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Item C09 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 6-17-2009 Division: _County Administrator Bulk Item: Yes X No - Department: Social ServiceslIn-Home Services_ -- Staff Contact Person/Phone #: Sheryl Graham/X451 0 AGENDA ITEM WORDING: Approval of Amendment 001 to the Alzheimer's Disease Initiative (ADI) Contract KZ-997 between the Alliance for Aging, Inc. (Area Agency on Aging) and the Monroe County Board of County Commissioners (Social Services/In-Home Services) for fiscal year 7/1/09 to 6/30/1 O. ITEM BACKGROUND: Approval of the Amendment 001 to ADI Contract #KZ-997 will decrease the amount under contract by $5,452.00 making the contract total to $56,746.00 from $62,198.00 PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to ADI Contract #KZ997 on 6-17 -09. CONTRACT/AGREEMENT CHANGES: decreasing contract KZ-997 by $5,452.00 for the total of $56,746.00 instead of$62,198.00 STAFF RECOMMENDATIONS: Approval TOTAL COST: $56,746.00 INDIRECT COST: -0- BUDGETED: Yes X No COST TO COUNTY: $0 (No Cash Match Required) SOURCE OF FUNDS: Grants REVENUE PRODUCING: Y es ~ No _ AMOUNT PER MONTH $50.00 Year $600.00 APPROVED BY: County Atty ~ OMB/Purchasing ~Risk Management _X_ DOCUMENT A TION: Included X Not Required_ DISPOSITION: AGENDA ITEM # Revised 1/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Alliance for Aging, Inc. Contract # Amendment 001 to ADI Contract #KZ-997 Effective Date: July 1, 2009 Expiration Date: June 30, 2010 Contract PurposelDescription: Approval of Amendment 001 to the Alzheimer's Disease Initiative (AD I) Contract#KZ-997 to decrease the amount under contract by $5,452.00 making the contract total to$56,746.00 from $62,198.00 Contract Manager: Sheryl Graham 4510 Social Services/Stop 1 (Name) (Ext.) (Department/Stop #) For BOCC meeting on 7/15/2009 Agenda Deadline: 6/30/2009 CONTRACT COSTS Total Dollar Value of Contract: $56,746.00 Current Year Portion: $ Budgeted? Yes X No Account Codes: 125 -6153609 - - - - - Grant:$56,746.00 (Fiscal Year) - - - - County Match: $0 (No Cash Match required) - - - - - - - - ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (eg. Maintenance, utilities, janitorial, salaries, etc) CONTRACT REVIEW Changes Date Out Division Director ~~r N~" &!JoI'9 Yes ~ Risk Manag\ment b/dq~Cit Yes @ v-J9dt EL ~ ~ C./!p\0'1 ~ 0~ \l o .M.B .IPurchasmg Yes County Attorney ~\d.l\ ~ Yes -'4d~ Comments: OMB Form Revised 2/27/01 MCP #2 Amendment 001 CONTRACT KZ 997 Page 1 THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred to as the "Alliance", and Monroe County Board of Commissioners. The purpose of this amendment is to decrease the amount under contract by $ 5,452 from $62,198 to $ 56,746. This includes a 9% reduction from the original 08/09 allocation. The provider must adjust the Unit Cost Methodology to take this decrease in funding into account. METHOD OF PAYMENT: 1. This amendment shall begin on July 1, 2009 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 shall be and are hereby changed to conform with this amendment. All provisions 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. This amendment and all its attachments are hereby made a part of the contract. IN WITNESS WHEREOF, the parties hereto have caused this 1-page amendment to be executed by their undersigned officials as duly authorized. PROVIDER: Monroe County Board of ALliANCE FOR AGING, INC. Commissioners. SIGNED BY: SlGNED BY: George Neugent Max B. Rothman, JD, LL.M. NAME: NAME: Mayor President & CEO TITLE: TITLE: July 15, 2009 DATE: DATE: L./ atE- ___--~-,-,--~"^""'-''"'-'~..-~--T--''.''''-O~--. CONTRACT KZ-997 Page 1 ALZHEIMERS' DISEASE INITIATIVE CONTRACT 2009-2010 THIS AGREEMENT 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." This agreement is subject to all provisions contained in the MASTER AGREEMENT executed between the Alliance and the Recipient, Agreement No. PA829, and its successor, incorporated herein by reference. Attachment I, II, ill, IV, V, VI, VII and vm are integral to this Agreement. I. Recipient Agrees: A. Services to be Provided: 1. To plan, develop, and accomplish the services delineated, or othelWise cause the planning, development, and accomplishment of such services and activities, under the conditions specified and in the manner prescribed in Attachment I of this aareement and included in the Service Provider Application (SPA) submitted in response to the March 2008 CCE/Lead Agencv RFP. The recipient will not be allowed to provide services that are not