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Item C42BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 4/15 — 4/16/09 Division: _County Administrator Bulk Item: Yes _X No _ Department: _Social Services/Nutrition Staff Contact Person/Phone #: Ellen Caron 292-4522 AGENDA ITEM WORDING: Request for approval of Vendor Agreement between Monroe County In -Home and Nutrition Services and Newtrition Concepts, Inc. ITEM BACKGROUND: The Alliance for Aging requires Nutrition Programs to have an on call licensed dietician in planning and providing nutrition services. The Alliance further requires that an agreement be entered into which itemizes the responsibilities and functions of the dietician as well as the method of payment. Danny Kolhage has requested that this agreement be approved by the Board of County Commissioners. PREVIOUS RELEVANT BOCC ACTION: Approval of Contract AA-929 between the Alliance for Aging and Monroe County Social Services, approved by the BOCC on 12/17/2008. CONTRACT/AGREEMENT CHANGES: Original Agreement - No changes. STAFF RECOMMENDATIONS: Approval TOTAL COST: $3053.00 INDIRECT COST: $0 BUDGETED: Yes X No COST TO COUNTY: $0 SOURCE OF FUNDS: Older Americans Act REVENUE PRODUCING: Yesfed X AMOUNT PER MONTH Year APPROVED BY: County Att04Purchasing Risk Management DOCUMENTATION: Incl Not Required DISPOSITION: Revised 1 /09 AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Newtrition Concepts, Inc. Contract # Effective Date: January 1, 2009 Expiration Date: December 31, 2009 Contract Purpose/Description: Provision of professional services of a licensed dietician Contract Manager: Sheryl Graham 4510 Social Services / Stop #1 (Name) (Ext.) (Department/Stop #) for BOCC meeting on 4/15-4/16/09 Agenda Deadline: March 31, 2009 CONTRACT COSTS Total Dollar Value of Contract: $ 3,053 Current Year Portion: $ Budgeted? Yes® No ❑ Account Codes: 125-6153109-530310- - Grant: $ 3053 125-6153209-530310- - County Match: $ N/A ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (e . maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes Date Out Date In Needed eview Division Director Yes❑ No❑ (,I Risk Manag�ent a3(-Q� Yes❑ No[r tT �) I O.M.B./Purch ing 3l �tf°� Yes❑ No `- - 3 1 k1l County Attorney a Yes[:] N60 3 4 G( Comments: -wits norm Kevisecl a/z //vi MLY 4Z VENDOR AGREEMENT Between Monroe County In -Home and Nutrition Services 1100 Simonton Street- Key West, F133040 And Cathy Clark -Reyes, R D , L D/N Newtrition Concepts, Inc PO Box 557083 Miami Fl 33255-7083 TeUFax: 305 812--2186 This agreement is made for Professional Nutritionist Consulting services between Monroe County In -Home and Nutrition Services (the Agency) and Cathy Clark -Reyes RD, LD/N (the Nutritional Consultant). The agreement is entered into effective day this lst day of January 2009 and expires on December 31, 2009 with the option to renew for one additional year on a year to year basis. The Nutritional Consultant accepts to perform the Responsibilities and Duties of the Dietitian/Nutritionist as related to nutrition program requirements. The Nutritional Consultant agrees to assume in full responsibility of the premises and mutual agreement with the Agency to the nutrition consultation services. Responsibilities and Functions: Monitoring of food services to ensure compliance with Chapter 64 Florida Administrative Code. This includes: Annual Facility Inspection and Annual Catering Monitoring and follow-ups. • Participate in developing the Nutrition Education plan and coordinate the provision of nutrition education for Congregate and Home delivered meals participants effectively and appropriately. Presentations and materials are to be distributed in English and Spanish as mandated by the Department of Elder Affairs and Alliance for Aging, Inc. • At a minimum of two times per year, provide menu review, input, approval, and attestation of menus and nutritional analyses developed by the In -Home and Nutrition Services food service provider. • Reviewing and approving menu substitutions. • Train staff, drivers, and volunteers in areas of nutrition, food service management, and sanitation as needed. 0 Assist in developing Nutrition Program participant satisfaction surveys. • Assist in Advisory Council Meeting. • Provide informal counseling and/or assist in developing interventions to assist participants that score high -risk nutritionally. Technical Support between the Agency and Alliance for Aging including but not limited to requests for information from Alliance for Aging, attendance at meetings, etc. Entire of Agreement This agreement ensures that these services are clearly and narrowly drafted in respect to the matters covered above. This agreement enters into consideration of the mutual covenants set forth herein and intending to be legally bound, the parties hereto agree as follow: Method of Payment: Monroe County In -Home and Nutrition Services agrees to pay the Consultant at the rate of Fees: On -site