WESTCHESTER COUNTY DEPARTMENT OF … 12, 2004 · Andrew J. Spano County Executive Department of...

Andrew J. Spano County Executive

Department of Social Services

Kevin P. Mahon Commissioner

WESTCHESTER COUNTY DEPARTMENT OF SOCIAL SERVICES

REQUEST FOR PROPOSALS (RFP)

FOR THE PROVISION OF CONSUMER DIRECTED PERSONAL ASSISTANCE PROGRAM

SERVICES (“CDPAP”) TO MEDICAL ASSISTANT RECIPIENTS

PROPOSALS WILL BE ACCEPTED UNTIL 5:00 P.M. NOVEMBER 12, 2004

Address proposals to:

Pamela Kiley Hoag Program Specialist/Contracts Management

Department of Social Services 112 East Post Road, 6th floor

White Plains, New York 10601

W

TABLE OF CONTENTS PAGE 1. INTRODUCTION AND SCHEDULE 1.1. RFP Availability and Dissemination 4 1.2. Informational Meeting 4 1.3. Questions and Inquiries 4 1.4. Proposal Requirements 4-5 2. PROGRAM BACKGROUND 2.1. General Background 5 2.2. History of the Consumer Directed Personal Assistance Program (“CDPAP”) 5 2.3. Applicable Laws, Regulations, Policies and Standards 5-6 3. PROGRAM OUTLINE 3.1. Program Participants 6 3.2. Term of Contract 6 3.3. Payment Provisions 6 4. SCOPE OF SERVICES 4.1. Vendor Agency Responsibilities 7-8 4.2. Confidentiality of Patient Records 8-9 5. DEPARTMENT RESPONSIBILITIES 9 6. CONSUMER RESPONSIBILITIES 9-10 7. PROPOSAL NARRATIVE INSTRUCTIONS 7.1. Letter of Transmittal 11 7.2. Cover Page 11 7.3. Table of Contents 11 7.4. Brief History of the Organization 11 7.5. Program Design 11-12 7.6. Budgetary and Financial Information 12 7.7. Disclosure Statement 12 8. PROPOSAL EVALUATION AND SELECTION 8.1. Organization and Capability 12-13 9. LEGAL REPRESENTATIONS AND UNDERSTANDINGS 13-16 10. CONTRACT

REQUEST FOR PROPOSALS – CDPAP 2

10.1. Terms and Conditions 16 10.2. Indemnification Insurance 16-17 10.6. Non-Collusion 17 10.7. Conflict of Interest 17 10.8. MBE/WBE 17 10.9. MacBride Principles 18 10.10. Westchester County Living Wage Incentive 18 10.11. Proposer Certification 18-19 APPENDIX “A” STANDARD INSURANCE PROVISIONS 20-21 APPENDIX “B” MBE/WBE 22-23 APPENDIX “C” MACBRIDE PRINCIPLES 24-25 APPENDIX “D” HIPAA BUSINESS ASSOCIATE 26-30 APPENDIX “E” WESTCHESTER COUNTY LIVING

WAGE INCENTIVE 31-38 APPENDIX “F” SOCIAL SERVICES LAW §365-f 39-40 APPENDIX “G” 95 LCM-102 41-44 APPENDIX “H” GIS 04 MA/010 44-46 APPENDIX “I” CERTIFICATION REGARDING

DEBARMENT AND SUSPENSION 47


1. INTRODUCTION AND SCHEDULE The Westchester County Department of Social Services (“the Department”) is requesting proposals from all public, not-for-profit, or proprietary vendors interested in providing Consumer Directed Personal Assistance Program (“CDPAP”) services to recipients of Medical Assistance in Westchester County. A Proposer may be an individual, a licensed home care services agency, a home care agency exempt from licensure, a certified home health agency or any other entity that is legally qualified under New York State law to enter into a contractual relationship with a social services district to provide services described in this part in support of the CDPAP program. The Department reserves the right to select multiple vendors based on competitive factors including, but not limited to, experience in CDPAP administration, indication of satisfactory audits and evidence of administrative supervision and oversight. ALL PROPOSERS ARE STRONGLY ADVISED TO READ CAREFULLY AND THOROUGHLY FAMILIARIZE THEMSELVES WITH EACH AND EVERY PARAGRAPH, TERM AND PROVISION OF THIS REQUEST FOR PROPOSALS. 1.1. RFP Availability and Dissemination

Copies of this Request for Proposals (“RFP”) may be obtained from Pamela Kiley Hoag, Program Specialist, Contracts Management, 112 East Post Road, 6th floor, White Plains, New York 10601, (914) 995-2261.

To ensure wider dissemination of information, proposal solicitations will be announced in The Journal News. The announcement will contain the above description and

information regarding the contact person for further information and copies of the RFP. Text of the RFP will be published on the Internet at www.westchestergov.com/RFP.

1.2. Informational Meeting

The Department will hold a meeting to answer questions regarding the RFP and to outline the criteria for the selection process on Tuesday, October 26, 2004, from 1:30 to 4:30 p.m. at 143 Grand Street, White Plains, New York, Basement Conference Rooms A, B, & C.

1.3. Questions and Inquiries

Requests for clarification of the RFP must be written and submitted to Pamela Kiley Hoag no later than 5:00 p.m. on Monday, November 1, 2004. Formal, written responses will be distributed by the County on or before Monday, November 8, 2004. No communications of any kind will be binding against the County except for formal written responses to any request for clarification.

1.4. Proposal Requirements 1.4.1. Proposals MUST be signed. Unsigned proposals will be rejected.

1.4.2. Proposers may be required to give an oral presentation to the County to clarify or elaborate on the written proposal.

1.4.3. No proposal will be accepted from nor any agreement awarded to any

proposer that is in arrears upon any debt or in default of any obligation owed to the County. Additionally, no agreement will be awarded to any


http://www.westchestergov.com/rfp

proposer that has failed to satisfactorily perform pursuant to any prior agreement with the County.

1.4.4. Five copies of each proposal must be delivered to Pamela Kiley Hoag,

112 East Post Road, 6th floor, White Plains, New York by 5:00 p.m. on Friday, November 12, 2004.

2. PROGRAM BACKGROUND 2.1. General Background New York State Department of Health (“NYSDOH”) statistics indicate that there were approximately 10,297 individuals over age 65 and approximately 19,687 individuals with

disabilities under age 65 eligible for Medical Assistance in Westchester County in March of 2004.1

The Department purchases personal care for Medicaid eligible recipients through contracts with various agencies, including one (1) Consumer Directed Personal Assistance Program (“CDPAP”). In 2003, the CDPAP was the largest provider of personal care in Westchester County servicing 10.1% of all Medicaid cases.

2.2. History of the Consumer Directed Personal Assistance Program (“CDPAP”)

Section 91 of Chapter 81 of the Laws of 1995 added Section 367-p to the Social Services Law which mandates that the local districts provide access to a consumer directed personal assistance program operated pursuant to Section 365-f of the Social Services Law. (See attached as Appendix “F” Social Services Law §365-f) “The purpose of the CDPAP is to allow chronically ill and/or physically disabled individuals receiving home care services under the Medical Assistance program greater flexibility and freedom of choice in obtaining such services while reducing administrative costs.” (See attached as Appendix “G” 95 LCM-102)

Westchester County began providing access to a CDPAP through a Memorandum of Understanding with a single vendor on May 1, 1996 and then, through a direct contract with the vendor agency, in 2003. In 2004, approximately 127 cases were serviced through this contract.

2.3. Applicable Laws, Regulations, Policies and Standards 2.3.1. Title XIX of the Social Security Act (42 U.S.C. 1396, et. seq.) enables

states to create Medical Assistance programs, which include the furnishing of personal care services to needy individuals. Funding for such programs is also authorized, requiring state contribution.

2.3.2. New York State authorizes the provision of personal care services in

Section 365-2 of Social Services Law. Applicable provisions of Section 365-2 pertaining to personal care are implemented through regulations found at 18 NYCRR 505.14.

2.3.3. To receive payment for the provision of these services, the vendor must

be enrolled in the Medical Assistance program in accordance with 18 NYCRR 504.1, et. seq.

1 New York State Department of Health Medicaid Statistics http://www.health.state.ny.us/nysdoh/medstat/el2004/mar_04_el.xls


http://www.health.state.ny.us/nysdoh/medstat/el2004/mar_04_el.xls

2.3.4. All claims for payment must be in conformity with 18 NYCRR 540.7 and applicable state and federal laws.

2.3.5. The County administers the Medical Assistance program for eligible persons as an agent of NYSDOH. In addition to requirements under the State and federal programs, compliance with all County Laws and the fulfillment of the County’s overall policy goals will be considered in evaluating the proposals.

2.3.6. Authorization for the Consumer Directed Personal Assistance Program

(“CDPAP”) is found in Social Services Law (“SSL”) Section 365-f. 2.3.7. A CDPAP aide may provide home health aide and skilled nursing

services when a registered professional nurse has determined that the individual who will instruct the CDPAP aide is self-directing and capable of providing such instruction. (Education Law section 6908(1)(A)(III).

2.3.8. Regulations governing the program are found in 10NYCRR, PART 501,

General Provisions. 2.3.9 95 LCM-102-Consumer Directed Personal Assistance Program (CDPAP)

3. PROGRAM OUTLINE

The CDPAP is a Medicaid funded home care services program that provides qualified individuals with tasks essential to the support of the patient’s maintenance in the home. The purpose of Consumer Directed Personal Assistance is to allow chronically ill and/or physically disabled individuals receiving home care services under the Medical Assistance program greater flexibility and freedom of choice in obtaining such services while minimizing the cost of service delivery. The program divides the responsibility for all aspects of service between the Local Department of Social Services (LDSS); the participating consumer; and the CDPAP provider.

