HomeMy WebLinkAboutDoc 529 - OR CCF Healthy Start-Medicaid IGAc���TEs ca
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Deschutes 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 September 2, 2009
Please see directions for completing this document on the next page.
DATE: August 26, 2009
FROM: Debi Harr CCF (541) 330 -4692
TITLE OF AGENDA ITEM:
Consideration of Board signature on document # 2009 -529, the 2009 -2011 Oregon Commission on
Children & Families Medicaid Intergovernmental agreement DES0911 -MAC.
PUBLIC HEARING ON THIS DATE? No
BACKGROUND AND POLICY IMPLICATIONS:
This document is the standard intergovernmental agreement between the Oregon Commission on
Children & Families and Deschutes County for Medicaid reimbursement claiming for Healthy Start
services. The State of Oregon reimburses Healthy Start programs with Federal Title XIX
Administrative Case Management dollars for services that lead to outreach, access and utilization of
health care services for families.
FISCAL IMPLICATIONS:
This agreement is the basis for claiming reimbursement for Healthy Start services. These funds are
granted to the local Healthy Start program, Healthy Families of the High Desert, formerly
Ready *Set *Go. The total amount has been included in the budget for 2009 -2010.
RECOMMENDATION & ACTION REQUESTED:
Approval and signature on document # 2009 -529, Oregon Commission on Children & Families 200 ?-
2011 Medicaid Intergovernmental agreement DES0911 -MAC.
ATTENDANCE: Debi Harr
DISTRIBUTION OF DOCUMENTS:
Return all three originals to Sandra Flickinger at the Oregon Commission on Children & Families, ` 30
Center Street NE, Suite 405, Salem, OR 97301 for OCCF signatures.
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
th e 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.)
Date:
(August 26, 2009
Please complete all sections above the Official Review line.
Contractor /Supplier /Consultant Name:
Contractor Contact: 'Marsha Clark
5138
Department:
CCF
Oregon Commission on Children & Families
Type of Document: Intergovernmental Agreement
Contractor Phone #:
(503) 378-
Goods and /or Services: Oregon Commission on Children & Families Healthy Start
Medicaid 2009 -2011 biennial funding
Background & History: This agreement is the standard intergovernmental
agreement between the Oregon Commission on Children & Families and Deschutes
County for Medicaid reirnbursement claiming for Healthy Start services. The State of
Oregon reimburses Healthy Start programs with Federal Title XIX Administrative Case
Management dollars for services that lead to outreach, access and utilization of health
care services for families.
Agreement Starting Date:
July 1, 2009
Annual Value or Total Payment: $215,000
Ending Date:
Insurance Certificate Received (check box)
Insurance Expiration Date:
N/A
June 30, 2011
Check all that apply:
I-1 RFP, Solicitation or Bid Process
fl Informal quotes ( <$150K)
X Exempt from RFP, Solicitation or Bid Process (specify — see DCC §2.37)
Funding Source: (Included in current budget? X Yes n No
If No, has budget amendment been submitted? n Yes U No
Is this a Grant Agreement providing revenue to the County? X Yes n No
Special conditions attached to this grant:
8/26/200'
Deadlines for reporting to the grantor: Quarterly reporting 45 days after the end of the
quarter.
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: Yes I I No
Contact information for the person responsible for grant compliance: Name: Hillary
Saraceno
Phone #:
(541) 317 -3178
Departmental Contact and Title: Debi Harr, Financial Analyst
Phone #:
(541) 330 -4692
Department Director Approval: / /. ::4 g/25709
ggnature Date
Distribution of Document: Please return all three originals to Sandra Flickinger at
the Oregon Commission on Children & Families, 530 Center Street NE, Suite 405,
Salem, OR 97301.
Official Review:
County Signature Required (check one): ❑ BOCC
❑ Department Director (if <$25K)
❑ Administrator (if >$25K but <$150K; if >$150K, BOCC Order No.
Legal Review Date
Document Number 2009 -529
8/26/2 )09
OCCF
State of Oregon
State Commissioners
Samuel Henry, Ed. D., Chair
Rich Brown
Superintendent Susan Castillo
Bruce Goldberg, M.D.
Michael Harper Sr.
Dan Krein
Rev. Mark Knutson
Jean Phelps
Thomas H. Schaefer
Robert Shlachter
Fred Warner
Laurie Warner
Dick Withnell
Jon Yunker
Ex- Officio Members
Jay Dixon
Senator Jeff Kruse
Victor Merced
Camille Preus
Stephanie Soares Pump
Molly Rogers
Honorable Nan Waller
Representative Gene Whisnant
Mickey Lansing
Executive Director
530 Center St NE, Suite 405
Salem, Oregon 97301
Phone: (503)373 -1283
Fax: (503)378 -8395
www.oregon.gov /OCCF
Theodore R. Kulongoski
Governor
August 7, 2009
Deschutes County CCF
Attn: Hillary Saraceno
1130 NW Harriman, Suite A
Bend, OR 97701
RE: 2009 -11 Medicaid Intergovernmental Agreement
Dear Hillary Saraceno,
Enclosed is the 2009-11 Medicaid Intergovernmental Agreement between the
Oregon Commission on Children and Families (OCCF) and Deschutes County.
The Agreement has been approved by the Department of Justice — Attorney
General's Office.
The process of the 50% required general fund Match will be handled slightly
different this biennium. In the past, the general fund match was deducted
directly from the county's remaining Healthy Start General Fund which caused
confusion in the second year of funding. This biennium we will invoice and
require all counties to submit payment for the required match each quarter.
Per Oregon Administrative Rule (OAR) 423 - 010 - 0027(3), all Intergovernmental
Agreements must be signed by the Board of County Commissioners. Please have
your County BOCC review, sign and mail two copies of the enclosed Agreement
to:
Oregon Commission on Children and Families
Attn: Sandra Flickinger
530 Center Street NE, Suite 405
Salem, OR 97301
Once all parties have signed, OCCF will send a fully executed Agreement to you
for your files.
If you have any questions, please don't hesitate to contact us.
incerely,
kg,244---‘
Marsha Clark
Operations Director
Enclosures: 2009 -11 County Medicaid Intergovernmental Agreement
AGREEMENT #DES0911 -MAC
OREGON COMMISSION ON CHILDREN AND FAMILIES
2009 -2011 COUNTY HEALTHY START - MEDICAID ADMINISTRATIVE ACTIVITIES
INTERGOVERNMENTAL AGREEMENT
This Oregon Commission on Children and Families 2009 -2011 County Healthy Start —
Medicaid Administrative Activities Intergovernmental Agreement (this "Agreement ") is entered
into by and between the State of Oregon (the "State ") acting by and through its State Commission
on Children and Families ("AGENCY ") and Deschutes County, a political subdivision of the
State of Oregon, acting by and through its Local Commission on Children and Families
("COUNTY").
RECITALS
WHEREAS, under Title XIX of the Social Security Act ("the Act "), the federal
government and states share the cost of funding the Medicaid program, which provides medical
assistance to certain low- income individuals. Federal Financial Participation ( "FFP ") is the
federal government's share for states' Medicaid program expenditures. The State is required to
share in the cost of medical assistance expenditures, and the Act permits both state and local
governments to participate in the financing of the non - Federal portion of medical assistance
expenditures ("State Share "). States may claim FFP for providing administrative activities that
are found to be necessary by the Secretary of the U.S. Department of Health and Human Services,
Centers for Medicare and Medicaid Services (`CMS ") for proper and efficient administration of
the Title XIX Medicaid Oregon State Plan (the "State Medicaid Plan ").
WHEREAS, the State Medicaid program is administered by the Department of Human
Services ( "DHS "), pursuant to ORS 409.010(3), 417.735(7), and 417.735(13), DHS has an
interagency agreement with AGENCY that authorizes AGENCY to administer Medicaid
administrative activities for purposes of the Healthy Start Family Support Services Program
authorized under ORS 417.795. AGENCY administers those Medicaid administrative services
through its Agreement with the COUNTY.
