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2015-2016 Fee-For-Service Agreement Milwaukee County DHHS Networks PowerPoint Presentation
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2015-2016 Fee-For-Service Agreement Milwaukee County DHHS Networks

2015-2016 Fee-For-Service Agreement Milwaukee County DHHS Networks

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2015-2016 Fee-For-Service Agreement Milwaukee County DHHS Networks

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  1. 2015-2016 Fee-For-Service AgreementMilwaukee County DHHS Networks

  2. 2015-2016 FFSA Timelines

  3. 2015-2016 FFSA Each County Contract Division will send out their own copy of the Agreement Agencies Work with DHHS Contract Administration regarding agencies that are unable to renew their Agreement because of pending Audit issues

  4. Delinquency & Court Services Division (DCSD)Other Items Due • Schedule of Services & Rates – Attachment A • CCSN Service Provision, Monthly Reporting & Agency Billing Process Policy & Procedure verification confirmation & receipt – Attachment B • Resource Guide Description Form • Application for Synthesis Login I.D. (if needed)

  5. Community Access to Recovery Services (CARS)Other Items Due Agreements must be signed by 11/21/14. In order to fully execute your Agreement, requested Desk Review items must be received (Insurance certificates, provider profile, etc.) no later than 11/28/14 to authorize services for January. Your agency should have received its Desk Review materials early October. If not, please follow up with CARS Quality Assurance.

  6. Wraparound MilwaukeeOther Items Due Agreements must be signed by 11/21/14. In order to fully execute your Agreement, any outstanding submission items must be received (Insurance certificates, audits, etc.) no later than 12/5/14 to authorize services for January. Any services delivered after 1/1/15 which do not conform with this timeline will be subject to reduced and/or delayed payment. Your agency is already aware of outstanding items, but can view them on the Summary Page of your Agreement.

  7. Wraparound Milwaukee Other Items Due, contd. • For agencies with State established rates, any rate changes for 2015 must be communicated to Wraparound by 4:30 p.m. 10/29/14, in order to avoid delays in payment. • Send notifications to margarita.drumgoole@milwaukeecountywi.gov • Include a copy of form DCF-F-2696-E​, Proposed Rate Request, or similar documentation. • All agencies are asked to review and update their agency demographic information in Synthesis • Use the “Updating Resource Guide Information on Synthesis” tutorial found on Wraparound’s website under Frequently Used Vendor Forms

  8. Milwaukee County Department of Health & Human Services 2015-2016 Fee for Service Agreement Overview of Changes

  9. Overview This presentation includes both additions/changes from previous year, as well as amplifications of specific requirements which have historically created confusion or are of particular importance The changes described in this presentation represent an overview of the most significant changes from the prior year and are NOT inclusive of ALL changes; agencies are responsible for carefully reading and complying with the Agreement and all relevant Policies and Procedures Unless otherwise indicated, all items discussed today apply to all contract divisions

  10. Overview, contd. Changes from previous year appear in Yellow highlighted text in Agreement New organizational structure of BHD and the Milwaukee County Mental Health Board Move toward standardized, DHHS-wide policy development Each Program’s Policy & Procedure Sign-Off Form is included with the Agreement (Attachment B)

  11. Section OneDefinitions Community Access to Recovery Services-CARS, added, formerly Service Access to Independent Living (SAIL) and WIser Choice. Milwaukee County Mental Health Board (MHB) added.

  12. Section TwoGeneral Obligations of the Provider E. Provider agrees to have access to a computer with internet capability and a functional Email account that Purchaser can use for ongoing communication with Provider. Provider also agrees to check Email a minimum of once per business day and respond to Purchaser within the requested time limits.

  13. Section TwoGeneral Obligations of the Provider, contd. I. Purchaser may immediately impose liquidated damages in the amount of $75 per day for each day beyond the deadline that the Provider fails to submit a requested response, data, other information, or other required notifications per Agreement. J. Provider agrees to comply with Purchaser required outcomes and measures or if Provider adopts Provider developed outcomes, Provider must submit for DHHS approval.

