PROWERS COUNTY, COLORADO BOARD OF COMMISSIONERS  DECEMBER 10, 2024  7:00a.m.  Mark Dorenkamp, Road & Bridge Supervisor  Update (AM Breakfast House, 4105 SN Main St, Lamar, CO 81052)  COMMISSIONERS BOARD ROOM, 2nd FLOOR OF COURTHOUSE  301 S. MAIN STREET, LAMAR, CO 81052  WORK: SESSION  9:00 a.m. 9:30a.m. 10:00a.m. 10:30a.m.  Gary Harbert, Veterans' Service Officer  County' VSO Monthly Report and Certification of Pay Cheryl Sanchez and Tallie Harmon, Prowers Economic Prosperity Heather Hamadi, Project Manager, Tyler Technologies Tyler Technologies ERP Pro update  PEP update monthly  Pete Hernandez, PC Consolidated Return Mail Center Manager  CRMC update OPC update  MEETING AGENDA  1:00 p.m.  Invocation Pledge of Allegiance Call Meeting to Order Roll Call    CONSENT AGENDA ACTION ITEMS:  1. Consider. Approval of Adoption of Agenda  2. Consider Approval of Payment of Bills Presented and of Voiding Checks, if any, for all County Funds and DHS Funds, which include WHC and H3C Funds 3. Consider Approval of November 19, 2024 Meeting Minutes  PUBLIC APPEARANCES  Anyone wishing to address the BOCC may do so at the discretion of the Board  and subject to at three-minute limitation.  UPDATES  Don Wilson, Interim County Administrator County Administrator update  PAT (busses, sponsors, logos) Changes to Holiday Schedule  Rose Pugliese, Esq.  County Attorney update  ACTION ITEMS:  1. Consider approval of SECO CMA Contract Amendment #2, C24-186984A2 to original Contact No. C24-186984 and authorizing Public Health Director, Meagan Hillman to 2. Consider approval of Fairgrounds Facility Rental Agreement and Waiver of Fees for Tri-State 9-11 Foundation, event scheduled for September 3-7, 2025. 3. Consider approval of Fairgrounds Facility Rental Agreement for Norma Valdez F, event 4. Consider approval of Colorado Department of Transportation (CDOT) Prowers County Signature Sheet, certifying total mileage as of December 31, 2024. 5. Consider approving Statement of Work Interpretation and Translation Services and Related Services Contract #R210605 Administered by OMNIA Partners and authorizing Department of Human Services Director, Lanie Meyers-Mireles to execute the  execute the Contract electronically.  scheduled for May 17, 2025.  Agreement.  2    6. Consider ratifying 11-29-2024 email poll approval of a Letter of Support sent to Tara Marshall, Colorado Department of Local Affairs for the SECOG Application for funding 7. Consider approval of NFP Contract Amendment No. 1, CT QAAA 2025-1019. A1,t to original Contract No. 25 QAAA 190688 in the amount of $648,742.00 and authorizing Public Health Director, Meagan Hillman to execute the Contract electronically. 8. Consider approval for adoption of the 2025 County Holiday Schedule and 2025 BOCC  of the SECOG Mini-Grant Program, FY2025.  Meeting Schedule.  9. Consider approval for Adoption of a County Retention Policy. 10. Consider approval of County Veterans Service Officer's Monthly Report and 11. Consider approval of adding a Special BOCC Meeting for December 13, 2024.  Certification of Pay- - November 2024.  PREVIOUSLY TABLED ACTION ITEMS:  1. None  EXECUTIVE SESSION  Executive Session pursuant to C.R.S. 524-6-402(4)b) Conference with the attorney for the purposesofrecelving legal advice on specific legal questions.  ADJOURN  NOTE: This Agenda is provided for informational purposes only. Action may be taken on any or all of the items. All times are approximate. Ifany given item is finished earlier than anticipated, the Commissioners. may move on to the next item. The only exceptions are public hearings on items which have had published notices of a  specific hearing time; those items will not begin until the specific time or after.  If you need assistance in participating in this meeting due to a disability as defined under the Americans with Disabilities Act, please call 719-336-8030 at least three days prior to the scheduled meeting to request an  accommodation.  3    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 12/10/2024 Submitter: Meagan Hillman, PCPHE Director  Submitted to the County Administration Office on: 11/25/2024  Return Originals to: Meagan Hillman, PCPHE  Number of originals to return to Submitter: 1, to confirm approval  Contract Due Date: 12/20/2024 Item Title/Recommended Board Action:  Consider approval of SECO CMA Contract Amendment #2, C24-186984A2 to original Contact No. C24-186984 and authorizing Public Health Director, Meagan Hillman to execute the Contract Justification or Background: SECO CMA contract amendment changing rate amounts.  electronically.  Fiscal Impact: This item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on: 11-25-2024  Additional Approvals (if required):  PLEASE. ATTACH THIS SHEET TO ALL. AGENDA ITEMS WHEN SUBMITTINGTO  COUNTY ADMINISTRATION.  THANK YOU!    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  STATE OF COLORADO CONTRACT MODIFICATION  CONTRACT AMENDMENT #2  State Agency Department ofHealth Care Policy and Financing Contractor Prowers County Public Health and Environment Original Contract Number C24-186984 Amendment Contract Number C24-186984A2  Contract Performance Beginning Date January 1,2025 Current Contract Expiration Date June 30, 2025 Current Contract Maximum Amount Medicaid Programs No Maximum for any SFY State General Fund Programs State Fiscal Year 2024-25 Estimated Contractor Shared  $21,693,981.00 $148,530.52  THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT Each person signing this Amendment represents and warrants that he or she is duly authorized to execute this Amendment and tol bind the Party authorizing his or her signature.  CONTRACTOR Prowers County Public Health and Environment Meagan L. Hilman, Director  STATE OF COLORADO Jared S. Polis, Governor Department of] Health Care Policy and Financing Kim Bimestefer, Executive Director  Date:  Date:  STATE CONTROLLER Robert. Jaros, CPA, MBA, JD Department ofHealth Care Policy and Financing Jerrod Cotosman, Controller  Amendment Effective Date:  In accordance with $24-30-202, C.R.S., this Amendment is not valid until signed and dated above by  the State Controller or an authorized delegate.  Amendment Contract Number: C24-186984A2 Page 1of114    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1. PARTIES  This Amendment (the "Amendment") to the Original Contract shown on the Signature and Cover Page for this Amendment (the "Contract") is entered into by and between the Contractor and the  State. 2. TERMINOLOGY  Except as specifically modified by this Amendment, all terms used in this Amendment that are defined in the Contract shall be construed and interpreted in accordance with the Contract  3. AMENDMENT EFFECTIVE DATE AND TERM  A. Amendment Effective Date  This Amendment shall not be valid or enforçeable until the Amendment Effective Date shown on the Signature and Cover Page for this Amendment. The State shall not be bound by any provision of this Amendment before that Amendment Effective Date, and shall have no obligation toj pay Contractor for any Work performed or expense incurred under this Amendment either before or after ofthe Amendment term shown in $3.B ofthis Amendment.  A. Amendment Term  The Parties' respective pertormances under this Amendment and the changes to the Contract contained herein shall commence on the Amendment Effective Date shown on the Signature and  Cover Page for this Amendment.  4. PURPOSE  This Amendment updates the General Contract Provisions and Exhibit B Statement of Work. The Contract and all prior amendments thereto, ifany, are modified as follows: A. The Contract Initial Contract Expiration Date on the Contract's Signature and Cover Page is hereby deleted and replaced with the Current Contract Expiration Date shown on the Signature B. The Contract Maximum Amount table on the Contract's Signature and Cover Page is hereby deleted and replaced with the Current Contract Maximum Amount table shown on the  5. MODIFICATIONS  and Cover Page for this Amendment.  Signature and Cover Page for this Amendment. C.T The Contract Provisions is hereby updated as follows. references to Exhibit B shall now refer to Exhibit B-1. references to Exhibit C: shall now refer to Exhibit C-1. references to Exhibit D shall now: refer to Exhibit D-1. references to Exhibit E shall now refer to Exhibit E-1.  D. Exhibit B is hereby deleted in its entirety and replaced with Exhibit B-1 as follows.. All E. Exhibit C is hereby deleted in its entirety and replaced with Exhibit C-1 as follows. All F. Exhibit D is hereby deleted in its entirety and replaced with! Exhibit D-1 as follows. All G. Exhibit E: is hereby deleted in its entirety and replaced with Exhibit E-1 as follows. All  Amendment Contract Number: C24-186984A2 Page 1 of24    Docusign Envelope ID: 08D45896-7084-4F7D-95BF-CA11DA86A3E9  6. LIMITS OF EFFECT AND ORDER OF PRECEDENCE  This Amendment is incorporated by reference into the Contract, and the Contract and all prior amendments or other modifications to the Contract, if any, remain in full force and effect except as specifically modified in this Amendment. Except for the Special Provisions contained in the Contract, in the event of any conflict, inconsistency, variance, or contradiction between the provisions of this Amendment and any of the provisions of the Contract or any prior modification tot the Contract, the provisions of this Amendment shall in all respects supersede, govern, and control. The provisions of this Amendment shall only supersede, govern, and control over the Special Provisions contained in the Contract to the extent that this Amendment specifically  modifies those Special Provisions.  Amendment Contract Number: C24-186984A2 Page 2 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  CONTRACT PROVISIONS  1. PARTIES  This Contract is entered into by and between Contractor named on the Cover Page for this Contract ("Contractor"), and the STATE OF COLORADO acting by and through the State agency named on the Cover Page for this Contract (the "State," the Department," or "HCPF"). Contractor and  the State agree to the terms and conditions in this Contract.  2. TERM AND EFFECTIVE DATE A. Effective Date  This Contract shall not be valid or enforceable until the Effective Date. The State shall not be bound by any provision of this Contract before the Effective Date and shall have no obligation toj pay Contractor for any Work performed or expense incurred before the Effective Date or after  the expiration or sooner termination of this Contract.  B. Initial Term  The Parties' respective performances under this Contract shall commençe on the Contract Performance Beginning Date shown on the Cover Page for this Contract and shall terminate on the Initial Contract Expiration Date shown on the Cover Page for this Contract (the "Initial Term") unless sooner terminated or further extended in accordance with the terms of this  Contract.  .E Extension Terms State's Option  The State, at its discretion, shall have the option to extend the performance under this Contract beyond the Initial Term for a period, or for successive periods, of one year or less at the same rates and under the same terms specified in the Contract (each such period an "Extension Term"). In order to exercise this option, the State shall provide written notice to Contractor in a form substantially equivalent to the Sample Option Letter attached to this Contract. Except as stated in $2.D, the total duration of this Contract, including the exercise of any options to extend, shall not exceed eight years from its Effective Date absent prior approval from the ChiefProcurement  Officer in accordance with the Colorado Procurement Code.  D. End ofTerm Extension  Ift this Contract approaches the end ofits Initial Term, or any Extension Term then in place, the State, at its discretion, upon written notice to Contractor as provided in $14, may unilaterally extend such Initial Term or Extension Term for a period not to exceed two months (an "End of Term Extension"), regardless of whether additional Extension Terms are available or not. The provisions of this Contract in effect when such notice is given shall remain in effect during the End of Term Extension. The End of Term Extension shall automatically terminate upon execution ofai replacement contract or modification extending the total term oft this Contract. The State is entering into this Contract to serve the public interest of the State of Colorado as determined by its Governor, General Assembly, or Courts. Ift this Contract ceases to further the  E. Early Termination in the Public Interest  Amendment Contract Number: C24-186984A2 Page 3 of24    Docusign Envelope ID: 8D4B896-7084-4F7D-958F-CA11DA86A3E9  public interest ofthe State, the State, in its discretion, may terminate this Contract in whole or in part. A determination that this Contract should be terminated in the public interest shall not be equivalent to a State right to terminate for convenience. This subsection shall not apply to a termination of this Contract by the State for Breach of Contract by Contractor, which shall be  governed by $12.A.i. . Method and Content  The State shall notify Contractor ofs such termination in accordance with $14. The notice shall specify the effective date of the termination and whether it affects all or a portion of this Contract, and shall include, to the extent practicable, the public interest justification for the  termination. ii. Obligations and Rights  Upon receipt of a termination notice for termination in the public interest, Contractor shall  be subject to the rights and obligations set forth in $12.A.i.a.  ii. Payments  Ift the State terminates this Contract in the public interest, the State shall pay Contractor an amount equal to the percentage of the total reimbursement payable under this Contract that corresponds to the percentage of Work satisfactorily completed and accepted, as determined by the State, less payments previously made. Additionally, if this Contract is less than 60% completed, as determined by the State, the State may reimburse Contractor for a portion of actual out-of-pocket expenses, not otherwise reimbursed under this Contract, incurred by Contractor which are directly attributable to the uncompleted portion of Contractor's obligations, provided that the sum of any and all reimbursement shall not exceed the  maximum amount payable to Contractor hereunder.  3. DEFINITIONS  The following terms shall be construed and interpreted as follows:  A. "Breach of Contract" means the failure ofal Party to perform any ofi its obligations in accordance with this Contract, in whole or in part or in a timely or satisfactory manner. The institution of! proceedings under any bankruptcy, insolvency, reorganization or similar law, by ora against Contractor, or the appointment ofai receiver or similar officer for Contractor or any ofits] property, which is not vacated or fully stayed within 30 days after the institution of such proceeding, shall also constitute a breach. If Contractor is debarred or suspended under $24- 109-105, C.R.S. at any time during the term oft this Contract, then such debarment or B. "Business Day" means any day in which the State is open and conducting business, but shall not include Saturday, Sunday or any day on which the State observes one oft the holidays listed C. "Chief Procurement Officer" means the individual to whom the Executive Director has delegated his or her authority, pursuant to $24-102-202, C.R.S. to procure or supervise the  suspension shall constitute a breach. in $24-11-101(1), C.R.S.  procurement of all supplies and services needed by the State.  Amendment Contract Number: C24-186984A2 Page 4 of24    Docusign Envelope ID: 08D4B896-7084.4F7D-95BF-CA11DA86A3E9  D. "Contract" means this agreement, including all attached Exhibits, all documents incorporated by reference, all referenced statutes, rules and cited authorities, and any future modifications E. "Contract Funds" means the funds that have been appropriated, designated, encumbered, or otherwise made available forj payment by the State under this Contract. F. "CORA'means the Colorado Open Records Act, $$24-72-200.1, et seq., C.R.S. G. "Deliverable" means the outcome to be achieved or output to be provided, in the form ofa tangible object or software that is produced as a result of Contractor's Work that is intended to H. "Effective Date" means the date on which this Contract is approved and signed by the Colorado State Controller or designee, as shown on the Signature Page for this Contract. Ifthis Contract is for a Major Information Technology Project, as defined in 24-37.3-102(2.0), C.R.S., then the Effective Date of this Contract shall be the later ofthe date on which this Contract is approved and signed by the State's ChiefInformation Officer or authorized delegate ort the date on which this Contract is approved and signed by the State Controller or authorized J. "Exhibits" means the exhibits and attachments included with this Contract as shown on the L. "Goods" means any movable material acquired, produced, or delivered by Contractor as set forth in this Contract and shall include any movable material acquired, produced, or delivered M. "Incident" means any accidental or deliberate event that results in or constitutes an imminent threat oft the unauthorized access, loss, disclosure, modification, disruption, or destruction of any communications or information resources oft the State, which are included as part oft the Work, as described in $$24-37.5-401, et seq., C.R.S. Incidents include, without limitation, (i) successful attempts to gain unauthorized access to a State system or State Records regardless of where such information is located; (ii) unwanted disruption or denial ofservice; (iii) the unauthorized use ofa State system for the processing or storage of data; or (iv) changes to State system hardware, firmware, or software characteristics without the State's! knowledge, O. "Party" means the State or Contractor, and "Parties" means both the State and Contractor. P. "PHI" means any protected health information, including, without limitation any information whether oral or recorded in any form or medium: (i) that relates to the past, present or future physical or mental condition of an individual; the provision of health care to an individual; or the past, present or future payment for the provision ofhealth care to an individual; and (ii) that identifies the individual or with respect to which there is ai reasonable basis to believe the information can be used toi identify the individual. PHI includes, but is not limited to, any information defined as Individually Identifiable Health Information by the federal Health "PII" means personally: identifiable information including, without limitation, any information maintained by the State about an individual that can be used to distinguish or trace an individual's: identity, such as name, social security number, date and place oft birth, mother's  thereto.  be delivered to the State by Contractor.  delegate, as shown on the Signature Page for this Contract. - "End ofTerm Extension" means the time period defined in $2.D. K. "Extension Term" means the time period defined in $2.C.  Cover Page for this Contract.  by Contractor in connection with the Services.  instruction, or consent.  N. "Initial Term" means the time period defined in $2.B.  Insurance Portability and Accountability Act.  Amendment Contract Number: C24-186984A2 Page 5of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  maiden name, or biometric records; and any other information that is linked or linkable to an individual, such as: medical, educational, financial, and employment information. PII includes, but is not limited to, all information defined as personally identifiable information in $$24-72- 501 and 24-73-101, C.R.S. "PII" shall also mean "personal identifying information" as set forth R. "Services" means the services to be performed by Contractor as set forth in this Contract and shall include any services to be rendered by Contractor in connection with the Goods. S. "State Confidential Information" means any and all State Records not subject to disclosure under CORA. State Confidential Information shall include, but is not limited to, PII, PHI, and State personnel records not subject to disclosure under CORA. State Confidential Information shall not include information or data concerning individuals that is not deemed confidential but nevertheless belongs to the State, which has been communicated, furnished, or disclosed by the State to Contractor which (i) is subject to disclosure pursuant to CORA; (ii) is already known to Contractor without restrictions at the time ofi its disclosure to Contractor; (iii) is or subsequently beçomes publicly available without breach ofa any obligation owed by Contractor to the State; (iv) is disclosed to Contractor, without confidentiality obligations, by ai third party who has the right to disclose such information; or (v) was independently developed without reliance on any T. "State Fiscal Rules" means the fiscal rules promulgated by the Colorado State Controller U. "State Fiscal Year" means a 12-month period beginning on July 1 of each calendar year and ending on June 30 of the following calendar year. Ifas single calendar year follows the term, V. "State Records" means any and all State data, information, and records, regardless of physical form, including, but not limited to, information subject to disclosure under CORA. W. Subcontractor" means any third party engaged by Contractor to aid in performance of the Work. Subcontractor" excludes provider agencies providing direct services to Members under X. "Work" means the Goods delivered and Services performed pursuant to this Contract. Y. "Work Product" means the tangible and intangible results ofthe Work, whether finished or unfinished, including drafts. Work Product includes, but is not limited to, documents, text, software (including source code), research, reports, proposals, specifications, plans, notes, studies, data, images, photographs, negatives, pictures, drawings, designs, models, surveys, maps, materials, ideas, concepts, know-how, and any other results ofthe Work. "Work Product" does not include any material that was developed prior to the Effective Date that is Any other term used in this Contract thati is defined in an Exhibit shall be construed and: interpreted  at $ 24-74-102, et. seq., C.R.S.  State Confidential Information. pursuant to 24-30-20203)8). C.R.S.  then it means the State Fiscal Year ending in that calendar year.  this Contract through the State General Fund programs.  used, without modification, in the performance oft the Work. as defined in that Exhibit, including the terminology in Exhibit D.  4. STATEMENT OF WORK  A. Contractor shall complete the Work as described in this Contract and in accordance with the provisions of Exhibit B and Exhibit E. The State shall have no liability to compensate Contractor for the delivery of any goods or the performance of any services that are not  specifically set forth in this Contract.  Amendment Contract Number: C24-186984A2 Page 6of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  B. The State, at its discretion, shall have the option to increase or decrease the statewide quantity of Goods and Services based upon rates established in this Contract, and increase the maximum amount payable accordingly. In order to exercise this option, the State shall provide written notice to Contractor: in a form substantially equivalent to the Sample Option Letter attached to this contract. Delivery of Goods and performance of Services shall continue at the same rates  and terms as described in this Contract. 5. PAYMENTS TO CONTRACTOR A. Maximum Amount  Payments to Contractor are limited to the payment described in Exhibit B and are based on the quantity of services performed and the number of Members served by Contractor.  B. Payment Procedures  Invoices and Payment  a. The State shall pay Contractor in the amounts and in accordance with the schedule and other conditions set forth in Exhibit B, Statement of Work and Exhibit C, Rates. b. Contractor shall initiate payment requests by invoice to the State, in a form and The State shall pay the Contractor for activities completed in accordance with the conditions set forth in Exhibit B, Statement of Work and Exhibit C, Rates within 90 days following the State's review oft the activities completed for the previous month, so long as the documented activities correctly represents Work completed by Contractor and previously accepted by the State during the erm that the payment covers. Ifthe State determines that the amount of any payment is not correct, then Contractor shall make all changes necessary to correct that payment. d. The processing of aj payment shall not constitute acceptance of the completion of requirements or quality any Work performed or Deliverables provided under this  manner approved by the State.  Contract.  ii. Interest  Amounts not paid by the State within 45 days of the State's acceptance of the invoice shall bear interest on the unpaid balance beginning on the 45th day at the rate of1 1% peri month, as required by $24-30-202(24)8), C.R.S., until paid in full; provided, however, that interest shall not accrue on unpaid amounts that the State disputes in writing. Contractor shall invoice the State separately for accrued interest on delinquent amounts, and the invoice shall reference the delinquent payment, the number of day's interest to be paid and the interest  rate.  iii. Payment Disputes  IfContractor disputes any calculation, determination or amount of any payment, Contractor shall notify the State in writing ofi its dispute within 30 days following the earlier to occur of Contractor's receipt of the payment or notification of the determination or calculation of the payment by the State. The State will review the information presented by Contractor andi may make changes to its determination based on this review. The calculation, determination or  Amendment Contract Number: C24-186984A2 Page7of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  payment amount that results from the State's review shall not bes subject to additional dispute under this subsection. No payment subject to a dispute under this subsection shall be due until after the State has concluded its review, and the State shall not pay anyi interest on any amount  during the period it is subject to dispute under this subsection.  iv. Available Funds-Contingency-Termination  The State is prohibited by law from making commitments beyond the term of the current State Fiscal Year. Payment to Contractor beyond the current State Fiscal Year is contingent on the appropriation and continuing availability of Contract Funds in any subsequent year (as provided in the Colorado Special Provisions). If federal funds or funds from any other non- State funds constitute all or some of the Contract Funds, the State's obligation to pay Contractor shall be contingent upon such non-State funding continuing to be: made available forp payment. Payments tol bei made pursuant to1 this Contract shall bei made only from Contract Funds, and the State's liability for such payments shall be limited to the amount remaining of such Contract Funds. If State, federal or other funds are not appropriated, or otherwise become unavailable to fund this Contract, the State may, upon written notice, terminate this Contract, in whole or in part, without incurring further liability. The State shall, however, remain obligated to pay for Services and Goods that are delivered and accepted prior to the effective date of notice of termination, and this termination shall otherwise be treated as if  this Contract were terminated in the public interest as described in $2.E.  6. REPORTING -NOTIFICATION A. Litigation Reporting  IfContractor is served with a pleading or other document in connection with an action before a court or other administrative decision-making body, and such pleading or document relates to this Contract or may affect Contractor's ability to perform its obligations under this Contract, Contractor shall, within 10 days after being served, notify the State of such action and deliver copies of such pleading or document to the State's Principal Representative identified on the  Cover Page for this Contract.  B. Performance Outside the State of Colorado or the United States, $24-102-206, C.R.S. To the extent not previously disclosed in accordance with $24-102-206, C.R.S., Contractor shall provide written notice to the State, in accordance with $14 and in a form designated by the State, within 20 days following the earlier to occur ofContractor's decision to perform Services outside of the State of Colorado or the United States, or its execution of an agreement with a Subcontractor to perform, Services outside the State ofColorado or the United States. Such notice shall specify the type of Services to be performed outside the State of Colorado or the United States and the reason why it is necessary or advantageous to perform such Services at such location or locations, and such notice shall be a public record. Knowing failure by Contractor to provide notice to the State under this section shall constitute a Breach of Contract. This section  shall not apply ift the Contract Funds include any federal funds.  7. CONTRACTOR RECORDS A. Maintenance  Amendment Contract Number: C24-186984A2 Page 8 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  Contractor shall maintain a file of all documents, records, communications, notes and other materials relating to the Work (the "Contractor Records"). Contractor Records shall include all documents, records, communications, notes and other materials maintained by Contractor that relate to any Workp performed by Subcontractors, and Contractor shall maintain all records related to the Work performed by Subcontractors required to ensure proper performance of that Work. Contractor shall maintain Contractor Records until the last to occur of: () the date three years after the date this Contract expires ori ist terminated, (ii) final payment under this Contract is made, (iii) the resolution ofany pending Contract matters, or (iv) if an audit is occurring, or Contractor has received notice that an audit is pending, the date such audit is completed and its findings have  been resolved (the "Record Retention Period").  B. Inspection  Contractor shall permit the State, the federal government, and any other duly authorized agent of a governmental agency to audit, inspect, examine, excerpt, copy and transcribe Contractor Records during the Record Retention Period. Contractor shall make Contractor Records available during normal business hours at Contractor's office or place of business, or at other mutually agreed upon times or locations, upon no fewer than two Business Days' notice from the State, unless the State determines that a shorter period of notice, or no notice, is necessary to protect  the interests oft the State. C.N Monitoring  The State, the federal government, and any other duly authorized agent ofa governmental agency in its discretion, may monitor Contractor's performance of its obligations under this Contract usingp procedures as determined by the State or that governmental entity. The State shall monitor Contractor's performance in a manner that does not unduly interfere with Contractor's  performance oft the Work. D. Final Audit Report  Contractor shall promptly submit to the State a copy of any final audit report of an audit performed on Contractor's records that relates to or affects this Contract or the Work, whether  the audit is conducted by Contractor or a third party. 8. CONFIDENTIAL INFORMATION-STATE RECORDS  A. Confidentiality  Contractor shall keep confidential, and cause all Subcontractors to keep confidential, all State Records, unless those State Records are publicly available. Contractor shall not, without prior written approval oft the State, use, publish, copy, disclose to any third party, or permit the use by any third party of any State Records, except as otherwise stated in this Contract, permitted by law, or approved in writing by the State. Contractor shall provide for the security of all State Confidential Information in accordance with all policies promulgated by the Colorado Office of Information Security and all applicable laws, rules, policies, publications, and guidelines. If Contractor or any ofits Subcontractors: will or may receive the following types ofdata, Contractor ori its Subcontractors shall provide for the security ofsuch data according to the following: () the most recently promulgated IRS Publication 1075 for all Tax Information and in accordance with  Amendment Contract Number: C24-186984A2 Page 9 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  the Safeguarding Requirements for Federal Tax Information attached to this Contract as an Exhibit, ifa applicable and (ii) the federal Health Insurance Portability and Accountability, Act for all PHI and the HIPAA Business Associate Agreement attached to this Contract, if applicable. Contractor shall immediately forward any request or demand for State Records to the State's  Principal Representative.  B. Other Entity Access and Nondisclosure Agreements  Contractor may provide State Records to its agents, employees, assigns and Subcontractors as necessary toj perform the Work, but shall restrict access to State Confidential Information to those agents, employees, assigns and Subcontractors who require access to perform their obligations under this Contract. Contractor shall ensure all such agents, employees, assigns, and Subcontractors sign agreements containing nondisclosure provisions at least as protective as those in this Contract, and that the nondisclosure provisions are in force at all times the agent, employee, assign, or Subcontractor has access to any State Confidential Information. Contractor shall provide copies of those signed nondisclosure provisions to the State upon execution of the  nondisclosure provisions ifrequested by the State.  C. Use, Security, and Retention  Contractor shall use, hold, and maintain State Confidential Information in compliance with any and all applicable laws and regulations only in facilities located within the United States, and shall maintain a secure environment that ensures confidentiality of all State Confidential Information. Contractor shall provide the State with access, subject to Contractor's reasonable security requirements, for purposes of inspecting and monitoring access and use of State Confidential Information and evaluating security control effectiveness. Upon the expiration or termination of this Contract, Contractor shall return State Records provided to Contractor or destroy such State Records and certify to the State that it has done so, as directed by the State. If Contractor is prevented by law or regulation from returning or destroying State Confidential Information, Contractor warrants it will guarantee the confidentiality of, and cease to use, such  State Confidential Information. D. Incident Notice and Remediation  IfContractor becomes aware of any Incident, Contractor shall notify the State immediately and cooperate with the State regarding recovery, remediation, and the necessity to involve law enforcement, as determined by the State. Unless Contractor can establish that Contractor and its Subcontractors are not the cause or source oft the Incident, Contractor shall be responsible for the cost of notifying each person who may have been impacted by the Incident. After an Incident, Contractor shall take steps to reduce the risk of incurring a similar type ofIncident in the future as directed by the State, which may include, but is not limited to, developing and implementing ar remediation plan that is approved by the State at no additional cost to the State. The State may adjust or direct modifications to this plan in its sole discretion, and Contractor shall make all modifications as directed by the State. If Contractor cannot produce its analysis and plan within the allotted time, the State, in its discretion, mayi perform such analysis andj produce ai remediation plan, and Contractor shall reimburse the State for the actual costs thereof. The State may, in its sole discretion and at Contractor's sole expense, require Contractor to engage the services of an  Amendment Contract Number: C24-186984A2 Page 10 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  independent, qualified, State-approved third party to conduct a security audit. Contractor shall provide the State with the results ofs such audit and evidence ofContractor's; planned remediation  inr response to any negative findings. E. Data Protection and Handling  Contractor shall ensure that all State Records and Work Product in the possession of Contractor or any' Subcontractors are protected and handled in accordance with the requirements of this  Contract, including the requirements of any Exhibits hereto, at all times.  F. Safeguarding PII  Ifc Contractor or any ofi its Subcontractors will or may receive PII under this Contract, Contractor shall provide for the security ofsuch PII, in a manner and form acceptable to the State, including, without limitation, State non-disclosure requirements, use of appropriate technology, security practices, computer access security, data access security, data storage encryption, data transmission encryption, security inspections, and audits. Contractor shall be a "Third-Party Service Provider" as defined in $24-73-103(1)0, C.R.S. and shall maintain security procedures and practices consistent with $824-73-101 et seq., C.R.S. In addition, as set forth in $ 24-74-102, et seq., C.R.S., Contractor, including, but not limited to, Contractor's employees, agents and Subcontractors, agrees not to share any PII with any third parties for the purpose ofinvestigating for, participating in, cooperating with, or assisting with Federal immigration enforcement. If Contractor is given direct access to any State databases containing PII, Contractor shall execute, on behalf ofitself and its employees, the certification attached hereto as Exhibit H on an annual basis Contractor's duty and obligation to certify as set forth in Exhibit H shall continue as long as Contractor has direct access to any State databases containing PII. If Contractor uses any Subcontractors to perform services requiring direct access to State databases containing PII, Contractor shall require such Subcontractors to execute and deliver the certification to the State on an annual basis, SO long as the Subcontractor has access to State databases containing PII.  9. CONFLICTS OF INTEREST A. Actual Conflicts of] Interest  Contractor shall not engage in any business or activities or maintain anyrelationships that conflict in any way with the full performance oft the obligations of Contractor under this Contract. Such a conflict of interest would arise when a Contractor's or Subcontractor's employee, officer or agent were to offer or provide any tangible personal benefit to an employee of the State, or any member of his or her immediate family or his or her partner, related to the award of, entry into  or management or oversight oft this Contract.  B. Apparent Conflicts of Interest  Contractor acknowledges that, with respect to this Contract, even the appearance ofa conflict of interest shall be harmful to the State's interests. Absent the State's prior written approval, Contractor shall refrain from any practices, activities or relationships that reasonably appear to be in conflict with the full performance of Contractor's obligations under this Contract.  . Disclosure to the State  Amendment Contract] Number: C24-186984A2 Page 11 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  Ifac conflict or the appearance ofa conflict arises, or ifContractor is uncertain whether a conflict or the appearance of a conflict has arisen, Contractor shall submit to the State a disclosure statement setting forth the relevant details for the State's consideration. Failure to promptly submit a disclosure statement or to follow the State's direction ini regard to the actual or apparent  conflict constitutes a Breach of Contract.  D.A Acknowledgement  Contractor acknowledges that all State employees are subject to the ethiçal principles described in $24-18-105, C.R.S. Contractor further acknowledges that State employees may be subject to  the requirements of $24-18-105, C.R.S. with regard to this Contract.  10. INSURANCE  Contractor shall obtain and maintain, and ensure that each Subcontractor shall obtain and maintain, insurance as specified in this section at all times during the term of this Contract. All insurance policies required by this Contract shall bei issued by insurance companies as approved by the State. Workers' compensation insurance as required by state statute, and employers' liability insurance covering all Contractor or Subcontractor employees acting within the course and scope of their  A. Workers' Compensation  employment. B. General Liability  Commercial general liability insurance covering premises operations, fire damage, independent contractors, products and completed operations, blanket contractual liability, personal injury, and  advertising liability with minimum limits as follows: i. $1,000,000 each occurrence; ii. $1,000,000 general aggregate; iv. $50,000 any one: fire. C. Automobile Liability  iii. $1,000,000 products and completed operations aggregate; and  Automobile liability insurance covering any auto (including owned, hired and non-owned autos)  with a minimum limit of $1,000,000 each accident combined single limit.  D. Protected Information  Liability insurance covering all civil, regulatory, and statutory damages, contractual damages, data breach management exposure, and all loss income or extra expense as a result of actual or alleged breach, violation or infringement of a right to privacy, consumer data protection law, confidentiality or other legal protection for personal information as well as State Confidential  Information with minimum limits as follows: i. $1,000,000 each occurrence; and ii. $2,000,000 general aggregate. E. Professional Liability Insurance Amendment Contract Number: C24-186984A2 Page 12 of24    Docusign Envelope ID: 08D4B896-7084-F7D-95BF-CA11DA86A3E9  Professional liability insurance covering any damages caused by an error, omission or any  negligent act with minimum limits as follows: 1. $1,000,000 each occurrence; and ii. $1,000,000 general aggregate.  F. Crime Insurance  Crime insurance including employee dishonesty coverage with minimum limits as follows:  i. $1,000,000 each occurrence; and ii. $1,000,000 general aggregate.  G.A Additional Insured  The State shall be named as additional insured on all commercial general liability: policies (leases and construction contracts require additional insured coverage for completed operations) required of Contractor and Subcontractors. A provider agency providing direct services to  Members are not considered a Subcontractor under this Contract.  H. Primacy ofCoverage  Coverage required of Contractor and each Subcontractor shall be primary and noncontributory over any insurance or self-insurance program carried by Contractor or the State.  . Cancellation  The above insurance policies shall include provisions preventing cancellation or non-renewal, except for cancellation based on non-payment of premiums, without at least 30 days prior notice to Contractor and Contractor: shall forward such notice tot the State in accordance with $14 within  seven days of Contractor's receipt ofs such notice.  J. Subrogation Waiver  All insurance policies secured or maintained by Contractor or its Subcontractors in relation to this Contract shall include clauses stating that each carrier shall waive all: rights sofrecovery under subrogation or otherwise against Contractor or the State, its agencies, institutions, organizations,  officers, agents, employees, and volunteers.  K.F Public Entities  If Contractor is a "public entity" within the meaning of the Colorado Governmental Immunity Act, $$24-10-101, et seq., C.R.S. (the "GIA"), Contractor shall maintain, in lieu of the liability insurance requirements stated above, at all times during the term of this Contract such liability insurance, by commercial policy or self-insurance, as is necessary to meet its liabilities under the GIA. Ifa Subcontractor is aj public entity within the: meaning oft the GIA, Contractor shall ensure that the Subcontractor maintains at all times during the terms of this Contract, in lieu of the liability insurance requirements stated above, such liability insurance, by commercial policy or self-insurance, as is necessary to meet the Subcontractor's obligations under the GIA.  L. Certificates  Amendment Contract Number: C24-186984A2 Page 13 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  Contractor shall provide to the State certificates evidencing Contractor's insurance coverage required in this Contract within seven Business Days following the Effective Date. Contractor shall provide to the State certifiçates evidencing Subcontractor insurance coverage required under this Contract within seven Business Days following the Effective Date, except that, if Contractor's subcontract is not in effect as of the Effective Date, Contractor shall provide to the State certificates showing Subcontractor insurance coverage required under this Contract within seven Business Days following Contractor's execution oft the subcontract. No later than 15 days before the expiration date of Contractor's or any Subcontractor's coverage, Contractor shall deliver to the State certificates ofinsurance evidencing renewals of coverage. At any other time during the term of this Contract, upon request by the State, Contractor shall, within seven Business Days following the request by the State, supply to the State evidence satisfactory to the State of compliance with the provisions of this section. Contractor shall provide all certificates electronically to the Department's designated insurance certificate submission site, unless the  Department has specifically directed otherwise.  11. BREACH OF CONTRACT  In the event ofa Breach of Contract, the aggrieved Party shall give written notice of breach to the other Party. If the notified Party does not cure the Breach of Contract, at its sole expense, within 30 days after the delivery ofwritten notice, the Party may exercise any ofthe remedies as described in $12 for that Party. Notwithstanding any provision of this Contract to the contrary, the State, in its discretion, need not] provide notice or a cure] period and mayimmedinteylemminate this Contract in whole or in part or institute any other remedy in this Contract in order to protect the public interest ofthe State; ori ifContractori is debarred or suspended under $24-109-105, C.R.S., the State, ini its discretion, need not provide notice or cure period and may terminate this Contract in whole or in part or institute any other remedy in this Contract as of the date that the debarment or  suspension takes effect. 12. REMEDIES A. State's Remedies  IfContractor isi in breach under any provision oft this Contract and fails to cure such breach, the State, following the notice and cure period set forth in $11, shall have all of the remedies listed in this section, in addition to all other remedies set forth in this Contract or at. law. The State may exercise any or all ofthe remedies available toi it, ini its discretion, concurrently or consecutively.  Termination for Breach of Contract  In the event of Contractor's uncured breach, the State may terminate this entire Contract or any part oft this Contract. Contractor shall continue performance ofthis Contract to the extent  not terminated, ifany. a. Obligations and Rights  To the extent specified in any termination notice, Contractor shall not incur further obligations or render further performance past the effective date of such notice, and shall terminate outstanding orders and subcontracts with third parties. However, Contractor shall complete and deliver to the State all Work not cancelled by the termination notice, and may incur obligations as necessary to do sO within this Contract's terms. At the  Amendment Contract Number: C24-186984A2 Page 14 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  request of the State, Contractor shall assign to the State all of Contractor's rights, title, and interest in and to such terminated orders or subcontracts. Upon termination, Contractor shall take timely, reasonable and necessary action to protect and preserve property in the possession of Contractor but in which the State has an interest. At the State's request, Contractor shall return materials owned by the State in Contractor's possession at the time of any termination. Contractor shall deliver all completed Work Product and all Work Product that was in the process of completion to the State at the  State's request. b. Payments  Notwithstanding anything to the contrary, the State shall onlypay Contractor for accepted Work received as of the date of termination. If, after termination by the State, the State agrees that Contractor was not in breach or that Contractor's action or inaction was excusable, such termination shall be treated as a termination in the public interest, and the rights and obligations oft the Parties shall be asi ift this Contract had been terminated in  the public interest under $2.E. Damages and Withholding  Notwithstanding any other remedial action by the State, Contractor shall: remain liable to the State for any damages sustained by the State in connection with any breach by Contractor, and the State may withhold payment to Contractor for the purpose of mitigating the State's damages until such time as the exact amount of damages due to the State from Contractor is determined. The State may withhold any amount that may be due Contractor as the State deems necessary to protect the State against loss including, without limitation, loss as a result of outstanding liens and excess costs incurred by the  State in procuring from third parties replacement Work as cover.  ii. Remedies Not Involving Termination  The State, in its discretion, may exercise one or more oft the following additional remedies:  a. Suspend Performance  Suspend Contractor's performance with respect to all or any portion oft the Work pending corrective action as specified by the State without entitling Contractor to an adjustment inj price or cost or an adjustment in the performance schedule. Contractor shall promptly cease performing Work and incurring costs in accordance with the State's directive, and the State shall not be liable for costs incurred by Contractor after the suspension of  performance. b. Withhold Payment  Withhold payment to Contractor until Contractor corrects its Work.  Deny Payment  Deny payment for Work not performed, or that due to Contractor's actions or inactions, cannot be performed or ift they were performed are reasonably of no value to the State;  Amendment Contract Number: C24-186984A2 Page 15 of24    Docusign Envelope ID: 08D4B9670844F7D.958.CAT1DABASES  provided, that any denial of payment shall be equal to the value of the obligations not  performed. d. Removal  Demand immediate removal ofany of Contractor's employees, agents, or Subcontractors from the Work whom the State deems incompetent, careless, insubordinate, unsuitable, or otherwise unacceptable or whose continued relation to this Contract is deemed by the  State to be contrary to the public interest or the State's best interest.  Intellectual Property  Ifany Work infringes, or if the State in its sole discretion determines that any Work is likely toi infringe, ap patent, copyright, trademark, trade secret or otheri intellectual property right, Contractor shall, as approved by the State (i) secure that right to use such Work for the State and Contractor; (ii) replace the Work with noninfringing Work or modify the Work sO that it becomes noninfringing; or, (iii) remove any infringing Work and refund  the amount paid for such Work to the State.  B. Contractor's Remedies  If the State is in breach of any provision of this Contract and does not cure such breach, Contractor, following the notice and cure] period in $11 and the dispute resolution process in $13  shall have all: remedies available at law and equity.  13. DISPUTE RESOLUTION A. Initial Resolution  Except as herein specifically provided otherwise, disputes concerning the performance of this Contract which cannot be resolved by the designated Contract representatives shall be referred in writing to a senior departmental management staffr member designated by the State and as senior  manager designated by Contractor for resolution.  B. Resolution of Controversies  If the initial resolution described in $13.A fails to resolve the dispute within 10 Business Days, Contractor shall submit any alleged breach of this Contract by the State to the Procurement Official oft the State Agency named on the Cover Page ofthis Contract as described in $24-102- 202(3), C.R.S. for resolution in accordance with the provisions of $24-106-109, C.R.S., and $$24-109-101.1 through 24-109-505, C.R.S. (the "Resolution Statutes"), except that if Contractor wishes to challenge any decision rendered by the Procurement Official, Contractor's challenge shall be an appeal to the Executive Director of the Department of Personnel and Administration, or their delegate, under the Resolution Statutes before Contractor pursues any further action as permitted by such statutes. Except as otherwise stated in this Section, all requirements of the Resolution Statutes shall apply including, without limitation, time  limitations.  Amendment Contract Number: C24-186984A2 Page 16 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  14. NOTICES AND REPRESENTATIVES  Each individual identified as a Principal Representative on the Cover Page for this Contract shall be the principal representative of the designating Party. All notices required or permitted to be given under this Contract shall be in writing, and shall be delivered (A) by hand with receipt required, (B) by certified or registered mail to such Party's principal representative at the address set forth on the Cover Page for this Contract or (C) as an email with read receipt requested to the principal representative at the email address, if any, set forth on the Cover Page for this Contract. Ifal Party delivers ai notice to another through email and the email is undeliverable, then, unless the Party has been provided with an alternate email contact, the Party delivering the notice shall deliver the notice by hand with receipt required or by certified or registered mail to such Party's principal representative at the address set forth on the Cover Page for this Contract. Either Party may change its principal representative or principal representative contact information, or may designate specific other individuals to receive certain types ofnotices in addition to or in lieu of a principal representative by notice submitted in accordance with this section without a formal amendment to this Contract. Unless otherwise provided in this Contract, notices shall be effective upon delivery  oft the written notice. A. Work Product Copyrights  15. RIGHTS IN WORK PRODUCT AND OTHER INFORMATION  To the extent that the Work Product (or any portion of the Work Product) would not be considered works made for hire under applicable law, Contractor hereby assigns to the State, the entire right, title, and interest in and to copyrights in all Work Product and all works based upon, derived from, or incorporating the Work Product; all copyright applications, registrations, extensions, or renewals relating to all Work Product. and all works based upon, derived from, or incorporating the Work Product; and all moral rights or similar rights with respect to the Work Product throughout the world. Tot the extent that Contractor cannot make any of the assignments required by this section, Contractor hereby grants to the State a perpetual, irrevocable, royalty-free license to use, modify, copy, publish, display, perform, transfer, distribute, sell, and create derivative works oft the Work Product and all works based upon, derived from, ori incorporating the Work Product by all means and methods andi in any format now known or invented int the: future. The State mayassign and license its rights under  this license.  ii. Assignments and Assistance  Whether or not Contractor is under contract with the State at the time, Contractor shall execute applications, assignments, and other documents, and shall render all other reasonable assistance requested by the State, to enable the State to secure patents, copyrights, licenses and other intellectual property rights related to the Work Product. To the extent that Work Product would fall under the definition of "works made for hire" under 171 U.S.C.S. $101, the Parties intend the Work Product to be a work made for hire. Contractor assigns to the State and its successors and assigns, the entire right, title, and interest in and to all causes ofa action, either in law or in equity, for past, present, or future infringement of intellectual property rights related tot the Work Product and all works based on, derived from, ori incorporating the  Work Product.  