Item C14 BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: 9-18-2013 Division: _County Administrator
Bulk Item: Yes X No _ Department: Social Services/Bayshore Manor
Staff Contact Person/Phone#: Sheryl raham/X4510
AGENDA ITEM WORDING: Approval of the Renewal of the Home and Community Based-
Medicaid Waiver(ADA-MW)Referral Agreement between the Alliance for Aging Inc. and the
Monroe County Board of County Commissioners (Monroe County Bayshore Manor) for Facility
Based Respite.
ITEM BACKGROUND: Approval of the of the Home and Community Based M/W Referral
Agreement will enable Monroe County Bayshore Manor to continue providing Facility Based Respite
services to Monroe County's elderly population under the Aging and Disabled Medicaid Waiver
program.
PREVIOUS RELEVANT BOCC'ACTION: Prior approval granted to the Horne and Community
Based-Medicaid Waiver Referral Agreement on December 15, 2010.
CONTRACT/AGREEMENT CHANGES: none
STAFF RECOMMENDATIONS: Approval
TOTAL COST: approx . $45,000.00 INDIRECT COST: _-0- BUDGETED: Yes X No
COST TO COUNTY: $-0- SOURCE OF FUNDS:
REVENUE PRODUCING: Yes o X AMOUNT PER MONTH Year
APPROVED BY. County Atr OMB/Purchasing_X_Risk Management
DOCUMENTATION: Included X Not Required
DISPOSITION: AGENDA ITEM#
Revised 1/09
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance for Aging, Inc. Contract
Effective Date: September 18,2013
Expiration Date: June 30,2014
Contract Purpose/Description: Approval of the Renewal of the Home and Community Based-Medicaid Waiver
(ADA-MW)Referral Agreement between the Alliance for Aging, Inc. and the Monroe County Board of County
Commissioners(Monroe County Bayshore Manor)for Facility Based Respite
Contract Manager: Sheryl Graham - fi 4510 Social Services/Stop 1
(Name) (Ext.) (Department/Stop#)
For BOCC meeting on 9/18/2013 Agenda Deadline: 9/3/2013
CONTRACT COSTS
Total Dollar Value of Contract: Approx. $45,000.00 Current Year Portion: $
Budgeted?Yes X No❑ Account Codes: -
Grant: Approx. $45,000.00(Fiscal - - - -
Year)
County Match: $-0- - - - -
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) (e .Maintenance,utilities,janitorial,salaries,etc)
CONTRACT REVIEW
Changes Date Out
Date In Needed ��7 lew f
Division Director Yes❑ No 0
Risk Management
Yes No = z.
O.M.B./Purchasing Yes 0 No
County Attorney Yes❑ No #}
Comments:
OMB Form Revised 2/27/01 MCP#2
HOME AND COMMUNITY BASED SERVICES
AGED AND DISABLED ADULT(ADA) MEDICAID WAIVER
REFERRAL AGREEMENT
This Referral Agreement between the Alliance for Aging. Inc., the Area Agency on Aging (AAA) for
Planning and Service Area (PSA) 11 and Monroe County Social Services/Bayshore Manor
the Service Provider, shall begin on January 1, 2013 or on the date the
agreement has been signed by both parties, whichever is later. This referral agreement is in effect for a
period of time that is equal to the Medicaid waiver provider's enrollment period with the State of Florida's
Medicaid fiscal agent and is contingent upon an annual appropriation by the Legislature. One purpose of
this agreement is to promote the development of a coordinated service delivery system to meet the
needs of the aged or disabled adults who are at risk of premature institutionalization. Another purpose of
this agreement is to enable eligible elderly participants to receive home and community based services
from qualified providers with oversight of the quality of care by the Medicaid Waiver Specialist employed
by the AAA. These services are authorized in order that the participant may remain in the least
restrictive setting and avoid or delay premature nursing home placement. Services and care are to be
furnished in a way that fosters the independence of each participant to facilitate aging in place. All
parties agree that routines of care provision and service delivery must be consumer driven to the
maximum extent possible. All parties agree to and will treat each participant with dignity and respect.
1. Objectives
A. To maintain a climate of cooperation and consultation with and between agencies, in order to
achieve maximum efficiency and effectiveness.
B. To participate together by means of shared information in the development of services.
C. To promote programs and activities designed to prevent the premature institutionalization of
elders and disabled adults.
