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06/18/2008 Contract DANNY L. KOLHAGE CLERK OF THE CIRCUIT COURT DATE: June 26, 2008 TO: Deb Barsell, Director Community Services ATTN: Ali Trivette Administrative Assistant FROM: PamelaG.}{anco~tv Deputy Clerk CY At the June 18, 2008, Board of County Commissioner's meeting the Board granted approval and authorized execution of the folowing: Amendment to State of Florida Department of Children and Families Contract No. KG060, extending the Contract for an additional six months. The new effective date of the Contract shall be December 31, 2008. The additional County match shall be $4,483.00 for the period from July I, 2008 through December 31, 2008. Home Care for the Elderly (HCE) Case Management Contract No. KH872 between the 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, 2008 through June 30, 2009. /' Alzheimer's Disease Initiative (ADI) Contract No. KZ897 between the Alliance for Aging, Inc. (Area Agency on Aging) and the Monroe County Board of County Commissioners (Community Services/In-Home Services) for Fiscal Year 7/1/08 to 6/30/2009. Community Care for the Elderly (CEC) Contract No. KC871 between the Alliance for Aging, Inc. (Area Agency on Aging) and the Monroe County Board of County Commissioners (Community Services/In-Home Services) for Fiscal Year 7/1/08 to 6/30/2009. Enclosed are three duplicate originals of the above-mentioned, executed on behalf of Monroe County, for your handling. Please be sure to return the fully executed "Monroe County Clerk's Office Originals" and the "Monroe County Finance Department's Originals" as soon as possible. Should you have any questions please do not hesitate to contact me. cc: County Attorney Finance w/o documents File/ CONTRACT KZ-897 Page 1 ALZHEIMERS' DISEASE INITIATIVE CONTRACT 2008-2009 THIS AGREEMENT is entered into between the Alliance for Aging, Inc., hereinafter referred to as the" Alliance," and Monroe County Board of Commissioners, hereinafter referred to as the "recipient." This agreement 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. I. Recipient Agrees: A. Services to be Provided: I. The recipient's service provider application for state fiscal year 2008 and any revisions thereto approved by the Alliance and located in the contract manager's tile, 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 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 2008 and the Department of Elder Affairs Home and Community Based Services Handbook dated 01103. In the event the handbook is revised, such revision will automatically be incorporated into the contract and the recipient will be given a copy of the revisions. II. The Alliance Agrees: A. Contract Amount: To pay for services in an amount not to exceed $65,888.00, subject to the availability of funds. Obligation to Pay: The Alliance's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. B. Source of Funds: 1 CONTRACT KZ-897 Page 2 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. III. Aging Resource Center Outsourced Functions: A. Perform ARC outsourced functions in accordance with policies and procedures developed by the Alliance for Aging. Refer to the following attachments: i. Attachment IV: Policies and Procedures for Outsourced Function- Screening II. Attachment V: Policies and Procedures for Outsourced Function- Triage 111. Attachment VI: Policies and Procedures for Activation from Waitlist- Client Services IV. Attachment VII: Policies and Procedures for Termination from Waitlist- Client Services B. Maintain wait lists in CIRTS in accordance with DOEA requirements. C. Report number of client contacts to the Aging Resource Center. D. Adhere to prioritization policy as set torth by the Department of Elder Atfairs. E. Update the agency Disaster Plan to incorporate ARC outsourced functions. F. Ensure against conflicts of interest and inappropriate self-referrals by referring consumers in need of options counseling or long-term care services beyond the provider's scope of services to the Aging Resource Center. G. Ensure that services provided are in the clients' best interest, are the most cost effective, of high quality, and are responsive and appropriate to the assessed needs. The Assessed Priority Consumer List (APCL) is maintained when services funded by the department are not available. Contracted providers of registered services for Alzheimer's Disease Initiative (ADI), Older American's Act (OAA), and Contracted Services (CS) maintain waiting lists in the CIRTS database for registered services when funding is not available. Note: OAA3E is an exempt funding source for ARC Wait List purposes. For services provided through OAA3E, no CIRTS client data entry is required. Registered Services for the above listed programs are as follows: Adult Day Care (ADC), Adult Day Health Care (ADHC), Chore (CHO), Escort (ESC), Home Health Aide (HHA), Homemaker (HMK), Model Day Care (MDC), Personal Care (PECA), Facility-Based Respite (RESF), In-Home Respite (RESP). IV. Recipient and Alliance Mutually Agree: A. Effective Date: 1. This contract shall begin on July 1, 2008 or on the date the contract has been signed by both parties, whichever is earlier. 2. Delivery of services shall end on June 30, 2009. 2 CONTRACT KZ-897 Page 3 IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed by their undersigned officials as duly authorized. PROVIDER: ALLIANCE FOR AGING, INC. SIGNED BY: &. ~ MaxB.R~~~- SIGNED BY: NAME: TITLE: DATE: NAME: Cha President & CEO Mayor Pro Tem TITLE: ~we 18, 2008 <'-'", DATE: "'.~~ ..,,,,,,..jlE 1'1( ~.,' . ;::".lb;:~~:;'/ ~....-/ / 3 06~O ~ooR / , -:r ~~) C) ~.' JC' ~.