Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL By: CareSource Indiana, Inc. Indiana Family & and Social Services Administration d/b/a Tippecanoe Villa Division Administration, Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorMedicaid Policy and Planning Title: President, Div Aging Date:\d31/\16/2023 Indiana Market By: Title: Medicaid director Date: 12/28/2022 | 06:23 PDT Date:\d32/\20/2023 16:40 EST Date: 12/28/2022 | 10:23 EDT 16:41 EST Electronically Approved by: Indiana Office of Technology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care2.1 State Licensure and Compliance with Applicable Laws, Rules, and is therefore not eligible Regulations 33 2.2 National Committee for RCAP. For enrolled RCAP participantsQuality Assurance (NCQA) Accreditation 34 2.3 Administrative and Organizational Structure 34 2.3.1 Staffing 35 2.3.2 Key Staff 35 2.3.3 Other Required Staff Positions 41 2.3.4 Suggested Staff Positions 43 2.3.5 Staff Training and Qualifications 44 2.3.6 Debarred Individuals 45 2.4 FSSA Meeting Requirements 46 2.5 Financial Stability 46 2.5.1 Solvency 46 2.5.2 Insurance Requirements 47 2.5.3 Reinsurance 47 2.5.4 Financial Accounting Requirements 48 2.5.5 Reporting Transactions with Parties of Interest 50 2.5.6 Medical Loss Ratio 51 2.5.7 Reserved 52 2.6 Subcontracts 52 2.7 Confidentiality of Member Medical Records and Other Information 56 2.8 Internet Quorum (IQ) Inquiries 56 2.9 Material Change to Operations 57 2.10 Future Program Guidance 57 2.11 Conflict of Interest 57 2.12 Capitation Related to a Vacated Program 57 2.13 Maintenance of Records 57 2.14 Maintenance of Written Policies and Procedures 58 2.15 Participation in Readiness Review 58 2.16 Dissemination of Information 58 2.17 FSSA Ongoing Monitoring 58 3.1 Covered Benefits and Services 59 3.2 Self-referral Services 60 3.3 Early and Periodic Screening, the Contractor must contact the local Area Agency on Aging Diagnosis and Treatment (AAAEPSDT) to initiate preServices 62 3.4 Drug Coverage 62 3.4.1 Drug Rebates 63 3.4.2 Preferred Drug List Requirements 63 3.4.3 DUR Board and MHQAC Reporting Requirements 65 3.4.4 Dispensing and Monitoring Requirements 65 3.4.5 E-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Prescribing 66
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUS TOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By: CareSource Indiana, Inc. Indiana Family & and Social Services Administration d/b/a Tippecanoe Villa Division Administration, Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorMedicaid Policy and Planning Title: President, Div Aging Date:\d31/\16/2023 Indiana Market Title: Medicaid director Date: 2/14/2023 | 06:23 PDT Date:\d32/\20/2023 09:51 EST Date: 2/15/2023 | 10:23 EDT 13:17 EST Electronically Approved by: Indiana Office of Technology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care1.0 Background 33 2.0 Administrative Requirements 34 2.1 State Licensure and Compliance with Applicable Laws, Rules, and is therefore not eligible Regulations 34 2.2 National Committee for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging Quality Assurance (AAANCQA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any Accreditation 34 2.3 Administrative and Organizational Structure 34 2.3.1 Staffing 35 2.3.2 Key Staff 35 2.3.3 Other Required Staff Positions 41 2.3.4 Suggested Staff Positions 42 2.3.5 Staff Training and Qualifications 43 2.3.6 Debarred Individuals 44 2.4 FSSA Meeting Requirements 45 2.5 Financial Stability 46 2.5.1 Solvency 46 2.5.2 Insurance Requirements 46 2.5.3 Reinsurance 46 2.5.4 Financial Accounting Requirements 48 2.5.5 Reporting Transactions with Parties of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Interest 49 2.5.6 Medical Loss Ratio (MLR) 50 2.5.7 Reserved 51 2.6 Subcontracts 51
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government Office of Medicaid Policy and Planning By: Coordinated Care Corporation Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorManaged Health Services, Div Aging Date:\d31/\16/2023 d/b/a MHS By: Title: CEO Title: Medicaid Director Date: 7/19/2024 | 06:23 09:03 PDT Date:\d32/\20/2023 Date: 7/19/2024 | 10:23 13:11 EDT Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Acting State Budget Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(32.1 State Licensure 13 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Program Accreditation 13 2.3 Subcontracts 14 2.4 Financial Stability 18 2.4.1 Solvency 18 2.4.2 Insolvency and Receivership 18 2.4.3 Reinsurance 19 2.4.4 Performance Bond Requirements 20 2.4.5 Financial Accounting Requirements 21 2.4.6 Insurance Requirements 22 2.5 Maintenance of Records 23 2.6 Disclosures 23 2.6.1 Definition of a Party in Interest 23 2.6.2 Types of Transactions Which Must Be Disclosed 24 2.7 Debarred Individuals 24 2.8 Medical Loss Ratio (RCAPMLR) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.25 2.9 Reserved 27
Appears in 1 contract
Sources: Amendment to Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By:\s1\ Title:\tP1r\ esident and CEO Date:5\d/11\3/2021 | 11:43 EDT Title:\Mt2e\dicaid director By:\s2\ Date5:\d/21\3/2021 | 12:09 EDT Electronically Approved by: Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorTechnology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇ ▇▇ . ▇▇▇▇ erda▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential 1.0 Background 10 2.0 Managed Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Entity- Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Requirements 11
Appears in 1 contract
Sources: Contract Amendment
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government By:\s1\ Coordinated Care Corporation Indiana Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ Title:\Ct1E\O Date:1\d21/\28/2021 | 13:55 CST By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 Title:\t2M\edicaid director Date:\1d22\/28/2021 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT 15:01 EST Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ Holw erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 1.A. SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3Table of Contents 1.0 Background 11 2.0 Administrative Requirements 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Program (RCAP) program to persons who require Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 14 2.4.1 Solvency 14 2.4.2 Insolvency and Receivership 14 2.4.3 Reinsurance 15 2.4.4 Performance Bond Requirements 16 2.4.5 Financial Accounting Requirements 16 2.4.6 Insurance Requirements 17 2.5 Maintenance of Records 18 2.6 Disclosures 18 2.6.1 Definition of a degree Party in Interest 18 2.6.2 Types of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Transactions Which Must Be Disclosed 19
Appears in 1 contract
Sources: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government Prosecuting Attorney Indiana Family & Social Services Administration d/b/a Tippecanoe Villa By:\s1\ Division of Aging By:\s1\ By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT 10:02 PST Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) limits American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Residential Care Assistance Program Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of careUniform Administrative Requirements, Cost Principles, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessmentAudit Requirements).
