07/17/2002 Contractclertiofttue
Circu Coufl
Danny L. Kolhage
Clerk of the Circuit Court
Phone: (305) 29~3550
FAX: (305) 295-8663
e-mail: phancock~monroe-clerk,com
MemDr
TO:
Louis Latorre, Director
SoCial Services Division
ATTN:
FROM:
Tracy Threlkeld
In-Home Services Program
Pamela G. Hanco~
Deputy Clerk
DATE: August 1, 2002
At the July 17, 2002, Board of County Commissioner's meeting the Board granted
approval and authorized execution of the following:
Board granted approval and authorized execution of Master Agreement No. PA329 for Fiscal Year
7/1/02 through 12/31/02 between the Alliance for Aging, Inc. (Area Agency on Aging for Miami-Dado and
Monroe Counties) and Monroe County Board of County Commissioners/Monroe County Social Services
(Monroe County In Home Service Program/Monroe County Nutrition Program).
Board granted approval and authorized execution of Alzheimer's Disease Initiative Contract No.
KZ297 for Fiscal Year 7/1/02 through 6/30/03 between the Alliance for Aging, Inc. Monroe County Board
of County Commissioners/Monroe County Social Services (Monroe County In Home Service Program, the
Case Management Agency).
Board granted approval and authorized execution of Community Care for the Elderly Contract No.
KC271 for Fiscal Year 7/1/02 through 6/30/03 between the Alliance for Aging, Inc. and the Monroe
County Board of County Commissioners/Monroe County Social Services (Monroe County In Home Service
Program, the Case Management Agency).
Board granted approval and authorizecl execution of Home Care for the Elderly Contract No.
KH272 for Fiscal Year 7/1/02 through 6/30/03 between the Alliance for Aging, Inc. and the Monroe
County Board of County Commissioners/Monroe County Social Services (Monroe County In Home Service
Program, the Case Management Agency).
Enclosed are four duplicate originals, executed on behalf of Monroe County, for your
handling. Please be sure that the fully executed "Monroe County Clerk's Office Original" and
the "Monroe County Finance Department's Original" are returned to our office as soon as
possible,
Should you have any questions please do not hesitate to contact this office.
Cc: County Administrator w/o documents
Finance w/o documents
Coun~t Attorney
File ,/
Rug 01 02 01: 19p In-Home Services {30S)292-4481 p. I
(305) ~1)4-4~41
BOARD OF COUNTY COMMISSIONERR
MAYOR Charles McCoy, District 3 '
Mayor pro tem Dixie Spehar, District 1
George Neugent, District 2
Bert Jimenez, District 4
Murray E. Nelson, District 5
In-Home Services Program
GATe Building
1100 Simonton Street
Key West, FL 33040
(305) 292-4583
(305) 292-4481 FAX
FAX COVER SHEET
Date: 8/1/02
To: Pam Hancock
Organization: Clerk of the Court
Fax #: 305-295-3663
From: Tracy Threlkeld
Message: The Alliance forAging will not care if
you correct the PA N.~mher in contracts KZ-297, KC-
271 and KH-272 to read PA-329. Mr. Jove has'told me on several
occasions to just white it out or line through it and write correct
number. If you have any questions, please feel free to contact either
myself or Mr. Jove at 305-455-6500 Ext 223.
Total number of pages including cover sheet i
Please confirm receipt by calling sender if checked
Warning: The information contained in this transmission is intended for the
use of the individual or entity named above. If you are not the intended
recipient of this facsimile/ or the em/~loyee or agent responsible for
delivering it to the recipient, you are hereby notified that any
dissemination, distribution, or copying of this facsimile i~ strictly
prohibited. If you have received this communication in error, please notify
us immediately by phone and return the original message to us at the above
address via mail. Thank you.
IHSFAX. DOC
..... enm.t,CIedl'a CIb o.w-a
07/01/2002
Contract Number KZ 297
ALZHEIMERS' DISEASE INITIATIVE CONTRACT
2002-2003
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. PA3.29 , 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, 2003; 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 15, 2003,
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 $65,888.00, 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:
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07/01/2002
Contract Number KZ 297
Program Title Year Funding Source CSFA# Fund
Amounts
ADI - Respite 2002 General Revenue 65004 $65,888.00
Services
ADI - Model Day 2002 General Revenue 65002 $0.00
Care
ADI - Alzheimer 2002 General Revenue 65002 $0.00
Special Projects
TOTAL FUNDS CONTAINED IN THIS CONTRACT: $65,888.00
III. Recipient and Alliance Mutually Agree:
A. Effective Date:
1. This contract shall begin on July 1, 2002 or on the date the contract has been
signed by both parties, whichever is later.
2. Delivery of services shall end on June 30, 2003. This contract shall end on
September 30,2003. See Attachment I, Section III.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 I.S.1. of the Master
Agreement, the recipient maintains responsibility for the performance of all
subrecipients 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) 670-6500 SC 455-6500
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07/01/2002
Contract Number KZ 297
2. The name, address, and telephone number of the representative of the recipient
responsible for administration of the program under this contract is:
Louis LaTorre
Gato Building - 1100 Simonton Street
Key West, Florida 33040
(305) 292-4573
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
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07/01/2002
Contract Number KZ 297
IN WITNESS THEREOF, the parties hereto have caused this 11 page contract to be executed
by their undersigned officials as duly authorized.
RECIPIENT:
ALLIANCE FOR AGING, INC.
MONROE COUNTY BOARD
OF COMMISSIONERS
BOARD PRESIDENT OR
AUTHORIZED DESIGNEE
NAME:
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NAME: STEVEN WEISBERG, M.S.
