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Item C07 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 6-17-2009 , Division: County Administrator Bulk Item: Yes —X— No Department: Social Services/In-Home Services_ Staff Contact Person/Phone#: Sheryl Graham/X4510 AGENDA ITEM WORDING: Approval of the Community Care for the Elderly(CCE) Contract KC- 971 between the Alliance for Aging, Inc. (Area Agency on Aging) and the Monroe County Board of Commissioners(Social Services/In-Home Services)for fiscal year 7/l/09 to 6/30/10. ITEM BACKGROUND: Approval of the CCE Contract will enable Monroe County In-Home Services to continue providing services to Monroe County's elderly population under the Community Care for the Elderly program. PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to Amendment 002 to CCE Contract#KC-871 on 3-18-09. CONTRACTIAGREEMENT CHANGES: none- STAFF RECOMMENDATIONS: Approval TOTAL COST: $503,344.00 INDIRECT COST: Q-_.BUDGETED: Yes -X—No_ COST TO COUNTY: Inkind (Space)Match of$22,995.00 SOURCE OF FUNDS: No Cash Match is Required- an Inkind(Space) Match of$22,995.00 and co-Payment Match of $22,305.00 will he used for the$45,300.00 Total Match Commitment. REVENUE PRODUCING: Yes X No_ AMOUNT PER MONTH annrox. Z NQ.00 Year approx. $30,000.00 APPROVED BY: County Atty X_ OMB/Purchasing _Risk Management—X - DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM# Revised 1/09 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Affiance for Aging, Inc. Contract#RC-971 Effective Date: July 1, 2009 Expiration Date: June 30, 2010 Contract Purpose/Description: Approval of the Community Care for the Elderly(CCE)Contract#KC-971 will enable Monroe County In-Home Services to continue providing services to Monroe County's elderly population. Contract Manager: Sheryl Graham 4510 Social Services/Stop I (Name) (Ext.) (Department/Stop#) For BOCC meeting on 6/17/2009 A enda Deadline: 6/2/2009 CONTRACT COSTS Total Dollar Value of Contract: $503,344.00 Current Year Portion: $ Budgeted?Yes X No❑ Account Codes: �125 -6153809�- - - Grant:$503,344.00(Fiscal Year) - County Match: (Required)Inkind Match of$22,995.00 and - - - - Client Co-Pay Match of$22,305.00 will be used for the $45,300,00 Total_Match Conurlitment ADDITIONAL COSTS uslimawd On-going Casts; S /yr For: (Not includW in dollar value above) (eg,Maintenance,utilities,'apilorial,aalatie etc CONTRACT REVIEW Changes Date Out Date Needed A,�� evi verDivision Director (y�� 6 Yes 0No P---Risk Managermentj- Yes❑ No V O.M.B./Purchasing Gr 8. 0 Yes❑ No _ 00, County Attorney 511°t �`� Yes❑ NoW Comments: pMB Form Revised 2/27/01 MCP#2 CONTRACT NUMBER KC 971 Page 1 COMMUNITY CARE FOR THE ELDERLY CONTRACT 2009-2010 THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as the "Alliance", and Monroe County, hereinafter referred to as the "recipient". This contract is subject to all provisions contained in the MASTER AGREEMENT executed between the Alliance and the recipient, Agreement No., and its successor, incorporated herein by reference. Attachment I, II, III, IV,V and VI are integral to this Agreement The parties agree: I. Recipient Agrees: A. Services to be provided: To plan, develop, and accomplish the services delineated, or otherwise 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 agreement and included in the Service Provider Application (SPA) submitted in response to the March 2008 CCE/Lead Agency 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 included in Attachment IV and ARC Outsourced Functions Policies and Procedures outlined in Attachment V B. Final Request for Payment: 1. The recipient must submit the final request for payment to the Alliance no later than July 15, 2010; if the recipient fails to do so, all right to payment is forfeited, and the Alliance will not honor any requests submitted after the aforesaid time period. 2. If the contract is terminated prior to the contract end date of July 1, 2010, then the recipient must submit the final request for payment to the Alliance no more than 45 days after the contract is terminated, but no later than July 15, 2010. If the recipient fails to do so, all right to payment is forfeited, and the Alliance will not honor any requests submitted after the aforesaid time period. C. Additional Reporting Requirements 1. If the Alliance has sanctioned the recipient, while the sanctions are in effect the recipient shall provide to the Alliance, on a monthly basis, the recipient's financial statements that reflect the current, un-audited revenues and the 1 CONTRACT NUMBER KC 971 Page 2 recipient's cash position as well as any other financial and/or programmatic documentation that may be requested by the Alliance. 