Agenda 05/22/2012 Item #16D 45/22/2012 Item 16.D.4.
EXECUTIVE SUMMARY
Recommendation to approve after - the -fact submital of a request for proposal application for the
Community Care for the Elderly, the Home Care for the Elderly, and the Alzheimer's Disease
Initiative Programs for a 6 year contract period with Senior Choices f /k/a Area Agency on Aging
for SWFL and authorize the Chairman to execute all related documents including the necessary
budget amendments for continuation of services. (Fiscal Impact: $830,245)
OBJECTIVE: To receive after - the -fact approval from the Board of County Commissioners (BCC) to
submit a request for proposal application for the Community Care for the Elderly, the Home Care for the
Elderly, and the Alzheimer's Disease Initiative in order to receive and manage associated grants and
continue providing senior care case management services.
CONSIDERATIONS: The Services for Seniors program managed within the Housing Human and
Veteran Services (HHVS) Department has been providing support services to Collier County's frail and
elderly citizens for over 32 years through the Community Care for the Elderly (CCE), Home Care for the
Elderly (HCE), and the Alzheimer's Disease Initiative (ADI) grant programs. All three grants are allotted
to the entity holding the Lead Agency title only. The grants are received from the Florida Department of
Elder Affairs (DOER) and are managed by Senior Choices of Southwest Florida (SCSF). The Lead
Agency is then a grantee of SCSF. These grants enable the County's Services for Seniors Program to
provide in home services to seniors and their caregivers so that they can remain in their homes and live
with independence and dignity.
The HHVS Department currently administers a three year contract as the designated Lead Agency that
will expire on June 30, 2012. Should Collier be designated the Lead Agency, this new contract will be for
a six year period instead of a three year period with annual grant funding allocations and associated
contracts. The Lead Agency will be responsible to respond to the needs of seniors and to manage the
spending authority for the CCE, HCE, ADI program services.
The grantor agency advised staff in February 2012 that the upcoming request for proposal (RFP) would
take place in April 2012. The RFP was released on April 2, 2012 with a submission date of April 30,
2012. Staff responded promptly, but there was insufficient time to meet the BCC agenda deadline with a
complete RFP packet. The request for proposal application for the CCE, HCE, and ADI was given to the
County Manager's Office for signature on April 30, 2012 and was submitted to the Senior Choices f /k/a
Area Agency on Aging the same day. This application was submitted by HHVS Department with the sole
purpose of providing services to the local community and enhancing the quality of life for Collier County
citizens, as stated in HHVS mission. Senior Choices will provide notice of the contract award on June 14,
2012 and the HHVS Department will bring the notice for the agreement to the BCC for approval. If the
agreement is approved by the BCC, the operations for CCE, HCE, and ADI programs will commence on
July 1, 2012.
FISCAL IMPACT: The level of funding is anticipated to be commensurate with the level of service
provided. As a point of reference, the annual funding allocation amount for the current year award is
$830,245 for the CCE, HCE, and ADI programs. The CCE program ($657,667) requires a 10% match or
$73,074. The Human Services Match Fund (708) currently has $72,600 available in Board Reserves and
the Services for Seniors Fund (123) Reserves would fund the balance of $474. Budget amendments are
required due to the timing difference in award notice (June 14, 2012) and contract execution. Funding
availability or use of funds begins July 1, 2012. Funds will not be expended unless Collier is awarded
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5/22/2012 Item 16.D.4.
this grant contract. This budget amendment is requested in order to prevent a disruption of services. A
subsequent Board action will take place to accept the contract and finalize the actual awarded amount.
GROWTH MANAGEMENT IMPACT: There is no growth management impact due to this request.
LEGAL CONSIDERATIONS: The Board will have the opportunity to accept or reject the funds
if the grant is approved. Accordingly, this Office has no issue with respect to the legal
sufficiency of this request, which requires a majority vote for Board action. -JBW.
RECOMMENDATION: Recommendation to approve after the fact submittal of a request for proposal
application for the Community Care for the Elderly, the Home Care for the Elderly, and the Alzheimer's
Disease Initiative Programs for a 6 year contract period with Senior Choices f/k/a Area Agency on Aging
for SWFL and authorize the Chairman to execute all related documents including the necessary budget
amendments.
Prepared by: Louise Pelletier, Case Management Supervisor, Housing, Human, and Veteran Services
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.4.
5/22/2012 Item 16.D.4.
Item Summary: Recommendation to approve after - the -fact submital of a request for
proposal application for the Community Care for the Elderly, the Home Care for the Elderly,
and the Alzheimer's Disease Initiative Programs for a 6 year contract period with Senior Choices
f /k /a Area Agency on Aging for SWFL and authorize the Chairman to execute all related
documents including the necessary budget amendments for continuation of services. (Fiscal
Impact: $830,245)
Meeting Date: 5/22/2012
Prepared By
Name: Bendisa Marku
Title: Operations Analyst,Wastewater
4/30/2012 3:21:07 PM
Submitted by
Title: Operations Analyst,Wastewater
Name: Bendisa Marku
4/30/2012 3:21:09 PM
Approved By
Name: GrantKimberley
Title: Interim Director, HHVS
Date: 4/30/2012 8:53:03 PM
Name: AlonsoHailey
Title: Administrative Assistant,Domestic Animal Services
Date: 5/7/2012 4:39:00 PM
Name: AckermanMaria
Title: Senior Accountant, Grants
Date: 5/8/2012 10:32:13 AM
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Name: WhiteJennifer
Title: Assistant County Attorney,County Attorney
Date: 5/8/2012 4:07:04 PM
Name: CarnellSteve
Title: Director - Purchasing /General Services,Purchasing
Date: 5/8/2012 5:00:58 PM
Name: KlatzkowJeff
Title: County Attorney
Date: 5/9/2012 1:50:41 PM
Name: StanleyTherese
Title: Management/Budget Analyst, Senior,Office of Management & Budget
Date: 5/14/2012 5:35:53 PM
Name: PryorCheryl
Title: Management/ Budget Analyst, Senior,Office of Management & Budget
Date: 5/14/2012 5:48:26 PM
Name: KlatzkowJeff
Title: County Attorney
Date: 5/15/2012 10:15:29 AM
Name: OchsLeo
Title: County Manager
Date: 5/15/2012 11:19:35 AM
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5/22/2012 Item 16.D.4.
5/22/2012 Item 16.D.4.
COLLIER COUNTY GOVERNMENT
HOUSING, HUMAN, AND VETERAN SERVICES
SERVICES FOR SENIORS PROGRAM
COMMUNITY CARE FOR THE ELDERLY
ALZHEIMER'S DISEASE INITIATIVE
HOME CARE FOR THE ELDERLY
REQUEST FOR PROPOSAL
LEAD AGENCY / PART A. PROGRAM MODULE
7/01/2012 - 6/30/2018
SUBMITTED APRIL 30, 2012
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2
TABLE OF CONTENTS
5/22/2012 Item 16.D.4.
I. A. SERVICE PROVIDER SUMMARY INFORMATION ..............................6
1. Organizational Capability ...................................................... ..............................7
2. Program Administration Experience ...................................... ..............................9
3. Fiscal Management ................................................................. .............................12
4. Staffing, Competency of Staff and Staff Development/Training Plan ................13
5. Community and Volunteer Support ....................................... .............................15
6. Disaster Emergency .......................................... ............................... .....17
...............
II. PROGRAM MODULE FORMATS ............................................... .............................20
A. General Information ...................................................................... .............................20
1. Needs Assessment ............................................. .............................20
2. Targeting .................... ............................... ...............................
... 22
3. Eligibility and Assessment/Reassessment Process ....... .............................24
4. System of Prioritization .................................... ...............................
26
5. Process for Reducing or Terminating Services ............. .............................29
6. Quality Assurance ............................................ ...............................
32
a. Client Satisfaction ........................................... .............................32
b. Internal Evaluation Process ............................... .............................33
c. File Quality /Data integrity .............................. ...............................
34
d. Case Management quality ................................. .............................35
B. Description of Service Delivery, Service Data (Includes Items 1,2 & 3) ............ 38 -52
1. Site Location
2. Days and Hours of Operation
3. Describe Specific Activities
C. New Service/New Provider Workplan ........................ ............................N /A
D. Outcome /Output Measures ...................................... .............................53
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3
5/22/2012 Item 16.D.4.
APPENDIXES
I. Notice of Intent to File Application Proposal for 2012 -2018 CCE Lead Agency
Designation
II. Applicant Attachment Checklist
III. Service Provider Application Checklist
IV. Contract Terms & Conditions Statement
V. Applicant Statement of Authorization & Capacity
VI. Statement of No Involvement
VII. Availability of Two Months (60 days) Cash
VIII. Statement of Compliance with Service Standards
IX. HIPAA /Confidentially Compliance Assurance
X. Administrative Assessment Checklist
XI. Independent Audit and Management Letter
XII. Utilization of Other Resources/Monitoring reports from other fenders
XIII. Disaster/Emergency Preparedness Plan
XIV. Transition Plan Statement (Waived for Current Providers)
XV. Description of Client Input Mechanism (Waived for Current Providers)
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4
EXHIBITS
A. Collier County Board of County Commissioners
B. Housing, Human and Veteran Services Organizational Chart
C. Client Surveys- Client Letters
D. Case Management Training Log
E. Training Schedule
F. Minimum Guidelines
G. Policy and Procedure for Adverse Actions
H. Client Satisfaction Survey
I. Grievance Procedure
J. Vendor Monitoring
K. Release of Information .
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5/22/2012 Item 16.D.4.
5/22/2012 Item 16.D.4.
s
I. A. Service Provider Summary Information
The mission of the Collier County Services for Seniors program is to assist frail, elderly
Collier County residents in greatest medical, economic and social need to remain in their homes
as long as possible and to improve or maintain their quality of life by preventing premature
nursing home placement. The Collier County Housing, Human, and Veteran Services (HHVS)
Department, Services for Seniors program has been the Lead Agency in Collier County for elder
services for more than thirty two (32) years. Collier's execution of the State Community Care for
the Elderly (CCE), Home Care for the Elderly (HCE), and Alzheimer's Disease Initiative (ADI)
grants have established a reputation of excellence in the service delivery system provided by the
HHVS Services for Seniors program. In the past six years, Services for Seniors has served over
2300 Collier County's citizens resulting in providing over 332,000 hours of service.
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Lr
SERVICE PROVIDER
5/22/2012 Item 16.D.4.
1.
PROVIDER INFORMATION:
2. GOVERNING BOARD CHAIR:
Executive Director
{Name/Address/Phone)
{Name/Address/Phone)
Fred Coyle, Chairman
Kim Grant, Interim Director
3299 Tamiami Trail E.
3339 Tamiami Trail E.
Naples FL 34112
Suite 211
Naples FL 34112
Name of Grantee Agency:
Legal Name of Agency:
Collier County Board of County Commissioners
Housing, Human and Veteran Services Department
3. ADVISORY COUNCIL CHAIR: (If applicable)
(Name/Address/Phone)
Mailing Address
3339 Tamiami Trail E.
Suite 211
Naples FL 34112
Telephone Number. f 239 252 -2273
4.
TYPE OF AGENCY /ORGANIZATION:
5. PROPOSED FUNDING PERIOD: 711/2012 — 6/30/2018
A. New Applicant
NOT FOR PROFIT: PRIVATE
X PUBLIC
B. Continuation X
PRIVATE FOR PROFIT
6.
FUNDS REQUESTED:
[ X ] CCE [ )q ADI [ X ] HCE [ ] EHEAP [ ] HCBS [ ] OTHER
7.
SERVICE AREA: [ X j Single County Collier
8.
ADDRESS FOR PAYMENT OF CHECKS ITEM #: [ X ] #1 [ ] #2
9.
-
CERTIFICATION BY AUTHORIZED AGENCY OFFICER
I hereby certify that the contents of this document are true, accurate and
complete statements. I acknowledge that intentio I
misrepresentation or falsification may result in the termination of financial assistance.
Name: Mark Isackson on behalf of Leo Ochs, Jr.
Signature:
Title:
County Manaoer
Date:
SUMMARY INFORMATION PAGE (sPA -P I)
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5/22/2012 Item 16.D.4.
1. Organizational Capability
The Services for Seniors section of the HHVS Department is fortunately situated in the
structure of County Government to provide designated services and to benefit from being part of
a large, established organization with access to supportive resources. The sole purpose of
County Government is to provide needed services to the local community, and everything we do
every day is in support of this mission. Such services include providing transportation systems,
land development services, utility services, and a large array of public services that will be
elaborated upon at various points within this application.
Collier County Government is a large, well structured organization with a long, solid
history. The organization has grown over time to parallel the constituent growth. We are proud
of our history with these programs, having had the privilege of serving in the capacity of Lead
Agency for over 30 years. Staff members have collectively over 100 years of case management
experience and have developed a stable, solid, complete network within the community and with
vendor partners.
Providing Lead Agency services under the structure of County Government offers many
benefits and assures long term stability. The organization has well established policies and
procedures set forth by the Board of County Commissioners and by the County Manager. These
policies ensure such aspects as safe and effective hiring practices, professional, structured
procurement guidance and the availability of a professional legal staff.
