Amendment 001 4 .
Amendment 001
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AMENDMENT TO 1999 OLDER AMERICANS ACT CONTRACT
THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred to as
the "Alliance ", and Monroe County hereinafter referred to as the "Provider ", amends
contract KG - 951.
1. Section // /, Paragraph B - 3, Method of Payment, is hereby amended to read:
The Alliance shall make payment to the provider for provision of services up to a maximum
number of units of service and at the rate(s) stated below:
Service to be Unit of Unit Maximum Maximum
Provided Service Rate Units Dollars
Information Episode: 1 Person Informed $ 5.211666 1,800 $ 9,381
Referral Episode: 1 Contact $ 5.130588 1,700 $ 8,722
IIIB Homemaking 1 Hour $ 19.690826 2,024.75 $ 39,869
Congregate Meals 1 Meal Served $ 7.266561 17,058 $123,953
Nutrition Ed. 1 Presentation $ 48.994444 180 $ 8,819
Outreach Episode: 1 Contact $ 69.87 100 $ 6,987
Home Del. Meals 1 Meal Delivered $ 6.203170 24,856 $154,186
Nutrition 'Ed. 1 Mailout or 1 $ 440.833333 12 $ 5,290
Face to Face Prsntn
IIID Homemaking 1 Hour $ 21.864810 1,364.75 $ 29,840
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2. Attachment III, Financial and Compliance Audits, is hereby deleted and replaced with a new
Attachment III, Audit Attachment, and subsequent Exhibits.
3. Attachment VI, Minimum Guidelines for Recipient Grievance Procedures, is hereby deleted and
replaced with a new Attachment VI, Minimum Guidelines for Recipient Grievance Procedures
Applicable to All Adverse Actions Deemed Terminations, Suspensions, or Reductions in Service.
4. This amendment shall be retroactive to January 1, 1999.
All provisions in the contract and any attachments thereto in conflict with this amendment shall be
and are hereby changed to conform with this amendment.
All provisions not in conflict with this amendment are still in effect and are to be- erformtg atie
level specified in the contract are hereby amended to conform with this amendm it. 'v F
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This amendment and all its attachments are hereby made a part of the contract. N -
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IN WITNESS WHEREOF, the parties hereto have caused this 11 page amendment to be executed
by their undersigned officials as duly authorized.
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PROVIDER: Monroe County ALLIANCE FOR AGING, INC.
SIGNED SIGNED BY :V ,
NAME: 10;162,k v11'1 na ' r j'o AI NAME: RAMONA FRISCHMAN
TITLE: M A we TITLE: PRESIDENT
DATE: - 7//e Al DATE: 1- 4 L 1 4 e
APPROVED S TO FOR
UFFICIE $
in L
B .4 ANNE A �'„
DATE
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BY
DEPU LERK
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ATTACHMENT III
AUDIT ATTACHMENT
The administration of funds awarded by the Department of Elder Affairs to the provider may be subject to audits and/or monitoring by
the Department as described in this section.
In addition to reviews of audits conducted in accordance with OMB Circular A -133, as revised (see "AUDITS" below), monitoring
procedures may include, but not be limited to, on -site visits by Department staff, limited scope audits as defined by OMB Circular A-
133, as revised, and/or other procedures. By entering into this agreement, the provider agrees to comply and cooperate with any
monitoring procedures /processes deemed appropriate by the Department of Elder Affairs. In the event the Department of Elder
Affairs determines that a limited scope audit of the provider is appropriate, the provider agrees to comply with any additional
instructions provided by the Department to the provider regarding such audit.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the provider is a State or local government or a non - profit organization as defined in OMB Circular A -133,
as revised.
5. In the event that the provider expends $300,000 or more in Federal awards in its fiscal year, the provider must have an audit
conducted in accordance with the provisions of OMB Circular A -133, as revised. Federal funds awarded through the
Department of Elder Affairs by this agreement, if any, are indicated in Section II. A. of the contract(s) incorporating by
reference the Master Agreement of which this document is an attachment. In determining the Federal awards expended in its
fiscal year, the provider shall consider all sources of Federal awards, including Federal funds received from the Department of
Elder Affairs. The determination of amounts of Federal awards expended should be in accordance with the guidelines
established by OMB Circular A -133, as revised. The provider is responsible for the procurement of an independent auditor to
conduct the audit required by this part. The provider is required to follow the auditor procurement standards specified in
Section .305, OMB Circular A -133, as revised. An audit of the provider conducted by the Auditor General in accordance with
the provisions OMB Circular A -133, as revised, will meet the requirements of this part.
