HomeMy WebLinkAboutCo. Mgr. - Home and Community Care Block Grant for Older Adults a
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DOA -730
(Rev. NOD)
Home and Community Bak Grant for Older Adult ,
1 County Funding Plan
1 •
I '
;.Illentification of Agency Dr Le4d RetspoilsNity for Cow Funding Plan
.County .0 rang a July 1,2002 through AMC 30,2003
'The,
any or owe with lead responsibility for planning and coordinating the Cpunty
:Fund*Plan recommends this bailing plan to the Board of Commissioners as a
.!coordinate4 means to ut -mod TESOUrCeS in the d&ice.of compreh ive
aging services to older is and their families,
I
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Oar§h County Manager's Office
I (Name of agencytoffice with lead rekponsibility
. iv
. . . . firi....::.: rr
f . *,/o_
A d a rim 1.13 I •lure (date)
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John Link, Jr. , anager
(Typt name and title of sipatory agent)
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Home and Community Care Block Grant for Okier Adults
County _ Ornge
County Funding F Ln July "J, 2002 through h J u i 3
Cowl,/Services Summary
! Pr J c cd Pro� l tt I FrQ jec bed Projected
!
Block Grant Furclin_ Required uired . Net ! USDA Total HCC BG Fie Ir'ibur r I! C EI G 1 of I
-MIC 5 Acces5 In-Hip rye• lather Total Local Match Service e Cost . Su L s iciy Furdi + Units. Rate I Iin k Units
i
nigregate 1 71€ \\\'\W \\\ 11 524 11 5240 ' 20016 1352E46 E 3.44 • 11,150 35
5e A si 5ta t 43283 "\ \ \\\ 4O3 43Cr92 ' ao92+ o92 l Oa I Id l 35 1000.
ii r r tin .73394 \\\\\\ \\V%. B155 81 549 : 81 549 20000 3.67 150 23087
LIcir Center 56777 V,,\\\\\\�\\\ 6309 6 3 63086 87 310 rin ! 2600 87 310
HQre-II 67 \\\\\\\ A\ 7500 75 75000 5000 13.5 : 3.0 b134
Horne-III L I.34.9 44%\ \•k 4ti\\.\. \ 1 261 1 2610 I 12610 'SIM 15.5 5 1 500
.It Dad Health rare 905-4 \\\ \\\4..\\,..,,...\\\VO 1 006 1.00510 L0060 902 30 I 4 2500
1c. e -Aid 3n12.a 3282 37759 37759 3282 10 10 2282
\\."..10.....W...\\", 0 g , 0
--- • I -• ----
\or \%\\•y\\ CI 0 • 0
\1\\i \\ \\\ 0 0 0 '•
•
• \‘'...N.\\'AV,\'‘. 0 0 0 :
\‘'...\\\\,..,..\\\ 0 0 0
I
Total 116677 87903 194 421 39r9001 44333 x1423916 16 4lE 412 1512 \\ V 3534 159259
IIICI . / C/S/10 Z ,
I
/6 Signature, Thai Erin a !ICIZI CO I . ss irnrs Date
ice
Lin
.. ADI)E lid . Home and Comm nay Ogre Black Cr-out fat OJT Ad u lt5. .
.fl.. l' .1l•;1 V T 1 ROV1I)W DOA-732(Hey-ICI -
r Coun ty D55 County Fell pig Plan Criu n ly Orange
.99 Tryca.Street July 1,20112 through June 11).20 3
Dr u+,..1.0., NC 27278 Provider Serve ices $urnrri pry
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C D E. i 1(._; I] I I
+er. 1.el.rve Projtcled Projected. Projected Frojec Leis
I]iei aruir Nark Gtant Tundi , Required Nat* USDA Teta HICCIX: im}unc HOCK; Tut2 I
es Dual EMI Ai':e hi-1 lcr 1'u-till Loral Match u Cost Suteid Fund. c. Unit; late Cli E IJ rt:ts
•uc Aid. • \\ \h 1' \ 32132 37759 37759 3 10 •IIs 3215.'2
• 0 0 C)
. Mil .
IN&M 0 U 0
INIM \\WO,‘\\\' 11J 0 _ . 1C1 ,
NM • \ . 0 il - 0 - i
MINNIE • \\\\VI 0 0 13 ME
\•\.' • !\ \ 0 '' 0 li
• MN . ' • 'I. 111.1;\A\ 0 .1) 13 .
