HomeMy WebLinkAbout11/06/2012 04G Adult Daycare and Respite Service Program and Foot Care Services Program for Senior Citizens Agreements rip "S m n k
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BUSINESS OF THE CITY COUNCIL
YAKIMA, WASHINGTON
AGENDA STATEMENT r ,
Item No.
For Meeting of: November 6, 2012
ITEM TITLE: Resolution authorizing agreements with Yakima County,
through the Office of Aging and Long Term Care (ALTC)
for the Adult Day Care and Respite Services Program and
the Foot Care Services Program at the Harman Center.
SUBMITTED BY: Chris Waarvick, Director of Public Works
Ken Wilkinson, Parks and Recreation Manager
CONTACT Ken Wilkinson, Parks and Recreation Manager, 575 -6020
PERSON /TELEPHONE:
SUMMARY EXPLANATION:
• Submitted for City Council consideration is a resolution authorizing agreements with Yakima
County, through the Office of Aging and Long Term Care (ALTC), for two programs at the
Harman Center, the Adult Day Care and Respite Services Program and also the Foot Care
Services program. The Adult Day Care Respite 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. The Foot Care Services Program
provides basic preventative foot care for senior citizens. Both programs began in 1990 and
have been very well received.
For 2013, the Adult Day Care and Respite Services Program will be allocated $13,000. The
ALTC Foot Care Services program will be allocated $42,000.
Resolution X Ordinance Other Agreements
(specify)
Contract: X Mail to: SE WA ALTC, P 0 Box 8349, Yakima, WA 98908
Contract Term: January 1, Amount: Adult
2013 - December 31, 2013 Daycare /Respite - $13,000; Expiration Date: 12/31/2013
FootCare - $42,000
Insurance Required? 'No
Funding ALTC Grant Phone: 965 -0105
Source:
APPROVED FOR
• SUBMITTAL: City Manager
STAFF RECOMMENDATION:
Staff respectfully requests adoption of the resolution authorizing execution of agreements
with Yakima County, through the Office of Aging and Long Term Care (ALTC), for the
delivery of Adult Day Care and Respite Services Program services and also delivery of the
Foot Care Services program at the Harman Center, and depending upon funding,
authorizing the City Manager to execute any subsequent amendments or reoccurring
agreements that are substantially in the form of the agreement approved pursuant to this
resolution, to provide these services for the following five years (2017), upon approval as to
form by the City Attorney.
BOARD /COMMISSION RECOMMENDATION:
ATTACHMENTS:
Click to download
❑ Resolution
❑ Adult Daycare Table of Contents
❑ Adult Daycare Performance Aqrmt
❑ Adult Daycare Exhibit A
❑ Adult Daycare Exhibit B Respite
❑ Adult Daycare Specific Provisions
❑ Foot Care Performance Aqrmt
❑ Foot Care Payment Provisions
• RESOLUTION NO. R -2012-
A RESOLUTION authorizing the City Manager to execute agreements with Yakima County,
through the Office of Aging and Long Term Care (ALTC), for the delivery
of the Adult Day Care and Respite Services Program and the Foot Care
Services Program for Senior Citizens at the Harman Center, and
depending upon funding, authorizing the City Manager to execute any
subsequent amendments or reoccurring agreements for the following five
years (2017), upon approval as to form by the City Attorney.
WHEREAS, the City of Yakima desires that an Adult Day Care Program and Respite
Services be available at the Harman Center; and
WHEREAS, the City of Yakima desires that Foot Care Program a Services be available
at th'e Harman Center; and
WHEREAS, Yakima County, through its Office of Aging and Long Term Care (ALTC), 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 agreements with Yakima County, through the Office of Aging and Long Term Care
(ALTC), in accordance with the terms of the attached agreements, now, therefore,
• BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF YAKIMA:
The City Council authorizes the City Manager to execute agreements with Yakima
County, through the Office of Aging and Long Term Care (ALTC), for the delivery of Adult Day
Care and Respite Services and also delivery of the Foot Care Services Program at the Harman
Center, and depending upon funding, authorizes the City Manager to execute any subsequent
amendments or reoccurring agreements that are substantially in the form of the agreement
approved pursuant to this resolution, for the following five years (2017), upon approval as to
form by the City Attorney. .
