Item D30
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
MEETING DATE: 4-19-2006
DIVISION: COMMUNITY SERVICES
BULK ITEM:
YES X
NO
DEPARTMENT: SOCIAL SERVICES
AGENDA ITEM WORDING: Approval of the Renewal of the Home Community Based/Medicaid Waiver
(ADA-MW) Case Management Contract between the Alliance for Aging, Inc. and the Monroe County Board
of County Commissioners (Monroe County In-Rome Services Program) retroactive to July 1, 2004.
ITEM BACKGROUND: The approval of the ADA-MW Referral for Case Management will enable
Monroe County In-Home Services to continue providing Case Management services to Monroe County's
elderly population under the Home and Community Based Services/Medicaid Waiver (ADA-MW) program.
There had been negotiations in regards to unit cost, thus no agreement was settled for 2005.
PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to the Horne And Community Based
Medicaid Waver Agreement on August 21,2002
CONTRACT/AGREEMENT CHANGES: N/A
STAFF RECOMMENDATION:
Approval
TOTAL COST: Approx. $300.00
COST TO COUNTY: -0-
BUDGETED:YES-2L NO
SOURCE OF FUNDS: ADA-MW
Referral for Fiscal year 712005 thru 612006
For approx. $300.00
REVENUE PRODUCING: YES
NO X AMT.PER MONTH
YEAR
APPROVED BY: COUNTY ATTY.l OMB/Purchasing
RISK MANAGEMENT -X
DIVISION DIRECTOR APPROVAL:
SHEILA BARKER
DOCUMENTATION:
INCLUDED X
TO FOLLOW NOT REQUIRED
DISPOSITION:
AGENDA ITEM#:
Revised 1 J03
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, Inc. Contract
Effective Date: April 19, 2006
Expiration Date:
Contract PurposelDescription: Approval of the Renewal of the Home and Community Based ~Medicaid Waver
(ADAIMW) Case Management Contract between the Alliance for Aging, Inc. and the Monroe County Board of
County Commissioners (Monroe County In-Home Services Program).
Contract Manager:
Deloris
(Name)
4589
(Ext)
Social Services/Stop 1
(Department/Stop #)
For BOCC meetino on
4/19/2006
Agenda Deadline:
4/4/2006
CONTRACT COSTS
Total Dollar Value of Contract: Approx. $ 300.00
Budgeted? Yes X No Account Codes:
Grant: Approx. $300.00
County Match: $ -0-
Current Year Portion: $
Estimated Ongoing Costs: $
(Not included in dollar value above)
/yr
ADDITIONAL COSTS
For:
(eg, Maintenance, utilities, janitorial, salaries, ell')
CONTRACT REVIEW
Division Director
Date In
Changes
Neede~~'" .
Yes (N~/j
.~.~
Date Out
Risk Management
O.~jPurchasing
""
"1 O~
County Attorney
:7
:J
Comments:
OMB Form Revised 2/27/01 MCr #2
HOME AND COMMUNITY BASED SERVICES
AGED AND DISABLED ADULT (ADA) MEDICAID WAIVER
CASE MANAGEMENT REFERRAL AGREEMENT
Inc. the area agency on aging (AM) for
planning and service area (PSA) 11 and en Yl-t :I:h I-h.:: YV I C
, a case management agency, shall begin on July 1. 2004 or on the te the agreement has been signed
by both parties, whichever is later. This referral agreement is in effect for a period of time that is equal to
the Medicaid waiver provider's enrollment period with the State of Florida's Medicaid fiscal agent and is
contingent upon an annual appropriation by the Legislature. The purpose of this agreement is to enable
eligible elderly participants to receive case management services from qualified providers with oversight
of the quality of care by the Medicaid Waiver Specialist employed by the AAA. These services are
authorized in order that the participant may remain in the least restrictive setting and avoid or delay
premature nursing home placement. Services and care are to be furnished in a way that fosters the
independence of each participant to facilitate aging in place. All parties agree that routines of care
provision and service delivery must be consumer~driven to the maximum extent possible. All parties
agree to and will treat each participant with dignity and respect.
I. Objectives
A, To maintain a climate of cooperation and consultation with and between agencies, in order to
achieve maximum efficiency and effectiveness.
B. To participate together by means of shared information in U,€ development and expansion of
services.
C, To promote programs and activities designed to prevent the premature institutionalization of
elders and disabled adults.
D. The parties of this agreement will provide technical assistance and consultation to each other on
matters pertaining to actual service deUvery and share appropriate assessment information and
care plans so duplication may not occur.
