Item C14
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
MEETING DATE: 1-18-2006
DIVISION: COMMUNITY SERVICES
BULK ITEM:
YES X
NO
DEPARTMENT: IN-HOME SERVICES
AGENDA ITEM WORDING: Approval of a Memorandum of Understanding for APS (Adult Protective
Services) Referrals between Monroe County Board of County Commissioners (In-Home Services), The Alliance
for Aging (Aging and Disability Resource Center/Aging Resource Center, Area Agency on Aging for Miami
Dade and Monroe Counties) and the Department of Children and Families.
ITEM BACKGROUND: Approval ofMOU will allow a climate of cooperation between agencies in order to
achieve equitable delivery of services to vulnerable elder Floridians in need of services or victims of abuse,
neglect, or exploitation.
PREVIOUS RELEVANT BOCC ACTION None
CONTRACT/AGREEMENT CHANGES: N/A
STA.FF RECOMMENDATION:
Approval
TOTAL COST: -0-
COST TO COUNTY: -0-
BUDGETED:---X- NO_
SOURCE OF FUNDS: NI A
REVENUE PRODUCING: YES_NO X
AMT.PER MONTH
YEAR
APPROVED BY: COUNTY ATT
OMB/Purchasing _ RISK MANAGEMENT _
DIVISION DIRECTOR APPROVAL:
SHEILA BARKER
DOCUMENTATION:
INCLUDED X
TO FOLLO\\! NOT REQUlRED_
DISPOSITION:
AGENDA ITEM#:
Revised 1/03
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Memorandum of Understanding
(MOU) Alliance for Aging, and Dept. of
Children & Families
Effective Date: 1/18/06
Expiration Date:
Contract PurposelDescription: Approval ofMOU will allow a climate of cooperation between agencies in order to
achieve equitable delivery of services to vulnerable elder Floridians in need of services or victims of abuse,
neglect, or exploitaiton.
Contract Manager:
For BOCC meetin on 1*18-06
(Ext.)
ill-Home Services/Stop I
(Department/Stop #)
A enda Deadline:
1-3*06
Q CONTRACT COSTS
Total Dollar Value ofContrac $-0- Current Year Portion: $
Budgeted? Yes _X_ No _ ccount Codes:
Grant $ -0-
County Match: $ -0-
Estimated Ongoing Costs: $_-0-
(Not included in dollar value above)
/yr
ADDITIONAL COSTS
For:
(eg. Maintenance, utilities, janitorial, salaries, etc)
CONTRACT REVIEW
Date In
Changes
Needeg. ...........
Yes . No.
Division Director
'~O,^^^_.,,~,,/
Risk Management
J1"J
O:M:.B.lPurchasing
./~~'<,
c9
~'\
I Nq
i,J
Yes
,:q~-v(~~
Yes
County Attorney
Yes
Comments:
OMB Form Revised 2/27/01 Mer #2
Date Out
Administrative Services Contract Review Worksheet
Contract with Atia#\ufm' ~i('G6 <r OCF ( ^~OU) BOCCMeetingDate
If there is a cost to Monroe County, is funding available? Yes No @
(If no call Depariment)
Is Cost to Monroe County:
under $5,OOO~
$5,000-$25,000_
over $25,000_
did the department get two written quotes? Yes No (check with department)
was this bid out'? Yes No (check with Lisa Cherry
Is this the low bidder? Yes No
FS 287. 0582 - all contracts which bind Monroe County for the purchas~ of servi~es or tangible personal prOper(
for a period in excess 0/ J fiscal year must have the follOWing statement Included In the contract_ "Monroe Coum
performance and obligation to pay under this contract, is contingent upon an annual appropriation by the HQec
Is Non Appropriation Clause present? Yes No
FS 287_133 - requirementfor vendors to file a public entity crime statement prior to issuance of a purchase order.
