HomeMy WebLinkAboutC19-212 Colorado Department of Health Care Policy and FinancingContractNumber20160000000000000010A4CONTRACTAMENDMENTNO.4OriginalContractNumber201600000000000000101.PARTIESThisAmendmenttotheabove-referencedOriginalContract(hereinaftercalledthe“Contract”)isenteredintobyandbetweenEagle CountyDepartmentofSocialandHumanServices,(hereinaftercalled“Contractor”),andthe STATEOFCOLORADO,actingbyandthroughtheDepartmentofHealthCarePolicyandFinancing,1570GrantStreet,Denver, Colorado$0203(hereinaftercalled“Department”or“State.”)2.EFFECTIVEDATEANDENFORCEABILITYThisAmendmentshallnotbeeffectiveorenforceableuntilitisapprovedandsignedbytheColoradoStateControllerordesignee (hereinaftercalledthe“EffectiveDate.”)TheDepartmentshallnotbeliabletopayorreimburseContractorforanyperformancehereunder, including, butnotlimitedto,costsorexpensesincurred,orbeboundbyanyprovisionhereofpriortotheEffectiveDate.3.FACTUALRECITALSThePartiesenteredintotheContracttoprovide EarlyandPeriodic Screening,DiagnosisandTreatment(EPSDT) servicesfor EagleCounty.ThepurposeofthisAmendmentistoextendtheContractthroughStateFiscalYear2019-20,toincreasethemaximum amountpayable,andtoreplaceExhibitA,StatementofWork.4.CONSIDERATIONThePartiesacknowledgethatthemutualpromisesandcovenantscontainedherein,andothergood andvaluableconsiderationaresufficientandadequatetosupportthisAmendment.5.LIMITSOFEFFECTThisAmendmentisincorporatedbyreferenceintotheContract,and theContractandallprioramendments thereto,ifany,remaininfullforceandeffectexceptasspecifically modifiedherein.6.MODIFICATIONSTheContractandallprior amendmentsthereto,ifany,aremodifiedasfollows:A.Section5,Term,SubsectionA,InitialTerm,isherebydeletedinitsentiretyandreplacedasfollows:Page1of3C19-212 InitialTermTheparties’respectiveperformancesunderthisContractshallcommenceonthelaterofJuly1,2019,ortheeffectivedate.ThisContractshallexpireJune30,2020,unlesssoonerterminatedorfurtherextendedasspecifiedelsewhereherein.B.Section7,PaymentstoContractors,SubsectionG,MaximumAmount,isherebydeletedinitsentiretyandreplacedasfollows:G.MaximumAmountThemaximumamountpayableunderthisContracttoContractorbytheDepartmentisshowninthefollowingtable,asdeterminedbytheDepartmentfromavailablefunds.PaymentstoContractorarelimitedtotheunpaidobligatedbalanceoftheContract.ThemaximumamountpayablebytheDepartmenttoContractoris:StateFiscalYear2015-2016$26,000.00StateFiscalYear2016-2017$27,000.00StateFiscalYear2017-2018$27,000.00StateFiscalYear2018-2019$27,000.00StateFiscalYear2019-2020$27,000.00TotalforAllStateFiscalYears$134,000.00C.ExhibitA3,StatementofWork,isherebydeletedinitsentiretyandreplacedwithExhibitA4,StatementofWork,attachedheretoandincorporatedbyreferenceintotheContract.AllreferenceswithintheContracttoExhibitA,ExhibitAl,ExhibitA2,and/orExhibitA3shallbedeemedtoreferencetoExhibitA4.D.ExhibitD,HealthyCommunitiesContractDeliverableSchedule-SFY2O2Oisherebyaddedinitsentirety.7.STARTDATEThisAmendmentshalltakeeffectonitsEffectiveDate.8.ORDEROFPRECEDENCEExceptfortheSpecialProvisionsandtheHIPAABusinessAssociatesAddendum,intheeventofanyconflict,inconsistency,variance,orcontradictionbetweentheprovisionsofthisAmendmentandanyoftheprovisionsoftheContract,theprovisionsofthisAmendmentshallinallrespectssupersede,govern,andcontrol.ThemostrecentversionoftheSpecialProvisionsincorporatedintotheContractoranyamendmentshallalwayscontrolotherprovisionsintheContractoranyamendments.9.AVAILABLEFUNDSPage2of3 Financialobligationsofthestatepayableafterthecurrentfiscalyeararecontingentuponfundsforthatpurposebeingappropriated,budgeted,orotherwisemadeavailabletotheDepartmentbythefederalgovernment,stategovernmentand/orgrantor.Page3of3 ContractNumber20160000000000000010A4EXHIBITA-4,STATEMENTOFWORKSECTION1.0PROGRAMPURPOSE1.1.InpartnershipbetweentheDepartmentandHealthyCommunitiesvendors,oursharedobjectiveistoensurethatchildrenandpregnantwomenenrolledinHealthFirstColorado,Colorado’sMedicaidProgram,andChildHealthPlanPlus(CHP+)receivethebestpossiblestartwithrespecttoutilizingthehealthcareservicesandsupportsavailabletothem.1.1.1.Towardthatend,theContractor:1.1.1.1.Providesoutreachtonon-enrolledindividualsandcommunity-basedorganizationsto,bringawarenessofHealthFirstColorado,CHP+andtheHealthyCommunitiesprogram.1.1.1.2.ProvidesoutreachandadministrativecasemanagementtomembersnewlyenrolledintoHealthfirstColoradoandCHP+.1.1.1.3.Directsmemberstoprimaryandspecialtymedicalprovidersasneeded.1.1.1.4.Directsmemberstocommunity-basedorganizationsandagenciesfornon-medicalservices.1.1.1.5.Coordinateswithcommunity-basedorganizations,theDepartmentandotherDepartmentcontractorstoassisttheminimprovingoverallhealthoutcomesasdeterminedbytheDepartment.1.1.1.5.1.Specifically,theContractor’sworkhelpstheDepartmentattainitsgoaltoincreasewell-childandoralhealth(EPSDTRates)toeightypercent(80%);toincreasechildleadscreeningtoonehundredpercent(100%)forchildrenatagesrecommendedbytheAdvisoryCommitteeonChildhoodLeadPoisoningPrevention(ACCLPP)andtoimproveeducationandoutcomesaroundmaternitysupportandthebenefitsandadvantagesofprenatalcareforpregnantwomen.SECTION2.0ACRONYMS,ABBREVIATIONS,DEFINITIONSANDOTHERTERMINOLOGY2.1.Acronyms,abbreviationsandotherterminologyaredefinedattheirfirstoccurrenceinthisStatementofWork.Thefollowinglistisprovidedtoassistthereaderinunderstandingacronyms,abbreviationsandterminologyusedthroughoutthisdocument.22.AcceptanceStatus—IndicationtotheContractorofwhetheradeliverablehasbeenAccepted(asreceived),AcceptedwithChanges,orNotAccepted.DeliverablesdeemedAcceptedwithChangesorNotAcceptedwillbeaccompaniedbytheactionstobetakentobringthedeliverabletoanAcceptedstatusaswellasadeadlineforitscompletion.Unlessotherwisestated,theDepartmentshallprovidecontractorwithnoticeofadeliverable’sacceptancestatuswithin30days.23.AdministrativeCaseManagement—assistingmembersandtheirfamilyrepresentativesto navigateColorado’spublicheaLthcaresystemtoaddressconcernsregardingeligibilityandenrollmentintheirrespectiveMedicalAssistancePrograminctudingapplicationassistanceasnecessary.2.4.BusinessDay-AnydayinwhichtheDepartmentisopenandconductingbusiness,butshallnotincludeSaturday,SundayorLegalHolidaysaslistedin§24-11-101(1),C.R.S.2.5.BusinessInterruption-AnyeventthatdisruptstheContractor’sabilitytocompletetheWorkforaperiodoftime,andmayinclude,butisnotlimitedtoaDisaster,poweroutage,strike,lossofnecessarypersonnelorcomputervirus.2.6.ChildHealthPlanPlus(CHP+)—CHP+isColorado’sChildren’sHealthInsuranceProgram(CHIP).ATitleXXIprogram,itisalow-costhealthinsuranceprogramforuninsuredColoradochildrenunderage19andprenatalwomenwhosefamiliesearntoomuchtoqualifyforHealthfirstColoradobutcannotaffordprivateinsurance.2.7.CloseoutPeriod-Theperiodbeginningontheearlierofninety(90)dayspriortotheendofthelastExtensionTermornoticebytheDepartmentofitsdecisiontonotexerciseitsoptionforanExtensionTerm,andendingonthedaythattheDepartmenthasacceptedthefinaldeliverablefortheCloseoutPeriod,asdeterminedintheDepartment-approvedandupdatedCloseoutPlan,andhasdeterminedthatthecloseoutiscomplete.2.8.CommunityResources-Anyprivate,nonprofitorgovernmentalorganization,entity,individualorprogramthatmayhelpmeetthenon-medicalneedsofamemberortheirfamily—especiallythoseneedsthatmaypresentabarriertothememberaccessingmedicalcareandfullyutilizingthebenefitsavailabletothemthroughtheMedicalAssistanceProgram.2.9.Disaster-AneventthatmakesitimpossiblefortheContractortoperformtheWorkoutofitsregularfacility,andmayinclude,butisnotlimitedto,naturaldisasters,fireorterroristattacks.2.10.EligibleButNotEnrolled(EBNE)—PregnantwomenandchildrenwhomaybeeligibleforHealthfirstColoradoorChildHealthPlanPlus,butwhomaynotbeenrolledintheprogram.2.11.EBNEOutreach—ToactivelygenerateawarenessandprovideeducationtowomenandchildrencurrentlynotenrolledintheHealthyCommunitiesbutwhomaybeeligible.SuchoutreachmayincludedirectcommunicationwithEBNEpopulations,individuallyorasgroups,aswellasindirectlyviaotherorganizationswhomayworkdirectlywiththispopulation.2.12.EarlyandPeriodicScreening,DiagnosticandTreatment(EPSDT)Rates-Well-childvisitsascountedontheCentersforMedicareandMedicaidServicesEarlyandPeriodicScreening,DiagnosticandTreatment(CMSEPSDT)416report.2.13.HealthfirstColorado,Colorado’sMedicaidProgram—ThenameforColorado’sMedicaidprogram.2.14.HealthyCommunitiesMemberRelationshipManagementSystem—ASalesforce-baseddatabasemanagedbytheDepartment.2.15.Inform—AnoundescribingtheactofprovidinginformationtoHealthfirstColoradoandColoradoChildHealthPlanPlusmembersbytheContractor.TheHealthyCommunities