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HomeMy WebLinkAboutR-2010-012 2010 ALTC Agreement for Day Break Adult Day Care and Respite Services Program at Harman CenterA RESOLUTION RESOLUTION NO. R-2010-12 authorizing and directing the City Manager to execute the Performance Agreement No. 2010 COY/2010 ALTC Contract Adult Day Care Respite between the City of Yakima and Yakima County, through the Office of Aging and Long Term Care (ALTC) and potential subsequent amendments thereto for the Adult Day Care and Respite Services program at the Harman Center. WHEREAS, the City of Yakima desires that an Adult Day Care Program and Respite Services be available at the Harman Center; and WHEREAS, Yakima County, through its Office of Aging and Long Term Care, is willing to provide funding to the City for these services in accordance with the attached agreement; and WHEREAS, the City Council deems it to be in the best interest of the City of Yakima to enter into the attached Performance Agreement No. 2010 COY/2010 ALTC Contract Adult Day Care Respite with Yakima County, through the Office of Aging and Long Term Care (ALTC) in accordance with the terms of the attached agreement, now, therefore, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF YAKIMA: The City Manager of the City of Yakima is hereby authorized and directed to execute the attached and incorporated "Performance Agreement No. 2010 COY/2010 ALTC Contract Adult Day Care Respite" between the City of Yakima and Yakima County, through the Office of Aging and Long Term Care (ALTC), and potential subsequent amendments thereto, for the Adult Day Care and Respite Services program at the Harman Center. ADOPTED BY THE CITY COUNCIL this 19th day of January 2010. Micah Cawley, May ATTEST: City Cle RES NO. R-2010-12 Adult Daycaie RespitestEms AGREEMENT NO. MOD. NO. FUNDING SOURCE AGREEMENT PERIOD 2010 City of Yakima Adult Day Care & Respite TITLE III -B, Title III -E, 1/01/10- 12/31/10 01 SFCSP & SCSA THIS AGREEMENT MODIFICATION to A reement N 2010 City of Yakima Adult Day Care & Respite is entered into this day of , 2010. This Modification shall consist of those points enumerate below and in no way alters any other terms or conditions of the original.Agreement not specifically mentioned in this Agreement Modification. The purpose of this modification is to: 1) Revise the contract to extend contract period to December 31, 2010. 2) Increase the contract to $30,000 for Adult Day Care and to $10,000 for Respite. The total contract amount increases from $16,750 to $40,000. EXHIBIT A 3) Revise EXHIBIT A ADULT DAY CARE STATEMENT OF WORK Section V. UNITS OF SERVICE, Part C. Anticipated Service Level by Quarter and Part D. Anticipated Expenditure Rate by Quarter. 4) Revise Section VI. PAYMENT CONSIDERATIONS. EXHIBIT B 5) Revise EXHIBIT B, RESPITE STATEMENT OF WORK, Section VII. UNITS OF SERVICE, Part D. Anticipated Service Level by Quarter and Part E. Anticipated Expenditure Rate by y Quarter. 6) Revise Section IX. PAYMENT CONSIDERATIONS. 7) Revise EXHIBIT C, BUDGET. CITY OF YAKIMA YAK IMA COUNTY, Southeast Washington Of Aging And Long Term Care ' --- i r 1A.._ , 1' 'l G' 1_ � �Office Dick Zais, Ci anager Date: \.,N;\\\,.,. Atte • = yPK1r"A �':��.� Brown, birector ' i �,' . 0 City Clerk City Contract No. &O/D- ,AL s S� *� Resolution No. R --841,0-12 ''k%, Date: %,,,..._.--- CONTRACT AUTHORIZATION BOARD OF YAKIMA COUNTY ATTEST: COMMISSIONERS ag5--ala Resolution No: CGL am) APROVED AS TO FORM: (at Clerk of the Board Deputy PrtSsecuting Attorney Date o 3Sc-o Page 1 0111111/00/ \\\ 0. YAKIM,,1 C ,,/� \:PQO'nFWq,S'.CG�` �`' yam••. 2010 AGREEMENT MODIFICATION #1 CITY OF YAKIMA EXHIBIT A ADULT DAY CARE STATEMENT OF WORK V. UNITS OF SERVICE C. Anticipated Service Level by Quarter: Month Hours Original Modified January - March 731 861 April - June 731 861 July - September 0 861 October - December 0 861 Total 1,462 3,444 Anticipated Service Levels include 386 additional units funded by client participation. D. Anticipated Expenditure Rate by Quarter: Month Original Modified January - March $6,375 $7,500 April - June $6,375 $7,500 July - September $0 $7,500 October - December P $7,500 Total $12,750 $30,000 VI. PAYMENT CONSIDERATIONS As consideration for services, as described in the Specific Provisions 'of this Agreement and in accordance with the Budget Provisions of this Agreement, the County agrees to pay the Contractor for client Adult Day Care services a sum not to exceed $30,000 as submitted on the 2010 Contract Budget Summary. The contracted amount shall be available during the period January 1, 2010 through December 31, 2010. Payment to the Contractor for this Agreement shall be based on $9.81 per hour, less client match as computed on the Senior Citizen Services sliding fee schedule. Page 2 2010 AGREEMENT MODIFICATION #1 CITY OF YAKIMA EXHIBIT B RESPITE STATEMENT OF WORK VII. UNITS OF SERVICE D. Anticipated Service Level by Quarter: Month Hours Original Modified January - March 288 338 April - June 288 339 July - September 0 338 October - December 0 339 Total 576 1354 Anticipated Service Levels include 335 additional units funded by client participation. E. Anticipated Expenditure Rate by Quarter: Month Original Modified January - March $2,000 $2,500 April - June $2,000 $2,500 July - September $0 $2,500 October - December 10 $2,500 Total. $4,000 $10,000 IX. PAYMENT CONSIDERATIONS As consideration for services, as described in the Specific Provisions of this Agreement and in accordance with the Budget Provisions of this Agreement, the County agrees to pay the Contractor a sum not to exceed $10,000 from available funds. This total sum shall be available during the period January 1, 2010 through December 31, 2010. These funds shall be used to provide Respite Care services. Payment to the Contractor for this unit rate price Agreement shall be based on the unit rate of $9.81 per hour, less client match as computed on the Senior Citizen Services sliding fee schedule. Page 3 EXHIBIT C BUDGET CITY OF YAKIMA ADULT DAY CARE - RESPITE JANUARY 1, 201 0 -JUNE 30, 2010 ADULT DAY CARE FUNDING SOURCE AMOUNT Title III -B (CFDA #93.044) $18,200 SCSA $11,800 Total $30,000 9 unduplicated individuals, 3,444 units of service, @ $9.81 per hour (less client match as computed on the Senior Citizen Services slide fee schedule); an additional 386 units were budgeted because of client participation. COPES rate for Level I is $9.81 per hour up to four hours per day or $39.25 for over four hours per day. RESPITE FUNDING SOURCE AMOUNT Title III -E (CDFA #93.52) $3,300 State Family Caregiver $6,700 Total $10,000 8 unduplicated individuals, 1,354 units of service, @ $9.81 per hour (less client match as computed on the Senior Citizen Services sliding fee schedule); an additional 335 units were budgeted because of client participation. Page 4 PERFORMANCE AGREEMENT NO. 2010 COY ADMINISTRATION OF AGREEMENT " Zolo THIS AGREEMENT is entered into this ti day of - 2009-- between Yakima County, hereinafter denominated the "County", through the Office of Aging and Long Term Care whose address is P.O. Box 8349, Yakima, Washington 98908, hereinafter denominated the "Department", and City of Yakima Day Break Adult Day Care, 101 N. 65th Ave., Yakima, Washington 98908, hereinafter denominated the "Contractor", whose duly authorized representatives are named in documents on file at the Office of Aging and Long Term Care. THE PURPOSE of this Agreement is to provide for the delivery of Adult Day Care and Respite services in accordance with the terms and conditions set forth in the provisions as listed below: ADDITIIONAL TERMS of this Agreement are set out in and governed by Basic Agreement No. ALTC-09. In the event the Basic Agreement is revised, this Agreement shall conform to the revisions. PAYMENT CATEGORY AMOUNTS SIGNATURES Adult Day Care $12,750 CITY OF YAKIMA Respite $ 4,000 TOTAL FUNDING ALLOCATION $16,750 Dick Zais, Ci anager PERIOD OF AGREEMENT January 1, 2010 - June 30, 2010 City Clerk ity Contract No. 2 of o - 08 solution No. R-2-010- 12 ate: !/Zipe) APPROVED AS TO FORM: YAKIMA COUNTY, Office of Aging and Long Term Care ti Senior Deputy Prosecuting Attorney Lori Brown Director Date:' / CONTRA AUTHORIZATION `\\``',,\MA cOU ��//i BOARD OF YAKIMA COUNTY ����yP.