E. To establish an effective working relationship between the case management agency that is
responsible for the development of care plans and authorization of services available under the
waiver, the service provider that is responsible for the direct provision of those services to
consumers served under the waiver program, and the AAA that is responsible for management
and oversight of the waiver program,
II. Under this Agreement, the Area Agency on Aging agrees to the following:
A. To facilitate the enrollment of providers with the Medicaid Fiscal Agent.
B. To ensure the case management agency is an active Medicaid provider prior to serving any
consumer under the Aged and Disabled Adult (ADA) Medicaid Waiver and Assisted Living for
Frail Elderly (ALE) Medicaid Waiver Programs and any other Medicaid Waiver program that may
be approved by the Centers for Medicaid and Medicare Services (CMS) and implemented in the
State of Florida.
C. To provide technical assistance and training to the case management agencies.
D. To provide on site monitoring of the case management agency at least semi~annuaHy.
E. To monitor and project Provider expenditures to assure spending is maintained within
spending authority. .
F. To complete a new referral agreement signed by all parties when unit rate changes are approved.
lI!. Under this Agreement, the Case Management Agency agrees to the following:
A. Assign qualified case managers as contained in the ADA Medicaid Waiver to provide case
management services under the Medicaid Home and Community Based Waiver for Aged and
Disabled Adults. Provider rates shall not exceed the approved negotiated rates that are at or
below the service provider's contracted rates.
B. Develop and implement the Plan of Care specifically outlining the service(s) to be delivered that
1
must be signed by the consumer.
C. Adhere to the federal waiver requirements and policies and procedures outlined in the
following manuals published by the Agency for Health Care Administration: Aged and
Disabled Adult Waiver Guidelines and the Medicaid Provider Reimbursement Handbook
(Non-Institutional 081), including any and all attachments or updates.
D. Provide to the AM a monthly summary of Aged and Disabled Adult Medicaid Waiver
expenditures billed and accrued.
E. Refer consumers to any qualified Service Provider as selected by the consumer.
F. Issue written service authorizations to the service provider with at least 24 hours notice, The
referral will contain at a minimum:
1" Name
2. Address (with directions if not easily accessible)
3. Pertinent information regarding consumer's health or disabilities and living situation
4. Detailed service description including frequency, duration and specific tasks to be
performed.
G. Evaluate quality of services and service documentation by the service provider.
H. Accept financial responsibility for service claims found to be out of camp Hance if the non
compliance was the result of a faflure by the case management agency to update, renew, or
terminate the service authorization.
I, To forward a monthly expenditure tracking report to the area agency no later than the date agreed
upon by both parties.
J. Monitor service providers for adherence to authorized care plans, authorized
reimbursement rates, and to ensure that the service provider is billing only for services authorized
in the care plan.
K. Develop and implement a policy to ensure that its employees, board members, and
management, will avoid any conflict of interest or the appearance of a conflict of interest
when disbursing or using the funds described in this agreement or when contracting with
another entity which will be paid by the funds described in this agreement. A conflict of
interest includes, but is not limited to, receiving, or agreeing to receive, a direct or indirect benefit,
or anything of value from a service provider, consumer, vendor, or any person wishing to benefit
from the use or disbursement of funds. To avoid a conflict of interest, the case management
agency must ensure that all individuals make a disclosure to the AAA of any relationship which
may be a conflict of interest, within thirty (30) days of an individual's original appointment or
placement on a board, or if the individual
is serving as an incumbent, within thirty (30) days of the commencement of the agreement.
L. To submit void or adjustment claims no later than 45 days after either party has identified the
error. The provider's refusal to adjust or void erroneous claims may result in termination of this
agreement and/or referral to the department, and will be referred to the Agency for Health Care
Administration for appropriate action.
M, The AAA may impose department~approved sanctions for non~compliance with items of this
agreement
IV. Under this agreement, the follOWing services will be delivered by the Service provider in
accordance with the plan of care or service authorization:
Service Unit Rate County/Region Served
A. Case ManaQement $45.00/hr
B.
C.
D.
E.
Monroe
2
v. Termination
In the event this agreement is terminated, the case management agency agrees to submit, at the
time notice of intent to terminate is delivered, a plan which identifies procedures to ensure
services to consumers will not be interrupted or suspended by the termination.
A. Termination at Will
This agreement may be terminated by any party upon no less than thirty (30) calendar days
notice, without cause, unless a lesser time is mutually agreed upon by both parties, in writing.