visits to Congregates Meal Sites $60 per hour Preparation Time Off -site Work $50 per hour Travel Time $60 per hour IN WITNESS WHEREOF, the parties here Monroe County In -Home and Nutrition Services, Sheryl Graham and the Nutritional Consultant Cathy Clark -Reyes, RD, LD/N have understood, negotiated and accepted the terms listed in this contract as of the date and year above to execute and renew this agreement. Cathy Clark -Reyes, RD, LD/N Vendor/Dietitian Sheryl Graham, MA, CWDP Monroe County In -Home and Nutrition Services Beginning Date 01/01/2009 E d A OE -OUNTY-TOPti"' Y RO ED A E i TANT COI TY ATTORNEY Date 12/31/2009 '7v/�� DEPARTMENT OF ELDER AFFAIRS PROGRAMS AND SERVICES HANDBOOK Chapter 4: Older Americans Act Service Requirements: Section 5—Nutrition Program Policies Planning for Nutrition Services Protection Manager training (see next paragraph). This may include the payment of a tuition fee, travel and per diem to local, statewide or out-of- state training programs designed to expand staff capacity to effectively carry out nutrition services. Food Protection Manager Training: Nutrition Programs that operate a kitchen and have three or more employees at one time engaged in the storage, preparation, display or service of food must identify an individual as the manager and that manager must successfully passed the test to become a Certified Food Protection Manager, (unless the manager is a Qualified Dietitian (refer to Nutrition Planning, section E). The manager must be present during the food service operation. Programs that do not prepare their own food must have a Certified Food Protection Manager responsible for the storage, display and serving of food for meal sites, but the Certified Food Protection Manager does not have to be present at all times. (Refer FAC 64E-11) New managers must be certified as a Food Protection Manager within 90 days of employment. The AAA may grant an extension up to 180 days. 2. Employee Food Safety Training Requirements: All food service staff and volunteers must receive semi-annual training on the prevention of food borne illness. Staff and Volunteers must be trained prior to assuming food service assignments 3. On going training plans should be based upon information obtained through the evaluation of training sessions and needs identified at that time, as well as staff requests. Approved Certified Food Protection Manager Training Programs: %,XD. Nutrition Consultant: 4. Each nutrition service provider shall obtain the advice of a licensed dietitian or licensed registered dietitian in planning and providing nutrition services. The number of consultation hours should be based on the size and complexity of the nutrition service provider, and may be established by the AAA. 5. The Qualified Dietitian or licensed registered dietitian shall be either a provider employee or an independent consultant, hired by the project (paid or in -kind.) The dietitian paid by the project's food service vendor is not acceptable in this position. 4-105 Date of Issuance: July 2008 DEPARTMENT OF ELDER AFFAIRS PROGRAMS AND SERVICES HANDBOOK Chapter 4: Older Americans Act Service Requirements: Section 5—Nutrition Program Policies Planning for Nutrition Services • Completed a pre -professional experience component of not less than 900 hours or has education or experience determined to be equivalent by the board. • Has an academic degree, from a foreign country, that has been validated by an accrediting agency approved by the United States Department of Education as equivalent to the baccalaureate or post - baccalaureate degree conferred by a regionally accredited college or university in the United States. • Completed a major course of study in human nutrition, food and nutrition, dietetics or food management. • Passed the State examination for licensure. • Completes continuing professional education requirements to maintain licensure. The above requirements are documented and verified by State of Florida, Department of Health, Division of Medical Quality Assurance Dietitian/Nutritionist License. Every Qualified Dietitian must provide a current copy of a State of Florida, Department of Health, Division of Medical Quality Assurance Dietitian/Nutritionist License to employer A resume for the provider's Qualified Dietitian, along with a copy of the individual's current registration with the Commission on Dietetic Registration of the American Dietetic Association and/or current Florida license with the Department of Health, Division of Medical Quality Assurance (Refer to F.A.C. Chapter 64138) shall be included in the funding application packet and submitted to the AAA when there is a personnel change in this position. 