10/21/2015 ContractHOME CARE FOR THE ELDERLY LEAD AGENCY CONTR
ORIGINAL
2015 -2016 Fiscal Year
THIS CONTRACT is entered into between the Alliance for Aging Inc., hereinafter referred to as the "Alliance" and
Monroe County Social Services, hereinafter referred to as the "provider," and collectively referred to as the "parties."
Attachments I, II, III, IV, V, VI, VII, VIII, IX, X, XI, A, B, C, D, E, F, G, H AND J are incorporated herein and made a
part of this Contract.
WHEREAS, the Alliance has been designated as the Area Agency on Aging for Planning and Service Area 11
encompassing Miami -Dade and Monroe Counties; and
WHEREAS, the Florida Department of Elder Affairs (the "Department ") has entered into a Contract with the Alliance to
fund community care service systems in Miami -Dade and Monroe Counties; and
WHEREAS, in accordance with Section 430.203, Florida Statutes, the Alliance has designated the provider as a Lead
agency for the Home Care for the Elderly (HCE) program;
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the
mutual covenants and conditions set forth in this Contract, the Parties agree as follows:
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this
contract including all attachments and exhibits, which constitute the contract document.
2. Incorporation of Documents within the Contract
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department of
Elder Affairs handbooks, manuals or desk books, as an integral part of the contract, except to the extent that the
contract explicitly provides to the contrary. In the event of conflict in language among any of the documents
referenced above, the specific provisions and requirements of the contract document(s) shall prevail over
inconsistent provisions in the proposal(s) or other general materials not specific to this contract document and
identified attachments.
Incorporation of Reference Memoranda:
In accordance with Chapter 287 F.S., amended, and Department of Financial Services' Chief Financial Officer
Memoranda, the following memoranda are hereby incorporated by reference:
(1) CFO Memo No. 02: Release date, October 3, 2012;
(2) CFO Memo No. 06: Release date, June 27, 2012;
(3) CFO Memo No. 01: Release date, July 26, 2012; and
(4) CFO Memo No. 04: Release date, June 30, 2006
3. Term of Contract
Effective Date:
This contract shall begin on July 1, 2015 or on the date the contract has been signed by both parties, whichever is
later.
Delivery of services shall end at midnight, local time in Miami, FL on June 30, 2016. The Alliance will not
reimburse the provider for services provided after this date. However, the parties recognize that they will need
to perform continued activities relating to reporting, invoicing and payment in July of 2016 to facilitate payment
for services rendered by the provider under this contract through and including the contract expiration date of
July 15, 2016.
4.0 Contract Amount
The Alliance agrees to pay for contracted services according to the terms and conditions of this contract in an
amount not to exceed _$10,622.00 or the rate schedule, subject to the availability of funds. Any costs or services
paid for under any other contract or from any other source are not eligible for payment under this contract.
4.1 Obligation to Pay
The Alliance's performance and obligation to pay under this contract is contingent upon an annual appropriation
by the Legislature to the Department and funding received by the Alliance under its contract with the Department.
4.2 Source of Funds
The costs of services paid under any other contract or from any other source are not eligible for reimbursement
under this contract. The funds awarded to the provider pursuant to this contract are in the state grants and aids
appropriations and consists of the following:
Program Title
Year
Funding Source
CSFA#
Fund Amounts
Home Care for the
Elderly
2015-
2016
General Revenue/Tobacco
Settlement Trust Funds
65010
$10,622.00
TOTAL FUNDS CONTAINED IN THIS CONTRACT:
$10,622.00
5. Renewals
The contract may be renewed on a yearly basis for no more than two additional years. Such renewals shall be
contingent upon satisfactory performance evaluations as determined by the Alliance and the availability of funds.
Any renewal of a contract shall be subject to mutual agreement, confirmed in writing, and subject to the same
terms and conditions set forth in the initial contract. The renewal price, or method for determining a renewal
price, is set forth in the bid, proposal, or reply. No other costs for the renewal may be charged.
In the event that a subsequent agreement may not be executed prior to the July 1 S` start date, the Alliance may, at
its discretion, extend this Agreement upon written notice for up to 90 days to ensure continuity of service.
Services provided under this extension will be paid for out of the succeeding agreement amount.
6. Compliance with Federal Law
6.1 If this contract contains federal funds the following shall apply:
6.1.1 The Provider shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations
6.1.2 If this contract contains federal funds and is over $100,000.00, the Provider shall comply with all applicable
standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s.
508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as
amended, and where applicable Environmental Protection Agency regulations 40 CFR 30. The Provider shall
report any violations of the above to the Alliance.
6.1.3 The Provider, or agent acting for the Provider, may not use any federal funds received in connection with this
contract to influence legislation or appropriations pending before the Congress or any state legislature. If this
contract contains federal funding in excess of $100,000.00, the Provider must, prior to contract execution,
complete the Certification Regarding Lobbying form, ATTACHMENT II. All disclosure forms as required by
the Certification Regarding Lobbying form must be completed and returned to the Contract Manager prior to
payment under this contract.
6.1.4 In accordance with Appendix A to 2 CFR 215, the Provider shall comply with Executive Order 11246, Equal
Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in
Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.
6.1.5 If this contract contains federal funds and provides services to children up to age 18, the Provider shall comply
with the Pro - Children Act of 1994 (20 U.S.C. 6081).
6.1.6 A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards will
not be made to parties listed on the government -wide Excluded Parties List System, in accordance with the OMB
guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." The
Excluded Parties List System contains the names of parties debarred, suspended, or otherwise excluded by
agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order
12549. The Provider shall comply with these provisions before doing business or entering into subcontracts
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receiving federal funds pursuant to this contract. The Provider shall complete and sign ATTACHMENT V
prior to the execution of this contract.
6.2 The Provider shall not employ an unauthorized alien. The Alliance will consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation will be cause for unilateral cancellation of this
contract by the Alliance.
6.3 If the Provider is a non - profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990 -N) and has its tax exempt status revoked for failing to
comply with the filing requirements of the 2006 Pension Protection Act or for any other reason, the Provider
must notify the Alliance in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Provider shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons.
Unless exempt under 2 CFR Part 170.110(b), the Provider shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR 170.
6.5 To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11 -116, the
Provider agrees to utilize the U.S. Department of Homeland Security's E- verify system to verify the employment
of all new employees hired by Provider during the contract or agreement term. The Provider shall include in
related subcontracts a requirement that sub - providers performing work or providing services pursuant to the state
contract utilize the E- verify system to verify employment of all new employees hired by the sub - provider during
any contract or agreement term. Providers meeting the terms and conditions of the
E- verify System is deemed to be in compliance with this provision. The Provider shall complete and sign
ATTACHMENT F prior to the execution of this Master Contract.
7. Compliance with State Law
7.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced
in all respects in accordance with the Florida law, including Florida provisions for conflict of laws.
7.2 The Provider shall comply with requirements of s. 287.058, F.S. as amended.
7.2.1 The Provider shall provide units of deliverables, including various client services, and in some instances may
include reports, findings, and drafts, as specified in this contract, which the Contract Manager must receive and
accept in writing prior to payment in accordance with s. 215.971, F.S. (1) and (2).
7.2.2 The Provider shall submit bills for fees or other compensation for services or expenses in sufficient detail for a
proper pre -audit and post- audit.
7.2.3 If itemized payment for travel expenses is permitted in this contract, the Provider shall submit bills for any travel
expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this contract.
7.2.4 The Provider shall allow public access to all documents, papers, letters, or other public records as defined in
subsection 119.011(12), F.S., made or received by the Provider in conjunction with this contract except for those
records which are made confidential or exempt by law. The Provider's refusal to comply with this provision will
constitute an immediate breach of contract for which the Alliance may unilaterally terminate the contract.
7.3 If clients are to be transported under this contract, the Provider shall comply with the provisions of Chapter 427,
F.S., and Rule 41 -2, F. A. C.
7.4 The provider may not subcontract with any individuals or entities on the discriminatory vendor list because they
may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S.
7.5 The Provider shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the
expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
7.6 In accordance with s. 287.135 F.S., any Provider on the Scrutinized Companies with Activities in Sudan List or
the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created pursuant to s.
215.473 F.S., is ineligible to enter into or renew a contract or agreement with the Department for goods or
services of $1 million or more. Pursuant to s. 287.135 F.S., the Department may terminate this Contract and any
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contract or agreement incorporating this Contract by reference if the Provider is found to have submitted a false
certification of its status on the Lists or has been placed on the Lists. Further, the Provider is subject to civil
penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification. If
any contract or agreement incorporating this Contract contains $1 million or more, the Provider shall complete
and sign ATTACHMENT H, Certification Regarding Scrutinized Companies Lists, prior to the execution of this
Contract.
8. Background Screening
The Provider shall ensure that the requirements of s. 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who are
not exempt from the Department's level 2 background screening pursuant to s. 430.0402(2) -(3), F.S. The
Provider must also comply with any applicable rules promulgated by the Department and the Agency for Health
Care Administration regarding implementation of s. 430.0402 and Chapter 435, F.S.
8.1 For purposes of this section, the term "direct service provider" means a person 18 years of age or older who,
pursuant to a program to provide services to the elderly, has direct, face -to -face contact with a client while
providing services to the client and has access to the client's living areas or to the client's funds or personal
property. This term includes coordinators, managers, and supervisors of residential facilities and volunteers.
8.2 Background Screening Affidavit of Compliance - To demonstrate compliance with section 6 of this Contract, the
Provider shall submit ATTACHMENT G, Background Screening Affidavit of Compliance annually, by January
15th.
8.3 Further information concerning the procedures for background screening is found at
http://elderaffairs.state.fl.us/doea/backgroundscreening.php.
9. Grievance and Complaint Procedures
9.1 Grievance Procedure
The Provider shall comply with and ensure sub - provider compliance with the Minimum Guideline for Recipient
Grievance Procedures, Appendix D, Department of Elder Affairs Programs and Services Handbook, to address
complaints regarding the termination, suspension or reduction of services, as required for receipt of funds.
9,2 Complaint Procedures:
The Provider shall develop and implement complaint procedures and ensure that sub - providers develop and
implement complaint procedures to process and resolve client dissatisfaction with services. Complaint
procedures shall address the quality and timeliness of services, provider and direct service worker complaints, or
any other advice related to complaints other than termination, suspension or reduction in services that require the
grievance process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook.
The complaint procedures shall include notification to all clients of the complaint procedure and include tracking
the date, nature of the complaint and the determination of the complaint on a complaint log.
10. Public Records and Retention:
10.1 The Provider, subject to the terms of section 287.058(1)(c), Florida Statutes, and any other applicable legal and
equitable remedies, shall:
a) Keep and maintain public records that ordinarily and necessarily would be required by the Department of
Elder Affairs in order to perform the services.
b) Provide the public with access to public records on the same terms and conditions that the
Department would provide the records and at a cost that does not exceed the cost provided in Chapter
119, Florida Statutes, or as otherwise provided by law.
c) Ensure that public records that are exempt or confidential and exempt from public records disclosure
requirements are not disclosed except as authorized by law.
d) Meet all requirements for retaining public records and transfer, at no cost, to the Alliance all public records in
possession of the Provider upon termination or expiration this contract and destroy any duplicate public records
that are exempt or confidential and exempt from public records disclosure requirements. All records stored
electronically must be provided to the Alliance or the Department in a format that is compatible with the
information technology systems of the Alliance or the Department.
11. Audits, Inspections, Investigations:
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11.1 The provider shall establish and maintain books, records, and documents (including electronic storage media) in
accordance with generally accepted accounting procedures and practices that sufficiently and properly reflect all
revenues and expenditures of funds provided by the Alliance under this contract. Provider agrees to maintain
records, including paid invoices, payroll registers, travel vouchers, copy logs, postage logs, time sheets, etc., as
supporting documentation for service cost reports and for administrative expenses itemized for reimbursement.
This documentation will be made available upon request for monitoring and auditing purposes. Whenever
appropriate, financial information should be related to performance and unit cost data.
11.2 The Provider shall retain all client records, financial records, supporting documents, statistical records, and any
other documents (including electronic storage media) pertinent to this contract for a period of six (6) years after
completion of the contract or longer when required by law. In the event an audit is required by this contract,
records shall be retained for a minimum period of six (6) years after the audit report is issued or until resolution
of any audit findings or litigation based on the terms of this contract, at no additional cost to the Alliance.
11.3 Upon demand, at no additional cost to the Alliance, the Provider shall facilitate the duplication and transfer of
any records or documents during the required retention period in Paragraph 10.2.
11.4 The Provider shall assure that the records described in Paragraph 10 will be subject at all reasonable times to
inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Alliance.
11.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Alliance, the
Department and federal auditors, pursuant to 45 CFR 92.36(1) (10), will be allowed full access to and the right to
examine any of the Provider's contracts and related records and documents pertinent to this specific contract,
regardless of the form in which kept.
11.6 The Provider shall provide a financial and compliance audit to the Alliance as specified in this contract and in
ATTACHMENT III and ensure that all related third -party transactions are disclosed to the auditor.
11.7 The Provider shall comply and cooperate immediately with any inspections, reviews, investigations, or audits
deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S.
11.8 The Provider shall maintain and file with the Alliance such progress, fiscal and inventory and other reports as the
Alliance may require within the period of this contract.
11.9 The Provider shall submit management, program, and client identifiable data, as specified by the Department of
Elder Affairs and / or the Alliance. The provider must record and submit program specific data in accordance
with the Department's Client Information Registration and Tracking System (CIRTS) Policy Guidelines.
11.10 If, under any contract or agreement incorporating this Contract by reference, the Provider is providing services
and is acting on behalf of the Department of Elder Affairs or the Alliance for Aging, Inc. as provided under
section 119.011(2), Florida Statutes, the Provider, subject to the terms of section 287.058(1)(c), Florida Statutes,
and any other applicable legal and equitable remedies, shall:
a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in
order to perform the services.
b) Provide the public with access to public records on the same terms and conditions that the Department of
Elder Affairs or the Alliance for Aging, Inc. would provide the records and at a cost that does not exceed the cost
provided in Chapter 119, Florida Statutes, or as otherwise provided by law.
c) Ensure that public records that are exempt or confidential and exempt from public records disclosure
requirements are not disclosed except as authorized by law.
d) Meet all requirements for retaining public records and transfer, at no cost, to the Department of Elder Affairs
or the Alliance for Aging, Inc. all public records in possession of the Provider upon termination or expiration of
any contract or agreement incorporating this Contract by reference and destroy any duplicate public records that
are exempt or confidential and exempt from public records disclosure requirements. All records stored
electronically must be provided to the Department of Elder Affairs or the Alliance for Aging, Inc. in a format
that is compatible with the information technology systems of the Department.
11.11 The Alliance for Aging, Inc. may unilaterally cancel this Contract, and any contract or agreement incorporating
this Contract by reference, notwithstanding any other provisions of this Contract, for refusal by the Provider to
comply with Section 8 of this Contract by not allowing public access to all documents, papers, letters, or other
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material made or received by the Provider in conjunction with the contract or agreement incorporating this
Contract by reference, unless the records are exempt from Section 24(a) of Article I of the State Constitution and
Section 119.07(1), Florida Statutes.
12. Nondiscrimination -Civil Rights Compliance
12.1 The Provider shall execute assurances in ATTACHMENT VI that it will not discriminate against any person in
the provision of services or benefits under this contract or in employment because of age, race, religion, color,
disability, national origin, marital status or sex in compliance with state and federal law and regulations. The
Provider further assures that all Providers, sub - providers, sub - grantees, or others with whom it arranges to
provide services or benefits in connection with any of its programs and activities are not discriminating against
clients or employees because of age, race, religion, color, disability, national origin, marital status or sex.
12.2 During the term of this contract, the Provider shall complete and retain on file a timely, complete and accurate
Civil Rights Compliance Checklist (ATTACHMENT B).
12.3 The Provider shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures will include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
12.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Provider, its successors, transferees, and assignees for the
period during which such assistance is provided. The Provider further assures that all sub - providers, vendors, or
others with whom it arranges to provide services or benefits to participants or employees in connection with any
of its programs and activities are not discriminating against those participants or employees in violation of the
above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Provider understands
that the Alliance may, at its discretion, seek a court order requiring compliance with the terms of this assurance or
seek other appropriate judicial or administrative relief, including but not limited to, termination of and denial of
further assistance.
13. Provision of Services
The Provider shall provide services in the manner described in in ATTACHMENT I of this agreement and in the
Service Provider Application (SPA). In the event of a conflict between the Service Provider Application and this
contract, the contract language prevails.