3.1. Program Participants

Persons eligible for a CDPAP services will be residents of Westchester County who are eligible for Medical Assistance and have been deemed eligible for long term care services that would typically be provided by a certified home health agency, a long term home health care program or a personal care program and has been determined by the LDSS to be able and willing to make informed choices as to the type and quality of services received, with or without the assistance of a legal guardian or adult household member. Individuals participating in the CDPAP may not receive duplicative services from another program. 3.2. Term of Contract The contract will be renewed on an annual basis. In 2005 the contract term will begin on January 1, 2005 and terminate December 31, 2005. 3.3. Payment Provisions Reimbursement to the CDPAP provider will be at the rates established by the New York State Department of Health. The New York State Department of Health shall pay the CDPAP directly for services rendered. It is expressly understood and agreed that the Westchester County Department of Social Services is not responsible for any payment to the CDPAP.


4. SCOPE OF SERVICES FOR CDPAP (a) The tasks and services which may be performed pursuant to the CDPAP include, but are not limited to, all services otherwise provided by a personal care aide, a home health aide, a registered nurse or licensed practical nurse. CDPAP aides may not perform skilled services that are the purview of physical therapists, occupational therapists and speech therapists unless the aide is licensed under the appropriate Education Law provision. Required skilled therapy services must be provided through another source. However, a CDPAP aide may, under the direction of the Consumer, assist with the performance of therapy programs that a licensed therapist has planned for a CDPAP recipient.(See attached as Appendix “H”GIS 04 MA/010) (b) The tasks and services that may be performed pursuant to the CDPAP shall not include the services of the designated representative.

4.1. Vendor Agency Responsibilities

The following criteria are the responsibilities of the vendor agency as required by this RFP. a. have the ability to bill Medicaid with an MMIS provider identification number

obtained through the rate approval process with the New York State Department of Health.

b. obtain and provide acceptable verification of liability insurance in the sum of not less that one million dollars ($1,000,000) per occurrence, naming the County of Westchester as an additional insured (for further information, (see Appendix “A”).

c. process the payroll for each CDPAP aide, including withholdings for Federal, State and local income tax and Social Security (FICA). Act as the employer of record for Social Security (FICA).

d. monitor the completion of the required annual worker health assessment and all

required employment documents.

e. act as the employer of record for insurance, unemployment and worker compensation benefits.

f. act as a fiscal intermediary for the purpose of billing the Medicaid program for

services received by the consumer. g. coordinate annual leave, health insurance and other benefit programs for each

CDPAP aide. h. monitor the completion of the required nursing assessment forms and the

consumer agreement outlining responsibilities assumed thereby. i. notify the district of changes in the consumer’s performance. j. maintain required records, including: (i) a personnel record for each CDPAP aide, which includes a copy of the

health assessment or medical that the State Department of Health requires for


employees of Certified Home Health agencies information needed for payroll and benefit processing;

(ii) a consumer record which includes copies of the local district

approval/referral, physician’s order, plan of care, a description of the responsibilities assumed by the consumer, ongoing nursing assessments and other documentation of the consumer’s fulfillment of his/her assumed responsibilities.

(iii) policies and procedures which address a consumer grievance and

complaint resolution process related solely to the vendor’s responsibilities. (iv) data collection and submission of reports as required by the local district

and the Department as well as documentation of the Local Consumer Organization’s efforts to monitor the consumer’s ability to meet its obligations.

k. assist the consumer with recruitment and Westchester specific service coverage

referrals, and provide informational support for training, supervision, advocacy and personal management.

l. monitor the consumer’s ability to meet contractual obligations. m. provide local support to the consumer by coordinating payroll distribution, the

distribution of forms and the collection of information. n. coordinate access to health facilities capable of providing the required annual

worker health assessment and other health related program requirements. o. establish an advisory committee which will consist of disabled consumers,

advocates and/or other interested parties. The committee will oversee quality assurance of this agreement and provide the Department and the vendor with assistance and support which may include peer counseling, referral and program monitoring.

Vendors participating in the consumer directed personal assistance program are not liable for the fulfillment of responsibilities agreed to be undertaken by the consumer.

4.2. Confidentiality of Patient Records Each Proposer must agree that all information, records and data collected in connection with the contract shall be protected from unauthorized disclosures. In addition, the agency must agree to guard the confidentiality of recipient information. Access to recipient identifying information shall be limited by the vendor to persons or agencies which require the information in order to perform their duties in accordance with the contract, including New York State, Westchester County, or the United States government. Any other party shall be granted access to confidential information only after complying

with the requirements of state and federal laws and regulations pertaining to such access. The County shall have absolute authority to determine if and when any other party has properly obtained the right to have access to the confidential information. Nothing herein shall prohibit the disclosure of information in summary, statistical, or other form which does not identify particular individuals.


The Proposer must also agree to adhere to 18 NYCRR 357 as well as the Health Insurance Portability and Accountability Act (“HIPAA”) of 1996, and its implementing regulation, the Standards for Privacy of Individually Identifiable Health Information 65 Fed. Reg. 82, 462 et seq. (Dec. 28, 2000) (hereinafter the “HIPAA Privacy Rule”) and all other applicable State and County laws regarding confidentiality of records. (Attached as Appendix “D” is the HIPAA Business Associate Terms)

5. DEPARTMENT RESPONSIBILITIES

The Department will be responsible for referring all recipients to be served under the contract, and will retain complete control of recipient eligibility determination, care plan development, service authorization and case management. The Department will also be responsible for monitoring and evaluating the Proposer’s performance.

5.1. Responsibilities of Westchester County Department of Social Services

a. enter into an agreement or agreements with vendors to provide CDPAP services. b. monitor the vendor’s performance under such agreement.. c. determine an applicant’s eligibility for Medical Assistance.

d. notify potential participants in the district of the availability of the CDPAP. e. determine an applicant’s eligibility to participate in the CDPAP through an initial

assessment and periodic reassessments.

f. provide the applicant with notice in writing of its decision to authorize, reauthorize, increase, decrease, discontinue or deny CDPAP services on forms required by the Department. The applicant/consumer is entitled to a fair hearing and to have such services continued unchanged until the fair hearing decision is issued (aid-continuing) in accordance with the requirements outlined in Part 358 of 18 NYCRR.

6. CONSUMER RESPONSIBILITIES

6.1. Responsibilities of consumers or their designated representatives participating in the CDPAP:

a. manage the services of the persons they employ, including recruiting,

interviewing, hiring, determining tasks to be completed, training, supervising and dismissing the personal assistant.

b. ensure that all persons they employ are in good physical health, as indicated by

the documentation in the personnel file maintained by the vendor agency. This documentation must include the same assurances and proof of good physical health that the Department of Health requires for employees of certified home health agencies pursuant to 10 NYCRR 763.13(c).

c. inform the vendor and the Department of Social Services of changes in their

medical or personal status, which may include, but are not limited to, hospitalization, medical condition, place of residence, employment, home and work phone numbers.


d. inform the vendor of changes in the employment status of the persons they employ, which may include, but are not limited to, hours worked, tax exemptions, and terminations.

e. attest to the accuracy of all required paperwork. f. process and transmit required paperwork to the CDPAP vendor, including time

sheets, annual personal assistant health assessments or medical examinations, and al required employment documents.

g. schedule and arrange for substitute coverage when needed. h. distribute paychecks to each person under their employ. i. insure that CDPAP aides work the hours indicated on time sheet. j. schedule an assessment by a registered nurse every six months unless the

frequency is otherwise authorized by the district and agreed upon by the consumer.

k. sign a contractual agreement with the CDPAP vendor to fulfill these

responsibilities.


7. PROPOSAL NARRATIVE INSTRUCTIONS

All proposals shall clearly and concisely explain how the Proposer will provide CDPAP services to the eligible caseload of recipients as detailed in the VENDOR AGENCY RESPONSIBILITIES. Each proposal must be signed by someone in the Proposer’s organization authorized to contractually commit the respondent. Each proposal shall be comprised of the following:

7.1. Letter of Transmittal

The letter should identify the Proposer, the authorized contact person and any areas of non-conformance with the specifications of the RFP. 7.2. Cover Page The cover page should contain the following: a. Title b. Period covered c. Name and Address of Respondent d. Name, Title, Telephone Number of Contact Person e. Signature of Corporate Officers or Authorized Agent 7.3. Table of Contents 7.4. Brief History of the Organization Provide and organizational chart and a brief description of the type and general history of the Proposer’s organization, which shows the Proposer’s experience and qualifications for providing CDPAP services. Identify all types of programs administered by the agency, relationship to any other agencies and any contractual obligations which might have an influence on the capabilities of the agency to perform the required services. (Specify the agency the contract was/is with, period of contract, amount of contract, name and telephone number of contact person for the contract). Provide the name and address of the agency and all satellite offices, including any plans for further expansion of office locations in the County. Provide information regarding whether the provider agency is not-for-profit or proprietary. 7.5. Program Design 7.5.1. Problem Statement

State what the objectives are in providing CDPAP services to the target population as well as what problems exist in providing the service. Briefly describe how the Proposer will address issues such as; the timely registration of aides, administrative supervision and oversight and training for consumers and aides.

7.5.2. Staffing Describe the staff designated for CDPAP administration. Identify


titles, number of persons in each title, job description for each title and minimum qualifications for each title. 7.5.3. Service Delivery In sufficient detail, describe the services to be provided and the mechanisms for providing them along with any other description which the Proposer feels is necessary to provide a complete picture of the proposed program and how it will operate. Include a detailed description of how the Proposer will meet the requirements of the RFP. 7.6. Budgetary and Financial Information 7.6.1. 2002-2003 Budgets Provide a detailed budget of the Proposer’s operations for 2002 and 2003. 7.6.2. Audited Financial Statement Appended to the proposal should be a copy of the Proposer’s latest audited financial statement. A Certified Public Accountant, independent of your organization, should prepare the financial statement.

