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HomeMy WebLinkAboutABHA AgrmtDeschutes 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 November 12, 2008 DATE: November 5, 2008 FROM: Scott Johnson, Director Deschutes County Mental Health 541-322-7502 i'1TLE OF AGENDA ITEM: Consideration of signature of Document No. 2008-596, the Accountable Behavioral Health Alliance Contract with the Oregon Division of Medical Assistance for Mental Health Services for Oregon Health Plan Members. PUBLIC HEARING ON THIS DATE? No. BACKGROUND AND POLICY IMPLICATIONS: Deschutes County participates as a member of the Accountable Behavioral Health Alliance (ABHA), our mental health managed care organization for Oregon Health Plan (OHP) members. ABHA manages federal Medicaid funds, assuring mental health services to about 25,000 OHP members residing in five Oregon counties including Deschutes County. Tammy Baney is the County Commissioner representing Deschutes County on the ABHA Board. The contract for CY 2009 will assure that the State of Oregon provides federal Medicaid funds to ABHA. Funds will be used by Deschutes County and other providers for authorized mental health services to OHP members. ABHA has prepared a summary outlining changes from the prior contract; it is attached to the Agenda Request. The summary has been reviewed and accepted by Mark Pilliod, Deschutes County Counsel. The ABHA Board members are being asked to review and sign the 2009 contract. FISCAL IMPLICATIONS: Allows Deschutes Count Mental Health to continue to receive Oregon Health Plan funding from ABHA as budgeted in 2008-2009. RECOMMENDATION & ACTION REQUESTED: Authorization for Commissioner signature of ABHA/DMAP 2009 contract. ATTENDANCE: Sherri Pinner, Business Manager, Deschutes County Mental Health DISTRIBUTION OF DOCUMENTS: Original should be mailed (priority mail if possible) to Seth Bernstein, Executive Director, Accountable Behavioral Health Alliance, 310 NW 5th St. Suite 206, Corvallis Oregon, 97330. Copy of signed document should be routed to Nancy England at Deschutes County Mental Health. Thank you. 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.) Date: Please complete all sections above the Official Review inc.l October 27, 2008 Contractor/Supplier/Consultant Name: Contractor Contact: Department: Mental Health Accountable Behavioral Health Alliance (ABHA) Seth Bernstein Contractor Phone #: 541-753-8665 Type of Document: Accountable Behavioral Health Alliance (ABHA) 2009 contract with the Oregon Division of Medical Assistance Programs. Goods and/or Services: Consideration and signature of document #2008-596. Request for Deschutes County's Commissioner on the ABHA Board to approve and sign the 2009 contract between ABHA and the Oregon Division of Medical Assistance Programs on behalf of Deschutes County. Background & History: Deschutes County participates as a member of the Accountable Behavioral Health Alliance (ABHA), our mental health managed care organization for Oregon Health Plan (OHP) members. ABHA manages federal Medicaid funds, assuring mental health services to about 25,000 OHP members residing in five Oregon counties including Deschutes County. Tammy Baney is the County Commissioner representing Deschutes County on the ABHA Board. The contract for CY 2009 will assure that the State of Oregon provides federal Medicaid funds to ABHA. Funds will be used by Deschutes County and other providers for authorized mental health services to OHP members. ABHA has prepared a summary outlining changes from the prior contract; it is attached to the Agenda Request. The summary has been reviewed and accepted by Mark Pilliod, Deschutes County Counsel. The ABHA Board members are being asked to review and sign the 2009 contract. Agreement Starting Date: January 1, 2009 Annual Value or Total Payment: Ending Date: December 31, 2009 In consideration of all work to be performed by Contractor under this Contract, DHS will pay Contractor a monthly Capitation