TITLE: PRESIDENT/CEO
DATE: f I rr) ~ 'L-
SIGNED
BY:
TITLE:
DATE:
FEDERAL ID NUMBER:
RECIPIENT FISCAL YEAR END DATE:
59-6000749
09/30
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4
07/01/2002
Contract Number KZ 297
ATTACHMENT I
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
I. STATEMENT OF PURPOSE
The Alzheimer's Disease Initiative (ADI) Program is focused on caring for persons 18 + with
memory disorders.
II. SERVICES TO BE PROVIDED
A. Services:
1. The recipient's service provider application for state fiscal year 2002, 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 ADI, 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 2002 and the Department of
Elder Affairs Client Services Manual dated 12/98. 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 106Z and 105Z. Duplication or
replication of both forms via data processing equipment is permissible, provided all
data elements are in the same format as included on departmental forms.
B. The recipient shall maintain documentation to support payment requests which shall be
5
07/01/2002
Contract Number KZ 297
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 two
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 third 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 to be
Provided
Unit of
Service
Unit
Rate
Maximum
Units
Maximum
Dollars
Respite/I n-Home
1 client hour $28.955394
2,275.50
$65,888
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.
Any changes in the amounts of the funds identified on the Budget Summary form
require a contract amendment.
2. With the exception of Case Management, the recipient agrees to implement a
Modified Spending Authority. Recipient is to offer services based on clients' service
plans and will not be restricted to providing the services as projected. Additional
budget revisions/contract amendments will not be required to move funding among
these services, with the exception of Case Management. Any changes in the total
amount of the funds under contract require a formal contract amendment.
3. This contract is for services provided during the 2002/2003 State Fiscal year
beginning July 1, 2002 through June 30, 2003, however, the contract is in effect
through September 30, 2003 in order to provide for maximization of resources and
to allow for greater flexibility to pay for the services rendered by June 30, 2003.
Services provided after June 30, 2003 cannot be reimbursed under this contract.
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07/01/2002
Contract Number KZ 297
4. The recipient will submit a draft closeout report by August 15, 2003. Any contract
amendments after August 15, 2003 determined necessary by the Alliance will be
based on the draft closeout reports.
5. The final expenditure report and request for payment will be due to the Alliance no
later than September 15, 2003. No expenditure reports or requests for payment will
be accepted after September 15, 2003.
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:
The recipient agrees to comply with applicable parts of Rule 58D-1, Florida
Administrative Code promulgated for administration of Sections 430.501 through
430.504, Florida Statutes, and the Department of Elder Affairs Client Services Manual
dated 12/98.
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
7
07/01/2002
Contract Number Kl 297
referral source, will receive services to the extent funding is available.
C. Co-payment Collections:
1. The recipient will establish annual co-payment goals. The Alliance also has the
option to withhold a portion of the recipient's Request for Payment if goals are not
met according to the Department of Elder Affairs' co-payment guidelines.
2. Co-payments include only the amounts assessed consumers or the amounts
consumers opt to contribute in lieu of an assessed co-payment. The contribution
must be equal to or greater than the assessed co-payment.
D. Evaluation, Statistics and Reports:
The recipient agrees to respond to requests for evaluation information and statistical
data concerning its consumers based on information requirements of the Memory
Disorder Clinics and Brain Bank. The recipient will ensure Model Day Care Centers
supported by this contract develop innovative therapies and interventions which can be
shared with other Alzheimer's Disease Initiative health and social services personnel
via training. Model Day Care Centers supported by this contract must report to the
provider all training activities provided to health care and social service personnel and
caregivers, as well as serve as a natural laboratory for service related applied research
by Memory Disorder Clinics. An annual Model Day Care Center Training Report,
ATTACHMENT IV, is due by July 5,2003.
E. Collaboration with Memory Disorder Clinics:
Memory Disorder Clinics are required to provide four hours of in-service training to all
respite and model day care centers in their designated service areas. The recipient
agrees to collaborate with Memory Disorder Clinics to assist in this effort.
F. Service Cost Reports:
The recipient will submit semi-annual service cost reports which reflect actual costs of
providing each service by program. This report provides information for planning and
negotiating unit rates.
8
07/01/2002
Report
Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Legend: *
**
Contract Number KZ 297
ATTACHMENT II
ALZHEIMER'S DISEASE INITIATIVE 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 Adv. Recon.**
June Expenditure Report/August Adv. Recon.**
Draft Closeout Report
Final Expenditure and Request for
Payment Report
Closeout Report
Advance based on projected cash need.
Submit to the
Alliance On
This Date
July 1
July 1
August 10
September 10
October 1 0
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.
Note # 1: 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.
Note # 2: The last two months of the recipient's fiscal reports covering actual expenditures
should reflect an adjustment repaying advances for the first two months of the
contract.
9
Contract Number KZ 297
07/01/2002
A TT ACHMENT III
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
BUDGET SUMMARY
3. Total
$ 65.888.00
$ 0.00
$ 65.888.00
1 . Respite
2. Model Day Care
10
Contract Number KZ 297
07/01/2002
ATTACHMENT IV
ANNUAL MODEL DAY CARE CENTER TRAINING REPORT
Model Day Care Center Name:
Print Name of Person completing report
Signature of Person completing report
Date
The purpose of each model day care program must be to provide service delivery to persons
suffering from Alzheimer's disease or a related memory disorder and training for health care
and social service personnel in the care of persons having Alzheimer's disease or related
memory disorders. This report documents the required training for the State Fiscal Year July
1 st through June 30th.
Actual Training Event(s) Number Health Number Total
Care Social People
Professionals Services Trained
Trained Personnel
Trained
Training Title:
Date:
Training summary:
11