HomeMy WebLinkAboutDoc 002 - Telecare MH Svcs - AmendmentDeschutes County Board of Commissioners
1300 NW Wall St., Suite 200, Bend, OR 97701-1960
(541) 388-6570 -Fax (541) 385-3202 -www.deschutes.org
AGENDA REQUEST & STAFF REPORT
For Board Business Meeting of February 5, 2014
DATE: January 29,2014
FROM: Lori Hill, Adult Treatment Supervisor Phone: 322-7535
Health Services-Behavioral Health Division
TITLE OF AGENDA ITEM:
Consideration of Board Signature of Document #2014-002, amendment #1 to the agreement
between Telecare Mental Health Services of Oregon, Inc. and Deschutes County Health Services
(DCHS).
PUBLIC HEARING ON THIS DATE? No
BACKGROUND AND POLICY IMPLICATIONS:
Residential Treatment Services are behavioral health services delivered on a 24-hour basis to
individuals eighteen (18) years of age or older with mental or emotional disorders. These
individuals may have been hospitalized; or at immediate risk of hospitalization. Some individuals
need to continue services to because they are a danger to themselves or others. Residential
Treatment Services include services delivered to individuals who the County, in conjunction with
the Oregon Health Authority (OHA) has determined are unable to live independently without
supervised intervention, training or support and are eligible for services funded under this
agreement.
Telecare provides 24-hour Residential Treatment Home (RTH) services for up to ten (10)
residents. They invoice the Division of Medical Assistance Programs (DMAP) in accordance with
procedures and forms prescribed by OHA. Deschutes County receives funds from OHA and pays
those funds to Telecare through this agreement.
The original contract amount is for the first six months of the contract, through December 31, 2013.
This amendment #1 reflects the funding amount for the term January 1, 2014 through June 30,
2014.
FISCAL IMPLICATIONS:
Maximum compensation is up to $592,500.
RECOMMENDATION & ACTION REQUESTED:
Behavioral Health requests approval.
ATTENDANCE: Lori Hill, Adult Treatment Supervisor
DISTRIBUTION OF DOCUMENTS:
Executed copies to: Nancy Mooney, Contract Specialist, Health Services
DESCHUTES COUNTY DOCUMENT SUMMARY
(NOTE: This form is required to be submitted with ALL contracts and other agreements,
regardless of whether the document is to be on a Board agenda or can be signed by the County
Administrator or Department Director. If the document is to be on a Board agenda, the Agenda
Request Form is also required. If this form is not included with the document, the document will
be returned to the Department. Please submit documents to the Board Secretary for tracking
purposes, and not directly to Legal Counsel, the County Administrator or the Commissioners. In
addition to submitting this form with your documents, please submit this form electronically to
the Board Secretary.)
Please complete all sections above the Official Review line.
Date: I January 6, 2014 I
Department: I Health Services, Behavioral Health I
Contractor/Supplier/Consultant Name: I Telecare Mental Health Services of Oregon, Inc.1
Contractor Contact: I Dwain Connolly Contractor Phone #: I 510-337-7950
Type of Document: Amendment #1 Personal Services Contract #2013-364
Goods and/or Services: Telecare provides 24-hour Residential Treatment Home (RTH)
services for up to ten (10) residents.
Background & History: Residential Treatment Services are behavioral health services
delivered on a 24-hour basis to individuals eighteen (18) years of age or older with mental or
emotional disorders who have been hospitalized, who are at immediate risk of hospitalization,
who need continue services to avoid hospitalization or who are a danger to themselves or
others or who otherwise require continuing care to remain in the community. Residential
Treatment Services include services delivered to individuals who the County, in conjunction with
the Oregon Health Authority (OHA) has determined are unable to live independently without
supervised intervention, training or support and are eligible for services funded under this
Agreement.
Telecare will invoice Division of Medical Assistance Programs (DMAP) in accordance with
procedures and forms prescribed by OHA. County agrees to pay Telecare funds that are
received by County through the Oregon Health Authority (OHA) by amendment to the contract
between Deschutes County and OHA.
