Item C28
<) p?
~~/;(~_c
Louis LaTorre, Senior Director
Social Services/dra
BOARD OF COUNTY COMMISSIONERS
YES _X_
AGENDA ITEM SUMMARY
DIVISION: COMMUNITY SEjlVICES, {yl.....
DEPARTMI;jNT: SOCIAL SERVICES t~ \
MEETING DATE: 6-15-2005
BULK ITEM:
NO
AGENDA ITEM WORDING: Approval of the Community Care for the Elderly (CCE) Contract # KC571
between the Alliance fOT Aging, Inc. and the Monroe County Board of County Commissioners (Monroe County
Social Scrvices/ln~Home Services Program) for Fiscal Year July l, 2005 through Illile 30, 2006.
ITEM BACKGROUND: The approval of the CCE Contract will enable Monroe County In-Home Services
to continue providing selYices to Monroe COWlty'S elderly population under the Community Care for the
Elderly (CCE) program.
PREVIOUS RELEVANT BOCC ACTION:
June 16,2004
CONTRACT/AGREEMENT C'RANCES:
N/A
STAFl' ~~e{)Mr.-lENDATION: Approval
TOTAL COST: $ 459,837.00
COST TO COUNTY: $ 51,093.00 - Required
Additional match approximately $] 19,83 LOO
Total combined match $170,924.00
BUDGETED: YES-X- NO _,_
SOURCE OIl FUNDS: CCE
Contract for fiscal year 7/2005 thru
6/2006 for $459,837.00
RJt:VENUE PRODUCING: YES _X_ NO_AMT PER MONTH: ~$2.333.00 AMT PER YEAR: iW'1.L
$28.000.00
APPROVED BY: COUNTY ATTY..x OMB/Purchasing 2L RISK MANAGEMENT --X
DI\lSION DIRECTOR APPROVAL: ~ Q Q~
, JAMES~\1ALLOCH
DOCUMENTATION: rNCUJDED__Z~ TO FOLLOW,~_~_ NOT REQUIRED_
DISPOSITION:
AGENDA ITEM#:
R<c,,~ :i~)J
MONROE COUNTY BOAlID OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract ,vith: The Alliance for Aging, Inc. Contract
Effective Date: 7/01/2005
Expiration Date: 6/30/2006
Contract PurposefDescription; Approval ofthe Community Care for the Elderly (CCE) Contract #KC57 I
between the AJliance for Aging, Inc. and the Monroe County Board of County Commissioners (Monroe County
Soclal Services/ln~Home Services Progr~ for Fiscal year July 1,2005 through June 30, 2006.
/-J;{:/ ----"'""'"C.~.
Contract Manager: Delo~~::'-:~ 4589 Social Services/Stop I
(Name) (/'" (Ext) (Department/Stop #)
For Boec meeting on 6/1512005
Agenda Deadline;
5/3 1105
CONTRACT COSTS
Total Dollar Value ofConl.ldct: $ 459,837.00
Budgeted? Yes X No ACcount Codes:
Grant: $ 459,837.00
County Match: $ 51,093,00 - Required
Approx. additional match
$119,831.00
Current Year Portion: $
~ ~ ~ -
---. _......-._.__.~ - ~...>-._---. ~
Estimated Ongoing Costs; $.__jyr
(NlIt included in dolin val"" abovc)
ADDrnONAL COSTS
For:
___._~c . _
(eg. Maintenance, uulities, janitorial. salaries, ele)
CONTRACT REVIEW
DiviSIon Director
Date In
S/~ loS
~~ '\~"'i'\5C
) U):_, '-'.C
Changes
Nce~
Yes ~)
c~-~
Yes rtLQ...-J
Yes ~)
Yes @
Rtsk Management
.J'''
O.M.B/Puft~ing < -1 ~f ~OS'
/ /-. -/1., r~
~~/ 4>-"'1}- ~. ,,:::'
County Attorney
Conunents:
OMB Form Revised 2/27/01 MCF #2
.dJ
....)r.. ~ --o.../! It.-- c<
(\ 1 \,~J.ttu.,
I.cL.~_...ccm_~.____c.._..mwc_.~c....
