06/18/1997 MEMORANDUM OF AGREEMENT
BETWEEN
THE ALLIANCE FOR AGING, INC.
AND
MONROE COUNTY SOCIAL SERVICES
c- .,
PERTAINING TO
HOME CARE FOR THE ELDERLY PROGRAM SPENDING AUTHORITY FOR 1997 -98
This Memorandum of Agreement outlines the Home Care for the Elderly Subsidy Payment spending
authority for Monroe County Social Services, hereinafter referred to as the "Provider for 1'997=8 and
details the responsibilities and the expectations associated with this authority.
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1. The Alliance For Aging has determined the total amount of Home Care for the Elderly subsidy
payments available to each Lead Agency within Planning and Service Area (PSA) 11 based on each
county's proportion of the clients enrolled in the Home Care for the Elderly Program as of June 1,
1997.
2. The 1997 -98 Home Care for the Elderly Subsidy Payment spending authority for the Provider is
$62,944.00. Under no circumstances must the Provider exceed the allocated spending authority
limits. To that effect, the Provider agrees to do the following:
a. The Provider will establish, house and maintain a client voucher file for each client enrolled
in the HCE Program. Client voucher files shall be intended to establish a proper audit trail of
services authorized and provided to clients enrolled in the HCE program.
b. Client voucher files will contain a separate service payment/utilization record (DOEA Form
133) for each month that the client is enrolled in the HCE program. DOEA Form 133
establishes a payment trail, by client, of services authorized for payment. It further serves
as the instrument for data entry of service utilization information in the Client Information,
Registration and Tracking System (CIRTS).
c. All items /services purchased by a caregiver in support of a client shall require prior
authorization from the case manager who shall so indicate in the client care plan /case record.
A receipt, signed by the caregiver, must be presented to the case manager and attached to
DOEA Form 133 in order to authorize payment. Receipts for all authorized items /services
must be present in the client voucher file in support of all caregiver reimbursements.
d. For services provided by vendors, including the Lead Agency, case managers will be
responsible for indicating the Provider ID /Location Code and Service Type on DOEA Form 133.
Service payment amount information shall be entered on DOEA Form 133 by the Lead Agency
utilizing vendor invoices which clearly indicate the client served, services received, date of
service and payment information. Prior authorization by the case manager is required before
a service is received. The authorization for the client to receive these services shall be the
case manager's entry into the client care plan /case record as well as the case manager's entry
on DOEA Form 133 to indicate Provider ID /Location, Service Code and payment information.
e. The Provider will enter all data for HCE Basic and Special Subsidies in CIRTS by the 15th of
each month for payments incurred between the 16th of the previous month and the 15th of
the current month.
MEMORANDUM OF AGREEMENT Page Two
Monroe County Social Services
& The Alliance For Aging
f. The Provider will run a CIRTS Monthly Utilization Report. The Provider will verify, correct and
certify the Monthly Utilization Report and submit this report to the Alliance by the 20th of the
month in which the report is generated. The Alliance may also require a Request for Payment
and Receipt and Expenditure Report to accompany this report.
g. Caregivers who are determined eligible for the HCE Basic Subsidy after the 15th of a month,
will be processed by the Provider to begin eligibility for the HCE Basic Subsidy in the first day
of the following month.
h. The Provider is responsible for continued monitoring of all vendors with which it holds
agreements for the provision of services to be reimbursed as Special Subsidies. Said
agreements must be approved by the Alliance, outline the vendor's responsibility to carefully
follow clients' care plans /service authorizations and adhere to spending limits.
3. The Alliance agrees to do the following:
a. The Alliance will verify and process the CIRTS data prior to payment for HCE Basic and
Special Subsidies.
b. Provided the monthly report is received from the Case Management agency by the due date,
the Alliance will process Basic and Special, Subsidy checks to caregivers by the third of the
month following the month services are rendered.
c. The Alliance will supply the Provider with a list of the amount paid each month to each
caregiver, the date the payment was made and the check number.
This Memorandum of Agreement will be in effect for the period June 1, 1997 through July 30, 1998
or until otherwise revised or terminated.
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PROVIDER: MONR • E COUNTY ALLIANCE FOR AGING, INC. x -`1
0 L SERVIC
�..• 3fr Y L. KOLHAGE, CLERK
SIGNED SIGNE D
DEPUTY CLERK
NAME. C , �� j S NAME:Willis N Murray
TITLE: / 1/1 / 1- / TITLE:President
DATE: OCo / 8 -9 DATE: /Q/ 27c
!? AS TO FOR
SUFFICIE ^ 1 /
FEDERAL ID NUMBER: 59-6000749 ( //
PROVIDER PROVIDER FISCAL YEAR ENDING DATE: 9/30 4,„„,-- i NE c. TTON