Women’s Wellness Connection Toolkit - 11/2016

How to Use This Section ................................................................................... 2

About CCGP ................................................................................................. 2

Client Eligibility and Enrollment ......................................................................... 2

Care Coordination Services ............................................................................... 5

Clinical Services ............................................................................................ 5

Treatment Referral Services .............................................................................. 5

Quality Assurance and Improvement .................................................................... 6

Performance Indicators ................................................................................. 6

CDC Core Performance Indicators ..................................................................... 6

State Performance Indicators .......................................................................... 6

Colorado Contract Monitoring System ................................................................ 7

Quality Assurance Strategies ........................................................................... 8

Progress reports ......................................................................................... 8

Data Entry and Documentation ........................................................................... 9

Data Collected and Reported in eCaST ............................................................... 9

Uses of Data ............................................................................................. 10

Data Cleaning and Data Quality ...................................................................... 11

eCaST Location and Software Requirements ....................................................... 12

Accessing eCaST ........................................................................................ 12

Data Security and Confidentiality .................................................................... 12

Authority for Data Collection ......................................................................... 12

Agency Reimbursement ................................................................................... 13

How does WWC Reimburse for CCGP? ............................................................... 13

What does CCGP Reimbursement Cover? ............................................................ 14

Adjustments to Reimbursement ...................................................................... 15

When does CCGP Reimburse? ......................................................................... 15

Tracking Budgets ....................................................................................... 16

Subcontracting ............................................................................................. 16

Technical Assistance ...................................................................................... 16

Professional Development and Training ............................................................. 16

Communications ........................................................................................ 17

Website .................................................................................................. 17

Women’s Wellness Connection Toolkit - 11/2016

The Women’s Wellness Connection (WWC) Care Coordination Grant Program (CCGP) is separate from the WWC Clinical Services program. This section is only applicable to agencies with CCGP contracts and not to organizations solely participating in WWC Clinical Services. In addition to this section, in general, CCGP agencies must follow policies and guidelines outlined in the rest of this WWC Provider Toolkit for CCGP clients.

Since the implementation of the Patient Protection and Affordable Care Act (ACA) and Colorado’s expansion of Medicaid services to legally present residents under 139 percent of the Federal Poverty Level on January 1, 2014, many Colorado women previously served by the WWC program now qualify for Medicaid or private insurance. Despite increased access to health care, including breast and cervical cancer screenings, barriers to care remain, especially among newly eligible populations. The WWC CCGP provides an opportunity for clinical service delivery organizations to make available patient navigation and case management services (“care coordination”) to insured clients who otherwise meet WWC’s eligibility requirements. The purpose of CCGP is to provide breast and cervical cancer screening care coordination services to women who have, or are eligible for, health insurance and who meet WWC age, income and legal presence criteria, as outlined in this WWC Provider Toolkit.

The overarching goal of CCGP is to increase the number of women screened for breast and cervical cancer in Colorado.

Agencies must determine if clients are eligible for WWC Clinical Services or CCGP. To be eligible for CCGP, a woman must have health insurance (including, but not limited to, Medicaid) or be eligible to enroll in Medicaid or other insurance. All uninsured clients should be referred to Health First Colorado or Connect for Health Colorado for assessment of eligibility for Health First Colorado or subsidized Marketplace health insurance coverage.

Enrollment and participation in the WWC program is voluntary.

Eligibility / Enrollment Requirement:

Verification Frequency:

Guidance:

1. Woman1 Verify at initial enrollment

Self-report

1 Transgender women (male-to-female) who have taken or are taking hormones and transgender individuals (female-to-male) who have not yet undergone a complete hysterectomy or bilateral mastectomy meet these eligibility criteria for WWC.

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Eligibility / Enrollment Requirement:

Verification Frequency:

Guidance:

2. Breast services: between the ages of 40 and 64 years

Verify at initial enrollment.

A woman is no longer eligible once she turns 65. Women between the ages of 21 and 39 years are not eligible for breast services.