WHEREAS, ORS 417.760 et seq. establish COUNTY as a governmental agency
authorized to perform governmental functions and exercise governmental powers. The Healthy
Start Program authorized in ORS 417.795, authorizes COUNTY to establish Healthy Start
Family Support Services programs through contracts, as funding becomes available.
WHEREAS, consistent with the goals of the Healthy Start Program, AGENCY and
COUNTY, intend to improve health services access and availability for children and families
eligible for medical assistance under Medicaid who reside in the geographic areas served by the
COUNTY pursuant to ORS 417.760 et seq. Under the Agreement, COUNTY, through
subcontracts with local providers ('Providers "), who must be enrolled with the DHS Department
of Medical Assistance Program ( "DMAP ") to provide Medicaid services, will perform Title XIX
administrative activities. COUNTY will utilize its Providers to provide outreach, health care
coordination, and other medical assistance related administrative activities that support the
administration of the State Medicaid Plan.
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WHEREAS, 42 CFR 433.51 permits the use of State funds allocated to the COUNTY to
be considered as the State Share in obtaining FFP; and
WHEREAS, AGENCY and COUNTY desire to enter into this contractual relationship
to ensure optimal utilization of available federal funding for Healthy Start administrative
activities in order to better serve the eligible Medicaid population of Oregon;
NOW THEREFORE, in consideration of the mutual premises set forth above and other
good and valuable consideration the receipt and sufficiency of which is hereby acknowledged, the
parties hereto agree as follows:
AGREEMENT
L EFFECTIVE DATE AND DURATION. Upon execution by each of the parties hereto
and approval as required by applicable law, the Agreement shall become effective as of July 1,
2009. Unless terminated earlier in accordance with its terms, the Agreement shall terminate on
June 30, 2011.
II. STATEMENT OF WORK. COUNTY shall, through subcontracts with its Providers,
provide Title XIX administrative activities, including but not limited to Outreach Activities to
Inform Families about Health Services and Benefits, Case Planning/Referral /Interagency
Coordination, and Wellness Activities and Preventative Health Care Services, each as further
defined in the attached Attachment A, which is incorporated herein by this reference (the
"Work "). Medicaid does not pay for administrative expenditures related to, or in support of,
services that are not included in the State Medicaid Plan, the Oregon Health Plan, or services
which are not reimbursed under Medicaid.
A. COUNTY Responsibilities.
1. COUNTY represents that it is a local governmental entity established
pursuant to ORS 417.760 et seq., and that it is authorized by local authority to
enter into the Agreement.
2. COUNTY shall enter into written subcontracts that require its Providers
to submit, necessary information for developing a Medicaid claim for Medicaid
allowable activities to AGENCY on a quarterly basis, including: a list of each
individual identified as performing activities under the Agreement and the salary
and other personnel expenses for each identified individual; and the actual time
study record of all activities.
3. COUNTY shall enter into written subcontracts that require its Providers
to participate in time studies required under the Agreement and to utilize the
specific activity codes ( "Activity Codes ") and time study methodology approved
by AGENCY, DHS, and the U.S. Department of Health and Human Services,
Centers for Medicare and Medicaid Services ( "CMS ") to document time spent on
each administrative activity listed in Attachment A and to claim all allowable
costs under the Agreement. COUNTY shall require its Providers to participate
in the time study during the four days per quarter determined by AGENCY. The
Activity Codes that COUNTY shall require its Providers to use are attached to
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the Agreement as Attachment A. AGENCY will provide the form of the time
study Providers must utilize to COUNTY.
4. COUNTY shall enter into written subcontracts that require its Providers
to participate, not less than annually, in State - offered Medicaid training on the
implementation of the time study and Activity Codes to ensure its Providers
makes claims only for allowable Medicaid administrative activities.
5. COUNTY shall enter into written subcontracts that require of its
Providers that all reimbursement claims for administrative activities are claimed
in accordance with OMB Circular A -87. The administrative activities eligible for
reimbursement must be directly related to the administration of the State
Medicaid Plan.
6. COUNTY shall enter into written subcontracts that require its Providers
to maintain, and make available to COUNTY and AGENCY upon request, the
following information on:
a. Employees who perform services under the Agreement: the
employee's name, title, job description, education level, salary, and other
personnel expenses for each individual; and
b. Cost information: records to indicate the nature and extent of
services provided, and other resources that have been applied to offset
costs; and
c. Time study records
d. Any other information applicable to the Medicaid administrative
services provided under the Agreement.
7. COUNTY shall enter into written subcontracts that require its Providers
to provide, all records that support the quarterly claim, upon request of
AGENCY, DHS, the Oregon Department of Justice, the Oregon Secretary of
State, or federal officials.
8. COUNTY'S written subcontracts with Providers shall comply with all
requirements of 42 CFR 434.6 as applicable.
9. COUNTY shall enter into written subcontracts that require of its
Providers that Medicaid eligible children and families receiving assistance
administered under this Agreement be free to accept or reject Medicaid services
and to receive such service from an enrolled provider of their choice unless
otherwise restricted to a provider of the Oregon Health Plan by DHS.
10. COUNTY must advise Provider that Provider may include in its claim to
COUNTY the actual costs billed to Provider by COUNTY for the performance
of Medicaid Administrative Activities provided by COUNTY to Provider in its
submission to the COUNTY for the purpose of calculating the Provider's
Medicaid Administrative Claim.
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11. COUNTY shall comply with and require by contract that any Provider
comply with all requirements set forth in this Agreement, including but not
limited to Attachment B, "Additional Requirements ", attached to and made a part
of this Agreement by this reference.
B. AGENCY Responsibilities.
1. DHS shall determine the dates during each quarter on which the time
study shall be conducted, and AGENCY shall communicate those dates to the
COUNTY and Providers conducting the time study.
2. Upon receipt of time study records from Providers, AGENCY will
compile the time study results on a quarterly basis, calculate the administrative
Medicaid claim, and submit the administrative Medicaid claim for payment to
DHS.
3. AGENCY shall provide technical assistance in the identification of
allowable Medicaid administrative activities under the Agreement.
4. AGENCY shall assist COUNTY and Providers in responding to any
federal Medicaid compliance issues related to the Agreement.
III. CONSIDERATION
A. Summary of Medicaid Payment Methodology
Under Title XIX of the Act, the federal government and states share the cost of
providing allowable Medicaid administrative activities. COUNTY will provide
under this Agreement 50% of the total allowable costs attributable to Medicaid
Administrative activities. AGENCY will pay COUNTY the total allowable
costs of providing Medicaid administrative activities in arrears on a quarterly
basis. COUNTY shall then reimburse AGENCY 50% of the total allowable
costs of providing Medicaid administrative activities, which represents the State
match portion of the Medicaid expenditures. The State match funds COUNTY
transfers to AGENCY shall be public funds that are not federal funds, or shall be
federal funds authorized by federal law to be used to match other federal funds.
DHS will claim the Federal Financial Participation (FFP) amount from U.S.
Department of Health and Human Services, Centers for Medicare and Medicaid
Services (CMS).
In addition, COUNTY on a quarterly basis will pay to AGENCY an
intergovernmental charge of 1% (one percent) of the total allowable cost of
providing Medicaid administrative activities.
Allowable administrative Medicaid costs are separate from any other direct
Medicaid or other services that may be provided by COUNTY pursuant to
separate Medicaid funding agreements or authorizations. Duplicate payments are
not allowable when determining administrative costs under Medicaid. Payments
for allowable activities must not duplicate payments that have been or should
have been included and paid as part of a rate for services, part of a capitation rate,
MedAdmIGA doc: 4 of 27
or through some other local, State or federal program. Medicaid administrative
costs may not be claimed for activities that are integral parts or extensions of
medical services. Furthermore, in no case shall COUNTY be reimbursed more
than the actual cost of the activities claimed by COUNTY under this Agreement.
