PROWERS COUNTY, COLORADO BOARD OF COMMISSIONERS MAY 13, 2025 7:00 a.m. Mark Dorenkamp, Road & Bridge Supervisor Update (AM Breakfast House, 410 S 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. Larry Caster, Enterprise Fleet Management 9:30 a.m. Leslie Mastrolann-Executive Director, Tracy Gutierrez- Senior Program Manager, SCEDD Updates 10:00 a.m. Dr. Claire H. Reed, Interim CEO, High Plains Community Health Center Update 10:15 a.m. Val Baldwin Discuss community Christmas Tree funding 10:30 a.m. Holly Fire & Ambulance Semi-annual updates 10:45 a.m BOCC - Updates Darla Scranton Specht Urban Renewal Overview Andy Sprouse ThinAir MEETING AGENDA 1:00 p.m. Invocation Pledge of Allegiance Call Meeting to Order Roll Call 1 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 February 22, 2025 Meeting Minutes 4. Consider Approval of May 5, 2025 Special Meeting Minutes PUBLIC APPEARANCES Anyone wishing to address the BOCC may do SO at the discretion of the Board and subject to a three-minute limitation. PRESENTATION Mark Henson, Executive Director Southeastern Developmental Services Inc. SDS Awareness Day Proclamation UPDATES Don Wilson, County Administrator County Administrator update Rose Pugliese, Esq. County Attorney update ACTION ITEMS: 1. Consider approval of a Proclamation, proclaiming May 13, 2025 as Southeastern Developmental Services Awareness Day. 2. Consider approval of Contract Amendment #4, Original Contract Number C24-186984. Contract between Department Health Care Policy and Financing and Prowers County Public Health and Environment, authorizing Public Health Director Meagan Hillman to execute the Contract electronically. 3. Consider approval of Memorandum of Understanding - Annual Reaffirmation between the Colorado Department of Human Service and Prowers County Department of Human Services which outlines the annual performance contract and explains the County's duties and responsibilities in implementing the Works Program. 2 4. Consider ratifying 4-21-2025 email poll approval of a Letter of Support sent to Congresswoman Lauren Boebert regarding City of Lamar's request for Congressional Community Project Funding for Wastewater Treatment Improvements. 5. Consider ratifying 4-25-2025 email poll approval for payment of bills presented for County General Fund Payroll, Payroll AP and AP in the amount of $1,045,221.45, DHS and WHC Payroll, Payroll AP, and AP in the amount of $262,405.55, and H3C Payroll, Payroll AP and AP, in the amount of $115,816.17 all with a Certification date of April 29, 2025 and authorizing the use of the Commissioner's signature stamps. 6. Consider approval of a Letter of Support sent to US Department of Transportation, Sean Duffy for Southeast Colorado Safe Streets and Roads for All (SS4A) through the Thriving Communities Program initiative in Southeast Colorado. 7. Consider approval of Memorandum of Understanding to facilitate the Prowers County Hotline County Connection Center with answer and processing of Child Welfare and Adult Protection Services related Hotline calls and performing tasks outlined in the MOU's effective January 1, 2025 and ending December 31, 2025 with Broomfield County and authorizing Director of Human Services, Lanie Meyers-Mireles to execute the MOU. 8. Consider ratifying 4-23-2025 email poll approval of a letter sent to Pamela Bondi, U.S. Attorney General Department of Justice, requesting support for the growing concerns of Colorado citizens related to the Second Amendment of the United States Constitution and authorizing the use of the Commissioner's signature stamps. 9. Consider ratifying 4-30-2025 verbal poll approval for payment of bills presented for County General Fund AP in the amount of $1,778.99 with a Certification date of April 30, 2025 and authorizing the use of the Commissioner's signature stamps. 10. Consider ratifying 5-2-2025 email poll approval of payment of bills presented for County General A/P Fund in the amount of $219,482.23 minus voided check no. 75015 in the amount of $86,355.25 for a grant total certification in the amount of $133,126.98 with a certification date of May 6, 2025, and authorizing the use of the Commissioner's signature stamps. 11. Consider approval of terms and conditions of the Buell Foundation Grant in the amount of $30,000 to Welcome Home Child & Family Center and authorizing Chairman Ron Cook and Director of Human Services, Lanie Meyers-Mireles to execute the document electronically. 12. Consider ratifying 4-24-25 email poll approval of a Stipulation between Applicant, Tri-State Generation and Transmission Association, Inc. and Opposers, Lower Arkansas Valley Water Conservancy District concerning water rights in Prowers and Bent Counties. 13. Consider approval of MOU with the State of Colorado Governor's Office of Federal Funds and Strategic Initiatives for the technical assistance and grant writing support provided under the Thriving Communities Program initiative in Southeast Colorado. 3 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 purposes of receiving legal advice on specific legal questions. Executive Session pursuant to C.R.S. 524-6-402/4)(b) Conference with the attorney for the purposes of receiving legal advice on specific legal questions for litigation updates. 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. If any 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, 4 PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 5-13-2025 Submitter: County Administration Office Submitted to the County Administration Office on: 4-14-2025 Return Originals to: County Administration Office & Jana Coen Number of originals to return to Submitter: 1 Contract Due Date: Item Dtle/Recommended Board Action: Consider approval of a Proclamation, proclaiming May 13, 2025 as Southeastern Developmental Services Awareness Day. Justification or Background: Fiscal Impact: This item is budgeted in the following account code: County: $ Federal: $ State: $ Other: $ Approved by the County Attorney on: - h Sonorary SProelamation Doutheasern Oadgfmental Plerices Phvarenes. Oay WHEREAS: Southeastern Developmental Services works with a broad coalition ofindividuals, family members, community groups, organizations and governmental entities to improve the quality of life of people with developmental disabilities. WHEREAS: Developmental disabilities affect more than a quarter of the families in the United States; and WHEREAS: The most effective way to overcome challenges associated with understanding people with development disabilities are through education to increase the understanding: and WHEREAS: We encourage all citizens to realize that individuals with developmental disabilities should be afforded opportunities to succeed in the community, including full access to housing, employment, and recreational activities; and WHEREAS: Opportunities for citizens with developmental disabilities to function as independently and productively as possible must be fostered in our community; and NOW THEREFORE, BE IT PROCLAIMED by the Prowers County Commissioners that the day of May 13, 2025 shall be known as: SOUTHEASTERN DEVELOPMENTAL SERVICES AWARENESS DAY Signed this 13th day of May 2025 Ron Cook, Commissioner. Roger Stagner, Commissioner. Ty Harmon, Commissioner. Attest: Jana Coen, Clerk PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 05/13/2025 Submitter: Meagan Hillman, PCPHE Director Submitted to the County Administration Office on:04/23/2025 Return Originals to: Meagan Hillman, PCPHE Number of originals to return to Submitter:1 Contract Due Date: 05/16/2025 Item Title/Recommended Board Action: Consider approval of Contract Amendment #4. Original Contract Number C24-186984. Contract between Department Health Care Policy and Financing and Prowers County Public Health and Environment, authorizing Public Health Director Meagan Hillman to execute the Contract electronically. Justification or Background: This is the annual contract for SECO CMA, our case management agency Fiscal Impact: This item is budgeted in the following account code: County: $ Federal: $ State: $ Other: $ Approved by the County Attorney on: 4-24-2025 Additional Approvals (if required): PLEASE ATTACH THIS SHEET TO ALL AGENDA ITEMS WHEN SUBMITTING TO COUNTY ADMINISTRATION. THANK YOU! Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B STATE OF COLORADO CONTRACT MODIFICATION CONTRACT AMENDMENT #4 State Agency Contract Performance Beginning Date Department of Health Care Policy and Financing July 1, 2025 Contractor Current Contract Expiration Date Prowers County Public Health and Environment June 30, 2026 Original Contract Number Current Contract Maximum Amount C24-186984 Medicaid Programs Amendment Contract Number No Maximum for any SFY C24-186984A4 State General Fund Programs State Fiscal Year 2024-25 $21,554,032.0G Estimated Contractor Shared $148,530.52 THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT Each person signing this Amendment represents and warrants that they are duly authorized to execute this Amendment and to bind the Party authorizing the person's signature. CONTRACTOR STATE OF COLORADO Prowers County Public Health and Environment Jared S. Polis, Governor Meagan L. Hilman, Director Department ofHealth Care Policy and Financing Kim Bimestefer, Executive Director Date: Date: STATE CONTROLLER Robert Jaros, CPA, MBA, JD Department of] Health 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: C24-186984A4 Page 1 of1 Docusign Envelope ID: 2ACF3C3-0088-41APBDFC-008788727588 1. PARTIES This Amendment (the "Amendment") to the Original Contract shown on the Signature and Cove: Page for this Amendment (the "Contract") is entered into by and between the Contractor and the State. 1. 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 2. 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 be 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 Amendmert either before or after of the Amendment term shown in $3.B of this Amendment. A. 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. 3. PURPOSE This Amendment updates the General Contract Provisions and Exhibit B Statement of Work. 4. MODIFICATIONS The Contract and all prior amendments thereto, if any, are modified as follows: A. The Contract Initial Contract Expiration Date on the Contract's s Signature and Cover Page is hereby deleted and replaçed with the Current Contract Expiration Date shown on the Signature and Cover Page for this Amendment. 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 Signature and Cover Page for this Amendment. C. The Contract Provisions is hereby updated as follows. D. Exhibit B-3 is hereby deleted in its entirety and replaced with Exhibit B-4 as follows. All references to Exhibit B, Exhibit B-1, Exhibit B-2, or Exhibit B-3 shall now refer to Exhibit B-4. E. Exhibit C-3 is hereby deleted in its entirety and replaced with Exhibit C-4 as follows. All references to Exhibit C, Exhibit C-1, Exhibit C-2, or Exhibit B-3 shall now refer to Exhibit C-4. F. Exhibit D-3 is hereby deleted in its entirety and replaced with Exhibit D-4 as follows. All references to Exhibit D, Exhibit D-1, Exhibit D-2, or Exhibit D-3 shall now refer to Exhibit D-4. G. Exhibit E-3 is hereby deleted in its entirety and replaced with Exhibit E-4 as follows. All references to Exhibit E, Exhibit E-1, Exhibit E-2, or Exhibit E-3 shall now refer to Exhibit E-4. Amendment Contract Number: C24-186984A4 Page 1 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 5. LIMITS OF EFFECT AND ORDER OF PRECEDENCE This Amendment is incorporated by reference into the Contract, and the Contract and all prio: 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 ofthis Amendment and any ofthe provisions of the Contract or any prior modification to 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: C24-186984A4 Page 2 of23 Docusign Envelope ID: 2ACF3C3-0088-1APBDFC-D08788727588 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," 99 the "Department; 29 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 oft this Contract before the Effective Date and shall have no obligation to pay Contractor for any Work performed or expense incurred before the Effective Date or after the expiration or sooner termination oft this Contract. B. Initial Term The Parties' respective performances under this Contract shall commence 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. C. 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 forr substantially equivalent to the Sample Option Letter attached to this Contract. Except as stated in $2.D, the total duration ofthis Contract, including the exercise of any options to extend, shall not exceed eight years from its Effective Date absent prior approval from the Chief Procurement Officer in accordance with the Colorado Procurement Code. D. End ofTerm Extension Ifthis Contract approaches the end of its 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 of1 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 of a replacement contract or modification extending the total term ofthis Contract. E. Early Termination in the Public Interest Amendment Contract Number: C24-186984A4 Page 3 of23 Docusign Envelope ID: 2ACF3C37-00841A08DFC-D08758727588 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. If this Contract ceases to further the 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. 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 sha.l be subject to the rights and obligations set forth in $12.A.i.a. iii. Payments If the State terminates this Contract in the public interest, the State shall pay Contractor anl 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 of a Party to perform any of its obligations in accordance with this Contract, in whole or in part or in a timely or satisfactory manner. The institution ofproceedings under any bankruptcy, insolvency, reorganization or similar law, by or against Contractor, or the appointment of a receiver or similar officer for Contractor or any ofi its property, which is not vacated or fully stayed within 30 days after the institution of such proceeding, shall also constitute a breach. IfContractor is debarred or suspended under $24- 109-105, C.R.S. at any time during the term ofthis Contract, then such debarment or suspension shall constitute a breach. 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 ofthe holidays listed in $24-11-101(1), C.R.S. Amendment Contract Number: C24-186984A4 Page 4 of23 Docusign Envelope ID: 2ACF3C37-0088-1A0D8DFC-D08788727588 C. "Chief Procurement Officer" means the individual to whom the Executive Director has delegated their authority, pursuant to $24-102-202, C.R.S. to procure or supervise the procurement of all supplies and services needed by the State. 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 thereto. E. "Contract Funds" means the funds that have been appropriated, designated, encumbered, or otherwise made available for payment by the State under this Contract. F. "CORA", means the Colorado Open Records Act, $$24-72-200.1, et seq., C.R.S. G. "Deliverable" means the outcome to be achieved or output to be provided, in the form of a tangible object or software that is produced as a result of Contractor's Work that is intended to be delivered to the State by Contractor. H. "Effective Date" means the date on which this Contract is approved and signed by the Colorado State Controller or designee, as shown on the Signature Page for this Contract. Ifthis Contract is for a Major Information Technology Project, as defined in $24-37.5-102/2.6), C.R.S., then the Effective Date of this Contract shall be the later oft the date on which this Contract is approved and signed by the State's Chief Information Offiçer or authorized delegate or the date on which this Contract is approved and signed by the State Controller or authorized delegate, as shown on the Signature Page for this Contract. I. "End ofTerm Extension" means the time period defined in $2.D. J. "Exhibits" means the exhibits and attachments included with this Contract as shown on the Cover Page for this Contract. K. Extension Term" means the time period defined in $2.C. L. "Goods" means any movable material acquired, produced, or delivered by Contractor as set forth in this Contract and shall include any movable material acquired, produced, or delivered by Contractor in connection with the Services. M. "Incident" means any accidental or deliberate event that results in or constitutes an imminent threat ofthe unauthorized access, loss, disclosure, modification, disruption, or destruction of any communications or information resources of the State, which are included as part ofthe Work, as described in $$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 of service; (iii) the unauthorized use of a State system for1 the processing or storage of data; or (iv) changes to State system hardware, firmware, or software characteristics without the State's knowledge, instruction, or consent. N. "Initial Term" means the time period defined in $2.B. 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 of health care to an individual; and (ii) that identifies the individual or with respect to which there is a reasonable basis to believe the Amendment Contract Number: C24-186984A4 Page 5 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 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. Q. "PIT" 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'si identity, such as name, social security number, date and place of birth, 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 identifiable information in $$24-72- 501 and 24-73-101, C.R.S. "PII" shall also mean "personal identifying information" as set forth at $ 24-74-102, et. seq., C.R.S. 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 of its disclosure to Contractor; (iii) is or subsequently becomes publicly available without breach of any obligation owed by Contractor to the State; (iv) is disclosed to Contractor, without confidentiality obligations, by a third party who has the right to disclose such information; or (v) was independently developed without reliance on any State Confidential Information. T. "State Fiscal Rules" means the fiscal rules promulgated by the Colorado State Controller pursuant to 24-30-20203)), C.R.S. U. "State Fiscal Year" means a 12-month period beginning on July 1 of each calendar year and ending on June 30 ofthe following calendar year. If a single calendar year follows the term, then it means the State Fiscal Year ending in that calendar year. 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 this Contract through the State General Fund programs. 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 used, without modification, in the performance of the Work. Amendment Contract Number: C24-186984A4 Page 6 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B Any other term used in this Contract that is defined in an Exhibit shall be construed and interpretec 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 ofl 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. B. The State, at its discretion, shall have the option to increase or decrease the statewide quantity ofGoods 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 ofMembers served by Contractor. B. Payment Procedures i. 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 manner approved by the State. C. 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 of 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. If the 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 ofa payment shall not constitute acceptance oft the completion of requirements or quality any Work performed or Deliverables provided under this 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 of 1% per month, as required by 24-30-202(24)a), 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 referençe the delinquent payment, the number of day's interest to be paid and the interest rate. Amendment Contract Number: C24-186984A4 Page 7 of23 Docusign Envelope ID: 2ACF3C37-008-1AP8DFC-D08788727588 I11. Payment Disputes If Contractor disputes any calculation, determination or amount of any payment, Contractor shall notify the State in writing of its dispute within 30 days following the earlier to occur of Contractor's receipt of the payment or notification ofthe determination or calculation ofthe payment by the State. The State will review the information presented by Contractor and may make changes to its determination based on this review. The calculation, determination or payment amount that results from the State's review shall not be subject to additional dispute under this subsection. Noj 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 any 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 contingen: on the appropriation and continuing availability ofContract 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 for payment. Payments to be made pursuant to this Contract shall be 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 Amendment Contract Number: C24-186984A4 Page 8 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 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 ifthe Contract Funds include any federal funds. 7. CONTRACTOR RECORDS A. Maintenance Contractor shall maintain a file of all documents, records, communications, notes and othe: 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 Work performed bys 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: (i) the date three years after the date this Contract expires or is terminated, (i) final payment under this Contract is made, (iii) the resolution of any pending Contract matters, or (iv) if an audit is occurring, or Contracto: 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 Contracto: 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 ofthe State. C. Monitoring The State, the federal government, and any other duly authorized agent of a governmental agency in its discretion, may monitor Contractor's performance of its obligations under this Contract using 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 ofthe 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 priar written approval oft the State, use, publish, copy, disclose to any third party, or permit the use by Amendment Contract Number: C24-186984A4 Page 9 of23 Docusign Envelope ID: 2ACF3C37-0088-1AD8DFC-D06758727588 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 of data, Contractor or its Subcontractors shall provide for the security of such data according to the following: (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 Principa. Representative. B. Other Entity Access and Nondisclosure Agreements Contractor may provide State Records to its agents, employees, assigns and Subcontractors as necessary to 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, anc 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 ofthe nondisclosure provisions if requested 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, anc shall maintain a secure environment that ensures confidentiality of all State Confidentia. 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 Confidentia. Information, Contractor warrants it will guarantee the confidentiality of, and cease to use, such State Confidential Information. D. Incident Notice and Remediation If Contractor becomes aware of any Incident, Contractor shall notify the State immediately anc 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 of Incident in the future as directed by the State, which may include, but is not limited to, developing and implementing ai remediation plan that is approved by the State at no additional cost to the State. The State may Amendment Contract Number: C24-186984A4 Page 10 of23 Docusign Envelope ID: 2ACF3C37-0088-1ADBDFC-D08758727588 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, may perform such analysis and 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 independent, qualified, State-approved third party to conduct a security audit. Contractor shall provide the State with the results ofsuch audit and evidence ofContractor's planned remediation in 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 IfContractor or any ofits 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 $$24-73-101 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 of itself 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 PIL, 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 any relationships that conflict in any way with the full performance of 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 oft the State, or any member oftheir immediate family or their partner, related to the award of, entry into or management or oversight ofthis Contract. B. Apparent Conflicts of Interest Contractor acknowledges that, with respect to this Contract, even the appearance of a conflict of interest shall be harmful to the State's interests. Absent the State's prior written approval. Amendment Contract Number: C24-186984A4 Page 11 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 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. C. Disclosure to the State If a conflict or the appearance of a conflict arises, or ifContractor is unçertain 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 in regard to the actual or apparent conflict constitutes a Breach of Contract. D. Acknowledgement Contractor acknowledges that all State employees are subject to the ethical 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 be issued by insurance companies as approved by the State. A. Workers' Compensation 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 thei: 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; iii. $1,000,000 products and completed operations aggregate; and iv. $50,000 any one fire. C. Automobile Liability Automobile liabilityi 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: Amendment Contract Number: C24-186984A4 Page 12 of23 Docusign Envelope ID: 2ACF3C37-08B41ADBDFC008788727585 i. $1,000,000 each occurrence; and ii. $2,000,000 general aggregate. E. Professional Liability Insurance Professional liability insurance covering any damages caused by an error, omission or any negligent act with minimum limits as follows: i. $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. 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. I. 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 to the State in accordance with $14 within seven days of Contractor's receipt of such notice. J. Subrogation Waiver All insurance policies secured or maintained by Contractor or its Subcontractors in relation cO this Contract shall include clauses stating that each carrier shall waive all rights ofrecovery under subrogation or otherwise against Contractor or the State, its agencies, institutions, organizations, officers, agents, employees, and volunteers. K. 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 ofthe 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 te GIA. Ifa Subcontractor is a 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 Amendment Contract Number: C24-186984A4 Page 13 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B liability insurance requirements stated above, such liability insurance, by commercial policy 0: self-insurance, as is necessary to meet the Subcontractor' S obligations under the GIA. L. Certificates Contractor shall provide to the State certificates evidencing Contractor's insurance coverage required in this Contract within seven Business Days following the Effective Date. Contracto- shall provide to the State certificates 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 oft 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 ofthe 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 ofi insurance 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 of a Breach of Contract, the aggrieved Party shall give written notice ofbreach 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 may immediately terminate this Contract in whole or in part or institute any other remedy in this Contract in order to protect the public interest ofthe State; or ifContractori is debarred or suspended under $24-109-105, C.R.S., the State, in 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 If Contractor is in breach under any provision ofthis 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 to it, in its discretion, concurrently or consecutively. i. Termination for Breach ofContract In the event of Contractor's uncured breach, the State may terminate this entire Contract Cr any part ofthis Contract. Contractor shall continue performance ofthis Contract to the extert not terminated, if any. a. Obligations and Rights Amendment Contract Number: C24-186984A4 Page 14 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 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 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 only pay 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 ofthe Parties shall be as ifthis Contract had been terminated in the public interest under $2.E. C. 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 ofthe following additional remedies: a. Suspend Performance Suspend Contractor' S performance with respect to all or any portion ofthe Work pending corrective action as specified by the State without entitling Contractor to an adjustment in 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 Amendment Contract Number: C24-186984A4 Page 15 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-E 3DFC-DOB75872758B Withhold payment to Contractor until Contractor corrects its Work. C. Deny Payment Deny payment for Work not performed, or that due to Contractor's actions or inactions, cannot be performed or if they were performed are reasonably of no value to the State; provided, that any denial of payment shall be equal to the value of the obligations not performed. d. Removal Demand immediate removal of any 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. e. Intellectual Property If any Work infringes, or if the State in its sole discretion determines that any Work is likely to infringe, a patent, copyright, trademark, trade secret or other 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, (ii) remove any infringing Work and refunc 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 pertormance of this Contract which cannot be resolved by the designated Contract representatives shall be referred in writing to a senior departmental management staffmember designated by the State and a senior manager designated by Contractor for resolution. B. Resolution of Controversies Ifthe 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 ofthe State Agency named on the Cover Page of this 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., anc $$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 anc Administration, or their delegate, under the Resolution Statutes before Contractor pursues any Amendment Contract Number: C24-186984A4 Page 16 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B further action as permitted by such statutes. Except as otherwise stated in this Section, al. requirements of the Resolution Statutes shall apply including, without limitation, time limitations. 14. NOTICES AND REPRESENTATIVES Each individual identified as a Principal Representative on the Cover Page for this Contract shal. 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 receip: 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 If a Party delivers a 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 principa. 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 of notices 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 of the written notice. 15. RIGHTS IN WORK PRODUCT AND OTHIER INFORMATION A. Work Product i. Copyrights 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. To 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, or incorporating the Work Product by all means and methods and in any format now known or invented in the future. The State may assign and license its rights unde: 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 Amendment Contract Number: C24-186984A4 Page 17 of23 Docusign Envelope ID: ACF3C3/.0841A080 DFC-DOB75872758B Product would fall under the definition of"works made for hire" under 17 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 ofaction, either in law or in equity, for past, present, or future infringement of intellectual property rights related to the Work Product and all works based on, derived from, or incorporating the Work Product. iii. Exclusive Property of1 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 of the State to Contractor are the exclusive property of 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 ofthe State. Upor termination of 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, licensed 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: (i) 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 ofthe 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 of the State of Colorado, and shall be subject to all provisions of this Contract. Amendment Contract Number: C24-186984A4 Page 18 of23 Docusign Envelope ID: ZACF3C37/0088-41A08088727588 C. Binding Effect Except as otherwise provided in $16.A, all provisions ofthis Contract, including the benefits anc burdens, shall extend to and be binding upon the Parties' respective successors and assigns. D. Authority Each Party represents and warrants to the other that the execution and delivery oft 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. AIl referençes 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 shal. be deemed to be an original, but all of which, taken together, shall constitute one and the same agreement. G. 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. H. Digital Signatures If any 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 digita signatures issued under the State Fiscal Rules, then any agreement or consent to use digita. signatures within the electronic system through which that signatory signed shall be incorporatec into this Contract by reference. I. Modification Except as otherwise provided in this Contract, any modification to this Contract shall only be effective ifagreed to in a formal amendment to this Contract, properly executed and approved ir accordance with applicable Colorado State law and State Fiscal Rules. Modifications permittec 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 Amendment Contract Number: C24-186984A4 Page 19 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 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 ofthis Contract. K. External Terms and Conditions 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 ir accordance with the intent oft this Contract. M. Survival of Certain Contract Terms Any provision of this Contract that imposes an obligation on a Party after termination or expiration of this Contract shall survive the termination or expiration of this Contract and shal. 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 of Registry 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 such taxes on Contractor. Contractor shall be solely responsible for any exemptions from the collection ofexcise, sales or use taxes that Contractor may wish to have in 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 ofthis Contract and all rights and obligations hereunder are reserved solely to the Parties. Any services or benefits which third parties receive as a result ofthis Contract are incidental to this Contract, and do not create any rights for such third parties. P. Waiver Al Party'sf 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. Amendment Contract Number: C24-186984A4 Page 20 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B Q. 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. R. Standard and Manner ofl Performance Contractor shall perform its obligations under this Contract in accordance with the highes: 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. Accessibility i. 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 ofl Information Technology (OIT), pursuant to Section $24-85-103(2.5), C.R.S. 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 $$24-85-101, et seq., C.R.S., and the Rules Establishing Technology Accessibility Standards, 8 CCR 1501-11:11.1 et. seg, as established by the Office ofInformation Technology pursuant to Section $24-85-103(2.5), C.R.S. U. Additional Provisions Contractor shall comply with all requirements shown in Exhibit A and Exhibit G. 17. COLORADO SPECIAL PROVISIONS (COLORADO FISCAL RULE 3-3) These Special Provisions apply to all contracts except where noted in italics. A. STATUTORY APPROVAL. $24-30-202(1), C.R.S. This Contract shall not be valid until it has been approved by the Colorado State Controller or designee. Ifthis Contract is for a Major Information Technology Project, as defined in $24-37.5- 102(2.6), C.R.S., then this Contract shall not be valid until it has been approved by the State's ChiefInformation Officer or designee. B. FUND AVAILABILITY. $24-30-202(5.5), C.R.S. Financial obligations of the State payable after the current State Fiscal Year are contingent upo. funds for that purpose being appropriated, budgeted, and otherwise made available. Amendment Contract Number: C24-186984A4 Page 21 of23 Docusign Envelope ID: 2ACF3C37-0088-1A0P8DFC-D08758727588 C. GOVERNMENTAL IMMUNITY. Liability for claims for injuries to persons or property arising from the negligence of the State, its departments, boards, commissions committees, bureaus, offices, employees and officials shall be controlled and limited by the provisions of the Colorado Governmental Immunity Act, $24- 10-101, et seq-, C.R.S.; the Federal Tort Claims Act, 28 U.S.C. Pt. VI, Ch. 171 and 28 U.S.C. 1346(b), and the State's risk management statutes, $$24-30-1501, et seq. C.R.S. No term o: condition of this Contract shall be construed or interpreted as a waiver, express or implied, of 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 (ini) be solely responsible for its acts and those of its employees and agents. E. COMPLIANCE WITH LA W. 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 of Denver. G. 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 in this Contract shall be construed as a waiver of any provision of $24-106-109, C.R.S. H. SOFTWARE PIRACY PROHIBITION. Amendment Contract Number: C24-186984A4 Page 22 of23 Docusign Envelope ID: 2ACF3C37-0088-41A08D-BDFC-D08758727588 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. Ifthe State determines that Contractor is in violation ofthis provision, the State may exercise any remedy available at law or in equity or under this Contract, including, without limitation, immediate termination of this Contract and any remedy consistent with federal copyright laws or applicable licensing restrictions. I. EMPLOYEE FINANCIAL INTEREST/CONFLICT OF INTEREST. $$24-18-201 and 24-50-507, C.R.S. The signatories aver that to their knowledge, no employee of the State has any personal o: beneficial interest whatsoever in the service or property described in this Contract. Contracto: has no interest and shall not acquire any interest, direct or indirect, that would conflict in any manner or degree with the performance of Contractor' S services and Contractor shall not employ any person having such known interests. J. VENDOR OFFSET AND ERRONEOUS PAYMENTS. $524-30-202(1) and 24-30-202.4, C.R.S. [Not applicable to intergovermmenta agreements Subject to 24-30-202.403.5), C.R.S., the State Controller may withhold payment under the State's vendor offset intercept system for debts owed to State agencies for: () unpaid child support debts or child support arrearages; (ii) unpaid balances oftax, accrued interest, or other charges specified in $$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 reasor, 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. Amendment Contract Number: C24-186984A4 Page 23 of23 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B EXHIBIT B-4, STATEMENT OF WORK 1. CASE MANAGEMENT OBLIGATIONS 1.1. Contractor" S Obligations 1.1.1. 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: 1.1.1.1. Community First Choice (CFC) 1.1.1.2. Family Support Services Program (FSSP) 1.1.1.3. HCBS Children with Complex Health Needs (HCBS-CWCHN) 1.1.1.4. HCBS Children': S Extensive Supports Waiver (HCBS-CES) 1.1.1.5. HCBS Children's S Habilitation Residential Program Waiver (HCBS-CHRP) 1.1.1.6. HCBS Children' S Home and Community Based Services Waiver (CHCBS) 1.1.1.7. HCBS Community Mental Health Supports Waiver (HCBS-CMHS) 1.1.1.8. HCBS Complimentary and Integrative Health Waiver (HCBS-CIH) 1.1.1.9. HCBS Developmental Disabilities Waiver (HCBS-DD) 1.1.1.10. HCBS Elderly, Blind and Disabled Waiver (HCBS-EBD) 1.1.1.11. HCBS Brain Injury Waiver (HCBS-BI) 1.1.1.12. HCBS Supported Living Services Waiver (HCBS-SLS) 1.1.1.13. Hospital Back-Up Program (HBU) 1.1.1.14. Intermediate Care Faclilities-Intellectual and Developmental Disabilities (ICF-IDD) 1.1.1.15. Nursing Facilities (NF) 1.1.1.16. Omnibus Reconciliation Act of 1987 Specialized Services Program (OBRA-SS) 1.1.1.17. Program for All-Inclusive Care for the Elderly (PACE) 1.1.1.18. State Supported Living Services Program (State SLS) 1.1.2. 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: 1.1.2.1. Colorado Revised Statutes, Title 25.5, Article 6, Sections 104 through and including 107. 1.1.2.2. Colorado Revised Statute, Title 25.5, Article 10 et seq. 1.1.2.3. Colorado Department of Health Care Policy and Financing written communications. 1.1.2.4. Colorado Department of Public Health and Environment at 6 C.C.R. 1011-1 et seq. 1.1.2.5. Colorado Department of Human Services 12 C.C.R. 2509-8 7.700 et seq. 1.1.2.6. All State Medicaid regulations promulgated by the Department. These regulations include, but are not limited to: 1.1.2.6.1. FSSP 10 CCR 2505-10, Sections 8.7561 et seq. Exhibit B-4, SOW Page I of49 Docusign Envelope ID: 2ACF3C37-008-1AP8DFC-D0875872758 1.1.2.6.2. Long-Term Care 10 CCR 2505-10, Sections 8.400 through 8.409 et seq. 1.1.2.6.3. Colorado Case Management Agency Requirements 10 CCR 2505-10, Section 8.720C et seq. 1.1.2.6.4. Community First Choice, 10 CCR 2505-10, Section 8.7600 et seq. 1.1.2.6.5. HCBS-BI 10 CCR 2505-10, Section 8.7101.E et seq. 1.1.2.6.6. HCBS-CWCHN 10 CCR 2505-10 Section 8.7101.D et seq. 1.1.2.6.7. HCBS-CES, 10 C.C.R. 2505-10 Section 8.7101.B et seq. 1.1.2.6.8. HCBS- CHCBS 10 CCR 2505-10, Sections 8.7101.A et seq. 1.1.2.6.9. HCBS-CHRP, 10 C.C.R. 2505-10 Section 8.7101.C et seq. 1.1.2.6.10. HCBS-CIH 10 CCR 2505-10, Section 8.7101.H et seq. 1.1.2.6.11. HCBS-CMHS 10 CCR 2505-10, Section 8.7101.F et seq. 1.1.2.6.12. HCBS-DD, 10 C.C.R. 2505-10 Sections 8.7101.J et seq. 1.1.2.6.13. HCBS-EBD 10 CCR 2505-10, Sections 8.7101.G et seq. 1.1.2.6.14. HCBS-SLS, 10 C.C.R. 2505-10 Sections 8.7101.I et seq. 1.1.2.6.15. PACE Section 25.5-5-412, Section 6a-b., C.R.S et seq. 1.1.2.6.16. Case Management Services, Determination ofl Developmental Disability, Laboratory and X-Ray, 10 CCR 2505-10 Section 8.607.2 through 8.6660.5.E. 1.1.2.6.17. Support Levels and Algorithms 10 CCR 2505-10 Section 8.7202.AA et seq 1.1.2.6.18. State SLS Program, 10 CCR 2505-10, Section 8.7560 et seq. 1.1.2.6.19. Recipient Appeals, 10 CCR 2505-10, Section 8.057 et seq. 1.1.2.6.20. Uniform Administrative Requirements, Cost Principles, and Audit Requirements fo: Federal Awards (Uniform Guidance), 2 CFR Chapter I, Chapter II, Part 200 et al. 1.1.3. 