6 CCR 1015-8
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Prevention Services Division – Rules promulgated by the Colorado Board of Health SERVICE RANTS FOR THE DENTAL ASSISTANCE PROGRAM 6 CCR 1015-8 [Editor’s Notes follow the text of the rules at the end of this CCR Document.]
1.1 Definitions
1) “Advisory Committee” means the Dental Advisory Committee created in Section 25-21-107.5, C.R.S.
2) “Department” means the Department of Public Health and Environment 3) “Eligible Senior” means an adult who:
a. Is sixty years of age or older; and b. Is eligible for old age pension assistance as defined in section 26-2-111(2), C.R.S.
4) “Qualified Grantee” means an entity that either provides comprehensive dental and oral health services or that can administer funds for such services through sub-grants, awards, or reimbursement processes that comply with the federal “Health Insurance Portability and Accountability Act of 1996” , 42 U.S.C. sec. 1320d to 1320d-8.
5) “Service grant” means a grant awarded by the Department to a qualified grantee pursuant to this article.
1.2 Application requirements
1) At a minimum, all applications for service grants submitted to the Department shall contain the following information:
A) Compliance with the definition of “qualified grantee” as defined in Section 1.1(4).
B) Demonstrates an establishment of coordination with local Area Agencies on Aging to include one of the following, but not limited to:
C) Defined service area.
D) A plan for outreach to include:
E) A description of plan for verifying eligibility of seniors.
F) An operating budget that designates a procedure for prioritization of funds to meet the needs of those eligible seniors most in need.
G) A description of the applicant's ability to comply with and monitor the implementation of the grant requirements, which includes a statement whether the applicant will charge a copayment to eligible seniors and certifying that the copayment shall not exceed twenty percent of the cost of the services provided. H) Demonstration of capacity to implement and administer the program specified in Section 2(1).
2) A successful applicant for participation in the program shall sign a contract with the Department or a Purchase Order with a scope of work that complies with the State's Procurement Rules in 24-101- 101 to 24-112-101, C.R.S.. The terms of the service grant contract/purchase order shall be determined by the Department and shall include, but need not be limited to, the following:
A) The total amount of grant to qualified grantee;
B) The qualified grantee's agreement to provide care to eligible seniors for length of grant;
C) The qualified grantee's agreement to provide the Department with semi-annual reports. At a minimum, the reports shall include:
D) Reasonable penalties and other enforcement remedies available to the Department in the event the qualified grantee breaches contract or purchase order;
E) The qualified grantee's agreement to notify the department if there is a decrease in eligible seniors served; and F) The time period of the grant.
1.3 Review of Application
1) The initial review will be done by the Department to determine whether the application is complete and to ensure the grantee meets the requirements of the definition previously stated in 1.1(4).
2) After initial review of applications, the dental advisory committee will review applications, and then submit their recommendations to the Department.
3) The Department will consider the recommendations made by the dental advisory committee, but is not bound by them. In the event the Department disagrees with the committee's findings, it will provide a written statement of its rationale to both the - applicant and the committee for their reference.
Allowable Procedures and Fees for Dental Services [Eff. 12/30/2008] 2.1 Effective December 31, 2008 through June 30, 2009, a qualified grantee, as defined in Section 1.1 of these regulations, may charge fees, not to exceed the maximum allowable fee, and perform the procedures for an eligible senior as set forth in Section 2.3.
2.2 Nothing in this part shall prohibit a qualified grantee from charging less than the allowable fee or reducing the amount of the patient co-payment set forth in Section 2.3. Any reduction in the amount of the patient co-payment shall be a the discretion of the qualified grantee.
2.3 Table of allowable procedures and fees
_____________________________________________________ Editor’s Notes History Sections 2.1 – 2.3 Eff. 12/30/2008.