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06/18/2003 Contract Clerk ollbe Circul coun Danny L. Kolhage Clerk of the Circuit Court Phone: (305) 292-3550 FAX: (305) 295-3663 e-mail: phancock@monroe-clerk.com Memnranlium TO: Louis Latorre, Director Social Services Division ATTN: Dotti Albury FROM: Pamela G. Hanco~Ziv Deputy Clerk \._Y DATE: June 24, 2003 At the June 18,2003, Board of County Commissioner's meeting the Board granted approval and authorized execution of the following: Home Care for the Elderly (HCE) Contract KH372 between the Alliance for Aging, Inc., and Monroe County Social Services/In-Home Services Program for fiscal year July 1, 2003 through June 30, 2004. Alzheimer's Disease Initiative (AD!) Contract KZ397 between the Alliance for Aging, Inc. and Monroe County Social Services/In-Home Services Program for fiscal year July 1,2003 through June 30, 2004. Community Care for the Elderly (CCE) Contract KC371 between the Alliance for Aging, Inc. and Monroe County Social Services/In-Home Services Program for fiscal year July 1, 2003 through June 30, 2004. /' Community Care for Disabled Adults (CCDA) Contract KG047 between the State of Florida, Department of Children & Families and Monroe County Social Services/In-Home Services Program for fiscal year July 1, 2003 through June 30, 2004. Enclosed are four duplicate originals of each of the above-mentioned, executed on behalf of Monroe County, for your handling. Please be sure that the fully executed "Monroe County Clerk's Originals" and the "Monroe County Finance Department's Originals" are returned to our office as soon as possible. Should you have any questions please do not hesitate to contact this office. cc: County Administrator wlo documents Finance wlo documents County Attorney File / O,~~rY Ao~!!~~E (305) 294-4641 BOARD OF COUNTY COMMISSIONERS MAYOR Dixie Spehar, District 1 Mayor Pro Tern Murray E. Nelson, District 5 George Neugent, District 2 Charles "Sonny" McCoy, District 3 David P. Rice, District 4 r~..... -..---.- MEMORANDUM Belle DeSantis and/ or Pam Hancock, Monroe County Clerk's Office Dotti Albury, Administrative Assistant, In-Home Services Program ~ 7/7/2003 TO: FROM: DATE: RE: CCD A Contract At the January 18, 2003, Board of County Commissioner's meeting the Board granted approval and authorized execution of Contract #KG047 between the Florida Department of Children and Families and Monroe County Board of Commissioners (Social Services/In-Home Services Program). This document was received back today July 7, 2003 from the Department of Children and Families fully executed. Please see enclosed the Clerk's Office Original and the Finance Division's Original. Thank you both for all your help. If you have any questions please call me at 292-4583. Enclosures Monroe County Clerk's Offj-- Original 04/10/03 CFDA No. FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES STANDARD CONTRACT Client I:8J Non-Client 0 Multi-District 0 THIS CONTRACT is entered into between the Florida Department of Children and Families, hereinafter. referred to as the "department," and Monroe County (Monroe County In Home Services), hereinafter referred to as the "provider." I. THE PROVIDER AGREES: A. Contract Document To provide services in accordance with the terms and conditions specified in this contract including all attachments and exhibits, which constitute the contract document. B. Requirements of Section 287.058 F.S. To provide units of deliverables, including reports, findings, and drafts, as specified in this contract, which must be received and accepted by the contract manager in writing prior to payment. To submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit. Where itemized payment for travel expenses are permitted in this contract, to submit bills for any travel expenses in accordance with section 112,061, F.S. or at such lower rates as may be provided in this contract. To allow public access to all documents, papers, letters, or other public records as defined in subsection 119.011 (1), F.S" made or received by the provider in conjunction with this contract except that public records which are made confidential by law must be protected from disclosure. It is expressly understood that the provider's failure to comply with this provision shall constitute an immediate breach of contract for which the department may unilaterally terminate the contract. C. Governing Law 1. State of Florida Law That this contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law including Florida provisions for conflict of laws. 2. Federal Law a, That if this contract contains federal funds the provider shall comply with the provisions of 45 CFR, Part 74, and/or 45 CFR, Part 92, and other applicable regulations. b. That if this contract contains federal funds and is over $100,000, the provider shall comply with all applicable standards, orders, or regulations issued under section 306 of the Clean Air Act, as amended (42 U.S.C. 7401 et seq,), section 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251 et seq.), Executive Order 11738 as amended and where applicable, and Environmental Protection Agency regulations (40 CFR, Part 30). The provider shall report any violations of the above to the department. c. That no federal funds received in connection with this contract may be used by the provider, or agent acting for the provider, to influence legislation or appropriations pending before the Congress or any State legislature. If this contract contains federal funding in excess of $100,000, the provider must, prior to contract execution, complete the Certification Regarding Lobbying form, Attachment N/A. If a Disclosure of Lobbying Activities form, Standard Form LLL, is required, it may be obtained from the contract manager, All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the contract manager, prior to payment under this contract. d. That unauthorized aliens shall not be employed. The department shall consider the employment of unauthorized aliens a violation of section 274A(e) of the Immigration and Nationality Act (8 U.S.C. 1324 a). Such violation shall be cause for unilateral cancellation of this contract by the department. e. That if this contract contains $10,000 or more of federal funds, the provider shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department of Labor regulation 41 CFR, Part 60 and 45 CFR, Part 92, if applicable, f. That if this contract contains federal funds and provides services to children up to age 18, the provider shall comply with the Pro-Children Act of 1994 (20 U.S.C. 6081). Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. This clause is applicable to all subcontracts. D. Audits, Inspections, Investigations, Records and Retention 1. To establish and maintain books, records and documents (including electronic storage media) sufficient to reflect all income and expenditures of funds provided by the department under this contract. 2. To retain all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this contract for a period of six (6) years after completion of the contract, or if an audit has been initiated and audit findings have not been resolved at the end of six (6) years, the records shall be retained until resolution of the audit CONTRACT # KG047 04/10/03 findings or any litigation which may be based on the terms of this contract, at no additional cost to the department. 3, Upon demand, at no additional cost to the department, the provider will facilitate the duplication and transfer of any records or documents during the required retention period in Subsection I, Paragraph 0,2. 4, To assure that these records shall be subject at all reasonable times to inspection, review, copying, or audit by Federal, State, or other personnel duly authorized by the department. 5. At all reasonable times for as long as records are maintained, persons duly authorized by the department and Federal auditors, pursuant to 45 CFR, Section 92.36(i) (10), shall be allowed full access to and the right to examine any of the provider's contracts and related records and documents, regardless of the form in which kept. 6. To provide a financial and compliance audit to the department as specified in this contract and in Attachment l.! and to ensure that all related party transactions are disclosed to the auditor. 7. To comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by the office of The Inspector General (Section 20,055, Florida Statutes). 8. To include the aforementioned audit, inspections, investigations and record keeping requirements in all subcontracts and assignments, E. Monitoring by the Department To permit persons duly authorized by the department to inspect and copy any records, papers, documents, facilities, goods and services of the provider which are relevant to this contract, and to interview any clients, employees and subcontractor employees of the provider to assure the department of the satisfactory performance of the terms and conditions of this contract. Following such review, the department will deliver to the provider a written report of its findings and request for development, by the provider of a corrective action plan where appropriate. The provider hereby agrees to timely correct all deficiencies identified in the corrective action plan, F. Indemnification NOTE: Except to the extent permitted by s.768.28, F.S., or other applicable Florida Law, Paragraph I.F.1. and 2. are not applicable to contracts executed between state agencies or subdivisions, as defined in subsection 768.28(2), F.S. 1. To be liable for and indemnify, defend, and hold the department and all of its officers, agents, and employees harmless from all claims, suits, judgments, or damages, including attorneys' fees and costs, arising out of any act, actions, neglect, or omissions by the provider, its agents, or employees during the performance or operation of this contract or any subsequent modifications thereof. 2. That its inability to evaluate its liability or its evaluation of liability shall not excuse the provider's duty to defend and to indemnify within seven (7) days after notice by the department by certified mail. After the highest appeal taken is exhausted, only an adjudication or judgment specifically finding the provider not liable shall excuse performance of this provision. The provider shall pay all costs and fees including attorneys' fees related to these obligations and their enforcement by the department. The department's failure to notify the provider of a claim shall not release the provider from these duties. The provider shall not be liable for the sole negligent acts of the department, G. Insurance To provide continuous adequate liability insurance coverage during the existence of this contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or subdivision as defined by subsection 768,28(2), F.S., the provider accepts full responsibility for identifying and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the provider and the clients to be served under this contract. Upon the execution of this contract, the provider shall furnish the department written verification supporting both the determination and existence of such insurance coverage, Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida, The department reserves the right to require additional insurance as specified in this contract. H. Confidentiality of Client Information Not to use or disclose any information concerning a recipient of services under this contract for any purpose prohibited by state or federal law or regulations (except with the written consent of a person legally authorized to give that consent or when authorized by law), I. Assignments and Subcontracts 1. To neither assign the responsibility for this contract to another party nor subcontract for any of the work contemplated under this contract without prior written approval of the department which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring without prior approval of the department shall be null and void, 2, To be responsible for all work performed and for all commodities produced pursuant to this contract whether actually furnished by the provider or its subcontractors, Any subcontracts shall be evidenced by a written document. The provider further agrees that the department shall not be liable to the subcontractor in any way or for any reason, The provider, at its expense. will defend the department against such claims, 3. To make payments to any subcontractor within seven (7) working days after receipt of full or partial payments from the department in accordance with section 287.0585, F.S., unless otherwise stated in the contract between the provider and 2 CONTRACT # KG047 04/10103 subcontractor. Failure to pay within seven (7) working days will result in a penalty that shall be charged against the provider and paid to the subcontractor in the amount of one-half of one percent (.005) of the amount due per day from the expiration of the period allowed for payment. Such penalty shall be in addition to actual payments owed and shall not exceed fifteen (15%) percent of the outstanding balance due. 4. That the State of Florida shall at all times be entitled to assign or transfer its rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the provider. In the event the State of Florida approves transfer of the provider's obligations, the provider remains responsible for all work performed and all expenses incurred in connection with the contract. This contract shall remain binding upon the successors in interest of either the provider or the department. J. Return of Funds To return to the department any overpayments due to unearned funds or funds disallowed pursuant to the terms and conditions of this contract that were disbursed to the provider by the department. In the event that the provider or its independent auditor discovers that an overpayment has been made, the provider shall repay said overpayment immediately without prior notification from the department. In the event that the department first discovers an overpayment has been made, the contract manager, on behalf of the department, will notify the provider by letter of such findings. Should repayment not be made forthwith, the provider will be charged at the lawful rate of interest on the outstanding balance after department notification or provider discovery. K. Client Risk Prevention and Incident Reporting 1, That if services to clients are to be provided under this contract, the provider and any subcontractors shall, in accordance with the client risk prevention system, report those reportable situations listed in CFOP 215-6 in the manner prescribed in CFOP 215-6 or district operating procedures. 2. To immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number (1-800-96A8USE). As required by Chapters 39 and 415, F,S" this provision is binding upon both the provider and its employees. L. Purchasing 1. To purchase articles which are the subject of or are required to carry out this contract from Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S" in the same manner and under the procedures set forth in subsections 946,515(2) and (4), F .S. For purposes of this contract, the provider shall be deemed to be substituted for the department insofar as dealings with PRIDE. This clause is not applicable to subcontractors unless otherwise required by law. An abbreviated list of products/services available from PRIDE may be obtained by contacting PRIDE, (850) 487-3774, 2. To procure any recycled products or materials, which are the subject of or are required to carry out this contract, in accordance with the provisions of sections 403.7065, and 287,045, F.S. M. Civil Rights Requirements 1, Not to discriminate against any employee in the performance of this contract or against any applicant for employment because of age, race, religion, color, disability, national origin, marital status or sex. The provider further assures that all contractors, subcontractors, subgrantees, or others with whom it arranges to provide services or benefits to participants or employees in conneCtion with any of its programs and activities are not discriminating against those participants or employees because of age, race, religion, color, disability, national origin, marital status or sex, This is binding upon the provider employing fifteen (15) or more individuals, 2. To complete the Civil Rights Compliance Questionnaire, CF Forms 946 A and 8, in accordance with CFOP 60-16, This is binding upon providers that have fifteen (15) or more employees, N. Independent Capacity of the Contractor 1 To act in the capacity of an independent contractor and not as an officer, employee of the State of Florida, except where the provider is a state agency. Neither the provider nor its agents, employees, subcontractors or assignees shall represent to others that it has the authority to bind the department unless specifically authorized in writing to do so, 2 This contract does not create any right to state retirement, leave benefits or any other benefits of state employees as a result of performing the duties or obligations of this contract, 3 To take such actions as may be necessary to ensure that each subcontractor of the provider will be deemed to be an independent contractor and will not be considered or permitted to be an agent, servant, joint venturer, or partner of the State of Florida, 4, The department will not furnish services of support (e,g., office space, office supplies, telephone service, secretarial or clerical support) to the provider, or its subcontractor or assignee, unless specifically agreed to by the department in this contract. 5. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the provider, the provider's officers, employees, agents, subcontractors, or assignees shall be the sole responsibility of the provider. 