AAAPB/TC CCE/HCE/ADI RFP-1

TITLE

2015 COMMUNITY CARE FOR THE ELDERLY (CCE), HOME CARE FOR THE ELDERLY (HCE), ALZHEIMER’S DISEASE INITIATIVE (ADI) REQUEST FOR PROPROSAL (RFP)

For

COMMUNITY CARE SYSTEM Lead Agency Designation in

MARTIN County

REQUESTOR

AREA AGENCY ON AGING OF PALM BEACH/TREASURE COAST, INC.

October 2014

NOTE: THERE ARE SIX CONCURRENT RFPS - ONE FOR EACH COMMUNITY CARE SERVICE AREA (CCSA). THE COMMUNITY CARE SERVICE AREAS INCLUDE INDIAN RIVER COUNTY, MARTIN COUNTY, OKEECHOBEE COUNTY, ST. LUCIE COUNTY, PALM BEACH COUNTY AREA A AND PALM BEACH COUNTY AREA B. APPLICANTS THAT INTEND TO SUBMIT A PROPOSAL FOR COMMUNITY CARE SYSTEM LEAD AGENCY DESIGNATION IN MORE THAN ONE CCSA MUST DO SO IN SEPARATE APPLICATIONS RESPONDING TO EACH RESPECTIVE RFP TEXT AND ADDRESSING THE SPECIFIC NEEDS IN THE COMMUNITY CARE SERVICE AREA FOR WHICH FUNDS ARE REQUESTED.

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TABLE OF CONTENTS

TITLE / PAGE
SECTION A / INTRODUCTION
1. / Background of Relevant Legislation / 5
2. / Statement of Need / 6
3. / Statement of Purpose / 7
SECTION B / RFP SPECIFICATIONS
I.A.A. / Statement of Work and Organizational Capacity: Service Delivery Methodology / 10
1) / Community Care Service System / 10
2) / Program Coordination / 10
3) / Case Management / 11
I.B.B. / Statement of Work and Organizational Capacity: Lead Agency Responsibilities
1) / Coordination / 11
2) / ClientConfidentiality / 12
3) / Client Identification / 12
4) / Comprehensive Assessment of Eligible Clients / 13
5) / Emergency Service Provision and Adult Protective Services Referrals / 13
6) / Service Care Plan / 14
7) / Resource Management and Development / 14
8) / Quality Assurance / 14
9) / Co-Payment / 15
10) / Disaster Preparedness and Related Services / 15
11) / Client Complaint Grievance and Appeal Procedures / 16
12) / Personnel Standards and Employee Benefits / 16
13) / Reporting and Request for Payment / 17
14) / Staffing Requirements / 18
15) / Training / 20
16) / Volunteers / 20
17) / Case Management Training and Certification / 21
18) / Contractual Compliance / 21
19) / Client Transition Plan / 21
20) / Documentation and Record Keeping / 22
21) / Programmatic, Fiscal and Extraordinary Incident Reporting / 22
1.C. / Coordination of Case Management & Clients to be Case Managed / 22
1.D. / Services to be Coordinated / 23
1.E. / Applicant’s Qualifications and Experience / 23
1.F. / Service Goals, Objectives, and Performance Measures / 24
2.A. / Contact Person / 27
2.B. / Questions Regarding the RFP / 27
2.C. / Restrictions on Communications / 28
2.D. / Funding Source and Method of Payment / 28
2.E. / Matching Requirement / 29
2.F. / Type of Contract and Method of Payment / 29
2.G. / Method of Cost Presentation / 29
2.H. / Proprietary/Confidential Information / 30
2.I. / Costs Incurred by Applicants / 30
2.J. / RFPTimeline / 31
2.K. / Notice of Intent to Submit a Proposal / 32
2.L. / Corrections or Rejection of Proposals / 32
2.M. / Acceptance of Proposal / 32
2.N. / Withdrawal of Proposal / 32
2.O. / Number of Copies Required and Submission Procedure / 33
2.P. / Notice of Final Contract Award / 34
2.Q. / Appeal Process / 34
2.R. / Contract Terms and Conditions / 35
SECTION C. / INSTRUCTIONS TO APPLICANTS RESPONDING TO RFP
1. / Title Page / 36
2. / Response to Introduction / 36
3. / Statement of Work/Response to RFP Specifications / 36
4. / Applicant’s Qualifications and Prior Experience / 36
5. / Applicant Certification / 36
6. / Contract Module (Part B) / 37
SECTION D. / PROPOSAL EVALUATION / 38
APPENDIX I / Sample Master Agreement and Standard Agreements / 40
APPENDIX II / Notice of Intent to Submit Proposal / 41
APPENDIX III / Contract Terms and Conditions Affidavit / 43
APPENDIX IV / Statement of No Involvement Form / 45
APPENDIX V / Service Provider Application Formats / 48
APPENDIX VI / Service Provider Applications Instructions / 67
APPENDIX VII / Notice of Instruction #: 062906-1-I-OVCS / 73
APPENDIX VIII / Proposal Required Documents / 75
APPENDIX IX / Proposal Evaluation Instrument / 77
APPENDIX X / Lead Agency Dispute Resolution / 87
APPENDIX XI / Applicant’s Checklist / 88
ATTACHMENT I / Proposed Services to Be Coordinated / 91

