1st Amendment 05/12/1999 `pOUMTyC -.
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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 f
MEMORANDUM
TO: Louie LaTorre
Director of Social Services
FROM: Ruth Ann Jantzen, Deputy Clerk .
DATE: May 19, 1999
On May 12, 1999, the Board of County Commissioners granted approval and
authorized execution of Amendment 001 to 1998 -99 Community Care for the Elderly
Contract between Monroe County and the Alliance for Aging, Inc., amending Contract
KG-851E.
Enclosed please fmd three duplicate originals of the above named Amendment,
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
County Administrator, w/o document
File
BOARD OF COUNTY COMMISSIONERS
_ E -- MAYOR Wilhelmina Harvey, District I
, � � Mayor pro tem Shirley Freeman, District 3
OUNTY o ROE 1:,1 "- George Neugent, District 2
KEY WEST FLORIDA 33040 ,dee
(305)_46,, ,` Nora Williams, District 4
• 1 `, � • 1 ' �� Mary Kay Reich, District 5
n,
MEMORANDUM
TO: Ruth Ann Jantzen
Deputy Clerk
Monroe County Clerk's Office
FROM: Tracy Threlkeld
Staff Assistant
In Home Services Program /Social Services
DATE: 6/1/99
RE: Fully Executed Amendment #001
Attached are 3 fully executed copies, for your distribution, of Amendment #001 to the 98 -99 Community Care For The
Elderly Contract
#KG -851 E. ; '4
`�" 1 atiaio
Thanks for all your help!
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Amendment 001
AMENDMENT TO 1998 -99 COMMUNITY CARE FOR THE ELDERLY CONTRACT
THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter
referred to as the "Alliance ", and the Monroe County Board of Commissioners, hereinafter
referred to as the "Provider ", amends contract KG-351E.
1. Section III, Paragraph B - 3, 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 Units Rate Total Award
Case Management 3,403 $38.919791 $132,444
Chore 2,574 $27.364451 $ 70,436
Homemaker 7,901.25 $20.292947 $160,340
• Personal Care 5,286.50 $23.249104 $122,906
Respite 2,624.50 $17.475098 $ 45,864
2. Attachment I, Financial and Compliance Audits, is hereby deleted and replaced with a
new Attachment I, Audit Attachment, and subsequent Exhibits.
3. 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.
4. This amendment shall begin on May 1 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 12 page amendment to be
executed by their undersigned officials as duly authorized.
PROVIDER: Monroe County Board of ALLIANCE FOR AGING, INC.
Commissioners
SIGN B SIGNED BYE-
lc afilMO 4 011
NAME: (LI L- A NAME: RAMONA FRISCHMAN
TITLE: ! ' . /41 1 TITLE: PRESIDENT
DATE: 5/Y J - f DATE: „ 5 , / 2 7� Q
(SEAL)
ATTEST: DANNY L. KOLHAGE, CLERK
BY ft
DE r Y CL •T1
APPROVED AS TO FORM
AND LE - UFFICIENCY
BY
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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.
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 financial
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
G ° • ee impson - 9. -•g CC ` onroe a merit 1.wp � ...o� . � _ .._ ° P ag e 4
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 11: 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 p;ovider 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 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
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:
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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 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 addres$:
Mr. James M. Dwyer
State of Florida Auditor General
P.C. 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 of
entity]'s compliance with specified requirements.
In our opinion, management's assertion [identf management's assertion - for
example, that complied with the aforementioned
requirements during the fiscal year ended ] is fairly stated, in all material
respects.
Sincerely,
Notes:
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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 pie specified and/or referred to in the grant
agreement. As such, it should not be necessary to repeat the compliance regL ;rements, 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)
for 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) --- -�,,
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ATTEST: DANNY L KOLHAGE CLERK
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(Date) o�dnr `
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.
APPROVED AS TO FORM
AND LE • L SUFFIC
BY
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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.
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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/ 3RANT NUMBER(S)
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)
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(Date) a is
One copy of this attestation statement shall be submitted after the provider's fiscal year
APPROVED AS TO FORM
AND L • SUFFICIE� :� • /
BY �� .t,..��
NE A ` T7 • N
o r -41 DATE
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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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ATTACIIMENT 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 afar 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
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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
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;
ee impson - 9899 - onroe amen ment .wp
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 preserver, 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.
•
•