12/17/2008 Contract
DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE:
December 30, 2008
TO:
Community Services
ATTN:
Dotli Albury,
In-Home Services Program
FROM:
Pamela G. Hanco~
Deputy Clerk U
At the December 17, 2008, Board of County Commissioners' meeting the Board granted
approval and authorized execution of the following:
Amendment 001 to the Community Care for the Elderly (CCE) Contract #KC871
between the Alliance for Aging, Inc., (Area Agency on Aging for Miami-Dade and Momoe
Counties) and the Momoe County Board of County Commissioners (Social Services/In-Home
Services) for fiscal year 7/0l/08 to 6/30109.
Renewal of the Home and Community Based Services Aged and Disabled Adult
Medicaid Waiver (ADA-MW) Contract between the Alliance for Aging, Inc., and the Momoe
County Board of County Commissioners (Momoe County In-Home and Nutrition Services
Program) for Direct In-Home Services.
)Older Americans Act (OAA) Contract #AA-929(l/l/09-12/3l/09) for Titles III-B, C-I,
C-I1, and III-E between the Alliance for Aging, Inc. (Area Agency on Aging for Miami-Dade and
Momoe Counties) and the Momoe County Board of County CommissionerslMomoe County
In-Home and Nutrition Services.
Enclosed are four duplicate originals of each of the above-mentioned, executed on behalf
of Momoe County, for your handling. Please be sure to return the fully executed "Monroe
County Clerk's Office Original" and the "Monroe County Finance Department's Original" as
soon as possible. Should you have any questions, please do not hesitate to contact our office.
cc: County Attorney
Finance wlo documents
File
CONTRACT AA-929
Page 1
THIS AGREEMENT is entered into between the Alliance for Aging, Inc., hereinafter referred to as the
"Alliance" and Monroe County Social Services, hereinafter referred to as the "contractor." This agreement is
subject to allllfovisions contained in the MASTER AGREEMENT executed between the Alliance and the
Recipient, Agreement No. PA-729, and its successor, incorporated herein by reference. THIS CONTRACT IS
SUBJECT TO FURTHER MODIFICATION IN ORDER TO INCORPORATE CERTAIN PASS-THROUGH
LANGUAGE REQUIRED BY THE STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS. ALL
SUBSEQUENT MODIFICATIONS WILL BE MADE THROUGH AMENDMENTS TO THIS CONTRACT.
Attachment I (OAA Program) and Attachment II (Report Calendar) and ARC Attachment,are <illlinteeral
part of this agreement and incorporated by reference." i; ~ ;=
~z L rr1
r:r.; :c- 0
The Budget Summary by Title is as follows: ..,." Z ~
Title III B (CFDAlCSFA# 93.044): $109,569 3~: C7\ ~
Title C1 (CFDAlCSFA# 93.045): $142,600C:::t\j::>: ;';)
Title C2 (CFDAlCSFA # 93.045): $ 210,832 gMF! ~ ::;;::;
Title III E (CFDAlCSFA # 93.052): $ 56,560 ::;~~ _ ~
~.C) .. <:)
1. The Alliance shall make payment to the provider for provision of services up to a maximtan n{;'ihbe~jlr u~ of
service and at the rate(s) stated below:
Service Maximum Maximum
Service(s) to be Provided Unit Rate Units of Dollars
Service
Homemaker $34.29 1,734 $59,459
Personal Care $40.07 1,130 $45,274
Screening & Assessment IlIB $42.05 115 $4,836
Congregate Meals $9.56 14,677 $140,311
Nutrition Education Cl $381.45 6 $2,289
Home Delivered Meals $6.13 34,269 $210,068
Nutrition Education C2 $382.05 2 $764
Facility Respite $10.34 5,470 $56,560
Total Contract $519,561
2. This agreement shail begin on January 1, 2009 or the date it has been signed by both parties,
whichever is earlier.
Ail provisions in the contract and any attachments thereto in conflict with this amendment shail be and
are hereby changed to conform with this amendment.
Ail provisions not in conflict with this amendment are still in effect and are to be performed at the level
specified in the contract are hereby amended to conform with this amendment.
This amendment and ail its attachments are hereby made a part of the contract.
DATE:
Geor L R. fl/e..,
/l1tJVor
1.;)-(7-08
SIGNED BY:
e.n f NAME:
~E-.ALLIANCE FOR AGING, INC.
~-~~
Max B. Rothman, ,LL.
NAME:
DATE:
TITLE:
TITLE:
CONTRACT AA-929
Page 2
ATTACHMENT I
OLDER AMERICANS ACT PROGRAM
I. STATEMENT OF PURPOSE
The Older Americans Act (OAA) Program is a federal program that provides assistance to older persons
and caregivers.