3 CONTRACT # KCi047 04/10/03 O. Sponsorship As required by section 286.25, F.S., if the provider is a non-governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (provider's name) and the State of Florida, Department of Children and Families," If the sponsorship reference is in written material, the words "State of Florida, Department of Children and Families" shall appear in the same size letters or type as the name of the organization. P. Publicity Without limitation, the provider and its employees, agents, and representatives will not, without prior departmental written consent in each instance, use in advertising, publicity or any other promotional endeavor any State mark, the name of the State's mark, the name of the State or any State affiliate or any officer or employee of the State, or represent, directly or indirectly, that any product or service provided by the provider has been approved or endorsed by the State, or refer to the existence of this contract in press releases, advertising or materials distributed to the provider's prospective customers. Q. Finallnvoice To submit the final invoice for payment to the department no more than 45 days after the contract ends or is terminated, If the provider fails to do so, all rights to payment are forfeited and the department will not honor any requests submitted after the aforesaid time period Any payment due under the terms of this contract may be withheld until all reports due from the provider and necessary adjustments thereto have been approved by the department. R. Use of Funds for Lobbying Prohibited To comply with the provisions of sections 11.062 and 216.347, F .S., which prohibit the expenditure of contract funds for the purpose of lobbying the Legislature, judicial branch, or a state agency. S. Public Entity Crime Pursuant to section 287.133, F.S., the following restrictions are placed on the ability of persons convicted of public entity crimes to transact business with the department: When a person or affiliate has been placed on the convicted vendor list following a conviction for a public entity crime, he/she 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 the repair of a public building or public work, may not submit bids on leases of real property to a public entity, may not be awarded or perform work as 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, F.S., for CATEGORY TWO for a period of thirty-six (36) months from the date of being placed on the convicted vendor list. T. Patents, Copyrights, and Royalties 1. If any discovery or invention arises or is developed in the course of or as a result of work or services performed under this contract, or in anyway connected herewith, the provider shall refer the discovery or invention to the department to be referred to the Department of State to determine whether patent protection will be sought in the name of the State of Florida, Any and all patent rights accruing under or in connection with the performance of this contract are hereby reserved to the State of Florida, 2. In the event that any books, manuals, films, or other copyrightable materials are produced, the provider shall notify the Department of State, Any and all copyrights accruing under or in connection with performance under this contract are hereby reserved to the State of Florida. 3. The provider, if not a state agency, shall indemnify and save the department and its employees harmless from any liability whatsoever, including costs and expenses, arising out of any copyrighted, patented, or unpatented invention, process, or article manufactured or used by the provider in the performance of this contract. 4. The department will provide prompt written notification of any claim of copyright or patent infringement. Further, if such claim is made or is pending, the provider may, at its option and expense, procure for the department, the right to continue use of, replace, or modify the article to render it non-infringing, If the provider uses any design, device, or materials covered by letters, patent, or copyright, it is mutually agreed and understood without exception that the compensation paid pursuant to this contract includes all royalties or costs arising from the use of such design, device, or materials in any way involved in the work contemplated by this contract. U. Construction or Renovation of Facilities Using State Funds That any state funds provided for the purchase of or improvements to real property are contingent upon the provider granting to the state a security interest in the property at least to the amount of the state funds provided for at least five (5) years from the date of purchase or the completion of the improvements or as further required by law, As a condition of receipt of state funding for this purpose, the provider agrees that, if it disposes of the property before the department's interest is vacated, the provider will refund the proportionate share of the state's initial investment, as adjusted by depreciation. 4 CONTRACT # KG047 04/10103 V. Information Security Obligations 1, To identify an appropriately skilled individual to function as its Data Security Officer who shall act as the liaison to the department's Security Staft and who will maintain an appropriate level of data security for the information the provider is collecting or using in the performance of this contract. An appropriate level of security includes approving and tracking all provider employees that request system or information access and ensuring that user access has been removed from all terminated provider employees, 2. To hold the department harmless from any loss or damage incurred by the department as a result of information technology used, provided or accessed by the provider. 3. To furnish Security Awareness Training to its staft, 4, To ensure that all provider employees who have access to departmental information are provided a copy of CFOP 50-6 and that they sign the DCF Security Agreement form (CF 114), a copy of which may be obtained from the contract manager, W. Accreditation That the department is committed to ensuring provision of the highest quality services to the persons we serve. Accordingly, the department has expectations that where accreditation is generally accepted nationwide as a clear indicator of quality service, the majority of our providers will either be accredited, have a plan to meet national accreditation standards, or will initiate one within a reasonable period of time, X. Agency for Workforce Innovation and Workforce Florida That it understands that the department, the Agency for Workforce Innovation, and Workforce Florida, Inc. have jointly implemented an initiative to empower recipients in the Temporary Assistance to Needy Families Program to enter and remain in gainful employment. The department encourages provider participation with the Agency for Workforce Innovation and Workforce Florida, Y. Health Insurance Portability and Accountability Act Where applicable, to comply with the Health Insurance Portability and Accountability Act (42 U. S, Section 210 et seq) as well as all regulations promulgated thereunder (45 CFR Parts 160, 162, and 164), Z. Emergency Preparedness If the tasks to be performed pursuant to this contract include the physical care and control of clients, the provider shall, within 30 days of the execution of this contract, submit to the contract manager an emergency preparedness plan which shall include provisions for pre-disaster records protection, alternative accommodations for clients in substitute care, supplies, and a recovery plan that will allow the provider to continue functioning in compliance with the executed contract in the event of an actual emergency. The department agrees to respond in writing within 30 days of receipt of the plan accepting, rejecting, or requesting modifications. In the event of an emergency, the department may exercise oversight authority over such provider in order to assure implementation of agreed emergency relief provisions. II. THE DEPARTMENT AGREES: A. Contract Amount To pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $91,713,00, subject to the availability of funds, The State of Florida's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. Any costs or services paid for under any other contract or from any other source are not eligible for payment under this contract. 8. Contract Payment Pursuant to section 215.422, F.S., the department has five (5) working days to inspect and approve goods and services, unless the bid specifications, purchase order, or this contract specify otherwise. With the exception of payments to health care providers for hospital, medical, or other health care services, if payment is not available within forty (40) days, measured from the latter of the date a properly completed invoice is received by the department or the goods or services are received, inspected, and approved, a separate interest penalty set by the Comptroller pursuant to section 55.03, F.S., will be due and payable in addition to the invoice amount. Payments to health care providers for hospital, medical, or other health care services, shall be made not more than thirty-five (35) days from the date eligibility for payment is determined, Financial penalties will be calculated at the daily interest rate of .03333%, Invoices returned to a provider due to preparation errors will result in a non-interest bearing payment delay, Interest penalties less than one (1) dollar will not be paid unless the provider requests payment. C. Vendor Ombudsman A Vendor Ombudsman has been established within the Department of Financial Services, The duties of this office are found in subsection 215.422 (7), F .S., which include disseminating information relative to the prompt payment of this state and assisting vendors in receiving their payments in a timely manner from a state agency. The Vendor Ombudsman may be contacted at (850) 410- 9724 or 1-800-848-3792, the State of Florida Comptroller's Hotline. D. Notice Any notice, that is required under this contract shall be in writing, and sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery. Said notice shall be sent to the representative of the provider responsible for administration of the program, to the designated address contained in this contract. 5 CONTRACT # KG047 04/10/03 III. THE PROVIDER AND DEPARTMENT MUTUALLY AGREE: A. Effective and Ending Dates This contract shall begin on July 1, 2003, or on the date on which the contract has been signed by the last party required to sign it, whichever is later, It shall end at midnight, local time in Monroe County, Florida, on June 30, 2004, B. Financial Penalties for Failures to Comply with Requirement for Corrective Action. 1. In accordance with the provisions of Section 402.73(7), Florida Statutes, and Section 65-29.001, Florida Administrative Code, corrective action plans may be required for noncompliance, nonperformance, or unacceptable performance under this contract. Penalties may be imposed for failures to implement or to make acceptable progress on such corrective action plans. 2, The increments of penalty imposition that shall apply, unless the department determines that extenuating circumstances exist, shall be based upon the severity of the noncompliance, nonperformance, or unacceptable performance that generated the need for corrective action plan, The penalty, if imposed, shall not exceed ten percent (10%) of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made Noncompliance that is determined to have a direct effect on client health and safety shall result in the imposition of a ten percent (10%) penalty of the total contract payments during the period in which the corrective action plan has not been implemented or in which acceptable progress toward implementation has not been made. 3. Noncompliance involving the provision of service not having a direct effect on client health and safety shall result in the imposition of a five percent (5%) penalty. Noncompliance as a result of unacceptable performance of administrative tasks shall result in the imposition of a two percent (2%) penalty. 4 The deadline for payment shall be as stated in the Order imposing the financial penalties. In the event of nonpayment the department may deduct the amount of the penalty from invoices submitted by the provider, C. Termination 1. This contract may be terminated by either party without cause upon no less than thirty (30) calendar days notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the contract manager or the representative of the provider responsible for administration of the program. 2. In the event funds for payment pursuant to this contract become unavailable, the department may terminate this contract upon no less than twenty-four (24) hours notice in writing to the provider. Said notice shall be sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery. The department shall be the final authority as to the availability and adequacy of funds, In the event of termination of this contract, the provider will be compensated for any work satisfactorily completed, 3, This contract may be terminated for the provider's non-performance upon no less than twenty-four (24) hours notice in writing to the provider, If applicable, the department may employ the default provisions in Rule 60A-1,006(3), FAC, Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the department's right to remedies at law or in equity. 4. Failure to have performed any contractual obligations with the department in a manner satisfactory to the department will be a sufficient cause for termination. To be terminated as a provider under this provision, the provider must have: (1) previously failed to satisfactorily perform in a contract with the department, been notified by the department of the unsatisfactory performance, and failed to correct the unsatisfactory performance to the satisfaction of the department; or (2) had a contract terminated by the department for cause, D. Renegotiations or Modifications Modifications of provisions of this contract shall be valid only when they have been reduced to writing and duly signed by both parties, The rate of payment and the total dollar amount may be adjusted retroactively to reflect price level increases and changes in the rate of payment when these have been established through the appropriations process and subsequently identified in the department's operating budget. E. Official Payee and Representatives (Names, Addresses, and Telephone Numbers): 1. The provider name, as shown on page 1 of this contract, and mailing address of the official payee to whom the payment shall be made is: Monroe County (Monroe County In Home Services) 1100 Si m onton Street Key West, FL 33040 3. The name, address, and telephone number of the contract manager for the department for this contract is: Theresa Phelan 1111 12th Street, #301 Key West, FL 33040 305 I 292-6810 6 CONTRACT # !-\.CJ047 04/10/03 2. The name of the contact person and street address where financial and administrative records are maintained is: Deloris Simpson Monroe County (Monroe County In Home Services) 1100 Simonton Street Key West, FL 33040 305 I 292-4589 4. The name, address, and telephone number of the representative of the provider responsible for administration of the program under this contract is: Deloris Simpson Monroe County (Monroe County In Home Services) 1100 Simonton Street Key West, FL 33040 305 I 292-4589 5. Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in writing to the other party and the notification attached to the originals of this contract. F. All Terms and Conditions Included This contract and its attachments, I, II and exhibits A, S, C, D, E & F, and any exhibits referenced in said attachments, together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications. representations, or agreements, either verbal or written between the parties. If any term or provision of this contract is legally determined unlawful or unenforceable, the remainder of the contract shall remain in full force and effect and such term or provision shall be stricken, By signing this contract, the parties agree that they have read and agree to the entire contract, as described in Paragraph III.F. above. IN WITNESS THEREOF, the parties hereto have caused this 71 page contract to be executed by their undersigned officials as duly authorized. -Jl6!?:. J,oJ.@ TITLE' ~ DATE: <:~ Ii', 2..003 STATE AGE 29 DIGIT FLAIR CODE: Federal EID # (~~ ~~:~~902 ({;~ I ....,.........pf:~, , -p)' ,,\,., 0- I ,,' .,.\\\ L~j;\:i\J. . ~"~ . . ." ,,;';1 f"'"' pr "_ ~_,',' ___-!::~ '7-..... I... I. ,...>/~<y ," ---~:,:< SIGNED BY: NAME: TITLE: DATE: PROVIDER: Monroe County (Monroe County In Home Services SIGNED BY: NAME: Provider Fiscal Year Ending Date: ~/30. /\.PPf~GiJ~D i\S T~) ~'i)!{~l; :~? :_~~~~1~~ (~ r':::i r-..-" c:::. ~.::.:;) ;:"U <-- c:::: r- I CD C:l '1 r rrl o ..." o :;;J ?:J I" r-\ c-:) ::0 CJ ... AfW~OVED AS TO FORM LEy 8 ::c,: ~~~) ~-~. i1~1 ,-- - ....J, - :.i: C) rfJ c.) ..