3. Cervical services: between the ages of 21 and 64 years

Verify at initial enrollment.

A woman is no longer eligible once she turns 65.

4. Have a family income (self-report) at or below 250 percent of the Federal Poverty Level

Verify annually and be sure to use the most current guidelines.

Self-report.

5. Lawfully present in the United States

Verify at initial enrollment, must be signed prior to WWC services being provided.

Obtain a signed affidavit and verify required identification for each client before services are rendered. It is recommended that the lawful presence affidavit template be copied onto your agency's own letterhead.

Keep the signed affidavit and proof used to verify lawful presence in the client’s medical record.

Refer to the Colorado Department of Revenue’s website for more guidance on lawful presence requirements.

A lawful presence affidavit signed after 8/1/2006 qualifies as up to date.

Have client re-sign if lawful presence status changes (i.e. if client becomes a citizen).

Effective January 1, 2017, lawful presence affidavits must reflect the program(s) for which the affidavit is being used. CDPHE has added “Women’s Wellness Connection (WWC) and WISEWOMAN” to the affidavit templates found on the website.

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Eligibility / Enrollment Requirement:

Verification Frequency:

Guidance:

The affidavit template by WWC/WISEWOMAN may be modified to include any additional programs at your agency that require an affidavit (though inclusion of the programs on the shared form should be confirmed with the other program(s)).

If the agency is using an affidavit from a different program (example: Colorado Indigent Care Program), the agency must modify the template to add WWC and WISEWOMAN or have the client sign a WWC/WISEWOMAN specific affidavit when enrolling in WWC and/or WISEWOMAN.

6. Have insurance or be eligible for insurance

Assess insurance status before clinical services are provided.

If eligible for insurance, assist client to enroll before clinical services are provided. If a client is eligible for insurance and the agency is able to enroll her in insurance on the day of enrollment, she is considered “insured.”

Document appropriate funding source for each procedure in eCaST (i.e. Medicaid, insurance).

7. Signed WWC Combined Consent Form

Client must sign at initial enrollment.

When a client signs this form, she is affirming that she: 1) understands CCGP eligibility rules and coverage, 2) has answered all eligibility questions honestly, and 3) has knowingly agreed to participate in CCGP.

The consent must be signed prior to entering any data in eCaST.

Keep the signed consent in the client’s medical record.

A Combined Clinical Services / Care Coordination consent form signed after 2/2/2015 qualifies as up to date.

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If the required forms (Lawful Presence Affidavit and WWC Consent) are omitted, a client is not enrolled in the WWC program and no services performed will be reimbursed. These forms can be found on the WWC website.

Clients may not be enrolled into CCGP after screening services have been provided (i.e. clients may not be referred into the program for reimbursement of a case manager’s time navigating client between abnormal screening and diagnostic procedures alone).

Agencies are required to comply with the guidelines stated in the Care Coordination: Patient Navigation and Case Management section of the WWC Provider Toolkit.

Agencies must not subcontract for patient navigation or case management services. Activities currently done by subcontractors, such as reminder calls or client notification of results, are acceptable.

Agencies are required to comply with the guidelines stated in the Clinical Services section of the WWC Provider Toolkit, except as outlined below.

Breast and Cervical Cancer clinical services are not reimbursable through CCGP. All references in the Clinical Services section to reimbursement of clinical procedures are not applicable to CCGP. Agencies must be contracted as a Health First Colorado provider and/or successfully bill private insurance for breast and cervical cancer screening services.

Pre-approval for procedures is not required. Approval from the nurse consultant for breast MRIs, ductograms, and those clients in need of active treatment following a diagnosis determined by excisional biopsy is not required in the CCGP. Approval for second cervical or breast biopsies are also not required.

Tracking and documentation. A tracking system must be in place to notify clients of abnormal results and referral status. Contacts should be clearly documented in the client’s chart. Please see the WWC Clinical Services Patient Navigation Case Management section of the toolkit for detailed lost to follow-up and refused policies.