Appears in 1 contract
Sources: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By:\s1\ Title:\t1P\resident, Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division Market Date:\d51/\12/2021 | 14:40 EDT By:\s2\ Title:\t2M\edicaid director Date:\d52/\12/2021 | 22:51 EDT Electronically Approved by: Indiana Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorTechnology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇ ▇▇ . ▇▇▇▇ erda▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(31.0 Background 9 2.0 Managed Care Entity- Contractor Requirements 10 2.1 State Licensure 10 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree Accreditation 10 2.3 Administrative and Organizational Structure 10 2.4 Staffing 11 2.4.1 Key Staff 12 2.4.2 Staff Positions 17 2.4.3 Training 18 2.4.4 Debarred Individuals 19 2.5 OMPP Meeting Requirements 20 2.6 Financial Stability 20 2.6.1 Solvency 20 2.6.2 Insurance 21 2.6.3 Reinsurance 21 2.6.4 Financial Accounting Requirements 22 2.6.5 Reporting Transactions with Parties of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level Interest 24 2.6.6 Medical Loss Ratio 25 2.6.7 Health Insurance Providers Fee 26 2.7 Subcontracts 27 2.8 Confidentiality of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, Member Medical Records and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Other Information 29
Appears in 1 contract
Sources: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Anthem Insurance Companies Inc. Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorTitle:\t1P\resident, Div Aging Date:\d31/\16/2023 Anthem IN Medicaid Date:\d31/\29/2021 | 06:23 PDT Date:\d32/\20/2023 15:54 EDT Title:\t2M\edicaid director Date:\d32/\29/2021 | 10:23 15:58 EDT Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇ ▇▇ . ▇▇▇▇ erda▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 121.0 Background 34 2.0 Administrative Requirements 34 2.1 State Licensure 34 2.2 National Committee for Quality Assurance (NCQA) Accreditation 34 2.3 Subcontracts 35 2.4 Financial Stability 37 2.4.1 Solvency 37 2.4.2 Insolvency and Receivership 37 2.4.3 Reinsurance 38 2.4.4 Performance Bond Requirements 39 2.4.5 Financial Accounting Requirements 39 2.4.6 Insurance Requirements 41 2.5 Maintenance of Records 41 2.6 Disclosures 41 2.6.1 Definition of a Party in Interest 41 2.6.2 Types of Transactions Which Must Be Disclosed 42 2.7 Debarred Individuals 42 2.8 Medical Loss Ratio 43 2.9 Health Insurance Providers Fee 44 2.10 Administrative and Organizational Structure 44 2.10.1 Staffing 45 2.10.2 Key Staff 45 2.10.3 Other Required Staff Positions 51 2.10.4 Suggested Staff Positions 51 2.10.5 Staff Training and Qualifications 52 2.11 FSSA Meeting Requirements 54 2.12 Maintenance of Written Policies and Procedures 54 2.13 Participation in Readiness Review 54 2.14 Confidentiality of Member Medical Records and Other Information 55 2.15 Material Change to Operations 55 2.16 Response to State Inquiries & Requests for Information 55 2.17 Dissemination of Information 55 2.18 FSSA Ongoing Monitoring 56 2.19 Future Program Guidance 56 2.20 Dual Eligible Special Needs Plans (D-10SNPs) Requirements 56 2.21 Capitation Related to a Vacated Program 57 EXHIBIT 1 SCOPE OF WORK 3.0 Covered Benefits 58 3.1 Self-6Referral Services 59 3.2 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services 60 3.3 Emergency Services 61 3.3.1 Emergency Room Services Copayment 62 3.3.2 Post-2.1(a)(3) limits the Residential Stabilization Services 63 3.4 Inpatient Services 64 3.5 Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility Conference Coverage 64 3.6 Medication Therapy Management Services 64 3.6.1 Goals of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.MTM Program 64 3.6.2 General Requirements 65 3.6.3 Target Members 66 3.6.4 Reporting 66 3.7 Diabetes Supplies Coverage 67 3.8 Drug Coverage 67 3.8.1 Drug Rebates 67 3.8.2 Preferred Drug List Requirements 68
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By:\s1\ Title:\t1P\resident, Anthem IN Medicaid Title:\t2M\edicaid director Date:\d51/\14/2021 | 12:56 EDT Date:\d52/\14/2021 | 13:22 EDT Electronically Approved by: Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorTechnology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇ ▇▇ . ▇▇▇▇ erda▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential 1.0 Background 10 2.0 Managed Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Entity- Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Requirements 11
Appears in 1 contract
Sources: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Anthem Insurance Companies, Inc., d.b.a Anthem Blue Cross and Blue Shield Indiana Family & and Social Services Administration d/b/a Tippecanoe Villa Division Administration, Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorMedicaid Policy and By: Planning By: Title: President, Div Aging Date:\d31/\16/2023 Anthem IN Medicaid Title: Medicaid director Date: 2/14/2023 | 06:23 PDT Date:\d32/\20/2023 11:17 PST Date: 2/15/2023 | 10:23 EDT 13:17 EST Electronically Approved by: Indiana Office of Technology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care1.0 Background 31 2.0 Administrative Requirements 32 2.1 State Licensure and Compliance with Applicable Laws, Rules, and is therefore not eligible Regulations 32 2.2 National Committee for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging Quality Assurance (AAANCQA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged Accreditation 32 2.3 Administrative and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Organizational Structure 32 2.3.1 Staffing 33 2.3.2 Key Staff 33 2.3.3 Other Required Staff Positions 39 2.3.4 Suggested Staff Positions 41 2.3.5 Staff Training and Qualifications 42 2.3.6 Debarred Individuals 43 2.4 FSSA Meeting Requirements 44 2.5 Financial Stability 44 2.5.1 Solvency 45 2.5.2 Insurance Requirements 45 2.5.3 Reinsurance 45 2.5.4 Financial Accounting Requirements 46
