Item C26
.'
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date:
6-18-2008
Division: Community Services
Bulk Item: Yes l No
Department: Social Services
Staff Contact Person: Jerry Eskew. x4425
AGENDA ITEM WORDING: Approval of the Alzheimers' Disease Initiative (AD!) Contract
Number KZ 897 between the Alliance for Aging, Inc. (Area Agency on Aging) and the Monroe County
Board of County Commissioners (Community Services/In-Home Services) for fiscal year 7/1/08 to
6/30/09.
ITEM BACKGROUND: The approval of this ADI Contract will enable Monroe County In-Home
Services to continue providing services to Monroe County's elderly population under the Alzheimers'
Disease Initiative program.
PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to the Alzheimer's Disease
Initiative (AD I) Contract Number KZ 797 on June 20, 2007
CONTRACT/AGREEMENT CHANGES: None
STAFF RECOMMENDATIONS: Approval
TOTAL COST: $65,888
Yes l No
COST TO COUNTY: $0 No Cash Match Required
SOURCE OF FUNDS:
REVENUE PRODUCING: Y es ~ No AMOUNT PER MONTH $50.00
Year $600.00
APPROVED BY: County Arty -X- OMB/Purchasing~ Risk Management_X_
DOCUMENTATION:
Included X
Not Required_
To Follow
DISPOSITION:
AGENDA ITEM #
Revised 8/06
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, Inc. Contract KZ 897
Effective Date: July 1, 2008
Expiration Date: June 30, 2009
Contract Purpose/Description: Approval of the Alzheimer's Disease Initiative (ADI) Contract Number KZ 897
between the Alliance for Aging, Inc. and the Monroe County Board of County Commissioners (Monroe County
Community Services/In-Home Services Program) for Fiscal year July 1,2008 through June 30, 2009.
Contract Manager:
Jerry Eskew
(Name)
4425
(Ext. )
Social Services/Stop 1
(Department/Stop #)
For BOCC meeting on
6/1812008
Agenda Deadline:
6/3/2008
CONTRACT COSTS
Current Year Portion: $16,472
125 - 6153608
Total Dollar Value of Contract: approx. $65,888
Budgeted? Yes X No Account Codes:
County Match: Required $0 No Cash Match Required
Additional Match:
Total Match $0
Estimated Ongoing Costs: $ /yr
(Not included in dollar value above)
ADDITIONAL COSTS
For:
(e./!;. Maintenance, utilities, janitorial, salaries, etC)
Division Director
t;1~v
(p . 3-D6
D , 3/ o~
~I '!jdS
Risk Management
O.M.B./Purchasing
County Attorney
Comments:
OMB Form Revised 2/27/01 MCP #2
CONTRACT REVIEW
Changes
Need~)
Yes Q!9I
Yes Q
DW
G ~~
~~..3-4!S'
Yes No
Yes G
CONTRACT KZ-897
Page 1
ALZHEIMERS' DISEASE INITIATIVE CONTRACT
2008-2009
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.
PA429, and its successor, incorporated herein by reference.
I. Recipient Agrees:
A. Services to be Provided:
1. The recipient's service provider application for state tiscal year 2008 and any
revisions thereto approved by the Alliance and located in the contract manager's
tile, 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 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 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 2008 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 ofthe revisions.
II. The Alliance Agrees:
A. Contract Amount:
To pay for services in an amount not to exceed $65.888.00, subject to the availability of
funds.
Obligation to Pay:
The Alliance's performance and obligation to pay under this contract is contingent upon
an annual appropriation by the Legislature.
B. Source of Funds:
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CONTRACT KZ-897
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. Aging Resource Center Outsourced Functions:
A. Perform ARC outsourced functions in accordance with policies and procedures
developed by the Alliance for Aging. Refer to the following attachments:
1. Attachment IV: Policies and Procedures for Outsourced Function-
Screening
11. Attachment V: Policies and Procedures for Outsourced Function-
Triage
111. Attachment VI: Policies and Procedures for Activation from
Waitlist- Client Services
IV. Attachment VII: Policies and Procedures for Termination 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-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. 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).
IV. Recipient and Alliance Mutually Agree:
A. Effective Date:
1. This contract shall begin on July 1, 2008 or on the date the contract has been
signed by both parties, whichever is earlier.
2. Delivery of services shall end on June 30, 2009.
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CONTRACT KZ-897
Page 3
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
Commissioners
ALLIANCE FOR AGING, INC.
SIGNED BY:
SIGNED BY:
Max B. Rothman, JD, LL.M.
NAME:
NAME:
President & CEO
TITLE:
TITLE:
DATE:
DATE:
/...------
3
CONTRACT KZ-897
Page 4
ATTACHMENT I
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
I. 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:
I. The recipient's service provider application for state fiscal year 2007 and any revisions thereto
approved by the Alliance and located in the contract manager's tile, 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 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 Service 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 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 2007 and the Department
of Elder Affairs Horne 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 1062 and 1052. 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.