6. In connection with the audit requirements addressed in paragraph 1., the provider shall fulfill the requirements relative to auditee
responsibilities, financial statements, audit findings follow -up, and report submission as provided in Sections .300, .310, .315,
and .320 of OMB Circular A -133, as revised. This includes, but is not limited to, preparation of fmancial statements, a schedule
of expenditures of Federal awards, a summary schedule of prior audit findings, and a corrective action plan.
7. If not otherwise disclosed as required by Section .310 (b)(2) of OMB Circular A -133, as revised, the schedule of expenditures
of Federal awards shall identify expenditures by contract number for each contract with the Department of Elder Affairs in
effect during the audit period.
8. If the provider expends less than $300,000 in Federal awards in its fiscal year, an audit conducted in accordance with the
provisions of OMB Circular A -133, as revised, is not required. In the event that the provider expends less than $300,000 in
Federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of OMB Circular A-
133, as revised, the cost of the audit must be paid from non - Federal and non -State funds (i.e., the cost of such an audit must be
paid from provider funds obtained from other than Federal/State entities).
PART II: STATE GRANTS AND AIDS
1. This part is applicable if the provider is a Local government or a non - profit or for profit organization as defined in Chapter
10.600, Rules of the Auditor General.
2. In the event that the provider receives more than $25,000 in State grants and aids in its fiscal year, the provider must have a
limited scope audit conducted in accordance with Section 216.349, Florida Statutes, and Chapter 10.600, Rules of the Auditor
General. State grants and aids amounts awarded through the Department of Elder Affairs by this agreement are indicated in
Section II. A of the contract(s) of which this agreement is an attachment. In determining the grants and aids received in its fiscal
year, the recipient shall consider aggregate grants and aids received directly from State agencies, including grants and aids funds
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received from the Department of Elder Affairs.
The audit report must include an auditor's examination attestation report, management assertion report (alternatively,
management's assertion may be included in the management representation letter), and a schedule of State financial assistance.
EXHIBITS 1, 2, and 3 to this agreement provide examples of these reports /schedule.
The auditor's examination attestation report must indicate whether management's assertion as to compliance with the following
requirements is fairly stated, in all material respects:
• activities allowed or unallowed
• allowable costs /cost principles
• matching (if applicable)
• reporting
In the event that the provider receives State grants and aids totaling $25,000 or Less in its fiscal year, the head of the provider
entity or organization must provide a written attestation under penalty of perjury, that the provider has complied with the
allowable cost provisions (or other applicable provisions) of the State grants and aids contract. EXHIBIT 4 to this agreement
provides an example attestation document that should be used by the agency head to attest to compliance with grants and aids
provisions.
III: REPORT SUBMISSION
I. Copies of audit reports for audits conducted in accordance with OMB Circular A -133, as revised, and required by PART I of
this agreement shall be submitted, when required by Section .320 (d), OMB Circular A -133, as revised, or when required by
number 2 below, by or on behalf of the provider directly to each of the following within 180 days after the end of the provider's
fiscal year:
A. The Alliance for Aging, Inc. at the following address:
Alliance for Aging, Inc.
Attn.: John Stokesberry
9500 S. Dadeland Boulevard, Suite 400
Miami, FL 33156
B. Federal Audit Clearinghouse designated in OMB Circular A -133, as revised (the number of copies required by Sections
.320 (d)(1) and (2), OMB Circular A -133, as revised, should be submitted to the Federal Audit Clearinghouse), at the
following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville, IN 47132
2. Pursuant to Section .320 (f), OMB C ircular A -133, as revised, the recipient shall submit a copy of the reporting package
described in Section .320 (c), OMB Circular A -133, as revised, and any management letters issued by the auditor, to:
A. The Alliance for Aging, Inc. at the following address:
Alliance for Aging, Inc.
Attn.: John Stokesberry
9500 S. Dadeland Boulevard, Suite 400
Miami, FL 33156
3. Copies of reports required by PART II of this agreement, and management letters prepared in conducting audits related to State
grants and aids audits required by PART II of this agreement, shall be submitted by or on behalf of the provider directly to each
of the following within 180 days after the end of the provider's fiscal year:
A. The Alliance for Aging, Inc. at the following address:
Alliance for Aging, Inc.
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Attn.: John Stokesberry
9500 S. Dadeland Boulevard, Suite 400
Miami, FL 33156
B. Mr. James M. Dwyer at the following address:
Mr. James M. Dwyer
State of Florida Auditor General
P. 0. Box 1735
Tallahassee, Florida 32302 -1735
PART IV: AUDIT WORKING PAPERS
1. The provider shall ensure that audit working papers are made available to the Department of Elder Affairs or its designee, upon
request, for a period of five (5) years from the date the audit report is issued, unless extended in writing by the Department of
Elder Affairs.
