The URL can be used to link to this page

Home My WebLink AboutItem C23 ~"o, Social Services/tabt BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY MEETING DATE: 1/15-16/03 DIVISION: COMMUNITY SERVICES BULK ITEM: YES X NO DEPARTMENT: SOCIAL SERVICES AGENDA ITEM WORDING: Approval of Model Coordination Agreement between the Department of Children and Families, Economic Self Sufficiency Services Program and the Department of Elder Affairs Comprehensive Assessment and review of Long Term Care Services Program (CARES) Area Agency on Aging and Board of County Commissioners/Monroe County Social Services (Monroe County In Home Service Program, the lead agency for Community Care for the Elderly (CCE) for Monroe County). ITEM BACKGROUND: The approval of this agreement will establish a partnership between the Department of Children & Families, Department of Elder Affairs and Monroe County In Home services to facilitate communication and cooperation in the completion of Medicaid eligibility determination. PREVIOUS RELEVANT BOCC ACTION: None CONTRACT/AGREEMENT CHANGES: N/A S'l'AF.F RECOMMENDA'110N: Approval TOTAL COST: $ -0- COST TO COUNTY: $ -0- REVENUE PRODUCING: YES BUDGETED: YES-2L NO SOURCE OF FUNDS:Community Care For the Elderly Grant NO~ AMT.PERMONTH YEAR APPROVED BY: COUNTY A TTYl OMB/Purchasing l RISK MANAGEMENT -.X DIVISION DIRECTOR APPROVAL: DOCUMENT A TION: INCLUDED X TO FOLLOW NOT REQUIRED_ AGENDA ITEM#: ~~< DISPOSITION: Revised 1/03 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Alliance For Aging, Inc. Contract Effective Date: December 5, 2002 Expiration Date: None Contract Purpose/Description: Approval of Agreement of Model Coordination will establish a partnership between the Department of Children & Families, Department of Elder Affairs and Monroe County In-Home Services to facilitate communication and cooperation in the completion of Medicaid eligibility determination. Contract Manager: Deloris Simpso~ 4589 Social Services/Stop I (Name) (Ext.) (Department/Stop #) For BOCC meetin on 01/15-16/2003 A enda Deadline: 12/31/2002 CONTRACT COSTS Total Do liar Val ue of Contract: $ -0- Budgeted? Yes X No 0 Account Codes: Grant: $ -0- County Match: $ -0- Estimated Ongoing Costs: $ (Not included in dollar value above) Current Year Portion: $ /yr ADDITIONAL COSTS For: (eg. Maintenance, utilities, janitorial, salaries, etc) Date In Division Director /2, (l '> /OL Risk Management I.J-, -,~ '(- L.i- O.M.B./Purchasing County Attorney ... Z /';,.;/ "z- Comments: CONTRACT REVIEW Changes Needed ____ ~Vi '(0 n YesD NoIT ~_ Yes 0 No gI . I . ..~ tU--<i~ YesD NollY' ~~ ().3?~ --h . YesC NoY LPt/ Date Out / Z(Z3/C L /.}-)(. .u.. /~ .?76 -a 2- /z/?JjZ- OMB Form Revised 2/27/01 MCP #2 .. MODEL COORDfflATION AGREEMENT BETWEEN THE DEPARTMENT OF CHILDREN AND FAMILIES, ECONONUCSEL~S~CIENCYSERVlCESPROG~ AND THE DEPARTMENT OF ELDER AFFAIRS, COMPREHENSIVE ASSESSMENT AND REVIEW FOR LONG TERM CARE SERVICES PROGRAM (CARES), AREA AGENCY ON AGING AND COMMUNITY CARE FOR THE ELDERLY (CCE) LEAD AGENCIES FOR MONROE COUNTY This Memorandum of Agreement, made this_5th_day of December. 2002, shall be in effect indefinitely between the Department of Children of Families, Economic Self-Sufficiency Services Program, the Department of Elder Affairs, Comprehensive Assessment and Review for Long Term Care Services Unit, the Alliance For Aging Inc., the Area Agency on Agingfor Planning and Service Area _11_ and Monroe County Social Services. Community Care for the Elderly Lead Agency for Monroe County. The purpose of this agreement is to establish a partnership between the above referenced programs of the Department of Children and Families and the Department of Elder Affairs to facilitate communication and cooperation in the completion of Medicaid eligibility determination. Timely Medicaidfinancial eligibility determination is critical to the success of initiatives to divert elders from institutional care to home and community-based care. Therefore, this partnership is formed to streamline and expedite the Medicaid eligibility determination process to enable elders to receive critical home and community-based care in lieu of institutional care. CCE Lead Agency agrees to: A. Submit a current assessment, completed within the past six months, Care Plan (DOEA Form 203), Patient Transfer and Continuity of Care (CF-MED 3008), and Informed Consent (CF-ES 2040) with the Request for Financial Assistance (RFA) to the Department of Children and Families (DC&F) Economic Self-Sufficiency Services office. This same package will be simultaneously forwarded to CARES for expediting the medical eligibility determination while the Request for Financial Assistance (RF A) is being processed by the DC&F office. B. VerifY the current Medicaid status of the applicant utilizing Consultec's telephone verification process, Medifax, Web:MD or any other reliable product, prior to submitting an RF A for processing. C. Review the RF A ensuring that all required information is completed and the form is signed by the consumer. The CCE lead agency case manager will also coordinate the application process when able,,,,with a trusted family member or friend who agrees to act as the personal representative for the consumer. D. Designate on the RF A the name and contact information for the designated representative, type of assistance the applicant is seeking; for example, AgedJDisabled Adult (ADA) waiver, Assisted Living for the Elderly (ALE) waiver, exparte for ALE waiver. If there is no one to act as a personal representative and the person is unable to attend an office appointment, CCE lead agency case manager will write this on the RF A to advise the Public Assistance Specialist (PAS). E. Ensure all