06/17/2009 Contract
DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE:
June 23,2009
TO:
Community Services
A TTN:
Dotti Albury
In-Home Services Programs
FROM:
Pamela G. Ha~
Deputy Clerk ~
At the June 17, 2009, Board of County Commissioners' meeting the Board granted
approval and authorized execution of the following:
. Alzheimer's Disease Initiative (AD I) Contract KZ-997 between the Alliance for Aging,
Inc. (Area Agency on Aging) and the Monroe County Board of County Commissioners (Social
Services/In-Home Services) for Fiscal Year 7/1/09 to 6/30/10.
· Community Care for the Elderly (CCE) Contract KC-971 between the Alliance for
Aging, Inc. (Area Agency on Aging) and the Monroe County Board of County Commissioners
(Social Services/In-Home Services) for Fiscal Year 7/1/09 to 6/30/1 O.
. Home Care for the Elderly (HCE) Contract KH-972 between the Alliance for Aging, Inc.
(Area Agency on Aging) and the Monroe County Board of County Commissioners (Social
Services/In-Home Services) for Fiscal Year 7/1/09 to 6/30/10.
· Amendment 001 to the Community Care for Disabled Adults (CCDA) Contract KG-061
(1/1/09-6/30/1 0) between the Florida Department of Children & Families and the Monroe
County Board of County Commissioners (Social Services/In-Home Services).
Enclosed are four 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 Original" and the "Monroe County Finance Department's Original". Should you
have any questions, please do not hesitate to contact our office.
cc: County Attorney
Finance w/o documents
File ./
OKYv~~Y ~o~~~~E
(305) 294-4641
BOARD OF COUNTY COMMISSIONERS
Mayor George Nugent, District 2
Mayor Pro Tern Sylvia J. Murphy, District 5
Kim Wigington, District 1
Heather Carruthers, District 3
Mario Di Gennaro, District 4
MEMORANDUM
DATE:
Isabel DeSantis and/or Pamela Hancock, County Clerk(s), Monroe County Clerk's Office
Dotti Albury, Administrative Assistant, In-Home service~
7/9/2009
TO:
FROM:
RE:
B.O.C.C. June 17,2009 Agenda Items
On June 17,2009, the Board of County commissioners approved and authorized execution of the following:
Amendment 0001 to the Community Care for Disabled Adults (CCDA) Contract KG-061 between Monroe
County and the Florida Department of Children & Families.
Alzheimer's Disease Initiative (ADO Contract KZ-997 for fiscal year July 1, 2009 through June 30, 2010
between Monroe County and the Alliance for Aging, Inc.
Community Care for the Elderly (CCE) Contract KC-971 for fiscal year July 1,2009 through June 30,2010
between Monroe County and the Alliance for Aging, Inc.
Honle Care for the Elderly (HCE) Contract KH-972 for fiscal year July 1,2009 through June 30,2010 between
Monroe County and the Alliance for Aging, Inc.
Enclosed are two (2) originals of the above mentioned fully executed.
Thank you.
Enclosures
CC: Sheryl Graham, Director, Social Services
CONTRACT KZ-997
Page 1
ALZHEIMERS' DISEASE INITIATIVE CONTRACT
2009-2010
THIS AGREEMENT is entered into between the Alliance for Aging, Inc., hereinafter
referred to as the "Alliance," and Monroe County Board of Commissioners, hereinafter
referred to as the "recipient." This agreement is subject to all provisions contained in the
MASTER AGREEMENT executed between the Alliance and the Recipient, Agreement No.
PA829, and its successor, incorporated herein by reference. Attachment I, II, ill, IV, V, VI,
VII and vm are integral to this Agreement.
I. Recipient Agrees:
A. Services to be Provided:
1. To plan, develop, and accomplish the services delineated, or otherwise cause the
planning, development, and accomplishment of such services and activities, under the
conditions specified and in the manner prescribed in Attachment I of this aareement
and included in the Service Provider Aoolication (SPA) submitted in resoonse to the
March 2008 CCE/Lead Aaencv RFP. The recipient will not be allowed to provide
services that are not included in the SPA submitted in response to the March 2008
CCE/Lead Agency RFP and included related Unit Cost Methodology submitted as an
integral part of the RFP application. In the event of the conflict between the Service
Provider Application and this contract, the contract controls. Additionally, the recipient is
subject to the Referral Protocol and ARC Outsourced Functions included in Attachment
IV and ARC Outsourced Functions Policies and Procedures outlined in Attachments
V,VI,VII and VIII.