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. 1.1.4. 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 Department regulations. 1.1.5. Contractor shall comply with written Operational Memos, policies, procedures, and guidance issued by the Department. 1.1.6. The general Business Functions of Contractor shall include, but is not limited to, all the following: 1.1.6.1. Contractor shall maintain a physical, publicly accessible, and Americans with Disability Act (ADA) compliant office within the Defined Service Area and appropriate staffing pattern to serve the Defined Service Area. 1.1.6.1.1. Non-standard business hours and method of contact information for urgent situations must be posted on Contractor's website in an easily accessible location and must remain up-to-date and align with Contractor's after-hours policy. Exhibit B-4, SOW Page 2 of49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 1.1.6.1.2. Contractor shall ensure adequate staffing through virtual or in-person services throughout the Defined Service Area in addition to a physical office space, providing access to its office for staff, Members, families, services providers, and others to best meet the needs ofi individuals based on individual preferences. 1.1.6.1.3. Contractor shall have the ability for case managers to travel, regional coverage, anc provide all required Work for the counties in which the agency operates. 1.1.6.1.4. Regular business office hours of operation shall follow an 8-hour schedule Monday through Friday 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 a procedure for notifying Members and the public ofunplanned closures or changes to regular business hours due to inclement weather or other emergencies, which includes emergency contact information. 1.1.6.1.5. Contractor shall have internal procedures for accommodating individuals, Members. and families who need assistance or consultation outside regular business office hours. 1.1.6.2. Contractor shall have an after-hours policy and procedure to respond to urgent situations outside of regular business hours as defined herein. 1.1.6.2.1. Contractor': s after-hours policy and proçedure shall include a response to all telephone calls, voicemails, and emails from Members and families on average within two Business Days of receipt by Contractor. 1.1.6.2.2. Procedures must provide Contractor after-hours contacts, e.g-, voicemail, pager, o: answering service numbers and alternative contacts and resources, and information, e.g., advocacy groups, community resources, etc., available to Members in urgen: situations including, but not limited to, hospital discharges, risk ofhomelessness, and unexpected termination of residential services. 1.1.6.2.3. Procedures must clearly document how Contractor will ensure a commensurate response to urgent situations including, but not limited to, hospital discharges, risk of homelessness, and unexpected termination of residential services. 1.1.6.2.4. Contractor shall notify individuals, Members, families, providers, and community partners ofthe procedures and make it readily available through a variety ofmethods, including the Contractor's website. 1.1.6.2.5. Non-standard business hours and method of contact information for urgent situations must be posted on Contractor's website in an easily accessible location and must remain up-to-date and align with Contractor's after-hours policy. 1.1.6.2.6. 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. Exhibit B-4, SOW Page 3 of4 49 Docusign Envelope ID: ZACF3C37-0068-41A0-B FC-00B758727585 1.1.6.2.7. Contractor shall protect Members' rights as they relate to the responsibilities ofCase Management Agencies as described in this Contract. 1.1.6.2.8. Contractor shall provide access to a telephone system and trained staff to ensure timely response to messages and telephone calls received after hours. 1.1.6.2.9. 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 ofthe Members they serve and ensure their interpretation and telecommunication services sufficiently meet the Member's need in a timely fashion. 1.1.6.2.10, Contractor shall follow communication standards set by the Department which includes, but is not limited to, Memo Series, technical assistance documents, Provider Bulletins, training documents, and email correspondence. 1.1.6.2.11. Contractor shall ensure all information entered into the Department's systems is accurate and entered within the timelines established within the Contract. 1.1.6.2.11.1. Systems include, but are not limited to, the Colorado interChange Medicaic Management Information System (MMIS) and its subsystems: Bridge HCBS Prior Authorization Request (PAR) subsystem and the Care and Case Management (CCM) System. 1.1.6.2.12. Contractor shall support the Department's National Core Indicators (NCI) efforts. 1.1.6.2.13. Contractor shall support the Department's Equity, Diversity, Inclusion, and Accessibility (EDIA) efforts to include participation in a 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 tha: promotes equitable treatment of historically underserved and marginalized communities. Contractor shall make the policy and procedure available to the Department upon request. 1.1.6.2.14. Contractor shall enroll and act as a Medicaid Targeted Case Management (TCM) provider for all HCBS waivers and CFC to include, but not limited to, providing ongoing case management and monitoring activities for the Defined Service Area. 1.1.6.2.15. 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 Service Area to another Defined Service Area. 1.1.6.2.16. Contractor may be granted a Conflict Free Case Management Authorization (CFCMA) by the Department to provide LTSS Case Management within the Defined Service Area when one is necessary to maintain services in rural and frontier service areas. 1.1.6.2.16.1. Contractor shall obtain and maintain approval for the CFCMA throughout the Contract Period to meet program requirements for a Case Management Agency. 1.1.6.2.16.2. The Department reserves the right to revoke Contractor's CFCMA at any time. 1.1.6.2.16.3. Contractor shall submit an annual report to the Department that includes, but is not limited to, the following information: Exhibit B-4, SOW Page 4 of4 49 Docusign Envelope ID: 2ACF3C37-0068-41A0-8DFC-DOB75872758B 1.1.6.2.16.3.1. Written processes in place to ensure remediation of conflict and separation of entities. 1.1.6.2.16.3.2. Documentation ofMember choice and informed consent of the conflict ofthe agency being selected. 1.1.6.2.16.3.3. A summary of the individuals participating in direct services and case management at the agency with the CFCMA. 1.1.6.2.16.3.4. Policies and procedures outlining how Contractor will validate that there are no other willing and qualified providers in their Defined Service Area with capacity to provide: services for all eligible Members in the service area. 1.1.6.2.16.3.5. How Contractor is supporting the recruitment of providers in their area to remediate conflict. 1.1.6.2.17. If Contractor is denied a CFCMA for any reason, or one is revoked, Contractor must have documented written plans for transitioning individuals and Members. Contractor shall continue to provide services until a transition may be successfully implemented. 1.1.6.2.17.1. DELIVERABLE: Annual report and written processes and procedures on implementing rural exception and only willing and qualified provider requirements for CMAS that have been granted a CFCMA. 1.1.6.2.17.2. DUE: June 15th of each year or prior to contract renewal for CMAS with an approved 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 of understanding 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 offered and accessed based on the Member's needs. As applicable, a memorandum of understanding shall address partnerships with: 1.2.1.1. Regional Accountable Entities (RAE) 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 services 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 Medicaii Members. 1.2.1.1.1.1. 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 Exhibit B-4, SOW Page 5 of49 Docusign Envelope ID: 2ACF3C37-0068-41A0-8DFC-D0B75872758B facilitation, follow-up, and solution focused on next steps for each Member collaboration. 1.2.1.1.1.2. 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 involvement with Child Welfare or Adult Protection. 1.2.1.1.1.3. Coordinating with the RAE for shared Members who admit to a hospital, to include, but not limited to, communicating reasons for admission, Member's hospital status, and plans for discharge. 1.2.1.1.1.4. 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. 1.2.1.1.1.5. Enter into a data sharing arrangement for the sharing of all necessary information for the RAE to assist Members in accessing and coordinating physical and behavioral health needs. 1.2.1.1.1.6. Contractor shall create a complex and creative solutions process with the RAE(s) and designated staffto 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 made available upon request, 1.2.1.1.1.7. Contractor shall honor Member's preferences for case management and care coordination, when applicable, while ensuring collaboration with the RAE occurs. 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 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 (CRS 25.5-L- 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 Colorado (Colorado's Medicaid Program) programs. 1.2.2.2. 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's designated service area. 1.2.2.3. 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 maintaining their benefits. Exhibit B-4, SOW Page 6 of 49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 1.2.3. Community Centered Boards 1.2.3.1. Community Centered Boards (CCB) are the agencies responsible for leveraging local anc regional resources to meet unmet needs for individuals with Intellectual anc Developmental Disabilities (IDD) and their families. 1.2.3.2. Contractor shall collaborate with CCBs, this may include, but is not limited to: 1.2.3.2.1. 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/or developmental delays or disabilities. 1.2.3.2.2. Coordinating care for non-waiver services for individuals and Members with intellectual and developmental delays or disabilities where applicable or appropriate. 1.3. Qualification and Training Requirements 1.3.1. Contractor's s personnel, including, but not limited to, Case Manager(s) and Case Management Supervisor(s) shall meet all qualification requirements listed in 10 C.C.R. 2505-10, Sections 8.7203.A to 8.7204 et seq. 1.3.2. Contractor shall ensure all case managers meet the qualification requirements established in 10 C.C.R. 2505-10, Section 8.7203.A et seq. 1.3.3. 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 specific knowledge and skills. 1.3.4. Contractor shall ensure that all case management staff 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 the Department, a Department-approved vendor, or Contractor. 1.3.5. Training modalities may include the Departments Learning Management System (LMS), web-based training, virtual instructor-led training, in-person training sessions and training materials available on the Department website. Contractor shall utilize training materials provided by the Department. 1.3.6. Required Case Management Training includes, but is not limited to: 1.3.6.1. Applicable Federal and State laws and regulations for LTSS programs 1.3.6.2. Community First Choice 1.3.6.3. Critical Incident Reporting 1.3.6.4. Determination ofl Developmental Disability or Delay 1.3.6.5. Disability and Cultural Competency 1.3.6.6. Equity, Diversity, Inclusion and Accessibility (EDIA) 1.3.6.7. Intake and Referral 1.3.6.8. Level of Care Screen (ULTC 100.2) 1.3.6.9. Long-Term Services and Supports Eligibility 1.3.6.10. Mandatory Reporting Exhibit B-4, SOW Page 7 of49 Docusign Envelope ID: 2ACF3C37-0068-41A0-8DFC-DOB75872758B 1.3.6.11. Notices and Appeals 1.3.6.12. Nursing Facility Admissions 1.3.6.13. Rapid Reintegration 1.3.6.14. Participant Directed Training 1.3.6.15. Person-Centered Support Planning and Person-Centered Support Plan 1.3.6.16. Pre-Admission Screening and Resident Review (PASRR) 1.3.6.17. State General Fund Program Ongoing Case Management 1.3.6.18. State General Fund Program Requirements and Services 1.3.6.19. System Documentation 1.3.6.20. Waiver Requirements and Services 1.3.6.20.1. DELIVERABLE: Case Management Training 1.3.6.20.2. DUE: Semi-Annually, trainings held between July 15t and December 315t are due January 15th, and trainings held between January 1st through June 1st are due June 15th 1.3.7. Contractor shall maintain supporting documentation demonstrating case managers attended the required trainings and make the information available to the Department upon reques.. Supporting documentation must include the name and description of the training, the date the training was held, case managers in attendance, and trainer sign-off showing the case manager completed the training. 1.3.8. There will be no exemptions to the above list of required trainings as all case managers shall have a basic knowledge of all case management activities regardless of ongoing duties. 1.3.9. Contractor shall participate in Department and vendor trainings, which will be tracked by the 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 or LMS. 1.3.10. For Case Managers who have a documented minimum of one-year immediate prior work experience at a different Colorado CMA, Contractor may assign independent case management activities once Contractor has verified that the Case Manager's training requirements were previously met. 1.3.11. Contractor may elect to perform additional training not outlined in the Contract, but 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 Department. 1.3.12. Case Management staff are required to retake training to address and remediate performance concerns as directed by the Department. 1.3.13. Contractor shall provide the date all case management staff, including new and existing staff, were 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. 1.3.14. Case Managers shall receive oversight reviews of their performance including their competency with completing the Level of Care Screen. Contractor shall shadow case Exhibit B-4, SOW Page 8 of49 Docusign Envelope ID: ZACF3C37-0088-1ADBDFC-D08758727588 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 and 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. Complaints 1.4.1. Contractor shall develop and maintain a formal complaints procedure, notify Members annually ofthe procedures, and make the procedure publicly available to include posting the procedure to Contractor's website. Procedures must include requirements for member notification in accordance with 10 CCR 2505-10 8.7201.D. 1.4.2. 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 managemer.t functions outlined in this Contract. Complaints received outside of the scope ofthis Contract shall not be included. Documentation shall consist of a complaint log that includes the date of complaint, name of the complainant, the nature of the complaint and the date and description ofthe resolution. 1.4.3. Contractor shall submit all complaints to the Community Advisory Committee for review, feedback, and input on resolving complaints. 1.4.4. 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 taken to address them to the Department. 1.4.5. Trend analysis shall include an examination ofinformation including, but not limited to: 1.4.5.1. A comparison of complaint types and number of complaints over a period oftime. 1.4.5.2. Number oftype of complaint against Contractor, time, location, individual involved, staff involved, and/or any additional relevant information. 1.4.5.3. An examination of potential reasons for the increase or decrease in complaints by total number, subcontractor, individual, or staff. 1.4.5.4. An examination of preventative measures that can be implemented to reduce the number or frequency of future complaints. 1.4.5.5. Implementation of a plan of action or any future actions to take place. 1.4.5.6. An analysis ofwhether the plan ofaction and changes made were effective or if additional changes need to occur. 1.4.5.7. As part of the complaint process Contractor shall include, but is not limited to, all of the following: 1.4.5.7.1. Document complaints received. 1.4.5.7.2. Address substantiated complaints. 1.4.5.7.3. Respond to complaints received and document actions taken to resolve and/or mitigate complaints. Exhibit B-4, SOW Page 9 of49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 1.4.5.7.4. Conduct a quarterly trend analysis of all complaints received for the full period oft the Contract. 1.4.5.8. Contractor shall maintain all supporting documentation related to the collection and follow-up to complaints and make it available to the Department upon request. 1.4.5.9. If Contractor received no complaints during the quarter, Contractor may submit the Complaint Trends Analysis to the Department identifying no complaints were reported during the quarter. 1.4.5.10. 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 oft the resolution. 1.4.5.11. Contractor shall submit the Complaint Trends Analysis to the Department for review and approval. 1.4.5.11.1. DELIVERABLE: Complaint Trend Analysis 1.4.5.11.2. DUE: Quarterly, by October 15th, January 151h, April 15th and June 15th of each year. 1.5. Continuous Quality Improvement Plan 1.5.1. 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 to a description oft the following: 1.5.1.1. 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. 1.5.1.2. How Contractor reviews work to determine whether the work is being completed in a correct and high-quality manner. 1.5.1.3. How Contractor identifies and addresses Case Management performance issues. 1.5.1.4. How Contractor notifies the Department of identified performance issues. 1.5.1.5. How Contractor will address at a minimum the following areas: operations, quality controls, staffing, training, and community engagement. Required tasks will be outlined in Department template that will be provided to Contractor yearly. 1.5.1.6. Contractor shall participate in the Department hosted Quality Community of Practice. 1.5.2. Contractor shall submit the Continuous Quality Improvement Plan to the Department for review, approval, and payment. The Department will establish a 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. 1.5.2.1. DELIVERABLE: Continuous Quality Improvement Plan 1.5.2.2. DUE: Within 90 Business Days after the Effective Date 1.5.3. 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. 1.5.3.1. DELIVERABLE: Continuous Quality Improvement Plan Update Exhibit B-4,SOW Page 10 of49 Docusign Envelope ID: 2ACF3C37-08541AD8DFC-D08758727588 1.5.3.2. DUE: Annually, by October 1st 1.6. Appeals 1.6.1. 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, CFC, PACE, Hospital Back-Up 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 at a hearing. 1.6.1.1. Contractor shall identify and disclose to the Department immediately, and no later than 45 Calendar Days prior to a scheduled appeal hearing, any conflict of interest that would interfere with Contractor's ability to represent the Department in any appeal. 1.6.2. 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 program eligibility or receipt of services. 1.6.3. Contractor shall process appeals in accordance with schedules published by the State of Colorado Office of Administrative Courts and rules promulgated by the Department. 1.6.4. Contractor shall develop an Appeals Packet which contains all relevant documentation to support Contractor': S denial or adverse action. 1.6.5. Contractor shall develop an Appeals Packet no later than 20 Business Days prior to the date of a scheduled hearing. 1.6.6. Contractor shall submit exceptions when applicable and include all relevant information. 1.6.7. Contractor shall cooperate with the Office ofthe State. Attorney General for any case in which it is involved. 1.6.8. Contractor shall document all appeals where Contractor attends any hearing in an Administrative Law Court. 1.6.9. Contractor shall make the Appeal Packets available to the Department upon request. 1.6.10. Contractor shall enter all Appeal Packets Created Dates and Court Decision Dates into the CCM system within 10 Business Days of packets being created and court hearings attendec. 1.6.10.1. Contractor shall receive reimbursement for all Appeals based on data entry into the CCM. 1.7. Critical Incidents 1.7.1. Critical Incident Reporting 1.7.1.1. Contractor shall be responsible for entering Critical Incident Reports (CIR) in the CCM as soon as possible, but no later than 24 hours (one Business Day) following notification. 1.7.1.2. 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 - Dutyt to 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). 1.7.1.3. Contractor shall document all CIR follow-up information in accordance with Department direction in the CCM and maintain detailed documentation. Exhibit B-4,SOW Page 11 of49 Docusign Envelope ID: 2ACF3C37-0088-1A08DFC-D08788727588 1.7.2. Critical Incident Follow-Up Completion and Entry 1.7.2.1. Contractor shall ensure all CIRs follow-up is completed and entered into the CCM within the timelines established by the Department and/or the Department's Quality Improvement Organization. 1.7.2.2. Timelines for follow-up are determined by the Department and depend on the type and severity ofthe CIR. The following are general timelines assigned to remediation and CIR follow up: 1.7.2.2.1. High Priority Follow Up- CIRs which require immediate attention and must be addressed to ensure the immediate health and safety of a waiver or CFC participant must be remediated within and responded to in the CCM within 24-48 hours. 1.7.2.2.2. 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 of the waiver or CFC participant must be completed in the CCM within three to four Business Days. 1.7.2.2.3. Low Priority Follow Up - CIRs that have been remediated by CMAs, have addressec immediate and long-term needs, have implemented services or supports to ensure health and safety, and those that have protocols in place to prevent a recurrence of a similar CIR but may require an edit to the CIR or additional information entered into the CCM. The follow-up for CIRs in this category must be completed and enterec within five Business Days. 1.7.2.3. PERFORMANCE STANDARD: 90% of all CIRs assigned follow-up are completed and entered into the CCM within the timelines established by the Department and/or the Department's Quality Improvement Organization each quarter. 1.8. Critical Incident Report Administrative Review 1.8.1. Contractor shall conduct a Critical Incident Report Administrative Review upon direction from the Department. 1.8.2. Critical Incident Report administrative reviews shall be initiated by the Department and will require the Contractor to upload documentation to the CCM as assigned. Contractor may be required to document that the reported incident of alleged Mistreatment, Abuse, Neglect, o: 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 of Public Health and Environment as necessary. Critical Incident Report administrative review may also require documentation of whether additional services might be needed as a result of the incident or gathering of additional documentation at the request ofthe Department. 1.8.3. Contractor shall be reimbursed for all critical incident reports through a Per Member Per Month (PMPM) payment for all Members enrolled in an HCBS waiver or CFC. Reimbursement will be based on all Members that are active in the CCM with the Contractor and have an approved PAR in the Bridge. 1.9. Human Rights Committee (HRC) 1.9.1. Contractor shall establish an HRC. The HRC is composed, to the extent possible, of two professional persons trained in the application of behavior development techniques and three Exhibit B-4, SOW Page 12 of49 Docusign Envelope ID: ZACF3C3/0068-1A08DDFC-008788727588 representatives comprised of one or more of the following: persons receiving Long-Term Care services, parents, Guardians, or Legally Authorized Representatives of persons receiving or whom have received Long-Term Care services, or persons with lived experience having long-term care needs, or persons caring for a loved one with long-term care needs. An employee or board member of a Provider Agency within the Contractor's designated service area shall not serve as a member of the HRC. 1.9.2. 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 of the HRC and make it available to the Department upon request. 1.9.3. Contractor shall submit a list of HRC members and documentation of qualifications of all new members annually. 1.9.3.1. DELIVERABLE: HRC Member List 1.9.3.2. DUE: Annually, by August 15th 1.9.4. Contractor shall notify the Department of any changes to the HRC members within 10 Business Days oft the date of change. 1.9.4.1. DELIVERABLE: HRC Member Updates 1.9.4.2. DUE: Within 10 Business Days oft the date of change to the HRC members 1.9.5. Contractor shall establish at least one HRC as a third-party mechanism to safeguard thei 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 Contractor. 1.9.6. Contractor shall develop policies and procedures which include, but are not limited to, HRC 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. 1.9.7. Contractor shall orient members regarding the duties and responsibilities of the Human Rights Committee and make this information available to the Department upon request. 1.9.8. Contractor shall provide the HRC with the necessary staff support to facilitate its functions. 1.9.9. Contractor shall keep proper documentation and record of all HRC recommendations and ensure that all documentation is a part oft the members record in the CCM. 1.9.10. Contractor shall maintain HRC meeting minutes, attendance logs, and supporting documentation related to an HRC meeting and make it available to the Department within 10 Business Days upon request. 1.9.11. Contractor shall notify the Department in writing of any changes to the HRC membership within 10 Business Days. 1.9.12. Contractor shall document all reviews within the CCM within 10 Business Days of the date ofthe HRC review. 1.9.13. Contractor shall be reimbursed for all HRC activities through a PMPM payment for all Members enrolled in HCBS-CES, HCBS-CHRP, HCBS-DD, and HCBS-SLS. Exhibit B-4, SOW Page 13 of 49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B Reimbursement will be based on Members that are active in the CCM with the Contractor and have an approved PAR in the Bridge. 1.9.14. Contractor shall invoice the Department for all State SLS, OBRA-SS, and FSSP Members reviewed by the Human Rights Committee using the template created by the Department. 1.9.14.1. DELIVERABLE: Human Rights Committee Invoice for State SLS, OBRA-SS, FSSP 1.9.14.2. DUE: Monthly, by the 15th 2. PRE-ENROLLMENT ACTIVITIES 2.1. LTSS LOC Referral, Intake, and Screening 2.1.1. Contractor shall perform all long-term services and supports Level of Care referral, intake, and screening functionslactivities for enrollment into the following waivers and programs: 2.1.1.1. Community First Choice (CFC) 2.1.1.2. Family Support Services Program (FSSP) 2.1.1.3. HCBS - Children with Complex Health Needs (HCBS-CWCHN) 2.1.1.4. Consumer-Directed Attendant Support Services (CDASS) 2.1.1.5. HCBS - Children's Extensive Supports Waiver (HCBS-CES) 2.1.1.6. HCBS - Children's Habilitation Residential Program Waiver (HCBS-CHRP) 2.1.1.7. HCBS - Children's Home and Community Based Services Waiver (CHCBS) 2.1.1.8. HCBS - Community Mental Health Supports Waiver (HCBS-CMHS) 2.1.1.9. HCBS - Complimentary and Integrative health (HCBS-CIH) 2.1.1.10. HCBS - Developmental Disabilities Waiver (HCBS-DD) 2.1.1.11. HCBS - Elderly, Blind, and Disabled Waiver (HCBS-EBD) 2.1.1.12. HCBS - Brain Injury Waiver (HCBS-BI) 2.1.1.13. HCBS -Supported Living Services Waiver (HCBS-SLS) 2.1.1.14. Hospital Back-Up Program (HBU) 2.1.1.15. In Home Supports and Services (IHSS) 2.1.1.16. Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities (ICF/IID) 2.1.1.17. Nursing Facilities (NF) 2.1.1.18. Omnibus Reconciliation Act of 1987 Specialized Services Program (OBRA-SS) 2.1.1.19. Program for All-Inclusive Care for the Elderly (PACE) 2.1.1.20. 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. and 10 CCR 2505-10, Sections 8.7202.B., 8.7202.E, and 8.401 et seq., shall include, but not limited to, the following: Exhibit B-4,SOW Page 14 of49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 2.2.1.1. Timelines shall be applied based on the location ofthe applicant at the time the Contractor receives the referral for a LOC Screen: 2.2.1.1.1. Hospital, Two Business Days, 2.2.1.1.2. Skilled Nursing Facility, Five Business Days, or 2.2.1.1.3. Community, 10 Business Days 2.2.1.2. CMAS shall not require a LTSS LOC Referral Form to intake a referral requesting a LOC Screen. 2.2.1.3. Conduct and document the Colorado Intake Screen Tool (CIST), LOC Screen, and Rapid Reintegration within required timelines set forth by the Department. 2.2.1.3.1.1. Conduct and document the CIST in the CCM within two Business Days referral requesting a LOC Screen for LTSS services, except for applicants entering the Hospital Buck-Up program. 2.2.1.3.2. Timeline to conduct and document the CIST does not extend the LOC Assessment timelines set forth by the Department. 2.2.1.3.3. Ensure documentation includes the individual'si need for LTSS and/or the individual's request for a LOC Screen even if the CIST indicates the individual may not be functionally eligible for LTSS. 2.2.1.3.3.1. Referral form/documentation requesting a LOC Screen is uploaded in the CCM. 2.2.1.3.4. Document all efforts to contact an applicant to conduct the CIST, LOC Screen, and any referrals made to non-LTSS services in the CCM. 2.2.1.4, Have a written policy and procedure for expediting the LTSS LOC referral or another referral for LOC Screen in the event that an applicant is in an emergency situation. 2.2.1.5. Conduct and document a LOC Screen without delay if an applicant has requested a Delay Determination or Developmental Disability Determination required for HCBS-DD. HCBS-SLS, HCBS-CES, and HCBS-CHRP waivers. 2.2.1.5.1. Individuals may opt to delay the LOC Screen while seeking a Delay Determination. or Developmental Disability Determination. In such cases, the Contractor shal. document this in the individual's record within the Care and Case Management (CCM) system. 2.2.1.5.2. Upon receiving a LTSS LOC referral, CMAS shall attempt to verify whether a LTC Medicaid Application has been submitted, but shall not delay or postpone a LOC Screen if the interview conducted to complete the CIST or subsequent contacts indicate that an applicant had not yet submitted a LTC Medicaid Application by the time the assessment is scheduled. 2.2.1.5.3. The CMA shall refer the applicant to the appropriate resources needed to submit thei: LTC Medicaid Application, if submission has not been completed throughout the intake referral process and subsequent to completing the assessment. 2.2.1.5.4. Hospital and Skilled Nursing Facility referrals do not require LTC Medicaid application verification. Exhibit B-4, SOW Page 15 of4 49 Docusign Envelope ID: 2ACF3C37-008-1A08DFC-D08788727588 2.2.1.6. 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 ofContractor according to 10 CCR 2505-10 section 8.057 and 8.7202.R et seq. The notification shall include the right to request a fair hearing before an Administrative Law Judge. 2.2.1.6.1. PERFORMANCE STANDARD: 100% of LTSS LOC Referrals and all intake referrals submitted to the Contractor are entered or uploaded into the CCM within two Business Days ofthe LTSS LOC Referral or intake referral receipt date. 2.3. Intellectual and/or Developmental Disability and Developmental Delay Determinations 2.3.1. Contractor shall determine whether an applicant meets the definition of an Individual with a Intellectual and/or Developmental Disability and Developmental Delay as defined under 10 CCR 2505-10, section 8. 7100.A, in accordance with 10 C.C.R. 2505-10 section 8.607.2 et seq. 2.3.2. Contractor may expedite psychological or adaptive behavior testing for Intellectual and/or Developmental Disability and Developmental Delay Determinations when there are delays due to issues identifying a provider or scheduling testing with aj provider in order complete the PASRR Level II assessments for individuals residing in skilled nursing facilities. Requests for testing funding must be submitted on the template prescribed byi the Department. 2.3.3. Contractor may request funding for testing necessary to complete Intellectual and/or Developmental Disability and Developmental Delay Determination to move forward with intake and referral activities. This includes cases where an applicant cannot access testing due to financial burden and other funding is not available ift they have submitted a long-term care. Medicaid application and the financial eligibility has not been determined. Requests for funding must be submitted to the Department for approval prior to funding being approved. 2.3.3.1. DELIVERABLE: Prior Approval for Testing Funding and Invoice 2.3.3.2. DUE: Monthly, by the 15th 2.3.3.3. Contractor shall maintain all supporting documentation related to the testing for DD Determination and make it available to the Department upon request. 2.3.4. Contractor shall complete the individual's determination record and assessment record in the CCM with all applicable dates and information within 10 Business Days after a determination is complete. 2.3.4.1. Contractor shall receive reimbursement for all determinations based on data entry into the CCM. 2.3.5. Contractor shall maintain the individual": S determination, documents, and upload them to the CCM. 2.3.6. 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 (unless eligible through Serious Emotional Disturbance criteria), HCBS-CES, State SLS, FSSP, and OBRA-SS. 2.3.7. Individuals shall be notified at the time of the decision of the determination that they have the right to appeal actions ofContractor to 10 CCR 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 Administrative Law Judge. Exhibit B-4, SOW Page 16 of 49 Docusign Envelope ID: 2ACF3C37-0068-1AD8DFC.008758727588 2.4. Waiting List Management 2.4.1. Contractor shall maintain a program specific waiting list within the CCM 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 ofthe other programs included within this Contract. 2.4.2. 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 CCR 2505-10 8.7202.G et seq. and 8.7101.J et seq. 2.4.2.1. 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 necessary for the individual. 2.4.3. The nameofaj person eligible for the program shall bej placed on the waiting list by Contractor making the eligibility determination. 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- 10 8.7202.J et seq. 2.4.5. 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. 2.4.6. The placement date used to establish a person's order on an HCBS waiver waiting list shall be: 2.4.6.1. The date on which the person was initially determined to have a developmental disability by Contractor; or 2.4.6.2. The 14th birth date if a child is determined to have a developmental disability by Contractor prior to the age of 14. 2.4.7. When an individual is eligible for a program and funding is not available, Contractor shall: 2.4.7.1. Verify demographic information. 2.4.7.2. Compile and correct data. 2.4.8. Contractor shall complete data entry of Waiting List record into the CCM within 10 Business Days of any addition or change to the Waiting List. 2.4.9. Contractor shall conduct and document, in the CCM, an annual follow-up with individuals 18 and older for all HCBS waivers with a Waiting List timeline of ASAA, Safety Net (SN), or "see date" to update changes in demographic information and ensure the individual is appropriately identified on waiting lists for1 thej program and services the individual is eligible to receive. 2.4.10. Contractor shall enter annual follow-up within the CCM within 10 Business Days of the contact. Exhibit B-4, SOW Page 17 of4 49 Docusign Envelope ID: 2ACF3C37-008-1AP8DFC-008788727588 2.4.10.1. Contractor shall receive reimbursement for annual waiting list contacts based on data entry into the CCM. 2.4.10.2. 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 CCM within 10 Business Days. 2.5. Program Enrollment from the Waiting List 2.5.1. HCBS-DD Enrollment from the Waiting List 2.5.1.1. When an enrollment becomes available from the HCBS-DD Waiting List, the Department will notify Contractor of the individual who will be offered an enrollment by the order of selection date. 2.5.1.2. Contractor shall notify the individual of the enrollment offer within five Business Days. Contractor shall make three attempts to contact the individual within a 30-calendar day period. Contractor shall document in the CCM 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 "Safety Net". 2.5.1.3. Individuals shall be notified at the time ofthe 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 Administrative Law Judge. 2.5.2. HCBS-DD Waiting List Enrollment Capacity Building 2.5.2.1. As appropriated and earmarked by the General Assembly, Contractor may receive capacity building funding to support the enrollment of individuals into the HCBS-DD waiver from the waiting list. 2.5.2.2. Contractor shall receive written notification of any capacity building funding for individuals enrolling into the HCBS-DD waiver from the waiting list. 2.5.2.3. 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 enrollment in the following categories: 2.5.2.3.1. Staffing costs 2.5.2.3.1.1. Recruiting and hiring 2.5.2.3.1.2. Professional development 2.5.2.3.1.3. Equipment and supplies 2.5.2.3.1.4. Information technology 2.5.2.3.2. Program costs 2.5.2.3.2.1. Advertising 2.5.2.3.2.2. Equipment and supplies 2.5.2.4. DELIVERABLE: Capacity Building Funding Expenses Exhibit B-4,SOW Page 18 of49 Docusign Envelope ID: ZACF3C37/0088-41AD8DFC-008758727588 2.5.2.5. 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 2.5.3. FSSP Enrollment from the Waiting List 2.5.3.1. 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 waiting list and prioritization ofi funding. 2.5.3.2. Contractor shall select individuals from the waiting list to enroll into FSSP in accordance with 10 CCR 2505-10 8.756let seq. 2.5.4. State SLS Enrollment from the Waiting List 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 8.7560. 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. 2.5.5. OBRA-SS Enrollment from the Waiting List 2.5.5.1. 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 funding needs being identified. 2.5.5.2. 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 existing allocations. 2.5.5.3. 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 request. 2.5.6. Waiting List Records Maintenance 2.5.6.1. 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 response or the last communication attempt. 2.5.6.2. If an individual or guardian declines an enrollment, Contractor shall enter the reason for declining an enrollment into the CCM Waiting List record within 10 Business Days of the enrollment being declined. 2.5.6.3. Contractor shall provide information and referrals to individuals, families and/or guardians at the time ofthe annual follow-up. 2.5.6.4. 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, waivers, CFC, and services. 2.5.6.5. Contractor shall provide assistance completing Medicaid financial applications or other public assistance program applications at the time assistance is requested by the individual, family, or guardian. Exhibit B-4, SOW Page 19 of4 49 Docusign Envelope ID: 2ACF3C37-008841APBDFC-008788727588 2.5.6.6. Individuals shall be notified at the time of 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 before an Administrative Law Judge. 2.6. Compilation and Correction of Waiting List Data 2.6.1. Contractor shall correct 100% of Waiting List data errors discovered by the Department within 10 Business Days of notification from the Department of an error. 2.6.1.1. PERFORMANCE STANDARD: 100% of Waiting List data corrected within 10 Business Days of notification. 2.7. Authorization and Reporting ofl HCBS-DD Enrollments 2.7.1. Contractor shall obtain prior authorization from the Department for all enrollments into the HCBS-DD waiver. 2.7.2. In 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 monthly on the date and template prescribed by the Department. 2.7.3, 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 8.057 et seq. The notification shall include the right to request a fair hearing before an Administrative Law Judge. 2.7.3.1. DELIVERABLE: HCBS-DD Vacancy Reporting 2.7.3.2. DUE: Monthly, by the 15th on the template prescribed by the Department 2.7.4. 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 Department. 2.7.4.1. DELIVERABLE: HCBS-DD Enrollment Date and Enrollment Change Reporting 2.7.4.2. DUE: Monthly, by the 15th on the template prescribed by the Department 3. ASSESSMENT AND ANNUAL REASSESSMENT 3.1. Contractor shall perform the Level of Care (LOC) Screen (ULTC 100.2) for each individual as directed by the Department and in accordance with regulations. 3.2. Contractor shall provide stafft that meet the case manager qualifications set forth in state statutes and regulations to perform all LOC Screens. 3.3. Contractor shall utilize and conduct the Department prescribed tools for the Initial LOC Screer for all new applicants to HCBS, CFC, PACE, Nursing Facilities, Hospital Back-Up, and ICF- IDD. 3.4. Initial LOC Screen include the following Assessment Event types: Initial, HCBS-DD Waitlist, Deinstitutionalization (DI), and Reverse Deinstitutionalization. LOC Screen Reassessments include the following Assessment Event type: Continued Stay Review. LOC Screen Unscheduled Reviews include the following Assessment Event type: Unscheduled Review. Exhibit B-4, SOW Page 20 of 49 Docusign Envelope ID: 2ACF3C37/0088-41A08DFC-008788727588 3.4.1. An Onscheduled Review Event Type shall be utilized when a LOC Screen is completed due to a significant change in the Member functioning and support needs including documented medical conditions, post hospitalization, or significant change in activities of daily living. 3.5. Contractor shall perform all Initial and Annual Reassessment Level of Care Screens for the operation of a 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 et seq. 3.6. The Initial LOC Screen shall include and ensure, but not limited to, the following: 3.6.1. 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 Screen ifthe interview conducted to complete the intake indicates that an applicant has not submitted a LTC Medicaid Application. 3.6.1.1. Hospital and Skilled Nursing Facility referrals do not require LTC Medicaid application verification. 