  14. Section Two General Obligations of the Provider, contd. K. DHHS Caregiver Background Check Policy and Procedure, No. 001 (policy can be found at: http://county.milwaukee.gov/ContractMgt15483.htm)

  15. Section Two Provider Obligations for Service Documentation EE. Provider agrees to ensure all DSP’s service documentation is legible. • The signature of the DSP on service documentation (progress notes, treatment plans, etc.) must contain at a minimum the first and last name, and not contain all capital letters or initials only. Electronic signatures are acceptable per required guidelines mentioned elsewhere in the Agreement.

  16. Section Two Provider Obligations for Service Documentation HH. Service Documentation will be on such forms and in such detail as may be required by Purchaser and will be made available to Purchaser upon request. SS. Emergency Management Plan – DHHS Emergency Management Plan Policy and Procedure, No. 002 (policy can be found at: http://county.milwaukee.gov/ContractMgt15483.htm)

  17. Section ElevenPerformance Measurement C. Purchaser reserves the right to establish and test for knowledge and competency standards related to Covered Services and/or Agreement requirements for Providers, Direct Service Providers, and Indirect Staff

  18. Section SixteenBilling A. Billing must reflect actual date of service provision and actual time spent providing Covered Service(s).

  19. Section EighteenCorrective Action, Conditional Status, Suspension, Termination, & Milwaukee County Debarment Purchaser’s authority for determination is final unless subject to appeal procedures defined by Chapter 110 of Milwaukee County Code of General Ordinances, or Article 1, Procurement Procedure Administrative Manual Milwaukee County Behavioral Health Division, Legal & Contractual Remedies, as applicable, or other applicable Federal or State laws, Purchaser has final authority for determination of substantiation of findings which may lead to a condition of Corrective Action.

  20. Section Twenty-TwoNotices • Notices for the following instances shall be in writing and shall be sent by registered or certified mail, return receipt requested, postage prepaid or via a national courier with return receipt requested and/or via email with acknowledgement by the recipient to the email address provided in the Agreement: • Termination of Agreement • Termination or Suspension of Direct or Indirect Service Provider • Suspension of Provider in whole or in part

  21. Section Twenty-FourWhistleblower Policy Whistleblower – Whistleblower Policy, No. 003 (policy can be found at: http://county.milwaukee.gov/ContractMgt15483.htm)

  22. Agreement Attachments Agreement: Signature Page (signature required) Attachment A: List of Services Covered by the Agreement (signature required) Attachment B: Policy and Procedure Sign-off Form (signature required) Attachment C: Service Specific Requirements - applicable to Wraparound Milwaukee and Delinquency & Court Services Division (does not require a signature)

  23. Program SpecificUpdates

  24. Wraparound MilwaukeeNew Policies • #070 - Housing Assistance • #071 - Interpretive Services for Client/Legal Guardians With Limited English Proficiency (LEP) or a Hearing Impairment • #072 - Certified Peer Specialist

  25. Wraparound MilwaukeeUpdated Policies • #011 – Consent/Acknowledgement and Authorization Forms • Youth age 14 and over MUST sign Consent Forms

  26. Wraparound MilwaukeeUpdated Policies, contd. • #014 – Critical Incident Reporting • Provider Agencies must report critical incidents to the youth’s parent/guardian, Care Coordinator/Care Coordinator Agency Supervisor/Lead and Wraparound Milwaukee Management within the same business day of becoming aware of the critical incident. • A threat to harm others may be required to be reported to Law Enforcement depending on who was threatened and/or the situation (i.e., threat to a public official, threat to public safety). • Critical incident documents (i.e., Department of Children and Families Serious Incident Report form) authored by the provider must be submitted via e-mail or fax to the Wraparound Milwaukee Quality Assurance Department upon completion of the document.

  27. Wraparound MilwaukeeUpdated Policies, contd. • #025 – In-Home Therapy • Updated forms • In-Home Note • In-Home Signature Log

  28. Wraparound MilwaukeeUpdated Policies, contd. • #035 - Provider Add/Drop • Add requests only accepted via the Vendor File Store upload process in Synthesis. Guidelines for “How to upload a file to Synthesis” can be found on the Wraparound Website (wraparoundmke.com) under the Provider Network Frequently Used Forms section. • The contents of the Add request are unchanged.