Due to Health First Colorado’s Creditable Coverage requirements, CCGP clients cannot be enrolled in Colorado Breast and Cervical Cancer program (BCCP). Because all CCGP clients have health insurance, they are ineligible for Health First Colorado’s BCCP. The agency must coordinate access to treatment services for these clients. The agency must establish relationships and/or subcontracts for referral sources for treatment services prior to offering screening services to any client in the CCGP.

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The Women’s Wellness Connection (WWC) program has established standards, systems, policies and procedures to monitor and assess current program effectiveness and to improve program performance.

Agencies are required to meet or exceed all established program performance indicators. Agencies meeting or exceeding indicators will be recognized for quality performance by WWC.

Performance indicators are classified into two categories:

Indicators required by the U.S. Centers for Disease Control and Prevention (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) grant are referred to as CDC Core Performance Indicators; and,

Indicators required by the Colorado Department of Public Health and Environment (CDPHE) are referred to as State Performance Indicators.

CDC does not require submission of client record-level clinical measures for CCGP; however, WWC received funding for CCGP by indicating that the following indicators would be gathered and reported in aggregate to the CDC National Breast and Cervical Cancer and Early Detection Program (NBCCEDP). WWC will review and report performance to agencies on the following performance indicators three times per fiscal year as evidenced by data in eCaST:

Complete Follow-up: The percentage of abnormal cases with complete follow-up should be at least 90 percent. Follow-up is complete when cases have a final diagnosis, cancer or not cancer.

Time from Screening to Diagnosis: At least 75 percent of all completed abnormal cases must be completed with 60 days or less.

Screening Performance Indicator

WWC will review and report performance to agencies on the following state performance indicator three times per fiscal year as evidenced by data in eCaST:

35% of CCGP clients 50 years of age and older, receiving cervical services also must receive a mammogram.

Business Relations Performance Indicator

CDPHE defines Business Relations as, “the degree to which the contractor is professional and respectful in its business approach and interactions with the agency.” WWC’s expectation is that agency representatives are courteous, cooperative and have a professional approach in all forms of communication, handle complaints efficiently and effectively, and manage change effectively.

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Data Entry Timeliness Performance Indicator

Agencies entering data into eCaST within 30 days can use eCaST for tracking incomplete cases and case management interventions. Also, timely data entry allows for accurate tracking of spending. The performance indicator is:

90 percent of all data for all procedures must be entered into eCaST within 30 days of service being performed.

Cost Performance Indicator

Agencies manage their WWC budgets by ensuring funds are fully spent by the end of the contract period. The performance indicator is:

Agency spending must be within five percent of where spending is expected to be at that point in the year.

For example: By the end of October agencies should have spent at least 24 percent of their budget because 29 percent of the fiscal year has passed.

Attendance Performance Indicators

Agencies most successful in the WWC program regularly attend conference calls and webcasts. The attendance performance indicator is:

At least one representative from each agency must attend the Quarterly Care Coordination Contractor calls hosted by WWC to ensure compliance. Agency staff can make up any WWC conference calls or webcasts by reviewing recordings or notes found on the WWC website. Once this is done, credit is given by including this information on the progress report.

Contract Compliance

This performance indicator allows for staff to document and account for other contractual compliance issues that are not covered in the performance indicators above.

Pursuant to Colorado state law, in 2009 WWC began determining contract management system (CMS) performance ratings for all contractors. The rating is developed based on five performance categories:

Quality of Service.

Budget/Cost Management.

Timeliness of Service.

Customer Service.

Contract Deliverables.

WWC has assigned program performance indicators and other measures to the five CMS performance categories listed above.

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Agencies will receive either a standard or below standard in each category each performance period.

A Final Contractor Performance Evaluation will be conducted at the end of the life of the contract. This rating will be posted on the state CMS website.

WWC provides feedback to agencies as part of its quality assurance and quality improvement plan. The plan has many distinct activities that relate to agency performance in the areas of quality and compliance.