ADOPTED BY THE CITY COUNCIL this 6th day of November, 2012.
Micah Cawley, Mayor
ATTEST:
Sonya Clear Tee, City Clerk
•
2013 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
•
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PERFORMANCE AGREEMENT NO. 2013 COY
ADMINISTRATION OF AGREEMENT
THIS AGREEMENT is entered into this day of , 2012 between 40
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. 65
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:
ADDITIONAL TERMS of this Agreement are set out in and governed by Basic
• Agreement No. ALTC - 10. In the event the Basic Agreement is revised, this Agreement shall
conform to the revisions.
PAYMENT CATEGORY AMOUNTS
Adult Day Care $8,000
Respite $5,000
TOTAL FUNDING ALLOCATION $13,000
PERIOD OF AGREEMENT 411
January 1, 2013 - December 31, 2013
CONTRACTOR SIGNATURES '
Tony O'Rourke, City Manager Lori J. Brown, Director
City of Yakima SE Washington Aging and Long Term Care
Date: Date:
Attest:
City Clerk
City Contract No.
Resolution No.
Date:
•
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EXHIBIT A
ADULT DAY CARE STATEMENT OF WORK
CITY OF YAKIMA
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;
• 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
1
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 2013 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.
• IV SERVICE SPECIFICATIONS
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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.
C. Reduction/Termination of Services
3
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 be accomplished 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.
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.
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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 4 unduplicated individuals served by this Agreement.
C. Anticipated Service Level by Quarter:
Month Hours
January - March 200
April - June 200
July - September 200
October - December 200
Total 800
D. Anticipated Expenditure Rate by Quarter for client services:
Month Rate
January - March $2,000
April - June $2,000_
July - September $2,000
October - December _$2,000
Total _ $8,000
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VI PAYMENT CONSIDERATIONS
• As consideration for services, as described 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 $8,000 as
submitted on the 2013 Contract Budget Summary. The contracted amount shall be
available during the period January 1, 2013 through December 31, 2013. Payment to the
Contractor for this Agreement shall be based on $10.00 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.
•
•
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EXHIBIT B
RESPITE STATEMENT OF WORK •
CITY OF YAKIMA
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 Traditional Respite care is to provide relief for families or other caregivers
of disabled adults. Both in -home and out -of -home Traditional 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.
The purpose of Short Term Respite care is to provide the in -home care necessary to
enable unpaid caregivers who do not qualify for Traditional Respite to attend family
caregiver educational classes and seminars.
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 55 and above or disabled. 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.
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. For Traditional Respite, 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. Short Term Respite shall be authorized by an ALTC TCARE - certified case manager
for family caregivers who have not undergone a full TCARE assessment or who do
not qualify for Traditional Respite services, enabling them to attend caregiver
educational offerings. Because TCARE assessments have not been completed for
these caregivers, the TCARE Information for Respite Care Service Providers form
cannot be generated. The home care agency shall meet with these family
• caregivers to obtain the information about the care receiver necessary to develop
Respite care instructions for agency care providers.
2
C. 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.
D. 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 TCare case manager.
E. 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 4 unduplicated individuals served by this Agreement.
3
• D. Anticipated Service Level by Quarter:
Month `Units
'January - March 88
April - June 88
July - September 88
October - December 88
Total 352
E. Anticipated Expenditure Rate by Quarter:
Month Total
January - March $1,250
April_,- June $1,250
July - September $1,250 '
'October - December ` $1,250
Total $5,000
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 Tess 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 Tess of respite care used.
4
3. If a Contractor has an hourly and daily rate, the hourly rate shall be paid for
each hour of respite care when less than 24 hours of service is provided. lb
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 episode of respite care is Tess than
using the hourly rate for the same amount of hours.
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 $5,000 from available funds as submitted on
the 2013 Contract Budget Summary. This total sum shall be available during the period
January 1, 2013 through December 31, 2013. These funds shall be used to provide
Respite Care services. Payment to the Contractor for this Agreement shall be based on
$14.20 per hour Tess client match as computed on the Senior. Citizen Services sliding fee
schedule.