ProgramutilizesseveralInformsincluding,butnotlimitedto,HealthfirstColoradoNewMember(Child)Inform,ColoradoChildHealthPlanPlusNewMember(Child)Inform,HealthfirstColoradoNewMember(Pregnant)Inform,ColoradoChildHealthPlanFlitsNewMember(Pregnant)Inform.2.16.Member-AnyindividualwhoiseligibleforEPSDTthroughHealthFirstColorado,apregnantwomanenrolledinHealthFirstColoradooranypersonenrolLedintheCHP+program.Whenreferringtoamemberwhoisaminor,membermayincludethemember’sparent,guardianorotherfamilyorpersonalrepresentative.MemberhasthesamemeaningasandreplacesthetermClient.2.17.MemberOnboarding—Outreach,navigationandeducationservicestoMembersortheirfamilyrepresentative.2.18.NewlyEnrolledMemberList—ThelistofmemberswhohaverecentlybecomeeligibleforaColoradoMedicalAssistanceProgram.ThelistisprovidedbytheDepartmenttotheContractorviatheHealthyCommunitiesMemberRelationshipManagementSystem.2.19.OperationalStartDate-ThelaterofJuly1,2019,orwhentheDepartmentauthorizestheContractortobeginfulfillingitsobligationsundertheContract.220.PersonallyIdentifiableInformation(P11)—Personallyidentifiableinformationincluding,withoutlimitation,anyinformationmaintainedbytheStateaboutanindividualthatcanbeusedtodistinguishortraceanindividual’sidentity,suchasname,SocialSecurityNumber,dateandplaceofbirth,mother’smaidenname,orbiometricrecords;andanyotherinformationthatislinkedorlinkabletoanindividual,suchasmedical,educational,financial,andemploymentinformation.P11includes,butisnotlimitedto,allinformationdefinedaspersonallyidentifiableinformationin§24-72-501,C.R.S.221.ProtectedHealthInformation(PHI)-Anyprotectedhealthinformation,including,withoutlimitationanyinformationwhetheroralorrecordedinanyformormedium:(1)thatrelatestothepast,presentorfuturephysicaLormentaLconditionofanindividual;theprovisionofhealthcaretoanindividual;orthepast,presentorfuturepaymentfortheprovisionofhealthcaretoanindividual;and(ii)thatidentifiestheindividualorwithrespecttowhichthereisareasonablebasistobelievetheinformationcanbeusedtoidentifytheindividual.PHIincludes,butisnotlimitedto,anyinformationdefinedasIndividuallyIdentifiableHealthInformationbythefederalHealthInsurancePortabilityandAccountabilityAct.222.Provider—AnyhealthcareprofessionalorentitythathasbeenacceptedasaproviderintheColoradoMedicaidprogram,Colorado’sCHP+program,ortheColoradoIndigentCareProgram,asdeterminedbytheDepartment.223.Referral-TooffertoaMemberorhis/herrepresentativethecontactinformationforanindividualoralistofcommunity’partnersorProviderstohelpmeettheMember’sindividualneeds.224.RegionalAccountableEntity(RAE)—UnderPhaseIIoftheAccountabLeCareCollaborative(ACC),thesingleregionalentityresponsibleforadministeringtheACCprograminadesignatedregion.Work—ThetasksandactivitiestheContractorisrequiredtoperformtofulfillitsobligationsundertheContract,includingtheperformanceofanyservicesanddeliveryofanygoods. SECTION3.0CONTRACTOR’SGENERALREQUIREMENTS3.1.TheDepartmentwillcontractwithonlyone(1)organization,theContractor,andwillworksolelywiththatorganizationwithrespecttoalltasksanddeliverablestobecompleted,servicestoberenderedandperformancestandardstobemet.3.2.TheContractormaybeprivytointernalpolicydiscussions,contractualissues,pricenegotiations,confidentialmedicalinformation,Departmentfinancialinformation,andadvanceknowledgeoflegislation.InadditiontoallotherconfidentialityrequirementsoftheContract,theContractorshallalsoconsiderandtreatanysuchinformationasconfidentialandshallonlydiscloseitinaccordancewiththetermsoftheContract.3.3.TheContractorshallworkcooperativelywithkeyDepartmentstaffand,ifapplicable,thestaffofotherDepartmentcontractorsorotherStateagenciestoensurethecompletionoftheWork.TheDepartmentmay,initssolediscretion,useothercontractorstoperformactivitiesrelatedtotheWorkthatarenotcontainedintheContractortoperformanyoftheDepartment’sresponsibilities.IntheeventofaconflictbetweentheContractorandanyotherDepartmentcontractor,theDepartmentwillresolvetheconflictandtheContractorshallabidebytheresolutionprovidedbytheDepartment.3.4.TheContractorshallinformtheDepartment,uponrequest,oncurrenttrendsandprovideinformationonnewtechnologiesinusethatmayimpacttheContractor’sresponsibilitiesunderthisContract.3.5.Deliverables35.1.AlldeliverablesshallmeetDepartment-approvedformatandcontentrequirements.TheDepartmentwillspecifythenumberofcopiesandmediaforeachdeliverable.352.Eachdeliverablewillfollowthedeliverablesubmissionprocessasfollows:3.5.2.1.TheContractorshallsubmiteachdeliverabletotheDepartmentforreviewandapprovalusingDepartment-createdformsortemplateswhenavailable.3.5.2.2.TheDepartmentwillreviewthedeliverableandmaydirecttheContractortomakechangestothedeliverable.TheContractorshallmakeallchangeswithinten(10)BusinessDaysfollowingtheDepartment’sdirectiontomakethechangeunlesstheDepartmentprovidesalongerperiodinwriting.TheDepartmentmaynotusethissectiontomakesubstantialsubstantivechangestotheWork.3.522.1.ChangestheDepartmentmaydirectinclude,butarenotlimitedto,modifyingportionsofthedeliverable,requiringnewpagesorportionsofthedeliverable,requiringresubmissionofthedeliverableorrequiringinclusionofinformationthatwasleftoutofthedeliverable.3.523.TheDepartmentmayalsodirecttheContractortoprovideclarificationorprovideawalkthroughofeachdeliverabletoassisttheDepartmentinitsreview.TheContractorshallprovidetheclarificationorwalkthroughasdirectedbytheDepartment.352.4.OncetheDepartmenthasreceivedanacceptableversionofthedeliverable,includingallchangesdirectedbytheDepartment,theDepartmentwillnotifytheContractorofitsacceptanceofthedeliverableinwriting.AdeliverableshallnotbedeemedacceptedpriortotheDepartment’snoticetotheContractorofitsacceptanceofthatdeliverable. 353.TheContractorshallemployaninternalqualitycontrolprocesstoensurethatalldeliverables,documentsandcalculationsarecomplete,accurate,easytounderstandandofhighquality.TheContractorshallprovidedeliverablesthat,ataminimum,areresponsivetothespecificrequirementsforthatdeliverable,organizedintoaLogicalorder,containnospellingorgrammaticalerrors,areformatteduniformLyandcontainaccurateinformationandcorrectcalculations.TheContractorshallretainalldraftandmarked-updocumentsandchecklistsutilizedinreviewingdeliverablesforreferenceasdirectedbytheDepartment.35.4.IfanyduedateforadeliverableweretofallonadaythatisnotaBusinessDay,thentheduedateshallbeautomaticallyextendedtothenextBusinessDay,unlessotherwisedirectedbytheDepartment.355.AllduedatesortimeLinesthatreferenceaperiodofdays,monthsorquartersshallbemeasuredincalendardays,monthsandquartersunlessspecificallystatedasbeingmeasuredinBusinessDaysorotherwise.AlltimesstatedintheContractshallbeinMountainTime,adjustedforDaylightSavingTimeasappropriate,unlessspecificallystatedotherwise.35.6.Nodeliverable,report,data,procedureorsystemcreatedbytheContractorfortheDepartmentthatisnecessarytofulfillingtheContractor’sresponsibilitiesundertheContract,asdeterminedbytheDepartment