D. All parties recognize that the consumer retains the right to assume risk, tempered only by the
individual's ability to assume responsibility for that risk.
E. All parties recognize that the consumer retains the right to choose which enrolled provider he/she
will receive services from.
F. To require the parties of this Agreement to provide technical assistance and consultation to each
other on matters pertaining to actual service delivery and share appropriate assessment
information and care plans so duplication may not occur.
G. To establish an<effective working relationship between the case management agency that is
responsible for the development of care plans and authorization of services available under the
waiver, the service provider that is responsible for the direct provision of those services to
consumers served under the waiver program, and the AAA that is responsible for management
and oversight of the waiver program.
Ill. Under this Agreement, the Service Provider agrees to the following:
A. To accept referrals for the 1915e Home and Community-Based Services - ADA Medicaid
Waiver from the enrolled case management agency.
B. To provide quality service(s) to the waiver participant as specified in Section IV., Provision of
service(s), subject to quality monitoring and/or observation by the case management agency
and/or the AAA and/or the Department of Elder Affairs (the "departmenf').
C. To provide only those services specifically outlined in the Plan of Care and authorized by the
enrolled case management agency.
D. Notify the AAA of any change of ownership action at least 90 days prior to the effective date of
closing. Medicaid Waiver provider numbers are non-transferrable,
1
g
E. To attach documentation regarding the service provider's qualifications to this agreement; and to
provide, as requested, any information regarding Medicaid Waiver billing, payment, or waiver
participant information, to the case management agency or AAA. Provider rates shall not
exceed the approved negotiated rates that are at or below the service provider's usual and
customary rates. If additional services are to be added to this agreement, a written request to
do so must be received by the AAA. If approved, an amendment must be prepared by the AAA
indicating the service(s) to be added. The necessary documentation regarding provider
qualifications for the additional services must be attached to the agreement.
F. To maintain the waiver participant's confidentiality according to 42 CFR 431.301.
G. Adhere to requirements contained in the Health Insurance Portability and Accountability Act
(H1PPA), as applicable, and to maintain the waiver participant's confidentiality.
H. To immediately report any changes in the waiver participant's condition to the case
management agency.
1. To maintain enrolled provider status by renewing applicable licensure, certification, contract
and/or referral agreements and by maintaining all provider qualifications as contained in the
Aged and Disabled Adult Medicaid Waiver under which services are provided.
J. Provide copies of all licensure, certification to the AAA to ensure provider qualification as per
the Florida Medicaid Aged and Disabled Adult Waiver Services Coverage and Limitations
Handbook.
K. To include its name and other appropriate information on a list of all enrolled providers which
will be shown to consumers during development of an individualized plan of care,
understanding that the consumer reserves the right at all times to a choice of enrolled
providers.
L. To immediately notify the case management agency of staffing shortfalls that will negatively
impact provision of service to Medicaid Waiver consumers.
M. To submit claim data for billing to the Medicaid fiscal agent after delivery of services has been
accomplished. All services should be billed within 60 days after services have been provided or
document reasons for delayed submission of claims. Such documentation shall be available for
review by the area agency on agency or by the department, upon request.
N. To submit claims for billing to the Medicaid fiscal agent at the agency's contracted rate, as per
page 5 of this agreement
Q. To submit voided or adjusted claims no later than 45 days after either party has identified the
error. The provider's refusal to adjust or void erroneous claims may result in termination of this
agreement and/or referral to the department, and will be referred by the department to the
Agency for Health Care Administration for appropriate action.
P. To develop and 'implement a policy to 'ensure that its employees, board members, and
management, will avoid any conflict of interest or the appearance of a conflict of interest when
disbursing or using the funds described in this agreement. A conflict of interest includes, but is
not limited to, receiving, or agreeing to receive, a<direct or indirect benefit, or anything of value
from._a service provider, consumer, vendor, or any person wishing to benefit from the use or
disbursement of funds. To avoid a conflict of interest, the service provider must ensure that all
individuals make a disclosure to the AAA of any relationship which may be a conflict of interest,
within thirty(30) days of an individual's original appointment or placement on a board, or if the
individual is serving as an incumbent, within thirty (30) days of the commencement of the
agreement.
Q. To report any significant changes in the waiver participant's condition to the case
management agency as soon as the provider becomes aware of such changes or within 48
hours, whichever is earlier.