Proposers who have been in business for the minimum period of one year and do not yet have an audited financial statement may submit a statement from a bank or other financial institution in lieu of the financial statement for the purposes of the initial phase of review. Such statement should document firm financial backing and adequate resource availability to enter into business. An audited statement must then be provided upon its completion.

7.7. Disclosure Statement Appended to the proposal should be a signed and notarized statement from a responsible officer in the organization disclosing any pending litigation, unsatisfied judgments, convictions for fraud or sanctions or penalties imposed by

governmental authorities. In addition, please sign the certification regarding debarment and suspension attached to this document (Appendix “I”).

8. PROPOSAL EVALUATION AND SELECTION Each proposal will be reviewed by the Department according to the selection criteria

defined below. The Department will select those proposals which, in its opinion, best meet the requirements of the RFP.

Approval of the Proposer(s) and final contract requirements are subject to approval of

the Westchester County Board of Acquisition and Contract. The approved Proposer(s) will be required to sign contracts with the Department. The contracts will be the final documents and will specify the rights and responsibilities of all parties. If the selected Proposer (s) refuses or is unable to sign said contract within a reasonable time frame as determined by the Department, the Department will withdraw the offer to contract and begin negotiations with the next highest-ranked Proposer, subject to Board of Acquisition and Contract and other appropriate approvals. Proposals will be rated on the following factors:


8.1. Organization Capability 8.1.1. Proposer’s History and Performance Record

Experience in CDPAP administration. Prior experience with target population. Performance on prior government contracts. “Best Practice” testimonials. Office in Westchester County. 8.1.2. Responsiveness to the RFP Compliance with basic requirements and understanding of basic services to be provided. Clarity and conciseness of the proposal. Timely submission of RFP application and materials. 8.1.3. Management Adequacy of the proposed organization and staffing plans

Ability to register aides quickly. Capacity of maintaining an available inventory of registered aides. Evidence of a plan for administrative supervision and oversight of CDPAP aides.

8.1.4. Quality Assurance Documented orientation program for the training of CDPAP consumers and aides. Available van service for transportation of aides.

Evidence of satisfactory audits (Diamond, Kerbis & Weinstein or Joint Commission on Accreditation of Healthcare Organizations JCAHO).

8.1.5. Financial Capability Indication of the respondent’s overall fiscal well-being. 9. LEGAL REPRESENTATIONS AND UNDERSTANDINGS Please take Notice, by submission of a proposal in response to this request for proposals, proposing entity agrees to and understands:

• that any proposal, attachments, additional information, etc. submitted pursuant to this Request for Proposals constitute merely a suggestion to negotiate with the County of


Westchester and is not a bid under Section 103 of the New York State General Municipal Law;

• submission of a proposal, attachments and additional information shall not entitle the

proposing entity to enter into a service agreement with the County of Westchester for the required services;

• by submitting a proposal, the proposing entity agrees and understands that the County of

Westchester is not obligated to respond to the proposal, nor is it legally bound in any manner whatsoever by submission of same;

• that any and all counter-proposals, negotiations or any communications received by a

proposing entity, its officers, employees or agents from the County, its elected officials, officers, employees agents, shall not be binding against the County of Westchester, its elected officials, officers, employees or agents unless and until a formal written agreement for the services sought by this RFP is duly executed by both parties and approved by the Westchester County Board of Acquisition & Contract, and the Office of the Westchester County Attorney.

Neither the receipt of this RFP nor the submission by its recipient of a proposal pursuant thereto shall be deemed to create an agreement among recipient, the County, the State of New York or between any of the parties. In addition, the County reserves, holds and may in its sole discretion, exercise the following rights and options with respect to this Request for Proposals:

9.1. To select the proposal that best satisfies the interests of the County and not necessarily on the basis of price or any other single factor.

9.2. To reject any and all proposals.

9.3. To issue additional subsequent solicitations for proposals and/or amendments to this RFP.

9.4. To conduct investigations with respect to the qualifications of each proposer.

9.5. To select any proposal as the basis for negotiations of a contract and to negotiate with one or more of the proposers for amendments or other modifications to their proposals.

9.6. To modify dates.

9.7. To enter into an agreement or agreements for only portions (or not to enter into an agreement for any) of the services contemplated by the proposal with one or more of the proposers.

9.8. To waive any irregularities in proposals received after notification to proposers

affected.

9.9. The County assumes no responsibility or liability of any kind for costs incurred in the preparation or submission of any proposal.

9.10. To exercise its discretion and apply its judgment with respect to any aspect of

this RFP, the evaluation of proposals and the negotiations and award of any contract.


9.11. While this is a Request for Proposals and not a bid, the County reserves the right to apply the case law under General Municipal Law §103 regarding bidder responsibility in determining whether a proposer is a responsible vendor for the purpose of this RFP.

9.12. The County is not responsible for any internal or external delivery delays which

may cause any proposal to arrive beyond the stated deadline. To be considered, proposals MUST arrive at the place specified herein and be time stamped prior to the deadline.

9.13. Evaluation criteria are not necessarily listed in order of importance. The County

reserves the right to weigh its evaluation criteria in any manner it deems appropriate.

9.14. It is the policy of the County, pursuant to Local Law No. 27-1997, to encourage

the meaningful and significant participation of business enterprises owned and controlled by persons of color or women.

9.15. CONTENTS OF PROPOSAL:

The New York State Freedom of Information Law as set forth in Public Officers Law, Article 6, Sections 84-90, mandates public access of government records. However, proposals submitted in response to the RFP may contain technical, financial or other data whose public disclosure could cause substantial injury to the proposer’s competitive position or constitute a trade secret. Proposers who have a good faith belief that information submitted in their proposal is protected from disclosure under the New York Freedom of Information Law shall insert the following notice in front of its proposal:

“NOTICE” The data on pages of this proposal identified by an asterisk (*) contain technical or financial information which are trade secrets or information for which disclosure would result in substantial injury to the respondent’s competitive position. The Proposer requests that such data be used only for the evaluation of the proposal, but understands that the disclosure will be limited to the extent that the County considers proper under the law. If the

County enters into an agreement with this Proposer, the County shall have the right to use or disclose the information as provided in the agreement, unless otherwise obligated by law. And the Proposer shall clearly identify the pages of the proposal containing such information by typing in bold face on the top of each page, “The Proposer believes that this information is protected from disclosure under the State Freedom of Information Law”.

The County assumes no liability for disclosure of information so identified, provided that the County has made a good faith legal determination that the information is not protected from disclosure under applicable law or where disclosure is required to comply with an order or judgment of a court of competent jurisdiction.


The contents of the proposal which is accepted by the County, except portions “Protected from Disclosure”, may become part of any agreement resulting from this RFP.

10. CONTRACT

After selection of the successful proposer (s), a formal written contract will be prepared by the County of Westchester and will not be binding until signed by both parties and approved by the Westchester County Board of Acquisition & Contract and the Office of the County Attorney. NO RIGHTS SHALL ACCRUE TO ANY PROPOSER BY THE FACT THAT A PROPOSAL HAS BEEN SELECTED BY THE COUNTY FOR SUBMISSION TO THE BOARD OF ACQUISITION & CONTRACT FOR CONTRACT APPROVAL. SAID BOARD HAS THE RIGHT TO REJECT ANY RECOMMENDATION AND THE APPROVAL OF SAID BOARD IS ABSOLUTELY NECESSARY BEFORE A VALID AND BINDING CONTRACT MAY BE EXECUTED BY THE COUNTY.

10.1. Terms and Conditions The Proposer accepts and agrees that any ensuing contract entered into

between the County ad one or more of the Proposers in connection with this RFP will contain, without limitation, the following language in substantially the following form:

10.2. Indemnification Insurance

“In addition to, and not in limitation of, the insurance provisions contained in Appendix “A”, the Contractor agrees:

(a) that except for the amount, if any, of damage contributed to,

caused by or resulting from the negligence of the County, the Contractor shall indemnify and hold harmless the County, its officers, employees and agents from and against any and all liability, damage, claims demands, costs, judgments, fees, attorneys’ fees or loss arising directly or indirectly out of the performance or failure to perform hereunder by the Contractor or third parties under the direction or control of the Contractor; and

(b) to provide defense for and defend, at its sole expense, any and

all claims, demands or causes of action directly or indirectly arising out of this Agreement and to bear all other costs and expenses related thereto.”

10.3. Proposer agrees that reimbursement will be at the rates established by the New York State Department of Health. The New York State Department of Health shall pay the CDPAP provider directly for services rendered. It is expressly understood and agreed that the Westchester County Department of Social Services is not responsible for any payment to the CDPAP

10.4. The Proposer expressly agrees: (a) That in the hiring of employees for the performance of work under this Agreement or any subcontract or Agreement hereunder; no Proposer, subcontractor nor any person acting on behalf of such Proposer or


subcontractor, shall by reason of race, creed, color, national origin, age, sex, disability or marital status, discriminate against any citizen of the State of New York who is qualified and available to perform the work to which the employment relates;

(b) That no Proposer, subcontractor, nor any person on his behalf shall, in

any shall, in any manner, discriminate against or intimidate any employee hired for the performance of work under this Agreement on account of race, creed, color, national origin age, sex, disability or marital status.

(c) That there may be deducted from the amount payable to the Proposer by

the County under this Agreement a penalty of fifty ($50.00) dollars for each person for each calendar day during which such persona was discriminated against or intimidated in violation of the provisions hereof;

(d) That this Agreement may be cancelled or terminated by the County, and

all monies due or to become due hereunder may be forfeited, for a second or any subsequent violation of this paragraph 10.4.