14. Monitoring by the Alliance for Aging
The Alliance will perform administrative and programmatic monitoring of the provider to ensure contractual
compliance, fiscal accountability, programmatic performance, and compliance with applicable state and federal
laws and regulations.
14.1 The provider will supply progress reports, including data reporting requirements as specified by the Alliance or
the Department to be used for monitoring progress or performance of the contractual services as specified in this
contract. Following the norms set down by the Department, the Alliance will track performance on a monthly
basis, through desk reviews of available fiscal, CIRTS, and research production reports and any other system or
process designated by the Alliance. Examples of review criteria are surplus /deficit, independent audits, internal
controls, reimbursement requests, subcontract monitoring, targeting, program eligibility, outcome measures,
service provision to clients designated as "high risk" by the Department of Children & Families, Adult Protective
Services program, data integrity, co- payments, client satisfaction, correspondence, and client file reviews.
14.2 The provider shall permit persons duly authorized by the Department or the Alliance to inspect and copy any
records, papers, documents, facilities, goods and services of the provider which are relevant to this contract, and
to interview any clients, employees, and sub - provider employees of the provider to be assure the Alliance of the
satisfactory performance of the terms and conditions of this contract. Following such review, the Alliance will
deliver to the provider a written report of its findings. The Provider hereby agrees to correct all deficiencies
identified in a timely manner as determined by the Contract Manager.
15. Coordinated Monitoring with Other Agencies
If the Provider receives funding from one or more of the State of Florida other human service agencies, in
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addition to the Department of Elder Affairs, then a joint monitoring visit including such other agencies may be
scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human
service agencies shall include the Department of Children and Families, the Department of Health, the Agency for
Persons with Disabilities, the Department of Veterans Affairs, and the Department of Elder Affairs. Upon
notification and the subsequent scheduling of such a visit by the designated agency's lead administrative
coordinator, the Provider shall comply and cooperate with all monitors, inspectors, and /or investigators.
16. Indemnification
The provider shall indemnify, defend, and hold harmless the Department and the Alliance and their officers,
agents, and employees from any claim, loss, damage, cost, charge, or expense whatever nature or character
arising out of any acts, actions, neglect or omission, action in bad faith, or violation of federal or state law by the
provider, its agents, employees, or sub - providers during the performance of this contract, whether direct or
indirect, and whether to any person or property. It is understood and agreed that the provider is not required to
indemnify the Alliance for claims arising out of the sole negligence of the Alliance.
The provider's obligation to indemnify, defend, and pay for the defense or, at the Department's and / or the
Alliance's option, to participate and associate with the Department and / or the Alliance in the defense and trial of
any claim and any related settlement negotiations, shall be triggered by the Department's and / or Alliance's
notice of claim for indemnification to the provider. The provider's inability to evaluate liability or its evaluation of
liability shall not excuse the provider's duty to defend and indemnify the Department and or the Alliance, upon
notice by the Department and / or the Alliance. Notice shall be given by registered or certified mail, return
receipt requested. Only an adjudication or judgment after the highest appeal is exhausted specifically finding the
Alliance solely negligent shall excuse performance of this provision by the provider. The provider shall pay all
costs and fees related to this obligation and its enforcement by the Department and / or the Alliance. The
Alliance's failure to notify the provider of a claim shall not release the provider of the above duty to defend and
indemnify. I( A 9I 1 S I 15 -
16.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph V is not applicable to contracts
executed between the Alliance and state agencies or subdivisions defined in s. 768.28(2), F.S.
17. Insurance and Bonding
17.1 The provider must provide continuous adequate liability insurance and worker's compensation insurance
coverage, on a comprehensive basis, and must hold such liability and worker's compensation insurances at all
times during the effective period of this contract and any renewal(s) or extension(s) of this contract. The Alliance
shall be included as an additional insured on the provider's liability insurance policy or policies and a copy
of the Certificate of Insurance shall be provided annually or when any changes — occur. The provider accepts
full responsibility for identifying and determining the type(s) and extent of liability insurance necessary to
provide reasonable financial protections for the provider and the clients to be served under this contract. Upon
execution of this contract, the provider shall furnish the Alliance written verification supporting both the
determination and existence of such insurance coverage. The limits of coverage under each policy maintained by
the provider do not limit the provider's liability and obligations under this contract. The provider shall ensure that
the Alliance has the most current written verification of insurance coverage throughout the term of this contract.
Such coverage may be provided by a self- insurance program established and operating under the laws of the State
of Florida. The Department and the Alliance reserve the right to require additional insurance where appropriate.
17.2 Throughout the term of this contract, the provider must maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the provider, authorized
to handle funds received or disbursed under this contract, in an amount commensurate with the funds handled, the
degree of risk as determined by the insurance company and consistent with good business practices.
17.3 If the provider is a state agency or subdivision as defined by section 768.28, F.S., the provider shall furnish, upon
request, written verification of liability protection in accordance with section 768.28, F.S. Nothing herein shall
be construed to extend any party's liability beyond that provided in section 768.28, F.S. (See also Indemnification
clause.)
18. Confidentiality of Information
The Provider shall not use or disclose any information concerning a recipient of services under this contract for
any purpose prohibited by state or federal law or regulations except with the written consent of a person legally
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authorized to give that consent or when authorized by law.
19. Health Insurance Portability and Accountability Act
Where applicable, the Provider shall comply with the Health Insurance Portability and Accountability Act (42
USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164).
20. Incident Reporting
20.1 The Contractor shall notify the Department immediately but no later than forty -eight (48) hours from the
Contractor's awareness or discovery of conditions that may materially affect the Contractor or Subcontractor's
ability to perform the services required to be performed under any contract or agreement which incorporate this
Master Contract by reference. Such notice shall be made orally to the Contract Manager (by telephone) with an
email to immediately follow.
20.2 The Provider shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a
child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number (1-
800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon both the Provider and
its employees.
21. New Contract(s) Reporting:
The Provider shall notify the Alliance within ten (10) days of entering into a new contract or agreement with any
of the remaining four (4) state human service agencies. The notification shall include the following information:
(1) contracting state agency; (2) contract name and number; (3) contract or agreement start and end dates; (4)
contract or agreement amount; (5) contract or agreement description and commodity or service; and (6)Contract
Manager name and number.
22. Bankruptcy Notification
During the term of this contract, the Provider shall immediately notify the Alliance if the Provider, its assignees,
sub - providers or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Provider must
also provide the following information to the Alliance: (1) the date of filing of the bankruptcy petition; (2) the
case number; (3) the court name and the division in which the petition was filed (e.g., Northern District of
Florida, Tallahassee Division); and, (4) the name, address, and telephone number of the bankruptcy attorney.
23. Sponsorship and Publicity
23.1 Any nongovernmental organization which sponsors a program financed partially by state funds or funds obtained
from a state agency shall, in publicizing, advertising, or describing the sponsorship of the program, state:
"Sponsored by, the State of Florida, Department of Elder Affairs and Alliance for Aging Inc." If the sponsorship
reference is in written material, the words "State of Florida, Department of Elder Affairs and the Alliance for
Aging" shall appear in the same size letters or type as the name of the organization (ref.: section 286.25, F. S.).
This shall include, but is not limited to, any correspondence or other writing, publication or broadcast that refers
to such program.
23.2 The provider shall not use the words "State of Florida, Department of Elder Affairs" and /or "The Alliance for
Aging, Inc." to indicate sponsorship of a program otherwise financed unless specific authorization has been
obtained by the Alliance prior to use.
24. Assignments
24.1 The provider shall not assign its rights and responsibilities under this contract without the prior written approval
of the Alliance. All contracts or agreements incorporating this Contract by reference shall remain binding upon
the successors in interest of either the Provider or the Alliance for Aging, Inc.
24.2 No approval by the Alliance of any assignment or subcontract shall be deemed in any event or in any manner to
provide for the incurrence of any obligation of the Alliance in addition to the dollar amount agreed upon in this
contract.
24.3 The State of Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or obligations
under any contract or agreement to another governmental agency in the State of Florida, upon giving prior written
notice to the Provider. In the event the State of Florida approves transfer of the Provider's obligations, the
Provider remains responsible for all work performed and all expenses incurred in connection with the contract or
agreement.
25. Subcontracts:
25.1 The Provider is responsible for all work performed and for all commodities produced pursuant to this contract,
whether actually furnished by the Provider or its sub - providers. Any subcontracts shall be evidenced by a written
agreement subject to all applicable terms and conditions of this contract. Alliance approval of the service
application presented by the provider shall constitute Alliance approval of the provider's proposed subcontracts if
the subcontracts follow the service and funding information identified in the provider's service application. All
other subcontracts proposed to be funded under this contract must be approved in advance by the Alliance. The
Provider agrees that the Alliance shall not be liable to any sub - provider in any way or for any reason. The
provider, at its expense, will indemnify and defend the Alliance against any sub - provider claims.
25.2 The provider shall promptly pay any sub - providers. Failure to pay sub - providers pursuant to any subcontract or
as required by law may result in enforcement action under this contract.
25.3 The provider maintains responsibility for the monitoring and performance of all subcontracts in accordance with
all applicable federal and state laws. Subcontractor monitoring must be done annually.
25.4 The Provider shall have a procurement policy that assures maximum free and open competition. Such
procurement policy must conform, as applicable, with Federal and State contracting and procurement regulations,
as set forth in Title 45 Code of Federal Regulations (CFR) part 74 - Sub -Part C, Ch.287.057 Florida Statutes
(F.S.), U.S. Office of Management and Budget (OMB) Circular 110, Florida Department of Management
Services (DMS) Rule 60A -1, Florida Administrative Code, and with the Department of Elder Affairs Program
and Services Handbook 2012.
25.5 Service Cost Reports and Unit Cost Methodology Reports:
The Provider shall submit annually to the Alliance Service Cost Reports which reflect Actual costs of providing
each service by program. This report is due to the Alliance 30 days after the contract year ends. The Provider
shall also submit, annually, Unit Cost Methodology Reports reflecting the annual Budgeted cost details for each
program. This report is due to the Alliance 30 days prior to the start of the new contract. These two reports
provide information for planning and negotiating unit rates, as well as source documents used in the Alliance's
annual monitoring of the Provider.
26. Funding Obligations:
26.1 The Alliance for Aging, Inc. acknowledges its obligation to pay the Provider for the performance of the
Provider's duties and responsibilities set forth in any contract or agreement incorporating this Contract by
reference.
26.2 The Alliance shall not be liable to the provider for costs incurred or performance rendered unless such costs and
performances are strictly in accordance with the terms of this contract, including but not limited to terms
governing the provider's promised performance and unit rates and/or reimbursement capitations specified.
26.3 The Alliance shall not be liable to the Provider for any expenditures which are not allowable costs as defined by
applicable federal or state law, or which expenditures have not been made in accordance with the terms of this
contract or fiscal or programmatic guidelines and requirements outlined by the current Department of Elder
Affairs Programs and Services Handbook.
26.4 The Alliance shall not be liable to the provider for expenditures made in violation of regulations, the Older
Americans Act, Department rules, Florida Statutes, or this contract.
27. Independent Capacity of Provider
27.1 The Provider will be acting in its independent capacity and not as an employee, agent or representative of the
Alliance or the Department. The provider shall not be deemed or construed to be an employee, agent or
representative of the Alliance or the Department for any purpose whatsoever. Nothing contained in this contract
is intended to, or shall be construed in any manner, as creating or establishing the relationship of
0J
employer /employee between the parties.
27.2 The Provider shall be responsible for completely supervising and directing the work under this contract whether
performed by the provider or by any sub - provider that it may utilize. The Provider shall be responsible for all
sub - providers who perform work under this contract. The Provider agrees that it is as fully responsible for the
acts and omissions of its sub - providers and of persons employed by them as it is for the acts and omissions of its
own employees.
27.3 It is further understood that the Alliance does not control the employment practices of the Provider and shall not
be liable for any wage and hour, employment discrimination, or other labor and employment claims against the
Provider or its sub - providers. All deductions for social security, withholding taxes, income taxes, contributions
to unemployment compensation funds and all necessary insurance for the Provider shall be the sole
responsibility of the Provider.
28. Payment
28.1 Payments shall be made to the Provider as services are rendered and invoiced by the Provider. The Alliance will
have final approval of the invoice for payment, and will approve the invoice for payment only if the Provider has
met all terms and conditions of the contract, unless the bid specifications, purchase order, or this contract specify
otherwise. The approved invoice will be submitted to the Alliance's finance section for budgetary approval and
processing pursuant to Attachment VIII.
28.2 Payment Documentation Required
The Provider shall maintain documentation to support payment requests which shall be available to the
Comptroller, the Department, or the Alliance upon request. Invoices must be submitted in sufficient detail for a
proper pre audit and post audit thereof. The provider shall comply with all state and federal laws governing
payments to be made under this contract including, but not limited to the following: (a) paragraph (16) (b) of
section 216.181, F. S., regarding advances; (b) Rule 69I- 40.103 F.A.C. pertaining to Restriction of Expenditures
from state funds; and (c) the Contract Payment Requirements sub - section of section C of the Reference Guide
for State Expenditures from the Department of Financial Services
http://www.dbf.state.fl.us/aadir/refereiice—guide ).
The Provider shall maintain detailed documentation to support each item on the itemized invoice or payment
request for cost reimbursed expenses, including paid sub - provider invoices, and will be produced upon request by
the Alliance. The Provider shall only request reimbursement for allowable expenses as defined in the laws and
guiding circulars cited in this agreement, in the Reference Guide for State Expenditures, and any other laws or
regulations, as applicable, and that administrative expenses do not exceed amounts budgeted in the provider's
approved service application.
The Provider will certify that detailed documentation is available to support each item on the itemized invoice or
payment request for cost reimbursed expenses, fixed rate or deliverables contracts or agreements incorporating
this Contract by reference, including paid sub - provider invoices, and will be produced upon request by the
Alliance or the Department. The Provider will further certify that reimbursement requests are only for allowable
expenses as defined in the laws and guiding circulars cited in Sections 6 and 7 of this Contract, in the Reference
Guide for State Expenditures, and any other laws or regulations, as applicable, and that administrative expenses
do not exceed amounts budgeted in the Provider's approved area plan as developed in accordance with and
pursuant to section 306(a) of the Older Americans Act of 1965, as amended.
28.3 The Provider shall provide units of deliverables, including reports, findings, and drafts as specified in this
contract to be received and accepted by the Alliance prior to payment.
29. Return of Funds
The Provider shall return to the Alliance any overpayments due to unearned funds or funds disallowed and any
interest attributable to such funds pursuant to the terms and conditions of any contract or agreement incorporating
this Contract by reference that were disbursed to the Provider by the Alliance. In the event that the Provider or its
independent auditor discovers that an overpayment has been made, the Provider shall repay said overpayment
immediately without prior notification from the Alliance. In the event that the Alliance first discovers an
overpayment has been made, the Contract Manager will notify the Provider in writing of such findings. Should
repayment not be made forthwith, the Provider shall be charged at the lawful rate of interest on the outstanding
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balance pursuant to s. 55.03, F.S., after Alliance's notification or Provider discovery.
30. Data Integrity and Safeguarding Information
The Provider shall ensure an appropriate level of data security for the information the Provider is collecting or
using in the performance of this contract. An appropriate level of security includes approving and tracking all
Provider employees that request system or information access and ensuring that user access has been removed
from all terminated employees. The Provider, among other requirements, must anticipate and prepare for the loss
of information processing capabilities. All data and software must be routinely backed up to insure recovery
from losses or outages of computer systems. The security over the back -up data is to be as stringent as the
protection required of the primary systems. The Provider shall insure all sub - providers maintain written
procedures for computer system backup and recovery. The Provider shall, prior to execution of this agreement,
complete the Data Integrity Certification form, ATTACHMENT IV.
31. Computer Use and Social Media Policy
The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use
Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all
personnel affiliated with third parties, such as, but not limited to, Area Agencies on Aging and Providers. Any
entity that uses the Department's computer resource systems must comply with the Department's policy
regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis,
RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing
networks such as flickr and YouTube (This policy is available on the Department's website at:
http: / /elderaffairs. state .fl.us /doea/financial.php).
32. Conflict of Interest
The Provider shall establish safeguards to prohibit employees, board members, management and sub - providers
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal gain. No employee, officer or agent of the Provider or sub - provider shall
participate in selection, or in the award of an agreement supported by state or federal funds if a conflict of
interest, real or apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or
agent; (b) any member of his/her immediate family; (c) his or her partner, or; (d) an organization which employs,
or is about to employ, any of the above, has a financial or other interest in the firm selected for award. The
Provider or sub - provider's officers, employees or agents will neither solicit nor accept gratuities, favors or
anything of monetary value from providers, potential providers, or parties to subcontracts. The Provider's board
members and management must disclose to the Alliance any relationship which may be, or may be perceived to
be, a conflict of interest within thirty (30) calendar days of an individual's original appointment or placement in
that position, or if the individual is serving as an incumbent, within thirty (30) calendar days of the
commencement of this contract. The Provider's employees and sub - providers must make the same disclosures
described above to the Provider's board of directors. Compliance with this provision will be monitored.