2
R. To report adverse incidents that affect the health, safety & welfare of a client to the Case
Management agency within 48 hours of its occurrence using the required reporting template as
provided by the AAA. Adverse incidents may include injury such as death, brain or spinal
damage, permanent disfigurement, fracture or dislocation of bones or joints, any condition
requiring medical attention to which the client has not given informed consent, any condition
that requires the transfer of the client within or outside an ALF or consumer's residence to a unit
providing a more acute level of care due to the adverse incident not related to the client's
condition prior to the incident, abuse, neglect or exploitation, resident elopement or an event
that is reported to law enforcement (does not include Baker Act transport or deaths by natural
causes).
S. To report any adverse incidents involving abuse, neglect, and exploitation to the Department of
Children & Families (DCF).
T. Participate in training arranged by the AAA, the Department, Department of Children and
Families and/or Agency for Health Care Administration, as required.
U. To review and correct any CIRTS exception reports submitted by the AAA monthly by the
stipulated time frame.
V. To adhere to the federal waiver requirements and the policies and procedures outlined in the
following manuals published by the Agency for Health Care Administration: the Florida
Medicaid Aged and Disabled Adult Waiver Services Coverage and Limitations Handbook, Aged
and Disabled Adult Waiver Procedure Codes and Fee Schedule, Aged and Disabled Adult
Waiver Incontinence Fee Schedule and Quality Standards, and the Florida Medicaid Provider
General Handbook, Department of Elder Affairs Programs and Services Handbook including
any and all attachments or updates.
W. If the Service Provider is enrolled as a home delivered meals vendor, the Area Agency will
retain the services of a registered dietitian to perform the following:
1. Conduct site inspections of all catering facilities. These may be unannounced.
2. Monitor meal delivery times and temperatures.
3. Review all menus submitted by the service provider and suggest changes as needed.
4. Work with the service provider to ensure that standardized recipes and computer-assisted
nutritional analyses are carried out.
X. Comply with any additional ADA Medicaid Waiver service provider related requests for
information from the Department regarding implementation of the Statewide Medicaid Managed
Care Program (SMMCLTC).
Y. To provide a home-like setting and community integration to all Medicaid Waiver consumers
receiving ADA Medicaid Waiver services in an ALF. The ALF provider shall support the consumer's
community inclusion and integration by working with the consumer and the consumer's Case
Manager to facilitate the integration of the consumer's personal goals and community activities.
Additional services must be offered as follows, unless medical, physical, or cognitive impairments
restrict or limit exercise of these options:
1. Private or semi-private rooms
2. Roommate for semi-private rooms
3. Locking door to living unit
4. Access to telephone and length of use
5. Eating schedule
6. Participation in facility and community activities
7. Ability to have unlimited snacks as desired, maintain personal sleeping schedule, prepare
snacks as desired, maintain personal sleeping schedule
The ALF provider must be in compliance with the consumer's Resident Bill of Rights.
Z. The AAA may impose department-approved sanctions for non-compliance with the
terms of this agreement.
3
Indemnification
1. To the extent set forth in Florida Statute 768.28, service provider agrees to indemnify,
defend, and hold harmless the AAA, and all of the AAA's officers, agents, and employees
and the department and all of the department's officers, agents, and employees from any
claim, loss, damage, cost, charge, or expense arising out of any acts, actions, neglect or
omission, action in bad faith, or violation of federal or state law by the service provider, its
agents or employees, during the performance of this agreement.
2. Service Provider obligation to indemnify, defend, and pay for the defense or, at the AAA's
and/or department's option, to participate and associate with the AAA and/or department in
the defense and trial of any claim and any related settlement negotiations, shall be triggered'
by the AAA's and/or department's notice of claim for indemnification to service provider.
Service provider's inability to evaluate liability or its evaluation of liability shall not excuse
service provider's or's duty to defend and indemnify the AAA and/or department, upon notice
by the AAA and/or department. Notice shall be given by registered or certified mail, return
receipt requested. Only an adjudication or judgment after the highest appeal is exhausted:
specifically finding the AAA and/or department solely negligent shall excuse performance of
this provision by service providers. The service provider shall pay all costs and fees related
to this obligation and its enforcement by the AAA and/or department. The AAA's or
department's failure to notify the service provider of a claim shall not release service provider
of the above duty to defend.
