INCLUSION & EXCLUSION POLICY FOR THE ADRC AND BOULDERCOUNTYHELP.ORG SERVICE DIRECTORY APPLICATION
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1 INCLUSION & EXCLUSION POLICY FOR THE ADRC AND BOULDERCOUNTYHELP.ORG & SERVICE DIRECTORY APPLICATION
2 Inclusion & Exclusion Policy for the ADRC Service Directory PURPOSE FOR THE AGING AND DISABILITY RESOURCES FOR COLORADO The Aging and Disability Resource for Colorado (ADRC) is a program of the Boulder County Area Agency on Aging (BCAAA). The purpose of the ADRC is to provide information, referral, and options counseling to people 60 and older, age with a disability, and caregivers that need information about long-term services and supports or assistance in accessing those services. The ADRC manages a catalog of long-term services and supports within the Network of Care Seniors and People with Disabilities service directory. This online web-based catalog provides an accurate and comprehensive directory of agencies providing services to older adults, adults with disabilities, and their caregivers. PURPOSE FOR INCLUSION & EXCLUSION POLICY The purpose of the ADRC Inclusion & Exclusion Policy is to assist agencies in determining if their program, services or business meets the criteria to be included in the directory. GENERAL INFORMATION FOR ALL AGENCIES AND SERVICE PROVIDERS Listed below are some guidelines which agencies and service providers need to understand. Final approval for the posting of any agency listing is based upon the review of an application, licensure, and past disciplinary action by the ADRC staff. An on-site visit may be made if appropriate (e.g. a new agency) ADRC staff reserve the right to edit language for formatting purposes, content and style; as well as inclusion in printed materials and other directories with which the ADRC has an agreement The ADRC reserves the right to exclude from its database any agency listing that the ADRC has adequate reason to believe may have a philosophy that could be hurtful to the well-being of individuals, groups or the community as a whole Submission of a completed Agency Application (either in paper format or through the online Add New Agency link) from an agency does not guarantee inclusion in the directory Inclusion in the directory does not constitute an endorsement by the BCAAA or the ADRC, however if an agency would like to link to the website please contact the ADRC at or infoadrc@bouldercounty.org September 2016 Page 1
3 Priority will be given to agencies and service providers that consistently serve older adults, caregivers, and adults with a disability within Boulder County Agencies must have been in existence for one year prior to inclusion in the directory; Exceptions can be made and are on case-by-case basis (See exceptions below). Agencies must meet professional, State, County, or city licensing and insurance protocols or requirements. At minimum the insurance requirements would include: o General Liability, Minimum limits of $1,000,000 Each Occurrence, $2,000,000 General Aggregate and $2,000,000 Products Completed Operations Aggregate o Professional Liability (as applicable), Professional liability coverage with minimum limits of $1,000,000 Per Loss and $1,000,000 Aggregate o Automobile Insurance (as applicable), Minimum limits $1,000,000 Each Accident o Workers Compensation (as applicable), Employer's Liability is required for minimum limits of $100,000 Each Accident/$500,000 Disease-Policy Limit/$100,000 Disease-Each Employee. Areas of Inclusion The directory includes providers that meet various areas of long-term service and support needs of older adults, adults with a disability and caregivers. Listed below are general areas of inclusion that can be found in the directory: Abuse or Neglect Accessibility or Modifications of Homes Crisis and Emergency Services Disease and Chronic Condition Diverse Communities Employment or Volunteering End of Life Financial Food, Meals or Nutrition Home Health Care, including Home Care Housing and Shelter Legal Mental Health Medical Equipment Physical Health Physical Therapy and Occupational Therapy Safety Specific Caregiving and Caregiver Support Substance Abuse Transportation or Driving Issues Veterans Exceptions to Inclusion & Exclusion Policy Listed below are exceptions to this policy and may automatically meet the Inclusion & Exclusion Policy: September 2016 Page 2