33. Public Entity Crime
Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of
real property to a public entity; may not be awarded or perform work as a provider, supplier, sub - provider, or
consultant under a contract with any public entity; and may not transact business with any public entity in excess
of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following
the date of being placed on the convicted vendor list.
The provider represents and warrants that the provider, its officers, directors, senior management, partners,
employees or agents have not been convicted of any public entity crimes within the last 36 months. If the provider
or any of its officers or directors is convicted of a public entity crime during the period of this agreement, the
provider shall notify the Alliance immediately. Non - compliance with this statute shall constitute a breach of this
agreement. The provider must ensure that it does not enter into with any sub - provider on the convicted vendors
list or otherwise prohibited from contracting for state funds pursuant to section 287.133, F.S.
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34. Purchasing
Procurement of Products or Materials with Recycled Content.
Reusable materials and products shall be used where economically technically feasible.
35. Patents, Copyrights, Royalties
If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed
produced or for which ownership was purchased in the course of or as a result of work or services performed
under this contract, the Provider shall refer the discovery, invention or material to the Alliance to be referred to
the Department of State. Any and all patent rights or copyrights accruing under this contract are hereby reserved
to the State of Florida in accordance with Chapter 286, F.S.
36. Emergency Preparedness and Continuity of Operations
36.1 The Provider shall, within thirty (30) calendar days of the execution of this contract, submit to the Contract
Manager verification of an emergency preparedness plan. In the event of an emergency, the Provider shall notify
the Alliance of emergency provisions.
36.2 In the event a situation results in a cessation of services by a sub - provider, the Provider shall retain responsibility
for performance under this contract and must follow procedures to ensure continuity of operations without
interruption.
36.3 In preparation for the threat of an emergency event as defined in the State of Florida Comprehensive Emergency
Management Plan, the Department may exercise authority over an area agency or service provider agency to
implement preparedness activities to improve the safety of the elderly in the threatened area and to secure area
agency and service provider facilities to minimize the potential impact of the event. These actions will be within
the existing roles and responsibilities of the area agency and provider.
36.4 In the event the President of the United States or Governor of the State of Florida declares a disaster or state of
emergency, the Department may exercise authority over an area agency or service provider agency to implement
emergency relief measures and/or activities.
37. Equipment
37.1 Use of Contract Funds to Purchase Equipment
No funds under this contract will be used by the Provider to purchase equipment.
37.2 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than
one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the
organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable,
tangible personal property of a non - consumable nature with an acquisition cost of $1,000.00 or more per unit,
and expected useful life of at least one year; and hardback bound books not circulated to students or the general
public, with a value or cost of $250.00 or more [for state funds].
38. PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
http://www.myflorida.com/apps/vbs/adoc/F7740—PUR]OOO.pdf
In the event of any conflict between the PUR 1000 Form and any terms or conditions of any contract or
agreement terms or conditions the contract shall take precedence over the PUR 1000 Form. However, if the
conflicting terms or conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the
terms or conditions contained in the PUR 1000 Form shall take precedence.
39. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon the Provider
or political subdivision granting to the state a security interest in the property at least to the amount of state funds
provided for at least 5 years from the date of purchase or the completion of the improvements or as further
required by law.
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40. Dispute Resolution
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce
the decision to writing and serve a copy on the Provider.
41. Financial Consequences of Non - Performance
If the Provider fails to meet the minimum level of service or performance identified in this agreement, or that is
customary for the industry, then the Alliance must apply financial consequences commensurate with the
deficiency. Financial consequences may include, but are not limited to, contract suspension, refusing payment,
withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation of contract
and reacquiring services from an alternate source.
41.1 The Provider will not be charged with financial consequences, when a failure to perform arises out of causes that
were the responsibility of the Alliance.
42. No Waiver of Sovereign Immunity
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to
which sovereign immunity may be applicable.
43. Venue
If any dispute arises out of this contract, the venue of such legal recourse will be Miami -Dade County, Florida.
44. Entire Contract
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or
representations shall be valid or binding upon the Alliance or the Provider unless expressly contained herein or
by a written amendment to this contract signed by both Parties.
45. Force Ma_ieure
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other
party and takes all reasonable efforts to cure the condition.
46. Severability Clause
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or
unenforceable; the other provisions are severable to that void provision and shall remain in full force and effect.
47. Condition Precedent to Contract: Appropriations
The Parties agree that the Alliance's performance and obligation to pay under this contract is contingent upon an
annual appropriation by the Legislature to the Department and a corresponding allocation under contract from the
Department to the Alliance.
48. Addition/Deletion
The Parties agree that the Alliance reserves the right to add or to delete any of the services required under this
contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by
both Parties. The Parties shall negotiate compensation for any additional services added.
49. Waiver
The delay or failure by the Alliance to exercise or enforce any of its rights under this contract will not constitute
or be deemed a waiver of the Alliance's right thereafter to enforce those rights, nor will any single or partial
exercise of any such right preclude any other or further exercise thereof or the exercise of any other right.
50. Compliance
The Provider shall abide by all applicable current federal statutes, laws, rules and regulations as well as
applicable current state statutes, laws, rules and regulations. The Parties agree that failure of the Provider to
abide by these laws shall be deemed an event of default of the Provider, and subject the contract to immediate,
13
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unilateral cancellation of the contract at the discretion of the Alliance.
51. Final Invoice
The Provider shall submit the final invoice for payment to the Alliance as specified in Paragraphs 3.4, 3.4.1 and
3.4.2 (date for final request for payment) of ATTACHMENT 1. If the Provider fails to submit final request for
payment by the deadline, then all rights to payment may be forfeited and the Alliance may not honor any requests
submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld
until all reports due from the Provider and necessary adjustments thereto have been approved by the Alliance.
52. Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and
duly signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to
reflect price level increases and changes in the rate of payment when these have been established through the
appropriations process and subsequently identified in the Alliance's operating budget.
53. Suspension of Work:
The Alliance may in its sole discretion suspend any or all activities under this contract when in the Department of
Elder Affairs determines that it is in the best interests of State to do so. The Alliance shall provide the Provider
written notice outlining the particulars of suspension. Examples of the reason for suspension include, but are not
limited to, budgetary constraints, declaration of emergency, or other such circumstances. After receiving a
suspension notice, the Provider shall comply with the notice and shall not accept any purchase orders. Within
ninety days, or any longer period agreed to by the Provider, the Alliance shall either (1) issue a notice authorizing
resumption of work, at which time activity shall resume, or (2) terminate the Contract or purchase order.
Suspension of work shall not entitle the Provider to any additional compensation.
54. Termination
54.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar days' notice
in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by
hand delivery to the Contract Manager or the representative of the Provider responsible for administration of the
contract. The Provider shall not furnish any product after it receives the notice of termination, except as necessary
to complete the continued portion of the contract, if any. The Provider shall not be entitled to recover any
cancellation charges or lost profits.
54.2 In the event funds for payment pursuant to this contract become unavailable, the Alliance may terminate this
contract upon no less than twenty -four (24) hours' notice in writing to the Provider. Said notice shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by
hand delivery to the Contract Manager or the representative of the Provider responsible for administration of the
contract. The Alliance will be the final authority as to the availability and adequacy of funds. In the event of
termination of this contract, the Provider will be compensated for any work satisfactorily completed prior to the
date of termination.
54.3 Termination for Cause:
This contract may be terminated for cause upon no less than twenty four (24) hours' notice in writing to the
Provider. Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other
breach and shall not be construed to be a modification of the terms and conditions of this contract. The
provisions herein do not limit the Alliance's or the Provider's rights to remedies at law or in equity.
54.4 Failure to have performed any contractual obligations with the Alliance in a manner satisfactory to the Alliance
will be a sufficient cause for termination. To be terminated as a Provider under this provision, the Provider must
have (1) previously failed to satisfactorily perform in a contract with the Alliance, been notified by the Alliance
of the unsatisfactory performance, placed by the Alliance under a corrective action plan and failed to correct the
unsatisfactory performance to the satisfaction of the Alliance as outlined in the corrective action plan; or (2) had a
contract terminated by the Alliance for cause.
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54.5 Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and
shall not be construed to be a modification of the terms and conditions of this contract. The provisions herein do
not limit the Alliance's right to remedies at law or to damages of a legal or equitable nature.
55. Successors
This contract shall remain binding upon the successors in interest of either the Alliance or the provider.
56. Electronic Records and Signature
The AAA authorizes, but does not require, the Provider to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this Contract. A provider that
creates and retains electronic records and uses electronic signatures to conduct transactions shall comply with
the requirements contained in the Uniform Electronic Transaction Act, s. 668.50, Fla. Stat. All electronic
records must be fully auditable; are subject to Florida's Public Records Law, Ch. 119, and Fla. Stat.; must
comply with section 28, Data Integrity and Safeguarding Information; must maintain all confidentiality, as
applicable; and must be retained and maintained by the Provider to the same extent as non - electronic records
are retained and maintained as required by this Contract.
56.1 The AAA's authorization pursuant to this section does not authorize electronic transactions between the
Provider and the AAA. The Provider is authorized to conduct electronic transactions with the AAA only upon
further written consent by the AAA.
56.2 Upon request by the AAA, the Provider shall provide the AAA or DOEA with non - electronic (paper) copies of
records. Non - electronic (paper) copies provided to the AAA of any document that was originally in electronic
form with an electronic signature must indicate the person and the person's capacity who electronically signed
the document on any non - electronic copy of the document.
57. Special Provisions
The Provider agrees to the following provisions:
57.1 Investigation of Criminal Allegations:
Any report that implies criminal intent on the part of the Provider or any sub - providers and referred to a
governmental or investigatory agency must be sent to the Alliance. If the Provider has reason to believe that the
allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney's
office, or other governmental agency, the Provider shall notify the contract manager. A copy of all documents,
reports, notes or other written material concerning the investigation, whether in the possession of the Provider
or sub - providers, must be sent to the Alliance's contract manager with a summary of the investigation and
allegations.
57.2 Volunteers:
The Provider shall ensure the use of trained volunteers in providing direct services delivered to older
Individuals and individuals with disabilities needing such services. If possible, the Provider shall work in
coordination with organizations that have experience in providing training, placement, and stipends for
volunteers or participants (such as organizations carrying out federal service programs administered by the
Corporation for National and Community Service), in community service settings.
57.3 Enforcement:
57.3.1 In accordance with Section 430.04, F.S., the Alliance may, without taking any intermediate measures available
against the Provider, rescind the Providers contract, if the Alliance finds that:
57.3.2 An intentional or negligent act of the Provider has materially affected the health, welfare, or safety of clients
served pursuant to any contract or agreement incorporating this Contract by reference, or substantially and
negatively affected the operation of services covered under any contract or agreement;
57.3.3 The Provider lacks financial stability sufficient to meet contractual obligations or that contractual funds have
been misappropriated;
57.3.4 The Provider has committed multiple or repeated violations of legal and regulatory standards, regardless of
whether such laws or regulations are enforced by the Alliance, or the Provider has committed or repeated
violations of Alliance standards;
15
57.3.5 The Provider has failed to continue the provision or expansion of services after the declaration of a state of
emergency; and /or
57.3.6 The Provider has failed to adhere to the terms of any contract or agreement incorporating this Contract by
reference.
57.3.7 In the alternative, the Alliance may, at its sole discretion, in accordance with section 430.04, F.S., take
immediate measures against the Provider, including: corrective action, unannounced special monitoring,
temporary assumption of the operation of one or more contractual services, placement of the Provider on
probationary status, imposing a moratorium on Provider action, imposing financial penalties for
nonperformance, or other administrative action pursuant to Chapter 120, F.S.
57.3.8 The provider consistently misses performance measure targets, or does not demonstrate to the satisfaction of the .
Alliance that a program budget surplus /deficit problem is being addressed in order to avoid closing out the
contract year with a budget variance of more than one percent.
57.3.9 In making any determination under this provision the Alliance may rely upon the findings of another state or
federal agency, or other regulatory body. Any claims for damages for breach of any contract or agreement
incorporating this Contract by reference are exempt from administrative proceedings and shall be brought
before the appropriate entity in the venue of Miami -Dade County.
57.4 Use of Service Dollars:
The Provider will optimize the use of contract funds by serving the maximum possible number of individuals
with the services allowed by this contract. The Provider will spend all federal, state, and other funds provided
by this contract to provide such services.
57.5 Surplus/Deficit Report:
The Provider will submit a consolidated surplus /deficit report in a format provided by the Alliance to the
Alliance's Contract Manager with the monthly request for payments according to the calendar on Attachment
VIII.
57.6 Surplus Recapture.
In accordance with its surplus /deficit management policies, in order to maximize available funding and minimize
the time that potential clients must wait for services, the AAA in its sole discretion can reduce funding awards if
the Provider is not spending according to monthly plans and is projected to incur a surplus at the end of the year.
58. Official Payee and Representatives (Names, Addresses, and Telephone Numbers):
The name, address, and telephone number of the representative for the Alliance for this contract is:
Max B. Rothman, JD, LL.M.
President and CEO
760 NW 107` Ave, Suite 214
Miami, Florida 33172
(305) 670 -6500, Ext. 224
The name, address, and telephone number of the representative of the provider responsible for administration of the
program under this contract is:
16
The Provider name, as shown on page 1 of this
Sheryl Graham, Senior Director
a.
contract, and mailing address of the official payee
Monroe County Social Services
1100 Simonton Street, 2 " Floor
to whom the payment shall be made is:
Key West, FL 33040
The name of the contact person and street address
b.
where financial and administrative records are
Kim Wilkes Wean, Compliance Manager
maintained is:
1100 Simonton Street, 1 st Floor
16
In the event different representatives are designated by either party after execution of this contract, notice of the name and
address of the new representative will be rendered in writing to the other party and said notification attached to originals
of this contract.
17
Key West, FL 33040
The name, address, and telephone number of the
Sheryl Graham, Senior Director
C.
representative of the Provider responsible for
1100 Simonton Street, 2 " Floor
administration of the program under this contract
Key West, FL 33040
is:
(305)292 -4510 or 4408
The section and location within the AAA where
Laurie Semo, Vice President Finance /CFO
d.
Requests for Payment and Receipt and
Alliance for Aging, Inc.
760 NW 107th Avenue, Suite214
Expenditure forms are to be mailed is:
Miami, Florida 33172 -3155
Contract Manager
e
The name, address, and telephone number of the
Alliance for Aging, Inc.
Contract Manager for the AAA for this contract is:
760 NW 107th Avenue, Suite 214
Miami, Florida 33172 -3155
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party and the notification attached to the originals of this contract.
In the event different representatives are designated by either party after execution of this contract, notice of the name and
address of the new representative will be rendered in writing to the other party and said notification attached to originals
of this contract.
17
51. All Terms and Conditions Included
This contract and its Attachments, I through X, A, B, C, D, E, F, G, H, K and any exhibits referenced in said
attachments, together with any documents incorporated by reference, contain all the terms and conditions agreed upon
by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this
contract shall supersede all previous communications, representations or agreements, either written or verbal between
the Parties.
By signing this contract, the Parties agree that they have read and agree to the entire contract.
IN WITNESS THEREOF, the Parties hereto have caused this 67 page contract, to be executed by their undersigned officials as
duly authorized.
Provider • MONROE COUNTY SOCIAL
SERVICES
SIGNED BY:
NAME: SHERYL GRAHAM
TITLE: ACTING COUNTY ADMINISTRATOR
DATE:
SIGNED BY:
NAME: DANNY KOLHAGE
TITLE:
DATE:
MAYOR
l012�1�s
ALLIANCE FOR AGING, INC.
SIGNED BY
NAME: MAX B. ROTHMAN, JD, LL.M.
