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Consent Agenda Item 5. F.

Regular BOS Meeting

Meeting Date:	02/05/2019
Submitted For:	Malissa Buzan	Submitted By:	Allison Torres, Case Manager
Department:	Community Services	Division:	GEST Division

Information

Request/Subject

Approval of a Provider Participation Agreement between the Arizona Health Care Cost Containment System (AHCCCS) and Gila County, a public agency of the State of Arizona, on behalf of Gila Employment and Special Training (GEST).

Background Information

This Provider Participation Agreement between AHCCCS and Gila County, a public agency of the State of Arizona, on behalf of GEST will allow GEST to continue providing Arizona Department of Economic Security (DES) Division of Developmental Disabilities (DDD) services to GEST participants. As part of the revalidation process, the County must also provide the Revalidation Address Verification Form, the Disclosure of Ownership/Control and Criminal Offenses Statements Form, and a W-9.

Evaluation

This agreement, along with the required forms, will allow GEST to continue providing DES/DDD services to those participants that have chosen GEST, and to receive payments for those services provided.

Conclusion

This agreement, along with the required forms, will allow GEST to continue providing DES/DDD services to those participants whose DES/DDD authorization indicated a specific need for these services.

Recommendation

The Gila County Community Services Department Director recommends that the Gila County Board of Supervisors approve the Provider Participation Agreement.

Suggested Motion

Approval of the Provider Participation Agreement between the Arizona Health Care Cost Containment System and Gila County, a public agency of the State of Arizona, on behalf of Gila Employment and Special Training (GEST), which will allow GEST to continue providing Arizona Department of Economic Security, Division of Developmental Disabilities services.

Attachments
Provider Participation Agreement