NOTE:A COMPLETE RFP PACKAGE, INCLUDING APPENDICES I – XI,ATTACHMENT I, UNIT COST BUDGET AND UNIT COST INSTRUCTIONS CAN BE DOWNLOADED FROM THE AREA AGENCY ON AGING PALM BEACH/TREASURE COAST, INC. WEBSITE AT

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SECTION A - INTRODUCTION

  1. Background of Relevant Legislation

The Florida Legislature demonstrated its commitment to the special needs of Florida’s aging citizens by passing the Community Care for the Elderly Act, Sections 430.201 – 430.207, Florida Statutes (the "CCE Act") in 1973. The purpose of the Community Care for the Elderly ("CCE")Program is to assist functionally impaired elderly persons in living dignified andreasonably independent lives in their own homes or in the homes of relatives or caregivers through the development, expansion, reorganization and coordination of various community-based services. Today, CCE funding is available in all of Florida's 67 counties.

The CCE Act was amended in 1995 and again in 2009 by the Florida Legislature. The CCE Act, as amendedrequires a continuum of care so that functionally impaired elderly persons age 60 and older may be assured the least restrictive environment suitable to their needs. The CCE Act also encourages innovative approaches to program management, staff training, and service delivery which have an impact on cost-avoidance, cost effectiveness, and program efficiency. To that effect, the amended CCE Act calls for two critical implementation steps:

  1. Section 430.204 (1) mandates that, the department shall fund, through each area agency on aging, at least one community care service system the primary purpose of which is the prevention of unnecessary institutionalization of functionally impaired elderly persons through the provision of community-based core services. Whenever feasible, an area agency on aging shall be the contracting agency of preference to engage only in the planning and funding of CCE core services for functionally impaired elderly persons.
  2. Section 430.203(9) defines a "Lead agency” as "an agency designated at least once every 6 years by an area agency on aging as the result of a competitive procurement conducted through a request for proposal."

The Area Agency on Aging of Palm Beach/Treasure Coast, Inc. (AAAPB/TC) has been designated by the State of Florida Department of Elder Affairs ("DOEA" or the "Department") as the area agency on aging for Planning and Service Area 9 (PSA9) which encompasses all of Indian River, Martin, Palm Beach, St. Lucie and Okeechobee counties. As such, the AAAPB/TC is identified by the State as the contracting agency of choice for the coordination and administration of the CCE Program in PSA9. Further, pursuant to Section 430.203(9), Florida Statutes, the AAAPB/TC, as the area agency on aging for PSA9, is responsible for designating Lead Agencies for the CCE Program in PSA9 at least once every 6 years.

TheAAAPB/TC has implemented an Aging and Disability Resource Center (ADRC). As an Aging and Disability Resource Center, the AAAPB/TC’s role isdescribed in Section. 430.2053, Florida Statutes as well asthe Department of Elder Affairs’ April 1, 2011 publication Aging and Disability Resource Centers: Five-Year Plan for Expanding ADRCs Statewide.

The duties and responsibilities of the CCELead Agencies within each area served by an agingand disability resource center shall be to:

(a)Develop strong community partnerships to maximize the use of community resources for the purpose of assisting elders to remain in their community settings for as long as it is safely possible.

(b)Conduct comprehensive assessments of clients that have been determined eligible and develop a care plan consistent with established protocols that ensures that the unique needs of each clientare met.

Through this RFP process, the AAAPB/TC intends to fulfill the legislatively mandated requirements referenced above by inviting community-based organizations interested in obtaining a CCE leadagency designation, to submit written proposals detailing their respective qualifications and plans for the provision of case management services to eligible CCE, HCE, and ADIclients in Martin County. All entities that are awarded a lead agency contract must agree to abide by all current and future applicable laws and regulations including, but not limited to, those regulations, policies and procedures adopted by DOEA and/or the AAAPB/TC regarding the Aging and Disability Resource Center.

