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Item C22
BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 9-20-2006 Division: Community Services Bulk Item: Yes X No � Department: Social Services/In-Home Services Staff Contact Person: Deloris Simnson AGENDA ITEM WORDING: Approval of Amendment #001 to the Community Care for the Elderly (CCE) Contract #KC 671 between the Alliance for Aging, Inc. (Area Agency on Aging for Miami - Dade and Monroe Counties) and the Monroe County Board of County Commissioners (Social. Services/In-Home Services Program). ITEM BACKGROUND: The approval of this amendment will provide an additional $20,000.00 to be used solely for Adult Protective Services (APS) consumers to receive services beyond the initial 30 day periodwith the consultation of the Alliance for Aging, Inc. PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to the Community Care for the Elderly (CCE) Contract KC671 on June 21, 2006. CONTRACT/AGREEMENT CHANGES. Amendment will allow an additional S20,000.00 to the CCE Contract #KC671 to be used solely for APS Consumers. STAFF RECOMMENDATIONS: Approval TOTAL COST: $701,095,17 BUDGETED: Yes X No COST TO COUNTY: $53,315.22 - Required SOURCE OF FUNDS: Ad Valorem Taxes Additional match $167,942.95 Total combined match $221,258.17 REVENUE PRODUCING: Yes X No AMOUNT PER MONTH appr..2,33.3.00 Year approx $28,000.00 APPROVED BY: County Atty X OMB/Pu casing X Risk Management _X— DOCUMENTATION: DISPOSITION: Revised 8106 Included X Not Required AGENDA :ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Alliance For Aging, Inc. Contract # Amendment #001 for Contract ##KC-671 Effective Date: September 1, 2006 Expiration Date: June 30, 2007 Contract Purpose/Description: Approval of Amendment #001 to the CCE Contract #IBC-671-Community Care for the Elderly (CCE) for an additional a2il, 000.00 to be used solely for APS consumers to receive services beyond the initial 30 days. ' Contract Manager: Del oris Simpson �� 4589 Social Services/Stop 1 (Name) (Ext.) (Department; Stop #) For BOCC meeting on 09/20/2006 Agenda Deadline: 09/05/2006 CONTRACT COSTS Total Dollar Value of Contract: $701,095.17 Budgeted? Yes X No Account Cedes: Grant: $479.837.00 County Match: $53,315,22 — Required Approx. additional match $167,942.95 Estimated Ongoing Costs: $ _—/yr (Not inoludeti in dollar value above) Date In 1 Division Director Risk Manage e _ O.M.B./J'U-1.ng County Attorney Comments: v in c orm .Kevlseu L/L 1/ui iviC:Y i7l Current Year Portion: $ ADDITIONAL COSTS For: CONTRACT REVIEW Changes Nee Yes i Na Yes No Yes No Yes > Nt3 utilities, janitorial, salaries, ew) Date Out C UNTY ooMONROE KEY WEST FLORDA 33040 (305)294-4641 BOARD OF COUNTY COMMISSIONERS Mayor Charles "Sonny" McCoy, District 3 Mayor Pro Tern Dixie M. Spehar, District 1 George Neugent, District 2 David P. Rice, District 4 Glenn Patton, District 5 MEMORANDUM TO: Monroe County Board of County Commissioners FROM: Dee Simpson, Senior Administrator, In -Home Services Program DATE: 8/31I2006 RE: Agenda Item regarding Amendment ##001 for Community Care for the Elderly (CCE) Contract #KC-671 This memorandurn is in regards to Amendment #001 for the Community Care for the Elderly (CCE) Contract #KC-671. This Amendment is between Monroe County Board of County Commissioners (Social Services/In- ltorne Services) and the Alliance for Aging, Inc. (Area Agency on Aging for Miami -Dade and Monroe Counties.) The approval of this Amendment will allow an increase to the contract in the amount of $20,000.00 to be used solely to provide services to Adult Protective Services (APS) consumers beyond the initial 30 day period as determined by Monroe County in consultation with the Alliance. APS consumers must be served in accordance with the provisions outlined in a separate memorandum (refer to 2006 APS Memorandum approved July 19, 2006). Once the additional $20,000 has been exhausted, service to APS clients must not continue for more that 30 days. The original Community Care for the Elderly Contract (CCE) #KC--671 has been approved by the board on June 21, 2006. Thank you, r Amendment 001 CONTRACT NUMBER KC671 Page 1 THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred to as the "Alliance", and Monroe County Board of Commissioners ("Monroe'). The