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HomeMy WebLinkAboutResolutions - 1979.06.07 - 12359P R June 7, 1979 MISCELLANEOUS RESOLUTION # 9001 BY: PUBLIC SERVICES COMMITTEE, HENRY W. HOOT, CHAIRPERSON IN RE: ACCEPTANCE OF THE 1979 THIRD PARTY LIABILITY PROGRAM CONTRACT TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Mr. Chairperson, Ladies and Gentlemen: WHEREAS pursuant to Public Act 105 of 1977 the Michigan Department of Social Services selected Oakland County for the Third Party Liability Pilot Program; and WHEREAS by Miscellaneous Resolution #8238 the Board of Commissioners entered into a contract for said program; and WHEREAS the State of Michigan wishes to renew said contract in the amount of 331,804 which provides for four (4) additional staff per- sonnel; and WHEREAS said contract covers a period of January 1, 1979 through September 30, 1979; and WHEREAS in addition to said contract funds, an incentive rebate of all funds recovered and a capitation rebate for all costs avoided will be pro- vided to the County pursuant to terms of the contract; and WHEREAS the Public Services Committee by Henry W. Hoot, Chairperson, recommends said contract be approved and said funds be accepted. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commis- sioners hereby approves the 1979 Third Party Liability Program Contract and hereby authorizes the County Executive and the Chairperson of the Board to execute said contract on behalf of the County with the Circuit Court and the State of Michigan; and accepts said recovery incentive and cost avoid- ance capitation incentives pursuant to the contract. PUBLIC SERVICES COMMITTEE alqa ibfil nry w. Hoot, Chairperson HER W APPROVE THE F9REGOING RESOLUTION f • " sTeir ' F P 411- June 7, 1979 MISCELLANEOUS RESOLUTION # 9001 BY: PUBLIC SERVICES COMMITTEE, HENRY W. HOOT, CHAIRPERSON IN RE: ACCEPTANCE OF THE 1979 THIRD PARTY LIABILITY PROGRAM CONTRACT TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS Mr. Chairperson, Ladies and Gentlemen: WHEREAS pursuant to Public Act 105 of 1977 the Michigan Department of Social Services selected Oakland County for the Third Party Liability Pilot Program; and WHEREAS by Miscellaneous Resolution 4238 the Board of Commissioners entered into a contract for said program; and WHEREAS the State of Michigan wishes to renew said contract in the amount of 331,804 which provides for four (4) additional staff per- sonnel; and WHEREAS said contract covers a period of January 1, 1979 through September 30, 1979; and WHEREAS in addition to said contract funds, an incentive rebate of all funds recovered and a capitation rebate for all costs avoided will be pro- vided to the County pursuant to terms of the contract; and WHEREAS the Public Services Committee by Henry W. Hoot, Chairperson, recommends said contract be approved and said funds be accepted. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commis- sioners hereby approves the 1979 Third Party Liability Program Contract and hereby authorizes the County Executive and the Chairperson of the Board to execute said contract on behalf of the County with the Circuit Court and the State of Michigan; and accepts said recovery incentive and cost avoid- ance capitation incentives pursuant to the contract. PUBLIC SERVICES COMMITTEE Hoot, Chairperson I HER' APPROVE T:e1:7REGOING RESOLUTION &` /,/,/ MEDICAL SUPPORT ENFORCEMENT AGREEMENT This Memorandum of Agreement, executed this day of 1979, effective as of January 1, 1979, is by and between the Michigan Department of Social Services, having a mailing address of 300 South Capitol Avenue, Lansing, Michigan 48926 (hereinafter referred to as the "Department"), Oakland County, having a mailing address of 1200 North Telegraph, Pontiac, Michigan 48053 (hereinafter referred to as the "County"), and the Sixth Judicial (Oakland County) Circuit Court, having a mailing address of 1200 North Telegraph, Pontiac, Michigan 48053 (hereinafter referred to as the "Court"). WITNESSETH: WHEREAS, the Department under the Social Security Act, Title XIX, Section 1902 (a) subsection 25, is responsible for administering a State Plan for Medicial Assistance which must: "Provide (A) that the State or local agency administering such plan will take all reasonable measures to ascertain the legal liability of third parties to pay for care and services (available under the plan) arising out of injury, disease, or disability, (B) that where the State or local agency knows that a third party has such a legal liability such agency will treat such legal liability as a resource made available for purposes of paragraph (17) (8), and (C) that in any case where such a legal liability is found to exist after medical assistance has been made available on behalf of the individual, the State or local agency will seek reimbursement for such assistance to the extent of such legal liability; and, WHEREAS, the Department has been designated to cooperate with the Federal government and with all other departments or agencies of the State in any plans established in cooperation with the Federal government, and is authorized