Item C29
~~~
Louis LaTorre, Senior Director
Social Services/dra
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
MEETING DATE: 6-18-2003
DIVISION: COMMUNITY SERVICES
BULK ITEM:
YES X
NO
DEPARTMENT: SOCIAL SERVICES
AGENDA ITEM WORDING: Approval of the Renewal of Home Care for the Elderly (HCE) Contract
between the Alliance for Aging, Inc. and the Monroe County Board of County Commissioners (Monroe County
Social Services/In-Home Services Program) for fiscal Year July 1, 2003 through June 30, 2004.
ITEM BACKGROUND: The approval of the HCE Contact will enable Monroe County In-Home Services
to continue providing services to the caregiver's of Monroe County's elderly population under the Home Care
for the Elderly (HCE) program.
PREVIOUS RELEVANT BOCC ACTION: June 2002
CONTRACT/AGREEMENT CHANGES: N/A
STAFf1' RECOMMENDATION: Approval
TOTAL COST: $3,637.00
COST TO COUNTY: $404.11 (Case Management Only)
BUDGETED: YES-L NO
SOURCE OF FUNDS: Home Care for the
Elderly Contract for $3,637.00
REVENUE PRODUCING: YES
NO~ AMT.PERMONTH
YEAR
APPROVED BY: COUNTY ATTY.l OMB/Purchasing l RISK MANA9EiMENT ---.X
/ /
I '
DOCUMENTATION:
INCLUDED_
TO fOLLOW X NOT REQUIRED
-- -
{,d9
AGENDA ITEM#:
DIVISION DIRECTOR APPROVAL:
DISPOSITION:
Revised 1/03
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, Inc. Contract
Effective Date: July 1, 20Q3
Expiration Date: June 30, 2004
Contract Purpose/Description: Approval of the Renewal of Home Care for the Elderly (HCE) Contract between
the Alliance for Aging, Inc. and the Monroe County Board of County Commissioners (Monroe County Social
Services/In-Home Services Program) for Fiscal Year July 1, 2003 through June 30, 2004.
Contract Manager:
Deloris Simps\od ~
(Nallle~'
6/18/2003
For BOCC meeting on
4573
(Ext. )
Social Services/Stop 1
(Department/Stop #)
Agenda Deadline:
6/3/2003
CONTRACT COSTS
Total Dollar Value of Contract: $ 3,637.00
Budgeted? Yes X No 0 Account Codes:
Grant: $ 3,637.00
County Match: $404.11 (Case Management Only) l ~I
Current Year Portion: $
/yr
ADDITIONAL COSTS
For:
(eg. Maintenance, utilities, janitorial, salaries, etc)
Estimated Ongoing Costs: $
(Not included in dollar value above)
CONTRACT REVIEW
Date In
Division Director Clll3 \ 0 ~
Risk Management , Il61 0 ~
O.M.B.lPurchasing It> / 13/ D"3
Changes
Needed
YesO No~
YesO NoV
YesO No~
County Attorney
Yes 0 No 0
Comments:
Date Out
~"~~~
,J.-/~-D
Z~
~ t3103
~/J3/03
0~3}3
OMB Form Revised 2/27/01 MCP #2
Jun 13 03 09:44a
In-Home Services
(3051292-4481
p.3
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, Inc. Contract
Effective Date: July I, 2003
Expiration Date: June 30, 2004
Contract PurposelDescription: Approval of the Renewal of Home Care for the Elderly (HCE) Contract between
the Alliance for Aging, Inc. and the Monroe County Board of County Commissioners (Monroe County Social
Services/In-Home Services Program) for Fiscal Year July 1,2003 through June 30, 2004.
Contract Manager:
Deloris Simps\OI~ .fi
(Namc~
6118/2003
4573
(Ext.)
Social Services/Stop 1
(Department/Stop #)
For BOCC meeting on
Agenda Deadline:
6/3/2003
CONTRACT COSTS
Total Dollar Value of Contract: $ 3,637.00
Budgeted? Yes X No 0 Account Codes:
Grant: $ 3,637.00
County Match: $404.11 (Case Management Only)
Current Year Portion: $
Estimated Ongoing Costs: $
(Not included in dollar value above)
/yr
ADDITIONAL COSTS
For:
(eg. Maintenance, utilities, janitorial, salaries, etc)
CONTRACT REVIEW
Date In
Changes
Needed
Yes 0 No 0
Division Director
Risk Management
YesD NoD
O.M .B.lPurchasing
YesD NoU
County Attorney
(
(C ..' (t - C J Yes 0
NOJ0'
I
Comments:
Date Out
Reviewer
~/~
-, -,,~.'. j/ /
". A/A ,./.
, '
t
t- ./-:;-~?
~
OMB Form Revised 2/27/01 Mep #2
AGENDA ITEM WITH LATE DOCUMENTATION
DIVISION:
Community Services
DEP ARTMENT: Social Services/In-Home Services Program
SUBJECT: Approval of the Renewal of Home Care for the
Elderly (HCE) Contract for Fiscal Year 7/1103 through 6/30/04.
DATE ITEM WILL BE AVAILABLE: 6-13-2003
AGENDA ITEM NUMBER
07/01/2003
Contract Number KH 372
HOME CARE FOR THE ELDERLY CONTRACT
2003-2004
THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as
the "Alliance", and the Monroe County Board of Commissioners, hereinafter referred to as
the "recipient". This contract is subject to all provisions contained in the MASTER
AGREEMENT executed between the Alliance and the recipient, Agreement No. PA329, and its
successor, incorporated herein by reference.
The parties agree:
I. Recipient Agrees:
A. Services to be Provided:
To plan, develop, and accomplish the services delineated, or otherwise cause the
planning, development, and accomplishment of such services and activities, under the
conditions specified and in the manner prescribed in Attachment I of this agreement.
B. Requirements of Section 287.058, Florida Statutes:
These requirements are herein incorporated by reference.
C. Final Request for Payment:
1. The recipient must submit the final request for payment to the Alliance no later than
September 15, 2004; if the recipient fails to do so, all right to payment is
forfeited, and the Alliance will not honor any requests submitted after the
aforesaid time period.
2. If the contract is terminated prior to the contract end date of September 30, 2004,
then the recipient must submit the final request for payment to the Alliance no more
than 45 days after the contract is terminated; if the recipient fails to do so, all
right to payment is forfeited, and the Alliance will not honor any requests
submitted after the aforesaid time period.
II. The Alliance Agrees:
Contract Amount:
To pay for contracted services according to the conditions of Attachment I in an amount
not to exceed $51,544.00, subject to the availability of funds. The Alliance's performance
and obligation to pay under this contract is contingent upon an annual appropriation by the
Legislature. The costs of services paid under any other contract or from any other source
are not eligible for reimbursement under this contract. The funds awarded to the recipient
pursuant to this contract are in the state grants and aids appropriations and consists of the
following:
07/01/2003
Contract Number KH 372
Program Title Year Funding Source CSFA# Fund Amounts
Home Care for the Elderly 2003 General Revenue 65001 $51,544.00
TOTAL FUNDS CONTAINED IN THIS CONTRACT: $51,544.00
III. Recipient and Alliance Mutually Agree:
A. Effective Date:
1. This contract shall begin on July 1, 2003 or on the date the contract has been
signed by both parties, whichever is later.
2. Delivery of services shall end on June 30, 2004 This contract shall end on
September 30, 2004. See Attachment I, Section 111.0.
B. Termination, Suspension, and/or Enforcement:
The causes and remedies for termination or suspension of this contract shall follow the
same procedures as outlined in Section III. B. and Section III. C. of the Master
Agreement.
C. Recipient Responsibility:
Notwithstanding the pass through language contained in Section I.S.1. of the Master
Agreement, the recipient maintains responsibility for the performance of all sub
recipients in accordance with all applicable federal and state laws.
D. Notice, Contact, and Payee Information:
1. The name, address, and telephone number of the contract manager for the Alliance
for this contract is:
Steven Weisberg
9500 South Dadeland Boulevard, Suite 400
Miami, Florida 33156
(305) 679-6500 SC 455-6500
2. The name, address, and telephone number of the representative of the recipient
responsible for administration of the program under this contact is:
Louis LaTorre
Gato Building - 1100 Simonton Street
Key West, Florida 33040
(305) 292-4573
2
07/01/2003
Contract Number KH 372
3. In the event different representatives are designated by either party after execution
of this contract, notice of the name and address of the new representative will be
rendered in writing to the other party and said notification attached to originals of
this contract.
4. The name (recipient name as shown on page 1 of this contract) and mailing
address of the official payee to whom the payment shall be made:
Monroe County Board of Commissioners
Gato Building - 1100 Simonton Street
Key West, Florida 33040
IN WITNESS THEREOF, the parties hereto have caused this 9-page contract to be executed
by their undersigned officials as duly authorized.
PROVIDER:
MONROE COUNTY BOARD
OF COMMISSIONERS
ALLIANCE FOR AGING, INC.
FOR DADE & MONROE COUNTIES
BOARD PRESIDENT OR AUTHORIZED DESIGNEE
SIGNED BY:
SIGNED BY:
NAME:
NAME:
Steven Weisberg, M. S.