10.5. The Proposer shall at his own cost and expense comply with all provisions of the Labor Law, including, without limitation, Articles 8, 8-A and 9 thereof, the Lien Law, the Worker’s Compensation Law and all other laws or ordinances affecting this Agreement.

10.6. Non-Collusion

The Proposer, by signing the proposal, does hereby warrant and represent that any ensuing agreement has not been solicited, secured or prepared directly or indirectly, in a manner contrary to the laws of the State of New York and the County, and that said laws have not been violated and shall not be violated as they relate to the procurement of the performance of the agreement by any conduct, including the paying or the giving of any fee, commission, compensation, gift, gratuity or consideration of any kind, directly or indirectly, to any County employee, officer or official.

10.7. Conflict of Interest

The award of a contract is subject to provision of all Federal, State and County laws. All firms must disclose with their proposals the name of any officer, director or agent who is also an employee of the County. Further, all firms must disclose the name of any County employee who owns, directly or indirectly, an interest of ten percent or more in the firm or any of its subsidiaries or affiliates.

10.8. MBE/WBE

Pursuant to Local law No 27-1997, it is the goal of the County to use its best efforts to encourage, promote and increase the participation of business enterprises which are owned and controlled by persons of color or women in contracts and projects funded by the County. Therefore, the County asks Proposers to complete the questionnaire attached hereto as Appendix “B”.


10.9. MacBride Principles

Pursuant to Act No. 56-1999, no County procuring officer may award or recommend for award any contract not subject to competitive bidding to a Proposer that does not execute a certification substantially in the form attached hereto as Appendix “C”. Therefore, the County asks Proposers to complete the questionnaire attached hereto as Appendix “C”.

10.10. Westchester County Living Wage Incentive

The successful Proposer (s)agree (s) to comply with each and every provision of the Westchester County Living Wage Incentive as set forth in Article III of Chapter 233 of the Laws of Westchester County (“Article III”). Article III requires that all Covered Employers shall provide payment of the Living Wage Incentive as forth in §233.402 of the Laws of Westchester County. (See Appendix ”E”)

10.11. Proposer Certificate

The Certificate attached as “PAGE 19” must be signed and included with all proposals.


PROPOSER CERTIFICATION The undersigned hereby certifies that it has thoroughly read and is familiar with each and every provision of the attached Request For Proposals. The u and understands that this proposal and all attachments, additional information, etc. submitted herewith constitute merely an offer to negotiate with the County of Westchester and is NOT A BID. Submission of this proposal, attachments and additional information shall not obligate or entitle the proposing entity to enter into a service agreement with the County of Westchester for the required services. The undersigned agrees and understands that the County of Westchester is not obligated to respond to this proposal nor is it legally bound in any manner whatsoever by the submission of same. Further, the undersigned agrees and understands that any and all proposals and negotiations shall not be binding or valid against the County of Westchester, its directors, officers, employees or agents unless an agreement is signed by a duly authorized officer of the County of Westchester and approved by the Westchester County Board of Acquisition and Contract and by the Office of the County Attorney. It is further understood and agreed that the County of Westchester reserves the right to reject consideration of any and all proposals including, but not limited to, proposals which are conditional or incomplete. It is further understood and agreed that the County of Westchester reserves all rights specified in the Request for Proposals. It is represented and warranted by those submitting this proposal that except as disclosed in the proposal, no officer or employee of the County of Westchester is directly or indirectly a party to or in any other manner interested in this proposal or any subsequent service agreement that may be entered into. __________________________________ Proposer Name __________________________________ Signature & Title


APPENDIX “A” STANDARD INSURANCE PROVISIONS (CONTRACTOR) 1. Prior to commencing work, the Contractor shall obtain at its own cost and expense the required insurance from insurance companies licensed in the State of New York, carrying a Best’s financial rating of A or better, and shall provide evidence of such insurance to the County of Westchester, as may be required and approved by the Director of Risk Management of the County. The policies or certificates thereof shall provide that thirty days prior to cancellation or material change in the policy, notices of same shall be given to the Director of Risk Management of the County of Westchester by registered mail, return receipt requested, for all of the following stated insurance policies. All notices shall name the Contractor and identify the Agreement. If at any time any of the policies required herein shall be or become unsatisfactory to the County, as to form or substance, or if a company issuing any such policy shall be or become unsatisfactory to the County, the Contractor shall upon notice to that effect from the County, promptly obtain a new policy, submit the same to the Department of Risk Management of the County of Westchester for approval and submit a certificate thereof. Upon failure of the Contractor to furnish, deliver and maintain such insurance, the Agreement, at the election of the County, may be declared suspended discontinued or terminated. Failure of the Contractor to take out, maintain, or the taking out or maintenance of any required insurance, shall not relieve the Contractor from any liability under the Agreement, nor shall the insurance requirements be construed to conflict with or otherwise limit the contractual obligations of the Contractor concerning indemnification. All property losses shall be made payable to and adjusted with the County. In the event that claims, for which the County may be liable, in excess of the insured amounts provided herein are filed by reason of any operations under the Agreement, the amount of excess of such claims or any portion thereof, may be withheld from payment due or to become due the Contractor until such time as the Contractor shall furnish such additional security covering such claims in form satisfactory to the County of Westchester. 2. The Contractor shall provide proof of the following coverage (if additional coverage is required for a specific agreement, those requirements will be described in the “Special Conditions” of the contract specifications):

(a) Workers’ Compensation Certificate for C-105.2 or State Fund Insurance Company form U-26.3 is required for Proof of Compliance with the New York State Workers’ Compensation Law. State Workers’ Compensation Board form DB-120.1 is required for proof of compliance with the New York State Disability Benefits law. Location of operation shall be “All locations in Westchester County, New York.” (Where an applicant claims to not be required to carry either a Workers’ Compensation Policy or Disability Benefits’ Policy, or both, a temporary permit may be issued if the employer completes for C-105.21 in duplicate. A copy of form C-105.21 is sent to the Workers’ Compensation Board Information Unit for investigation and report.) If the employer is self-insured for Workers’ Compensation, he/she should present a certificate from the New York State workers’ Compensation Board evidencing that fact.


(b) Employer’s Liability with minimum limit of $100,000,00 (c) Commercial General Liability Insurance with a minimum limit of

liability per occurrence of $1,000,000.00 for bodily injury and $100,000.00 for property damage or a combined single limit of $1,000,000.00 (c.s.l.), naming the County of Westchester as an additional insured. This insurance shall indicate on the certificate of insurance the following coverages:

(i) Premises-Operations. (ii) Broad Form Contractual. (iii) Independent Contractor and Sub-Contractor. (iv) Products and Completed Operations

(d) Automobile Liability Insurance with a minimum limit of liability per occurrence of $1,000,000.00 for bodily injury and a minimum limit of $100,000.00 per occurrence for property damage or a combined single limit of $1,000,000.00 unless otherwise indicated in the contract specifications. This insurance shall include for bodily injury and property damage the following coverages:

(i) Owned automobiles. (ii) Hired automobiles. (ii) Non-owned automobiles.

(e) Professional Liability. The Contractor shall provide proof of such insurance (limits of $1,000,000.00 per occurrence/$3,000,000.00 aggregate). 3. All policies and certificates of insurance of the Contractor shall contain the following clauses: (a) Insurers shall have no right to recovery or subrogation against the County of Westchester (including its employees and other agents and agencies), it being the intention of the parties that the insurance policies so effected shall protect both parties and be primary coverage for any and all losses covered by the above-described insurance. (b) The clause “other insurance provisions” in a policy in which the County of Westchester is named as an insured shall not apply to the County of Westchester. (c) The insurance companies issuing the policy or policies shall have no recourse against the County of Westchester (including its agents and agencies as aforesaid) for payment of any premiums or for assessments under any form of policy. (d) Any and all deductibles in the above described insurance policies shall be assumed by and be for the account of, and at the sole risk of, the Contractor.


APPENDIX “B”

QUESTIONNAIRE REGARDING BUSINESS ENTERPRISES OWNED AND CONTROLLED BY PERSONS OF COLOR OR WOMEN

As part of the County’s program to encourage the meaningful and significant participation of business enterprises owned and controlled by persons of color or women in County contracts, and in furtherance of Local Law No. 27-1997 we request that you answer the questions listed below.

The term persons of color means a United States citizen or permanent resident alien who is and can demonstrate membership of one of the following groups: (a) Black persons having origins in any of the Black African racial groups; (b) Hispanic persons of Mexican, Puerto Rican, Dominican, Cuban, Central or South American descent of either Indian or Hispanic origin regardless of race; (c) Native American or Alaskan native persons having origins in any of the original peoples of North American; or (d) Asian or Pacific Islander persons having origins in any of the Far East countries, South East Asia, the Indian sub-continent or the Pacific Islands.

An enterprise owned and controlled by persons of color or women means a business enterprise including a sole proprietorship, limited liability partnership, partnership, limited liability corporation or corporation that is (a) at least 51% owned by one or more persons of color or women; (b.) an enterprise in which such ownership interest by persons of color or women has and exercises the authority to control and operate, independently, the day-to-day business decisions of the enterprise; and (d.) an enterprise authorized to do business in this state which is independently owned and operated.

In addition, a business enterprise owned and controlled by persons of color or women shall be deemed to include any business enterprise certified as an MBE or WBE pursuant to Article 15-a of the New York State Executive law and implementing regulations, 9 NYCRR subtitle N Part 540 et seq., or as a small disadvantaged business concern pursuant to the Small Business Act, 15 U.S.C. 631 et seq., and the relevant provisions of the Code of Federal Regulations as amended.

1. Are you a business enterprise which is owned and controlled by persons of color or women in accordance with the standards listed above?

