Child and Teen Checkups (C&TC) Tribal and County Administrative Services Contracts

Posted: March 26, 2026

· Overview

· Eligible Providers

· Eligible Members

· Covered Services

· Billing

· Legal References

Overview

Minnesota Department of Human Services contracts with single and multi-county community health boards (CHBs) and Tribal governments to provide C&TC administrative services that include outreach and follow-up activities to enrolled families, young adults, and providers. There are five main objectives of C&TC administrative services required by federal regulations:

· Informing families or children enrolled in Medical Assistance (MA) about eligibility and services

· Assisting families or children with appointment scheduling and follow-up on referrals made because of a screening. This includes assisting families or children with accessing transportation and interpreter services for both screening and follow-up appointments

· Tracking the participation response from families or children and annually reminding those who choose not to participate in the program that they are still eligible for services

· Coordinating with other community child health programs such as WIC (Women, Infants and Children Program)

· Recruiting or educating providers to meet child or family medical needs and follow screening guidelines and program policy

Some health care systems provide C&TC outreach to their populations through the Integrated health partnerships (IHPs) (webpage) contract. The procedures for the IHP contract process differ from county and tribal agencies. Email the DHS IHP team at IHP.Admin.DHS@state.mn.us with questions about the IHP program.

Administrative Services Contract for Counties and Tribal Agencies

Minnesota Department of Human Services follows a triennial (three-year) cycle with amendment years in between. At the beginning of the triennium, Minnesota Department of Human Services will post an informational Bulletin about program requirements. Next, Minnesota Department of Human Services will send a notification email to all potential contractors with a Qualtrics survey link and due date for document submission. As part of the contract, county and tribal agencies will submit:

· Contractor (agency) name, address, staff

· Projected annual budget

· Board resolution authorizing signatures, if applicable

· Work plan

· Subcontractor information, if applicable

· Contract reviewer and signer names and email address

· Contractors are informed via email if additional information or materials are needed for process completion.

· Contract documents are reviewed by Minnesota Department of Human Services in the order received.

· Minnesota Department of Human Services will upload documents into DocuSign and send to the identified CHB or Tribe staff for review and signature after Minnesota Department of Human Services has approved all documents

· If a budget is revised after a contract has already been signed and before the contract period begins, the updated forms require signatures

· Contracts must be finalized and signed by both the Contractor and Minnesota Department of Human Services no later than December 31 of each calendar year

· Contract work cannot begin, per state law, until a signed contract is in place. Contracts that are not signed by all parties by December 31 are prorated according to the actual term of the contract, and billing cannot begin until the date of signature.

· Each contractor will receive a final signed copy of the contract.

Contract Amendment Process for Counties and Tribal Agencies

A contract amendment is a written, unilateral or mutually agreed upon change to a contract and may introduce or cancel specifications or terms of an existing contract while leaving its overall purpose and effect intact. A contract amendment must be processed any time a change needs to be made to the language of an existing contract which includes a budget update. The amendment must meet the same legal requirements as the original contract.

To initiate a contract amendment during the normal contract cycle, Minnesota Department of Human Services follows the amendment process. To initiate a contract amendment at other times, the Contractor must submit a request to Minnesota Department of Human Services who will make the final determination whether an amendment is required. If required, Minnesota Department of Human Services will develop the document and utilize DocuSign for review and signatures. Minnesota Department of Human Services will provide a fully signed copy of the contract amendment to the contractor.

Subcontracting Process for Counties and Tribal Agencies

A subcontract is a contract between the original contractor and a third party that assigns part of the performance of the original contract to the third party. CHBs or Tribes are allowed to subcontract portions of their work to other entities or qualified people to improve or expand the provision of outreach. The subcontracting option gives greater flexibility to pursue creative ways to use available administrative service funds. A CHB or Tribe wishing to enter a subcontract must provide this information when filling out the contract or amendment Qualtrics survey.

Annual Budgets for Counties and Tribal Agencies

Budgets are determined by the number of estimated eligible children by county or tribe of residence or financial responsibility as found in Appendix A or A1 tabs of the budget spreadsheet. The budget spreadsheet is sent to contractors at the beginning of each contract and amendment cycle.

