8-RFP 26-07 Older Adult Personal Care Services.docx

Montgomery County RFP 26-07 Department of Health and Human Services, Office of Aging Services (OAS) Older Adult Personal Care Services

Introduction Montgomery County is located approximately twenty miles west of Center City Philadelphia, PA. Governed by a three-member Board of Commissioners, the County government is a large diverse organization whose mission is to provide quality services in an efficient and cost-effective manner.

Montgomery County, with nearly 861,000 residents, is the third most populated county in the Commonwealth of Pennsylvania. Some of the services the county government provides its citizens include health and human services, a highly regarded community college, an outstanding park and historic site system, and a judiciary recognized as one of the Commonwealth’s finest.

The Montgomery County Department of Health and Human Services (HHS) offers a full continuum of services to ensure the health, safety and well-being of county residents. The Department serves children, families, young adults, adults and older adults through its offices which include: Children and Youth, Community Connections, Drug and Alcohol, Early Learning Resource Center, Housing and Community Development, Mental Health/Developmental Disabilities/Early Intervention, Public Health, Aging Services, Managed Care Solutions, and Veterans Services. Strategic Offices for the Department support dissemination of important health information and quality and compliance. HHS is fully integrated to provide seamless, coordinated care delivery all focused on enhancing the health and well-being of the residents of Montgomery County.

Montgomery County Office of Aging Services (OAS) procures Personal Care (PC) services to support older adults in their home by filling in the gaps of care provided by informal support or to provide service when no alternative exists. These services are targeted at the neediest older adults in Montgomery County by medical and economic status.

Scope of Work Purpose The purpose of this RFP is to provide interested applicants with information that enables them to prepare and submit proposals for consideration by OAS to satisfy the need for PC services for residents of Montgomery County enrolled in the OPTIONS program. The provision of PC services, defined as assistance related to activities of daily living (ADL) that an individual cannot meet independently, is provided directly in the older adult’s home.

Service Description A consumer receiving PC services must need some amount of hands-on help, setup or supervision to assist with the completion of ADLs. ADL support tasks include self-administering medications, feeding, skin and mouth care, shaving, ambulation, bathing, hair care and grooming, dressing, toileting and transfer activities. Alongside PC services the simultaneous provision of light housekeeping tasks may be requested. PC services are only provided in accordance with the service order developed and provided by OAS. If housekeeping tasks are approved, they will be indicated in the care plan and service order.

Eligibility for OPTIONS program services, including personal care services, shall be established based on a comprehensive needs assessment, known as a NAT, performed by OAS’s care management team. The OAS care manager will be responsible for the subsequent development of the care plan to address individual needs. The care plan is developed with the input of the older adult, lists formal service needs, and identifies which needs may be met through available informal support. The older adult will determine which agency is their preference to perform the tasks to be completed with support from their care manager. The consumer will direct their own care as much as possible depending upon their abilities and the confines of the OPTIONS program. All PC services provided must be consistent with the care plan or service order authorized by OAS.

Service Area Each contracted provider will indicate which Montgomery County Service Zones they are able to serve at initiation of the contract and throughout the contracted period. Contracted providers are not mandated to remain within their zones. Contracted agencies are encouraged to provide service throughout Montgomery County. Zones will be used for planning purposes. Reference for Montgomery County Service Zones Map attached.

Service Authorization and Termination Authorization OAS care managers will order contracted services initially by sending an email to the provider agency. The email will provide basic information on an older adult in need of PC services and requested schedule. More information about the referral is found in Co-Pilot, once the service order is accepted. The provider agency will respond within 2 business days via email to notify the OAS care manager as to whether they can or cannot fill the service order. If no response is received, the care manager will move to the next available provider in the interest of serving older adults in as timely a manner as possible. The provider will have 15 calendar days to complete their initial visit providing service. Any visits that predate OAS service orders will not be paid.