••.... �TATTEST: COMMISSIONERS ° �`�� �� Resolution No. 12/9/2009 Lc, z : c u Elerk of the Brd C-:'i•d) 4ti. :6 -Date: b l 6o , 3O 176 2010 ALTC CONTRACT CITY OF YAKIMA ADULT DAY CARE RESPITE TABLE OF CONTENTS ADMINISTRATION OF AGREEMENT (signature page) STANDARD TERMS AND PAYMENT PROVISIONS FOR MULTIPLE SERVICE PROVIDERS SPECIFIC PROVISIONS I. SERVICE SPECIFICATIONS II ANTICIPATED SERVICE LEVELS AND EXPENDITURE RATE III. ADMINISTRATIVE AGREEMENTS PAYMENT PROVISIONS I. CONSIDERATION II. GENERAL PAYMENT CONDITIONS III. BILLING PROCEDURES EXHIBIT A ADULT DAY CARE STATEMENT OF WORK I. APPLICABLE LAWS AND REGULATIONS II. PROJECT DEFINITION III. PARTICIPANTS IV. SERVICE SPECIFICATIONS V. UNITS OF SERVICE VI. PAYMENT CONSIDERATIONS EXHIBIT B RESPITE STATEMENT OF WORK I. APPLICABLE LAWS AND REGULATIONS II. PROJECT DEFINITION III. TARGET POPULATION IV. FINANCIAL PARTICIPATION V. PROGRAM ADMINISTRATION VI. SERVICE AREA VII. UNITS OF SERVICE VIII. STAFFING STANDARDS IX. PAYMENT CONSIDERATIONS EXHIBIT C BUDGET 12/9.12009 STANDARD TERMS AND PAYMENT PROVISIONS FOR MULTIPLE SERVICE PROVIDERS SPECIFIC PROVISIONS I. SERVICE SPECIFICATIONS The Contractor agrees that services provided within the terms of this Agreement shall meet the following specifications: A. Efforts will be made to assure access of service to the target population, to include at least the following: 1. Accessible office or site location; 2. Home visits or home delivery of services (if applicable); 3. Multicultural, bilingual persons to assist multicultural, bilingual clients in receiving services; 4. Publicity of program through public service announcements, brochures, etc. 5. Meeting with other service providers/agencies to explain services the Contractor provides and how referral can be made; 6. Ability to serve individuals with disabilities. B. Services shall be delivered in accordance with the State of Washington Aging and Adult Services Administration Program Standards and information submitted in Request for Proposal. The Contractor acknowledges receipt of a copy of said standards. Services provided shall comply with said standards as presently constituted or subsequently modified. II. ANTICIPATED SERVICE LEVELS AND EXPENDITURE RATES The Contractor agrees that: A. The levels of service to be provided shall be as described in the Program Attachments for Adult Day Care and Respite Care to this Agreement. Failure to meet the service levels as defined in the Program Attachments may result in a re- negotiation of the funding levels provided under the terms of this Agreement. B. The County may unilaterally reduce the Agreement budget within thirty (30) days of the dose of the quarter by the amount of the projected quarterly expenditures left unspent at the end of that quarter. The County shall submit to the Contractor notification of intent to recapture unspent funds and a modification to the budget reflecting the adjusted changes in the Agreement. III. ADMINISTRATIVE AGREEMENTS: A. Access by the County: The Contractor shall provide access at all reasonable times for the County to monitor and/or evaluate the provisions of services under this Agreement. The County may, with prior permission from the participant and knowledge of the Contractor, interview a certain percentage of participants to ascertain their experiences with the program. 12/10/2009 Page 1 B. Records and Reports: The Contractor agrees to: 1. Maintain program records and reports, including statistical information, and to make such records available for inspection by the County in order for the County to be assured that contracted activities remain consistent with the terms of this Agreement and the currently approved SE/ALTC Area Plan which shall be kept on file at the ALTC office. The Contractor further agrees to provide such information as requested by the County within the time limitations established by the County. 2. Submit the monthly report showing service level provided by the tenth day of each month following the month during which the services were provided. A quarterly report must be submitted to ALTC by the end of the month following the end of each quarter. 3. Complete and submit such additional reports as are required by the County within the specified time frames, providing the Contractor is given a written request for the reports thirty (30) days prior to the due date. C. Inventory: The Contractor agrees to: 1. Submit to the County vendor invoice(s) at the same time with the monthly billing before County reimbursement of expenditures of authorized equipment items of $5,000 or more; 2. Complete at least once a year physical inventory, using forms provided by the County, of all equipment purchased under this Agreement. D. Contractors Meeting: The Contractor agrees to have a representative attend the Office of Aging and Long Term Care Contractors and Long Term Care Planning Committee meetings. E. Program Publication: The Contractor agrees that: 1. The program shall be publicized on a regular basis, with all publicity and printed material identifying the Southeast Washington Office of Aging and Long Term Care as a funding agency; 2. All material distributed with regards to publicizing the program contain a statement assuring non-discrimination. Following is the wording suggested: City Of Yakima does not discriminate in providing services on the grounds of race, creed, color, religion, national origin, gender, age, marital status, or the presence of any sensory, mental, or physical handicap. 12,10/2000 Page 2 3. Materials publicizing the program must be printed in other appropriate languages in counties that have a specific minority 60+ population of two -(2%) percent or more of the general 60+ population. F. Additional Remuneration Prohibited: Neither the Contractor nor any of its officers, employees, agents or representatives, shall solicit, impose any fees, or accept any remuneration whatsoever from clients, friends, relatives, or representatives of any clients for services performed for that client under this Agreement other than the client matching monies or donations (see Section I). In the event that this provision is violated, the County shall have the right to assert a claim against the Contractor on its own behalf and/or on behalf of the client. G. Private Pay: The Contractor, who offers to the general public on a private pay basis a service comparable to the service described in this Agreement, must assure that the County is not charged more for the service than the private pay fee. The responsibility lies with the Contractor to justify that a service provided at a different rate is not comparable to this service. H. Maintenance of Funding Sources: The Contractor agrees that: 1. . The County funds are not used to replace funds from any other existing program funding; 2. It will continue or initiate efforts to obtain support from private sources and other public organizations for this service; 3. It will utilize new funding sources for this service if they become available through the County and it will make any changes necessary to meet the requirements of the new funding sources. I. Fees and Donations: The Contractor agrees that: 1. It will assure that older persons have the opportunity to contribute to all or part of the cost of the service, but service will not be denied if participant cannot or does not wish to contribute; 2. It shall utilize client donations to meet project expenses before using State or Federal funds; 3. It shall provide that the methods of receiving fees, donations and contributions from individuals shall be handled in such a manner so as not to publicly differentiate among individuals; 4. All project income derived from the provision of services described herein or incorporated by reference herein or derived or generated through program fund-raising activities or profits earned from fixed rate service shall stay with the project and shall be used to provide increased levels or improved quality of service to the target population. 12/10/2009 Page 3 The state requires that rates charged to others cannot be Tess than the program charges the state for the same services (usual and customary fee). The unit rate charged to the county must equal or exceed the rate billed the state for the same service or the state must be charged the lower rate. J. Monitoring/Assessment Procedures: The Contractor agrees to: 1. Monitor both its fiscal and program status monthly; and assess its performance on program objectives and activities covered under this Agreement on an ongoing basis. 