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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.