OAS will evaluate the older adult’s need for services periodically. This may change the services ordered. Providers must review new service orders in Co-Pilot and adjust services provided when notified. Service orders will be obtained by a provider and relayed via Co-Pilot only. Termination of service requests from OAS and other urgent communications are provided via email.

Amounts, frequencies, and dates of services exceeding approved orders or orders otherwise not in conformance with this Scope shall not be reimbursed, except where permitted in accordance with the Communications section of the scope. Unexplained deviations from the service order will be subtracted from billing at the discretion of OAS management.

Termination

When a provider determines there is risk for discharge from service for any reason the OAS care manager will be contacted via email for discussion. If the discussion on any concern allows, changes should be made to with the provider to allow service continuation. If it is determined that the older adult must be discharged from service, then the provider will deliver oral and written notification to the client, responsible party and OAS care manager at least 10 business days prior to discharge. During that time, the provider will make every attempt to provide service as per the OAS service order.

When an older adult or responsible party notifies a provider that they wish to terminate service, this must be communicated to OAS as soon as possible. Notice to OAS must be provided within 5 business days following the date the provider was made aware of the request for termination of service.

Communication and Documentation

Communication

The provider will be expected to notify the OAS care manager via email of any changes in the consumer’s condition or functioning that might warrant a change in service including an increase, decrease, or termination of service.

All efforts should be made to maintain the schedule as ordered in the OAS service order. Consistent or recurring weekly schedule changes that deviate from the authorized service order should not occur. The provider shall make reasonable and ongoing efforts to deliver services in accordance with the schedule specified in the service order. Any shifts in service must be within the same service month.

· Allowable Schedule Adjustments Without Notification

Scheduled service days may be adjusted within the same service week, if necessary, without prior notification or additional documentation, provided that:

1. The total number of authorized service days and hours remains as specified in the service order

2. The consumer agrees to the adjusted schedule

3. All services are delivered within the same service month.

Example: a service order authorizing two (2) hours on Monday and two (2) hours on Friday may be rescheduled to two (2) hours on Tuesday and two (2) hours on Thursday within the same service week, provided each shift remains two (2) hours in duration.

· Schedule Modifications Requiring Prior Authorization

Prior authorization from the Care Manager is required for any deviation from the service order, including but not limited to:

1. Permanent schedule changes that differ from the authorized service order

2. Combining or stacking authorized hours within a service week

3. Carrying authorized hours into a subsequent service week

4. Extending the length of any scheduled shift(s)

Exceptions for prior authorization of changes are allowable in emergencies. If an emergency and/or unexpected event occurs, warranting an extension of a scheduled shift, the provider shall document the nature and circumstances of the emergency and shall notify the care manager within twenty-four (24) hours of the occurrence or by the next business day, whichever occurs first, to discuss possible billing implications.

Documentation of the above communication(s) must be retained in consumer record. All documentation shall be retained in accordance with record retention requirements and made available for review during audits. Any unusual incidents would need to be submitted into the HHS Incident Portal.

Notification of change in agency ownership, name or status must be made in writing to OAS contract manager 30 days prior to the change. Additionally, any change in leadership/primary contact, including but not limited to the authorized signer and witness, must be provided to OAS contract manager as soon as possible but no later than 14 business days following the change.

Documentation

PC personnel must utilize an electronic verification system (EVS) by telephone or computer system to verify service provided. A provider is required to capture the date of service, actual time service started and ended and the tasks the worker completed or offered but consumer refused during their shift. Under this contract the scheduled time for service, or service orders provided, are not acceptable as proof of service provided. Any failure to provide documentation to support the actual arrival and departure time of personal care personnel will result in payment being deducted from billing. Applicants without current EVS systems in place may apply. Those applicants must detail how they will come into compliance with the EVS requirement prior to accepting any cases or within 3 months of contract start in their response. If EVS is not in place within 3 months, the contract is subject to forfeiture. In the uncommon event that EVS is inaccessible due to technical malfunction, internet connectivity disruption, or any other condition that prevents real-time documentation, a supervisor or director shall contact the consumer to verify that services were rendered, record the corresponding time in and time out, and document their signature and title.