· Multiply the total eligible child number by $26.50 to determine the amount available

· CHBs or Tribes should budget for the full available amount to reach maximum program participation

· All equipment purchases require prior Minnesota Department of Human Services approval regardless of projected amount of purchase and must demonstrate cost effectiveness of the purchase. Equipment and other items purchased must be used solely for the program or the cost must be prorated among programs sharing the equipment

· Equipment purchases include items such as computers, printers, laptops, headsets and office furniture. Clinic equipment is not included because checkups are part of direct services – not administrative services. Administrative services funding may only support outreach and follow-up activities

· Up to 10% or $10,000, whichever is less, of the total budget may be moved to other line items within the budget without prior DHS approval. Exception: Equipment purchase

Equipment Purchase Process for Counties and Tribal Agencies

To request approval, complete the request on the C&TC SharePoint site with the following information:

· Name of equipment

· Purpose and justification of purchase

· Program use percentage/cost allocation

· New or replacement equipment

· Total estimated cost, including shipping and handling and tax as applicable

· Indicate if a budget revision is needed and attach the spreadsheet

Follow the preceding guidelines for computer or other technological requests and:

· Identify whether it is a replacement purchase or in addition to current computer needs

· Include specifications and any other pertinent information

Minnesota Department of Human Services will review and either approve or request additional information for clarification.

Budget Revisions for County and Tribal Agencies

All budget revisions exceeding 10% of the total budget or $10,000, whichever is less, of the total approved budget require Minnesota Department of Human Services approval. To request approval, complete the request on the C&TC SharePoint site with the following information:

· Tribal or CHB name

· Reason for program pivot

· Justification

· Total dollar amount that will be moved

· Attach the current year Excel budget spreadsheet with identified adjustments

· Adjust all totals in revised budget, where necessary, including adjustments to indirect cost

· Budget changes should be made in red font. A multi-county CHB should submit a revised CHB budget, not a revised individual county budget

Minnesota Department of Human Services will review and either approve or request additional information for clarification.

Eligible Providers

The following providers may have a contract for C&TC administrative services through Minnesota Department of Human Services.

· County community health boards (CHBs)

· Tribal governments

Every contracted county, Tribe, and IHP has a specific coordinator assigned to their agency. Refer to Child and Teen Checkups County and Tribe Contact List (DHS-7927) (PDF).

Eligible Members

People covered by Medical Assistance under age 21. Managed care members may receive outreach from their managed care plan as well as their local Tribal, CHB, or medical clinic.

Covered Services

Coordinators:

· Inform enrolled children and families of the benefits of the C&TC program

· Send reminders when children are due for age-related screenings

· Assist families needing help with transportation, interpreters, and scheduling appointments

· Complete outreach with provider clinics to:

· Promote C&TC

· Encourage compliance with program requirements

· May receive notification of a referral because of a C&TC screening visit

· Assist with clinic and provider training needs

Billing for County and Tribal Agencies

Contracted county and tribes can refer to the 837P professional Basic Instructions MN–ITS user manual to bill for C&TC administrative services.

· Use the NPI or UMPI number assigned to your C&TC Administrative Services program to bill and be reimbursed for services. Contact MHCP if the 10-digit NPI or UMPI number changes during the contract period for any reason

· Contractors are responsible for certifying the performed duties are accurate

· Contractors must bill for actual expenditures of provided services as written in the contract

· Any unused portion of the contract amount will not be carried over to the following year

· Contract funds are not to be used for purposes other than those specified in the contract

· Bill HCPCS code X5623 for C&TC administrative services

· Include the MHCP-created generic PMI when billing for C&TC administrative services. Email Minnesota Department of Human Services at dhs.childteencheckups@state.mn.us if you have questions about a PMI

Bill up to the approved current year contract funding amount for actual services provided. Unused contract funds cannot be carried over from one budget year to another. It is important to maximize available funds each budget year to reach program goals.

Claims may be submitted up to one year from the date of service; however, contractors are strongly encouraged to bill Minnesota Department of Human Services for administrative services monthly basis or quarterly.

Claims can only be paid up to the approved contract amount. Expenditures that exceed the available contract amount should be recorded on the annual expenditure report (Appendix G). Administrative services funding must only be used to support outreach and follow-up activities.

Administrative outreach and follow-up services are different than direct care services and are billed separately.

Legal References

Minnesota Statutes, 256B.0625, subdivision 58 (Early and Periodic Screening, Diagnosis, and Treatment Services)