OHIO DEPARTMENT OF AGING AREA AGENCY ON AGING POLICY MANUAL

OHIO DEPARTMENT OF AGING AREA AGENCY ON AGING POLICY MANUAL Last Updated 3-30-2005 TABLE OF CONTENTS Policy # Title 101.00 ODA Policy Manual 1...
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OHIO DEPARTMENT OF AGING

AREA AGENCY ON AGING POLICY MANUAL

Last Updated 3-30-2005

TABLE OF CONTENTS Policy #

Title

101.00

ODA Policy Manual

102.00

State Advisory Council

103.00

Division of State into PSAs/Designation of New or Amendments of Existing PSAs

104.00

Designation of Area Agencies (AAA )

105.00

Withdrawal of Area Agency on Aging Designation

106.00

Hearing for Appeal of Adverse Action

107.00

Hearing Procedures for Service Providers

108.00

General Advocacy Responsibilities

109.00

Title III: Resource Allocation

109.01

Area Agency on Aging Administrative Allocation

Description

Authority

*

100.00 Section One – State Function ODA shall publish and regularly update a policy that shall be the primary vehicle to 45 CFR 1321.11 communicate departmental policy to AAAs, PAAs, and the aging network in general. ODA shall establish a State Advisory Council known as the Ohio Council for the Aging. ODA in accordance with section 305 of the Older Americans Act f 1965, has divided the state into geo-political areas which are distinct multi-county areas called Planning and Service Areas (PSAs). ODA shall designate a single public or private non-profit agency as the AAA for each PSA it has designated within the state. ODA shall have the power to withdraw an AAA designation whenever it, after reasonable notice and opportunity for a hearing, finds an area of non-compliance. ODA shall provide the opportunity for a hearing to: any applicant desiring designation as a PSA whose application has been denied; AAA whose application is being considered with other agencies or organizations whose application is denied and any AAA whose designation is withdrawn. ODA, subject to the conditions specified in the procedures set forth shall honor all written requests for appeal hearings which are submitted by service providers whose applications to provide services under an Area OAA § 307(a)(5) Plan have been denied, or whose subgrants or 45 CRF 1321.11 service contracts with an AAA have been prematurely terminated or the second or third year of a multi-year contract or grant is not renewed by the AAA. ODA will serve as an effective visible advocate for the elderly in the State of Ohio ODA’s allocation of Title III funds to AAAs is 42 USC 3025(a)(2)(c); 42 based upon the economic & social needs of the USC 3030(k) Population of persons 60 and over in east PSA. P.L. 89-73 as amended Allocation of funds for AAA administration shall through 12/21/92, §303(c) not exceed 10% of total base allocations available to the AAAs from OAA Title III funding ORC 173.16 ODA Policy 109.00 sources. ODA shall establish a fixed admin ODA Policy (SCS) allocation from SCSBG funds.

Origination Date & Notice # ( Before 1/99)

Rescinded/ Revision Date & Notice #

Revised 1/21/99 (#199NP016)

 

 



Revised 12/7/95

 Revised: 1/21/99 (#199NP016)

Revised: 6/23/94, 4/17/98

Comments

Policy #

Title

Description

110.00

Coordinated Monitoring Process

ODA shall establish monitoring procedure to evaluate the performance of federal or state funded programs or activities managed by AAAs.

111.00

Technical Assistance to Area Agencies on Aging

ODA shall provide technical assistance to AAAs in order that AAAs serve as effective and visible advocates for the elderly and remain in compliance…

112.00

Vacant (Previously – ODA Resource Center)

113.00

Training/Education: AAA Responsibilities and Requirements

114.00

Vacant (Previously – Title V)

115.00 116.00

Authority

*

Origination Date & Notice # ( Before 1/99)

OAA §306 (42 USC 3026) Area Plans

ODA Rule Filing

201.00

Area Agency on Aging Advisory Council

201.01

Area Agency on Aging Board of Trustees Schedule

201.02

Area Agency on Aging Governing Body

202.00

AAA Funding Formula

203.00

Vacant (Previously - AAA Research Activity)

204.00

Area Plan

Revised 4/98? Rescinded 1/21/99 (#199NP016)

As part of its Area Plan, AAAs shall provide ODA with a plan for training activities & its associated costs in order to improve agingrelated information skills, & service quality.

204.01

Area Plan: Use of Funds for MPSC Capital Improvements

Number available

Revised 7/30/98 Rescinded 1/21/99 (#199NP016) Rescinded 1/21/99 (#199NP016) Rescinded 1/21/99 (#199NP016)

Prior to ODA filing of any administrative rule under the process outlined in Section 119.03 of the ORC, AAAs shall have the opportunity to comment on such a rule through a public hearing. ODA will give notice… 200.00 Section Two – Area Agency on Aging Function OAA § 306(a)(6)(F) (42 AAA in each PSA shall establish a council to USC 3026) advise the AAA on matters relating to the OAA Regulations development and administration of the Area (1321.57 Fed Reg, Vol Plan 53, No. 69, Wed, 8/31/88) 45 CFR 1321.11 Because AAAs are subject to the Ohio Open Meetings laws (§121.22 ORC) each AAA is ORC § 121.22 required to develop a procedure to notify the 45 CFR §1321.61 general public of the time and place of Board of Trustee and/or advisory council meetings. AAAs in each PSA shall be governed by a body that oversees the AAA’s development of 45 CFR 1321.11 comprehensive & coordinated services to older persons in the PSA. Each AAA must develop and institute an allocation process for Title IIIB,C, & D funds.

OAA 1965, as amended; 42 USC 3026

Number available Number available Number available



Revised 6/19/97, 2/13/02, 11/14/03 (Notice #1103S179)

Revised 11/10/94

Revised 6/10/98

 Rescinded 2/01 (#0201P031)

Each AAA shall prepare and submit a strategic Area Plan every four years and an annual operational Area Plan to ODA. Proposed allocations of Older Americans Act grant funds for purposes as outlined in § 321.(1)(b) of OAA must be approved by ODA

Comments

Revised: 7/7/04 (#0704P102)

Vacant (Previously – Senior Awareness Liaison Aide Network) Vacant (Previously – Golden Buckeye Program)

117.00

Rescinded/ Revision Date & Notice #

8/20/99 (#899NP224)



Number available

Policy #

Title

Description

Authority

*

Origination Date & Notice # ( Before 1/99)

Rescinded/ Revision Date & Notice #

prior to an AAA issuing a grant award for such purposes. AAAs shall set specific goals to ensure that services are provided to older individuals (aged 60 and over) with greatest economic need & greatest social need, with special emphasis on low-income minority individuals in at least the proportion population within the respective provider’s geographic boundaries.

OAA 1965, as amended; 42 USC 3002, 3027 45 CFR §1321.11, §1321.65 and §1321.69 Ohio Administrative Code 5101:3-3-06 and 5101:33-08 ODA Policy 301.00

11/10/94

42 USC 3030s

3/21/02 (#0302I052)

204.02

Service Priority to Specific Client Groups

204.03

National Family Caregiver Support Program

204.04

Waiver Requests by AAAs

205.00

Priority Services

206.00

Request for the Direct Provision of A Service

207.00

Request for Variance from Prescribed ODA Service Taxonomy

208.00

Delegation of Authority

209.00

Service Provider Subcontracts

210.00

Quarterly Program Reports

AAA shall submit quarterly reports as prescribed by the ODA

OAA 1321.11 45 CFR

NAPIS (National Aging Program Information System)

In order to meet the OAA requirement for annual performance reporting, AAA shall collect information as necessary and, quarterly, submit participant characteristics and service profile by funding source on selected services funded in whole or in part…

45 CFR 1321

210.01

The Family Caregiver Support Program which recognizes the vital role performed by informal caregivers, is authorized by Title III-E of the OAA reauthorization of 2000 (the Act). AAAs may request a waiver of ODA policy or rules for any program funded by ODA. AAAs will allocate an “adequate proportion” (a minimum of 5% before transfers) of Title IIIB funds for each of the following categories of services demonstrate to the satisfaction of ODA that services being furnished for such category are sufficient to meet the need for such services in such area (§306(b)2) OAA) An AAA is prohibited from providing direct services for any of the following Title III parts without the written approval and/or authorization from ODA… The AAA may request a variance from the standard ODA service categories if the primary function or effect of the service to be provided deviates substantially from the prescribed definitions. The AAA may not delegate to another agency the AAA’s authority to award or administer OAA and SCSBG funds It is recognized that it is sometimes necessary and desirable to service providers to enter into continual agreement with individuals or organizations in order to effectively and efficiently provide for the delivery of services to older adults.

Revised 11/14/03 (#1103S179)

305(a)1(C); 42 USC 3025

OAA 1965 as amended, 42 USC 3026

7/25/95

P.L. 89-73, as amended through December 31, 1992, §307(a)(10), 45 CFR 1321.63(b)

Revised 1/21/99 (#199NP016)



45 CFR 1321.11 and 1321.25

Revised 12/7/95



Revised 8/1/01 (#0801S144)

8/1/01 (#0801S144)

Comments

Policy #

Title

Description

AAA Monitoring of Service Providers

Each AAA ill conduct periodic monitoring of activities carried out under the Area Plan.

212.00

Data Storage

All AAA data files that are maintained on any computer system must be regularly copied onto a secondary medium that can be removed from the computer system even if the original source documentation for electronic data files exist.

213.00

AAA Policy and Procedures Manual

Each AAA must develop and publish written policies and procedures for carrying out its functions as mandated in the OAA and OAA regulations as well as ODA’s Policies and Procedures manual.

Compliance with Civil Rights Laws

Each AAA shall take steps to fully comply with all applicable state and federal civil rights law and regulations governing the provision of services and the employment of personnel paid for, in whole or in part, with state or federal funds.

211.00

214.00

215.00 216.00

217.00

218.00

301.00

301.01

Authority

*

Origination Date & Notice # ( Before 1/99)

OMB Circular A-110; 45 CFR Part 92 & 74



OMB Circular A-110; 45 CFR Part 92



45 CFR Part 80 45 CFR Parts 84 & 85 45 CFR 1321 45 CFR Parts 90 & 91

Revised 8/1/01 (#0801S144)

Conflicts of Interest

All AAA grant awards and procurement practices shall be conducted in a manner to provide, to the maximum extent possible, open and free competition.

45 CFR §74.42, §74.43, §92.36, §1321.11

11/10/94

Records Retention

Each AAA shall maintain all financial and programmatic records, supporting documents, statistical records, and any other records which it is required to maintain under state or federal law, or which are reasonably considered pertinent to any grant(s) the AAA receives from or through the ODA.

45 CFR §74.53, §92.42, §1321.11, §1321.51, §1321.67

11/10/94

State Subsidy: 1084 MultiPurpose Senior Centers

300.00 Section Three – Service and Related Requirements Each AAA shall designate, where feasible, a focal point in each community, which shall be recognized as a facility, established to encourage the maximum collocation of services for older individuals. ODA through the twelve AAA shall make Amended Substitute House Bill (AM. Sub. H.B.) 1084 funds available, as per the ORC §173.11173.12, for the development of a statewide system of MPSCS in order to…

Comments

Revised 8/1/01 (#0801S144)

Vacant (Previously – Dissemination of Constituent Mail to Area Agencies on Aging) Vacant (Previously – Corporate Eldercare)

Community Focal Points

Rescinded/ Revision Date & Notice #





Rescinded 2/01 (#0201P031)

Number available.

Rescinded 1/29/98

Number available.

Policy #

Title

302.00

The Establishment & Maintenance of Information & Referral Providers

303.00

Vacant (Previously – Transportation Safety)

Description

303.02

Preservation of Federal Financial Participation

AAAs are required to take the necessary measures to preserve the federal & state financial participation involved in vehicles purchased with Title III or any other state funds administered through ODA.

303.03

Vacant (Previously – Vehicle Inventory)

Transportation Coordination

304.00

Nutrition Services

Each AAA is responsible for planning, administering, & evaluating a comprehensive & coordinated system for nutrition program services in each PSA.

304.01

Selection of Nutrition Service Providers

Each AAA is responsible for the selection of congregate and home-delivered nutrition service providers

304.02

Meal Service - Participant Eligibility

Individuals aged 60 or older & their spouses, regardless of age, are eligible to participate in the meal program.

Home-Delivered Meal Service Participant Eligibility

304.04

Congregate Meal Service - Level of Service

304.05

Home-Delivered Meal Service Level of Service

Individuals aged 60 or older who are homebound by reason of illness, incapacitating disability or otherwise isolated, & who meet all of the eligibility criteria listed below are eligible to participate in the home-delivered meals program. Each AAA is responsible for insuring that each nutrition program provides at least one hot or other appropriate meal per day, 5 or more days a week & any additional meals which the nutrition service provider may elect to provide Each AAA is responsible for insuring that each nutrition program provides, 5 or more days a week, at least one home-delivered (hot, cold,

Comments



OAA, 42 U.S.C. 3030(d), 321(a)(2); 42 U.S.C. 3030(1), 351(1) 45 CFR 74(M)(74.115) 45 CFR 1321.11

Number available

Revised 6/19/97

Revised 2/91

Rescinded 6/19/97 Each AAA will establish an effective & efficient process for promoting coordination between programs assisted with funds allocated under the OAA & administered through ODA, ODOT under § 3,9,16&18 of Federal Transit Act of 1964 as amended.

304.03

Rescinded/ Revision Date & Notice #

Rescinded 6/19/97

Vehicle Acquisition & Disposal

303.04

*

Each AAA shall provide the necessary assurances and actions to ensure the establishment and maintenance of information and referral (I&R) providers, or similar services, preferably county level, within its PSA.

The purchase of vehicles with funds administered by ODA and the disposal of same shall be authorized by the AAA prior to purchase or disposal.

303.01

Authority

Origination Date & Notice # ( Before 1/99)



OAA § 307(A)13) ORC Chapter 4759 ODA Meal & Nutrition Services: Specs & Guidelines issued 5/12/99

Revised 8/20/99 (#899NP224)

 OAA § 307 ODA Meal & Nutrition Services: Specs & Guidelines Issued 5/12/99





OAA § 339

Revised 7/97



Number available

Policy #

Title

Description

Authority

*

Origination Date & Notice # ( Before 1/99)

Rescinded/ Revision Date & Notice #

Comments

frozen, dried canned, or supplemental foods with a satisfactory storage life) meal per day.

304.06

Menu Policy

304.07

Food Handling: Preparation and Delivery

304.08

USDA Reimbursement Agreement

304.09

Nutrition Services Incentive Programs (NSIP)

304.10

Vacant (Previously Microwave Ovens)

305.00

Legal Services Coordination

306.00

Long-Term Care Facilities Ombudsman

307.00

308.00

309.00 310.00

Each AAA is responsible for insuring that each meal provided meets a minimum of 1/3 of the daily recommended dietary allowances… Each AAA is responsible for insuring that each nutrition provider will follow appropriate procedures to preserve the nutritional value and safety of all meals served. In accordance with the OAA of 1965, ODA will have an agreement with the USDA to ensure the availability of food, cash or a combination of food & cash to all Title III nutrition programs. The AoA awards NSIP funds to ODA according to Ohio’s percentage of the national eligible meal total from the prior year.

OAA § 307(A)(13) ORC Chpt 4759 ODA Meal & Nutrition Services: Specs and Guidelines issued 5/12/99

Revised 8/20/99 (#899NP224)

Meal & Nutrition Services: Specs & Guidelines Issued 5/12/99

Revised 7/97

OAA, 42 USC 3030(a), 42 USC 3030(e)(f)(g-11)(g13)(g-21)(g-22),45 CFR 1321.11

Revised 6/19/97

OAA, 42 USC 303a; § 309 NSIP

Revised: 1/1/01; 10/1/02, 11/14/03 (#1103S179) Rescinded

AAA shall enter into contract with providers of legal services which met the following standards as specified in 45 CFR 1321.73 and Section 307(a)(15) of OAA of 1965, as amended. The State Ombudsman Program will track closely those complaints which are received from any source.

Complaints Regarding Ombudsmen

The Office of the SLTCOP will be responsive to consumers & other individuals who are dissatisfied with the action or inaction of staff & volunteers who are representatives of the Office.

Conditions of Participation (COPs) & Service Specifications

AAAs shall include conditions of participation (COP) and services specifications as contractual requirements with service providers for the use of Title III, SCSBG and Alzheimer’s Respite funds.

45 CFR 1321.73 OAA of 1965, as amended § 307(a)(15)



173.19 ORC, 173:2-1-17 & 173:2-1-19 Ohio Admin Code

3/11/96

173:2-2-22 Ohio Admin Code

3/11/96

42 USC 3027(a)(44)

Vacant (Previously – Assistance for Independent Living) Vacant (Previously – Shared Living)

311.00

Home Energy Assistance Program (HEAP) Outreach

ODA shall administer through the AAA HEAP with federal funds granted by the ODOD to provide outreach & assistance for the enrollment of elderly & disabled in the program

312.00

Senior Volunteer State Subsidy

In accordance with HB 238, ODA shall administer, through its twelve AAAs, the Senior Volunteer State Subsidy funds.

Community Opportunities, Accountability & Training and Educational Services Act of 1998, Title III, § 301-309 45 CFR Part 2551-3; HB 94 (Biennium Budget BillTemporary Statutory Language)

6/30/94

Number Available

Revised: 5/12/99 (#599NP146) 8/1/01 – Appendix I (#0801S144) Rescinded 1/29/98

Number Available

Rescinded 1/29/98

Number Available

Revised 1/21/99, 7/7/04 (#0704P102)

Revised 7/7/04 (#0704P102)

Policy #

Title

313.00

Federal Reversionary Interest in MPSC

314.00

Vacant

315.00

Senior Community Services (SCS)

315.01

Care Coordination Program (CCP)

316.00

Alzheimer’s Respite

317.00

Disaster/Emergency Preparedness, Response, & Recovery

401.00

Title III: Notification of Grant Award, Spending Authority & Grant Closeout

402.00

AAA Cash Management

403.00

Title III: Financial Participation

404.00

State Subsidy: Aging Network

405.00

Title III Transfers of Funds

Description

Authority

*

AAAs shall implement a policy for protecting the federal government’s reversionary interest in facilities which have utilized Title III funds of OAA for the purposes of acquisition, construction, alteration, or renovation of MPSCs.

Origination Date & Notice # ( Before 1/99)

Rescinded/ Revision Date & Notice #

Comments



Number Available SCS funds will be awarded by ODA to each AAA on an annual basis. The purpose of these ORC 173, HB 94 funds is to provide a range of community-based (Biennium Budge Bill – services that assist Ohioans 60 years of age & temporary statutory older to remain independent in their own homes language.) and communities. AAAs may offer the CCP as part of a consumer-centered, coordinated, Am Sub HB 215 comprehensive network of community-based services. Alzheimer Respite funds will be awarded by ODA to each AAA on an annual basis. The purpose of these funds is to provide services HB 94 (Biennium Budget) that assist family caregivers of people of any age with Alzheimer’s Disease or related dementia. Each AAA shall have a written plan that summarizes how they will serve older adults & 45 CFR 1321 maintain operations in the event of an emergency or disaster. 400.00 Section Four – Fiscal and Cost Principals After approval of Area Plans, the ODA shall award OAA, SCSBG, Alzheimer’s Respite, & LTCOP funds to AAA for administration of social & nutrition services in accordance with intrastate funding formulas. Each AAA shall have a financial management system that meets the standards outlined in 45 CFR 74.21 & 45CFR 92.21. ODA reserves the right to select the method of payment to each AAA based on their compliance with state & federal rules & regulations. Under an approved Area Plan, federal funds along with the appropriate non-federal match are to be utilized to pay the costs of activities & services under the Title III grant. AAAs shall utilize state subsidized funding, entitled Aging Network funds allocated by ODA, as non-federal match for Title III Administration funds of the OAA of 1965 as amended. AAAs may request through its annual operational Area Plan and/or subsequent revisions to transfer between Parts B (Supportive Services & Senior Centers) and C (Nutrition Service) and/or between subparts 1

Revised: 8/1/01 (#0801S144) 7/7/04 (#0704P102)

Revised: 9/5/02; 10/1/02; 11/14/03 (#1103S179)

7/1/99 (#799NP170)

Revised: 8/1/01 (#0801S144)

8/1/01(#0801S1 44)

Revised: 7/7/04 (#0704P102)

Title III OAA, 42 USC 3021et. seq. §131.33 ORC

Revised: 8/20/99 Notice #899NP224

45 CFR Part 74 45 CFR Part 92

Revised: 8/20/99 (#899NP224)

OAA §304(d); 42 USC 3024; 45 CFR 1321.47

Revised: 8/88, 2/02, 11/14/03 #1103S179



OAA 1965 as amended; 42 USC 3028

11/10/94

Revised: 1/21/99 (#199NP016)

Policy #

Title

Description

Authority

*

Origination Date & Notice # ( Before 1/99)

Rescinded/ Revision Date & Notice #

Comments

(Congregate Nutrition Services) and 2 (HomeDelivered Nutrition Services) of Part C. 406.00

Vacant (Previously – Carryover)

407.00

AAA Grants and Contracts

408.00

Accountability for Federal Advances

409.00

Program Income

Rescinded 10/9/96 Each AAA is authorized to enter into agreements with community service provider agencies and organizations for the purpose of developing & implementing a comprehensive & coordinated community based system of services for older persons as provided for in the AAA’s approved Area Plan. AAAs have certain conditions & responsibilities attached to federal funds advanced to them from ODA. Program income represents income earned by the service provider from the federallysupported activity.

ODA Policies 207.00, 214.00, 216.00, 409.00, 409.01, 409.02 ROM-83-56 OAA 306(a)(3)(b)

Revised: 8/20/99 (#899NP224)

45 CFR 74.22 45 CFR 92.20 45 CFR 92.21

Revised: 8/20/99 (#899NP224)

42 USC 3030(c)(2)

Revised 8/88

409.01

Program Income: Contributions from Participants

AAAs will assure that agencies providing social & nutrition services under the Area Plan shall afford older persons the opportunity to contribute all or part of the costs of the social and nutrition services provided.

409.02

Program Income: Fiscal Management

Program income must be accounted for on an on-going basis and should be reported to ODA as it is earned through the established ODA financial reporting system.

42 USC 3030(c)(2)



410.00

Cost Allocation Plan

AAAs are required to use federal cost principles to charge administrative costs to federal grant programs.

45 CFR Part 74, 45 CFR Part 92, Office of Budget & Management Circular, A-102, A-110, A-122, A87, A-133, ASMB C-10

8/1/01 (#0801S144)

411.00

Financial Audits

501.00

Client Liability Collection

502.00

Unit of Service Verification

503.00

Vacant (Previously – Food Preparers: Food Safety and Quality Assurance)

504.00

Wide Area Network (WAN) Usage

505.00

Employment of Immediate Family

42 USC 3030(c)(2)



AAAs shall have an audit conducted in accordance with the guidelines identified in OMB Circular A-133 Office of Management and Budget (OMB) Circular A-1333. 500.00 Section Five – AAA and Other ODA-Funded Programs The PAA shall identify, invoice, collect, monitor, and reconcile the client liability payments 3/21/02 42 CFR 435 whenever the PAA has been designated as the (#0302I052) waiver providers’ collection agent. AAAS and PAAs shall ensure that units of service purchased with funds administered by 4/13/99 45 CFR § 92.20(a)(3) ODA are accurate and in accordance with (#499NP116) conditions specified in provider agreements.

Revised: 1/21/99 (#199NP016)

Rescinded 11/7/02 Use of WAN, electronic mail (e-mail), and online services have the great potential to enhance the productivity of the employees of AAAs, PAAs, RLTCOPs. AAAs and PAAs shall ensure that its

45 CFR 1321.11

1/21/99 (#199NP016)

45 CFR 1321.11

1/21/99

Number Available

Number Available

Policy #

Title & Business Associates

506.00

Vacant (Previously – Year 2000 Compliance (Issued as an emergency))

Description

Authority

*

employment practices in the hiring and supervision of employees is conducted in a manner which enhances public confidence in the agency and limits situations which give the appearance of partiality, preferential treatment, improper influence, or conflict of interest. 10/12/98 memo from the Ohio Dept. of Admin. Services

Origination Date & Notice # ( Before 1/99) (#199NP016)

Rescinded/ Revision Date & Notice #

Rescinded 11/20/98

Comments

Number Available

* OAA – Older Americans Act; USC – United States Code; Fed. Reg. – Federal Regulations; ORC – Ohio Revised Code; CFR – Code Federal Regulations; P.L. – Public Law; OMB – Office of Management and Budget; ODA – Ohio Department of Aging; H.B. – House Bill; ASMB – Assistant Secretary for Management & Budget

Ohio Department of Aging

101.00 – ODA Policy Manual Page 1 of 1

Policy The Ohio Department of Aging (ODA) shall publish and regularly update a policy that shall be the primary vehicle to communicate departmental policy to Area Agencies on Aging (AAAs), PASSPORT Administrative Agencies (PAAs), and the aging network in general. AAAs/PAAs must comply with all applicable policies. Procedure A – Scope and Content This manual is developed for AAAs/PAAs, and shall focus on their responsibilities. Procedure B – Manual Revision 1.

On an ongoing basis, ODA shall develop, revise, and delete policies and related procedures.

2.

Whenever changes are proposed, policy shall be forwarded to each AAA/PAA for its review and comment.

3.

ODA shall consider all comments prior to the issuance of final policy.

4.

All subsequent policy shall be issued through a policy notification that shall specify where in the manual it should be placed and, if applicable, which pages of the manual should be removed.

Date: January 21, 1999 (#199NP016) Authority/Basis: 45 CFR 1321.11

AAA Policy Manual (Master Word Document)

Ohio Department of Aging

102.00 – State Advisory Council Page 1 of 3

Policy The Ohio Department of Aging (ODA) shall establish a State Advisory Council known as the Ohio Council for the Aging. The purpose of this Council shall be to serve as the official State Advisory Council on Aging for the State of Ohio. In this regard, the Council shall advise and assist the Department to: 1.

Develop and implement the State Plan on Aging;

2.

Conduct public hearings;

3.

Represent the interests of older persons;

4.

Review and comment on State Plans, Area Plans, budgets, programs and policies which affect older persons;

5.

Develop recommendations for administrative or legislative action; and

6.

Disseminate information concerning older persons.

Procedure A – Membership 1.

The Ohio Advisory Council for the Aging shall consist of twelve (12) members to be appointed by the Governor with the advice and consent of the Senate. Two exofficio members of the Council shall be members of the House of Representatives appointed by the Speaker of the House of Representatives and shall be members of two different political parties. Two ex-officio members of the Council shall be members of the Senate appointed by the President of the Senate and shall be members of two different political parties. The Directors of the Departments of Mental Health, Mental Retardation and Developmental Disabilities, Health, Development, and Human Services, or their designees, shall serve as ex-officio members of the Council. Representatives from other departments and agencies may be invited to Council meetings.

2.

Membership of the Council shall represent all areas of Ohio and shall be as follows: a.

Majority of members of the Council shall have attained the age of sixty and have a knowledge of the continuing interest in the affairs and Welfare of the older citizens of Ohio. The fields of business, labor, health, law, and human services shall be represented in the membership; and

b.

No more than seven members shall be of the same political party.

102.00 – State Advisory Council Page 2 of 3

3.

Members of the Council shall be appointed for a term of three (3) years, except that for the first appointment members of the Ohio Commission on Aging who were serving on the Commission immediately prior to the effective date of this section shall become members of the Council the remainder of their unexpired terms. Thereafter, appointment to the Council shall be for a three-year term by the Governor. Each member shall hold office from the date of his appointment until the end of the term for which he was appointed. Any member appointed to fill a vacancy occurring prior to the expiration term for which his predecessor was appointed shall hold office for the remainder of the term. Any member may continue in office subsequent to the expiration date of his term until his successor takes office and shall be compensated for meetings he attends between the expiration of his term and the beginning of his successor's term.

Procedure B – Committee 1.

The Council may establish such committees as it deems necessary.

2.

The Chairman of the Council with the advice of the Director of the Department shall appoint Council members to such Council committees as may be needed. The Chairman may appoint nonmembers as advisors to Council committees as appropriate.

3.

Council committees shall function in an advisory capacity to the Council.

4.

The Council shall establish the following standing committees:

5.

a.

A Title III Select Committee to advise it on all aspects of the Title III programs under the Older Americans Act;

b.

A Legislative and Public Policy Committee; and

c.

A Budget and Finance Committee.

The Director of the Department shall designate the ODA personnel to staff each committee.

Procedure C – Meetings 1.

The Council shall hold at least six meetings annually and other meetings at the call of the Chairman. Notice of the meetings shall be sent to the members ten (10) days in advance.

2.

A quorum shall consist of at least one more than half of the total active membership of the Council. Ex-officio members will not be included for the purpose of a quorum.

3.

Ex-officio members of the Council shall not have voting powers.

102.00 – State Advisory Council Page 3 of 3

4.

Members of the Council shall be compensated at the rate of fifty ($50) do11ars for each day actually employed in the discharge of official duties, but not to exceed two thousand dollars per year, and, in addition, shall be allowed actual and necessary expenses in accordance with current state travel regulations.

5.

Meetings of the Council shall be open to the public. Non-members who wish to speak during a meeting shall notify the Chairman, in writing, in advance of the meeting.

Procedure D – Rules of Order 1.

Rules contained in the current edition of Roberts' Rules of Order shall be applicable to Council meetings.

Procedure E – Amendments to By-Laws 1.

These by-1aws may be amended at any regular meeting of the Council by a twothirds vote, provided that the amendment has been submitted, in writing, at the previous regular meeting.

Ohio Department of Aging

103.00 – Division of State into PSAs/Designation of New or Amendments of Existing PSAs Page 1 of 4

Policy: The Ohio Department of Aging (ODA), in accordance with section 305 of the Older Americans Act of 1965, has divided the state into geo-political areas which are distinct multi- county areas called Planning and Service Areas (PSAs). When the Department finds it appropriate, it may designate a new, or amend an existing PSA to enhance the administration of, the coordination of, or the delivery of services to the older persons within that geographical area. Any such consideration shall follow the below listed process which shall be completed no later than June of the year preceding a new State Plan. Procedure A: Designation of a New or Amendment of an Existing PSA Initiated by the Department 1.

2.

When, in the view of ODA, designation of a new or amending of an existing PSA is necessary, notification of the proposed change will be prepared and sent to: a.

all Area Agencies on Aging (AAAs); and

b.

all boards of county commissioners directly affected by the proposed change.

Within thirty days from the date of this notice, a notice of a public hearing to consider the designation of a new, or the proposed amendment of the current geographical boundaries of a PSA, will be published in the two newspapers with the widest circulation within the affected area. The notice shall appear at least once per week for a period of four weeks. a.

b.

The public hearing notice shall contain at a minimum: i.

the date of the hearing;

ii.

the location of the hearing;

iii.

the time of the hearing;

iv.

the purpose;

v.

the proposed geographical boundaries of the PSA; and the deadline and address of where written comments will be accepted.

The public hearing will be held no earlier than seven days after the publication of the final notice.

103.00 – Division of State into PSAs/Designation of New or Amendments of Existing PSAs Page 2 of 4

3.

After consideration of all public comments and the views of the 0hio Council for the Aging, the Director will issue final determination regarding PSA designation.

4.

The Department will notify the Commissioner of the Administration on Aging of its intent to designate a new PSA or amend an existing PSA prior to the submission or the beginning of a new State Plan.

Procedure B: Designation of a New of Amendment of a PSA not Initiated by the Department 1.

Any entity desiring the designation of a new or amendment of an existing PSA, shall make a formal, written proposal to ODA. a.

The proposal shall, at a minimum, provide the following information pertaining to the geographical boundaries of the proposed PSA; i.

geographical distribution of those individuals 60 years and older;

ii.

the incidence of need for supportive, nutritional services, etc.;

iii.

the distribution of low income individuals 60 years and older;

iv.

the distribution of local resources available;

v.

the views of public officials;

vi.

the appropriateness of the proposed boundaries; and

vii.

the impact on surrounding PSAs, i. e., its ability, to effectively and efficiently administer programs for the elderly relative to the changes in:

viii.

1)

demographics

2)

funding; and,

any other information the Department feels necessary.

2.

In the event that a unit of general local purpose government of 100,000 or more persons proposes that it be designated as a PSA, the Department, upon request, shall provide a hearing to year such justification for the designation.

3.

Upon receiving the completed proposal, the Director of the Department shall appoint a committee to review the proposal, and when applicable, the testimony from the hearing, to determine if there is significant cause to amend or designate a new PSA.

103.00 – Division of State into PSAs/Designation of New or Amendments of Existing PSAs Page 3 of 4

a.

4.

5.

The special committee shall: i.

function solely as an advisory body;

ii.

review the application and make a recommendation to amend or designate a new PSA based upon: 1)

the merits of the proposal and hearing testimony;

2)

any other information the special committee feels that would inhibit or promote the delivery of services to those 60+ individuals living within the area.

Upon receiving the results of the committee, the Director will make the determination of whether or not to pursue the possibility of designating a new PSA or amending existing ones. a.

Should the Director decide not to pursue the designation of a new, or the amendment of an existing PSA, the applicant will receive written notice, and be informed of the right to appeal to the Commissioner of the Federal Administration on Aging.

b.

Should the Director decide in favor of a new designation or an amendment to an existing PSA, notification of the proposed change will be prepared and sent to: i.

all AAAS; and,

ii.

all boards of county commissioners directly affected by the proposed change.

Within thirty days from the date of this notice, a notice of a public hearing to consider the designation of a new, or t h e proposed amendment of the current geographical boundaries of a PSA will be published in the two newspapers with the widest circulation within the affected area. The notice shall appear at least once per week for a period of four weeks. a.

The public hearing notice shall contain at a minimum: i.

the date of the hearing;

ii.

the location of the hearing;

iii.

the time of the hearing;

iv.

the purpose;

103.00 – Division of State into PSAs/Designation of New or Amendments of Existing PSAs Page 4 of 4

b.

v.

the proposed geographical boundaries of the PSA;

vi.

the deadline and address of where written comments will be accepted.

The public hearing will be held no earlier than seven days after the publication of the final notice.

6.

After consideration of all public comments and the views of the Ohio Council for the Aging, the Director will issue final determination regarding PSA designation.

7.

The Department will notify the Commissioner of the Administration on Aging of its intent to designate a new PSA or amend an existing PSA prior to the submission or the beginning of the next State Plan.

Ohio Department of Aging

104.00 – Designation of Area Agencies on Aging (AAA) Page 1 of 3

Policy The Ohio Department of Aging (ODA) shall designate a single public or private non-profit agency as the Area Agency on Aging (AAA) for each Planning and Service Area (PSA) it has designated within the state. The geo-political area of responsibility of the AAA shall be contiguous with that of the PSA it represents. The primary responsibility of the AAA shall be the development and administration of an "Area Plan" for aging services which addresses how the agency will take steps to encourage, expand, or improve, either by available funding or coordination within its area, a comprehensive and coordinated system of social services and opportunities for older adults. In designating the AAA the Department will comply with all of the standards outlined in Section 305 (c) of the Older Americans Act (OAA). Procedure A – Designation Conditions 1.

2.

The designation of a new AAA shall only be considered in the event of one of the following: a.

an existing AAA has been de-designated;

b.

an existing AAA has requested that its designation be withdrawn contingent on no other conditions; or,

c.

a new PSA has been designated requiring a new AAA.

In the event that an existing PSA is amended, ODA retains the option of soliciting applicants or retaining the existing AAA as the AAA for the New PSA.

Procedure B - Application 1.

The Department shall develop a standard application form to distribute to interested parties seeking designation as an AAA: a.

the application shall, at a minimum, contain the following criteria, as outlined in Section 305(c) of the OAA, regarding the determination of the eligibility of the entity desiring designation: i.

an AAA may be any of the following: 1)

a public or private non-profit agency in a PSA which is under the supervision of the ODA and has demonstrated capability and/or experience in planning, coordinating, developing and managing a broad range of supportive, social, and nutrition services within a PSA;

104.00 – Designation of Area Agencies (AAA) Page 2 of 3

b.

c.

2)

an established office on aging which is operating within a PSA designated by the ODA ;

3)

an established office on aging is a private or public unit whose only purpose is to be an advocate for the development of programs and opportunities for older adults. Such an agency must have demonstrated capabilities, and/or experience in planning, coordinating, developing, and managing a broad range of supportive, social and nutritional services within such a PSA;

4)

an office, agency, or unit of general purpose local government, which is designated for the sole purpose of serving as an AAA by the chief elected official of such a unit;

5)

an office or agency designated by the appropriate chief elected officials of a combination of units of general purpose local governments to act on behalf of such combination for such purpose;

the application should specifically state that in the designation Department shall offer refusal to any of local government if: i.

such a unit can meet listed above; and of an AAA, the right of first general purpose the requirements

ii.

the boundaries of such a unit and the boundaries of the area are reasonably contiguous.

the application should contain the views offered by the unit or units of general purpose local government in such an area.

Procedure C – Public Notice 1.

The Department shall issue a public notice, in newspapers of general circulation, etc., its intent to designate an AAA. Such a notice shall: a.

appear in the affected area at least once per week for a period of four weeks;

b.

also contain: i.

the location of where applications may be obtained;

ii.

the date and times of which applications may be obtained;

iii.

the deadline for applications to be accepted;

iv.

the location of where applications will be accepted.

104.00 – Designation of Area Agencies (AAA) Page 3 of 3

2.

A copy of the Department's policy explaining the process of designation, any unit of general purpose local government's ability to be considered for first right of refusal, criteria for selection, and any other forms deemed necessary by the Director of the Department will be made available in response to this notice.

3.

The Department will schedule at least a fifteen day period for the acceptance of formal applications that begins no sooner than the day following the date of the last published notice.

Procedure D – Review and Selection 1.

The Department shall afford the right of first refusal to any applicants that are units of general purpose local government meeting requirements established in Section 305(b)(5)(B) of the Older Americans Act of 1965.

2.

A formal review of all applications will be made by ODA staff members not earlier than one day nor later than 30 days after the final deadline for submission of applications.

3.

The ODA will conduct an on-site assessment of each applicant to determine whether the agency has the capacity to perform all the functions of an AAA, as outlined in Sections 305 and 306 of the OAA, and to verify information submitted in the application.

4.

The ODA will conduct a public hearing to obtain the views of older persons, public officials, service providers and other interested parties concerning the possible designation. The public hearing will be held within the geographical area in which the new AAA will be based.

5.

After receiving reviews of assessments conducted by ODA staff, and comments from the public hearing, a team selected by the Director of the ODA will review all material, along with comments from the Ohio Council for the Aging (OCFA), and will make a recommendation to the Director regarding which applicant shall be designated as the AAA.

6.

The Director of ODA shall make the final designation of any applicant as the new AAA.

7.

The Department shall notify any applicant who is denied designation as an AAA through a written notice. The notice shall contain the following information: a.

the specific reasons for non-designation;

b.

the right of the applicant to request the Department for a hearing on the issue.

Ohio Department of Aging

105.00 – Withdrawal of Area Agency on Aging Designation Page 1 of 2

Policy The Ohio Department of Aging (ODA) shall have the power to withdraw an Area Agency on Aging (AAA) designation whenever it, after reasonable notice and opportunity for a hearing, finds an area of non-compliance. This may include, but is not limited to, the following: 1.

The AAA fails to substantially comply with any provision of the rules and regulations of the Older Americans Act, as amended.

2.

The Area Plan on Aging, or required amendments to the Area Plan, are not approved by ODA.

3.

Malfeasance.

4.

Chronic failure to submit required reports in a timely fashion.

5.

Failure to abide by federal or state regulations pertaining to the use of funds.

6.

Failure to comply with rules and regulations established in the Office of Management and Budget circular A-102.

7.

Material failure to adequately address problems identified in annual evaluations of the AAA.

Procedure A - Notice 1.

2.

If the Department feels it has legitimate cause to withdraw an AAA designation, a notice of such intent, signed by the Director of the Department, with reasons for such shall be: a.

transmitted via certified mail to the AAA;

b.

transmitted via certified mail, to the parent agency of the AAA, if applicable;

c.

transmitted to chief elected officials of the units of general local purpose government within the Planning and Service Area (PSA);

d.

published in the two newspapers of the widest circulation within a PSA.

The notice shall contain the following: a.

the specific reasons for the withdrawal;

b.

the opportunity for the AAA to review any pertinent evidence on which the withdrawal was based;

105.00 – Withdrawal of Area Agency on Aging Designation Page 2 of 2

c.

the opportunity for a hearing with ODA to refute the basis for a withdrawal, at which time; i.

a representative from the AAA may appear; or

ii.

the AAA may choose to be represented by counsel or another representative; and/or

iii.

the opportunity for the AAA to present witnesses and documentary evidence.

Procedure B – New or Interim Designation 1.

The Director shall make a final decision of whether or not de- designation should occur based upon the response made to the notice by AAA.

2.

Upon a decision to de-designate the AAA, ODA shall:

3.

a.

send a notice of such action, via certified mail to the AAA and its parent agency, if applicable;

b.

immediately initiate the process of designating a new AAA.

If necessary to ensure continuity of services within the PSA, the ODA may, for a period of up to 180 days after its final decision to withdraw designation of an AAA: a.

perform the responsibilities of the AAA; or

b.

assign the responsibilities of the AAA to another agency in the PSA.

Ohio Department of Aging

106.00 – Hearings for Appeal of Adverse Action Page 1 of 2

Policy The Ohio Department of Aging (ODA) shall provide the opportunity for a hearing to: 1.

Any applicant desiring designation as a Planning and Service Area (PSA), whose application is denied;

2.

Any applicant desiring designation as an Area Agency on Aging (AAA), whose application is being considered with other agencies or organizations, whose application is denied; and

3.

any AAA whose designation is withdrawn.

Procedure A – Written Request 1.

The agency or organization desiring a hearing must submit a certified letter to ODA, which specifically requests a hearing and the reasons for such a hearing, within thirty days of the notice of an adverse action.

Procedure B – ODA Response 1.

Upon receipt of the request, ODA shall: a.

time/date stamp such a request;

b.

within five working days, notify the agency or organization of the date, time, and location of the hearing to be held. i.

Any such hearing must be held within forty-five days after the receipt of the request.

2.

The ODA Director shall designate a hearing officer of his/her choice to preside over the hearing.

3.

The hearing officer, upon completion of the hearing, shall make a recommendation and forward it to the ODA Director.

4.

The Director shall make the final decision within thirty days after the said hearing has been held at which time: a.

5.

ODA shall inform the agency or organization which made the request, of the decision through a certified letter.

ODA may terminate hearing procedures at any point if:

106.00 – Hearings for Appeal of Adverse Action Page 2 of 2

a.

the agency or organization which made the request for a hearing, negotiates a written agreement that resolves the issue(s) which prompted the hearing; or

b.

the agency or organization, in a written statement, withdraws their appeal.

Procedure C – Appeals to the Commissioner of the Administration on Aging 1.

Any applicant desiring designation as a PSA, who has appealed to ODA and is not satisfied with the outcome of the hearing set forth in Procedure B, may appeal to the Commissioner of the Administration on Aging per Federal Regulations 45 CFR, Section 1321.47.

Ohio Department of Aging

107.00 – Hearing Procedures for Service Providers Page 1 of 2

Policy The Ohio Department of Aging (ODA), subject to the conditions specified in the procedures set forth below, shall honor all written requests for appeal hearings which are submitted by service providers whose applications to provide services under an Area Plan have been denied, or whose subgrants or service contracts with an Area Agency on Aging (AAA) have been prematurely terminated or the second or third year of a multi-year contract or grant is not renewed by the AAA. Procedure A – Compliance with Local Hearing Process 1.

No request for an appeal hearing shall be honored by ODA unless the service provider has first appealed the adverse action with the AAA and fully complied with its policies governing appeal hearings at the local level.

2.

Any AAA which conducts an appeal hearing at the local level shall forward a copy of the service provider's written request for the appeal hearing and a copy of the AAA's final decision in the matter to ODA's Legal Unit within five working days of the date the AAA renders its decision.

Procedure B – Submission of Request to ODA 1.

Any service provider requesting an appeal hearing before ODA must submit its request in writing to the Director of ODA via certified mail within 15 working days of the date on which the AAA rendered its final determination with regard to the service provider's appeal at the local level.

2.

All written requests submitted to the Director must describe the adverse action which is being appealed and should include an explanation of why the provider considers the AAA's determination at the local level to be inappropriate.

3.

ODA will notify the AAA of the request for a hearing, and the time, date, and place of the hearing in as timely a manner as possible.

Procedure C – Hearing Process 1.

ODA shall schedule the appeal hearing within a reasonable time following receipt of the service provider's written request.

2.

ODA shall set the time, date, and a place of the hearing and shall designate a hearing officer to preside. ODA should make reasonable efforts to schedule the hearing to occur within the first 30 days immediately following the date on which the service provider's request was received by ODA.

3.

ODA shall allow the AAA an opportunity to participate in the appeal hearing.

107.00 – Hearing Procedures for Service Providers Page 2 of 2

4.