2. If the recipient is required to prepare a corrective action plan or respond to a Fiscal and/or Programmatic Monitoring, supporting documentation as requested by the Alliance shall be provided within the time frame stipulated by the Alliance. 3. If the recipient has requested transfers of funds between programs, supporting documentation shall be provided. 4. The recipient is to provide explanations to any program surplus/deficit and/or program spend-out plans as requested by the Alliance for Aging within the time period requested by the Alliance. 5. The recipient is responsible to report the units of services in CIRTS on a monthly basis. The recipient is ultimately responsible to ensure that sub- providers report units of service in CIRTS as well. The recipient is aware and accepts that all units of service not reported after a maximum of ninety (90) days after the date of service will not be honored and paid by the Alliance. These units will be considered forfeited. The recipient acknowledges that failure to meet the requirements set forth in the 2008 CCE/Lead Agency RFP and in this agreement as well as in the Master Agreement may result in delay or termination of payment and/or in sanctions and other enforcement actions as established in the Master Agreement, including termination of contract. II. The Alliance Agrees: A. Contract Amount To pay for services according to the conditions of Attachment I in an amount not to exceed $ 503,344 for the State Fiscal Year 2009-2010, subject to the availability of funds. Recipient must not exceed their quarterly allocations and spending authority as reflected in Attachment 111. Failure of the recipient to remain within allocated authorized spending authority amounts may result in the Alliance enforcing sanctions as set forth in the Enforcement Clause, Section III, B, of the Master Agreement. The Alliance reserves the right to adjust the CCE quarterly allocations and spending authority for each lead agency based on availability of funds or as deemed necessary. B. Obligation to Pay The Alliance's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. C. Source of Funds 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 2 CONTRACT NUMBER KC 971 Page 3 pursuant to this contract are in the state grants and aids appropriations and consists of the following: Program Title Year Funding Source CSFA# Fund Amounts Community Care 2009 General Revenue/Tobacco 65010 $503,344 for the Elderly Settlement Trust Funds TOTAL FUNDS CONTAINED IN THIS CONTRACT: $503,344 111. 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 later. 2. Delivery of services shall end on June 30, 2010. This contract shall end on July 15, 2010. See Attachment I, Section III.F. B. Termination, Suspension, and/or Enforcement: The causes and remedies for termination or suspension of this contract shall follow the same procedures as outlined in Section III. B. and Section III.C. of the Master Agreement. C. Recipient Responsibility: Notwithstanding anything to the contrary in the Master Agreement, the recipient maintains responsibility for the performance of all sub recipients and vendors in accordance with all applicable federal and state laws. D. Notice, Contact, and Payee Information: 1. The name, address, and telephone number of the contract manager for the Alliance for this contract is: Max B. Rothman, JD, LL.M. President and CEO 9500 South Dadeland Boulevard, Suite 400 Miami, Florida 33156 (305) 670-6500, Ext. 224 2. The name, address, and telephone number of the representative of the recipient responsible for administration of the program under this contact is: 3 CONTRACT NUMBER KC 971 Page 4 3. In the event different representatives are designated by either party after execution of this contract, notice of the name and address of the new representative will be rendered in writing to the other party and said notification attached to originals of this contract. 4. The name (recipient name as shown on page 1 of this contract) and mailing address of the official payee to whom the payment shall be made: (Fill in contact information). E. Renegotiation or Modification 1. Modifications or changes to the funding in this contract and corresponding services related to the increase or decrease, may be made in the form of a written Contract Amendment signed by the Alliance's President and CEO. The Board President or its Designee of the Recipient shall sign the Notice of Award Increase/Decrease and return it to the Alliance within fourteen (14) days or sooner if requested by the Alliance. By signing Notice of Award Increase/Decrease, the Board President or its Designee of the Recipient acknowledges the receipt of and agreement with the terms contained in the Notice. 