purpose of this amendment is to increase the amount under contract. by $20,000 for a revised total contract amount of $ 479,837. The additional $ 20,000 is, solely, to be used to provide services to APS consumers beyond the initial ail day period as determined by Monroe and in consultation with the Alliance. APS consumers must be served in accordance with the provisions outlined in a separate memorandum (refer to 2006 APS Memorandum). Once the additional $20,000 have been exhausted, service to APS clients must not continue for more than ail nays. This amendment shall begin on September 1, 2006 or the date it has been signed by both parties, whichever is earlier, All provisions in the contract and any attachments thereto in conflict with this amendment small be and are hereby changed to conform with this amendment. All previsions not in conflict with this amendment are still in effect and are to be performed at the level specified in the contract are hereby amended to conform with this amendment. This amendment and all its attachments are hereby made a part of the contract. IN WITNESS WHEREOF, the parties hereto have caused this amendment to be executed by their undersigned officials as duly authorized. PROVIDER: Monroe County Board of Commissioners SIGNED BY: SIGNED BY: NAME: NAME: TITLE: TITLE: ©ATE: DATE: ALLIANCE FOR AGING, INC. Pedro .love President & CEO MONF30E COUNTY ATTORNEY NATILEENE , CASSEL A , TA T C01jN11TV AXTORN,eEv, ate '` AGING AND DISABILITY RESOURCE CENTER/ AGING RESOURCE CENTER /AREA AGENCY ON AGING And I HE DEPARTMENT OF CHILDREN AND FAMILIES And COMMUNITY CARE FOR THE ELDERLY CASE MANAGEMENT AGENCY MEMORANDUM OF UNDERSTANDING FOR APS REFERRALS This Memorandum of Understanding, made this 16th -day of August '20()6, shall be in effect indefinitely between the Alliance for Aging, Inc., the Aging and Disability Resource Center/Aging Resource Center/Area Agency on Aging for §ltp4j P"a ing and Service Area 11; Monroe County In -Horne Services, the Communit Care for the Elderly case management agency- and the Dey partment of Children and Families for referrals made in Monroe county. ' Objectives 1. To maintain a climate of cooperation . between agencies in order to achieve equitable delivery of services to vulnerable elder Floridians in need of services or victims of abuse, neglect, or exploitation. 2. To Promote services and activities designed to Protect vulnerable elders and Prevent premature institutionalization, Pursuant to Chapters 415 and 430, Florida Statutes, 3. T-a Participate fnqethP-r by means cf s; are,4 information J'nlhrack.�ng defiv.- services to victims of abuse, neglect, exploitation, or vullnerable elders in need Of services, 4. TO Provide technical assistance and Consultation to each other on matters Definition of Terms • "Abuse," as defined ins, 415.102 (1) F.S., means any 4wiilful act or threatened act by a caregiver that causes or is likely to cause significant impairment to a vulnerable adult's physical, mental, or emotional health. Abuse includes acts and omissions. "Neglect,,, as defined in s, 415.102 (15) F.S., means the failure or omission can the part of the caregiver to provide the care, supervision, and services necessary to maintain the physical and menial health of the vulnerable adult, including, but not limited to, food, clothing, medicine, shelter, supervision, and medical services, that a prudent person would consider essential for the well- being of a vulnerable adult. The term "neglect" also means the failure of a caregiver to make a reasonable oho;-t t- protect a v,'Ine, able adult ;rorn abuse, neglect, or exploitation by others. "Neglect" is repeated conduct or a single incident of carelessness, which produces or could reasonably be expected to result in serious physical or psychological injury or a substantial risk of death. "Exploitation," as defined in s. 415,102 (7) F,S,, means a person who o Stands in a position of trust and confidence with a vulnerable adult and knowingly, by deception or intimidation, obtains or uses, or endeavors to obtain or use, a vulnerable adult's funds, assets, or property with the intent to temporarily or permanently deprive a vulnerable adult of the use, benefit, or possession of the funds, assets, or property for the benefit of sorrecne other t�garl the o Knows or shouid know that the vulnerable adult lacks the capacity to consent, and obtains or uses; or endeavors to obtain or use, the vulnerabl e adult fronds €ur per %peel-,f 6Ove the - benefit, or possession of the funds, assets; or properly for the benefit Of someone other- than the "Exploitation" may include, but is not limited to: Breaches of fiduciary relationships, su,Ch as the misuse of a power of attorney or the abuse of guardianship duties, resulting in the !