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 contractsearch/. By: By: Title: Executive Director Title: Chairman Date: 3/4/2025 | 06:23 PDT Date:\d32/\20/2023 10:11 EST Date: 3/4/2025 | 10:23 EDT 10:25 EST Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda▇▇▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, State Budget Director Approved as to Form and Legality: Office of Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12Form approval has been granted by the Office of the Attorney General pursuant to IC 4-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-313-2-14.3(e) on February 5, 2025 FA 24-80 ↵ Exhibit A Exhibit B Budget Narrative for 2025 Midwest Damage Prevention Training Conference (MWDPTC) Project Overview The 2025 Midwest Damage Prevention Training Conference (MWDPTC) aims to provide scholarships to individuals in the damage prevention industry in Indiana who may not have the means or opportunity to attend the conference otherwise. No resident The project also includes funds to support the attendance of Indiana Utility Regulatory Commission (IURC) staff, Indiana Damage Prevention Council Officers, and other related activities. Project Scope Scholarship Program The scholarship program will give preference to individuals who meets nursing facility level have never attended the MWDPTC before. Remaining scholarships will be granted to returning recipients based on need and a first-come, first-served basis. The only requirement is that the applicant works in the state of care will receive RCAP reimbursementIndiana. It is Additional Support The grant also includes funds to support the responsibility attendance of IURC staff, Indiana Damage Prevention Council Officers, Scholarship Sweets, and UPPAC lunch for UPPAC members only. Project Timeline Scholarship Program Application Period Starts on June 24, 2024, and ends when all scholarships are filled, which may last until the start date of the RCAP facility to conduct conference Conference Dates: November 11-13, 2025. Budget Details Scholarship Packages: 50 packages at the individual’s level Early Bird Rate of care assessment prior to applying to RCAP in order to determine whether $485 each: $72,750.00. Two nights of hotel for 150 attendees at $270.07 per night: $81,021.00. Scholarship Sweets (Orientation Program) Food and beverages: $1,300.00 IURC Team Package: $22,636.24. PC Officer Packages: $9,216.09. Scholarship Sweets AV: $650.00 UPPAC Lunch: $900.00. UPPAC AV: $300.00. Total Estimated Cost: $188,773.33 Funding Request: The total amount requested for this project is $188,773.33 Guidelines for filing the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.annual financial report:
Appears in 1 contract
Sources: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By: By: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Title: President and CEO Title: Medicaid Director Date: March 09, 2020 Date: March 9, 2020 Electronically Approved by: Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorTechnology By: (for) ▇▇▇▇▇▇ ▇▇▇▇▇, Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇ ▇▇ . ▇▇▇▇ erda▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇. ▇▇▇▇, ▇▇., Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(32.1 State Licensure 12 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, Accreditation 12 2.3 Administrative and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Organizational Structure 12 2.4 Staffing 13 2.4.1 Key Staff 13 2.4.2 Staff Positions 19 2.4.3 Training 21 2.4.4 Debarred Individuals 22 2.5 FSSA/OMPP Meeting Requirements 23 2.6 Financial Stability 23 2.6.1 Solvency 23 2.6.2 Insurance 24 2.6.3 Reinsurance 24 2.6.4 Financial Accounting Requirements 26
Appears in 1 contract
Sources: Contract for Providing Risk Based Managed Care Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government Indiana na Family & Social By: Coordinated Care Corporation India Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 By: Title: CEO Title: Medicaid director Date: 12/1/2022 | 06:23 PDT Date:\d32/\20/2023 16:56 CST Date: 12/2/2022 | 10:23 EDT 09:19 EST Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3Table of Contents 1.0 Background 11 2.0 Administrative Requirements 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Program (RCAP) program to persons who require Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 15 2.4.1 Solvency 15 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 16 2.4.4 Performance Bond Requirements 17 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of Records 20 2.6 Disclosures 20 2.6.1 Definition of a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP Party in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Interest 20
Appears in 1 contract
Sources: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By:\s1\ Title:\tC1E\O Date:\6d/11\ /2021 | 11:43 CDT Title:\tM2e\ dicaid director By:\s2\ Date:6\d/21\ /2021 | 13:11 EDT Electronically Approved by: Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorTechnology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇ ▇▇ . ▇▇▇▇ erda▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(31.0 Background 11 2.0 Managed Care Entity- Contractor Requirements 13 2.1 State Licensure 13 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Accreditation 13 2.3 Administrative and Organizational Structure 13 2.4 Staffing 14 2.4.1 Key Staff 14 2.4.2 Staff Positions 20 2.4.3 Training 22 2.4.4 Debarred Individuals 23 2.5 FSSA/OMPP Meeting Requirements 24 2.6 Financial Stability 24 2.6.1 Solvency 24 2.6.2 Insurance 25 2.6.3 Reinsurance 25 2.6.4 Financial Accounting Requirements 26 2.6.5 Reporting Transactions with Parties of Interest 28 2.6.6 Medical Loss Ratio 29 2.6.7 Health Insurance Providers Fee 30 2.7 Subcontracts 31 2.8 Confidentiality of Member Medical Records and Other Information 34 2.9 Internet Quorum (IQ) Inquires 34 2.10 Material Change 34 2.11 Future Program (RCAP) program Guidance 34 2.12 Conflict of Interest 35 2.13 Capitation Related to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, Vacated Program 35 3.0 HIP Plan Design and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Member Eligibility 35 3.1 HIP Plus 35
Appears in 1 contract
Sources: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Coordinated Care Corporation Indiana Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division By:\s1\ Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorMedicaid Policy & Planning Title:\t1V\ice President Date:\d112\/11/2020 | 15:22 EST Title:\t2M\edicaid director Date:\d122\/11/2020 | 15:28 EST Electronically Approved by: (if applicable) Indiana Office of Technology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇ ▇▇ . ▇▇▇▇ erda▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇. ▇▇▇▇, ▇▇., Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.5.M CAPITATION RATES
Appears in 1 contract
Sources: Contract #0000000000000000000018227