2. Monitor and assess on an ongoing basis the performance of any subcontracting agencies, and insure that funds made available are expended only in accordance with the specific provisions of this Agreement. 3. Recognize that the County will monitor and assess the activities and progress of all programs covered under this Agreement on an ongoing basis. Said monitoring and assessment will be accomplished through, but not limited to, review of program and financial reports, on-site visits (service delivery and administrative sites), conference with program administrators and staff, and visits by members of the Office of Aging and Long Term Care (ALTC) staff and ALTC Advisory Council. Monitoring may include assessing performance based on information submitted in the Request for Proposal (RFP). Prior notice of all such visits will be provided. 4. Authorize and/or participate in any program or fiscal evaluations or studies conducted by the County or DSHS. Prior notice will be provided as well as final reports of evaluations or studies. 5. Conduct a self-evaluation of the program annually. The self-evaluation shall include a survey of at least 10% of clients utilizing the service. The Contractor shall take steps to correct deficiencies found during the internal monitoring. Monitoring reports shall be made available to the County upon request. K. DISCLOSURE OF PERSONAL INFORMATION The Contractor shall not disclose the contents of any Client records, files, papers and communications except as necessary for the administration of programs to provide services to clients as stated in RCW 74.04.050, or its successor or replacement statute or as authorized by law. Other pertinent federal and state statutes and laws that protect Client records include the Public Records Act, codified as chapter 42.56 RCW, WAC 388-01-030 and chapter 388-01 WAC, the Health Insurance Portability And Accountability Act of 1996 ("HIPAA"), and chapter 70.02 RCW. As required by RCW 74.04.060 The Contractor shall treat information accessed under this Agreement with the degree of confidentiality required by the federal Social Security Act. 12/10/2009 Page 4 1. The Contractor shall limit access to client data to The Contractor and any subcontractor staff whose duties specifically require access to such data in the performance of their assigned duties. Contractor staff shall not access any individual client data for personal purposes. Clients shall only be permitted to access their own data. 2. The Contractor shall not use or disclose any information concerning any DSHS client for any purpose not directly connected with the administration of The County's responsibilities under this agreement except by prior written consent of the DSHS client, his/her attorney, parent or guardian. 3. The Contractor may disclose information to The County or to DSHS for purposes directly connected with the administration of their programs. This includes, but is not limited to, determining eligibility, providing services, and participation in an- audit. The Contractor shall disclose information for research, statistical, monitoring and evaluation purposes conducted by appropriate federal agencies and DSHS. DSHS must authorize in writing the disclosure of this information to any other party not identified in this section. L. DISSEMINATION TO STAFF Prior to making information available to new staff and annually thereafter, The Contractor shall ensure that staff accessing the Personal Information or PHI under this agreement are trained in HIPAA and use disclosure of PHI requirement an understand: 1. Confidentiality of Client Data a. Client Data is confidential and is protected by various state and federal laws. The basis for this protection is the individual's right to privacy as outlined in the HIPAA Privacy Rule — 45 CFR 160 to 45 CFR 164. b. Personal Information means demographic and financial information about a particular individual that is obtained through one or more sources (such as name, address, SSN, and phone numbers). RCW 42.56.230 lists the information that is exempted from public inspection and copying. 2. Use of Client Data a. Client data may be used only for purposes of these contracted services, directly related to providing services to the client or for the operation of aging and long-term care programs. b. Any personal use of client information is strictly prohibited. •12/10/2009 Page 5 c. Access to data must be limited to those staff whose duties specifically require access to such data in the performance of their assigned duties. 3. Disclosure of Information a. Client information may be provided to the client, client's authorized guardian, or a client -authorized 3rd party per WAC 388-01, and the Long Term Care Manual. b. Client information may be disclosed to other individuals or agencies only for purposes of administering DSHS programs. c. Questions related to disclosure are to be directed to the Southeast Washington Aging & Long Term Care Director and/or Home and Community Programs Public Disclosure Coordinator. d. Any disclosure of information contrary to this section is unauthorized and is subject to penalties identified in law. M. SECURITY OF DATA 1. The Contractor shall take reasonable precautions to secure against unauthorized physical and electronic access to data, which shall be protected in a manner that prevents unauthorized persons, including the general public, from retrieving data by means of computer, remote terminal, or other means. The Contractor shall take due care to protect said Data from unauthorized physical and electronic access. The data will be stored on computers with security systems that require individual user IDs and hardened passwords. Only persons who have signed the Washington State Notice of Nondisclosure confidentiality form covering this data share agreement will be able to access the data that The County shares with the Contractor under this agreement. 2. The Contractor shall remove data received under this agreement from computer equipment after it's been used for its stated purposes by using a "WIPE" utility for purging the Data from electronic storage media, degaussing the media, or physically destroying the media in such a way that Data cannot be recovered. Media includes, but is not limited to, the following: a. Personal computer-based hard drives; b. Floppy disks; c. Magnetic tapes (reels or cartridges); d. Compact Disks (CDs), including CDs from cameras; e. DVDs; f. Zip disks; 12/10/2009 Page 6 g. Portable RAM (Compact Flash, etc); h. Mainframe or mini mass storage (disk platters, arrays, etc); i. Storage Area Networks (SAN); and, j. Network Attached Storage (NAS). 3. The Contractor shall ensure disks and/or documents generated in printed form from the electronic file are properly returned, destroyed or shredded when no longer needed. Unauthorized individuals cannot have access to client information. Data destroyed shall include all copies of any data sets in possession after the data has been used for the purpose specified herein or within 30 days of the date of termination, and certify such destruction to DSHS. DSHS shall be responsible for destroying the returned documents to ensure confidentiality is maintained. The Data provided by DSHS will remain the property of DSHS and will be promptly destroyed when The Contractor and its subcontractors have completed the work for which the information was required, as fully described herein. 4. The Contractor shall protect information according to state and federal laws including the following incorporated by reference: a. Privacy Act 1974 5 USC subsection 552a; b. Chapter 40.14 RCW Preservation and Destruction of Public Records; c. Chapter 74.04 RCW General Provisions — Administration; d. Chapter 42.56.210 RCW Certain Personal & Other Records Exempt e. 45 CFR 205.50 provides for Safeguarding information for the Financial assistance Programs and identifies limitations to disclosure of said information; and, f. Public Law 99-508 (18 USC section 2510et. Seq. Electronic Communications Privacy Act of 1986) Part A of Title IV of the Social Security Act authorizes disclosure of client information and provides for safeguards, which restrict the use or disclosure of information concerning applicants or recipients to purposes directly connected with administration of the program. N. The Contractor shall indemnify and hold harmless Yakima County for any acts by the contractor staff related to the provisions of this contract, including the Disclosure of Personal Information. 