�: unauthorized appropriation, sale, or transfer of property; o Unauthorized taking of personal assets,, o Misappropriation, misuse, or transfer of moneys belonging to a vulnerable adult from a personal or joint account, or Intentional or negligent failure to effectively use a vulnerable adult's income and assets for the necessities required for that person's support and maintenance. "Vulnerable adult," as defined in s. 415.102 (26) F,S., means a person 18 years of age or older whose ability to perform the normal activities of daily living or to provide for his or her own care or Protection is impaired due to a mental, emotional, long-term physical, or developmental disability or dysfunction, or brain damage, or the infirmities of aging, "Vulnerable adult in need of services," as defined in s. 415.102 (27) F.&, means a vulnerable adult who has been determined by a protective investigator to be suffering from the ill effects of neglect not caused by a second party perpetrator and is in need of protective services or other services to prevent further harm. `Further Harm„ is when a vulnerable adult is expected to suffer ill effects froirdditionai or cot ti #ed mallreatment(s) of neglect without the provision of services. The potential for further harm will be inferred by the closure of a FePart 3s 3 "vulrerableadull; in neiad k , of qices",. or the i a of a Secorid party report �A/itl ,npe t?r , re r to idica rs" or ,Vedfied` AND the Protective investigator's initial assessment of risk of the is • "III effects of neglect" exist when a protective investigator determines that a vulnerable adult is suffering Some degree Of harm or injury or that there Is a reasonable expectation of harm or injury directly resulting from neglect, • "Protective services.." as defined in s, 415.102 (20) F,S., means services to Protect a vulnerable adult from further occurrences of abuse, neglect, or exploitation. Such services may include, but are not limited to, protective supervision, placement, and in -home and community -based services. • "Protective supervision," as defined in s. 415,102 (21) F.S,, means those services arranged for or implemented by the Department of Children and Families to protect vulnerable adults from further occurrences of abuse, neglect, or exploitation. • "Intake Entity" is the agency to which DCF sends DCF's Adult Protective Services (APS) referrals- There may be more than one intake entity in a county. Each Planning and Service Area's Aging and Disability Resource Center/Aging Resource Center/Area Agency on Aging (ADRC/ARC/AAA) determines which agency(ies) will be the intake entity(ies) for APS referrals in each county in their Planning and Service Area. ADRCs/ARCs/AAAs acting as the intake entity are responsible for notifying and transferring the appropriate documentation to the ADRC/ARC/AAA designated Community Care for the Elderly (CCE) case management agency (hereinafter referred to as the CCE Lead Agency) when services are needed, Identify the intake entity(ies) below. Ali APS referrals, regardless of risk level will be -spent to the following agency: r- ADRC/ARC/AAA ('T CCE Lead Agency All jligh" risk APS referrals will foqo,,,� inq q agency: A DRY 19 p. C,;! AA —ad All "intermediate" risk APS referrals will be sent to the following agency: f- ADRC/ARC,/AAA f- CCE Lead Agency Ali "low" risk APS referrals will be sent to the following agency: F ADRC/ARC/AAA f- CCE Lead Agency Under this Memcrand-urn of Understanding, the ADRC/ARC/AAA, CCE Lead Agency, and Department of Children and Families agree to the following- 1. Each Planning and Service Area's ADRC/ARC/AAA determines which agency(ies) will be the intake entity(ies) for DCF's Adult Protective Services (APS) referrals in each county in their Planning and Service Area. All APS referrals in need of home and community -based services will be sent to the , R M A IM I aPpro,pri-ate 12 ttake e-Gly in thie county in which the APS referral resides. 