-- - 7 CONTRACT # KG047 07/01/2003 Community Care for Disabled Adults/Fixed Price Adult Services Program ATTACHMENT I A. Services to be Provided 1. Definition of Terms a. Contract Terms (Refer to the Glossary in CFOP 75-2, Contract Management System for Contractual Services, which is incorporated by reference herein) b. Program or Service Specific Terms (1) Activities of Daily Living - Basic activities performed in the course of daily living, such as dressing, bathing, grooming, eating, using a commode or urinal, and ambulating around one's own home. (2) Client - Any person who is eligible and is at least eighteen (18) years through age fifty-nine (59), has one (1) or more permanent physical or mental limitations that restrict the client's ability to perform normal activities of daily living, and impede the client's capacity to live independently or with relatives or friends without the provision of community-based services. (3) Medicaid Institutional Care Program (MICP) - A program that serves Medicaid recipients who are determined eligible for a nursing home level of care, which provides primary, acute, and long-term care services at capitated federally- matched rates. (4) Nursing home - Any facility which provides nursing services as defined in Chapter 464, F.S., which is licensed in accordance with Chapter 400, F,S, (5) Outcomes - Quantitative indicators that can be used by the department to objectively measure a provider's performance toward a stated goal. (6) Outputs - Process measures of the quantity(ies) of services delivered, clients served, or similar units completed. (7) Performance Measures - Quantitative indicators, outcomes and outputs, that can be used by the department to objectively measure a provider's performance. (8) The Community Care for Disabled Adults Instructional Guide (Exhibit A) - A publication developed by the department to better assist department staff and acquaint contract provider staff with the types of services the department purchases for its clients, and the scope of those services as established by policy. Hereafter referred to as "The Guide". 2. General Description a. General Statement (1) The Community Care for Disabled Adults (CCDA) Program is designed to assist disabled adults, age eighteen (18) through fifty-nine (59), in utilizing available community and personal resources enabling them to remain in their own homes, and preventing their premature or inappropriate institutionalization. 04/30/03 8 PSMAI No. GA07 Contract No. KG047 07/01/2003 Community Care IVI Disabled Adults/Fixed Price Adult Services Program (2) Service providers will ensure that appropriate community-based services are provided to clients in a manner designed to meet the client's changing needs, to assist the client in avoiding or reducing unnecessary dependence on the delivered service(s), and to increase the client's self-reliance. b. Authority Sections 410.601-606, F.S., Chapter 65C-2, Florida Administrative Code (FAC,), and the annual appropriations act, with any proviso language or instructions to the department, constitute the legal basis for services to be delivered through the CCDA program. c. Scope of Service Services will be targeted toward eligible adults, age eighteen (18) through fifty-nine (59), in Monroe County, Florida, d. Major Program Goal Community-based services provided under this contract are designed to prevent inappropriate institutionalization of disabled adults. 3. Clients to be Served a. General Description Adults with disabilities, age eighteen (18) through fifty-nine (59), who are no longer eligible to receive children's services, and are too young to qualify for community and home- based services for the elderly, may be served under the provisions of this contract. b. Client Eligibility (1) Applicants must have one or more permanent physical or mental limitations, that restrict the ability to perform normal activities of daily living, as determined through the initial functional assessment and medical documentation of disability, Determination of a permanent disability must be established and evidenced in one of the following manners: (a) An applicant may present a check, awards letter, or other proof showing receipt of Social Security Disability Income, or some other disability payment (e.g., Worker's Compensation); or (b) An applicant may present a written statement from a licensed physician, licensed nurse practitioner, or mental health professional, which meets the district's criteria for evidence of a disability. This written statement must, at a minimum, include the applicant's diagnosis, prognosis, a broad explanation of level of functioning, and the interpretation of need for services based on identified functional barriers caused by the applicant's disabling condition. (2) Applicants must have an individual income at or below the prevailing MICP eligibility standard in order to receive free CCDA services, (3) Applicants with incomes above the standard will be assessed for a share of the costs, or may be required to provide volunteer services in lieu of payment. 04/30/03 9 PSMAI No. GAD? Contract No. KG047 07/01/2003 Community Care for Disabled Adults/Fixed Price Adult Services Program c. Client Determination (1) Clients will be assessed for eligibility determination, and prioritized for services by district or provider case management staff, in accordance with subsection 410.604 (2), F.S. (2) The district's program manager will make the final determination in the event of a dispute regarding client eligibility. d. Contract Limits (1) The total annual cost estimated or actual, for an individual receiving CCDA services, shall not exceed the average, annual general revenue portion of a Medicaid nursing home bed within the district area. (2) Clients must not be receiving comparable services from any other entity. In order to prevent duplication of services, client files must contain documentation verifying that all comparable community services and funding sources have been explored and exhausted. (3) The provider shall deliver services only to those persons who meet program eligibility criteria, and only to the extent that funds are available. B. Manner of Service Provision 1. Service Tasks a. Task List (1) The following tasks will be performed under this contract (check all that apply IZI). OAdult Day Care X Case Management OEmergency Alert Response X Personal Care OHome Health Aide OGroup Activity Therapy X Homemaker OHome Nursing X Home Delivered Meals Olnterpreter OTransportation OMedical Therapeutic Services OChore ORespite OPhysical and Exams OEscort (2) Details of services to be provided under this contract and the negotiated parameters of those services include: (Descriptions and minimum requirements for each service listed are listed in "The Guide"). 04/30/03 10 PSMAI No. GA07 Contract No. KG047 07/0112003 Community Care f(J, Disabled Adults/Fixed Price Adult Services Program b. Task Limits The following task limits are only applicable to a specific service(s) that a provider delivers to the clients: (1) Each district CCDA program shall include case management services and at least one other community service. (2) Respite Care services may be provided for up to two hundred forty (240) hours per client per calendar year, depending upon individual need. The service may be extended to three hundred sixty (360) hours, as recommended by the case manager and approved by an immediate supervisor. Documentation of approval must be evident in the case narrative section of the case manager's file. (3) Personal Care services will not substitute for the care usually provided by a registered nurse, licensed practical nurse, therapist, or home health aide. The personal care aide will not change sterile dressings, irrigate body cavities, administer medications, or perform other activities prohibited by Chapter 59A-8, FAC. (4) Homemaker service time does not include time spent in transit to and from the client's place of residence except when providing shopping assistance, performing errands or other tasks on behalf of a client. (5) Several restrictions apply to persons providing Homemaker service activities. Persons providing services must not: (a) engage in work that is not specified in the Homemaker assignment; (b) accept gifts from clients; (c) lend or borrow money or articles from clients; (d) handle client money, unless authorized in writing by a supervisor or case manager (as evident in the personnel file) and unless bonded or insured by the employer; (e) transport clients, unless authorized in writing by a supervisor or case manager. (6) The parameters of service delivery, by type of service, are detailed in "The Guide". (7) District task limits, which exceed those in "The Guide", and are distinctive to this contract, are listed here: 2. Staffing Requirements a. Staffing levels (1) The provider will meet the minimum staffing requirements for each service, as specified in 'The Guide". 04/30/03 11 PSMAI No. GAOl Contract No. KG047 07/01/2003 Community Care llJ, Disabled Adults/Fixed Price Adult Services Program (2) The provider will notify the department, in writing, within thirty (30) days whenever the provider is unable, or expects to be unable to provide the required quality or quantity of service because of staff turnovers or shortages. b. Professional Qualifications The provider will ensure that staff meets the professional qualifications for each service, as specified in "The Guide". c. Staffing Changes The provider agrees to notify the department's contract manager within two (2) working days if a key administrative position (e.g., executive director) becomes vacant. Planned staffing changes that may affect service delivery, as stipulated in this contract, must be presented in writing to the contract manager for approval at least two (2) weeks prior to the implementation of the change, d. Subcontractors Written requests by the provider to subcontract for the provision of services under this contract will be routed through the contract manager for department approval. All subcontracting is subject to the provisions of Section 1.1. of the Standard Contract. 3. Service Location and Equipment a. Service Delivery Location and Times (1) CCDA services may be delivered in the client's home or on-site at a facility, as negotiated by the department and the provider. (2) Facilities delivering on-site services to clients shall pass an annual inspection by the local environmental health and fire authorities. (3) Service providers will meet the minimum service location and time requirements as specified in "The Guide". (4) Services for this contract will be delivered at the following location(s) and times: SERVICE LOCA TION TIMES Case Management Client's Home As needed Personal Care Client's Home As needed Homemaking Client's Home As needed Home Delivered Meals Client's Home As needed b. Changes in Location The provider must notify the department of changes in the location of service delivery. Once the service delivery location is agreed upon, any proposed change must be presented in writing to the contract manager for approval, ten (10) days prior to implementation of that proposed change. In the event of an emergency, temporary changes in location may necessitate waiver of this designated standard by the district's 04/30/03 12 PSMAI No. GA07 Contract No. KG047 07/01/2003 Community Care for Disabled Adults/Fixed Price Adult Services Program program office. Such a waiver will take into consideration the continuity, safety, and welfare of the department's clients, and is at the department's sole discretion. c. Equipment (1) If equipment is applicable to a specific provider's contract, the provider must submit an equipment listing (Exhibit N/A) to the department which lists the equipment. The equipment required to perform the contracted services must be negotiated by the department and the provider. To ensure uniformity, safety, and quality of service to clients, any requests for equipment change must be presented in writing to the contract manager for approval at least ten (10) days prior to any proposed change, (2) The provider must inventory all equipment acquired under this contract annually. The inventory list must be made available within seven (7) days upon receipt of written request by the contract manager. The provider must list the items of equipment on the equipment listing (Exhibit N/A), as applicable to the provider's contract for specific services. 4. Deliverables a. Service Units A service unit is an appropriate, distinct amount of given service, which may include, but is not limited to, an hour or quarter hour of direct service delivery; a meal; an episode of travel; or a twenty-four (24) hour period of Emergency Alert Response maintenance, as defined in "The Guide". All service units, as well as their description and costs, are listed in "The Guide". b. Records and Documentation (1) Case Management provider files shall contain the following: (a) a completed client assessment (not more than one (1) year old); (b) a care plan (not more than one (1) year old); (c) a release of information form; (d) a copy of a completed Client Information System (CIS) form; (e) documentation of the client's age, disability, and income; (f) a copy of the referral/intake form; and (g) a case narrative. (2) Providers shall maintain information on each client served by this contract, which includes the following: (a) documentation of the client by name or unique identifier; (b) current documentation of eligibility for services; 04/30/03 13 PSMAI No. GAD7 Contract No. KG047 07/01/2003 Community Care tv. Disabled Adults/Fixed Price Adult Services Program (c) dates of service provision and delivery; (d) information documenting the client's need to receive services; (e) the number of service units provided; and (f) all other forms or records necessary for program operation and reporting, as set forth by the department. (3) Providers must ensure that all client records accurately match the invoices submitted for payment. Records must cross reference to each invoice for payment. (4) Providers must maintain documentation necessary to facilitate monitoring and evaluation by the department. (5) The case management provider must maintain documentation in the client's file that all comparable community services and funding sources have been explored and exhausted before using CCDA funding. c. Reports Report Title Reporting Report Date Due Number of DCF Office address Frequency copies due to receive report Quarterly Cumulative Quarterly 10/30/03 One Contract Manager Summary Reports 02/15/04 04/30/04 08/15/04 Performance Data Monthly 10th of the month One Contract Manager Report following the report period Active Client Log Monthly 10th of the month One Contract Manager following the report period Wait List Log Monthly 10th of the month One Contract Manager following the report period Client Cost Plans Updated 10th of the month One Contract Manager Monthly following the report period Cost Report Monthly 10th of the month One Contract Manager following the report period (1) Reporting requirements for this contract include, Exhibit B, Quarterly Cumulative Summary Reports, if applicable. Districts will negotiate with the provider on specific submission requirement criteria for these reports, (2) Providers of case management services agree to submit Quarterly Cumulative Summary Reports, which include management program data (e,g" 04/30/03 14 PSMAI No. GA07 Contract No, KG047 07/01/2003 Community Care fur Disabled Adults/Fixed Price Adult Services Program client identifiable data) to the department, according to negotiated instructions provided by the districts. (3) In the event of early termination of this contract, the provider will submit the final Quarterly Cumulative Summary Report within forty-five (A5) days after the contract is terminated. - (4) The provider agrees to submit a monthly Cost Report, Exhibit C, which details the number of units of service provided to each client during the report period. (5) The provider agrees to submit all other reports indicated above in formats to be determined by the provider. 5. Performance Specifications a. Performance Measures (1) 99 % of adults with disabilities receiving services will not be placed in a nursing home. (2) 25 # of qualified disabled adults (ages 18-59) provided case management. (3) 29 # of qualified disabled adults (ages 18-59) in the CCDA and ADA Medicaid Waiver Programs. b. Description of Performance Measurement Terms Placed - Assessment of an individual who is no longer able to remain in his present place of residence. (To place a client involves preparation for and follow up of moving a client into a more restrictive alternative living environment), c. Performance Evaluation Methodology (1) Measuring Outcomes. The department will measure the outcomes found in paragraph S.5.a, above as follows: (a) The outcome measurement contained in paragraph S.5.a.