3.6.2. Contractor shall consider an Initial LOC Screen to be complete when the following has been done: an in-person assessment is completed, the PMIP has been obtained and verified to be accurate by the Case Manager to certify LOC, the attestation form, if applicable, has been obtained and verified to be accurate by the Case Manager to determine target criteria, and the assessment has been entered in the CCM. 3.7. The. Annual LOC Screen Reassessment shall include and ensure, but not limited to, the following 3.7.1. A review of financial eligibility information. 3.7.1.1. Contractor shall take action regarding Member Medicaid eligibility within one Business Day of receipt from the eligibility site. 3.7.1.2. 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 the certification end date. 3.7.1.2.1. In the event Contractor fails to discontinue HCBS waiver and/or CFC services for a Member found ineligible for a HCBS and/or CFC, Contractor shall be responsible for reimbursing any providers for services rendered. 3.7.1.3. A review oft the LOC Screen information. 3.7.1.4. A review of all supportive information related to the LOC for the Member to include, but not limited to, documentation and interviews. 3.7.1.5. A review of relevant medical, educational, social, or other assessment records or information when applicable. 3.7.1.6. A review of all community living information and options as an alternative to nursing facililyinstitutionalized care. 3.8. The Initial LOC Screen and Annual LOC Screen Reassessment shall include and ensure, but nct limited to, the following: 3.8.1. Contractor shall ensure all LOC Screens are conducted in person with the individual, at minimum, and in the place where the individual or Member resides. 3.8.2. A review ofHCBS waiver Target Criteria for individual participation. Exhibit B-4, SOW Page 21 of49 Docusign Envelope ID: 2ACF3C37,085-1AD8BDC-D08758727588 3.8.3. Determine individual Level of Care Eligibility for enrollment in HCBS, CFC, PACE, HBU, Nursing Facility admission, or ICF-IDD admission. Analyzing the information obtained to determine the most appropriate responses to the LOC Screen questions. 3.8.3.1. Contractor shall verify that a Member meets institutional Level of Care by receiving a PMIP signed by a treating licensed 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 Initial Level of Care Screen; and within 90 Calendar Days of 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 for Individuals with Intellectual and Developmental Disabilities (ICF-IDD), and Program for All-Inclusive Care for the Elderly (PACE). 3.8.3.1.1. PERFORMANCE STANDARD: Contractor shall ensure a Professional Medical Information Page (PMIP) is signed within 90 Calendar Days ofthe certification start date and before the certification end date for a LOC Screen Reassessment 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- Inclusive Care for the Elderly (PACE). 3.8.4. Communicating Level of Care Eligibility status to the appropriate eligibility site. 3.8.5. A LOC Certification notice shall be provided to referring agencies such as PACE organizations, Nursing Facilities, or Hospitals upon obtaining written consent provided by the individual that meets HIPAA standards. 3.8.6. Providing Notice of Action to applicants and Members of all appealable actions related to their eligibility in a LTSS program. 3.8.6.1. Members shall be notified at the time oft the denial ofineligibility decision that they have the right to appeal the actions ofContractor 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. 3.8.6.2. Representing the Department in all appeals relevant to a LTSS program eligibility. 3.8.7. Documenting and maintaining LOC Screens, including all relevant information, utilizing the CCM within the timeframes established in 10 CCR 2505-10, Sections 8.7202.E and 8.7202.F et seq 3.9. Failure by Contractor to complete the Annual LOC Reassessment shall cause a break in payment authorization for waiver and/or CFC services for the individual or Member. 3.9.1. Contractor shall ensure that this break in payment authorization shall not affect the continuec delivery of waiver and/or CFC services to the individual or Member. Service costs incurrec during a break in payment authorization are non-allowable costs. 3.9.2. Contractor shall bear the sole financial responsibility for all costs incurred during this break in payment authorization and shall be responsible for reimbursing any providers for services rendered during the gap in eligibility. Exhibit B-4, SOW Page 22 of 49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D 0B75872758B 3.9.2.1. Contractor shall schedule an in-person Initial LOC Screen in accordance with 10 CCR 2505-10 Section 8.7202.E and shall adhere to the following processes and timelines based on type: 3.9.3. Hospital to HCBS or CFC 3.9.3.1. Contractor conducts and documents the LOC Screen and generates the electronic LOC Eligibility Determination in the Care and Case Management (CCM) system within two Business Days of receiving a referral. 3.9.3.2. LOC Eligibility Determination start date for Assisted Care Facility may be the date of referral on the LTSS LOC referral form received by the Contractor. 3.9.3.3. Referral to LOC Eligibility Determination not to exceed two Business Days. 3.9.4. Hospital to Skilled Nursing Facility 3.9.4.1. Contractor conducts and documents the LOC Screen and PASRR Level I Screen and generates the electronic LOC Eligibility Determination in the CCM within two Business Days ofreceiving a referral. 3.9.4.2. Contractor completes and documents the Nursing Facility Length of Stay form to indicate the length of stay necessary to meet the applicant's needs. 3.9.4.3. LOC Eligibility Determination start date may be the date the LTSS LOC Referral Form is received by the Contractor. 3.9.4.4. Referral to LOC Eligibility Determination not to exceed two Business Days. 3.9.4.5. Hospital timelines apply to any applicant in a hospital wanting to enroll in PACE anc HBU. 3.9.5. Skilled Nursing Facility to HCBS or CFC 3.9.5.1. Contractor conducts and documents the LOC Screen and generates the electronic LOC Eligibility Determination in the CCM within 5 Business Days of receiving a referral. 3.9.5.2. Referral to LOC Eligibility Determination not to exceed 5 Business Days. 3.9.6. Skilled Nursing Facility Payer Source Change 3.9.6.1. Contractor conducts and documents the LOC Screen and generates the electronic LOC Eligibility Determination in the CCM within 5 Business Days of receiving a referral. 3.9.6.2. Referral to LOC Eligibility Determination not to exceed 5 Business Days. 3.9.7. HCBS or CFC to Skilled Nursing Facility 3.9.7.1. Contractor conducts and documents the LOC Screen and PASRR Level I Screen and generates the electronic LOC Eligibility Determination in the CCM within 10 Business Days of receiving a referral. 3.9.7.2. Contractor completes the Nursing Facility Length of Stay form to indicate the length of stay necessary to meet the applicant' S needs. 3.9.7.3. LOC Eligibility Determination start date may be the Referral Form signature date. 3.9.7.4. Referral to LOC Eligibility Determination not to exceed 10 Business Days. 3.9.8. Community to HCBS or CFC Exhibit B-4, SOW Page 23 of49 Docusign Envelope D: 2ACF3C37-008-1ADP8DC-008758727588 3.9.8.1. Contractor conducts and completes the LOC Screen and generates the electronic LOC Eligibility Determination in the CCM within 10 Business Days of receiving a referral. 3.9.8.2. LOC Eligibility Determination start date for Assisted Care Facility may be the Referral Form signature date. 3.9.8.3. Referral to LOC Eligibility Determination not to exceed 10 Business Days. 3.9.9. Contractor shall conduct an Annual LOC Screen Reassessment no earlier than 90 Calendar Days prior to and no later than 30 Calendar Days prior to the current LOC Screen certification end date. 3.9.9.1. PERFORMANCE STANDARD: 100% ofInitial LOC Screens and Annual LOC Screen Reassessments 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 CCM following the timelines at 10 CCR 2505-10 Section 8.7202.E et seq. 3.9.10. Contractor shall receive reimbursement for all initial and reassessment LOC Screens based on data entry into the CCM. 3.10. At-Risk Diversion 3.10.1. Contractor shall: 3.10.1.1. 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 are being met to avoid nursing facility placement. 3.10.1.2. Initial Outreach shall include Member's first occurrence on the at-risk determination list as indiçated by the Department. 3.10.1.3. Ongoing Outreach shall include Member's subsequent occurrence on the at-risk determination list as indicated by the Department. 3.10.1.3.1. At-Risk Diversion activities shall include, but are not limited to: 3.10.1.3.2. Assessing the effectiveness of current support and services to determine if there is E need for additional resources, supports, and/or services. 3.10.1.3.3. Support in assessing if the individual has become eligible for any other resources including community resources and other Medicaid resources. 3.10.1.3.4. Documenting all At-Risk Diversion activities in detail in the CCM within 10 Business Days of the activity. 3.10.1.3.5. Maintaining all supporting documentation and make it available to the Department upon request. 3.10.1.3.5.1. DELIVERABLE: At-Risk Diversion Invoice 3.10.1.3.5.2. DUE: Monthly, by the 15th 3.11. Rapid Reintegration 3.11.1. Contractor shall initiate the Rapid Reintegration if applicable, during the LOC Screen for Nursing Facility. 3.11.1.1. Contractor shall provide Members information about community-based services using the Member preference guide available on the CCM and website. Exhibit B-4,SOW Page 24 of4 49 Docusign Envelope ID: ZACF3C37/0088-1A08DFC-D08788727588 3.11.1.2. Contractor shall complete the Rapid Reintegration within the CCM if the Member expresses a desire to return to the community. 3.11.1.3. 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 CCM. 3.11.1.4. Contractor shall ensure that any referrals deemed necessary during the Rapid Reintegration process are completed within two Business Days ofthe LOC Screen. 3.11.1.5. 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 Reintegration Plan or Rapid Referral. 3.11.1.5.1. DELIVERABLE: Rapid Reintegration Diversion Invoice 3.11.1.5.2. DUE: Monthly, by the 15th 3.12. Interim Support Level Assessment 3.12.1. The Contractor shall establish one point of contact for Interim Support Level Assessment (ISLA) related processes and communications. 3.12.2. Contractor shall conduct an ISLA for initial HCBS-DD and HCBS-SLS enrollments when criteria set forth at 10 C.C.R. 2505-10 Section 8.7202.AA et seq. are met, the Member has never had a Supports Intensity Scale (SIS) Assessment, and the Member is seeking Day Habilitation, Prevocational, Supported Employment Services and/or Residential Habilitation, Contractor shall not be reimbursed for an ISLA prior to the individual being determined eligible for a waiver through the Level of Care Screen and confirmation of financial eligibility. 3.12.3. Contractor shall conduct all initial ISLAS within 30 Calendar Days of the Member meeting both functional and financial eligibility. 3.12.4. Contractor shall upload the ISLA into the CCM within 10 Business Days of the assessment date. 3.12.5. Contractor shall complete the Departmemtpreseribed ISLA invoice, including attaching E copy ofthe ISLA, and submit it to thel Department within 30 Calendar Days ofthe assessment date. 3.12.6. Contractor shall complete the ISLA and enter the Department-specified outcomes from the ISLA into the Bridge prior to completion ofthe Pre Prior Authorization (PPA) and before the PAR Start Date. 3.12.6.1. DELIVERABLE: Completed Interim Support Level Assessment Invoice 3.12.6.2. DUE: Within 30 Calendar Days ofthe Assessment Date 3.13. HCBS-CES Applications 3.13.1. Contractor shall complete initial and CSR applications for persons applying for the HCBS- CES waiver as set forth by the Department's prescribed guidelines. Exhibit B-4, SOW Page 25 of4 49 Docusign Envelope ID: 2ACF3C37-0088-1AD8DFC.D08788727885 3.13.2. Initial HCBS-CES applications shall be submitted to the designated entity for 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. 3.13.3. CSR HCBS-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. 3.13.4. Contractor shall maintain all HCBS-CES applications and supporting documentation and make it available to the Department upon request. 3.14. HCBS-CHRP Support Need Level Assessment 3.14.1. 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. 3.14.2. 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 as necessary when individual" S needs change. 3.14.3. Contractor shall submit a list of all completed HCBS-CHRP Support Need Level Assessments on a template prescribed by the Department. 3.14.3.1. DELIVERABLE: Completed HCBS-CHRP Support Need Level Assessment List 3.14.3.2. DUE: Monthly, by the 15th 3.14.4. Contractor shall maintain all Support Need Level Assessments and supporting documentation and make it available to the Department upon request. 3.14.4.1. PERFORMANCE STANDAND: Support Need Level Assessment 3.14.4.2. 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. IfContractor 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 not be 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 services for both State SLS and OBRA-SS. 4.1.2. 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 Support Planning process, such as exercising free choice of providers. 4.1.3. Contractor shall provide the individual, Members, and/or guardian with written information about how to file a provider agency complaint as well as how to make a complaint against Contractor. Exhibit B-4, SOW Page 26 of 49 Docusign Envelope ID: ZACF3C37/0088-41A08DFC-008788727588 4.1.4. 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 services is initiated by the provider service agency. 4.2. State General Fund Service Expenditure Reporting 4.2.1. 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 the fiscal year the service is provided. 4.2.1.1. DELIVERABLE: State General Fund Program Service Expenditure Reports 4.2.1.2. DUE: Monthly, by the 15th of each month or Fiscal Year end close date determined by the Department for the month ofJune. 4.2.2. 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 ofthe fiscal year the service is rendered, Contractor must report the adjustment to the Department within 10 Business Days ofdiscovery 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. 4.2.3. 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. 4.3. State Supported Living Services (State SLS) 4.3.1. General Requirements 4.3.1.1. Contractor shall operate the State SLS program pursuant to 10 C.C.R. 2505-10 Section 8.7560et seq. 4.3.1.2. Contractor shall not add surcharges to the purchase of covered services for State SLS. 4.3.1.3. 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 parties upon request. 4.3.1.4. Contractor shall provide or coordinate with local service providers to 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 10 C.C.R. 2505-10 Section 8.7560 et seq. 4.3.1.5. 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 the funding allocated. Target caseload is calculated using the unique number ofl Members that receive direct services during the contract period. 4.3.2. State SLS Eligibility 4.3.2.1. Contractor shall determine eligibility for the State SLS program pursuant to 10 C.R.S. 2505-10 Section 8.7560.B et seq. 4.3.2.2. Contractor shall provide options counseling for State SLS after it is demonstrated that the Member has applied for HCBS waiver services and explored long-term care services Exhibit B-4, SOW Page! 27 of 49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B offered under the State Plan, including CFC, and has demonstrated that available Medicaid services cannot meet the Member's needs. 4.3.2.3. Contractor shall document any State SLS service needs for Member's enrolled in HCBS and/or CFC. 4.3.2.4. Eligibility for the State SLS program does not guarantee the availability of services and supports. 4.3.3. State SLS Individual Support Plans 4.3.3.1. Pursuant to 10 C.R.S. 2505-10 Section 8.7560.D et seq. all State SLS Members must have a State SLS ISP. 4.3.3.2. 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 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 State SLS ISP during this time. Contractor shall ensure the State SLS ISP is signed by all required parties prior to implementation. 4.3.3.3. The State SLS ISP shall be developed through an in-person meeting that includes, at a minimum, the individual seeking services and Contractor. 4.3.3.4. Contractor shall utilize the ISP within the CCM. 4.3.3.5. Contractor shall document and finalize all ISP information in the CCM within 10 Business Days oft the date of the initial ISP meeting. 4.3.3.5.1. PERFORMANCE STANDARD: Contractor shall ensure that 100% of the State SLS ISPs are developed within 10 Business Days ofthei individual's referral to a State General Fund program or after the initial ISP meeting. 4.3.3.6. 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. 4.3.3.7. If an 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. 4.3.4. State SLS Ongoing Case Management 4.3.4.1. Contractor shall utilize appropriated funds to perform Case Management duties in accordance with 10 C.C.R. 2505-10 Section 8.7560.E et seq.: 4.3.4.1.1. Intake and referral. 4.3.4.1.2. Determining program eligibility. 4.3.4.1.3. Supporting individuals with learning and accessing other community resources. 4.3.4.1.4. Developing a State SLS Individual Support Plan. 4.3.4.1.5. Maintaining the determination of eligibility for services and supports. 4.3.4.1.6. Providing service and support authorization and coordination. 4.3.4.1.7. Program transition coordination. 4.3.4.1.8. Case Management, policy, and regulation training. Exhibit B-4, SOW Page 28 of49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 4.3.4.1.9. Service records maintenance. 4.3.4.1.10. Otilization review. 4.3.4.2. Contractor shall document all ongoing case management activities in detail in the CCM within 10 Business Days oft the activity. 4.3.4.3. Contractor shall be reimbursed for ongoing case management activities based on information entered into the CCM. 4.3.4.4. The use of mass email communication, robotic and/or automatic voice messages cannot be used to replace Contractor'si required individualized case management activities. 4.3.5. State SLS Monitoring 4.3.5.1. 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 determined based on Member preference and need. 4.3.5.1.1. The Member's S selected modality must be documented within the case notes for each monitoring contact within the CCM. 4.3.5.1.2. State SLS Monitoring activities shall include, but not be limited to: 4.3.5.1.2.1. Monitoring all services and supports delivered pursuant to the State SLS Individual Support Plan. 4.3.5.1.2.2. Assessing the effectiveness ofthe State SLS supports and services. 4.3.5.1.2.3. Assessing if additional State SLS supports and services are needed. 4.3.5.1.2.4. Support in assessing ifthe individual has become eligible for any other resources including community resources and other Medicaid resources. 4.3.5.1.2.5. Reviewing health and safety concerns. 4.3.5.1.2.6. Reviewing any Critical Incidents. 4.3.5.1.3. Contractor shall document all monitoring activities in detail in the CCM within IC Business Days oft the activity. 4.3.5.1.4. Contractor shall be reimbursed for monitoring activities based on information enterec into the CCM. 4.3.5.1.4.1. PERFORMANCE STANDARD: 100% of monitoring activities shall occur ar the required quarterly interval. 4.3.6. State SLS Transfers 4.3.6.1. Contractor shall manage State SLS transfers in accordance with 10 C.R.S 2505-10 Section 8.7560.F et seq. 4.3.7. State SLS Direct Services 4.3.7.1. 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. 4.3.8. State SLS Records Maintenance Exhibit B-4, SOW Page 29 of49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D J B75872758B 4.3.8.1. Contractor shall maintain supporting documentation capable of substantiating all expenditures and shall make it available to the Department upon request as required in 10 C.C.R. 2505-10 Section 8.7560.H et seq. 4.3.8.2. 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 amount due or paid. 4.3.8.3. If Contractor does not maintain supporting documentation in the required format for all services rendered, the Department may recover these funds pursuant to 10 C.C.R. 2505- 10 Section 8.076 et seq. 4.3.8.4. Through ongoing monitoring, Contractor shall ensure all services reimbursed by Contractor are rendered by service providers in accordance with the State SLS Individual Support Plan. 4.3.8.5. Contractor shall attempt to resolve any discrepancies with the service provider directly. 4.3.8.6. Contractor shall notify the Department of any instances of suspected fraud or waste, and any supporting documentation at the time of discovery. 4.3.8.7. 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 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. 4.4.2. PASRR Level II Evaluation 4.4.2.1. Contractor will review the PASRR Level II Evaluations received from the Skillec Nursing Facility or State appointed vendor prior to developing an OBRA-SS Individual Support Plan or providing services. 4.4.3. Maintaining Eligibility and Enrollment 4.4.3.1. Contractor shall enroll individuals into OBRA-SS, if the individual resides in a nursing facility, demonstrates a need, and agrees to receive services. 4.4.3.2. Upon approval of the nursing facility admission by the State Intellectual Disability Authority and receipt ofthe Final Notice ofDetermination, Contractor shall send referrals to 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 appointed vendor. 4.4.3.3. Contractor shall maintain Member records within the CCM. All changes to OBRA-SS enrollments, shall be entered into the CCM within 10 Business Days of the change. The Department may adjust the number of authorized enrollments based on fluctuating Exhibit B-4, SOW Page 30 of 49 Docusign Envelope ID: 2ACF3C37/0068-1A08DFC.008788727588 enrollments. If the individual does not receive OBRA-SS within one calendar month Contractor shall inactivate the individual's record in the CCM. 4.4.4. OBRA-SS Individual Support Plans 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 oft the OBRA-SS ISP during this time. Contractor shall ensure the OBRA-SS ISP is signed by all required parties prior to implementation. 4.4.4.2. The OBRA-SS ISP shall be developed through an in-person meeting that includes, at a minimum, the individual seeking services and Contractor. 4.4.4.3. Contractor shall utilize the ISP template within the CCM. 4.4.4.4. Contractor shall document and finalize all ISP information in the CCM within 10 Business Days of the date of the initial ISP meeting. 4.4.4.4.1. PERFORMANCE STANDARD: Contractor shall ensure that 100% ofthe 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. 4.4.4.5. The OBRA 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. 4.4.4.6. Ifal Member seeks additional supports or alleges a change in need, Contractor shall review and update the ISP prior to changing the authorized services and supports. 4.4.4.7. Contractor shall maintain all OBRA-SS ISPs and supporting documentation and make them available to the Department upon request. 4.4.5. OBRA-SS Ongoing Case Management 4.4.5.1. Contractor shall utilize appropriated funds to perform Case Management duties to include: 4.4.5.1.1. Intake and referral. 4.4.5.1.2. Verifying a PASRR Level II Evaluation and Skilled Nursing Facility residency. 4.4.5.1.3. Developing an OBRA-SS Individual Support Plan. 4.4.5.1.4. Maintaining the determination of eligibility for services and supports. 4.4.5.1.5. Providing service and support authorization and coordination. 4.4.5.1.6. Ensuring there is not a duplication of authorized services with the services provided in the nursing facility. 4.4.5.1.7. Program transition coordination. 4.4.5.1.8. Service records maintenance. 4.4.5.1.9. Case Management, policy, and regulation training. 4.4.5.1.10. Otilization review. Exhibit B-4, SOW Page 31 of 49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC- DOB75872758B 4.4.5.2. Contractor shall document all ongoing case management activities in detail in the CCM within 10 Business Days of the activity. 4.4.5.3. Contractor shall be reimbursed for ongoing case management activities based on information entered into the CCM 4.4.5.4. The use of mass email communication, robotic and/or automatic voice messages cannot be used to replace Contractor'si required individualized case management activities. 4.4.6. OBRA-SS Monitoring 4.4.6.1. 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 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 CCM. 4.4.6.2. Monitoring activities shall include but not be limited to: 4.4.6.2.1. Monitoring all services and supports delivered pursuant to the OBRA-SS ISP. 4.4.6.2.2. Assessing the effectiveness of the supports and services. 4.4.6.2.3. Assessing if additional supports and services are needed. 4.4.6.2.4. Support in assessing if the individual has become eligible for any other resources including community resources or other Medicaid resources. 4.4.6.2.5. Reviewing health and safety concerns. 4.4.6.2.6. Reviewing any Critical Incidents. 4.4.6.3. Contractor shall document all monitoring activities in detail in the CCM within 10 Business Days of the activity. 4.4.6.4. Contractor shall be reimbursed for monitoring activities based on information entered into the CCM. 4.4.6.4.1. PERFORMANCE STANDARD: 100% of monitoring activities shall occur at the required quarterly interval. 4.4.7. OBRA-SS Direct Services 4.4.7.1. 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 funding. 4.4.7.2. Contractor shall not utilize or authorize OBRA-SS funds to provide or purchase services and supports that are covered and provided by the nursing facility. 4.4.7.3. 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 include: 4.4.7.3.1. Assistive Technology Exhibit B-4, SOW Page 32 of4 49 Docusign Envelope ID: 2ACF3C37-08B-1ADBDFC.D08758727588 4.4.7.3.2. Behavioral Consultation 4.4.7.3.3. Behavioral Line Services 4.4.7.3.4. Behavioral Counseling 4.4.7.3.5. Behavioral Counseling Group 4.4.7.3.6. Behavioral Plan Assessment 4.4.7.3.7. Day Habilitation - Specialized Habilitation 4.4.7.3.8. Day Habilitation - Supported Community Connections 4.4.7.3.9. Dental - Basic 4.4.7.3.10. Dental - Major 4.4.7.3.11. Mileage 4.4.7.3.12. Other Public Conveyance 4.4.7.3.13. Prevocational Services 4.4.7.3.14. Recreational Facility Fees/Passes 4.4.7.3.15. Job Coaching - Individual 4.4.7.3.16. Job Coaching - Group 4.4.7.3.17. Job Development - Individual 4.4.7.3.18. Job Development - Group 4.4.7.3.19. Job Placement 4.4.7.3.20. Vision 4.4.7.4. Services must be provided in accordance with the service definitions found in 10 C.C.R. 2505-10 Section 8.7500 et seq. 4.4.8. OBRA-SS Records Maintenance 4.4.8.1. Contractor shall maintain supporting documentation capable of substantiating all expenditures and shall make it available to the Department upon request as required in 10 C.C.R. 2505-10 Section 8.130.2 et seq. 4.4.8.1.1. Receipts or invoices must contain, at a minimum: Member name, service description, provider name, first and/or last date of service, service rate, and amount due or paid. 4.4.8.2. If Contractor does not maintain supporting documentation in the required format for all services rendered, the Department may recover these funds pursuant to 10 C.C.R. 2505- 10 Section 8.076 et seq. 4.4.8.3. Through ongoing monitoring, Contractor shall ensure all services reimbursed by Contractor are: rendered by service providers in accordance with the OBRA-SS Individual Support Plan. 4.4.8.4. Contractor shall attempt to resolve any discrepancies with the service provider directly. 4.4.8.5. Contractor shall notify the Department of any instances of suspected fraud and any supporting documentation at the time of discovery. Exhibit B-4, SOW Page 33 of4 49 Docusign Envelope ID: 2ACF3C37-0068-1AD8DFC.D08788727588 4.4.8.6. 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 the Department pursuant to 10 C.C.R. 2505-10 Section 8.076 et seq. 4.4.9. Mental Health Services Prohibited 4.4.9.1. 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 a Medicaid covered mental health diagnosis. 4.4.9.2. 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 of funding. 4.5. Family Support Services Program (FSSP) 4.5.1. Contractor shall administer and provide or purchase Family Support Services pursuant tc $25.5-10-305, C.R.S. and 10 C.C.R. 2505-10 Section 8.7561 et seq. 4.5.2. Eligibility, Needs Assessment, and Prioritization of Families. 4.5.2.1. Contractor shall determine individual eligibility for the FSSP pursuant to 10 C.R.S 2505- 10 Section 8.7561.C. 4.5.2.2. Contractor shall provide options counseling for FSSP after it is demonstrated that the Member has applied for HCBS waiver services and has demonstrated that the waiver cannot meet the Member's needs. 4.5.2.3. Contractor shall document any FSSP service needs for Member's enrolled in HCBS. 4.5.2.4. 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 2505-1C Section 8.7561.F and have documented scoring criteria for the tool. The tool shall be included in Contractor': S policies and procedures. 4.5.2.4.1. DELIVERABLE: Needs Assessment Tool Template and Scoring Criteria 4.5.2.4.2. DUE: Annually, by August 15th 4.5.2.5. 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 implemented. 4.5.2.6. Contractor shall assess all families, both on the waiting list as "As Soon as Available" and currently receiving FSSP services, for level of need on an annual basis in accordance with 10 CCR 2505 Section 8.7561.F et seq. 4.5.2.7. Contractor shall document all completed FSSP Needs Assessments within the CCM within 10 Business Days of completion ofthe assessment. 4.5.2.7.1. Contractor shall be reimbursed for most in need assessments based on information entered into the CCM. 4.5.2.8. Contractor shall maintain all Needs Assessment documentation and make it available to the Department upon request. Exhibit B-4, SOW Page 34 of 49 Docusign Envelope ID: 2ACF3C37-0088-1A0BDFC-D08788727588 4.5.2.9. The Department will notify Contractor of the target number ofi 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. 4.5.3. Family Support Plans (FSP) 4.5.3.1. Contractor shall ensure that individuals and families enrolled in the FSSP have ar individualized Family Support Plan (FSP) which meets the requirements of ar Individualized Plan, as defined in Section 25.5-10-202 et seq. and 25.5-10-211 C.R.S prior to receiving services. 4.5.3.2. The FSP shall be developed through by, at a minimum, a family representative, anc Contractor. Contractor shall ensure the FSP is signed by all required parties prior to implementation. 4.5.3.3. The FSP shall be effective for no more than one year. 4.5.3.4. If the Member seeks additional supports or alleges a change in need, Contractor shal review and update the FSP prior to changing the authorized services and supports. 4.5.3.5. Contractor shall upload a copy of the FSP information in the CCM within 10 Business Days of1 the FSP effective date. 4.5.4. FSSP Ongoing Case Management 4.5.4.1. 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 sources. 4.5.4.2. Contractor shall not charge families to provide direct services and case management fo: Family Support Services. 4.5.4.3. Contractor shall provide a list ofo qualified providers for appropriate services to applicants, Member(s), and families, during the individualized planning process, and to other interested parties upon request. 4.5.4.4. Contractor shall utilize appropriated funds to perform case management duties in accordance with 10 CCR 2505 8.7561.G et seq. to include: 4.5.4.4.1. Development, application assistance, and annual re-evaluation of the Family Support Plan (FSP) which shall be conducted at least once per year and include making changes to the FSP as indicated. 4.5.4.4.2. Providing service authorization and support coordination to include but not limited to assessing the effectiveness ofFSSP supports and services. 4.5.4.4.3. Ensuring all services and supports are delivered in accordance with the FSP. 4.5.4.4.4. Coordinating with families to obtain required documentation for services. 4.5.4.4.5. Supporting the individual in assessing eligibility for other community and/or Medicaid resources. Exhibit B-4, SOW Page 35 of49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 4.5.4.4.6. Program transition coordination. 4.5.4.4.7. Service records maintenance. 4.5.4.4.8. Case Management, policy, and regulation training. 4.5.4.4.9. Otilization review. 4.5.4.5. Contractor shall document all ongoing case management activities in detail in the CCM within 10 Business Days ofi the activity. 4.5.4.5.1. Contractor shall be reimbursed for ongoing case management activities based or information entered into the CCM. 4.5.4.5.2. The use of mass email communication, robotic and/or automatic voice messages cannot be used to replace Contractor's required individualized case managemen: activities. 4.5.5. FSSP Direct Services 4.5.5.1. 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 in the family home. 4.5.5.2. 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 if the need is a typical age-related need. The correlation between the need and the disability must be documented in the FSP. 4.5.5.3. Contractor shall ensure that all services are provided in the most cost-effective manner, meaning the least expensive manner to meet the need. 4.5.5.4. Contractor shall ensure that all services are authorized pursuant to the FSP. 4.5.5.5. Contractor shall utilize FSSP funds to provide funding to families for expenses referenced in 25.5-10-305(-), C.R.S and 10 C.R.S. 2505-10 Section 8.7561.D Contractor shall not authorize or provide any service that is not outlined in these regulations. 4.5.5.6. Contractor shall ensure the authorized services through FSSP are not duplicative of other resources the family has access to, including HCBS, CFC, third party insurance, etc. 4.5.5.7. Contractor shall prioritize funding for the FSSP pursuant to 10 C.R.S 2505-10 Section 8.7561.F et seq. 4.5.6. Family Support Council 4.5.6.1. Contractor shall establish and maintain a Family Support Council (FSC) pursuant to $25.5-10-304 et seq., C.R.S. and 10 C.C.R. 2505-10 Section 8.7561.B et seq. 4.5.6.2. Contractor shall ensure that the FSC is comprised primarily of individuals in services, family members, and guardians of individuals enrolled in FSSP. 4.5.6.3. Contractor shall submit a list of FSC members annually. 4.5.6.3.1. DELIVERABLE: FSC Member List 4.5.6.3.2. DUE: Annually, by August 15th Exhibit B-4, SOW Page 36 of 49 Docusign Envelope ID: ACFAC3700841A08DPCA D0B75872758B 4.5.6.4. Contractor shall notify the Department in writing of any changes to the FSC within 10 Business Days. 4.5.6.4.1. DELIVERABLE: FSC Member Updates 4.5.6.4.2. DUE: Within 10 Business Days oft the date of change to the FSC members 4.5.6.5. 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 ofthe 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. 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. 4.5.6.6.1. DELIVERABLE: FSC Meeting Minutes 4.5.6.6.2. DUE: Monthly, by the 15th of each month and by June 30th 4.5.7. FSSP Annual Report and Evaluation 4.5.7.1. 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 et seq. 4.5.7.2. Contractor shall create and submit an FSSP Annual Report and Evaluation to the Department. The FSSP Annual Report and Evaluation 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 deliverable. 4.5.7.3. Contractor must ensure the Annual Report and Evaluation does not contain Member PHI. 4.5.7.4. Contractor shall provide the Annual Report and Evaluation to the Department for review and post the report on the Contractor"': s website. 4.5.7.4.1. DELIVERABLE: FSSP Annual Report and Evaluation and Council Signature Page 4.5.7.4.2. DUE: Annually, by October 1st 4.5.8. FSSP Records Maintenance 4.5.8.1. Contractor shall maintain supporting documentation capable of substantiating all expenditures and reimbursements made to providers, Members and/or families. 4.5.8.2. When Contractor purchases services or items directly for Members and/or families, Contractor shall: 4.5.8.2.1. Maintain receipts or invoices from the service provider and documentation demonstrating that the provider was paid by Contractor. 4.5.8.2.1.1. 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, item(s) or service(s) cost and amount due or paid. 4.5.8.3. When Contractor reimburses Members and/or families for services or items, Contracto: shall: Exhibit B-4, SOW Page 37 of 49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 4.5.8.3.1. Ensure the Member and/or family provides Contractor with receipts or invoices prior to reimbursement. 4.5.8.3.1.1. Maintain receipts or invoices from the Member and/or family, and documentation demonstrating that the individual and/or family was reimbursed by Contractor. 4.5.8.3.2. 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. 4.5.8.4. When Contractor provides funding to Members and/or families for the purchase of services or items in advance, Contractor shall include, but is not limited to: 4.5.8.4.1. 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 available to the Department upon request. 4.5.8.4.2. Notify the Member and/or family that they are required to submit invoices or receipts to Contractor of all purchases made prior to the close oft the State Fiscal Year. 4.5.8.4.3. Ensure the Member and/or family provides Contractor with receipts or invoices. 4.5.8.4.4. 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 Contractor. 4.5.8.4.4.1. Ensure all receipts or invoices provided by the Members and/or family contain, at a 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 paid. 4.5.8.4.5. Contractor shall ensure the documentation received by the Member and/or family indicates that the amount was paid. 4.5.8.4.6. If a Member and/or family does not submit invoices or receipts, Contractor shal. document all attempts to obtain receipts or paid invoices and any remedial actior taken. Contractor shall make all supporting documentation available to the Department upon request. 4.5.8.4.7. If Contractor cannot provide supporting documentation as described in this section, the Department may recover any unsubstantiated expenditure from Contractor. 4.5.8.5. 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 date(s) of service. 4.5.8.5.1. Contractor shall ensure all program expenses related to multiple family expenses car. be substantiated through time tracking, wage costs, benefit costs, or any other supporting documentation to verify expenses related to proving the services. 5. DATA ENTRY, DATA MONITORING, AND OVERSIGHT 5.1. individua/Member Records Exhibit B-4, SOW Page 38 of 49 Docusign Envelope ID: 2ACF3C37/0088-1ADBDFC-D08788727688 5.1.1. Contractor shall: 5.1.1.1. Comply with all reporting and billing policies and procedures established by the Department, document individual and Member records within the CCM and adhere to the system requirements provided by the Department for these systems. Systems include, bui 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 through a COGNOS data query application. 5.1.1.2. Comply with all data entry guidelines for report-based Contract payments posted by the Department. 5.1.1.3. Maintain individual and Member records within the CCM for the purposes of individual and Member information management. 5.1.1.4. Maintain accurate and detailed documentation ofall case: management and State Genera. Fund Program activities required through the Contract. 5.1.1.5. 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 CCM. 5.1.1.6. Correct 100% of data errors discovered by the Department and confirm the accuracy of the data entered into the CCM within 10 Business Days of notification from the Department of an error. 5.1.1.6.1. PERFORMANCE STANDARD: 100% of data errors corrected within 10 Business Days of notification. 5.1.1.7. Develop and implement a plan to conduct, at minimum, an annual data integrity review That includes, but is not limited to, the following: 5.1.1.7.1. Member program records completeness and accuracy as directed by the Department 5.1.1.7.2. Member demographic information completeness and accuracy. 5.1.1.7.3. Member care team provider and team staff accuracy and completeness, as directed by the Department. 5.1.1.7.3.1. DELIVERABLE: Data Integrity and Data Quality Policies and Procedures 5.1.1.7.3.2. DUE: Annually, October 1st after the Contract Start Date or within 10 Business Days as revisions are made. 5.2. Systems Access and Training 5.2.1. 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: 5.2.1.1. Ensure all staff receive the required systems training as specified in this Contract. 5.2.1.2. Be responsible for management of user access and timely revocation for required systems to include the CCM, MMIS, Bridge, COGNOS, and PeakPro. 5.2.1.3. 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 necessary information are subject to resubmission and delay. Exhibit B-4, SOW Page: 39 of4 49 Docusign Envelope ID:: ZACF3C37-0068-41A0-BDF C-DOB75872758B 5.2.1.4. Ensure all revocation forms are submitted immediately upon knowledge of license user's separation ofe employment. 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 ofthe Contract. 6.2. Contractor shall establish and maintain internal control systems and standards that apply to the operation ofthe organization. 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 funds and record the amounts spent. 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 request. 6.5.1. DELIVERABLE: Transaction and Funds Documentation 6.5.2. DUE: Within 10 Business Days oft the Department's Request 7. SUBRECIPIENT STATUS AND REQUIREMENTS 7.1. Contractor has been determined to be a Subrecipient under 2 CFR Chapter I, Chapter II, Part 200 et al. Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance); Final 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 oft the Final Rule. 7.2.2. Contractor shall notify the State when expected or actual expenditures of federal assistance from all sources equal or exceed $1,000,000.00. 7.2.3. 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 qualify for a Single Audit. Exhibit B-4, SOW Page 40 of 49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 7.2.4. Pursuant to the Final Rule $200.512 (a)(1) the Single Audit must be completed and submitted to the Department within the earlier of 30 Calendar Days after receipt of the auditor's report(s), or nine months after the end ofthe audit period. Ifthe due date falls on a Saturday, Sunday, or federal holiday, the reporting package is due the next Business Day. 7.2.4.1. DELIVERABLE: as Audit 7.2.4.2. DUE: Within the earlier of 30 Calendar Days after receipt of the auditor's report(s), or nine months after the end of the audit period 7.2.5. fContractor 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 template. 7.2.5.1. DELIVERABLE: Attestation Form 7.2.5.2. DUE: Within the earlier of 30 Calendar Days after receipt of the auditor's report(s), or nine months after the end ofthe audit period 7.2.6. The audit period shall be Contractor's fiscal year. 7.3. Treatment of Funds 7.3.1. All funding identified as a subaward with matching federal dollars received through this Contract is subject to the requirements within Uniform Guidance. 