Agenda 09/26/2017 Item #16D1909/26/2017
EXECUTIVE SUMMARY
Recommendation to approve Amendment # 1 to Community Health Partners (CHP) Managed
Care Service Agreement #12-5854, to include case management chart review and referral services
for the Operations and Veteran Services (OVS) Division to assist in client claims requiring in-depth
medical history analysis.
OBJECTIVE: To approve Contract Amendment # 1 to Community Health Partners Managed Care
Service Agreement #12-5854, to include case management chart review and referral services for the OVS
Division to assist in client claims requiring in-depth medical history analysis.
CONSIDERATIONS: Approximately five service-connected cases a month that come to OVS require
in-depth medical history analysis or the expertise of medical professionals to adequately advocate and
assist clients with claims. The use of a medical case management provider (such as CHP) will help inform
the medical-claim decision-making process.
Successful claims can provide clients with anywhere from $100 to $1,200 per month for the rest of their
lives. Unsuccessful claims can cost hundreds of hours of staff overhead over the course of the claim and
appeal process.
OVS anticipates approximately 150 hours of regular analysis and 24 hours of higher -level analysis per
fiscal year, with an average of five cases per month. Given the unique characteristics of each case, the
actual monthly utilization will vary, and OVS will start with a pilot program to gauge participation. As
such, CHP will invoice based on actual utilization monthly. The total initial budget for the analysis pilot
program is $2,000, under Agreement #12-5854, which is set to expire on December 31, 2017. A new
agreement, which has been competitively solicited will be presented to the Board at a subsequent meeting
and the budget for future years will be adjusted based on the actual utilization of and the forecasted need
for the services.
FISCAL IMPACT: Funds will be made available in the amount of $2,000 from Cost Center 001-
155230-634999.
GROWTH MANAGEMENT IMPACT: There is no growth management impact.
LEGAL CONSIDERATIONS: This item is approved as to form and legality, and requires majority vote
for Board approval. -SRT
RECOMMENDATION: To approve Amendment # 1 to Community Health Partners Managed Care
Service Agreement #12-5854, to include case management chart review and referral services for the
Operations and Veteran Services Division to assist in client claims requiring in -depth medical history
analysis.
Prepared by: Sean Callahan, Director, Operations and Veterans Services
ATTACHMENT(S)
1. Amendment # 1 to Community Health Partners Managed Care Service Agreement, #12-5854,
(PDF)
16.D.19
Packet Pg. 1900
09/26/2017
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.19
Doc ID: 3604
Item Summary: Recommendation to approve Amendment # 1 to Community Health Partners
(CHP) Managed Care Service Agreement #12-5854, to include case management chart review and
referral services for the Operations and Veteran Services (OVS) Division to assist in client claims
requiring in-depth medical history analysis.
Meeting Date: 09/26/2017
Prepared by:
Title: – Operations & Veteran Services
Name: Sean Callahan
08/10/2017 12:18 PM
Submitted by:
Title: – Operations & Veteran Services
Name: Sean Callahan
08/10/2017 12:18 PM
Approved By:
Review:
Procurement Services Opal Vann Additional Reviewer Completed 08/14/2017 9:34 AM
Procurement Services Joshua Hammond Additional Reviewer Skipped 08/14/2017 2:15 PM
Procurement Services Sandra Herrera Additional Reviewer Completed 08/15/2017 7:53 AM
Public Services Department Joshua Hammond Level 1 Division Reviewer Completed 08/15/2017 8:34 AM
Public Services Department Steve Carnell Additional Reviewer Completed 08/17/2017 11:07 AM
County Attorney's Office Scott Teach Additional Reviewer Completed 08/18/2017 9:38 AM
County Attorney's Office Jeffrey A. Klatzkow Additional Reviewer Completed 08/18/2017 3:05 PM
Office of Management and Budget Valerie Fleming Additional Reviewer Completed 08/18/2017 4:31 PM
Budget and Management Office Ed Finn Additional Reviewer Completed 08/22/2017 12:21 PM
County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 08/23/2017 3:55 PM
Board of County Commissioners Michael Cox Meeting Completed 09/12/2017 9:00 AM
16.D.19
Packet Pg. 1901
16.D.19.a
Packet Pg. 1902 Attachment: Amendment # 1 to Community Health Partners Managed Care Service Agreement, #12-5854, (3604 : Veterans Services Medical
16.D.19.a
Packet Pg. 1903 Attachment: Amendment # 1 to Community Health Partners Managed Care Service Agreement, #12-5854, (3604 : Veterans Services Medical
16.D.19.aPacket Pg. 1904Attachment: Amendment # 1 to Community Health Partners Managed Care Service Agreement, #12-5854, (3604 : Veterans Services Medical