The hearing officer shall afford both the service provider and AAA an adequate opportunity to present their positions, but may limit or terminate discussion/testimony if: a.

One or more of the parties becomes unruly or combative;

b.

One or more of the parties becomes unnecessarily redundant in its discussion/testimony; The parties negotiate a written agreement that resolves the issue(s) prompting the hearing; and

c.

d.

5.

The service provider, in a written statement, withdraws its request for the appeal hearing.

The hearing officer shall record the hearing through the use of a tape/cassette recorder or similar mechanical devise, or through the use of a court report paid for by ODA.

Procedure D – Hearing Decision 1.

The hearing officer shall review the testimony or evidence collected at the hearing and shall make a written recommendation to ODA regarding whether the AAA's activity was appropriate.

2.

Within 30 working days of the date on which the hearing was held, ODA shall render a final decision on the appeal. ODA shall send a copy of the decision and the rationale for the decision to both parties.

3.

The decision of ODA is final and binding.

_____________________________________ Date: December 7, 1995 Authority/Basis: OAA § 307(a)(5); 45 CFR 1321.11

Ohio Department of Aging

108.00 – General Advocacy Responsibilities Page 1 of 1

Policy The Ohio Department of Aging (ODA) shall serve as an effective visible advocate for the elderly in the State of Ohio by: 1.

Reviewing and commenting on all state plans, area plans, budgets, and policies and programs which affect older persons.

2.

Conducting public hearings on the needs of older persons.

3.

Coordinating statewide planning and development of activities for older Ohioans.

4.

Reviewing and commenting upon applications to state and federal agencies for programs which meet the needs of older persons.

Procedure A – General Responsibilities 1.

The ODA shall seek to educate and inform members of the Ohio General Assembly and to otherwise review and influence the passage of legislation which will advance sound public policy affecting older Ohioans.

2.

The ODA will seek to ensure the most effective and efficient use of Older Americans Act, state and other resources earmarked for older Ohioans.

3.

The ODA will coordinate internal governmental reviews for all program plans and budgets received by the state that provides services to older Ohioans.

4.

The ODA will continue, with the Area Agency on Aging (AAA), to reassess the needs and services available to older persons.

5.

The ODA will attempt to dispel negative and incorrect images of aging facing the older population.

6.

The ODA will continue to encourage older persons to participate as members of community advisory groups, policy boards, planning, and other interest groups on behalf of all older Ohioans.

7.

The ODA will sponsor and carry out an annual Governor's Conference on Aging that will, in part, serve as a public hearing to solicit information for the general community and seniors on their perceived needs for services.

8.

The ODA will organize older Ohioans and service representatives in planning and conducting statewide special events, such as Senior Citizens Day, Governor's Art Show, Ohio State Fair Senior Citizens Program, Elderwalk and Senior Citizens Hall of Fame, on behalf of all older Ohioans.

Ohio Department of Aging

109.00 – Title III: Resource Allocation Page 1 of 2

Policy The Ohio Department of Aging's (ODA) allocation of Title III funds to Area Agencies on Aging (AAAs) is based upon the economic and social needs of the population of persons sixty (60) years of age and over in each Planning and Service Area (PSA). Procedure A – Title III Funding Formula for AAA Administration, Supportive Services, Congregate Meals, Home-Delivered Meals, and In-Home Services 1.

Each AAA is allocated a base grant of $375,000.

2.

An administrative funding allocation of $170,000 for the AAA is deducted from the $375,000 base grant.

3.

The balance of $205,000 is then distributed proportionately to funding lines (Social Services, Congregate Meals, Home-Delivered Meals, and In-Home Services).

4.

The procedure to distribute the balance of funding after the base and administrative funds are removed is based on the formula reflected below. Indicators in the formula are weighed in the following manner: a.

number of persons at or above age 60 accounts for 43% of the allocation;

b.

number of persons at or above age 75 accounts for 28% of the allocation;

c.

number of persons at or above age 60 and at or below the federal poverty level (FPL) accounts for 11% of the allocation; and

d.

number of minorities at or above age 60 accounts for 8% of the allocation;

e.

number of persons at or above the age of 60 living alone accounts for 8% of the allocation;

f.

number of persons at or above the age of 60 living in rural areas accounts for 2% of the allocation.

Procedure B – Title III-D Funding for In-Home Services 1.

Title III-D funds may not be used to supplant existing resources used to fund inhome services.

2.

Title III-D funds may only be used to fund the in-home services listed below: a.

Homemaker and home health aides;

b.

Visiting and telephone reassurance;

109.00 – Title III: Resource Allocation Page 2 of 2

c.

Chore maintenance;

d.

In-home respite care for families, including adult day care as a respite service for families; and

e.

Minor modification of homes that is necessary to facilitate the ability of older individuals to remain at home, and that is not available under other programs, except that not more than $150.00 per client per year may be expended under this part for such modification.

For further definitions please refer to the most recent ODA taxonomy of services. Procedure C – Approval and Distribution of Title III-B, C, and D Funds 1.

For the purpose of soliciting comments on the funding formula used for Title III-B, C, and D funds, ODA shall include the current funding formula used in each fouryear State Plan submission to the Administration on Aging.

2.

AAAs and the Ohio Advisory Council shall be notified of any proposed changes to the formula and given the opportunity to provide input prior to implementation.

3.

ODA will use the formula in the process of allocating funds under Title III-B, C, and D of the Older Americans Act of 1965 as amended.

Date: January 21, 1999 (#199NP016) Authority/Basis:42 USC 3025 (a) (2) (C); 42 USC 3030(k)

Ohio Department of Aging

109.01 – Area Agency on Aging Administrative Allocation Page 1 of 1

Policy Allocation of funds for Area Agency on Aging (AAA) administration shall not exceed 10% of total base allocations available to the AAAs from Older Americans Act Title III funding sources. The Ohio Department of Aging shall establish a fixed administrative allocation from Senior Community Service Block Grant (SCSBG) funds. Procedure A – Title III Administrative Allocation 1.

The Ohio Department of Aging (ODA) will reserve no more than 10% of total Title III funds available for allocation to the AAAs. This calculation will be based on the total funds available for allocation to the AAAs in parts B, C, D, E, F, and G.

2.

From the base grant provided through Policy 109.00 (A) (1), an administrative allocation in the amount of $170,000 will be deducted for each AAA.

3.

The balance of the statewide administrative allocation, calculated as shown below, shall be allocated to the AAAs through application of the intra-state funding formula. (Total base allocation x .10) - (170,000 x 12) = Balance

4.

The intra-state funding formula will automatically add the distributed balance to the $170,000 base, resulting in the total administrative allocation for each AAA.

5.

No additional transfers may be made into the AAA administration line item from Title III funds.

6.

No additional administrative expenses shall be charged to service dollars.

Procedure B – Senior Community Service Block Grant Administrative Allocation 1.

In SCSBG funds, at least $82,000 shall be awarded to each AAA for administrative expenses.

2.

The amount of the SCSBG administrative allocation may be adjusted if adjustments are made to the SCSBG budget line within the biennial budget period for those AAAS where $82,000 is less than 10% of the AAA’s SCSBG allocation.

Date: June 23, 1994; April 17, 1998 Authority/Basis: P.L. 89-73, as amended through December 21, 1992, § 303(c); ORC 173.16; ODA Policy 109.00; ODA Policy (SCS)

Ohio Department of Aging

110.00 – Coordinated Monitoring Process Page 1 of 5

Policy The Ohio Department of Aging (ODA) shall establish monitoring procedures to evaluate the performance of federal or state funded programs or activities managed by Area Agencies on Aging (AAAs). To the extent that the monitoring procedures set forth in this policy are applied to the PASSPORT program, these procedures also apply to Catholic Social Services of the Miami Valley as a PASSPORT Administrative Agency. The Coordinated Monitoring Process culminates in the issuance of the monitoring report for each AAA. This policy does not apply to regional long-term care ombudsman programs, or to Senior Community Services Employment Program grantees. These programs have separate monitoring processes and procedures and not all AAAs are responsible for the management of these programs. Goals The goals of the coordinated monitoring process are as follows: 1.

To determine compliance with federal and state fiscal and program requirements by the AAAs.

2.

To verify the accuracy of the information received from AAAs.

3.

To ensure that services are accessible and of high quality.

4.

To establish a baseline of knowledge in regard to new requirements, programs and services and to provide technical assistance to the AAAs.

5.

To identify trends and patterns which require systemic changes.

6.

To improve services and enhance communication between ODA and the AAAs.

7.

To identify and promote best practices throughout the aging network.

8.

To support informed involvement by AAA Advisory Council and governing board members in the operation of the AAA.

Procedure A – Scope 1.

2.

The coordinated monitoring process encompasses two activities. a.

Desk review of AAA plans, administrative reports and data by ODA.

b.

An on-site monitoring visit as set forth in Procedure B.

Other issues of concern to either ODA or the AAA may also be incorporated into the monitoring process and report.

110.00 – Coordinated Monitoring Process Page 2 of 5

Procedure B – On-Site Monitoring Visits 1.

2.

3.

ODA shall make an on-site monitoring visit to each AAA at the frequency specified in Section 2 of this Procedure. The scope of the monitoring visit includes, but is not limited to, the following: a.

Fiscal practices of the AAA;

b.

Program management and operations (e.g., PASSPORT and nonPASSPORT);

c.

Consumer satisfaction;

d.

Adherence to ODA mandated policies and procedures;

e.

Adherence to state and federal law governing grants and contracts;

f.

Best practices of the AAA;

g.

AAA Area Plan accomplishments and promising practices; and

h.

Other issues of concern to ODA or AAA.

Schedule for on-site monitoring visits: a.

ODA’s Fiscal Division will make an on-site monitoring visit each year unless it is determined by ODA that a specific AAA does not require an on-site visit.

b.

ODA’s Quality Support Division and Planning, Development and Evaluation Division will make an on-site monitoring visit to each AAA at a minimum of every two years.

ODA’s Monitoring Action Team will coordinate on-site monitoring visits to each AAA by multiple ODA divisions so that all on-site visits are made during the same 15-day period.

Procedure C – Desk Review 1.

Desk review encompasses ODA’s ongoing review of plans, administrative reports, and data required by ODA on a routine and on-going basis.

2.

The scope of desk review activities includes, but is not limited to, the following: a.

Review of ODA internal reports and mandated reports that AAAs must generate. Examples include OASIS report, AAA requests for funds, reports required pursuant to a Notice of Grant Award, reports required

110.00 – Coordinated Monitoring Process Page 3 of 5

pursuant to a waiver of ODA policy, audited financial statements, and PASSPORT skilled professional match reports. b.

Review of reports affecting consumer welfare and safety.

c.

Review of data and reports generated by ODA-designated reporting systems including OASIS, SAMS, and the PASSPORT/RSS system.

d.

AAA implementation of new or revised policies, statutes and rules.

e.

Area Plan narrative and budget submissions.

f.

Review of AAA governing board and advisory council minutes.

g.

Review of infrastructure issues by ODA’s Information Systems Division.

3.

ODA will bring issues that arise from desk review activities to the immediate attention of the affected AAA Director.

4.

ODA will incorporate issues that are unresolved at the time of the coordinated monitoring report or issues that require further follow up by the AAA.

Procedure D – Scheduling and Coordination 1.

All ODA monitoring activities are coordinated by the Monitoring Action Team. a.

The Monitoring Action Team includes designated staff of ODA Fiscal Management, Quality Support and Planning, Development, and Evaluation Divisions.

b.

The designated lead for ODA monitoring activities is the Monitoring Action Team chairperson, selected by the ODA Director.

2.

Before the beginning of each monitoring cycle, ODA will distribute a calendar by Notice to the AAAs of when each AAA can expect its on-site monitoring visit.

3.

At the time the calendar is issued, ODA will also indicate which AAAs will receive a combined fiscal/program on-site visit from ODA staff.

4.

ODA will send a pre-monitoring visit letter to the AAA. The pre-monitoring visit letter shall include: a.

The beginning and end of the 15-day period during which ODA will conduct on-site monitoring visits.

b.

Tracking sheets outlining issues from the previous monitoring report.

110.00 – Coordinated Monitoring Process Page 4 of 5

5.

If an on-site visit is scheduled that includes the program divisions, each ODA division will request any work required from the AAA prior to the visit with sufficient time for the AAA to respond before the visit.

6.

ODA and the AAA may negotiate another mutually agreed upon date for the onsite visit.

Procedure E – Contents of the Monitoring Report 1.

2.

The monitoring report includes, as applicable, the following sections: a.

Agency Profile – Summary of Agency programs, services, grants, unique characteristics, etc.

b.

Accomplishments – Summary of agency achievements, projects, successes, etc.

c.

Planning, Development and Evaluation division’s scope – PDE describes noteworthy activities and system direction.

d.

Quality Support Division’s Scope – QSD describes monitoring areas and the agency’s practice/current status.

e.

Fiscal Division’s Scope – Fiscal describes monitoring activities and the agency’s reporting to ODA.

f.

Monitoring Follow-Up – Identifies areas of non-compliance that requires corrective action be taken by the agency.

g.

Concerns and Recommendations – Agency issues and/or practices identified by ODA that are not out of compliance; however, may have practice implications, warrant mentioning and/or technical assistance. This section may require follow-up by the agency.

h.

Appendix – Acronyms and abbreviations.

Additional information may also be included in the monitoring report to the AAA that may be useful to the AAA in its management of programs and services.

Procedure F – Presentation and Distribution of the Monitoring Report 1.

Discussion of all issues, findings, concerns and additional information that are part of the monitoring report shall be held, in person or by phone, with the AAA as part of the exit conference.

2.

Any findings or areas of concern that have not previously been brought to the attention of the AAA shall not be included in the monitoring report.

110.00 – Coordinated Monitoring Process Page 5 of 5

1. 2.

ODA shall issue a report to the AAA Director and the AAA Director shall communicate the final report to the AAA’s governing body. ODA will be available to present the results of the monitoring report at the next regularly scheduled governing body or advisory council meeting to clarify the contents of the monitoring report including any actions requested by ODA.

Procedure G – Follow-up on Monitoring Report 1.

ODA may make additional visits to assist the AAA in addressing issues arising from the monitoring report.

2.

The AAA may request technical assistance to address any unresolved issues.

3.

Unless otherwise specified in the monitoring report, responses by AAAs to findings in the report are due to ODA within 30 days of the issuance of the report.

Date: July 7, 2004 (#0704P102) Authority Basis: Older American Act § 306 (42 U.S.C 3026) Area Plans

Ohio Department of Aging

111.00 Technical Assistance to Area Agencies on Aging Page 1 of 2

Policy The Ohio Department of Aging (ODA) shall provide technical assistance to Area Agencies on Aging (AAAs) in order that AAAs serve as effective and visible advocates for the elderly and remain in compliance with the Older Americans Act, federal regulation, and State policies and procedures. Technical assistance may either be in the form of trainings initiated by ODA or to AAA requests. Procedure A – AAA Requested Technical Assistance 1.

AAA staff will contact appropriate ODA Division to state request for technical assistance. This statement may either be a written request or a telephone request followed by a written request.

2.

Requests for technical assistance should be directed to the divisions as listed below: a.

Legal Legislative Division: requests concerning legal and legislative issues;

b.

Health and Community Services: requests concerning AAA coordination, Title III-B Social Services, Title III-C Nutrition, Title III-D In-Home Services, Title III-G Elder Abuse, Quality Assurance, HEAP, Ohio Energy Credits, Housing and Shared Living, Alzheimer’s, Nutrition, Transportation and Aging Network demonstrations and Senior Volunteer Programs;

c.

Communications: requests concerning public relations and special events;

d.

Fiscal: requests concerning fiscal management;

e.

Long Term Care: requests concerning Long Term Care, PASSPORT, Assistance for Independent Living and Quality Assurance;

f.

Ombudsmen: Long Term Care Ombudsman Program, legal service and public benefits;

g.

Human Resources Division: requests concerning personnel, office management, EEO and Affirmative Action.

h.

Management Information Systems Division: requests concerning demographic data, statistics, management information system design and evaluation;

i.

Bureau of Education and Training: requests concerning training, ODA/AAA orientation, ODA Resource Center, and audiovisual materials;

j.

Senior Employment/Golden Buckeye Program: requests concerning Title V Senior Employment and Golden Buckeye Cards;

111.00 Technical Assistance to Area Agencies on Aging Page 2 of 2

k.

3.

Senior Facilities: requests concerning Multi-purpose senior centers and Golden Age Villages.

ODA will follow-up to determine if necessary information was provided or if further information is needed.

Ohio Department of Aging

112.00 – Vacant Page 1 of 1

Policy Formerly: ODA Resource Center Rescinded: 1/21/99; Notice #199NP016 Number is available

Ohio Department of Aging

113.00 – Training/Education AAA Responsibilities and Requirements Page 1 of 2

Policy The Area Agency on Aging (AAA) shall provide, as part of its Area Plan, a plan for training activities and their associated costs in order to improve aging related information, skills and service quality. Procedure A – Staff Responsible 1.

Organization and implementation of an AAA training plan shall be the responsibility of the AAA director and the AAA staff person assigned for training coordination.

Procedure B – Funding 1.

The AAA will budget a minimum of $4,000 per year to fund training.

2.

Title III funds will be used for training.

Procedure C – Target Audience of training 1.

AAA sponsored/implemented training will be targeted to: a.

aging services network personnel;

b.

selected volunteers;

c.

selected others

Procedure D – Training Pan 1.

AAA Training Plans will be submitted to ODA as part of the “Area Plan for Programs on Aging". a.

2.

3.

The directions contained in the current Area Plan forms are to be followed.

Completed forms to be submitted with the Area Plan are: a.

Exhibit D-3: "Training Budget Composite of Proposed Training"

b.

The G series should be submitted with E-2a's; (G-1: "Proposal For Training/Education Event"; G-2 "Training Budget Form"; G-3 "Area Training Plan Sign-Off").

The local PSA members of the Ohio Network of Educational Consultants in the Field of Aging (ONECA) will may provide AAA's with technical assistance in the development of their raining plans.

113.00 – Training/Education AAA Responsibilities and Requirements Page 1 of 2

a.

b.

4.

The PSA ONECA members will review and sign off on the AAA Training Plan before submission to ODA. i.

Sign off may be "favorable";

ii.

Sign off may be "with reservations".

The PSA ONECA members may be involved in the implementation of the Training Plan.

Upon request of AAA training officers, The ODA Training Office will be available to provide technical assistance in the development and/or implementation of AAA training plans; a.

through the training officer;

b.

through the "AAA Training Assistance Guide" i.

"AAA Training Assistance Guide" to be developed by ODA in conjunction with AAAs and ONECA.

Procedure E – Training Events 1.

The AAA will provide a yearly calendar (with quarterly updates, as needed) of training events to the ODA Training Officer.

2.

The AAA will report to ODA on each training event. a.

Forms to be used are: i.

"Participant Registration Form" - For data collection by AAA;

ii.

"Participant Analysis Form" (1)

iii.

Submit this composite report to ODA ten (10) working days following each training event.

"Participant Evaluation Form" (1)

Submit this composite form to ODA ten (10) working days following each training event.

Ohio Department of Aging

114.00 – Vacant Page 1 of 1

Policy Formerly – Title V Rescinded 1/21/99 Number is available.

Ohio Department of Aging

115.00 – Vacant Page 1 of 1

Policy Formerly – Senior Awareness Liaison Aide Network Rescinded 1/21/99 Number is available.

Ohio Department of Aging

116.00 – Vacant Page 1 of 1

Policy Formerly – Golden Buckeye Program Rescinded 1/21/99 Number is available

Ohio Department of Aging

117.00 – ODA Rule Filing Page 1 of 1

Policy Prior to the Ohio Department of Aging (ODA) filing of any administrative rule under the process outlined in Section 119.03 of the Ohio Revised Code, Area Agencies on Aging (AAAS) shall have the opportunity to comment on such a rule through a public hearing. ODA shall give a notice to each AAA stating its intent to consider the adoption, the amendment, or the rescission of a rule; a statement of the reason or purpose for the adoption, amendment, or the rescission of the rule; and the time, the date, and the location of the public hearing. Procedure A – Notification of Intent to File Rules 1.

Upon ODA's filing of proposed rules with the appropriate bodies of state government, ODA shall immediately forward a copy of the public hearing notice to each of its AAAs.

2.

The notice to AAAs shall, at a minimum, contain the following information: a.

ODA's intent to consider the adoption, amendment, or rescission of a rule;

b.

a statement of the reason or purpose for the filing-,

c.

the time, date, and location of the public hearing.

Procedure B – Rule Attachment to Notice 1.

ODA shall include one copy of each rule being proposed for adoption, amendment, or rescission, to the notice sent to each AAA.

Ohio Department of Aging

201.00 – Area Agency on Aging Advisory Council Page 1 of 3

Policy The Area Agency on Aging (AAA) in each Planning and Service Area (PSA) shall establish a council to advise the AAA on matters relating to the development, administration, and operation of the Area Plan. Procedure A – AAA Relationship with Advisory Council 1.

The AAA shall prepare policies and guidelines on the method of selecting Advisory Council members. The policies and guidelines must adhere to the Older Americans Act (OAA) and the OAA regulations regarding mandates for composition, including terms to be served by members.

2.

Written information on topics to be discussed at Advisory Council meetings shall be provided in a timely manner to the Advisory Council.

3.

At a minimum, the AAA shall provide technical support to the Advisory Council in these areas: a.

Developing meeting agendas and selecting locations;

b.

Mailing meeting reminders;

c.

Providing training;

d.

Reviewing and drafting recommendations;

e.

Preparing and disseminating meeting minutes, reports and briefing papers, and;

f.

Gathering demographic data.

Procedure B – Functions of AAA Advisory council 1.

The Advisory Council shall carry out advisory functions which further the AAA's mission of advocating, developing and coordinating community-based systems of services for all older persons in the PSA.

2.

The Advisory Council shall continuously advise the AAA relative to: a.

Developing and administering the Area Plan;

b.

Operations conducted under the Area Plan;

c.

Conducting public hearings;

201.00 Area Agency on Aging Advisory Council Page 2 of 3

3.

d.

Representing the interests of older persons; and

e.

Reviewing and commenting on all community policies, programs, and actions which affect older persons with the intent of assuring maximum coordination and responsiveness to older persons.

The AAA shall submit the Area Plan and amendments for review and comment to the Advisory Council before it is transmitted to ODA for action.

Procedure C – Advisory Council Membership and Composition 1.

The Advisory Council membership shall include individuals and representatives of community organizations who will help to enhance the leadership role of the AAA in developing community-based systems of services.

2.

The Advisory Council shall be composed of more than fifty (50) percent older persons, including minority and older individuals living in rural areas, who are participants or who are eligible to participate in programs funded under the OAA.

3.

The Advisory Council shall include representatives from each of these groups:

4.

a.

Advocates for older persons;

b.

Representatives of health care provider organizations, including providers of veterans' health care, if appropriate;

c.

Representatives of supportive services provider organizations;

d.

Persons with leadership experience in the private and voluntary sectors;

e.

Local elected officials;

f.

Representatives of faith-based organizations; and

g.

The general public.

Advisory Council members shall not simultaneously serve as an AAA governing body member with the exception of the Advisory Council chairperson, who may serve as an ex-officio member of the governing body.

Procedure D – Meetings and Minutes 1.

The Advisory Council shall meet as often as necessary but no less than three (3) times per year.

2.

The AAA shall forward Advisory Council meeting minutes to the ODA chief of the Planning, Development and Evaluation Division in a timely manner.

201.00 Area Agency on Aging Advisory Council Page 3 of 3

3.

Advisory Council meeting minutes are subject to Policy 218.00 Records Retention.

4.

Advisory Council meetings are subject to Procedure A. of Policy 201.01 AAA Board of Trustees Schedule.

______________________________ Date: June 19, 1997, February 13, 2002, November 14, 2003 (#1103S179) Authority/Basis: OAA § 306 (a)(6)(F) (42 U.S.C. 3026); OAA Regulations (1321.57 Federal Register, Vol. 53, No. 69, Wednesday, August 31, 1988); 45 CFR 1321.11

Ohio Department of Aging

201.01 – Area Agency on Aging Board of Trustees Schedule Page 1 of 1

Policy Because AAAs are subject to the Ohio Open Meetings laws (§121.22 Ohio Revised Code), each AAA is required to develop a procedure to notify the general public of the time and place of Board of Trustee and/or advisory council meetings. Procedure A – Open Meetings 1.

The AAA Board of Trustees shall invite the public to attend all board meetings or portions of board meetings during which business is conducted pursuant to the AAAs' designation as an AAA or PAA. This policy does not apply to those meetings or portions of meetings dealing with issues unrelated to the organization's designation as an AAA.

Procedure B – Notice Content 1.

As part of its Area Plan submission, the AAA shall identify the procedures it will take to notify the general public of Board of Trustee meetings and Advisory Council meetings. Such procedures may include publication in newspapers, the posting of notices in senior centers and congregate meals sites, utilization of newsletters and other publications designed to reach older persons, or any other appropriate mechanism for notification identified by the AAA.

2.

At a minimum, the notice shall contain the following: a. scheduled dates for board meetings; b. scheduled times for board meetings; c. scheduled locations for board meetings; d. a contact name for more information.

3.

If the AAA elects to publicize a number of meetings in advance, the notice shall include a disclaimer that meeting times and places are subject to change and the phone number that may be called to confirm the meeting.

Procedure C – Documentation of Compliance 1.

AAAs will describe their method of notification in their Area Plan submission and will update this information as substantive changes occur.

2.

Copies of printed notices shall be forwarded to the ODA field representative upon request during the regular monitoring process.

3.

Approved minutes shall be transmitted at the same time they are submitted to board members upon request by any member of the general public.

Date: November 10, 1994 Authority/Basis: ORC §121.22; 45 CFR §1321.61

Ohio Department of Aging

201.02 – Area Agency on Aging Governing Body Page 1 of 2

Policy The Area Agency on Aging (AAA) in each Planning and Service Area (PSA) shall be governed by a body that oversees the AAA's development of comprehensive and coordinated services to older persons in the PSA. The governing body shall determine AAA policy, define specific needs to be addressed and the target population to be served, regularly evaluate the accomplishments of the adopted program plan, hire the Executive Director, lead in the development of financial resources, and represent the public interest. Procedure A – Functions and Responsibilities 1.

2.

3.

4.

The governing body shall determine the organization's mission and purpose by: a.

Defining and articulating the AAA's mission, goals, and primary constituents served;

b.

Guiding the AAA's planning and prioritizing among competing demands for resources; and

c.

Developing specific strategies to implement the AAA goals and measuring the effectiveness of those strategies.

The governing body shall select the AAA Executive Director by: a.

Defining and establishing clear objectives and expectations for the Executive Director, and developing a comprehensive job description, which clarifies the Executive Director's role and responsibilities;

b.

Relying on organizational audit of strengths and weaknesses of the AAA and the establishment of specific priorities for executive leadership; and

c.

Establishing compensation/conditions of employment for the Director.

The governing body shall support and review the Executive Director's performance by: a.

Designing the process by which the Executive Director is recruited and hired;

b.

Supporting the Executive Director in the implementation of policies set by the governing body; and

c.

Evaluating the performance of the Executive Director at least annually.

The governing body shall be responsible for effective organizational planning and shall:

201.02 Area Agency on Aging Governing Body Page 2 of 2

a. b. 5.

Be involved extensively as resources in planning, developing and implementing the AAA's goals and objectives; and Review and approve the AAA's Area Plan and budget.

The governing body shall have fiduciary responsibility to: a.

Set the guidelines for fundraising at the PSA level;

b.

Be involved in the AAA's long range financial planning;

c.

Be involved in the development of an adequate compensation and benefits package for AAA staff; and

d.

Oversee the expenditure of federal and state funds allocated to the AAA.

6.

The governing body is responsible to ensure that the AAA operates in accordance with all applicable local, state, and federal laws.

7.

The governing body shall establish and approve administrative and governing policies by:

8.

a.

Adopting human resources policies for the AAA; and

b.

Developing and approving policies consistent with Ohio Department of Aging policies to carry out the mission of the AAA.

The governing body shall assess its own performance by establishing a periodic review process to evaluate itself and review the AAA's administrative policies and the governing policies to measure effectiveness.

Procedure B – Conflict of Interest Because the governing body sets policy direction for the AAA, each AAA shall adopt written procedures that address the steps that must be taken when a conflict of interest exists for an individual member of the governing body. At a minimum, these written procedures must address these areas: 1.

The steps that an individual governing body member must follow in determining whether the member possesses a conflict; and

2.

The process of recusal from any involvement, including governing body discussions, on any issue before the governing body in which the member of the governing body possesses a conflict.

Additionally, governing body members of those AAAs which house Regional Long-Term Care Ombudsman Programs (RLTCOPs) must complete the RLTCOP conflict of interest screen. _______________________ Date: June 10, 1998 Authority Basis: 45 CFR 1321.11

Ohio Department of Aging

202.00 – Area Agency on Aging Funding Formula Page 1 of 1

Policy Each Area Agency on Aging (AAA) must develop and institute an allocation process for title IIIB, C and D Funds. As part of this process, a funding formula must be developed and used for the annual allocation of Title IIIB, C and D funds to service providers in their Planning and Service Areas (PSAs). This formula shall be applied separately to B, C and D funds awarded by the Ohio Department of Aging (ODA). Procedure A – Minimum Factors 1.

2.

The AAA funding formula shall consider: a.

proportion among counties of the PSA of persons 60 and over;

b.

those 60 and over in greatest economic and social need with particular attention to low-income minority individuals;

c.

new obligational authority, supplemental grants awards, and federal grant funds unearned from previous project year;

The AAA shall determine economic need by use of the poverty threshold established by the Bureau of Census.

Procedure B – Review and Distribution 1.

The AAA will review and update it's formula as often as a new Area Plan is submitted for approval.

2.

The funding formula must be clearly stated and in writing, and be made part of the AAA's Policy and Procedures Manual.

3.

The AAA funding formula will be reviewed by the Advisory Board and approved by the grantee agency board.

Ohio Department of Aging

203.00 – Vacant Page 1 of 1

Policy Formerly: AAA Research Activity Policy Rescinded 02/01; Notice #0201P031

Ohio Department of Aging

204.00 – Area Plan Page 1 of 3

Policy Each Area Agency on Aging (AAA) shall prepare and submit a strategic Area Plan every four years and an annual operational Area Plan to the Ohio Department of Aging (ODA). Both the strategic and operational Area Plans shall reflect the AAA's intent to provide for the development of a comprehensive and coordinated service delivery system for services to older Ohioans in the Planning and Service Area (PSA). The strategic and operational Area Plans will also reflect the intent to plan for and fund a broad spectrum of quality services for both frail and well elderly to persons 60 and over. Area Plan budget submissions apply to the following funding sources: Title III Parts B, C, D, F, the Senior Community Services Block Grant (SCSBG), Alzheimer's respite funds, and long-term care ombudsman funds. Area Plans must conform to all rules, regulations, and policies contained in the Older Americans Act of 1965, as amended, as well as other applicable laws, rules, regulations and policies as set forth by the federal government and the Ohio Department of Aging. Procedure A – Area Plan Format and Submission 1.

2.

AAAs will complete the area plan format as prepared and distributed by ODA. a.

AAAs will prepare and submit the Strategic Elements section and appendices section of the area plan format every four years.

b.

Every year, AAAs will prepare and submit the Operational Elements (Sections B, C, and D), appropriate Appendices section and Assurances section.

AAAs will be notified via an ODA Notice of Instruction of the submission date(s) for the area plan format.

Procedure B – Area Plan Development 1.

AAAs will utilize a strategic planning process that, at a minimum,: a.

includes an environmental scan to identify key issues,

b.

analyzes strengths, weaknesses, opportunities and threats,

c.

identifies service needs and gaps,

d.

identifies critical issues based on the above activities, and

e.

leads to development of strategic goals and objectives to address these issues.

204.00 – Area Plan Page 2 of 3

2.

AAAs will, through various mechanisms, such as a needs assessment, community forums, questionnaires, surveys, etc., assess the needs of the elderly of the PSA. The proposed implementation activities responding to these results/finding will be reflected in the area plan.

3.

AAAs shall conduct a public hearing on its strategic Area Plan document no less than 60 days prior to required submission date to ODA. a.

b.

AAAs shall follow its procedures pursuant to Policy 201.00 to notify the general public of the date, time and place of the public hearing. Notices of the public hearing shall contain the following: i. the reason for the public hearing; ii.

the date of the public hearing;

iii.

the time of the public hearing;

iv.

the location of the public hearing;

v. vi.

the deadline and address of where written comments will be accepted how the area plan document may be previewed prior to the public hearing; and

vii.

a contact name for more information.

Public hearings, unless specified elsewhere in ODA policy, will not be required on operational Area Plans.

Procedure C - Area Plan Budgets and Contract Summaries 1.

Area Plan budget exhibits (Section D) are to identify by funding source the percentage of funds that will be spent for each service the AAA plans to fund during its next program year as well as a percentage of funds that will be set aside under Procedure D.

2.

Within two months of the start of its program year, the AAA shall submit the Contract Summary report identifying all grants and contracts for which it has obligated funds as well as the dollar amount of any approved set asides under Procedure D.

3.

Unanticipated funding for which the AAA receives a Notice of Grant Award (NGA) after the beginning of its program year is expected to be obligated as defined by the NGA.

Procedure D – Set Aside of Funds as Part of an Area Plan Submission 1.

As part of its Area Plan budget submission, a AAA may propose to set aside funds for one of the following three purposes:

204.00 – Area Plan Page 3 of 3

a. b.

c.

2.

Funds may be set aside as part of a care coordination pool identified pursuant to Policy 315.01 Care Coordination. Funds may be set aside for major purchases of equipment for service providers that are not covered under the reimbursement rates set forth in service provider contracts. Examples include vans, computer equipment, and kitchen equipment. The Area Plan submission must specify the funding source from which purchases will be made and the type of equipment to be purchased. Funds may also be set aside for services that will be provided to older persons in the Planning and Service Area in the event of a natural disaster. Natural disasters include floods, tornadoes, extreme heat or cold, or other disasters declared by federal, state, or local government.

If ODA approves the set aside, the AAA shall record the dollar amount set aside when its Contract Summary report is submitted.

Procedure E - Area Plan Approval 1.

ODA has 30 days to respond to the area plan submission once it is complete. Upon completion of ODA review process for the strategic and operational plans, an approval letter will be sent to each AAA director within 60 days of the original submission. The approval letter may indicate conditional stipulations.

2.

AAAs will receive an NGA reflecting the new award of funds. This document may indicate conditional stipulations. ____________________________ Date: August 20, 1999, (#899NP224)

Authority/Basis: Older Americans Act, 1965, as amended; 42 U.S.C. 3026

Ohio Department of Aging

204.01 – Area Plan: Use of Funds for MPSC Capital Improvements Page 1 of 3

Policy Proposed allocations of Older Americans Act grant funds for purposes as outlined in Section 321.(1)(b) of the Older Americans Act must be approved by the Ohio Department of Aging (ODA) prior to an Area Agency on Aging (AAA) issuing a grant award for such purposes. Community Services Block Grant Funds allocated by ODA for provision of supportive services may not be used for construction, acquisition, renovation or alteration. Procedure A – Application Process 1.

The AAA must indicate through ODA's area plan process its intent to allocate Older Americans Act funds towards acquisition, alteration, renovation of existing facilities or the construction of a facility which will serve as a multipurpose senior center. a.

b.

Use of these funds must be outlined by project within the area plan. The AAA shall include in the appendix of the area plan the following information on each project it proposes to fund: i.

Project name (MPSC);

ii.

Project address (MPSC);

iii.

Grantee name;

iv.

Grantee address;

v.

Approximate total cost of project;

vi.

Approximate amount of Older Americans Act funds to be allocated toward the project;

vii.

Percentage of Older Americans Act funds in the project;

viii.

Indicate which activity is to take place: acquisition, construction, renovation, or alteration; and

ix.

Use of these funds with other sources of funds in above activities; list other sources of funds with amounts.

The AAA must also provide through the area plan approval process (updates, revision, new plan) a detailed narrative describing: i.

how this project fits into the long range plan of the AAA for provision of services;

204.01 – Area Plan: Use of Funds for MPSC Capital Improvements Page 2 of 3

c.

d.

ii.

dollar amount of Older Americans Act funds being utilized by the project; list the services funded by these dollars;

iii.

services (identify by using ODA taxonomy standards language) other than those listed in A.1 b.(2) currently being provided by the project to seniors;

iv.

how the project currently targets for delivering service to low-income minority;

v.

sources of project/senior center operating funds;

vi.

if this project is a focal point and identified in the area plan; and

vii.

start date for the project.

The AAA must provide assurances to the following: i.

the need for the project was identified and substantiated through a general needs assessment process which has been conducted within the past two years;

ii.

the needs assessment shows this activity to be a high priority within the planning and service area;

iii.

public hearings have included specific identification of these funds and for what purposes;

iv.

the AAA has assessed the impact of using these funds for the above purposes instead of spending on services; this assessment must show how services will be maintained if service dollars are used for MPSC capital improvements activity;

v.

the project and sponsor are either a public or private non-profit agency or organization and comply with Ohio Revised Code in meeting that definition, and are registered with the Secretary of State in that capacity; and

vi.

the project/grantee and the AAA have pursued and applied to other funding sources for the same purpose/project (e.g. ODA 1084, private foundations) and have been unsuccessful in obtaining funds from any specific funding source during the past three calendar years.

Approval for use of these funds for construction, acquisition, alteration and renovation will be forthcoming through the ODA area plan approval process.

204.01 – Area Plan: Use of Funds for MPSC Capital Improvements Page 3 of 3

Procedure B – Use of Grant Funds 1.

Any federal dollars approved by ODA for the use of construction, acquisition, renovation or alteration must be spent within the plan year in which the funds are awarded to the project. a.

ODA's policy on Federal Grant Unearned (See Policy #406.00) will apply to funds unspent at the close of the previous fiscal year.

Procedure C – Federal Reversionary Interest 1.

The AAA will comply with ODA Policy #313 on Federal Reversionary Interest.

Ohio Department of Aging

204.02 – Service Priority to Specific Client Groups Page 1 of 3

Policy AAAs shall set specific goals to ensure that services are provided to older individuals (aged sixty and over) with greatest economic need and greatest social need, with special emphasis on lowincome minority individuals in at least the proportion of the priority population within the respective service provider's geographic boundaries. Definitions: ADL: The term "activity of daily living" means a personal care skill performed, with or without the use of assistive devices, on a regular basis that enables the individual to meet basic life needs for food, hygiene, and appearance. The term "ADL" may refer to any activity as defined in rule 5101:3-3-06 (B)(1) of the Ohio Administrative Code (see Appendix). Frail: The term "frail" means that an older individual is determined to be functionally impaired because the individual is unable to perform at least two activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision. Greatest Economic Need: The term "greatest economic need" means the need resulting from an income level at or below the official federal poverty line. Greatest Social Need: The term "greatest social need" means the need caused by non-economic factors, which include physical and mental disabilities; language barriers; and cultural, social, or geographical isolation, including isolation caused by racial or ethnic status, that restricts the ability of an individual to perform normal daily tasks or threatens the capacity of the individual to live independently. IADL: The term "instrumental activity of daily living" means a community living skill performed, with or without the use of assistive devices, on a regular basis that enables the individual to independently manage the individual's living arrangement. The term "IADL" may refer to any activity defined in rule 5101:3-3-08(B)(4) of the Ohio Administrative Code (see Appendix). Low Income: The term "low income" refers to an older person whose annual income is at or below 100% of the official poverty line as prescribed in the most current version of the Older Americans Act. Minority: The term "minority" refers to individuals who are Black Non-Hispanic, Hispanic, American Indian/Alaskan Natives and Oriental/Asian/Pacific Islanders. Poverty Line: The official poverty line as issued by the Department of Health and Human Services. Rural: The term "rural" refers to any area which is not part of a Metropolitan Statistical Area and therefore includes rural farm, rural non-farm, and towns and cities up to 50,000 in population.

204.02 – Service Priority to Specific Client Groups Page 2 of 3

Severe Disabilities: The term "severe disabilities" means a severe, chronic disability attributable to mental or physical impairment, or a combination of mental and physical impairments that is likely to continue indefinitely and results in substantial functional limitation in three or more of the following major life activities: self-care, receptive and expressive language, learning, mobility, selfdirection, capacity for independent living, economic self-sufficiency, cognitive functioning, and emotional adjustment. Procedure A – Demonstration of Service Priority Efforts 1.

2.

In the operational elements of the Area Plan, with respect to the fiscal year preceding the fiscal year for which the operational elements are prepared, the AAA shall: a.

identify older low-income minority individuals and those associated with specific client groups listed in Procedure B.3 of this policy;

b.

describe the methods used to satisfy the service needs of such older individuals, and

c.

provide information on the extent to which the AAA met the goals required by the first paragraph in this policy.

This service priority policy is applicable to all services. Evaluation of ADL and IADL status applies to the following services: Adult Day Care, Homemaker, Personal Care, Chore, and Home Delivered Meals as required in the ODA service standards.

Procedure B – Programmatic Requirement 1.

AAAs are required to include in the Area Plan their strategy for giving preference to the population groups listed in this policy.

2.

AAAs shall include in each agreement made with a provider of any service under Title III, Title VII, and/or Senior Community Services Block Grant, a requirement that such provider will a.

specify how the provider intends to satisfy the service needs of low-income minority individuals and the other specific client groups defined in this policy in the area served by the provider;

b.

to the maximum extent feasible, provide services to low-income minority individuals and the other specific client groups defined in this policy in accordance with their need for such services; and

c.

meet specific goals established by the AAA for providing services to individuals with greatest economic and social need within the PSA.

204.02 – Service Priority to Specific Client Groups Page 3 of 3

3.

4.

Outreach efforts shall identify individuals eligible for, and inform them of, available assistance under Title III, Title VII, and Senior Community Services Block Grant with special emphasis on a.

older individuals residing in rural areas;

b.

older individuals with greatest economic need (with particular attention to low-income minority individuals);

c.

older individuals with greatest social need (with particular attention to lowincome minority individuals);

d.

older individuals with severe disabilities;

e.

older individuals with limited English-speaking ability; and

f.

older individuals with Alzheimer's disease or related disorders with neurological and organic brain dysfunction (and the caretakers of such individuals).

In designating focal points, as required in Policy 301.00, the AAA shall consider communities with the greatest incidence of older persons with the greatest economic and social needs.

Date: November 10, 1994 Authority/Basis: OAA, 1965, as amended: 42 U.S.C. 3002, 3027; 45 CFR §1321.11, §1321.65 and §1321.69; Ohio Administrative Code 5101:3-3-06 and 5101:3-3-08; ODA Policy 301.00

Ohio Department of Aging

204.03 – National Family Caregiver Support Program Page 1 of 4

Policy The Family Caregiver Support Program, which recognizes the vital role performed by informal caregivers, is authorized by Title III-E of the Older Americans Act Reauthorization of 2000 (the Act). Its intent is to directly benefit informal caregivers with services consistent with the Act’s mandates through a statewide, easily identifiable program that supports the efforts of caregivers. Goal for the Program: to provide support, services and education, outreach to the thousands of persons who provide assistance to vulnerable persons, either related or not, who may need to either rely on formal caregivers or seek entry into an institutional versus community living arrangement. These services aid the caregiver to better understand his/her role, consequences, when and how to access assistance, how to utilize services/information to be able to decrease stress, better care for their loved one, understand the needs of caregivers, access services for themselves and their loved one, etc. Unlike many other programs funded and managed by ODA through the AAAs, the caregiver rather than the care receiver is the target of the program. Therefore, for the purposes of the National Family Caregiver Support Act, AAAs should design programs and individual services that meet the identified needs of caregivers – the target clients of the program. As noted below, though, it will be the care receiver that actually must meet certain eligibility requirements in order for the caregiver to receive respite and supplemental services. Procedure A – Allocation of Funds 1.

ODA will allocate the Title III-E funds to AAAs based on the Title III allocation formula set forth in Policy 109.00.

2.

The limit on funds allocation for supplemental services is 20% of the funds granted to the AAA under Title III-E.

3.

The statewide limitation on funding for services for kinship caregivers is 10% of the total Title III-E allocation to Ohio. A AAA may seek to use a larger percentage than 10% of its grant allocation for kinship care, but should keep in mind that ODA may authorize a lesser percentage for kinship care if ODA believes on the basis of all AAA plans that the statewide percentage allocated to kinship care will exceed the 10% maximum.

4.

To ensure that the National Family Caregiver Support program is available on a statewide basis, AAAs shall allocate Title III-E funds to each of the counties in its Planning and Service Area via the approved funding formula it utilizes to distribute Title III-B funds. a.

Funds that must be allocated by formula are those that the AAA utilizes for respite and supplemental services where such services are not care coordinated centrally by AAA staff.

204.03 – National Family Caregiver Support Program Page 2 of 4

5.

b.

In situations where AAA’s are care coordinating caregiver support services, the AAA shall project the number of individuals that will be served by the AAA based on available funds and shall then apply an approved funding formula to this number to determine the number of caregivers that will be served in each county within the Planning and Service Area.

c.