�.\\\%.\\)A\ 0 0
. II. \\\\\\\\L„\ 01 1 (1 •
\''...\\\\ II 13 111
Total IMEN ii IM 0 0 EMU
it pay Car &Aclult Tay I lealth.Care NeServicv Gust '
ALJC ATiI-n •
C;Lre Certification of required minimu rr.local match d u i-i d ability. i/'•._ i /2//S2 r i r!, 002 .
aorta l uireJ local match will be E.X pcndcd turtu[i aeus[y Author ki Sicri FA 11 rer Title Da(i
i liStr tiwe With B X Crank Funding ' _' Sen..ice Provider ,1/4 j
ier.Cost Tot;L . - '
4,3 e., r Co.) %i illat Date. .
County Flaw�x�Officer ��� Si� itiatu re*�•l�iirm
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DOA-733
(Rev_ 3/00)
Home arid Community Care Block Grant for Older Adults
County Funding Flan
Methodokw to Addy s Service Needs of Low-Income Minority Elderly ,
(Older funericans Act, Section 3 Oo(a)(5) A ii))
Community Service Provides -- . Orange County Dept_ of Soci al Services
County . ran c July 1, 2002 through June 30, 2003
The Older Americans Act requires that the service provider attempt to provide services to
10W-111001=raiLiCority individuals in accordance to their aced for aging services. The
community sendc a provide hall &pecify how the service ii cds of low-income minority
eldorly will be met through the services identified en the Provider Services Summary
(DOA-732). This narrative shall address outreach and service delivery methodologies
that will Ensure that this target population is adequately served and conform with specific
objectives established by the J.Asea Agency on Aging, for providing deer to low
income minority individuals. Additional pages may he used as necessary,
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• DOA-734
(revised 1/99)
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July 1, 2002 through June 30, 2003
Home and Community Care Brock Grant ror Older Adults
Community Service Provider
• Standard Assurance
County et Social Services agrees to provide services through the Home and
(Name of Provider)
Community Care Block Grit, as specified on the ProviOer Services. Su (DOA-732)
in acaordarice with the following:
1. ervic-es shall he provided in accordarue with requirements set forth in:
• a) The County Finding Plan;
l The Division of Aging Home and Community Care Block Grant Procedures
Manual for Community Service Providers; and
0 The Division of Aging Services .Standards Manual, Volumes I through IV,
Community service rov idlers shall monitor any contracts with providers of Block
Grant services and take appropriate measures to =sure that services we provided in
accordance with the aforementioned document-s.
2. Priority shall be iven to providing services to those older persons with are greatest
economic or social needs, with particular attention to low-incoube minority
individuals. The service needs of low-income minority elderly will be addressed in
the mariner specified on the do10 to Address Service Nccds of Low-Income
Minority Elderly format (DOA-733.).
The following iervipe authorization activities will be carried out in conjunction with
all services provided through the Block Grant:
a) Eligibility determination;
b: Client intake/registration;
c) Client assessment/reassessments and assessment/reassess quarterly visits, as appropriate;
d: Deiermining the amount of spices to he received by the client; and
e) Reviewing cost sharing/voluntary.contributions 1iries with eligible clients.
4. Ail licenses, permits, bonds, and insurance necessary for ding out Block Grant
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DOA-734
(revised 1/
Services will be maintained by the community senice provider and any contracted
providers.
5. As Specified in 45 CFR 91.360h 01), cornmunity service providers shall have
procedures for settling all contractual and administrative issues arising out of
procurement of services through the Block Grant_ Community 8ervice providers
shall have procedures governing the evaluarion of bids for services and procedures
through which bidders and contracted. provider may appeal or dispute a decision
made by the community service provider.
6. Applicant/Client appeals ghat' be addressed as ,specified in Section 7 of the Division
of Aging Home and Community Care Block Grant Manual for Community Service
Providers, dated February 17, 1997.
7, Community spice providers are responsible for providing or arranging for tw w
provision of required loc.a1 match, as specified on the Provider Services Summary,
(DOA-742). Local match sal be expended simultaneously with Block Grant
funding.