included in the SPA submitted in response to the March 2008 CCE/Lead Agency RFP and included related Unit Cost Methodology submitted as an integral part of the RFP application. In the event of the conflict between the Service Provider Application and this contract, the contract controls. Additionally, the recipient is subject to the Referral Protocol and ARC Outsourced Functions included in Attachment IV and ARC Outsourced Functions Policies and Procedures outlined in Attachments V,VI,VII and VIII. 2. Consumers may not be enrolled in a Department of Elder Affairs' state general revenue funded program, including ADI, who are also enrolled in a Medicaid capitated 10ng-te011 care health plan or program. These programs include the Frail Elder Program operated by United Health Care, the Channeling Program operated by Miami Jewish Home and Hospital for the Aged, the Long Te011 Care Community Diversion Program 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 ~onsistent with and described in the recipient's service provider application for state fiscal year 2009 and the Department of Elder Affairs Home and Community Based Services Handbook dated 01/03. In the event the handbook 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 $62.198.00, subject to the availability of funds. Obligation to Pay: The Alliance's perfo011ance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. B. Source of Funds: 1 CONTRACT KZ-997 Page 2 The costs of services paid under any other contract or from any other source are not eligible for reimbursement under this contract. The funds awarded to the recipient pursuant to this contract are in the state grants and aids appropriations. III. Recipient and Alliance Mutually Agree: A. Effective Date: 1. This contract shall begin on July 1, 2009 or on the date the contract has been signed by both parties, whichever is earlier. 2. Delivery of services shall end on June 30, 2010. IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed by their undersigned officials as duly authorized. PROVIDER: Monroe County Board of ALLIANCE FOR AGING, INC. Commissioners SIGNED BY: SIGNED BY: Max B. Rothman, JD, LL.M. NAME: George Neugent NAME: President & CEO TITLE: Mayor TITLE: DATE: 6-17-09 DATE: 2 CONTRACT KZ-997 Page 3 ATTACHMENT I ALZHEIMER'S DISEASE INITIATIVE PROGRAM J. STATEMENT OF PURPOSE The Alzheimer's Disease Initiative (ADI) Program is focused on caring for persons 18 + with memory disorders. II. SERVICES TO BE PROVIDED A. Services: 1. The recipient's selVice provider application for state fiscal year 2009 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 selVices to be rendered by the recipient. 2. Consumers may not be enrolled in a Department of Elder Affairs' state general revenue funded program, including ADI, 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 Home and Hospital for the Aged, the Long Term Care Community Diversion Program operating in Planning and SelVice Areas 7 and 9, and any other areas that may participate in the Long Term Care Diversion Program through expansion and the Program of All Inclusive Care for the Elder1y (PACE) program scheduled to begin operation in the Miami-Dade County area, B. Manner of Service Provision: The selVices will be provided in a manner consistent with and described in the recipient's selVice provider application for state fiscal year 2009 and the Department of Elder Affairs Home and Community Based Services Handbook dated 01/03. In the event the handbook is revised, such revision will automatically be incorporated into the contract and the recipient will be given a copy of the revisions. III. METHOD OF PAYMENT A. The method of payment in this contract is based on a fixed rate reimbursement for approved services. The recipient must ensure fixed rates include only those costs that are in accordance with all applicable state and federal statutes and regulations and are based on audited historical costs in instances where an independent audit is required. All requests for payment and expenditure reports submitted to support requests for payment shall be on DOEA forms 106Z and 105Z. Duplication or replication of both forms via data processing equipment is permissible, provided all data elements are in the same format as included on departmental forms. 