Item C29
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Louis laTorre, Senior Director
Social Service:;.fdrli
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
DIVISION: COMMUNITY SERVICES / J-
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DEPARTMENT: SOCIAL SERVICES ;. ~
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AGE.NDA ITEM WORDING: Approval of the Home Care for the Elderly (HCE) Contract #KH 572 between
the A...lliancc for Aging, h1C, and the Monroe COWlty Board of County Commissioners (Monroe County Social
Servi ccslIn-Home Services Program) for Fiscal Year July 1,2005 through June 30,2006.
lTE~1 BACKGROUND: The approval of the HCE Contact will enable Monroe County In-Home Services
to continue providing services to the caregiver's of Monroe County's elderly population under the Home Care
for t!\c Elderly (RCE) program.
MEgTING DATE: 6-15-2005
BULK ITEM:
YES_X_
NO
PREVIOUS REIJEV ANT ROCC ACTION: June 162004.
CON'rRACT/AGREEMENT CHANGES:. .... NiA
STAI<t< RECOMMENDATJUN: Approval
BUDGETED: YES---X- NO
SOURCE OF FUNDS: Home Care for the
Elderly Contract for $3,637.00
TOT AL COST: $3,637.00 Case Management Only
COST TO COUNTY: Required $405.00
Additional $890.00
Total Combined Match $1,295.00
REVENV}: PRODUCING: YES_ NO~ AMT.PER MO~lH
YEAR
APPROVED BY: COUNTY ATIY,l OMBlPurchasing _];;~ RISK MANAGEMENT .-X
OIVISJON 01 RECTOR APPROVAL: ~AA~
() JAMES MAllOCH '-
DOCUMEl'iA TION: INCUJDED.....1L- TO FOLLOW ~~~ NOT REQUIRED_
DISPOSITION:
AGENDA ITEM#:
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MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, rnc. Contract
Effective Date: July 1,2005
Expiration Date: June 30, 2006
Contract Purpose/Description: Approval of the Home Care for the Elderly (fleE) Contract #KH 572 bel:ween the
Alliance for Aging, Inc, and the Monroe County Board of County Commissioners (Monroe County Social
Sc:rvlcesim-Home Services Program) for Fiscal Year July), 2005 through June 30, 2006.
/ ,,/ /;7
Contract Manager: Deloris Simpson /y'tY/-;;ff? / - 4589 Social Services/Stop 1
(Name) r;:::;//' (Ext.) (Department/Stop #)
For BOCC meeting on 6/1512005
Agenda Deadline:
5/3 112005
CONTRACI' COSTS
Total Dollar Value of Contract: $ 3,637.00
Budgeted? Yes X No Account Codes:
Grant: S 3,637.00
County Match: $405.00 (Case Management Only)Required.
Additional Match $890,00 Total
Match $1,295.00
Current Y car PortIOn: S
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Estimated Ongoing Costs: $___.~yr
(Not ",eluded III dollar value above)
ADDITIONAL COSTS
For:
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CONTRACT REVIEW
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07/01/2005
Contract Number KH 572
HOME CARE FOR THE ELDERLY CONTRACT
2005-2006
THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as
the "Alliance", and the Monroe County Board of Commissioners, hereinafter referred to as
the "recipient". This contract is subject to all provisions contained in the MASTER
AGREEMENT executed between the Alliance and the recipient, Agreement No. PA429, and its
successor, incorporated herein by reference.
The parties agree:
I. Recipient Agrees:
A. Services to be Provided:
To plan, develop, and accomplish the services delineated, or otherwise cause the
planning, development, and accomplishment of such services and activities, under the
conditions specified and in the manner prescribed in Attachment I of this agreement.
B. Requirements of Section 287.058. Florida Statutes:
These requirements are herein incorporated by reference.
C. Final Request for Payment:
1. The recipient must submit the final request for payment to the Alliance no later than
September 15, 2006; if the recipient fails to do so. all right to payment is
forfeited. and the Alliance will not honor any requests submitted after the
aforesaid time period.
