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Home My WebLink Aboutbocc.con.021.1985 �t-' �� r �g� �;� r` �ill` � '� �'' ;� �>- �-. � � �� ; ��,_ . ':�� ,� `al I . � � �;, t �, �,� ,, . : f �: ,� � ,� � ; - .•w� . < _ . _, _,- _, ��. � �- �, N�., r,..�,z.. „�..�. ��._ .. ��-�� GENERAL ASSIJRANCES REGkRDI,7G THE HOME A.dD COMMLTviT7 BASED SE+'CiIICES PAOGRAM OF TfiE COLURADO DE.'PR'r�:ENT OF SUCIAL SERVICES July 1, 19&5 - June 30, 1986 � Cl� 2:1(85) We, :*e undersigned, nereb� agree t at eac of the folloWing assurances wili be met iz rela:ion to the Home and Comrninity Based Services Program of the Colorado St�=� 'vepartment of Social Services. We, understand that these assurances constitute the concractual terRS of certification, against which performance will be monitared, authorized services will be reimlx:rsed, and future recer`ificaCion will be considered. A. The case management agency (�IA) designate has develo�ed and submitted to tY.e State a plan for local operatioas and program implementation for FY 84-55. The C"SA agsees to either continue to operace under this plan or submik a new plan. This local operationai plan conforms to a State-prescribed format a.Zd �utlines the process by which the following assurances will be met. Tf:e agency can document that at least the folirn+ing entities Were invited to participate in the public input process which preceded the 3evelopment of the plan: the boacd of county cortunissioness, the field supervisor of CDSS, the district health depaztment, the area agency on aging, county department(s) of sxial services, nursing homeCs). hospital<s), city and town government(s), and • the generai public. �,ry� � Co. Comm. �N' Q�lf+ � S. The CMA will have as a major objective that referzals to the agency of Medicaid long term care eligibie clients will result in a pereentage of i dir•ersions from nurs?ng home placement that is not less than the stateeide average of 12%. If that percentage of diversion is n�t achieved, the CMA will work with the Home an•d Community BaseC Services Unit in the Aging and ' Adult Services Diaision to develop and impiement strategies to effect a steady increase in nuzsing home diversions untii the statewide average ean j be achieved. Note: This assurance aertains only to HCBS cases wh�ch are aot Contiaued stay review 90-day referrals; the CSR 90-day referral case data should be � maintained as a separate category. _. Co. Comm. � CMA� C. The C!W Wili process paperwork in a timely and accurate manner so as to promote prompt service to clients and prampt payment of provider claims. � All forms wiil be submitted within the time constraints and according to the rocesses set forth in the HCB rules and re u�,�.pns. � P g " V � '. ' . Co. Comra. ` t?1A��'_ 1 � ; _.._ ., .,... . _.._,�.. ..;_._, , . . ... .: . . . . .... ...._.. . .. .. ..,_^....-�,.�...:—,J:'!'e:�'^.1�1'rL'e�^.. .. .., _ - � . . . - �� . t I . u��:: �,-. t ,'� �� s,�g ;�� ,� �,. . . : -�. , . . . - , f." k,,.... ,e .. „ d.-.::�.��+�. Ger.eral Assurancee: Page Tb+o D. The agancy s+ill assume a leaG responsiblity tor coordinating and de�eloping a local contir.u�vn of care `or the elderly. Coordinatio� resnonsiblities in�.ude the initiatioa of regular anQ adequate communications with providers, potential pcoviders, and the o:her entities '� cited in Assurance A 3bove. Coordination also includes making reasonable efforts io respond to inquiries and requests for assistance from persons seeking long ters �are, withou: regard ta p:ogram or come eligib,,il�'tp. Co. Cortur.. � Ct4A %.� �i — ,� E. The dgency will guard the :lients' ri�hts within the HCBS program. Clients have the right to apply for services, to have their eligibility tor ser�ices determined, to receive an adequate qisantity and quality of the services for which they are eli@ib2e, to apneal d�nials of service, and to have their cocmnunications with the agency d?alt with confidentially. The CMA wili r.otify each client of his/her right to appeal, and will facilitate appropriatE access to advocacy services from the Coloradc Long Term Care Jmbudsman, Aduit Protective and Supportive Services, and the Area Agency on Aging/Title III OA�1,P,dvocacy Servic s. Co. Comm. �� CMA �� e^. The CMA assures competent and professional operation of the agency and of the Home and Cocnmunity Based Services Program. Case managers and their support staff will be qualified, both by education and experience, to carry out their assigned duties. The agency wiil provide them r+ith adequate training and supe:vision to maintain ongoin uality of �s�e,,rYice. ' Co. Comm. � CMA 17/C�/ �— 6. The case management agency may certify and use individual providers in accordance with state zules. However, a case management agency Will be certified as an agency to provide other services only when it demonstrates and receives state approval taat: a) N�+ other previder in the community can provide that service, or b) The case management agency can provide the service more cost effective:y than other providers. �., � Co. Comm.�� CMA� S. The CMA v+ill extend HCBS provider certification only to individuals who are qualified to perform their assigned duties. The agency will provide I adequate monitoting and assure that edequate training takes place to maintain the ongoing quality of service. The agency Will annually i recertify only those provi.ders capable of perfor��inl ose ass�igned �luties. Co. Cnmm. � I. The CMA will comply with all current regui2tions of Federal and State Medicaid and HCBS progcams, as amended and revised. Ca. Comn. �� ^•MA� Signed, � A pir `�f Designa_�ase anagement Agency l�J✓�.