to contract with federal, state, or local units of government, and private agencies under the provisions of MCLA 400.10; and, _ -2- HEREAS, the Department under the Social Security Act, Title XIX, Section 912 (a)(2) is responsible for administering a State Plan for Medical ssistance which may: "Provide for entering into cooperative arrangements (inclu- ding financial arrangements), with any appropriate agency of any State (including, with resnct to the enforcement and collection of rights of payment for medical care by or through a parent, with a State's agency established or de- signated under section 454(3)) and with appropriate courts and law enforcement officials, to assist the agency or agencies administering the State Plan with respect to (A) the enforcement and collection of rights to support or payment assigned under this section and (B) any other mat- ters of common concern." :HEREAS, the Department desires to enter into an Agreement with the County, riend of the Court and the Court to: (1) Assist the Department in providing the services necessary to establish medical liability and secure indemnification for child- ren and eligible grantees receiving medical benefits within the meaning of applicable regulations of the United States Department of Health, Education and Welfare promulgated under Titles IVD, V. XIX, and XX of the Social Security Act. (2) Assist in other matters of common concern to the Court, County, Friend of the Court and the Department; and, HEREAS, the County is authorized by MCLA 45.3 to make all necessary ontracts, and to do all other necessary acts in relation to the property nd concerns of the County; and, HEREAS, the County, Friend of the Court, and the Court are desirous of ntering into such an Agreement with the Department, and the person or ersons signing this Agreement are duly authorized to bind the County, riend of the Court, and the Court to performance of its terms; and, HEREAS, the Prosecutor is statutorily empowered to seek support orders, n domestic relations matters outside of divorce proceedings; and, EREAS, the Friend of the Court is statutorily empowered to make recom- ndations to the Circuit Court regarding the proper amount of support d to enfor:e all support orders entered by said Court; and, -3- 'W, THEREFORE, in consideration of the above, and in consideration of the ,omises and mutual covenants hereinafter contained, the parties hereto wee as follows: DEFINITIONS A. The term "Medical Support Liability" shall mean the responsibility, as set forth by court order, of absent parents, guardians or other responsible parties to cover the cost of medical care for minor children and eligible grantees. B. The term "County Third Party Reimbursement Account" shall mean a special, separate account which shall be established by the County in the general fund for the recording of the deposit of incentive rebate payments as provided for in paragraphs IIID, IIIE, and IIIF of this Agreement. C. The term "Medical Support Collection Account" shall mean a special, separate account which shall be established by the Department for deposit of all medical collections received by the Department as a result of this Agreement. D. The term "recovery" shall mean the collection and/or return of monies, for a specified claim, previously charged against the programs administered under Titles V and XIX of the Social Security Act, to the Department, as a result of joint action performed by the parties to this Agreement. E. The term "county funded agencies" shall mean the Circuit Court and Friend of the Court of the County. F. The term "Medical Support Pilot Project Incentive Account" shall mean a special separate account established by the Department for payment of incentive reimbursements. COUNTY AND COUNTY FUNDED AGENCY RESPONSIBILITIES A. Jhe County and county funded agencies shall be jointly respon- sible during the life of this Agreement, for the modification of existing methods by which court orders for support of minor children and eligible grantees, are obtained and enforced so as to establish and enforce the responsibility of absent parents, guardians or other responsible parties to cover the cost of medical care for such minor children and eligible grantees. B. The County and county funded agencies shall be jointly respon- sible for development of a program ensuring enforcement of medical support liability through issuance and enforcement of appropriate support orders. The following aspects of the pro- gram shall be given emphasis: 1. The initial emphasis shall be to obtain, where feasible, appropriate support orders indicating therein medical support liability and to enforce such orders through statutorily authorized procedures. The court orders should be reflective of the amount of medical support ordered. 2. The second emphasis shall be to review existing orders and where such orders are silent as to medical support liability, modify same so as to establish such liability therein. 