AGENCY'S payment obligation is conditioned on: (1) AGENCY receiving
payment from DHS in an amount sufficient to pay COUNTY; (2) AGENCY
receiving the necessary time study results from Providers to calculate the
quarterly claim for Medicaid administrative activities; and (3) AGENCY
reasonably determining to accept the quarterly claim for Medicaid administrative
activities, in whole or in part. COUNTY'S obligation to perform under this
Agreement is conditioned on: (1) AGENCY'S timely payment in arrears for past
performance due under this Agreement, and (2) AGENCY receiving payment
from DHS in an amount sufficient to pay COUNTY for the provision of
prospective performance due under this Agreement.
B. Payment for all Work performed under this Agreement shall be subject to the
provisions of ORS 293.462. The maximum, not to exceed amount for the total
cost of providing Medicaid administrative activities under this Agreement is
$215,000. COUNTY shall reimburse AGENCY 50% of this amount for the
State match portion.
C. AGENCY will not pay for any Work performed before the beginning date or
after the expiration date of this Agreement including amendments thereto.
D. COUNTY shall submit claims for Medicaid allowable activities only. Medicaid
does not pay for administrative expenditures related to, or in support of, services
that are not included in the State Medicaid Plan, the Oregon Health Plan, or
services which are not reimbursed under Medicaid. In addition, Medicaid does
not pay for health care services that are rendered free of charge to the general
population. Thus, any administrative activity which supports the referral,
coordination, planning of screening or services that are provided free to the
general population would not be considered as Medicaid administration.
E. Total Allowable Administrative Costs for which COUNTY may request
reimbursement from AGENCY under this Agreement include the following
costs.
1. AGENCY incurs administrative costs in its administration of the Agreement,
including but not limited to processing the Provider time studies and
calculating the allowable Medicaid administrative claiming on behalf of
COUNTY, and payment of an intergovernmental charge to DHS.
AGENCY invoices COUNTY on a quarterly basis for the administrative
expenses incurred from the above responsibilities under this Agreement, not
to exceed actual costs.
2. COUNTY incurs indirect Medicaid costs in its administration of the
Agreement, including payment of AGENCY administrative costs invoiced to
COUNTY as described in paragraph 1 of this subsection and other actual
Medicaid indirect costs associated with administering the tasks authorized
under this Agreement with its Providers such as implementation of the time
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study requirements. COUNTY'S actual Medicaid indirect costs must be
documented and justifiable. COUNTY will include in its claim for Total
Allowable Administrative Costs to AGENCY the amount of the
COUNTY'S actual Medicaid indirect costs.
3. Consistent with Subsection II.A of this Agreement, COUNTY will obtain
Provider time study information for the purpose of obtaining reimbursement
for Provider Medicaid administrative claiming COUNTY'S total Allowable
Administrative Costs shall include the Provider Medicaid administrative
claiming information.
4. Total Allowable Administrative Costs that may be claimed by COUNTY
under this Agreement are the amounts described in paragraphs 2 and 3 of this
subsection.
F. COUNTY shall invoice AGENCY quarterly, in arrears for the Total Allowable
Administrative Costs identified in Subsection E of this section.
1. AGENCY will reimburse COUNTY in arrears on a quarterly basis for
the total allowable costs of providing Medicaid administrative services
accepted by AGENCY.
2. COUNTY will reimburse AGENCY quarterly upon invoice from the
State for the State match portion which is equal to 50% of the amount
billed by COUNTY and accepted by AGENCY for the total allowable
Medicaid administrative costs.
G. COUNTY shall send itemized invoice to the following AGENCY supervising
representative:
Marsha Clark, Business Services Manager
State Commission on Children and Families
Contracts and Procurement Office
530 Center Street NE, #405
Salem, OR 97301 -3754
H. COUNTY represents by its signature to this Agreement that for the purposes of
42 CFR 433.51, the funds it transfers to AGENCY pursuant to this Agreement
are public funds that are not federal funds, or are federal funds authorized by
federal law to be used to match other federal funds.
IV. RECOVERY OF FUNDS
To the extent permitted by law, including without limitation, applicable constitutional,
statutory and regulatory provisions and controlling governmental determinations and
orders, , COUNTY shall be financially responsible for the final amount of any claim for
Work provided under this Agreement that CMS, DHS, or AGENCY finds unallowable
under the Medicaid program. In the event CMS, DHS, or AGENCY finds any costs
claimed by COUNTY unallowable, AGENCY shall provide COUNTY written notice
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identifying the amount that must be refunded to CMS, DHS, or AGENCY. Within thirty
(30) calendar days of AGENCY'S notice, COUNTY shall either (1) make payment to
AGENCY for the full amount of the unallowable cost identified by AGENCY in its
notice; or (2) notify AGENCY in writing that COUNTY wishes to repay the
unallowable amount from future payments or other means. AGENCY may then offset
the unallowable amount from future payments owed to COUNTY under this Agreement,
or any payment to COUNTY from AGENCY under any other contract or agreement
between COUNTY and AGENCY, present or future. Nothing in this section shall be
construed as a waiver by either party of any process or remedy that might otherwise be
available. The rights and remedies of AGENCY set forth in this section shall not be
exclusive and are in addition to any other rights and remedies provided to AGENCY by
law or under this Agreement.
If payments to COUNTY by AGENCY under this Agreement are made in error or are
found to be excessive under the terms of this Agreement, AGENCY, after giving written
notification to COUNTY, shall enter into nonbinding discussions with COUNTY within
15 days of the written notification. If, after discussions, the parties agree that payments
were made in error or found to be excessive, AGENCY may withhold payments due
COUNTY under this Agreement in such amounts, and over such periods of time, as are
deemed necessary by the parties to recover the amount of the overpayment.
Nothing in this Agreement shall require COUNTY or AGENCY to act in violation of
law, including without limitation, applicable constitutional, statutory and regulatory
provisions and controlling governmental determinations and orders.
V. GENERAL PROVISIONS
A. Compliance with Law. COUNTY shall comply and shall require its Providers
to comply, with all federal, state and local laws, regulations, executive orders and
ordinances applicable to the Work under this Agreement. Without limiting the generality
of the foregoing, COUNTY expressly agrees to comply with: (i) Title VI of the Civil
Right Act of 1964; (ii) Section V of the Rehabilitation Act of 1973; (iii) the Americans
with Disabilities Act of 1990 and ORS 659A.142; (iv) the Health Insurance Portability
and Accountability Act of 1996; (v) the Federal Funding Accountability and
Transparency Act (FFATA) of 2006 (P.L.109 -282), provisions of which include but may
not be limited to a requirement for County and/or Providers to have a Data Universal
Numbering System (DUNS) number and to maintain a current registration in the Central
Contractor Registration (CCR) database; (vi) all regulations and administrative rules
established pursuant to the foregoing laws; and (vii) all other applicable requirements of
federal and state civil rights and rehabilitation statutes, rules and regulations. In the
performance of Work under this Agreement, COUNTY shall use recyclable and recycled
products to the maximum extent which is economically feasible. No federal funds may
be used to provide Services in violation of 42 USC 14402.
B. Subcontracts. COUNTY shall enter into subcontracts for the purposes of
performing the Work under the Agreement. COUNTY shall not permit any person or
entity to be a Provider unless the person or entity holds all licenses, certificates,
authorizations and other approvals required by applicable law to deliver the Work.
Subcontracts must be in writing and contain each of the provisions necessary to permit
COUNTY to comply with its obligations under the Agreement with respect to the Work
performed by the Provider, and any other provisions AGENCY deems to be reasonably
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appropriate. COUNTY shall maintain an originally executed copy of each subcontract at
its office and shall furnish a copy of any subcontract to AGENCY upon request.
C. Termination.
1. The Agreement may be terminated at any time by mutual written consent
of both parties, or by either party upon thirty (30) days notice, in writing, and
delivered by certified mail or in person.
