Item B3BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: 031 112016 Division: Social Services
Bulk Item: Yes X No Department: Social Services
Staff Contact Person: Shet -NI Graham 305 2g7_- ' 4 ! 510
h, 11n , , //0/. -'-0
AGENDA ITEM WORDING: Approval of Amendmcnt 001 of the Community Care for the Elderly
Contract (CC E) # KC -1571 between the Alliance for Aging, Inc., and Monroe County BOCCIMonroe
County Social Services for contract year 2015 -2016 (711115 – 6130116) in the amount of $413.700.
ITEM BACKGROUND. The purpose of this Amendment is to slake the following changes to the
existing CCE contract (1) with regard to Funding Source: to clarify that Tobacco Settlement Trust
Funds are no longer included in the State Grants anti Aids Appropriations which make up this
particular funding source and (2) with regard to Chore attd Enhanced Chore services: to move away
f'ronn a cost reimbursement rate to a fixed rate of service.
PREVIOUS RELEVANT BOCC ACTION: Prior approval granted by the BOCC on 9/15/2015 for
approval of the Community Care for the Elderly Contract (CCE) # KC -1571, contract year 15116.
CONTRACT/AGREEMENT CHANGES: Remove Tobacco Settlement Trust Funds from Funding
Source on page two (2) section 4.2. Change Chore and Enhanced Chore Rate and Service Units.
Amendment does NOT affect Total Contract Amount.
STAFF RECOMMENDATIONS, Approval
TOTAL COST: $413.700.00
COST TO COIJNTY: 10% CASH MATCH
BUDGETED: Yes — No —
SOURCE OF FUNDS: Grant funds
REVENUE PRODUCING: Yes X No _ AMOUNT PER: MONTH: S1,762 YEAR: $21,147
(SOURCE OF REVENUE – CLIENT CO PAYMENTS)
APPROVED BY:
DOCUMENTATION
County Atty.
Included X
OMB/Purchasing
Not Required
Risk Management
To Follow
DISPOSITION: AGENDA ITEM #
Revised W06
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, Inc. Contract: KC 1571 Amendment 001
Effective Date: 7/1/2015
Expiration Date: 6/311/2016
Contract Purpose /Deseription: Approval of Amendment 001 of Contract KC -1571 between the Alliance for
Aging, Inc., and Monroe County BOCCIMonroe County Social Services for contract year 2015 -2016 (7!1115 —
6l30l16) in the amount of $413,704.
Contract Manager: Sl>elyi Grallal7 (305) Social Services /Stop 1
°2I` �.�I, 292 -4510
(Name) (Ext.) (Depaltmentl4top #)
For BOCC ineetin = on 3/08/2016 Aryenda Deadline: 211E12016
CONTRACT COSTS
Total Dollar Value of Contract: $413,700,00
Budgeted: Yes V No CI Account Codes:
County Match: S10 % CASH MA'rC:H
Additional Match: -0-
Total Match $ 10% CASH MATCH
Estimated Ongoing Costs: $ /a
[tioi incItided in dollar value above]
Current Year Portion:
125 - 6153815
ADDITIONAL COSTS
For:
{c. g - maintenance, utilities, - janitorial, salaries, etc
OMB Farm Revised 2127101 MCP #2
CONTRACT REVIEW
Changes
Date Out
Date In
Needed
Reviewer
Department Head
2/10/2016
Yes No V
2/10/2016
Risk Management
O.M.B./Purchasing
Co>.tnty Attorney
� � I � � � �
Yes L No L
Yes. No ,�'/
Yes - No,4
' f
Comments:
l
OMB Farm Revised 2127101 MCP #2
L I
AMENDMENT 001 CONTRACT KC - 1571 ' 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 Servicesjln -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 CCE Contract for Chore and
Chore (Enhanced) funding for fiscal year July 41, 2015 - tune 30, 2016.
To change Funding Source on page two (2), section 4.2 to read:
PROGRAM TITLE YEAR FUNDING SOURCE CSFA# AMOUNT
2015 -
Fcornmunity Care for the Elderly 2016 General Revenue 65010 $413,700.00
AL CONTRACT AWARD 1 1 $413,700.00
To correct the service unit rate and the maximum units of service to read:
Rate Service Units
Chore $29.41 127
Chore (Enhanced) $32.19 97
This amendment does not change the total CCE contract funding of $413,700-00
The Alliance shall make payment to
the
provider for the provision
of services up to a maximum number
of units of service and at the rate(s)
stated
below:
Service to be Provided
Service
Maximum
Units of Service
Maximum
Unit Rate
Prior Units
Additional Total
Dollars
Case Aid
$21.98
299
0
299
$6,562.00
Case Management
$50.48
787
0
787
$39,728.00
Chorc
$29.43 1
127
0
127
$3,732.00
Chore (Enhanced)
$32.19
97
0
97
$3,123.00
Companionship
$15.33
1,142
0
1,142
$17,504.00
Homemaker
$22.06
6,325
0
6,325
$139,521.00
Home Improvement
Cost Reimb.
N/A
$746.00
Personal Care
$28.67
5,395
0
5,395
$154,672.00
Respite (In- Facility)
$10.00
2,445
0
2,445
$24,451.00
Respite (in -Home)
$23.08
970
0
970
$22,394.00
specialized Medical Equipment
Cost Reimb.
N/A
$1,267 -00
$413,700.00
TOTAL CONTRACT AWARD
Prepared on 01/29/2016
AMENDMENT 001 CONTRACT KC - 1571 Page 2
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 stiii 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 otticials as duly authorized.
PROVIDER:
ALLIANCE FOR AGING, INC.
Monroe County Board of County
Commissioners, Social Services /In -Rome
Services
SIGNED BY: f
NAME: Sheryl Graham
TITLE: Acting Cou nty Administrator
DATE: 2/4/2016
SIGNED BY:
NAME: Heather Carruthers
TITLE: Mayor
DATE:
SIGNED BY:
NAME: Max B. Rothman, J LL.M.
TITLE: President & CEO
DATE: D ' L
1
Ut6"IVIUNITY CARE FOR THE ELDERLY LEAD AGENCY CONTRACT
Ex 2015 -2016 fiscal Year
THIS CONTRACT is entered into between the Alliance for Agil1g Inc.. hereinafter referred to as the "Alliance" and
iVlonroe County Board of Commissioners, Social Serviceslltt -Home Services, hereinafter referred to as the "provider,"
and collectively referred to as the "parties."
Attachments 1. II, III. IV, V, VI, VII. VIII, IX. \, Xi. A, B, C, D, F, F. G. H AND .l are incclt herein and made a
part elf ills; . Co ntract
W HEREA S the t. fiance has been desigtlated as the Area Agency on Aging for Planning and Service Area 1 1
encolllpassin�� Miami -Dade and Monroe Counties: Lind
WHEREAS, the Florida Department of Elder Affairs {the "Department ") has entered into a Contract w.th the Alliance to
ftirld cc)rnrllunity care service s} stellls in Mlaim -D ade and Monroe Counties; and
WHEREAS, ill accordance with Section 430.2D3, Florida Sta(utes, the Alliance lltts designated the pro vider as a Lind
agency fell the Cc)mrnunity Cart foi 411e Elderly (;CCE) pi rain:
NOW THEREFORE. in consideration Of the services to be performed and payments to be inade. together with the
t1lLtttial covenatlts and collditions set forth li1 this Contract, the Parties aofee as lollowS:
1. Pur ose of Contract
The purpose of this contract IS to provide. services in accordance with the terms anld coriditions specified ill this
contract i tic l Lid 1tlg all attachments and ex111hits, which corlstittito the contract document.
2,
Incorporation of Documents within the Contract
The contract will incorporate tittachtnetlts, propclsall 1, state plan(s), grant agreements, relev:zlit Depart, 'it of
Fldcr Affairs handhooks. manuals or desk honks. as an integral pain of the. coiltrac[, except to the extent [hat the
contract explicitly provide~ to tllc contrary. lit the evens of conflict in language among any of the documents
referenced above. the specific provisions and requirements of the contract document(s) shall prevail aver
iticotlsistcr t provisions in tfle proposalts) or other general matel'ials not Specific io this contract document and
identified attachmeIlts.
Incorporation of Reference Memoranda:
In accordance with Chapter 287 F.S., amended, and Departntent of Financial Scrvices' Chief Fitancial Office)
Memor the following rnemorandll are hereby incorpora by reference.
(1) CI=D Meino No. 02: Release date, Dct(aber 3. 2012:
(.2) CFO Ivlemo No. 06: Release date. lune 27, 2012;
{3) CFO Menlo No. 01: Release date. 3uly 26. 1-012; and
(4) CFO ',%'Ic;lno No. (14: Release date.. June 307 2006
3, Terns of Contract
Effective Date:
This coiltiact. shall begin on July 1, 2€115 or on the date the contract has been siUmed by both parties. whichever" is
late
Delivery of sel shall end at midnight. locill tinle ill Miami. FL on ,June 30, 2015. The Alliance w ill 'lot
reiinllurse the provider for services provided after this date. HoWeve.r, the parties recognize that they will need
to perfOrrn continued activities relating to reporting invoiciilcl and payment in July of -1 016 to facilitate paytnetlt
for services rendered by the provides under this contract through and inc3uding the co expiration date of
July 15, 201
4.0 Contract Amount
The Alliance agrees to pay for contracted services according to the terms and conditions of this contract ill an
amount not to exceed $413,700.00 comprised ol' $384,300 hale, plus 5 ,6,300 recLirrinn funds for one additional
client, plus 523,100 that 'follows the client' for 4 additional clients, the rate schedule, subject to the avaiIahiI1ty
of funds. Any costs o r services p aid for under any other contract or from airy other source are not c1ig itvfe for
payment under this contract.
4.1 obligation to Pay
The Alliance perforlllarice i1 I'd obi ityation to pa y tender thts Contract 15 C()11611gent upon all
annual appropriation by the Legislature W the Department ally[ 1elnding received h }'the Alliance
under its contract with the Department.
4.2 Source of Funds
The costs of services paid under any tither contract or from any other source are not eligible for
reimbursement under this contract. The funds awarded to the provider pursuant to this contract
are in the state �xrams and aids appropriations and consistS of the fol' owing:
E�forthe m Title Year Funding Source CSFA# Fund Amounts
Community Care. 2t} 15- GelleI., RevcnuelTnbacc�] 55[110 413,70D.D�
EIderiy 2016 Se ttlement Trust Funds
413,700-00
TOTAL FUNDS CONTAINED IN THIS CONTRACT
Renewals
Tllt. CClilti 14't I11ay be renewed on a yearly basis for tic) 1110re than two additional y ears. Such renewals shall be
contingent upon satisfactory t�e.Ifor11r1llce eVf[Ilta[ionti aS determined by the Alliance and the availability QI funds.
Any renewal of a contract shall be. subject to tnutitaI �tgrcenient, confirmed in writing', and subject to the same.
terms and conditions set forth in the initial contract, The renewal price, or /Method for determining a renewal
price, is set forth in the bid. proposal, or reply. N other casts for the renewal may be charged.
In the went that a subsequent agreemeslt nla rent be executed prior to the JuI I'' start date. the Alliance may, at
its disc.retitln, extend this Agreement upt111 written notice for tip to 90 day; to ensure continuity of service.
Sel'v�ices provided under' this extension will be paid for out of the titlCCeedttlgcl-!'t'eI1nClll amount.
6. Coto liance with Federal Law
6.1 If this contract Cont ains federal funds the following shall apply:
6.1.1 The Provider shall conlply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other app]icable i'c =ulatiolls.
6.1.2 if' this C101111 contains federal fund~ and is 1��cr S I O03 ()00.00. the Provider snail comply will' all applicable
standards. orders, or regultttiOIlS issueG under s. 306 of the Cleats Air Act as amended (42 [?.5.0 . 7 t t Berl, }, S.
508 of the Federal Water Pt_)llut1otl Control Act as amended (33 U,S.C. 1 251, et seq.), Executive Order 1 1738, as
ametlded. and where applicable F.nvironnlental Protection Agency regulations 40 CFR 30. The Provider shall
report any violations of the above to the Alliance.
6.1.3 The Provider, or agent acting far the Provider. may not use any federal funds received in connection with this
contract to influence. le.gislatioll M' appropriations pending before the Con�*ress a1' e111Y state legisiaturc. li this
contract contains Federal funding in excess of $ 100,000 the Provider must, prior to contract execution,
complete the Certification Regarding Lobbying form, ATTACHMENT 11. All disclosure forms as required by
the Cetrtif_catinn Regarding Lobbying form must be coln}�leted and returned to the Contract Manager pliar to
payment gilder this contract.
6.1.4 In accordance with Appendix A to 2 CFR 215. the Provider shall comply with Executive Order 11246, Equal
Employment Opportunity, as amended by Executive Order 11375 and others. and as supplemented in
Departmcalt of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.
6.1.5 If this contract contains federal funds and provides services to Children up to age 18, the Provides silo// corllpfy
with the lira - Children Act of 1994 (20 U.S.C. 6081 }.
6.1.6 A contract award with an amount expected to equal (]r exceed $25.000.00 and certain other contract awards will
not be made to parties listed oil the government - wide Excluded Parties List System. in accordance with the LIMB
gl.tidelines at 2 CFR 180 that illlplement Executive Orders 12549 and 12687. "Debarment and Suspension." The
Excluded Parties List System contains the names of parties debar - ed, suspended. or otherwise excluded by
agencies. as well as parties declared ineligible under statutory rn re - 71.11, ory atltl�or'ity' other than Executive Order'
12549. The Provider Shall comply With these provisions before: doing business or entering into subcontracts
receiving federal tulids pursuant to this contract. The Provider shall complete and sign ATTACHMENT V
Prior to the execution of this contract.
6.2 `File Provider shall not employ a n uliatrthorized alien. The ,alliance will consider the e11iplov111cut of
unauthorized aliens a violati of the immigration and Nationality Act (8 U.S.C. 1324a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1 101). Such violation w•iII be cause for unilateral canceI [at ioil of this
contract by the Alliance.
6.3 If the Provider is i t non- profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporti :>g t'equire.m�l�ls ( a Form G1]0 or Perini 990 -N} and has its tax exempt status revoked for failing to
comply with the filing requirements of the 2005 Pension Protection Act or for ally other reason, the Provider -
rntrst notifv the Alliance in writing within thirty (30) days of receiving the IRS notice of revocation.
6.4 The Provider shall comply with Title 2 CFI Pact 275 regarding Trafficking in Persons.
Unless exempt under 2 CfrR .Pact 170.1 10(b), the. Provider shall comply with the reporting requirement- of the
Traltsparency Act as expressed in 2 CFR 170.
6.5 To comply with Presidential Executive Order 12989 and State of Flori da Executive. Order NLinbe.r 11 -116, the
Provider agrees to utilize the U.S. Department of Homeland Security's E- verify System to verify the employlne.nt
of all new employees hired by Provider during the contract or agreement term. The Provider shall include in
related subcontracts a requirement that , performing work or providing services pt:rsttant to the state
contract utilize the E- verify systein to verify employment of all new ernployees hired by the Sub - provider dul'ing
any contract or' agreement term. Providers meeting the terms and conditions Of the
E- verify Systern is deemed for be in compliance with this provision, The Provider shall complete and sign
ATTACHI�'IENT F pitta to the execution of this Master Contract.
7. Compliance with State Law
7.1 This contract is executed and entered into in the State of' Florida, ar:d shall be construed. perforinetl and enforced
in all respects in accordance with the Florida Iaw, including. Florida for conflict of Iaws.
7.2 The Provide - shall comply with I CAS. 287.()58. F.S. its amended.
7 -2.1 The Provider shall provide units of delivcrables. including various client services. and in so_ne instances may
include reports, findings, and drafts. as specified in this contract. «which the Contract Manager must receive and
accept in writing prior to payment in accordance with s. 215.971, F.S. ( I ) and (2).
7.2.2 The Provider shall submit hills for fees or other compens alnn for services or expenses in sufl'iciertt detail for a
proper pre - audit and post audit.
7.2.3 If iterniztd payment for travel expenses is permitted in this contract. the Provider shall submit gills for any travel
expenses in accordance with s. 1 12.061. F.S., or at such lower sates as may he provided in thiti contract.
7.2.1 The Provider Shall allow public access to all docunnents. papers, letters. or other public records as defined in
subsection 1 19.01 1(12}, F.S., made or received by the Provider in conjunction with this contract except for those
records which are made confidential or exempt by iaw. The Provider's reftssal to comply with this provision will
constitute an immediate breach of contract for which tiie Alliance ntay unilutkn - ally 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 slot subcontract with any individuals or entities on the discriminatory vendor list because they
tzjav not transact business with any puhlic entity, in accot'daltice witi) tie provisions of s. 257.13 - 4. F.S.
7.5 7'he Provider shall comply with the •7rovlslons of s. 11.0621, FS., and s. 216.347. F.S., which prohibit the
expenditure of contract funds for the purpose of lobbying the legislatu re, .judicIaI branch or a state agency.
3
7.6 In accordance with N. 267.135 F.S., any Provider on the Scrutini/ed Companies with Activities in Sudan List Or
the Scrutinized Companies with Activities in the Ira,) Petroleum Energy Sector Fist (.Lists). crewed pursuant to s.
215.473 F.S._ is ineligible to enter into or re :3ew a contract or agreement with the Department for goods or
services of $I million or nuzre. Purstrant to s. 287.135 F.S.. the Dcpartment may terminate this Contract and any
contract or agreement incorporating this Contract by reverence it tltc Provider is found to have submitted a false
certil'icr1tion of its status on the gists or has bceii placed on tlje Lists. FUrti7er, the PrOVlde•r is subject to eiVil
penalties, auorney's fees and costs and any costs for Investigations that led to the finding of false certification. If
any contract or agreement incorporating this Co tit rael contains $1 million or mire, tilt Provider shall complete
and sign ATTACHMENT H, Certification Regarding Scrutinized Companies Lists, prior to the execution of this
Contract.
8. Background Screening
The Provider Shall erasure that the requirements of s. 430.0402 and Chapter 435, F.S., as amended. are met
regarding background screening fo: all persons who mect the definition of a direct service prov=ider and who titre
not exempt from the Department's le',101 2 background screening pursuant to s. 43(].0402(2) -(3), F.S. The
Provider must also comply with any applicable rale.s promulgated by the Department and the Agency for Health
Care Administration regarding implementation of s. 430.0402 and Cliapter 435. F.S.
8.1 For purposes of this section. the. term "direct service provider" means a person 18 years of age or older who,
pursuant to a program to provide services to tlae elderly, has direct, face -to -face contact w:th a client while
providing services to the, client and has access to the client's livi:jg aarcus nr to the client's funds or personal
property. This term inclUde.s coordinators, managers, and supervisors of residential facilities and volunteers.
8.2 Background Screening Affidavit of Conlp }lance - To demonstrate compliance with section 6 of this Master
Contract. the Provider shall submit ATTACHMENT G, 13.ackgrnund Screening Affidavit of Compliance
annually. by Janttttt 15th.
8.3 Further information concerning the procedures For background screenim-T is found at
h tt p:lle I dcralf'ai €'s. set €te. fi .0 sldocatlb ac kg r❑ a ndsc recn i i]`T. ph p.
9. Grievance and Complaint Procedures
9.1 Grievance Procedure
The Provider shalt comply with and ensure sub - provider comphance with the Minimum Guidoline for Recipient
Grievance Procedures. Appendix D, Department of Elder Affairs Procratns and Services Handbook, to address
complaints regarding the termination. suspension or reduction of services, as required for receipt of funds.
9.2 CSnrtpiailit Procedures:
The Provider shall develop and Inipieinent complaint procedures and ensure that sub- providers develop and
impleniesit complaint ptncedures to prnce.ss :and resolve client dissatisfaction with services. Complaint
procedures shall address the quality and u tile Iine.ss of Services, provIde.r and direct service worier complai tits, or
any Other advice related to Complaints other than ierimnation, suspeiliiOn Of redl.AC6011 in Scrvices that require the
grievance p3'ocess as described in Appendix D. Department of Elder Affairs Programs and Scrvices Handbook.
The comp laitit procedures shaII include notification to all clients of the complain[ procedure and include tracking
the date. nature ovthe cornplairit and the dote.rminaat of the. complaint on a complaint log.
10. Public Records and Retention:
10.1 The Provider, subject to the terms of section 287.(15$(1 }(c), Florida Statutes, and any other applicatble legal and
equitable re- tidies, shall:
ay Keep and maintain public records that ordinarily and necessarily Would he required by the Department of
Elder Affairs in order to perform the services.
b) Provide the public with access to public record~ on the same terms and conditions that the
Departinem would provide the records and at a cast that does not exceed the cost provided in Chapter
11 Florid_t Statutes, or as otherwise provided by law.
c) Ensure that public records that a '.e exempt or con#idential and exempt from public records disclosure
requirements are not disclosed except as authorized by law.
21
d) Meet all requirements for retaini public records and transfer, at no cost, to the Alliance all public records in
possession of the Provider upon termination or expiration this contract and destroy piny duplicate public records
that are exempt or cunfidentiai and exempt from public records disclosure requireirients. All records stored
electronically Mtrst be pl OVided to the Department in a Format that is compatible with the information techriology
systerns of the Department.
11. Audits, InsWetions. Investigations:
11.1 The provider shall emablish and maintain books, records. and documents (including electrallic storage [nedia) in
accordance with generally accepted accixrnting procedures and practices that sufficiently and pfopedy reflect all
revenues and expenditures of funds provided by the Alliance tinder this contract. Provider agrees to maintain
records. incf.iding paid invoices. payroll registers. travel vouchers, copy lags, postage lags. tirne sheets. etc.. as
suppori.ing documentation for service cost reports and for administrative expenses itemized fc) reltnbuiseinent.
This docunlentatioil �v iii be nade available upon request fol mollitoring and auditing flttrposts. l�lnenever
appropriate. firtanciai information shouid be related to performance and unit cost data.
11.2 The Provider shall retain all client records. linancial records. stipp(,rtillg documents, statistical records. and any
either documents {including electronic storage media) pertinent to t1134 contract for a period of six ()} 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 1'etained far it i�linimuinn period of six (6) years after the audit report is issued or until resolution
of any audit findings ter litigation based zm the tel'ms of this contract, at no additional cost to the Alliance.
11.3 Upon deriland, at intl additional cost to the Alliance, t he Provider shall facilitate the duplication .rod transfer of
any rcc(I I'd s (It doc111 Ile 11ts during the ret;uIred retention period in Pa ~agraph 10.3. ; 9 ,
11.4 The Provider sllafl assure that the records described in Para�.ralrin 10 will be subject at ail re_isonahle times to
inspectit�n, roview, copying, or audit by federal, state. or either persaniiel duly authorized by the Alliance.
tl.± At all reasonable times for as long as records are maintained, persons drily autllcjrizccj by the AiiiLrnce, tile.