Payment for each OHP Member. ® Insurance Certificate Received (check box) Insurance Expiration Date: N/A County is Contractor Check all that apply: ❑ RFP, Solicitation or Bid Process 11/4/2008 D Informal quotes (<$150K) ® Exempt from RFP, Solicitation or Bid Process (specify — see DCC §2.37) Funding Source: (Included in current budget? ® Yes 0 No If No, has budget amendment been submitted? ❑ Yes ❑ No Is this a Grant Agreement providing revenue to the County? ❑ Yes ® 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: ❑ Yes 0 No Contact information for the person responsible for grant compliance: Name: Phone #: Departmental Contact and Title: Phone #: 541-322-7516 Department Director Approval: Nancy England, Contract Specialist Date Distribution of Document: Original should be mailed (priority mail if possible) to Seth Bernstein, Executive Director, Accountable Behavioral Health Alliance 310 NW 5th St. Suite 206, Corvallis Oregon 97330. Copy of signed document should be routed to Nancy England © DCMH. Official Review: County Signature Required (check one): ❑ BOCC 0 Department Director (if <$25K) ❑ Administrator (if >$25K but <$150K; if >$150K, BOCC Order No. Legal Review Date Document Number: 2008-596 11/4/2008 / E ){ b- 0 g 00 c f 0 punoj oaegM \ § § of 2= / o § 2 / 0 �ED \\ j \f § ( "Alternative Site" Increase font size on contract page numbers a2ƒƒ 00o \\ Exhibit A, Definitions Throughout J°7EsE@Bme+®°»2`:�e°tte &«{2K[ 307=7[{$(\}{)}(tfa «7} 0 {`/� � \\ /{\ _- _ \ , § -.3 0.Q ca \>0 a ! !\ - !o )\_/ In Definitions, but not found in text, recommendation — delete. ±~34(27 0(+]t$= �la � \}_1no; /=0 g cry, O. AMH Agrees - delete --_ a:±$ k;2r 3 00w0 20) , §\=ee,,ato 3 *;-=7070 y■«® ° , ;[Z Q No impact on ABHA or partner counties No impact on ABHA or partner counties c f 0 punoj oaegM \ § § of 2= / o § 2 / 0) C m 0 rr punoj aaayM 0 C D7 com 0> O 3 m 3 0' 3 m 0�p yN 17 n � O IDO D1 co cp c n P! N 0 OK a, r 0 CD m E m m D-> C a m o C o m= m m z -c r° W o 9 `'o 3 O m -a>CD2 00yoaa (1)(_0()(1.0°21°°' <m 2 N (O vNO , Nyto ON0NN'aa--0 nOO`<7 D a, a3SO dNN OO(DN� pO-O.N6�N.caO , .�' <n `�v 3 *Oi co O 01 .-. h..NN-ON2Q=(DO O C•N� N Cr 3N 3 0 0 (D nNODON (15 sN O) 0(D a- j (p of O si (D, O O N ONjN jaO N ra 0-� co N 71 . 0 (n (o .M 0) C m 0 rr punoj aaayM 0 C D7 com 0> O 3 m 3 0' 3 m 0�p yN 17 n � O IDO D1 co cp c n P! N 0 OK a, r 0 CD U) C S 0 0 1 punoJ GAMMA r c co co O > o 3x 3 O N o co 0- 3 CD -1 nN a C 0 o 03 CD W E a. _ c O "<0 O rF Z N 0 0 mu - Mo r W 6 nc. c 03 m c,O°iS->03o' >3v'onfl.oxc -cnamn*9poo- ma)aommy�0a2.momom.g0E000=O a,g_I< 3 •O �O =<_3: rco -O o J 6m mooncDia9<m<o=?-`Q7.dm.wm'Do3m• m=mrcco-0s--0 'O D N cn _ 0 0cp 8 =-08=-0_=_,,,N.)0- 3m�.omOmmU. .=O0QZ m.- 0 a m N N O= D O O to O O �, 6 ._+_ 7 COmO 0) 6 o N D. O 1 N a ^m' y 3 N O .-. N 4i N N= N N N m CD< o. 3 O N O== m 0 to N m < .O. U) C S 0 0 1 punoJ GAMMA r c co co O > o 3x 3 O N o co 0- 3 CD -1 nN a C 0 o 03 CD W E a. _ c O "<0 O rF Z N 0 0 mu - Mo r W 6 nc. c 03 m c?) `'y A O w M w a A cncp c m cep F 3 0 5 3 -r1 O 0 w £ rn as ye y0< O (J O N) • 0 g 0 O) 01 a W N "JCAHO" Psychiatric "Home -Based Approach" "Extended Medication Adjustment" UB- 92 "Community Services Section" (CSS) Ex. A # 92 Ex. A # 82 Ex. A # 70 X D 5D CD as 20 rn N Ex. A #36 Delete 0 CD i (D 0 ID n (D Change reference to UB -04. Revise for accuracy Replace with Medicaid Policy Unit 0 (D CD0-al 5. 133 s0 CO E 3 -0y o 0 �yma 3m m co < „.. 