2. Upon Receipt of a Notice of Award Increase/Decrease, the recipient shall update affected information in budget summaries, deliverable schedules, or any other applicable financial information contained in this contract. The parties shall then incorporate such changes into a contract amendment. This shall be done within ten working days of receipt of such notice. IN WITNESS THEREOF, the parties hereto have caused this 17-page contract (including Attachment 1-III) to be executed by their undersigned officials as duly authorized. RECIPIENT: MONROE COUNTY ALLIANCE FOR AGING, INC. BOARD PRESIDENT OR AUTHORIZED DESIGNEE SIGNED BY: SIGNED BY: NAME: George Neugent NAME: Max B. Rothman, JD, LL.M. TITLE: Mayor TITLE: President and CEO DATE: 6-17-09 DATE: Pn V F �' 4 - ASSISTANT C UNTY 1T T OFiPEEY �AP- CONTRACT NUMBER KC 971 Page 5 ATTACHMENTI COMMUNITY CARE FOR THE ELDERLY PROGRAM I. STATEMENT OF PURPOSE The Community Care for the Elderly (CCE) Program provides community-based services organized in a continuum of care to assist aged 60+ elders at risk of nursing home placement to live in the least restrictive environment suitable to their needs. II. SERVICES TO BE PROVIDED A. Services: 1. The recipient's service provider application submitted in response to the 2008 CCE /Lead Agency RFP 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. 2. 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 Home and Hospital for the Aged, the Long Term Care Community Diversion Program and the Program of All Inclusive Care for the Elderly (PACE) program. B. Manner of Service Provision: The services to be provided are those described in the recipient's service provider application submitted in response to the 2008 CCE /Lead Agency RFP and as described in this contract. All CCE services will be provided in a manner consistent with the conditions set down in the Department of Elder Affairs January 2003, Draft Home and Community-Based Services Handbook and by the Alliance. In the event either the handbook or the service provisions established by the Alliance 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 unit rate for approved services. The recipient must ensure fixed unit rates include only those costs which 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 106C and 105C. Duplication or replication of both forms via data processing equipment is permissible, provided all data elements are in the same format as included on department forms. 5 CONTRACT NUMBER KC 971 Page 6 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 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 11 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. D. Advance funds may be temporarily invested by the recipient in an insured interest bearing account. All interest earned 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. E. 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 Units of Dollars Rate Service Adult Day Care $16.17 TBD TBD Case Management $52.57 TBD TBD Chore $33.75 TBD TBD Homemaker $22.76 TBD TBD Housing Improvement $35.32 TBD TBD Material Aid $376.73 TBD TBD Intake $53.17 TBD TBD Personal Care $34.89 TBD TBD In Home Respite $23.59 TBD TBD Total $503,344 F. Additional Reporting Conditions: 1. The recipient agrees to implement the distribution of funds as detailed in the service provider application and the Budget Summary, ATTACHMENT III to this contract. Any changes in the total amounts of the funds identified on the Budget Summary form require a contract amendment. 2. The recipient is to offer services based on clients' service plans and will not be restricted to providing the services as projected. Additional budget revisions/contract amendments will be required to move funding among these 6 CONTRACT NUMBER KC 971 Page 7 services. Any changes in the total amount of the funds under contract require a formal contract amendment. 3. The Alliance reserves the right to adjust the total quarterly award as well as the contracted unit rate to reflect recipient costs and utilization rates based on actual consumers enrolled in the program. 4. This contract is for services provided beginning July 1, 2009 through June 30, 2010, however, the contract is in effect through July 15, 2010 in order to provide for maximization of resources and to allow for greater flexibility to pay for the services rendered by June 30, 2009. Services provided after June 30, 2009 cannot be reimbursed under this contract. 