The Collier County Board of County Commissioners (BCC) (see BCC - Exhibit A)
consistently provides strong support in the operations of these programs through its mission of
improving the lives of Collier County's elderly residents. According to the BCC strategic plan,
Focus Area III: Community Health, Wellness and Human Services, the goal is to improve the
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s
5/22/2012 Item 16.D.4.
quality of life and promote personal wellness, self reliance, and independence. Based on the
BCC guidance, the HHVS mission is to enhance the quality of life for Collier County citizens by
providing housing, human and veteran services that are compliant, efficient, and meet our
customer needs with compassion and dedication. The BCC has supported the Services for
Seniors program through financial resources which are 10% of the total grant allocation in a
form of cash contribution used to increase the services to the residents.
Being part of a large organization provides access to many needed resources that assist in
the execution of the Lead Agency activities. For example, the county's legal department assists
with approval of contractual documents and regulatory policies as it relates to program
implementation and compliance. The Office of Management and Budget acts as the internal
auditor for the fiscal and compliance monitoring. The Finance Division of the Clerk of Courts
acts as the agency's external auditor for our fiscal monitoring. The Purchasing Department acts
as the agent for cost savings in acquiring vendor services and products through contracts. The
Human Resources Department ensures our ability to meet high personnel standards including
employee Level II background screening, and training, a comprehensive employee benefits
package for all employees, and this translates to premium client care. Because of the availability
of these valuable operational resources, the grantor agency can be assured that quality and
accountability will always be maintained by Services for Seniors.
The Human Services Section of the HHVS department also includes social service
assistance for individuals needing medical and/or prescription assistance, Veteran Services
which serves many seniors and their spouses, and the Retired and Senior Volunteer Program
(RSVP) which enlists the assistance of senior volunteers in the community.
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5/22/2012 Item 16.D.4.
Furthermore, HHVS is situated in a division that focuses on service delivery to
individuals in our community, and this association buoys the departments' perspective on
excellence in service delivery. Sister departments in the Public Services Division include:
University Extension Services, Domestic Animal Services, Library, Museum, Parks and
Recreation, and Coastal Zone Management. The HHVS department (see HHVS Organizational
Chart- Exhibit B), along with their sister departments, provides high quality senior services in a
variety of community settings.
The County also has recently created a Grants Management Office under the Office of
Management and Budget to focus on audit compliance and accounting controls in all grant
programs throughout the County. This is viewed as a substantial boost to the professionalism of
the departments' fiscal team, and further demonstrates the organizational commitment to and
capacity for effectively managing these programs.
Regarding facilities, Services for Seniors offices are located in Naples, Florida at the
government complex on Airport Road. This location is very convenient to many of our clients
and also to network agencies and service providers. The staff is equipped with sufficient
transportation availability to see clients locally and in urban areas of the county. The offices
themselves are in a secured area and admittance is only by security key card. Clients who may
visit the office have access to a private location with one of our case managers. Staff is trained
on and follows HIPAA rules in the protection of the private information of our clients. Program
and fiscal staff are co- located to provide for effective communication.
Collier County HHVS Services for Seniors section is part of a strong, integrated system
designed to assure effective program operations.
2. Program Administration Experience
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io
5/22/2012 Item 16.D.4.
Services for Seniors program has provided the same high quality level of service and
sometimes with limited resources. One example would be maintaining the same level of service
with decreased level of staffing in both program and fiscal. However, the reduced level of
resources has not negatively influenced the services provided to the seniors. Services for Seniors
program has performed efficiently and effectively even when the client services and the DOEA
required standards have become increasingly more complex. Since the beginning of this grant
program, Services for Seniors has been the only lead agency and provider of case management
services in Collier County. One of the benefits that Services for Seniors program encompasses is
the highly experienced level of the staff and the partnerships with the health care providers that
has been established and nurtured over the 32 year period.
It has been an honor for the HHVS Services for Seniors program staff to have operated
this program for the past thirty two (32) years. Our staff has over 100 years combined
experience providing case management as well as experience related to both programmatic and
fiscal delivery of case management services for seniors with Senior Choices Provider Service
Area (PSA) 8 Area Agency on Aging (AAA).
The philosophy of the program is to employ professionals who have the skills,
knowledge, education, dedication, and experience to link individuals in need to the most
beneficial service that is also the least restrictive. Assisting individuals to live independently has
been the mission and the cornerstone of the program since its inception.
To accomplish this mission, our staff assesses an individual's situation in order to
determine the necessity to improve or maintain his/her health, family, social, or medical status to
remain in the least restrictive setting possible. As services are delivered the quality and quantity
of the services are carefully measured to ensure the outcomes are consistent with and on target
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5/22/2012 Item 16.D.4.
with the statewide outcome and measures of the Department of Elder Affairs. Case managers
also provide advocacy ensuring that the client's needs and best interests are upheld both by the
service delivery system and the community at large.
We value and respect our relationship with the grantor agency and have worked closely
with them over this time period to maximize the services provided for the allocated funding (and
other support) granted. An example of this is the open communication lines and our ability to
freely utilize the expertise of the grantor agency in both program and fiscal aspects.
Additionally, Services for Seniors works in partnership with the grantor agency in advocating for
residents of Collier County.
Services for Seniors has also created a substantial network of professionals and vendors
to leverage the grant funding over the years. In 2011 alone, staff estimated receiving a total of
$12,000 in -kind from this network, not to mention the hundreds of referrals we were able to
provide clients as a result. Collier has always operated a lean organization and managed to get
the maximum level of services for the grant dollars provided.
Our program has been very effective. The services that Services for Seniors provides
assist the Collier County seniors in remaining self - sufficient and independent, and helps protect
individuals from abuse, neglect, and exploitation. For instance, Services for Seniors program has
assisted in relocating seniors from substandard to suitable housing, equipped homes with
necessary plumbing supplies, and appliances. Other services include CHORE, such as heavy
cleaning of the homes and pest control. Our case managers interact frequently with the clients'
caregiver or family member to ensure quality communication is provided, to coordinate care, and
to be a positive influence in the client's life.
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12
5/22/2012 Item 16.D.4.
Services for Seniors assists seniors to remain in the least restrictive setting possible. Case
managers also provide advocacy ensuring that the client's needs and best interests are upheld
both by the service delivery system and the community at large. Service for Seniors program's
monitoring report for 2011 had a < 2.00 error rate and has not required a corrective action plan.
In Collier County, the focus is toward providing seniors with every available support to
enhance their quality of life. The community resource knowledge of case managers and how to
access those resources is invaluable in providing Collier County seniors sterling care.
3. Fiscal Management
The Services for Seniors program has well established staffing, protocols and procedures
for handling all fiscal matters. Also, all financial transactions are processed under the County's
fiscal policies. All procurement matters are performed in concert with the County's Purchasing
department and the Board of County Commissioner approved Purchasing Policies and
Procedures. Disbursements are reviewed rigorously for the highest grant accounting standards
by the Finance Department of the Clerk of the Circuit Court. Monthly reports and reconciliations
are performed within the department, and required reporting is provided timely to the grantor
agency. Services for Seniors staff has made substantial improvements at both the program and
fiscal levels to reassure clients are paying their co -pays and collection procedures are followed.
A monthly report is prepared and reviewed by both program and fiscal staff to reassure the co-
payment goal is being met.
The CCE program is supported by match dollars and the single audit report (please see
Attachment XI.) is the monitoring report for these general funds. During Single Audit, no
material deficiencies or weaknesses have been identified for these or similar programs. There
are written procedures which are followed for cash controls. Staff in HHVS coordinates with
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5/22/2012 Item 16.D.4.
13
staff in the Grants Management Office to establish accurate grant budgets and grant related
purchase orders, and in the preparation of contract and/or budget amendments that are frequently
required. Since, there are no other funding sources, there are no further monitoring reports to
provide.
4. Staffing, Competency of Staff and Staff Development/Training Plan
As indicated in a prior section, the program staff has over 100 years combined total
experience, and staff is very familiar with the programs of the Lead Agency, having operated
them for decades.
The Services for Seniors program staffing includes two sections which are program
compliance and fiscal compliance. The program section has five (5) full time employees
(FTE's) where one (1) FTE is the Case Management Supervisor and four (4) FTE's are Case
Managers. Each of these individuals has many years of experience in case management and
these specific programs; two staff members have been with the County and in these roles for 30
and 21 years respectively over 20 years, each. Current staff has Masters Degrees in Community
Mental Health and Gerontology as well as Bachelors Degree's in Accounting and Social
Services. Services for Seniors staff has received praise over the years from seniors themselves as
well as from persons working within the aging network. An example of a job well done given by
the Department of Elder Affair CDC+ staff states:
"You need to know that he praised you highly as a consultant. Can we clone you? He said he
had written a letter to your boss as well. That's great, Debbi, to know that loving, caring,
consultants are out there helping our consumers everyday. Thanks for being so punctual,
too." (see Client Surveys — Client Letters Exhibit C).
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5/22/2012 Item 16.D.4.
14
The fiscal compliance section has three (3) FTE's, where one (1) FTE is the Accounting
Manager and two (2) FTE's are Fiscal Technicians. Collier hired a new accounting manager
approximately one year ago. She has over 15 years of professional accounting experience and is
working diligently to learn the scope and the complexity of the fincancial program. The
technical staff supporting her has many years of experience in providing accounting services for
these programs. To augment the professional level of our accounting and fiscal control practices
on these and other grants, Collier County is in the process of hiring an additional accountant.
The Grants Management Office Manager is a degreed accountant, and has been a grants
accountant for over 5 years. This department also employs two (2) additional grant accountants
with extensive backgrounds and education in accounting. This department staff serves to assist
the Services for Seniors fiscal staff in assuring proper accounting controls and practices, and in
oversight controls for major accounting and financial transactions.
The case managers receive extensive on -going training internally and externally (see
Exhibit D, Case Management Training Log) in accordance with DOEA training requirements of
maintaining a minimum of six hours of in- service to include interviewing, record keeping, aging
network overview and community care system. In addition, Senior Choices provides annual
trainings for the 701B Assessment and Care Plan training and the case managers have scored
90% on post training tests. Case managers also attend additional training at Senior Choices for
the Assisted Living Waiver and Medicaid Waiver programs and DOEA Notice of Instructions
that require lead agency program and fiscal changes, as well as direct training from DOEA for
the Consumer Directed Care Plus (CDC +).
Program integrity is maintained through balanced estimated caseloads between 60 -70
clients per case manager. It is important to note that the entire staff of Collier County Services
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5/22/2012 Item 16.D.4.
15
for Senior's meets and exceeds training and certification requirements of the grantor agency and
the Florida Department of Elder Affairs. (See Case Management Training log & 2012 Training
Schedule, Exhibits D and E).
In Collier County, the focus is toward providing seniors with every available support to
enhance their quality of life. The expertise of all staff involved is of the highest caliber and this
team is committed to advancing skills and knowledge in order to assure accurate, effective
service provisions, grant compliance, and financial stewardship.
5. Community and Volunteer Support
The effectiveness in fostering community partnerships with the Services for Seniors
program is illustrated by the high visibility and recognition within Collier County. The Services
for Seniors program reputation as a quality community resource for elder care is demonstrated by
the active role the program serves in the Collier County's community social service network.
For example, the Services for Seniors program partners with the Alzheimer's Support Network
by attending monthly caregiver support meetings and with coordinating facility based respite
services to provide relief to caregivers in crisis. Staff has also served on committees for the
Leadership Council on Aging to assist with seniors needs assessment and resource development
for the new county -wide 211 program and has collaborated with Department of Children and
Families and the Collier County Sheriff s Office on Seniors Support & Assistance program when
abuse, neglect and/or fraud of a senior has been observed or suspected. Attendance at monthly
Naples Interagency Council meeting serves as a networking resource to enlist other community
services and resources to supplement what this Lead Agency is able to provide such as Hospice
for the terminally ill, holiday gift giving and to educate other community agencies on the
programs and services provided through DOEA.
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5/22/2012 Item 16.D.4.
16
In addition, staffs are able to network with staff from long term facilities to understand
the referral and eligibility process. These partnerships are critical to providing a comprehensive
set of services for our clients. The Services for Seniors program is also active in elder support
organizations throughout the State of Florida, such as the Florida Council on Aging and the
Florida Association of Service Providers.
Service providers contract with Collier County to provide different types of services.
These services include, but are not limited to homemaker, personal care, transportation, and
respite. These vendors provide a 10% in -kind contribution to the program. Additionally, Collier
County provides office space and utilities via in kind contribution. Another in -kind contribution
is accomplished by Services for Seniors program by enlisting the assistance of volunteer support
through the non - profit program, Grace Works, and the Covenant Church in Naples FL. Grace
Works has a referral form and website where staff can refer seniors requests for a specific service
and/or supply when seniors do not qualify for a grant. Examples are listed below:
• Covenant Church was able to replace a new water heater with donated time from a local
plumber to install the heater.
• Grace Works enlisted volunteers to visit seniors that are no longer able to leave the home.
• A volunteer from Grace Works was able to repair a senior's washing machine.
Due to the nature of our seniors needing skilled services and protecting seniors'
confidentiality, the Services for Seniors program is very cautious about enlisting volunteer
assistance. The seniors' health information is highly protected by the Health Insurance
Portability and Accountability Act ( HIPAA) and Services for Seniors program complies with all
the HIPAA guidelines. However, in the future Services for Seniors program would like to
complete a feasibility study and analysis for volunteer services which can include the possibility
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5/22/2012 Item 16.D.4.
of enlisting the aid of volunteers to work with our seniors.
