HomeMy WebLinkAboutExhibit00
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 of Miami - Department of Parks & Recreation, hereinafter referred to as the "Provider".
Pursuant to the terms and conditions of this Agreement, APD authorizes the Provider to furnish (BUDGET
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.
1. 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:
1. The Developmental Disabilities Waiver Services Coverage and Limitations Handbook, dated July
2007, and any updates or replacements thereto. The Handbook can be found at the Medicaid fiscal
agent's Web Portal: http://mymedicaid-florida.com. Click on Public Information for Providers, then on
Provider Support, and then on Provider Handbooks. 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 bound.
2. Attachment A, B, and/ or C, providing individually negotiated unit rates of payment for services not
already established and available on APD's website: http://apd.myflorida.com/providers, as referenced
in II.E., 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 AHCA. The Provider must at all times during the term of this Agreement,
maintain a current and valid Medicaid Provider Agreement with AHCA, and comply with the terms and
conditions of the Medicaid Provider Agreement.
ll. 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 (AHCA), 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 Plan (QIP) for needed corrections. The Provider
hereby agrees to correct all noted deficiencies identified by APD, AHCA, 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, AHCA, 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 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.
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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
Paris 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 AHCA.
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 shalt 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.
D. 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/providers. 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.]
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F. Return of Funds
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, CMS-1500. 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. TERMINATION:
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.
B. This Agreement may be terminated for the Provider's unacceptable performance, non-performance or
misconduct upon no Tess 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 APD 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 7/1/2014 or the date on which it has been signed by both parties, whichever
is later, and shall terminate, 6/30/2017, 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: Nadia N. Arquelles-Goicoechea
Telephone Number: 305-960-4962
Address: 4560 NW 47 Terrace, Miami, FL 33126
E-mail Address: narquelles(c�miamigov.com
2. The representative of the Provider responsible for administration of the services under this Agreement is:
Name: Nadia N. Arquelles-Goicoechea
Telephone Number: 305-960-4962
Address: 4560 NW 47 Terrace, Miami, FL 33126
E-mail Address: narquelles(a�miamigov.com
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3. The Agency for Persons with Disabilities contact person for this Agreement is:
Name: Hillary Jackson, Regional Program Supervisor
Telephone Number: 305-808-6251
Address: 401 NW 2nd Avenue, Suite S 811, Miami, FL 33128
E-mail Address: Hillary.Jackson c(�apdcares.orq
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.
VII. 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 SupportedLivingWaiver
Services Directory, which are incorporated into this Agreement by reference, contain all the terms and
conditions agreec 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 attachments and documents as referenced in Section I, Al 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: City of Miami - Department of
Parks & Recreation
SIGNED
BY:
NAME:
TITLE:
DATE:
See page 5
Please see attached City of
Miami Signature Page
STATE OF FLORIDA,
AGENCY FOR PERSONS WITH DISABILITIES
SIGNED
BY:
NAME: Evelyn Alvarez
Regional Operations Manager -
TITLE: Southern Region
DATE:
MEDICAID PROVIDER
ID: 024990496
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ADDENDUM
The following terms and conditions are incorporated into and form a part of the
Medicaid Waiver Services Agreement, dated July 1, 2014 to June 30, 2017, between the
Florida Agency for Persons with Disabilities, 401 NW 2nd Avenue, Suite S-811, Miami,
Florida 33128 (hereinafter referred to as the "APD") and the City of Miami acting by
and through its Department of Parks and Recreation, a Florida municipal corporation
located in Miami -Dade County, (hereinafter referred to as the "Provider").
Addendum Controlling. In the event there is a conflict between the terms and conditions
of the Agreement or any attachments, exhibits or addenda thereto and this Addendum,
this Addendum shall control.
The following language will be added to Sections C and D:
C. Indemnification
The City of Miami is self insured in accordance and subject to the Limitations as
set forth in Section 768.28 of the Florida Statues.
D. Insurance
The City of Miami is self insured in accordance and subject to the Limitations as
set forth in Section 768.28 of the Florida Statues.
rsr:Document Addendum for Medicaid Waiver Services Agreement with City of Miami and Signature Page (2).doc
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ATTEST: CITY OF MIAMI, a Florida
Municipal Corporation
TODD B. HANNON DANIEL J. ALFONSO
CITY CLERK CITY MANAGER
Date: Date:
APPROVED AS TO APPROVED AS TO
INSURANCE REQUIREMENTS: INSURANCE REQUIREMENTS:
ANN. ,-MARIE SHARPE
RISK MANAGEMENT
ADMINISTRATOR
VICTORIA MENDEZ
CITY ATTORNEY
Date: Date:
rsr:Document Addendum for Medicaid Waiver Services Agreement with City of Miami and Signature Page (2).doc
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