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Item G39
BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 11/20/2013 Division: Community Services Bulk Item: Yes X No Department: Social Services Staff Contact Person: ShervI Graham (305)292-4510 V-11 11MIJ IT,-"#1'12 AM1,47-- AGENDA ITEM WORDING: Request Approval of Amendment #001 to the Community Care for the Elderly (CCE) Contract #KC 1371 between the Alliance for Aging, Inc. (AAA) and Monroe County Board of County Commissioners (Social Services/In Home Services) for the contract period of 7/1/13 to 6/30/14. ITEM BACKGROUND: Approval of Amendment #001 to the CCE contract will modify Attachment 11, CCE Contract Report Calendar, of the original contract to include the addition of three (3) notes. PREVIOUS RELEVANT BOCC ACTION: Prior approval granted by the BOCC on 6/19/13 for the Community Care for the Elderly Contract (CCE) # KC 1371, between the Alliance for Aging, Inc. (AAA) and Monroe County Board of County Commissioners (Social Services/In Home Services) for the contract period of 7/l/13 to 6/30/14. CONTRACT/AGREEMENT CHANGES: The purpose of this amendment is to modify Attachment 11, CCE Contract Report Calendar, of the original contract to include additional notes. STAFF RECOMMENDATIONS: Approval TOTAL COST: $302,523.00 BUDGETED: Yes X No COST TO COUNTY: $67,227.34cash and in kind (match required) SOURCE OF FUNDS: Grant funds REVENUE PRODUCING: Yes N/A No AMOUNT PER: MONTH: YEAR: APPROVED BY: County Atty. � OJB/Purc Vasing V1 Risk Management DOCUMENTATION: Included x Not Required To Follow DISPOSITION: AGENDA ITEM # Revised 8/06 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Alliance For Aging, Inc. Contract: KC 1371 Effective Date: 11 /20/2013 Expiration Bate: 06/30/2014 Contract Purpose/Description: To Request Approval of Amendment #001 the Community Care for the Elderly (CCE) Contract #KC 1371 between the Alliance for Aging, Inc. (AAA) and Monroe County Board of County Commissioners (Social Services/In Home Services) for the contract period of 7/1/13 to /30/14. Contract Manager: Sheryl Gra (305)' Social Services/Stop 1 ', `292-4510 (Name) (Ext.) (Department/Stop #) For BOCC meeting on 11I20/2013 Agenda Deadline: 11/5/2013 CONTRACT COSTS Total Dollar Value of Contract: approx. $302,523.00 Current Year Portion: $_ 125-6153813 Budgeted? Yes X No Account Cedes: - - County Match: $33,613.67 (in kind) - - - Additional Match: $33,613.67(cash)` - - - - Total Match $67,227.34 ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (e.. Maintenance, utilities, janitorial, salaries, etc) CONTRACT REVIEW Changes Date Out Date Ne wer Division Director/ Yes No 44' Risk Management '�' Yes No O.M.B./Purchasing '' Yes No County Attorney Yes N Comments: _ OMB Form Revised 2127/01 'MCP ##2 Amendment 001 CONTRACT KC 1371 ORIGINAL Page 1 THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred to as the "Alliance", and Monroe County Board of Commissioners, Social Services/In-Home services. i # # ATTACHMENT II Report Number Based On Submit to AAA On This Date 1 July Advance* July 1 2 August Advance* July 1 3 July Expenditure Report August 15 4 August Expenditure Report September 15 5 September Expenditure Report October 15 6 October Expenditure Report November 15 7 November, Expenditure Report December 15 8 December Expenditure Report January 15 9 January Expenditure Report February 15 10 February Expenditure Report March 15 11 March Expenditure Report April 15 12 April Expenditure Report May 15 13 May Expenditure Report June 15 14 June Expenditure Report July 15 15 Final Expenditure and Request for Payment July 25 16 Close Out Report August 15 Legend: * Advance based on projected cash need. Note # 1: Report #1 for Advance Basis Agreements cannot be submitted to the Department of Financial Services (DFS) prior to July 1 or until the agreement with the AAA has been executed and a copy sent to DFS. Actualsubmission of the vouchers to DFS is dependent on the accuracy of the expenditure report. Note # 2: All advance payments made to the Contractor shall be returned to the AAA by the submission date of report #9. Note #3: Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects funds due back to the AAA payment is to accompany the report. All provisions in the contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the contract are hereby amended to conform with this amendment. This amendment and all its attachments - hereby made a part of the contract. This amendment and herebyall its attachments are ..- a part of the contract. Amendment 001 CONTRACT KC 1371 Page 2 IN WITNESS WHEREOF, the parties hereto have caused this 1 -page amendment to be executed by their undersigned officials as duly authorized. PROVIDER: Monroe County Board of ALLIANCE FOR AGING, INC. Commissioners, Social Services/In-Home Services. SIGNED BY: NAME: George Neugent TITLE: Mayor DATE: 11/20/2013 I M 7b, =9: Max B. Rothman, JD, LL.M. NAME: President & CEO TITLE: 0 Contract Number KC 1371 OMMUNITY CARE FOR THE ELDERLY CONTRACT 2013-2014 THIS AGREEMENT is entered into between the Alliance for Aging, Inc., hereinafter referred to as the "Alliance" and "Monroe County Board of Commissioners", hereinafter referred to as the "provider." THIS CONTRACT IS SUBJECT TO FURTHER MODIFICATION IN ORDER TO INCORPORATE CERTAIN PASS -THROUGH LANGUAGE REQUIRED BY THE STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS. ALL SUBSEQUENT MODIFICATIONS WILL BE MADE THROUGH AMENDMENTS TO THIS CONTRACT. Attachment I, II, III, IV, V, VI, VII, VIII, IX, X and XI are integral to this Agreement The parties agree: I. Provider Agrees: A. Services to be Provided: To plan, develop, and accomplish the services delineated, or otherwise cause the planning, development, and accomplishment of such services and activities, under the conditions specified and in the manner prescribed in Attachment I of this agreement and included in the Service Provider Application (SPA). The provider will not be allowed to provide services that are not included in the 2011 SPA and included related Unit Cost Methodology submitted as an integral part of the 2011 application. In the event of the conflict between the Service Provider Applicationand this contract, the contract controls. B. Final Request for Payment: 1 The provider must submit the final request for payment to the Alliance no later than July 15, 2014; 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. 