5� Q� -O,co O2 N O N a O- O N Dom) 00. y y J y N (D co N O- y y Q y y N o a (D (D C S O 0 N N N O N Ooh r. 3 5 o o a a 3 = 2_ m 6' Q - 6 (D N y A `G O s 2 N �.O 1,) (/i yCD Cr E y o Q Q ( a O fD AMH Agrees -delete AMH Agrees -delete AMH Agrees- delete AMH Proposes to reflect current ractice. AMH Proposes chg in term. No impact on ABHA or partner counties No impact on ABHA or partner counties No impact on ABHA or partner counties No impact on ABHA or partner counties No impact on ABHA or partner counties 0) c _a 0 punoj eaagM r m co01 O o g 3= m 0 o w 3 0 3 0 Po 0 oz E \ CD 0 CeD CP ET 0<-• o• o• o2 Go / 0 punoj aaagM \ ) § oq 3of 0 ¥(J a) CS QI Definition to PI "Medicaid Authorization Specialist" vs. "Mental Health Care Professional " as found in text "Measurable Objective" Residential Program" m> al 0) Ex. A #100 Y. } 0--. »\[E] -\(}(>/ 0 a/y/z ~ } Change "Quality to "Performance" to ali n with QAPI Obsolete - Information still in Rule. Measurable Objective is not found in the text of the Contract — Text reference - "Measurement of performance using objective quality indicators...." ii 0 o En AMH Agrees AMH Agrees — AMH reviewed. Both terms are still used in Rule, but willing to delete. Deleting in Definition Section \0 Z -- on \ -> No impact on ABHA or partner counties No impact on ABHA or partner counties No impact on ABHA or partner counties / 0 punoj aaagM \ ) § oq 3of 0 0 N C S 0 0 1 punod aaaNM r C7 C co co o E 3x 30 y�rt 0 O W 3 m 3O 0 n N � O m O so to a. _ c O 0 W 3 O rt AA N 0 m- Or OD o n�. C 0) m 0 0 -. 0 D "Stop Loss "Coverage and "Stop Loss Protection" H 1J m'.%) N 0 3 7 (D N O m Ex, A #180 and #181 Replace Stop Loaf Insurance with Stop Loss Coverage Same term. deleting current verbiage in Ex. A, Definitions in lieu of SD -00 co 3 o N fa W 0< N (.0 CO ' m os3-3..-0'3.g3.m. 0 0-3NJ C m 3 ca=0=0NO:DmdCmoD 0= so3-'3,-*.r or. N (D N t0 n Q µ 0 X 0 0 `°tc m y a ' o D 0- N (1) = 0. psychiatric treatment setting which conforms to established state - approved standards consistent with ORS 443.400 through ORS 443.455. Stop Loss Coverage - Protection against catastrophic and unexpected experiences related to >0o tk A D .-. W r ti N mo'o'D m y n E Q C _ 0- 0 (p o No impact on ABHA or partner counties 0 z -0 0' 3 3 D ea N 0 n+. O 0 3 m W D N C S 0 0 1 punod aaaNM r C7 C co co o E 3x 30 y�rt 0 O W 3 m 3O 0 n N � O m O so to a. _ c O 0 W 3 O rt AA N 0 m- Or OD o n�. C 0) m A W N Reference to enrollment of CAF children in Provision of Covered Services — Exhibit B - Statement of Work, Part I -Benefits, 1. Benefit Packa.e, d - 0 2 N Residential /Medical Youth Care Residential Center Provision of Covered Services — Exhibit B - Statement of Work, Part I -Benefits, 1. Benefit Package, d - Provision of Covered Services , Ex B, ease 33 MHO Contract - Definitions MHOs would like to see the language below moved from the Provision of Covered Services to the Enroll ment/Disenroll ment section. Ex. B, "Contractor agrees to perform the work in accordance with the terms, conditions and special provisions In Definitions, but not found in text. Hwa o Q 01 a A° n Qa Gi IQ o W .-k 0 In W N oo m k 2.“-) _ c o 5. m Z N a..R. N Q rI° ^' N 91 -, o m 0 D 41 faD W '0 0 0 N <a c rn A m n a In this instance, the contract is only addressing the outpatient services provided by the MHOs for children receiving BRS services. Placin. AMH Agrees to delete — language change occurred AMH Proposes - Delete t ter,yam= m c o K r� 0 a= Cr o S co N N N co C 49 O z 3 K Ar �. d< n, N N M W o007) N O i cnoctfl,0� N M cn O 5 n g. O O 0 O N 3 N 0 M tn0 N N S W LI !. No impact on ABHA or partner counties. The change in responsibility for BRS kids, that was substantive, occurred in the 2008 A.reement No impact on ABHA or partner counties No impact on ABHA or partner counties c Cr 0 n M puno j aaagM r c c N 6C co 0> 3 0 70 �7 no O co Q E c0 c '< 0 W 7 O rt 0) N 0 O — 03 CO c 0) to 0 o 0 o Y E m 0. ^o w 3 0 N 0 o oo rn al Review of Policies & Procedures Services Coordination plan vC)-0 O O N G, (D CL' Wo 2 n 0 m W co N O N Add "review and approval" after determination in last sentence. Services Coordination plan Plan o�°i 3 0 2 3 w� o_ a) 3 s o 0_ T a cD 2° 6 Q_ Z c v 3 3- n (D ((Dn = N N 3 co a n (fl x-. N y N a A_. CD 5O 3— O N^v<..3_.*G O -O fl'N`<N 0N o3r3 = a N W< O 5 5 y N N N m2 2 n Ol N co (D C • N N .� N N O (D 3 O O O j fC 3 N (D (D 2 N D 2 5- 3- a) ate.^>j epi co (D 11 (3. N v0 N (D 0 AMH Proposed language Housekeeping 0) 02—IEnv) 0 co ? 