6. Disaster Emergency
Collier County Government has a County wide Disaster/Emergency Plan that the HHVS
Department complies with and HHV S department has its own Disaster/Emergency Plan (see
Appendix XHL HHVS Departmental Emergency Operations Planning). This is reviewed and
updated annually. Recently, there was an unannounced drill where appropriate staff was called
to the Emergency Services Center and a disaster response was simulated. This was very valuable
to team members to be re- familiarized with the roles and actions necessary should an emergency
be declared.
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]8
Collier County Housing, Human & Veteran Services
Emergency Response Plan
Revised: Feb 27, 2012
5/22/2012 Item 16.D.4.
Purpose: To provide a plan for department operations and emergency response in
the event of a catastrophic event.
Description: This plan provides for on -going activities to ensure preparedness, actions
to be taken during an emergency event and the department's
responsibilities in responding to the needs of the division and county
should a disaster occur.
Roles for Emergency Response:
All members of the department located at Building H shall participate in the
preparedness and recovery of the department.
PRE -EVENT
During Pre -event / Event / and Post Event: Track and document "contracted" case
management which include interface with existing case management processes in
the event of overlap. Louise Pelletier
Each staff member shall prepare their individual office computers per instructions
provided by Facilities and IT but not to begin until instructed by Director or her
designee. All
Order and have supplies on hand for covering equipment (bags, tape, etc) Ann
Fasching, Anne Cardenas
Be responsible for overseeing preparations of computers and equipment of people
who may be on vacation or absent from work. (Ask for assistance from other
staff as needed.) Ann Fasching, Ana Parada, Anne Cardenas.
Prepare office equipment for possible water or wind damage. Ann Fasching, Ana
Parada
Confirm accuracy of office phone list. Ann Fasching
Confirm plans for staff and get contact numbers. Supervisors
Run updated lists of senior clients. Case managers for seniors
Clean out refrigerator. Nancy Mesa/Jacquelyn DeSear
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5/22/2012 Item 16.D.4.
Each program area needs to have at least one person in the office at all times
to handle calls or requests for that program. Supervisors will create a
schedule.
During the,storm, protect yourself and your, family.
POST -EVENT
Each staff member is responsible for setting up their computers and checking for
any damage.
Man phones in office and front desk. Ann Fasching, Marianne Deschaschell, Ana
Parada
Provide direction in office for Social Services & Services for Seniors Programs —
Louise Pelletier
Call Clients — All CMs in all program areas
Call Service Providers — all CM Services for Seniors call meal providers.
Confirm operating schedules & staffing for meal sites as well as site safety. Call
Clients. Heidi F.
Answer special needs phones in 4 hour shifts — Priscilla Doria, Dory Carillo, Ana
Parada,
I Activated: Canvass neighborhoods, mobile home parks and/or hardest hit areas
with teams from other areas as directed by EOC to help deliver food and water or
other tasks as needed — Rick Torres, Debbi Maxon, Carlton Bronson. Polly
Currie, Tammy Hammer, Zena Sellers.
Help register folks for food stamps — Lisa Carr, Nancy Mesa, Sandra Marrero,
Rosa Munoz, Jacquelyn DeSear, Elga Steingart.
IfActivated: Help with Blue Tarp program —, Lisa Oien, Wendy Klopf, Tammy
Hammer
EOC Representative from Department: Louise Pelletier, Steve Smith, Kim Grant.
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20
5/22/2012 Item 16.D.4.
General Information
II. A 1. Needs Assessment
The Department of Elder Affairs provides comprehensive and coordinated planning with
Senior Choices of Southwest Florida to assess clients' needs and priorities annually. Methods of
maintaining a current needs assessment for PSA 8 is developed from public input through public
hearings, information solicited from elders and their caregivers, and volunteers who assist clients
in the community. According to the Florida Department of Elder Affairs County Profile in 2011,
Collier County Seniors over 60 years of age is 68.6% of the total county population of 331,811;
where 3.2% of the seniors are 85 years or older. Minorities comprise 8.5% of the senior
population while minority seniors make up 1.4% of the senior population below the poverty level
of 125 %.
The increasing number of seniors needing assistance is due to three main factors:
1. Seniors have higher life expectancy rates
2. Seniors have exhausted their financial savings
3. Increasing rates for medical and prescription services
Collier County has an increased need for providing services to the seniors. Seniors in
need of services are placed on a waiting list that is created, maintained, and monitored by the
Senior Choices of Southwest Florida's Aging and Disability Resource Center (ADRC). As of
April, 2012, the waiting list encompasses the following clients:
• CCE -254 clients
• HCE -31 clients
• ADI -52 clients
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5/22/2012 Item 16.D.4.
21
• Total -337 clients
ADRC refers clients to Collier County Services for Seniors based on availability of funding.
Collier County Services for Seniors is responsible to assess the needs and recommend the
services for the referred seniors. Assessment data and information from Senior Choices and by
Services for Seniors is entered in the Department of Elder Affairs Client Information
Registration Tracking System (CIRTS) database. Seniors' needs are reviewed in both Senior
Choices' Triage Meeting weekly and Services for Seniors' staff meetings twice a month, and/or
as needed. The clients are served and their ongoing needs are continually evaluated based on
client assessments and team recommendations. During Services for Seniors' staff meetings, the
case management team assesses seniors' needs with the following three criteria:
1. Current knowledge of client conditions
2. Knowledge about the extent of the need for services in the senior's life
3. Realistic appraisal of existing available community resources
In addition, Services for Seniors are members of the Coalition on Aging in Collier
County where service providers and agencies discuss the needs of the seniors quarterly and are
currently establishing a Senior Center that would assist Seniors with all their needs.
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22
II. A 2. Targeting
5/22/2012 Item 16.D.4.
Services for Seniors Program
Targeting and Outreach — 2012
For the 2012 contract year, Services for Seniors program expects to provide services to
approximately 958 seniors which is a 2% increase from 2011. Services for Seniors program
assisted 939 seniors in 2011. Our goals to assist low - income minority seniors and those that
speak limited or no English continue to be our main focus in 2012 as part of the DOEA State
Plan on Aging Service Plan. To best meet the above goal, Services for Seniors recently has hired
a full time case manager who is bilingual to assist the clients with limited or no English speaking
language. The chart below shows the 2012 demographic characteristic of the seniors residing in
Collier County.
Target Senior Characteristics
2012
60+ served
958
Below Poverty Level (BPL)
394
Living Alone
478
Minority
352
Minority BPL
528
Low income Minority with Limited
English
89
Services for Seniors program has continually educated and informed senior residents
through active participation in informational senior expos, community meetings, public speaking
presentations at nonprofit social service agencies, mobile home parks, churches, subsidized
housing complexes, caregiver workshops, and civic organizations. Services for Seniors program
staff focuses their efforts to the most needed areas and targets neighborhoods based on the public
census information for the County. These neighborhoods include Golden Gate City, Naples
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5/22/2012 Item 16.D.4.
23
Manor, Immokalee, and other areas of need in Collier County. To comply with the target and
outreach plan for 2012 and to educate the senior residents on the DOEA programs Services for
Seniors program has met with the residents on:
• 1/11/12 at:Goodlette Arms Apartments, in Naples FL
• 1/21/12 at Garden Lakes Apartments in Immokalee FL
• 1/21/12 at Summer Glen Apartments in Immokalee FL
Services for Seniors program participated in the Collier County Senior Expo Fair on February 8,
2012, where Services for Seniors program provided information and eligibility requirements to
over 200 seniors who reside in Collier County. In February 2012, Senior Services met with the
Guadalupe Church Social Services and Haitian Baptist Church educating the community in what
services are offered for the seniors. Additionally, as part of the education and outreach, in March
2012, Services for Seniors program provided public information at the Immokalee Interagency
and Naples Interagency meetings. Services for Seniors program has joined an alliance with the
county -wide 211 program providing residents with human services resources. Services for
Seniors will remain committed in maintaining and improving community education and outreach
and providing the best services to the community.
Packet Page -1683-
24 5/22/2012 Item 16.D.4.
II.A. 3. Eligibility and Assessment/Reassessment Process
Referrals to the CCE, HCE, and ADI programs are made directly to the Senior Choices
ADRC Elder Helpline number. ADRC staff utilizes the DOEA Prioritization Form (701A) to
record client demographic data and initially identify client program eligibility and service needs.
The general eligibility criteria for CCE, HCE, and ADI programs are established by DOER.
When clients are referred to the Services for Seniors Program, the client's eligibility is confirmed
and verified by case management staff.
Eligibility for the CCE program requires:
• Individuals have to be 60 years age or older.
• Functional impairment is characterized by physical and mental limitation which restricts
the ability to perform the normal activities of daily living and impede the capacity to live
independently without provision of core services. Functional impairment shall be
determined through an assessment administered to each applicant.
• Clients may not be dually enrolled in the CCE program and in the Medicaid long term
care program.
Eligibility for the HCE program requires:
• Individuals have to be 60 years age or older.
• Income and Assets which do not exceed the Medicaid Institutional Care Program limits
for nursing home care eligibility.
• Be at risk of nursing home placement.
• There is a caregiver age 18 years or older that is willing to provide and assist in arranging
services and is qualified as an HCE caregiver as stated in DOEA guidelines.
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5/22/2012 Item 16.D.4.
25
• Additional requirements as stated in the DOEA Services Handbook in Program
Enrollment criteria.
Eligibility for the ADI program requires:
• Individuals must be 18 years of age or older and have a diagnosis of Alzheimer's disease
or related disorder.
• Caregivers are eligible to receive training, respite and support services to assist them in
the care of the client.
• There is no prohibition against an ADI client receiving more than one type of service at
the same period.
• Clients may not be dually enrolled in the ADI program and a Medicaid long term
program.
Services for Seniors staff continually evaluates clients eligibility for other services and programs
such as the Medicaid Waiver program, or the Older Americans Act (OAA) Nutrition Program. It
is the Services for Seniors program staff responsibility to advocate for client's services and if the
client is determined ineligible, the case manager will assist the applicant with securing other
community resources to provide assistance.
Assessment and Reassessment Process
Services for Seniors program staff completes an Initial assessment utilizing a
Comprehensive Assessment (701B) instrument to verify eligibility and determine the client's
individual service needs. The Services for Seniors program has a 14 calendar day time frame to
complete and enter the initial assessments into the CIRTS database. Seniors staff consistently
meets the requirement of the time frame and will continue to perform with high expectations to
meet the deadlines.
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Zs
5/22/2012 Item 16.D.4.
• Additional requirements as stated in the DOEA Services Handbook in Program
Enrollment criteria.
Eligibility for the ADI program requires:
• Individuals must be 18 years of age or older and have a diagnosis of Alzheimer's disease
or related disorder.
• Caregivers are eligible to receive training, respite and support services to assist them in
the care of the client.
• There is no prohibition against an ADI client receiving more than one type of service at
the same period.
• Clients may not be dually enrolled in the ADI program and a Medicaid long term
program.
Services for Seniors staff continually evaluates clients eligibility for other services and programs
such as the Medicaid Waiver program, or the Older Americans Act (OAA) Nutrition Program. It
is the Services for Seniors program staff responsibility to advocate for client's services and if the
client is determined ineligible, the case manager will assist the applicant with securing other
community resources to provide assistance.
Assessment and Reassessment Process
Services for Seniors program staff completes an Initial assessment utilizing a
Comprehensive Assessment (701B) instrument to verify eligibility and determine the client's
individual service needs. The Services for Seniors program has a 14 calendar day time frame to
complete and enter the initial assessments into the CIRTS database. Seniors staff consistently
meets the requirement of the time frame and will continue to perform with high expectations to
meet the deadlines.
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5/22/2012 Item 16.D.4.
Clients who are enrolled in CCE, HCE, or ADI are then assessed annually to reevaluate,
modify, and update the service needs. Client assessments are updated on an as- needed basis as
significant changes occur. The plan of care created by the case manager and client is developed
based on the gaps identified in these assessments. Services for Seniors staff utilizes the
Assessment Due Report from CIRTS and through an internal database, Client Information
Management System (CIMS), to remain in compliance with assessment due dates.
Services for Seniors staff has a very high level of expertise and their knowledge in
completing these assessments and gaps are identified in an efficient and timely manner. Staff
has been trained annually by Senior Choices in 701B Assessment and Care Plan completion and
has scored 90% on post training tests demonstrating the high level of knowledge and skills. This
high level of knowledge and skills of our staff positively affects the service delivery to our
clients.
II.A. 4. System of Prioritization
Senior Choices ADRC is the single point of entry for CCE, HCE, and ADI clients. All
client referrals requesting services come through the ADRC. The ADRC Intake Unit staff
conducts a telephone screening of each caller, prioritization of each caller and subsequent
placement on an Assessed Priority Consumer List ( "APCL "). The ADRC maintains the APCL
list of consumers for each lead agency in the PSA.
Referrals to the Services for Seniors program are received from the ADRC or, in the
case of a "High Risk" Adult Protective Services (APS) Referral, which is generated at the
Department of Children and Families, directly from the APS Referral Tracking Tool (ARTT).