•
•
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EXHIBIT - 1
INDEPENDENT AUDITOR'S REPORT ON
EXAMINATION OF MANAGEMENT'S ASSERTION
ABOUT COMPLIANCE WITH SPECIFIED REQUIREMENTS
(SAS Codification Section AT 500.55)
[Date]
Dear [Name] :
We have examined management's assertion' about [name of entity]'s compliance with the allowable
cost requirements [or other applicable requirements] established in the grant agreement(s) applicable
to the State grants and aids appropriations identified on Schedule of State Financial Assistance for the
year ended [indicate the applicable, fiscal year] included in the accompanying [title of management
report]. Management is responsible for [name of entity]'s compliance with those requirements. Our
responsibility is to express an opinion on management's assertion about the [name of entity]'s
compliance with specified requirements.
Our examination was made in accordance with attestation standards established by the American
Institute of Certified Public Accountants and, accordingly, included examining, on a test basis,
evidence about [name of entity,]'s compliance with those requirements and performing such other
procedures as we considered necessary in the circumstances. We believe that our examination provides
a reasonable basis for our opinion. Our examination does not provide a legal determination on [name
ofentity]'s compliance with specified requirements.
In our op_ inion, management's assertion [identifr manageme nt's ,assertion or e aPP le, that
earn lied with tie aforementioned re uirements durin ,the tAs ar ar en d
is fairly stated, in all material respects.
Sincerely,
Notes:
I. If the entity does not present its assertion in a separate report accompanying the practitioner's report, refer to SAS Codification Sections AT
500.56 and .57.
2. The practitioner should identify the management assertion report examined by reference to the report title used by management in its report
Further, he or she should use the same description of the compliance requirements as management uses in its report
3. Specific compliance requirements, and related criteria (if applicable) will be specified and/or referred to in the grant agreement. As such,
it should not be necessary to repeat the compliance requirements, and related criteria (if applicable) in the practitioner's report. Instances of
noncompliance should be reported in the manner prescribed in SAS Codification Sections AT 500.61 through .68.
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EXHIBIT - 2
MANAGEMENT ASSERTION REPORT
I, , hereby assert that,
(Provider's authorized representative)
complied with allowable cost requirements
(Provider Agency name)
[or other applicable requirements] of the grants and aids appropriations identified on the attached
Schedule of State Financial Assistance during the fiscal year ended
(Month, day, year)
(Signature)
(Title)
(Date)
If this assertion report is used, one copy shall be submitted after the provider's fiscal year end to each of the
parties designated in the contracts /grants for the identified grants and aids appropriations.
This statement does not need to be notarized.
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.f b
EXHIBIT - 3
Sample Organization
Schedule of State Financial Assistance
For the year ended
State Agency State Federal State Receipts Federal Through Total Receipts
And Program Contract/ CFDA State Receipts
Title Grant Number Number
(NOTE A)
Department of
Health
Head Start GHSO1 93.600 50,000 (1) 50,000 (1) 100,000
Women, Infant AB101 93.245 100,000 (1) 150,000 250,000
& Children
Department of
Elder Affairs
Community Care GC501 N/A 200,000 (1) 0 200,000
for the Elderly
Elder Care GC601 93.003 60,000 60,000 120,000
Total 410,000 410,000 (2) 820,000 (1)
(1) State Grants and Aids appropriations moneys. The grand total of State Grants and Aids Appropriations
moneys is $550,000.
(2) $390,000 of this amount is included in the expenditures presented in the Schedule of Expenditures of Federal
Awards. The remaining $20,000 was received under contract number GC601 but was not expended.
NOTE A: Federal CFDA numbers apply only to Federal programs.
CAUTION: The purpose of this schedule is format illustration only. The contract or grant numbers, CFDA
numbers and program titles are not intended to represent actual data.
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EXHIBIT - 4
ATTESTATION STATEMENT
CONTRACT/ GRANT NUMBER(S)
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I, , hereby attest, under penalty of perjury, that,
(Head of provider agency)
, complied with allowable cost
(Name of provider agency)
requirements [or other applicable requirements] of the grants and aids appropriations contracts/ grants
identified above during the fiscal year ended
(Month, day, year)
(Signature)
(Title)
(Date)
One copy of this attestation statement shall be submitted after the provider's fiscal year end to each of the
parties designated in the contracts/ grants for the identified grants and aids appropriations.
This statement does not need to be notarized.
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ATTACHMENT VI
MINIMUM GUIDELINES FOR RECIPIENT GRIEVANCE PROCEDURES
APPLICABLE TO ALL ADVERSE ACTIONS DEEMED TERMINATIONS, SUSPENSIONS, OR
REDUCTIONS IN SERVICE
Medicaid Waiver clients have the right to request a fair hearing from the Department of Children and
Families(DCAF) Office of Appeal Hearings in addition to or as an alternative to these procedures.