8. Providers expending $300, or more in federal fi nunuial asNistance through the
Home and. Community Care Block Grant, or in ti amhination with other federal
n.d ing shall receive an annual independent audit which meets the requirements of
the Division of Aging program Audit Guide for Aging Services, applicable North
Carolina General Statutes and Local Government Commission requirements, and
OMB Circular A-133. For-profit community sere ice providers shall have an annual
compliance audit which meets the requirements of A-133_ The audit shall be
performed within nine (9) months of the close of the provider's fiscal year. Upon
completion of the audit, non-profit and for-profit providers shall provide a copy of
the audit report and any opinion letter 'simultaneously to the County and the Area
Age, Federal funds will rot reimburse the cost of a single audit if the total (]f all
federal finds expended by the provider is less than $300,000
9. Compliance with dial Employment Opportunity and roans With Disabilities
Act requirements, as specified in paragraph fourteen 0 4) of the Agreernent for the
Provision of County Aging-Based Services (DOA-735) shall be maintained.
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DOA-734
(revised 1199)
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• 10. Providers In-Morrie Aide, Home Health, Housing and Home Improvement a and
Adult Day Care or Adult Day Health Care shall in and return the attached
assurance to the area agency on aging indicating that recipients of thm services
have been owed of their client rights, required in Section 314 of the 1 992
Amendments to the Older Americans Act.
-------- elr -----t1311t-fi ,_44.._4.41..,?.
(Authorized i re) (Date)
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Standard Assurance to Comply with Older America.na Act
Requirements Regarding Client Rights
for
Agencies Providing In-Home Services through the
• Home and Community Care Block Grant for Okkr Adults
As a provider of one or more of the a services fisted steel below, our agency agrees to notify all
Home a rid Community Care Block Grant clients receiving any of the below listed services
provided by this agency of the their rights as a service recipient. Services included In this
assn rant include:
-In-Home Aide •
-Horne Care (home health)
-Housing and Home. Improvement
-Adult Day Care or Ad uJt Day H ea Lth Care
Notification will include. at a minimum, an oral review of the information outlined below as weIJ
as providing each service recipient with a copy of the information in written form. In addition,
providers of in-home services will establish a procedure to document that client rights
information has been discussed with in-home services clients (eg. copy of signed Client Bill
of Rights statement).
Client Rights information to be communicated to service recipients will include, at a minimum,
the right to;
-be fui y Informed, i n advance. about each in-home
service to be provided a rtc any change in service(s)
that may affect the well-being of the participate;
-participate in planning and changing any in-horse servioe
provided unless the client is adjudicated incompetent;
-voice a grievance with respect pe to service that is or fails
to be provided, without di scri r i nation or reprisal as a
result of voicing a grievance;
• -confidentiality of records relating to the individual;
have property treated with respect; and
be fully informed both orally and in 'writing, in advance
of receiving an in-home service, of the individual's rights and obligations.
Client R ig h ill be distributed to, and discussed with, each 'new client receiving one or more
of the above listed se Ices prior to the on-set of service. For all existing clients, the above
information will be provided no later than the next regularly scheduled service reassessment.
Agency Name . r i o.t i-- T --_1 r-___.L•__---
Name of Agency Administrator: irVICALI ers MAI
----- ---_-TY_iLl.L 1.
Signature: All. 40L,fr � ifiktiaDate: _ ./ 6 ---
(Please return this f.., to your Area Agency on Aging and r lei n copy for your files.)
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Block Grant far Cider Ali$
1 ,1C aaa�� `_ _ —----- FIB rr�rrrur7i �r --- - _ _.. __.
▪rainCounty ae Ion _ — ___ Co+uTty Funding Plan -- -• •----- _.. .Cour--•
, l .14F0 UG,acia .