(1) above will be measured by dividing the total, fiscal year-to-date number of clients in the Community Care for Disabled Adults, Home Care for Disabled Adults, Cystic Fibrosis, and Medicaid waiver programs not transferred to a nursing home, by the total, fiscal year-to-date number of clients in the Community Care for Disabled Adults, Home Care for Disabled Adults, Cystic Fibrosis, and Medicaid wavier programs. (b) The outcome measurement contained in paragraph S,5.a,(2) above will be measured by the total number clients actively receiving case management from the Community Care for Disabled Adults, Home Care for Disabled Adults, Cystic Fibrosis, and Medicaid waiver programs, (c) The outcome measurement contained in paragraph S.5.a(3) above will be measured by the total number clients actively receiving daily living 04/30/03 15 PSMAI No. GA07 Contract No. KG047 07/01/2003 Community Care tv, Disabled Adults/Fixed Price Adult Services Program (1) By execution of this contract, the provider hereby acknowledges and agrees that its performance under the contract must meet the standards set forth above and will be bound by the conditions set forth below. If the provider fails to meet these standards, the department, at its exclusive option, may allow up to six months for the provider to achieve compliance with the standards, If the department affords the provider an opportunity to achieve compliance, and the provider fails to achieve compliance within the specified time frame, the department will terminate the contract in the absence of any extenuating or mitigating circumstances. The determination of the extenuating or mitigating circumstances is the exclusive determination of the department. (2) The Contract Performance Unit ("CPU") may elect to perform an on-site administrative and programmatic monitoring during the contract period. At a minimum, an annual desk monitoring will be performed which will be accomplished by a combination of the review(s) of reports or other documentation submitted by the provider, input from service recipients and others, and visits to the site of service delivery for programmatic review, (3) For on-site monitorings, a random discovery sample of open and closed files will be taken for review. This sample may be increased to a random statistical sample depending on the results of our review. The number of files reviewed will be contingent upon the population size of services rendered, To facilitate the sampling process, upon CPU request, the provider shall submit a universal events listing of all services provided under the contract prior to the monitoring visit. (4) A report outlining the department's findings during the on-site monitoring will be submitted to the provider within 30 days of concluding field work with an exit conference. The provider agrees to respond and submit a corrective action plan, if required, within 30 days of receiving the department's monitoring report, C. Method of Payment 1. Payment Clause a. This is a Fixed Price (Unit Cost) contract. The department shall pay the provider for the delivery of service units provided in accordance with the terms of this contract for a total dollar amount not to exceed $91,713.00, subject to the availability of funds. b. The department shall make payments to the provider for provision of services up to the maximum number of units of service at the rates shown below. Service Units Unit Price Maximum # of Units Case Management $47.73 220 Personal Care $51.11 278 Homemaking $27,11 1,241 Home Delivered Meals $ 6.97 4,786 04/30/03 18 PSMAI No. GA07 Contract No. KG047 07/01/2003 Community Care lv' Disabled Adults/Fixed Price Adult Services Program c. The provider's dollar match for this contract is 10,190.00. Case management and transportation services may be exempt from match requirement at the discretion of each district. d. Cash or in kind resources may be used to meet this match requirement. 2. Invoice Requirements The provider shall request payment through submission of a properly completed Invoice, Exhibit D, within 15 days following the end of the month for which payment is being requested. The provider shall submit to the contract manager an original Invoice, Exhibit D, and no copies, along with supporting documentation. Payment due under this contract will be withheld until the department has confirmed delivery of negotiated services. 3. Supporting Documentation a. It is expressly understood by the provider that any payment due the provider under the terms of this contract may be withheld pending the receipt and approval by the department of all financial and program reports due from the provider as a part of this contract and any adjustments thereto. Requests for payment, which cannot be documented with supporting evidence, will be returned to the provider upon inspection by the department. b. The provider must maintain records documenting the total number of recipients and names (or unique identifiers) of recipients to whom services were provided and the dates the services were provided so that an audit trail documenting service provision can be maintained. D. Special Provisions 1. Fees a. The provider will collect fees for services provided according to Rule 65C-2.007, FAC. b. No fees shall be assessed other than those established by the department. Fees collected in compliance with the department directives will be reinvested in a manner prescribed by the department. 2. Florida Statewide Advocacy Council The provider agrees to allow properly identified members of the Florida Statewide Advocacy Council access to the facility or agency and the right to communicate with any client being served, as well as staff or volunteers who serve them in accordance with subsections 402,165(8) (a) & (b), F.S. Members of the Florida Statewide Advocacy Council shall be free to examine all records pertaining to any case unless legal prohibition exists to prevent disclosure of those records. 3. Federal or State Audit Any federal or state audit resulting in a disallowance which was caused by the provider's non- compliance with federal regulations or an incorrect claim shall be repaid to the department by the provider upon discovery. 4. Information Technology Resources. All contract providers must adhere to the Department's procedures and standards when purchasing Information Technology Resources (ITRs) as part of this contract. These resources 04/30103 19 PSMAI No. GA07 Contract No. KG047 07/01/2003 Community Care tur Disabled Adults/Fixed Price Adult Services Program will revert to the Department at the conclusion of the contract. ITRs are data processing hardware, software, service, supplies, maintenance, training, personnel, and facilities. The provider agrees to secure prior written approval through the contract manager from the District Management Systems Director for the purchase of any ITR. The provider will not be reimbursed for any purchase made prior to this written approval. 5. Morals Clause The provider understands that performance under this contract involves the expenditure of public funds from both the state and federal governments, and that the acceptance of such funds obligates the provider to perform its services in accordance with the very highest standards of ethical and moral conduct. Public funds may not be used for purposes of lobbying, or for political contributions, or for any expense related to such activities, pursuant to Section I R of the Standard Contract of this contract. The provider understands that the Department is a public agency which is mandated to conduct business in the sunshine, pursuant to Florida Law, and that all issues relating to the business of the Department and the provider are public record and subject to full disclosure, The provider understands that attempting to exercise undue influence on the Department and its employees to allow deviation or variance from the terms of this contract other than negotiated, publicly disclosed amendment, is prohibited by the State of Florida, pursuant to Section III C of the Standard Contract. The provider's conduct is subject to all state and federal laws governing the conduct of entities engaged in the business of providing services to government. 6. Employee Loans Funds provided by the Department under this contract shall not be used by Not-For-Profit Corporations to make loans to their employees, officers, directors and/or subcontractors. Violation of this provision shall be considered a breach of contract, the termination of this contract shall be in accordance with the Standard Contract, Section III, Paragraph S, Subsection 3, A loan is defined as any advance of money for which the repayment period extends beyond the next scheduled pay period. 7. Emergency Plan The provider shall be responsible for the care, maintenance and, if necessary, the relocation of clients during any natural disaster or period of civil unrest. The provider shall submit its emergency plan to the Department for approval at the time of submission of the agency's proposal and must be updated annually, 8. Transportation Disadvantaged The provider agrees to comply with the proVISions of Chapter 427, Florida Statute, Part I, Transportation Services, and Chapter 41-2, Florida Administrative Code, Commission for the Transportation Disadvantaged, if public funds provided under this contract are used to transport clients. The provider agrees to comply with the provisions of CFOP 40-5 if public funds provided under this contract will be used to purchase vehicles which will be used to transport clients 9. Incident Reporting The Provider is required to document all reportable incidents, as defined in the District 11 Uniform Incident Reporting Protocol for Incident Reporting and Client Risk Prevention For Critical and Non-Critical Incidents, which is incorporated herein by reference, For each critical incident occurring during the administration of its program, the Provider must, within 24 hours of the incident, complete and submit the District's approved Incident Report form (Exhibit F) to the respective department program incident report liaison. The incident report liaison for this contract is Fernando Deheza, 401 NW 2nd Avenue, Suite N-1007, Miami, FL 33128, It is the Provider's responsibility to use the most current District 11 approved incident report for this purpose. A copy of the incident report must also be placed in a central file marked 04/30/03 20 PSMAI No. GA07 Contract No. KG047 07/01/2003 Community Care ,...., Disabled Adults/Fixed Price Adult Services Program "Confidential Incident Report" and in each client's file involved in the incident. Dissemination of the report within the department will be the responsibility of the department's program incident report liaison. Incidents that threaten the health, safety or welfare of any person or that plac~ any person in imminent danger must be reported immediately to the department by telephonic.contact. The information contained in the incident report is confidential. The dissemination, distribution or copying of the report is strictly prohibited, unless authorized by the Department. 10. Security Agreement Form The provider agrees to submit to the Department Contract Manager an original signed Security Agreement Form (CF-114) (Exhibit E) for all required personnel no later than thirty (30) days following the execution of this contract or thirty (30) days from date of employment. All personnel who require access to departmental information must sign the Security Agreement Form prior to receiving access to the information. / / 04/30/03 21 PSMAI No. GAD? Contract No. KG047 711 /200 I Corrununity Care for Disabled Adults Adult Services Program EXHIBIT A FLORIDA DEPARTMENT OF CH I LDREN & FAMILIES INSTRUCTIONAL GUIDE The Instructional Guide defines each of the approved Community Care for Disabled Adults program services and the requirements associated with the service tasks and delivery of those services as well as other reporting and billing information necessary for proper completion of the aforementioned model Attachment I's in a statutorily and administratively sound fashion. The CCDA program may be contracted for and financially managed in any of the three following ways: FIXED PRICE contracting, using the GAD? PSMA FIXED PRICE ADVANCE FUNDING contracting, using the GAD8 or COST REIMBURSEMENT contracting, using a district created PSMAI Each of the 15 districts may enter into anyone, two or three methods of contract payment with provider agencies serving the CCDA population for any number of approved CCDA services. All three methods are forms of a formal contract. The Adult Services Central Office has developed the GAD? and GAD8 Program Specific Model Attachments (PSMAl's) for your convenience and to insure that the minimum program requirements of the CCDA program are fulfilled and that uniformity of procurement and delivery of CCDA contractual services is maintained on a statewide basis. Both the GAD? and the GAD8 PSMAI methods of payment will be addressed in its own instructional chapter to distinguish its unique reporting and billing requirements from the other; Section A - FIXED PRICE or PSMA GAD? Section B - FIXED PRICE ADVANCE FUNDING or PSMA GAD8 and Section C - A Taxonomy of Services Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 z?- 711 /200 1 COftuilunity Care for Disabled Adults Adult Services Program SECTION A FIXED PRICE Fixed-price contracts should be used when the service to be provided can be broken down into standard units (i.e., trips, hours), and a specific rate is paid per unit for a specific period of time. This formal contract requires a 10% match, either in-kind or cash. As in the past, case management and/or transportation services may be exempt from this match requirement at the district's discretion. Contract providers using the fixed-price method of payment may negotiate monthly reporting with the district, but are required to submit three, six, nine and twelve month Cumulative Summary Reports that will be forwarded by the district office to the Central Office. A copy of the quarterly Cumulative Summary Form to be used in this reporting process has been labeled as an Exhibit to this contract. SECTION B FIXED PRICE ADVANCE FUNDING Advance funding may be given only to not-for-profit corporations or government agencies. Such advances may be made on a monthly basis up to the first two months of the contract and may not exceed the expected cash needs of the provider. This formal contract requires a 10% match, either in-kind or cash. Contract providers using the fixed-price advance funding method of payment may negotiate monthly reporting with the district, but are required to submit three, six, nine and twelve month Cumulative Summary Reports that will be forwarded by the district office to the Central Office. A copy Copies of the quarterly Cumulative Summary Forms to be used in this reporting process has have been labeled as an Exhibit to this contract and attached. Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 z'? 7/1/2001 Comlllunity Care for Disabled Adults Adult Services Program SECTION C A TAXONOMY OF SERVICES Adult Day Care (1) Adult day care means a social program which provides a protective environment where preventive, remedial, and restorative services are provided to adults in need of such care. (2) A unit of service is one hour of actual client attendance at the day care center, including travel to or from the center if the adult day care center is providing the transportation with CCDA funds. Minimum Service Standards (1) Licensing. This service must be provided in a licensed adult day care center in accordance with Chapter 400, Part V, Florida Statutes, and Chapter 58A-6, Florida Administrative Code (Regulations). (2) All adult day care centers, contracted with CCDA funds, must meet the following additional service standards: (a) Therapies. Occupational, physical, and speech or language therapy must be provided if care plans of the enrolled participants identify the need for such therapies. Arrangements must be made for clients who need transportation to another location in order to receive any therapies prescribed by a medical professional. (b) Transportation. Transportation services consist of conveying participants from home to the adult day care center and return home. If the day care center does not provide transportation directly, arrangements must be made with available transportation providers. The client's physicallimitation(s) must be considered when planning for transportation. Wheelchair clients may require an appropriately equipped vehicle. Provisions must be made to assist persons in getting on or off the vehicle, if needed. Revised 6/13/01 Revision No. .01 PSMAI No. CAO? Contract No. KG047 2tf. 7/1/2001 Community Care for Disabled Adults Adult Services Program Minimum Staffing Standards (a) Nursing Staff. A registered or licensed practical nurse, licensed by the State of Florida, must be on duty at the site during primary hours of program operation and available at other times. When the position is filled by a licensed practical nurse, this person must work under the supervision of a Registered Nurse. 1. Nursing service by a licensed registered nurse or licensed practical nurse, currently licensed in Florida, includes, but is not limited to: screening procedures for chronic diseases (e.g., hypertension, or diabetes); observation, assessment, and monitoring of clients health needs and daily functioning levels; administration or supervision of medications or treatments; counseling for participant, family or caregiver in matters relating to health and prevention of illness; and referral to other community resources with follow-up of suspected physical, mental, or social problems requiring definitive resolution. 2. The registered or licensed practical nurse must be on duty at the site during the primary hours of program operation. If the nurse leaves the site, the administrator must be on the premises during the center's hours of operation. (b) First Aid Certified Staff. At least one staff person, who has had an approved First Aid course and Cardio-Pulmonary Resuscitation (CPR) training, and is capable of recognizing symptoms of distress in this client population must be at the center at all times. '" Minimum Training Standards (1) Training Requirements. Each position must have a pre-service and in- service training plan. Areas to be covered must be appropriate to job responsibilities. Suggested topics include: medical record keeping; medical emergency procedures, monitoring for change (such as medical, psychological and social, physiological changes with age, chronic diseases); Adult Day Care (Health) policies and procedures; rehabilitation, and prescription drugs common to this population, as well as the interaction of those common drugs. Revised 6/13/01 Revision No. 01 PSMAI No. CAO? Contract No. KG047 25 7/1/2001 Community Care for Disabled Adults Adult Services Program (a) Pre-Service Training. Pre-service training must be documented in agency records as to content and duration. (b) In-Service Training. In-service training for staff will qe regularly scheduled. Minimum in-service training must be six hours'per year with content and hours documented in agency and staff records. Adult Day Health Care (1) Adult day health care is an organized day program of therapeutic, social and health activities and services provided to disabled adults for the purpose of restoring or maintaining optimal capacity for self care. (2) A unit of service is equal to one hour of actual client attendance at the day care center, including travel to or from the center if the adult day care center is providing the transportation with CCDA funds. Minimum Service Standards (1) Licensing. Adult day health care center will be licensed by the Agency for Health Care Administration (AHCA) in accordance with Chapter 400.551, F.S., and Chapter 58A-6, F.A.C., the Adult Day Care Rule that can be obtained from the Department of Elder Affairs. (2) Licensing Exemptions Adult day care centers exempted from licensure must adhere to the requirements stated in Chapter 400.553, F.S., and Chapter 58A-6, F.A.C., the Adult Day Care Rule. (3) Additional Standards. All day care centers, contracted for adult day health care services must meet the following service additional standards: (a) Medical Service. Medical services can be provided by either the personal physician or advanced registered nurse practitioner of the client, a staff physician, or both, and must emphasize preventive treatment, rehabilitation, and continuity of care and also provide for maintenance of adequate medical records. The health needs of clients may be supervised by an advanced registered nurse practitioner in accordance with protocols established in collaboration with the personal physician of the client or the site staff physician. Revised 6/13/01 Revision No. 01 PSMAI No. CAO? Contract No. KG047 2& 7/1/2001 Revised 6/13/01 Revision No. 01 Community Care for Disabled Adults Adult Services Program (b) Medical Therapeutic/Rehabilitative Services. Medical therapeutic/rehabilitative services appropriate to the needs of the client must be provided by a contractor or by on-site staff. 