HCCBG FY15 Funding Planr , � c
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IMPORTANT INFORMATION: HCCBG ALLOCATIONS REVISIONS 2012 -13
TO: Region O Lead Agency Directors
Jim Fish, BSRI
Amanda Harrelson, Columbus County Dept. of Aging
Ben Brow, New Hanover County Senior Resource Center
Wes Davis, Pender Adult Services, Inc.
FROM: Jane Jones, Region O AAA Director JSJ
DATE: May 14, 2014
RE: SFY 2014/2015 HCCBG Allocations
Attached please find the current SFY 2015 county Home & Community Care Block Grant
(HCCBG) funding for your county. This funding is pending the authorization of the SFY 2015 State
Social Services Block Grant (SSBG) Plan by the NC General Assembly during the upcoming legislative
short session and state appropriations authorized during the session. Any adjustments necessary will be
made in late summer.
}
Please move forward on your HCCBG proces� immediately. Your county has already scheduled your
HCCBG Committee meeting in the next few weeks to discuss recommendations for funding that will be
made to the County Commissioners. After your meetings have been held, and recommendations for
funding have been made, please complete the HCCBG Forms that can be found at
httv://www.nedhhs.gov/ap-inz/cobgd&et/cob:ud,gdn.htm. (Note that form DOA 735 is for the AAA use
only). Please complete your packet and forward to Ginny Brinson as soon as you possibly can and no
later than June 18, 2014.
Please contact me if you have questions or need assistance.
CC: Ginny Brinson, AAA/COG
Chris May, COG Director
AJ McClure, COG Finance Officer
County Managers
Serving Brunswick, Columbus, New 14onover and Pender CoLnfles
1480 Harbour Drive . Wilmington, NC 28401 . (910) 395 -4553 • (800) 218 -6575 w Fax. (910) 395 -2684
www.,capefeareog.org
A- R;; x:l 0pvor1k.ni :ylA`f rnai Ve Ac7r ^EAaA E- rp'nyer/P•ngrar-
REGION' 4
• 1 ,
initn,am )iilCge-, Raq iiiierrenlS-
A , ,ess Services*
In- Naive Sesvieee*
CongsegaEe Nui;i iun
Hors Delivered e2is
oizfl
ACC ill -F- ome 'I&CC G
r' ,1
140
H &CCBG
Oval
lv',axh
f'otal
57,887
6,432
554,319
48,239
5,360
53,599
IA2,720
15.669
159,689
121,79-4
13,533
135,327
Match T
07,793 1,07;,!
ATTENDEES:
Elizabeth Grace
Frannie Shively
Jane Jones
Dick Hayes
THE HOME AND COMMUNITY CARE BLOCK GRANT
ADVISORY COMMITTEE MEETING
May 22, 2014
GUESTS:
Ben Brow
Yvette Gosline
Ginny Brinson
Teresa Hewett
Gwen Stahl
Diane Berry
ABSENT:
Kathy Mullen (excused)
Kathy Rawlings (excused)
Emma Saunders
Susan Sprenger
Ellen Connor
Greg Kennedy
The Advisory Committee meeting was called to order by Elizabeth "Betty" Grace at 2:15 PM.
Betty Grace requested that Ben Brow present recommendations of HCCBG allocation.
Ben Brow presented allocation recommendations as noted on proposal (enclosed).
Ben explained that the allocated funds are lower than last years' allocation by $15,539. Medical Transportation
is recommended to bare the larger reduction ($6,050) due to the availability of two (2) DOT grants to provide
transportation service. Home Delivered and Congregate Meals funding will be reduced next fiscal year by 10
cents per meal due to a lower bid received during the Request for Proposal for Nutrition Services. Senior
Center operations funding was reduced in postage and supplies.
Susan Sprenger, Adult Protective Services, inquired about the allocation to Information and Options Counseling
and usage of the Senior Resource Center for services and activities.
Jane Jones presented information in reference to Option Counseling (social workers trained and certified to
provide resource information for clients to make educated decisions on how they wish to proceed with the
options available to them). Jane explained that a minimum of one Social Worker and Supervisor will need to be
qualified as Options Counselor by December 31, 2014, in order to receive block grant funding. New Hanover
County has already begun the training of all three SRC social workers for Options Counseling certification.
Funding is needed to complete the required training. Options counseling was introduced several years ago but
is now being aligned with funding eligibility.
Chris Dodson, Transportation Coordinator, presented information regarding the SRC transportation program
reductions in cost by using the county van for nutrition and shopping trips, and taxis for dialysis appointments
to reduce the wait time and ride time for the client. Other transportation grant funds (ROAP and DOT) reduce
the demand for HCCBG funds for transportation, making them available for other needed services.