7.3.1.1. All subawards must be used on allowable expenses associated with performing the activities outlined in this Contract and on allowable expenses per Uniform Guidance. 7.3.1.2. Any subawards not used on the activities outlined in this Contract is subject to recovery at the end ofthe Period of! Performance as identified by the Department. 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 of a 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 easily accessible location and format. Board ofDirector or Governing Body Changes 8.2.1. Contractor shall notify the Department in writing of any changes to the Board ofDirectors 0: Governing Body within 10 Business Days. 8.2.1.1. DELIVERABLE: Written notification of changes to Board of Director or Governing Body membership 8.2.1.2. DUE: Within 10 Business Days of the effective date 9. COMPENSATION AND INVOICING 9.1. State General Fund Program Allocations Exhibit) B-4,SOW Page 41 of4 49 Docusign Envelope ID: ZACF3C3/0088-41A08DDFC-D08758727588 9.1.1. The Department will notify Contractor in writing of Contractor's individual allocation for State SLS, OBRA-SS, and FSSP for each State Fiscal Year. 9.1.2. Reimbursement for activities and services performed by Contractor shall not exceed the maximum amount identified in Contractor's individual allocation. Activities and services must be rendered during the State Fiscal Year. 9.1.3. The Department, in its sole discretion, may increase or decrease Contractor's individua. 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 written notice by the Department to Contractor or by amendment of the Contract. The circumstances may include but shall not be limited to: 9.1.3.1. If necessary to fully utilize program appropriations. 9.1.3.2. Adjustments to reflect prior year final contract utilization and current year expenditures. 9.1.3.3. Supplemental appropriation changes resulting in an increase or decrease in the amounts originally appropriated and available for the purposes oft this program. 9.1.3.4. Closure of programs and/or termination of related contracts. 9.1.3.5. Delay or difficulty in implementing new programs or services. 9.1.3.6. Other special circumstances as deemed necessary by the Department. 9.1.3.7. Changes in Member utilization due to changing needs, new enrollments, terminations, and/or delays in services. 9.1.3.8. Target caseloads not being met. 9.2. State General Fund Program Target Caseloads 9.2.1. 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 of each State Fiscal Year. 9.2.2. Contractor may choose to enroll more individuals in State SLS, OBRA-SS, and FSSP thar authorized, ensuring all individuals can be served within the funding allocated. 9.2.3. Target caseload is calculated by the Department using the unique number of Members that receive direct services during the contract period. 9.2.4. Contractor shall enroll Members into OBRA-SS ifthe need for services is identified through the PASRR Level II and shall notify the Department if sufficient funding is not available in Contractor's individual allocation to support the individual's needs or to enroll a Member into the program. 9.2.5. 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. 9.3. State General Fund Program Compensation 9.3.1. The compensation under this Contract shall consist ofrates-based reimbursement intended tc 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 Exhibit B-4, SOW Page 42 of49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B specified in Exhibit C, Rates. Direct services for State SLS and OBRA-SS shall be reimbursed at the corresponding HCBS-SLS rates posted and distributed on the Department's website on the Provider Rates and Fee Schedule. Contractor shall be reimbursed for services that have individual support level rates at the level 4 rate for State SLS and at the level 6 rate for OBRA-SS. The Department shall pay Contractor for FSSP activities at the rates specified in Exhibit C, Rates. Direct services for FSSP shall be reimbursed at one dollar per unit. 9.3.2. The liability of the State, at any time, for such payment shall be limited to the unexpended amount remaining of such funds available to the Department. 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'si maximum allocation ofs State funding has been paid to Contractor, no additional funds shall be provided under this Contract. 9.3.4. Payment pursuant to this Contract is contingent upon Contractor, or subcontractor(s). securing and properly maintaining all necessary licenses, certifications, approvals, etc., required to properly provide the services or goods covered by the contract. 9.3.5. 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 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 using an Option Letter. 9.3.6. The rates for State SLS and OBRA-SS direct services will be posted on the Department's website on the HCBS-SLS Provider Rates and Fee Schedule. Contractor shall bill all FSSP direct services at one dollar per unit. 9.4. Adjustments to Fund Disbursement Amounts 9.4.1. 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 to the Fiscal Year contract if: 9.4.2. Contractor does not achieve the Performance Standards identified for each program. 9.5. Case Management Agency Compensation 9.5.1. The compensation under this Contract shall consist of rates-based reimbursement intended to cover the costs of all activities provided through this Contract. 9.5.2. Contractor will receive payment as specified in Exhibit C, Rates. 9.5.2.1. 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 Exhibit B-4, SOW Page 43 of 49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 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 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. Contractor shall meet all data entry requirements published by the Department for Contract payments based on data entered into the CCM, invoices submitted, and deliverables submitted in order to be reimbursed for the activities described below. 9.7.2. Applications - HCBS-CES 9.7.2.1. 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 fort the individual 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 ofthe month for assessments from the previous month. 9.7.3. Appeal Packets and Hearing Attendance 9.7.3.1. Contractor shall ensure that all Appeal Packets and Hearing Attendance information is entered into the CCM within the required timeframe. The Department will pay for all Appeal Packets and Hearing Attendances from data pulled from the CCM 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. 9.7.4. At-Risk Diversion 9.7.4.1. Contractor shall complete all At-Risk Diversion activities as required by the Department and shall invoice the Department for all completed contacts by the 15th day of the 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. 9.7.5. Case Management Training 9.7.5.1. Contractor shall submit the Case Management Training 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. Ifa case Exhibit B-4, SOW Page 44 of49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC- L J OB75872758B 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. 9.7.6. Community Advisory Committee Updates 9.7.6.1. 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. 9.7.7. Complaint Log and Trend Analysis 9.7.7.1. 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. 9.7.8. Continuous Quality Improvement Plan 9.7.8.1. 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 accepted by the Department. 9.7.9. Critical Incident Quarterly Follow-Up Completion and Entry Performance Standard 9.7.9.1. Contractor is eligible to receive a quarterly performance-based payment for timely completion of the requested HCBS and CFC CIR follow-up action. To receive this quarterly performance-based payment, Contractor must have 90% of all CIRs assigned follow-up completed and entered into the CCM 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 determine ifContractor will be awarded thej performance-based payment. HCBS and SGF 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 CCM within the required timeframe. The Department will pay per. Member enrolled each month based on actively enrolled Members pulled from the CCM on the 15th day ofthe 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 and CFC 9.7.11.1. Contractor shall ensure all CIRs have been entered in the CCM within the required timeframe. The Department will pay per. Member enrolled each month based on actively enrolled Members pulled from the CCM on the 15th day of the month for CHCBS, HCBS-BI, HCBS-CIH, HCBS- CWCHN, HCBS-CMHS, HCBS-EBD, and CFC. Exhibit B-4, SOW Page 45 of4 49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 9.7.12. Critical Incident Reporting and Critical Incident Report Administrative Review State SLS, OBRA-SS, FSSP 9.7.12.1. Contractor shall ensure all CIRs have been entered in the CCM 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 CCM 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 CCM within the required timeframes. The Department will pay disability determinations, based on data pulled from the CCM on the 15th day ofthe 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 15tt 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 oft testing 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 oft 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 and Evaluation 9.7.17.1. Contractor shall submit an FSSP Annual Report and Evaluation on an annual basis to the Department. Contractor shall receive payment for the Deliverable after it has been reviewed and accepted by the Department. 9.7.18. HCBS-DD Waiting List Enrollment Capacity Building 9.7.18.1. 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. 9.7.19. Human Rights Committee: HCBS IDD Waivers Exhibit) B-4,S SOW Page 46 of 49 Docusign Envelope ID: 2ACF3C3-0088-41ADBDFC-D08788727888 9.7.19.1. Contractor shall create all HRC packets in accordance with Department requirements anc 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 CCM on the 15th day of the month for HCBS-CES, HCBS- CHRP, HCBS-DD, and HCBS-SLS enrollments from the previous month. 9.7.20. Human Rights Committee Packet Creation: State SLS, OBRA-SS, FSSP 9.7.20.1. 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 packe: created once the invoice has been reviewed and accepted. All invoices shall be submitted in the format prescribed by the Department. 9.7.21. Interim Support Level Assessments 9.7.21.1. Contractor shall submit all completed assessments in the timeline and manor specified by the Department. The Department will pay for all completed assessments based on data submitted by Contractor on the 15th of each month. 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 CCM within the required timeframes. The Department will pay for initial and reassessment Level of Care Screens based on data pulled from the CCM on the 15th day ofthe month for Screens conducted in the previous month. 9.7.23. Long-Range Plan 9.7.23.1. 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. 9.7.24. Monitoring Contacts: State SLS and OBRA-SS 9.7.24.1. Contractor shall conduct and enter all monitoring contacts for State SLS and OBRA-SS into the CCM within the required timeframe. Contractor shall receive payment for the four required monitoring contacts per support plan year. The Department will pay for monitoring contacts based on data pulled from the CCM on the 15th day ofthe month for contacts conducted in the previous month. 9.7.25. Most in Need Assessment: FSSP 9.7.25.1. Contractor shall conduct and enter all completed Needs Assessments into the CCM within the required timeframe. Contractor shall receive 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 CCM on the 15th day ofthe month for assessments conducted in the previous month. 9.7.26. Needs Assessment: Initial and Reassessment 9.7.26.1. Contractor shall conduct and enter all initial and reassessment Needs Assessments into the CCM within the required timeframes. The Department will pay for initial and Exhibit B-4, SOW Page 47 of49 Docusign Envelope ID: 2ACF3C37/0088-1ADBDFC-008788727588 reassessment Needs Assessments based on data pulled from the CCM on the 15th day of the month for assessments conducted in the previous month. 9.7.27. Ongoing Case Management: State SLS, OBRA-SS, FSSP 9.7.27.1. Contractor shall conduct and enter all ongoing case management activities for State SLS. OBRA-SS, and FSSP into the CCM within the required timeframe. Contractor shal receive one ongoing case management payment each month per Member for allowable activities completed. The Department will pay for ongoing case management activities based on data pulled from the CCM on the 15th day ofthe month for activities conductec in the previous month. 9.7.28. Operations Guide 9.7.28.1. 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. 9.7.29. Operations Guide Updates 9.7.29.1. Contractor shall review the Operations Guide for years two, three, four, and five ofthis Contract, and determine if any modifications are required. Updates shall include but no. be limited to any changes in the Work, in the Department' s processes and procedures, o: 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. Contracto: 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. 9.7.30. Rapid Reintegration 9.7.30.1. Contractor shall conduct and enter all Rapid Reintegration activities at the Level of Care Assessment into the CCM 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 CCM 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. 9.7.31. 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, In-person initial At-Risk Diversion outreach, 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 CCM on the 15th day oft the month for activities from the previous month. 9.7.32. Support Need Level Assessment - HCBS-CHRP Exhibit B-4,SOW Page 48 of4 49 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D: 0B75872758B 9.7.32.1. Contractor shall maintain all supporting documentation related to the Support Need Leve. Assessment and make it available to the Department upon request. Contractor shal. 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. 9.7.33. Waiting List Management 9.7.33.1. Contractor shall enter all waiting list management contacts with individuals and families into the CCM within the required timeframe. The Department will pay for required waiting list contacts from data pulled from the CCM on the 15th ofthe month for contacts from the previous month. 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 FSSP waiting list when the event occurs during the same contact. 9.7.34. Year End Close Deadlines 9.7.34.1. The due dates identified in this section shall be adhered to, and information entered intc the CCM and/or submitted to the Department by a date identified in this Contract. For the month ofJune, the Department will notify Contractor ofthe 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. Contractor shall review all payments made by the Department to ensure all activities are appropriately reimbursed. 9.8.2. Contractor shall notify the Department of any errors in billing or payment by the 15th of the month for the prior month's s payment on the Department": S prescribed template to ensure over and under payments are adjusted. 9.8.2.1. DELIVERABLE: Payment Correction Form 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 ofthe 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-4, SOW Page 49 of 49 Docusign Envelope ID: 2ACF3C37-008-1A0.8 SDFC-DOB75872758B EXHBIT C-4, RATES Case Management Agency (CMA) Subaward Rates Table Description Rate Frequency Payment Funding Type Source Operations Guide $7,905.56 Annually- Deliverable Federal/State Year 1 ofthe Funded Contract Operations Guide Update $1,424.14 Annually - Deliverable Federal/State Years 2+of Funded the Contract Long-Range Plan $3,543.31 Annually Deliverable Federal/State Funded Committee Updates $1,071.73 Semi- Deliverable Federal/State Annually Funded Continuous Quality $506.72 Annually Deliverable Federal/State Improvement Plan Funded Complaint Trend Analysis $3,857.04 Quarterly Deliverable Federal/State Funded Case Management Training $648.75 Semi- Deliverable Federal/State Annually Funded Creation of Packet - Appeals $531.60 Per Packet Report Federal/State Funded Attendance at Hearing $490.97 Per Hearing Report Federal/State Appeals Funded IDD Critical Incident $6.30 Monthly, Per Report Federal/State Reporting (HCBS = CES, Member Funded HCBS - CHRP, HCBS - Enrolled DD, HCBS - SLS) LTSS Critical Incident $1.61 Monthly, Per Report Federal/State Reporting (HCBS - BI, Member Funded HCBS - CHCBS, HCBS- Enrolled CIH, HCBS-CWCHN, HCBS-CMHS, HCBS - EBD, CFC) HCBS Critical Incident $3,457.07 Quarterly Deliverable Federal/State Follow-Up Performance Funded Standard Human Rights Committee $5.95 Monthly, Per Report Federal/State (HCBS - CES, HCBS - Member Funded CHRP, HCBS - DD, HCBS Enrolled - SLS) Initial Level of Care $283.62 Per Report Federal/State Assessment (100.2) Assessment Funded CSR Level of Care $214.03 Per Report Federal/State Reassessment (100.2) Assessment Funded Exhibit C-4,1 Rates Page 1 of3 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B Rapid Reintegration Barrier $48.54 Per Invoice or Federal/State Questions Assessment Report Funded Rapid Reintegration $107.73 Per Invoice or Federal/State Assessment and Support Assessment Report Funded Post Rapid Reintegration $22.84 Per Survey Invoice or Federal/State Survey Questions Report Funded Interim Support Level $294.17 Per Invoice or Federal/State Assessment (ISLA) Assessment Report Funded Initial At-Risk Diversion = $104.70 Monthly Invoice or Federal/State Inl Person Report Funded Initial At-Risk Diversion - $87.45 Monthly Invoice or Federal/State Virtual Report Funded HCBS-CHRP Support Level $165.26 Per Invoice Federal/State Needs Assessment Assessment Funded Initial HCBS-CES $189.21 Per Report Federal/State Application Application Funded CSR HCBS-CES $142.76 Per Report Federal/State Application Application Funded Medicaid Eligible IDD $458.81 Per Report Federal/State Determination Determination Funded Medicaid Eligible Delay $272.96 Per Report Federal/State Determination Determination Funded IDD Determination Testing $481.10 Actual Costs Invoice Federal/State up to Rate for Funded Testing Rural Travel Add-On $37.46 Per Required Report Federal/State in Person Funded Contact for Rural and Frontier Agencies Case Management Agency (CMA) State Only Rates Table Waiting List Management $95.42 Per Contact Report State Funded Non-Medicaid Eligible IDD $458.81 Per Report State Funded Determination Determination Non-Medicaid Eligible $272.96 Per Report State Funded Delay Determination Determination Non-Medicaid Eligible IDD $481.10 Actual Costs Invoice State Funded Determination Testing up to Rate for Testing State SLS, OBRA-SS, and $349.18 Per Incident Report State Funded FSSP Critical Incident Exhibit C-4, Rates Page 2 of3 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B Reporting & Administrative Review: MANE State SLS, OBRA-SS, and $46.71 Per Incident Report State Funded FSSP Critical Incident Reporting & Investigations: Review: Non-MANE State SLS, OBRA-SS, and $125.73 Per Member Invoice State Funded FSSP Human Rights Reviewed Committee State SLS and OBRA-SS $220.69 Quarterly Deliverable State Funded Complaints Trend Analysis State SLS, OBRA-SS, and $51.81 Quarterly Deliverable State Funded FSSP CIR Follow-Up Performance Standard State SLS, OBRA-SS, and $91.67 Monthly, Per Report State Funded FSSP Ongoing Case Activity Management State SLS and OBRA-SS $104.70 Per Contact Report State Funded Monitoring - In Person State SLS and OBRA-SS $87.45 Per Contact Report State Funded Monitoring - Virtual State SLS Expenditure $625.76 Monthly Invoice State Funded Report OBRA-SS Expenditure $369.56 Monthly Invoice State Funded Report FSSP Needs Assessment $33.25 Per Report State Funded Assessment FSSP Expenditure Report $556.57 Monthly Invoice State Funded Family Support Council $418.29 Per Meeting Invoice State Funded Meetings FSSP Annual Report and $1,150.98 Annually Deliverable State Funded Evaluation Exhibit C-4, Rates Page 3 of3 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B EXHIBIT D-4, TERMINOLOGY 1. TERMINOLOGY 1.1. In addition to the terms defined in $Error! Reference source not found. of this Contract, the following list ofterms shall be construed and interpreted as follows: 1.1.1. Adverse Action - A denial, reduction, termination, or suspension from a long-term service and support program or service. 1.1.2. Affiliated Entity - An organization that directly or indirectly controls another entity, has substantially similar ownership of another entity, and/or owns a substantial share of another entity. 1.1.3. Appeal - The process a case manager participates in when an individual or Member appeals an adverse action made by the case manager. 1.1.4. 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 facility and live, instead, in a setting of their choice. 1.1.5. Behavioral Health Authorities (BHA) - The behavioral health administration established ir Part 200 of Article 50 ofTitle 27, C.R.S. 1.1.6. 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 of the holidays listed ir C.R.S. $24-11-101(1). 1.1.7. Business Interruption - Any event that disrupts Contractor's ability to complete the Work for aj period oft time, and may include, but is not limited to a Disaster, power outage, strike, loss of necessary personnel or computer virus. 1.1.8. Care and Case Management System (CCM) The Department's case management Information Technology (IT) platform. 1.1.9. 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 ofs such Member's needs. 1.1.10. Case Management Agency (CMA) - A public or private not-for-profit or for-profit organization contracted with the state of Colorado to provide case management services and activities pursuant to C.R.S. 25.5-6-1702. 1.1.11. Case Manager - A person who provides case management services and activities pursuant tc Article 6 and Article 10 ofc.R.S. Title 25.5 for Members receiving long-term services and supports. 1.1.12. Child Health Plan Plus - Colorado's public low-cost health insurance for certain children and pregnant women. It is for people who earn too much to qualify for Health First Colorado, but not enough to pay for private health insurance. 1.1.13. 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 Exhibit D-4, Terminology Page 1 of9 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D E B75872758B final deliverable for the Closeout Period, as determined in the Department-approved and updated Closeout Plan, and has determined that the closeout is complete. 1.1.14. Colorado Revised Statutes (C.R.S.) - The legal code of Colorado; the legal codified general and permanent statutes oft the Colorado General Assembly. 1.1.15. Community Centered Board (CCB) - A private for-profit or not-for profit organization that is an administrator of locally generated funding pursuant to CRS 25.5-10-206(6) and acts as a resource for persons with an intellectual and developmental disability or a child with a developmental delay. 1.1.16. Community First Choice (CFC) Servies and supports authorized through the section 1915(k) ofthe Social Security Act and provided in community settings to an individual clien: who requires an institutional level of care that would otherwise be provided in a Hospital, Nursing Facility, Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID), an institution providing inpatient psychiatric services for individuals under age 21, or an institution for mental diseases for individuals age 65 or over. 1.1.17. Complaints Any complaint received by Contractor as it relates to the services providec through this Contract to include, but not limited to general business functions, administration, State General Fund program functions, and case management functions. Excludes any complaints regarding activities outside the scope ofthis Contract. 1.1.18. Consumer-Directed Attendant Support Services (CDASS) - The service delivery option for 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 activities. 1.1.19. Contract = The agreement, including all attached Exhibits, all documents incorporated by reference, all referenced statutes, rules and cited authorities, and any future modifications thereto, that is entered into as a result of this solicitation. 1.1.20. Contract Funds - The funds that have been appropriated, designated, encumbered, or otherwise made available for payment by the State under the Contract resulting from this Solicitation. 1.1.21. Contractor - The individual or entity selected as a result of this solicitation to complete the Work contained in the Contract. 1.1.22. Contractor Pre-Existing Material - Material, code, methodology, concepts, process, systems, 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. 1.1.23. Corrective Action Plan - A written plan, which includes the specific actions the agency shall take to correct non-compliance with regulations and contractual obligations, which stipulates the date by which each action shall be completed. 1.1.24. Critical Incident - An actual or alleged event that creates the risk of serious harm to the health or welfare of an individual receiving services; and it may endanger or negatively impact the mental and/or physical well-being of an individual. 1.1.25. Critical Incident Report (CIR) Mistreatment, Abuse, Neglect or Exploitation (MANE) = A Critical Incident Report entered into the CCM with a category of Mistreatment, Abuse, Neglect, or Exploitation. Exhibit D-4, Terminology Page 2 of9 Docusign Envelope ID: 2ACF3C37-908-1ADPBDC-D08788727588 1.1.26. Critical Incident Report (CIR) Non-MANE - A Critical Incident Report entered into the CCM with a category of criminal activity, damage to consumer's property/theft, death, injury/illness, medication management issues, missing persons, other high-risk issues, and unsafe housingdisplacement. 1.1.27. Data - State Confidential Information and other State information resources transferred to Contractor for the purpose of completing a task or project assigned in the Statement ofWork. 1.1.28. Deliverable - Any tangible or intangible object produced by Contractor as a result of the work that is intended to be delivered to the Department, regardless of whether the object is specifically described or called out as a "Deliverable" or not. 1.1.29. Department - The Colorado Department ofHealth Care Policy and Financing, a department oft the government of the State ofColorado. 1.1.30. Designated Service Area - The geographical area determined by the State Department to be served by a Case Management Agency per C.R.S. 25.5-6-1702. 1.1.31. Disaster An event that makes it impossible for Contractor to perform the Work out of its regular facility or facilities, and may include, but is not limited to, natural disasters, fire, o: terrorist attacks. 1.1.32. Effective Date - The date on which the Contract resulting from this solicitation is approved and signed by the Colorado State Controller or designee, as shown on the Signature and Cover Page for the Contract. 1.1.33. Eligibility Determination The eligibility of an individual for a Long-Term Services and Supports (LTSS) program is determined by meeting all the requirements of the program, including Level of Care Determination and financial eligibility. 1.1.34. Fraud - An intentional deception or misrepresentation made by a person with the knowledge 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. 1.1.35. Goods - Any movable material to be acquired, produced, or delivered by Contractor which shall include any movable material acquired, produced, or delivered by Contractor in 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 Portability and Accountability Act of 1996, as amended. 1.1.38. Home and Community Based Services (HCBS) Waivers Services and supports authorized through a 1915(c) waiver of the Social Security Act and provided in community settings to an individual 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 Waive: for Children with Complex Health Needs (HCBS-CWCHN), Home and Community Based Services Community Mental Health Supports Waiver (HCBS-CMHS), Home and Community Based Services Waiver for Persons with Developmental Disabilities (HCBS- Exhibit D-4, Terminology Page: 3 of9 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 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 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 are ventilator-dependent or medically complex. 1.1.40. Incident - Any accidental or deliberate event that results in or constitutes an imminent threa: of the unauthorized access or disclosure of State Confidential Information or of the unauthorized modification, disruption, or destruction ofany State Records. 1.1.41. In-Home Services and Supports (IHSS) - Means services that are provided in the home and in the community by an Attendant under the direction of the Member or Member'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 services. 1.1.42. Intermediate Care Facility (ICF) - A residential facility that is certified by the Centers for Medicare and Medicaid (CMS) to provide habilitative, therapeutic and specialized suppor. services to persons with intellectual and developmental disabilities. 1.1.43. Intake, Screening and Referral - The initial contact between the individual and Contractor and shall include but is not limited to a preliminary screening in the following areas: ar individual's need for long term services and supports; an individual's need for referral to other programs or services; an individual's eligibility for financial and program assistance; and the need for a Level of Care Screen ofthe individual seeking services. 1.1.44. Key Personnel - The position or positions that are specifically designated as such in the Contract. 1.1.45. Learning Management System (LMS) - An online software application for the administration, delivery and tracking of case management training programs and materials. 1.1.46. Level ofCare - The level of assistance needed by an individual seeking services or a Member to perform activities of daily living, to include mobility; bathing; dressing; eating; toileting: transferring; and need for supervision as determined by the Level of Care Screen. 1.1.47. Level ofCare Determination - The eligibility determination of an individual for a Long-Term. Services and Supports (LTSS) program by a Case Management Agency as determined by the requirements of the program, using the Department prescribed instrument. 1.1.48. Long Term Care notice ofaction - The form required to be sent to individuals by Contractor within 11 Business Days regarding their appeal rights in accordance with 10 CCR 2505-10 8.507 et seq. 1.1.49. Long Term Services and Supports (LTSS) - The services and supports used by Members of all ages with functional limitations and chronic illnesses who need assistance to perform routine daily activities such as bathing, dressing, preparing meals, and administering medications. 1.1.50. Long Term Services and Supports (LTSS) Programs - Any oft the following publicly fundec programs: CHCBS, FSSP, HCBS-BI, HCBS-CES, HCBS-CHRP, HCBS-CWCHN, HCBS- CMHS, HCBS-DD, HCBS-EBD, HCBS-CIH, HCBS-SLS, CFC, HBU, Medicaid Nursing Facilities, OBRA-SS, PACE, State SLS. Exhibit D-4, Terminology Page 4 of9 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 1.1.51. Long Term Services and Supports Level of Care Eligibility Determination Screen (LOC Screen) - An evaluation conducted by 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) programs. 1.1.52. Medical Assistance (MA) Site - Designated sites allowed by statute or certified by the Department of Health 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. 1.1.53. Member - Any individual enrolled in the Colorado Medicaid program, State General Fund program, Colorado's CHP+ program or the Colorado Indigent Care Program, as determined by the Department. 1.1.54. National Core Indicators-Aging and Disabilities (NCI-AD) - Standard measures used across 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 of All-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 o: 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 making, and conduct futures planning with valid and reliable LTSS data. 1.1.55. Nursing Facility - A facility provider that meets the state nursing facility licensing standards established pursuant to C.R.S. $25-1.5-103 and is maintained primarily for the care anc treatment of inpatients under the direction of a physician. 1.1.56. Offeror - Any individual or entity that submits a proposal, or intends to submit a proposal, in response to this solicitation. 1.1.57. Operational Start Date - When the Department authorizes Contractor to begin fulfilling its obligations under the Contract. 1.1.58. Organized Health Care Delivery System - A Case Management Agency that contracts with other qualified providers to furnish services authorized in CHCBS, HCBS-BI, HCBS- CWCHN, HCBS-CES, HCBS-CIH, HCBS-CHRP, HCBS-CMHS, HCBS-DD, HCBS-EBD, 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. 1.1.59. Other Personnel - Individuals and Subcontractors, in addition to Key Personnel, assigned tc positions to complete tasks associated with the Work. Exhibit D-4, Terminology Page 5 of9 Docusign Envelope ID: ZACF3C37-0068-41A0-BDF C- OB75872758B 1.1.60. Pandemic Refers to an epidemic that has spread over several countries or continents, usually affecting a large number of people. 1.1.61. Period ofPerformance Means the total estimated time interval between the start ofan initial 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 3 200.211(b)(5) does not commit the awarding agency to fund the award beyond the currently approved budget period. 1.1.62. Person-Centered Approach - Respecting and valuing individuals' and Members' preferences, strengths, and contributions. 1.1.63. 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 informs the member of their rights and responsibilities. 1.1.64. Person-Centered Support Planning The process of working with the Member receiving 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 of the Member and of community resources. Support planning informs the Member receiving services of their rights and responsibilities. 1.1.65. Personally Identifiable Information 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 ofbirth, mother's 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 identifiable information in $24-72-501 C.R.S. 1.1.66. Pre-Admission Screening and Resident Review (PASRR) - The review that occurs for all individuals seeking admission to a Medicaid nursing facility to screen the Client for evidence of serious mental illness and/or intellectual and developmental disabilities or related conditions. The review determines whether the individual needs the level of services that a nursing facility provides and whether individuals who need nursing facility services also need specialized services. 1.1.67. Professional Medical Information Page (PMIP) - The medical information document signed by a licensed medical professional used as a component of the Level of Care Screening and Assessment to determine the individual's or Member's need for an LTSS program. 1.1.68. Program - A publicly funded program including but not limited to: Home and Community Based Services Waivers, Community First Choice (CFC), Medicaid Nursing Facility, Hospital Back-Up, Program for All-Inclusive Care for the Elderly (PACE), and State General Funded (SGF) Programs. 1.1.69. Protected Health Information - Any protected health information, including, without limitation any information whether oral or recorded in any form or medium: (i) that relates Exhibit D-4, Terminology Page 6 of9 Docusign Envelope ID: 2ACF3C37-0068-1A0-BDFC-D0B75872758B 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. 1.1.70. Provider - Any health care professional or entity that has been accepted as a provider in the Colorado Medicaid program, Colorado's CHP+ program or the Colorado Indigent Care Program, as determined by the Department. 1.1.71. Quality Improvement Strategy (QIS) - The Department's process to measure and improve its performance in meeting the HCBS waiver assurances annually as set forth in 42 CFR 441.301 and 441.302. QIS is also utilized to measure and improve quality performance for CFC. 1.1.72. Quarter - Four (4) distinct time periods during the State Fiscal Year. Quarter one (1) begins 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 Apri. 1 and ends June 30. 1.1.73. Rapid Referral - The Person-Centered process that occurs when a Member, who is seeking 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 Coordination Services. 1.1.74. Rapid Reintegration the Person-Centered process that occurs when a Member, who will be 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 Rapic Reintegration Plan. 1.1.75. Rapid Reintegration Plan = a written Person-Centered plan developed for the purpose of rapidly transitioning a Member(s) from a nursing facility and safely into the Community. 1.1.76. Regional Accountable Entity (RAE) - - A single regional entity responsible for duties previously performed by Regional Care Collaborate Organizations and Behavioral Health Organizations (BHO). 1.1.77. Resource Development The study, establishment and implementation of additional resources or services that extend the capabilities ofcommunity based LTSS systems to better serve LTSS applicants and Members and those likely to need community based LTSS in the future. 1.1.78. Rural and Frontier Defined Service Areas that are eligible for rural travel add-on reimbursement fori required in-person activities reimbursed through this Contract. 1.1.79. Services - The services and activities to be performed by Contractor as set forth in this Contract and shall include any services and activities to be rendered by Contractor in connection with the Goods. Services identified through this Contract specifically exclude any Home and Community Based Services, State Plan Benefit Services, and other Medicaid services reimbursed through a Medicaid Provider Agreement. 1.1.80. Start-Up Period - The period starting on the Effective Date and ending on the Operational Start Date. Exhibit D-4, Terminology Page 7 of9 Docusign Envelope ID: 2ACF3C3-0088-41A0BDFC-008758727888 1.1.81. State - The State of Colorado, acting by and through any State agency. 1.1.82. State Fiscal Rules - The fiscal rules promulgated by the Colorado State Controller pursuant to C.R.S. 24-30-20203)0). 1.1.83. State Fiscal Year - The 12-month period beginning on July 1 of each calendar year and ending on June 30 of the following calendar year. Ifa single calendar year follows the term, then it means the State Fiscal Year ending in that calendar year. 1.1.84. State Intellectual Disability Authority (SIDA) - The person authorized by the Department to 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 Determination to the nursing facility. 1.1.85. State General Fund Programs - Case management, services, and supports authorized by the General Assembly and provided in the family home, a community setting, or Nursing 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 1987 Specialized Services Program (OBRA-SS). 1.1.86. State Records Any and all State data, information, and records, regardless of physical form, including, but not limited to, information subject to disclosure under CORA. 1.1.87. Subcontractor - Third parties, if any, engaged by Contractor to aid in performance of the Work. 1.1.88. Support Need Level Assessment - The standardized assessment tool to identify and measure the practical support requirements for HCBS-CHRP waiver participants. 1.1.89. Surcharge - Any additional amount added by Contractor, over and above the rate charged by the subcontractor to Contractor, which would be shown on an individual's: support plan or on encounter data service rates submitted to the Department. 1.1.90. 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. 1.1.91. Target Criteria - Department defined criteria based on Member needs to access services under a HCBS waiver. 1.1.92. Targeted Case Management (TCM) - Required case management activities for Members enrolled in a HCBS waivers and/or CFC as defined in 10 CCR 2505-10 8.760 et seq. that are reimbursed as a State Plan benefit and through a Medicaid Provider Agreement. TCM 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 individuals' entrance into the waiver or State General Fund programs until approved capacity and funding become available. 1.1.94. Work - 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 o: 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 of the Work. "Work Exhibit D-4, Terminology Page 8 of9 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B Product" does not include any material that was developed prior to the Effective Date that is used, without modification, in the performance of the 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: 2.1.1. CFC - Community First Choice 2.1.2. CFR = Code of Federal Regulations 2.1.3. CHP+ -Child Health Plan Plus 2.1.4. CORA -Colorado Open Records Act, C.R.S. $24-72-200.1, et. seq. 2.1.5. C.R.S. = Colorado Revised Statutes 2.1.6. CPI - Consumer Price Index 2.1.7. CPI-U - CPI for all urban consumers 2.1.8. HIPAA - Health Insurance Portability and Accountability Act of 1996, as amended. 2.1.9. MFCU - the Colorado Medicaid Fraud Control Unit in the Colorado Department ofLaw 2.1.10. PCI - Payment Card Information 2.1.11. PHI - Protected Health Information 2.1.12. PII - Personally Identifiable Information 2.1.13. SFY - State Fiscal Year 2.1.14. U.S.C. - United States Code 2.1.15. VARA - Visual Rights Act of 1990 Exhibit D-4, Terminology Page 9 of9 Docusign Envelope ID: ZACF3C37-0068-41A0-B FC-D0B758727585 EXHIBIT E-4, CONTRACTORS ADMINISTRATIVE REQUIREMENTS 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. Baca County 1.2.2. Kiowa County 1.2.3. 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 containec in the Contract or to perform any of the Department's responsibilities. In the event ofa conflict between Contractor and any other State contractor, the State will resolve the conflict anc Contractor shall abide by the resolution provided by the State. 1.5. Contractor shall inform the Department on current trends and issues in the healthcare marketplace and provide information on new technologies in use that may impact Contractor": S responsibilities under this Contract. 1.6. Contractor shall maintain complete and detailed records ofall 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 tc the Department upon request throughout the term ofthe Contract. 1.7. Contractor shall submit a 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 or knowledge ofi media contact, Contractor must notify the Department using the template provided. 1.7.1. DELIVERABLE: Media Event Report 1.7.2. DUE: mmediately Following Direct or Indirect Contact with or Knowledge of Media Contact 1.8. Deliverables 1.8.1. All Deliverables shall meet Department-approved format and content requirements. The Department will specify the number of copies and media for each Deliverable. Exhibit E-4, Contractor's. Administrative Requirements Page 1 of22 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 1.8.1.1. 