SFY2003 11/20/2002
Cle" oldie
eircul eoon
Danny L. Kolhage
Clerk ofthe Circuit Court
Phone: (305) 292-8550
FAX: (305) 295-3663
e-mail: phancock@monroe-clerk.com
Memnranduin
TO:
Louis Latorre, Director
Social Services Division
ATTN:
Dotti Albury
FROM:
Pamela G. H~
Deputy ClerO
DATE:
December 12, 2002
At the November 20,2002, Board of County Commissioner's meeting the Board granted
approval and authorized execution ofthe following:
/ Home and Community Based Waiver Case Management Referral Agreement between
Alliance for Aging, Inc. and the Monroe County Board of County Commissioners (Monroe
County Social Services/In Home Services Program) for Fiscal Year July 1,2002 through June 30,
2003.
Amendment #003 to OAA Contract #AA-229 (01/01/02 - 12/31/02) between the Alliance
for Aging, Inc. (Area Agency On Aging for Miami-Dade and Monroe Counties) and the Monroe
County Board of County Commissioners/Monroe County Soc~al Services (Monroe County In
Home Service Program).
Enclosed are four duplicate originals of each of the above, executed on behalf of Monroe
County, for your handling. Please be sure that the fully executed "Monroe County Clerk's
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
County Attorney
File ./
.'i::,
HOME AND COMMUNITY BASED WAIVER
CASE MANAGEMENT REFERRAL AGREEMENT
This Referral Agreement, made this 1st day of July, 2002, between Alliance for Aging, Inc.,
the Area Agency on Aging for Planning and Service Area 11 and Monroe County, a case
management agency. This Referral Agreement is in effect for a period of time that is equal to
the Medicaid waiver provider's enrollment period with the State of Florida's Medicaid fiscal
agent. The purpose of this agreement is to enable eligible elderly participants to receive case
management services from qualified providers with oversight of the quality of care by the
Medicaid Waiver Specialist employed by the Area Agency on Aging. These services are
authorized in order that the participant may remain in the least restrictive setting and avoid or
delay premature nursing home placement. Services and care are to be furnished in a way that
fosters the independence of each participant to facilitate aging in place. All parties agree that
routines of care provision and service delivery must be consumer-driven to the maximum extent
possible. All parties agree to and will treat each participant with dignity and respect.
I. Objectives
A. To maintain a climate of cooperation and consultation with and between agencies, in
order to achieve maximum efficiency and effectiveness.
B. To participate together by means of shared information in the development and expansion
of services.
C. To promote programs and activities designed to prevent the premature institutionalization
of elders and disabled adults.
D. The parties of this Agreement will provide technical assistance and consultation to each
other on matters pertaining to actual service delivery and share appropriate assessment
information and care plans so duplication may not occur.
E. To establish an effective working relationship between the case management agency that
is responsible for the development of care plans and authorization of services available
under the waiver, the service provider that is responsible for the direct provision of those
services to consumers served under the waiver program, and the Area Agency on Aging
that is responsible for management and oversight of the waiver program.
II. Under this Agreement, the Area Agency on Aging agrees to the following:
A. To facilitate the enrollment of providers with the Medicaid Fiscal Agent.
B. To provide technical assistance and training to the case management agencies.
C. To provide on site monitoring of the case management agency at least semi-annually.
D. To monitor and project Provider expenditures to assure spending is maintained within
spending authority.
III. Under this Agreement, the Case Management Agency agrees to the following:
A. Assign qualified case managers as contained in the Aged and Disabled Adult Medicaid
Waiver to provide case management under the Medicaid Home and Community Based
Waiver for Aged and Disabled Adults.
B. Develop and implement the Plan of Care specifically outlining the service(s) to be
delivered which must be signed by the consumer.
C. Reevaluate the Plan of care at least every six months or more frequently if changes in the
consumers condition or the services being received have changed significantly, and make
changes to authorized services and/or service providers as needed.
D. Adhere to the policies and procedures as outlined in the following manuals published by
the Agency for Health Care Administration: Aged and Disabled Adult Waiver Guidelines
and the Medicaid Provider Reimbursement Handbook (Non-Institutional 081), including
any and all attachments or updates.
E. Provide to the Area Agency on Aging a monthly summary of Aged and Disabled Adult
Medicaid Waiver expenditures billed and accrued.
F. Refer consumers to any qualified Service Provider as selected by the consumer.
G. Issue written service authorizations to the service provider with at least 24 hours notice.
The referral will contain at a minimum:
1. Name
2. Address (with directions if not easily accessible)
3. Pertinent information regarding consumer's health or disabilities and living situation
4. Detailed service description including frequency, duration and specific tasks to be
performed
H. Evaluate quality of services and service documentation by the service provider.
I. Accept financial responsibility for service claims found out of compliance if the non-
compliance was the result of a failure by the case management agency to update, renew,
or terminate the service authorization.
J. Monitor service providers for adherence to authorized care plans and authorized
reimbursement rates.
K. Develop and implement a policy to ensure that its employees, board members, and
management, will avoid any conflict of interest or the appearance of a conflict of interest
when disbursing or using the funds described in this agreement or when contracting with
another entity which will be paid by the funds described in this agreement. A conflict of
interest includes, but is not limited to, receiving, or agreeing to receive, a direct or
indirect benefit, or anything of value from a service provider, consumer, vendor, or any
person wishing to benefit from the use or disbursement of funds. To avoid a conflict of
interest, the case management agency must ensure that all individuals make a disclosure
to the Area Agency on Aging of any relationship which may be a conflict of interest,
within thirty (30) days of an individual's original appointment or placement on a board,
or if the individual is serving as an incumbent, within thirty (30) days of the
commencement of the contract.
L. To submit void or adjustment claims no later than 45 days after the error has been
identified by either party. Any error not adjusted or voided within 45 days may be
adjusted or voided by the Area Agency on Aging. The provider's refusal to adjust or
void erroneous claims will result in termination of this agreement.
IV. Under this agreement, the following services will be delivered by the Service provider
in accordance with the plan of care or service authorization:
Service Unit Rate County/Region Served
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B.
C.
D.
E.
V. Termination
In the event this agreement is terminated, the case management agency agrees to submit, at the
time notice of intent to terminate is delivered, a plan which identifies procedures to ensure
services to consumers will not be interrupted or suspended by the termination.
A. Termination at Will
This agreement may be terminated by either party upon no less than thirty (30) calendar
days notice, without cause, unless a lesser time is mutually agreed upon by both parties,
in writing. Said notice shall be delivered by certified mail, return receipt requested, or in
person with proof of delivery .
B. Termination Because of Lack of Funds
In the event funds to finance this agreement become unavailable, the area agency may
terminate this agreement upon no less than twenty-four (24) hours notice in writing to the
other party. Said notice shall be delivered by certified mail, return receipt requested, or
in person with proof of delivery. The area agency shall be the final authority as to the
availability of funds.
C. Termination for Breach
Unless a breach is waived by the area agency in writing, or the parties fail to cure the
breach within the time specified by the area agency, the area agency may, by written
notice to the parties, terminate the agreement upon no less than twenty-four (24) hours
notice. Said notice shall be delivered by certified mail, return receipt requested, or in
person with proof of delivery .
In witness whereof, the parties have caused this 3 page agreement to be executed by their
undersigned officials as duly authorized.
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