AAA Operations Policy #7: Contracts and Commercial Relationships
This content is part of a public comment period. For more information, refer to Minnesota Board on Aging – State Plan on Aging.
Authority Reference | OAA, Section 212 45 CFR 1321.9(c)(2)(xiv) |
Operating Category | AAA Operations |
Policy
1. This policy relates only to Section 212 agreements under the Older Americans Act. For policies related to other types of contracts and grant agreements, please refer to Title III Administrative and Financial Requirements Policy #8: MBA Grant Agreements and Amendments between MBA and AAAs and #9: AAA Grants and Contracts with Service Providers.
2. MBA encourages AAAs to establish comprehensive and coordinated systems for supportive, nutrition, and other services for older adults by leveraging resources beyond OAA funding. In doing so through contracts and commercial relationships (“agreements”), AAAs can use both government and private funding to serve more older adults in need. Through this policy, MBA intends to facilitate increased access to services for older individuals while ensuring responsible oversight of federal funds and protecting the integrity of our aging services network.
3. Consistent with section 212 of the OAA, AAAs who seek to establish agreements to serve individuals or entities not otherwise receiving services under the Act must obtain prior approval from MBA. This policy applies to agreements with any entity (both for-profit and non-profit) for a AAA to provide goods or services in exchange for reimbursement or other financial consideration, with the expectation that the agreement will result in profit and reimbursement of initial costs. MBA has established this streamlined policy and procedure to expedite the prior approval process as much as possible.
4. For agreements involving multiple AAAs, one entity may submit information for prior approval on behalf of the group. The anticipated contractual expectations of each AAA must be clear in the information submitted. Service providers involved in these arrangements are not required to separately seek prior approval. AAAs must incorporate standard language related to conflicts of interest and compliance with MBA data use policies into each of the prospective agreements for which they are seeking approval.
5. Consistent with section 212 of the OAA, AAAs may use OAA funding to develop or initiate section 212 agreements. All 212 agreements must incorporate a guarantee that any OAA costs used in the development will be reimbursed to the AAA by the third-party entity. In addition, the OAA requires that any amount of payment to the AAA that exceeds this initial reimbursement will be used to provide, or support the provision of, OAA services.
6. Through this policy, MBA categorically pre-approves the following types of agreements, contingent on receipt of the minimum information outlined in the prior approval form:
A. Agreements with local, state, and federal governmental entities;
B. Agreements with other AAAs or AAA associations; and
C. Agreements with entities with which a AAA has a long-standing existing business relationship (of three years or more).
Note: AAAs that have received an audit report with financial findings within the previous twelve months are not eligible for the categorical approval of agreements, including the types of agreements listed above. Instead, AAAs in such situations must submit requests for approval of each prospective individual agreement.
7. MBA will also approve the following types of agreements, subject to review of the required prior approval forms:
A. A single agreement with an entity (or multiple entities) to provide specific services;
B. A category or type of agreement with a specific entity or a type of entity for the AAA to provide specific services (including through private pay arrangements);
C. A category or type of agreement with a type of entity (or multiple entities) for the AAA to provide a broad category of services;
Procedures
1. For agreements that are categorically preapproved, the AAA should complete and submit the Section 212 Agreements form included at the end of this procedure.
2. For potential agreements that require prior approval, AAAs must submit the following information for any new potential agreements that require prior approval by completing and submitting the Section 212 Agreements form and any required follow up information. AAAs may submit the prior approval form whenever necessary to receive approval prior to establishing an agreement subject to prior approval under section 212 of the OAA:
A. The name of OR type of the entity (or entities) with which it intends to establish agreement(s);
B. The nature of the agreement(s), including the specific service(s) OR the types of services to be provided under the agreement(s);
C. An estimate of the proposed costs incurred from all sources, including the estimated amount of OAA and state funds that will be used in implementing the agreement (e.g., administrative overhead, data systems, and/or staff time);
D. The duration of the agreement;
E. The completed risk-screening form; and
F. Signed assurances.
Note: If a non-disclosure or other confidentiality agreement prevents the AAA from disclosing required information, the AAA should submit publicly available information and attach a copy of the confidentiality agreement (redacted if necessary) to the submission for prior approval.
3. Risk screening factors for agreements requiring pre-approval include the following:
AAAs must assess prospective agreements for risk, according to the criteria identified below. If one or more of the identified risks are present, MBA will not approve without discussion with and/or the provision of further information from the AAA.
Under the following circumstances, the AAA must discuss or provide information described in MBA’s policy the prospective agreement(s) with MBA before prior approval can be obtained:
- Lacks sufficient liability insurance;
- Is not appropriately incorporated, as applicable;
- Is not in good standing with state and/or local licensing boards, as applicable;
- Is under investigation by the Internal Revenue Service and/or state and local tax revenue entities;
- Is under investigation by the State Medicaid agency, Medicaid Fraud Control Unit, State or U.S. Department of Health & Human Services Office of Inspector General (or equivalent), or the U.S. Department of Justice;
- Has been recently (within the last five years) sanctioned by the Internal Revenue Service, state and/or local tax revenue entities;
- Has recently (within the last five years) lost its state or local license due to non- compliance with state and/or local law;
- Has recently (within the last five years) lost its status as a Medicaid provider due to non- compliance with Medicaid law or regulation.
Assurances
AAAs must provide assurances of compliance with certain requirements under the Act, which are listed in the prior approval form. AAAs must also incorporate standard language related to conflicts of interest into each of the prospective agreements for which they are seeking approval.
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