TITLE:
TITLE:
President & CEO
DATE:
DATE:
FEDERAL 10 NUMBER:
PROVIDER FISCAL YEAR ENDING DATE:
59-6000749
09/30
3
07/01/2003
Contract Number KH 372
ATTACHMENT I
HOME CARE FOR THE ELDERLY PROGRAM
I. STATEMENT OF PURPOSE
The Home Care for the Elderly (HCE) Program encourages the provision of care in family-
type living arrangements in private homes on a not for profit basis as an alternative to
nursing home or other institutional care.
II. SERVICES TO BE PROVIDED
A. Services:
1. The recipient's service provider application for state fiscal year 2003, and any
revisions thereto approved by the Alliance and located in the contract manager's
file, are incorporated by reference in this contract between the Alliance and the
recipient, and prescribe the services to be rendered by the recipient.
2. Consumers may not be enrolled in a Department of Elder Affairs' state general
revenue funded program, including HCE, who are also enrolled in a Medicaid
capitated long term care health plan or program. These programs include the Frail
Elder Program operated by United Health Care, the Channeling Program operated
by Miami Jewish Home and Hospital for the Aged, the Long Term Care Community
Diversion Program operating in Planning and Service Areas 7 and 9, and the
Program of All Inclusive Care for the Elderly (PACE) program scheduled to begin
operation in the Miami-Dade County area.
B. Manner of Service Provision:
The services will be provided in a manner consistent with and described in the
recipient's service provider application for state fiscal year 2003 and the Department of
Elder Affairs Client Home And Community Based Services Handbook dated 01/03 In
the event the manual is revised, such revision will automatically be incorporated into
the contract and the recipient will be given a copy of the revisions.
III. METHOD OF PAYMENT
A. The method of payment in this contract is based on a fixed rate reimbursement for
approved services. The recipient must ensure fixed rates include only those costs which
are in accordance with all applicable state and federal statutes and regulations and are
based on audited historical costs in instances where an independent audit is required.
All requests for payment and expenditure reports submitted to support requests for
payment shall be on DOEA forms 106H and 105H. Duplication or replication of both
forms via data processing equipment is permissible, provided all data elements are in
the same format as included on department forms.
4
07/01/2003
Contract Number KH 372
B. The recipient shall maintain documentation to support payment requests which shall be
available to the Comptroller, the Department of Elder Affairs, or the Alliance upon
request.
C. The recipient may request a monthly advance for service costs for each of the first
three months of the contract period, based on anticipated cash needs. Detailed
documentation justifying cash needs for advances must be submitted with the signed
contract, approved by the Alliance, and maintained in the contract manager's file. All
payment requests for the fourth through the twelfth months shall be based on the
submission of monthly actual expenditure reports beginning with the first month of the
contract. The schedule for submission of advance requests is ATTACHMENT II to this
contract. Reconciliation and recouping of advances made under this contract are to be
completed by the time the final payment is made. All advance payments are subject to
the availability of funds.
D. Advance funds may be temporarily invested by the recipient in an insured interest
bearing account. All interest earned on contract fund advances must be returned to the
Alliance at the end of the first quarter of the contract period.
E. The Alliance shall make payment to the provider for provision of services up to a
maximum number of units of service and at the rate(s) stated below:
Service Unit of Unit Rate Maximum Maximum
to be Service Units Dollars
Provided
Case Management 1 hour $47.855263 76 $3,637
F. Contract Amendments:
1. The recipient agrees to implement the distribution of funds as detailed in the service
provider application and the Budget Summary, ATTACHMENT III to this contract.
A contract amendment is required to change the total amount of the contract. With
written notice to the Alliance's contract manager, funds may be moved from the
Case Management budget category to the Subsidies category. The Case
Management budget category can not be increased.
2. This contract is for services provided during the 2003/2004 State Fiscal year
beginning July 1, 2003 through June 30, 2004, however, the contract is in effect
through September 30, 2004 in order to provide for maximization of resources and
to allow for greater flexibility to pay for the services rendered by June 30, 2004.
Services provided after June 30, 2004 cannot be reimbursed under this contract.
3. The recipient will submit a draft closeout report by August 15, 2004. Any contract
amendments after August 15, 2004 determined necessary by the Alliance will be
based on the draft closeout reports.
5
07/01/2003
Contract Number KH 372
4. The final expenditure report and request for payment will be due to the Alliance no
later than September 15, 2004. No expenditure reports or requests for payment will
be accepted after September 15, 2004.
G. Any payment due by the Alliance under the terms of this contract .may be withheld
pending the receipt and approval by the Alliance of all financial and programmatic
reports due from the recipient and any adjustments thereto, including any disallowance
not resolved as outlined in Section I. T. of the Master Agreement.
IV. SPECIAL PROVISIONS
A. State Laws and Regulations:
1. The recipient agrees to comply with applicable parts of Rule Chapter 58H-1, Florida
Administrative Code promulgated for administration of Sections 430.601 through
430.608, Florida Statutes, and the Department of Elder Affairs Home and
Community Based Services Handbook dated 01/03.
2. The recipient agrees to comply with the provisions of Sections 97.021 and 97.058,
Florida Statutes, and all rules related thereto in the Florida Administrative Code.
B. Assessment and Prioritization for Service Delivery for New Consumers:
The following are the criteria to prioritize new consumers for service delivery. It is not
the intent of the Department of Elder Affairs to remove existing clients from any
program in order to serve new clients being assessed and prioritized for service
delivery.
1. Priority Criteria for Service Delivery:
a) individuals in nursing homes under Medicaid who could be transferred to the
community;
b) individuals in nursing homes whose Medicare coverage is exhausted and
may be diverted to the community;
c) individuals in nursing homes which are closing or in receivership and can be
discharged to the community; or
d) individuals whose mental or physical health condition has deteriorated to the
degree self care is not possible, there is no capable caregiver and
institutional placement will occur within 72 hours.
2. Priority Criteria for Other Assessed Individuals:
The assessment and provision of services should always consider the most cost
effective means of service delivery. Functional impairment shall be determined
through the department's consumer assessment form administered to each
applicant. The most frail individuals not prioritized in the group above, regardless of
referral source, will receive services to the extent funding is available.
6
07/01/2003
Contract Number KH 372
C. Consumer Information, Registration and Tracking System (CIRTS):
1. The recipient will ensure the collection and maintenance of Home Care for the Elderly
(HCE) subsidies and case management information on a monthly basis from the
Consumer Information, Registration and Tracking System (CIRTS). Maintenance
includes valid exports and backups of all data and systems according to department
standards.
2. The recipient must ensure all data for HCE subsidies are entered in the CIRTS by the
15th of each month. HCE subsidy data entered into the CIRTS by the 15th of the
month will be for payments incurred between the 16th of the previous month and the
15th of the current month. Case management data entered into the CIRTS by the 15th
of the month will be for units of service provided during the previous month from the
16th and up to and including the 15th of the current month or case management units
of service may be entered according to the recipient schedule, in aggregate on the 31 st
or daily, weekly or monthly.
3. The recipient will ensure data entry for HCE subsidies will cease on the 15th of the
month and the CIRTS Monthly Service Utilization Report, by consumer and by worker
identification is run.
4. The recipient will ensure the Monthly Utilization Report, by consumer and by worker
identification is verified, corrected, certified no later than the 20th of the month in which
the report is generated.
5. The recipient will ensure caregivers determined eligible for the HCE basic subsidy after
the 15th of a month, will be processed to begin eligibility. for the HCE basic subsidy on
the 1 st day of the next month.
6. The Alliance will reconcile and verify the CIRTS data prior to payment for HCE basic
and special subsidies and case management.
7. The Alliance will reconcile and verify the CIRTS data prior to payment for HCE basic
and special subsidies and case management.
7
07/01/2003
Report
Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
LeQend:
Note # 1:
Note # 2:
Contract Number KH 372
ATTACHMENT 1/
HOME CARE FOR THE ELDERLY PROGRAM
CONTRACT REPORT CALENDAR
Based On
July Advance * ...... ...... '.. ... ... ... ............... ... ... ..................
August Advance * ... ......... ......... ...... ...... ...... ... ...... ...... .....
July Expenditure Report... ... ... ... '.. ... ... ... ... ... ... ... ... ... ... ... ... .
August Expenditure Report... ... ... ... ... ... ... ... ... ... ... ... ... '" ... ...
September Expenditure Report ... ......... ..................... ..........
October Expenditure Report... ... ... ... ... ... ... ... ... ... ... .'. ... ... ... ..
November Expenditure Report ......... ...... ......... ...... ..............
December Expenditure Report........................ ......... ...... .....
January Expenditure Report ... ... ... ... ... ... ... ... ... ... ... '" ... ... .....
February Expenditure Report... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
March Expenditure Report...... ... .'. ... ... ... ... ... ... ... ... ... ... ... ... .
April Expenditure Report...................................................
May Expenditure Report/July Advance Reconciliation ** ..........
June Expenditure Report/August Advance Reconciliation ** .....
Draft Closeout Report... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .
Final Expenditure and Request for Payment Report... ... ... ... ....