,shallbeconsideredproprietary.35.7.IfanydeliverablecontainsongoingresponsibilitiesorrequirementsfortheContractor,suchasdeliverablesthatareplans,policiesorprocedures,thentheContractorshallcomplywithallrequirementsofthemostrecentlyapprovedversionofthatdeliverable.TheContractorshallnotimplementanyversionofanysuchdeliverablepriortoreceiptoftheDepartment’swrittenapprovalofthatversionofthatdeliverable.OnceaversionofanydeliverabledescribedinthissubsectionisapprovedbytheDepartment,allrequirements,milestonesandotherdeliverablescontainedwithinthatdeliverableshallberequirements,milestonesanddeliverablesofthisContract.35.8.Anydeliverabledescribedasanupdateofanotherdeliverableshallbeconsideredaversionoftheoriginaldeliverableforthepurposesofthissubsection.35.9.AllDeliverablesshallbesubmittedontheDepartment-providedtemplate(ifavailable).AllDeliverablesubmissionsmustbesignedbyanauthorizedContractorrepresentative.UseofAdobeeSigntocreateandapplyanelectronicsignatureispermitted.3.6.StatedDeliverablesandPerformanceStandards3.6.1.AnysectionwithinthisStatementofWorkheadedwithorincludingtheterm“DELIVERABLE”or“PERFORMANCESTANDARD”isintendedtohighlightadeliverableorperformancestandardcontainedinthisStatementofWorkandprovideaclearduedatefordeliverables.Thesectionswiththeseheadingsarenotintendedtoexpandorlimittherequirementsorresponsibilitiesrelatedtoanydeliverableorperformancestandard.-3.7.CommunicationRequirements3.7.1.CommunicationwiththeDepartment3.7.1.1.TheContractorshallenableallContractorstafftoexchangedocumentsandelectronic fileswiththeDepartmentstaffinformatscompatiblewiththeDepartment’ssystems.TheDepartmentcurrentlyusesMicrosoftOffice2013and/orMicrosoftOffice365forPC.IftheContractorusesacompatibleprogramthatisnotthesystemusedbytheDepartment,thentheContractorshallensurethatalldocumentsorfilesdeliveredtotheDepartmentarecompletelytransferrableandreviewable,withouterror,ontheDepartment’ssystems.3.7.2.CommunicationwithMembers,ProvidersandOtherEntities3.721.TheContractorshalluseSMS/textmessaging,e-mailandlettertemplatesstoredintheHealthyCommunitiesMemberRelationshipManagementSystemforallwrittenMembercommunicationswhenappropriatetousethem.3.722TheContractorshalluseanencryptedmeansofcommunicationwhenconveyingmemberPHIorP11electronically.InallcaseswhencommunicatingmemberinformationtotheDepartment,itisencouragedtousetheHealthyCommunitiesMemberRelationshipManagementSystemthroughitsnon-groupcommunication(chat,individualmessagingand@messaging)methods.3.7.3.ProgramPresenceandInformationAssurance3.73.1.TheContractorshallmaintainadedicatedphonelinetoreceivecallsfromMemberswithquestionsabouttheHealthyCommunitiesProgram.3.732ThededicatedphonelineshallbeansweredwithaHealthyCommunitiesProgram-specificgreetingwhenansweredlive.3.733.ThededicatedphonelineshallhaveaHealthyCommunitiesProgram-specificoutgoingvoicemessagewhenthephonecannotbeansweredbyaliveagent.3.73.4.UnlessotherwiseapprovedinwritingbytheDepartment,theoutgoingvoicemessageshallincludeanEnglishandSpanishversionofthemessageor,provideaphone-treeoptionforSpanish-speakingcallerstoselecttoreceivethesameinformationinSpanish.3.735.TheContractorshallmaintainanofficethatHealthyCommunitiesMembersmayvisitwithquestionsabouttheHealthyCommunitiesProgram.3.73.6.TheContractorshallassurethatMembershaveacc’esstoHealthyCommunitiesProgramstaffandinformationby:3.73.7.ProvidingandmaintainingameansbywhichMemberscancommunicatewithstaffduringregularbusinesshoursandensureMembersmayleavevoicemessages,emailmessagesortextmessages,ifavailable,andhavetheirmessagesreturnedwithintwobusinessdays.3.73.8.MakingprograminformationavailableontheContractororganization’swebsitewhereitmaybeeasilyseenorfoundbymembersusingasimplesitesearchandcontaining,atminimum:howtoreachContractorprogramstaff,hourstheyareavaiLable,locationofHealthCommunitiesProgramstaffforin-personvisits,linkstoDepartmentprogramwebsite,andbasicinformationabouthowtheHealthyCommunitiesProgrammayhelpthemember.3.73.9.TheContractorshallpublishtheHealthyCommunitiesProgram’sstatewidetoll-freenumber(844-511-KIDS(5437))onallitsHealthyCommunitiesProgram informationsourcesinadditionto,orinsteadof,thelocaltelephonenumberitcurrentlypublishes.3.73.10.Ensuringaltreceptionstaff,includingtheirbackupandtemporaryreplacementstaff,arefamiliarwithhowtoconnectMemberswithHealthyCommunitiesProgramstaffwhetherinperson,telephoneorroutingemail,voicemailorwebsiteinquiries.3.73.11.ReportingtotheDepartmenttheContractor’spublishedHealthyCommunitiesProgramphonenumber,thelinktotheHealthyCommunitiesProgramwebsite,thehoursstaffareavailableandhowinternalreceptionstaffaretrainedtomeetthisrequirement.3.73.12DELIVERABLE:ProgramPresenceandInformationAssuranceReport373.13.DUE:Withinsixty(60)daysoftheContractEffectiveDate.3.7.4.CommunicationPlan3.7.4.1.TheContractorshallcreateaCommunicationPlanthatincludes,butisnotlimitedto,following:3.7.42AdescriptionofhowtheContractorwillcommunicatetoMembersanychangestotheservicesthoseMemberswillreceiveorhowthoseMemberswillreceivetheservices.3.7.43.Adescriptionofthecommunicationmethods,includingthingssuchasemaillists,newslettersandothermethods,theContractorwillusetocommunicatewithProvidersandSubcontractor.37.4.4ThespecificmeansofimmediatecommunicationwithMembersandamethodforacceleratingtheinternalapprovalandcommunicationprocesstoaddressurgentcommunicationsorcrisissituations.37.45.AgeneralplanforhowtheContractorwilladdresscommunicationdeficienciesorcrisissituations,includinghowtheContractorwillincreasestaff,contacthoursorotherstepstheContractorwilltakeifexistingcommunicationmethodsforMembersorProvidersareinsufficient.37.46.AlistingofthefollowingindividualswithintheContractor’sorganization,thatincludescellphonenumbersandemailaddresses:3.7.47.AnindividualwhoisauthorizedtospeakontherecordregardingtheWork,theContractoranyissuesthatarisethatarerelatedtotheWork.37.48.AnindividualwhoisresponsibleforanywebsiteormarketingrelatedtotheWork.37.4.9.Back-upcommunicationstaffthatcanrespondiftheotherindividualslistedareunavailable.3.7.4.10.TheContractorshalldelivertheCommunicationPlantotheDepartmentforreviewandapproval.37.4.11.DELIVERABLE:CommunicationPlan374.12DUE:Withinforty-five(45)BusinessDaysaftertheEffectiveDate3.7.413.TheContractorshallreviewitsCommunicationPlanonanannualbasisanddetermineifanychangesarerequiredtoaccountforanychangesintheWork,intheDepartment’sprocessesandproceduresorintheContractor’sprocessesand procedures.TheContractorshallsubmitanAnnualCommunicationPlanUpdatethatcontainsallchangesfromthemostrecentlyapprovedpriorCommunicationPlan,AnnualCommunicationPlanUpdateorInterimCommunicationPlanUpdateorshallnotethattherewerenochanges.3.7.414.DELIVERABLE:AnnualCommunicationPlanUpdate3.7.4.15.DUE:Withinthirty(30)daysfromthedateofthechange3.7.4.16.TheDepartmentmayrequestachangetotheCommunicationPlanatanytimetoaccountforanychangesintheWork,intheDepartment’sprocessesandproceduresorintheContractor’sprocessesandprocedures,ortoaddressanycommunicationrelateddeficienciesdeterminedbytheDepartment.TheContractorshallmodifytheCommunicationPlanasdirectedbytheDepartmentandsubmitanInterimCommunicationPlanUpdatecontainingallchangesdirectedbytheDepartment.3.7.4.17.DELIVERABLE:CommunicationPlanUpdate3.7.4.18.DUE:Withinthirty(30)BusinessDaysfollowingthereceiptoftherequestfromtheDepartment,unlesstheDepartmentallowsforalongertimeinwriting3.8.BusinessContinuity3.8.1.TheContractorshallcreateaBusinessContinuityPlanthattheContractorwillfollowtocontinueoperationsafteraDisasteroraBusinessInterruption.TheBusinessContinuityPlanshallincludebutisnotlimitedtothefollowing:3.8.1.1.HowtheContractorwillreplacestaffthathasbeenlostorisunavailableduringorafteraBusinessInterruptionsothattheWorkisperformedinaccordancewiththeContract.3.8.1.2.HowtheContractorwillback-upallinformationnecessarytocontinueperformingtheWork,sothatnoinformationislostbecauseofaBusinessInterruption.3.8.1.3.IntheeventofaDisaster,theplanshallalsoincludehowtheContractorwillmakeallinformationavailableatitsback-upfacilities.3.8.1.4.HowtheContractorwillminimizetheeffectsonMembersofanyBusinessInterruption.3.8.1.5.HowtheContractorwillcommunicatewiththeDepartmentduringtheBusinessInterruptionandpointsofcontactwithintheContractor’sorganizationtheDepartmentcancontactintheeventofaBusinessInterruption.3.8.1.6.Plannedlong-termback-upfacilitiesoutofwhichtheContractorcancontinueoperationsafteraDisaster.3.8.1.7.ThetimeitwilltaketotransitionallactivitiesfromtheContractor’sregularfacilitiestotheback-upfacilitiesafteraDisaster.3.8.2.TheContractorshalldelivertheBusinessContinuityPlantotheDepartmentforreviewandapproval.3.8.2.1.DELIVERABLE:BusinessContinuityPlan3.8.2.2.DUE:Withinforty-five(45)BusinessdaysaftertheEffectiveDate3.8.3.TheContractorshallreviewitsBusinessContinuityPlanatleastsemi-annuallyand