Amendment Contract Number: C24-186984A2 Page 17 of24    Docusign Envelope ID: 0804B89670844F7D.958-CAIIDABASES  iii. Exclusive Property oft the State  Except to the extent specifically provided elsewhere in this Contract, all State Records, documents, text, software (including source code), research, reports, proposals, specifications, plans, notes, studies, data, images, photographs, negatives, pictures, drawings, designs, models, surveys, maps, materials, ideas, concepts, know-how, and information provided by or on behalf ofthe State to Contractor are the exclusive property oft the State (collectively, "State Materials"). Contractor shall not use, willingly allow, cause or permit Work Product or State Materials to be used for any purpose other than the performance of Contractor's obligations in this Contract without the prior written consent oft the State. Upon termination oft this Contract for any reason, Contractor shall provide all Work Product and State Materials to the State in a form and manner  as directed by the State. iv. Exclusive Property of Contractor  Contractor retains the exclusive rights, title, and ownership to any and all pre-existing materials owned or licensed to Contractor including, but not limited to, all pre-existing software, liçensed products, associated source code, machine code, text images, audio and/or video, and third-party materials, delivered by Contractor under the Contract, whether incorporated in a Deliverable or necessary to use a Deliverable (collectively, "Contractor Property"). Contractor Property shall be licensed to the State as set forth in this Contract or a State approved license agreement: () entered into as exhibits to this Contract; (ii) obtained by the State from the applicable third-party vendor; or (iii) in the case of open-source software, the license terms set forth in the applicable  open source license agreement. 16. GENERAL PROVISIONS A. Assignment  Contractor's rights and obligations under this Contract are personal and may not be transferred or assigned without the prior, written consent oft the State. Any attempt at assignment or transfer without such consent shall be void. Any assignment or transfer of Contractor's rights and obligations approved by the State shall be subject to the provisions oft this Contract.  B. Subcontracts  Contractor shall not enter into any subcontract in connection with its obligations under this Contract without the prior, written approval of the State. Contractor shall submit to the State a copy of each such subcontract upon request by the State. All subcontracts entered into by Contractor in connection with this Contract shall comply with all applicable federal and state laws and regulations, shall provide that they are governed by the laws oft the State of Colorado,  and shall be subject to all provisions oft this Contract.  C.E Binding Effect  Except as otherwise provided in $16.A, all provisions oft this Contract, including thel benefits and burdens, shall extend to and be binding upon the Parties' respective successors and assigns.  Amendment Contract Number: C24-186984A2 Page 18 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  D. Authority  Each Party represents and warrants to the other that the execution and delivery of this Contract  and the performance of such Party's obligations have been duly authorized.  E. Captions and References  The captions and headings in this Contract are for convenience of reference only, and shall not be used to interpret, define, or limit its provisions. All references in this Contract to sections (whether spelled out or using the $ symbol), subsections, exhibits or other attachments, are references to: sections, subsections, exhibits or other attachments contained herein or incorporated  as a part hereof, unless otherwise noted.  F. Counterparts  This Contract may be executed in multiple, identical, original counterparts, each of which shall be deemed to be an original, but all of which, taken together, shall constitute one and the same  agreement. G.E Entire Understanding  This Contract represents the complete integration of all understandings between the Parties related to the Work, and all prior representations and understandings related to the Work, oral or written, are merged into this Contract. Prior or contemporaneous additions, deletions, or other changes to this Contract shall not have any force or effect whatsoever, unless embodied herein. Ifany signatory signs this Contract using a digital signature in accordance with the Colorado State Controller Contract, Grant and Purchase Order Policies regarding the use of digital signatures issued under the State Fiscal Rules, then any agreement or consent to use digital signatures within the electronic system through which that signatory signed shall be incorporated  H. Digital Signatures  into this Contract by reference.  - Modification  Except as otherwise provided in this Contract, any modification to this Contract shall only be effectivei ifagreed toi in a formal amendment to this Contract, properly executed and approved in accordance with applicable Colorado State law and State Fiscal Rules. Modifications permitted under this Contract, other than contract amendments, shall conform to the policies issued by the  Colorado State Controller.  J. Statutes, Regulations, Fiscal Rules, and Other Authority  Any reference in this Contract to a statute, regulation, State Fiscal Rule, fiscal policy or other authority shall be interpreted to refer to such authority then current, as may have been changed  or amended since the Effective Date oft this Contract.  K. External Terms and Conditions  Amendment Contract Number: C24-186984A2 Page 19 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  Notwithstanding anything to the contrary herein, the State shall not be subject to any provision included in any terms, conditions, or agreements appearing on Contractor's or a Subcontractor's website or any provision incorporated into any click-through or online agreements related to the  Work unless that provision is specifically referenced in this Contract.  L. Severability  The invalidity or unenforceability of any provision of this Contract shall not affect the validity or enforceability of any other provision of this Contract, which shall remain in full force and effect, provided that the Parties can continue to perform their obligations under this Contract in  accordance with the intent ofthis Contract. M. Survival of Certain Contract Terms  Any provision of this Contract that imposes an obligation on a Party after termination or expiration oft this Contract shall survive the termination or expiration of this Contract and shall  be enforceable by the other Party.  N. Taxes  The State is exempt from federal excise taxes under I.R.C. Chapter 32 (26 U.S.C., Subtitle D, Ch. 32)(Federal Excise Tax Exemption Certificate ofRegistry No. 84-730123K) and from State and local government sales and use taxes under $$39-26-704(1), et seq., C.R.S. (Colorado Sales Tax Exemption Identification Number 98-02565). The State shall not be liable for the payment of any excise, sales, or use taxes, regardless of whether any political subdivision of the state imposes suchi taxes on Contractor. Contractor shall bes solelyresponsible: for any exemptions from the collection ofexcise, sales or use taxes that Contractor: may wish tol have inj place in connection  with this Contract. O. Third Party Beneficiaries  Except for the Parties' respective successors and assigns described in $16.A, this Contract does not and is not intended to confer any rights or remedies upon any person or entity other than the Parties. Enforcement oft this Contract and all: rights and obligations hereunder are: reserved solely to the Parties. Any services or benefits which third parties receive as a result oft this Contract are  incidental to this Contract, and do not create any rights for such third parties.  P. Waiver  Al Party's failure or delay in exercising any right, power, or privilege under this Contract, whether explicit or by lack of enforcement, shall not operate as a waiver, nor shall any single or partial exercise of any right, power, or privilege preclude any other or further exercise of such right,  power, or privilege. CORA Disclosure  To the extent not prohibited by federal law, this Contract and the performance measures and standards required under $24-106-107, C.R.S., if any, are subject to public release through the  CORA.  Amendment Contract Number: C24-186984A2 Page 20 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  R. Standard and Manner ofPerformance  Contractor shall perform its obligations under this Contract in accordance with the highest standards of care, skill and diligence in Contractor's industry, trade, or profession.  S. Licenses, Permits, and Other Authorizations  Contractor shall secure, prior to the Effective Date, and maintain at all times during the term of this Contract, at its sole expense, all licenses, certifications, permits, and other authorizations required to perform its obligations under this Contract, and shall ensure that all employees, agents and Subcontractors secure and maintain at all times during the term oftheir employment, agency or subcontract, all licenses, certifications, permits and other authorizations required to perform  their obligations in relation to this Contract.  T. Indemnification  General Indemnification  Contractor shall indemnify, save, and hold harmless the State, its employees, agents and assignees (the Indemnified Parties"), against any and all costs, expenses, claims, damages, liabilities, court awards and other amounts (including attorneys' fees and related costs) incurred by any of the Indemnified Parties in relation to any act or omission by Contractor, ori its employees, agents, Subcontractors, or assignees in connection with this Contract.  ii. Confidential Information Indemnification  Disclosure or use of State Confidential Information by Contractor in violation of $8 may be cause for legal action by third parties against Contractor, the State, or their respective agents. Contractor shall indemnify, save, and hold harmless the Indemnified Parties, against any and all claims, damages, liabilities, losses, costs, expenses (including attorneys' fees and costs) incurred by the State ini relation to any act or omission by Contractor, or its employees, agents,  assigns, or Subcontractors in violation of $8. ili. Intellectual Property Indemnification  Contractor shall indemnify, save, and hold harmless the Indemnified Parties, against any and all costs, expenses, claims, damages, liabilities, and other amounts (including attorneys' fees and costs) incurred by the Indemnified Parties in relation to any claim that any Deliverable, Good or Service, software, or Work Product provided by Contractor under this Contract (collectively, "IP Deliverables"), or the use thereof, infringes a patent, copyright, trademark, trade secret, or any other intellectual property: right. Contractor's obligations hereunder shall not extend to the combination ofany IP Deliverables provided by Contractor with any other product, system, or method, unless the other product, system, or method is (a) provided by Contractor or Contractor's: subsidiaries or affiliates; (b) specified by Contractor to work with the IP Deliverables; (c) reasonably required in order to use the IP Deliverables in its intended manner and the infringement could notl havel been avoided by substituting another reasonably available product, system, or method capable of performing the same function; or (d) is  reasonably expected tol be used in combination with the IP Deliverables.  Amendment Contract Number: C24-186984A2 Page 21 of24    Docusign Envelope ID: 08DAB89670844F7D.58FCAIIDABAJEX  iv. Accessibility Indemnification  Contractor shall indemnify, save, and hold harmless the state, its employees, agents and assignees (collectively, the "Indemnified Parties"), against any and all costs, expenses, claims, damages, liabilities, court awards and other amounts (including attorneys' fees and related costs) incurred by any of the Indemnified Parties in relation to Contractor's failure to complywith $824-85-101, et seq., C.R.S., ort the Accessibility Standards for Individuals with al Disability as established by the Office ofInformation Technology pursuant to Section $24-  85-103 (2.5), C.R.S.  U. Accessibility  Contractor shall comply with all applicable provisions of $$24-85-101, et seq., C.R.S., and the Rules Establishing Technology Accessibility Standards, 8 CCR 1501-11:11.1 et seq., as established by the Governor's Office of Information Technology (OIT), pursuant to Section ii. The State may require Contractor's compliance to the State's Accessibility Standards to be determined by a third party selected by the State to attest to Contractor's Work Product and software is in compliance with $$24-85-101, et seq., C.R.S., and the Rules Establishing Technology Accessibility Standards, 8 CCR. 1501-11:11.1 et seq. as established by the Office  $24-85-103(2.5), C.R.S.  ofInformation Technology pursuant to Section $24-85-103(2.5), C.R.S. Contractor shall comply with all requirements shown in Exhibit A and Exhibit G. 17.COLORADO SPECIAL PROVISIONS (COLORADO FISCAL RULE: 3-3) These Special Provisions apply to all contracts except where noted in italics.  V. Additional Provisions  A. STATUTORY APPROVAL. $24-30-202(1), C.R.S.  This Contract shall not be valid until it has been approved by the Colorado State Controller or designee. Ifthis Contract is for a Major Information Technology Project, as defined in $24-37.5- 102(2.6), C.R.S., then this Contract shall not be valid until it has been approved by the State's  ChiefInformation Officer or designee. B. FUND AVAILABILITY. $24-30-202(5.5), C.R.S.  Financial obligations oft the State payable after the current State Fiscal Year are contingent upon funds for that purpose being appropriated, budgeted, and otherwise made available.  . GOVERNMENTAL IMMUNITY.  Liability for claims for injuries to persons or property arising from the negligence of the State, its departments, boards, commissions committees, bureaus, offices, employees and officials shall be controlled and limited by the provisions of the Colorado Governmental Immunity Act, $24- 10-101, et seq., C.R.S.; the Federal Tort Claims Act, 28 U.S.C. Pt. VI, Ch. 171 and 28 U.S.C. 1346(b), and the State's risk management statutes, $$24-30-1501, et seq. C.R.S. No term or condition of this Contract shall be construed or interpreted as a waiver, express or implied, of  Amendment Contract Number: C24-186984A2 Page 22 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  any of the immunities, rights, benefits, protections, or other provisions, contained in these  statutes.  D. INDEPENDENT CONTRACTOR.  Contractor shall perform its duties hereunder as an independent contractor and not as an employee. Neither Contractor nor any agent or employee of Contractor shall be deemed to be an agent or employee of the State. Contractor shall not have authorization, express or implied, to bind the State to any agreement, liability or understanding, except as expressly set forth herein. Contractor and its employees and agents are not entitled to unemployment insurance or workers compensation benefits through the State and the State shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes incurred pursuant to this Contract. Contractor shall (i) provide and keep in force workers' compensation and unemployment compensation insurance in the amounts required by law, (ii) provide proof thereof when requested by the State, and (iii) be solely  responsible for its acts and those ofits employees and agents.  E. COMPLIANCE WITHLAW.  Contractor shall comply with all applicable federal and State laws, rules, and regulations in effect or hereafter established, including, without limitation, laws applicable to discrimination and  unfair employment practices.  F. CHOICE OF LAW,JURISDICTION, AND VENUE.  Colorado law, and rules and regulations issued pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Contract. Any provision included or incorporated herein by reference which conflicts with said laws, rules, and regulations shall be null and void. All suits or actions related to this Contract shall be filed and proceedings held in the State ofColorado and exclusive venue shall be in the City and County ofDenver.  G.P PROHIBITED TERMS.  Any term included in this Contract that requires the State to indemnify or hold Contractor harmless; requires the State to agree to binding arbitration; limits Contractor's liability for damages resulting from death, bodily injury, or damage to tangible property; or that conflicts with this provision in any way shall be void ab: initio. Nothing ini this Contract shall be construed  asa waiver of any provision of $24-106-109, C.R.S. H. SOFTWARE PIRACY PROHIBITION.  State or other public funds payable under this Contract shall not be used for the acquisition, operation, or maintenance of computer software in violation of federal copyright laws or applicable licensing restrictions. Contractor hereby certifies and warrants that, during the term of this Contract and any extensions, Contractor has and shall maintain in place appropriate systems and controls to prevent such improper use of] public funds. Ift the State determines that Contractor is in violation of this provision, the State may exercise any remedy available at law or in equity  Amendment Contract Number: C24-186984A2 Page 23 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  or under this Contract, including, without limitation, immediate termination oft this Contract and any remedy consistent with federal copyright laws or applicable licensing restrictions. EMPLOYEE FINANCIAL. INTEREST/CONFLICT OF INTEREST. $$24-18-201 and The signatories aver that to their knowledge, no employee of the State has any personal or beneficial interest whatsoever in the service or property described in this Contract. Contractor has no interest and shall not acquire any interest, direct or indirect, that would conflict in any manner or degree with the performance of Contractor's: services and Contractor shall not employ J. VENDOR OFFSET AND ERRONEOUS PAYMENTS. $924-30-202(1) and 24-30-202.4, [Not applicable to ntergovernmenta agreements Subject to 924-30-202.400.5), C.R.S., the State Controller may withhold payment under the State's vendor offset intercept system for debts owed to State agencies for: (i) unpaid child support debts or child support arrearages; (ii) unpaid balances oft tax, accrued interest, or other charges specified in $$39-21-101, et seq., C.R.S.; (iii) unpaid loans due to the Student Loan Division of the Department of Higher Education; (iv) amounts required to be paid to the Unemployment Compensation Fund; and (v) other unpaid debts owing to the State as a result of final agency determination or judicial action. The State may also recover, at the State's discretion, payments made to Contractor in error for any reason, including, but not limited to, overpayments or improper payments, and unexpended or excess funds received by Contractor by deduction from subsequent payments under this Contract, deduction from any payment due under any other contracts, grants or agreements between the State and Contractor, or by any other appropriate method for collecting debts owed to the State.  24-50-507, C.R.S.  any person having such known interests.  C.R.S.  Amendment Contract Number: C24-186984A2 Page 24 of24    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  EXHIBIT B-1, STATEMENT OF WORK  1.CASEI MANAGEMENT OBLIGATIONS 1.1. Contractor's Obligations  1.1.1. 1.1.1.1. 1.1.1.2. 1.1.1.3. 1.1.1.4. 1.1.1.5. 1.1.1.6. 1.1.1.7. 1.1.1.8. 1.1.1.9. 1.1.1.10. 1.1.1.11. 1.1.1.12. 1.1.1.13. 1.1.1.14. 1.1.1.15. 1.1.1.16. 1.1.1.17. 1.1.1.18. 1.1.2. 1.1.2.1. 1.1.2.2. 1.1.2.3. 1.1.2.4. 1.1.2.5. 1.1.2.6. 1.1.2.6.1. Exhibit B-1, SOW  Contractor shall provide case management activities outlined in this Contract for the following Home and Community Based Services (HCBS)waivers, non-HCBS programs, and  State General Fund programs:  Family Support Services Program (FSSP)  HCBS Children with a Life Limiting Illness Waiver (HCBS-CLLI) HCBS Children's Extensive Supports Waiver (HCBS-CES) HCBS Children's Habilitation Residential Program Waiver (HCBS-CHRP) HCBS Children's Home and Community Based Services Waiver (CHCBS) HCBS Community Mental Health Supports Waiver (HCBS-CMHS) HCBS Complimentary and Integrative Health Waiver (HCBS-CIH) HCBS Developmental Disabilities Waiver (HCBS-DD) HCBS Persons who are Elderly, Blind and Disabled Waiver (HCBS-EBD) HCBS Persons with Brain Injury Waiver (HCBS-BI) HCBS Supported Living Services Waiver (HCBS-SLS)  Hospital Back-Up Program (HBU) Long Term Home Health (LTHH) Nursing Facilities (NF)  Intermediate Care Facilities-Intellectual and Developmental Disabilities (ICF-IDD)  Omnibus Reconciliation Act of 1987 Specialized Services Program (OBRA-SS)  Program for All-Inclusive Care for the Elderly (PACE) State Supported Living Services Program (State SLS)  Contractor shall abide by and perform its duties and obligations in conformity with relevant federal law, all pertinent federal regulations, State law, rules and regulations of the Department of] Health Care Policy and Financing which include, but are not limited to: Colorado Revised Statutes, Title 25.5,A Article 6, Sections 104 through and including 107. Colorado Department ofHealth Care Policy and Financing written communications. Colorado Department of Public Health and Environment at 6C.C.R. 1011-1 et seq. Colorado Department of] Human Services 12 C.C.R. 2509-8 7.700 et seq. All State Medicaid regulations promulgated by the Department. These regulations  Colorado Revised Statute, Title 25.5, Article 10 et seq.  include, but are not limited to:  CHCBS 10CCR 2505-10, Sections 8.7101.A etseq.  Pagelof53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.1.2.6.2. 1.1.2.6.3. 1.1.2.6.4. 1.1.2.6.5. 1.1.2.6.6. 1.1.2.6.7. 1.1.2.6.8. 1.1.2.6.9. 1.1.2.6.10. 1.1.2.6.11. 1.1.2.6.12. 1.1.2.6.13. 1.1.2.6.14. 1.1.2.6.15. 1.1.2.6.16. 1.1.2.6.17. 1.1.2.6.18. 1.1.3. 1.1.4. 1.1.5. 1.1.6. 1.1.6.1. 1.1.6.1.1.  FSSP 10 CCR 2505-10, Sections 8.7558 et seq.  Long-Term Care 10 CCR 2505-10, Sections 8.400 through 8.409 et seq. Colorado Case Management System - 10 CCR 2505-10, Section 8.7200 et seq.  HCBS-BI I 10 CCR 2505-10, Section 8.7101.E et seq. HCBS-CES, 10 C.C.R. 2505-10 Section 8.7101.B et seq. HCBS-CHRP, 10 C.C.R. 2505-10 Section 8.7101.C et seq. HCBS-CIH 10 CCR2505-10, Section 8.7101.H et seq. HCBS-CLLI1 10 CCR 2505-10, Section 8.7101.D et seq. HCBS-CMHS 10 CCR 2505-10, Section 8.7101.F et seq. HCBS-DD, 10 C.C.R. 2505-10 Sections 8.7101.Jetseq. HCBS-EBD 10 CCR 2505-10, Sections 8.7101.G et seq. HCBS-SLS, 10 C.C.R. 2505-10 Sections 8.7101.I ets seq. PACE Section 25.5-5-412, Section 6a-b., C.R.S et seq.  Casel Management, Family Support, Laboratory and X-Ray, 10CCR 2505-10 Section  8.600 through 8.612.5  State SLS Program, 10 CCR 2505-10, Section 8.7557 et seq. Recipient Appeals, 10 CCR 2505-10, Section 8.057 et seq.  Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance), 2 CFR Chapter I, Chapter II, Part 200 et al. Contractor shall perform its obligations in conformity with the provisions ofTitle XIX ofthe Social Security Act and other applicable federal and state laws and regulations. Contractor shall ensure applicant, Member, and individual rights are protected in accordance with Title XIX of the Social Security Act, other applicable federal and state laws, and Contractor shall comply with written Operational Memos, policies, procedures, and guidance The general Business Functions of Contractor shall include, but is not limited to, all the Contractor shall maintain aj physical, publicly accessible, and Americans with Disability Act (ADA) compliant office within the Defined Service Area and appropriate staffing Contractor shall ensure adequate staffing through virtual or in-person services throughout the Defined Service. Area in addition to aj physical office space, providing access to its office for staff, Members, families, services providers, and others tol best meet the needs ofi individuals based on individual preferences. Contractor shall have the ability for case managers to travel, regional coverage, and provide all required Work for the counties in which the agency operates.  Department regulations. issued by the Department. following:  pattern to serve the Defined Service Area.  1.1.6.1.2.  Exhibit! B-1, SOW  Page2of53    Docusign Envelope ID: 08D4B89670844F7D-958.CATIDABSAJES  1.1.6.1.3.  Regular business office hours of operation shall follow a Monday through Friday schedule except for federal, state, or local holidays and unplanned closures due to inclement weather or other emergencies. Regular business office hours and holiday closures must be provided to all Members upon enrollment and at least annually, posted publicly at each office location, and posted on Contractor's website. Contractor shall have aj procedure for notifying Members and the public ofunplanned closures or changes to regular business hours due to inclement weather or other Contractor shall have internal procedures for accommodating individuals, Members, and families who need assistance or consultation outside regular business office hours. Non-standard business hours and method of contact information for crisis situations must be posted on Contractor's website in an easily accessible location. Contractor shall have an emergency on-call procedure to respond to crisis situations outside ofregular business hours. Procedures must clearly document how Contractor will ensure timely response to emergency situations such as hospital discharges, risk of homelessness, unexpected termination ofresidential services, etc. Contractor shall make the procedure available on Contractor's website. Contractor shall notify individuals, Members, families, providers, and community partners of the procedures and make it readily available through a variety of methods. Contractor shall have an internal policy and procedure to respond to all telephone calls, voicemails, and emails from Members and families on average within two Business Days oft receipt by Contractor. Contractor shall overcome any geographic barriers within the Defined Service Area, including distance from the agency office to provide timely assessment and case management services to individuals, Members and families, as required by Contract, Federal or State statutes and regulations. This may include staff who reside throughout the Defined Service. Area to best meet the needs of individuals and members. Contractor shall protect Members' rights as they relate to the responsibilities of Case Contractor shall provide access to a telephone system and trained staff to ensure timely Contractor shall provide access to telecommunication devices and/or interpreters for the hearing and vocally impaired and foreign language interpreters as needed to fulfil all Work. Contractor shall conduct an assessment of the communication needs of the Members they serve and ensure their interpretation and telecommunication services Contractor shall follow communication standards set by the Department which includes, but is not limited to, Memo Series, technical assistance documents, Provider Bulletins, Contractor shall support the Department's S National Core Indicators (NCI) efforts. Contractor shall support the Department's Equity, Diversity, Inclusion, and Accessibility (EDIA) efforts to include participation in al Department led EDIA assessment and survey. Contractor shall have a written policy and procedure on the agency's commitment to equity, diversity, inclusion, and accessibility that includes approaches to confronting racism and building opportunity for inclusion that promotes equitable treatment of  emergencies, which includes emergency contact information  1.1.6.1.4.  1.1.6.2.  1.1.6.3.  1.1.6.4. 1.1.6.5. 1.1.6.6.  Management Agencies as described in this Contract. response to messages and telephone calls received after hours.  sufficiently meet the Member's need in a timely fashion. training documents, and email correspondence.  1.1.6.7. 1.1.6.8. 1.1.6.9.  Exhibit B-1, SOW  Page3of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  historically underserved and marginalized communities. Contractor shall make the policy Contractor shall enroll and act as al Medicaid Targeted Case Management (TCM)provider for all HCBS waivers to include, but not limited to, providing ongoing case management Contractor may be granted a Conflict Free Case Management Waiver (CFCMW) by the Department to provide specific HCBS services within the Defined Service Area when one is necessary to maintain services in rural and frontier service areas. Contractor shall obtain and maintain approval for the CFCMW throughout the Contract Period to meet program requirements for a Case Management Agency. The Department reserves the right to revoke Contractor's CFCMW at any time. Contractor shall submit an annual report to the Department that includes, but is not Written processes in place to ensure remediation of conflict and separation of Documentation of Member choice and informed consent of the conflict of the A summary of the individuals participating in direct services and case Policies and procedures outlining how Contractor will validate that there are no other willing and qualified providers in their Defined Service Area with capacity toj provide services for all eligible members in the service area, How Contractor is supporting the recruitment of providers in their area to IfContractor is denied a CFCMW for any reason, or one is revoked, Contractor must have documented written plans for transitioning individuals and Members. Contractor shall continue toj provide services until a transition may be succesfiulyimpememted. DELIVERABLE: Annual report and written processes and procedures on implementing rural exception and only willing and qualified provider requirements DUE: June 15th of each year or prior to contract renewal for CMAS with an approved  and procedure available to the Department upon request. and monitoring activities for the Defined Service. Area.  1.1.6.10. 1.1.6.11. 1.1.6.11.1. 1.1.6.11.2. 1.1.6.11.3. 1.1.6.11.3.1. 1.1.6.11.3.2. 1.1.6.11.3.3. 1.1.6.11.3.4. 1.1.6.11.3.5. 1.1.6.11.4. 1.1.6.11.5. 1.1.6.11.6.  limited to, the following information:  entities.  agency being selected.  management at the agency with the CFCMW.  remediate conflict.  for CMAS that have been granted a CFCMW.  rural exception  1.2. Collaboration with other Care Coordination Entities and Case Management Agencies  1.2.1.  Contractor shall comply with written communication from the Department, provided by the Department, between Contractor and community partners and service providers that outline how Contractor will work together with these partners to coordinate care and better serve individuals and Members. Contractor shall establish written memorandum ofunderstanding with local care coordination entities that outline roles and responsibilities, avoidance of duplication of effort, and communication expectations. Contractor is responsible for streamlining the Member experience to ensure full range of Medicaid services are being  Exhibit B-1, SOW  Page4of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  offered and accessed based on the Member's needs. As applicable, a memorandum of  understanding shall address partnerships with: Regional Accountable Entities (RAE)  1.2.1.1. 1.2.1.1.1.  The RAE: is responsible for coordinating for physical health services and providing and arranging for behavioral health services, including, but not limited to mental health services or other non-waiver behavioral serviçes and supports available through Medicaid. The RAE promotes the population's health and functioning, coordinates care across disparate providers, interfaces with LTSS providers, and collaborates social, educational, justice, recreational, and housing agencies to foster healthy communities and address complex needs that span multiple agencies and jurisdictions. The RAE: manages a network of primary care physical health providers and behavioral health providers to ensure access to appropriate care for Medicaid Contractor shall ensure collaboration with RAEs occurs for all shared Members that need care coordination services for physical and behavioral health services. Contractor shall identify which community agencies are responsible for facilitation, follow-up, and solution focused on next steps for each Member Contractor shall collaborate with the appropriate RAE when a Member needs assistance in accessing or coordinating the Member's physical, behavioral, or mental health needs. This shall include but is not limited to Members who have complex medical or behavioral support needs, change of conditions or Coordinating with the RAE for shared Members who admit to a hospital, to include, but not limited to, communicating reasons for admission, Member's Collaborating with the RAE for shared Members discharging from the hospital to ensure all support needs are reflected in the Support Plan and the Member is connected to the necessary services to support a successful discharge. Enter into a data sharing arrangement for the sharing ofall necessary information for the RAE to assist Members in accessing and coordinating physical and Contractor shall create a complex and creative solutions process with the RAE(s) and designated staff to address needs spanning multiple Medicaid systems for all shared Members. This shall include, but not be limited to, a regularly scheduled joint coordination meeting at a cadence that best meets the Member's needs to ensure holistic case management and care coordination. This process shall be Contractor shall honor Member's preferences for case management and care coordination, when applicable, while ensuring collaboration with thel RAE occurs.  Members.  1.2.1.1.1.1.  collaboration.  1.2.1.1.1.2.  involvement with Child Welfare or Adult Protection.  1.2.1.1.1.3. 1.2.1.1.1.4. 1.2.1.1.1.5. 1.2.1.1.1.6.  hospital status, and plans for discharge.  behavioral health needs.  made available upon request,  1.2.1.1.1.7. 1.2.2.  Contractor shall work with the! Department to identify a Key Performance Indicator (KPI) to measure the effectiveness ofcoordination between Contractor and RAE. Medicaid Eligibility  Sites  Exhibit B-1,SOW  Pages 5of53    Docusign Envelope ID: 08D4B896-7084-4F7D-958F-CA11DA86A3E9  1.2.2.1.  County department of human/social services (counties) and Medical Assistance (MA) Sites are designated sites allowed by statute or certified by the Department ofHealth Care Policy and Financing (Department) to process the State-authorized Medical Assistance application for the programs that are administered by the Department and determine eligibility for said programs. The role of county departments, specified in CRS 25.5-1- 118, is specific to the responsibility for the local administration of Medical Assistance. Additionally, the Department is authorized to establish MA sites by statute (CRS25.5-4- 205 et seq). Counties and MA Sites use the Colorado Benefits Management System (CBMS) to determine eligibility for Child Health Plan Plus (CHP+) and Health First Contractor shall ensure collaboration with all county and Medical Assistance sites pertaining to application, renewal, case changes, or re-application status for members in Contractor shall collaborate with the appropriate counties and/or Medical Assistance sites to ensure proper follow-up and communication to support members in obtaining and  Colorado (Colorado's Medicaid Program) programs.  1.2.2.2. 1.2.2.3. 1.2.3. 1.2.3.1. 1.2.3.2. 1.2.3.2.1. 1.2.3.2.2.  Contractor's designated service area. maintaining their benefits. Community Centered Boards  Community Centered Boards (CCB) are the agencies responsible for leveraging local and regional resources to meet unmet needs for individuals with Intellectual and Contractor shall collaborate with CCBs, this may include, but is not limited to: Receiving referrals or sharing information necessary for the CCB and/or CMA to assist individuals and Members in accessing LTSS programs targeted for individuals with intellectual and developmental disabilities or children with disabilities. Coordinating care for non-waiver services for members with intellectual and  Developmental Disabilities (IDD) and their families.  developmental disabilities where applicable or appropriate.  1.3. Qualification and Training Requirements  1.3.1. 1.3.2. 1.3.3.  Contractor's personnel, including, but not limited to, Case Manager(s) and Case Management Supervisor(s) shall meet all qualification requirements listed in 10C.C.R. 2505-10, Sections Contractor shall ensure all case managers meet the qualification requirements established in Contractor shall ensure all staff assigned to perform the Work in this Contract pass competency-based training requirements as defined by the Department including, but not limited to disability/cultural competency, person centeredness, soft skills, as well as program Contractor shall ensure that all case management staffi receive training within 120 Calendar Days after the staff member's hire date and prior to being assigned independent case management duties. All other case management staff must receive retraining as required by Training modalities may include the Departments Learning Management System (LMS), web-based training, virtual instructor-led training, in-person training sessions and training  8.7203.A to 8.7204 et seq.  10C.C.R. 2505-10, Section 8.7203.A et seq.  specific knowledge and skills.  1.3.4.  thel Department, a Department-approved vendor, or Contractor.  1.3.5. Exhibit B-1, SOW  Page6of53    Docusign Envelope ID: 08D4B896-7084-4F70-95BF-CA11DA86A3E9  materials available on the Department website. Contractor shall utilize training materials  provided by the Department.  1.3.6. 1.3.6.1. 1.3.6.2. 1.3.6.3. 1.3.6.4. 1.3.6.5. 1.3.6.6. 1.3.6.7. 1.3.6.8. 1.3.6.9. 1.3.6.10. 1.3.6.11. 1.3.6.12. 1.3.6.13. 1.3.6.14. 1.3.6.15. 1.3.6.16. 1.3.6.17. 1.3.6.18. 1.3.6.19. 1.3.6.20. 1.3.7. 1.3.8. 1.3.9.  Required Case Management Training includes, but is not limited to: Applicable Federal and State laws and regulations for LTSS programs  Critical Incident Reporting  Determination ofDevelopmental Disability or Delay Disability and Cultural Competency Equity, Diversity, Inclusion and Accessibility (EDIA)  Intake and Referral Department Prescribed Tools Long-Term Home Health (LTHH) Long-Term Services and Supports Eligibility Mandatory Reporting Notices and Appeals Nursing Facility Admissions Rapid Reintegration Participant Directed Training  Level of Care Screen and Needs Assessment (Colorado Single Assessment) or  Person-Centered Support Planning and Person-Centered Support Plan Pre-Admission Screening and Resident Review (PASRR) State General Fund Program Ongoing Case Management State General Fund Program Requirements and Services  System Documentation Waiver Requirements and Services DELIVERABLE: Case Management Training  DUE: Semi-Annually, trainings held between July 1st and December 31st are due January 15th, and trainings held between January 1st through June 1st are due June 15th Contractor shall maintain supporting documentation demonstrating case managers attended the required trainings and make the information available to the Department upon request. Supporting documentation must include the name and description ofthe training, the date the training was held, case managers in attendance, and trainer sign-off showing the case have al basic knowledge of all case management activities regardless of ongoing duties. perform case management tasks including the correct application of the Colorado Single  manager completed the training.  1.3.10. There will bei no exemptions to the above list ofrequired trainings as all case managers shall 1.3.11. Case Managers shall meet competency requirements determined by the Department to  ExhibitB-1,SOW  Page7of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  Assessment and Person-Centered Support Plan. Case Managers must pass assigned training competemeyreguirements to independently perform Case Management activities. Department. Participation can be at the time of the presented training or, if applicable, following the training using the materials available from the Department's website orl LMS. experience at a different Colorado CMA, Contractor may assign independent case management activities once Contractor has verified that the Case Manager's training applicable to the Scope of Work, which may include mental health first aid, crisis intervention, and trauma informed care. Contractor may utilize the Department's Case Management Training Template to identify trainings attended that are not required by the  1.3.12. Contractor shall participate in Department and vendor trainings, which will be tracked by the 1.3.13. For Case Managers who have a documented minimum of one-year immediate prior work  requirements were previously met.  1.3.14. Contractor may elect to perform additional training not outlined in the Contract, but  Department.  1.3.15. Case Management staff are required to retake training to address and remediate performance 1.3.16. Contractor shall provide the date all case management staff, including new and existing staff, 1.3.17. Case Managèrs shall receive oversight reviews of their performance including their  concerns as directed by the Department.  werel hired and the dates ofreceived training in the areas identified in Section 1.2.3, using the reporting template provided by the Department for review, approval, and payment. competency with completing the Level of Care Screen. Contractor shall shadow case management staff completing the Level of Care Screen on an annual basis and prior to the end of each Contract Fiscal year to establish case manager's competency administering the Level of Care Screen. Documentation on case manager performance will be maintained by Contractor andj provided to the Department upon request. Supervisors, lead workers, or a case manager with at least three years of case management experience may perform the  shadowing.  1.4. Care and Case Management (CCM) System Training  1.4.1. 1.4.1.1. 1.4.1.2.  Contractor shall participate in all trainings required by the Department for the Care and Case Management (CCM) Information Technology system and the new Colorado Single Staff employed by Contractor shall participate in training on the Colorado Single Assessment and Person-Centered Support Plan instruments prior to performing the LOC Contractor shall receive a one-time payment for the training and oversight of Contractor staff in performing the Colorado Single Assessment and Person-Centered Support Plan. Payment will be calculated based on the average number of staff as specified by the DELIVERABLE: Colorado Single Assessment and Person-Centered Support Plan  Assessment and Person-Centered Support Plan.  Screen, Needs Assessment, or Person-Centered Support Plan.  Department. Training  1.4.1.3. 1.4.1.4.  DUE: As Provided byt the Department  1.5. Community First Choice  Exhibit) B-1,SOW  Page 80 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.5.1. 1.5.1.1. 1.5.1.2.  Contractor: shall participate in all trainings required by thel Department fori thei implementation Staff employed by Contractor shall participate in training provided by the Department DELIVERABLE: Completed Case Management Training on the Community First  ofCommunity First Choice.  and associated vendors on Community First Choice.  Choice Implementation.  1.6. DUE: As Assigned by the Department Complaints  1.6.1.  Contractor shall develop and maintain a formal complaints procedure, notify Members annually of the procedures, and make the procedure publicly available toi include posting the procedure to Contractor's website. Procedures must include requirements for member notification in accordance with 10 CCR 2505-109.519.20 and 10 CCR 2505-10 8.7201.D. Contractor shall receive, document, and track any complaint received by Contractor as it relates to the services provided through this Contract to include, but not limited to, general business functions, administration, State General Funded Programs, and case management functions outlined ini this Contract. Complaints received outside ofthe scope ofthis Contract shall not be included. Documentation shall consist ofa complaint log that includes the date of complaint, name of the complainant, the nature of the complaint and the date and Contractor shall submit all complaints to the Community Advisory Committee for review, Contractor shall analyze complaints for trends quarterly and shall submit all complaint- oriented trends observed since the Effective Date of this Contract and the remedial actions Trend analysis shall include an examination ofinformation including, but not limited to: A comparison of complaint types and number of complaints over aj period of time. Number oftype of complaint against Contractor, time, location, individual involved, staff An examination of potential reasons for the increase or decrease in complaints by total An examination of preventative measures that can be implemented to reduce the number  1.6.2.  description of the resolution.  1.6.3. 1.6.4. 1.6.5. 1.6.5.1. 1.6.5.2. 1.6.5.3. 1.6.5.4. 1.6.5.5. 1.6.5.6. 1.6.5.7. 1.6.5.7.1. 1.6.5.7.2. 1.6.5.7.3. Exhibit B-1,SOW  feedback, and input on resolving complaints. taken to address them to the Department.  involved, and/or any additional relevant information. number, subcontractor, individual, or staff. or frequency off future complaints.  Implementation ofaj plan of action or any future actions to take place.  An analysis of whether the plan ofaction and changes made were effective orifadditional As part of the complaint process Contractor shall include, but is not limited to, all ofthe  changes need to occur. following:  Document complaints received. Address substantiated complaints. mitigate complaints.  Respond to complaints received and document actions taken to resolve and/or  Page 9of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.6.5.7.4. 1.6.5.8. 1.6.5.9. 1.6.5.10.  Conductac quarterly trend analysis ofall complaints received for the full period ofthe Contractor shall maintain all supporting documentation related to the collection and follow-up to complaints and make it available to the Department upon request. If Contractor received no complaints during the quarter, Contractor may submit the Complaint Trends Analysis to the Department identifying no complaints were reported IfContractor received less than five complaints during the quarter and cannot establish a complaint trend, Contractor may submit the Complaint Trends Analysis to the Department with the complaint log that includes the date of complaint, name of the complainant, the nature of the complaint and the date and description ofthe resolution. Contractor shall submit the Complaint Trends Analysis to the Department for review and  Contract.  during the quarter.  1.6.5.11. 1.6.5.11.1. 1.6.5.11.2. 1.7.1. 1.7.1.1. 1.7.1.2. 1.7.1.3. 1.7.1.4. 1.7.1.5. 1.7.1.6. 1.7.2.  approval.  DELIVERABLE: Complaint Trend Analysis  DUE: Quarterly, by October 15th, January 15th, April 15th and June 15th of each year.  1.7. Continuous Quality Improvement Plan  Contractor shall create and implement a Continuous Quality Improvement Plan for the contract period. The Continuous Quality Improvement Plan shall include, but not be limited How Contractor oversees the work performed by Case Managers as outlined in the contract to ensure all tasks are being performed according to the requirements. How Contractor reviews work to determine whether the work is being completed in a How Contractor identifies and addresses Case Management performance issues. How Contractor notifies the Department ofi identified performance issues. How Contractor will address at a minimum the following areas: operations, quality controls, staffing, training, and community engagement. Required tasks will be outlined inl Department template that will bej provided to Contractor yearly. Contractor shall participate in the Department hosted Quality Community of Practice. Contractor shall submit the Continuous Quality Improvement Plan to the Department for review, approval, and payment. The Department will establish al regularly scheduled cadence with Contractor to review and discuss the CQI Plan, data, and agency specific quality dashboard. Contractor shall review the plan and metrics with the Department annually.  toa description oft the following:  correct and high-quality manner.  1.7.2.1. 1.7.2.2. 1.7.3.  DELIVERABLE: Continuous Quality Improvement Plan DUE: Within 90 Business Days after the Effective Date  Contractor shall review its Continuous Quality Improvement Plan on an annual basis and update the plan as appropriate to account for any changes. Contractor shall submit the Continuous Quality Improvement Plan Update or document that the plan was reviewed, and  changes were not required.  1.7.3.1. Exhibit B-1,SOW  DELIVERABLE: Continuous Quality Improvement Plan Update  Page 10of53    Docusign Envelope ID: 08D4B89-7084-4F7D-95BF-CA11DA86A3E9  1.7.3.2. 1.8. Appeals 1.8.1.  DUE: Annually, by October 1st  Contractor shall represent the Department and defend any adverse action in accordance with 10 CCR 2505-10 8.7202.R et seq., and 10 CCR 2505-10 Section 8.057 et. seq. in all HCBS, LTHH, PACE, Hospital Back-Upl Facilities, and Nursing Facility appeals initiated during this Contract. This section does not apply to State General Fund Programs. Contractor shall coordinate with the Department for any adverse actions necessitating Department attendance Contractor shall identify and disclose to the Department immediately, and no later than 45 Calendar Days prior to a scheduled appeal hearing, any conflict ofi interest that would interfere with Contractor's ability to represent the Department in any appeal. Contractor shall represent its actions at Administrative Law Judge hearings when the individual or Member appeals a denial or adverse action affecting individual's or Member's Contractor shall process appeals in accordance with schedules published by the State of Colorado Office of Administrative Courts and rules promulgated by the Department. Contractor shall develop an Appeals Packet which contains all relevant documentation to Contractor shall develop an Appeals Packet no later than 20 Business Days prior to the date Contractor shall submit exceptions when applicable and include all relevant information. Contractor shall cooperate with the Office oft the State. Attorney General for any case in which Contractor shall document all appeals where Contractor attends any hearing in an Contractor shall make the Appeal Packets available to the Department upon request.  atal hearing.  1.8.1.1. 1.8.2. 1.8.3. 1.8.4. 1.8.5. 1.8.6. 1.8.7. 1.8.8. 1.8.9. 1.9.1. 1.9.1.1. 1.9.1.2.  program eligibility or receipt of services.  support Contractor's denial or adverse action.  ofa scheduled hearing.  iti isi involved.  Administrative Law Court.  1.9. Critical Incidents  Critical Incident Reporting  Contractor shall be responsible for entering Critical Incident Reports (CIR) in the Department prescribed system as soon as possible, but no later than 24 hours (one Contractor shall ensure all suspected incidents of abuse, neglect, and exploitation are immediately reported consistent with current statute; Section 19-3-301 through 19-3-318 C.R.S. Colorado Children's Code, Section 18-8-115 C.R.S. (Colorado Criminal Code- Dutytol Report a Crime), 18-6.5-108 C.R.S. (Colorado Criminal Code-Wrongs to. At-Risk Adults), and Section 26-3.1-102, C.R.S. (Social Services Code-Protective Services). Contractor shall document all CIR follow-up information in accordance with Department direction in the Department prescribed system and maintain detailed documentation.  business day) following notification.  1.9.1.3. 1.9.2.  Critical Incident Follow-Up Completion and Entry  Exhibit B-1, SOW  Page 11 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-958F-CA11DA86A3E9  1.9.2.1. 1.9.2.2. 1.9.2.2.1.  Contractor shall ensure all CIRs follow-up is completed and entered into the Department's prescribed system within the timelines established by the Department Timelines for follow-up are determined by the Department and depend on the type and severity oft the CIR. The following are general timelines assigned to remediation and CIR High Priority Follow Up- CIRS which require immediate attention and must be addressed to ensure the immediate health and safety of a waiver participant must be remediated within and responded to in the Department prescribed system within 24- Medium Priority Follow Up - CIRs which require additional information or follow up to ensure appropriate actions are taken and there is no immediate risk to the health and safety oft the waiver participant must be completed in the Department prescribed Low Priority Follow Up - CIRs that have been remediated by CMAS, have addressed immediate and long-term needs, have implemented services or supports to ensure health and safety, and those that have protocols in place to prevent ai recurrence ofa similar CIR but may require an edit to the CIR or additional information entered into the Department prescribed system. The follow-up for CIRs in this category must be PERFORMANCE STANDARD: 90% of all CIRS assigned follow-up are completed and entered into the Department's prescribed system within the timelines established by the Department and/or the Department's Quality Improvement Organization each quarter.  and/or the Department's Quality Improvement Organization.  follow up:  481 hours.  1.9.2.2.2.  system within three to four Business Days.  1.9.2.2.3.  completed and entered within five Business Days.  1.9.2.3.  1.10. Critical Incident Report Administrative Review  1.10.1. Contractor shall conduct a Critical Incident Report Administrative Review upon direction 1.11. Critical Incident Report administrative reviews shall be initiated by the Department and will require the Contractor to upload documentation to the Department's prescribed system as assigned. Contractor may be required to document that the reported incident of alleged Mistreatment, Abuse, Neglect, or Exploitation (MANE) was reported to law enforcement, per mandated reporting laws, and to adult/child protection services to be screened for additional investigation by the Colorado Department of Human Services as appropriate. The Department may also request that the Contractor file a report with the Colorado Department ofPublic Health and Environment as neçessary. Critical Incident Report administrative review may also require documentation of whether additional services might be needed as a result of the incident or  from the Department.  gathering of additional documentation at the request oft the Department.  1.12. Human Rights Committee (HRC)  1.12.1. Contractor shall establish an HRC. The HRC is composed, to the extent possible, of two  professional persons trained in the application oft behavior development techniques and three representatives of persons receiving services, their parents, legal guardians, or authorized representatives. An employee or board member ofa service agency within the Contractor's  designated service area shall not serve as ai member oft the HRC.  Exhibit B-1, SOW  Page 12 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.12.2. Contractor shall establish and facilitate a Human Rights Committee (HRC) pursuant to 10  C.C.R. 2505-10 Section 8.7202.Q et seq. Contractor shall maintain qualifications for each member ofthe HRC and make it available to the Department upon request.  1.12.3. Contractor shall submit a list ofH HRC members annually.  1.12.3.1. 1.12.3.2.  DELIVERABLE: HRC Member List DUE: Annually, by August 15th Business Days oft the date of change. DELIVERABLE: HRC Member Updates  1.12.4. Contractor shall notify the Department of any changes to the HRC members within 10  1.12.4.1. 1.12.4.2.  DUE: Within 101 Business Days oft the date of change to the HRC: members  1.12.5. Contractor shall establish at least one. HRC as at third-partyr mechanism to safeguard the rights  of persons enrolled in HCBS-CES, HCBS-CHRP, HCBS-SLS, HCBS-DD, State SLS, OBRA-SS, and FSSP. The HRC is an advisory and review body to the administration of responsibilities for the committee's organization, use of Department required universal documents, the review process, mitigation of potential conflicts of interest, and provisions for recording dissenting opinions of committee members in the committee's recommendations. CMAs must also develop and adopt an HRC policy and procedure for the Rights Committee and make this information available to the Department upon request.  