,JJw~k~~~
~ --_.~~---
Date Out
S~2
,5d~d5'
5 d}O~'-:'
--~
J
I
f
l
I
I
f
r
r
I
I
!
r
i
I
I
i
i
i
f
I
/
1
I
f
f
I
!
,
j
!
f
I
t
t
t
I
07/01/2005
CONTRACT NUMBER KC571
COMMUNITY CARE FOR THE ELDERLY CONTRACT
2005.2006
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. PA429, 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, 2006 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,
2006, 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 $459,837.00, 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
07/01/2005
CONTRACT NUMBER KC571
Program Title Year Funding Source CSFA# Fund Amounts
Community Care 2005 General Revenue/Tobacco 65010 $459,837.00
for the Elderly Settlement Trust Funds
TOTAL FUNDS CONTAINED IN THIS CONTRACT: $459,837.00
III. Recipient and Alliance Mutually Agree:
A. Effective Date:
1. This contract shall begin on July 1, 2005 or on the date the contract has been
signed by both parties, whichever is later.
2. Delivery of services shall end on June 30, 2006. This contract shall end on
September 30, 2006. See Attachment I, Section III.F.
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) 670-6500 SC 455-6500
2. The name, address, and telephone number of the representative of the recfpient
responsible for administration of the program under this contact is:
Louis LaTorre
Gato Building - 1100 Simonton Street
Key West, Florida 33040
(305) 292-4573
'"l
,<;.
07/01/2005
CONTRACT NUMBER KC571
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 10-page contract to be executed
by their undersigned officials as duly authorized.
RECIPIENT:
MONROE COUNTY BOARD
OF COMMISSIONERS
ALLIANCE FOR AGING, INC.
BOARD PRESIDENT OR AUTHORIZED DESIGNEE
SIGNED BY:
SIGNED BY:
NAME:
NAME:
Steven Weisberg, M. S.
TITLE:
TITLE:
President & CEO
DATE:
DATE:
FEDERAL ID NUMBER:
RECIPIENT FISCAL YEAR END DATE:
59-6000749
09/30
3
07/01/2005
CONTRACT NUMBER KC571
ATTACHMENT I
COMMUNITY CARE FOR THE ELDERLY PROGRAM
I. STATEMENT OF PURPOSE
The Community Care for the Elderly (CCE) Program provides community-based services
organized in a continuum of care to assist aged 60 + elders at risk of nursing home
placement to live in the least restrictive environment suitable to their needs.
II. SERVICES TO BE PROVIDED
A. Services:
1. The recipient's service provider application for state fiscal year 2005, 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 CCE, 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 2005 and the Department of
Elder Affairs 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 106C and 105C. 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.
The recipient shaH maintain documentation to support payment requests which shall be
available to the Comptroller, the Department of Elder Affairs, or the Alliance upon
request
4
07/01/2005
CONTRACT NUMBER KC571
C. The recipient may request a monthly advance for service costs for each of the first two
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 third 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 Unit Rate Maximum Maximum
Service Units Dollars
Case Management 1 hour $50.78 1 ,880 $95,464
Homemaker 1 hour $34.14 3,330 $113.689
Personal Care 1 hour $42.38 5,427 $230,016
Respite (In-Home) 1 hour $26.23 788 $20,668
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
Any changes in the total amounts of the funds identified on the Budget Summary
form require a contract amendment.
2. With the exception of Case Management, the recipient agrees to implement a
Modified Spending Authority. Recipient is to offer services based on clients' service
plans and will not be restricted to providing the services as projected. Additional
budget revisions/contract amendments will not be required to move funding among
these services, with the exception of Case Management. Any changes in the total
amount of the funds under contract require a formal contract amendment.
3. This contract is for services provided during the 2005/2006 State Fiscal year
beginning July 1, 2005 through June 30, 2006, however, the contract is in effect
through September 30,2006 in order to provide for maximization of resources and
to allow for greater flexibility to pay for the services rendered by June 30,2006.
Services provided after June 30, 2006 cannot be reimbursed under this contract.
5
07/01/2005
CONTRACT NUMBER KC571
4. The recipient will submit a draft closeout report by August 15, 2006. Any contract
amendments after August 15, 2006 determined necessary by the Alliance will be
based on the draft closeout reports.