The original contract amount reflected in this contract is through December 31, 2013. This
amendment #1 reflects the funding amount for the term January 1, 2014 through June 30, 2014.
IAgreement Starting Date: I July 1, 2013 I Ending Date: I June 30,2014
Annual Value or Total Payment: Maximum com ensation for Januar 1.2014 throu h Jun
30. 2015 is $592,500, the maximum consideration for the duration of the contract is
$1,185,000.
1/6/2014
Check all that apply:
D RFP, Solicitation or Bid Process
D Informal quotes «$150K)
[2J Exempt from RFP, Solicitation or Bid Process (specify see DCC §2.37)
Funding Source: (Included in current budget? [2J Yes D No
If No, has budget amendment been submitted? DYes D No
Is this a Grant Agreement providing revenue to the County? DYes [2J No
Special conditions attached to this grant:
Deadlines for reporting to the grantor:
If a new FTE will be hired with grant funds, confirm that Personnel has been notified that it is a
grant-funded position so that this will be noted in the offer letter: DYes D No
Contact information for the person responsible for grant compliance: Name:
Phone #:
Departmental Contact and Title: Nancy Mooney, Contract Specialist
Phone #: '--_____....J
Distribution of Document: Return originals to Nancy Mooney, Behavioral Health
Department.
Deputy Director Approval: G_
Date
Department Director Approval: ---~..Lf--¥-'<:-----
Date
Official Review:
County Signature Required (check one): ~ BOCC 0 Department Director (if <$25K)
ut <$150K; if >$150K, BOCC Order No. _____),
DateLegal Review
Document Number ::.20!::..1.!.-4!--O::::.:O~2=--_______
1/612014
~:t'~
LEGAL COUNSEL
DESCHUTES COUNTY SERVICES CONTRACT AMENDMENT #1
DOCUMENT NO. 2014-002
AMENDING DESCHUTES COUNTY CONTRACT NO. 2013-364
THAT CERTAIN AGREEMENT, Deschutes County Contract No. 2013-364 dated July 1, 2013 , by and between
DESCHUTES COUNTY , a pol itical subdivision of the State of Oregon ("County ") and Telecare Mental Health
Services of Oregon , Inc . ("Contractor"), is amended , effective upon signing of all parties, as set forth below.
Except as provided herein , all other provisions of the contract remain the same and in full force .
County's performance hereunder is conditioned upon Contractor's compliance with provisions of ORS
279B .220 , 279B .225, 279B .230 , and 279B .235 , which are hereby incorporated by reference . In addition
Standard Contract Provisions contained in Deschutes County Code Section 2.37 .150 are hereby incorporated
by reference . Contractor certifies that the representations, warranties and certifications contained in the original
Contract are true and correct as of the effective date of this Amendment and with the same effect as though
made at the time of this Amendment.
The above listed contract is amended as follows (new language is indicated by bold font and deleted language
is indicated by strikeout font) :
EXHIBIT 1
DESCHUTES COUNTY SERVICES AGREEMENT
STATEMENT OF WORK, COMPENSATION
PAYMENT TERMS AND SCHEDULE
Definitions :
Adult Mental Health Initiative (AMHI): AMHI is a system reform project initiated by the
Oregon Health Authority (OHA). The purpose of the initiative is to improve the system of
community-based long term care and residential services for people who have been in the
Oregon State Hospital. The proposal is to shift resources and authority from the State of
Oregon to Mental Health Organizations and counties for the referral and management of
individuals placed in state hospital and residential facilities . This would only include people
involved in or at risk of the civil commitment process.
Residential Treatment Services :
For the purposes of this Agreement, Residential Treatment Services are behavioral health
services delivered on a 24-hour basis to individuals eighteen (18) years of age or older with
mental or emotional disorders who have been hospitalized , who are at immediate risk of
hospitalization , who need continuing services to avoid hospitalization or who are a danger
to themselves or others or who otherwise require continuing care to remain in the
community . Residential Treatment Services includes services delivered to individuals who
the County, in conjunction with the OHA has determined are unable to live independently
without supervised intervention , training or support and are eligible for MHS 28 Services
funded through this Agreement.