The AAA shall conduct its outreach and program efforts in such fashion as to ensure that all counties in the Planning and Service Area have access to information, assistance, and counseling services.

Title III-E funds shall supplement, and not supplant, any Federal, State, or local funds expended to provide services described in section 373 of the Act.

Procedure B – Eligibility Requirements 1.

There are no eligibility requirements for caregivers who receive any of the following core support services: information; assistance; and counseling

2.

For respite and supplemental services: the following apply: a.

The caregiver must be caring for an individual who is 60 years old or older and frail OR

b.

The caregiver must be 60 years of age or older and be caring for i.

an individual aged 18 or younger meeting the definition of “grandchild” as defined in this policy; or

ii.

other family member with a diagnosed condition of MR/DD who is age 18 or younger.

Procedure C – Participant Cost Sharing The AAA shall use the income of the care recipient (self reported) to determine fees in accordance with 173-3-01 of the Ohio Administrative Code Procedure D – Service Requirements 1.

AAA may provide, contract with entities, and/or coordinate with other entities to provide the following caregiver support services: a.

Information

b.

Assistance

c.

Individual counseling, the organization of support groups, and caregiver training to caregivers

204.03 – National Family Caregiver Support Program Page 3 of 4

2.

d.

Respite - AAAs shall use existing ODA service standards as set forth in Policy 308.00, where applicable

e.

Supplemental services

The AAA is allowed to provide case management, information and assistance and outreach directly without requesting waivers. The AAA shall be allowed to provide caregiver counseling directly with an approved waiver. The AAA shall be allowed to provide supplemental services depending on the nature of the service, directly, with a waiver, consistent with usual practice. The AAA shall contract for respite services in accordance with Policy 407.00 AREA AGENCIES ON AGING GRANTS AND CONTRACTS.

Procedure E - Planning and Coordination Responsibilities 1.

Each AAA shall coordinate the activities of the AAA, or entity that the AAA has contracted with, with the activities of other community agencies and voluntary organizations providing the type of services described in Procedure D of this policy.

2.

The AAA shall interface with other programs, (i.e. respite and other services) in place that support caregivers, as well as other agencies and organizations, particularly Alzheimer’s Association, local boards of MRDDD, and county Kinship Navigator Programs.

3.

The first year, AAA shall submit a plan that details how the Caregiver program will be promoted throughout the PSA. After the first year, this promotion plan shall become part of the AAA ongoing planning and reporting process.

Procedure F: programmatic reporting requirement For reporting purposes: the “client” is the caregiver. Definitions Family caregiver, an adult family member, or another individual, who is an informal provider of in-home and community care to an older individual. Grandchild, an individual who is not more than 18 years of age cared for by grandparent, step grandparent, relative by blood or marriage, person with legal relationship or is raising the child informally. Information, to caregivers about available services Assistance, to caregivers to facilitate accessing services

204.03 – National Family Caregiver Support Program Page 4 of 4

Counseling, individual counseling, the organization of support groups, and caregiver training to caregivers to assist the caregivers in making decisions and solving problems relating to their caregiving roles. Respite care, services that enable caregivers to be temporarily relieved from their caregiving responsibilities which shall/may include in-home, institutional and emergency respite. Supplemental services, services provided on a limited basis, that complement the care provided by caregivers. (Example of service fitting this definition is legal services; this is a good section for flexibility or services that can’t be provided by other sources) Frail or functionally impaired older person (OAA definition): a person who is “unable to perform at least two activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or due to a cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual”

Date: March 21, 2002, (#0302I052) Authority/Basis: 42 U.S.C. 3030s

Ohio Department of Aging

204.04 – Waivers Requests by AAAs Page 1 of 3

Policy AAAs may request a waiver of ODA policy or rules for any program funded by ODA. Requests that are submitted with an area plan submission pursuant to Policy 204.00 Area Plans will receive a response as part of the area plan approval process. Except as listed in the procedures, ODA will respond to the AAAs within 30 calendar days of receipt. Procedure A – Submission of Requests for Waivers 1.

Waiver requests submitted as part of an area plan submission by an AAA will be forwarded by the PDE Division to the Director’s Executive Assistant.

2.

Requests for Waivers from ODA policy and rules, not included as part of an area plan, should be submitted to ODA to the attention of the Director’s Executive Assistant. Waiver requests that are not submitted as part of the area plan submission should be submitted on the Request for Waiver form (see appendix to this policy).

3.

Information submitted on a Request for Waiver form must be complete before ODA will initiate review. ODA will contact a AAA if it deems that additional information is required in order to make a determination on the AAA’s request.

4.

ODA will issue written notification to the AAA regarding the approval or denial of the Request for Waiver. The AAA will receive a response within 30 days.

5.

ODA will place a time period limiting the duration of a waiver. ODA approval of waivers related to area plans will not extend beyond the strategic planning period identified by ODA in the area plan document.

Procedure B – Submission of Requests for Waivers Constituting an Emergency 1.

Complete emergency waiver requests shall be reviewed by ODA staff and a determination shall be made regarding the approval or denial of the Request for Waiver within five working days.

2.

For the purposes of this policy, an emergency exists if the requested waiver is needed to ensure the timely provision of services to consumers, e.g., an established service provider’s contract is terminated by the AAA.

3.

The AAA shall specify whether its request for a waiver constitutes an emergency at the time its request is submitted.

Procedure C – Approvals, Denials and Appeals 1.

Waiver requests that are not part of an area plan submission are reviewed by an ODA interdisciplinary team that contains one or more representatives of each ODA Division affected by the waiver.

204.04 – Waivers Requests by AAAs Page 2 of 3

2.

Waiver requests submitted as part of an area plan submission are reviewed by the PDE Division and other affected ODA Divisions as part of the area plan approval process.

3.

The ODA interdisciplinary team makes recommendations to the Director of ODA as to approving and/or denying waiver requests. The Director of ODA makes the final decision on all waiver requests. The Director’s decision shall be final.

__________________________ Date: November 14, 2003 (#1103S179) Authority Basis: OAA 305 (a)(1)(C), (42 USC.3025)

204.04 – Waivers Requests by AAAs Page 3 of 3

AAA REQUEST FOR WAIVER

AAA waive the following rule or policy and/or procedure:

is requesting ODA

Policy and Procedure Citation: Time Period Requested To Be Covered By Waiver: Rationale:

AAA Contact Name

Contact Telephone Number

AAA Director

Date

Is this request an emergency as defined in policy?

 Yes

 No

For ODA Use Only: Waiver:

Approved

Denied

Conditions of Approval:

Time Period Approved for Waiver:

ODA Authority

Title MAIL TO: Ohio Department of Aging 50 W. Broad Street, 9th Floor Columbus, OH 43215-3363

Date

Ohio Department of Aging

205.00 Priority Services Page 1 of 3

Policy Area Agencies on Aging (AAAs) will allocate an "adequate proportion": (a minimum of 5% before transfers) of Title IIIB funds for each of the following categories of services or demonstrate to the satisfaction of ODA that services being furnished for such category are sufficient to meet the need for such services in such area (Section 306(b)(2) OAA): 1.

2.

3.

Services associated with ACCESS to services (e.g. transportation, outreach, and I&R); In-Home Services (e.g. homemaker, home health aide, visiting, telephone reassurance, chore, home maintenance, and supportive services); and Legal Assistance.

Any AAA allocating less than 5% of Title IIIB funds to any of these service categories must submit a Letter of Notification outlining the AAA's intention to fund any of the above categories below the 5% requirement. This must be done six months prior to the fiscal year in which funding for such categories will be below the 5% minimum. ODA will approve or disapprove this action. This Policy does not apply to allocation of carryover funds. Procedure A – Letter of Notification 1.

ODA will review the AAA's Letter of Notification document for appropriateness. The format for the Letter of Notification will be pre-printed by ODA.

2.

ODA will review the Letter of Notification and within 30 days, notify the AAA of approval/disapproval status. If the Letter of Notification is not approved, the AAA is eligible to apply for a waiver of this Policy.

Procedure B - Area Plan 1.

Each AAA shall prepare its Area Plan reflecting "adequate proportions" of Title IIIB funds allocated to access, in-home, and legal services or shall demonstrate through the appropriate Area Plan exhibits that other funding sources are providing these categories of services and are sufficient to meet the need for such services in such area.

Procedure C – Request for Waiver 1.

Any AAA which cannot meet the requirements of Procedure B due to: a.

the inability to secure services; or

b.

the inability to secure a reasonable rate for such services; or

205.00 Priority Services Page 2 of 3

c.

the determination of the lack of need for such service;

must notify ODA in writing of its intent to apply for a waiver to this policy five months prior to the fiscal year in which the 5% minimum will not be met. The waiver (the Area Plan Appendix 4: Waiver of Title III-B Priority Services) will be submitted to ODA through the Area Plan process. 2.

Prior to the submission of the waiver, the AAA shall conduct a public hearing to receive comments from concerned individuals within the planning and service area (PSA). a.

The AAA shall follow its procedures pursuant to Policy 201.00 to notify the general public of the date, time and place of the public hearing. Notices of the public hearing shall contain the following: i. ii. iii. iv. v. vi. vii.

b.

3.

the reason for the hearing the date of the hearing the time of the hearing the location of the hearing the deadline and address of where written comments will be accepted; how the document may be previewed prior to the public hearing; a contact name for more information.

The AAA shall prepare a record of the hearing, which shall be submitted with the Area Plan and become part of the waiver request to ODA. The record must contain documentation of the waiver review and included comments from the public on the AAA's intent to request a waiver of the 5% minimum funds requirement.

The Waiver shall also include: a.

detailed rationale which supports the AAA's reasons for requesting a waiver from the 5% minimum categorical funding of priority services;

b.

and, if appropriate, any action the AAA will take to meet these unmet needs.

Procedure D - Approval/Disapproval 1.

ODA will approve or disapprove the waiver as part of the annual Operational Plan review process.

Date: July 25, 1995 Authority/Basis: OAA 1965, as amended, 42 U.S.C. 3026

205.00 Priority Services Page 3 of 3

AAA Notice of Intent for Funding Priority Services

In accordance with ODA Policy 205.00 (Priority Services), the AAA will use this NOTICE OF INTENT form to notify ODA of the AAA's intent to fund any of the priority services categories (Access, In-Home, and Legal) below the 5% requirement. This notice must be submitted six months prior to the fiscal year in which funding for such categories will be below 5% minimum. Each service category must have a separate NOTICE OF INTENT. This Notification will inform the Ohio Department of Aging of the intent of (name of the AAA) _______________________________________________________________ to fund priority category of __________________________ AAA services at less than the required 5% minimum funding levels beginning ________ and ending _________________. JUSTIFICATION: Provide a detailed explanation of the circumstances leading to this request. At a minimum, address: • • • • • • •

geographical area affected; how the services in this category will be provided; number of clients which will be affected; number of clients who received this service during the AAA's most recently concluded program year; Title III dollars which will be affected; other sources of funds (source and amounts) which will provide these services; and other agencies who will be providing these services, etc. (use additional sheets as necessary).

Ohio Department of Aging

206.00 – Request for Direct Provision of a Service Page 1 of 3

Policy An Area Agency on Aging (AAA) is prohibited from providing direct services for any of the following Title III parts without the written approval and/or authorization from ODA: supportive services (Title IIIB), nutrition (Title IIIC), in-home (Title IIID), health promotion/disease prevention (Title IIIF), and elder rights (Title VII). This prohibition also includes services funded with ODA Senior Community Block Grant (SCSBG) funds unless addressed otherwise in Policy 315.00. Regional Ombudsman services are exempted from adherence to this policy as the ODA State Ombudsman Program conducts its own process for designating regional ombudsman programs. Procedure A – Direct Service Provision Application Process 1.

AAAs must conduct a public hearing regarding the AAA's intent to provide a direct service. The AAA may conduct the public hearing as part of the Area Plan process, or use a similar process if the request occurs between Area Plan submissions. The public hearing activity must include a specific review of the "Application for Direct Provision of Service" document submitted to ODA for consideration.

2.

AAAs must apply in writing on the exhibit, "Application for Direct Provision of Service" and submit a copy of the public hearing record when requesting AAA direct provision of a service in the ODA service taxonomy or other allowable service. Requests shall be submitted to ODA’s Planning, Development and Evaluation (PDE) Unit for review and written approval or denial.

3.

When requests to provide direct service are made during the Area Plan process, approval of the Area Plan shall constitute approval of the request to provide direct service.

4.

When requests to provide direct service are made between Area Plan submissions, ODA’s PDE Unit shall coordinate review by appropriate ODA staff and shall approve or deny such requests within 15 working days of receipt by ODA. ODA reserves the right to request additional information required to justify direct service requests and in so doing may extend the 15 day review period.

5.

Criteria used by ODA to evaluate the AAA's request includes all of the following, but is not limited to: a.

the direct provision of service is necessary to assure an adequate supply of such services;

b.

such services are directly related to the AAA's administrative function;

c.

where such services of comparable quality can be provided more economically by the AAA;

206.00 – Request for Direct Provision of a Service Page 2 of 3

6.

d.

the direct provision of service by the AAA does not create competition between the AAA and the private sector; or

e.

the direct provision of service by the AAA does not conflict with its duties as a PASSPORT Administrative agency.

Requests, once approved, will be valid for a period not longer than the period governed by the AAA's approved four-year strategic plan, but may be for a shorter period as requested by the AAA or specified by ODA.

Procedure B – Allowable Nutrition Service Activities by AAA 1.

2.

Allowable nutrition service activities that can be performed by the AAA and supported with service dollars must meet the following criteria: a.

antecedent to and supportive of the direct service;

b.

do not involve direct contact with the client (excluding nutrition education presentations);

c.

present no conflict of interest with case management; and

d.

do not duplicate provider activity; e.g. the AAA is acting as the primary provider.

Nutrition service activities that meet the above criteria include but are not limited to the following: a.

nutrition education development;

b.

nutrition education approval;

c.

nutrition education presentation;

d.

procurement of meals (catering contracts and related quality assurance);

e.

menu planning;

f.

menu approval;

g.

provider level policy and procedure/standards development;

h.

initiation of nutrition site selection (not approval);

i.

monitoring of nutrition site operations;

j.

provision of food handling and sanitation training;

206.00 – Request for Direct Provision of a Service Page 3 of 3

k.

provision of site operations training; and

l.

fundraising (any activity [e.g. special events, corporate donations, sale of goods] generating funds to increase meals served, facilitate access to meals, purchase equipment, or provide other nutrition-related services).

3.

Before service dollars can be used to support nutrition service activity(ies) the AAA must secure ODA written approval.

4.

No AAA shall add any nutrition services activities to AAA staff responsibilities without prior ODA approval. a.

AAAs requesting to add any of the nutrition service activities mentioned in Procedure B (2) must submit the appropriate Area Plan exhibit to the PDE Unit for approval. The application period is not limited to the Area Plan process. It must, however, follow the process outlined in Procedure A (1).

b.

The request will be granted only if, in the judgment of ODA, the activity can be provided more economically, efficiently and effectively by the AAA.

Procedure C – Direct Provision of a Service in an Emergency 1.

In an emergency, AAAs may provide a specified direct service for a time-limited period with prior approval from ODA.

2.

For the purpose of this policy, "emergency" means either: a.

the inability of a current service provider to continue meeting its service obligations to service participants; or

b.

a service not presently funded by the AAA is needed due to the existence of a natural disaster.

3.

AAAs requesting authorization from ODA to directly provide a service due to the existence of an emergency should submit the request as outlined in Procedure A. 2. above, except that a public hearing is not required.

4.

ODA, if it grants authorization to the AAA, shall specify a time-limited period during which the AAA may continue to provide the direct service based on the nature of the emergency.

____________________________ Date: January 21, 1999 (#199NP016) Authority/Basis: P.L. 89-73, as amended through December 31, 1992, section 307(a)(10); 45 CFR 1321.63(b)

Ohio Department of Aging

207.00 – Request for Variance from Prescribed ODA Service Taxonomy Page 1 of 1

Policy The Area Agency on Aging (AAA) may request a variance from the standard Ohio Department of Aging (ODA) service categories if the primary function or effect of the service to be provided deviates substantially from the prescribed definitions. Durations for ODA approved variances shall coincide with that of the Area Plan that is in effect at the time of the variance approval. AAAs desiring the continuation of a variant service must resubmit a variance request with each full Area Plan submission. Procedure A – Submission of Request for Variance 1.

AAA must apply in writing on the approved Exhibit E-2 form when requesting a variance in service taxonomy and allowable services.

2.

The request for variance review will coincide with ODA's Area Plan/Update review process or as an amendment to the current Area Plan.

3.

ODA approval of the request for variance will include at a minimum, information on taxonomy classification (program and activity codes); service name; and indication of time-limited status, if applicable.

4.

After the AAA receives the approval of the request for variance submitted as an amendment to the current Area Plan, the AAA will complete and submit Exhibit E2a: Project Summary Information--Social and Nutrition Services within 10 working days to the ODA Planner.

Ohio Department of Aging

208.00 - Delegation of Authority Page 1 of 1

Policy The Area Agency on Aging (AAA) may not delegate to another agency the AAA's authority to award or administer Older Americans Act and Senior Community Services Block Grant funds. Procedure A – Requirements 1.

The AAA shall establish and follow a formal process for funding all services paid for with Older Americans Act and Senior Community Services Block Grant funds (see also 407.00, Procedure C, Paragraph 1).

2.

The AAA shall ensure in all of its grants and contracts that it retains the authority to monitor fiscal and programmatic use of all Older Americans Act and Senior Community Services Block Grant funds by service providers.

____________________________________ Date: December 7, 1995 Authority/Basis: 45 CFR 1321.11 and 1321.25

Ohio Department of Aging

209.00 – Service Provider Subcontracts Page 1 of 1

Policy: It is recognized that it is sometimes necessary and desirable for service providers to enter into continual agreement with individuals or organizations in order to effectively and efficiently provide for the delivery of services to older adults. The Area Agency on Aging (AAA) shall ensure that no service provider enter into a subcontract without the knowledge, review and approval of the AAA prior to the issuance of an award to the service provider by the AAA. This policy does not apply to the usual and customary need of all service providers to enter into procurement contracts with vendors of supplies and equipment. Procedure A – AAA Review and Decision-Making 1.

At a minimum, the AAA shall require information regarding the service provider's intent to subcontract funds as part of its request for proposal (RFP) process.

2.

The AAA shall review the service provider's request to subcontract, and grant or deny an approval regarding the need to subcontract, based upon the following criteria: a.

by subcontracting, the service would be afforded a more effective service delivery;

b.

by subcontracting, the service would be afforded a more efficient service delivery;

c.

sufficient rationale exists to support the service provider subcontracting with an entity, rather than the AAA directly contracting with that same entity.

3.

Upon any approval to subcontract, the above-noted information shall be kept on file by the AAA, and made available to the Ohio Department of Aging upon request.

4.

Subcontractors are bound by the same requirement as those mandated by the AAA of the service provider.

Ohio Department of Aging

210.00 – Quarterly Program Reports Page 1 of 2

Policy Area Agencies on Aging (AAA) shall submit quarterly reports as prescribed by the Ohio Department of Aging (ODA). Procedure A – Report Format and Submission 1.

AAAs must report contractual and programmatic information in the appropriate format. This format will be prescribed through a Notice of Instruction.

2.

Quarterly reporting periods will be:

3.

a.

January 1st through March 31st;

b.

April 1st through June 30th;

c.

July 1st through September 30th; and

d.

October 1st through December 31st .

If the AAA cannot submit complete reports or cannot meet report deadlines, the AAA must contact the ODA staff person, designated through a Notice of Instruction, to obtain an extension.

Procedure B – Report Due Dates 1.

All quarterly reports must be received by ODA no later than the 20th calendar day of the month following the end of the quarter. Refer to Policy 304.09 for reporting USDA data. Data for the Period

Jan – March Quarterly Data, 2001 April – June Quarterly July – September Quarterly Data October – December Quarterly Data Contract Information for New Year Final Reports for a Program Year

Revisions to final reports

2.

Due at ODA April 20th Data July 20th October 20th January 20th 60 days after new program year commences 60 days after program year ends Call ODA Designated Contact

When the deadline date falls on a Saturday or Sunday, the data will be due the next business day following the 20th calendar day.

210.00 – Quarterly Program Reports Page 2 of 2

3.

Final report data, in addition to the 4th quarter data, must also be submitted to ODA. This final data submission captures the program year information not included in the 4th quarter data, but is still applicable to the same program year. Final report data should contain year-to-date information for the entire program year and is due at ODA 60 days following the end of the program year for which data is being reported.

4.

The summaries are due 60 days following the beginning date of the AAA’s new program year.

5.

Final revisions to Nutrition Services Quarterly Reports for USDA Adjustments must be submitted by the 15th day of November for the 12 months ending October 31st.

_______________________________________ Date: August 1, 2001 (#0801S144) Authority Basis: OAA 1321.11 45 CFR

Ohio Department of Aging

210.01 – NAPIS (National Aging Program Information System) Page 1 of 5

Policy In order to meet the Older Americans Act requirement for annual performance reporting, Area Agencies on Aging (AAA) shall collect information as necessary and, quarterly, submit participant characteristics and service profile by funding source on selected services funded in whole or in part by Older Americans Act, Senior Community Services Block Grant, or Alzheimer’s Respite dollars as prescribed by the Ohio Department of Aging (ODA). Procedure A – Report Format and Submission 1.

AAAs must report participant identification, characteristics, service profile and provider information via the SAMS (Senior Assistance Management System) software products by Synergy Software Technologies Inc. NOTE: In SAMS, the Intake section of the Assessment asks all of the questions needed to meet the NAPIS participant demographic requirements. Service dollars may be used for the purchase of SAMS products at the AAA or provider level.

2.

For the NAPIS Cluster 1 services (Personal Care, Homemaker, Chore, Home Delivered Meals, Adult Day Services, and Case Management) the required data is name, address, ID# (generated by Date of Birth and last four digits of the Social Security Number), race, gender, rural status, live alone status, poverty status, ADL/IADL and services received. This activity is referred to as Client Registration in NAPIS. AAA may add additional services.

3.

For the NAPIS Cluster 2 services (Congregate Meals, Nutrition Counseling, and Assisted Transportation) with the addition of Transportation the required data is name, address, ID#, race, gender, rural status, live alone status, poverty status and services received. AAAs may include additional services because of client registration.

4.

For the NAPIS Cluster 3 services (Legal Assistance, Nutrition Education, and Outreach) the required data is the client count but not the detailed registration information. In SAMS, AAAs should use the “aggregate client” (ID #9999999999) to record the Client Count. AAAs may add additional services.

5.

The Nutrition Risk Assessment shall be completed for participants receiving Congregate Meals, Home Delivered Meals, Case Management and Nutrition Counseling.

6.

Quarterly reporting periods will be October through December; January through March; April through June; and July through September.

7.

The data will be exported to ODA utilizing the SAMS Data Export function with the Service Unit Records, Client Personal Information and Administrative data boxes checked in the Data Export window. AAAs with a waiver from using SAMS will use their previously established procedures to prepare and ship data to ODA.

210.01 – NAPIS (National Aging Program Information System) Page 2 of 5

Procedure B. – Report Due Dates NAPIS data must be exported to ODA’s MIS Unit by midnight on the 20th calendar day of the month following the end of the quarter. When the 20th of the month falls on a weekend, the data is due the next business day. Definitions Client Descriptors (taken from the AOA NAPIS guidelines) 1.

Minority Status – Minority older persons are confined to the following designations: a.

African American, Not of Hispanic Origin – A person having origins in any of the black racial groups of Africa.

b.

Hispanic Origin – A person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race.

c.

American Indian or Alaskan Native – A person having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition.

d.

Asian American/Pacific Islander – A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, Japan, Korea, the Philippine Islands, Samoa and the Hawaiian Islands.

e.

Non-Minority – Any person who is not considered a minority.

2.

Impairments in Activities of Daily Living – The inability to perform one or more of the following six activities of daily living without personal assistance, stand-by assistance, supervision or cues: eating, dressing, bathing, toileting, transferring in and out of bed/chair, and walking.

3.

Impairments in Instrumental Activities of Daily Living – The inability to perform one or more of the following eight instrumental activities of daily living without personal assistance, or stand-by assistance, supervision or cues: preparing meals, shopping for personal items, medication management, managing money, using telephone, doing heavy housework, doing light housework, and transportation ability. (Transportation ability refers to the individual’s ability to make use of available transportation.)

4.

Poverty – Persons considered to be in poverty are those whose income is at or below the official poverty guideline (as defined each year by the Office of Management and Budget, and adjusted by the Secretary (DHHS) in accordance with subsection 673 (2) of the Community Services Block Grant Act (42 U.S.C. 9902 (2)).

210.01 – NAPIS (National Aging Program Information System) Page 3 of 5

5.

Living alone – A one person household (using the Census definition of household) where the householder lives by himself or herself in an owned or rented place of residence in a non-institutional setting, including board and care facilities, assisted living units and group homes.

NAPIS Service Definitions 1.

Personal Care (1 Hour) – Providing personal assistance, stand-by assistance, supervision or cues for persons with the inability to perform with one or more of the following activities of daily living: eating, dressing, bathing, toileting, transferring in and out of bed/chair or walking.

2.

Homemaker (1 Hour) – Providing assistance to persons with the inability to perform one or more of the following instrumental activities of daily living: preparing meals, shopping for personal items, managing money, using the telephone or doing light housework.

3.

Chore (1 Hour) – Providing assistance to persons having difficulty with one or more of the following instrumental activities of daily living: heavy housework, yard work or sidewalk maintenance.

4.

Home Delivered Meals (1 Meal) – Provision, to an eligible client or other eligible participant at the client’s place of residence, a meal which:

5.

a.

complies with the Dietary Guidelines for Americans (published by the Secretaries of the Department of Health and Human Services and the United States Department of Agriculture;

b.

provides, if one meal is served, a minimum of 33 and 1/3 percent of the current daily Recommended Dietary Allowances (RDA) as established by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences;

c.

provides, if two meals are served, together, a minimum of 66 and 2/3 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second meal shall be balanced and proportional in calories and nutrients; and,

d.

provides, if three meals are served, together, 100 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second and third meals shall be balanced and proportional in calories and nutrients.

Adult Day Care/Adult Day Health (1 day) – Provision of personal care for dependent adults in a supervised, protective, congregate setting during some portion of a twenty-four hour day. Services offered in conjunction of adult day care/adult day health typically include social and recreational activities, training,

210.01 – NAPIS (National Aging Program Information System) Page 4 of 5

counseling, meals for adult day care and services such as rehabilitation, medications assistance and home health aide services for adult day health. 6.

Case Management (1 Hour) – Assistance either in the form of access or care coordination in circumstances where the older person and/or their caregivers are experiencing diminished functioning capacities, personal conditions or other characteristics which require the provision of services by formal service providers. Activities of case management include assessing needs, developing care plans, authorizing services, arranging services, coordinating the provision of services among providers, follow-up and reassessment, as required.

7.

Congregate Meals (1 Meal) – Provision, to an eligible client or other eligible participant at a nutrition site, senior center or some other congregate setting, a meal which: a.

complies with the Dietary Guidelines for Americans (published by the Secretaries of the Department of Health and Human Services and the United States Department of Agriculture;

b.

provides, if one meal is served, a minimum of 33 and 1/3 percent of the current daily Recommended Dietary Allowances (RDA) as established by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences;

c.

provides, if two meals are served, together, a minimum of 66 and 2/3 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second meal shall be balanced and proportional in calories and nutrients; and,

d.

provides, if three meals are served, together, 100 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second and third meals shall be balanced and proportional in calories and nutrients.

8.

Nutrition Counseling (1 Hour) – Provision of individualized advice and guidance to individuals, who are at nutritional risk, because of their health or nutritional history, dietary intake, medications use or chronic illnesses, about options and methods for improving their nutritional status, performed by a health professional in accordance with state law and policy.

9.

Transportation (1 One Way Trip) – Provision of assistance, including escort, Assisted to a person who has difficulties (physical or cognitive) using regular vehicular transportation.

10.

Transportation (1 One Way Trip) – Provision of a means of going from one location to another. Does not include any other activity.

210.01 – NAPIS (National Aging Program Information System) Page 5 of 5

11.

Legal Assistance (1 Hour) – Provision of legal advice, counseling and representation by an attorney or other person acting under the supervision of an attorney.

12.

Nutrition Education (1 Session) -- A program to promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information and instruction to participants or participants and caregivers in a group or individual setting overseen by a dietitian or individual of comparable expertise. [Note: this is the only service of the 14 listed services in the SPR where the unit measure (one session) refers to either an individual or group service. In this case, for example, a group of people attending a session on nutrition issues for the elderly would count as one unit of “Nutrition Education”.]

13.

Information and Assistance (1 Contact) – A service for older individuals that (A) provides the individuals with current information on opportunities and services available to the individuals within their communities, including information relating to assistive technology; (B) assesses the problems and capacities of the individuals; (C) links the individuals to the opportunities and services that are available; (D) to the maximum extent practicable, ensures that the individuals receive the services needed by the individuals, and are aware of the opportunities available to the individuals, by establishing adequate follow-up procedures. [Note: the service units for information and assistance refer to individual, one-onone contacts between an information and assistance provider and an elderly client or a care giver. An activity that involves a contact with several current or potential clients/caregivers (what is considered group services) should not be count as a unit of information and assistance.

14.

Outreach (1 Contact) – Interventions initiated by an agency or organization for the purpose of identifying potential clients (or their care givers) and encouraging their use of existing services and benefits. [Note: the service units for outreach refer to individual, one-on-one contacts between a service provider and an elderly client or care giver. An activity that involves a contact with several current or potential clients/care givers (what is considered group services) should not be counted as a unit of outreach.

Note: Respite services which offer temporary, substitute supports or living arrangements for older persons in order to provide a brief period of relief or rest for family members or other caregivers, should be assigned to the service which best matches the form of respite being offered—such as personal care, homemaker, or adult day services. Please use SAMS to indicate when respite is provided through the Alzheimer’s Respite program.

Date: August 1, 2001 (#0801S144) Authority Basis: 45 CFR 1321

Ohio Department of Aging

211.00 – AAA Monitoring of Service Providers Page 1 of 2

Policy Each Area Agency on Aging (AAA) will conduct periodic monitoring of activities carried out under the Area Plan. The AAA will develop and follow a schedule for monitoring, on a regular basis, all Older Americans Act-funded grants and contracts, and where appropriate, state funded grants and contracts. Procedure A – Scope 1.

The AAA will develop and follow a schedule for monitoring all Older Americans Act-funded grants and contracts, and where appropriate, state funded grants and contracts throughout the period specified by the AAA’s contract with the service provider.

2.

The AAA will conduct on-site monitoring annually. The AAA may vary the scope of this annual monitoring visit based on the provider’s past performance and may monitor more often in cases where the provider requires greater oversight.

3.

The AAA will review and comment, as necessary, on all fiscal and programmatic reports required by either ODA or the AAA from each contractor as part of the monitoring process.

4.

The AAA will assure provider adherence to Policy 308 Conditions of Participation and Service Specifications.

Procedure B – Monitoring Components 1.

The AAA will develop monitoring/assessment tools to be used for the monitoring activity.

2.

Monitoring tools shall address, at a minimum: a.

compliance with: i. the Older Americans Act (OAA) and its regulations; ii. the Ohio Department of Aging (ODA) Policies and Procedures; iii. Civil rights laws; iv. 45 CFR, Public Welfare Part 74 “Uniform administrative requirements for awards and sub- awards to institutions of higher education, hospitals, other non-profit organizations, and commercial organizations; and certain grants and agreements with state, local governments and Indian tribal governments” or Part 92 “Uniform administrative requirements for grants and cooperative agreements to state and local governments.” And

b.

client documentation as set forth in Policy 308.00 Conditions of Participation and Service Specifications;

211.00 – AAA Monitoring of Service Providers Page 2 of 2

c.

training;

d.

program income, voluntary contributions, and funds collected pursuant to OAC Rule 173-03-01 Cost Sharing

e.

AAA Policies and Procedures;

f.

ODA Policy 502.00, Unit of Service Verification;

g.

adherence to ODA taxonomy; and

h.

quality assurance requirements set forth in Policy 308.00 Conditions of Participation and Service Specifications.

3.

Due to critical safety issues inherent in ODA funded Nutrition Services, each AAA must ensure that nutrition services monitoring tools adequately address monitoring of specific food service procedures for procuring, producing, handling, serving and delivering food (see current ODA Home Delivered Nutrition Services Monitoring Guide and Tool).

4.

In cases where the provider is a vendor of services as opposed to a sub recipient of grant funds (e.g. the AAA selects the clients as in the care coordination model), the AAA may alter the scope of the monitoring process, but must still monitor the provider for compliance with applicable federal and state laws, civil rights requirements as specified in Policy 214.00, Conditions of Participation and Service Specifications as specified in Policy 308.00, and provider quality assurance activities.

Procedure C – Staffing 1.

Due to the technical nature and critical safety issues inherent in ODA funded services, each AAA must; a.

utilize qualified staff to monitor, assess and evaluate all nutrition service providers (see ODA Policy 304.00, Procedure B.) i.

b.

In the event that AAA staffing changes or other circumstances may prevent an AAA from completing its nutrition services monitoring, assessment and evaluation responsibilities, the AAA must contact the appropriate ODA staff to determine an appropriate alternative arrangement to complete at least critical food service monitoring.

ensure that provider agencies utilize qualified staff to supervise, monitor, assess and evaluate all ODA funded services as specified in ODA Service Standards.

Date: August 1, 2001 (#0801S144) Authority Basis: OMB Circular A-110; 45 CFR Part 92 & 74

Ohio Department of Aging

212.00 – Data Storage Page 1 of 1

Policy All Area Agency on Aging (AAA) data files that are maintained on any computer system must be regularly copied onto a secondary medium that can be removed from the computer system even if the original source documentation for electronic data files exist. Preferably, this information should be stored in a location other than the AAA to safeguard the possible event of theft, fire damage, etc. Data files affected by this policy are defined as: 

all files "backed-up" by the back-up option included in both of the OASIS systems; and



all other spreadsheet files that are used by the AAA to store fiscal or programmatic information.

Procedure A – Data Storage 1.

The AAA should, on a regular basis, weekly or daily, depending on amount of information entered, copy information to a secondary medium.

2.

This secondary medium should be stored away from the computer system, preferably in a location other than the AAA, in a fire-proof safe, safety deposit box, residence, etc.

Ohio Department of Aging

213.00 – AAA Policy and Procedures Manual Page 1 of 2

Policy Each Area Agency on Aging (AAA) must develop and publish written polices and procedures for carrying out its functions as mandated in the Older Americans Act (OAA) and OAA Regulations, as well as the Ohio Department of Aging's (ODA's) Policies and Procedures Manual. Procedure A – Manual Development 1.

The AAA shall review, minimally, the following for incorporating mandated functions and prudent management practices into their Policies and Procedures: a.

OAA Act;

b.

OAA Regulations;

c.

ODA's Policy and Procedures Manual;

d.

Dept. of Health & Human Services (DHHS) 45 CFR. Part 74; and

e.

Office o f Management and Budget (OMB) Circular A-102

Procedure B – Review Procedures 1.

The manual shall contain procedures for review and comment on the AAA manual by ODA at least 60 days prior to final publication.

2.

The manual shall contain procedures for revisions, updates and distribution.

Procedure C – Minimum Manual Content 1.

The manual shall address, at a minimum the following: a.

The process for the award of all ODA funds by the AAA;

b.

All contracting requirements associated with each funding resource;

c.

All service-related requirements, including standards, when applicable;

d.

AAA monitoring/assessment functions;

e.

AAA technical assistance functions;

f.

The process for suspension and/or termination of grants/contracts;

213.00 – AAA Policy and Procedures Manual Page 2 of 2

g.

h.

Hearing procedures i.

Area Plan/Area Plan revisions;

ii.

suspensions or termination of grant or contract; and

iii.

denial of funding to applicants;

Advisory Council i.

selection method;

ii.

county/geographical representation rules;

iii.

terms of all members;

iv.

voting rights;

i.

Affirmative Action

j.

504 Accessibility

k.

Any other requirements of the AAA aimed at ensuring compliance with ODA policy, or further AAA specification of ODA policy.

Authority/Basis: OMB Circular A-110; 45 CFR Part 92

Ohio Department of Aging

214.00 – Compliance with Civil Rights Laws Page 1 of 5

Policy Each Area Agency on Aging (AAA) shall take steps to fully comply with all applicable state and federal civil rights laws and regulations governing the provision of services and the employment of personnel paid for, in whole or in part, with state or federal funds. Procedure A – Definitions 1.

2.

3.

Minority Business Enterprise a.

The business must be at least 51 percent owned and controlled by one or more persons belonging to the following groups: African-Americans, Hispanics, American Indians and Asians. Or

b.

The company must be owned and controlled for one year prior to applying for MBE certification by one or more persons belonging to the following groups: African-Americans, Hispanics, American Indians and Asians. and

c.

The company must be at least 51 percent owned and controlled by one or more persons belonging to the following groups: African-Americans, Hispanics, American Indians and Asians.

Women’s Business Enterprise a.

51 percent ownership by a woman or women.

b.

Proof of effective management of the business (hire-fire, decision-making role, etc.)

c.

Control of the business as evidenced by signature role on loan and contracts.

Small Business a.

The existing business has average annual sales for the preceding three years not exceeding $5 million, and the business employs no more than 100 people, including affiliates.

Procedure B – Provision of Services 1.

Except as otherwise permitted by state and federal law, no person shall, on the basis of race, color, national origin, disability, sex, age, or religion, be excluded from participation in, be denied the benefits of, or be subjected to, discrimination under any program or activity funded in whole or in part with state and federal funds.

214.00 – Compliance with Civil Rights Laws Page 2 of 5

a.

Each AAA must complete the U.S. Department of Health and Human Services’ “Assurance of Compliance” (form HHS-690) and submit with its area plan to the Ohio Department of Aging (ODA).

b.

Each AAA must adopt a written non-discrimination policy. The policy must be distributed to each of the AAA’s providers and be made available to service recipients. The policy must be signed by the AAA director and must include procedures for monitoring all aspects of the AAA’s operations, to ensure that no other policy or practice has the effect of discriminating against program participants on the basis of race, color, national origin, disability, sex, age, or religion.

c.

Each AAA must take positive steps to ensure that small businesses, minority-owned firms, and women’s business enterprises are utilized to the fullest extent practicable when procuring goods and services paid for with federal or state funds or local matching funds.

d.

Each AAA must include the following or similar language in each of its provider contracts: i.

In the hiring of employees for the performance of work under the contract or subcontract, no contractor or subcontractor shall, by reason of race, color, religion, sex, age, disability or national origin, discriminate against any individual in the employment of a person qualified and available to perform the work to which the contract relates;

ii.

No contractor, subcontractor, or any person acting on behalf of any contractor or subcontractor shall in any manner discriminate against, intimidate, or retaliate against any employee hired for work under the contract on account of race, color, religion, sex, age, disability or national origin.

2.

Each AAA must ensure in its area plan that preference is given to older individuals with the greatest economic and social needs, with particular attention to low-income minority individuals as well as older individuals residing in rural areas.

3.

Each AAA must require its providers to specify how the providers intend to satisfy the service needs of low-income minorities and those individuals residing in rural areas of the area served by the providers; provide services to low-income minorities and those individuals residing in rural areas to the maximum extent feasible, in accordance with their need for such services; and meet specific objectives established by the AAA for providing services to low-income minorities and those individuals residing in rural areas within the area they serve.

214.00 – Compliance with Civil Rights Laws Page 3 of 5

Procedure C – Employment 1.

Except as otherwise permitted by state or federal law, no AAA may by reason of race, color, religion, sex, age, disability or national origin discriminate against any individual in the employment of a person qualified and available to perform any work funded with state or federal funds. Nor shall any AAA discriminate, intimidate, or retaliate against any employee hired for the performance of any work funded in whole or in part with state or federal funds on account of race, color, religion, sex, age, disability or national origin. a.

Each AAA must develop a written non-discrimination policy. The policy must be signed by the AAA director and must include procedures for monitoring all aspects of the AAA’s operations to ensure no other policy or practice has the effect of discriminating against employees on the basis of race, color, religion, sex, age, disability or national origin.

b.

Each AAA must, to the extent authorized under state and federal law, give a preference to older individuals when hiring staff.

2.

Pursuant to section 125.111 of the Ohio Revised Code, each AAA shall have a written affirmative action program for the employment and effective utilization of economically disadvantaged persons (i.e., African-Americans, Hispanics, Asians, and American Indians/Alaskan Natives). The affirmative action program shall be submitted annually no later than January 1 to ODA’s Equal Employment Monitoring Coordinator.

3.

Annually, each AAA must file a description of its affirmative action program and a progress report on its implementation with the Ohio Civil Rights Commission, the Minority Development Office of the Ohio Department of Development and ODA’s Equal Employment Monitoring Coordinator.

Procedure D – Equal Opportunity Representatives 1.

Each AAA will assign responsibility for the implementation of this policy to a designated Equal Opportunity Representative (s). a.

The Equal Opportunity Representative must have sufficient authority within the agency to coordinate and ensure compliance with the requirements of this policy. b. Reasonable efforts must be made to ensure that the Equal Opportunity Representative is familiar with the civil rights laws and regulations of the state and federal governments. To this end, the Equal Opportunity Representative hired by the AAA: i.

Must have experience with handling civil rights complaints and a basic understanding of state and federal civil rights requirements prior to being hired or appointed by the AAA, and receive training approved by ODA within sixty days of being assigned to his/her position.

214.00 – Compliance with Civil Rights Laws Page 4 of 5

ii.

Must make a reasonable effort to remain current on the status of state and federal civil rights laws and regulations, as well as the requirements of the Older Americans Act governing the provision of services to persons with the greatest social and economic need, particularly low-income minorities and individuals residing in rural areas.

Procedure E – Complaint Handling Process 1.

Each AAA must develop written policies and procedures governing the investigation of civil rights complaints received from AAA personnel or the recipients of any services funded in whole or in part with state or federal funds received by the AAA. The policies developed by the AAA: a.

Must ensure that all complaints are promptly and thoroughly investigated by the Equal Opportunity Representative in accordance with the policies and procedures adopted by the AAA.

b.

Must ensure that complainants are informed of their right to file complaints with the Ohio Civil Rights Commission and the federal Equal Employment Opportunity Commission.

c.

Must be made available to all employees of the AAA and to all recipients of services funded in whole or in part, with state or federal funds.

d.

The AAA policies and procedures shall provide for an alternate method of investigating complaints where the AAA’s Equal Opportunity Representative is the subject of the complaint.

2.

The Equal Opportunity Representative shall record the date and time on which any complaint is received, and maintain an incident log describing the actions taken in response to the complaint.

3.

If an AAA’s Equal Opportunity Representative finds reason to believe that the allegations of discrimination have been substantiated by the investigation, the representative shall inform the AAA director and the complainant in writing of said findings. Notification shall be in accordance with the AAA’s complaint policy but shall not exceed a 45-day time period. If the Equal Opportunity Representative finds no reason to believe that the alleged discrimination has occurred, the representative shall inform the director and the complainant in writing of said decision. Notification shall be in accordance with the AAA’s complaint policy but shall not exceed a 45day time period. The complainant shall also be informed of his/her right to submit complaints to the Ohio Department of Aging, the Ohio Civil Rights Commission, the U.S. Equal Employment Opportunity Commission, and/or the U.S. Department of Health and Human Services.

214.00 – Compliance with Civil Rights Laws Page 5 of 5

4.

Any complaint submitted directly to the Ohio Department of Aging by an Equal Opportunity Representative, an AAA employee, or a recipient of services, shall be submitted in writing. The complaint shall include a description of the type of discrimination alleged, the time and place that the alleged discrimination took place and any other facts deemed pertinent by the complainant. The complaint shall be submitted not later than 180 days from the date of the alleged discriminatory act or acts.

5.

The Ohio Department of Aging will open an investigation within 90 days after receipt of the complaint, and also provide a copy to the applicable AAA. The complainant’s identity will not be revealed if such request is in writing and is included when the complaint is submitted to the Ohio Department of Aging. a.

If the complainant’s allegations of discrimination are substantiated by the investigation, ODA’s Equal Employment Monitoring Coordinator will inform the Director of the Department, the AAA director, and the complainant of the findings, in writing, within 45 days. The department will then offer to engage in conciliation efforts with the AAA and complainant. The AAA and the complainant are free to withdraw from the conciliation process at any time If a conciliation agreement is reached, the AAA will be bound by the terms of the agreement. If no conciliation agreement is reached, ODA will take whatever action it deems appropriate against the AAA, and the complainant is free, at any time, to file a complaint with the Ohio Civil Rights Commission, the U.S. Equal Employment Opportunity Commission, and/or the U.S. Department of Health and Human Services. Any AAA determined by a state or federal agency to be guilty of discrimination and in violation of state or federal law must take any remedial actions mandated by a state or federal agency in accordance with state or federal law or risk de-designation.

b.