Referrals are processed following priorities established by DOEA and outlined in the Client
Services Manual. The most frail individuals not prioritized according to A, B or C, listed below
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27
5/22/2012 Item 16.D.4.
receive services to the extent that funding is available, based on the individual's functional
impairment (prioritization score /rank). Clients in the following subgroups are given first priority
for case management and services:
A. Abuse, Neglect and Exploitation:
I. Elderly persons determined by Adult Protective Services (APS) to be victims of abuse,
neglect or exploitation, and individuals are in need of immediate services to prevent
further harm and are referred by Adult Protective Services (APS) as "high risk" will be
given primary consideration for receiving services.
2. High Risk APS referrals must be given "primary consideration" and thus an assessment
and services must commence within 72 hours after referral to the Department or as
established in accordance with Department agreements by local protocols developed
between Department services contractors and APS.
B. Priority Criteria for Individuals in Nursing Home in Receivership:
I. The provider shall ensure that, pursuant to Section 400.126.(12) Florida Statutes, those
elderly persons determined through CARES assessment to be persons 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, are referred for such care, as appropriate.
II. Residents referred pursuant to this subsection shall be given primary consideration for
receiving services under the CCE program in a manner as persons classified to receive
such services pursuant to Section 430.205, F.S.
C. Priority Criteria for Service Delivery:
1. Individuals in nursing home under Medicaid who could be transferred to the community;
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5/22/2012 Item 16.D.4.
2. Individuals in nursing homes under Medicaid whose Medicare coverage is exhausted and
may be diverted to the community;
3. Individuals who mental or physical health conditions have deteriorated to the degree that
self care is not possible, there is no capable caregiver, and institutional placement will
occur within 72 hours; or
4. For the purpose of transitioning individuals receiving Community Care for the Disabled
Adult (CCDA) and Home Care for the Disabled Adult (HCDA) services through the
Department of Children and Families (DCF) Adult Services to community based services
provided through the DCF, when services are not currently available, the Area Agency on
Aging (AAA) Lead Agency case manager shall ensure that "Aging Out" individuals are
prioritized for services only after Adult Protective Services (APS) High Risk and
Imminent Risk individuals.
ADRC intake unit staff completes the DOEA Prioritization Form (701A) on
individuals requesting services. Depending on the availability of funds and the attrition rate, the
ADRC determines when clients on the APCL list will be referred to the Services for Seniors
program for service activation based on their priority score and rank. All referrals from the
ADRC are received by the Case Management Supervisor and the backup designee and are
assigned to case management staff for completion of the DOEA Assessment Instrument (701B),
which is required within 14 calendar days after receiving the client referral from the ADRC.
Based on the assessment completed, case management staff completes and submits a Triage
Request Form (TRF) identifying the services needed by the client to address the identified gaps.
Senior Choices approves the request for services based on priority scores /ranks levels and the
funding available.
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29 5/22/2012 Item 16.D.4.
APS referrals identified as "High Risk" have first priority and are assessed by Services
for Seniors and services started within 72 hours of receipt of the referral. The Case Management
Supervisor, and the backup designee, receives an email notification alerting the Lead Agency an
APS referral has been made requiring immediate attention. The Services for Seniors program
follows the APS Referral protocol as outlined in the DOEA Client Services Manual.
Those APS referrals not identified as "High Risk" and CARES referrals are handled
by the ADRC and referred to the Services for Seniors program to complete a comprehensive
assessment as determined necessary and appropriate by the ADRC.
When currently enrolled, active clients are in need of additional services, a service
request form is completed (based on needs /gaps identified in the assessment instrument) by the
assigned case manager and submitted to Senior Choices who reviews the request and approves
the additional services based on the priority scores /rank and available funding.
II.A.S Process for Reducing or Terminating Services
The Services for Seniors program endeavors to provide quality service to each of our
clients. In the event of a disagreement between the clients and our agency's care decisions, staff
moves quickly to resolve any conflict or dispute.
At the Initial Assessment, and all subsequent annual assessments, clients are informed of
their "right to grieve" and are provided an explanation of the procedure. The client signs the
Grievance Procedure attesting it has been explained to them and that the client has received a
copy of the procedure along with the "Minimum Guidelines for Recipient Grievance Procedures
Applicable to all Adverse Actions Deemed Terminations, Suspensions or Reductions in
Services" (see Minimum Guidelines, Exhibit F). A copy of this signed document is placed in the
client's file /record.
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5/22/2012 Item 16.D.4.
30
As support and services are provided to the clients, functioning may increase to the point
where individuals require less service. If through assessing the client's needs, it is determined
that less services are required, a care plan is created that allows for the gradual reduction that
occurs as the clients condition improves. Sometimes improvement in functioning occurs, both
through provision of service and/or through additional supports provided by the family or
community of the individual. In this case, staff would seek to reduce services accordingly.
If a client is being considered for service reduction or is to be transferred to another
program resulting in an adverse effect, the client will be given 10 calendar days notice in order to
"grieve" the decision before the reduction or transfer occurs. This also applies to the termination
of services (see Policy and Procedure for Adverse Actions, Exhibit G). Unless the client
personally requests the reduction or termination, the 10 calendar day notice applies.
The client must be informed by the decision maker of the action in writing, no less than
10 calendar days (not including Saturday, Sunday, or legal holiday) prior to the date the adverse
action will be taken. Services cannot be suspended, reduced, or terminated, nor any adverse
action taken during the 10 day period. The notice must contain a statement of what action is
intended to be taken, the reasons for the intended action, and an explanation of the following:
1. The clients' right to a grievance review within the 10 day notification period
2. The clients' right, after a grievance review, for further appeal to Senior Choices
3. A statement that the current services/benefits will continue if a grievance review is
requested and will continue until a final decision is made regarding the adverse action
4. A statement that the client may represent himself/herself or use legal counsel, a relative
or friend, or qualified representative in the requested review proceedings
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5/22/2012 Item 16.D.4.
5. Client provided a copy of the "Collier County Services for Seniors Grievance Procedure"
and "Minimum Guidelines for Recipient Grievance Procedures Applicable to all Adverse
Actions Deemed Terminations, Suspensions or Reductions in Services ".
In the case of the services being terminated and case being closed, these decisions will be
made in conjunction with the case manager, supervisor, the client, and the family or caregiver.
The following are conditions that may warrant a case being terminated:
1. Change in placement, where the client cannot be maintained at home
2. If the client moves out of the service area; the client requests the termination of services
3. Chronic non - payment of copayments
4. It is determined services are no longer necessary; the client is no longer eligible
5. Death of the client
In all cases of termination of services, the case record will reflect the reasons for
termination of services.
The Services for Seniors team have been and will continue to be in compliance and
follow protocol as outlined in the DOEA manual and the internal standard operating procedures
(SOP'S).
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5/22/2012 Item 16.D.4.
32
II.A. 6 Quality Assurance
a. Client Satisfaction
In an effort to continue to provide excellent services, Services for Seniors' primary tool
used in determining client satisfaction is the annual client satisfaction survey. In June 2011, a
total of 239 surveys were mailed to seniors. Eighty -eight percent (88 %) of the seniors responded
that they were very satisfied with their case managers and there was 0% dissatisfaction reported
with the services received. Sixteen (16) clients requested that a supervisor contact them. The
case management supervisor was able to contact fourteen (14) of the sixteen (16) clients who
wanted to communicate their gratitude and/or requested an increase in their in home services.
The supervisor discussed each case with the assigned case manager to verify need and requested
increases to Senior Choices for approval. The outcome of the survey shows that the clients were
satisfied with the services provided and will continue to improve our services to maintain this
level of satisfaction. (See Client Satisfaction Survey, Exhibit H). Often, case managers receive
letters from seniors expressing their gratitude and satisfaction with the services they receive (see
Exhibit L).
At the Initial Assessment and all the subsequent annual assessment, clients are given the
Services for Seniors formal grievance procedure to explain the process of reporting any
disagreement with client care decisions. (See Grievance Procedure Exhibit 1). Throughout the
year, Senior Choices conducts annual telephone surveys and home visits with active clients.
During the Services for Seniors annual program monitoring, Senior Choices disseminates the
results of the surveys to Services for Seniors. Based on the results of the surveys, a follow up
with the clients must be completed.
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5/22/2012 Item 16.D.4.
Services for Seniors maintains both a complaint log and incident log where every client
complaint and incident is recorded by the case managers. The case managers work with both the
clients and the service providers to resolve all client complaints. When necessary the case
manager supervisor will assist in the resolution of client concerns. These logs are submitted
quarterly to Senior Choices and reviewed at the annual monitoring. Services for Seniors staff
proactively utilizes these logs /reports as a risk assessment and analyze them to improve the
processes best satisfy our clients.
b. Internal Evaluation Process
Services for Seniors conducts annual CCE, HCE, and ADI vendor monitoring in
conjunction with other PSA 8 Lead Agencies to ensure vendor service delivery maintains
standards of excellence including program and fiscal components (see Vendor Monitoring,
Exhibit J). Vendors maintain current licenses of operation, employee back ground screenings
logs and complaints and incident files that are all reviewed in detail by Services for Seniors staff
to assure delivery of quality services.
Any client issue and/or complaint that are brought to the case manager's attention are
discussed in Services for Seniors staff meetings and/or as needed. The case management team
consistently follows up with both the vendor and the client to resolve any dissatisfaction of
services or any other issues of concern to the client.
During every client assessment/home visit, case managers assess and verify with the
client that the authorized services are being provided and are of the highest quality. Any issues or
concerns are discussed with the case manager supervisor who contacts the vendor directly to
report concerns.
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5122/2012 Item 16.D.4.
34
c. File Quality/Data Integrity
To ensure file quality and data integrity, the case manager supervisor or designated staff
proofreads completed 701 B Assessments and the corresponding DOEA CIRTS Turnaround
reports to verify the data of both documents are consistent and completed accurately and
correctly. The assessments are returned to the assigned case manager to file or to make the
necessary corrections.
In addition, when the CIRTS data entry staff is entering the 701 B Assessment into the
DOEA CIRTS data base, staff is also proofreading for accuracy as part of tight controls and error
elimination. Case managers are required to sign both documents attesting the information is
correct on the assessment. The case manager supervisor reviews four (4) client files per month
and uses the schedule that Seniors Choices posts for client file reviews. After a Seniors Choices
client file review and the report is received, the case manager supervisor ensures that all
requested corrections are completed and that copies of all the file corrections are submitted to
Senior Choices within the requested time frame of 30 days. To date, Services for Seniors has
shown a significant decrease in file errors and have been successful in reaching the goal of
having < 2.00 error file rate and no Corrective Action plans required.
The Services for Seniors program staff is committed to providing confidentiality for all
clients receiving or waiting to receive services and strictly adheres to the laws set forth in the
Health Insurance Portability and Accountability Act (HIPAA).
At the Initial Assessment and all the subsequent assessments, Services for Seniors obtains
a signed "Release of Information" form (see Release of Information Form Exhibit K). This form
is obtained in order to collect and share client data for the purposes of provision of all services.
All case managers are careful with client information when communicating with vendors. Only
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5/22/2012 Item 16.D.4.
information which needs to be shared in order to provide services and ensure client's safety is
given on a need- to- know basis. All client files are kept in locked cabinets to protect sensitive
client information. Closed client files are securely maintained for seven (7) years per public
records retention.
d. Case Management Quality
Collier County's Services for Seniors case management staff currently serves 464 clients
including those served in the Nutrition programs. The current case management team has over
100 years of combined social service case management experience and continues to strive for
excellence each day in providing quality services to our seniors. There has been a minimal staff
turnover rate and the case management team has a combined total of over 60 years being
employed at Collier County Services for Seniors program. Case Managers coordinate all the
services a client receives while residing in the home. Case managers possess strong assessment
skills, ongoing support, and the knowledge and coordination of community services while
addressing the needs of the client's caregiver and family members.
During a 701 B assessment, Services for Seniors case managers are keenly aware of how
important the assessment tool is in developing a comprehensive care plan for the client and care
giver to receive services to assist the client in remaining independent and maintaining their
quality of life.
Over the last three years, the senior population demands have changed. Seniors are living
longer which has generated increased medical and prescription costs and in addition to the
deflated economy, many senior have exhausted their life savings.
Services for Seniors program case managers are increasing their resourcefulness and
continue to advocate for their seniors with commitment. Over the last year, Services for Seniors
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5/22/2012 Item 16.D.4.
36
program has partnered with two new resources, a non -profit organization, Grace Works and a
local community church, Naples Covenant Church to assist client with supplies and services that
could not be funded by grant limitations. The Services for Seniors program has worked diligently
in maintaining positive relationships with health care vendors, day care agencies and other
support agencies in Collier County.
Case managers assist family caregivers in receiving support and counseling through the
Alzheimer's Support Network and the Mental Health Association of Southwest Florida.
Recently, staff has referred caregivers to the Lee Memorial Hospital - the Care Program in Lee
County.
Case managers provide ongoing monitoring of client services to ensure that the services
the clients receive assist the client to remain in the home safely. Case managers utilize the Client
Information Management Tracking System (CIMS) data base to document client narratives and
all case management billing activities. Case managers participate in several activities that are
non - billable which include trainings required by DOEA, internal trainings, the participation in
senior events and CIRTS data entry.
