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Home My WebLink AboutCascade Pacific Alliance Medicaid Transformation Partner Provider CASCADE PACIFa ACTION ALLIANCE CONTRACT AMENDMENT CPAA ACH LLC Contract No: MC Contract#19-078 1217 4th Ave E.,Suite 200 Olympia,WA 98506 ®Amendment/Modification No: DY2-K2293-32 (360)539-7576 Contractor INFORMATION Agency Name Agency Address EIN# Mason County Community Services 415 N.6th Street 91-6001354 Shelton,WA 98584 Authorized Contract Signer Title Phone Number Kevin Shutty Contract Signer's E-Mail Agency Fax Number Contact's Phone Number (if different than above) CPAA INFORMATION Contract Title Medicaid Transformation Project Contact Person Title Contact Phone Number Christina Mitchell Program Director 360-539-7576 x 131 Contact E-Mail Address Contact's Fax Number mitchelic@crhn.org 360-943-1164 CONTRACT INFORMATON Funding Source Effective Dates Amendment Amount HCA Date of Execution to January 31,2022 (if applicable) $ 154,170 Reason for Amendment: $Base $Rural Service $Attribution $Multi Project $Health $Provider Incentive Incentive $8,200 $0 Equity Reporting $42,930 $0 Incentive $103,040 $0 Cascade Pacific Action Alliance ACH LLC Amendment DY2 Contract#K2293-32 Page 1 THIS"MEDICAID TRANSFORMATION PROJECT AMENDMENT"(AMENDMENT)is made and entered into by and between Cascade Pacific Action Alliance(CPAA)an Accountable Community of Health(ACH) And Mason County Community Services a Medicaid Transformation Project Partnering Provider(Partner) pursuant to Washington State's Medicaid Transformation Project(MTP). 3. ® THIS ITEM APPLIES ONLY TO BILATERAL AMENDMENTS The Contract identified herein,including any previous amendments thereto,is hereby amended as set forth in item 5 below by mutual consent of all parties hereto. 4. l THIS ITEM APPLIES ONLY TO UNILATERAL AMENDMENTS The Contract identified herein,including any previous amendments thereto,is hereby unilaterally amended as set forth in item 5 below pursuant to the changes and modifications clause as contained therein. 5. PURPOSE OF AMENDMENT: a) To define methodology for funding allocation i. The calculation for DY 2 funds are based on calculations provided by Washington State Health Care Authority(HCA).Funding is contingent upon the achievement value CPAA receives for submission of HCA required documentation and 100%completion of Partner Provider deliverables as stated in the Partner's original contract Addendum B—Scope of Work. b) To define funding area allocations i. Base incentive—Allocation based on selection as Partner Provider ii. Rural incentive—Allocation based on RUCA score(rural-urban commuting area)derived from averaged zip codes reported in the original RFP submitted iii. Attribution—Allocation based on Medicaid lives served based on zip codes reported in original RFP submitted iv. Health Equity—Allocation based on Community Needs Index score averaged by zip codes provided in the original RFP submitted v. Bonus incentive—Allocation based on multi-project participation in more than one project area c) To present definitions for MTP Projects Areas,MTP Interventions and Change Plans i. MTP Project areas were developed by Washington State's Health Care Authority.Participation in the various Project Areas was determined by each Accountable Community of Health(ACH).CPAA selected to participate in the following project areas: • 2A:Bi-Directional Integration of Care • 2B:Community-Based Care Coordination • 2C:Transitional Care • 3A:Addressing the Opioid Use Public Health Crisis • 3B:Reproductive and Maternal/Child Health • 3D:Chronic Disease Prevention and Control Cascade Pacific Action Alliance ACH LLC Amendment DY2 Contract#K2293-32 Page 2 ii. MTP Interventions support each of the six MTP Project areas.Every project area has its own menu of state-approved,evidence-based interventions as defined in the MTP project toolkit that must be pursued to achieve targeted levels of improvement for project-specific outcomes. iii. MTP Implementation Partners chose which MTP Interventions to implement for each of their CPAA approved MTP Project areas which are listed in the Partner's Change Plan. d.)To provide further definition to the Partner's original contract Addendum B— Statement of Work under Section 3"The Partners Roles and Responsibilities" Item X—"The Partner will complete tasks and deliverables as set forth in the Change Plan and agrees to notify the CPAA Program Manager if timeline or deliverable will not be submitted as required."Per this amendment: The Partner may amend the Change Plan under two conditions: i. Annual Modifications ii. A qualifying event e.) Annual Modification i. Organizations requesting a Change Plan modification must do so in writing using the