Each case record will include intake information and progress notes for the older adult. A progress or journal note must clearly state the date of contact, reason for contact, and outcome. The person completing the note must also sign the documentation. All notes to cancel appointments will specify who is cancelling the appointment and what date or dates of service are cancelled. The first date consumer received service will be clearly documented in the case chart. Maintain all documentation confirming changes to the schedule, missed visits, or deviation from the service order.

All PC personnel under this contract must receive a supervisory visit every 6 months at the older adult’s residence. The purpose of the visit is to review the service plan and delivery of service by PC staff. This supervisory visit does not have to be completed by a registered nurse and may be completed by any qualified supervisor on staff. These supervisory visits must be documented and retained in the consumer record.

Each provider will have a written policy pertaining to confidentiality and sexual harassment. All providers will have a policy to address personnel discipline, including the progressive consequences towards termination of employment.

Provider shall make available to OAS upon request all internal client records and files relevant to care provision, assessments, employee records, communication logs, and provider policies/procedures.

Compensation and Billing Procedure A Unit Price will be paid by the County to the Provider for services provided during the term of the Agreement as follows:

The unit price includes all costs required to ensure compliance and/or fulfillment of the service requested. A unit of service is defined as an hour of time spent performing tasks on behalf of the older adult. Time spent travelling to and from the consumer’s home is not counted as service time. No additional cost will be due from OAS consumers above the agreed upon rate for dates and hours of authorized service. The minimum block of time is 2 hours.

All billing issues including discrepancies, billing data deficiencies, missing consumers in Co-Pilot, insufficient quantities or incorrect rates should be addressed to the assigned care manager for resolution. All inquiries should be made to the care manager and copied to the care manager supervisor via email.

All providers will capture the actual time spent providing service. Service times will be captured, rounded and billed based on the closest quarter hour. Providers must have spent at least 8 minutes of time serving an older adult to be paid for a quarter hour. See table below for breakdown:

OAS will make payment to the provider only for services authorized by care managers. Only services verified by the service order may be billed to OAS. The provider must have documentation to support services delivered including date, actual time in/time out, and what actual services were delivered to consumer or offered and refused. Services delivered must be consistent with the consumer’s service order. Records must be available upon request and if records fail to be available or supportive of billing, OAS will retrieve funds billed for those hours of service unavailable or unverified.

Provider will not be paid for services provided to older adults outside of Montgomery County without prior approval by OAS care manager. Provider will not be paid for services provided by an individual not employed by the specific contracted provider. Hours provided by an individual compensated by the provider’s franchise and not the specific contracted provider will be deducted from billing. All providers must be an Agency Employed Model and as such the staff must be paid by the provider.

The provider will electronically submit to OAS a detailed invoice indicating actual costs for services provided in the previous month by the 15th of the following month. Invoices shall be prepared via the Co-Pilot system required by OAS and shall be accompanied by such forms required for accurate program reporting. All billing must be submitted within 60 days after service is completed or non-compliance fees may be assessed.

Unusual Incident Reports

Unusual incident report submissions will follow HHS and Aging Services policies. Unusual incident reports will be entered into the Montgomery County HHS Portal within 24 hours of the adverse event or the next business day. Submission of an unusual incident report is not a substitute for a report of need (RON) under the Older Adults Protective Services Act (OAPSA). In addition, the record of unusual incident events must be maintained in the consumer file and/or within another tracking record as directed by the agency incident management policy. Please direct questions pertaining to the HHS Portal - Incident Reports - to the following email address: MCOSSincidents@montgomerycountypa.gov.

Insurance Please note that a certificate of insurance must be forwarded annually to OAS Contract Manager listing OAS as a holder.

