07/21/1999
MEMORANDUM OF AGREEMENT
BETWEEN
THE ALLIANCE FOR AGING, INC.
AND
MONROE COUNTY SOCIAL SERVICES
PERTAINING TO
HOME CARE FOR THE ELDERLY PROGRAM SPENDING AUTHORITY FOR 1998-99
This Memorandum of Agreement outlines the Home Care for the Elderly Subsidy Payment spending authority
for Monroe County Social Services, hereinafter referred to as the "Provider", for 1999-00 and details the responsibilities
and the expectations associated with this authority.
1. The Alliance For Aging has determined the total amount of Horne Care for the Elderly subsidy payments available
to each Lead Agency within Planning and Service Area (PSA) 11 based on each county's proportion of the clients
enrolled in the Horne Care for the Elderly Program as of June I, 1999.
2. The 1999-00 Horne Care for the Elderly Subsidy Payment spending authority for the Provider is $31,472.00. Under
no circumstances must the Provider exceed the alloalted spending autllority limits. To that effect, the Provider
agrees to do the following:
a. The Provider will establish, house and maintain a client voucher file for each client enrolled in the HCE
Program. Client voucher files shall be intended to establish a proper audit trail of services authorized and
provided to clients enrolled in the HCE program.
b. Client voucher files will colltain a separate SB'Vice payment/uti/ivltion record (DOEA Form 133) for each
month that the client is enrolled in the HCE program. DOEA Form 133 establishes a payment trail, by
client, of services authorized for payment. It further serves as the instrument for data entry of service
utilization information in the Client Information, Registration and Tracking System (CIRTS).
c. All items/services purchased by a caregiver in support of a client shall require prior authorization from the
case manager who shall so indicate in the client care plan/case record. A receipt, signed by the caregiver,
must be presented to the case manager and attached to DOEA Form 133 in order to authorize payment.
Receipts for all authorized items/services must be present in the client voucher file in support of all caregiver
reimbursements.
d. For services provided by vendors, including the Lead Agency, case managers will be responsible for
indicating the Provider IDlLocation Code and Service Type on OOEA Form 133. Service payment amount
information shall be entered on DOEA Form 133 by the Lead Agency utilizing vendor invoices which clearly
indicate the client served, services received, date of service and payment information. Prior authorization
by the case manager is required before a service is received. The authorization for the client to receive these
services shall be the case manager's entry into the client care plan/case record as well as the case manager's
entry on DOEA Form 133 to indicate Provider ID/Location, Service Code and payment information.
e. The Provider will enter all data for HCE Basic and Special Subsidies in CIRTS by the 15th of each month
for payments incurred between the 16th of the previous month and the 15th of the current month.
MEMORANDUM OF AGREEMENT
Monroe County Social Services
& The Alliance For Aging
Page Two
f. The Provider will run a CIRTS Monthly Utilization Report. The Provider wili verify, correct and certify the
Monthly Utilization Report and submit this report to the Alliance by the 20th of the month in which the
report is generated. The Alliance may also require a Request for Payment and Receipt and Expenditure
Report to accompany this report. . .
g. Caregivers who are determined eligible for the HCE Basic Subsidy after the 15th of a month, will be
processed by the Provider to begin eligibility for the HCE Basic Subsidy in the first day of the following
month.
h. The Provider is responsible for continued monitoring of all vendors with which it holds agreements for the
provision of services to be reimbursed as Special Subsidies. Said agreements must be approved by the
Alliance, outline the vendor's responsibility to carefully follow clients' care plans/service authorizations and
adhere to spending limits.
3. The Alliance agrees to do the following:
a. The Alliance will verify and process the CIRTS data prior to payment for HCE Basic and Special Subsidies.
b. Provided the monthly report is received from the Case Management agency by the due date, the Alliance will
process Basic and Special, Subsidy checks to caregivers by the third of the month following the month
services are rendered.
c. The Alliance will supply the Provider with a list of the amount paid each month to each caregiver, the date
the payment was made and the check number.
This Memorandum of Agreement will be in effect for the period June 1, 1999 through December 31, 1999 or until
otherwise revised or terminated.
PROVIDER: MONROE COUNTY BOARD
OF COMMISSIONERS
ALLIANCE FOR AGING, INC.
BOARD PRESIDENT OR
AUTHORIZED DESIGNEE
SIGNE~~~ _
BY: ,.- r, ~
NAME: ()J // helm ,./) OJ HClfVY
TITLE: A1A I/or
~
DATE: 7~.;J /- <19
SIGNED 01
BY:KCl..\'ff'n'f)C\ ~~~
NAME:RAMONA FRISCHMAN. EdD
TITLE:President
DATE: ~l 'if q ~
FEDERAL ID NUMBER: 59-6000749
PROVIDER FISCAL YEAR ENDING DA TE:..2Q.Q.
(SMlJ
~IWlNY '. KOlIlAGE, ClERk ,
8Y"ok!(! ./fJv~
OEPUfY CLERK '