Contractor.  1.12.6. Contractor shall develop policies and procedures which include, but are not limited to, HRC  emergency review of Rights Modifications.  1.12.7. Contractor shall orient members regarding the duties and responsibilities of the Human 1.12.8. Contractor shall provide the HRC with the necessary staff support to facilitate its functions. 1.12.9. Contractor shall keep proper documentation and record of all HRC recommendations and 1.12.10. Contractor shall maintain HRC meeting minutes, attendance logs, and supporting 1.12.11. Contractor shall notify the Department in writing of any changes to the HRC membership 1.12.12. Contractor shall document all: reviews within the Department's prescribed system within 10  ensure that all documentation is a part of the members record in the Department's prescribed documentation related to an HRC meeting and make it available to the Department within 10  system.  Business Days upon request. within 10 Business Days.  Business Days of the date oft the HRC review.  2. PRE-ENROLLMENT ACTIVITIES 2.1. LTSS LOC Referral, Intake, and Screening  2.1.1. 2.1.1.1. 2.1.1.2. Exhibit B-1,SOW  Contractor shall perform all long-term services and supports Level of Care referral, intake, and screening functions/activities for enrollment into the: following waivers and programs:  CHCBS  Consumer-Directed Attendant Support Services (CDASS)  Page 13of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  2.1.1.3. 2.1.1.4. 2.1.1.5. 2.1.1.6. 2.1.1.7. 2.1.1.8. 2.1.1.9. 2.1.1.10. 2.1.1.11. 2.1.1.12. 2.1.1.13. 2.1.1.14. 2.1.1.15. 2.1.1.16. 2.1.1.17. 2.1.1.18. 2.1.1.19.  Family Support Services Program (FSSP)  HCBS-BI HCBS-CES HCBS-CHRP HCBS-CIH HCBS-CLLI HCBS-CMHS HCBS-DD HCBS-EBD HCBS-SLS Hospital Back-Up  In Home Supports and Services (IHSS)  Intermediate Care Facilities for Individuals with Intellectual and Developmental  Disabilities (ICF/IID) Nursing Facilities PACE  Omnibus Reconciliation Act of 1987 Specialized Services Program (OBRA-SS)  State Supported Living Services Program (State SLS)  2.2. Contractor shall perform all Long Term Supports and Services Level of Care (LTSS LOC) referral, intake, and screening functionslactivities in accordance with $25.5-6-104, C.R.S. and1 10 CCR2 2505-10, Sections 8.7202.B., 8.7202.E, and 8.401 et seq., shall include, but not limited to,  the following:  2.2.1.1. 2.2.1.1.1. 2.2.1.1.2. 2.2.1.1.3. 2.2.1.1.3.1. 2.2.1.2. 2.2.1.3. 2.2.1.3.1.  Timelines shall be applied based on thel location ofthe applicant at the time the Contractor receives the LTSS Level of Care (LOC)referral or another intake referral:  Hospital Skilled Nursing Facility, or Community  Programs such as Hospital Back-up and PACE are subject to timelines based on the location of the applicant at the time the Contractor receives the LTSS LOC CMAS shall not require al LTSS LOC Referral form toi intake a referral requesting al LOC Conduct and document the Colorado Intake Screen Tool (CIST), LOC Assessment, and Rapid Reintegration within required timelines set forth by the Department. Conduct and document the CIST in the Department's prescribed system within 2 business days of receiving the LTSS LOC referral or any other intake referral  referral or another referral for LOC. Assessment.  Assessment.  requesting a LOC. Assessment.  Exhibit B-1,SOW  Page 14of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  2.2.1.3.2. 2.2.1.3.3. 2.2.1.3.4. 2.2.1.3.4.1. 2.2.1.3.5. 2.2.1.4. 2.2.1.5. 2.2.1.6.  Timeline to conduct and document the CIST does not extend the LOC Assessment Ensure documentation includes thei individual'si need for LTSS and/or the individual's request foraLOC Screen eveni ifthe CIST indicates the individual may not be eligible LTSS LOC referral form is uploaded to the Department's prescribed system. Any other referral requesting: a LOC Assessment is uploaded in the Department's Document all efforts to contact an applicant to conduct the CIST, LOC Assessment, and any referrals made to non-LTSS services in the Department's prescribed system. Have a written policy and procedure for expediting the LTSS LOC referral or another referral for LOC Assessment in the event that an applicant is in an emergency situation. Conduct and document a LOC Assessment without delay if an applicant has requested a Delay Determination or Developmental Disability Determination required for HCBS- For an individual who is not being discharged from a hospital or a nursing facility, the CIST, and LOC Assessment shall be conducted and documented in the Department's prescribed system within 10 business after receiving confirmation that the Medicaid application has been received by the county department of social services. CMAS shall attempt to verify that a LTC Medicaid Application has been submitted after receiving a LTSS LOC referral but should not delay a LOC Assessment ift the interview conducted to complete the CIST indicates that an applicant has not Hospital and Skilled Nursing Facility referrals do not require LTC Medicaid Individuals shall be notified at the time of the decision of their application for publicly funded LTSS that they have the right to appeal the actions of Contractor according to 10 CCR 2505-10 section 8.057 and 8.7202.R et seq. The notification shall include the right PERFORMANCE STANDARD: 100% of LTSS LOC Referrals and all intake referrals submitted to the Contractor are entered or uploaded into the Department prescribed system within two Business Days of the LTSS LOC Referral or intake  timelines set forth by the Department.  for LTSS.  prescribed system.  DD,HCBS-SLS, HCBS-CES, and HCBS-CHRP waivers.  2.2.1.6.1.  submitted a LTC Medicaid Application.  2.2.1.6.2. 2.2.1.7.  application verification.  to1 request a fair hearing before an Administrative Law Judge.  2.2.1.7.1.  referral receipt date.  2.3. Developmental Disability and Delay Determinations  2.3.1. 2.3.2.  Contractor shall determine whether an applicant meets the definition of an Individual with a Developmental Disability or Delay as defined under 10 CCR 2505-10, section 8.8.7100.A., Contractor may expedite psychological or adaptive behavior testing for Developmental Disability Determinations when there are delays due to issues identifying a provider or scheduling testing with a provider in order complete the PASRR Level II assessments for individuals residing in skilled nursing facilities. Requests for testing funding must be  in accordance with 10C.C.R. 2505-10 section 8.607.2 et seq.  submitted on the template prescribed by the Department.  Exhibit B-1,SOW  Page 15of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  2.3.3.  Contractor may request funding for testing necessary to complete Delay or Developmental Determination to move forward with intake and referral activities. This includes cases where an applicant cannot access testing due to finançial burden and other funding is not available ifthey have submitted a long-term care. Medicaid application and the financial eligibility has notl been determined. Requests for funding must be submitted tot the Department for approval  prior to funding being approved. DUE: Monthly, by the 15th  2.3.3.1. 2.3.3.2. 2.3.3.3. 2.3.4. 2.3.5. 2.3.6.  DELIVERABLE: Prior Approval for Testing Funding and Invoice  Contractor shall maintain all supporting documentation related to the testing for DD Contractor shall complete the individual's determination record and assessment record ini the Department prescribed system with all applicable dates and information within 10 Business Contractor shall maintain the individual's determination, documents, and upload them to the Contractor shall ensure that all determinations are complete, in accordance with Department regulations, and the individual has been determined to have a disability or delay prior to enrollment into HCBS-DD, HCBS-SLS, HCBS-CHRP, HCBS-CES, State SLS, FSSP, and Individuals shall be notified at the time of the decision of the determination that they have the right to appeal actions ofContractor to 10CCR: 2505-10 sections 8.057 et seq., 8.7202.R et seq. The notification shall include the right to request a fair hearing before an  Determination and make it available to the Department upon request.  Days after a determination is complete. Department's prescribed system.  OBRA-SS.  2.3.7.  Administrative Law Judge.  2.4. Waiting List Management  2.4.1.  Contractor shall maintain aj program specific waiting list within the Department's prescribed system for all eligible individuals for whom funding is not available. Waiting lists may be applicable for HCBS-DD, State SLS, OBRA-SS and FSSP dependent on available funding. Contractor shall: not maintain a waiting list for any oft the other programs included within this Contractor shall determine HCBS-DD waiting list eligibility by conducting an assessment that clearly defines detailed and member specific information that specifies how the individual meets the HCBS-DD waiver requirement for needing access to services and supports twenty-four (24) hours a day pursuant to 10 CCR2505-10 8.7202.G et seq. and Contractor's description of daily living needs of an individual who requires access to twenty-four (24) hour a day services and support in the LOC waiting list assessment should indicate services and support needs that are only available in the HCBS-DD waiver to determine why access to services and supports twenty-four hours a day are Thei name ofaj person eligible for thej program shall bej placed on the waiting list by Contractor  Contract.  2.4.2.  8.7101.J et seq.  2.4.2.1.  necessary for the individual. making the eligibility determination.  2.4.3.  Exhibit B-1,SOW  Page 16of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  2.4.4.  When an eligible person is placed on the waiting list for Waiver services, a written notice of action including information regarding individual rights and appeals shall be sent to the person or the person's legal guardian in accordance with the provisions of 10 C.C.R. 2505- When funding has been made available for an individual Contractor will remove the person from the "As Soon as Available" (ASAA) waiting list within 10 Business Days. The placement date used to establish a person's order on an HCBS waiver waiting list shall The date on which the person was initially determined tol have a developmental disability The 14th birth date if a child is determined to have a developmental disability by When an individual is eligible for aj program and funding is not available, Contractor shall:  108.7202.J et seq.  2.4.5. 2.4.6. 2.4.6.1. 2.4.6.2. 2.4.7. 2.4.7.1. 2.4.7.2. 2.4.8. 2.4.9.  be:  by Contractor; or  Contractor prior to the age of14. Verify demographic information. Compile and correct data.  Contractor shall complete data entry of Waiting List record into the Department prescribed system within 10 Business Days of any addition or change to the Waiting List. Contractor shall conduct and document, in the Department's prescribed system, an annual follow-up with individuals 18 and older for all HCBS waivers with a Waiting List timeline ofASAA, Safety Net (SN), or "see date" to update changes in demographic information and ensure the individual is appropriately identified on waiting lists for the program and services PERFORMANCE STANDARD: 100% of HCBS individuals 18 and older with an ASAA, SN, or "see date" timeline on the Waiting List are contacted annually and documented within the Department's prescribed system within 10 Business Days.  the individual is eligible to receive.  2.4.9.1.  2.5. Program Enrollment from the Waiting List  2.5.1. 2.5.1.1. 2.5.1.2.  HCBS-DD Enrollment from the Waiting List  When an enrollment becomes available from thel HCBS-DD Waiting List, thel Department will notify Contractor ofthe individual who will be offered an enrollment by the order of Contractor shall notify the individual of the enrollment offer within 5 Business Days. Contractor shall make three attempts to contact the individual within a 30-calendar day period. Contractor shall document in the Departments prescribed system all attempts to contact the individual for the enrollment offer. If the individual does not respond to the offer of enrollment, Contractor shall change the individuals waiting list timeline to Individuals shall be notified at the time oft the enrollment offer that they have the right to appeal the actions ofContractor to 10 CCR 2505-10 sections 8.7202.R et seq. and 8.057 et seq. The notification shall include the right to request a fair hearing before an  selection date.  "Safety Net".  2.5.1.3.  Administrative Law. Judge.  2.5.2. Exhibit] B-1, SOW  HCBS-DD Waiting List Enrollment Capacity Building  Page 17of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  2.5.2.1. 2.5.2.2. 2.5.2.3.  As appropriated and earmarked by the General Assembly, Contractor may receive capacity building funding to support the enrollment of members into the HCBS-DD Contractor shall receive written notification of any capacity building funding for If funding is allocated, Contractor shall report how the capacity building funding was used to support the enrollment of the authorized Member(s) into the HCBS-DD waiver on a template developed by the Department. Funding must be used to support Member  waiver from the waiting list.  individuals enrolling into the HCBS-DD waiver from the waiting list.  enrollment ini the following categories:  2.5.2.3.1. 2.5.2.3.1.1. 2.5.2.3.1.2. 2.5.2.3.1.3. 2.5.2.3.1.4. 2.5.2.3.2. 2.5.2.3.2.1. 2.5.2.3.2.2. 2.5.2.4. 2.5.2.5. 2.5.3. 2.5.3.1.  Staffing costs Recruiting and hiring Professional development Equipment and supplies Information technology Program costs Advertising Equipment and supplies  DELIVERABLE: Capacity Building Funding Expenses  DUE: Quarterly, if funding is allocated, by October 31st, January 31st, April 30th, and June 15th or the Fiscal Year end close date determined by the Department  FSSP Enrollment from the Waiting List  In cooperation with the local Family Support Council, Contractor shall develop procedures for determining how and which individuals on the Waiting List will be enrolled into FSSP. These procedures must comply with Department regulations on Contractor shall select individuals from the waiting list to enroll into FSSP in accordance  waiting list and prioritization of funding. with 10 CCR 2505-10 8.756let seq. State SLS Enrollment from the Waiting List  2.5.3.2. 2.5.4. 2.5.4.1.  Contractor shall develop procedures for determining how and which individuals on the waiting list will be enrolled into the State SLS program in accordance with 10 C.C.R. 2505-10 Section 8.7.7557. These procedures shall be made available to the Department upon request and used to select individuals from the waiting list to enroll into State SLS. Contractor shall determine when funding is not available within Contractor's existing State General Fund program allocation and notify the Department that additional funding is being requested to enroll the individual into OBRA-SS within 10 Business Days of  2.5.5. 2.5.5.1.  OBRA-SS Enrollment from the Waiting List  funding needs being identified.  Exhibit] B-1, SOW  Page 18of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  2.5.5.2. 2.5.5.3. 2.5.6. 2.5.6.1.  Contractor shall place the individual on the waiting list until funding becomes available or Contractor may partially fund services when limited funding is available within Contractor shall develop procedures for determining how and when individuals will be placed on the waiting list and make the procedures available to the Department upon  existing allocations.  request.  Waiting List Records Maintenance  Contractor shall remove individuals from the Waiting List after an enrollment is authorized to the individual and the individual or guardian accepts or refuses the authorization for enrollment within 10 Business Days after the individual or guardian's Ifa an individual or guardian declines an enrollment, Contractor shall enter the reason for declining an enrollment: into thel Department prescribed system Waiting List record within Contractor shall provide information and referrals to individuals, families and/or Contractor shall continue to refer individuals on the Waiting List to other community resources that may be available and inform individuals of their choice of providers, Contractor shall provide assistance completing Medicaid financial applications or other public assistance program applications at the time assistance is requested by the Individuals shall be notified at the time oft the enrollment authorization that they have the right to appeal actions of Contractor as described in 10 CCR 2505-10 section 8.057 et seq., 8.7202.R et seq. The notification shall include the right to request a fair hearing  response or the last communication attempt.  2.5.6.2. 2.5.6.3. 2.5.6.4. 2.5.6.5. 2.5.6.6.  10 Business Days oft the enrollment being declined. guardians at the time oft the annual follow-up.  waivers, and services.  individual, family, or guardian.  before an Administrative Law. Judge.  2.6. Compilation and Correction of Waiting List Data  2.6.1. 2.6.1.1.  Contractor shall correct 100% of Waiting List data errors discovered by the Department PERFORMANCE STANDARD: 100% of Waiting List data corrected within 10  within 10 Business Days ofnotification from the Department of an error.  Business Days ofnotification.  2.7. Authorization and Reporting ofHCBS-DD: Enrollments  2.7.1. 2.7.2. 2.7.3.  Contractor shall obtain prior authorization from the Department for all enrollments into the Ina accordance with 10 CCR 2505 Section 8.7101.J, Contractor shall inform the Department of all vacancies in the HCBS-DD waiver. Vacancies shall be submitted to the Department Individuals shall be notified at the time of the enrollment authorization that they have the right to appeal the actions of Contractor to 10 CCR 2505-10 section 8.7202.R and 8.057et seq. The notification shall include the right to request a fairl hearing before an Administrative  HCBS-DD waiver.  monthly on the date and template prescribed by the Department.  Law. Judge.  Exhibit) B-1, SOW  Page 19of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  2.7.3.1. 2.7.3.2. 2.7.4. 2.7.4.1. 2.7.4.2.  DELIVERABLE: HCBS-DD Vacancy Reporting  DUE: Monthly, by the 15th on the template prescribed by the Department Contractor shall report all enrollment dates or changes to enrollment status for the HCBS- DD waiver to the Department monthly on the date and template prescribed by the DELIVERABLE: HCBS-DD Enrollment Date and Enrollment Change Reporting DUE: Monthly, by the 15th on the template prescribed by the Department  Department.  3. SCREENING AND ASSESSMENT  3.1. Contractor shall perform the Level of Care (LOC) (100.2) Assessment as indicated in Section 3.2 or the LOC Screen and Needs Assessment as indicated in Section 3.3 for each Member as 3.2. Contractor shall not perform both a LOC. Assessment (100.2) and a LOC Screen and Needs Assessment for the same Member unless directed to do SO by the Department.  directed by the Department.  3.3. Level of Care Assessment (100.2)  3.3.1. 3.3.2.  Contractor shall provide staff that meet the case manager qualifications set forth in state Contractor shall utilize and conduct the Department prescribed tools for the Initial LOC Assessment for all new applicants to the HCBS waivers, PACE, Nursing Facilities, Hospital Back-Up, and ICF-IDD. Initial Level of Care Assessment include the following Assessment Event types: Initial Review, HCBS-DD Waitlist, Deinstitutionalization (DI), and Reverse Deinstitutionalization. Continued Stay Review LOC Assessments include the following Assessment Event types: Continued Stay Review and Unscheduled Review. An Unscheduled Review Assessment Event Type shall be utilized when a LOC Assessment is completed due to a significant change in the Member functioning and support needs including documented medical conditions, post hospitalization, or significant change in Contractor shall schedule an in-person Initial LOC Assessment in accordance with 10 CCR 2505-10 8.7202.E. and shall adhere to the following processes and timelines based  statutes and regulations to perform all LOC. Assessments.  3.3.3.  activities of daily living.  3.3.3.1. 3.3.3.1.1. 3.3.3.1.1.1. 3.3.3.1.1.2. 3.3.3.1.1.3. 3.3.3.1.1.4. 3.3.3.1.2. Exhibit B-1,SOW  on type:  Hospital to HCBS  Contractor conducts and documents the LOC Assessment within 2. Business Days LOC Eligibility Determination start date for Assisted Care Facility may be the date ofreferral on the LTSS LOC referral form received by the Contractor. Contractor generates a LOC Eligibility Determination in the Department's prescribed system within 2 Business Days of the LTSS LOC referral or another Referral to LOC Eligibility Determination not to exceed 2 Business Days.  ofreceiving a LTSS LOC: referral for LOC. Assessment.  referral requesting a LOC. Assessment. Hospital to Skilled Nursing Facility  Page 20of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  3.3.3.1.2.1.  Contractor conducts and documents the LOC Assessment Screen and PASRR Level I Screen within 2 Business Days of receiving a LTSS LOC referral or Contractor completes and documents the Nursing Facility Length of Stay form to indicate the length of stay necessary to meet the applicant's needs. LOC Eligibility Determination date may be the date ofLTSS LOC referral form Contractor generates a LOC Eligibility Determination in the Department's prescribed system within 2 Business Days oft the LTSS LOC Referral or another Referral to LOC Eligibility Determination not to exceed 2 Business Days. Hospital timelines apply to any applicant in a hospital wanting to enroll in PACE  another referral for LOC. Assessment.  3.3.3.1.2.2. 3.3.3.1.2.3. 3.3.3.1.2.4. 3.3.3.1.2.5. 3.3.3.1.2.6. 3.3.3.1.3. 3.3.3.1.3.1. 3.3.3.1.3.2. 3.3.3.1.3.3. 3.3.3.1.4. 3.3.3.1.4.1. 3.3.3.1.4.2. 3.3.3.1.4.3. 3.3.3.1.5. 3.3.3.1.5.1. 3.3.3.1.5.2. 3.3.3.1.5.3. 3.3.3.1.5.4. 3.3.3.1.5.5. Exhibit B-1, SOW  isr received by the Contractor.  referral requesting a LOC Assessment.  and, HBU.  Skilled Nursing Facility to HCBS  Contractor conducts and documents the LOC. Assessment within 51 Business Days oft the LTSS LOC: referral date or another referral requesting a LOC. Assessment. Contractor generates a LOC Eligibility Determination in the Department's prescribed system within 5 Business Days of the LTSS LOC referral or another Referral to LOC Eligibility Determination not to exceed 5 Business Days. Contractor conducts and documents the LOC. Assessment within 5 Business Days ofthe LTSS LOC: referral date or another referral requesting a LOC Assessment. Contractor generates a LOC Eligibility Determinations in the Department's prescribed system within 5 Business Days of the LTSS LOC Referral or another Referral to LOC Eligibility Determination not to exceed 5 Business Days. Contractor completes the LOC. Assessment and PASRR Level IS Screen within 10 Business Days of the LTSS LOC referral date or another referral requesting a Contractor completes thei nursing facility length ofs stay form to indicate the length LOC Eligibility Determination start date will be the date of referral on the LTSS LOC: referral form or another referral requesting a LOC Assessment. Contractor generates a LOC Eligibility Determination in the Department's prescribed system within 10 Business Days ofthe LTSS LOC: referral or another Referral to LOC Eligibility Determination not to exceed 10 Business Days.  referral requesting a LOC Assessment Skilled Nursing Facility Payer Source Change  referral requesting a LOC. Assessment. HCBS to Skilled Nursing Facility  LOC Assessment.  of stay necessary to: meet the applicant'sn needs.  referral requesting a LOC Assessment.  Page 21 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  3.3.3.1.6. 3.3.3.1.6.1. 3.3.3.1.6.2. 3.3.3.1.6.3. 3.3.3.1.6.4. 3.3.3.1.6.5.  HCBS Referral  Contractor completes the LOC. Assessment within 10 Business Days oft the LTSS LOC referral date or another referral requesting a LOC Assessment. LOC Eligibility Determination start date for Assisted Care Facility may be the date ofreferral on the LTSSLOC referral form received by the Contractor. Contractor generates a LOC Eligibility Determination in the Department's prescribed system within 10 Business Days of the LTSS LOC referral or another Referral to LOC Eligibility Determination not to exceed 10 Business Days. Contractor shall attempt to verify that a LTC Medicaid Application has been submitted after receiving a LTSS LOC referral but should not delay a LOC Assessment if the interview conducted to complete the CIST indicates that an Hospital and Skilled Nursing Facility referrals do not require LTC Medicaid Contractor shall consideral LOC. Assessment to be complete when the following has been done: an in-person assessment is completed, the PMIP has been obtained and verified to bea accurate by the Case Manager to determine target criteria, and the assessment has been A LOC Certification notice shall be provided to referring agencies such as PACE organizations, Nursing Facilities, or Hospitals upon obtaining written consent provided PERFORMANCE STANDARD: Contractor shall ensure a Professional Medical Information Page (PMIP) is signed by a medical professional and dated no earlier than six months from the certification start date and ofa an Initial LOC Assessment. Contractor shall conduct all Level of Care Assessments in accordance with regulations. Contractor shall conduct an in-person Continued Stay Review Assessment every 12 months for Clients who are continually enrolled for the HCBS waivers, PACE, Nursing Facilities, Hospital Back-Up, and ICF-IDD. Contractor shall enter the review into the Department's prescribed system within 10 Business Days of conducting the assessment. PERFORMANCE STANDARD: Contractor shall ensure a Professional Medical Information Page (PMIP) is signed within 90 Calendar Days of the certification start date and before the certification end date for a Continued Stay Review (CSR) for all applicants and individuals currently receiving services through the Hospital Back-Up Unit (HBU), Nursing Facility (NF), Intermediate Care Facility for Individuals with Intellectual and Developmental Disabilities (ICF-IDD), and Program for All- Contractor shall enter and complete the Continued Stay Reviews within 10 Business Days Failure by Contractor to complete the annual Level of Care Assessment shall cause a break inj payment authorization for waiver services for the individual or Member.  referral requesting al LOC. Assessment.  applicant has not submitted a LTC: Medicaid Application.  3.3.3.1.6.6. 3.3.3.2.  application verification.  entered ini the Department's) prescribed system. by the applicant that meets HIPAA standards.  3.3.3.3. 3.3.3.3.1. 3.3.3.4. 3.3.3.5.  3.3.3.5.1.  Inclusive Care for the Elderly (PACE). after conducting the assessment.  3.3.3.6. 3.3.4.  Exhibit B-1, SOW  Page 22 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  3.3.4.1, 3.3.4.2. 3.3.4.3.  Contractor shall ensure that this break in payment authorization shall not affect the continued delivery ofwaiver services to the individual or Member. Service costs incurred Contractor shall bear the sole financial responsibility for all costs incurred during this break inj payment authorization and shall be responsible for reimbursing providers for any Contractor shall notify all providers of the discontinuation of services no later than 11 Calendar Days prior to the certification end date that services shall not be authorized past  during a break in payment authorization are non-allowable costs. loss in funding as a result oft the break in payment authorization.  the certification end date.  3.4. Level of Care Screen and Needs Assessment  3.4.1.  Contractor shall perform all Initial and Annual Reassessment Level of Care Screens and Needs Assessments for the operation ofa CMA in accordance with $25.5-6-104, C.R.S., 10 CCR 2505-10, Section 8.401, and 10 CCR 2505-10, Sections 8.7202.E et seq. and 8.7202.F The Initial and Reassessment Level of Care Screen shall include and ensure, but not A verification of Long-Term Care (LTC) Medicaid Financial eligibility or LTC All Level of Care Screens are conducted in person with the individual or Member, at minimum, and in the place where the individual or Member resides. Needs Assessments shall be conducted in person or virtually based on the Member's Contractor shall verify that a Member meets institutional level of care by receiving a PMIP signed by a medical professional and dated no earlier than six months from the certification start date and no later than 90 Calendar Days from the evaluation date of an InitialLevel of Care Screen; and within 90 Calendar Days oft the certification start date and before the certification end date for a Reassessment for all individuals and Members currently receiving services through Hospital Back-Up Unit (HBU), Nursing Facility (NF), Intermediate Care Facility forl Individuals with Intellectual and Developmental Disabilities (ICF-IDD), and Program for All-Inclusive Care for the Areview of all supportive information related to the Level of Care for the Member to Communicating Level of Care Eligibility status to the appropriate eligibility site. Representing the Department in all appeals relevant to a LTSS program eligibility. Areview ofHCBS waiver Target Criteria for applicant or Member participation. Determine individual or Member! Level of Care Eligibility for enrollment in an HCBS Waiver, PACE, HBU, Nursing Facility admission, or ICF-IDD admission. Analyzing the information obtained to determine the most appropriate responses to the Level of  ets seq.  3.4.1.1. 3.4.1.1.1. 3.4.1.1.2. 3.4.1.1.3. 3.4.1.1.4.  limited to, the following:  Medicaid application submission.  preference.  Elderly (PACE).  3.4.1.1.5. 3.4.1.1.6. 3.4.1.1.7. 3.4.1.1.8. 3.4.1.1.9.  include, but not limited to, documentation and interviews.  Care Screen questions.  Exhibit B-1, SOW  Page 23 of53    Docusign Envelope ID: 08D4B59670844F7D.958P-CATIDABAJES  3.4.1.1.10. 3.4.1.1.11.  Providing notice of action to Members of all appealable actions related to their Documenting and maintaining Level of Care Screens and Needs Assessments, including all relevant information, utilizing the Department's prescribed system within the timeframes established in 10 CCR 2505-10, Sections 8.7202.E and  eligibility in a LTSS program.  8.7202.F et seq. Level of Care Screen  3.4.2. 3.4.2.1. 3.4.2.1.1. 3.4.2.1.2. 3.4.2.1.3. 3.4.2.1.4. 3.4.2.2. 3.4.2.2.1. 3.4.2.2.2. 3.4.2.2.3. 3.4.2.2.4. 3.4.2.2.5. 3.4.2.3. 3.4.2.3.1. 3.4.2.3.1.1. 3.4.2.3.1.2. 3.4.2.3.1.3. 3.4.2.3.1.4. 3.4.2.3.2. 3.4.2.3.2.1. 3.4.2.3.2.2.  The LOC Screen shall include the following event types:  Initial Reassessment Off-Cycle Review Waiting List programs: HCBS Waivers PACE Nursing Facilities Hospital Back-Up ICF-IDD 8.7202.E.:  Contractor shall conduct an Initial LOC Screen prior to enrolling in the following  Contractor shall conduct an Initial LOC Screen in accordance with 10 CCR 2505-10  Hospital to HCBS  Contractor conducts and documents the LOC. Assessment within 2 business days of receiving a LTSS LOC referral or another referral requesting a LOC LOC Eligibility Determination start date for Assisted Care Facility may be the date ofreferral on the LTSS LOC referral form received by the CMA. Contractor generates a LOC Eligibility Determination in the Department's prescribed system within 2 business days of the LTSS LOC referral or another Referral to LOC Eligibility Determination not to exceed 2 Business Days. Contractor conducts and documents the LOC Assessment and PASRR Level 1 Screen within 2 business days of receiving a LTSS LOC referral another referral Contractor completes and documents the Nursing Facility Length of Stay form to indicate the length of stay necessary to meet the applicant's needs.  Assessment.  referral requesting a LOC. Assessment. Hospital to Skilled Nursing Facility  requesting a LOC. Assessment.  Exhibit B-1,SOW  Page 240 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  3.4.2.3.2.3.. 3.4.2.3.2.4. 3.4.2.3.2.5. 3.4.2.3.2.6. 3.4.2.3.3. 3.4.2.3.3.1. 3.4.2.3.3.2. 3.4.2.3.3.3. 3.4.2.3.4. 3.4.2.3.4.1. 3.4.2.3.4.2. 3.4.2.3.4.3. 3.4.2.3.5. 3.4.2.3.5.1.  LOC Eligibility Determination date may be the date of] LTSS LOC: referral form Contractor generates a LOC Eligibility Determination in the Department's prescribed system within 2 Business Days of the LTSS LOC Referral or another Referral to LOC Eligibility Determination not to exceed 2 Business Days. Hospital timelines apply to any applicant in al hospital wanting to enroll in PACE  isr received by the Contractor.  referral requesting a LOC assessment.  andHBU.  Skilled Nursing Facility to HCBS  Contractor conducts and documents the LOC Assessment within 51 Business Days of the LTSS LOC: referral date or another referral requesting a LOC. Assessment. Contractor generates a LOC Eligibility Determination in the Department's prescribed system within 5 Business Days of the LTSS LOC or another referral Referral to LOC Eligibility Determination not to exceed 5 Business Days. Contractor conducts and documents the LOC Assessment within 51 Business Days oft theLTSS LOC: referral date another referral requesting a LOC. Assessment. Contractor generates a LOC Eligibility Determinations in the Department's prescribed system within 5 Business Days of the LTSS LOC Referral or another Referral to LOC Eligibility Determination not to exceed 5 Business Days. Contractor completes the LOC. Assessment and PASRR Level 1 Screen within 10 Business Days of the LTSS LOC referral date or another referral requesting a LOC Assessment. Contractor completes the nursing facility length of stay form to indicate the length of stay necessary to meet the applicant'si needs. LOC Eligibility Determination start date will be the date ofreferral on the LTSS LOCreferral form another referral requesting a LOC Assessment. Contractor generates a LOC Eligibility Determination in the Department's prescribed system within 10 business days of the LTSS LOC referral or another Referral to LOC Eligibility Determination not to exceed 10 Business Days. Contractor completes the LOC. Assessment within 101 Business Days oft the LTSS LOC: referral date another referral requesting a LOC. Assessment. LOC Eligibility Determination start date for Assisted Care Facility may be the date ofreferral on the LTSS LOC referral form received by the Contractor.  requesting a LOC. Assessment.  Skilled Nursing Facility payer source change  referral requesting a LOC Assessment. HCBS to Skilled Nursing Facility  3.4.2.3.5.2. 3.4.2.3.5.3.. 3.4.2.3.5.4.. 3.4.2.3.6. 3.4.2.3.6.1.. 3.4.2.3.6.2.  referral requesting a LOC Assessment.  HCBS Referral  Exhibit B-1,SOW  Page 250f53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DAB6A3E9  3.4.2.3.6.3. 3.4.2.3.6.4. 3.4.2.3.7.  Contractor generates a LOC Eligibility Determination in the Department's prescribed system within 10 Business Days oft the LTSS LOC referral or another Referral to LOC Eligibility Determination not to exceed 10 Business Days. CMAS shall attempt to verify that a LTC Medicaid Application has been submitted after receiving a LTSS LOC referral but should not delay a LOC Assessment ift the interview conducted to complete the CIST indicates that an applicant has not Hospital and Skilled Nursing Facility referrals do not require LTC Medicaid The Initial Level of Care Screen shall include, but is not limited to the following:  referral requesting a LOC. Assessment.  submitted al LTC Medicaid Application.  3.4.2.3.8. 3.4.2.4. 3.4.2.4.1.. 3.4.2.4.2. 3.4.2.4.3. 3.4.2.4.4. 3.4.3. 3.4.3.1. 3.4.3.2.  application verification.  A review of financial eligibility information Ar review of the Level of Care Screen information  A review of relevant medical, educational, social, or other assessment records or Areview ofall community living information and options as an alternative to nursing  information when applicable. nclnyinstitutionalized care. Annual Level of Care Screen Reassessment  Contractor shall conduct an Annual Reassessment Level of Care Screen no earlier than 90 Calendar Days prior to and no later than 30 Calendar Days prior to the current Level An Off-Cycle Review event type shall be utilized when a Level of Care Screen is needed outside of the Annual Reassessment cycle, due to a material change in the Member's condition that can reasonably be expected to result in a change in the Level of Care or In the event Contractor fails to conduct the Annual Reassessment Level of Care Screen for al Member enrolled in a HCBS waiver, Contractor shall be responsible for reimbursing any providers for services rendered during the gap in eligibility. Contractor shall follow 10 C.C.R. 2505-10, Section 8.7202.M et seq. when transferring a Member from one county to another county or from one Defined Contractor shall take action regarding Member Medicaid eligibility within one In the event Contractor fails to discontinue waiver serviçes for a Member found ineligible for a HCBS waiver, Contractor shall be responsible for reimbursing any PERFORMANCE STANDARD: 100% of Initial Level of Care Screen and Annual Level of Care Screen assessments are conducted within required timelines at 10 CCR 2505-10, Sections 8.7202.E et seq. and 8.7202.F et seq. and are entered into the Department prescribed system. The Level of Care Screen must be entered into the Department' s prescribed system  of Care Screen certification end date.  Target Criteria eligibility.  3.4.3.2.1. 3.4.3.2.2. 3.4.3.2.3. 3.4.3.2.4. 3.4.4.  Service. Area to another Defined Service Area. Business Day of receipt from the eligibility site.  providers for services rendered.  following the timelines at 100 CCR 2505-10 Section 8.7202.E et seq.  Exhibit B-1, SOW  Page 26 of53    Docusign Envelope ID: 8D4B59670844F7D.958FP-CATIDABASES  3.4.4.1.  Members shall be notified at the time oft the eligibility decision that they have the right to appeal the actions of Contractor to 10 CCR 2505-10 Section 8.057 et seq. and 8.7202.R The notification shall: include the right to request a fair hearing before an Administrative  Law. Judge. Needs Assessment programs: HCBS Waivers  3.4.5. 3.4.5.1. 3.4.5.1.1. 3.4.5.2.  Contractor shall conduct an Initial and Annual Needs Assessment for the following  Contractor shall conduct a Needs Assessment (Initial) prior to enrollment into a HCBS waiver, annually (Reassessment), and as needed (off-cycle) by the Member due to a material change of situation or condition that may reasonably result in a change in the support needs ofthel Member. Members who are: financially eligible, who choose to enroll in HCBS waiver services, and who meet the required Level of Care for LTSS and waiver Target Criteria: for one ofmore HCBS waivers must have al Needs Assessment conducted. Contractor shall conduct a Needs Assessment with Members to determine the level Contractor shall explain to the Member the option to respond to required questions only or the choice to answer additional voluntary questions in the Needs Assessment. Contractor shall conduct and document a Needs Assessment for Members in accordance Within 15 Business Days after determination of Level of Care and Financial The Needs Assessment shall be administered prior to the Person-Centered Support Plan being developed with the Member; however, both the Needs Assessment and Person-Centered Support Planning may occur during a single session with the Member. However, they may also be completed over two or more sessions, if the The Needs Assessment shall be conducted at time, modality, and location convenient to the Member and should include people ofthe Member's identified preference.  3.4.5.2.1. 3.4.5.2.2. 3.4.5.3. 3.4.5.3.1. 3.4.5.3.2.  ofsupport needed and identify personal preferences and goals.  with the following timelines: eligibility for HCBS Waivers.  Member needs or prefers to do sO.  3.4.5.3.3.  3.5. At-Risk Diversion  3.5.1. 3.5.1.1. 3.5.1.2. 3.5.1.2.1. 3.5.1.2.2.  Contractor shall:  Outreach the identified At-Risk Diversion individuals in conjunction with timelines determined by the Department to ensure basic health and safety needs in the community Initial Outreach shall include any Member'si first occurrence on the at-risk determination  arel being met to avoid nursing facility placement. list as indicated by the Department.  At-Risk Diversion activities shall include, but are not limited to: need for additional resources, supports, and/or services.  Assessing the effectiveness of current support and services to determine if there is a  Exhibit B-1,SOW  Page 27of53    Docusign Envelope ID: 08DAB89670644F7D.958.CATIDABSAJES  3.5.1.2.3. 3.5.1.2.4. 3.5.1.2.5. 3.5.1.2.5.1. 3.5.1.2.5.2. 3.6.1. 3.6.1.1. 3.6.1.2. 3.6.1.3. 3.6.1.4. 3.6.1.5.  Support in assessing if the individual has become eligible for any other resources Documenting all At-Risk Diversion activities in detail int the Department's prescribed Maintaining all supporting documentation and make it available to the Department  including community resources and other Medicaid resources. system within 10 Business Days of the activity.  upon request.  DELIVERABLE: At-Risk Diversion Invoice  DUE: Monthly, by the 15th  3.6. Rapid Reintegration  Contractor shall initiate the Rapid Reintegration if applicable, during the LOC Assessment Contractor shall provide Members information about community-based services using the Member preference guide available on the Department's prescribed system and Contractor shall complete the Rapid Reintegration within the Department's prescribed Contractor shall ensure the Rapid Reintegration includes the Rapid Reintegration barrier questions and either the Rapid Reintegration Plan or Rapid Referral as determined by the Contractor shall ensure that any referrals deemed necessary during the Rapid Reintegration process are completed within 2 Business Days of the LOC. Assessment. Contractor shall complete the post Rapid Reintegration satisfaction survey at the next scheduled contact with the Member or within 90 Calendar Days of the transition, whichever is earlier. The Rapid Reintegration survey shall be completed with any Member transitioning from a Nursing Facility to the community that received a Rapid  for Nursing Facility. website.  system ifthe Member expresses a desire to return to the community.  Department's prescribed system.  Reintegration Plan or Rapid Referral. DUE: Monthly, by the 15th  3.6.1.6. 3.6.1.7. 3.7.1.  DELIVERABLE: Rapid Reintegration Diversion Invoice  3.7. Supports Intensity Scale-A Assessment  Contractor shall conduct a Supports Intensity Scale-A (SIS) assessment for all HCBS-DD and HCBS-SLS enrollments and reassessments when criteria set forth at 10 C.C.R. 2505-10 Section 8.612 et seq. are: met. Contractor shall not bei reimbursed for an SIS assessment prior tot the individual being determined eligible for a waiver through the Level of Care Screen and confirmation offinancial eligibility. Contractor. shall not be reimbursed: for SIS: reassessments without prior authorization from the Department to conduct the SIS reassessment. Contractor shall conduct all initial SIS Assessments within 60 Calendar Days from the date oft the Initial Level of Care Screen. Contractor shall conduct all SIS reassessments within 60 Contractor shall enter the SIS Assessment into SIS-A Online within 65 Calendar Days of  3.7.2. 3.7.3.  calendar days from the date ofa approval from the Department.  completing the Level of Care Screen.  Exhibitl B-1, SOW  Page 280 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  3.7.4.  Contractor shall complete the SIS-A assessment and enter it into SIS-A Online prior to the  Prior Authorization Review (PAR)Date.  3.8. HCBS-CES Applications  3.8.1. 3.8.2. 3.8.3. 3.8.4.  Contractor shall complete initial and CSR applications for persons applying for the HCBS- Initial HCBS-CES applications shall be submitted to the designated entity fori review no more than 30 Calendar Days after the initial LOC is completed or no more than 30 Calendar Days after the Applicant/family has chosen enrollment onto the HCBS-CES waiver. CSRHCBS-CES applications shall be submitted to the designated entity in accordance with timelines as set forth by the Department in order to prevent any break in services. Contractor shall maintain all HCBS-CES applications and supporting documentation and  CES waiver as set forth by the Department's prescribed guidelines.  make it available to the Department upon request.  3.9. HCBS-CHRP Support Need Level Assessment  3.9.1. 3.9.2. 3.9.3. 3.9.3.1. 3.9.3.2. 3.9.4. 3.9.4.1. 3.9.4.2.  Contractor shall conduct a Support Need Level Assessment for all HCBS-CHRP enrollments and re-assessments as set forth by the Department's prescribed guidelines. Contractor shall conduct an initial Support Need Level Assessment within 45 Calendar Days from the date oft the Initial Level of Care Screen. Contractor shall conduct all reassessments Contractor shall submit a list of all completed HCBS-CHRP Support Need Level DELIVERABLE: Completed HCBS-CHRP Support Need Level Assessment List Contractor shall maintain all Support] Need] Level Assessments and supporting documentation  as necessary when individual's needs change.  Assessments on a template prescribed by the Department.  DUE: Monthly, by the 15th  and make it available to the Department upon request.  PERFORMANCE STANDAND: Support Need Level Assessment DUE: Within 10 Business Days oft the Department's request  4. STATE GENERAL FUND PROGRAM OBLIGATIONS  4.1. Service and Support Requirements  4.1.1.  Contractor shall administer the three State General Fund Programs: State SLS, OBRA-SS, and FSSP and purchase services and supports for persons determined to be eligible under this Contract. If Contractor has been determined to be the only willing and qualified provider by the Department: for the Defined Service Area, Contractor must administer the State Programs and purchase and/or provide services and supports for persons determined to be eligible under this Contract. Contractor: shall notl bei responsible for guaranteeing services to eligible persons under this Contract if there are no Providers available to provide services and supports. Contractor must ensure separation of case management responsibilities and the provision of Contractor shall ensure that written notifications are provided to individuals and Members informing them of their rights and the potential influence Contractor has on the Service  services for both State SLS and OBRA-SS.  4.1.2.  Planning process, such as exercising free choice of providers.  Exhibit B-1,SOW  Page 29of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  4.1.3. 4.1.4.  Contractor shall provide the individual, Members, and/or guardian with written information about how to file aj provider agency complaint as well as how to make a complaint against Contractor shall have procedures for a dispute resolution process, as described in 10 C.C.R. 2505-10, Section 8.7202.S et seq., when an action to terminate, change, reduce or deny  Contractor.  services is initiated by the provider service agency.  4.2. State General Fund Service Expenditure Reporting  4.2.1. 4.2.1.1. 4.2.1.2. 4.2.2.  Contractor shall report all State SLS, FSSP, and OBRA-SS direct service expenditures on the template provided by the Department. All services must be reported and reimbursed within DELIVERABLE: State General Fund Program Service Expenditure Reports DUE: Monthly, by the 15th of each month or Fiscal Year end close date determined by Adjustments to direct service expenditures must be added to the next direct service expenditure report submitted by Contractor at the time of discovery. If the adjustment is identified after the close oft the fiscal year the service is rendered, Contractor must report the adjustment to the Department within 101 Business Days of discovery and a check must be sent to the Department with the amount of the overpayment in addition to details about the overpayment to include member name, program, services, and dollar amount. Contractor shall verify all services are supported with required documentation as required in 10 C.C.R. 2505-10 Sections 8.7560 et seq., 8.7561 et seq., and 8.7202.V et seq.  the fiscal year the service is provided.  the Department for the month ofJune.  4.2.3.  4.3. State Supported Living Services (State SLS)  4.3.1. 4.3.1.1. 4.3.1.2. 4.3.1.3. 4.3.1.4.  General Requirements 8.7560et seq.  Contractor shall operate the State SLS program pursuant to 10 C.C.R. 2505-10 Section Contractor shall not add surcharges to the purchase of covered services for State SLS. Contractor shall provide a list of qualified providers for all services to Members and families, during the State SLS Individual Support Plan process, and to other interested Contractor shall provide or coordinate with local service providers toj provide community services to individuals enrolled in State SLS who meet the intellectual and developmental disabilities criteria and the eligibility requirements for the specific program required in The Department will notify Contractor of the target number of individuals that shall be served through State SLS prior to the start of each State Fiscal Year (SFY). Contractor may choose to enroll more individuals in State SLS than authorized, ensuring all individuals can be served within thei funding allocated. Target caseload is calculated using the unique number of members that receive direct services during the contract period. Contractor shall determine eligibility for the State SLS program pursuant to 10 C.R.S.  parties upon request.  10 C.C.R. 2505-10 Section 8.7560 et seq.  4.3.1.5.  4.3.2. 4.3.2.1. Exhibit] B-1, SOW  State SLS Eligibility  2505-10 Section 8.7560.B et seq.  Page 30of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  4.3.2.2. 4.3.3. 4.3.3.1. 4.3.3.2.  Eligibility for the State SLS program does not guarantee the availability of services and  supports.  State SLS Individual Support Plans a State SLS ISP.  Pursuant to 10C.R.S. 2505-10 Section 8.7560.D et seq. all State SLS Members must have Contractor shall develop a State SLS Individual Support Plan (State SLS ISP) within 10 Business Days after an: initial Individual Support Plan (ISP) meeting for thosei individuals not established with Contractor and with a Developmental Disability determination at time of referral. Contractor shall have up to 10 Business Days to complete additional meetings and/or assessments that allow for the creation of the State SLS ISP during this time. Contractor shall ensure the State SLS ISP is signed by all required parties prior to The State SLS ISP shall be developed through an in-person meeting that includes, at a Contractor shall utilize the ISP within the Department's prescribed system. Contractor shall document and finalize all ISP information int thel Department's prescribed system within 10 Business Days of the date oft the initial ISP meeting. PERFORMANCE STANDARD: Contractor shall ensure that 100% of the State SLS ISPs are developed within 101 Business Days oflheindvdualsreiemal to a State The State SLS ISP shall be effective for no more than one year and reviewed by Contractor at least every six months in an in-person monitoring contact. Ifan individual seeks additional supports or alleges a change in need, Contractor shall review and update the ISP prior to changing the authorized services and supports. Contractor shall utilize appropriated funds to perform Case Management duties in  implementation.  4.3.3.3. 4.3.3.4. 4.3.3.5. 4.3.3.5.1. 4.3.3.6. 4.3.3.7. 4.3.4. 4.3.4.1. 4.3.4.1.1. 4.3.4.1.2. 4.3.4.1.3. 4.3.4.1.4. 4.3.4.1.5. 4.3.4.1.6. 4.3.4.1.7. 4.3.4.1.8. 4.3.4.1.9. 4.3.4.1.10. Exhibit B-1,SOW  minimum, the individual seeking services and Contractor.  General Fund program or after the initial ISP meeting.  State SLS Ongoing Case Management  accordance with 10 C.C.R. 2505-10 Section 8.7560.E ets seq.:  Intake and referral. Determining program eligibility.  Supporting individuals with learning and accessing other community resources. Maintaining the determination of eligibility for services and supports. Providing service and support authorization and coordination. Case Management, policy, and regulation training.  Developing a State SLS Individual Support Plan.  Program transition coordination. Service records maintenance. Utilization review.  Page 31 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  4.3.4.2. 4.3.4.3. 4.3.4.4. 4.3.4.4.1.  Contractor shall document all ongoing case management activities in detail in the Department's prescribed system within 10 Business Days oft the activity. The use of mass email communication, robotic and/or automatic voice messages cannot be used to replace Contractor'si required individualized case management activities.  State SLS Monitoring  State SLS Monitoring shall be person centered and include at least one in person contact with the Member and three additional monitoring contacts per year using the individual's selected modality; in person or virtual and should be discussed and The Member's selected modality must be documented within the case notes for each monitoring contact within the Department's prescribed system. State SLS Monitoring activities shall include, but not be limited to:  determined based on Member preference and need.  4.3.4.4.1.1. 4.3.4.4.2. 4.3.4.4.2.1. 4.3.4.4.2.2. 4.3.4.4.2.3. 4.3.4.4.2.4. 4.3.4.4.2.5. 4.3.4.4.2.6. 4.3.4.4.3. 4.3.4.4.3.1. 4.3.4.5. 4.3.4.5.1. 4.3.4.6. 4.3.4.6.1.  Monitoring all services and supports delivered pursuant to the State SLS Assessing the effectiveness oft the State SLS supports and services. Assessing if additional State SLS supports and services are needed. Support in assessing ift the individual has become eligible for any other resources including community resources and other Medicaid resources.  Individual Support Plan.  Reviewing health and safety concerns. Reviewing any Critical Incidents.  Contractor shall document all monitoring activities in detail in the Department's PERFORMANCE STANDARD: 1009ofmonitoring activities shall occur at the  prescribed system within 10 Business Days oft the activity.  required quarterly interval.  State SLS Transfers  Contractor shall manage State SLS transfers in accordance with 10 C.R.S 2505-10  Section 8.7560.F et seq. State SLS Direct Services  Contractor shall utilize appropriated funds to provide or subcontract with providers to provide services to support individuals with an intellectual and developmental disability living in the community in accordance with 10 C.C.R. 2505-10 Section  8.7560.H.  4.3.4.7. 4.3.4.7.1. 4.3.4.7.2.  State SLS Records Maintenance  Contractor shall maintain supporting documentation capable of substantiating all expenditures and shall make it available to the Department upon request as required Receipts, invoices, and service logs must contain, at a minimum: Member name, service description, provider name, first and/or last date of service, service rate, and  in1 10C.C.R. 2505-10 Section 8.7560.H et seq.  amount due or paid.  Exhibit B-1, SOW  Page 32 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  4.3.4.7.3. 4.3.4.7.4. 4.3.4.7.5. 4.3.4.7.6. 4.3.4.7.7.  IfContractor does not maintain supporting documentation in the required format for all services rendered, the Department may recover these funds pursuant to 10C.C.R. Through ongoing monitoring, Contractor shall ensure all services reimbursed by Contractor are rendered by service providers in accordance with the State SLS Contractor shall attempt to resolve any discrepancies with the service provider Contractor shall notify the Department of any instances ofs suspected fraud or waste, Contractor shall notify all service providers that all records and supporting documentation related to services rendered through State SLS are subject to inspection and recovery by the Department pursuant to 10 C.C.R, 2505-10 Section  2505-10 Section 8.076 et seq. Individual Support Plan.  directly.  and any supporting documentation at the time ofdiscovery.  8.076 et seq.  4.4. Omnibus Budget Reconciliation Act of 1987 Specialized Services (OBRA-SS)  4.4.1.  Contractor shall provide or arrange for the provision of OBRA-SS to any individual where the Pre-Admission Screening and Resident Review (PASRR) Level II Evaluation identified the need for placement into a nursing facility and need for additional specialized services. Contractor shall ensure the OBRA-SS being provided are listed on the individual's Notice of Determination (NOD). Contractor shall ensure that OBRA-SS are related to the individual's intellectual or developmental disability or related condition and individualized to the  resident's needs. PASRR Level III Evaluation  4.4.2. 4.4.2.1, 4.4.3. 4.4.3.1. 4.4.3.2.  