2. If the person who is the subject of the APS referral needs immediate protection from further harm, the referral will be designated as "high -risk" and will be staffed by APS and the ADRC/ARC/AAA designated Community Care for the Elderly (CCE) case management agency (hereinafter referred to as the CCE Lead Agency) to determine the need for specific services to avert a crisis or stabilize the situation. Such services will be time limited and must be designed to abate the emergency or crisis situation that places the person at risk of further harm. The CCE Lead Agency must initiate the emergency or crisis resolving service(s) within 72 hours of referral. This includes services recommended by APS, but not currently provided. Case management alone does not meet this requirement. F f-Or Consumers who are currently receiving 00EA funded services, and who are referred by APS, the 72-hour time frame includes not only those existing services, but also any additional emergency Or Cri-ris re-sclving service(s) reqUested bv APS. e tjp rirov; , - shall not cee.d JYJ da-s ules ns APS a"id thie, CCE I e-nid Aqenev the emergency or crisis still exists, and that continuation of the services arse necessary to stabilize Uje Dersorl,s sitI'latio Sfa_ff MUS4 n. APS advise consurners upon referral that services will be time-:Mnited up to 30 (jays. Upon receipt of the referral, the CCE Lead Agency must clearly communicate to the consumer that services are limited to 30 days. Notification of services extending beyond 30 days will be provided to the ADRC/ARC/AAA by the CCE Lead Agency prior to the 30'" day. 3. When the vulnerable adult is no Wger in danger ref harm as determined jointly through an APS and CCE Lead Agency staffing, he or she may apply for DOEA-funded services based on DOER guidelines. The provision of these services will be based on DOER prioritization criteria. 4. Emergency or crisis resolving services should begin as requested by the APS Protective Investigators recommendations. if at any time during the process there are any disagreements between the APS Protective Investigator- and the CCE Lead Agency regarding services to be provided, the APS Protective Investigator Supervisor and a Case Manager Supervisor at the CCE Lead Agency will jointly review the ease to resolve the issues. The CCE Lead Agency will forward notes from the weekly joint staffing sessions held with APS to the ADRC/ARC/AAA if requested to do so. If the issue(s) cannot be resolved at this level, the case will be referred to the ADRC/ARC/AAA and the DCF district office for final resolution. 5. All AIDS referrals made during business hours will be entered into the APS Referral Tracking Tool (ARTT) the ray the referral to the intake entity is made. 0. Within three hours of entering the referral into the ARTT, a referral packet will be sent via fax or hand delivered to the intake entity. A referral packet will include the following: r - s ,v ..l u s err sy:r UJIDacity, to Consent Assessmenf, .�:d sft `tea€e$y Assessment o� �atct'y Factors, : ctors, b • Adult Safety Assessment of Overall Safety, and • Court Order: if .services were court ordered, 7, Only an APS Protective investigator with the approval of an APS Protective Investigator Supervisor, or APS PMtedive investigator Supervisor can initiate APS referrals_ 8. APS "high -risk" referrals made after business fours require a telephone call to the intake entity. The following referral information must be provided: name, social security number, address, service assessment, risk factors (such as environmental concerns), and type of report. The referral will be entered into the ARTT within the first three hours of business the following day. Within three hours of entering the referral into the ARTT, a referral packet will be sent via fax or hand delivered to the intake entity (see #6 above for packet contents). 9. Only referrals for clients age 60 and older will be sent to the intake entity and entered into the ARTT. 10. The intake entity ,,�,fill confirm receipt of a faxed referral by contacting the dtF office via telephone or email. Email messages must only refer to the abuse report number and roust not include the name or social security number of the referral. 