.1:P 0 Box 8181 _L • . .____ Julitlr rinsioarough,INC a _ __ Provider sr Summa r -- -- - — -
_ __—:- f fa4e Rjld Rrcij,eGlEd RrJod
" rhea One) I H i�i��r��- Fi Tit
. real Fund rig Re. i rEid i I is USDA T _ _
fir~
• ,; I Purd Aceaa Iri•-I a Otter T�taI Focal hutch l r�r t Buddy Fundi.9 I Urlg5 Fah G1[er -- ___
?, _ 1111.1.1.1.11.111n. 8.'1 5 81,549y �, O $ 3•67 166 2'
Tres �1a�� � `. ,
I I.!fl_-I-lDm 56,777 11111.11M•W� 6. 03,ci V7,310 n0 .600 87.310
e I I :i • 137,51[10 ' 11ltitii L11.1 L _ i '
- _ - �L I � • • 1.261 • 12.11t $_ 13_513 •5 1, o_
1��larra�III x �1� - ,
',krdill I uIIFi Care _ < �_ # Witt�.i��i 1,uiL 1o. eo 3 $ a ,ODT 4; �,5aci
7!+tal ' wi'Ik1I1 VaioNina 116.677 . 81,903 56,777 _ 251,3 i 2044 . I 2 g E'.3 7 114,452 liVISLILIMIL_ 2,924 12E1,591
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mu k 024 Care and Mutt .' '-- - --�- - _ ..
D I-Io C &POW COaI __ _ _ I - -- _
A ' ADI-1C Garimalan€1 rt�r L minimum!�l i dn■uriat . . Arr f ,,. f* I el
•- .02O . .Required kiwi rr o will be PNFaFLOC' XIll _ - * ..11121.11V.Ti'IIa 4•
TrIlllepallatiOn 10 tI HI _ Zvi mica f~ ! r
Adiiilrilsk i 63,5 — •_ '•
New r.Coal Thal 11113,645 ' _ -- _.. mm r _.:!,131...9,on -. FluaricE CHTRivi' Dole ,S7onilt.re,C ,..• -As cin,
• - '' •; F c rr�a r r i.ARi 9rE LU h ,
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NJ
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4 13
DOA-7n
(Rev. MD
Home un d Community Care Black Grant for Older Adults
County Fading Plan
Methodology to Address Service Needs of Low-Income Minority Elderly
(Older Americans Act, Section 3 (a)(5)(AXii)
Community Service PrO'i ' Orange County Depariment on Aging
I
County: Orangc Lily 1, 2002 through Jame 30,2003 1
The Older Am ri.cians Act requires that the service provider attempt to provide services to
low-income minority individuals in accorc.ance to their need for aging services. The
community service Kovider shail specify-how the service needs of low-income minority
elderly and rural elderly will he met through the services identified on the Provider
Services Summary OA-732) This narrative shall address outreach and service
delivery methodokties that will pure that this target population.is adequately steed
and confurrm with specific objectives establish.W establish. by the Area Agency on Aging, for
providing services to low income minority individuals, Additional pages may be used as
necessary.
The Orange County Department on Aging,while providing services to any County
resident sixty years and oiler, makia special efforts to reach those individuals who are
low-income minority and.rural elderly. The Deparirrient accom.plishes this accomplish through the
following methods:
• Coordinate services through the four J A-op tcd similar.mcal situ providing
facility space and access services in these locations. Fixed troop route are
operated far those who reside outside the municipal bus service area, The
Information Specialist makes monthly vii Ls to each.oi-the meal it to remind
participants of the spices availabLe and assist individuals in accessing resources to
meet their needs.
▪ Provide low and no-cud programs and activities at each of the three senior centers,
with scholarships available for those activitie.s that have a fee attached. Thme
offerings are advised in the free departmental bi-monthly publication,the Senior ' •
Times.. The Senior Times is distributed at the eerite�, mailed to lc participants*
homes, and era in the S tm y edition of the Chapel Hill Herald with a
distribution of approximately 25,000 households in Orange County.
• Work closely with tide D a tmcnt o Social to a that in-borne and
L respite care s c targets to those low-i rt individuals who
could benefit.
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4
17 Maki rimientations to church pups in mrai Orange County to inform residents of
senices for seniors and to promote volunteerism through the Friend-to-Friend
Program, .
• use UNC-CE &iuderits hi provide ouch to targcted nei boThood , which affords
students the opportunity to gain valuable experience in community outreach while
maximizing outmach funding. •
Continue the extensive publicity camper to make age County senior citizens
aware that all atilt rrsourcc ayailabl9 to them regardless of the geographic
location. This includ &distributing Eldercare unity Resource Guides to r
civic end church pup. Rev.