Department and federal auditors. pursuant to 45 CFR 92.36(3) ( 10), will be allowed full access to and the ri to
examine any ()i ti providers contracts and related records and documents pel'tinullt to this specific contract,
regardless cif the form in which kept.
11.6 The Provider shall provide a financial and compliance audit to the Alliance as specified ill ti - .is contract and in
ATTACHMENT Ill and ensure that a- related third - party transactions are disclosed to the auditor.
11.7 Tile Provider shall cortlply and cooperate inllnediately with any inspections, reviews. investi{ atinll5, or audit;
deemed necessary by tine office of the lllspe.c.ti?1' ereneral pursuant to s. 201.055. RS.
1.11.8 The Provider shall maintain and file with the Alliance such progress, fiscal and inventory and cuter reports as the
Alliance may require within the period of this contract.
11.9 The Provider Shall Submil management, proRraill, and client identifiable data. as specified by the Department of
Elder Affairs and I or the Alliance. The provider ITntrtit reCOrd and SLihmlt program specific data M accordance
with the Department's Client InformatIOTi Registration and Tracking System (CIRTS) Policy Guidelines.
11.14 If, tinder aim contract. or agreement - oI this Contract b4' reference, the PravidLi is providing services
and is actin., Oil behalf of the Department of Eldcr Affairs or the Al liance for Aging. Inc. as provided Under
section 1 19.011 (2). Florida Statutes. tite Provider, subject to the terms cif' section 287.058(1) 1. Florida Statutes.
and any other applicable legai and equitable remedies. shall:
a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in
order to perform the services.
b) Provide the public with access to public records oil the same terms and conditions that the Department of
Fitter Affairs or the Alliance for Aging. Inc. would provide the records and at a cost that does not exceed the cost
provided in Chapter 119, Florida Statutes, or as other - Wise provided by law.
cl Ensure that public records that are exempt or confidential and exempt frorn public records Llisciosure
requirements are not disclosed except as authorized by law.
5
d) Meet all requirements for retaining public records and transfer. at no cost, to the Department of Elder Affairs
or the Alliance for Agung, Inc. all public records in possession of the Provider upon termination or expiration of
any contract or agreement incorporating thi Contract by reference and destroy any duplicate public records that
are exez,ipt or confidential and exempt from public records disclosure requirements. All records stored
e.lectronicaliy must be provided to the Departn of Elder Affairs or the Alliance for Aging. Inc. in a format
that is compatible with the inform technology systenls of the Departnlent.
11.11
The Alliance for Agin«. Inc. nla }' Uilif�tte- tally cancel this Contrttet, ._nd any contract or arreeinent 1SiCO3'poratln,
�.� this Contract by reference, notwithstanding any other provisions of this Contract, for refusal by the Provider to
comply with Section.+ ?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 acrreement incorpolatirig this
Contract by reference. unless the records al exempt from Section 24(a) of Article I of the State Constitution and
Section 1 l9) 07( 1), Florida Statutes.
12. Nondiscrimination -Civil Rights Compliance
12.1 The Provider shall execute assurances in ATTACHMENT WI that it will not discriminate against any persoll to
Lhe provision of services or benefits under this contract or in employment because of age. race, religion, color.
disability, national origin, marital status oi' sex in cOn,phance with state and federal law and regulations- The
Provider further assures that all Providers, sub- provider's, sub- gr, or other` with whore it arranves to
provide services or benefits in connection with any of its programs and activities are not discominatin, against
clients or employees because of age, race, religion, color, disability, national origin. marital Status or sex
12.2 During the term of this contract, the Provider shall coirlplete and retain on file a timely, complete and accurate.
Civil Rights Cornpfiarice Checltilist [ATTAC.HMENT B].
12.3 The Provider ,hall establish procedures pursuant to federal law to handle complaints of discriminatiton involvillg
services or benefits through this contract. These procedures will include llotif_ying clients. eillployees, and
participants of the right to file a. complaint with the appropriate federal or ,,Tate entity.
12.4 If this contract contains federal funds. 111ese aSSUrances are a condition of continued receipt of or benefit from
federal finanial assistance.. and are binding upon the Provider, its successors, transferee and assignees. for tilt
period during which such assistance is provided. The Provider further assures that all sub- provlder_S. vends }rs, of
others vv'ith whom it arranges to provide services or benefits to participants or employees in connection with any
Of its prograuns -,Inc[ activities are not discriminating against those participants or employees in violation of the
above statutes, regulations, guidelines, and standards. h the ev ent of failure to comply, the Provider understands
that the Alliance may. at its discretion, seek a court order requiring compliance with the terl of this assurance or
seek other appropriate judicial or administrative relief_ including bo not limited to, termination of and denial of
further assistance.
13, Provision of Services
The Provider shalt provide service~ in the m anner described in in ATTACHMENT I col' this aarcenlent and in the
Service Provider Application (SPA). Ill the event of a conflict between the Service Provider Application and this
contract, the contract language prevail
14. Monitoring by the Alliance for Aging
The Alliance will perform administrative and programs - vatic monitoring of the provider to ensure contractual
Co rripliance. fisCtil accountability, programmatic performance. and compliance with applicable state and federal
laws and r'et"Ul ations.
14.1 The provider will supply progress reports, including data reporting requirements as specified by the Alliance or
the Department to be used for monitoring progress or performance of the contractual services as specified in this
contract. Following the norms set down by the Department. the Alliance will track performance on a monthly
basis, through desk reviews of available fiscal. CIRTS, and research production reports and ar.,y other system or
process desig by the Alliance. Fxainples c7{' review criteria are SurplUsldeficit, independe-lit audits. internal
controls, reirnbul requests, subcontract monitoring, targeting, program eligibility, outcome measures.
Service provision to clients designated as "High risk" by the Department of Children & Families, Adult Protective
Services program. data integrit_y4 co- payments. client satisfaction, correspondence. and client file reviews.
6
13.2 The provider shall permit persons duly authorized by the Department or the Alliance to inspect and copy any
records papers, document,, facilities. goads and services of the provider which are relevant to thiti contract, and
to interview any clients. employees, and sub - provider employees of the provider to be assure th= Alliance of the
satisfactory performance of the terms and conditions of this contract. Following such review. the Alliance veil}
deliver to the provider a written report of its findings. The Provider hereby agrees to correc_ all def'iciellcies
idei;[ifiud lit a timely 111MIner as determint by the Contract Manager.
15. Coordinated Monitoring Frith Other Agencies
If the Provider receives funding from one or more of the State cif Florida ether human service agencies. in
addition to the Department of Elder AfFttrl's, lltel� a �Clii3t t11L7n1tol'lll� Vls1t including Such other a+ ^ei�eies Ilia}' be
scheduled. For the purposes of this contract, and pursuant to s. 287.0575. F.S. as amended. Floriria's Iitamat3
service agencies shall include the Department of' Children and Families, the Department of Health, the Agency
for PerNons vvith Disahilities. the Department of Veterans Affairs. and the Department of Elder Affairs. Upon
notification and the subsequent scheduling of such a visit by the designated agency_ lead administrative
coordinator. the Provider shall comply a ;;d cooperate with all monitors. inspectors, and/or investi
15, Indemnilicatio
The provider shall indemnify, defend, and hold harmless the Department and the Alliance and their officers.
agents, and employees from any claim, loss, damage, cost. charge:, or expense whatever ntlture or character
arising out of any acts, actions. neglect or oinlssion. action in bad faith, or violation of federal or state law by the
Provider, its agents, employees. or sub - provider~ during the performance of this Contract, whet direct or
indirect, and whether to any person or property. It is lrnderstood and agreed that the provider is not required to
indemnify the Alliance for claims arisini_f out of the sole negligence. of the Alliance.
The provider's obli,ation to inden - mify, defend. and pay for the defense or. at the Department's and 1 or the
Alliance's option. to participate and associate with the Department and 1 or the Alliance it) the defense and [vial of
any clailrt and any related settlement negotiations, shall he triggered by tier Department's and 1 or Alliance's
notice of claim fnr indemnification to the provider. The provider's inability to evaluate liability or its evaluation
of liability shall not excuse the provider's duty to defend and indemnify the Department and or the Alliance., upon
notice by the Department and 1 or the Alliance. Notice shall be given by registered or certified mail. return
receipt requested. Only in adjudication <)I 'lid-meat after the highest appeal is exhausted specifically finding the
Alliance solely negligent shall excuse performance of this provision by the provider. The provider shall pav all
costs and fens related to this obliL)ratioii and its enforcement by the Department and 1 or the Alliance. The
Alliance's failure to notify the provide, of a claim shall not release the provider of the above duty to defend and
indemnify. 1,6 * 9j15]15
15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida la Paragraph J5 is not applicable to contracts
executed be.tvveen the Alliance and state ;agencies or subdivisions detrned In s. 76 9,28(2), F. S.
17. Insurance and Bonding
17.1 The provider must provide continuous adequate liability i13stirallce and worker's compensation insurance
coverage. on a comprehensive basis, and must hold such liability :end worker's compensation insurances at all
times during the effective period of this contract and any renewals) or extension(s) of this contract. The All ianee
shall be included as an additional insured on the provider's liability insurance policy or policies and a copy
of the Certificate of Insurance shall he provided annually or when any changes — occur. The provider accepts
fall re for identifying and determining the type(s) and extent of liability insurance necessary to
provide reasonable financial protections for the provider and the clients to be served under this contract. Upon
execution of this contract, the provider shall furnish the Alliance written verification supporting both the
determination and existence of such insurance Coverage. The limits of coverage under each policy maintained by
the provider do not Ili the provider's liability and obligations under this contract. The provider shall ensure that
the Alliance has the most current written verification of insurance coverage throughout the term of this contract.
Such coverage may be provided by a self - insurance pro =ararn estahlished and operating tinder the laws of the State
of Florida. The Department and the Alliance reserve the right to req uire additional insurance where appropriate.
17.2 Throughout the term of this conn the provide;' must maintain a insurance bond from a responsible
commercial insurance company covering all officers. director~, employees and agents of the provider. authorized
to handle funds received or disbursed under this contract. in an amount commensurate with the minds handled. rhe.
7
degree of risk as determined by tine insttrance company and consistent with good business practices.
17.3 if the provider is a. state agency or subdivision as defined by section 758.28, F.S.. tlae provider shall furnish, upon
request. written verification of liability protection in accordance with section 765.28, F.S. Noticing herein shall
be a0E1strned -.o extend arty party's liability beyond that provided in section 768.28, F.S. (See also Indemnification
clause.)
18. Confidentialitv of Information
The Provider shall not use or disclose any Wforrmatlon concerning a recipient of services Linder this contract for
any purpose 9rohibited by state or federal law oi regulations except with the written consent of a person legally
authorized to give that consent or when authorized by law.
19. Healt1h Insurance Portability and Accountability Act
Where applicable, the Provider shall comply with the Health Insurance. Por[ability and Accountability Act (42
USC 1320d. }. as well as all regulations promulgated thereunder (45 CFR 160, 162. and 164).
20. Incident Deporting
20.1 The Contractor shall t}otify the Department immediately [lot 110 later than forty -eight (48) hours from the
Contractor's awareness or discovery of ccnditiotrs that inay materiLllly affect the Contractor or Subcontractor's
ability to perform the services required to be performed under any contract or at"Freenient which incorporate this
Master Contract by reference. Such notice shall be mode orally to the Contract Manager (by telephone) With an
email to imiatediately follow.
20.2 Tile Provider shall immediately report knowledge or reasonable suspicion of abuse. neglect, or exptoitatinn of a
child, aged person. or disabled adult to t"ie Florida Abuse Hotline on the statewide toll - free te.lepholle number ( 1-
800 96ABUSE). As required by Chapters 39 an 415, F.S., this provision is hinding Moon both the Provider and
its employees.
21. New Contract(s) Deporting:
The Provider ~hall notify [lie AiIiance within ten (10) days of entering into a 110 contrac[ or agreement with any
of tile. remaining four (4) state human service agencies, The notification shall include the following
information: (1 ) contracting state agency: (2) contract nraiw and number; (3) contract or agreement start and end
dates: (4) contract or agreement amount; (5) contract or ag reeirrnnt descriptlon and commodity or service. and (5)
Contract Manager name and number.
22. Bankruptcy Notif ication
During the term of this contract, the Provider shall inimccliately notify the Alliance if the Provider, its assignees,
sub- providers or affiliates file a claim for bankruptcy. Within ten ( M) days after notification, the Provider rnu�t
also provide the following inforim;ation to the Alliance: ( 1) the elate oi' filing of the bankruptcy petition; (2) the
cast number. (3) the court name and the division in which the petition was filed (e.g., Northern District of
Florida. Tallahassee Division) , and, (4) the name, raddress, and telcpllonc number of the bankruptcy attorney.
23. S ponsorship and Publicity
23.1 Any nongovernmental Organization which sponsors a program financed partially by state funds or funds obtained
from a state agency shall. in publicizing, advertising, or describing the sponsorship of the program, s #ale:
- 'Sponsored by. the State of Florida. Department of Elder Affairs and Alliance for Ageing Inc." If the sponsorship
reference is in written material. the words "State of Florida, Department of Elder Affairs and the Alliance fur
Aging' shall appear in the . ~rime size letters or type as the name of the organization (ref.: section ?8b?5. F. S.).
This shall include, but is not limited to. any correspondence or other writing, publication or broadcast that refers
to such program.
23.2 The provider shall not use the words "State of Florida. Department of Elder Affairs" and/or "The Alliance for
Aging, Inc." to indicate sponsorship of a program otherwise financed unless specific authorization has been
obtained by the Alliance plio:' to use.
24. Assignments
24.1 The provider sltalI not assign its rights and responsibilitics under this contract without the prior written approval
of the Alliance. All contracts or agreements incorporating this Contract by reference shall remain binding upon
iy
the sucressol:s in iintel of either the ProN'der or (Ile Alliance for Agin;. IFnc.
24.2 No approval by the Alliance of any assignrr]e)nt t7r subcontract shall L ,e deemLd in any event uF' in any manner to
provide for the incurrence of any obligation of the Alliance in addit_on to the dollar amount agreed upon in this
contract.
243 The State of Florida is at all times entilh -,d w assign nr transfer. in whole. oF' part, its rights, duties. or obligations
under any contract or agreement to another governmental a�enc in tine State of Florida, upon giving prior written
notice to the. Provider. In the event the. State of Florida transfer of the Provider's ohlinations, the
Provider remains responsible for all wort; performed and all expenses incutl'ed ern ii71]r]�Ct1C1n W'rth the CLlntrarct or
agreement.
25. Subcontracts:
25.1 The Provider is responsible For all work performed and for all conlmadit�es produced pursua to this contract,
whether actually furnished by the Provider or its sub- providers, Any subcontracts ;hall be evidenced by a written
acree.nient .subject to all applicable terms and conditions M this contract. Alliance approval of the service
application presented by the provider' shall constitute Allian approval of the prov'ider's proposed subcontracts its
the subcontracts follow the service and funding information identified in tine provides'' service application. All
Other subcontracts proposed to be funded under this contract must be approved in advance by r1]e alliance. The
prilv'der agrees that the alliance shall snot be liable to any sub - provider in any way or for any reason. Tine
provider, a t its expense, will inden]ni1=y and defend the Alliance against any sub - provider' claii]]s.
25.2 Tine provider shatll pronnplly pay' any° sub - providers. FatilElrc to pay sub- providers Pursuant to my subcontract or
as required by lave may result in enforcel - nent action under Ellis contract.
25.3 The provider maintains respol]sihiiity for the monitorI z and periot�nnance of all subcnntl'acts in accordance with
all appliI cal3le federal and state laws. Subcontractor mr.7nitnriln4� Onus[ be done annually.
25.4 Tile Provider shall have aL procurement policy that assures m<ixirnum free and Open c_rmpetition• Stich
pr'oc.urement policy must conform, as applicable. with Federal and State contractinz,• and procurement regulations.
as set forth In Title 45 Code of Federal Rcgulartiorls (CFR) pant 74 - Sub -Part C. Ch.287.057 Florida Statutes
(F.S.). U.S. Office of Management and Budget (OMB Circular 110. Florida Department of _Management
Services [DMS] Rule 6OA -1, Florida Administrative Code., and with the Department of Elder A #fairs Program
and Services Handbook 2012
25.5 Service Cost Reports and unit Cost Nletliodologi! Reports:
The Provider shall submit annually to the Alliance Sel' Cost Re xll�ts, vviniclt F'effcct actual costs of providing
each -service my program. This report is due to tl]e Alliance 30 days urwr the contract year ands. The Providel'
shall also submit, annually. Unit Cost Melhorjol2gy ke ort5 reflecting the a�nni�tti Bisdgetcri lust details for each
program. This report is due Co the Alliance 30 buys prior to the start of the. new cant }'act. These two reports
provide ilnformation for planning, and nc6otiating unit rates. as well as source documents used ill the Alliance's
annual momtortng of the Provider-
26. Funding Obligations:
26.1 - rbe Alliance for Aging• Inc. acknowledges its obligation to pay the Provider for' the performance of tl]e
Provider's duties and responsibilities set North in any Contract Of agree i]t isneorporating Ibis Contract by
reference.
26.2 The Alliance shall not be liable to the provider for costs incurred or performance rendered unless such costs and
perfornnal]ce.s are strict.ty in accordance with the terms of this contract. including but no_ limited to terms
governing the provider`s promised perforaianc.e and unit rates and/or reimbursement capitations specified.
26.3 The Alliance shall not be liable- to the provider for any expenditures which are not allowable costs as defined by
applicable federal or state law, or which expenditures have: not been made nn accordance with Tile ter'inns of tills
contract or fiscal or programmatic ctTuidelines and requirements outlined by the current Department of Eider
Affairs Prow rams and Services Handbo:nk.
26.4 The Alliance shall not. be liable to the provider for expenditures made in violation of' regul.ttiLrins, the Older
Americans Act, Department rules. Florida Statutes. or this contract.
27. Inds endent Capacity of Provider
9
27.1 The provider will. be acting In Its i ndependent capacity and not as stn employee. agent or representative of the
Alliance or the Department. The provider shall not be deemed or construed to be an employee, a 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 Clealtiu- or e.stablishin4a the relationship of
employerlemployee between the parties. Y
27.Z The provider shall be rispontiible for completely supervising and directing tile. work under this ::ontract whether
performed by the provider or by any sub- provider that it may utiIir.e. The provider shall be re spa ntiihle for all Suh-
providers who perform work under this contract. The provider agrees that it is as fully responsible for the acts and
orillssions of its "Lib- providers and of persons employed by there, as it is for the acts and on�issinns of its ow
employees.
27.3 It is furthel understood that th Alliance does not control the employment practices of the provider and shall not
he liable for any wage and hour, emplo discrin ination, or other labor and employment ela'inls against the
provider or its sob- provider's. All deductions for social Security, withholding taxes. income taxes, contributions to
unemployment compensation fluid~ and ale necessary insurance for the provider shalI be the sole ias pan sibility i_ - ,f
the pi
28. Payment
28.1 Pavnlents shall be made to the Provider as services are rendered and invoiced by the Provider. The Alliance's
Contract. Manager will have final approval of the Invoice for payment, and will approve the invoice for payment
only if the Provider has met all terins and conditions of the coiaract, unless the bid Specifications, purchase order,
or this contract specify ratllerwise. The approved invoice wiif he submitted to the Alliance's finance section for
budgetary approval and processing,
28.2 Payment Docutuentation Required
The provider shall maintain docum loll to support payllle.3ll requests which shall be available to the
Comptroller. file Department, or the Alliance upon retlueSt, invoice; must he submitted in st.ifflcie.nt detail for a
proper pre audit and post audit thereof. The provider shall comply with all state and federal iaws governing
payments to be made under this contract including, but not limited to the following; (a) paragraph (16) (b) of
section 216.181, F. S.. regarding advances; [b) Rule 691 - 40.103 F.A.C. pertainin- to Restriction of Expenditures
from State funds; and (c) the Contract Payment RegUiMllents sub- section of section C of the Reference Guide. for
State Expenditures from the Depaillnent of Financial Services h ttn: Ilwvvv�. d bf.state .fl_ uslaadirfr u ference 011 CIC / }.
The provider shall maintain detailed documentation to support each item on the itemised invoice OF payment
request for cost reimbursed expenses, including, paid sub - provider invoices, and will be produced upon request by
the Alliance. The provider shall only request reimbursement for allowable e.xpcnseti as defined in the laws and
guiding circularS cited il this ct in tile'. Reference Guide fo State Expenditures, and any other laves or
regttialiOtis, as applicable, and that administrative expellees do not exceed anlount.s budgeted ill the provider'~
approved service application.
The Provide; will certify that detailed documentation is available to support each item on the itemized invoice or
payment request for cost reimbursed expenties, tired rate or deliverables contracts or agreements incorporating
this Contract by reference, including paid Sub - provider invoices, and will be produced upon request h the
Alliance or the Department. The Provider will further certify that reimbursement requests are only for allowable
expenses as defined in the laws and ;aiding circulars cited lit Sections 6 and 7 of this Contract. in the Reference
Guide for State. Expenditures. and ally other laves or regulations. as applicable, and that administrative cxpense.s
do not exceed amounts budgeted in the P'rovider's approved are plan -,is developed ill aco with and
pursuant to section 306(a) of the Older Americans Act of 1965, as amended.
28.3 The Provider and Sub - providers shall provide units of deliverables, including reports, findings, and drafts as
specified in this contract to be received and accepted by the Contraci Manager prior to payment.
29. Return of Funds
The Provides' shall return to the Alliance any overpayments due to unearned funds or funds d'Lsallowed and an
interest attributable to such funds purSUant to the terins Gild condItic-ns of .env contract or agreement incorporating
this Contract by reference that were disbursed to the Provider by the Alliance. In the event that the Provider or its
independent auditor discovers that an overpayment has been made, the Provider shall repay said overpavtnent
10
immediately without prior n otification from the Alliance. In the event that the Alliance first discovers all
overpayment has beet) made, the Contract Manay?e.r will notify the Provider in writing of such findings. Sllouid
repayment not be made forthwith, the Provider shall be. charged at the lawful rate of interest on the outstanding
balance pursuant to N. 55,03, F. S., after Alliance's notification or Provider discovery.
30. Data [ytogrity and Safeguarding Information
The provider shall ensure an appropriate level of data SetUrltV for Lhe inf01'111ation the provider 1s collecting or'
using in the performance. of this contract. Ail appropri level of security includes approving and tracking all
provider employees that request system or information access and ensuring that user access has been removed
front a] terminated emplo Tile provider, ttmono other requirements. must anticipate and prepare for the Ioss
or ilformation processing capabilitics. All data and software must he routinely backed up to insure recOVUY
from losses or outage; of computer systems. The security over the back -tip data is to be as stringent as the
protectiotl required of the primary s The provider shall insure all sub - providers maintain written
procedures for computer system backup and recovery. The provider shall. priol to execution 01 this agrecillellt.
complete the Data Integrity Certification foray, ATTACH'I ENT IN.