If the complainant’s allegations of discrimination are not substantiated by the investigation, ODA’s Equal Employment Monitoring Coordinator will inform the Director of the Department, the AAA director, and the complainant within 30 days of the decision. The complainant is free at any time to pursue any statutory rights he /she may have with the Ohio Civil Rights Commission, the federal Equal Employment Opportunity Commission, and/or the U.S. Department of Health and Human Services.

Procedure E – ODA Assessment Of AAA Efforts 1.

Annually, ODA will review AAA compliance with requirements of this policy.

2.

ODA’s Equal Employment Monitoring Coordinator will ensure that technical assistance and training are available to AAA staff and providers.

Date: August 1, 2001(#0801S144) Authority Basis: 45 CFR Part 80; 45 CFR Parts 84 & 85; 45 CFR 1321; 45 CFR Parts 90 & 91

Ohio Department of Aging

215.00 – Vacant Page 1 of 1

Policy Formerly – Dissemination of Constituent Mail to Area Agencies on Aging Policy Rescinded 2/01 (Notice #0201P031)

Ohio Department of Aging

216.00 – Vacant Page 1 of 1

Policy Formerly – Corporate Eldercare Policy Rescinded January 29, 1998

Ohio Department of Aging

217.00 – Conflicts of Interest Page 1 of 1

Policy All AAA grant awards and procurement practices shall be conducted in a manner to provide, to the maximum extent possible, open and free competition. Each AAA shall be alert to organizational conflicts of interest. Procedure A – Development Of Policies And Procedures 1.

Each Area Agency on Aging (AAA) shall develop policies governing the performance of its officers, employees or agents engaged in the selection, award and/or administration of grants and contracts funded with state and/or federal dollars to ensure freedom from conflicts of interest.

Procedure B – Minimum Provisions At a minimum, AAA policies prohibiting conflicts of interest shall provide the following: 1.

No employee, officer, or agent of the AAA may participate in the selection, award, or administration of a grant or contract supported with funds awarded by or through the Ohio Department of Aging if a conflict of interest, real or apparent, exists. For purposes of this policy, a conflict of interest exists when a.

the employee, officer or agent,

b.

any member of his immediate family,

c.

his or her partner, or

d.

an organization which employs any of the above, or is considering hiring any of the above,

has a financial or other interest in the firm or organization selected for the award. 2.

No employee, officer, or agent of the AAA may either solicit or accept gratuities, favors, or anything of monetary value from grant recipients, potential grant recipients, contractors, potential contractors, or parties to sub-agreements. Subject to ODA approval, however, AAAs may set minimum rules where the financial interest is not substantial or the gift is an unsolicited item of nominal intrinsic value.

Date: November 10, 1994 Authority/Basis: 45 CFR §74.42, §74.43, §92.36, §1321.11

Ohio Department of Aging

218.00 – Records Retention Page 1 of 2

Policy Each AAA shall maintain all financial and programmatic records, supporting documents, statistical records, and any other records which it is required to maintain under state or federal law, or which are reasonably considered pertinent to any grant(s) the AAA receives from or through the Ohio Department of Aging. Except as otherwise provided under state or federal law, all records maintained by an AAA pursuant to this policy shall be made available for inspection and/or copying by the public. Procedure A – Retention Period 1.

Except as otherwise provided in state or federal law, or as provided in paragraph 2 of this procedure, all records maintained pursuant to this policy shall be maintained in compliance with applicable federal regulations and OMB Circulars (see references below) for a period of not less than three years.

2.

If any litigation, claim, negotiation, audit or other action involving the records has been started before the three year period has expired, the records shall be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular three year period, whichever is later.

Procedure B – Public Access 1.

Except as otherwise provided in state or federal law, or as provided in paragraph 3 of this procedure, no AAA shall deny the public access to any records maintained in compliance with this policy. Each AAA shall adopt policies governing the procedure through which the public may inspect and/or make or receive copies of any records maintained pursuant to this policy. Such policies may establish reasonable fees to cover the costs the AAA incurs to provide copies of records to the public.

2.

Unless otherwise mandated under state or federal law, all copies of AAA records which are maintained by the Ohio Department of Aging are subject to Ohio's Public Records Law and, upon request, shall be made available to the public for inspection and/or copying.

3.

The following records are confidential and may not be released to the public: a.

Each AAA shall have procedures which protect the confidentiality of information about older persons which is collected in the course of carrying out its responsibilities under the Older Americans Act. The procedures shall insure, at a minimum, that no information about an older person obtained by a service provider or an AAA in the course of carrying out its responsibilities under the Older Americans Act may be disclosed by the provider or the AAA in a form that identifies the person without the informed consent of the person or of his legal representative, unless the disclosure is required by

218.00 – Records Retention Page 2 of 2

court order, or for program monitoring by authorized federal or state monitoring agencies or AAAs. b.

No AAA may require a provider of legal assistance under the Older Americans Act to disclose any information that is protected by attorney/client privilege.

c.

Each AAA shall protect the privacy of each older person with respect to his or her service contributions.

d.

Files and records maintained by regional long-term care ombudsman programs shall be disclosed to the public in accordance with procedures established by the State Long-Term Care Ombudsman. Under no circumstances, however, may any AAA or local ombudsman program permit the review and copying of records which disclose the identity of any resident or recipient, any complainant who is not a resident or recipient, or any individual providing information about a complainant with respect to whom the AAA or regional program maintain files or records unless: i.

The resident or recipient, complainant, or individual, or his legal representative consents to the disclosure and the consent is given in writing; or

ii.

a) b)

iii.

The resident, recipient, complainant or individual gives consent orally; and The consent is documented contemporaneously in a writing made by a Representative of the office in accordance with such regulations established by the state long-term care ombudsman; or The disclosure is required by court order.

Date: November 10, 1994 Authority/Basis: 45 CFR §74.53, §92.42, §1321.11, §1321.51, §1321.67

Ohio Department of Aging

301.00 – Community Focal Points Page 1 of 2

Policy Each Area Agency on Aging (AAA) shall designate, where feasible, a focal point in each community which shall be recognized as a facility established to encourage the maximum collocation of services for older individuals. Special consideration shall be given to designate Multipurpose Senior Centers (MPSCS) as such focal points. Procedure A – Designation of Focal Points/Area Plan Submission 1.

2.

3.

In designating focal points each AAA shall: a.

use the guidelines established in the training manual "Community Focal Point Designation Handbook", published by the National Association of Area Agencies for the National Council on Aging; and/or

b.

contact the Senior Facilities Division of the Ohio Department of Aging (ODA) for technical assistance.

The AAA must specify in the Area Plan the communities which it proposes to designate and develop focal points. In making the determination, the AAAs must consider: a.

Communities with the greatest incidence of older persons with the greatest economic and social needs.

b.

The delivery pattern of services.

c.

the location of MPSCs and congregate nutrition sites.

d.

Geographic and natural boundaries.

e.

Location of suitable facilities.

In developing the maximum collocation and coordination of services the AAA must: a.

Establish guidelines for operating schedules which are convenient for older persons.

b.

Assure the focal point has direct access to information and referral systems and emergency services program.

c.

Encourage service providers to collocate their services at the focal point and coordinate with other services at the focal point.

301.00 – Community Focal Points Page 2 of 2

Procedure B – Area Agency Assessment 1.

The division of Senior Facilities shall utilize updated Area Plans as well as any information gathered during any Area Plan year, to develop and maintain a current Directory of Community Focal Points.

2.

ODA shall review progress in developing community focal points at least annually during assessment visits to the AAA.

Ohio Department of Aging

301.01 – State-Subsidy: 1084-Multipurpose Senior Centers Page 1 of 4

Policy The Ohio Department of Aging (ODA), through the twelve Area Agencies on Aging (AAA's), shall make Amended Substitute House Bill (Am. Sub. H.B.) 1084 funds available, as per the Ohio Revised Code Sections 173.11-173.12, for the development of a statewide system of multipurpose senior centers (MPSCS) in order to: 1.

Provide a focal point for the comprehensive service delivery in each community.

2.

To facilitate access to services provided by the Older Americans Act.

Procedure A – Programmatic Description 1.

Am. Sub. H. B. 1084 provides state funds for the acquisition, renovation or new construction of buildings for MPSCS. These centers, operated by nonprofit organizations, provide for a service delivery network for older persons. The primary outcome is to provide for a place for socialization, needed social services, education, and new and expanded opportunities for older persons to contribute to their communities.

Procedure B – Programmatic Requirements 1.

The program year begins July 1 and ends June 30. a.

There will be two project selection days each year. i.

The spring project selection day with priority given to new construction projects will be in early March.

ii.

The fall project selection day with priority given to renovation projects will be in early September.

b.

Projects will be constructed and operated according to all rules and regulations contained in Ohio Revised Code 173.11 and 173.12 and the H. B. 1084 Manual.

c.

Each project must provide a 2/3 local match (either cash or in-kind) to 1/3 state participation. The Director of the ODA will approve or disapprove a waiver to match requirements.

Procedure C – Application Process 1.

The AAA will have 10 working days to announce the availability of funds and location of application materials.

301.01 – State-Subsidy: 1084-Multipurpose Senior Centers Page 2 of 4

2.

AAA shall review and comment on each project. Only those projects passing the AAA Review criteria (based on Am. Sub. H.B. 1084 regulations) will be forwarded to the ODA MPSC Administrator. a.

The MPSC Coordinator shall make site visits and provide technical assistance prior to the submission of applications to the ODA.

b.

The project shall be ranked by priority by the AAA.

c.

AAA shall have 20 working days to review applications.

3.

The ODA shall have 20 working days to review application prior to final selection by the State MPSC Committee.

4.

The ODA shall notify the AAA in writing of the final selection and allocation of funds.

5.

Those projects not funded will be held for review for the next project selection day.

Procedure D – Allocation Formula 1.

Allocation of funds is by "Request for Proposal" (RFP). The approved allocation will be reflected on a "Notification of Grant Award" and sent to the AAA, along with an "Acceptance Form" and an "Assurance of Compliance" form.

Procedure E – Budgeting 1.

Each project will be required to submit an estimated construction budget with the application.

2.

After the bids are selected each project is required to submit an actual budget on Cost Distribution Report (CDR) #353. (See Procedure D.)

Procedure F – Cash Distribution 1.

AAA's shall submit a CDR, for each approved project, reflecting allocation of funds by the cost category, to the MPSC Administrator for approval. This report will be forwarded to the Fiscal Division for check processing.

2.

To process requests for payments from the projects, the AAA must complete a CDR reflecting the current request, based upon bills submitted from the project. The report, along with the bills, must be submitted to the MPSC Administrator for approval. The MPSC Administrator will forward this information to the Fiscal Division for processing of an Authorization for Withdrawal. No funds are to be distributed to a project until receipt of a letter authorizing the withdrawal from the account.

301.01 – State-Subsidy: 1084-Multipurpose Senior Centers Page 3 of 4

Procedure G – Reporting/Programmatic – Fiscal 1.

AAA MPSC Coordinator will submit monthly reports on the progress of each MPSC project to the ODA MPSC Administrator for approval prior to reimbursement. a.

The AAA MPSC Coordinator shall conduct a monthly site visit to review construction progress.

b.

The AAA MPSC Coordinator shall submit on a monthly basis: i.

Work progress schedule;

ii.

Cost Distribution Report, #353;

iii.

bills for entire construction during that specific period.

Procedure H – Property Management 1.

The AAA shall keep accurate records on property or equipment purchased with Senior Facilities funds (Am. Sub. H.B. 1084) and local match, whether purchased with cash or in-kind (donated). a.

Property records must include: i.

a description of the property;

ii.

manufacturer's serial number or other identification number;

iii.

source of property, including grant number;

iv.

acquisition date and cost;

v.

percentage of state participation in the cost of the project or equipment purchase.

2.

If the property is to be shared with other groups under the age of 60, approval must be obtained in writing from ODA.

3.

If property (real or equipment) is to be disposed of prior to the required term, such as ten years for renovation and twenty years for new construction, approval must be obtained in writing from ODA. a.

Nonexpendable property with a unit cost of less that $1,000 may be disposed of or used for other programs without reimbursement to the AAA.

301.01 – State-Subsidy: 1084-Multipurpose Senior Centers Page 4 of 4

b.

Nonexpendable property with a unit cost of $1,000 or more or real property may be used by t h e grantee f o r the purpose for which funds were granted or disposed of provided that compensation is made to ODA or the AAA. i.

4.

The amount of compensation shall be computed by applying percentage of state participation in the cost of the original project to the current fair market value of the property.

Waivers to the above requirements may be granted by ODA with sufficient documentation for reasons thereof.

Procedure I – Carry-Over 1.

Although construction budgets do not use carry-over", any funds originally allocated and left unexpended in a project will remain at the AAA level and be reallocated to another Am. Sub. H.B. 1084 project, within the same PSA, selected by the State Committee.

2.

If there are no projects needing funds, the money will be returned to the state for reallocation to projects in other areas.

Procedure J – Evaluation 1.

The AAAs will be required to monitor program effectiveness as stated in Am. Sub. H.B. 1084 regulations.

Ohio Department of Aging

302.00 – The Establishment & Maintenance of Information & Referral Providers Page 1 of 2

Policy Each Area Agency on Aging (AAA) shall provide the necessary assurances and actions to ensure the establishment and maintenance of information and referral (I&R) providers, or similar services, preferably county level, within its planning and service area (PSA). Such information and referral services will be reasonably conveniently accessible, by toll free or collect call accessibility where possible, to all older individuals within the planning and service area. The purpose of such services shall be to assist the user with the identification of available and appropriate community resources that will address his/her unmet needs. Procedure A – Assessment of Existing I&R Services within the PSA 1.

Each AAA shall conduct a survey, designed by the Ohio Department of Aging (ODA), prior to the submission of its Area Plan, to: a.

identify the I&R service providers within its PSA;

b. determine the type or scope of services (generic or elderly specific, 24 hour crisis line, etc.) offered by each provider; c.

identify the geographical area served by each provider as well as; i.

2.

assess the toll free or collect call accessibility of individuals living within that geographical area;

d.

identify the geographical areas where no I&R services are offered;

e.

identify the type or scope of I&R services that are needed, but not available within the geographical areas.

A compilation of the results of the survey will be included in the Area Plan.

Procedure B – Unmet Needs 1.

2.

Where significant need for I&R services exists the AAA may choose to resolve this need by: a.

coordinating with local providers to establish and maintain an I&R service or similar provider; or

b.

provide Title III funding for the establishment and maintenance of an I&R provider.

A proposed plan will be submitted as part of the Area Plan which will:

302.00 – The Establishment & Maintenance of Information & Referral Providers Page 2 of 2

a.

identify the unmet needs of the PSA;

b.

identify the plan of action of the AAA to resolve these unmet needs, specifying at a minimum the: i.

option to be taken;

ii.

completion date;

iii.

amount of Title III funds involved.

Ohio Department of Aging

303.00 – Vacant Page 1 of 1

Policy Formerly – Transportation Safety Rescinded June 19, 1997

Ohio Department of Aging

303.01 – Vehicle Acquisition & Disposal Page 1 of 2

Policy The purchase of vehicles with funds administered by the Ohio Department of Aging (ODA) and the disposal of same shall be authorized by the Area Agency on Aging (AAA) prior to purchase or disposal. This policy applies only to grants and contracts which are either cost reimbursement or those that allow such purchases. Title III-B (Supportive Services) funds may be used only toward the purchase of vehicles which are involved in the transportation of clients to services. Title IIIC-1 Congregate Nutrition Services funds may be used only toward the purchase of vehicles involved in the delivery of food to congregate sites, and Title IIIC-2 Home-Delivered Meals Services funds may only be used toward the purchase of vehicles involved in delivering meals to homebound recipients. Title III A, D, and F funds may not be used for purchasing vehicles of any kind. ODA Senior Community Services Block Grant (SCSBG) funds may be used in the purchase of vehicles. Procedure A - AAA Requirements for Vehicle Acquisition 1.

Each AAA shall develop policies and procedures which: a.

2.

Address the AAA and provider planning process for determining: i.

The need for the vehicle; and

ii.

Type of vehicle needs.

b.

Outline the process service providers must follow when making vehicle acquisition requests;

c.

Require AAA approval for both acquisition and disposal, and outline said procedures;

d.

Delineate solicitation of bids process;

e.

Outline criteria a vehicle must meet in order to be authorized for disposal. At a minimum, this criteria must address mechanical and exterior conditions;

f.

Outline the process a service provider must follow to dispose of a vehicle; and

g.

The AAA shall ensure compliance with ODA policy 303.02 Preservation of Federal Financial Participation.

The AAA shall:

303.01 – Vehicle Acquisition & Disposal Page 2 of 2

a.

b.

3.

At a minimum, include in the contractual agreement between the AAA and the service provider the following: i.

The total ODA funds involved in the vehicle acquisition;

ii.

The percentage of each funding source used in the vehicle acquisition;

iii.

Delineation of the AAA's right to terminate the contract according to 45 CFR 74(M)(74.115).

iv.

The AAA's right to transfer title according to Circular A-102.

v.

A requirement that the service provider must obtain AAA approval for disposal. After such approval is granted, to publicly solicit bids for the vehicle, selecting the highest bidder for the sale; and

vi.

A requirement that the service provider must maintain adequate insurance coverage to protect the vehicle investment and its cargo.

Specify in the contract that the vehicle be properly maintained in accordance with ODA transportation service specifications.

AAAs may establish policies and procedures that address the protection of the aging network's use of vehicles (e.g., liens, contractual language, AAA retaining the title to vehicle).

Procedure B – Vehicle Inventory 1.

Each AAA shall maintain an inventory of all vehicles which are purchased, in whole or in part, by funds identified in the policy statement and is subject to review during routine ODA monitoring visits. ODA will supply the inventory software in which this information must be maintained.

2.

Vehicle inventory information shall be updated prior to the end of each state fiscal year, and shall be submitted to ODA upon request.

Date: June 19, 1997 Authority/Basis: OAA, 42 U.S.C. 3030(d), 321(a)(2); 42 U.S.C. 3030(1), 351(1); 45 CFR 74(M)(74.115); 45 CFR 1321.11

Ohio Department of Aging

303.02 – Preservation of Federal Financial Participation Page 1 of 3

Policy: Area Agencies on Aging (AAAs) are required to take the necessary measures to preserve the federal and state financial participation involved in vehicles purchased with Title III or any other state funds administered through the Ohio Department of Aging (ODA). Vehicles purchased with program income generated from activities supported by funds administered through ODA are subject to this policy. Procedure A – Vehicle Purchase 1.

At the time of a vehicle purchase the AAA shall: a.

file a lien on the vehicle title listing the AAA as the first lien holder; i.

2.

if a vehicle, which has been purchased with funds administered by ODA, is used as trade-in for another vehicle (regardless of major funding source of said vehicle) a lien is required unless conditions listed in Procedure C2A of this policy apply;

b.

the AAA may choose to retain title possession, or return the title to the grantee;

c.

draw up a contractual agreement between the AAA and the grantee which includes: i.

the total ODA funds involved in the vehicle purchase;

ii.

the percentage of federal/ODA financial participation;

iii.

the right to terminate the contract according to 45 CFR. Part 74, Subpart M, Section 74.115;

iv.

the right to transfer title according to OMB Circular A-102, Attachment N, Section 36c(2).

The AAA shall complete and submit to the Ohio Department of Aging (ODA) an ODA VEHICLE INVENTORY FORM within 30 days of acquisition.

Procedure B – Vehicle Disposal Information for ODA Vehicle Inventory System 1.

Prior to any vehicle disposal, the AAA will make the determination for such action.

2.

AAA has the responsibility for vehicle disposition approval/disapproval. The AAA must complete and submit to ODA the following information on an ODA VEHICLE INVENTORY FORM:

303.02 – Preservation of Federal Financial Participation Page 2 of 3

a.

Agency information

b.

Manufacturer

c.

Year of manufacture

d.

Vehicle identification number

e.

Current mileage

f.

General condition of vehicle

g.

Type of disposal (trade-in, salvage, sale, etc.)

Procedure C – Vehicle Disposal Procedures 1.

2.

The AAA will be responsible for approving or disapproving provider requests for disposing of a vehicle purchased in whole or in part with ODA-administered funds. a.

The AAA will be responsible for developing policies and procedures regarding vehicle disposition by providers.

b.

Upon approval, if the vehicle is to be sold, the AAA shall require the grantee to publicly solicit bids for the vehicle and to select the highest bidder for the sale.

c.

Upon the sale, trade-in, salvage or transfer of title of the vehicle, the AAA shall cancel the lien posted on the vehicle title.

d.

The percentage of the original ODA financial participation should be applied to the sale or trade-n value. Monies obtained from any financial activity should either be: i.

credited toward the operation of the ODA-funded transportation service;

ii.

credited toward the purchase of another vehicle;

iii.

returned to the AAA.

The AAA may waive the preservation of federal financial participation policy for TRADE-IN activity when the following circumstance exists: a.

The replacement vehicle is purchased with funds other than ODAadministered funds (including match for any ODA-administered funds) and two out of the four conditions listed below are met by the ODA vehicle to be used as a "trade-in":

303.02 – Preservation of Federal Financial Participation Page 3 of 3

i.

Vehicle mileage is 100,000 or more.

ii.

Poor mechanical and exterior conditions are present (as outlined on Vehicle Inventory Form Instructions).

iii.

The fair market value is $1,000 or less.

iv.

The vehicle is five years or older.

Procedure D – Transfer/Termination 1.

2.

In cases where the AAA has terminated a contract and/or desires to transfer a vehicle between Title III service providers, the AAA shall: a.

determine the current market value of the vehicle;

b.

apply the percentage of the original non-federal financial participation tot the current market value;

c.

offer to "buy-out" the grantee's non-federal share.

In cases where a transfer occurs within a sub-grantee agency and the vehicle is to be primarily used for non-Title III/ODA activities, the sub-grantee shall reimburse the Title III/ODA program the market value of the vehicle. a.

Date: February 1991

The AAA shall ensure that three estimates of the market value is obtained and the highest estimate is used in determining the reimbursement amount.

Ohio Department of Aging

303.03 – Vacant Page 1 of 1

Policy

Formerly – Vehicle Inventory Rescinded June 19, 1997

Ohio Department of Aging

303.04 – Transportation Coordination Page 1 of 1

Policy Each Area Agency on Aging (AAA) will establish an effective and efficient process for promoting coordination between programs assisted with funds allocated under the Older Americans Act (OAA) and administered through the Ohio Department of Aging (ODA) and programs administered by the Ohio Department of Transportation (ODOT) under Sections 3, 9, 16, and 18 of the Federal Transit Act of 1964, as amended. Procedure A – Coordination 1.

Each AAA shall, as appropriate, participate in local coordinating councils, where already established, for the purpose of maintaining regular contact and input into local transportation planning and coordination efforts.

2.

Each AAA shall, as appropriate, enter into Memorandums of Understanding with providers of transportation funded with Federal Transit Administration (FTA) dollars which address coordination efforts within the AAA's planning and service area.

3.

Each AAA shall, as appropriate, advocate for coordination of OAA and FTA dollars within its planning and service area.

Ohio Department of Aging

304.00 – Nutrition Program Services Page 1 of 1

Policy Each Area Agency on Aging (AAA) is responsible for planning, administering, and evaluating a comprehensive and coordinated system for nutrition program services in each planning and service area (PSA). Nutrition program services include congregate and home-delivered meals, client finding, outreach, nutrition education, nutrition screening, shopping assistance and counseling. Procedure A – Nutrition Program Services Definitions 1.

All nutrition services above are defined by and found in the Ohio Department of Aging (ODA) Meal & Nutrition Services: Specifications and Guidelines, taxonomy, and/or NAPIS definitions.

2.

Only those nutrition services with an established ODA definition can be funded with state and/or federal funds awarded by ODA.

Procedure B – Staffing 1.

Each AAA must employ a licensed dietitian as defined in ORC Chapter 4759 to coordinate and/or administer nutrition services in the PSA.

2.

Either the AAA must employ a licensed dietitian for all congregate and/or homedelivered meal providers, or the meal providers must obtain the services of a licensed dietitian on staff or consulting basis.

3.

Nutrition counseling shall be provided only by a licensed dietitian.

4.

A licensed dietitian shall plan and supervise special or therapeutic menus in accord with ODA's Meal & Nutrition Services: Specifications and Guidelines.

5.

Nutrition education shall be provided by a licensed dietitian or persons who have been granted an exemption from the Ohio Board of Dietetics. (ODA 0200-7/99)

____________________ Date: August 20, 1999 (#899NP224) Authority Basis: OAA § 307(A)(13); ORC Chapter 4759; ODA Meal & Nutrition Services: Specifications and Guidelines issued May 12, 1999

Ohio Department of Aging

304.01 – Selection of Nutrition Service Providers Page 1 of 1

Policy Each Area Agency on Aging (AAA) is responsible for the selection of congregate a homedelivered nutrition service providers. Procedure A – Criteria And Procedures For Selection 1.

Each AAA must follow the competitive bid process outlined in ODA Policy 407.00 AAA Grants and Contracts for nutrition service providers’ selection.

2.

Each AAA must select nutrition providers that furnish either congregate services or home-delivered services or both.

3.

Each AAA will give preference to the extent feasible to the selection of meal providers which: a.

have demonstrated an ability to provide meals efficiently and reasonably; and

b.

furnish assurances to the AAA that they will maintain efforts to solicit voluntary support, and that funds made available to them will not be used to supplant funs from non-federal resources.

Procedure B – ODA Recognized USDA Eligible Nutrition Service Provider Change 1.

2.

ODA will consider approving the expansion of ODA recognized USDA eligible nutrition providers provided the AAA: a.

determines that expansion will create increased meal services at the same or reduced cost;

b.

determines that expansion will lower costs for the same meal service;

c.

is forced to seek alternative service providers that may necessitate expansion, due to the loss of a current ODA recognized nutrition provider; and/or

d.

will explain how the change will affect the PSA geographical areas served, affect service to the target population, and change service units and program costs.

Each AAA must submit to ODA all necessary amendments to their current approved Area Plan.

Ohio Department of Aging

304.02 – Meal Service - Participant Eligibility Page 1 of 1

Policy Individuals aged 60 or older and their spouses, regardless of age, are eligible to participate in the meal program. At a nutrition provider's discretion, handicapped or disabled individuals who have not attained 60 years of age, but who reside in housing facilities occupied primarily by the elderly at which congregate nutrition services are provided, are eligible to participate in the congregate meals program. At a nutrition provider's discretion, individuals under 60 years of age volunteering for meal service during meal hours, are eligible to participate on the same bases as elderly participants. At a nutrition provider's discretion, individuals with disabilities who reside at home with older individuals who are eligible under the Older Americans Act (OAA) are eligible to participate in the meals programs. Procedure A – Eligibility Criteria Requirements 1.

Each AAA must insure that each nutrition provider (both congregate and homedelivered meals) will follow and comply with the Meal & Nutrition Services: Specifications and Guidelines.

2.

Each AAA must establish procedures that will allow nutrition providers the option to serve: a.

b. c.

3.

handicapped or disabled individuals, under 60 years of age, residing in housing facilities, occupied primarily by the elderly, at which meal services are provided; individuals providing volunteer services during meal hours; and individual with disabilities who reside at home with and accompany older individuals who are eligible under the OAA.

Each AAA will provide technical assistance to each nutrition provider in implementing procedures 2a, b, and c.

Procedure B – Congregate Meals Congregate meal participants must meet any further requirements defined by Meal & Nutrition Services: Specifications and Guidelines. Procedure C – Home-Delivered Meal Participants 1.

Home-delivered meal participants must meet the eligibility requirements for home-delivered meal participants as defined by Meal & Nutrition Services: Specifications and Guidelines.

2.

An in-home assessment must be done within 3 months, and at least once every 12 months after that.

Authority Basis: OAA § 307; Meal & Nutrition Services: Specifications and Guidelines, issued 5/12/99

Ohio Department of Aging

304.03 – Home-Delivered Meal Service - Participant Eligibility Page 1 of 2

Policy Individuals aged 60 or older who are homebound by reason of illness, incapacitating disability or otherwise isolated, and who meet all of the eligibility criteria listed below are eligible to participate in the home-delivered meals program. The eligible participant's spouse, regardless of age or condition, may receive a home-delivered meal if receipt of the meal is in the best interest of the participant according to criteria determined by the AAA. At a nutrition program's discretion, individuals with disabilities who reside at home with older individuals who are eligible under the Older Americans Act (OAA) are eligible to participate in the home-delivered meals program. Procedure A – Eligibility Criteria Requirements 1.

Each Area Agency on Aging (AAA) must insure that each nutrition program will, at a minimum, meet all participant eligibility determination standards and procedures as outlined in the Ohio Department of Aging's (ODA) HOME-DELIVERED NUTRITION SERVICES STANDARDS (see appendix).

2.

Each AAA must insure that each nutrition program has written eligibility criteria that are used to determine that participants meet all of the following minimum criteria: a.

a person must be 60 years of age or older, or be the spouse of a person 60 years of age or older;

b.

a person must be home bound; i.e., does not leave his/her home under normal circumstances;

c.

a person must be unable to participate in the congregate nutrition program because of physical or emotional difficulties;

d.

a person must be physically or emotionally unable to obtain food or prepare complete meals;

e.

there is no adult living at the same residence or in the vicinity that is able and willing to prepare all meals;

f.

a person must be able to feed him/herself without assistance from the nutrition program staff;

g.

a person with special dietary needs can have those special needs met by the meal provided by the nutrition program;

h.

a person must agree to be home when meals are delivered or contact the program when absence is unavoidable.

304.03 – Home-Delivered Meal Service - Participant Eligibility Page 2 of 2

3.

Each AAA must establish procedures that will allow nutrition program administrators the option to offer a meal, on the same basis as meals are provided to elderly participants, to individuals with disabilities who reside at home with individuals who are eligible under the OAA. a.

The AAA will provide technical assistance to each nutrition program in determining the feasibility and cost effectiveness in establishing a policy to offer home-delivered meals to individuals with disabilities who reside at home with individuals who are eligible under the OAA.

Ohio Department of Aging

304.04 – Congregate Meal Service – Level of Service Page 1 of`1

Policy Each Area Agency on Aging (AAA) is responsible for insuring that each nutrition program provides at least one hot or other appropriate meal per day, 5 or more days a week and any additional meals which the nutrition service provider may elect to provide. Appropriate homedelivered meals may be hot, cold, frozen, dried, canned, or supplemental foods with a satisfactory storage life. Each meal served must assure a minimum of one-third of the daily recommended dietary allowances as established by the Food and Nutrition Board of the national Research Council of the National Academy of Science. Procedure A – Days of Meal Service 1.

The AAA must insure that meal services are provided 5 or more days a week for congregate and home-delivered meal service except in rural areas where such frequency is not feasible.

2.

With prior approval by the Ohio Department of Aging (ODA), the AAA may approve a nutrition provider to change a site to less than 5 days per week.

Procedure B – Service Levels Each participant's level of need will be determined according to Meal & Nutrition Services: Specifications and Guidelines. Procedure C - Site Openings, Closings, Relocations 1.

The AAA will provide and document ongoing technical assistance to nutrition providers in assessing he need for site openings, closings, and reallocations and client finding and outreach strategies to maintain or expand meal served in the PSA.

2.

The AAA is responsible for and expected to give final written approval for all site openings, closings, and relocations.

3.

All site changes are reported to ODA in the Area Plan.

Date: July 1997 Authority/Basis: OAA § 339

Ohio Department of Aging

304.05 – Home Delivered Meal Service - Level of Service Page 1 of`1

Policy Each Area Agency on Aging (AAA) is responsible for insuring that each nutrition program provides, 5 or more days a week, at least one home-delivered (hot, cold, frozen, dried, canned, or supplemental foods with a satisfactory storage life) meal per day. Each meal served must assure a minimum of one-third of the daily recommended dietary allowances as established by the Food and Nutrition Board of the National Academy of Sciences – National Research Council. Procedure A – Service Levels 1.

Each nutrition program may provide up to two meals per day to an eligible participant.

2.

The AAA is responsible for insuring that each nutrition program bases the number of home-delivered meals a participant receives on the following: a.

the participant's need for meal service;

b.

availability of assistance from family or friends.

This includes changing, after enrollment, the level of meal service for a participant in response to a change in the availability of help from care givers and changes in the participant's status or condition. 3.

The AAA is responsible for insuring that each nutrition program provides all homedelivered meals, in accordance with guidelines established in ODA Home-Delivered Nutrition Services Standards (see appendix).

Ohio Department of Aging

304.06 – Menu Policy Page 1 of`2

Policy Each Area Agency on Aging (AAA) is responsible for insuring that each meal provided meets a minimum of one-third of the daily recommended dietary allowances as established by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences. Special menus will be provided where feasible and appropriate to meet the particular dietary needs arising from the health requirements, or ethnic background of eligible individuals. Procedure A – Menu Development All menus will be developed in accord with procedures established in the Meal & Nutrition Services: Specifications and Guidelines. Procedure B – Nutritional Adequacy Nutrient content of menus must be based on a required meal pattern established in the Meal & Nutrition Services: Specifications and Guidelines, computer nutrient analysis, or a combination of both methods. Procedure C – Special Menus 1.

Each AAA must establish procedures to provide special menus where feasible, appropriate, and cost-effective to meet the particular dietary needs arising from health reasons, religious requirements, or ethnic backgrounds of eligible individuals.

2.

Using the knowledge and expertise of a licensed dietitian, the AAA must provide technical assistance to each nutrition provider in determining the need, feasibility, and cost-effectiveness in establishing a service for special menus. The following criteria should be used: a.

There are sufficient number of persons who need the special menus to make this service a practical and cost-effects use of funds;

b.

The food and skills necessary to prepare the special menus are available in the planning and service area; and

c.

The type of special diet considered for service can be produced and delivered safely and cost-effectively.

Procedure D – Therapeutic Diets 1.

Nutrition programs may offer menus for medical restrictions requiring calculated diets (e.g., 2 gm Na+, 1500 ADA, renal) only when those therapeutic diets can be obtained from a hospital or facility approved by the licensed dietitian when those special diets are produced under the supervision of the licensed dietitian.

304.06 – Menu Policy Page 2 of`2

2.

Therapeutic diet menus must approximate as closely as possible (given the medical restrictions, religious requirements, or the ethnic background) the meal pattern and nutrient content of meals as specified in Meal & Nutrition Services: Specifications and Guidelines.

3.

The AAA will insure that therapeutic diets for health reason will follow these procedures: a.

A written diet order from the participant's physician must be on file with the nutrition provider; and

b.

At least every six months, the licensed dietitian must review each written diet order with the physician and update it according to physician instructions.

Procedure E – Emergency Food Supplies Nutrition providers must prepare clients for emergencies when meals may not be served as scheduled by either: 1.

Supplying clients with shelf stable meals; or

2.

Instructing clients regarding how to keep shelf stable foods available for emergencies.

Procedure F. Staffing - Standard Modified And Therapeutic Menus 1.

A licensed dietitian must review, approve, and sign all standard and therapeutic menus before use.

2.

If changes are made in standard or therapeutic menus prior to service, these changes must be reviewed an approved by a licensed dietitian.

3.

If a nutrition provider or AAA is temporarily without the services of a licensed dietitian, the AAA must obtain the services of a consultant dietitian to review, approve, and sign menus prior to menu use.

________________________ Date: August 20, 1999 (#899NP224) Authority Basis: OAA § 307(A)(13); ORC Chapter 4759; ODA Meal & Nutrition Services: Specifications and Guidelines issued 5/12/99

Ohio Department of Aging

304.07 – Food Handling: Preparation & Delivery Page 1 of`1

Policy Each Area Agency on Aging (AAA) is responsible for insuring that each nutrition provider will follow appropriate procedures to preserve the nutritional value and safety of all meals served. This includes insuring compliance with all state and local health laws and ordinances concerning the handling, preparation, serving, and delivery of food. No nutrition provider will change as of January 1, 1987 its method of meal preparation, service, or delivery without prior approval from the AAA and the Ohio Department of Aging. Procedure A – Food Handling, Preparation, & Delivery Requirements Each AAA must ensure that each nutrition provider will at all times meet the standards for food handling, preparation, and delivery prescribed in Meal & Nutrition Services: Specifications and Guidelines. Procedure B - Food Preparation, Service, and Delivery Changes 1.

Each AAA is required to conduct, and submit to ODA, a detailed cost/service study that verifies increased meal service at the same or reduced costs. or the same service level at reduced cost, before ODA will approve any change in the current nutrition provider meal preparation, service, or delivery method.

2.

Changes from or to the following methods require prior approval by the AAA and ODA: central kitchen preparation, on-site preparation, catered meal service, frozen home-delivered meal service, and frozen congregate meal service.

3.

ODA reserves the right to require a detailed cost/service study and prior approval of any other service changes not included above.

4.

In the event of a change in meal preparation, service, or delivery, the AAA should include a statement in its contract with the nutrition provider that the nutrition provider must give the AAA written notice prior to the expected change and written assurance of continued quality service at the same unit cost, regardless of the change. Failure to so do can be considered grounds for cancellation of the contract.

5.

ODA expects written notification from the AAA about changes in meal preparation, service, and/or deliver. ______________________________ Date: July 1997 Authority Basis: Meal & Nutrition Services: Specifications and Guidelines issued 5/12/99

Ohio Department of Aging

304.08 – USDA Reimbursement Agreement Page 1 of`2

Policy In accordance with the Older Americans Act (OAA) of 1965, the Ohio Department of Aging (ODA) shall have an agreement with the United States Department of Agriculture (USDA) to ensure the availability of food, cash, or a combination of food and cash to all Title III nutrition programs. Through Area Agencies on Aging (AAAs), all Title III nutrition programs must accept, use, and manage the current resources available from the USDA Nutrition Program for the Elderly. AAAs shall establish procedures, including periodic on-site program monitoring activities, to ensure that such disbursements are used by nutrition programs for the elderly solely for the purpose of purchasing United States commodities and other foods of United States origin for use in their feeding operations. Purchases include catered meals which are eligible for USDA reimbursement. This policy also covers home-delivered meals funded through Title III nutrition programs using Senior Community Services Block Grant (SCSBG) funds. These SCSBG funds may not be used to replace Title III-C2 funding, and must be used to maintain or expand services. Procedure A – Program Description And Requirements 1.

The Nutrition Program for the Elderly was established by USDA to provide a cash supplement, or commodities, to AAAs for Title III-C nutrition programs. ODA has elected to receive cash in lieu of commodities.

2.

Each AAAs shall enter into a written agreement with each nutrition program within its planning and service area specifying the proposed USDA reimbursement at the estimated rate established by the USDA. Should the USDA adjust the per meal reimbursement rate, payments to AAAs shall be adjusted accordingly. a.

AAAs shall reimburse only Title III-C/SCSBG nutrition programs for USDA eligible meals; and

b.

A USDA eligible meal is any meal that meets these three requirements: i. ii.

iii.

Served to persons age 60 or older and their spouses, regardless of age; Contain one-third the Recommended Dietary Allowance (RDA) or approximately one-third the RDA to accommodate special needs related to health requirements or religious and ethnic customs; Served by a nutrition service provider which is under the jurisdiction, control, management, and audit authority of the State Unit on Aging (SUA) or the AAA. A nutrition service provider is not required to be the recipient of funds provided by either the SUA or AAA. Funding may come from any source. However, the SUA or AAA must oversee the nutrition service operations of the provider to ensure that criteria I, ii, and iii are followed, as well as any other applicable regulations and policies prescribed by the U.S. Department of Health & Human Services and USDA-FNS.

304.08 – USDA Reimbursement Agreement Page 2 of`2

3.

USDA reimbursements may be used for the purchase of raw food only.

4.

USDA reimbursement shall be used to purchase U.S. agricultural commodities and other foods for AAA nutrition projects.

Procedure B – Budgeting and Reporting 1.

AAAs shall budget an estimated dollar amount annually in the Area Plan for meals based on current rates and anticipated meals levels.

2.

Each AAA shall report all USDA meals through both Title III-C and monthly meals reporting processes, as outlined in Policy 304.09 Reports On USDA Meals. Expended USDA funds shall be reported quarterly through OASIS Title III/SCSBG reporting system.

3.

AAAs shall be reimbursed on a quarterly basis if funds are available.

4.

USDA field staff may audit nutrition programs, including evaluation of site operations, for eligibility of meals.

Date: June 19, 1997 Authority/Basis: OAA, 42 U.S.C. 3030(a); 42 U.S.C. 3030(e)(f)(g-11)(g-13)(g-21)(g-22); 45 CFR 1321.11

Ohio Department of Aging

304.09 – Nutrition Services Incentive Program (NSIP) Page 1 of`3

Policy The Administration on Aging awards Nutrition Services Incentive Program (NSIP) funds to the Ohio Department of Aging (ODA) according to Ohio’s percentage of the national eligible meal total from the prior year. A NSIP meal is a meal served in compliance with all the requirements of the Older Americans Act (OAA). NSIP funds will be awarded by ODA to each Area Agency on Aging (AAA) on an annual basis. The purpose of these funds is to support the Congregate Nutrition Programs and Home-Delivered Nutrition Programs. AAAs shall establish procedures to ensure compliance with all applicable ODA policies. ODA elects to receive grants of cash from Administration on Aging rather than commodities from the United States Department of Agriculture. Procedure A – Allocation of Funds 1.

ODA will allocate NSIP funds to AAAs based on each AAA’s prior year percentage of the state Congregate Nutrition Programs and Home-Delivered Nutrition Programs eligible meal count. The amount of each AAA allocation will be designated in the Notice of Grant Award (NGA).

2.

AAA will allocate NSIP funds to the Congregate Nutrition Programs and HomeDelivered Nutrition Programs in the specific county it was earned in the prior year to an eligible agency. Allocations may be adjusted based on expected eligible meal count changes for the Congregate Nutrition Programs and Home-Delivered Nutrition Programs during the contract year.

3.

AAA is not required to provide matching funds to earn NSIP funds.

4.

AAA may not use NSIP funds to meet matching requirements for the OAA Title III or any other federal funds.

5.

NSIP funds can not be transferred between the Title IIIC-1 Congregate Nutrition Program and Title IIIC-2 Home-Delivered Nutrition Program

Procedure B – NSIP Meal Requirements 1.

An eligible meal for NSIP funds is a meal served in compliance with the following criteria regardless of funding source: a.

b.

The meal must meet the Recommended Dietary Allowances/Dietary References Intakes and the Dietary Guidelines for Americans.

The meal is available to individuals age 60 and over, and their spouse, regardless of age. The meal is reimbursable when served to individuals under the age of 60 and who meet one or more of the following criteria:

304.09 – Nutrition Services Incentive Program (NSIP) Page 2 of`3

2.

i.

handicapped or disabled residing in housing facilities occupied primarily by older individuals at which the Congregate Nutrition Program services are provided;

ii.

disabled and reside at home with and accompany older eligible individuals to the Congregate Nutrition Program or lives with a recipient of a home delivered meal; or

iii.

provide volunteer services for the Congregate Nutrition Programs and Home-Delivered Nutrition Programs.

d.

The NSIP meal may be reimbursable when the home delivered meal is provided within the supplemental services category under the Title III-E National Family Caregiver Support Program to persons aged 60 and over who are either care recipients or caregivers (as well as their spouses, regardless of age).

e.

The meal is provided to the individual without a mandatory fee. Contributions can be collected, but only on an understood voluntary basis.

f.

The meal is served by an agency, which is under the jurisdiction, control, management, and audit authority of ODA and AAA following the requirements of the Title IIIC-1 Congregate Nutrition Program, Title IIIC-2 Home-Delivered Nutrition Program and state/local laws.

An ineligible meal for the NSIP is any meal with a set fee, such as a private pay meal program, PASSPORT meal service, or other means-tested meal programs.

Procedure C – Reporting Requirements 1.

OASIS/SAMS meal count figures will determine NSIP funding allocations to the AAAs.

2.

AAAs must report the number of eligible meals served each month for the Congregate Nutrition Programs and Home-Delivered Nutrition Programs on the monthly request for funds form.

3.

AAAs must report the number of eligible meals served each quarter through the OASIS/SAMS reporting system(s). All eligible meals reported through OASIS/SAMS for the twelve months ending the 30th day of September must be submitted to ODA by the 15th day of November.

4.

The annual total of eligible meals reported through the request for funds form must match the annual total of eligible meals reported through OASIS/SAMS. Should there be a discrepancy; ODA will request that the figures be reconciled and that any necessary adjustments be made in OASIS/SAMS to reflect the final accurate meal count.

304.09 – Nutrition Services Incentive Program (NSIP) Page 3 of`3

Procedure D – Allowable Costs 1.

NSIP funds will be used to purchase foods of United States origin for the Congregate Nutrition Programs and Home-Delivered Nutrition Programs.

2.

NSIP funds shall not be used to support AAA administrative costs.

3.

NSIP funds awarded to the AAA must be expended in accordance to ODA Policy 401 Notification of Grant Awards, spending authority and grant closeouts.

Procedure E – Monitoring Requirements 1.