0. The Contractor will partner with ALTC's oral health program to promote health and disease prevention. This may include dissemination of educational materials or Aging and Long Term Care presentations on oral health. P. VENUE. Any action, suit, or judicial proceeding for the enforcement of this Agreement shall be brought in the Superior Court for the State of Washington in Yakima County, Washington 12/10/2009 Page 7 PAYMENT PROVISIONS I CONSIDERATION Payment shall be based on claims for reimbursement as reported on the Office of Aging and Long Term Care invoice and support documentation and shall be contingent upon the receipt of all required financial and program reports by the respectively assigned due dates. The County shall not be held responsible for any financial loss suffered by the Contractor as a result of performance of services as outlined in this Agreement in the mutually agreed budget, service delivery standards, units of service and payment standards. II GENERAL PAYMENTS CONDITIONS The Contractor agrees to the following standards in satisfactorily performing the terms and conditions of this Agreement: A. No payment shall be made for any contracted activity rendered by the Contractor which is not identified within the terms and conditions of this Agreement and set forth within a category of the budget. B. The Contractor shall submit to the County a written request for approval of budget revision when: 1. The revision would change the scope or objectives of any contracted activity category; 2. Additional revenue is received for contracted activities within the terms of this Agreement; 3. The Contractor desires to transfer funds from one budget category to another. Budget category transfers shall, for the purpose of this Agreement, be defined as transfers inclusive of those occurring between sub -object categories when the cumulative amount of all transfers exceeds five percent (5%) of the County budgeted amount for administration or service delivery. C. Payments shall be based on the County's receipt of all fiscal and programmatic reports required by this Agreement to substantiate claims for reimbursement. The County expressly reserves the right to withhold payment in whole or in part when: 1. The Contractor fails to submit all required documentation, or 2. In the County's judgment, additional information is required to substantiate the basis upon which claims for reimbursement are made, provided the request for such additional information is consistent with the requirements of this Agreement; or 3. Claims for reimbursement are inconsistent with the terms and conditions of this Agreement; or _,10/2009 Page 8 4. Claims for reimbursement on unit rate price Agreements exceed the administrative and service delivery budgets without in-kind contributions by greater than ten (10%) percent of their respective allotted amount; or 5. Claims for reimbursement on line -item cost Agreements exceed the administrative and service delivery budgets of County contracted funds by greater than ten (10%) percent of their respective allotted amount. D. Program Income: Gross income received by the contractor and/or subcontractors directly generated by federal funds or a federal grant supported activity or earned as the result of the grant and/or federal contract. 1. Program income may include, but is not limited to, income from: fees for services performed, proceeds from the sale, lease or rent of assets which were acquired using federal funds, contributions/donations from clients, honorariums, consultant fees, training fees, and the like, earned by staff when time spent earning such honorarium or fee was charged to federal funds, and revenue generated from sale of fabricated items. 2. Use program income in accordance with the Department of Health and Human Services Administration of Grants, 45CFR, Sec. 25. Costs borne by the program income must be used to satisfy cost sharing requirements. The County agrees to promptly notify the Contractor of any proposed reduction in funding by State, Federal, or other officials. The Contractor agrees that upon receipt of such notice it shall take appropriate and reasonable action to reduce its spending in the affected funding area so that expenditures do not exceed the funding level which would result if said proposed reduction became effective. III BILLING PROCEDURES A. The Contractor shall submit written claims for reimbursement of contracted activities provided on the appropriate forms. All payments will be based on contracted activities provided unless otherwise approved in writing by the County. B. The County agrees to make payment for contracted activities provided as approved by the Auditor of Yakima County with County warrants within thirty (30) working days. This is contingent upon the availability of funds and receipt of the Contractor's claims for reimbursement by the County by the tenth day of each month following the month during which the services were provided. No payment shall be made in the month services are rendered unless otherwise approved. by the County. If the last working day of a month falls on a Saturday, Sunday or holiday, payment will be made on the last County working day of the month. 12/10/2009 Page 9 EXHIBIT A ADULT DAY CARE STATEMENT OF WORK CITY OF YAKIMA I APPLICABLE LAWS AND REGULATIONS The Contractor agrees that services contemplated or delivered within the terms of this Agreement and funds administered in the delivery of the specified services shall be provided in accordance with all applicable Federal, State, and local laws and regulations, A. CFR Title 45, Subtitle A, Part 74, (Administration of Grants) B. Older Americans Act (PL 109-365) C. WAC 388-106-1100 through 1120 (Senior Citizens Service Act) D. WAC 388-106-0300 (COPES Services) E. WAC 388-71-0702 through 0776 (Adult Day Care) II. Project Definition An adult day services program is a community-based program designed to meet the needs of adults with impairments through individual plans of care. This type of structured, comprehensive, nonresidential program provides a variety of health, social, and related support services in a protective setting. By supporting families and caregivers, an adult day services program enables the person to live in the community. An adult day services program assesses the needs of the persons served and offers services to meet those needs. The persons served attend on a planned basis. Nothing in this generic description of adult day services may be construed to modify the specific services or eligibility requirements referenced in the definition of adult day care and adult day health. Adult Day Care Services is a supervised daytime program providing core services as defined under WAC 388-106-0800 subsection (2). Core services are appropriate for adults with medical or disabling conditions that do not require the intervention or services of a registered nurse or licensed rehabilitative therapist acting under the supervision of the client's physician. The adult day care center must offer and provide on site the following core services as listed in WAC 388-106-0800: A. Personal Care Services as defined in WAC 388-71-0215, or its successor; B. Social services on a consultation basis; C. Routine health monitoring with consultation from a registered nurse that a consulting nurse acting within the scope of practice can provide with or without a physician's order; 1 2/9/2009 Page 1 D. General therapeutic activities that an unlicensed person can provide or that a licensed person can provide with or without a physician's order. These services are planned and provided as an integral part of the client's plan of care and are based on the client's abilities, interests and goals; E. General health education that an unlicensed person can provide or that a licensed person can provide with or without a physician's order; F. A nutritional meal and snacks provided each four-hour period at regular times comparable to normal meal times, including modified diet if needed and within the scope of the program, as provided under WAC 388-71-0770; G. Supervision and/or protection for clients who require supervision or protection for their safety; H. Assistance with arranging transportation to and from the program; I. First aid and provisions for obtaining or providing care in an emergency. III PARTICIPANTS The Contractor agrees that: A. The target population for the day care program is individuals who are appropriate for care services as referenced in the Adult Day Care WAC 388- 71-0704. B. There will be written assessment procedures utilized by the Contractor to determine if clients meet the program target population criteria. C. The indicators used by the Office of Aging and Long Term Care to assess its effectiveness at targeting services to individuals who may be vulnerable are: Low-income 75 years of age or older Racial or Ethnic minority Limited or non-English speaking Office of Aging and Long Term Care (ALTC) funding should encourage the effective targeting of services to the vulnerable elderly by the Contractor. Specific goals to be targeted for 2010 are as follows: Target Group Percentage Racial or ethnic minorities 19% Low-income 40% 75 years of age or older 55% Limited or non-English speaking 6% The Contractor must report on clients served in these categories. 