Greg Kennedy presented information about the activities people over the age of 60 can be involved in at the
senior center such as Aging/ Emotional/Grief /Dementia/Parkinson /Prostate Cancer /Blind and Visually
Impaired/Deaf and Hard of Hearing Support Groups, Tai Chi, Men's Exercise, Crafts, Ballet, Senior Tar Heel
Presentation, Taxes, Meet the Candidates, and one -stop and precinct voting. Recently, the SRC broke the
record as having the largest turnout for a Hearing Screening event with 70 screened and overflow notified of
next available screening.
Yvette Gosline explained that the current ratio of clients (300) to social worker and HDM driver in the Home
Delivered program works well for detailed assessment and interview time with the clients. HDM routes (30)
are manageable for volunteer drivers to deliver the meals within the TILT time limit, and volunteer drivers and
sub drivers are currently maintained with the rare use of SRC staff to deliver meals. Information and Options
Counseling has triaged and served 2,107 clients thus far this year.
Question was raised if a quorum was present. Internet research revealed that v.-ithout a previously set required
number that those present having attended majority of meetings was sufficient. Absentee voting members to be
notified by email for comments and/or input. It was recommended that a future meeting address the issues and
establish policies and procedures that would be representative of County protocol for all future meetings.
Betty Grace requested a motion. Dick Hayes proposed to accept the proposal as presented, seconded by Frannie
Shively. Motion approved by all voting members. No negative votes. No negative remarks from other
attendees.
No further questions or comments.
Betty Grace moved that the meeting be adjourned, seconded by Dick Hayes.
Meeting was adjourned at 4:15 PM.
Respectfully submitted by B. Brow, Manager SRC
County: New Hanover
Date:
05/22/2014
SFY
2014 -2015
Home & Community Care Block Grant Meeting
Worksheet
Decisions
Is this a budget revision?
Yes No X
Federal/State Home & Community Care Block Grant Funding:
Total $970,140 FY
2014 -2015
What amount of monies should the identified services receive?
12/13
Recommended
Service
Provider Allocation
Allocation
Difference
Transportation: General
SRC 28,000
28,000
-0-
Medical
SRC 54,944
48,894
< $ 6,050
Home Delivered Meals
SRC 296,097
290,440
< $ 5,657
Congregate
SRC 82,248
80,823
' $ 1,425
Case Assistance /I &R
SRC 180,629
180,579
$ 50
Senior Center Operations
SRC 34,275
31,918
< $2,357
In Home Aide Services
SRC (Interim) 208,166
208,166
-0-
Adult Day Care/Health
SRC (Elderhaus, Inc.) 101,320
101,320
-0- _.
HCCBG Total
$ $985,679
$ 970,140
$15,539
0�7 iS'�
r
DOA -730
(Rev. 2114)
Home and Community Care Block Grant for Older Adults
County Funding Plan
Identification of Agency or Office with Lead Responsibility for County Funding Plan
County: New Hanover July 1, 2014 through June 30, 2015
The agency or office with lead responsibility for planning and coordinating the Count}
Funding Plan recommends this funding plan to the Board of Commissioners as a
coordinated means to utilize community -based resources in the delivery of
comprehensive aging services to older adults and their families.
NHC Senior Resource Center
(Name of agency /office with lead responsibility
Au razed signature (date)
Avril Pinder, Asst. CoqnV Manager
(Type name and title of signatory agent)
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DOA -733
(Rev. 2/14)
Home and Community Care Block Grant for Older Adults
County Funding Plan
July 1, 2014 through June 30, 2015
Methodology to Address Service Needs of Low Income (Including Low- Income Minority
Elderly), Rural Elderly and Elderly with Limited English Proficiency
(Older Americans Act, Section 305(a)(2)(E))
Community Service Provider Elderhaus Inc.
County New Hanover
The Older Americans Act requires that the service provider attempt to provide services to
low - income minority individuals in accordance to their need for aging services. The
community service provider shall specify how the service needs of low income, low -
income (including low income minority elderly), rural elderly and elderly with
limited English proficiency will be met through the services identified on the Provider
Services Summary (DOA -732). This narrative shall address outreach and service
delivery methodologies that will ensure that this target population is adequately served
and conform with specific objectives established by the Area Agency on Aging, for
providing services to low income minority individuals. Additional pages may be used as
necessary.
Elderhaus Inc. will make every attempt to locate and provide services for Low income,
minority elderly, rural elderly and elderly with English proficiency by utilizing the
following methods:
We advertise our services in the Wilmington Journal, a weekly minority owned paper that
is distributed in the African- American community. Outreach to the Hispanic community
through advertisements/brochures, promotion at local festivals.
We place brochures in the various Churches in New Hanover, Pender & Brunswick
counties. We use the city /county access channels to share information about our
program.