contract having a value in excess of the threshold/or Category two($25,OOO, 2002 Florida Statutes). Statement
which reads as follows: "A person or affiliate who has been placed on the convicted vendor list following a
conviction/or public entity crime may not submit a bid on a contract to provide any goods or services to a public
entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or
public work, may not submit bids on leqses of real property to public entity, may not be awarded or petjOrm work a~
a contractor, supplier. subcontractor, or consultant under a contract with any public entity, and may not transact
business with any public entity in excess of the threshold amount provided in Section 287.017, for CA TEGOR Y
for a period of 36 months from the date of being placed on the convicted vendor list" Is Public Entity Crime
Statement present? Yes No
Is Ethics form or statement present? "Contractor warrants that he/it has not employed, retained or otherwise had
act on his/its belzalfanyformer County ojJicer or employee in violation of Section 2 of Ordinance No_ 10-1990 or
any County ojJicer or employee in violation of Section 3 of Ordinance No_ 10-1990_ For breach or Violation of this
provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion
deductfrom the contract or purchase price, or otherwise recover, the full amount of any fie, commission, '
percentage, gift, or consideration paid to the former County ojJicer or employee" . Yes No
(If no comment on contract summary)
If this is a grant agreement, is budget set up? Yes No(NIA:)
~/
(If no keep copy with resolution folder)
.~
If this is an amendment, is original contract included? Yes No "ff(0
(lfno make note to department)
/-,
Is there a cost of1iving clause? Yes No tJ/tV Ifso does wording match Purchasing Policy Wording "adjusted
annually in accordance with the percentageC'hange in the Consumer Price Index for all urban consumers (CPI-U) for
the most recent 12 months available"? Yes No N/A
Additional Comments_~
~---.,~-~----
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_._-^--~~-'~cc'CO,~-~^~.c,~___~~~"c.___~"~_~~'^~~cc_.-^^^'---"-,-,-C'~_.'^~~_"--'---c'~,__~^____~oo
Contract read and
Jf cost to tvJonroe County IS over $) 00,000 route to Sr. Director Administrative Services, otherwise route to BlId!)ct
rJircctc)r. . " ".:__)
AGING AND DISABILITY RESOURCE CENTER! AGING
RESOURCE CENTER IAREA AGENCY ON AGING
And
THE DEPARTMENT OF CHILDREN AND FAMILIES
And
COMMUNITY CARE FOR THE ELDERLY CASE MANAGEMENT
AGENCY
MEMORANDUM OF UNDERSTANDING FOR APS REFERRALS
This Memorandum of Understanding, made this _18th_ day of _January_, 2006,
shall be in effect indefinitely between the Alliance for Aging, Inc., the Aging and
Disability Resource Center/Aging Resource Center! Area Agency on Aging for
Planning and Service Area 11; Monroe County In~Home Services, the Community
Care for the Elderly case management agency; and the Department of Children and
Families for referrals made in Monroe county.
Objectives
1. To maintain a climate of cooperation between agencies in order to achieve
equitable delivery of services to vulnerable elder Floridians in need of
services or victims of abuse, neglect, or exploitation.
2. To promote services and activities designed to protect vulnerable elders and
prevent premature institutionalization, pursuant to Chapters 415 and 430,
Florida Statutes.
3. To participate together by means of shared information in tracking delivery of
services to victims of abuse, neglect, exploitation, or vulnerable elders in
need of services.
4. To provide technical assistance and consultation to each other on matters
pertaining to actual service delivery and to share appropriate assessment
information and care plans.
Page 1 of 11
Deti nition ot Terms
. "Abuse," as defined in s. 415.102 (1) F.S., means any willful act or
threatened act by a caregiver that causes or is likely to cause significant
impairment to a vulnerable adult's physical, mental, or emotional health.
Abuse includes acts and omissions.
. "Neglect," as defined in s. 415.102 (15) F.S., means the failure or omission
on the part of the caregiver to provide the care, supervision, and services
necessary to maintain the physical and mental health of the vulnerable adult,
including, but not limited to, food, clothing, medicine, shelter, supervision, and
medical services, that a prudent person would consider essential for the well-
being of a vulnerable adult. The term "neglect" also means the failure of a
caregiver to make a reasonable effort to protect a vulnerable adult from
abuse, neglect, or exploitation by others. "Neglect" is repeated conduct or a
single incident of carelessness, which produces or could reasonably be
expected to result in serious physical or psychological injury or a substantial
risk of death.