Closeout Report ... ... ... ... ... ......... ...... ...... ... ......... ...... ........
*
Advance based on projected cash need.
**
Submit
to the Alliance
on This Date
July 1
July 1
August 10
September 10
October 10
November 10
December 10
January 10
February 10
March 10
April 10
May 10
June 10
July 10
August 15
September 15
September 15
Submission of expenditure reports mayor may not generate a payment
request. If final expenditure report reflects funds due back to the Alliance,
payment is to accompany the report.
Report #1 for Advance Basis Contracts cannot be submitted to the Alliance
prior to July 1 or until the contract with the Alliance has been executed.
Actual submission of the vouchers to the Department of Elder Affairs is
dependent on the accuracy of the expenditure report.
The last three months of the recipient's fiscal reports covering actual
expenditures should reflect an adjustment repaying advances for the first
three months of the contract.
8
07/01/2003
Contract Number KH 372
ATTACHMENT '"
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
1. Case Management... ... ... ... ... '" ... ... '" ... ... ... ... ...
2. Subsidy Payments 1 ............ ......... ...................
$ 3,637.00
$47,907.00
3. Total... '" ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... '" ... ....
$51,544.00
* * * * * *
1 All subsidy payments are made by the Alliance, on behalf of the recipient, to eligible caregivers after proper
verification in CIRTS for any given month during which service was provided to a homebound HCE elder
consumer.
9
Monrce County~lerk'8 oma ~
07/01/02
Contract Number KH 272
HOME CARE FOR THE ELDERLY CONTRACT
2002-2003
THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as
the "Alliance", and the Monroe County Board of Commissioners, hereinafter referred to as
the "recipient". This contract is subject to all provisions contained in the MASTER
AGREEMENT executed between the Alliance and the recipient, Agreement No. PA329, and its
successor, incorporated herein by reference.
The parties agree:
I. Recipient Agrees:
A. Services to be Provided:
To plan, develop, and accomplish the services delineated, or otherwise cause the
planning, development, and accomplishment of such services and activities, under the
conditions specified and in the manner prescribed in Attachment I of this agreement.
B. Requirements of Section 287.058, Florida Statutes:
These requirements are herein incorporated by reference.
C. Final Request for Payment:
1. The recipient must submit the final request for payment to the Alliance no later than
September 15, 2003 .; if the recipient fails to do so, all right to payment is
forfeited, and the Alliance will not honor any requests submitted after the
aforesaid time period.
2. If the contract is terminated prior to the contract end date of September 30, 2003,
then the recipient must submit the final request for payment to the Alliance no more
than 45 days after the contract is terminated; if the recipient fails to do so, all
right to payment is forfeited, and the Alliance will not honor any requests
submitted after the aforesaid time period.
II. The Alliance Agrees:
Contract Amount:
To pay for contracted services according to the conditions of Attachment I in an amount
not to exceed $51,544.00, subject to the availability of funds. The Alliance's performance
and obligation to pay under this contract is contingent upon an annual appropriation by the
Legislature. The costs of services paid under any other contract or from any other source
are not eligible for reimbursement under this contract. The funds awarded to the recipient
pursuant to this contract are in the state grants and aids appropriations and consists of the
following:
1
07/01102
Contract Number KH 272
Program Title Year Funding Source CSFA# Fund
Amounts
Home Care for 2002 General Revenue 65001 $51,544.00
the Elderly
TOTAL FUNDS CONTAINED IN THIS CONTRACT: $51,544.00
III. Recipient and Alliance Mutually Agree:
A. Effective Date:
1. This contract shall begin on July 1, 2002 or on the date the contract has been
signed by both parties, whichever is later.
2. Delivery of services shall end on June 30, 2003 This contract shall end on
September 30, 2003. See Attachment I, Section 111.0.
B. Termination, Suspension, and/or Enforcement:
The causes and remedies for termination or suspension of this contract shall follow the
same procedures as outlined in Section III. B. and Section III. C. of the Master
Agreement.
C. Recipient Responsibility:
Notwithstanding the pass through language contained in Section I.S.1. of the Master
Agreement, the recipient maintains responsibility for the performance of all
subrecipients in accordance with all applicable federal and state laws.
D. Notice, Contact, and Payee Information:
1. The name, address, and telephone number of the contract manager for the Alliance
for this contract is:
Steven Weisberg
9500 South Dadeland Boulevard, Suite 400
Miami, Florida 33156
(305) 679-6500 SC 455-6500
2
07/01/02
Contract Number KH 272
2. The name, address, and telephone number of the representative of the recipient
responsible for administration of the program under this contact is:.
Louis LaTorre
Gato Building - 1100 Simonton Street
Key West, Florida 33040
(305) 292-4573
3. In the event different representatives are designated by either party after execution
of this contract, notice of the name and address of the new representative will be
rendered in writing to the other party and said notification attached to originals of
this contract.
4. The name (recipient name as shown on page 1 of this contract) and mailing
address of the official payee to whom the payment shall be made:
Monroe County Board of Commissioners
Gato Building - 1100 Simonton Street
Key West, Florida 33040
3
07/01/02
Contract Number KH 272
I N WITNESS THEREOF, the parties hereto have caused this 10 page contract to be executed
by their undersigned officials as duly authorized. .
RECIPIENT:
MONROE COUNTY BOARD
OF COMMISSIONERS
BOARD PRESIDENT OR
AUTHORIZED DESIGNEE
SIGNED ~./'
BY:
NAME: t)'/~ /~ S '.S'J Y)"l l' M L c~ ..;
I
TITLE:
/vj"Lv... "
I
?J7'7
Z-;,)'~'-_
DATE:
FEDERAL 10 NUMBER:
RECIPIENT FISCAL YEAR END DATE:
ts...., ~. 4
~ -- ..t~
y DEPUTY-tLERK
ALLIANCE FOR AGING, INC.
~.~~~ ~
NAME: STEVEN WEISBERG, M.S.
TITLE: PRESIDENT/CEO
DATE: Dig ) ~ "--
59-6000749
09/30
07/01/02
Contract Number KH 272
ATTACHMENT I
HOME CARE FOR THE ELDERLY PROGRAM
I. STATEMENT OF PURPOSE
The Home Care for the Elderly (HCE) Program encourages the provision of care in family-
type living arrangements in private homes on a not for profit basis as an alternative to
nursing home or other institutional care.
II. SERVICES TO BE PROVIDED
A. Services:
1. The recipient's service provider application for state fiscal year 2002, and any
revisions thereto approved by the Alliance and located in the contract manager's
file, are incorporated by reference in this contract between the Alliance and the
recipient, and prescribe the services to be rendered by the recipient.
2. Consumers may not be enrolled in a Department of Elder Affairs' state general
revenue funded program, including HCE, who are also enrolled in a Medicaid
capitated long term care health plan or program. These programs include the Frail
Elder Program operated by United Health Care, the Channeling Program operated
by Miami Jewish Home and Hospital for the Aged, the Long Term Care Community
Diversion Program operating in Planning and Service Areas 7 and 9, and the
Program of All Inclusive Care for the Elderly (PACE) program scheduled to begin
operation in the Miami-Dade County area.
B. Manner of Service Provision:
The services will be provided in a manner consistent with and described in the
recipient's service provider application for state fiscal year 2002 and the Department of
Elder Affairs Client Services Manual dated 12/98. In the event the manual is revised,
such revision will automatically be incorporated into the contract and the recipient will
be given a copy of the revisions.
III. METHOD OF PAYMENT
A. The method of payment in this contract is based on a fixed rate reimbursement for
approved services. The recipient must ensure fixed rates include only those costs
which are in accordance with all applicable state and federal statutes and regulations
and are based on audited historical costs in instances where an independent audit is
required. All requests for payment and expenditure reports submitted to support
requests for payment shall be on DOEA forms 106H and 105H. Duplication or
replication of both forms via data processing equipment is permissible, provided all
data elements are in the same format as included on department forms.
5
07/01/02
Contract Number KH 272
B. The recipient shall maintain documentation to support payment requests which shall be
available to the Comptroller, the Department of Elder Affairs, or the Alliance upon
request.
C. The recipient may request a monthly advance for service costs for each of the first
three months of the contract period, based on anticipated cash needs. Detailed
documentation justifying cash needs for advances must be submitted with the signed
contract, approved by the Alliance, and maintained in the contract manager's file. All
payment requests for the fourth through the twelfth months shall be based on the
submission of monthly actual expenditure reports beginning with the first month of the
contract. The schedule for submission of advance requests is ATTACHMENT II to this
contract. Reconciliation and recouping of advances made under this contract are to be
completed by the time the final payment is made. All advance payments are subject to
the availability of funds.
D. Advance funds may be temporarily invested by the recipient in an insured interest
bearing account. All interest earned on contract fund advances must be returned to the
Alliance at the end of the first quarter of the contract period.
E. The Alliance shall make payment to the provider for provision of services up to a
maximum number of units of service and at the rate(s) stated below:
Service to be
Provided
Unit of
Service
Unit
Rate
Maximum
Units
Maximum
Dollars
Case Management
1 client hour $37.885416
96
$3,637
F. Contract Amendments:
1. The recipient agrees to implement the distribution of funds as detailed in the service
provider application and the Budget Summary, ATTACHMENT III to this contract.
