MINISTERIAL ADJUSTMENT No. 1 to HUMAN SERVICES AND PUBLIC HEALTH PERSONAL/PROFESSIONAL SERVICE AGREEMENT

Transcription

1 MINISTERIAL ADJUSTMENT No. 1 to HUMAN SERVICES AND PUBLIC HEALTH PERSONAL/PROFESSIONAL SERVICE AGREEMENT THIS AGREEMENT made and entered into by and between the COUNTY OF HENNEPIN, STATE OF MINNESOTA, through the Hennepin County Human Services and Public Health Department, A-2300 Government Center, Minneapolis, Minnesota 55487, hereinafter referred to as the "DEPARTMENT, on behalf of the Metro Counties Consortium, hereinafter known as the COUNTY and Medical Transportation Management, Inc. (an S corporation duly organized under the laws of the State of Missouri), 16 Hawk Ridge Drive, Lake Saint Louis, Missouri 63367, hereinafter referred to as the CONTRACTOR. IT IS HEREBY AGREED that the certain Agreement between the above-named parties covering the purchase of brokerage services for Access Transportation Services (ATS) of Non-Emergency Medical Transportation (NEMT), for the period of July 1, 2010 through December 31, 2011 as made and entered into on June 29, 2010, including any subsequent amendments or ministerial adjustments, is hereby adjusted in accordance with the provisions set forth below: Clause 2, SERVICES TO BE PROVIDED, paragraph c shall be added: 2. SERVICES TO BE PROVIDED c. Effective October 1, 2010 services to be purchased through this Agreement shall also include the provision of administrative non-emergency Access Transportation Services (ATS) of Non- Emergency Medical Transportation (NEMT) for State Medical Review Team (SMRT) authorized clients residing in the eight county metro area. In : Contracted Services, pages 1 and 2, dated July 2010, shall be effective through September 30, 2010, thereafter : Contracted Services, pages 1a and 2a shall be added and effective October 1, In : Contracted Services, page 5a shall be added and effective October 1, This adjustment shall be effective October 1, Except as hereinabove adjusted, all other terms, conditions and provisions of said Contract #A shall remain in full force and effect. (The remainder of this page is intentionally left blank) Ministerial Adjustment Revised 8/2010 1

2 CONTRACTOR, having signed this Agreement, and the proper County officials having signed this Agreement, the parties hereto agree to be bound by the provisions herein set forth. COUNTY OF HENNEPIN, STATE OF MINNESOTA Human Services and Public Health Department Director or Designee Date signed: Medical Transportation Management, Inc. By: Title: Date signed: Ministerial Adjustment Revised 8/2010 2

3 EXHIBIT A SERVICE SUMMARY Medical Transportation Management, Inc. (MTM) Access Transportation Services (ATS) Non-Emergency Medical Transportation (NEMT) Effective October 1, 2010: Summary: Medical Transportation Management, Inc. (MTM) will provide administrative services for Access Transportation Services (ATS) of Non-Emergency Medical Transportation (NEMT) and related services for covered recipients in the area of the Metro Counties Consortium (MCC) whose membership consists of Anoka, Chisago, Dakota, Hennepin, Isanti, Ramsey, Sherburne, and Washington. Neither the administration of Special Transportation Services (STS) nor the costs of the transportation are included in this Agreement. MTM will have sufficient staffing level to provide contracted services for coverage of the NEMT telephone call center as well as provide quality assurance that the transportation providers meet health and safety standards for vehicle maintenance, operation, and inspection. Target Population: Covered recipients are eligible clients enrolled in MA, PMAP, MinnesotaCare, any one of the MHCP programs or authorized by the Department of Human Services State Medical Review Team (SMRT). Recipients must also reside in one of the eight (8) metropolitan counties, and request transportation to an enrolled Medicaid provider. Agency Status: MTM is a privately held S corporation organized under the laws of the State of Missouri. Service Site: The Minnesota call center is located at Thompson Street, St. Paul, MN. Calls taken after hours will be transferred to the call center located at corporate headquarters in Lake St. Louis, Missouri. In case of relocation within Minnesota, MTM will advise COUNTY of new location of Minnesota call center. Client Eligibility: Client eligibility is determined by computer verification downloaded daily from the Minnesota Department of Human Services or the issuance of an authorization number by Department of Human Services State Medical Review Team (SMRT). Funding Source: Administrative services will be funded by the eight (8) metropolitan counties according to the number of trip legs provided for clients. In the event of MTM being paid by the Minnesota Department of Human Services (DHS) for Federal Financial Participation (FFP) the trip leg rate will be adjusted. THE REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK 1a

4 Effective October 1, 2010: PERFORMANCE MEASUREMENT SUMMARY Medical Transportation Management, Inc. (MTM) Access Transportation Services (ATS) Non-Emergency Medical Transportation (NEMT) PROGRAM TARGET GROUP: Eligible clients must be enrolled in MA, PMAP, MinnesotaCare, any one of the MHCP programs or be authorized by the State Medical Review Team (SMRT). Clients must also reside in one of the eight (8) metropolitan counties, and request transportation to an enrolled Medicaid provider. PROGRAM GOAL AND OUTCOME: Brokerage of administrative services for Access Transportation Services (ATS) for Non-Emergency Medical Transportation (NEMT) OUTCOME INDICATORS 1. Compliance with HIPAA disclosure requirements. 2. Calls answered within 30 seconds. 3. Number of calls abandoned reduced. 4. Complaint rates decrease. METHOD OF DATA COLLECTION 1. Reports and customer survey 2. Reports and customer survey 3. Reports and customer surveys 4. Reports and customer surveys PERFORMANCE TARGETS % compliance 2. 95% of all calls between the hours of 8:00 a.m. and 6:00 p.m. will be answered within 30 seconds. 3. Call abandonment rate of less than 5% monthly. 4. Complaint rate of 3% or less per month. COMMENTS: N/A 2a

5 State Medical Review Team (SMRT) eligibility for services Effective October 1, 2010, Anoka, Chisago, Dakota, Hennepin, Isanti, Ramsey, Sherburne and Washington counties of the Metro Counties Consortium (MCC) have agreed to participate with providing the administrative services for Access Transportation Services (ATS) for Non-Emergency Medical Transportation (NEMT) for State Medical Review Team (SMRT) authorized clients. A SMRT client s eligibility will be authorized by SMRT via a specific authorization number sent to CONTRACTOR. The SMRT authorization number will come directly from the Minnesota Department of Human Services State Medical Review Team. THE REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK 5a