31. Computer Use and Social Media Poliev
The Department of EIder Affairs has implemented a new Social Media Policy. in addition to its Computer Use
Policy, which applies to all. employees. contracted employees, consultants, (BPS and volunleet's, including all
pertirrnnc.I af'tiiiatai with third parties, such as, but not limited to, Area A4cncles on Aging and vendors. Any
erltitV that uses the ❑epartrncnt'y corrlpute.r' resotir'ce systerlis must comply with the LDepartmelit's policy
retarding social niedia. Social Media includes. but is not hmited to blogs, podcasts, discussion loruills. Wi - s.
RSS feeds, video sharing, social networks life MySpace, Facebook and Twitter. its well as content sharing.
networks such as Flicltir and YOUTubc jbis policy is available on the Department's website at:
http://eideraffair,s.state.fl.us/doe2i/financial.plip).
32. Conflict of Interest
The Provider shall establish safeguards to prohibit ernployces, board members. matlagernent and sub-providers
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal aain. No employee, officer or auent of the Provider of s;lb- Provieler shall
participate in selection. or in tile aw,11 - d of W1 agreement .support::d by state at federal funds if a conflict Of
interest, real or apparent. vvclu]d be involved. Such a conflict would arise when: (a) the cillployee, office'. of
agent; (b) any member of his/her immediate. family: (c) h or her partner. or (d) an organizatiotl which employs.
or is about to employ any of the above., has a financial or other interest in the firm selected for award. The
Pro or sub proVider's officers, employees or agents will ne -ither solicit nor accept gratuities, favors 01
anything of monetary value from providers, potential providers, or parties to subcontracts. The Provider's board
members and management must disclose tL] the Alliance any relationship which may be, or' may be perceived to
be. a conflict of interest within thirty (3M calendar nays of an 1ndiVidual'S (snglllal appointlrlent or pl acement ill
that position. or if the individual is serving• as an iticuEllbent, within thirty (30) calendar days of the
conrmence.rnent of this contract. The Pr'ovider's employees and sub - providers must make the same disclosures
described above to the Provider's board of directors. Compliance with this provision will be nlenitored.
33. Public Entity Crime
Pursuant to s. 287.133. F.S., a person or affiliate who has been placed on the convicted vendor list Following a
conviction For a public entity crime nlav not Submit a bid. proposal. O r reply on a contract to p tiny goods
or services to a public entity may not submit a bid. proposal, or reply oft a contract with a public entity for the
construction or repair' of a public building or public work may not submit bids• proposals, or rep Iius on lease. of
real. property to a public entity: may not be awarded or perform work as a provider, Supplier, sub - provider. ol
consultant under a contract with any public. entity; and play not transact business with any public entity in excess
ol'the threshold amount provided in s. 287.017. ES., for CATEGORY TWO for a period of 3G months following
the date of being placed On the convicted vendor list.
The provider represents and warrants that the provider, its officers, directotss, senior ma il acre Inent. partners,
employees or agents have not been convicted of any public entity cringes within the last 36 months. If the provider
or any of its officers or directors is convicted of a public entity crime during the period Of this agrce3rleilt, the
provider shall notify the Alliance inlulediately. Non - compliance with this statute shall constitate a breach of this
agreement. The provider' mast ensure. that it does not enter into with any svb- provider on the convicted vendors
list or otherwise prohibited from con tract in for state funds pursuant to section 2S7.133. F. S.
34. Purchasing
Procurement of Produets or Materials with Recycled Content.
Reusable materials and products shall be used where economicalf_y technically feasible.
35. Patents, Copyrights, Royalties
If this contract is awarded state funding . and if arty discovery, invention or copyrightable material is developed
produced or for which ownership was purchased in the course of Or as a result of work or services performed
under this contract. the Provider shall refer the discovery, invention ()r raterial to the alliance to be referred to
the Department of State. Any and all patent rights or copyrlght5 accruing under this contract are hereby reserved
to the State of Florida ill accordance with Chapter 286, F.S.
36. Ernergenev Pre ar•edness and Continuity of Operations
36A The Provider shall. within thirty (30) calendar days of the executiort of this contract, submit to the Contract
Mangy €ger verification of an emergency preparedness plan. i n the event of an emergency, the Provider shall notify
the Alliance of esrtergency provistons.
36.2 I the event -I situation results in a cessation of services by a sub - provider. the Provider shall retain i'ttip4n11llrllty
f or performance under this contract ar•d must follow procedures to ensure continuity of op erations without
interruption.
36.3 lit preparation for the threat of an emergency event as defined in the State of Florida Comprehensive E-i
Management Plan, the Department may exercise authority over an area Agency or service provider agency to
implement preparedness activities to improve the safety of tilt elderly in the threatened area and to secure area
agency and service provider facilities to niininlize the potelitial impact of the event. Thcse actions will be within
tile. e.xistink7 roles and responsibilities of the area a��ency and provider.
36.4 In the event the President of tite United States or Governor of the State of Florida declares a disaster or state of
emergency, rhe. Depart1rtent may exercise authority over an area age -ncy or service provider agency to irilplement
cinergency r--lief measures and/or lictivities.
37. Equipment
37.1 Use of Contract Fu nds to Purchase Equipment
No funds under this contract ►vill he used by the Provider to purchase equipment.
37.2 Fquipnent means: (a) all article of nonexpendable. tangible personal propert haying a useful life of more than
one year and an ar:quisitioll cost which equals or exceeds the lesser of the capitalization level established by the
01- altizatioon for the financial statement purposes, or 55.000.00 [tor federal funds], or (b): nonexpendable,
tangible personal property cif a lion- cconsurtiable nature with an acquisition cost of 51.000.00 or "tore per unit,
and expected useful life of' at least one yeas; acid hardback bound books not circulated to students or the general
public, with a value or cost of 5250.00 or more [for state funds},
33. PUR 1000 Form:
The PUR 1000 Form 1s hereby incorporated by reference and available at:
help: llwww. novflotil 'ida.cantlt�ppslvbsl.€ciocll77 [l_PC,'lzI000.pcif'
in the event of any conflict between the PUR 100 Form and any terms or conditions of anv contract or
agreement terms or conditions the contract Shall take precedence o ver the PUR 1000 Form. However, if the
coriflicting terms or conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the
terms or conditions contained in the PUR 1000 Form shall take precedence..
39. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon the Provider
or political mbdivisioil aranIing to the state a security Imerest in the property at least to the amount of state funds
provided for at least 5 year, florn the date of purchase or the completion of the improvements or as further
required by law.
12
40. Dispute Resolution
Any dispute concerning performance of the contract shall he decidec. by the Contract Manager. who shall reduce
the decision to writing and serve a copy on the Provider.
41. Financial Consequences of Nnn Performance
If the Provider fai4s to meet the minin1u11l level of service or performance identified in this agreement, or that is
clistQrntil'y for the industry. then the Alliance must apply financial corlsequenc.es ConllTienSuratE with the
deficiency. Financial consequences may include. but are not Iii -cited to, contract suspension. refusing p ayment,
withholding payments until deficiency cured. tendering only partial payments, and/or cancellation of carltract
and reacquiring services From ill alternate source.
41.1 The Provider w not he charged with Financial consequences, when a faiiure to perform arise. ntlt of causes that
were the responsibility of the Alliallce.
42. No Waiver of Sovereign Immunity
Nothing contained in this agreement is intended to serve as a wwver of stive.ri igrt mnrnunity by any entity to
which sovereig11 inullurlity may be applicable.
43. Venue
if any dispute arises out of this contract, the venue 01� such legal reci)urse will be Miami -Dade CCLinty. Florida,
44. Entire Contract
This contract contains 'all the terms and conditions agreed upon by the Parties_ No oral agreements or
representations shall be valid or binding upon the Alliance or the Provider unless expres ly cc retained herein or
by a written anleridnient to this contract signed by both Parties.
45. Farce Ma'etire
The Parties will not be liable for any delays or !allures 1!l ped - 01 . 1 lttnce {hie to circumstance~ Beyond their control.
provided the party experiencing the force 111,ljeure condition provides ilnrnecliato written nouficativii to the All
Marty and takes all reasonahie efforts to cure the condition.
46. Severahility Clause
The Parties agree that if a court of competent jurisdiction deems any term or conditio,t laer�eill void or
urienforceahle; the other provisions are severable to that void provision and shall remain in full force and effect.
47. Condition Precedent to Contract: App rol miatio n s
The Parties agree that the Alliance's perfi�rrnanee arld obligation to pay under this contract is contingent upon an
annual appropriation by the Legislature to the Department and a corresponding allocation under contract from the
Department to the Alliance.
4$. AdditionlDeletion
The Parties agree that the Alliance reserves the right to add or to delete any of the services r quired tinder this
contract when deemed to be in the State. of Florida's best interest and reduced to a written ainelldment signed by
both Parties. The Parties shall negotiate compensation for any additional services added.
49. Waiver
The delay or failure by rile Alliance to exercise or ell force any of its rights under this contract will not constitute
or be deemed a waiver of the Alliance's right thereafter to l enforce those. rights, ,or will any sinfle or partial
exercise of tiny st►ch right preclude an _y other or further exercise thereof or the exercise of any rather right.
50. Compliance
The Provider shall abide by tall applicable current federal statutes. laws, rules Lund regu'ations as well as
applicable current state statute~, laws, rules and regulations. The Parties agree that failure of the Provider to
abide by these laws shall he deemed an event of default of the Provider. and subject the. r()ntract to inirnediale.
unilateral cancellation of the contract at the discretion of the Alliance,
13
53. F i nal Invoice
The Provider shall submit the final invoice for payment to the Alliance as specified in Paragraphs 3.4, 3.1.1 and
3.4.2 (date for final request for payment) of ATTACHMENT L If (lie Provider fails to submit final request for
Payment by the deadline, then all rights to payment may he forfeited Mid the Alliance may not honor uny requests
submitted after the aforesaid Lirne period, Any payment due under the terms of this contract may he vvitllhelcl
until all report, due from the Provider and necessary adjustt]cnIs' tile Few have been approved by :he Alliance.
52. Renegotiati or Modifications
Modification; of tile provisions of this comract shall be valid only when they have been reduced to writing, and
duly Signed by both parties. The rate ol' payment and the totai doiliir amount may be adjusted retroactively to
reflect price level increases and changes in the rate of payment when these have been estaEllished through the
appropriations process and subsequently identified in the Alliance's operating budget.
53. Suspension of Work_
The AiIIunce may in its SoIc discretion suspend any or all activrtes, u ri de I t11is contract vvlien in the Department of
Elder Affair determine that it is in the best interests of State to do so. The Alliance Shall provide the Provider
written notice outlining the particulars of suspension. Fxan of the reason for suspe include, but are not
limited to, budgetary constraints, declio of emer,ency, or other such cir'cuknstrrnces. Alter receiving a
suspension notice, the Provider shall comply with the notice and shall not accept Inv purchase orders. Within
ninety days, or any longer period agreed to by the Prov the Alliance' shall ellkre.r { i } r sue a notice atttl]orizin��
resumption of work. at which time activity shrill resume, or (2) terminate the Contract or purchase order.
Sesspension of work shall not entitle the Provider to any additional corl]pir .cation.
54. 'Termination
54.1 This coittracr may be terminated by either party wilhout. cause upon no less than thirty (30) calendar clays' notice
M tvriLing to the other party sinless a "ooller time is rrltttually agreed upon in writing. Said notice shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verif"icatiort ,71' delivery or by
hand deIIver'y' to the Contract Manager or the representative of the Provider responsihle for administration of the
contract. The Provider shall not furnish any product after it receives the notice of termination. except as
necessary to complete the continued portion of the contract, if any. The Provider shall not be entitled to recover
any cancellation charges or lost profits.
54.2 In the event funds for payment pursuant to this contract become unavailable, the Alliance may terminate this
contract upon no less than twenty -lour (2`1) hours' notice in writing to the Provider. Said notice. ilia!! be
delivered by U.S. Postal Service or anV expedited delivery tierv'ice that provides verification -of delivery or by
hand delivery to the Contract Manager or rl1P repretientatrve of the Provider responsible for adt-linistration of the
contract. The Alliance will be (he final atkthority as to the availability and adequacy of funds. In the event of
termination of this contract. the Provider will be compensated for any work satisfactorily completed prior to the
date of termination.
54.3 Termination for Cause:
This contract may be terminated for cause upon no less than twenty four x24) hours' notice in writing to the
Provider. Waiver of breach of any provisions of this contract shall not be deemed to be a waiver ol' any other
breach and shall not be construed to he it modification of tile, terms and conditions of this contract. The
provisions herein do not limit the Alliance's or the Provider's rights to remedies at law o in equity.
54.4 Failure to have performed any contractual obligations with the Alliance in a mariner satisfactcry to the Alliance
will be, a sufficient cause for termination. To be terminated as a Provider under this provision. the Provider must
have (1) previously failed to satisfactorily perform in a contract with the Alliance, been notified by the Alliance
of the unsatisfactory performance, placed by the Alliance under it corrective action plan and failed to correct the
kill Satisfactorr performance to the satisfaction of the Alliance as outlined in the corrective action plan: or (2) had
a contract Laminated by the Alliance for cause.
54.5 Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and
shall not be construed to be a modification of the teams and conditit �rls of this corlt.ract. The prxlvrsions 1lercin do
not limit the Alliance's right to remedies at law or to damages of a legal or equitable nature.
14
5 �. Su ccessors
This ctmtritct shall rcihlilin bindirh�- tipnll the successors in interest of either the Alliance or the provider,
56. Electronic Records and Signature
The AAA authorizes, but does riot require, the Provider to) create and retain electronic re.ctsrds and to use
electronic Signatures to conduct transactions ntcessary to carry out the terms of this Contract. A provider that
creates and retains electronic records and uses electronic signittires to conduct trall5actiulls shali conhply witll
the requirements contained in the Uniform Elec is Transaction Act, s. 668.50, Fla. Stat. All electronic
records nlust be fully atiditable_ are subject to Florida's f'rihlic• Records Law. Ch. 119, and Fla. Scat.; must
comply with section 28, Doter relic �ril� and Scrfegvorrlrrig lnji)r'mation; must maintain all coilfidentialit-y, as
applicable. and must be retained and llli3iittained by the Provider to the sanie extent as non- electl records
are retained and m aintained as reclulred by this Contract.
56.1 The AAA's authorization pursualrl: to this sectioil does not allt'lol electronic tr.insactions between the
Provider and the AAA. The Provider is authorized t cnnduci clectronic transactions with the AAA only upon
further written consent by the AAA.
56.2 Upon request by the AAA, tilt Provides' shall provide the AAA or DOEA with no electronic (paper) copies of
records. Von - electronic [paper) copies provided to the AAA of any document that was originally in electronic
form with all electronic signature nhust indicate the person and the person's capacity who eiectrollically signed
the document on any clan - electronic cope Of tilt. dnculnent.
57. Sve.cial Provisions
The Provider agrees to the. I Pravislcl11
57.1 Investigation of Criminal Allegations;
Any report thai Implies criminal intent nil the. part of the Prav'Jer' or allY stib- providers and referred to a
governmental or lnvestiga agency must be sent to the Alliance. If the Provider has reason to believe. that the
allegations will be referred to the State Attorney, a law ellforcel:leltt ageticy, t11c L]niLed States Attorne
-
office, or o ther governmental ,t- enc.y, the Provider shall nntily the contract manager. A copy o1 all docLiments.
reports, notes or other written material concerning the investigatio". whether in the possession of the Provider
or Sub - providers, n hlist be sent to the Alliances contnact ihlanager vv °it:il a stirllmar_v �)f the investigation and
allegatioils.
57.2 Volunteers
The Provider shall etlstlre the use of ti volunteers in Providing direct services dclivere.d to older
Individtials find individual with disabilities needing such services. If possible, the Provider shall work ill
coordination with organizations that have experience in providing training, placement, and stipends for
volunteers car participants ( suclh as organizations carrying ai.it federal service. proal'allls administered by the
Corporation for National and Community S in comiminiiy service settings.
57.3 Enforcement:
57.3.1 dll acco rd ince with Section 430.04, F.S., the Alliance may. 4vtt1u7ut taking "illy Intermediate measures availabie
to it against the Provider, rescind the Providers designation as an area Agency on Etaing. 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 ptlrstlant to any Contract or agreement Incorporating this Contract by reference, or substantially and
neaatsvely affected the operation of services covered under any contract or agreement:
57.3.3 The Provider lacks Financial stability sufficient to illeet contracmd ohligations or that c��ntracttiad funds have
been misappropriated:
57.3.E The Pn�vider has committed ihlLSkiple or repeated violations of legal and regulatory standards, regardless of
whether such laws or regulations are enforced by tine Alliance. or the Provider has committed or repeated
violations of Alliance standards:
57.3.5 The Provider has failed to continuc (ike prc }vision or expansion of .services after the declaration of a state of
emer-encV; and /or
57.3.6 The Provider has failed to adhere to '.he terms of any contract ar agreement incorporating this Contract by
reference.
15
557.3.7 In the alternative, the Alliance may, as its sole discretion, in accordance with section 430,04. P.S., take
immediate ireasure.s agrainst the Provider, including: corrective action. tinannounce.d speckd monitoring.
temporary assumption of the operaticm of one or more contraNu ll servicesti placr:mel�t of the Prt ?videi' on
probationary status, imposing a moratO riurn till Provider action, imposing l'Manciai penalties for
nonperformance. or other administrative action PLSrstlant to Chapter 120.. F.S.
57.3.$ The provider consistently misses performance measure targets, or noes not demonstrate to the satisfaction of
the Alliance that a program budget surp1Lis /dCf icit problem is being addressed in order to avoid Closing out the
contract year with a budget variance of more than two percent.
57.3.9 In nutting any determination under this provision the Alliance may rely upcnz t.lie findings of Another state or
federal agency, or other reguiatory body. Ally claims for damages for hreach of any contract or agreement
are exempt from administrative pl'c7ceedings and shall he brought
incorporating this Contract by referejjce
before the appropriate entity ill the venue of Miami -Dade County.
57.4 Lase of Service Dollars:
The Provides will optitniae the rise. of contract funds by serving the maximum possible. nilmber of individuals
With appropriate care plans with the services ifiawed by this contract. The Provider will spend -,ill federal, state.
and other funds provided by this c0litract to provide suers Sery ice S.
57.5 Surplus/Deficit Report:
The Provider will subiYlit a consolidated surplusldefic1t report by plecraln in a Format provided by the Alliance to
the Alliance's Contract Manager with the monthly request for pavments accordirio to the caiend_Lr on Attaschmeill
VIII,
57.6 Surplus Recapture.
In accordance with its surplus /deficit ]nana lTement policie.s> in order to nt rxilnir: available Funding and minimize
the time. that potential clients must Wait 'ter service:. the AAA in its sole discretion can reduce funding awards if
the. Provider is not spending accord inU to nwnthIv plalis and is projects d to ineur a surl)lns at the end of the. year.
58. Official Payee and Re resent.atives i Name s. Addresses. and Telephone Numbers]:
- l'he Warne, address, and telephone number o the representative for the Alliance for this contract is:
Max B. Rothmo+r. JD, LL.A4.
Pre sale m an(/ cl 0
760 NW 107 Ave, Suite 214
Miami, Florida 33172
(305 670 -6500, Ext. 221
Tile 1}arne, address. an(i telephone ntunber of the representative of the ps'ovider responsible for administration of the
program under this contract is:
The Provider naiz}e, as shown on page i of this
a. contract, and mailing address of the official payee
to whom the payment shall be made is:
Monroe County Board of Con
I 100 Simonton Street, 2"` floor
Key West, FL 33040
The name of the contact person and sts'eet address
b_ where financial and administrative records are
maintained s:
Sheryl Gradiam, Senior Director
Monroe County Board of Commissioners
1 100 Simonton Street, 2`" floor
Key West, FL 33040
1 6
The name, address, and telephone number of the Sheryl Graham, Senior Director
C. representative of the Provider responsible for Monroe County Board of Commissioners
administration of the program under this contract 1100 Simonton Street, ? " floor
Key West, FL 33040
(305) 292 - 45.10
The section and location within the AAA where Laurie Semo, CFO
d- Requests for Payment and Receipt and 760 NW 107th Avenue, Suite214
Expenditure forms are to be mailed is: Miami, Florida 33172 -3155
Contract Manager
The name, address, and telephone number of the Alliance far Aging, Inc.
e 760 NW 107th Avenue, Suite 214
Contract Manage;- for the AAA far thin contract is:
Miami. Florida 33172 -3155
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party and the notification attached to the originals of this contract.
In the event different representatives are designated by either party after execution of this contract, notice of the name and
address of the new representative will be rendered in writing to the other party and said notification attached to originals
o this contract.
51. All Terms and Conditions Included
This contract and its Attachments, I through X. A. B, C, D, E, R G, H, K and any exhibits referenced in said
attachments, together with any docunjea,ts incorporated by reference, contain all the terms and conditions
agreed upo-ii by the Parties. There are no provisions, terms, conditions, or obligations other than these
contained herein, and this contract shall supersede all previous coinmt3nications. representations or agreements,
zither written or verbal between the Parties.
By signing this contract. the Parties agree that they have read and agree to the entire contract.
IN WITNESS THEREOF, the Parties hereto have caused this 68 page contract, to be executed by their undersigned
officials as duty authorized.
Monroe County Board of Corninissioners,
Provider : Social Services /In- Horne Services
7
SIGNED BY: ��
I��
NAME: SHERYL GRAHAM
ALLIANCE FOR AGING, INC.
� C
C
SIGNED BY:=
NAME: MAX B. ROTHMAN,1D, LL.M.
TITLE: ACTING COUNTY ADMINISTRATOR
DATE: Q -
SIGNED BY:
NAME: DANNY KOLHAGE
TITLE: MAYOR
DATE: _ -- ) 0 / 17
TITLE. PRESIDENT AND CEO 5
DATE: `CEP a 21 f7t`' .-
INDEX TO ATTACHMENTS
Attachment I
SERVICE PROVISIONS HOME CARE FOR THE ELDERLY
Attachment II
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 IX
REQUEST FOR PAYMENT FORM
Attachment X
RECEIPT AND EXPENDITURE REPORT
Attachment XI
COST REIMBURSEMENT SUMMARY
Attachment A
DOEA HANDBOOK
Attachment B
CIVIL RIGHTS COMPLIANCE CHECKLIST
Attachment C
REFERRAL PROTOCOL AGING AND DISABILITY RESOURCE CENTER (ADRC) —
OUTSOURCED FUNCTIONS
Attachment D
DOEA COMPUTER USE POLICY
Attachment E
BUSINESS ASSOCIATE AGREEMENT
Attachment F
E- VERIFY
Attachment G
BACKGORUND SCREENING AFFIDAVIT OF COMPLIANCE
Attachment H
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
Attachment I
ALLIANCE FOR AGING SURPLUS DEFICIT POLICY
18
ATTACHMENT I
COMMUNITY CARE FOR THE ELDERLY PROGRAM
SECTION 1. SERVICfES TO BE PROVIDED
I.I. DEFINITIONS OF TERMS AND ACRONYMS
1A.1 CONTRACT ACRONYMS
Activities of Daily Living (AD.L)
Adult Protective Services (APS)
Adult Protective Services Referral Tracking Tool (ARTT)
Assessed Priority Consumer List ( APCL)
Comprehersive. Assessment and Review for Long- Te.r :n Care Services (CARES)
Cornl7llmit Care for the Disabled Adu :t (CODA)
Community Care for the Elderly (CCE)
Client Tnforrnation and Recistration Tracking System (C1RTS)
Department oi' Children and Families (DCF)
Department of Elder Affairs (DOEA)
Home Care for Disabled Adults (HCDA)
Instrumental Activities of Daily Living (.IADL)
Planning and Service Area (PSA)
1.1.2 PROGRAM SPECIFIC TERMS
Adult Protective Services Referral Tracking Too]: A system designed to track DCF APS referi to AAAs
and CCE Lead Agencies for vicurns of second party ahosc, neglect, and exploitation whc need home and
community- based Services as identified by APS staff.
Aging Out: The condition of reaching Coil years of ace and being transitioned from the Department of Children
and Families (DCF) Services. Community Care for Disabled Adults (CODA) or Home Care for Disabled
Adults (14CDA) services to (lie Department's community -Based services.
Area Plan: A plain developed by the area at c3icy cm alTing Out] ii1ing a comprehensive and ccord1nated service
delivery system in its planning and service area in accordance with the Section 306 (42 L.S.C. 3026) of the
Older Americans Act and Department iEiStructiow, The Area Plan includes perfor'rtiance mew ores and unit
rates per service offered pei' cnunty.
Area Plan Update: A revision to the area plan wherein the area agency on aging enters CCE specific dataI in
the C.iRTS. An update may also include otlier revisions to the area plan as. instructed by the Departmient.
Functional Assessment: A comprehensive, systematic, and multidimensional review ol' ar person's ability to
re.rnain independent and in the least restrictive 11 v1 1; iirrangement. DOEA Form 701 B is tktied by case managers
to conduct the functional assessment.
1.2 GENERAL DESCRIPTION
1.2.1 General Statement
The primary purpose of the CCE program is, to prevent, decrease or delay premature or inappropriate and
expensive placement of older persons iii nursing Homes and other iE1Stitutiuns.
1.2.2 Community Care for the Elderly Mission Statement
The CCE Program assists functionally impaired elderly persons in living its independently as possible in their
own Homes or in the primes of relatives or caregivers. The program provides a continuum o. care through the
deveIopme.nt, expansion, reorgan1z.ation rind coordination of multiple corn munity -based tie rvIecs to assist elders
to reside in the least restrictive environment suitable to their needs.
1.2.3 Authority
The releva3nt authority govern ing CCE program are.:
(1) Rule 5SC -l. Florida Administrative. Code
(2) Sections 430.201 through 430.207. F.S.
1.2.4 Scope of Service and Eligible Individual
The services to be provided are those described in the provider's service provider application submitted in
19
response to the 2011 CCE RFP and as described in this ccnZtract. The Con ity Ctare for tl,c 1=.iderly (CCF)
Program The major goals of the proorain are to preserve fhe independence of eldel:s and prevent or delay more
costly instiltitional care ihrotlClz a community care. service. system that provides case management and rather in
home and community Services as needed. under the direction of << lead agency and provide a continuairZi ol'
service alternatives that meet the diverse needs of functionally impaired elders.
1.2.5 The provider's service provider application submitted in response to the 2011 CCE RFP. as well as the RFP
itself is incorporated by reference in this contract between the Alliance and the provides and made a part of this
contract,
1.3 INDIVIDUALS TO BE SERVED
1.3.1 General Eligibility
The CCE program provides a cont 1nuam of services for funetional Impa1red elders.
1.3.2 Individual Eligibility
Ira order to receive services under this contract. an applicant must:
(1) Be at least 60 years cif a,Te.;
(2) Be functionally impaired as determined through the initial comprehensive assessinenr, and
(3) Not be dt }ally enrolled in the CCE program and a Medi ca: d capitated long -term car: pro orain.
1.3.2.1 Targeted Croups
Priority for services provided under this contract s {tali be �,ive.n to those eligible persons assessed to be at risk of
placement in an instI tut ion or xho are IbLiWd. Ile 'Y lected or exploited.
SECTION 11. MANNER O F SERVICE PROVISION
2.0 Conditions
2.1 All services under this contract will he provided in a manner consistent with the conditions set Forth iii the
2013 Florida Department of Elder Affairs Programs and Services Handbook or any subsequent
revisions made to the Handbook and the provider's service provider application Sttbniitted in response to
the 2011 CCF Lead Agency IZFP (SPA). in critic of conflict between the SPA and the Handbook, the
Handbook prevails.
2.1.1 Client access tr} services ass sslt3ent and cli��ihility deteintinatic�n itiust csznforni to the protocols listed in
ATTACHMENT C.
2. 1.2 The provider will offer services batted on clients' Service plans.
2.2 Service Tasks
2.2.1 Referrals for Medicaid Waiver Services:
{ 1} The provider must assess and identify potential Medicaid eligible CCE clients refer these individuals for
application for Medicaid Waiver services,
(2) The provider must require individuals who have been identified as being potentially Medicaid Waiver
eligible to apply for Medicaid Waiver services in order to receive CCE services and can only receive CCE
services while the Medicaid Waiver eligibility determination is pending. 11 (Ile client is found ineligible. for
Medicaid Waiver services for any reason other than failure tea provide required documentation. then the
individual inay continue to receive CCE services.
[3} The provider must advise individuals who have been identified as being potentially Medicaid Waiver
eligible of the responsibility to apple for Medicaid Waiver services as a condition of receiving CCE services
while the eligibility determination is being processed.
2.2.2 Delivery of Service. to Eligible Clients
The provider shall provide a continuum of services that meets tine diverse needs of functionally impaired ciders.
The provider shall perform and report performance of the services in accordance with the current
)0
DOER Prcigtam5 and Services Handbc-ok. The services include the followinc categories:
1) Care Services;
(2) Health Maintenance Services; atici
(3) Other Support Services.
2.2.2.1 Core Services for Programmatic Operation
The Provider shall ensure that core Services include a variety of day care: services.
and other basic services that are most needed to prevent urin(Lcessary institutionalization. Cure services that
the.. Provider will provide must he described on the Service Provider Application and are referenced oil
Attachment V11 of this contract. Core services may include tilt fallowing:
(1) Adult Day Care:
(2) Chore Services:
(3) Companionship;
(4) Fscotl;
(5) Financial Risk Reduction;
t6) Home Delivered Meals:
(7 ) Homemaker;
(S) Housing Improvement:
(q) Legal Assistance:
(10) Pest Control Servicen:
1 l ) Respite Services.
(12) Shopping Assistance; and
[ 13) Transpogati otz
2,2.2.2 Health Maintenance Services
Tile Contractor shall ensure that health maintenance services ere rutttine health servici 5 that are necessary to
help maintain the health of functionally impaired elders. Tile services are limited to medical therapeutic
services. non - medical prevention services, personal care services, home health Aide services. horde nt�rsina
servi ces. and emergency response s%st.ems. Typical services to he provided it the unit rate identified in the
Area Plan as updated. are the following:
{ l ) Adult Day Health Care;
(2) Emergency Alert Response:
(3) Gerontological Counsel
(4) Health Support:
(5) Home Health Aide.:
(6) Medication Management:
(7) Mental Health Counselinocreening:
($) Nutrition Counseling:
(9') occupational Therapy
(10) Personal Cure;
( 1 1 Physical Therapy.
21
(12? Skilled Ntn SCFVices
(13) Specialized Medical Equipment, Services and Supplies; aild
(14) Speech Therapy.
2.2.2.3 Other Support Services
The Provider shall ensure that support services expand the cnntinuuitl ul care. Options to assist functionally
impaired elders and their cirregrv'ers. Support Ser'v'ices are to he provided at the unit rate identified in the
Area Plan as updated. Iii order to ensure optimal client level the targeted yearly' averaLle cas-elnad, (defined
as initial contractual caseload plus all additional referrals as a result of `motley follows the client') inust be
maintained throughout the contract year. ()the,. Support Services include the following;
[ 1 ) Caregiver TraininglSLipport;
(2) Case Aide:
(3) Casa Mi anagement;
(4) Intake;
(5) Material Aid; and
(0) Other.
2.2:3 Aging 00 Contiunaers:
ill be referred by DCF to the ADRC Inr �rlroilnlent into the corresponding
2.2.3.1 All "Aging Out ' coilstiirterti w
aged program managed by the Alliance..
2.2.3.2 Ctinsunui's active in the C.CDA and HCDA pronrams that are turning 60 and are efigihle for CCE andlnr
HCE veil: be Opened in the correspondiiia urged program managed by the Alliance if fundiilc is available. If
furldiii_ is available, these con urnerti will be made active. it fundiilg rs :lot available, they vi il! be waitlistcd
(oI these programs but will be given priority for activatiOil once funding is available.
Consuillea's �rctive in the Medicaid Waiver. upon tinning age 60. will continue t be eligible for atld receive
Medicaid Waiver Sci
2.3 SLRVIC.E TIMES AND LOCATION
2.3.1 Service Tinter
The Provider shall ensure the prtivisic) Oi'the services litited in this coatiac.t is availahle at t roes appropriate
to i client service needs at a minimum. durin normal business hours. Normal bu41ness 1 ours are defined
as Monday 1.111 Friday. 9:00am to 7:00pni. 4
2.4 REPORTS
2.4.1 The Provider shall respond to additional routine and/or sped al requests for information and reports required
by the Alliance in a timely manner as determined by the Contract Manager. The Provider shall establish dire
dates for any sub- providers that permits the Provides to rneet the. Alliance's repoiting rcquire3nents.
2.4.2 Client Information and Registration Tracking System ( CIRTS) Reports
The Provider Sha4f input CCE specific drtta into CIRTS to elisure CIRTS data accuracy foilowing the
Alliance CIRTS Data Integrity Policy.
2.4.3 The Alliance reserves the right to adjust the total award as well as the contracted Lrnit rate to reflect provider
costs and utilization rates based On active clients enrolled in the progr'am-
2.4.4 The Alliance may withl101d payttaent Under the ter ins of this contract, pending the receipt and approval by
the Alliance of complete and ace urate Financial and programmatic reports due from the provider and any
adiustm'e th ereto_ inciuding any disallowance nod. resolved.
2.4.5 The provider shall provide the Alliance with a ll expenditure plan by July 15 or two weeks after this contract
has been signed', a monthly update is due on the 21" dray of each frilfovv'ing month. The expeildittue plan and
2-)
updates host follow the format provided by the Alliance.
2.4.6 The provider shall respond to surplatsldeficit inquiries and will provide ad -hoc report~ acs requested b_y the
Alli ance.
2.5 ELECTRONIC- RECORDS AND DOCUMENTATION
The provider will ensure the collection and niaimenance of client and service inforination on a 11ioiithly basis
frntti the Client tnfortnaatiari alad Registration Tracking Systcrn (CIRTS ). Maintenance includes valid export~
and backul)S of all data and systems according it) Alliance and Department standards.
2.5.1 Timely Data Entry
The provider rz}ust e.riter all ret�uired CCE data Per the Department'~ CIRTS Pnlit.y Guidelines for
consurners alid service s in the CIRTS database. The data nutst he entered into CIRTS before the provider
Submits it; request for paaynlent and expenditure. reports to the Alliance. as per Attachment VIII.
2.5.2 Data Accuracy
The provider will rill} in(}ntitiy CIRTS reports and verify client and service data in CIRTS is accurate. This
report i7ltttil be suhniiu.ed to the Alliance with the monthly request for Payment and expenditure report and
must lie reviewed by the Alliance before the provider's regatest [or payment and expenditure reports can he
approved by the Alliance.
2.5.3 Failure to Maintain CIRTS Database
Failure tcr ensure the collecti011 and Inaintetrance of the CIRTS data may result in the Alliance enactin <- the
"Enforcement" claaw e. of this aure.ement [see 2.71, irtclarding delaying or withk1olding pa }'went noel] the
problen7 is corrected.
2.5.4 Computer System Backup and Recovery
Mach pro' +icier. among other regLi ire tile nts. rnusl anticipate land prepare for the. Ions of In format loil proce.sSirtg
capabilities. The routine bricking up of data and software is requ real to recd ver from losses ter arutagt.- of the
computer system. Data and software essential to) tilt coiltinuerd operation of provider functions must he
hacked up. The security controls over the b.,3ckLIp resources shall be <ts stringent as the prr)tection regttir'ed
of the primary resources. It is recon tinended that a copy of the hacked up data be stared in a secure, offsite
location. 'File provider shall maintain written policies and procedures for conipute.r backup and recovery.
These policies and procedures sliall be niade available to the Alliance upon request.
2.6 PERFORNIANU SPECIFICATIONS
2.6.1 Outcomes
(I) The Provider shall timely subunit to the. Alliance ail reports described in AT'I I,
SECTION 2.4 REPORTS;
(2) The Provider shall timely submit to the Alliance all information described in ATTACHMENT I,
SECTION 2.5 ELECTRONIC RECORDS AND DOCUMENTATION
13) The Provider shall ensure services in this contract are in accordance with the current DOER Programs
and Services Handbook.
2.6.2 The performance of the Provider in providing the services deScribcd in this contract shall be measured by the
current Area Plan strategies for the fallowing criteria:
(1) Percent of APS referrals who are in need cif inlinediate services to prevent further harr_i who are served
within 72 hours:
(2) Percent of elders assessed with high Or moderate risk: environments who 11nproved their environment
score:
(3) Percent of new Service recipient~ with high -risk nutrition score whose nutritional Status ii�iproved:
0) Percent of new service recipients whose ADL assessinent 5 -core. has been maintained or improved:
23
(5.) Percent of new service recipients whose IADL assessment score has been maintai tied or Improved:
(6) Percent ol' family and family assisted caregivers who self - report they are likely to provide cart.
(7) Perce,lt of caregivers whose ability to provide core is maintained or improved after one year of service
intervention (as determined by the caregiver and the assessor):
The Provider's pci will be documented in the Alliance's Li tin ual monitoring report.
2.7 Compliance and Enforcement
2.7.1 The provider shall comply with all the terms and conditions set - forth In this contract, the CC RFP pursuant
to which this contract was awarded. the Service Provider Application and the most recent edition cif the
Departrwrit of Elder Affairs Programs and Service Handbook. The provider is also responsible to respond to
any fiscal or prograrnmatic monitoring items /issue~ within the timeframe stipulated by the Alliance.
Monitoring Items /1 55ue5 may include Corrective Actions. Reportable Conditions or Quality Inlprovclnent
Recornmenciations provided by the Alliance. The provider is ttlso responsible to provide timely response 10
any istyuiry related to program expenditure~ includilws but not limited Lo, addressing program surplus of
deficit and corresponding program spead -out plan.
Failure to ineet any of the contractual requirements or compliance items ni�.ntioncd above will i in the
irnposIL1011 of sanctions rind/ or other enforcement actions by the Alliance.
2.8 PROVIDEWS FINANCIAL OBLIGATIONS
2.8.1 N Level of Effort, and Earmarking Requirement
The Provider must provide a lrlatch o f kit least IU percent of the ccst for all CC services. The match will be
m ade in the form of cash and /or Iii - kind resources. At the end of the contract period, all CCE; funds expended
must be properly matched. State funds cannot he used to match another state- funded prog aril.
2.8.2 Cost Sharing and Co- payments
The provider in conjunction with the Alliance shall establish an annual co payincnt goal (amount to he
collected f rom clients'). Using the method pre in the con Department of Eider Affairs Program and
Services Handbook, the provider shall pro_}cct the annual co- pavinems to be collected from each active client
in all income ranges pricer to the start of each fiscal year. The provider is required to meet at least 90 percent
of the goal. Co- payments collected in the CCE program can be used as part of the local match.
The Alliance For Agin Inc. will hold back 5q% of the provider"--, contract amount. The alrlOunt field back
shall be released to the provider after 'O) le- of the adjusted annual goal is collected, but no later than February
1 5th cif t he fiscal year. Hold flack am unts not earned by providers as of February 15th will Ne reallocated to
other providers meeting or exceeding 50 %. of their annual coal. except when no provider agency is tneeting
or exceeding its annual goal, or when an agency that is mucting or e&ceedillg such goal affirms that it lacks
the capacity to receive additional fund, -.
2.9 ALLIANCE FOR AGING RESPONSIBILITIES
2.9.1 Program Guidance and Tecl►nical Assistance
The Alliance will provide to the Provider guidance. and technical assistance as needed to ensure the
successful fllflllment of the contract by the Provider.
2.9.2 Contract Monitoring
The Alliance will review and evaluate the performance of the Provider under the terms of this contract.
Monitorin4� shall be conducted through direct contact with the Pro-vidcr through telephone., in writing, or all
onsite visit. The Alliance's determination of acceptable performance shall be conclusive. The Provider
agrees to cooperate with the Alliance in monitoring the prngress of c«mplt.tion of the service tasks and
deliverables. The Alliance may use, but is 11nt limited to, one or mo re of the following methods for
mollilorine:
(1) Desk reviews and analytical revicws:
(2) Scheduled. unscheduled and follow -up on -site visits;
(3) Client ,visits
(4y Review of independent auditor's reports:
(S) Review of third -party documents and/or evakir ktioll;
(6) Review of progress reports;
24
(7) Review crf customer satisfaction surveys:
(S) Agreed -upon procedures review by an external auditor or consultant:
(9) Limited - scope reviews: and
( 10) Other procedures as deemed nece5sarv.
SECTION I11. METHOD OF PAYMENT
3.1 General Statement of Method of Payment
The method of payment For this contract includes advance~, cost tGinibursoment for administration costs. as
well as fixed rate and cost reimbur`enient for sen�ices. Payment inav lie authorized for all allowable
expenditures to complete the tasks identified in the deliverable~. in accordance with all applicahle state and
Federal statutes and regulations. and are based on audited historical costs ui insta where an independent
audit is required. All Provider requests fur paynienl a nd expenditure reports 5ubnlltted to support request~ fQI'
payment shall be oil Department forms I06C and 1050, included as Att lchnients IX. X, and l'.. Duplication
or replication of both forms via data processing equipment is perinitisihle, provided all data elements are in the
Sane format as incitided on departilie.nt forms
3.1.1 Provider invoices shall be submitted, no later than 60 days after the end of the month on which the expense
wa incun except that invoices cannot be `ubniitted beyond the date for final invoicing, as Stated in this
contract. invoices submitted lute will not be honored. Exceptions t this rote are at the discretion of the
Alliance, oii a case by case basis, such exceptions niust be requested prior to the expiration c,f the invoicing
deadline. In niakinc* a de.termitiation cif the exception the AIIiancc ve't1I consider whether the disruiptioil to the
billing cycle was beyond the control of the provider, the frequency with which such exceptions are requested
by the provider, and whether the Alliance can request re.imburseniei at a Fite date f 17[]EA. Exceptions
for invoicing Bite after the closeout date will not he made.
3.2 Advance Payments
Non profit providers may request a inc rithly advance for service casts cos each of the first two months of the
contract period, based oil anticipated citsh needs. Detailed doctunentation justifying cash needs for advances
must be submitted with the signed contract, approved by the Alliance. and maintained in the contract
inanager's fill:. All pavine.nt requests for the third through the two -Ifth months shall be based on the
suthrius4ion of tnonihly actual expenditure reports lzeginni�ig vv�ith the first month of the contract. The schedule
for submission of advance requests is ATTACHMENT VIII to this contract. Reconciliation and recouping
of advances m ade under this contract are to be Completed fry October. All advance payments are Subject to
(lie availability of funds.
3,3 Advance funds may be teniporarily invested by the provider in an insured interest bearing account. All
interest earned on contract fund advances niust be returned to the Alliance within thirty (30) days of the end of
the first quarter of the contract period.
3.4 Final Request for Payment:
3.4.1 The provider must submit the final re-quest for payinent to the Alliance no later than July 15, 2015: il' the
provider fails to der so, al! ri�Tlit to payment iti Forfeited, and the Ailiatice will not honor ill requests submitted
after the aforesaid time period.
3.4.2 if the contract is terininated prior to the contract end date of June 30. 2016. then the provider must suhinit the
final request for payinent Lo the Alliance no more than 45 days .:(ter the contract is terininated, but no later
than JIlly 15. 2 If the provider fails to do so, all right to payment is forfeited, and the Alliance will
not honor any requests submitted after the aforesaid time period.
3.5 Documentation for Payment
The Provider will maintain documentation to support payment requests that shall be available to the Alliance
or authorized individuals, such as Department of Financial Services. upon request.
3.5.1 The Provider must require sub-providers to enter all required data per the Departmenl*s CIRTS Policy
Guidelines for clients and services in the CIRTS database. The data must be entered into the CIRTS before
the sub - providers submit their request for payment and expenditure reports to the Provider. The Provider shall
`3 5
establisil time frarnes to assure compliance witit due dates for the requests for payment and expenditure
report,, to the A1liailee.
3.5.2 The Provides must rccluire. sub - providers to run monthly CIRTS report~ and verify client gird service data ill
the CUM is accurate. This report must be submitted to the Provider with the monthly reclue. -4 for payment
and expenditure report and must be reviewed by the Provider before the sub- provider's request for payment
and expenditure reports can be approved by the Provider.
3.6 Remedies for Nonconforming Services,
The Provider shall ensure that all goads and/or services provided under this contract are delivered tinkly,
completely and commensurate with required standards of quality. Such goods anchor sei'vfcc - will only be
delivered to eiigible program participants.
3.6.1 It the Provider fail~ to meet the prescribed quAlty standards :or services. such servicz5 will not be
reimbursed tinder this contract. In addition, any rionconforntin47. goods {including home delivered nteals�
and/or services not nieeting such standards will not fie reimbursed under this contract. The Prtovider's
signature on tile request R11- payment form ccrtities 1 n-kinteriance of supporting docti tientation and
acknowledgement that the Provider shall solely bear the casts assoclated with prepai - ing or providing
nciilcoilforttling hoods and /nr services. The Alliance requires imnlecfiate notice of any Sign'- ficant and /or
sv,stcnnc inI ractlons that compromise the quality. Security or continuity o services Ln chants.
3,6.2 Financial Consequences of Surplus
Provider shall ensure. the provision of services to the prr�jected nunlber of clients in accordance. wi th
Alliance's precasts and within the contract imount. The Provider , ,hail ensure ex penditure of 100'/' of the
contract amount budgeted ror services to clients at the tinit rates estahii.shed in this contract. In the event the
Provider has a surplus of l or more at the end of the contract term. the Alliance will reallocate 1% of the
budget for the next year contract terirl to nther feat! agencies found to be serving clients to the richest extent of
therr allocated budgets.
3.6.3 Consequences for Non - Compliance
The Provider shall ensure that services an reports are performed P ursuant to contract requireilients. It a any
tune the Provider is notified by the Alliance's Contract Manager that it has failed to coiTecLly. completely, Or
adequately perform these service and reports, the Provider will have to d to Submit a Corrective Action
Plan ("CAP") to the Contract Manage; that addresses the identified d iciectcy and states how the deficiency
will be remedied within a time period approved by the Contract Manager. The Alliance may assess a financial
consequence for iron - compliance o il the Provider for each deficiency identil'ied in the CAP which is not
corrected pursuant to the CAP. The Alliance stay also assess a financial consequence for failure' to tiltte.ly
submit a CAP. in the event the Prnvicl�r fails tit correct ten idel_tified deficiency within the approved time
period specified in the CAP, the Alliance may deduct. fr ont the payttlent of the invoice for the following
nionth, 1 `I. of the ,monthly value. of the Management and General Cost's contponelIt 01 the unit rate for etch
day the deficiency i5 not corrected. The Alliance inlay also deduct. from the payllleatt Of the invoice for the
f'ollowillonth. I % of t m
he monthly value of the Management and Genera! Cost's component of the unit rate.
�, .n
for each day the Provides' fails to timely submit ely sub a CAP, beginning the 1 ith day after notification by (lie
Contract Manager (if the deficiency. If. or to the extent, there is Lily conflict between this paragraph and any
other paragraph in this contract, this paragraph shall have precedence.
26
ATTACHMENT II
CIIRTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
AGREFNIENTS
The undersigned certifies. to the best of his or her knowledge and belief, that:
(.1 ) No federal apprclpr'iated funds have been paid or will be paid, by or on behalf of the undersigned, 'o anv person for
influellcing or attempting to inlluellce an L}fiicer o3' einplovee of ally State or federal agency. a member of congress, an
officer or cnlployee of congress. an elrrployee of a rnernber of c.o11gre,,s, or ail officer or employee of t41e state
le��islator, ill connection wit11 the rl�� ardiri�r of any federal grallt, the ma'_king of any federal loan, the entering into of
any cooperative agreement, and the extension, continu.ition. rcnewal, amendment, or mLldificatiall of any federal
contract. grant, loan. or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence a11 ofliLer or enlpla .
yee of any agency, a membel of congress, an officer or mplo of
couQi or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative,
agrecrnent, the undersigned shall complete and submit Standard Dorm -LLL. "Disclosure For to Report Lof?byirlg.'
in acco r dance with AS lntitrLlctioilS.
(3) The undersigned shall require that the lan of this certification be included ill tile awarcl do cuments for all sub -
awards at a tiers [i subcontracts sub - grants, land contracts under `mrils. loans Lind cooperative agreements)
and that all sub- providers shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction Was Made
or entered into. SUbIIIISS1011 of this certification i5 a pl'crequisite for making or entLrnlg into this transaction iillposed
by section 3372, Title 31, U.S. Code. Any person who bails to file the required certification shall b= subject to a civil
penalty of rintless than 510,000 and not Amore. than .S 100.000 for each such f(iilure.
_ J
S l cu latu re Dat
SHERYL GRAHAM KC 1571
Name of Authorized Individual Application or Agreement Nurnher
MONROE C011N SOCCJSOCIAL SERVICES
Name and Address of Or-larlizati011
DOEA Fenn 103
(Revised Nov 20( )?}
Off
27
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT'
The administration of resources awarded by the Alliance for Aging, [lie to the provider m ay be subject to audits aildlor
monitoring by the Alliance or the Florida Department of Elder Affairs, as described in this section.
MONITORING
In addition to reviews of talents conducted ilt accordance with O]M B Circular A -133, as revised, and Sec_ioil ? 15.97, F.S..
(See "AUDITS" below), monitoring procedures may include, but not he limited to. oil-site visits by the Department of
staff, limited scope audits as defined by OMB Circular A -i33, as revised. andlor other procedures. By entering into this
agreement, [lie l]roVl{ er a��recs to comply and cooperate with ally monitoring procedures /processes deerncvd appropriate by
I
he Alliance or the Departrent of Elder Affairs. In the event the Alliance fc:r Aging. Inc. detennines that a limited scope
audit of the provider is appropriate, the provider agrees to comply with ally additional instructions provided by the
Alliance for Aging, Inc. to the provider ref ardint such audit. The provider further agrces to comply slid cooperate with
any inspections, reviews. inv�esti,Tatiow, or audits deemed necess..l - y by the Chief Financial Officer (CFC)) or Auditor
General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the provider is a Stutz or local government or a non - profit organization as defined in OMB
Circular A -133. its r evised.
I !1 rile event that tile. prry -der expends °S750.000 i]r Chore in federal ; warck during its fiscal Ve m, the provider must halve a
single or program- s p ecific audit conducted ill accordance with tilt proviSiorls elf {)N1B Circular A -] 33, as revised.
EXHIBIT 1 to this agreernelit indlc ttte5 federal resources awarded through the Department of fader Af'Fairs tend the
Alliance by this afire- ernent. In determining the - federal awards expended in its fiscal year the provider shall consider all
soil rces of federal awards, illcIudnlg federal resources received from the Alliance or the Department of Elder Affairs. The
determination of amounts of federal awards expended should be in accordance with the guideline~ esrtblishcd by OMB
C1rcuIar A -133. as revised. An audit of the provider conducted by the A Lid itor Gone ral i!1 accordance faith the provisions
of OMB Circular A -133. as revised. wiiI meet the require.nlents of this part.
i!1 Conitection with the audit requircments tlddre;ise.d in art I, paragraph 1. til? provider Shall fulfill the requirements
relative. to auditee responsibilities as provided in Subpart C of ON1B Circular A -133. ,is revised.
if the provider expcnds less than S750,000 in federal awards in its fiscal year, an audit conducted in accordance with the
provisions of OMB Circular A - 133, as revised, iti riot required. In the event that the provider expend~ ':ess 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 frum non- federal resources (i.e., the cost of such audit must
be paid from provider resources obtained from ether titan fedet entities.)
An audit conducted in accordance with (his part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Alliance for Aging, Inc. ~hail be based oil the agre.ernent's
requirements, illcludmg wily rules, regulations. or statutes re fore.nced in the agreement. The. financial state?nents shall
disclose whether or not the matching requirement was met for each applicable at - n All questioned costs and
liabilities due to the Alliance for AgTing, Inc. shall be fully disclosed in the audit report with reference to the Alliance for
Aging, Inc. a- reement involved. If not otherwise disclosed as retluired by Section 310(b) (2) of'OMB Circular A -133. as
revised. the schedule of expenditures of federal awards shrill identify expendihii by agreement ilt.lrllher for each
agreement with the Alliance for Ag ing, f ile. in effect during the audit period. Financial reporting packages re.qu :red tinder
this part must be submitted within the earlier of 30 days after receipt of the audit repol or 9 months after the end of the
provider's fiscal year end.
28
PART II: STATE FUNDED
This part is applicable if the provider is a non -state entity as del'ined by Section 215.137 Florida Statutes.
In the event that the provider expends a total amartnt of state financial assistance cqual to o r in excess of `75(),000 In any
fiscal year of such provider (for fiscal years ending September 30, 20 or thereafter), the provider 111ust have a State
single or project - specific audit fol' such fiscal year in .accordance evilll Sectitr :i 215.'37, Florida Statutes ; applicable• !'isles of
Department of Financial Services; and Chapters 117.550 (local governmental entities) or 10.050 (nonprofit and for -
profit organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance
awarded through the Alliance fol A�7ing, Inc. by this avreenie.nt. In delerniin li; the state financial assistance c cpendcd in
its fiscal year, the provider shall consider all sources of state financial assistance, including state financial assistance
received from the Alliance for Aging.. Inc.. other stale agencies, and other .ion -state entities. State financial assistance
does not iliclude. federal direct or pass - through awards and resources received by a non -State entity For federal program
matching requirements.
In connection with tiie audit requirements addressed in fart 1I. paragraph 1; the provider shall ensure that the audit
colnphes wide the rcc;u ire ments of Section 215.97(8), l Statute S. This includes submission Of a financial reporting
package as defined f'y Section 215.97(2), Florida Statutes, and Chapter 11).550 ( Iocal governmental entities) or 10.650
(no(lprofit and for - profit organizations). Rules of the Auditor Cie nerai. ti
If the pi expends less than S750,()00 in state Financial assistance ill it4 fiscal year (for fiscal years beginning can or
after Jaary 1, 201 `�), an audit conducted in accordance with the provisions of Sect ioli ? 1 S.�y7, Flol'ica Statutes, is not
n u
required. Ili the event that the provider expends less than 5750,000 in state financial assistance in its fiscal year and elects
to have 'in audit conducted in accordance wide the pl'oVitilonS of Section 21 5.97, Florida Statutes. the cost of the audit
must be paid from the non -state entity's resources ( i.e.. tfie cost of Such all audit must be paid fron the provider resources
obtained from other than State entities).
An audit conducted in Accordance with this part shall cover the entire organization for the organization's fiscal year.
agre.ctileilts with the Alliance for Aging, Inc. sliall be bused on ;b
the agree ent's
Compliance findings related to
1 including any applicable rules, regulations. or statutes. The financial staleme.nts shall disclose whether ol
not the matching requirement was snot for each applicable agreement. All questioned costs and liabilities due to the
Alliance for Aging. Inc. shall he fully dlsclo in the audit report with l to tiie Alliance tot Aging. Inc.
agreement involved, If not Otherwise disclosed as required by Rule 091- 5.003. Fla. Admin. Code, the sched tile of
expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with [lie
Alliance for Aging, Inc. in effect during the audit period. Financial reporting packages required under this part must be
subrritted within �45 days after delivery Of the audit report, but no later than 12 months after the pro ,ides'S fiscal year end
for local g uovernmentai entities. Non -prof It or for - profit organizatlniis are required to be submitted within 45 nays after
delivery of the audit report, but no later thou 9 nionths after the provider's fiscal year end. Notwithstanding the
LippllcabiIity of Illlti polli on, the Alliance and the Department of Elder Affairs re.t,ain all right and Ohl igat: oil to coon toi and
oversee the performance of this agreement as outlined throughout this docunnent and pursuant to law.
PART Ill; REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with Diu113 Circular A -133, as revised, and recluired by
PART € of this agreement shall he submitted, when recluire.d by' Section .3?[3 w). C..]M$ Cil'ctilar A -l; -}, as revised, by or
a�n beagle of the provider dire ctly to each of the folloWiti-:
The Alliance for Aging, Inc. at eacli of the following addresse%:
Alliance for Aging, Inc.
Attn: Fiscal Manager
7641 NW 107"' Ave. Suite 214
Miami, FL. 33172 -3155
29
The Federal Audit Clearinghouse designated in OMB Circular A -133, as revised (the number of copies required by
Sections .320(d) (I) and (2), OMB Circular A -133. as revised. should he submitted to the Federal Audit Clearinghouse),
at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East lit "' Street
Jeffersonville, IN 47132
Other Federal agencies and pass - through entities in accordance with Section., 320 (e) and (f }. COMB Circular A -133. as
revised.
Pursuant to Sections .320( OM 13 Circular A -133, as revised. the provider shaii submit a copy of the reporting package.
described in Section .320(c ). OMB Circular A -133, as revised. and any management letter issued by the auditor. to the
Alliance for Aging, .Inc. at each of the following addre
Alliance for aging, Inc.
Attn: Fiscal Manager
760 ;•IW 107" Ave. Suite 214
Miami, FL. 3:3172 - 31550
Additionally, copies of financial reporting packages required by Part lI of this aareeillent shall be Stibnlitted by or on
behalf of the provide;' decd to each of the following:
The All imice for Aging. Inc. at each of the following addresties:
Alliance for Aging, Inc.
Attn: Fiscal Manager
760 NW 107` Ave. Suite 214
Miami, FL. :33172.3155
The Auditor GeueralIs Office at rile following addreS,
State of Florida Auditor General
Claude Pepper Building, Room S74
I I 1 West 11ladison Street
Tallahassee, Florida 32399 -1450
Any reports. management letter, or other information required to be submitted to the Alliance for Aging. Inc. pursuant to
this agreemem shall he Submitted timely in accordance with OMB Circular A -133, Florida Statutes, and Chapters 10.550
(load govel t ile ntaI entities) or ]0.6}0 (nonprofit and for- prolit Organizations). Rule` of the Auditor General, as
applicable.
Providers, when submitting financial reporting packages to the Alliance for Aging. Inc. for audits done in accordance with
OMB Circular A -133 or Chapters 10.550 (local goverri menta I entities) or 10.650 (nonprofit and for- prctit organ izatl oil s
Rules of the Auditor General. should indicate the elate that the reporting package was delivered to the provider in
correspondence accompanying the reporting package.
PART IV: RECORD RETENTION
The provider shall retain sufficient records demo- mstratirlg its Compliance with the terms of this agree +Went 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 Aocess to such records tipern request. The provider Shall ensure that audit working papers are made
ava'table to the Alliance for Aging, Inc., or its designee, the Department or its designee. CFO, or Auditor General upon
request for a period of six years from the date the audit report i5 issued, unless extended in writing by the Alliance for
Aging, Inc.
30
ATTACHMENT III
EXHIBIT - 1
i. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIF NT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
PROGRAM TITLE
TO'T'AL FEDERAL AWARD
FUNDING SOURCE ' CFDA AMOUNT
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSLIAN'f TO THIS AGREEMENT CONSIST
OF TUE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
FUNDING SO[IRCE � I AMOUN
PROGRAM TITLE
TOTAL STATE AARD {;
W
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97, F.S.
PROGRAM TITLE FL7NDING SOURCE CSFA AMOCINT
Community Care for the Elderly PF o�ra:n General Revenue 65010 541:3,700.00
TOTAL AWARD 1 $413,700.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO
'PHIS AGREEMENT ARE AS FOLLOWS-
3l
ATTACHMENT III
EXHIBIT -2
PART 1: AUDIT RELATIONSHIP DETERMINATION
provlders whn rece[vc titatc or federal resourcu•, !nay oE' -lay nW l,e. 'ubject to the audit reefuiie nlent5 0l {JIVIF3 C'irctllar A 1 33, as
rvviti 2
cd. and/or Section 15.97, Fla. 5wt. Providers who) are detemimed to be recipients Or soh- rccillicni of federal awa[ds a11i11or
s tin,111cial assistance nlav he subject to the audit requirements if the audit threshold requirements ,ct forth in Part I and/or Part 11
ill' Exhibit I is mel. P"(Wi iers who 11ave floe- deterinined to he vc.rldc?r5 are nut suhjccl to) the au dit requirements elf OMB Circular A-
133, as revised, andior Section 215 -97, Fla. Star. Regardless of whothcr the audit requirement~ arc met. 1)"M de'_s wI ( ha bee 11
delcimlricd to he rcc:ipientti i]! st117- recipients of federal 't\vurds and/or State fitlaincial assistance !-Mist C0111111y with k1lV1icLtllle
progranlnm[ic and fiscal compliance requirements.
In acc.lydunce: with Sec. 210 of Ol''1B Circulatr A -133 and /or Ruie 691 - 5.006. FAC. provider has hcen dctermined to he:
Vendor or excirtpt entity aild 1101 sLlbjCCI iL) () M. B Circul A -133 andlslr Sectit -n 2 15. i'•S•
_X Recipien(1sub -r ipient suh to OMB Circular A - 3 and/or Section 215.1'. F=.S.
NOTE: If a provider is deierrmned in hL: a recipient ISub -"e illlent 0 f federal alnd or State 1 Ilancl aj l astiistancc and h1 is lice approved
by the Department to subconiract, they Illust col"111V with Sect on 2i5- 1 17[.7). F.5 -. an[1 Rulc. f1�31- . t]L][�f2). F AC' [static financial
assistance) and Section — .400 ()U\4B Circular A -13i [fc..der,tl :awards}.
PART 11: FISCAL C:ONIPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE XIATCHING FUNDS ON FEDERAL AWARDS. Prot iders whn recclv'e 1Cdoral aw'.irds or
who Matching funds e I1 leilLrall aG1'ai'i15 atand hi1 a1'4' dL'tl I'11}Inld M(7 he a tiull- rLilplln[ [11 L1st i iilllFllV l4'Itl1 thL. following 11SCal 1i1w5. i'111eti
and reoula(ielns:
STATES, LOCAL GOVERNNIFNTS AND INDIAN TRIBES MUST FOLLONV:
2 CFR Par( 227 Cast Principles for State, Local and Indian Ti Gove-ramenis (For {) v1 C.ircliIar A -87)
(]N4B Circular A -102 — AdmIilistraLlVC Rcquirc.rnC11tS
ONIB Circular A -133 — Audit Requirements
Re1'erellcc Guicic l01 Slate. EXPenditureS
Othcr requirements set forth in program last's, rtiieS and re+'Lll ilit)115
NON- PROFIT ORGANIZATIONS musT FOLLOW:
? CFi2 Par( 23 {� Ccltit PI'inciple5 rile Nc)n Profit (]rganl�auollS (F ly' C)N1I3 Circular A- l 22 — C.c)st Principles)"
2 CF l2 Part 215 1dminitilrEitive Reyuirement5 {I orlllerly t]I11B CirLulcEr A [ If3 — Aciniin +SErtlli�t i�ertuircailr.n[s]
Rerluircl en's)
()MJ3 Circular A -133 — Audi Reg Liiieillents
Reference: Guide fni State Expendilures
0111cr 1 requirements tied forth In program law's. rules and regulat)0ns
EDUCATIONAL INSTITUTIONS ( EVEN IF A PART OF A STATE OR LOCAL GOVF.RNMENTs MUST
FOLLOW
2 CFR Part 22i) Cn.tit F'rincil)les fir!' 1 i1L1[ arielllal instllu OM $ {1 t]i'merly Clrcula!' A -2 1 — Cc'tit Principle~
2 CFR Part 215 Adnlinistra(ive Requirc:menl.s {1 nrnlerly ONfB Circular A -I 10 — AclllainistratiGC Rcq iremen15}
OMB Ciriuiar A -133 — Audit Requirements
Reference Guide iQr Slate Expenditures
Other fiscal requirements set forth in pre�glrtm IuGVS, rules and reIulatiun5
"Some federali programs allay lx exempted Iron complianrc will! the Col,j Principle~ Circulars as n 1te[l ill the {..)iviB Circular
A -133 Con1p]iatnc.e Supplement, Appendix 1-
STATE FINANCIAL ASSISTANCE, ProGiders w' lio reccive stale 11na11c:a1 assistance and Gvho are deterimiled to he a
rccipientlsuh- re.cipier.t mutit crulll,ly with the f0liowing fitical laws, roll s alld i'eruiEStie)T)
Section 215.117, Fla. Stat.
Chapter 691 -5, Fla. Admin. Code
State Projects Compliance Supplc[nent
Reference Ouide for Statc: Expenditures
Other fiscal requirements set forth in program law's. rules and re��tilations
32
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS,
LOANS AND COOPERATIVE AGREEMENTS
The undersigned, an atitll0rized representative of :he Provider named in the contract or agreement to which this form is an
attachment, hereby certifies that:
( 1 ) The Provider and ttrly sub- providers of services under this contract have financial management systerrls c ip.3hlc of
providing certain Information. including: { i ] accurate, current, and complete disclosure of the financial results of each
grant - funded project or program in accordance with the prescribed reporting regtiireillentti; i.2) the source and
application of funds for all agreement suppc,rted activities; and t3) the rornparison of outlays with budgeted amounts
for each award. The inability to process inforintttian itt accordance with these regttirenlents could result in a return of
grant funds that have not been accounted for pre }peri - v.
(2) Managentent lnl'ormation Systems used by the Provider. sub - provides' {s }, or any outside entity (Al which tine I'rnvidei
is dependent for data that is to be reported. transmitted or calculated, have been assessed and verified to be capable of
processing data accurately, inciudlll- year -date dependent data. FoE' those systems identified to l.c non- cs:rnlpliant,
providcr(s] will take imrnedlate action to assure data integrity.
(3) If this contract includes the provision of hardware. software, firi microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing yetrr -date dependent data accurately. Ail versions
of these products offered by the Provider (represented by the undersigned) and ptii'chased by the State will be vilified
for accuracy and integrity of data pries to transfer.
In tilt event of ally decrease in functionality related to time and date related codes and internal suf+r'outines flat
itnpede the hardware or software prograrns from operating properly. the Provider agrees to immediately make
required L'[7r'IL'CFions to restore llal'dW'tti'l' wind tiC]ftW'arL' pr0gritrllS t0 tl1L' shrine li've'n oI functionality as warranted herein,
at no charge to the _State, and wnthout rrlterl'upt to the ongoiilg huffiness of'the state. tiillc being c,€ the essence.
(4) The Provider and any sub- providerts) of services under this contract warrant their policies and procedures irn.lude a
disaster plan to provide for service delivery' to continue in case of an elller'genCy' lnCltldiilg elIler?CIn[ leti ai']4nng from
data integrity conlplittnce issues.
The Provider shall require that the. language of this certification be included in all sub- agjeemcnts, sub - grasps, and other
agreements and that all sub- providers shall certi`y coslipliance accordingly.
This certification is a material representation of fact upon which reliance vas placed when this transactioi3 was made car
entered 'nto . Subm'ssion of this certification is a prerequisite for oinking or entering into this transaction unposed by
OMB Circulars A -102 and 2 CFR Part 215 (formerly OMB Circular A -1 10),
M0NR0 E,(_ 7 '0t]NTY BOC.CIS
Name and_A4drkss of Provider
L
Signature
IAL S);ITVICES- 1 SWS1l ONT 5
1 TE 2 -257. KEY W FST. FL. 3317
q
Date
ACTING COUNTY ADMINISTRATOR
Title
SHERYL GRAHAM
Name of Authorized Signer
(Ravi ed luny 3[1[18}
33
A'ITTACHMFNT V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION. INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOVER TIER COVERED TRANSACTIONS
(1) The prospective provider certifies, by signing this certification, neither it nor its principals is presently
debarred, suspended, proposed for debarment, declared i lie Iigible, or vo It ntarlIV excIUde fi'Orn partielpation in
this tramaction by any federal department or agency,
{2} Where the pi prOv'ide� is unable to �ertifv to any ()t tlle. sttitenle1 t in this certification, such
prospectiv rticipant shall attach an explanation to this certification.
• l�rS
Signature:
Date
_ACTING COUNTY ADMINTSTRATOR Monroe Count. • Board of Commissioners. Social
Services /In -Home Services
Title Agency /Organizatiai V. .
(Certification signature should be same as Contract signature.)
Instructions for Certification
1. The terms "covered transaction," "deharre.d." "suspended." "ineligible," "tower tier covered transaction,"
"person," "primary covered transaction." and "voluntarily excluded." aS used ]lereill. have the ineailings set out
in the sections of rules irnplement.ing Executive; ❑rder 12549. (2 CFR 180.5-190 1020, as Supplemented by
CFR 376.1[) - 376,995), Yau may contact the Contract Manages' for assistance in obtaining a copy of those.
regulations.
?. This certification i5 a material representation of facts upcnl which reliance was placed when the parues entered
into this transaction. If it is later determined that the Provider k now inoIy rendered - ,ill crroncous certification, In
additioit to other remedies available to the federal gt�vernnlel the Department may pursue available re
including suspension an debarment.
3. The Provider will provide linmediate written notice to the Contract Manager 11' at any tulle the Provider learns
that its certification was etl'oneous when submitted or has become erroneous by reason of changed
circurnstance.s. The Provider may decide the method and frequency by which it determines the eligibility of its
principals. Each participant to a lower tier covered transaction may, but is not required to, check the Excluded
Parties List System (FPLS).
4. 'rile Provider will include a "Certification Regarding Debarment, Suspension, tile IIgibility and Voluntary
Exclusion - Lower Tier Covered Transactioil" ill aII its lover tier covered transactions and in all soIicltations
for lower tier covered transactions.
5. The Provider agrees that it shall not knowingly enter into arty Iower tier covered transaction with a period who
is debarred, suspended, deternuned ineligible or voluntarily excluded from participation, unless otherwise
authorized by the federal government.
6. It the Provider knowingly enters into a lower tier covered trarsaction with a person NVihC) is suspended,
debarred. Ineligible.. or voluntarily excluded from participation ill tltis transaction, in addition to other remedies
ay.rilable to the Federal government, tle Depattntent may pursue available remedies, including suspension,
and/or debarment.
The Provider may rely upon a certification of a prospective participant in a lower tier covered transaction that it
is not debarred, suspended, inclicible, or voluntarily excluded from the covered transaction, unless it kilow5
that the certification is erroneo
34
r [irx isLd .111 rlc 2 00 8 )
ATTACHMENT VI
ASS [)RANGES - NON- C'ONSTRLICTION PROGRAiNIS
Public re burlet: for this collection of infOrination is osltnlaied to n eravv 45 1E111lutes p el' resl7onsc, including time for
reviewing 1n,tructions. searchin.- exlsling data SOUrces. � nthcrin- and I71aintalninv [h- data needed and cornplelirlg and reviowin - 2 Llic
collection of in1ornlallcll. fiend coninie'nts recardin`! the burden es6itlate or any other aspect of (his collectic: of illfOrriltition,
including stt�T,est.ions for reducin'7 111 is burden. to the Office nl' ivla nag enieni and Bud Let . Paperwork Reductirin Pr�jecl [t73 4fi r][? 13 ) ,
WashinCton. DC 20503-
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE Or M ANAGEMENT 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 yoll 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.
I - Has the legal authority to all Ply 1 .'r federal assistance, and the InstiIuliona1. manaLwrial and financial capability [including funds
SulIMenl to pray tilt niln- federal share 01' 1ar(ljeCt Cost) til entiure l)rnPrr planning, nMn a"CHICElt. aild conipleilon of the pr()jccl
described ill this apple( atiiln.
?. Will give the awarding regency, the Comptroller Clc:neral of the United Statics, and il'appropriate.., the Sate. Ihrou any aLl01011ZCd
rcpresenkalive, access icy and (lie 1'10111 to eXalndne :ail records. boats. papers, or document related to the award. and'xilI c.st:ablish
a IN - Open aC{ OUTIL111r' NVSl ll, ail aCLi]f'il.li7C.l' byjl17 generally accepted accoundng Nuindards or agency di1 c'[IVcs,
3. Will establish safquards it) prohibit einplo_yees from tising their p()sitiillls Icrr a tlffllosc that cons ilutes or presents illc
aplxaranCC ni lhcrS(lnal 01' tlrgclni�ciliuilal C(1ntlicl c1I interezt. of persc}Ela1 gain.
4- Will initiate anti complete, tIir work �vIihin [fie applicable bale 1'rnllc titer receipt ol'approval ul the awarding agency.
5. Weil corllply wall the Intergoverllniental Personnel Act of 1970 (42 L?.S -C. 4725 -1763) rc]alin� to prescribed standards for
r Ile ri1. Syz L nls for programs iulided under one o f the ill Slaw [es to rqiilaltonS specillod in Appendix A of OPM's Standards Vol a
Merit Svs[etn of Personnel Achninistration (5 C.F.R. 900. Subpart F).
6. Will comply with all 1e del'al StaLuics relating to Flondiscriniinuunn. These include but are no[ lil it): fa:1 Title V1 ill dle Civil
Ri.- his each of 1064 (P.L. 88 -352) which prohibit =. discri iii ination nil the !}asiS of race. color c1r national owl in: (h) Title IX of Ilse
Edueaticlil Atli(n(iilli nls e�1 1()7'•2. as amended (:20 U,S.C. 1681 -1681. and 1187 - 1686), which prollihi(s discrimination nn the
basis of sex; (c) Secdo n 504 ot� the Rchabklitanon Act ai 1!t73. as tll7londed 1,2 tJ.S.C. 794 �y'fllilt I) i'171k111l1S efl5lri Ill li7tttfe7n L]i]
the basis of handicaps; (d) the Ace Discrinlin non Act of 1975. as amended (42 U&C. 6101- 61(ii). which piohibits
discri111ination oil I.11e basis of ace; f.e.) tllc Drug Ahuse. 0f fice and Treat ment Act rat 1972 (P.L. 92 -255). as amends d, reIaiinv to
n(lndiscrinlinatitlll on the hasis of drL12 abuse: (1) the CiltllPrchensive Alcohol Abuse tin([ Alcoholism Prevention. Treatment and
Rchabilita[ion Act of 1970 (P.L. 91- 016). as amended. relating to nondiscrimination on the basis of alcohol ahusc or alcoholism;
(v) 523 and 527 of the Public Health Service Act of 19 12 (42 L.S.C. 290 did -3 and 290 ce 3), as aniended, relatlnc to
confidentiality nl' alcohol and drug abuse pat low records: (h Tile V 11 nI (lie Civil RiUltts Act (.) f 1968 {42 L1.S.C. 3601 et
sect.). as alnindecl. relating to nondiscrimination in Elie stile, rental or financilly of housing: (1) any other nondkscrirnlnation
provisions in the specific siatute(si under which Application for federal assistance i5 being made. and ( the re.cluirellwnts of tray
gather nondl."crililinaltioll statutes) which relay apply to the applictlti(ln.
7. Will comply, or ha, already complied, wish the requirenlenls ill' Titles II and ill of the uniform Relocation Assistance and Read
Pro perty Accluisiti_ln Policies .Act of 1170 (P.L 91 - 6=46) which provide filr fair and equ1101e ircatment of persons displaced or
whilse property IS tlCgUired aS a resull of federal or 1ecderally assisted progrtnls. These rcytnrenleintS apply ti, all intcres[s in real
property acquired for project purposes re-gardlcss 0 f leder;al Participation in purchases.
8. Will compiv. as applicable, with the provision. of (lie. Hatch Act (5 U.S.C. 1501 -15()8 and 7324- 7323). which linlit the:
1�elliIical racIIVilies ,) f•cmPloy'ees %V hose principal enlpinynleilt tictivities are funded in whole or in part with federal ItkndS.
9. Will conll>ly, as applicable. with the provisions (11' tfle Davis -Bacon Act (40 U.S.C. 276a to 276a -7). Iht Copeland Act (40
U,S.C.. 276c and 18 U3 S.C. 874) and the Contract Work H OUr.s and Safety Standards Act (4 U.S.C.. :327 :33:3), rcgardin,
labor standards !nr ledorally lSsistod cons(ruclior sub agree tile nl ti.
35
10, Will comply, 11 'applicable. 4Nitll fl ood insurance purchase Ferltli1 of Section 102 (a) of the Flown Disaster Protection Act of
197.3 (P -L. 93 -234) which requires recipients in a special flood ha7.ard area to participate In the presgranl and to purchase iloo d
insurance il•the (dial cost of insurable construction and accluisillon is `r 10.000 or tncn'e-
I I. Will compty with cnvi ronnlenlal stftn(iarils which may be prescribed ptirstlaill W [Ile lolloW {�t) Instl( tit E[l!1 ill i'rlv'1i_[)nf11L'tltal
tluttlity 1'0nil•01 mcasure5 under the National Ew,ironmental Policy Act of 1404 [P.L- 91 -190) anti F.xeculiv'e. Order (E0) 1 1514:
(h) notiricalion of violaiing 111cillties ptn'suanf to EO 1 1738: (c) pi-cifection of wetlands puIsuant to ED 11990: (d) evaltiatiori of
flood hazards in Ilticrdplainti in accordance with E[] 11988: (e) assttrance of project consistency with the approved State
nlanaccineni prograrn dcvcictpecl wilder the Crustal Zone Managenleilt Act of 1972 (16 U.S.C. 1451 et seq..,: (f) conforniity of
federal ar.tictns M Slate (Clear Air) Inlplenlenttttinn PIttns under Section [76(c) of the Clear Air Act of 19 as amended (42
U.S.C. 7401 et seq.); (g) protection oI underground sources o[drinkin« water tinder tllc Safe DrinkinIg Water Act of 1474. as
arnended. (P.L. 93 -523); and (h) protection o1'enciatlgered species tinder the E3ltianaered Species Act of 1973. t6 amcncledi (P.L.
93 -205 }.
12. Will crlln111); with Ilse Wild and Scenic Rivers Act Of 1968 (16 U.S.C 1 721 et scc 1.) relawd to protecting Components ol
pf3teniitil co [11ponents of the national wild and scenic rivers systcn1,
13. Will assist lice awarding a, in assuring Compliance with Section 106 of the National 1-l1sto['ic Preservati - .)n Act of 1906, pis
arlleilde.tl (16 U.S.C. 470), Et) 1 1595 (ide:ntificanoll an[1 prottclion of historic properttesl..ind the Archaeological and Historic
Preservation Act of 1974 1 UI.S.C. 469a -I c'_ sect
14. Wilt c.vt11ply with P.L. 93 -348 re the protection 01 hunittir suh itivolved in resntn'ch. deveiopnlcnt, and related
activi[ies stipporled by this award of assixtancc.
17. Will comply w•rtil the Labl)ratory Animal Welfare Act of 1966 [P -L• 99 -544, as aawnded, 7 U.S.C, 2 c- seq.) pertaining to
[he care. handling. and E1'ealillt'.111 0I' warm blooded ailimals held for research. ieaching. or either ,tttiv'itics supported hy ihis award
o aS�i4larlL e.
[6. Will comply with the Lead - Based Paint poistsni3lu PI'ev'ention Act (42 U.S.C. 4801 et secl.), which prOhihits the use Of lend
based PRitl[ in corltitrucIlon or rehahiIi tat ion of residence strtictures.
17, Will cause ui be [ltrfttt'alieti [he required financial and compliance suclils in accord lnce with lltt Sin-lo Audit Act AlllonC[S11LE1iS (if
1996 and OMB ('ircular No. A- 133..Atic[its of States. Local Govcrnntents. and Non- Profit t.lrgani7aiions.
I8- Will Comply with all applicable rc.gtllrenients c!1 all o llc; federal laws, excc:nlive orders. regulations rend policies kovernin (his
program.
SIGN ATI'RL Of' Af. rlicJltt71 1L'1?ItlII'1'E�GOFFICIAL TITI -F:
I
' 1
SHERYL GRAHAM
ACTING C[)UN 1 Y ADMINISTRATOR
APPf_ICAN7 ORC,ANIL.ATION DATL•. SL :RNI M Lt]
Monroe County Board of Commissioners. Social Services /In -]Home � 'll / is -
Services
I i• �L l
ATTACHNIENT V11
COMMUNITY CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
The alliance shall make payment to the provider for provision cif services up to a maximurll nrr1nber of ur;its cif scxvice
and at the rate(s) stated belo�v:
37
Service
Maximum Units
Maximum
Service to be Provided
Unit Rate
at Service
Dollars
Case Aide
21.98
299
6,562.00
Case Management
50.48
787
39,728.00
Chore
=Rei rnbursernent
Cast
3,732.09
Chore (En iianced)
NIA
Cost
3 123.00
Reimbursement
Companionship
15.33
1,142
17,504.04
Homemaker
22.05
6,325
139,521.00
Home Improvement
NIA
Cost
746.00
Reimbursement
Personal Care
28.67
5,395
154,572.00
Respite (in Facility)
10.00
2,445
24,451.00
Respite (In Home)
23.08
970
22,394.00
Specialized Medical Equipment
NIA
Cost
1,267.00
Reimbursement
TOTA
$413,700.00
37
ATTACHMENT VIII
COMMUNITY CARE FOR THE ELDERLY
INVOICE REPORT SCHEDULE
Report Number
Based On
Submit to Alliance on
this Date
1
July Advance*
July 1
Aticrust Advance"
July ]
_,
iuIy Expenditure Report + 1112 advance reconciliation
Alt;ust 15
4
August Expenditt+re Report + 1112 advance reconciliation
5epternher 15
5
septcinber Expetlditure Report + 11]? advance reconciliatloll
October 15
6
October Expenditure. Report + 3113 adv ince reconciIIatIoil
November 15
7
Novernbcr Expenditure Report + 111? advance reconclIIatioil
Dec.ernber 15
8
Decernber Expenditure. Report + 1112 advance reconeiIiatiM
January 15
9
3anuary Expenditure Report + 111? advance reconc111ati(NI
February 15
1 [}
February Expenditure Report + 1112 advance reconciliation
March 15
1 {
Mardi Expenditure Report+ 111? advance reconc11iation
April 15
12
April Expenditure Report + 1112 advance rec011ciIId6 Oil
May 15
13
May Expenditure Report + 1112 advance reconciIiatioil
3une 15
14
1t.rne Expenditure Report+ 111? advance recunciliation
July 15
15
Final Expenditure and closeout
July 15
Legend: Advance based on projected cash need.
38
ATTACHMENT IX
REQUEST FOR PAYMENT
HOME CARE FOR THE ELDERLY
RECIPiENT NAME. ADDRESS, PHONE4 and FEID° TYPE OF PAYMENT:
This Request period:
From:- To =—
Coniract Pericd -
Regular —
Contract a
—
Advance
Reporl
PSA s
CERTIFICATION: 1 hereby cariify to the best of my knowledge that this requasl or refund conforms
with the terms and the
purposes of the above contract.
Prepared by:- -- Date: Approved by: -
Da<e —
PART A: BUDGET SUMMARY CCE Admin.
CCE Services
TOTAL
1, Approved Contract Amount S—
S
2- Previous Funds Received for Contract Period S
3- Contract Balance
4- Previous Funds Requested and Not Received for Contract Period S
5. CONTRACT. BALANCE S
s-
6 -- -
PART B. CONTRACT FUNDS REQUEST
i. Anticipated Cash Need (1 st - 2nd months} S
5- -
S-
2. Net Expenditures For Month $
S
S
5-
(DOEA Form 105C- Pal B. Line 4)
3. TOTAL
PART C: NET FUNDS REQUESTED
1. Less Advance Applied
2. TOTAL FUNDS REQUESTS] {Part B Line 3. minus Part C Line 1 } S -
S - --
S— -
$
4OEA FORM i06C
39
ATTACHMENT X
FtFCEIPT AND EXPENDITURE REPORT
}-COME CARE FOR THE ELDERLY
A . RESS, PH11 NE 11 and ElEl0
�C]VI17E R N AC /1.3
R
yr _
f rn nl -tin Jiriq
3. Expemlitlrr—
T4 I[-'; REPG +HT F'EV OU:
—
-
F3uJ et
CCf- Admin. - _
Y.. to EJ-11
C:UNTfiAC - i F'NRlOD:
A ra yed f3�rr
$U.C7C1
CCE Srrvl:es
__.
C:ONTHACT +r
k[71ViCJI
S Cf.OD
$0 [:]C]
$0-00
REPORT 7l
77 f]VVIOI
so Oc]
SO 170
SO 00
PSAri
a F) V:'0!
Gi: R F11= ICATkC]N I r_eni[y to the k� sl n1 rr +y kr�owlr�cigc�
-1141 halirF tt�,t tiic rep—t i.s cnr[+plete a Cr corru� and till , ?r,tlay�
Y[1.00
r,erein are fnr purposes set forth in
thre contrcicl.
Pri=p.irArl key -
FART A E3UQC:FTEQ VF•]COME I RECEIPT -S
1 . Approvnck
2. Acli+atl Reccrpts
3. Tnt31 Hc+cc +ipts
to Qaxrj
A P-r"
4. F' ?rcenl of
Liudge
L3Laj 4 t
F nr This Pr-p r[
�` eF�r
SCJ
$0.[70
$0.00
aD' VIC]!
l tale F+rnd^
-OD
:.p
S0.00
$CI -UU
H71V /01
p. Program Income
SCI 00
$0.00
50.00
#>IVia'
3. L- oc:a1 C:asYl NSatc Y1
4. SUBTOTAL- C_ASI -i FSFCt- IE - IS
5. L.cnl in -Kinr! M -ich
so n[]
Sq VD
SC].tl [7
NF71 V.�Ur
F. TO1 AL REG F_IP TS
PAFTT Q Ex ENQI E URES
T Adrnlnist —tive. S— vices
�. SUrvinc Subcnrarnc.nr[
3 Adult Pr,tncliva Scr'J ice=;
4. i OTAL l- XPENI7ITURF
Ajl f C : C] f Hi_r-7 HEVEI`JLJE ANC] EXRENDI1 L1171 - 5
1. Program lrtr-nmc' (F'h
T C'CC: F'I Collentdd 'r T 17 —
[inrlucle. ^ T— cvllFCICJ]
PAFi 1 0 - GCI PAY I=N'r3
1. Tnt.r rat Co- peryn—nts a.c e-es�r >a
?_- T-1-1 or Go- paymenl e. r_olracted
(Far Tr --kVng HurpnnFS - Illy)
1 Flpnrovr•Ck
2 F- pendl:ur
3. Expemlitlrr—
Rerr_ent cat
-
F3uJ et
Fc.r This RcL ?ort
Y.. to EJ-11
A ra yed f3�rr
$U.C7C1
:30 00
y�(7.00
k[71ViCJI
S Cf.OD
$0 [:]C]
$0-00
77 f]VVIOI
so Oc]
SO 170
SO 00
a F) V:'0!
50. no
$aof7
Y[1.00
Nr31 V /UI
U Intr -rest.
111 A[ivar'00 Hecuupc -d
—
2 ri .�turri r�F CR Advanc: S_ -
3. C3iher Earn.sJ
C:URREN 1' N'O" F H YEAH -TO -QA CE
40
ATTACHMENT XT
Cost Reimbursement Summary
Contract #
Report (invoice) Number:
Budget Number of
Category Description Units Service Date Amount
C
0
zs
TOTAL A D M I N I ST RATI O N $0.00
N
pJ
N
Q,}
x
ur
TOTAL EXPENSES $D•00
41
ATTACHMENT A
De.pailment of Elder Affairs Protrrams & Services Handbook, provided till M
Also, available at the Department's Intranet site under. "PubliC',Lti011s ".
42
ATTACHMENT B
STATE OF FLORIDA DEPARTMENT OF EIDER AFFAIRS
PART[: READ THE :A17AC! M 1NSI'RUCTIONS FOR 11,1.1 INFORMATION 'F' HiCI1 'w5 LL HELP YOU CO IPLETE THIS FORM.
1, Briefly doscribe the gecl area ser,ed by the progranllfacility and the tyPO Of set -'ice Prt)vided:
The entire Florida Keys ( Mtmrr]c Coumv. apprc)mi -rely 1207 mile~ long) art, considered rural %ith strnle urban cl!ttractec•is[ics. Services
to be provided by MC1HS With this grant are: cuss: IlianageTTIVIIt. ill home and lal:ility ree, pttl. s bore. cltlnpanil nsllip. ],t.rscntti
homemaking, Enhanced chore and SNIE.
7- Compare the Still Con7l7l SillOn tt) till' po pulatiolt. Iti ytalt 3'e l7rl'tienlatlyl. i]1 lllc I ?[.)ptfl:lSii�n�
If N/A i�l' '�'C7. explain. N/A YES NO
❑ ® ❑
S. Compare. [lie client ccxnpositil)n to the population. Are race a Sex eizaracteris[ics representative ui the
populaticzn'' 11'NIA or NO. explain. E YES N(?
9. Are eli'gihiIiiy require ii ents for services applied to clients and app] l call ts w) regard W I e, clrlr ?t,
national nr ioin, sex, ti-t -, religion ul' ciisahiIity? II N/A or NO, explain. NIA YES N {}
10. Are all henefits, servicos and facilities available to applicants and parilcipams in an equally eftective NO
manner rcLardless of r :[ e. sex. color. age, national w reli Tis]n ter disability`? 1l' NIA or NO, explain. 1� ® ❑
11- f=t7r i)t- patient services, are rr)ortt assi �nnitnts ntadi: s�iilu re�arcl tt) rrlcL.::l�lc�r. i)atic,nal crri��in
or disability? if NIA or NO, explain. NIA YES NO
OLIR AGFNCY IS NOT t 1 PATIE)NT FACILI N F1 El
Rcc August Pale 100 "_'
43/64
P[)PLii.A'ClON OF AREA SERVED. Source ofdata: US CENSUS 2010
Tuletl ";c White :'c Black [[i;pcutic [ lthrr r. 1 111;
71165 7" 3(`r 7 7', __ I ) v 2.0 {)ryr 4! .(,9r
3.
STAFF CUR RFNTLY FM PLO YED. Effective dale: 7111201 ?
Total # ':� 1Vhite `:r. Rla,ck `'I I lispanic `.% []tiler 1 .4 Female t]isabl'�!
4 6?`:7 17!4.. ] �c7 h 7 e U c
4.
CLIENTS CURRENTLY ENROLLED OR REGis 1'flective datc: 7/1/2015
1'nitr! # I Whiz r $! rck Sr tlispnrlic c/c FcIL) rk. Disabled
� OVer 40
�1)
S c-.[ Rr.G 14U
5.
ADVIS OR G[IVER BOARD. IF APPLICABLE.
ToW # "% Whi3c `7r R1 'K ;i Ulher k I emalr. : Disahlcd
W7, 013
PART It: USE A SEPARATE SHVET [7F P;APER FOR ANY EXPLANATIONS REQUIRt1i(. MORE SPACE.
fi.
Is an Assurance. ()ICompliaice l)n file with DOE A? If NIA or N0. explail7. NIA- YES NO
❑ ® ❑
7- Compare the Still Con7l7l SillOn tt) till' po pulatiolt. Iti ytalt 3'e l7rl'tienlatlyl. i]1 lllc I ?[.)ptfl:lSii�n�
If N/A i�l' '�'C7. explain. N/A YES NO
❑ ® ❑
S. Compare. [lie client ccxnpositil)n to the population. Are race a Sex eizaracteris[ics representative ui the
populaticzn'' 11'NIA or NO. explain. E YES N(?
9. Are eli'gihiIiiy require ii ents for services applied to clients and app] l call ts w) regard W I e, clrlr ?t,
national nr ioin, sex, ti-t -, religion ul' ciisahiIity? II N/A or NO, explain. NIA YES N {}
10. Are all henefits, servicos and facilities available to applicants and parilcipams in an equally eftective NO
manner rcLardless of r :[ e. sex. color. age, national w reli Tis]n ter disability`? 1l' NIA or NO, explain. 1� ® ❑
11- f=t7r i)t- patient services, are rr)ortt assi �nnitnts ntadi: s�iilu re�arcl tt) rrlcL.::l�lc�r. i)atic,nal crri��in
or disability? if NIA or NO, explain. NIA YES NO
OLIR AGFNCY IS NOT t 1 PATIE)NT FACILI N F1 El
Rcc August Pale 100 "_'
43/64
i2. IS the pro�ramlia[ lilt) accessible to nom - English speaking clients`' If NIA or NCI, explain. NIA YES N{
�
❑ ® ❑
13. Are employees. applicams and participants informed of their protection against discrimination? If YES,
ho " VcrbaI ❑ Wri tic n ❑ Poster ❑ If N/A or NO, explai11- N/A YES NO
❑ ® ❑
14. Clive the number anci current Status of any tliscrimInatioft cnmpiaints ICL'ardinv sere ices or cmployment IiICd
against the pro rata /facility. NIA NUMBER
❑ 0�
15, Is the program /11161ity physically accessible to �nciblhly. hcai m_-, anci si 7hl -ilnp ij3'tLI individuals'? if N/A or
140, cx171aiot. 141x. YES NO
❑ ® ❑
PART III: l'tiE 1 OLI.OIV•IS( QL?ES 'PIONS APPLY TO PROGRANIS AND F'ACIIA'14ES W11I1 is OR 13OIZE E1mPLOYT3 ?S.
16. Has a self- evaluation heen conducted w idontity any barriers it) servin clisahled individuals. and to make
any necessary modifications'? If NO. explain. Y1 5 NO
® ❑
17. Is [l,erc all established f?ricvancc Procedure that intorpe,rales Liuc pj in the I .-Jutit,n Lei complaint,, It
N[ }, explain. YE.S NO
® ❑
tS. Has a person been desicSnatcd tO coordinate Section 504 compliance activilic"? It' NO, explain. YES E N {} ❑
19. Do recruitment and notification materials advise appljcalll,. employees and participants cii' iieinciisci•iiitinatit )n
oil the basis of disability? I1' NI. }. cxplain. YES N[?
® ❑
20. ILre auxiliary aids available to assure accessibility o; services lo hearing and sight - impaired individwdi Ji
Nt7. explain. YES NO
® ❑
PARS' IV. FOR PROGRAMS OR FACILITILS WITH 543 OR I�IORf EMPLOYEES AND FEl7F.IZAL Ct)tiTR:Vt "[;5 OF $50, 00 .00 OR v10RE.
21. DO vtni have a wr n itte ai l'ii•mLttive action plan'? If NO, explain. Y5 NO
Reviewed By
Program Office
Date
On -Site ❑ Desk Review ❑
Kevked Augusa 2010, Pane ? k&2
In Compliance: YES ❑ NO ❑
Notice of C: )rrective Action Sent �1�1
Telephone Response Due �1�1
Response Rcmvcd I�1
44164
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
I. I]cscribe the +geographic service area sEU:h : ,.ti }l district, county. city or Other locality. if the program/facility serves a
specific target populatiosi such as adolescents, describe the target population. Also. defisie the type of service
provided.
?. Enter the percent of the populatiosi served by race. and sex. The population served includes persons in the
g
eographical tu'ea for which services are provided such as a city. county oi� other regional area. Population statistics
can be obtained from local chambers of commerce. libraries, or ally publication from the 1 Census containing
Florida population statistics. Include the source of your population statistics. ( "Oilier" races include Asian/Pacific
Islanders and American Indian /Alaskan Natives.)
3. Enter the total number of full -time staff and theft percent by race. sex and disability. Include. the effective d lie of your
s u ntimary.
4. Enter the total liallibes of clients who are enrolled, registered or cur served by the program] or facility, and list
their percent by race, sex and disability. Include the date that enrollment was counted,
5. Enter tlie. total number of act visor_v board Ine:mbers and their percent by race. sex. and disability. U there is iio advisory
or governino board, leave this section blank.
6. Each recipient of federal financial assistance must have on Mile an assurance that the program wdl be conducted i
compliance with all nondiscrinsinatory provisions as required in 45 Chit $[]. 'ibis is usu ally a standard part of the
contract language for I]OEA recipients and their sub - grantees, 45 CFR 801.4 (a).
7, Is the race, Sex, and national origin of the staff rellective of the general population" For e.a�_mple. it 10% Of the
population is Hispanic. is there a Comparable percenta-ye of Hispanic Stt
8 Where (lie re is a siuni11cant variation between the race, sex or ethiiic composition of the client~ ar:Li their lvailttbility in
the population, the progranilfacility has the responsibility to deti.s'171i'le the reasons for such variation and take
whatever action may be necessary to correct any discrimination. &e Ijje legitittiate disparities may exist when
programs are ti:iiics inaied to sen e target populations Stich as elderly' or disahleel persons. 45 CFR �U.3 [ICY (6).
9. Do e.li;ibility requirements imlawfuily exclude persons in protected trrL7ups from the provision of service; sir
employment'? Evidence of such may be indicated in staff and client representation (Questions 3 and 41 and also
througli on - site record analysis o f persons who applied but were denied services or employment, 45 CFR S03 (a) and
45 CFR 8[1.1 (b) f?)-
lfl. Participants or clients "'list be provided services such as n7edical, nursing and dental care. laboratory services.
physical and recreational therapies, counseling and social services without regard to race, Sex, color. national origin,
religion. age or disability. Courtesy titles, appointment ;chCduling and accuracy of record keeping must be applied
uniforr'ly and without regard to race, .sex. color. national origin, religion. w1TC or disability. Entiances, waitin T rooms.
reception areas, restrooms and other faciiities must also be equally available to all clients. 45 CFR 80.3 (b).
1 1. For in services, residents tin"st be assigned to rooms, wards. etc.. without regard to race, color, national origin
or disability. Also, residents niust snot lit asked whether they are will "tl to share ae Cnl'mi7elatieJnS with persons of a
different race, color, national origin, or disability, 45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those: potions who
i'ay not speak English. hi geographic areas vv'he.re a slims icInc population of non - English speaking people live.
program accessibility may include tiie employment of bilinguai staff. tsi other areas, it is sufficient t❑ have a policy or
will assist in t
Plan for service, such ras a currant list of names and to ie.phone. nus'bers of bilingual individuals who
45164
provision of services, 45 CFR 801.3 (a).
13. Programslfacilities must make Information rewarding the nondiscriminatory provisinnti of Title VI available to their
prrrticipanis, beneficiaries or any aathcr interested parties. This should include information on their rig = to file a
complaint of discrimination with either the Floridu DepartrTtetTt of 1 =icier Allair5 or tl3e U.S. Department of HHS. The
information may he suppl verbally or in writing to tvr:r }' individual. ot may be supplied illi-migh the use oi' an equal
opportunity policy poster displayed in a public area of the facility, 45 CFR 90.6 {d}
14. Report number of discrimination complaints filed agalnl l the pragrainKacihty. lildicate the base~, e.g.. race.. color.
treed, sex, age., national origin, disability, retaliation. the issues involved. e.?:.. services or employment, placement.
termination, etz. Indicate the civil rinitts law or policy alleged to have: been violated a1c)"Ll with the name and address
m
of the local, state car federal agency with whotrt the complaint has been Filed. Indicate the current status, e..g settled.
no reasonable cause found, failure to concili F�dlurt to cooperate. under review, etc.
15. The prcwramlfacility must he physically accessible to disabled individuals. Physical accessibility includes designated
parking areas, curb cuts or level approaches, ramps and adequate widths to entrances, The lobby, public telephotle,
rLstronnT facilities, water fountrtiETS, information and adlnissiorts offices should be accessible. Door widths and (niffic
areas of administrative offices, cafeterias, restroonTS, reci areas, counters and serving lines should he obse.rv+.d
for accessibility. Ele.valors should be observed for door width and Braille or raised numbers. Switches and controls
for light. heat, ventilation. fire alarmN, and rattier essentials should be itTStulled at an appropriate height for mobility
impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requites that a t'ecipient of federal financial assistance conduct a self -
evaluation to identify any accessibility harriers. Self- evaluation is a four step process
E l. With the assistance of a disabled individuaflorgani7.ation evaluate currerTt practices and policies vvfTiclT do not
COMply wi.h Section 504.
b. Modify policies and practices that do riot meet Section 5 04 requirements.
c, Take remedial steps to chiTZinate.. any discrimination that has been ide.ntiried.
d. Maintain self - evaluation on file. (This checklist may be Lised to satisfy tilts requirement if these lout' steps have
been followed.), 45 CFR 54.6.
17 Programs or facilities that employ 15 or more persons toast adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action piolTibited
by Sectio 504,45 CFR 54.7 {b}•
N. Prop -rases or facilities that employ 15 or more: pcj mtt5t dcsi�p i at least one person to coordinate efforts to
comply with Section 5014.45 CFR 84.7 (a).
19. Continuing steps n ust be taken to notify employees and the public of the program/facility's policy of
nondiscrimination oil the basis of disability. This includes recruitnWnt material. notices for hcat'ings, newspaper ads.
and other appropriate written comillunicLtion, 45 CFR 84.8 (,a).
7Q. Programslfaciiities that cmpioy i5 or tnoi'e persons must pricy - de appropriate auxiliary aids to persons with iiTipaired
int' -led to, interpre
sensory, manual of speaking skills k%herc necessary. Auxiliary aids may include, but are not 1 pro for
1TearisT; impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide
equally effective services, 45 CFR 84.52 [d).
21. Programs /facilities with 50 or more employees and $50,000.00 in federal contracts must de %'clop, and
maintain a written affirmative action compliance progrttnl in accordance with Executive Order 1 1246, 41 CFR 60 and
Title VI of the Civil Rights Act of 1364. as amended-
DOEA Farm IUI - H, ReriStd AAu2?us1 ?C}IU
X16164
ATTACHMENT C
REFERRAL Mo DADE
Issue.: Screening, Triage.. and Referral For Activation under tine Ci,rrimttnity Care for [lit FldcrlylHotne Care for
the Flderly.
Policy: Referrals will be based on avtti[ahility of i in accordance with pnoritization requirements.
Purpose: To ensure itmdinv is spent expedillously and consumers .Are referred into prcr-1-Trams for appropriate
services,
Procedure for Nlrrnroe County
1Zoles and Responsibiiitieti
A. Alliance. for Aging l Aging and Disability Resource Center
Reconciles
overall p and Lc�ad Agency specific spendirag Je.v'el� on :a monthly basis to
ensure the Lead Agency is operating within the furn_]m« allocation.
r Reviews the number of cases released for activation bctse.d on projected funding available.
Screens consumers to link with approl�rlate resources and prioritize for DOEA furtde.d prograrns
e
and services. and s nmends potential cases for activation Nlvtied upon prr7teited funding Available by Lead
Agency.
r Selects consumers from the waiting Hst hosed on tl - .eir prioritization sGOre.
Refers coilsurners from fife waiting list to the l ead Agency in M onroe C far activation,
fused on availability Of funds.
r llZirnittn - s Compliance with serv standards and offlcomc measures.
Reviews care flans and f ices per tile. File 1Zev iew Policies and Procedures.
Reviews data in CIRTS.
B. Case Management Agency
r Requests and accepts referrals I rorn the A 'iug a Disability Re:SOUI - CC Unte.r. to serve an
�,ptiitaal caseload and to avoid s�it'pitises or deficits in aced }'dance �vitla the. AA -A CCFIHCE
Surplus/Deficit fo
the ADRC c
s Analysi policy.
Refers inquiries Aron} Analysis y i ices t
nterested in ser vices C. r Information and Referral
to Community resources. Screening, Triage. anti Long-Term Care Options CourtiseiinL as
appropriate.
r The functions of Scre::ning and Intake are: outsotnced to the Lead Agency. Screening and Intake
may also be completed by the ADRC.
r Completes comprehensive assessillents on new consumers and annual o :t existing,
consumers and develops care plans and reviews care plans semi- annually_
r Authorizes service delivery and enters data into CIRTS.
r Screens consumers for SMMCLTC efigibility.
Biils in CIRTS as appropriate.
r Monitors care plans in an effort to keep costs down while sustaining the individuals in the
community.
Il. Management of the Assessed Prioritized Consumer List (APCL).
A. Referrals ti] the ADRC are rooted to the Information and Referral Specialists or Intake Unit start
47164
depending o the type of referral. Che.nts are pi'(Wided infor €zlatiol] on conji resc)trceS and
programs available incibding private pay options. Persons are directed to those resources Most capable of
meeting the treed they have e.xpt'cssed to ADRC staff. Cases present ill stron, identifiers that indicate
the consumer Might benefit from publicly funded long teT111 c.€re services are screened, entered i nto
CIRTS, triaged alld provided options Counseling, in Monroe. County, the ft€nctions of Screciling and
Intake are outsourced to the Lead Agency. Screening and Intake €nay also be completed by the ADRC.
DOEA prioritization requirements will be adhered to by both entities, as follows:
AP5 Hull Risk Referral (See Section B)
? Immment Risk cases will be pl~ioritized for Activation after APS High Risk RJerrals have been
served. If budgetary collstr�tiizts prevent. opening new cases. clients will be placed on the APCL.
ADRC staff will contact the client on a monthly basis to determine if there has been a change in
the Clienl'S Sitt- 136011.
3_ All other CARES referrals will be screened aFiil prioritized in accordance with DOER
requirements.
a. 11Qin Oil( CL7F15tiiTitl'S will be refen by DCF ]l )I' prioritl7�ltlon and/or activation 3n the
Corresponding aged pro ralri TTlailaged by the Alliance, 31 appropriate (See sect€ot1 IV).
5. CC111tiill - ne'rs applying for the Community Care for the Elderly (CCE) and/or Home Care far the
Elderly [HM programs will be Contacted and screened eking the statewide assessment form
developed by the Department of Elder Affairs for this parpose {Form 701S). 11' a consumer is
being served through a DOEA- funded agency which enters their annual astiCSSment illtcl CIRTS,
[he Pi'io1 - 11V Score ge11erated by that assessment will determine their ranking oil the APCL.
fi.
Coil SU €T1ers refe for' iF1r.] uSiOY1 under the State%kIde Medicaid Managed Care Long Ter11z Care
Program APCL will be contacted and screened by an ADRC staff person f:�llowinU rile sable
procedure as the one described under Section S. Individuals who appCa € "IS potelltially eligi ble
i'or other types of puhlic assistance will be referred to the Economic Self- St €ffic:icllcy Ullit at the
Department of Children and Families.
7. All other I'C.felrals will he waldistcd and prit)ritizCd, clu €i11, ��hir11 tiiTle other L.ni - n - n 11111
resources will be researched. illcicidiag private
pay f sCi'v1cCS pI'oV €derS. ConsulTlers on the
waiting lists will be reassessed according to the 20) 9 Department of Elder Affairs Programs and
Services Handbook. or any revisions made thereafter.
B. HiPAA forms will he sent to the consumer as appropriate.
IIl. [opening New Cases
A. CCE/HCE Clients
The Fiscal Department will monitor Lead Agency specific spc €iding levels irn a monthly halls to
elzstire each Lead Agency is operating within its spending authol'ity'. in addition, the fiscai
department ,vill analyze Surplus /dCficit pl'Qjections, and share the inforlr€ation with the Lead
Agency to assist in their cletermination of slot availability. The Lead Agency will request
referrals directly from the ADRC. Tile I Department will be notified of the number of new
cases being referred to the Lead Agency for activation.
48/64
3. Upton receipt of the request for rcfe.lrals frorn the Lead Agency, the ADRC Intake Unit
Supervisor will refer the Prioritized Risk Report to identify the consusners on the APCL to be
opened.
3. In response to the request for referrals. the ADRC Intake Unit Supervisor will refer wait listed
clients to the Lead Agency for activation, in accordance with prioritization reyuireme.nts. The
Intake. Unit will update the wait list enrollment using the appropriate code to terminate from the
APCL. Upon receipt of referral. the Lead Agen will enter the APPL erlrt?1[rtlent, and
subsequent e.nralInle11 ts to r'ef'lect. client status.
4. Upon receipt cif' list of clients released froth the waiting list, the Lead Agency will e nter the
APPL enrollment, will contact clients to offer prograrn enrollment, and will proceed with
activation. The Lead Agr,.ncy will enter subsequent enrolltrients into CIRTS to reflect client
status.
?. Tile. ADRC will oversee the cnr()llrllent process to enSLIrC referrals have timely outcomes In
CIRTS .
S. Statewide Medicaid Managed Care Long Term Care Program Clients
1. The 17epartment of Elder Affairs will run the APCL ( Assessed Priority COFISti =leer List] report to
review clients wait listed far the SMMCLTCP. DOEA %vill p rovide the ADRC with a list of
individuals authorized for rcle.ase from the APCL.
? Far cliellts active. ill CCE or HCE renal authorized for release hnm the Medlc�rrd ��'tiive.r waiting
list, the ADRC will be responsible for the application process. For CCE active clients the
ADRC will notify the Lead Agency in order to waive the co -pay.
C. APS Referrals
APS Low and Interrned1cite Risk referr Its will be screened and prioritized by the ADRC for
services rrs per the lJl]EAI:�PS Melllorandum of Understanding. Low and Intermediate Risk
referrals are also offered information an d referral ttI addit[CMul cnlmltt11111y I'e"OUIce•ti. lnciuding
privato pay as appropriate:.
2 APS High Risk Referrals are not waitlisted. They are 1111nle.diately referred for service frolll DCF
ill Monroe. County to the Lead Agency'. ARTT referrals will be forwarded directly the Lead
Agency. APS cases are to be served for a maximutn of 31 calendar days. ]t' additional tithe is
justified. the case management agelley will staff the case with the Alliance to obtain the
extension needed.
3. blpoil receipt of the APS High Risk referral. the Lead Agency will coordinate services to begin
within the 72 hour period mandated by statute. A coll1prehonsive Assessment will be done within
72 hours of the referral. Services required under the cure plan will remain in place for a
maxi mtlIli of 31 clays, uriless an extension has becn gt'anted.
4. The Lead A +;ency will enter ACTV enrolhnent under their provider number In CIRTS. In
addition, service codes will be entered by service slate for all services provided. If a service(s) is
not provided as r udder the care plan, an NDP code will steed to be entered in CIRTS and
ile Should document the reason for flan- delivery of such
the case notes under the client f
serv ices).
I9/64
IV. Acting Out Con, uLmiers:
A. All "Aging C)UC consumers will be referred by DCF to the ADRC For enrullmcnt IMO the c0rrespc)[Idillg
aged program i by the Alliance.
B3 Consumers active in the C.CDA and HCDA programs that lure turning 60 and are eligible for CCE and/or
HCE will be opened in the corresponding aged program managed by the Alliance. if funding 3s available.
If tuncliijg is available, these consumers will be inade active~ ]f funding is not available, they will be
waidisted for these programs but will he given priority for activation once funding I available.
Note: These ADRC policies and procedures are subject to change. Any modifications will be done through a
contract amendment.
50/64
ATTACHMENT D
Department's Computer Use Policy and its Social Medici Policy, provided on CD.
l 164
ATTACHMENT E
Alliance for Aging, Inc.
Business Associate Agreement
This Business Associate Agreement is dated _9115120'15_ , by the Alliance for Aging, Inc.
("Covered Entity ") and _NIONROE COUNTY BOCCISOCIAL 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
1995 (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 a.-id security of patients' PHI, as set forth in,
but no' limited to the Code of Federal Regulations (C.F.R.), specifically 45 C.F.R. §§ 164.502te),
164,504te], 164.308(b), and 164.314(a-b)(2010) tas 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 120101 require business associates of covered
entities to comply with the HIPAA Security Rule, as set forth ri. but not limited to 45 C.F.R. §§ 154.308,
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
othem 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, user 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
persc -ns or processes.
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2.9 Electronic Protected Health Information.(ePHI) Health information as specified in 45 CFR
§150.103 {1 }(i) or (17(11} limited to the information created or received by Business Associate from or on
behalf of Covered Entity.
2,10 HITEGH. The Health Information Technology for Economic and Clinical Health Act (2009)
2.11 Information System. An interconnected set of information resources under the same direct
management control that shares common functionality. A system normally includes hardware, software.
information, data, applications. communications, and people.
2.12 integrity. The property that data or information have not been altered or destroyed in an unauthorized
manner.
213 Malicious software. Software, for example. a virus, designed to damage or disrupts a sysiern.
2.14 Part I. Part t — Improved Privacy Provisions and Security provisions located at 42 United States Code
(U.S.C,) §§ 17931 and 17934 (2010),
2.15 Password. Confidential authentication information composed of a string of characters.
2.16 Physical Safeguards. The physical measures, policies, and procedures to protect a covered entity's
electronic information systems and related buildings and equipment, from natural and environmental
hazards, and unauthorized intrusion.
2.17 Privacy Rule. The Standards for Privacy of individually Identifiable Health Information at 45 CFR Part
160 and Part 164, subparts A and E.
2.18 Protected Health Information. (PHI) Health information as defined in 45 CFR §160.102•, limited to the
information created or received by Business Associate from or on behalf of Covered Entity
2,19 Required By Law. Has the same meaning as the term "required by law" in 45 CFR § 164.103.
2.20 Secretary. The Secretary of the Department of Heatth 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 irformation at 45
CFR part 164, subpart C, and amendments thereto.
2.24 Technical Safeguards. The technology and the policy and procedures for its use that protect electronic
protected health information and control access to it.
2.25 Unsecured PHI. Protected health information that is not secured through the use of technology or
methodology specified by the Secretary in guidance issued under 42 U.S.C. section 17932(h)(2).
2.26 All other terms used, but not othe - wise 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.
3.2 Business Associate agrees to:
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(a) tmplement policies and procedures to prevent. detect, contain and correct Security violations in
accordance with 45 CFR § 164.346;
(b) Prevent use ter disclosure of the PHI other than as provided far 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 §§ 164.363. 164.3 164.312, and 164.316.
13 �1 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 ir) violation of the requirements
of this Agreement.
3.4 Business Associate agrees to promptly report to Covered Entity any use or disclosure of the PHt 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 lnformation.
16 Business Associate agrees to ensure that any agent, including a subcontractor, to whom it provides o P + HHi
received from, or created or received by Business Associate on behalf of Covered Entity, agrees
same restrictions and conditions that apply through this Agreement to Business Associate with respect to
such information.
37 it Business Associate has PHI in a Designated Record Set:
(a) Business Associate agrees to provide access, at the request of Covered Entity during regular
business hours, to PHI in a Designated Record Set, to Covered Entity or, as directed by Covered Entity,
to an individual in order to meet the requirements under 45 CFR §164.524'. and
{b} Business Associate agrees to make any amendmeni(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, hooks, and records, including policies and
procedures and PHI, relating to the use and disclosure of PHI received from, or created or received by
Business Associate on behalf of Covered Entity, available to the Covered Entity or to the Secretary upon
request of either for purposes of determining Covered Entity's compliance with the Privacy Rule.
3.9 Business Associate agrees to document such disclosures of PHI and information related to such
disclosures as would be required for Covered Entity to respond to a request by an individual for an
acec- unting of disclosures of PHI in accordance with 45 CFR § 164.528.
3,10 Business Associate agrees to provide to Covered Entity or an individual, upon request, information
collected e SO O p�H f t`p accordance Entity e with CFR §tl 13404. {dual for an accounting of
discl osures 64.528 and A£ =iFiA §
54
3.11 Business Associate specifically agrees to use security measures that reasonably and appropriately
protect the confidentiality, integrity, and availability of PHI in electronic or any other form, that it creates,
receives, maintains, or transmits on behalf of the Covered Entity.
3.12 Business Associate agrees to implement security measures to secure passwords used to access ePHI
that it accesses, maintains, or transmits as part of this Agreement from malicious software and other
man -made and natural vulnerabilities to assure the availability, integrity, and confidentiality of such
information.
3,13 Business Associate agrees to implement security measures to safeguard ePHI that it accesses,
maintains, or transmits as part of this agreement from malicious software and other man -made and
natural 'vulnerabilities to assure the availability integrity, and confidentiality of such information.
3.14 Business Associate agrees to comply with:
(a) ARRA § 13404 (Application of Knowledge Elements Associated with Contracts):
(b) ARRA § 13405 (Restrictions on Certain Disclosures and Sales of Health Information ); and
(c) ARRA § 13406 (Conditions on Certain Contacts as Fart 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 p&orm functions,
activities, or services for, or on behalf of, Covered Entity as specified in any and all contracts with
Covered Entity provided that such use or disclosure would not violate the Privacy Rule if done by
Covered Entity or the minimum necessary policies and procedures of the Covered Entity.
5.0 Specific Use and Disclosure Provisions.
5.1 Except as otherwise limited in this agreement or any related agreement, Business Associate may use
PHI for the proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
5,2 Except as otherwise limited in t`his agreement or any related agreement, Business .Associate may
disclose PHI for the proper management and administration of the Business Associate, provided that
disclosures are Required By law, or Business Associate obtains reasonable assurances from the
person to whom the information is disclosed that it will remain confidential and used or further disclosed
only as Required By Law or for the purpose for which it was disclosed to the person. and the person
notifies the Business Associate of any instances of which it is aware in which the confidentiality of the
information has been breached.
5.3 Business Associate may use PHI to provide data aggregation services to Covered Entity as permitted by
45 CFR §164,504(e ) (2)(i ) (B), only when specifically author +zed by Covered Entity.
514 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 limitations} in its notice of privacy practices of
Covered Entity in accordance with 45 CFR § 164.520, to the extent that such limitation may affect
Business Associate's use or disclosure of PHI, by providing a copy of the most current Notice of Privacy
Practices (NPP) to Business Associate as Attachment Xl to this Agreement. Future Notices and/or
modifications to the NPP shall be posted on Covered Entity's website at www.alliancefora in .or .
6.2 Covered Entity shall notify Business Associate of any restriction to the use or disclosure of Pill
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.
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7.0 Permissible Requests by Covered Entity. Except for data aggregation or management and
administrative activities of Business Associate, Covered Entity shall not request Business Associate to
use or disclose PHI in any manner that would not be permissible under the Privacy Rule if done by
Covered Entity.
8.0 Effective Date and Termination.
8.1 The Parties hereby agree that this agreement amends, restates and replaces any other Business
Associate Agreement currently in effect between Covered Entity and Business Associate and that the
provisions of this agreement shall be effective as follows:
(a) These Business Associate Agreement provisions, with the exception of the electronic security
provisions and the provisions mandated by ARRA, HITECH and Part I shall be effective upon the later of
April 14, 2003, or the effective date of the earliest contract entered into between Business Associate and
Covered Entity that involves the use of PHI,
(b) The electronic security provisions hereof shall be effective the later of April 21, 2005 or the
effective date of the earliest contract entered into between Business Associate and Covered Entity that
involves the use of PHI; and
(c) Provisions hereof mandated by ARRA, HITECH andror Part t shall be effective the later of
February 17, 2010 or the effective date of the earliest contraci entered into between covered entity and
business associate that involves the use of PHI or ePHI.
82 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 mate - ial term of this
Agreement and cure is not possible; or
(c) If neither termination nor cure is feasible, Covered Entity shall report the violation to the Secretary.
8.3 Effect of Termination. Except as provided in subparagraph (b) of this section, upon termination of this
agreement, for any reason, Business Associate shall return all PHI and ePHI received from Covered
Entity, or created or received by Business Associate on behalf of Covered Entity.
(a) This provision shall apply to PHI and ePHI that is in the possession of subcontractors or agents of
Business Associate. Business Associate shall retain no copies of the PHI and ePHI.
(b) In the event that Business Associate or Covered Entity determines that returning the PHI or ePHI
is infeasible, notification of the conditions that make return of PHI or ePHI infeasible shall be provided to
the other party- Business Associate shall extend the protections of this Agreement to such retained PHI
and ePHI and limit further uses and disclosures of such retained PHI and ePHI, for a minimum of six
years and so long as Business Associate maintains such PHI and ePHI, but no less than six (5) 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 tirre 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 1995, Pub. L. No. 104 -191.
56
11.0 Survival. Any term, condition, covenant or obligation which requires performance by eithe- 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 Bole and Security Rule.
13,0 Incorporation by reference. Any future new requirements), changes or deletions} enacted in federal
law which create new or different obligations with respect to HIPAA privacy and/or security, shall be
automatically incorporated by reference to this Business Associate Agreement on the respective effective
date(s).
14.0 Notices. All notices and communications required, necessary or desired to be given pLrsuant to this
agreement, including a change of address for purposes of such notices and communications, shall be in
writing and delivered personally to the other party or sent by express 24 -hour guaranteed courier or
delivery service, or by certified mall of the Uf cited 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 BOCCISOCIAL SERVICES
1100 SIMONTON STREET, SUITE 2 -257
KEY WEST, FLORIDA 33040
Any such notice shall be deemed delivered upon actual receipt. If any notice cannot be delivered or delivery
thereof is refused, delivery will be deemed to have occurred on the date such delivery was attempted.
15,0 Governing Law. The laws of the State of Florida, without giving effect to principles of conflict of laws,
govern all matters arising under this agreement.
16.0 Severability, If any provision in this agreement is unenforceable to any extent, the remainder of this
agreement, or application of that provision to any persons or circumstances other than those as to which
it is geld 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 hap 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 1 O] O of this agreement.
57
Covered Entity:
�'
Icy: 7 Date:
(signature)
S EA'
Busine Associate: �MONROE COUNTY BOCCISOCIAL SERVICES
By:
i a
I
f - f���_ Date:
-
(signature)
-ekv-
SIGNED BY-
NAME- DANNY KOLRAGE
TITTLE: MAYOR
DATE: L.
s Y)
Y
7 r
58
ATTACHMENT F
Verification of Employment Status Certification
As condition of contracting with the Alliance for Agin -, Inc., MONROE COUNTY
BOCCISOCIAL SERVICES hereby re'fe'rrer] to as contract0r, certifies the LiSL' o t
U.S. Department of Homeland. Security's E- verify system to veri['y the ez�aploynjent eligi'�iI'ty of all
new employees hired by Contractor durinu the contract term to P erforn, enaployment duties pursuant to
this Agreement and (b) that any subcontracts include an express requil meat that s2sbconLractors
performing work or providing services pursuant ir7 this Agreer�ient utilize [he F- verify system to verify
floe employment eligitziiity t�F all new ell' hired by the subcontracLor during tine contract term.
59
Xl A C I 11 I F N T G
BACKGROUND SCREENING
11, 1-- D E R
AY FA J RS
Affidavit of Compliance - Employer
AUTHCIAITY: Thl fue'm Is 4 eq ulet!<) 01 �l eormply .0th Elie aueslabW
rLqum e I (tor I j s t) ce 1 I ai L 415 - 115 [3) t F 16 0 dA Si 2 K
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60
ATTACHMENT H
CERTIFIC:A'FION REGARDING SCRUTINIZED COMPANIES LISTS
The Lin dersigned, an authorized representative of the ConIractor named in the contract or agrceaiient to which
this form is an attachinent, hereby certifies that:
07 The Contractor understands that pursuant to s. 287.115 F.S., any company at the time of bidding or
submitting a proposal for a new contract oi renewal of an existing contract, that is on tine Scrutinized
Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities In the Iran Petroietnn
Sector List fcollectiveiy_ "the. Lists"? is ineligible for, and may not bid on, submit a proposal for, or enter into
or relie.w it contract pursuant to which funding is provided by the Department of Elder Affai" (Department)
for goods or sen of S 1 mi IIi on or more.
(2) Tine Contractor understands that. pt.lrsuant to s. 287.135 F.S.. any company that submits a false certificating
is subject to civil penalties, attnrney's fees and costs and any costs for investigations that led to the finding of
false certification.
(3) The Contractor u tide l:5t.ands that the contract to which this corm it an attachment may be terminated by the
AAA if the Contractor submits a false certification or has been placed on the Lists.
This certification, required by Florida law, is a material representation of fact rlpon whicli relialnce was placed
when this transaction walade or entered into. Submi5sioi} of this certificatinn is a prercq uisite. for making or
, g
enteF'lilg into this transaction-
f
Signatur
D�lte.
(Same as contract signature)
_ACTING COUNTY ADMFNISTRATO
Title
MONROE COUNTY BOCCISOCIAL SERVICFS
Company Name
61
ATTACHMENT J
Alliance for Aging Fiscal Policy and Procedures
SL'RPLLiSIDEFICIT ANALYSIS -- COMMUNITY CARE FOR THE ELDERLY 4.CCE1 AND HOME
CARE. FOR THE ELDERLY {HCE)
POLICY: Available funds for CCE and HCF will be optimiz -ed by usin. the most recent available data to
analv7.e contractor spending patterns and trends in order to serve the hlrge�t number of clients.
Purpose: To ensure contract compliance requiring that all available. fund-L-1 is spent expeditiously and
completely to avoid any surpluses or deficits.
A. Procedures:
1. Spendif,g patterns ❑f each provider by prograln will b analyzed on at monthly basis. In accordaf,ce
with contract requirements, Lead Agencies must justify projected surpluses or deficits.
2. Ali noted surpluses or deficits i1, spending andlor re.pc)i - t ing patterns will be reviewed and docmuc.nte� I
in order for the Alliance to initiate appropriate steps to ensrn'e that ct?nsur„ers continue re.cesvtng
services in accordance with appropriate care plans.
Lead Agencies will submit invafices by the deadline date Specified ir, their contracts. Invoices not
stil}rnlltC ill tli,le 1�'lll nrft Fre reimbursed Until the' following monthly cycle. Invoices not submitted
on time bias airplus /deficit repolts. Prcfviders astiusnc ti,e - consequences of delayed invoicing on ti,e
accuracy of surplus/deficit pro
4. Lead Agencies should request referrals for activation directly from the ARC oil an ongoing basis. is
often as needed. to ensure that an optimal caseload is maintained so that the Lead Agency will i,ot
realize a year -end surplal5 or deficit. .An Optimal caseload is considered the number of cases nece IV
for each Lead Agency to maintain throughout the fsscarl year 5❑ as not to experience ally projected
surpluses or deficits. The aictual number of cases constituting all opilmai caseload should have
concurrence of both a fiscal representative from the Lead Agency and the Alliance Fiscal Analyst.
5. Requesting referrals for activation directly from the ARC will expedite the referral process: however.
it is inctt+��be�,t tlptli, Lead Agencies ti} mailtain tit, optimal caseload so a s not to create. any surpluses
fnr the curTCnt fiscal yeas nor any deficits, that when annualized. create deficits if, the next fiscal year.
For example, if a Lead Agency identifies "x°' number of clients will leave nr have left the program
dire to placement in af,other program, etc -, the Lead Agency call request replacement of these. clients
with new referrals by contacting the ARC directly. The Lead Agency i�,trst ensur however, that the
e.
nrunher of referrals requested does lx)t result in a number of cases that exceeds it opti mal caseload. In
det-�rrninmg the Optimal caseload for pu1 of requesting additional cases. factors such as historical
attl�it.ion rates and anticipated vacancies due to client tran,fers to other piog�al „s catr, be considered.
Under t, Circumstances can reductions in care plans occtlr for purposes of creating neCd for
n
additional referrals.
6. APS referrals are not wait listed and are referred to Lead Agencies on a rotation basis. Fundinb for
individuals designated as imrt,inent Risk and Aging Out will be authorized on an as- deeded basis by
the fiscal department upon review of funding. availability.
7. Ea c:h Lead Agency wili detiignate -,I person who is the point of contact and is authorized to request
referrals from the ARC: including the date( s) for referrals to be sent to the Lead Age.r,cy. Is, no
situatitm, Should the datets) established for receiving the referrals be more than 30 days from tl,e date
Of Te-quest.
8. At least n,onthiv. the Fiscal Analyst for the Alliance will monitor the number of cases that are
maintained by the Lead Agency to determine any projected surplus or deficit. 11' it is determined that
a projected deficit exists, the Fiscal Analyst will advise the ARC and the Lead Agency that no
additional referrals may be sent until there is conciuTence between the Alliance and the Lead Agency
about the budget projections. When there is concurrence about the budget projections. both the ARC
and the Lead Agency will be notified by the Fiscal Analyst that referrals can be sent. if watTanted.
62
1. By [lie IS' of each month, using the most cul`rent provider invoicing and �nrolImcnt data, the Alliance
Fiscal Analyst will prepare a preliminary surplus /deficit projection. taking i nto account historical
attrition rates. Adult Protective Services referrals, historical per rilemberll�e.} month (PMPivT) spending
rates, and the number of recently referred cases sent to the Lead Agency that may not have yet been
entered in C1RTS or activated {APPL1. In addition. sLlrplutiideficit forecast; will fors33afly incorporate
identified late blll!l3glilnn- billing patterns, changes to expenditures per consumer, lags in the
enrollment processes and any other information that may improve the accuracy of the pre }ections.
10. To monitor the provider's expC-lditL1res, the Alliance Fiscal Analyst will use the Alliance for Aging
CCE Expense and Projection Report tool. This tool compares a 131nnthly expenditure plan based on
projected caseloads that assumc historical attrition and enrollment factors, against actual invoicing.
On a monthly basis. the Alliance. will compare the cumulative expenditure to the momh of the report
against the CLimulative planned expenditure. For example, if for the December report. the cumulative
planned expenditltre was projected to be 55 percent and il' the actual reptx COMUlative expenditure
for Deccinher is 48 percent, they the nleasured slirplw, for the month of December w0ii -d he seven ( 7)
percent,
IL The Alliance Fiscal Analyst will send to the Fiscal Officer of each Lead Agency monthly preliminary
surl:lus /deficit reports and all Analysis of the findings. towher with any inquiries regLll'ding the
findings. This communication will be sent via electronic mail. lit addition. surplus /de.l'icit reports wi3i
be discussed in conference. on at least a monthly basis, with Lead Agencies to achieve consensus
forecasts.
12. The Fiscal officer of the lead Agency will respond to the Alliance's Fiscal Analyst within tvvo [2J
working days via electronic mail with tilt requested information, noting ally discrepane.ics between
the Alliance's projections and that of the Lead Agency. For example. the Lead Agency may report
atypical attrition or en rollment factors due tO LlltLlslli3l Cil CI.1n15tallco Stich as higher than usual attrition
or clients transferring to other r'unded programs. if a Lead Agency Iequested additional referrals in
excess of what had been determined to be the optimal caseload in order to prevent a ,urplu or deficit.
[hen a justif lCaliorl for requesting the additional referrals should be included as part of the response.
The Fiscal Anialvst will not contintle. to track and verify that the justification for tile additional
referrals has not resulted in a potential sui or deficit nor had an adverse impact on any clients
receiving services.
13. Based on the: it3lormatlon rece from the ]read A;xcncy. the Alliance Fiscal Analyst will either
mc.ldify 01 . o the preliminary surpltis /deficit report. The fiscal Analyst will Submit this report to
the Vice President for Finance who will present it for discussion with the Execume. Management
Group (E,MG). The FMG will decide oil an appropriate course of action to address [Ile surplus or
deficit.
14. A monthly surplus /deficit lllectingti will be held durillg which the Fiscal Analyst will conit
with contract management staff about the status and pr(iec -ions c)i'st3rplus /deficit~ for the programs.
1-5, Tile monthly surplus/deficit reports will he sent by the Alliance to DOEA. as required.
R. Remedial Actions for Surplus /Deficit:
For the surplttsldeficit reports covering the months of July through September. the Alliance will initiate
remedial action when two consecutive monthly reports indicate surpluses iii excess of five t5) percent for
each month.
a. Remedial action will consist of a. de- obligation of su funds ill all amount sufficient enough to
bring the year -to -date. cumulative surplus to less than five (5) percent of the cun year -
date expected expenditures. For example, for the ,tirplus /deficit report corresponding to the 111 013th
of October, the expected c_lnlulative expenditure is 33.3 percent of the contract amount. If file
reported e.xpenditurc, by the November report deadline. for services provided throLtgh September
30"' is 25 percent of the contras l atnounl and, if there is also a cumulative surplus of five (5)
percent or mo in August. then the Alliance 4vI de - obligate an anlolil that will b!ii the
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Culthulativ'e year -to -elate stn to less than give. (5) percent. In this example, the itmount of de -
obligated fronds is 8.3'7r (33.3 { /t minus 25 %) of the contract.
b. De obligated funds will be used by the ARC to make referrals on a client choice Fasts. The Fiscal
Analyst will advise the ARC of the numher of referrals to be made based on the amount of funds
available. Once all persons to be referred are identified and th clinics at case lilanageinent
agency made. the ARC will 11c)tify the Alliance fiscal office and the Lead Agencies ill order for
appropriate contract amendments to be prepared and e.xectrted.
?.
Far reports c.oLerin�� the October till - ough December period. the Alliance will initiate remedial action when
two consecutive monthiy reports show' UlinulatiL'C sllrplllSes 141 e iL'etiti of two and a half will ) Perce de 1n
cat:ll montlh. A cumulative Surplus incurred ill September, 11 larger thaIl five (5) pC3'Cel7t will be considered
fol' the consecutive count. For example. if the report for the mo41.11 of Si.ptetilhei sholr's ,i projected surplus
in excess of five (5) percent and the report for October shows a stlrplLIS ill CXCess of two alld a halt {2.5}
percent, then a de_() lligatioll of funds will he initiated that i5 equal to the miiount needed to decreaisc the
surplus to 110 more than two and I Half (2.5) percent. Ill illis exa mple. there Were two consecutive Ilis7 nth:;
in which there was a surplus for each month that exceeded the established threshold. Since the remedial
action was initiated in the October tllrou�h the Deceillbcr period, the,' t aniowlt for the reduction of the
sLirplus is two and a half (2.5) percent, These Surpluses arc Iriea urtd ti, ,ill� rile DDEA surplt4sldtficit
reporting tool w ith expenditures shown as reported by the l ead AUency-
a. The remedial action will he the same as Stated in sections R.l.a. grid B.1.b.above. except the
rcfeie ;hc.e.d surplus atllolvance is two and a half (2.5) percent.
�. For reports coveri the January tilrou�glh March period. he Alli._mce will itiitial.e Icnhedial action Mien c h
C011SCCLI11VC month Iy reports show' c11mLllative slit I)luse.s in 0xces,, of olie and it half ( 1.5) pe - cent elit iii eac
month. A cumulative surplus incurred in December. if lark p for the month of December Shows a
er than two and a half' ( percent will be
l C1n5idel'd for the. Consecutive count. Fol example, if the rep
projected surplus in excess of two and al half ( percent and rile lei }l)rt f or January Slit714'S a tiLlrplti5 3t1
excess of one and a half (l .5) pel then a dc- obligation of fonds will be initiated that is equal to the
amount needed to decrease the surpl us to no Vlore than one and a half ( 1.5) perce ;lt. I1, tltiw example. there
were two consecutive months ill which there was a surplus for each montll that exceeded the establ
threshoij. Since the remedial action was initiated in the January through March period then the amount for
the reduction of the surplus is one and a half( 1.5) percent. These. surpluses are Illeastired using the DOEA
surplus/deficit reporting tool Ivith expenditures sliolvn as re po r ted b the Lead Agency.
a. The remedial action will be the same as stated i section 13.1.a. and B.l.b. above, except the
referenCed surplus allowance is one and a hall (1.5) percent.
4. For reports covering the April acid M period. the Alliance will initiate rerriedial action for each month
which the surplus exceeds one (1) percent. The amount exceeding the one (1 percent threshold will be de -
oblivated. These surpluses at'e Itie<tsured using the DOEA surplus/deficit reporting tool with expenditures
showlh as reported by the Lead Agency.
a. The remedial action will be the same as stated in sections B. i .a, and B. i .b.above. except the
re.lei surplus allowance is one [ 1 y percent,
5. For the report covering the .tune period, if the surplus exceeds one f l.1 percent, it will be nr.ted as a program
coryipfiance issue and incorporated its purl o f the monitoring or the Lead Agency by the Alliance. The
agency may also be placed on corrective action.
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