STATE OF WASHINGTON

DEPARTMENT OF SOCIAL AND HEALTH SERVICES

Aging and Long-Term Support Administration

Home and Community Services Division

PO Box 45600, Olympia, WA 98504-5600

H16-071 – Procedure

August 8, 2016

AMENDED December 28, 2016

TO: / Area Agency on Aging (AAA) Directors
FROM: / Bea Rector, Director, Home and Community Services Division
Chanh Ly, Director, Management Services Division
SUBJECT: /
SFY17 State/Federal Interlocal Agreement
Purpose: / To notify Area Agencies on Aging (AAA) of their allotments, supplemental reporting forms, final interlocal agreement language, budget forms, and instructions for State Fiscal Year (SFY) 2017.
Background: / AAA allotments were not known in time to request line item budgets for July 1, 2016. In order to have contracts in place for SFY17, ALTSA sent out maximum consideration contracts based on 100% of AAA SFY17 funding. AAA’s will be required to submit line item budgets by October 31, 2016.
What’s new, changed, or
Clarified: / This MB was amended to update the Title V SCSEP minimum expenditure requirement for Earnings, Wages and Fringe Benefits.
Specific funding information is as follows:
·  Case Management/Nursing Services (CM/NS) SFY17 unit rates increased due to higher salary standards for new positions created by caseload growth in the legislative budget metric.
·  In consultation with a Washington Association of AAA (W4A) workgroup, SFY17 staffing ratios are changing from the previous case handling ratio, which included case managers, case aides, and RNs, to a new clinical ratio which only includes case managers and RNs. Each AAA will start by maintaining or improving their June 2016 ratio. February clinical ratios are noted on the attached budget worksheet as a ballpark figure. Actual clinical ratios will be added to State/Fed contract with the first amendment after those numbers are known. Case handling FTE will still be captured on the billing worksheet to understand staffing patterns and trends. Case handling ratios will be automatically calculated, however, they only apply to AAAs who are buying down their caseload ratios.
·  Expected ratio of Supervisors to case handling staff is 1:10.
o  Information on how the staffing ratios are defined and calculated is provided in the attached document entitled “AAA Case Management Program Ratio and FTE Clarifications.”
o  The DSHS Allocated TXIX/Chore BARS Support Form and supporting documents must be submitted electronically each month.
o  The formula used to determine the Staff to Client Ratio adjustment for clinical staff to client ratio that exceeds the June baseline will be calculated as follows: There will be no deduction the first month the client ratio exceeds the baseline. On the second occurrence, a .3 factor will be used to reduce payment. After the second occurrence, the factor within the formula that determines the amount of deduction taken will increase from .3 to .6 and will remain at .6 for any month when the ratio is missed for the remainder of the contract period.
o  Additional TXIX matching funding available to grandfathered AAAs will be increased based on the historical inflation factors of the past decade applied to the original grandfathered amount. The amount of SCSA may not be increased. Grandfathered AAAs may make up the difference with local match if they wish. Any additional local match used to draw down federal match over the new grandfathered level will need to buy down the case handling to client ratio.
o  Any AAA may spend qualifying local funds in TXIX to bring down federal matching funds. Case ratio buy down will only be required on the federal portion.
·  Core Service Contract Management (CSCM) will be billed using the same in-home caseload as Case Management/Nursing Services.
·  DDA and HCS-Contracted Nursing Services will continue to be reimbursed on a cost reimbursement basis.
·  Title V SCSEP funding is based on participant slots assigned to each county. A maximum of 12.1% can be spent on administration. A minimum of 75% must be spent on Earnings, Wages, and Fringe Benefits (EWFB). The grant application waiver request to spend a minimum of 65% on EWFB was not approved.
·  The State Family Caregiver Support Program (SFCSP) funding level remains the same and $50,000 is kept at ALTSA for Virtual Private Network (VPN) access and statewide training.