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government PURE STORAGE INC By: Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorTechnology By: Vice President, Div Aging Date:\d31/\16/2023 Americas Public SectoTritlSea: lCehsief Information Officer Date: 1/31/2024 | 06:23 PDT Date:\d32/\20/2023 07:46 PST Date: 1/31/2024 | 10:23 EDT 11:35 EST Electronically Approved by: Indiana Office of Technology By: (for) ▇▇▇▇▇ ▇▇▇▇▇▇, Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda▇▇▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12DocuSign Envelope ID: AF6132C0-10D2BD-4A31-686E -1CD4889E439A DocuSign Envelope ID: 9D16B17D-2.1(a)(3) limits the Residential Care Assistance Program A239-4AD1-849F-379FA814BDD8 (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care“State”), and is therefore not eligible for RCAP. For enrolled RCAP participantsPure Storage, the Contractor must contact the local Area Agency on Aging Inc., ▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇, Suite 260, Mountain View, CA 94041 (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment“Contractor”).
Appears in 1 contract
Sources: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government United Healthcare Insurance Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorTitle:\t1C\EO, Div Aging Date:\d31/\16/2023 Indiana M&R Title:\t2M\edicaid director Date:\d112\/22/2021 | 06:23 PDT Date:\d32/\20/2023 10:57 CST Date:\d122\/23/2021 | 10:23 EDT 10:31 EST Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ Holw erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 1.A. SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3Table of Contents 1.0 Background 13 2.0 Administrative Requirements 13 2.1 State Licensure 13 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Program (RCAP) program to persons who require Accreditation 13 2.3 Subcontracts 14 2.4 Financial Stability 16 2.4.1 Solvency 16 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 17 2.4.4 Performance Bond Requirements 18 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of Records 20 2.6 Disclosures 20 2.6.1 Definition of a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP Party in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Interest 20
Appears in 1 contract
Sources: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By:\s1\ Title:\tC1E\O Date:6\d/11\/2021 | 11:44 CDT Title:\Mt2e\ dicaid director By:\s2\ Date:6\d/21\ /2021 | 13:12 EDT Electronically Approved by: Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorTechnology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇ ▇▇ . ▇▇▇▇ erda▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(31.0 Background 9 2.0 Managed Care Entity- Contractor Requirements 10 2.1 State Licensure 10 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree Accreditation 10 2.3 Administrative and Organizational Structure 10 2.4 Staffing 11 2.4.1 Key Staff 12 2.4.2 Staff Positions 17 2.4.3 Training 18 2.4.4 Debarred Individuals 19 2.5 OMPP Meeting Requirements 20 2.6 Financial Stability 20 2.6.1 Solvency 20 2.6.2 Insurance 21 2.6.3 Reinsurance 21 2.6.4 Financial Accounting Requirements 22 2.6.5 Reporting Transactions with Parties of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level Interest 24 2.6.6 Medical Loss Ratio 25 2.6.7 Health Insurance Providers Fee 26 2.7 Subcontracts 27 2.8 Confidentiality of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, Member Medical Records and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Other Information 29
Appears in 1 contract
Sources: Amendment to Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_▇▇▇▇▇▇▇.▇▇ L Coordinated Care Corporation Indiana Family & and Social Services Administration d/b/a Tippecanoe Villa Division Administration, d.b.a Managed Health Services Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorMedicaid Policy and Planning By: By: Title: CEO Title: Medicaid director Date: 2/9/2023 | 08:55 PST Date: 2/10/2023 | 12:23 EST Electronically Approved by: Indiana Office of Technology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care1.0 Background 30 2.0 Administrative Requirements 31 2.1 State Licensure and Compliance with Applicable Laws, Rules, and is therefore not eligible Regulations 31 2.2 National Committee for RCAP. For enrolled RCAP participantsQuality Assurance (NCQA) Accreditation 31 2.3 Administrative and Organizational Structure 31 2.3.1 Staffing 32 2.3.2 Key Staff 32 2.3.3 Other Required Staff Positions 38 2.3.4 Suggested Staff Positions 39 2.3.5 Staff Training and Qualifications 40 2.3.6 Debarred Individuals 41 2.4 FSSA Meeting Requirements 42 2.5 Financial Stability 43 2.5.1 Solvency 43 2.5.2 Insurance Requirements 43 2.5.3 Reinsurance 43 2.5.4 Financial Accounting Requirements 45 2.5.5 Reporting Transactions with Parties of Interest 46 2.5.6 Medical Loss Ratio (MLR) 47 2.5.7 Reserved 48 2.6 Subcontracts 48 2.7 Confidentiality of Member Medical Records and Other Information 52 2.8 Internet Quorum (IQ) Inquiries 52 2.9 Material Change to Operations 52 2.10 Future Program Guidance 52 2.11 Conflict of Interest 53 2.12 Capitation Related to a Vacated Program 53 2.13 Maintenance of Records 53 2.14 Maintenance of Written Policies and Procedures 53 2.15 Participation in Readiness Review 53 2.16 Dissemination of Information 54 2.17 FSSA Ongoing Monitoring 54 3.0 Covered Benefits and Services 54 3.1 Covered Benefits and Services 54 3.2 Self-referral Services 56 3.3 Early and Periodic Screening, the Contractor must contact the local Area Agency on Aging Diagnosis and Treatment (AAAEPSDT) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.57 3.4 Drug Coverage 58
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Coordinated Care Corporation Indiana Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 Title:\t1C\EO Date:\d31/\29/2021 | 06:23 PDT Date:\d32/\20/2023 15:13 CDT Title:\t2M\edicaid director Date:\d32/\29/2021 | 10:23 16:15 EDT Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇ ▇▇ . ▇▇▇▇ erda▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(31.0 Background 33 2.0 Administrative Requirements 33 2.1 State Licensure 33 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Program (RCAP) program to persons who require Accreditation 33 2.3 Subcontracts 34 2.4 Financial Stability 36 2.4.1 Solvency 36 2.4.2 Insolvency and Receivership 36 2.4.3 Reinsurance 37 2.4.4 Performance Bond Requirements 38 2.4.5 Financial Accounting Requirements 38 2.4.6 Insurance Requirements 40 2.5 Maintenance of Records 40 2.6 Disclosures 40 2.6.1 Definition of a degree Party in Interest 40 2.6.2 Types of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level Transactions Which Must Be Disclosed 41 2.7 Debarred Individuals 41 2.8 Medical Loss Ratio 42 2.9 Health Insurance Providers Fee 43 2.10 Administrative and Organizational Structure 43 2.10.1 Staffing 44 2.10.2 Key Staff 44 2.10.3 Other Required Staff Positions 50 2.10.4 Suggested Staff Positions 50 2.10.5 Staff Training and Qualifications 52 2.11 FSSA Meeting Requirements 53 2.12 Maintenance of care will receive RCAP reimbursement. It is the responsibility Written Policies and Procedures 53 2.13 Participation in Readiness Review 53 2.14 Confidentiality of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, Member Medical Records and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Other Information 54
