance two (2) to three
(3) mutually agreed upon goals:
4.3.1.3.1. The RCCO that serves Members in the Contractor's county.
4.3.1.3.2. The BHO that serves Members in the Contractor's county.
4.3.1.3.3. The Contractor may include additional partners beyond the mandatory two (2)
listed in Sections 4.3.1.3.1 through 4.3.1.3.2.
4.3.1.3.4. Documentation of the RCCO:BHO Collaboration shall be through meeting
minutes, agendas, and sign in sheets attached to the Collaboration Template
submitted by the semi-annual report due dates of each Reporting Period.
4.3.1.4. Alternative Collaboration — the county has the option to convene at least once per
calendar quarter, with at least three (3) of the below partners, while advancing two
(2) to three (3) mutually agreed upon goals:
4.3.1.4.1. BHO that serves Members in the Contractor's County.
4.3.1.4.2. Local Public Health Agency (LPHA) that serves Members in the Contractor's
County.
Page 11 of 19
4.3. 1.4.3. Medical Assistance Site (MA Site) that serves Members in the Contractor's
County.
4.3.1.4.4. RCCO that serves Members in the Contractor's County.
4.3. l .4.5. Regional Connect for Health Colorado Partners.
4.3.1.4.6. Hospitals and Clinics that serve Members in the Contractor's County.
4.3.1.4.7. Federally Qualified Health Clinic (FQHC) that serves Members in the
Contractor's County.
4.3.1.4.8. Private Practice Providers such as Medical, Dental or Behavioral Health that
serve Members in the Contractor's County.
4.3.1.4.9. Community Mental Health Centers (CMHC) that serve Members in the
Contractor's County.
4.3.1.4.10. Long-term Care Facilities that serve Members in the Contractor's County.
4.3.1.4.11. Single Entry Point (SEP) Agencies that serve Members in the Contractor's
County.
4.3.1.4.12. Community Centered Boards (CCB) that serve Members in the Contractor's
County.
4.3.I.4.13. County Sheriff/Local Law Enforcement that serves Members in the
Contractor's County.
4.3.I.4.14. Ute Mountain Ute Tribe.
4.3.1.4.15. Southern Ute Indian Tribe.
4.3.1.4.16. If the Contractor chooses the Alternative Collaboration option, the Contractor
must request pre -approval from the Department and provide supporting
documentation prior to the Alternative Collaboration being eligible for a
Collaboration Performance Incentive Payment.
4.3.1.4.16.1. The Department reserves the right to deny any request for pre -approval of
an Alternative Collaboration.
4.3.1.4.17. Documentation of the Alternative Collaboration shall be through meeting
minutes, agendas, and sign in sheets attached to the Collaboration Template
submitted by the semi-annual report due dates of each Reporting Period.
4.3.1.5. General Requirements for the Collaboration Performance Incentive Standard
4.3.1.5.1. The Contractor may host any or all of the meetings in Sections 4.3.1.2, 4.3.1.3
or 4.3.1.4 in collaboration with other counties, but in the event that it does
combine any meeting with another county or other counties, the Contractor
shall provide at least one (1) representative to attend that meeting.
4.3.1.5.2. The Contractor shall develop the meeting agenda for each meeting it hosts,
based on the meeting and collaboration type.
4.3.1.5.2.1. If the Contractor is convening either the RCCOiBHO Collaboration or the
Alternative Collaboration, the agenda shall include the following topics:
4.3.1.5.2.1.1. Recognition of the roles and responsibilities for each of the partners.
Page 12 of 19
4.3.1.5.2.1.2. Cultivating collaboration and the coordination of services among all of
the partner agencies.
4.3.1.5.2.1.3. Establishing two (2) to three (3) goals that the partners would like to
accomplish over the next year to improve clients' access to care.
4.3.1.5.3. In the event that the Contractor hosts a meeting in collaboration with another
county or other counties, then the Contractor may develop the agenda in
collaboration with those other counties.
4.3.1.5.4. The Contractor shall take meeting minutes and compile a list of attendees for
each meeting it hosts. In the event that the Contractor hosts a meeting in
collaboration with another county or other counties, then the Contractor may
create the meeting minutes and list of attendees in collaboration with those other
counties.