3. The final emphasis shall be to work with the Department to secure all goals and statutory requirements concerning Third Party Liability. C. The County and county funded agencies hereby designate Circuit Court as the liaison agency (or agencies) responsible during the life of this Agreement for providing to the Department upon request, the information, reports, or other data specified in paragraphs IID, IIF, IIG, IIN, IIIC, IVO in this Agreement. D. The County and county funded agencies shall provide the Depart- ment through the liaison agency (or agencies) with the following information in all cases where medical support liability is established: 1. Name of payor and case number and ID number, 2. Names and birthdates of children and spouse. 3. Name and address of employer of payor. 4. Name and address of insurers. 5. Policy, group and control numbers, 6. Effective dates of insurance coverages. 7. Date of court order which requires payment. t This information shall be provided to the Department on magnetic tape or in some other form whtch is compatible with the Depart- ment's computer system so as to allow the Department to invoice apnropriate insurance carriers. S. -5- E. Any reimbursement recovered directly by the County, Court or Friend of the Court for medical expenses already covered by the Department shall be sent to the Department to be deposited in the Medical Support Collection Account. ' F. The County and county funded agencies shall prepare and submit through the liaison agency (or agencies) all financial, program progress, and other reports as may be requested by the Depart- ment. G. The County and county funded agencies shall maintain an inven- tory of all equipment purchased with funds provided by the Department pursuant to paragraph IIIC of this Agreement. The County shall take the necessary action to assure that title to all aforesaid equipment shall be vested in the Department upon expiration of this Agreemeht, or in the event equipment is purchased with combined County and program funds, the pro- rata share of title to said equipment shall be vested in the Department or otherwise protected. H. The Friend of the Court, being the county funded agency respon- sible for seeking support orders in domestic relations matters, including but not limited to paternity actions, shall seek, where appropriate, orders of the Circuit Court naming the party to be responsible for medical, dental and hospital expenses of the minor children, eligible grantees, wards or dependents of the parties to such proceedings. I. The Friend of the Court, or such county funded agency as is responsible for making recommendations regarding support in divorce proceedings shall seek, where appropriate, orders of the Circuit Court naming the party to be responsible for medical, dental and hospital expenses of the minor children, eligible grantees, wards, or dependents of the parties to such proceedings. J. The County shall establish and maintain the County Third Party . Reimbursement Account, and all incentive rebates made pursuant to paragraphs IIID, IIIE or HIP of this Agreement which are ? recorded in this account shall be divided monthly as follows: 1. 50% shall go into the Oakland County general fund. 2. 50% shall go to the Circuit Court general account which shall be subject to appropriation by the Board of Commis- sioners in accordance with the Laws of the State of Michigan. -6- K. The Friend of the Court where appropriate, shall, exercising such discretion as they may be afforded by law, initiate and pursue or prosecute legal proceedings against such persons as are determined through orders of the Court, in domestic rela- tions matters, to have incurred medical support liability. L. The County shall, by expenditure of county funds, maintain its pre-agreement fiscal effort relative to medical support ser- vices provided under this Agreement. State program funds provided by this Agreement shall not be used as a substitute for local funds that would normally have been made available for the items covered by this Agreement. M. In the performance of his obligations under this contract, the Prosecutor shall be subject to the supervisory authority of the Attorney General. MCLA 14.30; MSA 3.183. N. The County and county funded agencies shall maintain suitable records and prepare monthly reports indicating cases filed, cases closed, medical support orders sought, medical support orders obtained, existing support orders modified so as to indicate medical support liability and such other information as the Department shall require in writing. 