updatetheplanasappropriatetoaccountforanychangesintheContractor’sprocesses,proceduresorcircumstances.TheContractorshallsubmitanUpdatedBusinessContinuityPlanthatcontainsaltchangesfromthemostrecentlyapprovedpriorBusinessContinuityPlanorUpdatedBusinessContinuityPlanorshallnotethattherewerenochanges.3.8.3.1.DELIVERABLE:UpdatedBusinessContinuityPlan3.8.3.2.DUE:Withinthirty(30)daysfromthedateofthechange.3.8.4.IntheeventofanyBusinessInterruption,theContractorshallimplementitsmostrecentlyapprovedBusinessContinuityPlanorUpdatedBusinessContinuityPlanimmediatelyaftertheContractorbecomesawareoftheBusinessInterruption.Inthatevent,theContractorshallcomplywithallrequirements,deliverables,timelinesandmilestonescontainedintheimplementedplan.3.9.DepartmentSystemAccess3.9.1.IftheContractorrequiresaccesstoanyDepartmentcomputersystemtocompletetheWork,theContractorshallhaveandmaintainallhardware,softwareandinterfacesnecessarytoaccessthesystemwithoutrequiringanymodificationtotheDepartment’ssystem.TheContractorshallfollowallDepartmentpolicies,processesandproceduresnecessarytogainaccesstotheDepartment’ssystems.3.10.HIPAAPolicies3.10.1.TheContractorshalldevelopanddeliveraHIPAAPolicytotheDepartmentforreviewandapproval.TheHIPAAPolicyshalladdresstheContractor’spoliciesforProtectedHealthInformation(PHI),technologiesinplaceforprotectingPHI,andtrainingsprovidedtoContractorstaff.3.10.1.1.DELIVERABLE:HIPAAPolicy3.10.1.2.DUE:Ten(10)BusinessDaysAftertheEffectiveDate3.102TheContractorshallupdatetheirHIPAAPolicy,atleastannually,toincludeanytechnical,proceduralorotherchangesanddeliverthisHIPAAPolicyUpdatetotheDepartmentforreviewandapproval.3.10.2.1.DELIVERABLE:UpdatedHIPAAPolicy3.10.2.2.DUE:Withinthirty(30)daysfromthedateofthechange.3.11.OnboardingPlan3.11.1.TheHealthyCommunitiesContractorshallcreateanannualonboardingplantodescribehowtheHealthyCommunitiesContractorandtheRAEwillpartnertoonboardeligibleMemberssuccessfully.Theannualonboardingplanshallinclude,butisnotlimitedto,thefollowinginformation:3.11.1.1.SharedgoalsandobjectivesforMemberonboarding.3.11.1.2.TargetedstrategiesandactivitiesthatwillbeimplementedtomaximizeMemberoutreachandimprovehealthoutcomes.3.11.1.3.Anyinnovativepilotprojectsthatarebeinginitiatedtogether.3.11.1.4.Timelines. 3.11.2.DELIVERABLE:OnboardingPlan3.11.3.DUE:AnnuallybySeptember30andwithinthirty(30)daysfromwhenanyagreedmodificationsaremade,thereafter.3.11.4.TheContractorshallupdatetheOnboardingPlanincollaborationwiththeirRAEatleastanntially.SECTION4.0PERSONNELGENERALREQUIREMENTS4.1.PersonnelGeneralRequirements4.1.1.TheContractorshallprovidequalifiedpersonnelasnecessarytoperformtheWorkthroughoutthetermoftheContract.TheContractorshallprovidetheDepartmentwithafinallistofpersonnelassignedtotheContract.4.12.TheContractorshalldesignateastaffmembertoserveasProjectLead.TheProjectLeadshallmonitorallprojectactivities,ensurethecompletionofallWorkinaccordancewiththeContract’srequirements,andwillactastheprimarypointofcontactwiththeDepartmentforallcommunications,tasksanddeliverables.4.13.TheContractorshalldesignateaBackupProjectLeadwhowillactasProjectLeadintheeventofProjectLead’sabsenceextendingmorethanthree(3)businessdays.4.1.4.TheContractorshalldesignatetheAccountingContactwhowillactastheprimarypointofcontactforquestionsandconcernsregardingbudgets,reimbursementrequests,invoicesorexpenditures.4.1.5.DELIVERABLE:FinallistofnamesofthepersonnelassignedtotheContract,including,atminimum,theProjectLead,BackupProjectLeadandAccountingContact.4.1.6.DUE:Withinfive(5)BusinessDaysfollowingtheEffectiveDate4.12.IfanyoftheContractor’spersonnelarerequiredtohaveandmaintainanyprofessionallicensureorcertificationissuedbyanyfederal,stateorlocalgovernmentagency,thentheContractorshallmaintaincopiesofsuchcurrentlicensesandcertificationsandprovidethemtotheDepartmentuponrequest.4.13.TheContractorshallensurethatallpersonnelhavesufficienttrainingandexperiencetocompleteallportionsoftheWorkassignedtothem.TheContractorshallprovideallnecessarytrainingtoitspersonnel,exceptforDepartment-providedtrainingspecificallydescribedintheContract.‘HA.Subcontractors4.1.4.1.TheContractormaysubcontracttocompleteWorkrequiredbytheContract.TheconditionsforusingaSubcontractororSubcontractorsareasfollows:4.1.4.2.TheContractorshallprovidetheorganizationalnameofeachSubcontractorandallitemstobeworkedonbyeachSubcontractortotheDepartment.4.1.4.3.TheContractorshallobtaintheDepartment’spriorconsentandwrittenapprovalforanyuseofSubcontractor(s).4.1.4.4.TheContractorshallmakeorallowforappropriatearrangementsforSubcontractor stafftofullyparticipateinDepartmentrequiredtrainings,annualconferences,meetingsandsitevisits,includingsitevisitstotheSubcontractorsite.4.1.4.5.DELIVERABLE:NameofeachSubcontractorentity,contactinformationofstaffperformingsubcontractwork,alistofitemsonwhicheachSubcontractorwillworkandacopyofanyagreements,contracts,memorandaofunderstandingusedtocarryouttheworkoftheContractregardlessofwhetherfundsareexchanged.4.1.4.6.DUE:Thelaterofthirty(30)dayspriortotheSubcontractorbeginningworkortheEffectiveDate.forotheragreements,contractsandmemorandaofunderstanding,copiesofsameareduewithinthirty(30)daysofenteringtheagreement.4.1.5.TheContractorshallfullycooperatewiththeschedulingofandparticipationinanysitereviewsbyaDepartmentdesigneeaswellasanyfollowupmeetingsdeemednecessarybytheDepartmenttoaddressspecificissuesrequiringcorrectiveaction.4.1.6.TheContractorshallhaveatleastone(1)memberofitsstaffattend,inperson,viaconferencecallorwebconferencingwhenavailable,atleastninety(90)percentofallregularHealthyCommunitiesfamilyHealthCoordinatormeetings.4.1.7.Ifallappropriatestaffandsubcontractorstaffcannotattendanygivenmeeting,theContractorshallensuretheyallareprovidedthesametrainingasthoseinattendance.4.1.8.TheContractorshallnotifytheDepartmentatleastwithinone(1)BusinessDaywhenanyindividual,employee,intern,orsubcontractorwithaccesstoDepartmentdatasystemsleavesemploymentandatleastwithinfive(5)BusinessDaysofhiringanewemployee.4.1.9.TheContractorshallensureallprovisionsofthisContractwillbecarriedoutduringsuchemployment/subcontractorgapsortransitionsandshallsecurereplacementswithinthirty(30)days.SECTION5.0PROJECTREQUIREMENTS5.1.TheContractorshallserveastheHealthyCommunitiesContractorforEagleCounty.5.2.TheContractorshallcompletetheWorkpursuanttotheDepartment’spoliciesincludingtheDepartment’sHealthyCommunitiesMemberRelationshipManagementSystemprocedures.TheseproceduresmaybeupdatedregularlybytheDepartmentviaawebsite.TheContractorshallcomplywithallupdatedprocedures.5.3.RegionalAccountableEntity(RAE)Coordination5.3.1.TheContractorshallworkcollaborativelywithitsRAEorRAEs,ifapplicable,toalignandcoordinateonboardingandoutreachactivities.53.1.1.Toenableacollaborativepartnership,theContractorshallestablishadocumentedagreement,eitheraMemorandumofUnderstanding(MOU)oracontract,withtheRAEorRAEs,ifapplicable,thatservethesamecountyorcountiestheContractorservesinaccordancewiththeACCPhaseIIImplementation—RAEandHealthyCommunitiesCollaborationpolicydocumenteffectiveJuly1,2018.53.12DELIVERABLE:CopyofMOUorcontractwithRAEorRAEs,ifapplicable.53.13.DUE:Withinthirty(30)daysofthecompletionoftheagreementandthirty(30)days