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Item C21BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 10-21-2009 Bulk Item: -Yes_ Division: _County Administrator. Department Soci-al-Servioe&/1n-Home-Services_ Staff Contact Person/Phone #: Sheryl Graham/X4510 AGENDA ITEM WORDING: Approval of Amendment 003 to the Community Care for the Elderly (CCE) Contract KC-971 between the Alliance for Aging, Inc. (Area Agency on Aging) and the Monroe County Board of Commissioners (Social Services/In-Home Services) for fiscal year 7/l/09 to 6/30/10. ITEM BACKGROUND: Approval of Amendment #003 to the CCE Contract will revise and replace Attachment III of the original contract KC 971 regarding Referral Protocol PREVIOUS RELEVANT BOCC ACTION: Prior approval granted for Amendment #001 to CCE Contract #KC-971 on 7-15-09. CONTRACT/AGREEMENT CHANGES: To revise and replace Attachment III of the original contract KC 971 regarding Referral Protocol, relating to issue, policy and purpose. STAFF RECOMMENDATIONS: Approval TOTAL COST: $494,520.00 INDIRECT COST: _-0-_BUDGETED: Yes X No _ COST TO COUNTY: Inkind (Space) Match of $22,201.00 SOURCE OF FUNDS: Grants No Cash Match is Required- an Inkind(Space) Match of $22,201.00 and co -Payment Match of $22,305.00 will be used for the $44,506.00 Total Match Commitment. REVENUE PRODUCING: Yes X No _ AMOUNT PER MONTH approx. $2,500.00 Year approx. $30,000.00 APPROVED BY: County Atty X OMB/Purchasing X Risk Management _X_ DOCUMENTATION: DISPOSITION: Revised 1 /09 Included X Not Required AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMN ARY Contract with: Alliance for Aging, Inc. Contract Amendment 003 to contract # KC- 971 Effective Date: July 1, 2009 Expiration Date: June 30, 2010 Contract Purpose/Description: Approval of Amendment 003 to the CCE Contract #KC-971 will revise and replace Attachment III regarding Referral Protocol, relating to issue, policy and purpose. Contract Manager: Sheryl Graham 4510 Social Services/Stop 1 (Name) (Ext.) (Department/Stop #) For BOCC meeting on 10/21/2009 Agenda Deadline: 10/6/2009 CONTRACT COSTS Total Dollar Value of Contract: $494,520.00 Budgeted? Yes X No Account Codes: Grant:$494,520.00 (Fiscal Year) County Match: (Required) Inkind Match of $22,201.00 and Client Co -Pay Match of $22,305.00 will be used for the $44,506.00 Total Match Commitment Estimated Ongoing Costs: $ (Not included in dollar value above) /yr Current Year Portion: $_ 125-6153809 - ADDITIONAL COSTS For: itilities, janitorial, salaries, etc) CONTRACT REVIEW Division Director Date In /0/1 101 Changes Nee Yes No Date Out Reviewe `J Risk Man ement OM.B./P Ching County Attorney �' 10 I 1 t c j �r `()C\ Yes Now Yes No Yes ( `1 Comments: OMB Form Revised 2/27/01 MCP #2 Amendment 003 CONTRACT KC 971 Page 1 THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred to as the "Alliance", and Monroe County Board of Commissioners. The -purpose of�thi& amendment is -to -revise -and replace -attachment Hl-of the-originaV— -- contract to read: REFERRAL PROTOCOL Issue: Screening, Triage, and Referral for Activation under the Community Care for the Elderly/Home Care for the Elderly Programs and for the Aging & Disabled Adults and the Assisted Living for the Elderly Medicaid Waivers. Policy: Referrals will be based on availability of funds, in accordance with prioritization requirements. Purpose: To ensure funding is spent expeditiously and consumers are referred into programs for appropriate services. Procedure for Monroe County: Roles and Responsibilities A. Alliance for Aging / Aging Resource Center ➢ Monitors overall program and Lead Agency specific spending levels on a monthly basis to ensure the Lead Agency is operating within the funding allocation. ➢ Determines the number of cases for activation based on projected funding available. ➢ Screens consumers to link with appropriate resources and prioritize for DOEA-funded programs and services. ➢ Recommends potential cases for activation based upon projected funding available by Lead Agency. ➢ Selects consumers from the waiting list based on their prioritization score. ➢ Refers consumers from the waiting list to the Lead Agency in Monroe County for activation, based on availability of funds. ➢ Monitors compliance with service standards and outcome measures. ➢ Reviews care plans and files per the File Review Policies and Procedures. ➢ Reviews data in CIRTS. B. Case