NOTICE TO THE RECIPIENT OF THE ADVERSE ACTON TO BE TAKEN AND EXPLANATION OF THE
GRIEVANCE PROCEDURES FOR REVIEWING THAT DECISION
• The recipient must be informed in writing no less than 10 calendar* days prior to the date the adverse action will be
taken.
(Prior notice is not applicable where the health or safety of the individual is endangered if action is not
taken immediately; however, notice must be made as soon thereafter as practicable.)
• Services cannot be reduced, terminated nor any adverse action taken during the 10 day period.
• The Notice must contain:
a statement of what action is intended to be taken;
the reasons for the intended action;
an explanation of:
1) the individual's right to a grievance review if requested in writing and delivered within 10
calendar* days of the Notice postmark (assistance in writing, submitting and delivering the
request must be offered and available to the individual);
2) in Medicaid Waiver actions, the individual's right to request a fair hearing from DCAF;
3) the individual's right, after a grievance review, for further appeal;
4) the right to seek redress through the courts if applicable;
a statement that current benefits will continue if a grievance review is requested, and will continue until a
final decision is made regarding the adverse action; and
a statement that the individual may represent herself or use legal counsel, a relative, a friend, or
other qualified representative in the requested review proceedings.
• All records of the above activities must be preserved in the client's file.
GRIEVANCE REVIEW PROCEDURE UPON TIMELY RECEIPT OF A WRITTEN REOUEST FOR REVIEW
• Within 7 calendar* days of the receipt of a request for review, the provider must acknowledge receipt of the request
by a written statement delivered to the requester. This statement must also provide notice of:
the time and place scheduled for the review;
the designation of one or more impartial reviewers who have not been involved in the decision at
issue;
the opportunity to examine, at a reasonable time before the review, the individual's own case
record, and to a copy of such case record at no cost to the individual;
the opportunity to informally present argument, evidence, or witnesses without undue interference
at a reasonable time before or during the review;
a contact person for any accommodations required under the Americans with Disabilities Act;
assistance, if needed, in order to attend the review; and
the stopping of the intended action until all appeals are exhausted.
• All grievance reviews must be conducted at a reasonable time, date and place by one or more impartial reviewers
who have not been directly involved in the initial determination of the action in question.
• The reviewer(s) must provide written notification to the requester within 7 calendar* days after the grievance review
of:
the decision, stating the reasons therefore in detail;
the effect the decision has on current benefits, if favorable, or the circumstances regarding
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continuation of current benefits until all appeals are exhausted;
the individual's right to appeal an adverse decision to the Area Agency on Aging
by written request within 7 calendar* days;
the availability of assistance in writing, submitting and delivering the appeal to the appropriate
agency;
the opportunity to be represented by herself or by legal counsel, a relative, a friend or other
qualified representative.
PROCEDURE FOR APPEALS OF A GRIEVANCE REVIEW DECISION UPON TIMELY RECEIPT OF A
WRITTEN APPEAL TO THE AREA AGENCY ON AGING
• Within 7 calendar* days of the receipt of a notice of appeal of a grievance review decision, the AAA must
acknowledge receipt of the notice of appeal by a written statement delivered to the appellant. This statement must
also provide notice of:
the time and place scheduled for the appeal;
the designation of one or more impartial AAA officials who have not been involved in the
decision at issue;
the opportunity to examine at a reasonable time before the appeal the individual's own case record
to date, and to a copy of such case record at no cost to the individual;
the opportunity to informally present argument, evidence, or witnesses without undue interference
during the appeal;
assistance, if needed, in order to attend the appeal; and
the stopping of the intended action until all appeals are exhausted.
• All appeals of grievance reviews must be conducted at a reasonable time, date and place by one or more impartial
AAA officials who have not been directly involved in the initial determination of the action in question.
• The designated AAA official(s) must provide written notification to the requester within 7 calendar* days after
considering the grievance review appeal of:
the decision, stating the reasons therefore in detail;
the effect the decision has on current benefits, if favorable, or the circumstances regarding
continuation of current benefits until all appeals are exhausted;
the individual's right to appeal, if applicable. Except for Medicaid Waiver actions, the decision of
the AAA shall be the final decision; and
the availability of assistance in requesting a fair hearing, including a notice regarding
accommodations as required by the ADA.
• All records of the above activities must be preserved and remain confidential. A copy of the final decision must be
placed in the client's file.
* In computing any period of time prescribed or allowed by these guidelines, the last day of the period so
computed shall be included unless it is a Saturday, Sunday, or legal holiday, in which event the period shall run
until the end of the next day which is neither a Saturday, Sunday, or legal holiday.
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