1

SUPPLEMENT “BF”

Georgia Department of Community Health Designation of the Department of Human Services Division of Aging Services as the Primary Point of Entry for Referrals to Long Term Support Programs under the Balancing Incentives Program

This Supplement “BF” to the Interagency Master Agreement between the Georgia Department of Community Health and the Georgia Department of Human Services in support of the Balancing Incentives Program is made and entered into this 1st day of June, 2013.

Purpose:To establish guidelines and agreement for collaboration with DHS/DAS for certain functions related to marketing, screening and referral to Long Term Support Programs. The Balancing Incentives Program is authorized and described in Section 10202 of the Patient Protection and Affordable Care Act of 2010.

Designed to assist States in rebalancing their long-term care systems, the Balancing Incentives Program (BIP) requires that States implement three structural changes in their system of community-based long-term services and supports (LTSS); a No Wrong Door/Single Entry Point (NWD/SEP) eligibility determination and enrollment system; core standardized assessment instruments; and conflict-free case management. The agreement between DHS/DAS and DCH focuses on the first of the three structural changes; implementation of a No Wrong Door Entry Point for long term supports and services.

PROJECT OFFICES:

DHS:DCH:

Division of Aging ServicesDivision of Medicaid

RESPONSIBILITIES:

BIP Medicaid Grant

Mutual Responsibilities:

  1. DCH and DHS, through its Division of Aging Services, shall work together to provide a No Wrong Door Entry Point for community-based services, utilizing a marketing plan and public outreach strategies.
  1. DCH and DHS, through the Division of Aging Services, shall provide for regular communication on collaborative marketing, outreach, and training strategies with the Department of Community Health Division of Medicaid.
  1. DCH and DHS/DAS may mutually agree from time-to-time to amend the frequency and reporting party for specific reports without amending the Supplement BF. Such agreement shall be memorialized in a writing signed by each agency’s Project Leader. Exercise of this option will be dictated by the needs of the BIP Program to ensure flexibility of quality improvements as required by the agreement with CMS.

DHS, Division of Aging Services

Aging and Disability Resource Centers

  1. Aging and Disability Resource Connection (through DAS and the Area Agencies on Aging within the Georgia Aging Network) will be designated by DCH to serve as the primary point of entry for referrals and inquiries from the community. DHS/DAS will respond to those referrals within one (1) business day of receipt of the referral or inquiry. “Response” constitutes a follow up by telephone or other means and does not indicate that a referral or screening is complete.

Deliverables: Report of all inquiries or referrals by date received, source of the inquiry, and date of response

Frequency: Monthly by the 15th of each month

Receiving Party: DCH, Division of Medicaid

  1. Aging and Disability Resource Connection (through DAS and the Area Agencies on Aging within the Georgia Aging Network) will develop and deploy an eligibility portal, system, and portal to facilitate SSI and Medicaid determinations in the ADRC.

Deliverables: Development and implementation of eligibility portal

Frequency: Development by 1/1/14 with implementation by 6/30/14

Receiving Party: DCH, Division of Medicaid

Marketing Plan and Outreach

  1. DHS/DAS will work with DCH to develop a marketing plan for outreach through the two Department websites, printed materials, public service announcements, and use of a toll free telephone number.

Deliverables: Marketing Plan

Frequency: By 7/1/13 with quarterly updates

Receiving Party: DCH, Division of Medicaid

  1. DHS/DAS will provide access to its Resources and Services URL as well as its telephonic response system to the public for the purpose of outreach.

Deliverables: Website availability and statewide telephonic response service

Frequency: Ongoing

Receiving Party: DCH, Division of Medicaid

DCH, Division of Medicaid

  1. DCH will work with DHS/DAS to develop a marketing plan for outreach through the two Department websites, printed materials, public service announcements, and use of a toll free telephone number.

Deliverables: Marketing Plan

Frequency: By 7/1/13 with quarterly updates

Receiving Party: DCH, Division of Medicaid

  1. DCH will provide access to the Integrated Eligibility system upon its implementation in order to facilitate a web based single entry point for referrals to long term community support services programs.

Deliverables: Web based access to the Integrated Eligibility system upon implementation

Frequency: Ongoing following implementation

Receiving Party: DCH, Division of Medicaid

  1. DCH will provide written instructions on the format and content of all CMS statistical and summary reports to the Division of Aging.

Deliverables: Written instructions on the format and content of all CMS statistical and summary reports

Frequency: Within 5 days of DCH’s receipt of CMS report request

Receiving Party: DHS, Division of Aging

  1. DCH will pay one-twelfth the contract amount monthly within thirty (30) days of receipt of invoice.

PAYMENT FOR SERVICES

Each invoice for payment must reference: Contract Number (S599, Supplement BF), Contractor’s tax identification number, and an itemization of activities being billed. Invoices shall be directed to:

Attn: Deputy Director

Aging and Special Populations Unit

Division of Medicaid

Georgia Department of Community Health

Two Peachtree Street, N.W., 37th Floor

Atlanta, Georgia 30303-3159

The relevant deliverables associated with the invoice shall be submitted to the Project Leader identified above as the DCH Representative. All deliverables and standards must be met for payment to be issued.

The payments made by DCH to DHS/DAS under this Supplement BF shall not exceed the cost of providing those services, or that portion of the total funds in FFP under this Agreement designated for this purpose as outlined in this Supplement. DCH shall have no responsibility for payment beyond this amount. It is expressly understood that the total amount of payments to the Contractor will not exceed the maximum provided in the Interagency Master Agreement, unless the Contractor has obtained approval in the form of an Agreement amendment authorizing an increase in the total payment, prior to expenditures of any amounts in excess of the maximum provided for in this paragraph.

REPRESENTATIVES

DCH

Contract Administration:

Pam Gordon

Georgia Department of Community Health

Two Peachtree Street, N.W., 40th Floor

Atlanta, Georgia 30303-3159

Telephone: (404) 463-0348

Fax #: (404) 657-7200

Email:

Project Leader:

Deputy Director, Aging and Special Populations Unit

Balancing Incentives Program

Georgia Department of Community Health

Two Peachtree Street, N.W., 37th Floor

Atlanta, Georgia 30303-3159

Telephone: (404) 651-6889

Fax#: (404) 656-8366

Email:

DHS

Contract Administration:

Monica Daniels

Contract Liaison

Office of Contracts and Procurement

Georgia Department of Human Services

Two Peachtree Street, N.W., 27th Floor

Atlanta, Georgia 30303-3142

Telephone: (404) 656-4613

Fax#: (404) 651-9337

Email:

Project Leader:

Aging and Disability Resource Connection (ADRC)

Cynthia Haley-Dunn

Georgia Department of Human Services

Division of Aging Services

Two Peachtree Street, N.W., 33rd Floor

Atlanta, Georgia 30303-3142

Telephone: (404) 656-1705

Fax #: (404) 657-5285

Email:

DHS, Division of Aging Services

James J. Bulot, Ph.D., Division Director

Georgia Department of Human Services

Division of Aging Services

Two Peachtree Street, N.W., 33rd Floor

Atlanta, Georgia 30303-3142

Telephone: (404) 657-5258

Email:

FOR DCH: David Cook, Esq., Commissioner ______(initials)

FOR DHS: Clyde L. Reese, Esq., Commissioner______(initials)