Management Agency ➢ Accepts referrals from the Aging Resource Center. ➢ Refers inquiries from consumers interested in services to the ARC for Information and Referral to community resources, Screening, Triage, and Long -Term Care Options Counseling, as appropriate. ➢ Through outsourcing, the functions of Screening and Intake may also be completed by the Lead Agency. ➢ Completes comprehensive assessments on new consumers and annual reassessment on existing consumers and develops care plans and reviews care plans semi-annually. ➢ Authorizes service delivery and enters data into CIRTS. ➢ Screens consumers for Medicaid Waiver eligibility. ➢ Bills in CIRTS and Medicaid as appropriate. ➢ Monitors care plans in an effort to keep costs down while sustaining the individuals in the community. II. Management of the Assessed Prioritized Consumer List (APCL). Amendment 003 CONTRACT KC 971 Page 2 A. Referrals to the ARC are routed to the Information and Referral Specialists or Intake Unit staff depending on the type of referral. Clients are provided information on community resources and programs available including private pay options. Persons are directed to those resources most capable of meeting the need they --have-expressed-to-ARC-staff. - -Cases-presenting strong- identifiers--that--indicate the - consumer might benefit from publicly funded long term care services are screened, entered into CIRTS, triaged and provided options counseling. Through outsourcing, the functions of Screening and Intake may also be performed by the Lead Agency. DOEA prioritization requirements will be adhered to by both entities, as follows: APS High Risk Referrals (See section B) 2. Imminent Risk cases will be prioritized for activation after APS High Risk Referrals have been served. If budgetary constraints prevent opening new cases, clients will be placed on the APCL. ARC staff will contact the client on a monthly basis to determine if there has been a change in the client's situation. 3. All other CARES referrals will be screened and prioritized in accordance with DOEA requirements. 4. Aging Out consumers will be referred by DCF for prioritization and/or activation in the corresponding aged program managed by the Alliance, as appropriate (See section IV). 5. Consumers applying for the Community Care for the Elderly (CCE) and/or Home Care for the Elderly (HCE) programs will be contacted and screened using the statewide assessment form developed by the Department of Elder Affairs for this purpose (Form 701A). If a consumer is being served through a DOEA-funded agency which enters their annual assessment into CIRTS, the Priority Score generated by that assessment will determine their ranking on the APCL. 6. Consumers referred for inclusion under the Assisted Living for the Elderly (ALE) Medicaid Waiver APCL will be interviewed and screened using the 701 A form. 7. Consumers referred for inclusion under the Aging and Disabled Adult (ADA) Medicaid Waiver APCL will be contacted and screened following the same procedure as the one described under Section 5. Individuals who appear as potentially eligible for other types of public assistance will be referred to the Economic Self -Sufficiency Unit at the Department of Children and Families. 8. All other referrals will be waitlisted and prioritized, during which time other community resources will be researched, including private pay/fee for services providers. Consumers on the waiting lists will be reassessed according to Department requirements (NOI #062906-1-1-OVCS 6/29/2006). B. HIPAA forms will be sent to the consumer as appropriate. Amendment 003 CONTRACT KC 971 III. Opening New Cases A. CCE/ADA/ALE/HCE Clients Page 3 The Fiscal Department will monitor Lead Agency specific spending levels on a monthly basis to ensure each Lead Agency is operating within its quarterly funding allocation and/or spending authority. In addition, the department will do cost projections, and share the information with the Surplus/Deficit review committee to determine slot availability. The ARC and the Quality Assurance Department will be notified when funding is available and the number of new cases to be activated by Lead Agency. 2. Upon notification from the Vice President for Finance of funding availability, the Aging Resource Center Intake Unit Supervisor will run the Prioritized Risk Report to identify the consumers on the APCL to be opened. 