3. It is the intent and understanding of the parties that neither the service provider, nor any of its
employees are employees of the AAA or the department and shall not hold themselves out '
as employees or agents of the AAA or department without specific authorization from the
AAA or department. It is the further intent and understanding of the parties that the AAA or
department does not control the employment practices of the service provider and shall not
be liable for any wage and hour, employment discrimination, or other labor and employment
claims against the service provider.
111. Under this Agreement,the Area Agency on Aging agrees to the following:
A. To ensure that new and existing waiver service providers initially meet and continue to meet waiver
service provider qualifications.
B. To offer technical assistance or necessary training to all ADA Medicaid Waiver service providers
enrolled in the ADA Medicaid Waiver program for the purpose of administering the program.
C. To assist the Department in conducting monitoring and other related management/administrative
functions for compliance with state and federal laws and rules governing waiver program
operations.
D. To report any adverse incident reports to the Department within 48 hours of the AAA being
notified by the case management agency.
E. To develop and maintain written policies and procedures, as necessary, to ensure necessary
performance standards.
F. To assist the ADRC in maintaining the APPL (waitlist) for Medicaid Home and Community Based
Waiver Service Programs.
G. Assist the Department in reporting follow-up for substantiated reports of abuse, neglect, and
exploitation within 10 working days of receipt.
H. To review and correct the CIRTS exception reports monthly and provide the Department with a
summary of the resolutions, as requested.
4
IV: Under this agreement, the following services will be delivered by the Service provider
in accordance with the plan of care or service authorization:
Service Unit Rate County/Region Served
A. Facility Based Respite $10.00/hour Monroe
B.
C.
D.
E.
V. Termination
In the event this agreement is terminated, the case management agency and the service provider agree
to submit, at the time notice of intent to terminate is delivered, a plan which identifies procedures to
ensure services to consumers will not be interrupted or suspended by the termination.
A. Termination at Will
This agreement may be terminated by any party upon no less than thirty (30) calendar days
notice, without cause, unless a lesser time is mutually agreed upon by both parties, in writing.
Said notice shall be delivered by certified mail, return receipt requested, or in person with proof
of delivery.
B. Termination Because of Lack of Funds
In the event funds to finance this, agreement become unavailable, the area agency may
terminate this agreement upon no less than twenty-four (24) hours notice in writing to the other
party. Said'notice shall be delivered by certified mail, return receipt requested, or in person with
proof of delivery. The area agency shall be the final authority as to the availability of funds.
C. Termination for Breach
Unless a breach is waived by the area agency in,writing, or the parties fail to cure the breach
within the time specified by the area agency, the area agency may, by written notice to the
parties, terminate the agreement upon no less than twenty-four (24) hours notice. Said notice
shall be delivered by certified mail, return receipt requested, or in person with proof of delivery.
In witness whereof, the parties have caused thispage agreement to be executed by their undersigned
officials as duly authorized. S
Area Agency on Aging Se p i
signature signature
Max B. Rothman JD LL.M. RM a
print name print name
tt
President/CEO r i rAj
title tide
1�
date date
MO E OUNTy ATTOR
PRE D AS T4
PEDRt) U MTOPINEY
Date ��
Monroe Canty Clerk
HOME AND COMMUNrTY BASED SERVICES
AGED AND DISABLED ADULT(ADA)MEDICAID WAIVER
REFERRAL AGREEMENT
This Referral Agreement between the liar Aaina nM
MW Service Area(PSA) 11 and Martyr the Area Agency on Age (AAA) for
Service F` tder. SW begin on July 1 2t)p4 or on the date the
the
Pwtbs WhWwer tl waiver is inter. Thisreferral agent is in effect for agreement has been signed by both
provider's eruolime"t Period with the State of Florida's tires that is equal to the
Owftfrlt upon' annual 6pnopriatbn by flee mid and is
pr1"obe tfte development of a coordinated service delivery system topurpose� Oft «�errt to
disabled adults who are at risk of premature�tzation. A"Ot theaged or
agreemem is to
ePr s8rvtifbl oversight oft Participants t�MMW home and community b servl from qualified
These ser*"are authorized in order that thcarsthee p a t may
tremain��by the AAA
avoid or�y Premature nursing home��" �et be self ng arW
Um cam PrOYWOn and and nde�a Of each participant to facilitate aging M ptywe. Ali parties agree that grouway
es of
agree to and will treat service
each Participant must be mourner driven to the msxirnwn extent Possible AD parties
Participant with dignity and respect.