1. Physical therapy. Progress notes must be written in the client's medical record, at least quarterly, and signed by the physical therapist. 2. Occupational therapy as an adjunct to treatment of patients with physical and mental limitations. Progress notes must be written in the client's medical record, at least quarterly, and signed by the occupational therapist. 3. Speech pathology/audiology for clients with speech and language disorders. Progress notes must be written in the medical record of the client, at least quarterly, and signed by the speech therapist. (c) Social Work Services. Social work services to assist with personal, family and other problems that interfere with the effectiveness of treatment must be provided to clients and their families. These services will be provided by the social work staff employed by the Adult Day Care Center and are not to be confused with the case management responsibilities of the CCDA case manager. [The CCDA case manager will complete the functional assessment of the client, will counsel in the development of a service plan, will arrange for services, and will provide ongoing monitoring of the client's situation to ensure that needed services are received]. (d) Nutritional Services. The administrator must designate a staff person to be responsible for the daily operation of the food service. The program must meet the following criteria: 1. Provide a minimum of one meal per day to participants attending or in transit to the center for four or more hours daily. Meals are to be of suitable quality and quantity and meet at least one third of the current Recommended Dietary Allowance (RDA) established by the Food and Nutrition Board, National Academy of Sciences, and the National Research Council, adjusted for age, sex, and activity. PSMAI No. CA07 Contract No. KG047 27 711 /200 I COl,....unity Care for Disabled Adults Adult Services Program 2. provide dietary and nutritional education for the client and his family and as adjunct to nutritional services; and 3. ensure that all basic services provided by program aides in this service area are provided under the direct su'pervision of the staff person responsible for the service. (e) Recreational and Social Activities. Planned recreational and social activities must be provided by an individual with specialization in therapeutic recreation. Such services must be suited to the needs of the clients and designed to encourage physical exercise, to prevent deterioration, and to stimulate social interaction. All basic services provided by program aides must be provided under the direct supervision of the recreation therapist. The registered recreation therapist may be retained as a consultant. (f) Transportation Services. Transportation from home to center and return must be a function of the program. If the center does not provide transportation directly, arrangements for day care participants needing transportation must be established. The client's physicallimitation(s) must be considered when planning for transportation. Wheelchair clients may require an appropriately equipped vehicle. There must be an escort on a bus or van to assist persons in getting on and off the vehicle when needed. (g) Operational Requirements. Each center must provide services for a minimum of five hours per day, five days per week. Minimum Staffing Standards (1) Staffing Requirements. At least two staff and all staff drivers must have received training in emergency procedures, CPR by an approved instructor and basic first aid. At least one staff person who has passed both First Aid and Cardio-Pulmonary Resuscitation training must be at the site during the designated daily hours of operation. Minimal staffing must consist of: (a) Full-Time Professional Staff. A minimum of two full-time (forty hours per week) professional staff members will be present during all operational hours. Professionals include the center director, assistant center director, social worker, registered nurse, and recreational therapist. Revised 6/1 3/0 1 Revision No. 01 PSMAI No. CA07 Contract No. KG047 2C(; 7/1/2001 Corrllllunity Care for Disabled Adults Adult Services Program (b) Staff/Client Ratio. There will be a minimum of one full-time staff member for every six participants in the center. The owner or operator may be considered in the count when serving in a dual capacity and provided the owner or operator provides direct services ~nd is included in the work schedule for the center. Additional staff will be required as the client population increases maintaining a one-to-six ratio. Clerical staff, accountants, cooks and other non-direct care staff (with the exception of the administrator) will not be considered when calculating the staff/client ratio. (c) Center Director. There will be one full-time professional designated as center director. (d) Assistant Center Director. There will be one full-time professional designated as assistant program director to act in the absence of the center director. (e) Nursing Staff. A registered nurse (RN) or licensed practical nurse (LPN) will be on site during the primary hours of program operation and on call during the hours the center is open. Arrangements will be formalized for obtaining the services of an LPN or RN in anticipation of potential absences, planned and unplanned, of the regular nursing staff. (f) Additional Staff. Direct care staff members, from a variety of fields, will be employed in sufficient number to complete a staffing ration of one full-time staff member for each six clients. (2) Staff appropriate to the services offered below must be on the premises of the center during the designated daily hours of operation. (a) Nursing. Nursing services must include services rendered by registered nurses (RN) or licensed practical nurses (LPN) that work under the supervision of a registered nurse. Such nurses must evaluate quarterly, at a minimum, the particular needs of each client and provide care and treatment, including medication supervision, as indicated. Narrative nursing notes must be entered in the client's medical record at least weekly indicating the individual's progress toward achieving health goals. More frequent notes are required if indicated by the client's condition. Narrative nursing notes should address the client's progress in self care services oriented toward activities of daily living and personal hygiene, and the extent of assistance provided by health care professionalss and program aides in this service area. Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 29 7/1/2001 Community Care for Disabled Adults Adult Services Program (b) Nutritionist. Nutritional services must include dietary and nutritional education and must be provided under the supervision of a dietitian who meets licensure and certification as set forth in 58A-6, F.A.C. (c) Social Worker. Minimum qualifications for this position must meet licensure and certification as set forth in 58A-6, F.A.C. Services provided by program aides in this service area must be provided under the direct supervision of a social worker. (d) Occupational Therapist. Minimum qualifications for this position must meet licensure and certification as set forth in 58A-6, F.A.C. (e) Speech Therapist. Minimum qualifications for this position must meet licensure and certification as set forth in 58A-6, F.A.C. (f) Physical Therapist. Minimum qualifications for this position must meet licensure and certification as set forth in 58A-6.01 (6)(c)1., F.A.C. (g) Center Director. Minimum qualifications for this position must meet licensure and certification as set forth in 58A-6, F.A.C. (3) Additional Major Functions and Duties of the Center Director. Major Functions and Duties, additional to those outlined in Chapter 58A-6, Florida Administrative Code: (a) Recruits, screens and trains staff of facility. (b) Plans and provides organized programs of pre-service and in- service training for staff. (c) Interprets policies and procedures to staff and clientele. (d) Ensures integration and coordination between program and appropriate community resources. (e) Maintains close supervision of staff in the following areas of operation: secretarial and bookkeeping; housekeeping; maintenance; transportation; food services; consulting services; and direct services. (f) Evaluates the performance of each staff member. Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 ;?JJ 7/1/2001 Community Care for Disabled Adults Adult Services Program (g) Assures accurate and timely completion of all records and reports, including those required for the Client Information System (CIS); maintains program statistical data and records as required. (h) Special Requirement. This is an eligible service for clients who are included within the 2176 Medicaid Waiver Projects (coded 17). Reporting must comply with the 2176 Medicaid procedures. Case Management (1) Case management is a client centered series of activities which includes planning, arrangement for and coordination of appropriate community-based services for an eligible Community Care for Disabled Adult client. (2) Case management is an approved service, even when delivered in the absence of other services. Case management includes intake and referral, comprehensive assessment, development of a service plan, arrangement for service and monitoring of client's progress to assure the effective delivery of services and reassessment. (3) A unit of service is one hour of elapsed time involved in the above described case management activities. Recommended Staffing and Caseload Standards The average caseload should not exceed fifty-five cases per full-time CCDA case manager, unless approved by the district office. A caseload consists of those clients determined eligible and receiving case management. Minimum Qualifications (1) Contract Service Providers. Case managers must possess a Bachelor's degree in social work, sociology, psychology, nursing, or related field. Other directly related job education or experience may be substituted for all or some of these basic requirements upon approval of the district office. (2) DCF Staff. DCF case managers must be qualified as described by departmental job specifications. Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 sf 711/200 I Community Care for Disabled Adults Adult Services Program (b) Tasks to be accomplished will be determined by evaluating the health and well being of the client, and the capability of chore service staff. (c) Specific chore tasks, for example shopping or err;:mds, may be scheduled at regular intervals, if needed. (d) Procedures must be developed for chore service workers who will handle the client's money. (e) Chore services may include tasks such as those listed in the service definition, as well as the installation or adjustment of simple door locks and other basic security devices. (f) Chore services may be provided by homemaker or other staff, as long as the worker performing the dual function meets the chore job description and qualifications. When one employee provides multiple services, individual tracking documentation must be maintained for each service. For instance, if a staff person makes a two hour visit to a client's home and performs an hour of chore and an hour of homemaker tasks, the time must be recorded as one hour of homemaker and one hour of chore services rather than two hours of each service, or two hours of only one or the other. (3) Training Requirements: Contract Service Providers or Volunteers Revised 6/13/01 Revision No. 01 (a) Pre-Service Training. Staff or volunteers providing this service must receive at least three hours of training in the following areas: 1. Safety and home accident prevention; 2. Procedures for handling client's money (if chore-worker handles money); 3. Client confidentiality; 4. Program policies and procedures; 5. CCDA purpose and philosophy; 6. Emergency procedures in the event of a crisis during the course of work; PSMAI No. CA07 Contract No. KG047 5.3 7/1/2001 Community Care for Disabled Adults Adult Services Program (c) Client must have, or be willing to arrange for, any special provisions needed for installation, such as private line telephone service. (d) Client must be mentally and physically able to use the equipment appropriately. (3) Service Tasks. The service provides a means of responding to an emergency situation arising in the home setting involving a disabled adult. It does not provide emergency services, but rather contacts the appropriate personnel who will provide emergency services. (a) Program requires operating a 24-hour, community-based personal emergency response system designed particularly for functionally impaired persons living in the community. (b) Providers will purchase, rent or lease equipment that meets the attached specifications and arrange for installation, training and maintenance of the equipment. Batteries and telephone jack installation fees are costs incurred by the client, unless there is an inability to pay for these expenses. It is allowable for the provider to purchase batteries and pay for installation if the client cannot pay. (c) Providers will designate an emergency response center where emergency signals are responded to according to a specified operating protocol. (d) Providers will ensure that client, signal activity, and service records are maintained either by the provider or the response center. (e) Providers will arrange monthly phone calls to each client's home to test system operation, update records and provide direct client contact. (f) Operational and technical manuals and training will be provided to appropriate agency personnel. (g) The provider or contracting agency will receive detailed manuals from the emergency response equipment vendor relating to operational aspects of the system including technical specifications, installation, testing and field coordination. (h) The emergency response center will receive detailed manuals relating to operational aspects of the system including physical arrangement of equipment, installation of all elements, testing Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 '3) 7/1/2001 Revised 6/13/01 Revision No. 01 Community Care for Disabled Adults Adult Services Program (a) Client must need the above described service in order to achieve a specific goal which will help them to function more independently. (b) Client must show measurable improvement in social, interpersonal, and communication skills through the provision of this service in order to continue to be eligible to receive the service. Scope of Service (a) Group activity therapy may only be provided by a professional staff person with demonstrated abilities in group dynamics and skill in conducting the above described group activities. (b) Group activity therapy should provide an arena in which clients in need of service can increase their success in social interaction, communication, and interpersonal functioning. (c) Group activity therapy is not considered a psychiatric service where medical treatment in the form of group therapy is provided. Training Requirements (a) Pre-Service Training. A total of ten hours per year is required for contract service providers and DCF staff. The following topics should be included: 1. CCDA Program and purpose; 2. Local service providers and community resources; 3. Medical and psychological aspects of disability; 4. Group therapy and group dynamics; 5. Communication skill building activities; 6. Recreational activities for the disabled client; 7. Interpersonal and social skill building activities. PSMAI No. CA07 Contract No. KG047 3q 711/200 I Community Care for Disabled Adults Adult Services Program (b) In-Service Training. Staff providing group activity therapy must be scheduled for in-service training to augment and/or refresh their knowledge. A minimum of six hours per year will be scheduled for in- service training. Content, duration, and documentation of .attendance must be on file in the agency and staff records. Home Delivered Meals (1) A home delivered meal is a hot or other appropriate, nutritionally sound meal that meets one-third of the current daily recommended dietary allowances (RDA) served in the home to a disabled person. (2) The unit of service is one meal delivered. Scope of Service The CCDA service criteria will be met if the meals are provided by a contractor who is approved to provide home delivered meals that are funded by Older Americans Act (Title III-C), or Community Care for the Elderly (CCE). The CCDA program cannot claim commodities or cash-in-lieu of commodities, if subcontracting with a Title III-C-2 provider. Training Requirements (a) Pre-Service. All contract service providers and DCF staff (volunteers or paid) involved in home-delivered meals service, whether in meal preparation or delivery, must receive pre-service training. Training will be appropriate to respective job duties and responsibilities and must minimally provide instructions for performing assigned tasks. If staff or volunteers have received prior equivalent service training, this training can be substituted for part or all of the required hours for pre- service training. (b) In-Service. In-service training for all staff involved in home- delivered meals service will be regularly scheduled. Minimum in- service training must be six hours per year with attendance, content and hours documented in agency and staff records. Special Conditions Revised 6/13/01 Revision No. <0 1 PSMAI No. CA07 Contract No. KG047 31 7/1/2001 Community Care for Disabled Adults Adult Services Program (1) Food Service Contract Provisions. Revised 6/13/01 Revision No. 01 (a) Food service contracts are defined as contracts for the purchase of meals or portions of meals or for food preparation. (b) All recipients of awards must adhere to the standards set forth in this manual. (c) Written specifications for food service contracts must be approved by the district program office prior to solicitation of bids for such contracts. (d) Specifications for bids, and terms and conditions of the proposed contracts, must establish methods and responsibilities for each of the following: 1. Delivery. a. Transportation: trucks, vans. b. Delivery sites: number and location. c. Delivery schedule: (1) Number of days each week; (2) Hour of delivery for each site. d. Types of containers for bulk food delivery, if applicable. e. Types of containers for individual service. f. Return of containers: (1) How and by whom. (2) Condition (washed, sterilized, etc.). 