0. The County reaffirms its obligation to repay the $600,000.00 advanced it by the Department on September 22, 1978 which is to be reduced by credits representing the County's incentive payment portions of recoveries for Departmentally furnished medical care and services rendered to recipients from April 1, 1976 through September 30, 1978 as provided in the November 30, 1978 amendment to the Medical Support Enforcement Agreement between the parties, said agreement originally executed January 9, 1978. In the event that there are unforseen circumstances which result in the recoveries being insufficient to repay the advance, a maximum of 10% (ten percent) of the capitation rate payment to the County, made pursuant to paragraph IIIE, can be utilized in a calendar quarter, to offset against the remaining portion of the advance. Further, the advance can be reduced ) by credits representing the County's incentive payment por- tions of recoveries made pursuant to paragraph IIIF below. II. DEPARTMENT RESPONSIBILITIES A. The Department shall designate the Third Party Liability Sec- tion of the Department as -the contracting office responsible to facilitate communication between the County/Court/Friend of the Court, and the Department regarding any aspect of this Agreement. Further said contracting office shall provide technical assistance and advice to the County and the county funded agencies. B. The Department shall provide the liaison agency (or agencies) with an accurate accounting of medical expenditures incurred by the Department in all identified cases covered by a domes- tic relations order of the Court where the County and county funded agencies act as an agent responsible for implementing recovery. Such accounting will be provided on magnetic tape or some other form compatible with the computer system used by the County and county funded agencies. The Department will provide the designated liaison agency (or agencies) with a copy of the billings to insurance carriers for all said cases. C. The Department shall make payment for the actual direct expen- ditures incurred by the County or county funded agencies pur- suant to this Agreement subject to prior approval by the Department. The total amount to be paid shall not exceed $331,804.00, under this Agreement, as indicated in program budget, a copy of which is attached hereto, and made a part hereof by reference. Said payment shall be made monthly by the Department, to the County, upon receipt and approval of an itemized statement of expenditures. Validation for expendi- tures and reasonableness of, will be subject to audit by any State or Federal agency. D. The Department shall make incentive payments to the County Third Party Reimbursement Account where joint action by the Department and the County and county funded agencies has been taken which ultimately will result in the recoveries of moneys expended by the Department for medical care services to reci- pients rendered from and after October 1, 1978 for whom there is a valid support order of any kind ordered by the Court. Such Incentive payments will be made in accordance with the pro- visions of paragraphs IIIE and IIIF below. E. Where the incentive payment is based on the identification by the County of recipients Who have valid insurance coverage, the Department will make such incentive payment by a capita- tion rate of $2.50 (two dollars and fifty cents) per reci- pient so identified. The rate will be paid for each month . the recipient is so insured. This capitation rate consti- tutes the minimum incentive payment and will be in effect from October 1, 1978 until April 1, 1979 at which time it will be subject to renegotiation based upon the following formula used to develop the rate: 1. Monthly Medicaid expenditures for ADC recipients, 2. A 15% (fifteen percent) incentive rate and 3. Actual insurance recovery rate (minimum recovery rate is 50% (fifty percent). Once the Department has implemented a computer assisted sys- tem to validate such insurance identifications, the County, will be credited for all valid insurance identifications received by the Department and a retroactive payment will be made to the County for such prior identifications along with the first monthly payment based on current submissions. F. Where the incentive payment is based upon a recovery directly to the County, Court or Friend of the Court for reimbursement of medical care and services rendered from and after October 1, 1978, the Department shall pay to the County 15% (fifteen percent) of the recovery made by the County or county funded agencies for departmentally reimbursed medical care and services referred to in paragraph IIID above. IV. GENERAL PROVISIONS A. Duration of Program This Agreement shall terminate no later than September 30, 1979. B. Department's Source of Funds - Termination The Department's payment of funds as provided in paragraphs IIIC, IIID, IIIE, IIIF and IVO of this Agreement is subject to and conditional upon the continued availability of State funds appropriated specifically for this service. No com- mitment is made by the Department to continue or expand such activities. The Department may terminate this Agreement immediately upon written notice to the designated liaison agency (or agencies) at any time prior to the completion of this Agreement period if, in the opinion of the Department, ' funding beomces unavailable for this service or such funds 7 are restricted. C. Cost Documentation The County and county funded agencies agree to maintain books. records, documents and follow accounting procedures and prac- tices-which —reflect all direct and Indirectcosts of any - nature expended in the performance of this Agreement. Further, _ the accounting system will provide for