___________No

___________Yes (as a business owned and controlled by persons of color)

___________Yes (as a business owned and controlled by women)

2. If you are a business owned and controlled by persons of color, please specify, the minority classifications which apply:

3. Are you certified with the State of New York as a minority business enterprise (“MBE”) or a women business enterprise (“WBE”)?


___________No

___________Yes (as a MBE)

___________Yes (as a WBE)

4. If you are certified with the State of New York as an MBE, please specify the minority classifications which apply:__________________________________________________________

5. Are you certified with the Federal Government as a small disadvantaged business concern?

___________No

___________Yes

Name of Firm/Business Enterprise:______________________________________________________

Address:______________________________________________________________________

Name/Title of Person completing MBE/WME Questionnaire:_________________________________

Signature:_____________________________________________________________________


APPENDIX “C”

CERTIFICATION REGARDING BUSINESS DEALINGS WITH NORTHERN IRELAND

A. The Contractor and any individual or legal entity in which the Contractor holds a ten (10%) or greater ownership interest and any individual or legal entity that holds a ten percent (10%) or greater ownership interest in the Contractor (a) has no business operations in Northern Ireland, or (b) shall take lawful steps in good faith to conduct any business operations in Northern Ireland in accordance with the MacBride Principles. B. For purposes of this Certification, “MacBride Principles” shall mean those principles relating to nondiscrimination in employment and freedom of workplace opportunity which require employers doing business in Northern Ireland to:

(1) increase the representation of individuals from under represented religious groups in the work force, including managerial, supervisory, administrative, clerical and technical jobs;

(2) take steps to promote adequate security for the protection of employees from underrepresented religious groups both at the workplace and while traveling to and from work;

(3) ban provocative religious or political emblems from the workplace;

(4) publicly a advertise all job openings and make special recruitment efforts to attract applicants from underrepresented religious groups;

(5) establish layoff, recall and termination procedures which do not in practice favor a particular religious group;

(6) abolish all job reservations, apprenticeship restrictions and differential employment criteria which discriminate on the basis of religion;

(7) develop training programs that will prepare substantial numbers of current employees from underrepresented religious groups for skilled jobs, including the expansion of existing programs and the creation of new programs to train, upgrade and improve the skills of workers from underrepresented religious groups;

(8) establish procedures to assess, identify and actively recruit employees from underrepresented religious groups with potential for further advancement; and (9) appoint a senior management staff member to oversee

affirmative action efforts and develop a timetable to ensure their full implementation.

C. For purposes of this Certification, “Northern Ireland” shall be understood to be the six counties partitioned from the Irish Province of Ulster, and administered from London and/or from Stormont. D. The Contractor agrees that the warranties and representation in paragraph “A” are material conditions of this Agreement. If the County receives information that the Contractor is in violation of paragraph “A”, the County shall review such information and give the Contractor opportunity to respond. If the County finds that such a violation has occurred, the County may declare the Contractor in default, and/or terminate this Agreement. In the event of any such termination, the County may procure the supplies, services or work from another source in accordance with applicable law. The Contractor shall pay to the County the difference between the contract price for the uncompleted portion of this Agreement and the cost to the County of

REQUEST FOR PROPOSALS - CDPAP 24

completing performance of this Agreement either by itself or by engaging another contractor. If this is a contract other than a construction contact, the Contractor shall be liable for the difference in price if the cost of procurement from another source is greater than what the County would have paid the Contractor plus any reasonable costs the County incurs in any new procurement and if this is a construction contract, the County shall also have the right to hold the contractor in partial or total default in accordance with the default provisions of this Agreement. In addition, the Contractor may be declared not to be a responsible bidder or proposer for up the three (3) years, following written notice to the Contractor giving the Contractor the opportunity for a hearing at which the Contractor may be represented by counsel. The rights and remedies of the County hereunder shall be in addition to, and not in lieu of, any rights and remedies the County has pursuant to this Agreement or by operation of law or in equity. Agreed: Name of Contractor__________________________________________________________ By: (Authorized Representative)______________________________________________________ Title:______________________________________________________________


APPENDIX “D”

HIPAA Business Associate

Terms

Pursuant to the Health Insurance Portability and Accountability Act (“HIPAA”) of 1996, and its implementing regulation, the Standards for Privacy of Individually Identifiable Health Information, 65 Fed. Reg. 82,462 et seq. (Dec. 28, 2000) (hereinafter the “HIPAA Privacy Rule”), the COUNTY OF WESTCHESTER, acting by and through its Department of Social Services, with an office at 112 East Post Road, White Plains, New York 10601, (“Covered Entity”) and _____________________, with an office at (“Business Associate”) (jointly “the Parties”) agree that the following terms address the requirements of the HIPAA Privacy Rule with respect to “business associates,” as that term is defined in the HIPAA Privacy Rule.

Specifically, the following terms are intended to ensure that the Business

Associate will establish and implement appropriate safeguards (including certain administrative requirements) for “Protected Health Information” the Business Associate may create, receive, use, or disclose in connection with certain functions, activities, or services (collectively “services”) to be provided by Business Associate to Covered Entity pursuant to this Agreement.

I. Definitions “Individual” shall have the same meaning as the term "individual" in 45 CFR § 164.501 and shall include a person who qualifies as a personal representative in accordance with 45 CFR § 164.502(g). “Protected Health Information” shall have the same meaning as the term "protected health information" in 45 CFR § 164.501, limited to the information created or received by Business Associate from or on behalf of Covered Entity. “Required By Law” shall have the same meaning as the term "required by law" in 45 CFR § 164.501. “Secretary” shall mean the Secretary of the Department of Health and Human Services or his designee. Other terms used, but not otherwise defined, in this agreement shall have the same meaning as those terms in the federal Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and its implementing regulations, including those at 45 CFR Parts 160 and 164.


II. Obligations and Activities of the Business Associate: (a) The Business Associate agrees to not use or further disclose Protected Health Information other than as permitted or required by this Schedule or as required by law.

(b) The Business Associate agrees to use the appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as provided for by this Schedule.

(c) The Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to the Business Associate of a use or disclosure of Protected Health Information by the Business Associate in violation of the requirements of this Schedule.

(d) The Business Associate agrees to report to the Covered Entity, as soon as reasonably practicable, when it becomes aware of any use or disclosure of the Protected Health Information not provided for by this Schedule.

(e) The Business Associate agrees to ensure that any agent, including a subcontractor, to whom it provides Protected Health Information received from, or created or received by the Business Associate on behalf of the Covered Entity agrees to the same restrictions and conditions that apply through this Schedule to the Business Associate with respect to such information.

(f) The Business Associate agrees to provide access, at the request of the Covered Entity, and in the time and manner designated by the Covered Entity, to Protected Health Information in a Designated Record Set, to the Covered Entity or, as directed by the Covered Entity, to an Individual in order to meet the requirements under 45 CFR 164.524, if the business associate has protected health information in a Designated Record Set.

(g) The Business Associate agrees to make any amendment(s) to Protected Health Information in a Designated Record Set that the Covered Entity directs or agrees to pursuant to 45 CFR 164.526 at the request of the Covered Entity or an Individual, and in the time and manner designated by the Covered Entity, if the Business Associate has protected health information in a Designated Record Set.

(h) The Business Associate agrees to make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the Business Associate on behalf of the Covered Entity available to the Covered Entity, or to the Secretary of Health and Human Services, in a time and manner designated by the Covered Entity or the Secretary, for purposes of the Secretary determining the Covered Entity's compliance with the Privacy Rule.

(i) The Business Associate agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for Covered Entity to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

(j) The Business Associate agrees to provide to the Covered Entity or an Individual, in time and manner designated by the Covered Entity, information collected in accordance with this Agreement, to permit the Covered Entity to respond to a request by an


Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528.

III. Permitted Uses and Disclosures by Business Associate

(a) General Use and Disclosure Provisions

Except as otherwise limited in this Schedule, the Business Associate may use or disclose Protected Health Information to perform functions, activities, or services for, or on behalf of, the Covered Entity as specified in the Agreement, provided that such use or disclosure would not violate the Privacy Rule if done by Covered Entity.

(b) Specific Use and Disclosure Provisions:

(i) Except as otherwise limited in this Schedule, the Business Associate may use Protected Health Information for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate.

(ii) Except as otherwise limited in this Schedule, the Business Associate may disclose Protected Health Information for the proper management and administration of the Business Associate, provided that disclosures are Required By Law, or the Business Associate obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as Required By Law or for the purpose for which it was disclosed to the person, and the person notifies the Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached.

(iii) Except as otherwise limited in this Schedule, the Business Associate may use Protected Health Information to provide Data Aggregation services to Covered Entity as permitted by 45 CFR 164.504(e)(2)(i)(B).

(iv) The Business Associate may use Protected Health Information to report violations of law to appropriate federal and State authorities, consistent with 45 CFR 164.502(j)(1).

IV. Obligations of Covered Entity

Provisions for the Covered Entity To Inform the Business Associate of Privacy Practices and Restrictions (a) The Covered Entity shall notify the Business Associate of any limitation(s) in its notice of privacy practices of the Covered Entity in accordance with 45 CFR 164.520, to the extent that such limitation may affect the Business Associate's use or disclosure of Protected Health Information.


(b) The Covered Entity shall notify the Business Associate of any changes in, or revocation of, permission by the Individual to use or disclose Protected Health Information, to the extent that such changes may affect the Business Associate's use or disclosure of Protected Health Information.

(c) The Covered Entity shall notify the Business Associate of any restriction to the use or disclosure of Protected Health Information that the Covered Entity has agreed to in accordance with 45 CFR 164.522, to the extent that such restriction may affect the Business Associate's use or disclosure of Protected Health Information.