DOA -734
(revised 2114)
July 1, 2014 through June 30, 2015
Home and Community Care Block Grant for Older Adults
Community Service Provider
Standard Assurances
L 5 't C_ agrees to provide services through the Home and
(Name of Provider)
Community Care Block Grant, as specified on the Provider Services Summ (DOA -732) in
accordance with the following:
Services shall be provided in accordance with requirements set forth in:
a) The County Funding Plan;
b) The Division of Aging Home and Community Care Block Grant Procedures
Manual for Community Service Providers; and
C) The Division of Aging Services Standards Manual, Volumes I through IV or at
http: / /w-ww. ncdhhs .gov /aginWmonitor /mpoligy.httn .
Community service providers shall monitor any contracts with providers of Block
Grant services and take appropriate measures to ensure that services are provided in
accordance with the aforementioned documents.
2. Priority shall be given to providing services to those older persons with the greatest
economic or social needs. The service needs of low - income minority elderly will be
addressed in the manner specified on the Methodology to Address Service Needs of
Low - Income (Including Low Income Minority Elderly), Rural elderly and Elderly
limited English Proficiency format, (DOA -733).
3. The following service authorization activities will be carried out in conjunction with
all services provided through the Block Grant:
a) Eligibility determination;
b) Client intake /registration;
c) Client assessment/reassessments and quarterly visits, as appropriate;
d) Determining the amount of services to be received by the client; and
C) Reviewing cost sharing/voluntary contributions policies with eligible clients.
4. All licenses, permits, bonds, and insurance necessary for carrying out Block Grant
DOA -734
(revised 2114)
Services will be maintained by the community service provider and any contracted
providers.
5. As specified in 45 CFR 92.36(b)(11), community service providers shall have
procedures for settling all contractual and administrative issues arising out of
procurement of services through the Block Grant. Community service providers shall
have procedures governing the evaluation of bids for services and procedures through
which bidders and contracted providers may appeal or dispute a decision made by the
community service provider.
6. Applicant/Client appeals shall be addressed as specified in Section 7 of the Division of
Aging Home and Community Care Block Grant Manual for Community Service
Providers, dated February 17, 1997.
7. Community service providers are responsible for providing or arranging for the
provision of required local match, as specified on the Provider Services Sumrnary,
(DOA -732). Local match shall be expended simultaneously with Block Grant
funding.
8. Providers expending $500,000 or more in federal financial assistance through the
Home and Community Care Block Grant, or in combination with other federal funding
shall receive an annual independent audit which meets the requirements of the
Division of Aging Program Audit Guide for Aging Services, applicable North Carolina
General Statutes and Local Government Commission requirements, and OMB Circular
A -133. For - profit community service providers shall have an annual compliance audit
which meets the requirements of A -133. The audit shall be performed within nine (9)
months of the close of the provider's fiscal year. Upon completion of the audit, non-
profit and for -profit providers shall provide a copy of the audit report and any opinion
letter simultaneously to the County and the Area Agency. Federal funds will not
reimburse the cost of a single audit if the total of all federal funds expended by the
provider is less than $500,000. (Refer to New Audit Requirements section at
htip:// www. ncdhhs .gov/aainp-/monitor /mpolicy.htm ).
9. Compliance with Equal Employment Opportunity and Americans with Disabilities Act
requirements, as specified in paragraph fourteen (14) of the Agreement for the
Provision of Comfy Aging -Based Services (DOA -735) shall be maintained.
DOA -734
(revised 2114)
10. Providers In -Home Aide, Horne Health, Housing and Home Improvement, and Adult
Day Care or Adult Day Health Care shall sign and return the attached assurance to the
area agency on aging indicating that recipients of these services have been informed of
their client rights, as required in Section 314 of the 2006 Amendments to the Older
Americans Act.
616114
i (Authorized Signature) (Date)
Standard Assurance To Comply with Older Americans Act
Requirements Regarding Clients Rights
For
Agencies Providing In -Home Services through the
Home and Community Care Block Grant for Older Adults
As a provider of one or more of the services listed below, our agency agrees to notify all Home
and Community Care Block Grant clients receiving any of the below listed services provided by
this agency of their rights as a service recipient. Services in this assurance include:
-Home Aide
• Home Care (home health)
• Housing and Home Improvement
• Adult Day Care or Adult Day Health Care
Notification will include, at a minimum, an oral review of the information outlined below as well
as providing each service recipient with a copy of the information in written form. In addition,
providers of in -home services will establish a procedure to document that client rights
information has been discussed with in -home services clients (e.g. copy of signed Client Bill of
Rights statement).