I. Objectives
A. To maintain a climate of cooperation and cormAhWon achieve maximum efficiency with and between agencies in
order to
B. To promote programs and and designed
to
elders and disabled adults. F»evertt the premature instltutionatization of
C. To require the parties of#)is Agreement to provide technical
Other on matters Pertaining to actual service and
seand consultations seen
information and care plans so du eery �d share appropriate assessment
D. To estallIsh an may
responsible for the deve, wOf n of�WIAP Vie"the case management agency that is
waiver, the service provider that is responsible forand a 01 services avallable under the
consumers served Under the waiver program,Or the AAA lsioprov responsible those services to
and oventight of the waiver program. for management
fl. Under this Agreement,the Service Rrovkler agrees to the following:
A. To accept referrals for the 1915c Home end Common Waiver from the enrolled case Community-wed Services - ADA Medicaid
B. To provide quality service(s)to theswreiyerm agency�
s�cs(s), subject to quality m�and/or�P�ed in Section IV.. Provision of
and/or the AAA and/or the Department of Elder Affairs(the' by the
management agency,
C. en provide e m those services sperm,out In the Plan of Care and authorized by the
enrolled case management agency.
D. To attach documentation provider's qualifications,to taus so OM
and to
Provide, as requested, any I action r�pad`Waiver ice!P P>�information, to the case management'agency or AAA p� PaY M or waiver
exceed approved negotiated rates that are at tx Wow the rovkbr rates aril not
Customary rates. If additional sates are to be added to'thlsent setvlce providers usual and
do so must be received by the AAA. if �reemerat, a ►request to
meting the service(s) to be add •art amenocasawyd document mast be
prepared<n,the AAA
qualifications for the additional services mast be tO �a 8 provider
E To maintain the waiver participant's coifagreement
xW*akY according toF. To immediately report any changes waiver ti 42 nrs 43i.3p1:
management agency. Partici�rtt's condition to the case
t
G. To maintain enrolled provider status by renewing applicable iicensure, certification, contract
and/or referral agreements and by maintaining all provider qualifications as contained In the
Aged and Disabled Adult Medicaid Waiver under which services are provided,
H. To include Its name and other appropriate information on a list of all enrolled providers which
will be shown to consumers during development of an individualized plan of care,
understanding that the consumer reserves the right at all times to a choice of enrolled
providers.
I. To immediately notify the case management agency of staffing shortfalls that will negatively
impact provision of service to Medicaid Waiver consumers.
J. To submit claim data for billing to the Medicaid fiscal agent after delivery of services has been
accomplished. All services should be billed within 60 days after services have been provided or
document reasons for delayed submission of claims. Such documentation shall be available for
review by the area agency on agency or by the department,upon request.
K. To submit claims for billing to the Medicaid fiscal agent at the agency's contracted rate.
L. To submit void or adjustment claims no later than 45 days after either party has identified the
error. The provider's refusal to adjust or void erroneous claims may result in termination of this
agreement and/or referral to the department, and will be referred by the department to the
Agency for Health Care Administration for appropriate action.
M. To develop and implement a policy to ensure that its employees, board members, and
management, will avoid any conflict of interest or the appearance of a conflict of interest when
disbursing or using the funds described in this agreement.A conflict of interest includes,but is
not limited to, receiving, or agreeing to receive,a direct or indirect benefit,or anything of value
from a service provider, consumer, vendor, or any person wishing to benefit from the use or
disbursement of funds. To avoid a conflict of interest,the service provider must ensure that all
individuals make a disclosure to the AAA of any relationship which may be a conflict of interest,
within thirty(30)days of an individual's original appointment or placement on a board, or if the
individual is serving as an incumbent, within thirty (30) days of the commencement of the
agreement.
N. To adhere to the federal waiver requirements and the policies and procedures outlined in the
following manuals published by the Agency for Health Care Administration: the Aged0sabled
Adult Waiver Guidelines and the Medicaid Provider Reimbursement Handbook (Non-
Institutional 081),including any and all attachments or updates.
0. If the Service Provider is enrolled as a home delivered meals vendor, the Area Agency will
retain the services of a registered dietitian to perform the following;
t. Conduct site inspections of all catering facilities. These may be unannounced.