TITLE: PRESIDENT AND CEO
DATE: $EP 18 2015
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INDEX TO ATTACHMENTS
Attachment I SERVICE PROVISIONS HOME CARE FOR THE ELDERLY
Attachment 11 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS,
LOANS AND AGREEMENTS
Attachment III FINANCIAL AND COMPLIANCE AUDIT
Attachment IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,
GRANTS, LOANS AND COOPERATIVE AGREEMENTS
Attachment V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
Attachment VI ASSURANCES NON CONSTRUCTION PROGRAMS
Attachment VII BUDGET SUMMARY
Attachment Vill INVOICE CONTRACT REPORT SCHEDULE
Attachment 1A
REQUEST FOR PAYMENT I FORM
Attachment X
RECEIPT AND EXPENDITURE REPORT
Attachment XI
COST REIMBURSMENT SUMMARY
Attachment A
DOEA HANDBOOK
Attachment B
CIVIL RIGHTS COMPLIANCE CHECKLIST
Attachment C
REFERRAL PROTOCOL AGING AND DISABILITY RESOURCE CENTER (ADRC) —
OUTSOURCED FUNCTIONS
Attachment D
DOEA COMPUTER USE POLICY
Attachment E
BUSINESS ASSOCIATE AGREEMENT
Attachment F E-VERIFY
Attachment G BACKGROUND SCREENING AFFIDAVIT OF COMPLIANCE
Attachment H CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
Attachment J ALLIANCE FOR AGING SURPLUS DEFICIT POLICY
19
1. st =rn KI i °2
ATTACHMENT I
HOME CARE FOR THE ELDERLY PROGRAM
SECTION I. SERVICES TO BE PROVIDED
1. Scope of Service and Eligible Individual
1.1 The services to be provided are those described in the provider's service provider application submitted in
response to the 2011 HCE RFP and as described in this contract. The Home Care for the Elderly (HCE)
Program encourages the provision of care in family -type living arrangements in private homes on a not for
profit basis as an alternative to nursing home or other institutional care.
1.2 The provider's service provider application submitted in response to the 2011 HCE Lead Agency RFP, as well
as the RFP itself is incorporated by reference in this contract between the Alliance and the provider and made a
part of this contract.
1.3 INDIVIDUALS TO BE SERVED
1.3.1 General Eligibility
The Home Care for the Elderly program serves elders age 60 and older at risk of placement in a nursing
home or other institutional settings who can remain in a family style setting through the provision of
subsidies.
1.3.2 Individual Eligibility
In order to receive services under this contract, an applicant must:
(1) Be at least 60 years of age;
(2) Have income and assets which do not exceed the Medicaid Institutional Care Program limits;
(3) Be at risk of nursing home placement;
(4) Have an adult caregiver living in the home that is willing and able to provide care and assist in
arranging services for the client.
(5) Eligible applicants must be screened, prioritized and referred to the provider by the Aging Resource
Center prior to enrollment.
(6) Not be enrolled in a Medicaid Capitated Long Term Care Program.
1.3.3 Caregiver Eligibility
Caregivers eligible to receive services under this contract must:
(1) Be at least 18 years of age;
(2) Be capable of providing a family -type living environment;
(3) Be a relative or a friend who has been accepted by the client as a surrogate family or is a responsible adult
with whom the client has made an arrangement to provide home care services;
(5) Be willing to accept responsibility for the social, physical and emotional needs of the care recipient;
(6) Be physically present and live in the home to provide supervision and to assist in arrangement of services
for the client;
(7) Maintain the residential dwelling free of conditions that pose an immediate threat to the life, safety, health
and well -being of the home care client; and
(8) Be without record of conviction of abuse, neglect or exploitation of another person.
1.3.4 Targeted Groups
Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk of
placement in an institution.
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Contract r ,1 ;,.,,1 :r it �H
SECTION II. MANNER OF SERVICE PROVISION
2.0 Conditions
2.1 All services under this contract will be provided in a manner consistent with the conditions set forth in the
2013 Florida Department of Elder Affairs Programs and Services Handbook or any subsequent
revisions made to the Handbook and the provider's service provider application submitted in response to
the 2011 HCE Lead Agency RFP (SPA). In case of conflict between the SPA and the Handbook, the
Handbook prevails.
2.1.1 Client access to services, assessment and eligibility determination must conform to the protocols listed in
ATTACHMENT C.
2.1.2 The provider will offer services based on clients' service plans.
2.2 Service Tasks
2.2.1 Delivery of Service to Eligible Clients
The provider shall provide services authorized under this contract as referenced on ATTACHMENT VII that
meets the diverse needs of functionally impaired elders. The provider shall perform and report performance of
the services in accordance with the current DOEA Programs and Services Handbook.
To achieve the goals of the HCE program, the Contractor shall perform or ensure that its Subcontractors perform
the following tasks:
(1) Client Eligibility Determination;
(2) Assessment and Prioritization of Service Delivery for New Clients;
(3) Delivery of Services to Eligible Clients; and
(4) Monitoring the performance of its Subcontractors.
Client Eligibility Determination
The Provider shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client
is based on meeting the requirements in ATTACHMENT 1, Section 1.3
Basic Subsidy
The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses
incurred in caring for the client. The Basic Subsidy is provided for support and maintenance of the care
recipient, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any
other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any
part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less, the full
Basic Subsidy shall be provided to the caregiver as if the client were in the home.
Special Subsidy Services
Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre- authorized
and are based on additional specialized medical or health care services, supplies or equipment needed to
maintain the health and well -being of the individual elder. The Special Subsidy for additional medical
support and special services is a cash payment to reimburse the costs of any other service or special care not
covered by Medicaid, Medicare, or private insurance when these services are determined to be essential to
maintain the well -being of the home care recipient. A Special Subsidy shall be paid to the approved
caregivers when the client is in the home for any part of the month. Special Subsidy Services are authorized
through a vendor agreement. All Special Subsidy services must be performed in accordance with the
Department of Elder Affairs Programs and Services Handbook. Special Subsidy services include:
(1) Adult Day Care;
(2) Adult Day Health Care;
(3) Caregiver Training /Support;
(4) Chore;
(5) Chore (Enhanced);
(6) Counseling (Gerontological);
(7) Counseling (Mental Health /Screening);
(8) Home Delivered Meals;
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(9) Home Health Aide Service;
(10) Homemaker;
(11) Housing Improvement;
(12) Material Aid;
(13) Personal Care;
(14) Respite (Facility Based or In- Home);
(15) Specialized Medical Equipment, Services and Supplies;
(16) Transportation.
2.3 SERVICE TIMES AND LOCATION
2.3.1 Service Times
The Provider shall ensure the provision of the services listed in this contract is available at times appropriate to
meet client service needs at a minimum, during normal business hours. Normal business hours are defined as
Monday through Friday, 8:OOam to 5:OOpm.
2.4 REPORTS
2.4.1 The Provider shall respond to additional routine and /or special requests for information and reports required
by the Alliance in a timely manner as determined by the Contract Manager. The Provider shall establish due
dates for any sub - providers that permits the Provider to meet the Alliance's reporting requirements.
2.4.2 Client Information and Registration Tracking System (CIRTS) Reports
The Provider shall input HCE specific data into CIRTS to ensure CIRTS data accuracy following the Alliance
CIRTS Data Integrity Policy.
2.4.2.1 The recipient must ensure all data for HCE subsidies are entered in the CIRTS by the 15th of each month.
HCE subsidy data entered into the CIRTS by the 15th of the month will be for payments incurred between the
16th of the previous month and the 15th of the current month. Case management data entered into the CIRTS
by the 15th of the month will be for units of service provided during the previous month from the 16th and up
to and including the 15th of the current month or case management units of service may be entered according
to the recipient schedule, in aggregate on the 31 st or daily, weekly or monthly.
2.4.2.2 The recipient will ensure data entry for HCE subsidies will cease on the 15th of the month and the CIRTS
Monthly Service Utilization Report, by consumer and by worker identification is run.
2.4.2.3 The recipient will ensure the Monthly Utilization Report, by consumer and by worker identification is
verified, corrected, certified no later than the 20th of the month in which the report is generated.
2.4.2.4 The recipient will ensure caregivers determined eligible for the HCE basic subsidy after the 15th of a month,
will be processed to begin eligibility for the HCE basic subsidy on the 1 st day of the next month.
2.4.5 The Alliance reserves the right to adjust the total award as well as the contracted unit rate to reflect provider
costs and utilization rates based on active clients enrolled in the program.
2.4.6 The Alliance may withhold payment under the terms of this contract, pending the receipt and approval by the
Alliance of complete and accurate financial and programmatic reports due from the provider and any
adjustments thereto, including any disallowance not resolved.
2.4.7 The provider shall provide the Alliance with an expenditure plan by July 15 or two weeks after this contract
has been signed; a monthly update is due on the 21 day of each following month. The expenditure plan and
updates must follow the format provided by the Alliance.
2.4.8 The provider shall respond to surplus /deficit inquiries and will provide ad -hoc reports as requested by the
Alliance.
2.5 ELECTRONIC RECORDS AND DOCUMENTATION
The provider will ensure the collection and maintenance of client and service information on a monthly basis
from the Client Information and Registration Tracking System (CIRTS). Maintenance includes valid exports
and backups of all data and systems according to Alliance and Department standards.
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KH 15/1'
2.5.1 Timely Data Entry
The provider must enter all required HCE data per the Department's CIRTS Policy Guidelines for consumers
and services in the CIRTS database. The data must be entered into CIRTS before the provider submits its
request for payment and expenditure reports to the Alliance as per Attachment VIII.
2.5.2 Data Accuracy
The provider will run monthly CIRTS reports and verify client and service data in CIRTS is accurate. This
report must be submitted to the Alliance with the monthly request for payment and expenditure report and
must be reviewed by the Alliance before the provider's request for payment and expenditure reports can be
approved by the Alliance.
2.5.3 Failure to Maintain CIRTS Database
Failure to ensure the collection and maintenance of the CIRTS data may result in the Alliance enacting the
"Enforcement" clause of this agreement (see 2.7.2), including delaying or withholding payment until the
problem is corrected.
2.5.4 Computer System Backup and Recovery
Each provider, among other requirements, must anticipate and prepare for the loss of information processing
capabilities. The routine backing up of data and software is required to recover from losses or outages of the
computer system. Data and software essential to the continued operation of provider functions must be
backed up. The security controls over the backup resources shall be as stringent as the protection required of
the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite
location. The provider shall maintain written policies and procedures for computer backup and recovery.
These policies and procedures shall be made available to the Alliance upon request.
2.6.1 Outcomes
(1) The Provider shall timely submit to the Alliance all reports described in ATTACHMENT I, SECTION
2.4 REPORTS;
(2) The Provider shall timely submit to the Alliance all information described in ATTACHMENT I,
SECTION 2.5 ELECTRONIC RECORDS AND DOCUMENTATION;
(3) The Provider shall ensure services in this contract are in accordance with the current DOEA Programs and
Services Handbook.
2.6.2 The performance of the Provider in providing the services described in this contract shall be measured by the
current Area Plan strategies for the following criteria:
(1) Percent of elders assessed with high or moderate risk environments who improved their environment
score;
(2) Percent of new service recipients with high -risk nutrition scores whose nutritional status improved;
(3) Percent of new service recipients whose ADL assessment score has been maintained or improved;
(4) Percent of new service recipients whose IADL assessment score has been maintained or improved;
(5) Percent of family and family- assisted caregivers who self -report they are likely to provide care;
(6) Percent of caregivers whose ability to provide care is maintained or improved after one year of service
intervention (as determined by the caregiver and the assessor);
2.7 Compliance and Enforcement
2.7.1 The provider shall comply with all the terms and conditions set -forth in this contract, the HCE RFP pursuant to
which this contract was awarded, the Service Provider Application and the most recent edition of the
Department of Elder Affairs Programs and Services Handbook. The provider is also responsible to respond to
any fiscal or programmatic monitoring items /issues within the timeframe stipulated by the Alliance and
provide supporting documentation as requested by the Alliance. Monitoring Items /Issues may include
Corrective Actions, Reportable Conditions or Quality Improvement Recommendations provided by the
Alliance. The provider is also responsible to provide timely response to any inquiry related to program
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expenditures including, but not limited to, addressing program surplus or deficit and corresponding program
spend -out plan.
Failure to meet any of the contractual requirements or compliance items mentioned above will result in the
imposition of sanctions and/ or other enforcement actions by the Alliance.
2.8 ALLIANCE FOR AGING RESPONSIBILITIES
2.8.1 Program Guidance and Technical Assistance
The Alliance will provide to the Provider guidance and technical assistance as needed to ensure the successful
fulfillment of the contract by the Provider.
2.8.2 Contract Monitoring
The Alliance will review and evaluate the performance of the Provider under the terms of this contract.
Monitoring shall be conducted through direct contact with the Provider through telephone, in writing, or an
onsite visit. The Alliance's determination of acceptable performance shall be conclusive. The Provider agrees
to cooperate with the Alliance in monitoring the progress of completion of the service tasks and deliverables.
The Alliance may use, but is not limited to, one or more of the following methods for monitoring:
(1) Desk reviews and analytical reviews;
(2) Scheduled, unscheduled and follow -up on -site visits;
(3) Client visits;
(4) Review of independent auditor's reports;
(5) Review of third -party documents and/or evaluation;
(6) Review of progress reports;
(7) Review of customer satisfaction surveys;
(8) Agreed -upon procedures review by an external auditor or consultant;
(9) Limited -scope reviews; and
(10) Other procedures as deemed necessary.
SECTION III. METHOD OF PAYMENT
3.1 General Statement of Method of Payment
The method of payment for this contract includes advances, cost reimbursement for administration costs, as
well as fixed rate and cost reimbursement for services. Payment may be authorized for all allowable
expenditures to complete the tasks identified in the deliverables, in accordance with all applicable state and
federal statutes and regulations, and are based on audited historical costs in instances where an independent
audit is required. All Provider requests for payment and expenditure reports submitted to support requests for
payment shall be on Department forms 106C and 105C, included as Attachments IX, X, and XI. Duplication
or replication of both forms via data processing equipment is permissible, provided all data elements are in the
same format as included on department forms.
3.1.1 Provider invoices shall be submitted, no later than 60 days after the end of the month on which the expense was
incurred, except that invoices cannot be submitted beyond the date for final invoicing, as stated in this contract.
Invoices submitted late will not be honored. Exceptions to this rule are at the discretion of the Alliance, on a
case by case basis; such exceptions must be requested prior to the expiration of the invoicing deadline. In
making a determination of the exception the Alliance will consider whether the disruption to the billing cycle
was beyond the control of the provider, the frequency with which such exceptions are requested by the
provider, and whether the Alliance can request reimbursement at a late date from DOEA. Exceptions for
invoicing late after the closeout date will not be made.
3.2 Advance Payments
Non - profit providers may request a monthly advance for service costs for each of the first two months of the
contract period, based on anticipated cash needs. Detailed documentation justifying cash needs for advances
must be submitted with the signed contract, approved by the Alliance, and maintained in the contract manager's
file. All payment requests for the third through the twelfth months shall be based on the submission of monthly
actual expenditure reports beginning with the first month of the contract. The schedule for submission of
advance requests is ATTACHMENT VIII to this contract. Reconciliation and recouping of advances made
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KH 15 Q
under this contract are to be completed by October. All advance payments are subject to the availability of
funds.
3.3 Advance funds may be temporarily invested by the provider in an insured interest bearing account. All interest
earned on contract fund advances must be returned to the Alliance within thirty (30) days of the end of the first
quarter of the contract period.
3.4 Final Request for Payment:
3.4.1 The provider must submit the final request for payment to the Alliance no later than July 15, 2016; if the
provider fails to do so, all right to payment is forfeited, and the Alliance will not honor any requests submitted
after the aforesaid time period.
3.4.2 If the contract is terminated prior to the contract end date of June 30, 2016, then the provider must submit the
final request for payment to the Alliance no more than 45 days after the contract is terminated, but no later than
July 15, 2016. If the provider fails to do so, all right to payment is forfeited, and the Alliance will not
honor any requests submitted after the aforesaid time period.
3.5 Documentation for Payment
The Provider will maintain documentation to support payment requests that shall be available to the Alliance or
authorized individuals, such as Department of Financial Services, upon request.
3.5.1 The Provider must require sub - providers to enter all required data per the Department's CIRTS Policy
Guidelines for clients and services in the CIRTS database. The data must be entered into the CIRTS before the
sub - providers submit their request for payment and expenditure reports to the Provider. The Provider shall
establish time frames to assure compliance with due dates for the requests for payment and expenditure reports
to the Alliance.
3.5.2 The Provider must require sub - providers to run monthly CIRTS reports and verify client and service data in the
CIRTS is accurate. This report must be submitted to the Provider with the monthly request for payment and
expenditure report and must be reviewed by the Provider before the sub - provider's request for payment and
expenditure reports can be approved by the Provider.
3.6 Remedies for Nonconforming Services
The Provider shall ensure that all goods and/or services provided under this contract are delivered timely,
completely and commensurate with required standards of quality. Such goods and/or services will only be
delivered to eligible program participants.
3.6.1 If the Provider fails to meet the prescribed quality standards for services, such services will not be reimbursed
under this contract. In addition, any nonconforming goods (including home delivered meals) and/or services
not meeting such standards will not be reimbursed under this contract. The Provider's signature on the request
for payment form certifies maintenance of supporting documentation and acknowledgement that the Provider
shall solely bear the costs associated with preparing or providing nonconforming goods and /or services. The
Alliance requires immediate notice of any significant and/or systemic infractions that compromise the quality,
security or continuity of services to clients.
3.6.2 Financial Consequences of Surplus
Provider shall ensure the provision of services to the projected number of clients in accordance with Alliance's
forecasts and within the contract amount. The Provider shall ensure expenditure of 100% of the contract amount
budgeted for services to clients at the unit rates established in this contract. In the event the Provider has a
surplus of I% or more at the end of the contract term, the Alliance will reallocate I% of the budget for the next
year contract term to other lead agencies found to be serving clients to the fullest extent of their allocated
budgets.
3.6.3 Consequences for Non - Compliance
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C ontract _ _, :_,�.3 ., —,<
The Provider shall ensure that services and reports are performed pursuant to contract requirements. If at any
time the Provider is notified by the Alliance's Contract Manager that it has failed to correctly, completely, or
adequately perform these services and reports, the Provider will have 10 days to submit a Corrective Action
Plan ( "CAP ") to the Contract Manager that addresses the identified deficiency and states how the deficiency
will be remedied within a time period approved by the Contract Manager. The Alliance may assess a financial
consequence for non - compliance on the Provider for each deficiency identified in the CAP which is not
corrected pursuant to the CAP. The Alliance may also assess a financial consequence for failure to timely
submit a CAP. In the event the Provider fails to correct an identified deficiency within the approved time period
specified in the CAP, the Alliance may deduct, from the payment of the invoice for the following month, 1% of
the monthly value of the Management and General Cost's component of the unit rate for each day the
deficiency is not corrected. The Alliance may also deduct, from the payment of the invoice for the following
month, 1% of the monthly value of the Management and General Cost's component of the unit rate for each day
the Provider fails to timely submit a CAP, beginning the 11th day after notification by the Contract Manager of
the deficiency. If, or to the extent, there is any conflict between this paragraph and any other paragraph in this
contract, this paragraph shall have precedence.
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ATTACHMENT II
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an
officer or employee of congress, an employee of a member of congress, or an officer or employee of the state
legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of
any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal
contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of
congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying,"
in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all sub -
awards at all tiers (including subcontracts, sub - grants, and contracts under grants, loans and cooperative agreements)
and that all sub - providers shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil
penalty of not less than $10,000 and not more than $100,000 for each such failure.
Signature
SHERYL GRAHAM
Name of Authorized Individual
pq I / IS
Date
KH 1572
Application or Agreement Number
MONROE COUNTY BOCC /SOCIAL SERVICES
1100 SIMONTON ST. SUITE 2 -257
KEY WEST. FLORIDA 33040
Name and Address of Organization
DOEA Form 103
(Revised Nov 2002)
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ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Alliance for Aging, Inc. to the provider may be subject to audits and/or
monitoring by the Alliance or the Florida Department of Elder Affairs, as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A -133, as revised, and Section 215.97, F.S.,
(see "AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits by the Department of
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 Alliance or the Department of Elder Affairs. In the event the Alliance for Aging, Inc. determines that a limited scope
audit of the provider is appropriate, the provider agrees to comply with any additional instructions provided by the
Alliance for Aging, Inc. to the provider regarding such audit. The provider further agrees to comply and cooperate with
any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial Officer (CFO) or Auditor
General.
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.
In the event that the provider expends $750,000 or more in federal awards during its fiscal year, the provider must have a
single or program - specific audit conducted in accordance with the provisions of OMB Circular A -133, as revised.
EXHIBIT 1 to this agreement indicates federal resources awarded through the Department of Elder Affairs and the
Alliance by this agreement. In determining the federal awards expended in its fiscal year, the provider shall consider all
sources of federal awards, including federal resources received from the Alliance or 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. An audit of the provider conducted by the Auditor General in accordance with the provisions
of OMB Circular A -133, as revised, will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the provider shall fulfill the requirements
relative to auditee responsibilities as provided in Subpart C of OMB Circular A -133, as revised.
If the provider expends less than $750,000 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 $750,000
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 resources (i.e., the cost of such audit must
be paid from provider resources obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Alliance for Aging, Inc. shall be based on the agreement's
requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements shall
disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and
liabilities due to the Alliance for Aging, Inc. shall be fully disclosed in the audit report with reference to the Alliance for
Aging, Inc. agreement involved. 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 agreement number for each
agreement with the Alliance for Aging, Inc. in effect during the audit period. Financial reporting packages required under
this part must be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the
provider's fiscal year end.
I:
Contract Nurnber Kk 1" " 1"
PART II: STATE FUNDED
This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2), Florida Statutes.
In the event that the provider expends a total amount of state financial assistance equal to or in excess of $750,000 in any
fiscal year of such provider (for fiscal years beginning on or after January 1, 2015), the provider must have a State single
or project - specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the
Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit
organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance awarded
through the Alliance for Aging, Inc. by this agreement. In determining the state financial assistance expended in its fiscal
year, the provider shall consider all sources of state financial assistance, including state financial assistance received from
the Alliance for Aging, Inc., other state agencies, and other nonstate entities. State financial assistance does not include
federal direct or pass- through awards and resources received by a nonstate entity for federal program matching
requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the provider shall ensure that the audit
complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting
package as defined by Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650
(nonprofit and for - profit organizations), Rules of the Auditor General.
If the provider expends less than $750,000 in state financial assistance in its fiscal year (for fiscal years beginning on or
after January 1, 2015), an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not
required. In the event that the provider expends less than $500,000 in state financial assistance in its fiscal year and elects
to have an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit
must be paid from the nonstate entity's resources (i.e., the cost of such an audit must be paid from the provider resources
obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Alliance for Aging, Inc. shall be based on the agreement's
requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or
not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the
Alliance for Aging, Inc. shall be fully disclosed in the audit report with reference to the Alliance for Aging, Inc.
agreement involved. If not otherwise disclosed as required by Rule 69I- 5.003, Fla. Admin. Code, the schedule of
expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the
Alliance for Aging, Inc. in effect during the audit period. Financial reporting packages required under this part must be
submitted within 45 days after delivery of the audit report, but no later than 12 months after the provider's fiscal year end
for local governmental entities. Non - profit or for - profit organizations are required to be submitted within 45 days after
delivery of the audit report, but no later than 9 months after the provider's fiscal year end. Notwithstanding the
applicability of this portion, the Alliance and the Department of Elder Affairs retain all right and obligation to monitor and
oversee the performance of this agreement as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages 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, by or
on behalf of the provider directly to each of the following:
The Alliance for Aging, Inc. at each of the following addresses:
Alliance for Aging, Inc.
Attn: Fiscal Manager
760 NW 107 Ave. Suite 214
Miami, FL. 33172 -3155
The Federal Audit Clearinghouse designated in OMB Circular A -133, as revised (the number of copies required by
29
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 10 Street
Jeffersonville, IN 47132
Other federal agencies and pass- through entities in accordance with Sections .320 (e) and (f), OMB Circular A -133, as
revised.
Pursuant to Sections .320(f), OMB Circular A -133, as revised, the provider shall submit a copy of the reporting package
described in Section .320(c), OMB Circular A -133, as revised, and any management letter issued by the auditor, to the
Alliance for Aging, Inc. at each of the following addresses:
Alliance for Aging, Inc.
Attn: Fiscal Manager
760 NW 107` Ave. Suite 214
Miami, FL. 33172 -31550
Additionally, copies of financial reporting packages required by Part Il of this agreement shall be submitted by or on
behalf of the provider directly to each of the following:
The Alliance for Aging, Inc. at each of the following addresses:
Alliance for Aging, Inc.
Attn: Fiscal Manager
760 NW 107` Ave. Suite 214
Miami, FL. 33172 -3155
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399 -1450
Any reports, management letter, or other information required to be submitted to the Alliance for Aging, Inc. pursuant to
this agreement shall be submitted timely in accordance with OMB Circular A -133, Florida Statutes, and Chapters 10.550
(local governmental entities) or 10.650 (nonprofit and for- profit organizations), Rules of the Auditor General, as
applicable.
Providers, when submitting financial reporting packages to the Alliance for Aging, Inc. for audits done in accordance with
OMB Circular A -133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit organizations),
Rules of the Auditor General, should indicate the date that the reporting package was delivered to the provider in
correspondence accompanying the reporting package.
PART IV: RECORD RETENTION
The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of
six years from the date the audit report is issued, and shall allow the Alliance for Aging, Inc. or its designee, the CFO or
Auditor General Access to such records upon request. The provider shall ensure that audit working papers are made
available to the Alliance for Aging, Inc., or its designee, the Department or its designee, CFO, or Auditor General upon
request for a period of six years from the date the audit report is issued, unless extended in writing by the Alliance for
Aging, Inc.
30
ATTACHMENT III
EXHIBIT —1
i. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
PROGRAM TITLE I FUNDING SOURCE I CFDA I AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST
OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE I FUNDING SOURCE I CFDA I AMOUNT
T S TATE AWARD I $p
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97. F.S.
PROGRAM TITLE
FUNDING SOURCE
CSFA
AMOUNT
Home Care for the Elderly Program
General Revenue
65010
$10,622.00
TOTAL AWARD
$10,622.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO
THIS AGREEMENT ARE AS FOLLOWS:
31
ATTACHMENT III
EXHIBIT -2
PART I: AUDIT RELATIONSHIP DETERMINATION
Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A -133, as
revised, and /or Section 215.97, Fla. Stat. Providers who are determined to be recipients or sub - recipients of federal awards and /or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and /or Part 11
of Exhibit 1 are met. Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A-
133, as revised, and /or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, providers who have been
determined to be recipients or sub - recipients of federal awards and /or state financial assistance must comply with applicable
programmatic and fiscal compliance requirements.
In accordance with Sec. 210 of OMB Circular A -133 and /or Rule 691 - 5.006, FAC, provider has been determined to be:
Vendor or exempt entity and not subject to OMB Circular A -133 and /or Section 215.97, F.S.
X Recipient/sub- recipient subject to OMB Circular A -133 and /or Section 215.97, F.S.
NOTE: If a provider is determined to be a recipient /sub- recipient of federal and or state financial assistance and has been approved
by the Department to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I- .006(2), FAC [state financial
assistance] and Section — .400 OMB Circular A -133 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive federal awards or
state matching funds on federal awards and who are determined to be a sub- recipient must comply with the following fiscal laws, rules
and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A -87)*
OMB Circular A -102 — Administrative Requirements
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON - PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non - Profit Organizations (Formerly OMB Circular A -122 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements)
Requirements)
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST
FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A -21 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -110 — Administrative Requirements)
OMB Circular A -133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
*Some federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular
A -133 Compliance Supplement, Appendix 1.
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a
recipient/sub- recipient must comply with the following fiscal laws, rules and regulations:
Section 215.97, Fla. Stat.
Chapter 69I -5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
32
C )a�, ° Y i: i flu Y €'H 15 7
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS,
LOANS AND COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the Provider named in the contract or agreement to which this form is an
attachment, hereby certifies that:
(1) The Provider and any sub - providers of services under this contract have financial management systems capable of
providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each
grant- funded project or program in accordance with the prescribed reporting requirements; (2) the source and
application of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts
for each award. The inability to process information in accordance with these requirements could result in a return of
grant funds that have not been accounted for properly.
(2) Management Information Systems used by the Provider, sub - provider(s), or any outside entity on which the Provider
is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be capable of
processing data accurately, including year -date dependent data. For those systems identified to be non - compliant,
provider(s) will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions
of these products offered by the Provider (represented by the undersigned) and purchased by the State will be verified
for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly, the Provider agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted herein,
at no charge to the State, and without interruption to the ongoing business of the state, time being of the essence.
(4) The Provider and any sub - provider(s) of services under this contract warrant their policies and procedures include a
disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from
data integrity compliance issues.
The Provider shall require that the language of this certification be included in all sub - agreements, sub - grants,
and other agreements and that all sub - providers shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
OMB Circulars A -102 and 2 CFR Part 215 (formerly OMB Circular A -110).
IAL SERVICES 1100 SIM
Name ddress of Provider
_ _ACTING COUNTY ADMINISTRATOR O CI /1_�;V IS
Signature Title I ate
SHERYL GRAHAM p CCU ORNEY
Name of Authorized Signer pp QVED RM
(Revised June 2008) _
.�
33
Date 1 lu ( S
�'ntract Number KH I"
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(1) The prospective provider certifies, by signing this certification, neither it nor its principals is presently
debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in
this transaction by any federal department or agency.
(2) Where the prospective provider is unable to certify to any of the statements in this certification, such
prospective p ipant shall attach an explanation to this certification.
Signature
_ACTING COUNTY ADMINISTRATOR_
Title
(Certification signature should be same as Contract signature.)
Instructions for Certification
Date
Agency /Orgam a_tion , Y
1 Y _
'ay
The The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction,"
"person," "primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out
in the sections of rules implementing Executive Order 12549. (2 CFR 180.5- 180.1020, as supplemented by 2
CFR 376.10- 376.995). You may contact the Contract Manager for assistance in obtaining a copy of those
regulations.
2. This certification is a material representation of facts upon which reliance was placed when the parties entered
into this transaction. If it is later determined that the Provider knowingly rendered an erroneous certification, in
addition to other remedies available to the federal government, the Department may pursue available remedies,
including suspension and/or debarment.
3. The Provider will provide immediate written notice to the Contract Manager if at any time the Provider learns
that its certification was erroneous when submitted or has become erroneous by reason of changed
circumstances. The Provider may decide the method and frequency by which it determines the eligibility of its
principals. Each participant to a lower tier covered transaction may, but is not required to, check the Excluded
Parties List System (EPLS).
4. The Provider will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary
Exclusion - Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations
for lower tier covered transactions.
5. The Provider agrees that it shall not knowingly enter into any lower tier covered transaction with a person who
is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise
authorized by the federal government.
6. If the Provider knowingly enters into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies
available to the federal government, the Department may pursue available remedies, including suspension,
and /or debarment.
7. The Provider may rely upon a certification of a prospective participant in a lower tier covered transaction that it
is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows
that the certification is erroneous.
(Revised June 2008)
34
-..4
ATTACHMENT VI
ASSURANCES— NON - CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the
collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348- 0043),
Washington, DC 20503.
rLEANE VU NUI KEIUKN YOUK UUMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET, SEND
IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the
awarding agency. Further, certain federal awarding agencies may require applicants to certify to additional assurances.
If such is the case, you will be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability (including funds
sufficient to pay the non - federal share of project cost) to ensure proper planning, management, and completion of the project
described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish
a proper accounting system in accordance with generally accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728 -4763) relating to prescribed standards for
merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a
Merit System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil
Rights Act of 1964 (P.L. 88 -352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. 1681 -1683, and 1685 - 1686), which prohibits discrimination on the
basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 1794), which prohibits discrimination on
the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. -- -- 6101- 6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92 -255), as amended, relating to
nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and
Rehabilitation Act of 1970 (P.L. 91 -616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism;
(g) - - 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd -3 and 290 ee 3), as amended, relating to
confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. - 3601 et
seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination
provisions in the specific statute(s) under which application for federal assistance is being made; and 0) the requirements of any
other nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91 -646) which provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of federal participation in purchases.
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. -1501 -1508 and 7324 - 7328), which limit the
political activities of employees whose principal employment activities are funded in whole or in part with federal funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. _.276a to 276a -7), the Copeland Act (40
U.S.C. 276c and 18 U.S.C. - 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. __ 327 -333), regarding
labor standards for federally assisted construction sub - agreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of
1973 (P.L. 93 -234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood
insurance if the total cost of insurable construction and acquisition is $10,000 or more.
35
i
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental
quality control measures under the National Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514;
(b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of
flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. - 1451 et seq.); (f) conformity of
federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42
U.S.C. — 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as
amended, (P.L. 93 -523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L.
93 -205).
12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1721 et seq.) related to protecting components or
potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as
amended (16 U.S.C. -470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic
Preservation Act of 1974 (16 U.S.C. - 469a -1 et seq.).
14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89 -544, as amended, 7 U.S.C. - _ 2131 et seq.) pertaining to
the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award
of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.), which prohibits the use of lead -
based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of
1996 and OMB Circular No. A -133, Audits of States, Local Governments, and Non - Profit Organizations.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies governing this
program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
TITLE
SHERYL GRAHAM
ACTING COUNTY ADMINISTRATOR
APPLICANT ORGANIZATION
DATE SUBMITTED
MONROE COUNTY SOCIAL SERVICES
00, is I I S
ATTACHMENT VII
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
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:
37
Service
Maximum
Maximum
Service to be Provided
Unit
Units of
Dollars
Rate
Service
Case Management
$50.48
210
$10,622.00
Total
$10,622.00
37
ATTACHMENT VIII
HOME CARE FOR THE ELDERLY
INVOICE REPORT SCHEDULE
Report Number
Based On
Submit to Alliance on
this Date
1
July Advance*
July 1
2
August Advance*
July 1
3
July Expenditure Report + 1/12 advance reconciliation
August 15
4
August Expenditure Report + 1/ 12 advance reconciliation
September 15
5
September Expenditure Report + 1/12 advance reconciliation
October 15
6
October Expenditure Report + 1/12 advance reconciliation
November 15
7
November Expenditure Report + 1/12 advance reconciliation
December 15
8
December Expenditure Report + 1/ 12 advance reconciliation
January 15
9
January Expenditure Report + 1/12 advance reconciliation
February 15
10
February Expenditure Report + 1/12 advance reconciliation
March 15
11
March Expenditure Report + 1/12 advance reconciliation
April 15
12
April Expenditure Report + 1/12 advance reconciliation
May 15
13
May Expenditure Report + 1/12 advance reconciliation
June 15
14
June Expenditure Report+ 1/12 advance reconciliation
July 15
15
Final Expenditure and closeout
July 15
Legend: * Advance based on projected cash need.
W .
ATTACHMENT IX
REQUEST FOR PAYMENT
HOME CARE FOR THE ELDERLY
RECIPIENT NAME, ADDRESS, PHONE# and FEID#
TYPE OF PAYMENT:
This Request Period: From: To:
Contract Period
Regular
Contract #
Advance
Report #
PSA #
CERTIFICATION: I hereby certify to the best of my knowledge that this request or refund conforms with the terms and the purposes of the above contract.
Prepared by: Date: Approved by: Date:
PART A: BUDGET SUMMARY
CCE Admin.
CCE Services
TOTAL
1. Approved Contract Amount
$
$
$
$
2. Previous Funds Received for Contract Period
$
$
$
$
3. Contract Balance
$
$
$
$
4. Previous Funds Requested and Not Received for Contract Period
$
$
$
$
5. CONTRACT BALANCE
$
$
$
$
PART B: CONTRACT FUNDS REQUEST
1. Anticipated Cash Need It st - 2nd months)
$
$
$
$
2. Net Expenditures For Month
$
$
$
$
(DOEA Form 105C, Part B, Line 4)
3. TOTAL
$
$
$
$
PART C: NET FUNDS REQUESTED
1. Less Advance Applied
$
$
$
$
2. TOTAL FUNDS REQUESTED (Part B Line 3, minus Part C Line 1)
$
$
$
$
DOEA FORM 106C
Wit
ATTACHMENT X
RECEIPT AND EXPENDITURE REPORT
HOME CARE FOR THE ELDERLY
PHONE # and FEID#
Program Funding
THIS REPORT PERIOD:
PROVIDER NAME, ADDRESS,
From To
CCE Admin.
CONTRACT PERIOD:
CCE Services
CONTRACT #
REPORT #
PSA#
I to the best of my knowledge and belief that the report is complete and correct and all outlays
CERTIFICATION: certify
herein are for purposes set forth in the contract.
Approved by: Data
Prepared by
PART A: BUDGETED INCOME / RECEIPTS
1' Approved
2 Receipts
3
Percent
Approved et
Fort Thi Re
Year to Date
$0.00
$0.00
$0.00
#DIV /01
1. State Funds
$0.00
$0.00
$0.00
#DIV /O!
2. Program Income
$0.00
$0.00
$0.00
#DIV /O!
3. Local Cash Match
4. SUBTOTAL: CASH RECEIPTS
5. Local In -Kind Match
6. TOTAL RECEIPTS
$0.00
$0.00
$0.00
#DIV /O!
PART B: EXPENDITURES
1. Approved
Budget
2. Expenditures
For This Report
3. Expenditures
Year to Date
4. Percent of
Approved Budget
$0.00
$0.00
$0.00
#DIV /O!
1. Administrative Services
$0.00
$0.00
$0.00
#D V/01
2. Service Subcontractor(s)
$0.00
$0.00
$0.00
#DIV /01
3. Adult Protective Services
4. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
#DIV /01
IIL Advance Recouped
PART C: OTHER REVENUE AND EXPENDITURES
11. Interest:
I. Program Income (PI)
1. Earned on GR Advance $
$
1. CCE: PI Collected YTD $
2. Return of GR Advance $
(Includes fees collected)
3. Other Earned $
PART D: CO- PAYMENTS CURRENT MONTH YEAR -TO -DATE
1 . Total of Co- payments assessed $ $
2. Total of CO- payments collected $ $
(For Tracking Purposes only)
DOEA FORM 105C
Ravisad 5/25/2010
no]
ATTACHMENT XI
Cost Reimbursement Summary
Contract #
Report (invoice) Number:
Budget
Number of
Category Description
Units
Service Date
Amount
o
M
4,j;
E`'
TOTAL ADMINISTRATION
$0.00
CL
w
TOTAL EXPENSES
$0.00
41
��..�m i" i o <'
ATTACHMENT A
Department of Elder Affairs Programs & Services Handbook, provided on CD.
Also, available at the Department's Intranet site under, "Publications ".
42
ATTACHMENT B
STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
The entire Florida Keys (Monroe County, approximately 120 miles long) are considered rural with some urban characteristics.
Service(S) to be provided by MCIHS with this grant are: case management.
2. POPULATION OF AREA SERVED. Source of data: US CENSUS 2010
Total # % White % Black % Hispanic % Other % Female
73,165 723 5.7 19.6 2 46.6
3. STAFF CURRENTLY EMPLOYED. Effective date: 7/1/2015
Total # % White % Black % Hispanic % Other % Female % Disabled
42 63% 17% 12% 8 %n 72% 0%
nn - -�TVmnT)T:T LFF,. A-*- '7/1 /7(11 S
'}. 1..L1i.1V1J L.
Total #
l/1 \1 \li1`11L1 Ll�i�vui...u✓
% White
v�����
% Black
-. �+�•+���----• - __
% His p anic
-___._ ___ - -_ _
% Other
% Female
% Disabled bled
40
16
63%
38%
25%
75%
69%
100%
100%
J. t1LJV 113l/1\ 1
Total #
"IX
% White
%Black
_� --
%Hispanic
%Other
% Female
% Disabled
5
100
0
0
0
40%
0%
7.
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS KEQUIKINU iVIUKE NrA'
6.
Is an Assurance of Compliance on file with DOEA? If N/A or NO, explain.
N/A
❑
YES
®
NO
❑
7.
Compare the staff composition to the population. Is staff representative of the population?
If N/A or NO, explain.
N/A
El
YES
Z
NO
El
8.
Compare the client composition to the population. Are race and sex characteristics representative of the
population? If N/A or NO, explain.
N/A
❑
YES
®
NO
❑
9.
Are eligibility requirements for services applied to clients and applicants without regard to race, color,
national origin, sex, age, religion or disability? If N/A or NO, explain.
N/A
❑
YES
®
NO
❑
10.
Are all benefits, services and facilities available to applicants and participants in an equally effective
manner regardless of race, sex, color, age, national origin, religion or disability? If N/A or NO, explain.
N/A
❑
YES
®
NO
❑
11.
For in- patient services, are room assignments made without regard to race, color, national origin
or disability? If N/A or NO, explain.
N/A
®
YES
❑
NO
❑
OUR AGENCY IS NOT AN INPATIENT FACILITY
Revised August 2010, Page Iof 2
43/64
12.
Is the program/facility accessible to non- English speaking clients? If N/A or NO, explain.
N/A
❑
YES
®
NO
❑
Telephone
Response Due
On -Site ❑ Desk Review ❑
Response Received
13.
Are employees, applicants and participants informed of their protection against discrimination? If YES,
how? Verbal ❑ Written ❑ Poster ❑ If N/A or NO, explain.
N/A
❑
YES
®
NO
❑
14.
Give the number and current status of any discrimination complaints regarding services or employment filed
against the program/facility.
N/A
❑
NUMBER
_0
15.
Is the program/facility physically accessible to mobility, hearing, and sight- impaired individuals? If N/A or
NO, explain.
N/A
El
YES
Z
NO
PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES.
16. Has a self - evaluation been conducted to identify any barriers to serving disabled individuals, and to make
any necessary modifications? If NO, explain.
YES
®
NO
❑
17.
Is there an established grievance procedure that incorporates due process in the resolution of complaints? If
NO, explain.
YES
NO
18.
Has a person been designated to coordinate Section 504 compliance activities? If NO, explain.
YES
®
NO
❑
19.
Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination
on the basis of disability? If NO, explain.
YES
®
NO
❑
20.
Are auxiliary aids available to assure accessibility of services to hearing and sight- impaired individuals? If
NO, explain.
YES
®
NO
❑
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE.
21. Do you have a written affirmative action plan? If NO, explain. YES NO
® ❑
Reviewed By
In Compliance: YES ❑ NO* ❑
Program Office
*Notice of Corrective Action Sent
Date
Telephone
Response Due
On -Site ❑ Desk Review ❑
Response Received
Revised August 2010, Page 2 of 2
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INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves a
specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
Enter the percent of the population served by race and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population statistics
can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing
Florida population statistics. Include the source of your population statistics. ( "Other" races include Asian/Pacific
Islanders and American Indian/Alaskan Natives.)
3. Enter the total number of full -time staff and their percent by race, sex and disability. Include the effective date of your
summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex and disability. Include the date that enrollment was counted.
5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no advisory
or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for DOEA recipients and their sub - grantees, 45 CFR 80.4 (a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability in
the population, the program/facility has the responsibility to determine the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR 80.3 (b) (6).
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on -site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a) and
45 CFR 80.1 (b) (2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin,
religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied
uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting rooms,
reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR 80.3 (b).
11. For in- patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national origin
or disability. Also, residents must not be asked whether they are willing to share accommodations with persons of a
different race, color, national origin, or disability, 45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those persons who
may not speak English. In geographic areas where a significant population of non - English speaking people live,
program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy or
plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist in the
45/64
provision of services, 45 CFR 80.3 (a).
13. Programs /facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries or any other interested parties. This should include information on their right to file a
complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS. The
information may be supplied verbally or in writing to every individual, or may be supplied through the use of an equal
opportunity policy poster displayed in a public area of the facility, 45 CFR 80.6 (d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement,
termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address
of the local, state or federal agency with whom the complaint has been filed. Indicate the current status, e.g., settled,
no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated
parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone,
restroom facilities, water fountains, information and admissions offices should be accessible. Door widths and traffic
areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed
for accessibility. Elevators should be observed for door width and Braille or raised numbers. Switches and controls
for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for mobility
impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self -
evaluation to identify any accessibility barriers. Self- evaluation is a four step process:
a. With the assistance of a disabled individual /organization, evaluate current practices and policies which do not
comply with Section 504.
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate any discrimination that has been identified.
d. Maintain self - evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have
been followed.), 45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited
by Section 504.45 CFR 84.7 (b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7 (a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads,
and other appropriate written communication, 45 CFR 84.8 (a).
20. Programs /facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired
sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters for
hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide
equally effective services, 45 CFR 84.52 (d).
21. Programs /facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60 and
Title VI of the Civil Rights Act of 1964, as amended.
DOEA Form 101 -B, Revised August 2010
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ATTACHMENT C
REFERRAL PROTOCOL DADE
Issue: Screening, Triage, and Referral for Activation under the Community Care for the Elderly /Home Care for
the Elderly.
Policy: Referrals will be based on availability of funds, in accordance with prioritization requirements.
Purpose: To ensure funding is spent expeditiously and consumers are referred into programs for appropriate
services.
Procedure for Monroe County:
I. Roles and Responsibilities
A. Alliance for Aging / Aging and Disability Resource Center
➢ Reconciles overall program and Lead Agency specific spending levels on a monthly basis to
ensure the Lead Agency is operating within the funding allocation.
➢ Reviews the number of cases released for activation based on projected funding available.
➢ Screens consumers to link with appropriate resources and prioritize for DOEA- funded programs
and services.
➢ Recommends potential cases for activation based upon projected funding available by Lead
Agency.
➢ Selects consumers from the waiting list based on their prioritization score.
➢ Refers consumers from the waiting list to the Lead Agency in Monroe County for activation,
based on availability of funds.
➢ Monitors compliance with service standards and outcome measures.
➢ Reviews care plans and files per the File Review Policies and Procedures.
➢ Reviews data in CIRTS.
B. Case Management Agency
➢ Requests and accepts referrals from the Aging and Disability Resource Center, to serve an
optimal caseload and to avoid surpluses or deficits in accordance with the AAA CCE /HCE
Surplus /Deficit Analysis policy.
➢ Refers inquiries from consumers interested in services to the ADRC for Information and Referral
to community resources, Screening, Triage, and Long -Term Care Options Counseling, as
appropriate.
➢ The functions of Screening and Intake are outsourced to the Lead Agency. Screening and Intake
may also be completed by the ADRC.
➢ Completes comprehensive assessments on new consumers and annual reassessment on existing
consumers and develops care plans and reviews care plans semi - annually.
➢ Authorizes service delivery and enters data into CIRTS.
➢ Screens consumers for SMMCLTC eligibility.
➢ Bills in CIRTS as appropriate.
➢ Monitors care plans in an effort to keep costs down while sustaining the individuals in the
community.
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II. Management of the Assessed Prioritized Consumer List (APCL).
A. Referrals to the ADRC are routed to the Information and Referral Specialists or Intake Unit staff
depending on the type of referral. Clients are provided information on community resources and
programs available including private pay options. Persons are directed to those resources most capable of
meeting the need they have expressed to ADRC staff. Cases presenting strong identifiers that indicate
the consumer might benefit from publicly funded long term care services are screened, entered into
CIRTS, triaged and provided options counseling. In Monroe County, the functions of Screening and
Intake are outsourced to the Lead Agency. Screening and Intake may also be completed by the ADRC.
DOEA prioritization requirements will be adhered to by both entities, as follows:
APS High Risk Referrals (See Section B)
2. Imminent Risk cases will be prioritized for activation after APS High Risk Referrals have been
served. If budgetary constraints prevent opening new cases, clients will be placed on the APCL.
ADRC staff will contact the client on a monthly basis to determine if there has been a change in
the client's situation.
3. All other CARES referrals will be screened and prioritized in accordance with DOEA
requirements.
4. Aging Out consumers will be referred by DCF for prioritization and/or activation in the
corresponding aged program managed by the Alliance, as appropriate (See section IV).
5. Consumers applying for the Community Care for the Elderly (CCE) and/or Home Care for the
Elderly (HCE) programs will be contacted and screened using the statewide assessment form
developed by the Department of Elder Affairs for this purpose (Form 701S). If a consumer is
being served through a DOEA- funded agency which enters their annual assessment into CIRTS,
the Priority Score generated by that assessment will determine their ranking on the APCL.
6. Consumers referred for inclusion under the Statewide Medicaid Managed Care Long Term Care
Program APCL will be contacted and screened by an ADRC staff person following the same
procedure as the one described under Section 5. Individuals who appear as potentially eligible
for other types of public assistance will be referred to the Economic Self- Sufficiency Unit at the
Department of Children and Families.
7. All other referrals will be waitlisted and prioritized, during which time other community
resources will be researched, including private pay /fee for services providers. Consumers on the
waiting lists will be reassessed according to the 2015 Department of Elder Affairs Programs and
Services Handbook, or any revisions made thereafter.
B. HIPAA forms will be sent to the consumer as appropriate.
61
III. Opening New Cases
A. CCE/HCE Clients
The Fiscal Department will monitor Lead Agency specific spending levels on a monthly basis to
ensure each Lead Agency is operating within its spending authority. In addition, the fiscal
department will analyze surplus /deficit projections, and share the information with the Lead
Agency to assist in their determination of slot availability. The Lead Agency will request
referrals directly from the ADRC. The Fiscal Department will be notified of the number of new
cases being referred to the Lead Agency for activation.
2. Upon receipt of the request for referrals from the Lead Agency, the ADRC Intake Unit
Supervisor will run the Prioritized Risk Report to identify the consumers on the APCL to be
opened.