Clients Rights information to be communicated to-service recipients will include, at a minimum,
the right to:
• be fully informed, in advance, about each in -home service to be provided and any
change and any change in service(s) that may affect the wellbeing of the participant;
participate in planning and changing any in -home service provided unless the client
is adjudicated incompetent;
voice a grievance with respect to service that is or fails to be provided, without
discrimination or reprisal as a result of voicing a grievance;
• confidentiality of records relating to the individual;
have property treated with respect; and
• be fully informed both orally and in writing, in advance of receiving an in -home
service, of the individual's rights and obligations.
Client Rights will be distributed to, and discussed with, each new client receiving one or more of
the above listed services prior to the onset of service. For all existing clients, the above
information will be provided no later than the next regularly scheduled service reassessment.
Agency Name: Elderhaus, Inc.
Name of Agency
Signature:
Date: Z5�
(Please reten this form to your Area Agency on Aging and retain a copy for your files.)
CLIENT/PATIENT RIGHTS
1. You have the right to be fully informed of all your rights and responsibilities as a
client/patient of the program.
2. You have the right to appropriate and professional care relating to your needs.
3. You have the right to be fully informed in advance about the care to be provided by the
program.
4. You have the right to be fully informed in advance of any changes in the care that you may
be receiving and to give informed consent to the provision of the amended care.
5. You have the right to participate in determining the care that you will receive and in altering
the nature of the care as your needs change.
6. You have the right to voice you grievances with respect to care that is provided and to
expect that there will be no reprisal for the grievance expressed.
7. You have the right to expect that the information you share with the agency will be
respected and held in strict confidence, to be shared only with your written consent and as it
relates to the obtaining of other needed community services.
8. You have the right to expect the preservation of your privacy and respect for your property.
9. You have the right to receive a timely response to you request for service.
10. You shall be admitted for service only if the agency has the ability to provide safe and
professional care at the level of intensity needed.
11. You have the right to be informed of agency policies, changes, and costs for services.
12. If you are denied service solely on you inability to pay, you have the right to be referred
elsewhere.
13. You have the right to honest, accurate information regarding the industry, agency and of
the program in particular.
14. You have the right to be fully informed about other services provided by this agency.
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Supplement to Provider Services Summary
Interim HealthCare of the Eastern Carolinas, Inc.
In -Home Services Detail
Name of Community Service Provider
DOA -732 Supplement (Effective: 7/08)
July 1, 2014 through June 30, 2015
Revision #
A
B
C
F
G
H
HCCBG
Required
Net
Projected
Projected
Projected
In -Home
Local
Service
HCCBG
Reimbursement
HCCBG
In -Home Services
Funding
Match
Cost
Units
Rate
Clients
Level I - 235 Respite
0
0
Level I - 041 H Mgmt
34000
3778
37778
2225
16.9788
10
Subtotal Level I
34000
3778
37778
2225
t ' O ���t,
t,;'��,,<;Si��R
10
Level II - 236 Respite
0
0
Level II - 042 PC
92166
10241
102407
5934
17.2576
32
Level II - 043 H Mgmt
0
0
Subtotal Level II
92166
10241
102407
5934
32
��,��,�,,�3>} �a�1��1�,i;,��F
Level III - 237 Respite
0
0
Level Ill - 044 H Mgmt
0
0
Level III - 045 PC
82000
9111
91111
5222
17.4476
15
Subtotal Level III
82000
9111
91111
5222
1,�a'���' "�<<;,f
WAN,
Level IV - 238 Respite
0
0
Level IV - 046 H Mgmt
0
0
Subtotal Level IV
0
0
0
0
t #�
0
'01i �, s6 +�
,
'i
,
Total
208166
23130
231296
13381
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DOA -733
(Rev. 2114)
Home and Community Care Block Grant for Older Adults
County Funding Plan
July 1, 2014 through June 30, 2015
Methodology to Address Service Needs of Low Income (Including Low - Income Minority
Elderly), Rural Elderly and Elderly with Limited English Proficiency
(Older Americans Act, Section 305(a)(2)(E))
Community Service Provider Interim HealthCare_ of the Eastern Carolinas, Inc.
County New Hanover
The Older Americans Act requires that the service provider attempt to provide services to low -
income minority individuals in accordance to their need for aging services. The community
service provider shall specify how the service needs of low income, low- income (including low
income minority elderly), rural elderly and elderly with limited English proficiency will be
met through the services identified on the Provider Services Summary (DOA -732). This
narrative shall address outreach and service delivery methodologies that will ensure that this
target population is adequately served and conform with specific objectives established by the
Area Agency on Aging, for providing services to low income minority individuals. Additional
pages may be used as necessary.
Interim HealthCare of the Eastern Carolinas, Inc. shall provide In Home Aide Level services
to qualified consumers in New Hanover County as outlined in the Home and Community Care Block
Grant for Older Adults. Those determined to be in need of In Home Aide services will be eligible for
services regardless of their income although some recipients will be asked to voluntarily participate
in the consumer contributions program.
