HomeMy WebLinkAboutAging & Long Term Care (ALTC) Footcare 2017ALTCCOG 20/7-23
PERFORMANCE AGREEMENT NO. 2017 COP (FOOTCARE3
ADMINISTRATION OF AGREEMENT
THIS AGREEMENT is entered into by and between Southeast Washington Aging and Long Term
Care Council of Governments hereinafter denominated "SE WA ALTC COG", whose address is P.O. Box
8349, Yakima, Washington 98908, and the City of Pasco, whose address is P.O. Box 293, Pasco, Washington
99301, hereinafter denominated the "Contractor", whose duly authorized representatives are named in
documents on file at the Southeast Washington Aging and Long Term Care Council of Governments
Administrative office.
The parties agree that this contract agreement becomes effective at the time of execution by the Southeast
Washington Aging and Long Term Care Council of Governments Director and/or Governing Board.
THE PURPOSE of this Agreement is to provide for the delivery of Footcare 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 Basic Agreement
January 2016 (QasicAgreementNo. 20167ansaslc-IXOP). In the event the Basic Agreement is revised, this
Agreement shall conform to the revisions.
PROGRAM AMOUNTS
Title III B
Foot Care - Pasco $16,440
Foot Care - Burbank 2 052
TOTAL FU1VDINGALL0C47701V
PERIOD OFAGREEMENT
January 1, 2017 - December 31, 2017
�ave3abell, City Manager
City of Pasco
Date: / &2
Appro As To L al Form:
D iel Clark, A #359
Yakima County Senior Deputy Prosecuting Attorney
and Civil Legal Counsel for SE WA ALTC COG
Brow Director
SE Washington Aging and Long Term Care
Council of Governments
Date:�L2g��
=1
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STANDARD TERMS AND PAYMENT PROVISIONS
CITYOFPASW
2017 FOOTCARE
SPECIPICPROVISIONS
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. 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)
E. WAC 246-840-700, 710; RCW 18.79 (Standards of Nursing Conduct)
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, 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. 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, a copy of which has
been provided to the Contractor 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 clients
meet the program target population criteria.
C. The indicators used by SE WA ALTC COG 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
Living alone
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IV
V.
SE WA ALTC COG funding should encourage the effective targeting of services to the vulnerable
elderly by the Contractor. Specific goals to be attained for 2016 are as follows:
Target Group
Percentage
Racial or ethnicminori8es
22%
Low-income
9L7%
75 years of age or older
5040
Limited or non-English speaking
9%
Living alone
90%
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. Ginics 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 Franklin County and the in the City of Burbank in Walla
Walla County.
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 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.
ANTICIPATED SERVICE LEVELS AND EXPENDrWRE RATES
The Contractor agrees that:
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A. The levels of service to be provided shall be as described in the Payment Provisions: Section IV
— Units of Service of this Agreement. Failure to meet the service levels as defined in the Payment
Provisions: Section IV — Units of Service may result in a renegotiation of the funding levels
provided under the terms of this Agreement.
B. SE WA ALTC COG may unilaterally reduce the Agreement budget within thirty (30) days of the
close of a quarter by the amount of the projected quarterly expenditures left unspent at the end
of that quarter. SE WA ALTC COG 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 SE WA ALTC COG:
The Contractor shall provide access at all reasonable times for SE WA ALTC COG to monitor
and/or evaluate the provisions of services under this Agreement. SE WA ALTC COG 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 SE WA ALTC COG in order for SE WA ALTO COG to be
assured that contracted activities remain consistent with the terms of this Agreement and
the currently approved SE WA ALTC COG Area Plan which shall be kept on file at the SE
WA ALTC COG Administrative office. The Contractor further agrees to provide such
information as requested by SE WA ALTC COG within the time limitations established by
SE WA ALTC COG;
2. Submit quarterly service reports to SE WA ALTC COG by the end of the month following
the end of each quarter;
3. Submit an agreed upon monthly service unit report by the tenth day of each month.
Contract payment requests will not be processed until service unit reporting is
complete. Contractor shall attach the report to the invoice submission to verify service
recording is complete.
a. The following information shall be collected. In the event that information cannot
be obtained, Contractor shall notify SE WA ALTC COG.
