2nd Amendment 04/17/2013AMY REAVILIN, CPA
CLERK OF CIRCUIT COURT & COMPTROLLER
MONROE COUNTY, FLORIDA
DATE: May 2, 2013
TO: Sheryl Graham, Director
Social Services Department
ATTN.• Dotti Albury
In -Home Services Programs
FROM. Pamela G. Hanco *C.
At the April 27, 2013, Board of County Commissioner's meeting the Board granted approval and
authorized execution of the following:
Item C13 Amendment 002 to the Community Care for the Elderly (CCE) Contract KC -1271
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 July 1, 2012 to June 30, 2013.
Item C14 Amendment 002 to the Home Care for the Elderly (HCE) Contract KH -1272 between the
Alliance for Aging, Inc. (Area Agency on Aging) and the Monroe County Board of County
Commissioners (Social Services /In -Home Services) for the period of July 1, 2012 to June 30, 2013.
Enclosed are five duplicate originals of each of the above - mentioned, executed on behalf of
Monroe County, for your handling. Please be sure to return two fully executed duplicate originals as
soon as possible. Should you have any questions, please do not hesitate to contact our office.
cc: County Attorney w/o documents
Finance
File A/
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3117 Overseas Highway, Marathon, FL 33050 Phone: 305- 289 -6027 Fax: 305 -289 -6025
88820 Overseas Highway, Plantation Key, FL 33070 Phone: 852 -7145 Fax: 305 - 852 -7146
Amendment 002 CONTRACT KC 1271 Page 1
THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred
to as the "Alliance ", and Monroe County Board of Commissioners.
The purpose of this amendment is to modify Attachment III of the original contract to read:
REFERRAL PROTOCOL
Issue: Screening, Triage, and Referral for Activation under the Community Care for
the Elderly /Home Care for the Elderly Programs and for the Aging & Disabled Adults
and the Assisted Living for the Elderly Medicaid Waivers.
Policy: Referrals will be based on availability of funds, in accordance with prioritization
requirements.
Purpose: To ensure funding is spent expeditiously and consumers are referred into programs
for appropriate services.
Procedure for Monroe County:
Roles and Responsibilities
A. Alliance for Aging / Aging and Disability Resource Center
➢ Reconciles overall program and Lead Agency specific spending levels on a
monthly basis to ensure the Lead Agency is operating within the funding
allocation.
➢ Reviews the number of cases released for activation based on projected
funding available.
➢ Screens consumers to link with appropriate resources and prioritize for
DOEA- funded programs and services.
➢ Recommends potential cases for activation based upon projected funding
available by Lead Agency.
➢ Selects consumers from the waiting list based on their prioritization score.
➢ Refers consumers from the waiting list to the Lead Agency in Monroe County
for activation, based on availability of funds.
➢ Monitors compliance with service standards and outcome measures.
➢ Reviews care plans and files per the File Review Policies and Procedures.
➢ Reviews data in CIRTS.
B. Case Management Agency
➢ Requests and accepts referrals from the Aging and Disability Resource
Center, to serve an optimal caseload and to avoid surpluses or deficits in
accordance with the AAA CCE /HCE Surplus /Deficit Analysis policy.
➢ Refers inquiries from consumers interested in services to the ADRC for
Information and Referral to community resources, Screening, Triage, and
Long -Term Care Options Counseling, as appropriate.
➢ The functions of Screening and Intake are outsourced to the Lead Agency.
Screening and Intake may also be completed by the ADRC.
➢ Completes comprehensive assessments on new consumers and annual
reassessment on existing consumers and develops care plans and reviews
care plans semi - annually.
➢ Authorizes service delivery and enters data into CIRTS.
➢ Screens consumers for Medicaid Waiver eligibility.
➢ Bills in CIRTS and Medicaid as appropriate.
➢ Monitors care plans in an effort to keep costs down while sustaining the
individuals in the community.
Amendment 002 CONTRACT KC 1271 Page 2
II. Management of the Assessed Prioritized Consumer List (APCL).
A. Referrals to the ADRC are routed to the Information and Referral Specialists or
Intake Unit staff depending on the type of referral. Clients are provided information on
community resources and programs available including private pay options. Persons are
directed to those resources most capable of meeting the need they have expressed to
ADRC staff. Cases presenting strong identifiers that indicate the consumer might benefit
from publicly funded long term care services are screened, entered into CIRTS, triaged and
provided options counseling. In Monroe County, the functions of Screening and Intake are
outsourced to the Lead Agency. Screening and Intake may also be completed by the ADRC.
DOEA prioritization requirements will be adhered to by both entities, as follows:
APS High Risk Referrals (See section B)
2. Imminent Risk cases will be prioritized for activation after APS
High Risk Referrals have been served. If budgetary constraints prevent
opening new cases, clients will be placed on the APCL. ADRC staff will
contact the client on a monthly basis to determine if there has been a change
in the client's situation.
3. All other CARES referrals will be screened and prioritized in accordance with
DOEA requirements.
4. Aging Out consumers will be referred by DCF for prioritization
and /or activation in the corresponding aged program managed by the
Alliance, as appropriate (See section IV).
5. Consumers applying for the Community Care for the Elderly
(CCE) and /or Home Care for the Elderly (HCE) programs will be contacted
and screened using the statewide assessment form developed by the
Department of Elder Affairs for this purpose (Form 701A). If a consumer is
being served through a DOEA- funded agency which enters their annual
assessment into CIRTS, the Priority Score generated by that assessment will
determine their ranking on the APCL.