12/9/2009 Page 2 IV SERVICE SPECIFICATIONS A. Eligibility Determination The purpose of eligibility determination is to assess whether an applicant meets the financial and program eligibility criteria for adult day care. Financial Eligibility: Income below 40 percent of the state median income for free services; sliding -fee scale applies if income is between 40 percent and 100 percent of state median income. Program Eligibility: The applicant must be 60 years of age or older, both willing and able to participate in the adult day care program on a regular scheduled basis and both willing and able to use day care services to achieve treatment goals. 1. Adult day care center staff are responsible for determining the financial and program eligibility of an applicant for day care services. 2. Eligibility must be determined prior to the provision of adult day care services and within thirty (30) days after the applicant has requested service. Eligible applicants may be provided services as of the date of application. 3. A Participant Intake Form (PIF) or other client tracking information shall be completed on each client served and submitted as required to the Office of Aging and Long Term Care. B. Eligibility Re -determination The purpose of the eligibility re -determination is to assess whether an adult day care client continues to meet financial and program eligibility criteria. 1. Adult day care center staff are responsible for re -determining eligibility. A new Senior Citizens Services Application must be completed to document whether the client was found to be eligible or ineligible. 2. Eligibility must be determined: a. Within thirty (30) days after the adult day care center has received information that a change has occurred in the client's circumstances that may make the client ineligible; b. At six-month intervals if change occurs; c. At twelve-month intervals when the client's gross monthly income at the time of eligibility determination is derived exclusively from pensions, Social Security benefits (SSA), Supplemental Security Income (SSI), or a combination thereof. 12/9/2OOn Page 3 C. Reduction/Termination of Services The Discharge Plan Form must be completed when a client becomes ineligible for adult day care services or when services are reduced or terminated for any reason. 1. Adult day care center staff are responsible for determining whether services provided to a client should be reduced or terminated. 2. Reasons for reduction of services: a. Client requests a reduction; b. In the professional judgment of adult day care center staff, the client no longer requires the number of service days now being provided or is not both willing and able to effectively utilize the number of service days now being provided to achieve treatment goals. Whenever possible, service reductions should be accomplished through mutual negotiation with the client and the client's family and/or others in his/her informal support system and the client's physician; c. Funding cutbacks require reduction. 3. Reasons for termination of services: a. Client requests termination; b. In the professional judgment of day care center staff, the client no longer requires adult day care services, adult day care services no longer meet the client's needs or the client is not both willing and able to effectively utilize the adult day care program to achieve treatment goals. Whenever possible, service termination should beaccomplished through mutual negotiation with the client and with the involvement of client's family and/or others in his/her informal support system and the client's physician; c. Funding cutbacks require termination. 4. A client who disagrees with a decision of adult day care staff to reduce or terminate services has ninety (90) days after receipt of the Discharge Plan Form to request a fair hearing. Services may not be reduced or terminated until the fair hearing decision is rendered if the request for a hearing is received prior to the effective date for reduction or termination. 12/9/2009 Page 4 D. The day care center must be located in geographic areas which contain major concentrations or high proportions of target group older persons. E. Transportation to and from the center must be available. F. The day care center must operate at least three (3) days a week and designate at least four (4) consecutive hours a day when it provides a structured program. G. The day care center must meet the minimum staffing requirements for a center, which operates five (5) days a week and has an average daily attendance of less than twenty (20) participants. H. The day care center should have a written plan for evaluating whether the program is meeting the day care standards and the needs of the participants. I. Participants shall be referred to other services as needed. J. The Contractor shall establish a system through which clients of services under this approved Agreement may present grievances as outlined in the Basic Agreement, Section XXIV. K. Services shall be provided throughout Yakima County. V. UNITS OF SERVICE A. Definition: A unit of Adult Day Care service shall consist of one (1) hour of Adult Day Care service, not including transportation time. B. There will be 9 unduplicated individuals served by this Agreement. C. Anticipated Service Level by Quarter: Month Hours January - March 731 April - June 731 Total 1,462 Anticipated Service Levels include 163 additional units funded by client participation. D. Anticipated Expenditure Rate by Quarter for client services: Month Rate January - March $6,375 April - June $6,375 Total $12,750 12/9/2009 Page 5 VI PAYMENT CONSIDERATIONS As consideration for services, as described in the Specific Provisions of this Agreement and in accordance with the Budget Provisions of this Agreement, the County agrees to pay the Contractor for client Adult Day Care Core services a sum not to exceed $12,750 as submitted on the 2010 Contract Budget Summary. The contracted amount shall be available during the period January 1, 2010 through June 30, 2010. Payment to the Contractor for this Agreementshall be based on $9.81 per hour, less client match as computed on the Senior Citizen Services sliding fee schedule. The payment for COPES services will be in addition to the contracted amount. The COPES payment will be based on claims for reimbursement as reported on the COPES services billing. This includes clients now authorized, number of units of service and the actual number of units provided. The COPES unit rate will be $9.81 per hour or $39.25 per day and revised, if applicable, to reflect the unit rate established by DSHS. Services are reimbursed on an hourly basis up to four hours per day. Any service provided over four hours per day shall be reimbursed at the daily rate. In addition, COPES transportation rate to Day Break is $3.00_ per day if utilizing the Dial -A -Ride program. 