3. In response to the request for referrals, the ADRC Intake Unit Supervisor will refer wait listed
clients to the Lead Agency for activation, in accordance with prioritization requirements. The
Intake Unit will update the wait list enrollment using the appropriate code to terminate from the
APCL. Upon receipt of referral, the Lead Agency will enter the APPL enrollment, and
subsequent enrollments to reflect client status.
4. Upon receipt of list of clients released from the waiting list, the Lead Agency will enter the
APPL enrollment, will contact clients to offer program enrollment, and will proceed with
activation. The Lead Agency will enter subsequent enrollments into CIRTS to reflect client
status.
5. The ADRC will oversee the enrollment process to ensure referrals have timely outcomes in
CIRTS.
B. Statewide Medicaid Managed Care Long Term Care Program Clients
The Department of Elder Affairs will run the APCL (Assessed Priority Consumer List) report to
review clients wait listed for the SMMCLTCP. DOEA will provide the ADRC with a list of
individuals authorized for release from the APCL.
2. For clients active in CCE or HCE and authorized for release from the Medicaid Waiver waiting
list, the ADRC will be responsible for the application process. For CCE active clients the
ADRC will notify the Lead Agency in order to waive the co -pay.
C. APS Referrals
APS Low and Intermediate Risk referrals will be screened and prioritized by the ADRC for
services as per the DOEA/APS Memorandum of Understanding. Low and Intermediate Risk
referrals are also offered information and referral to additional community resources, including
private pay as appropriate.
2. APS High Risk Referrals are not waitlisted. They are immediately referred for service from DCF
in Monroe County to the Lead Agency. ARTT referrals will be forwarded directly the Lead
Agency. APS cases are to be served for a maximum of 31 calendar days. If additional time is
justified, the case management agency will staff the case with the Alliance to obtain the
extension needed.
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3. Upon receipt of the APS High Risk referral, the Lead Agency will coordinate services to begin
within the 72 hour period mandated by statute. A comprehensive assessment will be done within
72 hours of the referral. Services required under the care plan will remain in place for a
maximum of 31 days, unless an extension has been granted.
4. The Lead Agency will enter ACTV enrollment under their provider number in CIRTS. In
addition, service codes will be entered by service date for all services provided. If a service(s) is
not provided as required under the care plan, an NDP code will need to be entered in CIRTS and
the case notes under the client file should document the reason for non - delivery of such
service(s).
IV. Aging Out Consumers:
A. All "Aging Out" consumers will be referred by DCF to the ADRC for enrollment into the corresponding
aged program managed by the Alliance.
B. Consumers active in the CCDA and HCDA programs that are turning 60 and are eligible for CCE and/or
HCE will be opened in the corresponding aged program managed by the Alliance if funding is available.
If funding is available, these consumers will be made active. If funding is not available, they will be
waitlisted for these programs but will be given priority for activation once funding is available.
Note: These ADRC policies and procedures are subject to change. Any modifications will be done through a
contract amendment.
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t N K H 1-5
ATTACHMENT D
Department's Computer Use Policy and its Social Media Policy, provided on CD.
51/64
.flat _ ty "t t -nPr
ATTACHMENT E
Alliance for Aging, Inc.
Business Associate Agreement
This Business Associate Agreement is dated 9/15/2015 , by the Alliance for Aging, Inc
( "Covered Entity ") and _MONROE COUNTY BOCC /SOCIAL SERVICES_, ( "Business Associate "), a not -for-
profit Florida corporation.
1.0 Background,
1.1 Covered Entity has entered into one or more contracts or agreements with Business Associate that
involves the use of Protected Health Information (PHI).
1.2 Covered Entity, recognizes the requirements of the Health Insurance Portability and Accountability Act of
1996 ( HIPAA) and has indicated its intent to comply in the County's Policies and Procedures.
1.3 HIPAA regulations establish specific conditions on when and how covered entities may share information
with contractors who perform functions for the Covered Entity.
1.4 HIPAA requires the Covered Entity and the Business Associate to enter into a contract or agreement
containing specific requirements to protect the confidentiality and security of patients' PHI, as set forth in,
but not limited to the Code of Federal Regulations (C.F.R.), specifically 45 C.F.R. §§ 164.502(e),
164.504(e), 164.308(b), and 164.314(a -b) (2010) (as may apply) and contained in this agreement.
1.5 The Health Information Technology for Economic and Clinical Health Act (2009), the American Recovery
and Reinvestment Act (2009) and Part I — Improved Privacy Provisions and Security provisions located
at 42 United States Code (U.S.C.) §§ 17931 and 17934 (2010) require business associates of covered
entities to comply with the HIPAA Security Rule, as set forth in, but not limited to 45 C.F.R. §§ 164.308,
164.310, 164.312, and 164.316 (2009) and such sections shall apply to a business associate of a
covered entity in the same manner that such sections apply to the covered entity.
The parties therefore agree as follows:
2.0 Definitions. For purposes of this agreement, the following definitions apply:
2.1 Access. The ability or the means necessary to read, write, modify, or communicate data/information or
otherwise use any system resource.
2.2 Administrative Safeguards. The administrative actions, and policies and procedures, to manage the
selection, development, implementation, and maintenance of security measures to protect electronic
Protected Health Information (ePHI) and to manage the conduct of the covered entity's workforce in
relation to the protection of that information.
2.3 ARRA. The American Recovery and Reinvestment Act (2009)
2.4 Authentication. The corroboration that a person is the one claimed.
2.5 Availability. The property that data or information is accessible and useable upon demand by an
authorized person.
2.6 Breach. The unauthorized acquisition, access, use, or disclosure of PHI which compromises the
security or privacy of such information.
2.7 Compromises the Security. Posing a significant risk of financial, reputational, or other harm to
individuals.
2.8 Confidentiality. The property that data or information is not made available or disclosed to unauthorized
persons or processes.
52
.,,. * ' , , 1.
2.9 Electronic Protected Health Information.(ePHI) Health information as specified in 45 CFR
§160.103(1)(i) or (1)(ii), limited to the information created or received by Business Associate from or on
behalf of Covered Entity.
2.10 HITECH. The Health Information Technology for Economic and Clinical Health Act (2009)
2.11 Information System. An interconnected set of information resources under the same direct
management control that shares common functionality. A system normally includes hardware, software,
information, data, applications, communications, and people.
2.12 Integrity. The property that data or information have not been altered or destroyed in an unauthorized
manner.
2.13 Malicious software. Software, for example, a virus, designed to damage or disrupts a system.
2.14 Part I. Part I — Improved Privacy Provisions and Security provisions located at 42 United States Code
(U.S.C.) §§ 17931 and 17934 (2010).
2.15 Password. Confidential authentication information composed of a string of characters.
2.16 Physical Safeguards. The physical measures, policies, and procedures to protect a covered entity's
electronic information systems and related buildings and equipment, from natural and environmental
hazards, and unauthorized intrusion.
2.17 Privacy Rule. The Standards for Privacy of Individually Identifiable Health Information at 45 CFR Part
160 and Part 164, subparts A and E.
2.18 Protected Health Information. (PHI) Health information as defined in 45 CFR §160.103, limited to the
information created or received by Business Associate from or on behalf of Covered Entity.
2.19 Required By Law. Has the same meaning as the term "required by law" in 45 CFR § 164.103.
2.20 Secretary. The Secretary of the Department of Health and Human Services or his or her designee.
2.21 Security incident. The attempted or successful unauthorized access, use, disclosure, modification, or
destruction of information or interference with system operations in an information system.
2.22 Security or Security measures. All of the administrative, physical, and technical safeguards in an
information system.
2.23 Security Rule. The Security Standards for the protection of Electronic Protected Health Information at 45
CFR part 164, subpart C, and amendments thereto.
2.24 Technical Safeguards. The technology and the policy and procedures for its use that protect electronic
protected health information and control access to it.
2.25 Unsecured PHI. Protected health information that is not secured through the use of technology or
methodology specified by the Secretary in guidance issued under 42 U.S.C. section 17932(h)(2).
2.26 All other terms used, but not otherwise defined, in this Agreement shall have the same meaning as those
terms in the Privacy Rule.
3.0. Obligations and Activities of Business Associate.
3.1 Business Associate agrees to not use or disclose PHI other than as permitted or required by this
agreement or as Required by Law.
53
3.2 Business Associate agrees to:
(a) Implement policies and procedures to prevent, detect, contain and correct Security violations in
accordance with 45 CFR § 164.306;
(b) Prevent use or disclosure of the PHI other than as provided for by this Agreement or as required
by law;
(c) Reasonably and appropriately protect the confidentiality, integrity, and availability of the ePHI that
the Business Associate creates, receives, maintains, or transmits on behalf of the Covered Entity; and
(d) Comply with the Security Rule requirements including the Administrative Safeguards, Physical
Safeguards, Technical Safeguards, and policies and procedures and documentation requirements set
forth in 45 CFR §§ 164.308, 164.310, 164.312, and 164.316.
3.3 Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to
Business Associate of a use or disclosure of PHI by Business Associate in violation of the requirements
of this Agreement.
3.4 Business Associate agrees to promptly report to Covered Entity any use or disclosure of the PHI not
provided for by this Agreement of which it becomes aware. This includes any requests for inspection,
copying or amendment of such information and including any security incident involving PHI.
3.5 Business Associate agrees to notify Covered Entity without unreasonable delay of any security breach
pertaining to:
(a) Identification of any individual whose unsecured PHI has been, or is reasonably believed by the
Business Associate to have been, accessed, acquired, or disclosed during such security breach; and
(b) All information required for the Notice to the Secretary of HHS of Breach of Unsecured Protected
Health Information.
3.6 Business Associate agrees to ensure that any agent, including a subcontractor, to whom it provides PHI
received from, or created or received by Business Associate on behalf of Covered Entity, agrees to the
same restrictions and conditions that apply through this Agreement to Business Associate with respect to
such information.
3.7 If Business Associate has PHI in a Designated Record Set:
(a) Business Associate agrees to provide access, at the request of Covered Entity during regular
business hours, to PHI in a Designated Record Set, to Covered Entity or, as directed by Covered Entity,
to an individual in order to meet the requirements under 45 CFR §164.524; and
(b) Business Associate agrees to make any amendment(s) to PHI in a Designated Record Set that
the Covered Entity directs or agrees to pursuant to 45 CFR § 164.526 at the request of Covered Entity or
an Individual within 10 business days of receiving the request.
3.8 Business Associate agrees to make internal practices, books, and records, including policies and
procedures and PHI, relating to the use and disclosure of PHI received from, or created or received by
Business Associate on behalf of Covered Entity, available to the Covered Entity or to the Secretary upon
request of either for purposes of determining Covered Entity's compliance with the Privacy Rule.
3.9 Business Associate agrees to document such disclosures of PHI and information related to such
disclosures as would be required for Covered Entity to respond to a request by an individual for an
accounting of disclosures of PHI in accordance with 45 CFR § 164.528.
3.10 Business Associate agrees to provide to Covered Entity or an individual, upon request, information
collected to permit Covered Entity to respond to a request by an Individual for an accounting of
disclosures of PHI in accordance with 45 CFR § 164.528 and ARRA § 13404.
54
C. :$ar a, , Pr K
3.11 Business Associate specifically agrees to use security measures that reasonably and appropriately
protect the confidentiality, integrity, and availability of PHI in electronic or any other form, that it creates,
receives, maintains, or transmits on behalf of the Covered Entity.
3.12 Business Associate agrees to implement security measures to secure passwords used to access ePHI
that it accesses, maintains, or transmits as part of this Agreement from malicious software and other
man -made and natural vulnerabilities to assure the availability, integrity, and confidentiality of such
information.
3.13 Business Associate agrees to implement security measures to safeguard ePHI that it accesses,
maintains, or transmits as part of this agreement from malicious software and other man -made and
natural vulnerabilities to assure the availability, integrity, and confidentiality of such information.
3.14 Business Associate agrees to comply with:
(a) ARRA § 13404 (Application of Knowledge Elements Associated with Contracts);
(b) ARRA § 13405 (Restrictions on Certain Disclosures and Sales of Health Information); and
(c) ARRA § 13406 (Conditions on Certain Contacts as Part of Health Care Operations).
4.0 Permitted Uses and Disclosures by Business Associate. Except as otherwise limited in this
Agreement or any related agreement, Business Associate may use or disclose PHI to perform functions,
activities, or services for, or on behalf of, Covered Entity as specified in any and all contracts with
Covered Entity provided that such use or disclosure would not violate the Privacy Rule if done by
Covered Entity or the minimum necessary policies and procedures of the Covered Entity.
5.0 Specific Use and Disclosure Provisions.
5.1 Except as otherwise limited in this agreement or any related agreement, Business Associate may use
PHI for the proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
5.2 Except as otherwise limited in this agreement or any related agreement, Business Associate may
disclose PHI for the proper management and administration of the Business Associate, provided that
disclosures are Required By Law, or Business Associate obtains reasonable assurances from the
person to whom the information is disclosed that it will remain confidential and used or further disclosed
only as Required By Law or for the purpose for which it was disclosed to the person, and the person
notifies the Business Associate of any instances of which it is aware in which the confidentiality of the
information has been breached.
5.3 Business Associate may use PHI to provide data aggregation services to Covered Entity as permitted by
45 CFR §164.504(e)(2)(i)(B), only when specifically authorized by Covered Entity.
5.4 Business Associate may use PHI to report violations of law to appropriate Federal and State authorities,
consistent with 45 CFR §164.502(j) (1).
6.0 Obligations of Covered Entity.
6.1 Covered Entity shall notify Business Associate of any limitation(s) in its notice of privacy practices of
Covered Entity in accordance with 45 CFR § 164.520, to the extent that such limitation may affect
Business Associate's use or disclosure of PHI, by providing a copy of the most current Notice of Privacy
Practices (NPP) to Business Associate as Attachment XI to this Agreement. Future Notices and /or
modifications to the NPP shall be posted on Covered Entity's website at www.allianceforaging.org
6.2 Covered Entity shall notify Business Associate of any restriction to the use or disclosure of PHI
that Covered Entity has agreed to in accordance with 45 CFR § 164.522, to the extent that such
restriction may affect Business Associate's use or disclosure of PHI.
55
7.0 Permissible Requests by Covered Entity. Except for data aggregation or management and
administrative activities of Business Associate, Covered Entity shall not request Business Associate to
use or disclose PHI in any manner that would not be permissible under the Privacy Rule if done by
Covered Entity.
8.0 Effective Date and Termination.
8.1 The Parties hereby agree that this agreement amends, restates and replaces any other Business
Associate Agreement currently in effect between Covered Entity and Business Associate and that the
provisions of this agreement shall be effective as follows:
(a) These Business Associate Agreement provisions, with the exception of the electronic security
provisions and the provisions mandated by ARRA, HITECH and Part I shall be effective upon the later of
April 14, 2003, or the effective date of the earliest contract entered into between Business Associate and
Covered Entity that involves the use of PHI;
(b) The electronic security provisions hereof shall be effective the later of April 21, 2005 or the
effective date of the earliest contract entered into between Business Associate and Covered Entity that
involves the use of PHI; and
(c) Provisions hereof mandated by ARRA, HITECH and /or Part I shall be effective the later of
February 17, 2010 or the effective date of the earliest contract entered into between covered entity and
business associate that involves the use of PHI or ePHI.
8.2 Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business Associate,
Covered Entity shall either:
(a) Provide an opportunity for Business Associate to cure the breach or end the violation and
terminate this agreement if Business Associate does not cure the breach or end the violation within the
time specified by Covered Entity;
(b) Immediately terminate this agreement if Business Associate has breached a material term of this
Agreement and cure is not possible; or
(c) If neither termination nor cure is feasible, Covered Entity shall report the violation to the Secretary.
8.3 Effect of Termination. Except as provided in subparagraph (b) of this section, upon termination of this
agreement, for any reason, Business Associate shall return all PHI and ePHI received from Covered
Entity, or created or received by Business Associate on behalf of Covered Entity.
(a) This provision shall apply to PHI and ePHI that is in the possession of subcontractors or agents of
Business Associate. Business Associate shall retain no copies of the PHI and ePHI.
(b) In the event that Business Associate or Covered Entity determines that returning the PHI or ePHI
is infeasible, notification of the conditions that make return of PHI or ePHI infeasible shall be provided to
the other party. Business Associate shall extend the protections of this Agreement to such retained PHI
and ePHI and limit further uses and disclosures of such retained PHI and ePHI, for a minimum of six
years and so long as Business Associate maintains such PHI and ePHI, but no less than six (6) years
after the termination of this agreement.