The goal of the WWC progress reports is to increase agency ability to make changes throughout the fiscal year that enable them to maximize volume and quality of screenings completed and streamline reporting expectations across WWC contracts where possible. Agencies are required to submit three progress reports to provide status of deliverables and plan for improvement when deliverables have not been met. Find more information on the WWC website: https://www.colorado.gov/cdphe/wwc-progress-report.

Program risk assessments

WWC performs a program risk assessment annually to determine monitoring levels and which agencies may receive site visits. The following factors are assessed:

Performance implementing the program or services.

Complexity of the program or services.

Program or services eligibility.

New to the program.

Personnel implementing the program or services.

Program site visits

WWC staff members conduct site visits with WWC agencies each fiscal year. Site visits serve as an opportunity to highlight program successes, challenges encountered, lessons learned, useful tools, and technical assistance needs. Site visits are conducted by each agency’s assigned program coordinator, and the WWC Nurse Consultant will be available by phone, if needed. Find more information on the WWC website: https://www.colorado.gov/cdphe/wwc-training-and-technical-assistance.

Clinical chart audits

The purpose of the WWC clinical chart audit is to ensure compliance with Women’s Wellness Connection (WWC) program clinical requirements, including adherence to clinical guidelines. Clinical chart audits serve as an opportunity to determine quality of clinical services provided, evaluate clinic workflows and protocols, and solicit valuable feedback. Chart audits also assist agencies in identifying areas for potential clinical quality improvement, developing a plan for making improvements and offering additional technical assistance in order to meet

Women’s Wellness Connection Toolkit - 11/2016

clinical requirements. Clinical chart audits are a common element of a quality assurance process. Find more information on the WWC website: https://www.colorado.gov/cdphe/wwc-training-and-technical-assistance.

Performance improvement plans

Agencies out of compliance with the contract may be placed under a performance improvement plan.

Agencies are required to manually enter Women’s Wellness Connection (WWC) encounter-level data in the Electronic Cancer Surveillance and Tracking (eCaST) web application. eCaST is a program management and public health surveillance tool. It is not an electronic health record and should not be used to gather any information beyond required data elements used for breast and cervical cancer screening surveillance. Based on data entered, agency Grant Activity Statements are generated within the eCaST application, making eCaST data entry the only way WWC service delivery agencies can access grant funds.

eCaST was developed by the Colorado Department of Public Health and Environment (CDPHE) in 2005. It is updated and maintained by CDPHE to meet U.S. Centers for Disease Control and Prevention (CDC) National Breast and Cervical Cancer and Early Detection Program (NBCCEDP) reporting and documentation requirements.

Data for other public health screening programs are also collected in eCaST. Client demographic data is shared across grant programs, but clinical information is accessible only by each program. It is possible that your agency may use eCaST for other public health programs. Programs using eCaST include:

Women’s Wellness Connection (Clinical Services and Care Coordination).

Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN).

Colorectal Cancer Screening Program.

All clinical services must be submitted into eCaST if the CCGP agency is requesting reimbursement for care coordination services. If CCGP funds care coordination for a client’s cancer screening services, all related screening and diagnostic procedures must be reported in eCaST along with the funding source (other than WWC).

WWC provides forms agencies may use to collect data that must be reported via eCaST. Data must be entered within 30 days of providing each clinical service procedure to a WWC client. WWC forms can be found on the WWC website.

Information collected on each form is summarized below.

Client Profile Tool includes age, insurance status, lawful presence and financial eligibility. Agencies are responsible for ensuring this form is filled out completely and to the best of the client’s knowledge. Use of this form is optional and may be

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substituted by detailed documentation of the same information within the agency’s records.

Clinical Cycle Form can be used by agencies to document a client’s medical history, clinical findings of services performed during screening visits, and recommended follow-up. Use of this form is optional and may be substituted by detailed documentation of the same information within the agency’s medical records. This form should not be used or saved as documentation within the medical chart.