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DOA-734
(revised 1/99)
July 1, 2002 through June 30, 2003
How and Community Care Block Grit ror Older Adams
Cony She Provider
Standard Assurances
,! Pi;.. ., . .3 _ 1 . agrees to provide i through the Home and
(• anic 0' wider)
Community Care Btu Grant, as specified on the Provider dices Summary (DOA-732)
in accordance with the knowing:.
1. Services shall be provided in accordance with requiremerits set forth in:
•
a) Tbe County Funding Plan; •
b) The Division of Aging Home and Conaramity Care Block Grp Prooedures
Manual for Community Service Providers; iarid
c) The Division of Aug Services Standards Manua], Volumes i through 1V.
Commuoity service providers shall monitor any contracts with providers of Block
Grant services e appropriate mires to ensure that services are provided in
accordauce with the aforementioned documents_
2. Priority ll be given to providing services to those older persons with the greatest
nornic or vial needs, with particular attention to low-income minority
'individuals_ The Scrvi ce needs of low-income minority elderly win be addressed in
the specifieti on the Methodology to Addr.eis,s. er vi s. of Low-Income
El_frilerl 'fu t, (DOA133)+
3. The following service authorization activities will be carried out in conjwaction with
all services provided through the Btu Grant:
a) Eligibility determination;
b) Client in.t e!regiscration;
e) Client assessment/reassessments and quarterl visits, as app i ice;
d) Determining the amount of vices to be received by the olio: and
e) Reviewing cost sbaringivoluntary contributions policies with eligible clients.
4. All licenseq nen-rnitis Fr nfi R An c1 inu rr. r r n cuirii ' r r~ornrinn nut R i I r m
DOA-734
' 1/99)
W. Providers In-Home Aide, Home Health, Housing and Home Improvement, and
Adult Day Care or Adult Day Huth Care shall sign and return the attached
assurance to the area any on aging indicating that Tee:Vents of these services
have been informed of their client rights, T in lion 314 of the 1992
Amendments to the O1dr Americans Act
1611M r.a- •• cm:11" k 0 ti
I (Authorized Signature) (Date .
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Standard Msurarice To Comply with Older Americans Act
. Requiremenis Regarding Clients Rights
For
Agencies Providing In-Horne Services through the
Home and Community r e Block Grant for Older Adults
•
As a provider of one or more of the services Ited below, our agency to notify all Rome
and Community are Block Grant clients receiving any of the below listed services provided by
this agency of their rights as a service recipient. Services in this assurance include:
• Ffli-io Aide
▪ Home Care (home h ea Rh) •
a Housing and Home improvement
• Adult Day Care or Adult Day Hearth Care
•
Notification will incfucje, at a minimum, an oral review of the information ation i rigid below as well
as providing each service recipient with a copy of the information in written form. In addition,
providers of in-home services will establish a procedure to document that client rights
information has been discussed wi
th in-home services clients (e.g. copy of signed Client Bill of
Rights statement).
Clients Rights information to be comniunicoted to service recipients will include, at a minimum,
the right :
• be fairy informed. in advance, about each in-home service to be provided end any
change and any change in service(s) that may affect the wellbeing of the participant;
S parficipate in planning and changing any in,home service provided unless the client is
adjudicated incompetent;
• voice a grievance witi respect to service that is or fails to be provided, without
discrimination or reprisal as a result of voicing a grievance;
evance;
• confrdentiality of records relating to the individual;
• - have propel treated livith respect; and
a be fully informed both orally and in wring, in fiance of receiving an in-home
sentice, of the individual's rights and obligations.
Client Rights will be clistnbuted to, and discussed with, each new client mceiving one or more of
the above listed services prior to the onset of service. For all existing clients* the above
information Il be provided no later than the next regularly scheduled service reassessment.
Agency Name;., L. k * i I .t.
_---
Name Of Agency Administrator
Signature- iaillik.: - ' . Ds
(Please return t . i a your Area Agency on Aging and retain a copy for your files.)