Contractor will review the PASRR Level II Evaluations received from the Skilled Nursing Facility or State appointed vendor prior to developing an OBRA-SS Individual  Support Plan or providing services. Maintaining Eligibility and Enrollment  Contractor shall enroll individuals into OBRA-SS, if the individual resides in a nursing Upon approval of the nursing facility admission by the State Intellectual Disability Authority and receipt ofthel Final Notice ofl Determination, Contractor shall sendi referrals toj providers for OBRA-SS within 10 Business Days from the date the PASRR Notice of Determination is issued and/or received from the Skilled Nursing Facility or State Contractor shall maintain Member records within the Department prescribed system. All changes to OBRA-SS enrollments, shall be entered into the Department prescribed system within 10 Business Days of the change. The Department may adjust the number of authorized enrollments based on fluctuating enrollments. If the individual does not receive OBRA-SS within one calendar month Contractor shall inactivate the individual's  facility, demonstrates ai need, and agrees to receive services.  appointed vendor.  4.4.3.3.  record in the Department prescribed system. OBRA-SS Individual Support Plans  4.4.4. Exhibit B-1, SOW  Page 33 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  4.4.4.1.  Contractor shall develop an OBRA-SS Individual Support Plan (ISP) within 10 Business Days after an initial ISP meeting for those individuals not established with Contractor and with a Developmental. Disability determination at time of referral. Contractor shall have up to 10 Business Days to complete additional meetings and/or assessments that allow for the creation of the OBRA-SS ISP during this time. Contractor shall ensure the OBRA-SS ISP is signed by all required parties prior to implementation. The OBRA-SS ISP shall be developed through an in-person meeting that includes, at a minimum, the individual seeking services and Contractor. Contractor shall utilize the ISP template within the Department's prescribed System. Contractor shall document and finalize alll ISPi information int the Department'sp prescribed system within 10 Business Days of the date of the initial ISP meeting. PERFORMANCE STANDARD: Contractor shall ensure that 100% of the OBRA- SS Individual Support Plans are developed within 10 Business Days of the individual's referral to a State General Fund program or after the initial ISP meeting. The OBRA ISP shall be effective for no more than one year and reviewed by Contractor Ifan member seeks additional supports or alleges a change ini need, Contractor shall review and update the ISP prior to changing the authorized services and supports. Contractor shall maintain all OBRA-SS ISPs and supporting documentation and make  4.4.4.2. 4.4.4.3. 4.4.4.4. 4.4.4.4.1. 4.4.4.5. 4.4.4.6. 4.4.4.7. 4.4.5. 4.4.5.1. 4.4.5.1.1. 4.4.5.1.2. 4.4.5.1.3. 4.4.5.1.4. 4.4.5.1.5. 4.4.5.1.6. 4.4.5.1.7. 4.4.5.1.8. 4.4.5.1.9. 4.4.5.1.10.. 4.4.5.2. 4.4.5.3.  at least every six months in an in-person monitoring contact.  them available to the Department upon request. OBRA-SS Ongoing Case Management  Contractor shall utilize appropriated funds to perform Case Management duties to  include:  Intake and referral.  Verifying a PASRR Level III Evaluation and Skilled Nursing Facility residency. Maintaining the determination of eligibility for services and supports. Providing service and support authorization and coordination.  Developing an OBRA-SS Individual Support Plan.  Ensuring there is not a duplication of authorized services with the services provided  in the nursing facility. Program transition coordination. Service records maintenance. Utilization review.  Case Management, policy, and regulation training.  Contractor shall document all ongoing case management activities in detail in the Department's prescribed system within 10 Business Days oft the activity. The use of mass email communication, robotic and/or automatic voice messages cannot be used to replace Contractor'srequired individualized case management activities.  Exhibit) B-1, SOW  Page 340 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  4.4.6. 4.4.6.1.1.  OBRA-SS: Monitoring  Monitoring shall be person centered and include at least one in person contact with the Member and three additional monitoring contacts per year using the individual's selected modality; in person or virtual and should be discussed and determined based on Member preference and need. The Member's selected modality must be documented within the narrative for each monitoring contact within the Department's  prescribed system.  4.4.6.2. 4.4.6.2.1. 4.4.6.2.2. 4.4.6.2.3. 4.4.6.2.4. 4.4.6.2.5. 4.4.6.2.6. 4.4.6.3. 4.4.6.3.1. 4.4.7. 4.4.7.1.  Monitoring activities shall include but not be limited to:  Monitoring all services and supports delivered pursuant to the OBRA-SS ISP.  Assessing the effectiveness of the supports and services. Assessing if additional supports and services are needed. including community resources or other Medicaid resources.  Support in assessing if the individual has become eligible for any other resources  Reviewing health and safety concerns. Reviewing any Critical Incidents.  Contractor shall document all monitoring activities in detail in the Department's PERFORMANCE STANDARD: 100% of monitoring activities shall occur at the  prescribed system within 10 Business Days oft the activity.  required quarterly interval. OBRA-SS Direct Services  Contractor shall not utilize OBRA-SS funds to purchase mental health related services. Contractor shall seek provision of, or payment for, mental health services for those individuals through the Medicaid-funded mental health system or other local sources of Contractor shall not utilize or authorize OBRA-SS funds to provide or purchase services Contractor shall utilize appropriated funds to provide services or coordinate with a provider to support individuals with intellectual and developmental disabilities living in a nursing facility. Contractor shall not utilize funding for services that are provided by the Nursing Facility through Medicaid reimbursement. Services eligible through OBRA  funding.  4.4.7.2. 4.4.7.3.  and supports that are covered and provided by the nursing facility.  include:  4.4.7.3.1. 4.4.7.3.2. 4.4.7.3.3. 4.4.7.3.4. 4.4.7.3.5. 4.4.7.3.6. 4.4.7.3.7. Exhibit B-1, SOW  Assistive Technology Behavioral Consultation Behavioral Line Services Behavioral Counseling Behavioral Counseling Group Behavioral Plan Assessment Day Habilitation - Specialized Habilitation  Page 35of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  4.4.7.3.8. 4.4.7.3.9. 4.4.7.3.10. 4.4.7.3.11. 4.4.7.3.12. 4.4.7.3.13. 4.4.7.3.14. 4.4.7.3.15. 4.4.7.3.16. 4.4.7.3.17. 4.4.7.3.18. 4.4.7.3.19. 4.4.7.3.20. 4.4.7.4. 4.4.8. 4.4.8.1. 4.4.8.1.1. 4.4.8.2. 4.4.8.3. 4.4.8.4. 4.4.8.5. 4.4.8.6. 4.4.8.7. 4.4.8.7.1.  Day Habilitation - Supported Community Connections  Dental - Basic Dental-I Major Mileage  Other Public Conveyance Prevocational Services Recreational Facility Fees/Passes Job Coaching - Individual Job Coaching - Group Job Development - Individual Job Development - Group Job Placement Vision  Services must be provided in accordance with the service definitions found in 10C.C.R.  2505-10 Section 8.7500 et seq. OBRA-SS Records Maintenance  Contractor shall maintain supporting documentation capable of substantiating all expenditures and shall make it availablet to the Department upon request as required in 10 Receipts ori invoices must contain, at ai minimum: Member name, service description, provider name, first and/or last date ofs service, service rate, and amount due or paid. IfContractor does not maintain supporting documentation in the required format for all services rendered, the Department may recover these funds pursuant to 10C.C.R. 2505- Through ongoing monitoring, Contractor shall ensure all services reimbursed by Contractor are rendered by service providers in accordance with the OBRA-SS Individual Contractor shall attempt to resolve any discrepancies with the service provider directly. Contractor shall notify the Department of any instances of suspected fraud and any Contractor shall notify all service providers that all records and supporting documentation related to services rendered through OBRA-SS are subject to inspection and recovery by  C.C.R. 2505-10 Section 8.130.2 et seq.  10 Section 8.076 et seq. Support Plan.  supporting documentation at the time of discovery.  the Department pursuant to 10 C.C.R. 2505-10 Section 8.076 et seq.  Mental Health Services Prohibited  Contractor shall not utilize state funds to purchase mental health related services for individuals with intellectual disabilities who are Medicaid eligible and who also have  al Medicaid covered mental health diagnosis.  Exhibit) B-1, SOW  Page 360 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  4.4.8.7.2.  Contractor shall seek provision of, or payment for, mental health services for those individuals through the Medicaid funded mental health system or other local sources  offunding.  4.5. Family Support Services Program (FSSP)  4.5.1. 4.5.2. 4.5.2.1. 4.5.2.2.  Contractor shall administer and provide or purchase Family Support Services pursuant to  $25.5-10-305, C.R.S. and 10 C.C.R. 2505-10 Section 8.7561 et seq. Eligibility, Needs Assessment, and Prioritization of Families  Contractor shall determine individual eligibility for the FSSP pursuant to 10 C.R.S 2505- After FSSP eligibility has been determined, Contractor shall conduct an FSSP Needs Assessment prior to authorizing services. Contractor shall develop a Needs Assessment Tool that is, at a minimum, inclusive of all requirements outlined in 10 C.C.R 2505-10 Section 8.7561.F and have documented scoring criteria for the tool. The tool shall be DELIVERABLE: Needs Assessment Tool Template and Scoring Criteria  10 Section 8.7561.C.  included in Contractor's policies and procedures. DUE: Annually, by August 15th  4.5.2.2.1. 4.5.2.2.2. 4.5.2.3. 4.5.2.4. 4.5.2.5. 4.5.2.6. 4.5.2.7.  Any revisions to the needs assessment tool template and scoring criteria must be submitted to the Department within 10 Business Days of the updated tool being Contractor shall assess all families, both on the waiting list as "As Soon as Available" and currently receiving FSSP services, for level ofneed on an annual basis in accordance Contractor shall document all completed FSSP Needs Assessments within the Department's prescribed system within 10 Business Days of completion of the Contractor shall maintain all Needs Assessment documentation and make it available to The Department will notify Contractor of the target number of individuals that shall be served through FSSP prior to the start of each State Fiscal Year (SFY). Contractor may choose to enroll more individuals in FSSP than targeted, ensuring all individuals can be served within the funding allocated. Target caseload is calculated using the unique number of members that receive direct services during the contract period.  implemented.  with 10 CCR2 2505 Section 8.7561.F et seq.  assessment.  the Department upon request.  4.5.3. 4.5.3.1.  Family Support Plans (FSP)  Contractor shall ensure that individuals and families enrolled in the FSSP have an individualized Family Support Plan (FSP) which meets the requirements of an Individualized Plan, as defined in Section 25.5-10-202 et seq. and 25.5-10-211 C.R.S Contractor shall develop the FSP within 10 Business Days after an initial Individualized Support Plan (ISP) meeting for thosei individuals not established with Contractor and with a Developmental Disability or Delay Determination at the time of referral. Contractor shall ensure the FSP is signed by all required parties prior to implementation.  prior to receiving services.  4.5.3.2.  Exhibit B-1, SOW  Page 37of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  4.5.3.3. 4.5.3.3.1. 4.5.3.4. 4.5.3.5. 4.5.3.6. 4.5.4. 4.5.4.1.  The FSP shall be developed through by, at a minimum, a family representative, and Contractor shall ensure that FSPs are developed within 10 Business Days oft the Most  Contractor.  in Need Assessment being authorized. The FSP shall be effective for no more than one year.  If the Member seeks additional supports or alleges a change in need, Contractor shall review and update the FSP prior to changing the authorized services and supports. Contractor shall document and finalize all FSP information in the Department's prescribed system within 10 Business Days of the initial FSP meeting.  FSSP Ongoing Case Management  Pursuant to 10 C.R.S 2505-10 Section 8.7561.G Contractor shall provide case management for the FSSP, to include coordination of services provided for individuals with an IDD or Developmental Delay that consists of facilitating enrollment, assessing needs, locating, coordinating, and monitoring needed FSSP funded services, and monitoring the effective and efficient provision of services across multiple funding Contractor shall not charge families to provide direct services and case management for Contractor shall provide a list ofqualified providers for appropriate services to applicants, Member(s), and families, during the individualized planning process, and to other Contractor shall utilize appropriated funds to perform case management duties in Development, application assistance, and annual re-evaluation oft the Family Support Plan (FSP) which shall be conducted at least once per year and include making Providing service authorization and support coordination toi include but notl limited to Ensuring all services and supports are delivered in accordance with the FSP. Coordinating with families to obtain required documentation for services. Supporting the individual in assessing eligibility for other community and/or  sources.  4.5.4.2. 4.5.4.3. 4.5.4.4. 4.5.4.4.1. 4.5.4.4.2. 4.5.4.4.3. 4.5.4.4.4. 4.5.4.4.5. 4.5.4.4.6. 4.5.4.4.7. 4.5.4.4.8. 4.5.4.4.9. 4.5.4.5.  Family Support Services.  interested parties upon request.  accordance with 10 CCR2505 8.7561.G et seq. to include:  changes to the FSP as indicated.  assessing the effectiveness ofFSSP supports and services.  Medicaid resources. Program transition coordination. Service records maintenance. Utilization review.  Case Management, policy, and regulation training.  Contractor shall document all ongoing case management activities in detail in the Department's prescribed system within 10 Business Days oft the activity.  Exhibit B-1,SOW  Page 38 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  4.5.4.6. 4.5.5. 4.5.5.1.  The use of mass email communication, robotic and/or automatic voice messages cannot be used to replace Contractor's required individualized case management activities. Contractor shall utilize appropriated FSSP funds to purchase services and/or reimburse or advance funds to families for expenses that are incurred as a result of supporting the family and/or individual with an intellectual or developmental disability or delay living Contractor shall only authorize and advance or reimburse services that are needed as a result of the individual's Intellectual and Developmental Disability or Developmental Delay and shall not be approved ifthe need is a typical age-related need. The correlation Contractor shall ensure that all services are provided in the most cost-effective manner, Contractor shall ensure that all services are authorized pursuant to the FSP. Contractor shall utilize FSSP funds toj provide funding toi families for expenses referenced in $25.5-10-305(a-), C.R.S and 10C.R.S. 2505-10 Section 8.7561.D Contractor shall not authorize or provide any service that is not outlined in these regulations. Contractor shall ensure the authorized services through FSSP are not duplicative of other resources the family has access to, including HCBS waivers, third party insurance, etc. Contractor shall prioritize funding for the FSSP pursuant to 10 C.R.S 2505-10 Section  FSSP Direct Services  in the family home.  4.5.5.2.  between the need and the disability must be documented in the FSP. meaning the least expensive manner to meet the need.  4.5.5.3. 4.5.5.4. 4.5.5.5.  4.5.5.6. 4.5.5.7. 4.5.6. 4.5.6.1. 4.5.6.2. 4.5.6.3. 4.5.6.3.1. 4.5.6.3.2. 4.5.6.4. 4.5.6.4.1. 4.5.6.4.2. 4.5.6.5.  8.7561.F et seq. Family Support Council  Contractor shall establish and maintain a Family Support Council (FSC) pursuant to $25.5-10-304 et seq., C.R.S. and 100 C.C.R. 2505-10 Section 8.7561.B et seq. Contractor shall ensure that the FSC is comprised primarily of individuals in services, family members, and guardians ofindividuals enrolled in FSSP. Contractor shall submit a list ofFSC members annually. DELIVERABLE: FSC Member List DUE: Annually, by August 15th  Contractor shall notify the Department in writing of any changes to the FSC within 10  Business Days.  DELIVERABLE: FSCI Member Updates  DUE: Within 10 Business Days oft the date of change to the FSC members Contractor shall provide orientation and training to all FSC members on the duties and responsibilities of the FSC. The training and orientation shall be documented with a record ofthe date oft the training, who provided the training, training topic, and names of attendees. Contractor shall make the training and orientation materials available to the  Department upon request.  Exhibit B-1, SOW  Page3 39of53    Docusign Envelope ID: D8DAB89670844F7D.958P.CATIDABASES  4.5.6.6.  Contractor shall ensure the FSC fulfills all duties outlined in 10 C.C.R. 2505-10 Section 8.7561.B et seq. Contractor shall document the meeting minutes and submit them to the Department. Contractor shall maintain all supporting documentation related to an FSC  meeting and make it available to the Department upon request. DELIVERABLE: FSCI Meeting Minutes DUE: Monthly, by the 15thd ofeach month and by June 30th  4.5.6.6.1. 4.5.6.6.2. 4.5.7. 4.5.7.1. 4.5.7.2. 4.5.7.2.1. 4.5.7.2.2. 4.5.8. 4.5.8.1.  FSSP Evaluation  In coordination with the FSC, Contractor shall be responsible for evaluating the effectiveness oft the FSSP on an annual basis. Contractor shall ensure the annual program evaluation addresses all areas required in 10 CCR 2505-10 Section 8.7561.I ets seq. Contractor shall provide the Annual Evaluation Report to the Department for review and  approval.  DELIVERABLE: Annual Evaluation Report DUE: Annually, by June 1st FSSP Annual Program Report  Contractor shall create and submit an FSSP Annual Program Report to the Department. The FSSP Program Report shall contain all requirements outlined in 10 CCR 2505-10 Section 8.7561.K et seq. Council member signatures approving the report must be submitted as a separate attachment to the Annual Program Report. Contractor must ensure Contractor shall provide the FFS Program Report to the Department for review and DELIVERABLE: FSSP Annual Program Report and Council Signature Page  the Annual Program Report does not contain Member PHI.  4.5.8.2. 4.5.8.2.1. 4.5.8.2.2. 4.5.9. 4.5.9.1. 4.5.9.2. 4.5.9.2.1. 4.5.9.2.1.1. 4.5.9.3. 4.5.9.3.1.  approval.  DUE: Annually, by October 1st  FSSP Records Maintenance  Contractor shall maintain supporting documentation capable of substantiating all expenditures and reimbursements made to providers, Members and/or families. When Contractor purchases services or items directly for Members and/or families, Maintain receipts or invoices from the service provider and documentation Receipts or invoices must contain, at a minimum: Member and/or family name, provider name, first and/or last date of service, item(s) or service(s) purchased, When Contractor reimburses Members and/or families for services or items, Contractor Ensure the Member and/or family provides Contractor with receipts or invoices prior  Contractor shall:  demonstrating that the provider was paid by Contractor.  item(s) or service(s) cost and amount due or paid.  shall:  to reimbursement.  Exhibit B-1, SOW  Page 40of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  4.5.9.3.1.1. 4.5.9.3.2. 4.5.9.4. 4.5.9.4.1.  Maintain receipts or invoices from the Member and/or family, and documentation demonstrating that the individual and/or family was reimbursed by Contractor. Ensure all receipts or invoices provided by the Members and/or family contain, at a minimum: Member and/or family name, provider name, first and/or last date of service, item(s) or service(s) purchased, items(s) or service(s) cost, and amount paid. When Contractor provides funding to Members and/or families for the purchase of services or items in advance, Contractor shall include, buti is not limited to: Establish policies and procedures outlining Contractor's processes for advancing funds, ensuring supporting documentation is received by the Member and/or family, and remedial action steps Contractor will take if supporting documentation is not received. The policies and procedures shall identify timelines and shall be made Notify the Member and/or family that they are required to submit invoices or receipts to Contractor ofall purchases made prior to the close oft the State Fiscal Year. Ensure the Member and/or family provides Contractor with receipts or invoices. Maintain receipts or invoices from the Members and/or family, and documentation demonstrating that the Members and/or family was provided with advanced funds by Ensure all receipts ori invoices provided by the Members and/or family contain, at ai minimum: Members and/or family name, provider name, first and/or last date ofservice, item(s) or service(s) purchased, items(s) or service(s) cost, and amount Contractor shall ensure the documentation received by the Member and/or family Ifal Member and/or family does not submit invoices or receipts, Contractor shall document all attempts to obtain receipts or paid invoices and any remedial action taken. Contractor shall make all supporting documentation available to the If Contractor cannot provide supporting documentation as described in this section, the Department may recover any unsubstantiated expenditure from Contractor. Contractor shall ensure supporting documentation is recorded for all FSSP dollars for multiple family services to include a detailed description of the service provided and the Contractor shall ensure all program expenses related to multiple family expenses can be substantiated through time tracking, wage costs, benefit costs, or any other supporting documentation to verify expenses related to proving the services.  available to the Department upon request.  4.5.9.4.2. 4.5.9.4.3. 4.5.9.4.4. 4.5.9.4.4.1.  Contractor.  paid.  4.5.9.4.5. 4.5.9.4.6.  indicates that the amount was paid.  Department upon request.  4.5.9.4.7. 4.5.9.5. 4.5.9.5.1.  date(s) ofs service.  5. DATA ENTRY, DATA MONITORING, AND OVERSIGHT  5.1. Individua/Member Records  5.1.1. 5.1.1.1. Exhibit B-1, SOW  Contractor shall:  Comply with all reporting and billing policies and procedures established by the Department, document individual and Member records within the Department's  Page 41 of53    Docusign Envelope ID: 08D4B89670844F7D.958P.CAIIDABASES  prescribed systems and adhere to the system requirements provided by the Department for these systems. Systems include, but are not limited to, the Colorado interChange Medicaid Management Information System (MMIS) and its subsystems: Bridge HCBS PAR subsystem and the Care and Case Management (CCM) System. Contractor shall have access to member eligibility, PAR, and claims data through reporting provided Maintain individual and Member records within the Department's prescribed systems for Maintain accurate and detailed documentation ofall case management and State General Maintain accurate and detailed supporting documentation of all activities required through this Contract to substantiate reimbursement and make all documentation available to the Department upon request if not documented within the Department's Correct 100% of data errors discovered by the Department and confirm the accuracy of the data entered into the Department prescribed system within 10 Business Days of PERFORMANCE STANDARD: 100% of data errors corrected within 10 Business Develop and implement a plan to conduct, at minimum, an annual data integrity review. Member program records completeness and açcuracy as directed by the Department. Member care team provider and team staffaccuracy and completeness, as directed by DELIVERABLE: Data Integrity and Data Quality Policies and Procedures DUE: Annually, October 1st after the Contract Start Date or within 10 Business Days as  through a COGNOS data query application.  5.1.1.2. 5.1.1.3. 5.1.1.4.  the purposes ofindividual and Member information management. Fund Program activities required through the Contract.  prescribed systems.  5.1.1.5. 5.1.1.5.1. 5.1.1.6. 5.1.1.6.1. 5.1.1.6.2. 5.1.1.6.3. 5.1.1.7. 5.1.1.8.  notification from the Department of an error.  Days ofnotification.  That includes, but is not limited to, the following:  Member demographic information completeness and accuracy.  the Department.  revisions are made.  5.2. Systems Access and' Training  5.2.1. 5.2.1.1. 5.2.1.2. 5.2.1.3. 5.2.1.4.  Contractor shall develop and implement policies and procedures to internally oversee data integrity and data quality to include but not limited to! how Contractor will: Ensure all staffr receive the required systems training as specified in this Contract. Bei responsible for management of user access and timelyrevocation for required systems Ensure all provision forms are reviewed and submitted accurately and completely within at least 14 Calendar Days prior to needing access. Any forms submitted without all Ensure all revocation forms are submitted immediately upon knowledge ofl license user's  toi include the CCM, MMIS, Bridge, COGNOS, and PeakPro. necessary information are subject to resubmission and delay.  separation of employment.  Exhibit B-1,SOW  Page 42of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  5.2.1.5.  Conduct an internal audit of all provisioned user licenses monthly or quarterly to ensure that the list of users is up to date, permissions are accurate, and revocation forms are  submitted in a timely manner.  6. ACCOUNTING  6.1. Contractor's accounting methods shall conform to the standards of Generally Accepted Accounting Principles (GAAP), and any updates thereto, throughout the Term oft the Contract. 6.2. Contractor shall establish and maintain internal control systems and standards that apply to the 6.3. Contractor shall assure, all financial documents are filed in a systematic manner to facilitate audits, all prior years' expenditure documents are maintained for use in the budgeting process and for audits, and records and source documents are made available to the Department, its contracted representative, or an independent auditor for inspection, audit, or reproduction. 6.4. Contractor shall establish any necessary cost accounting systems to identify the application of 6.5. Contractor shall document all transactions and funding sources, and this documentation shall be available for examination by the Department within 10 Business Days of the Department's  operation of the organization.  funds and record the amounts spent.  request. 6.5.1. 6.5.2.  DELIVERABLE: Transaction and Funds Documentation DUE: Within 10 Business Days oft the Department's Request  7. SUBRECIPIENT STATUS AND REQUIREMENIS  7.1. Contractor has been determined tol be a Subrecipient under 2 CFR ChapterI, Chapter II, Part 200 eta al. Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal. Awards (Uniform Guidance); Finall Rule (the "Final Rule"), released! December 26, 2013, and subsequently updated, and thus shall be required to follow all requirements and guidance  contained in the Final Rule.  7.2. Single Audits 7.2.1.  Under the Final Rule, all Non-Federal Entities, as defined in the Final Rule, expending $1,000,000.00 or more from all federal sources (direct or from pass-through entities) must have a single or program-specific audit conducted for that year in accordance with Subpart F Contractor shall notify the State when expected or actual expenditures of federal assistance Ift the expected or actual expenditures of federal assistance from all sources do not equal or exceed $1,00,000.00 Contractor shall provide an attestation to the State that they do not Pursuant to thel Final Rule $200.512 (a)(1) the Single Audit must be completed and submitted tot the Department within the earlier of 30 Calendar Days after receipt of the auditor's report(s), or nine months after the end oft the audit period. Ift the due date falls on a Saturday, Sunday, or federal holiday, the reporting package is due the next Business Day.  oft the Final Rule.  7.2.2. 7.2.3. 7.2.4.  from all sources equal or exceed $1,000,000.00.  qualify for a Single Audit.  7.2.4.1. Exhibit B-1, SOW  DELIVERABLE: Single Audit  Page 43 of53    Docusign Envelope ID: 08D4B89670844F7D.95FP.CATDABAJES  7.2.4.2. 7.2.5. 7.2.5.1. 7.2.5.2. 7.2.6. 7.3.1. 7.3.1.1. 7.3.1.2.  DUE: Within the earlier of 30 Calendar Days after receipt of the auditor's report(s), or IfContractor did not receive enough federal funds to require a Single Audit, Contractor shall submit an attestation form stating a Single Audit was not required utilizing the Department's  nine months after the end of the audit period  template.  DELIVERABLE: Attestation Form nine months after the end of the audit period The audit period shall be Contractor's fiscal year.  DUE: Within the earlier of 30 Calendar Days after receipt of the auditor's report(s), or  7.3. Treatment ofl Funds  All funding identified as a subaward with matching federal dollars received through this All subawards must be used on allowable expenses associated with performing the activities outlined in this Contract and on allowable expenses per Uniform Guidance. Any subawards not used on the activities outlined in this Contract is subject to recovery at the end oft the Period of Performance as identified by the Department.  Contract is subject to the requirements within Uniform Guidance.  7.4. Subcontracting Subawards  7.4.1.  Contractor shall ensure any Subcontractors performing activities outlined in this Contract on behalfofthe Contractor fulfill all obligations outlined within this Contract and all obligations  ofas subrecipient.  8. - FINANCIAL TRANSPARENCY  8.1. Contractor: shall comply with all transparency: requirements pursuant to C.R.S. Title 25.5-6-1708. 8.2. Contractor shall ensure: all documents are available on Contractor's website in an easilyaccessible  location and format. Board ofl Director or Governing Body Changes  8.2.1. 8.2.1.1. 8.2.1.2.  Contractor shall notify the Department in writing of any changes to the Board ofDirectors or DELIVERABLE: Written notification of changes to Board of Director or Governing  Governing Body within 10 Business Days.  Body membership  DUE: Within 10 Business Days oft the effective date  9. COMPENSATION AND INVOICING 9.1. State General Fund Program Allocations  9.1.1. 9.1.2. 9.1.3.  The Department will notify Contractor in writing of Contractor's individual allocation for Reimbursement for activities and services performed by Contractor shall not exceed the maximum amount identified in Contractor's individual allocation. Activities and services The Department, in its sole discretion, may increase or decrease Contractor's individual allocations under this Contract by notifying Contractor's Representative. Increases or decreases in the amount of State funding during the term of this Contract may be made by  State SLS, OBRA-SS, and FSSP for each State Fiscal Year.  must be rendered during the State Fiscal Year.  Exhibit tB-1,SOW  Page 44of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  written notice by the Department to Contractor or by amendment of the Contract. The  circumstances may include but shall not be limited to: Ifnecessary to fully utilize program appropriations.  9.1.3.1. 9.1.3.2. 9.1.3.3. 9.1.3.4. 9.1.3.5. 9.1.3.6. 9.1.3.7. 9.1.3.8. 9.2.1. 9.2.2. 9.2.3. 9.2.4.  Adjustments to reflect prior year final contract utilization and current year expenditures. Supplemental appropriation changes resulting in an increase or decrease in the amounts  originally appropriated and available for thej purposes oft this program. Closure ofprograms and/or termination of related contracts. Delay or difficulty in implementing new programs or services. Other special circumstances as deemed necessary by the Department.  Changes in Member utilization due to changing needs, new enrollments, terminations,  and/or delays in services. Target caseloads not being met.  9.2. State General Fund Program Target Caseloads  The Department will notify Contractor in writing of the target number of individuals that shall be served in State SLS, OBRA-SS, and FSSP prior to the start ofeach State Fiscal Year. Contractor may, choose to enroll more individuals in State SLS, OBRA-SS, and FSSP than authorized, ensuring all individuals can be served within the funding allocated. Target caseload is calculated by the Department using the unique number of members that Contractor shall enroll members into OBRA-SS ift the need for services is identified through the PASRR Level II and shall notify the Department ifs sufficient funding is not available in Contractor's individual allocation to support the individual's needs or to enroll a Member Contractor shall redirect unallocated funding from one State General Fund program to another to fully utilize funding allocated and best serve member needs within the Defined Service Area. Contractor shall notify the Department if Contractor cannot use all of the funding allocated for State General Fund programs or if Contractor has additional funding needs that could support Members with unmet needs during the Fiscal Year.  receive direct services during the contract period.  into the program.  9.2.5.  9.3. State General Fund Program Compensation  9.3.1.  The compensation under this Contract shall consist ofrates-based reimbursement intended to cover the costs of all State General Fund activities provided through this Contract. The Department shall pay Contractor for the State SLS and OBRA-SS activities at the rates specified in Exhibit C, Rates. Direct services for State SLS and OBRA-SS shall be reimbursed at the rates posted and distributed on the Department's website on the Provider Rates and Fee Schedule. The Department shall pay Contractor for FSSP activities at thei rates specified in Exhibit C, Rates. Direct services for FSSP shall be reimbursed at one dollar per The liability of the State, at any time, for such payment shall be limited to the unexpended  unit.  9.3.2.  amount remaining of such funds available to the Department.  Exhibit] B-1,SOW  Page 45of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  9.3.3.  Payments shall be made in accordance with rates as specified in Exhibit C, Rates of this Contract as determined by the Department and may be amended during the term of the contract using an Option Letter. When Contractor'sn maximum allocation of State funding has been paid to Contractor, no additional funds shall be provided under this Contract. Payment pursuant to this Contract is contingent upon Contractor, or subcontractor(s), securing and properly maintaining all necessary licenses, certifications, approvals, etc., required toj properly provide the services or goods covered by the contract. The rates specified in Exhibit C; Rates are determined by the approved appropriation from the Colorado General Assembly. The Department, at its discretion, shall have the option to increase or decrease these rates as the Department determines is necessary based on its approved appropriation or to correct an administrative error in rate calculations. To exercise this option, the Department shall provide written notice to Contractor in a form substantially similar to the Sample Option Letter int the original Contract, and any newi rates table or exhibit shall be effective as of the effective date of that notice unless the notice provides for a different date. The Department may modify the rates shown in this section based on the Medicaid Provider rate increases or decreases authorized by the Colorado legislature or due to an administrative error. If the Department does modify these rates, the Department may The rates for State SLS and OBRA-SS direct services will be posted on the Department's website on the Provider Rates and Fee Schedule. Contractor shall bill all FSSP direct services  9.3.4. 9.3.5.  modify them using an Option Letter.  9.3.6.  at one dollar per unit.  9.4. Adjustments to Fund Disbursement Amounts  9.4.1. 9.4.2. 9.5.1. 9.5.2. 9.5.2.1.  The Department reserves the right to adjust during the Contract period and post-period adjustment to disbursements following the end ofthe Contract period, or an adjustment tot the Contractor does not achieve the Performance Standards identified for each program. The compensation under this Contract shall consist ofrates-based reimbursement intended to  Fiscal Year contract if:  9.5. Case Management Agency Compensation  cover the costs of all activities provided through this Contract. Contractor will receive payment as specified in Exhibit C, Rates.  The rates specified in Exhibit C are determined by the approved appropriation from the Colorado General Assembly. The Department, at its discretion, shall have the option to increase or decrease these rates as the Department determines necessary based on its approved appropriation or to correct an administrative error in rate calculations. To exercise this option, the Department shall provide written notice to Contractor in a form substantially similar to the Sample Option Letter in the original Contract, and any new rates table or exhibit shall be effective as of the effective date of that notice unless the notice provides for a different date. The Department may modify the rates shown in this section based on the Medicaid Provider rate increases or decreases authorized by the Colorado legislature or due to an administrative error. If the Department does modify these rates, the Department may modify them through the use of an Option Letter.  9.6. Rural or Urban Designation  Exhibit B-1, SOW  Page 46of53    Docusign Envelope ID: 08D4B896/0B44F7D.958F-CATIDABSASES  9.6.1.  The Department shall determine whether Contractor is a Rural and Frontier or an Urban  agency.  9.7. Detailed Invoicing and Payment Procedures  9.7.1. 9.7.1.1,  Applications - HCBS-CES  Contractor shall submit all HCBS-CES applications to the Department's vendor for review and approval, as directed by the Department. The Department will pay: for initial application per person applying for HCBS-CES per year, as well as CSR HCBS-CES application each year thereafter. The Department will not pay for initial or CSR applications that were denied due to being incomplete. Incomplete applications include any application that did not contain: a signature page, a completed Level of Care, DD or Delay Determination date, dates of service, or partial application (missing pages) which are required from Contractor necessary to process the application. An incomplete application denial is different than a denial for the client not meeting nighttime and/or daytime criteria. The Department will pay for HCBS-CES applications from reports received by the Department's vendor on the 11th oft the month for assessments from the  previous month.  9.7.2. 9.7.2.1.  Appeal Packets and Hearing Attendance  Contractor shall ensure that all Appeal Packets and Hearing Attendance information is entered into the Department prescribed system within the required timeframe. The Department will pay for all Appeal Packets and Hearing Attendances from data pulled from the Department prescribed system on the 15th day of the month for Appeal Packets and Hearing Attendance from the previous month. Contractor shall maintain all  supporting documentation and packets related to all Appeals.  9.7.3. 9.7.3.1.  At-Risk Diversion  Contractor shall complete all At-Risk Diversion activities as required by the Department and shall invoice the Department for all completed contaçts by the 15th day ofthe month for all contacts completed in the previous month. The Department will pay for contacts once the invoice and supporting documentation is reviewed and accepted.  9.7.4. 9.7.4.1.  Case Management Training  Contractor shall submit the Case Management Training deliverable. Contractor will receive payment once the Department has reviewed and accepted the Deliverable. If the original submission is rejected by the Department, Contractor shall not receive payment until a revised deliverable has been received and accepted by the Department. Ifa case manager did not receive one or more of the required trainings prior to being assigned independent duties, Contractor shall not receive payment for the Deliverable until all trainings have been provided. Contractor shall have 30 Calendar Days to provide any  outstanding trainings and resubmit the Deliverable. Community. Advisory Committee Updates  9.7.5. 9.7.5.1.  Contractor shall submit the Committee Updates Deliverable. Contractor shall receive payment once the Department has reviewed and accepted the Deliverable. If the Deliverable shows that no committee meeting updates have been included, Contractor  shall not receive payment for the Deliverable. Complaint Log and' Trend Analysis  9.7.6. Exhibit B-1,SOW  Page 47of53    Docusign Envelope ID: 08D4B89670844F7D.95FP.CATIDABAJES  9.7.6.1.  Contractor shall submit a quarterly Complaint Log and Trend Analysis deliverable. Contractor will receive payment once the Department has reviewed and accepted the Deliverable. Ifthe original submission is rejected by the Department, Contractor shall not receive payment until a revised deliverable has been received and accepted by the  Department.  9.7.7. 9.7.7.1.  Community First Choice Training  Contractor shall receive a one-time payment for completing Community First Choice trainings as directed by the Department. The payment will be based on an allocation calculated' by the Department based on funding availability, thet time required fort training  completion, and the average number of case managers participating.  9.7.8. 9.7.8.1.  Continuous Quality Improvement Plan  Contractor shall submit the Continuous Quality Improvement Plan deliverable and updates. Contractor shall receive payment once the Department has reviewed and accepted the Deliverable. If the original submission is rejected by the Department, Contractor shall not receive payment until a revised deliverable has been received and Critical Incident Quarterly Follow-Up Completion and Entry Performance Standard Contractor is eligible to receive a quarterly performance-based payment for timely completion of the requested HCBS CIR follow-up action. To receive this quarterly performance-based payment, Contractor must have 90% ofall CIRS assigned follow-up completed and entered into the Department's prescribed system within the timelines assigned by the Department and/or Department Quality Improvement Organization. The Department will calculate Contractor's performance at the close of each quarter to determinei ifContractor will be awarded thej performance-based payment. HCBS and SGF  accepted by the Department.  9.7.9. 9.7.9.1.  CIRs will be calculated and paid separately.  9.7.10. Critical Incident Reports and Critical Incident Report Administrative Review: HCBS IDD  Waivers  9.7.10.1.  Contractor shall ensure all CIRs have been entered in the Department prescribed system within thei required timeframe. The Department willj payperMember enrolled eachi month based on actively enrolled Members pulled from the Department prescribed system on the 15th day of the month for HCBS-CES, HCBS-CHRP, HCBS-DD, and HCBS-SLS  enrollments from the previous month.  9.7.11. Critical Incident Reports: HCBS LTSS Waivers  9.7.11.1.  Contractor shall ensure all CIRs have been entered in the Department prescribed system within the required timeframe. The Department will pay per Member enrolled each month based on actively enrolled Members pulled from the Department prescribed system on the 15th day of the month for CHCBS, HCBS-BI, HCBS-CIH, HCBS-CLLI, HCBS-  CMHS, and HCBS-EBD. OBRA-SS, FSSP  9.7.12. Critical Incident Reporting and Critical Incident Report Administrative Review State SLS,  9.7.12.1.  Contractor shall ensure all CIRs have been entered in the Department prescribed system within the required timeframe. The Department will pay for all State SLS, OBRA-SS, and FSSP CIRs MANE and CIRs non-MANE based on data pulled from the  Exhibit) B-1, SOW  Page4 48of53    Docusign Envelope ID: 8D4B896-7084-4F7D-95BF-CA11DA86A3E9  Deparmentspreserbed system on the 15th day of the month for CIRS from the previous  month.  9.7.13. Developmental Disability and Delay Determinations  9.7.13.1.  Contractor shall input all disability determinations into the Department prescribed system within the required timeframes. The Department will pay disabliydeteminations, based on data pulled from the Department prescribed system on the 15th day of the month for  determinations from the previous month.  9.7.14. Direct Services: State SLS, OBRA-SS, FSSP  9.7.14.1.  Contractor shall submit the State General Fund program direct service expenditure report invoice: for all direct service expenditures for State SLS, OBRA-SS, and FSSP byt the 15th of each month. The Contract shall receive reimbursement for allowable direct services not to exceed maximum for State General Fund programs for all reimbursable activities  for the fiscal year.  9.7.15. Testing for IDD Determinations  9.7.15.1.  Contractor shall obtain prior approval from the Department for IDD Determination Testing funding by invoicing the Department each month for the costs of IDD Determination testing by the 15th day ofthe month. Ifapproved, the Department will pay for the actual cost oftesting once the request has been approved. and the invoice has been reviewed and accepted. All invoices shall be submitted in the format prescribed by the  Department.  9.7.16. Family Support Council Meetings  9.7.16.1,  Contractor shall submit meeting minutes to the Department for FSC meetings attended by the 15th day of the month for meetings attended in the previous month, and by June 30th or the Fiscal Year end close date determined by the Department for all meetings attended in June. The Department will pay for up to six FSC: meetings for the Designated Service Areas attended within the Fiscal Year once the invoice has been reviewed and accepted. Contractor shall maintain all supporting documentation related to an FSC  meeting and make it available to the Department upon request.  9.7.17. FSSP Annual Report  9.7.17.1.  Contractor shall submit an FSSP Report on an annual basis to the Department. Contractor shall receive payment for the Annual FSSP Report afteri it has been reviewed and accepted  by the Department.  9.7.18. FSSP Evaluation Report  9.7.18.1.  Contractor shall submit an FSSP Evaluation Report on an annual basis to the Department. Contractor shall receive payment for the FSSP Evaluation Report after it has been  reviewed and accepted by the Department.  9.7.19. HCBS-DD Waiting List Enrollment Capacity Building  9.7.19.1.  The Department will pay Contractor for each new member enrolled into the HCBS-DD waiver from the waiting list as authorized by the Department and as funding is appropriated and earmarked by the General Assembly. The Department will determine which HCBS-DD enrollments from the waiting list qualify for capacity building funding  as defined in this Contract.  Exhibit B-1, SOW  Page 49 of53    Docusign Envelope ID: 8DAB89670644F7D.958.CATIDABSAJES  9.7.20. Human Rights Committee: HCBS IDD Waivers  9.7.20.1.  Contractor shall create all HRCj packets in accordance with Department requirements and timeframes. Contractor shall maintain all supporting documentation related to a Human Rights Committee meeting and make it available to the Department upon request. The Department will pay per member enrolled each month based on actively enrolled members pulled from the Department prescribed system on the 15th day of the month for HCBS-CES, HCBS-CHRP, HCBS-DD, and HCBS-SLS enrollments from the previous  month.  9.7.21. Human Rights Committee Packet Creation: State SLS, OBRA-SS, FSSP  9.7.21.1.  Contractor shall invoice the Department for all State SLS, OBRA-SS, and FSSP member packets created during a Human Rights Committee meeting by the 15th day ofthe month for all meetings held in the previous month. The Department will pay for each packet created once the invoice has been reviewed and accepted. All invoices shall be submitted  in the: format prescribed by the Department.  9.7.22. Level of Care Screen: Initial and Reassessments  9.7.22.1.  Contractor shall conduct and enter all initial and reassessment Level ofCare Screens into the Department's) prescribed system within the required timeframes. The Department will pay for initial and reassessment Level of Care Screens based on data pulled from the Department's prescribed system on the 15th day of the month for Screens conducted in  the previous month.  9.7.23. Rapid Reintegration  9.7.23.1.  Contractor shall conduct and enter all Rapid Reintegration activities at the Level of Care Assessment into the Department's prescribed system within the required timeframes. The Department will pay for Rapid Reintegration based on an invoice template provided by the Department or data pulled from the Department's prescribed system on the 15th day of the month for Rapid Reintegration completed in the previous month. Rapid Reintegration shall include reimbursement for completing Rapid Reintegration barrier  questions, assessment and support, and post survey questions.  9.7.24. Long-Range Plan  9.7.24.1.  Contractor shall submit a Long-Range Plan on an annual basis and present it to the Department. Contractor shall receive payment for the Long-Range Plan after it has been  reviewed and accepted by the Department.  9.7.25. Monitoring Contacts: State SLS and OBRA-SS  9.7.25.1.  Contractor shall conduct and enter all monitoring contacts for State SLS and OBRA-SS into the Department's prescribed system within the required timeframe. Contractor shall receive payment for the four required monitoring contacts per service plan year. The Department will pay for monitoring contacts based on data pulled from the Department's prescribed system on the 15th day of the month for contacts conducted in the previous  month.  9.7.26. Most in Need Assessment: FSSP  9.7.26.1. Exhibit B-1,SOW  Contractor shall conduct and enter all completed Needs Assessments into the Department' s prescribed system within the required timeframe. Contractor shall receive  Page 50of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  payment for one. Needs Assessment for members enrolled or on the FSSP ASAA waiting list per fiscal year. The Department will pay for Needs Assessments each month based on data pulled from the Department's prescribed system on the 15th day oft the month for  assessments conducted in the previous month.  9.7.27. Needs Assessment: Initial and Reassessment  9.7.27.1.  Contractor shall conduct and enter all initial and reassessment Needs Assessments into the Department's prescribed system within the required timeframes. The Department will pay for initial and reassessment Needs Assessments based on data pulled from the Department's prescribed system on the 15th day of the month for assessments conducted  in the previous month.  9.7.28. Ongoing Case Management: State SLS, OBRA-SS, FSSP  9.7.28.1.  Contractor shall conduct and enter all ongoing case: management activities for State SLS, OBRA-SS, and FSSP into the Department's prescribed system within the required timeframe. Contractor shall receive one ongoing case management payment each month permember for allowable activities completed. The Department will pay for ongoing case management activities based on data pulled from the Department's S prescribed system on the 15th day oft the month for activities conducted in the previous month.  9.7.29. Operations Guide  9.7.29.1.  Contractor shall develop an Operations Guide that meets all: requirements outlined in this Contract for year one. Contractor shall receive payment for the Operations Guide once  the deliverable has been reviewed and accepted by the Department.  9.7.30. Operations Guide Updates  9.7.30.1.  Contractor shall review the Operations Guide for years two, three, four, and five of this Contract, and determine if any modifications are required. Updates shall include but not be limited to any changes in the Work, in the Department's s processes and procedures, or in Contractor's processes and procedures. Contractor shall submit the Annual Operations Guide Update as well as a summary of all changes to the Department or an explanation demonstrating that the Operations Guide was reviewed, and Contractor determined that no edits were necessary. The Department shall review the Operations Guide Update and the summary to determine whether significant modifications were completed. Contractor shall receive payment for the updated Operations Guide only after the Department has determined that significant changes were made, and the Department has accepted the Deliverable. Ifminor changes or no changes were completed Contractor shall not receive payment for this deliverable. The Department does not consider changes such as updating  dates, contact information or locations to be significant changes.  9.7.31. Rural Travel Add-On for Rural and Frontier Counties  9.7.31.1.  Contractor shall receive an additional payment for Rural Travel Add-On for Rural and Frontier Counties for the following activities only: initial and Reassessment, Level ofCare Screen, initial and Reassessment Needs Assessment, At-Risk Diversion, State SLS and OBRA-SS In-Person Monitoring, and State SLS and OBRA-SS In-Person Individualized Support Plans. Payment shall be based on approved invoices or data pulled from the Department prescribed system on the 15th day of the month for activities from the  previous month.  Exhibit B-1, SOW  Page 51 of53    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  9.7.32. SIS-A Assessments  9.7.32.1.  Contractor shall enter all SIS assessments into SIS Online by the last day of the month. The Department will pay for all SIS-A Assessments from data pulled from the Department prescribed system on the 15th day of the month for assessments from the previous month. Reassessment requests must be reviewed and accepted by the  Department prior to completion, entry, and payment.  9.7.33. Support Need Level Assessment - HCBS-CHRP  9.7.33.1.  Contractor shall maintain all supporting documentation related to the Support Need Level Assessment and make it available to the Department upon request. Contractor shall invoice the Department for all completed assessments by the 15th day of the month for all assessments completed in the previous month. The Department will pay for assessments once the invoice and supporting documentation is reviewed and accepted.  9.7.34. Training on the Colorado Single Assessment, and Person-Centered Support Plan Instruments 9.7.35. Contractor shall receive a one-time payment for the training and oversight of Contractor's  and Streamlined Eligibility  staff in performing the Colorado Single Assessment, and Person-Centered Support Plan. Payment will be made calculated based on the average number of staff as specified by the Department. This funding is subject to recovery if the number of staff trained is below the average number of staff as specified by the Department. Waiting List Management Contractor shall enter all waiting list management contacts with individuals and families into the Department prescribed system within the required timeframe. The Department will pay for required waiting list contacts from data pulled from the Department prescribed system on the 15th oft the month for contacts from thej previous month or using ani invoice developed by thel Department. The Department shall not pay for more than one contact per individual (18 and older) on the HCBS-DD ASAA, See Date and Safety Net waiting list and State SLS, OBRA-SS, or FSSP ASAA waiting list per year. Contractor shall only be reimbursed for one waiting list contact for the HCBS-DD, State SLS or  9.7.35.1.  FSSP waiting list when the event occurs during the same contact.  9.7.36. Year End Close Deadlines  9.7.36.1.  The due dates identified in this section shall be adhered to, and information entered into the Department's prescribed systems and/or submitted to the Department by a date identified in this Contract. For the month ofJune, the Department will notify Contractor of the modified due date to account for year-end closing. Any submission past the  assigned year end close date will not be reimbursed.  9.8. Payment and Billing Errors  9.8.1. 9.8.2. 9.8.2.1.  