Breast and Cervical Diagnostics Forms can be used by agencies to document diagnostic, follow-up and treatment services. Use of these forms is optional and may be substituted by detailed documentation of the same information within the agency’s medical records. These forms should not be used or saved as documentation in the medical chart. It is the agency’s responsibility to document this data elsewhere in the medical chart and dispose of these forms following HIPPA laws.

eCaST data replaces many standard reporting requirements, such as progress reports and grant invoicing. Your agency should use the eCaST application to:

Ensure client eligibility

WWC eligibility criteria are embedded in the eCaST application. Clients and services not meeting demographic and clinical eligibility requirements are flagged and reimbursement withheld if entered into eCaST in error. For more information on program eligibility requirements, see the Eligibility and Enrollment section of this Toolkit.

Monitor quality of clinical services

eCaST is used to monitor adherence to WWC clinical algorithms on individual client, agency and state levels. Abnormal breast and cervical cancer screening results per WWC’s clinical algorithms are embedded in eCaST, and clients requiring follow up are automatically flagged in the system with reimbursement withheld. In addition to client-specific eCaST features, reports assessing agency performance on CDC clinical core performance indicators are also available. Agencies should use eCaST in addition to other clinic processes to ensure all clients are receiving appropriate and timely diagnostic services. For more information on follow up of clinical services, see the Clinical Services section of this Toolkit.

Reimburse for grant activity

Grant activity is assessed each month based on clinical services entered into eCaST. A Grant Activity Statement is generated for agencies with complete cancer screenings containing no data entry errors. Statements are available from the eCaST application. For more information on WWC reimbursement, see the Reimbursement section of this Toolkit.

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Monitor grant spending and screening goals

eCaST has a billing dashboard feature to help agencies monitor grant fund expenditures. This feature can be used to project funds needed through the remainder of the fiscal year. WWC requires that agencies keep on pace to spend all grant funds allotted. This ensures WWC continues to receive needed funding from the CDC.

WWC state staff members use eCaST to:

Monitor data across all Care Coordination agencies to ensure volume of data entry errors is low.

Ensure that the clinical quality of services provided meet CDC clinical core performance indicators.

Ensure each agency is on pace to spend 100 percent of grant funds over the contract period.

Identify agencies in need of funding increases or decreases.

Client records are not submitted to the CDC. Client-level data for the CCGP is not submitted to the CDC. Instead this data will be reported to the CDC in summary form.

There are limitations to eCaST data entry and use. Because eCaST is a public health surveillance tool, WWC agencies should use their own systems or Electronic Health Records to track and/or recall clients for future screenings, and agencies may not enter data on non-WWC funded screenings. Two examples of data not allowed into eCaST are: 1) data entry in text fields outside of breast/cervical cancer screening scope; and 2) data on breast or cervical cancer screenings for clients not enrolled in the WWC program. eCaST report features are designed to help agencies manage grant funds effectively. However, reports and dashboard features should not be used to aggregate or analyze data for display in public presentations or reports without WWC approval.

WWC requires participation in a data cleaning project in mid-August and February in preparation for CDC data submissions. Agencies are required to review all cancer screenings performed over the previous one and a half years that do not meet a CDC clinical core performance indicator or contain data errors. Agencies must review these screenings to confirm accuracy, review completeness and correct errors.

WWC staff members provide a list of screenings requiring review to the agency eCaST Coordinator. Typically, lists are provided via an Excel spreadsheet in early to mid-August and February. Agencies are given two to four weeks to complete requested activities, depending on volume of screenings for review.

Other data cleaning and data quality projects are conducted as needed after identifying concerning data trends or at CDC’s request. Projects can be focused on specific agencies or implemented statewide. Agency participation is required.

Communication regarding specific clients is primarily sent via unencrypted email. Clients are referenced by eCaST identification number alone so that no Personal Health Information (PHI)

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is exposed. Fax, encrypted email, and file transfer protocol sites may be used when WWC must communicate PHI. Please use the same secure means to communicate PHI with WWC staff members. Information shared with WWC is confidential.