specific identification . of all sources of funds, all contracts, purchase orders, accounts payable and cash disbursements. D. Examination and Maintenance of Records - The"County and county funded agencies agree to permit the Department or any of its identified agents access to the facilities being utilized at any reasonable time to observe the operation of the program. The County and county funded agencies further agree to retain all books, records or other documents relevant to this Agreement for six years after final payment, and assume such costs relative thereto, and Federal auditors and any persons duly authorized by the Department shall have full access to and the right to examine any of said materials during the said period. If an audit is initiated prior to the expiration of the six-year period, and extends past that period, all documents must be maintained until the audit is completed. The Department shall provide findings and recommendations of audits to the designated liaison agency. The Department will adjust final payment to the County, where required, based on the findings of an audit. If no payments are due and owing the County, the County agrees to refund all amounts which may be due the Department. E. Insurance Coverages The County, at its own expense, shall provide and maintain public liability insurance in such amounts as necessary to cover all claims which may arise out of the County and county funded agencies operations under the terms of the Agreement. Unemployment compensation coverage, and worker's compensation insurance shall be maintained in accordance with applicable Federal and State laws and regulations. Reimbursement for such expense shall be available pursuant to paragraph IIIC of this Agreement only to the extent that the cost thereof is attributable directly to services rendered pursuant to this Agreement. F. Compliance with Civil Rights, Other Laws The County and county funded agencies shall not discriminate against an employee or applicant for employment with respect to hire, tenure, terms, conditions, or privileges of employ- ment, or a matter directly or indirectly related to employment, because of race, color, religion, national origin, age, sex, height, weight, or marital status. MCLA 37.2209. The County and county funded agencies shall comply with provisions of Title VI of the Civil Rights Act of 1964, and any amendments thereto._ The County and.county_funded agencjes shall also -1 0- comply with the provisions of the Handicapped Civil Rights Act of 1976, being Public Act 220, and the Rehabilitation Act of 1973, being Section 504 of Public Act 93-112. Such laws stating that no employee or client or otherwise qualified handicapped individual shall, solely by reason of his handi- cap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance. Further the County and county funded agencies agree to comply with all other Federal, State and local laws, regulations and standards, and any amendments thereto, as they may apply to them. G. Royalties The Department reserves a royalty-free non-exclusive license to use and authorize others to use all copyrightable or copy- righted material resulting from this program. H. Reports All reports and other similar materials made as a result of this Agreement shall acknowledge the support provided by the Department. I. Confidentiality Information provided by the Department or the local Department of Social Services in cooperation with the County and county funded agencies and in furtherance of the aims and purposes of this Agreement shall be kept confidential and used only for the purposes directly connected with the administration of the program implemented by this Agreement. J. Political Activities None of the funds, materials, property, personnel or services contributed by the Department or County and county funded agencies under this Agreement shall be used in the performance of this Agreement for any partisan political activity, or to further the election or defeat of any candidate for public office. K. Pc.ligious Activity There shall be no religious worship, instruction or prosely- tization as part of or in'connection with the performance of this Agreement. L. Subcontracts The County and county funded agencies may not assign this Agreement or enter into subcontracts to this Agreement with additional parties without obtaining prior written approval of the Department. The Department, as a condition of granting such approval, shall require that such assignees or subcontractors shall be subject to all conditions and pro- visions of this Agreement. The County and county funded agencies shall be responsible for the performance of all assig- nees or subcontractors. M. Liability The County and county funded agencies at their own expense and without state reimbursement shall indemnify, save and hold harmless the Department against any and all expense and lia- bility of any kind which they may sustain, incur, or be re- quired to pay arising out of this Agreement; provided, however, that the provisions of this paragraph shall not apply to lia- bilities or expenses caused