  1. Statement of Need

Demographic data of the 60 years of age and over population for Martin County shows that the 60 years and over age group has 53,013 individuals of which about 3,268 live below the poverty level.

The emerging picture reveals a growing population of elders who are living longer. It is reasonable to expect that as these individuals age in place and begin to grapple with the infirmities of old age their reliance on a caregiver to help them with their activities of daily living will grow as well.

The Community Care Service System as defined by Ch. 430 F.S. addresses the needs of the growing population of older, physically impaired individuals, through the provision of case management and other core services, which are provided under the direction of lead agencies that coordinate the activities of individual contracting agencies providing CCE services.

The lead agency must provide the services as outlined in Attachment I, either directly or through subcontracts. In addition, Case Management must be provided, and cannot be subcontracted, by the Lead Agency.

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All services provided by the Lead Agencies, either directly or through subcontracts must meet the description, delivery standards, provider qualifications and record keeping and reporting standards set forth in the 2014 DOEA Program and Services Handbook.

As the contracting agency for the coordination and administration of the CCE, HCEand ADI Programs in PSA 9, AAAPB/TC intends to address the needs of the elderly community of MartinCounty through the issuance of this RFP which will seek innovative approaches to service delivery and program management while emphasizing improved quality and customer satisfaction at a reasonable cost.

In responding to this RFP, prospective Lead Agencies should propose ways of delivering case management services in the most cost effective manner possible.

3.Statement of Purpose

The purpose of this RFP is to secure aqualified service agencyto be designated by the AAAPB/TC as a Lead Agency to provide case management and other Community Care Service Systems functions in Martin County.The Lead Agency will be responsible for referrals and managing the spending authority for the CCE, HCE, and ADI program services. All organizations selected to be Lead Agencies through this RFP process will be required to process enrollments for all consumers who are eligible for benefits under the Emergency Home Energy Assistance for the Elderly Program (EHEAP) in their CCSAs.

Lead Agencies will coordinate Community Care for the Elderly, (CCE), Home Care for the Elderly (HCE), and Alzheimer’s Disease Initiative (ADI) funded services in each Community Care Service Area (CCSA). The Lead Agency must provide Case Management directly. The AAAPB/TChas final authority over any services to be directly provided by the Lead Agency.

In accordance with Section 430.204(1)(b), Florida Statutes, DOEA shall fund, through each area agency on aging in each county as defined in Section 125.011 (1), Florida Statutes, more than one community care service systemthe primary purpose of which is the prevention of unnecessary institutionalization of functionally impaired elderly persons through the provision of community-based core services.

Accordingly, the AAAPB/TCintends to designate oneLead Agency for Martin County.

The designated Lead Agency will beexpected to plan for and provide case management and arrange for the provision of approved services on a Community Care Service Area-wide basis.Failure to provide services on aCommunity Care Service Area-wide basis may result in sanctions or other enforcement actions authorized under the contract between the Lead Agency and the AAAPB/TC.

The purpose of a designated Lead Agency is to provide case management to all CCE, HCE, and ADI clients and to ensure service integration and coordination of service providers within the Community Care Service System.

The responsibilitiesof a designated Lead Agency are to:

  1. Ensure that all other funding sources available have been exhausted before targeting CCE, HCE and/or ADI funds.
  2. Ensure that coordination is established with all community-based health and social services for functionally impaired older persons funded wholly or in part by federal, state, and local funds in order to provide a continuum of care.
  3. Provide directly or establish subcontracts or vendor agreements, when applicable, for core and other contracted services.
  4. Provide case management to applicants and ongoing recipients of core and other contracted services.
  5. Assess and collect co-payments for coreand other contracted services.
  6. Train and use volunteers to the fullest extent possible to provide services to clients and assist with other Lead Agency activities.
  7. Compile accurate reports.
  8. Monitor subcontracts and vendor agreements to ensure quality services and efficient use of funds. Make payments to subcontractors for coreand other contracted services.
  9. Initiate and maintain coordination among agencies.
  10. Arrange in-service training for staff, including volunteers and core service subcontractors and other contracted service subcontractors,in keeping with the standards set forth in the 2014 Department of Elder Affairs Programs and Services Handbook.
  11. Accept voluntary contributions, gifts, and grants to carry out a community care service system.
  12. Demonstrate innovative approaches to program management, staff training, and service delivery that impact on cost avoidance, cost-effectiveness, and program efficiency.
  13. Establish and follow procedures for handling recipient complaints concerning such adverse actions as service termination, suspension, or reduction in services.
  14. Conduct client satisfaction surveys to evaluate and improve service delivery.
  15. Implement Measurable Client Outcomes directed at:
  1. Maintaining clients in the least restrictive settings.
  2. Targeting high risk clients.
  3. Improving quality of life.
  4. Improving or maintaining functional status.
  1. Improve Operations and Accessibility by:
  2. Assuring case management services are available on-call, including evenings, weekends and emergencies for Adult Protective Services ("APS") cases.
  3. Providing service(s), other than case management, within 72 hours to Adult Protective Services referrals classified as high risk and in need of services to prevent further harm.
  4. Responding to referrals for persons at Imminent Risk of institutional placement.
  5. Ensure Client Information and Registration Tracking System ("CIRTS") timely data input and integrity.
  6. Developingandimplementingcomplaintproceduresandensuringthat subcontractors develop andimplementcomplaintprocedurestoprocessandresolveclientdissatisfactionwithservices.