11. APS referrals for home and community -based services are not limited to �;0111rnunity tare for,Elderly or Horne tare for the Elderly services, and may iPICI.Ide non- OFA funded so�-,ices coordinated by the GGE Lead Agency. 12. If the ARTT is not available at the time of referral; a DCF Fornn 1099 vjill be v'i '� _ ':i u: is Jvafl,lufee, L he s r mi roil€ 7` ff ,_N_..7 . , 4 ° ; a 13. An APS referral initially sent to APS Protective Supervision that is later referred to the intake entity will be entered into the ARTT, 1 4- Each referral will be entered separately into the ARTT_ if services are being requested for more than one member in a household, separate referrals will be entered into the ARTT. 15. Only APS referrals for victims of abuse, neglect, exploitation and vulnerable adults as identified by APS staff will be put into the ARTT. 16. All APS referrals, regardless of risk level (i.e., high, intermediate, or low), will be entered into the ARTT. -1 7. If a new abuse report, !nunriber) is received for an individuai who had been reported and referred previously, a new referral will be entered into the ARTT, regardless of whether or not the individual is currently receiving services. 1& The intake entity must acknowledge receipt of the APS referral in the ARTT the same day the referral packet is received, 19. The CCE Lead Agency will enter the case status in the "Action Taken by Provider" field (#30) and/or the "Staffing or Additional Comments" field (#3 1) in the ARTT, along with the "Service Provider's Signature" (#36). The "Schedule Staffing Date" (#37) must be entered into the ARTT within 72 hours from the time the referral packet is received for "high- risk" referrals and within I ;referral ten business days for "interme-diate" and "low" risk referrals, if the leterral is a --ceded. 20. The intake entity will work together with APS staff to identify and maintain, in le OCShel jf f nt IJ i ,1v ie r-e, 21. A 701 B comprehensive assessment must be completed within 72 hours for "high -risk" referrals and in accordance with Department of Elder Affairs policy for "intermediate" and .1ow" risk referrals. 22, GCE co -payments for services will be waived for APS referrals during the first 30 (lays of service or until the vulnerable adult's crisis situation has stabilized. 23. The following information will be entered in the Client Information and Registration Tracking System (CIRTS) for all APS referrals: 0 Assessment information; must include the referral date, referral source set to Abuse/Neglect, and risk level (high, intermediate, low), * Enrollment information, * Care plan information, and a Units of service provided. 24. APS "high -risk" referrals must have the following information entered in CIRTS: & Units of service for case management and core type services are entered using the date specific method for the first month. This includes Older Americans Act services that may normally be reported in aggregate. After the initial month, GCE Lead Agencies may return to entering aggregate units. 0 For current consumers referred by Adult Protective Services and determined "high -risk," the date of service delivery and units of service are entered as if the client were, a new "high -risk" referral, i.e., date specific. 0 Informal services arranged bytihe case rnanager, churchas. neighbors, or other community resources, are entered in CIRTS on the Senjices Received Screen for the mooth the service is omvided. _,r'he �_ode :s 11,,on-Depaftment of LE�der Aii-fa-,irs Prxranns f,",JDPI, The J ser,tice is listed as "Other" and the unit is one episode with no unit cost_ !