4 Government agencies (public or civil service) that provide social, educational or health services may be included in the directory Professional membership organizations or nonprofit agencies in the health or human services field National or regional agencies that offer human services, support, advocacy, or education for older adults, adults with a disability and caregivers that are currently not available in the Boulder County community may be included in the directory. Requirements of Inclusion Agencies will be required to provide an annual update of the online service directory through the Add/Correct Info link located on the agency listing or by going to Failure to do so may result in the removal of the agency from the directory until such update is completed. Exclusionary Criteria Listed below are criteria that will exclude an agency from being included in the directory: Potential grounds for exclusion or removal from the directory upon investigation by the appropriate agency, which may include, but is not limited to: o Service non-delivery, o Fraud, o Misrepresentation, o Discrimination (age, race, nationality, sex, sexual orientation, gender, religion, creed, body size, etc.), or o Proven or alleged criminal activities Any agency that knowingly provides false information will not be included or will immediately be removed from the directory for an indefinite period of time Any faith-based service organization that offer no special community-based service components (e.g. food pantry, serving hot meals, social services, etc.) Any agency that proselytize as part of a community service (e.g. providing a sermon during a meal) Match-making services of any kind, including dating sites, home sharing, roommate pairing, or matching unpaid caregivers with older adults or adults with disabilities Recreational or medical marijuana businesses Any agency that does not meet professional, State, County, or city licensing and insurance protocols or requirements September 2016 Page 3
5 Any agency that delivers an illegal service Any non-licensed or non-ombudsman monitored personal home care, assisted living facility, or skilled nursing facility based on state licensing regulations Any agency that misrepresents themselves or their services Any agency that receives a commission, fee, bonus, share of a profit, compensation, payment, stipend or reward from a third party for services given to older adults, adults with disabilities, or caregivers with the intent of creating an undue advantage or profit from the service SPECIFIC CRITERIA FOR CERTAIN TYPES OF AGENCIES AND SERVICE PROVIDERS Specific Criteria for Home Health Care Agencies Home health care agencies must maintain a Class A or B Home Health Care license through the State of Colorado Department of Public Health & Environment. Specific Criteria for Private Practice Mental Health Providers Mental health providers must: Provide documentation of clinical Geropsychology training and/or experience from an accredited institution. Provide documentation of clinical Rehabilitation Counseling training/or experience from an accredited institution. Provide a criminal background check, or other proof demonstrating that a criminal background check has been performed. Copy of certification, and/or copy of license or license number, and/or bonding, and/or liability insurance (as appropriate); and Provide two references upon request supporting a Geropsychology or Rehabilitation Counseling background. Specific Criteria for Care/Case Managers Entities that provide care management, care coordination, or case management must maintain one of the following certifications or licenses as well as a business license: Care Manager Certification (CMC) through the National Academy of Certified Care Managers (NACCM); Certified Case Manager (CCM) through the Commission for Case Manager Certification (CCMC); Certified Advanced Social Work Case Manager (C-ASWCM) through the National Association of Social Workers; September 2016 Page 4
6 Certified Social Work Case Manager (C-SWCM) through the National Association of Social Workers; Licensed Clinical Social Worker or Registered Nurse through the State of Colorado Department of Regulatory Agencies; Entities that are contracted or licensed through the State of Colorado. If none of the above certifications apply, then the agency can supplement the following levels of education: Graduate degree in the field of Social Work; Graduate degree in the field of Gerontology; For Mental Health practitioners, please see Specific Criteria for Private Practice Mental Health Providers. Specific Criteria for Private Practitioners and Businesses Private practitioners and businesses must: Deliver a service that is either no cost, low-cost, or sliding scale fee for in-home services, or services in a specialty area related to older adults and/or adults with disabilities and/or family caregivers Provide appropriate and relevant documentation upon request; Evidence of a criminal background check or proof demonstrating that a criminal background check has been performed for any type of service offered in the home. APPEAL PROCESS FOR ORGANIZATIONS If agency application for inclusion into the directory is not deemed to meet the criteria for inclusion, the ADRC will notify the appropriate contact person of the agency in writing or by . If an agency would like to appeal a decision regarding their inclusion or exclusion into the directory, the agency will follow these guidelines: Contact the ADRC to obtain the ADRC Feedback Form for Resource Directory Inclusion Fill out the form, which includes: o Name of agency o Name of contact person o Contact information (phone, mailing address, ) o Reason for appeal o Signature and date September 2016 Page 5
