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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: Pamela G. HancoMJ.,v 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 1,2008 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 I, 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 Number KH 872 Page 1 HOME CARE FOR THE ELDERLY CONTRACT 2008.2009 THIS AGREEMENT is entered into between the Alliance for Aging, [nc., 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. PA729, and its successor, incorporated herein by reference. Attachment [ & II are integral to this Agreement. I. Recipient Agrees: A. Services to be Provided: 1. 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 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 HCE. 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 2007 and the Department of Elder Affairs Client Home And Community Based Services Handbook dated 01/03 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. II. The Alliance Agrees: A. Contract Amount: To pay for services in an amount not to exceed $12.750.00, subject to the availability of funds. Obligation to Pay: 1 Contract Number KH 872 Page 2 The Alliance's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. B. Source of Funds: 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. 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. IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed by their undersigned officials as duly authorized. PROVIDER: NAME: ALLIANCE FOR AGING, INC. Charle NAME: SIGNED BY: SIGNED BY: President & CEO TITLE: Mayor Pro Tern TITLE: or.:, /30 bOd~ / ./ DATE: June 18, 2008 DATE: .,~?{.;~..- ....~.;,... '~"''''''''.'.'.''''''' . .... ~., :," AM~'" "'--' ;.....-..-~,.-;;-:::- '.._-.- ::J:: _" (:, ~ -,'" .'- ~~,;.~ ,..., = = co <- c:= , I ......I ., ,0 ] ~{\-~>,,-~ -, 7/(.' : ;>',~:l~~,t.j~, ,\ ", ',rl ,-","' " .'~-.' -0 :% -'II . ~ (,0) (:) '-'; 2 Contract Number KH 872 Page 3 ATTACHMENT I HOME CARE FOR THE ELDERLY PROGRAM J. STATEMENT OF PURPOSE The Home Care for the Elderly (HCE) Program encourages the provision of care in family- type living arrangements in private homes on a not for profit basis as an alternative to nursing home or other institutional care. II. SERVICES TO BE PROVIDED A. Services: 1. The recipient's July 2008 application 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 HCE, 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 any other areas that may participate in the Long Term Care Community Diversion Program through expansion and the Program of All Inclusive Care for the Elderly (PACE) program. B. Manner of Service Provision: The services will be provided in a manner consistent with and described in the recipient's July 2008 application and the Department of Elder Affairs Home and Community-Based Services Handbook dated 01/03. 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 fixed 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 where an independent audit is required. All requests for payment and expenditure reports submitted to support requests for payment shall be on DOEA forms 106H and 10SH. Duplication or replication of both forms via data processing equipment is permissible, provided all data elements are in the same format as included on department forms. 3 Contract Number KH 872 Page 4 B. The recipient shall maintain documentation to support payment requests which shall be available to the Comptroller, the Department of Elder Affairs, or the AIIi,mce upon request. C. The recipient may request a monthly advance for service costs 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 nine 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 May & June 2009 reports. 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. Contingent upon the recipient's ability to maintain program expenditures within the assigned quarterly allocations and the availability of funds, the Alliance shall make payment to the provider for provision of services at the rate(s) stated below: SERVICE TO BE PROVIDED UNIT RATE MAXIMUM UNITS MAXIMUM DOLLARS Case Management $47.86 266 $12,750 F. 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: 1. The recipient agrees to comply with applicable parts of Rule Chapter 58H-1, Florida Administrative Code promulgated for administration of Sections 430.601 through 430.608, Florida Statutes, and the Department of Elder Affairs Home and Community Based Services Handbook dated 01103. 2. The recipient agrees to comply with the provisions of Sections 97.021 and 97.058, Florida Statutes, and all rules related thereto in the Florida Administrative Code. 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 4 Contract Number KH 872 Page 5 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 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 groups one, two or three above, regardless of referral source, will receive services to the extent funding is available. C. Consumer Information, Registration and Tracking System (CIRTS): 1. The recipient will ensure the collection and maintenance of Home Care for the Elderly (HCE) subsidies and case management information on a monthly basis from the Consumer Information, Registration and Tracking System (CIRTS). Maintenance includes valid exports and backups of all data and systems according to department standards. 