The eCaST application is located on CDPHE’s Health Informatics Portal at: https://www.healthinformatics.dphe.state.co.us/.

Agencies do not need to install additional software beyond a web browser. eCaST data entry is a WWC contract requirement; therefore, it is important that eCaST users at your agency have access to an eCaST-supported web browser. eCaST runs most efficiently on Google Chrome (download at https://www.google.com/intl/en/chrome/browser/); however, Mozilla Firefox and Internet Explorer version 9+ are also supported. Note eCaST does not function on, and is not supported on, Internet Explorer version 8 or earlier versions.

All staff members needing new access to eCaST are required to complete the eCaST Basics Video Training session before they are given access. The eCaST Basics Video Training session consists of a set of modular videos demonstrating proper use of eCaST and a subsequent set of sample data entry tasks to be completed in a test environment before access can be requested and granted to the individual user. The eCaST Basics Training regimen can be taken at any time throughout the year. Staff members must coordinate their training with the WWC Data Coordinator (Nick Roth, nicholas.roth@state.co.us).

When an existing eCaST user no longer needs access for WWC data entry, an agency must report this change to WWC within 15 days so that the user’s account can be de-activated.

All eCaST users are required to agree to the Colorado Department of Public Health and Environments (CDPHE) “Data use, security, and confidentiality” agreement prior to accessing the eCaST application. This agreement is signed by the user electronically when enrolling or annually renewing access to eCaST. A copy of this agreement and CDPHE’s security policy can be found at: https://www.healthinformatics.dphe.state.co.us/.

WWC receives authority to collect client data through the CDC’s NBCCEDP and Colorado Revised Statute 25-6-103.

The WWC Statement of Work for contracts includes the requirement for collecting and submitting breast and cervical cancer screening data.

CDPHE is not a Health Insurance Portability and Accountability (HIPAA) entity. According to Title 45 CFR 164.512, however, “A covered HIPAA entity may disclose protected health information to a health oversight agency for oversight activities authorized by law.” Thus, CDPHE can receive protected health information as it relates to health oversight activities. Additional information regarding CDPHE and the HIPAA privacy rule language can be found in your agency’s contract with CDPHE.

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CCGP agencies must comply with the following section rather than the Agency Reimbursement section of the WWC Provider Toolkit.

Due to billing system limitations, clients who become insured mid-way through their clinical services may receive either WWC Clinical Services through the point of insurance or CCGP care coordination services for their complete screening. Clients who receive any clinical services through the WWC Clinical Services program are not eligible for CCGP.

Agencies will only be paid for cases that meet eligibility, performance and data requirements. Reimbursement is determined by the clinical outcome of the case; therefore, services become eligible for reimbursement when the screening is clinically complete and data has been entered accurately into eCaST.

The amount reimbursed for care coordination services is based upon entry of screening and diagnostic procedures into eCaST which demonstrates successful completion of care coordination services. Agencies are reimbursed more for cases where case management (through completion of diagnostic procedures) is provided than for cases where patient navigation (through completion of health history plus health education and/or screening procedures) is provided. CCGP agencies are reimbursed separately for care coordination of breast and cervical cancer screenings.

Reimbursement will occur according to the CCGP Bundled Payment System Reimbursement rates may be revised or updated during the year. Case management is not reimbursable unless diagnostic services are complete.

Reimbursement for breast cancer screening care coordination services include2:

Partial Patient Navigation (B7): Coordination of care through assessment of need for screening mammogram. Agencies with documentation that a client is up to date per guidelines and who have provided breast cancer health education or a Clinical Breast Exam may receive partial reimbursement for patient navigation without completion of a mammogram. Agency must complete data entry in eCaST on:

o Client demographic information (may be gathered from WWC Client Profile Tool).

o Breast health history.

o Breast health education if requesting B7 without clinical breast exam.

o Clinical breast exam, if performed, with funding source (other than WWC).

o Screening follow-up recommendation.