5. The recipient shall submit a draft closeout report by July 15, 2010. 6. The final expenditure report and request for payment will be due to the Alliance no later than July 15, 2010. No expenditure reports or requests for payment will be accepted after July 15, 2009. G. Any payment due by the Alliance under the terms 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: 1. The recipient agrees to comply with applicable parts of Rule Chapter 58C-1, Florida Administrative Code promulgated for administration of Sections 430.201 through 430.207, Florida Statutes, and the Department of Elder Affairs January 2003, Draft Home and Community-Based Services Handbook. 3. The recipient agrees to comply with the provisions of Sections 97.021 and 97.058, Florida Statutes, and all rules related thereto in the Florida Administrative Code. 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. Abuse, Neglect and Exploitation: The recipient will ensure that pursuant to Section 430.205(5), Florida Statute, those elderly persons who are determined by adult protective services to be victims of abuse, neglect, or exploitation who are in need of immediate services to prevent further harm and are referred by adult protective services, will be given primary consideration for receiving Community Care for the Elderly Services. As used in this subsection, "primary consideration" means that an assessment and services 7 CONTRACT NUMBER KC 971 Page 8 must commence within 72 hours after referral to the department or as established in accordance with department contracts by local protocols developed between department service recipients and adult protective services. 2. Priority Criteria for Individuals in Nursing Homes in Receivership The recipient will ensure that pursuant to Section 400.126 (12), Florida Statute, those elderly persons determined through a CARES assessment to be a resident who could be cared for in a less restrictive setting or who do not meet the criteria for skilled or intermediate care in a nursing home, will be referred for such care, as appropriate for the resident. Residents referred pursuant to this subsection shall be given primary consideration for receiving services under the Community Care for the Elderly program in a manner as persons classified to receive such services pursuant to Section 430.205, Florida Statute. 3. Priority Criteria for Service Delivery: a) Individuals in nursing homes under Medicaid who could be transferred to the community; 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. e) For the purpose of transitioning individuals receiving Community Care for Disabled Adults (CCDA) and Home Care for Disabled Adults (HCDA) services through the Department of Children and Families (DCF) Adult Services to community-based services provided through the department, when services are not currently available, area agency on aging staff and lead agency case managers shall ensure that "Aging Out" individuals are prioritized for services only after Adult Protective Services (PAS) High Risk and Imminent Risk individuals. 4. Priority Criteria for Service Delivery for Other Assessed Individuals: The assessment and provision of services should always consider the most cost effective means of service delivery. Service priority for individuals not included in groups one, two or three above, regardless of referral source, shall be determined through the department's client assessment form administered to each applicant, to the extent funding is available. First priority will be given to applicants at the higher levels of frailty and risk of nursing home placement. For individuals assessed at the same priority and risk of nursing home placement, priority will be given to applicants with the lesser ability to pay for services. 5. Referrals for Medicaid Waiver Services: 8 CONTRACT NUMBER KC 971 Page 9 a) The recipient must identify, through the consumer assessment, potential Medicaid eligible CCE consumers and refer these individuals for Medicaid Waiver services. b) Individuals who have been identified as being potentially Medicaid Waiver eligible are required to apply for Medicaid Waiver services in order to receive CCE services and can only receive CCE services while the Medicaid Waiver eligibility determination is pending. If the consumer is found ineligible for Medicaid Waiver services for any reason other than failure to provide required documentation, they may continue to receive CCE services. c) Individuals who have been identified as being potentially Medicaid Waiver eligible must be advised of their responsibility to apply for Medicaid Waiver services as a condition of receiving CCE services while the eligibility determination is being processed. C. Co-payment Collections: 1. The recipient will establish annual co-payment goals. The Alliance 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. 3. Co-payments collected in the CCE program can be used as part of the local match. D. Match: The recipient will assure a match requirement of at least 10 percent of the cost for all Community Care for the Elderly services. The match will be made in the form of cash and/or in kind resources. At the end of the contract period, all Community Care for the Elderly funds expended must be properly matched. E. Service Cost Reports: The recipient will submit semi-annual service cost reports which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 9 CONTRACT NUMBER KC 971 Page 10 ATTACHMENT II COMMUNITY CARE FOR THE ELDERLY PROGRAM CONTRACT REPORT CALENDAR Report Submit To The Number Based On Alliance On This Date 1 July Expenditure Report August 15 2 August Expenditure Report September 15 3 September Expenditure Report October 15 4 October Expenditure Report ............................................ November 15 5 November Expenditure Report ......................................... December 15 6 December Expenditure Report ......................................... January 15 7 January Expenditure Report ............................................ February 15 8 February Expenditure Report ........................................... March 15 9 March Expenditure Report ............................................... April 15 10 April Expenditure Report ................................................. May 15 11 May Expenditure Report/July Advanced Reconciliation ** ..... June 15 12 June Expenditure Report/August Advanced Reconciliation ** July 15 13 Final Expenditure and Request for Payment Report .............. July 15, 2010 14 Closeout Report ............................................................ July 15, 2010 Legend: ** Submission of expenditure reports may or 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: 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. 10 CONTRACT NUMBER KC 971 Page 11 ATTACHMENT III COMMUNITY CARE FOR THE ELDERLY PROGRAM BUDGET SUMMARY Case Quarter Dates Management CCE Services TOTAL First N/A Second N/A Third N/A Fourth N/A Total 11 CONTRACT NUMBER KC 971 Page 12 ATTACHMENT IV REFERRAL PROTOCOL Issue: Screening, Triage, and Referral for Activation under the Community Care for the Elderly/Home Care for the Elderly Programs and for the Aging & Disabled Adults and the Assisted Living for the Elderly Medicaid Waivers. Policy: Referrals will be based on availability of funds, in accordance with prioritization requirements. Purpose: To ensure funding is spent expeditiously and consumers are referred into programs for appropriate services. Procedure for Monroe County: I. Roles and Responsibilities A. Alliance for Aging/Aging Resource Center ➢ Monitors overall program and Lead Agency specific spending levels on a monthly basis to ensure the Lead Agency is operating within the funding allocation. ➢ Determines the number of cases for activation based on projected funding available. ➢ Screens consumers to link with appropriate resources and prioritize for DOEA-funded programs and services. ➢ Recommends potential cases for activation based upon projected funding available by Lead Agency. ➢ Selects consumers from the waiting list based on their prioritization score. ➢ Refers consumers from the waiting list to the Lead Agency in Monroe County for activation, based on availability of funds. ➢ Monitors compliance with service standards and outcome measures. ➢ Reviews care plans and files per the File Review Policies and Procedures. ➢ Reviews data in CIRTS. B. Case Management Agency ➢ Accepts referrals from the Aging Resource Center. ➢ Refers inquiries from consumers interested in services to the ARC for Information and Referral to community resources, Screening, Triage, and Long-Term Care Options Counseling, as appropriate. ➢ Through outsourcing, the functions of Screening and Intake may also be completed by the Lead Agency. ➢ Completes comprehensive assessments on new consumers and annual reassessment on existing consumers and develops care plans and reviews care plans semi-annually. ➢ Authorizes service delivery and enters data into CIRTS. ➢ Screens consumers for Medicaid Waiver eligibility. ➢ Bills in CIRTS and Medicaid as appropriate. ➢ Monitors care plans in an effort to keep costs down while sustaining the individuals in the community. ll. Management of the Assessed Prioritized Consumer List (APCL). 12 CONTRACT NUMBER KC 971 Page 13 A. Referrals to the ARC are routed to the Information and Referral Specialists or Intake Unit staff depending on the type of referral. Clients are provided information on community resources and programs available including private pay options. Persons are directed to those resources most capable of meeting the need they have expressed to ARC staff. Cases presenting strong identifiers that indicate the consumer might benefit from publicly funded long term care services are screened, entered into CIRTS, triaged and provided options counseling. Through outsourcing, the functions of Screening and Intake may also be performed by the Lead Agency. DOEA prioritization requirements will be adhered to by both entities, as follows: 1. APS High Risk Referrals (See section B) 2. Imminent Risk cases will be prioritized for activation after APS High Risk Referrals have been served. If budgetary constraints prevent opening new cases, clients will be placed on the APCL. ARC staff will contact the client on a monthly basis to determine if there has been a change in the client's situation. 3. All other CARES referrals will be screened and prioritized in accordance with DOEA requirements. 4. Aging Out consumers will be referred by DCF for prioritization and/or activation in the corresponding aged program managed by the Alliance, as appropriate (See section IV). 5. Consumers applying for the Community Care for the Elderly (CCE) and/or Home Care for the Elderly (HCE) programs will be contacted and screened using the statewide assessment form developed by the Department of Elder Affairs for this purpose (Form 701A). If a consumer is being served through a DOEA-funded agency which enters their annual assessment into CIRTS, the Priority Score generated by that assessment will determine their ranking on the APCL. 6. Consumers referred for inclusion under the Assisted Living for the Elderly (ALE) Medicaid Waiver APCL will be interviewed and screened using the 701 A form. 7. Consumers referred for inclusion under the Aging and Disabled Adult (ADA) Medicaid Waiver APCL will be contacted and screened following the same procedure as the one described under Section 5. Individuals who appear as potentially eligible for other types of public assistance will be referred to the Economic Self-Sufficiency Unit at the Department of Children and Families. 8. All other referrals will be waitlisted and prioritized, during which time other community resources will be researched, including private pay/fee for services providers. Consumers on the waiting lists will be reassessed according to Department requirements (NOI #062906-1-1-OVCS 6/29/2006). 13 CONTRACT NUMBER KC 971 Page 14 B. HIPAA forms will be sent to the consumer as appropriate. III. Opening New Cases A. CCE/ADA/ALE/HCE Clients 1. The Fiscal Department will monitor Lead Agency specific spending levels on a monthly basis to ensure each Lead Agency is operating within its quarterly funding allocation and/or spending authority. In addition, the department will do cost projections, and share the information with the Surplus/Deficit review committee to determine slot availability. The ARC and the Quality Assurance Department will be notified when funding is available and the number of new cases to be activated by Lead Agency. 2. Upon notification from the Vice President for Finance of funding availability, the Aging Resource Center Intake Unit Supervisor will run the Prioritized Risk Report to identify the consumers on the APCL to be opened. 3. Based on available funding, the ARC Intake Unit Supervisor will refer wait listed clients to the Lead Agency for activation, in accordance with prioritization requirements. The Lead Agency will update the wait list enrollment using the appropriate code to terminate from the APCL. B. APS Referrals 1. APS Low and Intermediate Risk referrals will be screened and prioritized for services as per the DOEA/APS Memorandum of Understanding. Low and Intermediate Risk referrals are also offered information and referral to additional community resources, including private pay as appropriate. 2. APS High Risk Referrals are not waitlisted. They are immediately referred for service from DCF in Monroe County to the Lead Agency. ARTT referrals will be forwarded directly the Lead Agency. APS cases are to be served for a maximum of 31 calendar days. If additional time is justified, the case management agency will staff the case with the Alliance to obtain the extension needed. 3. Upon receipt of the APS referral, the Lead Agency will coordinate services to begin within the 72 hour period mandated by statute. A comprehensive assessment will be done within 14 working days of the referral. Services required under the care plan will remain in place for a maximum of 31 days, unless an extension has been granted. 4. The Lead Agency will enter ACTV enrollment under their provider number in CIRTS. In addition, service codes will be entered by service date for all services provided. If a service(s) is not provided as required under the care plan, an NDP code will need to be entered in CIRTS and the case notes under the client file should document the reason for non-delivery of such service(s). IV. Aging Out Consumers: 14 CONTRACT NUMBER KC 971 Page 15 A. All "Aging Out' consumers will be referred by DCF for activation in the corresponding aged program managed by the Alliance. B. Consumers active in the CCDA and HCDA programs that are turning 60 and are eligible for CCE and/or HCE will be opened in the corresponding aged program managed by the Alliance if funding is available. If funding is available, these consumers will be made active. If funding is not available, they will be waitlisted for these programs but will be given priority for activation once funding is available. C. Consumers active in the ADA Medicaid Waiver, upon turning age 60, will continue to be eligible for and receive ADA Medicaid waiver services. 15 CONTRACT NUMBER KC 971 Page 16 ATTACHMENT V Aging Resource Center Outsourced Funtions A. Perform ARC outsourced functions in accordance with policies and procedures developed by the Alliance for Aging. (ATTACHMENT VI) 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-term 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. Through outsourcing, the function of Screening may also be completed by the Lead Agency for the Community Care for the Elderly, Home Care for the Elderly, Aging and Disabled Adults, and the Assisted Living for the Elderly Medicaid Waivers. 16 CONTRACT NUMBER KC 971 Page 17 ATTACHMENT VI 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 information from clients in order to assist in determining level of need and eligibility for DOEA funded services Procedure: ARC Contracted Providers will collect information from callers and conduct a 701A assessment. Alternatively, if a 701E assessment already exists or is provided from another source (i.e. CARES) the information from the 701B can be utilized. Based on the information provided via the 701A(B) assessment, the ARC Contracted Provider will make a determination as to the services that the caller is in need of receiving. The ARC Contracted Provider will determine the appropriate funding source(s)that provides the needed services. 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. The caller will be provided with general information regarding the ARC as well as the ARC Elder Helpline contact number. The caller will be informed of the services and funding sources that they are being placed on the wait list for in CIRTS. ARC Contracted Provider will create a client record in 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]. If the ARC Contracted Provider determines that the caller may qualify for more than one funding source, ARC Contracted Provider is encouraged to enter the appropriate information under multiple funding sources. [If there is an existing client record in CIRTS, the client record in CIRTS will be updated with appropriate information]. ARC Contracted Provider will inform 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. Note: These ARC policies and procedures are subject to change. Any modifications will be done through a contract amendment. 17 Amendment 002 CONTRACT ACC 871 Page 1 THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred to as the"Alliance", and Monroe County. The purpose of this amendment is to change the maximum units of services under contract and adjust the unit rate based on the Unit Cost. METH©© OF PAYMENT: 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 Units of Dollars 140 Service Adult Day Care $16.17 - 1,000 516,182.27 Case Mana ement $52.57 1,772 $93,155.14 Chore $33.75 185 $6,242.83 Homemaker $22.76 7,200 $163,882.00 Housing Improvement $35.32 160 $5,650.93 Material Aid $376.73 15 55,650.93 Intake $53.17 200 510,634.30 Personal Care - $34.89 3,668 $127,981.40 In Home Respite $23,59 1 t 4 4 5<A This amendment shall begin on November 1, 2008 or the date it has been sighed 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 ALLIANCE FOR AGING, INC. BONED BY: BIGNED BY: Max B. Rothman, JD, LL.M. NAME_: NAME: President& CEO TITLE: TITLE: DATE; PATE; M �t5tN1Y�t OIiN aSST ASS1 TANI GUu ­-J iC RNEY a [fate—