E AND ADI1ESS H r and ConmuoI -
.Cu m I310A Grunt fur L Adults
•C1II7i SI= CI IRDVIDEI
•Chatham"CAffikirrunitx Actium.Inc- Cnwinty Funding FlaiL Olin 15' Dram _
J.ly I..,,202 ih m ath June la,IOW
x
oro ! C 27312 Provider S.rviuw 5' 'y
r
r .E r H I
L }l2ci d Projected ProjecL€d Prcijected
Ora} Block Gr;rtit Pnn l l Required NIL' USIA ToihI 1-1CCI3G Reimburse I-IC • Told
ilirectintiL Access In-Finme 0 LInffr _Lo I Local Ivlakh! Sew Cost Eu dy [alibiing Units gate clients Lirits
(forvegate
lion
• 1C131216 \\\ \ 111.524 11 . 2.0016 ] 335 3.414 X) 35366 MEI 0 0.1.1 • -
- 0 0 ME
0 ' 0
1
. =I
• M= KIM 0 . 0 0 INE
••\! \ 1 CI . a 0
• •
\ \ .1\\\' II _ D L •
0 0 i 1M• WWI G 0 I] •
. ME 0 0 0
II MEN ID• 0 0 =.
10371 1x3716 11.524 115240 2nLItx 1 6 : \\ 600 351 Kb
Alt Day Care&At1 ift Day Health Cara Dile 15:1-Vii Cost _ demo: `
A • KC • - 11011Vallpfe-
• �C rdli kicn of r q minimum'LEI match alai Iabi[it)• ]1!
y Cale
moo,iatn -
Roitured Iric.L match will �ded ci1Ib1�1 LIeowly I died . ture. 1p at .
with Block Grain flintling. Coo r' •-t-Senrite Provider v. \ ,
5er.Cog. 'TowL r 14942 _
—Adirgior 91'6 1-
_ r
Si patnu-�,C'ollnity Finaacenflirrer
Date � ' i ers pat,:
-willigra - -.I.
al
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_ DOA-733
(Rev. 1 r 99)
IHome and Community Block Grant for Older Adults
County Funding Dian
Methodology gy to Address Service Needy of 1,nw-Income Minority Elderly
(Older Americans pct, Section 306(21)()(AXi!)
Community srMico Provider: Joint Orange-Cl at am Community Action
I
County; Oningc My 1, 2002 t trcush Tunic 10,2003
The Older Americans AAA squirt*th u t trial the Service priavider attempt.provide serviceo to l -
ltt me minority individuals in accordance to their need for aging setvicei. The community service
provider shall upecify how the s.rvicc new of low-ir-11CI;MW EllinOritY 1dQr1y will be and through the
se roes identified on tile Frovider Serviceg Sanani f(I )A-73 2). This n irrative shall add.ra%s
outreach arid sip methad.ologies that will ensure that this tart population is adequateky semed and
conform with ipcdi fic objectives cAtablished by[hi:Arta Agcy on Acing, tear providing icus tei
low-income minority individuals. Additio l pages maybe used as necessary.
Joint Or .use-C]iitham Community Adjoin,Inc_ (J (7A) was catablislad in. 1966 and built on a
foundation latIcitizeni participation with eonstinenb from all walks AUL.pior and rites black
white;public.and non-public. The agency is dedicated to sensing the needs of all very low and low-
i.dcotrie rats ot~Orange aLid Chatham.counties. The Agency's nlission ig"to help rills help
t se1v F'and attain a status of Emancial independence through stlf-help init ti _ JOCCA is a
vital part of tivc of thousand of very law arid low-income rus di rn and plays a salient part iri thair
everyday existence.. '1'o meet the needs of clients,JOCCA relies on the coordiumzed efforts!and
partner6hips with other 1113E13:11 EMN1G13 agcncii s,the private scctur, lo Gal govcimar. and privath
foundations
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The I u ition program Director and Nutrition Site Managers am responsible for the day-to day
supervision of the Congrogatio Nutrition Program in Coup County, In cooperative agreements
with dut Orange Coup Department on Aug,11..11C .ch l of Nursing,local Health and
Recreation Departments,Cooperthiz,Extension,North State Legal Services,Durk=Technical
C1mmuni[y Collkgea And the t{C.Division of Aging,JOCCA is able to provide but not limited
to .1.11e following *traces to its partithp is. .
. Creative Arts a1d Crafts including Gas
Nf i(.ifn,"T-iealt.Education C1assco
Assessments of Vita/Signs
preliminary.Health Scr ff-e.g.Blood Pressure and Diabetic Chad;
Lego] Service's
Adult Basic Services.( E)
Gortera Equivalency Diploma(GED)
annual May Day Fromm
Health Fay
Crime piivviontilaii'Workshops
kayo Prevention Workshops
Transportation to Congregate Nutrition Sit .