4.4. Training Performance Incentive Standard
4.4.1. The Contractor may earn the Training Performance Incentive Payment for each
Reporting Period if at least seventy five percent (75%) of its eligibility technicians
and/or supervisors complete the designated number of hours based on the number of
programs the eligibility technician and/or supervisor works with. This will be based
on the eligibility technician and/or supervisor having the adequate security profile in
CBMS as described in Section 4.4.1.3.
4.4.1.1. The medical assistance eligibility technician andior supervisor will be responsible
for twelve (12) hours of training in the contractual period if the eligibility technician
and/or supervisor has the security profile to only authorize Medical Assistance.
4.4.1.1.1. Eight (8) hours of training must be completed from the Mandatory Courses
listed in Exhibit C as trained by an SDC -certified trainer using SDC -approved
materials.
4.4.1.1.2. An additional four (4) hours of training can be completed through other courses
offered by the Health Care and Economic Security Staff Development Center
(SDC), SDC -certified county trainers or the Department. Other trainings must
be pre -approved, per the process and timelines stated in the County Incentives
Program Guide.
4.4.1.1.3. National, statewide, regional or local training may qualify to meet the Training
Performance Incentive Standard. The Contractor shall seek approval for
training developed by sources other than the SDC, Department or SDC certified
county trainers in advance of submitting the documentation for the Training
Performance Incentive Standard.
4.4.1.1.4. The Contractor shall provide agendas and training content when requesting pre -
approval for trainings not offered by the SDC, the Department, or an SDC -
certified trainer.
4.4.1.2. The eligibility technician and/or supervisor will be responsible for eight (8) hours
of training in the contractual period if the eligibility technician and/or supervisor
has the security profile to authorize Medical Assistance plus one (1) or more
programs from Exhibit D.
Page 13 of 19
4.4.1.2.1. The eight (8) hours of training can be completed from the Mandatory Courses
listed in Exhibit C as trained by an SDC -certified trainer using SDC -approved
materials.
4-4.1-3, Management and Eligibility Enrollment Specialist (EES) CBMS access users are
subject to the Training Performance Incentive Standard.
4.4.2_ The required amount of training can be completed during the First and Second
Reporting Periods, if the required amount is met by the conclusion of the Second
Reporting Period.
4.4.3. The Contractor shall log all eligible training hours in the Department's Learning
Management System (LMS). Only training hours logged in the LMS system will count
towards the Training Performance Incentive Standard.
4.5. Child Welfare Performance Incentive Standard
4.5.1, The Contractor may earn a Child Welfare Performance lncendve Payment in each
Reporting Period in which the Contractor:
4.5.1.1. Maintains enrollment, for each Reporting Period, in the Accountable Care
Collaborative (ACC) for foster care youth at or above the level specified for the
Contractor in the County Incentives Program Guide.
4.5.1.1.1. Enrollment levels in the ACC for foster care youth will be measured oil the first
working day after the end of each Reporting Period.
4.5.1.1.2. The Contractor shall not actively disenroll foster care youth from the ACC.
4.5.1.1.3_ The Contractor is encouraged to enroll foster care youth into the ACC. to
4.5,1-2. Ensures an application for Medicaid State Plan benefits is entered in CBMS within
ten (10) business days of closure of TRAILS Medicaid benefits for a certain
percentage of all foster care youth TRAILS Medicaid closures. The Contractor's
percentage benchmark is in the County Incentives Program Guide,
4.5.1.2.1. If a new application for Medicaid State Plan benefits is unnecessary because
the foster care youth's guardian is currently receiving Medical Assistance, the
Contractor shall ensure that the request for Medical Assistance is entered in
CBMS within ten (10) business days of the foster care youth's TRAILS
Medicaid closure.
4.5, l .2.2. The Contractor will provide the Department, no later than the Second Reporting
Period due date, a written process and/or procedure that details the Contractor's
internal workflow to ensure an application and/or request fnr Medicaid State
Plan benefits is entered in CBMS within ten (10) business days of closure of
TRAILS Medicaid for foster care youth.