Monitoring Providers will be expected to cooperate fully with Montgomery County Health and Human Services staff as they perform programmatic and fiscal monitoring. Provide access to agency records as permitted under OAPS regulations. On-site visits for this purpose may take place as needed. Monitoring visits may be unannounced. All external monitoring/reviews will be forwarded to the OAS Performance and Planning specialist for review.

Non-compliance A payment of up to $200.00 per occurrence of noncompliance will be assessed. This includes, but is not limited to, non-compliance with providing requested monitoring paperwork within the timeframe provided and failure to report billing by the 10th of the month following service. The $200.00 per occurrence fee may be assessed on a monthly basis when billing is not submitted timely.

Forms Provided (electronic)

· OAS Montgomery County Service Zones Map

· PA DOH TB Risk Assessment

· CDC TB Risk and Symptom Guide

· Agency Profile and Contact Sheet

· Price Certification Form for In-Home Services Requirements Hiring and Staffing A face-to-face interview, in-person or virtual, must be completed prior to hire. The date when the interview occurred must be documented in the worker file. It is best practice to write a summary of the interview as well. Upon hire a provider agency must obtain two satisfactory professional and personal references. Professional references are preferred, and at least one reference must be professional. References may not be acquired from a relative of the potential hire. Documentation of references must be available for review. Please include name of reference, name of individual collecting reference, date reference was obtained, relationship to potential hire, length of time reference has known the potential hire and satisfactory information reported.

In addition, staff require a PA State Criminal Record Check at the time of hire or within one year immediately preceding the date of the application. An FBI Background Check will be completed if the staff member has resided outside of the state of Pennsylvania in the last two (2) years. If the potential employee cannot provide verification that they were a Pennsylvania resident for the past 2 years or if information presented on the application or during the interview process calls their residence as Pennsylvania for the past 2 years into question, then a federal criminal history record check must be pursued and obtained.

Providers will verify at time of hire, and annually thereafter, that their staff are not under suspension or debarment by the Commonwealth, any other state or the federal government. This verification will include a comparison through The Office of Inspector General’s List of Excluded Individuals and Entities (LEIE), Medicheck, and SAM.

It is strongly recommended that a PA Child Abuse History Clearance be obtained if recurrent contact with minors occurs in contracted work. It is recommended that criminal background and child abuse checks occur every 5 years. Documentation of the record checks must be kept on file and available for review by OAS staff.

For providers that consider hiring individuals with any criminal or child abuse record, OAS requires providers to develop and implement a written process for evaluating whether each candidate with a criminal background is suitable for employment within their organization. Each agency’s process must include documentation of review and outcomes for each staff assessment when any record is identified. A record of the internal review and outcome must be kept on file and made available to OAS upon request. OAS retains the right to direct the removal of a worker with a criminal history from any case. Every effort should be made to support consumer safety.

All PC workers or other personnel having direct contact with consumers are required to complete a TB test (IGRA or TST) prior to contact with consumers. The Montgomery County Office of Public Health should be notified immediately if TB is suspected. If there is a positive TB test result the employee must obtain a letter from their physician stating they do not have TB, are not contagious and are safe to provide care prior to start of work.

Following the initial TB test, an annual TB test will not be required of the PC, or other personnel with consumer contact unless the employee had a known exposure or ongoing transmission of TB. If the employee had a known exposure, ongoing transmission, or results of the PA DOH TB Risk Assessment or review of CDC TB Risk and Symptom Guide indicate the need for a TB test, complete the TB test. If that TB test is negative, do another test 8-10 weeks after the last exposure. The employee must obtain a letter from their physician stating they do not have TB, are not contagious and are safe to continue to care for consumers. The PA DOH TB Risk Assessment and the CDC TB Risk and Symptom Guide review will be required for all PC workers and other personnel with consumer contact prior to contact with consumers and annually thereafter. PC and other personnel will discontinue contact with consumers if there is a threat of spreading TB.