6. Consumers referred for inclusion under the Assisted Living for
the Elderly (ALE) Medicaid Waiver APCL will be interviewed and screened
using the 701A form.
7. Consumers referred for inclusion under the Aging and
Disabled Adult (ADA) Medicaid Waiver APCL will be contacted and screened
following the same procedure as the one described under Section 5.
Individuals who appear as potentially eligible for other types of public
assistance will be referred to the Economic Self- Sufficiency Unit at the
Department of Children and Families.
8. All other referrals will be waitlisted and prioritized, during which time other
community resources will be researched, including private pay /fee for
services providers. Consumers on the waiting lists will be reassessed
according to the 2012 Department of Elder Affairs Programs and Services
Handbook, or any revisions made thereafter.
B. HIPAA forms will be sent to the consumer as appropriate.
III. Opening New Cases
Amendment 002 CONTRACT KC 1271
A. CCE /HCE Clients
Page 3
The Fiscal Department will monitor Lead Agency specific spending levels on
a monthly basis to ensure each Lead Agency is operating within its spending
authority. In addition, the fiscal department will analyze surplus /deficit
projections, and share the information with the Lead Agency to assist in their
determination of slot availability. The Lead Agency will request referrals
directly from the ADRC. The Fiscal Department will be notified of the number
of new cases being referred to the Lead Agency for activation.
2. Upon receipt of the request for referrals from the Lead Agency, the ADRC
Intake Unit Supervisor will run the Prioritized Risk Report to identify the
consumers on the APCL to be opened.
3. In response to the request for referrals, the ADRC Intake Unit Supervisor will
refer wait listed clients to the Lead Agency for activation, in accordance with
prioritization requirements. The Intake Unit will update the wait list enrollment
using the appropriate code to terminate from the APCL. Upon receipt of
referral, the Lead Agency will enter the APPL enrollment, and subsequent
enrollments to reflect client status.
4. Upon receipt of list of clients released from the waiting list, the Lead Agency
will enter the APPL enrollment, will contact clients to offer program
enrollment, and will proceed with activation. The Lead Agency will enter
subsequent enrollments into CIRTS to reflect client status.
5. The ADRC will oversee the enrollment process to ensure referrals have
timely outcomes in CIRTS.
B. MW /ALW Clients
1. The Department of Elder Affairs will run the APCL (Assessed Priority
Consumer List) report to review clients wait listed for the ALW and MW
programs. DOEA will provide the ADRC with a list of individuals
authorized for release from the APCL.
2. For clients identified as active in CCE or HCE and authorized for release
from the Medicaid Waiver waiting list, the Lead Agency will be
responsible for the Medicaid Waiver application process.
C. APS Referrals
APS Low and Intermediate Risk referrals will be screened and prioritized by
the ADRC for services as per the DOEA/APS Memorandum of
Understanding. Low and Intermediate Risk referrals are also offered
information and referral to additional community resources, including private
pay as appropriate.
2. APS High Risk Referrals are not waitlisted. They are immediately referred for
service from DCF in Monroe County to the Lead Agency. ARTT referrals will
be forwarded directly the Lead Agency. APS cases are to be served for a
maximum of 31 calendar days. If additional time is justified, the case
management agency will staff the case with the Alliance to obtain the
extension needed.
Amendment 002 CONTRACT KC 1271 Page 4
3. Upon receipt of the APS High Risk referral, the Lead Agency will coordinate
services to begin within the 72 hour period mandated by statute. A
comprehensive assessment will be done within 72 hours of the referral.
Services required under the care plan will remain in place for a maximum of
31 days, unless an extension has been granted.
4. The Lead Agency will enter ACTV enrollment under their provider number in
CIRTS. In addition, service codes will be entered by service date for all
services provided. If a service(s) is not provided as required under the care
plan, an NDP code will need to be entered in CIRTS and the case notes
under the client file should document the reason for non - delivery of such
service(s). M o _n
IV. Aging Out Consumers:
A. All "Aging Out" consumers will be referred by DCF to the ADRG =fnr enroiwentUnto
the corresponding aged program managed by the Alliance.
b
B. Consumers active in the CCDA and HCDA programs that are turning (Marare
eligible for CCE and /or HCE will be opened in the corresponding aged program
managed by the Alliance if funding is available. If funding is available, these
consumers will be made active. If funding is not available, they will be waitlisted for
these programs but will be given priority for activation once funding is available.
C. Consumers active in the ADA Medicaid Waiver, upon turning age 60, will continue to
be eligible for and receive ADA Medicaid Waiver services.
Note: These ADRC policies and procedures are subject to change. Any modifications will be
done through a contract amendment.
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. This
amendment and all its attachments are hereby made a part of the contract.
IN WITNESS WHEREOF, the parties hereto have caused this 1 -page amendment to be executed
by their undersigned officials as duly authorized.
PROVIDER:
M roe County B and of
Commission
SIGNED BY: 't-
n7l
George Neugent
NAME:
, Mayor
TITLE:
4 -17 -2013
DATE:
is
AMY N UiLIIL1, CLERK MO
ALLIANCE FOR AGING, INC.
SIGNED BY:
max Kotn7TTan�,u1},-t'Cm.
NAME:
President & CEO
TITLE:
DATE: MAY 2 H013
� CO NTY