Said notice shall be delivered by certified mail, return receipt requested, or in person with
proof of delivery.
B. Termination Because of Lack of Funds
In the event funds to finance this agreement become unavailable, the area agency may
terminate this agreement upon no less than twenty.four (24) hours notice in writing to the
other party. Said notice shall be delivered by certified mail, return receipt requested, or in
person with proof of delivery, The area agency shall be the final authority as to the
availability of funds.
C. Termination for Breach
Unless a breach is waived by the area agency in writing, or the parties fail to cure the breach
within the time specified by the area agency, the area agency may, by written notice to the
parties, terminate the agreement upon no less than twenty.four (24) hours notice. Said
notice shall be delivered by certified mail, return receipt requested, or in person with proof of
delivery.
VI. Agreement
Not withstanding the effective date as determined in the First Paragraph of this agreement, this
contract is retroactive to July 1, 2004.
In witness whereof, the parties have caused this ~ page agreement to be executed by their
undersigned officials as duly authorized.
Area Agency on Aging
Service Provider
Signature
signature
Steven Weisberg, M.S.
Print name
Charles "Sonny" McCoy
Print name
Mayor
President/CEO
Title
Tille
Date
Date
3
", J ~. '""
f6c'!
HOl\IE AND COl\Il\IIUNITY BASED WAIVER
REFERRAL AGREEMENT
This Referral Agreement, made this 1st day of July, 2002 between Alliance. ff~o~p. ging, the Area
Agency on Aging for Planning and Service Area lL and Monroe County.(~tigJ:l) Service
Provider. This Referral Agreement is in effect for a period of time that is equal to the Medicaid
waiv~r prtY'der's.enrollment period with the Stme ofFlori~a's Medic~id fis~al agent. One purpose
of this agre eot IS to promote the development of a coordmated serVIce delIvery system [0 meet
the needs the aged or disabled adults who are at risk of premature institutionalization. Another
purposeo! this agreement is to enable eligible elderly participants to receive Home and
Community Based Waiver Services from qualified providers with oversight of the quality of care
by the Medicaid Waiver Specialist employed by the Area Agency on Aging. These services are
authorized in order that the participant may remain in the least restrictive setting and avoid or delay
premature nursing home placement. Services and care are to be furnished in a way that fosters the
independence of each participant to facilitate aging in place. All parties agree that routines of care
provision and service delivery must be consumer driven to the maximum extent possible. All
parties agree to and will treat each participant with dignity and respect.
I. Objectives
A. To maintain a climate of cooperation and consultation with and between agencies,
in order to achieve maximum efficiency and effectiveness.
R To participate together by means of shared information in the development and
expansion of services.
C. To promote programs and activities designed to prevent the premature
institutionalization of elders and disabled adults.
D. To require the parties of this Agreement to provide technical assistance and
consultation to each other on matters pertaining to actual service delivery and share
appropriate assessment information and care plans so duplication may not occur.
E. To establish an effective working relationship between the case management
agency that is responsible for the development of care plans and authorization of
services available under the waiver, the service provider that is responsible for the
direct provision of those services to consumers served under the waiver program,
and the Area Agency on Aging that is responsible for management and oversight of
the waiver program.
II. Vnder this Agreement, the Service provider agrees to the following:
A. To accept referrals for the 1915c Home and Community Based Service CHCBS)
Medicaid Waiver from the enrolled case management agency.
B. To provide quality service(s) to the waiver participant as specified in Section IV,
Provision of serVlcets) is subject to quality monitoring and/or observation by the
case management agency andlor the Area Agency on Aging and/or the Department
of Elder Affairs.
C To provide only those services specifically outlined in the Plan of Care and
authorized by the enrolled case management agency,
D. To attach documentation regarding the service provider's qualifications to this
agreement; and to provide. as requested, any information regarding Medicaid
Waiver billing, payment, or waiver participant information, to the case management
agency or Area Agency on Aging. Provider rate increases/decreases must be
forwarded to the Area Agency on Aging along with justification for any increase. If
additional services are to be added to this agreemem, a written request to do so must
. be received by the Area Agency on Aging and an amendment must be prepared by
the Area Agency on Aging listing the added service(s). The necessary
documentation regarding provider qualifications for the additional services must be
attached to the agreement.
E. To maintain the waiver participant's confidentiality according to 42 CFR 431.30l.
F To immediately report any changes in the waiver participant's condition to the case
management agency.