3 CONTRACT KZ-997 Page 4 B. The recipient shall maintain documentation to support payment requests which shall be available to the Comptroller, the Department of Elder Affairs, or the Alliance upon request. C. The recipient shall maintain documentation to support payment requests which shall be available to the Alliance, the Department of Elder Affairs or the Comptroller upon request. D. The recipient may request a monthly advance for service costs for each of the first two months of the contract period, based on anticipated cash needs. Detailed documentation justifying cash needs for advances must be submitted with the signed contract, approved by the Alliance, and maintained in the contract manager's file. All payment requests for the third through the twelfth months shall be based on the submission of monthly actual expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests is ATTACHMENT II to this contract. Reconciliation and recouping of advances made under this contract are to be completed by the time the final payment is made. All advance payments are subject to the availability of funds. E. Advance funds may be temporarily invested by the recipient in an insured interest bearing account. All interest eamed on contract fund advances must be returned to the Alliance within thirty (30) days of the end of the first quarter of the contract period. F. The Alliance shall make payment to the provider for provision of services up to a maximum number of units of service and at the rate(s) stated below: Service Maximum Maximum Service to be Provided Unit Rate Units of Dollars Service In Home Respite $24.03 2,588 $62,198 G. Any payment due by the Alliance under the tenns of this contract may be withheld pending the receipt and approval by the Alliance of complete and accurate financial and programmatic reports due from the recipient and any adjustments thereto, including any disallowance not resolved as outlined in Section I.T. of the Master Agreement. IV. SPECIAL PROVISIONS A. State Laws and Regulations: The recipient agrees to comply with applicable parts of Rule 580-1, Florida Administrative Code promulgated for administration of Sections 430.501 through 430.504, Florida Statutes, and the Department of Elder Affairs Client Home and Community Based Services Handbook dated 01/03. B. Assessment and Prioritization for Service Delivery for New Consumers: The following are the criteria to prioritize new consumers for service delivery. It is not the intent of the Department of Elder Affairs to remove existing clients from any program in order to serve new clients being assessed and prioritized for service delivery. 1. Priority Criteria for Service Delivery: a. individuals in nursing homes under Medicaid who could be transferred to the community; 4 CONTRACT KZ-997 Page 5 b. individuals in nursing homes whose Medicare coverage is exhausted and may be diverted to the community; c. individuals in nursing homes which are closing and can be discharged to the community; or d. Individuals whose mental or physical health condition has deteriorated to the degree self care is not possible, there is no capable caregiver and institutional placement will occur within 72 hours. 2. Priority Criteria for other Assessed Individuals: The assessment and provision of services should always consider the most cost effective means of service delivery. Functional impairment shall be determined through the department's consumer assessment form administered to each applicant. The most frail individuals not prioritized in groups one, two or three above, regardless of referral source, will receive selVices to the extent funding is available. C. Co-payment Collections: 1. The recipient will establish annual co-payment goals. The Alliance also has the option to withhold a portion of the recipient's Request for Payment if goals are not met according to the Department of Elder Affairs' co-payment guidelines. 2. Co-payments include only the amounts assessed consumers or the amounts consumers opt to contribute in lieu of an assessed co-payment. The contribution must be equal to or greater than the assessed co-payment. D. Evaluation, Statistics and Reports The recipient agrees to respond to requests for evaluation information and statistical data conceming its consumers based on information requirements of the Memory Disorder Clinics and Brain Bank. The recipient will ensure Model Day Care Centers supported by this contract develop innovative therapies and interventions which can be shared with other Alzheimer's Disease Initiative health and social services personnel via training. Model Day Care Centers supported by this contract must report to the provider all training activities provided to health care and social selVice personnel and caregivers, as