2. Consumers may not be enrolled in a Department of Elder Affairs' state general revenue
funded program, including ADI, who are also enrolled in a Medicaid capitated long-term
care health plan or program. These programs include the Frail Elder Program operated
by United Health Care, the Channeling Program operated by Miami Jewish Home and
Hospital for the Aged, the Long Term Care Community Diversion Program and the
Program of All Inclusive Care for the Elderly (PACE) program scheduled to begin
operation in the Miami-Dade County area.
B. Manner of Service Provision:
The services will be provided in a manner consistent with and described in the recipient's
service provider application for state fiscal year 2009 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.
II. The Alliance Agrees:
A. Contract Amount:
To pay for services in an amount not to exceed $62.198.00, subject to the availability of funds.
Obligation to Pay:
The Alliance's performance and obligation to pay under this contract is contingent upon an annual
appropriation by the Legislature.
B. Source of Funds:
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CONTRACT KZ-997
Page 2
The costs of services paid under any other contract or from any other source are not eligible for
reimbursement under this contract. The funds awarded to the recipient pursuant to this contract
are in the state grants and aids appropriations.
III. Recipient and Alliance Mutually Agree:
A. Effective Date:
1. This contract shall begin on July 1, 2009 or on the date the contract has been signed by
both parties, whichever is earlier.
2. Delivery of services shall end on June 30, 2010.
IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed by their
undersigned officials as duly authorized.
PROVIDER:
Monroe County Board of ALLIANCE FOR AGING, INC.
/ CommiSSiO~
SIGNED BY: ~ ~ e 0 f-p,-..J SIGNED BY:
/ 0--
NAME: George Neugent NAME:
TITLE:
Mayor
President & CEO
TITLE:
7/A9
DATE:
6-:-17-09
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CONTRACT KZ-997
Page 3
ATTACHMENT I
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
I. STATEMENT OF PURPOSE
The Alzheimer's Disease Initiative (ADI) Program is focused on caring for persons 18 + with memory
disorders.
II. SERVICES TO BE PROVIDED
A. Services:
1. The recipient's service provider application for state fiscal year 2009 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 ADI, who are also enrolled in a Medicaid capitated long-term
care health plan or program. These programs include the Frail Elder Program operated
by United Health Care, the Channeling Program operated by Miami Jewish Home and
Hospital for the Aged, the Long Term Care Community Diversion Program operating in
Planning and Service Areas 7 and 9, and any other areas that may participate in the
Long Term Care Diversion Program through expansion and the Program of All Inclusive
Care for the Elderly (PACE) program scheduled to begin operation in the Miami-Dade
County area.
B. Manner of Service Provision:
The services will be provided in a manner consistent with and described in the recipient's
service provider application for state fiscal year 2009 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 fonns 1062 and 1052. Duplication or replication of both forms via data processing
equipment is permissible, provided all data elements are in the same format as included on
departmental forms.
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CONTRACT KZ-997
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 Alliance upon request.
C. The recipient shall maintain documentation to support payment requests which shall be
available to the Alliance, the Department of Elder Affairs or the Comptroller upon request.
D. The recipient may request a monthly advance for service costs for each of the first two
months of the contract period, based on anticipated cash needs. Detailed documentation
justifying cash needs for advances must be submitted with the signed contract, approved by
the Alliance, and maintained in the contract manager's file. All payment requests for the third
through the twelfth 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 the time the final payment is
made. All advance payments are subject to the availability of funds.
E. Advance funds may be temporarily invested by the recipient in an insured interest bearing
account. All interest earned on contract fund advances must be returned to the Alliance
within thirty (30) days of the end of the first quarter of the contract period.
F. The Alliance shall make payment to the provider for provision of services up to a maximum
number of units of service and at the rate(s) stated below:
Service Maximum Maximum
Service to be Provided Unit Rate Units of Dollars
Service
In Home Respite $24.03 2,588 $62,198
G. Any payment due by the Alliance under the terms of this contract may be withheld pending
the receipt and approval by the Alliance of complete and accurate financial and
programmatic reports due from the recipient and any adjustments thereto, including any
disallowance not resolved as outlined in Section I. T. of the Master Agreement.
IV. SPECIAL PROVISIONS
A. State Laws and Regulations:
The recipient agrees to comply with applicable parts of Rule 58D-1, Florida Administrative
Code promulgated for administration of Sections 430.501 through 430.504, Florida Statutes,
and the Department of Elder Affairs Client Home and Community Based Services Handbook
dated 01/03.
B. Assessment and Prioritization for Service Delivery for New Consumers:
The following are the criteria to prioritize new consumers for service delivery. It is not the
intent of the Department of Elder Affairs to remove existing clients from any program in order
to serve new clients being assessed and prioritized for service delivery.
1 . Priority Criteria for Service Delivery:
a. individuals in nursing homes under Medicaid who could be transferred to the
community;
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CONTRACT KZ-997
Page 5
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. Co-payment Collections:
1. The recipient will establish annual co-payment goals. The Alliance also has the option
to withhold a portion of the recipient's Request for Payment if goals are not met
according to the Department of Elder Affairs' co-payment guidelines.
