Item C14BOARD 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
StaffContact Person/Phone #: Sheryl G ,,ham/X45 10
AGENDA ITEM WORDING: Approval of 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 7/1/12
to 6/130/13.
ITEM BACKGROUND: Approval of Amendment 002 to the HCE 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 Amendment #001 the Home
Care for the Elderly (HCE) Grant Contract #KH-1272 on 8-15-12.
CONTRACT/AGREEMENT CHANGES: Will modify the language in Attachment III of the HCE
original contract #KH- 1272.
STAFF RECOMMENDATIONS: Approval
TOTAL COST: $10,800.00 INDIRECT COST: --O--BUDGETED: Yes X No
COST TO COUNTY: SO (No Cash Match Required) SOURCE OF FUNDS: Grant
REVENUE PRODUCING: Yes No
APPROVED BY: County Attax
DOCUMENTATION: Included X
DISPOSITION:
Revised 1 /09
AMOUNT PER MONTH Year
OMB/Purchasing X Risk Management
Not Required
AGENDA ITEM #
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance for Aging, Inc. Contract: Amend. 2 to HCE Contract #KH-1272
Effective Date: July 1, 2012
Expiration Date: June 30, 2013
Contract Purpose/Description: Approval of Amendment 002 to the Home Care for the Elderly (HCE) Contract
4KH-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 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
f now responsible to release clients from the waiting lists for the ADA and ALW programs.
Contract Manager: Sheryl Graham 4510 Social Services/Stop I
(Name) (Ext.) (Department/Stop #)
For BOCC meeting on 4/17/2013 Agenda Deadline: 4/2/2013
CONTRACT COSTS
"Total Dollar Value of Contract: $10,800.00
Budgeted? Yes X No ❑ Account Codes:
Grant:$10,800.00 (Fiscal Year)
County Match: $0 (No Cash Match required)
Estimated Ongoing Costs: $
Not included in dollar value above)
/yr
Current Year Portion: $
_125_-6153912_-_
ADDITIONAL COSTS
For:
(eg. Maintenar
etc)
CONTRACT REVIEW
Changes Date Out
Division Director
A)ate, In
?
Needed pview
Yes U No
Risk Management
Yes ❑ No
O.M.B./Purchasing
t13
Yes ❑ No.... , V113
<;ounty Attorney
Yes ❑ N
Comments:
f
viviis corm Kevlsea lfl //ui 1viuF #Z
I
Amendment 002 CONTRACT KH 1272 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:
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.
y 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.
y 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 KH 1272 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 KH 1272
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. 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
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.
Amendment 002 CONTRACT KH 1272 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.
Mayor
4-17-2013
SIGNED BY:
NAME:
TITLE:
ALLIANCE FOR AGING, INC.
Max B. Rothman, JD, LL.M.
President & CEO
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: HCE 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.
Contract Number KH 1272 Page 8
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.
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.
w 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.
10, 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.
y 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.
r 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
8
/
C6ntract Number KH1272 Page 9
the community.
A. Referrals to the /\DRCare routed to the Information and Referral Specialists VrIntake Unit staff
depending on the type Of referral. Clients are provided information OD CODlDlUOdv r8SOUrCeS and
pnOgF8rOs available including phV8t8 pay options. [zH[S0DS are directed to those r8SOU[Ces most
capable of meeting the need they have expressed to AORC staff. Cases presenting EtFOOg identifiers
that indicate the CODsUnle[ might benefit from publicly funded |0Og term CaFS services are SCR38O8d.
entered into [||RTS. triaged and provided DpdODs counseling. In Monroe County, the functions Of
Screening and |n\8he are 0UtSOu[c8d to the Lead Agency. Screening and |Ot3kg may also be
CVDlp|et8d bythe /\ORC.