Contractor shall review all payments made by the Department to ensure all activities are Contractor shall notify the Department ofa any errors in billing or payment by the 15th oft the month for the prior month'sp payment on the Department's! prescribed template to ensure over  ppropriatelyreimbursed.  and under payments are adjusted.  DELIVERABLE: Payment Correction Form  Exhibit B-1,SOW  Page 52of53    Docusign Envelope ID: 08D4B89670B44F7D.958F-CATIDABAJES  9.8.2.2.  DUE: On the 15th of each month for corrections on the prior month's payment, with exception ofJune payments which must meet year-end close deadlines established by the Department. Contractor shall specify on the form if corrections have not been identified  for the prior month's! payment.  9.9. Unexpended Funds  9.9.1.  Contractor shall remit any Subawards disbursed under this Contract that are. not expended by  the close oft the Period of Performance.  9.10. Closeout Payments  9.10.1. Notwithstanding anything to the contrary in this Contract, all payments for the final month  of this Contract shall be paid to Contractor no sooner than 10 Business Days after the Department has determined that Contractor has completed all the requirements of the  Closeout Period.  Exhibit B-1,SOW  Page 53 of53    Docusign! Envelope ID: 8D4B89670844F7D958F-CATIDABASES  EXHIBIT C-1, RATES  Case Management Agency (CMA) Subaward Rates Table  Description Operations Guide  Rate $7,905.56 $1,424.14 $3,543.31 $1,071.73 $506.72 $3,857.04 $648.75 $531.60 $490.97 $6.30  Frequency Annually Yearlofthe Contract Years 2+0 of the Contract Annually Semi- Annually Annually  Payment Type  Funding Source Funded Funded Funded Funded Funded Funded Funded Federal/State Funded Federal/State Funded Federal/State Funded Federal/State Funded  Deliverable Federal/State  Operations Guide Update Long-Range Plan Committee Updates Continuous Quality Improvement Plan Complaint Trend Analysis Case Management Training Creation ofl Packet - Appeals Attendance at Hearing- Appeals IDD Critical Incident Reporting (HCBS - CES, HCBS - CHRP, HCBS - DD, HCBS- SLS) LTSS Critical Incident Reporting (HCBS -BI, HCBS-CHCBS, CMHS, HCBS-I EBD, HCBS-S SCI, HCBS - CLLI) HCBS Critical Incident Follow-Up Performance Standard Human Rights Committee (HCBS - CES, HCBS CHRP, HCBS-I DD, HCBS - SLS) Initial Level ofCare Assessment (100.2) CSR Level of Care Assessment (100.2) Initial Level of Care Screen  Annually- Deliverable Federal/State  Deliverable Federal/State Deliverable Federal/State Deliverable Federal/State  Quarterly Deliverable Federal/State  Semi- Annually Per Packet Per Hearing Monthly, Per Member Enrolled Monthly, Per Member Enrolled  Deliverable Federal/State  Report Report Report  $1.61  Report  $3,457.07 $5.95  Quarterly Deliverable Federal/State  Funded Federal/State Funded Federal/State Funded Federal/State Funded Federal/State Funded  Monthly, Per Member Enrolled Per Assessment Per Assessment Per Screen  Report  $283.62 $214.03 $210.27 Page 1of4  Report Report Report  Exhibit C-1, Rates    Docusign Envelope ID: 8D4B896-7084-4F7D-95BF-CA11DA86A3E9  Annual Reassessment - Level ofCare Screen Initial Needs Assessment Required Questions Only Annual Reassessment Needs Assessment - Required Questions Only Initial Needs Assessment- - Voluntary Questions Included  $195.63 $265.49 $249.20 $331.87  Per Screen Per Assessment Per Assessment Per Assessment Per Assessment Per Assessment Per Assessment Per Assessment Monthly Monthly Per Assessment Per Application Per Application Per Determination Per Determination Actual Costs up to Rate for Testing Per Required in Person Contact for Rural and Frontier Agencies Payment  Report Report Report Report  Federal/State Funded Federal/State Funded Federal/State Funded Federal/State Funded Federal/State Funded Funded Funded Funded Federal/State Funded Funded Funded Federal/State Funded Federal/State Funded Federal/State Funded Federal/State Funded Federal/State Funded Federal/State Funded Federal/State Funded  Annual Reassessment Needs Assessment - Voluntary Questions Included Rapid Reintegration Barrier Questions Rapid Reintegration Assessment and Support Post] Rapid Reintegration Survey Questions SIS Assessment Initial At-Risk Diversion - In Person Initial At-Risk Diversion - Virtual HCBS-CHRP Support Level Needs Assessment Initial HCBS-CES Application CSR HCBS-CES Application Medicaid Eligible IDD Determination Medicaid Eligible Delay Determination IDD Determination Testing Rural Travel Add-On  $317.15 $48.54 $107.73 $22.84 $357.09 $104.70 $87.45 $165.26 $189.21 $142.76 $458.81 $272.96 $481.10 $37.46  Report  Invoice or Federal/State Invoice or Federal/State  Report Report Report Report Report Report Invoice Report Report Report Report Invoice Report  Per Survey Invoice or Federal/State  Invoice or Federal/State Invoice or Federal/State  Completed Training Plan for the Colorado Single Exhibit C-1, Rates  Calculated Allocation Based Page2of4  One-Time Deliverable Federal/State  Funded    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  Assessment and Person- Centered Support Plan Instruments Completed Training on Community First Choice  on Funding Availability Celdulittdd oorfinddigg AAgihbiliyy $95.42 $458.81 $272.96 $481.10  Upoa-Tiaining DoliNershbde Fattaral/Statte  AAlhoetiborfBasdd Upôorlfpleiag  FFudlad  Completion  Case Management Agency (CMA) State Only Rates Table  Waiting List Management Non-Medicaid Eligible IDD Determination Non-Medicaid Eligible Delay Determination Non-Medicaid Eligible IDD Determination Testing State SLS, OBRA-SS, and FSSP Critical Incident Reporting & Investigation: MANE State SLS, OBRA-SS, and FSSP Critical Incident Reporting & Investigation: Non-MANE State SLS, OBRA-SS, and FSSP Human Rights Committee State SLS and OBRA-SS Complaints Trend Analysis State SLS, OBRA-SS, and FSSP CIR Follow-Up Performance Standard State SLS, OBRA-SS, and FSSP Ongoing Case Management State SLS and OBRA-SS Monitoring - In Person State SLS and OBRA-SS Monitoring - Virtual State SLS Expenditure Report OBRA-SS Expenditure Report Exhibit C-1, Rates  Per Contact Per Determination Per Determination Actual Costs up to Rate for Testing Per Incident  Report Report Report Invoice  State Funded State Funded State Funded State Funded  $349.18  Report  State Funded  $46.71  Per Incident  Report  State Funded  $125.73 $220.69 $51.81 $91.67 $104.70 $87.45 $625.76 $369.56 Page3of4  Per Member Reviewed  Invoice  State Funded  Quarterly Deliverable State Funded Quarterly Deliverable State Funded  Monthly, Per Activity Per Contact Per Contact Monthly Monthly  Report Report Report Invoice Invoice  State Funded State Funded State Funded State Funded State Funded    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  FSSP Needs Assessment FSSP Expenditure Report Family Support Council Meetings FSSP Annual Report FSSP Program Evaluation  $33.25 $556.57 $418.29 $621.79 $529.19  Per Assessment Monthly Per Meeting Annually Annually  Report Invoice Invoice  State Funded State Funded State Funded  Deliverable State Funded Deliverable State Funded  Exhibit C-1, Rates  Page 40 of4    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  EXHIBIT D-1, TERMINOLOGY  1. TERMINOLOGY  1.1. In addition to the terms defined in $3 of this Contract, the following list of terms shall be  construed and interpreted as follows: and support program or service.  1.1.1. 1.1.2. 1.1.3. 1.1.4. 1.1.5. 1.1.6. 1.1.7. 1.1.8. 1.1.9.  Adverse Action - A denial, reduction, termination, or suspension from a long-term service Affiliated Entity = An organization that directly or indirectly controls another entity, has substantially similar ownership ofanother entity, and/or owns a substantial share of another Appeal - The process a case manager participates in when a Client or Member appeals an At Risk Diversion - is a Person-Centered process through which services are arranged or provided to enable a Member of an At-Risk Population to avoid admission to a nursing Behavioral Health Authorities (BHA) - The behavioral health administration established in Business Day - Any day in which the State is open and conducting business, but shall not include Saturday, Sunday, or any day which the State observes one oft the holidays listed in Business Interruption - Any event that disrupts Contractor's ability to complete the Work for ap period of time, and may include, but is not limited to a Disaster, power outage, strike, loss Care and Case Management System (CCM) - The Department's case management Case Management - The assessment of a Member eligible to receive or receiving long-term services and supports, the development and implementation of a Support Plan for such Member, referral and related activities, the coordination and monitoring oflong-term service and supports delivery, the evaluation of service effectiveness, and the periodic reassessment organization contracted with the state of Colorado to provide case management services and Article 6 and Article 10 ofC.R.S. Title 25.5 for members receiving long-term services and and pregnant women. Itis for people who earn too much to qualify for Health First Colorado,  entity.  adverse action made by the case manager.  facility and live, instead, in a setting of their choice. Part 200 of Article 50 ofTitle 27, C.R.S.  C.R.S. $24-11-101(1).  ofnecessary personnel or computer virus. Information Technology (IT) platform.  ofsuch Member's needs.  1.1.10. Case Management Agency (CMA) - A public or private not-for-profit or for-profit 1.1.11. Case Manager - A person who provides case management services and activities pursuant to 1.1.12. Child Health Plan Plus - Colorado's public low-cost health insurance for certain children  activities pursuant to C.R.S. 25.5-6-1702.  supports.  but not enough to pay for private health insurance.  1.1.13. Client - Any individual applying for or seeking information for LTSS.  Exhibit D-1, Terminology  Page 1 of9    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.1.14. Closeout Period - The period beginning on the earlier of 90 Calendar Days prior to the end  of the last Extension Term or notice by the Department of its decision to not exercise its option for an Extension Term, and ending on the day that the Department has accepted the final deliverable for the Closeout Period, as determined in the Department-approved and  updated Closeout Plan, and has determined that the closeout is complete. and permanent statutes oft the Colorado General Assembly.  1.1.15. Colorado Revised Statutes (C.R.S.)- - The legal code of Colorado; the legal codified general 1.1.16. Community Centered Board (CCB) - A private for-profit or not-for profit organization that  is an administrator oflocally generated funding pursuant to CRS 25.5-10-206(6) and acts as ar resource for persons with an intellectual and developmental disability or a child with a through this Contract toi include, but not limited to general business functions, administration, State General Fund program functions, and case management functions. Excludes any services that assist an individual in accomplishing activities of daily living when included as a waiver benefit that may include health maintenance, personal care, and homemaker reference, all referenced statutes, rules and cited authorities, and any future modifications otherwise made available for payment by the State under the Contract resulting from this  developmental delay.  1.1.17. Complaints - Any complaint received by Contractor as it relates to the services provided  complaints regarding activities outside the scope ofthis Contract.  1.1.18. Consumer-Directed Attendant Support Services (CDASS) - The service delivery option for  activities.  1.1.19. Contract - The agreement, including all attached Exhibits, all documents incorporated by 1.1.20. Contract Funds - The funds that have been appropriated, designated, encumbered, or 1.1.21. Contractor - The individual or entity selected as ai result of this solicitation to complete the 1.1.22. Contractor Pre-Existing Material - Material, code, methodology, concepts, process, systems,  thereto, that is entered into as a result of this solicitation.  Solicitation.  Work contained in the Contract.  technique, trade or service marks, copyrights, or other intellectual property developed, licensed, or otherwise acquired by Contractor prior to the Effective Date ofthis Contract and independent of any services rendered under any other contract with the State. take to correct non-compliance with regulations and contractual obligations, which stipulates or welfare of an individual receiving services; and it may endanger or negatively impact the Critical Incident Report entered into the Department prescribed system with a category of Department prescribed system with a category of criminal activity, damage to consumer's  1.1.23. Corrective Action Plan - A written plan, which includes the specific actions the agency shall 1.1.24. Critical Incident - An actual or alleged event that creates thei risk ofs serious harm to the health 1.1.25. Critical Incident Report (CIR) Mistreatment, Abuse, Neglect or Exploitation (MANE) - A 1.1.26. Critical Incident Report (CIR) Non-MANE - A Critical Incident Report entered into the  the date by which each action shall be completed. mental and/or physical well-being of ani individual. Mistreatment, Abuse, Neglect, or Exploitation.  Exhibit] D-1, Terminology  Page2of9    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  property/theft, death, injury/illness, medication management issues, missing persons, other Contractor for the purpose ofcompleting a task or project assigned in the Statement ofWork. work that is intended to be delivered to the Department, regardless of whether the object is  high-risk issues, and unsafe housingdispacement.  1.1.27. Data = State Confidential Information and other State information resources transferred to 1.1.28. Deliverable = Any tangible or intangible object produced by Contractor as a result of the 1.1.29. Department - The Colorado Department ofHealth Care Policy and Financing, a department 1.1.30. Designated Service Area - The geographical area determined by the State Department to be 1.1.31. Disaster - An event that makes it impossible for Contractor to perform the Work out ofi its 1.1.32. Effective Date - The date on which the Contract resulting from this solicitation is approved 1.1.33. Eligibility Determination = The eligibility of an individual for a Long-Term Services and 1.1.34. Fraud - An intentional deception or misrepresentation made by a person with the knowledge 1.1.35. Goods - Any movable material to be acquired, produced, or delivered by Contractor which  specifically described or called out as a "Deliverable" or not.  oft the government of the State of Colorado.  served by a Casel Management Agency per C.R.S. 25.5-6-1702.  regular facility or facilities, and may include, but is not limited to, natural disasters, fire, or and signed by the Colorado State Controller or designee, as shown on the Signature and Cover Supports (LTSS) program is determined by meeting all the requirements of the program, that the deception could result in some unauthorized benefit to that person or some other person and includes any act that constitutes fraud under any federal or state law. shall include any movable material acquired, produced, or delivered by Contractor in  terrorist attacks.  Page for the Contract.  including Level of Care Determination and financial eligibility.  connection with the Services.  1.1.36. Health First Colorado - Colorado's! Medicaid program.  1.1.37. Health Insurance Portability and Accountability Act (HIPAA) - The Health Insurance 1.1.38. Home and Community Based Services (HCBS) Waivers - Services and supports authorized  Portability and Accountability Act of 1996, as amended.  through a 1915(c) waiver oft the Social Security Act and provided in community settings toa client who requires an institutional level of care that would otherwise be provided in a Hospital, Nursing Facility, or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID). This includes: Children's Home and Community Based Services Waiver (CHCBS), Home and Community Based Services Waiver for Persons with Brain Injury (HCBS-BI), Home and Community Based Services Children's Extensive Services Waiver (HCBS-CES), Home and Community Based Services Children's Residential Habilitation Program Waiver (HCBS-CHRP),Home and Community Based Services Waiver for Children with a Life Limiting Illness (HCBS-CLLI), Home and Community Based Services Community Mental Health Supports Waiver (HCBS-CMHS), Home and Community Based Services Waiver for Persons with Developmental Disabilities (HCBS- DD), Home and Community Based Services Waiver for Persons who are Elderly, Blind and Disabled (HCBS-EBD), Home and Community Based Services Supported Living Services  Exhibit D-1, Terminology  Page3of9    Docusign Envelope ID: 08D4B89670844F7D.958.CATIDABAJES  Waiver (HCBS-SLS), and Home and Community Based Services Waiver for Persons with  Spinal Cord Injury (HCBS-CIH).  1.1.39. Hospital Back-Up A LTSS program for Members who have complex wound care and/or 1.1.40. Incident - Any accidental or deliberate event that results in or constitutes an imminent threat 1.1.41. In-Home Services and Supports (IHSS) -Means services that are provided in the home and  are ventilator-dependent or medically complex.  of the unauthorized access or disclosure of State Confidential Information or of the unauthorized modification, disruption, or destruction ofa any State Records. in the community by an Attendant under the direction of the client or client's Authorized Representative, including Health Maintenance Activities and support for activities of daily living or instrumental activities of daily living, Personal Care services and Homemaker Medicare and Medicaid (CMS) to provide habilitative, therapeutic and specialized support and shall includel buti is not limited to apreliminary screeningi int the following areas: a Client's need for long term services and supports; a Client's need for referral to other programs or services; a Client's eligibility for financial and program assistance; and the need for a Level  services.  1.1.42. Intermediate Care Facility (ICF) - A residential facility that is certified by the Centers for 1.1.43. Intake, Screening and Referral - The initial contact between the individual and Contractor  services to persons with intellectual and developmental disabilities.  of Care Screen and Needs Assessment oft the Client seeking services.  1.1.44. Key Personnel - The position or positions that are specifically designated as such in the 1.1.45. Learning Management System (LMS) - An online software application for the 1.1.46. Level ofCare - The level ofassistance needed by an individual seeking services or ai member 1.1.47. Level ofCarel Determination - The eligibility determination of an individual foral Long-Term 1.1.48. Long Term Care notice of action - The form required to be sent to Clients by Contractor 1.1.49. Long Term Services and Supports (LTSS) - The services and supports used by Members of  Contract.  administration, delivery and tracking of case: management training programs and materials. to perform activities of daily living, to include mobility; bathing; dressing; eating; toileting; transferring; and need for supervision as determined by the Level ofCare Screen. Services and Supports (LTSS) program by a Case. Management Agency as determined by the requirements oft the program, using the Department prescribed instrument. within 11 Business Days regarding their appeal rights in accordance with 10 CCR 2505-10 all ages with functional limitations and chronic illnesses who need assistance to perform routine daily activities such as bathing, dressing, preparing meals, and administering programs: CHCBS, FSSP, HCBS-BI, HCBS-CES, HCBS-CHRP, HCBS-CLLI HCBS- CMHS, HCBS-DD, HCBS-EBD, HCBS-CIH, HCBS-SLS, HBU, LTHH, Medicaid Nursing  8.507 et seq.  medications.  1.1.50. Long Term Services and Supports (LTSS) Programs - Any oft the following publicly funded  Facilities, OBRA-SS, PACE, State SLS.  Exhibit D-1, Terminology  Page 40 of9    Docusign Envelope ID: 08D4B89-7084-4F7D-95BF-CA11DA86A3E9  1.1.51. Long Term Services and Supports Level of Care Eligibility Determination Screen (LOC  Screen) - An evaluation conducted byt the case manager with the individual seeking services and others chosen by the individual to participate (such as family members, friends, and/or caregivers), to determine an applicant or member's eligibility for long-term services and supports based on their need for institutional level of care as determined by utilizing the Department's prescribed instrument, with supporting diagnostic information from the Individual's medical providers, for the purpose of determining the Individual's level of functioning for admission or continued stay in Long-Term Services and Supports (LTSS) Department of Health Care Policy and Financing (Department) to process the State- authorized Medical Assistance application for the programs that are administered by the program, Colorado's CHP+ program or the Colorado Indigent Care Program, as determined participating states to assess the quality of life and outcomes of seniors and adults with physical disabilities- -including traumatic or acquired brain injury-who are accessing publicly-funded services through the Older Americans Act (OAA), Program ofAll-Inclusive Care for the Elderly (PACE), Medicaid, and/or state-funded programs. The project is coordinated by Advancing States and Human Services Research Institute (HSRI). NCI-AD data are gathered through yearly in-person Adult Consumer Surveys administered by state Aging, Disability, and Medicaid Agencies (or an Agency-contracted vendor) to a sample of at least 400 individuals in each participating state. NCI-AD data measures the performance of states' long-term services and supports (LTSS) systems and service recipient outcomes, helping states prioritize quality improvement initiatives, engage in thoughtful decision Department prescribed instrument, with the individual seeking services or member and appropriate collaterals as requested and/or necessary (such as family members, advocates, friends and/or caregivers), and including supporting information from the individual's providers to determine the individual's service needs, goals, available resources, and established pursuant to C.R.S. $25-1.5-103 and is maintained primarily for the care and  programs.  1.1.52. Medical Assistance (MA) Site - Designated sites allowed by statute or certified by the  Department and determine eligibility for said programs.  1.1.53. Member - Any individual enrolled in the Colorado Medicaid program, State General Fund 1.1.54. National Core Indicators-Aging and Disabilities (NCI-AD) - Standard measures used across  by the Department.  making, and conduct futures planning with valid and reliable LTSS data.  1.1.55. Needs Assessment - A comprehensive evaluation conducted by the case manager, using the  potential funding resources.  1.1.56. Nursing Facility A facility provider that meets the state nursing facility licensing standards 1.1.57. Offeror - Any individual or entity that submits a proposal, or intends to submit a proposal, 1.1.58. Operational Start Date - When the Department authorizes Contractor to begin fulfilling its 1.1.59. Organized Health Care Delivery System - A Case Management Agency that contracts with  treatment ofinpatients under the direction ofaj physician.  ini response to this solicitation. obligations under the Contract.  other qualified providers to furnish services authorized in the CHCBS, HCBS-BI, HCBS- CCLI, HCBS-CES, HCBS-CIH, HCBS-CHRP, HCBS-CMHS, HCBS-DD, HCBS-EBD,  Exhibit] D-1, Terminology  Page5o of9    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  and HCBS-SLS waivers. CMAS are: responsible for purchasing specific goods and services for members, authorized on the Person-Centered Support Plan, as set forth by the  Department's prescribed guidelines for OHCDS. positions to complete tasks associated with the Work.  1.1.60. Other Personnel - Individuals and Subcontractors, in addition to Key Personnel, assigned to 1.1.61. Pandemic- - Refers to an epidemic that has spread over several countries or continents, usually 1.1.62. Period ofPerformance- - Means the total estimated time interval between the start of an initial  affecting a large number of people.  Federal award and the planned end date, which may: include one or more funded portions, or budget periods. Identification of the period of performance in the Federal award per 8 200.211(b)(5) does not commit the awarding agency to fund the award beyond the currently  approved budget period. strengths, and contributions.  1.1.63. Person-Centered Approach-I Respecting and valuingi individuals' and Members' preferences, 1.1.64. Person-Centered Support Plan - A document, using the State-prescribed instrument, that  identifies approved services, regardless of funding source, necessary to assist a member to remain safely in the community and develop in accordance with the Department rules. The plan includes the funding source, frequency, amount, and provider of each service and is developed with the member and people chosen by the member to identify goals, needed services, individual choices and preferences, and appropriate service providers based on the member's Assessment and knowledge of the individual and community resources and services and people chosen by the Member to identify goals, needed services, individual choices and preferences, and appropriate service providers based on the Member seeking or receiving services, assessment, and knowledge ofthe Member and of community resources. Support planning informs the Member receiving services of his or her rights and limitation, any information maintained by the State about an individual that can be used to distinguish or trace an individual's identity, such as name, social security number, date and place ofbirth, mother's maiden name, or biometric records; and any other information that is linked or linkable to an individual, such as medical, educational, financial, and employment information. PII includes, but is not limited to, all information defined as personally Clients seeking admission to a. Medicaid nursing facility to screen the Client for evidence of serious mental illness and/ori intellectual and developmental disabilities ori related conditions. The review determines whether the Client needs the level of services that a nursing facility provides and whether Clients who need nursing facility services also need specialized by a licensed medical professional used as a component of the Level of Care Screening and Assessment to determine the Client's or Member's need for an LTSS program.  informs the member oft their rights and responsibilities.  1.1.65. Person-Centered Support Planning - The process of working with the Member receiving  responsibilities.  1.1.66. Personally Identifiable Information - Personally identifiable information including, without  identifiable information in $24-72-501 C.R.S.  1.1.67. Pre-Admission Screening and Resident Review (PASRR) - The review that occurs for all  services.  1.1.68. Professional Medical Information Page (PMIP) - The medical information document signed  Exhibit] D-1, Terminology  Page 6of9    Docusign Envelope ID: 8DAB89670844F7D-958.CATIDABSAJES  1.1.69. Program - Aj publicly funded program including, but not limited to: Home and Community  Based Services Waivers, Medicaid Nursing Facility, Hospital Back-Up, Program for All- Inclusive Care for the Elderly (PACE), Long Term Home Health (LTHH), and State General limitation any information whether oral or recorded in any form or medium: (i) that relates to the past, present or future physical or mental condition of an individual; the provision of health care to an individual; or the past, present or future payment for the provision ofhealth care to an individual; and (ii) that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual. PHI includes, but is not limited to, any information defined as Individually Identifiable Health Information by the federal Health Insurance Portability and Accountability Act. Colorado Medicaid program, Colorado's CHP+ program or the Colorado Indigent Care its performance in meeting the HCBS waiver assurances annually as set forth in 42 CFR on. July 1 and ends September 30. Quarter two (2) begins on October 1 and ends December 31. Quarter three (3) begins on January 1 and ends March: 31. Quarter four (4) begins on. April admission to a nursing facility, does not oppose living in the Community, and is experiencing Unstable Housing, is rapidly referred to a Transition Coordinator to receive Transition admitting into a nursing facility, does not oppose living in the Community, and is not experiencing Unstable Housing and receives services as described in the member's Rapid rapidly transitioning a member(s) from ai nursing facility and safely into the Community. previously performed by Regional Care Collaborate Organizations and Behavioral Health resources or services that extend the capabilities ofc community based LTSS systems to better serve LTSS Clients and Members and those likely to need community based LTSS in the  Funded (SGF)Programs.  1.1.70. Protected Health Information - Any protected health information, including, without  1.1.71. Provider Any health care professional or entity that has been accepted as a provider in the 1.1.72. Quality Improvement Strategy (QIS) - The Department's process to measure and improve 1.1.73. Quarter - Four (4) distinct time periods during the State Fiscal Year. Quarter one (1)b begins  Program, as determined by the Department.  441.301 and 441.302.  land ends June 30.  1.1.74. Rapid Referral - The Person-Centered process that occurs when a member, who is seeking  Coordination Services.  1.1.75. Rapid Reintegration - the Person-Centered process that occurs when a member, who will be  Reintegration Plan.  1.1.76. Rapid Reintegration Plan - a written Person-Centered plan developed for the purpose of 1.1.77. Regional Accountable Entity (RAE) - A single regional entity responsible for duties 1.1.78. Resource Development The study, establishment and implementation of additional  Organizations (BHO).  future.  1.1.79. Rural and Frontier - Defined Service Areas that are eligible for rural travel add-on 1.1.80. Services - The services and activities to be performed by Contractor as set forth in this  reimbursement for required in-person activities reimbursed through this Contract.  Contract and shall include any services and activities to be rendered by Contractor in  Exhibit D-1, Terminology  Page7of9    Docusign Envelope ID: 08D4B89-7084-4F7D-95BF-CA11DA86A3E9  connection with the Goods. Services identified through this Contract specificallye exclude any Home and Community Based Services, State Plan Benefit Services, and other Medicaid  services reimbursed through a Medicaid Provider Agreement.  1.1.81. Start-Up Period - The period starting on the Effective Date and ending on the Operational  Start Date.  1.1.82. State - The State of Colorado, acting by and through any State agency.  1.1.83. State Fiscal Rules - The fiscal rules promulgated by the Colorado State Controller pursuant 1.1.84. State Fiscal Year - The 12-month period beginning on July 1 of each calendar year and 1.1.85. State Intellectual Disability Authority (SIDA) - The person authorized by the Department to  to C.R.S. 24-30-20203)8).  ending on June 30 of the following calendar year. If a single calendar year follows the term, review PASRR Level II Evaluations and approve or deny a nursing facility admission for individuals with intellectual and developmental disabilities. SIDA issues the Letter of General Assembly and provided ini the familyhome, a community setting, orNursing Facility using 100% General Fund dollars. Including, the Family Support Services Program (FSSP), State Supported Living Services Program (State SLS), and Omnibus Reconciliation Act of  then it means the State Fiscal Year ending in that calendar year.  Determination to the nursing facility.  1.1.86. State General Fund Programs - Case management, services, and supports authorized by the  1987 Specialized Services Program (OBRA-SS).  1.1.87. State Records - Any and all State data, information, and records, regardless of physical form, 1.1.88. Subcontractor - Third parties, if any, engaged by Contractor to aid in performance of the 1.1.89. Support Need Level Assessment - The standardized assessment tool to identify and measure 1.1.90. Surcharge Any additional amount added by Contractor, over and above the: rate charged by 1.1.91. Target Criteria - Department defined criteria based on Member needs to access services 1.1.92. Targeted Case Management (TCM) - Required case management activities for Members  including, but not limited to, information subject to disclosure under CORA.  Work.  the practical support requirements for HCBS-CHRP waiver participants.  the subcontractor to Contractor, which would be shown on an individual's service plan or on  encounter data service: rates submitted to the Department.  under a HCBS waiver.  enrolled in a HCBS waivers as defined in 10 CCR 2505-10 8.761.14 et seq. that are reimbursed as a State Plan benefit and through a Medicaid Provider Agreement. TCM individuals' entrance into the waiver or State General Fundj programs until approved capacity  activities are excluded from the Work within this Contract.  1.1.93. Waiting List - A list of otherwise eligible individuals established to manage selection of 1.1.94. Work-T The delivery ofthe Goods and performance ofthe Services described in the Contract. 1.1.95. Work Product = The tangible and intangible results of the Work, whether finished or  and funding become available.  unfinished, including drafts. Work Product includes, but is not limited to, documents, text,  Exhibit) D-1, Terminology  Page 8of9    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  software (including source code), research, reports, proposals, specifications, plans, notes, studies, data, images, photographs, negatives, pictures, drawings, designs, models, surveys, maps, materials, ideas, concepts, know-how, and any other results of the Work. "Work Product" does not include any material that was developed prior to the Effective Date that is  used, without modification, in the performance ofthe Work.  2. ACRONYMS AND ABBREVIATIONS  2.1. The following list is provided to assist the reader in understanding certain acronyms and  abbreviations used in this Contract: CFR - Code ofFederal Regulations CHP+ -Child Health Plan Plus C.R.S.- Colorado Revised Statutes CPI- Consumer Price Index CPI-U-( CPI for all urban consumers  2.1.1. 2.1.2. 2.1.3. 2.1.4. 2.1.5. 2.1.6. 2.1.7. 2.1.8. 2.1.9.  CORA -Colorado Open Records Act, C.R.S. $24-72-200.1,ct.seq,  HIPAA-Health Insurance Portability and Accountability Act of 1996, as amended. MFCU - the Colorado Medicaid Fraud Control Unit in the Colorado Department ofLaw  PCI- Payment Card Information  2.1.10. PHI-P Protected Health Information 2.1.11. PII-Personally Identifiable Information 2.1.12. SFY - State Fiscal Year 2.1.13. U.S.C.-D United States Code 2.1.14. VARA- Visual Rights Act of 1990  Exhibitl D-1, Terminology  Page9of9    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  EXHIBIT E-1, CONTRACTORS ADMINISTRATIVE REQUIREMENIS  1. CONTRACTOR'S GENERAL REQUIREMENTS  1.1. The Department will contract with only one organization, Contractor, and will work solely with that organization with respect to all tasks and deliverables to be completed, services to be  rendered and performance standards to be met under this Contract.  1.2. Contractor shall serve as the Case Management Agency for the following counties:  1.2.1. 1.2.2. 1.2.3.  Baca County Kiowa County Prowers County  1.3. Contractor may be privy to internal policy discussions, contractual issues, price negotiations, confidential medical information, Department financial information, advance knowledge of legislation and other Confidential Information. In addition to all other confidentiality requirements of the Contract, Contractor shall also consider and treat any such information as Confidential Information and shall only disclose it in accordance with the terms of the Contract. 1.4. Contractor shall work cooperatively with Department staff and, if applicable, the staff of other State contractors to ensure the completion of the Work. The Department may, in its sole discretion, use other contractors to perform activities related to the Work that are not contained in the Contract or to perform any of the Department's responsiblities. In the event ofa a conflict between Contractor and any other State contractor, the State will resolve the conflict and 1.5. Contractor shalli inform thel Department on current trends andi issues int thel healthçare marketplace and provide information on new technologies in use that mayi impact Comtractorsreponsbilities 1.6. Contractor shall maintain complete and detailed records of all meetings, system development life cycle documents, presentations, project artifacts, and any other interactions or Deliverables related to the Work described in the Contract. Contractor shall make such records available to 1.7. Contractor shall submit al Media Event Report in instances where Contractor is contacted directly or indirectly by the media, including but not limited to newspaper or television, or Contractor believes an event has occurred that may result in what the Contractor deems to be potentially negative media coverage for Contractor's agency, the Department, or the Member's served by Contractor. Immediately following direct or indirect contact with orl knowledge ofmedia contact,  Contractor shall abide by the resolution provided by the State.  under this Contract.  the Department upon request throughout the term ofthe Contract.  Contractor must notify the Department using the template provided.  1.8. DELIVERABLE: Media Event Report  1.9. DUE: Immediately Following Direct or Indirect Contact with or Knowledge of Media Contact 1.10.1. All Deliverables shall meet Deparument-aPproved format and content requirements. The  1.10. Deliverables  Department will specify the number of copies and media for each Deliverable.  Exhibit E, Contractor's. Adminstrative Requirements  Pagelof1    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.10.1.1. 1.10.1.1.1. 1.10.1.1.2. 1.10.1.1.3. 1.10.1.1.3.1. 1.10.1.1.3.2. 1.10.1.1.3.3. 1.10.1.1.3.4. 1.10.1.1.3.5. 1.10.1.1.4. 1.10.1.1.5. 1.10.1.2.  Contractor shall submit each Deliverable to the Department for review and approval and shall adhere to the following Deliverable process such for any documentation creation,  review, and acceptable cycle, Contractor shall:  Gather and document requirements for the Deliverable.  Create a draft ini the Department-approved format for the individual Deliverable. Perform internal quality control review(s) of the Deliverable, including, but not  limited to: Readability. Spelling. Grammar. Completion. Accessibility.  Adhere to all required templates or development ofte templates. Perform modifications that include version control and tracked changes. The Department will review the Deliverable and may direct Contractor to make changes tothel Deliverable. Contractor shall make all changes within five Business Days following the Department's direction to make the change unless the Department provides a longer Changes the Department direct include, but are not limited to, modifying portions of the Deliverable, requiring new pages or portions of the Deliverable, requiring resubmission oft the Deliverable or requiring inclusion ofinformation or components The Department may also direct Contractor to provide clarification or provide a walkthrough of any Deliverable to assist the Department in its review. Contractor shall provide the clarification or walkthrough as directed by the Department. Once the Department has received an acceptable version ofthel Deliverable, including all changes directed by the Department, the Department will notify Contractor of its acceptance of the Deliverable in writing. A Deliverable shall not be deemed accepted prior to the Department's: notice to Contractor ofi its acceptance of that Deliverable. complete, accurate, easy to understand and of high quality, as described herein. Contractor shall provide Deliverables that, at a minimum, are responsive to the specific requirements for that Deliverable, organized into a logical order, contain accurate spelling and grammar, are formatted uniformly, and contain accurate information and correct calculations. Contractor shall retain all draft and marked-up documents and checklists utilized in reviewing date shall be automatically extended to the next Business Day, unless otherwise directed by  period in writing.  1.10.1.2.1.  that were left out oft the Deliverable.  1.10.1.2.2. 1.10.1.3.  1.10.2. Contractor shall employ an internal quality control process to ensure that all Deliverables are  Deliverables for reference as directed by the Department.  1.10.3. In the event any due date for a Deliverable falls on a day that is not a Business Day, the due  the Department.  Exhibit) E, Contractor's Adminstrative Requirements  Page 10 of1    Docusign Envelope ID: 8D4B89670844F7D.958.CATIDABSAJES  1.10.4. All due dates or timelines that reference a period of days, months or quarters shall be  measured in Calendar Days, months and quarters unless specifically stated as being measured in) Business Days or otherwise. All times stated in the Contract shall be considered to be in Mountain Time, adjusted for Daylight Saving Time as appropriate, unless specifically stated that is necessary to fulfilling Contractor's responsibilities under the Contract, as determined Deliverables that are plans, policies or procedures, then Contractor shall comply with all requirements of the most recently approved version of that Deliverable. Contractor shall not implement any version of any such Deliverable prior to receipt ofthe Department's written approval of that version of that Deliverable. Once a version of any Deliverable described in this subsection is approved by the Department, all requirements, milestones, and other Deliverables contained within that Deliverable shall be considered to be requirements, Any Deliverable described as an update of another Deliverable shall be considered a  otherwise.  1.10.5. No Deliverable, report, data, procedure or system created by Contractor for the Department 1.10.6. Ifany Deliverable contains ongoing responsibilities or requirements for Contractor, such as  by the Department, shall be considered proprietary.  milestones and Deliverables oft this Contract.  1.10.6.1.  version of the original Deliverable for the purposes of this subsection.  1.11. Stated Deliverables and Performance Standards  1.11.1. Any section within this Statement of Work headed with or including the term  DELIVERABLE" or PERFORMANCE STANDARD" is intended to highlight a Deliverable or performance standard contained ini this Statement of Work and provide a clear due date for the Deliverables. The sections with these headings are for ease ofreference not intended to expand or limit the requirements or responsibilities related to any Deliverable or  performance standard, except to provide the due date for the Deliverables.  1.12. Communication with the Department  1.12.1. Contractor shall enable all Contractor staff to exchange documents and electronic files with  the Department staffi in formats compatible with the Department's: systems. The Department currently uses Microsoft Office 2016 and/or Microsoft Office 365 for PC. IfContractor uses a compatible program, then Contractor shall ensure that all documents or files delivered to the Department are completely transferrable and reviewable, without error, on the within the scope of the Contract. Contractor shall comply with all direction contained within ac completed transmittal. For a transmittal to be considered complete, it must include, at a  Department's: systems.  1.12.2. The Department will use a transmittal process to provide Contractor with official direction  minimum, all oft the following:  1.12.2.1. 1.12.2.2. 1.12.2.3. 1.12.2.4.  The date the transmittal will be effective.  Direction to Contractor regarding performance under the Contract.  A due date or timeline by which Contractor shall comply with the direction contained in The signature ofthe Department employee who has been designated to sign transmittals.  the transmittal.  Exhibit E, Contractor's Adminstrative Requirements  Pagelof1    Docusign Envelope ID: 08DAB89670844F7D-958.CATIDABSAJES  1.12.2.4.1.  The Department will provide Contractor with the name ofthe person itl has designated to sign transmittals on behalf of the Department, who will be the Department's primary designee. The Department will also provide Contractor with a list ofbackups who may sign a transmittal on behalf of the Department if the primary designee is unavailable. The Department may change any of its designees from time to time by  providing notice to Contractor through a1 transmittal.  1.12.3. The Department may deliver a completed transmittal to Contractor in hard copy, as a scanned  attachment to an email or through a dedicated communication system, if such a system is Ifat transmittal is delivered through a dedicated communication system or other electronic system, then the Department may use an electronic signature to sign that transmittal. primary designee, or backup designees if the primary designee is unavailable, to obtain direction. If the Department does not provide direction otherwise, then the transmittal with process, it shall contact the Department's primary designee, or backup designees if the primary designee is unavailable, and have the Department confirm that direction through a circumstances be used to modify the term of the Contract or any compensation under the Contract. Transmittals are not intended to be the sole means of communication between the Department and Contractor, and the Department may provide day-to-day communication to  available.  1.12.3.1.  1.12.4. If Contractor receives conflicting transmittals, Contractor shall contact the Department's  the latest effective date shall control.  1.12.5. In the event that Contractor receives direction from the Department outside oft the transmittal  transmittal prior to complying with that direction.  1.12.6. Transmittals may not be used in place of an amendment, and may not, under any  Contractor without using a transmittal. transmittals upon request by the Department.  1.12.7. Contractor shall retain all transmittals for reference and shall provide copies of any received 1.12.8. Contractor shall provide written notification to the Department in instances where Contractor  has not been successful in meeting requirements or timelines identified in this Contract. This requirement applies to instances where multiple Members are impacted and there is an established pattern over time. Contractor shall not include single instances. This notification must be provided to the Department within three Business Days of discovery on a template  provided by the Department.  1.12.8.1. 1.12.8.2.  DELIVERABLE: Self-Disclosure ofContract Requirements Not Met  DUE: Within 3 Business Days ofDiscovery  1.13. Individual and Member Engagement 1.13.1. Person- and Family-Centered Approach  1.13.2. Contractor shall actively engage Members in their health and well-being by demonstrating  the following:  1.13.2.1. 1.13.2.2.  Responsiveness: tol Member and family/caregiver needs by incorporating best practices in  communication and cultural responsiveness in service delivery. Utilization of various tools to communicate clearly and concisely.  Exhibit E, Contractor's. Adminstrative Requirements  Pagel 1 of1    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.13.2.3.  Contractor shall align Member engagement activities with the Department's s person- and family-centered approach that respects and values individual preferences, strengths, and  contributions.  1.14. Cultural Responsiveness  1.14.1. Contractor shall provide and facilitate the delivery of services in a culturally competent  manner to all individuals and Members, including those with limited English proficiency and diverse cultural and ethnic backgrounds, disabilities, and regardless of gender, sexual that may be easily understood and is readily accessible by individuals and Members. accessibility standards, such as Section 508 ofthe Americans with Disabilities Act, Section  orientation, or gender identity.  1.14.2. Contractor shall provide all information fori individuals and Members in ai manner and format 1.14.3. Readily accessible is defined as electronic information and services that comply with modern  504 oft the Rehabilitation Act.  1.15. Language Assistance Services  1.15.1. Contractor shall provide language assistance services including bilingual staff and/or  interpreter services, at no cost to any individual or Member. Language assistance shall be provided at all points of contact, in a timely manner and during all hours of operation.  1.15.2. Contractor shall make oral interpretation available in all languages.  1.15.3. Contractor shall ensure the competence of language assistance provided by interpreters and 1.15.4. Contractor shall not use family and friends to provide interpretation services except by 1.15.5. Contractor shall provide interpreter services for all interactions with individuals and 1.15.6. Contractor shall notify individuals and Members verbally regarding the individual's or 1.15.7. Oral interpretation for any language. Oral interpretation requirements apply to all non- 1.15.8. Contractor shall ensure that language assistance services shall include, but are: not limited to, 1.15.9. Contractor shall ensure that customer service telephone functions easily access interpreter or  bilingual staff.  request of the individual or Member.  Members when there is no Contractor staff person available who speaks a language Member's right to receive the following language assistance services, as well as how to  understood by an individual or Member.  access the following language assistance services.  English languages, not just those that the state identifies as prevalent. the use of auxiliary aids such as TTY/TDY and American Sign Language.  bilingual services.  1.16. Written Materials for Individuals and Members  1.16.1. Contractor shall ensure that all written materials it creates for distribution to individuals and 1.16.2. Contractor shall ensure that all written materials it creates for distribution to individuals and  Members meet all noticing requirements of 45 C.F.R. Part 92. Members are culturally and linguistically appropriate to the recipient.  1.16.3. Contractor shall write all materials in casy-to-understand language.  Exhibit) E, Contractor's Adminstrative Requirements  Pagel lofl    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.17. Individual and Member Communications  1.17.1. Contractor shall maintain consistent communication, both proactive and responsive, with 1.17.2. Contractor shall assist any individual or Member who contacts Contractor, including  individuals and Members.  individuals and Members not: in Contractor's Defined Service Area who need assistance with  contacting his/her/their CMA, CCB, RAE, or other agencies.  1.18. Individual and Member Rights  1.18.1. Contractor shall have written policies guaranteeing each individual's and Member's right to 1.18.2. Contractor shall provide information to individuals and Members regarding their rights that  be treated with respect and due consideration for his or her dignity and privacy.  include, but are not limited to:  1.18.2.1. 1.18.2.2. 1.18.2.3. 1.18.2.4. 1.18.2.5. 1.18.3.1. 1.18.3.2. 1.18.3.3. 1.18.3.4. 1.18.3.5. 1.19. Start-Up Plan  The right to be treated with respect and due consideration for their dignity and privacy. The right to be free from any form of restraint or seclusion used as a means of coercion,  The right to participate in decisions regarding their services.  discipline, convenience or retaliation.  The right to request and receive a copy of their records.  The right to obtain available and accessible services under the Contract.  1.18.3. Contractor shall post and distribute rights to individuals, including but not limited to:  Individuals/Members. Individua's/Members families. Providers. Case Workers. Stakeholders.  1.19.1. Contractor shall create a Start-Up Plan in year one of the Contract that contains, at a  minimum, the following:  1.19.1.1. 1.19.1.2. 1.19.1.3. 1.19.1.4. 1.19.1.5.  A description of all steps, timelines, and milestones necessary to fully transition the services described in the Contract from a prior contractor to Contractor. A description of all steps, timelines, milestones, and Deliverables necessary for Contractor to be: fully able toj perform all Work by the Operational Start Date. A listing of all personnel involved in the start-up and what aspect of the start-up they are An operational readiness review for the Department to determine if Contractor is ready  responsible for.  tol begin pertormance of all Work.  The risks associated with the start-up and aj plan to mitigate those risks.  1.19.2. DELIVERABLE: Start-Up Plan Exhibit E, Contractor's. Adminstrative Requirements  1.19.3. DUE: 20 Calendar Days Prior to the Contract Start Date  Pagelof1    Docusign Envelope ID: 8DAB89670844F7D.958.CATIDABSAJES  1.20. Start-Up Period  1.20.1. With input from the Department, Contractor shall complete all of the following during the  Start-Up Period in year one ofthe Contract:  1.20.1.1. 1.20.1.1.1. 1.20.1.1.2. 1.20.1.1.3. 1.20.1.1.4. 1.20.1.2. 1.20.1.2.1. 1.20.1.2.2. 1.20.1.2.3. 1.20.1.2.4. 1.20.1.3. 1.20.1.3.1. 1.20.1.3.2. 1.20.1.4. 1.20.1.5.  Schedule and facilitate al KickoffMeeting that includes the following:  Key Personnel. Department Leadership. Department Project Team Members.  Any other relevant and needed persons or organizations.  Develop Kickoff Meeting materials and an agenda that contains, at a minimum, the Initial timelines for starting the Work and creating initial Deliverables. Establishment of Communication channels to describe how the Work is to be Transmission methods and specific Deliverable templates or requirements. Any other item required toi initiate and ensure Work is started and completed on time. Prepare Kickoff Meeting Minutes and deliver them to the Department for review and  following:  completed.  approval.  DELIVERABLE: KickoffMeeting Agenda & Materials DUE: Within three Business Days after the KickoffN Meeting  Create a Policy and Procedures Manual that contains the policies and procedures for all systems and functions necessary for Contractor to complete its obligations under the Prepare all documents, forms, training materials, and any other documents, information and protocols that require approval by the Department prior to the end of the Start-Up Period and are necessary for Contractor to begin work on the Operational Start Date. Contractor shall deliver all documents, forms, training materials, and any other documents, information and protocols that require approval by the Department to the Department for review and approval in a timely manner that allows the Department to review and approve those documents prior to end oft the Start-Up Period.  Contract.  1.20.1.5.1. 1.20.1.5.2. 1.21. Operations Guide  DELIVERABLE: Policies & Procedures Manual DUE: No later than the Operational Start Date  1.21.1. Contractor shall not engage in any Work under the Contract, other than the Work described  in this Sections 1.136 and 12.17 prior to the Operational Start Date. The Department shall not be liable to Contractor for, and Contractor shall not receive, any payment for any period  prior to the Operational Start Date under this Contract. include the creation and management of the following:  1.21.2. Contractor shall create and implement an Operations Guide. The Operations Guide shall  Exhibit E, Contractor's. Adminstrative Requirements  Pagel 1of1    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.21.2.1. 1.21.2.2. 1.21.2.3. 1.21.3.1. 1.21.3.2.  Communication Plan. Business Continuity Plan. Closeout Plan.  1.21.3. Contractor shall submit the Operations Guide to the Department for review and approval.  DELIVERABLE: Operations Guide  DUE: Within 30 Business Days after the Effective Date  1.21.4. Contractor shall review its Operations Guide on annual basis and determine if any  modifications are required to account for any changes in the Work, in the Department's processes and procedures or in Contractor's processes and procedures and update the Guide as appropriate to account for any changes. Contractor shall submit an Annual Operations Guide Update that contains all changes from the most recently approved prior Operations Guide or Annual Operations Guide Update or shall note that there were no changes.  1.21.4.1. 1.21.4.2.  