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1st Amendment 12/12/2016 • Fully ORIGINIL KC -1671 Amendment 001 Executed THIS AMENDMENT is entered into between the Alliance for Aging, Inc. hereinafter referred to as the "Alliance ", and Monroe County Board of County Commissioners, Social Services/In -Home Services, hereinafter referred to as the "Provider ", and collectively referred to as the "Parties." The purpose of this amendment is to make the following changes to existing contract. • To replace, in whole REFFERAL PROTOCOL, ATTACHMENT C, attached to this Amendment. This amendment does not change the total contract funding of $413.700.00 The Budget Summary by Title for the whole contract year (July 1, 2016 -June 30, 2017) is as follows: Maximum Maximum Service to be Provided Service Unit Rate Units of Dollars Service Case Aid $21.98 299 $6,562.00 Case Management $50.48 787 $39,728.00 Chore $29.41 127 $3,732.00 Chore (Enhanced) $32.19 97 $3,123.00 Companionship 15.33 1,142 $17,504.00 Homemaker $22.06 6,325 $139,521.00 Home Improvement Cost Reimbursed 75 $746.00 Personal Care $28.67 5,395 $154,672.00 Respite (In- Facility) $10.00 2,445 $24,451.00 Respite (In Home) $23.08 970 $22,394.00 Specialized Medical Equipment Cost Reimbursed 127 $1,267.00 TOTAL $413,700.00 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. KC -1671 Amendment 001 IN WITNESS WHEREOF, the parties hereto have caused this amendment to be executed by their undersigned officials as duly authorized. MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, ALLIANCE FOR AGING, INC. SOCIAL SERVICES/IN -HOME SERV ES y.... ie4 ht.41€1 �2 SIGNED SIGNED BY: (�' 1 Ma B. Rothman, , LL.M. NAME: ( eW r3e_ P.Pi t ae l+ NAME: L � President & CEO TITLE: MAYOR TITLE: DATE: 0 /0 //CO DATE: 1 - 1 IC, .: 16 -4..N \ ,.. -- 11 0 - '"'""h 1 7- ■ idli joi k � � JJ �R YIUN, CLERK i -1 _ , . CLERK 7 /e _, ,k) . At • J1 Z1,1 (, KC -1671 Amendment 001 ATTACHMENT C REFERRAL PROTOCOL Issue: Screening, Triage, and Referral for Activation under the Community Care for the Elderly /Home Care for the Elderly. 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: I. Roles and Responsibilities A. Alliance for Aging / Aging and Disability Resource Center 1. Reconciles overall program and Lead Agency specific spending levels on a monthly basis to ensure the Lead Agency is operating within the funding allocation. 2. Reviews the number of cases released for activation based on projected funding available. 3. Screens consumers to link with appropriate resources and prioritize for DOEA- funded programs and services. 4. Recommends potential cases for activation based upon projected funding available by Lead Agency. 5. Selects consumers from the waiting list based on their prioritization score. 6. Refers consumers from the waiting list to the Lead Agency in Monroe County for activation, based on availability of funds. 7. Monitors compliance with service standards and outcome measures. 8. Reviews care plans and files per the File Review Policies and Procedures. 9. Reviews data in CIRTS. B. Case Management Agency 1. 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. 2. 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. 3. Completes comprehensive assessments on new consumers and annual reassessment on existing consumers and develops care plans and reviews care plans semi - annually. 4. Authorizes service delivery and enters data into CIRTS. 5. Identifies consumers for placement onto the Statewide Medicaid Managed Care Long Term Care Program (SMMCLTC) waiting list 6. Bills in CIRTS as appropriate. 7. Monitors care plans in an effort to keep costs down while sustaining the individuals in the community. IL 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 t • KC -1671 Amendment 001 identifiers that indicate the consumer might benefit from publicly funded long term care services are screened, entered into CIRTS, triaged and provided options counseling. DOEA prioritization requirements will be adhered to by both entities, as follows: 1. 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. 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). 4. 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 701S). 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. 5. Consumers referred for inclusion under the Statewide Medicaid Managed Care Long Term Care Program APCL will be contacted and screened by an ADRC staff person 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. 6. 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 2016 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 A. CCE/HCE Clients 1. 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, for release to the Lead Agency (TAEL). 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. KC -1671 Amendment 001 B. Statewide Medicaid Managed Care Long Term Care Program Clients 1. The Department of Elder Affairs will run the statewide APCL (Assessed Priority Consumer List) report to review clients wait listed for the SMMCLTCP. DOEA will provide the ADRC with a list of individuals authorized for release from the APCL. 2. For clients active in CCE or HCE and authorized for release from the SMMCLTCP waiting list, the ADRC will be responsible for the application process. For CCE active clients the ADRC will notify the Lead Agency in order to waive the CCE co -pay. C. APS Referrals 1. 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. 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). IV. Aging Out Consumers: A. All "Aging Out" consumers will be referred by DCF to the ADRC for enrollment into the corresponding aged program managed by the Alliance. B. Consumers active in the CCDA and HCDA programs that are turning 60 and are 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. Note: These ADRC policies and procedures are subject to change. Any modifications will be done through a contract amendment.