WASHINGTON STATE LONG-TERM CARE OMBUDSMAN PROGRAM MULTI-SERVICE CENTER QUESTIONS AND ANSWERS. regarding. Request for Proposals.

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WASHINGTON STATE LONG-TERM CARE OMBUDSMAN PROGRAM MULTI-SERVICE CENTER PO BOX 23699 Federal Way, WA 98003 QUESTIONS AND ANSWERS regarding Request for Proposals for Snohomish County Long-Term Care

1 WASHINGTON STATE LONG-TERM CARE OMBUDSMAN PROGRAM MULTI-SERVICE CENTER PO BOX Federal Way, WA QUESTIONS AND ANSWERS regarding Request for Proposals for Snohomish County Long-Term Care Ombudsman Program The following questions were submitted, and the responses provided, pursuant to the Question and Answer Period terms of the above-referenced Request for Proposals. The following questions and answers were published on the Washington State Long- Term Care Ombudsman Program s website, on March 30, 2016.

2 1. Would you be able to elaborate on the distinction between "personnel management" and "program management"? For purposes of Long-Term Care Ombudsman Programs (Ombudsman Programs), federal regulations refer to personnel management and programmatic oversight. The Subgrantee Agency in which a local Ombudsman Program is organizationally located is responsible for personnel management, but not programmatic oversight, of certified Long-Term Care Ombuds (Ombuds), including Regional, Staff, and Volunteer Ombuds. For more information on state and federal laws governing Ombudsman Programs, see the Request for Proposals for the Snohomish County Long-Term Care Ombudsman Program (RFP). Personnel management refers to requiring Ombuds to follow the Subgrantee Agency s lawful personnel policies and procedures, so long as they do not prohibit Ombuds from performing the duties or adhering to the requirements set forth in federal and state laws governing Ombudsman Programs, and the policies and procedures of the State Ombudsman Program. Examples of personnel management functions include but are not limited to: budgeting; job classification; recruiting, hiring and firing; administering compensation and benefits; overseeing professional development; and handling employee relations. Programmatic oversight refers to requiring Ombuds to perform the duties and adhere to the requirements set forth in federal and state laws governing Ombudsman Programs, and the policies and procedures of the State Ombudsman Program. Examples of programmatic oversight include but are not limited to: granting, refusing, suspending, and removing certification of individual Ombuds and local Ombudsman Programs; refusing, suspending, and removing such certifications; monitoring the performance of individual Ombuds and local Ombudsman Programs; establishing procedures and specifying content for Ombuds training and certification; leading state-level coordination and supporting local coordination between the Ombudsman Program and other entities with regard to Ombuds responsibilities relating to the health, safety, welfare, and rights of residents of long-term care facilities. 2. What's a reasonable figure in terms of how much time it might take for one of our supervisors to manage the LTCOP for Snohomish County? The Subgrantee Agency in which a local Ombudsman Program is organizationally located is responsible for personnel management, but not programmatic oversight, of certified Ombuds, including Regional, Staff, and Volunteer Ombuds. The time required for personnel management will vary from one local Ombudsman Program to another. Factors include the number of Staff and Volunteer Ombuds who report to the Regional Ombuds, the relative experience of the Ombuds and the person(s) responsible for personnel management; the number and nature of applicable personnel policies and procedures, and other factors. For local Ombudsman Programs in Q & A re RFP for Snohomish Co. LTC Ombudsman Program, March 30, 2016 Page 2 of 7