ODA will review quarterly the AAA submitted meal counts.

2.

NSIP funds are subject to the provisions of ODA Policy 502.00 Unit of Service Verification.

3.

The AAAs must make adjustments in OASIS/SAMS to reflect accurate meal counts.

Date: January 1, 2001, October 1, 2002, November 14, 2003 (#1103S179) Authority/Basis: OAA, 42 USC 3030a; § 309. Nutrition Services Incentive Program

Ohio Department of Aging

304.10 – Vacant Page 1 of 1

Policy Formerly– Microwave Ovens RESCINDED

Ohio Department of Aging

305.00 – Legal Services Coordination Page 1 of`1

Policy The Area Agency on Aging (AAA) shall enter into contract with providers of legal services which met the following standards as specified in 45 CFR 1321.73, and Section 307(a)(15) of the Older Americans Act of 1965, As Amended. Procedure A. Legal Service Requirements 1.

The AAA shall determine that each provider of legal services: a.

Has staff with expertise in specific areas of law affecting older persons in economic or social need; for example, public benefits, institutionalization, and alternatives to institutionalization;

b.

Demonstrates the capacity to provide effective administrative and judicial representation in the areas of law affecting older persons with social or economic need;

c.

Demonstrates the capacity to provide support to other advocacy efforts, for example, the long-term care ombudsman program;

d.

Demonstrates the capacity to effectively deliver legal services to institutionalized, isolated, and homebound individuals;

e.

Has offices and/or outreach sits which are convenient and accessible to older persons in the community;

f.

Demonstrates the capacity to provide legal services in a cost-effective manner; and

g.

demonstrates the capacity to obtain other resources to provide legal services to older persons.

Authority/Basis: 45 CFR 1321.73; Older Americans Act of 1965, As Amended, § 307(a)(15)

Ohio Department of Aging

306.00 – Long Term Care Facilities Ombudsman Page 1 of`3

Policy The State Ombudsman Program will track closely those complaints which are received from any source. This formalized procedure will ensure that complaints are handled efficiently by the State Ombudsman Program or by the Regional Ombudsman Program to which the complaint may be assigned and that reporting of accurate data will be accomplished. Procedure A Complaints received via written correspondence will be referred to the appropriate Regional Ombudsman Program. The Regional Program will make a decision regarding acceptance of the complaint for investigation. Options include accepting the complaint and responding through investigation, information, or advocacy; or declining to investigate in accordance with rule 173:2-118 of the Ohio Administrative Code. 1.

When a complaint is declined, the Regional Ombudsman Program will refer the complaint to the State Ombudsman, who will make a final decision as to disposition. The Regional Ombudsman Program may decline a complaint for the following reasons: the complaint is frivolous, vexatious, or not made in good faith; the complaint is received so long after the occurrence that an adequate investigation cannot be conducted; a conflict of interest exists; or the Regional Ombudsman Program lacks adequate resources to handle the complaint. a.

2.

The State Ombudsman will inform the Regional Ombudsman Program of the decision in writing and will provide a written or documented verbal response to the complainant referencing rule 173:2-1-18 of the Ohio Administrative Code.

When a complaint is assigned to an ombudsman on the State Program staff because a conflict of interest exists for the Regional Ombudsman Program, because the Regional Ombudsman Program lacks adequate resources to conduct an investigation, or the Regional Ombudsman Program has requested the assistance of the State Program, the following procedures will be used: a.

A case number will be assigned using the federal fiscal year as the first two digits then proceeding numerically. For example, the first complaint assigned in federal fiscal year 1996 for investigation by a representative of the State Ombudsman Program would be "96001." The case number will be entered in the common ombudsman electronic directory in a file created for purposes of carrying out this procedure. The file should include the date of the assignment, the case number, and the name of the ombudsman receiving the assignment.

b.

The ombudsman receiving the assignment will contact the complainant to complete intake then proceed with handling the complaint in accordance with rule 173:2-1-17 of the Ohio Administrative Code, “Complaint Handling Protocol.

306.00 – Long Term Care Facilities Ombudsman Page 2 of`3

3.

c.

While the case is open, the ombudsman handling the case will maintain documentation in an electronic file in the common ombudsman directory. In this way, when the ombudsman is not available, other ombudsmen of the State Program can respond to urgent activity or inquiries. The documentation file will be assigned a password that is made available to the unit secretary.

d.

The ombudsman handling the case will provide the State Ombudsman with updates via the weekly report process used by the Ohio Department of Aging. Information will be communicated using the case number to maintain confidentiality.

e.

The ombudsman handling the case will provide the data required by the statewide uniform reporting system no later than the 10th business day following the end of the quarter.

f.

The State Ombudsman Program will provide updates to the Regional Ombudsman Program on the status of complaints referred to the State Ombudsman Program.

When the complaint is referred to a Regional Program for handling, the following procedure will be followed: a.

The State Ombudsman will assign a reference number beginning with the number of the PSA to which the complaint is assigned, followed by an ordinal indicator. For example, the first complaint assigned to PSA 2 would be given the reference number, "02001."

b.

A memorandum of referral will be sent to the Regional Program accompanied by the complaint letter or an explanation of the complaint, if received by telephone.

c.

A letter will also be sent to the complainant indicating that a referral has been made and providing the address and telephone number of the respective Regional Program.

d.

The memorandum of referral accompanying the complaint letter will include instruction to the Regional Program to notify the State Ombudsman of the name of the ombudsman to whom the complaint is assigned.

e.

The Elder Rights Unit secretary will enter the reference number, date assigned and the name of the ombudsman handling the case in the common electronic directory in a file created for purposes of carrying out this procedure.

f.

An assigned representative of the State Program will maintain contact with the Regional Program regarding the status of the referral.

306.00 – Long Term Care Facilities Ombudsman Page 3 of`3

4.

When a complainant is a long-term care facility resident, correspondence will be mailed in a manner that protects confidentiality (e.g., in an envelope which does not identify the Ohio Department of Aging).

Procedure B When a complaint is received via the telephone, the complainant will first be asked whether he or she has contacted the Regional Program. If the contact has been made and the complainant was not satisfied or the complainant does not wish to contact the Regional Program, the ombudsman receiving the call will perform an intake of the complaint and obtain additional information about the concern regarding the Regional Program. Handling of the complaint will proceed according to section A of this procedure in conjunction with the policy and procedure for handling complaints against representatives of the Office.

Date: March 11, 1996 Authority/Basis: 173.19 Ohio Revised Code; 173:2-1-17 and 173:2-1-18 Ohio Administrative Code

Ohio Department of Aging

307.00 – Complaints Regarding Ombudsmen Page 1 of`3

Policy The Office of the State Long-Term Care Ombudsman will be responsive to consumers and other individuals who are dissatisfied with the action or inaction of staff and volunteers who are representatives of the Office. Complaints received shall be addressed at the level most effective to resolution of the concern. The Regional Long-Term Care Ombudsman Program (RLTCOP) Director shall at all times be notified of complaints received by the State Program. Notification of the ombudsman who is the subject of a complaint will be made at the discretion of the RLTCOP Director, or the sponsoring agency director, if the RLTCOP Director is the subject of the complaint. Procedure A – Provision of Information 1.

Upon the occasion of the State Long-Term Care Ombudsman receiving a complaint regarding the activities of a representative of the Office who is a paid or volunteer member of a designated regional program, the following information shall be provided to the complainant: a.

Structure of the Aging Network: the respective roles of the ODA, SLTCO, AAA, sponsoring agency, RLTCO program director, and the names and means of contacting said individuals.

b.

The recommended hierarchy for lodging a complaint is as follows: i. ii. iii. iv. v.

Contact with the RLTCOP program director; if not satisfactory, The direct supervisor of the RLTCOP director at a sponsoring agency; if not satisfactory, The director of the appropriate AAA; if not satisfactory, The SLTCOP; if not satisfactory, The Director of the Ohio Department of Aging.

c.

The complainant's right to contact any of these individuals in an attempt to have their concern resolved.

d.

The right to remain anonymous in pursuing a resolution to their complaint (the complainant will be advised of any potential limitations to this choice).

e.

The right of the RLTCOP director to be notified of the complaint.

Procedure B – Complaint Intake Complaints received by the State Program regarding ombudsman activities shall be transferred to an ombudsman staff of the state program who is certified as a program director. The certified staff person receiving the call shall provide the information identified in paragraph A and perform an intake of information which shall include the following information as appropriate to the complaint:

307.00 – Complaints Regarding Ombudsmen Page 2 of`3

1.

Data to include but not be limited to: a.

complainant name, address, telephone, relationship to client;

b.

ombudsman name, regional program;

c.

provider name, address, telephone;

d.

client (resident/recipient) name, address, telephone, sex, age.

2.

Statement of complaint, including pertinent information regarding the ombudsman and other persons involved, dates, specific actions or failure to act, any perceived negative outcome, and any other information applicable to the complaint.

3.

Statement of complainant's desired outcome.

4.

Complainant's choice of first contact for response to the complaint as listed in Procedure A.1.b.

Procedure C – Notification of Regional Long-Term Care Ombudsman Program & Representative The RLTCOP director will be notified of the complaint and provided with the intake information within the confidentiality provisions of the Office. If the complaint is about the program director, notification shall be provided to the director of the sponsoring agency. The RLTCOP director or the sponsoring agency director may exercise discretion as to notification of the ombudsman who is the subject of the complaint. Procedure D – Assignment By The State Ombudsman 1.

In accordance with the State Ombudsman’s duty to oversee the Office of the State Long-Term Care Ombudsman and to certify all representatives of the Office, the State Ombudsman shall be notified of all complaints regarding activities of ombudsmen. If, after the sponsoring agency has followed its internal grievance procedure, the complainant is not satisfied, the State Ombudsman shall assign a representative of the State Program to review the matter.

2.

The State Ombudsman shall require a final report of the disposition of the complaint.

3.

When a representative of the State Ombudsman Program is assigned to investigate a complaint, an action plan shall be developed regarding the following, as appropriate: a.

Complainant's choice of who will investigate/respond to the complaint;

b.

Type of investigative steps agreed upon with the complainant to verify or explain the complaint;

c.

Time frames for reporting back to the complainant - fifteen working days unless otherwise determined in consultation with the complainant;

307.00 – Complaints Regarding Ombudsmen Page 3 of`3

d.

Means chosen to implement the complainant's desired outcome if the complaint is verified.

Procedure E – Knowledge of a Complaint 1.

Knowledge of any complaints made regarding the ombudsman program to the Governor's Office shall be brought to the attention of the Director of the Department of Aging and the State Ombudsman; and

2.

Any complaint made to the Director of the Department of Aging shall be handled at the Director's discretion in accordance with the following provisions: a.

The Director may assign such persons as she chooses to handle the complaint, except that: i.

no person assigned to handle a complaint regarding the Office of the State Long-Term Care Ombudsman shall have a conflict of interest as defined by O.A.C. 173:2-1-16; and

ii.

the person assigned shall treat all information regarding identities in a confidential manner in accordance with O.A.C. 173:2-1-17.

b.

The complaint shall be handled in accordance with paragraph B above.

c.

The Director shall require a final report of the disposition of the complaint. A final status report shall be provided to the SLTCO, RLTCOP, and the AAA.

3.

When complaints are received by an Area Agency on Aging which is not also the sponsoring agency of the RLTCOP, the Area Agency on Aging shall refer the complaint to the State Long-Term Care Ombudsman, who will follow the procedure outlined above.

4.

When complaints are received by the RLTCOP or the sponsoring agency, the program or agency shall follow its own policy for handling complaints about representatives of the program.

Date: March 11, 1996 Authority/Basis: 173:2-1-22 Ohio Administrative Code

Ohio Department of Aging

308.00 – Conditions of Participation & Service Specifications Page 1 of`49

Policy Area Agencies on Aging (AAAs) shall include conditions of participation (COP) and service specifications as contractual requirements with service providers for the use of Title III, Senior Community Services Block Grant (SCSBG) and Alzheimer’s Respite funds. These conditions of participation and service specifications may be added to by a AAA provided the additional provisions neither conflict with nor diminish those required by ODA policy. Procedure A – Conditions Of Participation 1.

Service providers shall meet all conditions to be eligible to provide services using Title III, SCSBG and Alzheimer’s Respite funds.

2.

Elements for these conditions are outlined in Appendix A.

Procedure B – Service Specifications 1.

Minimum specifications have been developed for: Adult Day Service Chore Service Home Modification & Maintenance Service Homemaker Service Meal & Nutrition Service Personal Care Service Transportation Service

2.

Applicable acronyms and definitions used in service specifications are outlined in Appendix A, and actual specifications are in Appendices B-I.

Date: May 12, 1999 (#599-NP146); August 1, 2001 (#0801S144) Authority Basis: 42 U.S.C. 3027(a)(44)

308.00 – Conditions of Participation & Service Specifications Page 2 of 49 Appendix A Title III, SCSBG & Alzheimer’s Respite Conditions of Participation & Service Specifications Appendices, Acronyms & Definitions

A.

Appendices These are Appendices to ODA Policy 308.00 Conditions of Participation & Service Specifications: Appendix A Appendix B Appendix C Appendix D Appendix E Appendix F Appendix G Appendix H Appendix I

B.

Appendices, Acronyms & Definitions Conditions of Participation Adult Day Service Chore Meal & Nutrition Homemaker Home Modification & Maintenance Personal Care Transportation

Acronyms These Acronyms are used in COP and Service Specifications: AA AAA ADL ADS BA BS CFR COP CPR DRI EBT GED HACCP HDM HMK IADL LD LPN LSW NSI OAC OBMV ODA ORC OT PAT

Associate of Arts Area Agency on Aging Activity of Daily Living Adult Day Service (formerly Adult Day Care) Bachelor of Arts Bachelor of Science Code of Federal Regulations Conditions of Participation Cardiopulmonary Resuscitation Dietary Reference Intake Electronic Benefit Transfer General Education Diploma Hazardous Analysis Critical Control Point Home-Delivered Meal Homemaker Instrumental Activity of Daily Living Licensed Dietitian Licensed Practical Nurse Licensed Social Worker Nutrition Screening Initiative Ohio Administrative Code Ohio Bureau of Motor Vehicles Ohio Department of Aging Ohio Revised Code Occupational Therapy Passenger Assistance Training

308.00 – Conditions of Participation & Service Specifications Page 3 of 49 Appendix A Title III, SCSBG & Alzheimer’s Respite Conditions of Participation & Service Specifications Appendices, Acronyms & Definitions

PCA PCS PSA PT RD RDA RLTCOP RN RT SCSBG ST STNA US USDA C.

Personal Care Aide Personal Care Services Planning & Service Area Physical Therapy Registered Dietitian Recommended Daily Allowance Regional Long-Term Care Ombudsmen Program Registered Nurse Recreational Therapy Senior Community Services Block Grant Speech Therapy State-Tested Nurse Aide United States United States Department Of Agriculture

Definitions These Definitions are used in COP and Service Specifications: 1.

"ADL" means the activities of daily living for bathing, grooming, toileting, dressing, eating and mobility which refers to bed mobility, transfer, and locomotion.

2.

"APPROVED SOURCE" means a designation given to food handling and processing entities that comply with state and federal food safety regulations and inspections.

3.

CAREGIVERS" means relatives, friends, or significant others who provide assistance to the participant and are responsible for the participant’s care on a continuing basis.

4.

“DIRECT SERVICE STAFF” means individuals involved in the provision of a service to a participant. Involvement may include the coordination, supervision, or provision of personal care or health-related services and routine contact with the participant such a hands-on physical assistance, verbal cuing, reminding, or monitoring activities according to service specifications.

5.

"IADL" means the instrumental activities of daily living of shopping, meal preparation, laundry, community access activities which are telephoning, transportation, legal, or financial, and environmental activities which are house cleaning, heavy chores, and yard work or maintenance.

6.

“LOWER CONCENTRATED SWEETS/SODIUM/FAT MODIFIED DIET” means any food regimen ordered by the participant or recommended by a health professional requiring the avoidance or decreased frequency of, and substitutions for, foods that are high in sugar, sodium, or fat (e.g., no added-salt diets).

308.00 – Conditions of Participation & Service Specifications Page 4 of 49 Appendix A Title III, SCSBG & Alzheimer’s Respite Conditions of Participation & Service Specifications Appendices, Acronyms & Definitions

7.

“RETURN DEMONSTRATION” means a test of proficiency completed by a paraprofessional to demonstrate proficiency in a task for which the paraprofessional has received training.

8.

“SCSBG” refers to the senior community services block grant received by the Ohio Department of Aging through legislation enacted by the Ohio General Assembly.”

9.

“SHELF STABLE MEAL/EMERGENCY MEAL” means a nutritious meal that is used in emergency situations, and which does not require refrigeration or heating to maintain food safety.

10.

“TERMINATION” means the agreement between the AAA and the provider has ended, and the provider will no longer be paid for services provided to Title III and SCSBG participants.

11.

“TEXTURED MODIFIED DIET” means any food regimen ordered by the participant or recommended by a health professional requiring the substitution of one or more foods with a firm or fibrous quality with either (1) the same food in a chopped, ground, or pureed form; or (2) foods that are similar in nutritive value with a softer consistency to help chewing and swallowing (e.g., tomato juice for tossed salad).

12.

“THERAPEUTIC DIET” means any physician ordered food regimen requiring a daily minimum or maximum amount of one or more specific nutrients, or a specific distribution of one or more nutrients. Examples are calorie specific diabetic diets, complex renal diets with specific protein, sodium, potassium, and fluid restrictions.

13.

“TITLE III” refers to that part of the Older Americans Act which funds supportive and nutrition services.

14.

“USDA ELIGIBLE MEAL” means any meal meeting these United States Department of Agriculture Requirements: served to persons age sixty or older, and their spouses, regardless of age; contains one-third the RDA or approximately onethird the RDA to accommodate special needs related to health requirements or religious and ethnic customs; and served by a nutrition service provider that is under the jurisdiction, control, management, and audit authority of ODA or the AAA. A nutrition service provider is not required to be the recipient of funds provided by either ODA or the AAA. Funding may come from any source. However, ODA or the AAA must oversee the nutrition service operations of the provider to ensure all these criteria are followed, as well as any other applicable regulations and policies prescribed by the US Department of Health & Human Services and USDA.

Date: June 30, 1994; May 12, 1999

308.00 – Conditions of Participation & Service Specifications Page 5 of 49 Appendix B Conditions of Participation & Service Specifications

Service providers shall have a current contract with the AAA, and shall meet these COP: 1.

Be a formally organized business or service agency providing the services applied for, and shall: a.

Disclose all entities with a five percent or more ownership, and have a written statement defining the purpose of the business or service agency;

b.

Have a written statement of policies and directives, bylaws, or articles of incorporation;

c.

Have a written table of organization that clearly identifies lines of administrative, advisory, contractual, and supervisory authority unless the business is a sole proprietorship;

d.

Operate the business in compliance with all applicable federal, state, and local laws, and shall have a written statement supporting compliance with:

e.

(i)

Non-discrimination laws, federal wage and hour laws, and workers’ compensation laws in the recruitment and employment of individuals;

(ii)

Non-discrimination laws in the provision of services; and

(iii)

Federal rules and statutes take precedence over these conditions in cases where discrepancies between these exist.

Have a written affirmative action plan that must be appropriately updated, and will be reviewed at least annually, unless

2.

Have a physical facility from which to conduct business. The facility should have a telephone and a designated and utilized locked storage space for the maintenance of participant records.

3.

Have written procedures supporting the operation of the business and provision of service, and shall: a.

Have a system to document services delivered, billed, and reimbursed that complies with service specifications;

b.

Provide evidence supporting financial responsibility in the coverage of participant loss due to theft, property damage, or personal injury, and have a written procedure which identifies the steps a participant must take to file a liability claim;

308.00 – Conditions of Participation & Service Specifications Page 6 of 49 Appendix B Conditions of Participation & Service Specifications

4.

c.

Have a written procedure for reporting and documenting all participant incidents including significant changes that affect service delivery or imminent health or safety risks.

d.

Maintain a file for each participant. Each file shall include this identifying data: i.

Participant's name, address, and telephone number;

ii.

Participant's date of birth and gender;

iii.

Name and telephone number of participant's contact person or caregiver;

iv.

Service provider’s contact person and telephone number;

v.

Participant's functional abilities or limitations relevant to authorized services; and

vi.

Additional demographic data requested by the AAA.

e.

Maintain documentation of each participant contact and each service delivered;

f

Obtain written approval from the participant to release participant information; and

g

Retain all participant records for at least three years or until an audit is completed and all exceptions resolved, whichever is later.

h

Have a written procedure for follow-up and investigation of participant complaints and grievances, and a method to inform participants at the inception of services of the contact number for the RLTCOP.

i

Provide opportunity for title iii, SCSBG, and Alzheimer’s Respite participants to make voluntary contributions for services. Voluntary contributions are to be added to the amounts made available by the AAA, and must be used to increase the number of meals served, facilitate access to meals, and/or provide other supportive services directly related to the service delivered when the contribution was made.

Have written personnel policies and documentation that support personnel practices for providers which include:

308.00 – Conditions of Participation & Service Specifications Page 7 of 49 Appendix B Conditions of Participation & Service Specifications

a.

Job descriptions or statements of job responsibilities including qualifications for each position involved in the delivery of services unless the business is a sole proprietorship;

b.

Performance appraisals or a development plan for all employed or contract workers, and volunteers involved in providing service to participants unless the business is a sole proprietorship;

c.

Prior to service provision, a provider staff signature and a date that indicates completion of orientation that includes: i.

Employee position description and expectations;

ii.

Personnel Policies;

iii.

Reporting Procedures and Policies;

iv.

Table of Organization and Lines of Communication; and

v.

A code of ethics which declares that the provider staff shall not: (a)

Use the participant's vehicle;

(b)

Consume the participant's food and drink without the participant’s consent or the participant offering it;

(c)

Use the participant's telephone for personal calls;

(d)

Discuss personal problems or religious or political beliefs with the participant;

(e)

Accept gifts or tips from the participant;

(f)

Bring friends or relatives of the employee to the participant's home;

(g)

Consume alcoholic beverages or use medicine or drugs for any purpose other than medical while in the participant’s home or prior to the delivery of service;

(h)

Smoke in the participant's home, with or without the participant's permission;

(i)

Breach the participant's privacy or the confidentiality of participant records; and

308.00 – Conditions of Participation & Service Specifications Page 8 of 49 Appendix B Conditions of Participation & Service Specifications

(j)

Bring or eat personal food in the participant's home without the participant’s consent.

(k)

A policy that assures that all participant information will remain confidential.

5.

Deliver services in compliance with service specifications practices for providers.

6.

Sign a contract with each AAA responsible for the PSA in which provider services are rendered. The provider shall:

7.

a.

Maintain documentation demonstrating that all requirements outlined in service specifications have been met when delivered either directly or by sub-contract;

b.

Allow access to ODA, AAA, and other representatives with a need to access the provider’s facility, policies, procedures, records, and other documents related to the provision of Title III, SCSBG, and Alzheimer's Respite Services;

c.

Demonstrate compliance regarding background investigations of direct service workers.

d.

Demonstrate that computers and software are year 2000 compliant.

Failure to meet any of the requirements of these conditions may lead to termination of the AAA contract with the Title III, SCSBG, or Alzheimer’s respite service provider.

Date: June 30, 1994; May 12, 1999

308.00 – Conditions of Participation & Service Specifications Page 9 of 49 Appendix C Adult Day Service

A.

Purpose

ADS is designed to meet the needs of functionally or cognitively impaired adults through individualized care plans that encourage optimal capacity for self-care and maximize functional abilities in a community-based setting. ADS consist of structured, comprehensive, continually supervised components provided in a protective setting. Components may include, but are not limited to, health services, participant activities, PCS, and rehabilitative services such as PT, ST, and OT. Participants attend ADS on a planned basis during specified hours. B.

C.

Unit of Service 1.

One unit of ADS is five or more hours of direct service at the ADS center.

2.

One-half unit of ADS is less than five hours, but not including five hours, of direct service at the ADS center.

3.

A unit of ADS, excluding transportation, shall include all administrative costs, materials, supplies, and labor expenses.

Transportation 1.

ADS transportation furnished directly or contractually by the provider shall met specifications identified in Appendix I.

2.

A unit of transportation includes all administrative and provider-related costs associated with the trip. A unit of ads transportation is:

3.

D.

a.

A round trip; or

b.

A one-way trip; or

A mileage rate with trip costs based on a pre-determined AAA distance between the participant’s residence and the ADS center multiplied by an established ADS mileage rate.

Provider Agency & Facility Requirements 1.

If the ADS facility is housed in a building with other programs or services, the provider shall assure that: a.

A separate, identifiable space is available for ADS during operation hours; and

b.

At least sixty square feet of center space is available per participant, excluding hallways, offices, rest rooms, and storage areas.

2.

The ADS center shall have at least one accessible, working toilet per each ten participants.

3.

Medications shall be kept in locked storage at appropriate temperatures.

308.00 – Conditions of Participation & Service Specifications Page 10 of 49 Appendix C Adult Day Service

E.

4.

Toxic substances shall be stored in an area not accessible to participants.

5.

A fire and emergency safety plan, including conspicuously posted evacuation procedures, shall be documented.

6.

Periodic inspections and routine maintenance of fire extinguishers, smoke alarms, and quarterly evacuation drills shall be documented.

7.

The provider shall provide or arrange for participant transportation to the ADS center. Transportation shall include participant assistance with transfers to and from the vehicle, center, and participant’s home.

Participant Service Management 1. An initial participant intake assessment shall be conducted by the ADS center staff within the first two days of attendance at the ADS center, or assessment documentation shall be completed by the AAA, if the AAA is providing case management services to the participant, no more than thirty days prior to first day of attendance. 2.

3.

4.

The intake assessment documentation shall include: a.

A health profile including health risk factors, psycho-social profile, diet, medications, and name of the attending physician;

b.

Functional and cognitive profiles that identify ADLS and IADLS requiring attention or assistance by ADS center staff; and

c.

A social profile including social activity patterns, life events, community resources, caregiver data, formal and informal support systems, and behavior patterns.

Within the first thirty days of attendance, or ten units of service, whichever occurs first, a health assessment shall be developed by an RN for each participant. A care plan shall be developed for each participant to identify needs, problems, difficulties, goals, and objectives. The care plan shall document: a.

Interests and social rehabilitative needs;

b.

Health needs;

c.

Specific goals, objectives, and planned interventions that enable goals; and

d.

The participant and caregiver participated in, or provided input into, the development of the care plan.

An interdisciplinary care conference with ADS service workers, the participant or the participant’s caregiver, and which may include the AAA representative, if the AAA is providing case management services to the participant, shall be conducted

308.00 – Conditions of Participation & Service Specifications Page 11 of 49 Appendix C Adult Day Service

and documented for each participant at least every six months. The plan shall be revised according to changes in the participant’s status, condition, and response to service, when applicable. 5.

The provider shall document the physician’s verbal or written authorization prior to administering medications, nursing services, nutrition counseling, or therapeutic services. The provider shall obtain the physician’s signature and plan of treatment within the first thirty days of attendance, or ten units of service, and at least every ninety days for participants who receive medications, nursing services, nutrition counseling, or therapeutic services.

6.

At least two staff persons shall be present in the ADS center when more than one participant is in attendance. At least one of the two staff must be paid direct service staff.

7.

The staff to participant ratio shall be at least one staff person to every six participants.

8.

An RN or LPN under the direct supervision of an RN shall be on site at the center a minimum of eight hours per month while participants are in attendance.

9.

The daily attendance roster shall document arrival and departure times of participants, their modes of transportation, participants’ or designees’ signatures or initials, and the staff persons’ signatures. In cases where a participant’s signature in problematic an alternative method of documenting attendance can be devised.

10.

Participant activities shall be supervised by an activity director/coordinator.

11.

Daily and monthly planned activities shall be posted in full view of participants.

12.

A noon meal and snacks shall be procured or prepared by the provider: a.

Each meal shall provide one-third of the DRI/RDA, and shall meet either the ODA-approved meal pattern or a LD-approved nutrient analysis.

b.

Documentation shall demonstrate that all meals are prepared or subcontracted by a provider that is in compliance with Ohio Department of Health law established in the food service operation section 2231.32 of the ORC. The provider shall maintain a copy of the food service preparer’s or sub-contractor’s current Ohio food service license.

c.

The provider shall procure or prepare therapeutic diets that are prescribed by the participant’s attending physician, when applicable.

d.

For therapeutic diets, the provider shall maintain documentation of menu approval by a LD, or the meal shall be prepared under the direction of a LD.

308.00 – Conditions of Participation & Service Specifications Page 12 of 49 Appendix C Adult Day Service

F.

Personnel Requirements 1.

ADS staff must participate in at least eight hours of annual in-service or continuing education that may include these topics: a.

Sensitivity to aging and the aging process;

b.

Illness and disability;

c.

Chronic diseases;

d.

Special needs of the elderly;

e.

Special needs of the elderly with dementia; and

f.

Death and dying.

2.

Task-based instruction must be provided for center PCA staff that deliver PCS to participants prior to providing PCS to participants.

3.

Evidence of educational programs offered to center direct service staff shall list the instructor’s title and qualifications.

4.

Evidence should support that ADS staff possess these qualifications: a.

RN, LPN, LSW, PT, ST, and OT staff must have current Ohio licensure from an applicable licensing board.

b.

The activity director/coordinator must have a BS, BA, or AA degree in RT, or a related degree, or must demonstrate proof of successful completion of the National Certification Council of Activities Professionals; or two years of experience in a similar position.

c.

ADS staff that provide PCA must be a high school graduate, or possess a GED, or have a minimum of two years work experience in providing or assisting with individual personal care or social activities.

d.

Transportation staff must meet all transportation personnel requirements outlined in transportation service specifications (Appendix I).

June 30, 1994, Revised May 12, 1999

308.00 – Conditions of Participation & Service Specifications Page 13 of 49 Appendix D CHORE Service

A.

Purpose Chore service is designed to improve, restore, and maintain a safe and healthy living environment by performing tasks beyond the participant's capability and removing hazards posing threats to the participant's health and welfare. Service is limited to those that are not the legal or contractual responsibility of a landlord. Tasks included in this service may include, but are not limited to: 1.

2.

Heavy household chores a.

Wash walls and ceilings;

b.

Wash inside and outside windows that are not hard to reach;

c.

Remove, clean, and replace curtains and drapes; and

d.

Shampoo carpets and furniture.

Simple household chores a.

Repair water faucets;

b.

Unclog drains;

c.

Install smoke alarms;

d.

Change and install electrical fuses; and

e.

Light pilot lights.

3.

Disposal of garbage, paper, trash, and other waste materials.

4.

Pest Control

5.

Perform seasonal maintenance on the participant’s property such as: a.

Repair screens;

b.

Repair broken window panes;

c.

Cut grass;

d.

Rake and remove leaves;

e.

Trim shrubs;

308.00 – Conditions of Participation & Service Specifications Page 14 of 49 Appendix D CHORE Service

6. B.

C.

f.

Remove snow and ice, and provide chemical treatment, if needed;

g.

Change and install light bulbs;

h.

Perform maintenance on smoke alarms;

i.

Change and install furnace filters;

j.

Clean, change, and install storm windows and door screens;

k.

Clean spouts and gutters.

Do essential shopping.

Unit of Service 1.

A unit of service is one hour of direct service.

2.

The unit rate shall include the cost of materials, labor, supplies, equipment, administrative costs, and applicable fees associated with the chore requested.

Provider Agency Requirements 1.

The provider shall maintain a participant record that documents service delivery in accordance with tasks requested. Records should bear the participant’s or caregiver’s signature upon completion of chores.

2.

Upon request, the provider shall maintain and furnish to the participant, caregiver, or AAA a list of chemicals and substance s used for each chore performed.

3.

The provider shall comply with any applicable local codes or ordinances in the performance of each chore.

4.

The provider shall inform the participant and care giver of any specific health or safety risks expected during the job, and assist in coordinating times and dates of service to insure minimal hazardous risks to the participant.

5.

The provider shall furnish to the participant a warranty covering workmanship and materials used for pest control.

June 30, 1994, Revised May 12, 1999

308.00 – Conditions of Participation & Service Specifications Page 15 of 49 Appendix E Meal & Nutrition

A.

Taxonomy 1.

2.

3.

4.

Congregate Meal a.

Congregate meal service is designed to promote socialization and sustain and improve participants’ health through safe and nutritious meals served in a group setting.

b.

The unit of service rate is one meal prepared and delivered according to these service specifications. Up to three meals per day may be provided.

c.

The unit rate shall include all costs including administrative, in-kind, food production, packaging, and delivery.

Congregate Meal (Ineligible for USDA reimbursement) a.

A congregate meal that is ineligible for USDA reimbursement is a meal purchased at a congregate site by guests or staff who are less than sixty years of age.

b.

The unit of service rate is one meal prepared and delivered according to these specifications.

c.

The unit rate shall include all costs including administrative, in-kind, food production, packaging, and delivery.

Home-Delivered Meal (HDM) a.

HDM service is designed to sustain and improve participants’ health through safe and nutritious meals served in a home setting.

b.

The unit of service rate is one meal prepared and delivered according to these specifications. Up to three meals per day may be provided.

c.

The unit rate shall include all costs including administrative, in-kind, food production, packaging, and delivery.

Nutrition Education a.

Nutrition education service is designed to promote better health through discussion or distribution of nutrition-related information to participants or caregivers in a group setting or on an individual basis.

b.

The HDM unit of service rate shall include one lesson plan prepared and conducted according to these specifications.

c.

The congregate unit of service rate is one session prepared and conducted according to these specifications.

308.00 – Conditions of Participation & Service Specifications Page 16 of 49 Appendix E Meal & Nutrition

d.

5.

6.

B.

The unit rate shall include all costs including administrative, in-kind, supplies, travel, and record documentation time.

Nutrition Screening a.

Nutrition screening service is designed to identify participants on an individual basis or in a group setting who are at nutritional risk.

b.

The unit of service rate is one nutrition checklist or screen conducted according to these specifications.

c.

The unit rate shall include all costs including administrative, in-kind, supplies, travel, and documentation time.

Nutrition Counseling a.

Nutrition counseling service is designed to provide individualized guidance on appropriate food and nutrient intakes for participants with special needs, taking into consideration the participant’s desires, health, cultural, socioeconomic, functional, and psychological factors, including home and caregiver resources.

b.

the unit of service rate is one hour of nutrition counseling conducted according to these specifications.

c.

the unit rate shall include all costs including administrative, in-kind, supplies, travel, and record documentation time.

Meal Service Specifications 1.

Menu Specifications a.

Menu Planning (i)

The provider must ensure that each meal is nutritionally adequate based on the DRI/RDA for persons aged sixty years and older

(ii)

Each meal must meet one-third the DRI/RDA.

(iii)

The provider must ensure the nutritional adequacy of menus by utilizing the required menu pattern: computer nutrient analysis, or a combination of the above.

(iv)

The provider must implement the US dietary guidelines.

(v)

The provider must ensure that all menu types offered (e.g., regular, shelf stable, culturally-specific) meet these requirements: preapproved by a LD; include specified serving sizes for each food; and all menu substitutions retain the nutritional adequacy of the

308.00 – Conditions of Participation & Service Specifications Page 17 of 49 Appendix E

Meal & Nutrition

pre-planned menu (through pre-approval by a LD; or adherence to a menu substitution list/procedure pre-approved by a LD).

b.

c.

(vi)

The provider’s food preparer must ensure that participants have access to the ingredient contents of meals.

(vii)

The provider’s food preparer must comply with ODA Policy 503.00 food preparers food safety and quality assurances and the nutrition label education act, if applicable.

Menu Pattern and Components (i)

The menu pattern applies to all meals. However, the breakfast meal does not require vegetables, and substitution from another food group is unnecessary. Providers are encouraged to vary the selection of additional required items.

(ii)

Each meal must include the five food groups (except breakfast), and select two additional of these required items: (a)

two ounces or equivalent of meat or meat alternate;

(b)

eight ounces or equivalent of milk or milk alternative;

(c)

one serving of bread or bread alternative;

(d)

one serving of fruit; and

(e)

one serving of vegetable.

(f)

each meal must include two additional required items: one ounce of meat; one serving of bread; one serving of vegetable; one serving of dessert.

(g)

each meal must include meal accompaniments as needed (e.g., one teaspoon margarine served with bread, roll or cooked potato).

(h)

each meal must meet one-third the DRI/DRA for healthy men and women ages sixty years and older.

Food Group/Nutrient Specifications i.

Meat/Meat Alternate (a)

Seven grams of protein count as one ounce cooked meat.

308.00 – Conditions of Participation & Service Specifications Page 18 of 49 Appendix E

Meal & Nutrition

ii.

iii.

(b)

In determining nutritional adequacy, the weight of a cooked, edible portion of meat or alternate must not include the weight of breading and fillers.

(c)

At least twice weekly, meat served must be a plain entrée (e.g., pork chop, chicken, veal, and fish).

(d)

Alternates for one ounce of cooked meat include one egg; one ounce natural or processed cheese; one fourth cup cottage cheese; two tablespoons peanut butter; one half cup cooked dried beans or peas; or one and a half ounces luncheon meat.

(e)

Meat alternates must not be served at consecutive meals or on consecutive days, except emergency meals, to optimize nutrient density, particularly for iron.

(f)

Cheese served as a meat alternate cannot be counted as a milk alternate. Artificial/imitation cheese or cheese food products cannot be served as meat alternates.

Milk/Milk Alternate (a)

A serving size is one cup.

(b)

Milk alternates include one half cup evaporated milk; one cup lactose-free milk; one and a half ounces natural or processed cheese; eight ounces plain yogurt; and one cup ultrahigh temperature milk.

(c)

Low-fat milk, cheese, and yogurt are preferred.

(d)

Cheese served as a milk alternate cannot be counted as a meat alternate. Artificial/imitation cheese or cheese food products cannot be served as a milk alternates.

(e)

Ultrahigh temperature chocolate milk drink or hot cocoa mix must contain at least twenty percent of the DRI/RDA for calcium.

Bread/Bread Alternate (a)

A serving size is one slice.

(b)

Bread alternates include one small two ounce muffin; one half english muffin; two inch cube of cornbread; one half bagel; one two and a half inch diameter biscuit; one six

308.00 – Conditions of Participation & Service Specifications Page 19 of 49 Appendix E

Meal & Nutrition

inch diameter tortilla; one seven inch diameter waffle; two four inch diameter pancakes; three fourth cup ready to eat cereal; one slice french toast; one half cup cooked grits; four crackers; one half cup bread dressing or stuffing; one half cup pasta, noodles, or rice; one small sandwich bun; (one to one and a half ounces) two graham cracker squares; and one half of a large sandwich bun (one and a half ounce). (c)

iv.

v.

vi.

Breading on meat, poultry, or fish cannot be counted as a bread serving.

Fruit (a)

Serving size is one half cup or one piece of whole fresh fruit. Fresh, frozen, or canned fruit packed in juice, light syrup, or without sugar are preferred.

(b)

Molded (gelatin) salad counts as a fruit serving when modification to the recipe or serving size ensures that each serving contains at least one half cup fruit.

(c)

Desserts that contain fruit (e.g., cobblers, pie) do not contain enough fruit to count as a fruit serving.

Vegetables (a)

A serving size is one half cup.

(b)

Fresh or cooked frozen vegetables are preferred.

(c)

Potatoes count as a vegetable.

(d)

The serving size of lettuce salad with other raw vegetables is one cup.

Dessert Options (a)

The provider has the option of serving a dessert as one of the two additional required items.

(b)

Dessert examples include cake, pie, fruit cobbler or crisp, cookies, ice cream, frozen yogurt, sherbet, pudding, fruit in gelatin, brownie, and pastry/sweet breads (e.g., danish, donuts).

(c)

Preferred desserts should contain fruit and low-fat products, and be made with whole grains and low-fat milk.

308.00 – Conditions of Participation & Service Specifications Page 20 of 49 Appendix E Meal & Nutrition

vii.

d.

(d)

Food containing empty calories (e.g., plain gelatins, twocrusted pies) is discouraged.

(e)

Fruit ingredients of desserts do not count toward the fruit requirement except as noted for molded gelatins.

Additional Requirements (a)

The provider must choose two food items, in addition to the set menu pattern, to ensure the nutritional adequacy of meals. These choices will allow the provider to be more flexible within the menu cycle to better meet participants' needs and preferences (e.g., alternating casserole, hot sandwich, and meat and potato meals).

(b)

The provider must offer meal accompaniments (e.g., condiments, spreads, and garnishes) which are traditionally associated with a menu item. Examples include mustard or mayonnaise with a meat sandwich; tartar sauce with fish; and salad dressing with tossed salad. These items add variety, flavor, and eye appeal to the meals and enhance the meal’s palatability and participant satisfaction.

(c)

The provider must serve at least one-third the DRI/RDA for vitamin c in each meal.

(d)

The provider that uses the computer-analyzed menu option must supply one-third DRI/RDA in a minimum of six of these ten nutrients: protein, calcium, iron, vitamin c, vitamin a, thiamin, niacin, folic acid, zinc, and pyridoxine (vitamin b6).

Lower Concentrated Sweets/Sodium/Fat Modified Meals i.

The provider must offer menu items lower in concentrated sweets, sodium, and fat when requested. A physician's order is not required. The provider must offer at least one or more of these modifications to the regular menu: (a)

In one meal (a lower concentrated sweets/sodium/fat meal); or

(b)

In separate meals (a lower concentrated sweet meal, a lower sodium meal, and a lower fat meal); or

308.00 – Conditions of Participation & Service Specifications Page 21 of 49 Appendix E Meal & Nutrition

(c) ii.

2.

Any other combination of the above (e.g., a lower concentrated sweet meal and a lower sodium/fat meal).

The provider must offer these modifications to the regular menu for: (a)

Concentrated sweets (high sugar foods): fresh, juicepacked, or unsweetened frozen fruit, sugar-free gelatin, sugar-free pudding, angel food cake, vanilla wafers, or graham crackers for a similar dessert; sugar-free fruit drinks; and sugar-free alternates for high sugar condiments (e.g., jelly, syrup, honey);

(b)

Sodium: lower sodium entrée (e.g., baked meat patty for veal parmigiana); and

(c)

Fat: lower fat entrée (e.g., chicken without skin).

Agency Responsibilities a.

Food Sanitation and Safety i. A provider cited for critical items during the local Health Department inspection must furnish a copy of that inspection report and the follow-up report to the AAA within five working days of receipt from the inspecting agent. ii. A provider cited by the Ohio Department of Agriculture or USDA regulatory agents must furnish a copy of the findings and corresponding corrective plans within five working days of receipt from the regulatory agent to the AAA. iii.

A provider that elects to deliver food that requires rethermalization (e.g., reheating) by the provider or the participant must use foods that are commercially prepared or meet these criteria: (a)

Processing must adhere to the HACCP system;

(b)

Only freshly prepared or commercially processed foods can be used (no leftovers);

(c)

When necessary, must modify preparation techniques to ensure quality;

(d)

On-site production must be accessible to the AAA for periodic monitoring; and

(e)

Written preparation directions for both commercially prepared and self-produced meals must be included.

308.00 – Conditions of Participation & Service Specifications Page 22 of 49

. Appendix E Meal & Nutrition

b.

iv.

Food items, including donations, must be from an approved source

v.

Food items, including donations, must be from an approved source Food preparers must develop and implement a time and temperature monitoring system for food preparation, handling, and delivery.

vi.

Food preparers who do not serve meals directly to the participants must label meals with a production date.

vii.

For congregate meal sites, the provider must develop a procedure for food removed by participants at the end of the meal that: Allows the participant to remove foods that are not potentially hazardous (e.g., fruit, bread, juice, cookies, crackers);

(b)

Describes all circumstances when participants may remove other foods; and

(c)

Includes the participant instruction component for permitted food items including potentially hazardous items when removed.

Participant Choice i.

ii.

c.

(a)

The provider must adopt a participant choice plan that offers the participant the opportunity to make choices about food served using one of these methods: (a)

Allow each participant to make choices within the milk, bread, desserts (if offered), fruit and vegetable, or entrees (meat/alternative alone or combined with other foods) groups; or

(b)

Meet with or survey groups of participants to elicit ideas into the menu planning process; or

(c)

Implement an AAA-approved alternative plan.

The provider must develop an AAA-approved system that offers participants access to ingredient content of meals.

Emergency Procedures i.

The provider must develop and implement written contingency procedures for situations such as

308.00 – Conditions of Participation & Service Specifications Page 23 of 49 Appendix E Meal & Nutrition

(a)

d.

Short-term weather-related emergencies, loss of power, onsite/central kitchen malfunctions, or meal delivery delays. Procedures must include timely participant notification.

ii.

The provider must prepare participants for emergencies when the provider may not serve meals as scheduled by either instructing participants about keeping shelf stable foods available for use in emergencies, or supply participants with shelf stable meals.

iii.

The provider must begin regular meal delivery within two working days of establishing the eligibility of HDM participation, or on a date negotiated with the participant and AAA.

iv.

The provider must deliver meals to participants who need immediate meal support within twenty-four hours; or within a period negotiated with the AAA using regular, shelf stable, or frozen meals.

v.