2. If the contract is terminated prior to the contract end date of September 30, 2006,
then the recipient must submit the final request for payment to the Alliance no more
than 45 days after the contract is terminated; if the recipient fails to do so. all
right to payment is forfeited, and the Alliance will not honor any requests
submitted after the aforesaid time period.
II. The Alliance Agrees:
Contract Amount:
To pay for contracted services according to the conditions of Attachment I in an amount
not to exceed $51,544.00, subject to the availability of funds. The Alliance's performance
and obligation to pay under this contract is contingent upon an annual appropriation by the
Legislature. The costs of services paid under any other contract or from any other source
are not eligible for reimbursement under this contract. The funds awarded to the recipient
pursuant to this contract are in the state grants and aids appropriations and consists of the
following:
07/01/2005
Contract Number KH 572
Program Title Year Funding Source CSFA# Fund Amounts
Home Care for the Elderly 2005 General Revenue 65001 $51,544.00
TOTAL FUNDS CONTAINED IN THIS CONTRACT: $51,544.00
III. Recipient and Alliance Mutually Agree:
A. Effective Date:
1. This contract shalf begin on July 1, 2005 or on the date the contract has been
signed by both parties, whichever is later.
2. Delivery of services shall end on June 30, 2006 This contract shall end on
September 30,2006. See Attachment I, Section 111.0.
B. Termination, Suspension, and/or Enforcement:
The causes and remedies for termination or suspension of this contract shall follow the
same procedures as outlined in Section 111. B. and Section III. C. of the Master
Agreement
C. Recipient Responsibility:
Notwithstanding the pass through language contained in Section I.S.1. of the Master
Agreement, the recipient maintains responsibility for the performance of all sub
recipients in accordance with all applicable federal and state laws.
D. Notice, Contact, and Payee Information:
1. The name, address, and telephone number of the contract manager for the Alliance
for this contract is:
Steven Weisberg
9500 South Oadeland Boulevard, Suite 400
Miami, Florida 33156
(305) 679-6500 SC 455-6500
2. The name, address, and telephone number of the representative of the recipient
responsible for administration of the program under this contact is:
Louis LaTorre
Gato Building - 1100 Simonton Street
Key West, Florida 33040
(305) 292-4573
2
07/01/2005
Contract Number KH 572
3. In the event different representatives are designated by either party after execution
of this contract, notice of the name and address of the new representative will be
rendered in writing to the other party and said notification attached to originals of
this contract.
4. The name (recipient name as shown on page 1 of this contract) and mailing
address of the official payee to whom the payment shall be made:
Monroe County Board of Commissioners
Gato Building - 1100 Simonton Street
Key West, Florida 33040
IN WITNESS THEREOF, the parties hereto have caused this 9-page contract to be executed
by their undersigned officials as duly authorized.
PROVIDER:
MONROE COUNTY BOARD
OF COMMISSIONERS
ALLIANCE FOR AGING, INC.
FOR DADE & MONROE COUNTIES
BOARD PRESIDENT OR AUTHORIZED DESIGNEE
SIGNED BY:
SIGNED BY:
NAME:
NAME:
Steven Weisberg, M. S.
TITLE:
TITLE:
President & CEO
DATE:
DATE:
FEDERAL 10 NUMBER:
PROVIDER FISCAL YEAR ENDING DATE:
59-6000749
09/30
3
07/01/2005
Contract Number KH 572
ATTACHMENT I
HOME CARE FOR THE ELDERLY PROGRAM
I. STATEMENT OF PURPOSE
The Home Care for the Elderly (HCE) Program encourages the provision of care in family-
type living arrangements in private homes on a not for profit basis as an alternative to
nursing home or other institutional care.