2. Menus. a. Written by whom. b. Approved by whom. PSMAI No. CA07 Contract No. KG047 LiD 7/1/2001 Revised 6/13/01 Revision No. 01 Community Care for Disabled Adults Adult Services Program c. Compliance with required meal pattern and other standards required herein. d. CCDA program person responsible for receipt and review of menus at least 5 weeks in advance of service. e. Approval of substitutions on menus. 3. Sanitation. a. Compliance with federal, state and local regulations. b. Food preparation facility inspection within previous 6 months. c. Delivery standards: (1) Temperature maintenance; (2) Sanitary conditions. 4. Inspections. Inspection of food preparation, packaging and storage areas by the department. 5. Food. a. Number of meals: (1) Provision for flexibility; (2) Time limits for ordering amounts of food. b. Cost schedule. c. Food purchased by whom. d. Food provided: entree, vegetable, fruit, milk, dessert, juice, salad, beverage, cream (or substitute), condiments, butter or margarine. e. If foods do not meet proper specifications, the department will not be required to pay. PSMAI No. CA07 Contract No. KG047 '-tl 7/1/2001 Community Care for Disabled Adults Adult Services Program f. If the caterer fails to deliver a meal or any portion of meals, the department will procure food from other sources at the caterer's expense. 6. Administration. a. Sales tax exemption. b. Caterer's financial records open for audit. c. Supply information for nutrition reporting on labor and raw food costs. d. Insurance coverage. e. Bonding. f. Food cost changes. g. Length of contract. h. Approval by PDAA. I. Dates/times of contract payments to contractor. j. Holidays and other days when meals are not to be served. (e) All proposed food service contracts with profit-making organizations must be submitted for prior approval by the district. (2) Insurance. It is strongly recommended that food service providers have adequate liability insurance coverage, including product liability. Home Health Aide (1) Home health aide service means health or medically-oriented tasks furnished to an individual in his or her residence by a trained home health aide. The home health aide must be employed by a licensed home health agency and supervised by a licensed health care professional who is an employee or contractor of the home health agency. Revised 6/13/01 Revision No. .01 PSMAI No. CA07 Contract No. KG047 Lf2 711/2001 Community Care for Disabled Adults Adult Services Program (2) The unit of service is one hour (or quarter hour portion) of time spent performing designated home health aide services. It does not include time spent in transit, but rather is the time spent providing services to the client. (3) This is a health maintenance service as defined by Section 410.603(4), F.S. It lists those routine health service(s) necessary to help maintain the health of a disabled adult. Eligibility to Receive Home Health Aide Services The client's medical supervision is under an established plan of treatment. A plan of treatment means a written instruction provided by the attending physician for the provision of health care to a disabled adult in his or her home. Service Tasks (a) The home health aide will perform only those activities contained in a written assignment by a health care professional. (A health care professional is any person who has completed a course of study in a field of health care, such as a nurse. The person is usually licensed by a governmental agency, such as a board of nursing, and becomes registered or licensed in that health care field. In some instances, the person is certified by a state regulatory body, such as with a certified nurses' aide.) Home health aide activities include assisting the patient with personal hygiene, ambulation, eating, dressing and shaving. (b) The home health aide may perform other activities as taught by a health professional employee for a specific patient. These include and are limited to: assisting with the change of a colostomy, ileostomy or urestomy bag; a shampoo; the reinforcement of a dressing; assisting with the use of devices for aid to daily living (i.e. walker, wheelchair); assisting with prescribed range of motion exercises which the home health aide and the patient have been taught by a health professional, assisting with prescribed ice cap or collar; doing simple urine tests for sugar, acetone or albumin; measuring and preparing special diets; measuring fluid intake and output; and supervising the self- administration of medications. This supervision means reminding clients to take medications, opening bottle caps for clients, reading the medication label to clients, observing clients while taking medications, checking the self-administered dosage against the label of the Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 y-~ 711 /200 I Revised 6/13/01 Revision No. 01 Community Care for Disabled Adults Adult Services Program container and reassuring clients that they have obtained and are taking the correct dosage. (c) The home health aide will not: change sterile dres~ings;irrigate body cavities, such as an enema; irrigate a colostomy or wound; perform a gastric lavage or gavage; catheterize a patient; administer medications; apply heat by any method; care for a tracheotomy tube; administer eye drops; or any personal health service which has not been included by the professional nurse in the patient care plan. (d) The home health aide must keep records of personal health care activities and the hours spent performing the tasks. (e) The home health aide will observe appearance and gross behavior changes in the patient and report any changes to the professional nurse. (f) The home health aide patient services must be evaluated by a health professional staff person at least every two weeks in the home for the purposes of observing service delivery and the status of the client. (g) The agency must maintain a ratio of at least one health professional employee for every five nonprofessional persons providing health services. When full-time equivalents are used in the case of part-time nonprofessional persons providing health services, the actual number of such persons supervised must not exceed twelve clients. (h) This service must be provided in compliance with Chapter 59A- 8, F.A.C., Home Health Aide. Service Criteria (a) The plan of treatment will be established and reviewed by the attending physician in consultation with agency staff involved in giving service to the patient, at such intervals as the severity of the patient's illness requires, but in any instance, at least every 60 days and shall include, but not be limited to the following: 1. 2. Diagnosis; Types of services and equipment required; PSMAI No. CA07 Contract No. KG047 YY- 7/1/2001 Community Care for Disabled Adults Adult Services Program 3. Specific frequency of visits such as two times a week or three times a week; 4. Activities permitted; 5. Diet; 6. Medications and treatments; 7. Dated signature of the physician. (b) Assessment of the need for home health aide services must be made by the case manager. A service plan must be developed, specifying frequency and duration of service, and formulated with the nurse supervisor, physician, licensed physical therapist, or licensed occupational therapist prior to the delivery of service. (c) A registered nurse, either paid or volunteer, must be on staff or under contract as a consultant to make home visits to each client at least every two weeks. The registered nurse will supervise the home health aides, assess whether the service plan is being carried out properly, attend or provide in-service training, review reports and records, and assist in employee performance evaluations. (d) The home health aide records services rendered during each visit, completes time and attendance records, participates in performance evaluations, prepares incident reports as the need arises, and attends pre-service and in-service training. (e) The service provider must develop emergency procedures to be followed in the event of a crisis during the course of care. (f) Home health aide care will not substitute for care provided by a registered or practical nurse, or a licensed therapist. Training (a) Pre-Service. The home health aide must have training in supportive services, which are required to provide and maintain bodily and emotional comfort, and assist the patient toward independent living in a safe environment. If the aide receives training through a vocational school, licensed/certified home health agency, or hospital, the curriculum will be documented. If training is received through the Revised 6/13/01 PSMAI No. CA07 Revision No. 01 Contract No. KG047 If> 7/1/2001 Community Care for Disabled Adults Adult Services Program agency, the curriculum will consist of at least forty-two hours, which include: 1. Role of the home health aide, differences in families, ethics, and orientation to the agency (two hours); 2. Physical appearance and personal hygiene (one hour). The following topics should be included: uniform; hair; hands and fingernails; cleanliness; teeth; makeup; perfume; jewelry and smoking; 3. Supervision by a registered nurse, registered physical therapist, occupational therapist, registered speech therapist (three hours). The following topics should be included: role of the supervisor; role of the aide; role of the physician; role of the patient; plan of care; assignment of tasks; record keeping; and performance evaluation; 4. Personal care services (twenty-four hours), to include the following topics; bathing; dressing; toileting; feeding (eating); bed making; ambulation; body mechanics; transfer techniques; range of motion and exercises; 5. Nutrition and food management (four hours), to include the following topics: basic food requirements; purchasing of food; preparation of food; storage of food; serving of food; and special diets; 6. Household management (two hours), to include the following topics: care of bedroom, bathroom, kitchen; care of clothing; and safety in the home; 7. Emotional aspects of disability, including death and dying (six hours); 8. If staff or volunteers have received prior equivalent service training, this training can be substituted for part or all of the required hours of pre-service training. The personnel file of the staff member or volunteer must include documentation of the prior training. (b) In-Service. In-service training for contract service providers, DCF staff and home health aides must be regularly scheduled to augment or refresh the home health aide's knowledge in any of the Revised 6/13/01 PSMAI No. CA07 Revision No. 01 Contract No. KG047 ~(p 7/1/2001 Community Care for Disabled Adults Adult Services Program above listed areas. A minimum of six hours per year is required; staff records must be documented to indicate training provided. Homemaker Service (1) Homemaker service means the performance of or assistance in accomplishing specific home management duties including housekeeping, meal planning and preparation, shopping assistance, and routine household activities by a trained homemaker. With district approval, it may include the purchase of home and/or cleaning supplies needed for the delivery of services. Otherwise, clients are responsible for purchasing their own cleaning supplies. (2) The unit of service is one hour (or quarter hour portion) of time spent in the provision of designated homemaker duties by a trained homemaker. It does not include time in transit to and from the client's place of residence except when providing shopping assistance, performing errands or other tasks on behalf of the client. If the service is to be provided to a couple, the unit of service must be assigned to either the eligible husband or wife, preferably the one who usually performs homemaking duties. Service Tasks (a) Meal planning and preparation; (b) Housekeeping; (c) Laundry; (d) Clothing repair; (e) Minor home maintenance. (e.g. changing light bulbs); (f) Shopping assistance; (g) Assistance with budgeting and paying bills; (h) Client transportation, if permitted; (i) Record keeping as required; U) Reporting changes in client condition or behavior, to supervisor; PSMAI No. CA07 Contract No. KG047 Revised 6/13/01 Revision No. 01 Lf7 7/1/2001 Community Care for Disabled Adults Adult Services Program (k) Following established emergency procedures. *Restrictions on homemaker activities: 1. Must not engage in work that is not specified in the homemaker assignment; 2. Must not accept gifts from clients; 3. Must not lend or borrow money or articles from clients; 4. Must not perform services requiring a public health nurse, a home health aid, or personal care worker to perform; 5. Must not handle money unless authorized by supervisor or case manager and bonded or insured by employer; 6. Must not transport the client unless authorized by supervisor or case manager. Service Provision Log. The homemaker is required to fill out a client service provision log. Any form used must record the following: the date of the visit; activities performed during the visit, and number of hours spent performing the activities. Training Requirements (a) Pre-Service. A total of twenty hours are required covering the following: CCDA program and purpose; medical and psychological aspects of disability; interpersonal relationships; nutrition and meal preparation; marketing and food storage; use of household equipment and supplies; planning and organizing household tasks; principles of cleanliness and safety of the home; record-keeping; agency policies and procedures; and emergency procedures. (b) If staff or volunteers have received prior equivalent service training, this training can be substituted for parts or all of the required hours of pre-service training. The personnel file of the staff member or volunteer must include documentation of the prior training. Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 Lt8 7/1/2001 Comlllunity Care for Disabled Adults Adult Services Program Home Nursing Services (1) Home nursing service is part-time or intermittent nursing care administered to an individual by a licensed professional or practical nurse or advanced registered nurse practitioner, as defined in Chapter 46'4, F.S., in the place of residence used as the individuals home, pursuant to a plan of care approved by a licensed physician. (2) The unit of service is one hour of client contact by the advanced registered nurse practitioner or the licensed practical nurse. (3) This is a health maintenance service as defined by Section 410.603(4), F.S. It lists those routine health service(s) necessary to help maintain the health of a disabled adult. Eligibility to Receive Home Nursing Services (a) A physician's prescription/plan of treatment is required to obtain home nursing services. A request for continuation of services, signed by a physician, is required at sixty-day intervals. (b) Funding sources inclusive of, but not limited to, Medicare, Medicaid and third party payment must be exhausted prior to utilization of CCDA funding for provision of home nursing services. Service Tasks (a) Home nursing provides services that assist the client in his/her efforts to maintain an optimal level of health of body and mind. (b) Home nursing assists the client to prevent the occurrence or progression of illness, thus decreasing the frequency of hospitalizations. (c) Home nursing can be rendered through a home health agency, or provided by an independently practicing registered nurse, a registered nurse employed by a county health unit, or an independently practicing licensed practical nurse working under the direction of a registered nurse. (d) Nursing service shall not be rendered in hospitals or skilled or intermediate care facilities. Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 <-j~ 711 /200 I Community Care for Disabled Adults Adult Services Program (e) Nursing services rendered in the home shall include observation, assessment, nursing diagnosis, care, health teaching and counseling, maintenance of health, prevention of illness, administration of prescribed medications and treatments, and the supervision and teaching of others in the performance of nursing tasks. Training Requirements (a) Pre-Service. A provider of home nursing services must hold a license, in good standing, to practice professional or practical nursing in the State of Florida. (b) In-Service. In-service training requirements can be met through attendance at professional meetings/conferences and/or completion of required course work for continuation of registration or licensure status. A minimum of six hours of meeting attendance, course work or other training related to the job function must be obtained per year; content and duration must be documented in staff and agency records. Interpreter Service (1) Interpreter service is assisting a client to communicate despite a hearing or speech impairment or language barrier. (2) A unit of interpreter service is one hour spent in providing interpreter service to and/or for a client. It does not include time spent in transit to and from a client's home or service provider, but rather is the time spent in interpreting for the client. Eligibility to Receive Interpreter Services (a) Client must have communication barrier significant enough to prevent him or her from effectively and accurately receiving or giving information. (b) Client must not be able to secure the service from his or her own support system. Scope of Service (a) Interpreter service is to be used to free clients from significant barriers to communication. Barriers: language and deafness. Revised 6/13/01 PSMAI No. CA07 Revision No. 01 Contract No. KG047 so 711 /200 I Community Care for Disabled Adults Adult Services Program (b) Interpreter service should be used to assist clients to access community resources, medical services, or social security, disability, or other governmental agency resources. Training Requirements (a) Interpreters for the deaf must have one of the following nationally or state recognized certifications: comprehensive skills certified, interpreting certified, trans-literator certified, or QA screened level 3. (b) Language interpreters must be sufficiently proficient in the languages to be translated. Medical Equipment/Supplies (1) The purchase of medical equipment/supplies for use by CCDA clients is allowable under the CCDA program. Medical equipment/supplies may be durable, such as walkers, wheelchairs, bedside commodes, etc., or it may be non-durable, such as Chux bed pads, colostomy supplies, adult diapers, etc. Durable equipment should be loaned and returned to the program when the client no longer needs it, so that others may use it. Non-durable equipment/supplies are not to be reused. Expenditures of more than $100.00 are to be approved by the district before purchase. (2) There is no measurable "unit" of service for this category. Instead, providers are requested to maintain documentation regarding the expenditure of CCDA funds for this service. The following information should be tracked: (a) Description of the kinds of equipment requested and needed, and, how many requests were received for each (annually); (b) Of the requests documented, how many received the needed equipment (annually); (c) Itemization of durable equipment purchased: description, quantity, and price per item (annually); (d) Number of clients utilizing each type of durable equipment purchased (annually); Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 iiI 7/1/2001 Community Care for Disabled Adults Adult Services Program (e) Itemization of non-durable equipment purchased: description, quantity, and price per item (annually); (f) Number of times non-durable equipment and supplies was given to CCDA clients. Scope of Service (a) The purchase of medical equipment/supplies should be used only as the last resource to provide the client with needed items. (b) The purchase of medical equipment/supplies can include both durable and non-durable equipment. Durable equipment should be loaned to clients so that more than one person may use the equipment. Medical Therapeutic Services (1) Medical Therapeutic Services are those corrective or rehabilitative services which are prescribed by a physician or nurse practitioner licensed in the State of Florida, provided by a professionally licensed, registered or certified professional and are designed to assist the disabled person to maintain or regain sufficient functional skills to live independently in the least restrictive environment possible. (2) Such therapies are necessary services for individuals who have suffered physical damage or debilitation due to disease or trauma and may include occupational therapy, physical therapy and services for individuals with speech, hearing and language disorders. (3) The unit of service is one hour of client contact by the health professional in the client's place of residence or facility where the service can be provided (e.g., hospital outpatient rehab center). (4) This is a health maintenance service as defined by Section 610.403(4), F.S. It lists those routine health service(s) necessary to help maintain the health of a disabled adult. Eligibility to Receive Medical Therapeutic Services (a) A physician or nurse practitioner, or speech, occupational, or physical therapist, must prescribe the needed services. A request for Revised 6/13/01 PSMAI No. CA07 Revision No. 01 Contract No. KG047 tJz 7/1/2001 Com,.lunity Care for Disabled Adults Adult Services Program continuation of services, signed by one of the professionals named above is required at sixty day intervals. (b) A client receiving like services under another prowam component will not be regarded as eligible for duplicative medical therapeutic services, for example, a recipient of physical and occupational therapy while in an adult day care program will not be eligible for duplicative services in his/her place of residence or at a provider facility, unless the frequency of treatment(s) required does not correspond with the frequency of attendance at day care. Scope of Service (a) Services shall include occupational therapy, physical therapy, speech pathology and audiology. Definitions for these therapies may be found in the glossary. (b) Payment for supplies and equipment deemed by the therapist or physician as reasonable and necessary to the success of the treatment rendered to the client, will be eligible under this program in accordance with district program budgets. All resources will be exhausted prior to the utilization of CCDA funds for the purchase of supplies or equipment for medical therapeutic services. THE CCDA PROGRAM SHALL BE THE PROVIDER OF LAST RESORT. Education and Training Requirements. Any provider of a medical therapeutic service must hold current registration, certification or license to practice in the State of Florida in the designated area of the services to be provided. (a) Pre-Service. None is required. (b) In-Service. In-service training requirements can be met through attendance at professional meetings/ conferences and/or required course work for continuation of registration, certification or licensure status. A minimum of six hours of meeting attendance, course work or other training related to the job function must be obtained per year; content and duration must be documented in staff and agency records holding documentation of the employee's professional qualifications. Personal Care Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 53 7/1/2001 Community Care for Disabled Adults Adult Services Program (1) Personal care means services to assist the disabled adult with bathing, dressing, ambulation, housekeeping, supervision, emotional security, eating, supervision of self-administered medications and assistance with securing health care from appropriate sources. Personal care services do not include medical services. (2) A unit of service is one hour (or quarter hour) of elapsed time spent in providing designated personal care services by a qualified personal care aide. It does not include time spent in transit to and from the client's home. (3) This is a health maintenance service as defined by Section 410.603(4), F.S. It lists those routine service(s) necessary to help maintain the health of a disabled adult. Service Tasks. The personal care aide will perform such tasks as: (a) Assisting the client with personal hygiene, dressing, feeding, or transfer or ambulatory needs, including use of wheelchair, crutches, walker; (b) Assisting with toileting and/or use of a bedpan; (c) Assisting the client with self-administered medications when ordered by the client's physician, and as prescribed in the personal care plan. The personal care aide may not administer the medication, but may bring the medication to the client and remind the client to take the medication at a specific time; (d) Assisting with food, nutrition and diet activities including preparation of meals when essential to good health; (e) Performing household services such as changing bed linens when the performance is essential to good health; (f) Accompanying the client to clinics, physician office visits, or other trips when health care needs require personal care assistance. Service Task Restrictions: (a) A registered nurse, either paid or volunteer, must be on the staff or under contract to make home visits to supervise personal care aides at least every 60 days. The registered nurse will assess whether activities in the service plan are being carried out properly; attend or provide in-service training; review reports and records; and conduct or Revised 6/13/01 PSMAI No. CA07 Revision No. 01 Contract No. KG047 c:)'1 7/1/2001 Comlllunity Care for Disabled Adults Adult Services Program 6. Household management (2 hours), to include: care of bedroom, bathroom, kitchen, care of clothing and safety in the home. 7. Physical, mental, and social aspects of disability; social aspects of death and dying (2 hours). (b) If staff or volunteers have received prior equivalent training, it may be substituted for part or all of the required hours of pre-service training. The personnel file of the staff member of volunteer must include documentation of the prior training. (c) In-Service Training. Staff providing personal care must be regularly scheduled for a minimum of 6 hours in-service training per year; training must be documented in staff records. Physical and/or Mental Examinations (1) CCDA funds may be used to purchase the services of a physician, psychologist, psychiatrist, or mental health professional in order for a CCDA client to receive needed medical or mental health services. (Use the departments approved fee schedule.) (2) A unit of service is measured in episodes, with one episode (one unit) defined as one examination, either physical or mental, made by one physician, psychologist, or mental health professional. (3) This is a health maintenance service as defined by Section 410.603(4), F.S. It lists those routine health service(s) necessary to help maintain the health of the disabled adult. THE DPOAA MUST APPROVE EACH EXAMINATION BEFORE SERVICES ARE RENDERED. Scope of Service. Physical and mental examinations should be provided for the purpose of evaluation, rather than extensive treatment provided over time through numerous examinations. Training Requirements. (a) Pre-Service Training. A provider of physical or mental examinations must hold a license in good standing to practice medicine, or to conduct psychological examinations, or in the case of Revised 6/13/01 PSMAI No. CA07 Revision No. 01 Contract No. KG047 )"~ 7/1/2001 Community Care for Disabled Adults Adult Services Program professional mental health counseling, must be certified as a mental health professional. (b) In-Service Training. There are no in-service training requirements. Respite Care (1) Respite care means relief or rest for a caregiver from the constant supervision, companionship, therapeutic and personal care on behalf of the client for a specified period of time. The purpose of the service is to maintain the quality of care to the client for a sustained period of time through temporary, intermittent relief of the primary caregiver. (2) The unit of service is one hour or quarter hour of elapsed time spent in the provision of respite care services by a qualified worker. Scope of Service (a) Respite care may be provided for up to 240 hours per client per calendar year depending upon individual need. The service may be extended up to 360 hours as recommended by the client's case manager and with documented approval by their immediate supervisor. The service may be provided during a concentrated period or spaced throughout the year. Additional hours may be approved by the district on a case by case basis. (b) The case manager will determine the level and intensity of care required by a client. The case manager may obtain consultation from other service providers, the client's family, caregiver, physician, or nurse to determine the appropriate level of respite care needed. (c) Respite care will not be substituted for the care usually provided by a registered nurse, licensed practical nurse, or therapist. (d) In-home respite care may be provided by staff qualified as a homemaker, home health aide, personal care worker, sitter or companion, a combination of the above, or a trained volunteer, provided that service standards are met. Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 <)7 711/200 I Revised 6/13/01 Revision No. 01 Community Care for Disabled Adults Adult Services Program (e) Services provided for respite purposes will be classified as such and not as homemaker, home health aide, personal care services and the like, even though a homemaker or health aide may render the service. (f) Respite care staff must be appropriately supervised. A health or social service professional must be available to supervise and provide in-service training to workers providing the respite services. If, for medical reasons, a home health aide must provide all or part of the respite care services, a registered nurse or health professional must supervise the aide. As an alternative, an agreement may be developed with a visiting nurses association, the Red Cross, or a home health agency, to supervise respite staff. (g) Respite care staff will be adequately trained to respond to a crisis, which may occur during the caregiver's absence. (h) Respite care is to be provided in the client's home in familiar surroundings, however, when a respite caregiver is not available to go to the client's home, respite care may be provided by foster homes, adult congregate living facilities, or nursing homes on a temporary basis. RESPITE CARE SERVICE MAY NOT BE PROVIDED TO RESIDENTS RESIDING IN NURSING HOMES OR ASSITED LIVING FACILITIES. Training Requirements. (a) Pre-Service Training. Staff or volunteers providing this service must receive at least twenty hours of instruction in the following areas: 1. Health problems and care of disabled persons; 2. Basic personal care procedures such as grooming; 3. First aid and handling of emergencies. Formal written emergency procedures will be developed for the respite staff to follow should an emergency occur; 4. Food, nutrition, meal preparation, and household management; 5. If staff or volunteers have received prior equivalent service training, the prior training can be substituted for part or all of the required hours of pre-service training. PSMAI No. CA07 Contract No. KG047 58 7/1/2001 Community Care for Disabled Adults Adult Services Program (b) In-Service. In-service training for respite care workers will be scheduled regularly. Minimum in-service training must be provided at least once per year for a total of six hours. Content and,duration must be documented in staff records. Training. Training required is dependent upon level of care provided. If personal care is to be provided, the personal care standards must be met. Education. Education required is dependent upon level of care provided; however, the respite worker must have the ability to read, write, and complete required reports. Transportation (1) Transportation service is the transport of a client to and/or from service providers or community resources. Any transportation essential to the implementation of the service plan is allowable. (2) Transportation service is measured in trips: one trip is defined as one, one-way trip measured from a point of origin to a destination. The following are two examples of measurement: Example #1: Client is taken from home to the doctor's office. 1 trip Client is taken from the doctor's office to the drug store. 1 trip Client is taken from the drug store back home. 1 trip Total # trips this episode: 3 Example #2: Client is taken from home to rehab therapy. 1 trip Client is taken from rehab therapy to the grocery store. 1 trip Client is taken from the grocery store to the drug store. 1 trip Client is taken from the drug store back to the grocery store (forgot eggs). 