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUS TOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Anthem Insurance d.b.a Anthem Blue Companies, Inc., Cross and Blue Shield Indiana Family & and Social Services Administration d/b/a Tippecanoe Villa Division Administration, Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorMedicaid and Policy Planning By: By: Title: President, Div Aging Date:\d31/\16/2023 Anthem IN Medicaid Title: Medicaid director Date: 12/29/2022 | 06:23 PDT Date:\d32/\20/2023 10:20 PST Date: 12/29/2022 | 10:23 EDT 15:16 EST Electronically Approved by: Indiana Office of Technology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care2.1 State Licensure and Compliance with Applicable Laws, Rules, and is therefore not eligible Regulations 33 2.2 National Committee for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging Quality Assurance (AAANCQA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any Accreditation 34 2.3 Administrative and Organizational Structure 34 2.3.1 Staffing 35 2.3.2 Key Staff 35 2.3.3 Other Required Staff Positions 41 2.3.4 Suggested Staff Positions 43 2.3.5 Staff Training and Qualifications 44 2.3.6 Debarred Individuals 45 2.4 FSSA Meeting Requirements 46 2.5 Financial Stability 47 2.5.1 Solvency 47 2.5.2 Insurance Requirements 47 2.5.3 Reinsurance 48 2.5.4 Financial Accounting Requirements 49 2.5.5 Reporting Transactions with Parties of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Interest 50 2.5.6 Medical Loss Ratio 52 2.5.7 Reserved 53 2.6 Subcontracts 53
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts DatabaseDatabas e: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUS TOM_APPS.SOI_PUBLIC_CNTRCT S.GBL foregoing terms of this Contract, do by their respective signatures dated below agree to the terms thereof. By: CareSource Indiana, Inc. Indiana Family & and Social Services Administration d/b/a Tippecanoe Villa Division Administration, Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorMedicaid Policy and Planning Title: President, Div Aging Date:\d31/\16/2023 Indiana Market Title: Medicaid director Date: 12/28/2022 | 06:23 PDT Date:\d32/\20/2023 17:36 EST Date: 12/28/2022 | 10:23 EDT 18:28 EST Electronically Approved by: Indiana Office of Technology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care1.0 Background 33 2.0 Administrative Requirements 34 2.1 State Licensure and Compliance with Applicable Laws, Rules, and is therefore not eligible Regulations 34 2.2 National Committee for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging Quality Assurance (AAANCQA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any Accreditation 34 2.3 Administrative and Organizational Structure 34 2.3.1 Staffing 35 2.3.2 Key Staff 35 2.3.3 Other Required Staff Positions 41 2.3.4 Suggested Staff Positions 42 2.3.5 Staff Training and Qualifications 43 2.3.6 Debarred Individuals 44 2.4 FSSA Meeting Requirements 45 2.5 Financial Stability 46 2.5.1 Solvency 46 2.5.2 Insurance Requirements 46 2.5.3 Reinsurance 46 2.5.4 Financial Accounting Requirements 48 2.5.5 Reporting Transactions with Parties of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Interest 49 2.5.6 Medical Loss Ratio (MLR) 50 2.5.7 Reserved 51 2.6 Subcontracts 51
Appears in 1 contract
Sources: Professional Services Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL Coordinated Care Corporation, Indiana Family & and Social Services Administration d/b/a Tippecanoe Villa Division Administration, d.b.a Managed Health Services Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorMedicaid Policy and Planning By: By: Title: CEO Title: Medicaid director Date: 12/28/2022 | 15:29 PST Date: 12/28/2022 | 18:32 EST Electronically Approved by: Indiana Office of Technology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care2.1 State Licensure and Compliance with Applicable Laws, Rules, and is therefore not eligible Regulations 33 2.2 National Committee for RCAP. For enrolled RCAP participantsQuality Assurance (NCQA) Accreditation 34 2.3 Administrative and Organizational Structure 34 2.3.1 Staffing 35 2.3.2 Key Staff 35 2.3.3 Other Required Staff Positions 41 2.3.4 Suggested Staff Positions 43 2.3.5 Staff Training and Qualifications 44 2.3.6 Debarred Individuals 45 2.4 FSSA Meeting Requirements 46 2.5 Financial Stability 46 2.5.1 Solvency 46 2.5.2 Insurance Requirements 47 2.5.3 Reinsurance 47 2.5.4 Financial Accounting Requirements 48 2.5.5 Reporting Transactions with Parties of Interest 50 2.5.6 Medical Loss Ratio 51 2.5.7 Reserved 52 2.6 Subcontracts 52 2.7 Confidentiality of Member Medical Records and Other Information 56 2.8 Internet Quorum (IQ) Inquiries 56 2.9 Material Change to Operations 56 2.10 Future Program Guidance 57 2.11 Conflict of Interest 57 2.12 Capitation Related to a Vacated Program 57 2.13 Maintenance of Records 57 2.14 Maintenance of Written Policies and Procedures 58 2.15 Participation in Readiness Review 58 2.16 Dissemination of Information 58 2.17 FSSA Ongoing Monitoring 58 3.1 Covered Benefits and Services 59 3.2 Self-referral Services 60 3.3 Early and Periodic Screening, the Contractor must contact the local Area Agency on Aging Diagnosis and Treatment (AAAEPSDT) to initiate preServices 62 3.4 Drug Coverage 62 3.4.1 Drug Rebates 63 3.4.2 Preferred Drug List Requirements 63 3.4.3 DUR Board and MHQAC Reporting Requirements 65 3.4.4 Dispensing and Monitoring Requirements 65 3.4.5 E-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Prescribing 66