Division of Medical Assistance Programs (DMAP):
An office of the Oregon Health Authority responsible for coordinating Medical Assistance
Programs, including the OHP Medicaid Demonstration and the Children'S Health Insurance
Page 1 of 5 -Document No . 2014-002 , Amending Deschutes County Contract No. 2013-364
20 4~OO?
Program (CHIP). DMAP writes and administers the state Medicaid rules for medical
services, contracts with providers, maintains records of Individual eligibility and processes
and pays DMAP providers.
Extended Care Services:
Non-OHP Medicaid rehabilitative services that are reimbursed on a fee for service basis.
These services are billed with the use of specially designated Non-Oregon Health Plan
(OHP) Medicaid Extended Care Services billing codes. Use of these codes requires prior
authorization by the County and Central Oregon Health Board.
Part A Funds: These funds are dispersed directly to Deschutes County by State of Oregon
through Intergovernmental Contract for Financing of Community Mental Health Services.
Part B Funds: These funds are awarded to Deschutes County by State of Oregon through
Intergovernmental Contract for Financing of Community Mental Health Services as a
limitation amount only. Funds are not dispersed directly to Deschutes County. The OHA's
Division of Medical Assistance Programs (DMAP) disburses the award up to the limitation
amount directly to the service provider on a fee-for-service basis.
Personal Care Services:
Services delivered in Residential Treatment Homes or Facilities that include but are not
limited to the following: crisis stabilization, money and household management, supervision
of daily living activities, provision of care for safety and well-being, administration and
supervision of medication, provision and arrangement of routine transportation, behavior
management, management of diet and physical health problems.
1. Contractor shall perform the following work:
Service 1: Residential Treatment Home (RTH):
A. The purpose of RTH services is to stabilize resident's psychiatric symptoms, improve independent living
skills, and then discharge the resident into an appropriate and safe level of community services of less
intensity as clinically appropriate.
B. Contractor shall provide 24-hour RTH services for up to ten (10) residents. Contractor shall provide
RTH services described in the attached Service Description titled "Residential Treatment Services,
Service ID code MHS 28, Exhibit 1A and in accordance with OAR 309-035-0250 through 309-035-0460,
in homes at two locations in Deschutes County.
Services shall include:
1. Non-ReSidential Adult Mental Health Services, Service ID Code MHS 20 B, Exhibit 1 B;
2. Residential Treatment Services, Service ID Code MHS 28, Exhibit 1-D;
3. Medicaid reimbursable service billings in accordance with the OHA Medicaid General Provider
Rules 410-120-0000 through 410-120-1940; OHA Mental Health and Developmental Disability
Services Medicaid Payment for Rehabilitative Mental Health Services Rule as listed in OAR
309-016-0600 through 309-016-0650; and Integrated Services and Supports Rule 309-032
1500 through 309-032-1565.
4. Contractor must enroll all Individuals served in Oregon State's Client Process Monitoring
System (CPMS) database within twenty-four (24) hours of admission and disenroll within
twenty-four (24) hours of discharge.
5. Residential Screening Process: The Contractor must jOintly partiCipate with the County in a
screening process for all potential admissions to a RTH facility. Contractor understands that the
County must also approve any Individual admitted to the facility.
C. The Contractor must ensure the following at the Facility where RTH services are provided:
1. Currently have in place and maintain throughout the life of this Agreement. licensing as a
Residential Treatment Home as defined in OAR 309-035-0250 through 309-035-0460.
2. Contractor must obtain and maintain any other licenses and/or certifications as necessary or
required by law or administrative rule for a provider of RTH services and as an operator of the
Page 2 of 5 -Document No. 2014-002, Amending Deschutes County Contract No. 2013-364
I
facility. This will include Contractor maintaining approval under OAR 309-012-0130 through
309-012-0220, "Certificates of Approval for Mental Health Services".
3. Contractor agrees to provide only those outpatient behavioral health services that are required
for Contractor's role as a residential treatment provider. Contractor agrees to not utilize this
certification to establish or provide any other outpatient services within Deschutes County
unless expressly approved by County under separate agreement.