3m - 13 n 33CNOD�.x003 o * D(Dd N "G 3 O O. (n wm co n (D 3 3' co C 3 3 co a ,3.' O ID (Tn0o.0mm�!"dCDAmmm OQ N N (O inO nY 3 Z v Na '2r 'Q O 3 If O a �. CD 3 COS (D o (D No impact on ABHA or partner counties No impact on ABHA or partner counties punoj aaagM r m O C CO CO 0> a 0 F1 m - n � O m n co cT Q E cp '< W rF Ala N 0 O ,- 03 r CO 03 0 CO CO J �� 6 nW CD 0 (� ('p O. Fr o 0 0 3 wm ZOO �o D O (D CL (p 0 a -3_h < Oti(O m 3 m DCR co CD y �0) N `Z y 03 N (n v (p 3 3 3 mo_ 93 m_ 3 N X O c _ 030 O y 3- Specified in Part I, ••6 =oco A.O '.o. O" y (n N r.O= a O 7 N -1y m Fm O. 01 n O m fn 91 F - fD o 3 sy = O (Oj( .=+mon 0 o 3 CD fp m a .3-. ""F N m 0, xo D E O '. ' n 0 N d - co co D ET 0 (3p 3 Specified in Part I, pg 6 of the contract. Will not define in Definition Section 2,-"0 3m �No(o_mci2W =-o .-.m C-; a. - , -, c 30 .� 9 3 3oc00] .0Cnn ID 0 ° 1 0 x co 16 c mmoc- a° (o3(o00 aQ=o °< o ED gm z 020 CD CD -' O a 3 3 cn (0 nxB300D000-e_1 < m 0* 0 -.= O-o.� m o'NToaoo' -ea) (Dr y N 0 0 w= 94_0 a- 0 3— < O ... 3 3 3 3 N 0 `< m D 0 0 y, o N �' [p m o a s 0 o o D(1 0 CD 7 co °z D o 0)3 m N ,0. 0 O C 3 CD " D 0) C S <m 0 1Y punoJ aaayf Ari co co Al O > 3 N O 0 o w 3 m cp3 0 •( n N O m O Al Q E cp % n a W � 0 n O -r • r >y 0 co m N CJ N N � NJ 0 ISA for Children and Adolescence Health Care Professionals vs. Health Care Providers SHCN considerations when establishing provider care network Special Health Care Needs assessment mechanisms Ex B, ISA pages, pg 47, (8)(a) M X CO (0 01 0) :0 P 6 MHO Provider Capacity Assurance Report document MHO Provider Capacity Assurance Report document Language" The Intensive Service Array (ISA) targets Inconsistent use throughout — AMH will review and align verbiage when agreement is aligned with the FCHP. Duplicative Language. Take out of body. Keep age AMH has done an instance by instance review of usage and has found no need for change, but will entertain dialog with MHOs. See MHO Provider Capacity Assurance Report See MHO Provider Capacity Assurance Re ort No impact on ABHA or partner counties No impact on ABHA or partner counties ABHA will have to complete a more extensive annual report. No impact on ABHA or partner counties 0I -Q SD CD n N 03 m Q O Q a E coo cD P. c = - N •-• �O_N � 3— O °-O N N f0 5 O- ] (O N v N Pa n3 v a om(D vW Qm 3 O- •+ O 0 S (o N 0 n punod aaaLM o g O 3 0 n 0 o co 3 yr A m N (n N A Enrollment and Disenrollment Psychiatric Rehabilitative principles and staff develo. ment Enroll m e nt/Disen roll ment section. Ex. B, Part III, . 4. X D See Attachment Old methodology - delete SO 3a�oo= Of<m 971 "n, -II a0N _3 X BNaO y < fOm o- 0O o-th-i•-• now 1'0 "00o 3=-P=C0 <w28. N N a.N =jS 2 o Froo< D O<aO o m33wo0�a= 30 .. - o O•• yNOSC1n Mz -0-=0_.o. <cDN zoMc '4 C o 'r •= �0 Q..O 0 CD N7Oy• -aCt 0 d ='m a Cl ? C Enrollment section does not apply to MHOs, should be revised to describe AMH Proposes - Delete 0 0 m o r v0o =0)a O 0 v 3 3 No impact on ABHA or partner counties No impact on ABHA or partner counties gik 0) 0 0 punoJ wow r w co 0) L) (0 o E 3x 0 00 o a Cal 6/2 71( } \/cn 0- a NJ00 10 > cD ,[/7 �(\2 § = CD ED !\/\ \y/% �c 0 al 22 =0 /C >C fl 50,00500m�3.0 _ :a \#!r\, §/}$20§gaC040-'05 _ - e-,rz%=z®z«rE °({} *5= 00on�\Eon ® J f (/ \`` 03 /« ,! 0 so \-® » ; \wE(\;E[-to)ƒe:E( R =,e=2;.l2=E�&[[z§G&J /-z-- °co @ a-1n-0==g%a-033-003 e2 ]m3=€a, g;§=E7§ 671 0— 0. , 9 !{` ){a& 2a > «(/E=g`E,—EIse&3J ` ,J \a»�\`}{;09- � ^[—a��f \ \\_ \(\ 9 CD r\\w3 ° x22$z2. . ID § E>;] & »o _(j3< = -mE / m 0 pUrI0j aaaiM o& 3 m [ o7 3u 2m ( N CO N J N 0) Ex K -Mental Health Organization Provider Ca.acit Mental Health Organization Provider Capacity Assurance Report 0 Ol a (D mF co m x W CO COa A m x W CO 0 New Exhibit in its entirety Delete existing Exhibit K and replace it in its entirety with inclusion of language in item 22 of this matrix. QD) o m c- a m 3 FE rd . = N (D (D 3 a co 0 -aa o m 3m -o 3n mo ' E. < (p (A. o a See MHO Provider Capacity Assurance Re.ort Attachment m -u > D730° -0—I mom 2030��aaO-y 3'Dn-a.ON�.o. n. --h (.0 I ah ° ma—I>mC s co a n ((0 3 (D o (D C O] 41 v