7 The Feedback Form must be ed or mailed back to ADRC within 30 days of original notification of inclusion or exclusion. Appeal will be reviewed by Community Living Program Manager who oversees the ADRC. A recommendation by the Community Living Program Manager will be made through phone contact. If the agency does not agree with the recommendation made by Community Living Program Manager then the recommendation can be appealed within 10 days to the Boulder County Area Agency on Aging Director. This decision from the Boulder County Area Agency on Aging Director will be final. September 2016 Page 6
8 Inclusion & Exclusion Policy for the ADRC and Agency Directory Application Agency Name: Agency Private Contact Name: Agency Private Contact Title: Agency Private Contact Phone & Agency Description: Agency Agency Phone: Agency Fax: Agency Website: Agency Address (If more than one, list all in Boulder County): If a client calls and does not speak English, is there someone regularly on staff that can assist the client who is fluent in the language? (Circle Answer) Yes No If yes, what language(s)? What is the application process? What are the eligibility requirements? Fees (Including private pay costs and sliding scale, if applicable): Accepted Types of Payment: Cash/Check Medicaid Medicare Private Insurance Geographical Area Served: Hours (Office and/or Service Hours): Other: If you agency provides homemaking, personal care, skilled nursing (including CAN), contractors for home modifications, transportation, or an assisted living facility, please answer the following question: Have you considered enrolling as a Medicaid Provider for community based long-term care services? Yes, I would like more information about being a Medicaid Provider for community based long-term care services. No thanks. September 2016 Page 7
9 Service Provider Certification I certify that the information provided in my application is true and accurate to the best of my knowledge. In addition, I certify that I have read and understood the Inclusion/Exclusion policy and that my agency complies with the Inclusion criteria. I understand that Boulder County Area Agency on Aging, a Division of Community Services, as the Lead Agency in the Information & Assistance/Referral Network of Boulder County, does not guarantee inclusion in its Network of Care Seniors and People with Disabilities on-line Service Directory and that the listing of agencies, businesses and programs is based on established inclusion/exclusion criteria, which I have received and read. In addition, I understand that this information may be provided to individuals and published in a variety of formats, including a webbased resource database and that listing or publication of information does not guarantee referral for services. I also agree to inform Boulder County Area Agency on Aging of any agency or program changes or discrepancies in a timely manner as well as providing an annual update. Agency/Business Name Director/Owner/Authorized Agent s Name (Please Print) Director/Owner/Authorized Agent s Signature Date September 2016 Page 8
10 Supplemental Questions Form 1. Do you hold a current United States Internal Revenue Code Section 501(c)3 in Colorado? Yes No Not applicable 2. Has your agency/business been in existence and serving Boulder County for at least one (1) year? Yes No Start-Up Date: 3. If your agency/business has been in existence and serving Boulder County for at least one (1) year, has it also been licensed through the state for at least one (1) year? Yes No Your agency/business does not require a state license September 2016 Page 9
11 Proof of Documentation Form (Proof of licenses, registrations, background checks, bonding, liability, references) Provide proper documentation of the following, when applicable: Copy of Colorado Department of Public Health and Environment Health Facilities and Emergency Medical Services Division License for Home Health Care Agencies State of Colorado Attorney Registration Number # Evidence of a criminal background check, or other proof demonstrating that a criminal background check has been performed. Copy of certification, and/or copy of license or license number, and/or bonding, and/or liability insurance (as appropriate) References included September 2016 Page 10
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