Local Health Department Contract Training

1. Local Health Department Contract Training Core Contract Training

2. 902KAR 8:170 Local Health Department Financial Management Requirements Section 7 Contracting for services

3. 902KAR 8:170 The contract is between the Local Health Department (LHD) and the Contractor (provider) and should be signed by both parties prior to July 1 each fiscal year to ensure no interruption of services. Technically, if the contract is not signed by July 1 by both parties there is no effective contract in place. Services should only be provided once both parties have signed the agreement.

4. 902KAR 8:170, Section 7 (10) All Local Health Department contracts and contract amendments are subject to review by the Department for Public Health.

5. CH-50 The CH-50 template was created for contracts related to Minor Object Codes 180-189, under General Ledger Account #573, as detailed in the Financial Management section of the Administrative Reference. Please review contracts for provider numbers “18***” to verify usage of the appropriate template.

6. CH-51 Local Health Department Employment Contract

7. CH51 - Employee Contracting Regulations For questions and concerns related to contracted employees, please contact the Local Health Personnel Branch at 502-564-6663, option 5

8. CH 51-Personal Service Contracts CH 51 contracts should be used to fill positions not available in the Local Health Merit Classifications. All CH 51 contracts will be reviewed by the Local Health Personnel Branch prior to execution. Positions in the below programs will be allowed to contract when requested: • Home Health • HANDS • School Health • First Steps

9. CH51 - Employee Contracting Regulations 902 KAR 8:170, Section 7 (4) (b) A health department shall not use a personal services contract to substitute for establishing a position in the local health department (c) A health department shall not contract for personal services with an individual who works 1,200 hours or more in a year, except with Department for Public Health (DPH)approval. • All CH51 contracts are to be sent to DPH for review to determine if DPH approval is needed • Some merit positions may be approved for contracting if they are time limited or other unique situation

10. CH51 - Employee Contracting Regulations • Approved CH51 contracts that exceed 1,200 hours per year or demonstrate a trend of 100 hours per month shall have benefit costs of retirement and health and life insurance • If a retiree that participates in the KY Retirement System (KRS) and works 1,200 hours or more per year (fiscal or calendar), the LHD shall pay into retirement, but not the employee • All retirees returning to work should check with KRS before start date

11. CH51 - Employee Contracting Regulations 902 KAR 8:160, Section 3-Multiple Agency contracting (2) An agency employee shall not: (d) Enter into a contract with or hold an additional full-time or part-time position in another agency unless approved by the cabinet in writing • If an employee contracts with multiple agencies, the total of all hours worked will be reported to KRS and the employee and agencies may be subject to retirement and insurance contributions • A contracted employee or merit employee may be subcontracted by their agency to work at other agencies

12. CH51 - Employee Contracting Guidelines • Complete application process • Send application to Local Health Personnel and/or Program Lead at the Department for Public Health for program specific qualifying • Obtain all contract employee signatures for required documents • Send all independent contractor contracts (CH 53M) to KRS for review, if with an individual • Contact LHP Branch with any questions

13. CH-52 • The CH-52 contract type was created by DPH to provide a standardized template that local health departments may use to enter into a contract with a public or private entity to provide needed health services. • CH-52 is used for agreements between LHDs & Boards of Education, Payor Code 8 agreements, and contracts between 2 LHDs.

14. CH-52 When two health departments contract for the services of one employee, the health department requesting the services should write the contract. • First Party – requesting the employee • Health Department – supplying the employee

15. CH-53M Local Health Department Independent Contractor Agreement

16. CH-53M The CH-53M contract template shall be used to enter into contractual agreements with independent service providers.

17. CH-55 Medicaid Statement of Authorization For Independent Contractors only – CH-53M If the Contractor is performing services ON-SITE and the LHD will bill Medicaid on behalf of the Contractor, the CH-55 form is required and shall be included in the CH-53M form, after the signature page. The contract shall have an “N” at the top of page 1.

18. CH-55 AFM strongly recommends if the Contractor is a Medicaid provider that the contractor bill for the services performed OFF-SITE. The CH-55 form is NOT required in these instances.

19. LHD to Bill Third Party If the LHD contracts with a Contractor and the LHD will be the third party biller: • This includes patients that are provided services by the Contractor at the contractor site, who have insurance, Medicaid, Medicare, etc. (with the exception of Lab services). • For CPT codes not listed on the DPH Medicaid Preventive Fee Schedule, the LHD will not receive payment from Medicaid.

20. LHD to Bill Third Party • If CPT codes are not billable by LHDs to Medicaid or other third party plans, the LHD should not agree to bill on behalf of the contractor. • If the LHD is responsible for billing the third party payors, the contractor should not bill third party payors.

21. Payment Information Without an amendment, total payments detailed CH-53M may be up to 20% greater than the total contract (amount listed in #1). (1) This Payment made under the terms of each section of this contract shall not exceed: Contract Section #Amount   20112 $10,000 24510 $10,000 (2) The total payments made under the terms of this contract shall not exceed $24,000: ($10,000+ $10,000) x 1.2 = $24,000 Payment in #2 cannot exceed $24,000

22. Labs The independent contractor shall be responsible for billing all third parties for lab services (201 “Pathologist” and 250 provider numbers). Examples of 201 provider service: Level IV pathology specimen – 88305 Level V pathology specimen - 88307

23. Supplemental Reporting When the contracted provider bills third party payors, there are some services that DPH requests LHDs to report through the Supplemental Reporting System to obtain necessary federal & state data information.

24. Supplemental Reporting Some of those services include: Mammograms, Breast Ultrasounds, PAPS, HPV Tests, Lead Tests, etc. The CH-47 Patient Services Supplemental Reporting Document can be found at the link below: https://chfs.ky.gov/agencies/dph/dafm/Pages/lhd-documents.aspx

25. Board of Health Member Contracts If a contracting medical professional is a governing board of health member, then an automatic exception to the conflict of interest provision of the contract policies is made if the annual amount will not exceed $10,000. 902 KAR 8:170, Section 7, (6) (a) 4(b)

26. Board of Health Member Contracts Contracts exceeding $10,000 must be approved by the Commissioner of the Department for Public Health. A letter of justification indicating the necessity and rationale for contracting with a board member must be submitted to the Commissioner’s office with the proposed contract.

27. CH-54 The CH-54 contract template shall be used for entering into service agreements for LHD audit purposes.

28. CH-58 The CH-58 contract template shall be used for entering into service agreements for LHD taxing district audits.

29. Lease Agreements DPH provides a standard lease agreement document for use by LHDs.

30. Templates Current templates can be found on the L: drive under the LHDContracts folder, in the folder appropriate to the pertinent fiscal year. This is also where you will find training presentation materials, program specific boilerplate language, and program specific rate grids.