Interim will share information about the In Home Aide program with local doctors, hospital
discharge planners, hospice agencies, skilled agencies, senior advocacy groups, Adult Protective
Services and the Community Alternatives Program agency (CAP). The program information will be
disseminated via written and oral education as well as through weekly marketing visits and phone
calls made by Interim.
Interim will admit low - income, including low income minority elderly consumers, rural
elderly and rural elderly and elderly with limited English proficiency as well older adults (age 60 and
over) using the following priorities:
*Older adults for whom the need for Adult Protective Services has been substantiated by the
Department of Social Services and the service is needed as part of the adult protective services plan.
• Older adults who are at risk of abuse, neglect, and /or exploitation.
• Older adults with extensive impairments in activities of daily living (ADL's), or instrumental
activities of daily living (IADL's), who are at risk of placement or substitute care.
* Older adults with extensive ADL or IADL impairments.
* Older adults with less extensive (1 -2) ADL or IADL impairments.
* Well older adults.
Interim HealthCare of the Eastern Carolinas, Inc. complies with Title VI of the Civil Rights
Act of 1964, the Rehabilitation Act of 1973. And the Americans with Disabilities Act of 1990.
DOA -734
(revised 2114)
July 1, 2014 through June 30, 2015
Home and Community Care Block Grant for Older Adults
Community Service Provider
Standard Assurances
Interim HealthCare of the Eastern Carolinas, Inc. agrees to provide services through the Home
and Community Care Block Grant, as specified on the Provider Services Summ (DOA -
732) in accordance with the following:
1. Services shall be provided in accordance with requirements set forth in:
a) The County Funding Plan;
b) The Division of Aging Home and Community Care Block Grant Procedures
Manual for Community Service Providers; and
C) The Division of Aging Services Standards Manual, Volumes I through IV or at
http: / /www.ncdhhs.goy /aging /monitor /mpolicy.htm .
Community service providers shall monitor any contracts with providers of Block
Grant services and take appropriate measures to ensure that services are provided in
accordance with the aforementioned documents.
2. Priority shall be given to providing services to those older persons with the greatest
economic or social needs. The service needs of low - income minority elderly will be
addressed in the manner specified on the Methodology to Address Service Needs of
Low - Income &cludigg Low Income Minority Elderly), Rural elderly and Elderly with
limited English Proficiency format, (DOA -733).
3. The following service authorization activities will be carried out in conjunction with
all services provided through the Block Grant:
a) Eligibility determination;
b) Client intake /registration;
c) Client assessment/reassessments and quarterly visits, as appropriate;
d) Determining the amount of services to be received by the client; and
e) Reviewing cost sharing/voluntary contributions policies with eligible clients.
4. All licenses, permits, bonds, and insurance necessary for carrying out Block Grant
Services will be maintained by the community service provider and any contracted
DOA -734
(revised 2114)
providers.
5. As specified in 45 CFR 92.36(b)(11), community service providers shall have
procedures for settling all contractual and administrative issues arising out of
procurement of services through the Block Grant. Community service providers shall
have procedures governing the evaluation of bids for services and procedures through
which bidders and contracted providers may appeal or dispute a decision made by the
community service provider.
6. Applicant/Client appeals shall be addressed as specified in Section 7 of the Division of
Aging Home and Community Care Block Grant Manual for Community Service
Providers, dated February 17, 1997.
7. Community service providers are responsible for providing or arranging for the
provision of required local match, as specified on the Provider Services Summary,
(DOA -732). Local match shall be expended simultaneously with Block Grant
funding.
Providers expending $500,000 or more in federal financial assistance through the
Home and Community Care Block Grant, or in combination with other federal funding
shall receive an annual independent audit which meets the requirements of the
Division of Aging Program Audit Guide for Aging Services, applicable North Carolina
General Statutes and Local Government Commission requirements, and OMB Circular
A -133. For -profit community service providers shall have an annual compliance audit
which meets the requirements of A -133. The audit shall be performed within nine (9)
months of the close of the provider's fiscal year. Upon completion of the audit, non-
profit and for -profit providers shall provide a copy of the audit report and any opinion
letter simultaneously to the County and the Area Agency. Federal funds will not
reimburse the cost of a single audit if the total of all federal funds expended by the
provider is less than $500,000. (Refer to New Audit Requirements section at
http://w-ww.ncdhhs.goy/aizing /monitor/moolicy.htm ).
9. Compliance with Equal Employment Opportunity and Americans with Disabilities Act
requirements, as specified in paragraph fourteen (14) of the Agreement for the
Provision of County Aging -Based Services (DOA -735) shall be maintained.