i. Full name including first, middle initial and last
ii. Street and mailing address (if different)
iii. Home telephone number including the area code
iv. Units of Service for Current Month
v. Gender
vi. Date of Birth
vii. Urban/rural
viii. Race and Ethnicity
ix. Primary language spoken
x. Household composition (lives alone)
A. Yes or No — is household income at or below 100% Federal Poverty Level
4. Submit the Quarterly financial report upon request to SE WA ALTC COG by the end of
the month following the end of each quarter;
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5. Complete and submit such additional reports as are required by SE WA ALTC COG 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. Contractors Meeting: The Contractor agrees to have a representative attend meetings of the
SE WA ALTC COG Contractor's meeting and the Long Term Care Planning Committees.
D. Program Publication: The Contractor agrees that:
1. The program shall be publicized on a regular basis, with all publicity and printed material
identifying the SE WA ATLC COG 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 Pasco 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 disability.
3. Materials publicizing the program must be printed in other appropriate languages in
counties that have a specific minority 60+ population of three (3%) percent or more of
the general 60+ population.
E. 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, SE WA ALTC COG shall have the right to assert a claim
against the Contractor on its own behalf and/or on behalf of the client.
F. 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 SE WA ALTC COG 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.
G. Maintenance of Funding Sources: The Contractor agrees that:
1. SE WA ALTC COG 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 SE WA
ALTC COG and it will make any changes necessary to meet the requirements of the new
funding sources.
H. 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;
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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 SE
WA ALTC COG must equal or exceed the rate billed the state for the same service or the
state must be charged the lower rate.
I. 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 SE WA ALTC COG 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 SE WA ALTC COG staff
and SE WA ALTC COG 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
SE WA ALTC COG 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 SE WA ALTC COG upon request.
J. SECURITY OF DATA
1. The Contractor shall take reasonable precautions to secure against unauthorized
physical and electronic access to data, which shall be protected in a manner that
prevents unauthorized persons, including the general public, from retrieving data by
means of computer, remote terminal, or other means. The Contractor shall take due
care to protect said Data from unauthorized physical and electronic access. The data
will be stored on computers with security systems that require individual user IDs and
hardened passwords. Only persons who have signed the Washington State Notice of
Nondisclosure confidentiality form covering this data share agreement will be able to
access the data that SE WA ALTC COG shares with the Contractor under this
agreement.
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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);
i. Storage Area Networks (SAN); and,
j. Network Attached Storage (NAS).
3. The Contractor shall ensure disks and/or documents generated in printed form from
the electronic file are properly returned, destroyed or shredded when no longer needed.
Unauthorized individuals cannot have access to client information. Data destroyed shall
include all copies of any data sets in possession after the data has been used for the
purpose specified herein or within 30 days of the date of termination, and certify such
destruction to SE WA ALTC COG. SE WA ALTC COG shall be responsible for destroying
the returned documents to ensure confidentiality is maintained.
The Data provided by SE WA ALTC COG will remain the property of SE WA ALTCCOG
and will be promptly destroyed when The Contractor and its subcontractors have
completed the work for which the information was required, as fully described herein.
4. The Contractor shall protect information according to state and federal laws including
the following incorporated by reference;
a. Privacy Act 1974 5 USC subsection 552a;
b. Chapter 40.14 RCW Preservation and Destruction of Public Records;
C. Chapter 74.04 RCW General Provisions — Administration;
d. Chapter 42.56.210 RCW Certain Personal & Other Records Exempt
e. 45 CFR 205.50 provides for Safeguarding information for the Financial
assistance Programs and identifies limitations to disclosure of said information;
and,
f. Public Law 99-508 (18 USC section 2510et. Seq. Electronic Communications
Privacy Act of 1986) Part A of Title IV of the Social Security Act authorizes
disclosure of client information and provides for safeguards, which restrict the
use or disclosure of information concerning applicants or recipients to purposes
directly connected with administration of the program.
K. Emerged Preparedness
Contractor will develop an emergency plan that includes the administrative office, local offices
and clients that defines what procedures should be followed when a disaster occurs. The plan
will outline what process is to be followed to provide the necessary services for a client when
normal services may be disrupted. The plan must include a list of those who are at most risk
and updated frequently. This plan must be submitted to SE WA ALTC COG for review.