fromthedateofanymodificationstotheagreementbutnolaterthanSeptember30,2019,unLessadatechangeisapprovedinwritingbytheDepartment.53.1.4.DELIVERABLE:RAEMeetingScheduleforthecontractperiod.53.15.DUE:ByJuly31,2019,unlessadatechangeisapprovedinwritingbytheDepartment.5.4.EBNEOutreach5.4.1.TheContractorshallconduct,onaveragethroughoutthecontractperiod,aminimumofone(1)EBNEoutreachactivityperquarterforeachcountyitservesunderthecontract.5.4.1.1.Outreachmayinclude,butisnotlimitedto,thefollowingactivities:5.4.1.1.1.Healthfairs.5.4.1.1.2.Back-to-schoolnights.5.4.1.1.3.Workshops,presentations,andin-serviceannouncementstocommunity-basedorganizationsandagencieswhointeractwiththesimilarpopulationsservedbyHealthyCommunities.5.42Theoutreachinformationshall,ataminimum,incLudethefolLowingprograminformation:V5.42.1.InformationdescribingHealthFirstColorado(Colorado’sMedicaidProgram)andChildHealthPlanFlits(CHP+)includingbasiceligibilityrequirementsfortheseprograms,benefitsandservices.5.422.HowandwheretheEBNEindividualcanapplyforMedicalAssistance.5.423.InformationabouttheroleoftheRAEincoordinatingMembercareandprovidingothersupportinaccordancewiththeOnboardingPlan.542.4.InformationabouttheservicesandresourcesprovidedbyFamilyHealthCoordinators.5.43.TheContractorshallassistEBNEswiththeapplicationprocess,whichmayincludeanyofthefollowing:5.43.1.CompletingapaperColoradoMedicalAssistanceProgramsapplicationortheColoradoProgramEligibilityandApplicationKit(PEAK),downloadingthePEAKfIealth(Smartphone)Application,linkingtheapplicationtotheMember’sPEAKaccountandprovidingbasicinformationabouthowtousetheapplicationorwheretofindadditionalhelp.5.432.ProvidingonsitePresumptiveEligibility(PE)determinationsforthosewhomayqualify.5.433.Providinganappropriatereferral,whennecessary,toanotherapplicationassistancesite,including,butnotlimitedto,alocaldepartmentofhumanorsocialservices,aPEsite,aCertifiedApplicationAssistantSite(CAAS),oraMedicalAssistance(MA)site.5.5.MemberOnboarding5.5.1.TheContractorshallassistMembersenrolledinHealthFirstColoradoandCHP+withnavigatingtheprograms. 5.5.2.InaccordancewiththeOnboardingPlan,theContractorshallperformthefollowingtasksforallindividualswhoqualifyfortheHealthyCommunitiesProgram:5.5.2.1followupwithpregnantwomen,children,families,andEBNEsregardingthestatusoftheirapplicationasrequestedbytheMember.5.5.2.2ProvideHealthyCommunitiesProgramMemberswithalistofappropriateHealthFirstColoradoandCHP+Providersandreferralswhenappropriate.5.5.2.3ProvideassistancesettingappointmentswhenrequestedbyHealthyCommunitiesProgramMembers.5.5.2.4Providereferralsformedicalandnon-medicalprogramstoHealthyCommunitiesProgramMembersasrequestedbytheMember.5.5.2.5FollowupwithMemberswhomissedtheirappointmentasrequestedbyphysical,oralandmentalhealthProviders.5.5.2.6TheContractorshallassistMembersinfindingoraccessingappropriatecommunityresourcesandensurefamilieshaveaccesstotheprograms.5.5.2.7FollowupwithMemberswhohavenotreceivedpreventiveoralormedicalserviceswithintherecommendedtimeframeasoutlinedintheDepartment-adoptedperiodicityschedules.5.5.2.8AssistinresolvinganyissuesorconcernsregardingenrollmentintoHealthFirstColoradoorCHP+andeligibilityissues,includingbyfacilitatingcontactwithCHP+contractor,countydepartmentofsocialorhumanservicestechnicians,theDepartment’sEligibilityandEnrollmentMedicalAssistanceProgramcontractor,theDepartment’sEnrollmentBrokerorotherMedicalAssistancesitesasappropriate.5.5.2.9AssistHealthFirstColoradoMemberswithschedulingNon-EmergentMedicalTransportation(NEMT)throughtheHealthFirstColoradoTransportationBrokerorlocaldepartmentofhumanorsocialservices.5.5.2.10AssistMemberswithresolvingissuesincludingProviderdemandsforpayment,collectionsissuesandanyadditionalquestionsandissuesregardingprogrambenefitsornavigation,asrequestedbyMembers.5.5.3TheDepartmentwillprovideaccesstothedatabasesystemsandinformationnecessarytocarryouttheprovisionsofthiscontract,including,butnotlimitedto,theColoradoBenefitsManagementSystem(CBMS),theHealthyCommunitiesMemberRelationshipManagementSystem,ProviderWebPortal,theBenefitsUtilizationSystem(BUS),PEAKPro,andinterChange,onanas-neededbasisasdeterminedbytheDepartment’sHealthyCommunitiesProgramandContractsManager.5.5.4TheContractorshalleducatetheMemberregardingtheavailabilityofservicesofferedbytheHealthyCommunitiesProgram.5.6.ProviderandCommunityPartnerOutreach5.6.1.TheContractorshalleducateProvidersonallservicesprovidedbyoravailablethroughHealthyCommunitiesProgram.5.62.TheContractorshallassistProviderstoconfirmprogrameligibilityandresolve eligibilityverificationdiscrepanciestopreventreschedulingormembersmissingappointments.5.63.TheContractorshaltassistProviderswithmissedappointmentfollow-upasrequested.ThisassistanceshallincludecallingMemberstocoordinateassistanceneededtoattendappointments.ThismayincludeprovidingtotheMemberresourcereferralssuchastransportationassistanceorchildcareresourcestoallowtheMembertoattendanappointment.5.6.4.TheContractorshallassistcommunitypartnersinunderstandingtheHealthfirstColoradoandCHP+medicalassistanceprograms,programbenefits,andprogramadministration.5.65.TheContractorshallplan,manage,andcoordinatecollaborativeeffortsandactivitieswithcommunitypartnerstoensurebetterservicedeliveryandeducationtothepopulationsserved.5.6.6.TheContractorshallattendrelevantmeetings,conferences,andotherchannelsofcollaborationinconjunctionwithcommunitypartnersatnoadditionalcosttotheDepartment.5.7.MemberRelationshipManagementSystem5.7.1.TheContractorshallprovideaccessforemployeesperformingtheWorktousetheHealthyCommunitiesMemberRelationshipManagementSystemasrequired.5.72.TheContractorshallassurethatallinformationneededtoassistMembers,suchasProvidersandcommunityresourcesareaddedtotheHealthyCommunitiesMemberRelationshipManagementSystemastheyrelatetotheHealthyCommunitiesPrograminatimelymannerandassurelistsareavailableforusebyMembersandCommunityPartnersasneeded.5.73.TheContractorshallassurethatallHealthyCommunitiesstaffarecomputerliterateandabletousetheHealthyCommunitiesClientRelationshipManagementSystemtoitsfullpotential.5.7.3.1.AttheDepartment’sdiscretion,theDepartmentmayaskContractorstafftocompletecomputerandHealthyCommunitiesMemberRelationshipManagementSystemproficiencytestingandtocomplete,attheContractor’sexpense,trainingdeemedappropriatebytheDepartment.5.7.4.TheContractorshaltenterdataaccuratelyintotheHealthyCommunitiesMemberRelationshipManagementSystemaccordingtoconventionsagreeduponbythecollaborationbetweentheContractorandtheDepartment,suchasoutreachevents,referralsandinteractionswithMembers.5.75.TheContractorshallassuretheHealthyCommunitiesMemberRelationshipManagementSystemisuptodatepriortothe10thdayofeachmonth.TheDepartmentwillgeneratereportsformonthlycontacts,referrals,andoutreachactivitiesonthe10thofthemonthtomeetreportingrequirements.5.7.6.TheContractorshallsubmitallrequestsforextensionsofthedeadlinetotheDepartmentinwritingnolaterthanthe5thofthemonth.5.8.Training 