5. The final expenditure report and request for payment will be due to the Alliance no
later than September 15, 2006. No expenditure reports or requests for payment
will be accepted after September 15, 2006.
G. Any payment due by the Allfance 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 58C-1, Florida
Administrative Code promulgated for administration of Sections 430.201 through
430.207, 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. Abuse, Neglect and Exploitation:
The recipient will ensure that pursuant to Section 430.205(5), Florida Statute, those
elderly persons who are determined by adult protective services to be victims of
abuse, neglect, or exploitation who are in need of immediate services to prevent
further harm and are referred by adult protective services, will be given primalY
consideration for receiving Community Care for the Elderly Services. As used in
this subsection, "primary consideration" means that an assessment and services
must commence within 72 hours after referral to the department or as established in
accordance with department contracts by local protocols developed between
department service recipients and adult protective services.
2. Priority Criteria for Individuals in Nursing Homes in Receivership
The recipient will ensure that pursuant to Section 400.126, (12), Florida Statute,
those elderly persons determined through a CARES assessment to be a resident
who could be cared for in a less restrictive setting or does not meet the criteria for
skilled or intermediate care in a nursing home, the recipient will ensure the resident
is referred for such care, as appropriate for the resident. Residents referred
6
07/01/2005
CONTRACT NUMBER KC571
pursuant to this subsection shall be given primary consideration for receiving
services under the Community Care for the Elderly program in a manner as persons
classified to receive such services pursuant to Section 430,205, Florida Statutes.
3. 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 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,
4. Priority Criteria for Service Delivery 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 groups one, two or three
above, regardless of referral source, will receive services to the extent funding is
available.
5. Referrals for Medicaid Waiver Services:
a) The recipient must identify, through the consumer assessment, potential
Medicaid eligible CCE consumers and to refer these individuals to CARES
and SSI related payments (if applicable) for approval for Medicaid Waiver
services.
b} Individuals who have been identified as being potentially Medicaid Waiver
eligible are required to apply for Medicaid Waiver services in order to receive
eeE services and can only receive eeE services while the Medicaid Waiver
eligibility determination is pending. If the consumer is found ineligible for
Medicaid Waiver services for any reason other than failure to provide
required documentation, they may continue to receive CCE services.
c) Individuals who have been identified as being potentially Medicaid Waiver
eligible must be advised of their responsibility to apply for Medicaid Waiver
services as a condition of receiving CeE services while the eligibility
determination is being processed.
C. Co.payment Collections:
1. The recipient will establish annual co-payment goals. The Alliance has the option to
withhold a portion of the recipient's Request for Payment if goals are not met
according to the Department of Elder Affairs' co-payment guidelines.
7
07/01/2005
CONTRACT NUMBER KC571
2. Co-payments include only the amounts assessed consumers or the amounts
consumers opt to contribute in lieu of an assessed co-payment. The contribution
must be equal to or greater than the assessed co-payment.
3. Co-payments collected in the CCE program can be used as part of the local match.
D. Match:
The recipient will assure a match requirement of at least 10 percent of the cost for all
Community Care for the Elderly services. The match will be made in the form of cash
and/or in kind resources. At the end of the contract period, all Community Care for the
Elderly funds expended must be properly matched.
E. Service Cost Reports:
The recipient will submit semi-annual service cost reports which reflect actual costs of
providing each service by program. This report provides information for planning and
negotiating unit rates.
8
07/01/2005
Report
Number
1
I
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
LeQend:
Note # 1:
Note # 2:
CONTRACT NUMBER KC571
ATTACHMENT II
COMMUNITY 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 I July Advanced Reconciliation ** .....
June Expenditure Report I August Advanced 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 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 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 two months of the recipient's fiscal reports covering actual
expenditures should reflect an adjustment repaying advances for the first
two months of the contract.
9
07/01/2005
CONTRACT NUMBER KC571
ATTACHMENT III
COMMUNITY CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Case Management ................................. $ 95,464.00
Core Services ...... ............................... $364,373.00
Total.................................................... $459,837.00
10
07/01/2004
CONTRACT NUMBER KC471
COMMUNITY CARE FOR THE ELDERLY CONTRACT
2004~2005
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. PA429, and its
successor, incorporated herein by reference.