m m . n m o hospital is no longer Medically Appropriate. AMH will assume responsibility for other services not included in the Diagnostic Related Grou. DRG See comments, item #21. As described above. oz -o 0) 3 a� 0 T o D co cn > C 0 0 rt punoI aiogm r 0 0 N nN o co N 3 N -n -4 n N C o Ivw (D E 2 c O/� 03 N 0 0 rt 03 L C i C co 0 0 r z n a 0 • 0 0 m < . u• p N C.. 0 o GO co Wm W (0 W O N.) CO Grievance System - Previously 0 0 v 0 N co N m 3 QA/QI to QAPI Redundant Verbiage & submission date change: Key Personnel Data Certification Form Assurance Report Ex B pg 67 m X co D (0 A 6 m X W -o (O W O 0) 90 Ex. B, pg 75, 2.b. Align Grievance System with new n y 3 DG N TC 0 p 0 A m N O. N (D . co O N 9 Do�co N s4 CD `D3 C) N p '6 •a 0 -o m 3 = i W n X fl- N fn .. D 0-m j 0 O. Change Assurance to Assessment and QA to QAPI in a & b. Delete submission date verbiage in the paragraph and change (b) to read: (b) submission due on effective date of this agreement (Delete remainder.) 0 m (O CD -1 (D 0 m 3 co AMH Proposes Change to 30 day requirement to "submission due on the effective date of this contract. (Delete existing remaining language) Provided to Tammy for inclusion in contract No impact on ABHA or partner counties oz 0 0 m 3 CD 0 0 3 D (oW 'D No impact on ABHA or partner counties No impact on ABHA or partner counties Cto c a m n punoj aaagM O g 3 m n0) o 3 co - 3 m a m ti � O ca to E L Q C C) '< O•* N � O.� co r m C 1y co co m co -4 co ca Inconsistent headings on Ex G.4, G4A and G4B re.orts Debarment, Suspension and Terminated Providers Records Retention — Financial and Clinical C iV 2 D° t 0 'a D N = O 03 hi Length of time to retain grievance logs CSCI QMP Domain numbered 32,37, 47, 51 and 55 Exhibit G, pg 122 and 124 Ex E pg. 108, item 10 Ex B 1II.3.d and Ex N7 AMH will use the same direction header on all three G reports as Inconsistent tense throughout section omD�_1,0po+30 ,0)0 ,000 a C• m °' mt*-aFP DN utG ' o, 2 m :i N-oN an d S3'0 O a N y— 03 ad (C aa'_ Dao 0 CO to - S CO 3 8.13 v O 9 N N r -m See financial records retention requirements in item 37. language in OAR 410-141-0260 AMH Agrees Revised language taken to Contracts and Procurement — OC&P feels verbiage should remain the same. Language at DOJ for further review T a = N U o up p (0 (D N 0 AMH Proposes No Action No impact on ABHA or partner counties No impact on ABHA or partner counties O z v O m j R13, 0 o ° c° D cnD No impact on ABHA or partner counties punod wow N CO c C N 0 m nN 0 W 3 w 3 m 0 m n N � O Fp co Q) is Q E L Q c C) 'G 0 ^, o O I"-• CO cc CD O PZi o 0 .5 co cn 0. .7- G_ o`G ▪ w 3 O FN 0 gO 00 a a) al Aaa coO a a Subcontracting Key Personnel Signature Authorization Form Signature Authorization Form - Schedule 5 Data Transmission Exhibit G4B, Prevention, Education and Outreach Performance Measure Requirements M x 0 0 an co Schedule 6: Key Personnel - Schedule 6 cn 0 r- 0. C N W Schedule 5, pg 212 — Due date language revisions Exhibit G4B Is MCO allowed to This report shall be "due upon effective date of this contract." Deleting "Mcmber "This form is "due upon effective date of this Contract?' No changes needed at this time As information is specified, changes will be required. Need to add a column for the "actual number of activities" performed for each activity outlined on the form Placeholder language appropriate for G4, G4Aand G4B. "The requirements AMH Agrees Deleting this line of matrix. AMH Agrees to language listed AMH Agrees No change at this time. Allows ABHA more No impact on ABHA or partner counties No impact on ABHA or partner counties No impact on ABHA or partner counties No impact on ABHA or partner counties It N Cr. 0 0 punod wow c C 0 a op o \{ ip\Local Settings \Temporary Internet File IM loyFuoJV£\ IN -10 \/00 _ / f n punoj eaagM E 03 § o 3x / 3§ § m 0 k k § $ co [/ CD in CD -7122 \}/\/ \°�0- 0000»2 ` CO Er \�(`� cD \ To 3 E*00)0 =o>=!,«\m[/-a� J;lGmEt&,E-, [t!®E a ID m;I—°:,:—o,n 0-_ EA 0 ®F°=©E 2,\a(D �� 1 < — 7=; m7 ]$o:yRc m5§&a=» - a„ al Si .