To enhance the provision of services at the local level, the Department is charged with dividing the state
into distinct planning and service areas (PSAs) and designating an Area Agency on Aging (AM) for each
of them. The Alliance is responsible for assessing the needs of older persons within PSA-ll.
The OAA Program is the only federal supportive services program directed solely toward improving the
lives of older people. The Alliance fosters the development and implementation of comprehensive and
coordinated systems to serve older individuals. Under current law, all service providers funded under part
B of the Act must follow priorities established by the Alliance and approved by the Department of Elder
Affairs for serving the elderly, providing assurances that preference will be given to those with the greatest
economic and social need, with particular attention to low-income minority older individuals residing in
rural areas.
The Older Americans Act provides a framework for a partnership among the different levels of govermnent
and the public and private sectors with a common objective - improving the quality of life for all older
Americans by helping them to remain independent and productive.
II. SERVICES TO BE PROVIDED
A. Services:
The recipient's service application for the calendar year 2009 and any revisions thereto approved by
the Alliance and located in the grant manager's file, are incorporated by reference in this agreement
between the Alliance and the recipient and prescribe the manner in which the recipient will meet the
requirements of the Older Americans Act.
B. Manner and Service Provision:
The services will be provided in a manner consistent with and described in the recipient's service
provider application for the calendar year 2008, the 2008 Department of Elder Affairs Home and
Community-Based Services Handbook, the Department of Elder Affairs National Family Caregiver
Support Program Guidelines, and the Department of Health and Human Services, Office of Assistant
Secretary, Administration on Aging, Program Instruction, AoA-PI-01-02. In the event the manual or
guidelines are revised, such revision will automatically be incorporated into the agreement and the
recipient will be given a copy of the revisions. The recipient agrees to perform the services of the
agreement in accordance with all federal, state, and local laws, rules, regulations and policies that
pertain to Older Americans Act funds.
III. METHOD OF PAYMENT
A. The method of payment in this agreement includes advances and fixed rate for all other services. The
recipient must ensure all costs and fixed rates include only those costs which are in accordance with
all applicable state and federal statutes and regulations and are based on historical costs and audited
historical costs when applicable. All requests for payment and expenditure reports submitted to
support requests for payment shall be on DOEA forms 106A, I05A and 106E.
CONTRACT AA-929
Page 3
This agreement is subject to those Federal cost principles applicable to the particular organization
concerned [Office of Management and Budget (OMB) circulars A-87, A-122, A-21, 45 CFR part 74,
and 48 CFR part 31].
B. The recipient shall maintain documentation to support payment requests which shall be available to
the Alliance, the Department of Elder Affairs staff or the Comptroller for the State of Florida upon
request.
C. The due date for the request for payment and expenditure reports shall be on the 5th day of the month
following the month being reported.
D. The Alliance shall make payment to the recipient for a total dollar amount stated in the contract,
subject to the availability of funds. Unit rates listed in Paragraph E are the Alliance's share not to
exceed 90% of the gross cost per unit of service.
E. If applicable, recipient may implement a Modified Spending Authority for these services, WITHIN
Tm:IR RESPECTIVE TITLES.
Under this Modified Spending Authority, the total units of service and maximum dollar amount
projected by the recipient and included in the Service Grid may fluctuate based on consumers'
service plans. Additional budget revisions/amendments will not be required in order to move funding
among services within any given funding title, with the exception of Screening! Assessment, Case
Aide, and Case Management. The total agreement amount per funding title cannot be exceeded
without prior approval and an agreement amendment.
F. The recipient may request a monthly advance for each of the first two months of the agreement
period, based on immediate anticipated cash needs. Detailed documentation justifying cash needs for
advances must be submitted with the signed agreement, approved by the Alliance, and maintained in
the grant manager's file. For-profit organizations cannot receive advance funds. 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 agreement. The schedule for submission of
invoices is ATTACHMENT II to this agreement. Reconciliation and recouping of advances made
under this agreement are to be completed by the time the final payment is made. All payments are
subject to the availability of funds.
G. A final receipt and expenditure report (closeout report) will be forwarded to the Alliance within sixty
(60) days after the agreement ends or is terminated. All monies which have been paid to the recipient
and not used to retire outstanding obligations of the agreement being closed out must be refunded to
the Alliance along with the final receipt and expenditure report.
H. Interested Earned on General Revenue and Federal Funds: All interest income earned on the advance
of general revenue and federal funds must be separately identified and returned to the Alliance,
together with the payment and expenditure reports. Advances on Federal funds must be maintained
in interest-bearing accounts in accordance with 45 CFR 74.22 (k). Interest amounts earned on
Federal funds up to $250.00 per year may be retained by the recipient for administrative expenses.
I. Any payment due by the Alliance under the terms of this agreement 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.
J. The recipient agrees to implement the distribution of funds as detailed in the service application and
the Budget Summary, ATTACHMENT III to this agreement. Any changes in the amounts of
federal funds identified on the Budget Summary form require an agreement amendment.