5.8.1.AttheDepartment’srequest,theContractorshallattendDepartmentaltrainings.Departmentaltrainingsmayinclude,butarenotlimitedto:5.8.1.1.TrainingontheHealthyCommunitiesMemberRelationshipManagementSystemandaccesstothesystemforeachoftheContractor’scurrentemployeesworkingwiththeHealthyCommunitiesProgramandthosewhomtheContractormayhiretoworkontheprogramduringthecontractyear.5.8.1.2.Qualityassuranceandothertrainingsduringsitevisits.5.8.2.ContractorshallfollowtheDepartment’sstandardizedtrainingcurriculum.5.82.1.Trainingcurriculumwillinclude,butnotbelimitedto,informationregardingthefollowingtopics:5.8.2.1.1.HealthyCommunitiesMemberRelationshipManagementSystemdataentryincludingdataentryconventions.5.8.2.1.2.HealthfirstColoradoandCHP+benefits.5.8.2.1.3.HealthfirstColoradoandCHP+eligibility.5.8.2.1.4.CBMSuse.5.8.2.1.5.UseofPEAKtoassistMembers.5.8.2.1.6.Othertopicsasneededtofulfilltheprogram’spurpose.5.9.Reporting5.9.1.ContractorQuarterlyReport5.9.1.1.Bytheendofthemonthaftereachfiscalquarter,theContractorshallsubmitareportsummarizing,ataminimum,thefollowing:5.9.1.1.1.Theactivityofthepreviousquarterincludingnoteworthyaccomplishments,projectstatus,challengesorbarrierstoprogramefforts,andcollaborationswithcommunityorotheragencypartners;5.9.1.1.2.AdescriptionoftheoutreachactivitiesconductedbytheContractorthatquarter;5.9.1.1.3.AdescriptionoftheeventsandactivitiesthattheContractorconductedtoincreasethenumberofwell-childandoralhealthvisits,increasephysicalhealthvisits,andincreaseoralhealthvisits;5.9.1.1.4.AlistofstaffwhoperformedWorkduringthequarter;5.9.1.1.5.ThetotalnumberoffullTimeEquivalent(FTE)hourstheContractorstaffspentoncontractWorkduringthequarter;and5.9.1.1.6.OtherinformationrequestedbytheDepartmentfromtheHealthyCommunitiesMemberRelationshipManagementSystem.5.9.1.2.DELIVERABLE:ContractorQuarterlyReport.5.9.1.3.DUE:Bytheendofthemonthaftereachfiscalquarter5.9.2.ProposedProgramBudget5.92.1.TheContractorshallsubmitadetailedProposedProgramBudgettotheDepartmentwithinthirty(30)daysoftheissuanceorrenewaloftheContractwiththeDepartment. Ataminimum,theBudgetReportshallincludeallanticipatedprogramrelatedexpensesforemployee(s)andoperatingexpensesfortheentireContractualperiod.5.9.2.1.1.DELIVERABLE:ProposedProgramBudget.5.9.2.1.2.DUE:Withinthirty(30)daysoftheissuanceorrenewaloftheContractwiththeDepartment.5.9.3.FinalReport5.9.3.1.Thefinalreportshallconsistoftheaccumulationofthequarterlyreportswithanadditionalsummaryrepresentingthewholeyear.5.9.3.2.DELIVERABLE:finalReport.5.9.3.3.DUE:Thirty(30)daysaftertheContractexpires,renewsoristerminated.5.9.4.AdHocReporting5.9.4.1.TheContractorshallprovideAdHocReportsasrequestedbytheDepartment.5.9.4.2.WhenanAdHocReportisrequested,theContractorshallcoordinatewiththeDepartmenttoconfirmitsunderstandingoftherequestandidentifythebestmethodforresponse.5.9.4.3.TheContractorshallprovidealladhocreportswithinthirty(30)daysoftheDepartment’srequestatnoadditionalcosttotheDepartment.SECTION6.0PERFORMANCESTANDARDS6.1.TheContractorshalladheretoallperformancestandardspublishedbytheDepartmentviapoliciesandproceduresdocuments,aswellasthosepublishedontheHealthyCommunitiesMemberRelationshipManagementSystem,trainingmaterialsorperiodicDepartmentalcommunications.6.1.1.NewMemberCommunicationStandard6.1.1.1.TheContractorshallreachouttonewlyenrolledMemberswithanInformtosharetheirbenefits(HealthFirstColoradoorCHP+),offernavigationassistance,andproviderorresourcereferralwithinsixty(60)daysoftheMember’senrollmentorwithintwo(2)weeksofappearingontheNewlyEnrolledMemberListwhicheverislater.6.1.12.TheContractorshallattempttoreachmembersatleastthree(3)timeswithinatwo(2)weekperiod—preferablyvaryingthetimesofdayanddaysofweekcalled.Wheneverpossible,theContractorshallleaveamessagefortheMembertoreturnthecall.UponthefinalattempttoreachtheMember,theContractorshallleaveaprograminformationalmessage(Inform)thatprovidesinformationabouttheprogramandhowthemembermayaccessprogramservices.SuchmessagesmayonlybeleftwithinstrictadherencetoHIPAAguidelinesandtheBusinessAssociateAgreementwiththeDepartment.6.1.2.TheContactormayprovideanInformviamailunderallofthefollowingconditions:6.12.1.AftertheContractorhasattempted,butwasunable,toreachthememberorfamilyrepresentativeorothermeansornoinformationforothercommunicationmethods wasprovidedbytheDepartment;6.122.TheInformviamailusesDepartment-approvedlettertemplategeneratedintheHeatthyCommunitiesMemberRelationshipManagementSystem,orotherDepartment-approvedletterandtheinteractionisrecordedinthedatabase.Whilenotrequired,itispreferredthateachlettercontainsomehandwritteninformationormessageincludinghand-addressingtheenvelopewheneverpossible;6.12.3.Informsaremailedwitha“ReturnServiceRequested”insigniaontheenvelope,addressinformationiscorrectedandloggedinthedatabasewithinone(1)weekofmailbeingreturned,andanotherletterissenttothenewaddress;and6.12.4.TheContractorhascertifiedtotheDepartmentwithinfive(5)daysoftheexecutionoftheContractthatitisfollowingallrequirementsforInformsviamaiLherein.6.1.3.IftheContractorusedautomated(robo)callingsystemstoreachMembers,itshallusesuchsystemsonlyafterinitialattemptstoreachMembersthroughothermeanshavefailed.Regardless,theContractorshallensurethattheuseofsuchsystemsiscarriedoutwithinstrictadherencetoHIPAAguidelines,andtheBusinessAssociateAgreementwiththeDepartmentprovidingonlytheminimuminformationrequiredtoprovidersofsuchservicesasnecessary.TheContractorshallensurethatsuchserviceproviderscomplywithallotherstaterulesandregulationregardingcontactingMembersinsuchamanner.TheContractorisencouragedtostaggerthetimeofdayanddaysofweek,includingeveningsandweekendsperfederalCommunicationsCommissionlimitations,tooptimizechancesofreachingmembers.Whenavailable,evenifatgreaterexpense,theContractorshallutilizeinteractivetoolstoallowmemberandrecipientstoprovidefeedbacksuchasanswerstosurveyquestions,requestsforacallbackoradditionalinformation.SECTION7.0PERFORMANCEMETRICS7.1.BytheEffectiveDateofthisContract,theDepartmentwillprovidetheContractorwithhistoricaldatawithwhichtodeterminepastperformanceandestablishabaselineforcomparingfutureperformanceandperformancechange.Additionally,bythattime,theContractorwillhaveregular,timelyaccesstobenefitutilizationdataforwell-childvisitsandoralhealthscreeningsforallmembersintheContractorservicearea.72.ContractorgoalswillbeestablishedtohelpimprovethescreeningparticipationratesforchildwellnessvisitsandincreaseoralhealthscreeningsasreportedbytheDepartmentontheCMSEPSDT416ReportperCMScriteria.73.Performanceexpectationsareasfollows:7.3.1.ChildWelinessVisitScreeningParticipationRates7.3.1.1.ContractorswhosebaselinedataisatoraboveCMSchildwellnessvisitscreeningparticipationcriteriaofeightypercent(80%),theexpectationistoincreaseperformancebytwo(2)percentagepointsforthecontractperiod.7.3.1.2.Contractorswhosebaselinedataisbetweensixtypercent(60%)and79.99percentforchildweilnessvisitscreeningparticipation,theexpectationistoincreaseperformancebyaminimumoffour(4)percentagepointsforthecontractperiod.7.3.1.3.Contractorswhosebaselinedataisbelowsixtypercent(60%)forchildwellnessvisit