A contract amendment is required to change the total amount of the contract. With
written notice to the Alliance's contract manager, funds may be moved from the
Case Management budget category to the Subsidies category. The Case
Management budget category can not be increased.
2. This contract is for services provided during the 2002/2003 State Fiscal year
beginning July 1, 2002 through June 30, 2003, however, the contract is in effect
through September 30, 2003 in order to provide for maximization of resources and
to allow for greater flexibility to pay for the services rendered by June 30, 2003.
Services provided after June 30, 2003 cannot be reimbursed under this contract.
3. The recipient will submit a draft closeout report by August 15, 2003. Any contract
amendments after August 15, 2003 determined necessary by the Alliance will be
based on the draft closeout reports.
6
07/01/02
Contract Number KH 272
4. The final expenditure report and request for payment will be due to the Alliance no
later than September 15, 2003. No expenditure reports or requests for payment will
be accepted after September 15, 2003.
G. Any payment due by the Alliance under the terms of this contract may be withheld
pending the receipt and approval by the Alliance of all financial and programmatic
reports due from the recipient and any adjustments thereto, including any disallowance
not resolved as outlined in Section IT of the Master Agreement.
IV. SPECIAL PROVISIONS
A. State Laws and Regulations:
1. The recipient agrees to comply with applicable parts of Rule Chapter 58H-1, Florida
Administrative Code promulgated for administration of Sections 430.601 through
430.608, Florida Statutes, and the Department of Elder Affairs Client Services
Manual dated 12/98.
2. The recipient agrees to comply with the provisions of Sections 97.021 and 97.058,
Florida Statutes, and all rules related thereto in the Florida Administrative Code.
B. Assessment and Prioritization for Service Delivery for New Consumers:
The following are the criteria to prioritize new consumers for service delivery. It is not
the intent of the Department of Elder Affairs to remove existing clients from any
program in order to serve new clients being assessed and prioritized for service
delivery.
1. Priority Criteria for Service Delivery:
a) individuals in nursing homes under medicaid who could be transferred to the
community;
b) individuals in nursing homes whose medicare coverage is exhausted and
may be diverted to the community;
c) individuals in nursing homes which are closing or in receivership and can be
discharged to the community; or
d) individuals whose mental or physical health condition has deteriorated to the
degree self care is not possible, there is no capable caregiver and
institutional placement will occur within 72 hours.
2. Priority Criteria for Other Assessed Individuals:
The assessment and provision of services should always consider the most cost
effective means of service delivery. Functional impairment shall be determined
through the department's consumer assessment form administered to each
applicant. The most frail individuals not prioritized in the group above, regardless of
referral source, will receive services to the extent funding is available.
7
07/01/02
Contract Number KH 272
C. Consumer Information, Registration and Tracking System (CIRTS):
1. The recipient will ensure the collection and maintenance of Home Care for the
Elderly (HCE) subsidies and case management information on a monthly basis
from the Consumer Information, Registration and Tracking System (CIRTS).
Maintenance includes valid exports and backups of all data and systems according
to department standards.
2. The recipient must ensure all data for HCE subsidies are entered in the CIRTS by
the 15th of each month. HCE subsidy data entered into the CIRTS by the 15th of
the month will be for payments incurred between the 16th of the previous month
and the 15th of the current month. Case management data entered into the CIRTS
by the 15th of the month will be for units of service provided during the previous
month from the 16th and up to and including the 15th of the current month or case
management units of service may be entered according to the recipient schedule,
in aggregate on the 31 st or daily, weekly or monthly.
3. The recipient will ensure data entry for HCE subsidies will cease on the 15th of the
month and the CIRTS Monthly Service Utilization Report, by consumer and by
worker identification is run.
4. The recipient will ensure the Monthly Utilization Report, by consumer and by worker
identification is verified, corrected, certified no later than the 20th of the month in
which the report is generated.
5. The recipient will ensure caregivers determined eligible for the HCE basic subsidy
after the 15th of a month, will be processed to begin eligibility for the HCE basic
subsidy on the 1 st day of the next month.
6. The Alliance will reconcile and verify the CIRTS data prior to payment for HCE
basic and special subsidies and case management.
7. The Alliance will reconcile and verify the CIRTS data prior to payment for HCE
basic and special subsidies and case management.
8
07/01/02
Report
Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Legend: *
**
Note # 1:
Note # 2:
Contract Number KH 272
ATTACHMENT II
HOME CARE FOR THE ELDERLY PROGRAM
CONTRACT REPORT CALENDAR
Based On
July Advance*
August Advance*
September Advance*
July Expenditure Report
August Expenditure Report
September Expenditure Report
October Expenditure Report
November Expenditure Report
December Expenditure Report
January Expenditure Report
February Expenditure Report
March Expenditure Report
April ExpendrtureReport
May Expenditure Report/July Adv. Recon.**
June Expenditure Report/August Adv. Recon.**
Draft Closeout Report
Final Expenditure and Request
for Payment Report
Closeout Report
Advance based on projected cash need.
Submit to
The Alliance
On This Date
July 1
July 1
August 1
August 15
September 15
October 15
November 15
December 15
January 15
February 15
March 15
April 15
May 15
June 15
July 15
August 15
September 15
September 15
Submission of expenditure reports mayor may not generate a payment
request. If final expenditure report reflects funds due back to the
department, payment is to accompany the report.
Report #1 for Advance Basis Contracts cannot be submitted to the Alliance
prior to July 1 or until the contract with the Alliance has been executed.
Actual submission of the vouchers to the Department of Elder Affairs is
dependent on the accuracy of the expenditure report.
The last three months of the recipient's fiscal reports covering actual
expenditures should reflect an adjustment repaying advances for the first
three months of the contract.
9
07/01/02
Contract Number KH 272
ATTACHMENT III
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
1. Case Management
$
$
$
47.907.00
51.544.00
3.637.00
2. Subsidy payments1
3. Total
1 All subsidy payments are made by the Alliance, on behalf of the recipient, to eligible
caregivers after proper verification in CIRTS for any given month during which service was provided
to a homebound HCE elder consumer.
10
Amendment 001
CONTRACT KH 272
PAGE 1
THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred to
as the "Alliance", and Monroe County Board of Commissioners, hereinafter referred to as the
"Recipient", amends contract KH 272.
The purpose of this amendment is to change the approved unit rate(s) the recipient shall be
reimbursed under this contract based on the unit costing spreadsheets submitted by the recipient and
approved by the Alliance on December 6, 2002.
1. Attachment I, Section III, Paragraph E, Method of Payment, is hereby amended to read:
The Alliance shall make payment to the provider for provision of services up to a maximum
number of units of service and at the rate(s) stated below:
Service to be
Provided
Unit of
Service
Unit
Rate
Maximum
Units
Maximum
Dollars
Case Management
1 hour
$47.233766
77
$3,637
2. This amendment shall begin on the date on which the amendment has been signed by both
parties. Rates shall be adjusted retroactively to July 1, 2002.
All provisions in the contract and any attachment~ 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.
Amendment 001
CONTRACT KH 272
PAGE 1
IN WITNESS WHEREOF, the parties hereto have caused this 2 page amendment to be executed by
their undersigned officials as duly authorized.
PROVIDER: MONROE COUNTY BOARD
OF COMMISSIONERS
ALLIANCE FOR AGING, INC.
FOR DADE AND MONROE COUNTIES
SIGNED BY i.!i-;< >no ~<~1LlJ
SIGNE~-':"
~
)
NAME:
Dixie Spehar
NAME: STEVEN WEISBERG. M.S.
TITLE:
Mayor
TITLE: PRESIDENT/CEO
DATE:
January 15, 2003
DATE:
L-h I ~ ')
..-~.
FEDERAL 10 ~~~;::''<
/'\Y>:x ~ _ ~.: ,.
J/Y:Y)~ fJ,"'\,t ;~
PROVIDER 1~~",- ~~(~G DATE
, ' , /r~ q"'-/. ,0/ I ~ .
,'< , ~ <,[0')' <....-/~.:..--,.).:; J
..:>Si~t~f ".'
59-6000749
09/30
~~~
Louis LaTorre, Senior Director
Social Services/dra
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
MEETING DATE: 6-18-2003
DIVISION: COMMUNITY SERVICES
BULK ITEM:
YES X
NO
DEPARTMENT: SOCIAL SERVICES
AGENDA ITEM WORDING: Approval of the Renewal of Home Care for the Elderly (HCE) Contract
between the Alliance for Aging, Inc. and the Monroe County Board of County Commissioners (Monroe County
Social Services/In-Home Services Program) for Fiscal Year July 1, 2003 through June 30, 2004.
ITEM BACKGROUND: The approval of the HCE Contact will enable Monroe County In-Home Services
to continue providing services to the caregiver's of Monroe County's elderly population under the Home Care
for the Elderly (HCE) program.