{)$}&&— : _§\& E \�a 0=0000300E 5 - _ —E -_ -6 0.- CD CO _ co _{\(/ a:\? -0 0.® ; \&»§ (Em$°afk;rGEso0 _ \//;}E®»®.a¥, (0) -,D T( \ 0 :ae0o0- — \ —' » _ o r L - . o 7 \\ }/ > \\ D. SD (� CD 0 co _ / f n punoj eaagM E 03 § o 3x / 3§ § m 0 k k § $ co Gra ti E. 7 V, 0 0 O NCD o < w < o 4 c "g w H c 0 O W A m Data Validation for Level of Need Ex B, pg 72 8 3 - 0 0 3 0 3 0 0 v N v (D -0N a • co co n O 5 N* N c <. N v 5 3 O N N N= J Q ti 0 t< - X o v NN- mmaDpp-44oQ®.yEm*aa3fQmnQ no 0. O 3 J�'NOO' n Fij co DOON v N O O -is. O 3 E OQnQnyn<-5R Q < 3 N -.: N vd.N-4. SO 3-,1?-F„(13, N 0 3 n 3 ._N0 oD3 v FN -O a N - N K 3mOnNo 0 0100-00)=-,--0 i n v N a -)O 0 Q co . 0 /i ° NN=DO - 0 NO ,1 -`Z 0 0 0m O 3NN 3 Q O 0 ,l N & 0O N.+ n 0NC 0 CO = N N2. Do not place on Contractually Re•uired R•ts list No impact on ABHA or partner counties 4t punod eieq r 0) W c N co 0 c oto 3vi 3 o 0 -n —1 no ^0 C W E 2 c0 '< 0 <i M Q N 0 0 a)i— sm cc c 01 0 Ot O O a (0 Part VII - Interpretation and Administration of Agreement Paragraph C.2 Contested Case Hearin.. Q D) 0 coO TO' O co ISA Progress Review Report Chg OAR citations (n E C� (p 5 O "O (D 0 0. -i.— •00.. 3 O C O xi O N O a N W O OO . W a 3 OW —2.s. O O N Ex B, pg 72 Citations : OAR 410-141-1570 thru 410-141-1700 2330 3ID1D1000Q0*<CD3S D1 (D 0 O m . 6 E O a 0- 3 O O c 0 • m (D N (D 0_ T1 31D* ... 3 (D CO y a = W W O N 3. a O 00 M 0 0. co 0' F6' 3 O < 3 N C N rt N 0 o O d O 0 0 GS 0 i O y ••i S C N m.N p <- a N C .' .-..CD W 3 N `� _ 2 G CC O. (D O M 0 35 n O O (U -a m a O . i 1 0 AMH Proposes — Housekeeping mcDm5momD6mvX'D 0 o. n ns3 =�Tman (D O 0 C Q £. N S< s. N= W O n v (D m Q O m (D ° w D ''a mm o-m�mgs,mo—(o is, 0. .CSNo m(d am m .r tet.. fla - m Z CT A 0 E(o c(o •... I C0( co w 3� D N a Do not place on Contractually Re.uired R.ts list No impact on ABHA or partner counties O z O co3 �a O0 m1 0 ° 03 D 0 m COD No impact on ABHA or partner counties punod aaa4M c0 O g 3 N E. LAI en a CD 0 ( \}00 o o « Cr. 0 punoJ eaayf / m /§ § ( 01 ca cm NJ // CD 00 co Agreement in its Entirety Pon ®}\ 0 un Agreement in its Entirety Em- co°° 6 co CD o 0Ec// a\&/cc0x2+\(/\\\\ :°&®G&;+F =,e%I !®&'5ct S o9 - li &/ m(«®& y` cs ][, On Ex. K Listing, Change name of report from Mental Health co„ Practitioncr Rcport to Mental Health Organization Provider Capacity Assurance Re . ort. AMH Proposes - Title to be used throughout the contract to represent this document 9, \ \ *§ \\\\ (0 ®(+ No impact on ABHA or partner counties « Cr. 0 punoJ eaayf / m /§ § ( V, 3. a 0 0 a. m 00 9 0 0 r r 'n 0 0 CD 74 N 00 0- go N o 0 0 00 0) a; 0 0 punoj eielMA r 1.0 0 fD 0 > o _ 3 0 0 70 :-i � a O a) to at E a= cQ C n '< Q 0 "S N� 0 rt Q, r m (32 a) (Q 0 N o V V V Vo C,3,. A. O_n 0-(0m0:U-<C�;S5 0>00)EC(01>a 0 0 Q. 2 o N v 00 0 x a co 0 O N 0 9) N ='O N ca. D_ N 9 (D C 0 0 O. E •m o_03 gD0 mfD 3ca) 9 3 a,m 13) ,-Ov °'.m _IN c'm yeZ o 7 m z 3C7 i< N co O Do 0 3 ° 090 =o -0 3a ) O _co 3 o 0) a; 0 0 punoj eielMA r 1.0 0 fD 0 > o _ 3 0 0 70 :-i � a O a) to at E a= cQ C n '< Q 0 "S N� 0 rt Q, r m (32 a) (Q m cn c punoJ aaa4M r m co c co co 0> o 3' m nN o co N 9 N a 0 -n -1 n 0 O � o C1 co co E 0. _ cO n C4 M p.F Z N 0 O Or o� co c (a N w2< = aam.y.= ='3a y < CO c O< 2 U y -'a. m f=1 W n m e. �' N V N< PD) m 0 =m m C N Z1—gnm Fr; .} -1 o N< -,=.00..00.'=0)-.-10<-,-2,02.0.5 n ID a '_ 0 In 0- CD a K =....0 _=ay .v0 b oS r. m °1 m- N U O w X E n-0 CO m E 5,< n m p c c. m° _o m -2 ^`cr.mcmy._.,OC. CD N .�. co l a y C O O Q LL ai co n S(O < m• 0- N m O N .- coDi - C. cD 0) CO p cn c punoJ aaa4M r m co c co co 0> o 3' m nN o co N 9 N a 0 -n -1 n 0 O � o C1 co co E 0. _ cO n C4 M p.F Z N 0 O Or o� co c (a N • p � rn y N m W y O E M E. W cop m B. ra 0 y a T O r A n 0< 0 o• <p 0 (.0. Z;)- 2 q. aq. ga. o F N 0 g O oil a c m N 0 0. 0 = O. D 0- 0 0 0 Informational Materials and (J X S ca 6 m � aco 5 0 i 3 0 o 3 Add to Member Handbook 0 g o o o= r- d 2 o 0 0 0 o 0= 5= 3.