12/9/2009 Page 6 EXHIBIT {8 RESPITE STATEMENT OF WORK CITY OF YAKIMA I APPLICABLE LAWS AND REGULATIONS The Contractor agrees that services contemplated or delivered within the terms of this Agreement and funds administered in the delivery of the specified services shall be provided in accordance with all applicable Federal, State, and local laws and regulations, in particular the following: A. WAC 388-106-1200 through 1230 (Respite Services) B. WAC 388-71-0702 through 388-71-0776 (Adult Day Services) C. Title III E of the Older American's Act (PL 109-365) Section 371-374 (National Family Caregiver Support Program) D. RCW 74.41.010 - 74.41.090 (State Family Caregiver Support Program) II PROJECT DEFINITION The purpose of respite care is to provide relief for families or other caregivers of disabled adults. Both in-home and out -of -home respite is available and is provided on an hourly and daily basis, including 24-hour care for several consecutive days. Respite care workers provide supervision, companionship and personal care services usually provided by the primary caregiver of the disabled adult. Services appropriate to the needs of individuals with dementia illnesses are also provided. Medically related services, i.e. administration of medication or injections; are provided by a licensed health practitioner. III TARGET POPULATION State Respite — To be eligible to receive respite care, a caregiver shall meet the target population criteria for respite services as referenced in the Respite Program Standards under Eligibility Requirements for Caregivers. State Family Caregiver Support Program (SFCSP) — To be eligible to receive caregiver support, an unpaid caregiver may be any age, but must have primary responsibility for the care of an adult 18 years of age and older with a functional disability. National Family Caregiver Support Program (NFCSP) — To be eligible to receive caregiver support, an unpaid caregiver may be any age, but must be providing care to a recipient age 60 and above. Priorities shall be given to unpaid older individuals with the greatest social and economic needs. A sliding fee scale is used for Respite care and the Family Caregiver Support programs. 12/9/2009 Page 1 IV FINANCIAL PARTICIPATION DSHS requires eligible participants to pay part of the cost of the respite care services received. A case manager shall administer a sliding -fee schedule (the same as the Senior Citizens Services Act (SCSA) fee schedule), which shall be updated annually, to determine the participant's share of the cost of respite care services. A. In determining the amount the participant shall pay, the following shall apply: 1. There shall be no charge to the participant if his or her income is at or below 40 percent of the State. Median Income. 2. If the participant's income is between 40 and 99 percent of the State Median Income, he or she will be charged a percentage of the cost of respite care. This amount shall be calculated using the sliding fee schedule. 3. If the participant's income is 100 percent or more of the State Median Income, he or she will pay the full cost of the service. 4. The cost of respite care shall be determined by the number of hours or days of respite care service authorized and used, and the rate of the service, as negotiated between the respite care program and Contractor. 5. The caregiver shall not be means -tested nor be required to pay for the care received. If a caregiver does not meet all of the eligibility requirements but requests respite care, the full cost of respite care services shall be charged. V PROGRAM ADMINISTRATION A. An in-home assessment shall be conducted by an ALTC TCARE-certified case manager in the participant's home using the Tailored Caregiver Assessment and Referral (TCARE) tool. The same assessment and scheduling procedures shall apply to all respite care participants and caregivers regardless of share in the cost of respite care. Upon completion of the assessment, a Respite Information Form for Providers shall be generated by the TCARE tool and sent to the Contractor. It shall include information on the care receiver's Activities of Daily Living and Instrumental Activities of Daily Living as well as the care receiver's memory and decision— making status and health-related issues. Contact information for both the care receiver and caregiver will be included. [It shall be the responsibility of the Contractor to discuss with the caregiver the details of the plan of care.] B. All authorizations for service shall be made through the case manager. Case managers shall encourage caregivers to schedule respite care in advance. If respite care cannot be provided when requested, a waiting list shall be used. 12/9/2009 Page 2 C. Maximum Hours The Respite Case Manager shall determine the dollars available during any one month and authorize hours to the Contractor accordingly. The Contractor shall not deliver more service hours than authorized by the Respite case manager. D. Levels of Care Provided The level of care refers to the activities that will be performed for a participant during a given respite care episode. The Respite case manager shall determine, during the in-home assessment, the level of care needed. The program shall provide for any one of or a combination of the following levels of care for the participant: Level 1: Help with activities that require no special training; e.g., companion- ship, supervision, meal preparation. Level 2: Help with activities of daily living for which special training is required, but a licensed health practitioner is not required. It includes personal care, lifting, turning and transferring. Level 3: A licensed health practitioner (LPN or RN) must perform these tasks. VI SERVICE AREA Services shall be provided throughout Yakima County. VII UNITS OF SERVICE A. Definition: A unit of Respite service shall consist of one (1) hour of service. B. Level of Care: Relates to activities that will be performed for a participant during a given respite visit. Levels of care allowable for this contract are Levels I and II. C. There will be 8 unduplicated individuals served by this Agreement. D. Anticipated Service Level by Quarter: Month Units January - March 288 April - June 288 Total 576 Anticipated Service Levels include 168 additional units funded by client participation. 12/9/2009 Page 3 E. Anticipated Expenditure Rate by Quarter: Month Total January - March $2,000 April - June $2,000 Total $4,000 F. Payment Provisions The respite care program shall ensure: 1. That a record of all units of service used by a caregiver, (as reported by the Contractor) is maintained. 2. That funds received from participants shall be reported to ALTC by the agencies collecting them. ALTC shall report funds collected from participants to DSHS as part of monthly invoicing. These funds shall only be used within the respite care program. 3. The Contractor shall not be paid for more service hours than authorized by the case manager. 4. Funds from participants and caregivers not meeting all of the eligibility criteria shall be accounted for at the Contractor level. G. Rates Each program shall negotiate for an hourly and daily rate with the Contractor whenever possible. Rates of payment to respite care Contracting Agencies shall not exceed, and may be less than, rates paid by DSHS to, Contracting Agencies for the same level of care. DSHS shall notify AAA's of the current maximum allowable rates. 1. If a Contractor has only an hourly rate, this rate shall be paid for each hour of respite care used, including 24 consecutive hours of respite care. 2. If a Contractor has only a daily rate, the rate shall be paid for 24 consecutive hours or less of respite care used. 3. If a Contractor has an hourly and daily rate, the hourly rate shall be paid for each hour of respite care when Tess than 24 hours of service is provided. The total amount paid at the hourly rate shall not exceed the Contractor's daily rate for that level of care. The daily rate shall be paid for 24 consecutive hours of respite care. The daily rate shall also be used for less than 24 consecutive hours of respite IF by using the daily rate the cost of the episodeof respite care is less than using the hourly rate for the same amount of hours. 12/9/2009 Page 4 4. DSHS shall pay Medicaid certified nursing homes and developmentally disabled facilities providing respite care services the Medicaid rate approved for that facility. The rate paid to non -Medicaid certified nursing homes providing respite care services may not exceed the average Medicaid rate in that county. It shall be unlawful for any nursing home which has a Medicaid contract with DSHS to charge any amounts in excess of the Medicaid rate from the date of eligibility for services covered, except for any supplementation permitted by DSHS pursuant to RCW 18.51.070. The participant shall pay for services not included in the Medicaid rate. VIII STAFFING STANDARDS A. Service Delivery 1. There shall be written procedures for recruiting, screening, training, supervising, and monitoring in-home and out -of -home respite care workers. 