Short Term Respite care sha /% be: in voiced Separatel from ; rrO cjiOnal Respite Care
The invoice is to.'be; %abe %d ak ii6ort Term Resp fe:
5
STANDARD TERMS AND PAYMENT PROVISIONS FOR MULTIPLE SERVICE PROVIDERS
1110 SPECIFIC PROVISIONS
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 close 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.
• B. Records and Reports: The Contractor agrees to:
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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.
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
5
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.
The state requires that rates charged to others cannot be less 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.
3. 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.
IP 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 previsions of this Agreement.
6
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 41)
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 410
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.
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.
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 3 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
8
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;
g. Portable RAM (Compact Flash, etc);
II/
h. Mainframe or mini mass storage (disk platters, arrays, etc);
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;
9
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.
O. 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.
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;
io
3. The Contractor desires to transfer funds from one budget category to
another. Budget category transfers shall, for the purpose of this Agreement,
41
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
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.
E. Termination of Contract
11
1. Either party may terminate this Agreement immediately upon written notice, sent
by certified mail, to the addresses listed on Page 1. If the Contractor fails to
• comply with the terms and conditions of this Agreement, the County may pursue
such remedies as are legally available, including, but not limited to, the immediate
termination of this Agreement.
2. TERMINATION DUE TO CHANGE IN FUNDING: If the funds ALTC relied
upon to establish this Agreement are withdrawn, reduced or limited, or
if additional or modified conditions are placed on such funding, ALTC
may immediately terminate this Agreement by providing written notice
to the Contractor. The termination shall be effective on the date
specified in the termination notice.
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
PERFORMANCE AGREEMENT NO. 2013 CITY OF YAKIMA
ADMINISTRATION OF AGREEMENT
THIS AGREEMENT is entered into this day of , 2012, by and
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, whose address is 129 North Second
Street, Yakima, Washington, 98901, 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 Foot Care services in
accordance with the terms and conditions set forth in the provisions as listed below:
ADDITIONAL TERMS of this Agreement are set out in and governed by ALTC's "Basic
Agreement No. ALTC - 12." In the event the Basic Agreement is revised, this Agreement shall
conform to the revisions. The City of Yakima shall be an additional party to the Basic
Agreement and shall have all of the rights and privileges of Yakima County Southeast
Washington Aging and Long Term Care contained in said Basic Agreement.
PROGRAM AMOUNTS
Foot Care
Title III -B CFDA #93.044
Title III -D CFDA #93.043
SCSA
TOTAL FUNDING ALLOCATION $42,000
•
PERIOD OF AGREEMENT
January 1, 2013 - December 31, 2013
CONTRACT SIGNATURES
Tony O'Rourke, City Manager Lori 3. Brown, Director
City of Yakima SE Washington Aging and Long Term Care
Date: Date:
Attest:
City Clerk
City Contract No._
Resolution No.
Date:
411
1
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D5DED3F310EO \PDFConvert.1777.1.2013 SIG COY.doc
STANDARD TERMS AND PAYMENT PROVISIONS
• SPECIFIC PROVISIONS
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. CFR Title 45, Chapter XIII, Subchapter C, Part 1321 (Older Americans Act)
C. WAC 388 -106 -1100 through 1120 (Senior Citizens Services Act)
D. Older American Act (PL 109 -365)
II PROJECT DEFINITION
Geriatric Preventative Foot Care services are intended to provide early detection of existing
and potential foot problems as well as alleviate dry skin problems, and maintenance of
healthy nails. Services include foot inspection and palpation, foot soaks, nail trimming, and
instructions in foot health maintenance. Referrals for follow -up treatment are made to local
physicians and podiatrists.
III PARTICIPANTS
• The Contractor agrees that:
A. The target population for geriatric preventative foot care services are the individuals
age 60 and over who:
1. Need one or more of the program services to avoid additional health
problems or assist with activities of daily living, thereby reducing the need for
other services; AND
2. Are not eligible for or have exhausted other sources of payment for similar
services (Medicare, Medicaid, insurance) or similar services are not available.