II. SERVICES TO BE PROVIDED
A. Services:
1. The recipient's service provider application for state fiscal year 2005, and any
revisions thereto approved by the Alliance and located in the contract manager's
file, are incorporated by reference in this contract between the Alliance and the
recipient, and prescribe the services to be rendered by the recipient
2. Consumers may not be enrolled in a Department of Elder Affairs' state general
revenue funded program, including HCE, who are also enrolled in a Medicaid
capitated long term care health plan or program. These programs include the Frail
Elder Program operated by United Health Care, the Channeling Program operated
by Miami Jewish Home and Hospital for the Aged, the Long Term Care Community
Diversion Program operating in Planning and Service Areas 7 and 9, and the
Program of All Inclusive Care for the Elderly (PACE) program scheduled to begin
operation in the Miami-Dade County area.
B. Manner of Service Provision:
The services will be provided in a manner consistent with and described in the
recipient's service provider application for state fiscal year 2005 and the Department of
Elder Affairs Client Home And Community Based Services Handbook dated 01/03 In
the event the manual is revised, such revision will automatically be incorporated into
the contract and the recipient will be given a copy of the revisions.
III. METHOD OF PAYMENT
A. The method of payment in this contract is based on a fixed rate reimbursement for
approved services. The recipient must ensure fixed rates include only those costs which
are in accordance with all applicable state and federal statutes and regulations and are
based on audited historical costs in instances where an independent audit is required.
All requests for payment and expenditure reports submitted to support requests for
payment shall be on DOEA forms 106H and 105H. Duplication or replication of both
forms via data processing equipment is permissible, provided all data elements are in
the same format as included on department forms.
4
07/01/2005
Contract Number KH 572
B. The recipient shall maintain documentation to support payment requests which shall be
available to the Comptroller, the Department of Elder Affairs, or the Alliance upon
request.
C. The recipient may request a monthly advance for service costs for each of the first
three months of the contract period, based on anticipated cash needs. Detailed
documentation justifying cash needs for advances must be submitted with the signed
contract, approved by the Alliance, and maintained in the contract manager's file. All
payment requests for the fourth through the twelfth months shall be based on the
submission of monthly actual expenditure reports beginning with the first month of the
contract. The schedule for submission of advance requests is ATTACHMENT II to this
contract. Reconciliation and recouping of advances made under this contract are to be
completed by the time the final payment is made. All advance payments are subject to
the availability of funds.
D. Advance funds may be temporarily invested by the recipient in an insured interest
bearing account. All interest earned on contract fund advances must be returned to the
Alliance at the end of the first quarter of the contract period.
E. The Alliance shall make payment to the provider for provision of services up to a
maximum number of units of service and at the rate(s) stated beiow:
Service Unit of Unit Rate Maximum Maximum
to be Service Units Dollars
provided
Case Management 1 hour $47.855263 76 $3,637
F. Contract Amendments:
1. The recipient agrees to implement the distribution of funds as detailed in the service
provider application and the Budget Summary, ATTACHMENT III to this contract.
A contract amendment is required to change the total amount of the contract. With
written notice to the Alliance's contract manager, funds may be moved from the
Case Management budget category to the Subsidies category. The Case
Management budget category can not be increased.
2. This contract is for services provided during the 2005/2006 State Fiscal year
beginning July 1, 2005 through June 30, 2006, however, the contract is in effect
through September 30, 2006 in order to provide for maximization of resources and
to allow for greater flexibility to pay for the services rendered by June 30, 2006.
Services provided after June 30,2006 cannot be reimbursed under this contract
3. The recipient will submit a draft closeout report by August 15, 2006. Any contract
amendments after August 15, 2006 determined necessary by the Alliance will be
based on the draft closeout reports.
k
....
07/01/2005
Contract Number KH 572
4. The final expenditure report and request for payment will be due to the Alliance no
later than September 15, 2006. No expenditure reports or requests for payment will
be accepted after September 15, 2006.
G. Any payment due by the Alliance under the terms of this contract may be withheld
pending the receipt and approval by the Alliance of all financial and programmatic
reports due from the recipient and any adjustments thereto, including any disallowance
not resolved as outlined in Section LT~ of the Master Agreement.