1 trip Client is taken from the grocery store back home. 1 trip Total # trips this episode: 5 Scope of Service Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 r;q 7/1/2001 Community Care for Disabled Adults Adult Services Program (a) Services will be provided on a demand/response basis. Except for emergencies, clients must request services at least twenty-four hours in advance to facilitate efficient use of vehicles and staff. (b) Existing transportation systems and equipment must be utilized before CCDA funds are used for transportation services. (c) Services may be provided by ambulance, taxicab, common carrier, or provider vehicle. The agency or the vehicle owner must provide excess liability coverage. Transportation services will be provided only by persons having a valid Florida driver's license. If volunteers are used, they must have a valid driver's license. Drivers who transport clients on a regular basis in provider vehicles must have a valid Florida Chauffeurs license. (d) When transporting one or two clients, a driver may act as an escort provided that the case manager determines that the client cannot be left alone while receiving the services, and the client's needs will not interfere with the driver's ability to safely control the vehicle. In such instances, only one or the other may be counted in units of service; transportation trips or escort hours. (e) If the client requires supervision while in the vehicle, which the driver cannot provide, a staff person other than the driver must provide supervIsion. (3) Minimum Service Standards. The following service standards for transportation must be adhered to: (a) Provide services in compliance with federal, state and local rules and regulations issued by the Department. (b) Document that staff personnel and volunteers are fully trained to provide the services offered by the transportation program. (c) CCDA funds may not be used to purchase vehicles. (d) Document that all drivers who transport clients on a regular basis in provider vehicles have: 1. A valid State of Florida Chauffeur License; 2. Minimum of one year driving experience with vehicles similar to those to be operated for the provider; Revised 6/13/01 Revision No. 01 PSMAI No. CA07 Contract No. KG047 &0 711 /200 I Revised 6/13/01 Revision No. 01 Community Care for Disabled Adults Adult Services Program 3. A safe driving record acceptable for insurance coverage; 4. Successfully completed an American Red Cross or similar program. (e) Document that volunteers who drive privately owned automobiles to transport clients meet the minimum requirements set forth in CFOP 125-1, Community ResourcesNolunteer Management.. (f) Obtain and maintain minimum vehicle insurance coverage on all provider owned or leased vehicles in accordance with the Division of Risk Management. (g) All unusual incidents, accidents or problems must be reported to proper authorities and investigated by supervisory staff and records maintained. Training Requirements. (a) Pre-Services Training. A total of 10 hours is required for contract service providers and DCF staff. If staff or volunteers have received prior equivalent training, it can be substituted for parts or all of this requirement. The following topics should be included in the training: interpersonal relationships; operation of vehicle and equipment; accident and emergency procedures in the event something may happen to the client while being transported; and CCDA program and purpose. (b) In-Service Training. Contract service staff providing medical transportation must be scheduled regularly for in-service training to augment or refresh knowledge in any of the above listed areas. A minimum of six hours must be scheduled per year, content and duration documented in agency and staff records. PSMAI No. CA07 Contract No. KG047 ~r EXHIBIT B Fiscal Year 2003-2004 Community Care for Disabled Adults Cumulative Summary Report I. Demographics District: Name of Contract Manager: Phone Number: SC Reporting Period: 3 Month 6 Month 9 Month 12 Month Local II. Expenditures (1) Total CCDA dollars: (2) Total expenditures this quarter: (3) Total expenditures spent to date: (4) Encumbrances *: (5) Balance: III. Report Prepared By: Phone Number: * such as medical equipment, retrofitting, special needs etc. GZ s: o :::J s: -< -l o fii Ul () C m z -l (J) ~ ~~~~~~~~~~~~~~~~~~~~~~~I~~I~~~ o 000000000000000000000:0 olo,olo 00, o 0 0 0 0 0 0 0 0, o. 0 0 0 0,0 0 0 0 0 o~~_C)Lo_C:>.!.~~<?c)._<?:<::l, (J) ; ~ () m ice III ;;0 3 VI < ... CD (5 m. iIt 0 C ~ C Z -.I 0 :::J ::::j en ~ ;::;: (J) ~ s: 0 ::l s: -< ~ CD III Ui Oc o :::J ~~ iIt ~iltiltiltiltiltliltiltiltilt~iltiltilt~iIt~iltliltiltlilt!iltiilt:iltlilt'iIt:iltilt:iIt 0 ~ ~ ~ ~~;~ ~~~i~~ ~ ~ ~i~'~~ ~ ~'~!~'~~I~I~~:~r~~"~ ~ o 0000000000000000000100 0101010!010 0:0 () ;;r o ., CD ~ 0 C (Jl 0 ::l c.n ~ ;::+ ..... ~iltiltiltiltiltiltiltiltilt~iltilt,~~~iItiltilt o 0 0 0 0 0 0 0,0 0 0 0 0 0 0 0 0: 0: o. o 0 0 0 0 0 0 010 0 0 0 0 0 0 0 0 0 0 00000000:000000000-0,0 s: 00 o :::J ~s: -< ~ ~~~~~~~~I~~~~~i~'~~~I~~~i~'~!~1 o 0000000000000000000010010 o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CllC)_!..C)[ 0 ~ p o o :c o 3 CD () ~ () 0 0 :::J :l> ..., 0 s: CD 0 () :::J 0 ... c: ;;r :J -< ... '< (J) c: :J 3 :c 3 0 III 3 .:::! CD ;;0 (J) CD CD S. "0 0 (") ;:4. CD - VI 0 ..., - ;;r CD ~ 0 :::J - ;;r 0 - m X :c OJ ::::j () DEPARTMENT OF CHILDREN AND FAMILIES EXHIBIT 0 OFFICE OF FAMILY SAFTEY MONTHLY REQUEST FOR PAYMENT AND EXPENDITURE REPORT PROVIDER FED. ID # NAME AND MAILING ADDRESS OF PAYEE: CONTRACT AMNT.:_ REIMBURSEMENT YTD.: CONTRACT BALANCE: DATE: CONTRACT#: PERIOD OF SERVICE PROVISION: NAME OF SERVICE UNITS! AMOUNT PER UNIT! TOTAL AMOUNT OR DESCRIPTION OF MATERIALS QUANTITY EPISODE DUE TOTAL TOTAL MATCH REQUIRED PAYMENT FOR CONTRACT: REQUESTED THIS MNTH. YTD. LOCAL CASH MATCH n FLORIDA DEPARTMENT OF LOCAL IN-KIND ~ CHILDREN TOTAL DEDUCTIONS ~I , FAMILIES REMAINING MATCH BALANCE SIGNITURE OF PREPARER APPROVED BY DATE COMPLETED TITLE 'IF THIS INVOICE IS FOR A FIXEO PRICE CONTRACT, THE REQUEST FOR PAYMENT WILL BE DETERMINED BY DIVIDING THE LENGTH OF THE CONTRACT INTO THE CONTRACTED AMOUNT (EX.-S12,OOOIALlOCATlONj DIVIDED BY 12 MONTHS [THE LENGTH OF THE CONTRACT]=S1.000 PAYMENT REQUEST) ON A COST REIMBURSEMENT CONTRACT THE PAYMENT REQUEST WILL BE THE MONTHLY REQUEST EXPENSE. CHILDREN AND FAMILIES USE ONLY DATE INV. RCD. APPROVED BY: DATE IORG AMNT. EO OBJ DESC. IOCA Gf ~LCIH riApREN lS2J & FAMI LI ES EXHIBIT E SECURITY AGREEMENT FORM The Department of Children and Families has authorized you: Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g., printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer crimes are a violation of the department's disciplinary standards and, in addition to departmental discipline, the commission of computer crimes may result in Federal and/or State felony criminal charges. . By my signature, I acknowledge that I have received, read and understand the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Sections 7213, 7213A, and 7431 of the Internal Revenue Code, which provide civil and criminal penalties for unauthorized inspection or disclosure of Federal tax data. . By my signature, I acknowledge that it is the policy of the Department of Children and Families that under no circumstances shall any contract employee be allowed access to IRS tax information. I understand that a security violation may result in criminal prosecution according to the provisions of Federal and State statutes and may also result in disciplinary action against me according to the provisions in the Employee Handbook. I agree to be bound by the provisions of CFOP 50-6. The minimum department security requirements are: . Personal passwords are not to be disclosed. . Information is not to be obtained for my own or another person's personal use. Print Employee's Name Signature of Employee Date Print Supervisor's Name Signature of Supervisor Date (pc) Distribution of Copies: Original - Personnel File/Contract File Copy - Security File Copy - Employee CF 114, JF 08/2001 Florida Department of CHILDREN & FAMI LI ES District 'cking Number (for CRITICAL incidents) 11,66 (COL), 59 (SFETC) YEAR Sequence Code Check if CLOSED Program Code (AS, DA, DD, ESS, FS), MH, SA DISTRICT 11 INCIDENT REPORT EXHIBIT F (Critical incidents must be reported to District Administrator within 24 hours of notification.) CHECK IF CRITICAL 0 [CONFIDENTIAL WARNING: The information contained in this report is confidential. You are hereby notified that dissemination, distribution, or copying of this document is strictly prohibited, unless authorized by the Department of Children & Families. I. IDENTIFYING INFORMATION Reporting Party Phone #: Reporting Party Name District Program Area: Specific Program: Please respond to one of the following as appropriate. a. Contract Provider Name Contract Facility Name (if appropriate) b. Foster Home Name c. DS Home Name d. DCF Facility Name e. Other Name Is this a licensed facility? 0 Yes 0 No 0 Don't know. Specific location/address where incident occurred: Date of Incident / / Time of Incident DCF Unit # Check one box only. 1. 0 Abuse/Neglect/Exploitation 2.0 Altercation 3. 0 Bomb Threat 4.0 Client Injury 0 Illness 5. 0 Client Death 6.0 Contraband DDrugs 7.0 Elopement 8.0 Escape 9.0 Media Coverage 10. 0 Misconduct DCriminal Activity 11. 0 Sexual Battery 12. 0 Suicide Attempt 13. 0 Theft DVandalism DDamage DSabotage 14. 0 Other Incidents 15. 0 Non-Critical Other FIRST Name LAST Name Add SS# if Birth Date Race Gender Client Employee Participant Witness employee or client is a participant _I ---.!_ D D D 0 _1_1- 0 0 0 0 _1_1- 0 D 0 0 _1_1- 0 0 0 0 . ... Give Detailed Account - (Who, What, When, Where, Why, How) - Add Pages If Necessary ,lP Co CONFIDENTIAL V. CORRECTIVE ACTION AND FOLLOW UP Immediate corrective action taken Is follow-up action needed? NOD YEsD If yes, specify: &7 CONFIDENTIAL VI. INDIVIDUALS NOTIFIED EXTERNAL NOTIFICATION Agency Notified Person Contacted Status Date/Time Called Copy Abuse Registry Name Report Accepted 1-800-962-2873 D D ID# Yes D NoD Agency for Health Care Administration Name: N/A D D Law Enforcement-Department Officer's Name I Badge # Case # (if avail) N/A D D ParenUGuardian/ Family Member Name Name: N/A D D Other (Please Specify) Name: N/A D D DCF (for providers only) Name: N/A D D VII. REVIEW AND SIGNATURES NAME SIGNATURE TITLE PHONE # DATE REPORTING / / EMPLOYEE --- SUPERVISOR / / --- l DCF INTERNAL NOTIFICATION Individual/Agency DatelTime Called Copy Individual/Agency Notified DatelTime Called Copy Notified Client Relations D D Employee Safety Program D D District Administrator D D Florida Local Advocacy Committee D D Division Director/ H.R. Workers' Compensation Facility Director D D Coordinator (employee related incidents only) D D District Legal Counsel D D Program Office/Risk Manager D D DS Support Coordinator/Case D D Others - (Please specify) D D Manager EEOC D D Contract Manager VIII. DCF REVIEW AND SIGNATURES IR Liaison Review: NAME SIGNATURE TITLE PHONE # DATE Initial if complete. ADMINISTRATOR / ON CALL MANAGER / / --- DIVISION DIRECTOR/ FACILITY DIRECTOR / / --- (Q g ATTACHMENT I I The administration of resources awarded by the Department of Children & Families to the pi'ovider may be subject to audits as described in this attachment. MONITORING In addition to reviews of audits conducted in accordance with OMS Circular A-133 and Section 215.97, F.S., as revised, the Department may monitor or conduct oversight reviews to evaluate compliance with contract, management and programmatic requirements. Such monitoring or other oversight procedures may include, but not be limited to, on-site visits by Department staff, limited scope audits as defined by OMS Circular A-133, as revised, or other procedures. Sy entering into this agreement, the recipient agrees to comply and cooperate with any monitoring procedures deemed appropriate by the Department. In the event the Department determines that a limited scope audit of the recipient is appropriate, the recipient agrees to comply with any additional instructions provided by the Department regarding such audit. The recipient further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Department of Financial Services or the Auditor General. AUDITS PART I: FEDERAL REQUIREMENTS This part is applicable if the recipient is a State or local government or a non-profit organization as defined in OMS Circular A-133, as revised. In the event the recipient expends $300,000 or more in Federal awards in its fiscal year, the recipient mllst have a single or program-specific audit conducted in accordance with the provisions of OMS Circular A- ] 33, as revised. In determining the Federal awards expended in its fiscal year, the recipient shall consider all sources of Federal awards, including Federal resources received from the Department of Children & Families. The determination of amounts of Federal awards expended should be in accordance with guidelines established by OMS Circular A-133, as revised. An audit of the recipient conducted by the Auditor General in accordance with the provisions of OMS Circular A-133, as revised, will meet the requirements of this part. In connection with the above audit requirements, the recipient shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMS Circular A-133, as revised. The schedule of expenditures should disclose the expenditures by contract number for each contract with the Depat1ment in effect during the audit period. The financial statements should disclose whether or not the matching requirement was met for each applicable contract. All questioned costs and liabilities due the Department shall be fully disclosed in the audit report package with reference to the specific contract number. 03/01/2003 eoq PART II: STATE REQUIREMENTS This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2)(1), Florida Statutes. In the event the recipient expends a total amount of state financial assistance equal to or in excess of $300,000 in any fiscal year of such recipient, the recipient must have a State single or project-specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the Executive Office of the Governor, the Department of Financial Services and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General. In determining the state financial assistance expended in its fiscal year, the recipient shall consider all sources of state financial assistance, including state financial assistance received from the Department of Children & Families, other state agencies, and other nonstate entities. State financial assistance does not include Federal direct or pass-through awards and resources received by a nonstate entity for Federal program matching requirements. In connection with the audit requirements addressed in the preceding paragraph, the recipient shall ensure that the audit complies with the requirements of Section 215.97(7), Florida Statutes. This includes subm ission of a financial reporting package as defined by Section 215.97(2)( d), Florida Statutes, and Chapters 10.550 or 10.650, Rules of the Auditor General. The schedule of expenditures should disclose the expenditures by contract number for each contract with the Department in effect during the audit period. The financial statements should disclose whether or not the matching requirement was met for each applicable contract. All questioned costs and liabilities due the Department shall be fully disclosed in the audit report package with reference to the specific contract number. P ART III: REPORT SUBMISSION Any reports, management letters, or other information required to be submitted to the Department pursuant to this agreement shall be submitted within 180 days after the end of the provider's fiscal year or within 30 days of the recipient's receipt of the audit report, whichever occurs first, directly to each of the following unless otherwise required by Florida Statutes: A. Contract manager for this contract (2 copies) B. Department of Children & Families ASFMI Building 2, Room 301 1317 Winewood Boulevard Tallahassee, FL 32399-0700 03/01/2003 10 C. Copies of the reporting packages for audits conducted in accordance with OMB Circular A-] 33, as revised, and required by Part 1 of this agreement shall be submitted, when required by Section .320(d), OMB Circular A-133, as revised, by or on behalf of the recipient directly to the Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by Sections .320(d)(l) and (2), OMB Circular A-133, as revised, should be submitted tQ the Federal Auditing Clearinghouse), at the following address: . Federal Audit Clearinghouse Bureau of the Census 120 I East 10'h Street Jeffersonville, IN 47132 and other Federal agencies and pass-through entities in accordance with Sections .320(e) and (t), OMB Circular A-133, as revised. D. Copies of reporting packages required by Part II of this agreement shall be submitted by or on behalf of the recipient directly to the following address: Auditor General's Office Room 401, Pepper Building 111 West Madison Street Tallahassee, Florida 32399-1450 Providers, when submitting audit report packages to the Department for audits done in accordance with OMB Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit or for-profit organizations), Rules of the Auditor General, should include, when available, correspondence from the auditor indicating the date the audit report package was delivered to them. When such correspondence is not available, the date that the audit report package was delivered by the auditor to the provider must be indicated in correspondence submitted to the Department in accordance with Chapter 10.558(3) or Chapter 10.657(2) Rules of the Auditor General. PART IV: RECORD RETENTION The recipient shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years from the date the audit report is issued and shall allow the Department or its designee, the Department of Financial Services, or the Auditor General access to such records upon request. The recipient shall ensure that audit working papers are made available to the Department or its designee, the Department of Financial Services, or the Auditor General upon request for a period of three years from the date the audit report is issued, unless extended in writing by the Department. 03/0 I /2003 1(