2. Monitor meal delivery times and temperatures.
3. Review all menus submitted by the service provider and suggest changes as needed.
4. Work with the service provider to ensure that standardized recipes and computer-assisted
nutritional analyses are carried out.
P. The AAA may Impose department-approved sanctions for non-compliance with the
terms of this agreement.
Q. Indemnification
1. To the extent set forth in F.5.768.28,the service Provider agrees to indemnify,defend,and
hold harmless the AAA,and all of the AAA's officers,agents,and employees and the
department and all of the department's officers,agents,and employees from any claim,loss,
damage,cost,charge,or expense arising out of any acts,actions,neglect or omission,
action in bad faith,or violation of federal or state law by the service provider,its agents or
employees,during the performance of this agreement. !Nothing contained in this section
shall be construed to be a waiver by either party of any protections under sovereign
immunity,section 768.28 Florida Statutes;or any other similar provision of law.
2
2. Service Provider obligation to indemnify,defend,and pay for the defense or,at the AAA's
and/or department's option.to participate and associate with the AAA and/or`department in
the defense and trial of any Maim and any related settlement negotiations,shall be triggered
by the AAA's and/or department's notice of claim for Indemnification to service',provider.
Service provider's inability to evaluate liability or its evaluation of liability snail not excuse
service provider's or's duty to defend and indemnify the AAA and/or department,upon notice
by the AAA and/or department, !Notice shaft be given by registered or certified mail,return
receipt requested. Only an adjudication or judgment after the highest appeal is exhausted
specifically finding the AAA and/or department solely negligent shelf excuse performance of
this provision by service providers and a. The:service provider shall pay all costs and fees
related to this obligation and its enforcement by the AAA and/or department,The AAA's or
department's failure to notify the service provider of a claim shelf not release service provider
of the above duty to defend.
3. It is the intent and understanding of the parties that neither the service provider,nor any of its
employees are employees of the AAA or the department and shall not hold themselves out
as employees or agents of the AAA or department without specific authoriim ion from the
AAA or department. It is the further intent and understanding of the parties that the AAA or
department does not control the employment practices of the service provider and shall not
be liable for any wage and hour,employment discrimination,or other labor and employment
claims against the service provider.
Iff.Under this Agreement.the Area Agency on Aging agrees to the following:
A. To facilitate the enrollment of providers with the Medicaid Fiscal Agent.
B. To Provide technical assistance and training to Service Providers.
C. To notify the case management agency within 48 hours of any approved service provider
rate adjustment.
0. To regularly monitor the Service Providers in accordance with requirements specified by the
department.
E. To complete a new referral agreement signed by all parties when unit rate changes are approved.
IV. Under this agreement, the following services will be deliveredt by the Service provider
In accordance with the plan of care or service authorization:
Service Unit Rate County/Region Served
A, F if Based Respite It4n nn er hr.
Monroe
B.
C.
0.
E.
V. Termination
In the event this agreement is terminated,the case management agency and the service provider agree
to submit, at the time notice of intent to terminate is delivered, a plan which ident�es procedures to
ensure services to consumers will not be interrupted or suspended by the termination.
A. . Termination at Will
3
'
8- Termination Because of Lack ofFunds
^, In the event funds ,o finance m�
` terminate thisupon become unavailable the area agency may
' p"w/»r�exv�ry� Thea,�aegvncy� —/certified'"^''' return receipt»oqueo'eg or no less than twentY-fOur(24) hours notice in — —~ ~^=
�' Tenn�annnhnWeach ''a"pene/ma/aumontyasuo�e avaoebility Of funds.
-- "'p�'m��«»
Unless ebreach
. ' iewaiveUby |heareaagenoy |nwhU»g o' the Parties tail to cure
the breach within the time specified by the area agency, the area 'o ' written notice to th*Parties, terminate the agreement upon no less than twenty-four 24) hours —'~~.snoVbegeU,eredbyoenifiadmaU` return receipt requested,or/»person with Proof of
Said notice
In witness whereof the pac8ea have Caused this�paQvagme �»�eaxeomeUuy�e�udelivery.
~'="waaou�aumn,�ed. e ndersigne«
Area Agency onAging
,e','=e
^
the rrutheirns.
Mayor
Cate
asle
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PEDROnoum'/°'"~--
ASSISTANT
Dow
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