  29. Wraparound MilwaukeeUpdated Policies, contd. • #054 – Provider Agency Responsibilities and Guidelines • Informational item-not a requirement, but a useful internal monitoring resource for agencies to monitor the status of providers’ driver’s license status. • Agencies with a PARS account are eligible for the Employer Notification feature, which allows direct notification of actions against an individual’s license.  Call 608-250-4606 for information on obtaining Employer Notification through PARS. To obtain paperwork and information on PARS, go to: www.portal.wi.gov/register/

  30. Children’s Court Services Network2015 Plans • Move to Synthesis for CCSN • Phase One: Manage agencies and providers in Synthesis • Phase Two: Authorize and invoice for services in Synthesis • CCSN Service Provision, Monthly Reporting & Agency Billing Process Policy & Procedure • Additional Unit Requests • Contact Human Service Worker (HSW) • Provide rationale to HSW for exceeding maximum allowed units • Provider Resource Fair

  31. Children’s Court Services Network2015 Plans Payor of Last Resort CCSN Service Descriptions – Service Codes – Provider Credentials Policy & Procedure – Attachment F (formerly known as Appendix A)

  32. Children’s Court Services NetworkJuvenile Justice Reform and Reinvestment Initiative (JJRRI) • Federal grant partnership • Office of Juvenile Justice and Delinquency Prevention • Georgetown University Center for Juvenile Justice Reform • Vanderbilt University • Urban Institute • Implementation • Standardized Program Evaluation Protocol (SPEP) • Program Improvement • System Alignment • Evaluation / Cost-Benefit Analysis

  33. Children’s Court Services NetworkGoals of JJRRI • Short-term outcomes: • Improved SPEP scores as a result of program improvement plans, • Improved matching of youth to services based on assessed risk/need, • The development of practices and policies linking SPEP scores and cost data to system-level decision making, and • Increased cost effectiveness and efficiency. • Long-term outcomes: • Decreased recidivism rates, • Improved cost effectiveness of juvenile justice services, and • The reduction in public cost Source: Georgetown University Center for Juvenile Justice Reform

  34. Children’s Court Services NetworkJJRRI Project Progress • Completed: • Identification, collection and development of data/information on the four (4) components of the SPEP tool (service type, quality, dosage, and risk score) • No Pilot Scores produced/ Pilot process informed Score 1 • Current: • Score 1 Completed Fall 2014 • Scores/Feedback Report Distribution and Site Visits • FFSA Attachments: • Standardized Program Evaluation Protocol (SPEP) Quality Measures • Standardized Program Evaluation Protocol (SPEP) Service Classifications and Dosage Targets

  35. Children’s Court Services NetworkJJRRI Project Progress – cont. • Next Steps: • Prepare for next data collection cycle • Score 2 time frame: Jan – Dec 2014 • Data Collection: February 2015 • Program Improvement Phase • Action Plans • Technical assistance to address trends • Develop long term, sustainable methods of obtaining these data

  36. Break

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  38. DHHS Provider Networks / Contract Administration Interface Engage in DHHS centralized QA process & QA Committee Discuss/approve audit/review indicators Assists with site audits/reviews, will frequently be the audit Lead Frequently drafts the audit/review agency report, and dialogues regarding the same Collaborate regarding FFS Agreement yearly revisions Provide forum for discussing policy changes and Background Check/Drivers Abstract info. that needs additional review

  39. Insurance Requirements Audit and Accounting RequirementsMaintaining Financial RecordsGeneral Information on Allowable CostsAudit Requirements and Waiver Procedures Insurance & Audit Requirements

  40. Section ThirteenInsurance Requirement Auto Liability: required for all agency vehicles (owned, non-owned, and/or hired). Coverage: $1 million per accident Auto Liability Insurance Requirement: The Provider shall have Automobile Liability Insurance, and/or Auto and Umbrella Liability that meets the Minimum Limits for non-owned and/or hired autos covering all non-owned & hired vehicles for employees and ISP with liability limits of: $1 million per accident. Commercial General and/or Business Owner’s Liability: Required of ALL Providers and must include premises and off premises liability coverage

  41. Section ThirteenInsurance Requirement, contd. Commercial General and/or Business Owner’s Liability: Required of ALL Providers and must include premises and off premises liability coverage Coverage may include Agency Umbrella policy to reach 1 million in coverage for Commercial General or Auto Liability minimum.