2. In addition, either Party may terminate the Agreement, in whole or in
part, immediately upon notice to the other, or if AGENCY terminates, at such
later date as AGENCY may choose to establish in such notice, under any of the
following conditions:
a. Federal or state regulations or guidelines are modified, changed, or
interpreted in such a way that the Work under the Agreement is prohibited or
AGENCY is prevented from paying for such Work from the planned funding
source;
b. AGENCY fails to receive funding, appropriations, limitations, or other
expenditure authority at levels sufficient to pay for the Work; or
c. The other party, including its employees, agents or assigns, commits any
material breach or default of any covenant, warranty, or obligation under this
Agreement, fails to perform the Work under this Agreement within the time
specified herein or any extension thereof, or so fails to pursue the Work as to
endanger the other's performance under this Agreement in accordance with
its terms, and fails to correct such breach, default, or failures within ten (10)
calendar days after delivery of notice by the other Party, or if AGENCY
terminates, such longer period as AGENCY may choose to specify in such
notice.
3. Upon receiving a notice of termination from AGENCY, COUNTY shall
immediately cease all activities under the Agreement, unless expressly directed
otherwise by AGENCY in the notice of termination. Upon termination,
COUNTY shall deliver to AGENCY all Agreement documents, information,
works -in- progress and other property that are or would be deliverables had the
Agreement been completed.
4. Termination of this Agreement pursuant to this Subsection V.0 shall be
without prejudice to any obligations or liabilities of either party already accrued
prior to such termination. Specifically, but without limiting the generality of the
preceding sentence, termination of this Agreement shall neither affect
AGENCY'S right to recover funds from COUNTY pursuant to Section IV nor
COUNTY'S right to payment under Subsection III.A for Work appropriately
performed prior to termination.
5. In the event insufficient funds are appropriated for performance of the
Work under this Agreement and the COUNTY has no other lawfully available
funds to pay for such Work, then the COUNTY may terminate this Agreement at
the end of its current fiscal year, with no further liability or penalty to AGENCY.
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COUNTY must deliver written notice to AGENCY of termination pursuant to
this paragraph 5 not later than (a) thirty (30) days from the determination by the
COUNTY of the event of non - appropriation or (b) thirty (30) days from the end
of the legislative session, whichever first occurs.
D. Confidentiality of Client Information
1. The Work provided under the Agreement does not include the use of,
access to, exchange of or disclosure of personally identifiable health information.
Therefore, the parties reasonably believe that the HIPAA Privacy Rules in 45
CFR Parts 160 and 164 do not apply. The Agreement does not require or provide
for the use of "standard transactions" as that term is used in the HIPAA
Transaction Rules, 45 CFR Part 162. If the Work is revised, or if the federal
HIPAA requirements are changed or interpreted in a way that would require the
Work to comply with any HIPAA requirement, the parties may amend the
Agreement to address such change or interpretation.
2. The use or disclosure of information concerning the administration of the
Medicaid program shall be limited to persons directly connected with the
administration of the Agreement unless otherwise authorized or required by law.
AGENCY and COUNTY shall apply confidentiality policies to all requests from
outside sources.
E. Record Maintenance; Access. COUNTY shall maintain all fiscal records
relating to the Agreement in accordance with generally accepted accounting principles.
In addition, COUNTY shall maintain any other records pertinent to the Agreement in
such a manner as to clearly document COUNTY'S performance. COUNTY
acknowledges and agrees that AGENCY, DHS, the Oregon Department of Justice, the
Oregon Secretary of State's Office, and the federal government and their duly authorized
representatives shall have access to such fiscal records and other books, documents,
papers, plans, and writings of COUNTY that are pertinent to the Agreement to perform
examinations and audits and to make excerpts and transcripts. COUNTY shall retain and
keep accessible all such fiscal records, books, documents, papers, plans, and writings for
a minimum of seven (7) years, or such longer period as may be required by applicable
law, following final payment and termination of the Agreement, or until the conclusion of
any audit, controversy or litigation arising out of or related to the Agreement, whichever
date is later. COUNTY shall require its Providers to comply with the requirements in this
section.
F. Notice. Except as otherwise expressly provided in the Agreement, any
communications between the parties hereto or notices to be given hereunder shall be
given in writing by personal delivery, facsimile, or mailing the same, postage prepaid to
COUNTY or AGENCY at the address or number set forth below, or to such other
addresses or numbers as either party may indicate pursuant to this section. Any
communication or notice so addressed and mailed shall be effective on the fifth calendar
day after the date of mailing. Any communication or notice delivered by facsimile shall
be effective on the day the transmitting machine generates a receipt of the successful
transmission, if transmission was during normal business hours of the recipient, or on the
next business day, if transmission was outside normal business hours of the recipient. To
be effective against AGENCY, any notice transmitted by facsimile must be confirmed by
telephone notice to AGENCY'S Office of Contracts and Procurement at (503) 373 -1283.
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To be effective against COUNTY, any notice transmitted by facsimile must be
confirmed by telephone notice to COUNTY'S Local Commission on Children and
Families Office. Any communication or notice given by personal delivery shall be
effective when actually delivered.
Notices to AGENCY: State Commission on Children and Families
Contracts and Procurement Office
530 Center Street NE, #405
Salem, OR 97301 -3754
Notices to COUNTY: Deschutes County Commission on Children & Families
1130 NW Harriman, Suite A
Bend, OR 97701
G. Severability. The parties agree that if any term or provision of the Agreement is
declared by a court of competent jurisdiction to be illegal or in conflict with any law, the
validity of the remaining terms and provisions shall not be affected, and the rights and
obligations of the parties shall be construed and enforced as if the Agreement did not
contain the particular term or provision held to be invalid.
H. Counterparts. The Agreement may be executed in several counterparts, all of
which when taken together shall constitute one agreement binding on all parties,
notwithstanding that all parties are not signatories to the same counterpart. Each copy of
the Agreement so executed shall constitute an original.
I. Governing Law; Venue; Consent to Jurisdiction. The Agreement shall be
governed by and construed in accordance with the laws of the State of Oregon without
regard to principles of conflicts of law. Any claim, action, suit or proceeding
(collectively, "Claim ") between AGENCY (and/or any other agency of the State of
Oregon) and COUNTY that arises from or relates to the Agreement shall be brought and
conducted solely and exclusively within a circuit court in the State of Oregon of proper
jurisdiction. In no event shall this section be construed as a waiver by the State of
Oregon of any form of defense or immunity, whether sovereign immunity, governmental
immunity, immunity based on the eleventh amendment to the Constitution of the United
States or otherwise, from any Claim or from the jurisdiction of any court. COUNTY,
BY EXECUTION OF THE AGREEMENT, HEREBY CONSENTS TO THE IN
PERSONAM JURISDICTION OF SAID COURTS.
J. Assignment of Contract, Successors in Interest.
1. COUNTY shall not assign or transfer its interest in the Agreement
without prior written approval of AGENCY. Any such assignment or transfer, if
approved, is subject to such conditions and provisions as the AGENCY may
deem necessary. No approval by the AGENCY of any assignment or transfer of
interest shall be deemed to create any obligation of the AGENCY in addition to
those set forth in the Agreement.
2. The provisions of this Agreement shall be binding upon and shall inure
to the benefit of the parties hereto, and their respective successors and permitted
assigns.
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K. No Third Party Beneficiaries. AGENCY and COUNTY are the only parties to
the Agreement and are the only parties entitled to enforce its terms. The parties agree
that COUNTY'S performance under this Agreement is solely for the benefit of
AGENCY to assist and enable AGENCY to accomplish its statutory mission. Nothing
in the Agreement gives, is intended to give, or shall be construed to give or provide any
benefit or right, whether directly, indirectly or otherwise, to third persons any greater than
the rights and benefits enjoyed by the general public unless such third persons are
individually identified by name herein and expressly described as intended beneficiaries
of the terms of the Agreement.
L. Integration and Waiver. The Agreement, including all of its Attachments,
constitutes the entire agreement between the parties on the subject matter hereof. There
are no understandings, agreements, or representations, oral or written, not specified
herein regarding the Agreement. The failure of either party to enforce any provision of
the Agreement shall not constitute a waiver by that party of that or any other provision.
The remedies provided herein are cumulative and not exclusive of any remedies provided
by law.