DOA -734
(revised 2114)
10. Providers In -Home Aide, Home Health, Housing and Home Improvement, and Adult
Day Care or Adult Day Health Care shall sign and return the attached assurance to the
area agency on aging indicating that recipients of these services have been informed of
their client rights, as required in Section 314 of the 2006 Amendments to the Older
Americans Act.
Jr- -3o -.=)o/ 9t
(Authorized Signature) (Date)
Standard Assurance To Comply with Older Americans Act
Requirements Regarding Clients Rights
For
Agencies Providing In -Home Services through the
Home and Community Care Block Grant for Older Adults
As a provider of one or more of the services listed below, our agency agrees to notify all Home
and Community Care Block Grant clients receiving any of the below listed services provided by
this agency of their rights as a service recipient. Services in this assurance include:
• In -Home Aide
• Home Care (home health)
• Housing and Home Improvement
• Adult Day Care or Adult Day Health Care
Notification will include, at a minimum, an oral review of the information outlined below as well
as providing each service recipient with a copy of the information in written form. In addition,
providers of in -home services will establish a procedure to document that client rights
information has been discussed with in -home services clients (e.g. copy of signed Client Bill of
Rights statement).
Clients Rights information to be communicated to service recipients will include, at a minimum,
the right to:
• be fully informed, in advance, about each in -home service to be provided and any
change and any change in service(s) that may affect the wellbeing of the participant;
• participate in planning and changing any in -home service provided unless the client
is adjudicated incompetent;
• voice a grievance with respect to service that is or fails to be provided, without
discrimination or reprisal as a result of voicing a grievance;
• confidentiality of records relating to the individual;
• have property treated with respect; and
• be fully informed both orally and in writing, in advance of receiving an in -home
service, of the individual's rights and obligations.
Client Rights will be distributed to, and discussed with, each new client receiving one or more of
the above listed services prior to the onset of service. For all existing clients, the above
information will be provided no later than the next regularly scheduled service reassessment.
Agency Name: Interim HealthCare of the Eastern Carolinas, Inc
Name of Agency Administrator: Donna "Lou" Byrd
Signature: DC.._ Date: 03/24/2014
(Please return this form to your Area Agency on Aging and retain a copy for your files.)
CLIENT /PATIENT RIGHTS
1. You have the right to be fully informed of all your rights and responsibilities as a
client/patient of the program.
2. You have the right to appropriate and professional care relating to your needs.
3. You have the right to be fully informed in advance about the care to be provided by the
program.
4. You have the right to be fully informed in advance of any changes in the care that you may
be receiving and to give informed consent to the provision of the amended care.
5. You have the right to participate in determining the care that you will receive and in altering
the nature of the care as your needs change.
6. You have the right to voice you grievances with respect to care that is provided and to
expect that there will be no reprisal for the grievance expressed.
7. You have the right to expect that the information you share with the agency will be
respected and held in strict confidence, to be shared only with your written consent and as it
relates to the obtaining of other needed community services.
8. You have the right to expect the preservation of your privacy and respect for your property.
9. You have the right to receive a timely response to you request for service.
10. You shall be admitted for service only if the agency has the ability to provide safe and
professional care at the level of intensity needed.
11. You have the right to be informed of agency policies, changes, and costs for services.
12. If you are denied service solely on you inability to pay, you have the right to be referred
elsewhere.
13. You have the right to honest, accurate information regarding the industry, agency and of
the program in particular.
14. You have the right to be fully informed about other services provided by this agency.
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DOA -733
(Rev. 2114)
Home and Community Care Block Grant for Older Adults
County Funding Plan
July 1, 2014 through June 30, 2015
Methodology to Address Service Needs of Low Income (Including Low - Income Minority
Elderly), Rural Elderly and Elderly with Limited English Proficiency
(Older Americans Act, Section 305(a)(2)(E))
Community Service Provider New Hanover County Senior Resource Center
County NEW HANOVER
The Older Americans Act requires that the service provider attempt to provide services to
low- income minority individuals in accordance to their need for aging services. The
community service provider shall specify how the service needs of low income, low -
income (including low income minority elderly), rural elderly and elderly with
limited English proficiency will be met through the services identified on the Provider
Services Summary (DOA -732). This narrative shall address outreach and service
delivery methodologies that will ensure that this target population is adequately served
and conform to specific objectives established by the Area Agency on Aging, for
providing services to low income minority individuals. Additional pages may be used as
necessary.
Though New Hanover County is second smallest in area (328 Sq. miles) in the State, it is
one of the most populous as its cog= seat, Wilmin tgton, is one of the state's largest
cities. At the 2010 census, the population was 202,667, an increase of 26.4 percent from
160,367 at the 2000 census. The population density equates to approximately- 1,058 per
square mile and approximately 14.2% over the age of 65 years. According to the 2010
census 15.9% live below the poverty level. The NHC Senior Resource Center (NHC-
SRC) has developed a case assistance program. (Life Enrichment Program) committed to
identifying all the needs of the individuals that come in contact with our staff and
volunteers.