The provider must ensure that delivery persons understand how to respond to common participant in-home emergencies (e.g., a participant is non-responsive) or meal-related concerns (e.g., a participant has not eaten previous meals).

vi.

The provider must keep a daily route log that includes, at a minimum, the participants’ names and delivery dates and times.

Congregate Meals Site Operations i.

The provider is responsible for ensuring that participants are aware of, or can easily access information about, the hours of service and menus and directions/instructions for personal safety in emergency situations (e.g., choking, fires, and tornadoes).

ii. The provider must follow a written meal reservation procedure that does not create unnecessary barriers to the participation of eligible persons. e.

Personnel Training i.

The provider must follow and document a training plan, in addition to the orientation required by cop, for all personnel (including volunteers) who participate in food preparation, handling, and delivery.

ii.

At a minimum, the training must develop skills and abilities in these areas: (a)

Participant rights and responsibilities;

308.00 – Conditions of Participation & Service Specifications Page 24 of 49 Appendix E Meal & Nutrition

f.

3.

(b)

Sensitivity to the needs of persons who are elderly or disabled;

(c)

Handling emergencies;

(d)

Food preparation, when applicable;

(e)

Special meal preparation and service (e.g., textured modified diet, therapeutic diets), when applicable;

(f)

Meal service and delivery;

(g)

Food service sanitation; and

(h)

Handling hazardous materials, when applicable.

Provider Monitoring i.

Consistent with cop, the provider must monitor all aspects of the operation and take immediate action to improve practices.

ii.

These aspects of provider operations require monitoring: (a)

Food temperatures during storage; preparation, transport, and delivery of food to the nutrition site; holding food before and during the meal service;

(b)

Food packaging and transporting systems;

(c)

Preparation, holding, and delivery practices; ensuring retention of food quality characteristics (e.g., flavor and texture);

(d)

Participant satisfaction by eliciting comments from participants about the dining environment, type of food, portion size, temperature, meal delivery, meal service schedules, and staff professionalism;

(e)

Food acceptance patterns that are to be used to adjust and modify menus; and

(f)

All applicable federal, state, and local policies, procedures, cop, and service specifications.

Agency Responsibility a.

Participant Rights And Responsibilities

308.00 – Conditions of Participation & Service Specifications Page 25 of 49 Appendix E Meal & Nutrition

i.

The provider must assure that staff is knowledgeable, and that staff inform participants about participant rights and responsibilities.

ii.

Each participant has the right to:

iii.

b.

(a)

Receive referrals (e.g., food stamps, transportation) when requested and as necessary;

(b)

Comment about needed improvements without fear of retaliation;

(c)

Receive timely information about meal site closings and delivery cancellations due to weather or other reasons;

(d)

Be treated with respect and courtesy;

(e)

Have personal information handled and recorded using methods that ensure confidentiality;

(f)

Enjoy congregate meals in an unhurried, pleasant environment;

(g)

Choose or request less food after standard menu items have been offered; and

(h)

Have access to the ingredient content of meals.

Each Participant is Responsible for: (a)

Making and canceling reservations according to site procedures; and

(b)

Informing providers of changes related to the participant’s eligibility status (e.g., improved health; increased family support).

Congregate Meals Participant Enrollment i.

Congregate meals providers must ensure that each participant is at least sixty years of age, or is the spouse of an eligible participant.

ii.

The provider must develop a prioritization system that distributes service equitably, if waiting lists exist. Applicants determined at nutritional risk are given priority for meal service. At a minimum, the applicant's risk status must be based on: (a)

The national NSI determine checklist and protocol; or

308.00 – Conditions of Participation & Service Specifications Page 26 of 49 Appendix E Meal & Nutrition

c.

(b)

A nutritional assessment such as one provided by a local health provider's LD.

(c)

The risk status of married couples must be based on the spouse with the greatest need.

HDM Participant Assessment and Enrollment i. The HDM provider must ensure that each participant meets the eligibility requirements before enrollment and, subsequently, at intervals determined to be appropriate to the participant's situation. An in-home assessment must be done within the first three months and at least once every twelve months afterwards. ii.

iii.

d.

The provider must ensure that each participant meets these criteria: (a)

Be at least sixty years of age;

(b)

Be unable to prepare their own meals;

(c)

Be unable to participate in the congregate nutrition program because of physical or emotional difficulties;

(d)

Lack other meal support service in the home or community; or

(e)

Be the spouse of an eligible participant.

The provider must establish procedures for participant waiting lists. The prioritization system must distribute service equitably according to these specifications: (a)

Applicants at nutritional risk must be given priority for meal service. At a minimum, the applicant's risk status must be based on the NSI determine checklist and protocol, or a nutritional assessment such as one provided by a local health provider's LD.

(b)

Applicants with the lowest income may receive priority (though income cannot be used as an eligibility criterion).

(c)

The risk status of married couples must be based on the spouse with the greatest need.

Contributions i.

With prior AAA approval, the provider may elect to participate in the Ohio EBT system and accept this as a contribution toward the meal.

308.00 – Conditions of Participation & Service Specifications Page 27 of 49 Appendix E Meal & Nutrition

C.

ii.

Congregate meals providers must establish a required fee for ineligible guests and staff. The required fee must cover the actual contracted unit cost of the meal for guests and staff. Required fees received are considered program income and will be used according to program income requirements.

iii.

Voluntary contributions shall be accepted.

Nutrition Service Specifications 1.

2.

3.

Nutrition Education a.

A LD must approve the annual written nutrition education plan and any materials used or distributed. The plan and materials must be tailored to the needs, interests, and abilities of participants; contain accurate and relevant information; and be written at an appropriate literacy level for the target population.

b.

The LD who approves the plan must identify the minimum credentials for the instructor for each planned session based on the content and the Ohio dietetic licensure requirements.

c.

Providers funded through Title III-C must offer nutrition education at least every six months.

d.

Providers funding through Title III -F must offer nutrition education at a frequency defined by the AAA contract.

Nutrition Screening a.

The provider must use the NSI determine checklist with participants. The checklist is designed for self-administration by the participant, and does not require professional staff to collect data.

b.

The provider who offers levels one and two screens must follow the NSI protocols for referral of participants for levels one and two screens.

c.

Level one screen must be administered by a social service or health professional.

d.

Level two screens administered separately or in conjunction with a level one screen must be administered by a health professional who meets the Ohio dietetic licensure requirements or exemptions, preferably a LD with recent clinical experience.

Nutrition Counseling

308.00 – Conditions of Participation & Service Specifications Page 28 of 49

Appendix E Meal & Nutrition

a.

The provider must either be or employ an individual qualified to provide nutrition counseling. The individual must be a RD by the commission on dietetic registration and LD by the Ohio Board of Dietetics.

b.

Nutrition counseling services must be delivered in the participant's home or other community-based setting.

c.

The provider must assess the participant's nutritional needs. This assessment must include, but is not limited to, height, weight, and weight history; adequacy of nutrient intake; medications; clinical data including diagnosis and diagnostic test results; observations of both oral and motor skills, when applicable; and caregiver and participant interactions during feeding, when applicable.

d.

The provider must develop, implement, evaluate, and revise the nutrition care plan based on the participant’s status and response. The care plan must include the nutrients required, feeding modality, method of nutritional education and counseling, and the expected, measurable outcomes. The care planning process must include the participant, caregiver, AAA, physician, and relevant service providers, when applicable.

e.

For AAA case managed participants the provider must give the AAA a copy of the report of the assessment outcome and the nutrition intervention plan within seven working days following the initial assessment.

f.

Providers must maintain readily accessible records of nutrition counseling services provided to each participant to ensure continuity of care with other health and social service professionals, including physicians, who coordinate or oversee the participant’s overall status and linkages within the community.

June 30, 1994, Revised May 12, 1999

308.00 – Conditions of Participation & Service Specifications Page 29 of 49 Appendix F Homemaker

A.

B.

C.

Purpose 1.

Homemaker (HMK) service is designed to enable participants to achieve and maintain clean, safe, and healthy environments.

2.

The HMK service component is intended for the participant and specifically excludes services for all other household members except when homemaker services are utilized for the purpose of respite for caregivers. The participant must be present during service delivery.

Unit of Service 1.

One unit of HMK service is one hour of direct service.

2.

The unit rate shall include all administrative costs, travel, and record documentation time.

3.

The number of units is determined according to the AAA and provider contract.

4.

Tasks in this service include, but are not limited to: a.

Performing house cleaning including dusting furniture; sweeping, vacuuming, and washing floors; kitchen care including washing dishes, appliances, and counters; washing inside windows within reach from the floor; removing trash;

b.

Maintaining a clean bathroom including cleaning the tub, shower, sink, toilet bowl, commode chair/urinal, mirrors, and tub or shower lining; and

c.

Planning and preparing the participant’s meals, including special diets; shopping for and purchasing groceries; running errands; and

d.

Changing bed linens; and washing, drying, folding, ironing, and putting away the participant’s laundry.

Provider Agency Requirements 1.

The provider must be able to deliver services five days a week. Evidence of a back-up service delivery plan must be provided.

2.

The provider shall maintain a participant record of each episode of service delivery that documents service tasks performed, HMK arrival and departure times, and the participant’s or caregiver’s signature upon completion of service delivery.

3.

The provider shall document that the HMK meets one or more of these training criteria prior to participant service provision:

308.00 – Conditions of Participation & Service Specifications Page 30 of 49 Appendix F Homemaker

a.

STNA or the Medicare competency evaluation program for home health aides as set forth in 42 CFR 484; or

b.

Has received provider agency training and skills testing. The subject areas listed in these specifications shall be included in training programs and in skills testing. Skills testing shall include a return demonstration of the skills. Training and testing shall be documented by the provider and shall include training site information, date and length of training, including the number of hours, instruction material and subjects, signature of the trainer, and all testing results; or

c.

One year of institutional or community-based direct service delivery in health care within the last three years. The HMK must successfully complete skills testing by return demonstration of task responsibilities in lieu of training.

4.

Immediate, independent participant services may be provided by the HMK for specific tasks on which instruction and skills testing by return demonstration have been completed.

5.

The HMK training program of twenty hours of instruction and skill testing, or skill testing for individuals described in these specifications, shall include all these subject areas: a.

House cleaning skills including dusting furniture; sweeping, vacuuming and washing floors; kitchen care, including washing dishes, appliances, and counters; bathroom care; emptying and cleaning the bedside commode; changing bed linens; washing inside windows within reach from the floor; and removing trash;

b.

Meal preparation/nutrition including special diet preparation; grocery planning and shopping; and errands for the sole purpose of picking up prescriptions;

c.

Laundry that includes folding, ironing, and putting away laundry;

d.

Basic home safety;

e.

Universal precautions for infection control including hand washing and disposal of bodily waste;

f.

Body mechanics;

g.

Communication and listening skills;

h.

Participant mobility;

308.00 – Conditions of Participation & Service Specifications Page 31 of 49 Appendix F Homemaker

D.

E.

i.

Emergency protocol; and.

j.

Documentation skills

6.

The provider shall maintain evidence of the completion of eight hours of inservice continuing education for each HMK in a twelve-month period, excluding agency and program specific orientation, initiated after the first anniversary of employment with the provider, and each year following.

7.

The HMK may not transport the participant or drive the participant’s vehicle.

Supervisory Requirements 1.

The supervisor shall complete and document a participant home visit, which may occur at the initial HMK visit to the participant, to define the expected activities of the HMK, and prepare a written activities plan.

2.

The supervisor shall evaluate the HMK’s compliance with the activity plan, and the HMK’s performance. If the AAA is providing case management services to the participant, the supervisor shall discuss recommended modifications with the AAA. The supervisor shall conduct and document a: a.

Participant visit at least every ninety-three days to evaluate the HMK’s compliance with the plan or activity checklist; and

b.

Supervisory participant visit at least every one hundred eighty-six days while the HMK is present and providing participant services.

Personnel Qualifications 1.

The HMK shall be a high school graduate, or possess a GED, or have a minimum of two years of work experience.

2.

A supervisor shall meet at least one of these qualifications: a.

Be an RN, LPN under the supervision of an RN, or LSW, currently licensed to practice in the state of Ohio; or

b.

Have a BS, BA, or AA degree in one of these areas: i.

Home economics/nutrition or dietetics;

ii.

Counseling;

iii.

Gerontology;

iv.

Social work;

308.00 – Conditions of Participation & Service Specifications Page 32 of 49 Appendix F Homemaker

c.

v.

Nursing

vi.

Public health;

vii.

Health education; or

viii.

Other related field; or

Have a minimum of four years of direct community service experience in the provision of home care services.

June 30, 1994, Revised May 12, 1999

308.00 – Conditions of Participation & Service Specifications Page 33 of 49 Appendix G

Home Modification & Maintenance

A.

Purpose Minor home modification and maintenance service is designed to enhance the participant’s independence, improve the participant’s health and safety, and upgrade accessibility of the participant’s home environment. 1.

2.

Minor home modification and maintenance services are limited to those services that: a.

Cannot be accomplished through existing informal or formal supports; and

b.

Are not the legal or contractual responsibility of a landlord or homeowner (other than the participant).

Tasks included in this service shall include, but are not limited to: a.

b.

c.

3.

Minor Home Modifications i.

Installation of safety devices such as smoke alarms, carbon monoxide detectors, or replacement of batteries;

ii

Installation of devices to improve the participant's ability to perform ADLS; and

iii.

Minor interior and exterior modifications to improve accessibility or mobility (e.g., ramps, doorways).

Minor Home Maintenance i.

Inspections of furnaces and water heaters;

ii.

Plumbing and electrical repair; and

iii.

Inspection and maintenance of water pumps.

Minor Household Repairs i.

Repair or replacement of window and door screens;

ii.

Repair or replace broken window panes; and

iii.

Replacement or installation of electrical fuses.

Home modification and maintenance service provided through Title III shall not exceed $150 per participant per program year or increase the property value.

308.00 – Conditions of Participation & Service Specifications Page 34 of 49 Appendix G Home Modification & Maintenance

4.

B.

Unit of Service 1.

2.

C.

Home modification/repair services provided through SCSBG funding shall not exceed the per participant per program year established in ODA Policy 315.00 SCSBG.

Unit of service is one job order with a unit rate of the price quoted and accepted by the AAA. The unit rate shall include the cost of materials, labor, supplies, equipment, administrative costs, and applicable fees associated with the job requested.

Provider Service Requirements 1.

The provider shall obtain the property owner’s written consent to modify the property. The provider shall ensure that the owner understands that the property will be left in the modified state if the participant vacates the premises.

2.

The provider shall secure permits required for completing each job order in compliance with federal, state, and local building codes and standards.

3.

The provider shall verify signed and dated authorization from the participant and AAA or a designated sub-recipient for the job prior to commencing the work.

4.

The provider shall furnish the AAA with a verbal estimate of service costs to be followed by a written price quote within seven days of the initial AAA request, or in an alternate time period acceptable to the AAA.

5.

The provider cannot bill the AAA in excess of the written estimate unless a written cost revision is authorized by the AAA.

6.

The provider shall inform the participant and the AAA of any health and/or safety risks expected during the job, and shall assist the participant and the AAA in coordinating times and dates of service to assure minimal hazardous risks to the participant.

7.

The provider shall furnish a full or limited warranty covering workmanship and materials with the final invoice submitted to the AAA. Invoices will not be paid unless a warranty is provided.

8.

The provider shall obtain the participant’s signature and date at the completion of the job order certifying that the work authorized has been completed, the property was left in satisfactory condition, and incidental damages have been repaired.

Date: June 30, 1994, Revised May 12, 1999

308.00 – Conditions of Participation & Service Specifications Page 35 of 49 Appendix H Personal Care

A.

Purpose PCS is designed to enable participants to achieve optimal function with ADLS and IADLS, PCS may also be used to provide respite for the participant’s caregiver. PCS must be provided in the participant’s residence.

B.

C.

Unit of Service 1.

One unit of service is equal to one hour of direct service.

2.

The unit rate shall include all administrative costs, travel, and record documentation time.

3.

Tasks in this service include, but are not limited to: a.

Reading and recording the participant’s temperature, pulse, and respiration;

b.

Performing house cleaning including dusting furniture; sweeping, vacuuming, and washing floors; kitchen care including washing dishes, appliances, and counters; washing inside windows within reach from the floor;

c.

Providing bathroom care; emptying and cleaning the bedside commode and urinary catheter bags; changing bed linens; removing trash; and washing, drying, folding, ironing, and putting away the participant’s laundry;

d.

Performing personal hygiene and grooming assistance using bed, tub, shower, and partial bath techniques; shampooing the participant’s hair in the sink, tub, or bed; providing nail and skin care; assisting the participant with oral hygiene, toileting, and eliminations; and

e.

Planning and preparing the participant’s meals, including special diets; shopping for and purchasing groceries; and running errands.

Provider Agency Requirements 1.

The provider must be able to deliver services five days a week. Evidence of a back-up service delivery plan must be provided.

2.

The provider shall maintain a participant record of each service delivery. The record will document specific tasks performed, the PCA’s signature and arrival and departure times, and the participant’s or caregiver’s signature upon completion of service delivery.

3.

The provider shall document that the PCA providing participant services meets at least one of these training criteria prior to participant service provision:

308.00 – Conditions of Participation & Service Specifications Page 36 of 49 Appendix H Personal Care

4.

a.

Successfully completed the STNA, or the Medicare competency evaluation program for home health aides established in 42 CFR 434, without a twenty four month lapse in employment; or

b.

Has received provider agency training and testing. Testing shall include written test and skills testing by return demonstration. The subject areas listed in these specifications shall be included in the training and testing programs. Training and testing shall be documented by the provider and

c.

Shall include training site information; date and length of training that includes the number of hours, instruction materials, and subject areas; signature of trainer; and all testing results; or

d.

Has one year of satisfactory institutional or community-based direct service delivery in health care within the last three years. The PCA must successfully complete written testing and skills testing by return demonstration.

The provider must maintain evidence of the completion of eight hours of in-service continuing education for each PCA in a twelve month period, excluding agency and program-specific orientation, initiated after the first anniversary of employment with the provider and each year following. The PCA training program of sixty hours of instructions and skill testing by return demonstration for PCA staff described in these specifications shall include these subject areas: a.

Communication skills including the ability to read, write, and make brief and accurate oral or written reports;

b.

Observation, reporting, and documentation of participant status and services rendered;

c.

Reading and recording temperature, pulse, and respiration;

d.

Universal precautions for infection control procedures;

e.

Basic elements of body functioning and changes in body function that should be reported to the supervisor;

f.

Maintenance of a clean, safe, and healthy environment of house cleaning and laundry that includes dusting furniture; sweeping, vacuuming, and washing floors; kitchen care including washing dishes, appliances, and counters; bathroom care; emptying and cleaning the bedside commode and urinary catheter bags; changing bed linens; washing inside windows within reach from the floor; removing trash; and folding, ironing, and putting away laundry.

g.

Recognition of emergencies, knowledge of emergency procedures, and basic home safety;

308.00 – Conditions of Participation & Service Specifications Page 37 of 49 Appendix H Personal Care

D.

E.

h.

The physical, emotional, and developmental needs of the participant, including the need for respect and privacy of the participant and their property;

i.

Appropriate and safe techniques in personal hygiene and grooming including bed, tub, shower, and partial bath techniques; shampooing in the sink, tub, or bed; nail and skin care; oral hygiene; toileting and elimination; safe transfer and ambulation; normal range of motion and positioning; and adequate nutrition and fluid intake.

j.

Meal preparation and nutrition planning that include special diet preparation, grocery purchase, planning, and shopping; and running errands for the sole purpose of picking up prescriptions.

5.

Additional training and skill testing by return demonstration is required for any other assigned tasks not included in these service specifications.

6.

The PCA is prohibited from administering medications in the home or any setting as defined in chapter 2723 of the ORC.

7.

The PCA may not transport the participant or drive the participant’s vehicle.

Supervisory Requirements 1.

Prior to participant service initiation, the supervisor shall complete and document a participant home visit, which may occur at the initial PCA visit to the participant, to define the expected activities of the PCA and prepare a written PCA activity plan. Where the AAA is providing case management services, the PCA activity plan shall be consistent with the AAA service checklist completed by the AAA and the participant.

2.

The supervisor shall evaluate the PCA’s compliance with the activity plan, the participant’s satisfaction, and the PCA’s performance. Where the AAA is providing case management services, the supervisor shall discuss recommended modifications with the AAA. The supervisor shall conduct and document a: a.

Visit to the participant at least every sixty-two days to evaluate compliance with the activity plan; and

b.

Supervisory visit to the participant at least every one hundred twenty-four days while the PCA is present and providing participant care.

Personnel Qualifications 1.

The PCA shall be a high school graduate, or have completed a GED or have a minimum of two years of work-related experience.

2.

The PCA supervisor or trainer shall be a currently licensed Ohio RN or LPN under the supervision of an RN

Date: June 30, 1994, Revised: May 12, 1999

308.00 – Conditions of Participation & Service Specifications Page 38 of 49 Appendix I Transportation

A.

Purpose Transportation service is designed to move participants to and from services, activities, and resources via a motorized vehicle.

B.

Unit of Service

C.

1.

A unit of service is a one-way trip.

2.

An AAA may contract for other units of service as long as the units are translated into one-way trips when reported to ODA.

3.

The unit rate shall include all administrative costs and training and record documentation time.

Provider Agency Requirements 1.

The provider may be an individual or agency.

2.

The provider shall document that all utilized vehicles have insurance in compliance with Ohio’s financial liability law requirements.

3.

The provider shall document that all vehicle operators and owners maintain proof of financial responsibility as required in section 4509.101 of the ORC for motor vehicles.

4.

The provider shall document that each vehicle operator has a current/valid Ohio motor vehicle operator’s license, or a license appropriate to the vehicle (i.e., commercial driver’s license).

5.

The provider shall have a written plan for regularly scheduled maintenance and safety inspection of vehicles used, and must document compliance with the plan.

6.

The provider shall document that an annual OBMV check on vehicle operators has been successfully completed.

7.

The provider shall maintain daily service logs or trip sheets that include:

8.

a.

Date of service;

b.

Participant’s name and pick up and destination points;

c.

Participant’s signature or initials or designee’s signature; and

d.

Odometer or mileage calculation signed by vehicle operator

Prior to transporting participants, the vehicle operator must complete a vehicle inspection that must include at a minimum the items listed in appendix I-E of these specifications.

308.00 – Conditions of Participation & Service Specifications Page 39 of 49 Appendix I Transportation

9.

D.

A copy of the certificate of insurance and vehicle registration shall be maintained in each vehicle.

Service Requirements The provider is responsible for assuring the safety of each vehicle used to transport participants according to these standards: 1.

2.

3.

Vehicles designed for transporting less than five individuals shall: a.

Be equipped with seat belts for each individual transported; and

b.

Have documentation that an annual safety inspection has been conducted through either the Ohio state highway patrol safety inspection unit or a certified mechanic as outlined in appendices I-A and I-B of these specifications.

Vehicles equipped for transporting participants remaining in wheelchairs shall: a.

Be equipped with permanently installed floor wheelchair restraints for each wheelchair position used;

b.

Have documentation that an annual vehicle inspection has been conducted by the Ohio state highway patrol safety inspection unit or a certified;

c.

Have a Mechanic available as outlined in appendices I-A and I-B of these specifications;

d.

Have documentation of daily inspection and testing of the wheelchair lift prior to transporting any participant that day as outlined in appendix I-b of these specifications; and

e.

Have documentation that each operator has been trained and skill-tested in the proper use of the wheelchair lift and securing mechanisms prior to transporting any wheelchair- bound participant.

Vehicles designed for transporting five or more participants/ individuals shall: a.

Be equipped with functional safety belts for each participant transported, unless state law exempts the vehicle;

b.

Be equipped with Fresno lens (any vehicle larger than fifteen passenger van);

c.

Be equipped with emergency equipment specified in appendix I-A of these specifications; and

308.00 – Conditions of Participation & Service Specifications Page 40 of 49 Appendix I Transportation

d.

E.

Training 1.

The provider must document that each vehicle operator has completed the DRIVE training or other AAA-approved passenger assistance course that meets the minimum criteria specified in appendix I-C of these specifications. The operator must have completed the training within six months prior to hire or within the first year of employment by the provider.

2.

Each vehicle operator shall complete a DRIVE refresher course or other AAAapproved passenger assistance refresher course at least every three years.

3.

Each vehicle operator shall complete one of these defensive driving programs within one year prior to hire, or within the first three months of employment:

4.

F.

Have documentation of at least an annual vehicle inspection by the Ohio state highway patrol safety inspection unit or a certified mechanic as outlined in appendix I-A of these specifications.



National safety council;



Ohio Department of Development; or



Any other AAA-approved defensive driving course.

Each vehicle operator shall complete an AAA-approved defensive driving training course at least every three years.

Personnel Qualifications The vehicle operator shall:

G.

1.

Have a current/valid Ohio motor vehicle operator’s license, or license appropriate to the vehicle (i.e., commercial driver’s license);

2.

Have at least two years of licensed driving experience;

3.

Be able to understand written or oral instructions and document services delivered; and

4.

Receive hands-on transfer technique instructions prior to transporting participants.

Coordination Of Transportation Services 1.

To the extent feasible the provider is required to participate in the design and delivery of a coordinated non-emergency transportation system with their service area.

308.00 – Conditions of Participation & Service Specifications Page 41 of 49 Appendix I Transportation

2.

To facilitate the coordination of non-emergency transportation services among multiple providers and/or funding sources; providers may apply to ODA for waivers from specific conditions of participation and transportation service specifications. a

Waiver applications must be made in writing to the AAA.

b.

The waiver application must include a plan which:

c.

i.

Identifies the specific COPS and service specifications for which the provider is applying for a waiver;

ii.

Demonstrates how the waivers will facilitate coordination within the service area;

iii.

Demonstrates how the provider will preserve the integrity of program requirements set forth in state or federal law; and

iv.

Demonstrates how the provider will ensure the health and safety of participants, clients, vehicle operators and the general public.

Upon review and recommendation of the AAA the waiver application will be submitted to ODA for final approval.

__________________________ Date: June 30, 1994, Revised May 12, 1999, August 1, 2001 (#0801S144)

308.00 – Conditions of Participation & Service Specifications Page 42 of 49 Appendix I-A Transportation

Required Annual Inspection Elements for Vehicles Equipped to Concurrently Transport Five or More Participants, Including the Wheelchair-Bound A.

B.

C.

Seating 1.

All seats must be securely fastened to the floor.

2.

No broken tubing or protruding pieces of metal should be around seats.

Defrosters & Heaters 1.

Must operate as designed.

2.

Heater cores must be clean and free of leaks and obstructions to the flow of air.

3.

Hoses must not have cracks or leaks and must otherwise be in good condition.

4.

Fan guards must be metal or plastic.

Windshield Wipers/Washers 1.

Must operate as designed.

2.

Wiper blades in the vehicle operator’s field of vision must be clean.

3.

Wiper blades must not be brittle or badly worn.

D.

The Floor Must Be Metal and Intact Without Holes

E.

Mirrors

F.

1.

Must have at least one rear view interior mirror that is properly secured and in proper placement.

2.

Must have at least one mirror on each side of the vehicle that is properly secured and in proper placement.

3.

Prismatic lens must be properly installed.

4.

All mirrors must enable vehicle operators to see a clean image (i.e., without cloudiness, cracks, or other obstacles on the mirror to interfere with reflection).

Emergency Equipment 1.

Three red reflectors must be stored in the vehicle.

2.

The vehicle must have a five pound dry chemical fire extinguisher with the minimum rating outlined in section 20.b.c. of the Ohio fire code and based on

308.00 – Conditions of Participation & Service Specifications Page 43 of 49 Appendix I-A Transportation

section 10 of the National Fire Protection Association. The fire extinguishers must be securely mounted near the vehicle operator for easy access. 3. G.

H.

I.

The vehicle must be equipped with a first aid kit.

Brakes 1.

Properly located and free of crimps, rust, breaks in integrity, and not in contact with inappropriate vehicle components.

2.

Tail exhaust pipes are properly secured to prevent dropping on brake lines.

3.

Vehicles using vacuum-assisted brakes: wheel cylinders, master cylinders, hydrovac, and hose connections must be free of fluid leaks.

4

Vehicles using air brakes: reservoirs, chambers, valves, connections, and lines must be free of air leaks.

5.

During inspections, brake pads must be checked against the vehicle manufacturer’s specifications.

6.

All moisture ejection valves must be free of leaks and in proper working order.

Emergency Brake 1.

The vehicle must have a functional emergency brake that is capable of stopping or holding the vehicle in an emergency or while parked. The emergency brake shall hold the vehicle on any grade and under all conditions of loading on a surface free of snow, ice, or loose material.

2.

If the emergency brake is located on the drive shaft, the brakes shall: a.

Hold the vehicle in parked position;

b.

Be properly mounted; and

c.

Have cables that are properly lubricated and not hazardously worn.

Steering Gear 1.

The steering shaft must have no more than one half-inch upward motion when the steering wheel is pulled upwards.

2.

The steering gear assembly, power steering unit, brackets, and mounting bolts must be securely fastened.

3.

If installed, power steering must be operative, properly mounted, and have correct fluid levels and belt tensions.

308.00 – Conditions of Participation & Service Specifications Page 44 of 49 Appendix I-A Transportation

4.

Tie rod ends must function properly.

5.

Tires must not rub any chassis or body component in any position.

J.

The Horn Must Operate As Designed

K.

Windshield/Windows

L.

1.

Window glass must be free of chips or cracks and be securely mounted without exposed edges.

2.

Plexiglas may not be used to replace safety glass.

Emergency Door (Applicable To Bus-Type Vehicles) 1.

The door must be able to open to its maximum width without catching or binding.

2.

All handles must be permanently installed.

3.

Operating instructions for the emergency door must be lettered or decaled inside the emergency door.

4.

The safety buzzer must operate as designed, and be placed in the vehicle operator’s area to warn passengers that the emergency door is opened.

5.

The door must be free of temporary or permanent obstructions.

6.

No padlocks or other added security devises are to be used to secure the door while the vehicle is in motion.

M.

Springs/Shocks Must Be Intact and Properly Mounted

N.

Tires 1.

Must have no less than two sixteenth inch tread pattern measured anywhere on the tire.

2.

Retread tires should not be located on the steering axle.

3.

Must be free of irregular wear, cuts, bruises, and breaks.

4.

Must be balanced and in proper alignment.

5.

All lugs must be present and fitted tightly on tires.

6.

All tread types must match mated tires.

308.00 – Conditions of Participation & Service Specifications Page 45 of 49 Appendix I-A Transportation

O.

Exhaust System 1.

Must be intact and operating as designed.

2.

All pipe and muffler joints must be properly welded or clamped.

3.

Exhaust manifolds must be free of cracks and missing bolts.

P.

Lights must operate as designed and meet ORC and OAC requirements for vehicle lighting.

Q.

The vehicle body condition must be intact and free of broken parts that can cause injury.

R.

Gas Tank Must

S.

1.

Be free of rust/damage and/or leaks.

2.

Be securely mounted.

The seating area and aisle must be free of debris.

________________________ Date: June 30, 1994, Revised May 12, 1999, August 1, 2001 (#0801S144)

308.00 – Conditions of Participation & Service Specifications Page 46 of 49 Appendix I-B Transportation

Required Daily Wheelchair Lift Inspection Elements For each day services are provided, providers must complete and document an inspection of the wheelchair lift prior to any participant service that day according to these specifications: 1.

Run the lift through one complete cycle to be sure that it is operable.

2.

Check for any signs of seal leaking or binding of hardware.

3.

Check for frayed or damaged lift cables, hydraulic hoses, or chains.

4.

Check for physical damage and jerky operation.

5.

Check for hazardous protrusions and exposed edges. Assure that all protrusions are adequately padded and protected.

6.

Check all fasteners and assure that all bolts are snug.

7.

Make sure the lift is properly secured to the vehicle when stored.

8.

Clean the lift completely of dirt, mud, gravel, and corrosive elements such as salt.

9.

Lubricate the lift in compliance with the manufacturer’s requirements.

10.

Providers shall not use the lift any time repairs are necessary.

Date: June 30, 1994, Revised May 12, 1999, August 1, 2001(#0801S144)

308.00 – Conditions of Participation & Service Specifications Page 47 of 49 Appendix I-C Transportation

Required Passenger Assistance Course Elements The DRIVE curriculum includes the following elements. At a minimum, an approved passenger assistance course must include these elements: 1.

Completion of an ODA or AAA-approved aging sensitivity course within six months of employment.

2.

Basic characteristics of major disabling conditions that detail functional disabilities affecting ambulation and transportation including musculoskeletal, neurological, sensory impairment, cardiovascular conditions

3.

Basic considerations in transporting older persons:

a.

An overview of diseases which commonly affect older adults, such as dementia, Parkinson’s disease and diabetes.

b.

Attitudes of vehicle operators and passengers and an understanding of sensory loss and of techniques to assist passengers with sensory loss. Functional factors such as spasticity, loss of skin sensation and balance, pain, and breathing; and

c.

d.

Common assistive devices such as crutches, canes, walkers, wheelchairs, braces, prostheses, slings, and guide/support dogs.

4.

A hands-on practicum should include these special assistance considerations: a.

Observation for signs of difficulty;

b.

Proper way to offer to assist participant;

c.

Proper assistance techniques; and

d.

Management of wheelchairs.

5.

Environmental considerations affecting passengers.

6.

Operating assistive equipment.

7.

Emergency procedures.

8.

Inspection techniques for assistive equipment and procedures for inspecting wheelchair lifts.

Date: June 30, 1994, Revised May 12, 1999, August 1, 2001(#0801S144)

308.00 – Conditions of Participation & Service Specifications Page 48 of 49 Appendix I-D Transportation

Minimum Health Requirements for Vehicle Operators

1.

2.

The vehicle operator must have a signed statement from a licensed physician declaring that the vehicle operator: a.

Does not have any physical or mental limitations likely to interfere with safe driving, passenger assistance, or emergency activities;

b.

Has vision in both eyes, ordinary depth perception, and visual acuity of twenty/thirty in both eyes together with or without correction;

c.

Has adequate hearing to assure safe response to horns, emergency vehicle sirens, and train signals; and

d.

Is not impaired by the use of alcohol, narcotics, or habit-forming drugs.

The signed physician statement must be updated at least every two years.

Date: June 30, 1994, Revised May 12, 1999, August 1, 2001(#0801S144)

308.00 – Conditions of Participation & Service Specifications Page 49 of 49 Appendix I-E Transportation

Required Vehicle Safety Checklist Elements Vehicle Id:

Odometer:

Date:

Indicate Inspection by Placing Checkmarks () in Boxes. Interior: Daily  Clean Appearance  Engine Oil  Seats (Tears, Loose Armrests, Etc.)  Seat Belts  Wheelchair Restraint  Wheelchair Lift Ramp (Good Operating Condition and Secure)  Cargo Barriers (Secure and In Place)  Floor Coverings

Fluids: Monthly

Lights: Weekly  Headlights: High, Low Beams  Tail Lights, Marker Lights  Brake Lights  Turn Signals (Front and Rear)  Backup Lights  4-Way Hazard (Front and Back)  License Plate Light  Interior Lights

Belts & Hoses: Monthly  Fan  Alternator  Heater Hose  Radiator  No Leaks under Vehicle

Exterior: Weekly  No Body Damages  Clean Appearance  Mirrors (Adjusted and Clean)  Windows (Clean)  Doors (Operable In/Outside)  Door Locks (Operable)  Windows (Clean) Electrical/Mechanical: Weekly  Horn  Windshield Wipers Washer  Heater  Air Conditioning  Defroster Optional (winter):  Gauges (Oil, Fuel, Temperature,  Brake, Etc.)  Emergency Brake  Foot Brake

 Brake Fluid  Engine Coolant  Power Steering*  Automatic Transmission*  Fuel  Windshield Washer  Battery

Tires: Monthly  Inflation  Wear  Sidewall or Tread  Damage  Spare Emergency Equipment: Monthly  Fire Extinguisher  First Aid Kit  Three Flares, Fuses, Or  Reflectorized Triangles  Emergency Jack Tire Tools

Monthly  Small Shovel and/or  Non-Corrosive Traction  Material (Sand/Cat Litter)

*Must Be Checked At Operating Temperature

Date: June 30, 1994, Revised May 12, 1999, August 1, 2001(#0801S144)

Ohio Department of Aging

309.00 - Vacant Page 1 of`1

Policy Formerly– Assistance for Independent Living (AIL) Rescinded January 29, 1998

Ohio Department of Aging

310.00 – Vacant Page 1 of`1

Policy Formerly– State Subsidy: Shared Living Rescinded January 29, 1998

Ohio Department of Aging

311.00 – Home Energy Assistance Program (HEAP) Outreach Page 1 of 2

Policy The Ohio Department of Aging (ODA) shall administer, through the Area Agencies on Aging (AAAs), an outreach program to provide information and assistance to Ohio elders and people with disabilities regarding the Home Energy Assistance Program (HEAP) and other energy assistance programs, e.g. Percentage of Income Plan (PIPP) and the Home Weatherization Assistance Program (HWAP), administered by the Ohio Department of Development (ODOD). The outreach effort is supported through a grant of federal funds made to ODA by ODOD. Procedure A – Programmatic Description 1. HEAP is designed to help low-income (at or below 150% of the federal poverty guidelines) Ohioans meet winter home heating costs. 2. HEAP funds pay a portion of the winter heating expenses by means of a credit on the heating utility bill or, a voucher for customers of rural cooperatives, municipal utilities, and users of bulk fuel (such as wood, heating oil and propane). Procedure B - Programmatic Requirement 1. ODA shall contract with AAAs for the performance of local outreach and assistance to elders and people with disabilities to ensure access to energy assistance programs administered by ODOD for which they may be eligible. 2. AAAs shall award funds to local service providers for outreach activities. AAAs may request a variance to provide HEAP Outreach directly. 3. Variance request shall be in writing. Requests shall include the rationale, and a plan for assuring that direct provision of HEAP Outreach will achieve performance results expected on required HEAP Outreach activities identified in the Notice of Funding Availability (NoFA). Procedure C – Application Process AAAs shall submit proposals responsive to the instructions in the Request for Proposals (RFPs) issued by ODA each August. Procedure D – Allocation Process 1. Funds shall be allocated through the RFP process. Approved allocations shall be reflected through Notification of Grant Awards (NGAs) sent to AAAs. 2. ODA shall allocate the funds based upon its established formula.

311.00 – Home Energy Assistance Program (HEAP) Outreach Page 2 of 2

Procedure E – Budgeting Use of funds is subject to the requirements and restrictions of ODOD, and shall be reflected by the allowable budgetary categories included in the ODA-issued RFP. Procedure F – Cash Distribution 1. Distribution of funds is by reimbursement and generated by reporting expenses on the Project Financial Report. 2. ODA shall not advance funds to AAAs and AAAs shall not advance funds to local providers beyond the first month of the new grant. Procedure G – Program Evaluation Each AAA grantee is required to submit monthly and final program reports using the forms and instructions contained in the NOFA. The final program report shall include: 1. A narrative summarizing the activities reported in relationship to the activities planned and stated in the HEAP Outreach proposal; and 2. A program activity report totaling the activities conducted during the program year for each reporting category. Procedure H – Fiscal Reporting 1. The AAA shall report all expenses on the Project Financial Report due on the twelfth (12th) working day of the month. 2. Capital expenditures are not allowable costs under this grant. 3. Carryover is not allowed under this grant. 4. The final Project Financial Report shall reflect final expenditures. If there is an overpayment of funds, the AAA shall remit a check payable to ODA to the attention of the ODA Fiscal Management Unit with the final Project Financial Report.

____________________________________ Date: January 21, 1999, July 7, 2004 (#0704P102) Authority Basis: Community Opportunities, Accountability, and Training and Educational Services Act of 1998, Title III, Sections 301-309

Ohio Department of Aging

312.00 – Senior Volunteer State Subsidy Page 1 of 3

Policy In accordance with H.B. 238, the Ohio Department of Aging (ODA) shall administer, through its twelve Area Agencies on Aging (AAAs), the Senior Volunteer State Subsidy funds. Then the AAAs shall transfer the State Subsidy funds to the following three federal programs of the Corporation for National and Community Service (CNCS): Retired Senior Volunteer Program (RSVP), Foster Grandparent Program (FGP), and the Senior Companion Program (SCP), in order to enhance and expand these programs. ODMR/DD Foster Grandparent programs shall not receive funds under this subsidy. Procedure A – Programmatic Descriptions 1.

RSVP is open to people 55 years or older. Volunteer assignments assist young and old in a variety of settings that range from hospitals, to schools, to senior centers. Sponsoring agencies are selected by CNCS to house each RSVP project (service provider) in the state.

2.

FGP provides volunteer opportunities for low-income persons, 55 years or older, to give supportive person-to-person service in health, education, welfare or related settings to help alleviate the physical, mental or emotional problems of children having special or exceptional needs. Sponsoring agencies are selected by CNCS to house each FGP project (service provider) in the state. Volunteers receive stipends.

3.

SCP provides volunteer opportunities for low-income persons, 55 years or older, to give assistance and companionship to adults in need of in-home services to help them maintain independent living. Some volunteers serve institutionalized persons on a limited basis. Sponsoring agencies are selected by CNCS to house each SCP project (service provider) in the state. Volunteers receive stipends.

Procedure B - Programmatic Requirements 1.

In accordance with CNCS guidelines: a.

RSVP volunteers must be 55 years and older.

b.

SCP and FGP volunteers must be 55 years or older, low income, and be able to pass an annual physical examination to be given at the program's expense.

Procedure C – Allocation Formula 1.

ODA shall determine the formula for allocation of funds in the Senior Volunteer State Subsidy.

2.

ODA shall allocate funds to the three Senior Corps programs of CNCS (service categories) according to the following formula:

312.00 – Senior Volunteer State Subsidy Page 2 of 3

3.

a.

RSVP shall receive 50% of the total allocation; FGP shall receive 25% of the total allocation; and SCP shall receive 25% of the total allocation.

b.

Within each of the three CNCS programs, funds shall then be divided equally among the CNCS designated projects.

c.

If an existing sponsoring agency is designated by CNCS as sponsor of an additional project, then that sponsoring agency shall also be allocated the additional project's Senior Volunteer State Subsidy funds.

ODA shall determine and notify the AAAs of the exact funding allocation available to each of the projects.

Procedure D – Budgeting 1.

Upon approval of the state biennial budget, AAAs will be notified of the funding level of each individual Senior Corps project.

2.

Funds shall be indicated on the appropriate AAA Area Plan exhibits.

3.

Funds under this subsidy shall pay for volunteer support and/or volunteer expenses.

4.

Funds under this subsidy may not be used to pay for indirect costs of the sponsoring agency.

5.

Funds under this subsidy may not be used to pay for ODA or AAA administrative costs.

Procedure E – Cash Distribution AAAs shall submit to ODA’s, Fiscal Division one consolidated "Request for Funds" form no later than 20 calendar days following the end of each quarter. This "Request for Funds" form will include a total request for each program (RSVP, FGP, SCP) and a grand total for all projects. Procedure F – AAA Reporting Requirements 1.

AAAs shall develop forms to be used for project proposals and for reporting programmatic/fiscal activities to the AAA.

2.

AAAs shall submit Contract Summary Report records (E2As) for each project (service provider) and each program (service category, e.g. RSVP, FGP, SCP) via the OASIS/SAMS Quarterly Report System, within 60 days of Notice of Funding Availability, or with submission of the October quarterly OASIS/SAMS reports, whichever comes first.

3.

AAAs shall submit programmatic and fiscal data for each project (service provider) and each program (service category, e.g. RSVP, FGP, SCP) via the SAMS Quarterly Report system, (see ODA Policy 210.00, Quarterly Program Reports).

312.00 – Senior Volunteer State Subsidy Page 3 of 3

a.

For the purpose of OASIS/SAMS reporting, the "client" is one volunteer and a unit represents one hour of volunteer service.

Procedure G – Property Management Property Management shall be in accordance with 45CFR, Part 74 and specific CNCS regulations. Procedure H – Monitoring Process 1.

AAAs’ sole responsibility will be to act as a pass through for state funds from ODA.

2.

Actual on-site monitoring of the individual projects shall be performed by the CNCS State office staff. a.

Copies of CNCS monitoring reports shall be available to AAA staff upon request.

Date: July 7, 2004 (#0704P102) Authority Basis: 45 CFR Part 2551-3; HB 94 (Biennium Budget Bill – Temporary Statutory Language)

Ohio Department of Aging

313.00 – Federal Reversionary Interest in MPSC Page 1 of 3

Policy The Area Agency on Aging (AAA) shall implement a policy for protecting the federal government's reversionary interest in facilities which have utilized Title III funds of the Older Americans Act (OAA) for the purposes of acquisition, construction, alteration, or renovation of multipurpose senior centers (MPSCs). There will remain a federal reversionary interest for 10 years if Federal funds were used to acquire, alter or renovate the facility or 20 years if federal monies were used to construct the center. Additionally, each AAA will: 1.

