N.M. Code R. § 9.2.12.10 - GENERAL PROVISIONS

A. The state agency on aging (state agency) must approve the provision of corporate eldercare services proposed by the area agency prior to the delivery of the service.

B. An area agency which engages in corporate eldercare and/or private case management services must:

(1) assure that all activities conform with the responsibilities of the area agency as described in the Older Americans Act, as amended, and the laws, regulations and policies of the state of New Mexico;

(2) assure that preference in receiving services will not be given to particular older individuals as a result of a contract or commercial relationship;

(3) focus on the needs of older persons in greatest need, with particular attention to low-income minority older persons, and engage only in activities which are consistent with its statutory mission and related state policy;

(4) maintain the integrity and public purpose of services provided, and service providers under the area plan, in all contracts or arrangements;

(5) disclose to the state agency and the commissioner of the U.S. administration on aging the identity of each non-governmental entity with which the area agency has a contract or commercial relationship relating to providing any services to older individuals and the nature of such contract or relationship;

(6) demonstrate that a loss or diminution in the quantity or quality of the services provided, or to be provided under the area plan has not resulted and will not result from such contract or relationship;

(7) demonstrate that the quantity or quality of the services provided in the area plan will be enhanced as a result of such contract or relationship;

(8) on request from the state agency or the commissioner, for the purpose of monitoring compliance with the act (including conducting an audit), disclose all sources and expenditures of funds received or expended to provide such services;

(9) not use Title III funds and related matching funds (or other public funds) to pay any of the cost (including AAA administrative costs) to provide corporate eldercare services;

(10) when entering into an eldercare contract, must assure, and include in its contract, that payment received from private third parties such as corporations fully covers, at a minimum, the cost of the services provided including the cost of administration and overhead;

(11) establish and maintain appropriate fiscal controls to provide separate accountability of public funds from funds received from a private corporation or other third party under a corporate eldercare contract, and shall account for private contract revenues and expenditures separately from federal and state funds awarded under the approved area plan;

(12) submit for state agency approval a cost allocation plan;

(13) provide documented assurances that public funds are not used to supplement third party payments made by a corporation under an eldercare contract;

(14) must include the results of all financial activity in their audited financial statements;

(15) describe the area agency's approach to, plans for and current involvement with corporate eldercare in the area plan or any amendment to the area plan;

(16) include in their area plan, and amendments thereof, an exhibit describing their relationships with the employer, insurance company or brokering organization, services rendered to older persons as a consequence of these agreements or contracts; and a signed statement of assurance of compliance with this policy;

(17) when proposing to furnish corporate eldercare services prior to the area plan or revision:

(a) obtain approval from the area agency governing board or entity;

(b) hold a public hearing on the proposed service and the impact on the area agency and the community;

(c) furnish the state agency with a service delivery plan and budget; and

(d) obtain approval from the state agency prior to entering into a contract to provide corporate eldercare;

(18) must assure that any involvement in providing corporate eldercare will not adversely impact upon or in any way create a conflict of interest or the appearance of a conflict of interest with the ability of the area agency to carry out its statutory mission;

(19) treat information collected and produced under any corporate eldercare contract, and all records maintained, the same as other information collected under the area plan and shall be available for review by the state agency and must be provided to the state agency upon request; and

(20) maintain the confidentially of all information collected on individual clients which is confidential.

C. The provisions above do not constrain the area agency from utilizing OAA Title III B or state funds to develop new resources and coordinate services to develop other eldercare and private case management services systems in its planning and service area.

D. Area agencies shall establish service standards including response time, caseloads, and waiting lists to assure that older persons in greatest need, specifically low-income, minority persons are appropriately served with the available federal and state funding. Whenever it is determined by the state agency that the responsibilities of the employer, insurance company or brokering agent contracts are inhibiting the area agency in its ability to meet its adopted service standards, or to fulfill its statutory mission as an area agency, the area agency will initiate immediate corrective action, or will terminate its contract with an employer, insurance company or brokering agent within 60 days.

Notes

N.M. Code R. § 9.2.12.10

Recompiled 10/01/01