4.5.1.3. The Contractor must meet the requirements in both Sections 4.5.1.1 and 4.5.1.2 to
earn a Child Welfare Performance Incentive Payment for the Reporting Period.
4.5.1.4. The Contractor shall ensure foster care youth have only have one Medicaid case,
either State Plan Medicaid through CBMS or TRAILS Medicaid, open at one time_
4.5.1.5. The Contractor shall be exempt for cases where the foster care youth and/or
guardian opts -out of Medical Assistance, enrollment in the ACC, or otherwise
elects to not participate in any of the performance measures listed in Section 4.5_
Page 14 of 19
Foster care youth and/or guardians who opt -out will be removed from the
Department's calculation used to determine if the Contractor meets the
requirements in Section 4.5.
4.5.1.6. If further clarity and/or guidance is needed to implement the Child Welfare
Performance Incentive but is not found in this Amendment or in the County
Incentives Program Guide, the Department will work with the Contractor to provide
additional direction. The Department's decision in these cases is final and not
subject to appeal.
4.6. LTSS Performance Incentive
4.6.1. The Contractor may earn a LTSS Performance Incentive Payment for the Second
Reporting Period if the Contractor:
4.6.1.1. Completes at least eighty-five percent (85%) of all Long Term Care Determinations
and Redeterminations as Timely Determinations and Timely Redeterminations.
4.6.1.1.1. The LTSS Performance Incentive shall follow the same requirements as the
Eligibility Timeliness and Backlog Performance Incentive as found only in
Sections 4.2.1.4, 4.2.1.5, 4.2.1.6, 4.2.1.6.1, 4.2.1.6.2, 4.2.1.7 and 4.2.1.7.1.
4.6.1.2. Utilizes the Department approved DSS 1 form to communicate with Single Entry
Points and/or Community Centered Boards for at least ninety-five percent (95%)
of functional determinations.
4.6.1.2.1. Compliance with the DSS 1 requirement shall be detennined by a random
sample of functional determination cases for the Second Reporting Period..
4.6.1.2.2. If the Contractor utilizes electronic communications and/or workflows and not
the paper DSS 1 form, the Contractor may continue its current process if the data
fields found on the DSS 1 are added to the Contractor's electronic
communications and/or workflows.
4.6.1.3. The Contractor must meet the requirements in both Section 4.6.1.1 and 4.6.1.2 to
earn a LTSS Performance Incentive Payment.
4.6.1.4. If further clarity and/or guidance is needed to implement the LTSS Performance
Incentive but is not found in this Amendment or in the County Incentives Program
Guide, the Department will work with the Contractor to provide additional
direction. The Department's decision in these cases is final and not subject to
appeal.
4.7. Semi -Annual Reporting
4.7.1. The Contractor shall create a Semi -Annual Incentive Report for each Reporting Period
that includes all of the following for the Reporting Period:
4.7.1.1. The meeting agendas, meeting minutes, lists of attendees and goals including the
Collaboration Template to document its compliance with the Collaboration
Incentive Standard.
4.7.1.2. Any Eligibility Timeliness and Backlog Incentive Standard exemption forms for
the Reporting Period.
4.7.1.3. The Training Performance Incentive Standard Template for both Reporting
Periods. The Template is due on the Second Reporting Period due date.
Page 15 of 19
4.7.2. The Contractor shall submit the Semi -Annual Incentive Report to the Department.
4.7.2.1. DELIVERABLE: Semi -Annual Incentive Report
4.7.2.2. DUE: January 5"' for the First Reporting Period ending December 3 i st and July 5"'
for the Second Reporting Period ending June 30"'
5. EXEMPTIONS
5.1. If a Determination or Redetermination is delayed for unusual circumstances as defined
under 10 C.C.R. 2505-8.100.3.D (d), the Contractor is eligible to submit an exemption
form.
5.1.1. The Department will not include any Untimely DetenninationslRedeterminations in its
calculation of the Eligibility Timeliness and Backlog Performance Incentive Standard
ifthe Department has approved that Untimely Determination/Redetermination as being
untimely because of unusual circumstances as specified in 4.1.
5.1.2. The Contractor shall be responsible for submitting one (1) exemption form that details
each of the cases for which the Contractor is requesting an exemption.