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: 1.8.1.1.1. Gather and document requirements for the Deliverable. 1.8.1.1.2. Create a draft in the Department-approved format for the individual Deliverable. 1.8.1.1.3. Perform internal quality control review(s) of the Deliverable, including, but nct limited to: 1.8.1.1.3.1. Readability. 1.8.1.1.3.2. Spelling. 1.8.1.1.3.3. Grammar. 1.8.1.1.3.4. Completion. 1.8.1.1.3.5. Accessibility. 1.8.1.1.4. Adhere to all required templates or development of templates. 1.8.1.1.5. Perform modifications that include version control and tracked changes. 1.8.1.2. The Department will review the Deliverable and may direct Contractor to make changes to the 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 period in writing. 1.8.1.2.1. Changes the Department direct include, but are not limited to, modifying portions cf the Deliverable, requiring new pages or portions of the Deliverable, requiring resubmission of the Deliverable or requiring inclusion ofinformation or components that were left out of the Deliverable. 1.8.1.2.2. The Department may also direct Contractor to provide clarification or provide a walkthrough of any Deliverable to assist the Department in its review. Contracter shall provide the clarification or walkthrough as directed by the Department. 1.8.1.3. Once the Department has received an acceptable version of the 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 S notice to Contractor of its acceptance of that Deliverable. 1.8.2. Contractor shall employ an internal quality control process to ensure that all Deliverables are 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 Deliverables for reference as directed by the Department. 1.8.3. In the event any due date for a Deliverable falls on a day that is not a Business Day, the due date shall be automatically extended to the next Business Day, unless otherwise directed by the Department. Exhibit E-4, Contractor's Administrative Requirements Page 2 of22 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 1.8.4. 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 otherwise. 1.8.5. No Deliverable, report, data, procedure or system created by Contractor for the Department that is necessary to fulfilling Contractor's responsibilities under the Contract, as determined by the Department, shall be considered proprietary. 1.8.6. Ifany Deliverable contains ongoing responsibilities or requirements for Contractor, such as Deliverables that are plans, policies or procedures, then Contractor shall comply with all requirements oft the most recently approved version ofthat 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, milestones and Deliverables ofthis Contract. 1.8.6.1. Any Deliverable described as an update of another Deliverable shall be considered a version ofthe original Deliverable for the purposes of this subsection. 1.9. Stated Deliverables and Performance Standards 1.9.1. 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 in this Statement ofWork and provide a clear due date for the Deliverables. The sections with these headings are for ease ofr reference nct 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. 1.10. Communication with the Department 1.10.1. Contractor shall enable all Contractor staff to exchange documents and electronic files with the Department staff in formats compatible with the Department's systems, including Microsoft Office products. Contractor shall communicate with the Department's primary designee, who will be identified to Contractor, to obtain information about the specific Microsoft products currently in use, as may be upgraded from time to time. At a minimum, Contractor shall have the capability to exchange documents and electronic files compatible with Microsoft Office 365, unless the Department's primary designee otherwise specifies. If Contractor 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 Department': 's systems. 1.10.2. The Department will use a transmittal process to provide Contractor with official direction within the scope ofthe Contract. Contractor shall comply with all direction contained within a completed transmittal. For a transmittal to be considered complete, it must include, at a minimum, all oft the following: 1.10.2.1. The date the transmittal will be effective. 1.10.2.2. Direction to Contractor regarding performance under the Contract. Exhibit E-4, Contractor's. Administrative Requirements Page 3 of22 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 1.10.2.3. A due date or timeline by which Contractor shall comply with the direction contained in the transmittal. 1.10.2.4. The signature oft the Department employee who has been designated to sign transmittals. 1.10.2.4.1. The Department will provide Contractor with the name oft the person it 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 ofi its designees from time to time by providing notice to Contractor through a transmittal. 1.10.3. 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 available. 1.10.3.1. Ifa transmittal is delivered through a dedicated communication system or other electronic system, then the Department may use an electronic signature to sign that transmittal. 1.10.4. If Contractor receives conflicting transmittals, Contractor shall contact the Department's primary designee, or backup designees if the primary designee is unavailable, to obtai direction. If the Department does not provide direction otherwise, then the transmittal with the latest effective date shall control. 1.10.5. In the event that Contractor receives direction from the Department outside ofthe transmittal 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 transmittal prior to complying with that direction. 1.10.6. Transmittals may not be used in place of an amendment, and may not, under any 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 Contractor without using a transmittal. 1.10.7. Contractor shall retain all transmittals for reference and shall provide copies of any received transmittals upon request by the Department. 1.10.8. 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. 1.10.8.1. DELIVERABLE: Self-Disclosure of Contract Requirements Not Met 1.10.8.2. DUE: Within Three Business Days of! Discovery 1.11. Individual and Member Engagement 1.11.1. Person- and Family-Centered Approach 1.11.2. Contractor shall actively engage Members in their health and well-being by demonstrating the following: Exhibit E-4, Contractor's. Administrative. Requirements Page 4 of22 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 1.11.2.1. Responsiveness to Member and family/caregiver needs byi incorporating best practices in communication and cultural responsiveness in service delivery. 1.11.2.2. Utilization ofvarious tools to communicate clearly and concisely. 1.11.2.3. Contractor shall align Member engagement activities with the Department's person- and family-centered approach that respects and values individual preferences, strengths, and contributions. 1.12. Cultural Responsiveness 1.12.1. 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 orientation, or gender identity. 1.12.2. Contractor shall provide all information for individuals and Members in a manner and format that may be easily understood and is readily accessible by individuals and Members. 1.12.3. Readily accessible is defined as electronic information and services that comply with modern accessibility standards, such as Section 508 of the Americans with Disabilities Act, Section 504 oft the Rehabilitation Act. 1.13. Language Assistance Services 1.13.1. Contractor shall provide language assistance services including bilingual staff and/o: 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. 1.13.2. Contractor shall make oral interpretation available in all languages. 1.13.3. Contractor shall ensure the competence of language assistance provided by interpreters and bilingual staff. 1.13.4. Contractor shall not use family and friends to provide interpretation services except by request oft the individual or Member. 1.13.5. Contractor shall provide interpreter services for all interactions with individuals and Members when there is no Contractor staff person available who speaks a language understood by an individual or Member. 1.13.6. Contractor shall notify individuals and Members verbally regarding the individual's or Member's right to receive the following language assistance services, as well as how to access the following language assistance services. 1.13.7. Oral interpretation for any language. Oral interpretation requirements apply to all non- English languages, not just those that the state identifies as prevalent. 1.13.8. Contractor shall ensure that language assistance services shall include, but are not limited to, the use of auxiliary aids such as TTY/TDY and American Sign Language. 1.13.9. Contractor shall ensure that customer service telephone functions easily access interpreter or bilingual services. 1.14. Written Materials for Individuals and Members Exhibit E-4, Contractor's. Administrative Requirements Page 5 of22 Docusign Envelope ID: ZACF3C37-0068-41A0-BDF C OB75872758B 1.14.1. 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. 1.14.2. Contractor shall ensure that all written materials it creates for distribution to individuals and Members are culturally and linguistically appropriate to the recipient. 1.14.3. Contractor shall write all materials in easy-to-understand language. 1.15. Individual and Member Communications 1.15.1. Contractor shall maintain consistent communication, both proactive and responsive, with individuals and Members. 1.15.2. Contractor shall assist any individual or Member who contacts Contractor, including individuals and Members not in Contractor's Defined Service Area who need assistance with contacting his/her/their CMA, CCB, RAE, or other agencies. 1.16. Individual and Member Rights 1.16.1. Contractor shall have written policies guaranteeing each individual's and Member's right to be treated with respect and due consideration for their dignity and privacy. 1.16.2. Contractor shall provide information to individuals and Members regarding their rights that include, but are not limited to: 1.16.2.1. The right to be treated with respect and due consideration for their dignity and privacy. 1.16.2.2. The right to participate in decisions regarding their services. 1.16.2.3. The right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation. 1.16.2.4. The right to request and receive a copy of their records. 1.16.2.5. The right to obtain available and accessible services under the Contract. 1.16.3. Contractor shall post and distribute rights to individuals, including but not limited to: 1.16.3.1. individuals/Members, 1.16.3.2. Individual' s/Member's families. 1.16.3.3. Providers. 1.16.3.4. Case Workers. 1.16.3.5. Stakeholders. 1.17. Start-Up Plan 1.17.1. Contractor shall create a Start-Up Plan in year one of the Contract that contains, at a minimum, the following: 1.17.1.1. A description of all steps, timelines, and milestones necessary to fully transition the services described in the Contract from a prior contractor to Contractor. 1.17.1.2. A description of all steps, timelines, milestones, and Deliverables necessary for Contractor to be fully able to perform all Work by the Operational Start Date. 1.17.1.3. A listing ofall personnel involved in the start-up and what aspect of the start-up they are responsible for. Exhibit E-4, Contractor's Administrative Requirements Page 6 of22 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 1.17.1.4. An operational readiness review for the Department to determine if Contractor is ready to begin performance of all Work. 1.17.1.5. The risks associated with the start-up and a plan to mitigate those risks. 1.17.1.5.1. DELIVERABLE: Start-Up Plan 1.17.1.5.2. DUE: 20 Calendar Days Prior to the Contract Start Date 1.18. Start-Up Period 1.18.1. With input from the Department, Contractor shall complete all of the following during the Start-Up Period in year one oft the Contract: 1.18.1.1. Schedule and facilitate a Kickoff Meeting that includes the following: 1.18.1.1.1. Key Personnel. 1.18.1.1.2. Department Leadership. 1.18.1.1.3. Department Project Team Members. 1.18.1.1.4. Any other relevant and needed persons or organizations. 1.18.1.2. Develop Kickoff Meeting materials and an agenda that contains, at a minimum, the following: 1.18.1.2.1. Initial timelines for starting the Work and creating initial Deliverables. 1.18.1.2.2. Establishment of Communication channels to describe how the Work is to be completed. 1.18.1.2.3. Transmission methods and specific Deliverable templates or requirements. 1.18.1.2.4. Any other item required to initiate and ensure Work is started and completed on time. 1.18.1.3. Prepare Kickoff Meeting Minutes and deliver them to the Department for review and approval. 1.18.1.3.1. DELIVERABLE: Kickoff Meeting Agenda & Materials 1.18.1.3.2. DUE: Within three Business Days after the Kickoff Meeting 1.18.1.4. 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 Contract. Such policies and/or procedures shall be included, but are not limited to: 1.18.1.4.1. Determination ofDevelopmental Disability 1.18.1.4.2. Defined Service Area Exceptions Process 1.18.1.4.3. Member Rights 1.18.1.4.4. Critical Incident Reporting 1.18.1.4.5. Gricvance/Complaint Procedures 1.18.1.4.6. Monitoring 1.18.1.4.7. Human Rights Committee 1.18.1.4.8. Community Advisory Committee Exhibit E-4, Contractor's. Administrative Requirements Page 7 of22 Docusign Envelope ID: 2ACF3C37-008-1AP8DFC-D08788727588 1.18.1.4.9. Training 1.18.1.4.10. Case Management Operations 1.18.1.4.11. After-hours Policies and Procedures 1.18.1.4.12. Denial and Discontinuation of Services 1.18.1.4.13. Safeguards Necessary to Prevent Conflict of Interest 1.18.1.5. 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-U, 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. 1.18.1.5.1. DELIVERABLE: Policies & Procedures Manual 1.18.1.5.2. DUE: No later than the Operational Start Date 1.19. Operations Guide 1.19.1. Contractor shall not engage in any Work under the Contract, other than the Work described in this Sections 1.116 and 12.17 prior to the Operational Start Date. The Department sha.l 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. 1.19.2. Contractor shall create and implement an Operations Guide. The Operations Guide shal include the creation and management ofi the following: 1.19.2.1. Communication Plan. 1.19.2.2. Business Continuity Plan. 1.19.2.3. Closeout Plan. 1.19.3. Contractor shall submit the Operations Guide to the Department for review and approval. 1.19.3.1. DELIVERABLE: Operations Guide 1.19.3.2. DUE: Within 30 Business Days after the Effective Date 1.19.4. 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. 1.19.4.1. DELIVERABLE: Annual Operations Guide Update 1.19.4.2. DUE: Annually, by July 315t 1.19.5. The Operational Start Date shall not occur until Contractor has completed all requirements ofthe Operations Guide unless the Department provides written approval otherwise. 1.19.6. Communication with Members, Providers, and Other Entities Exhibit E-4, Contractor's. Administrativel Requirements Page 8 of22 Docusign Envelope ID: 2ACF3C37-0068-1A0-BDFC-D0B75872758B 1.19.6.1. Contractor shall create a Communication Plan that includes, but is not limited to, all of the following: 1.19.6.1.1. 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. 1.19.6.1.2. A description of the communication methods, including things such as email lists, newsletters and other methods, that Contractor will use to communicate with Providers and Subcontractors. 1.19.6.1.3. The specific means of immediate communication with Members and a method for accelerating the internal approval and communication process to address urgent communications or crisis situations. 1.19.6.1.4. 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 are insufficient. 1.19.6.1.5. A listing ofthe following individuals within Contractor's organization, including cell phone numbers and email addresses: 1.19.6.1.5.1. An individual who is authorized to speak on the record regarding the Work, the Contract or any: issues that arise that are related to the Work. 1.19.6.1.5.2. An individual who is responsible for any website or marketing related to the Work. 1.19.6.1.5.3. Back-up communication staff that can respond in the event that the other individuals listed are unavailable. 1.19.6.1.5.4. An outline of the process for the Contractor's communication, timely responses and emergency protocols in the event there is a natural disaster or Pandemic. 1.19.6.1.5.5. 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. 1.19.7. Business Continuity Plan 1.19.7.1. 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 to a 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: 1.19.7.1.1. The essential services and functions provided by Contractor. 1.19.7.1.2. The lead person and response team responsible for implementing the business continuity plan, individual/team roles, and contact information. 1.19.7.1.3. How emergency responses procedures will be implemented and who will activate the business continuity plan. Exhibit E-4, Contractor's. Administrative Requirements Page 9 of22 Docusign Envelope ID: 2ACF3C37-008-1AD8DFC-D08788727588 1.19.7.1.4. How Contractor will implement a flexible work plan that includes social distancing hygiene etiquette, cancellation ofr non-essential activities, closure ofbuildings, and/or relocation to alternative facilities. 1.19.7.1.5. How Contractor will address training personnel, preparing equipment, and backup systems. 1.19.7.1.6. How Contractor will address budget and finance mechanisms to ensure financing of essential services. 1.19.7.1.7. How Contractor will ensure necessary supplies and equipment are available to maintain essential services. 1.19.7.1.8. 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. 1.19.7.1.9. 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 contrcl response and immediate mandatory sick leave. 1.19.7.1.10. How Contractor will ensure or enhance communication and information technology infrastructure to support tele-commuting. 1.19.7.1.11. How Contractor will back-up all information necessary to continue performing the Work remotely, sO that no information is lost because ofal Business Interruption. 1.19.7.1.12. In the event of a Disaster, the plan shall also include how Contractor will make al information available at its back-up facilities. 1.19.7.1.13. How Contractor will maintain complete back-up copies of all data, databases, operating programs, files, systems, and software pertaining to enrollment information at a Department-approved, off-site location. 1.19.7.1.14. How Contractor will minimize the effects on Members of any Business Interruption to include how Contractor will notify Members of closures and cancellations. 1.19.7.1.15. How Contractor will communicate with the Department during the Business Interruption and points of contact within Contractor's organization the Department can contact in the event of a Business Interruption. 1.19.7.1.16. How Contractor will transition from in-person meetings to conference calls or other virtual platforms or cancel or delay meetings as necessary. 1.19.7.1.17. Planned long-term back-up facilities out ofwhich Contractor can continue operations after a Disaster. 1.19.7.1.18. The time period it will take to transition all activities from Contractor's regular facilities to the back-up facilities after a Disaster. 1.19.7.1.19. How Contractor will prepare necessary internal staff for implementing the business continuity plan, which may include tests, drills, or training annually and revising the plan based on lessons learned. 1.19.7.1.20. How Contractor will identify and engage with external organizations to help the community, such as sharing best practices and sharing timely and accura:e information about a Business Interruption. Exhibit E-4, Contractor's Administrative Requirements Page 10 of22 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 1.19.7.1.21. How Contractor will implement steps to return to normal after a Business Interruption. 1.19.8. Closeout Plan 1.19.8.1. 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: 1.19.8.1.1. Transfer ofi individuals and Members 1.19.8.1.2. Transfer of documentation to include all electronic and physical documentation. 1.19.8.1.3. Transfer of all individual and Member records through the Department Case Management Systems. 1.19.8.1.4. Transfer of services 1.19.8.1.5. Transfer of Case Management Services 1.19.8.2. 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 ofthe transition on Members and the Department. 1.19.8.2.1. Contractor shall ensure all policy, procedures, training, and appeals information are transferred to the Department. 1.19.8.3. Contractor shall deliver the Closeout Plan to the Department for review and approval. 1.19.8.4. Contractor shall provide weekly updates to the Department throughout the creation ofand the performances within the Operations Guide, that show Contractor's status toward meeting the milestones described herein. 1.19.8.5. Contractor shall be ready to perform all Work by the Operational Start Date. 1.19.9. Closeout Period 1.19.9.1. During the Closeout Period, Contractor shall complete all ofthe following: 1.19.9.1.1. 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 Update that has been approved by the Department. 1.19.9.1.2. Provide to the Department, or any other contractor at the Department's direction, al reports, data, systems, Deliverables, and other information reasonably necessary fcr a transition as determined by the Department or included in the most recent Closeout Plan or Closeout Plan Update that has been approved by the Department. 1.19.9.1.3. Ensure that all responsibilities under the Contract have been transferred to the Department, or to another contractor at the Department's direction, without significart interruption. Exhibit E-4, Contractor's. Administrative Requirements Page I1 of22 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 1.19.9.1.4. Notify any Subcontractors of the termination of the Contract, as directed by the Department. 1.19.9.1.5. 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. 1.19.9.1.5.1. DELIVERABLE: Member Notifications 1.19.9.1.5.2. DUE: 90 Calendar Days prior to termination ofthe Contract 1.19.9.2. 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 determination for that requirement. 1.19.9.3. 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 requirements shall survive termination ofthe Contract. 1.19.10. Long-Range Plan 1.19.10.1. 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: 1.19.10.1.1. Administrative and case management accomplishments of Contractor in the previous year. .19.10.1.2. Identified unmet needs of eligible persons in the Defined Service Area and action steps necessary to meet those needs. 1.19.10.1.3. How Contractor will solicit input from Members and families to ensure quality services. 1.19.10.1.4. Local area issues that impact or are expected to impact the Defined Service Area and action steps on how to resolve those issues. 1.19.10.1.5. Policies that are considered by Contractor to be a barrier to ensuring a comprehensiv: case management system and suggested modifications to overcome the barriers. 1.19.10.1.6. A summary ofhow 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 Defined Service Area. 1.19.10.1.7. A summary of how Contractor is working to recruit new and existing providers to expand their services in the Defined Service Area. Exhibit E-4, Contractor's Administrative Requirements Page 12 of22 Docusign Envelope ID: 2ACF3C37-00841ADSDFC-008788727588 1.19.10.1.8. A summary of past efforts and future plans to accelerate equity, diversity, inclusion, and access. 1.19.10.1.9. The Contractor's efforts to recruit members oft the Community Advisory Committee who represent the characteristics of the community as it relates to diversity of race, ethnicity, religious affiliation, etc. 1.19.10.1.10. How Contractor will engage with and facilitate existing social networks including, but 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 Defined Service Area. 1.19.10.1.11. How State General Fund programs and supports will be used to support individuals, Members, and families within the Defined Service Area. 1.19.10.1.12. How the voices of historically underserved and marginalized communities will be incorporated into decision-making within the Defined Service Area. 1.19.10.1.13. How feedback will be obtained from community members, Members receiving services, and individuals seeking or waiting for services and how the feedback will be incorporated into strategies for delivering case management services within the Defined Service Area. 1.19.10.1.13.1. DELIVERABLE: Long-Range Plan 1.19.10.1.13.2. DUE: At this interval: 1.19.10.1.14. September 15, 2026 for Contractors with names beginning in A through M 1.19.10.1.15. September 15, 2027 for Contractors with names beginning in N through Z 1.19.10.1.16. September 15, 2028 for Contractors with names beginning in A through M 1.19.10.1.17. September 15, 2029 for Contractors with names beginning in N through Z 1.19.10.2. Contractor shall present the key findings from the Long-Range Plan to the Departmen: within 20 Business Days of the Long-Range Plan being submitted to the Department. 1.19.10.3. Contractor shall make any changes to the Long-Range Plan as directed by the Department and resubmit the Deliverable within 10 Business Days of the request. 1.19.11. Community Advisory Committee 1.19.11.1. Within 30 Calendar Days of the Contract execution date, Contractor shall establish a Community Advisory Committee ofno less than five committee members that will meet atl 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. 1.19.12, The Community Advisory Committee shall include, but not be limited to, at least one person as the regional representation from among the following categories: 1.19.12.1. 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, and Exhibit E-4, Contractor's Administrative Requirements Page 13 of22 Docusign Envelope ID: 2ACF3C37-008-1A08DFC-D08758727588 1.19.12.2. Regional representation from one or more LTSS Members or family members cf individuals receiving LTSS and make every effort to recruit and maintain a majority of individuals with this lived experience on the committee: 1.19.12.2.1. Members with I/DD and/or 1.19.12.2.2. Members with disabilities 1.19.12.2.3. Members shall be given priority of selection over family members. 1.19.13. Contractor shall submit the Community Advisory Committee member list annually on the template prescribed by the Department. 1.19.14. If Contractor is unable to recruit and maintain a majority of members, advocates, and people with lived experience on the committee, Contractor shall outline efforts to do SO with their deliverable submissions. 1.19.14.1. DELIVERABLE: Community Advisory Committee Member List 1.19.14.2. DUE: Annually, by August 15th 1.19.15. Contractor shall notify the Department of any changes to Community Advisory Committee membership within 10 Business Days of the date of change. 1.19.15.1. DELIVERABLE: Community Advisory Committee Membership Updates 1.19.15.2. DUE: Within 10 Business Days of the date of change to the membership list. 1.19.16. The Community Advisory Committee shall include at least two regional representatives of individuals or family members of individuals receiving long-term disability and/or I/DD services. 1.19.17. The Contractor shall demonstrate efforts to recruit members ofthe committee who represen: the characteristics of the community as it relates to diversity of race, ethnicity, religious affiliation, etc. These efforts shall be reflected in the Long-Range Plan. 1.19.18. The Community Advisory Committee is an advisory body to the Contractor that provides recommendations and is not a decision-making body. As such the Community Advisory Committee shall: 1.19.18.1. 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 barriers at a local or regional level, in the Long-Range Plan. 1.19.18.2. Support the Contractor with developing strategies for resolving complaints at the local or regional level. 1.19.18.3. Maintain and post public notices of meetings, meeting minutes, and documented follow up on Contractor's website. 1.19.18.4. 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. Exhibit E-4, Contractor's. Administrative Requirements Page 14 of22 Docusign Envelope ID: 2ACF3C37-0068-1A0-BDFC-DOB75872758B 1.19.18.5. Contractor shall post meeting minutes and any related follow-up action items once approved by the Community Advisory Committee and Contractor on Contractor's website. 1.19.18.6. 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. 1.19.18.7. Provide reports to the Department and its committees upon request. 1.19.18.8. 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 purpose, criteria, and reports. 1.19.18.9. The Community Advisory Committee must use the operational templates prescribed by the Department as minimum standards. 1.19.18.9.1. DELIVERABLE: Semi-annual Community Advisory Committee Meetings Summary 1.19.18.9.2. DUE: Semi-Annually, for meetings held between July ISt and December 315, Committee Updates are due January 15th, 2 and for meetings held between January 1st through June 1st, Committee Updates are due June 15th 1.20. Performance Reviews 1.20.1. The Department may conduct performance reviews or evaluations of Contractor in relation to the Work performed under the Contract. 1.20.2. The Department may work with Contractor in the completion ofany performance reviews 0: evaluations or the Department may complete any or all performance reviews or evaluations independently, at the Department' S sole discretion. 1.20.3. Contractor shall provide all information necessary for the Department to complete all 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 performance review or evaluation. 1.20.4. The Department may conduct these performance reviews or evaluations at any point during the term ofthe Contract, or after termination ofthe Contract for any reason. 1.20.5. The Department may make the results of any performance reviews or evaluations available to the public or may publicly post the results of any performance reviews or evaluations. 1.20.6. The Department may recoup funding as a result of any performance review or evaluation where payment was: rendered for services not complete or not in alignment with federal and/or state regulations or this Contract. 1.21. Corrective Action Plan 1.21.1. When the Department determines that Contractor is not in compliance with any term of1 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: 1.21.1.1. A detailed description of actions to be taken including any supporting documentation. Contractor's employee(s) responsible for implementing the actions. Exhibit E-4, Contractor's. Administrative Requirements Page 15 of22 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 1.21.1.2. The implementation time frames and a date for completion. 1.21.2. Contractor shall submit the Corrective Action Plan to the Department within 10 Business Days ofthe receipt ofa written request from the Department. 1.21.2.1. DELIVERABLE: Corrective Action Plan 1.21.2.2. DUE: Within 10 Business Days of receipt of a written request from the Department 1.21.3. Contractor shall notify the Department in writing, within three Business Days, if it will not 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, ofthe deadline for Contractor's compliance. 1.21.4. Upon receipt ofContractor's Corrective Action Plan, the Department will accept, modify, or reject the proposed Corrective Action Plan. Modifications and rejections shall be accompanied by a written explanation. 1.21.5. In the event of a rejection of Contractor's Corrective Action Plan Contractor shall re-write a revised Corrective Action Plan and resubmit it along with requested documentation to the Department for review. 1.21.5.1. DELIVERABLE: Revised Corrective Action Plan 1.21.5.2. DUE: Within five Business Days of the Department's rejection 1.21.6. Upon acceptance by the Department Contractor shall implement the Corrective Action Plan. 1.21.7. If corrections are not made by the timeline and/or quality specified by the Department then funds may be withheld from this Contract. Payments of funds from this Contract will resume beginning the month that the correction is made and accepted by the Department. 1.21.8. As part of the Corrective Action Plan, supporting documentation demonstrating that deficiencies have been remediated may be required. Contractor shall ensure all supporting documentation is submitted within the timeframes established in the Corrective Action Plan. 1.21.9. Upon receipt of Contractor's supporting documentation, the Department will accept, request modifications, or reject the documentation. Modifications and rejections shall be accompanied by a written explanation. 1.21.10. In the event of a rejection ofContractor's supporting documentation to the Corrective Action Plan, Contractor shall correct and resubmit the supporting documentation to the Department for review. 1.21.11. If a Corrective Action Plan or any supporting activities or documentation are required to 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. 1.21.11.1. DELIVERABLE: Revised Supporting Documentation 1.21.11.2. DUE: Within five Business Days oft the Department's rejection 1.21.12. Ifcorrections are: not made by the timeline and quality specified by the Department then funds may be withheld and recovered from this Contract. Payments of funds from this Contract will resume beginning the month that the correction is made and accepted by the Department. 1.22. Renewal Options and Extensions Exhibit E-4, Contractor's. Administrative Requirements Page 16 of2 22 Docusign Envelope ID: 2ACF3C37-0068-41A0-8DFC-D0B75872758B 1.22.1. The Department may, within its sole discretion, choose to not exercise any renewal option in the Contract for any reason. If the Department chooses to not exercise an option, it may reprocure the performance oft the Work in its sole discretion. 1.22.2. The Parties may amend the Contract to extend beyond eight years, in accordance with the 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 provide sufficient time to transition the Work. 1.23. Department System Access 1.23.1. In the event that Contractor requires access to any Department computer system to complete the Work, Contractor shall have and maintain all hardware, software, and 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 the Department's systems. 1.23.2. Contractor shall be responsible for any costs associated with obtaining and maintaining 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 obtaining and maintaining access to Department systems. 1.24. Provider Fraud 1.24.1. Contractor shall notify the Department and the Colorado Medicaid Fraud Control Unit ofthe Colorado Department of] Law (MFCU) ifit identifies or suspects possible Provider Fraud as a result of any activities in its performance ofthis Contract. 1.24.2. Upon identification or suspicion of possible Provider Fraud, Contractor shall complete Contractor Suspected Fraud Written Notice Form provided by the Department. 1.24.2.1. For each incident of identified or suspected Provider Fraud, Contractor shall provide all of the following, at ai minimum: 1.24.2.1.1. Written documentation of the findings. 1.24.2.1.2. Information on any verbal or written reports. 1.24.2.1.3. All details ofthe findings and concerns, including a chronology ofContractor actions which resulted in the reports, in a format agreed to by the Department. 1.24.2.1.4. Information on the identification ofany affected claims that have been discovered. 1.24.2.1.5. Any claims data associated with its report (in a mutually agreed upon format, if possible). 1.24.2.1.6. Any additional information as required by the Department. 1.24.3. 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 MFCU. 1.24.3.1. DELIVERABLE: Completed Contractor Suspected Fraud Written Notice Form 1.24.3.2. DUE: Within three Business Days following the initial discovery of the Fraud or suspected Fraud Exhibit E-4, Contractor's Administrative Requirements Page 17 of22 Docusign Envelope ID: 2ACF3C37-00841A08DFC.D08788727588 1.24.4. Contractor shall revise or provide additional information related to Contractor Suspected Fraud Written Notice Form as requested by the Department or the MFCU. 1.24.4.1. DELIVERABLE: Contractor Suspected Fraud Written Notice Revisions and Additional Information 1.24.4.2. 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. 1.25. Member Fraud 1.25.1. Contractor shall notify the Department if it identifies or suspects possible Member Fraud as a result of any activities in its performance ofthis Contract. 1.25.2. Upon identification or suspicion of possible Member Fraud, Contractor shall complete Contractor Suspected Fraud Written Notice Form provided by the Department. 1.25.2.1. For each incident ofi identified or suspected Member Fraud, Contractor shall provide all of the following, at a minimum: 1.25.2.1.1. All verbal and written reports related to the suspected fraud. 1.25.2.1.2. All details of the findings and concerns, including a chronology ofContractor actions which resulted in the reports, and the Member's State ID number, and Member's date of birth if applicable. 1.25.2.1.3. Information on the identification of any affected claims that have been discovered. 1.25.2.1.4. Any claims data associated with its report in a format agreed to by the Department. 1.25.2.1.5. Any additional information as required by the Department. 1.25.3. For each incident of identified or suspected Member Fraud, Contractor shall deliver the completed Contractor Suspected Fraud Written Notice Form to the Department a. parclemfraudaois or at such other email address as provided by the Department from time to time. 1.25.3.1. DELIVERABLE: Completed Contractor Suspected Fraud Written Notice Form 1.25.3.2. DUE: Within three Business Days following the initial discovery of the Fraud or suspected Fraud 1.25.4. Contractor shall revise or provide additional information related to Contractor Suspected Fraud Written Notice Form as requested by the Department. 1.25.4.1. DELIVERABLE: Contractor Suspected Fraud Written Notice Revisions and Additional Information 1.25.4.2. DUE: Within three Business Days following the Department's request, unless the 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 ofthe Contract. Exhibit E-4, Contractor's, Administrative Requirements Page 18 of22 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-DOB75872758B 2.2. The following positions can concurrently be assigned to other CMA contractual designee roles and responsibilities as needed by the CMA, but must be included in at least one position description within the CMA. 2.2.1. Contractor shall designate the following Key Personnel positions: 2.2.1.1. Executive Director or Administrator 2.2.1.2. Finance Director 2.2.1.3. Case Management Director 2.2.1.4. Continuous Quality Improvement Lead 2.2.1.5. Contract Lead 2.2.1.6. Information Technology Liaison 2.2.1.7. Regional Accountable Entity (RAE) Liaison 2.2.1.8. Medical Assistance (MA) Site/County Eligibility Liaison 2.2.1.9. Member and Family Liaison 2.2.2. The Contract Lead shall be responsible for all the following: 2.2.2.1. Serving as Contractor' s primary point of contact for the Department. 2.2.2.2. Serving as Contractor's primary point of contact for contract deliverables and other contract-related questions or issues for the Department. 2.2.2.3. 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 ofall work. 2.2.2.4. Ensuring the timely submission and accuracy of all Deliverables submitted to the Department. 2.2.3. The Continuous Quality Improvement Lead shall be responsible for all the following: 2.2.3.1. Development, implementation and ongoing oversight of the Contractors Continuous Quality Improvement Plan, 2.2.3.2. Reporting to the Department on identified quality trends 2.2.3.3. Operate as the Contractor's point of contact for activities including but not limited to Quality Improvement Strategies, Performance and Quality Reviews, Corrective Action Plan implementation. 2.2.4. The Information Technology Liaison shall be responsible for all the following: 2.2.4.1. Operate as the Contractor's point of contact for CCM and Bridge vendors, 2.2.4.2. Provide oversight of data integrity within Contractor system(s), if applicable, and data entered into CCM and Bridge. 2.2.5. The RAE Liaison shall be responsible for all the following: 2.2.5.1. Coordination between Contractor and the RAE(s) contracted within the Contractor's designated service area, Exhibit E-4, Contractor's Administrative Requirements Page 19 of22 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC-D0B75872758B 2.2.5.2. Actively participate in RAE/CMA workgroup meetings. 2.2.6. The MA Site/County Eligibility Liaison shall be responsible for all oft the following: 2.2.6.1. Coordination between Contractor and MA Site/County Eligibility within the Contractor designated service area, 2.2.6.2. Establishing and maintaining point of contact between agencies for Member escalations as they occur. 2.2.7. The Member and Family Liaison shall be responsible for all the following: 2.2.7.1. Regulatory and contractual requirements of Community Advisory Committee, 2.2.7.2. CMA internal policies and procedures to ensure Member and family access to a primary point ofcontact at the CMA to ensure a Member and family always have a point ofcontact regardless of case management assigned, 2.2.7.3. CMA internal policies and procedures to ensure Member and family access to communication in their primary language and any reasonable accommodations, 2.2.7.4. CMA internal policies and procedures to review: 2.2.7.4.1. Critical Incident Reports Trends Analysis, 2.2.7.4.2. Complaints and Grievances, 2.2.7.5. Review and ensure responses occur to urgent and prioritized needs as outlined in the member's contingency plan and/or back-up plan and the CMA's After-hours policy and procedures as outlined in 1.1.6.2.1 to mitigate health and safety risks and deploy appropriate community resources. 2.2.8. Contractor shall post the name and contact information for the individual appointed as the Member and Family Liaison on Contractor's website. 2.2.9. 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 of 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 each Defined Service Area. 2.2.9.1. DELIVERABLE: Key Personnel, final list ofi individuals assigned to the Contract 2.2.9.2. DUE: Within five Business Days after the Effective Date and annually by July 15th 2.2.10. Contractor shall update this list upon the Department's request to account for changes in the individuals assigned to the Contract. 2.2.10.1. DELIVERABLE: Key Personnel, updated list of individuals assigned to the Contract 2.2.10.2. DUE: Within five Business Days after any change to the Key Personnel list 2.2.11. 