Will maintain and submit to the Ohio Department of Aging (ODA) an inventory of such funds and facilities, and

2.

Notify ODA of awards of Title III funds made for the purposes of acquiring or construction senior centers and provide information required for the inventory of MPSCs.

Procedure A – Applications 1.

Each AAA will notify ODA through the Area Plan process of its intent to award/fund Title III funds for construction, renovation, alteration or the acquisition of a MPSC facility.

Procedure B – Record of Inventory of Senior Centers 1.

The AAA must have provided to ODA the following information: a.

date and amount of the award, and what proportion the award is of the entire project;

b.

the nature of the award: acquisition, construction, renovation, alteration;

c.

the name and address of the grantee;

d.

the name and address of the senior center, if different from the grantee.

Procedure C – Recipient Of Award Responsibilities 1.

Recipients of federal funds must immediately file the following Notice of Record with the appropriate unit of local government, i.e. Recorder's Office, upon purchase or completion of construction of the facility: "This is to serve as notice to all potential sellers, purchasers, transferors and recipients of a transfer of the real property described below as to the Federal Government's reversionary interests as set forth in Section 312 of the Older

313.00 – FEDERAL REVERSIONARY INTEREST IN MPSC Page 2 of 3

Americans Act of 1965 as amended, 42 U.S.C. 3030B, which have arisen as a result of (grantee's name) receipt and use of Department of Health and Human Services; grant funds in connection with the purchase or construction of said property. The property to which this notice is applicable is (address) and identified as Parcel (insert appropriate name of local unit of government's recording agency). Said real property is also described as: (insert description provided in survey). Further information as to the Federal Government's interests referred to above can be obtained from: (name and address of Area Agency on Aging)." 2.

After the Notice has been recorded, the grantee must provide the Director of the AAA with a copy.

Procedure D – Reports 1.

Each AAA will submit a report (form to be provided by ODA) regarding the status of MPSC's ownership and use.

2.

This report shall be submitted annually with the final Title III program reports.

3.

The AAA will promptly notify ODA in writing of any change in status or any other action which could affect the Federal reversionary interest in MPSCS. a.

Upon receipt of this notification, ODA will forward instructions to the AAA on procedures regarding the recapturement of funds.

Procedure E – Monitoring 1.

The AAA shall monitor MPSCs constructed or acquired with previously allocated Title III funds to protect any federal reversionary interest invested.

2.

The AAA will conduct an annual program evaluation to assure proper utilization of the centers for the prescribe term list below. (Use Staff Review Documents for Senior Facilities - 1084).

3.

The required period for monitoring these centers is:

4.

a.

acquisition, renovation, alteration:10 years

b.

new construction: 20 years

The AAA must ensure every project that has received Title III funds for capital improvement, acquisition or construction has filed an ODA Non-Alienation Agreement against the facility's property title (Deed) which would require a notification to the AAA upon transfer or sale of the property. a.

Upon such notification, the AAA will apprise ODA of such and will either: i.

state the terms of repayment by the applicant and pursue such; or

313.00 – FEDERAL REVERSIONARY INTEREST IN MPSC Page 3 of 3

ii.

request a waiver of repayment of funds from ODA.

Procedure F – Recovery of Funds 1.

The AAA shall pursue recovery of Title III funds from the applicant or owner of the facility recipient of federal funds if circumstances exist as outlined in Section 312, Part A of the Older Americans Act. a.

2.

The AAA may petition ODA for a waiver of the repayment of funds. a.

b.

3.

The amount of recovery shall be computed by applying the percent of federal participation in the cost of the original project to the current fair market value of the property.

This petition will be made in writing and include: i.

a historical background of the senior center;

ii.

a description of the nature of the circumstances that led to the request for a waiver;

iii.

itemize total OAA funds awarded to the recipient;

iv.

an estimate of the total Federal share of the center's value when it ceased to be used for program purposed; and

v.

the date at which circumstances made a waiver advisable.

Appropriate documentation which supports the request for a waiver should be submitted with the AAA's petition.

If a center files for bankruptcy or is placed up for auction, the AAA must file a lien against the property unless a waiver has been granted. The amount of the lien shall be based upon the percent of federal participation in the cost of the original project to the current fair market value of the property.

Ohio Department of Aging

314.00 – Vacant Page 1 of`1

Ohio Department of Aging

315.00 – Senior Community Services Page 1 of 2

Policy Senior Community Services (SCS) funds will be awarded by the Ohio Department of Aging (ODA) to each Area Agency on Aging (AAA) on an annual basis. The purpose of these funds is to provide a range of community-based services that assist Ohioans sixty years of age and older to remain independent in their own homes and communities. Priority shall be given to specific client groups in accordance with Policy 204.02 – Service Priority to Specific Client Groups. Procedure A – AAA Administration Funds for administration of the AAA shall be allocated in accordance with ODA Policy 109.01 – Area Agency on Aging Administrative Allocation. Procedure B – Service Requirements 1.

Allowable services that may be funded with SCS funds include: a.

Housing: i.

Home repairs (Not to exceed in 2004 the average of $1,800 per client each program year effective with the beginning of each AAA’s next program year). a.

ii.

For subsequent years, this figure is adjusted by applying an inflation rate that is determined by the Consumer Price Index (CPI).

Counseling, information and assistance, rental housing database, community coordination, and planning. AAAs may facilitate these services through the use of a Housing Coordinator at the AAA.

b.

Transportation: Transportation designed to move clients to and from services (including the purchase of vehicles), activities, and resources via a motorized vehicle;

c.

Nutrition Services: i.

Home Delivered Meals – One or more meals per day provided to homebound individuals (including purchase of vehicles and equipment used to transport meals.

ii.

Congregate Meals – One or more meals per day provided to individuals in a congregate setting (e.g., senior center)

iii.

Supplemental Nutrition Services and Activities – Services and activities that promote and improve nutritional health of older adults, including but not limited to, Senior Farmers’ Market

315.00 – Senior Community Services Page 2 of 2

Nutrition Program, Nutrition Education, Nutrition Counseling, and Food Pantry activities. Each activity or service must be included in ODA service standards or approved in AAA Area Plan. d.

Personal Care: Basic health maintenance, including respite, or personal hygiene assistance;

e.

Homemaker: House cleaning, laundry, essential shopping, including respite, errands and meal preparation;

f.

Adult Day Services: A safe supervised group environment provided to individuals with moderate physical or mental disabilities, and including respite.

g.

Decision Support Systems: Software, hardware, or services used to enhance the aging network’s information gathering, reporting, and analysis capabilities. The activity or service must be included in ODA service standard and approved in AAA Area Plan.

2.

AAAs that wish to fund other services with SCS funds must obtain approval from ODA. If the request is to provide a service not already included in ODA’s taxonomy, the AAA must apply for a variance from ODA taxonomy in accordance with ODA POLICY 207.00 VARIANCE FROM ODA TAXONOMY.

3.

SCS funds may be used to pay for Care Coordination Program’s (uniform system of client assessment program for Title III and SCS funds) case management staffing costs at the AAA.

4.

AAAs shall use existing ODA service standards (Policy 308.00) where applicable for services funded under the Senior Community Services.

Procedure C – Programmatic Reporting Requirement AAAs shall report services funded by the SCS through the ODA reporting system.

Date: August 1, 2001 (#0801S144); July 7, 2004 (#0704P102) Authority Basis: ORC 173; HB 94 (Biennium Budget Bill-Temporary Statutory Language)

r

Ohio Department of Aging

315.01 – Care Coordination Program Page 1 of 3

Policy The Area Agencies on Aging (AAA) may offer the Care Coordination Program (CCP) as part of a consumer-centered, coordinated, comprehensive network of community-based services. The Program shall offer choices to the older adult and their caregiver, when applicable, to age in place safely and shall support them as their needs change. The purpose of the CCP is to facilitate access and utilization of home- and community-based services for persons with diverse incomes and needs. The population served shall be older persons and may include caregivers of eligible care recipients. AAAs that offer the program may employ innovative case management techniques to coordinate a wide range of traditional and/or brokered services, including those not defined in ODA taxonomy. Brokered services are those funded with dollars over which the case manager has no authority or control. Procedure A – Required Program Components Care Coordination Programs are defined as having a minimum of the following four components: 1.

Screening;

2.

Assessment and reassessment;

3.

Care planning; and

4.

Ongoing contact between the case manager and the consumer.

Procedure B – Program Plan and Budget AAA’s that offer this program shall develop a plan for its delivery and evaluation. This plan shall be submitted and/or updated as part of the annual area plan process. The plan shall include: 1. 2. 3. 4. 5. 6. 7. 8. 9.

Consumer eligibility requirements Assessment instrument Matrix of funded and commonly brokered services Linkages between CCP and other programs Methods/delivery of case management services Service cost caps, if applicable Anticipated number of consumers by funding source to be served A budget by funding source identifying administrative, case management and service costs Evaluation component in addition to quality assurance activities

315.01 – Care Coordination Program Page 2 of 3

Procedure C – Consumer Eligibility The AAA shall establish eligibility criteria for consumers based on the funding source requirements, which may include, but are not limited to, age, physical or mental disability, or caregiver status. Consumers must need ongoing or episodic case management for coordination of services delivered by service providers and/or informal caregivers. The AAA shall provide consumers with information about each of the programs for which they are eligible. This shall include, but not be limited to, services and/or benefits available, care plan cost caps and estimated date of initiation of services. AAAs shall allow consumers to choose the program in which they will be enrolled. Consumers’ participation in CCP will not be terminated due to changes in income or functional status unless the consumer chooses to enroll in PASSPORT. AAAs may develop and use a prioritization system that identifies consumers at most risk. These consumers may receive services before others who had requested services on an earlier date. Procedure D – Funding Of Services 1.

The AAA shall maintain records to ensure that the funding sources for services arranged through CCP are identified with the exception of brokered services.

2.

The AAA shall fund and/or broker services.

3.

Case management shall be a direct service, i.e., funded as a service from the CCP budget.

4.

Cost share requirements do not apply to case management.

Procedure E – Scope of Services 1.

The AAA shall determine which services and/or brokered services will be offered in the CCP. Services may include activities not described in the ODA taxonomy.

2.

The AAA shall request a variance for any service, except for brokered services, not currently in the ODA taxonomy, as outlined in ODA Policy 207.00 Request for Variance from Prescribed ODA Service Taxonomy.

3.

The AAA shall assure that care coordinated services that are part of the current ODA taxonomy are delivered in compliance with Conditions of Participation and current service specifications in ODA Policy 308.0.

Procedure F – Case Management 1.

The AAA shall provide case management services directly and/or through contract with an external agency. These services shall include advocacy and may include brokering of services.

315.01 – Care Coordination Program Page 3 of 3

2.

The AAA shall establish guidelines for the frequency, duration, and method of AAA staff level of involvement. Flexible patterns of case management are encouraged such as: a.

basing contact patterns on consumer’s needs/strengths;

b.

conducting case management by telephone.

3.

An agency that contracts to provide case management with a AAA shall not provide a second service to CCP consumers to avoid causing a conflict of interest unless the AAA has a waiver to do so.

4.

The AAA shall monitor contracted case management services as part of the quality assurance program in accordance with ODA Policy 211.

Procedure G – Assessment and Care Plan 1.

The AAA shall develop written procedures that ensure that the assessment process will: a.

Collect the data needed to determine eligibility and service need; and

b.

Facilitate ease of access for consumers residing in the community and/or being transferred from another program or type of care setting.

2.

The AAA shall develop written procedures that ensure the consumer or his/her designated representative’s active involvement with the development and implementation of the care plan.

3.

The AAA shall develop written procedures that ensure the consumer or his/her designated representative’s understanding of his/her rights and responsibilities to voice concerns to the AAA and the designated Regional Long-term Care Ombudsman Program.

Procedure H – Program Oversight By ODA AAAs shall be reviewed to ensure practices are consistent with ODA policies. This shall include minimally an annual review of the AAA’s CCP plan; periodic review of service delivery and funds utilization data; and onsite monitoring including review of consumer records.

Date: June 10, 1998; September 5, 2002; October 1, 2002; November 14, 2003(1103S179)

Authority Basis: Am Sub HB 215

Ohio Department of Aging

316.00 – Alzheimer’s Respite Page 1 of 3

Policy Alzheimer Respite funds will be awarded by the Ohio Department of Aging (ODA) to each Area Agency on Aging (AAA) on an annual basis. The purpose of these funds is to provide services that assist family caregivers of people of any age with Alzheimer’s disease or related dementia. Procedure A – Allocation of Funds 1.

ODA will allocate Alzheimer’s Respite funds to AAAs based on the Title III allocation formula set forth in Policy109.00. An amount of each allocation will be designated in the Notice of Grant Award (NGA) solely for the use by Alzheimer’s Association Chapters for core services.

2.

Alzheimer’s Association core services funds will be distributed to the Alzheimer’s Association Chapter covering each county via each AAA’s approved Title III funding formula utilizing a grant process. Policy 407.00 AREA AGENCIES ON AGING GRANTS AND CONTRACTS does not apply for funding of core services.

3.

AAAs may retain up to 10% of the Alzheimer Respite funds, exclusive of the amount set aside in Procedure A.1, for administration of the Alzheimer Respite program.

Procedure B – Service Requirements 1.

Alzheimer’s Association core services: In recognition of the strength of the Alzheimer’s Association national network that people turn to for information and help when caring for victims of Alzheimer’s disease and related disorders, the core services are defined as the activities listed below. It is not required to provide all of the following activities through the grant. a.

Telephone Helpline: a toll-free phone number and local information and support service for families, professionals and the general public. The single statewide phone number will automatically connect the caller to the Alzheimer Association chapter responsible for the area from where the call is made.

b.

Support Groups: ongoing groups of family members who share information and provide support to one another.

c.

Family Education: educational programs for family members caring for people with Alzheimer’s disease.

d.

Public Education: educational programs and materials geared toward the general public.

316.00 – Alzheimer’s Respite Page 2 of 3

2.

e.

Professional Education: educational programs for professionals and paraprofessionals working with people with Alzheimer’s disease.

f.

Newsletters

g.

Safe Return: a national program that helps return people home safely if they wander away and become lost.

Other allowable services are as follows: a.

Personal Care: Respite using service as defined in Policy 308.00 Appendix H;

b.

Homemaker: Respite using service as defined in Policy 308.00 Appendix F;

c.

Adult Day Care: Respite using service as defined in Policy 308.00 Appendix C;

d.

Visiting: Temporary in-home respite other than Personal Care or Homemaker;

e.

Alzheimer Education: Caregiver training, support groups and family care planning meetings;

f.

Institutional Care: Respite for 24 hours or more in a hospital or other institutional setting; and

g.

Alzheimer Association Core Services as defined in Procedure B.1.

3.

AAAs may request a variance from allowable Alzheimer’s Respite services in accordance with ODA Policy 207.00 REQUEST FOR VARIANCE FROM PRESCRIBED ODA SERVICE TAXONOMY.

4.

AAAs may not use Alzheimer Respite dollars as match for Title III B, C, D, & F funds of the federal Older Americans Act.

5.

AAAs shall use existing ODA service standards as set forth in Policy 308.00, where applicable, for services funded under Alzheimer Respite Procedure B.2.

6.

The cost sharing required by rule 173-2-02 of the Ohio Administrative Code is not mandatory for any Alzheimer Respite services, but AAAs may elect to implement cost sharing for services funded under Procedure B.2.

316.00 – Alzheimer’s Respite Page 3 of 3

Procedure C - Programmatic Reporting Requirement 1.

AAAs shall develop a process to quantify the Alzheimer’s Association Core Services funded by Procedure B.1.

2.

AAAs shall report services funded by Procedure B.2 through the MIS OASIS reporting system.

Date: July 1, 1999 (#799-NP170); August 1, 2001 (0801S144) Authority Basis: House Bill 94 (Biennium Budget)

Ohio Department of Aging

317.00 – Disaster/Emergency Preparedness, Response and Recovery Page 1 of 7

Policy Each Area Agency on Aging (AAA) shall have a written plan that summarizes how they will serve older adults and maintain operations in the event of an emergency or disaster. AAAs shall collaborate with service providers and disaster assistance organizations in advance of and during a disaster or emergency on attending to the special needs of older adults who are victims of a disaster or emergency. Procedure A – Disaster/Emergency Planning 1.

ODA will use the terms “disaster” and “emergency” to refer to any situation that jeopardizes the health, safety, and welfare of older persons or requires the AAA to deliver special services to older disaster victims. Examples include 1) an isolated emergency, e.g. a fire at an RSS facility; 2) a countywide emergency, e.g. a snow emergency; and 3) a severe emergency that warrants additional assistance from the State of Ohio or Federal Government, e.g. the 1997 and 1998 floods. While ODA uses “disaster” and “emergency” interchangeably, it will specify when it is referring to a state or federally declared disaster.

2.

The purpose of each AAA having a role in disaster/emergency preparedness, response and recovery is to coordinate with service providers, disaster assistance organizations and other organizations to meet the special needs of older persons in a disaster situation by:

3.

a.

Educating older persons, aging network staff and the general public about the importance of preparing for potential emergencies or disasters in order to prevent injury or property damage, and of the AAA role in the event of an emergency.

b.

Preparing older persons and aging network staff to help older disaster victims and address their immediate and future needs including, but not limited to, helping them apply for and/or obtain services from disaster assistance and other programs.

c. .

Preparing aging network staff to help older disaster victims recover from disasters by conducting training and public awareness activities and providing individual assistance to rebuild their lives following a disaster.

The AAA should consider the following in developing an Emergency/Disaster Plan: a.

The types of emergencies/disasters prevalent in the area.

b.

The capacity of the AAA and service providers.

c.

The roles and responsibilities of the Ohio Department of Aging. See Appendix A.

317.00 – Disaster/Emergency Preparedness, Response and Recovery Page 2 of 7

4.

d.

The plans and responsibilities of disaster assistance agencies, e.g. the county Emergency Management Agencies and Red Cross Chapters that serve the area.

e.

Provisions for educating the senior population, aging network, disaster assistance organizations and the general public about disaster preparation, disaster assistance and aging network services.

f.

Contingency protocols for maintaining administrative operations when the agency headquarters and/or some of its functions are inaccessible.

g.

Protocols for communicating and working with ODA, service providers and disaster assistance organizations.

h.

Protocols for communicating with the Long-Term Care Ombudsman (LTCO), particularly when long-term care facilities are located within the area affected by a disaster.

i.

Procedures for contacting clients who would be at high risk in a disaster situation.

j.

Provisions for disaster advocacy, outreach and assistance to older adults during the response and recovery phases of an emergency/disaster.

k.

Procedures to test and update the Emergency/Disaster Plan.

Resources available to assist AAAs to develop emergency/disaster plans are listed in Appendix B.

Procedure B – AAA Responsibilities Under a State and /or Federally Declared Disaster 1.

AAAs may be asked to undertake the following activities under a state or federally declared disaster: a.

Maintain a presence at Emergency Operations Centers and/or Disaster Recovery Centers, either in-person or by provision of contact phone numbers and resource materials.

b.

Inform older disaster victims and their families about disaster assistance and other programs.

c.

Refer older disaster victims to the National Teleregistration Center and/or assist with the teleregistration process.

d.

Assist with completing applications and establishing eligibility for disaster assistance programs, e.g. Small Business Administration, FEMA Disaster Housing Assistance Program, FEMA Individual Assistance and relief organization services, e.g. Red Cross.

317.00 – Disaster/Emergency Preparedness, Response and Recovery Page 3 of 7

e.

Follow-up and provide advocacy, if needed, to ensure that individuals were able to complete the application process and/or received the assistance for which they were eligible.

f.

Inform older disaster victims and aging network staff of services the AAA can provide or access including, but not limited to, alternative housing, home repair, chore, meals and counseling.

g.

Help address unmet service needs, including, but not limited to: i.

ii. iii.

h.

Allocating and/or re-allocating available resources to aging network providers to fund gap-filling services. Assisting providers in identifying additional funding sources. Directly coordinating recovery services provided by workers volunteering and/or missioned to assist older disaster victims.

If the AAA disaster assistance services meet the criteria for FEMA and/or AoA disaster reimbursement, collaborate with the CEMA, OEMA, FEMA, ODA and disaster relief organizations to: i. ii.

Request assistance to meet unmet needs. Submit applications to AoA and others for disaster advocacy and outreach funding, and FEMA for public assistance funding.

2.

The AAA shall provide a regular status report to ODA’s Disaster Coordinator when it is involved in responding to the needs of older disaster victims during a state or federally declared disaster.

3.

The extent of the AAAs involvement under a state or federally declared disaster will be determined by the type of damage caused by the disaster, the geographic coverage of the disaster and the number of older adults impacted by the disaster.

4.

Costs associated with the activities outlined above may be reimbursable through FEMA’s Public Assistance Program, AoA’s Disaster Assistance Fund and/or existing funding streams. The AAA should consult the AAA Disaster Services Funding Matrix located in Appendix C of this Policy to determine what funding sources may be available to pay AAAs’ or providers’ costs associated with a state or federally declared disaster.

Date: August 1, 2001 (#0801S144) July 7, 2004 (#0704P102) Authority Basis: 45 CFR 1321 Includes:

Appendix A: Role in Disaster Preparedness, Response and Recovery Operations Appendix B: Disaster Preparedness, Response and Recovery Resources Appendix C: AAA/PAA Disaster Services Funding Matrix

317.00 – Disaster/Emergency Preparedness, Response and Recovery Page 4 of 7 Appendix A Role in Disaster Preparedness, Response and Recovery Operations

Contingency Planning Develop and maintain a contingency plan that ensures that ODA’s vital functions are maintained in the event that ODA headquarters or vital infrastructures are incapacitated. At a minimum, this plan will contain staffing responsibilities, communication and data back-up protocols. The plan will be tested and revised annually. Information Develop and maintain data collection protocols that will be used by both ODA and AAAs to report agency activities and needs of older disaster victims during a state or federally declared disaster. Serve as an information clearinghouse between Ohio’s aging network and the following agencies: Ohio Emergency Management Agency, Federal Emergency Management Agency, Administration on Aging, Governor’s office, state and federal relief organizations (e.g., Red Cross, AmeriCorps) and other state agencies. Awareness Develop promotional/educational materials for the aging network to educate older citizens on how to prepare, respond and recover from man-made and natural disasters. This includes, but is not limited to, preparing and distributing Disaster Fact Sheets and public service announcements, participating in OEMA’s Severe Weather campaigns and utilizing ODA media (e.g., Ohio’s Heritage, Aging Connection, ODA web page and Finer with Age) to promote disaster preparedness. Support Provide technical assistance to AAAs and other aging network providers to develop and/or modify their disaster preparedness plans and mitigate the potential for injury/damage during a disaster. Identify and secure funds and resources (e.g., volunteers) to help AAAs and other aging network providers respond to the needs of older adults during and after a man-made or natural disaster, including, but not limited to, applying for AoA Disaster Funds and FEMA Public Assistance. Coordination Participate in the development of statewide disaster planning efforts (e.g., Ohio Emergency Operations Plan and Severe Weather Awareness campaigns) and coordinate with state and federal agencies (e.g., AoA, FEMA, OEMA and relief organizations). Represent the needs and interests of the aging network and older adults at the Emergency Operation Center during a state or federally declared disaster. Coordinate the aging network’s presence at Disaster Recovery Centers during a state or federally declared disaster. Where appropriate, develop written missions, agreements or memoranda of understanding.

317.00 – Disaster/Emergency Preparedness, Response and Recovery Page 5 of 7 Appendix B Disaster Preparedness, Response and Recovery Resources

Publications Emergency Preparedness Manual for the Aging Network, Administration on Aging, 1995. http://www.aoa.gov/prof/aoaprog/disaster_assist/Disaster_Asst_Manual_Full.pdf Statement of Understanding between the American National Red Cross and the Administration on Aging http://www.aoa.gov/prof/aoaprog/disaster_assist/AoA-ARC-MOU-2001.pdf Disaster Preparedness for Seniors by Seniors, What We Can Do to Save Our Lives, Rochester-Monroe County Chapter, American Red Cross. http://www.redcross.org/services/disaster/beprepared/seniors.html Disaster Preparedness Guide for Elders, State of Florida Department of Elder Affairs http://elderaffairs.state.fl.us/doea/english/EUDisaster/2003/Disaster%202003.pdf Mid-Florida Area Agency on Aging Emergency Preparedness Plan http://www.mfaaa.org/emergency/ Websites Federal Emergency Management Agency http://www.fema.gov/ Ohio Emergency Management Agency http://www.state.oh.us/odps/division/ema/ Ohio Emergency Management Association http://www.bright.net/~protectr/ American Red Cross http://www.crossnet.org/ U.S. Substance Abuse and Mental Assistance Center (DTAC) http://www.mentalhealth.org/dtac/default.asp

Health

Administration

Disaster

Technical

317.00 – Disaster/Emergency Preparedness, Response and Recovery Page 6 of 7 Appendix C AAA/PAA Disaster Services Funding Matrix Funding Source

A

B

C

D

E

Description

Comments

AAA Administrative Funds

• Disaster planning collaboration, provider TA/AAA generated education & awareness • Assisting in shelters

• AAAs should track staff hours assisting in shelters separately. • During a federally declared disaster these activities may be reimbursable through FEMA's Public Assistance Program and/or AoA Disaster Grant.

Title III Service Funds (i.e. III-B)

To contract for providing disaster related: • Education/awareness • I&R • Outreach and advocacy • Gap-filling services (allowable Title III services only).

• AAAs/providers should track staff hours conducting these activities separately. • During a federally declared disaster these activities may be reimbursable through FEMA's Public Assistance Program and/or an AoA Disaster Grant.

To contract for providing disaster related gap-filling services (allowable SCS services only).

• AAAs/providers should track staff hours conducting these activities separately. • During a federally declared disaster these activities may be reimbursable through FEMA's Public Assistance Program and/or an AoA Disaster Grant.

SCS Care Coordination Administrative Funds

Activities covered by SCS Care Coordination administrative funds

• AAAs should track staff hours conducting these activities separately. • During a federally declared disaster these activities may be reimbursable through FEMA's Public Assistance Program.

PASSPORT -- Case Management

Activities covered by PASSPORT assessment and case management funds, e.g. • Developing individual disaster plans for high-risk clients • Contacting or case managing high-risk clients

• AAAs should track staff hours conducting these activities separately. • During a federally declared disaster some of these activities (e.g., overtime) may be reimbursable through FEMA's Public Assistance Program.

Senior Community Service Funds

317.00 – Disaster/Emergency Preparedness, Response and Recovery Page 7 of 7 Appendix C AAA/PAA Disaster Services Funding Matrix Funding Source

F

G

H

Description

Comments

FEMA -- Public Assistance (federally declared disasters only)

Response activities required as a result of the disaster

• Enables local governments and eligible non-profit organizations to recover funds expended in response, and to assist with repairs and rebuilding on a cost share basis. • Administered in Ohio by the Ohio Emergency Management Agency, Disaster Recovery Branch. • During the floods of 1997 and 1998, used to make repairs to two senior centers.

AoA -- Disaster Outreach/Advocacy (federally declared disasters only)

• Disaster outreach/advocacy and to provide gap filling services • Awarded to State Unit on Aging • Must meet AoA service definition

• If received ODA would distribute to AAAs based on the number of 60+ disaster victims impacted by disaster. • AAAs must submit a plan on how they will use the funds.

Disaster recovery services to older adults and persons with disabilities when provided by the Corporation for National Service (CNS).

During the flood of 1998 FEMA, ODA, CNS, Governor's Community Services Council (GCSC), AAA 8 and AAA 9 developed a mission to utilize volunteers from the National Civilian Conservation Corps (NCCC) and Ohio Volunteers in Service to America (VISTA) to assist older adults with disaster clean-up. The AAAs coordinated the volunteers' activities, and provided shelter and meals. The AAAs were reimbursed for the cost of coordinating the volunteers and for their shelter and meals. ODA allowed the AAAs to use SCS funds to cover initial costs. AAAs paid back SCS funds after FEMA reimbursement was received.

FEMA -- Missioned Activities (federally declared disasters only)

Ohio Department of Aging

401.00 – Notification of Grant Awards, Spending Authority, & Grant Closeout Page 1 of 2

Policy After approval of Area Plans, the Ohio Department of Aging (ODA) shall award Older Americans Act, Senior Community Services Block Grant, Alzheimer's Respite, and Long-Term Care Ombudsman funds to Area Agencies on Aging (AAAs) for administration of social and nutrition services in accordance with intrastate funding formulas. ODA shall grant federal and state funds by a Notification of Grant Award (NGA) to AAAs. AAAs may not unconditionally obligate a fiscal year's federal funds prior to receipt of a Notification of Grant Award. Procedure A – Notification of Grant Awards 1.

Upon final approval of the Area Plan, notification from the United States Department of Health and Human Services Administration on Aging, and application of the intrastate funding formula, the ODA Fiscal Management Unit will issue a NGA to each AAA.

2.

NGAs Title III of the Older Americans Act funds will be issued for a period of 24 months.

3.

NGAs for state funds will be issued for a period of 12 months. Funds from state sources that are not earned during the period governed by the NGA will lapse.

4.

AAAs may not unconditionally obligate the funds prior to the beginning of the approved NGA period. AAAs may make obligations only up to the amount approved on a NGA for a given period.

5.

AAAs shall charge to the grant only allowable costs resulting from obligations incurred during the period of the NGA.

6.

ODA will only issue revised NGAs due to a change in base allotment or an allowable transfer of funds between categories.

Procedure B – Spending Authority fFor Older Americans Act Funds 1.

For NGAs of federal funds, each AAA is authorized to spend or obligate up to the amount authorized by the NGA during the first 12 months of the NGA. Each AAA is authorized to spend or obligate the lesser of the remaining balance or ten percent (10%) of the NGA during the second 12 months of the NGA. The ten percent (10%) is determined from the independent audit report. Amounts spent in the second 12 months over ten percent may not be charged to the funds covered by the NGA.

2.

ODA will monitor costs charged against each AAA's NGA to make sure each allotment is used as designated in the approved Area Plan.

401.00 – Notification of Grant Awards, Spending Authority, & Grant Closeout Page 2 of 2

Procedure C – Grant Closeout 1.

Each AAA shall liquidate all obligations relating to a NGA within 90 days after the end of the period for which the NGA has been awarded.

2.

Each AAA shall use their accounting records to determine if funds received from ODA were in excess of allowable amounts. Excess funds received shall be returned within 135 days after the end of the period for which the NGA has been awarded.

3.

ODA will conduct a reconciliation of amounts reported to ODA, funds paid to each AAA, and funds returned to ODA. The reconciliation will occur after the receipt of the OMB Circular A-133 independent audit. Based on the reconciliation, ODA will issue a final reconciliation letter to each AAA reporting the status of the grant. Any outstanding issues will be communicated at that time.

Revised: August 20, 1999 (#899NP224) Authority/Basis: Title III Older Americans Act, 42 USC 3021 et. seq; § 131.33 ORC

Ohio Department of Aging

402.00 – AAA Cash Management Page 1 of 2

Policy Each Area Agency on Aging (AAA) shall have a financial management system that meets the standards outlined in 45 CFR 74.21 and 45 CFR 92.21. ODA reserves the right to select the method of payment to each AAA based on their compliance with state and federal rules and regulations. Procedure A – Request for Funds 1.

All requests for funds shall be made on forms prescribed by ODA, including requests for funds that have been set aside pursuant to Policy 204.00, Area Plan.

2.

When advances are requested and approved, ODA will advance only a reasonable estimate to cover current cash requirements. ODA will not advance funds greater than the sum of the contract obligations and approved set asides (as determined through the submission of an approved Area Plan pursuant to Policy 204.00 Area Plan) as reported by OASIS for Parts B, C, D, and F of Title III of the Older Americans Act, the Senior Community Services Block Grant, Alzheimer's Respite, and long-term care ombudsman.

3.

Each AAA shall use funds received first by ODA for the oldest, outstanding, actual and allowable expense of the particular grant for which the funds were requested.

4.

ODA reserves the right to request the return of funds received by a AAA from ODA in excess of allowable expenses at any time. ODA will give at least a one-week notice of this request.

Procedure B – Payment of Funds for Unit of Service Agreements. 1.

Advances of funds are within the discretion of the AAA. If AAA monitoring, service provider audits, or past experience with a service provider revealed problems with over-reporting of units of service earned or insufficient documentation supporting units earned, the AAA may pay the service provider on an "as earned and reported" basis until the problems are corrected.

2.

By the end of the contract period, service providers shall only be paid for services earned and reported to the AAA. If no payment is made, service providers shall return any funds in excess of the amount earned for services reported to the AAA. AAAs should have a process that reconciles services earned and reported and funds paid.

Procedure C – Payments of Funds for Grant Agreements 1.

Reimbursement is the preferred method when a service provider's financial management system does not meet the standards identified in 45 CFR 74.21 and 45 CFR 92.21.

402.00 – AAA Cash Management Page 2 of 2

2.

Where a service provider is not being reimbursed pursuant to a unit of service agreement pursuant to Policy 407.00 Area Agencies on Aging Grants and Contracts, the AAA may at its discretion choose to advance funds to the service provider.

3.

AAAs electing to advance funds to a service provider under this section must reconcile future requests for funds by the service provider against advances of funds already made by the AAA. Only amounts supported by actual, reported expenditures that are consistent with the terms of the grant award may be reimbursed.

4.

Funds advanced to the service provider that are not supported by actual reported expenditures consistent with the terms of the grant award must be returned to the AAA by the end of the contract period.

Date: August 20, 1999 (#899NP224) Authority/Basis: 45 CFR Part 74; 45 CFR Part 92

Ohio Department of Aging

403.00 – Title III: Financial Participation Page 1 of 1

Policy Under an approved Area Plan, federal funds along with the appropriate non-federal match are to be utilized to pay the costs of activities and services under the Title III grant. Procedure A – Federal Financial Participation 1.

Allowable federal participation: a.

Area Agencies on Aging (AAAs) are allowed to use federal funds to pay up to seventy five percent (75%) of the cost of AAA administration; and

b.

AAAs are allowed to use federal funds to pay up to eighty-five percent (85%) of the cost of Titles III B, C1, C2 and D social, nutrition, and in-home services.

c.

AAAs are allowed to use federal funds to pay up to seventy five percent (75%) of the cost of services and administration funded through Title III-E National Family Caregiver Support Program.

Procedure B – Non-Federal Participation 1.

Non-federal requirements: a.

AAAs must exert all efforts to ensure that sufficient non-federal cash, allowable in-kind contributions or a combination of both are available to meet the minimum match required under the grant award; and

b.

Non-federal match used to support other federally funded programs is not allowable as match for funds awarded by the Ohio Department of Aging (ODA).

Procedure C – Participation Monitoring 1.

The ODA Fiscal Management Division will monitor the use of funds through quarterly reporting, on-site visits, and assessments of the AAA.

Date: August 1988, February 2002; November 14, 2003 (#1103S179). Authority/Basis: OAA § 304 (d); 42 USC 3024; 45 CFR 1321.47

Ohio Department of Aging

404.00 – State Subsidy: Aging Network Page 1 of 2

Policy Area Agencies on Aging (AAAs) shall utilize state subsidized funding, entitled Aging Network funds allocated by the Ohio Department of Aging (ODA), as non-federal match for Title IIIAdministration funds of the Older Americans Act of 1965, As Amended (OAA). Procedure A – Programmatic Description The Ohio General Assembly annually appropriates funds to ODA for allocation to AAAs. This allocation shall be utilized as non-federal match to the administrative funding provided under the OAA of 1965, As Amended. Procedure B – Programmatic Requirements These funds are to be used to match the Title III Administration allocation. Procedure C – Application Process After notification from ODA of allocation, these funds should appear in the Area Plan under nonfederal funds, state cash. Procedure D – Allocation Process Each AAA is allocated one-twelfth (1/12) of the appropriation allocated by state legislation. This allocation will be reflected on a Notification of Grant Award and sent to the AAA, along with Acceptance and Assurance of Compliance Forms. Procedure E – Budgeting Funds are to be allocated for administrative line items. Procedure F – Cash Distribution Funds are to be distributed in four quarterly allotments throughout the Title III program year. Procedure G – Reporting Expenditures are to be reported quarterly on QRPT-2 and QRPT-7 (see appendix). Procedure H – Property Management AAAs shall maintain an inventory control list of all equipment purchased.

404.00 – State Subsidy: Aging Network Page 2 of 2

Procedure I – Carryover ODA has approved carryover of eight percent (8%) of the base award from the previous year. For funds in excess of eight percent (8%), the AAA must submit a plan for use to ODA within thirty (30) days after the end of the project period. Procedure J – Evaluation Evaluation will be on-going quarterly by reviewing of reports and during the annual Title III assessment.

Ohio Department of Aging

405.00 – Title III Transfers of Funds Page 1 of 3

Policy An Area Agency on Aging (AAA) may request through its annual operational Area Plan and/or subsequent revisions to transfer between Parts B (Supportive Services and Senior Centers) and C (Nutrition Service) and/or between subparts 1 (Congregate Nutrition Services) and 2 (HomeDelivered Nutrition Services) of Part C. This transfer applies only to the current fiscal year funding level for an AAA’s program year as identified through an Ohio Department of Aging (ODA) Notice of Funding Availability. Transfer authorization excludes federal grant unearned (also known as “carryover”) from previous project years. Transfers will not be permitted out of Part C, subpart 2 (Home-Delivered Nutrition Services) if the AAA funds home-delivered meals with ODA’s Senior Community Services Block Grant funds. AAAs may not transfer funds from Parts B, C (1 and 2), D, or F into its Title III AAA Administration allocation, but will be allowed to transfer dollars out of the AAA Administration allocation into Parts B, C (1 and 2), D, and F. These percentages apply to transfers: •

For transfers between Parts B and C: An AAA may request to transfer up to 25% between those parts for federal fiscal years 1994 and 1995, and 20% for federal fiscal years 1996 and until such time as the maximum percentage is changed by the Older Americans Act.



For transfers between subpart 1 and subpart 2 of Part C: An AAA may request to transfer up to 30% between those parts (before transfers from Part B).

Procedure A. Review Process 1.

All requests to transfer funds must be expressed through submission of Area Plan exhibit. Please refer to Area Plan instructions to determine which exhibits and appendices should be submitted and to which appropriate unit.

2.

As part of the Area Plan review process, this calculation will be used to determine policy compliance: Transfer Amount [of any given part]  Base amount For transfers between Title III-B and C, the denominator is the base allocation of the part that is being reduced. If either C1 or C2 are being reduced, then the denominator is the sum of C1 and C2. The numerator is the amount being transferred. For transfers between Title III C-1 and C-2, the denominator is the sum of the base allocations for C1 and C2. The numerator is the transfer amount.

405.00 – Title III Transfers of Funds Page2 of 3

Example: Assume that PSA X has the following original base allocation: Title III B Title III C1 Title III C2

$20 $10 $5

Sample Transfer 1 If PSA X proposes to transfer $3 from Title III C1 to Title III B, the calculation would be: Transfer amount Base allocations for the Sum of C1 and C2

or

3 = 20% (10+5)

Sample Transfer 2 If PSA X proposes to transfer $4 from Title III B into Title III C2, the calculation would be as follows: Transfer amount Base allocation for Title III B

or

4 20

= 25%

Sample Transfer 3 If PSA X proposes to transfer $5 from Title III C1 to Title III C2, the calculation would be: Transfer amount Base allocations for the Sum of C1 and C2

or

5 = 33% (10+5)

In this example, the transfer would not be allowed because it exceeds the maximum allowable percent that can be transferred between Title III C1 and Title III C2. 3.

When requests to transfer funds are made at the time of submission of the Area Plan budget to ODA, approval of the budget exhibit shall constitute approval of the requests to transfer funds.

4.

When requests to transfer funds are made outside the Area Plan budget process, ODA shall approve or deny such requests within fifteen working days of receipt unless federal approval is required in which case approval notification will be made within five days of the receipt of federal approval. ODA reserves the right to request additional information required to justify transfer requests and in so doing may extend the fifteen-day review period.

5.

The final opportunity for AAAs to request ODA approval to transfer funds for the current program year shall be August 31.

405.00 – Title III Transfers of Funds Page 3 of 3

Procedure B – Waiver 1.

An AAA may request higher transfer maximums from ODA only if it satisfactorily demonstrates that available funds for a particular Part are insufficient to satisfy the need for services in its PSA.

2.

ODA will deny the waiver request if the Administration on Aging does not provide special authorization for the requested transfer.

Date: November 10, 1994; January 21, 1999 (#199NP016) Authority/Basis: OAA 1965, as amended; 42 USC 3028

Ohio Department of Aging

406.00 – Vacant Page 1 of 1

Policy Formerly – Carryover Rescinded 10/9/96

Ohio Department of Aging

407.00 – Area Agencies on Aging Grants and Contracts Page 1 of 6

Policy Each Area Agency on Aging (AAA) is authorized to enter into agreements with community service provider agencies and organizations for the purpose of developing and implementing a comprehensive and coordinated community based system of services for older persons as provided for in the AAA's approved Area Plan. Each AAA is ultimately responsible to the Ohio Department of Aging (ODA) for insuring that all Older Americans Act (OAA) and ODA funds are utilized in the appropriate manner for activities and services authorized under an Area Plan. Definitions “Purchase of Service Contract” means a contractual agreement in which a service provider is paid for services based upon a pre-determined price per unit of service delivered. The price paid per unit encompasses all elements associated with the production of the unit of service. “Cost Reimbursement” means grants and contracts in which a provider is paid for services delivered based upon allowable costs related to actual expenditures incurred by providers to deliver a service, regardless of the number of services provided. “Unit of Service” means a unit of service as defined in the ODA Taxonomy of services for specific services. Procedure A – Service Provider Agreements 1.

AAAs which are nonprofit agencies are required to comply with the procurement requirements outlined in 45 CFR Part 74 and AAAs which are local governmental agencies are required to comply with the procurement requirements outlined in 45 CFR Part 92 when awarding contracts for goods and services paid for with federal funds.

2.

Except as provided in paragraph (2) (a) of this Procedure and Procedure (F) of this Policy, all service provider agreements must take the form of purchase of service contracts in which providers are paid for only those services actually delivered. a.

The following services may be exempted, at the AAA's discretion, from unit of service reimbursement: Client Finding Home Maintenance/Repair Socialization Information and Assistance Visiting Ombudsman Chore

b.

Mass Outreach Telephoning Congregate Client Finding Congregate Mass Outreach Home Delivered Client Finding Home Delivered Mass Outreach

The cost reimbursement method may be used as an alternative to unit of service reimbursement for any of the exempted services listed above.

407.00 – Area Agencies on Aging Grants and Contracts Page 2 of 6

Procedure B – Grant and Contract Process 1.

AAAs which award a grant or contract through a competitive award process must make reasonable efforts to notify potential providers within the Planning and Service Area (PSA) of the request for proposals (RFP) or invitations to bid (ITB). For the purposes of this policy, "reasonable effort" includes publication in newspapers and any other appropriate mechanism for notification identified by the AAA that is designed to create broad public awareness of the grant or contract. The public notice shall identify at a minimum the: a.

services to be funded;

b.

source and purpose of funding for the proposed service (e.g., Title III-B, Title III-C2, Title III-F);

c.

geographic area to receive services under the proposed grant or contract;

d.

client group to be served; and

e.

name and telephone number for a contact person at the AAA.

2.

AAAs shall, through such public notice of a RFP or ITB, make special effort to attract minority organizations to make application.

3.

AAAs shall allow applicants a reasonable period to respond to the RFP or ITB.

4.

AAAs shall include, at minimum, in the RFP and ITB, a a.

timetable denoting significant dates in the RFP or ITB process (e.g., due date of proposal, expected date of award, etc.);

b.

list of factors which the bidder/offer or must fulfill in order for its proposal to be considered a responsive proposal;

c.

clear and accurate description of the technical requirements, including service specifications and service delivery category definitions for the good or service being solicited;

d.

clear and accurate listing of either all the elements of the bid price as defined by the AAA or, in the alternative a requirement that the bidder/offer or specify the elements of the price;

e.

listing of equipment, if any, which the AAA intends to procure separately utilizing funds from the amounts it has set aside in an approved area plan, pursuant to 204.00; and

f.

list of review criteria which will be utilized by the AAA to evaluate each RFP or ITB.

407.00 – Area Agencies on Aging Grants and Contracts Page 3 of 6

5.

6.

A RFP shall request the applicant to provide, at minimum: a.

an overview of how the applicant will meet the need for the proposed service;

b.

a detailed description of the services to be provided and the method of delivery, including a description of the clients to be served; the methods of acquiring clients (e.g., referral, outreach); and compliance with the ODA service specifications and taxonomy; and Policy 301.00 (A)(3)(c) COMMUNITY FOCAL POINTS;

c.

how the service provider intends to satisfy the service needs of low-income minority individuals in the area served by the service provider;

d.

the projected units of service to be delivered and the numbers and characteristics of clients to be served;

e.

the price per unit and disclosure of the elements that are included in the price. Elements not included in the price must be disclosed; and

f.

a budget that details; unit costs and projected contract expenditures by service category and, optionally, by line item;

ii.

projected contract revenues (e.g., local match, program income, United States Department of Agriculture [USDA]); and

iii.

revenues and expenditures, related to the proposed services, from other sources.