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government THE MIND TRUST, INC. By: Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division Department of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 Education By: Title: CEO Title: Chief Financial Officer Date: 8/15/2022 | 06:23 PDT Date:\d32/\20/2023 13:42 EDT Date: 8/15/2022 | 10:23 20:31 EDT Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK The Mind Trust (TMT) is grateful for the opportunity to submit a proposal to the Indiana Code 12Department of Education (IDOE) to serve as the management team to administer the Student Enrichment Grants program defined by House Enrolled Act (HEA) 1251 (2022). Since 2006, The Mind Trust has worked to transform Indianapolis’ K-12 education system so that every student, regardless of race or socioeconomic status, receives an equitable, high-10quality education. Since launching in 2006, The Mind Trust has supported the launch of 41 schools that will collectively serve more than 15,000 students at scale alongside 13 education support nonprofit organizations. In July 2021, The Mind Trust launched Advancing Educational Equity—a six-6year, equity-2.1(a)(3) limits focused strategic plan aimed at tripling student proficiency across Center Township in Indianapolis. The Mind Trust will particularly emphasize improving outcomes for Black and Latino students and students from low-income households who have historically been excluded from educational opportunity. Advancing Educational Equity has racial equity at the Residential Care Assistance Program (RCAP) program forefront of each aspect of our work to persons who require ensure The Mind Trust is focused on equitably serving all Indianapolis children, families, and communities. The plan focuses on four key priorities—great schools, engaging community, racial equity, and thriving ecosystem. Since the onset of the COVID-19 pandemic, TMT has collaborated with funders, schools, and community partners to meet the elevated community needs stemming from the pandemic. We have led on three key initiatives that specifically sought to address the academic and social-emotional impacts of the pandemic on families, students, and educators over the past two years. ● TMT served as the project manager for the development of the Indiana eLearning Lab, a degree statewide initiative of care less than the Indianapolis eLearning Fund that provided by a health facility licensed under Indiana Code 16-28-3-2professional development and support to nearly 22,000 teachers statewide. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is After the responsibility initial design and launch of the RCAP facility eLearning Lab, The Mind Trust worked with funders and partners to coordinate a collaborative handoff of the project to its long-term home at the Indiana Department of Education as the Indiana Learning Lab. ● TMT launched and supported a total of 50 Community Learning Sites that served 1,278 students and supported students’ eLearning and social-emotional needs during the 2020-21 school year. These sites provided a safe, supportive environment for students to conduct eLearning and were created to alleviate the individual’s level childcare crisis the pandemic caused for working families. Feedback across Community Learning Sites was consistently positive. One mother noted, “This eLearning site has been such a blessing for our family. My husband and I both work full time outside of care assessment prior the home and were unsure what to applying to RCAP in order to determine whether do when eLearning was announced. We have appreciated the individual meets nursing facility level of careavailability, the location, and the staff. We feel our child was safe and cared for throughout his time here.” Conversations with parents also found an appreciation for the many benefits Community Learning Sites afforded students, including structure and social interaction; tutoring support; and a safe, distraction-free environment. Parents emphasized an increase in academic engagement from their child after they began attending a Community Learning Site compared to when they were participating in eLearning at home. ● The Mind Trust partnered with United Way of Central Indiana to launch Indy Summer Learning Labs (ISLL) in June 2021. ▇▇▇▇ served students across Indianapolis who were impacted by lost learning opportunities resulting from COVID-19. Thirty-nine sites spread across Indianapolis supported over 3,000 students in first through ninth grades who engaged in full-day academic and enrichment programming. The Mind Trust supported the recruitment of over 200 in-person, licensed teachers and teacher aids and 54 virtual teachers to staff the sites. Post-assessment results from the 2021 ISLL were promising. Students grew in English Language Arts by 12 percentage points after participating in ISLL with 41% of students achieving proficiency. Math performance grew by 17 percentage points with 45% of students proficient according to post-assessment data. Parent and family surveys also indicated strong satisfaction across all sites with 91.5% of parents reporting “good” or “great” satisfaction with the program and their student’s experience. Family demand for free, accessible summer programming remains high, which is therefore one of many reasons ISLL will take place again in summer 2022. This year’s ISLL will be held at more than 40 schools, churches, and community organizations across Center Township, serving as many as 5,000 students who are entering first through ninth grades. TMT’s experience and success leading initiatives that specifically address the academic and social-emotional needs of students and families positions us to effectively lead and deliver on the promise of the Student Enrichment Grants program being offered by the IDOE. HEA 1251 outlines the requirements for IDOE to establish criteria and develop processes to administer the program. TMT proposes to manage the development of the program design for IDOE while working alongside relevant stakeholders and partners to ensure broad adoption and strong family buy-in to the program throughout the state of Indiana. Through the development of a project team, alongside the expertise of key TMT personnel, TMT is well positioned to support the IDOE in meeting the requirements of HEA 1251, including (but not eligible for RCAP. For enrolled RCAP participants, limited to): establishing final criteria to identify enrichment students; determining the Contractor must amount of funds available and the number of grants to be awarded; developing the program forms; coordinating the identification and certification of participating entities; and managing the initiative’s partners and vendors; and secure data needed to contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessmentstudent and/or family and/or school.