3 Washington, personnel management time has varied from an average of two to four hours per month, with additional time needed depending on specific circumstances. 3. Our agency receives an annual audit in accordance with local/state/federal contracts we currently hold. Does this suffice for the LTCOP program, or does this contract require its own audit? A separate audit is not needed as long as the agency s annual audit includes the local Ombudsman Program, and also satisfies the audit requirements of the Subgrant Contract, including Section 9 of the General Terms and Conditions set forth in the Sample Contract attached to the Request for Proposals. 4. Would it be possible to view a sample budget for the Snohomish County program? What are the current costs for staff, mileage, training, supplies, etc...? What is the salary level for current staff? This would be helpful to know in order to formulate a budget that has continuity with the current program. Sample budgets are not provided as part of the RFP process. Contintuity with the policies and procedures of another agency in which a local Ombudsman Program has been located is not a component of the selection process. 5. Specifically, which training costs are covered by MSC and which are covered by the Subgrantee? The State Ombudsman Program and the Multi-Service Center (MSC) will pay the cost of training and certification materials for all Ombuds; travel expenses for Regional Ombuds to attend regional and statewide retreats held by the State Ombuds; and lodging for Regional Ombuds at statewide retreats with prior approval of the State Ombuds. Expenses such as wages and benefits for trainers/presenters, travel time, space costs, catering, and volunteer travel must be within the approved budget submitted by the subgrantee. The State Ombuds will periodically offer additional training and will indicate when costs are or are not covered. Examples include registration fees to attend conferences, special webinars, and other events. Q & A re RFP for Snohomish Co. LTC Ombudsman Program, March 30, 2016 Page 3 of 7

4 6. Are their currently other funding sources besides the MSC contract that sustain the program in Snohomish County? If so, is there a possibility for these funding sources to be transferred over to a new Subgrantee? Subgrantee Agencies are encouraged to seek additional funding to support the local Ombudsman Program. The development of such funding is handled at the discretion of the Subgrantee Agency, and the actual provision of additional funding may vary. The State Ombuds and MSC are not aware of any funding sources that may be transferred to the successful proposer for this RFP. The State Ombuds is available for consultation with subgrantee agencies regarding potential sources for additional funding. 7. Pg 1 of 10 of the sample contract refers to the Adult Family Home Initiative? Could you elaborate on this initiative and how it relates/differs from the LTCOP? How much staff time does it take to manage this program? Is this completed by the Regional Ombudsman or is additional staff necessary? The Adult Family Home Initiative provides limited funding, allocated by the state legislature, to ensure that residents living in adult family homes have access to Ombuds services. This funding is already included in the Projected Award for Snohomish County for fiscal year Individuals who live in adult family homes are often more isolated than other vulnerable adults living in larger settings such as assisted living and nursing homes. Because of past abuses in the adult family home industry, the state legislature wanted to improve Ombuds access in adult family homes. The only requirement for subgrantees related to this initiative is to indicate on monthly invoices any expenses specific to Ombuds work in adult family homes. There are no minimum requirements. 8. Page 3 of 10 of sample contract: "Ensure that services provided through Medicaid funds are used to assist individuals to gain access to Medicaid services." Could you elaborate on what this means/when and how often this occurs? Are Medicaid funds part of this contract? The statement regarding Medicaid funds in the Sample Contract will be removed from the SFY 2017 contract. Due to a decision by the Centers for Medicare & Medicaid Services, the Washington State Ombudsman Program no longer accesses Medicaid administrative funds. New possibilities are being explored, however, with the State Unit on Aging (DSHS) on ways to access Medicaid administrative funds in the future. Q & A re RFP for Snohomish Co. LTC Ombudsman Program, March 30, 2016 Page 4 of 7