. "Exploitation," as defined in s. 415.102 (7) F.S., means a person who
o Stands in a position of trust and confidence with a vulnerable adult and
knowingly, by deception or intimidation, obtains or uses, or endeavors
to obtain or use, a vulnerable adult's funds, assets, or property with the
intent to temporarily or permanently deprive a vulnerable adult of the
use, benefit, or possession of the funds, assets, or property for the
benefit of someone other than the vulnerable adult; or
o Knows or should know that the vulnerable adult lacks the capacity to
consent, and obtains or uses, or endeavors to obtain or use, the
vulnerable adult's funds, assets, or property with the intent to
temporarily or permanently deprive the vulnerable adult of the use,
benefit, or possession of the funds, assets, or property for the benefit
of someone other than the vulnerable adult.
Page 2 of 11
"Exploitation" may include, but is not limited to:
o Breaches of fiduciary relationships. such as the misuse of a power of
attorney or the abuse of guardianship duties, resulting in the
unauthorized appropriation, sale, or transfer of property;
o Unauthorized taking of personal assets;
o Misappropriation, misuse, or transfer of moneys belonging to a
vulnerable adult from a personal or joint account; or
o Intentional or negligent failure to effectively use a vulnerable adult's
income and assets for the necessities required for that person's
support and maintenance.
. "Vulnerable adult," as defined in s. 415.102 (26) F.S., means a person 18
years of age or older whose ability to perform the normal activities of daily
living or to provide for his or her own care or protection is impaired due to a
mental, emotional, long~term physical, or developmental disability or
dysfunction, or brain damage, or the infirmities of aging.
. "Vulnerable adult in need of services," as defined in s, 415.102 (27) F.S.,
means a vulnerable adult who has been determined by a protective
investigator to be suffering from the ill effects of neglect not caused by a
second party perpetrator and is in need of protective services or other
services to prevent further harm.
. "Further Harm" is when a vulnerable adult is expected to suffer ill effects
from additional or continued maltreatment(s) of neglect without the provision
of services. The potential for further harm will be inferred by the closure of a
report as a "vulnerable adult in need of services"; or the closure of a second
party report with one or more maltreatment findings of "Some Indicators" or
"Verified" AND the protective investigator's initial assessment of risk of the
victim is "high."
Page 3 of 11
. "III effects of neglect" exist when a protective investigator determines that a
vulnerable adult is suffering some degree of harm or injury or that there is a
reasonable expectation of harm or injury directly resulting from neglect
. "Protective services," as defined in s. 415.102 (20) F.S., means services to
protect a vulnerable adult from further occurrences of abuse, neglect, or
exploitation. Such services may include, but are not limited to, protective
supervision, placement, and inwhome and community-based services.
. "Protective supervision," as defined in s. 415.102 (21) F.S., means those
services arranged for or implemented by the Department of Children and
Families to protect vulnerable adults from further occurrences of abuse,
neglect, or exploitation.
. "Intake Entity" is the agency to which DCF sends DCF's Adult Protective
Services (APS) referrals. There may be more than one intake entity in a
county. Each Planning and Service Area's Aging and Disability Resource
Center! Aging Resource Center! Area Agency on Aging (ADRC! ARC! AAA)
determines which agency(ies) will be the intake entity(ies) for APS referrals in
each county in their Planning and Service Area. ADRCs! ARCs! AAAs acting
as the intake entity are responsible for notifying and transferring the
appropriate documentation to the ADRC! ARC! AAA designated Community
Care for the Elderly (CCE) case management agency (hereinafter referred to
as the CCE Lead Agency) when services are needed.
Identify the intake entity(ies) below.
All APS referrals, regardless of risk level wi be sent to the following agency:
ADRC! ARC! AAA CCE Lead Agency
OR
All "high" risk APS referrals will be sent to t~ following agency:
ADRC/ARC!AAA rt/ CCE Lead Agency
Page 4 of II
All "intermediate" risk APS referrals will be sent to the following agency:
ADRC!ARC/AAA CCE Lead Agency
All "low" risk APS referrals will be sent to the following agency:
/
ADRC/ARC/AAA ~CCE Lead Agency
Under this Memorandum of Understanding, the ADRC/ARC/AAA, CCE Lead Agency,
and Department of Children and Families agree to the following:
1. Each Planning and Service Area's ADRC/ARC/AAA determines which
agency(ies) will be the intake entity(ies) for DCF's Adult Protective Services
(APS) referrals in each county in their Planning and Service Area. All APS
referrals in need of home and community-based services will be sent to the
appropriate intake entity in the county in which the APS referral resides.