6. Responsibilities and functions of the Qualified Dietitian shall include, but are not limited to, the following: a. Participate in developing menus with input from the advisory council (Reference: Section 1); b. Ensure all menus as written meet nutritional criteria as required by DOEA (refer to Menu Planning, Development, Review and Approval Requirements section); 4-107 Date of Issuance: July 2008 DEPARTMENT OF ELDER AFFAIRS PROGRAMS AND SERVICES HANDBOOK Chapter 4: Older Americans Act Service Requirements: Section 5—Nutrition Program Policies Planning for Nutrition Services Qualified Dietitian Definition: For the purpose of the Florida elderly nutrition program, a "Qualified Dietitian" is a licensed or licensed registered dietitian and shall have one or more of the following qualifications: a. Registered Dietitian (RD) A Registered Dietitian is a food and nutrition expert who has met the following criteria to earn the RD credential: • Completed a minimum of a bachelor's degree at an U.S. regionally accredited university or college or equivalent and course work approved by the Commission on Accreditation for Dietetics Education (CADE) of the American Dietetic Association (ADA). • Completed a CADE-accredited or approved supervised practice program at a healthcare facility, community, agency, or a foodservice corporation, or combined with undergraduate or graduate studies. • Passed a national examination administered by the Commission on Dietetic Registration (CDR). • Completes continuing professional educational requirements to maintain registration. The above requirements are documented and verified by The American Dietetic Associations' Commission on Dietetic Registration. Every RD must provide a current copy of the Commission on Dietetic Registration (CDR card) issued by American Dietetic Association to employer. b. Licensed Dietitian/Nutritionist (LD or LD/N) Florida has regulatory laws for dietitians and nutrition practitioners. (Florida Statutes Chapter 468.509, FAC Chapter 646). Licensed Dietitians are food and nutrition experts who have met the following criteria as outlined in the Florida State Statutes 468.509 and FAC Chapter 6413) and have earned LD or LD/N credential. Completed a minimum of a bachelor's or post baccalaureate degree with a major course of study in human nutrition, food and nutrition, dietetics, or food management, or an equivalent major course of study, from a school or program accredited, at the time of the applicant's graduation, by the appropriate accrediting agency recognized by the Commission on Recognition of Post and Secondary Accreditation and the United States Department of Education. 4-106 Date of Issuance: July 2008 DEPARTMENT OF ELDER AFFAIRS PROGRAMS AND SERVICES HANDBOOK Chapter 4: Older Americans Act Service Requirements: Section 5—Nutrition Program Policies Planning for Nutrition Services c. Approve all menus (as indicated by a Authorizing signature on each weekly or monthly posted menu) 4 weeks prior to implementation; d. Monitor local meal sites and home delivered meal routes for compliance with food safety and sanitation requirements (See Requirements for Home Delivered Meals); e. Monitor food service for adherence to contract specifications (See Food Service Contract Requirements). This includes but is not limited to measuring potentially hazardous food temperatures and portion size; f. Participate in developing the nutrition education plan and coordinate the provision of nutrition education so it is effective and appropriate; g. Provide staff and volunteer training in areas of nutrition, food service management and food safety; h. Participate in the development of client satisfaction preference assessment tools, and Assessment of results; i. Participate in developing nutrition standards and delivery components of the food service vendor contract; and j. Provide nutrition counseling for clients that have high -risk nutritional scores (any score higher than 5.5 on the assessment tool). This service must be provided by a Florida Licensed Dietitian (FAC Chapter 64138-43). Any dietitian providing nutrition counseling should be covered by malpractice insurance. D. Technical Assistance: Each nutrition service provider should: 1. Inform the AAA of technical assistance needs for quality improvement and corrective action measures. 2. Provide technical assistance to its contract agencies, other related clients, and its advisory council. E. Records and Reports: Nutrition providers are required to: 4-108 Date of Issuance: July 2008 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 all provisions 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 A.NIEND1IENTS TO THIS CONTRACT. Attachment 1(OAA Program) and Attachment II (Report Calendar) and ARC Attachment are an integral part of this agreement and incorporated by reference. The Budget Summary by Title is as follows: Title III B (CFDA/CSFA # 93.044): $ 109,569 Title C1 (CFDA/CSFA # 93.045): $ 142,600 Title C2 (CFDA/CSFA # 93.045): $ 210,832 Title III E (CFDAICSFA # 93.052): $ 56,560 1. The Alliance shall make payment to the provider for provision of services up to a maximum number of units of service and at the rate(s) stated below: 2 Service(s) to be Provided