  42. Section ThirteenWorker’s Compensation Insurance Worker’s Comp Requirement for Waiver of Subrogation: A Waiver of Subrogation for Worker’s Compensation by endorsement in favor of Milwaukee County is also required. A copy of the endorsement shall be provided. All providers shall have Worker’s Comp coverage for all employees and Independent Service Providers All provider agencies, including sole proprietorships or partnerships, regardless of the type of legal entity, number of employees, etc., are required to have Worker’s Comp Coverage

  43. Section ThirteenInsurance (Professional Liability) Professional Liability: If the services provided constitute professional services, Provider shall maintain Professional Liability (E&O) coverage. Includes Certified/Licensed Mental Health & AODA Clinics. 1MM/3MM Hospital, Licensed Physician or any other qualified healthcare provider under Sect 655 of state statutes : 1MM/3MM

  44. Section ThirteenInsurance (Professional Liability), contd. Professional Liability Minimum: Other Licensed or Certified Professionals for Non-healthcare services (i.e. if a license or certification is required to perform the service). Examples, licensed or certified counselors, therapists, clinical social workers, etc. $1,000,000 per Occurrence Annual aggregate reduced to $1,000,000, or, in some cases, the Statutory limits, whichever is higher If professional liability or E&O insurance is required, the check box will be checked on the Agreement Schedule of Coverage, Para. F.

  45. Section Thirteen Insurance (waiver requests), contd. • Contract Administration will not be accepting insurance waiver requests. • Any deviations, or requests for waiver from the above requirements shall be submitted in writing to the Milwaukee County Risk Manager for approval prior to the commencement of activities under this Agreement: • Milwaukee County Risk Manager • Milwaukee County Courthouse – Room 302 • 901 North Ninth Street • Milwaukee, WI 53233 • Unless and until a waiver is granted, it should be assumed that the contract requirement is in effect.

  46. Section ThirteenInsurance, contd. • Additional Insured: Milwaukee County shall be named as Certificate Holder and receive copies of, an “additional insured” endorsement, for general liability, automobile insurance, and Umbrella/Excess liability insurance. • Exceptions of compliance with “additional insured” endorsement are: • Transport companies insured through the State “Assigned Risk Business” (ARB). • Professional Liability (E&O) where additional insured is not allowed.

  47. Section ThirteenInsurance, contd. Upon Renewal, Provider shall furnish County annually on or before the date of renewal, evidence of a Certificate indicating the required coverage (with the Milwaukee County Department of Health and Human Services named as the “Certificate Holder ”) Certificate Holder Milwaukee County Dept. of Health & Human Services Contract Administrator 1220 W. Vliet Street, Suite 300 Milwaukee, WI 53205

  48. Who Must Have An Audit? Audits are required by State Statute if the care & service purchased with State funding exceeds $25,000 per year Statutes allow the Dept. to waive audits. Audits may not be waived if the audit is a condition of state licensure, or is needed to claim federal funding (e.g. Group Foster Care or RCCs) Standards for audits are found in Provider Agency Audit Guide, 1999 Revision issued by WI Department of Corrections and Workforce Development or Department of Health Service Audit Guide (DHSAG) current revision issued by Wisconsin Departments of Health Services. (on line at www.dhfs.state.wi.us/grants) NEW ~ ALL Providers that receive $750,000 or more in federal awards must also have audit performed in accordance Office of Management and Budget (OMB) Uniform Grant Guidance under Part 200 (online at http://www.whitehouse.gov/omb/grants_docs).

  49. Procedures for Request for Extension of Annual Independent Audit • Audits are due within 6 months of Providers fiscal year end (June 30th, if calendar fiscal year). • Extensions are at the sole discretion of DHHS. DHHS must receive a request for an extension not later than thirty (30) days prior to the due date for the audit. A request for an extension must include:  • an explanation as to why an extension is necessary;  • the date upon which the Purchaser will receive the audit;  • the unaudited financial statements of the Provider; and,  • any additional information Provider deems relevant to Purchaser's determination. 

  50. Extension Request, contd. No extension will be granted for a period greater than ninety (90) days beyond the original date that the audit was due. Requests for extension of audit due date must be submitted to: Milwaukee County Department of Health and Human Services Contract Administrator 1220 W. Vliet Street, Suite 300 Milwaukee, WI 53205