IV. SPECIAL PROVISIONS
A. State Laws and Regulations:
1. The recipient agrees to comply with applicable parts of Rule Chapter 58H-1, Florida
Administrative Code promulgated for administration of Sections 430.601 through
430.608, Florida Statutes, and the Department of Elder Affairs Home and
Community Based Services Handbook dated 01/03.
2. The recipient agrees to comply with the provisions of Sections 97.021 and 97.058,
Florida Statutes, and all rules related thereto in the Florida Administrative Code.
8. Assessment and Prioritization for Service Delivery for New Consumers:
The following are the criteria to prioritize new consumers for service delivery. It is not
the intent of the Department of Elder Affairs to remove existing clients from any
program in order to serve new clients being assessed and prioritized for service
delivery.
1. Priority Criteria for Service Delivery:
a) individuals in nursing homes under Medicaid who could be transferred to the
community;
b) individuals in nursing homes whose Medicare coverage is exhausted and
may be diverted to the community;
c) individuals in nursing homes which are closing or in receivership and can be
discharged to the community; or
d) individuals whose mental or physical health condition has deteriorated to the
degree self care is not possible, there is no capable caregiver and
institutional placement will occur within 72 hours.
2. Priority Criteria for Other Assessed Individuals:
The assessment and provision of services should always consider the most cost
effective means of service delivery. Functional impairment shall be determined
through the department's consumer assessment form administered to each
applicant. The most frail individuals not prioritized in the group above, regardless of
referral source, will receive services to the extent funding is available.
6
07/01/2005
Contract Number KH 572
C. Consumer Information, Registration and Tracking System (CIRTS):
1. The recipient will ensure the collection and maintenance of Home Care for the Elderly
(HCE) subsidies and case management information on a monthly basis from the
Consumer Information, Registration and Tracking System (CIRTS). Maintenance
includes valid exports and backups of all data and systems according to department
standards.
2. The recipient must ensure all data for HCE subsidies are entered in the CIRTS by the
15th of each month. HGE subsidy data entered into the GIRTS by the 15th of the
month will be for payments incurred between the 16th of the previous month and the
15th of the current month. Case management data entered into the CIRTS by the 15th
of the month will be for units of service provided during the previous month from the
16th and up to and including the 15th of the current month or case management units
of service may be entered according to the recipient schedule, in aggregate on the 31st
or daily, weekly or monthly.
3. The recipient will ensure data entry for HGE subsidies will cease on the 15th of the
month and the GIRTS Monthly Service Utilization Report, by consumer and by worker
identification is run.
4. The recipient will ensure the Monthly Utilization Report, by consumer and by worker
identification is verified, corrected, certified no later than the 20th of the month in which
the report is generated.
5. The recipient will ensure caregivers determined eligible for the HCE basic subsidy after
the 15th of a month, will be processed to begin eligibility for the HCE basic subsidy on
the 1 st day of the next month.
6. The Alliance will reconcile and verify the CIRTS data prior to payment for HCE basic
and special subsidies and case management.
7. The Alliance will reconcile and verify the CIRTS data prior to payment for HCE basic
and special subsidies and case management.
7
07/01/2005
Report
Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Leoend:
Note # 1:
Note # 2:
Contract Number KH 572
ATTACHMENT II
HOME CARE FOR THE ELDERLY PROGRAM
CONTRACT REPORT CALENDAR
Based On
July Advance * .......... .......... ............... ........... ............ .....
August Advance * ...........................................................
July Expenditure Report ....................................................
August Expenditure Report. ......... ......... ......... ............ ........
September Expenditure Report. ............. ... ......... ............ .....
October Expenditure Report ...............................................
November Expenditure Report.. ........ ......... ............ ......... ....
December Expenditure Report ............................................
January Expenditure Report....... ...... .... ...... ..... ............ ... ....
February Expenditure Report.. .................. ......... ........... .....
March Expenditure Report .................................................
April Expenditure Report ....... ................ ........... .......... .......
May Expenditure Report/July Advance Reconciliation ** ..........
June Expenditure Report/August Advance Reconciliation ** .....
Draft Closeout Report .......................................................
Final Expenditure and Request for Payment Report ................