DELIVERABLE: Annual Operations Guide Update  DUE: Annually, by July 31St  1.21.5. The Operational Start Date shall not occur until Contractor has completed all requirements  ofthe Operations Guide unless the Department provides written approval otherwise.  1.21.6. Communication with Members, Providers, and Other Entities  1.21.6.1. 1.21.6.1.1. 1.21.6.1.2. 1.21.6.1.3. 1.21.6.1.4.  Contractor shall create a Communication Plan that includes, but is not limited to, all of A description of how Contractor will communicate to Members any changes to the services those Members will: receive or how those Members will receive the services. A description of the communication methods, including things such as email lists, newsletters and other methods, that Contractor will use to communicate with The specific means of immediate communication with Members and a method for accelerating the internal approval and communication process to address urgent A general plan for how Contractor will address communication deficiencies or crisis situations, including how Contractor will increase staff, contact hours or other steps Contractor will take if existing communication methods for Members or Providers Al listing of the following individuals within Contractor's organization, including cell An individual who is authorized to speak on the record regarding the Work, the An individual who is responsible for any website or marketing related to the Back-up communication staff that can respond in the event that the other  the following:  Providers and Subcontractors.  communications or crisis situations.  are: insufficient.  1.21.6.1.5. 1.21.6.1.5.1. 1.21.6.1.5.2. 1.21.6.1.5.3.  phone numbers and email addresses:  Contract or any issues that arise that are: related to the Work.  Work.  individuals listed are unavailable.  Exhibit E, Contractor's Adminstrative Requirements  Pagel lof1    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.21.6.1.5.4. 1.21.6.1.5.5.  An outline of the process for the Contractor's communication, timely responses and emergency protocols ini the event there is ai natural disaster or Pandemic. Communication Plan shall include steps for responding to the Department, provider agencies, Members and community organizations in the event there is a  natural disaster or Pandemic.  1.21.7. Business Continuity Plan  1.21.7.1.  Contractor shall create a Business Continuity Plan that Contractor will follow in order to continue operations after a Disaster or a Business Interruption to include but not limited toal Disaster, Pandemic, power outage, strike, loss of necessary personnel, or computer virus. The Business Continuity Plan shall include, but is not limited to, all of the  following:  1.21.7.1.1. 1.21.7.1.2. 1.21.7.1.3. 1.21.7.1.4. 1.21.7.1.5. 1.21.7.1.6. 1.21.7.1.7. 1.21.7.1.8. 1.21.7.1.9. 1.21.7.1.10. 1.21.7.1.11. 1.21.7.1.12. 1.21.7.1.13.  The essential services and functions provided by Contractor. continuity plan, individual/team roles, and contact information.  The lead person and response team responsible for implementing the business How emergency responses procedures will bei implemented and who will activate the How Contractor will implement a flexible work plan that includes social distancing, hygiene etiquette, cancellation ofnon-essential activities, closure ofbuildings, and/or How Contractor will address training personnel, preparing equipment, and backup How Contractor will address budget and finance mechanisms to ensure financing of How Contractor will ensure neçessary supplies and equipment are available to How Contractor will replace staff that are lost or unavailable during or after a Business Interruption SO that the Work is performed in accordance with the Contract. How Contractor will manage employees who are exposed to a Pandemic related illness or are suspected to be ill or become ill at a worksite, such as infection control How Contractor will ensure or enhance communication and information technology How Contractor will back-up all information necessary to continue performing the Work remotely, sO that no information is lost because ofa Business Interruption. In the event of a Disaster, the plan shall also include how Contractor will make all How Contractor will maintain complete back-up copies of all data, databases, operating programs, files,systems, and software pertaining to enrollment information  business continuity plan.  relocation to alternative facilities.  systems. essential services. maintain essential services.  response and immediate mandatory sick leave. infrastructure to support tele-commuting.  information available at: its back-up facilities. at a Department-approved, off-site location.  Exhibit] E, Contractor's. Adminstrative Requirements  Pagel lof1    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.21.7.1.14. 1.21.7.1.15. 1.21.7.1.16. 1.21.7.1.17. 1.21.7.1.18. 1.21.7.1.19. 1.21.7.1.20. 1.21.7.1.21.  How Contractor will minimize the effects on. Members of any Business Interruption to include how Contractor will notify members ofclosures and cancellations. How Contractor will communicate with the Department during the Business Interruption and points of contact within Contractor's organization the Department How Contractor will transition from in person meetings to conference calls or other Planned long-term back-up facilities out ofwhich Contractor can continue operations The time period it will take to transition all activities from Contractor's regular How Contractor will prepare necessary internal staff for implementing the business continuity plan, which may include tests, drills, or training annually and revising the How Contractor will identify and engage with external organizations to help the community, such as sharing best practices and sharing timely and accurate How Contractor will implement steps to return to normal after a Business  can contact in the event ofa Business Interruption. virtual platforms or cancel or delay meetings as necessary.  after a Disaster.  facilities to the back-up facilities after al Disaster.  plan based on lessons learned.  information about a Business Interruption.  Interruption.  1.21.8. Closeout Plan 1.21.8.1.  Contractor shall create a Closeout Plan that describes all requirements, steps, timelines, milestones, and Deliverables necessary to fully transition the services described in the Contract from Contractor to the Department or to another contractor selected by the Department to be Contractor after the termination of the Contract. The Closeout Plan  shall include, but is not limited to: Transfer ofindividuals and Members  1.21.8.1.1. 1.21.8.1.2. 1.21.8.1.3. 1.21.8.1.4. 1.21.8.1.5. 1.21.8.2.  Transfer of documentation to include all electronic and physical documentation. Transfer of all individual and Member records through the Department Case  Management Systems. Transfer ofs services  Transfer of Case Management Services  The Closeout Plan shall also designate an individual to act as a closeout coordinator who will ensure that all requirements, steps, timelines, milestones, and deliverables contained in the Closeout Plan are completed and work with the Department and any other contractor to minimize the impact oft the transition on Members and the Department. Contractor shall ensure all policy, procedures, training, and appeals information are Contractor shall deliver the Closeout Plan to the Department for review and approval.  1.21.8.2.1. 1.21.8.3.  transferred to the Department.  Exhibit] E, Contractor's Adminstrative Requirements  Page lofl    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.21.8.4. 1.21.8.5. 1.22. Closeout Period  Contractor shall provide weeklyupdates to thel Department throughout the creation ofand the performances within the Operations Guide, that show Contractor's status toward Contractor shall be ready to perform all Work by the Operational Start Date.  meeting the milestones described herein.  1.22.1. During the Closeout Period, Contractor shall complete all of the following:  1.22.1.1.  Implement the most recent Closeout Plan or Closeout Plan Update as approved by the Department in the Operations Guide, as described herein and complete all steps, Deliverables and milestones contained in the most recent Closeout Plan or Closeout Plan Provide to the Department, or any other contractor at the Department's direction, all reports, data, systems, Deliverables, and other information reasonably necessary for a transition as determined by the Department or included in the most recent Closeout Plan Ensure that all responsibilities under the Contract have been transferred to the Department, or to another contractor at the Department's direction, without significant Notify any Subcontractors of the termination of the Contract, as directed by the Notify all Members that Contractor will no longer be the CMA as directed by the Department. Contractor shall create these notifications and deliver them to the Department for approval. Once the Department has approved the notifications, Contractor shall deliver these notifications to all Members, but in no event shall Contractor deliver any such notification prior to approval of that notification by the Department. DUE: 90 Calendar Days prior to termination oft the Contract  Update that has been approved by the Department.  1.22.1.2.  or Closeout Plan Update that has been approved by the Department.  1.22.1.3. 1.22.1.4. 1.22.1.5.  interruption. Department.  1.22.1.5.1. 1.22.1.5.2. 1.22.1.6.  DELIVERABLE: Member Notifications  Continue meeting each requirement of the Contract as described in the Department- approved and updated Closeout Plan, or until the Department determines that specific requirement is being performed by the Department or another contractor, whichever is sooner. The Department will determine when any specific requirement is being performed by the Department or another contractor and will notify Contractor of this The Closeout Period may extend past the termination of the Contract. The Department will perform a closeout review to ensure that Contractor has completed all requirements of the Closeout Period. If Contractor has not completed all of the requirements of the Closeout Period by the date of the termination of the Contract, then any incomplete  determination for that requirement.  1.22.1.7.  requirements shall survive termination oft the Contract.  1.23. Long-Range Plan  1.23.1. The Contractor shall create and present to the Department a Long-Range Plan for its Defined  Service. Area that describes, at a minimum, the following:  Exhibit E, Contractor's Adminstrative Requirements  Page lof1    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.23.1.1. 1.23.1.2. 1.23.1.3. 1.23.1.4. 1.23.1.5. 1.23.1.6.  Administrative and case management accomplishments of Contractor in the previous Identified unmet needs of eligible persons in the Defined Service Area and action steps How Contractor will solicit input from Members and families to ensure quality services. Local area issues that impact or are expected to impact the Defined Service Area and Policies that are considered by Contractor to be a barrier to ensuring a comprehensive case management system and suggested modifications to overcome the barriers. As summary of how Contractor is working to recruit and retain case management staff currently and for the future to maintain and improve the case management services in its 1.23.1.7. A summary of how Contractor is working to recruit new and existing A summary of past efforts and future plans to accelerate equity, diversity, inclusion, and The Contractor's efforts toi recruit members ofthe Community Advisory Committee who represent the characteristics of the community as it relates to diversity ofrace, ethnicity, not limited to: CCBs, RAEs, Behavioral Health Authorities, schools, nursing facilities and other unpaid supports and advocacy partners will be used to support members in the  year.  necessary to meet those needs.  action steps on how to resolve those issues.  Defined Service Area.  providers to expand their services in the Defined Service Area.  1.23.1.8. 1.23.1.9.  access.  religious affiliation, etc.  1.23.1.10. How Contractor will engage with and facilitate existing social networks including, but  Defined Service Area.  1.23.1.11. How State General Fund programs and supports will be used to support individuals,  members, and families within the Defined Service Area.  1.23.1.12.  How the voices of historically underserved and marginalized communities will be and individuals seeking or waiting for services and how the feedback willl bei incorporated into strategies for delivering case management services within the Defined Service Area.  incorporated into decision-making within the Defined Service. Area.  1.23.1.13. How feedback will be obtained from community members, members receiving services,  1.23.2. DELIVERABLE: Long-Range Plan and Presentation to the Department  1.23.3. DUE: Annually, by August 15th 1.24. Community Advisory Committee  1.24.1. Within 30 Calendar Days of the Contract execution date, Contractor shall establish a  Community Advisory Committee of no less than five committee members that will meet at least quarterly to obtain public input and guidance for CMA operations and follow rules and  regulations set: forth in C.R.S. 8.7201.C.  1.24.2. The Community Advisory Committee shall include, but not bel limited to, at least one person  as the regional representation from among the following categories:  Exhibit] E, Contractor's. Adminstrative Requirements  Page lofl    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.24.2.1.  The Defined Service Area's county commissioners, area agencies on aging, medical professionals, physical and/or intellectual disability professionals, ombudsmen, human services agencies, county government officials, mental/behavioral health professionals, Regional representation from one or more LTSS members or family members of individuals receiving LTSS and make every effort to recruit and maintain a majority of  and  1.24.2.2. 1.24.2.2.1. 1.24.2.2.2. 1.24.2.2.3.  individuals with this lived experience on the committee:  Members with IDD and/or Members with disabilities  Members shall be given priority of selection over: family members.  1.24.3. Contractor shall submit the Community Advisory Committee member list annually on the 1.24.4. IfContractor is unable to recruit and maintain a majority ofmembers, advocates, and people  template prescribed by the Department.  with lived experience on the committee, Contractor shall outline efforts to do SO with their  deliverable submissions.  1.24.4.1. 1.24.4.2.  DELIVERABLE: Community Advisory Committee Member List  DUE: Annually, by August 15th  1.24.5. Contractor shall notify the Department of any changes to Community Advisory Committee  membership within 10 Business Days oft the date of change.  1.24.5.1. 1.24.5.2.  DELIVERABLE: Community Advisory Committee Membership Updates DUE: Within 10 Business Days oft the date of change to the membership list. individuals or family members of individuals receiving long-term disability and/or I/DD the characteristics of the community as it relates to diversity of race, ethnicity, religious recommendations and is not a decision-making body. As such the Community Advisory Provide public input and guidance to the Contractor in the review of service delivery policies and procedures, marketing strategies, resource development, overall operations, service quality, individual member satisfaction and other related programmatic opportunities. The Contractor shall receive and consider recommendations from the Community Advisory Committee to modify policies and procedures to address systemic Support the Contractor with developing strategies fori resolving complaints at the local or Maintain and post public notices of meetings, meeting minutes, and documented follow  1.24.6. The Community Advisory Committee shall include at least two regional representatives of 1.24.7. The Contractor shall demonstrate efforts to recruit members of the committee who represent 1.24.8. The Community Advisory Committee is an advisory body to the Contractor that provides  services.  affiliation, etc. These efforts shall be reflected in the Long-Range Plan.  Committee shall:  1.24.8.1.  barriers at a local or regional level, ini the Long-Range Plan.  1.24.8.2. 1.24.8.3.  regional level.  up on Contractor's website.  Exhibit) E, Contraçtor's. Adminstrative Requirements  Page 1 of1    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.24.8.4. 1.24.8.5. 1.24.8.6. 1.24.8.7. 1.24.8.8. 1.24.8.9. 1.24.8.9.1. 1.24.8.9.2.  Contractor shall post the meeting date, time, and location of the meeting and the meeting agenda at least 10 Business Days prior to the meeting on Contractor's website. Contractor shall post meeting minutes and any related follow-up action items once approved by the Community Advisory Committee and Contractor on Contractor's Report to the Contractor's governing body or board of directors quarterly on all case management complaints trends and follow-up completed by the Contractor. Provide reports to the Department and its committees upon request.  website.  The Community Advisory Committee may be combined in purpose or name with other CMA committees in the Contractor's defined service area sO long as it meets the above The Community Advisory Committee must use the operational templates prescribed by DELIVERABLE: Semi-annual Community Advisory Committee Meetings DUE: Semi-Annually, for meetings held between July 15t and December 315t, Committee Updates are due January 15th, and for meetings held between January 1st  purpose, criteria, and reports. the Department as minimum standards.  Summary  through June 1s, Committee Updates are due. June 15th  1.25. Performance Reviews  1.25.1. The Department may conduct performance reviews or evaluations of Contractor in relation 1.25.2. The Department may work with Contractor in the completion ofany performance: reviews or 1.25.3. Contractor shall provide all information necessary for the Department to complete all  tot the Work performed under the Contract.  evaluations or the Department may complete any or all performance reviews or evaluations performance reviews or evaluations, as determined by the Department, upon the Department's request. Contractor shall provide this information regardless of whether the Department decides to work with Contractor on any aspect of the pertormance review or  independently, at the Department's sole discretion.  evaluation.  1.25.4. The Department may conduct these performance reviews or evaluations at any point during 1.25.5. The Department may make the results of any performance reviews or evaluations available 1.25.6. The Department may recoup funding as a result of any performance review or evaluation  the term oft the Contract, or after termination ofthe Contract for any reason.  to the public or may publicly post the results of any performance reviews or evaluations. where payment wasi rendered for services not complete or not in alignment with federal and/or  state regulations or this Contract.  1.26. Corrective Action Plan  1.26.1. When the Department determines that Contractor is not in compliance with any term of this  Contract, Contractor, upon written notification by the Department, shall develop a corrective  action plan. Corrective action plans shall include, but not be limited to:  Exhibit E, Contractor's. Adminstrative Requirements  Pagelof1    Docusign Envelope ID: 8D4B896/0844F7D.958FP-CATIDABASES  1.26.1.1. 1.26.1.2.  A detailed description of actions to be taken including any supporting documentation.  Contractor's employee(s)r responsible for implementing the actions. The implementation time frames and a date for completion. Days of the receipt ofa written request from the Department. DELIVERABLE: Corrective Action Plan  1.26.2. Contractor shall submit the Corrective Action Plan to the Department within 10 Business  1.26.2.1. 1.26.2.2.  DUE: Within 10 Business Days ofr receipt of a written request from the Department be able to present the Corrective Action Plan by the due date. Contractor shall explain the rationale for the delay and the Department may grant an extension, in writing, oft the deadline reject the proposed Corrective Action Plan. Modifications and rejections shall be revised Corrective Action Plan and resubmit it along with requested documentation to the  1.26.3. Contractor shall notify the Department in writing, within three Business Days, ifit will not  for Contractor's compliance.  1.26.4. Upon receipt of Contractor's Corrective Action Plan, the Department will accept, modify, or 1.26.5. In the event ofa a rejection of Contractor's Corrective Action Plan Contractor shall re-write a  accompanied by a written explanation.  Department for review.  1.26.5.1. 1.26.5.2.  DELIVERABLE: Revised Corrective Action Plan DUE: Within five Business Days oft the Department's rejection  1.26.6. Upon acceptance by the Department Contractor shall implement the Corrective Action Plan. 1.26.7. Ifcorrections are not made by the timeline and/or quality specified by the Department then 1.26.8. As part of the Corrective Action Plan, supporting documentation demonstrating that 1.26.9. Upon receipt of Contractor's supporting documentation, the Department will accept, request 1.26.10. In the event of a rejection of Contractor's supporting documentation to the Corrective Action 1.26.11. Ifa Corrective Action Plan or any supporting activities or documentation are required to  funds may be withheld from this Contract. Payments offunds from this Contract will resume beginning the month that the correction is made and accepted by the Department. deficiencies have been remediated may be required. Contractor shall ensure all supporting documentation is submitted within the timeframes established in the Corrective Action Plan. modifications, or reject the documentation. Modifications and rejections shall be Plan, Contractor shall correct and resubmit the supporting documentation to the Department correct a deficiency, are not submitted within the requested timeline and/or quality specified by the Department, funds may be suspended or withheld from this Contract. DELIVERABLE: Revised Supporting Documentation  accompanied by a written explanation.  forreview.  1.26.11.1.  1.26.11.2. DUE: Within five Business Days of the Department's rejection  1.26.12. Ifcorrections are: noti madel byt the timeline and quality specified by thel Department then funds  may be withheld and: recovered from this Contract. Payments offunds from this Contract will resume beginning the month that the correction is made and accepted by the Department.  Exhibit E, Contractor's Adminstrative Requirements  Pagel lof1    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.27. Renewal Options and Extensions  1.27.1. The Department: may, within its sole discretion, choose to not exercise any renewal option in 1.27.2. The Parties may amend the Contract to extend beyond eight years, in accordance with the  the Contract for any reason, If the Department chooses to not exercise an option, it may Colorado Procurement Code and its implementing rules, in the event that the Department determines the extension is necessary to align the Contract with other Department contracts, to address state or federal programmatic or policy changes related to the Contract, or to  reprocure the performance oft the Work ini its sole discretion.  provide sufficient time to transition the Work.  1.28. Department System Access  1.28.1. In the event that Contractor requires access to any Department computer system to complete  the Work, Contractor shall have and: maintain alll hardware, software, andi interfaces: necessary to access the system without requiring any modification to the Department's system. Contractor shall follow all Department policies, processes, and procedures necessary to gain access to systems needed to perform the Work under this solicitation, as determined by the Department. The Department will not reimburse Contractor for any costs associated with  access to the Department's systems.  1.28.2. Contractor shall be responsible for any costs associated with obtaining and maintaining  obtaining and maintaining access to Department systems.  1.29. Provider Fraud  1.29.1. Contractor shall notify the Department and the Colorado Medicaid Fraud Control Unit ofthe 1.29.2. Upon identification or suspicion of possible Provider Fraud, Contractor shall complete  Colorado Department of Law (MFCU) ifit identifies or suspects possible Provider Fraud as  ar result of any activities in its performance oft this Contract.  Contractor Suspected Fraud Written Notice Form provided by the Department.  1.29.2.1. 1.29.2.1.1. 1.29.2.1.2. 1.29.2.1.3. 1.29.2.1.4. 1.29.2.1.5. 1.29.2.1.6.  For each incident ofi identified or suspected Provider Fraud, Contractor shall provide all  oft the following, at ai minimum: Written documentation oft the findings. Information on any verbal or written reports.  All details oft the findings and concerns, including a chronology of Contractor actions which resulted in the reports, in a format agreed to by the Department. Information on the identification of any affected claims that have been discovered. Any claims data associated with its report (in a mutually agreed upon format, if  possible).  Any additional information as required by the Department.  1.29.3. For each incident of identified or suspected Provider Fraud, Contractor shall deliver the  completed Contractor Suspected Fraud Written Notice Form to the Department and the DELIVERABLE: Completed Contractor Suspected Fraud Written Notice Form  MFCU.  1.29.3.1.  Exhibit] E, Contractor's. Adminstrative Requirements  Page lofl    Docusign Envelope ID: 8D4B896-7084-4F7D-95BF-CA11DA86A3E9  1.29.3.2.  DUE: Within three Business Days following the initial discovery of the Fraud or  suspected Fraud  1.29.4. Contractor shall revise or provide additional information related to Contractor Suspected  Fraud Written Notice Form as requested by the Department or the MFCU.  1.29.4.1. 1.29.4.2.  DELIVERABLE: Contractor Suspected Fraud Written Notice Revisions and Additional DUE: Within three Business Days following the Department's or the MFCU's request, unless the Department or MFCU provides for a different period in its request.  Information  1.30. Member Fraud  1.30.1. Contractor shall notify the Department ifit identifies or suspects possible Member Fraud as 1.30.2. Upon identification or suspicion of possible Member Fraud, Contractor shall complete  aresult ofany activities in its performance oft this Contract.  Contractor Suspected Fraud Written Notice Form provided by the Department.  1.30.2.1. 1.30.2.1.1. 1.30.2.1.2. 1.30.2.1.3. 1.30.2.1.4. 1.30.2.1.5.  For each incident of identified or suspected Member Fraud, Contractor shall provide all  ofthe following, at ai minimum:  All verbal and written reports related to the suspected fraud.  All details oft the findings and concerns, including a chronology of Contractor actions which resulted ini the reports, and the Member's State ID number, and Member's date Information on thei identification of any affected claims that have been discovered. Any claims data associated with its report in a format agreed to by the Department.  ofbirth ifapplicable.  Any additional information as required by the Department.  1.30.3. For each incident of identified or suspected Member Fraud, Contractor shall deliver the  completed Contractor Suspected Fraud Written Notice Form to the Department at atclemfaudaslccoss or at such other email address as provided by the Department DELIVERABLE: Completed Contractor Suspected Fraud Written Notice Form DUE: Within three Business Days following the initial discovery of the Fraud or  from time to time.  1.30.3.1. 1.30.3.2.  suspected Fraud  1.30.4. Contractor shall revise or provide additional information related to Contractor Suspected  Fraud Written Notice Form as requested by the Department.  1.30.4.1. 1.30.4.2.  DELIVERABLE: Contractor Suspected Fraud Written Notice Revisions and. Additional DUE: Within three Business Days following the Department's request, unless the  Information  Department provides for a different period in its request.  2. CONTRACTOR PERSONNEL 2.1. Personnel General Requirements  2.1.1.  Contractor shall provide qualified Key Personnel and Other Personnel as necessary to  perform the Work throughout the term oft the Contract.  Exhibit E, Contractor's. Adminstrative Requirements  Page 1of1    Docusign Envelope ID; 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  2.1.2. 2.1.2.1. 2.1.2.2. 2.1.2.3. 2.1.2.4. 2.1.2.5. 2.1.2.6. 2.1.2.7. 2.1.2.8. 2.1.2.9. 2.1.3. 2.1.3.1. 2.1.3.2. 2.1.3.3. 2.1.3.4. 2.1.4. 2.1.5.  Contractor shall designate the following Keyl Personnel positions:  Executive Director or. Administrator Finance Director Case Management Director Continuous Quality Improvement Lead Contract Lead Information Technology Liaison Regional Accountable Entity (RAE) Liaison Medical Assistance (MA) Site/County Eligibility Liaison The Contract Lead shall be responsible for all the following:  Member and Family Liaison  Serving as Contractor's primary point of contact for the Department. contract-related questions or issues for the Department.  Serving as Contractor's primary point of contact for contract deliverables and other Ensuring the completion of all Work in accordance with the Contract's requirements. This includes, but is not limited to, ensuring the accuracy, timeliness, and completeness Ensuring the timely submission and accuracy of all Deliverables submitted to the Contractor shall post the name and contact information for the individual appointed as the Contractor shall provide the Department with a final list of individuals assigned to the Contract and appropriate contact information for those individuals using the template provided by the Department. Contractors with more than one Defined Service Area must submit the final list ofi individuals assigned to the Contract using the template provided by the Department for each Defined Service Area. The Department shall determine which Key Personnel may be allocated across organizational functions, which Key Personnel must be dedicated to the Contract, and which Key Personnel or Other Personnel must be dedicated to DELIVERABLE: Key Personnel, final list ofi individuals assigned to the Contract DUE: Within five Business Days after the Effective Date and annually by July 15th Contractor shall update this list upon the Department's request to account for changes in the DELIVERABLE: Key Personnel, updated list ofi individuals assigned to the Contract DUE: Within five Business Days after any change to the Key Personnel list Contractor shall not permit any individual proposed for assignment to Key Personnel positions to perform any Work prior to the Department's approval of that individual to be  ofall work. Department.  Member and Family Liaison on Contractor's website.  each Defined Service. Area.  2.1.5.1. 2.1.5.2. 2.1.6. 2.1.6.1. 2.1.6.2. 2.1.7.  individuals assigned to the Contract.  assigned as Key Personnel.  Exhibit E, Contractor's. Adminstrative Requirements  Pagelof1    Docusign Envelope ID: 8D4B89670844F7D.958F-CATIDABSAJES  2.1.8. 2.1.8.1.  Other Personnel  Contractor shall have sufficient staffing levels to include case managers, case aids, supervisors, and other staff as necessary to complete the Work and to maintain caseload sizes to support the Work. Contractor shall meet or exceed best practice standards as set forth by the Department through operational memos for HCBS waiver caseloads. Contractor shall not exceed the best practice caseload size standards without written Contractor's Case Manager(s) shall meet all the qualifications listed in 10 C.C.R. 2505- Contractor shall ensure appropriate staffing and infrastructure to address the needs ofa all All Key Personnel and Other Personnel assigned to this Contract shall complete annual Equity, Diversity, Inclusion, and Accessibility (EDIA) related training. Training must ensure staff are culturally competent and provide culturally responsive services and business practices at all levels oft the agency. The Department's EDIA Officer and/or their designee will offer free EDIA-related professional development training to Contractor  approval from the Department. 10, Section 8.7203.A et seq.  2.1.8.2. 2.1.8.3. 2.1.8.4.  populations including children and adults for all HCBS waivers.  upon request within the Department's LMS.  2.2. Background Checks  2.2.1.  Contractor shall conduct background checks on all new applicants for positions in which direct care, as defined in section $26.3.1.101(3.5), C.R.S. will bej provided to an at-risk adult, as defined in section $26-3.1-101 (1.5), C.R.S to include at a minimum a Colorado Bureau of Investigation check. On and after January 1,2 2019, prior to employment, Contractor shall submit the name ofa a person who will be providing direct care, to an at-risk adult, as well as any other required identifying information, to the Colorado Department of Human Services for a check of the Colorado Adult Protective Services data system pursuant to section $26- 3.1-111, C.R.S. to determine ift the person is substantiated in a case ofmistreatment of an at- Ifany of Contractor's Key Personnel, or Other Personnel, are required to have and maintain any professional licensure or certification issued by any federal, state, or local government agency, then Contractor shall maintain copies of such current licenses and certifications and  risk adult.  2.2.2.  provide them to the Department upon request.  2.3. Personnel Availability  2.3.1.  Contractor shall ensure Key Personnel and Other Personnel assigned to the Contract are available for meetings with the Department during the Department's normal business hours, as determined by the Department. Contractor shall also make these personnel available outside oft the Department's: normal business hours and on weekends with prior notice from Contractor shall ensure that appropriate Key Personnel and Other Personnel are available for all regularly scheduled meetings between the Contractor and the Department. The Department may, at times, require specific personnel to attend ai meeting and will notify the  the Department.  2.3.2.  Contractor of such request.  Exhibit E, Contractor's. Adminstrative Requirements  Pagelof1    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  2.3.3. 2.3.4. 2.3.5.  Contractor shall ensure that the Key Personnel and Other Personnel attending all meetings between the Department and Contractor have the authority to represent and commit Contractor regarding work planning, problem resolution and program development. At the Department's direction, Contractor shall make its Key Personnel and Other Personnel available to attend meetings as subject matter experts with stakeholders both within the State All of Contractor's Key Personnel and Other Personnel that attend any meeting with the Department or other Department stakeholders shall be present at the meeting through video conference, telephonic, or in-person depending on the purpose and intent of the meeting. If Contractor has any personnel attend by telephone or video conference, Contractor shall provide all additional equipment necessary for attendance, including any virtual meeting Contractor shall respond to all telephone calls, voicemails, and emails from the Department Contractor shall respond to Department directed escalations according as prescribed by the  government and external private stakeholders.  space or telephone conference lines.  2.3.6. 2.3.7.  within two Business Days of receipt by Contractor.  Department.  2.4. Other Personnel Responsibilities  2.4.1.  Contractor shall use its discretion to determine the number of Other Personnel necessary to perform the Work in accordance with the requirements of this Contract. If the Department determines that Contractor has not provided sufficient Other Personnel to perform the Work in accordance with the requirements oft this Contract, Contractor shall provide all additional Other Personnel necessary toj perform the Work in accordance with the requirements of this Contractor shall ensure that all Other Personnel have sufficient training and experience to complete all portions of the Work assigned to them. Contractor shall provide all necessary training to its Other Personnel, except for State-provided training specifically described in Contractor may subcontract to complete aj portion oft the Work required by the Contract. The  Contract at no additional cost to the Department.,  2.4.2.  this Contract.  2.4.3. 2.4.3.1. 2.4.3.2. 2.4.3.2.1. 2.4.3.2.2. 2.4.3.3. 2.4.3.4.  conditions for using a Subcontractor or Subcontractors are as follows: Contractor shall not subcontract more than 40% oft the Work.  Contractor shall provide the organizational name of each Subcontractor and all items to be worked on by each Subcontractor to the Department for approval prior to DELIVERABLE: Name of each Subcontractor, description of work being completed, and percentage of work being completed by the Subcontractor.  commencement ofWork.  DUE: Annually, by July 15th Business Days oft the change.  Contractor shall notify the Department of any changes to Subcontractors within 10 Contractor shall obtain prior consent and written approval for any use of Subcontractor(s).  3. INFORMATION TECHNOLOGY RELATED REQUIREMENTS  3.1. Protection of System Data Exhibit! E, Contractor's Adminstrative Requirements  Page lofl    Docusign Envelope ID: #DAB89670844F70.858CATIDABAJE)  3.1.1.  In addition to the requirements of the main body of this Contract, if Contractor or any Subcontractor is given access to State Records by the State or its agents in connection with Contractor's pertormance under the Contract, Contractor shall protect all State Records in accordance with this Exhibit. Allj provisions ofthis Exhibit that refert to Contractor shall apply equally to any Subcontractor performing work in connection with the Contract. For the avoidance of doubt, the terms oft this Exhibit shall apply to the extent that any oft the following statements is true in regard to Contractor access, use, or disclosure of State  3.1.2. 3.1.2.1. 3.1.2.2. 3.1.2.3. 3.1.3. 3.1.3.1. 3.1.3.2. 3.1.3.3. 3.1.3.4. 3.1.3.5. 3.1.4. 3.1.4.1. 3.1.4.2. 3.1.4.3.  Records:  Contractor provides physical or logical storage of State Records.  Contractor creates, uses, processes, discloses, transmits, or disposes of State Records. Contractor is otherwise given physical or logical access to State Records in order to  perform Contractor's obligations under this Contract.  Contractor shall, and shall cause its Subcontractors, to do all oft the following: Provide physical and logical protection for all hardware, software, applications, and data that meets or exceeds industry standards and the requirements ofthis Contract. Maintain network, system, and application security, which includes, but is not limited to, network firewalls, intrusion detection (host and network), annual security testing, and improvements or enhancements consistent with evolving industry standards. Comply with State and federal rules and regulations related to overall security, privacy, Provide that security is not compromised by unauthorized access to workspaçes, computers, networks, software, databases, or other physical or electronic environments. Promptly report all Incidents, including Incidents that do not result in unauthorized  contidentiality, integrity, availability, and auditing.  disclosure or loss of data integrity, to the State. Colorado Information Security Policy (CISP) Compliance  Contractor shall assess its compliance with the CISPs, in effect at the time of the assessment, issued by the Governor's Office of Information Technology ("OIT") posted For the purposes ofreviewing and assessing compliance with the CISPs, Contractor shall consider itself to be both the Information Technology Service Provider (ITSP) and Contractor shall deliver to the State the signed CISP Attestation, on a form provided by the Department, indicating that Contractor has assessed its compliance with the CISPS and has developed a plan to correct, in a timely manner, any security vulnerabilities  at www.otstate.co.1sAbout/policies under Information Security.  Business Owner.  identified during the assessment. DELIVERABLE: CISP Attestation  3.1.4.3.1. 3.1.4.3.2. 3.1.4.4. 3.1.4.4.1.  DUE: Within 30 Business Days after the Effective Date  Contractor shall assess its compliance with the CISPS on an annual basis and deliver to the State the signed CISP Attestation, on a form provided by the Department.  DELIVERABLE: Annual CISP Attestation  Exhibit E, Contractor's. Adminstrative Requirements  Pagelofl    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  3.1.4.4.2. 3.1.4.5.  DUE: Annually, by June 30th ofeach year  Contractor shall cause its Subcontractors to comply with the CISPS and to assess their compliance on at least and annual basis. If any Subcontractor's assessment determines that the Subcontractor is not in compliance, then Contractor shall ensure that Subcontractor corrects, in a timely manner, any security vulnerabilities identified during  the assessment.  3.1.5. 3.1.5.1.  Health and Human Services HIPAA Security Rule Risk Assessments  Contractor shall deliver to the State a signed Initial HHS Attestation, on a form provided by the Department, indicating that Contractor has conducted a risk assessment of its operations related to the services provided under this Contract that satisfies the requirement of 45 CFR. 164.3080/C)00)0A) (the "HIPAA Security Rule"), and that Contractor has developed a plan to correct, in a timely manner, any vulnerabilities in administrative, technical, or physical safeguards identified during the assessment.  3.1.5.1.1. 3.1.5.1.2. 3.1.5.2.  DELIVERABLE: Initial HHS Attestation DUE: Within 30 Business Days after the Effective Date  Contractor shall conduct an annual risk assessment ofits operations related to the services provided under this Contract that satisfies the requirement of the HIPAA Security Rule and deliver to the State the signed Annual HHS Attestation, on a form provided by the  Department.  3.1.5.2.1. 3.1.5.2.2. 3.1.5.3.  DELIVERABLE: Annual HHS Attestation DUE: Annually, by June 30th of each year  Contractor shall cause its Subcontractors to comply with the HIPAA Security Rule and assess their compliance on at least an annual basis. If any Subcontractor's assessment determines that the Subcontractor is not in compliance, then Contractor shall ensure that Subcontractor corrects, in a timely manner, any vulnerabilities in administrative, Subject to Contractor's reasonable access security requirements and upon reasonable prior notice, Contractor shall provide the State with scheduled access for the purpose ofi inspecting and monitoring access and use of State Records, maintaining State systems, and evaluating Contractor shall perform background checks on all of its respective employees and agents performing services or having access to State Records provided under this Contract. A background check performed during the hiring process shall meet this requirement. Contractor shall perform a background check on any employee if Contractor becomes aware ofany reason to question the employability of an existing employee. Contractor shall require Contractor shall deliver to the State the signed Background Check Attestation, on a form provided by the Department, indicating that background checks have been completed on  technical, or physical safeguards identified during the assessment.  3.1.6.  physical and logical security control effectiveness.  3.1.7.  all Subcontractors to meet the standards oft this requirement.  3.1.7.1. 3.1.7.1.1. 3.1.7.1.2.  employees participating in operations related to this Contract. DELIVERABLE: Background Check Attestation DUE: Within 30 Business Days of the Effective Date  Exhibit! E, Contractor's Adminstrative Requirements  Page 1of1    Docusign Envelope ID: 08D4B896-7084-4F7D-95BF-CA11DA86A3E9  3.1.7.2.  IfContractor will have access to Federal Tax Information under the Contract, Contractor shall agree to the State's requirements regarding Safeguarding Requirements for Federal Tax Information and shall comply with the background check requirements defined in  IRS Publication 1075 and $24-50-1002, C.R.S.  3.2. Data Handling 3.2.1.  The State, in its sole discretion, may securely deliver State Records directly to Contractor. Contractor shall maintain these State Records only within facilities or locations that Contractor has attested are secure, including for the authorized and approved purposes of backup and disaster recovery purposes. Contractor may not maintain State Records in any data center or other storage location outside the United States for any purpose without the Contractor shall not allow remote access to State Records from outside the United States, including access by Contractor's employees or agents, without the prior express written consent ofoIs. Contractor shall communicate any request regarding non-U.S. access to State Records to the Security and Compliance Representative for the State. The State shall have Upon request by the State made any time priort to 601 Business Days following the termination of this Contract for any reason, whether or not the Contract is expiring or terminating, Contractor shall make available to the State a complete and secure download file ofall data that is encrypted and appropriately authenticated. This download file shall be made available to the State within 10 Business Days of the State's request, and shall contain, without limitation, all State Records, Work Product, and system schema and transformation définitions, or delimited text files with documents, detailed schema definitions along with attachments in its native format, Upon the termination of Contractor's provision of data processing services, Contractor shall, as directed by the State, return all State Records provided by the State to Contractor, and the copies thereof, to the State or destroy all such State Records and certify to the State that it has done SO. If legislation imposed upon Contractor prevents it from returning or destroying all or part of the State Records provided by the State to Contractor, Contractor shall guarantee the confidentiality of all State Records provided by the State to Contractor and will not actively process such data anymore. The State retains the right to use the established operational services to access and retrieve State Records stored on Contractor's infrastructure at its sole discretion and at any time. Upon request oft the State or of the supervisory authority, Contractor shall submit its data processing facilities for an audit oft the measures referred to in this Exhibit in accordance  prior express written consent oft the State.  3.2.2.  sole discretion to grant or deny any such request.  3.2.3.  3.2.4.  with the terms ofthis Contract.  Exhibit E, Contractor's/ Adminstrative Requirements  Page 1 ofl    PROWERS COUNTY AGENDA ITEM REQUEST FORM  Hearing Date Requested: 12-10-2024 Submitter: Administration Office  Submitted to the County Administration Office on: 11-25-2024 Return Originals to: Jana Coen & Administration Office Number of originals to return to Submitter: 2  Contract Due Date:  Item Ttle/Recommended Board Action:  Consider approval of Fairgrounds Facility Rental Agreement and waiver of fees for Tri-  State 9-11 Foundation, event scheduled for September 3-7, 2025.  Justification or Background:  Fiscal Impact: This item is budgeted in the following account code:  County: Federal: State: Other:  $_ $_ $ $_  Approved by the County Attorney on: Additional Approvals (if required):    PROWERS COUNTY FAIRGROUNDSI FACILITY  RENTAL AGREEMENT  9/3-7/2025  Today's Date: H-al-202t Name ofOrganization: TRI-STATE -LEDENDATON Name & Address of Authorized Agent: DouG ARBOUR POBOXLa3 LAMAR CB 81050 Phone: (7I4)L41-0959 Sales Tax) ID: Type of  Date(s) of Events:_ 9-6-2025  Set Up Time: 7 Event Starts: 9 Finish Time: 5 Arena Centennial  ampm Aam) pm am (pm Home Ec Pavilion  Vaqueros  EventATPOTcPCADE ANDTRIBUTE FORALL FIPSTPESPONDEPS Ifapproved by the Board of County Commissioners (the Commisione-".lagre to pay fees in the amount of s2t50e or tosubmit a request for a Waiver oft the feesI understand the decision to waive any or all ofthe fees are at thet total discretion of the Commissioners. Ih have attached copies of my State of Colorado Sales Tax License and the City ofLamar Sales Tax License, if applicable. Failure to do so will result in denial of my rental request,  AND MIL ITARY PAST AND PRESENT  unless Iam legally exempt. The attached lease terms are part of this Agreement.  1-21-2024  Authorized  Date  Lh  Ageat  The Commissioners reserve the right to: not lease any portion or all oft the Fairgrounds to any organization which it deems in its sole discretion, to be in direct and adverse competition to Prowers County merchants or is otherwise detrimental to Prowers County citizens. Fees may be adjusted at the discretion of the Commissioners based upon  the number of participants or unique conditions. Fees are based on daily rates.  Rental Approved:  Soamalion Mainténance & Facilities Director  11-26-34 Date Date  Chairman  Prowers County Board of Commissioners  For County Use Only: Date Booking Fee Paid ($25.00): Date Rental Fee Paid: Inspection completed:  Damage/Cleaning Deposit: Date Paid:  Damage/Cleaning Deposit Refunded: Y/N, ifn no, see attached.  Please note that any deposit refund due back to you willl be provided by a Prowers County check. Checks are  issued upon approval at the Commissioners' meetings. Liability Insurance received: Yes No_ Date:  Update 08/27/2024  Fairgrounds Rental Agreement    PROWERS COUNTY FAIRGROUNDS  FACILITY RENTAL RESERVATION AGREEMENT  Between Prowers County Board ofCommissioners (Commissioners) and the Authorizing Agent  the facility, including any parking areas, if applicable (Rented Premises).  (User) renting  1. Determination of fees for use of the facilities shall be made by the Commissioners in accordance with the established fee schedule and agreed to by the User at the time the reservation is confirmed. Use oft the Rented Premises shall not include Prowers County personnel, including, but not limited to, County Maintenance 2. Unique events may require an increase in fees/charges and/or conditions in addition to those shown. The Commissioners reserve the right to modify any oft the conditions as necessary on a case-by-case basis. use of the Fairgrounds is subject to approval by the Commissioners. All County holidays are observed Holiday County Maintenance Personnel. No) Prowers County Personnel will be made availablet to the User over County- by approved Thanksgiving and Christmas holidays. Additional fees will be assessed for events scheduled on holidays. Overtime charges for County Maintenance Personnel at a rate oft two times the normal will be. charged for holiday events, in addition to regular fees and charges, with the exceptions hourly described  Personnel.  rate  previously in this paragraph. Fees and deposits:  3.  Use ofa all facilities shall be scheduled through the Prowers County Administration Office a) A non-refundable booking fee of $25.00 per event must be paid when each event is scheduled. b) The $25.00 booking fee is due before an individual or entity may have their name placed on the Fairgrounds c) Ifthe event does not go forward for whatever reason, the $25.00 fee WILLNOT BE REFUNDED. d) The remainder of the Rental Fee and Damage/Cleaning: Deposit must be submitted to the office no less than ten (10) working days prior to the date scheduled. (Commercial users: fees must be paidi inc certified funds.)The Damage/Cleaning Deposit is required and due from all Users whether use fees are waived or not. Failure to fees ten (10) working days prior to the event may result in cancellation of facility use. Access to the facilities pay at any time other than stated on this form is not allowed unless prior approval is received from the Commissioners. Please note that the Damage/Cleaning Deposit refund, if any, due back to the User will be provided by a Prowers County check. Checks are issued upon approval at the Commissioners' meetings. 4. The scheduling of the activities shall be made in the name of one individual who must, as a condition of read this document and accept responsibility for adequately supervising the event; assure that the facilities use, are used for thej purpose for which they are: scheduled; reimburse the County for damage to the property ori facilities including excessive clean-up costs that may occur in connection with the event; assure payment, in full, ofall charges for space and equipment requested; and ensure that all promotion and advertising of events the use of the facilities shall identify the individual or group sponsor of thei event. 5. The Damage/Cleaning: Deposit must be paid within ten. (10) days prior to the scheduled event. The Damage/Cleaning. Deposit shall be utilized by Prowers County, ifnecessary, for cleanup and repair of ofthe Rented Premises. Int the event that the User performs cleanup oft thel Rented Premises in a suitable damages manner and there is no damage, The Damage/Cleaning Deposit will be reviewed for return to the User at the next regularly scheduled meeting of the Commissioners. The Rented Premises is an alcohol-free facility. alcohol is brought to the Fairgrounds. the entire deposit will be retained. The User will be personally Ifany liable 6. Inc case of cancellation, the Rental Fee willl ber refunded (less thel booking fee)i ifnotice ofcancellation isr received ten (10) working days prior to scheduled use. Ift the event is canceled due to inclement weather, the event may  only.  calendar to reserve a facility at the Fairgrounds.  involving  for any expense for damage and/or cleanup in excess of the required deposit.  Update 08/27/2024  2  Fairgrounds Rental Agreement    bei rescheduled with no additional fees due. Ifthe event is rescheduled for any other reason without the required  notice, an additional booking fee will be charged.  7. Subleasing or charging additional fees to use thel Rented Premises will not be permitted.  8. Non-commercial Users may have one (1) day in advance for set-up, decorating, etc. between the hours of 8:00 am and 4:00 pm, provided that there is nothing previously booked on that date. Ifadditional days are required for set-up, an additional fee of $100 will be charged for each additional day. Commercial Users: If special set- 9. Liability insurance is required for all commercial events. Certain "at risk" activities, i.e. rodeos, tractor pulls, carnivals, circuses, etc. are required to provide liability insurance. An insurance certificate showing Prowers County as an additional insured must be provided to the County no later than ten (10) business days prior to 10. Under Colorado Law, an equine professional is not liable for any injury to or the death ofaj participant ine equine activities resulting in the inherent risks of equine activities, pursuant to Section 13-21-119, Colorado Revised 11. The User acknowledges that the User's rental of Prowers County's property is not subject to the direct supervision and control of] Prowers County personnel. Accordingly, and in express consideration for the within Agreement, User hereby agrees to indemnify, and hold harmless, Prowers County, its officers, agents, and employees from and against any and all claims for liability asserted for personal injury, or property damage to anya and all persons or entities whatsoever, and arising out oft the User's rental of Prowers County's property as hereinabove set forth. This indemnification expressly extends to any and all damage awards, and shall further cover all costs of defense, which shall be conducted in Prowers County's sole discretion, including attorney's 12. The Agreement shall be and become binding upon, and inure to the benefit oft the parties hereto, their heirs, personal representatives, successors and designs. Any action necessary to construe, interpret, or enforce the provision of the Agreement shall be brought and maintained in the District Court in and for Prowers County, Colorado, with the substantially prevailing party therein being entitled, as a matter of contract law an agreement tor recover its costs and expenses therein incurred, including reasonable attorneys' and expert witness fees. 13. Falsified or misleading information on this form may be cause for cancellation oft this Agreement andi forfeiture of the Damage/Cleaning Deposit and/or Rental Fees paid and may result in loss of future usage of the Rented 14. The User shall be required to call for an on-site facility orientation with thel Fairgrounds caretaker no later than five (5) working days prior tot the event. The User will be familiarized with information pertaining to use ofthe facility, obtain keys, and will have the opportunity to ask questions of the Fairgrounds caretaker. The Fairgrounds Caretaker can be reached by calling 719-931-0034 and is available to schedule an orientation Monday - Friday 9:00 am tol Noon and 1:00pm to 3:00pm. Regularly scheduled monthly meeting organizers are not required to complete an orientation, however, are expected to cooperate with the expectations for use outlined in this Agreement. The User understands that Prowers County does not employ 7 day per week, 24 hour per day Fairgrounds Personnel. The Fairgrounds Caretaker hours are scheduled from 8:00 am to 5:00 pm, Monday -Friday. The Fairgrounds Caretaker schedule may change to correlate with an event; however, changes must be pre-approved and are at the discretion oft the Prowers County Maintenance Supervisor. 