-, c' ...., = .., = .... <- .,1'1 c: :::J 1- .j I -l , :<! , 1 ~ r:-:' c.) 0 CONTRACT KZ-897 Page 4 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 2007 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 ADl, 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 any other areas that may participate in the Long Term Care Diversion Program through expansion 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 2007 and the Department of Elder Affairs Home and Community Based Services Handbook dated 01103. In the event the handbook 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 tixed rates include only those costs that are in accordance with all applicable state and federal statutes and regulations and are based on audited historical costs in instances \vhere an independent audit is required. All requests for payment and expenditure reports submitted to supp0l1 requests for payment shall be on DOEA forms I 06Z 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 fOl1l1s. B. The recipient shall maintain documentation to SlIpp0l1 payment requests which shall be available to the Comptroller. the Department of Elder A tfairs. or the Alliance upon request. 4 CONTRACT KZ-897 Page 5 C. The recipient shall maintain documentation to support payment requests which shall be available to the Alliance, the Department of Elder Affairs or the Comptroller upon request. D. 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 momhs 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 A TT ACHMENT II to this contract. Reconciliation and recouping of advances made under this contract are to be completed by the time the tinal payment is made. All advance payments are subject to the availability offunds. E. 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 within thirty (30) days of the end of the first quarter of the contract period. F. The Alliance shall make payment to the provider for provision of services up to a maximum number of units of service and at the raters) stated below: Service Maximum Maximum Service to be Provided Unit Rate U nits of Dollars Service In Home Respite $24.03 2,742 $65,888 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 complete and accurate 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 580-1, Florida Administrative Code promulgated for administration of Sections 430.501 through 430.504, Florida Statutes, and the Department of Elder Affairs Client Home and Community Based Services Handbook dated 01/03. B. Assessment and Prioritization for Service Delivery for New Consumers: The following are the criteria to prioritize new consumers for service deiivery. 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: 5 CONTRACT KZ.897 Page 6 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 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 ddivery, Functional impairment shall be detennined through the department's consumer assessment form administered to each applicant. The most frail individuals not prioritized in groups om:, two or three above, regardless of referral SOLlrce, will receive services to the e'dent funding is available. C. Co-payment Collections: I. 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 AITairs' 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 is due by July 5, 2008. 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 vvith Memory Disorder Clinics to assist in this ctYort. F. Service Cost Reports: 6 CONTRACT KZ 897 Page 7 The recipient will submit semi-annual service cost reports which ret1ect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 7 Report Number 1 2 3 4 5 6 7 8 9 10 11 12 13 14 16 Leqend: Note # 1: Note # 2: CONTRACT KZ 897 Page 8 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 Advance Reconciliation ** ........... June Expenditure Report/August Advance Reconciliation ** ...... Final Expenditure and Closeout Report... ...... ........ * Advance based on projected cash need. Submit to the Alliance on This Date 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 July 20 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 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. 8 CONTRACT KZ 897 Page 9 ATTACHMENT III ANNUAL MODEL DAY CARE CENTER TRAINING REPORT Model Day Care Center Name: Printed Name of Person Completing Report Signature of Person Completing Report Date Executed The purpose of each model day care program must be to provide service delivery to persons sutTering 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 1st through June 30th. Number Number Total Actual Training Event(s) Health Care Social People Professionals Services Trained Trained Personnel Trained Training Title: Date: Training Summary: "'ill '" *"'''' 9 CONTRACT KZ 897 Page 10 Attachment IV Policy and Procedure for Outsourced function - Screening Objective: To ensure that a comprehensive list of clients in need of services is maintained in CIRTS by appropriate funding source and that the ARC is thereby able to effectively gauge the level of elder service need in Miami-Dade and Monroe Counties. Policy: To obtain necessary information from clients in order to assist in determining level of need and eligibility for DOEA funded services Procedure: 1. ARC Contracted Providers will collect information from callers and conduct a 701A assessment. Alternatively, if a 701B assessment already exists or is provided from another source (i.e. CARES) the information from the 701B can be utilized. 2. Based on the information provided via the 701A(B) assessment, the ARC Contracted Provider will make a determination as to the services that the caller is in need of receiving (see Contract Amendment APCL). 3. The ARC Contracted Provider will determine the appropriate funding source(s) that provides the needed services (see Contract Amendment APCL). 4. If the caller is in need of a service(s) that is not provided by the ARC Contracted Provider, the ARC Contracted Provider will refer caller to the ARC Elder Helpline utilizing the ARC Referral Form and/or to an ARC Contracted Provider that provides the needed service. 5. The caller will be provided with general information regarding the ARC as well as the ARC Elder Helpline contact number. 6. The caller will be informed of the services and funding sources that they are being placed on the wait list for in CIRTS. 7. ARC Contracted Provider will create a client record in CIRTS (if there is no existing record) and enter the services needed for the caller by funding source and service. [If there is an existing record in CIRTS, the appropriate fields will be updated]. 