M. Amendment. No waiver, consent, modification or change of terms of the
Agreement shall bind either party unless in writing and signed by both parties and when
required the Department of Administrative Services and Department of Justice. Such
waiver, consent, modification or change, if made, shall be effective only in the specific
instance and for the specific purpose given. COUNTY, by signature of its authorized
representative, hereby acknowledges that it has read this Agreement, understands it, and
agrees to be bound by its terms and conditions.
N. Headings. The headings and captions to sections of the Agreement have been
inserted for identification and reference purposes only and shall not be used to construe
the meaning or to interpret the Agreement.
O. Construction. This Agreement is the product of negotiations between
representatives of AGENCY and representatives of COUNTY. The provisions of this
Agreement are to be interpreted and their legal effects determined as a whole. An
arbitrator or court interpreting this Agreement shall give a reasonable, lawful and
effective meaning to the Agreement to the extent possible, consistent with the public
interest.
P. Limitation of Liabilities. EXCEPT FOR LIABILITY OF DAMAGES
ARISING OUT OF OR RELATED TO SECTIONS VI AND V OF THIS
AGREEMENT, NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR ANY
INCIDENTAL OR CONSEQUENTIAL DAMAGES ARISING OUT OF OR
RELATED TO THE AGREEMENT. NEITHER PARTY SHALL BE LIABLE FOR
ANY DAMAGES OF ANY SORT ARISING SOLELY FROM THE TERMINATION
OF THIS AGREEMENT OR ANY PART HEREOF IN ACCORDANCE WITH ITS
TERMS.
Q. Force Majeure. Neither AGENCY nor COUNTY shall be held responsible for
delay or default caused by fire, civil unrest, labor unrest, natural causes and war which is
beyond respectively, the AGENCY'S or COUNTY'S reasonable control. Each party
shall, however, make all reasonable efforts to remove or eliminate such cause of delay or
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default and shall, upon the cessation of the cause, diligently pursue performance of its
obligations under the Agreement.
R. Time is of the Essence. The parties agree that time is of the essence under this
Agreement.
VI. FEDERAL PROVISIONS
A. In addition to the requirements of Subsection V.A, COUNTY shall comply and,
as indicated, require all Providers to comply with the following federal requirements. For
purposes of the Agreement, all references to federal and state laws are references to
federal and state laws as they may be amended from time to time.
1. Equal Employment Opportunity. If the Agreement, including amendments,
is for more than $10,000, then COUNTY shall comply with Executive Order
11246, entitled "Equal Employment Opportunity," as amended by Executive
Order 11375, and as supplemented in Department of Labor regulations (41 CFR
Part 60).
2. Clean Air, Clean Water, EPA Regulations. If the Agreement, including
amendments, exceeds $100,000 then COUNTY shall comply with all applicable
standards, orders, or requirements issued under Section 306 of the Clean Air Act
(42 U.S.C. 1857(h)), the Federal Water Pollution Control Act as amended
(commonly known as the Clean Water Act) (33 U.S.C. 1251 to 1387),
specifically including, but not limited to Section 508 (33 U.S.C. 1368).
Executive Order 11738, and Environmental Protection Agency regulations (40
CFR Part 15), which prohibit the use under non - exempt Federal contracts, grants
or loans of facilities included on the EPA List of Violating Facilities. Violations
shall be reported to AGENCY, the U.S. Department of Health and Human
Services and the appropriate Regional Office of the Environmental Protection
Agency. COUNTY shall comply with, and include in its contracts with all
Providers receiving more than $100,000 in Federal Funds language requiring the
Provider to comply with, the federal laws identified in this section.
3. Energy Efficiency. COUNTY shall comply with applicable mandatory
standards and policies relating to energy efficiency that are contained in the
Oregon energy conservation plan issued in compliance with the Energy Policy
and Conservation Act (Pub. L. 94 -163).
4. Truth in Lobbying. COUNTY certifies, to the best of COUNTY'S
knowledge and belief that:
a. No federal appropriated funds have been paid or will be paid, by or on
behalf of COUNTY, to any person for influencing or attempting to influence
an officer or employee of an agency, a Member of Congress, an officer or
employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any federal contract, the making of any
federal grant, the making of any federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment
or modification of any federal contract, grant, loan or cooperative agreement.
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b. If any funds other than federal appropriated funds have been paid or will
be paid to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with this
federal contract, grant, loan or cooperative agreement, COUNTY shall
complete and submit Standard Form LLL, "Disclosure Form to Report
Lobbying" in accordance with its instructions.
c. COUNTY shall require that the language of this certification be included
in the award documents for all subawards at all tiers (including subcontracts,
subgrants, and contracts under grants, loans, and cooperative agreements)
and that all subrecipients and subcontractors shall certify and disclose
accordingly.
This certification is a material representation of fact upon which reliance was
placed when the Agreement was made or entered into. Submission of this
certification is a prerequisite for making or entering into the Agreement
imposed by section 1352, Title 31, U.S. Code. Any person who fails to file
the required certification shall be subject to a civil penalty of not less than
$10,000 and not more than $100,000 for each such failure.
5. Resource Conservation and Recovery. COUNTY shall comply and require
all Providers to comply with all mandatory standards and policies that relate to
resource conservation and recovery pursuant to the Resource Conservation and
Recovery Act (codified at 42 USC 6901 et. seq.). Section 6002 of that Act
(codified at 42 USC 6962) requires that preference be given in procurement
programs to the purchase of specific products containing recycled materials
identified in guidelines developed by the Environmental Protection Agency.
Current guidelines are set forth in 40 CFR Parts 247 -253.
6. Audits. COUNTY shall comply and, if applicable, require Providers to
comply, with the applicable audit requirements and responsibilities set forth in
the Office of Management and Budget Circular A -133 entitled "Audits of States,
Local Governments and Non - Profit Organizations."
7. Debarment and Suspension. COUNTY shall not permit any person or
entity to be a Provider if the person or entity is listed on the non - procurement
portion of the General Service Administration's "List of Parties Excluded from
Federal Procurement or Nonprocurement Programs" in accordance with
Executive Orders No. 12,549 and No. 12,689, "Debarment and Suspension" (See
45 CFR part 76). This list contains the names of parties debarred, suspended, or
otherwise excluded by agencies, and contractors declared ineligible under
statutory authority other than Executive Order No. 12549. Providers with awards
that exceed the simplified acquisition threshold shall provide the required
certification regarding their exclusion status and that of their principals prior to
award.
8. Medicaid Compliance. To the extent COUNTY provides any Work whose
costs are paid in whole or in part by Medicaid, COUNTY shall comply with and
require its Providers to comply with the federal and state Medicaid statutes and
regulations applicable to the Work, including but not limited to:
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a. Keeping such records as may be necessary to disclose the extent of
services furnished to clients and, upon request, furnish such records or other
information to DHS, the Oregon Department of Justice and the Secretary of
the U.S. Department of Health and Human Services;
b. Complying with all applicable disclosure requirements set forth in 42
CFR 1002.3(a) and 42 CFR Part 455, Subpart B;
c. Complying with any applicable advance directive requirements specified
in 42 USC Section 1396(a)(57) and 42 CFR section 431.107(b)(4);
d. Complying with the applicable certification requirements of 42 CFR
sections 455.18 and 455.19, including that information submitted with any
claim for the provision of Medicaid Services is true, accurate and complete;
and
e. Requiring that entities receiving $5 million or more annually under this
Agreement and any other Medicaid contract shall, as a condition of receiving
such payments, adopt written fraud, waste and abuse policies and procedures
and inform employees, contractors and agents about the policies and
procedures in compliance with Section 6032 of the Deficit Reduction Act of
2005, 42 USC §1396a(a)(68).
COUNTY shall include in all agreements with Providers receiving Medicaid
language requiring the Provider to comply with the record keeping and reporting
requirements set forth in this section and with the federal laws identified in this
section.