2. If the contract is terminated prior to the contract end date of June 30, 2014, 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, 2014. 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. C. Additional Reporting Requirements 1. If the Alliance has sanctioned the provider, while the sanctions are in effect the provider shall provide to the Alliance, on a monthly basis, the provider's financial statements that reflect the current, un-audited revenues and the provider's cash position as well as any other financial and/or programmatic documentation that may be requested by the Alliance. Contract Number KC 1371 2. If the provider is required to prepare a corrective action plan or respond to a Fiscal and/or Programmatic Monitoring, supporting documentation as 41- requested by the Alliance shall be provided within the time frame stipulated by the Alliance. 3. The provider is to provide explanations to any program surplus/deficit and/or program spend -out plans as requested by the Alliance for Aging within the time period requested by the Alliance. 4. The provider is responsible to report the units of services in CIRTS on a monthly basis. The provider is ultimately responsible to ensure that sub - providers report units of service in CIRTS as well. 5. Invoices must be submitted no later than 90 days after the end of the month on which the expense was incurred, except that invoices can not be submitted after close out report date (usually July 15th.) Invoices submitted late will not paid. 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 DOER. The provider acknowledges that failure to meet the requirements set forth in the 2008 CCE/Lead Agency RFP and in this agreement as well may result in delay or termination of payment and/or in sanctions and other enforcement actions, including termination of contract. 11. The Alliance Agrees: A. Contract Amount To pay for services according to the conditions of Attachment I in an amount not to exceed 302,523 for the State Fiscal Year 2013-2014, subject to the availability of funds. B. Obligation to Pay The Alliance's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. C. 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: 9 Contract Number KC 1371 'Fund Amounts to. Million s - •_ Settlement Trust Funds TOTALES CONTAINED IN THIS CONTRACT: 111. Provider and Alliance Mutually Agree: A. Effective Date: 1. This contract shall begin on July 1, 2013 or on the date the contract has been signed by both parties, whichever is later. 2. Delivery of services shall end on June 30, 2014. This contract shall end on July 15, 2014. See Attachment 1, Section III.F. B. Termination, Suspension, and/or Enforcement: 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 Contractor or the representative of the contractor responsible for administration of the contract. Failure to have performed any contractual obligations with the Alliancein a manner satisfactory to the Alliance will be a sufficient cause for termination. To be terminated as a contractor under this provision, the contractor must have (1) previously failed to satisfactorily perform' in a' contract with the Alliance, been notified by the Alliance of the unsatisfactory performance and failed to correct the unsatisfactory performance to the satisfaction of the Alliance; or (2) had a contract terminated by the Alliance for cause C. Provider Responsibility: The provider maintains responsibility for the performance of all sub providers and vendors in accordance with all applicable federal and state laws. D. Notice, Contact, and Payee Information: 1. The name, 'address, and telephone number of the contract manager for the Alliance for this contract is: Max B. Rothman, JD, LL.M. President and CEO 760 NW 107`h Ave, Suite 214 Miami, Florida 33172 fli (305) 70-6 00, Ext. 224 3 Contract Number KC 1371 2. The name, address, and telephone number of the representative of the provider responsible for administration of the program under this contact is: Sheryl Graham Social Services Director Gato Building 1100 Simonton Street Key West FL 33040 3. 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. 4. The name (provider name as shown on page 1 of this contract) and mailing address of the official payee to whom the payment shall be made: Monroe County Board of Commissioners Gatti Building 1100 Simonton Street Key West FL 33040 E. Renegotiation or Modification 1. Modifications or changes to the funding in this contract and corresponding services related to the increase or decrease, may be made in the form of a written Contract Amendment signed by the Alliance's President and CEO. The Board President or its Designee of the Provider shall sign the Notice of Award Increase/Decrease and return it to the Alliance within fourteen (14) days or sooner if requested by the Alliance. By signing Notice of Award Increase/Decrease, the Board President or its Designee of the Provider acknowledges the receipt of and agreement with the terms contained in the Notice. 