The mission of the Life Enrichment Program is to provide quality and responsive services
to older adults and their families. It is the goal of this program to promote social,
physical, economic and emotional well- being, while encouraging maximum
independence and improving the quality of life for older adults and their caregivers.
Services provided by LEP include five areas of focus:
Information Services: The gateway to assistance
Home Based Services: Bringing resources to the door
Protection & Advocacy: Ensuring the right to safety and dignity eaith Independence Services: Promoting wellness
Community Enrichment: Enhancing quality of life
Social Workers assess needs and link individuals with the most appropriate services. The
intake process begins with an inquiry from a prospective client, family member, a
member of the community, or an agency. Our friendly social workers are very
knowledgeable about not only services provided directly by the SRC, but those offered by
other community agencies. We act as a community liaison between the client, family and
multiple community organizations. Our team responds to the growing needs of our Older
Adult Community, and advocates on their behalf. We evaluate potential clients for
programm eligibility and participate in the development of community resources and
services.
The SRC has a Case Worker located at the building entrance who is dedicated to
providing service or triage to the appropriate individual to provide assistance. A kiosk for
E -Pass has been installed in the SRC lobby for senior access and hands -on assistance (if
needed) from a case worker to make the use of the system less frustrating and still private.
Home visits are offered to engage and assist families, who are in the process of planning
for loved ones.
The Center continues to maintain connections with local community sites (churches,
senior housing, etc.) in low income and rural communities for presentations and
educational events for all outreach programs. Transportation assistance is also publicized
for these events when funding is available. The Center is also a site for early voting and
primary elections with access to candidate forums and transportation as available for
many on -site events. Our website is being re- designed to be more senior friendly and
promote the many services offered at the SRC.
at
DOA -734
(revised 2114)
July 1, 2014 through June 30, 2015
Home and Community Care Block Grant for Older Adults
Community Service Provider
Standard Assurances
_New Hanover County agrees to provide services through the Home and Community
(Name of Provider)
Care Block Grant, as specified on the Provider Services Summary (DOA -732) in
accordance with the following:
Services shall be provided in accordance with requirements set forth in
a) The County Funding Plan;
b) The Division of Aging Home and Community Care Block Grant Procedures
Manual for Community Service Providers; and
c) The Division of Aging Services Standards Manual, Volumes I through IV or
hqp://www.ncdhhs.gov/agiLig/monitoL/mpolicy.htm
Community service providers shall monitor any contracts with providers of Block
Grant services and take appropriate measures to ensure that services are provided in
accordance with the aforementioned documents.
2. Priority shall be given to providing services to those older persons with the greatest
economic or social needs. The service needs of low- income minority elderly will be
addressed in the manner specified on the Methodology to Address Service Needs of
Law - Income (Including Low Income Minority Elderly). Rural elderly and Elderly
with limited English ProficiencX format, (DOA -733).
3. The following service authorization activities will be carried out in conjunction with
all services provided through the Block Grant:
a) Eligibility determination;
b) Client intake /registration;
C) Client assessment /reassessments and quarterly visits, as appropriate;
d) Determining the amount of services to be received by the client; and
e) Reviewing cost sharing /voluntary contributions policies with eligible clients.
DOA -734
(revised 2114)
4. All licenses, permits, bonds, and insurance necessary for carrying out Block Grant
Services will be maintained by the community service provider and any contracted
providers.
5. As specified in 45 CFR 92.36(b)(11), community service providers shall have
procedures for settling all contractual and administrative issues arising out of
procurement of services through the Block Grant. Community service providers
shall have procedures governing the evaluation of bids for services and procedures
through which bidders and contracted providers may appeal or dispute a decision
made by the community service provider.
6. Applicant /Client appeals shall be addressed as specified in Section 7 of the Division
of Aging Home and Community Care Block Grant Manual for Community Service
Providers, dated February 17, 1997.
7. Community service providers are responsible for providing or arranging for the
provision of required local match, as specified on the Provider Services Summary,
(DOA -732). Local match shall be expended simultaneously with Block Grant
funding.
8. Providers expending $500,000 or more in federal financial assistance through the
Home and Community Care Block Grant, or in combination with other federal
funding shall receive an annual independent audit which meets the requirements of
the Division of Aging Program Audit Guide for Aging Services, applicable North
Carolina General Statutes and Local Government Commission requirements, and
OMB Circular A -133. For -profit community service providers shall have an annual
compliance audit which meets the requirements of A -133. The audit shall be
performed within nine (9) months of the close of the provider's fiscal year. Upon
completion of the audit, non - profit and for - profit providers shall provide a copy of
the audit report and any opinion letter simultaneously to the County and the Area
Agency. Federal funds will not reimburse the cost of a single audit if the total of all
federal funds expended by the provider is less than $500,000. (Refer to New Audit
Requirements section athiip://www.ncdhhs.gov/aging/monitor/Mpolicy.ht ).