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L.
The plan should include the following:
a. Contractor must designate a staff person to oversee planning tasks and
determine how emergency management is carried out in the local
jurisdiction(s);
b. Contractor must communicate and establish working relationships with local
emergency operations leadership such as SE WA ALTC COG emergency
management, fire department, law enforcement, etc.;
C. Participate in plan development, drills, exercises and other preparedness
activities. Request of local emergency operations leadership to notify your
agency to be included in ongoing exercises and other preparedness activities;
d. Identify other partners such as the American Red Cross, Salvation Army who
are active in disaster situations
e. Contractor must have a plan for serving currently authorized clients during
periods when normal services may be disrupted. This may include
earthquakes, floods, snowstorms, etc. Reasonable efforts to contact all clients
beginning with those who have been determined to be most at risk must be
made;
f. Through the duration of the disaster the contractor shall continue to contact
clients at least weekly who have declined services to offer services and identify
significant changes in condition.
Once the emergency policy has been developed, SE WA ALTC COG should be provided a copy
for review and approval.
MANDATED REPORTING:
All employees of the contractor are mandatory reporters of abuse and neglect of vulnerable
adults and children as required under RCW 74.34.035 and RCW 26.44.030. The contractor
must immediately report all suspected incidents to the appropriate protective services and
shall not impede or interfere with any DSHS or law enforcement investigation. Employees
shall not be discouraged from reporting suspected incidents by any other contractor or
employee. Suspected incidents that must be reported are defined in RCW 26.44.020 and
74.34.035 and include:
1. Physical abuse
2. Sexual abuse
3. Mental/emotional abuse
4. Neglect by others
5. Self-neglect
6. Exploitation including financial
7. Abandonment
M. CRIMINAL HISTORY[BACKGROUND CHECKS
The Contractor agrees to undergo a criminal history background check conducted by SE WA
ALTC COG every two years, and as required by RCW 43.20A.710. RCW 43.43.830 through
43.43.842, and WAC 388-06. If the Contractor has employees or volunteers who will have
unsupervised access to Clients in the course of performing the work under this Contract, the
Contractor must conduct and maintain documentation of criminal history background checks
being completed every two years on those employees or volunteers.
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PAYMENT PROVISIONS
Payment shall be based on claims for reimbursement as reported on the SE WA ALTC COG invoice and
support documentation and shall be contingent upon the receipt of all required financial and program
reports by the respectively assigned due dates.
SE WA ALTC COG 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 SE WA ALTC COG 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;
C. Payments shall be based on SE WA ALTC COG's receipt of all fiscal and programmatic reports
required by this Agreement to substantiate claims for reimbursement. SE WA ALTC COG
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 SE WA ALTC COG'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.
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.
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SE WA ALTC COG agrees to promptly notify the Contractor of any proposed reduction in funding by
State, Federal, or other officials. The Contractor agrees that upon receipt of such notice it shall take
appropriate and reasonable action to reduce its spending in the affected funding area so that
expenditures do not exceed the funding level which would result if said proposed reduction became
effective.
III BILLING PROCEDURES
A. The Contractor shall submit written claims for reimbursement of contracted activities provided
on the appropriate forms. All payments will be based on contracted activities provided unless
otherwise approved in writing by SE WA ALTC COG.
B. SE WA ALTC COG agrees to make payment for contracted activities provided as approved by
SE WA ALTC COG with warrants within thirty (30) working days. This is contingent upon the
availability of funds and receipt of the Contractor's claims for reimbursement by SE WA ALTC
COG 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
SE WA ALTC COG.
IV. UNITS OF SERVICE
A. Definition: A unit of Geriatric Preventative Foot Care service shall consist of one (1) foot care
treatment.
B. Minimum Anticipated Service Level by Contract:
County Units
Franklin County 643
Burbank, Walla Walla County 80
V. PAYMENT CONSIDERATIONS
As consideration for services, as described in the Specific Provisions of this Agreement, SE WA ALTO COG
agrees to pay the Contractor a sum not to exceed $18,492 from available funds. Of this total sum,
$2,052 is for footcare services in Burbank, Walla Walla County. This total sum shall be available during
the period January 1, 2017 through December 31, 2017. 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 $25.57 per unit of footcare services less client donations.
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