2. Co-payments include only the amounts assessed consumers or the amounts consumers
opt to contribute in lieu of an assessed co-payment. The contribution must be equal to
or greater than the assessed co-payment.
D. Evaluation, Statistics and Reports
The recipient agrees to respond to requests for evaluation information and statistical data
concerning its consumers based on information requirements of the Memory Disorder Clinics and
Brain Bank. The recipient will ensure Model Day Care Centers supported by this contract
develop innovative therapies and interventions which can be shared with other Alzheimer's
Disease Initiative health and social services personnel via training. Model Day Care Centers
supported by this contract must report to the provider all training activities provided to health care
and social service personnel and caregivers, as well as serve as a natural laboratory for service
related applied research by Memory Disorder Clinics. An annual Model Day Care Center
Training Report is due by July 5, 2009.
E. Collaboration with Memory Disorder Clinics:
Memory Disorder Clinics are required to provide four hours of in-service training to all respite and
model day care centers in their designated service areas. The recipient agrees to collaborate
with Memory Disorder Clinics to assist in this effort.
F. 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.
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CONTRACT KZ 997
Page 6
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CONTRACT KZ 997
Page 7
ATTACHMENT II
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
CONTRACT REPORT CALENDAR
Report Based On
Number
1 July Advance * ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
2 August Advance * ...........................................................
3 July Expenditure Report ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ....
4 August Expenditure Report ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
S September Expenditure Report ... ... ... ... ... ... ... ... ... ... ... ... ... ....
6 October Expenditure Report ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ..
7 November Expenditure Report... ... ... ... ... ... ... ... ... ... .. . ... ... ... ..
8 December Expenditure Report ... ... ... ... ... ... ... ... ... ... ... ... ... .....
9 January Expenditure Report ... . .. ... ... ... ... ... ... ... ... ... ... ... ... ... ..
10 February Expenditure Report ... ... ... ... ... ... ... ... ... ... ... ... ... ... ....
11 March Expenditure Report...... ...... ... ...... ... ...... ... ...... ... ... .....
12 April Expenditure Report ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ....
13 May Expenditure Report/July Advance Reconciliation ** ...........
14 June Expenditure Report/August Advance Reconciliation ** ... ...
16 Final Expenditure and Closeout Report .................
Leaend:
*
Advance based on projected cash need.
**
Submit
to the Alliance
on This Date
July 1
July 1
August 10
September 10
October 10
November 10
December 10
January 10
February 10
March 10
April 1 0
May 10
June 10
July 10
July 20
Submission of expenditure reports mayor may not generate a payment request. If final
expenditure report reflects funds due back to the Alliance, payment is to accompany the
report.
Note # 1 :
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.
Note # 2:
The last two months of the recipient's fiscal reports covering actual expenditures should
reflect an adjustment repaying advances for the first two months of the contract.
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CONTRACT KZ 997
Page 8
ATTACHMENT III
ANNUAL MODEL DAY CARE CENTER TRAINING REPORT
Model Day Care Center Name:
Printed Name of Person
Completing Report
Signature of Person
Completing Report
Date Executed
The purpose of each model day care program must be to provide service delivery to persons suffering
from Alzheimer's disease or a related memory disorder and training for health care and social service
personnel in the care of persons having Alzheimer's disease or related memory disorders. This report
documents the required training for the State Fiscal Year July 1 st through June 30th.
Number Number Total
Actual Training Event(s) Health Care Social People
Professionals Services Trained
Trained Personnel
Trained
Training Title:
Date:
Training Summary:
******
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CONTRACT KZ 997
Page 9
ATTACHMENT IV
Aging Resource Center Outsourced Functions
A. Perfonn ARC outsourced functions in accordance with policies and procedures
developed by the Alliance for Aging. Refer to the following attachments:
i. Attachment V: Policies and Procedures for Outsourced Function-Screening
ii. Attachment VI: Policies and Procedures for Outsourced Function-Triage
iii. Attachment VII: Policies and Procedures for Activation from Waitlist- Client
Services
iv. Attachment VIII: Policies and Procedures for Tennination 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-tenn 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).
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CONTRACT KZ 997
Page 10
ATTACHMENT V
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 701 B assessment already exists or is provided from another
source (Le. CARES) the information from the 701 B can be utilized.
2. Based on the information provided via the 701 A(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.
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CONTRACT KZ 997
Page 11
ATTACHMENT VI
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 701 A(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.
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CONTRACT KZ 997
Page 12
Attachment VII
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.
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CONTRACT KZ 997
Page 13
Attachment VIII
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 (Le. 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.
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