� c no �_- a_. '0'3o_amm3m32m'a,aaa225 .O d-�(p <. r•.CD - 'O n0 N 3 (D = co N 3 pj O O 3 3 0 3 9) 3 91 3 N- inpi 0,00.to.m� oro3 an at to 3t0i fa) N an N* O' 0_0 fl=_1 N(O .3.0 O O 2.(C N O Oa s N n D N 3 N' .3.. N= o 63 3 . N N r. y 0a co 0 co N N N 0 .O. (A o cp N .. following the end of each calendar quarter — 06-01, 09-01,12-01 and 03-01" AMH proposes in order to be (D O Z 2. —I (n .0 ao T. 30 lo0.830 ac'<3cp -o D CD O O (D 3 <. N N Q. 03 (0 p_ (D N " No impact on ABHA or partner o 2 a 0 �a CD 0C) 3 (o m co D 4t punod aaagM 0 Ca O CO N 3 o a a 70 n N 0 O TD 03ecit t0 a� cp C c) c4 O rt a) N O rt CO l— a) a) to -I O r 0 00 F N cn a o H N $ o 00 J al 0)) ISA Progress Review Report- pg. 51 - Duplicate of 49 on this matrix. CD 0 Q CD W C a0 CD 0 T SD CO 00 Ex B, ISA pages, pg 47, (8)(n)(iii) 2' A_ J N J 0 Education for OHP Members Current language: Contractor shall collaborate and assist AMH in the collection and reporting of data for use in an ISA ' O?xi W< -4m-oat V o d c7) N - Ci d a_.0 8-' y CD M O at y CD �, oO N Oms-'62°`,2l. a W n D) 0 0 !. 3 C m N o>0.=-104,0 @+m°' -^ m f%+ 6 .z y 0 mCD o w n O CD N' a b <? dy G () () C S _ requirements "Cost Sharing, if applicable." Place holder language already exists in the 2008 MHO Agreement for the ISA Progress Review Report. No changes O < m m -o p C. CD CO Q.0 a O o O r Eo=mm oa(0 � m O 0.,,<0- N c im om w D consistent with other MCO contracts. Contracting: Please add "Cost Sharing, if a..licable 01 J O Z O m 0 m m M o ° D D mm N = D counties cn 0 0 punod aaa4M 0> 3 z 0 CO CO Ex. C Consideration Provider Enrollment Ex Update language — (0 3 m ram ro (D O N 3 O O 0 0 O(0 0 0 0 Q a-0 en 0 a 0 W D v Q C o Q 0 m 3-e 40 a s -h m 5 Civ - nm 10) m 0 O (Dw m .0.. O O N -' 0 (D (D n �=-� O 0 O (D -3°=(0°51) O _ N (D 0_ 0 0" a= O. 3o N O O O a) N o> 0 'O co N O- -n co O O p (D d N < O 0. O O r --. (D (D N a-. a 3-• O O N N `Q 3 tU Q Q 0 (Q CO`G N m m 0 (0 m AMH Proposes No contract changes required as a result of this process for MCOs 0 -0 N m 0 CD o (D O 3 CT' SD 0 4t punod wow 0 > 3 m l/cn o N 3 0 M V! n -0 o� 0 N Cr, o g M a a v, A co 0 00 Po 0 0 0 s. o y scn s'— te „ 3 o O Lt go 0 0 oo N �= O 0 CO CO 0 D CO Credentialing Process Payment In Full, Services Not Delivered Due to Moral or Religious Reasons Services Not Delivered Due to Moral or Religious Reasons Services Not Delivered Due to Moral or Religious Reasons Services Not Delivered Due to Moral or Religious Reasons Pg 61 of 202 O C 5 on 5 co -_ Delete: I Com, tra oll Schedule 5.1 Delete Row - Objections to Services Based on Moral or Religious Grounds Schedule 5 - Delete bullet number 5 Delete asterisk on Ex. B 2 - Contractually Required Reports, Policies and Procedures, item 3 Template Attached Calculation of Rate Methodology AMH Proposes No action being taken =C` CMS does not want a void in reporting. Requested a form saying MHO does/doesn't have such services. No changes No impact on ABHA or partner counties Iii f 14"1,9litair ti III III No impact on ABHA or partner counties No impact on ABHA or partner counties No impact on ABHA or partner counties 4t 0) C S N 0 M puno j eaagM r co w 0 m 2-0 O o IC, 0 - J 0 0 (-n n W 0 A 0 0 m 0 9 O g T 0 x 0 0� 7< F_ w 3 v, d oPt-. g Q H 0 0 0 00 00 J 00) 001 A Standard Terms and Conditions - Practitioner Incentive Plan Allied Agencies Independent Contractor O 51->= ee=r .A. Page 75 - Contractually Required Reports — Item #2, Practitioner Incentive Plan Pg. 91 — new language re uirements a,AII billings and - - - payments See Redline version for language. 1111111111 MMIS Replacement CFR citation 438.6, a.5, i,C.Iv No changes Due to further AMH review, it is decided that no action is required at this time. Federal language —Language received from DOJ. Internal discussions occurring. It is possible that new MMIS system No impact on ABHA or partner counties No impact on ABHA or partner counties Will increase ABHA and partner county administrative burden. 