The case managers receive extensive training internally and externally (see Exhibit D,
Case Management Training Log) in accordance with DOEA training requirements of
maintaining a minimum of six hours of in- service to include interviewing, record keeping aging
network overview and community care system. In addition, Senior Choices provides annual
trainings for the 701B Assessment and Care Plan completion and the case managers have scored
90% on post training tests. Case managers also attend additional training at Senior Choices for
the Assisted Living Waiver and Medicaid Waiver programs and DOEA Notice of Instructions
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5/22/2012 Item 16.D.4.
that require lead agency program and fiscal changes, as well as direct training from DOEA for
the Consumer Directed Care Plus (CDC +) program
Case manager caseloads vary from 60 -70 clients depending on the complexity of the
client case and geographic location of the senior. The case manager supervisor assists in case
manager assignments during high referrals, case manager vacation/absences and when the case
manager needs additional support/guidance.
CIRTS reporting and record keeping is assigned to specific the case managers and fiscal
staff to minimize billing /file integrity errors. Case managers billing time is explained in detail in
the Client Information Management System (CIMS) narrative notes to clarify travel time and
time spent with client and family members.
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5/22/2012 Item 16.D.4.
II.B. Description of Service Delivery, Service Data (Includes Items 1 Site Location, 2 Days
and Hours of Operation & 3 Describes Specific Activities.
SERVICE: Adult Day Care
SPTE LOCATION& (If different from Summary Page; provider may attach a list of sites.)
FUNDING:
X CCE, ❑ HCE ❑ ADI ❑ OTHER
PROVIDED:
Directly X To Be Subcontracted
DAYS
AVAILABLE:
Monday - Friday
HOURS
g am — 4:30pm
AVAILABLE:
ACTIVITIES
Adult day care is a program of therapeutic social and health activities and services
INCLUDED:
provided to elders who have functional impairments. Services are provided in a
protective, community -based environment.
COORDINATION
The client can request a particular provider from a list of vendors provided to them
METHODS USED
by the case manager. If the client is unable to make a choice, a rotation list is
TO ASSURE
utilized and the next vendor in line is selected. Based on the plan of care developed
CLIENT CHOICE,
with the client identifying the gaps/needs, the approved services are authorized to
SERVICE
the chosen/selected vendor. If other resources or providers of services are present,
AUTHORIZATION
the case manager coordinates all services to supplement what is being provided to
AND AVOIDANCE
avoid duplication. Case management staff works with all community
OF DUPLICATION
resources/entities to provide the services needed by the client without duplicating
OF SERVICE.
what is already in place.
CONPALTNICATION
PROCESS
BETWEEN
Contacts with providers and clients are made in person, by phone, fax, email, or
AGENCY,
mail; whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME — HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE C LETE:
i
We will vi ove service in all areas of the county or counties we propose to
serve.
Signature of authorized agency representative
Packet Page -1699-
39
SERVICE: Basic Subsidy
SITELOCATION /S: 3339 Tamiami Tr_ F.- Rm ?11 Nan1Pc FT. 'Id11?
5/22/2012 Item 16.D.4.
FUNDING:
❑ CCE, X HCE ❑ ADI ❑ OTHER
PROVIDED:
X Directly To Be Subcontracted
DAYS
AVAILABLE:
NA
HOURS
AVAILABLE:
NA
ACTIVITIES
Basic subsidy is a fixed cash payment made to approved caregivers each month to
INCLUDED:
offset some of their expenses for providing support and maintenance of the elder
care recipient. This may include medical costs not covered by Medicaid, Medicare
or other insurance.
COORDINATION
Services for Seniors administers the HCE program and authorizes basic subsidy
METHODS USED
payments to eligible clients.
TO ASSURE
CLIENT CHOICE,
SERVICE
AUTHORIZATION
AND AVOIDANCE
OF DUPLICATION
OF SERVICE,
COMMUNICATION
PROCESS
BETWEEN
Services for Seniors is the provider. Contacts with clients are made in person, by
AGENCY,
phone, fax, email, or mail, whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME—HOW
WILL IT BE USED
TO INCREASE
There is no program income
AVAILABILITY OF
SERVICE?
APPLIC , LEASE &TUTE:
We pr above service in all areas of the county or counties we propose to
serve.
Si of au orized agency representative
Packet Page -1700-
40 5/22/2012 Item 16.D.4.
SERVICE: Case Management
SrrE LocATroN /s: 3339 Tamiami Tr. E., Rm 211, Naples, FL. 34112
FUNDING:
X CCE, X HCE X ADI 0 OTHER
X Directly To Be Subcontracted
PROVIDED:
DAYS
Monday — Friday (on call 24/7)
AVAILABLE:
HOURS
8 am - 5 pm Monday — Friday (on call 24/7)
AVAILABLE:
Case Management is a client centered service that assists individuals in identifying
ACTIVITIES
physical and emotional needs and problems through an interview and assessment
INCLUDED:
process; discussing and developing a plan for services which addresses these needs;
arranging and coordinating agreed upon services; and monitoring the quality and
effectiveness of the services. Case Management is a service for actively enrolled
clients that provides continuing support and addresses the changing needs of clients.
COORDINATION
Collier County Services for Seniors is the only Lead Agency in Collier County. If a
METHODS USED
client is very discontent with the assigned Case Manager and if no resolution to the
TO ASSURE
discontent is forthcoming, then another Case Manager is assigned.
CLIENT CHOICE,
SERVICE
AUTHORIZATION
AND AVOIDANCE
OF DUPLICATION
OF SERVICE.
COMMUNICATION
PROCESS
BETWEEN
Services for Seniors is the provider. Contacts with clients is made in person, by
AGENCY,
phone, fax, email, or mail, whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME — HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE COMPLETE:
We will e e service in all areas of the county or counties we propose to
serve.
Signature of authorized agency representative
Packet Page -1701-
41 5/22/2012 Item 16.D.4.
SERVICE: Chore
SITE LOCATION /S: (If different from Sun n ary PaLye: -provider may attarh n list of citPc 1
FUNDING:
X CCE, DHCE ❑ ADI D OTHER - - - -- -- — -- - -
PROVIDED:
Directly X To Be Subcontracted
DAYS
Monday — Friday (weekends PRN)
AVAILABLE:
HOURS
8 am - 5:00pm
AVAILABLE:
ACTIVITIES
INCLUDED:
Chore is defined as the erformance of routine house or
p yard tasks, including such
jobs as seasonal cleaning; yard work; lifting and moving furniture, appliances or
heavy objects; household repairs which do not require a permit or specialist; and
household maintenance. Pest control may be included, when not performed as a
distinct activity.
COORDINATION
METHODS USED
The client can request a particular provider from a list of vendors provided to them
TO ASSURE
by the case manager. If the client is unable to make a choice, a rotation list is
CLIENT CHOICE,
utilized and the next vendor in line is selected. Based on the plan of care developed
SERVICE
with the client identifying the gaps/needs, the approved services are authorized to
AUTHORIZATION
the chosen/selected vendor. If other resources or providers of services are present,
AND AVOIDANCE
the case manager coordinates all services to supplement what is being provided to
OF DUPLICATION
avoid duplication. Case management staff works with all community
OF SERVICE.
resources/entities to provide the services needed by the client without duplicating
what is already in place.
COMMUNICATION
PROCESS
BETWEEN
Contacts with providers and clients are made in person, by phone, fax, email, or
AGENCY,
mail; whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME—HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEAS
We will ovi ve. ervice in all areas of the county or counties we propose to
serve.
Signature of autho ' Cy representative
Packet Page -1702-
42
SERVICE: Chore (Enhanced)
5/22/2012 Item 16.D.4.
SITE LOCATION /s: different from Summary Pa e; Di vider may attach a list of sites
FUNDING:
X CCE, ❑ HCE ❑ ADI 0 OTHER
PROVIDED:
Directly X To Be Subcontracted
DAYS
AVAILABLE:
Monday — Friday (weekends PRN)
HOURS
8 am — 5:00pm
AVAILABLE:
ACTIVITIES
INCLUDED:
Enhanced chore is the performance of an house or d task necessary
p Y yard ary to provide a
clean, sanitary and safe living environment. This service is beyond the scope of
chore due to the level of service needed. The service includes a more intensified,
thorough cleaning to address more demanding circumstances. Pest control may be
included when not performed as a distinct activity.
COORDINATION
The client can request a particular provider from a list of vendors provided to them
METHODS USED
by the case manager. If the client is unable to make a choice, a rotation list is
TO ASSURE
utilized and the next vendor in line is selected. Based on the plan of care developed
CLIENT CHOICE,
with the client identifying the gaps/needs, the approved services are authorized to
SERVICE
the chosen/selected vendor. If other resources or providers of services are present,
AUTHORIZATION
the case manager coordinates all services to supplement what is being provided to
AND AVOIDANCE
avoid duplication. Case management staff works with 0 community
OF DUPLICATION
resources/entities to provide the services needed by the client without duplicating
OF SERVICE.
what is already in place.
COMMUNICATION
PROCESS
BETWEEN
Contacts with providers and clients are made in person, by phone, fax, email, or
AGENCY,
mail; whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME — HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE COMPLETE:
We will o ve service in all areas of the county or counties we propose to
serve.
Signafae of auth agency representative
Packet Page -1703-
43 5/22/2012 Item 16.D.4.
SERVICE: Companionship
SITE LOCATioNAS: of differ,-nt frnm.Crnmmory Pam— _-r_:4-__ \
FUNDING:
X CCE, ❑ HCE ❑ ADI ❑ OTHER
PROVIDED:
Directly X To Be Subcontracted
DAYS
AVAILABLE:
Monday Friday
Y— Y (weekends PRN)
HOURS
AVAILABLE:
g am — 5:00pm
ACTIVITIES
INCLUDED:
Companionship is visiting a client who is socially and/or geographically
P P g Y g graphically isolated,
for the purpose of relieving loneliness and providing continuing social contact with
the community. This service includes activities such as engaging the client in casual
conversation, providing assistance with reading, writing letters, escorting a client to
a medical appointment and diversional activities such as playing games, going to
the movies, the mall, the library or grocery shopping.
COORDINATION
The client can request a particular provider from a list of vendors provided to them
METHODS USED
by the case manager. If the client is unable to make a choice, a rotation list is
TO ASSURE
utilized and the next vendor in line is selected. Based on the plan of care developed
CLIENT CHOICE,
with the client identifying the gaps/needs, the approved services are authorized to
SERVICE
the chosen/selected vendor. If other resources or providers of services are present,
AUTHORIZATION
the case manager coordinates all services to supplement what is being provided to
AND AVOIDANCE
avoid duplication. Case management staff works with all community
OF DUPLICATION
resources/entities to provide the services needed by the client without duplicating
OF SERVICE.
what is already in place.
COMMUNICATION
Contacts with providers and clients are made in person, by phone, fax, email, or
PROCESS
mail; whichever is the most efficient at the time.
BETWEEN
AGENCY,
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME—HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE COMPL/;service
We will p in all areas of the county or counties we propose to
serve.
Signature of au ncy representative
Packet Page -1704-
44
5122/2012 Item 16.D.4.
SERVICE: Emergency Alert Response
SITE LocAmN /s: different from Summary Page; provider may attach a list of sites.
FUNDING:
X CCE, ❑ HCE ❑ ADI ❑ OTHER
PROVIDED:
Directly X To Be Subcontracted
DAYS
7 days a week
AVAILABLE:
HOURS
24 hrs a day
AVAILABLE:
ACTIVITIES
Emergency alert /response service is a community -based electronic surveillance
INCLUDED:
system, which monitors the frail homebound elder by means of an electronic
communication link with a response center.
COORDINATION
The client can request a particular provider from a list of vendors provided to them
METHODS USED
by the case manager. If the client is unable to make a choice, a rotation list is
TO ASSURE
utilized and the next vendor in line is selected. Based on the plan of care developed
CLIENT CHOICE,
with the client identifying the gaps/needs, the approved services are authorized to
SERVICE
the chosen/selected vendor. If other resources or providers of services are present,
AUTHORIZATION
the case manager coordinates all services to supplement what is being provided to
AND AVOIDANCE
avoid duplication. Case management staff works with all community
OF DUPLICATION
resources/entities to provide the services needed by the client without duplicating
OF SERVICE.
what is already in place.
COMMUNICATION
PROCESS
BETWEEN
Contacts with providers and clients are made in person, by phone, fax, email, or
AGENCY,
mail; whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME—HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE COMPLETE:
We will provide Jet (eifin all areas of the county or counties we propose to
serve.
Si a of orize envy representative
Packet Page -1705-
45 5/22/2012 Item 16.D.4.
SERVICE: Homemal inz
SITE LOCATIONS: (If different from gnmmary Pave- nrn AA-r may attanlh n 1; at Mf o;+oo) AOW
FUNDING:
X CCE, ❑ HCE ❑ ADI ❑ OTHER - -- - -
PROVIDED:
Directly X To Be Subcontracted
DAYS
AVAILABLE:
Monday — Friday (weekends PRN)
HOURS
AVAILABLE:
8am -5pm
ACTIVITIES
INCLUDED:
Homemaker service is defined as the accomplishment of specific home
management duties including housekeeping, laundry, cleaning refrigerators,
clothing repair, minor home repairs, assistance with budgeting and paying bills,
client transportation, meal planning and preparation, shopping assistance, and
routine house -hold activities by a trained homemaker.
