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Item C13BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 4-17-2013 Bulk Item: Yes X No Division: _County Administrator Department: Social Services/In-Home Services Staff Contact Person/Phone #: Sheryl `Than/X4510 AGENDA ITEM WORDING: Approval of 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 Commissioners (Social Services/In-Home Services) for fiscal year 7/1/12 to 6t"30/13. ITEM BACKGROUND: Approval of Amendment 002 to the CCE Contract will clarify the language to reflect that the ADRC releases clients from the waiting list, and the Lead Agency enrolls the client Into APPL (Applicant) status in CIRTS. No change will be made to the current process. The policy will also show the revision to acknowledge that DOEA is now responsible to release clients from the waiting lists for the ADA and ALW programs. PREVIOUS RELEVANT BOCC ACTION: Prior approval granted for the CCE Contract #KC-1271 on 8-15-12. CONTRACT/AGREEMENT CHANGES: Will modify the language in Attachment III of the CCE original contract #KC-1271. STAFF RECOMMENDATIONS: Approval TOTAL COST: $302,523.00 INDIRECT COST: -0- BUDGETED: Yes X No COST TO COUNTY: Inkind (Space) Match of $2,035.00 SOURCE OF FUNDS: Grants No Cash Match is Required- an Inkind(Space) Match of $2,035.00 and co -Payment Match of S28,217.00 will be used for the $30,252.00 Total Match Commitment. REVENUE PRODUCING: Yes X No _ AMOUNT PER MONTH approx.$2,500.00 Year gpprox. $30,000.00 APPROVED BY: County Arty,- X OMB/Purchasing X Risk Management _X_ DOCUMENTATION: Included X Not Required DISPOSITION: Revised 1/09 AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Alliance for Aging, Inc. Contract Amendment Contract # KC-1271 001 Effective Date: July 1, 2012 Expiration Date: June 30, 2013 Contract Purpose/Description: Approval of Amendment 002 to the Community Care for the Elderly (CCE) Contract #KC-1272 will clarify the language in Attachment III of the original contract to reflect that the ADRC releases clients from the waiting list, and the Lead Agency enrolls the client into the APPL (Applicant) status in CIRTS. No change will be made to the current process. The policy will also show the revision to acknowledge that DOEA is now responsible to release clients from the waiting lists for the ADA and ALW programs. Contract Manager: Sheryl Graham 4510 Social Services/Stop 1 (Name)4 (Ext.) (Department/Stop #) For BOCC meeting on 4/17/2013 Agenda Deadline: 4/2/2013 CONTRACT COSTS Total Dollar Value of Contract: $302,523.00 Budgeted? Yes X No 0 Account Codes: Grant: $302,523.00 (Fiscal Year) County Match: (Required) Inkind Match of $2,035.00 and Client Co -Pay Match of $28,217.00 will be used for the $30,252.00 Total Match Commitment Current Year Portion: $ 125-6153812 - ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (eg. Maintenance, utilities, janitorial, salaries, etc) CONTRACT REVIEW Division Director Risk Management O.M.B./Purchasin D to In Changes Date Out Needed �v}ewe Yes No j r Yes E No 9 Yes ❑ No County Attorney Yes No Comments: OMB Form Revised 2/27/01 MCP #2 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: raxlxs: ' : l Ci i7�Zl7 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 GCE/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 11. 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. & 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 Amend0Nenk002 CONTRACT KC 1271 A. CCE/HCE Clients The FlSC8| Department will monitor Lead Agency specific spending levels on a monthly basis to ensure each Lead Agency is operating within its spending 8VthDhb/. |naddition, 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 Ofnew cases being referred [Othe 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 onthe APCLbzbeopened. 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 [eqUin8DleDtS. The Intake Unit will update the wait list 8OnDUDl8nt using the appropriate code toterminate from the APCL. Upon receipt of referral, the Lead Agency will enter the APPLenrollment, 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 annoUnnent, will contact clients kJoffer program enrollment, and will proceed with activation. The Lead Agency will enter subsequent enrollments into {}|FJT8to reflect client status. 5. The ADRC will oversee the enrollment process toensure referrals have timely outcomes inC|RT8. B. MW/ALW Clients 1. The Department OfElder Affairs will run the APCL Priority Consumer List) report to review clients wait listed for the ALW and MW OnOg[GF0S. [XOEA will provide the /\[}RC with G list Of individuals authorized for release from the /\PC[. 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 p[OCeSS. C. APS Referrals /\PG Low and Intermediate FUak referrals will be screened and prioritized by the ADRC for services as per the DOEA/APS K8arnonandunn of Understanding. Low and |nbannadiata Risk referrals are also offered information and referral to additional CODl[Dunib/ n8SOU[CeS' including private pay aaappropriate. 2. /\PS High Risk Referrals are DOtvv8iUiSted. 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 jushfied, the case [n8n8ge0OeOt 8QeACy will staff the C8S8 with the Alliance to DbL3iD 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). 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. 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: SIGNED BY: NAME: TITLE: DATE: Monroe County Board of Commissioners. George Neugent Mayor 4-17-2013 ALLIANCE FOR AGING, INC. Max B. Rothman, JD, LL.M. 1 President & CEO TITLE: DATE: SON t3 O NEY---- OV A. Albury-Dotti From: Carlos Lahitte <lahittec@elderaffairs.org> Sent: Monday, March 18, 2013 3:10 PM To: Albury-Dotti; Graham -Sheryl; Wilkes -Kim Cc: Lisa Mele Subject: NCE and CCE ADRS amendments explanation. For Monroe County Lead Agency: 1. Language was clarified to reflect that the ADRC releases clients from the waiting list, and the Lead Agency enrolls the client into APPL (Applicant) status in CIRTS. No change was made to the current process. 2. The policy was revised to acknowledge that DOEA is now responsible to release clients from the waiting lists for the ADA and ALW programs. The information contained in this message may be privileged and/or confidential and protected from disclosure. If the reader of this message is not the intended recipient or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify the sender immediately. t;ontract Number KC 1271 ATTACHMENT III 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. v 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. r Completes comprehensive assessments on new consumers and annual reassessment on existing consumers and develops care plans and reviews care plans semi-annually. r Authorizes service delivery and enters data into CIRTS. Screens consumers for Medicaid Waiver eligibility. Bills in CIRTS and Medicaid as appropriate. 12 Contract Number KC 1271 Monitors care plans in an effort to keep costs down while sustaining the individuals in the community. it. 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 2011 Department of Elder Affairs Programs and Services Handbook, or any revisions made thereafter. t� Gontract Number KC 1271 B. HIPAA forms will be sent to the consumer as appropriate. III. Opening New Cases A. CCE/ADA/ALE/HCE Clients 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. i3. 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. 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. Ir 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 services). 14 Contract Number KC 1271 k 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 CODA 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. C. Consumers active in the ADA Medicaid Waiver, upon turning age 60, will continue to be eligible for and receive ADA Medicaid Waiver services. 15