2. If the person who is the subject of the APS referral needs immediate
protection from further harm, the referral will be designated as "high-risk" and
will be staffed by APS and the ADRCI ARCI AAA designated Community Care
for the Elderly (CCE) case management agency (hereinafter referred to as
the CCE Lead Agency) to determine the need for specific services to avert a
crisis or stabilize the situation. Such services will be time limited and must be
designed to abate the emergency or crisis situation that places the person at
risk of further harm. The CCE Lead Agency must initiate the emergency or
crisis resolving service(s) within 72 hours of referraL This includes services
recommended by APS, but not currently provided. Case management alone
does not meet this requirement For consumers who are currently receiving
DOEA funded services, and who are referred by APS, the 72~hour time frame
includes not only those existing services, but also any additional emergency
or crisis resolving service(s) requested by APS. The provision of services
shall not exceed 30 days unless APS and the eeE Lead Agency jointly agree
the emergency or crisis still exists, and that continuation of the services are
necessary to stabilize the person's situation. APS staff must advise
consumers upon referral that services will be time-limited up to 30 days.
Page 5 of 11
Upon receipt of the referral, the GGE Lead Agency must clearly communicate
to the consumer that services are limited to 30 days.
3. When the vulnerable adult is no longer in danger of harm as determined
jointly through an APS and GGE Lead Agency staffing, he or she may apply
for DOEA~funded services based on DOEA guidelines. The provision of these
services will be based on DOEA prioritization criteria.
4. Emergency or crisis resolving services should begin as requested by the APS
Protective Investigator's recommendations. If at any time during the process
there are any disagreements between the APS Protective Investigator and
the GCE Lead Agency regarding services to be provided, the APS Protective
Investigator Supervisor and a Case Manager Supervisor at the CCE Lead
Agency will jointly review the case to resolve the issues. The GGE Lead
Agency will forward notes from the weekly joint staffing sessions held with
APS to the ADRG/ARC/AAA if requested to do so. If the issue(s) cannot be
resolved at this level, the case will be referred to the ADRC/ ARC! AAA and the
DCF district office for final resolution.
5. All APS referrals made during business hours will be entered into the APS
Referral Tracking Tool (ARTT) the day the referral to the intake entity is
made.
6. Within three hours of entering the referral into the ARTT, a referral packet will
be sent via fax or hand delivered to the intake entity. A referral packet will
include the following:
. DCF Form 1099 printed from the ARTT, if the ARTT is available at the
time of referral,
. Capacity to Consent Assessment,
. Adult Safety Assessment of Safety Factors, and
. Adult Safety Assessment of Overall Safety, and
. Court Order, if services were court ordered,
Page 6 of 11
7. Only an APS Protective Investigator with the approval of an APS Protective
Investigator Supervisor, or APS Protective Investigator Supervisor can initiate
APS referrals.
8. APS "high~risk" referrals made after business hours require a telephone call
to the intake entity. The following referral information must be provided:
name, social security number, address, service assessment, risk factors
(such as environmental concerns), and type of report. The referral will be
entered into the ARTT within the first three hours of business the following
day. Within three hours of entering the referral into the ARTT, a referral
packet will be sent via fax or hand delivered to the intake entity (see #6 above
for packet contents),
9. Only referrals for clients age 60 and older will be sent to the intake entity and
entered into the ARTT.
10. The intake entity will confirm receipt of a faxed referral by contacting the DGF
office via telephone or email. Email messages must only refer to the abuse
report number and must not include the name or social security number of the
re fe rral.
11 . APS referrals for home and community-based services are not limited to
Community Care for Elderly or Home Care for the Elderly services, and may
include non-DOEA funded services coordinated by the GeE Lead Agency.
12. If the ARTT is not available at the time of referral, a DCF Form 1099 will be
manually completed. When the ARTT becomes available, the referral will be
entered into the ARTT.
13. An APS referral initially sent to APS Protective Supervision that is later
referred to the intake entity will be entered into the ARTT.