well as selVe as a natural laboratory for service related applied research by Memory Disorder Clinics. An annual Model Day Care Center Training Report is due by July 5, 2009. E. Collaboration with Memory Disorder Clinics: Memory Disorder Clinics are required to provide four hours of in-selVice training to all respite and model day care centers in their designated service areas. The recipient agrees to collaborate with Memory Disorder Clinics to assist in this effort. F. Service Cost Reports: The recipient will submit semi-annual service cost reports which reflect actual costs of providing each selVice by program. This report provides information for planning and negotiating unit rates. 5 CONTRACT KZ 997 Page 6 6 CONTRACT KZ 997 Page 7 ATTACHMENT II ALZHEIMER'S DISEASE INITIATIVE PROGRAM CONTRACT REPORT CALENDAR Report Based On Submit Number to the Alliance on This Date 1 July Advance * ............................................................... July 1 2 August Advance * ........................................................... July 1 3 July Expenditure Report................................. ... ...... ... ... .... August 10 4 August Expenditure Report ... ...... ... ... ,.. ......... ... ... ...... ... ...... September 10 5 September Expenditure Report ... ........................................ October 10 6 October Expenditure Report ... ... ... . .. ... . .. ... ... ... ... ... ... ... .., ... .. November 10 7 November Expenditure Report ... ...... ... ... ... ... ...... ...... ...... ... .. December 10 8 December Expenditure Report......... ... ... ... ... ...... ... ... ... ... ..... January 10 9 January Expenditure Report ... ... ... ... ... ... ... ... ... ... ... ... ... ... ..... February 10 10 February Expenditure Report ...... ... ... ... ...... ... ...... ...... ... ... .... March 10 11 March Expenditure Report ............... ...... ......... ... ... ... ...... ... .. April 1 0 12 April Expenditure Report ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ....... May 10 13 May Expenditure Report/July Advance Reconciliation - ........... June 10 14 June Expenditure Report/August Advance Reconciliation - ...... July 10 16 Final Expenditure and Closeout Report ................. July 20 Leqend: * Advance based on projected cash need. - Submission of expenditure reports mayor may not generate a payment request. If final expenditure report reflects funds due back to the Alliance, payment is to accompany the report. Note # 1 : Report #1 for Advance Basis Contracts cannot be submitted to the Alliance prior to July 1 or until the contract with the Alliance has been executed. Actual submission of the vouchers to the Department of Elder Affairs is dependent on the accuracy of the expenditure report. Note # 2: The last two months of the recipient's fiscal reports covering actual expenditures should reflect an adjustment repaying advances for the first two months of the contract. 7 CONTRACT KZ 997 Page 8 A IT ACHMENT III ANNUAL MODEL DAY CARE CENTER TRAINING REPORT Model Day Care Center Name: Printed Name of Person Signature of Person Date Executed Completing Report Completing Report The purpose of each model day care program must be to provide service delivery to persons suffering from Alzheimer's disease or a related memory disorder and training for health care and social service personnel in the care of persons having Alzheimer's disease or related memory disorders. This report documents the required training for the State Fiscal Year July 1st through June 30th. Number Number Total Actual Training Event(s) Health Care Social People Professionals Services Trained Trained Personnel Trained Training Title: Date: Training Summary: ****** 8 CONTRACT KZ 997 Page 9 A IT ACHMENT IV Aging Resource Center Outsourced Functions A. Perfonn ARC outsourced functions in accordance with policies and procedures developed by the Alliance for Aging. Refer to the following attachments: i. Attachment V: Policies and Procedures for Outsourced Function-Screening ii. Attachment VI: Policies and Procedures for Outsourced Function-Triage iii. Attachment VII: Policies and Procedures for Activation from Waitlist- Client Services iv. Attachment VIII: Policies and Procedures for Tennination from Waitlist- Client Services B. Maintain wait lists in CIRTS in accordance with DOEA requirements. C. Report number of client contacts to the Aging Resource Center. D. Adhere to prioritization policy as set forth by the Department of Elder Affairs. E. Update the agency Disaster Plan to