by or resulting from the acts or omissions of the Department or any of its officers or employees. Further, in the event the County, county funded agencies, or their employees become involved in or are threatened with litigation they shall immediately notify the Department and the Department may enter into such litigation to protect the interests of the Department as they may appear. N. Cancellation of Agreement If, in the opinion of the Department, the County or county funded agencies fail to comply with the conditions of this Agreement or to fulfill its responsibilities as indicated in the Agreement, or the Department determines that the method and techniques being utilized in accomplishing the goal are not acceptable or compatible with the Department's policies, the Department reserves the right to cancel this Agreement by giving sixty (60) days written notice to the designated liaison agency (or agencies). The County and county funded agencies may terminate this Agreement upon sixty (60) days ) written notice to the Department at any time prior to the completion of the Agreement period if the Department fails to comply with the conditions of this Agreement. -12- 0. Closeout In the event this Agreement is concluded or terminated, the designated liaison agency (or agencies) shall provide the Department within thirty (30) days after conclusion or ter- mination all financial, performance and other reports re- quired as a condition of the Agreement for the purpose of determining whether and to what extent the Department or the County is entitled to a further final payment pursuant to this Agreement. If this Agreement is terminated prior to completion of the program, the Department shall make payment for expenditures incurred by the County and county funded agencies, prior to the date of termination, and for the County incentive portion of recoveries realized as a result of this Agreement. P. Disputes The designated liaison agency shall notify the Department in writing of the intent of the County and county funded agencies to pursue a claim against the Department for breach of any terms of this Agreement. No suit may be commenced by the County and county funded agencies for breach of this Agreement prior to the expiration of ninety (90) days from the date of such notification. Within this ninety (90) day period, the representatives of the County and county funded agencies, at the request of the Department, must meet the Department for the purpose of attempting resolu- tion of the dispute. Q. Agreement Inclusiveness/Amendment This Agreement contains all the terms and conditions agreed upon by the parties. All items incorporated by reference are to be attached. No other understanding, oral or other- wise, regarding the subject matter of this Agreement shall be deemed to exist or to bind any of the parties hereto. The County and county funded agencies agree, upon request by the Department and receipt of the proposed amendment, to amend this Agreement, if and when required in the opinion of the Department, due to a revision of Federal or State laws or regulations. If the County and county funded agencies refuse to sign such amendment within fifteen (15) days after receipt, this Agreement shall terminate upon such refusal. This Agreement may otherwise be amended only by the written consent of all parties hereto. -13- R. Continuing Responsibilities Termination, conclusion or cancellation of this Agreement shall not be construed so as to terminate the on-going responsibilities of the County and county funded agencies contained in the Examination and Maintenance of Records and Closeout paragraphs included in this Agreement. , Michigan MICHIGAN DEPARTMENT OF SOCIAL SERVICES -14- IN WITNESS WHEREOF, the Department, the Court, and the County have caused this Agreement to be executed by their respective officers, agents or representatives duly authorized to do so. Dated at , Michigan this_ day of , 1979 By: thairman, Board of Commissioners Witness: By: County Executive County By: Circuit. Court Judge Dated at this_ day of , 1979 By: Witness: APPROVED AS TO FORM •$R. 63178 ASS'T ATTORNEY GENERAL ,•-•• #9001 June 7, 1979 Moved by Hoot supported by Moore the resolution be adopted. AYES: Kasper, Kelly, Lewand, McConnell, McDonald, Moffitt, Montante, Moore, Moxley, Murphy, Page, Patterson, Perinoff, Pernick, Peterson, Price, Roth, Wilcox, Aaron, Doyon, Dunaskiss, Fortino, Gabler, Gorsline, Hobart, Hoot. (26) NAYS: None. (0) A sufficient majority having voted therefor, the resolution was adopted. STATE OF MICHIGAN) COUNTY OF OAKLAND) I, Lynn D. Allen, Clerk of the County of Oakland and having a seal, do hereby certify that I have compared the annexed copy of Miscellaneous Resolution #9001 adopted by the Oakland County Board of Commissioners at their meeting held on June 7, 1979 with the original record thereof now remaining in my office, and that it is a true and correct transcript therefrom, and of the whole thereof. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County at Pontiac, Michigan this 7g1 day of 441 Qq 19..a Lynn D. Allen Clerk By Deputy Clerk