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 assigned as. Key Personnel. Exhibit E-4, Contractor's. Administrative Requirements Page 20 of 22 Docusign Envelope ID: 2ACF3C37-00841ADBDFC-008788727588 2.2.12. Other Personnel 2.2.12.1. 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. Contractor shall not exceed the best practice caseload size standard of 1:65 without written approval from the Department. 2.2.12.2. Contractor's Case Manager(s) shall meet all the qualifications listed in 10 C.C.R. 2505- 10, Section 8.7203.A et seq. 2.2.12.3. Contractor shall ensure appropriate staffing and infrastructure to address the needs of all populations including children and adults for all HCBS waivers and CFC. 2.2.12.4. 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 ofthe agency. The Department's EDIA Officer and/or their designee will offer free EDIA-related professional development training to Contractor upon request within the Department's LMS. 2.3. Background Checks 2.3.1. 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 be 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, 2019, prior to employment, Contractor shall submit the name of 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 ofHuman Services for a check oft the Colorado Adult Protective Services data system pursuant to section $26- 3.1-111, C.R.S. to determine if the person is substantiated in a case of mistreatment of an at- risk adult. 2.3.2. If any ofContractor'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 provide them to the Department upon request. 2.4. Personnel Availability 2.4.1. 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 the Department. 2.4.2. 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 a meeting and will notify the Contractor of such request. Exhibit) E-4, Contractor's. Administrative Requirements Page 21 of22 Docusign Envelope ID: 2ACF3C37-0068-41A0-BDFC- D0 B75872758B 2.4.3. 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. 2.4.4. At the Department's 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 government and external private stakeholders. 2.4.5. 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 space or telephone conference lines. 2.4.6. Contractor shall respond to all telephone calls, voicemails, and emails from the Department within two Business Days of receipt by Contractor. 2.4.7. Contractor shall respond to Department directed escalations according as prescribed by the Department. 2.5. Other Personnel Responsibilities 2.5.1. 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 to perform the Work in accordance with the requirements ofthis Contract at no additional cost to the Department. 2.5.2. 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 this Contract. 2.5.3. Contractor may subcontract to complete aj portion of the Work required by the Contract. The conditions for using a Subcontractor or Subcontractors are as follows: 2.5.3.1. Contractor shall not subcontract more than 40% ofthe Work. 2.5.3.2. 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 commencement of Work. 2.5.3.2.1. DELIVERABLE: Name of each Subcontractor, description of work being completed, and percentage of work being completed by the Subcontractor. 2.5.3.2.2. DUE: Annually, by July 15th 2.5.3.3. Contractor shall notify the Department of any changes to Subcontractors within 10 Business Days ofthe change. 2.5.3.4. Contractor shall obtain prior consent and written approval for any use ofSubcontractor(s). Exhibit E-4, Contractor's. Administrative Requirements Page 22 of 22 Docusign Envelope ID: 2ACF3C37-0068-41A0-8DFC-DOB75872758B STATE OF COLORADO THIRD PARTY ENTITY / ORGANIZATION CERTIFICATION FOR ACCESS TO PII THROUGH A DATABASE OR AUTOMATED NETWORK Meagan L. Hilman Prowers County Public Heal Pursuant to S 24-74-105, C.R.S., I, on behalf of (the "Organization"), hereby certify under the penalty of perjury that the Organization has not and will not use or disclose any Personal Identifying Information, as defined by $ 24-74-102(1), C.R.S., for the purpose ofinvestigating for, participating in, cooperating with, or assisting Federal Immigration Enforcement, including the enforcement of civil immigration laws, and the Ilegallmmigration and Immigrant Responsibility Act, which is codified at 8 U.S.C. SS 1325 and 1326, unless required to do sO to comply with Federal or State law, or to comply with a court-issued subpoena, warrant or order. I hereby represent and certify that I have full legal authority to execute this certification on behalf of the Organization. Signature: Meagan L. Hilman Printed Name: Director of Public Health Title: Date: PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 5/13/25 Submitter: Department ofl Human Services Submitted to the County Administration Office on: 4/17/25 Return Originals to: Department ofHuman Services Number of originals to return to Submitter: 1 Contract Due Date: ASAP Item Title/Recommended Board Action: "Consider approval ofMemorandum ofUnderstanding Annual Reaffirmation between the Colorado Department of Human Service and Prowers County Department of Human Services which outlines the annual performance contract and explains the County's duties and responsibilities in implementing the Works Program. 9 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): PLEASE ATTACH THIS SHEET TO ALL AGENDA ITEMS WHEN SUBMITTING TO COUNTY ADMINISTRATION. THANK YOU! COLORADO CDHS Department of Human Services MEMORANDUM OF UNDERSTANDING - ANNUAL REAFFIRMATION The State of Colorado Department of Human Services and the Board of County Commissioners or other elected governing body of Prowers County, Colorado. This Memorandum of Understanding (MOU) is made this 1st day of July 2025 between the State of Colorado Department of Human Services (CDHS) and the Board of the County Commissioners or other elected governing body of Prowers County, Colorado (the "County"). CDHS is the sole state agency with the responsibility to administer or supervise the administration of the human services programs listed in CRS 26-1-201. The Colorado General Assembly enacted Senate Bill 97-120 in response to the passage of the federal "Personal Responsibility and Work Opportunity Reconciliation Act of 1996" thereby adopting the Colorado Works Program ("Works Program") for the purposes of this MOU. CRS 26-2-715 requires CDHS, and the County to enter into an annual performance contract that explains the County's duties and responsibilities in implementing the Works Program. CDHS and the County understand and agree that the services and assistance outlined in this MOU are subject to available appropriations by the General Assembly, and the County. Neither party will be obligated to provide services or assistance if adequate appropriations have not been made. The following terms are agreed to by CDHS and the County: 1) MOU MEETS PERFORMANCE CONTRACT REQUIREMENT a) The parties agree that the provisions of this MOU constitute compliance with CRS 26-2- 715. 2) TERM Page 1 of 11 COLORADO a COHS Department of Human Services a) The term of this MOU will be from July 1, 2025, through June 30, 2026. This MOU shall be reaffirmed annually through an amendment signed by both parties. 3) REQUIRED DUTIES OF THE COUNTY a) The County will administer and implement the Works Program using fair and objective criteria, and in compliance with federal law, State Statute, and applicable program policy in 9 CCR 2503-6 (Works Program). b) The County will not reduce the basic assistance grant administered according to CRS 26-2-709, except as otherwise outlined in 9 CCR 2503-6. c) The County will not restrict eligibility or the provisions of services, nor will it impose sanctions that are inconsistent with State Statute or Federal law and applicable program policy, including the process and sanctions outlined in 9 CCR 2503- 6. d) For the term of this MOU, the County's negotiated Work Participation Rate (WPR) will be held accountable only to the adjusted WPR, after the caseload reduction credit is applied, with the elimination and removal of the Two-Parent rate. The County's agreement to meet the federally required participation rate is relevant to CDHS's anticipation that CDHS will, in turn, be able to meet any work participation rates imposed by the federal government. e) The parties acknowledge that the WPR is, as of the signing of this MOU, the only federally mandated performance goal identified specifically in CRS 26-2- 712 (4). The parties also acknowledge that in an effort to help individuals prepare for and enter the workforce, they are encouraged to adopt employment focused measures, as outlined under "OPTIONAL OUTCOME MEASURES" below. f) The County will maintain sufficient records, and will permit CDHS or its duly designated agents and/or representatives of the federal government, to inspect the records and make such records available to CDHS as specified in CRS 26-2-717 for the Colorado Works Program. The County must also continue to report to CDHS as currently required by CRS 26-2-716 and 717 for the Colorado Works Program and must report to CDHS as required by law. In addition, Counties or county departments that are covered entities, or contracting parties to a Business Associate Agreement, pursuant to the Health Insurance Portability & Accountability Act of 1996 (HIPAA), must comply with HIPAA, as required by law. Page 2 of 11 COLORADO - CDMS Department of Human Services g) As specified by rule and state statute, counties shall have flexibility in determining the approaches needed to achieve federal and State requirements. The County agrees to provide CDHS with its adopted policies and any updated written information when, or if, changes to these policies are made in these Programs. The County agrees to provide the information and policies specified in paragraph (h) herein, to CDHS for review and approval prior to adopting aforementioned policies. h) Outside of what is required by statute or rule, the parties agree that information and policies provided by the County to CDHS, as described in paragraph (g) herein, are for informational purposes and are provided to assist CDHIS in meeting its responsibilities, with respect to the Colorado Works Programs. Nothing in this MOU gives CDHS the authority to require any County policies beyond what is required by statute or rule. The County acknowledges CDHS's right to review, comment upon or request reasonable additional information or clarification of any County policies or records. Such requests will be made in writing and directed to the County Department of Human/Social Services Director. i) The County will utilize the technical assistance, training and reporting or tracking resources offered by CDHS in order to administer the Programs, including those that support the four purposes of Temporary Assistance to Needy Families (TANF) and will meet the WPR. j) The County will participate in formal expeditious vetting processes with CDHS to review, draft and recommend policies or rule changes that would have a positive impact on WPR and meet federal guidelines. k) In order to maximize the caseload reduction credit for the State, the County will actively identify and report third party Maintenance of Effort (MOE) contributions, in accordance with the timelines and guidelines established by CDHS. 4) OPTIONAL OUTCOME MEASURES a) Counties may submit a proposal as an attachment to this MOU, describing additional employment focused performance measures, specific to employment. Such proposals may be submitted either at the time of execution or at any time during the period of this MOU. The proposal is limited to issues regarding the pursuit of programs, strategies, and associated evaluation plans that focus on improving employment outcomes and contribute to the evidence base for effective programs. In addition, terms and conditions will require either interim targets for each performance measure or a framework for how interim goals will be set after the Page 3 of 11 COLORADO - CDHS Department of Human Services baseline measures are established. The terms and conditions will establish a review process for programs, strategies and metrics designed to achieve optimal outcomes. b) Upon approval of the proposal by CDHS, the County or region will be subject to the performance measures, interim goals, and other conditions set forth in the MOU addendum, and negotiated WPR that consider employment focused outcome measures and anticipated statewide case-load credit reductions. 5) DUTIES OF CDHS a) In consultation with the Counties, CDHS will oversee the statewide implementation of the Works Program, and will develop standardized forms that streamline the application process, the delivery of services, and the tracking of participants. b) CDHS will monitor the County's provision of basic assistance grants and, if necessary, perform the duties outlined in CRS 26-2-712 (5). c) CDHS exercises oversight of and responsibility for the development, implementation, maintenance, and enhancement of the State Benefit System and its application relative to the Works Program. Because the State Benefit System is a system that utilizes decision tables run by a rules engine for determining eligibility and amount of benefits to the extent allowed by law, the County will not be sanctioned or required to follow a remediation plan for erroneous decisions made by the State Benefit System. Without limitation, this applies to erroneous eligibility decisions, erroneous determination of amount of benefits, erroneous decisions resulting in overpayments and subsequent claims, and erroneous decisions resulting in underpayments and subsequent supplemental payments of restorative benefits. (1) The State acknowledges that liability to third parties resulting from erroneous, inaccurate or inadequate State Benefits System notices to Works Program households, is properly the State's liability. CDHS will not take recovery action against the County for any claim, including a legal claim, that is defined in this paragraph as a State Benefit System caused error. This provision does not apply to any errors, claims or issues caused by the County's inaccurate data entry in the system, the County's failure to follow clear, reasonable, and lawful instruction, or failure to follow program rules formally adopted by the State Board of Human Services. This provision does apply to the State Benefit System training and data entry rules and/or any rules that are part of the State Benefit System rule engine. Page 4 of 11 COLORADO - CDHS Department of Human Services d) CDHS will develop and provide training for Works Program staff, as required by CRS 26-2-712 (7). e) CDHS will hold Contracted Agencies with cooperative agreements with the State Department responsible for providing reception and placement services for refugees, accountable to its own WPR and must not include refugees receiving Contracted Agency's services in the County's calculation of the WPR. The Contracted Agency's negotiated WPR will be held accountable only to the adjusted WPR after the case-load reduction credit is applied with the elimination and removal of the Two- Parent rate. f) CDHS will use valid data from the State Benefit System and other sources, as necessary, to accurately calculate the County's WPR. Prior to submitting its calculation to the federal government, CDHS will provide the County the individual data variables and supporting information used in the calculations, SO that the County may review the data to ensure the accuracy, validity and proper calculation of the WPR. g) CDHS will provide technical assistance and available resources to the Counties to help Counties meet WPR and Payment Accuracy Goals. h) CDHS will provide ongoing technical assistance, training, and reporting for tracking resources to help the County administer the program, in support of the four purposes of TANF and to meet WPR. i) CDHS will conduct formal expeditious collaborative processes with the County to review, draft and recommend policies or rule changes that would have a positive impact on work participation rate and meet federal guidelines. j) In order to maximize the caseload reduction credit for the State, CDHS agrees to actively identify and report third party Maintenance of Effort (MOE) contributions. k) The amount identified for a County's level of spending shall be identified annually in the Allocation Agency Letter as required in CRS 26-2-712. 6) JOINT STATE AND COUNTY DUTIES a) The State and Counties will work together in partnership to communicate performance expectations and results to jointly achieve federally required performance outcome measures related to the WPR. Page 5 of 11 COLORADO - COMS Department of Human Services b) As needed, the State and Counties will convene meetings, workshops, focus groups, or other forums to share information, best process, or targeted strategies to achieve the spirit and intent of this MOU document and related federally required performance requirements. c) The State and the Counties will work together to ensure that the information entered and reported in the Colorado Benefits Management System is as accurate as possible. The State shall work to address any system issues in a timely manner, and Counties will enter accurate client and provider information in the systems. 7) REMEDIATION PLANS The County, in consultation with CDHS may develop a remediation plan if, during the term of this MOU, the County engages in any of the following actions: a) Spending, federal or state, Works Program funds in a manner disallowed by Federal or State law, which could include receipts or recoveries that are not reported; b) Failing to meet the WPR, after the caseload reduction credit is applied, as contained in this MOU and/or failing to meet the negotiated performance measures; c) Reducing the basic assistance grant, restricting eligibility or the provision of services, or imposing sanctions in a manner inconsistent with a federally compliant state law and state plan, and applicable program policy; 8) SANCTIONS a) Subject to the limitations set forth herein, if CDHS subject to a federal sanction, and the County's remediation plan was insufficient, CDHS may impose sanctions on the County pursuant to this MOU only if during the term of this MOU, the County engages in any of the following actions: 1. Failing to meet the WPR, after the caseload reduction credit is applied, as contained in this MOU and/or not meeting negotiated performance measures; 2. Reducing the basic assistance grant, restricting eligibility or the provision of services, or imposing sanctions in a manner inconsistent with Page 6 of 11 COLORADO COMS Department of Human Services a federally compliant state law and state plan and applicable program policy; b) A: sanction should not be imposed on the County for failing to adhere to a state regulation that conflicts with federal law. c) The county will not be sanctioned or required to follow a remediation plan if: 1. the County can demonstrate by a preponderance of evidence that CDHS provided inaccurate guidance, training or data with regards to performance under this MOU; and, 2. that the County's reliance on this information is the proximate cause for the imposed sanctions. If the County can only demonstrate that it is the proximate cause for part of the sanction, the County will not be liable for that portion of the sanction. 9) PROCEDURES FOR IMPOSING REMEDIATION PLAN OR SANCTIONS a) The process for a sanction or remediation plan against the County by CDHS will be as follows: 1. CDHS will provide the County with written notice of the County's failure to meet the performance measures outlined in this MOU. This notification will include all associated documentation that supports CDHS's determination of the performance failure. Upon receiving such notice, the County has sixty (60) days to contest, explain, offer evidence of mitigating factors, and/or submit a remediation plan to correct the alleged performance problem. 2. If the County's remediation plan does not rectify the performance problem, CDHS may determine the appropriate level of sanction. CDHS shall take into consideration as a mitigating factor any violation of a state regulation that exceeds or conflicts the requirements of the federal law. CDHS will provide the County one hundred eighty (180) days written notice of the proposed sanction before imposing any sanction. This notification will include the rationale of imposing the sanction, as well as, all associated documentation, a calculation of the proposed sanction, and an indication of what constitutes a remedy or correction that will allow the County to avert the sanction, if any remedy or Page 7 of 11 COLORADO COMS Department of Human Services correction is possible. Upon receiving such notice, the County has sixty (60) days to contest, explain or offer evidence of mitigating factors, sanctions are imposed. 3. If a sanction is imposed, the amount cannot be greater than that imposed by the federal government. If CDHS has incurred a sanction due to the failure of more than one County to meet its obligations under the terms of this MOU, the County will only be sanctioned for its share of the sanction. b) CDHS will provide the County with all documents received from the federal government related to any proposed or imposed federal sanction within twenty (20) days of receipt, together with all CDHS documents related to the actions giving rise to that federal sanction, or that related to the sanction process. If CDHS fails to provide the required documentation within the twenty (20) days, it may not hold the County liable for that sanction. 10) CIRCUMSTANCES FOR CDHS ASSUMING ADMINISTRATION a) If the County continues to knowingly or consistently fail to meet its obligation specified in this MOU, CDHS may assume the County's administration and implementation of the Works Program. i) In that event, CDHS will provide the County ninety (90) days written notice before assuming these duties. Upon receipt of such notice, the County shall have the opportunity to contest, explain, offer evidence of mitigating factors, or to correct the failure before assuming the duties. b) If the County continues to consistently fail to meet its obligation specified in this MOU, the County at its sole discretion may ask CDHS to assume the County's administration and implementation of the Works Program. CDHS is under no obligation to accept or assume the administration of the Works Program. i) If CDHS assumes the County's administration and implementation of the Works Program, it may retain the unused portion of the allocation that was provided to the County, as part of the County's block grant for its administration and implementation of the Program, in accordance with the formulas described in CRS 26-2-714 for the Colorado Works Program. CDHS will, in consultation and in conjunction with the County, develop or modify automated systems to meet the reporting requirements of CRS 26-2-717 for the Colorado Works Program Page 8 of 11 COLORADO COMS Department of Human Services 11) DISCRETIONARY MATTERS The parties agree that all portions of Part 7 or Article 2 of Title 26, C.R.S. for the Colorado Works Program grant discretion to either party regarding the administration of the Works in the County, will not be affected by the execution of this MOU except as explicitly stated herein. 12) SEVERABILITY To the extent that this MOU is executed, and the performance of the obligations of the parties may be accomplished within the intent of the MOU, the terms of the MOU are severable. Thus, should any term or provision herein be declared invalid or become inoperative for any reason, such invalidity or failure shall not affect the validity of any other term or provision herein. The waiver of any break of term, herein shall not be construed as a waiver of any other term, or of the same term upon subsequent breach. 13) INTEGRATION OF UNDERSTANDING This MOU is intended as the complete integration of the understanding between the parties concerning the matters negotiated between them and incorporated in this MOU. No prior or contemporaneous addition, deletion, or other amendment hereto shall have any force or effect whatsoever, unless embodied in writing. No subsequent notation, renewal, addition, deletion, or other amendment hereto shall have any force or effect unless embodied in a written amendment executed by the parties. The parties recognize the nature of the relationship between the County and State. This relationship is governed more broadly by pertinent provisions of the Colorado Constitution and of State statutes and rules, and for Colorado Works includes, lawful rules promulgated by the State Board of Human Services. The parties further recognize that this MOU is not intended to supersede or change the relationship between the County and the State as established by any legal authority. 14) NO THIRD-PARTY BENEFICIARY This MOU is binding on CDHS and the County as well as their respective successors and assigns. It is agreed that the enforcement of the terms and conditions of the MOU are reserved for CDHS and the County, to the extent permitted by law. Nothing contained in this MOU allows a claim or right of action by a third party. Any third-party receiving Page 9 of 11 COLORADO COHS Department of Human Services services or benefits under the provisions of this MOU is deemed an incidental beneficiary. 15) DISPUTE RESOLUTION a) Prior to the execution of this document, if CDHS or the County are unable to reach agreement concerning the inclusion of, or wording of, provisions of the MOU that apply to the Colorado Works Program, either CDHS or the County may refer the dispute to the State Board of Human Services for resolution pursuant to the provisions of CRS 26-2-715 (3). b) Subsequent to the execution of this document, CDHS and the Counties will work in good faith to resolve a dispute arising from any provision of this executed MOU as applied to the Colorado Works program. If the parties are unable to resolve such dispute, any of the following non-binding mediation options are available by agreement of the parties; i) Mediation by the Governor or a third party of the Governor's choosing. Such review must be initiated by notice provided to the Governor and other party, by certified mail. Decision by the Governor, or his appointed third-party, in non-binding. ii) Mediation by a dispute resolution panel, to consist of one County designated member, one CDHS designated member, and one member selected by the other two panelists. Each party must pay for its own costs and attorney fees and must share equally in any fees paid to panel members. The panel's decision shall be made by a majority vote of its members and is non-binding. iti) Mediation by the State Board of Human Services. If the State Board is requested to mediate, the provisions of CRS 26-2-715 concerning time limits and final effect of the State Board's decision will not apply. The State Board of Human Services' decision is non-binding. c) None of these options will be a jurisdictional prerequisite to legal action by either party. Page 10 of 11 COLORADO CDHS Department of Human Services Minna Castillo, Deputy Executive Director, Community Partnerships, State of Colorado Department of Human Services COUNTY OF COLORADO, by and through the BOARD OF COUNTY COMMISSIONERS Chairman ATTEST: County Clerk to the Board Date: Page 11 of 11 PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 5/13/25 Submitter: Don Wilson, County Administrator Submitted to the County Administration Office on: Email Poll 4/21/25 Return Originals to: Don Wilson, County Administrator Number of originals to return to Submitter: 1 Contract Due Date: N/A Item Itle/Recommended Board Action: Consider ratifying 4-21-2025 email poll approval of a Letter of Support sent to Congresswoman Lauren Boebert regarding City ofLamar's request for Congressional Community Project Funding for Wastewater Treatment Improvements. 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): Board of County Commissioners Prowers County 301 South Main, Suite 215 D1 I Lamar, Colorado 81052-2857 (719) 336-8025 FAX: (719) 336-2255 TyHarmon RON COOK ROGER STAGNER FIRST DISTRICT SECOND DISTRICT THIRD DISTRICT 4/21/25 Congresswoman Lauren Boebert Lone Tree District Office 9360 Station Street Suite 300 Lone Tree, CO 80124 RE: City of Lamar Wastewater Treatment Plant Improvements Project Dear Congresswoman Boebert, On behalf of the Prowers County Commissioners, please accept this letter of support to appropriate House of Representatives Community Project Funding (CPF) capital for the City of Lamar Wastewater Treatment Plant (WWTP) Improvements Project. CPF funds would allow this rural community to commence Phase II ofthe WWTP Improvements Project. Phase II includes the construction of a new Biolac Treatment System and the decommissioning of the outdated wastewater treatment lagoons. This project will protect public health and the environment, promote economic development, and mitigate financial impacts to the economic hub of Prowers County. We understand the City is currently unable to receive additional wastewater from planned residential and commercial developments, including hotels, commercial properties, agricultural processing, and transportation and commerce support infrastructure. Recognizing this project's importance, this project is a top priority for the County to encourage future development and rural job creation within our County. The Prowers County Commissioners encourage you to support this important project. Your advocacy will significantly benefit Prowers County and help make this project a reality. Thank you for your consideration. Sincerely, Prowers Coumtyammisigéss - Ron Cook B ao) County Commissioner Roger Stagner County Commissioner /4 Ty Harmon County Corpmissioner PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 5-13-2025 Submitter: Paula Gonzales, County Finance Director Submitted to the County Administration Office on: Email Poll 4-25-2025 Return Originals to: Jana Coen & Paula Gonzales Number of originals to return to Submitter: 1 Contract Due Date: Item Tile/Recommended Board Action: Consider ratifying 4-25-2025 email poll approval for payment of bills presented for County General Fund Payroll, Payroll AP and AP in the amount of $1,045,221.45, DHS and WHC Payroll, Payroll AP, and AP in the amount of $262,405.55, and H3C Payroll, Payroll AP and AP, in the amount of $115,816.17 all with a Certification date of April 29, 2025 and authorizing the use of the Commissioner's signature stamps. Justification or Background: Fiscal Impact: This item is budgeted in the following account code: County: $ Federal: $ State: $ Other: $ PROWERS COUNTY APPROVE TO PAY APPROVE PAYMENTS AS HEREIN SET FORTH. CHECK NUMBERS AS LISTED BELOW ARE ALL INCLUSIVE, ARE SET OPPOSITE THEIR NAMES, AND TOTALING THE SUM OF: $1,046,562.66 DRAWN ON COUNTY GENERAL FUNDS. DATED AS OF: April 29, 2025 # A/P PAYROLL FRI NGES COUNTY GENERAL FUND $ 32,326.01 322,655.04 104,890.88 ARPAI FUND $ FSA ACCOUNT $ BOOKING FEES ACCOUNT $ PUBLIC HEALTH. AGENCY $ 1,960.90 117,218.68 31,081.51 ROAD & BRIDGE FUND $ 68,116.38 79,057.57 21,445.37 SALES & USE TAX FUND $ CONSERVATION TRUST FUND $ CAPITAL FUND $ OTHER. AGENCIES FUND $ LODGING TAX FUND $ 211.75 67.30 CRMC FUND $ 873.16 117,779.43 34,953.44 OPC FUND $ 382.80 84,121.33 29,421.11 Totals $ 103,659.25 S 721,043.80 $ 221,859.61 DATE: April 29, 2025 9 BOCC CHAIRMAN DATE: April 29, 2025 A MMVISSPNER DATE: April 29, 2025 ROMMISIQAER) DATE: April 29, 2025 CLERK TO THE BOARD Total Paid Approve To Pay $ 1,046,562.66 AP + Fringes $ 325,518.86 Total Pd Certification Payroll $ 325,518.86 Total Payroll + Fringes $ 942,903.41 STATE OF COLORADO) Ending Check No. 75112 js SS: Beginning Check No. 75068 COUNTY OF PROWERS) 1 Total Number of Checks: 45 Solovgs Camoloull Prowers County Treasurer's Office PROWERS COUNTY APPROVE TO PAY APPROVE PAYMENTS AS HEREIN SET FORTH. CHECK NUMBERS AS LISTED BELOW ARE ALL INCLUSIVE, ARE SET OPPOSITE THEIR NAMES, AND TOTALING THE SUM OF: $1,046,562.66 DRAWN ON COUNTY GENERAL FUNDS. DATED AS OF: April 29, 2025 # A/P PAYROLL FRINGES COUNTY GENERAL FUND $ 32,326.01 322,655.04 104,890.88 ARPA FUND $ FSA ACCOUNT $ BOOKING FEES ACCOUNT $ PUBLIC HEALTH AGENCY $ 1,960.90 117,218.68 31,081.51 ROAD & BRIDGE FUND $ 68.116.38 79,057.57 21,445.37 SALES & USE TAXI FUND $ CONSERVATION TRUST FUND $ CAPITAL FUND $ OTHER AGENCIES FUND $ LODGING TAX FUND $ 211.75 67.30 CRMC FUND $ 873.16 117,779.43 34,953.44 OPC FUND $ 382:30 4,121.33 29,421.11 Totals $ 103,59.25 $ 721,043/60- $ 221,859.61 8m DATE: April 29, 2025 ZBOCC. CHAIRMAN DATE: April 29, 2025 D COMMISSIPNER DATE: April 29, 2025 OOMMESIOINER DATE: April 29, 2025 CLERK TO THE BOARD Total Paid. Approve To Pay $ 1,046,562.66 AP + Fringes $ 325,518.86 Total Pd Certification - Payroll $ 325,518.86 Total Payroll + Fringes $ 942,903.41 STATE OF COLORADO) Ending Check No. 75112 SS: Beginning Check No. 75068 COUNTY OF PROWERS) 1 Total Number of Checks: 45 Bolou aploill Prowers County Treasurer's Office PROWERS COUNTY TREASURER CERTIFICATION COUNTY GENERALI FUND-01 0010 April 29, 2025 75068-75112 $ 32,326.01 April Unemployment s (544.38) Payrol $ 322.655.04 Total Fringes s 104.890.88 Totals 459,327.55 ARPA- 0018 Total_s ROAD & BRIDGE FUND -02 0020 $ 68,116.38 April Unemployment S (158.13) Payroll s 79.057.57 Fringes_ s 21.445.37 Totals 168.461.19 FSA (Cafeteria) 552 0552 S Totals Sheriffs Booking Fees 0675 $ Totals SALES & USE TAXF FUND - 03 0900 $ Totals CONSERVATION TRUSTE FUND - 06 0130 $ Totalls CAPITALI FUND -07 0100 $ Totals OTHER AGENCIES FUND- 08 S Totalls LODGING TAX -09 0014 s April Unemployment $ (0.42) Payrots 211.75 Total Fringes_s 67.30 Totalfs 278.63 PUBLIC HEALTH AGENCY- 11 0676 $ 1.960.90 April Unemployment S (234,45) Payrol s 117.218.68 Total Fringes S 31.081.51 Total s 150,026.64 CRMC 0016 $ 873.16 April Unemployment S (235.57) Payron s 117.779.43 Total Fringess 34.953.44 Total_s 153,370.46 )PC 0017 s 382.80 April Unemployment (16826) Payrol S B4.121.33 Total Fringes S 29.421.11 Totals 113,756.98 Padla Gon3EEinance Direclar GRAND TOTALS 1.045.221.45 Detail Register 2 Prowers County, CO Payroll Summary - - IDRAIS Packet: PYPKT00021 April 2025 PD 4/30/25 Pay Period: 04/01/2025 04/30/2025 Payroll: Set: 01 Payroll Set 01 Males Paid: 80 Females Paid: 97 Total Direct Deposits: 529,230.84 Unknown Paid: 0 Total Check Amounts: 0.00 Total Employees: 177 EARNINGS TAXES Pay Code Units PayA Amount Code Subject To Employee Employer Adult Trans OT 9.25 298.31 Federal W/H 667,389.88 44,609.94 0.00 CHS Security OT 141.75 4,629.95 MC 703,528.72 10,201.21 10,201.21 Elected Official 0.00 50,470.26 S5 703,528.72 43,618.74 43,618.74 Extra Duty 0.00 211.75 State W/H 667,389.88 25,028.00 0.00 Hourly' Wage 22,690.42 470,452.82 Unemployment 670,573.54 0.00 1,341.21 Incentive 0.00 25,200.00 Total: 123,457.89 55,161.16 Jail Nursing-H 14.50 725.00 JBBS-H 24.50 3,123.75 MH Trans-OT 18.00 600.75 OT 96.75 2,866.88 Salary 0.00 162,464.33 Total: 22,995.17 721,043.80 DEDUCTIONS Code Subject To Employee Employer 457% 4,827.33 193.09 0.00 457 AMT 0.00 250.00 0.00 4571 Roth % 3,526.34 176.32 0.00 457 Roth AMT 0.00 270.00 0.00 Accident 0,00 518.29 0.00 AFLACAT 0.00 490.94 0.00 AFLAC PT 0.00 1,704.70 0.00 Child Support 0.00 3,332.22 0.00 Colonial AT G.00 590.36 0.00 Colonial Pre1 Tax 0.00 624.90 0.00 Critical AT 0.00 197.35 0.00 Dental 0.00 4,748.80 0.00 FSA 0.00 525.00 0.00 Garn-Martinez 0.00 300.00 0.00 Health Insurance 0.00 7,056.48 129,108.52 Hospital IN-Pre Tax 0.00 53.26 0.00 HSA- CSB 0.00 500.00 0.00 HSA- GNI Bank 0.00 50.00 0.00 HSA Peoples CU 0.00 135.00 0.00 HSA- TBKI Bank 0.00 1,300.00 0.00 Legal Aid 0.00 375.80 0.00 Life Ins-AD&D 0.00 0.00 1,154.88 Life Ins-Dependent 0.00 25.76 0.00 MASA 0.00 747.00 0.00 Nationwidel Retiremen 0.00 170.00 0.00 Retirement 710,514.64 35,525.75 35,525.75 Retirement Loan 0.00 7,533.20 0.00 Supp Life-Employee 0.00 610.40 0.00 Supp Life-Spouse 0.00 51.80 0.00 Vision 0.00 298.65 909.30 Total: 68,355.07 166,698.45 RECAP 01-F Payroll Set 01 Eamings: 721,043.80 Benefits: 0.00 Deductions: 68,355.07 Taxes: 123,457.89 Net Pay: 529,230.84 4/24/2025 12:44:08 PM Page 1 ofz Detail Register / Prawers County, CO Employees Not Included in Packet - I COIORAVS Packet: PYPKT00021 April 2025 PD 4/30/25 Pay Period: 04/01/2025 04/30/2025 Payroll Set: 01 Payroll Set 01 Department: 43. Road & Bridge Employee: HALLDI Hall, Dillon Base Group Pay Code Position Based on Rate GI/Project Account Rate/Amount Units Pay Amount Monthly HouHourly' Wage R&B Operator Hourly 002-43-411200 20.000000 0.00 0.00 4/24/2025 12:44:08 PM Page 2 of2 Check Register - - Prowers County, CO Packet: APPKT00051 105.04.2025 & PY 4.2025 I By Check Number CORAV Vendor Number Vendor Name Payment Date Payment Type Discount Amount Payment Amount Number Bank Code: General Fund Op-General Fund Operating Account Payment Type: Regular AFL1 Aflac 04/29/2025 Regular 0.00 2,195.64 75068 All1 Airgas Intermountain Inc. 04/29/2025 Regular 0.00 595.06 75069 AMAZON Amazon Capitals Services 04/29/2025 Regular 0.00 278.82 75070 ATM1 Atmos Energy 04/29/2025 Regular 0.00 525.33 75071 VEN00896 B&5 Sand & Gravel, LLC 04/29/2025 Regular 0.00 52,786.25 75072 WHITE Barbara White 04/29/2025 Regular 0.00 7,870.32 75073 BSL1 Business! Solutions Leasing, Inc. 04/29/2025 Regular 0.00 580.82 75074 CLH1 C&I LHeat and Air 04/29/2025 Regular 0.00 402.62 75075 CKBRLAW CAMPBELLI KILLIN BRITTAN & RAY,LI 04/29/2025 Regular 0.00 2,050.00 75076 Canon1 Canon Financial Services 04/29/2025 Regular 0.00 1,037.70 75077 CDPHE RF CDPHE Vitals 04/29/2025 Regular 0.00 588.00 75078 SALAZ Celia M. Salazar 04/29/2025 Regular 0.00 5,031.00 75079 CINTASCORP CINTAS CORPORATION NO.2 04/29/2025 Regular 0.00 676.59 75080 CLN1 Colonlal Life & Accident Ins Co. 04/29/2025 Regular 0.00 1,215.26 75081 CAA3 Colorado Assessors Association/CAA 04/29/2025 Regular 0.00 245.00 75082 CAI1 Continental American Insurance Con 04/29/2025 Regular 0.00 768.90 75083 CHP1 County Health Pool 04/29/2025 Regular 0.00 143,964.59 75084 VEN00981 COUNTY OF FREMONT 04/29/2025 Regular 0.00 180.00 75085 ELE1 Electral Pro LLC 04/29/2025 Regular 0.00 32.20 75086 FSR1 Family Support Registry 04/29/2025 Regular 0.00 3,332.22 75087 FNB1 Frontier Bank 04/29/2025 Regular 0.00 177,277.84 75088 GOB1 Gobin's 04/29/2025 Regular 0.00 1,774.76 75089 HST1 Home! Store LLC 04/29/2025 Regular 0.00 785.85 75090 COJ1 Jana Coen 04/29/2025 Regular 0.00 229.60 75091 FPL5 John Deere Financial 04/29/2025 Regular 0.00 2,229.72 75092 FPL5 John Deere Financial 04/29/2025 Regular 0.00 26.99 75093 1257 Jose Manuel Soto. JR. 04/29/2025 Regular 0.00 3,968.90 75094 LAP1 Lamar Auto Parts 04/29/2025 Regular 0.00 153.39 75095 LBM1 Lamar BMS 04/29/2025 Regular 0.00 4,378.95 75096 LEG1 LegalShield 04/29/2025 Regular 0.00 375.80 75097 MT51 MASA MEDICAL AIR TRANSPORTAT 04/29/2025 Regular 0.00 747.00 75098 VEN00982 MEDICARE PARTI B 04/29/2025 Regular 0.00 95.55 75099 VEN00954 Mountain Peak Law Group, PC 04/29/2025 Regular 0.00 300.00 75100 WINSORN Nancy Winsor 04/29/2025 Regular 0.00 8,152.86 75101 NCA1 Nationwide! Retirement: Solutions 04/29/2025 Regular 0.00 170.00 75102 VEN00983 OLDCASTLE: SW GROUP INC (UNITED 04/29/2025 Regular 0.00 2,337.30 75103 OAP1 O'Reilly Automotive Parts 04/29/2025 Regular 0.00 141.29 75104 PRECIS PRECISION. AUTO GLASS LLC-ALEC P' 04/29/2025 Regular 0.00 352.65 75105 PRC1 Prowers County 04/29/2025 Regular 0.00 525.00 75106 SEM1 SEMCO Inc (SOUTH EAST MACHINER 04/29/2025 Regular 0.00 449.20 75107 SHC1 Share Corporation 04/29/2025 Regular 0.00 308.03 75108 MRS1 Shred America 04/29/2025 Regular 0.00 60.80 75109 1043 Taylor! Septic & Plumbing 04/29/2025 Regular 0.00 38.56 75110 VEN00985 WAGNERI RENTS 04/29/2025 Regular 0.00 2,973.14 75111 4/24/2025 1:00:22 PM Page 1 of 3 Check Register Packet: APPKT00051-105.04.2025 & PY 4.2025 Vendor Number Vendor Name Payment Date Payment Type Discount Amount Payment Amount Number ZOHO ZOHO Corporation 04/29/2025 Regular 0.00 2,322.00 75112 Total Regular: 434,531.50 Bank Code General Fund Op! Summary Payable Payment Payment Type Count Count Discount Payment Regular Checks 93 45 0.00 434,531.50 Manual Checks 0 0 0.00 0.00 Voided Checks 0 0 0.00 0.00 Bank Drafts 0 0.00 0.00 EFT's 0 0 0.00 0.00 93 45 0.00 434,531.50 4/24/2025 1:00:22 PM Page 2 of 3 Check Register Packet: APPKT0051-105.042025 & PY 4.2025 Fund Summary Fund Name Period Amount 999 Pooled Cash 4/2025 434,531.50 434,531.50 4/24/2025 1:00:22 PM Page 3 of 3 Payment Register Prowers County, CO APPKT00050 - PYPKT00021 - April 2025 PD 4/30/25 Vendor - 01 Set 01 B9 OIORAIS Bank: General Fund Op General Fund Operating Account Vendor Number Vendor Name Total Vendor Amount CRA1 CCOERA 78,584.70 Payment Type Payment Number Payment Date Payment Amount Bank Draft DFT0000024 04/24/2025 71,051.50 Payable Number Description Payable Date Due Date Discount Amount Payable. Amount INV0000077 Retirement 04/30/2025 04/30/2025 0.00 71,051.50 Bank Draft DFT0000025 04/24/2025 7,533.20 Payable Number Description Payable Date Due Date Discount Amount Payable Amount INV0000078 Retirement Loan 04/30/2025 04/30/2025 0.00 7,533.20 Vendor Number Vendor Name Total Vendor Amount CRA2 CCOERA 889.41 Payment Type Payment Number Payment Date Payment Amount Bank Draft DFT0000020 04/29/2025 176.32 Payable Number Description Payable Date Due Date Discount Amount Payable Amount INV0000059 457 Roth % 04/30/2025 04/30/2025 0.00 176.32 Bank Draft DFT0000021 04/24/2025 193.09 Payable Number Description Payable Date Due Date Discount Amount Payable Amount INV0000057 457 % 04/30/2025 04/30/2025 0.00 193.09 Bank Draft DFT0000022 04/24/2025 250.00 Payable Number Description Payable Date Due Date Discount Amount Payable Amount INV0000058 457 AMT 04/30/2025 04/30/2025 0.00 250.00 Bank Draft DFT0000023 04/24/2025 270.00 Payable Number Description Payable Date Due Date Discount Amount Payable Amount INV0000060 457 Roth AMT 04/30/2025 04/30/2025 0.00 270.00 Bank: Payroll Tax Check Payroll Tax Checking Account Vendor Number Vendor Name Total Vendor Amount CDR3 Colorado Department of Revenue 25,028.00 Payment Type Payment Number Payment Date Payment Amount Bank Draft DFT0000019 04/30/2025 25,028.00 Payable Number Description Payable Date Due Date Discount Amount Payable Amount INV0000091 State WH 04/30/2025 04/30/2025 0.00 25,028.00 Vendor Number Vendor Name Total Vendor Amount CST2 Colorado! State Treasurer 1,341.21 Payment Type Payment Number Payment Date Payment Amount Bank Draft DFT0000017 04/30/2025 1,341.21 Payable Number Description Payable Date Due Date Discount Amount Payable Amount INV0000089 Unemployment 04/30/2025 04/30/2025 0.00 1,341.21 Vendor Number Vendor Name Total Vendor Amount VEN00980 EFTPS 152,249.84 Payment Type Payment Number Payment Date Payment Amount Bank Draft DFT0000015 04/30/2025 20,402.42 Payable Number Description Payable Date Due Date Discount Amount Payable Amount INV0000087 Medicare' WH 04/30/2025 04/30/2025 0.00 20,402.42 Bank Draft DFT0000016 04/30/2025 87,237.48 Payable Number Description Payable Date Due Date Discount Amount Payable Amount INV0000088 Social Security WH 04/30/2025 04/30/2025 0.00 87,237.48 4/24/2025 1:09:55 PM Page 1 of 4 Payment Register APPKT00050 PYPKT00021 April 2025 PD 4/30/25 Bank Draft DFT0000018 04/30/2025 44,609.94 Payable Number Description Payable Date Due Date Discount Amount Payable Amount INV0000090 Fed WH 04/30/2025 04/30/2025 0.00 44,609.94 4/24/2025 1:09:55 PM Page 2 of 4 Payment Register APPKT00050 PYPKT00021 - April 2025 PD 4/30/25 Payment Summary Payable Payment Bank Code Type Count Count Discount Payment General Fund Op Manual Bank Draft 6 6 0.00 79,474.11 Packet Totals: 6 6 0.00 79,474.11 Payable Payment Bank Code Type Count Count Discount Payment Payroll Tax Check Manual Bank Draft 5 5 0.00 178,619.05 Packet1 Totals: 5 5 0.00 178,619.05 4/24/2025 1:09:55 PM Page 3 of 4 Payment Register APPKT00050 PYPKT00021 - April 2025 PD 4/30/25 Cash Fund Summary Fund Name Amount 999 Pooled Cash 258,093.16 Packet Totals: -258,093.16 4/24/2025 1:09:55 PM Page 4 of 4 0 - e d a o a - 8 B N De e - 5 8 F * 8 Da PROWERS COUNTY TREASURER CERTIFICATION OF EXPENDITURES DATE: April 29, 2025 Prepared by: PROWERS COUNTY DEPARTMENT OF HUMAN SERVICES FUND Mindy Maestas SALARY 101556-101597 111,269.00 FRINGE 68342-68343 & 68345-68357 97,245.54 OPERATING 68337-68341 350.36 CANCELLED WHC SALARY 54925-54941 29,736.98 WHC FRINGE 9049-9059 23,326.22 OPERATING 9060 2,120.54 FORFEITURE CRA (1.643.09) TOTAL:S 262.405.55 Information Only VOIDED CHECKS #'s: 68336 & 68344 lla LanieMireles, Dircctor PROWERS COUNTY TREASURER CERTIICATION OF EXPENDITURES DATE: April 29,2 2025 Prepared by: HOTLINE COUNTY CONNECTION CENTER FUND Mindy Maestas H3C SALARY 31705-31732 66,524.82 H3C FRINGE 4212-4218 49,127.09 H3C OPERATING 4211 164.26 H3C CANCELLED TOTAL:S 115,816.17 Information Only VOIDED CHECKS #'s: IA Lanie Mireles, Director - o PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 5/13/25 Submitter: Don Wilson, County Administrator Submitted to the County Administration Office on: 4/28/25 Return Originals to: Don Wilson & Jana Coen Number of originals to return to Submitter: 1 Contract Due Date: N/A Item Tite/Recommended Board Action: Consider approval of a Letter of Support sent to US Department ofTransportation, Sean Duffy for Southeast Colorado Safe Streets and Roads for All (SS4A) through the Thriving Communities Program initiative in Southeast Colorado. 