-3pecific information about the linformal service(sl should be cne L ontaId �n the file on the hard copy of ire care plan. 1) ... ._ t I - � I I 25. if the person who is the subject of the APS referral refuses to be assessed or there is a delay in service provision for reasons beyond the control of service providers, the CCE Lead Agency will do the following: Contact the APS investigator to discuss the situation and determine the next best course of action. If the referral is a "high -risk" referral, APS must be contacted within 24 hours. • Create an entry in the Received Services screen in CIRTS with Case Management as the Service with the appropriate date and units if case management services were provided. • "High -risk" referrals require an additional entry in the CIRTS Received Services screen Identifying the reason for the delay in service provision. The Program is set to "NDP" and one of the following codes is listed as the Service: o PLHS - Placed in hospital o PLNH - Placed in nursing home o PLAF - Placed in ALF c� PLFM - Placed with family CI F - Consurer refused o GLUV — Consumer unavailable; cannot be located o CLDC - Consumer deceased The nur ber of units should be set to Off and the nit type set -0 PS. 26. The AGRUARC/AAA will run CIRTS reports nnonthly to compare referral dates vV 1h s-3rvices received rates to ensure compliance with the 72-hour statute. Signature Title Printed Narne A-O—RCFARCAAA Signature "viayor Title ,C, V Charles "Sonny" MCrE I Printed Name Signature Title Printed Narne Department of Children and FarnOies Date —te -e C serv.4178's, o n r o nun E L 8-16-2006 Date A AS t3 I OT-AW I I tyll i I CONTRACT KC 671 Page 1 COMMUNITY CARE FOR THE ELDERLY CONTRACT 2006-2007 IJIS AGiREEVIEN'F is entered into between the Alliance for Aging, Inc., hereinafter referred to as the "Alliance," and Monroe County Board of Commissioners, hereinafter referred to as the "recipient." 'Fliis agreement is subject to all provisions contained in the MASTFR ACREETNTLu"NT executed bet-Aeen the Alliance and the Recipient, Agreement No. PA429, and its snecessor, incorporated herein by reference. I. Recipient Agrees: A. Services to be Provided: 1. The recipient's service provider application for state fiscal year 2006, and any revisions thereto approved by the Alliance and located in the contract manager's file, are incorporated by reference in this contract between the Alliance and the recipient, and prescribe the services to be rendered by the recipient. Consumers may not be enrolled in a Department of Elder Affairs' state general revenue funded program, including CCE, who are also enrolled in a Medicaid capitated long- term care health plan or program. These programs include the Frail Elder Program operated by United Health Care, the Channeling Program operated by Miami Jewish Hoare and Hospital for the Aged, the bong Term Care Corninunity Diversion Prograrn operating in Planning and Service Areas 7 and 9, and the Program of All Inclusive Care for the Elderly (PACE) program scheduled to begin operation in the Miami -Dade County area. B. Manner of Service Provision: The services will be provided in a manner consistent with and described in the recipient's service provider application for state fiscal year 2006 and the Department of Elder Affairs Home and Community Based Services Handbook dated 01103_ In the event the manual is revised, such revision will automatically be incorporated into the contract and the recipient will be given a copy of the revisions II. The Alliance Agrees: A. Contract Amount: To pay for services in an amount not to exceed $459,837.00, subject to the availability of funds. Obligation to Pay: The :\Ihance`s performance and obli ation to pay tinder this contract is curntinoertt upon 'all annual appropriation by the I,euislature. . Source of Funds, The costs of Services paid tinder any other contract or frorn any other source; are riot eligible %i,,r rCinrbcrr-sc;rnCnt under thiscontract. The funds awarded to the r2cipileflit pursuant to this contract are in the state grants and aids appropriations. M. Pe ip:ent artd Alliance Mutually Agree - A, Effective date: ?, Ih; s contract shall begin on :July 1, 2006 or on the date the contract has been signeu by berth parties, whichever is earlier. CONTRACT KC 671 Page 2 2. Delivery of services shall end on June 30, 2007, IN WITNESS WHEREOF, the parties hereto have caused this 2-page agreement to be executed by their undersigned officials as duty authorized. FRQL,/IDER: Monroe CounN Board of Comm isAi6nprs SIGNED BY: Z NAME: Charles 1ffmccoy TITLE: DATE: June 21, 2006 (BEAU A;TUST' ANININ L. rPLHAGE� CL' R5 ly l CLERK -3CE CC A"VT --Y A P �VrTO, NEY ALLIANCE FOR AGING, INC, SIGNED BY: Pedro Jov6, NAME: President & CEO TITLE: DATE: