Item C21BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: 10-21-2009
Bulk Item: -Yes_
Division: _County Administrator.
Department Soci-al-Servioe&/1n-Home-Services_
Staff Contact Person/Phone #: Sheryl Graham/X4510
AGENDA ITEM WORDING: Approval of Amendment 003 to 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 Amendment #003 to the CCE Contract will revise and replace
Attachment III of the original contract KC 971 regarding Referral Protocol
PREVIOUS RELEVANT BOCC ACTION: Prior approval granted for Amendment #001 to CCE
Contract #KC-971 on 7-15-09.
CONTRACT/AGREEMENT CHANGES: To revise and replace Attachment III of the original
contract KC 971 regarding Referral Protocol, relating to issue, policy and purpose.
STAFF RECOMMENDATIONS: Approval
TOTAL COST: $494,520.00 INDIRECT COST: _-0-_BUDGETED: Yes X No _
COST TO COUNTY: Inkind (Space) Match of $22,201.00 SOURCE OF FUNDS: Grants
No Cash Match is Required- an Inkind(Space) Match of $22,201.00 and co -Payment Match of
$22,305.00 will be used for the $44,506.00 Total Match Commitment.
REVENUE PRODUCING: Yes X No _ AMOUNT PER MONTH approx. $2,500.00
Year approx. $30,000.00
APPROVED BY: County Atty X OMB/Purchasing X Risk Management _X_
DOCUMENTATION:
DISPOSITION:
Revised 1 /09
Included X Not Required
AGENDA ITEM #
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMN ARY
Contract with: Alliance for Aging, Inc. Contract Amendment
003 to contract # KC-
971
Effective Date: July 1, 2009
Expiration Date: June 30, 2010
Contract Purpose/Description: Approval of Amendment 003 to the CCE Contract #KC-971 will revise and
replace Attachment III regarding Referral Protocol, relating to issue, policy and purpose.
Contract Manager: Sheryl Graham 4510 Social Services/Stop 1
(Name) (Ext.) (Department/Stop #)
For BOCC meeting on 10/21/2009 Agenda Deadline: 10/6/2009
CONTRACT COSTS
Total Dollar Value of Contract: $494,520.00
Budgeted? Yes X No Account Codes:
Grant:$494,520.00 (Fiscal Year)
County Match: (Required) Inkind Match of $22,201.00 and
Client Co -Pay Match of $22,305.00 will be used for the
$44,506.00 Total Match Commitment
Estimated Ongoing Costs: $
(Not included in dollar value above)
/yr
Current Year Portion: $_
125-6153809 -
ADDITIONAL COSTS
For:
itilities, janitorial, salaries, etc)
CONTRACT REVIEW
Division Director
Date In
/0/1 101
Changes
Nee
Yes No
Date Out
Reviewe `J
Risk Man ement
OM.B./P Ching
County Attorney
�'
10 I 1 t
c j �r `()C\
Yes Now
Yes No
Yes
( `1
Comments:
OMB Form Revised 2/27/01 MCP #2
Amendment 003 CONTRACT KC 971 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�thi& amendment is -to -revise -and replace -attachment Hl-of the-originaV— --
contract to read:
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:
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.
II. Management of the Assessed Prioritized Consumer List (APCL).
Amendment 003 CONTRACT KC 971 Page 2
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:
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).
B. HIPAA forms will be sent to the consumer as appropriate.
Amendment 003 CONTRACT KC 971
III. Opening New Cases
A. CCE/ADA/ALE/HCE Clients
Page 3
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 72 hours 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:
A. All "Aging Out" consumers will be referred by DCF for activation in the corresponding
aged program managed by the Alliance.
Amendment 003 CONTRACT KC 971
Page 4
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
-- ---cons=ers-wM l-be-made-active.-if-funding-is-not-anailabte;11W wiH-tip-waitfisted 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.
METHOD OF PAYMENT:
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
Commissioners.
SIGNED BY:
NAME:
TITLE:
DATE:
ALLIANCE FOR AGING, INC.
SIGNED BY:
Max B. Rothman, JD, LL.M.
NAME:
President & CEO
TITLE:
DATE:
PROVE—D AS
PEDRO J. MFRCA,
���
SSISTANT C0 T `r AT"i 11r_iw )Y
Date
Amendment 001 CONTRACT KC 971 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 $ 8,824
from $503,344 to $ 494,520.
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:
SIGNED BY:
NAME:
TITLE:
DATE:
Monroe County Board of
Commissioners.
George Neugent
Mayor
July 15, 2009
SIGNED BY:
NAME:
TITLE:
DATE:
RUNTY A TG AS 7 .
OU TY,4 CRh'EY
ALLIANCE FOR AGING, INC.
Max B. Rothman, JD, LL.M.
President & CEO