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HomeMy WebLinkAboutAgreements/Contracts - GRIS (002)K 19-043 to r � FOUNDATIONAL COMMUNITY SUPPORTS PROVIDER AGREEMENT THIS FOUNDATIONAL COMMUNITY SUPPORTS PROVIDER AGREEMENT ("Agreement") is made by and between AMERIGROUP Washington, Inc. ("AMERIGROUP") and the undersigned Provider ("Provider"), effective as of the date of complete execution of this Agreement as evidenced by the date affixed beneath the authorized signature of AMERIGROUP (the "Effective Date"). RECITALS: A. AMERIGROUP has been selected by the Washington State Health Care Authority ("HCA'') as a Third -Party Administrator (TPA) responsible for the implementation and administration of the Foundational Community Supports Program ("FCS") under the Medicaid Transformation Project. B. Provider is authorized in the State of Washington to provide Covered Services to Covered Persons. C. Under FCS, AMERIGROUP desires that Provider provide certain supported employment services for individuals living with Serious Mentally Ill ("SMI") and/or living with co-occurring Serious Mentally III/Substance Use Disorder (SMI/SUD), and Provider desires to provide such services. AGREEMENT: NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, AMERIGROUP and Provider agree as follows: 1. Amerigroup and Provider each desire to participate in the FCS supported employment services for individuals living with Serious Mentally Ill ("SMI") and/or living with co-occurring Serious Mentally III/Substance Use Disorder (SMI/SUD) (the "Program") and to provide the Program goals, services, and objectives as specified on Exhibit A, attached hereto and incorporated herein. 2. Amerigroup and Provider have entered into a Participating Provider Agreement, and the terms of such agreement are incorporated into this Agreement. To the extent any provision contained in this Agreement conflicts with the terms and conditions of Provider's Provider Participation Agreement with Amerigroup, then Provider's Provider Participation Agreement shall control. 3. The parties acknowledge and agree that all information related to the Program created and/or furnished by one party to the other party as a result of this Agreement is proprietary and confidential. Provider and Amerigroup agree not to use such proprietary and confidential Page: 1 OF 5 information except for the purpose of carrying out their obligations under this Agreement. Neither party shall disclose any proprietary and confidential information to any person or entity without the other party's express written consent, except as required pursuant to applicable law, regulatory requirements or legal order, in which case such party shall immediately notify the other party of the receipt of any such request for disclosure prior to the disclosure. 4. The parties acknowledge that in connection with the Program, each may be acquiring and making use of "protected health information" ("PHI") as defined at 45 CFR § 160.103 (as such provision is currently drafted and subsequently updated amended or revised) which is subject to the requirements of the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and the federal Standards for Privacy and Security of Individually Identifiable Health Information ("Privacy and Security Rule") promulgated thereunder. Each party shall comply with the applicable provisions of HIPAA, the Privacy and Security Rule, as well as the Health Information Technology for Economic and Clinical Health Act ("HITECH"), any other regulations promulgated under HIPAA or HITECH, and any other applicable law, and each party shall require its personnel and other persons engaged in the provision of services hereunder to comply with same. 5. The Agreement will commence on the Effective Date and will be in force until September 30, 2019, unless otherwise terminated as provided herein. 6. Either party may terminate this Agreement with or without cause on fifteen (15) days' prior written notice to the other party. This Agreement will automatically terminate upon one or more of the following events: a. Termination of Provider's Provider Participation Agreement with Amerigroup; b. Elimination of the Program by HCA. 7. The parties hereto represent to each other that to their knowledge this Agreement (i) has been validly executed and delivered, and (ii) has been duly authorized by all corporate action necessary for the authorization. 8. This Agreement shall be construed and interpreted in accordance with the laws of the State of Washington. Amerigroup and Provider will each comply with all applicable state and federal regulatory requirements when performing their respective obligations under this Agreement. 9. This Agreement is solely for the benefit of Provider and Amerigroup and will not be construed to give rise to or create any liability or obligation to, or to afford any claim or cause of action to, any other person or entity. 10. Each party agrees to indemnify, defend, and hold harmless the other party from and against any and all liability, loss, claim, damage or expense, including defense costs and legal fees, incurred in connection with a breach of any representation and warranty made by a party in this Agreement, and for claims for damages of any nature whatsoever, arising from a party's performance or failure to perform its obligations hereunder. Page: 2 OF 5 IN WITNESS WHEREOF, Amerigroup and Provider have entered into this Agreement. AMERIGROUP WASHINGTON, INC. Page: 3 OF 5 Signature: By: Title: Date: Signature: By: Title: Tom Taylor BOCC Chair Date: Page: 4 OF 5 EXHIBIT A Provider Responsibilities: Provider shall provide the following supported employment support service dollars to individuals living with Serious Mentally Ill ("SMI") and/or living with co-occurring Serious Mentally III/Substance Use Disorder (SMUSUD) individuals. Below is a list of allowable expenditures for support service dollars: 1. Interview or work clothing 2. Transportation fees such as gas or bus passes 3. Certifications such as food handler car, forklift certification, flagger certification 4. Identification required for employment such as ID card, Driver's License, and/or copy of birth certificate 5. Other miscellaneous costs that will help an FCS enrollee with securing full time employment. All miscellaneous items must be pre -approved by Amerigroup. Provider understand and agrees that Provider will not give cash to any individuals living with Serious Mentally Ill ("SMI") and/or living with co-occurring Serious Mentally III/Substance Use Disorder (SMUSUD) individuals as part of the Program. Provider shall maintain an invoice log of all expenditures of the $5,000 provided by Amerigroup and shall keep receipts of any such expenditures. Provider will submit an invoice log to Amerigroup on a quarterly basis, which log shall be due to Amerigroup by the 15a' of the month following the end of each quarter. Amerigroup Responsibilities: Amerigroup shall deliver to Provider Five Thousand Dollars ($5,000) to use as described herein for the Program. Amerigroup shall establish and maintain a Rate Table to track Provider's services under this Agreement. Page: 5 OF 5 Public Comment Period March 18, 2019 10:30 a.m. In Attendance: Tom Taylor, Chair Cindy Carter, Vice -Chair Barbara J. Vasquez, Clerk of the Board 10:35 a.m. Barbara Morgan, Chair of the Grant County Republican Party, came in to discuss I- 1639 concerning firearms and is asking for the commissioners to sign a resolution supporting the Federal Second Amendment and Article 1, Section 2 and & of the Washington State Constitution. Ms. Morgan asked about the Commissioners agenda and calendar. The agenda process was discussed. Commissioner Taylor stated the draft resolution will likely go before our Civil Attorney for review. He may suggest revisions then get it back to the Commissioners to take favorable action or no favorable action. Commissioner Carter stated that Commissioners have been advised to be careful when speaking out and/or signing documents. 10:48 a.m. Phil Anderson also discussed I-1639 and stated that the resolution they are presenting is an expression by the Grant County Republic Central Committee. The proposed resolution is supporting the Constitution. Mr. Anderson read into the record his statement. Further discussion ensued.