Closeout Report ..............................................................
*
Advance based on projected cash need.
Submit
to the Alliance
Qn This Date
July 1
July 1
August 10
September 10
October 10
November 10
December 10
January 10
February 10
March 1 0
April 10
May 10
June 10
July 10
August 15
September 15
September 15
Submission of expenditure reports mayor may not generate a payment
request. If final expenditure report reflects funds due back to the Alliance,
payment is to accompany the report.
**
Report #1 for Advance Basis Contracts cannot be submitted to the Alliance
prior to July 1 or until the contract with the Alliance has been executed.
Actual submission of the vouchers to the Department of Elder Affairs is
dependent on the accuracy of the expenditure report.
The last three months of the recipient's fiscal reports covering actual
expenditures should reflect an adjustment repaying advances for the first
three months of the contract
8
07/01/2005
Contract Number KH 572
ATTACHMENT III
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
3. Total..... ........... ....... ........ ................ ..............
$ 3,637.00
$47,907.00
$51,544.00
1. Case Management..........................................
2. Subsidy Payments 1 .. n....................................
* * * * * *
j All subsidy payments are made by the Alliance, on behalf of the recipient, to eligible caregivers after proper
verification in CIRTS for any given month during which service was provided to a homebound HCE elder
consumer.
9
07/01/2004
Contract Number KH 472
HOME CARE FOR THE ELDERLY CONTRACT
2004-2005
THIS CONTRACT is entered into between the Alliance for Aging, Inc,. hereinafter referred to as
the "Alliance", and the Monroe County Board of Commissioners, hereinafter referred to as
the "recipient", This contract is subject to all provisions contained in the MASTER
AGREEMENT executed between the Alliance and the recipient. Agreement No, PA429, and its
successor, incorporated herein by reference,
The parties agree:
I. Recipient Agrees:
A. Services to be Provided:
To plan, develop, and accomplish the services delineated. or otherwise cause the
planning. development, and accomplishment of such services and activities, under the
conditions specified and in the manner prescribed in Attachment I of this agreement
B. Requirements of Section 287.058, Florida Statutes:
These requirements are herein incorporated by reference.
C. Final Request for Payment:
1. The recipient must submit the final request for payment to the Alliance no later than
September 15, 2005; if the recipient fails to do so, all right to payment is
forfeited, and the Alliance will not honor any requests submitted after the
aforesaid time period.
2. If the contract is terminated prior to the contract end date of September 30, 2005,
then the recipient must submit the final request for payment to the Alliance no more
than 45 days after the contract is terminated; if the recipient fails to do so, all
right to payment is forfeited, and the Alliance will not honor any requests
submitted after the aforesaid time period.
II. The AHiance Agrees:
Contract Amount:
To pay for contracted services according to the conditions of Attachment I in an amount
not to exceed $51,544.00, subject to the availability of funds. The Alliance's performance
and obligation to pay under this contract is contingent upon an annual appropriation by the
Legislature. The costs of services paid under any other contract or from any other source
are not eligible for reimbursement under this contract. The funds awarded to the recipient
pursuant to this contract are in the state grants and aids appropriations and consists of the
following:
1
01/01/2004
Contract Number KH 412
Program Title Year Funding Source CSFA# Fund Amounts
Home Care for the Elderlv 2004 General Revenue 65001 $51,544.00
TOTAL FUNDS CONTAINED IN THIS CONTRACT: $51,544.00
III. Recipient and Alliance Mutually Agree:
A. Effective Date:
1. This contract shall begin on July 1, 2004 or on the date the contract has been
signed by both parties, whichever is later.
2. Delivery of services shall end on June 30, 2005 This contract shall end on
September 30, 2005. See Attachment I, Section m.D.
B. Termination, Suspension, and/or Enforcement:
The causes and remedies for termination or suspension of this contract shall follow the
same procedures as outlined in Section III. B. and Section III. C. of the Master
Agreement.
C. Recipient Responsibility:
Notwithstanding the pass through language contained in Section 1.5.1. of the Master
Agreement, the recipient maintains responsibility for the performance of all sub
recipients in accordance with all applicable federal and state laws.