9. Americans with Disabilities Act. COUNTY shall comply with and require
all Providers by contract to comply with Title II of the Americans with
Disabilities Act of 1990 (codified at 42 USC 12131 et. seq.) in the construction,
remodeling, maintenance and operation of any structures and facilities, and in the
conduct of all programs, services and training associated with the delivery of
Work.
10. Pro - Children Act. COUNTY shall comply with and require all Providers
by contract to comply with the Pro - Children Act of 1995 (codified at 20 USC
section 6081 et. seq.).
11 HIPAA Compliance. COUNTY shall comply with and require all
Providers to comply with Title II of the Americans with Disabilities Act of 1990
(codified at 42 USC 12131 et. seq.) in the construction, remodeling, maintenance
and operation of any structures and facilities, and in the conduct of all programs,
services and training associated with the delivery of services.
Additional Certification: By execution of the Agreement, I, an authorized representative of
COUNTY, certify that COUNTY has provided training and education to its employees and
agents employed to affect the required terms and conditions of this Agreement, and so require of
them that all data, claims, submissions or other submissions that provide a basis for claiming or
receiving reimbursement under the Agreement will be true, accurate, and complete; that payment
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of claims to COUNTY will be from federal and State funds, and therefore, any falsification or
concealment of a material fact by COUNTY when submitting claims or other submissions to
obtain payments may be prosecuted under federal and State laws.
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be duly
executed as of the dates set forth below their respective signatures.
State of Oregon County
acting by and through its Commission
on Children and Families
acting by and through its Local Commission
on Children and Families
By: By:
Name: Name:
Title: Title:
Date: Date:
Tammy Baney, Chair
Deschutes County Board of
Commissioners
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OREGON COMMISSION ON CHILDREN AND FAMILIES
2009 -2011 COUNTY HEALTHY START — MEDICAID
INTERGOVERNMENTAL AGREEMENT
ATTACHMENT A
ACTIVITY CODES
Al. Outreach Activities to Inform Families about Health Services and Benefits
Meetings, home visits or phone contacts to obtain information about a family's access to health
care, and to inform families about state programs to pay for medical care (i.e. Medicaid, EPSDT,
etc.), creating or dissemination of materials to inform children and families about Medicaid and
health benefits available, assisting a child and family in determining and establishing Medicaid
eligibility (i.e. collecting information for the Medicaid application, helping complete necessary
forms for the Medicaid application, helping complete necessary forms for the Medicaid
application, updating any forms when a child's circumstances change), related staff travel,
clerical, and paperwork.
A2. Outreach and Application Assistance for Non - Medicaid /OHP Programs:
Activities that assist the child/family in gaining access to non- Medicaid/OHP services and
effectively utilizing social services and community wellness programs. (Included are housing,
commodities, food banks, Women's Infant and Children Program ( "WIC "), foster care, financial
assistance, exercise and weight loss programs, energy assistance, child care, after school
programs, friendly visitor and vocational services). Activities that assist the child/family in
applying for these services, including form preparation, related staff travel, clerical, and
paperwork.
Bl. Case Planning, Monitoring, Coordination, Referral and Training of Medicaid /OHP
Covered Services
Case planning and referral includes the following types of activities; included in all of them are
related staff travel, clerical, and paperwork:
• Case Planning: Planning, coordination and monitoring case plans for vulnerable
children and families, including any agency staffing to coordinate and plan services
(Individual Family Support Plan, - IFSP -, multidisciplinary team meetings,
conferencing on health, developmental, Public Health Department consultations),
arranging for services, writing case plans or summaries, preparing material for case
reviews, coordinating child specific services (i.e. psychological counseling, health,
substance abuse counseling and consultation), arranging transportation, related
travel and paperwork.
• Referral and Coordination: Making referrals for and coordinating the delivery of
screenings, examinations, assessments and evaluations for health, vision, dental,
developmental, mental health, substance abuse, and other medical or nutritional
services, contact to parents regarding health needs of child, related travel and
paperwork, gathering background information and supportive data such as social
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history and medical history, from standardized forms, notifying primary medical
providers of target population services, developmental screenings and related
service information, arranging transportation.
• Immunization: Notifying parents of immunization requirements, scheduling
immunizations, coordination of immunizations for children and recruitment of
providers to do immunizations, assessing and tracking immunization status,
arranging transportation, related travel and paperwork.
• Maternal Care Services: Arranging for prenatal, postpartum and newborn care,
pre - pregnancy risk prevention, coordinating health education for new mothers
regarding; 1) infant health and development, 2) accident and disease prevention
and home safety. Arranging transportation, related travel and paperwork.
• Family Planning: Developing a family planning, education, counseling and service
program compatible with community norms, locating or developing family
planning information and materials and methods of distribution, developing a
family planning service referral network, related travel and paperwork.
• Developmental Delay: Early identification of age appropriate child development
and / or delays to assure health and developmental problems are found, diagnosed
and treated; assuring early medical consultation and evaluation; preparing and
disseminating child health related materials to parents and others; assisting families
to use the appropriate medical care and understand age appropriate child
development; promote and advocate for appropriate planning for the health /
medical needs of children; related travel and paperwork.
• Other Wellness Activities: Disseminating preventative health care information and
materials, programs and presentations on preventative health care related topics
such as substance abuse prevention programs (this does not include teaching or
facilitating health classes at educational institutions), related travel and paperwork.
• Participating in or coordinating training which improves the delivery of
Medicaid/OHP services, enhances early identification, intervention, screening and
referral of children with special health needs.
B2. Case Planning, Monitoring, Coordination, Referral and Training of Non -
Medicaid/OHP Covered Services
• Assessing and monitoring of the home learning environment using standardized
forms, creating and disseminating information on positive and interactive learning
environments, providing or arranging for reading material for the child, providing
or arranging for age appropriate toys.
• Classroom instruction or presentations, preparation, related paperwork and travel,
attendance at conferences, providing educational or career guidance or
consultation. Includes related staff travel, clerical, and paperwork.
• Case management of social services and community wellness programs (including
housing, commodities, food banks, WIC, foster care, financial assistance, exercise
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and weight loss programs, energy assistance, child care, after school programs,
friendly visitor and vocational services) arranging transportation for these services.
Making referrals for and coordinating the delivery of these social services and
community wellness programs. Arranging transportation for these services and
coordinating or participating in training events and seminars for these services.
Includes related staff travel, clerical, and paperwork.
• Making direct referrals to social services such as housing, energy assistance,
educational and /or special education, childcare, education and Early Intervention,
vocational and transportation to these services, etc., monitoring and follow -up.
Includes related staff travel, clerical and paperwork.
• Participating in or coordinating training which improves the delivery of non -
Medicaid/OHP services.
C1. Medicaid /OHP transportation and translation means:
Assisting an individual to obtain transportation to services covered by OHP, arranging for or
providing translation services to facilitate access to OHP services. Include related paperwork,
clerical activities or staff travel required to perform these activities.
C2. Non - Medicaid /OHP Transportation and Translation means:
Assisting an individual to obtain transportation to services not covered by Medicaid /OHP, or
arranging for or providing translation services related to related to social, vocational, or
educational programs. Include related paperwork, clerical activities or staff travel time required
to perform these activities.
Special Note: Use this code when accompanying an individual to non - Medicaid/OHP services.
Di. System Coordination Related to Medicaid /OHP Services
Working internally and with other agencies to improve services, expand health and medical
services and their utilization to specific target populations, gathering information about their
functions, to improve early identification of health and developmental problems, related staff
travel, clerical, and paperwork.
D2. Coordination Related to Non - Medicaid /OHP Services
Working internally and with other agencies to improve social services, identify gaps in services,
expand and improve capacity to engage in non- Medicaid/OHP activities, expand access and
linkage to non- Medicaid/OHP services, their utilization by specific target populations; related
staff travel, clerical, and paperwork.
E. Direct Health Care Services
Providing direct care, service or treatment to a child in order to correct a condition, (i.e. primary
health care, speech, OT, PT, counseling, or providing screenings such as vision or hearing). Such
services include related staff travel, clerical, and paperwork.