The parties agree:
r. 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, 2005 if the recipient fails to do so, an 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,
2005, 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, aU right to payment is forfeited, and the
Alliance will not honor any requests submitted after the aforesaid time
period.
U. The Alliance Agrees:
Contract Amount:
To pay for contracted services according to the conditions of Attachment f in an amount
not to exceed $459,837.00, 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
07/01/2004
CONTRACT NUMBER KC471
Program Title Year Funding Source CSFA# Fund Amounts
Community Care 2004 General Revenue/Tobacco 65010 $459,837.00
for the Elderly Settlement Trust Funds
TOTAL FUNDS CONTAINED IN THIS CONTRACT: $459,837.00
III. Recipient and Alliance Mutually Agree:
A. Effective Date:
1. This contract shall begin on Ju Iy 1, 2004 or on the date the contract has been
signed by both parties, whichever is later.
2. Delivery of services shall end on June 30,2005. This contract shall end on
September 30,2005. See Attachment I, Section IlI.F.
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) 670-6500 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
07/01/2004
CONTRACT NUMBER KC471
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 10-page contract to be executed
by their undersigned officials as duly authorized.
RECIPIENT:
MONROE COUNTY BOARD
OF COMMISSIONERS
BOARD PRESIDENT OR AUTHORIZED DESIGNEE
ALLIANCE FOR AGING, INC.
.' >;~/</
SIGNED BY: /<'/f;(L' ';;""~Ld/(// (
~'-~c..
17 ../ ~~~
:>/ ./ j./ ~'.. ....~GNED BY' .
;. ~,.-.--'t",./ '"....~""~.....' ~..,
NAME: Steven Weisberg, M. S.
NAME: Murray E.Nelson
TITLE:
Mayor/Chairman
TITLE:
President & CEO
C {2$Jo ~
DATE:
June 16, 2004
DATE:
FEDERAL 10 NUMBER:
RECIPIENT FISCAL YEAR END DATE:
59.6000749
09/30
~~L~ClERK /1
~~~~
":l
'"
07/01/2004
CONTRACT NUMBER KC471
ATTACHMENT I
COMMUNITY CARE FOR THE ELDERLY PROGRAM
I. STATEMENT OF PURPOSE
The Community Care for the Elderly (CCE) Program provides community-based services
organized in a continuum of care to assist aged 60 + elders at risk of nursing home
placement to live in the least restrictive environment suitable to their needs.
II. SERVICES TO BE PROVIDED
A. Services:
1. The recipient's service provider application for state fiscal year 2004, 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 CCE, 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 2004 and the Department of
Elder Affairs 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 1 G6G and 105C. 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.
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.
4
07/01/2004
CONTRACT NUMBER KC471
C. The recipient may request a monthly advance for service costs for each of the first two
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 third 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 If to this
contract. Reconciliation and recouping of advances made under this contract are to be
completed by the time the final payment is made. AU 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
AJliance 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 Unit Rate Maximum Maximum
Service Units Dollars
Case Management 1 hour $47.732 2,000 $95,464
Homemaker 1 hour $27.113999 4,193 $113,689
Personal Care 1 hour $51.114666 4,500 $230,016
Respite (In-Home) 1 hour $22.964444 900 $20,668
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.
Any changes in the total amounts of the funds identified on the Budget Summary
form require a contract amendment.
2. With the exception of Case Management, the recipient agrees to implement a
Modified Spending Authority. Recipient is to offer services based on clients' service
plans and will not be restricted to providing the services as projected. Additional
budget revisions/contract amendments will not be required to move funding among
these services, with the exception of Case Management. Any changes in the total
amount of the funds under contract require a formal contract amendment.
3. This contract is for services provided during the 2004/2005 State Fiscal year
beginning July 1, 2004 through June 30,2005, however, the contract is in effect
through September 30, 2005 in order to provide for maximization of resources and
to allow for greater flexibility to pay for the services rendered by June 30, 2005.
Services provided after June 30, 2004 cannot be reimbursed under this contract.
5
07 f01/2004
CONTRACT NUMBER KC471
4. The recipient will submit a draft closeout report by August 15, 2005. Any contract
amendments after August 15, 2005 determined necessary by the Alliance will be
based on the draft closeout reports.