D. Notice, Contact, and Payee Information:
1. The name, address, and telephone number of the contract manager for the Alliance
for this contract is:
Steven Weisberg
9500 South Dadeland Boulevard, Suite 400
Miami, Florida 33156
(305) 679-6500 SC 455-6500
2. The name, address, and telephone number of the representative of the recipient
responsible for administration of the program under this contact is:
Louis LaTorre
Gata Building - 1100 Simonton Street
Key West, Florida 33040
(305) 2924573
2
07/01/2004
Contract Number KH 472
3. In the event different representatives are designated by either party after execution
of this contract, notice of the name and address of the new representative will be
rendered in writing to the other party and said notification attached to originals of
this contract.
4. The name (recipient name as shown on page 1 of this contract) and mailfng
address of the official payee to whom the payment shall be made:
Monroe County Board of Commissioners
Gato Building - 1100 Simonton Street
Key West, Florida 33040
IN WITNESS THEREOF, the parties hereto have caused this 9-page contract to be executed
by their undersigned officials as duly authorized.
PROVIDER:
MONROE COUNTY BOARD
OF COMMISSIONERS
ALLIANCE FOR AGING, INC.
FOR DADE & MONROE COUNTIES
BOARD PRESIDENT OR AUTHORIZED DESIGNEE
<-'-,~:.::>7f.,c,-;
SIGNED BY;f;::>':<:c/Z"Z,:'
~--~~:~~.~cf
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_.A "-""SIGNED
/
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NAME:
Steven Weisberg, M. S.
NAME:
Murray a./ Nelson
TITLE:
Mayor/Chairman
TITLE:
President & CEO
DATE:
June 16, 2004
DATE:
~VC6101
FEDERAL ID NUMBER:
PROVIDER FISCAL YEAR ENDING DATE:
59-6000749
09/30
3
07/01/2004
Contract Number KH 472
ATTACHMENT I
HOME CARE FOR THE ELDERLY PROGRAM
I. STATEMENT OF PURPOSE
The Home Care for the Elderly (HCE) Program encourages the provision of care in famHy-
type living arrangements in private homes on a not for profit basis as an alternative to
nursing home or other institutional care.
II. SERVICES TO BE PROVIDED
A. Services:
1. The recipient's service provider application for state fiscal year 2004, and any
revisions thereto approved by the Alliance and located in the contract manager's
file, are incorporated by reference in this contract between the Alliance and the
recipient, and prescribe the services to be rendered by the recipient
2. Consumers may not be enrolled in a Department of Elder Affairs' state general
revenue funded program, including HCE, who are also enrolled in a Medicaid
capitated long term care health plan or program. These programs include the Frail
Elder Program operated by United Health Care, the Channeling Program operated
by Miami Jewish Home and Hospital for the Aged, the Long Term Care Community
Diversion Program operating in Planning and Service Areas 7 and 9, and the
Program of All Inclusive Care for the Elderly (PACE) program scheduled to begin
operation in the Miami-Dade County area.
B. Manner of Service Provision:
The services will be provided in a manner consistent with and described in the
recipient's service provider application for state fiscal year 2004 and the Department of
Elder Affairs Client Home And Community Based Services Handbook dated 01/03 In
the event the manual is revised, such revision will automatically be incorporated into
the contract and the recipient will be given a copy of the revisions.
III. METHOD OF PAYMENT
A. The method of payment in this contract is based on a fixed rate reimbursement for
approved services. The recipient must ensure fixed rates include only those costs which
are in accordance with all applicable state and federal statutes and regulations and are
based on audited historical costs in instances where an independent audit is required.
All requests for payment and expenditure reports submitted to support requests for
payment shall be on DOEA forms 106H and 105H, Duplication or replication of both
forms via data processing equipment is permissible, provided all data elements are in
the same format as included on department forms.
4
07J01/2004
Contract Number KH 472
B. The recipient shall maintain documentation to support payment requests which shall be
available to the Comptroller, the Department of Elder Affairs, or the Alliance upon
req uest.