The AAA may enter into grants and contracts with public and private entities subject to the availability of funds. a

7.

i.

A Contract Plan Summary for each service provider, reflecting such agreements, will be forwarded to the ODA Management Information Systems Unit (MIS) within 60 days after the beginning of the AAA's program year. i.

Revisions to individual Contract Plan Summaries must be submitted with the quarterly Ohio Aging Services Information System (OASIS) reports. Revisions are considered to be any contract changes affecting total clients, annual units of service, and funding changes.

ii.

All final revisions are to be submitted sixty days before the end of the program funding year.

The AAA must maintain documentation regarding how contract decisions were made.

407.00 – Area Agencies on Aging Grants and Contracts Page 4 of 6 Procedure C – Grant and Contract Provisions 1.

AAA grants and contracts for services included in the approved Area Plan shall include clauses that, at a minimum: a.

b.

reference applicable federal, state and local laws and regulations, and any applicable federal circulars; describe the services to be provided and any related conditions (e.g., quantity, quality, etc.); i.

for subrecipient grants and contractual relationships as defined in OMB A-133, funds must be identified by part (as noted in Title III language) and by source (e.g., Senior Community Services Block Grant); and

ii.

funds will not lose their identity by part or source even when such funds become carryover (federal or state grant unearned) when awarded in a subrecipient grant and contractual relationship.

c.

specify the compensation, including amount, method of payment, and required match to be provided;

d.

describe the review, monitoring and audit rights of the service provider, ODA, and the Administration on Aging (AoA.);

e.

describe the recordkeeping and reporting requirements for compliance and assurance of access to such records by the AAA and ODA;

f.

assure that equal employment opportunities will exist and that no discrimination on the basis of race, color, religion, sex, age, handicap or national origin will result;

g.

provide for methods of modifying, suspending or terminating the contract, if necessary;

h.

require the provider to indemnify and hold the AAA and ODA harmless for any liabilities, claims, suits, demands or other consequences from any cause whatsoever, and all costs in connection therewith, arising out of or relating in any manner to, the provider's performance under the service agreement unless prohibited by statute;

i.

require the service provider, to the maximum extent feasible, to provide services to low-income minority individuals and to use its best efforts to promote access to its services by low-income minority individuals; j. require the service provider to meet specific objectives established by the AAA for giving service priority to specific client groups as detailed in Policy 204.02;

407.00 – Area Agencies on Aging Grants and Contracts Page 5 of 6

k.

shall include a list of focal points in the service area covered by the contract;

l.

specify that collection and management of program income earned from the service activity must be in accordance with ODA Policy 409.00 Program Income; 409.01 Program Income: Contributions From Participants; and 409.02 Program Income: Fiscal Management;

m.

specify that service providers who subcontract for provision of services must do so in accordance with this policy; and

n.

require compliance with the Provider Conditions of Participation and with applicable service specifications.

Procedure D – Service Provider Subcontracts 1.

The AAA must ensure that no service provider enters into a subcontract without the prior knowledge, review and approval of the AAA.

2.

Pursuant to Policy 208.00 DELEGATION OF AUTHORITY, the AAA may not delegate to another agency the authority to award or administer Older American Act or ODA funds.

3.

The AAA must review the service provider's request to subcontract, and grant or deny an approval regarding the need to subcontract, based upon the following criteria: a.

by subcontracting, the service would be afforded a more effective and efficient service delivery; and

b.

sufficient rationale exists to support the service provider subcontracting with an entity, rather than the AAA directly contracting with that same entity.

Procedure E – Multi-Year Grants and Contracts 1.

AAAs may enter into multi-year grants and contracts with service providers. Funds may only be obligated for the period for which a "Notification of Grant Award" (NGA) has been received from ODA.

2.

The maximum period between competitions for a particular grant or contract should be three years.

3.

AAAs shall insure to the extent possible that multi-year granting or contracting provides a greater advantage than annual competition.

4.

The multi-year grant or contract shall contain: a.

a clause assuring renewal based on satisfactory performance;

407.00 – Area Agencies on Aging Grants and Contracts Page 6 of 6

b.

provisions for early termination or modification of the grant or contract should unforeseen events occur (e.g., unsatisfactory performance, reduced funding, changed market conditions, mandated program requirements).

Procedure F – Waiver 1.

Waivers from this policy will be considered for special circumstances, e.g. demonstration proposals, pilot projects, research demonstration proposals, services provided under a taxonomy waiver, and one-time services.

2.

If requesting a waiver to allow the use of an alternative method of contracting for any service(s) not listed in Procedure D.1, AAAs must apply in writing. Requests shall be submitted to the Planning, Development and Evaluation Unit (PDE) of ODA.

3.

ODA's evaluation of the waiver request will be based upon the AAA's ability to demonstrate that the cost reimbursement method of contracting is of greater benefit to the service delivery activity than the purchase of service method of contracting.

4.

When requests for this waiver are made at the time of submission of the Area Plan to ODA, approval of the Area Plan shall constitute approval of the waiver request unless otherwise stated.

5.

When requests for this waiver are made between operational Area Plan submissions, the PDE unit of ODA shall coordinate review by appropriate ODA staff and shall approve or deny such requests within fifteen working days of receipt by ODA. ODA reserves the right to request additional information required to justify AAA intent and in so doing may extend the fifteen day review period.

Procedure G – Reallocation of Unearned Funds 1.

If, during the contract period, the AAA determines that a service provider is not earning a proportionate share of the funds specified in the contract between the service provider and the AAA, the AAA may reallocate funds that it estimates a service provider will not earn to other service providers.

2.

A AAA that reallocates funds from a service provider that is not earning its contract award to other existing service providers, the AAA need not follow the process set forth in Procedure B of this policy.

Date: August 20, 1999 (#899NP224) Authority/Basis: ODA Policies 207.00, 214.00, 216.00, 409.00, 409.01, 409.02; ROM-83-56; OAA 306(a)(3)(b)

Ohio Department of Aging

408.00 – Accountability for Federal Advances Page 1 of 2

Policy AAAs have certain conditions and responsibilities attached to federal funds advanced to them from ODA. An "advance" is a payment made to the AAA upon its request before the AAA makes disbursements. ODA is responsible for minimizing the time elapsing between the transfer of funds from the United States Treasury and the payment of funds to the AAAs. The AAA must also minimize the time elapsing between the advance of federal funds and their disbursement. Procedure A – Timing 1.

Cash advances are to be limited to the minimum amounts needed for the actual and immediate cash requirements of the AAA in accordance with ODA policies. Cash advances are to be timed to be as close as is administratively feasible to the actual disbursements by the AAA.

2.

AAAs advancing cash to service providers shall conform substantially to the same standards of timing and amount as apply to advances by ODA to AAAs.

Procedure B – Depositories AAAs shall deposit and maintain advances of federal funds in interest-bearing and insured accounts unless one of the following conditions applies: 1.

The AAA receives less than $120,000 in federal awards per year.

2.

The best, reasonably available interest bearing account would not be expected to earn interest in excess of $250 per year on federal cash balances.

3.

The depository would require an average or minimum balance so high that it would not be feasible within the expected federal and non-federal cash resources.

Procedure C – Accountability Each AAA shall be accountable for receipts, obligations, expenditures, and interest earned on the federal funds in accordance with federal and state regulations. Procedure D – Repayment Of Interest Income 1.

Upon issuance of its audited financial statements, the AAA should determine what portion of interest income earned for the year ended as reported in the financial statements was generated from federal advances.

2.

AAAs designated as governmental entities shall remit interest income generated by advances of federal funds to ODA quarterly within 30 days after the end of the quarter, including interest earned for the quarter. The AAA shall reconcile interest income reported on final financial statements to amounts submitted quarterly within

408.00 – Accountability for Federal Advances Page 2 of 2

60 days after the issuance of the final audit report. Interest income up to $100 per year may be retained for administrative expenses. 3.

AAAs that are non-profit entities shall remit interest income generated by advances of federal funds to ODA annually within 60 days after the issuance of the final audit report, including interest earned for the period covered by the final audit report. Interest income up to $250 per year may be retained for administrative expenses.

4.

Checks should be made payable to the U.S. Department of Health and Human Services and forwarded to: Ohio Department of Aging, Attention: Executive Secretary, Fiscal Management Unit, 50 West Broad Street, Ninth Floor, Columbus, OH 43215-5928.

5.

Documentation supporting the calculation of interest income should accompany each check.

Date: August 20, 1999 (#899NP224) Authority/Basis: 45 CFR 74.22; 45 CFR 92.20; 45 CFR 92.21

Ohio Department of Aging

409.00 – Program Income Page 1 of 2

Policy Program income represents income earned by the service provider from the federally-supported activity. Such earnings may include, but are not limited to, income from consumer donations, sale of goods, usage or rental fees, and royalties on patents and copyrights, as well as proceeds from the sale of personal, real property, or assets purchased with grant funds with an acquisition cost of less than one thousand dollars ($1,000). Program income earned during the project period shall be retained by the service provider and, in accordance with the grant or other agreement, shall be added to funds committed to the service provider by the Area Agency on Aging (AAA) and be used to further eligible program objectives. AAAs must use the Additional Cost Alternative as their method of calculating program income. An illustration for handling additional cost program income: Original Basis

Use of Program Income

Grant $75,000

Program Income $10,000

Match $25,000

Matching Funds $25,000 Grant Funds $75,000 Total $110,000

Under the alternative, the income is used for costs which are in addition to the allowable costs of the project or program which further the objectives of the federal statute under which the grant was made. Examples for purposes for which the income must be used are: 1.

Expanding the project or program.

2.

Continuing the project or program after grant or subgrant support ends.

3.

Obtaining equipment or other assets needed for the project or program or for other activities that further the statute's objectives.

Procedure A – Additional Requirements 1.

All program income earned under Title III, Parts B and D must stay with the provider who earns it.

2.

All program income earned under Title III, Parts B, C-1, C-2, and D must be used only for allowable expenses under the part from which it was earned.

3.

Program income earned as a result of services provided with Title III, Part B assistance may be used for any service which that contractor is authorized to provide with Title III-B funds.

409.00 – Program Income Page 1 of 2

4.

5.

Title III C-1 and C-2 program income must be used to provide services under the respective part, in accordance with the 1981 amendments to the Older Americans Act. Program income may be used to: a.

Increase the number of meals served by the service provider; and

b.

Provide other supportive services directly related to nutrition services.

Program income earned as a result of services provided with Title III, Part D assistance may be used for only those services which that contractor is authorized to provide with Title III-D.

Date: August 1988 Authority/Basis: 42 USC 3030(c)(2)

Ohio Department of Aging

409.01 – Program Income: Contributions from Participants Page 1 of 1

Policy The Area Agency on Aging (AAA) will assure that agencies providing social and nutrition services under the Area Plan shall afford older persons the opportunity to contribute all or part of the costs of the social and nutrition services provided. Every effort should be made to increase donations and ensure that participants will be informed of their opportunity to contribute. Procedure A – Contributions 1.

Each older recipient shall determine for him/herself what he/she is able to contribute toward the cost of the social and nutrition service.

2.

No older person shall be denied a social or nutrition service because of his/her failure to contribute to all or part of the cost of such service.

3.

The AAA, in conjunction with the Advisory Council, shall ensure that contributions from individuals shall be handled in such a manner as to protect the privacy of each older person with respect to his/her contribution. Lists of contributors and their donations, and copies of receipts, are not to be kept. The AAA shall consult with the Advisory Council regarding proposed methods of accepting contributions for services.

4.

The AAA shall advise the service provider to establish and publish suggested contributions.

Authority/Basis: 42 USC 3030(c)(2)

Ohio Department of Aging

409.02 – Program Income: Fiscal Management Page 1 of 1

Policy Program income must be accounted for on an on-going basis and should be reported to the Ohio Department of Aging (ODA) as it is earned through the established ODA financial reporting system. Program income generated from social and nutrition services shall be retained by the recipient of the contract. Procedure A – Accountability 1.

The Area Agency on Aging (AAA) shall ensure that program income generated from participant contributions must be counted daily by no less than two people simultaneously, preferably by agency employees who are bonded and who are independent of the bookkeeper and other project staff responsible for project financial recordkeeping. The activity of making change shall be physically separated from activity of collecting program income from consumers of service.

2.

The AAA shall ensure that cash and checks should be segregated and listed on a standard receipt form. The total of checks and cash should be added and compared with the total of the receipt form, and both persons should sign the receipt form. The checks and cash should be forwarded to the person responsible for making bank deposits simultaneously, the receipt form should be sent to the project manager for later comparison with bank deposit slips.

3.

The AAA shall ensure that all program income generated from participant contributions must be deposited on a daily basis into the appropriate account. In the event that program income cannot be deposited on the day it is collected, it must be kept in a locked place (i.e., file cabinet or safe). The bookkeeper should not be the same person who is responsible for depositing the contributions in the bank.

4.

The AAA shall ensure that program income must be identified separately in appropriate ledgers.

All program income will be reflected on appropriate program financial reports (QRPT-3, 4, 5 and where applicable, QRPT-9A, B).

Authority/Basis: 42 USC 3030(c)(2)

Ohio Department of Aging

410.00 – AAA Cost Allocation Plan Page 1 of 4

Policy The Area Agencies on Aging (AAA) are required to use federal cost principles to charge administrative costs to federal grant programs. The cost principles applicable to a non-Federal entity apply to all Federal awards received by the entity, regardless of whether the awards are received directly from the Federal Government or indirectly through a pass-through entity. AAAs must have a written cost allocation plan that details both the direct charges to each activity or program and the methodology for determining the indirect charges. This plan should be reviewed by AAA Management on a regular basis and adjusted whenever the basis for allocation changes or a new activity or program is instituted. Procedure A – Applicable Cost Principles 1.

AAAs which are nonprofit agencies are required to comply with the cost principles described in the Office of Management and Budget Circular A-122, Cost Principles for Non-Profit Organizations.

2.

AAAs which are local government agencies are required to comply with the cost principles described in the Office of Management and Budget Circular A-87, Cost Principles for State and Local Governments.

Procedure B – Allowable Costs 1.

The amount chargeable to a Federal program is comprised of the allowable direct costs, plus the allocable indirect costs, less applicable credits.

2.

Allowable costs are those that are necessary and reasonable for the proper and efficient performance and administration of the award and authorized, or not prohibited, under Federal, State or local laws.

3.

A cost is allocable if the goods or services involved are chargeable to the program based on the relative benefits received.

Procedure C – Cost Allocation Plan 1.

The cost allocation plan should include the following information: a

An organization chart;

b

A copy of the agency’s most recent Annual Report to support the allowable costs of each central service activity included in the plan; and

c.

A certification signed by the AAA Director that the plan was prepared in accordance with the applicable Circular, contains only allowable costs, and was prepared in a manner that treated similar costs consistently among the various Federal awards and between Federal and non-Federal awards.

410.00 – AAA Cost Allocation Plan Page 2 of 4

2.

For each allocated service the plan must also: a

Briefly describe the service performed by each unit or staff member

b

Identify the unit or staff position rendering the service

c

List the items of expense included in the cost of the service (salaries, benefits, etc.) and the programs benefiting from the service

d

Identify the method used to distribute the cost of the service to the programs

e

Provide a summary schedule showing the allocation of each service to the benefited programs.

Procedure D – Classification of Costs 1.

All costs should be divided into one of three categories, which will dictate how they are distributed: a.

Direct costs that can be specifically identified with a particular cost objective (function, organizational unit, contract, or grant) and are charged directly to that grant;

b.

Indirect costs incurred for a common or joint purpose benefiting more than one cost objective (program) or not easily assignable to one cost objective and are charged based on an reasonable allocation methodology (payroll processing, supplies, etc.); Note: this is not an indirect cost rate.

c.

Combination costs, primarily salaries of staff members who provide direct support to more than one cost objective, or provide a combination of direct and indirect support. These costs must be supported by time studies. The resulting direct time is charged directly to the appropriate grant, the indirect time is allocated based on a reasonable allocation methodology.

Procedure E – Allocation Methodology 1.

Any method of distribution can be used which will produce an equitable distribution of cost. In selecting the most appropriate method the agency should consider whether the effort involved is worth the higher degree of accuracy. The following are some suggested bases for distributing central service costs. These are suggestions only and should not be used if they are not suitable for the particular services involved.

410.00 – AAA Cost Allocation Plan Page 3 of 4

Types of Service Accounting Accounts Payable Motor Pool Office Space Human Resources Local Telephones

Suggested Bases Number of Transactions Number of checks issued Miles driven or days used Square feet of space occupied Number of Employees Number of Telephones

Procedure F – Time Studies 1.

2.

Salaries and wages of employees chargeable to more than one grant program must be supported by time studies as detailed below: a.

The report must reflect an after-the-fact determination of the actual activity of each employee.

b.

Each report must account for the total activity for which employees are compensated.

c.

The reports must be signed by the individual employee or by a responsible supervisor who has first hand knowledge of the activities performed by the employee.

d.

The reports must be prepared at least monthly and should be inclusive of pay periods.

Time studies supporting charges to the various PASSPORT cost centers should follow the instructions and format specified in the PASSPORT Administrative Manual.

Procedure G – Use of Budget Estimates 1.

Budget estimates do not qualify as support for charges to Federal awards but may be used for interim accounting purposes. If budget estimates are used for interim accounting purposes: a.

The method used for establishing the budget is a reasonable estimate of the actual cost;

b.

At least quarterly, the actual costs are compared to the budgeted amounts and necessary adjustments are made; and

c.

The budget estimates are revised at least quarterly based on the actual costs.

410.00 – AAA Cost Allocation Plan Page 4 of 4

Procedure H – Cost Shifting Any cost allocable to an award or cost objective may not be charged to other awards to overcome fund deficiencies, to avoid restrictions imposed by the award, or for other reasons. This practice is unallowable cost shifting. Procedure I – Documentation All charges must follow the written Cost Allocation Plan and be supported by formal accounting records. Procedure J – Monitoring 1.

ODA will approve AAA cost allocation plans and test the application of the plan to specific program costs, including the supporting documentation.

2.

ODA has 30 days to respond to the submission by a AAA of a cost allocation plan. Upon completion of ODA review, an approval letter will be sent to each AAA director within 60 days of the original submission. The approval letter may indicate conditional stipulations.

3.

ODA may ask for the return of any funds that are deemed to be non-allowable because they do not meet Federal standards or ODA policy.

4.

A AAA that disagrees with the disapproval of its cost allocation plan, the conditional stipulations attached to the approval of its cost allocation plan, or the determination by ODA that funds must be returned by the AAA may file a written appeal with the Director of ODA, setting forth the reasons for its appeal.

Date: August 1, 2001 (#0801S144) Authority Basis:  45 CFR Part 74 Uniform Administrative Requirements for Awards and Subawards to Institutions of Higher Education, Hospitals, and other Non-Profit Organizations  45 CFR Part 92 Uniform Administrative Requirements for Grants and Cooperative Agreements with State and Local Governments  Office of Budget and Management Circular A-102, Grants and Cooperative Agreements with State and Local Governments  Office of Budget and Management Circular A110, Uniform Administrative Requirements for Grants and Agreements With Institutions of Higher Education, Hospitals and Other Nonprofit Organizations  Office of Management and Budget Circular A-122 , Cost Principles for Non-Profit Organizations  Office of Management and Budget Circular A-87 Cost Principles for State and Local Governments  ASMB C-10: Implementation Guide for Circular A-87  Office of Management and Budget Circular A-133 Compliance Supplement

Ohio Department of Aging

411.00 – Financial Audits Page 1 of 2

Policy Each Area Agency on Aging (AAA) shall have an audit conducted in accordance with the guidelines identified in Office of Management and Budget (OMB) Circular A-133. Each AAA shall also conform to the applicable guidelines contained in the Ohio Department of Aging’s (ODA) Sub recipient Audit Guide. Procedure A – Audit Procurement 1.

Purchase of audit services by nonprofit organizations shall be in accordance with the procurement standards prescribed by OMB Circular A-110, Uniform Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and Other Non-Profit Organizations.

2.

Purchase of audit services by governmental entities shall be in accordance with the procurement standards prescribed by OMB Circular A-102, Uniform Administrative Requirements for Grants and Cooperative Agreements with State and Local Governments.

3.

Audits shall be scheduled to be completed within nine (9) months after the end of the AAA’s fiscal year.

Procedure B – Audit Follow-Up When independent auditors complete fieldwork, the audit follow-up period begins and is not satisfactorily completed until all weaknesses have been corrected, findings resolved, and payment of questioned costs has been finalized. When the audit fieldwork has been completed for an AAA, each AAA shall: 1.

Notify ODA of the audit exit conference and forward a draft copy of its audit report at least 48 hours prior to the conference.

2.

Submit two copies of the final reporting package to the ODA Chief of Fiscal Management within 30 days after receiving the final package. The final reporting package includes: the financial statements and schedule of expenditures of federal awards, summary schedule of prior audit findings, audit

3.

Report(s), corrective action plan, and data collection form.

4.

Be responsible for the correction of weaknesses, resolution of findings, and payment of questioned costs identified in the final audit report.

Procedure C – Management Of AAAs Subrecipients’ Audits To ensure that audits are conducted in accordance with OMB Circular A-133, each AAA shall:

411.00 – Financial Audits Page 2 of 2

1.

Determine which providers should have audits conducted under OMB Circular A133 and ensure that they are aware of the requirements.

2.

Ensure audits are conducted for each of its subrecipients who are required to have an audit conducted under OMB Circular A-133. Each AAA shall require its subrecipients to provide written notification to the AAA when a subrecipient has an audit conducted under OMB Circular A-133, but was not required to have an audit.

3.

Follow-up to ensure weaknesses, findings, and questioned costs identified in subrecipients audit reports are resolved in a timely manner.

Date: January 21, 1999 (#199NP016) Authority/Basis: OMB Circular A-133

Ohio Department of Aging

501.00 – Client Liability Collection Page 1 of 6

Policy The PAA shall identify, invoice, collect, monitor and reconcile the client liability payments whenever the PAA has been designated as the waiver providers' collection agent. The client liability is the amount of the client's financial obligation to share in the costs of PASSPORT Home Care services. The amount is determined by subtracting allowable deductions from the client's monthly income. The remaining amount is to be paid by the client toward the cost of PASSPORT Home Care services. The amount is determined by following client liability calculation guidelines as stated in OAC 5101:1-39-95. The PAA or waiver services providers can act as designated collection agents. Whenever the service provider is the designated collection agent, the PAA shall reduce the provider's payment for services by the amount of liability assigned to the provider. The designated collection agent is responsible for invoicing and collecting client liability amounts. Procedure A – Introduction The PAA shall collect the client's liability only when the PAA has a signed agreement from the client or authorized representative which identifies that the payment of client liability is required as a condition of waiver eligibility (client agreement with the care plan). Procedure B – Identification 1.

The PAA shall use the liability amount as determined by the County Department of Job and Family Services (CDJFS) in its budget for the Medicaid waiver eligibility determination. The CDJFS documents the financial and patient liability determination within the Client Registry Information System - Enhanced (CRIS-E). When the CDJFS has not yet made a final liability determination, the liability amount presumptively determined by the PAA for application to the cost of PASSPORT Home Care waiver services is used instead.

2.

The PAA shall not collect a liability payment for the month of enrollment.

3

The cost of Case Management is not included in the service cost calculation for client liability. Case Management is considered an administrative expense.

Procedure C – Invoicing 1.

The PAA shall prepare a monthly invoice and submit it to the client, or his/her authorized representative, Power of Attorney (POA) or Guardian on or before the first day of the month in which the services are provided.

2.

The PAA's invoice form shall contain a notice reminding the client that payment of the liability amount is an indication of client agreement with the care plan. The notice should also indicate that failure to abide by this agreement could result in disenrollment from the PASSPORT Home Care program.

3.

A copy of the PAA billing format will be retained at the PAA for review by ODA. A sample form is attached to this policy. (See Attachment A)

501.00 – Client Liability Collection Page 2 of 6

4.

The client's liability payment will be due by the 10th of each month during which PASSPORT services are provided.

Procedure D – Collection and Monitoring 1.

The PAA shall establish an accounts receivable for each client having a liability obligation and track both monthly obligation and payments received. The PAA shall ensure that all payments are received by a single centralized unit.

2.

The PAA shall report both monthly client liability receivables and actual payments on the PASSPORT MONTHLY FINANCIAL REPORT form. The PAA will also report any adjustments or corrections to prior monthly totals on this report. 3.

The PAA shall credit all payments received to the client's oldest outstanding obligation.

4.

DISENROLLING TO COMMUNITY SERVICES: While the PAA is transitioning a client who is leaving the PASSPORT Home Care program to other community services, the PAA shall invoice clients for liability amounts due and accruing (Ref: OAC 173:3-1-05).

5.

ODJFS HEARINGS: The PAA shall invoice clients for liability amounts that become due or past due while the client is receiving PASSPORT Home Care services that are continuing as a result of an appeal on an ODA or ODJFS action.

This obligation to invoice clients would not apply when the action which the client is appealing is the imposition of the initial client liability. Procedure E – Reconciliation 1.

The PAA shall assure that the collected amount of client liability does not exceed the value of PASSPORT-paid home care services received by the client during the month.

2.

The PAA shall undertake a retrospective review of the actual costs of PASSPORT Home Care waiver services and compare those costs with the amount of client liability collected for each month. This review will be conducted monthly and may require the assistance of the PAA's MIS and clinical staff. The month of review occurs approximately three months after each month of service. This should allow sufficient time for providers to bill and be paid for their services.

3.

Whenever the PASSPORT Home Care services are discontinued within the month, e.g., when a client dies, is disenrolled to other community supports, or permanently relocates to a nursing facility, do the following: a.

The PAA shall apply the liability payment collected for that month to the cost of PASSPORT Home Care waiver services, unless otherwise directed by the CDJFS. If the amount of the liability payment received exceeds the

501.00 – Client Liability Collection Page 3 of 6

amount necessary to cover those costs, then the PAA shall refund the excess amount to the client or authorized representative, as appropriate. b.

Should a client die before receiving monthly income which accounts for any portion of the client liability, then the client (estate) shall not be obligated to pay that portion of the monthly liability payment.

4.

Billing Errors: The PAA shall revise liability accounts to adjust for differences between the PAA-determined estimate and the CDJFS-determined amount. Such adjustments are to occur by the next scheduled client invoice date and are to be reflected on the next invoice. It is allowable for the PAA to credit payment overages to future months' obligations when this practice is approved by the client.

5.

Inter-site Transfers: When a PASSPORT Home Care client transfers to a different region of the state which is serviced by another PAA, then the client liability amount due and the payment are to be coordinated between the two agencies. The originating PAA is the designated collection agent. The originating PAA will calculate the costs of authorized home care services which are paid by PASSPORT and delivered to the client by the PAA sites during the month of transfer. The originating PAA will then adjust the client liability, if necessary. Any balance would be remitted to the client or authorized representative. The relocation PAA is responsible for collecting client liability payments in future months.

Procedure F – Disenrollment and Reenrollments 1.

If the client fails to pay the liability by the due date, then the PAA must determine if the client is physically or mentally capable of meeting this expectation. disenrollment procedures would be initiated immediately for clients who willfully refuse to pay the client liability.

2.

The PAA shall follow relevant notice and state hearing requirements imposed by OAC 5101:6-1-01 through 5101:6-9-01. Individuals who do not have access to the ODJFS hearings process will be informed of the manner in which they can gain access to ODJFS or other ODA hearing rights which may be available.

3.

Clients are eligible for re-enrollment subsequent to a disenrollment which was based on a finding that the client or authorized representative willfully failed to pay the liability owed to the PAA. The client or authorized representative must agree to pay any client liability which becomes due and owing after reenrollment in addition to any client liability amounts owed at the time of the disenrollment.

Procedure G – ODA Role 1.

ODA shall provide the PASSPORT Monthly Statement of Client Liability report form by which the PAAs are to identify the individual and aggregate monthly amount of client liability amounts which are owing as well as the amounts which have been paid.

501.00 – Client Liability Collection Page 4 of 6

2.

The aggregate monthly client liability amount due will be shown on the "Community Care Choices Monthly Financial Report/ Part A. Cash-Flow Section (Request for Funds)" as income to the PAA. The adjusted total will be used when determining the amount of cash advance to the PAA.

Procedure H – Uncollectible Funds 1.

The PAA shall maintain a record of all payments made by each client. The PAA shall notify clients on a monthly basis of the amount of their obligation for the current month and past due amounts from prior periods. Collection of the sum of these receivables is the responsibility of the PAA.

2.

If a client has been disenrolled for non-payment of liability, the PAA shall continue to notify the individual in writing of the past due liability for two consecutive months. The notice shall inform the client that failure to pay past due amounts will result in further collection action by the Ohio Attorney General (OAG).

3.

ORC Section 131.02 allows accounts to be certified to the Ohio Attorney General when the account is at least 45 days past due. The PAA can only initiate a certifying action after a client has been disenrolled.

4.

The PAA shall complete the certification letter as shown in Attachment B including the dates during which the PASSPORT client received services and send it to the Ohio Department of Aging. ODA will forward the information to the Ohio Attorney General. The PAA shall retain detailed records of the debtor's account for access by the Attorney General.

5.

Once the PAA has notified ODA using the certification letter of past-due liability, any billing amount which is outstanding is deemed to be bad debt and is eliminated from the account. The PAA shall show the bad debt as an adjustment on the "Community Care Choices Monthly Financial Report/Part A - Cash flow section (Request for funds).

_____________________________ Date: March 21, 2002 (#0302I052) Authority/Basis: 42 CFR 435

501.00 – Client Liability Collection Page 5 of 6 Attachment A Sample Billing Form Using PAA Letterhead

INVOICE

Client Name (or Authorized Representative or POA/GUARDIAN) Address Line #1 Address Line #2 City, State, Zip Code

Invoice Number:

Invoice Date: Dear

,

We are pleased to be able to provide home care services to you through the PASSPORT program. We hope that these services are meeting your expectations. Please call your Case Manager if you have any concerns about the services.

Invoice Month:

Current Amount:

Past Due Amount: The calculation to establish the amount of your client liability has previously been reviewed with you or your authorized representative. This calculation identifies your monthly share of the PASSPORT Home Care costs. Payment of this liability amount is a condition of the client agreement criteria for eligibility into the PASSPORT Home Care program. Please contact us if you are unable to pay your client liability amount. A failure to pay could result in your being disenrolled from the PASSPORT Home Care program. Should you be disenrolled, you could lose your Medicaid eligibility.

Prior Credit:

Total Amount Due:

(Full payment is due by the 10th of each month. Please submit your payment immediately to: PAA Name and Address.)

501.00 – Client Liability Collection Page 6 of 6 Attachment B Sample Certification Letter Using PAA Letterhead

Date:

Debtor’s Name

Social Security Number

Debtor’s Address $ Total Amount Owed

Debtor's Birth Date

Date of death (if applicable)

Inclusive dates of PASSPORT service Description of PAA efforts to collect:

If applicable: Date of Bankruptcy filing:

Bankruptcy Court Location:

Docket #:

Signature of PAA Official

Date: March 21, 2002 (0302I052) Authority/Basis: 42 CFR 435

Date of Signature

Ohio Department of Aging

502.00 – Unit of Service Verification Page 1 of 5

Policy Area Agencies on Aging (AAAs) and PASSPORT Administrative Agencies (PAAs) shall ensure that units of service purchased with funds administered by the Ohio Department of Aging (ODA) are accurate and in accordance with conditions specified in provider agreements. This policy applies to all purchase of service agreements. Procedure A – Service Provider Agreements 1.

AAA and PAA provider agreements shall disclose the unit of service rate to ensure the agreed upon rate for units of service provided.

2.

AAA and PAA agreements and ODA conditions of participation and service specifications shall describe unit of service documentation requirements to ensure that proper documentation exists for purchased units of service.

3.

AAA and PAA provider agreements shall include language that provides for an opportunity to review provider records in order to determine compliance with conditions of participation and/or service specifications.

4.

AAA and PAA provider agreements shall include language that allows for recovery of funds due to noncompliance with conditions of participation and/or service specifications and for units not documented as delivered and received by a client.

Procedure B – Unit of Service Verification 1.

2.

Each AAA and PAA shall verify accurate and appropriate billing of units of service. At a minimum, each shall establish a process that ensures that the purchase of units of service are: a.

Actually provided to eligible recipients/clients;

b.

Not paid in excess of the units delivered; and

c.

Not paid in excess of the contracted number of units of service purchased by the AAA; or not paid in excess of the PAA-authorized number of units of service.

Each AAA and PAA shall also ensure that the service provider: a.

Utilizes a method of reporting units of service that is within the contract definition, conditions of participation, and service specifications for the specific unit of service; and/or

b.

Maintains sufficient documentation to support services provided.

502.00 – Unit of Service Verification Page 2 of 5

Procedure C – Passport and Care Coordination Review Guidelines 1.

At a minimum, during each program year PAAs shall perform a review that includes at least 25% of all providers with the ten largest providers based on dollars spent by the PAA, being mandatory. The remainder of the 25% would be selected based upon the following criteria in order: a.

Prior performance based on monitoring and third party information. If prior monitoring of a service provider indicated major weaknesses in management practices or substandard performance of services and did not meet the criteria set forth in this policy for verification, then the service provider should be prioritized to have an unit of service verification performed. “Third party information” is information received from clients, relatives, or guardians of clients or any party that has information regarding the services performed by or management practices of the service provider.

b.

Type of service. Some services may have more inherent risk of problems associated with delivery of the services. The services that tend to have a greater risk of vulnerability to error based on current practices of PASSPORT should be prioritized to have an unit of service verification review performed; and

c.

Date of last review. The longer a service provider goes without substantial monitoring, the greater the risk of problems occurring and not being detected by the PAA. The review shall be completed to determine compliance with Procedure B.

2.

For each provider reviewed, PAAs shall verify all units of service provided to a minimum of 10% of clients with a minimum of 10 clients and a maximum of 30 clients for a three month period. The clients shall be chosen to ensure all services are reviewed. Confidentiality of client records shall be maintained.

3.

The review of an additional three month period shall be conducted if errors or exceptions totaling 7% or more of the units sampled are found during the unit of service verification review, as based on the provider’s invoice.

4.

Errors or exceptions found, or recommendations noted, shall be promptly communicated in writing to the provider, including the amount due to the PAA. a.

Adjustments required affecting PASSPORT should be promptly adjusted on the PASSPORT Management Information System.

502.00 – Unit of Service Verification Page 3 of 5

b.

Errors or exceptions found where an amount is due to the PAA and the contract has expired, the PAA shall invoice the provider. A receivable account should be set up to track amounts due to the PAA.

5.

The amounts due to a PAA by a service provider or major weaknesses in a service provider’s billing system found as a result of an unit of service verification shall be considered in accordance with the Ohio Administrative Code 5101:3-31-15 (provider sanctions).

6.

PAAs are encouraged to conduct the unit of service verification review throughout the program year so that errors or exceptions can be communicated to providers before new contract periods. The review should not necessarily begin after a program year has ended.

7.

PAAs may contract with a qualified firm to conduct the unit of service verification.

Procedure D – Non-Passport Funding Sources Review Guidelines 1.

2.

At a minimum, during each program year AAAs shall perform a review that includes at least 50% of all providers with contracts for services that are expected to be less than $300,000. The criteria used to select service providers for the review shall be based on the following criteria in order: a.

Prior performance based on monitoring and third party information. If prior monitoring of a service provider indicated major weaknesses in management practices or substandard performance of services and did not meet the criteria set forth in this policy for verification, then the service provider should be prioritized to have an unit of service verification performed. “Third party information” is information received from clients, relatives, or guardians of clients or any party that has information regarding the services performed by or management practices of the service provider;

b.

Type of service. Some services may have more inherent risk of problems associated with delivery or documentation of the delivery of the services. The non-PASSPORT services that tend to have a greater risk of vulnerability to error should be prioritized to have an audit of service verification review performed; and

c.

Date of last review. The longer a service provider goes without substantial monitoring, the greater the risk of problems occurring and not being detected by the AAA.

For each provider reviewed, AAAs shall use a sampling methodology that allows for an accurate representation of all services provided by a provider. Confidentiality of client records shall be maintained.

502.00 – Unit of Service Verification Page 4 of 5

3.

The review of additional units of service shall be conducted if errors or exceptions totaling 7% or more of the units sampled are found during the unit of service verification review, as based on the provider's invoice.

4.

Errors or exceptions found, or recommendations noted, shall be promptly communicated in writing to the provider, including the amount due to the AAA. a.

Errors or exceptions found where an amount is due to the AAA and the agreement has not expired, the AAA shall reduce future payments by the amount due. Adjustments required affecting the Ohio Aging Services Information Systems (OASIS) Quarterly Reporting system should be promptly reported on OASIS in accordance with ODA Policy 210.00 Quarterly Program Reports; and

b.

Errors or exceptions found where an amount is due to the AAA and the agreement has expired, the AAA shall invoice the provider. A receivable account should be set up to track amounts due to the AAA.

5.

The amounts due to an AAA by a service provider or major weaknesses in a service provider’s billing system found as a result of an unit of service verification shall be considered in the determination of future contract awards.

6

AAAs are encouraged to conduct the unit of service verification review throughout the program year so that errors or exceptions can be communicated to providers before new contract periods. The review should not necessarily begin after a program year has ended.

7.

AAAs may contract with a qualified firm to conduct the unit of service verification.

Procedure E – Request for Exemption 1.

A request for an exemption from Procedure C.1. and C.2. or D.1. and D.2. may be made if an AAA or PAA has developed an alternative method for satisfying the objectives outlined in Procedure B. A request for exemption must be made each year.

2.

Exemption requests shall be made, and must be approved, by the ODA Fiscal Management Unit before an alternative method is implemented.

Procedure F – Error Reporting 1.

AAAs and PAAs shall prepare a report summarizing their error or exceptions found if during the unit of service verification review, error or exceptions totaling 15% or more of the provider invoice amount.

2.

The report shall be completed no later than 30 days after the end of the unit of service verification review and sent to the ODA Chief of Fiscal Management. The report shall include:

502.00 – Unit of Service Verification Page 5 of 5

a.

A description of procedures performed in the unit of service verification review;

b.

Results from the unit of service verification review, including a disclosure of errors or exceptions and reimbursements recovered; and

c.

Recommendations addressing corrective action for the errors or exceptions found at the service provider.

Procedure G – Annual Reporting 1.

Each AAA and PAA shall prepare an annual composite report, which shall be available upon ODA request that summarizes its unit of service verification review. The report shall be completed no later than 60 calendar days after the end of its program year.

2.

The composite report shall include: a.

A description of procedures performed in the unit of service verification review;

b.

Results from the unit of service verification review, including a disclosure of errors or exceptions and reimbursements recovered; and

c.

Recommendations for improving the AAA or PAA's monitoring of unit of service contracts.

Date: April 13, 1999 (#499NP116) Authority/Basis: 45 CFR Sec. 92.20(a)(3)

Ohio Department of Aging

503.00 – Vacant Page 1 of 1

Policy Formerly – Food Preparers: Food Safety and Quality Assurances

Rescinded 11/7/02

Ohio Department of Aging

504.00 – Wide Area Network (WAN) Usage Page 1 of 2

Policy Use of the Wide Area Network (WAN), electronic mail (E-mail), and on-line services have the great potential to enhance the productivity of the employees of Area Agencies on Aging (AAAs), PASSPORT Administrative Agencies (PAAs), and Regional Long-Term Care Ombudsman Programs (RLTCOPs). Each AAA, PAA, and RLTCOP shall have in place policies and procedures that define the personal responsibility of its employees relating to the appropriate use of the WAN, E-mail, Internet, and any associated components. These local policies shall, at a minimum, address the issues contained in this policy and should address local usage issues as well. Procedure A – Definitions For the purposes of this policy, these definitions shall apply: 1.

"Wide Area Network" or "WAN" means the electronic, computer-based network linking the Ohio Department of Aging (ODA) with AAAs, PAAs, and RLTCOPs.

2.

"Electronic mail" or "E-mail" means the transmission of memoranda, messages, and files over electronic networks, both internal messaging systems and external communications via the WAN or Internet.

3.

"Agency" means AAAs, PAAs, and RLTCOPs.

Procedure B – Permitted Use of the Wan, E-Mail, Internet, & Associated Components 1.

Each agency director is responsible to determine which employees shall have access and their degree of access to the WAN, E-mail, and Internet.

2.

Each agency shall devise written protocols governing E-mail correspondence with outside parties.

3.

Access over the WAN to the Internet and E-mail services is for the purpose of carrying out the business of the agency. Care shall be taken to ensure that access to news groups is for work-related purposes only.

4.

Steps shall be taken by the agency to prevent the inadvertent dissemination of information to any party for whom the information is not intended.

Procedure C – Prohibited Use of the Wan, E-Mail, Internet & Associated Components 1.

Internet and E-mail access shall not be used to operate an outside business for personal gain, to send chain letters, or solicit money for any causes (e.g., religious, political).

2.

E-mail communication shall not contain incendiary statements which might incite violence or describe or promote the use of weapons, or devices associated with

504.00 – Wide Area Network (WAN) Usage Page 2 of 2

terrorist activities. Communication shall not be designed to intentionally malign or embarrass others. 3.

E-mail and the Internet shall not be used to download, disseminate, solicit, or review pornographic messages or images.

4.

E-mail and the Internet shall not be used to disseminate or print copyrighted materials or software in violation of the copyright laws.

5.

E-mail should not be used to disseminate confidential or employee medical information.

Date: January 21, 1999 (#199NP016) Authority/Basis: 45 CFR 1321.11

Ohio Department of Aging

505.00 – Employment of Immediate Family & Business Associates Page 1 of 3

Policy Each Area Agency on Aging (AAA) and PASSPORT Administrative Agency shall ensure that its employment practices in the hiring and supervision of employees is conducted in a manner which enhances public confidence in the agency and limits situations which give the appearance of partiality, preferential treatment, improper influence, or conflict of interest. Procedure A – Definitions For the purposes of this policy: 1.

"Closely related by blood, marriage, or adoption" means a spouse, children, parents, grandparents, siblings, and grandchildren.

2.

"Significant relationship" means persons living together as a spousal or family unit when not legally married or related when the nature of the relationship may impair the objectivity or independent judgement of one individual working with the other.

3.

"Business associate" means parties who are joined together in a relationship for business purposes or acting together to pursue a common business purpose or enterprise apart other than the normal enterprise carried out by the AAA or PAA.

4.

"Supervision" means the direct ability or power to effectively recommend the hire, transfer, suspension, promotion, discharge, assignment, reward, or discipline of another employee of the agency.

Procedure B – Hiring of Employees 1.

The AAA/PAA director shall not have in the employ of the AAA/PAA any person closely related to the director by blood, marriage, or adoption; any person with whom the director has another significant relationship; or any person who is a business associate of the director.

2.

Hiring practices of the AAA/PAA shall be designed to prevent any person in a supervisory relationship with AAA or PAA employees from employing, participating in the decision to employ, or influencing the employment of any person closely related by blood, marriage, or adoption; with whom the employee has another significant relationship; or who is a business associate of the employee.

3.

No member of an AAA or PAA governing body shall influence the appointment or hiring of a person who is closely related to the member by blood, marriage, or adoption; with whom the member has another significant relationship; or who is a business associate of the member.

4.

A supplement employment statement like the example in Attachment 1 should be completed and signed by all new hires as a condition of employment.

505.00 – Employment of Immediate Family & Business Associates Page 2 of 3

5.

Procedure B pertains to any person hired after the effective date of this policy.

Procedure C – Supervision 1.

No AAA or PAA employee shall directly supervise any person closely related to the employee by blood, marriage, or adoption; with whom the employee has another significant relationship; or who is a business associate of the employee.

2.

Should a supervisory conflict arise in the course of an employee's tenure or segregation of duties (e.g., marriage), the AAA/PAA shall work expeditiously to relocate or transfer one of the individuals to eliminate the conflict to the extent permitted by law.

3.

AAAs or PAAs may relocate or transfer an employee to another position within the AAA/PAA to the extent permitted by law.

Date: January 21, 1999 (#199NP016) Authority/Basis: 45 CFR 1321.11

505.00 – Employment of Immediate Family & Business Associates Page 3 of 3 Attachment 1 Supplemental Employment Statement

___

I have no known relatives or business associates currently employed by (name of AAA/PAA).

___

I have relatives or business associates currently employed by (name of AAA/PAA), and have listed them below: Relatives or Business Associates Name

Relationship

Position

___

I have no interest in any business that currently (or has in the past) done business with (name of AAA/PAA).

___

I have business interests that are or have been involved in business with (name of AAA/PAA) and have listed them below: Business Interests Name of Business

Signature:

My Interest

Date:

Summary of Services

Ohio Department of Aging

506.00 – Vacant Page 1 of 1

Policy Formerly – Year 2000 Compliance (Issued as an emergency)

Rescinded 11/20/98