COORDINATION
The client can request a particular provider from a list of vendors provided to them
METHODS USED
by the case manager. If the client is unable to make a choice, a rotation list is
TO ASSURE
utilized and the next vendor in line is selected. Based on the plan of care developed
CLIENT CHOICE,
with the client identifying the gaps/needs, the approved services are authorized to
SERVICE
the chosen/selected vendor. If other resources or providers of services are present,
AUTHORIZATION
the case manager coordinates all services to supplement what is being provided to
AND AVOIDANCE
avoid duplication. Case management staff works with all community
OF DUPLICATION
resources/entities to provide the services needed by the client without duplicating
OF SERVICE.
what is already in Pie.
COMMUNICATION
PROCESS
BETWEEN
Contacts with providers and clients are made in person, by phone, fax, email, or
AGENCY,
mail; whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME — HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASWe will p o service in all areas of the county or counties we propose to
serve.
Sign o utho ' � representative
Packet Page -1706-
46
5/22/2012 Item 16.D.4.
SERVICE: Material Aid
SrrE LocAnox /s: (If different from Summary Page; provider may attach a list of sites.)
FUNDING:
X CCE, X HCE ❑ ADI ❑ OTHER
PROVIDED:
Directly X To Be Subcontracted
DAYS
Monday — Friday
AVAILABLE:
HOURS
g am — 5:00pm
AVAILABLE:
ACTIVITIES
Material aid is defined as: Goods or food such as direct distribution of commodities,
surplus food, clothing, smoke detectors, eyeglasses, hearing aids, security devices,
INCLUDED:
etc.; Food item(s) necessary for the health, safety or welfare. This may include
condiments or paper products necessary for food consumption and delivery charges.
Alcohol, drugs and tobacco products are excluded; Repair, purchase, delivery and
installation of any household appliance to assist with household tasks necessary for
the health, safety, or welfare of the person; The purchase of materials necessary to
perform chore or enhanced chore services (refer to chore and enhanced chore
services); and the purchase of construction materials necessary to perform housing
improvements, alterations and repairs (refer to housing improvement service).
COORDINATION
The client can request a particular provider from a list of vendors provided to them
METHODS USED
by the case manager. If the client is unable to make a choice, a rotation list is
TO ASSURE
utilized and the next vendor in line is selected. Based on the plan of care developed
CLIENT CHOICE,
with the client identifying the gaps /needs, the approved services are authorized to
SERVICE
the chosen/selected vendor. If other resources or providers of services are present,
AUTHORIZATION
the case manager coordinates all services to supplement what is being provided to
AND AVOIDANCE
avoid duplication. Case management staff works with all community
OF DUPLICATION
OF SERVICE.
resourcestentities to provide the services needed by the client without duplicating
what is already in place.
COMMUNICATION
PROCESS
Contacts with providers and clients are made in person, by phone, fax, email, or
BETWEEN
AGENCY,
mail; whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME — HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE COMPLETE:
We will vi /ffvi
ce in all areas of the county or counties we propose to
serve.
Si of atr664E4-agencyrepresentative
Packet Page -1707-
47
5/22/2012 Item 16.D.4.
SERVICE: Medication Manaeement
SITE LoeAZTON /S: (If different from Summary Pane- nrnvirlPr may attach a liet of eitae 1
FUNDING:
X CCE, ❑ HCE ❑ ADI ❑ OTHER
PROVIDED:
Directly X To Be Subcontracted
DAYS
AVAILABLE:
Monday — Friday
HOURS
AVAILABLE:
g am — 5:00pm
ACTIVITIES
INCLUDED:
Medication management screening and education is defined as identification and
counseling regarding the medication regimes that clients are using, including
prescription and over - the - counter medications, vitamins and home remedies. These
services also help to identify any dietary factors that may interact with the
medication regime. The combination of alcohol or tobacco with various
medications and diets, along with the effects on specific conditions, would ideally
be included in this service. This can be done on a one -on -one or group basis.
COORDINATION
The client can request a particular provider from a list of vendors provided to them
METHODS USED
by the case manager. If the client is unable to make a choice, a rotation list is
TO ASSURE
utilized and the next vendor in line is selected. Based on the plan of care developed
CLIENT CHOICE,
with the client identifying the gaps/needs, the approved services are authorized to
SERVICE
the chosen/selected vendor. If other resources or providers of services are present,
AUTHORIZATION
the case manager coordinates all services to supplement what is being provided to
AND AVOIDANCE
avoid duplication. Case management staff works with all community
OF DUPLICATION
resources/entities to provide the services needed by the client without duplicating
OF SERVICE.
what is already in place.
COMMUNICATION
PROCESS
BETWEEN
Contacts with providers and clients are made in person, by phone, fax, email, or
AGENCY,
mail; whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME—HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE COMPLETE:
We will pr //i vice in all areas of the county or counties we propose to
serve.
Signature of iruthohze6lgency representative
Packet Page -1708-
5/22/2012 Item 16.D.4.
48
SERVICE: Personal Care
,RrrF. T.nra'rrnN /S- of different from Summary Pa—ae: vrovider may attach a list of sites.)
FUNDING:
X CCE, X HCE D ADI 0 OTHER
PROVIDED:
Directly X To Be Subcontracted
DAYS
AVAILABLE:
Monday — Friday (weekends PRN)
HOURS
8 am - 5 pm
AVAILABLE:
ACTIVITIES
INCLUDED:
Personal Care is assistance with eating, dressing, personal hygiene and other
activities of daily living. This service may include assistance with meal preparation,
housekeeping, chores such as bed making, dusting and vacuuming incidental to the
care furnished or essential to the health and welfare of the individual. Personal Care
can include accompanying the client to clinics, physician office visits, or trips for
the purpose of health care provided that the client does not require special medical
transportation. Personal Care can also include shopping, assistance to purchase
food, clothing and other items needed for the clients personal care needs. This aid is
not permitted to drive the client but can meet the client at medical visits.
The client can request a particular provider from a list of vendors provided to them
COORDINATION
by the case manager. If the client is unable to make a choice, a rotation list is
METHODS USED
utilized and the next vendor in line is selected. Based on the plan of care developed
TO ASSURE
with the client identifying the gaps/needs, the approved services are authorized to
CLIENT CHOICE,
the chosen/selected vendor. If other resources or providers of services are present,
SERVICE
the case manager coordinates all services to supplement what is being provided to
AUTHORIZATION
avoid duplication. Case management staff works with all community
AND AVOIDANCE
resources /entities to provide the services needed by the client without duplicating
OF DUPLICATION
what is already in place.
OF SERVICE.
Contacts with providers and clients are made in person, by phone, fax, email, or
COMMUNICATION
mail; whichever is the most efficient at the time.
PROCESS
BETWEEN
AGENCY,
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME — HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE COMPLE
We will ovi a th a service in all areas of the county or counties we propose to
serve.
SiP4106 o th d agency representative
Packet Page -1709-
49 5/22/2012 Item 16.D.4.
SERVICE: Pest Control (Initiation/Maintenance)
SITE LOCATION /S: (If different from Summary Page; provider may attach a list of sites.)
FUNDING: X CCE, 0 HCE 0 ADI D OTHER
PROVIDED:
Directly X To Be Subcontracted
DAYS
AVAILABLE:
Monday — Friday
HOURS
AVAILABLE:
g am — 5:00pm
ACTIVITIES
Initial pest control services assists in ridding the environment of insects and other
INCLUDED:
potential carvers of disease and enhances the safety, sanitation and cleanliness for
recipients. Initiation covers start up costs. Pest control maintenance services assist
in ridding and maintaining the environment free of insects and other potential
carriers of disease and enhances the safety, sanitation and cleanliness for recipients.
COORDINATION
METHODS USED
The client can request a particular provider from a list of vendors provided to them
TO ASSURE
by the case manager. If the client is unable to make a choice, a rotation list is
CLIENT CHOICE,
utilized and the next vendor in line is selected. Based on the plan of care developed
SERVICE
with the client identifying the gaps/needs, the approved services are authorized to
AUTHORIZATION
the chosen/selected vendor. If other resources or providers of services are present,
AND AVOIDANCE
the case manager coordinates all services to supplement what is being provided to
OF DUPLICATION
avoid duplication. Case management staff works with all community
OF SERVICE.
resources/entities to provide the services needed by the client without duplicating
what is already in place.
COMMUNICATION
PROCESS
BETWEEN
Contacts with providers and clients are made in person, by phone, fax, email, or
AGENCY,
mail; whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME—HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE COMPLETE:
We will provide in all areas of the county or counties we propose to
serve.
Signaffre'of au rued agepcy representative
Packet Page -1710-
50
5122/2012 Item 16.D.4.
SERVICE: Respite (Facility Based)
SITE LOCATION /S: (If different from Summary page: provider may attach a list of sites.)
FUNDING:
X CCE, ❑ HCE XADI 0 OTHER
PROVIDED:
Directly X To Be Subcontracted
DAYS
AVAILABLE:
Monday — Friday
HOURS
AVAILABLE:
8 am to 4:30 pm
ACTIVITIES
INCLUDED:
Facility -based respite care is the provision of relief or rest for a primary caregiver
from the constant, continued supervision and care of a functionally- impaired older
person by providing care for the older person in an approved facility -based
environment for a specified period of time.
COORDINATION
The client can request a particular provider from a list of vendors provided to them
METHODS USED
by the case manager. If the client is unable to make a choice, a rotation list is
TO ASSURE
utilized and the next vendor in line is selected. Based on the plan of care developed
CLIENT CHOICE,
with the client identifying the gaps/needs, the approved services are authorized to
SERVICE
the chosen/selected vendor. If other resources or providers of services are present,
AUTHORIZATION
the case manager coordinates all services to supplement what is being provided to
AND AVOIDANCE
avoid duplication. Case management staff works with all community
OF DUPLICATION
resources/entities to provide the services needed by the client without duplicating
OF SERVICE.
what is already in place.
COMMUNICATION
PROCESS
BETWEEN
Contacts with providers and clients are made in person, by phone, fax, email, or
AGENCY,
mail; whichever is the most efficient at the tame.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME - HOW
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE COMP .
We will tauonzed ve service in all areas of the county or counties we propose to
serve. .
Signature of agency representative
Packet Page -1711-
51
SERVICE: Respite (In -home)
5/22/2012 Item 16.D.4.
SITE LoCATIows: different from Summary Page; provider may attach a list of sites.)
FUNDING: X CCE, X HCE X ADI 0 OTHER
PROVIDED: Directly X To Be Subcontracted
DAYS Monday —Friday (weekends PRN)
AVAILABLE:
USE OF PROGRAM
INCOME — HOW
WILL IT BE USED
TO INCREASE There is no program income
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE COMP
We will pr a e� ove service in all areas of the county or counties we propose to
serve.
Signature of authorized agency representative
Packet Page -1712-
HOURS
AVAILABLE:
gam_5pm
ACTIVITIES
In-home respite care is the provision of relief or rest for a primary caregiver from
INCLUDED:
the constant, continued supervision and care of a functionally impaired older person
by providing care for the person in the home fora specified period of time.
COORDINATION
The client can request a particular provider from a list of vendors provided to them
METHODS USED
by the case manager. If the client is unable to make a choice, a rotation list is
TO ASSURE
wed and the next vendor in line is selected. Based on the plan of care developed
CLIENT CHOICE,
with the client identifying the gaps/needs, the approved services are authorized to
SERVICE
the chosen/selected vendor. If other resources or providers of services are present,
AUTHORIZATION
the case manager coordinates all services to supplement what is being provided to
AND AVOIDANCE
avoid duplication. Case management staff works with all community
OF DUPLICATION
resources /entities to provide the services needed by the client without duplicating
OF SERVICE.
what is already in place.
COMMUNICATION
PROCESS
BETWEEN
Contacts with providers and clients are made in person, by phone, fax, email, or
AGENCY,
mail; whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME — HOW
WILL IT BE USED
TO INCREASE There is no program income
AVAILABILITY OF
SERVICE?
APPLICANT, PLEASE COMP
We will pr a e� ove service in all areas of the county or counties we propose to
serve.
Signature of authorized agency representative
Packet Page -1712-
52
5/22/2012 Item 16.D.4.
SERVICE: Specialized Medical Eauinment, Services & Supplies
SITE LocATIoN /s: (If different from Summary Page; Drovider may attach a list of sites.)
FUNDING:
X CCE, X HCE X ADI ❑ OTHER
PROVIDED:
Directly X To Be Subcontracted
DAYS
AVAILABLE:
Monday — Friday
HOURS
g am — 5:00pm
AVAILABLE:
ACTIVITIES
INCLUDED:
Specialized medical equipment, services and supplies include the following:
Adaptive devices, controls, appliances or services that enable clients to increase
their ability to perform activities of daily living. This service also includes repair of
such items as well as replacement parts; Dentures, walkers, reachers, bedside
commodes, telephone amplifiers, touch lamps, adaptive eating equipment, glasses,
hearing aids, and other mechanical or non - mechanical, electronic, and non-
electronic adaptive devices; Supplies may include items such as adult briefs, bed
pads, oxygen or nutritional supplements; Medical services pay for doctor visits or
dental visits; and Pharmaceutical services payment for needed prescriptions
COORDINATION
The client can request a particular provider from a list of vendors provided to them
METHODS USED
by the case manager. If the client is unable to make a choice, a rotation list is
TO ASSURE
utilized and the next vendor in line is selected. Based on the plan of care developed
CLIENT CHOICE,
with the client identifying the gaps/needs, the approved services are authorized to
SERVICE
the chosen/selected vendor. If other resources or providers of services are present,
AUTHORIZATION
the case manager coordinates all services to supplement what is being provided to
AND AVOIDANCE
avoid duplication. Case management staff works with all community
OF DUPLICATION
resources /entities to provide the services needed by the client without duplicating
OF SERVICE.
what is wady in Pte•
COMMUNICATION
PROCESS
BETWEEN
Contacts with providers and clients are made in person, by phone, fax, email, or
AGENCY,
mail; whichever is the most efficient at the time.