D. Contractor shall provide RTH services to Individuals who meet the following criteria:
1. Be eig hteen (18) years or older; and
2. Be referred by the Oregon Health Authority (OHA) Adult Mental Health Initiative (AMHI) and
approved by County in collaboration with the program treating referral hospital, responsible
Community Mental Health Program (CMHP) and/or the Mental Health Organization (if enrolled)
responsible for the Individual. (See Exhibit 1 "Referrals"); and
3. Have an Axis I Diagnosis according to the Diagnostic and Statistical Manual of Mental
Disorders; and
4. Be currently approved for Long Term Psychiatric Care by AMHI; or
5. Be referred directly by Deschutes County in accordance with County Bed Referral procedures
(Exhibit 1 E); or
6. Be a Medicaid eligible Individual in a benefit category that allows for payments for Medicaid
Rehabilitative Services.
2. County Services. County shall provide Contractor, at County's expense, with material and services
described as follows:
1. County will maintain primary responsibility for screening and approval of admissions to the residential
treatment facilities and will provide Residential Specialist staff to participate in this process. Screenings
will be conducted in coordination with Contractor's RTH staff, however, any resident accepted for
admission to the facility must also be approved by the County for placement. Residential Specialist staff
will also provide regular outreach and coordination with Contractor's RTH staff.
2. County agrees to provide a letter of support to Contractor as part of certification application outlined in
1 (B)(2) for Contractor to operate as an Outpatient Mental Health Provider within Deschutes County and
to provide the required monitoring and oversight in coordination with Addictions and Mental Health
Division.
3. County agrees to provide all other out-patient behavioral health services including but not limited to:
medication management, individual and group therapy and supported employment services.
3. Consideration. Subject to availability of funds, Contractor will receive payment for providing the services
described in Exhibit 1, Paragraph 1.
A Contractor shall bill DMAP in accordance with procedures and forms prescribed by OHA for all services
funded under Part B dollars. Contractor agrees that payment for these services shall be DMAP's
responsibility and not County's responsibility. Contractor shall not invoice or expect payment from
County for services billed to DMAP under this subsection.
i) All Extended Care Services reimbursable service billings shall be in accordance with the OHA
Medicaid General Provider Rules 410-120-0000 through 410-120-1940 and MHS Mental Health and
Developmental Disability Services Medicaid Payment for Rehabilitative Mental Health Services Rule
as listed in OAR 309-016-0600 through 309-016-0685.
ii) Contractor shall bill all Personal Care Services in accordance with forms and procedures prescribed
by OHA.
iii) Contractor agrees to complete, monitor and obtain all prior authorizations as needed for Extended
Care Service and Personal Care Service billing submissions.
B. The State of Oregon acting by and through the Oregon Health Authority (OHA) will disperse
funds to Deschutes County through amendment to the contract between OHA and Deschutes
County, contract #141408. County agrees to pay to Contractor, all "Part A" funds received by County
which are allocated by OHA to County for services provided by Contractor as described in this Exhibit.
Contractor agrees that consideration described in this Paragraph 3 of Exhibit 1 are acceptable
and sufficient payment for providing the services described in Paragraph1 of Exhibit 1.
Contractor agrees that no further payment or consideration is expected from County for services
Page 3 of 5 -Document No. 2014-002, Amending Deschutes County Contract No. 2013-364
provided in this Contract. County agrees to make payment of OHA funds to Contractor within
thirty (30) days receipt of furnds from OHA.
i) Contractor agrees to invoice County on a monthly basis for Part A payments that are approved by
the OHA as part of Contractor's budget and paid to the County by amendment to OHA State
Contract. County agrees to make approved payments to Contractor within thirty (30) days of receipt
of invoice and receipt of funds from the OHA.
ii) Contractor agrees to complete and submit all documentation of expenditures for all Part A funds as
required by OHA and the County and to comply with all requirements of the Service Description in
which funding is allocated.
C. Funding for operation of the facilities will be in accordance with a budget submitted by Contractor to
OHA and County and approved by OHA and County.
