SFY10 State/Federal Interlocal Agreement

H09-043 – Procedure July 6, 2009

TO: Area Agency on Aging (AAA) Directors FROM: Bill Moss, Director, Home and Community Services Division Kathy Marshall, Director, Management Services Division SUBJECT: SFY10 State/Federal Interlocal Agreement PURPOSE: To notify Area Agencies on Aging (AAA) of their initial allotments, supplemental reporting forms, interlocal agreement, budget forms, and instructions for state fiscal year (SFY) 2010. BACKGROUND: Funding for Case Management and Nursing Services will continue to be based on the number of cases authorized per month multiplied by the approved monthly unit rate per case.

WHAT’S NEW, Due to the long legislative session, there is insufficient time to prepare, CHANGED, OR review and approve line item budgets by July 1, 2009, so ADSA is sending CLARIFIED: out 3-month maximum consideration contracts based on the following:

 Case Management/Nursing Services (CM/NS) unit rates remain at the levels established for SFY 09 as there was no vendor rate increase for SFY10.

o The following staffing ratios are required for SFY10: 1:68 Case Handling Staff to Client Ratio 1:570 Registered Nurse to Client Ratio 1:8 Supervisor to case Handling Staff Ratio o Clarification regarding how the required staffing ratios are defined and calculated is provided in the attached document entitled “AAA Ratio Clarifications”. o The Case Handling Staff List must be submitted electronically each month. o The formula used to determine the Staff to Client Ratio Adjustment for case handling staff to client ratio that exceeds 1:68 will change as follows: after the second occurrence, the factor within the formula that determines the amount of deduction taken will increase from .3 to .6 and will remain at .6 for the remainder of the contract period. o The TXIX subsidy remains at the SFY09 funding level for 1 grandfathered AAAs. o AAAs are no longer required to report nursing services expenditures separately from the unit rate. The Centers for Medicare and Medicaid Services (CMS) has determined that these services are not eligible for the enhanced 75% federal match.

 Core Services Contract Management (CSCM) is based on SFY09 funding levels and includes the full allotment for AAAs with DDD- only home care agency contracts. In addition to the base funding, 2.5% has been added for functions related to Roads to Community Living contracts and 2.5% has been added for the additional monitoring requirements related to implementing Substitute House Bill (SHB) 2361.

 DDD and HCS-Contracted Nursing Services will continue to be reimbursed on a cost reimbursement basis but the DDD Nursing Services can no longer be billed at the 75% match rate.  Revised TXIX billing forms will be distributed under a separate cover.

 Agency Provider/Individual Provider Transition funding has been provided to assist AAAs in working with clients and providers impacted by SHB 2361.

 NSIP funding has been moved to the Older Americans Act agreement and is no longer reported in this budget. Any unspent funding from SFY09 will be moved to the CY09 OAA agreement.

 Title V funding is based on 80 percent of SFY09 funding. The funding may be increased or decreased in the future depending on the finalized federal dollars and slot allocation.

 Title V-ARRA carryover from the SFY09 agreement will be added in a subsequent amendment.

 The State Family Caregiver Support Program (SFCSP) continues to be funded at the SFY09 level with $80,000 kept at ADSA for local Virtual Private Network (VPN) access and statewide training.

 SCSA received an admin reduction of $142,000, reducing the admin lid from 18% to 16.5% for SFY10.

 Volunteer Chore, Kinship Navigator, Kinship Caregiver Support Program (KCSP), and Senior Drug Education continue to be funded at the SFY09 level.

 Senior Farmers Market Nutrition Program (SFMNP) continues to be funded at the SFY09 level for state funding and received an increase of $8,398 in federal funding.

 Chronic Care Management (CCM) (previously titled Intensive Chronic Case Management) will be funded at $180 per client, per month, for the five participating AAAs through September 30, 2009. 2 Expansion of the program is being discussed and further information will come out as soon as it is known.

 MIPPA (Medicare Improvements for Patients & Providers Act) for Beneficiary Outreach & Assistance funding was added and additional information will be distributed in a separate MB.

 FTE Worksheets are now required for HCS-contracted nursing services.

 Statement of Work – the following sections of the Statement of Work have been updated for SFY10: o Case Management o Core Services Contract Management o Laptop Replacement Schedule o Title V o SFCSP o Kinship Navigator Program o Chronic Care Management o MIPPA

 Special Terms and Conditions - an additional item has been added titled, Amendment Clause Exception.

ACTION:  Submit State/Federal line item budgets and FTE worksheets and the CSCM Supplemental Worksheet to Anna Glaas by July 31, 2009.  Any concerns regarding the revised language in the Interlocal Agreement Statement of Work should be directed to your AAA Specialist by July 20, 2009. RELATED None REFERENCES: ATTACHMENT(S): SFY10 State/Federal Budget Forms: SFY10 Budget Instructions:

SFY10StateFedBudg SFY10 SF et.xls BudgetInstructions.doc AAA Interlocal Agreement: 2010 Initial Funding:

1016LS AAA SFY10InitialFunding. State-Fed Agmt Sample.doc xls CSCM Supplemental Worksheet: Core Services FTE Definitions:

SFY10 CSCM SFY10 CORE SUPPLEMENTAL WORKSHEET.doc SERVICES FTE DEFINITIONS.doc Attachment A- CM/RN Revenue: Statement of Work:

SFY10 ATTACHMENT SFY10 State-Federal A CM-NS REVENUES.xls SOW.doc

3 AAA Ratio Clarifications:

SFY10 AAA RATIO CLARIFICATIONS.doc CONTACT(S): Direct general questions or questions regarding caseload, unit method, or Interlocal Agreement to your AAA Specialist: Aaron Van Valkenburg, AAA Unit Manager (360) 725-2554 [email protected]

Susan Shepherd, AAA Specialist (360) 725-2418 [email protected]

Karen Fitzharris, AAA Specialist (360) 725-2446 [email protected]

Brent Apt, AAA Specialist (360) 725-2560 [email protected]

Leigh Wellcome, AAA Specialist (360) 725-2547 [email protected]

Fiscal Questions: Anna Glaas, Grants Unit Supervisor (360) 725-2374 [email protected]