G. To maintain enrolled provider status by renewing applicable licensure, certification,
contract, and/or referral agreements and by maintaining all provider qualifications
as contained in the Aged and Disabled Adult Medicaid Waiver under which
services are provided,
H. To include its name and other appropriate information on a list of all enrolled
providers which will be shown to consumer during development of an
individualized plan of care, understanding that the consumer reserves the right at all
times to a choice of enrolled providers.
1. To immediately notify the case management agency of staffing shortfalls which
will negatively impact provision of service to Medicaid Waiver consumers.
J. To submit claim data for billing to the Medicaid fiscal agent after delivery of
services has been accomplished. All services should be billed within 60 days after
services have been provided or document reasons for delayed submission of claims.
Such documentation shall be available for review by the area agency on agency or
by the Department of Elder Affairs, upon request.
K. To submit claims for billing to the Medicaid fiscal agent at the agency's usual and
customary rate. Ir is a violation of federal regulation to bill Medicaid more than the
agency's usual and customary rate.
L. To submit void or adjustment claims no later than 45 days after the error has been
identified by either party. Any error not adjusted or voided within 45 days may be
adjusted or voided by the Area Agency on Aging. The provider's refusal to adjust
or void erroneous claims will result in termination of this agreement.
Nt To develop and implement a policy to ensure that its employees, board members.
and management, will avoid any conflict of interest or the appearance of a conflict
of interest when disbursing or using the funds described in this agreement. A
conflict of interest includes, but is not limited to, receiving, or agreeing to receive, a
direct or indirect benefit, or anything of value from a service provider, consumer,
vendor, or any person wishing to benefit from the use or disbursement of funds. To
avoid a conflict of interest, the service provider must ensure that all individuals
make a disclosure to the Area Agency on Aging of any relationship which may be a
conflict of interest, within thirty (30) days of an individual's original appointment
or placement on a board, or if the individual is serving as an incumbent, within
thirty (30) days of the commencement of the contract.
N. To adhere to the policies and procedures as outlined in the following manuals
published by the Agency for Health Care Administration: the AgedJDisabled Adult
Waiver Guidelines and the Medicaid Provider Reimbursement Handbook (Non-
Institutional 081), induding any and all attachments or updates.
III. Under this Agreement, the Area Agency on Aging agrees to the following:
A. To facilitate the enrollment of providers with the Medicaid Fiscal Agent.
B. To provide technical assistance and training to Service Providers.
C. To notify the case management agency within 48 hours of any approved service
provider rate adjustment.
D. To regularly monitor the Service Providers in accordance with requirements
specified by the Department of Elder Affairs.
IV. Under this agreement, the following services will be delivered by the Service provider
in accordance with the plan of care or service authorization:
Service
U nit Rate
CountylRegion
Served
A.NUTRITlorr PROG. MEALS
B.''PeIlSLWL COf2Q
c. 6HcQ.e_
D. tt(:ynerrYlKe12-
E. ~ i1.e-
$ 5.00
jl;>46 . DD
...$41.00
-J05,cD
..tt 2Z, 00
MONROE
mcnQDt?..
monR...DE.
men (2.C;f_
n1cnt2C'f .
V. Termination-
fn the event this agreement is terminated, the case management agency and the service provider
agree to submit, at the time notice of intent to terminate is delivered, a plan which identifies
procedures to ensure services to consumers will not be interrupted or suspended by the termination.
A. Termination at Will
This agreement may be terminated by any par1y upon no less than thirty (30)
calendar days notice, without cause, unless a lesser time is mutually agreed upon by
both parties, in writing. Said notice shall be delivered by certitled mail, return
receipt requested, or in person with proof of delivery.
B. Termination Because of Lack of Funds
In the event funds to finance this agreement become unavailable. the area agency
may terminate this agreement upon no less than twenty-four (24) hours notice in
writing to the other party. Said notice shall be delivered by certified mail, return
receipt requested, or in person with proof of delivery, The area agency shall be the
final authority as to the availability of funds.
C. Termination for Breach
Unless a breach is waived by the area agency in writing. or the parties fail to cure
the breach within the time specified by the area agency. the area agency may. by
written notice to the parties, terminate the agreement upon no less than twenty-four
(24) hours notice. Said notice shall be delivered by certified mail, return receipt
requested, or in person with proof of delivery.
In witness whereof, the parties have caused this 3- page agreement to be executed by their
undersigned officials as duly authorized.
A.r, A'~S' 'd
rea tt~ncy on gmg . erVlce provl er
\.lJ( (J:.~ LJ~
signature
signature
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print rlame
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title
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