Change Plan Modification Request Form(Addendum A)request must be submitted by 11/01/2019 to reporting@cpaawa.org f.) Qualifying Event i. Organizations are asked to complete the Change Plan Modification Request Form (Addendum A)and submit to reporting@cpaawa.org within 60 days of the qualifying event to request a Change Plan Modification ❖ A qualifying event is defined as an unforeseen circumstance that alters the scope of work or execution of work fundamentally. Staff turnover or delayed implementation do not count as qualifying events. g.) To provide additional reporting information i. Partners will submit reporting in accordance with the chart below to reporting@cpaawa.org Quarter 1 (Jan-Mar) Quarter 2(Apr—Jun) Quarter 3(Jul-Sep) Quarter 4(Oct-Dec) 1.Change Plan 1.Change Plan 1.Change Plan 1.Change Plan Progress Report Progress Report Progress Report Progress Report 2.Intervention Metrics 2.Intervention Metrics 3.Change Plan Update April 30,2019 July 31,2019 October 31,2019 January 31,2020 ii. Partners participating in Projects 2A and 3A will submit project specific information related to pay for reporting(P4R)metrics established by the Washington State Health Care Authority(HCA).In order to align with the HCA reporting timeframe,CPAA will gather this information from partners on a Cascade Pacific Action Alliance ACH LLC Amendment DY2 Contract#K2293-32 Page 3 slightly earlier schedule than Change Plan Progress Reports outlined above. CPAA Program Managers will coordinate with each partner to complete this reporting requirement. a.Project 2A:The MeHAF Site-Self Assessment needs to be completed semiannually between April 1 and June 30,2019 and October 1 and December 31,2019. b.Project 3A: Complete the CPAA Opioid Response P4R Metrics Survey semiannually by June 15,2019 and December 15,2019. iii. Projected quarterly payments are stated below.Payments are estimated and subject to change based on Health Care Authority information. Reporting QTR 1 Reporting QTR 2 Reporting QTR 3 Reporting QTR 4 $25,760 $25,760 $25,760 $25,760 h.) Provide guidelines for Project 2B Pathways Outcome Based Payments i. An"Addendum B"will be included with this amendment only for Partners selected for and participating in Project 2B 6. ❑ This is a unilateral amendment. Signature of contractor is not required below. ® Contractor hereby acknowledges and accepts the terms and conditions of this amendment. Signature is required below. IN WITNESS WHEREOF,CPAA and the Partner have signed this agreement. PARTNER SIG\A DATE 1 fI3I1q CEO:CE REM.AL REP' AT\ORK SIGNATURE DATE Cascade Pacific Action Alliance ACH LLC Amendment DY2 Contract#K2293-32 Page 4 Addendum A—Change Plan Modification Request Form Change Plan Modification Request Form Annual C ang2 Plan Modification Request Prrrpsc • Please complete the Change Plan Modification Request Form and submit to reportingricoaews Qrg between 10/01/2019 and 11/01/2019. • Once the Change Plan Modification Request has been approved,you will receive your or ganization's • original approved Change Plan with instructions on how to make modifications. • Please follow the instructions and submit your organization's updated Change Plan by 12/31/2019. • Submitted Change Plans will go through an internal approval process before being accepted. Qualifying Change Plan Mockfication Process: • Please complete the Change Plan Modification Request Form and submit to re portn coaa;=;a.o e. '.. within 60 days of a qualifying event. o A qualifying event is defined as an unforeseen circumstance that fundamentally alters the scope of work or execution of work.Staff turnover or delayed implementation are not qua`ifying events,as these events will be captured in quarterly Reporting. • Once the Change Flan Modification Request has been approved,you will receive your organ zation's original approved Change Plan with instructions on how to make modifications. • Please follow the Instructions and submit your organiz_tion's updated Change Plan within 30 days of receipt. • Submitted Change Plans will go through an internal approval process before being accepted. Organization Name: Name of Requester: Date of Request Type of Request [ )Annual Change Plan Modification Request U,Qualifying Event Change Plan Modification Request Description of Qualif/ing Event: Project Areas Affected: U.2A:Bi-Directional Integration of Care U213:Community-Based Care Coordination U 2C:Transitional Care USA:Opioid Response (,,,i,3B:Maternal and Child Health ( )SD:Chronic Disease Prevention and Control Reason far Changes: Brief Description of Changes: For internal use only- U Follow:-up Requested j,,,i,Re quest Approved [ )Request Denied Cascade Pacific Action Alliance ACH LLC Amendment DY2 Contract#K2293-32 Page 5