CONTRACT AA-929
Page 4
K. Financial Reports: The recipient agrees to provide an accurate, complete and current disclosure of the
financial results of this agreement as follows:
1. To submit all requests for payment and expenditure reports according to the format, schedule and
requirements specified in ATTACHMENT I.
2. The completed manual units of service portions of the Older Americans Act Annual Report, if
applicable, are due to the grant manager on the date established by the Alliance. The Department
of Elder Affairs will obtain the remaining Report sections from the Consumer Information,
Registration and Tracking System (CIRTS).
IV. SPECIAl., PROVISIONS
A. Match
The recipient will assure a match requirement of at least 10 percent of the cost for all services funded
through this agreement. The recipient's match will be made in the form of cash and/or in-kind
resources. At the end of the agreement period, all Older Americans Act funds expended must be
properly matched.
B. Consumer Contributions and Co-payments for Services
I) The recipient assures compliance with Section 315 of the Older Americans Act as amended in
2006, in regard to consumer contributions. Recipients may charge co-payments to those persons
able to pay part or all of the cost of services only for services not paid for with Older Americans
Act funds.
2) Voluntary contributions are not to be used for cost sharing or matching. (See Title 45, chapter
XIII, Part 1321.67, CFR.)
3) Accumulated voluntary contributions are to be used prior to requesting Federal reimbursement.
(See Title 45, Chapter XIII, Part 1321.67, CFR.)
4) Voluntary contributions and related interest earned are program income and must be used to
expand services.
C. Title III Funds
The recipient assures compliance with Section 306 of the Older Americans Act as amended in 2006,
that funds received under Title III will not be used to pay any part of a cost (including an
administrative cost) incurred by the recipient to carry out an agreement or commercial relationship
that is not carried out to implement Title III.
D. Prioritization for Service Delivery
The recipient shall develop and implement policies and procedures consistent with Older Americans
Act targeting criteria.
E. 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.
F. Caregiver Forums
CONTRACT AA-929
Page 5
The recipient will collaborate with the Alliance in supporting a Statewide Caregiver Forum
coordinated by the Department of Elder Affairs. The Alliance will sponsor the attendance of a
minimum of ten caregivers and contribute $1,000.00 toward the expense of speakers and
miscellaneous training expenses using agreement funds. Sponsorship of caregivers includes
providing funds for all expenses related to caregivers attending this event; to include registration,
travel, and local respite services. Recipients are also encouraged to help the Alliance plan and
conduct local caregiver forums utilizing Title III-E funds. Caregiver Forums are defined in the
Department of Elder Affairs Title III-E National Family Caregiver Support Guidelines.
Report
Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Legend: ·
Note #1:
Note #2:
CONTRACT AA-929
Page 6
ATTACHMENT II
AGREEMENT REPORT CALENDAR
ADVANCE BASIS AGREEMENT
TITLE III
Month
Based On
Submit To
Alliance On
This Date
Janu
Februa
. March
A ril
Ma
i June
Jul
Au st
Se tember
October
November
December
Janu
Janu
Februa
March 5
A ril5
Ma 5
June 5
Jul 5
Au st 5
Se tember 5
October 5
November 5
December 5
Janu 5
Februa 14
Februa 28
Advance based on projected cash need.
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.
Reports # I and #2 for Advance Basis Agreements cannot be submitted to the Alliance until
the agreement with the Alliance has been executed.
The last two months of the recipient's fiscal reports covering actual expenditures shall reflect
an adjustment repaying advances for the first two months of the agreement, if advances have
not been recouped.
CONTRACT AA-929
Page 7
ARC ATTACHMENT
Outsourced Aging Resource Center (ARC) functions and policies and Procedure
I. Under this Contract the provider agrees to the following:
A. Perform ARC outsourced functions in accordance with policies and procedures
developed by the Alliance for Aging. Refer to the following attachments:
1. ARC Attachment I: Policies and Procedures for Outsourced Function-
Screening
11. ARC Attachment II: Policies and Procedures for Outsourced Function-
Triage
111. ARC Attachment III: Policies and Procedures for Activation from
Waitlist- Client Services
IV. ARC Attachment IV: 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 forth by the Department of Elder Affairs.
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 R(:spite (RESP).
CONTRACT AA.929
Page 8
ARC Attachment I
Alliance for Aging, Inc.
Aging Resource Center/Elder Helpline
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.
CONTRACT AA-929
Page 9
ARC Attachment II
Alliance for Aging, Inc.
Aging Resource Center/Elder Helpline
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.
CONTRACT AA-929
Page 10
ARC Attachment III
Alliance for Aging, Inc.
Aging Resource Center/Elder Helpline
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.
CONTRACT AA-929
Page 11
ARC Attachment IV
Alliance for Aging, Inc.
Aging Resource Center/Elder Helpline
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.