15. Every effort has been made to provide that the Rented Premises is adequately maintained and appropriately prepared for normal use. Iti is further understood that the building and grounds systems can, and do, fail at times. Failures may include, but are not limited to: electrical outlet power losses and blown breakers due to abnormal use and overloaded circuits, public announcing or loudspeaker malfunctions, lighting failures, water supply problems, and restroom malfunctions, etc. There are no guarantees against such failures either implied or stipulated in this Agreement. Prowers County Personnel will only be made available during off-hours in the  up/tear-down is required, standard facility use days will be charged on a % day basis.  the scheduled event.  Statutes.  and expert witness fees.  Premises.  Update 08/27/2024  3  Fairgrounds Rental Agreement    event of an emergency pertaining to life safety or unsanitary conditions. All other unexpected occurrences 16. The User understands that costs incurred by Prowers County due to responding to non-emergency, calls for service, facility or grounds clean-up, and sub-contractor repairs for damages to equipment or facilities will billed to the user at a rate of2 times the actual costs. Iti is the User's responsibility to minimize non-emergency be 17. The User agrees that it is their responsibility to provide, and be responsible for, the equipment or supplies necessary to circumvent potential failures in the buildings, restrooms, or arena including, but not limited to: portable generators, portable toilets, portable amplifier or loudspeaker systems, water, and/or water trucks for wetting a dusty arena floor, toilet paper and hand towel paper supplies, first aid supplies, etc. 18. The User is specifically responsible to ensure adherence toi these written and any posted policies and to: a) Provide written documentation specifying any concerns, system failures, or break-downs and deliver that documentation to the Fairgrounds Caretaker. Please do not manipulate circuit breakers. b) Pick-up trash and debris accumulated during the event including parking areas and deposit thei trash in the c) Re-stock indoor and outdoor men's and women's restrooms with toilet paper and paper hand towels as needed throughout the event. The Fairgrounds Caretaker will make these items available to users. d) Pick-up trash in, and around, the indoor and outdoor restrooms, the kitchen, and concession stands and leave fixtures, appliances, and counter surfaces clean. Sweep and mop, or vacuum indoor floor surfaçes. e) Make appropriate arrangements for providing the necessary crowd control, public safety, and building 3) Provide event security and present evidence ofs said security upon request by the Commissioners.  should be documented and will be addressed ont the next regular workday.  calls for service.  55-gallon trash drums provided, or ifi full, into available dumpsters.  security for the event.  Ensure that scheduled dance events end at 12:00 Midnight; no exceptions.  19. Prowers County assumes no responsibility for lost or stolen items.  20. Alcohol is not allowed on the Fairgrounds at any time. The county. has a zero-tolerance policy regarding alcohol. Any violation of this policy will result in immediate revocation of access to the Fairgrounds, a permanent ban going forward, and County retention of the entire damage deposit. Local law enforcement 21. Building or grounds emergency call: 931-0034 or 931-9335. Medical or safety emergency call: 911.  has been authorized to remove parties in violation oft this policy.  Ihave read, understand, and agree to thet terms and conditions outlined int this agreement.  Date: Organization: Authorizing Agent Printed name: Authorizing Agent Signature: Forl Rodeo Events:  Authorized Tractor/Equipment Operator) Printed Name:  Update 08/27/2024  Fairgrounds Rental Agreement    PROWERS COUNTY FAIRGROUNDS  FEE SCHEDULE Not For Resident or Non-Resident  #of days/head oflivestock  Facilities Requested Arena Rent Daily Pavilion Rent Daily Home Economics' Bldg. Rent Daily Vaqueros Bldg. Rent Daily Use of Parking Lots Arena. Lot/Grounds Daily Overnight Boarding (Arena Pens) $5/Head Daily *Pavilion Boarding Rodeo Events Minimum. Fee Daily R.V. or Camper Parking One Electric Pedestal: and One Water Connection per Rented Space only Daily Dry Camping and Horsel Penning atl Designated Southwest Parking Lot ONLY Daily Elmer's Garden Daily Cleaning/Damage Deposit (Due 10 days prior to event)  Profit $150 $150 $250 $225  Local For orl Non-Local Profit $300 $300 $250 $225  Total  For Profit $970 $970 $500 $425 $210 $10/head $40 $50  $5/Head $20 $30  $20 $30  $10 $0.00 $1000  $10 $0.00 $1000  $20 $0.00 $1000  *Rental Fees for the Pavilion for Not for Profit will not be charged since the Event Organizer is responsible for  collecting the fee. The feei is still subject to 50/50 split, at the Commissioners' discretion  TOTAL (DUE 101 DAYS PRIOR TO USE) Update 08/27/2024  $  $ 5  $  $  Fairgrounds Rental Agreement    1. Fees are based upon aj per calendar day rate. Events which extend beyond midnight oft the scheduled day 2. The Commissioners reserve the right to request verification ofr not-for-profit status. 3. A commercial event is defined as an activity where fees are charged to entrants and the sponsoring retains some or all oft the proceeds from the activity or where goods or services are offered for sale or entity lease tot the general public. The Commissioners. reserve the right to determine ifan eventi is a commercial 4. Commercial vendors will pay ai fee in addition to the fees listed on the attached fee schedule in the activity. amount of 1% of gross sales, based upon the vendor's projections. The amount oft the projected sales willl be verified 5. RV or Camper Parking is only allowed for a total of three (3) days per thirty (30)-day time period, unless a. RV or Camper Parking in conjunction with al Registered Event must follow the policies set forth in  may bes subject to a fee for an additional day.  by comparison oft the projection to Sales Tax as reported to the State.  inc conjunction with a Registered Event.  8a. below.  b. For RV or Camper Parking NOT in conjunction with a Registered Event:  i. Electrical and water hook-up fees are to be paid and collected at the Prowers County Administration Office at 301 S Main Street, Suite 215, Lamar, CO 81052 or by calling (719)336-8025 during normal business hours OR at the Fairgrounds Drop Box. ii. Each individual RV hook-up is provided for use exclusively by only one reserved RV. ii. No horses or livestock shall be penned near or around RV hook-up areas. Paid RV users iv. No RV, Trailer, Camper or Horse Trailer electrical hook-ups are allowed at any electrical V. The individual or organization on record at the Prowers County Administration Office will ber responsible to pay for any damage incurred due to unauthorized electrical or water  There isi no sharing of electrical or water hook-ups. must pen horses in covered stalls. outlet located on the Pavilion Structure.  connections.  6. Itist the responsibility oft the Event Organizer to make arrangements to meet on-site with the Fairgrounds Caretaker no latert than four (4) days prior toi the event toi receive building keys and facility use instructions. a. Covered and uncovered stall: fees are to bei reserved, collected, refunded for cleaning, and accounted  7. REGISTERED EVENTS ONLY:  for by the Event Organizer with the understanding that  ifcovered stalls are cleaned by the Event Organizer after use, the amount collected is split  50%/50% between the Event Organization and Prowers County.  8.1 REGISTERED EVENTS ONLY:  a. RV Electrical and water hook-up fees are to be: reserved, collected, and accounted for by the Event  Organizer with the understanding that:  1. Each individual RV hook-up is provided for use exclusively by only one reserved RV. ii. No horses or livestock shall be penned near or around RV hook-up areas. Paid RV users iii. No RV, Trailer, Camper or Horse Trailer electrical hook-ups are allowed at any electrical outlet located on the Pavilion Structure.. The Event Organization willl be responsible to pay  There is no sharing of electrical or water hook-ups. must pen horses in covered stalls.  for any damage incurred due to unauthorized electrical connections.  Update 08/27/2024  Fairgrounds Rental Agreement    PROWERS COUNTY FAIRGROUNDS REGISTERED RODEO EVENTS  FAIRGROUNDS USE:  The Prowers County Fairgrounds is available for registered rodeo events in-season from April through October. Conditions for use of the facilities for all events including registered rodeo events are specifically detailed in the 1. Prowers County Fairgrounds Facility Rental Reservation Agreement, 31 pages. Revised October20,2011. 2. Prowers County Fairgrounds Facility Rental Agreement, 1 page. Revised October 20, 2011. 4. All event organizers who may be interested in reserving the Prowers County Fairgrounds for a registered rodeo event are encouraged to: read very carefully all ofthe rental information provided by Prowers County  following information:  3. Fairgrounds Fee Schedule, 2 pages. Revised October 18, 2011.  before scheduling any rodeo event.  REGISTERED RODEO EVENTS:  Scheduled registered rodeo events are to be conducted in cooperation with the established fees and agreements for use of the Prowers County Fairgrounds. Event organizers are encouraged to include this information in all event literature distributed toj potential rodeo participants in an effort to lessen costly misunderstandings during the event.  Unless otherwise specified, the following are applicable to registered rodeo events:  1. The fairgrounds rodeo arena is watered regularly using a water reel. Use of the water reel by event organizers is prohibited. The rodeo arena may be watered once daily during a registered rodeo event at the event organizers request only ifs scheduled and coordinated with the Fairgrounds Caretaker. 2. Thei fairgrounds rodeo arena is worked prior to the rodeo event by the Fairgrounds Caretaker using Prowers County equipment. Working the arena during the event is the responsibility of the event coordinator. The county tractor and attached arena king finisher are available for use by the event coordinator, or specified driver, for the duration oft the event. A key to the tractor is provided only after the specified driver has met 3. Concession stand use is by reservation only. Call thel Prowers County Extension service (719-336-7734)to 4. The event organizer is responsible to reserve and collect fees for covered stalls located in the Prowers County Pavilion. The stalls are located in the Prowers County Sale Barn and set-up by Prowers County a. Scheduling with the Fairgrounds Caretaker for setting up horse stalls in the Pavilion. b. Scheduling with the Fairgrounds Caretaker for cleaning the stalls after the event.  on-site with the Fairgrounds Caretaker for operating instructions.  reserve.  Staff before the event.  5. The event organizer is responsible for ensuring the following:  6. The event organizer is responsible for reserving and collecting all fees associated with R.V. hook-ups, dry  camping, and horse stall fees.  The event organizer is responsible for ensuring the following:  1. No horses shall be tied or penned at, or near, any R.V. electrical or water hook-up located at the arena parking area and arena parking area fencing, or at the R.V. hook-ups located north of the Prowers 2. No R.V. campers, horse trailers, or other similar vehicles shall not be allowed to park near, and/or plug any electrical cord into the electrical outlets located in the Prowers County Pavilion. 3. Nol horses: shall bet tiedt to, or pennedi near, any permanent fence or anyt tree located anywhere on Prowers  County Pavilion.  County Fairgrounds property.  Update 08/27/2024  7  Fairgrounds Rental Agreement    4. All dry camping and horse penning shall be located in the southwest dirt parking area only. Under no circumstances shall dry camping and penning be located on roto-mill, asphalt, or grass areas elsewhere on the Prowers County Fairgrounds property. Thel Event Organizer isi responsible fort the cost of clean- 5. All R.V. hook-ups (pedestal) provided for use during registered rodeo events are for one (1) R.V. camper only. Under no circumstances shall more than one R.V. camper plug into a reserved pedestal. 6.-4 AIl horses and livestock are prohibited from access to paved pedestrian and driveways, grassy areas, treed areas, and covered buildings with the exception of the Prowers County Pavilion.  upi ifhorses are penned or tied in areas outside dry camp areas.  Update 08/27/2024  8  Fairgrounds Rental Agreement    USE OF THE PROWERS COUNTY FAIRGROUNDS R.V.  ELECTRIC PEDESTALS  In an on-going effort to mitigate potential damage, and to maintain safe, reliable electrical pedestals it is the  responsibility oft the Event Organizer to: remind each camper utilizing the pedestals that:  Each electrical pedestal is wired for 50 amp., 30 amp., or 20 amp. uses and should not be overloaded with Each electrical pedestal is intended to be used by a single user. One camper one pedestal. Choose one 50, 30, or 20-amp outlet that best meets the required load for each R.V. or Camp Trailer. Each electrical pedestal is complete and ready for use. Under no circumstances shall the face plate cover ber removed and/or the electrical outlets, wiring, or related pedestal components be manipulated. Use only safe and well-maintained electrical cords and plugs designed to carry the specified load. Under noc circumstances shall exposed cord wires be direct wired into any electrical pedestal or pedestal outlet. Do not secure livestock or pets to the electrical pedestals or water hydrants located in designated R.V. The electrical pedestal located north of the Crow's Nest is intended for auxiliary use only and is not Report any damaged pedestals to the event coordinator, or fairgrounds staff as soon as the damage is discovered. Damage to pedestals will be charged to the event organizer at a rate double the cost for repair  multiple or piggyback cords and appliances.  campsites or throughout the fairgrounds. available for campers. orr replacement.  Under no circumstances shall RV Pedestals be used by vendors.  Campers are encouraged to use the electrical pedestals safely and responsibly. The pedestals are checked daily and potential safety hazards are: reported to event coordinators fori immediate corrective actions. Recommendations may include re-locating campers who share pedestals, removing and replacing hazardous cords, rescinding use of an  electrical pedestal, or requiring compensation for repairing damaged pedestals.  Update 08/27/2024  9  Fairgrounds Rental Agreement    HOME EC. BUILDING CHECKLIST  Dor not tape or hang decorations from the ceiling grid or ceiling tile. Dor not tape or staple decorations toi tables, chairs, walls, windows, or doors Please place all chairs andi tables back as they were before leaving. Cleaning supplies arei int the custodial supply closet located int the men'sr room.  Clean and put away any items that you used.  Please clean and dry all counter tops, sinks, and appliances in restrooms.  Sweep and Vacuum the floors. Wipe down all the tables. south door oft the building. Turni the meeting room lights off. (689 in the winter or 759 ini the summer)  Pickup all trash in restrooms, kitchen, and meeting room and place in the dumpsters located outside the  Please return thermostat settings back to the original temperature.  Close and lock ally windows and doors. Place the building keys in the drop boxl located near the south door.  Please leave the building in the condition you found it.  Please call (719)931-0034 to reachi the caretaker.  KITCHEN CHECKLIST  Please plan for enough time to clean-up after use. Iti is yourr responsibility to clean the Kitchen after usingi it.  Wash all dishes and utensils and place backi in the proper location.  Wipe off all counter tops.  Clean all of the appliances you use including the stove, microwave, coffee machine, and refrigerator.  Clean and dry the sinks and faucets. Clean up alls spills on floorsa and counter tops.  Sweep and mopi floors.  Leftover food will be disposed of, be sure to take leftovers with you.  Update 08/27/2024  10  Fairgrounds Rental Agreement    VAQUEROS BUILDING CHECKLIST  Dor not tape or hang decorations from the ceiling grid or ceiling tile. Don not tape or staple decorations to tables, chairs, walls, windows, or doors Please place all chairs and tables back as they were before leaving. Cleaning supplies are ini the custodial supply closet located in the men's room.  Clean and put away any items that you used.  Please clean and dry all counter tops, sinks, and appliances in restrooms.  Sweep and' Vacuum thei floors. Wipe down all the tables. south door oft the building. Turn the meeting room lights off. (689 in the winter or 759 in the summer)  Pickup all trash in restrooms, kitchen, and meeting room and place ini the dumpsters located outside the  Please return thermostat settings back to the original temperature.  Close and lock all windows and doors. Place thel building keysi in the dropl box located neart the south door.  Please leave the building in the condition you found it.  Please call (719) 931-0034 to reach the caretaker.  KITCHEN CHECKLIST  Please plan for enough time to clean-up after use. Iti is your responsibility to clean the Kitchen after usingi it.  Wash all dishes and utensils and place back int the proper location.  Wipe off all counter tops.  Clean all oft the appliances you use including the stove, microwave, coffee machine, and refrigerator.  Clean and dry the sinks and faucets. Clean up all spills on floorsand counter tops.  Sweep and mop floors.  Leftovert food willl be disposed of, be sure to take leftovers with you.  Update 08/27/2024  11  Fairgrounds Rental Agreement    PROWERS COUNTY  REQUEST FOR WAIVER. OF FEES AT FAIRGROUNDS  On behalf of TRI-STATE 9-lfundatusl I do hereby request a waiver of fees for rental ofthe  Fairgrounds. The waiver is needed because  EAREA 501BAOU-PAPROEITTHAT HDAORS 0122 LOCAL EIPSIPESARADEPS ANDMILITAPY P4ST 444 PRESEATEERON  THE SUREQURDING AEA  SET 6 2025 Date(s) of] Event Authorizedpent S Fees Included in Waiver Request OB Booking Fee a Pavilion Rent a Vaqueros Bldg Rent $ Arenal Pens ORV: Parking  11-21-2024  Date  $ $750.00 $ $  a Arena Rent a Home Ec Bldg Rent $ 1260.00 Parking Lots Pavilion Boarding $ ODry Camping  150.00 $   Request is approved with the following conditions:  Date:  Chairman  Prowers County Board of Commissioners Request is denied for the following reason:  Date:  Chairman  Prowers County Board of Commissioners    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 12-10-2024 Submitter: Administration Office  Submitted to the County Administration Office on: 11-25-2024 Return Originals to: Jana Coen & Administration Office Number of originals to return to Submitter: 2  Contract Due Date:  Item Ttle/Recommended Board Action: scheduled for May 17, 2025. Justification or Background:  Consider approval of Fairgrounds Facility Rental Agreement for Norma Valdez F, event  Fiscal Impact: This item is budgeted in the following account code:  County: Federal: State: Other:  $_ $_ $_ $_  Approved by the County Attorney on: Additional Approvals (if required):    LVSSEUVI EU  PROWERS COUNTY FAIRGROUNDS FACILITY NOV21231  RENTAL AGREEMENT  Today's Date: 1-5-2024 Name of Organization:  Date(s) of] Events:_ 05112025 Set Up Time: 0500 mpm Event Starts: U00 am pm Finish Time:_ 2400 am pm  Name & Address of Authorized Agent: CYmG Uoidez F 10638n 3 Lomey (o *Phone: (575) 390-M762  Arena Centennial  Home Ec Pavilion  Vaqueros  Sales Tax ID: Type of Event:  ipciCSErcan  Graduation Parly  Ifapproved by the Board of County Commissioners (the Commissioners"), Iagree to pay fees in the amount of $1250 or to submit a request for a waiver oft the fees. lunderstand the decision to waive any or all oft the fees are at thet total discretion oft the Commissioners. Ihave attached copies of my State of Colorado Sales Tax License and the City of Lamar Sales Tax License, if applicable. Failure to do sO will result in denial of my rental request,  unless Iam legally exempt. The attached lease terms are part ofthis Agreement.  *Jormo Ualdez T.  3 1/20/24 Date  Authorized Agent  The Commissioners reserve the right to not lease any portion or all of the Fairgrounds to any organization which it deems in its sole discretion, to be in direct and adverse competition to Prowers County merchants ori is otherwise detrimental to Prowers County citizens. Fees may be adjusted at the discretion of the Commissioners based upon  the number of participants or unique conditions. Fees are based on daily rates.  Rental Approved:  1126:24 Date Date  Maintenance Facilities Director F  Chairman  Prowers County Board ofCommissioners  For County Use Only: Date Rental Fee Paid: Inspection completed:  Date Booking Feel Paid (625.001120 Damage/Cleaning Deposit:  Date Paid:  Damage/Cleaning Deposit Refunded: Y/N, ifno, see attached.  Please note that any deposit refund due back to you will be provided by al Prowers County check. Checks are  issued upon approval att the Commissioners' meetings. Liability Insurance received: Yes_ No_ Date:  Update 08/27/2024  Fairgrounds Rental Agreement    PROWERS COUNTY FAIRGROUNDS  FACILITY RENTAL RESERVATION AGREEMENT Between Prowers County Board ofCommissioners (Commissioners) and the Authorizing Agent (User)  the facility, including any parking areas, ifa applicable (Rented Premises).  renting  1. Determination of fees for use of the facilities shall be made by the Commissioners in accordance with the established fee schedule and agreed to by the User at the time the reservation is confirmed. Use oft the Rented Premises shall not include Prowers County personnel, including, but not limited to, County Maintenance 2. Unique events may require an increase in fees/charges and/or conditions in addition to those shown. The Commissioners reserve the right to modify any oft the conditions as necessary on a case-by-case basis. use of the Fairgrounds is subject to approval by the Commissioners. All County holidays are observed Holiday County Maintenance Personnel. Nol Prowers County Personnel will be made available to the User over County- by approved Thanksgiving and Christmas holidays. Additional fees will be assessed for events scheduled on holidays. Overtime charges for County Maintenance Personnel at a rate of two times the normal will be charged for holiday events, in addition to regular fees and charges, with the exceptions hourly described  Personnel.  rate  previously in this paragraph. Fees and deposits:  3.  Use ofall facilities shall be scheduled through the Prowers County Administration Office a) Al non-refundable booking fee of $25.00 per event must be paid when each event iss scheduled. b) The $25.00 booking fee is due before an individual or entity may have their name placed on the Fairgrounds c) Ifthe event does not go forward for whatever reason, the $25.00: fee WILL NOT BE REFUNDED. d) The remainder oft the Rental Fee and Damage/Cleaning Deposit must be submitted to the office no less than ten(10) working days prior to the date scheduled. (Commercial users: fees must be paidi ini certified funds.)The Damage/Cleaning Deposit is required and duel from all Users whether use fees are waived or not. Failure to fees ten (10) working days prior to the event may result in cancellation of facility. use. Access to the facilities pay at any time other than stated on this form is not allowed unless prior approval is received from the Commissioners. Please note that the Damage/Cleaning Deposit refund, ifa any, due back to the User will be provided by al Prowers County check. Checks are issued upon approval at the Commissioners' meetings. 4. The scheduling oft the activities shall be made in the name of one individual who must, as a condition of use, read this document and accept responsibility for adequately supervising the event; assure that the facilities are used for the purpose for which they are scheduled; reimburse the County for damage toi thej property or facilities including excessive clean-up costs that may occur in connection with the event; assure payment, in full, ofall charges for space and equipment requested; and ensure that all promotion and advertising of events the use oft the facilities shall identify the individual or group: sponsor oft the event. 5. The Damage/Cleaning Deposit must be paid within ten (10) days prior to the scheduled event. The Damage/Cleaning Deposit shall be utilized by Prowers County, ifnecessary, for cleanup and repair of damages ofthe Rented Premises. In: the event that the User performs cleanup ofthe Rented Premises in a suitable manner and there is no damage, The Damage/Cleaning: Deposit will be reviewed for return to the User at the next regularly scheduled meeting of the Commissioners. The Rented Premises is an alcohol-free facility. Ifany alcohol is brought to the Fairgrounds. the entire deposit will be retained. The User will be personally liable 6. Inc case ofcancellation, thel Rental Fee willl bei refunded (lessi the booking fee)i ifnotice ofcancellation: ist received ten (10) working days prior to scheduled use. Ifthe event is cançeled due to inclement weather, the event may  only.  calendar to reserve a facility at the Fairgrounds.  involving  for any expense for damage and/or cleanup in excess of the required deposit.  Update 08/27/2024  2  Fairgrounds Rental Agreement    bei rescheduled with no additional fees due. Ifthe eventi is rescheduled for any other reason without the required  notice, an additional booking fee will be charged.  7. Subleasing or charging additional fees to use the Rented Premises will not be permitted.  8. Non-commercial Users may have one (1) day in advance for set-up, decorating, etc. between thel hours of 8:00 am and 4:00 pm, provided that there is nothing previously booked on that date. Ifa additional days are required fors set-up, an additional fee of $100 will be charged for each additional day. Commercial Users: If special set- 9. Liability insurance is required for all commercial events. Certain "at risk" activities, i.e. rodeos, tractor pulls, carnivals, circuses, etc. are required to provide liability insurance. An insurance certificate showing Prowers County as an additional insured must be provided to the County no later than ten (10) business days prior to 10. Under ColoradoL Law, an equine professional is not liable for any injuryto or the death ofa participant in equine activities resulting in the inherent risks of equine activities, pursuant to Section 13-21-119, Colorado Revised 11. The User acknowledges that the User's rental of Prowers County's property is not subject to the direct supervision and control of Prowers County personnel. Accordingly, and in express consideration for the within Agreement, User hereby agrees to indemnify, and hold harmless, Prowers County, its officers, agents, and employees from and against any and all claims for liability asserted for personal injury, or property damage to any and all persons or entities whatsoever, and arising out ofthe User's rental of Prowers County's property as hereinabove set forth. This indemnification expressly extends to any and all damage awards, and shall further cover all costs of defense, which shall be conducted in Prowers County's sole discretion, including attorney's 12. The Agreement shall be and become binding upon, and inure to the benefit of the parties hereto, their heirs, personal representatives, successors and designs. Any action necessary to construe, interpret, or enforce the provision of the Agreement shall be brought and maintained in the District Court in and for Prowers County, Colorado, withi the substantially prevailing party therein being entitled, as a matter of contract law an agreement to recover its costs and expenses therein incurred, including reasonable attorneys' and expert witness fees. 13. Falsified or misleading information on this form may be cause for cancellation oft this Agreement and forfeiture ofthe Damage/Cleaning Deposit and/or Rental Fees paid and may result in loss of future usage oft the Rented 14. The User shall be required to call for an on-site facility orientation with the Fairgrounds caretaker no later than five(5) working days priort to the event. The User willl be familiarized with information pertaining to use ofthe facility, obtain keys, and will have the opportunity to ask questions of the Fairgrounds caretaker. The Fairgrounds Caretaker can be reached by calling 719-931-0034 and is available to schedule an orientation Monday - Friday 9:00 am to Noon and 1:00pm to 3:00pm. Regularly scheduled monthly meeting organizers are not required to complete an orientation, however, are expected to cooperate with the expectations for use outlined in this Agreement. The User understands that Prowers County does not employ 7 day per week, 24 hour per day Fairgrounds Personnel. The Fairgrounds Caretaker hours are scheduled from 8:00 am to 5:00 pm, Monday -Friday. The Fairgrounds Caretaker schedule may change to correlate with an event; however, changes must be pre-approved and are at the discretion oft thel Prowers County Maintenance Supervisor. 15. Every effort has been made to provide that the Rented Premises is adequately maintained and appropriately prepared for normal use. Iti is further understood that the building and grounds systems can, and do, fail at times. Failures may include, but are not limited to: electrical outlet power losses and blown breakers due to abnormal use and overloaded circuits, public announcing or loudspeaker malfunctions, lighting failures, water supply problems, and restroom malfunctions, etc. There are no guarantees against such failures either implied or stipulated in this Agreement. Prowers County Personnel will only be made available during off-hours in the  up/tear-down is required, standard facility use days will be charged on a % day basis.  the scheduled event.  Statutes.  and expert witness fees.  Premises.  Update 08/27/2024  3  Fairgrounds Rental Agreement    event of an emergency pertaining to life safety or unsanitary conditions. AlI other unexpected occurrences 16. The User understands that costs incurred by Prowers County due to responding to non-emergency calls for service, facility or grounds clean-up, and sub-contractor repairs for damages to equipment or facilities will billed to the user at a rate of2 times the actual costs. It is the User's responsibility to minimize 17. The User agrees that it is their responsibility to provide, and be responsible for, the equipment or necessary to circumvent potential failures in the buildings, restrooms, or arena including, but not limited supplies to: portable generators, portable toilets, portable amplifier or loudspeaker systems, water, and/or water trucks for wetting a dusty arena floor, toilet paper and hand towel paper supplies, first aid: supplies, etc. 18. The Useri is specifically responsible to ensure adherence to these written and any posted policies and to: a) Provide written documentation specifying any concerns, system failures, or break-downs and deliver that documentation to the Fairgrounds Caretaker. Please do not manipulate circuit breakers. b) Pick-up trash and debris accumulated during the event including parking areas and deposit thei trash in the c) Re-stock indoor and outdoor men's and women's restrooms with toilet paper and paper hand towels as needed throughout the event. The Fairgrounds Caretaker will: make these items available to users. d) Pick-up trash in, and around, the indoor and outdoor restrooms, the kitchen, and concession stands and leave fixtures, appliances, and counter surfaces clean. Sweep and mop, or vacuum indoor floor surfaces. e) Make appropriate arrangements for providing the necessary crowdi control, public safety, and building g) Provide event security and present evidence ofsaid security upon request by the Commissioners.  should be documented and will be addressed on the next regular workday.  be  calls for service.  non-emergency  55-gallon trash drums provided, or iffull, into available dumpsters.  security for the event.  f Ensure that scheduled dance events end at 12:001 Midnight; no exceptions. 19. Prowers County assumes no responsibility for lost or stolen items.  20. Alcohol is not allowed on the Fairgrounds at any time. The county has a zero-tolerance policy regarding alcohol. Any violation of this policy will result in immediate revocation of access to the Fairgrounds, a permanent ban going forward, and County retention of the entire damage deposit. Local law enforcement 21. Building or grounds emergency call: 931-0034 or 931-9335. Medical or safety emergency call: 911.  has been authorized to remove parties in violation of this policy.  Ihave read, understand, and agree to the terms and conditions outlined ini this agreement.  Date: 20/24 Organization: NA  V  Authorizing Agent Printed name: Nacmcr Foxes  Authorizing Agent SigpMNormg Naldez Flour  For) Rodeo Events:  Authorized Tractor/Equipment Operator Printed Name:  Update 08/27/2024  Fairgrounds Rental Agreement    PROWERS COUNTY FAIRGROUNDS  FEE SCHEDULE Not For Resident or Non-Resident  #of days/head oflivestock  Facilities Requested Arena Rent Daily Pavilion Rent Daily Home Economics' Bldg. Rent * $250 Daily Vaqueros Bldg. Rent Daily Use of Parking Lots Arenal Lot/Grounds Daily Overnight Boarding (Arena Pens) $5/Head Daily *Pavilion Boarding Rodeo Events Minimum Fee Daily R.V.or Camper Parking Onel Electric Pedestal and One Water Connection per Rented Space only Daily Dry Camping and Horse Penning at Designated Southwest Parking Lot ONLY Daily Elmer's Garden Daily  Profit $150 $150  Local For or Non-Local Profit $300 $300 $250 $225  Total  For Profit $970 $970 $500 $425 $210 $10/head $40 $50  $225  $5/Head $20 $30  $20 $30  $10 $0.00  $10 $0.00 $1000  $20 $0.00 $1000  Cleaming/Damage Deposit %31000 (Due 10 days prior to event)  * Rental Fees for the Pavilion for Not for Profit will not be charged since the Event Organizer is responsible for  collecting the fee. The fee is still subject to 50/50 split, at the Commissioners' discretion  (DUE 101 DAYSPRIOR' TOTAL TO USE) $ Update 08/27/2024  $ 5  $  $  Fairgrounds Rental Agreement    1. Fees are based upon aj per calendar day rate. Events which extend beyond midnight of the scheduled day 3. A commercial event is defined as an activity where fees are charged to entrants! and the sponsoring entity retains some or all oft the proceeds from the activity or where goods or services are offered: for sale or lease tothe general public. The Commissioners reserve! the rightt to determine ifam event is a commercial activity. 4. Commercial vendors will pay a fee in addition to the fees listed on the attached fee schedule in the amount of1%ofg gross sales, based upon the vendor's projections. The amount oft the projected sales will be verified 5. RV or Camper Parking is only allowed for a total oft three (3). days per thirty (30)-day time period, unless a. RV or Camper Parking in conjunction with a Registered Event must follow the policies set forth in  may be subject to a feei for an additional day.  2. The Commissioners reserve the right to request verification ofnot-for-profit status.  byic comparison oft the projection to Sales Tax as reported to the State.  in conjunction with a Registered Event.  8a. below.  b. For RV or Camper Parking NOT in conjunction with a Registered Event:  - Electrical and water hook-up fees are to be paid and collected at the Prowers County Administration Office at 301 S Main Street, Suite 215, Lamar, CO 81052 or by calling (719)336-8025 during normal business hours OR at the Fairgrounds Drop Box. ii. Each individual RV hook-up is provided for use exclusively by only one reserved RV. iri. No horses or livestock shall be penned near or around RV hook-up areas. Paid RV users iv. No. RV, Trailer, Camper or Horse Trailer electrical hook-ups are allowed at any electrical V. Thei individual or organization on record at the Prowers County Administration Office will ber responsible to pay for any damage incurred due to unauthorized electrical or water  There is no sharing of electrical or water hook-ups. must pen horses in covered stalls. outlet located on the Pavilion Structure.  connections.  6. Iti is the responsibility of the Event Organizer to make arrangements to meet on-site with the Fairgrounds Caretaker no later than four (4) days priort toi the event to receive building keys and facility use: instructions. a. Covered and uncovered: stall: fees are to be reserved, collected, refunded for cleaning, and accounted  7. REGISTERED EVENTSONLY:  for by the Event Organizer with the understanding that  ifcovered stalls are cleaned by the Event Organizer after use, the amount collected is split  50%/50% between the Event Organization and Prowers County.  8. REGISTERED EVENTS ONLY:  a. RV Electrical and water hook-up fees are to be reserved, collected, and accounted for by the Event  Organizer with the understanding that:  i. Each individual RV hook-up is provided for use exclusively by only one reserved RV. ii. No horses or livestock shall be penned near or around RV hook-up areas. Paid RV users ii. No RV, Trailer, Camper or Horse Trailer electrical hook-ups are allowed at any electrical outlet located ont the Pavilion Structure. The Event Organization will be responsible to pay  There is no sharing of electrical or water hook-ups. must pen horses in covered stalls.  for any damage incurred due to unauthorized electrical connections.  Update 08/27/2024  6  Fairgrounds Rental Agreement    PROWERS COUNTY FAIRGROUNDS REGISTERED RODEO EVENTS  FAIRGROUNDS USE:  The Prowers County Fairgrounds is available for registered rodeo events in-season from April through October. Conditions for use oft the facilities for all events including registered rodeo events are specifically detailed in the 1. Prowers County Fairgrounds Facility Rental Reservation. Agreement, 3 pages. Revised October 20,2011. 2. Prowers County Fairgrounds Facility Rental Agreement, 1 page. Revised October 20, 2011. 4. All event organizers who may be interested in reserving the Prowers County Fairgrounds for a registered rodeo event are encouraged to read very carefully all oft the rental information provided by Prowers County  following information:  3. Fairgrounds Fee Schedule, 2 pages. Revised October 18, 2011.  before scheduling any rodeo event.  REGISTERED RODEO! EVENTS:  Scheduled registered rodeo events are to be conducted in cooperation with the established fees and agreements for use of the Prowers County Fairgrounds. Event organizers are encouraged to include this information in all event literature distributed toj potential rodeo participants in an effort tol lessen costlyr misunderstandings during the event.  Unless otherwise specified, thei following are applicable to registered rodeo events:  1. The fairgrounds rodeo arena is watered regularly using a water reel. Use of the water reel by event organizers is prohibited. The rodeo arena may be watered once daily during a registered rodeo event at the event organizers request only ifs scheduled and coordinated with the Fairgrounds Caretaker. 2. The fairgrounds rodeo arenai is worked prior to the rodeo event by the Fairgrounds Caretaker using Prowers County equipment. Working the arena during the event is the responsibility of the event coordinator. The county tractor and attached arena king finisher are available for use by the event coordinator, or specified driver, for the duration of the event. A key to the tractor is provided only after the specified driver has met 3. Concession stand use is by reservation only. Call the Prowers County Extension service (719-336-7734)to 4. The event organizer is responsible to reserve and collect fees for covered stalls located in the Prowers County Pavilion. The stalls are located in the Prowers County Sale Barn and set-up by Prowers County a. Scheduling with the Fairgrounds Caretaker for setting up horse stalls in the Pavilion. b. Scheduling with thel Fairgrounds Caretaker for cleaning the stalls after the event.  on-site with the Fairgrounds Caretaker for operating instructions.  reserve.  Staff before the event.  5. The event organizer is responsible for ensuring the following:  6. The event organizer is responsible for reserving and collecting all fees associated with R.V. hook-ups, dry  camping, and horse stall fees.  The event organizer is responsible for ensuring thei following:  1. No horses shall be tied or penned at, or near, any R.V. electrical or water hook-up located at the arena parking area and arena parking area fencing, or at the R.V. hook-ups located north of the Prowers 2. No R.V. campers, horse trailers, or other similar vehicles shall not be allowed toj park near, and/or plug any electrical cord into the electrical outlets located in the Prowers County Pavilion. 3. Nohorses shall bet tied to, or penned near, any permanent fence or anyt treel located anywhere on Prowers  County Pavilion.  County Fairgrounds property.  Update 08/27/2024  7  Fairgrounds Rental Agreement    4. All dry camping and horse penning shall be located in the southwest dirt parking area  Under no  circumstances shall dry camping and penning be located on roto-mill, asphalt, or grass areas only. elsewhere on the Prowers County Fairgrounds property. The Event Organizer is responsible for the cost of clean- 5. All R.V. hook-ups (pedestal) provided for use during registered rodeo events are for one (1) R.V. camper only. Under no: circumstances shall more than one R.V. camper plug into al reserved pedestal. 6. All horses and livestock are prohibited from access to paved pedestrian and driveways, treed areas, and covered buildings with the exception oft the Prowers County Pavilion. grassyareas,  up ifhorses are penned or tied in areas outside dry camp areas.  Update 08/27/2024  8  Fairgrounds Rental Agreement    USE OF THE PROWERS COUNTY FAIRGROUNDS R.V.  ELECTRIC PEDESTALS  In an on-going effort to mitigate potential damage, and to maintain safe, reliable electrical pedestals it is the  responsibility oft the Event Organizer to remind each camper utilizing the pedestals that:  Each electrical pedestal is wired for 50 amp., 30 amp., or 20 amp. uses and should not be overloaded with Each electrical pedestal is intended to be used by a single user. One camper one pedestal. Choose one 50, 30, or 20-amp outlet that best meets the required load: for each R.V. or Camp Trailer. Each electrical pedestal is complete and ready for use. Under: no circumstances shall the face plate cover ber removed and/or the electrical outlets, wiring, or related pedestal components be. manipulated. Use only safe and well-maintained electrical cords and plugs designed to carry the specified load. Under noo circumstances shall exposed cord wires be direct wired into any electrical pedestal or pedestal outlet. Do not secure livestock or pets to the electrical pedestals or water hydrants located in designated R.V. The electrical pedestal located north of the Crow's Nest is intended for auxiliary use only and is not Report any damaged pedestals to the event coordinator, or fairgrounds staff as soon as the damage is discovered. Damage to pedestals will be charged to the event organizer at a rate double the cost for repair  multiple or piggyback cords and appliances.  campsites or throughout the fairgrounds. available for campers. or1 replacement.  Under no circumstances shall RV Pedestals be used by vendors.  Campers are encouraged to use the electrical pedestals safely and responsibly. The pedestals are checked daily and potential safety hazards are reported to event coordinators fori immediate corrective actions. Recommendations may include re-locating campers who share pedestals, removing and replacing hazardous cords, rescinding use of an  electrical pedestal, or requiring compensation for repairing damaged pedestals.  Update 08/27/2024  9  Fairgrounds Rental Agreement    HOME EC. BUILDING CHECKLIST  Dor not tape or hang decorations from the ceiling grid or ceiling tile. Do not tape or staple decorations tot tables, chairs, walls, windows, or doors Please place all chairs and tables back as they were before leaving. Cleaning supplies are int the custodial supply closet located ini the men's room.  Clean and put away any items that you used.  Please clean and dry all counter tops, sinks, and appliances in restrooms.  Sweep and' Vacuum the floors. Wipe down all the tables. south door oft the building. Turn the meeting room lights off. (689 in the winter or 759 in the summer)  Pickup all trash in restrooms, kitchen, and meeting room and place in the dumpsters located outside the  Please return thermostat settings back to the original temperature.  Close and lock all windows and doors. Place the building keysi in the drop box located near the: south door.  Please leave the building ini the condition youi foundi it.  Please call (719)931-0034 to reach the caretaker.  KITCHEN CHECKLIST  Please plani for enough time to clean-up after use. It isy your responsibility to clean the Kitchen after usingi it.  Wash all dishes and utensils and place back in the proper location.  Wipe off all counter tops.  Clean all of the appliances you use including the stove, microwave, coffee machine, and refrigerator.  Clean and dry the sinks andi faucets. Clean up all spills on1 floorsand counter tops.  Sweep: and mopi floors.  Leftover food will be disposed of, be sure to take leftovers with you.  Update 08/27/2024  10  Fairgrounds Rental Agreement    VAQUEROS BUILDING CHECKLIST  Do not tape or hang decorations from the ceiling grid or ceiling tile. Dor not tape or staple decorations tot tables, chairs, walls, windows, or doors Please place all chairs and tables back as they were before leaving. Cleaning supplies are in the custodial supply closet located in the men'sroom.  Clean and put away any items that you used.  Please clean and dry all counter tops, sinks, and appliances inr restrooms.  Sweep and Vacuum thet floors. Wipe down all the tables. south door of the building. Turn the meeting room lights off. (689 ini the winter or 759 ini the summer)  Pickup all trash inr restrooms, kitchen, and meeting room and place int the dumpsters located outside the  Please return thermostat settings back to the original temperature.  Close and lock all windows and doors. Place the building keys ini the drop box located neari the south door.  Please leave the building in the condition you found it.  Please call (719) 931-0034 to reachi the caretaker.  KITCHEN CHECKLIST  Please plan for enough time to clean-up after use. It is your responsibility to clean the Kitchen after using it.  Wash all dishes and utensils and place backi int the proper location.  Wipe off all counter tops.  Clean all of the appliances you use including the stove, microwave, coffee machine, and refrigerator.  Cleanand dry the: sinks and faucets. Clean up all spills on floors and counter tops.  Sweep and mop floors.  Leftoveri food will be disposed of, be sure to take leftovers with you.  Update 08/27/2024  11  Fairgrounds Rental Agreement    11/21/24,3:16PM  MSB Payment System  PROWERS COUNTY  COLORADO -  Prowers County, Colorado Administration (719)336-8025 11-21-2024 CC1996851 05/17/2025 Miryam Flores Credit Card 6904 81052 $25.00 $0.45 $25.45  301 South Main Street, Suite 215 Lamar, CO 81052  Transaction Date Transaction ID Item Reference Customer Name Payment Type Account Number Billing Zip Subtotal Convenience Fee Total Amount Order Details Item Reference 1x$25.00  05/17/2025 $25.00  THANK YOU FOR YOUR PAYMENT Payment Processed by MSB  pslaminmabrenusnasencomuicpycww  1/1    PROWERS COUNTY AGENDA ITEM REQUEST FORM  Hearing Date Requested:1z-10-2024 Submitter: Mark Dorenkamp-RaB Supervisor  Submitted to the County Administration Office on: 11-25-2024  Return Originals to:  2  Number of originals to return to Submitter:  1  Contract Due Date:  December 31, 2024  Item Ttle/Recommended Board Action:  Consider approval of Colorado Department of Transportation (CDOT) Prowers County  Signature Sheet, certifying total mileage as of December 31, 2024  Justification or Background:  Annual mileage report for Road and Bridge Department. Fiscal Impact: This item is budgeted in the following account code:  County:  Federal: $  State: $  Other: $  Approved by the County Attorney on: Additional Approvals (if required):    I  e 9 B    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 12/10/24 Submitter: Department of Human Services  Submitted to the County Administration Office on: 11/25/24 Return Originals to: Department ofH Human Services Number of originals to return to Submitter: 1  Contract Due Date: ASAP  Item Title/Recommended Board Action:  "Consider approving Statement of Work Interpretation and Translation Services and Related Services Contract #R210605 Administered by OMNIA Partners and authorize Department of  Human Services Director, Lanie Meyers-Mireles to sign the agreement."  Justification or Background:  HCPFis requiring we have a contracted interpreter service available to DHS. We will only be  charged the $0.64 or $0.69/minute feei if we use the service.  Fiscal Impact: This item is budgeted in the following account code:  County: Federal: $ State: Other: $  Approved by the County Attorney on: Additional Approvals (if required):  PLEASE ATTACH' THIS SHEET: TO ALL AGENDA ITEMS WHEN SUBMITTING TO  COUNTY ADMINISTRATION.  THANK YOU!    Language Line Services, Inco  Statement of Work  Interpretation and Translation Services and Related Services  Contract #R210605 Administered by OMNIA Partners  Customer # (ifa applicable):  Participating Public Agency ("Customer"): Prowers County  Department of Human Services OMNIA Participation ID:  This Statement ofWork is subject to cooperative purchasing Contract #R210605 (the "Contract") between Region 4 Education Service Center, administered by OMNIA Partners, Public Sector ("OMNIA") on behalf of Participating Public Agencies, and Language Line Services, Inc. ("Company) for Interpretation and Translation Services and Related Solutions. This document is the sole document that reflects Customer's participation! in the Contract and pricing for these services. This document must be signed by an authorized representative of you, the Customer. Pricing is only final upon a signature by an authorized officer of Language Line Services. Pricing changes, ifany, will be made on next full monthly billing cycle.  1. LANGUAGELINE PHONE INTERPRETING 1.1. SCOPE OF WORK  (a) DESCRIPTION OF SERVICES. LanguageLine will provide qualified and trained interpreters for Phone Interpreting to facilitate effective communication between Customer's service providers and Limited English Proficient (LEP) individuals by converting spoken language (b) SERVICE DELIVERY. Services are delivered on-demand via telephone, as initiated by Customer's service providers and invoiced monthly following service delivery. Services are available twenty-four (24) hours a day; seven (7) days a week; 365 days a year, including (a) PERI MINUTE USAGE FEES for LanguageLine Phone and InSight Audio Interpreting  statements between English and another language. holidays, in over 240 spoken languages.  1.2. PHONE INTERPRETING FEES  Language Tiers 1 2  Languages  Per Minute Charge $0.64 $0.69  Spanish All other languages  1.3. PHONE INTERPRETING EQUIPMENT  (a) OPTIONS AND DEFINITIONS. Equipment purchase and lease options are available for the equipment identified below for use with the Phone Interpreting services. All Equipment requests must be submitted in writing over the term of this Agreement and the appropriate (b) PHONEI INTERPRETING EQUIPMENTLEASE FEES. AI monthly leasei fee per unit applies, and thel Equipment remains the property ofl LanguageLine. The monthly fee covers the cost ofe equipment programming and providing any necessary replacements and maintenance. (c) PHONE INTERPRETING LEASED EQUIPMENT ADDITIONAL TERMS. Upon the termination of the Agreement, Customer shall, at its cost, return the Equipment to Language Line Services within thirty (30) days following the termination date. Customer acknowledges that ownership of the Equipment remains with Language Line Services, and that the  fees will apply.  1SolutionTM Analog Dual Handset Phone 1Solution Dual Handset IP Phone Panasonice Cordless Phone with Dual Handsets  $4.50 $12.50 $10.50  Equipment must ber returned upon the termination oft the Agreement.  02021 Languagel Lines Services, Inc.-1 Lower Ragsdale Drive, Bldg 2-Monterey, CA9 93940. swylenuasatnecon CONFIDENTIAL WFORMATON-REVC522 1    Language Line Services, Inco  Statement of Work  Interpretation and Translation Services and Related Services  Contract #R210605 Administered by OMNIA Partners (d) PHONEI INTERPRETING EQUIPMENT PURCHASES. Thei following Equipment is available for purchase from LanguageLine during the life oft the agreement. Upon depletion of current Equipment models and release ofr new Equipment models, updated pricing will automatically apply. Purchased equipment is covered by a one-year replacement warranty from the manufacturer. Standard rates att thet time of purchase will apply. Ifa applicable, proof of sales tax exemption must be provided to aopemmengigeyereon and ComtacAomnatratonream@arguageinecon Details will be available from your  Account Executive. 1Solution. Analog Dual Handset Phone 1Solution Dual Handset IP Phone Panasonic Cordless Phone with Dual Handsets Panasonic Headset Handsets with Splitter Handset Splitters (price per unit) Wall Splitters (price per unit)  $60.00 $150.00 $60.00 $25.00 $10.00 $6.00 $6.00  2. LANGUAGELINE DIRECT RESPONSE 2.1. SCOPE OF WORK  (a) DESCRIPTION OF ERVICES.Languageune will provide qualified and trained interpreters for Phone Interpreting to facilitate effective communication between Customer's service providers and Limited English Proficient (LEP) individuals by converting spoken language Standard in-language prompts for greeting messages, language menu, and hold/dial-out  statements between English and another language.  STANDARD message  Prompts recorded by al LanguageLinee Certified linguist Custom LanguageLine call flow and call routing Capability to integrate with Customer's IVR  Capability to transmit call to Customer's Direct Inward Dial (DID) number  PREMIUM  Customizable in-language prompts for greeting messages, language menu, and  hold/dial-out message Prompts recorded by al Languagelinee Certified linguist Custom LanguageLine call flow and call routing Customizable options menu Capability to integrate with Customer's IVR  Capability to transmit call to Customer's Direct Inward Dial (DID) number (b) SERVICE DELIVERY. Services are delivered on-demand via telephone, as initiated by Limited English Proficient (LEP) individuals and routed directly to Customer's service providers, andi invoiced monthly following service delivery. Services are available twenty-four (24) hours a day; seven (7) days a week; 365 days ay year, including holidays.  2.2. DIRECT RESPONSE FEES (a) STANDARD (b) PREMIUM perI language (c) DEDICATED TOLL-FREE LINE per line fees for LanguageLine Phone Interpreting.  $350.00 $650.00 $150.00 $0.25  (d) INCREMENTAL PRICE PER MINUTE applied to Customer's contracted per minute usage  3. LANGUAGELINE INSIGHT VIDEO INTERPRETING  3.1. SCOPE OFWORK  92021 Languagel Line Services, Inc 1 Lower Ragsdale Drive, Bldg. 2- Monterey, CAS 93940. www. Lanquageline com CONFIDENTIAL  2    Language Line Services, Inco  Statement of Work  Interpretation and Translation Services and Related Services  Contract #R210605 Administered by OMNIA Partners (a) DESCRIPTION OF SERVICES. LanguageLine will provide qualified andi trained interpreters for InSight Video Interpreting to facilitate effective communication between Customer's service providers and Limited English Proficient (LEP) individuals by converting spoken or signed language statements between English and another language. Equipment purchases (b) SERVICE DELIVERY. Services are delivered on-demand via a native iOS or Android Application (the "App") or a Mac/PC using a Chrome, Edge, or Firefox browser. Each call has full end-to-end encryption ensuring privacy. Services are available 24/7 for ASL, Spanish, Mandarin, Arabic, Polish, Cantonese, French, Korean, Portuguese, Vietnamese and Russian, and during business or extended business hours for 30 or more additional (b) PER MINUTE USAGE FEES for LanguageLine InSight Video Interpreting Based on Total  are optional.  