2 The technical level which displays in eCaST is listed in parenthesis beside each bundled set of services.

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Full Patient Navigation (B8): Coordination of care through completion of mammogram to obtain remainder of patient navigation fee. Agency must complete data entry in eCaST on:

o Mammogram with funding source (other than WWC).

o Screening follow-up recommendation.

Case Management (B9): Services from level B8, plus coordination of care to complete diagnostic services through point of final diagnosis and data entry in eCaST on:

o Applicable breast cancer diagnostic procedures provided to the client.

o The funding source (other than WWC) for each procedure.

o Final diagnosis summary information.

Reimbursement for cervical cancer screening care coordination services include:

Patient Navigation (C7): Coordination of care through assessment of need for Pap test (with or without HPV testing) and completion of screenings if determined the client is outside of recommended screening intervals. Agencies with documentation that a client is up to date per ASCCP guidelines and who have provided cervical cancer health education may receive reimbursement for patient navigation without completion of a Pap test (with or without HPV testing). Agencies must complete data entry in eCaST on:

o Client demographic information (may be gathered from WWC Client Profile Tool).

o Cervical health history.

o Cervical health education if requesting C7 without clinical procedures.

o Applicable cervical cancer screening procedures provided to the client with funding source (other than WWC).

o Screening follow-up recommendation.

Cervical Level (C8): Services from level C7, plus coordination of care to complete diagnostic services through point of final diagnosis and complete data entry in eCaST on:

o Applicable cervical cancer diagnostic procedures provided to the client.

o The funding source (other than WWC) for each procedure.

o Final diagnosis summary information.

o

Agencies are paid according to the CCGP BPS after all information on a client’s cycle has been entered completely and accurately into eCaST. CCGP agencies accept these fees as payment

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in full. Clients must not be billed for these services. Reimbursement should cover costs associated with:

Enrollment of clients in CCGP.

Patient navigation and case management of clinical services.

Entry of all information into eCaST.

Coordination of access to treatment services using the client’s insurance, when applicable.

Other administrative costs such as attending required meetings and trainings, updating grant information, etc.

When there is a difference between what an agency was paid earlier in the fiscal year and the current balance, funds will be adjusted (credited or debited) on the agency’s Grant Activity Statement. Adjustments may occur in the following circumstances:

Client information is updated, demonstrating ineligibility for the WWC program.

Services are added or removed from eCaST that change the case status from closed to open.

Services are added to or removed from eCaST that cause the reimbursement level to change.

Data are changed by data entry staff from a known to a missing value.

Reimbursement was made in error for duplicate clients identified.

WWC places a case on hold or administrative override because the case does not meet contractual requirements. Contractors are not required to change the funding source for services previously rendered, even if the new coverage is retroactive (for example, Health First Colorado). While it is not a requirement to change the funding source in eCaST, it is also not allowable to charge the same service to two funders (for example, WWC and Health First Colorado). Agencies that choose to retroactively charge Health First Colorado or another funder for services previously paid by WWC must change the funding source in eCaST from WWC to the new funding source.

Agencies should work directly with WWC program staff regarding non-payment of clients screened. If WWC staff members are unable to rectify reimbursement issues, agencies may work with the WWC fiscal officer.

Grant Activity Statements are generated the 15th of each month or the first business day after the 15th, except for the first month of the fiscal year (July), on the agency’s behalf according to services entered in eCaST. All clients with complete and accurate clinical and follow-up data in eCaST at that time will be included in the billing cycle. The final Grant Activity Statement is generated 30 days after the end of the fiscal year (i.e., 30 days after June 29).

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Reimbursement checks are produced by and mailed from the state controller’s office, not the Colorado Department of Public Health and Environment. Each check received will include a payment voucher number. This number is also listed on each Grant Activity Statement, the invoice generated in eCaST, so that agencies can verify clients associated with checks received.