2. The recipient must ensure all data for HCE subsidies are entered in the CIRTS by the 15th of each month. HCE subsidy data entered into the CIRTS by the 15th of the month will be for payments incurred between the 16th of the previous month and the 15th of the current month. Case management data entered into the CIRTS by the 15th of the month will be for units of service provided during the previous month from the 16th and up to and including the 15th of the current month or case management units of service may be entered according to the recipient schedule, in aggregate on the 31 st or daily, weekly or monthly. 3. The recipient will ensure data entry for HCE subsidies will cease on the 15th of the month and the CIRTS Monthly Service Utilization Report, by consumer and by worker identification is run. 5 CONTRACT KH 872 Page 6 4. The recipient will ensure the Monthly Utilization Report, by consumer and by worker identification is verified, corrected, certified no later than the 20th of the month in which the report is generated. 5. The recipient will ensure caregivers determined eligible for the HGE basic subsidy after the 15th of a month, will be processed to begin eligibility for the HGE basic subsidy on the 1st day of the next month. 6. The Alliance will reconcile and verify the GIRTS data prior to payment for HGE basic and special subsidies and case management. 7. The Alliance will reconcile and verify the GIRTS data prior to payment for HGE basic and special subsidies and case management. 6 Report Number 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 CONTRACT KH 872 Page 7 ATTACHMENT II HOME CARE FOR THE ELDERLY 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 I July Advanced Reconciliation .. ..... June Expenditure Report I August Advanced Reconciliation .. Final Expenditure and Closeout Report Leqend' Advance based on projected cash need. Note # 1: Note # 2: .. Submit To The Alliance On This Date July 1 July 1 August 15 September 15 October 15 November 15 December 15 January 15 February 15 March 15 April 15 May 15 June 15 July 15 July 15 Submission of expenditure reports mayor may not generate a payment request. If final expenditure report reflects funds due back to the department, 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 two months of the contract. 7 CONTRACT KH 872 Page 8 EXHIBIT A 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: I. 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. Y Recommends potential cases for activation based upon projected funding available by lead Agency. y Selects consumers from the waiting list based on their prioritization score. y Refers consumers from the waiting list to the lead Agency in Monroe County for activation, based on availability of funds. y Monitors compliance with service standards and outcome measures. y 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). 8 CONTRACT KH 872 Page 9 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: 1. 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 701A 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 (NO! #062906-1-!-OVCS 6/29/2006). B. HIPAA forms will be sent to the consumer as appropriate. III. Opening New Cases 9 CONTRACT KH 872 Page 10 A. CCE/ADAlALE/HCE Clients 1. 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 I ntake 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. 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. 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 consumers will be made active. If funding is not available, they will be waitlisted 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. V. Aging Resource Center Outsourced Functions: A. Perform ARC outsourced functions in accordance with policies and procedures developed by the Alliance for Aging. 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 forth by the Department of Elder Affairs E. Update the agency Disaster Plan to incorporate ARC outsourced functions. 10 CONTRACT KH 872 Page 11 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. Through outsourcing, the function of Screening may also be completed by the Lead Agency for the Community Care for the Elderly, Home Care for the Elderly, Aging and Disabled Adults, and the Assisted Living for the Elderly Medicaid Waivers. 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: 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. 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. The ARC Contracted Provider will determine the appropriate funding source(s) that provides the needed services. 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. The caller will be provided with general information regarding the ARC as weil as the ARC Elder Helpline contact number. The caller will be informed of the services and funding sources that they are being placed on the wait list for in C1RTS. 11 CONTRACT KH 872 Page 12 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]. 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]. 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. Note: These ARC policies and procedures are subject to change. Any modifications will be done through a contract amendment. 12