D. Contractor shall be entitled to reimbursement for travel expenses 0 YES ~NO
[Check one]
4. The maximum compensation.
A. The maximum consideration under this Agreement shall be $592,500. This maximum compensation is
calculated for payments provided through December 31, 2013. Payments beyond December 31, 2013
will be agreed upon through an amendment, signed and executed by both Parties. For payments
January 1, 2014 through June 30, 2014, County will pay Contractor up to the total maximum amount
allocated by Oregon Health Authority for Contractor services to the County under the contract between
OHA and County, Contract #141408; maximum compensation during June 1, 2014 through June
30,2014 will not exceed $592,500. The maximum consideration for the duration of this Contract
will not exceed $1,185,000. All funds allocated to County as "Part B" payments will be paid directly to
the Contractor by DMAP on the County's behalf. All funds allocated to County for services provided by
the Contractor as "Part A" payments, will be paid to the Contractor directly by the County. All funds will
be paid in accordance with a budget that is approved by Oregon Health Authority.
B. All funds awarded to Contractor under this Agreement are subject to Oregon Health Authority
monitoring and adjustment. All adjustments in funds awarded will be made by amendment to the
contract between OHA and County. Oregon Health Authority will monitor and adjust funds awarded
throughout the term of this Agreement at Oregon Health Authority discretion.
C. Recovery of Overpayment: All payments made to Contractor under this Agreement are su bject to
recovery by OHA and/or the County in accordance with OAR 410-120-1397 Recovery of Overpayments
to Providers --Recoupments and Refunds and Service Element Descriptions for MHS 28, MHS 20, and
MHS 37 funds:
i. If a federal audit of the work rendered by Contractor under this Agreement results in a refund to or
disallowance by the federal government of funds paid to Contractor under this Agreement, Oregon
Health Authority and/or County may recover from Contractor the amount of the refund or
disallowance and any applicable Oregon Health Authority matching funds.
ii. If Contractor expends funds paid to Contractor under this Agreement for purposes not authorized by
this Agreement, Oregon Health Authority and/or County may recover the amount of the
unauthorized expenditure from Contractor.
iii. If billings under this Agreement result in payments to Contractor to which Contractor is not entitled,
Oregon Health Authority and/or County, after giving written notification to Contractor, may withhold
from payments due to Contractor such amounts, over such periods of time as are necessary to
recover the amount of overpayment.
D. Contractor may also receive funding for Start-up Special Projects as outlined in Service ID Code MHS
37, Exhibit 1-C.
Page 4 of 5 -Document No. 2014-002, Amending Deschutes County Contract No. 2013-364
5. Schedule of Performance or Delivery.
a. County's obligation to pay depends upon Contractor's delivery or performance in accordance with the
schedule listed in Exhibit 1, Paragraph 1.
b. County will only pay for completed work that conforms to the terms of the Agreement.
6. Renewal. This Agreement may be renewed as outlined in this Agreement and subject to the following
conditions:
a. Renewal will be based on the County Annual Implementation Plan approved by the OHA.
b. Renewal is subject to the availability of funding.
7. Modification of Exhibit 1-A through 1-0, State Requirements for Behavioral Health Subcontract
In the event the State of Oregon modifies the terms of SE 28, 20, or 37, it is understood and agreed that this
Agreement will also be revised accordingly. Authority to change this Exhibit to comply fully with Deschutes
County's Contract with OHA shall rest with the Director of Contractor and the Director of County. Both
parties must agree for the Exhibit to be modified.
CONTRACTOR: TELECARE MENTAL HEALTH SERVICES OF OREGON, INC.
~ Dated this Is""-of r"Y"J ,2014.PM A~NDCFO
COUNTY: DESCHUTES COUNTY HEALTH SERVICES
I
Dated this ___of _____, 2014 BOARD OF COUNTY COMMISSIONERS f
I
TAMMY BANEY, CHAIR
ANTHONY DEBONE, VICE CHAIR
ATTEST:
Recording Secretary ALAN UNGER, COMMISSIONER
Page 5 of 5 -Document No. 2014-002, Amending Deschutes County Contract No. 2013-364