5.1.3. The Contractor shall provide adequate information on the exemption form for the
Department to quantify personnel issues if the Contractor requests an exemption due
to staff vacancies, staff training, or other personnel issues.
5.2. The Department may approve or reject any request for Untimely
Determination/Redetermination exemptions and may limit the total number of exempted
Untimely Detenninations/Redetenninations for the Eligibility Timeliness and Backlog
Performance Incentive Standard.
52.1. The Department will deny exemption requests that do not meet timeliness definition
set forth in I0 C,C.R, 2505-8.100.3.D (d) and Section 1.1.12 due to the fault of the
Contractor and/or any exemption requests based on the following:
52.1.1. Failure of the Contractor to timely act on a Determination or Redetennination
which resulted in a failure to meet the timeliness requirements in Sections 1.1.11
and 1.1.12.
5.2.1.2. Failure of the Contractor to act on client verification that was submitted timely
which was requested for a Determination or Redetermination.
5.2.1.3. Failure of the Contractor to manually authorize a Determination or Redetermination
with a mass update exception.
5.2.1.4. Failure of the Contractor to manually authorize a Redetermination when the auto
re -enrollment or Ex Parte processes were not successful.
52.1.5_ Failure of the Contractor to pull any and all applicable COGNOS reports for the
purposes of fulfilling Exhibit A-3, Statement of Work.
5.2.2. The reasons for denial of an exemption as stated in Section 5.2.1 are not all-inclusive
and the Department reserves the right to deny any exemption for reasons not stated in
Section 4.
5.2.2.1. Prior to denying an exemption for reasons beyond those stated in Section 5.2, 1, the
Department may, at its discretion, request further information from the Contractor
to determine whether the request for exemption meets the exemption standards as
stated in Section 5, Exemptions.
Page 16 of 19
6. COMPENSATION
6.1. Compensation
6.1.1. Incentive Payment
6.1.1.1. The Department shall pay the Contractor, after the end of the fiscal year in which
the work was performed, an Performance Incentive Payment for each Performance
Incentive Standard it meets during the applicable Reporting Period as follows:
6.1.1.1.1. The Department shall pay the Contractor an Eligibility Timeliness and Backlog
Performance Standard Payment as shown in Exhibit B for each Reporting
Period that the Contractor meets the requirements for that Performance
Incentive Standard.
6.1.1.1.2. The Department shall pay the Contractor a Collaboration Performance
Incentive Payment as shown in Exhibit B for each Reporting Period that the
Contractor meets the requirements for that Performance Incentive Standard.
6.1.1.1.3. The Department shall pay the Contractor a LTSS Performance Incentive
Payment as shown in Exhibit B for each Reporting Period that the Contractor
meets the requirements for that Performance Incentive Standard.
6.1.1.1.4. The Department shall pay the Contractor a Child Welfare Performance
Incentive Payment as shown in Exhibit B for each Reporting Period that the
Contractor meets the requirements for that Performance Incentive Standard.
6.1.1.1.5. The Department shall pay the Contractor a Training Performance Incentive
Payment as shown in Exhibit B for each Reporting Period that the Contractor
meets the requirements for that Performance Incentive Standard.
6.1.2. Remaining Funds Incentive Pool Payment
6.1.2.1. The Department will create a Remaining Funds Incentive Pool each SFY.
6.1.2.1.1. The Remaining Funds Incentive Pool shall include the following:
6.1.2.1.1.1. The total amount of all base incentive payments allocated to any Contractor
that selected to not participate in the Incentives Performance Standard
Program for that SFY.
6.1.2.1.1.2. Each of the base incentive payments that were not earned by the Contractor
during a Reporting Period in that SFY.
6.1.2.1.2. In the event that the Remaining Funds Incentive Pool is zero dollars ($O.QU) for
any SFY, the Contractor shall not receive a Remaining Funds Incentive Pool
Payment for that SFY.
6.1.2.2. The Remaining Funds incentive Pool will be paid as follows:
6.1.2.2.1. The Contractor shall be eligible for payment from the Remaining Funds
Incentive Pool based on the dollar amount of incentives met during that SFY.