2. It is the responsibility of the Contractor to provide training to workers. ALTC will monitor to insure training standards are met. 3. Sufficient staff shall be available to ensure that all authorized requests for service can be met in a timely manner. IX. PAYMENT CONSIDERATIONS As consideration for services, as described in the Specific Provisions of this Agreement and in accordance with the Budget Provisions of this Agreement, the County agrees to pay the Contractor a sum not to exceed $4,000 from available funds as submitted on the 2010 Contract Budget Summary. This total sum shall be available during the period January 1, 2010 through June 30, 2010. These funds shall be used to provide Respite Care services. Payment to the Contractor for this Agreement shall be based on $9.81 per hour less client match as computed on the Senior Citizen Services sliding fee schedule. 12/9/2009 Page 5 EXHIBIT C BUDGET CITY OF YAKIMA ADULT DAY CARE RESPITE JANUARY 1, 2010 — )UNE 30, 2010 ADULT DAY CARE FUNDING SOURCE AMOUNT Title III -B (CFDA #93.044) $6,814 SCSA $5,936 Total $12,750 9 unduplicated individuals, 1,462 units of service, @ $9.81 per hour (less client match as computed on the Senior Citizen Services slide fee schedule) an additional 163 units were budgeted because of client participation. COPES rate for Level I is $9.81 per hour up to four hours per day or $39.25 for over four hours per day. RESPITE FUNDING SOURCE AMOUNT Title III -E (CDFA #93.52) $1,352 State Family Caregiver $2,648 Total $4,000 8 unduplicated individuals, 576 units of service, @ $9.81 per hour (less client match as computed on the Senior Citizen Services sliding fee schedule) an additional 168 units were budgeted because of client participation. 12/9/2009 ITEM TITLE: BUSINESS OF THE CITY COUNCIL YAKIMA, WASHINGTON AGENDA STATEMENT Item No. For Meeting of: January 19, 2010 Consideration of a Resolution authorizing an agreement with Yakima County Office of Aging and Long Term Care (ALTC) for the City of Yakima Day Break Adult Day Care and Respite Services Program at the Harman Center SUBMITTED BY: Chris Waarvick, Director of Public Works Ken Wilkinson, Parks and Recreation Manager CONTACT PERSON/TELEPHONE: Ken Wilkinson, 575-6020 SUMMARY EXPLANATION: Staff respectfully requests City Council consideration of a resolution authorizing an agreement with Yakima County ALTC for the adult day care and respite services program at the Harman Center. The Adult Day Care Services program is a community-based, supervised daytime program providing a variety of services designed to meet the needs of adults with impairments through individual plans of care. Due to state revenue forecasts and budget uncertainty, funds have been cut and this contract is only for six months, This agreement allocates $12,750 for the Adult Day Care Program and $4,000 for Respite care services, for a total funding allocation of $16,750 for the first six months of 2010. Resolution X Ordinance Contract X Other (Specify)Performance Agreement No. 2010 COY ALTC Contract Adult Day Care Respite January 1, 2010 — June 30, 2010 Mail to:Aging and Long Term Care; Post Office Box 8349, Yakima WA 98908 Phone: 965-0105 Funding Source: 16 750 Yakima Day Break Adult Day Care Respite grant APPROVED FOR SUBMITTAL: City Manager STAFF RECOMMENDATION: Staff respectfully requests the City Council to adopt the resolution authorizing execution of the Performance Agreement No. 2010 COY/2010 ALTC Contract City of Yakima Adult Day Care Respite for the Day Break Adult Day Care and Respite services program at the Harman Center. BOARD/COMMISSION RECOMMENDATION: COUNCIL ACTION: ma/Agenda Statement Adult Daycare Deeprte 2010,rtf SE Washington Aging & Long Term Care ALE irriire'g 81e4i ScSA News Southeast Washington Volume 1, Issue 1 FOR MORE INFORMATION Contact Cathy Knight at the Washington Associa- tion of Area Agencies (W4A): (360) 485-9761 W4Aaoinciwashington.org Inside this issue: SCSA Community Partnerships Hope Options Inside Story Inside Story Inside Story December 2009 Protect The Homecare Solution. What is SCSA? The Senior Citizens Ser- vices Act (SCSA) was passed by the legislature in 1977 to build a system of community-based ser- vices to help seniors stay home and avoid costly institutional care. The network of services created through SCSA meets these goals in an extraordinarily cost effective manner. At its current funding level of $9 million dollars per year, SCSA provides an incredible re- turn on that investment in the ser- vices it funds directly and leverage of matching funds. What Does SCSA Funding Di- rectly Support? Success Story SCSA is a critical funding source for Senior Information and Assistance, Nutrition, Transporta- toin, Footcare, Adult Day Care, Adult Day Health, Health Promotion and Bathing Assistance. Senior I&A is the starting point for older adults and their caregivers, providing informa- tion and support related, to services, including long term care planning and financing options. The service is especially helpful for seniors not eligible for Medicaid to learn of op- tions in the community. The broad array of services supported by SCSA helps people remain in their homes and commu- nity and supports wellness. Mrs C is 81 years old. Herhusband died in the 60's and she has no children. Her only relatives live across the .„ country and do not visit, A bank employee called Senior I&A when Mrs C began writing overdrafts on her check- ing account. An l&A specialist talked with her and found she would be out of money in a few months. She helped Mrs C make changes to her insurance policy, apply for Medicare, housing assistance & free medications. Over time, as Mrs. C's memory and cognitive ability declined, the I&A specialist helped her secure an apartment in public housing, Meals on Wheels, and a volunteer to assist with errands and household tasks. Without I&A intervention and support, Mrs. C would very likely have needed institutional care, at much greater cost. Volume 1, Issue 1 December Page 2 How Does $155,879 in SCSA Become $508,379 through Community Partnerships? SCSA is the primary funding source that gives Area Agencies on Aging the flexibility to lever- age community resources for service systems tailored to local community needs. AAA's, along with their partners in every part of the state, utilize these funds to provide services that local communities believe are most important, and those they are most willing to support with additional local funds. The Hope Options program in Snohomish County is an exam- ple of how these valuable re- sources have been used to tailor services to meet local commu- nity needs. SCSA funding helped develop and sustain the Stabilized Housing for the Mentally 111 Program, a partner- ship between the Everett Hous- ing Authority and Snohomish County Long Term Care & Ag- ing. Known as Hope Options, the program promotes stable housing and support for seniors 60+ who have mental health or behavioral problems and are at risk of losing their housing. With $155,879 provided with SCSA funding for operational costs, the program provides a Geriatric Mental Health Special- ist who delivers intervention and crisis resolution counseling. With the modest investment of SCSA funds to initiate the program, Everett Housing Authority pro- vided 40 Section 8 vouchers and 7 Project based housing vouch- ers with a value of $352,500. • Mr. A was referred to Hope Op- tions by the Snohomish County Veterans Assistance Program. He is a 63 year old Vietnam Vet (Marines 1967) whose wife had recently died. He was facing eviction due to confusion and inability to pay his rent and maintain a safe and sanitary household. His income was $271/mo. WA. was ap- proved for case man- agement and Section 8 housing the day fol- lowing re - "With ease management assistance, his income increased...." ferral to the program. With case management assistance his income increased to $2000/month through SSDI. Mr. A now has an informal caregiver that visits approxi- mately three times per week to assist with cooking, cleaning, and personal care. Page 3 December Volume 1, Issue 1 SCSA Money is Leaven for the Loaf Most federal grants and dem- onstration projects require ap- plicants to provide matching funds. Without SCSA funds from our state, Washington Area Agencies