screeningparticipation,theexpectationistoincreaseperformancebyaminimumofseven(7)percentagepointsforthecontractperiod.7.3.2.ChildOralHealthScreeningParticipationRates7.3.2.1.TheContractorisexpectedtoincreasechiLdoralhealthscreeningparticipationbytwo(2)percentagepointsabovetheirbaselineforthecontractperiod.7.3.3.WhiletheCMSEPSDT416ReportdataishowtheDepartmentisevaluatedbyCMS,forpurposeoftheseperformancemetricswithrespecttothiscontractandanyincentiveprogramsthatmaybedevelopedforthesepurposes,theDepartmentwillusedatarepresentedintheHealthyCommunitiesMemberRelationshipManagementSystem.SECTION8.0CLOSEOUTPERIOD8.1.1.TheContractshallhaveaCloseoutPeriod.8.1.1.1.TheCloseoutPeriodshallbeginontheearlierofninety(90)dayspriortotheendofthelastrenewalyearoftheContractornoticebytheDepartmentofnon-renewal.TheCloseoutPeriodshallendonthedaythattheDepartmenthasacceptedthefinaldeliverablefortheCloseoutPeriod,asdeterminedintheDepartment-approvedandupdatedCloseoutPlanandhasdeterminedthatthecloseoutiscomplete.8.1.12.ThisCloseoutPeriodmayextendpasttheterminationoftheContractandtherequirementsoftheCloseoutPeriodshallsurviveterminationoftheContract.8.1.2.CloseoutPeriod8.1.2.1.DuringtheCloseoutPeriod,theContractorshallcompletethefollowing:8.12.1.1.ImplementthemostrecentCloseoutPlanorCloseoutPlanUpdatethathasbeenapprovedbytheDepartment,asdescribedinSection8.1.3andcompleteallsteps,deliverablesandmilestonescontainedinthemostrecentCloseoutPlanorCloseoutPlanUpdatethathasbeenapprovedbytheDepartment.8.12.12.ProvidetotheDepartment,oranyothercontractorattheDepartment’sdirection,allreports,data,systems,deliverablesandotherinformationreasonablynecessaryforatransitionasdeterminedbytheDepartmentorincludedinthemostrecentCloseoutPlanorCloseoutPlanUpdatethathasbeenapprovedbytheDepartment.8.12.1.3.EnsurethatallresponsibilitiesundertheContracthavebeentransferredtotheDepartment,ortoanothercontractorattheDepartment’sdirection,withoutsignificantinterruption.8.12.1.4.NotifyanySubcontractoroftheterminationoftheContract,asdirectedbytheDepartment.8.12.1.5.NotifyallMembersthattheContractorwillnolongerbetheHealthyCommunitiesOutreachandCaseManagementContractor.TheContractorshallcreatethesenotificationsanddeliverthemtotheDepartmentforapproval.OncetheDepartmenthasapprovedthenotifications,theContractorshalldeliverthesenotificationstoallMembers,butinnoeventshalltheContractordeliveranysuchnotificationpriortoapprovalofthatnotificationbytheDepartment.8.12.1.6.DELIVERABLE:MemberNotifications 8.12.1.7.DUE:Thirty(30)dayspriortoterminationoftheContract8.1.2.2.ContinuemeetingeachrequirementoftheContractasdescribedintheDepartment-approvedandupdatedCloseoutPlan,oruntiltheDepartmentdeterminesthatspecificrequirementisbeingperformedbytheDepartmentoranothercontractor,whicheverissooner.TheDepartmentwilldeterminewhenanyspecificrequirementisbeingperformedbytheDepartmentoranothercontractorandwillnotifytheContractorofthisdeterminationforthatrequirement.8.1.2.3.TheDepartmentwillperformacloseoutreviewtoensurethattheContractorhascompletedallrequirementsoftheCloseoutPeriod.IntheeventthattheContractorhasnotcompletedalloftherequirementsoftheCloseoutPeriodbythedateoftheterminationoftheContract,thenanyincompleterequirementsshallsurviveterminationoftheContract.8.1.3.CloseoutPlanning8.1.3.1.CloseoutPlan8.1.3.1.1.TheContractorshallcreateaCloseoutPlanthatdescribesallrequirements,steps,timelines,milestonesanddeliverablesnecessarytofullytransitiontheservicesdescribedintheContractfromtheContractortotheDepartmenttoanothercontractorselectedbytheDepartmenttobetheHealthyCommunitiesOutreachandCaseManagementContractoraftertheterminationoftheContract.TheCloseoutPlanshallalsodesignateanindividualtoactasacloseoutcoordinator,whowillensurethatallrequirements,steps,timelines,milestonesanddeliverablescontainedintheCloseoutPlanarecompletedandworkwiththeDepartmentandanyothercontractortominimizetheimpactofthetransitiononMembersandtheDepartment.TheContractorshalldelivertheCloseoutPlantotheDepartmentforreviewandapproval.8.1.3.12.DELIVERABLE:CloseoutPlan8.1.3.1.3.DUE:Thirty(30)daysfollowingtheEffectiveDate8.1.3.2.TheContractorshallupdatetheCloseoutPlan,atleastannually,toincludeanytechnical,proceduralorotherchangesthatimpactanysteps,timelinesormilestonescontainedintheCloseoutPlan,anddeliverthisCloseoutPlanUpdatetotheDepartmentforreviewandapproval.8.1.3.3.DELIVERABLE:CloseoutPlanUpdate8.1.3.4.DUE:Withinthirty(30)daysofthedatechangesaremade9SECTION9.0PAYMENTInitiativesReimbursedfromContractFundsHeldinReserve:9.1TheDepartmentwillimplementanincentiveprogramthroughwhichtheContractormayearnuptofifteenpercent(15%)oftheannualContractamounttobepaidoutquarterlyandannuallyuponthesuccessfulcompletionofthefollowinginitiativesandunderthefollowingcircumstances.9.2ProcessImprovementInitiative9.2.1TheContractorshallbeeligibleeachquartertoreceive1.25%ofthetotalContractamountuponsuccessfulcompletionoftheProcessImprovementInitiative. 9.2.2TheContractorshallsubmitontimeallContractprocessdeliverablesduewithintheContractperiodregardlessofwhichContractperiodthedeliverablemaycover.9.2.3ProcessdeliverablesarethoselistedinExhibitD,HealthyCommunitiesContractDeliverableSchedule-5FY2020.9.2.4TheDepartmentwillprovidetheContractorwrittennoticeofreceiptofeachdeliverable,indicatingthedateofreceipt,withintwo(2)BusinessDaysofreceiptbytheDepartment.9.2.5TheDepartmentwillprovidetheContractorwrittennoticeofeachdeliverable’sAcceptanceStatuswithinten(10)BusinessDaysofreceipt.9.2.6TheContractorshallcompletealldeliverabledeficiencies(e.g.theContractorwasnotifiedbytheDepartmentthatthedeliverablewas“NotAccepted”or“AcceptedwithChanges”)withinten(10)BusinessDaysoftheofContractornotice.9.2.7Initiativecompletionpaymentswillbepaidoutquarterlyprovidedalldeliverablesdueduringtheperiodweresubmittedontime.Paymentsforsubsequentquarterswillrequirealllatepriorquarterdeliverablesweresubmittedandthedeliverablesforthepaymentperiodwerereceivedontime.9.2.8AlldeliverabledeficienciesduewithinadeliverablecompletionpaymentperiodmustberemediedbytheduedatefortheContractortobeeligibleforpayment.9.3ProgramImprovementInitiative9.3.1TheContractorshallbeeligibletoreceiveuptofivepercent(5%)ofthetotalContractamountuponsuccessfulcompletionoftheProgramImprovementInitiative.9.3.2TheProgramImprovementInitiativerequiresthattheContractordeliverDepartment-approvedtraining(s)orpresentation(s)atone(1)ormorequarterlymeetings.AsofthedateofContractexecutionthesearescheduledforAugust21,2019;November13,2019;February19,2020;andMay20,2020.9.3.3Contractorswithtotalannualcontractamountsunder$100,000.00may,andareencouragedto,presentincollaborationwithone(1)othercontractorinthesamegroup.Thesecontractorsshallreceivefivepercent(5%)ofthetotalContractamountuponsuccessfulcompletionofthetrainingorpresentationincludedintheProgramImprovementInitiative.9.3.4Contractorswithtotalannualcontractamountsbetween$100,000.00and$200,000.00shallcompleteone(1)trainingorpresentationduringthecontractperiod.Thesecontractorsshallreceivefivepercent(5%)ofthetotalContractamountuponsuccessfulcompletionofthetrainingorpresentationincludedintheProgramImprovementInitiative.9.3.5Contractorswithtotalannualcontractamountsover$200,000.00shallconducttwo(2)suchtrainingsorpresentationsduringthecontractperiod.Thesecontractorsshallreceive2.5%ofthetotalContractamountuponsuccessfulcompletionofeachtrainingorpresentationincludedintheProgramImprovementInitiative.9.3.6TheContractorshallsubmititstrainingorpresentationtopic(s)forapprovalnolaterthanJuly24,2019.Trainingorpresentationtopicsubmissionsshallinclude: 