Providers are required to use PA DOH TB Risk Assessment and CDC TB Risk and Symptom Guide at a minimum. Reference for PA DOH TB Risk Assessment and CDC TB Risk and Symptom Guide attached. The provider will maintain a written policy regarding late paperwork for TB testing and screenings and the consequences thereof.

If any transportation tasks are included in the service order, a valid driver’s license and proof of auto insurance are required by the direct care worker and must be kept on file. The direct care worker will use their own vehicle, or the consumer’s vehicle if requested, and agency allows for any transportation tasks.

The provider shall not provide services under this agreement to any of its own employees, officers, directors, owners, agents, or to any individual who holds any formal or informal role, position, or decision-making authority within the organization. Services may only be provided to eligible consumers who are independent of the provider and have no employment, contractual, or governance relationship with the provider.

Personnel records must be maintained and contain the following: job application, proof of licensure if applicable, annual performance evaluations, health exams, orientation, face to face interview date preferably with summary, two satisfactory references, PA State Criminal Record Check, PA Child Abuse History Clearance if applicable, summary of skills worker is approved to deliver which was completed at hire and annually, annual competency review, trainings, copy of driver’s license or ID, date of hire and signed confidentiality agreement. Any TB test completed must have documentation in the worker chart which includes the date it was completed, signature of the medical professional who completed the test and the outcome.

Regulatory All applicable federal, state and local regulations will be adhered to. This includes but is not limited to compliance with the Older Adults Protective Services Act (OAPSA) and all amendments, Pennsylvania Code 28 Chapter 51, Pennsylvania Code 28 Chapter 61, and Pennsylvania Code 28 Chapter 611. If there is a difference in applicable standards, the most stringent of standards will be adhered to.

Pennsylvania Older Adult Protective Services Act PA Code 28 Chapter 51 PA Code 28 Chapter 61 PA Code 28 Chapter 611

Metrics and Outcomes Mandated data elements will be entered into the Montgomery County HHS Portal no later than 30 days after the end of the service period. Additional reporting may be required. Failure to satisfactorily complete the invoice and submit data by the due dates may result in payments being withheld and/or non-compliance fees being levied.

Key Performance Indicators (KPIs) are essential for effective program evaluation. Key Performance Indicators are required to be reported annually.

KPIs/Objectives:

· Timeframes

· ≥90% of accepted service orders initiate first visit within 15 business days; exclusions permitted for documented consumer-driven delays/refusals, hospitalization/institutionalization or death.

· Documentation

· ≥95% adherence to approved service orders, with exceptions permitted for consumer‑initiated cancellations and OAS-permitted day-of-week shifts within the same service week.

Information Technology Providers are required to utilize encryption services for all electronic communications containing personally identifiable information. Standard Microsoft encryption services are utilized by OAS.

Data may be shared across HHS offices in accordance with all applicable regulations and guidelines.

Data

· Montgomery County Health and Human Service is the sole owner of the data contained within this RFP and any and all reports requested. No additional fees will be assessed by contractor for full download of data collected.

Confidentiality

· The Contractor agrees to protect the confidentiality of the County’s confidential information.

· The Contractor shall not use or disclose any information about a recipient receiving services from, or otherwise enrolled in, a County program affected by or benefiting from Services under the Contract for any purpose not connected with the Contractor’s responsibilities, except with consent pursuant to applicable law or regulations. All material associated with direct disclosures of this kind (including the disclosed information) shall be provided to the County prior to the direct disclosure.

· Compliance with Laws. Contractor will comply with all applicable laws or regulations related to the use and disclosure of information, including information that constitutes Protected Health Information (PHI) as defined by the Health Insurance Portability and Accountability Act (HIPAA).

Data Breach or Loss

· The Contractor shall comply with all applicable data protection, data security, data privacy and data breach notification laws, including but not limited to the Breach of Personal Information Notification Act, Act of December 22, 2005, P.L. 474, No. 94, as amended, 73 P.S. §§ 2301—2329.