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division of Aging contractsearch/. By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 Title:\t1A\dministrator Title:\tI2\DOH Chief of Staff Date:\d41/\13/2022 | 06:23 PDT Date:\d32/\20/2023 10:44 EDT Date:\d42/\13/2022 | 10:23 11:07 EDT Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda▇▇▇▇, Commissioner Electronically Approved by: State Budget Agency Approved as to Form and Legality: Office of Attorney General By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to (for) Form and Legality by: approval hasbeen granted by the Office of the Attorney General Bypursuant to IC 4-13-2-14.3(e) on M arch 15, 2022 FA 22-18 The local health department ("LHD") shall complete the 2021 Local Health Department Annual Survey on or before May 6, 2022. Upon acceptance by the Local Health Department Outreach Division ("LHDOD") of the 2021 LHD Annual Survey ("Survey") and approval of a contract for services the local health department shall be paid the sum of One Thousand Dollars and No Cents ($1,000). The Survey is accessible online via RedCap. The LHD shall access the Survey via a unique link and code to be provided by the LHDOD. Name of Organization: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance COUNTY Program (RCAP) program to persons who require a degree Description: 2021 Annual Survey Budget Period: 1/1/2022 - 5/6/2022 Salaries and Wages $ 1,000.00 Fringe Benefits $ - Consultants $ - Contractual $ - Supplies $ - Equipment $ - Travel $ - Other Operating Total Budget $ 1,000.00 Federal Agency: Department of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, Health and is therefore not eligible Human Services CFDA Number: 93.354 Grant Award Number: NU90TP922179 Award Name: Cooperative Agreement for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.emergency Response: Public Health Crisis Response
Appears in 1 contract
Sources: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: By: By: ▇▇▇▇▇://▇ ▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division , Executive Vice President ▇▇▇▇ ▇. ▇▇▇, Director of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorInnovative , Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda▇▇▇▇▇▇▇, Commissioner Electronically Approved byCommissioner, Indiana Department of Transportation 8/12/2021 | 09:22 EDT Date: State 8/13/2021 | 05:31 PDT APPROVALS STATE OF INDIANA Budget Agency By: (forFOR) ▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇▇, Director Date: STATE OF INDIANA Department of Administration By: (FOR) ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Commissioner Date: Approved as to Form and Legality: Office of the Attorney General By: (FOR) ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the ▇ Attorney General Byof Indiana Date: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Underground bore elevation/vault diagrams Structural Analysis Geotechnical Report Site walkthrough Land Survey Intermodulation Study AM Certification FCC Documents License FAA Approval NEPA/Programmatic CE Land Rights/Title Review Other regulatory documents as needed
Appears in 1 contract
Sources: Broadband Corridor Access Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government Indiana na Family & Social By: Anthem insurance Companies Inc. India Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorBy: Title: President, Div Aging Date:\d31/\16/2023 Anthem IN Medicaid Title: Medicaid director Date: 11/27/2022 | 06:23 PDT Date:\d32/\20/2023 14:52 PST Date: 11/27/2022 | 10:23 EDT 21:02 EST Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda▇▇▇▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3Table of Contents 1.0 Background 11 2.0 Administrative Requirements 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Program (RCAP) program to persons who require Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 15 2.4.1 Solvency 15 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 16 2.4.4 Performance Bond Requirements 17 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of Records 20 2.6 Disclosures 20 2.6.1 Definition of a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP Party in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Interest 20
Appears in 1 contract
Sources: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government Learfield Communications Inc. Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 Utility Regulatory Commission By: By: Title: Senior Manager-Business Development Title: Chairman Date: 7/21/2023 | 06:23 PDT Date:\d32/\20/2023 15:27 EDT Date: 7/27/2023 | 10:23 15:50 EDT Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12Submitted to: (Vendor name) Learfield Contact: ▇▇▇▇▇ ▇▇▇▇▇▇ Date: 05/16/2023 E-10mail address: ▇▇▇▇▇▇▇▇▇▇@▇▇▇.▇▇.▇▇▇ Phone: 317-6234- 5157 Vendor respectfully declines (please state reason): Media Budget (inclusive of agency costs/commission): $290,000 Creative Agency (if known): ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ creative run by ▇▇▇▇▇▇▇▇▇ State Agency Contact: ▇▇▇▇▇ ▇▇▇▇▇▇ Creative Agency Contact: ▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Email: ▇▇▇▇▇▇▇▇▇▇@▇▇▇.▇▇.▇▇▇ Email: ▇▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇ m P.O. Number (if known): State Agency Billing Contact: ▇▇▇▇ ▇▇▇▇▇ ▇▇▇-2.1(a)(3▇▇▇-▇▇▇▇ ▇▇▇▇▇▇▇@▇▇▇.▇▇.▇▇▇ Funding Source: Underground Plant Protection Account (UPPA) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, Fund General Fund or other condition, may make the resident eligible for nursing facility care Federal or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Dedicated Dedicated PeopleSoft Fund ID: 48691