9.3.6.1.Overviewofthetrainingorpresentatio1includingtheintendedpresenter.9.3.6.2.Thetrainingorpresentationpurpose,e.g.howitwillhelpfamilyHealthCoordinatorsimprovetheirwork,etc.9.3.6.3.Abriefoutlineofthetrainingorpresentationincludingproposedhandouts.9.3.6.4.Requesteddate(s)oftrainingorpresentation9.3.6.5.Anindicationofhowtheaudienceparticipationandunderstandingwillbeevaluated.9.3.7DELIVERABLE:Trainingandpresentationtopicsubmission(s)9.3.8DUE:July24,20199.3.9TheContractor’strainingshallbecomposedofthefollowing:9.3.9.1.A20-minuteA/Vpresentation,eitherin-personorremotelyviawebinar9.3.9.2.Uptoten(10)minutesforfollowup,questionandanswerperiod,etc.9.3.9.3.HandoutswhichshallconsistofthepresentationPowerPointslides(3slidesperpage)butmayalsoincludeanymaterialrelevanttothepresentationtopic9.3.9.4.Examinationwhichshallbecomprisedofatleastthree(3)(butnomorethanten(10))questionsthataddressthefundamentalpointsofthepresentationandwillgaugetheaudience’sparticipationinandunderstandingofthepresentation.TheDepartmentwilladministertheexaminationtoremoteparticipantselectronicallyimmediatelyafterthepresentationasanonlinesurveyandwilladministertoin-personparticipantsviaawrittenexamination.9.3.9.5.DELIVERABLE:Presentation,handoutsandexamination9.3.9.6.DUE:fifteen(15)BusinessDayspriortothescheduledpresentation9.3.9.7.TheDepartmentwillnotifytheContractorwithinone(1)BusinessDayofreceiptofthepresentation,handoutandevaluation.TheDepartmentwillnotifytheContractoroftheirAcceptanceStatuswithinthree(3)businessdaysofreceipt.TheContractorshallremedyanydeficiencyandresubmittotheDepartment.withinfive(5)BusinessDaysofAcceptanceStatus.9.3.9.8.DELIVERABLE:Remediedpresentation,handoutsandexamination9.3.9.9.DUE:five(5)BusinessDaysfromnotificationofAcceptanceStatus.9.3.10Inlieuofeachtrainingorpresentationasdescribedabove,theContractormaysubmitforDepartmentapprovalbyJuly24,2019,anyotherProgramImprovementInitiativeofitschoosing.9.3.11TheDepartmentwillnotifytheContractoroftheAcceptanceStatusoftheProgramImprovementInitiativewithinthirty(30)daysofcompletionofthetrainingorpresentation.9.4ProgramOutcomesInitiative9.4.1TheContractorshallbeeligibletoreceiveuptofivepercent(5%)ofthetotalContractamountuponsuccessfulcompletionoftheProgramOutcomesInitiative. 9.4.2TheContractorwillbeeligibleforpaymentattheendofthecontractperiodperthefollowingtieredpaymentstructure:9.4.2.1.40%-44.99%ofnewMemberInformscompleted—Pays1.25%reservefunds9.4.2.2.45%-49.99%ofnewMemberInformscompleted—Pays2.5%reservefunds9.4.2.3.50%-54.99%ofnewMemberInformscompleted—Pays3.75%reservefunds9.4.2.4.55%orgreaterofnewMemberInformscompleted—Pays5%reservefunds9.4.3AcompletedInformmeansprovidingtomembersontheNewlyEnrolledMemberListprogram-specificinformationincluding:nameandcontactinformationfortheirmanagedcareorganizationorRAE;feeForServicetreatmentasapplicable;anoverviewofcoveredmedical,behavioralandoralhealthbenefits;non-coveredservicesandbenefits(memberreimbursement,etc.)andexamplesofservicesthatmayrequirepriorauthorization;supportformemberidentifiedneedsformedical,behavioralororalhealthcareorrelatedservicessuchasnon-emergencymedicaltransportation,orcommunitybasedservicesorsupports.9.4.4Additionally,ContractorstaffdenotingacompletednewMemberInformintheHealthyCommunitiesMemberRelationshipManagementSystemshallbeconsideredanattestationthatallormostoftheaboveinformationwasprovided,inpersonorbytelephone,automated(robo)callmessagedeliveredinitsentirety,text/SMSmessage,tothemember/family.InformsmadeviamailmayonlybeusedfollowingthecriteriainSection6.1.2ofthisContractandmayaccountfornomorethanfifteenpercent(15%)oftheContractor’stotalInformstoNewlyEnrolledforthisinitiative.9.4.5TheDepartmentwillmakeavailableintheMemberRelationshipManagementSystemreportsthattheContractorcanreview,at-will,itsprogresstowardthismeasure.9.4.6AnInformmaybedenotedas“Completed”iftheContractorstaff,afterspeakingwiththemember/family,wasabletoaddressallofthemember’s/family’squestionsorconcernsidentifiedintheinteractionandprovideinformationforthemtofindadditionalhelpappropriatetotheirprogram.9.5UnclaimedContractorFundsPool9.5.1TheDepartmentwillcreateaperformancepoolfromanymoniesnotdistributedtothecontractorsforperformanceontheProcessImprovement,ProgramImprovementandProgramOutcomesInitiatives.9.5.2TheContractoriseligibleforperformancepooldistributionsifatleastthirty-fivepercent(35%)oftheirnewMemberInformsassignedarecompletedregardlessofthelevelofreimbursement,ifany,theyreceivedfortheProgramOutcomesInitiative.TheDepartmentwilldistributethefundsasfollows:9.5.2.1.30%totheHealthyCommunitiescontractorwithgreatestimprovementinWellChildScreeningRates9.5.2.2.20%totheHealthyCommunitiescontractorwithsecondgreatestimprovementinWell-ChildScreeningRates9.5.2.3.10%totheHealthyCommunitiescontractorwiththirdgreatestimprovementinWellChildScreeningRates 9.5.2.4.20%totheHealthyCommunitiescontractorwithgreatestimprovementinChildOralHealthScreeningRates9.5.2.5.12%totheHealthyCommunitiescontractorwithsecondgreatestimprovementinChildOralHealthScreeningRates9.5.2.6.8%totheHealthyCommunitiescontractorwiththirdgreatestimprovementinChildOralHealthScreeningRates9.5.2.7.Intheeventofatie,thetiedcontractorswillsplitequallytheavailablefundsforthecategory.9.5.3Theamountofunclaimedpoolfundsshallbenomorethan$444,243.60forthecontractperiod.9.6ContractPayment9.6.1TheContractorshallsubmitaninvoiceandQuarterlyReporttotheDepartmentforWorkperformedunderthisContract.TheContractorshallsubmitthesedocumentsnolaterthanthelastdayofthemonthfollowingtheendofthefiscalquarter.TheDepartmentwillnotpayouttheinvoiceuntiltheContractor’sQuarterlyReporthasbeenreceivedandAccepted.9.6.2TheContractorshallincludeonallinvoicestheContractroutingnumber(fromthefirstpageoftheContract),theappropriateStateofColoradoVendorCodeattributedtotheContractorandauniqueinvoicenumberfromanyotherprograms/entitiesunderthesamevendorcode.9.6.3TheContractorshallsubmitquarterlyinvoicesreflectingonefiscalquartereach.9.6.4TheContractorshallsubmitallinvoicesassoonaspossibleafterthecloseofthefiscalquarterbutnolaterthanthelastdayofthemonthfollowingtheendofthefiscalquarter.9.6.5TheContractorshallsubmitinvoiceselectronicallytothedesignatedemailmailbox(hcpf_healthycomm@state.co.us)asasinglefifeattachmentinasearchableAdobePortableDocumentformat(.pdf)usingthefollowingfilenamingconvention:##MonYR—ContractorName-$#,###.##-#####.pdf(Thetwo-digitcontractmonth01-12—three-lettermonthnameandtwo-digityear—ContractorName—dollaramountofthisinvoice—Contractorinvoicenumber.pdf—forexample:‘040ct17—BoulderCountyHousingandHumanServices-$6,543.21—0417.pdf’)9.6.6TheContractorshallsignallinvoices.AdobeeSignispermitted.9.6.7ThetotaloftheinvoicessubmittedbytheContractorforaltperiodsduringacontractperiodshallnotexceedtheContractmaximumamountforthatyear.9.6.8TheContractorshallnotincludeonthequarterlyinvoicemorethan21.25%ofthetotalContractamount.9.6.9TheDepartmentwillremitpaymenttotheContractorviaElectronicfundsTransfer(EFT)unlessotherarrangementshavebeenmadewiththeDepartment’sAccountingSectionperDepartmentpolicy. ExhibitDHealthyCommunities:SFY2OContractorDeliverablesScheduleNote:Pleasereviewthecontract(SFY16)ANDcontractamendmentforcompletecontractdeliverableinformation.ContractSectionDueSFY2O19DueSFY2O2ONotesBaseContract:§13ProofofLiabilityInsurance...within10businessdaysofnewpolicyeffectivedate6.1.1.3MailedInformsCertification7/5/20195.9.2ProposedBudget7/5/2019...ANDwithin1businessdayofstaffleavining/5businessdaysofnewstaffemployment-notificationrequiredofbackupwhenlead4.1.1.3.1ProjectLead-Staffing7/5/2019willbeabsentformotethan3days3.7.3CommunicationPlan*9/30/2019...ANDwithin30daysofchanges3.8BusinessContinuityPlant8/15/2019...ANDwithin30daysofchanges3.1HIPAAPolicies*6/30/20196/30/2020...ANDwithin30daysofchanges3.7.2.3ProgramPresenceReport7/29/2019...ANDwithin30daysofchanges4.1.4SubcontractorList7/30/2019...ANDwithin30daysofchanges4.1.4SubmitCopySubcontracts7/30/2019...ANDwithin30daysofchanges5.3RAECoordinationAgreementUpdate10/31/2019...ANDwithin30daysofchanges5.3RAECoordinationMeetingSchedule7/31/2019...ANDwithin30daysofchanges3.11OnboardingPlanUpdate9/30/2019...ANDwithin30daysofchangesQuarterlyReport-4thQuarter=CumulativeWithin1monthafterfiscalquarterend(byendofOctober,5.9.1AnnualReportJanuary,April,July-forprioryear)8.1.3.1CloseoutPlan*6/30/20196/30/2020...ANDwithin30daysofchanges9.2.4InvoicesDue(forpreviousperiod)Within1monthafterendofbillingperiod4.1.6QuarterlyMeetingsAttendanceCertificationWithin2businessdaysaftermeetingIfnochangesfromprevioussubmisison,Itispermissibletosubmitastatementtothateffect.TobesubmittedonDepartment-providedtemplate