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BRANCH OFFICE CLERK OF THE CIRCUIT COURT BRANCH OFFICE
3117 OVERSEAS HIGHWAY MONROE COUNTY 88820 OVERSEAS HIGHWAY
MARATHON, FLORIDA 33050 500 WHITEHEAD STREET PLANTATION KEY, FLORIDA 33070
TEL. (305) 289 -6027 KEY WEST, FLORIDA 33040 TEL. (305) 852 -7145
FAX (305) 289 -1745 TEL. (305) 292 -3550 FAX (305) 852 -7146
FAX (305) 295 -3660
MEMORANDUM
TO: Louie LaTorre
Director of Social Services
FROM: Ruth Ann Jantzen, Deputy Clerk .4
DATE: March 17, 1999
On March 10, 1998, the Board of County Commissioners granted approval and
authorized execution of Amendment 001 to the 1998/1999 Alzheimers Disease Initiative
Contract, Contract KG-897, between Monroe County and the Alliance for Aging, Inc.
Enclosed please find three duplicate originals, executed on behalf of Monroe
County. Please be sure that one fully executed copy is returned to this office as soon as
possible.
If you have any questions regarding the above, please do not hesitate to contact
this office.
cc: County Attorney
Finance
Community Services Director, w/o document
County Administrator, w/o document
File
1
•
Amendment 001
AMENDMENT TO 1998/1999 ALZHEIMERS DISEASE INITIATIVE 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 KG897.
3. Section I, Paragraph N, Public Entity Crime, is hereby deleted. Paragraphs 0 through V, on
pages 4 -7 are re- numbered accordingly to accommodate the deletion.
4. Section I, Paragraph T, Assignments and Contracts is hereby amended to read:
Alliance approval of the provider's Service Provider Application for the Local Service
Programs funds for July 1, 1998 to June 30, 1999 shall constitute Alliance approval of the
provider subcontracts if the subcontracts follow the service and funding information
identified in the approved Service Provider Application. No such approval by the Alliance of
any assignment or subcontract shall be deemed in any event or in any manner to obligate
the Alliance beyond the total dollar amount agreed upon in this contract. All such
assignments or subcontracts shall be subject to the conditions of this contract and to any
conditions of approval that the Alliance shall deem necessary.
5. Attachment 1, Financial and Compliance Audits, is hereby deleted and replaced with a new
Attachment I, Audit Attachment, and subsequent Exhibits.
6. Attachment III, Minimum Guidelines for Recipient Grievance Procedures, is hereby deleted
and replaced with a new Attachment III, Minimum Guidelines for Recipient Grievance
Procedures Applicable to All Adverse Actions Deemed Terminations, Suspensions, or
Reductions in Service.
7. This amendment shall begin on February 15 or on the date on which the amendment has
been signed by both parties, whichever is later.
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 performed
at the level specified in the contract are hereby amended to conform with this amendment.
This amendment and all its attachments are hereby made a part of the contract.
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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.
PROVIDER: Monroe County ALLIANCE FOR AGING, INC.
SIGNED BY: SIGNED BY: o�
S\zarr,o
NAME: .1.1\\ i hR \ uj NAME: RAMONA FRISCHMAN
TITLE: Vt lI 1 Di JJ TITLE: PRESIDENT
DATE: 2 / l�/77 DATE: 4 ) /2 / q
•
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BY O ,.. a .
DEP �`j CLERK
APPROVED AS TO F • •
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ATTACHMENT I
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.
8. 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.
9. 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 financial statements, a schedule of
expenditures of Federal awards, a summary schedule of prior audit findings, and a corrective
action plan.
10. 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.
11. 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
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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 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 Tess 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
1. 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 Circular 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
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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. 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 [ 1 0+ ` 4' 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 [ t a t ' e included in the accompanying
.4 _ " « . Management is responsible for [ $en's compliance with
those requirements. Our responsibility is to express an opinion on management's assertion about
the ` sk n '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 [Mil �� 1 '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 [ � : , 41 tf 's compliance with specified requirements.
In our opinion, management's assertion [
a ;4;;V:
is fairly stated, in all material respects. 3
Sincerely,
Notes:
1. 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)
APPROVED AS TO
AND Cy
BY • •�il_ /S,�
(Date)
.4/ E E TON
- `l
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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EXHIBIT -3
Sample Organization
Schedule of State Financial Assistance
For the year ended
State Agency State Federal State Federal Through Total Receipts
And Program Contract/ CFDA Receipts 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)
1, , 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)
APPROVED SUM E
AND SUM
NN TTON
BY -4 E4
(Date) • c
DA
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 III
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
fmal, 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 REQUEST 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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1
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 fmal 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 fmal 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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