C. The recipient may request a monthly advance for service costs for each of the first
three months of the contract period, based on anticipated cash needs. Detailed
documentation justifying cash needs for advances must be submitted with the signed
.contract, approved by the Alliance, and maintained in the contract manager's file. All
payment requests for the fourth through the twelfth months shall be based on the
submission of monthly actual expenditure reports beginning with the first month of the
contract. The schedule for submission of advance requests is ATTACHMENT II to this
contract. Reconciliation and recouping of advances made under this contract are to be
completed by the time the final payment is made, All advance payments are subject to
the availability of funds,
D. Advance funds may be temporarily invested by the recipient in an insured interest
bearing account. All interest earned on contract fund advances must be returned to the
Alliance at the end of the first quarter of the contract period.
E. The Alliance shall make payment to the provider for provision of services up to a
maximum number of units of service and at the rate(s) stated below:
Service Unit of Unit Rate Maximum Maximum
to be Service Units Dollars
Provided
Case Management 1 hour $47,855263 76 $3,637
F. Contract Amendments:
1. The recipient agrees to implement the distribution of funds as detailed in the service
provider application and the Budget Summary, ATTACHMENT III to this contract.
A contract amendment is required to change the total amount of the contract. With
written notice to the Alliance's contract manager, funds may be moved from the
Case Management budget category to the Subsidies category, The Case
Management budget category can not be increased.
2. This contract is for services provided during the 2004/2005 State Fiscal year
beginning July 1, 2004 through June 30, 2005, however, the contract is in effect
through September 30, 2005 in order to provide for maximization of resources and
to allow for greater flexibility to pay for the services rendered by June 30, 2005.
Services provided after June 30, 2005 cannot be reimbursed under this contract.
3, The recipient will submit a draft closeout report by August 15, 2005. Any contract
amendments after August 15, 2005 determined necessary by the Alliance will be
based on the draft closeout reports.
5
01/01/2004
Contract Number KH 472
4. The final expenditure report and request for payment will be due to the Alliance no
later than September 15, 2005. No expenditure reports or requests for payment will
be accepted after September 15, 2005.
G. Any payment due by the Alliance under the terms of this contract may be withheld
pending the receipt and approval by the Alliance of all financial and programmatic
reports due from the recipient and any adjustments thereto, including any disallowance
not resolved as outlined in Section I.T. of the Master Agreement
IV. SPECIAL PROVISIONS
A. State Laws and Regulations:
1. The recipient agrees to comply with applicable parts of Rule Chapter 58H-1, Florida
Administrative Code promulgated for administration of Sections 430.601 through
430.608, Florida Statutes, and the Department of Elder Affairs Home and
Community Based Services Handbook dated 01/03.
2. The recipient agrees to comply with the provisions of Sections 97.021 and 97.058,
Florida Statutes, and all rules related thereto in the Florida Administrative Code.
B. Assessment and Prioritization for Service Delivery for New Consumers:
The following are the criteria to prioritize new consumers for service delivery. It is not
the intent of the Department of Elder Affairs to remove existing clients from any
program in order to serve new clients being assessed and prioritized for service
delivery.
1, Priority Criteria for Service Delivery:
a) individuals in nursing homes under Medicaid who could be transferred to the
community;
b) individuals in nursing homes whose Medicare coverage is exhausted and
may be diverted to the community;
c) individuals in nursing homes which are closing or in receivership and can be
discharged to the community; or
d) individuals whose mental or physical health condition has deteriorated to the
degree self care is not possible, there is no capable caregiver and
institutional placement will occur within 72 hours.
2. Priority Criteria for Other Assessed Individuals:
The assessment and provision of services should always consider the most cost
effective means of service delivery. Functional impairment shall be determined
through the department's consumer assessment form administered to each
applicant The most frail individuals not prioritized in the group above, regardless of
referral source, will receive services to the extent funding is availableo
6
07/01/2004
Contract Number KH 472
C. Consumer Information, Registration and Tracking System (CIRTS):
1. The recipient will ensure the collection and maintenance of Home Care for the Elderly
(HCE) subsidies and case management information on a monthly basis from the
Consumer Information, Registration and Tracking System (CIRTS). Maintenance
includes valid exports and backups of aU data and systems according to department
standards.