· For Data and Confidential Information in the possession, custody, and control of the Contractor or its employees, agents, and/or subcontractors:

· The Contractor shall report unauthorized access, use, release, loss, destruction or disclosure of Data or Confidential Information (“Incident”) to the County within one (1) hour of when the Contractor knows of or reasonably suspects such Incident, and the Contractor must immediately take all reasonable steps to mitigate any potential harm or further access, use, release, loss, destruction or disclosure of such Data or Confidential Information.

· The Contractor shall provide timely notice to all individuals that may require notice under any applicable law or regulation as a result of an Incident. The notice must be pre-approved by the County. At the County’s request, Contractor shall, at its sole expense, provide credit monitoring services to all individuals that may be impacted by any Incident requiring notice.

· The Contractor shall be solely responsible for any costs, losses, fines, or damages incurred by the County due to Incidents.

· As to Data and Confidential Information fully or partially in the possession, custody, or control of the Contractor and the County, the Contractor shall diligently perform all of the duties required in this section in cooperation with the County, until the time at which a determination of responsibility for the Incident, and for subsequent action regarding the Incident, is made final.

Sensitive Information

· The Contractor shall not publish or otherwise disclose, except to the County or the Contractor’s subcontractors and except matters of public record (which is to be determined entirely in the discretion of the County), any information or data obtained hereunder from private individuals, organizations, or public agencies.

Contract Period with Option to Extend The term of this contract shall be for an initial three (3) years commencing on July 1, 2026 through June 30, 2029. The contract may, by mutual assent of the parties, be extended for two (2) additional one (1) year periods or portion thereof, up to a cumulative total of five (5) years based on availability of funding.

Proposal Submittal Offeror must submit their Proposal electronically through the Bonfire Portal. In addition, a current W9 and completed Appendix “A” document must also be uploaded as separate documents.

Questions All questions related to this Request for Proposal are to be submitted through the Bonfire Portal.

RFP Response Narrative Format Template

Introduction The format that follows is to be used in preparing your proposal in response to the RFP. The applicant’s operations, plans, capabilities, and prior experience are of primary interest to Montgomery County Department of Health and Human Services, Office of Aging Services. The completed proposal must follow the format shown and may not exceed 12 pages, excluding title page and requested attachments.

Title Page: showing RFP number, due date and time, proposer name, address, telephone number, contact person, email address, and EIN number.

Background Statement and Prior Experience

1. Provide a brief (no more than one page) description of the applicant’s business, including:

a. History and future plans

b. Vendor size

c. Vendor financial stability (include copy of most recent audit as an attachment)

d. Number of years in business

e. Provider Identification (EIN)

f. Corporate name and address

g. Contact person(s) name, telephone number and email

2. Describe the agency’s broad purpose for serving its community as stated in its mission statement and the goals it hopes to achieve.

3. Provide an overview of the services your agency currently delivers.

4. Describe your prior experience providing PC services.

Service Description, Communication and documentation

1. Describe the PC services and tasks that will be offered and provided under this contract

2. List any other services offered by the agency and describe how they relate to the service being bid on.

3. Indicate your service zones using the provided Montgomery County Service Zone Map

4. Discuss how you will provide services to individuals and families in a culturally sensitive manner and how you will deliver services in the individual’s language.