PROVIDER &
CLIENT
USE OF PROGRAM
INCOME — HO W
WILL IT BE USED
There is no program income
TO INCREASE
AVAILABILITY OF
SERVICE?
APPLICANT, PLE COMP
We will r e ve service in all areas of the county or counties we propose to
serve.
Si o o ' Sency representative
Packet Page -1713-
5/22/2012 Item 16.D.4.
53
H. D Goals, Objectives and Performance Measures
a. Empower older people, individuals with disabilities, their families and other consumers
to choose and easily access options for existing mental and physical health and long term
care.
Many of our seniors become overwhelmed and depressed due their inability to make
decisions. As a result of Senior for Services program and case manager's support these elderly
clients feel empowered when they are able to make decisions regarding their care.
Clients have an active role in developing their care plan with the case manager to address
the care needs identified in the assessment while reflecting their consumer choices and
preferences. Services for Seniors program staff empowers the clients and the families we service
through the Client Choice Provider process. Once services are approved by Senior Choices, case
managers assist the client in choosing their home care provider and may change the provider or
health aide if they have a legitimate reason for dissatisfaction. Clients also feel empowered
when they are able to contribute to the cost of their services with the copayment charge
mandated under the Community Care for the Elderly (CCE) and the Alzheimer's Disease
Initiative (ADI) services.
b. Enable individuals to maintain a high quality of life for as long as possible through the
provision of home and community -based services, including supports for family
caregivers.
Services for Seniors goal is to enable clients to remain safely in their home for as long as
possible by creating the correct care plan with the appropriate services and service levels. Often,
the senior and the family member are fearful of letting go of the issue that they need help. The
case manager's role is to assure the clients and their, family members that staying home is
Packet Page -1714-
5/22/2012 Item 16.D.4.
54
important and with the "appropriate" services, the clients can live independently. Additionally,
support for the caregiver is instrumental. The caregiver may give up from exhaustion, physically
and mentally if there is lack of support or no support. A respite service enables care for the
client and relief for the family.
Services for Seniors partners with several community agencies and has been instrumental
in working with the Coalition on Aging in Collier County in securing a Senior Center where both
clients and families can receive information and support.
c. Empower older people and their caregivers to live active, healthy lives to improve their
mental and physical health status.
Empowering our seniors to live active and healthy lives can be a challenge. For many of
our seniors, their biggest goal is to be able to stay in their own home. For many seniors, once
they change their physical environment to a nursing or assisted living facility, their mental and
physical health declines rapidly. Case managers are always searching for available resources for
clients and caregivers. Senior Choices offers Tai Chi for Seniors to promote balance and agility,
two factors that seniors lose as they age. Senior Choices work in the communities to provide
classes to interested seniors. Case managers provide information about health classes to clients
and caregivers including the Blue Book Resource Guide, information about the Congregate Meal
Sites for meals, bingo and socialization, and Bone Builders classes to fight weakness and
osteoporosis. Case managers have been able to even work with local churches to obtain
volunteer services where volunteers stay with our seniors while the family attends support
groups and/or exercise classes. Case managers assess and update care plans as necessary to
accommodate the growing needs of our clients.
Packet Page -1715-
55
5/22/2012 Item 16.D.4.
All the above services are related to serving the seniors by empowering and enabling
individuals and their caregivers to maintain a high quality of life and to improve their mental and
physical health status.
Services for Seniors Purpose
To assist those frail, elderly Collier County residents in greatest medical, economic and social
need to remain in their homes as long as possible and to improve or maintain their quality of life
by preventing premature institutionalization.
Services for Seniors Program
The Services for Seniors program provides professional case management services for
individuals 60 years of age and older, who are at risk for nursing home placement. The Services
for Seniors Program performs services for the elders for Collier County. The services provided
include support services, such as personal care, homemaking, supplies, daycare and subsidies to
caregivers to enable our frail elderly to age in place. The grant is provided by the Department of
Elder Affairs and the Area Agency on Aging and the following is a breakdown of Services for
Seniors Program Performance Measures /Outcomes for the year July 2010 -June 2011:
• Total staff - 8 FTE's
• Programmatic Staff - 5 FTE's
• Fiscal Staff - 3 FTE's
• # of Clients Served - 957
• # of Senior Assessments- 456
• # of Service Units Provided- 139,856.
a # of Direct Service Hours by Services for Seniors — 4,529.50
Packet Page -1716-
5/22/2012 Item 16.D.4.
56
III. Contract Module
Collier County has a sophisticated electronic accounting system (SAP) that accounts for
individual grant programs separately from other revenue sources, tracks actual revenues
(sponsor, program income, and local) and expenditures with budgeted amounts in order to meet
the financial needs for grant management and fiscal oversight. Internal procedures assure that
grant expenditures are allowable through as well as regular monitoring and review. In Fiscal
Year 2010, the County implemented a companion Grants Management System (GMS) that
further supports overall grants administration. GMS acts as an internal control to assure grant
funding and required grant match is tracked separately within unique funds and projects. The
County also has a dedicated Grant Compliance Office which as of February 1, 2012 has been
reorganized under the corporate leadership of the Office of Management & Budget. OMB will
implement centralization of core administrative and fiscal functions of grants management to
provide additional oversight to ensure single audit compliance in areas such as cash
management, required reporting and grant asset management. OMB works in conjunction with
the County's Clerk of Courts Finance Department. The Clerk — governed by Florida Statute —
provides an additional layer of independent oversight in the financial management of grants and
is responsible to prepare the Comprehensive Annual Financial Statements as well as coordinate
the single audit.
1. Budget/Cost Allocation
Please see attached spreadsheets for all
2. Matching /Co- payment/Program Income
Please refer to the Fiscal Management section and the detailed worksheets for this
information. All match, co -pay and in -kind information is delineated. In addition, the service
funding levels in the spreadsheets match the Budget Summary Worksheet for each grant
Packet Page -1717-
57
5/22/2012 Item 16.D.4.
currently in existence, with the exclusion of the Lead Agency allocation which is no longer
applicable.
3. Cash Availability
The General Fund is the primary operating fund of Collier County. Pending
reimbursement, grant expenses are cash flowed primarily through the General Fund. The
County's corporate credit rating is investment quality signified by the financial health and strong
unassigned cash balance in the General Fund. At September 30, 2011, the unassigned General
Fund cash balance totaled $54,458,662 which represented 19.8% of total general fund expenses
and net transfers. This unassigned balance percentage, exceeds budget policy minimum threshold
of 10% and exceeds the minimum unassigned general fund balance of 10% recommended by
Moody's Investor's Service. The anticipated cash flow need for one month's operating cash
based on 1/12 of the funds applied for in this application is approximately $70,100.
Packet Page -1718-
ss
APPENDIX
Packet Page -1719-
5/22/2012 Item 16.D.4.
59
Notice of Intent to File Application Proposal for
2012 -2018 CCE Lead Agency Designation
Date: 4/12/2012
Agency Name: Collier County Housing, Human and Veteran Services —
Services for Seniors Program
Agency Address: 3339 Tamiami Trail East, Suite 211, Naples FL 34112
Contact Person: Kim Grant, Interim Director
Telephone: (239) 252 -2273 Fax: (239) 252 -2638
Senior Choices a/k/a Area Agency on Aging for SWFL
Attn: Gail A. Holton, Director of Programs and Quality Improvement
15201 N. Cleveland Ave Suite 1100
North Fort Myers, FL 33903
Date Received:
Time Received:
Received by:
Packet Page -1720-
5/22/2012 Item 16.D.4.
APPENDIX I
FS
so
5/22/2012 Item 16.D.4.
APPENDIX 11
APPLICANT ATTACHMENT CHECKLIST
Required Attachments to Service Providers Application (SPA)
(Initial and returned with application)
Director's
Initials Attachments
10� 1. Applicant Attachment Checklist
1-6 d" 2. Service Provider Application Checklist
A— 3. Contract Terms and Conditions
-K&-i—
4. Applicant Statement of Authorization and Capacity
14
5. Statement of No Involvement
1
6. Availability of Two Months (60 days) Cash
K
7. Statement of Compliance with Service Standards and Requirements
8. HIPAA/Confidentially Assurance
9. Administrative Assessment Checklist
10. Independent Audit and Management Letter
f)% -WO&9 11. Utilization of Other Resources/Monitoring reports from other funders
12. Disasterency Preparedness Plan
13. Transition Plan Statement (Waived for Current Providers)
14. Description of Client Input Mechanism (Waived for Current
Providers)
Packet Page -1721-
61
SERVICE PROVIDER APPLICATION CHECKLIST
5/22/2012 Item 16.D.4.
APPENDIX III
(Initial, include page numbers as they appear in your application, and return with application)
TABLE OF CONTENTS
I. A. Service Provider Summary Information
II. PROGRAM MODULE FORMATS
A General Information
4. Needs Assessment p �o
5. Targeting F d4L
6. Eligibility and Assessment/Reassessment Process f.
5. System of PrioritizationP- 2 10
6. Process for Reducing or Terminating Services
7. Quality Assurance P - 3-1
a. Client SatisfactionP- 3D.-
b. Internal Evaluation Process r -33
c. File Quality /Data integrity • 3'-(
d. Case Management quality 1.35
B Description of Service Delivery, Service Data (Includes Items 1,2 & 3) ff 3k' Saa-
2. Site Location
4. Days and Hours of Operation
5. Describe Specific Activities
C New Service/New Provider Workplan NJA
D Outcome /Output Measures P • S 3
Packet Page -1722-
62
In the event
Contract Terms & Conditions Statement
(sign and returned with application)
Board of County Commissioners of Collier County Florida
(Name of Agency)
5/22/2012 Item 16.D.4.
APPENDIX N
should be awarded a contract for the provision of services based on this Request for Proposals
for 2013 -2018 Community Care for the Elderly (CCE) Lead Agency Designation,
Board of County Commissioners of Collier County Florida
(Name of Agency)
agrees to abide by e terms and conditions of the sample contract, master agreement and their
respeptlye attac ents, including the billing and payment process.
Signature of Authorized Representative
Li- 3o iz
Date
Packet Page -1723-
63 5/22/2012 Item 16.D.4.
APPENDIX V
Applicant Statement of Authorization & Capacity
The undersigned hereby CERTIFIES and AGREES that:
(1) The applicant is duly authorized by its governing body to submit this application to
SENIOR CHOICES.
(2) The applicant has fully reviewed the model contract (Attachment H) and the Master
Agreement (Attachment H.A.) and is willing and has the organizational and financial capacity
and expertise to execute each of its duties under the contract.
The applicant understands that SENIOR CHOICES may or may not award a contract for all
services proposed by the applicant.
Signature of Authorized Signer Date
Packet Page -1724-
sa
5/22/2012 Item 16.D.4.
APPENDIX VI
Statement of No Involvement
(signed and returned with application)
I, Mark Isackson-on behalf of Leo Ochs, Jr. as an authorized
representative of Board of County Commissioners of Collier County Florida,
certify that
no member of this firm nor any person having interest in this firm has been awarded a
contract by SENIOR CHOICES on a non - competitive basis to:
(1) develop this Request for Proposal
(2) perform a feasibility study concerning the scope of work contained in this RFP; or
(3) develop a program similar to what is contained in this RFP.
Signature of Authorized Representative
x•30• � Z
Date
Packet Page -1725-
L•R
5/22/2012 Item 16.D.4.
AVAILABILITY OF TWO MONTH'S (60 days) CASH
APPENDIX VII
I, _ Mark Isackson on behalf of Leo Ochs, Jr. as an authorized
representative of the Board of County Commissioners of Collier County Flori da, certify that the
organization has available two month's cash calculated as two- twelfth of the allocation of
estimated Community Care for the Elderly (CCE), Alzheimer's Disease Initiative (AD]) and
Home Care for the Elderly (HCE) funding
for Collier .
following: (please list)
County, equal to $_ $165,233.88 , through the
Ad valor gene s
Signature of Authorize epresentative
Date
Packet Page -1726-
fib
5/22/2012 Item 16.D.4.
APPENDIX VIII
Statement of Compliance with Service Standards:
I, _Mark Isackson on behalf of Leo Ochs, Jr. have
read and understand the requirements and standards for all services to be coordinated or provided
directly for which my agency / company,
is applying and would be held responsible. I hereby issue this statement of assurance that this
agency / company i in compliance with and is able to meet all of the requirements and standards
noted in Departm t of Elder Affairs Home and Community Based Services Handbook (2009)
for se ed in this proposal.
Date
Packet Page -1727-
87
5/22/2012 Item 16.D.4.