incorporate ARC outsourced functions, F. Ensure against conflicts of interest and inappropriate self-referrals by referring consumers in need of options counseling or long-tenn care services beyond the provider's scope of services to the Aging Resource Center. G. Ensure that services provided are in the clients' best interest, are the most cost effective, of high quality, and are responsive and appropriate to the assessed needs. The Assessed Priority Consumer List (APCL) is maintained when services funded by the department are not available. Contracted providers of registered services for Alzheimer's Disease Initiative (ADI), Older American's Act (OAA), and Contracted Services (CS) maintain waiting lists in the CIRTS database for registered services when funding is not available. Note: OAA3E is an exempt funding source for ARC Wait List purposes. For services provided through OAA3E, no CIRTS client data entry is required. Registered Services for the above listed programs are as follows: Adult Day Care (ADC), Adult Day Health Care (ADHC), Chore (CHO), Escort (ESC) , Home Health Aide (HHA), Homemaker (HMK), Model Day Care (MDC), Personal Care (PECA), Facility-Based Respite (RESF) , In-Home Respite (RESP). 9 CONTRACT KZ 997 Page 10 ATTACHMENT V Policy and Procedure for Outsourced function - Screening Objective: To ensure that a comprehensive list of clients in need of services is maintained in CIRTS by appropriate funding source and that the ARC is thereby able to effectively gauge the level of elder service need in Miami-Dade and Monroe Counties. Policy: To obtain necessary infonnation from clients in order to assist in detennining level of need and eligibility for DOEA funded services Procedure: 1. ARC Contracted Providers will collect infonnation from callers and conduct a 701A assessment. Altematively, if a 701 B assessment already exists or is provided from another source (Le. CARES) the infonnation from the 701 B can be utilized. 2. Based on the infonnation provided via the 701A(B) assessment, the ARC Contracted Provider will make a detennination as to the services that the caller is in need of receiving (see Contract Amendment APCL). 3. The ARC Contracted Provider will detennine the appropriate funding source(s) that provides the needed services (see Contract Amendment APCL). 4. If the caller is in need of a service(s) that is not provided by the ARC Contracted Provider, the ARC Contracted Provider will refer caller to the ARC Elder Helpline utilizing the ARC Referral Fonn and/or to an ARC Contracted Provider that provides the needed service. 5. The caller will be provided with general infonnation regarding the ARC as well as the ARC Elder Helpline contact number. 6. The caller will be infonned of the services and funding sources that they are being placed on the wait list for in CIRTS. 7. ARC Contracted Provider will create a client recordin CIRTS (if there is no existing record) and enter the services needed for the caller by funding source and service. [If there is an existing record in CIRTS, the appropriate fields will be updated]. 8. If the ARC Contracted Provider detennines that the caller may qualify. for more than one funding source, ARC Contracted Provider is encouraged to enter the appropriate infonnation under multiple funding sources. [If there is an existing client record in CIRTS, the client record in CIRTS will be updated with appropriate infonnation]. 9. ARC Contracted Provider will infonn caller that they will receive a follow-up call (or home visit in case of active client) to check on their status based on DOEA Wait List Reassessment Standards and encourage caller to contact the ARC Elder Helpline with any questions. 10 CONTRACT KZ 997 Page 11 ATTACHMENT VI Policy and Procedure for Outsourced function - Triage Objective: To ensure that clients in need of DOEA funded services receive services based on the highest level of need, first, as funding becomes available. Policy: To assist clients in obtaining DOEA funded services as funding becomes available, based on level of need as determined by a CIRTS priority score. Procedure: 1. ARC Contracted Provider will conduct periodic follow-up calls (or home visit in case of active client) to check on client status based on DOEA Wait Ust Reassessment Standards. 2. Based on the information provided via the 701A(B) assessment, the ARC Contracted Provider will update the client information in CIRTS specifically as it pertains to level of need for services by funding source 3. The ARC Contracted Provider will ensure that the CIRTS prioritization score is accurately maintained, according to DOEA Standards. 