2. Upon Receipt of a Notice of Award Increase/Decrease, the provider shall update affected information in budget summaries, deliverable schedules, or any other applicable financial information contained in this contract. The parties shall then incorporate such changes into a contract amendment. This shall be done within ten working days of receipt of such notice. IN WITNESS THEREOF, the parties hereto have caused this contract (including Attachment I- 111) to be executed by their undersigned officials as duly authorized. 1=10TT1111:4za Y 11111117141TV 11111 A, -: A I 1 41 1 li r-r MeT I Tkew T k" 0 T Coptract Numbpr KC 1371 SIGNED BY: SIGNED BY: George Neugent NAME: NAME: Max B. Rothman, �DLL.M. MAYOR TITLE: TITLE: President and CEO DATE: 9, t• 13 DATE: JUN 2 8 2013 (SE,4Lj A HEA I IN, CLERK 5 Contract Number KC 1371'` ATTACHMENT fir, COMMUNITY CARE FOR THE ELDERLY PROGRAM 1. STATEMENT OF PURPOSE The Community Care for the Elderly (CCE) Program provides community -based services organized in a continuum of care to assist aged 60+ elders at risk of nursing home placement to live in the least restrictive environment suitable to their needs. Fi. SERVICES TO BE PROVIDED A. Services: 1. The provider's service provider application submitted in response to the 2011 CCE /Lead Agency RFP and any revisions thereto approved by the Alliance and located in the Contract Manager's file are incorporated by reference in this contract between the Alliance and the provider, and prescribe the services to be rendered by the provider. 2. Consumers may not be enrolled in a Department of Eider Affairs state general revenue funded program, including CCE, who are also enrolled in a Medicaid capitated long-term care health plan or program. These programs; include the Frail Elder Program operated by United Health Care, the Channeling Program operated by Miami Jewish Home and Hospital for the Aged, the Long Term Care `Community Diversion Program and the Program of All Inclusive Care for the Elderly (PACE) program. xj B. Manner of Service Provision: The services to be ;provided are those described in the provider's service provider application submitted in response to the 201`1 CCE /Lead Agency application and as described in this contract. All CCE services will be provided in a manner consistent with the conditions set down in the 2011 Florida Department of Elder Affairs Programs and Services Handbook or any revisions made thereafter. and by the Alliance. In the event either the handbook or the service provisions established by the Alliance is revised, such revision will automatically be incorporated into the contract and the provider will be given a copy of the revisions, III. METHOD OF PAYMENT methodA. The of payment in this contractbased on -• unit rate forapproved services. The provider must ensure fixed unit rates include only those costs which are in accordance withi i • ` state and federal statutesand regulationsand are based on • -• historical costsindependent • required. requestsAll • payment and expenditure r-ii • -• to support requestsfor Payment thM be on WEA forms!. • 105C.• • or -i • of both formsdata processing equipment is permissible, provided data the same format as included on department forms. 2 e B. The provider shall maintain documentation to support payment requests which shall be available to the Comptroller, the Department of Elder Affairs, or the Alliance upon request. C. The provider 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 If to this contract. Reconciliation and recouping of advances made under this contract are to be completed by March and April. All advance payments are subject to the availability of funds. D. 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. E. The Alliance shall make payment to the provider for provision of services up to a maximum number of units of service and at the rate(s) stated below: Service to be Provided Service Unit Rate Maximum Units of Service Maximum Dollars Case Aide $21.98 200 $4,396 Case Management $50.48, 1,230 $51,991 Chore $29.41 85 $2,500 Chore (Enhanced) $32.19 65 $2,092 Companionship $15.33 765 $11,726 Home Modifications $50.00 10 $500 Homemaker $22.06 4,101 $90,468 Personal Care $28.67 3,614 $103,618 Facility Respite $10.00 1,638 $16,380 In Home Respite $23.08 454 $15,002 Specialized Medical Equipments $17 50 850 Transportation $40.00 75 3,000 Total $302,523 1. The provider agrees to implement the distribution of funds as detailed in the service provider application and the Budget Summary, ATTACHMENT III to this contract. Any changes in the total amounts of the funds identified on the Budget Summary form require a contract amendment. W Contract Number KC 1371 2. The provider is to offer services based on clients' service plans and will not be restricted to providing the services as projected. Additional budget revisions/contract amendments will be required to ` move funding among these services. ;Any changes in the total amount of the funds under contract require a formal contract amendment. 3. The Alliance reserves the right to adjust the total award as well as the contracted unit rate to reflect provider casts and utilization rates based on actual consumers enrolled in the program. 4. This contract is for services provided beginning July 1,'2013 through June 30, 2014, however, the contract is in effect through July 15, 2014 in order to provide for maximization of resources and to allow for greater flexibility to pay for the services rendered by December 31, 2011. Services provided after June 30, 2013 cannot be reimbursed under this contract. 5. The provider shall submit a final closeout report by July 15, 2014. 6. The final expenditure report and request for payment will be due to the Alliance no later than July 15, 2014. No expenditure reports or requests for payment will be accepted after July 15, 2014. 7 Any payment due by the Alliance under the terms of this contract may be withheld 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. 8 The provider need to provide the Alliance with an expenditure plan by July 15 or two weeks after contract has been signed, a monthly update due on the 21 of each following month. The expenditure plan and updates must follow the format provided by the Alliance IV. SPECIAL PROVISIONS A. State Laws and Regulations; 1. The provider agrees to comply with applicable parts of Rule Chapter 58C-1, Florida Administrative Code promulgated for administration" of Sections 430.201 through 430.207, Florida Statutes, and ` the Department of Elder Affairs 2011 Florida Department of Elder Affairs Programs and Services Handbook or any revisions made thereafter. 2. The provider agrees to comply with the provisions of Sections 97.021 and 97.058, Florida Statutes, and all rules related thereto in the Florida Administrative Code. B. Assessment and Prioritization for Service Delivery for New Consumers: The following - the criteria to prioritize new• sr service delivery. s the intent of Department of ffi- to remove existing clients from program in orderto serve new clients being assessed and prioritized for service delivery. Contract Number KC 1371 1. Abuse, Neglect and Exploitatiol 2. Priority Criteria for Individuals in Nursing Homes in Receivership The provider will ensure that pursuant to Section 400.126 (12), Florida Statute, those elderly persons determined through a CARES assessment to be a resident who could be cared for in a less restrictive setting or who do not meet the criteria for skilled or intermediate care in a nursing home, will be referred for such care, as appropriate for the resident. Residents referred pursuant to this subsection shall be given primary consideration for receiving services under the Community Care for the Elderly program in a manner as persons classified to receive such services pursuant to Section 430.205, Florida Statute. 3. Priority Criteria for Service Delivery: a) Individuals in nursing homes under Medicaid who could be transferred to the community; b) Individuals in nursing homes, whose Medicare coverage is exhausted and may be diverted to the community; C) Individuals in nursing homes which are closing and can be discharged to the community; or d) Individuals whose mental or physical health condition has deteriorated to the degree self care is not possible, there is no capable caregiver and institutional placement will occur within 72 hours. e) For the purpose of transitioning individuals receiving Community Care for Disabled Adults (CCDA) and Home Care for Disabled Adults (HCDA) services through the Department of Children and Families (DCF) Adult Services to community -based services provided through the department, when services are not currently available, area agency on aging staff and lead agency case managers shall ensure that "Aging Out' individuals are prioritized for services only after Adult Protective Services (PAS) High Risk and Imminent Risk individuals. 4. Priority Criteria for Service Delivery for Other Assessed Individuals: The assessment and provision of services should always consider the most cost effective means of service delivery. Service priority for individuals not included in groups one, two or three above, regardless of referral source, shall be determined through the department's client assessment form administered to each applicant, to OF, the extent funding is available. First priority will be given to applicants at the higher 24 Contract Number KC 1371 levels of frailty and risk of nursing home placement. For individuals assessed at the same priority and risk of nursing home placement, priority will be given to applicants with the lesser ability to pay for services. 5. Referrals for Medicaid Waiver Services: a) The provider must identify, through the consumer assessment, potential Medicaid eligible CCE consumers and refer these individuals for Medicaid Waiver services. b) Individuals who have been identified as being potentially Medicaid Waiver eligible are required to apply for Medicaid Waiver services in order to receive CCE services and can only receive CCE services while the Medicaid Waiver eligibility determination is pending. If the consumer is found ineligible for Medicaid Waiver services for any reason other than failure to provide required documentation, they may continue to receive CCE services. C) Individuals who have been identified as being potentially Medicaid Waiver eligible must be advised of their responsibility to apply for Medicaid Waiver services as a condition of receiving CCE services while the eligibility determination is being processed. C. Co -payment Collections: NOW- 1. The provider will establish annual co -payment goals. The Alliance has the option to withhold a portion of the provider's Request for Payment if goals are not met according to the Department of Elder Affairs co -payment guidelines. 2. Co -payments include only the amounts assessed consumers or the amounts consumers opt to contribute in lieu of an assessed co -payment. The contribution must be equal to or greater than the assessed co -payment. 3. Co -payments collected in the CCE program can be used as part of the local match. D. Match: The provider will assure a match requirement of at least 10 percent of the cost for all Community Care for the Elderly services. The match will be made in the form of cash and/or in kind resources. At the end of the contract period, all Community Care for the Elderly funds expended must be properly matched. E. Service Cost Reports: The provider will submit semi-annual service cost reports which reflect actual costs of providing each service by program. This report provides information for planning and negotiating unit rates. 10 Contract Number KC 1371 ATTACHMENT 11 COMMUNITY CARE FOR THE ELDERLY PROGRAM CONTRACT REPORT CALENDAR Report Number Based On Submit To The 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 1112 Advance Reconciliation Octoberl 5 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 Januaryl 5 9 January Expenditure Report ...1/12 Advance Reconciliation... February 15 10 February Expenditure Report..1/12 Advance Reconciliation... March 15 1' 1 March Expenditure Report ..1112 Advance Reconciliation .... April 15 12 April Expenditure Report ... 1/12 Advance Reconciliation'.... May 15 13 May Expenditure Report ... 1/12 Advance Reconciliation'....... Junel 5 14 June Expenditure Report ... 1112 Advance Reconciliation ...... July 15 16 Final Expenditure and Closeout Report ........... July 15 Legend: Contract Number KC 1371 !&ATTACHMENT III ATTACHMENT III Issue: Screening, Triage, and Referral for Activation under the Community Care for the Elderly/Home Care for the Elderly Programs and for the Aging & Disabled Adults and the Assisted Living for the Elderly Medicaid Waivers. 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: Dies and Responsibiiities A. Alliance for Aging / Aging and Disability Resource Center ➢ B. 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 DOER -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. Case Management Agency > Requests and accepts referrals from the Aging and Disability Resource Center, to serve an optimal caseload and to avoid • • deficits in accordance with the AAA CCE/HCE Surplus/Deficit Analysis •• Refers inquiries from • Interested in services to the ADRC for Information and Referral to • resources, Screening, .•- 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 • new • and annual reassessment • existing consumers and develops care • and reviews care plans semi-annually. • service •® and enters •. into CIRTS. > Screens • for Medicaid Waiver eligibility. Bills in CIRTS and Medicaid as appropriate. 12 Contract Number KC 1371 ➢ Monitors care Mans in an effort to keep costs down while sustaining the individuals in the community. I I. 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 C RTS, 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: 1. APS High Risk Referrals (See section ,8) 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 DQEA 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 701A). 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 Assisted Living for the Elderly (ALE) Medicaid Waiver APCL will be interviewed and screened using the `701A form 7. Consumers referred for inclusion under the Aging and Disabled Adult (ADA) Medicaid Waiver APCL will be contacted' and screened 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. 8. 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 2012 Department of Elder Affairs Programs and Services Handbook, or any revisions made thereafter. 1 Contract Number KC 1371 B. HIPAA farms will be seat to the consumer as appropriate. Or III. Opening New Cases A. CCETHCE Clients Ali 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. MWIALW Clients The Department of Elder Affairs will run the APCL (Assessed Priority Consumer List) report to review clients wait listed for the ALW and MW programs. DOER will provide the ADRC with a'list of individuals authorized for release from the APCL. For clients identified as active in CCE or HCE and authorized for release from the Medicaid Waiver waiting list, the Lead Agency will be responsible for the Medicaid Waiver application process. APS Referrals ollg • i ` `• i i • i if i Is 2. APS High Risk Referrals are not waitlisted. They are immediately referred for service from 0017 in Monroe Countv to the Lead Agency. ARTT referrals will be forwarded directly .# Agency. • be a for ofcalendar Contract Number KC 1371 the Alliance to obtain the extension needed. 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 CODA 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 (In 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. C. Consumers active in the ADA Medicaid Waiver, upon turning age 60, will continue to be eligible for and receive ADA Medicaid Waiver services. Note: These ADRC policies and procedures are subject to change. Any modifications will be done through a contract amendment. 15 Contract Number KC 1371 z,. TTACHMENT IV 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 can 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. 9(3)The undersigned shall require that the language of this certification be included in the award documents or all sub -awards at all tiers (including subcontracts, sub -grants, and contracts under grants, loans and cooperative agreements) and that all subproviders 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:SIcie. Any person who fails to file the required certification shall be subject to a civil penalty of not less than 10,040.00 and not more than $104,000.00 for each such failure. t l .t H CLERK Signature to ILI _ e • Name # # A)EA Farm 103((Revised Nov 2002) Contract Number KC 1371 ATTAMMENITV W Faft-M or resources &it provicter Mayi ve st - U16 and/or monitoring by the Alliance of Elder Affairs, as described in this section. 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 Alliance 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 for Aging. In the event the Alliance for Aging determines that a limited scope audit of the provider is appropriate, the provider agrees to comply with any additional instructions provided by the Alliance to the provider regarding such audit. The provider further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by any level of government. 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. b h 'In the event that the provider expends $500,000.00 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 Alliance of Elder Affairs 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 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 L 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 $500,000.00 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 $500,000.00 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 of Elder Affairs shall be based on the a --• s WA Contract Number KC 1371 As an Alliance requirement the Statement of Functional Expenses need to be part of the Financial and Compliance Audit Report. 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 $500,000.00 in any fiscal year of such provider (for fiscal years ending September 30, 2004 or thereafter), 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 Alliance 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 of Elder Affairs 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 191received from the Alliance of Elder Affairs, 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 11, 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 $500,000.00 in state financial assistance in its fiscal year (for fiscal years ending September 30, 2004 or thereafter), 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 $500,000.00 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). M 18 Contract Number KC 1371 s As Alliance requirementofFundionalExpenses'! to be !. ofthe Financial and Compliance Audit Report. PANT Ili: REPORT SUBMISSION Ocopies 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 the following address: Alliance for Aging, Inc. Attn: Carlos Lahitte 760 NW 107'h Ave. Suite 214 Miami, FL 33172 Contract Number KC 1371 ATTACHMENT V 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 subreciplents 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 R 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 subrecipients 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/subrecipient subject to OMB Circular A-133 and/or Section 215.97, F.S. NOTE: If a provider is deterniined to be a recipient /subrecipient of federal and or state financial assistance and has been approved by the Alliance to subcontract, they must comply with Section 215.97(7), F.S., and Rule 691- .006(2), FAC [state financial assistance] and Section .400 OMB Circular A-133 [federal awards]. PART H: 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 subrecipient, 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 • i -1w ffigili'migi •• 2 CFR Part 230 Cost Principles for Non -Profit Organizations (Formerly OMB Circular A-192 - Cost Principles)- 2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A-1 10 - 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 20 Contract Number KC 1371 EDUCATIONAL INSZTi' MONS N IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW 2 CFR fart 220 Cost Principles for Educational Institutions O (Formerly Circular A-2 - Cost Principles)* 2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A-1 10 - Administrative Requirements) COMB Circular A-1 3 — 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 notedin 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/subrecipien , must comply with the following fiscal laws, rules and regulations: Section 215.97, Fla. Stat Chapter 691-5, Fla. Admin. Code State Projects Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations 0, ATTACHMENT V RTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AN 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: (I)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 Wndersigned) and purchased by the State will be verified for accuracy and integrity of data prior to iransfer. 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 subagreements, subgrants, 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-1 10). 1 �AA"Stb-o Q - 304c' g, t 5��A ;dd r e o ider _h f4mv nk, Title Da MON E COUNTY Igner A 1 IName 01, ul onz A AMY CLERK 22 HEA DO PEDRO B�A P1 'MERK . ) /11 2- 1 �Z Contract Number KC 1371' {Revised June 2013} Contract Number KC 1371 ATTACHMENT VII CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (I)The prospective provider certifies, by signing this certification, neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, orvoluntarily excluded from participation in this transaction by any federal Alliance or agency. (2)Where the prospective provider is unable to certify to any of the statementsin this certification, such prospective participant shall attach an explanation to this certification. A r H LIN, CLERK JOB EP CL Signature to ARK Title Agency/Organiz OE COUNTY O EY PHQYED AS 'i (Certification signature should be same as Contract signature.) ure.) CADO Instructions for Certification ��C C ASSISTANT CO NTY A OR7 N�� �EY D I.The terms "covered transaction," "debarred," "suspended," "ineligible," To-wer—Ti—er 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 Alliance 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 Alliance may pursue available remedies, including suspension, and/or debarment. I The provider'may rely upon a certification of a prospective participant hi 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. �4 ATTACHMENT VIII !s s • s s s. { •. • s • i. -l-s • s ! • s ! ! • ! • ••- s s -s • • s• +s w! s «•- s S s•- .!- � • -s s PLEASE DO NOT RETURN YOUR COMPLETED FORM TO TTiE OFFICE OF MANAGEMENT AND BUDGET, SENT? 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. 9 Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding gency. 5.Wiil 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 discrirrunation 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 prohibitsdiscrimination on the basis of sex, (c) Section 504 of the Rehabilitation Act of;1973, as amended (29 U.S.C.194), which prohibits discrimination on the basis of handicaps; (d) the Age Discri nation Act of 1975, as amended (42 U.S.C._6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse abuse; (f) the Comprehensive Alcc hol`Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act' cif 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 (j) 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 H and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91--(46) Arhich 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. funds., 8 * Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C.. 1501-1508 and 7324-7328), which limit the litical activities of employees whose principal employment activities are funded in whole or in part with Federal W� 25 Contract Number KC 1371 9.Wi11 comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. 276a to 276a-7), the Copeland ct (40 U.S.C. 276c and 18 U.S.C. 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-3 3), garding labor standards for federally assisted construction suba ments. 10.Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 19733 (P.L. 9 -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 $10,000.00 or more; 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 Eta 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.1401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 9-523); 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 components of the national wild and scenic rivers system. (16 U S.C..1721 et seq.) related to protecting components or potential 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.Wiil 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 ng this program SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE MAYOR GEORGE NEUGENT APPLICANTORGANIZ;ATION DATE SUBMITiET? MONROE COUNTY BOARD OF COUNTY COMMISSIONERS MC} OE COUNTY (ISEAL) IR ED A R �CLERK �. 2___ ISTANT C TUT 4EY Le e 1s- Im ATTACHMENT DC ! � x • � It " a x 1 CrvqL RIGHTS 1LIANCE CHECKLIST Program/Facility CCE j ���TTIIIY 1 1 ` " ` COUNTY :BOARDOFCOUNTY CONVAISSIONERS x•. - ii 1 • !Completed BKIN4 WEAN City, State, • • . - KEY WEST, FL. 33040 Date: u J G Telephone. • • 4588 PART 1. READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU IN THE COMPLETION OF 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) which are considered rural with some urban characteristics. Services MCIHS will provide with this grant are: case management, homemaking, personal care and respite. Total# % White % Black % Hispanic % Other % Female 73,165 72.3% 5.7% 19.6% 2.0% 46.6% 3. 4/1/2013 Total# % White % Black % Hispanic % Other % Female % Disabled 20 70% 30% 1% 0% 80% 00/0 4. CLUE VIS CURRENTLY ENROLLED OR REGISTERED Effective date: 5/30/13 Total# % White % Black % Hispanic % Other % Female % Disabled % Over 40 285 86.8% 12.2% 160/0 71% 72% 1 /0 100% 5. ADviSORY OR i 1 BOARD, I Total # % White % Black % Hispanic % Other % Female % Disabled 5 100°/0 0°l0 00/0 (M 60% 00/0 PART K USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. 6 Is an Assurance of Compliance on file with the Alliance? If NA or NO explain NA YES (X) NO 7. Comppstaff are the staff composition to the population. Is starepresentative of the population? If NA or NU, explain. NA YES {X } NO 8. Compare the client composition to the population. Are race and sex characteristics representative of the Population? If NA or NO, explain. NA YES EX ) NO 27 3- G Contract Number KC 171' i Are • ! requirements i applied toclients and . )plicants without regard to race, color, national origin, sex, age, religion or disabi 'tv? If NA or NO, NA YES M NO 10. Are all benefits, services and facilities available to applicants and participants in an equall effective manner regardless of race, sex, color, age, national origin, religion or disability? IYNA or NO explain. NA YES NO M Aligrantslprograms under the AAA that we provide services for are for people 60 and under. 11. For in -patient services are room assignments made without regard to race, color, national origin or disability. If NA or 96, explain. NA M YES NO 12. Is the program/facility accessible to non-English speaking clients? If NA or NO, explain. NA YES { Xi N0 13. Are ir protection against ! iqmplo sn� applicants #Verbal'i i i` ■ If NA or #M 28 NumbeF KC 1371 14. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/ fficilitv. Z EP,0 15. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals? If NA or NO, explain. NA&O 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 110 individuals, and to make any necessary modifications? If NO, explain. e5 11TS No 17. Is there and established grievance procedure that incorporates due process in the resolution of complaints? If NO, explain. ( 0 YES NO 18. Has a person been designated to coordinate Section 504 compliance activities? If YES No NO, explain. 11 ❑ 19. Do recruitment and notification materials advise applicants, em loyees and participants of nondiscrimination on the basis of disability? If NO, explain. 29 Contract Number KC 1371 41 YESNe 0 20. Are auxiliary aids available to assure accessibility of services to hearing and sight impaired individuals? If NO, explain. 00 GLO PARTIV. FOR PROGRAMS OR FACILITIES WITH 50OR MORE EMPLOYEES AND FEDERAL CONTRACTS OFS50,000OR MORE. 21. Do you have a written affirmative action plan? If NO, explain. DOER USE ONLY w RevieReviewed By wed Incompliance: YES o NO* o Program Office *Notice of Corrective Action Sent �te Telephone Response Due On -Site _Site n Site n Desk Review n Response Received DOEA Form 101-A, Revised May 2013 Page 2 of 2 M 30 Contract Number KC 1371 ATrAC14MENTIX FNSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST I.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. 2.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 80A (a). Us 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 803 (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) and45CFR80.1(b)(2). 1O.ParticipAnts or clients must be prqvideci 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 onigmi, religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping inust be applied unifon-nly 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 a1clients, 45 CFR 80.3 (b). 31 CONTRACT KC 1371 I I.For in -patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national ongin 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 bgual 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 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 Alliance of Elder Affairs or the U.S. Alliance 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: -With the assistance of a disabled individual /organization, evaluate current practices and policies which do not comply with Section 504. -Modify policies and practices that do not meet Section 504 requirements. *Take remedial steps to eliminate any discrimination that has been identified. -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.Prograrns 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). 32 CONTRACT KC 1371 Page33 19.Continuing steps most 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 OF 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). 2 1.Programs /facilities with 50 or more employees and $50,000 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. 33 611 EWF.Td TUNFAZM. CONTRACT KC 131 Verification of Employment Status Certification As a condition of contracting with the Alliance for Aging, Inc., Monroe County Board of Commissioners, 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. Signature (Same as contract signature) MAYOR Title MONROE COUNTY BOARD OF COMMISSIONERS Company Name �A WPM jo�yj M 34 CONTRACT KC 1371 Page 35 ®r`: ATTACHMENT XI Alliance for Aging, Inc. Business Associate Agreement This Business Associate Agreement is dated by the Alliance for Aging, Inc ("Covered Entity") and _MONROE COUNTY BOCC , ("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 Cade (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 mangier 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. 35 CONTRACT KC 1371 Page 36' 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. 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 1. 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. 36 CONTRACT KC 1371 3.0. Obligations and Actives of Business Associate. IV3.1 Business Associate agrees to not use or disclose PHI other than as permitted or required by this • or as Required by Law. 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 (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. F 3.9 Business Associate agrees to document such disclosures of PHI and information related to such resx+ni-t#' 4isclosures of PHI in accordance with 45 CFR § 164.528. 37 CONTRACT KC 1371 Page 38 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. 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 j 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 assurancesfrom 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 §164.5020)(1). ! Obligations of Covered 6.1 Covered Entity shall notify Business Associate of any limitation(s) in its notice of privacy practices of CoveredEntity in accordance164.520, tothe extent that such limitationBusiness Associate's use or disclosureof by providinga copyof #Notice# PrivacyPractices to Business Associate Attachment XI tothisAgreement.iand/or#the NPPshallbe posted on Covered Entity's website at www.alliaaceforag 6.2 CoveredEntity shall notifyBusiness Associate of # tothe useor disclosure of that Covered Entity has agreed to in accordance with 45 CFR § 164.522, to the extent that such restriction may affect Business Associate's or disclosure of 38 CONTRACT KC 1371 Page 39 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, H ITECH 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 itterminate 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 • the Health Insurance Portability and Accountability Act • 1996, • L. No. 104-191. 39 CONTRACT KC 1371 Page 40 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. 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 low 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/IN HOME SERVICES PROGRAM 1100 SIMONTON STREET, KEY WEST, FL. 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 bylaw. 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. 180 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 secti n 10.11 o� his agreement. U hzr Covered Entity: , JUN 2 S 2013 0 By: ©ate: M o (signature) 0 w Business As; rate•`;_,_ O ROE COUNTY SOCC o o> By ' •tom. Dat r i Z� 3 _o arc 113 (signature) E s OR%*UGEN , MAYOR cc a a :�► Fl�A , CL4RK O Q , _.