Item C27�.. .�-t--- -
Louis LaTorre, Senior Director
Social Services/dra
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
MEETING DATE: 01-21-2004 DIVISION: COMMUNITY SERVICES
BULK ITEM: YES X NO
DEPARTMENT: SOCIAL SERVICES
AGENDA ITEM WORDING: Approval of a Memorandum of Understanding between the tollowing provicier-
Summit Home Respiratory Services and the Monroe County Board of County Commissioners (Monroe County
Social Services/In-Home Services Program).
ITEM BACKGROUND: The approval of the Memorandum of Understanding will allow assurances from the
Provider (Summit Home Respiratory Services) that they will cooperate with Monroe County, the lead agency in
its performance of duties under Monroe County's Case Management contract with the Home and Community
Based Services Waiver through the Alliance of Aging.
PREVIOUS RELEVANT BOCC ACTION None
CONTRACT/AGREEMENT CHANGES: N/A
17 01 ..• • .
TOTAL COST: N/A
COST TO COUNTY: N/A
REVENUE PRODUCING: YES
BUDGETED: YES— NO
SOURCE OF FUNDS: N/A
NO X AMT.PER MONTH YEAR
APPROVED BY: COUNTY ATTY. X OMB/Purchasing RISK MANAGEMENT ,
DIVISION DIRECTOR APPROVAL: L
ZES LOCH
DOCUMENTATION: INCLUDED X LLOW NOT REQUIRED
DISPOSITION: AGENDA ITEM#:
(223 r7-
Revised 1/03
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Memorandum of Understanding
(MOU) with Summit Home Respiratory Services
Effective Date: 01/21/2004
Expiration Date:
Contract Purpose/Description: This Memorandum of Understanding (MOU) will allow assurances from the
Provider (Summit Home Respiratory Services) that they will cooperate with Monroe County, the lead agency in
its performance of duties under Monroe County's Case Management contract with the Home and Community
Based Services Waiver through the Alliance for Aging.
Contract Manager: Deloris Simpson,( 4589 Social Services/Stop 1
(Name) i z� (Ext.) (Department/Stop #)
For BOCC meeting on 1 / 21 / 0 4 Agenda Deadline: 1 / 6 / 0 4
CONTRACT COSTS
Total Dollar Value of Contract: $-0- Current Year Portion: $
Budgeted? Yes X No Account Codes: - - - -
Grant: $ -0- - - - -
County Match: $ -0- - - - -
Estimated Ongoing Costs: $
(Not included in dollar value above)
/yr
ADDITIONAL COSTS
For:
(eg. Maintenance,
CONTRACT REVIEW
Date In
Division Director j Z I L`(' n 3
/
Risk Management 1,112`� l ��
Changes
Needed
Yes to
Yes N
/ Date Out
e erg
x i q,`j v�
2/ �ld3
O.M.B./Purchasing /
County Attorney 1/0 �/o `l
Yes oNo� _
Yes 0
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Comments:
OMB Form Revised 2127/01 MCJF 42
MEMORANDUM OF UNDERSTANDING
This Memorandum of Understanding is entered this day ofJ-Ial
2003, by and between Monroe County (County) and Summitt Home Resp. (Provider).
WHEREAS, Monroe County has entered into a contract with the Alliance for Aging,
Inc. to provide case management services for the Home and Community Based Services
Aged and Disabled Adult Medicaid Waiver and Assisted Living for Frail Elderly Medicaid
Waiver programs; and
WHEREAS, the County is required to develop and implement a plan of care for each
consumer, reevaluate the plan periodically, refer consumers to qualified service providers,
issue written service authorizations to service providers, evaluate the quality of services and
service documentation by the service provider, and monitor service providers for adherence
to authorized care plans and authorized reimbursement rates; and
WHEREAS, County needs assurances from Provider that the Provider will cooperate
with County in its performance of its duties under its case management contract;
NOW THEREFORE, the Parties agree as follows:
1. Provider has been listed by the Alliance for Aging, Inc. on the choice of provider
list.
2. Provider shall accept referrals from County for the Home and Community Based
Service Medicaid Waiver consumers who chooses the Provider for services under
this program.
3. Provider shall supply only those services specifically outlined in the plan of care
and authorized by County.
4. Provider shall adhere to a separate referral agreement between the area Alliance
on Aging for Planning and Service.
5. Provider shall immediately notify County of staffing shortfalls which will
negatively impact provision of service to Medicaid Waiver consumers.
6. Provider shall make available such reports to the County as are required for the
case management agency in the DOEA Client Services Manual as well as the
Aged/ Disabled Adult Waiver Guidelines and the Medicaid Provider
Reimbursement Handbook.
7. County shall adhere to the provisions of the Home and Community Based Waiver
Case Management Referral Agreement between it and the Alliance for Aging, Inc.
8. County shall develop and implement a plan of care for the consumer.
9. County shall refer consumers to any qualified service provider as selected by the
consumer.
10. County shall monitor service provider for adherence to authorized care plans and
authorized reimbursement rates as well as evaluate quality of services and
service documentation by the Provider.
11. Provider covenants and agrees to indemnify and hold harmless Monroe County
Board of County Commissioners from any and all claims for bodily injury
(including death), personal injury, and property damage (including property
owned by Monroe County) and any other losses, damages, and expenses
(including attorney's fees) which arise out of, in connection with, or by reason of
services provided by the Provider or any of its Subcontractor(s) to any.of the
clients whom are referred by County to Provider and which are occasioned by the
negligence, errors, or other wrongful act or omission of the Provider or its
Subcontractors in any tier, their employees, or agents.
12. Should County determine that the Provider is in breach of any of its obligations
under this agreement or failing to provide satisfactory services under a care plan,
County shall notify the Alliance for Aging, Inc. and the Provider of such breach or
deficiency.
WHEREFORE, the parties hereto have caused the above presents to be executed by their
duly authorized representatives.
BOARD OF COUNTY COMMISSIONERS
ATTEST: OF MONROE COUNTY, FLORIDA
DANNY L. KOLHAGE, Clerk
By:
Deputy Clerk
Date:
By:
Mayor
r
MONROE COUNTY ATTORNEY
APP VED AS TO F
ZANNE A. HU o
ON /
ASSISTANT C01�1VyY3ATXQflNY
EY 1 D