0 11 .r o 0 3 ID o n O .. W 0 N rri F 0 N co 0 i Cn punoj Glow r m c c 0o m 0> O 32 3 m n ooay o O 7 N • 0 d n (J.) co A F 0, 00 O O 0) 3 O G 4613 0) 00 Information Privacy/Security/Ac cess o T1 O. D D O' 0 y gD o a) 0 N Information Privacy/Security/Ac cess If the Work performed under this contract re. uires Contractor (D Q! a a? m3 n' (D m J O Cl O� r = 3 j Q' ' m r J mNmv O] L O w7.1 O : O g 6o-3 N S N N J <OJ (D N co N D� N O O OW030000 J 300 O .27003 A O v -.4. . oo0Dd O -.4. . O 0 D3 X IQ O— O_ O N A O Q- 5 J CO < N N O 0 J ' O <. N 00aD-o30a O0O n O O 0> *. CD O N— N J s N (D --h (2, 3 , ur m 3 c35 D Ol (D n CD ED S aN a3 O N p C 3 1- 03 J N O N No impact on ABHA or partner counties o O N O 0C w 3 =r03m,.y3'J 03 O. N o_ 3 C (D N O' ,c)D J m m O d J d * ma FDI- m m m m O z- o cD J 6. O JJ N O,<`G JN ..o :llal :7uapul :pa1ewuoj Formatted: Bullets and Numbering Z 6u1peaH :paNewnoj Formatted: Bullets and Numbering Z 6ulpeaH :paaeauoj 0) C a N M punod wow 01 co C 0) 0 W o g 2x N 0 co o00 N co a 0 no 0 O iii CO Q t— Q C C) O W p rh N a; O COMO b r c 03 CO CD 117 oo oro c H 0 O g M n W y A 0 0 m 0 3. 0 00a 3 oc 0 O c o < w Y m • a. c Bo N o O o O n � gt a 0 1 punoj eieq r a1 co 0) 01 -1 p N G ED o< T T N a O O' AOJ3N-•O" N oO0.ON C C 3 �1O O J 0 O .is W OO 0 Si. A NO �SO D)NO UN ( a O g_ D co co C Ft O O 3s(1"1 _N v !0 C Nuc 2 3_. O-1N�3ON=N3 .. O g <_ -):Z(2, rt. 0—o O O n 5 .0-. 32-, N D (D p COCn cow- O.-. N� 0= (D NO pp N=cn N . O* (.0_5 (D .-. g 2 P. pNON '2w J D_N CCD D 2C�_OC (i).-1 0 y 3 0 Np0Tl < C 0 N O N0) 0 N5kNNcN O TN n O in- *p ND 0 NC 0_N gt a 0 1 punoj eieq r a1 co 0) 01 n b • tJJ o• 0 d ", cn 6 w • a 0 0 =3 7 'e 3 m 0 7' 0 m0 f < Fr m NP. G 7 • 0 y N 6 O O o oo CD CO 0 <E CDz�M9 M O 3 _ 0 CD (D N 0 Et O0(ooD)CD0 . N 0— 0= , 0 CO N co 0 cD-D5. 0 .-. O< j 0Om:s-0 0 = DI 0 O N 0 3 . --, 5 n- 01 CD 00 — 3 0 N .O-. O S oo -1 A L N q0 O` = 0 n s Cl I3 <comw.sD— N O. O 3 rt<NDmu,�DD 0 a S C 0 3 0 O a o' w N O r 0 co= O 0 0 0 3 Z �p `G O O_ O . j 0 t y N 0 � g z a w D 0 0 On 0 -D —w m = D a 0 It 0) c a 0 punOd WOW O > 3 z 3 O VI O CO 3 6- 3 m -4 0 CnN 3 c N 0 0 aj � 0 co 5.co N N 0 am ..<om =. o — c 6 0 O z O a 0, 13) m 3 3a ro o ° aD (D D c Cr. 0 0 punOd aaaiM 0w ow N W 0 m i7 mO E a= cQ C C) '<0 O rt a) N m 0 I -1 - CO I - co 0) m J CO - N J N Delegated Activities Service Area change info Service Area change info Notice of Action — Grievance System Clackamas MHO service moving to be included under the responsibility of GOBHI JBH service moving to be included under the responsibility of GOBHI Gilliam Cty (Clackamas MHO) moving to GOBHI Douglas County (JBH) moving to GOBHI No Changes being made to the contract language. AMH will create a supplementary form that can be used, for the MHOS Effective Jan. 1. 2009. To be completed when OC&P is ready to work on Plan specific contracts. Effective Jan. 1, 2009. To be completed when OC&P is ready to work on Plan specific contracts. No action required. MHOs elected to use AMH boiler plate templates previously approved by CMS. No impact on ABHA or partner counties No impact on ABHA or partner counties • 4t punod aaagM r O E 3x 3 W nro 0 o (C 5 m H O v o Lo W vi A 0up v C11 J A ISA Progress Review Report Ex B, Part II, 1, b., (8), n, =(0-- `".0 p d N O l i N > co yo =XI.1.-- CD B F m (8) ISA for Children and Adolescents (A) Contractor shall collaborate and assist AMH in the collection and reporting of data for use in an ISA 0_0dD5m m dA-00-o593CD m a °maa�m(T)a5-.<-nc_ono. QO�=Q1nmc� 5 xi O Qy-,�DN= O W N O N N co ^ -C 0OO 3 c N w convenience, like the financial MHO workbooks, only if a MHO chooses to do so. See comments above, item #19 03 ff) O 0 mO 0 FT? 3 CD O N Cn C puno j aaa4M r m CO C Al CO 0 > O r 0 a 0 t 0 w n oc o N y liJ 0 n a (0 a 0 F 5 m 5 0 3 m O G 0 o (p F 00 N o< w y N o. 0 0 0 J 0) Exhibit H - Encounter Data See Ex. H attachment, pgs 137-141 0 co oal j O .a (D 3 -• O v z Q N ~ N0 3 N� CO n N m D' =am3 (D co 3 cs 0 x"O N O nO 0 0= N N N O y = �v O m N 0. Attachment No impact on ABHA or partner counties Formatted: Bullets and Numbering a m 0 rt punoJ aaat{M 0 D O 3 x 3 N 0 C O CO 3 w 3 co