4. If the caller is in need of a service(s) that is not provided by the ARC Contracted Provider, the ARC Contracted Provider will refer caller to the ARC Elder Helpline utilizing the ARC Referral Form and/or to an ARC Contracted Provider that provides the needed service. 5. The caller will be informed of the services and funding sources that they remain on the wait list for and/or have been removed from the wait list for. 6. ARC Contracted Provider will advise client of any change in their CIRTS priority score based on the updated information. 7. ARC Contracted Provider will remind client of the ARC Elder Help Une contact number and to contact the ARC Elder Help Une with any questions or concerns. 8. As funding becomes available, ARC Contracted Provider will run CIRTS Prioritization Report and activate clients according to DOEA Standards (refer to ARC Client Activation Policies and Procedures). The Contracted Provider will apply targeting criteria, as appropriate, to prioritized clients to ensure activations meet programmatic requirements. 11 CONTRACT KZ 997 Page 12 Attachment VII Policy and Procedure for Activation from Wait List - Clients/Services Objective: To ensure that elders in need of DOEA funded services in Miami-Dade and Monroe Counties and on the CIRTS wait list begin to receive services as funding becomes available. Policy: ARC will work with ARC Contracted Providers to ensure that clients waiting for DOEA funded services begin to receive those services as funding becomes available. Procedure: 1. ARC Contracted Provider will activate clients on CIRTS wait list based on DOEA prioritization polices and funding availability. 2. ARC Contracted Provider will update CIRTS status by funding source and service for any services being activated for the client using appropriate CIRTS codes. 3. Client may be left on wait list of a different funding source than the one being activated if ARC Contracted Provider detennines that it is appropriate. 4. Client may also be left on wait list in CIRTS if they are being activated by the ARC Contracted Provider under a temporary non-DOEA funding source and ARC Contracted Provider detennines that the clients need will persist after the temporary funding source is exhausted. 5. ARC Contracted Provider will infonn the client of any services/funding source that they are being activated for as well as those services and funding sources that they will continue to be wait listed for. 6. ARC Contracted Provider will infonn client to contact the ARC Elder Helpline if they have any questions or concerns regarding the status of any of their services. 12 CONTRACT KZ 997 Page 13 Attachment VIII Policy and Procedure for Tennination From Wait List - ClientslServices Objective: To ensure that the comprehensive list of clients in need of selVices in CIRTS is appropriately maintained by funding source and that the ARC is thereby able to effectively gauge the current level of elder selVice need in Miami-Dade and Monroe Counties. Policy: ARC will maintain an accurate and current list of clients in need of elder selVices in Miami- Dade and Monroe Counties with the assistance of the ARC Contracted Providers. Procedure: 1. ARC Contracted Provider will re-screen clients which the ARC Contracted Provider initially placed on the CIRTS walt list for selVices based on DOEA Reassessment Standards. 2. The re-screening may be in the fonn of a phone screening or a home visit depending on the clients status (i.e. active/pending) 3. ARC Contracted Provider will detennine if the client is no longer in need (or eligible) for any of the selVices they were wait listed for. 4. ARC Contracted Provider will tenninate the client from the wait list (entirely or by specific selVice) using the appropriate CIRTS tennination code for any selVices or funding source for which the client is detennined to no longer be eligible for or no longer in need of. 5. ARC Contracted Provider will info/11l the client of any selVices/funding source that they are being removed from the wait list for. 6. ARC Contracted Provider will info/11l client of their ability to be re-added to the wait list if their level of need should change. 7. ARC Contracted Provider will inform client to contact the ARC Elder Helpline if they have any questions or concems regarding their wait list status. 8. Reference DOEA Notice of Instruction: Assessed Priority Consumer List#:062906-1-I-OVCS as applicable. 13