on Aging and other community services would not be able to capture federal grants. SCSA is critical for leveraging funds for federal grants and demonstration programs. Fed- eral grants matched with SCSA provide such services as Meals on Wheels, Senior ansportation, Chore Ser- ces, Health Promotion, Medi- cation Management, and oth- ers. SCSA supports community co- ordination capacity resulting in better access to community services, streamlining systems through strategic planning that addresses the needs of folder adults as well as children and young families. Federal Demonstration Pro- grams also come with matc requirements. Communities are able to participate primarily because SCSA resources are available to leverage grant dol- lars. Currently, a few of the demonstration programs avail- able in Washington include: Program - .. • , Nursing Home Diversion escription • ' , - ,:' -, ,',,, Provides flexible services to middle income adults to prevent or delay need for Medicaid -funded services and skilled nurs- ing facility care. Dementia Partnership Provides special services and support for caregivers and their loved ones with dementia through specially trained consult- ants and services. Aging & Disability Research Centers Provides a "one-stop" access point for all community mem- bets needing assistance to plan their long term care and avoid the need for Medicaid. Chronic Disease Self- Management Evidence -based programs teach individuals with chronic 111 - ness to better manage the difficulties in their lives and avoid unnecessary healthcare interventions. Page 4 December Volume 1, Issue 1 SCSA Funds Help Prepare Washington for the Changing Demography and the Age Wave Washington State is a leader in the development of cost effective cornmunity-based long term care services. SCSA funds have allowed us to work with federal programs and policymakers to prove through demonstration programs that community-based care not only works, but is less than half the cost of institutional care. Washington State 60+ Adults 1970-2030 2500000 2000000 1500000 1000000 500000 1970 1976 1982 1988 1994 2000 2006 2012 2018 2024 2030 The first Baby Boomers will be eligible for Medi- care in two years. Fol- lowing them will be a legion of older adults, may of whom will need long term care ser- vices. Now is not the time to eliminate our access to federal grants by cutting re- sources used for lever- aging, match, and inno- vative community ser- vices. We count on our elected officials to understand the importance of efficient, effective, community -driven services. SCSA funding has not kept pace with the growing number of seniors and the effect of inflation on the cost of services. Supporting Senior Citizens Services Act funding is one way to assure that our state continues to provide high quality care for the oldest and frailest citizens of Washington State. SCSA Allocations per Capita (60+) 1998 2001 2003 2005 2007 2009 E3 Series]. • • F 4r,2 heet Caregiver Screening, Assessment, and Planning Through the Family Caregiver Support Program August2009 WisnOnglOn 31Ile Departmat af Health Semce' ADSA Aging I Disabily Servtis Adminisnlim Background In 2007, the legislature revised RCW 74.41.050 mandating development of an evidence -based caregiver assessment and referral tool that could be used to better tailor the support and services unpaid caregivers receive to their unique needs. There was also legislative intent to have greater consistency in the policies and services offered through the statewide Family Caregiver Support Program offices. The Tailored Caregiver Assessment and Referral (TCARE®) model was found to best match the legislative mandate and intent. Beginning in July 2009, Washington began using TCARE® in some Family Caregiver Support Program offices (see implementation schedule on page 2). Why Screen and Assess Caregivers Stress is the number one challenge facing the more than 600,000 family caregivers who provide care to loved ones in Washington State. National studies show that caregivers are twice as likely to have physical and emotional health problems as adults not in a caregiving role. A consistent, objective, and reliable screening and assessment process offers caregivers: • A clearer understanding of the impact of caregiving on their physical and emotional health and relationships. • A method to identify if they are at high risk for stress and depression. Support and guidance in developing personal goals to address unresolved problems, stressors, and potential risks. • An individualized plan to meet their unique goals and needs and receive appropriate and timely referrals for services before they are in crisis. [ "Finally someone is asking ME the right questions." — a Washington State Family Caregiver after answering screening questions A consistent, objective, and reliable screening and assessment process can be used on a state- wide policy level to: • Identify high risk caregivers and ensure limited resources are available to those most in need. • Test which support and services are most essential. • Collect better state-wide data to inform policy and budget decisions. TCARE® Defined TCARE® combines a screening and assessment tool that identifies the sources and level of a caregiver's stress with one-on-one consultation and support with a specially trained TCARE® caregiver specialist. Using the screening and assessment's results, caregiver specialists help caregivers: • Develop goals to reduce stress and concrete strategies to achieve them. • Navigate through the local service system and identify available resources that best meet the caregiver's unique needs. The principal designers behind TCARE® are nationally renowned researcher Rhonda Montgomery PhD, Karl Kosloski and colleagues at the University of Wisconsin -Milwaukee. To learn more about the caregiver identity change theory behind Montgomery's development of TCARE®, visit www.adsa.dshs.wa.gov/professional/TCARE or the national TCARE website at www.tcare.uwm.edu. How Caregivers Access TCARE® TCARE screening and assessments are completed through the local Family Caregiver Support Program office (see implementation schedule below). Not every caregiver goes through a TCARE® screening and assessment. It depends on his or her situation, service eligibility, and what type of support is needed. The first step for any family caregiver in need of Family Caregiver Support Program services is to make the call to their local office. The important message is that there is help available at every step of a caregiver's journey. Staff will guide them through the screening and assessment process. TCARE® Implementation Schedule TCARE® is now available through the Washington State Family Caregiver Support Program in Clallam, Grays Harbor, Island, Jefferson, King, Kitsap, Pacific, Pierce, Skagit, Snohomish, and Whatcom counties. TCARE will be available in all other counties in January 2010. Additional TCARE® and Caregiving Information Visit www.adsa.dshs.wa.gov/professional/TCARE for current updates and information on TCARE implementation. •Visit www.adsa.dshs.wa.gov/caregiving to find contact information for the local Family Caregiver Support Program and a wealth of information and resources on a variety of caregiving topics. Contact Information Statewide level: Contact: Hilari Hauptman, Haupthp(&,dshs.wa.gov or 360-725-2556 Leigh Wellcome, Wellcla@dshs.wa.gov or 360-725-2547 Local level: Contact the local Family Caregiver Support Program office. Contact information can be found at www.adsa.dshs.wa.gov/Resources/clickmap.htm WASHINGTON STATE DEPARTMENT OF SOCIAL & HEALTH SERVICES 2 of 2 The Family Caregiver Su rport Prograrn offer helpful resources and infarrnation Talk to Knowledgeable and Carng,People The Family Caregiver Support.01.10yT..is a service offered `through the Area Agency :; anAging._Find your area's Family Caregiver' Support Program by • Looking in the: yellow`pagesfor the Area Agency on Aging under "Sernior Services •Visiting www adsa dshs wa gav and clicking<on Local Services "` :_Calling;l 800 422 3263 Find Information on the.lntern'et Helpful information and resources are available at www adsa dshs wa.gov/caregivinq Firi"d articles, booklets, tips, shortcuts;and information about services that can address: • your needs questions, and challe•nges ,n.5 ha of.Soc ivices ADSA Agirig &:Disability? Services:Ad i rs trauion <`:`. <'i'DSHS;22 ,1,331;:,('3109);