5. The final expenditure report and request for payment will be due to the Alliance no
later than September 15,2005. No expenditure reports or requests for payment
will be accepted after September 15, 2005.
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 LT. of the Master Agreement.
IV. SPECIAL PROVISIONS
A. State Laws and Regulations:
1. The recipient agrees to comply with applicable parts of Rule Chapter 58C-1, Florida
Administrative Code promulgated for administration of Sections 430.201 through
430.207, 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. Abuse, Neglect and Exploitation:
The recipient will ensure that pursuant to Section 430.205(5), Florida Statute, those
elderly persons who are determined by adult protective services to be victims of
abuse, neglect, or exploitation who are in need of immediate services to prevent
further harm and are referred by adult protective services, will be given primary
consideration for receiving Community Care for the Elderly Services. As used in
this subsection, "primary consideration" means that an assessment and services
must commence within 72 hours after referral to the department or as established in
accordance with department contracts by local protocols developed between
department service recipients and adult protective services.
2. Priority Criteria for Individuals in Nursing Homes in Receivership
The recipient will ensure that pursuant to Section 400.126,(12), Florida Statute,
those elderly persons determined through a CARES assessment to be a resident
who could be cared for in a less restrictive setting or does not meet the criteria for
skilled or intermediate care in a nursing home, the recipient will ensure the resident
is referred for such care, as appropriate for the resident Residents referred
6
01/01/2004
CONTRACT NUMBER KC471
pursuant to this subsection shall be given primary consideration for receiving
services under the Community Care for the Elderly program in a manner as persons
classified to receive such services pursuant to Section 430.205, Florida Statutes.
3. 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 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.
4. Priority Criteria for Service Delivery 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 groups one, two or three
above, regardless of referral source, will receive services to the extent funding is
available.
5, Referrals for Medicaid Waiver Services:
a) The recipient must identify, through the consumer assessment, potential
Medicaid eligible CeE consumers and to refer these individuals to CARES
and S81 related payments (if applicable) for approval for Medicaid Waiver
services.
b) Individuals who have been identified as being potentially Medicaid Waiver
eligible are required to apply for Medicaid Waiver services in order to receive
GGE services and can only receive eeE services while the Medicaid Waiver
eligibility determination is pending. If the consumer is found ineligible for
Medicaid Waiver services for any reason other than failure to provide
required documentation, they may continue to receive GeE services.
c) Individuals who have been identified as being potentially Medicaid Waiver
eligible must be advised of their responsibility to apply for Medicaid Waiver
services as a condition of receiving eeE services while the eligibility
determination is being processed,
C. Co~payment Collections:
1 , The recipient will establish annual co-payment goals. The Alliance has the option to
withhold a portion of the recipient's Request for Payment jf goals are not met
according to the Department of Elder Affairs' co-payment guidelines.
7
07/01/2004
CONTRACT NUMBER KC471
2. Co-payments include only the amounts assessed consumers or the amounts
consumers opt to contribute in lieu of an assessed co-payment. The contribution
must be equal to or greater than the assessed co-payment.
3. Co-payments collected in the CCE program can be used as part of the local match.
D. Match:
The recipient will assure a match requirement of at least 10 percent of the cost for all
Community Care for the Elderly services. The match will be made in the form of cash
and/or in kind resources. At the end of the contract period. all Community Care for the
Elderly funds expended must be properly matched.
E. Service Cost Reports:
The recipient will submit semi-annual service cost reports which reflect actual costs of
providing each service by program. This report provides information for planning and
negotiating unit rates.
8
07101/2004
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 KC471
ATTACHMENT II
COMMUNITY CARE FOR THE ELDERLY PROGRAM
CONTRACT REPORT CALENDAR
Based On
July Advance * .............................................................
August Advance ** ......................,.................................
July Expenditure Report .. H.............................................
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 I July Advanced Reconciliation ** .....
June Expenditure Report I August Advanced 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 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 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 two months of the recipient's flscal reports covering actual
expenditures should reflect an adjustment repaying advances for the first
two months of the contract.
9
07/0112004
CONTRACT NUMBER KC471
ATTACHMENT III
COMMUNITY CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Case Management ................................. $ 95,464.00
Core Services ..................................... $364,373.00
Total......................................,............. $459,837.00
10