Page 7 of 11
14. Each referral will be entered separately into the ARTT. If services are being
requested for more than one member in a household, separate referrals will
be entered into the ARTT.
15. Only APS referrals for victims of abuse, neglect, exploitation and vulnerable
adults as identified by APS staff will be put into the ARTT.
16. All APS referrals, regardless of risk level (i.e., high, intermediate, or low), will
be entered into the ARTT.
17. If a new abuse report (number) is received for an individual who had been
reported and referred previously, a new referral will be entered into the ARTT,
regardless of whether or not the individual is currently receiving services.
18. The intake entity must acknowledge receipt of the APS referral in the ARTT
the same day the referral packet is received.
19. The CCE Lead Agency will enter the case status in the "Action Taken by
Provider" field (#30) and/or the "Staffing or Additional Comments" field (#31)
in the ARTT, along with the "Service Provider's Signature" (#36) and the
"Schedule Staffing Date" (#37). This information must be entered into the
ARTT within 72 hours from the time the referral packet is received for "high~
risk" referrals and within ten business days for "intermediate" and "low" risk
referrals.
20. The intake entity will work together with APS staff to identify and maintain, in
accordance with law, accurate social security numbers should the two
agencies have different social security numbers for the same individual.
21. /A 701 B comprehensive assessment must be completed within 72 hours for
"high-risk" referrals and in accordance with Department of Elder Affairs policy
for "intermediate" and "low" risk referrals.
Page 8 of 11
22. GGE co-payments for selVices will be waived for APS referrals during the first
30 days of selVice or until the vulnerable adult's crisis situation has stabilized.
23. The following information will be entered in the Client Information and
Registration Tracking System (CIRTS) for all APS referrals:
. Assessment information; must include the referral date, referral
source set to Abuse/Neglect, and risk level (high, intermediate, low),
. Enrollment information,
. Gare plan information, and
. Units of selVice provided.
24. APS "high-risk" referrals must have the following information entered in
GIRTS:
. Units of service for case management and core type selVices are
entered using the date specific method for the first month. This
includes Older Americans Act services that may normally be reported
in aggregate. After the initial month, GGE Lead Agencies may return to
entering aggregate units.
. For current consumers referred by Adult Protective Services and
determined "high-risk," the date of service delivery and units of
selVice are entered as if the client were a new "high-risk" referral, i.e.,
date specific.
. Informal services arranged by the case manager, i.e., churches,
neighbors, or other community resources, are entered in CIRTS on
the SelVices Received Screen for the month the service is provided.
The code is Non-Department of Elder Affairs Programs (NDP), The
service is listed as "Other" and the unit is one episode with no unit
cost. Specific information about the informal service(s) should be
contained in the file on the hard copy of the care plan.
Page 9 of 11
25. If the person who is the subject of the APS referral refuses to be assessed or
there is a delay in service provision for reasons beyond the control of service
providers, the CCE Lead Agency will do the following:
. Contact the APS investigator to discuss the situation and determine
the next best course of action. If the referral is a "high-risk" referral,
APS must be contacted within 24 hours.
. Create an entry in the Received Services screen in CIRTS with Case
Management as the Service with the appropriate date and units if
case management services were provided.
. "High-risk" referrals require an additional entry in the CIRTS Received
Services screen identifying the reason for the delay in service
provision. The Program is set to "NDP" and one of the following
codes is listed as the Service:
o PLHS - Placed in hospital
o PLNH - Placed in nursing home
o PLAF ~ Placed in ALF
o PLFM - Placed with family
o CLRF - Consumer refused
o CLUV - Consumer unavailable; cannot be located
o CLOG - Consumer deceased
The number of units should be set to "0" and the unit type set to EPS.
26. The AORG/ARC/AAA will run GIRTS reports monthly to compare referral dates
with services received dates to ensure complJance with the 72-hour statute.
Page 10 of 11
Signature
Title
Printed Name
ADRC/ ARC! AAA
Date
Signature
Mayor
Title
Charles "Sonny" McCoy
Printed Name
Signature
Title
Printed Name
Department of Children and Families
Date
(SEAl)
ATTEST: DANNY L KOlHAGE, CLERK
BY
DEPUTY CLERK
Board of County Commissioners/ln.Home Services Proqram
CCE Lead Agency
Date
Page II of II