5. Discuss how you will successfully administer PC services addressing the following components?

a. Acceptance of referrals and timeframe for service initiation.

b. Use of Co-Pilot system for accessing service orders.

c. Termination of services and timeframes required.

d. Following the provided service order to meet all consumer needs identified for a shift of service

e. Ensuring transportation is only provided when formally indicated in the service order and that the driver has a valid license and proof of insurance

6. Discuss your ability to meet all service communication requirements:

a. Affirm understanding of schedule adjustments that do not require notification

b. Affirm understanding of schedule adjustments that require prior authorization and exceptions to policy

c. Affirm ability and process to retain records of required communications in case files

7. Describe your EVS system capabilities or ability to obtain EVS system capabilities prior to accepting cases or within 3 months of contract start

8. Describe your system of maintaining case records including intake information, progress notes and all information required for contract

9. Describe your process for maintaining the requirement of in-home supervisory visits every 6 months

10. Affirm your ability to provide access to internal client records and files relevant to care provision, assessments, communication logs, and provider policies/procedures on request

11. Affirm your understanding of billing hours and time rounding requirements for the contract Agency Organization

1. State the name and position of any staff who will perform work under the contract including the staff person who will have ultimate responsibility for the contract if the applicant is successful.

2. State the names of the authorized signer and witness and include their title and email address.

3. Describe your recruitment, training and supervision processes.

a. How will you manage staff hiring and volunteers, background checks, and suspension/disbarment checks?

b. How will you ensure services are not provided to an individual with a formal or informal role within your organization?

c. How will you maintain personnel records including components required under the contract?

d. Describe your process for considering a hire with a criminal or child abuse background reported?

4. Describe your program components.

a. What are your hours of operations?

b. Where will your staff be located?

c. What staff will be available to assist with this contract? Please be specific in regards to number and job position(s).

5. What is your record retention policy, what is contained in a typical record, and do you keep paper and/or electronic records?

6. Describe your TB testing processing for new hires including screening tools and written policy regarding failure to complete TB testing

7. Describe your internal policies for confidentiality, sexual harassment, and progressive discipline.

8. Submit as an attachment - an organizational chart, clearly indicating lines of authority among all positions and full time or part time designation.

9. Submit as an attachment - a copy of job descriptions for all positions to be covered under this contract, stating skills, qualifications, training and experience required, and listing the duties and activities of the position.

Communication, Fiscal, Cost Proposal/Budget, Invoicing, and Data Reporting

1. Describe how your agency will utilize encryption services for all electronic communications noting personally identifiable information.

2. Describe how your agency will ensure a program invoice, supplied by OAS indicating actual costs for services, is provided by the 15th of the month following service.

3. Describe how your agency will ensure required data and unusual incidents are entered into the Montgomery County HHS Portal no later than 30 days after the end of the service period for required data and 24 hours for unusual incident reports

4. Describe procedures to be followed to ensure accurate and timely reporting and invoicing to the county. The county will supply the invoice format.

a. Include drawing down other funding sources as a priority to offset expenses prior to the use of county funding (if applicable)

b. Include accounting process to manage separation of funds for each contracted service (if applicable)

c. Include data collection processes to mitigate the risk of duplicate reporting.

5. Describe how your agency will track and annually report the KPIs noted in the contract.

6. Describe how your agency will meet data requirements, maintain confidentiality, manage data breaches, and handle sensitive information. Describe your plan for compliance if needed.

7. Submit as an attachment – Agency Profile and Contact Sheet

8. Submit as an attachment – Price Certification Form for In-Home Services

9. Submit as an attachment – most recently available audit report and/or annual report with breakdown of revenue sources and budgets

10. Submit as an attachment – current certificate of liability and worker’s compensation insurance listing the Office of Aging Services List of Attachments to be Submitted

1. Organizational Chart

2. Job Descriptions

3. Agency Profile and Contract Sheet

4. Price Certification Form for In-Home Services

5. Most recent audit report, Yellow Book audit required if recipient of $750,000 or more in Federal Funding per Generally Accepted Governmental Auditing Standards.

a. If a Yellow Book audit is not applicable, the most recently available Annual Financial Audit, including breakdowns of revenue sources, expenditures and budgets, is required.

6. Current Certificate of Insurance Coverage (Liability and Worker’s Compensation) listing Montgomery County Office of Aging Services, PO Box 311, Norristown, PA 19404-0311 as a holder.

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