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HomeMy WebLinkAboutExhibitallod agency for persons with disabilities State of Florida MEDICAID WAIVER SERVICES AGREEMENT This Agreement is entered into between the Florida Agency for Persons with Disabilities, hereinafter referred to as "APD', and City of114iami-Parks & Recreation, hereinafter referred to as the "Provider". Pursuant to the terms and conditions of this Agreement, APD authorizes the Provider to furnish Developmental Disabilities Home and Community -Based Services (HCBS) Medicaid waiver services to eligible APD clients, and to receive payment for such services. The services that may be provided in any one APD service area are limited to the services that the APD area office, pursuant to the standards specified in Florida's HCBS waivers, authorizes the Provider to furnish in that service area. AGREEMENT DOCUMENTS: A. The Medicaid Waiver Services Agreement consists of the terms and conditions specified in this Agreement, any attachments, and the following documents, which are incorporated by reference: The Developmental Disabilities Waiver Services Coverage and Limitations Handbook, dated October 2003, and any updates or replacements thereto. The Handbook can be found at the AHCA website: http://flc)ridamedicaid.acs-inc.com/index.isp. The Handbook lists the requirements for specific services as well as the Core Assurances, which provide the terms and conditions by which the provider of Developmental Disabilities HCBS waiver services agrees to be bourd. 1. The Family and Supported Living Waiver Services Directory, and any updates or replacements thereto. The Directory can be found at the APD website: http://aod.mvflDrida.com/clients. The Directory describes recipient and provider requirements for Family -and Supported Living HCBS waiver services. 2. AttachmentA/B providing individually negotiated unit rates of payment for services not already established and available on APD's website, as referenced in ILE, and any other service or data requirements, as applicable. B. Prior to executing this Agreement and furnishing any waiver services, the Provider must have executed a Medicaid Provider Agreement with the Agency for Health Care Administration (AHCA), and be issued a Medicaid provider number by ARCA. The Provider must at all times during the term of this Agreement maintain a current and valid Medicaid Provider Agreement with ARCA, and comply with the terms and conditions of the Medicaid Provider Agreement. it. THE PROVIDER AGREES: To comply with all of the terms and conditions contained within this Agreement, including all documents incorporated by reference and any attachments. A. Monitoring, Audits, Inspections, and Investigations To permit persons duly authorized by APD, the Agency for Health Care Administration (ARCA), or representatives of either, to monitor, audit, inspect, and investigate any recipient records, payroll and expenditure records (including electronic storage media), papers, documents, facilities, goods and services of the Provider which are relevant to this Agreement, and to interview any recipients receiving services and employees of the Provider to assure APD of the satisfactory performance of the terms and conditions of this Agreement. 1. Following such monitoring, audit, inspection, or investigation, APD or its authorized representative, will furnish to the Provider a written report of its findings and, if deficiencies are found, request for development, by the Provider, a Quality Improvement Pian (QIP) for needed corrections. The Provider hereby agrees to correct all noted deficiencies identified by APD, ARCA, or their authorized representatives within the specified period of time identified within the report documentation. Failure to correct noted deficiencies within stated time frames may result in termination of this Agreement. 2. Upon demand, and at no additional cost to the APD, ARCA, or their authorized representatives, the Provider will facilitate the duplication and transfer of any records or documents (including electronic storage media), during the required retention period of six years after termination of the Agreement, or if an audit has been initiated and audit findings have not been resolved at the end of six years, the records Revised August 2006 t14 i: : I APD Medicaid Waiver Services Agreement shall be retained until resolution of the audit findings or any litigation which may be based on the terms of this Agreement, at no additional cost to APD. 3. To comply and cooperate immediately with APD requests for information, records, reports, and documents deemed necessary to review the rate setting process to ensure that provider rates are based on accurate information and reflect the existing operational requirements of each service. Any individual who knowingly misrepresents the information required in rate setting commits a felony of the third degree, punishable as provided in sections 775.082 and 775.083, F.S. 4. To comply and cooperate immediately with any inspections, reviews, investigations or audits deemed necessary by APD's Office of the inspector General pursuant to section 20.055, F.S. 5. To include the aforementioned audit, inspections, investigations and record keeping requirements in all subcontracts and assignments. B. Confidentiality of Client Information Not to use or disclose any information concerning a client receiving services under this Agreement for any purpose prohibited by state or federal law or regulation, except with the written consent of a person legally authorized to give that consent or when authorized by law. This includes compliance with: the Health Insurance Portability and Accountability Act of 1996, 42 U.S.C. 1320d, and all applicable regulations provided in 45 CFR Parts 160, 162, and 164; and 42 CFR, Part 431, Subpart F, relating to the disclosure of information concerning Medicaid applicants and recipients. C. Indemnification 1. To be liable for and indemnify, defend, and hold APD, AHCA and all of their officers, agents, and employees harmless from all claims, suits, judgments, or damages, including attorneys' fees and costs, arising out of any act, actions, neglect, or omissions by the Provider, its agents, employees, or subcontractors during the performance or operation of this Agreement or any subsequent modifications thereof, whether direct or indirect, and whether to any person or tangible or intangible property. The Provider shall not be liable for that portion of any loss or damages proximately caused by the negligent act or omission of APD or ARCA. 2. That its inability to evaluate its liability or its evaluation of liability shall not excuse the Provider's duty to defend and to indemnify within 7 days after notice by APD or AHCA by certified mail. After the highest appeal taken is exhausted, only an adjudication or judgment specifically finding the Provider not liable shall excuse performance of this provision. The Provider shall pay all costs and fees, including attorneys' fees related to these obligations and their enforcement by APD or AHCA. APD or AHCA's failure to notify the Provider of a claim shall not release the Provider of these duties. Insurance To obtain and maintain at all times continuous and adequate liability insurance coverage during the term of this Agreement. The Provider accepts full responsibility for identifying and determining the type and extent of liability insurance necessary to provide reasonable financial protection for the Provider and APD clients served by the Provider. All insurance policies shall be through insurers authorized or eligible to write policies in Florida. Such coverage may be provided by a self-insurance program established and operating under Florida law. E. Payment To accept payment for goods and services at rates periodically established by AHCA and APD. The most current rates are available on APD web site: http://apd.myflorida.com/clients. The signatories recognize that APD is limited by appropriation and acknowledge that Florida law requires AHCA and APD to make any adjustment necessary to comply with the availability of moneys and any limitations or directions provided for in the General Appropriations Act, including but not limited to adjusting fees, reimbursement rates, lengths of stay, number of visits, or number of services, or limiting enrollment. [See sections 393.0661, 409.906, 409.908, F.S.] F. Return of Funds Revised August 2006 APD Medicaid Waiver Services Agreement To be responsible for the timely correction of all billing or reimbursement errors resulting in an overpayment, including reimbursement for services not properly authorized or documented. Reimbursement will be made pursuant to the Florida Medicaid Provider Reimbursement Handbook, Non -Institutional 081. Federal regulations, 42 CFR § 433.312, require refund of overpayments within 60 days of discovery. AHCA will be the final authority regarding the timeliness of the reimbursement process. G. Independent Status That the Provider acts at all times in the capacity of an independent service provider and not as an officer, employee, or agent of APD, AHCA, or the State of Florida. The Provider shall not represent to others that it has the authority to bind the APD or AHCA unless specifically authorized in writing to do so. In addition to the Provider, this is also applicable to the Provider's officers, agents, employees, or subcontractors in performance of -- - this Agreement. III TERM!NAT!ON: A. This Agreement may be terminated by either party without cause, upon no less than 30 calendar days notice in writing to the other party unless a lesser time is mutually agreed upon in writing by both parties. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. S. This Agreement may be terminated for the Provider's unacceptable performance, non-performance or misconduct upon no less than 24 hours notice in writing to the Provider. Waiver by either party of any breach of any term or condition of this Agreement shall not be construed as a waiver of any subsequent breach of any term or condition of this Agreement. If RPD determines that the Provider is not performing in accordance with any term or condition in this Agreement, APD may, at its exclusive option, allow the Provider a period of time to achieve compliance. The provisions herein do not limit APD's right to any other remedies at law or in equity. IV. GOVERNING LAW: This Agreement shall be construed, performed, and enforced in all respects in accordance with all the laws and rules of the State of Florida, and any applicable federal laws and regulations. V. AGREEMENT DURATION: This Agreement shall be effective 7/9/2008 or the date on which it has been signed by both parties, whichever is later, and shall terminate on 7/1/2019 which is no later than three years from the effective date. VI. OFFICIAL REPRESENTATIVES (Names, Address, Telephone Number, and E-mail Address): 1. The Provider's contact person and street address where financial and administrative records are maintained is: Name: Marta Faria Telephone Number: (305) 461-7201, Ext. 222 Address: 4560 N.W. 4th Terrace E-mail Address: MFaria@ci.miami.fl.us 2. The representative of the Provider responsible for administration of the services under this Agreement is: Name: Nadia Arguelles Telephone Number: (305) 461-7201, Ext. 221 A _-.iA c Add_ess: -160 T N.W. 4LLL Terrace E-mail Address: NArguelles@ci.miami.fl.us Revised August 2006 APD Medicaid Waiver Services Agreement 3. The Agency for Persons with Disabilities contact person for this Agreement is: Name: Hillary Jackson, Operations Management Consultant - Medwaiver Telephone Number: 305-808-6251 Address: 401 NW 2 Avenue Suite S-811 Miami FL 33128 E-mail Address: Hillary Jacksom( 2pd.state.fl.us 4. Upon change of the representative's names, addresses, telephone numbers, and e-mail addresses, by either party, notice shall be provided in writing to the other party and the notification attached to the originals of this Agreement. Vll. INTEGRATED AGREEMENT: Only this Agreement, any attachments referenced, the Medicaid Provider Agreement, the Developmental Disabilities Waiver Services Coverage and Limitations Handbook, and the Family and Supported Livinc Waiver Services Directory, which are incorporated into this Agreement by reference, contain all the terms and conditions agreed upon by the parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this Agreement shall supersede all previous communications, representations, or agreements, either verbal or written between the parties. If any term or provision of the Agreement is found to be illegal or unenforceable, the remainder of the Agreement shall remain in full force and effect and such term or provision shall be stricken. The Provider, by signing below, attests that the Provider has received and read the entire Agreement, inclusive of its attachment's and documents as referenced in Section I, A., including the service -specific requirements and Core Assurances for enrolled providers, contained in the Developmental Disabilities Waiver Services Coverage and Limitations Handbook and the Family and Supported Living Waiver Services Directory, and understands each section and paragraph. IN WITNESS THEREOF, the parties hereto have caused this 4 page Agreement to be executed by their undersigned officials as duly authorized. PROVIDER: STATE OF FLORIDA, City of Miami -Parks & Recreation AGENCY FOR PERSONS WITH DISABILITIES SIGNED SIGNED BY: BY: NAME: NAME: Evelyn Alvarez TITLE: TITLE: Area ii Program Adrninistrator DATE: DATE: Medicaid Provider #: 0 and/or (DD Waiver) (FSL Waiver) (SEE ATTACHED SIGNATURE PAGE) Revised August 2006 aTTES T Pri3cilia k Thompson, City Clerk Department of Parks & Recreation Ernest Burkeen, Jr., Director APPROVED AS TO FORM AND CORRECTNESS.- Julie ORRECTNESS: Julie O. Bru City Attomey rj :Document signature page CITY OF III, Mla a Florida ma uaacipa. corporation V., Pedro G. s-iernand.ez, City -14ana,er APPROVED AS TO INSURANCE REQURENENTS: LeeAnn Brehm Risk Management Director