DOEA prioritization requirements will be adhered to by both entities, as follows:
APS High Risk Referrals (See section B\
2. |rOrDineOt FUSk C@SeS will be prioritized for activation 3fterAPS High Risk
Referrals have been served. /f budgetary constraints prevent opening new caSea,
clients will be placed on the APCL AORC staff will contact the client on a monthly basis
to determine ifthere has been 3change iOthe client's situation.
3. All other CARES referrals will be screened and prioritized in accordance with []C}E/\
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 consumer is being aenxad through a OC}EArfunded agency
which enters their annual assessment into C/RTS. the Priority Score generated by that
assessment will determine their ranking onthe APCL
6. Consumers referred for inclusion under the Assisted Living for the Elderly
(ALE) Medicaid Waiver APCL will be interviewed and screened using the 701 A form.
7. COn3u[D8[S referred for inclusion under the Aging and Disabled Adult
/A[]A\ Medicaid Waiver APCL will be contacted and SCr88n8d fO||Ovving the S8rDe
procedure as the one described under Section 5. Individuals who appear as pot8Dd@||y
eligible for other b/p8S Of public assistance will be [gf8[r8d to the ECOnOrOiC Self -
Sufficiency Unit 3t the Department OfChildren and Families.
& All other referrals will bevv8it|iSted and prioritized, during which time other community
resources will be researched, including private pay/fee for services providers,
[|OnsUnnenS on the waiting lists will be reassessed according tOthe 2O11 Department of
Elder Affairs Programs and Services Handbook, Orany revisions made thereafter.
I
Contract Number KH 1272 Page 10
||/ Opening New Cases
A. CCEIADA/ALE/HCE Clients
The Fiscal Department wiUmOAitor Lead Agency speCifiCSDendiOgleVels0la monthly
basis to ensure each Lead Agency iSoperating within its spending authority. In addition,
the fiscal department will analyze surplus/deficit projections, BDdShan8theiOh}rnGUoO
with the Lead Agency tOassist iDtheir determination Cf slot availability. The Lead
Agency will request referrals directly from the A[)RC.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
A[)RC |Dt3k8 Unit Supervisor will run the PhOhUz8d Risk Report to identify the
consumers onthe APCLkobeopened.
3. In n9Sp0Os8 to the request for referrals, the AORC Intake Unit Supervisor will refer wait
listed clients to the Lead Agency for activation, in accordance with phOhUZ3UOO
requirements. The /Ot8he Unit will update the wait list eOnO//Dl8Ot U3iOA the appropriate
code to terminate from the APCL. Upon receipt of referral, the Lead Agency will enter
the APPL enno|/rnent, and subsequent enrollments to reflect client status.
B. APSRefena|a
APS Low and Intermediate Risk referrals will be screened and prioritized by the /\DRC
for services as per the O(]EXAPS Memorandum of Understanding. Low and
Intermediate Risk referrals are also offered information and referral to additional
community resources, including private pay as appropriate.
2. AP8 High Risk Referrals are not vvaiUiatexj. They are immediately referred for omniue
from OCF in Monroe County to the Lead Agency. ARTT referrals will be forwarded
directly the Lead Agency. APS cases are to be served fora maximum of 31 calendar
days. If additional time is jusUfied, the case management agency will staff the case with
the Alliance t0obtain the extension needed.
3. Upon receipt of the APSHigh Risk referral, the Lead Agency will coordinate services to
begin within the 72hour period mandated by statute. Acomprehensive assessment will
bedone within 72hours Ofthe 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 ACTVenrollment under their provider number inQRTS. In
addition, service codes will b8entered bvservice date for all services provided. If
5enviCg(S)iSnot provided a3required under the care plan, 8DN[}Pcode will need kJbe
entered inC|RTSand the case notes under the client file should document the reason
for non -delivery Ofsuch ServiCS/S\.
A. All "Aging Out" consumers will be referred by []CF to the A[JRC for enrollment into the
corresponding aged program managed by the Alliance.
Contract Number KH 1272 !age 11
B. Consumers active ►n 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.
M