·  Kinship Caregiver Support Program (KCSP), KCSP funding is allocated based on the 2008-2012 American Community Survey (ACS) 5-Year Estimate provided by the US Census Bureau. The ACS 5-Year estimate reports the number of grandparents responsible for their own grandchildren under age 18 in each Planning and Service Area (PSA). Funding is provided with a minimum of $10,000 allocated to each PSA. ACS information can be found at http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml
·  Senior Farmers Market Nutrition Program (SFMNP) The state funding level remains the same as SFY16. Unspent FFY16 funding from SFY16 contracts will be added to SFY17 contracts in a separate amendment once the carryover is known, and must be spent by 9/30/16.
The following changes were made to the state/federal BARS forms:
·  TXIX
o  Case Handling Staff tab will be completed the same as SFY16, but the formula will display a clinical staff ratio on the Staff/Client Ratio Adjustment tab, as well as a Case Handling ratio for informational purposes and for buying down caseload with additional federal funds matched with local funds.
o  AAAs are no longer required to report nursing capacity.
o  Each AAA will have a unique required Clinical Staff to Client Ratio that will be equal to their June 2016 Clinical Staff to Client Ratio. This must be reported on the Staff ClientRatioAd tab of the TXIX billing form.
o  AAAs must include the number of times during the fiscal year the required ratio was exceeded on the StaffClientRatioAd tab. A formula on this tab will select the factor to use in calculating the amount of ratio adjustment taken against the reimbursement based on the AAAs reported number of times exceeding the required ratio.
·  Family Caregiver Support Program line items were changed to eliminate the annual FCSP fiscal report, increase accuracy of NAPIS reporting and determine costs for paid services.
o  Information Services was added as a separate budget line item.
o  Access Assistance was separated from Access and Support Services and combined with Assessment and Coordination to include 1:1 contacts, assists, screenings, and assessment/coordination/care planning activities.
o  Support Services was separated from Access and Support Services to include counseling (mental health), trainings/consultation, and support groups.
o  Respite Care Services and Supplemental Services remain as separate line items.
o  Services to Grandparents/Relatives remain the same. The annual federal fiscal report to reflect the breakdown of these funds by service type will continue to be required.
o  Memory Care and Wellness Services remain the same.
o  A FCSP Service Line Crosswalk is provided as an attachment to this MB.
A template has been developed for AAAs to report their cumulative TXIX Medicaid fund balance for TXIX CM/NS and CSCM that must be submitted to ALTSA annually.
Changes made to the ALTSA/AAA State/Federal Agreement language are detailed on the attachment “SFY17 Contract Language Changes.”
ACTION: / Submit State/Federal line item budgets, FTE worksheets and Core Services Contract Management Supplemental Worksheet to Anna Glaas and your AAA Specialist by October 31, 2016.
Submit the TXIX Fund Balance Report to ALTSA 45 days from the AAA’s fiscal year-end close. The report template is attached.
ATTACHMENT(S): /
1. SFY17 Contract Language Changes

/ 2.  SFY17 State/Fed Statement of Work
/ 3.  SFY17 AAA Case Management Program Ratio and FTE Clarifications

4.  SFY17 Initial Funding
/ 5.  SFY17 CM/NS and CSCM Revenue
/ 6.  SFY17 State/Fed Budget Instructions

7.  SFY17 State/Fed Budget form
/ 8.  SFY17 CSCM Supplemental Worksheet
/ 9.  TXIX Fund Balance Report

10.  SFY17 TXIX Billing Form
/ 11.  SFY17 SFCSP Billing Form
/ 12.  FCSP Service Line Crosswalk

CONTACT(S): / Direct general questions or questions regarding caseload, unit method, or Interlocal Agreement to your AAA Specialist:
Andrea Meewes Sanchez, AAA Unit Manager
(360) 725-2554

Dana Allard-Webb, AAA Specialist
(360) 725-2552

Susan Shepherd, AAA Specialist
(360) 725-2418

Marcy Goodman, AAA Specialist
(360) 725-2446

Paula Renz, AAA Specialist
(360) 725-2560

Fiscal Questions:
Anna Glaas, AAA Grants Unit Supervisor
(360) 725-2374

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