Shaming and l reational Ti rye
The Conertgate Nutrition Fromm is aiivtztised lu the Gal riemivapera.. JOCK}g
brochures also dissurninitiol dough out thu her to deliyiry area,. Annoinicoinents are
also mag U all interagency meetings about the luncheon gram.
Roferrads ft progrArrl participation arc r ived from cote EllMaart surViCe agentieg.
community residznts,1 oat community churches,civic orgardattions and current prey"
participant..
Priority errnsid&ation for service,( )will be 2ivert to older irdividuals who eumPlifY the
geatest rcciiecouQmic ;special attention will b given to Low-income titiir'ity
1.31.vidualg. Tile following iriority symt mill be util
(1) Iligliest priority will be giyon to le abasied. neglected and./or exploited and for whoa
the 2Crv1 e 15 ECCdoci EL9 identified by DS S;
(2) Individuals at risk of abusm,neglect and/or exploitation;
(3) 'Individuals who do not Svc a Gare provider or anoihcr Tesrponsible P to assist with care;
(4) Individuals who experience impairment in performance DT-daily living.
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IOCCA Km(5] Congreg5te Meal S items'located in OrangE County. In 2001 we served
34393 meals to 494 unduplicated patucipani24.. A site gager i%k aiJ at each sits and is
responsible for the daily operation nutrition program_ There is also a CSBG Cue
INetsinagc,r analanIntake S ia1iUM who are rtifi.bily reb lusiblE for tlic coordination,o
referral and provision ion of sorVICS to low-income Families and individuals. Thtse services
Include but are not limited to: Vereathenzation.,Emergency Assistance!Title V Older Worker's
Program,.and Information Reforrai
In conclusion,JOCCA relies.heavily on interagency coordination.,cooperation r s e
mobilizaii.ou.aadijr fund 1.clicraiging. During lac.Fast yam, them has b a°a mignificant increase
in the demand for vices- ecp..ia Iy frari the"workin.g per~}. In order to continue to meet
this denim', MCC A rrmnst intensify its Te$ource mobilization efrom through the solicitation
of finds from federal.staze.,local and private source;intensify utilization of vokw rs;
and uahtncr ik.fundraiking off`rart .
OA 734
(revLed 1/99)
July I., 2002 through June 3G, 2003
•
. Home and Community Care'Block. Grant for Older Adults
Community Service Provider
. Standard Assurances
Joint ha C agrees to provide spices through tho Home and
(Name of Provider) .
Community Care Block Grant! as specified un the er 1. s r (DOA-Th2)
in.accordance with the following:
I. Services shall be provided in accordacce with requirements set forth in:
a) The County Funding Plan;
1 ) The Division of Aging Home and Community Care Block Grant Procedures
ManuEl! for Community Service Providers; and
c) The Division of Aging Services Standards Manual 1 Volumes I through I
Community service providers shall monitor any contracts with providers of Block
Grant services and take appropriate measures to ensure that services at provided in
accordance with the aforementioned documents
2+ Priority ill in given to providing services to those older persons with the grerakest
economic or social mss, with particular attention to low-income minority .
individuals The service needs of iow-incume minority elderly will be addressed in
t h e manner specified on the �.) . *,.,+i 1 1 ' . Ai I I tz. y-. r . IL ilk ' 1 1 .= 4 ,*al..
Minors format. (DOA-733)
T
The following service authorization a.ctivitios will be carried out in_ conjunction with
all services provided through the Block Grant: .
a) Eligibility determination; •
b) Client intake/registration.;
c) Client assessmertherassessments and•cparterly visits, ag appropriate;
d) Determining the amount of services to be received by the client; and
e) Reviewing cost sharingivoluritary contributions policies with eligible clients.
A A11 Viriorripekin rermitg hniviA Anti insurance LILWASSarif for carrying our Block Grant
23
DOA-734
(revised 1/99)
Services will be maintained by the community service provider arid any contracted
providers_
5. As specified in 45 CFR 92.36(0(105 5 commuui service providers shall have
procedures for settling all oontractual and adminisrrative issues arising out of
procurement prockirement of services through the Block rant. Community mice providers
shall have procedures governing the evaluation of bids for services and procedures
through which hers and contracts providers may app or dispute a decision
made by the community service provider.