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.
4
CONTRACT KZ-897
Page 5
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 ofthe
contract period, based on anticipated cash needs. Detailed documentation justitying 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 A TT ACHMENT 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 offunds.
E. 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.
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 2,742 $65,888
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:
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:
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CONTRACT KZ-897
Page 6
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.
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 impaimlent
shall be detennined through the department's consumer assessment fonn administered to each applicant. The most frail individuals not
prioritized in groups one. two or three above. regardless of referral source. will receive services to the extent timding is available.
C. Co-payment Collections:
I. 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 concerning 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 service personnel and caregivers,
as well as serve 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,
2008.
E. Collaboration with Memory Disorder Clinics:
Memory Disorder Clinics are required to provide four hours of in-service 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:
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CONTRACT KZ 897
Page 7
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.
7
Report
Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
16
Leqend:
Note # 1:
Note # 2:
CONTRACT KZ 897
Page 8
ATTACHMENT II
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
CONTRACT REPORT CALENDAR
Based On
July Advance * ...............................................................
August Advance * ... ......... ... ...... ... ... ... ...... ............... ... .....
July Expenditure Report... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .
August Expenditure Report ............ ... ... ...... ... ... ...... ...... ......
September Expenditure Report ......... ... ...... ... ............ ...... ....
October Expenditure Report...... ... ... ... ........................... .....
November Expenditure Report ........................... ...... ...........
December Expenditure Report ...... ...... ............ ...... ...... ........
January Expenditure Report... ... ... ... ... ... ... ... ... ... ... ... ... ... .....
February Expenditure Report... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .
March Expenditure Report... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
April Expenditure Report ... ... ......... .................. ... ......... .......
May Expenditure Report/July Advance Reconciliation ** ...........
June Expenditure Report/August Advance Reconciliation ** ......
Final Expenditure and Closeout Report .................
*
Advance based on projected cash need.
Submit
to the Alliance
on This Date
July 1
July 1
August 10
September 10
October 1 0
November 10
December 10
January 10
February 10
March 10
April 1 0
May 10
June 10
July 10
July 20
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.
**
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.
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.
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CONTRACT KZ 897
Page 9
ATTACHMENT III
ANNUAL MODEL DAY CARE CENTER TRAINING REPORT
Model Day Care Center Name:
Printed Name of Person
Completing Report
Signature of Person
Completing Report
Date Executed
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 1 st 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:
* * * * * *
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CONTRACT KZ 897
Page 10
Attachment IV
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:
1. ARC Contracted Providers will collect information from callers and conduct a 701A
assessment. Alternatively, if a 701B assessment already exists or is provided from another
source (i.e. CARES) the information from the 701B can be utilized.
2. 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 (see
Contract Amendment APCL).
3. The ARC Contracted Provider will determine 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 Form and/or to an ARC Contracted Provider that provides the needed service.
5. The caller will be provided with general information regarding the ARC as well as the ARC
Elder Helpline contact number.
6. The caller will be informed 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 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].
8. 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].
9. 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.
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CONTRACT KZ 897
Page 11
Attachment V
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 List 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 Line contact number
and to contact the ARC Elder Help Line 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.
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CONTRACT KZ 897
Page 12
Attachment VI
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 determines 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 determines that the clients need will persist after the temporary funding
source is exhausted.
5. ARC Contracted Provider will inform 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 inform client to contact the ARC Elder Helpline if they
have any questions or concerns regarding the status of any of their services.
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CONTRACT KZ 897
Page 13
Attachment VII
ine
Policy and Procedure for
Termination From Wait List - Clients/Services
Objective: To ensure that the comprehensive list of clients in need of services in CIRTS is
appropriately maintained by funding source and that the ARC is thereby able to
effectively gauge the current level of elder service need in Miami-Dade and Monroe
Counties.
Policy: ARC will maintain an accurate and current list of clients in need of elder services 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 wait list for services based on DOEA Reassessment
Standards.
2. The re-screening may be in the form of a phone screening or a home visit depending
on the clients status (i.e. active/pending)
3. ARC Contracted Provider will determine if the client is no longer in need (or eligible) for
any of the services they were wait listed for.
4. ARC Contracted Provider will terminate the client from the wait list (entirely or by
specific service) using the appropriate CIRTS termination code for any services or
funding source for which the client is determined to no longer be eligible for or no
longer in need of.
5. ARC Contracted Provider will inform the client of any services/funding source that they
are being removed from the wait list for.
6. ARC Contracted Provider will inform 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 concerns regarding their wait list status.
8. Reference DOEA Notice of Instruction: Assessed Priority Consumer List#:062906-1-I-
OVCS as applicable.
13