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By:\s1\ Title:\tP1r\ esident and CEO Date:\5d/11\ 3/2021 | 11:45 EDT By:\s2\ Title:\tM2e\ dicaid director Date:\5d/2\13/2021 | 12:06 EDT Electronically Approved by: Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division Office of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorTechnology By: (for) ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Div Aging Date:\d31/\16/2023 | 06:23 PDT Date:\d32/\20/2023 | 10:23 EDT Chief Information Officer Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇ ▇▇ . ▇▇▇▇ erda▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(31.0 Background 12 2.0 Managed Care Entity- Contractor Requirements 14 2.1 State Licensure 14 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, Accreditation 14 2.3 Administrative and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Organizational Structure 14 2.4 Staffing 15 2.4.1 Key Staff 15 2.4.2 Staff Positions 21 2.4.3 Training 23 2.4.4 Debarred Individuals 24 2.5 FSSA/OMPP Meeting Requirements 25 2.6 Financial Stability 25 2.6.1 Solvency 25 2.6.2 Insurance 26 2.6.3 Reinsurance 26 2.6.4 Financial Accounting Requirements 27
Appears in 1 contract
Sources: Contract for Providing Risk Based Managed Care Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇.▇▇▇▇.▇▇.▇▇▇/apps/psp/idoaguest/contractsearch/ Tippecanoe County Government SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL United Healthcare Insurance Indiana Family & Social Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irectorTitle:\t1C\EO, Div Aging Date:\d31/\16/2023 Indiana M&R Title:\t2M\edicaid director Date:\d31/\29/2021 | 06:23 PDT Date:\d32/\20/2023 09:16 CDT Date:\d32/\29/2021 | 10:23 16:16 EDT Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇ ▇▇ . ▇▇▇▇ erda▇▇, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇. ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 121.0 Background 34 2.0 Administrative Requirements 34 2.1 State Licensure 34 2.2 National Committee for Quality Assurance (NCQA) Accreditation 34 2.3 Subcontracts 35 2.4 Financial Stability 37 2.4.1 Solvency 37 2.4.2 Insolvency and Receivership 37 2.4.3 Reinsurance 38 2.4.4 Performance Bond Requirements 39 2.4.5 Financial Accounting Requirements 39 2.4.6 Insurance Requirements 41 2.5 Maintenance of Records 41 2.6 Disclosures 41 2.6.1 Definition of a Party in Interest 41 2.6.2 Types of Transactions Which Must Be Disclosed 42 2.7 Debarred Individuals 42 2.8 Medical Loss Ratio 43 2.9 Health Insurance Providers Fee 44 2.10 Administrative and Organizational Structure 44 2.10.1 Staffing 45 2.10.2 Key Staff 45 2.10.3 Other Required Staff Positions 51 2.10.4 Suggested Staff Positions 51 2.10.5 Staff Training and Qualifications 52 2.11 FSSA Meeting Requirements 54 2.12 Maintenance of Written Policies and Procedures 54 2.13 Participation in Readiness Review 54 2.14 Confidentiality of Member Medical Records and Other Information 55 2.15 Material Change to Operations 55 2.16 Response to State Inquiries & Requests for Information 55 2.17 Dissemination of Information 55 2.18 FSSA Ongoing Monitoring 56 2.19 Future Program Guidance 56 2.20 Dual Eligible Special Needs Plans (D-10SNPs) Requirements 56 2.21 Capitation Related to a Vacated Program 57 EXHIBIT 1 SCOPE OF WORK 3.0 Covered Benefits 58 3.1 Self-6Referral Services 59 3.2 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services 60 3.3 Emergency Services 61 3.3.1 Emergency Room Services Copayment 62 3.3.2 Post-2.1(a)(3) limits the Residential Stabilization Services 63 3.4 Inpatient Services 64 3.5 Care Assistance Program (RCAP) program to persons who require a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility Conference Coverage 64 3.6 Medication Therapy Management Services 64 3.6.1 Goals of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.MTM Program 64 3.6.2 General Requirements 65 3.6.3 Target Members 66 3.6.4 Reporting 66 3.7 Diabetes Supplies Coverage 67 3.8 Drug Coverage 67 3.8.1 Drug Rebates 67 3.8.2 Preferred Drug List Requirements 68
Appears in 1 contract
Sources: Professional Services
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ▇▇▇▇▇://▇▇▇▇▇▇.▇▇.▇▇▇/apps/idoa/contractsearch/ Tippecanoe County Government Indiana na Family & Social By: United Healthcare Insurance Company India Services Administration d/b/a Tippecanoe Villa Division of Aging By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 By: Title: Chief Executive Officer Title: Medicaid director Date: 12/1/2022 | 06:23 PDT Date:\d32/\20/2023 18:36 EST Date: 12/2/2022 | 10:23 EDT 09:23 EST Electronically Approved by: Department of Administration By: (for) ▇▇▇▇▇▇▇ ▇▇▇▇ erda, Commissioner Electronically Approved by: State Budget Agency By: (for) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) ▇▇▇▇▇▇▇▇ ▇ ▇▇▇▇▇▇, Attorney General EXHIBIT 1 SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3Table of Contents 1.0 Background 11 2.0 Administrative Requirements 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) limits the Residential Care Assistance Program (RCAP) program to persons who require Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 15 2.4.1 Solvency 15 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 16 2.4.4 Performance Bond Requirements 17 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of Records 20 2.6 Disclosures 20 2.6.1 Definition of a degree of care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP Party in order to determine whether the individual meets nursing facility level of care, and is therefore not eligible for RCAP. For enrolled RCAP participants, the Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a resident will stop on the day the resident meets nursing facility level of care or refuses the level of care assessment.Interest 20
Appears in 1 contract
Sources: Contract