languages of lesser diffusion. 3.2. INSIGHT VIDEO INTERPRETING FEES  (a) ACTIVATION Monthly Service Fee or One-Time Fee  Waived  Volume  Spanish Per Minute Charge $1.50  Other Spoken Languages Per Minute Charge $1.85  Sign Language Per Minute Charge $2.25  4. LANGUAGE ONSITE INTERPRETING 4.1. SCOPE OF WORK  (a) DESCRIPTION OF SERVICES. LanguageLine will provide highly qualified interpreters in- person (physical onsite) at Customer's business locations or using Customer's online conferencing platform (virtual onsite) to perform conseçutive interpreting between Customer's Service Providers and Limited English Proficient (LEP) individuals, by converting spoken or  signed language statements between English and another language.  (b) SERVICE DELIVERY  Services are available by assignment, with language availability dependent upon Virtual onsite assignments using Customer's online conferencing platform may be requested 1-2 days in advance at 1-888-225-6056, option 1 or Physical onsite assignments at Customer's business locations may be requested up to 5 days in advance at 1-888-225-6056, option 1 or Business locations City/state/region) where physical onsite assignments will be  regional resources.  onsiterequests@lanquageline.com, onsterequests@lanquageline.com.  requested: City and State:  4.2. LANGUAGELINE ONSITE INTERPRETING FEES billed in 15-minute increments. (b) MILEAGEITRAVEL REIMBURSEMENT  (a) MINIMUM. ASSIGNMENT TIME is two (2) hours, with time beyond minimum assignment time  02021 Language Lines Services, Inc. 1 Lower Ragsdale Drive, Bldg. 2-Montercy, CAS 93940. www. Languagell Ine. com  MPORUATON-REVIS22 3    Language Line Services, Inco  Statement of Work  Interpretation and Translation Services and Related Services  Contract #R210605 Administered by OMNIA Partners  Charged att the prevailing IRS rate. Parking/tolls charged if applicable.  For one-way travel exceeding 60 miles, travel time may be charged at the applicable  hourly rate.  (c) CANCELATION. Assignments canceled with less than one full business days' notice will be charged at the applicable rate for the greater of the minimum assignment time or reserved  time for the assignment.  4.3. PRICING TABLE. Rate Standard Hourly Rate Non-Standard Hourly Rate Emergency/Holiday Hourly Rate  Spanish $75.00 $112.50 $150.00  American Sign Other Spoken Language $100.00 $150.00 $200.00  Languages $90.00 $135.00 $180.00  (a) Standard Hourly Rate is applied for assignments between 8:00 a.m. and 5:00 p.m. local time (b) Non-StandardHourlyl Ratei is applied fora assignments occurring before 8:00a.m. or after5 5:00 p.m. local time Monday through Friday, SaturdaylSunday or for assignments with less than (c) Emergency/lHoliday Rate is applied for assignments with less than one hour's notice or assignments on federally recognized holidays. Emergency service not available in all areas. (a) DESCRIPTION OF SERVICES. Testing and training programs assess Customer's bilingual staff andi interpreters' ability to provide quality, careful communication and proficiency ini two languages, as well as competence in the requisite medical or other industry-specific vocabulary. Programs focus on the critical interpretation skills of accuracy, efficiency, and cultural competency. Tests and training courses are delivered remotely by assessors with a proven internal record ofs superior performance as an interpreter and typically hold advanced degrees in language related fields. The content and curricula have been developed in conjunction with leading academic experts and validated by psychometricians.  Monday through Friday, with more than one full business days' notice.  one full business days' notice.  LANGUAGELINE TESTING & TRAINING 5.1. SCOPE OF WORK  (b) DELIVERABLES.  Assessments and courses offered in 46 languages. Test results delivered within 5 business days.  Training deliverables will be agreed-upon at the beginning of the project.  5.2. LANGUAGELINE TESTING AND TRAINING FEES  (a) CANCELATION  Cancelation policy for live Language Tests: Atl least three business days' notice Less than three business days' notice One business day or less notice  Notice  Credit Credit in full Credit at 50% of fee No credit  Training courses can be rescheduled or canceled only by the person who submitted  the original Training Registration Form.  02021 Languagel Lines Services, Inc. 1Lower Ragsdalet Drive, Bidg. 2-Monterey, CA9 93940 ywwslanquapeline com- CONFIDENTIAL  4    Language Line Services, Inco  Statement of Work  Interpretation and Translation Services and Related Services  Contract #R210605 Administered by OMNIA Partners Written cancelation of onsite training courses with at least 10 business days' notice Written cancelation of web training courses with at least three business days' notice prior to the Learning Management System registration will be credited in full. Tor reschedule or cancel, please e-mail LA@lanauseunecom.  prior to the course start date will be fully credited.  (b) PRICING TABLES. Prices are in U.S. dollars, per individual test or course, and are subject  to change. Language Skills Test Fees Language Test Name Language Proficiency Test (LPT) Specialty LPT eLanguage Proficiency Test (eLPT) Specialty eLPT Bilingual Fluency Assessment (BFA) Specialty BFA eBilingual Fluency Assessment (eBFA) Specialty eBFA (BFAC) Specialty BFAC (eBFAC) Speciaity eBFAC Interpreter Skills Test Fees Interpreter Test Name  100- 499* Tests $155 $145 $135 $200 $200 $200 $200 $150 $140 $130 $115 $185 $185 $185 $185 $145 $135 $120 $115 $175 $175 $175 $175 $135 $120 $110 $105 $155 $155 $155 $155 $190 $190 $190 $190 $175 $175 $175 $175  1-49* 50-99* Tests Tests $165  500 or More  Bilingual Fluency Assessment for Clinicians $160 $150 $140 $135 eBilingual Fluency Assessment for Clinicians $145 $135 $120 $115  100- Tests  1-49* 50-99*  500 or  Tests Tests 499* More $155 $145 $135 $125 $140 $125 $115 $110 $200 $185 $165 $150  Interpreter Readiness Assessment (IRA) elnterpreter Readiness Assessment (elRA) Interpreter Skills Test (IST)  02021 Language Line Services, Inc. 1Lower Ragsdale Drive, Bldg. 2-Monlerey, CA93940- wwwlansaelmacen CONFIDENTIAL MPORATON-RLV22 5    Language Line Services, Inco  Statement of Work  Interpretation and Translation Services and Related Services  Contract #R210605 Administered by OMNIA Partners  Specialty IST einterpreter Skills Test (eIST) Specialty elST Mediçal Certification Test (MCT) Court Certification Test (CCT) Interpreter Training Course Fees Course Title Fundamentals of Interpreting Advanced Medical Training (AMT) Professional Skills and Ethics Module 1- Medical Interpreter Training: Professional Skills and Ethics Module 2- Medical Interpreting Training: Phone or Working in the Healthcare System Module 2 - Medical Interpreting Training: Web Working in the Healthcare System Module 3- Medical Interpreter Training: Phone or Terminology and Advanced Skills Module 3- Medical Interpreter Training: Terminology and Advanced Skills Combined Modules - Intensive Advanced Medical Interpreter Training (2 oft the 3 above modules) Combined Modules - Intensive Advanced Medical Interpreter Training (2 of the 3 above modules)  $225 $225 $225 $225 $185 $165 $150 $135 $200 $200 $200 $200 $220 $210 $195 $185 $220 $210 $195 $185  Training 1-4* Web Web Onsi te Web Onsi te Onsi te Web Phone or ** Onsite Web  5-9* $400 $520 $390 $230 $520 $290 $520 $290 $805 $460  10" or $285 $500 $290 $175 $400 $230 $400 $230 $635 $345  Delivery Courses Courses More  $445 $575  Module 1- Medical Interpreter Training: Phoneor **  $230 ** $290 ** $290  $460  eTests will be billed when the test linki is delivered to the client.  *Group discounts for tests are applied once the minimum number of tests have been completed within the calendar year. Group training discounts are based on the actual **Delivered via phone or onsite, and requires a minimum of 5 participants to conduct At training manual may be purchased for $69 with the advanced Medical Interpreter Training. A1 training manual with in-language glossary may be purchased for $99 with Interpreter association members qualify for group discounts upon submission ofa copy Group training discounts are based on the actual number of participants.  number of participants. the training.  the advanced Mediçal Interpreter Training. of their membership card to LAQlanguageine.com.  02021 Lenguage Line Services, Inc. Lower Ragsdale Drive, Bldg. 2- Monterey, CA9 93940- ww.L lanquageline.com- CONFIDENTIALI INFORMATION-  6    Language Line Services, Inco  Statement of Work  Interpretation and Translation Services and Related Services  Contract #R210605 Administered by OMNIA Partners  6. LANGUAGELINE TRANSLATION AND LOCALIZATION  6.1. SCOPE OF WORK  (a) DESCRIPTION OF SERVICES. LanguageLine utilizes ISO-certified workflows to convert CUSTOMER's written and/or digital content between languages with attention to accuracy, tone, style, and attention to regional language and cultural sensitivities, including: Modifying graphics and design to properly display translated text Converting tol local currencies and units of measurement Addressing local regulations and legal requirements  Translation of written text Changing content to suit preferences  Using proper formatting for elements like dates, addresses, and phone numbers Services may be requested at psmawinuseineconAcIARGUEAQgE, via email to nsaton@angiasgeneon or by calling 1-800-878-8523. LanguageLine will provide all deliverables as agreed-upon at the beginning of the  (b) DELIVERABLES.  project.  6.2. PRICINGTABLES. Translation fees, which include Translation and copyediting, are based ont the  English word count. BEDIRECTIONAL: Tier1 Spanish (US/Latin America)  TRANSLATION FEE (PER WORD) $0.15/word $0.18/word $0.22/word $0.26/word $0.29/word PRICING $75.00- Spanish $99.00 - all other listed language $60.00/hour $45.00/hour $55.00/hour Individual Quote Individual Quote 10% of the invoice value (0.5-hour minimum @$55.00/hour)  TIERS  ENGLISHPLANGUACE AND ANGUAGEPENGLISH  Tier2 Arabic, Chinese, Portuguese (Brazil), Russian, Vietnamese Tier3 Bengali, Czech, Farsi, French, German, Hindi, Hungarian, Italian, Korean, Malay, Polish, Portuguese (Portugal), Tagalog, Thai, Urdu Tier4 Albanian, Bulgarian, Estonian, Haitian Creole, Japanese, Khmer, Lao, Latvian, Lithuanian, Nepali, Slovak, Slovenian, Somali, Turkish  All other LanguageLine supports 240+ languages)  ADDITIONAL: PRICING COMPONENTS  Minimum charge per document translation order Proofreading (third linguistic step when required) Basic ayoulromatinyDesxop Publishing Localization Engineering Services In-Language Recordings Project Management Rush! Fees  Transerpion/ransaton of Audio or Video files  0% rush charge applies when an expedite delivery date is requested  02021 Language Lines Services, Inc.. 1LowerF Ragsdale Drive, Bidg, 2-Monterey, CAS 93940 *www.L Languageunes com"  INFORMATION. REV05.23-23 7    Language Line Services, Inco  Statement of Work  Interpretation and Translation Services and Related Services  Contract #R210605 Administered by OMNIA Partners  Unless indicated otherwise, a one-hour minimum will apply to alll hourly services.  6.3. DELIVERY GUIDELINES. Because the actual number of English words is not known until the source document has been translated, turn- around commitments are based on the estimated number of English words that will be delivered, as determined in LanguageLine's bestj judgment before commencing work. Additional services could add extra days to a project timeline.  ESTIMATED NUMBER OF ENGLISH WORDS  STANDARD DELIVERY 1-3 business days 4-6 business days 6-8 business days 8+b business days  Less than 1,500 words 1,501 to 4,000 words 4,001 to 7,500 words 7,501+ words  AC 0% rush charge will apply when an expedited delivery date is requested. Requests received on weekends and holidays will be processed on the next business day. Holidays are New Year's Day, President's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, day after Thanksgiving, Christmas Eve, and Christmas Day. The person signing this SOW on behalf of Customer certifies that such person has read, acknowledges, and understands all of the terms and conditions, and is fully authorized to execute this SOW on behalf of and bind the Customer to all its terms and conditions. Both Parties agree the delivery of the signed SOW by facsimile or e-mail or use of a facsimile signature or electronic signature or other similar electronic reproduction of a signature shall have the same force and effect of execution and delivery as the original signature, andi in the absence of an original signature, shall constitute the original signature. This contract is subject to and contingent upon the continuing availability of State and or federal funds for  thep purposes hereof. Customer  LanguageLine Accepted and agreed to date: Signature:  Accepted and agreed to date: Signature: Name: Title:  Name: Bonaventura A. Cavaliere  Title: CFO  02021 Languagel Line Services, Inc. 1 Lower Ragsdale Drive, Bldg. 2- Monterey, CAS 93940- ww.languageline. com  REV05.23.23 8    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 12-10-2024 Submitter: Administration Office  Submitted to the County Administration Office on: Email Poll 11-29-2024  Return Originals to: SECED  Number of originals to return to Submitter: 1  Contract Due Date:  Item Title/Recommended Board Action: the SECOG Mini-Grant Program, FY2025. Justification or Background:  Consider ratifying 11-29-2024 email poll approval of a Letter of Support sent to Tara Marshall, Colorado Department of Local Affairs for the SECOG application for funding of  Fiscal Impact: This item is budgeted in the following account code:  County: Federal: State: Other:  $_ $_ $_ $_  Approved by the County Attorney on:  Additional Approvals (if required):    Board of County Commissioners  Prowers County 301 South Main, Suite 215 Lamar, Colorado 81052-2857  COLORAD9 THOMAS GRASMICK FIRST DISTRICT November 27th, 2024  (719) 336-8025 RONCOOK SECOND DISTRICT  FAX: (719) 336-2255  ROGER STAGNER THIRD DISTRICT  Colorado Department of Local Affairs 1313 Sherman Street, Suite 518 Denver, Colorado 80203 ATTN: Tara Marshall RE: SECOG Mini-Grant Program Dear Ms. Marshall,  The Prowers County Board of County Commissioners is pleased to express our support for the Southeast Council of Governments (SECOG) application to DOLA for funding of the SECOG Mini- The program's value has enabled the Southeast Council of Governments to focus on and complete projects ini the Southeast areai including Prowers County. We have a deep understanding of the needs of our population and firmly believe this funding will: significantly address the needs of our residents, providing various resources that aide in the welfare of our community. Many of these projects have been challenging due to financial obstacles that the SECOG Mini-Grant program has helped alleviated. The Prowers County region has seen the benefits in the past from DOLA's support, and hope the community continues to prosper with Therefore, we support the Southeast Council of Governments' efforts to apply fori the FY2025  Grant Program.  DOLA's assistance.  Cycle 25-26 EIAF Tier 1 Grant Application.  Thank you for your continuous support of Southeast Colorado.  Sincerely, Ron Cook County Tom  Commissioner  ts  phwh Roger Stagner_ hahz  County Commissioner County Commissionér    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 12/10/2024 Submitter: Meagan Hillman, PCPHE Director  Submitted to the County Administration Office on:11/27/2024  Return Originals to: Meagan Hillman, PCPHE  Number of originals to return to Submitter: 1, to confirm approval  Contract Due Date: 12/20/2024 Item Tite/Recommended Board Action:  Consider approval of NFP Contract Amendment No. 1, CT QAAA 2025-1019 A1, to original Contract No. 25 QAAA 190688 in the amount of $648,742.00 and authorizing Public Health Justification or Background: NFP contract amendment increasing award amount Fiscal Impact: This item is budgeted in the following account code:  Director, Meagan Hillman to execute the Contract electronically.  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on: 12-2-2024 Additional Approvals (if required):  PLEASE. ATTACH THIS SHEET TO. ALL. AGENDA ITEMS WHEN SUBMITTINGTO  COUNTY ADMINISTRATION.  THANK YOU!    COLORADO Department of Early Childhood  STATE OF COLORADO CONTRACT MODIFICATION  CONTRACT AMENDMENT #1  State. Agency Colorado Department of Early Childhood (CDEC) 710 South Ash Street, Building C Glendale, CO 80246 Contractor Prowers County Public Health Southeast Nurse-Family Partnership 1001 South Main Street Lamar, Colorado 81052 Original Contract Number 25 QAAA 190688 Amendment Contract Number CT QAAA 2025-10194 Al July1,2024 June 30, 2025  Current Contract Maximum Amount Initial Term State Fiscal Year 2025 CTQAAA 2025-1019  $648,742*  *And $90,000 pooled GAE shared amongst various contractors as described in Contract, see. Exhibit C  Section 11.  Total for All State Fiscal Years $648,742  Contract Performance Beginning Date Current Contract Expiration Date  Signature Page Begins on Next Page  THE REST OF THIS PAGE IS INTENTIONALLYIEFT BLANK  Amendment Contract) Number: CTQAAA 2025-1019A1 Page 1 of4  Version 07.2024    COLORADO Department ofE Early Childhood  SIGNATURE PAGE  THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT Each person signing this Amendment represents and warrants that he or she is duly authorized to execute this Amendment and to bind the Party authorizing his orl her signature.  CONTRACTOR Partnership  STATE OF COLORADO Jared S. Polis, Governor Lisa Roy, Ed.D., Executive Director Colorado Department of Early Childhood  Prowers County Public Health Southeast Nurse-Family  By: Stephanie Beasley, Deputy Executive Director  By: Meagan Hillman PA-C, MBA, Director of PCPHE  Date:  Date:  STATE CONTROLLER Robert Jaros, CPA, MBA, JD  By: Laura Curnow, CDEC Controller  Amendment Effective Date:  Ina accordance with $24-30-202, C.R.S., this Amendment is not valid until signed and dated above by the State  Controller or an authorized delegate.  Amendment Contract Number: CT QAAA 2025-1019A1 Page 2 of4  Version 07.2024    COLORADO Department of Early Childhood  1. PARTIES  This Amendment (the "Amendment") to the Original Contract shown on the Signature and Cover Page for this Amendment (the "Contract") is entered into by and between the Contractor, and the  State. 2. TERMINOLOGY  Except as specifically modified by this Amendment, all terms used in this Amendment that are defined in the Contract shall be construed and interpreted in accordance with the Contract.  3. AMENDMENT EFFECTIVE DATE AND TERM  A. Amendment Effective Date  This Amendment shall not be valid or enforceable until the Amendment Effective Date shown on the Signature and Cover Page for this Amendment. The State shall not bel bound by any provision of this Amendment before that Amendment Effective Date, and shall have no obligation to pay Contractor for any Work performed or expense incurred under this Amendment either before or after oft the Amendment term shown in $3.B ofthis  Amendment. B. Amendment Term  The Parties' respective performances under this Amendment and the changes to the Contract contained herein shall commence on the Amendment Effective Date shown on the Signature and Cover Page for this Amendment and shall terminate on the termination oft the  Contract.  4. PURPOSE  Prowers County Public Health Southeast Nurse-Family Partnership (SENFP) shall positively impact pregnancy outcomes, child health and development, and economic self-sufficiency of enrolled families in Baca, Prowers, Kiowa, Bent, Otero, and Crowley counties by delivering high quality nursing services that comply with Nurse Family Partnership (NFP) model fidelity. This  Amendment shall add funds to SFY25 and amends exhibits A, B, and C. The Contract and all prior amendments thereto, ifany, are modified as follows:  5. MODIFICATIONS  A. Increase the Contract Amount for SFY25 by $44,740 from $604,002 to $648,742 and Increase the Maximum Amount for All State Fiscal Years from $604,002 to $648,742. The Contract Maximum Amount table on the Contract's Signature and Cover Page is hereby deleted and replaced with the Current Contract Maximum Amount table shown on  the Signature and Cover Page for this Amendment.  B. Exhibit A - Statement of Work  Exhibit A - Amendment #1, which is attached and incorporated by this Amendment, shall  replace Exhibit A of the Original Contract.  C. Exhibit B - Budget  Exhibit B - Amendment #1, which is attached and incorporated by this Amendment, shall  replace Exhibit B oft the Original Contract.  Amendment Contract Number: CT QAAA2025-1019AI Page3of4  Version 07.2024    COLORADO Department ofEarly Childhood  D. Exhibit C - Additional Provisions  Exhibit C - Amendment #1, which is attached and incorporated by this Amendment, shall  replace Exhibit C oft the Original Contract.  6. LIMITS OF EFFECT AND ORDER OF PRECEDENCE  This Amendment is incorporated by reference into the Contract, and the Contract and all prior amendments or other modifications to the Contract, if any, remain in full force and effect except as specifically modified in this Amendment. Except for the Special Provisions contained in the Contract, in the event of any conflict, inconsistency, variance, or contradiction between the provisions of this Amendment and any oft the provisions ofthe Contract or any prior modification tothe Contract, the provisions ofthis Amendment shall in all respects supersede, govern, and control. The provisions oft this Amendment shall only supersede, govern, and control over the Special Provisions contained in the Contract to the extent that this Amendment specifically  modifies those Special Provisions.  Amendment Contract Number: CT QAAA2 2025-1019A] Page 4 of4  Version 07.2024    - 1 a 8 3  &%  5    %    %        9            %    ExhibitB B- Amendment #1  COLORADO Depr otEastyCaadhood Contractor Name Budget Period ProjectN Name Counites Served  Colorado Department of Early Childhood BUDGET WITH. JUSTIFICATIONI FORM  Program Contact Name, Title Phone Email Fiscal Contact Name, Title Phone Email Funded Caseload  RoxieR Rankin, RN, MSNN Nurses Supervisor 719-688-8724 mnlinepoEunAE Reyna Perez,A Accountant 719-336-8721 EMSPRESDRITNSNT  Prowers CountyP Publick Health8 &E Environment July1 1,2024- June3 30,2 2025 Nurse Home Visitor Program Baca, Bent, Crowley, Kiowa, Otero, Prowers, Cheyenne Personnel Services- Salaried Employees Descrptond OTV Fringe Benefits Include: Federall Insurance Contributions Act (FICA), Healthl Insurance, Visionl Insurance, Lifel Insurance, Gross or and5 5%m matching retirement Provides oversight, assistancea andr management for) Home Visitors, Home) Visitors conduct homev visitsa ando coordinate visiting schedules withf families. Home Visitors conducth hamev visits ando coordinate visiting schedules withf families. Home Visitors conducth home visits ando coordinate visiting schedules withf families. Administrative Assistant. BilingualA Aide.  Expenditure Categories  State Fiscal Vear 2025 (SFY) AOther CCDEC $0 $o $87,704 $o $0 $95,324 $0 So $73,598 $o $0 $78,540 so so $54,521 50 so $7,299 $0 $o $396,986 State Fiscal Vear (SFY) 2025 A.Other CCDEC Sourcesc of B.Medlcaid Funding Revenue Fundint (NHVP) $0 $2,617 $13,502 $o $4,000 $6,500 so 50 $4,800 $o $0 $2,500 so $2,000 $8,000 $0 $0 $5,000 $0 $6,000 $4,000 $0 $0 $1,200 $0 $0 $10,595 So SO $1.500 $14,617 $57,597 A. Other B.Medicaid CCDEC Sourcesof Funding Funding Revenue (NHVPI s0 so $22,248 so So $15,367 $0 $0 $37,615 $0 $14,617 $95,212 State Fiscal Year (SFY) 2025 A.Other C.CDEC Total Sourcesof B.Medicaid Funding Funding Revenue (NHMP) $11.366 so so $11,366 $1.442 $0 so $1,442 $924 so so $924 $75 $o $o $75 $3,800 $o $o $3,800 $3.783 so so $3,783 $3.600 so so $3,600 so so $24,990  Percento of  Time on Total Amount Sourcesof B.N Medicaid Fonding  Position Title  Annual Salary Fringe Project For Project Funding Revenue (NHVP)  Supervisor Nurse Home Visitor (NHV) Nurset Home Visitor (NHV) Nurse Home Visitor (NHV) Admins Support/Data Entry BilingualAide  $91,331 $25,608 75,00% $87,704 $75,919 $19,405 100,00% $95,324 $76,179 $15,819 80,00% $73,598 $78,279 $19,896 80,00% $78,540 $37.741 $16,780 100.00% $54,521 $37.513 $14,626 14.00% $7,299  1.Total Personnel Services (includingf fringe! benefits)! $396,986  Supplies & Operating! Expenses  Item  Descriptiond ofltem  Office Operating Expenses( (ie. supplies) Client Supporti Materials Printing &Publications Postal& Shipping Services Communications! (cellular, networks services) Medicals Supplies Technology Community Coalition ITSupport Repair Insurane/Morierscomp Program Support Fee RentalCosts  Thisi includes paper, ink, pens, paperc clips, filefi folders, travelingt foldersa andg generaloffices supplies necessaryt tos supportt the Itemst thata augmentt thep programo curriculuma andh helpt the client's assimilationo ofk knowledger regarding material., Thisi includes books, object! lessonr materials, foldersa ando others supplies: Itemsf ford clientsi includingb babys supplies, calendars, personalhygine, Forms neededt toi implementt thep program: asw wella asuse ofmediat toi increasec commuitya awarenessi ins service area, Forr nursest tomailt theiro dataa ando othern materials eachv weekt tot thes Supervisora ands Supports staff, Alsof for mailing cards, letters, Includesi in-house long distance asw wella asv wireless devicesf forv wifiando cellp phonesf fort ther nurses. Includer replacements stethoscopes, scales, bloodp pressure cuffs,masks, etc, Thesei items areu usedf forp physicala Ton maintain8 &r replace computers ands softwarez asr neededt toefficientlyi implementt the Nurse-Family Partnership program. The NationalService Officei isu using E-Facilitators whichr require home visitorst tou usea ane elelctronic device during theirv visits. Tabletsare neededb byr nurses toe efficientlyi implement thep program. Upgrading currentt tabletsf for4 4nurses: Essentialf forr maintaining thefi fidelity oft thep program. Thec coalition must meet4 4timesp pery yeara andc currentlyt then meetingsa are over thel lunchh houra andw wep providet thel lunche Weh haveb betterp participation by holdingt thisn meeting overk lunch. Somec oft the members drive over1 1hourt toa attendther meeting andp providing lunchisas smallv wayt tos show ourg gratitudef fort theirs service. Costs ofouriTs service providerf ford computers, laptops, tablets, printers, andc copier costsa allocatedt toN Nurseh Home Visiting: This equipmenti ise essentialtor maintainf fidelity ofthe programa andprovide qualitys servicestoc clients. Basedo onf formula county usesf forl  implementations ofthe program, books, anda additionali items: informationtoc clients. mothera andc child.  ofthe  Tservicesf fore emplovee andd devices  Costso ofc our liabilitya andw worker's compi insurance costsa allocatedt toN Nurse Home Visiting. National Service Office Fee;R Requiredo costf for Nurse-F Family Partnership! (NFP) Generalr rental costsf for thep program's operatianl location (doesn notir includer meeting roomf fees)  Subtotal  Items Exdluded from MTDC: (Rental costs, tuition, chohrhipy/elowships, participant support, equipment, capital expenditures)  Item  Description ofitem  Subtotali items removed from! MTDC 2.Total Supplies & Operating! Expenses  Training and Technical Assistance Description ofltem  Item  Per NHV NHV NHV NHV NHV/Supervisor Supervisor NHV  Fee $5,683 $721 $462 $75 $950 $3,783 $300  Nurse Education Experiences (OANCE)Licensing Professional Development SupervisorE Expansion/Replacements Fee MentalHealth Consulation  Requiredt trainingf forr newn nurses Covers cost ofa additionalt trainingf forr nurses Requiredf feeo onlyf forr new's Supervisor mental! healthf fort team/group setting  Nurse-Family PartnershipE Education Materials Costt tocoverr requiredr materials Partnersi inP Parenting Education! (PIPEIT Training Costo covers PIPE training Dyadic Assessment of Naturalistic Caregiver- Child Costo coversr required trainingr materials  3.Totall Training and Technical Assistance $24.990  Pagelof2  Rev1 1/5/2024    Exhibit B- Amendment: #1 State Fiscal Year (SFY) 2025 A. Other CCDEC Sourceso of B.Medicaid Funding Fmding Revenue NHVPI $o $38,000 $0 so $12,000 $0 $o $50,000 State Fiscal Year (SFY) 2025 C.CDEC S0 $0 $o so $0 so $14,617 $567.188 $o $14,617 $529,573  Travel  Item  Description ofitem  Visit8 &C Outreach Mileage TraveltoA AttendR Required1 Training  Outreach mileagei is necessaryf forn nursest tot traveltoclient! Prowers8 & Cheyenne Counties w/NHVt tov various countiess served,  throughoutt then region, Baca, Bent, Crowley, Kiowa, Otero,  Necessaryf fort thes supervisor toa attendmandatoy: staten meeting andu trainings: Mandatory. Joint Visit Observations bys supervisor  5.TotalTravel Allowablei in UnAllowable A.Other MTDC inMTDC Sources of B.Mediçaid Funding calculation Calculation Fundina Revenue (NHVP) so TOTAL DIRECT COSTS  Contracter/Conuitant (payments tot third parties or entities) Nocostsi inthisc categorys shallb ber reimbursedb byCDEC.  Name  Description ofitem  6.Total Contactor/Consulants:  MODIFIED TOTALI DIRECT COSTS (MTDC)  Uniform Guidancez ZCFR2 200.1 "Modified TotalD Direct Cost (MTDC)"- means allo directs salariesa andv wages, applicablef fringe benefits, materialsa ands supplies, services,t travel, andi uptothe first $25,000ofe eachs subaward (regardless ofthep period ofp performance ofthes subawardsu undert thea award). MTDCe excludese equipment, capitalexpenditures, chargesf forp patient care rentald costs, tuitionr remission, scholarships andf fellowships, participant supporto costsa andt thep portiono ofe eachs subawardi inexcess of $25,000. Otheri items may only bee excluded when  necessaryt toz avoidas seriousi inequityi int thec distributiono ofin indirecto costs, andw witht thea approvald ofthed cognizant agencyf forir indirecto costs.  Indirect Costs  Statel Fiscal Year (SFV) 2025 A. Other CCDEC Sourcesof B.Medicaid Funding Fundino Revenue (NHVPI su 581 $o $0 $81,554 so $14,617 $648,742  (nott toe exceed1 10% unless Negotiated Federall Indirect Costr rate or Negotiated Statel Indirect Costr rateisa attached)  kem  Descriptionc ofl Item  State Federallr Indirect costr rate  Negotiatedi indirectrate 0f15-4%OfMTDC  Totall Indirect TOTAL  *Figures arer roundedi using! basica accountings standards. (0.00-0.49=0;0 0.50-0.99=1.0)  Page2of2  Rev 1/5/2024    COLORADO Department of Early Childhood  Exhibit C-A Amendment #1  ADDITIONAL PROVISIONS  1.S SERVICE PROVISIONS  The Contractor shall provide the services according to the plans submitted in the "Statement of Work", attached and incorporated herein by this reference as EXHIBIT A. Inall cases, the descriptions, plans, timetables, tasks, duties, and responsibilities oft the Contractor as described in the Statement of Work, shall be adhered to ini the performance of the requirements of this contract. In the event of a conflict, the terms and conditions oft this contract shall control over the Statement of Work. Any significant changes to the Statement of Work (SOW)  require an amendment to the contract. 2. GOALS. AND OBJECTIVES  The Contractor shall be responsible for the achievement of any goals and objectives as specified within the Statement ofWork (EXHIBIT A) oft this contract unless written notice of any modifications are furnished by the State to the Contractor allowing adequate time for compliance during the term of this contract.  3. COPY OF SUBCONTRACT Representative upon execution.  The Contractor shall provide to the State a copy ofa any executed subcontract between the Contractor and any provider of serviçes to fulfill any requirements oft this contract. Subcontracts shall be emailed to the Contract  4.1 PAYMENT  In consideration of the provision of services and reporting and subject to all payment and price provisions and further subject to verification by the State ofi full and satisfactory compliance with the terms of this contract, the State shall pay to the Contractor an amount not to exceed the amount specified in the Budget (EXHIBIT B), of A. The Contractor shall submit requests for payment to the OnBase Invoice Submission Process no less than i. Link to Frequently Asked Ouestions about the OnBase Invoice Submission Process.  this contract.  monthly on forms prescribed and provided by the State.  ii. Link to Vendor Invoice Guidance  iii. For technical issues please contact the OnBase Administrator at iv. Fori invoice issues, please contact CDEC Invoicing@stateco.us B. Payment shall be made on a cost reimbursement basis for services rendered.  CDEC OnBase Admin@state.co.Is  Itis understood any vacancy savings in the personnel category and/or any savings in any other category shall require written approval from the State prior to any redistribution of any savings by the Contractor. ANY COST SAVINGS THAT ARE REDISTRIBUTED BY CONTRACTOR WITHOUT WRITTEN D. IT IS UNDERSTOOD ANY COSTS THAT EXCEED THE CONTRACTED AMOUNT SHALL: NOT BE: PAID BY CDEC. IfContractor has a legitimate need for additional funds, the Contractor shall request additional funds from the CDEC 60 days prior to projected depletion of contracted funds. CDEC shall  APPROVAL SHALL NOT BE REIMBURSED BY THE STATE.  Page 1of4  Revision Date 11/4/2024    COLORADO Department of Early Childhood  Exhibit C-A Amendment #1  review each request and notify Contractor in writing ofapproval or denial. Approval of additional funds E. Timely Invoicing Invoices shall be submitted no later than 30 days following the last day of the month. End of State Fiscal Year invoices are on a compressed timeframe. Invoices for all services provided prior to. June 30th shall be invoiced by. July 5th. Contractors who are unable to provide the invoice by July 5th shall notify the state oft the amount to be booked as accounts payable by July 13th by sending an email to OnBase Invoice Submission Process. Final invoices for services prior to June 30th shall be submitted by F. The Contractor shall maintain source documentation to support all payment requested pursuant to this contract. All source documentation shall be provided to the State by the Contractor upon request. G. Itisu understood that the State reserves the right to offset funds pursuant to this contract based on the discovery of overpayment or improper use of funds by the Contractor. Overpayment or improper use of funds is interpreted to apply to specific terms of prior year contracts, and includes without limitation requirements oft the Generally Accepted Accounting Principles (GAAP) issued by the American Institute ofCertified Public Accountants, and applicable sections oft the Colorado Revised Statutes. H. The State shall review monthly invoices throughout the fiscal year. If, after ai number of months, the State determines the Contractor is not needing/using the funding allocated for the Contractor's work in the Contract, the State shall remove these funds from the contract budget by Option Letter for aj proportional reduction ofs services with prior written notification to the Contractor. This provision does not allow fora  shall require an official modification to the Contract by Amendment or Option Letter.  September 14th. Invoices received after September 14th may not be paid.  reduction in the rate of pay.  5.PARTICIPATION  The Contractor representative(s) is required to participate in any Department of Barly Childhood sponsored  meetings related to this contract. 6.SUPPLANTING  Payments made to the Contractor under this contract shall supplement and not supplant other state, local or  federal expenditures for services associated with this contract.  7. BUDGET CHANGES  Contractor may request in writing adjustments to the direct costs in the current year budget (EXHIBIT B) not to exceed 10% oft the total budget. Requests shall be made in the form ofa written budget revision request to the appropriate program staff. Written approval for the budget revision shall be required prior to any changes to the budget related to the budget revision request. The total dollar amount oft the contract budget cannot be changed as aj result ofthe budget revision request. Budget adjustment requests over 10%, adding new expense lines, and/or changes to the total dollar amount of the budget require a formal amendment. No adjustments to Contractor may request in writing up to a 5% increase to the "Gross or. Annual Salary" of an individual employee ifaj position currently listed in the contract becomes vacant and the new incoming employee shall be hired at al higher or lower salary. No increase within the salary range is authorized without prior written approval from CDEC. Adding additional staff requires an amendment to the contract. Vacancy savings cannot  the Indirect Costs portion ofthe budget are allowable without a formal amendment.  Page 2of4  Revision Date 11/4/2024    COLORADO Department of! Early Childhood  Exhibit C-A Amendment #1  be used to change salary amounts for existing personnel without an amendment. Any change to personnel requires prior written approval from CDEC staff. This process shall never change the Contract Maximum Amount. Contractor: must use available unused funds from either vacancy savings or another category within the contract. Thei revision request may not at any time compromise the integrity oft the funded program as  determined by CDEC program staff.  8. TRAVEL costs.  Travel costs must be listed in Exhibit B - Budget under travel including airfare, hotel, mileage and per diem A. Mileage shall not exceed the State mileage rate per. ntps./www.coloradondogovpacticose/travel-iscal-rule  B. Per Diem shall not exceed State per diem rate for the area oftravel per attps./www.coloradoowpacticoserravel-Iiscal-rul. E Hotel rates cannot exceed any: rate established for conference attendance. D. Usage of airfare or Out of State Travel requires pre-approval from CDEC.  9. CRITICAL INCIDENT REPORTING  Within 48 hours oft the occurrence ofa a critical incident involving any child or family and/or an on duty agency staff member of any family support program staff funded through the Department of Early Childhood (CDEC), the agency must report in writing the details oft the critical incident to the CDEC Program Manager for the involved family support program. Critical incidents may include, but are not limited to, awareness of an egregious incident of abuse and/or neglect, near fatality, or fatality ofany child currently enrolled in a family support program; involuntary termination ofa a program staff's employment; criminal allegations involving program staff and related to his/her employment; negative media attention about the family support program; any major injury or threat to the security of an agency staff member while on duty and visiting an enrolled child  or family.  10. MANDATED REPORTING  A. All program staff are required by law to report suspected child abuse and neglect. Mandatory reporters must report suspected child abuse and neglect to the local county child welfare agency, the local law enforcement agency, or by calling the child abuse reporting hotline system at 1-844-CO-4KIDS (1-844- B. All program staff are required to take the online mandatory reporter training on the Colorado Department of Human Services (CDHS) Child Welfare Training System: htps/ww.olonadoewis.com/mandated.  264-5437).  reporter-training.  Page 3 of4  Revision Date 11/4/2024    COLORADO Department ofE Early Childhood  Exhibit C-Amendment #1  11. GENERAL ACCOUNTING ENCUMBRANCE (GAE)  A. Nurse Home Visitor General Accounting Encumbrance (NHVP-GAE) shall be utilized as follows: Nurse Family Partnership (NFP) training costs, often sites experience staff tumover in a fiscal year and they will be permitted to use the GAE to cover costs OfNFP required training that was not ii. Travel costs associated with NFP training. For example, ifas site hires ai new. Nurse Home Visitor, and this staff member is required to attend NFP orientation, the site will be able to bill the GAE: for the training registration and travel expenses for the training. Travel costs may include mileage, hotel iii. Operational items not included in their budget such as cell phones, tablets, laptops. Due to staff turnover, sites are to not include potential operational item expenses in their budgets, but rather iv. Transition salaries to pay new staff during the overlap with the staff member leaving in order to provide time for adequate training. Once the original staff member leaves, the new staffmember's V. Translation and interpretation services to serve clients who are deaf or hard of hearing, and those B. Payment to Contractor is made from available funds encumbered and shared across multiple contractors. The State may increase or decrease the total funds encumbered at its sole discretion and without formal notice to Contractor. No minimum payment is guaranteed to Contractor. The liability of the State for  included in their budget.  accommodations and per diem for the staff member attending the training. utilize the GAE in order to purchase necessary items for new staff. salary would be paid against the existing line in their budget.  whose primary language is not English.  such payments is limited to the encumbered amount remaining ofs such funds. C. Invoices shall be submitted separately for pre-approved expenditures.  The Contractor shall submit requests for payment to CDEC Invoicing@statecous A. To comply with federal guidelines, purchasing gift cards with funds from CDEC contract funds is not allowed. Please see citations 45CFR75.406 and 45CFR75.302.A for more information.  12.GIFT CARDS  13.SAM.GOV REQUIREMENT FOR STATE FUNDED CONTRACTS  A. Individuals who are excluded from participation in federal health care programs are also prohibited from participating in federal govemment procurement and non-procurement programs according to title 2 of the Code of Federal Reg.at.CR.1376147 and 42 CFR part 1001, which clarifies that this B. Any individual or entity excluded from participation in Medicare, Medicaid, and other Federal health care programs under Title XI oft the Social Security Act, 421 U.S.C.1320a-7, 1320a-7a, 1320c-5, or 1395ccc, and implementing regulation at 42CFR part 1001, will be subject to the prohibitions against participating in covered transactions, as set forth in this part and part 180, and is prohibited from participating in all Federal Government procurement programs and non-procurement programs. C. Contractor shall have a formal written policy regarding SAM.gov checks for all staff upon hiring and not less than annually including procedures for maintaining records of the evidence of this check.  applies toi individuals and entities.  Page 4 of4  Revision Date 11/4/2024    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 12/10/24 Submitter: Don Wilson, Administration Office Submitted to the County Administration Office on: 12/4/24  Return Originals to: Don Wilson Number of originals to return to Submitter: 1  Contract Due Date: N/A  Item Title/Recommended Board Action:  Consider approval for adoption oft the 2025 County Holiday schedule and BOCC Meeting Schedule.  Justification or. Background: Annual requirement  Fiscal Impact: This item is budgeted in the following account code:  County: $  0  Federal: $  0  State: $  0  Other: $  0  Approved by the County Attorney on: Additional Approvals (ifr required):    S  HOLIDAYS - 2025 Revised 12/3/2024  OLORAD9  January 1-V Wednesday February 17 - Monday April 18 - Friday May 26 - Monday July 4- Friday  New Year's Day Presidents' Day Good Friday Memorial Day Independence Day Labor Day Veterans Day Thanksgiving  September 1- Monday November 11 - Tuesday November 27 - Thursday November 28- Friday  Day after Thanksgiving  December 24- Wednesday December 25 - Thursday December 26 - Friday  Christmas Eve Christmas Holiday Day after Christmas  Approved by BOCC:  Ron Cook, BOCC Chair  Date    2025  COMMISSIONER MEETING DATES 2025  PAYROLL DUEI DATES By: 12:00 Noon  AGENDA ITEMS DUE DATES By 12:00 Noon  Tuesday January14 Wednesday January8 Tuesday February11 Wednesday February5  January February March April May June July August  Tuesday January 28 Wednesday January2 22 Wednesday January 22 Tuesday February 25 Wednesday February 19 Wednesday February19  Tuesday Tuesday Tuesday Tuesday Tuesday Tuesday Tuesday Tuesday Tuesday Tuesday  March 11 March 18 April8 April 22 May13 May27 June1 10 June 24 July8 July22  Wednesday March5 Wednesday March12 Wednesday Tuesday Wednesday Tuesday Wednesday Wednesday Tuesday Wednesday  Thursday March 20 Monday Tuesday Thursday Tuesday  April2 April 15 May7 May 20 June4 June 18 July1 July16  April 21 May 20 June 19 July22  Tuesday August 12 Wednesday August 6 Tuesday Septemberg Wednesday September3 Tuesday October 14 Wednesday October 8 Tuesday November 11 Tuesday November4 Tuesday Decemberg Wednesday December3  Tuesday August 19  Budget Kick Off Budget Budget  Tuesday August 26 Wednesday August 20 Wednesday August 20 Tuesday September: 23 Wednesday September: 17 Friday September 19 Tuesday October: 28 Wednesday October22 Wednesday October 22 Tuesday November 25 Wednesday November 19 Monday November 17 Tuesday December 23 Wednesday December: 17 Thursday December 18  September Tuesday September: 16  October November December  Tuesday October: 21  Approved by BOCC: Ron Cook, BOCC Chair  Date    PROWERS COUNTY AGENDA ITEM REQUEST FORM  Hearing Date Requested: 12/10/24 Submitter: Don Wilson, Administration Office Submitted to the County Administration Office on: 12/4/24  Return Originals to: Don Wilson Number of originals to return to Submitter: 1  Contract Due Date: N/A  Item Title/Recommended Board Action:  Consider approval for Adoption oft the County Retention Policy Justification or Background: Update and addition to County Policies  Fiscal Impact: This item is budgeted ini the following account code:  County: $  0  Federal: $ 0  State: $  0  Other: $  0  Approved by the County Attorney on: Additional Approvals (if required):    O,  OLORAD  RECORDS RETENTION AND DESTRUCTION POLICY  The Prowers County Board of County Commissioners recognizes the importance of protecting and preserving Prowers County's (the County"records while managingando organizing the ocumentaylmtormations created or received by County  Elected Officials and County employees.  County records must be created and retained for various purposes, including, but not limited to:  Administrative, legal, andi fiscal.  Providing efficient andi timely access to records for County Elected Officials, staff, and the public. Complying with Federal and State laws and any other regulations regarding record retention that may apply.  Preserving the County's history.  This Records Retention and Destruction Policy includes Record Retention Schedules, which establish how long County records must ber maintained to comply with legal and operational requirements. The: schedule guides the proper destruction  of records in an appropriate and efficient manner while preserving accountability and transparency.  SECTION 1: PURPOSE  The purpose oft this Policyi is to ensure that necessary records and documents are adequately protected and maintained and to establish procedures for discarding records that are no longer needed by the County or no longer have original value at This policy also aims to help County Elected Officials and employees understand their obligations regarding the creation, retention, and destruction of electronic records and documents, including emails, webi files, text files, sound and movie files,  the proper time using prescribed methods.  PDFS, and other document formats. SECTION 2: SCOPE  This Policy applies to all physical records generated during the normal course of Prowers County's operations, including original documents, reproductions, and electronic records. All computer files, documents, and software created or stored County Elected Officials are responsible for creating, maintaining, storing, and destroying various records as part of their statutory duties. Each official will follow a statutorily supported Retention Schedule that defines categories of records, retention requirements, and approved methods of destruction. Statutorily designated policies will supersede this Policy, where applicable. Records Retention Schedules for the Elected Offices of Clerk and Recorder, County Treasurer, Public Trustee and Sheriff can bel located here: ttps/archives.colorado.gov/records>-monagement/county-records-management.  on County computer systems are the property oft the Countya and subject to this Policy.    SECTION 3: ADMINISTRATION  The County Administrator (the "Administrator") is responsible for the administration of this Policy and ensuring that it is  followed. The Administrator is authorized to:  Monitor local, state, and federal laws affecting record retention. Annually review the record retention and destruction program.  Monitor compliance with this Policy.  In cases where the County Administrator is not the custodian of certain records (e.., criminal justice, elections, DMV), the  respective Elected Official willi follow: specificst statutory guidance related to their office and records.  SECTION 4: OWNERSHIP OF RECORDS  All computer files, documents, and software created, used, or stored on County computer systems are the property of Prowers County. No County Elected Official or employee has any personal or property rights to such records. Unauthorized  use, transmittal, removal from the premises, or destruction of such records is strictly prohibited. SECTION 5: SUSPENSION OF RECORD DISPOSAL IN THE EVENT OF LITIGATION OR CLAIMS  The Administrator or County Attorney (the "County Attorney") shall take the necessary steps to promptly suspend record  destruction if:  The County is served with any subpoena or document request.  Ane employee becomes aware ofag governmental investigation or audit and notifies the Administrator or County  Attorney.  Any litigation involving the County isi initiated. destruction will be suspended until determined otherwise. SECTION 6: RECORD RETENTION SCHEDULE The Record Retention Schedule is categorized as follows:  The Administrator or County Attorney will notify departments or offices affected by the preceding events, and document  Accounting and Finance  Accounts Payable ledgers and schedules o Accounts Payable invoices and receipts Accounts Receivable ledgers and schedules o Accounts Receivable invoices and receipts  7 years 5 years 7 years 5y years Permanent completion date) Permanent 7y years 7y years (post sale)  Physical Annual Audits D General Ledgers Financial Statements Investment Records  Annual Audit -records and supporting documents 7years (post  2    o Bank Statements and Canceled Checks Employee Expense Reports Credit Card Statements  7y years 5 years 2y years  Contracts  Contracts and Corresponding documents  7y years (post expiration)  Correspondence and Internal Memoranda  Routine Correspondence Contracts  2y years requirement  Items directly pertaining to Accounting, Finance, or See associated  Electronic Documents  ) Back up procedures to safeguard information o Electronic copies of other media types  1y year When Available  Grant Records  Grant Proposal (non- awarded) documentation  1y year completion)  Grant Agreement (Awarded) and corresponding 7 years (post grant  Insurance Records  o Annual Loss Summaries Audits and Adjustments o Insurance Policies  10 years 3 years (post final adjustment) Permanent Permanent  Claims and Corresponding documents  Legal Filesand Papers  ) Legal Memoranda, Opinions, Litigation Files  7y years (post topic closed) 7y years (post appeal period)  Court Orders  3    Payroll Documents  W-2 and W-4 Forms Payroll Deductions Payroll Registers (gross & net) Timecard /Sheets  3years (post- employment) 3years (post- employment) 5 years 2years (post- employment)  Pension Records  Pension and Employee Benefit Plan  6 years from the date the plan is filed *unless benefits will need to be determined  Personnel Records  Employee Files I-91 forms  7y years (post- employment) 1y year (post- employment) 7years (post- employment) 2years (post- employment)  Contract Employee Files Timecard /Sheets  Property Records  o Deeds, Assessments, and Right of Way O Purchase, Sale, Lease Agreements Property Insurance  Permanent Permanent Permanent  Tax Records  Excise, Payroll, Sales and Use Records Returns - Federal and State  7years Permanent Permanent  O Audits  4    SECTION 7: RECORD DESTRUCTION  Departments: and offices must maintain al logo of destroyed records, documenting the date, method, volume, and description of the records, along with who authorized and supervised the destruction. When a third-party service is used, the department head must ensure that the provider has appropriate security measures in place to protect the records during  destruction.  SECTION 8: PERSONAL IDENTIFIABLE INFORMATION (PII)  Per C.R.S. 6-1-713 et seq., Prowers County must take extra care to protect Personal Identifiable Information (PII), which includes data such as Social Security numbers, driver's license numbers, medical records, and more. The County must take  steps to prevent unauthorized access, use, or disclosure of such information.  SECTION 9: PROCEDURES FOR SECURE DISPOSAL OFF PII in non-secure methods, i.e. trash or standard recycling. This Policy is effective commencing on December  The County will dispose of PII securely through shredding, incineration, or electronic overwriting. No PII should be discarded  2024, by the Prowers County Board of County Commissioners.  Ron Cook, Chair  Thomas Grasmick, Vice-Chair Roger Stagner, Commissioner  Attest  Jana Coen Clerk to the Board  5    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 12/10/2024 Submitter: Gary Harbert, Veterans Officer  Submitted to the County Administration Office on: 12/4/2024 Return Originals to: 1Copy BOCC, 1 Copy to Veterans Office Number of originals to return to Submitter: 0-email only  Contract Due Date:  Item Tite/Recommended Board Action: Consider Approval of County Veterans Service  Officer's Monthly Report and Certification of Pay - November 2024 Justification or Background: (Briefoverview: for the Commissioners) Fiscal Impact: This item is budgeted in the following account code:  County: $ NOTE: picked up. 719-336-2606  Federal: $  State: $  Other: $  Please email a signed copy of the CVA report to the Veteran Office or call for the report to be  PLEASE ATTACH THIS SHEET TO ALL. AGENDA ITEMS WHEN SUBMITTINGTO  COUNTY ADMINISTRATION.  THANK YOU!    Colorado Division of Veterans Affairs  County Veterans Service Officer Monthly Report and Pay Request  State Fiscal Year 2023-2024  ON OF VETE  County: Month:  PROWERS NOVEMBER  In compliance with C.R.S. 528-5-707 and for the purposes of semiannual payment, we hereby certify that 168 hours have been worked by accredited veterans service officers and  assistants in the month stated above.  Inc compliance with C.R.S.52 28-5-804 and for the purpose of providing prompt, efficient, and uniform service to Colorado veterans, we hereby certify the wait time for an appointment with  1  our veterans service office was no more than  days in the month stated above.  Inc compliance with C.R.S. $28-5-804 and for the purpose of! providing prompt, efficient, and uniform service to Colorado veterans, we hereby certify the following outputs by our CVSOin  the month stated above:  Telephone Calls Emails Appointments Outreach Events Total Served  139 70 42 0 251  Appendix C  CVA 26-County Veterans Service Office monthly report and pay request  October. 2023-supersedes all earlier versions    This is verified as at true and accurate record. We acknowledge that the lack ofti timely submission  ofthis form can result in delayed or missing payments.  Sany Horbus County Vetérans Service Officer 12/1/2024 Date  County Commissioner or Designee  Date  Please return this form no later than the 10th ofthe following month to:  Colorado! Division of Veterans Affairs dvamio@amvastte.ous  Appendix C  CVA. 26-County' Veterans Service Office monthly report and pay request  October 2023-supersedes alle earlier versions    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 12-10-2024 Submitter: Administration Office  Submitted to the County Administration Office on: 12-5-2024  Return Originals to: N/A  Number of originals to return to Submitter: N/A  Contract Due Date:  Item Ttle/Recommended Board Action:  Consider approval of adding a Special BOCC Meeting for December 13, 2024  justification or Background:  Fiscal Impact: This item is budgeted in the following account code:  County: $ Federal: State: Other:  $_ $ $ -  Approved by the County Attorney on:  Additional Approvals (if required):