As stated in the Geriatric Preventative Foot Care Program Standards. All
persons served should be members of the target population. To the
degree feasible, persons served should meet the vulnerability criteria.
B. There will be written assessment procedures utilized by the Contractor to determine
if the program target population criteria are met by the clients served.
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:
4110
3
Low - income
75 years of age or older
•
Racial or Ethnic minority
Limited or non - English speaking
Living alone
ALTC funding should encourage the effective targeting of services to the vulnerable
elderly by the Contractor. Specific goals to be attained for 2013 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%
Living alone 40%
The Contractor must report on clients served in these categories.
D. Local medical professionals will be available to provide consultation services and act
in an advisory capacity.
E. Clinics will be held monthly at each designated facility that will include, but not be
limited to, low- income housing facilities and senior centers.
F. Participants shall be referred to the Information and Assistance /Case Management
Program as needed.
G. 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.
H. Services shall be provided throughout Yakima County.
IV. 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. Multicultural, bilingual persons to assist multicultural, bilingual clients in
receiving services;
3. Publicity of program through public service announcements, brochures, etc.
4. Meeting with other service providers /agencies to explain services the
Contractor provides and how referral can be made;
5. Ability to serve individuals with disabilities.
4
B. Services shall be delivered in accordance with the State of Washington Aging and
• Disabilities 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.
V. 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 City of Yakima 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 close 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.
VI. 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.
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 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:
5
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
meetings of the Office of Aging and Long Term Care Contractors and Long Term
Care Planning Committee.
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:
The 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.
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;
3. It will continue or initiate efforts to obtain support from private sources and
other public organizations for this service;
6
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.
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.
The state requires that rates charged to others cannot be less 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.
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
8
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 Tong -term care programs.
b. Any personal use of client information is strictly prohibited.
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 3 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
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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;
g. Portable RAM (Compact Flash, etc);
h. Mainframe or mini mass storage (disk platters, arrays, etc);
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 so that unauthorized individuals cannot access
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
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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.
O. 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
PAYMENT PROVISIONS
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
411 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;
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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
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.
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41) E. Termination of Contract
1. Either party may terminate this Agreement immediately upon written notice, sent
by certified mail, to the addresses listed on Page 1. If the Contractor fails to
comply with the terms and conditions of this Agreement, the County may pursue
such remedies as are legally available, including, but not limited to, the immediate
termination of this Agreement.
2. TERMINATION DUE TO CHANGE IN FUNDING: If the funds ALTC relied
upon to establish this Agreement are withdrawn, reduced or limited, or
if additional or modified conditions are placed on such funding, ALTC
may immediately terminate this Agreement by providing written notice
to the Contractor. The termination shall be effective on the date
specified in the termination notice.
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.
IV. UNITS OF SERVICE
A. Definition: A unit of Geriatric Preventative Foot Care service shall consist of
one (1) foot care treatment.
B. There will be 653 unduplicated individuals served by this Agreement (547
participants shall reside in the upper valley and 106 shall reside in the lower
valley).
C. Anticipated Service Level by Quarter:
Month UV Units LV Units Total
January - March 658 89 747
April - June 658 89 747
July - September 658 90 748
October - December 658 89 747
Total 2,632 357 2,989
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Anticipated Service Levels include 737 additional units in the upper valley
Y
funded by donations and 72 units in the lower valley.
D. Anticipated Expenditure Rate by Quarter:
Month UV Rate LV Rate Total
January - March $9,000 $1,500 $10,500
April - June $9,000 $1,500 $10,500
July - September $9,000 $1,500 $10,500
October - December $9,000 $1,500 $10,500
Total $36,000 $6,000 $42,000
V. 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 $42,000 from available funds as submitted on the 2013
Contract Budget Summary. This total sum shall be available during the period January 1,
2013 through December 31, 2013. These funds shall be used to provide Geriatric
Preventive Foot Care services. Payment to the Contractor for this unit rate price agreement
shall be based on the unit rate of $19.00 in the Upper Valley and $21.00 per unit in the 0
Lower Valley, less client donations. Client donations must be spent first before ALTC funds.
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