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): Board of County Commissioners Prowers County 301 South Main, Suite 215 Ia )1 Lamar, Colorado 81052-2857 (719) 336-8025 FAX: (719) 336-2255 Ty! Harmon RON COOK ROGER STAGNER FIRST DISTRICT SECOND DISTRICT THIRDI DISTRICT April 13, 2025 The Honorable Sean Duffy US Department ofTransportation 1200 New Jersey Ave, SE Washington, DC 20590 RE: Support for the Southeast Colorado Safe Streets and Roads for All (SS4A) Planning Grant Dear Secretary Duffy, The Prowers County Board of County Commissioner have reviewed the information presented by the Southeast Colorado Thriving Communities Program (SECO-TCP) team regarding the coordinated regional grant application for USDOT Safe Streets and Roads for All (SS4A) planning grant funding. This funding will support the development ofa Comprehensive Transportation Safety Action Plan for the Southeast Colorado region. Prowers County plans to actively participate in and support the regional USDOT- SS4A planning grant application submitted by SECO-TCP (or designated lead applicant). Our County is interested in ensuring the resulting regional Comprehensive Transportation Safety Action Plan includes the following activities relevant to our community: Identification of roadway characteristics or design elements strongly correlated with safety issues in our county. Development of prioritized safety projects and specific countermeasure recommendations applicable to our county. Benefit-Cost Analysis or similar economic and engineering documentation elements for future priority projects within our county. We support this collaborative regional effort, which will provide critical resources to advance transportation safety planning activities in Prowers County and across Southeast Colorado. Thank you for your favorable consideration oft the Southeast Colorado Region's SS4A Planning Grant application. Sincerely, Ron Cook County Commissioner Ty Harmon County Commissioner Roger Stagner County Commissioner PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 5/13/25 Submitter: Department of Human Services Submitted to the County Administration Office on: 4/22/25 Return Originals to: Department of Human Services Number of originals to return to Submitter: 1 Contract Due Date: ASAP Item Tile/Recommended Board Action: Consider approval of Memorandum of Understanding to facilitate the Prowers County Hotline County Connection Center with answer and processing of Child Welfare and Adult Protection Services related Hotline calls and performing tasks outlined in the MOU's effective January 1, 2025 and ending December 31, 2025 with Broomfield County and authorizing Director of Human Services, Lanie Meyers-Mireles to execute the MOU. Justification or Background: Fiscal Impact: This item is budgeted in the following account code: County: $ Federal: $ State: $ Other: $ Approved by the County Attorney on: 5-5-2025 Additional Approvals (if required): PLEAST ATTACH THIS SHEET TO ALL AGENDA ITEMS WHEN SUBMITTING TO COUNTY ADMINISTRATION. THANK YOU! Docusign Envelope ID: 11BODSE7-807D-4019816F-48022ABAZE MEMORANDUM OF UNDERSTANDING Between BROOMFIELD COUNTY and PROWERS COUNTY INTRODUCTION: This Memorandum of Understanding ("MOU") is entered into by and between Prowers County, Colorado body corporate and politic by and through its Board of County Commissioner ("Prowers County'), and Broomfield County, Colorado ("Broomfield County") a body corporate and politic by and through its Board of County Commissioners. Prowers County and Broomfield County shall jointly be referred to as the "Parties." PURPOSE: 1. This MOU is developed in partnership between Prowers County and Broomfield County, with confirmation by the State of Colorado ("State"), for Prowers County to manage and administer calls to the hotline regarding persons that reside in Broomfield County, Colorado. 2. Prowers County, through its Hotline County Connection Center ("HCCC"), agrees to answer and process Child Welfare ("CW") related and APS related hotline calls on behalf of Broomfield County ("Call Coverage Services"). Prowers County will perform the tasks outlined in this MOU as they relate to Call Coverage Services. Broomfield County will perform the tasks identified in the MOU to assist the HCCC with successfully receiving the Hotline calls SO Broomfield County can complete the final disposition of each call. TERM, AMENDMENT, TERMINATION: 1. Term of MOU: a. This MOU becomes effective January 1, 2025 for the period of 12 months, ending December 31, 2025. b. The parties shall notify each other at least 30 days prior to expiration of the MOU to execute an extension. 2. Amendments: a. The Parties may request changes to this MOU, which shall be effective only upon the written agreement of the Parties. b. Any changes, modifications, revisions, or amendments to this MOU shall be incorporated by written instrument, executed and signed by the Parties, and will be effective in accordance with the terms and conditions contained herein. 3. Termination: a. Any party may, at its sole discretion, terminate or cancel the MOU upon 30 days' written notice to the other party. RATE FOR SERVICES: 1. The calculations used to determine the rate of the Call Coverage Services are based on an annual projection of the number of Child Protection Program Area 5, Program Area 4, and Institutional reports taken and an equivalent number of Other Child Welfare ("Other CW") Inquiry related call reports. For purposes oft this MOU, 10 "Other CW" calls will equal 1 report. a. Projected numbers of Program Area 5, Program Area 4, Institutional, "Other CW", and APS reports will be based on a combination ofi information from the Results Oriented Management data base and the actual numbers of calls received through the HCCC for the previous 12 months. Page 1 of 15 Docusign Envelope ID: 11B00SE/-807D4C19816F4802P2ABAZE 2. Broomfield County is allocated 4 free reports, child abuse/neglect or APS reports, each month for a total of48 free reports of any type per year. 3. Prowers County has entered into agreements with other Colorado counties to provide the same services as contemplated in this MOU. In the event the HCCC must expend additional funds to accommodate adding additional positions to take calls on behalf ofall ofthe other counties including Broomfield County, the cost of that expansion may be proportionately distributed amongst all of the counties that receive HCCC Call Coverage Services. Should this situation arise, Broomfield County will be notified 60 days in advance of any additional costs required for HCCC's services so it can determine whether to terminate the MOU. 4. Prowers County will invoice for the Call Coverage Services. Invoices shall include a description of the services performed as Broomfield County may request. Broomfield County will submit payment for services satisfactorily performed within 60 days of receipt. 5. The rates of Call Coverage Services provided to Broomfield County per the terms of the MOU are: Estimated number of Child Abuse/Neglect Reports Jan 2025 - Dec 2025 174 CW Inquiries 40 Divided by 10 4 Total Estimated Reports 178 Less the Allotrient of Reports (4 per month or 12 per quarter) -48 Total Estimated Reports to be billed 130 Rate per Report $ 25.00 Estimated Investment for C/W Reports $ 3,250.00 Estimated number of APS reports Jan 2025 - Dec 2025 42 Rate per APS Report $ 25.00 Estimated Investment: for APS reports $ 1,050.00 Total Investment for Call Coverage services $ 4,300.00 6. Broomfield County will be billed quarterly for actual number of reports taken, less the allotted reports 12 reports of any type per quarter. JOINT RESPONSIBILITIES SHARED BETWEEN BROOMFIELD COUNTY AND PROWERS COUNTY HCCC: 1. Both Prowers County and Broomfield County acknowledge that the State of Colorado Department of Human Services must approve this MOU prior to final execution. 2. This MOU was preceded by an official request for Call Coverage Services from the Board of County Commissioners for Broomfield County. 3. Both parties understand that nothing in this MOU supersedes or replaces each party's requirements and responsibilities to follow and adhere to all requirements as set forth in state and federal statute, Volume 71 Rules and/or Division of Child Welfare Policy. 4. Both parties agree to maintain appropriate insurance coverage to fulfill their respective obligations under this MOU. Each party shall be responsible for ensuring its own compliance with applicable insurance requirements. GENERAL RESPONSIBILITIES OF PROWERS COUNTY HCCC: 1. The Prowers County HCCC will make the appropriate routing changes and take all the after-hours calls for Broomfield County. After-Hours is defined as any time outside of normal business operating hours, including week-ends and holidays. 2. All next step decisions regarding Hotline call records will be left to the discretion of Broomfield County. Broomfield County will be responsible to complete a review of all information in THA and Trails to ensure appropriate disposition. Page 2 of 15 Docusign Envelope ID: 11B00E7-807D-4C19816F-4802P2ABA22E 3. Reports, which can be referred to as Referrals, taken by the HCCC will be entered into the THA, submitted, and transferred to Broomfield County's Trails Inbox. HCCC will notify Broomfield County of a referral via email during business hours and by personal contact during after-hours (pursuant to Volume 7 Rules). It will be the responsibility of Broomfield County to check the pending queue and manage the final disposition of all records. a. HCCC will provide the Hotline ID and/or Referral ID number (pursuant to Volume 7 Rules) to an entity designated by Broomfield County. 4. Ifthe HCCC believes the report is of an immediate response nature, the HCCC will notify Broomfield County while information is being entered into the THA or CAPS. 5. Information and Referral (non-CW) calls will be sent to Broomfield County's Pending Incoming Hotline Queue (pursuant to Volume 7 Rule). It will be the responsibility of] Broomfield County to check the pending queue and manage the final disposition of all records. Call purpose will be included in the comments. Callers will be redirected back to the Broomfield County main Department of] Human Services number. Broomfield County can request a brief synopsis. 6. IfHCCC receives a call from law enforcement or medical personnel that requires immediate response from Broomfield County, HCCC will transfer the call to an Broomfield County on-call designee. Ifthe Broomfield County on-call designee is not available, HCCC will take a message and continue to make attempts to notify the County. Ifappropriate, the HCCC will take a report while notifying the County. 7. APS reports will be documented in the Colorado Adult Protection System, ("CAPS") and in the THA. Once complete, the record will be transferred to the County's Pending Incoming Hotline Queue. Broomfield County will confirm receipt and update in the THA. a. If an APS call is regarding an adult over 70 years old, the HCCC will document the call in the THA and advise the reporter to call local law enforcement. The HCCC will then notify the County oft the call. b. Notification to Broomfield County that an APS report has been taken by the HCCC will be made by email during both open and after-hours. GENERAL RESPONSILITIES OF BROOMFIELD COUNTY 1. Broomfield County willj provide an updated list of on-call Broomfield County employees' name(s) or designees and telephone/celiphone numbers and email addresses at all times. The on-call list will include backup contact name(s) and number(s) and email addresses in case the first employee is unable to answer within the notification time frame as outlined in Volume 7 Rules. Ifthe designee changes, it is the Broomfield County's responsibility to immediately inform the HCCC of the change and to provide the required contact information. 2. Broomfield County will notify the HCCC of any special circumstances where Broomfield County staff will be unavailable by email (business hours) or voice telephone/celiphone (i.e. employees are in court, meetings, training after-hours, etc.) Broomfield County should make every attempt to identify another entity that can receive notifications. This can be any entity designated by Broomfield County. GENERAL PROVISIONS 1. This MOU is not intended to create any agency or employment relationships between the parties nor is it intended to create any third-party rights or beneficiaries. 2. Nothing contained herein shall be construed as a waiver of any party or any immunity at law including immunity granted under the Colorado Governmental immunities Act. 3. No modification or waiver oft this MOU or of any covenant, condition, or provision herein contained shall be valid unless in writing and duly executed by the party to be charged therewith. Page 3 of 15 Docusign Envelope ID: 1180DSE7-807D-4C19816F-4802P2ABAZZE 4. This MOU and the parties conduct hereunder shall be subject to local, state and federal laws and regulations, including requirements associated with confidentiality ofi information and HIPAA privacy requirements. 5. The Parties to this MOU are subject to the provisions of Colorado Constitution, Article X, Section 20 regarding multiple fiscal year obligations. Therefore, no obligation extending beyond December 31, 2025 shall be enforceable unless and until County, acting through the Board, has adopted a budget for 2026 providing forj payment of such obligations. Broomfield County shall immediately notify Prowers County should funding under this MOU fail to be appropriated in such instance, Prowers County: may immediately terminate this MOU. 6. All three of the authorizing and confirming agencies listed below must agree to the conditions set forth in the proceeding document before the MOU can be finalized. 7. All signatories have the appropriate delegation ofa authority to sign this MOU. 8. This MOU is subject to all applicable federal, state and local laws, regulations and rules, whether now in force or hereafter enacted or promulgated. If any term or provision of this MOU is held to be invalid or illegal, such term or provision shall not affect the validity or enforceability of the remaining terms and provisions. Meeting the terms of this MOU shall not excuse any failure to comply with all applicable laws and regulations, whether or not these laws and regulations are specifically listed herein. 9. No third-Party Beneficiary. It is expressly understood and agreed that enforcement oft the terms and conditions of this MOU, and all rights of action relating to such enforcement, shall be strictly reserved to the Parties, and nothing contained in this MOU shall give or allow any such claim or right of action by any other or third person or entity on such MOU. Iti is the express intention oft thej parties hereto that any person or entity, other than the Parties, receiving services or benefits under this MOU shall be deemed to be incidental beneficiaries only. 10. Each Party agrees to be responsible for its own liability incurred as a result ofi its participation in this MOU. In the event any claim is litigated, each Party will be responsible for its own expenses of litigation or other costs associated with enforcing this MOU. No provision of this MOU shall be deemed or construed to be a relinquishment or waiver of any kind oft the applicable limitation of liability provided to each Party by the Colorado governmental Immunity Act, C.R.S. 24-101-101 et seq. and Article XI ofthe Colorado Constitution. FEDERALLY FUNDED SERVICES The City has received federal funding for this work from the US Department ofHealth and Human Services - Child Welfare Block. For any work subject to funding by the Federal Government, the Contractor agrees to comply with all applicable Federal contracting requirements in Exhibit A and any other federal or state contracting terms which may be applicable to the work. Page 4 of 15 Docusign Envelope ID: 11B0DSE7-807D04019816F-4802P2ABAZZE Approving Entities Approving Entities Signed: Signed: Name: Name: Title: Title: Entity: Entity: State Confirmation 4/22/2025 Date: stgmeduy: Signed: Beaditte Rohiguy 251F8392C7EC4PA. Name: Bernadette Rodriguez Title: Entity: Page 5 of 15 Docusign Envelope ID: 11B05E7-807D4C19816F4802P2ABAZZE EXHIBIT A FEDERAL UNIFORM GRANT GUIDANCE REQUIRED CONTRACT CLAUSES The Parties to the Agreement to which this Exhibit is attached hereby acknowledge that the Agreement is subject to the provisions of 2 C.F.R. Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. In accordance with 2 C.F.R. 200.327 the following provisions are hereby added and incorporated into the Agreement; to the extent that the terms of the Agreement and this exhibit conflict, the terms of this exhibit shall control. During the performance of this Agreement, the Contractor agrees as follows: A. SUPPLEMENTAL DEFAULT AND REMEDY PROVISIONS. (Applicable to all contracts and subcontracts in excess of $250,000, the simplified acquisition threshold as adjusted for inflation. See 2 CFR Part 200, Appendix I(A)) In addition to the contractual, administrative and legal provisions within the Agreement to which this Exhibit is attached and incorporated into, the following Default and Remedy provisions apply. 1. Contractor's failure to perform or observe any term, covenant or condition of this document or failure to fulfill in a timely and proper manner its obligations under this Agreement shall constitute an event of default under this Agreement. Each of the following shall also constitute an event of default ("Event of Default") under this Agreement: a. Contractor fails or refuses to perform or observe any other term, covenant or condition contained in this Agreement, and such default continues for a period of ten days after written notice thereof from City to Contractor. b. Contractor (i) is generally not paying its debts as they become due, (ii) files, or consents by answer or otherwise to the filing against it of a petition for relief or reorganization or arrangement or any other petition in bankruptcy or for liquidation or to take advantage of any bankruptcy, insolvency or other debtors' relief law of any jurisdiction, (iii) makes an assignment for the benefit of its creditors, (iv) consents to the appointment of a custodian, receiver, trustee or other officer with similar powers of Contractor or of any substantial part of Contractor's property or (v) takes action for the purpose of any of the foregoing. C. A court or government authority enters an order (i) appointing a custodian, receiver, trustee or other officer with similar powers with respect to Contractor or with respect to any substantial part of Contractor's property, (ii) constituting an order for relief or approving a petition for relief or reorganization or arrangement or any other petition in bankruptcy or for liquidation or to take advantage of any bankruptcy, insolvency or other debtors' relief law of any jurisdiction or (iii) ordering the dissolution, winding-up or liquidation of Contractor. 2. On and after any Event of Default, City shall have the right to exercise its legal and equitable remedies, including, without limitation, the right to terminate this Agreement or to seek specific performance of all or any part of this Agreement. In addition, City Page 6 of 15 Docusign Envelope ID: 11BODSE7-0/D4C19816F-4802P2ABA2ZE shall have the right (but no obligation) to cure (or cause to be cured) on behalf of Contractor any Event of Default; Contractor shall pay to City on demand all Page 1 Updated 10/25/2024 costs and expenses incurred by City in effecting such cure, with interest thereon from the date of incurrence at the maximum rate then permitted by law. City shall have the right to offset from any amounts due to Contractor under this Agreement or any other agreement between City and Contractor all damages, losses, costs or expenses incurred by City as a result of such Event of Default and any liquidated damages due from Contractor pursuant to the terms of this Agreement or any other agreement. 3. ALL remedies provided for in this Agreement may be exercised individually or in combination with any other remedy available hereunder or under applicable laws, rules and regulations. The exercise of any remedy shall not preclude or in any way be deemed to waive any other remedy Except as modified herein, all terms and conditions of the existing contract between the parties remain in full force and effect. B. TERMINATION FOR CONVENIENCE OF CITY. (Applicable to all contracts in excess $10,000. see 2 CFR Part 200, Appendix II(B)) 1. City shall have the option, in its sole discretion, to terminate this Agreement, at any time during the term hereof, for cause and for convenience and without cause. City shall exercise this option by giving Contractor written notice of termination. The notice shall specify the date on which termination shall become effective 2. Upon receipt of the notice, Contractor shall commence and perform, with diligence, all actions necessary on the part of Contractor to effect the termination of this Agreement on the date specified by City and to minimize the liability of Contractor and City to third parties as a result of termination. AlL such actions shall be subject to the prior approval of the City. Such actions shall include, without limitation: a. Halting the performance of all services and other work under this Agreement on the date(s) and in the manner specified by City. b. Not placing any further orders or subcontracts for materials, services, equipment or other items. C. Terminating all existing orders and subcontracts. d. At City's direction, assigning to City any or all of Contractor's right, title, and interest under the orders and subcontracts terminated. Upon such assignment, City shall have the right, in its sole discretion, to settle or pay any or all claims arising out of the termination of such orders and subcontracts. e. Subject to City's approval, settling all outstanding liabilities and all claims arising out of the termination of orders and subcontracts. f. Completing performance of any services or work that City designates to be completed prior to the date of termination specified by City. Page 7 of 15 Docusign Envelope ID: 1BODSE/-0/D4019816F-480AF2ABA2ZE g. Taking such action as may be necessary, or as the City may direct, for the protection and preservation of any property related to this Agreement which is in the possession of Contractor and in which City has or may acquire an interest. Page 2 Updated 10/25/2024 3. Within 30 days after the specified termination date, Contractor shall submit to City an invoice, which shall set forth each of the following as a separate line item: a. The reasonable cost to Contractor, without profit, for all services and other work City directed Contractor to perform prior to the specified termination date, for which services or work City has not already tendered payment. Reasonable costs may include a reasonable allowance for actual overhead, not to exceed a total of 10% of Contractor's direct costs for services or other work. Any overhead allowance shall be separately itemized. Contractor may also recover the reasonable cost of preparing the invoice. Taking such action as may be necessary, or as the City may direct, for the protection and preservation of any property related to this Agreement which is in the possession of Contractor and in which City has or may acquire an interest. b. A reasonable allowance for profit on the cost of the services and other work described in the immediately preceding subsection (1), provided that Contractor can establish, to the satisfaction of City, that Contractor would have made a profit had all services and other work under this Agreement been completed, and provided further, that the profit allowed shall in no event exceed 5% of such cost. c. The reasonable cost to Contractor of handling material or equipment returned to vendor, delivered to the City or otherwise disposed of as directed by the City. 4. In no event shall City be liable for costs incurred by Contractor or any of its subcontractors after the termination date specified by City, except for those costs specifically enumerated and described in the immediately preceding subsection 3. Such non-recoverable costs include, but are not limited to, anticipated profits on this Agreement, post-termination employee salaries, post-termination administrative expenses, post-termination overhead or unabsorbed overhead, attorneys' fees or other costs related to the prosecution of a claim or lawsuit, prejudgment interest, or any other expense which is not reasonable or authorized under such subsection 3. 5. In arriving at the amount due to Contractor under this Section, City may deduct: a. AlL payments previously made by City for work or other services covered by Contractor's final invoice; b. Any claim which City may have against Contractor in connection with this Agreement; C. Any invoiced costs or expenses excluded pursuant to the immediately preceding subsection 4; and d. In instances in which, in the opinion of the City, the cost of any service or other work performed under this Agreement is excessively high due to costs incurred to Page 8 of 15 Docusign Envelope ID: 11BODSE/-807D4C19816F-4802F2ABAZE remedy or replace defective or rejected services or other work, the difference between the invoiced amount and City's estimate of the reasonable Page 3 Updated 10/25/2024 cost of performing the invoiced services or other work in compliance with the requirements of this Agreement. 6. City's payment obligation under this Section shall survive termination of this Agreement. C. EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE. (Applicable to all federally assisted construction contracts as defined in 41 CFR Part 60-1.3 by grantees and their contractors and subcontractors, in excess of $10,000; see 2 CFR Part 200, Appendix II(C)). During the performance of this contract, the Contractor agrees as follows: 1. The Contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. The Contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion, or transfer, recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause. 2. The Contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin. 3. The Contractor will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with the Contractor's legal duty to furnish information. 4. The Contractor will send to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding, a notice to be provided by the agency contracting officer advising the labor union or workers' representative of the contractor's commitments under section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. Page 9 of 15 Docusign Envelope ID: VIBODSE7807D4C19816F-4802F2ABAZZE Page 4 Updated 10/25/2024 5. The Contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, as amended and of the rules, regulations, and relevant orders of the Secretary of Labor, 6. The Contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, as amended, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. 7. In the event of the Contractor's non-compliance with the nondiscrimination clauses of this contract or with any of such rules, regulations, or orders, this contract may be canceled, terminated or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. 8. The Contractor will include the provisions of paragraphs (1) through (8) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The Contractor will take such action with respect to any subcontract or purchase order as may be directed by the Secretary of Labor as a means of enforcing such provisions including sanctions for noncompliance: Provided, however, that in the event the Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction, the Contractor may request the United States to enter into such litigation to protect the interests of the United States. D. DAVIS-BACON ACT COMPLIANCE. (Applicable to prime construction contracts exceeding $2,000; see 2 CFR Part 200, Appendix I(D)) 1. The Contractor shall comply with 40 U.S.C. 3141-3148 as supplemented by 29 C.F.R. Part 5. 2. AlL laborers and mechanics employed by the Contractor on construction work pursuant to this Agreement, and subject to the provisions of the federal acts and regulations listed herein, shall be paid wages at rates not less than the prevailing wages on similar construction in the locality as determined by the Secretary of Labor in accordance with the Davis-Bacon Act. In addition, the Contractor must pay wages not less than once a week. 3. The parties acknowledge that the City must report all suspected or reported violations to the Federal awarding agency. 4. The Contractor shall also comply and ensure subcontractor compliance with the Copeland "Anti-Kickback" Act (40 U.5.C. 3145), as supplemented by Department of Labor regulations (29 CFR Part 3, "Contractors and Subcontractors on Public Building Page 5 Updated 10/25/2024 Page 10 of 15 Docusign Envelope ID: MBODSE/-8O7D4C19816F4802F2ABAZE or Public Work Financed in Whole or in Part by Loans or Grants from the United States"). As such Contractor and any subcontractors thereof are prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The City must report all suspected or reported violations to the Federal awarding agency. E. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT COMPLIANCE. (Applicable to agreement is in excess of $100,000 and involving the employment of mechanics or laborers; see 2 CFR Part 200, Appendix II(E)). The Contractor shall comply with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). The Contractor is required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hours in the work week. Contractor shall comply with 40 U.S.C. 3704 as it is applicable to construction work. No laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. F. INVENTIONS MADE UNDER THE AGREEMENL. (Applicable to federally funded contracts for the performance of experimental, developmental, or research work; see 2 CFR Part 200, Appendix I(F)) If the Federal award providing funding for this Agreement meets the definition of "funding Agreement" under 37 CFR S 401.2 (a) and this Agreement is between the City and a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under that Funding Agreement, the City and Contractor shall comply with the requirements of 37 CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements, 1 and any implementing regulations issued by the awarding agency. G. CLEAN AIR AND CLEAN WATER ACTS COMPLIANCE. (Applicable to all contracts and subgrants in excess $150,000; see 2 CFR Part 200, Appendix II(G)) 1. Clean Air Act. a. The Contractor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act at 42 U.S.C. S 7401 et. seq. b. The Contractor agrees to report each violation to the City and understands and agrees that the City will, in turn, report each violation as required to assure notification to the State of Colorado, the Federal reporting agency, and the appropriate Environmental Protection Agency Regional Office. C. The Contractor agrees to include these requirements in each subcontract exceeding $150,000 financed in whole or in part with Federal assistance. Page 6 Updated 10/25/2024 2. Federal Water Pollution Control Act. Page 11 of 15 Docusign Envelope ID: 11B0D8E/-807D4019816F-4802P2ABA22E a. The Contractor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Federal Water Pollution Control Act, as amended, 33 U.S.C. 1251 et. seq. b. The Contractor agrees to report each violation to the City and understands and agrees that the City will, in turn, report each violation as required to assure notification to the State of Colorado, the Federal reporting agency, and the appropriate Environmental Protection Agency Regional Office. C. The Contractor agrees to include these requirements in each subcontract exceeding $150,000 financed in whole or in part with Federal assistance. H. DEBARMENT AND SUSPENSION. (Applicable to all contracts and subcontracts; see 2 CFR Part 200, Appendix I(H)) Contractor acknowledges that a contract utilizing Federal funding may not be awarded to parties listed on the governmentwide exclusions in the System for Award Management (SAM). in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235), "Debarment and Suspension. " In addition, Contractor affirms that neither it nor its principals are suspended or debarred or otherwise excluded from procurement by the Federal Government and do not appear in the SAM Exclusions, which is a list maintained by the General Services Administration. I. BYRD ANTI-LOBBYING AMENDMENT COMPLIANCE. (Applicable to awards or contracts of $100,000; see 2 CFR Part 200, Appendix II(I)) Contractors who apply or bid for an award of $100,000 or more shall file the required certification set forth in CERTIFICATION REGARDING LOBBYING, 44 C.F.R. Part 18, Appendix A. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining a Federal contract, grant, or any other award covered by 31 U.S.C. 5 1352. Each tier shall also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the recipient. J. PROCUREMENT OF RECOVERED MATERIALS.(To the extent applicable by law; See 2 CFR Part 200, Appendix II(J)) Contractor also agrees to comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act of 1976 as amended, 42 U.S.C. 6962. The requirements of Section 6002 include procuring only items designated in the guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal year exceeded $10,000; procuring solid Page 7 Updated 10/25/2024 Page 12 of 15 Docusign Envelope ID: 1BODSE/-807D4C19816F-802P2ABA2ZE waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines. In the performance of this Agreement, the Contractor shall make maximum use of products containing recovered materials that are EPA-designated items unless the product cannot be acquired: 1. Competitively within a timeframe providing for compliance with the contract performance schedule; 2. Meeting contract performance requirements; or 3. At a reasonable price. Information about this requirement, along with the list of EPA designated items, is available at EPA's Comprehensive Procurement Guideline (CPG) Program web site, MtPV/Amascmswamm.smmsartNEsAETNwa The Contractor should, to the greatest extent practicable and consistent with law, purchase, acquire, or use products and services that can be reused, refurbished, or recycled; contain recycled content, are biobased, or are energy and water efficient; and are sustainable. This may include purchasing compostable items and other products and services that reduce the use of single-use plastic products. See Executive Order 14057, section 101, Policy. K. PROHIBITED TELECOWMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT. (To the extent applicable by law; See 2 CFR Part 200, Appendix "(K)) Contractor and subcontractor, if applicable, are prohibited from expending funds arising from this contract to: 1. Procure or obtain covered telecommunications equipment or service; 2. Extend or renew a contract to procure or obtain covered telecommunications equipment or service; or 3. Enter into a contract (or extend or renew a contract) to procure or obtain covered telecommunications equipment. 4. As described in section 889 of Public Law 115-232, "covered telecommunications equipment or services" means any of the following: a. Telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary or affiliate of such entities; b. For the purpose of public safety, security of government facilities, physical security surveillance of critical infrastructure, and other national security purposes, video surveillance and telecommunications, equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities); Page 8 Updated 10/25/2024 Page 13 of 15 Docusign Envelope ID: 11B0DSE/-807D4C19818F-4802F2ABASZE C. Telecommunications or video surveillance services provided by such entities or using such equipment; and d. Telecommunications or video surveillance equipment or services produced by an entity that the Secretary of Defense in consultation with the Director of the National Intelligence or the Director of the Federal Bureau of Investigation, reasonably believes to be an entity owned or controlled by, or otherwise connected to, the government of a covered foreign country. 5. For the purposes of this section, "covered telecommunications equipment or services" also include systems that use covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. 6. See Public Law 115-232, section 889 for additional information. See also 2 CFR 200.471. L. DOMESTIC PREFERENCE. (To the extent applicable by law; See 2 CFR Part 200, Appendix H(L) and 2 CFR 200.322) As appropriate and to the extent consistent with law, the Contractor should, to the greatest extent practicable, provide a preference for the purchase, acquisition, or use of goods, products, or materials produced in the United States (including but not limited to iron, aluminum, steel, cement, and other manufactured products). The requirements of this section must be included in all subawards including all contracts and purchase orders for work or products under this award. For purposes of this section: 1. "Produced in the United States" means, for iron and steel products, that all manufacturing processes, from the initial melting stage through the application of coatings, occurred in the United States. 2. "Manufactured products" means items and construction materials composed in whole or in part of non-ferrous metals such as aluminum; plastics and polymer-based products such as polyvinyl chloride pie; aggregates such as concrete; glass, including optical fiber; and lumber. M. CONTRACTING WITH SMALL AND MINORITY BUSINESSES. WOMEN'S BUSINESS ENTERPRISES. AND LABOR SURPLUS AREA FIRMS. (See 2 CFR 200.321) 1. If subcontracts are to be let, Contractor must take the following affirmative steps to assure that small and minority businesses, women's business enterprises, and labor surplus firms are used when possible: a. Placing qualified small and minority businesses and women's business enterprises on solicitation lists. b. Assuring that small and minority businesses, and women's business enterprises are solicited whenever they are potential sources; Page 9 Updated 10/25/2024 Page 14 of 15 Docusign Envelope ID: 11B0DSE7-807D-4C19816F4802F2ABAZE C. Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women's business enterprises; d. Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority businesses, and women's business enterprises; and e. Using the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce. N. ADDITIONAL REQUIREMENTS OF FUNDING SOURCE AGENCY. Finally, the Parties additionally agree that Federal Funding source agency rules and regulations may require the incorporation and additional legal or regulatory references or contract provisions and nothing herein by this Exhibit is intended to revise, negate or conflict with any such necessary provision, rather the intent is to summarize and memorialize all applicable provisions, to the extent possible. Page 10 Updated 10/25/2024 Page 15 of 15 PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 5-13-2025 Submitter: Don Wilson, County Administrator Submitted to the County Administration Office on: Email Poll 4-23-2025 Return Originals to: Don Wilson & Jana Coen Number of originals to return to Submitter: 1 Contract Due Date: Consider ratifying 4-23-2025 email poll approval of a letter sent to Pamela Bondi, U. S. Attorney General Department of Justice, requesting support for the growing concerns of Colorado citizens related to the Second Amendment of the United States Constitution and authorizing the use of the Commissioner's signature stamps. Item Tile/Recommended Board Action: 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): Board of County Commissioners Prowers County 301 South Main, Suite 215 I - ) Lamar, Colorado 81052-2857 (719) 336-8025 FAX: (719) 336-2255 Ty Harmon RON COOK ROGER: STAGNER FIRST DISTRICT SECOND DISTRICT THIRD DISTRICT April 23, 2025 The Honorable Pamela Bondi Attorney General of the United States U.S. Department of Justice 950 Pennsylvania Avenue NW Washington, DC 20530-0001 Re: Request for Support Dear Honorable Attorney General Bondi, The Prowers County Board of County Commissioners respectfully requests the support of the Department of Justice and its Second Amendment Enforcement Task Force regarding the growing concerns of Colorado citizens related to the Second Amendment ofthe United States Constitution. Over the past several years, the right to keep and bear arms in Colorado has been increasingly restricted. Most recently, Senate Bill 25-003 has imposed excessively burdensome requirements that, in effect, create a socioeconomic barrier to exercising this constitutional freedom. This legislation demands significant financial investment and time commitments from individuals, effectively forming a class system around a fundamental right. We are asking the Second Amendment Task Force to investigate the validity and constitutionality ofthe burdens this legislation places on our citizens and local law enforcement. As a rural, lower-income community, many of our residents lack the disposable income and available time to pay for mandated fees and courses simply to enjoy what were once accessible freedoms whether that be participating in an annual hunting trip, a shooting sports event, or ensuring the protection of one's family, home, and livestock. Senate Bill 25-003 also imposes unfunded administrative burdens on our County Sheriff's Department, diverting resources from critical law enforcement duties to instead monitor and process the lawful activities of everyday citizens. Since 2013, we have publicly identified Prowers County as a strong defender ofthe Second Amendment. We have taken proactive steps to preserve this right for our residents. Rural communities like ours represent the majority of Colorado s land, agricultural production, and supply chain infrastructure. However, our voices are often overshadowed by urban population centers, despite the original intent of our nation's system of governance which was designed to ensure even minority voices are heard on issues of significance. We, along with other counties, have brought these concerns to the Governor of Colorado and our U.S. Senators, but have received no acknowledgment or meaningful response. We now turn to the Second Amendment Enforcement Task Force in the hope that you will recognize the severity of this issue and provide guidance, recommendations, and any appropriate actions to help restore and protect the Second Amendment rights of our citizens. Sincerely, i - a A Ron Cook / Bn County Commissioner Roger Stagnerkez County Commissioner /4 Ty Harmon County Commissioner PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 5-13-2025 Submitter: Paula Gonzales, County Finance Director Submitted to the County Administration Office on: Verbal Poll 4/30/2025 Return Originals to: Jana Coen & Paula Gonzales Number of originals to return to Submitter: 1 Contract Due Date: Item ntle/Recommended Board Action: Consider ratifying 4-30-2025 verbal poll approval for payment of bills presented for County General Fund AP in the amount of $1,778.99 with a Certification date of April 30, 2025 and authorizing the use of the Commissioner's signature stamps. Justification or Background: Fiscal Impact: This item is budgeted in the following account code: County: $ Federal: $ State: $ Other: $ PROWERS COUNTY APPROVE TO PAY APPROVE PAYMENTS AS HEREIN SET FORTH. CHECK NUMBERS AS LISTED BELOW ARE ALL INCLUSIVE, ARE SET OPPOSITE THEIR NAMES, AND TOTALING THE SUM OF: $1,778.99 DRAWN ON COUNTY GENERAL FUNDS. DATED AS OF: April 30, 2025 # A/P PAYROLL FRINGES $ COUNTY GENERAL FUND $ 1,778.99 $ ARPA FUND $ $ FSA. ACCOUNT $ $ BOOKING FEES ACCOUNT $ $ PUBLIC HEALTH AGENCY $ $ ROAD & BRIDGE FUND $ $ SALES & USE TAX FUND $ $ CONSERVATION TRUST FUND $ $ CAPITAL FUND $ $ OTHER AGENCIES FUND $ $ LODGING TAX FUND $ $ CRMC FUND $ $ OPC FUND $ Totals $ 1,778.99 $ DATE: April 30, 2025 Bi ARMAN DATE: April 30, 2025 OMMISSIG ER DATE: April 30, 2025 CAMMISWER DATE: April 30, 2025 CHERK TO THE BOARD Total Paid Approve To Pay $ 1,778.99 AP + Fringes $ 1,778.99 Total Pd Certification - Payroll $ 1,778.99 Total Payroll + Fringes $ STATE OF COLORADO) Ending Check No. 75113 jss: Beginning Check No. 75113 COUNTY OF PROWERS) 1 Total Number of Checks: 1 Bolou Comyploill Prowers County Treàsurer's Office PROWERS COUNTY APPROVE TO PAY APPROVE PAYMENTS AS HEREIN SET FORTH. CHECK NUMBERS AS LISTED BELOW ARE ALL INCLUSIVE, ARE SET OPPOSITE THEIR NAMES, AND TOTALING THE SUM OF: $1,778.99 DRAWN ON COUNTY GENERAL FUNDS. DATED AS OF: April 30, 2025 # A/P PAYROLL FRINGES $ COUNTY GENERAL FUND $ 1,778.99 $ ARPA FUND $ $ FSA. ACCOUNT $ $ BOOKING FEES ACCOUNT $ $ PUBLIC HEALTH AGENCY $ $ ROAD & BRIDGE FUND $ $ SALES & USE TAX FUND $ $ CONSERVATION TRUST FUND $ $ CAPITAL FUND $ $ OTHER. AGENCIES FUND $ $ LODGING TAX FUND $ $ CRMC FUND $ $ OPC FUND $ Totals $ 1,778.99 $ DATE: April 30, 2025 8 BO CC CHAARMAN, DATE: April 30, 2025 ROMMISSINER DATE: April 30, 2025 oM GNER DATE: April 30, 2025 CLERKTO THE BGARD Total Paid Approve To Pay $ 1,778.99 AP + Fringes $ 1,778.99 Total Pd Certification - Payroll $ 1,778.99 Total Payroll + Fringes $ STATE OF COLORADO) Ending Check No. 75113 SS: Beginning Check No. 75113 COUNTY OF PROWERS) 1 Total Number of Checks: 1 lolow Copou Prowers County Treasurer's Office PROWERS COUNTY TREASURER CERTIFICATION COUNTY GENERAL FUND-01 0010 April30,2025 75113 $ 1.778.99 Payroll S Total Fringess Totals 1,778.99 ARPA- 0018 Total_s ROAD & BRIDGE FUND -02 0020 S Payroll S - Fringes_ $ Totals FSA (Cafeteria) 552 0552 S 2024 S Totalls Sheriff's Booking. Fees 0675 $ 2024 s Payrol $ Totalls SALES & USE TAX FUND: - 03 0900 $ 2024 $ Total_s CONSERVATION TRUST FUND - 06 0130 S 2024. S Totalls CAPITAL FUND -07 0100 $ 2024 S Totalfs OTHER AGENCIES FUND- 08 S 2024 $ Totals LODGING TAX-09 0014 $ 2024 $ Payroll $ TotalF Fringes_s Totalfs PUBLIC HEALTH AGENCY 11 0676 $ Payroll $ Total Fringes - $ Total_s CRMC 0016 $ Payrol $ Total Fringes $ Totals OPC 0017 $ A Payroll s Total Fringes S Totals Paula Gonzales. Finance Director GRANDTOTALIS 1,778.99 Check Register - Prowers County, CO Packet: APPKT00055 - Payroll Replacement Check I By Check Number CORAI Vendor Number Vendor Name Payment Date Payment Type Discount Amount Payment Amount Number Bank Code: General Fund Op-General Fund Operating Account MARTINEZC Conni Martinez 04/30/2025 Regular 0.00 1,778.99 75113 Bank Code General Fund Op Summary Payable Payment Payment Type Count Count Discount Payment Regular Checks 1 0.00 1,778.99 Manual Checks 0 0 0.00 0.00 Voided Checks 0 0 0.00 0.00 Bank Drafts 0 0.00 0.00 EFT's U U 0.00 0.00 1 1 0.00 1,778.99 4/30/2025 4:01:36 Pi Page 1 of 2 Check Register Packet: APPKT00055-Payroll Replacement Check Fund Summary Fund Name Period Amount 999 Pooled Cash 4/2025 1,778.99 1,778.99 50r 2025 :01 36 PM Page 2 of 2 PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 5-13-2025 Submitter: Paula Gonzales, Finance Director Submitted to the County Administration Office on: Email Poll 5-2-25 Return Originals to: Paula Gonzales & Jana Coen Number of originals to return to Submitter: 1 Contract Due Date: Item Title/Recommended Board Action: Consider ratifying 5-2-2025 email poll approval of payment of bills presented for County General A/P Fund in the amount of $219,482.23 minus voided check no. 75015 in the amount of $86,355.25 for a grant total certification in the amount of $133,126.98 with a certification date of May 6, 2025, and authorizing the use of the Commissioner's signature stamps. 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 APPROVE TO PAY APPROVE PAYMENTS AS HEREIN SET FORTH. CHECK NUMBERS AS LISTED BELOW ARE ALL INCLUSIVE, ARE SET OPPOSITE THEIR NAMES, AND TOTALING THE SUM OF: $219,482.23 DRAWN ON COUNTY GENERAL FUNDS. DATED AS OF: May 6, 2025 # A/P PAYROLL FRINGES $ COUNTY GENERAL FUND $ 169,992.06 $ ARPA FUND $ $ FSA ACCOUNT $ $ BOOKING FEES ACCOUNT $ $ PUBLIC HEALTH AGENCY $ 2,593.08 $ ROAD & BRIDGE FUND $ 32,518.99 $ SALES & USE TAX FUND $ $ CONSERVATION TRUST FUND $ 899.30 $ CAPITAL FUND $ $ OTHER. AGENCIES FUND $ $ LODGING TAX FUND $ 10,628.62 $ CRMC FUND $ 1,348.37 $ OPC FUND $ 1,501.81 Totals $ 219,482.23 $ DATE: May 6, 2025 Bb DATE: May 6, 2025 COMMIBS ONER A DATE: May 6, 2025 V £9M MMSEI PNER DATE: May 6, 2025 CLERK TO THE BOARD Total Paid Approve To Pay $ 219,482.23 AP + Fringes $ 219,482.23 Total Pd Certification - Payroll $ 219,482.23 Total Payroll + Fringes $ STATE OF COLORADO) Ending Check No. 75172 SS: Beginning Check No. 75114 COUNTY OF PROWERS) 1 Total Number of Checks: 59 lous Camyploill Prowers County Treasurer's Office PROWERS COUNTY APPROVE TO PAY APPROVE PAYMENTS AS HEREIN SET FORTH. CHECK NUMBERS AS LISTED BELOW ARE ALL INCLUSIVE, ARE SET OPPOSITE THEIR NAMES, AND TOTALING THE SUM OF: $219,482.23 DRAWN ON COUNTY GENERAL FUNDS. DATED AS OF: May 6, 2025 # A/P PAYROLL FRINGES $ COUNTY GENERAL FUND $ 169,992.06 $ ARPA FUND $ $ FSA. ACCOUNT $ $ BOOKING FEES ACCOUNT $ $ PUBLIC HEALTH AGENCY $ 2,593.08 $ ROAD & BRIDGE FUND $ 32,518.99 $ SALES & USE TAX FUND $ $ CONSERVATION TRUST FUND $ 899.30 $ CAPITAL FUND $ $ OTHER. AGENCIES FUND $ $ LODGING TAX FUND $ 10,628.62 $ CRMC FUND $ 1,348.37 $ OPC FUND $ 1,501.81 Totals $ 219,482.23 $ DATE: 30A May 6, 2025 BE : BOBC CHAIEFAAN DATE: May 6, 2025 COMMISSION DATE: May 6, 2025 MISSIANER DATE: May 6, 2025 CLERK 70 THE BOARD Total Paid Approve To Pay $ 219,482.23 AP + Fringes $ 219,482.23 Total Pd Certification Payroll $ 219,482.23 Total Payroll + Fringes $ STATE OF COLORADO) Ending Check No. 75172 SS: Beginning Check No. 75114 COUNTY OF PROWERS) 1 / Total Number of Checks: 59 loluky Coyploull Prowers County Treasurer's Dffice PROWERS COUNTY TREASURER CERTIFICATION COUNTY GENERAL FUND-01 0010 May6,2025 75114-75172 $ 169,992.06 Void Ck # 75015 Paidi in Emor $ (86.355.25) Payroll s Total Fringes S Totals 83,636.81 ARPA- - 0018 Totals ROAD & BRIDGE FUND 02 0020 $ 32.518.99 Payroll S Fringes $ Totalfs 32,518.99 FSA (Cafeteria) 552 0552 $ 2024 $ Totals Sheriff's Booking Fees 0675 $ 2024 $ Payroll S Totalls SALES & USE TAXI FUND -03 0900 $ 2024 $ Totalls CONSERVATION: TRUSTE FUND . 06 0130 $ 899.30 2024 S Total_s 899.30 CAPITAL FUND 07 0100 $ . 2024 $ - Totals OTHER AGENCIES FUND- 08 S 2024 S Totalls LODGING TAX-09 0014 $ 10,628.62 2024 $ Payroll $ Total Fringes s Totalls 10,628.62 PUBLIC HEALTH AGENCY-11 0676 $ 2.593.08 Payroll S Totai Fringes S - Total_s 2,593.08 CRMC 0016 $ 1,348.37 Payroll $ Total Fringes $ Total $ 1,348.371 OPC 0017 $ 1,501.81 Payroll $ Total Fringes S Totals 1,501.81 Paula Gonzales, Finance Direcior GRAND TOTALIS 133.126.98 Check Register 6 Prowers County, CO Packet: APPKT00056 101.05.2025 05062025 By Check Number CORAN Vendor Number Vendor Name Payment Date Payment Type Discount Amount Payment. Amount Number Bank Code: General Fund Op-General Fund Operating Account ACA2 ACut Above Pest Control LLC 05/06/2025 Regular 0.00 120.00 75114 AIR1 A-1 Rental & Sales 05/06/2025 Regular 0.00 40.00 75115 AMAZON Amazon Capital Services 05/06/2025 Regular 0.00 202.12 75116 ATM2 Atmos Energy 05/06/2025 Regular 0.00 1,140.44 75117 ATM1 Atmos Energy 05/06/2025 Regular 0.00 435.87 75118 ACS1 Avenu Insights & Analytics 05/06/2025 Regular 0.00 6,771.57 75119 HERNANDEZB Brad Hernandez 05/06/2025 Regular 0.00 312.34 75120 BULLER Buller Bookkeeping 05/06/2025 Regular 0.00 806.00 75121 CAPITAL Capital One 05/06/2025 Regular 0.00 1,042.90 75122 VEN00972 CDPHE COLORADO! DEPT OF PUBLIC 05/06/2025 Regular 0.00 20.00 75123 CET1 Century Link 05/06/2025 Regular 0.00 470.78 75124 CINTASCORP CINTAS CORPORATION NO. 2 05/06/2025 Regular 0.00 676.59 75125 LAM1 City ofL Lamar 05/06/2025 Regular 0.00 85,355.25 75126 COLOR Colorado Energy Systems 05/06/2025 Regular 0.00 695.00 75127 DEL1 Coloradoland" Tire & Service 05/06/2025 Regular 0.00 187.60 75128 VISTA DESTINATIONIQ 05/06/2025 Regular 0.00 7,128.62 75129 DISA DISA 05/06/2025 Regular 0.00 42.00 75130 DAF1 District Attorney 05/06/2025 Regular 0.00 32,734.67 75131 GOB1 Gobin's 05/06/2025 Regular 0.00 576.81 75132 GRN2 Granada SOS 05/06/2025 Regular 0.00 1,250.00 75133 GTA1 Great America Financial Services 05/06/2025 Regular 0.00 70.11 75134 VEN00986 Holly Car Show & Demolition Derby 05/06/2025 Regular 0.00 3,500.00 75135 HSC1 Holly Senior & Community Center 05/06/2025 Regular 0.00 1,250.00 75136 HST1 Home Store LLC 05/06/2025 Regular 0.00 246.26 75137 IACME IACME 05/06/2025 Regular 0.00 1,150.00 75138 VEN00990 JACQUELINE! HARBERT 05/06/2025 Regular 0.00 25.00 75139 FPL1 John Deere Financial 05/06/2025 Regular 0.00 259.79 75140 FPLS John Deere Financial 05/06/2025 Regular 0.00 183.87 75141 KIMB1 Kimball Midwest- 05/06/2025 Regular 0.00 593.49 75142 LAP1 Lamar Auto Parts 05/06/2025 Regular 0.00 1,208.22 75143 LBM1 Lamar BMS 05/06/2025 Regular 0.00 518.48 75144 LSI1 Lamar Senior Citizens, Inc. 05/06/2025 Regular 0.00 1,250.00 75145 VEN00987 Marco Enciso 05/06/2025 Regular 0.00 8,037.50 75146 MSW1 Marshall & Swift/Boeckh, LLC 05/06/2025 Regular 0.00 688.20 75147 MCKESS McKesson Medical Surgical 05/06/2025 Regular 0.00 230.61 75148 Mirage Mirage Technologies 05/06/2025 Regular 0.00 3,120.00 75149 VEN00983 OLDCASTLE SW GROUP INC (UNITED 05/06/2025 Regular 0.00 3,105.00 75150 VEN00988 Performance Reel LLC 05/06/2025 Regular 0.00 13,820.00 75151 RSC3 Ranchers Supply Co., Inc. 05/06/2025 Regular 0.00 7,539.76 75152 REDLUND Redlund Equipment 05/06/2025 Regular 0.00 259.58 75153 VEN00989 RESILIENT MINDS COUNSELING, PLLI 05/06/2025 Regular 0.00 925.00 75154 RPI1 Robinson Printing 05/06/2025 Regular 0.00 120.00 75155 STAGNERR Roger Stagner 05/06/2025 Regular 0.00 195.00 75156 CKN1 Ron Cook 05/06/2025 Regular 0.00 195.00 75157 SAP1 Sanofi Pasteur Inc 05/06/2025 Regular 0.00 323.46 75158 SCP1 SE Colorado Power Association 05/06/2025 Regular 0.00 899.30 75159 SE01 SECOM 05/06/2025 Regular 0.00 4,271.08 75160 MRS1 Shred America 05/06/2025 Regular 0.00 32.25 75161 SKS1 Skyline Steel 05/06/2025 Regular 0.00 3,832.50 75162 STR1 Stericycle Inc 05/06/2025 Regular 0.00 172.09 75163 DUNAG Thomas Dunagan 05/06/2025 Regular 0.00 100.00 75164 VEN00958 TYH HARMON 05/06/2025 Regular 0.00 195.00 75165 TTI1 Tyler Technologies Inc 05/06/2025 Regular 0.00 9,329.58 75166 VER1 Verizon Wireless 05/06/2025 Regular 0.00 418.62 75167 5/1/2025 9:58:45 AM Page 1 of4 Check Register Packet: APPAT0055.101052025 05062025 Vendor Number Vendor Name Payment Date Payment Type Discount. Amount Payment Amount Number VIA1 Viaero Wireless 05/06/2025 Regular 0.00 187.70 75168 WAG1 Wagner Equipment Co 05/06/2025 Regular 0.00 6,261.54 75169 WRE1 WEX BANK 05/06/2025 Regular 0.00 491.68 75170 WileyC Wiley Community Center 05/06/2025 Regular 0.00 1,250.00 75171 ZOHO ZOHO Corporation 05/06/2025 Regular 0.00 3,218.00 75172 Bank Code General Fund Op! Summary Payable Payment Payment Type Count Count Discount Payment Regular Checks 99 59 0.00 219,482.23 Manual Checks 0 0 0.00 0.00 Voided Checks 0 0 0.00 0.00 Bank Drafts 0 ) 0.00 0.00 EFT's 0 0 0.00 0.00 99 59 0.00 219,482.23 5/1/2025 9:58:48 AM Page 2 of 4 - Check Register 6 Prowers County, CO Packet: APPKT00055 Payroll Replacement Check - By Check Number CORAT Vendor Number Vendor Name Payment Date Payment Type Discount Amount Payment Amount Number Bank Code: General Fund Op-General Fund Operating Account MARTINEZC Conni Martinez 04/30/2025 Regular 0.00 1,778.99 75113 Bank Code General Fund Op Summary Payable Payment Payment Type Count Count Discount Payment Regular Checks 1 1 0.00 1,778.99 Manual Checks 0 0 0.00 0.00 Voided Checks 0 0 0.00 0.00 Bank Drafts 0 0 0.00 0.00 EFT's 0 0 0.00 0.00 1 1 0.00 1,778.99 4/30/2025 4:01:36 PM Page 1 of 2 Check Register Packet: APPKT00055-Payro.l: Replacement Check Fund Summary Fund Name Period Amount 999 Pooled Cash 4/2025 1,778.99 1,778.99 4/30/2025 4:01:36 PM Page 2 of 2 PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 5/13/25 Submitter: Department ofHuman Services Submitted to the County Administration Office on: 4/30/25 Return Originals to: Department of Human Services Number of originals to return to Submitter: 1 Contract Due Date: ASAP Item Tite/Recommended Board Action: "Consider approval oft terms and conditions ofthe Buell Foundation Grant in the amount of $30,000 to Welcome Home Child & Family Center and authorizing Chairman Ron Cook and Director of Human Services, Lanie Meyers-Mireles to execute the document electronically". Justification or Background: These funds are utilized for operation costs at WHC. Fiscal Impact: This item is budgeted in thè following account code: Estimated revenue in the amount of $30,000 with no match required. County: $ Federal: $ State: Other: Approved by the County Attorney on: 5-5-2025 Additional Approvals (if required): PLEASE ATTACH THIS SHEET TO ALL AGENDA ITEMS WHEN SUBMITTING TO COUNTY ADMINISTRATION. THANK YOU! Docusign Envelope ID: CBDCCBE1-18C0-46C0-907C-B20DAD650737 1873 S. Bellaire St., Suite 600 BUELL Denver, CO 80222 FOUNDATION (303) 744-1688 Investing in Colorado's Future www.buelfoundationorg April 25, 2025 Lanie Meyers-Mireles, Director Welcome Home Child and Family Development Center PO Box 1157 Lamar, Colorado 81052 Re: Grant # 8295 Dear Ms. Meyers-Mireles: The Trustees of the Temple Hoyne Buell Foundation are pleased to inform Prowers County Department of Human Services fbo Welcome Home Child and Family Development Center that a grant has been approved in the amount of $30,000 for general operating support. Please reference the grant number in any correspondence related to this grant. This grant has been approved based upon the following terms and conditions: 1. Tax Exempt Status: The organization is a nonprofit recognized by the Internal Revenue Service as a public charity as described in Sections 501(c)(3) and 509(a)(1), 509(a)(2), or 509(a)(3) - Type 1, Type II or functionally integrated Type III ofthe IRS Code of 1986 as amended (the "Code"), or a governmental agency organized under the laws of the State of Colorado. 2. Expenditure of Funds: This grant, and any income earned upon investment of grant funds, is made for the charitable purposes outlined above and may not be expended for any other purpose without this Foundation's prior written approval. The grant period is May 1, 2025 through April 30, 2026. Any unexpended funds, or funds used for purposes other than those allowed by this agreement, must be returned to the Foundation upon written notice. No Buell Foundation funds may be used for lobbying purposes. 3. Records and Reports: You are required to keep financial records with respect to this grant and to provide this Foundation with a written report summarizing the use of all grant funds after funds have been expended, due no later than May 31, 2026, and other reports as we may reasonably require. No new, requests will be funded until a satisfactory report has been received. All records shall be retained for at least four years following the year in which all grant funds are fully expended. 4. Required Notification: You are required to provide this Foundation with immediate written notification of (a) any change in your organization's tax-exempt status, (b) anyi inquiry or audit by the Internal Revenue Service, (c) your inability to expend the grant for the purposes described in this letter, or (d) any expenditure from this grant made for any purposes other than those for which the grant was intended. Additionally, you must submit a written request to us in advance if the funds cannot be expended within the stated grant period. 5. Reasonable Access: You will permit this Foundation and its representatives reasonable access to your files, records, accounts, and personnel for purposes of making such financial audits, verifications, or program evaluations as this Foundation deems necessary or appropriate concerning this grant award. 6. Condition of Grant: This grant is conditioned upon your acceptance oft the terms set forth above, and this Foundation reserves the right to discontinue, modify, or withhold any payment under this grant award, or to Docusign Envelope ID: CBDCCBE1-18C0-46C0-907C-820DAD650737 Welcome Home Child and Family Development Center Grant #8295 Page 2 request a refund of any grant funds, if it reasonably determines that your organization has not fully complied with the terms and conditions ofthis grant. 7. Publicity: This Foundation may include information concerning this grant, including the amount and purpose of the grant and any related materials (including your logo and trademark and other information about your organization and its activities) in the Foundation's periodic public reports, newspapers, and news releases. You will obtain the Foundation's approval, which shall not be unreasonably withheld, concerning the text of any proposed publicity concerning this grant prior to its release. 8. Representations: Your representations contained in this letter are true and may be relied upon by the Foundation. You will immediately notify the Foundation in writing if you faili to comply with any provision of this letter or if any of your representations are no longer true. Ift the conditions of this grant meet with your approval, please sign and return this letter with electronic authorized signatures within 14 days after its receipt. Payment will be issued within three weeks of our receipt of the signed contract and following the schedule of conditions (if any) outlined above. Congratulations on this recognition of your important efforts. We look forward to working with you during the coming year. Sincerely, Sausam Barluon Laura Carlson Vice President of Programs AGREED AND ACCEPTED BY THE UNDERSIGNED AUTHORIZED SIGNATORIES (all signatures below are required): X X Signature, Commissioner Signature, Director Prowers County Prowers County Department of Human Services Lanie Meyers-Mireles Printed Name: Printed Name: Director Department of Human Services Title: Title: Date: Date: PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: -13-2025 Submitter: Rose Pugliese, Esq., County Attorney Submitted to the County Administration Office on: Email Poll 4-24-2025 Return Originals to: Rose Pugliese, Esq., and Jana Coen Number of originals to return to Submitter: 1 Contract Due Date: Item Ttle/Recommended Board Action: Consider ratifying 4-24-25 email poll approval of a Stipulation between Applicant, Tri-State Generation and Transmission Association, Inc. and Opposers, Lower Arkansas Valley Water Conservancy District concerning water rights in Prowers and Bent Counties. Justification or Background: Fiscal Impact: This item is budgeted in the following account code: County: $ Federal: $ State: $ Other: $ Approved by the County Attorney on: 4-24-2025 Additional Approvals (if required): DISTRICT COURT, WATER DIVISION 2, STATE OF COLORADO 501 N. Elizabeth Street, Suite 116 Pueblo, Colorado 81003 CONCERNING THE APPLICATION FOR WATER RIGHTS OF: TRI-STATE GENERATION AND TRANSMISSION ASSOCIATION, INC. IN PROWERS AND BENT COUNTIES. AC COURT USE ONLYA Attorneys for Tri-State Generation and Transmission Association, Case No. 23CW3036 Inc. (07CW74; 15CW3007) Alan E. Curtis, #34571; Nicoli R. Bowley, #58709; Andrea Bonato-Gach, #60705 CURTIS, JUSTUS, & ZAHEDI, LLC 1333 W. 120th Ave., Suite 302 Westminster, Colorado 80234 (303) 595-9441 lanc@ewatelw.com: colb@gpwatetlawcom: andib@czwatetlaw.com Julie Anne Rech, #33947; Roger Williams, #26302 TRI-STATE GENERATION AND TRANSMISSION ASSOCIATION, INC. 1100 West 116th Avenue Westminster, Colorado 80234 Tele: (303) 452-6111 Attorneys for Lower Arkansas Valley Water Conservancy District Peter D. Nichols, #33167; Patrick M. Haines, #38970; Katherine E. Carter, #60954 BERG HILL GREENLEAF RUSCITTI LLP 1712 Pearl Street Boulder, Colorado 80302 (303) 402-1600 pdn@bhgrlaw.com; pmh@bhgrlaw.com; ilietineante@glvcn Attorney for Board of County Commissioners for Prowers County, Colorado Rosel F. Pugliese, #38973 ROSE: F. PUGLIESE, LLC 9235 N. Union Blvd, Ste. 150, #128 Colorado Springs, CO 80920 (970) 589-3755 glieclawimégmailon STIPULATION BETWEEN APPLICANT TRI-STATE GENERATION AND TRANSMISSION ASSOCIATION, INC. AND OPPOSERS, THE LOWER ARKANSAS VALLEY WATER CONSERVANCY DISTRICT AND THE BOARD OF COUNTY COMMISSIONERS FOR PROWERS COUNTY, COLORADO Applicant, Tri-State Generation and Transmission Association, Inc. (Tri-State) and Opposers, the Lower Arkansas Valley Water Conservancy District (the Lower Ark District) and the Board of County Commissioners for Prowers County, Colorado (Prowers County), stipulate and agree as follows: 1. The Lower Ark District and Prowers County consent to entry of a decree in this case no less restrictive on Tri-State and no less protective of Lower Ark District's and Prowers County's water rights than the draft decree dated December 16, 2024 and attached as EXHIBIT A (Proposed Decree). 2. The Lower Ark District and Prowers County will remain parties in this case for the limited purpose ofe ensuring that any decree entered in this case complies with this Stipulation and that Tri-State complies with the terms of this Stipulation. 3. If any provisions material to this Stipulation are not acceptable to any other party in the case, the Lower Ark District and Prowers County may, in their sole discretion, elect to participate in support of Tri-State's current position (consistent with the Proposed Decree) on one or more issues in this case. 4. Tri-State will provide the Lower Ark District's and Prowers County's respective undersigned counsel with a copy ofany proposed decree that is different from thel Proposed Decree (Revised Decree) and a reasonable period of time to review the Revised Decree to determine whether the Revised Decree complies with this Stipulation. 5. Paragraph 12 of the March 30, 2009 Decree in Case No. 2007CW74, Water Division 2 (07CW74 Decree) describes Tri-State's 16,767.52 shares in the Amity Mutual Irrigation Company (AMIC shares). 6. Paragraph 14.C describes miscellaneous water rights comprised of Tri-State's water rights in the: (i) Sapp Ditch; (11) Ralph Massar Ditch; ()H.L. Bates Ditch; (iv)J. K. Martin Ditch; and (v) Brumfield Ditch (collectively, Miscellaneous Water Rights). 7. Paragraph 18 ofthe 07CW74 Decree states the AMIC shares and Miscellaneous Water Rights (collectively, Iri-State's AMIC Shares/Miseelaneous Water Rights) are subject to 07CW74 Decree dry-up requirements. 8. On April 3, 2025, representatives for Tri-State participated in aj pre-application discussion with Prowers County representatives for 1041 matters to discuss a draft of the 1041 Application, and all participants in the discussion agreed to continue to engage in discussions toward Tri- State submitting its 1041 Application to Prowers County for Parcels T-08, AM-027, AM-057 and AM-072 in a timely manner. 9. Should it become necessary in the future, Tri-State will also apply for and obtain 1041 permits before Tri-State's AMIC Shares/Miscelaneous Water Rights are removed from irrigation use on any additional parcels ofhistorically irrigated lands. Page 2 of3 10. This Stipulation binds and benefits Tri-State, the Lower Ark District, Prowers County, and their respective successors in interest. 11. Tri-State, the Lower Ark District and Prowers County will bear their own costs and fees associated with this case. 12. This Stipulation is enforceable by Tri-State, Lower Ark District, and Prowers County as both an agreement and an Order of the Water Court. 13. The Lower Ark District and Prowers County consent to Tri-State's motion to approve this Stipulation as an Order ofthe Water Court. 14. Tri-State, the Lower Ark District, and Prowers County affirm the signatories to this Stipulation are legally authorized to bind the parties. Dated: April 18, 2025. CURTIS, JUSTUS, & ZAHÉDILLC BERG HILL GREENLEAF RUSCITTI LLP Alan E. Curtis, #34571 Péter D. Nichols, #33167 Nicoli R. Bowley, #58709 Patrick M. Haines, #38970 Andrea Bonato-Gach, #60705 Katherine E. Carter, #60954 ATTORNEYS FOR TRI-STATE ATTORNEYS FOR THE LOWER ARK DISTRICT ROSE F. PUGLIESE, LLC Rose F.P Pugliese, #38973 ATTORNEYS FOR PROWERS COUNTY Page 3 of3 PROWERS COUNTY AGENDA ITEM REQUEST FORM Hearing Date Requested: 5/13/25 Submitter: Don Wilson, County Administrator Submitted to the County Administration Office on: 4/28/25 Return Originals to: Don Wilson & Jana Coen Number of originals to return to Submitter: 1 Contract Due Date: N/A Item Tite/Recommended Board Action: Consider approval ofMOU with the State of Colorado Governor's Office of Federal Funds and Strategic Initiatives for the technical assistance and grant writing support provided under the Thriving Communities Program initiative in Southeast Colorado. Justification or Background: Fiscal Impact: This item is budgeted in the following account code: County: $ Federal: $ State: $ Other: $ Approved by the County Attorney on: 5-6-2025 Additional Approvals (if required): MEMORANDUM OF UNDERSTANDING Version 4/21/25 This document describes the agreed-upon responsibilities and expectations between the State of Colorado Governor's Office of Federal Funds and Strategic Initiatives (henceforth, "OFFSI") and Prowers County (henceforth, COMMUNITY PARTNER") for the technical assistance and grant writing support provided under OFFSI's Thriving Communities Program initiative in Southeast Colorado. Whereas, OFFSI, working in partnership with Southeast Colorado Economic Development (henceforth, "SECED") and utilizing contracted services from Stantec Inc. (henceforth, CONSULTANT). intends to utilize awarded funds from the U.S. Department of Transportation ("USDOT") to provide targeted technical assistance and build capacity for successful grant applications for communities in Southeast Colorado, including the COMMUNITY PARTNER. The Southeast Colorado Safe Streets and Roads for All (SS4A) Regional Planning Grant Application (henceforth, PROJECT"), developed collectively by all participating communities, including the COMMUNITY PARTNER, with facilitation and drafting support from the CONSULTANT, OFFSI, and SECED during the Project Timeline. Whereas, the COMMUNITY PARTNER, representing COMMUNITY PARTNER, affirms its commitment to fully engage in the collaborative development of the PROJECT and coordinating with all participating communities, as evidenced by Letter(s) of Support from designated County officials referenced. SCOPE OF WORK OFFSI's Thriving Communities Program will provide technical assistance to COMMUNITY PARTNER through partnership with SECED and contracted services from the CONSULTANT, to develop and submit a regional SS4A Planning Grant application. During the PROJECT, designated County Team staff and other key stakeholders will participate in the following major phases of the PROJECT: 1. Project initiation and management activities led by the CONSULTANT, including the grant kick-off call, weekly check-in meetings, and review of tools such as the application "win matrix" 2. Collaboratively contribute local data and perspectives to support the CONSULTANT in drafting the core narrative, analysis, budget, and mapping elements required for the regional grant application. 3. Review the draft Regional SS4A Application and provide timely feedback from the COMMUNITY PARTNER perspective, coordinated via the CONSULTANT and OFFSI. 1 4. Assist in the final review and confirmation of the Regional SS4A Application package prepared by the CONSULTANT prior to its submission by the designated lead applicant county. DELIVERABLES Successful completion of the PROJECT will result in the submission of the Regional SS4A Planning Grant Application, supported by the County Team. This application is intended to position the region competitively to secure federal funding through the SS4A program, enabling the development of a regional comprehensive safety action plan and better position communities in Southeast Colorado to secure future transportation funding. By participating in PROJECT, COMMUNITY PARTNER acknowledges that the project process, results, and any work product developed may be included on the Roadmaps to Recovery website to inform the work of other Colorado communities. OFFSI ROLES AND RESPONSIBILITIES Under this agreement, OFFSI serves as the Thriving Communities Program administrator and coordinator. OFFSI is responsible for the following: 1. Work with partner SECED and the CONSULTANT to participate in and coordinate the technical assistance activities related to the development and submission of the regional SS4A Planning Grant application (Project) to position the COMMUNITY PARTNER and participating communities for success in securing future transportation funding. 2. Manage the contract with, and payment of, the CONSULTANT providing technical assistance for the PROJECT. 3. Provide ongoing guidance and coordination support to the COMMUNITY PARTNER and participating communities related to the Thriving Communities Program and the regional SS4A application process. 4. Provide program materials and communications with and for the COMMUNITY PARTNER and participating communities as needed to support overall PROJECT coordination and submission. 5. Clearly communicate project timelines, data needs, and any reporting requirements, and assist the COMMUNITY PARTNER in meeting them. COMMUNITY PARTNER ROLES AND RESPONSIBILITIES Under this Agreement, the COMMUNITY PARTNER is responsible for the following: 1. Serve as the primary point(s) of contact representing the County, facilitating communication between the Prowers County stakeholders, OFFSI, SECED, the CONSULTANT, and other participating communities. 2 2. Actively participate in all phases of the PROJECT, including providing necessary local data and feedback as well as required reporting, for the full Project Timeline as detailed in the "Time Period" section below. To maintain the project budget and schedule, an OFFSI Program Manager shall be assigned to the PROJECT and included in all communication with COMMUNITY PARTNERS. The COMMUNITY PARTNER shall not direct the CONSULTANT to carry out tasks or expend hours without the prior approval of OFFSI Program Manager. FUNDING This PROJECT is funded by the United States Department of Transportation (USDOT). Such funds have been allocated to this PROJECT in recognition of the importance of transportation and safety planning. The COMMUNITY PARTNER is not required to provide any match funding to participate in this program. OFFSI manages the USDOT funds related to this project. All activities in the project shall be conducted in accordance with USDOT and State of Colorado rules and regulations. No funds shall be paid to the COMMUNITY PARTNER for participation in the PROJECT. TIME PERIOD This Agreement shall remain in effect from the date of signature by all parties through submission of the regional SS4A Planning Grant application (anticipated on or before June 26, 2025), unless modified in writing before that date. COMPLIANCE WITH LAW In connection with the, activities rendered under this Agreement, OFFSI and the COMMUNITY PARTNER agree to abide by all federal, state and local laws, ordinances, and regulations. CONFLICT RESOLUTION If OFFSI and the COMMUNITY PARTNER cannot reach agreement under any dispute, they agree to use senior management from both parties to settle the dispute and to make final decisions. TERMINATION By signing this Agreement, the COMMUNITY PARTNER commits to participating, in good faith, in the entirety of this PROJECT. Completion of the PROJECT is defined as approving, adopting, or operationalizing the strategies developed as part of the PROJECT. 3 Termination of participation in this project can be initiated by OFFSI if another party has breached their responsibilities under this Agreement (see Roles and Responsibilities sections above). Termination must be made in writing to or by the OFFSI Project Manager or the COMMUNITY PARTNER'S lead applicant and must specify the breach in responsibilities made by the other party. GOVERNING LAW This Agreement will be construed in accordance with, and all actions arising hereunder will be governed by the laws of the State of Colorado. SIGNATURES Prowers County Board of County Commissioners Ron Cook, Chairman Date [STATE OF COLORADO GOVERNOR'S OFFICE OF FEDERAL FUNDS AND STRATEGIC INITIATIVES] [Manager] Date MEMORANDUM OF UNDERSTANDING (LEAD APPLICANT) Version 4/21/25 This document describes the agreed-upon responsibilities and expectations between the State of Colorado Governor's Office of Federal Funds and Strategic Initiatives (henceforth, "OFFSI") and Prowers County (henceforth, "COMMUNITY PARTNER") for the technical assistance and grant writing support provided under OFFSI's Thriving Communities Program initiative in Southeast Colorado. Whereas, OFFSI, working in partnership with Southeast Colorado Economic Development (henceforth, "SECED") and utilizing contracted services from Stantec Inc. (henceforth, 4 "CONSULTANT), intends to utilize awarded funds from the U.S. Department of Transportation ("USDOT") to provide targeted technical assistance and build capacity for successful grant applications for communities in Southeast Colorado, including the COMMUNITY PARTNER. The Southeast Colorado Safe Streets and Roads for All (SS4A) Regional Planning Grant Application (henceforth, PROJECT"), developed collectively by all participating communities, including the COMMUNITY PARTNER, with facilitation and drafting support from the CONSULTANT, OFFSI, and SECED during the Project Timeline. Whereas, the COMMUNITY PARTNER, has agreed to serve as the designated "LEAD APPLICANT" for the submission of the regional PROJECT application on behalf of the participating Southeast Colorado communities Whereas, the COMMUNITY PARTNER, representing COMMUNITY PARTNER, affirms its commitment to fully engage in the collaborative development of the PROJECT and coordinating with all participating communities, as evidenced by Letter of Support from the County. SCOPE OF WORK OFFSI's Thriving Communities Program will provide technical assistance to COMMUNITY PARTNER through partnership with SECED and contracted services from the CONSULTANT, to develop and submit a regional SS4A Planning Grant application. During the PROJECT, designated COMMUNITY PARTNER staff and other key stakeholders will participate in the following major phases of the PROJECT: 1. Project initiation and management activities led by the CONSULTANT, including the grant kick-off call, weekly check-in meetings, and review of tools such as the application "win matrix" 2. Collaboratively contribute local data and perspectives to support the CONSULTANT in drafting the core narrative, analysis, budget, and mapping elements required for the regional grant application. 3. Review the draft Regional SS4A Application and provide timely feedback from the COMMUNITY PARTNER perspective, coordinated via the CONSULTANT and OFFSI. 4. Assist in the final review and confirmation of the Regional SS4A Application package prepared by the CONSULTANT prior to its submission by the designated lead applicant county. DELIVERABLES Successful completion of the PROJECT will result in the submission of the Regional SS4A Planning Grant Application, supported by the COMMUNITY PARTNER. This application is intended to position the region competitively to secure federal funding through the SS4A program, enabling the development of a regional comprehensive safety action plan and better position communities in Southeast Colorado to secure future transportation funding. 5 By participating in PROJECT, the COMMUNITY PARTNER acknowledges that the project process, results, and any work product developed may be included on the Roadmaps to Recovery website to inform the work of other Colorado communities. OFFSI ROLES AND RESPONSIBILITIES Under this agreement, OFFSI serves as the Thriving Communities Program administrator and coordinator. OFFSI is responsible for the following: 1. Work with partner SECED and the CONSULTANT to participate in and coordinate the technical assistance activities related to the development and submission of the regional SS4A Planning Grant application (Project) to position the COMMUNITY PARTNER and participating communities for success in securing future transportation funding. 2. Manage the contract with, and payment of, the CONSULTANT providing technical assistance for the PROJECT. 3. Provide ongoing guidance and coordination support to the COMMUNITY PARTNER and participating communities related to the Thriving Communities Program and the regional SS4A application process. 4. Provide program materials and communications with and for the COMMUNITY PARTNER and participating communities as needed to support overall PROJECT coordination and submission. 5. Clearly communicate project timelines, data needs, and any reporting requirements, and assist the COMMUNITY PARTNER in meeting them. LEAD APPLICANT COMMUNITY PARTNER ROLES AND RESPONSIBILITIES Under this Agreement, the COMMUNITY PARTNER, in its capacity as LEAD APPLICANT, is responsible for the following: 1. Serve as the primary point(s) of contact representing the County, facilitating communication between the Prowers County stakeholders, OFFSI, SECED, the CONSULTANT, and other participating communities. 2. Actively participate in all phases of the PROJECT, including providing necessary local data and feedback as well as required reporting, for the full Project Timeline as detailed in the "Time Period" section below. 3. Ensure the County's registration in SAM.gov and Grants.gov are active and maintained as required for federal grant submission. 4. Serve as the official applicant submitting the final regional SS4A Planning Grant application package prepared by the CONSULTANT via Grants. gov by the deadline specified by USDOT. 5. Determine and manage Prowers County's internal review and sign-off process required for the submission of the application. 6 To maintain the project budget and schedule, an OFFSI Program Manager shall be assigned to the PROJECT and included in all communication with COMMUNITY PARTNERS. The COMMUNITY PARTNER shall not direct the CONSULTANT to carry out tasks or expend hours without the prior approval of OFFSI Program Manager. FUNDING This PROJECT is funded by the United States Department of Transportation (USDOT). Such funds have been allocated to this PROJECT in recognition of the importance of transportation and safety planning. The COMMUNITY PARTNER is not required to provide any match funding to participate in this program. OFFSI manages the USDOT funds related to this project. All activities in the project shall be conducted in accordance with USDOT and State of Colorado rules and regulations. No funds shall be paid to the COMMUNITY PARTNER for participation in the PROJECT. TIME PERIOD This Agreement shall remain in effect from the date of signature by all parties through submission of the regional SS4A Planning Grant application (anticipated on or before June 26, 2025), unless modified in writing before that date. COMPLIANCE WITH LAW In connection with the activities rendered under this Agreement, OFFSI and the COMMUNITY PARTNER agree to abide by all federal, state and local laws, ordinances, and regulations. CONFLICT RESOLUTION If OFFSI and the COMMUNITY PARTNER cannot reach agreement under any dispute, they agree to use senior management from both parties to settle the dispute and to make final decisions. TERMINATION By signing this Agreement, the COMMUNITY PARTNER commits to participating, in good faith, in the entirety of this PROJECT. Completion of the PROJECT is defined as approving, adopting, or operationalizing the strategies developed as part of the PROJECT. Termination of participation in this project can be initiated by OFFSI if another party has breached their responsibilities under this Agreement (see Roles and Responsibilities sections above). Termination must be made in writing to or by the OFFSI Project Manager or the 7 COMMUNITY PARTNER'S lead applicant and must specify the breach in responsibilities made by the other party. GOVERNING LAW This Agreement will be construed in accordance with, and all actions arising hereunder will be governed by the laws of the State of Colorado. SIGNATURES Prowers County Board of County Commissioners Ron Cook, Chairman Date [STATE OF COLORADO GOVERNOR'S OFFICE OF FEDERAL FUNDS AND STRATEGIC INITIATIVES] [Manager] Date 8