�.. Chairman of the Board of County Commissioaers PITKIN � County i 8 JUI,Y, 1985 � Date , � ��< i. : �„� � ..� ��; a,; �..,, ...a_��:, ai . ��j .,a:: SPECIF:C ASS�?.FNCc.S � REGARfi IIIG HOME PND COh:t^.UNITf BAScD SEi2';;CES PROGR?M C: THE COLOR?.DU DEPP_i:':^:'IEI:T OF SCCIAL SERViCES July 1, 19&S - June 30, 1986 I :HESE ASSUFANC�S pE.RTAI:J O1JI.Y TO NEW CASE hIANAG&MEPIT AGENCTES �CMAs) WFi'CH ARE NOT COUNTY DEPAFC7',4cNT8 OF SOCIAL Se.R7ICES. C:SAs applying for recertific2tior. or nev CMt_ designees which are county departments of social services need not tomplete this section, s�ace `_hese t�rms are atherwise assured. We, the undersigred, hereby assure that the � O��v��A� .SC�iPUil�% , (Agency Name) as the certi:ied case marag�ment agenc;� for �� f/�I/V (County) vili comply witn the follow:rg assurances in the impienentation of the H�me and Community Eased Servic=s Program in this county. The CAtA will also comply with the tu!es ar.d regu!ations promulgated by the Colorado State Board of Social Services as specif:ed �a the appiicable portions �f the Colorado Str.te Departmen! of Sociat Services stafi maauals. Specific Assurance A. Case Ma:iage.^:er.t A'ency Or�aanization There shall be a defined organization which identifies the supervi�,ory structure and the relati;ashio of the case mar_agement ageacy to ot`:er agency functions. The organizational cnart shall be submitted wik;: the plan for local operatiors. Specific Assurance B. Personnel System There shail be a syste� :or recruiting, hiring, evaluating, and terminating er.,ployees :�at is :esponsi�re to af:irmative action an� 504 compliance. If the case r�ianager=nt ager_cy :s other than a countx department of social ser�ices, Written documentation Csuch as a procedure manual) shall 5e submit�ed M:th the oian For local operatiors. Specific Assurance C. Ph�•sic21 P:ant(Business Ooera�ioa There shall be a pY:ysicai ?lan:: out of which the case management agency snall consistFr.tly opera�_. T::e:e sha2L be in place aecessary equipmer.t £or publi� con*_act and :cr other :ar.saction of business, such as telephones, typewri:ers, and office furniture. ' Sp?Cif:c Assuranc.e D. P.ccess There 5ha11 be r.o ba:rie:s, eithe: physical or programmatic, which prohibit client participation. Clienks shall be p:ovided with an � opportunity .`or cas� management agency staff to come to the clients; i.e., � hospital, home visits. The case management agency shall comply with anti-discrimination pxo:�isions as defined in Colorado Department of Social Services Stuff bianuai, Lo:. VII, 7.000.91. The CM.9 shall substzkute "CMA" for "county department' in the application and accepeance of the provi�ion of 7.000.91. . .. ._.... . _ , .. ... .,........,..., i , wrr�w , �,�%; '` � � �_ < .�' *� � . . . `. yy.�..-. ..�... :�.. =r'�t ��q °+� ' . Specific Assezances IPage Tb�o � Specific Assurance E. P.ccour.tinY Sv^t�:n .�__..'_—= The accour,cing °ystc: snai: ccmoly witn rulr; ar�1 re��iations o£ the � Colorado State Departr:�nt of Social Services. 'i..e case mar.agement agenc� shall assur? that funds are used solely for authorized �urposes; that all souzCe dccur2nts are filzd ir. a sy;t�matiC r�anner to facilitate audits; ' that all source docume^ts are r�tair.ed until canr_el.led by audit and all audi.r i�:uea ...:C resal:�d; �nd tn�t b;�::s, recorcis, and source documents are made availaDle to the Department of Social Services or its representati�.�es for insp�ction, "Llld1Y� or reproduction during normal business hours. The case maaagement ag=ncy Purther shall assure timely and aporopr' -� resoiution of audit f:nding:s and recom:nendations. The case mana�e:- `_ ageac�� shall submit an =xpl�nation of the accaunting system with = �lan Yor local operations. Specific Assur�r - r'. Fi>cal Intermediary ?'he case ma,. �mer.t a_;ency shall act as a fiscal intermediary for ii�dividual ,: riders r.e=tified by the case mana�emAnt agency. The case managem�nt < acy shail be respoasible fot the suthorization of expenditure accordar.ce with the case plan, for assurir_g ttiat the service is z--omplishen, for billing Nu"fIS, for reimbursement to the providers, zr.c for zccounting for the exoe^ditures and d.isbursements. Specific Assurance G. Contract Process A pracess foz establishia;, monitcr.ing, evaluating, and terminating contractual serriees ccr.sistent %+itn state ar.d local :equirements shall be established. Contr2cYS shall oe kep: on £ile at tne c3se maaagement agency. Specific Assurance H. Ch1A as Pzovider of 9not�er Service The case nanageroent agency may certify and use ir_diridual prroviders in accozdance with state rules. However, a case mara�ement a5ency �+ill be certified as an agency to provide othez services only wh,an it demonstrates and receives state approval that: a) No other provider in the comnuni:y car.• provide thar. service, or b) The case management agency can pr.ovide the ser+ice nore cost effecti•rely than other providers. Specific Assurance I. Przctice Standards �i The case management agency sha11 be knoNledgeabl� of the :star.dards for case management practice developed by the Colorado State� Depart�nent of j Social Services. These practice star.dards shall be cons�icerei and applied , in the performance of case management services and in tkie eva:uation of � employee performance. _ . ._Signed, � i� �. �� '-_!"� Director of Designated�e Jhfina€�em t Agency �1 ��jx..— � Chairman of the Hoard of County C�mmissioners 1,��'�'= - - - Counr.y � Date 7�s/�'_�—__ � _ .. .__.... ...,.. ,