6. Appli t'Client appeals shall he a.ddressed FpcdfifAl in Section 7 of Division
of Aging Home and Community Care Block Drat Manual for Community Service
Providers, dated February 17, 1997.
7L Community service providers are responsible for providing Dr arranging for the
provision of required local match, as specilied on the Provider Services Summary,
(DOA732). Local match shall expended simultaneously with Block Grant
funding'
8. Providers expending $3OOXXD or more in federal Financial assistance through the
Home and Community Care Block Grant, or in combination with other federal
funding shall receive an annual independent audit which meets the requirements of
the Division of Aging Program Audit Guide for Aging Services, applicable North
Carolina General Statutes and Local Goverment Commission requirements. and
0 Circular A-133. Forprofir community service providers shill have an Dual
compliance ire audit which trieets the requirements of A-133. The audit shall be
performed within nine (9) months of the close of the provider's fiscal year. Upon
completion of the audit, non-profit and for-profit providers shall provide a copy of
the audit report and any opinion letter simultaneously to the County and the Area
Agency+ Federal Funds will not reimburse the cost of a single audit if the total of all
federal funds expended by the provider is less than $300'
9. Compliance with Equal Employment Op rtuniiy and Americans With Disabilities
Act requirement, as ponied in paragraph fourteen (14) of the Agreement for the
I is ' '11 6 6 I j ' r.1.1-��:_ 1/21 . ' (DOA-735) shall be maintained.
_ 21
DOA-734
(reiised 1/99)
•
•
to. Providers In-Home Aide, Home Health,.Housing and Home Improvement, and
Adult Day Care or Adult Day Huth Care i sign amid return the attached
assurance to the area agcy on aging indicating that.recipiems of these services'
have bcon informed of their client ri.' iS. as required in Section 314 of the 1992
Amendments to the Oder Americans Act
' ) . L 1 *IMP— . ,—)1 e. 6 -4_____.
....—. ks. ,,, ...zcalik, .~~ (AIILbOTiZetI Sigature) ( 3 )
•
•
•
•
•
•
25
Standard Assurance To Comply Older Americans Act
Requirements Regarding ng C i ients Rights
For
Agencies Providing In-Home Services through the
Home and Community Care Block Grant for+Older Adult;
;
As a provider of one or more of the services listed below, our agency agrees to notify all Home
and Community Care Btu Grant dents receiving any of the below listed services provided
lii this agency of their rights as a service recipienL Services in this assurance include:
• I n-H Akie
• Horne Care (home health)
• Houág and Home Improvement
• Adult Day Care Of Adult Day Health Care
Notification will include, at a minimum, an oral' review of the information outlined hem as well
as providing each service recipient with a copy of the information i n written form. .in addition,
providers of in-hole services will establish a procedure to document that client y hts
■ with in-home J
information has been discussed n-h o services clients (eg. copy of signed Client Bill of
Rights statenienty
Clients Rights information tc be communicated to service recipients Mil include, at a minimum,
the right to:
•
• be fatly informed, in advance; about each in-ham service to be provided and any
change and any change in service(s) that may affect the wellbeing of the participant;
• particip:dte in planning and changing any En.home service provided unless the client is
adjudicated incompetent;
▪ voice a grievance with respect lc service that is or fails to be provided,without
discrimination or reprisal as a result of Voicing a grievance;
• confidentiality of reoords relating to the individual;
• have proms treated with respect; and
• be fully informed both orally and in Ong, in advance of receiving an in-home
service! of the individual's fights and obligations_
Client Rights will be distributed to, and discussed with, each new client receiving one or more of
the above lid service prior to the onset service. For all exi ling clients, the above
information will be provided nil later than the next regularly scheduled service massessment.
Agency Na . , & a 4 • i,_:i _ L rn imn . &y A -& 0 rl, In
Name of gency mi nistr or: 5.0
_.
Signature. � ,.. a_a 1.4 , : exic
I . # L LA _. Daie2/ki.y. 2-
ir
(Reese return this form to your Area Agency on Aging and retain a copy for your files,)