PREVIOUS RELEVANT BOCC ACTION: June 2002
CONTRACT/AGREEMENT CHANGES: N/A
STAJ.;'J.;' R.fi.:COMM~NUATION: Approval
TOTAL COST: $3,637.00
COST TO COUNTY: $404.11 (Case Management Only)
BUDGETED: YES-L NO
SOURCE OF FUNDS: Home Care for the
Elderly Contract for $3,637.00
REVENUE PRODUCING: YES
NO--.1L AMT.PER MONTH
YEAR
APPROVED BY: COUNTY A TTYl OMB/Purchasing l RISK MANA~MENT -X
DIVISION DIRECTOR APPROVAL: \ Vi/ if C.a /
S MALLOCH
DOCUMENTATION:
INCLUDED_
TO FOLLOW_X_ NOT REQUIRED_
AGENDA ITEM#:
r~7
DISPOSITION:
Revised 1/03
AGENDA ITEM WITH LATE DOCUMENTATION
DIVISION:
Community Services
DEP ARTMENT: Social Services/In-Home Services Program
SUBJECT: Approval of the Renewal of Home Care for the
Elderly (HCE) Contract for Fiscal Year 7/1/03 through 6/30/04.
DATE ITEM WILL BE AVAILABLE: 6-13-2003
AGENDA ITEM NUMBER
~~~
Louis LaTorre, Senior Director
Social Services/dra
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
MEETING DATE: 6-18-2003
DIVISION: COMMUNITY SERVICES
BULK ITEM:
YES X
NO
DEPARTMENT: SOCIAL SERVICES
AGENDA ITEM WORDING: Approval of the Renewal of Home Care for the Elderly (HCE) Contract
between the Alliance for Aging, Inc. and the Monroe County Board of County Commissioners (Monroe County
Social Services/In-Home Services Program) for Fiscal Year July 1, 2003 through June 30, 2004.
ITEM BACKGROUND: The approval of the HCE Contact will enable Monroe County In-Home Services
to continue providing services to the caregiver's of Monroe County's elderly population under the Home Care
for the Elderly (HCE) program.
PREVIOUS RELEVANT BOCC ACTION: June 2002
CONTRACT/AGREEMENT CHANGES: N/A
STAFJ:;' llliCOMMENUATION: Approval
TOTAL COST: $3,637.00
COST TO COUNTY: $404.11 (Case Management Only)
BUDGETED: YES X NO
SOURCE OF FUNDS: Home Care for the
Elderly Contract for $3,637.00
REVENUE PRODUCING: YES
NO.-lL AMT.PER MONTH
YEAR
APPROVED BY: COUNTY A TTYl O~B/Purchasing l RISK MANAJ~MENT ---X
DIVISION DIRECTOR APPRO V AL: \ / a.Va ' !
S~MALLOCH
DOCUMENT A TION:
INCLUDED_
TO FOLLOW_X_ NOT REQUIRED_
C,J~
DISPOSITION:
AGENDA ITEM#:
Revised ] 103
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, Inc. Contract
Effective Date: July 1, 20Q3
Expiration Date: June 30, 2004
Contract Purpose/Description: Approval of the Renewal of Home Care for the Elderly (HCE) Contract between
the Alliance for Aging, Inc. and the Monroe County Board of County Commissioners (Monroe County Social
Services/In-Home Services Program) for Fiscal Year July 1,2003 through June 30, 2004.
Contract Manager:
Deloris Simps,ond #
(Name~'"
6/18/2003
For BOCC meeting on
4573
(Ext. )
Social Services/Stop 1
(Department/Stop #)
Agenda Deadline:
6/3/2003
CONTRACT COSTS
Total Dollar Value of Contract: $ 3,637.00
Budgeted? Yes X No 0 Account Codes:
Grant: $ 3,637.00
County Match: $404.11 (Case Management Only) v'
Current Year Portion: $
/yr
ADDITIONAL COSTS
For:
(eg. Maintenance, utilities, janitorial, salaries, etc)
Estimated Ongoing Costs: $
(Not included in dollar value above)
CONTRACT REVIEW
Date In
Division Director (I t l?t \ 0 &
Risk Management c;, Ii ~ J 0 ~
O.M.B.lPurchasing LP 113/ D"3
Changes
Needed
YesD No~
YesD NoV
YesD No~
County Attorney
Yes D No D
Comments:
Date Out
%J-iE~
,~/~:.D
~
~, l3/D3
C,1/3/03
to/l3}rs
OMB Form Revised 2/27/01 MCP #2
Jun 13 03 09:44a
In-Home Services
(305J292-4481
p.3
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, inc. Contract
Effective Date: July 1,2003
Expiration Date: June 30, 2004
Contract Purpose/Description: Approval of the Renewal of Home Care for the Elderly (HCE) Contract between
the Alliance for Aging, Inc. and the Monroe County Board of County Commissioners (Monroe County Social
Services/In-Home Services Program) for Fiscal Year July 1,2003 through June 30, 2004.
Contract Manager:
Deloris Simps\ol~ .fi
(Namc~
6/18/2003
4573
(Ext.)
Social Services/Stop 1
(Department/Stop #)
For BOCC meeting on
Agenda Deadline:
613/2003
CONTRACT COSTS
Total Dollar Value of Contract: $ 3,637.00
Budgeted? Yes X No 0 Account Codes:
Grant: $ 3,637.00
County Match: $404.11 (Case Management Only)
Current Year Portion: $
Estimated Ongoing Costs: $
(Not included in dollar value above)
/yr
ADDITIONAL COSTS
For:
(eg. Maintenance, utilities, janitorial, salaries, elc)
CONTRACT REVIEW
Date In
Changes
Needed
Yes 0 No 0
Division Director
Risk Management
YesO NoD
O.M.B./Purchasing
Yes 0 No U
County Attorney
(
(c-- (t- - C J
YesD
N~P
Date Out
Reviewer
~
--r:
!
t ./i'(;'?
--
Comments:
OMB Form Revised 2/27/01 Mep #2
AGENDA ITEM WITH LATE DOCUMENTATION
DIVISION:
Community Services
DEP ARTMENT: Social Services/In-Home Services Program
SUBJECT: Approval of the Renewal of Home Care for the
Elderly (HCE) Contract for Fiscal Year 7/1/03 through 6/30/04.
DATE ITEM WILL BE AVAILABLE: 6-13-2003
AGENDA ITEM NUMBER
07/01/2003
Contract Number KH 372
HOME CARE FOR THE ELDERLY CONTRACT
2003-2004
THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as
the "Alliance", and the Monroe County Board of Commissioners, hereinafter referred to as
the "recipient". This contract is subject to all provisions contained in the MASTER
AGREEMENT executed between the Alliance and the recipient, Agreement No. PA329, and its
successor, incorporated herein by reference.
The parties agree:
I. Recipient Agrees:
A. Services to be Provided:
To plan, develop, and accomplish the services delineated, or otherwise cause the
planning, development, and accomplishment of such services and activities, under the
conditions specified and in the manner prescribed in Attachment I of this agreement.
B. Requirements of Section 287.058, Florida Statutes:
These requirements are herein incorporated by reference.
C. Final Request for Payment:
1. The recipient must submit the final request for payment to the Alliance no later than
September 15, 2004; if the recipient fails to do so, all right to payment is
forfeited, and the Alliance will not honor any requests submitted after the
aforesaid time period.
2. If the contract is terminated prior to the contract end date of September 30, 2004,
then the recipient must submit the final request for payment to the Alliance no more
than 45 days after the contract is terminated; if the recipient fails to do so, all
right to payment is forfeited, and the Alliance will not honor any requests
submitted after the aforesaid time period.
II. The Alliance Agrees:
Contract Amount:
To pay for contracted services according to the conditions of Attachment I in an amount
not to exceed $51,544.00, subject to the availability of funds. The Alliance's performance
and obligation to pay under this contract is contingent upon an annual appropriation by the
Legislature. The costs of services paid under any other contract or from any other source
are not eligible for reimbursement under this contract. The funds awarded to the recipient
pursuant to this contract are in the state grants and aids appropriations and consists of the
following:
07/01/2003
Contract Number KH 372
Program Title Year Funding Source CSFA# Fund Amounts
Home Care for the Elderlv 2003 General Revenue 65001 $51,544.00
TOTAL FUNDS CONTAINED IN THIS CONTRACT: $51,544.00
III. Recipient and Alliance Mutually Agree:
A. Effective Date:
1. This contract shall begin on July 1, 2003 or on the date the contract has been
signed by both parties, whichever is later.
2. Delivery of services shall end on June 30, 2004 This contract shall end on
September 30, 2004. See Attachment I, Section 111.0.
B. Termination, Suspension, and/or Enforcement:
The causes and remedies for termination or suspension of this contract shall follow the
same procedures as outlined in Section III. B. and Section III. C. of the Master
Agreement.
C. Recipient Responsibility:
Notwithstanding the pass through language contained in Section I.S.1. of the Master
Agreement, the recipient maintains responsibility for the performance of all sub
recipients in accordance with all applicable federal and state laws.