5 9. If you're able to disclose, can you give any detail as to why the current Subgrantee, Snohomish County, has decided not to renew the contract? The Snohomish County Division on Aging (County) is the current Subgrantee Agency for the Ombudsman Program in Snohomish County. After many years of successfully providing Ombuds services, a technical issue arose in relation to County job classifications that conflicted with the program requirements of federal and state laws governing Ombudsman Programs, and the policies and procedures of the State Ombudsman Program. (See Question 1 above for more information on the unique nature of Ombudsman Programs with regard to personnel management and programmatic oversight.) During a sustained and good faith effort, the County, the State Ombuds, and MSC tried to resolve the conflict, but were ultimately unable to do so. A mutual decision was reached to not renew the current subcontract. While located within the Snohomish County Division on Aging, the Snohomish County Long-Term Care Ombudsman Program recruited, trained, and supported hundreds of individuals who served as Certified Volunteer Ombuds and provided countless hours of services for the benefit of the residents of long-term care facilities located in Snohomish County 10. Can you elaborate on what the attorney fees are that the RFP refers to [in Section 8 of the Sample Contract]? How much would or should we allow for these type of fees in the budget? Section 8 of the Sample Contract refers to the unlikely possibility that a legal dispute could arise over the subgrant, leading one of the parties to file a lawsuit against the other. If this were to happen, the Subgrantee would pay its own attorney fees and costs, and the State Ombuds/MSC would pay its own fees and costs. Note: As an entirely separate matter, state and federal laws require the State Ombuds to be represented by an attorney as part of advocating for the rights of long-term care residents and fulfilling other Ombuds requirements. At the direction of the State Ombuds, the Ombuds attorney occasionally consults directly with local Ombuds on programattic Ombuds issues, but this cost is covered entirely by the State Ombuds/MSC, not by the Subgrantee Agency. Q & A re RFP for Snohomish Co. LTC Ombudsman Program, March 30, 2016 Page 5 of 7

6 11. As a non-profit 501(c)3 organization we receive donations from many individuals and businesses in the community, including long-term care facilities. The donations are used for general operational support and do not directly fund programs. Would this be considered a conflict of interest? The State Ombuds must consider both organizational and individual conflicts of interest that may impact the effectiveness and credibility of Ombuds work. One example of an organizational conflict is requiring that an Ombuds perform conflicting activities in an organization that receives grants or donations from long-term care facilities. Conflicts of interest must be disclosed to the the State Ombuds, and remedied or removed to the approval of the State Ombuds. Ultimately, the State Ombuds determines whether a conflict exists such that certification of an individual Ombuds or a local Ombudsman Program should be refused, suspended, or removed. This determination is necessarily fact-intensive. 12. We publish a bi-monthly newspaper that accepts advertising to help cover the cost of the publication. If the newspaper accepted advertising from a long-term care facility would this be considered a conflict of interest? The State Ombuds must consider both organizational and individual conflicts of interest that may impact the effectiveness and credibility of Ombuds work. Federal and state laws governing Ombudsman Programs provide examples, but not exhaustive lists, of circumstances that constitute conflicts. A conflict of interest likely exists when a Subgrantee Agency includes advertising for a long-term care facility in agency materials such as a newspaper. The business relationship between the facility and the Subgrantee Agency could have a chilling effect on the willingness of a resident in that particular facility to utilize Ombuds services to file a complaint concerning the facility s treatment of the resident. Conflicts of interest must be disclosed to the the State Ombuds, and remedied or removed to the approval of the State Ombuds. Ultimately, the State Ombuds determines whether a conflict exists such that certification of an individual Ombuds or a local Ombudsman Program should be refused, suspended, or removed. This determination is necessarily fact-intensive. Q & A re RFP for Snohomish Co. LTC Ombudsman Program, March 30, 2016 Page 6 of 7

7 13. If a member of our Board of Directors worked for a long-term care facility would this be considered a conflict of interest? The State Ombuds must consider both organizational and individual conflicts of interest that may impact the effectiveness and credibility of Ombuds work. One example of an organizational conflict is requiring that an Ombuds perform conflicting activities in an organization that has governing board members with any ownership, investment, or employment interest in a long-term care facility. Conflicts of interest must be disclosed to the the State Ombuds, and remedied or removed to the approval of the State Ombuds. Ultimately, the State Ombuds determines whether a conflict exists such that certification of an individual Ombuds or a local Ombudsman Program should be refused, suspended, or removed. This determination is necessarily fact-intensive. Q & A re RFP for Snohomish Co. LTC Ombudsman Program, March 30, 2016 Page 7 of 7

Long-Term Care Ombudsman Program Final Rule Federal Register, Vol. 80, No. 28, Published February 11, CFR Parts 1321 and 1327

Long-Term Care Ombudsman Program Final Rule Federal Register, Vol. 80, No. 28, 7704-7767 Published February 11, 2015 45 CFR Parts 1321 and 1327 Final Regulation Federal Register, Vol. 80, No. 28 PART 1321