In performing these listed responsibilities, the provider must conform to the regulations and standards contained in the 2014 Department of Elder Affairs Programs and Services Handbook, the Adult Protective Services Operational Manual, andthe Master and Standard Agreements executed with the AAAPB/TC. These documents are available on the AAAPB/TC website.

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SECTION B- RFP SPECIFICATIONS

  1. Statement of Work and Organizational Capacity:
  1. Service Delivery Methodology

1) Community Care Service System

A Lead Agency designation is contingent upon the applicant’s ability to promptly acceptreferrals, provide case management and coordinate the delivery of services on a Community Care Service Area-wide basis for all eligible clients residing in the designated service area of Martin County.Interested applicants will need to demonstrate the ability to accept referrals promptly and provide case management services, coreand other contracted service coordination on a Community Care Service Area-wide basis, within the time frames indicated in the 2014 Program and Services Handbook

If a bid is not received for a CCSA, the AAAPB/TC is not bound to the RFP process and may proceed to enter into negotiations with any other entities suitable and deemed to be in the best interest of the consumers.

All service dollars are to remain in the CCSA to address the needs of elders and their caregivers in that area. However, by virtue of its obligation to manage the wait list for the entire planning and service area (PSA 9), AAAPB/TC reserves the right to redirect funding throughout the area in order to serve consumers that are at greatest risk of institutional placement, irrespective of CCSA boundaries. Lead Agencies are therefore urged to outreach to consumers in greatest need in their CCSA.

2) Program Coordination

Unless otherwise contracted, the AAAPB/TC will be the single point of entry for all CCE, HCE and ADI clients. All client referrals forindividuals requesting services through CCE, HCE and ADIprograms in Martin County must come through the AAAPB/TC’s Agingand Disability Resource Center ("ADRC"). The intake process will be carriedout by the Intake Unit staff at the AAAPB/TC and will include a telephone screening of each caller, prioritization of each caller, and subsequent placement on an Assessed Priority Consumer List ("APCL"). The AAAPB/TC will be responsible for the upkeep of the APCL.

As the Lead Agency determines that funding is available, they will request the AAAPB/TC to release persons from the APCL. This activity will be performed in compliance with the Consumer Program Activation Protocols. (Available on the AAAPB/TC website and referenced in Section 52.3 of the Master Agreement and Section 2.1.2 of the Standard Agreements.)Lead Agencies shall comply with the process as described in the Consumer Program Activation Protocols and any subsequent modification of this process.

Within 14 working days after receiving a client referral for activation, the Lead Agency will be required to complete a home visit in order to perform a comprehensive assessment of the client and to develop an appropriate care plan.

3) Case Management

The role of the Lead Agency is to provide case management and other required functions of the CCE Program as detailed in the Department of Elder Affairs, December 2014Program and ServicesHandbook. Funding for CCE core services and other contracted services willbe awarded separately,to the Lead Agencies selected through this procurement, based on the availability of funds. Those applicants selected as CCE Lead Agencies will need to provide the AAAPB/TC, prior to contract execution, an action plan outlining the process and timelines for the selection of the service provider agencies they expect to subcontract with for the provision of CCE core services and other contracted services. All core services and other contracted services must be provided at a unit rate as derived through the unit cost budget. The AAAPB/TC reserves the right to review and approve all subcontracted reimbursement rates for core services and other contracted services.

Case Management, must be provided directly by a designated Lead Agency. It cannot be outsourced or subcontracted to another service provider.