The purpose of the proposed rules is to implement Section 430.2053(12), F.S. This statute establishes requirements under which aging resource centers shall operate.

DEPARTMENT OF ELDER AFFAIRS
Division of Volunteer and Community Services

RULE NO: RULE TITLE
58B-1.001: Definitions
58B-1.003: Operating Procedures
58B-1.005: Monitoring and Sanctioning Service Providers
58B-1.007: Oversight Standards for the Aging Resource Center Governing Body
58B-1.009: Outcome Measures
PURPOSE AND EFFECT: The purpose of the proposed rules is to implement Section 430.2053(12), F.S. This statute establishes requirements under which aging resource centers shall operate.
SUBJECT AREA TO BE ADDRESSED: The proposed rules shall establish definitions, operating procedures, monitoring and sanctioning of access points, oversight standards for the aging resource center governing body, outcome measures, and quality assurance standards for aging resource centers in order to meet the requirements set forth in Section 430.2053(12), F.S.
SPECIFIC AUTHORITY: 430.08, 430.2053(12) FS.
LAW IMPLEMENTED: 430.2053 FS.
A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
TIME AND DATE: September 20, 2006, 9:30 a.m. – 12:00 Noon
PLACE: J. L. Young Garden Apartments, Community Room, 8220 North Florida Avenue, Tampa, Florida 33604, Telephone number [phone].
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 72 hours before the workshop/meeting by contacting: Jim Crochet, Department of Elder Affairs, Office of the General Counsel, 4040 Esplanade Way, Tallahassee, FL 32399-7000, telephone number [phone], Email address [e-mail]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Jim Crochet, Department of Elder Affairs, Office of the General Counsel, 4040 Esplanade Way, Tallahassee, FL 32399-7000, telephone number [phone], Email address [e-mail].

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

58B-1.001 Definitions.

In addition to the definitions included in Chapter 430, F.S., the following terms shall apply in this rule chapter:

(1) Access Point: A service provider or other entity that performs one or more aging resource center functions under an agreement with the aging resource center. The agreement can be in the form of a referral agreement, contract, memorandum of understanding, or any similar document.

(2) Aging Resource Center (ARC): An entity approved by the Department of Elder Affairs (DOEA), accessible through multiple entry points, that provides access to economic and long-term care services for all elders and their families, regardless of ability to pay. The eligibility functions are determined by the Comprehensive Assessment and Review for Long-term Care Services (CARES)/DOEA and the Department of Children and Families (DCF) Economic Self – Sufficiency programs integrated through collocation of DOEA and DCF staff. The ARC coordinates the following functions under its contract with DOEA:

(a) Access, information and referral;

(b) Screening and triage;

(c) Eligibility determination;

(d) Long-term care options counseling;

(e) Fiscal control; and

(f) Quality assurance.

(3) Aging Resource Center client: An individual currently receiving services through any of the programs referred by the ARC, including individuals referred to private providers.

(4) Executive Director: An individual who shall be delegated responsibility for the ARC management and implementation of governing body policy; and who shall be accountable to the governing body for the ARC’s performance. The ARC executive director may be the same individual who serves as the area agency on aging executive director.

(5) Governing Body: The board of the area agency on aging as described in Section 20.41(7), F.S.

(6) Information and Referral Specialist: The staff person(s) responsible for providing:

(a) Information to individuals about available long-term care resources and services;

(b) Referral of individuals to the resources most capable of meeting their needs; and

(c) Follow-up on referrals.

(7) Intake, Screening and Triaging Professional: The staff person(s) responsible for carrying out the following duties and responsibilities:

(a) For Title XIX (Medicaid/MedWaiver) services:

1.Assisting in the initial preliminary determination of programs and services that may serve the needs of the individual; and

2, Providing information on eligibility criteria and the application process.

(b) For other funded services (Older Americans Act, Community Care for the Elderly, Home Care for the Elderly, Alzheimer’s Disease Initiative, and contracted services), determining an applicant’s:

1. Potential eligibility for non-Medicaid programs;

2. Prioritized need for long-term care services; and

3. Priority for a comprehensive assessment.

Specific Authority 430.08, 430.2053(12) FS. Law Implemented 430.2053 FS. History–New________.

 

58B-1.003 Operating Procedures.

(1) SERVICE DELIVERY and ACCESSIBILITY. At a minimum, information shall be provided to all persons accessing the ARC by telephone, the Internet, or in person.

(a) The ARC shall, at a minimum, maintain regular business hours from 8:00 a.m. to 5:00 p.m., Monday through Friday, excluding state and national holidays.

(b) A staff member shall be assigned to answer the published, main telephone number of the ARC during regular business hours.

(c) The ARC shall ensure there is a system in place for answering and responding to calls received outside of the regular business hours.

1. The system shall, at a minimum, identify the agency, hours of operation, and give callers the option to leave a message or speak with a live attendant. The live attendant may be a private answering service.

2. The system shall instruct callers to dial “911” in the event of an emergency.

3. Messages shall be responded to the next business day.

(d) The ARC shall maintain an adequate number of access points to ensure that consumers who reside in all counties in the planning and service area have access to ARC services.

(2) EXECUTIVE STAFF REQUIREMENTS: At a minimum, executive staffing requirements shall consist of at least one of the following:

(a) An executive director who shall be a full-time employee having designated authority over the staff and all activities of the ARC; and

(b) A fiscal officer.

(3) PROFESSIONAL STAFF REQUIREMENTS: Professional staff shall be available to perform the tasks required of the ARC. Additional professional staff shall be required to adequately meet the needs of elders residing within the area served by the center if the minimum staffing standards cannot adequately meet those needs.   At a minimum, the ARC shall employ the following professional staff:

(a) One Information and Referral Specialist; and

(b) One Intake, Screening and Triaging Professional.

The minimum professional staff requirement does not preclude an individual from performing the functions of both positions, provided the individual meets the minimum qualifications for each position as outlined in subsection (4) of this rule.

(4) MINIMUM EDUCATION and EXPERIENCE REQUIREMENTS: The ARC executive staff and professional staff shall meet minimum standards for education and experience and shall demonstrate competency in job knowledge pertinent to their areas of responsibility. The following are the criteria for ARC executive staff and professional staff:

(a) The executive director shall meet the following minimum standards:

1. Have a Bachelor’s Degree from an accredited college or university in public administration, education, social work, or a related academic area with a minimum of five years of professional or administrative supervisory experience in social, economic, health, or rehabilitative services. A Master’s degree can substitute for one year of required work experience.

2. Work experience as indicated above may be substituted for the required college education on a year for year basis.

3. Five years experience in project management or community organization and planning related to elderly services is preferred.

(b) The fiscal officer shall meet the following minimum standards:

1. Have the appropriate educational and accounting experience as indicated below:

a. A current CPA certification; or

b. A Bachelor’s Degree in accounting with two years of cost accounting experience in a non-profit setting; or

c. Have at least four years experience with Medicaid fiscal regulations and four years with state accounting procedures. The four years experience for each category may occur simultaneously.

2. Demonstrate a working knowledge of cost principles and internal control procedures for grants and contracts with the federal government for non-profit organizations (OMB circulars A-87, A-110, A-122, and A-133).

(c) The Information and Referral Specialist shall meet the following minimum standards:

1. Have a Bachelor’s Degree from an accredited college or university in a human services related field; or

2. Have an Associate of Arts Degree from an accredited entity in a human services related field and a minimum of two years experience in information and referral services, case management, call center services, social services, or related work experience; or

3. Have a high school diploma or GED and four years experience in information and referral services, case management, call center services, social services, or related work experience.

(d) The Intake, Screening and Triaging Professional shall meet the following minimum standards:

1. Have a Bachelor’s Degree from an accredited college or university in a human services related field; or

2. Have an Associate of Arts Degree from an accredited entity in a human service related field and a minimum of two years experience as a caseworker, case manager, intake specialist, or related work experience with the long-term care client population; or

3. Have a high school diploma or GED and four years experience as a caseworker, case manager, intake specialist, or related work experience with the long-term care client population.

(5) RECORDS: The ARC shall maintain books, records, and documents (including electronic storage media) in accordance with generally accepted accounting principles and sound business practices that sufficiently and properly reflect all revenues and expenditures of funds provided by the department. This documentation shall be made available upon request for monitoring and auditing purposes.

(a) All financial documents shall be filed, retained, and made available in the manner described in the contract with the department for a period of at least five (5) years after termination of the contract. If an audit has been initiated and audit findings have not been resolved at the end of the five (5) years, the records shall be retained at least until resolution of the audit findings.

(b) The ARC shall be audited annually by an independent accounting firm and shall submit the final report of the audit to the Department within six months after the end of the ARC’s fiscal year.

(6) INFORMATION TECHNOLOGY STANDARDS: The ARC shall meet the minimum standards for information technology provided below.

(a) The ARC shall have sufficient computer hardware and software resources to provide:

1. Connectivity to DOEA applications via a private network such as the Florida Suncom network or a subion Virtual Private Network (VPN). The department shall verify the security of all connections to its information systems.

2. A computing environment sufficient to operate the department’s application programs. These applications require the current versions of the Microsoft or Netscape branded browsers that support the execution of Java, meet the version 4.0 Hypertext Markup Language (HTML 4.0) standards, and the version 1.0 Cascading Style Sheets (CCS 1.0) standard.

(b) The ARC shall have information technology measures in place that meet security requirements for computer viruses, Denial of Service (DOS) attacks, and malware; and compliance with the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA).

(c) The ARC shall maintain operational security including, but not limited to, current security patches that ensure stability of the network.

(d) The ARC shall utilize information technology that ensures compatibility and connectivity with the department.

(e) The ARC shall employ staff with technical expertise needed to support and maintain a computerized information system in accordance with the ARC’s contract with the department.

(f) The ARC shall include information technology protocols in its disaster/emergency and continuity of operations plans to ensure data backup and continuity during a disaster or emergency.

Specific Authority 430.08, 430.2053(12) FS. Law Implemented 430.2053 FS. History–New________.

 

58B-1.005 Monitoring and Sanctioning of Access Points Service Providers.

This rule applies only to access points that have a direct monetary funding agreement with the ARC.

(1) MONITORING: The ARC shall perform administrative, programmatic, quality assurance, and, if applicable, fiscal monitoring of access points to ensure compliance with ARC agreements.

(a) The ARC shall ensure appropriate methods for monitoring and sanctioning access points, including a grievance process, if the entity is eligible to file a grievance.

(b) In addition to monitoring access points in accordance with ARC agreements, ARC monitoring procedures shall include, at a minimum, the following elements:

1. Ensuring that professional staff has the minimum educational and experience requirements required in Rule 58B-1.003, F.A.C.

2. Timeliness and accuracy of the functional screening and financial eligibility;

3. Timeliness and accuracy of eligibility determination and enrollment procedures;

4. Effectiveness of information and referral services and long-term care options counseling;

5. Effectiveness of processes for receiving and acting on complaints and resolving client grievances and other persons who use ARC services; and

6. Identification of training and technical assistance needs.

(2) SANCTIONING: ARC access points that do not meet ARC agreements may be subject to sanctioning. Sanctions may include, but are not limited to, the following:

(a) Development, submission, and implementation of an acceptable corrective action plan to address identified areas of concern, agreement breaches, and noncompliance issues;

(b) Submission of additional and/or more detailed financial and/or performance reports;

(c) Designation as a high-risk access point, requiring additional monitoring visits;

(d) Repayment of disallowed costs;

(e) Amendments to the current ARC agreement;

(f) Restrictions on ability to draw down programmatic and administrative funding;

(g) Imposition of required technical assistance;

(h) Limitation or prohibition of direct service provision;

(i) Limitation or prohibition of use of specific service providers;

(j). Financial penalties not to exceed $5,000 per agreement violation;

(k) Suspension of the entity’s ability to function as an access point; and

(l) Termination of the entity’s ability to function as an access point.

Specific Authority 430.08, 430.2053(12) FS. Law Implemented 4302053 FS. History–New________.

 

58B-1.007 Oversight Standards for the Aging Resource Center Governing Body.

Pursuant to its contract with the ARC, the department shall monitor the performance and oversight activities of the ARC governing body to ensure the appropriateness and quality of care received by clients. The governing body shall be accountable for oversight standards for the ARC including, but not limited to:

(1) Compliance with legal and contractual requirements, established department policies, and effective management principles;

(2) Ensuring that services are provided in the most cost effective and cost saving manner in order to provide services to the greatest number of eligible individuals to help them remain in the community and avoid unnecessary institutional care;

(3) Reviewing the implementation of policies, governing body directives, and overall organizational accountability;

(4) Reviewing human resource management;

(5) Ensuring the ARC has a system for recruiting, hiring, evaluating, and terminating employees;

(6) Ensuring the ARC has written protocols for the development of cooperative relationships with community service agencies, and documented existence of cooperative relationships to ensure the intent of the ARC concept and mission are met;

(7) Ensuring compliance with program guidelines;

(8) Ensuring information management and data integrity, including accurate and reliable collection of client specific data;

(9) Completing a written annual performance evaluation of the executive director;

(10) Ensuring that the ARC develops an annual operational plan to be submitted to the department. The plan shall demonstrate that the ARC is achieving the goals as set forth by contract, statute, and rules;

(11) Ensuring that the ARC develops and incorporates disaster/emergency and continuity of operations plans in cooperation with those established by the area agency on aging for the planning and service area; and

(12) Overseeing the appropriateness of the ARC financial operations.

Specific Authority 430.08, 430.2053(12) FS. Law Implemented 430.2053 FS. History–New________.

 

58B-1.009 Outcome Measures and Quality Assurance Standards.

(1) OUTCOME MEASURES: The ARC governing body shall ensure that ARCs perform the following minimum outcome measures:

(a) Adhere to the annual Legislative mandate for the percentage of individuals, age 60 and older, determined to be eligible for nursing home placement that are placed in home and community based services; and

(b) Demonstrate the average monthly savings per client for home and community based services as compared to nursing home care for comparable client groups.

(c) Establish baseline measures for the processing time for applicants seeking services under the programs outlined in Sections 430.2053(11)(a) through (g), F.S., which are administered by the ARC through its contract with DOEA.

1. The processing time shall begin on the date applicants make their initial contact with the ARC and end on the date they are enrolled to receive services.

2. In addition to establishing the baseline information as outlined in subparagraph (1)(c)1. above, the ARC shall implement measures to track and report processing time on an ongoing basis for each of the programs referenced in Sections 430.2053(11)(a) through (g), F.S.

3. This requirement does not apply to applicants who are placed on an assessed priority consumer list for services.

(2) QUALITY ASSURANCE STANDARDS: The ARC governing body shall ensure that the ARC develops quality assurance standards to provide assurance that clients are receiving appropriate services and access points are adhering to the terms of the ARC agreements. This activity shall include the following elements:

(a) Ensuring access points adhere to the ARC agreements regarding the provision of client services in the most effective and cost saving manner. This shall be determined through regular monitoring, feedback and client satisfaction surveys.

(b) Ensuring that clients receive appropriate care and services while living in the community in order to avoid nursing home placement. This shall be accomplished through periodic clinical review of client care plans, client progress towards goals, and client satisfaction surveys.

(c) Ensuring that an annual program improvement plan is developed and submitted to the department in response to the department’s monitoring report.

Specific Authority 430.08, 430.2053(12) FS. Law Implemented 430.2053 FS. History–New________.