V. Permissible Requests by Covered Entity The Covered Entity shall not request the Business Associate to use or disclose Protected Health Information in any manner that would not be permissible under the Privacy Rule if done by Covered Entity, except if the Business Associate will use or disclose protected health information for, and the Agreement includes provisions for, data aggregation or management and administrative activities of Business Associate.

VI. Breach of Provisions (a) Upon the Covered Entity's knowledge of a material breach by Business Associate of the terms of this Schedule, Covered Entity shall

(i) provide an opportunity for the Business Associate to cure the breach or end the violation. Covered Entity shall terminate the Agreement if the Business Associate does not cure the breach and end the violation within the time specified by Covered Entity;

(ii) immediately terminate the Agreement if the Business Associate has breached a material term of this Schedule and cure is not possible; or

(iii) If neither termination nor cure are feasible, the Covered Entity shall report the violation to the Secretary.

(b) Effect of Termination.

(i) Except as provided in paragraph (b)(ii) below, upon termination of the Agreement, for any reason, the Business Associate shall return or destroy all Protected Health Information received from the Covered Entity, or created or received by the Business Associate on behalf of the Covered Entity. This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents of the Business Associate. The Business Associate shall retain no copies of the Protected Health Information.

(ii) In the event that the Business Associate determines that returning or destroying the Protected Health Information is infeasible, the Business Associate shall provide to the Covered Entity notification of the conditions that make return or destruction infeasible. Upon mutual agreement of the


Parties that return or destruction of Protected Health Information is infeasible, the Business Associate shall extend the protections of this Schedule to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes that make the return or destruction infeasible, for so long as Business Associate maintains such Protected Health Information.

VII. Miscellaneous (a) Regulatory References. A reference in this Schedule to a section in the HIPAA Privacy Rule means the section as in effect or as amended, and for which compliance is required.

(b) Amendment. The Parties agree to take such action as is necessary to amend this Schedule from time to time as is necessary for the Covered Entity to comply with the requirements of the Privacy Rule and the Health Insurance Portability and Accountability Act, Public Law 104-191.

(c) Survival. The respective rights and obligations of the Business Associate under Section VI of this Schedule shall survive the termination of the Agreement.

(d) Interpretation. Any ambiguity in this Schedule shall be resolved in favor of a meaning that permits the Covered Entity to comply with the HIPAA Privacy Rule.

(e) If anything in this Schedule conflicts with a provision of any other agreement on this matter, this Schedule is controlling. R\HIPAA\HIPAA Business Associate Addendum


APPENDIX “E”

LOCAL LAW INTRO NO.__________________________- 2002 A LOCAL LAW adding Article III to Chapter 233 of the Administrative Code of Westchester County to establish a Living Wage Incentive to Promote Health and Safety for the Residents of Westchester County and to create a Child Care Living Wage Task Force. BE IT ENACTED by the County Board of the County of Westchester as follows: Section 1. Chapter 233 of the Administrative Code of Westchester County is amended to add a new Article III, as follows:

ARTICLE III

WESTCHESTER COUNTY LIVING WAGE INCENTIVE Sec. 233. 401. Definitions. Sec. 233 .402. Living Wage Incentive Rate Established. Sec. 233. 403. Worker Retention Policy For Certain Covered Employees. Sec. 233. 404. Retaliation and Discrimination Barred. Sec. 233. 405. Reporting Requirements. Sec. 233. 406. Posting and Notification. Sec. 233. 407. Compliance, Enforcement and Sanctions. Sec. 233. 408. Child Care Living Wage Task Force. Sec. 233. 409. No impairment Clause. Sec. 233. 410. No Private Right of Action Against the County. Sec. 233.411. Severability Sec. 233. 401. Definitions. 1. “County Assistance “ shall mean any tax abatement, grant, loan, bond financing or other economic incentive of at least $100,000 realized over a twelve month period that is awarded directly by the County to a non-governmental entity for purposes related to economic or business development. County Assistance shall not include assistance awarded by the Westchester County Industrial Development Agency or any other entities in which the County lacks the legal authority to impose eligibility conditions beyond those enumerated in state law, nor shall it include any other categories of assistance where state or federal law prohibits the County from making such assistance subject to the requirements of this section. In addition, County Assistance shall not include assistance awarded to a not-for-profit organization the mission of which is to provide cultural, educational or social services.


2. “County Lease” shall mean any agreement where the County leases or rents a commercial building, office space or facility from a non-governmental entity and where the County is the primary tenant and receives Building Services. For purposes of this section, the County is a “primary tenant” where it occupies 50% or more of the entire commercial building, office space or facility. County Lease shall also include lease agreements between the County and any tenant or concessionaire, not including a tenant or concessionaire that utilizes the County property primarily for storage or maintenance of equipment, that occupies County-owned property or facility and provides or receives Building Services and the total vale of such agreement is in excess of $50,000.00 over any twelve-month period. 3. “Covered Employee” shall mean a person who performs Home Care or Building Services in connection with a Service Contract, County Assistance, or a County Lease. Employees shall not be considered Covered Employees if they are either (1) under eighteen (18) years of age; (2) work in a government sponsored training program; (3) are volunteers; and/or (4) are employed as part of a County or private youth employment program. 4. “Covered Employer” shall mean any person that (1) is a party to a Service Contract; or (2) provides Building Services in connection with a County Lease or County Assistance provided that the Covered Employer employs at least fifteen (15) full-time equivalent employees regardless of whether those employees are Covered Employees or not. 5. “Full-Time Equivalent” shall mean any combination of hours worked by one or more Covered Employees that generates between 35 and 40 hours of work per week. 6. “Health Insurance Benefits” shall consist of the payment by the Covered Employer to its Covered Employees or on their behalf of an amount no less that $1.50 per hour worked towards the provision of health insurance benefits for employees and/or their dependents. A Covered Employer is not required to provide health insurance benefits to a Covered Employee that works less than seventeen and one half (17 ½) hours per week, but if the Covered Employer elects not to provide health insurance benefits, it must pay its Covered Employees the higher Living Wage Incentive Rate specified in 233.402(20 for Employers that elect not to provide health insurance benefits. 7. “Person” shall mean any natural person, firm, association, partnership, corporation association, business or organization of any kind. 8. “Qualified Retention Employee” shall mean a Covered Employee who performed Building Services for a Covered Employer for at least three months when a Covered Employer sells, transfers, assigns or otherwise conveys the duties of a contract to perform Building Services to another Person. 9. “Service Contract” means any duly executed contract between the County and a person or his or her subcontractor whereby the County is committed to expend funds for services enumerated below and which are provided to or on behalf of the County, and which involves an expenditure of $50,000. or more in any twelve-month period. The term “Service Contract” shall not include contracts for the purchase or lease of goods, products, equipment, supplies, and services incidental to the delivery of services or other property. Service Contracts shall be limited to the following categories: (a) “Building Services” shall mean any custodial, janitorial or


security guard services; and (b) “Home Care Services” shall mean personal care services provided by the Westchester County Department of Social Services under the County’s Medicaid Personal Care/Home Attendant programs and in accordance with the applicable provisions of Federal and New York State law, rules and regulations. 10. “Services Contractor” shall mean any person, other than an employee, that enters into a Service Contract with the County. 11. “Subcontractor” shall mean any person, other than an employee, that enters into a Service Contract with a Service Contractor to assist the primary Service Contractor in performing a Services Contract. Sec. 233.402. Living Wage Incentive Rate Established. 1. Applicability. Covered Employers shall pay no less than the Living Wage Incentive Rate to their Covered Employees who actually perform work or render services in connection with a project, matter, contract or subcontract for which the Covered Employer (1) has received a Service Contract or County Assistance; or (2) provides Building Services rendered in connection with a County lease as all such terms are defined in Section 233.401. Except as provided for in Sections 233.402(5) or 233.409 herein, Covered Employers shall pay the greater of (1) the living wage incentive pursuant to this law; (2) terms of collective bargaining agreement between the Covered Employer and his or her Covered Employees; or (3) the applicable prevailing wage. 2. Amount of Living Wage Incentive Rate. The living wages incentive shall be calculated on an hourly basis as follows: a. commencing January 1, 2004 $10.00 per hour plus $1.50 for health insurance benefits; or $11.50 without health insurance benefits; b. commencing January 1, 2005; $10.75 per hour plus $1.50 for health insurance benefits; or $12.25 without health insurance benefits; c. commencing January 1, 2006; $11.50 per hour plus $1.50 for health insurance benefits; or $13.00 without health insurance benefits; 3. Compensated Leave. Covered Employers shall provide at least twelve (12) compensated days leave per year to Covered Employees working full-time for sick leave, vacation or personal necessity at the Covered Employee’s request. Paid holidays, consistent with established employer policy, may be counted toward the required twelve (12) compensated days off. Part-time Covered Employees shall be entitled to a pro-rata equivalent of the compensated days provided to Covered Employees working full-time. A Covered Employee shall be eligible to use accrued days off after the first six months of employment with the Covered Employer as a Covered Employee or in accordance with


the policies of the Covered Employer, whichever occurs first. A Covered Employee shall accrue one day of compensated leave per month of full-time equivalent employment. 4. All County Service Contracts, County Assistance agreements, County Leases and requests for proposals for County Service contracts which are subject to the requirements of this Article shall contain the following language or substantially equivalent language: a. This contract, lease or agreement is subject to the Westchester County Living Wage Incentive as set forth in Article III of Chapter 233 of the Laws of Westchester County (“Article III”). Article III requires that all Covered Employers shall provide payment of the Living Wage Incentive as set forth in §233.402 of the Laws of Westchester County.

b. Pursuant to the provisions of Article III, the County shall have the authority, under the appropriate circumstances, to terminate this contract and seek other remedies as set forth therein, for violations of this Article.

c. The Covered Employer agrees to uphold the Worker Retention Policy for certain Covered Employees as set forth in §233.403 where such provision is applicable. d. The Covered Employer agrees to require any subcontractor or other employer that will provide Home Care Services or Building Services in connection with this contract, lease or agreement to pay the Living Wage Incentive Rate and comply with all other requirements of Article III, including the Worker Retention Policy for certain Covered Employees, where such provision is applicable. 5. No Reduction in Collective Bargaining or Prevailing Wage Rates. Nothing in this Article shall be construed or interpreted to require or authorize any Covered Employer to reduce wages set by a collective bargaining agreement or required under any prevailing wage in order to comply with the Living Wage Incentive Rate as set forth in §233.402. Sec. 233.404. Worker Retention Policy for Certain Covered Employees. In the event that a Covered Employer who provides Buildings Services pursuant to a Service Contract sells, transfers or assigns or otherwise conveys the duties of a Service Contract to another Person, all Qualified Retention Employees shall be retained for a period of not less than ninety (90) days. A Covered Employer may not discharge Qualified Retention Employees without cause during that ninety (90) day period.