D. Notice, Contact, and Payee Information:
1. The name, address, and telephone number of the contract manager for the Alliance
for this contract is:
Steven Weisberg
9500 South Dadeland Boulevard, Suite 400
Miami, Florida 33156
(305) 679-6500 SC 455-6500
2. The name, address, and telephone number of the representative of the recipient
responsible for administration of the program under this contact is:
Louis LaTorre
Gato Building - 1100 Simonton Street
Key West, Florida 33040
(305) 292-4573
2
07/01/2003
Contract Number KH 372
3. In the event different representatives are designated by either party after execution
of this contract, notice of the name and address of the new representative will be
rendered in writing to the other party and said notification attached to originals of
this contract.
4. The name (recipient name as shown on page 1 of this contract) and mailing
address of the official payee to whom the payment shall be made:
Monroe County Board of Commissioners
Gato Building - 1100 Simonton Street
Key West, Florida 33040
IN WITNESS THEREOF, the parties hereto have caused this 9-page contract to be executed
by their undersigned officials as duly authorized.
PROVIDER:
MONROE COUNTY BOARD
OF COMMISSIONERS
ALLIANCE FOR AGING, INC.
FOR DADE & MONROE COUNTIES
BOARD PRESIDENT OR AUTHORIZED DESIGNEE
SIGNED BY:
SIGNED BY:
NAME:
NAME:
Steven Weisberg, M. S.
TITLE:
TITLE:
President & CEO
DATE:
DATE:
FEDERAL 10 NUMBER:
PROVIDER FISCAL YEAR ENDING DATE:
59-6000749
09/30
3
07/01/2003
Contract Number KH 372
ATTACHMENT I
HOME CARE FOR THE ELDERLY PROGRAM
I. STATEMENT OF PURPOSE
The Home Care for the Elderly (HCE) Program encourages the provision of care in family-
type living arrangements in private homes on a not for profit basis as an alternative to
nursing home or other institutional care.
II. SERVICES TO BE PROVIDED
A. Services:
1. The recipient's service provider application for state fiscal year 2003, and any
revisions thereto approved by the Alliance and located in the contract manager's
file, are incorporated by reference in this contract between the Alliance and the
recipient, and prescribe the services to be rendered by the recipient.
2. Consumers may not be enrolled in a Department of Elder Affairs' state general
revenue funded program, including HCE, who are also enrolled in a Medicaid
capitated long term care health plan or program. These programs include the Frail
Elder Program operated by United Health Care, the Channeling Program operated
by Miami Jewish Home and Hospital for the Aged, the Long Term Care Community
Diversion Program operating in Planning and Service Areas 7 and 9, and the
Program of All Inclusive Care for the Elderly (PACE) program scheduled to begin
operation in the Miami-Dade County area.
B. Manner of Service Provision:
The services will be provided in a manner consistent with and described in the
recipient's service provider application for state fiscal year 2003 and the Department of
Elder Affairs Client Home And Community Based Services Handbook dated 01/03 In
the event the manual is revised, such revision will automatically be incorporated into
the contract and the recipient will be given a copy of the revisions.
III. METHOD OF PAYMENT
A. The method of payment in this contract is based on a fixed rate reimbursement for
approved services. The recipient must ensure fixed rates include only those costs which
are in accordance with all applicable state and federal statutes and regulations and are
based on audited historical costs in instances where an independent audit is required.
All requests for payment and expenditure reports submitted to support requests for
payment shall be on DOEA forms 106H and 1 OSH. Duplication or replication of both
forms via data processing equipment is permissible, provided all data elements are in
the same format as included on department forms.
4
07/01/2003
Contract Number KH 372
B. The recipient shall maintain documentation to support payment requests which shall be
available to the Comptroller, the Department of Elder Affairs, or the Alliance upon
request.
C. The recipient may request a monthly advance for service costs for-each of the first
three months of the contract period, based on anticipated cash needs. Detailed
documentation justifying cash needs for advances must be submitted with the signed
contract, approved by the Alliance, and maintained in the contract manager's file. All
payment requests for the fourth through the twelfth months shall be based on the
submission of monthly actual expenditure reports beginning with the first month of the
contract. The schedule for submission of advance requests is ATTACHMENT II to this
contract. Reconciliation and recouping of advances made under this contract are to be
completed by the time the final payment is made. All advance payments are subject to
the availability of funds.
D. Advance funds may be temporarily invested by the recipient in an insured interest
bearing account. All interest earned on contract fund advances must be returned to the
Alliance at the end of the first quarter of the contract period.
E. The Alliance shall make payment to the provider for provision of services up to a
maximum number of units of service and at the rate(s) stated below:
Service Unit of Unit Rate Maximum Maximum
to be Service Units Dollars
Provided
Case Management 1 hour $47.855263 76 $3,637
F. Contract Amendments:
1. The recipient agrees to implement the distribution of funds as detailed in the service
provider application and the Budget Summary, ATTACHMENT III to this contract.
A contract amendment is required to change the total amount of the contract. With
written notice to the Alliance's contract manager, funds may be moved from the
Case Management budget category to the Subsidies category. The Case
Management budget category can not be increased.
2. This contract is for services provided during the 2003/2004 State Fiscal year
beginning July 1, 2003 through June 30, 2004, however, the contract is in effect
through September 30, 2004 in order to provide for maximization of resources and
to allow for greater flexibility to pay for the services rendered by June 30, 2004.
Services provided after June 30, 2004 cannot be reimbursed under this contract.
3. The recipient will submit a draft closeout report by August 15, 2004. Any contract
amendments after August 15, 2004 determined necessary by the Alliance will be
based on the draft closeout reports.
5
07/01/2003
Contract Number KH 372
4. The final expenditure report and request for payment will be due to the Alliance no
later than September 15, 2004. No expenditure reports or requests for payment will
be accepted after September 15, 2004.
G. Any payment due by the Alliance under the terms of this contract may be withheld
pending the receipt and approval by the Alliance of all financial and programmatic
reports due from the recipient and any adjustments thereto, including any disallowance
not resolved as outlined in Section I.T. of the Master Agreement.
IV. SPECIAL PROVISIONS
A. State Laws and Regulations:
1. The recipient agrees to comply with applicable parts of Rule Chapter 58H-1, Florida
Administrative Code promulgated for administration of Sections 430.601 through
430.608, Florida Statutes, and the Department of Elder Affairs Home and
Community Based Services Handbook dated 01/03.
2. The recipient agrees to comply with the provisions of Sections 97.021 and 97.058,
Florida Statutes, and all rules related thereto in the Florida Administrative Code.
B. Assessment and Prioritization for Service Delivery for New Consumers:
The following are the criteria to prioritize new consumers for service delivery. It is not
the intent of the Department of Elder Affairs to remove existing clients from any
program in order to serve new clients being assessed and prioritized for service
delivery.
1. Priority Criteria for Service Delivery:
a) individuals in nursing homes under Medicaid who could be transferred to the
community;
b) individuals in nursing homes whose Medicare coverage is exhausted and
may be diverted to the community;
c) individuals in nursing homes which are closing or in receivership and can be
discharged to the community; or
d) individuals whose mental or physical health condition has deteriorated to the
degree self care is not possible, there is no capable caregiver and
institutional placement will occur within 72 hours.
2. Priority Criteria for Other Assessed Individuals:
The assessment and provision of services should always consider the most cost
effective means of service delivery. Functional impairment shall be determined
through the department's consumer assessment form administered to each
applicant. The most frail individuals not prioritized in the group above, regardless of
referral source, will receive services to the extent funding is available.
6
07/01/2003
Contract Number KH 372
C. Consumer Information, Registration and Tracking System (CIRTS):
1. The recipient will ensure the collection and maintenance of Home Care for the Elderly
(HCE) subsidies and case management information on a monthly basis from the
Consumer Information, Registration and Tracking System (CIRTS). Maintenance
includes valid exports and backups of all data and systems according to department
standards.
2. The recipient must ensure all data for HCE subsidies are entered in the CIRTS by the
15th of each month. HCE subsidy data entered into the CIRTS by the 15th of the
month will be for payments incurred between the 16th of the previous month and the
15th of the current month. Case management data entered into the CIRTS by the 15th
of the month will be for units of service provided during the previous month from the
16th and up to and including the 15th of the current month or case management units
of service may be entered according to the recipient schedule, in aggregate on the 31 st
or daily, weekly or monthly.
3. The recipient will ensure data entry for HCE subsidies will cease on the 15th of the
month and the CIRTS Monthly Service Utilization Report, by consumer and by worker
identification is run.
4. The recipient will ensure the Monthly Utilization Report, by consumer and by worker
identification is verified, corrected, certified no later than the 20th of the month in which
the report is generated.
5. The recipient will ensure caregivers determined eligible for the HCE basic subsidy after
the 15th of a month, will be processed to begin eligibility for the HCE basic subsidy on
the 1 st day of the next month.
6. The Alliance will reconcile and verify the CIRTS data prior to payment for HCE basic
and special subsidies and case management.
7. The Alliance will reconcile and verify the CIRTS data prior to payment for HCE basic
and special subsidies and case management.
7
07/01/2003
Report
Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Leqend:
Note # 1:
Note # 2:
Contract Number KH 372
ATTACHMENT II
HOME CARE FOR THE ELDERLY PROGRAM
CONTRACT REPORT CALENDAR
Based On
July Advance * ...............................................................
August Advance * ...........................................................
July Expenditure Report... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ....