appropriate and necessary documentation is attached to the RF A, specifYing the case manager's name and telephone number as well as the service status of the individual. All appropriate and necessary documentation will be updated and forwarded to the DCF Economic Self-Sufficiency Services Specialist within 5 days of any change that takes place, i.e., change in enrollment status, change in case manager or change in case manager's contact information. For consumers transitioning from a nursing home to the ADA or ALE waivers, DC&F will provide appropriate and necessary documentation to DoEA and subsequent documentation will be sent to DC&F as soon as the individual is in their new living arrangement (discharged from nursing home) and receiving waiver services. F. Provide the consumer or personal representative with the list of documents that will be needed for the initial as well as the annual eligibility determination and assist the consumer or personal representative in assembling those documents. G. Arrange, upon notification of the appointment, for transportation, respite care, escort or any other services necessary to ensure the consumer or personal representative keeps a scheduled appointment, if possible. H. Aid in obtaining any documents that are needed. DCF Economic Self-Sufficiency Services Unit agrees to: NOTE: CASES that are direct enrollees such as SSI or MEDS-AD should be excluded from these requirements. A. NotifY the CCE lead agency case manager and CARES of the Economic Self- Sufficiency Services Specialist acknowledging receipt and assignment of the application or ex parte process within 5 working days and of any changes thereafter via the Notice of Receipt ofHospice/HCBS Referral (CF-AA 2516) or the Client Status Transmittal (CF-'MED 3007). B. Provide duplicate notices to the CCE Lead Agency case manager via mail or fax of all scheduled appointments and documentation. needed in sufficient time to permit the case manager to arrange any service that may be needed to facilitate the appointment, if possible. C. Arrange for a telephone interview in lieu of a home visit if the home visit will delay the eligibility process or if the consumer is physically unable to attend an interview without jeopardizing his or her welfare. D. Ex parte, upon discharge, all requests for transition applicants currently residing in a nursing facility under the Institutional Care Program (ICP) to Medicaid Waiver funded programs in the community when waiver funds are available. Waiver benefits cannot be authorized until the individual is in the appropriate living arrangement. Waiver services cannot be authorized while the individual is still living in a nursing home. E. Provide duplicate Notices of Case Action (CS-ES Form 2266) or any other appropriate documentation necessary to the CCE Lead Agency case manager and CARES for Medicaid waiver participants upon enrollment and each change in income level. F. Notify the CCE Lead Agency case manager of any problems that may be identified in the initial or annual eligibility process as well as any missed or cancelled appointments or failure to return information by the consumer or personal representative. The case manager should be notified of any problems prior to issuing a notice of adverse action. Area Agenty on Aging agrees to: A. Facilitate communication between the DCF Economic Self-Sufficiency Services Program unit, DOEA CARES unit and CCE Lead Agencies by arranging for regular conference calls or meetings to identify, prevent or resolve any problems in the eligibility determination process. B. Arrange for training of all CCE Lead Agency case managers on the eligibility determination process including medical and financial components. DOEA CARES Program agrees to: NOTE: Refer to Memorandum of Agreement attached herein for additional local protocols. A. Date stamp the same calendar day received, all Medicaid waiver packages, and medical information consisting of completed forms submitted by Economic Self- Sufficiency Services Specialists or CCE case managers. B. Contact the assigned case manager or Economic Self-Sufficiency Services Specialist by phone, e-mail, fax or written transmittal within four work days concerning Medicaid waiver cases received by local CARES offices that are absent necessary forms or required information. ...., C. Following review of a completed Medicaid waiver package, initiate contact with the case manager within four workdays for cases that do not appear to meet level of care criteria. The purpose of this contact is to discuss the assessment and obtain any required clarification. Should the client's level of care remain questionable, the assigned CARES staff will conduct an on-site assessment, at the discretion of their supervisor, prior to staffing the case with the CARES Physician Consultant. D. Staff and mail all levels of care (form #603) on Medicaid Waiver cases within twelve work- days or less of receipt of the completed package of forms. All levels of care will clearly addressed to the assigned case manager and Economic Self- Sufficiency Specialist as well as indicate the client's name and the determination established. E. Provide assistance as requested to case managers and Economic Self-Sufficiency Specialists in contacting physician's offices by phone or written correspondence in order to secure completed Form# 3008 in order to make the level of care determination within twelve works days. Economic Self-Sufficiency CARES Signature Signature Printed Name Printed Name Title Title Date Date Alliance for Aging -Area Agency on Aging Monroe County - CCE Lead Agency Signature Signature Printed Name Printed Name Title Title Date Date ~~. 'OBERT . E.. DATE ./Z~/9 ~e7: