Item B2BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: 3/01/2016
BLlik item: Yes X No
Department: Social Services
Staff Contact /Phone #: Sheryi GrahanV305- 292 -4510_
AGENDA ITEM WORDING: Approval of Amendment 001 for Hone: Care for the Elderly (HCE)
Contract KH -1572 between the Alliance for Aging. Inc.. and Monroe County BOCC/Monroe County
Social Services for the contract year 2015 -2016 (7/1/15 — 6130116) in the amount of $10,622.00.
ITEM BACKGROUND: The ptupose of this Amendment is to make the following change with
regard to the Funding Source: to clarify that Tobacco Settlement Trust Funds are no longer included in
the State Grants and Aids Appropriations which make up this particular funding source.
PREVIOUS RELEVANT BOCC ACTION: Prior approval granted by the BOCC on 9/15/2015 for
HCE Contract K11-1 572 for contract year 2015 -2016,
CONTRACT/AGREEMENT CHANGES: Remove Tobacco Settlement Trust Funds from Funding
Source on page two (2) section 4.2.
STAFF RECOMMENDATIONS: Approval
TOTAL COST: S 10,622.00
DIFFERENTIAL OF LOCAL PREFERENCE:
INDIRECT COST: 0
BUDGETED: Yes No
NIA
COST TO COUNTY: S 10° o CASH MATCH SOURCE OF FUNDS: GRANT FUNDS &
General Revenue for Match
REVENUE PRODUCING: Yes Nq, X AMOUNT PER YEAR X
APPROVED BY: County Attorney ! 'OMBIPurchasing( Risk Management
DOCUMENTATION: Included X Not Required
DISPOSITION:
AGENDA ITEM 4
Revised 6 15
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, Inc. Contract: KH 1572 Amendment 001
Effective Date: 7/1/2015
Expiration Date: 6/30/2016
Contract Purpose /Description: Approval of Amendment 001 for Home Care for the Elderly (HCE) Contract KH-
1572 between the Alliance for Aging, Inc., and Monroe County BOCCIMonroe County Social Services for the
contract year 2015 -2016 (711115 -- 6130/16) in the amount of $10,622.00.
Contract Manager: Sheryl Graham (305) Social Services/Stop 1
292 -4510
(Name) �` ` (Ext.) (Department/Stop 4)
- 2/ ,' r pU,f o
For BOCC meeting on 3/01/2016 Agenda Deadline: 2/02016
CONTRACT COSTS
Total Dollar Value of Contract: $10,622.00 Current Year Portion: $
125 -61 53915
Budgeted: Yes A N o - Account Codes:
County Match: $10 % CASH MATCH
Additional Match: -0-
Total Match $ 10% CASH MATCH
Estimated Ongoing Costs: $ lyr
(blot included for dollar value above)
ADDITIONAL COSTS
For
{c.g. NEaintc iiance, utilities, janitorial. salaries. etc}
U1V1E H Form Remised 2127/01 MCP #2
CONTRACT REVIEW
Department Head
Date In
2110/2016
Changes
Needed
Yes 4. No i -l
Reviewer
��
Date Out
2/10/2016
Risk Management
O.M.B./Purchasing
-
`] f
Yes D No f -7
Yes D No
- -
County Attorney
a l i w
Yes D NO<
1
l
Comments:
U1V1E H Form Remised 2127/01 MCP #2
AMENDMENT 001 CONTRACT KH - 1572 Page 1
THIS AMENDMENT is entered into between the Alliance of Aging, Inc. hereinafter referred to as the
"Alliance ", and Monroe County Board of County Commissioners, Social Srevices /ln -Home Services, hereinafter
referred to as the "Contractor", and collectively referred to as the "Parties."
The Purpose of this amendment is to make the following changes to the existing HCE Contract for fiscal year
July 01, 2015 - June 30, 2016.
To change Funding Source on page two (2), section 4.2 to read:
PROGRAM TITLE
YEAR
FUNDING SOURCE
CSFA#
AMOUNT
Home Care for the Elderly
2015 -
2015
General Revenue
65010
$10,622.00
TOTAL CONTRACT AWARD
1
$10,622.00
This amendment does not change the total CCE contract funding of $10,622.00
All provisions in the contract and any attachments thereto in conflict with this amendment shall be
are hereby changed to conform with this amendment.
All provisions not in conflict with this amendment are still in effect and are to be performed at the
level specified in the contract are hereby amended to conform with this amendment.
This amendment and all its attachments are hereby made a part of the contract.
IN WITNESS WHEREOF, the parties hereto have caused this amendment to be executed by their
undersigned officials as duly authorized.
Monroe County Board of County
Commissioners, Social Services/In-
Home Services
_ ! r
SIGNED B -
NAME: Sheryl Graham
TITLE: Acting County Administrator
DATE: 2/4/2016
SIGNED BY:
NAME: Heather C arruthers
TITLE: Mayor
DATE:
Prepared on 02/02/2016
J
ALLIANCE FORAGING, INC.
SIGNED BY:.
NAME: Max B. Rothman, JD, LL.M.
TITLE: President & CEO
DATE: ; - "5 - f )-&-16
i
1
I -10 CARE FOR THE ELDERLY LEAD AGENCY CONTRACT
2015 -2016 Fiscal Year
THIS CONTRACT is entered into between the Alliance for Aging Inc., thereinafter referred to as the "Alliance" and
Monroe County Social Services, hereinafter referred to as tlhe "provider." and CoIlectiveIy referred to as the "parties.'
Attachments 1, II. 111, IV, V, V1. V11, VIII, Ifs{, X, XI, A. B. C. D. F, F. G. H AND J are incorporated herein and made a
part of this Contract,
WHEREAS, the Alliance has been designated as the Area ACe.ncy on Ainng For Planning mid Service Area 11
encompassing Miami -Dade and Monroe Counties: anti
WHEREAS, the Florida Department of Elder Affairs (the "Department") has entered into a Contract with the Alliance to
fund corn munity Care set v'ice system~ in Miami -Dade and Monroe Coumies: and
WHEREAS, irh accordance with Section 430203. Florida Statutes. the Alliance has designated the provider as a Lead
a-ency for the Home Cure for the Elderly (HCE) program,
NOW THEREFORE, it) consideration oI the services to be performed and payments to be made., together with the
rhhutu 11 covenants and conditions set Forth irh this Contract, the Parties agr'ec as follows:
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this
contract including all attachments and exhibits. which constitute the corhti - act dohcunicrii,.
2. Incorporation of Documents within the Contract
The, contract will incorporate attachments, propo�sjl(s), state plan(s), grant agreenientc, relevant: Departr ent of
Elder Affairs handbooks, manuals or desk books, the an integrtal ]girt of the contract, except to the extent that the
contract explicitly provides to the contrary. In the event of conflict in lttnrtiage amoihv any of file documents
referenced above, the specific provisions and regtrireinent.s of the contract document(s) shall prevail over
incon',isIent Prov isions in the proposal(s) or other general materials not specific to this contract doCLlihhi:ilt and
identified attachments.
Incorporation of Reference Memoranda:
In [accordance with Chapter 287 F.S., amended, and Department of Financial Services' Chief Financial Officer
Memoranda, the following memoranda are hereby incorporated by reference.:
(1) CFO Memo No. 02: Release dote., October 3, ?012;
(2) CFO Menlo No. 06: Release date, June 27, 2012;
(3) CFO Menlo No. 01: Release date, July 26, 1 012; and
(.4) CFO Menlo No. 04: Release date, June, 30, 2006
3. Terns of Contract
Effective Date:
This contract shedl begin ore July 1, 2011 or on the date the contract has been signe by I ?otlh parties, whichever is
later
Delivery of services shall end at midnight, local time in Miami, FL on June 30, 2016. The Alliance will not
reimburse the provider for services provided after this date. Hovvever. the parties recogn [fl they will need
to perform continued activities relating to reporting, invoicing and payment in .1uIy of 2016 to facilit` to payment
for services rendered by the provider under this contract throtiglh and including the contract expiratkNp date of
Jul 17, 2016.
mil. {I Contract Amount
The Alliance agrees to pay for contracted services according to the terms and cond itions of this Contract in an
airiount not to exceed _ ,J10 522.00 or the rate schedule, subject to the availability t�f funds. Ally costs or services
paid for under any other contract or from any other source are not eligible For payment under this contract.
4A Obligation to Pay
The Alliance's pe.rforlrnince and obi 1 gat ioil to pay under this contract is coil upon an annual appropriation
by the Legislature to the Department and funding received by the Alliance tinder its contract with the Department.
4.2 Source of Funds
The costs of services paid tinder any other contract or from any other source are not eligible For reimbursement
Lender this contract. The funds awarded to the provider pLirsliant to this contract are in the state tyrants and aids
appropriations Enid consists of the followirlg:
Program Title
Year
Funding Source
CSF A#
Fund Amounts
Home Care for the
Elderly
2015-
2016
General Revenue /Tohacco
Settlement Trust Funds
65010
S 1 0,62 2.00
TOTAL FUNDS CONTAINED IN THIS CONTRACT:
S 10,622.00
5. Renewals
The contract may be renewed on a ) basis for no more than two additional years. Such renewals shall be
contingent upon satisfactory performance e ,.duatrons a4 determined by the. Alliance find the availability of funds.
Any renewal of a contract shall be subject to mtitual agreement, confirmed in writing, and subject to the same
ter'nis and conditions Set forth in the Milial contract. The renewal price, or method for detennimng a renewal
price., is set forth in the hid, proposal, or reply. No other costs for the renewal may he charged.
In the event that a subsequent agreement may not he executed prier to the July f'' stai7 date.. the Alliance nifty, at
its discretion. extend this Agreemem upon written notice for III) to 90 flays to ensure continuity of service.
Services provided Lender this extension will he paid for out cif the succeeding a=re.cment amount.
6. Compliance witli Federal Lary
6.1 1f thiS contract contains federal Funds the folIowin, shall apply:
5.1.1 The Provider Shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations.
61.2 If this contract contains federal funds and k over $100,000,00. the Provider ~hall comply with all applicable
standards, orders, or regtladons issued under s. 306 of the Cloan Air Act t :s amended (42 U.S.C. 7401. et seq.), s.
508 of the Federal Water PoIIunoil Control Act as amended (33 U.S.C. 1251, et seq.), Nxecutive Order 1173 S, as
amended. and where applicable Frivironrttcrital Protection Agency regulations 40 CFR 30. The Provider shall
report any violations of the above to the Allittnee.
6.1.3 Tile Provider or regent acting For the Provider, may not use any federal funds received in connection with this
contract to influence leglslanon or appropriations pending before the Congress or any state legislature. If this
contract contains federal Funding in excess of `-,100,000.00, the Provider tntist. prior to contract execution,
complete the Cer[ification Re- arding Lobbying form. ATTACHMENT 11. All disclosure forms as required by
the Certifrcation Regarding; Lobbying, form must be completed and returned to the. Contract Manager prior to
payment under this contract.
6.1.4 111 accordance with Appendix A to 2 CFR 215, the Provider shrill comply with Executive Order 11246 Equal
Employment Opportunity, as altiended by Executivc Order 11375 and ethers, and as supplemented in
Departine.nt of Labor re,ulation 41 CFR 60 and. 45 CFR 92, If applicable.
5.1.5 if this contract contains federal funds and provides services to children up to age 18, the Provider sha11 comply
with the Pro - Children Act of 1994 (20 Ur S.C. 6081).
6.1.6 A contract award with an aniount expected to equal or exceed 525,000.00 and certain ether contract awards will
not be made to parties listed on the governlnent -wide Excluded Parties List System, in accordance with the OMB
guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689. ` Debarnwrit and Suspension." Tile
Excluded Parties List System contains the names of parties debarred. suspended. tx' otherwise excluded by
agencies, as well as parties declared ineligible Linder statutory or regulatory authority other than Executive Order
12549. The Provider shall comply with these provisions before doing business or entering into subcontracts
receiving federal funds pursuant to this contract. The Provider shall complete and sigh ATTACHMENT V
prior to the execution of this contract.
6.2 The Provider shall not emplov an tinatithorized alien. The Alliance will consider the employment of
unauthorized aliens a violation of the Immigration and Nationahty Act (8 U.S.C. 1.324a) and the h1lrnigration
Reform and Control Act of 1986 (8 U.S.C. 1 101 ). Such violation will be cause for unilateral cancellation of this
contract by the Allkince.
61.3 If the Provider is a non - profit provider and IS 5uI)JON to Internal Revenue Service t.IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990 -N) and has its tax e.xenlpt Status revoked for failing to
comply with the filing requirements of the 2006 Pension Protection Act or for any other reason, the Provider
:gust notify the Alliance in writing within thirty (..30) days of receiving the IRS notice of revocation.
6.4 The Provider ~hall comply with Title 2 CFR Part 275 regarding Trafficking ill Persons.
Unless exempt under 2 CFR Part 170.110(b), the Provider Shall comply with ille reporting requiremeilis of the
Transparency Act as expressed in 2 CFR 170,
6.5 To comply with Presidential Executive. Girder 12989 and State of Florida Executive Order Numher 1 1 -1 16, the.
Provider aoFrees to utilize the U.S. Department of Horne.land Security's E- verify systeill to verity the employment
of all new employees hired by Provider during the contract or agreement term. The Provider shall include ill
related subcontracts a requirement that sub - providers pe.rfornling work ol providing Services pursuant to the state
contract utilize the E- verity system to verify employment of all new employees hired by the sub - provider during
any contract or agreement term. Providers meeting the terms and conditions of the
E- verify System is deemed to be in compliance with [his provision. The- Provider shall complete and sign
ATTACHMENT F price to the execution of this Master Contract.
Compliance with State Law
7.1 This contract is executed and entered into In the State of Florida, and shall he construed, performed and enforced
in all respects in accordance with the Florida Iaw, including Florida provisions for conflict of Iaws.
7.2 I - he Provider shall comply with requirements of s. 28 7.058. F.S. is amended.
7.2.1 The Provider sliall provide ullit.s of deliverables, including various client services, and in sonle instances may
iticlude reports. findings, and drafts. as specified in this contract, which the Contract Manages must receive and
accept in writing prior to payment in accordance with s. ?1 5.971. F.S. ( I l and (2).
7.2.2 The Provider shall submit Bills for fees or other componsation for services or expenses in sufficient detail for a
proper pre -audit and post - audit.
7.2.3 if itenliLrd payment for travel expenses is permitted in this contract. the Provider shall submit bills for any travel
expenses In accordance. with ,. 1 12.061, I". S._ or at such lower rates as play he provided in this contract.
7.2.4 The Provider shall allow public access to all documents, papers, letters, or other public records as defined in
subsection 119.01 102), F.S.. made or received by the Provider in conjunction with this colnvact except for those
records which are made confidential or exempt by law. The Provider's refusal to comply with this provision will
constitute an immediate breach of contract for which the Alliance may unilaterally terminate the contract.
7.3 If clients are to be transported under this contract. the Provider shall comply with the provisions of Chapter 427,
F.S., and Rule 41 -2, F. A. C.
7.4 The provider may not subcontract with any individuals or entities on the discriminatory vendor list because they
may not transact business with any public entity, in accordance with the provisions of s. 287.134. F.S.
7.5 The Provider shall comply with the provisions of s. 1 062. F.S., and s. 216317. F.S., which prohibit the
cxpcnditure of contract funds for the purpose of lobbying the legislature, _judicial branch or a state agency.
7.6 In accordance with s. 287.135 F.S., any Provider on the Scrutinized Companies with Activities in Sudan List or
the SC:1'LltiniZed Companies with Activities In the Iran Petroleum Energy Sector List (Lists), created pursuant to s.
215.473 F.S., is ineligible to enter into or renew a contract or agreement with the Department for goods or
services of S1 million or more. Pursuant to s. 287.135 F.S.. the Department may terminate this Contract and any
contract or agrecmcnt incorporating this Contract by reference if the Provider is found to have submitted a false
certification of its status on the Lists or has been placed on the Lists. Further, the Provider is subject to civil
penalties, attorney's fees and costs and any costs for investigations that led to the finding of Use certification. if
any contract or agreement incorporating this Contract contain Sl million or more. the Provider shall complete
and sign ATTACHMENT 14, Certification Regarding Scrutinized Companies Lists, prior to the execution of this
Contract.
S. Backt!round Screening
The Provider shall ensure that the requirements of s. 430.0402 and Chapter 435, 1 =.S., as amended, are met
ret7arding background screening for all persons who meet the definition ol' a direct Service provider and who are
not exempt from the Department's level 2 background screening frLirtiuiint to s. 430.040 - (3). F.S. The
Provider must also comply with any applicable rules promulgated by the Department and the Agency for Health
Care Administration re implementation of s. 430.0402 and Chapter 4 F.S.
8.1 For purposes of this section, the term - direct service provider" mcans a person 18 years of age or older who,
pursuant to tt program to provide Services to the elderly. has direct, face -to -Face contact with a client while
providing se rvices to the client and has access to the client's living areas or to the client's funds or personal
property. This term includes coordinators. managers. and supervisors of residential facilities and Volunteers,
8.2 Background Screening Affidavit of Compliance - To demonstrate compliance with section 6 of this Contract, the
Provider shall submit ATTACHMENT G, Background Screening Affidavit of Compliance annually, by January
15th,
8.3 Further informatitnn concerning the procedures for background screening is found at
ltttp; Ilefderaff airs, state. fl. usldoealhackgroundscreening .ph {�.
9. Grievance and Complaint Procedures
9.1 Grievance Procedure
The Provider shall comply with and ensure sub - provider compliance with (lie NMillimum Guideline for Recipient
Grievance Procedures, Appendix D, Department of Elder Affairs Programs and Services Handhook, to address
complaints regarding the termi Suspeilsion or reduction of tie.rvices, as regUlred for receipt of funds.
9,2 Complaint Procedures:
The Provider shall develo and implement complaint procedures quid ensure that sub- providers develop and
implement complaint procedures to process and resolve client dissatisfaction with services. Complaint
procedures shall address the duality and timeIines.s of services, provider and direct service worker complaints, or
any other advice related to complaints ot lie r than termination, suspenz [on or reduction in services that require the
grievance process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook.
The complaint procedures S hall in clude notification to all clients of the complaint procedure and Include tracking
the date. nature of the complaint and the determination of the complaint oil a complaint log.
10. Public Records and Retention:
I0.1 The Provider sitbject to the terms oI' section 287.05 S t 1 )(c). Florida Statutes, and tiny either applicable. legal tend
equitable remedies, shall:
a) Keep and maintain public records that ordinarily and necessarily would be required by the Department of
Elder Affairs in order to perform the services.
b) Provide the public with access to public records oil the same terms and conditions that the
Department would provide the records and at a cost that sloes not exceed the cost provided in Chapter
119, Fl Statutes, or as otherwise provided by law.
c) Ensure that public records that are exempt or conl'idential and exempt f public records disclosure
requirements are not disclosed except as authorized by law.
d) Meet all requirements for retaining puhhe records and transfer, at no cost, to the Alliance all public records in
possession of the Provider upon termination or expiration this contract and destroy any duplicate public records
that are exempt or confidential and exempt from public records disclosure requirements. All records stored
electronically must be provided to the Alliance or the Department in a format that is compatible with the
information technology systems of the Alliance or the Department.
11. Audits. Inspections, Investigations:
4
11.1 The provider shall establish and maintain books, records. and documents (including, electronic storage media) in
accordance with generally accepted accounting procedures and practices that Sufficiently and properly reflect all
revenues and expenditures of funds provided by the Alliance under this contract. Provider agrees to maintain
records, including paid invoices, payroll registers, travel vouchers, copy logs. postage logs, time sheets, etc., as
supporting d LlcUmentation for service cost reports and for administrative expenses itemized for reimbursement.
This documentation will be made available upon request For Monitoring and auditing purposes. Whenever
appropriate, financial information should be related to performance and unit Cost data.
11.2 The Provider shall ret all client records, financial records. supporting documents, statistical records. and any
other documents (including electronic storage media) pertinent to this contract for it period of six (0) years after
completion of the contract or longer when required by law. in the event an audit is required by this contract,
records shall be retained for a minimuaTl perioci of six (6) year's after the audit report is issued or until resolution
of ally audit findings or litigation based oil the terms of this contract, at no additional cost to the Alliance.
11.3 Upon demand, at no additional cost to the Alliance, the Provider shall facilitate the duplication and transfer of
any records or documents during the required retention period in Paragraph I0.2.
11.4 The Provider shall assure that the records described in Paragraph W will be subject at all reasonable times to
inslIectiorl. review, copying, or audit by federal, state, or other personnel duly authorized by tits Alliance.
11.5 At all reasonable times for as long as records are maintained persons duly ;authorized by the Alliance, the
Department and federal (auditors, pursuant to 45 CFR 92.:36(1) (10). will be allowed 1 . till access to and the right to
examine any of the Provider's contract and related records and documents pertinent to this specific contract,
regardless of the form in which kept.
11,6 The Provider shall provide a financial and compliance audit to the Aliianco as specified in this contract and in
ArI'TACHMENT 111 and cn. that all related third-party transactions are disclosed to the auditor.
11.7 The Provider shall comply and cooperate immediately with any inspections, reviews Investig or audits
deemed necessary by the office of the Inspector General pursuant to s. 20.Oi5, F.S.
11.5 The Provider shall malnta in and file with the AIIIalice such progress, fiscal and inventory and other reports as the
Alliance may 1 w•ithill the perind of this contract.
11) The Provider shall submit wanagernent, program, az31d chent identifiable data, as Specified by the Department of
EIder Affairs and 1 or the Alliance. The provider must record 1 submit program specific data in accordance
with the Departinealt's C'lient Information Retgistration and Tracking System (CIRTS) Policy Guidelines.
11.14 If Llrldel" any contract o r agreement in corporating this Contract by reference, the Provider is providing services
nand is (acting on behalf' of the De:parttnent of Elder Affairs or the Alliance for Aging, Inc. as provided tinder
section 1 ]9,01 l(2), Florida Statutes, the Prov ider, subject to the terms of Section 287.058(1 )(0. Florid Statute".
and any other applicable legal and equitable remedies, sha
a) Keep and maintain public re.corcls that ordinarily and necessarily vvould be required by the public agency M
order to perform the services,
b) Provide the public with access to public records can the same terms and conditions that talc Department of
Elder Affairs or the Alliance for Aging, Inc, would provide the records and at a cost that does not exceed the cost
provided in Chapter 1 i 9, Florida Statutes, or as otherwise provided by Iaw.
c) Ensure that public records that are exempt or confidential and exempt fl public records disclnsur e
requirements arc not disclosed except w, authorized by Jaw.
d) Meet all requirements for retaining public records and transfer, at no cast, to the Department of Elder Affairs
or the Alliance for Aging, Inc. all public recor ill possession of the Provider upon termination or expiration of
any contract o1 agreement irlcorporatin�t, this Contract by reference and destroy any duplicate public records that
are exempt or confidential and exempt from public records diSCIOSLll - e requirements. All records Stored
electronically must be provided to the Department of Elder Affairs or the Alliance for Aging, Inc. in a format
that is compatible with the information technology systems of the Department.
11.11 The Alliance For Aging, I nc. may u nilaterally cancel this Contract and any contract or agreement incorporating
this Contract by reference, notwithstanding any other provisions of this Contract, for refusal by the Pl' C1Vader to
comply with Section 8 of this Contract by not allowing public access to all documents, papers, letters, or other
material made or received by the Provider in conjunction with the contract or agreement incorporating this
Contract by reference, unless the records are exempt frorn Section 24(a) of Article I of the State: Constitution and
Section 1 19.07(1 ), Florida Statutes.
12. Nondiscrimination- Civil _Riahts Compliance
12.1 The Provider shall execute assurances in ATTACHMENT VI that it will not discriminate against any person in
the provision of services or benefits tinder this contract or in employment because of a race, reli color,
disability. national origin, marital status or sex in compliancy: with state and federal law and revulations. The
Provider further assures that all Providers. sub - providers, Stab - grantees. or others with whom it arranges to
Provide services or benefits in connection with any of its programs and activities are not discriminating against
clients or employees because of age, race, religion, color, disabrhty, national ortg3n, marital status or sex.
12.2 Dur'im, the term of this contract, the Provider shall complete and retain on file a timely, complete and accurate
Civil Rig =hts Compliance Checklist (ATTACHMENT I3).
12.3 The Provider shall establish procedures pursuant to federal lave to handle complaints of discrimination involving
services or benefits through this contract. These procedure~ will include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity. U
12.4 If this contract contains federal funds. t.11ese assurances are a condition of continued receipt of or benefit from
federal financial assistance. and are binding upon the Provider, its Successors, transferees. and assignee~ for the
period during which such assistance is provided. The Provider rurther assurc5 that all sub- providers, vendors, or
others with whom it arranges to provide services or benefits to participants or employees in connection with any
Of its programs and activities are not discriminating against those participants or employee~ in violation of the
above statutes, regulations, guidelines, and standards. in the event of failure to comply. the Provider understands
that the Alliance may, at its discretion, seek, a court order requiring compliance with the terms of tilts assurance or
seek other appropriate judicial or administrative relief, including but not limited to, termination of and denial of
further assistance.
13. Provision of Services
The Provider shall provide services in the manner described in in ATTACHMENT I of this agreement and ill the
Service Provider Application (SPA). In the event of a conflict botween the Set Provider Application and this
contract, the contract language prevails.
14. Monitoring by the Alliance for Aging
The Alliance will perform administrative and programmatic irionItoring of the provider to ensure contractual
compliance, fiscal accountability, programmatic performance, and compliance with applicable state and federal
laws and regulations.
14.1 The provider will supply progress reports, including data reporting requirements its specified by the Alliance at
the Dopartinent to be used for monitoring protyreSs or performance of the contractual services its specified in this
contract. Following the norms set down by the Department, the Alliance will track performance on a monthly
basis, throuS4h desk reviews of available Fiscal, Ci.RTS. and research production reports and any other system or
process designated by the Alliance. Examples of review criteria are surplcisldeficit, independent audits, Internal
controls, reimbursement requests. subcontract inonitoring, larget.ing. program eligibility, outcome pleasures,
service provision to clients designated as "high risk" by the Department of Children & Families, Adult Protective.
Services program, data integrity, co- payments, client satisfaction, correspondence, and client file reviews.
14.2 The provider shall pert persons duly authorized b the Department or the Alliance to inspect and copy any
records, papers. documents. tttc.ilities, goods and services of the provider which are relevant to this contract. and
to interview any clients, employees, wid sub - provider employees of the provider to be assure the Alliance of the
satisfactory performance of the terms and conditions of this contract. Following such review. the Alliance will
deliver to the provider a written report of its findings. The Provider hereby agrees to correct all deficiencies
Identified in a timely manner as determined by the Contract Manager.
15. Coordinated Monitorinfyr with Other AP
encies
ff the Provider receives funding from one or more of the State of Florida other human Service agencies, in
addition to the Department of Elder Affairs. then a joint monitoring visit including such other agencies may be
scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended. Florida's human
sel-vice a- ellCicS Sh all inclLtde the Department of Children and Families, the Department of Health. the Agency for
Persons with Disabilities, the Department of Veterans Affairs, and the Department of Elder Affairs. Upoll
notification and the subsequent scheduling Of such it visit by the designated agency's lead administrative
coordinator, the Provider shall comply and cooperate with all monitors, inspector's, and/or investigators.
16. Indemnification
The provider shall indemnify, defend. and hold harmles's the Department and tile. Alliance and their officers.
regents, and employees from any claim, loss, damage, cost, charge, or expense whatever nature or Character
arising out of any anti, actions, nculect or omission, action in had faith, or violation of federal or state law by the
provider, its agents, employees, or sub - providers during the performance of this contract, whether direct or
indirect, and whether to any person or property. it is understood and agreed that the provider is not required to
indemnify the Alliance for claim; a nsing out of the sole negligence of the Alliance.
The pr'ovider's ohligation to inderrinify, defend. and pay for the defense or, at the Department's and / or the
Alliance's option, to participate and associate with the De part nicnt and 1 or the Alliance in the defense and trial of
any Clain/ and any relate settlement negotiations, shall he triggered by the Department's and / or Alliance's
notice of claim for indemnification to the provider. The provider's [liability to evaluate liability or its evaluation of
liability shall not excuse the provider's duty to defend and indemnify the Department and o the Alliance, upon
notice by the Department and 1 or the Alliance. Notice shrill be given by registered or certified (nail, return
receipt requested. Only an adjudication or judgment after the highest appeal is exhausted specilically finding the
Alliance solely negligent shall excuse pe.rfor'mance of this provision by the provider. The provider shall pary all
costs and fees related to this obligation and its enforcement by the Department and / or the Alliance. The
Alliance's failure to notify the provider of a claim shall not relearse the provider of the above duty to defend and
indemnify.
16.1 Except to the extent permitted by s. 768. F.S., or other Florida lave, Paragraph y5 is not applicable to contracts
executed between the Alliance and state a cencies or subdivisions defined in s. 768.28(21, F.S.
17. Insurance and Bondin
17.1 The provider must provide continuous adequatte liability insurance and worker's compensation insurance
coverage, on al comprehensive basis, and must hold such liability and worker's compensation insurances at ali
times during the effective period of this contract and any renewal(s) or emension(s) of this contract. The Alliance
shall he included as an additional insured on the provider's liability insurance policy or policies and a copy
of the Certificate of Insurance shall he provided annually or when any changes - occur. The Provider accepts
full responsibility for identifying and detcrinining the (ypcis) and extent of liability insurance necessary to
provide reasonable financial protections for the provider and the clients to be served under this contract. Upon
execution of this contract, the provider shrill furnish the Alliance written verification supporting both the
dctermination and existence of such insurance coveraige. The linlits of ck under each polity maintained by
the provider do not limit the provider's lialbility and obligations under' tiers contract. The provider shall ensure that
the Alliance has the most current written verification of insurance coveragw throughout the term of this contract.
Such coverage may be provided by it self - insurance program established and operating under the laws of the State
of Florida. The Department and the Alliance reserve the right to require additional insurance whcr'c appropriate.
17.2 Throughout the terra cif this contract, the provider must maintain an insurance bond from a responsible
commercial inSLlrrince company covering all officers, directors, employees an agents of the provider, authorized
to handle funds received or disbursed under this contract, in an amount commensurate with the fiends handled, the
degree. of risk as determined by the insurance company and consistent with good business practices.
17.3 If the provider is a state agency of subdivision as defined by section 768.23. F.S., the provider snail fill upon
request, written verification of liability protection in accordance with section 768.28. F.S. Nothing herein shall
be construed to extend any party's liability beyond that provided in section 768.28, F.S. [.See also Indenmil'icati011
clause.)
18. Confidentiality of Information
The Provider shall not use or disclose any information concerning a r'ecipierli of services under this contract for
any purpose prohibited by state or federal law or regulations except with the written consent of a person legally
7
authorized to give that consent or when authorized by law.
19. Health Insurance PoFtahility and Accountability Act
Where applicable, the Provider ~hall comply with the Health Insurance Portability and Accountability Act (42
USC 13 20d.). as well as all regulations promuIuated thereunder (47 CFR 160. 162, and 164).
20. Incident Reporting
20.1 The Contractor shall notify the Department irrlmediatc.ly but no later than forty -eight (48 ) hours from the
Contractor's awareness or discovery of conditions that may materially affect the Contractor or Subcontractor''~
ability to perform the services required to be perfornl d under any contract or agreement which incorporate. this
Master Contract by reference. Such notice shall be {Wade orally to the Contract Manager (by telephone) with an
email to immediately follow.
20.2 The Provider shall immediately report knowledge or reasonable suspicion of abuse. Neglect, or exploitation el a
child, aged person. or disabled adult to the Florida Abuse Hotline on the statewide tall -tree telephone number ( l-
800 96ABUSE). As required by Chapters 39 and 417. F.S_ this provision is binding upon both the Provider and
its etllpioyees.
21. New Contract(s) R_ eporting:
The Provider shall notify the Alliance within ten ( 10) days of entering into a new contract or agrt ei�aelat with any
of the remaining four (4) state human service agencies. The notification shall include the following information:
{ 1) contracting state agency: (2) contract name and number. (3) contract or agreemeni start and end dotes; (4)
contract or agreerne.nt amou nt. , (5) contract or agreement d escription and commodity or service and {6)C.ontract
Manger name and number.
22. Bankruptcv Notification
During the term of this contract, the Provider Shall immediately notify the Alliance if the Provider, itti assignees,
sub - providers or affiiitttes file a claim for bankruptcy. Within ten ( 10) days after notification, the Provider Must
also provide the following information to the Alliance: ( I ) the date of filin of the bankruptcy petition; (2) the
cask. 31urnber, (3) the court narne and the division in which the petition was filed (e.g., Northern District of
Florida, Tallahassee Division): and. (4) the tlairit, address, quad telephone number of the bankruptcy attorney.
23. Sp onsorship and Publicitv
23.1 Any nongoveralmental organisation which .sponsor's a program financed partially by state funds or Funds obtained
from a state agency Shall, in publicizing. advertising. or descrihing the sponsorship of the program, .state:
"Sponsored by, the State of l orida, Dcpartlnent o Elder Affairs and Alliance for Aging Inc." If the sponsorship
reference is in written material, the words "State of Florida, Department of Elder Affairs and the Alliance for
Aging" shall appear in the same size letters or type as the name of the organization (re.f.: section 286.25, F_ S.).
This shall include, but is not limited to, any carresponlence or other writing, publication or broadcast that re f et:5
to such progranl.
23.2 The provider ~hail not use the words "State of Florida, Department of Elder Affairs" and/or . :The Alliance for
Aging. Inc." to indicate sponsorship of a program otherwise financed unless specific authorization has been
obtained by the Alliance prior to USe.
24. Xs_s_ignments
24.1 The provider ,hall not assign its rights rind responsibilities under this contract without tilt prior written approval
of the Alliance. All contracts or agreements incorporating this Contract by fefcrence shall remain binding upon
the successors in interest of either the Provider or the Al fiance for Aging. Ins.
24.2 No approval by the Alliance of any assignment or subcontract shall be deemed in any event czr in any manner to
provide for the incurrence of any obligation of the Alliance in addition to the dollar amount agreed upon in this
contract.
24.3 The State of Florida is at all times entitled to Assign ar transfer, in whole: or part. its rights. dirties, or obligations
under any contract or agreement to another governmental avencv in the State of Florida. upon giving prior written
notice to the Provider. In the event the State of Florida approves transfer of the Provider's obligations, the
Provider remains responsible For all work performed and all expenses incurred in connection with the contract or
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ac
25. Subcontracts:
25.1 The Provider is responsible for all work performed and far all commodities produced pursuant to this contract,
whether actually furnished by the Provider or its ,uh- providers. Any subcontracts shall be evidenced by a written
agreement Subject to all applicable terms and condition, of this contract. Alliance approval of the service
application presented by the provider shall Conslitute Alliance approval of the provider's proposed subcontracts if
the subcontracts follow the service and ftlnding information identified in tic provider's service application. All
other subcontracts proposed to be funded under this contract must be approved in advance by the Alliance. The
Provider agrees that the Alliance shall not be liable to an)' sub- provider in any way or for any reason. The
provider, at its expense, will indemnify and defend the Alliance against any sub - provider claims.
25.2 The provider shall promptly pay any sub-providers. Failure to pay sub - providers pursuant to any subcontract ill'
cis required by law may result in enforcement action under this, contract.
25.3 The provider maintains responsibility for the monitoring and performance of all subcontracts in accordance with
all applicable federal and state laws. Subcontractor nionitoriny must be done annually.
25.4 The Provider shall have a procurement policy that assures maximum l'ree and open competition. Such
procurement policy must conform. as applicable, with Federal and State contracting Lind procurement regii kit] ons.
as set forth in Title 45 Code of Federal Regulations (CFR.) ;part 74 - Sub-Part C, 011.257.057 Flo6da Statutes
(F.S.), U.S. Office of Management and Bud;e.t (OMB) Circular 110. Florida Department of Management
Services (DMS) Rule 60A -1, Florida Administrative Code. and with the Department of Elder Affairs Program
and Services Handbook 2012.
25.5 Service Cost Reports and Unit Cost Methodology Reports-
The Provider shall submit annually to the Alliance S ervice Cost Rep) t , which re.11ect Actual costs of providing
each service by program. This report is due to the Alliance 30 days after the contract year ends. The Provider
~hall also tiUblillt, annually Lirtit Cost Mir }iodalo y .R:poits reflectina the annual Budgeted cost details for each
prograln. This report is due to the Alliance 0 clays prior to the strut of the new contract. Those two reports
provide information for planning and negotiating unit rates, as well as source documents used in the Alhance's
annual monitorinti-, of the Provider.
26. )l; undina ObRizations:
26.1 The Alliance for Acring. Inc. acknowledges its obligation to pay the Provider for the performance of the
Provider's duties Lind responsibilities, set forth in any contract or agreernent incorporating this Contract by
reference.
26.2 The Alliance shall not be liable to the provider for cots incuri or performance rende.l unless such costs and
performances are strictly in accordance with the team, of this contract., inc.iuding but not limited to terms
governing, the provider's promised performance and unit rates and/or reiribursement capita.tlons spcclfied.
26.3 The Afliance shall not be liable to [lie Provider for any expenditures which are not allowable Costs as defined by
applicable federal or state lave, or which expenditures have not been made in accordance N']th the terms of this
contract or fiscal or programmatic guidelines and requirements outliner/ by the current Department of Elder
Affairs Programs and Services Handbook,
26.4 The Alliance shall not be liable to the provider for expenditures made in violation of regulations, the Older
Americans Act, Department rules, Florida Statutes, or this contract.
27. Independent Capacity of Provider
27.1 The Provider will be acting in its independent capacity and not as an employee, agent or representative of the
Alliance or the Department. The provider Shall not be deemed or construed to be an employee. agent or
representative of the Alliance or the Department for any purpose whatsoever. Nothing contained in this contract
is intended to, or shall be construed in any manner. as creating or establishing the relationship of
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employerlernployce between the parties.
27.2 The Provider shall he responsible for completely supervising and directing the wort: under this contract whether
performed by the provider or by any suh- provider that it ma)! utilise. The Provider shall be responsible for all
sub - providers who perform work un der this contract. The Provider agrees that it is as Fully resp011sible for the
acts and omissions of its sub-providers and of persons employed by theirs as it is for the acts and omissions of its
own employees.
27.3 It is further understood that the Alliance dues not control the employment practices of the Provider and shall not
be liable for any wage and hour, employment discrimination, or other labor and employment claims against the
Provider or its stab- providers. All deductions For sociai security. withholding taxes', income taxes, contributions
to unemployrnent compensation funds and all necessary insurance for the Provider shall be the sole
responsihility of the Provider.
28. Payment
28.1 Paynicnts shall be made to the Provider as services are rendered and invoiced by the Provider. The Alliance will
have final approval of the invoice for payment, and will approve the invoice for payment only it' the Provider has
met all terms and conditions of the contract. unless the bid specifications, purchase order. or this contract specify
otherwise. The approved invoice will be submitted to the Alliance's finance section for budgetary approval and
processing pursuant to Attach ViII.
28.2 Payment Documentation Required
The Provider shall maintain documentation to support payment requests which shall be available to (lie
Comptroller, the Department, or the Alliance upon recluest. Invoices must be submitted in sufficient detail for a
proper pre audit and post audit thereof. The provider shall comply with all stale and federal laws governing
payments to be made utttlel' this contract including, but not limited to the following: (a) paragraph (16) (b) of
section 216.181. F. S.. regarding advances: (h) Rule 691 - 1().103 F.A.C. pertaining to Restriction or Expenditures
from State funds: and (c) the Contract Payment Requirements Sub - section of section C of the Reference Guide
for State Expenditures from the Department of Financial Services
Iltf p: rlLL'�VLS'. dbt. titittc:.f l.lr �tiidcl }.
The Provider shall maintain detailed documentation to support each item on the itemized invoice or pa
request for cost reimbursed expenses. including paid sub - provider invoices, and will be produced upon request by
the Alliance, The Provider shall only request reimbursement for allowable expenses as defined in the laws and
guiding circular's cited in this agreement, in the Reference Guide for State Expenditures, and any other laws or
rcgt[lations. a applicable. and that administrative expenses do not exceed amounts budgeted i the provider'~
approved set application.
The Provides' will certify that detailed documentation is available to support each item on the itemized invoice or
payment request for cost reimbursed expenses, fixed rate or deliverables contracts or agreements i ncorporating
this Contract by reference, including paid sub- provider invoices. and will. be Produced upon requost: by the
Alliance or the Department. The Provider will further certify that reirrrburSement regnests are only for allowable
expenses as defined in the laws and guiding circulars cited in Sections 6 and 7 of this Contract, in the Reference
Guide for State ExpenditUIVS, and any other law's or regulations, as applicable, and that iadministrative expenses
do not exceed amounts budgeted in the Provider's approved area plan as developed in accordance Lvith and
pursuant to section 300(a) of the Older Americans Act of 1969, as amended.
28.3 The Provider shall provide units of deliverables, including reports. findings. and drafts as specified in this
contract to be received and accepted by the Affiance prior to payment.
29. Return of Funds
The Provider shall return to the Alliance any overpayments dire to unearned funds oi - funds disallowed and anv
interest attributable to such funds pursuant to the terms and conditions of any contract or amreement incorporating
this Contract by reference that were disbUrS d to the Provider by the Alliance. In the event that the Provider or tt.c
independent auditor discovers that an overpayment has been made. the Provider shall repay said overpayment
immediately without prior notification from the Alliance. In the event that the Ailiance First discovers an
overpayment has been made, the Contract Manager will notify the Provider in writing of such findings. Should
repayment not be made forthwith, the Provider shall be charged at the lawful rate of interest on the outstanding
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balance. pursuant to s. 55.03, F.S., after Alliance's notification or Provider discovery.
30. Data Integrity and Safeguarding lnformation.
The Provider shall CIISUrC ar] appropriate level of data security for the information the Provider is collecting 01'
using in the performance of this contract. An appropriate level of security includes approving and tracking all
Provider emplovees th request System sir inf'ornNation access and ensuring that Grsc.r accts; has been removed
from all terminated employees. The Provider. among other requirements, 111uti1 rniticipate and prepare for the loss
of information processing. capabilities. All data and software must be routinely hacked tip to insure recovery
fralm Iosses or outages of computer systems. The security over the back -tip data is to be as stringent as the
protection required of the primary systems. The Provider shah insure till sub - providers maintain written
procedures for computer system backup and recovery. The Provider shall, prior to crecution of this aoree file lit.
complete the Data Integrity Certification Dorm, ATTACHMENT IV.
X Computer Use and Social Media Poliev
The Department of Elder Affairs his implememed a new Social Media Policy, in addition to its Computer Use
Policy, which applies to all employees, contracted employees, consultants. OPS and volunteers, including all
personnel affiliated with third parties, Such as, lxrt not limited to, Area Agencies on Aging and Providers. Any
entity that uses the Dep�u computer resource systerns must comply with the Departments policy
regarding social media. Social Media includes, but is not hrrtited to blogs, podcasts, discussion forums. Wilds..
RSS feeds, video sharing, social networks like. MySpace, Facebook and Twitter, as well as content sharing
networks such as flickr and YouTube ['This policy is available on the Department's wehsit.e at:
littp : / /eide raffai rs.s tate..fl.us /doea/fi nanci al.ph p }.
32. Conflict of Interest
The Provider shall establish .safeguard to prohibit employees, board members. management and sub-providers
Frorll using their positions fur a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal gain. No employee. officer or agent of the Provider or sub - provider shall
participate in selection, or in the award of an agreement supported by state or federal funds it' a conflict of
interest, real or apparent, would be involved. Such a conflict would arise when: (a) the employee. officer or
agent; (b) any member of his/her immediate family, [c} his or her partner, o; (d) an organization which employs,
or' is about to employ, any of the above, has a financial or other interest in the firm selected for award. The
Provider or sub - provider's officers, employees or agents will neither solicit nor accept gratuities, favors of
any thing of monetary value from providers, potential providers, or parties to subcontracts. The Provider's board
members and managen ent must disclose to the Alliance any relationship which may be, or may be perceived to
be. a conflict of' interest within thirty [30) calendar days o f all individual's original appointment or placement in
that position, or if the individual is serving as an Incumbent. within thirty (30) calendar days of the
commencement of this contract. The Provider's employees and sub - providers n}ust make the same disclosures
described above to the Provider's board of directors. Cormpliance with this provision will he ! monitored.
33. Public lsntity grime
Pursuant to s. 287.13:3, 1=.5., a person or affiliate who has been placed on the convicted vendor list following a
conviction. for a public entity crime may not suhmit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity; may riot submit a bid, proposal, or reply on a contract with a public entity for rile
construction or repair of a public building or public work; may not submit bids. proposals, or replies on leases of
real property to a public entity: may not be awarded o1 perform work as a provider, supplier. sub - provider, or
consultant under a contract with any public entity, and may not transact business with any public entity in excess
of the threshold armourit pro vidcd In s. 287.017. F.S., for CATEGORY TWO for a period of 36 months following
the d ate of being placed on the convicted vendor list.
The provider represents and warrants that the provider, its officers, directors, .senior management, partners,
employees or agents have not been convicted of any public entity cranes within the last 36 months. If the provider
or any of its officers or directors is convicted of a public entity crime daring the period of this agreement, the
provider shall notify the Alliance immediately. Nun - compliance with this statute shall constitute a breach of this
agreement. The provider must ensure that it does not enter Into with any sub - provider on the convicted vendors
list or otherwise prohibited from contracting for state funds pursuant to section 287.133, F.S.
34. Purchasing
Procurcment of Prodttc.ts or Materials with Recycled Content,
Reusable materials and products shall be used where economically technically feasible.
35. Patents, Copvrights, Royalties
It this contract is awarded state funding and if any discovery. invention or copyrightable material is developed
produced or for which ownership was purchased in the coarse of or as a result of work or services pci'forrned
under this contract, the Provider shall refer the discovery. invention or material to the Alliance to be referred to
the Department of Stan:. Any and all patent rights or copyrights accruing sunder this contract are hereby reserved
to the State of Florida in accordance. with Chapter 286. H.S.
36. Emergency Preparedness and Continuity of Operations
36.1 The Provider shall, within thirty 130) calendar days of' the execution of this contract, .subinit to the Contract
Manauer verification of an entcr�gency preparedness plan. In the event of an emer�gertc_y. tine Provider shall notify
the Alliance of ernergency provisiorus.
36.2 In the event a. situation results in a cessation of Services by a sub - provider, the Provider shall retain responsibility
for performance under this contract and intt.st follow pr0cidUZ'es to cnsurc continuity of operation. without
interruption.
36.3 In preparation for the threat of an emergency event as del in the State of Florida Coinpreliensive Emergency
Managcrnent Plan, the Department ratty exercise authority over an area agency or service provider agency to
implement preparedness activities to improve the safety of' the elderly in the threatened area and to secure area
agency and service provider facilities to i3riitimire the potential impact of the event. These actions will he. within
the existing roles and responsibilities of the area agenes' and provider.
36.4 In (lie event (lie President iii the United States or Governor of the State of Florida declares a disaster or state of
crncrgency, the Department may exercise authority over an area agency or service provider agency to ii11plement
emergency relief measures and /or activities.
37. Equipment
37,1 Use of Contract Funds to Purchase Equipment
No funds under this contract will be used by the Provider to purchase equipment.
37.2 Equiptent meaits. (a) an article of none xpe.ndable, tangible personal property having a useful life of muse than
one year and in acquisition cost which eclujals or exceeds the lesser of the capitalization level established by the
nr� anizatwn for the financial Statement purposes, or 55,000.00 I for federal ftinds], or (b), nonexpendable.
(angible personal property of a non- consur nature with an acquisition cost of Sl,tlt]O. O or more per unit,
and expected useful life of at least one year: and hardback bound books not CirCUlated to StUdentS or the general
public, with a value or cost of 5250.00 or niore [f Or state funds].
38. PUR 1000 form:
The PUR 1000.For is hereby incorporated by reference and available at:
hap:llva wvv .nivflorida.coni/apl)tily bsAtdocIF774t)_PUIt I 000.pdf
In the event of any conflict between the PUR 1000 Forin and any terns or conditions of any contract or
aurceinent terms or conditions the contract shall take precedence over the PUR 1000 Fornt. However, if the
conflicting terms or conditions in the PUR 1000 Forms are required by any section of the Florida Statutes. the
terms or conditions contained in the PUR 1000 Fornt shall take precedence.
39. Use of State Funds to Purchase or Improve Real Propertv
Any state funds provided for the purchase of or irnprovetnent.s to real property are contingent upon the Pro vider
or political subdivision granting to the state a security interest in the property at least to the. amount of State funds
provided for at least 5 years frorn the date of purchase or the completion of the improvements or as further
I— Cquired by law.
1'
40. Dispute Resolution
Any dispute concerning performance of the contract ~hall be decided by the Contract ManaCTU, W110 Shall reduce
the de4i to wrltmLy and serve a copy on the Provider.
41. Financial Consequences of Non- Performance
If the Provider tails to meet the minimum level of service or performance identified in this agreement. or that is
customary for the industry, then the Alliance Dust apply financial conSequenceS commensurate with tile
deficiency. Financial consequences may melt :de, but are not limited to, contract suspension, refusing payrnenL
withholding payments until deficiency is cured, tendering only partial payments, and/or cancellation - Of contract
and reacquiring Service from an a source.
41.1 The Provider will riot be charged with financial consequences, when a failure to perform arises out of causes that
were the responsibility of the Alliance,
42. No Waiver of Sovereign_ Immunity
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by ally' entity to
which soverei�mn Immunity may be applicable. y
43. Venue
If ally dispute arise.- Out of this contract, the venue of Such legal recourse will be U3lami -Dade County. Florida.
44. Entirc Contract
This contract contains all the terins and conditions agreed upon by the Parties. No oral agreements or
representations shall be valid or binding upon the Alliance oj the Provider unless ixpressIv contained herein sir'
by a written amendment to t contract ,'giled by hr }th Parties.
45. Force Maieure
The Parties will not be liable for any delay or 1 in performance due to circtirltstances beyond their control.
provided the party experiencing the force Illaleurc condition provides inlrrlediate written slotification to the other
Party and t akes all reasonable efforts to cure the condition.
46. Severability Clause
The Parties a-re.e that if a court Of' competent jurisdiction deenis any term or conditiotl herein void or
mientorcCabfe, the other provisions are .Sev erable to that void provision and shall remain il full force and effect.
47. Condition Precedent to Contract: Appropriations
The Parties agree that the Alliance - s performance and obligation to pay under this contract is contingent upon an
annual appropriation by the Legislature to the Department and a corresponding aflocatloil under contract froll, t he
Department to the Alliance.
48. Addition/Deletion
The Parties agree that the Alliance reserves the right to add oi to delete ally of the services required tinder this
contract when deemed to be in the State of Florida's hest interest and reduced to a written amendment signet] by
both Parties. The Parties shall necrotiate compensation for any additional Services added.
49. Waiver
The delay or failure by the Alliance to exercise or enforce any of i[s rights tinder this Contract will not constitute
or be deemed a waiver of the Alliance's right thereafter to enforce those rights, nor will any single or partial
exercise of any such right preclude any tither or further exercise thereof or the exercise of arty other right.
50. Compliance
The Provider shall abide by all applicable current federal statutes, law's. rules and regulations as well as
applicable current state statutes, laws. rules and regulations. The Parties agree that failtire of the Provider to
abide by these laws shall be deemed an event of default tit the Provider. and subject the contract to immediate,
13
unilateral cancellation of tike contract at the discretion of the Alliance.
51. Final Invoice
The Provider slhail Submit the final invoice For payment to the Alliance as specified in Paragraph, 3.4, 7.4. l and
3.4.2 (date for final request for payment} of ATTACHMii;'.tiT 1. If the Provider fall to submit final request For
payment by the deadline- then all rights to payment may be forfeited and the Alliance may not honor any I'equests
submitted after the aforesaid time period. Any payment due under the terns of thk Collti'aCt rnav be witlhheld
until all reports Clue from the Provides' and necessary adjustments thereto have been approved by tlhe Alliance.
51 Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and
duly signed by both parties. The rate of payment and the total dollar anuxllht may be adjusted retroactively to
reflect price level Increases and changes in the rate of payment when these have been established through the
appropriations process and subsequently identified in the Alliance's operating Midget.
53. Suspension of 'Work:
The Alliance may in its sole discretion suspend any or all activ16es under this contract when sn tlic Department of
Rides Affairs determines that it is in the best interest, of State to do .so} The Alliance shall provide the Provider
written notice outlining the particulars of suspension. Examples of the reason for su.spe.nsiort include, but arc. not
limited to, budgetary constraints, declaration of eme.rgcncy. or other such circumstances. After receiving a
st,Ispen,lon notice:, the Provider shall comply with the notice. and shall not accept any purchase orders. Within
rhine.ly days, or any longer period agreed to by the Provider, the Alliance shal I tither f l) issue a notice aiitlhorizing
resumption tit work. at which time activity shall resume, or (?) terminate the Contract or purchase order.
SLISpe.n,ion chi work shall not entitle the Provider to any additional cc) mpen sat ion.
54. Termination
54.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar da vs' notice
in writing to the other party unless a s,00nes' time is mutually reed tlpr.}n in writing. Said notice Shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verification of dehvery or by
hand delivery to the Contract Manager or the representative of the Provider responsible for administration of the
contract. The Provider shall not furnish any product after it receives the notice of termination, except as necessary
to complete the continued portion of the contract, if any. The Provider shall not be entitled to recover any
cancellation charges or lost profits.
54.2 In the event funds for payment PUF - Stant to this Contract become unavailable. the Alliance may termirate this
contract upon no less than twenty -four (24) hours' notice in writing to the Provider. Said notice shall be
delivered by U,S. Postal Service or any expedited delivery service that provides verification of delivery or by
hand delivery to the Contract Manacre.r or the representative of the Provider responsible for administration of the
contract. The Alliance will be the final authority ass to the availability and adequacy of funds. In the event of
terslhination of this contract. the Provider will be compensated for any work satisfactorily completed prior to the
date of ternhinatiorl.
54.3 Termination for Cause.
This contract may be terminated for Cause upon no less Chilli twenty four (24) hours' notice ill writing to the
Provider. Waiver of breach of any provisions of this contract shall not be deemed to be a walve.r of any other
breach and shall not be construed to be a modification of the Perms and conditions of this contract. The
pro lsl oil s hereln do not IImit the All lance's or the Provider's right~ to remedies at law or in equity,
54.4 Failure to have performed any contractuaf obligations with the Alliance in a manner satisfactory to the Alliance
will be a sufficient cause for termination. To be terminated cis a Provider under this provision, the Provider must
[have (l) previously failed to satisfactorily perform in a contract with the Alliance, been notified by the Alliance
of the unsatisfactory performance, placed by the Alliance under a corrective action plan and failed to correct the
unsatisfactory performance to the satisfaction of the Alliance as outlilled in the corrective action plan or f2) had a
contract terminated by the Alliance for cause..
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54.5 Waiver of breach of any provisions of this contract shrill not be dcerned to he a vvaiver of' any other breach and
shrill not be construed to be a modification of the terms and conditions of this contract. The provisions herein do
not limit the Alliance's right to remedies at law or to damages of a legal or equitable nature.
55. Successors
This contract Shall remain binding Upoll the Successors irl iiiterest of el Cher the Alliance or the provider.
56. _Electronic Records and Signature
The AAA authorizes, but does not require, the Provider to create and retain electronic records and to use
electronic si-natures to conduct transactions necessary to carry out the terms of this Contract. A provider that
creates and retains electronic records and uses electronic signatures to conduct transactions shall comply with
the requirements contained in the Uizcfnrm E;lcctromc 7'r Act, s. 008.50, Fla. Stat. All electronic
records imist be fully auditahle; are subject to Rorida's Public Records Law, Ch. 119, and Fla. Stat.; must
comply with section 28. Dote IrrtegritJ Wl.rl Erzfarnrrrtiorl; must maintain all confidentiality, as
applicable; and must be retrained and maintained by the Provider to the same extent - , is non - electronic records
are retained and maintained its required by this Contract.
56.1 The AAA's authnriza6011 pursuant to this section does not autholizc clectr'onic transactions betweell the
Provider and the AAA. The Provider is authorized to conduct electronic transactions with the AAA only upon
further written consent by the AAA.
56? Upon request by the AAA, the Provider shrill provide the AAA or 17OEA with non - electronic (paper) copies of
records. broil- electronic ( paper) copies provided to the AAA of any document that was originally in electronic
101 , 111 with an electronic S1gIMUH must indicate the person and the person's capacity who electronically s14 -lied
the docLlMCM on any non - electronic copy «f the document.
57. Special Provisions
The Provider agrees to the fO I 10 W i 11 PTO v'is1011
57.4 investigation of Criminal Allegations:
Any report that implies criminal intent on the Dart of the Provider or any sub- providers rind referred to a
governmental or investigatory agency must be sent to the Alliance. If the Provide; has reason to believe that the
allegations will he referred to the State Attorney_ a law enforcement agency, the United States Attorney's
office. or other governmental agency, the Provider shall notify the contract ma nager. A copy of all doatments.
reports, notes or other written material c.onceming the mvestigatlon, whether in the possession of the Provider
or sub - providers, must be sent to the Alliance's contract manager with a so mmary of the investigation and
allegations.
57.2 Volunteers:
The Provider s ha I I ensure the use. of trainer! volunteers in providing direct services delivered to older
Individuals and Individuals with disabilities needillg tiuch SOI vlcel. If possible, the Provider shall work in
coordination with organizations that have experience in providing training, placement, and stipends for
volunteers or participants (such as organizations carrying out federal service programs administered by the
Corporation for National and Community Service), III community Service settim",
57.3 Enforcement:
57.3.1 IIl accordance with Section 430.04, F.S., the Alliance may, without taking any intermediate measures available
against the Provider, rescind the Providers contract, if the Alliance finds that:
57.3.2 An intentional or negligent act of the Provider has materially affected the health, welfare. or safety of clients
served pursuant to any contract or agreement incorporating this Contract by reference, or substantially and
negatively affected the. operation of services covered udder any contract or agreement:
57.3.3 The Provider lacks financial stabillty Sufficient to meet contractual obligations or that contractual funds have
been misappropriated;
57.3.4 The Provider has committed multifllc or repented violations of legal and regulator standards, regardless of
Whether such laws or reculations are enforced by the Alliance. of the Provider has committed or repeated
violations of Alliance standards:
15
57.3.5 The Provider has failed to continue the provision] or expansion at' services after the declaration of a state of
eniergettcy; and/or
57.3.6 The Provider has failed to adhere to the terms of any contract or agreement incorporating. this Contract by
reference.
57.3.7 In the alternative, the Alliance inlay, at its sole discretion, in accordance with section 430.04, F.S., take
immediate measures against the Provider. includinc: corrective action. unannounced special monitoring.
temporary assumption of the operation of one or more contractual services, placement of the Provider on
probationary status, imposing a moratorinm on Provider action, imposing financial penalties for
nonperformance, or other administrative action pursuant M Chapter 1201, F.S.
57.3.8 The provider consistently misscs performance measure tar;ets. or does not deinoitstrate to the satisfaction of the
Alliance, that a progrim budget surplus /deficit problem is being addressed in order to avoid Closing out the
contract year with a budget variance of more than one percent.
57.3.9 In Making any determination tinder this provision the Alliance may rely upon the findings of another state or
federal agency, oi other regulatory body. Any claims for damages for breach of any contract or agreement
incorporating this Contract by reference are exempt from administrative proceedings and sliall be brought
be.lore the appropriate entity in the venue of Miami -Dade County.
57.4 Use of Service Dollars:
The Provider will optimize the Ilse of contract funds by .wrvin g the maximum possible number of individuals
with the services allowed by this contract. The Provider will spend all federal. state, and other funds provided
by this contract to provide such services.
57.5 Surplus/Deficit Report:
The Provider will submit it consolidated surplus/deficit report in a Format provided by the Alliance to the
Alliance's Contract Manager with the monthly requcst For payments according to the calendar oil Attach €rent
Vlll.
57.6 Surplus Recapture.
In accordance with its surplus /deficit management policies, in order to maximize availuble fundiiig and n]inin]ize
the tinge that potential clients must wait for services. the AAA ii] its sale discretion can reduce funding awards if
the Provider is not spending according to monthly plans and is projected to incur a surplus at the end of the year.
58. Official Payee acid Representatives (Nimes. Addresses. and Telephone Numbers):
The name, address. and telephone number of the represe tit at] ve for the AIIiancc for this contract is:
Mm B. Rothman, JR Ll.. A1.
Pre.eidem talc/ CEO
760 NW 107` Ave, Suite?
Miami, Florida 33172
{305] 670- 6500, Ext. 271
The name, address, quid telephone nuniber of the representative (it' the provider responsible for administration of the
program under this cont ract is:
a
The Provider name, as Shown on page 1 of this
Sheryl Graham. Senior Director
a.
contract, and mailing address of tllc official payee
M0111 Corinty Social Services
to whom the payment shall be made is:
1 100 Simonton Street, 2 " Floor
Key tiVc.st. Flw. 3300
The name of the contact person and street address
b.
where financial and administrative records are
Kim Wilkes Wean. Compliance Manager
maintained is:
1100 Simonton Street, lst Floor
a
Key West. FL 33040
The name, address, and telephone numher of the
C. representative of the Provider responsible for
administration of the program under this contract
is;
The section and location within the AAA where
d- Requests for Payment and Receipt and
Expenditure forms are to he mailed is;
e. The name, address. and telephone number of the
Contract Manager for the A, for this contract is;
Sheryl Graham. Senior Director
i 100 Simonton Street, 2 "` Floor
Key West, FL 33440
(305)292 -4510 or 4408
Laurie Semo. Vice President Finance/CF0
Alliance for Aging, Inr.
760 NW 1071h Avenue, Suite214
Miami. Florida 33172 -3155
Contract Manager
Alliance for Aging, Inc.
760 NW I07th Avenue. Suite 214
Miami. Florida 33172 -3155
Upon change of representatives (names, addreti.ties. tcleph()ne numbers) by either party. notice shall be. provided in
writing to the other party and the notification attached to the originals of this contract.
In ilie e veil t different representatives are designated by eil lie I - Marty after execution of this contr;let. notice of the. name and
address of the new representative will be rendered in writing to the other party and said notification attached to originals
of this contract.
17
5L All Terms and Conditions Included
This contract and its Attachments, l through X, A, B, C, D, E. F, G, H, K and any exhibits referenced in said
attachments, together with any documents incorporated by r'eterence, contain all the terms and conditions agreed upon
by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this
contract shall supersede all previous communications. representations or agreements, either written or verbal between
the Parties.
By si -nhio this contract. the Parties agree. that they have read and agree to the entire <<3ntract.
IN WITLESS THEREOF, the Parties hereto have caused this 67 page contract. to he executed by their undersigned officials as
duly aUthorized.
Provider MONROE COUNTY SOCIAL
SERVICES
ALLIANCE FOR AGING, INC.
SIGNET] BY:
NAME: SHERYL GRAHAM
TITLE: ACTING COUNTY ADMINISTRATOR
DATE': O Ci�
SIGNED BY:
NAME.: DANNY KOLHAGE
TITLE: MAYOR
1$
SIGNED l3I , �
wr
NAME: MAX B. ROTHMAN, JD. I.L.M.
TITLE: PRESIDENT AND CEO
DATE: VP 19 / U; 4 ;
G I
DATE: /I D
INDEX TO ATTACHMENTS
Attachment I
SERVICE PROVISIONS HOME CARE FOR THE ELDERLY
Attachment 11
CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS,
LOANS AND AGREEMENTS
Attachment III
FINANCIAL AND COMPLIANCE AUDIT
Attachment IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,
GRANTS, LOANS AND COOPERATIVE AGREEMENTS
Attachment V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
Attachment VI
ASSURANCES NON CONSTRUCTION PROGRAMS
Attachment VII
BUDGET SUMMARY
Attachment VIII
INVOICE CONTRACT REPORT SCHEDULE
Attachment 1X
REQUEST FOR PAYMENT FORM
Attachment X
RECEIPT AND EXPENDITURE REPORT
Attachment XI
COST REIMBURSMENT SUMMARY
Attachment A
Attachment B
Attachment C
Attachment D
Attachment E
Attachment F
Attachment G
Attachment H
Attachment J
DOEA HANDBOOK
CIVIL RIGHTS COMPLIANCE CHECKLIST
REFERRAL PROTOCOL AGING AND DISABILITY RESOURCE CENTER (ADRC) —
OUTSOURCED FUNCTIONS
OOEA COMPUTER USE POLICY
BUSINESS ASSOCIATE AGREEMENT
E- VERIFY
BACKGROUND SCREENING AFFIDAVIT OF COMPLIANCE
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
ALLIANCE FOR AGING SURPLUS DEFICIT POLICY
19
ATTACHMENT I
HOME CARE FDIC THE ELDERLY PROGRAM
SECTION I. SERVICES TO BE PROVIDED
1. Scope of Service and Eligible Individual
1.1 The services to he provided are those described in the provider's service provider application submitted in
response to the 2011 HCE RFP and as described ill this contract. The Houle Care for the Elderly (HCE)
Prograrn enconra -es the provision of care in family -type living arrangements in private iionles oil a not For
profit basis as an alternative to nursing home or other in4tituliomal care.
1.2 The provider's service provider application subinittcd in response to the 2011 HCE Lead Agency RFP. as well
as the RFP itself is incorporated by reference in this contract between the Alliance. and the provider and made a
part of this contract.
1.3 INDIVIDUALS TO BE SERVED
1.3.1 General Eligibility
The Hoarse Care f'or the Elderly program serves elders age fief and older at risk of placement in a nursing,
horne or other iHtitut settings - emaiil in family style setting throu the ltrovi.sinrl of
siibsidies.
1.3.2 Individual Eligibility
In order to receive services under this contract, an applicant ITUrst:
( 1) Be at least 60 _years ❑f .age:
12) Have income and assets which der not exceed t he Medicaid Institutional Care PrO litilit.ti:
( 3 ) Be at risk of nui:siilc home placement; y
l] Have an adult caregivef' living lit the fie >irle. that is wiliira�7 and able cal provide care. and assist i :1
arranging service. for the client.
i 1 Eligible applicants illti.st he screened. prioritized and referred to the provider by the Aging RzsOui
Ccnter prior to enrolImelat.
(6) Not be enrolled in a Medicaid Capitated t -o no Term Care Proeram.
.1.:3.3 Caregiver Eligibility
Caregivers eligible to receive services under this C0110 - I'M Hoist:
(1) Be at least 18 Years of age:
(2) Be Capable of providing a family -tvpe iivin�u cnvai'OFtrltent;
(3) Be a relative or a f'riCild who has been accepted by the client as a surrogate famIIv or is a responsible adult
with whoin the client has made an a rran cre rne n t to provide home care serviccs;
(.5) Be willing to accept responsibility for the social. physical land emotional needs of the care recipient:
k6) Be physical present and live in the 110 'Ile to provide superv'is[on and to assist in arrangement of services
for the client:
(7) Maintain the residential dwelling free of conditions that parse -,m immediate threat to the life. safety, llcalth
and well -being of the home care client; and
(8) Be without record of conviction of abuse. neglect or e x p I oi tat i o of another persoil.
1.3.4 Targeted Groups
Priority for services provided under this contract shall be _given to those eii«ible persons assessed to be at risk of
placement in an institution.
20
SECTION 11. MANNER OF SERVICE PROVISION
2.0 Conditions
2.I All Services tinder this contract will be provided in a manner consistent with the conditions Set forth in the
2013 Florida Department of Elder Affairs Programs and Services Handbook or any subsequent
revisions made to the Handbook and the provider service provider application tiubnlitted in response to
the 2011 HCE Lead Agency RFP {SPA). In C I ire of conflict between the SPA and the Handboal :, the
Handhool: prevails.
2.1.1 Client access t❑ services, assessment and eligibility deternunari
ATTACHMENT C. on n7ust confoiiri to the protocols listed in
2.1.2 The provider will offer services hatted on clients' service plans.
2.2 Service Tasks
2.2.I Delivery of Service to Eligible Clients
The provider shall provide services authorized under this contract as referenced on ATTACHMENT VII that
meets the diverse needs 0 function.ilIv irnpaiwd elders. The provider shall perform and report performance of
the services in accordance with the current DOEA Programs and Services Handbook.
To achieve the goals of the HCE, program. the Contractor shall per#e�i in or ensure that its Sub COnlractcrl s pe.t foi77t
the (611 owl ng tasks:
(1) Client Eligibility Deterinination:
(2) Assessinent and Prioritization of Service Delivery for New Clients:
(3) Delivery of Services to Elivihlc Clients: and
(4) Monitoring tite performance of its Subcontractors.
Client Eligibility Determination
The. Pry >vider shall ensure that applicant d�ittt i.s cvaluatrd to detel eligibility. Eligibility tit be.corne a client
is based on ineeting the rec uirenionts in ATTACHMENT 1, Section 1.3
Basic Subsidy
The Basic Subsidy is it cash payment made to an approved caregiver each n7onth to reimburse sorne expenties
intui't'ed in caring for the client. The Basic Subsidy is provided I01' support and maintenance of the care
recipient. i housiitg, l'arad. clothing, and Medical costs [lot covered by Medicaid, Medicare or any
other insurance. A Basic Subsidy ,hall be paid to approved earegiv'e.rs when tine client is in tile. hoine. fo city
part of tile. month. Il - the client is hospitalized or iii any other teniporary institution for 30 days or less, the full
Basic Subsidy shall be provided to the caregiver as if the client were in the honie.
Special Subsidy Services
Though every eligible HCE client z'eceivr.s a Basic Subsidy, Special Subsidy payrnents are pre - authorized
and are based on additional specialized medical or health ctn sel supplies or equipment needed to
maintain the health and welt -being of the individual elder. The Special Subsidy for additional medical
support and special services is a cash payn to reimhurse the coasts of any other service or special care not
cov ered by Medicaid. Meclicar'e, or private ifasuranCe when these services are deterinined to be essentiaf to
Inaintain the well -being of the hcfrne care recipient. A Special Subsidy shall be paid to the approved
caregivers where tine client is tit the ]tome for any ]tart of the month- Special Subsidy Services are authorized
through a vendor ;agreernent. All Special Subsidy services must he perforn in accordance with the
Department of Elder Affairs Prograrns and Services Handbook. Special Subsidy services include:
(1) Adult Day Care;
(2) Adult Day Health Care.;
(3) Cwegiver Training /Support;
(4) Chore;
(5) Chore (Enhanced);
(6) Cuunseiirig iGerottioiogical };
(7) Counselintr (Mental Health /Screening ):
(8) Horne Delivered Meals-,
?1
(9) Home. Health Aide. Service:
(14) Homemaker;
(11) Housing Improvement:
(] 2) Material Aid:
0.3) ,Personal Care:
(14) Respite (Facility Based or In- Home);
(15) Specialized Medical Equipment. Services and Supplies.
(16) Transportation.
23 SERVICE TIMES AND LOCATION
2.:3.1 Service Times
The Provider shtall ens ure the provision of the services 3isted 1n this contract is ava1lahle. at times appropriate to
meet client service needs at a minimum, during normal business hours. Normal business hours are defined as
Monday through Friday, 8:00ain to 5:00pm.
2.4 REPORTS
2.4.1 The Provider shrill respond to additional routine and/or special requests for information and reports required
by the Alliance iii a timely manner as determined by the Contract Manager, The Provider shall establish due
dates for any sub- providers that pe.rin.its the Provider to meet the AIIiaiwe's reporting requirements.
2.4.2 Client Information and Registration Tracking System (CIRTS) Deports
The Provider shall input HCF specific data into CIRTS to ensure CIRTS data accuracy following the Alliance
CIRTS 1]ata Integrity Policy.
2.4.2.1 The recipient must ensure all data for HCE subsidies are entered in the CIRTS by the 15th cif each Month.
HCE subsidy data entered into the CIRTS by the 15th of the month will he for payments incurred between the
l6th of the previous month and the 15th of the current month. Case management data entered into the CIRTS
by the 15th of the month evil I be for units of service provided dul'lllg the previous month from the 111th and up
to and including the 15th of the current 111011th or case manacement units of service may be entered a.ccordinC
to the recipient schedule, in aggregate on the 31st or daily, weekly or monthly.
2.4.2.2 The recipient will ensure data entry for HCE subsidies will cease oil the 15tH of the month and the CIRTS
Monthly Service. Utilization Report, by consumer and by worker identification is rtrn.
2.4.2.3 The recipient will ensure the Monthly Utilization Report, by consumer and by worker identification is
verified, corrected, certified no later than the 20th of the month in which the report is generated.
2.4.2.4 The recipient will ens tre care. al determined chgihle for the HC F: basic subsidy after the 1501 of a month,
will be processed to begin eligibility for the HCE basic strbsidy on the 1 tit day of the next 111011th.
2.43 The Alliance reserves the right to adjust the total award as well its the contracted tilt rate to reflect provider
costs and utilization rates based on active clients enrolled in the program.
2.4.6 The Alliance may withhold payment under the terms of this contract, pendiri<, the receipt and approval by the.
Alliance of complete and accurate financial and pro+ararnmatic reports dire from the provides and any
ad thereto, including any disallowance not resolved.
2.4.7 The provider shall provide the Alliance with an expenditure plan by July 15 or two weeks after this contract
has been signed; a monthly update is due on the 21" day of each following month. The expenditure plan and
updates must follow the format provided by the Alliance.
2.4.8 The provider shall respond to surplus /deficit Inquiries and will provide ad -hoc reports as requested by the
Alliance.
2.5 ELECTRONIC RECORDS AND DOCUMENTATION
The provider will ensure the collection and maintenance of client and service information on a monthly basis
from the Client Information and Registration Tracking System (CIRTS). Maintenance includes valid exports
and backups of all data Mid systems according to Alliance and Department standard;.
22
2.5.1 Timely Data Entry
The provider must enter all required HCE data per the Department's CIRTS Policy Guidelines for col islime.rs
and services in the CIRTS database. The data must be eiltcred into CIRTS before the provider submits its
request for payment and expenditure reports to the A]Iiance as per Attachment VIII..
2.5.2 Data Accuracy
The providcf will "till monthly CIRTS reports and verily client aild service data in CIRTS is accurate. This
report ""lust be submitted to the Alliance with the "Ninthly request for payment and expenditure report and
must be reviewed by the Alliance before t }le provider's request for payment and expenditure reports can be
approved by the Alliance..
2.5.3 Failure to Maintain CIRTS Database
Failure to ensure the collection and maintenance of the CIRTS data may result in the Alliance enactina, the
- Enforcement" clause of this agreement (sce 2.7.2), includin, delaying or withholding payment until the
problem is corrected.
2.5.4 Computer System Backup and Recovery
Each provider. among other requirinients, must anticipate and prepare for the lnss of infornlat.ton processing
capabilities. Tile routine backing tip 01 data and software is required to recover from losses or otitaaes of the
s;01111)ufel' system. Data and software essential to the continued operation of provider functions must be
backed lip. The security controls ()yet the backup resnurccs shall he as stringent as the prcitectinn required of
the primary rVsolirces. It is recommended chat a copy of' the backed up data be stored in a secure. offsite
location. The provider shall maintairl written policies and procedures for computer backup and recovery.
These policies and procedures shall be trade .available to the Alliance upon request.
2.6.1 Outcomes
(1) The Provider shall tiillely submit to the Alliance all reports described in ATTACHMENT I, SECTION
2.4 REPORTS:
(2) The Provider shall timely subinit to the Alliance all information described in ATTACHMENT I.
SECTION 2.5 ELECTRONIC RECORDS AND DOCUMENTATION-,
(3) The Provider shall ensure. services in this contract are in accordance with the current DOEA Programs and
Services Handbook.
2.6.2 The performance of the Provider in providinc the services described in this contract shall bc measured by the
curl'ent Area Plan strategies for the following criteria:
(1) Pei of elders assessed with high 01 incider.atc risk: environments who improved their environment
SCOre:
(21 Percent of new service recipiclits with high -risk nutrition scoi whose. nutritional status improved;
(3) Percent of new service. recipients whose ADD. assess inent .score has been maintained or improved;
(4Y Percent of new service recipients whose TAI L assessment score has bCeil InUirltl}ined or improved:
(5) Percent of family and family- assisted caregivers who Self- report they are Iikely ter provide care:
{6} Percent of caregivers whose ability to provide care is maintained or improved after one. year of Service
intervention (as determined by tile caregiver gild the assessor):
2.7 Compliance and Enforcement
2.7,1 The provider shill comply with all the terilis and conditions set -forth in this contract, the HCE RFP pursuant to
which this contract was awarded, the Service Provider Application and the Most recent edition of the
Department of Elder Affairs Programs and Services Handbook. The provider is also responsible to respond to
any fiscal or programmatic monitoring ite.inslissties within the tirrieframe stipulated by the Alliance and
provide supporting dOCU nentanon as requested by the Alliance. Monitoring Iterns /Bsucs may include.
Corrective Actions. Reportable Conditions or Quality Improvement Recorinneridations provided by the
Alliance. The provider is also responsible to provide timely response to any inquiry related to program"
23
expenditures including, but not limited to, addressinyOl proCTram surplus or deficit and corresponding program
spend -rout plan. y
Failure to meet any of the contractual requirements or compliance. items mentioned above will result in the
imposition of sancIto11s an dl or ether enforcernent actions by the All[ance.
2.8 ALLIANCE FOR AGING RESPONSIBILI'T'IES
2.8.1 Program Guidance and 'Technical Assistance
The Alliance will provide to the Provider guidance and technical assistance as needed to ensure the successful
fulfillntent of the contract by the Provider.
2.8.2 Contract Monitoring
]'lie Alliance will review and evaluate the performance of the Provider under the terms of this wilt :act.
Monitoring shall be conducted through direct contact with the Provider through telephone, in writing. or an
onsite visit. The Alliance'~ deterrninatiott of acceptable performance shall be conclusive. The Provider agrees
to cooperate with the Alliance in monitoring the progress of completion of the service tasks and deliverables.
The Alliance may it 5c, but is not limited to. one or more of the following methods four monitnring;
(1) Desk reviews and analytical reviews.
(2) Scheduled, unscheduled and follow -up on -site visits,
(3) Client visits;
(4) Review of independent auditor's reports;
(5) Review of third - party documents 3ndlor evalua[1031:
(6) Review of progress reports;
(7) Review of cu,torrrer satisfaction surveys.
(8) Agreed -upon procedures review by ail external auditor or consultant:
(9) Limited -scope reviews: and
(10) Other procedures as deemed necessary.
SECTION W. M ETHOD OF PAY MINT
3.1 General Statement of ]Method of Payment
The method of payment for this contract includes advances, cost reimbursement for administration costs, as
well as fixed rate and cost reimburseillent for' services. Payment may be authorized for all allowable
expenditures to complete the tasks. identified in the deliverables. in accordance with ail appheable state and
federal statutes and regulations. and are based on audited historical casts in instances where an independent
audit is rv:quircd. All Provider requests for payment and expenditure reports submitted to support requests for
payment shall be on Department forms 106C and 105C, included as Attachments IX, X. and X1. Duplication
or replication of both forges via data prracessin.- equipment is permissible, provided all data elements are in the
flame format as included on department forms.
3.1.1 Provider invoices shall be submitted, no later than 60 days after the end of the morrth on which the expense was
incurred, except that invoices cannot be submitted beyond the dote for final invoicing, as stated in this contract.
Invoices submitted late will not be honored. Exceptions to this rule are at the discretion of the Alliance, on a
case by case basis; such exceptions must be requested prior to the expiration of the invoicing deadline. In
malting 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 whither the Alliance can request reimbursement at a late date from DOEA. Exceptions for
invoicing late after the closeout date will not be made.
3.2 Advance Payments
Non- profit providers may request a monthly advance for service costs for each of the fir:5i two rnorithti 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 's
file. All payment requests for the. third through the twelfth months shall be based on the submission of monthly
actual expenditure reports beginning with the first month of the contract. The schedule for submission of
advance requests is ATTACHMENT VIII to this contract.. Reconciliation and recouping of advances made
74
trucer this contract are to be completed by October, All advance payments are subject to the availability of
funds.
3.3 Advance funds may he temporarily invested by the provider in an insured interest bcaring account. All interest
earned an contract fund advances must be returned to the Alliance within thirty (30) days of the end of the first
quarter of the. contract period.
3.4 Final Request for Payment:
3.4.I The provider must submit (lie final request for payment to the Alliance no later than July 15, 2016; if the
provider fails to do so, all right to payinont is forfeited, and the Alliance will riot honor ally requests submitted
after the aforesaid time period.
3.4.2 If the contract is tei irtinated prior to the contract end date of June 30, 2016. then the provider must submit the
final request for payment to the Alliance no more than 45 days after the contract is terminated, but no later than
July 15, 2016. If the provider fails to do so, all right to payment is forfeited, and the Alliance will not
honor any requests submitted after the aforesaid time period.
3.5 Documentation for Payment
The Provider will maintain documentation to support payment requests that shall be available to [lie Alliance Or
authorized individuals, Stich as Department of Financial Services. upon request.
3.5.1 The Provider must require sub - providers to enter all required data per the Department's CIRTS Policy
Guidelines for clients and services in the CIRTS database. The data must be entered into the CIRTS before the
sub- provider~ submit their request for payment and expenditure reports to the Provider. The Provider shall
establish time frume5 to assure coMplianct wit]} dLte dattes for the requCSts i'or payment and expenditure reports
to the Alliance.
3. i.2 The Provider mu t require sLib- providers to run monthly CIRTS reports and verify client and service data in the
CIRTS is atccurate. This report hoist be submitted to the Provider with the ntonthfy request for payment and
expenditure report and must be reviewed by the Provider before the sub - provider's request for pavmem and
expenditure reports can be approved by the Provider.
3.6 Remedies for Nonconforming Services
The Provider shall etistrre that all goads andlor services provided Linder this contract are delivered timely,
compietely and carnine.nsurate with required standards of tlLtality. Such goods and/or services will only be
delivered to eligible program participants.
16.1 ill the Provider fatil.s to meet the prescribed duality standards for services. such services will not he reimbLirsed
under this contract. In addition, any nonconforming goods (including Dome delivered meals) and/or services
not meeting such standards will not be reirribursed Linder this contract. The Provider's signature on the request
for payment form certifies maintenance of supporting documentation and acknowledgement that the Provider
shall solely bear the costs associated with preparing or providing nonconforming goods atldlor services. The
Alliance requires immediate notice of any significant and/or systemic infractions that compromise t110 quality,
sCCUrity or Continuity of se.r ice S to clients.
3.6.2 Financial Consequences of Surplus
Provider shall ensure the provision of services to the protected number of clients in accordance with Alliance's
forecasts and within the contract amount. The Provider shall ensure expenditure of 100% of the contract anjottnt
budgeted for services to clients at the unit rates established in this contract. In the event the Provider- has a
stn-I)ius of 17: or more it the end of the contract term. the Afliance will reallocate Vk of the budget for the next
year contract tern, to other lent] at¢encies found to be serving clients to the fullest extent of their allocated
bi.tdgets.
3.6.3 Consequences for Non - Compliance
25
The Provider shall ensure that services and reports are performed pur mart to contra requirements. If at any
time the Provider is notified by the Alliance's Contract Man.lger that it has Failed to correctly, completely, or
adegLiate.ly perform these services and reports, the Provider will have 10 days to submit a Corrective Action
Plan ("CAP ") to the Contract Manager that adcires,ses the. identified deficiency and states how the. deficiency
will be remedied within it time period approved by the Contract Manager. The Alliance may assess a financial
Consequence for non -co rnpliance on the Provider for each deficiencv identified in the CAP which is not
Corrected pUr'Sltant to the CAP. The Alliance may also assess a financial consequence for failure to timely
submit a CAP. Ira the event the Provider Fails to ccoj an identified deficiency within the approved tune period
specified in the CAP, the Alliance may deduct, from the pa_yinelit Csf the inGioi' for the follnx ing month, lr'r of
the monthly value of tilt. Manare3rient and General Cost's component of the unit rate for each day the.
deficiency is not corrected. The Alliance nza aiso deduct. from the payment of the invoice for the following
month. 1 ` %c Of tfie monthly value of the Management and General Cost's component of the unit rate for each day
the Provider fails to timely strbmit a CAP, beainnii�� the 1 tth day after notificatirr :z by the Contract Mat�ager of
the deficiency. If, or to the extent, tf ere is any conflict between this paraT-aph and any other paragraph. in this
contract, this paragraph shall have precedence.
26
ATTACHMENT II
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS. LOANS AND
AGREEMENTS
The undersigned certifies. to the befit of his or her knowledge and belief, that:
[ 1) No Federal ap propriated funds have been paid or wiII be paid, by or on behalf of €lie undersigned, to any person for
ill flklericin�T or atteniptina to influence tin officer or employee of any state or federal agency, �r niet 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 info of
ally Cooperative agreement, and the extension, continuation, renewal, amendment. or modificatio of any federal
contract Arent, loan, or cooperative agreement.
Q) 11 any funds other than federal appropriated funds have been paid or will be paid to any person for influencincy or
attempting ]:o influence art officer or employee of any agency, a member of congress, an officer or employee of
congress, or all 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 "Disclosure Form to Report Lobbying,
in accordance with its insti
( The undersigned shall require that the langTuage of this Certification be included in the award documents For all sub -
awards at all tiers (including subcontracts.. sub- rants, and contracts uncfer grcliits. loans and cooperative a
and that al sub - providers shall certify and disclose acCCyrdinZ�l }'.
This certification is a material representation of fact upon which rCliance was placed when this transaction was made
or entered into. Submissioil of this certification is a prerequi,,iCC for making or entering into this transaction imposed
by section 1352, Title 3I. U.S. Code. Any person who Fail to file the required certification shall be subject to a civil
penalty of clot !C�s than 510 ,000 and not more than 3100.000 l�Or each such f�liILlr
Ls is
Signature Data
SHERYL GRAHAM
Name of Authorized Individual
[CH 1572
Application or Agreement Number
MONROh COUNTY BOCCISOClAL SERVICES
t 100 SIMO_'VTON ST. SUITE 2 -257
K EY WEST, FLORIDA 33040
Name and Address of Organization
DUEA Form 1W
(Rc.vi.sed N(v 200
(S
27
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Alliance for Aging, Itic, to the provider may be subject to audits and/or
monitoring by the Alliance or the Florida Department of Elder Affair as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A -133, as revised, and Section 215.97. F.S„
(see "AUDITS" below). monitoring procedures may include, but not he linvtcd to, on -site visits by the Department of
staff, IIrtlited scope audits as defined by OMB Circular A -133. as revised, and /or either procedures. By entering into this
agreement, the provider agrees to comply and cooperate with any monitoring procedures /processes deemed appropriate by
the Alliance or the Department of E=lder Affairs. In the event the Alliance for Aging, Inc. determines that a limited scope
audit of the provider is appropriate, the provider a+,i - ees to comply with ally additional instructions provided by the
Alliance for Aging, Inc. to the provider regarding such audit. The provider further- agrees to comply and cooperate with
any inspections, reviews, investi7ations, or audits deemed necessary by the Chief Financial Officer (CFO) or Auditor
General.
AUDITS
PART I. FEDERALLY FUNDED
This part is applicable if the provider is a State Or ideal govei or a non- prolit organization as defined in OMB
Circular A- 133, as revised.
In the event that the provider expends $750,000 or more in federal awards during its fiscal year, the provider riltrst 11ave a
single or program/- Specific audit conducted ill accordance Gvi[ll the provisions of t7M$ Circular A -133, as revised.
If lI131T 1 to this tlgrecrll %nl indicates resources awarded through the Department of )alder Affairs and the
Alliance by this aureetnent. In deteri nining the federal awards expended in its fiscal year, the provider shall consider all
sources of federal awards, including fedel resource~ received front the Alliance or the Department of Fldcr Affairs. The
determination of amounts of federal awards expended should be in accordance with the guidelines cstablished by OMB
Circular A -133, as revised, Ali audit Lit the provider c[onductCd 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 M Part 1, paragraph 1., the provider shall fulfill the requirements
relative to auditee responsibilities as provided ill Subpart C of OM13 Circular A -133, as revised.
If the provider expends less than X750,000 in federal awards in its fiscal year, an audit conducted in accordance with the
provisions of OMB Circular A -133. as revised, is not required. In the event that the provider expends less than 5750,000
in federal awards in its fiscal year and elects to have an ,audit Conducted in accordance with the provisions of OMB
Circular A -133, as revised, the cost of the audit must be paid from non- federal resources 0 c., the cost of such audit must
be paid from provider resources obtained from other than federal entities.)
An audit entiducted in accordance with this part shall coves the entire orUanization for the organization's fiscal year.
Compliance findings related (o agreements with the Alliance for Aging, Inc. shall be hatted alt the agreement's
requirements, including any rules, regulations. or statutes referenced in the agreement. The financial statements shall
disclose whether or not the thatching recluirement was met for each applicable agreement. All questioned costs and
liabilities due to the Alliance. for Aging, Inc, shall be fully disclosed in the audit report with reference to the Alliance for
Aging, Inc. agreement involved. 1f ilot otherwise disclosed as recluired by Section 3W4 b)(2) of OMB Circular A -13.3, as
revised. the schedule of expenditures of federal awards shall identil expenditures by agreement number for each
agreement with the Alliance for Aging, Inc. in effect during the aridit period. );financial reporting package.~ required under
this part inust be sul7ntitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the
provider's fiscal year cnd.
28
PART II: STATE FUNDED
This part is applicable if tale 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 etluaI to or iri excess of `750.000 in any
fiscal year of such provider [for Fiscal years beginning on or after.lanuary I. 2015), the provider must have a Suite single
or project - specific audli for such fiscal year ill accordance with Sectic"I 215.97. Florida Statutes; applicable rules of the
Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for- profit
organizations). Rules of the Auditor General. EXHIBIT 1 to this agreement indicates state financial assistance awarded
through the Alliance for Aging, Inc. by this agreement. In determining the state financial assistance expended in its fiscal
year. the provider shall consider all sources of state financial assistance. includir ;e mate financial assistance received from
the Alliance for Aging Inc.. otiiur state agencies, and ether nonstatt entities. State financial assistance dries not include
federal direct or pass - through award. and re5otrrCeS r eceived by a ttonstate entity for federal program matching
requirclnents.
In connection with the audit requirements addressed in Part 1I, paragraph 1. the provider shall ensur'c that the Ltudit
complies with the requireruents of Section 215,97($ ), Florida Statut This includes submission of a Financial reporting
package Lis defined b� Section 215.97 Florida Statutes, rind Chapter 10.550 (local governmental entities) or 10.656
(nonprofit and for-profit organizations), Rules cif the Auditor General.
If the provider expends less than $750,000 in state financial assistance in its fiscal year (For fiscal years beginning on or
after January 1. 2015), an audit conducted in accordance with the provisions cif' Section 215.97, Florida Statutes, is not
required. In the event that the provider expends less than $500 - 00() in state financial assistance in its fiscal year and elects
to have an audit conducted in accordance with the piovisions of Section 215.97. Florida Statutes, tite cost of the audit
must be paid from the nonstate entity's resources i.e., the cost of strc11 ail audit must be paid from the provider r'eSOUrces
obtained from Other than State entities }.
Are audit conducted in accordance with this part shall cover the entire organization for the or fiscal year.
Compliance findings related to agreements with the Alliance fir Apia Inc. shall be based (in the aacerrtent's
requirertrettts. including any applicable rules. re:t.11 ttiOrts, or statute The financial Statements shall disclose whethel' or
not the matching requ was tttet for each applicable agrecinent. All questioned costs and liabilities due to the
Alliance for Aging. Inc, shall be folly disclosed in the audit report with reference to the Alliance for Aging, Ilac.
at� Involved. If not otherwise disclosed as required by Rule 691 - 5.003, Fla, Admin. Code, the schedule of
expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the
Alliance for Aging. Inc. in effect during the audit period. Financial reporting packages required under this part must be
submitted within 45 stays after delivery cif the: audit report, but no later than 12 months after the provider's fiscal year end
for local governmental entities. Non - profit ar for- profit organizations are required to be Submitted within 45 days after
deliver of the audit report, but no later than 9 Ij}ontliti after the provider's fiscal year end. Notwithstanding the
applicability of th is portion. the Alliance and the Department of Elder Affairs retain all Fight and obligation to monitor alid
oversee the performance n1'this a�"recillent as outlined throughout this document and ptu'SUar3t to law.
PART III; REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A -133, Lis revised, and required by
PART I of this agreement shall be Submitted. when required by Section .320 (d). O Circular A - 133, as revised, by rn
tan behalf of the provider directiy to each of the folIowirtQ:
The Alliance for Aging, Inc. at each of the following addresses:
Alliance for Aging, Inc.
Attn: Fiscal Manager
7641 NW 107` Ave. Suite 214
Miami, FL. 3:3172 -3155
The Federal Audit Clearinghouse ocsig in OMB Circular A -133. as revised (tile dumber of copies required by
29
Sections .3 20 (d) (1) and (2) OMB Circular A- i 33. as revised. should be Submitted to the Federal Audit Clearinghouse),
at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10 "' Street.
Jeffersonville, IN 47132
Other federal agencies and pass - through entities in accOrdanr.e with Sections .320 (e) and (1 ), OMB Circular A -133. as
revised.
Pursuant to Sections .320(f). OMB Circular A -13 3, as revised, the provider shaII subtttit a copy of the reportingF package.
described in Section .320(c). OMB Circular A -133, as revised. and any manauement letter issued by the auditor. to the
Alliance for Aging, Inc. at each of Tile following addresses:
Alliance for Aging, Inc.
Attn: Fiscal Manager
760 NW 107` Ave. Suite 214
Miami, FL. 33172 -31550
Additionally, copies of financial reporting packages retluircd by Part II of this a-rcernent shall be submitted by or on
behalf of the pi di reed y to each of the folIowira�t:
The Alliance for Agirrc *, Inc. at each of the followint+ addresses:
Alliance. for Aging, Inc.
Attn: Fiscal Manager
760 NW 107` Ave. Suite 213
Miami, FL. 33172 -3155
The A Lid itor General's Office at the following address
State of Florida Auditor general
Claude Pepper Building, Room 574
11.1 VVest Madison Street
Tallahassee, Florida 32399 -1450
Any reports, naanitgernen£ letter, or other iraforn'ration required to he submitted to the Alliance. for Aging. Inc. pursuant to
this agreement shall be submitted timely in accordance with OM I3 Circular A -1:13. Florida SUMItes, and Chapters 10.550
(local governrmentai entities] or 10.650 (nonprofit and for- profit organizations). Rules of the Auditor General- as
applicable.
Providers, when Submitting financial reporting packages to the Alliance for Aging, Inc. for audits done in accordance with
OMB Circular A -133 or Chapters 10.550 (loca) - overnmental t.ntities) or 10.650 (n oi profir and for - profit organ 1zatt oil s }_
Roles of the Auditor Geraerai, should indicate the date that the reporting package was dclivered to the provider ira
Corresponde accompanying the reporting package.
PART IV: RECORD RETENTION
The provider shall retain sufficient records dernonstratinc its compliance with rile terms of this agreement for a period of
six years from the date the audit report is issued, and shall allow the Alliance for Aging, Inc. or its designee, the CFO or
Auditor General Access to such records upon reyue.st. The provider shall ensure that audit working papers are made
available to the Alliance for Aging, Inc., or its designee. the Department or its designee. CFO. or Auditor General upon
request for a period of sir years from the date the audit report is issued. unless extended in writing by the Alliance for
A Inc..
30
ATTACHMENT III
EXHIBIT —1
i. FEDERAL, RESOURCES AWARDED TG THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
PROGRAM TITLE
TOTAL FEDERAL AWARD
FU NDING S OURCE I CFDA I AMOUNT
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMFNT CONSIST
OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDE PROGRA
PROGRAM TITLE FUNDING SOURCE --
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE
PROGRAM TITLE
Home Care for the F.lderly Program
ECT TO See. 215.97. F.S.
FUNDING SOURCE
General Revenue
TOTAL AWARD
CFDA I AMOUNT
$0
CSFA AM OUNT
65010 I $10,62100
$10,622.00
COMPLIANCE REQUIREMENTS APPLICABLE TU STATE RESOURCES AWARDED PURSUANT TO
THIS AGREEMENT ARE AS FOLLOWS:
31
ATTACHMENT III
EXHIBIT -2
PART I: AUDIT RELATIONSHIP DETERMINATION
Provicdeis who recelvc state or tedtral I Inav or may ntit bC subjeC.t ire the audit require111ents !if { NIB Circular A -133, as
1'evised. and/or Section 215.97. Fla- Stat. Provider, who are determined to be !'eciPICfltti or stub - recipients of federal awards an /or
~tart linanciad assistance may be SubjCCt to the audit requirements if'thc audit threshold requirements set lorth in Part I and /or Par( II
of Fxhibit I are met. Koviders wIIo have been dClermined to he vendo" are !lilt SllbjeCt (0 tile Mid Ii requiremcnts [11 OMB C. ire LiIar A-
133, as rc,viscd. and/ Section 215 -97. I ia. Staff. Re`ardless of Nv lie tlur the J Lid] t rE.{luirenlell1S 41 ille1. providCrS wjlc� hrtVe bee 11
determined to he recipients or suh- recipients c if federal award andlor slate finaicial assistance must comply with applicable
Programmatic and fiscal compliance. requirements.
In accordauce With Sec. 21 of OMB C11VUlar A -133 and/or Rule 691 - 7.006, FAC, Provider has been determined to he:
Vendor or exempt entity and not subject to ONIB Circular A -1 and/or Section -1 15.97. F.S.
X Reciplelit/sub- rccipie sublet( to 0MB Circular A- 113 and/or Sect Ion 215,97, F, S.
NOTE: II a pr{ivider is determined to he a I Ipient Aub- recipient oaf fedei'aI and or ~late financial assistance. Lind has hue approved
by the Department to subcontract, they hires( comply with Section 215.97(7). F.S., tend Rule 691 - .[06] 2]. FAC: [slate financial
(assistance] and Section - .400 ( Circular A -1 33 [federal awards].
PART II: FISCAL CC7MPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE; ;MATCHING FUNDS ON FEDERAL AWARDS. Providers w•hn receive rederal awards nr
state n aichin funds oil #edural award and Nvho are d termined lit he a Stir}- rCetlJicllt must Lt7111p{y L1'IE}7 fhl fete {5w1rt fiscal itlw.ti. rules
and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW-
2 CFR Part 225 Cost Principles foi State. i -ocal and Inditln Tribal Giveinments (Formerly OMB Circular A -87)`
OMB Circular A-102 — Admim Rcquiremems
OMB Circular A -133 - Audit Requirement
RefercPcc Guide for Stinc Expenditures
01110.1 fiscal requirementS set forth in Program laws. rules and regul ati0115
NON - PROFIT ORGANIZATIONS HEIST FOLLOW:
2 CFR I'art 2301 Cast Principles for Nom- t'rofi( Organizations (.Formerly OMB Circular A -122 - Cost Principles)*
2 CI=R Par( 215 Adrninisl ran ve Requirements (Forrnerdy OMB CIroular A - d 10 - Adniiitistrative: RCtlrtiremenis)
Re{Iuiremcnts'i
OMB Circular A -1 ;3 - Audit Rcquirements
ReI'crer Guide for Sme Fxpendilures
01her fiscal requirements slit forth in pnwrarn Iatwm, rules and re ulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STA'T'E OR LOCAL GOVERNMENT) MUST
FOLLOW-
2 CFR Pari 2 -10 Cost Principles for Educational Institut. t NIB [Formerly Circular A - - Cost PriricipJe.sf'
2 CFR Part ' 15 Ad InInisirative Requirement, (Formerly 0_V1B Circular A -1 10 - Ad ill iitistratIve Requirements)
OMB Circular A -133 - Audit Regtiiremen(s
Reference Guide for State Expenditures
Other fiscal requirements se( forth ill Program laws, rules and regulations
*Sorlle [c{leral prod =rams 111'1' be exc111p(e0 from compliance with the Gist Principles Circulars as noted en the OMR Circular
A -133 Compliance S Lipp] ement, Appendix i.
STATE FINANCIAL ASSISTANCE Prnv[del Who receive state finance iA assistance and who are determined to be a
reci Pic fltlsuh- recipient Must comply with the follo�,v1n, (t. laves. rule., and re illalirms:
Section 215.97. Fla. Si at.
Chapter 691. -5, Fla. Admin. Coifs
State PrO Compliance SuPpICnlCnt
Reference Guide for State Expenditures
01her fiscal requirements set ford( in program laves, relies and regulations
322
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS,
LOANS AND COOPERA'T'IVE AGREFMENTS
The undersigned, an authorized representative of the Provider named ire tite contract or agreement to which this for i5 all
attachment, herehv certifies that:
[ i.) The Provider and any sub - providers of services under this contma have financial management systems capable of
pi Oviding 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 Rinds for all agreement supported activities; and (3) the comparison o €' 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 Inforniation Systeizls used by the Provider, sub-provider(s), or any otrtside entity ors which the Provider
i5 dependent foe data that is to be reported. transmitted or calculated, have been assesses[ and verified to be capable of
processing data accurately, including year -date dependent data. For those systems identified to be non- compliant.
providff(s) will tame intiriediate action to assure data integrity.
{,} if this contract includes the provision of hardware, software. firmware. microcode or imbedded chip tecktrrologv. the
undersigned warl that these products ar'e capable of processing year -date dependent data accurately. All versioias
of these products offered by the Provider (represented by the undersigned) and purchased by the State will be verified
for accuracy and integrity of data pi to transfer
In the event of ,illy decrease in functionality related to time and date related codes and internal suhroutmes that
impede the hardware or softw<ue programs from operating properly. the Provider agrees to irnmediateiv rriafe
required corrections to restore hardware and software programs to the same level oi' functionality as warmnted herein.
at no charge to the State. and without iiueiTuption to the ongoing business of the state, time being of the essence:.
[4] The Provider and any sub providers) 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 ernergcncy including emergencies arisinc from
data integrity compliance issues. ` ZN
The Provider shall i that the ian;trage of this certification be included i all sub - agreements. Sub - grants.
and tither agreements and that all Sub provider5 shall certify compliance accordingly.
This certification is a material repl of fact Upon Which reliance was placed when this transaction was made. ar
entered into. Submission of this certification is a prerequisite for making or entering into this transaction ;Inposed by
OMB Circulars A -102 and 2 CFR Part 235 (formerly Gi'148 Circular A -1 10).
MONROE,QgUNTY BOCC /SOCIAL SERVICES 1 100 SIMONT ST. SUITE 2 -257 KEY WEST. FL. 33040
Nance aj�q Address 01 Provider
� ' - 9 _ACTING COUNTY ADNIiNiS TRATOR
Signattare Title t
Date
SHERYL GRAHAM
.�
Name of Authorized Signer
(Rev; eel .ltwe 200 8
8]
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT. SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
f l) The prospective provider certifies, by signing this certification. neither it nor it principals is presently
debarred, suspended. proposed for deba" declal ineligible, ol voluntarily excluded l'f'()rn participation in
this transaction by any federal department or a�cncy
( Where the prospective provider is unable to certify to any of the statements in this certification, such
l�r�y,pectiy'e pa iticipant shall attach can explanation tri this certification.
Signature
— ACTING COUNTY ADMINISTRATOR
Title
(Certification tilg should be same as Contract tilgriature.)
Instructions for Certification
Date.
N
Anel�cylOrganizatio,n. -.. -.. �
1S-
1. The terms "covered tr'ansactiorl." "debarred." "suspended,'' "Ineligible." ° !ow•el - tier covered transaction,
"person." "primary covered transaction," rtrjd "voirintariiv excluded," as used herein, have the mearlin�s se.t out
in the sections of rules implementing Executive 01 12549. (? CFR 1$0.5 150.1020, as supplemented by 2
CPR 376.10 - 376.995). You may contact the Contract Manager for assistance in obtaininL7 ar copy nt' those
reguiationti.
�. This ceniflcatlon ]ti a njater representation of facts upon which 1 trace vas placed when the parties entered
intro this transaction. II it is later determined that the Provider knowingly rendered an er certif'icatiorj, il
addition to other rernedies available to the Federal government, the Department ratty pursue available rernedies,
including suspension and/or debarment.
3. The Provider will provide immediate written notice to the Contract. Maiiager if at any time the Pr(nvider learns
that its certification was erroneous wheii submitted ar hatS became err•onenus by reason of chanced
circumstances. The Provider "nay decide the method and frequencv by which it determines the eli of its
principals. Each participant to a lower tier covered transaction may, but is oat required to, clieck the E_xciuded
Parties List System [EPLS].
4. The Provider will include a "Certification Regarding Debarment. Suspe.nsicln, Ineligibility and Voluntary
Exclusion - Lower Tier Covered Transaction" in all its louver 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 ol volclntarily excluded from participatio unless otherwise
authorized by the federal government,
G. If the Provider knowingly enters into a lower tier covered transaction with a person w110 is suspended.
debarred. ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies
available to the federal government,
t the Departiiaent ay pursue available remedies, including suspension,
and/or debarment.
�. The Provider may " upon a certification of a prospective participant ire a lover tier covered transaction that it
is not debarred, suspended, ineligible_ or voluntarily excluded from the covered transaicticm. unless it knows
that the certification is erroneous,
(Revised iunc -
34
ATTACHMENT VI
ASSURANCES•— NON - CONSTRUCTION PROGRAMS
Public reporting hurclell Iur Illis c(illeciittn ill 111tt)1 is cstiilralcd to average 45 rrlillcitex per rc.sporlse. ittcluclin� [foie fc,I
rc.v'iewing instructions, Scarching cxistin� data s[ztlrce.s. gatherin , and illaintaillinc the data needed and con3pletin� and reVlL4 t1
colicc[icm of illf0rmati0?I1 Scud comments regarding the burden cstiinate or any other as pect of [I1is collecticin of information,
including sug- e.ationti for reducing this burden, to (Ile Ofliec of manaRe.lncni. and F3tl
Washington. DC 205(13. dcel. Paperwork Rcduclicrrl Prr,jcc! (0348
`
PLEASE DO NOT RETURN YOUR CO'IPLETED FORM TO THE OFFICE OF MANAGE M. NT AND BUDGET, SEND
IT TO THE ADDRESS PROVIDED BY THE SPONSORING= AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. IF yon 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 [he. lo gal authority to apply for fcdcr.il a5sislarlCe. alld the institutional, inartagerial ancf financial capability (including funds
sulficiellt to pay tile; lion - federal sllare. 01' project roll) In ellstlre proper planning *. managenlem. and conipletiori o the project
described in this appiic.ltion.
?. Will �vive the awarding a-enc•y, the Co ill ptroIleI General of the United Sttrtcs, told i!'appropria[e. the Swic, throu :any All110ri7cd
represe1:1ativc•, access to and the rigilt to examine all recc,t'ds. hunks, papers. cif (10C'UHICn(5 1 t❑ the tlwtlyd; anti wIIl establish
a proper uccnu III in system in aiccordalncc with generally accepted accounting standards fir agency dit'eetives.
3. Will establish sates uardti 10 prc)hibit crlipfciyee., front using. (Heir positions for rl i7ul'pc (izi[ CimStilutes 0 1 pre.,enis [fie
appearance of porsoll'al ororgani /ational collffict of interC -,i, or Personal "'fin.
-f. Will illitiai[e ancf complete [fie work within file applicable, lino frame after receipt of approvat of [he a wardln�r agency.
5_ Will ccllnply with tile. Intergoverninenial Personnel Act csf 1970 (42 U.S.C. 4728 -4703) relating to prescribed standards for
incri[ sysieins for pi funded under one c ) I - the 19 s u i t utes or 1 u1;11innti specified in Appendix A o f OPM's Stand ti'cls loj a
?Merit System ol' Personnel Administration (5 C.I- - ,R. 900 Subpart F).
!?• Will rcrrnp vvitil all federal stztutc relating W norrdls m
criIIIinatn. These Include: but are nest limited Io: (a) Titic V1 of• [he Civil
Rights Act u1 1964 {1'.L, ,4 -352) which prohibits discrimination oil Ilic lzasis of race, Color nr na[ional origin: (h} Tits IX of [he.
l duration Aniendnicnis cif 1972, as aniended (20 U,S,C. 168 1 - 1683, and 1685 - 1686), which prcillihits discrirnin.lticin on (he
basis cif sex: {c) Section 504 ref the Rehabilitation Act of 1 as amended (29 U.S.C. 704). which prolij)1tS discfIillllnation or
the basis ol handicap~_ (e,1) the Agc Discrimination Act of 1975, as amended (42 U&C.. 6101- 6107), which prohibits
cl iscriniinati(111 c,n ilia hasis of• age, (c} the Drug Amuse. Office Lint] Treaunent Act of 1972 f P.L. 92-255), as am f
eride . relaaflo to
nc�n disc l'irninatioll ctrl the b.lsis of clru abuse; ill the Comprehensive Alcc h(A Abutie and Alcoholitim Preveill.ion. Treatment and
RehabiIi tar ion Act of 1970 (P. L. 91- 6,16), as amended. reIat111- to nnnili Seri lnina(lon ctrl the basis of alcolioI abuse r)r alccqlc,f ISM ;
(_) 523 and 527 (11' the Public Health. Service Act of 1r712 021 U_S,C. 290 dd -3 and 290 cc 3), as aniended, re.liting to
cc,ni'identiality Of alcohol and drug abuse patient records: (11) Title VIII of the Civil Rights Act of 196ft (42 C). S.C. 360€ cl
sect.}, as aended, relating lit nondiscrirltination in The sale. renal or finan n1
cing housing: (i) any otlwr nondiscrimination
Provisions in m the specific stalute(s) under which itpplicalion for federal assista ace is beg in and (.j) tilt rcc}uiretllents of anv
other nondiscrimination statute(,) which inay ripply to the zipplicatlon. -
7. WIII con1p1y, cn' Ilas already C(xllp11ed. wits the rectuiremcnis of Titles 11 and III of the unifiirirl RelocaIIon .Assistance. and Real
Property Accluisitiarl Policies Act of 1970 (P.1.. 91 -646) which provide ftlr fair and equitable Ireatnlent of persons displaced or
Whose property is acquired as a result Of fcderaE or f'ederall assisted prti Trams. "t'ilesc leyuirc.meriis Lip)))s re,} ill inerests in real
Property acquired for project purposes regardless of federal par[icip,111011 in purchases.
Will corliply, as applicable, Wild (hc provisi011s of tilt. Hatch Act (5 U.S.C. 1501 -1508 and 7321- 732$), which linlil the
Political activiticti t: whose principal eriplovnlent activities are funded in whole c,r in part with federal fund~.
Will comply, as applic; able. Willi the provisions of [lie Davis -Bacon Act (40 U.S.C. 276ar to 276a -7). the Copeland Act (40
U.S.C. 276e and 19 U.S.C. 874) ancf the Contract Work Hours and Safety Standards Act (40 U.S.C. 327 - 333}. re-arding
labor standards for federally assisted construction soh- agreements.
10 Will comply, 11' applicable, with flood insurance purchase rcquirenicn[; n1' Sec(ion 102(x) of the Flood Disaster Proicclion Act of
1973 I.P.L_ 93 -2:34) which requires recipien(s in a special flood haiard area to parlicillate in the pro. -ran) and to) purchase flood
insui'ailcc if the total cost of insurable construction and acquisition is S l (),()00 or inol'e.
35
If- Will comply with environmental standards which may he prescribed pursuant to the following: (a) institution o1 cimronittental
quality control measures under the National Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514'.
(b) notirica(ioll of violating facilitiCS pursuant to EO 11739; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of
flood hazards in rloodplains in accordance with EO 11988: (e) wsuran%e of prt?jcct consistency with the approved State
manauemcnt program developed under the Coastal Zone Mana—ement Act of 1972 (16 U.S.C. 1451 el sill.); (f) conformity of
federal ac(ic�ns to State (Clear Air) Implementation Plans under Section 176( ' c) of (lie Clear Air Act of 1955. as amended (42
U -S -C. 7401 ct set1 protection of ttncfcrground SuurCCS of drinhi11 T water under the Sale Drinking Water Act of 1974. as
amended. ( -L. 93 -523): and (h) protection o1'endanLycred Species under the Endangered Spores Act of 1973, as amended. {P,L.
93-205).
I?. Will comply with the Wild and Scenic Rivers Act of 1968 06 U_S -C. 1721 et sey.) related to protecting componcw( or
potential components of the nat4mal wild and Scenic rlvc1's systeln.
1 ;. Will assist the awarding agency in assuring COYnpIir_mce; with Sectitnl 100 of (lie National Historic Preservation Act of 19W as
amended (16 U.S.C- 470).1:(7 1 ] 593 (identil'ication and protection of historic properties). and the Archaeological and Historic
Preservation Act of 1974 (16 U.S.C. 469a -1 et. tiny.).
14. Will comply with P.L. 93 -348 regarding 111e protection of 11Llfnan subjects involved in research, development. and related
activiiics Supported by this award tsf assistance.
15 Will comply with the Laboratory Animal Weltitre Act of 1966 (P.L. 99 - 544. as amended. 7 U.S.C. 2131 et sq.) pertaining to
the cart. handling, and trcatmc;n( of warns blooded animals Belli For rl'sear h. Leaching. or caller activities suppoited by this award
of as-3 tal7C0.
lh Will comp with the Lead -Based Paint PoisoninL, Prevention Act s4? U.S.C. 4901 e( secs), which prohibits the uSC or lead -
hased paint In construction or rehabiIimtlon o f residence struciures.
17. Will cause to he perrormed the required financial and compliance audits in accordance with (lit Single .audit Act Amendmems of
1996 and 0K4B Circular No. A -133, Audits of SULK -S, Local Governments. and N on- Prof - iI OrLianictttions.
18. Will comply with all applicable regLlil_ClnCIAt - of all olhrr federal hews, execu(Ive order,, regula(ions and policies governin this
Program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICI AL I
I ITLF:
f�
SHERY'L GRAHAM
LL_ -
ACTING COUNTY ADMINISTRATOR
APPLICANT ORGANILA ri0\
DA - i - F SLIIihtITTFD
MONROE COUNTY SOCIAL SERVICES
�
36
ATTACHIVIFNI' VII
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
The Alliance shall snake payment to the provider for provision ol' services tip to a Enaxinn ❑m minihei of t.Fnits of service
and at the rate(s) stated below:
37
Service
Maximum
Service to be Provided
Unit
Units of
Maximum
Dollars
Rate
Service
Case Mwiagcmeiit
%50.48
210
- -
510,622.00
$10,622.00
Total
37
ATTACHMENT VIII
HOME CARE FOR THE ELDERLY
INVOICE REPORT SCHEDULE
Report Number
Based On
Submit to Alliance on
this Date
1
July Advance"
JuIv 1
August Advance °`
July 1
3
July Expenditure. Report + 1 /12 advance reconciliation
August 1
4
August Fxpenditure Report + 1112 advance reconciliatiol�
September 15
5
September Expenditure Report + 1112 advance reconciliation
October 17
f7
October Expenditure. Report + 1112 advance reconciliation
November 15
7
November Expenditure Report + 1112 advance. reconciliation
December 15
8
December Expenditure Re. port + 1112 advance: reconciI Han 011
January 15
9
January Expenditure Repoo + 1112 advance reconc111ation
Fehruary 15
1[3
February Expenditure Report + 1112 advance reconciliation
March 15
l 1
March Expenditure Report + 1112 advance re.conc:iliaticn
April 15
12
April Expenditure Report + 1112 advance reconciliation
May 15
13
May Expenditure. Report + 1112 advance reconciliations
Stine 15
14
June Expenditure Report— 1/12 advance reconciliation
July 15
I5
Final Expenditure �jnd closeout
July 15
Legend: Advance based on projected cash need.
38
ATTACHMENT IX
REQUEST FOR PAYMENT
HOME CARE FOR THE ELDERLY
RECIPIENT NAME. ADDRESS, PHONE» and FEID4 TYPE OF PAYMENT 7 This Request Period:
From: To:
Regular _ Contract Period _
Contract :r
Advance Report # _
PSA 1
CERTIFICATION: I hereby certify to the best of my knowledge that this request or r -etund conforms with the terms and the purposes of the above contract.
Prepared by: _ Dale:_ Approved by:.
Date:
PART A: BUDGET SUMMARY CCE Admin. CCE Services
TOTAL
t. Approved Contract Amount $ _ $
$
2. Previous Funds Received for Contract Period 5 $
5—
S
3. Contract Baiance S— S
S
S-
4. Previous Funds Requested and Nol Received for Contract Period $ g_
$
$
5. CONTRACT BALANCE S 5
S
S
PART B: CONTRACT FUNDS REQUEST
1 • Anticipated Cash Need (Ist - 2nd months) S S
S
S
2. Net Expendaures For Month $_ $
$
$
(00EA Form I05C. Part B, Line 4)
3. TOTAL
PART C: NET FUNDS REQUESTED
1. Less Advance Applied g S
$_
5
2. TOTAL FUNDS REQUESTED (Part B Line 3, minus Part C Line 1 )
❑QEA FORM 106C
39
ATTACHMENT X
RECEIPT AND EXPENDITURE REPORT
HOME CARE FOR THE ELDERLY
Pf3CrVl DER NAME. ADDRESS, PHC]NE 77 and F - EP D41
Prnr3 ea rn Funding.
TEif' RF =PORT PEF3l L71.3:
Fron. To
CCE Admin.
CONTRA[[ I
CCE S""icr=s
CON I RAC:T !f
HFPC)RT if
P$AH
CE RTIPICATION : I ❑er[ify to the best of my knowledge-
and lb[tlie f that ulna f. pt:n is corrlpl ct� and cnrrnc - t and .911 r
herein are for purposes set forth In the
corttrac-t.
Prcpafed `y : - Pa:e : - .
Arrrarr ,4j I:y — _
Gnle
PA13T A BLIt7GETED INCOMI- I RECEIPTS
1 Approve +d
2- Actua! ]- ieceipls
:3. TetiI Reccipt5
4. Pvrcem of
BucJ e!1
For Ttli� Report
Year to Date
Approved
Bud .t
$0.00
50.00
$0.00
101DIV/01
1 . Sta1v Funds
2. f'ragram Incorrre
T
SO-01D
_S0.010
irllr Vlpl
3- 1 Pc:a1 Cash Ma tcf'i
:!:0.00
so.no
S000
rr Df Viol
a. S U E3 7 C3 I Al - C: AgH Ff ECEIPi - S
b. Lc+c:at rn -Klrld rAa tr• - -h
E. TOTAL RECEIPTS
S0.0c
f:":5.011)
$n.an
UDIV /Of
PAR 3j : FXr E"DITURES
1. Approved
2. Expenditure-
1. Expenclituru5
•7. P--,t r,f
Bud cat
For This Fie: ort
Year to Date
Approved Bird et
5D -DD
$O.UU
$0.00
VDIV/DI
1 . Ad mirl- t —livt3 Se ryir: e!
2 - Scr VILL3 Sub LUflI r-- tnr(5]
yQ.00
$0.00
S0. Q()
r4DEVIUt
- Act 11 P *Tc:ctivc` iervica?
SD. no
SO. +JO
$0.00
if Dl Viet
-7 r C) I AI- EX P E NDI rU R ES
sa.00
$0.00
50.00
4E)r VIClI
PAR f C:: C TH E F3 REVENUE AND EXF- N 171 TU F3 E S
H. lint--t
M. Advance H OL.ped
I. P,og, tm Income: (F'1)
7 - 1 - reed or•. C3
Ad Va tl et S
H:
_
1. t:CE: f I collected Yr $ _.
r. H.iwo eF CR
Advunc•. :a
(Includes fee r. [611 E+e:1sd)
3. Otll ear Ea rrleC!
:5
PAH f D Cr7- PAYMENTS
c:D1 -3R r. -NT 6�1 CAN 11 I
Y AR- T(a -C)A 1 E
1 . 1 otal of Go- payments at3srsscd
5
2. Total of C:n paymerts cofie:cicd
$
S
(! of Tralckrrrg Purp — nnly)
L�• ?L/� � �rrn,r �
40
ATTACHMENT XI
Cost Reimbursement Summary
Contract #
Report (invoice) Number:
Budget
Numberof
Category Description
Units
Service Date
Amount
c
E
TOTAL ADMINISTRATION
$0.00
Ln
au
❑
aU
n
x
ua
TOTAL EXPENSES
41
ATTACHMENT A
Department of Elder Affairs Programs c& Services Handbook, provided on CD.
Also, available at the Department's Intranet site under. "Publications ",
42
STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS ATTAcxMENT B
PART I: READ THI - ATTA['HI ?f► Iti5'i'RL!CI'I[ }tig FOR ILLC'S'fR_1'C IV , ItiF[.1k1IA'fi[}S 11I3It'II 11'iLL III ?I.P YOU CUMi'I.l 1'E T11 IS FORM.
l - Brici1v describe the � arcci scrvec3 h} the pr[lvramliacility and the type of serv p ov�ided-
'fhe emire Florida Keys (Monroc County. ap1?r()ximately 120 imles iom are considered iwal wkh same urban characteristics.
Ser•vrice(S) tO be Provided by NIC:IHS with this gran[ are: case mana�rernetlt.
2. POPULATION OF AREA SER Source of data: US CENSUS 2010
'1 ataf Y Si Waive
r Black `i�• Ffispanir 7r {][ltrr `.'r l�emalc
73.16- 72.5 5.7 19.4 2 1G.[,
3. S CURRENTLY" EMPLOYED. Effective date: 7/1/2015
Total # 7 Whiie �i Rhu& 7r jfl llaniti i7thcl' r }enlaf� r L7i .hl tl
t � C3ri
17% 1 2 �S'i 72r,
4. CLIENT CURRENTLY ENROLLED OR REGISTERED. Ef' f'ective elate: 71f12015
Mack His anic q Other'
r , p' i' ri ale I- ]icahlI'd r (her 1t1
16 63:r. iK`7r 2 i7r. 75�i Gcl`:r
Wlii[c % M It}C)4i ItJ[]r
5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE. I
Tcx;f! # `r while r7 31atk n� Hkp rlic Offier i FLnlnle % f }isahled
5 100 0 ii 0 40ri
PART II: USE A SEPARATE SHEET 0P PAPER FOR ANN EXPLA:SATIONS REQUIRING MORE SPACE.
6. Is an Assurunce of Compliance on file with DOEAL' If' N /II Or N[]. explain_
7. Compare the staffcotllpositi[m to the POptilalion. Is stall reprtsitlfati�'e ral the ptrptti itinn:�
II' NIA nr NO, explain.
NIA YES NO
❑ ® ❑
N/A YES NO
]
❑ ® ❑
H. Compare the client Composition to the ppulation. Are race and sex cht[racteritifics I of the
population? 11' N/A or NO. explain. ,'VIA YES NO
❑ ® ❑
9. Are eli-ibility i'ecltlirements 1'or -sset applied to clients and applicants veIthouI rcuard to lace, u}]t r.
national relivioll ar disability? If NIA or NO. explain. IVr1.A YES NO
❑ ® ❑
10. Are all benefits, serv'icCS and I available to appIi call l} and parlici pan Is in an equally eftective
nrtnller re.L irdie [ }1 race, SC \, c.ill(}t'. [`?l. [1[ttio ll11 06'0 n, reIi'i0n or d sahiIiIV - ) [I NIA or NO. explain. NIA YF:S NO
❑ ® ❑
11. For in- patielll services. al morn assi-'nments made; wi I'e to raci., color. national orig ill
car disability! II' NIA or NO, explain . N/A YES NO
OUR AGENCY IS NOT AN INPATIENT FACILITY ® ❑ ❑
Revised Auru.s[ _'uIQ, Pile inl Z
43164
12. Is the progrartalfacility accessible to non - English speaking clients:' 11' NIA nr N[), explain. NIA YES NO
❑ ® ❑
13. Are em ployees. applicants and participants informed of their pr[xeciian alrain5t diticrinlinalion? 11' YkS.
how? Verbal ❑ Writtcn ❑ Poster ❑ Il' NIA or NO, explain. NIA YES NO
❑ ® ❑
14. Give the number and current status of any discrimination complaints reps ding services or employment filed
against the program/ acihiv• NIA NL]rvI13ER
❑ 0
15. Is the progralt�llac lilt}' physically accessible (0 rru�l }iliEy. hearin��. and Sighi- iml�aircd inclivicluals'? I1' R'JA or
NO, explain. NIA YES NO
PART III: THE: FOLLOWING OUESTIONS APPLY TO PRUGRAN'IS AND FACILITIES 1VI'1'I1 15 OR MORE FNIPLUYF.E.4.
lb. Has a self - evaluation been conducted to) identify any har'r'iers to serving, disabled individuals. and to make
any necessary modifications? If NO. explain. YES NO
® ❑
17. Is (here an eslablished grievance procedure that incorporates clue process in the resoltltioia i?1 c[�lzipla!lats'? 11'
NO, explain. YES NO
® ❑
18. Hasa person been designated to coordinate Secti(m 504 compliance activities'! U NCI, explaili. YES NO
® ❑
19. Dry recruitnaxn1 and notification. materials advise applicants, emplovecs and participants of nondiscrimination
on the basis of disability? If NO, explain. YES NO
® ❑
10, Are auxiliary rods available t[3 assure accessibility of services to hearin-o and si«ht- impaired individlaal- If
NO. explain. YES NO
® ❑
PART IV: FOR PROGRXXIS OR FAC'ILITIES WITH 50 OR NIORE EMPLOYEES AND FEDERAL CUNTRACTS OF *50,004.0o OR moo.
21. Do you have a written affirmative action plan'? 11 NO, explain. YFS NO
® ❑
Reviscd Aus[!s! 2010. Page 2 nt 2
44/64
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
Describe the geographic service nre.l such as a district, county. city or other locality. If the pro'Fr1tln/tacility serves a
specific target p0puiation such as adolescents. describe the target population. Also, define. the type :;I' Se.rv'
provided.
?. Filter the percent of the population served by race and sex. The population served includes persons ill 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 anv publication from the 1980 Census col'tainii'
Florida population statistics. Include t l'e source ol' your perl)ulatic 11 statistics. ("Other" races include Asian/Pacific
Islanders and American Indiarl/Alaskan Natives.)
3. Enter the total tzumhe.r of full -time staff and their - percent by race. sex and disabiIity. Include the cffective date ol' your
stlr�']ntiry. -
4. Enter the total number of clients who are enrolled, registered or currently .served by the program or facility. and list
their perceill by race, sex and disability. Include the date. that en1 was counted.
5. Ente r the total nun'her of tcfviscrry board titembcs's an tile'
r percent by race, sex. acid disability. If there is nn advisory
or governing board. leave this .section blank.
f�. Each recipient of Federal financial assistance must have on rile an assurance that the pro {rain will be conducted ill
compliance with all nondiscriminatory provisions acs required in 45 CFR 80. This is usually a standard part of the
contract lantruage for DOEA recipients and their sub- grantees. 45 CFR 80.4 (a).
7. Is the lace, sex, and national nrrt of the .staff reflective of the genera! population? For example, i# ]flc7�, cif the
population is Hispanic, is Ihere a comparable percentage of Hispanic staff?
$. VVhcre there is a :significant variation between the race, sex or ethnic composition of the clients and tticii a4'allahrlity° in
the population, the progralnllfaellity has the. responsibility to determine. the reasolls tol such variation and talke
whatever action may be necessary to correct any tliscrirrrinatiOn. Some legitiniate disparities :nay exist vvl'en
programs are sanctioned to Serve target populatimis such as olderly or disabled persons. 45 CFR 80.3 (b) (6).
9. ❑o eligibility re[lttiren'eIlls unlawfully exclude persons in protected groups from the provision of services of
employment? Fvidence of such may he indicated in .staff and client r'eprescntatiori (Questions 3 and 4) and also
tl'rotlah on -site record analysis of person~ who applied but were denied services or employment 45 CFR 80.3 (a) and
45 CFR 80.1 (b) (2)
10 P tlr'ticiPnts err clients "'list he provided services such as liledicai, nursing and dental care.. laboratory services,
physical and recreational therapies, counselinc, and social services without regard to race, sex, color, national orisrill.
religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied
rir'iforinly and without regard t« race, sex, color, national origin. religiurt. age or disability. Er'tr'anc.is. waiting rooms.
reception areas. restroorns and other facilities must also be equally available to all clients, 45 CFR 80.3 (b).
11.
For in-pat ie111 services, residents musI be assigned to rooms, wards, etc., «ithotlt regard to race, color, natiorltrl origin
or disability. Also. residents must not be asked whuther' they arc. Willing to share accommodations with persons of a
different race, color, national origin, or disability, 45 CFR 80.3 (a).
12• The prograrn /facility and all services must be. accessible to participants and applicants, including those persons who
may not speak English. In geagrapl'ic areas where a Significant population of non - English speaking people live,
program accessibility may include the employment of bilingual staff'. In other areas, it is sufficient to have a policy or
plan for service. such as a current list of ntlmes and telephone 11nlnbel:s of bilingual individuals who will assist in the
45/64
provision of services, 45 CFR 80.3 (a).
I3. Programs /facilities rnust make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries or any other interested pariie.s. This should include information on their right to file a
complaint of discrimination with either the Florida Department of Eider Affairs or the U.S. Department of HHS. Tire.
i n formation m ay bo supplied verbally or in writing to every individual. or may be supplied through the use o r gin equarl
opportunity policy poster displayed! in a public aire.a of the facility, 45 CFR 80.6 (d).
14. Report number of discHmination complaints filed against the program/facility. Indicate the. basis, e.g., race, color,
creed, sex, age. national origin, disaibility, retaliation, the issues involved. e.g.. services or employment, placement,
termination, etc. indicate the civil rights law or policy alleged to have be.et� violat:ecl along with the name and address
of the local, state or federal agency with wham the compiaint has been tiled. Indicate the current status e.g., settled.
no reasonable cause found, failure to conciliate, failure: to cooperate. under revicw. etc.
15. The prograrn/facility must be physically accessible to disabled individuals. Physical accessibility includes designated
parking areas, curb cuts or level approaches, ramp~ and adequate widths to entrances. The lobby, public telephone,
restroom facilities, water fountains, information and admissions offices should be accessible. Doom widths and traffic
aireais of administrative offices, cafetvria.s, restrooms, recreation areas. counters and serving liner should be observed
for accessibility. Elevators should be observed I door width and Braille or raised numbers. Switches and controls
for light, heat, ventilation, hire alarms, and ether essentials should he installed at an appropriate height for mobility
impaired individuals.
16, Section 504 of the Rehabilitation Act of 1 973 require~ that a recipient of federal financial assistance conduct a self -
evaluation to identify any accessibility barriers. Self- evaluation is a four step process:
a. Witt) the assistance of a disabled i rid ividLia I /Orcanizaition, evaluate current practices and policies which do not
comply with Section 504,
b. Modify policies and practices that do not meet Sectio 504 requirem
c. Take remedial St to eliminate any discrimination th has been identified.
d. Maintain self - evaluation Uri file, Jhis checklist may be used to satisfy this requirement if these four steps have
been folkiwed.), 45 CFR 84.6.
17. Programs nr facilities that emP1oy l5 or more persons must adopt grievance proced Lire s 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 ).
l8. Programs or facilities that employ 15 or more persons must desicf na�te at leaist one person to coordinate efforts to
comply with Section 504.45 CFR 84.7 (at).
19. Continuing steps must be taken to notify employees and the public of the prourairilfaciiity's policy of
nondiscrimination on the basis o f disability, This includes recruitmerit material, notices for hearings, newspaper ads.
and other appropriate written communication, 45 CFR 84.8 (a).
20. Prograinslfacilities 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 ).
I. Pro .ramslfac.iIIties with 50 or more employees and 550.000.00 in federal contracts must develop, implement and
maintain a written atffirmative action compliance program in accordance with Executive Order 11246, 41 CFR 50 and
Title VI of the Civil Rights Act of 1964, as amended.
DOhA t oim 101 -B, Rvviwd AUI iU)t 2010
40/64
ATTACHMENT C
REFERRAL PROTOCOL DADE
Issue: Screening, Triage, and Referral For Activation tinder the Community Care for the I;IderlylHome Care for
the Elderly.
Policy: Reterrak will be bused on availability of funds. in accordance with prioritization requirements.
Purpose: To ensure funding is spent expeditiously and consurllers are referred into progrtrnls for appropriate
Services,
Procedure for Monroe County:
1. Roles and Responsibilities
A. Alliance. for Aging 1 Aging rind Disab11ity ResotiFee Center
Reconciles overall prograin and Lead Agency specific spending levels on as monthly basis to
ensure the Lead Agency is operating within the funding allocation.
r Reviews the number of cases released for activation based on projected funding available..
Screens consumers to ling with appropriate resources and prioritize for DDEA funded programs
and services.
Recommends potential cases for activation based upon projected funding availabte. by Lead
Aoencv.
Selects consnnlers From the waiting list based nn their prioritization scare.
r Revers corrsm -hers From the waitintr list to the Lead Agency in Monroe County for activation,
based on availability of funds.
Monitors compliance with service standards and outcome measures.
Rcview� Care plans tend files per the file Review Policies and Procedures.
Reviews data in CIRTS.
B. Case Management Agency
Requests and accepts referrals from the Aging and Disabili Resource Center. to serve an
optimal caseload and to avoid surpluses or deficits ill accordance with the AAA CCh /HCE
Surplus /Deficit Analysis policy.
Refers inquiries From consumers interested to service, to the ADRC for Information and Referral
to coirullunity resources. Screening_ Triage. and Long-Term Care [options Counseling. as
appropriate.
The functions of Screening and Intake are outsourced to the Lead Agency. Screening and Intake
may also be completed by the ADRC.
Completes comprehensive assesssnnts on new con sumers and annual reassessment on existing,
consumers and develops care.. plans and reviews care plans semi - annually.
Auttlorices service deiivery and enters data into CIRTS.
Screens consumers for SMMCLTC eiigihili
Bills in CIRTS as appropriate.
r Monitors care plarrs in an effort to keep costs down while sustaining the individuals in the
crnllrllunity.
47/64
Ii. h4aniuement of the Assessed Prioritized Consumer List (APCL).
A.
Referral-, 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 oil COMI'liullity 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 strung identifiers that indicate
the conSUmer might benefit Ironi publicly funded long terns curt services are screened, entered into
CIRTS. triaged and provided options counseling, In ,Xlonroe County. the functions of Screening and
Intake are outsourced to the Lead Agency. Screening and Intake may also be completed by the ADRC.
DOEA prioritization requirements will be adhered to by both entities, as follows:
APS High Risk Referrals {See Section I3}
?. Irrlininem Risk crises will be prioritized for activation after APS High Risk Referrals !lave. been
Served. If budgetary constraints prevent openin1, 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 ill
the client's situation.
3. All other CARES referrals will be screened and prioritized in accordance with DUFA
requiremenis.
4. Aging Out consumers will be referred by DCF for prioritization and/or activation in the
corresponding aged prograln managed by the Alliance, as appropriate (See section M.
5. Consumers applying for the Community Care for they Elderly (CCE) and /or Horne Cure for the
Elderly (HCE) programs will be contacted and screened using the statewide a.ssessraent form
developed by the Department of Elder Affairs for this purpose (Form 701St'. If a cottsume.r• is
beirig served through a DOEA- funded agency which enters their annual assessnient into CIRTS,
the Priority Score generated by that its sess men t will determine their ranking on the APCL.
G. Consu hers referred for inclusion under the Statewide Medicaid Managed Care Long Terre Care
Program APCL will he contacted and screened by an ADRC staFf person following the same
procedure as the one described Linder Section 5. Individuals who appear as potentially eligible
for other type's of pLIbfiC ass] StanCC Wlll be i'Cfell - ed tO the F,C01101111C 5eIF- SU. ffrciency L1nit at the
Department of Children and Families.
7. All tither referrals will he waithsted and prioritized, during. which tirne other community
resaurccS will he reSearchCd, including {private pa /f'ee ftrr services providers. Consumers on the
waiting lists will be reassessed according to the 2015 Department of Elder Affairs Programs and
Services Handbook, or any revisions made thereafter.
B. HIPAA forms will be sent to the consumer as appropriate.
48/64
I[I. Opening New Cases
A. CCEiHCE Clients
The Fiscal Department will monitor Lead Agency specific spending levels on a monthly basis to
ensure each Lead Ageney is operating vvitliin its spending authority. to addition, the fiscal
department will analyze Surplus /deficit projections, and shwwe the information with the Lead
Agency to assist in their determination of Slot availability. The Lead Agency will request
referrals directly frorn the ADRC. The Fiscal Department will be notified of the number of new
cases been referred to the Lead Agency for activatioal.
?. Upon receipt of the reques( 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.
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 (snit 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 statu".
4, Upon receipt of litit of clients released from the waiting list, the Lean Agency will enter the
APPL enrollment, will contact clients to Offer program enrollment, and will proceed with
lctivotion. The Lead Agency will enter sLlb} equcnt enrollments into CIRTS to reflect client
status.
5. The ADRC will oversee the enrollment process to ensure referrals have timely outcomes in
CIRTS.
B. Statewide Medicaid Managed Care Long Term Care Program Clients
The Department of Eider Affairs will run the APCL {Assessed Priority Consumer List] report to
review client wait listed for the SMMCLTCP. DOEA will provide the ADRC with a fist of
individuals authorized for release from the APCL.
?. For clients active in C:CF, or HCE and authorized for release From the Medicaid Waiver waiting
fist. the ADRC will he responsible for the application process. For C.CE active clients the
ADRC will notify the Lead Agency iri order to waive the co -pay.
C. APS Referrals
APS Low and intermediate Risk referrals will he screened and prioritized by the ADRC for
services as per the DOEAIAPS Wniorandtrlti of Understanding. Low and Intermediate Risk
referrals are also offered information and re.fe.rral to additional conumunity 1 including
private pay as appropriate.
2. APS High Risk Referrals are not waitiisted. They are immediately referred for service from DCF
ire iWnroe County to the Lead Agency. ARTT referrals will be f'orwar'ded directly the Lead
Agency. APS cases are to he served for a maximurn of 31 calendar days. If additional (in is
justified. the case management agency will staff the case with the Alliance to obtain the
extension needed. 4
49164
3. Upon receipt of the kPS High Risk referral, the Lead Agency w0l. coordinate services to begin
within the 72 hour period mandated by statute. A comprehensive assessment will be done within
72 hOUrti of the referral. Services required cruder the care plan will remain in place for a
maxi mum of 3i days, unless to emension has been granted.
4. The Lead Agency will eater ACTV enr'allnlent under their provider numher 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 doCl MCF)t the reason for nom - delivery of such
service(~),
IV. Aging Chit Consumers:
A. Ali "Aging Out" consumers will be referred by DC 1~ to the ADRC for enrollment Irmo the corresponding
aged program managed by the Alliance.
B. Consumers active in the CODA and HCDA prrsc111I)S €hLIt are turrlinb 60 and are choibic for CCF andlor
HCE will be opened in the corresponding aged procri'a n managed by the Alliance if funding is available.
If funding is available. these consumers will be made active. 11' funding is riot a���tilable, they will be
wa :(listed for these programs but will lie given priority for act 1 vat ion once. funding is available..
Note: 'rbese ADRC policies and procedures are Subject to change. Any modifications will be done through a
contract amendment.
50/64
ATTACHMENT D
Del?arErnent's Computer Use Policy and its Social Media. Policy. provided on CD,
5 1164
ATTACHMENT E
Alliance for Aging, Inc.
Business Associate Agreement
This Business Associate Agreement is dated 9/15/2015 , by the Alliance for Aging, Inc
( "Covered Entity ") and — MONROE COUNTY 8CCCISOCIA!_ SERVICES_, ("Business Associate "), a not -for-
profit Florida corporation.
1.0 Background.
1,1 Covered Entity has entered into one or more contracts or agreements with Business Associate that
involves the use of Protected Health information (PHI).
1.2 Covered Entity, recognizes the requirements of the Health Insurance Portability and Accountability Act of
1996 (HIPAA) and has indicated its intent to comply in the County's Policies and Procedures.
1.3 HIPAA regulations establish specific conditions on when and how covered entities may share information
with contractors who perform functions for the Covered Entity.
1.4 HIPAA requires the Covered Entity and the Business Associate to enter into a contract or agreement
containing specific requirements to protect the confidentiality and security of patients' PHI, as set forth in,
but not limited to the Code of Federal Regulations (C.F.R.), specifically 45 G.F.R. §§ 164.502(e),
164.504(e), 164.308 (b), and 164.314(a -b) (2610) (as may apply) and contained in this agreement.
1.5 The Health Information Technology for Economic and Clinical Health Act (2009), the American Recovery
and Reinvestment Act (2009) and Part I — Improved Privacy Provisions and Security provisions located
at 42 United States Code (U.S.C.) §§ 17931 and 17934 (2010) require business associates of covered
entities to comply with the HIPAA Security Rule, as set forth in, but not limited to 45 C.F.R. §§ 164.308,
164.310, 164.312, and 164.316 (2009) and such sections shall apply to a business associate of a
covered entity in the same manner that such sections apply to the covered entity.
The parties therefore agree as follows:
2,0 Definitions. For purposes of this agreement, the following definitions apply:
2.1 Access. The ability or the means necessary to read, write, modify, or communicate data/information or
otherwise use any system resource.
2.2 Administrative Safeguards. The administrative actions, and policies and procedures, to manage the
selection, development, implementation, and maintenance of security measures to protect electronic
Protected Health Information (ePHI) and to manage the conduct of the covered entity's workforce in
relation to the protection of that information.
2.3 ARRA. The American Recovery and Reinvestment Act (2009)
2.4 Authentication. The corroboration that a person is the one claimed.
2.5 Availability. The property that data or information is accessible and useable upon demand by an
authorized person.
2.6 Breach, The unauthorized acquisition, access, use, or disclosure of PHI which compromises the
security or privacy of such information.
2,7 Compromises the Security. Posing a significant risk of financial, reputational, or other harm to
individuals.
2.8 Confidentiality. The property that data or information is not made available or disclosed to unauthorized
persons or processes.
52
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 Econornic and Clinical Health Act (2009)
2.11 Information System. An interconnected set of information resources under the same direct
management control that shares common functionality. A system normally includes hardware, software,
information, data, applications, communications, and people.
2.12 Integrity. The property that data or information have not been altered or destroyed in an unauthorized
manner.
2.13 Malicious software, Software, for example, a virus, designed to damage or disrupts a system
2.14 Part I. Part I - Improved Privacy Provisions and Security provisions located at 42 united States Code
(U,S.C.) §§ 17931 and 17934 (2010).
2.15 Password. Confidential authentication information composed of a string of characters.
2.15 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 § 154.103.
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 154, subpart C, and amendments thereto.
2.24 Technical Safeguards. The technology and the policy and procedures for its use that protect electronic
Protected health information and control access to it.
2.25 Unsecured PHI. Protected health information that is not secured through the use of technology or
methodology specified by the Secretary in guidance issued under 42 U.S.C. section 17932(h )(2).
2.26 All other terms used, but not otherwise defined, in this Agreement shall have the same meaning as those
terms in the Privacy Rule.
3.0. Obligations and Activities of Business Associate.
3.1 Business Associate agrees to not use or disclose PHI other than as permitted or required by this
agreement or as Required by Law.
53
3.2 Business Associate agrees to:
(a) Implement policies and procedures to prevent, detect, contain and correct Security violations in
accordance with 45 CFR § 164,306;
(b) Prevent use or disclosure of the PHI other than as provided for by this Agreement or as required
by law;
(c) Reasonably and appropriately protect the confidentiality, integrity, and availability of the ePHI that
the Business Associate creates, receives, maintains, or transmits on behalf of the Covered Entity; and
(d) Comply with the Security Rule requirements including the Administrative Safeguards, Physical
Safeguards, Technical Safeguards, and policies and procedures and documentation requirements set
forth in 45 CFR §§ 164.308, 164.310, 164.312, and 164.316,
3.3 Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to
Business Associate of a use or disclosure of PHI by Business Associate in violation of the requirements
of this Agreement,
3.4 Business Associate agrees to promptly report to Covered Entity any use or disclosure of the PHI not
provided for by this Agreement of which it becomes aware. This includes any requests for inspection,
copying or amendment of such information and including any security incident involving PHI.
3.5 Business Associate agrees to notify Covered Entity without unreasonable delay of any security breach
pertaining to:
(a) Identification of any individual whose unsecured PHI has been, or is reasonably believed by the
Business Associate to have been, accessed, acquired, or disclosed during such security breach; and
{b) All information required for the Notice to the Secretary of HHS of Breach of Unsecured Protected
Health Information.
3.6 Business Associate agrees to ensure that any agent, including a subcontractor, to whom it provides PHI
received from, or created or received by Business Associate on behalf of Covered Entity, agrees to the
same restrictions and conditions that apply through this Agreement to Business Associate with respect to
such information.
3,7 If Business Associate has PHI in a Designated Record Set:
(a) Business Associate agrees to provide access, at the request of Covered Entity during regular
business hours, to PHI in a Designated Record Set, to Covered Entity or, as directed by Covered Entity,
to an individual in order to meet the requirements under 45 CFR §164.524; and
M Business Associate agrees to make any amendment(s) to PHI in a Designated Record Set that
the Covered Entity directs or agrees to pursuant to 45 CFR § 164.526 at the request of Covered Entity or
an Individual within 10 business days of receiving the request.
3.8 Business Associate agrees to make internal practices, books, and records, including policies and
procedures and PHI, relating to the use and disclosure of PHI received from, or created or received by
Business Associate on behalf of Covered Entity, available to the Covered Entity or to the Secretary upon
request of either for purposes of determining Covered Entity's compliance with the Privacy Rule.
3.9 Business Associate agrees to document such disclosures of PK and information related to such
disclosures as would be required for Covered Entity to respond to a request by an individual for an
accounting of disclosures of PHI in accordance with 45 CFR § 164.528.
310 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.
5 4
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.
112 Business Associate agrees to implement security measures to secure passwords used to access ePHI
that it accesses, maintains, or transmits as part of this Agreement from malicious software and other
man -made and natural vulnerabilities to assure the availability, integrity, and confidentiality of such
information.
3.13 Business Associate agrees to implement security measures to safeguard ePHI that it accesses,
maintains, or transmits as part of this agreement from malicious software and other man -made and
natural vulnerabilities to assure the availability, integrity, and confidentiality of such information.
3.14 Business Associate agrees to comply with:
(a) ARRA § 13404 (Application of Knowledge Elements Associated with Contracts );
(b) ARRA § 13405 (Restrictions on Certain Disclosures and Sales of Health Information); and
(c) ARRA § 13406 (Conditions on Certain Contacts as Part of Health Care Operations).
4.0 Permitted Uses and Disclosures by Business Associate, Except as otherwise limited in this
Agreement or any related agreement, Business Associate may use or disclose PHI to perform functions.
activities, or services for, or on behalf of, Covered Entity as specified in any and all contracts with
Covered Entity provided that such use or disclosure would not violate the Privacy Rule if done by
Covered Entity or the minimum necessary policies and procedures of the Covered Entity.
5.0 Specific Use and Disclosure Provisions.
5.t Except as otherwise limited in this agreement or any related agreement, Business Associate may use
PHI for the proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
5.2 Except as otherwise limited in this agreement or any related agreement, Business Associate may
disclose PHI for the proper management and administration of the Business Associate, provided that
disclosures are Required By Law, or Business Associate obtains reasonable assurances from the
person to whom the information is disclosed that it will remain confidential and used or further disclosed
only as Required By Law or for the purpose for which it was disclosed to the person, and the person
notifies the Business Associate of any instances of which it is aware in which the confidentiality of the
information has been breached.
5.3 Business Associate may use PHI to provide data aggregation services to Covered Entity as permitted by
45 CFR §164.504(e )(2)(i )(8), only when specifically authorized by Covered Entity.
5.4 Business Associate may use PHI to report violations of law to appropriate Federal and State authorities.
consistent with 45 CFR §164.502(j) (1 }.
6.0 Obligations of Covered Entity.
6.1 Covered Entity shall notify Business Associate of any limitation(s) in its notice of privacy practices of
Covered Entity in accordance with 45 CFR § 164.520, to the extent that such limitation may affect
Business Associate's use or disclosure of PHI, by providing a copy of the most current !Notice of Privacy
Practices (iNPP) to Business Associate as Attachment XI to this Agreement. Future (Notices and/or
modifications to the NPP shall be posted on Covered Entity's website at www.allianceforaging.org
6.2 Covered Entity shall notify Business Associate of any restriction to the use or disclosure of PHI
that Covered Entity has agreed to in accordance with 45 CFR § 164,522, to the extent that such
restriction may affect Business Associate's use or disclosure of PHI.
55
7.4 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 AR RA, HITECH and Part I shall be effective upon the later of
April 14, 2003, or the effective date of the earliest contract entered into between Business Associate and
Covered Entity that involves the use of PHI;
{b} The electronic security provisions hereof shall be effective the later of April 21, 2005 or the
effective date of the earliest contract entered into between Business Associate and Covered Entity that
involves the use of PHI; and
[c] Provisions hereof mandated by ARRA. HITECH and/or Part I shall be effective the later of
February 17, 2010 or the effective date of the earliest contract entered into between covered entity and
business associate that involves the use of PHI or ePHI.
8.2 Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business Associate,
Covered Entity shall either:
(a) Provide an opportunity for Business Associate to cure the breach or end the violation and
terminate this agreement if Business Associate does not cure the breach or end the violation within the
time specified by Covered Entity;
{b} Immediately terminate this agreement if Business Associate has breached a material term of this
Agreement and cure is not possible; or
(c) If neither termination nor cure is feasible, Covered Entity shall report the violation to the Secretary.
8.3 Effect of Termination. Except as provided in subparagraph (b) of this section, upon termination of this
agreement, for any reason, Business Associate shall return all PHI and ePHI receivers from Covered
Entity, or created or received by Business Associate on behalf of Covered Entity.
(a) This provision shall apply to PHI and ePHI that is in the possession of subcontractors or agents of
Business Associate. Business Associate shall retain no copies of the PHI and ePHI.
(b) in the event that Business Associate or Covered Entity determines that returning the PHI or ePHI
is infeasible, notification of the conditions that make return of PHI or ePHI infeasible shall be provided to
the other party. Business Associate shall extend the protections of this Agreement to such retained PHI
and ePHI and limit further uses and disclosures of such retained PHI and ePHI, for a minimum of six
years and so long as Business Associate maintains such PHI and ePHI, but no less than six (6) years
after the termination of this agreement.
9.0 Regulatory References, A reference in this agreement to a section in the Privacy Rule or Security Rule
means the section then in effect or as may be amended in the future.
10.0 Amendment, The Parties agree to take such action as is necessary to amend this agreement from time
to time as is necessary for Covered Entity to comply with the requirements of the Privacy Rule, the
Security Rule and the Health insurance Portability and Accountability Act of 1996, Pub, L. No. 104 -131.
56
11.0 Survival. Any term, condition, covenant or obligation which requires performance by either party hereto
subsequent to the termination of this agreement shall remain enforceable against such party subsequent
to such termination.
12.0 Interpretation. Any ambiguity in this agreement shall be resolved to permit Covered Entity to comply
with the Privacy Rule and Security Rule,
13.0 Incorporation by reference. Any future new requirement {s}, changes or deletion {s} enacted in federal
law which create new or different obligations with respect to HiPAA privacy and/or security, shall be
automatically incorporated by reference to this Business Associate Agreement on the respective effective
dates ).
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 -lour guaranteed courier or
delivery service, or by certified mail of the United States Postal Service, postage prepaid and return
receipt requested, addressed to the other party as follows (or to such other place as any party may by
notice to the others specify):
To Covered Entity: Alliance for Aging, Inc.
Attention: Max Rothman
760 NW 107 Avenue
Miami, Florida 33172
To Business Associate- MONROE COUNTY BOCC /SOCIAL SERVICES
_1100 SIMONTON ST. SUITE 2 -257
KEY WEST, FLORIDA 33040
Any such notice shall be deemed delivered upon actual receipt. It 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 Paws of the State of Florida, without giving effect to principles of conflict of Iaws,
govern all matters arising under this agreement.
16.0 Severability. If any provision in this agreement is unenforceable to any extent. the remainder of this
agreement, or application of that provision to any persons or circumstances other than those as to which
it Is held unenforceable, will not be affected by that unenforceability and will be enforceable to the fullest
extent permitted by law.
17.0 Successors. Any successor to Business Associate (whether by direct or indirect or by purchase,
merger, consolidation. or otherwise) is required to assume Business Associate's obligations under this
agreement and agree to perform them in the same manner and to the same extent that Business
Associate would have been required to if that succession had not taken place. This assumption by the
successor of the Business Associate's obligations shall be by written agreement satisfactory to Covered
Entity.
18.0 Entire Agreement. This agreement constitutes the entire agreement of the parties relating to the
subject matter of this agreement and supersedes all other oral or written agreements or policies relating
thereto, except that this agreement does not limit the amendment of this agreement in accordance with
section 10.0 of this agreement_
i7
Covered Entity: _
Y 1T �� ti �� Date:
{signature} �
Business Associate: _MONROE COUNTY BOCCISOCIAL SERVICES
(signature) SHEFTYL GRAHAM, ACTING COUNTY ADMINISTRATO
SIGNED BY: —
NAME: DANNY KOLHAGE
TITLE: MAYOR
DA'T'E: l Al AS
c_ 3)
58
ATTACHMENT )F
Verification of Employment Status Certification
As a condition of contracting with the Alli -,ince for Aging, Inc., MONROE COUNTY
ROCCISOCIAL SERVICES , Hereby referred to as contractor, certifies the use of the U.S. Department
of Homeland Security's E- verify systetij to verify the eMployrnerlt. eligibility of all new crnployecs
hired by Contractor during,, the contract tcrm to perform employment duties pursuant to this Agreement
and (b) that imy Subcontracts include an express requirement that subcontractors performing wore of
providing services pursuant to this Agreement utilize the E- verify system to verify the employment
efigibility of all riew employees hired by the subcontractor dzrrin¢ the C[7I7tr£ict terttl.
59
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60
ATTACHMENT H
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
The undersigned. an authorized representative of the Contractor named in the contract or agreement to whicil
this forth is an attachment, hereby certifies that:
(1) The Contractor understands that pursuant to s. ' 1 87,135 F.S., any company at the time of biddint7 of
submitting a proposal for a new contract or renewal of all existing contract, that is on the "Scrutinized
Companies with Activities in Stldall List' or the "Scrutinized Collipa:iies with Actin ities in tale Iran Petroieun3
Sector List (collectively, the I fists ") is ineligible for, and may not bid on. subiltit a proposal for, or enter into
or renew a contract pursuant to which funding iti provided by the Department of Elver Affairs (Department)
for goods or services of Si million or more.
{2) The Contractor understands that. pursuant to s. 287.135 F.S., any company that submits a false certification
is subject to ciViI penalties_ attorney's fees and costs acid any costs for investigations that red to the finding of
false cernflcatioll.
(3) The Contractor understands that the contract to which this Norm is an attachment may he terminated by the.
AAA if the Contractor su bill its a false certification or has been placed on the Lists.
This certification, required by Florida law, is a material represeillatioit 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.
r
Si- nature Date `
(Same as contract signature)
ACTING COUNTY ADMINISTRATOR
Title
` i' ONROE COUNTY BOCC /SOCIAL SERVICES
Company Name
61
ATTACHMENT .1
Alliance for Aging Fiscal Policy and Procedures
SURPLUS/DEFICIT ANALYSIS — C:ON]MUNITY CARE FOR ]'HE ELDERLY (CCE) AND HOME
CARD. FOR THE ELDERLY MCE]
POLICY: Available. funds For CCE and FICE Will be optilnired by using the most recent available' data to
analyze contractor spending patterns and trends in order to serve the largest number of clients.
Purpose: To ensure contract compliance requiring that all available ftlnding is spent expeditiously and
completely to avoid any surpluses or d eficits.
A. Procedures:
1. Spendirr- patterns of each provider by prograrn will be analyzed oil a monthly basis. In accordance
with contract requirements, Lear! Agencies must projected surpluses or deficits,
2. All noted surpluses or deficits in spendingr anchor rep oning. patterns will be reviewed and documented
iv order far the Alliance to initiate arpprapriate steps to ensure that consumers continue receiviricr
services in accordance with appropriate care plaits.
3. Lead Agencies will suhnil invoices by the deadline date specified in their contracts. Invoices 1101
submitted on tine will not he reimhursed until the following rrtontllly cycle. Invoices not Stlbrttitled
on time bias surplus /deficit re Providers assume the consequences of delayed invoicing on the
accuracy of surplus/deficit projections.
4. Lead Agencies should request referrals fOr activation directly from the ARC on all ongoing basis. is
often as needed, to ensure that �an optirttal caseload is maintained so that the Lead Agency will not
real ice a year - end surplus ar deficit. All optlinal caseload is considered the itumher of cases necessary
for each Lead Agency to maintain throughout the fkcal Year so as not to experience any projected
surpluses or deficits. The actual number of casts constituting an optimal caseload should lta<<e
concurrence of berth a fiscal representative. from the Lead Agency and the Alliance Fiscal Analyst.
5. Requesting referrals for activation directly from the ARC will expedite the referral process; however.
it is incumbent upon Lead Agencies to ma- Intalin an optimal caseload so as not to create any surpluses
far the Cti ITC 11t frscai year nor any deficits, that when all ltuali zed . create deficits in the next fiscal year.
For example, 11'a Lead Agency identifies ' rturtther of clients will tea ve or have left the program
clue to placement in anot.Itel pl etc., the Lead Avency can request replacement of these clicl1ts
with ne.w referrals by contacting the ARC directly. The Lead Agency must ensurc, however. that the
number of referrarls requested does not result in a: nLlIllber of cases that exceeds its optimal caseload. 11}
deters Brig the optimal caseload for purposes of requesting additional cases, factors such as historical
attrition rates and anticipated vacancies due to client transfers to other programs can be considered.
Under no circumstances can reductions in care plans Occur for purposes of creating need fol
additional referrals,
6. APS referrals are not wart listed and are referred to Lead Agencies on a: rotation basis. Furldirng for
individuals designated as Irltrninent Rill: and Aging Out will be authorized oft an as- needed basis by
the fiscal dept. upon review Of funding availability.
7. Each Lead Agency will de.5ignate a persolt who is tile point of contact and is authol to request
r from the ARC including the dale(s) for referrals to he sent to the Lead Agency. In no
situation, sluauld the date(S) established for receiving the referrals be more than 30 days from the date
Of ]_CgUeST.
�. At least monthly. the Fiscal Analyst for the Alliance will monitor the number of cases than are
maintained by the L&td Age.11cy to determine any projected surplus or deficit. If it is determined that
a projected deficit cxlsts,the f =iscal Analyst will advise the ARC and the Lead Agency that no
62
additional referrals may be sent untii there is concul between the Alliance and the Lead Agency
at}ou1: the budget projectlon. When there is concurrence about the budget projections. both the ARC
a nd the Lead Agency will be llotllil[d []_y' the Fiscal Analyst that referrals can be tiL'1 }t, if warranted.
9 By the 18" Of each month, using the "lost curl - ent provider invoicing al }d enrollment delta, the Alliance
Fiscal Analyst will prepare a preliminary surplus/deficit proj taking into account histc }ricLil
attrition rates, Adult Pt'otecl7ve. 5zl'v'iLey referrals, 1listrtrical per iwinberlper lllonth (PmpM) spending
rates, and the number of recentdv referred cases sot }t to the Lead Agency that may not have yet been
entered in C1RT5 or activated (APPL). [n addition. Sul fi }recasts ��idi formally incorporate
identified late billing /non biliin; patterns, changes to expenditures per ConsLlliler, lags in the
enroll : processes and Duly other information that may improve the accuracy of the projections.
Id. To monitor the provider's expenditu the Alliance Fiscal Analyst will use the Alliance for Aging
CCE Expense and Projection Report tool. This tool compares a monthly expenditure plan batted ore
prgjected caseinads t hat assume historical Attrition and 1:111 oll rnerlt factors, against actual InvoiclnLY.
On a montilly basis, the Alliance will comparc the CLlnttllative expenditure to the month of the report
a.crayi }Sl tile. eLilIllllLlti�t planne expellciiture. For example, if for the December report- the cumulative
planned expenditure was projected to he 55 percent and if the actual reported culnul,.itive expenditure
for December is 48 percent, there the n}ea.sui stll fol tl }e month of December would be seven (7)
percent.
[I. The Alliance fiscal Analyst Nvill set to the Fiscal Officer of each Lead Agency inolltilly prelirl }inaly
surplus/deficit reports and all antllysls of the findings. together with any inquiries re�rarAing the.
findings. This cominu11icatiOn will he sent via electronic mall. In addition, surplus/deficit reports will
he discussed in conference. Ul} at least a moilthly basis. with Lead Agencies to achieve; Consensus
forecasts.
1?. The Fiscal Officer of the Lead Agencl will respond to the Alliance's Fiscal Analyst within two [?)
working days via electronic lrrtril with the requested information. noting any discrepancies between
the Alliance's 1 }rejections and that of the Lead Agency. For e.xtunpfe. the Lead Agency may report
atypical attrition or enrollment factors due to unusual ciret11n5ttrnces sucl} tiff higher than usual attrition
or clients transferring to other funded programs. If a Lead Agency requested additional referrals in
excess of what had been determined to be the optimal caseload in order to prevent a Surplus or deficit.
there a justificLition for requesting the additional referrals sho be included as part of the response
The Fiscal Analyst will continue to track and verify that the justification for the additional referrals
has not resulted in a potential surplus of deficit nor had an adverse impact on any clients receiving
service,.
Based on the itlformaticlrl received from the Lead Agency, the Alliance's I iscal Analyst will either
modi or affirm the preliminary S1.11 report. The fise:rl Analyst will suhlnit this report to
the Vice President for Finance who will present it fol discussion with the Exectitive Management
Group (I--MG). The EMG wilt decide on an appropriate coarse of action to address the surplus or
deficit.
14
15
A monthly surpllrsldeficit meetil }g will be held during which the Fiscal Analyst will communicate
with contract mallagelllent staff about the status and projections of surplus/deficits for the programs.
Tile tllollthly'Surplus /deficit reports will he sent by the Alliance to DOEA, as required.
B. Remedial Actions col• Surplus/Deficit:
1. For the surplus/deficit reports covering the months of July through September, the Alliance will initiate
rernediai action when two consecutive 111 011thlY reports indicate surpluses in excess of five (7) percent for
each month-
a. Remedial action will co r l$ISt of a de- obligation of Stll 17lLIS funds 111 an
Amount SuffiCient enough to bring the year - €o -date [:umutativr< Surpluti to less than Dive {S} percent
of the Cumulative year -to -date expected expenditures. FOr example, for the Sul /dedrert report
63
corresponding to the month of October. the expected eunlulative expenditure is 333 percent of the.
contract: alllount. If the reported expenditure. by the November report deadline. For services
provided through Scptcn�ber 3U` is ?5 Percent of the contract arlrount arid, if there is also a
cumulative surplus of fire (5) percent or more in ALl+ *t1st, then the Alliance will de- obii(* *ate an
ar11C1L1r1 that WIII 111'll1C tl1L' cl3111t31FitlVe ye8l'-t(1 - dclte st1Cp1L's to lCSS than true 5} percent, In thl.5
example, the al of de-obligated funds i` 8.3 r 1c (D.3% ['minus 25% of the contract,
b. De- obligated funds will be used by the ARC. to !mike referrals on a client
choice basis. The Fiscal Analyst will advise the ARC of tilt. number of referrals to be made based
on the amount of funds avIn lab le. Once aII persons to be referred are identified and their cht�icc. of
case management apenev made. the ARC w 11 notify the Alliance fiscal office and the Lead
A,encies in order for approp''late contract anlcrldntents to be prepared and executed.
'.
For reports covering the ()clober 1111'otIgh December period, th Alliance Will initiate remedial Action when
two consecutive monthly reports show CU11111416ve su1 }bases in excess of two and a hall (2.5) percent in
each month. A cumulative surplus incurred in Sel)ielllbcr, if larger than five (5) percent will he considered
for the consecutive count. For example, if the report for the nloilth of September shows it projected surplus
H) excess of five (5) percent and the report for October show a strrpius in excess of two and a hal €' (2.5)
Pei then a cle.- obligation of funds will be initiated that is equal to the amount needed to decrease the
Surplus to no more than two and a halm (15) percent. In this OVIIIiple, there were two consecutive months
in which there was a surplus for each ntonth that exceeded the established threshold. Since the remedial
action was i'liliated in the October through the Decernher period, then the amount for the reduction of t.l1e
surplus is two and a half (2.5) percent, These Surpluses 11 llle�lstlred using the DOEA .surplus /deficit
reporting too] with expenditures shown as reported by the Lend Agency.
a. The remedial action will be the same as stated in Sections 13.I.a. and 8.1- b.above, except the
referenced surplus allowance is two and a half (2.5) percent.
3. For reports covering the January through March period, the Alliance will initiate remedial action whe.r1 two
consecutive monthly reports show ctinlLrlative Surpluses in excess of one and a half O..5.) percent in each
month. A cLlttlulative surplzrs mcm - red it December, if larger than two and a half (2.5) Pei will be
considered tilt the consecutive count. For example, if the report for the inonth of December shows a
projected Surplus in excess of two and a half (15) percent and the report for January shows a surplus in
excess of one and it half (1.5) percent, Ihen a de- obligation of tunas will be initiated that is equal to the
amount needed to decrease the surplus to no nlol than one and a halt ( 1.5) percent. In this exalllple., there
were two consecutive ['months in which there was a surplus for each month that exceeded file established
threshold. Since the remedial action was initiated in the January through March period then tllc amount for
the reduction of the Surplus is one and a half (I.5) percent. These surl-
)ltlses are measured using the l]QEA
surplus /deficit repotting too] with expenditures shown a5 reported by the Lead Agency,
a. The remedial action will be the .Same as stated in section B.I.a. and B.I.b. above, except the
referenced surplLlS allowance is one and a halt (1.5 percent.
4. For reports covering the April and May period, Tile Alliance will initiate remedial action (or each month in
which the surplus exceeds one (1) percent. The anu011nt exceeding the one (1) percent threshold will be de-
obligated. These Surpluses are measured using the DOER surplus /deficit report' ['. tool with expenditures
Shown as repotted by the Lead Agency.
a. Tile remedial action will be the salne as stated in seciiow, B. ka. and S.l.h.above, except the
referenced su! allowance is one ( l) pe'
5. For the report covering the Jtrlie period, if the surplus exceeds one { I) percent, it will be noted as a progralrl
Compliance issue and incorporated Its part of the 111o111tor'rng of the Lead A.cncy by the Alliance. The
agencv may also be placed 021 corrective action.
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