Sec. 233.404. Retaliation and Discrimination Barred. It shall be unlawful for any person to retaliate or discriminate against an individual for making known a violation of this Article, for seeking or communicating information to others regarding rights conferred by this Article, for exercising any other right protected under this Article or for participating in any proceeding relating to this Article. The protection shall also apply to any individual who mistakenly, but in good faith, alleges a violation of this Article, or who seeks or communicates information regarding rights conferred by this Article in circumstances where he or she mistakenly, but in good faith, believes this law is applicable. Sec.233.405. Reporting Requirements. 1. Notice of Application for Service Contracts, County Lease or County Assistance. No Service Contract, County Lease or County Assistance shall be duly executed, unless, the Covered Employer files with the County of Westchester, a written certification which shall include the following: a. The name, address and telephone number of both the prospective Covered Employer, and of any subcontractor or other employer that will employ Building Services or Home Care Services employee in connection with the Services Contract, County Lease or for which County Assistance is awarded; b. A description of the service to be provided under the Service Contract, County Lease or for which County Assistance is awarded; c. A statement of the projected number of Covered Employees, by job title and wage levels, that will be employed under the prospective Service Contract, County Lease or County Assistance or that will be employed by any subcontractor or other employer that will employ Building Services or Home Care Service employees in connection with the Service Contract, County Lease or for which County Assistance is awarded; d. A written commitment to pay all Covered Employees a Living Wage Incentive as defined under this Article. 2. Notice of New Subcontractor. During the term of a Service Contract, County Lease or project for which County Assistance is awarded, if a new subcontractor or other employer begins providing Building Services or Home Care Services in connection with the Service Contract, County Lease or project for which County Assistance is awarded,


the Covered Employer shall promptly provide written notification to the County of the name, address and telephone number of the new Covered Employer. 3. Payroll Record keeping and Reporting. Each Covered Employer shall maintain payrolls records, including any supplementary documentation relating to hours worked withholdings and/or contributions for all Covered Employees and shall preserve same for a period of not less than three (3) years from the date of termination of the applicable Service Contract, County Lease or County Assistance program pursuant to which the Living Wage Incentive is paid. Upon written request by the County, a Covered Employer shall produce for inspection and copying said payroll records for all of its Covered Employees. Sec. 233.406. Posting and Notification. 1. Every Covered Employer shall conspicuously post on its premises, in an area where notices to employees and applications for employment are regularly posted or in an area that is accessible to all Covered Employees on a daily basis, two copies of this law informing employees of their rights under this Article. The Covered Employer shall also provide to each Covered Employee, in person or by mail, a copy of a written notice informing the Covered Employees of their rights under this Article. 2. The Covered Employer shall notify Covered Employees of the eligibility requirements with Federal Earned Income Tax Credit under Section 32 of the Internal Revenue Code of 1954 and for the New York State Earned Income Tax Credit (“EIC”). The Covered Employer shall make available forms to secure the EIC credits, upon request of the Covered Employee. Sec. 233.407. Compliance, Enforcement and Sanctions. 1. Grievance Procedure. Any Covered Employee who believes that any Covered Employer is in violation of the requirements of this Article has the right to file a sworn complaint with the County department or agency that monitors or oversees the Service Contract, County Lease or County Assistance with supporting documentation, which complaint shall contain a detailed outline of the alleged violation. In filing a grievance and upon the request of the complaining Covered Employee, said Covered Employee’s identity shall be kept confidential. 2. A Covered Employer may dispute allegations of the complaint with the appropriate evidence. The County shall make a final determination on the question of compliance. 3. Where a finding of non-compliance with this Article has been determined by the County, the Covered Employer will be given a written notice by the County. The Covered Employer shall be given the right to cure the violation within thirty (30) days from the date of the notice. Should the Covered Employer fail to cure the violation


within such time, the County shall impose sanctions including, but not limited to, one or more of the following: a. Suspending and/or terminating the Service Contract, County Lease or County Assistance agreement for cause; b. Requiring the Covered Employer to refund the County an amount relative to the particular County Contract, County Lease or County Assistance involved and the extent of the violation; c. Deeming the Covered Employer ineligible for future County Service Contracts, County Lease or County Assistance unless and until all

penalties and restitution have been paid in full, and until the County determines in its sole discretion to restore eligibility; d. Imposing a fine payable to Westchester County in the sum of five hundred dollars ($500.00) per week for each Covered Employee who was not paid in accordance with this Article; e. Requiring the Covered Employer to: (1) reinstate the affected Covered Employee, (2) make restitution of wages to the Covered Employee; and (3) grant to the Covered Employee any additional relief deemed appropriate by the County to make whole the Covered Employer.

Sec.233.408. Child Care Living Wage Task Force. There shall be a Child Care Living Wage Task Force that will research and develop a proposal by August 1, 2003, to establish a Child Care Living Wage Incentive Program for child care workers employed at child care agencies that contract with the Westchester County Department of Social Services to serve significant numbers of low-income Westchester Families. The membership of this Task Force shall consist of a total of ten (10) members: five (5) members appointed by the County Executive; two (2) members appointed by the County Board of Legislators; two (2) members of the Westchester County Living Wage Coalition; and one (1) member from the Child Care Council of Westchester. This task force shall develop a proposal by (1) surveying best practices developed in other localities for securing living wages for child care workers; (2) consulting with program administrators and policy experts with experience; (3) considering the development, programming and operations of the child care industry to evaluate and improve the delivery of services, worker retention policies and training programs through the use of child care living wage incentive programs. Sec. 233.409. No Impairment Clause. Nothing herein shall cause any person to impair an existing Service Contract, County Lease, County Assistance, collective bargaining agreement or contravene any applicable provision of law. Sec. 233.410. No Private Right of Action Against the County.


No person shall have the authority to maintain a private right of action against Westchester County or any of its officers or employees relating to either the enforcement or implementation of this Article. Sec. 233.411. Severability. If any section of this Article or the application thereof to any individual, partnership, or circumstance shall be adjudged invalid or unconstitutional by any court of competent jurisdiction, such order or judgment shall not affect, impair or invalidate the remainder thereof, but shall be confined in its operation to the controversy in which such order or judgment was rendered. §2. The Clerk of the Board, as soon as practicable after the adoption of this Local Law, shall cause a notice to be published at least once in one or more newspapers published in the County of Westchester, selected by the Clerk for that purpose, said notice to contain the number, date and adoption and a true copy of this Local Law and a statement that this Local Law, which changes a provision of law relating to County contracts, is subject to a referendum on petition pursuant to the provisions of Section 209.171(7) of the Westchester County Administrative Code and Section 24(2)(b) of the Municipal Home Rule Law. §3. This local law shall take effect sixty (60) days after its adoption.


APPENDIX “F”

SOCIAL SERVICES LAW TITLE 11, Article 5 §365-f. Consumer directed personal assistance program 1. Purpose and intent. The consumer directed personal assistance program is intended to permit chronically ill and/or physically disabled individuals receiving home care services under the medical assistance program greater flexibility and freedom of choice in obtaining such services. The department shall, upon request of a social district or group of districts, provide technical assistance and such other assistance as may be necessary to assist such districts in assuring access to the program. 2. Eligibility. All eligible individuals receiving home care shall be provided notice of the availability of the program and shall have the opportunity to apply for participation in the program. On or before October first, nineteen hundred ninety-six each social services district shall file an implementation plan with the commissioner of the department of health. An “eligible individual”, for purposes of this section is a person who: (a) is eligible for long term care and services provided by a certified home health agency, long term home health care program or AIDS home care program authorized pursuant to article thirty-six of the public health law, or is eligible for personal care services provided pursuant to this article; (b) is eligible for medical assistance; (c) has been determined by the social services district, pursuant to an assessment of the person’s appropriateness for the program, conducted with an appropriate long term home health care program, a certified home health agency, or an AIDS home care program or pursuant to the personal care program, as being in need of home care services or private duty nursing and is able and willing or has a legal guardian able and willing to make informed choices, or has designated a relative or other adult who is able and willing to assist in making informed choices, as to the type and quality of services, including but not limited to such services as nursing care, personal care, transportation and respite services; and (d) meets such other criteria, as may be established by the commissioner, which are necessary to effectively implement the objectives of this section. 3. Division of responsibilities. Eligible individuals who elect to participate in the program assume the responsibility for services under such program as mutually agreed to by the eligible individual and provider and as documented in the eligible individual’s record. Such individuals shall be assisted as appropriate with service coverage, supervision, advocacy and management. Providers shall not be liable for fulfillment of responsibilities agreed to be undertaken by the eligible individual. This subdivision, however, shall not diminish the participating provider’s liability for failure to exercise reasonable care in properly carrying out its responsibilities under this program, which shall include monitoring such individual’s continuing ability to fulfill those


responsibilities under this program, which shall include monitoring such individual’s continuing ability to fulfill those responsibilities documented in his or her records. Failure of the individual to carry out his or her agreed to responsibilities may be considered in determining such individual’s continued appropriateness for the program. 4. Participating providers. All agencies or individual who meet the qualification to provide home health, personal care or nursing services and who elect to provide such services to persons receiving medical assistance may participate in the program. Any agency or individuals providing services under a patient managed home care program authorized under the former section thirty-six hundred twenty-two of the public health law or the former sections three hundred sixty-five-f of this chapter may continue to provide such services under this section. 5. Waivers, regulation and effectiveness. (a) The commissioner may, subject to the approval of the director of the budget, file for such federal waivers as may be needed for the implementation of the program. (b) Notwithstanding any other provision of law, the commissioner is authorized to waive any provision of section three hundred sixty-seven-b of this title related to payment and may promulgate regulations necessary to carry out the objectives of the program, and which describe the responsibilities of the eligible individuals in arranging and paying for services and the protections assured such individuals if they are unable or no longer desire to continue in the program. 6. This section shall be effective if, to the extent that, and as long as, federal financial participation is available for expenditures incurred under this section. (Added L. 1995,c. 81, §77; amended L. 1996, c.474, §229.)


APPENDIX “G”

LOCAL COMMISSIONERS MEMORANDUM DSS-4037EL (Rev. 9/89) Transmittal No: 95 LCM-102 Date: September 18, 1995 Division: Health and Long Term Care TO: Local District Commissioners SUBJECT: Consumer Directed Personal Assistance Program (CDPAP) As enacted in Section 77 of Chapter 81 of the Laws of 1995, Section 365-f of the Social Service law was repealed and a new Section 365-f has been added to change the program name from Patient managed Home Care to Consumer Directed Personal Assistance Program (CDPAP). The statute incorporates many of the components found in previous statutes, including Chapter 795 of the Laws of 1992 which was transmitted to the districts in 93 LCM-113. In addition, Section 91 of chapter 81 of the laws of 1995 added a new Section 367-p to the Social Services Law. This Section states that “...each local district shall ensure access to a consumer directed personal assistance program operated pursuant to section three hundred sixty-five-f of this title is available in the district to allow persons receiving home care pursuant to this title to directly arrange and pay for such care.” The purpose of CDPAP is to allow chronically ill and/or physically disabled individuals receiving home care services under the Medical Assistance program greater flexibility and freedom of choice in obtaining such services while reducing administrative costs. All agencies or individuals who meet the qualifications to provide home health, personal care or nursing services and who elect to provide such services to persons receiving Medical Assistance, may participate in the program. Agencies or individuals providing services under a Patient Managed Home Care program, the former Section 3622 of the Public Health Law or the former Section 365-f of the Social Services Law, may continue to provide services under the CDPAP. Eligible individuals currently in receipt of home care services will be advised of program guidelines by their local department of social services, and may apply for participation. According to Section 77 of Chapter 81 of the Laws of 1995, “an eligible individual, for purposes of this section is a person who:


(a) is eligible for long term care and services provided by a certified home health agency, long term home health care program or AIDS home care program authorized pursuant to article thirty-six of the public health law, or is eligible for personal care services pursuant to this article; (b) is eligible for medical assistance; (c) has been determined by the social services district, pursuant to an assessment of the person’s appropriateness for the program, conducted with an appropriate long term home health care program, a certified home health agency, or an AIDS home care program, or pursuant to the personal care program, as being in need of home care services or private duty nursing and is able and willing or has a legal guardian able and willing to make informed choices, or has designated a relative or other adult who is able and willing to assist in making informed choices, as to the type and quality of services, including but not limited to such services as nursing care, personal care, transportation and respite services; and (d) meets such other criteria, as may be established by the commissioner, which are necessary to effectively implement the objectives of this section.”

Eligible individuals who elect to participate in CDPAP assume the responsibility for services under the program as mutually agreed to by the eligible individual and the provider as documented in the individual’s record. Such responsibilities may include: 1. Recruit workers 2. Hire workers 3. Train workers 4. Supervise workers 5. Fire workers 6. Arrange for back-up coverage when necessary 7. Arrange/coordinate provision of other services 8. Maintain records for processing of payroll and benefits Providers shall not be liable for fulfillment of responsibilities agreed to be undertaken by individuals participating in CDPAP. This does not, however, diminish the provider’s liability for failure to exercise reasonable care in properly carrying out its responsibilities under this program. Such responsibilities include monitoring the individual’s continuing


ability to fulfill those responsibilities documented in his or her record. An individual’s failure to exercise reasonable care in properly carrying out its responsibilities under this program. Such responsibilities include monitoring the individual’s continuing ability to fulfill those responsibilities documented in his or her record. An individual’s failure to carry out the agreed responsibilities may be considered in determining that person’s continued appropriateness for the program. Social services districts which have implemented, or initiated action to implement, a CDPAP should continue those efforts. Other districts should begin developing programs based upon the information contained in this transmittal. Two possible methods of implementing CDPAP are: 1. Memorandum of Understanding (MOU) Districts that have identified an immediate demand for the CDPAP delivery arrangement can use this administrative mechanism to quickly establish a program by using an established CDPAP. Six districts are pursuing this approach with Concepts for Independence, a New York City based CDPAP provider. The MOU is a legal document which details the roles and responsibilities of the entities that would administer the CDPAP. These entities would include the following: a. the district which would conduct an assessment of the consumer to determine appropriateness for the program and authorize services; b. an existing CDPAP provider to act as a fiscal agent to bill the Medical Assistance program and perform administrative functions such as payroll processing at the direction of the consumer; and c. a third party such as an independent living center located in the district, to act as a liaison between the CDPAP provider and the consumer. 2. Locally Established Program The district enters directly into a contract with a vendor to provide the CDPAP. The contract between the district and the vendor should include a delineation of the roles and responsibilities of the district, vendor and consumer. The Department will convene an advisory group to assist in developing


regulations for CDPAP. Regulations and an administrative directive will be issued as a part of this effort. Districts are requested to contact Ms. Deirdre Barnes at (212) 383-1431 (user ID AV0060) or Mr. Fred Waite at (518) 473-5490 (user ID 0LT150) for further information concerning CDPAP or to pursue either of the options described above. ________________________ Richard T. Cody Deputy Commissioner Division of Health and Long Term Care


APPENDIX “H” WGIUPD GENERAL INFORMATION SYSTEM 4/27/04 DIVISION: Office of Medicaid PAGE 1 GIS 04 MA/010 TO: Local Commissioners, Medicaid Directors FROM: Betty Rice, Director Division of Consumer and Local District Relations Scope of Services (Revision of GIS 02 MA/024) EFFECTIVE DATE: Immediately CONTACT PERSON: Christopher Phillips Bureau of Long Term Care: (518) 474-6580 or (518) 474-5271 The purpose of this GIS is to clarify the scope of services that an aide in the Consumer Directed Personal Assistance Program (“CDPAP”) may provide, particularly with regard to occupational therapy, physical therapy and speech therapy services. The scope of services that a CDPAP aide may provide includes all services provided by a personal care services aide, home health aide, registered nurse or licensed practical nurse. A CDPAP aide is able to provide nursing services because the Education Law specifically exempts CDPAP aides from having to be licensed under Article 139 of the Education Law, otherwise known as the Nurse Practice Act. The Education Law provisions governing physical therapists (Article 136), occupational therapists (Article156) and speech therapists (Article 159) do not exempt CDPAP aides from their licensure requirements. CDPAP professionals or any other health care professional are subject to the Education Law’s licensure provisions. A CDPAP aide may not evaluate the recipient, plan a therapy program or provide other skilled therapy services unless the aide is also licensed under the appropriate Education Law provision. Any required skilled therapy services must be provided through another source, such as a licensed home care services agency, CHHA, LTHHCP or a licensed therapist in private practice. Although a CDPAP aide may not provide skilled therapy services directly, an aide may, under the direction of the consumer, assist with the performance of therapy programs that a licensed therapist has planned for that CDPAP recipient. As stated in GIS 02 MA/024, social services districts’ CDPAP assessments and authorizations should continue to include the full scope of home care services that the Medicaid recipient requires and for which he or she, or his self-directing representative, agrees to be responsible under the CDPAP program. A district’s CDPAP authorizations


must include assistance needed with personal care, home health aide and skilled nursing tasks and also any physical therapy, occupational therapy and speech therapy services that the recipient may require and the aide may perform.


APPENDIX “I”

Certification Regarding Debarment and Suspension 1) As required by Federal Executive Order 12549, and prescribed by federal regulations, including 40 CFR Part 32, the contractor certifies that it, and its principals:

(a) Are not presently disbarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded by any Federal department or agency;

(b) Have not within a 3-year period preceding this proposal been

convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction, including any violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements or receiving stolen property;

(c) Are not presently indicted for or otherwise criminally or civilly

charged by a Government entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (b) above; and

(d) Have not within a 3 year period preceding this application/proposal

had one or more public transactions (Federal, State or local) terminated for cause or default.

2) Where the Contractor is unable to certify to any of the statements in this paragraph, the Contractor shall attach an explanation to this certification. Date:___________________ _________________________ Signature _________________________ Title _________________________ Organization


WESTCHESTER COUNTY DEPARTMENT OF … 12, 2004 · Andrew J. Spano County Executive Department of...

Documents

Transcript of WESTCHESTER COUNTY DEPARTMENT OF … 12, 2004 · Andrew J. Spano County Executive Department of...