Unit Rate Unit Maximum Units of Service Maximum Dollars Homemaker $34.29 1,734 $59,459 Personal Care $40.07 1,130 $45,274 Screening & Assessment IIIB $42.05 115 $4,836 Congregate Meals $9.56 14,677 $140,311 Nutrition Education C1 $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 This agreement shall begin on January 1, 2009 or the date it has been signed by both parties, whichever is earlier. All provisions in the contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. All 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 all its attachments are hereby made a part of the contract. IN WITNESS WHEREOF, the parties hereto have caused this amend ,ent to be exert d by their undersigned officials as duly authorized. rjj as PROVIDER: - m i _ JI roe County a�` ALLIANCE FOR AGING, INC. i es ! n z SIGNED BY: '" 't SIGNED BY: Max B. Rothman, J LL.M. NAME: a� i �� �� E'�? NAME: n TITLE: /E'J TITLE: President & CEO rn DATE: DATE: 'C ✓ J 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 (AAA) for each of them. The Alliance is responsible for assessing the needs of older persons within PSA-11. 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 government 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 k. The method of payment in this agreement includes advances and fired rate for all other set" ices. The recipient must ensure all costs and tiled rates include only those costs which are in accordance v% ith all applicable state and federal statutes and regulations and are based on historical costs and audited historical costs w hen applicable. All requests for payment and expenditure reports submitted to support requests for payment shall be on DOER forms 106A, 105A 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 51h 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 THEIR 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 H 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 Famed on General Revenue and Federal Funds: All interest income earned on the advance of Leneral 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 S250.00 per year may be retained by the recipient for administrative expenses. 1. 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 resol%ed as outlined in Section I.T. of the Master Agreement. The recipient agrees to implement the distribut ton of binds as detailed in the service application and �he Budget Summarv, ATTACH,NIENT III to `his agreement. Any changes in the amounts of federal funds identified on the Budget Summary torn require an aurecment 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 C( IRTS). 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 1) 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 111. D. Prioritization for Service Delivery The recipient shall develop and implement policies and procedures consistent with Older .\Anericans Act tametin,u criteria. E. Service Cost Reports The recipient will submit semi-annual service cost reports which reflect actual costs of providing each scry ice by program. Tliis report prop ides infoi7nation for planning and negotiating unit rates. F. CaregiN er 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. CONTRACT AA-929 Page 6 ATTACHMENT II AGREEMENT REPORT CALENDAR ADVANCE BASIS AGREEMENT TITLE III Number .,N�_ � maw"n Submit To Alliance On This Date 1 January Advance * Janua 1 2 February Advance * January 1 3 March January Expenditure Report February 5 4 Aril February Expenditure Report :March 5 5 May March Expenditure Report Aril 5 6 June Aril Expenditure Report May 5 7 July May Expenditure Report June 5 8 August June Expenditure Report July 5 9 September July Expenditure Report August 5 10 October August Expenditure Report September 5 11 November September Expenditure Report October 5 12 December October Expenditure Report November 5 13 November Expenditure Report December 5 14 December Expenditure Report January 5 15 Final Payment Request February 14 16 Closeout Package Februa 28 Legend: * Advance based on projected cash need. Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects funds due back to the Alliance, payment is to accompany the report. Note # 1: Reports # 1 and #2 for Advance Basis Agreements cannot be submitted to the alliance until the agreement with the Alliance has been executed. Note #2: 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: i. ARC Attachment I: Policies and Procedures for Outsourced Function - Screening ib— ARC Atta�hmenrI Rolicies-auul Piocedures for -6titsourced Function —- Triage iii. 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 Respite (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 701E assessment already exists or is provided from another source (i.e. CARES) the information from the 701E 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). 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]. 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. 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.