3. Based on available funding, the ARC Intake Unit Supervisor will refer wait listed clients to the Lead Agency for activation, in accordance with prioritization requirements. The Lead Agency will update the wait list enrollment using the appropriate code to terminate from the APCL. B. APS Referrals 1. APS Low and Intermediate Risk referrals will be screened and prioritized for services as per the DOEA/APS Memorandum of Understanding. Low and Intermediate Risk referrals are also offered information and referral to additional community resources, including private pay as appropriate. 2. APS High Risk Referrals are not waitlisted. They are immediately referred for service from DCF in Monroe County to the Lead Agency. ARTT referrals will be forwarded directly the Lead Agency. APS cases are to be served for a maximum of 31 calendar days. If additional time is justified, the case management agency will staff the case with the Alliance to obtain the extension needed. 3. Upon receipt of the APS referral, the Lead Agency will coordinate services to begin within the 72 hour period mandated by statute. A comprehensive assessment will be done within 72 hours of the referral. Services required under the care plan will remain in place for a maximum of 31 days, unless an extension has been granted. 4. The Lead Agency will enter ACTV enrollment under their provider number in CIRTS. In addition, service codes will be entered by service date for all services provided. If a service(s) is not provided as required under the care plan, an NDP code will need to be entered in CIRTS and the case notes under the client file should document the reason for non -delivery of such service(s). IV. Aging Out Consumers: A. All "Aging Out" consumers will be referred by DCF for activation in the corresponding aged program managed by the Alliance. Amendment 003 CONTRACT KC 971 Page 4 B. Consumers active in the CCDA and HCDA programs that are turning 60 and are eligible for CCE and/or HCE will be opened in the corresponding aged program managed by the Alliance if funding is available. If funding is available, these -- ---cons=ers-wM l-be-made-active.-if-funding-is-not-anailabte;11W wiH-tip-waitfisted for these programs but will be given priority for activation once funding is available. C. Consumers active in the ADA Medicaid Waiver, upon turning age 60, will continue to be eligible for and receive ADA Medicaid waiver services. METHOD OF PAYMENT: This amendment shall begin on July 1, 2009 or the date it has been signed by both parties, whichever is earlier. All provisions in the contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the contract are hereby amended to conform with this amendment. This amendment and all its attachments are hereby made a part of the contract. This amendment and all its attachments are hereby made a part of the contract. IN WITNESS WHEREOF, the parties hereto have caused this 1-page amendment to be executed by their undersigned officials as duly authorized. PROVIDER: Monroe County Board of Commissioners. SIGNED BY: NAME: TITLE: DATE: ALLIANCE FOR AGING, INC. SIGNED BY: Max B. Rothman, JD, LL.M. NAME: President & CEO TITLE: DATE: PROVE—D AS PEDRO J. MFRCA, ��� SSISTANT C0 T `r AT"i 11r_iw )Y Date Amendment 001 CONTRACT KC 971 Page 1 THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred to as the "Alliance", and Monroe County Board of Commissioners. The purpose of this amendment is to decrease the amount under contract by $ 8,824 from $503,344 to $ 494,520. The provider must adjust the Unit Cost Methodology to take this decrease in funding into account. METHOD OF PAYMENT: 1. This amendment shall begin on July 1, 2009 or the date it has been signed by both parties, whichever is earlier. All provisions in the contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the contract are hereby amended to conform with this amendment. This amendment and all its attachments are hereby made a part of the contract. This amendment and all its attachments are hereby made a part of the contract. IN WITNESS WHEREOF, the parties hereto have caused this 1-page amendment to be executed by their undersigned officials as duly authorized. PROVIDER: SIGNED BY: NAME: TITLE: DATE: Monroe County Board of Commissioners. George Neugent Mayor July 15, 2009 SIGNED BY: NAME: TITLE: DATE: RUNTY A TG AS 7 . OU TY,4 CRh'EY ALLIANCE FOR AGING, INC. Max B. Rothman, JD, LL.M. President & CEO