Each agency receives a funding amount that it can use to provide services under the WWC program each fiscal year. Once an agency’s total budget amount has been reached, the WWC program will not pay for any additional expenses incurred by the agency. Agencies are encouraged to contact WWC staff in order to determine if there is a possibility to receive additional funds.

Agencies that are under-spent in their budgets may have funds taken back and reallocated to other agencies at any time during the contract period.

Budget Tracking Reports are available in eCaST as a tool for agencies to monitor their budget progress during the fiscal year. The Budget Tracking Report includes the percent of funds expended, year-to-date total paid, and average costs per screening as well as average cost per woman served. The budget reports are updated during the mid-month billing reimbursement process. Agencies are notified monthly via the WWC Update when billing reports are available to be printed by agency staff.

Subcontracts are not required for CCGP but agencies must refer clients for additional required services such as mammograms, ultrasounds, breast biopsies, colposcopies, Loop Electrosurgical Excision Procedures (LEEP), Magnetic Resonance Imaging (MRI) or other approved breast or cervical diagnostic services, if they are not being directly provided by the agency.

Women’s Wellness Connection (WWC) offers technical assistance in addition to this toolkit to help agencies run a successful WWC program.

Professional development and training focuses on the topics necessary to provide a quality breast and cervical cancer screening program, including program orientation, data entry, outreach, case management and programmatic best practices. The WWC Program Calendar showing calls and trainings is on the WWC website at https://www.colorado.gov/cdphe/wwc-calendar.

Quarterly Care Coordination Contractor calls (attendance required) are in June, September, December and March. An agenda is posted in the WWC Update. These quarterly calls are open to staff at agencies involved in CCGP program administration and provide staff the opportunity to discuss care coordination work. These conference

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calls or webcasts are archived on the WWC website at https://www.colorado.gov/cdphe/wwc-training-and-technical-assistance.

Health Improvement Team (HIT) calls are on the third Thursday of even-numbered months (i.e. August, October, etc.) from 11:00 a.m.-12:00 p.m. An agenda is posted in the WWC Update. HIT calls are open to staff at agencies involved in client care or WWC program administration. These conference calls or webcasts are archived on the WWC website at https://www.colorado.gov/cdphe/wwc-training-and-technical-assistance.

eCaST User’s Group (EUG) Meetings are on the fourth Wednesday of odd-numbered months (i.e. July, September, etc.) from 2:30-3:30 p.m. An agenda is posted in the WWC Update and all eCaST users are encouraged to attend. EUG meetings are an opportunity for WWC staff to provide updates and additional training as well as solicit feedback from users on the eCaST application. These webinars are archived on the WWC website at https://www.colorado.gov/cdphe/wwc-training-and-technical-assistance.

CCGP orientation training is provided via orientation videos embedded within the WWC provider toolkit.

eCaST technical assistance webinar is offered the first Wednesday of even-numbered months via webcast. This webinar is optional and provides an opportunity for eCaST users to get one-on-one technical assistance from the data team.

Clinical webcasts are offered once or twice per year and provide agencies knowledge of and competency on clinical best practices. See WWC Update for announcements about upcoming clinical webcasts. Clinical webcasts are archived on the WWC website at https://www.colorado.gov/cdphe/wwc-training-and-technical-assistance.

Technical assistance and capacity building is provided by program staff. Talk to your Program Coordinator if your agency staff needs technical assistance.

Important messages from WWC usually come from the Section Manager. Please read emails from cdphe_wwc@state.co.us immediately.

WWC Update is WWC’s weekly electronic newsletter. It is recommended that the WWC coordinator and eCaST coordinator receive and review the weekly WWC Update, but anyone interested in WWC may subscribe at http://us9.campaign-archive1.com/home/?u=eb19585e98311e09762feb612&id=678bb5dfe7.

WWC has a page on the State of Colorado website: https://www.colorado.gov/cdphe/womens-wellness-connection. All forms, tools and documents referenced in the WWC Toolkit are linked in Provider resources.