August Expenditure Report... ...... ... '" ... ... ... ... ... ... ... ... ... ... ...
September Expenditure Report...... ... ... '" ... ... '" ... ... ... '" ... ....
October Expenditure Report... '" ... '" '" '" '" '" ... ... ... '" ... ... ... ..
November Expenditure Report ... ............ ......... ....................
December Expenditure Report ... ...... ... ... ............... ..............
January Expenditure Report...... ... ... ... ... ... ... ... ... ... ... ... ... ... ..
February Expenditure Report... ... ... ... '" '" ... ... ... ... ... '" ... ... ...
March Expenditure Report... ... ... ... ... ... ... ... ... ... '" ... ... ... ... ... .
April Expenditure Report... ... ... ... ... ... ... ... ... ... ... '" '" '" ... ... ...
May Expenditure Report/July Advance Reconciliation ** ..........
June Expenditure Report/August Advance Reconciliation ** .....
Draft Closeout Report... ... ... ... ... ... ... ... ... ... ... ... ... ... '" ... ... ... .
Final Expenditure and Request for Payment Report... '" ... ... ... .
Closeout Report ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
*
Advance based on projected cash need.
**
Submit
to the Alliance
on This Date
July 1
July 1
August 10
September 10
October 10
November 10
December 10
January 10
February 10
March 10
April 10
May 10
June 10
July 10
August 15
September 15
September 15
Submission of expenditure reports mayor may not generate a payment
request. If final expenditure report reflects funds due back to the Alliance,
payment is to accompany the report.
Report #1 for Advance Basis Contracts cannot be submitted to the Alliance
prior to July 1 or until the contract with the Alliance has been executed.
Actual submission of the vouchers to the Department of Elder Affairs is
dependent on the accuracy of the expenditure report.
The last three months of the recipient's fiscal reports covering actual
expenditures should reflect an adjustment repaying advances for the first
three months of the contract.
8
07/01/2003
Contract Number KH 372
ATTACHMENT III
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
1. Case Management... ... ... ... ... ... ... ... ... ... ... ... ... '"
2. Subsidy Payments 1 ............... ... ...... ................
$ 3,637.00
$47,907.00
3. T ota I .............................................................
$51,544.00
* * * * * *
1 All subsidy payments are made by the Alliance, on behalf of the recipient, to eligible caregivers after proper
verification in CIRTS for any given month during which service was provided to a homebound HCE elder
consumer.
9
Monrce County ~&erk'8 oma ~
07/01/02
Contract Number KH 272
HOME CARE FOR THE ELDERLY CONTRACT
2002-2003
THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as
the "Alliance", and the Monroe County Board of Commissioners, hereinafter referred to as
the "recipient". This contract is subject to all provisions contained in the MASTER
AGREEMENT executed between the Alliance and the recipient, Agreement No. PA329, and its
successor, incorporated herein by reference.
The parties agree:
I. Recipient Agrees:
A. Services to be Provided:
To plan, develop, and accomplish the services delineated, or otherwise cause the
planning, development, and accomplishment of such services and activities, under the
conditions specified and in the manner prescribed in Attachment I of this agreement.
B. Requirements of Section 287.058, Florida Statutes:
These requirements are herein incorporated by reference.
C. Final Request for Payment:
1. The recipient must submit the final request for payment to the Alliance no later than
September 15, 2003; if the recipient fails to do so, all right to payment is
forfeited, and the Alliance will not honor any requests submitted after the
aforesaid time period.
2. If the contract is terminated prior to the contract end date of September 30, 2003,
then the recipient must submit the final request for payment to the Alliance no more
than 45 days after the contract is terminated; if the recipient fails to do so, all
right to payment is forfeited, and the Alliance will not honor any requests
submitted after the aforesaid time period.
II. The Alliance Agrees:
Contract Amount:
To pay for contracted services according to the conditions of Attachment I in an amount
not to exceed $51,544.00, subject to the availability of funds. The Alliance's performance
and obligation to pay under this contract is contingent upon an annual appropriation by the
Legislature. The costs of services paid under any other contract or from any other source
are not eligible for reimbursement under this contract. The funds awarded to the recipient
pursuant to this contract are in the state grants and aids appropriations and consists of the
following:
1
07/01/02
Contract Number KH 272
Program Title Year Funding Source CSFA# Fund
Amounts
Home Care for 2002 General Revenue 65001 $51,544.00
the Elderly
TOT AL FUNDS CONTAINED IN THIS CONTRACT: $51,544.00
III. Recipient and Alliance Mutually Agree:
A. Effective Date:
1. This contract shall begin on July 1, 2002 or on the date the contract has been
signed by both parties, whichever is later.
2. Delivery of services shall end on June 30, 2003 This contract shall end on
September 30, 2003. See Attachment I, Section 111.0.
B. Termination, Suspension, and/or Enforcement:
The causes and remedies for termination or suspension of this contract shall follow the
same procedures as outlined in Section III. B. and Section III. C. of the Master
Agreement.
C. Recipient Responsibility:
Notwithstanding the pass through language contained in Section I.S.1. of the Master
Agreement, the recipient maintains responsibility for the performance of all
subrecipients in accordance with all applicable federal and state laws.
D. Notice, Contact, and Payee Information:
1. The name, address, and telephone number of the contract manager for the Alliance
for this contract is:
Steven Weisberg
9500 South Dadeland Boulevard, Suite 400
Miami, Florida 33156
(305) 679-6500 SC 455-6500
2
07/01/02
Contract Number KH 272
2. The name, address, and telephone number of the representative of the recipient
responsible for administration of the program under this contact is:
Louis LaTorre
Gato Building - 1100 Simonton Street
Key West, Florida 33040
(305) 292-4573
3. In the event different representatives are designated by either party after execution
of this contract, notice of the name and address of the new representative will be
rendered in writing to the other party and said notification attached to originals of
this contract.
4. The name (recipient name as shown on page 1 of this contract) and mailing
address of the official payee to whom the payment shall be made:
Monroe County Board of Commissioners
Gato Building - 1100 Simonton Street
Key West, Florida 33040
3
07/01/02
Contract Number KH 272
IN WITNESS THEREOF, the parties hereto have caused this 10 page contract to be executed
by their undersigned officials as duly authorized. .
RECIPIENT:
ALLIANCE FOR AGING, INC.
MONROE COUNTY BOARD
OF COMMISSIONERS
BOARD PRESIDENT OR
AUTHORIZED DESIGNEE
SIGNED ,../'
BY:
~~~~ ~
NAME: C Ac..Y I ~ S \S,.1 "M l' !vI L (<. ...;
/
NAME: STEVEN WEISBERG, M.S.
TITLE:
Iv( ~LYU''''''
I
?J7
i 7 z....u.~'-
TITLE: PRESIDENT/CEO
D I b) ~~
DATE:
DATE:
FEDERAL 10 NUMBER:
RECIPIENT FISCAL YEAR END DATE:
59-6000749
09/30
(s>AL> ~b~
~~LERK
07/01/02
Contract Number KH 272
ATTACHMENT I
HOME CARE FOR THE ELDERLY PROGRAM
I. STATEMENT OF PURPOSE
The Home Care for the Elderly (HCE) Program encourages the provision of care in family-
type living arrangements in private homes on a not for profit basis as an alternative to
nursing home or other institutional care.
II. SERVICES TO BE PROVIDED
A. Services:
1. The recipient's service provider application for state fiscal year 2002, and any
revisions thereto approved by the Alliance and located in the contract manager's
file, are incorporated by reference in this contract between the Alliance and the
recipient, and prescribe the services to be rendered by the recipient.
2. Consumers may not be enrolled in a Department of Elder Affairs' state general
revenue funded program, including HCE, who are also enrolled in a Medicaid
capitated long term care health plan or program. These programs include the Frail
Elder Program operated by United Health Care, the Channeling Program operated
by Miami Jewish Home and Hospital for the Aged, the Long Term Care Community
Diversion Program operating in Planning and Service Areas 7 and 9, and the
Program of Alllnciusive Care for the Elderly (PACE) program scheduled to begin
operation in the Miami-Dade County area.
B. Manner of Service Provision:
The services will be provided in a manner consistent with and described in the
recipient's service provider application for state fiscal year 2002 and the Department of
Elder Affairs Client Services Manual dated 12/98. In the event the manual is revised,
such revision will automatically be incorporated into the contract and the recipient will
be given a copy of the revisions.
III. METHOD OF PAYMENT
A. The method of payment in this contract is based on a fixed rate reimbursement for
approved services. The recipient must ensure fixed rates include only those costs
which are in accordance with all applicable state and federal statutes and regulations
and are based on audited historical costs in instances where an independent audit is
required. All requests for payment and expenditure reports submitted to support
requests for payment shall be on DOEA forms 106H and 10SH. Duplication or
replication of both forms via data processing equipment is permissible, provided all
data elements are in the same format as included on department forms.
5
07/01/02
Contract Number KH 272
B. The recipient shall maintain documentation to support payment requests which shall be
available to the Comptroller, the Department of Elder Affairs, or the Alliance upon
request.