9. Compliance with Equal Employment Opportunity and Americans with Disabilities
Act requirements, as specified in paragraph fourteen (14) of the Agreement for the
Provision of County Aging -Based Services (DOA -735) shall be maintained.
DOA -734
(revised 2114)
1. Providers In -Home Aide, Home Health, Housing and Home Improvement, and
Adult Day Care or Adult Day Health Care shall sign and return the attached
assurance to the area agency on aging indicating that recipients of these services
have been informed of their client rights, as required in Section 314 of the 2006
Amendments to the Older Americans Act.
Standard Assurance To Comply with Older Americans Act
Requirements Regarding Clients Rights
For
Agencies Providing In -Home Services through the
Home and Community Care Block Grant for Older Adults
As a provider of one or more of the services listed below, our agency agrees to notify all Home
and Community Care Block Grant clients receiving any of the below listed services provided by
this agency of their rights as a service recipient. Services in this assurance include:
In -Home Aide
• Home Care (home health)
• Housing and Home Improvement
• Adult Day Care or Adult Day Health Care
Notification will include, at a minimum, an oral review of the information outlined below as well
as providing each service recipient with a copy of the information in written form. In addition,
providers of in -home services will establish a procedure to document that client rights
information has been discussed with in -home services clients (e.g. copy of signed Client Bill of
Rights statement).
Clients Rights information to be communicated to service recipients will include, at a minimum,
the right to:
• be fully informed, in advance, about each in -home service to be provided and any
change and any change in service(s) that may affect the wellbeing of the participant;
• participate in planning and changing any in -home service provided unless the client
is adjudicated incompetent;
• voice a grievance with respect to service that is or fails to be provided, without
discrimination or reprisal as a result of voicing a grievance;
• confidentiality of records relating to the individual;
• have property treated with respect; and
• be fully informed both orally and in writing, in advance of receiving an in-home
service, of the individual's rights and obligations.
Client Rights will be distributed to, and discussed with, each new client receiving one or more of
the above listed services prior to the onset of service. For all existing clients, the above
information will be provided no later than the next regularly scheduled service reassessment.
Agency Name: New Hanover County Senior Resource Center
Name of Agency Administrator: Avril Pinder, Assistant County Manager
Signature: Date: a v cc
(Please return this form to your Area Agency on Aging and retain a copy for your files.)
CLIENT/PATIENT RIGHTS
1 a You have the right to be fully informed of all your rights and responsibilities as a
client/patient of the program.
2. You have the right appropriate and professional care relating to your needs.
3. You have the right to be fully informed in advance about the care to be provided by the
program.
4. You have the right to be fully informed in advance of any changes in the care that you may
be receiving and to give informed consent to the provision of the amended care.
5. You have the right to participate in determining the care that you will receive and in altering
the nature of the care as your needs change.
6. You have the right to voice you grievances with respect to care that is provided and to
expect that there will be no reprisal for the grievance expressed.
7. You have the right to expect that the information you share with the agency will be
respected and held in strict confidence, to be shared only with your written consent and as it
relates to the obtaining of other needed community services.
8. You have the right to expect the preservation of your privacy and respect for your property.
9. You have the right to receive a timely response to you request for service.
10. You shall be admitted for service only if the agency has the ability to provide safe and
professional care at the level of intensity needed.
11. You have the right to be informed of agency policies, changes, and costs for services.
12. If you are denied service solely on you inability to pay, you have the right to be referred
elsewhere.
13. You have the right to honest, accurate information regarding the industry, agency and of
the program in particular.
14. You have the right to be fully informed about other services provided by this agency.
21
Start date: 6/10/2014
From: Teresa Hewett, Finance Department (7408)
Signatures required:
Lisa Wurtzbacher, Finance Director
Avril Pinder, Assistant County Manager
Woody White, Chairman
ine(s) of document(s) attached:
2 original — Home and Community Care Block Grant ( HCCBG) FY 15 Funding
Allocation Plan
Explanation of document(s):
Attached are two original HCCBG FY15 Funding AIlocation Plans. The FY15 recommended
budget includes appropriation for these grant funds. Please let me know if you have any
questions. Thank you, Teresa
----------- --- ---- ----------,._ -wfor finance department iise -------- -------------- -- ------------- -----------
DATE ADDED TO LASERFICHE
PICKED UP BY:
Print Name & Date
Signature
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