8. If the ARC Contracted Provider determines that the caller may qualify for more than one funding source, ARC Contracted Provider is encouraged to enter the appropriate information under multiple funding sources. [If there is an existing client record in CIRTS, the client record in CIRTS will be updated with appropriate information]. 9. ARC Contracted Provider will inform caller that they will receive a follow-up call (or home visit in case of active client) to check on their status based on DOEA Wait List Reassessment Standards and encourage caller to contact the ARC Elder Helpline with any questions. 10 CONTRACT KZ 897 Page 11 Attachment V Policy and Procedure for Outsourced function - Triage Objective: To ensure that clients in need of DOEA funded services receive services based on the highest level of need, first, as funding becomes available. Policy: To assist clients in obtaining DOEA funded services as funding becomes available, based on level of need as determined by a CIRTS priority score. Procedure: 1. ARC Contracted Provider will conduct periodic follow-up calls (or home visit in case of active client) to check on client status based on DOEA Wait List Reassessment Standards. 2. Based on the information provided via the 701A(B) assessment, the ARC Contracted Provider will update the client information in CIRTS specifically as it pertains to level of need for services by funding source 3. The ARC Contracted Provider will ensure that the CIRTS prioritization score is accurately maintained, according to DOEA Standards. 4. If the caller is in need of a service(s) that is not provided by the ARC Contracted Provider, the ARC Contracted Provider will refer caller to the ARC Elder Helpline utilizing the ARC Referral Form and/or to an ARC Contracted Provider that provides the needed service. 5. The caller will be informed of the services and funding sources that they remain on the wait list for and/or have been removed from the wait list for. 6. ARC Contracted Provider will advise client of any change in their CIRTS priority score based on the updated information. 7. ARC Contracted Provider will remind client of the ARC Elder Help Line contact number and to contact the ARC Elder Help Line with any questions or concerns. 8. As funding becomes available, ARC Contracted Provider will run CIRTS Prioritization Report and activate clients according to DOEA Standards (refer to ARC Client Activation Policies and Procedures). The Contracted Provider will apply targeting criteria, as appropriate, to prioritized clients to ensure activations meet programmatic requirements. 11 CONTRACT KZ 897 Page 12 Attachment VI Policy and Procedure for Activation From Wait List - Clients/Services Objective: To ensure that elders in need of DOEA funded services in Miami-Dade and Monroe Counties and on the CIRTS wait list begin to receive services as funding becomes available. Policy: ARC will work with ARC Contracted Providers to ensure that clients waiting for DOEA funded services begin to receive those services as funding becomes available. Procedure: 1. ARC Contracted Provider will activate clients on CIRTS wait list based on DOEA prioritization polices and funding availability. 2. ARC Contracted Provider will update CIRTS status by funding source and service for any services being activated for the client using appropriate CIRTS codes. 3. Client may be left on wait list of a different funding source than the one being activated if ARC Contracted Provider determines that it is appropriate. 4. Client may also be left on wait list in CIRTS if they are being activated by the ARC Contracted Provider under a temporary non-DOEA funding source and ARC Contracted Provider determines that the clients need will persist after the temporary funding source is exhausted. 5. ARC Contracted Provider will inform the client of any services/funding source that they are being activated for as well as those services and funding sources that they will continue to be wait listed for. 6. ARC Contracted Provider will inform client to contact the ARC Elder Helpline if they have any questions or concerns regarding the status of any of their services. 12 CONTRACT KZ 897 Page 13 Attachment VII ine Policy and Procedure for Termination From Wait List - Clients/Services Objective: To ensure that the comprehensive list of clients in need of services in CIRTS is appropriately maintained by funding source and that the ARC is thereby able to effectively gauge the current level of elder service need in Miami-Dade and Monroe Counties. Policy: ARC will maintain an accurate and current list of clients in need of elder services in Miami-Dade and Monroe Counties with the assistance of the ARC Contracted Providers. Procedure: 1. ARC Contracted Provider will re-screen clients which the ARC Contracted Provider initially placed on the CIRTS wait list for services based on DOEA Reassessment Standards. 2. The re-screening may be in the form of a phone screening or a home visit depending on the clients status (i.e. active/pending) 3. ARC Contracted Provider will determine if the client is no longer in need (or eligible) for any of the services they were wait listed for. 4. ARC Contracted Provider will terminate the client from the wait list (entirely or by specific service) using the appropriate CIRTS termination code for any services or funding source for which the client is determined to no longer be eligible for or no longer in need of. 5. ARC Contracted Provider will inform the client of any services/funding source that they are being removed from the wait list for. 6. ARC Contracted Provider will inform client of their ability to be re-added to the wait list if their level of need should change. 7. ARC Contracted Provider will inform client to contact the ARC Elder Helpline if they have any questions or concerns regarding their wait list status. 8. Reference DOEA Notice of Instruction: Assessed Priority Consumer List#:062906-1-I- OVCS as applicable. 13