9.0 Regulatory References. A reference in this agreement to a section in the Privacy Rule or Security Rule
means the section then in effect or as may be amended in the future.
10.0 Amendment. The Parties agree to take such action as is necessary to amend this agreement from time
to time as is necessary for Covered Entity to comply with the requirements of the Privacy Rule, the
Security Rule and the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104 -191.
56
11.0 Survival. Any term, condition, covenant or obligation which requires performance by either party hereto
subsequent to the termination of this agreement shall remain enforceable against such party subsequent
to such termination.
12.0 Interpretation. Any ambiguity in this agreement shall be resolved to permit Covered Entity to comply
with the Privacy Rule and Security Rule.
13.0 Incorporation by reference. Any future new requirement(s), changes or deletion(s) enacted in federal
law which create new or different obligations with respect to HIPAA privacy and /or security, shall be
automatically incorporated by reference to this Business Associate Agreement on the respective effective
date(s).
14.0 Notices. All notices and communications required, necessary or desired to be given pursuant to this
agreement, including a change of address for purposes of such notices and communications, shall be in
writing and delivered personally to the other party or sent by express 24 -hour guaranteed courier or
delivery service, or by certified mail of the United States Postal Service, postage prepaid and return
receipt requested, addressed to the other party as follows (or to such other place as any party may by
notice to the others specify):
To Covered Entity: Alliance for Aging, Inc.
Attention: Max Rothman
760 NW 107 Avenue
Miami, Florida 33172
To Business Associate: MONROE COUNTY BOCC /SOCIAL SERVICES
1100 SIMONTON ST. SUITE 2 -257
KEY WEST, FLORIDA 33040_
Any such notice shall be deemed delivered upon actual receipt. If any notice cannot be delivered or delivery
thereof is refused, delivery will be deemed to have occurred on the date such delivery was attempted.
15.0 Governing Law. The laws of the State of Florida, without giving effect to principles of conflict of laws,
govern all matters arising under this agreement.
16.0 Severability. If any provision in this agreement is unenforceable to any extent, the remainder of this
agreement, or application of that provision to any persons or circumstances other than those as to which
it is held unenforceable, will not be affected by that unenforceability and will be enforceable to the fullest
extent permitted by law.
17.0 Successors. Any successor to Business Associate (whether by direct or indirect or by purchase,
merger, consolidation, or otherwise) is required to assume Business Associate's obligations under this
agreement and agree to perform them in the same manner and to the same extent that Business
Associate would have been required to if that succession had not taken place. This assumption by the
successor of the Business Associate's obligations shall be by written agreement satisfactory to Covered
Entity.
18.0 Entire Agreement. This agreement constitutes the entire agreement of the parties relating to the
subject matter of this agreement and supersedes all other oral or written agreements or policies relating
thereto, except that this agreement does not limit the amendment of this agreement in accordance with
section 10.0 of this agreement.
57
Covered Entity:
Date: SEP 1 S 2m
Business Associate: MONROE COUNTY BOCC /SOCIAL SERVICES
By: Date:
oQ As/ Is
(signa u HERYL GRAHAM, ACTING COUNTY ADMINISTRATO
SIGNED BY:
NAME: DANNY KOLHAGE
TITLE: MAYOR
DATE: 0 /Z/ � � S
ATTACHMENT F
Verification of Employment Status Certification
As a condition of contracting with the Alliance for Aging, Inc., MONROE COUNTY
BOCC /SOCIAL SERVICES , hereby referred to as contractor, certifies the use of the U.S. Department
of Homeland Security's E- verify system to verify the employment eligibility of all new employees
hired by Contractor during the contract term to perform employment duties pursuant to this Agreement
and (b) that any subcontracts include an express requirement that subcontractors performing work or
providing services pursuant to this Agreement utilize the E- verify system to verify the employment
eligibility of all new employees hired by the subcontractor during the contract term.
59
ATTACHMENT Vs
BACKGROUND SCREENING
E L D E R!
AFFAIRS Affidavit of Compliance - Employer
STATE OF FLOPUDA i.
AUTHORITY: 1`hls form Is required annually of all efWayers to comply with the attestation
r6clu"ments so forth in section 435,06(3), Florida Staltites—
The lean - employer' means any Person or entity required by law to conduct Wckground s(treefring,
irtcluding but not limited to, Area Apricies on Atprv& Aging Resource Centers, Aging and Disability
flrs()utut- crillri-, Lead Agencies, linill-Term Carr Ombudsman Program, Srrviu& Wallh ht-Arriatwr Nrrcl-i
of We proglatn Srr Prn"'Wenti, Oiwr-*)n Prouridem, and any o1hri IterA)n or artily witch hivv•;
employees of has volunteers In service who meet the definition of a direct service probWer. See
435.02,43G,0402, Fla. Stat.
A direct vt provid(n K 'a per%on 18 years )f W, or elder wha, ptir5umil to a program to prquirlp,
-Wrviccs 10 thr- eWdy, has dirrij, Nrc-lo-fare contact vikth adient. while priyuiding client
and tkas .recess to the clients livingateak, funds, petsortal property, at personal Identification iniorryWion
as detii*d in s. 917.568. The tern) Includes coordinators, managers, and svpearsrrs of residential
fx and vnWeers,' § 4� (1)(h), fla, 'Aat
ATEESMQN
As the duty authorized representative of
located at
ift eet Addiev.ti City leofe 70 C13 de
do heretyy affirm under penalty of perjury
NOM.'r of Rep)
that the above named emplow is in compliance with the provisions Of Chapter 435 and 1section
43U.040r2, Plot Ida Statutes, regarding level 2 background screening.
Signature of Representative
STATE 0 F FLORIDA, COUNTY OF
Sworn to (or affirmed) and subscribed before me this _ day of , 20_ by
to me or produced
(Name of Representative) who is pemonally known
as proof of identification.
Nw, Tyr V. swmo Nw—of p0wVO4
Notary Public
Ell
Conmacl `H
ATTACHMENT H
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to which
this form is an attachment, hereby certifies that:
(1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or
submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized
Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran Petroleum
Sector List (collectively, "the Lists ") is ineligible for, and may not bid on, submit a proposal for, or enter into
or renew a contract pursuant to which funding is provided by the Department of Elder Affairs (Department)
for goods or services of $1 million or more.
(2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false certification
is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of
4 " 'alse certification.
(3) The Contractor understands that the contract to which this form is an attachment may be terminated by the
AAA if the Contractor submits a false certification or has been placed on the Lists.
This certification, required by Florida law, is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction.
Oq
/Is hs
SigZ Da
(Same as contract signature)
ACTING COUNTY ADMINISTRATOR
Title
_MONROE COUNTY BOCC /SOCIAL SERVICES
Company Name
NIO, N �l
61
ATTACHMENT J
Alliance for Aging Fiscal Policy and Procedures
SURPLUS/DEFICIT ANALYSIS - COMMUNITY CARE FOR THE ELDERLY (CCE) AND HOME
CARE FOR THE ELDERLY (HCE)
POLICY: Available funds for CCE and HCE will be optimized by using the most recent available data to
analyze contractor spending patterns and trends in order to serve the largest number of clients.
Purpose: To ensure contract compliance requiring that all available funding is spent expeditiously and
completely to avoid any surpluses or deficits.
A. Procedures:
1. Spending patterns of each provider by program will be analyzed on a monthly basis. In accordance
with contract requirements, Lead Agencies must justify projected surpluses or deficits.
2. All noted surpluses or deficits in spending and/or reporting patterns will be reviewed and documented
in order for the Alliance to initiate appropriate steps to ensure that consumers continue receiving
services in accordance with appropriate care plans.
3. Lead Agencies will submit invoices by the deadline date specified in their contracts. Invoices not
submitted on time will not be reimbursed until the following monthly cycle. Invoices not submitted
on time bias surplus /deficit reports. Providers assume the consequences of delayed invoicing on the
accuracy of surplus /deficit projections.
4. Lead Agencies should request referrals for activation directly from the ARC on an ongoing basis, as
often as needed, to ensure that an optimal caseload is maintained so that the Lead Agency will not
realize a year -end surplus or deficit. An optimal caseload is considered the number of cases necessary
for each Lead Agency to maintain throughout the fiscal year so as not to experience any projected
surpluses or deficits. The actual number of cases constituting an optimal caseload should have
concurrence of both a fiscal representative from the Lead Agency and the Alliance Fiscal Analyst.
5. Requesting referrals for activation directly from the ARC will expedite the referral process; however,
it is incumbent upon Lead Agencies to maintain an optimal caseload so as not to create any surpluses
for the current fiscal year nor any deficits, that when annualized, create deficits in the next fiscal year.
For example, if a Lead Agency identifies "x" number of clients will leave or have left the program
due to placement in another program, etc., the Lead Agency can request replacement of these clients
with new referrals by contacting the ARC directly. The Lead Agency must ensure, however, that the
number of referrals requested does not result in a number of cases that exceeds its optimal caseload. In
determining the optimal caseload for purposes of requesting additional cases, factors such as historical
attrition rates and anticipated vacancies due to client transfers to other programs can be considered.
Under no circumstances can reductions in care plans occur for purposes of creating need for
additional referrals.
6. APS referrals are not wait listed and are referred to Lead Agencies on a rotation basis. Funding for
individuals designated as Imminent Risk and Aging Out will be authorized on an as- needed basis by
the fiscal dept. upon review of funding availability.
7. Each Lead Agency will designate a person who is the point of contact and is authorized to request
referrals from the ARC including the date(s) for referrals to be sent to the Lead Agency. In no
situation, should the date(s) established for receiving the referrals be more than 30 days from the date
of request.
8. At least monthly, the Fiscal Analyst for the Alliance will monitor the number of cases that are
maintained by the Lead Agency to determine any projected surplus or deficit. If it is determined that
a projected deficit exists, the Fiscal Analyst will advise the ARC and the Lead Agency that no
62
additional referrals may be sent until there is concurrence between the Alliance and the Lead Agency
about the budget projections. When there is concurrence about the budget projections, both the ARC
and the Lead Agency will be notified by the Fiscal Analyst that referrals can be sent, if warranted.
9. By the 18` of each month, using the most current provider invoicing and enrollment data, the Alliance
Fiscal Analyst will prepare a preliminary surplus /deficit projection, taking into account historical
attrition rates, Adult Protective Services referrals, historical per member /per month (PMPM) spending
rates, and the number of recently referred cases sent to the Lead Agency that may not have yet been
entered in CIRTS or activated (APPL). In addition, surplus /deficit forecasts will formally incorporate
identified late billing/non- billing patterns, changes to expenditures per consumer, lags in the
enrollment processes and any other information that may improve the accuracy of the projections.
10. To monitor the provider's expenditures, the Alliance Fiscal Analyst will use the Alliance for Aging
CCE Expense and Projection Report tool. This tool compares a monthly expenditure plan based on
projected caseloads that assume historical attrition and enrollment factors, against actual invoicing.
On a monthly basis, the Alliance will compare the cumulative expenditure to the month of the report
against the cumulative planned expenditure. For example, if for the December report, the cumulative
planned expenditure was projected to be 55 percent and if the actual reported cumulative expenditure
for December is 48 percent, then the measured surplus for the month of December would be seven (7)
percent.
11. The Alliance Fiscal Analyst will send to the Fiscal Officer of each Lead Agency monthly preliminary
surplus /deficit reports and an analysis of the findings, together with any inquiries regarding the
findings. This communication will be sent via electronic mail. In addition, surplus /deficit reports will
be discussed in conference, on at least a monthly basis, with Lead Agencies to achieve consensus
forecasts.
12. The Fiscal Officer of the Lead Agency will respond to the Alliance's Fiscal Analyst within two (2)
working days via electronic mail with the requested information, noting any discrepancies between
the Alliance's projections and that of the Lead Agency. For example, the Lead Agency may report
atypical attrition or enrollment factors due to unusual circumstances such as higher than usual attrition
or clients transferring to other funded programs. If a Lead Agency requested additional referrals in
excess of what had been determined to be the optimal caseload in order to prevent a surplus or deficit,
then a justification for requesting the additional referrals should be included as part of the response.
The Fiscal Analyst will continue to track and verify that the justification for the additional referrals
has not resulted in a potential surplus or deficit nor had an adverse impact on any clients receiving
services.
13. Based on the information received from the Lead Agency, the Alliance's Fiscal Analyst will either
modify or affirm the preliminary surplus /deficit report. The fiscal Analyst will submit this report to
the Vice President for Finance who will present it for discussion with the Executive Management
Group (EMG). The EMG will decide on an appropriate course of action to address the surplus or
deficit.
14. A monthly surplus /deficit meeting will be held during which the Fiscal Analyst will communicate
with contract management staff about the status and projections of surplus /deficits for the programs.
15. The monthly surplus /deficit reports will be sent by the Alliance to DOEA, as required.
B. Remedial Actions for Surplus/Deficit:
1. For the surplus /deficit reports covering the months of July through September, the Alliance will initiate
remedial action when two consecutive monthly reports indicate surpluses in excess of five (5) percent for
each month.
a. Remedial action will consist of a de- obligation of surplus funds in an
Amount sufficient enough to bring the year -to -date cumulative surplus to less than five (5) percent
of the cumulative year -to -date expected expenditures. For example, for the surplus /deficit report
63
corresponding to the month of October, the expected cumulative expenditure is 33.3 percent of the
contract amount. If the reported expenditure, by the November report deadline, for services
provided through September 30"' is 25 percent of the contract amount and, if there is also a
cumulative surplus of five (5) percent or more in August, then the Alliance will de- obligate an
amount that will bring the cumulative year -to -date surplus to less than five (5) percent. In this
example, the amount of de- obligated funds is 8.3 % (33.3% minus 25 %) of the contract.
b. De- obligated funds will be used by the ARC to make referrals on a client
choice basis. The Fiscal Analyst will advise the ARC of the number of referrals to be made based
on the amount of funds available. Once all persons to be referred are identified and their choice of
case management agency made, the ARC will notify the Alliance fiscal office and the Lead
Agencies in order for appropriate contract amendments to be prepared and executed.
2. For reports covering the October through December period, the Alliance will initiate remedial action when
two consecutive monthly reports show cumulative surpluses in excess of two and a half (2.5) percent in
each month. A cumulative surplus incurred in September, if larger than five (5) percent will be considered
for the consecutive count. For example, if the report for the month of September shows a projected surplus
in excess of five (5) percent and the report for October shows a surplus in excess of two and a half (2.5)
percent, then a de- obligation of funds will be initiated that is equal to the amount needed to decrease the
surplus to no more than two and a half (2.5) percent. In this example, there were two consecutive months
in which there was a surplus for each month that exceeded the established threshold. Since the remedial
action was initiated in the October through the December period, then the amount for the reduction of the
surplus is two and a half (2.5) percent. These surpluses are measured using the DOEA surplus /deficit
reporting tool with expenditures shown as reported by the Lead Agency.
a. The remedial action will be the same as stated in sections B.l.a. and B.l.b.above, except the
referenced surplus allowance is two and a half (2.5) percent.
3. For reports covering the January through March period, the Alliance will initiate remedial action when two
consecutive monthly reports show cumulative surpluses in excess of one and a half (1.5) percent in each
month. A cumulative surplus incurred in December, if larger than two and a half (2.5) percent will be
considered for the consecutive count. For example, if the report for the month of December shows a
projected surplus in excess of two and a half (2.5) percent and the report for January shows a surplus in
excess of one and a half (1.5) percent, then a de- obligation of funds will be initiated that is equal to the
amount needed to decrease the surplus to no more than one and a half (1.5) percent. In this example, there
were two consecutive months in which there was a surplus for each month that exceeded the established
threshold. Since the remedial action was initiated in the January through March period then the amount for
the reduction of the surplus is one and a half (1.5) percent. These surpluses are measured using the DOEA
surplus /deficit reporting tool with expenditures shown as reported by the Lead Agency.
a. The remedial action will be the same as stated in section B.l.a. and B.l.b. above, except the
referenced surplus allowance is one and a half (1.5) percent.
4. For reports covering the April and May period, the Alliance will initiate remedial action for each month in
which the surplus exceeds one (1) percent. The amount exceeding the one (1) percent threshold will be de-
obligated. These surpluses are measured using the DOEA surplus /deficit reporting tool with expenditures
shown as reported by the Lead Agency.
a. The remedial action will be the same as stated in sections B. La. and B.l.b.above, except the
referenced surplus allowance is one (1) percent.
5. For the report covering the June period, if the surplus exceeds one (1) percent, it will be noted as a program
compliance issue and incorporated as part of the monitoring of the Lead Agency by the Alliance. The
agency may also be placed on corrective action.
Z