C. The recipient may request a monthly advance for service costs for each of the first
three months of the contract period, based on anticipated cash needs. Detailed
documentation justifying cash needs for advances must be submitted with the signed
contract, approved by the Alliance, and maintained in the contract manager's file. All
payment requests for the fourth through the twelfth months shall be based on the
submission of monthly actual expenditure reports beginning with the first month of the
contract. The schedule for submission of advance requests is A TT ACHMENT II to this
contract. Reconciliation and recouping of advances made under this contract are to be
completed by the time the final payment is made. All advance payments are subject to
the availability of funds.
D. Advance funds may be temporarily invested by the recipient in an insured interest
bearing account. All interest earned on contract fund advances must be returned to the
Alliance at the end of the first quarter of the contract period.
E. The Alliance shall make payment to the provider for provision of services up to a
maximum number of units of service and at the rate(s) stated below:
Service to be
Provided
Unit of
Service
Unit
Rate
Maximum
Units
Maximum
Dollars
Case Management
1 client hour $37.885416
96
$3,637
F. Contract Amendments:
1. The recipient agrees to implement the distribution of funds as detailed in the service
provider application and the Budget Summary, ATTACHMENT III to this contract.
A contract amendment is required to change the total amount of the contract. With
written notice to the Alliance's contract manager, funds may be moved from the
Case Management budget category to the Subsidies category. The Case
Management budget category can not be increased.
2. This contract is for services provided during the 2002/2003 State Fiscal year
beginning July 1, 2002 through June 30, 2003, however, the contract is in effect
through September 30, 2003 in order to provide for maximization of resources and
to allow for greater flexibility to pay for the services rendered by June 30, 2003.
Services provided after June 30, 2003 cannot be reimbursed under this contract.
3. The recipient will submit a draft closeout report by August 15, 2003. Any contract
amendments after August 15, 2003 determined necessary by the Alliance will be
based on the draft closeout reports.
6
07/01/02
Contract Number KH 272
4. The final expenditure report and request for payment will be due to the Alliance no
later than September 15, 2003. No expenditure reports or requests for payment will
be accepted after September 15, 2003.
G. Any payment due by the Alliance under the terms of this contract may be withheld
pending the receipt and approval by the Alliance of all financial and programmatic
reports due from the recipient and any adjustments thereto, including any disallowance
not resolved as outlined in Section IT of the Master Agreement.
IV. SPECIAL PROVISIONS
A. State Laws and Regulations:
1. The recipient agrees to comply with applicable parts of Rule Chapter 58H-1, Florida
Administrative Code promulgated for administration of Sections 430.601 through
430.608, Florida Statutes, and the Department of Elder Affairs Client Services
Manual dated 12/98.
2. The recipient agrees to comply with the provisions of Sections 97.021 and 97.058,
Florida Statutes, and all rules related thereto in the Florida Administrative Code.
B. Assessment and Prioritization for Service Delivery for New Consumers:
The following are the criteria to prioritize new consumers for service delivery. It is not
the intent of the Department of Elder Affairs to remove existing clients from any
program in order to serve new clients being assessed and prioritized for service
delivery.
1. Priority Criteria for Service Delivery:
a) individuals in nursing homes under medicaid who could be transferred to the
community;
b) individuals in nursing homes whose medicare coverage is exhausted and
may be diverted to the community;
c) individuals in nursing homes which are closing or in receivership and can be
discharged to the community; or
d) individuals whose mental or physical health condition has deteriorated to the
degree self care is not possible, there is no capable caregiver and
institutional placement will occur within 72 hours.
2. Priority Criteria for Other Assessed Individuals:
The assessment and provision of services should always consider the most cost
effective means of service delivery. Functional impairment shall be determined
through the department's consumer assessment form administered to each
applicant. The most frail individuals not prioritized in the group above, regardless of
referral source, will receive services to the extent funding is available.
7
07/01/02
Contract Number KH 272
C. Consumer Information, Registration and Tracking System (CIRTS):
1. The recipient will ensure the collection and maintenance of Home Care for the
Elderly (HCE) subsidies and case management information on a monthly basis
from the Consumer Information, Registration and Tracking System (CIRTS).
Maintenance includes valid exports and backups of all data and systems according
to department standards.
2. The recipient must ensure all data for HCE subsidies are entered in the CIRTS by
the 15th of each month. HCE subsidy data entered into the CIRTS by the 15th of
the month will be for payments incurred between the 16th of the previous month
and the 15th of the current month. Case management data entered into the CIRTS
by the 15th of the month will be for units of service provided during the previous
month from the 16th and up to and including the 15th of the current month or case
management units of service may be entered according to the recipient schedule,
in aggregate on the 31 st or daily, weekly or monthly.
3. The recipient will ensure data entry for HCE subsidies will cease on the 15th of the
month and the CIRTS Monthly Service Utilization Report, by consumer and by
worker identification is run.
4. The recipient will ensure the Monthly Utilization Report, by consumer and by worker
identification is verified, corrected, certified no later than the 20th of the month in
which the report is generated.
5. The recipient will ensure caregivers determined eligible for the HCE basic subsidy
after the 15th of a month, will be processed to begin eligibility for the HCE basic
subsidy on the 1 st day of the next month.
6. The Alliance will reconcile and verify the CIRTS data prior to payment for HCE
basic and special subsidies and case management.
7. The Alliance will reconcile and verify the CIRTS data prior to payment for HCE
basic and special subsidies and case management.
8
07/01/02
Report
Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Legend: *
**
Note # 1 :
Note # 2:
Contract Number KH 272
ATTACHMENT II
HOME CARE FOR THE ELDERLY PROGRAM
CONTRACT REPORT CALENDAR
Based On
July Advance*
August Advance*
September Advance*
July Expenditure Report
August Expenditure Report
September Expenditure Report
October Expenditure Report
November Expenditure Report
December Expenditure Report
January Expenditure Report
February Expenditure Report
March Expenditure Report
April ExpendnureReport
May Expenditure Report/July Adv. Recon.**
June Expenditure Report/August Adv. Recon.**
Draft Closeout Report
Final Expenditure and Request
for Payment Report
Closeout Report
Advance based on projected cash need.
Submit to
The Alliance
On This Date
July 1
July 1
August 1
August 15
September 15
October 15
November 15
December 15
January 15
February 15
March 15
April 15
May 15
June 15
July 15
August 15
September 15
September 15
Submission of expenditure reports mayor may not generate a payment
request. If final expenditure report reflects funds due back to the
department, payment is to accompany the report.
Report #1 for Advance Basis Contracts cannot be submitted to the Alliance
prior to July 1 or until the contract with the Alliance has been executed.
Actual submission of the vouchers to the Department of Elder Affairs is
dependent on the accuracy of the expenditure report.
The last three months of the recipient's fiscal reports covering actual
expenditures should reflect an adjustment repaying advances for the first
three months of the contract.
9
07/01/02
Contract Number KH 272
ATTACHMENT III
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
1. Case Management
$
$
$
47.907.00
3.637.00
2. Subsidy Payments 1
3. Total
51.544.00
: All subsidy payments are made by the Alliance, on behalf of the recipient, to eligible
caregivers after proper verification in CIRTS for any given month during which service was provided
to a homebound HCE elder consumer.
10
Amendment 001
CONTRACT KH 272
PAGE 1
THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred to
as the "Alliance", and Monroe County Board of Commissioners, hereinafter referred to as the
"Recipient", amends contract KH 272.
The purpose of this amendment is to change the approved unit rate(s) the recipient shall be
reimbursed under this contract based on the unit costing spreadsheets submitted by the recipient and
approved by the Alliance on December 6, 2002.
1. Attachment I, Section III, Paragraph E, Method of Payment, is hereby amended to read:
The Alliance shall make payment to the provider for provision of services up to a maximum
number of units of service and at the rate(s) stated below:
Service to be
Provided
Unit of
Service
Unit
Rate
Maximum
Units
Maximum
Dollars
Case Management
1 hour
$47.233766
77
$3,637
2. This amendment shall begin on the date on which the amendment has been signed by both
parties. Rates shall be adjusted retroactively to July 1, 2002.
All provisions in the contract and any attachment~ 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.
Amendment 001
CONTRACT KH 272
PAGE 1
IN WITNESS WHEREOF, the parties hereto have caused this 2 page amendment to be executed by
their undersigned officials as duly authorized.
PROVIDER: MONROE COUNTY BOARD
OF COMMISSIONERS
ALLIANCE FOR AGING, INC.
FOR DADE AND MONROE COUNTIES
SIGNED BY J);-;< >no ~./'d..IJ
SIGNE~---""
~
~
NAME:
Dixie Spehar
NAME: STEVEN WEISBERG. M.S.
TITLE:
Mayor
TITLE: PRESIDENT/CEO
DATE:
January 15, 2003
DATE:
L-h 1 ~ ')
~~~'-
:,~ouN:;;';'..'o,
FEDERAL 10 ~m~t-,>\
"i7Y~PJ!iY \\
PROVIDER ~~~t\~.FfJ,\~G DATE
\\.~~ <:,;ZttJ '{f::;:>>o/{ ~/
:/<.. :~., . L E CLBiI<
<~,;.>~:~ ~::~~ =-
59-6000749
09/30