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F. Other Services
All other paid job related activities that do not fall under one of the above categories, lunches,
paid leaves, conferences, staff meetings, and personnel issues.
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OREGON COMMISSION ON CHILDREN AND FAMILIES
2009 -2011 COUNTY HEALTHY START — MEDICAID
INTERGOVERNMENTAL AGREEMENT
ATTACHMENT B
ADDITIONAL REQUIREMENTS
AGENCY hereby grants COUNTY the authority to subcontract the Work required under this
Agreement but COUNTY may not assign or transfer any of its interests in this Agreement
without the prior written consent of the AGENCY. AGENCY'S consent to subcontracts shall
not relieve COUNTY of any of its duties or obligations under this Agreement. In addition to any
other provisions AGENCY may require, COUNTY shall include in any permitted subcontract
under this Agreement a requirement that subcontractor be bound by the following provisions as if
the subcontractor were COUNTY:
I. STATEMENT OF WORK
A. COUNTY Responsibilities. COUNTY shall:
1. Utilize the specific activity codes ( "Activity Codes ") for time study ( "Time
Study "), as set forth in Attachment A, and approved by Department of Human
Services ( "DHS ") and the U.S. Department of Health and Human Services,
Centers for Medicare and Medicaid Services ( "CMS ") to document all time spent
on the Work and to claim all costs under this Agreement for allowable Medicaid
administrative activities.
2. Ensure training is available and provided to its employees and subcontractors on
the implementation of the Time Study and Activity Codes to ensure COUNTY'S
subcontractors make claims only for allowable Medicaid administrative
activities.
3. Ensure that all reimbursement claims for the Work are in accordance with OMB
Circular A -87 and the State Medicaid Plan, both of which are incorporated herein
by this reference. The Work for which COUNTY claims reimbursement must be
directly related to the administration of the State Medicaid Plan for Federal
Financial Participation (FFP) to be available.
4. Maintain the following information on employees and subcontractors who
perform Work under this Agreement: the employee's or subcontractors
employee's name, title, job description, salary, and other personnel expenses for
each individual; the percent of time each employee spends on the coded activities
identified in the Time Study; costs attributable to each person's position
providing Work; the salary of each person providing Work under subcontracts.
5. Claim indirect costs in accordance with OMB Circular A -87.
6. Monitor compliance with the requirements of this Agreement and maintain all
records that support the quarterly payment claim for the Work performed,
including but not limited to, position details, cost information, Time Study
results, records to indicate that services were requested and the extent of services
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provided, other resources that have been applied to offset costs, and any other
information applicable to the Work provided under this Agreement.
7. Upon request from AGENCY, DHS, the Oregon Department of Justice, the
Secretary of State's Office, or the federal government, make available all records
that support the quarterly payment claim for Work performed.
8. Assure that Medicaid eligible children and families receiving assistance under
this Agreement are free to accept or reject Medicaid services and/or to receive
such services from an enrolled provider of their choice unless otherwise
restricted to a provider of the Oregon Health Plan by DHS.
9. Use the Medicaid - eligible percentage for the COUNTY in its cost calculations
unless another statistically based calculation has been approved by AGENCY
and DHS.
II. CONSIDERATION.
COUNTY shall submit claims for Medicaid allowable activities only. Medicaid does not
pay for administrative expenditures related to, or in support of, services that are not
included in the State Medicaid Plan, OHP, or services which are not reimbursed under
Medicaid. In addition, Medicaid does not pay for health care services that are rendered
free of charge to the general population. Thus, any administrative activity which supports
the referral, coordination, planning of screening or services that are provided free to the
general population would not be considered as Medicaid administration.
III. GENERAL PROVISIONS
A. Amendment
The terms of this Agreement shall not be waived, altered, modified, supplemented or
amended, in any manner whatsoever, except by written agreement signed by the
Parties. This Agreement shall not be amended after the expiration date. No
amendment to this Agreement shall be effective until it has been signed by all Parties
and all necessary governmental approvals have been obtained.
B. Compliance with Applicable Law
COUNTY shall comply with all federal, state and local laws, regulations, executive
orders and ordinances applicable to the Work under the Agreement. Without limiting
the generality of the foregoing, COUNTY expressly agrees to comply with the
following laws, regulations and executive orders, as they may be amended from time
to time during the term of the Agreement, to the extent they are applicable to the
Agreement: (i) Titles VI and VII of the Civil Rights Act of 1964, as amended; (ii)
Sections 503 and 504 of the Rehabilitation Act of 1973, as amended; (iii) the
Americans with Disabilities Act of 1990, as amended; (iv) Executive Order 11246, as
amended; (v) The Age Discrimination in Employment Act of 1967, as amended, and
the Age Discrimination Act of 1975, as amended; (vi)The Vietnam Era Veterans'
Readjustment Assistance Act of 1974, as amended; (vii) The Family Educational
Rights and Privacy Act, as amended; (viii) ORS Chapter 659, as amended; (ix) all
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regulations and administrative rules established pursuant to the foregoing laws; and
(x) all other applicable requirements of federal and state civil rights and rehabilitation
statutes, rules and regulations. These laws, regulations and executive orders are
incorporated by reference herein to the extent that they are applicable to the
Agreement and required by law to be so incorporated. AGENCY'S performance
under this Agreement is conditioned upon COUNTY'S compliance with the
provisions of ORS 279.312, 279.314, 279.316, and 279.320, which are incorporated
by reference herein. In the performance of Work under this Agreement, COUNTY
shall use recycled and recyclable products to the maximum extent which is
economically feasible.
C. Compliance with Federal Law
1. Equal Employment Opportunity
If this Agreement, including amendments, is for more than $10,000, then
COUNTY shall comply with Executive Order 11246, entitled "Equal
Employment Opportunity," as amended by Executive Order 11375, and
as supplemented in Department of Labor regulations (41 CFR Part 60).
2. Clean Air, Clean Water, EPA Regulations
If this Agreement, including amendments, exceeds $100,000 then
COUNTY shall comply with all applicable standards, orders, or
requirements issued under Section 306 of the Clean Air Act (42 U.S.C.
1857(h)), the Federal Water Pollution Control Act as amended
(commonly known as the Clean Water Act) (33 U.S.C. 1251 to 1387),
specifically including, but not limited to Section 508 (33 U.S.C. 1368).
Executive Order 11738, and Environmental Protection Agency
regulations (40 CFR Par 15), which prohibit the use under non - exempt
Federal contracts, grants or loans of facilities included on the EPA List
of Violating Facilities. Violations shall be reported to AGENCY, DHS,
the U.S. Department of Health and Human Services, and the appropriate
Regional Office of the Environmental Protection Agency, COUNTY
shall include and cause all subcontractors to include in all contracts with
subcontractors receiving more than $100,000 in Federal Funds, language
requiring the subcontractor to comply with the federal laws identified in
this section.
3. Energy Efficiency
COUNTY shall comply with applicable mandatory standards and
policies relating to energy efficiency that are contained in the Oregon
energy conservation plan issued in compliance with the Energy Policy
and Conservation Act (Pub. L. 94 -163).
4. Truth in Lobbying
COUNTY certifies, to the best of the COUNTY'S knowledge and belief
that:
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a. No federal appropriated funds have been paid or will be paid, by or
on behalf of COUNTY, to any person for influencing or attempting
to influence an officer or employee of an agency, a Member of
Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any federal
contract, the making of any federal grant, the making of any federal
loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment or modification of any
federal contract, grant, loan or cooperative agreement.
b. If any funds other than federal appropriated funds have been paid or
will be paid to any person for influencing or attempting to influence
an officer or employee of any agency, a Member of Congress, an
officer or employee of Congress, or an employee of a Member of
Congress in connection with this federal contract, grant, loan or
cooperative agreement, COUNTY shall complete and submit
Standard Form LLL, "Disclosure Form to Report Lobbying" in
accordance with its instructions.
c. COUNTY shall require that the language of this certification be
included in the award documents for all subawards at all tiers
(including subcontracts, subgrants, and contracts under grants, loans,
and cooperative agreements) and that all subreceipients and
subcontractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance
was placed when this Agreement was made or entered into. Submission
of this certification is a prerequisite for making or entering into this
Agreement imposed by section 1352, Title 31, U.S. Code. Any person
who fails to file the required certification shall be subject to a civil
penalty of not less than $10,000 and not more than $100,000 for each
such failure.