APPENDIX IX
E IPAA /Confidentially Compliance Assurance:
I, _Mark Isackson on behalf of Leo Ochs, Jr. , as an authorized
representative of Board of Count Commissioners of Collier County Florida, hereby issue this
statement of assurance that this agency /company has determined that:
[ X ] it is considered a "covered entity" and is in compliance with and is able to meet all
of the requirements of the Health Insurance Portability and Accountability Act of 1996.
[ ] it is not considered a "covered entity," but will comply with the intent of the Act in
the areas of privacy, se unity and billing.
Authorized Representative
L( 3 r
Date
Packet Page -1728-
68 5/22/2012 Item 16.D.4.
APPENDIX X
ADMINISTRATIVE ASSESSMENT CHECKLIST
Agency: Board of County Commissioners of Collier CoupV Florida
Date: April 26, 2012
Address: 3339 E. Tamiami Trail Suite 211 No. of Employees: _Aynrox 1500
Naples, Fl 34112
No. of Business Locations: Approx 10 in County
Director's Name: Kimberley Grant, Interim Director
Administrative Assessment: An assessment of your organization's managerial, financial,
and administrative capabilities will be made partially on the basis of your response to the
following questions. If response other than "yes" or "no" needs to be made, please
reference the appropriate question and give your response on a separate page. This
information must be completed and returned with your response to our Request for
Proposals.
Packet Page -1729-
69
1. Property Management
5/22/2012 Item 16.D.4.
YES NO OTHER
a. Are property records which describe the X _
equipment, including the item number, the
manufacturer's model number, equipment
identification number, grant or contract
identification number, acquisition date,
location and condition of equipment
maintained?
2. Procurement
a. Are written purchasing policies for
procurement of supplies, equipment,
construction, and other services on
file?
b. Is a code of conduct in writing maintained X
which governs performance of the officers,
employees or agents engaged in procurement
which states that they will avoid any
conflict of interest?
3. Accounting
a. Are financial reports prepared monthly X _
for internal management purposes?
b. Does an independent auditor perform X _
a certified audit annually?
C. Are basic books of accounting X
maintained?
(1) General ledgers
(2) Project ledgers
(3) Accounts receivable /cash
receipt journal
(4) Accounts payable /cash
disbursement journal
d. Is there adequate segregation of duties among personnel X _
in accounting functions listed below?
(1) Is payroll prepared by someone
other than the timekeepers and
persons who deliver paychecks
to employees?
Packet Page -1730-
70
(2) Are duties of the bookkeeper
separate from cash - related
functions?
(3) Is the signing of checks limited
to those authorized to make
disbursements and whose duties
exclude posting and recording of
cash received?
(4) Are personnel performing disburse-
ment functions excluded from the
purchasing, receiving, inventory,
and general ledger services?
4. Revenue
a.
Are receipts recorded in a cash receipt
journal by individual cost centers?
b.
Is an equitable system of allocating fees
and other third party payments to funding
sources used when two or more sources are
involved?
C.
Do controls exist to ensure that all
appropriate costs for eligible service
provisions are billed to third party
payers in a timely manner?
d.
Are there guidelines for assessing fees?
e.
Are these guidelines known to the book-
keeper /cashier?
f.
Is every effort extended to collect fees?
g. Are uncollectible write -offs approved by a
responsible official?
h. Are all checks marked "For Deposit Only"
immediately upon receipt?
i. Are receipts deposited on a regular basis?
Packet Page -1731-
5/22/2012 Item 16.D.4.
YES NO OTHER
X
X
X
X
X
X
X
X
X
X
X
X
n
5. Expenditures
a. Are expenditure entries posted by cost
centers?
5/22/2012 Item 16.D.4.
YES NO OTHER
_X_ _
b.
Is there a system for allocating direct
X
cost when the project is funded by two or
_
more sources?
C.
Are there written procedures for making
X
refunds to clients, third party payers
_
and others?
d.
If non - profit, does the agency have a
X
tax exempt number?
_
e.
Are written travel policies maintained?
X
f.
Are time and attendance records kept for
X
all employees by program, by funding
_
source?
g.
Are Federal quarterly payroll tax forms
(U.S. 94 1) submitted in a timely manner?
X
h.
Are individual payroll records maintained
X
on each employee?
_
6. Disbursements
a.
Are checks issued in pre- numbered sequential
X
order and are all applicable check numbers
_
accounted for?
b.
Are banks notified in writing when
X
authorized check signers terminate
_
employment with the provider?
C.
Are ledgers /journals reconciled to bank
X
statements on a monthly basis?
_
d.
When not in use, are checks locked in a
X
secure cabinet?
_
C.
Is it prohibited to make disbursements
X
for cash receipts?
_
Packet Page -1732-
w
v
Packet Page -1733-
i
5/22/2012 Item 16.D.4.
72
YES NO OTHER
f.
Are cash receipts from accounts
_ _X_
receivable or other sources mixed with
petty cash funds?
g.
Are disbursements from petty cash
_X_ _
documented by approved supporting
invoices?
7. Personnel
a.
Are personnel policies in writing and
_X_ _
approved by appropriate authority?
b.
Are job descriptions provided to all
employees at time of initial employment?
_X_
C.
Are job descriptions on file for all
X_
positions?
d.
Is each staff member appraised on
performance, at least annually?
_X _
e.
Are staff members asked to review and
X
comment on their evaluation?
_
Packet Page -1733-
5/22/2012 Item 16.D.4.
COLLIER COUNTY GOVERNMENT
HOUSING, HUMAN, AND VETERAN SERVICES
SERVICES FOR SENIORS PROGRAM
COMMUNITY CARE FOR THE ELDERLY
ALZHEIMER'S DISEASE INITIATIVE
HOME CARE FOR THE ELDERLY
REQUEST FOR PROPOSAL
LEAD AGENCY / PART B. CONTRACT MODULE
7/01/2012 — 6/30/2018
SUBMITTED APRIL 30, 2012
Packet Page -1734-
2
TABLE OF CONTENTS
SPA -C CONTRACT MODULE
SPA -C I UNIT COSTING METHODOLOGY
5/22/2012 Item 16.D.4.
a. Personnel Allocations ............................................................ ..............................4
b. Support Budget ...................................................................... ..............................6
c. Supporting Budget by Program Activity ............................... ..............................7
SPA -C II MATCH
a. Commitment of Cash Donation .............................................. .............................12
b. Commitment for Donation of Building Space ......................... ............................N /A
c. Commitment of In -Kind Contribution of Supplies .................. ............................N /A
d. Commitment of In -Kind Contribution of Equipment .............. ............................N /A
e. Commitment of In -Kind Contribution of Services ................. .............................13
f. Commitment of in -Kind Volunteer Personnel and Travel ....... ............................N /A
SPA -C IIIAvailability of Documents .................................... .............................14
Packet Page -1735-
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5/22/2012 Item 16.D.4.
SERVICE DESCRIPTION
1
1 Adult Day Care
2
Adult Day Health Care
3
1 Basic Subsidy
4
1 Case Aid
5
Case Management (CCE)
6
Chore
7
1 Chore (Enhanced)
8
I Companionship
9
!Emergency Alert Response
10
1 Escort
_
11
1 Home Delivered Meals C2
12
I Homemaker
13
_
!Housing Improvement
14
_
Intake C2 -- - - -- -_
15
(Material Aid ---- - - - --- ---- --_-
16
_— _'___�_
1Medication Management
17
;Other
18
:Personal Care
19
Control (Enhanced Initiation)
_Pest
20
1 Pest Control (Initiation)
21
!Pest Control (Maintenance)_
_
22
Pest Control (Rodent)
23
Respite (Facility Based)
24
_
Respite (In -Home)
25
Shopping Assistance
Skilled Nursing Services
_26
27
Specialized Medical Equipment, Services & Supplies
28
Transportation -Other
29
Non -DOEA Services & Activities
30
Fundraising & Unallowable Activities
31
33
Case Management (ADI)
34
Case Management (HCE)
35
Med Waiver Case Management
36
OAA/Other Programs
37
38
39
j
41
43
44
Revised May 19, 2003
Packet Page -1743-
,2
5/22/2012 Item 16.D.4.
SPA -C II a MATCH COMMITMENT OF CASH DONATION
Agency Name: Board of County Commissioners of Collier County, Florida
Donor Identification:
Name: Board of County Commissioners of Collier County, Florida
Street:
3339 Tamiami Trail E., Bldg H, Suite 211
City:
Naples
State:
FL
Zip:
34112
Phone:
239 - 252 -2273
Authorized Representative:
Total Amount
# Payments
Amount/Payment
Contribution Period
Special Conditions:
Donor Certification:
$ 16.603.96
12
$ 1.383.67
711/2012 — 6/30/2013
I hereby certify intent to make the cash donation set forth above for use in the specified
program during the program's upcoming funding period. This cash is not included as
match for any other State or Federally assisted progr or contract and is not borne by
the federal government directly under any fAeral q* ht or contract.
Signature of Donor or Representative: ���il� Date: 3�
Packet Page -1744-
5/22/2012 Item 16.D.4.
13
II a MATUM UUMMITMENT OF IN -KIND UUNTK113U I IUN Uf SEKVIGCS
BY STAFF OF SERVICE PROVIDER OR STAFF OF OTHER ORGANIZATIONS
Name: Collier County Board of County Commissioners
onor Identification: Accu -Care, Health Force, Homestead, Always There, Premiere, Dial -A-
urse, Brightstar, Visiting Angles, Care Club, Millennium House, VIP America, ADT
Note: Collier County is submitting the actual contracts with each of these vendors to
show the in -kind 10% matches provided by each.
Name: Various for each vendor, see attached contracts for each
Street:
City:
State:
Zip:
Phone:
Representative: . Per each contract (See Exhibit L. Vendor Contracts)
personal services described below are committed for use by the project for the period of:
Description of Positions: Note: Collier County is submitting the actual contracts with each
of these vendors to show the in -kind 10% matches provided by each.
!Position Service . Hourly Rate or #Hours
le Annual Salary Worked
11.
TOTAL - $
Value to project = (# of hours provided) x (hourly rate of annual salary).
to Proiect
Value
or Certification: It is certified that the time devoted to the project will be performed during
nal working hours.
se services are not included as match for any other State or Federally assisted program or
:Tact and are not borne by the Federal Government directly or indirectly under any Federal
it or contract except as provided for under (cite the authorizing Federal regulation or
if applicable). ��/j/
ignature of Donor or
Packet Page -1745-
41.3x• 1 Z
14
5/22/2012 Item 16.D.4.
undersigned hereby gives assurance that the following documents are maintained in the
nistrative office of the provider and are accessible for review by the AAA.
1. Current Board Roster
2. Articles of Incorporation
3. Corporate By -Laws
4. Advisory Council By -Laws and Membership
5. Current Equipment Inventory
6. Bonding Verification
7. Staffing Plan
a. Position Descriptions
b. Pay Plan
C. Organizational Chart
8. Personnel Policies Manual
9. Financial Procedures Manual
10. Operational Procedures Manual
11. Affirmative Action Plan
12. Outreach Plan, if applicable
13. Americans With Disabilities Act Assurance
14. Staff Development and Training Plan
15. Unusual Incident File
16. Service Subcontracts
17. Co -Pay and Contribution System
18. Civil Rights Compliance Documentation
CERTIFICATION BY AUTHORIZED AGENCY OFFICIAL:
hereby certify that the documents identified above currently exist and are available for review
pon request.
ignature Date
ame of Authorized Individual
Director -Corp Financial and Management Serv.
Title of Authorized Individual
Packet Page -1746-
Y
5
Co -ter CoUnty
office of Management & Budget
TO: Leo Ochs, County Manager
CC: Kim Grant, Housing, Human, and Veteran Services
5/22/2012 Item 16.D.4.
Grant Applic on Reviewed and
s,,,,i,u County Manager or
County Manager
�� Date
After the fact approval by the BCC
is required at the May 22, 2012
BCC meeting.
FROM: Joshua Thomas, Grants Support Specialist
SUBJECT: County Manager review and approval of a Community Care for the Elderly, Home Care for
the Elderly, and Alzheimer 's disease Initiative grants.
April 27, 2012
The Collier County Housing, Human, and Veteran Services (HHVS) Department, Services for
Seniors program has been the Lead Agency in Collier County for elder services for more than thirty two
ears. Collier's execution of the State Community Care for the Elderly (CCE), Home Care for the
(32) y
ive (ADI) grants have established a reputation of
Elderly (HCE), and Alzheimer's Disease Initiat
excellence in the service delivery system provided by the HHVS Services for Seniors program. In the past
six years, Services for Seniors has served over 2,300 Collier County's citizens resulting in providing over
332,000 hours of service.
The grant requires a 10% match of $72,600 which is currently located in Public Services reserved
funding (fund 708). Due to the complexity of the budget for this grant and new staffing it was necessary
to request after the fact approval. We are requesting your approval, followed by after the fact approval o
the Board of County Commissioners at the May 22, 2012 BCC meeting.
Once you have reviewed the proposal, please sign in the box above and call me for pickup at 239-
252 -8989. Please let me know if you have any questions regarding this request.
v
3299 Tamiami Trail East, Suite 201 • Naples, Florida 34 112-5746 - 239 252 8973 •FAX 239-252-8928
Packet Page -1747-