6.1.2.2.2. Based on the proportion of total incentive funds that the Contractor is eligible
to be paid in each SFY, the Contractor shall receive the same proportion of
funds from the Remaining Funds Incentive Pool.
Page 17 of 19
6.1.2.2.3. The Contractor's payment of funds from the Remaining Furids Incentive Pool
shall never exceed the county's share of Medicaid expenditure, as specified in
Section 2, County Determinalions.
6.2. Payment Procedures
6.2.1. The Contractor shall receive an incentive allocation for each of the Reporting Periods
within ninety days (90) days following the end of the fiscal year in which the work was
performed. This allocation will reflect the maximum the Contractor can earn for each
Performance Incentive Standard per Reporting Period.
6.2.2_ Actual Performance Incentive Payment maximums are dependent on the Contractor's
share of Medicaid county administration expenditure. In no event shall the Contractor
be paid more than the Contractor's county share of Medicaid county administration
expenditure in any Reporting Period.
6.2.3. The Department may add any unearned funds from the First Reporting Period into to
the Second Reporting Period allocation for any SFY.
6.2.3.1. The Contractor shall receive the Incentive Performance Payments through the
County Financial Management System (CFMS).
6.2.4. The Department may use any unearned Second Reporting Period Incentive
Performance Payments during the county administration close out process.
6.2.4.1. In the event that the Contractor believes that the calculation or determination of any
payment is incorrect, the Contractor shall notify the Department of the error within
thirty (30) days of receipt of the payment or notification of the determination of the
payment, as appropriate. The Department will review the information presented by
the Contractor and may make changes based on this review. The determination or
calculation that results from the Department's review shall be final, No disputed
payment shall be due until after the Department has concluded its review.
Page 18 of 19
EXHIBIT D, LIST OF COLORADO DEPARTMENT OF HUMAN SERVICES (CDHS)
PROGRAMS FOR TRAINING INCENTIVE
The below list provides a list of eligible CDHS programs that will assist the Contractor in
determining how many training hours are required based on the number of programs each
eligibility technician andior supervisor works.
1. Supplemental Nutrition Assistance Program (SNAP)
I . Temporary Assistance to Needy Families (TANF)
2. Adult Financial
3. Child Welfare
4. Child Support Services
5. Adult Protective Services
6. Low Income Energy Assistance Program (LEAP)
7. Colorado Child Care Assistance Program (CCAP)
8. Employment First
EXHIBIT E, SMALL, MEDIUM AND LARGE COUNTY LIST
The below categorizes counties as small, medium and large for purposes of qualification of
exemptions for timeliness and/or backlog incentives.
Small
Archuleta
Grand
Phillips
Baca
Gunnison
Pitkin
Beni
Hinsdale
Rio Blanco
Cheyenne
Jackson
Routt
Clear Creek
Kiowa
San Juan
Costilla
Kit Carson
San Miguel
Crowley
Lake
Sedgwick
Custer
Lincoln
Summit
Doiores
Mineral
Washington
E Ibert
Ouray
Yuma
Gilpin
Park
Medium
Alamosa
Garfield
Morgan
Broomfield
Huerfano
Otero
Chaffee
La Plata
Prowers
C'onejos
Las Animas
Rio Grande
Delia
Logan
Saguache
Douglas
Moffat
Teller
Eagle
Montezuma
Fremont
Montrose
Large
Adams
Arapahoe
Boulder
Denver
El Paso
Jefferson
Larimer
Mesa
Pueblo
Weld
EXHIBIT F, LIST OF MANDATORY TRAININGS FOR TRAINING PERFORMANCE
INCENTIVE
For the Training Performance Incentive Standard, the Contractor shall select from the list below
of Mandatory Trainings in order to meet the required number of training hours and qualify for a
Training Performance Incentive Payment:
1. Redetermination, Recertification and Reassessment (RRR) Web -based Training
2. Income Training
3. Reasonable Compatibility
4. Buy -In Training
5. Building Foundations for Medical Assistance Programs for eligibility technicians and/or
supervisors gaining CBMS access.
6. Any additional trainings the Department may add. The Department shall communicate to
the Contractor if additional trainings are added that qualify for the Training Performance
Incentive