5. Resource Conservation and Recovery
COUNTY shall comply and cause all subcontractors to comply with all
mandatory standards and policies that relate to resource conservation and
recovery pursuant to the Resource Conservation and Recovery Act
(codified at 42 USC 6901 et. seq.). Section 6002 of that Act (codified at
42 USC 6962) requires that preference be given in procurement
programs to the purchase of specific products containing recycled
materials identified in guidelines developed by the Environmental
Protection Agency. Current guidelines are set forth in 40 CFR Parts 247-
253.
6. Audits
COUNTY shall comply and, if applicable, cause a subcontractor to
comply, with the applicable audit requirements and responsibilities set
forth in the Office of Management and Budget Circular A -133 entitled
"Audits of States, Local Governments and Non - Profit Organizations."
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7. Debarment and Suspension
COUNTY shall not permit any person or entity to be a subcontractor if
the person or entity is listed on the non - procurement portion of the
General Service Administration's "List of Parties Excluded from Federal
Procurement or Nonprocurement Programs" in accordance with
Executive Orders No. 12,549 and No. 12,689, "Debarment and
Suspension ". (See 45 CFR part 76). This list contains the names of
parties debarred, suspended, or otherwise excluded by agencies, and
contractors declared ineligible under statutory authority other than
Executive Order No. 12549. Subcontractors with awards that exceed the
simplified acquisition threshold shall provide the required certification
regarding their exclusion status and that of their principals prior to
award.
8. Medicaid Compliance
To the extent COUNTY provides any service whose costs are paid in
whole or in part by Medicaid, COUNTY shall comply with and require
its subcontractors to comply with the federal and state Medicaid statutes
and regulations applicable to the service, including but not limited to:
a. Complying with all applicable disclosure requirements set forth in 42
CFR Part 455, Subpart B;
b. Complying with any applicable advance directive requirements
specified in 42 CFR section 431.107(b)(4);
c. Complying with the certification requirements of 42 CFR sections
455.18 and 455.19; and.
e. Requiring that entities receiving $5 million or more annually under
this Agreement and any other Medicaid contract shall, as a condition
of receiving such payments, adopt written fraud, waste and abuse
policies and procedures and inform employees, contractors and
agents about the policies and procedures in compliance with Section
6032 of the Deficit Reduction Act of 2005, 42 USC §1396a(a)(68).
COUNTY shall include and require all subcontractors to include in all
contracts with subcontractors receiving Medicaid, language requiring the
subcontractor to comply with the requirements set forth in this section
and with the federal laws identified in this section.
9. Americans with Disabilities Act
COUNTY shall comply and require all subcontractors to comply with
Title II of the Americans with Disabilities Act of 1990 (codified at 42
USC 12131 et. seq.) in the construction, remodeling, maintenance and
operation of any structures and facilities, and in the conduct of all
programs, services and training associated with the delivery of services.
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10. Pro - Children Act
COUNTY shall comply and require all subcontractors to comply with
the Pro - Children Act of 1995 (codified at 20 USC section 6081 et. seq.).
11. HIPAA Compliance.
COUNTY shall comply with and require all Providers to comply with
Title II of the Americans with Disabilities Act of 1990 (codified at 42
USC 12131 et. seq.) in the construction, remodeling, maintenance and
operation of any structures and facilities, and in the conduct of all
programs, services and training associated with the delivery of services.
D. No Third Party Beneficiaries
The parties to this agreement are the only parties entitled to enforce its terms.
Nothing in the Agreement gives, is intended to give, or shall be construed to give
or provide any benefit or right, whether directly, indirectly or otherwise, to third
persons unless such third persons are individually identified by name herein and
expressly described as intended beneficiaries of the terms of this Agreement.
E. Confidentiality of Client Information
1. COUNTY shall treat all information as to personal facts and circumstances
obtained by COUNTY on Medicaid eligible individuals as privileged
communication, shall hold such information confidential, and shall not
disclose such information without the written consent of the individual, his or
her attorney, the responsible parent of a minor child, or the child's guardian,
except as required by law. Nothing prohibits the disclosure of information in
summaries, statistical information, or other form which does not identify
particular individuals.
2. The use or disclosure of information concerning Medicaid eligible or
potentially eligible individuals shall be limited to persons directly connected
with the administration of this Agreement. Confidentiality policies shall be
applied to all requests from outside sources. AGENCY, COUNTY, DHS
and subcontractors will share information as necessary to effectively serve
Medicaid eligible, or potentially eligible individuals.
3. To the extent that any individually identifiable health information about
students is used to perform the Work under this Agreement, the
confidentiality of that information is governed by the Family Educational
Rights and Privacy Act. Accordingly, such student information is not
included within the requirements of the Privacy Rules, 45 CFR Part 164,
adopted by the U.S. Department of Health and Human Services to implement
the Health Insurance Portability and Accountability Act of 1996 ( "HIPAA ").
In addition, this Agreement does not require or provide for the use of
"standard transactions" as that term is used in the HIPAA transaction rules,
45 CFR Part 162. If the Work is revised, or if the federal HIPAA
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requirements are changed, in a material way that would require compliance
with HIPAA, the Parties may amend the Agreement to address such material
changes.
F. Access to Records
COUNTY shall maintain all fiscal records relating to this Agreement in
accordance with generally accepted accounting principles, In addition,
COUNTY shall maintain any other records pertinent to this Agreement in such a
manner as to clearly document COUNTY'S performance COUNTY
acknowledges and agrees that AGENCY, DHS, the Oregon Department of
Justice, the Oregon Secretary of State's Office and the federal government and
their duly authorized representatives shall have access to such fiscal records and
other books, documents, papers, plans, and writings of COUNTY that are
pertinent to this Agreement to perform examinations and audits and to make
excerpts and transcripts. COUNTY shall retain and keep accessible all such
fiscal records, books, documents, papers, plans, and writings for a minimum of
seven (7) years, or such longer period as may be required by applicable law,
following final payment and termination of this Agreement, or until the
conclusion of any audit, controversy or litigation arising out of or related to this
Agreement, whichever date is later.
G. Written Notice
Except as otherwise expressly provided in this Agreement, any notice to be given
shall be in writing by personal delivery, facsimile, e-mail or mailing the same
postage prepaid to AGENCY or COUNTY at the address or numbers set forth
below or to such other addresses or numbers as either Party may indicate.
1. AGENCY: Marsha Clark, Business Services Manager
Oregon Commission on Children and Families
530 Center Street, Suite 405
Salem, OR 97301
Phone: 503- 373 -1283
Fax: 503- 378 -8395
e -mail: marsha.clark @state.or.us
This AGENCY employee is assigned to monitor Agreement compliance
and act as AGENCY'S Agreement Administrator on matters concerning
the Agreement.
2. COUNTY:
(Name and Title)
(County /Agency)
(Address)
(City /State /Zip)
Phone:
Fax:
e -mail:
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3. PROVIDER:
(Name and Title)
(County /Agency)
(Address)
(City /State /Zip)
Phone:
Fax:
e -mail:
Any notice delivered by fax shall be deemed to be given when receipt of
the transmission is generated by the transmitting machine. To be
effective against AGENCY, such fax transmission must be confirmed by
telephone notice to the AGENCY person(s) identified in Subsection 1
above. Any notice given by e -mail shall be deemed to be given upon
actual receipt by the addressee.
Any notice given in writing by personal delivery or mailing the same,
postage prepaid, shall be deemed given five (5) days after mailing to
COUNTY or AGENCY at the address or numbers set forth above. Any
communication or notice by personal delivery shall be deemed given
when actually receive by the intended party.
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