2. The recipient must ensure all data for HCE subsidies are entered in the CIRTS by the
15th of each month. HGE subsidy data entered into the GIRTS by the 15th of the
month will be for payments incurred between the 16th of the previous month and the
15th of the current month. Case management data entered into the GIRTS by the 15th
of the month will be for units of service provided during the previous month from the
16th and up to and including the 15th of the current month or case management units
of service may be entered according to the recipient schedule, in aggregate on the 31st
or daily, weekly or monthly.
3. The recipient will ensure data entry for HCE subsidies will cease on the 15th of the
month and the CIRTS Monthly Service Utilization Report, by consumer and by worker
identification is fun.
4. The recipient will ensure the Monthly Utilization Report, by consumer and by worker
identification is verified, corrected, certified no later than the 20th of the month in which
the report is generated.
5. The recipient will ensure caregivers determined eligible for the HCE basic subsidy after
the 15th of a month, will be processed to begin eligibility for the HGE basic subsidy on
the 1 st day of the next month.
6. The Alliance will reconcile and verify the GIRTS data prior to payment for HCE basic
and special subsidies and case management.
7. The Alliance will reconcile and verify the CIRTS data prior to payment for HCE basic
and special subsidies and case management
7
/2004
Report
I';itlmber
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]",egend:
Note # 1:
Note # 2:
Contract Number KH 472
ATTACHMENT II
HOME CARE FOR THE ELDERLY PROGRAM
CONTRACT REPORT CALENDAR
~~sed QU
July Advance * .. ................. ......... .,. ................... ... ...... ....
August Advance * ...........................................................
July Expenditure Report............. w....................................
August Expenditure Report ................................................
September Expenditure Report ...........................................
October Expenditure Report ...............................................
November Expenditure Report ............................................
December Expenditure Report.....".................. .. .. . ... .. .. .. . . ...
January Expenditure Report.......... .... ..... . ........ .. ... .. ... . .. .. ....
February Expenditure Report........................... .. ......... .......
March Expenditure Report .... .......... ..' ..... ......... ...... .., .........
April Expenditure Report.. ........ ............... .......... .... ..... .......
May Expend iture Report/July Advance Reconciliation ** ..........
June Expenditure Report/August Advance Reconciliation ** .....
Draft Closeout Report .......................................................
Final Expenditure and Request for Payment Report................
Closeout Report .... ...... ...... .......... ..... ....... ........ ... .... ...... ."
'*
Advance based on projected cash need.
Submit
to the Alliance
Q.n This DiJ~
July 1
July 1
August 10
September 10
October 10
November 10
December 10
January 10
February 10
March 10
April 10
May 10
June 10
July 10
August 15
September 15
September 15
submission of expenditure reports mayor may not generate a payment
request. If final expenditure report reflects funds due back to the Alliance,
payment is to accompany the report.
**
Report #1 for Advance Basis Contracts cannot be submitted to the Alliance
prior to July 1 or unUl the contract with the Alliance has been executed.
Actual submission of the vouchers to the Department of Elder Affairs is
dependent on the accuracy of the expenditure report.
The last three months of the recipient's fiscal reports covering actual
expenditures should reflect an adjustment repaying advances for the first
three months of the contract.
8
3. Total........ .... ..... ...... ........ ...... .......... ." ........ ..'
$ 3,637.00
$47,907.00
$51.544.00
07101/2004
Contract Number KH 472
ATTACHMENT III
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
1. Case Management..........................................
2. Subsidy Payments 1 ..............................".........
* * * * * *
1 All subsidy payments are made by the Alliance, on behalf of the recipient, to eligible caregivers after proper
verification in CIRTS for any given month during which service was provided to a homebound HCE elder
consumer.
9