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01/17/2018 Agreementz CAURr yY CUIOG;•.C�• Kevin Madok CPA Clerk of the Circuit. Court & Comptroller — Monroe County, Florida DATE: March 20, 2018 TO: Sheryl Graham, Director Social Services ATM: Lourdes Francis, Administrator FROM: Pamela G. HancC. SUBJECT: Janua 17' BOCC Meeting Enclosed are two duplicate originals of the following items for your handling: C31 Ratification of Standard Contract # AA -1829, Older Americans Act between the Alliance for Aging, Inc., and the Monroe County Board of County Commissioners/Monroe County Social Services/In -Home Services and Nutrition Programs for the contract period of January 1, 2018 through December 31, 2018 in the amount of $628,937.57. C34 Ratification of Nutrition Services Incentive Program Contract .US -851 between the Alliance for Aging, Inc., and Monroe County Board of County Commissioners, Social Services/In- Home Services for the Contract Year 2018 (January 1, 2018 - December 31, 2018) in the amount of $32,486.47. Should you have any questions, please feel free to contact me at ext. 3550. Thank you. cc: County Attorney w/o document Finance File KEY WEST 500 Whitehead Street Key West, Florida 33040 305- 294 -4641 MARATHON 3117 Overseas Highway Marathon, Florida 33050 305 - 289 -6027 PLANTATION KEY 88820 Overseas Highway Plantation Key, Florida 33070 305- 852 -7145 PK/ROTH BUILDING 50 High Point Road Plantation Key, Florida 33070 305- 852 -7145 'N ORIGINAL ALLIANCE FOR AGING, INC. STANDARD CONTRACT AA -1829 OLDER AMERICANS ACT PROGRAM TITLE III THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as the "Alliance," and Monroe County Board of County Commissioners, Social Services /In -Home Services, hereinafter referred to as the "Provider ", and collectively referred to as the "Parties." The term contractor for this purpose may designate a vendor, sub - grantee or sub - recipient, the status to be further identified in ATTACHMENT III, Exhibit -2 as necessary. WITNESSETH THAT: WHEREAS, the Alliance has established through the Area Plan on Aging that it is in need of certain services as described herein; and WHEREAS, the Provider has demonstrated that it has the requisite expertise and ability to faithfully perform such services as an independent contractor of the Alliance. NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the mutual covenants and conditions hereinafter set forth, the Parties agree as follows: 1. Purpose of Contract The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments and exhibits, which constitute the contract document. 2. Definitions ADL — Activities of Daily Living APS — Adult Protective Services 1 ADA — Americans with Disabilities Act Alliance — Area Agency on Aging F►t APCL — Assessed Priority Consumer List C) CIRTS — Client Information and Registration Tracking System g g Y c N C) C DOEA — Department of Elder Affairs (The Department) n .. I &R — Information and Referral IADL — Instrumental Activities of Daily Living. c MOA — Memorandum of Agreement '*7 CI MOU — Memorandum of Understanding OAA — Older Americans Act PSAs — Planning and Service Areas corresponding to Miami -Dade and Monroe Counties SPA — Service Provider Application 3. Incorporation of Documents within the Contract The contract incorporates by reference attachments, proposal(s), solicitation(s), Provider's Service Provider Application, and the current DOEA Programs and Services Handbook. Any and all contracts or agreements executed between the Provider and the Alliance during the effective period of this contract shall be governed in accordance with the applicable laws and statutes. 4. Incorporation of Reference Memoranda In accordance with Chapter 287 F.S., amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, October 3, 2012; (2) CFO Memo No. 07: Release date, June 27, 2012; (3) CFO memo No. 01: Release date, July 26, 2012; and (4) CFO Memo No. 06: Release date, June 30, 2010. Page 1 of 70 AA -1829 5. Term of Contract This contract shall begin on January 1, 2018 or on the date on which the contract has been signed by the last party required to sign it, whichever is later. It shall end at midnight, local time in Miami, Florida, on December 31, 2018, unless renewed or extended as provided herein. 6. Contract Amount The Alliance agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $628,937.57 subject to the availability of fiends. Any costs or services paid for under any other contract or from any other source are not eligible for payment under this contract. Renewals By mutual agreement of the parties, the Alliance may renew the contract for two additional one year. Contingent upon satisfactory performance evaluations by the Alliance and the availability of funds, any renewal is subject to the same terms as the original contract, with the exception of establishing unit rates which is described further in this section. The original contractual unit rates are set forth in the bid proposal and reply. Requests to renegotiate the original contractual established rates are provided for in the Alliance's approved Reimbursement Rate Review Policy, which is incorporated by reference. The parties shall re- evaluate the contract's reimbursement rates on an annual basis pursuant to DOEA's Notice of Policy Clarification: Service Cost Reports Notice #092815- 1- PC -SCBS dated September 28` 2015 and the approved Alliance's Reimbursement Rate Review Policy. This contract may be extended upon mutual agreement for one extension period not to exceed six months to ensure continuity of service. Services provided under this extension will be paid for out of the succeeding agreement amount. ' 8. Compliance with Federal Law 8.1 This contract contains federal finds. The following shall apply: 8.1.1. The Provider shall comply with the provisions of 45 CFR 74 and /or 45 CFR 92, and other applicable regulations. 8.1.2. If this contract contains federal funds and is over $100,000.00, the Provider shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738, as amended, and where applicable Environmental Protection Agency regulations 40 CFR 30. The contractor shall report any violations of the above to the Alliance. 8.1.3. The Provider, or agent acting for the Provider, may not use any federal finds received in connection with this contract to influence legislation or appropriations pending before the Congress or any State legislature. If this contract contains federal funding in excess of $100,000.00, the contractor must, prior to contract execution, conplete the Certification Regarding Lobbying form, ATTACHMENT Il. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the Contract Manager, prior to payment under this contract. 8.1.4. In accordance with Appendix A to 2 CFR 215, the contractor shall comply with Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 1 1375 and others, and as supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable. 8.1.5. If this contract contains federal finds and provides services to children up to age 18, the contractor shall comply with the Pro - Children Act of 1994 (20 U.S.C. 6081). Page 2 of 70 AA -1829 8.1.6. A contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards shall not be made to parties listed on the government -wide Excluded Parties List System, in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." The Excluded Parties List System contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. The Provider shall comply with these provisions before doing business or entering into subcontracts receiving federal funds pursuant to this contract. The Provider shall complete and sign ATTACHMENT V prior to the execution of this contract. 8.2. The Provider shall not employ an unauthorized alien. The Alliance shall consider the employment of unauthorized aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324 a) and the Immigration Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation shall be cause for unilateral cancellation of this contract by the Alliance. 8.3. If the Provider is a non - profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization reporting requirements (filing a Form 990 or Form 990 -N) and has its tax exempt status revoked for failing to comply with the filing requirements of the 2006 Pension Protection Act or for any other reason, the Provider must notify the Alliance in writing within thirty (30) days of receiving the IRS notice of revocation. 8.4. The Provider shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons. 8.5. Unless exempt under 2 CFR Part 170.110(b), the Provider shall comply with the reporting requirements of the Transparency Act as expressed in 2 CFR 170. 8.6. To comply with Presidential Executive Order 12989 and State.of Florida Executive Order Number 11 -116, Provider agrees to utilize the U.S. Department of Homeland Security's E- verify system to verify the employment of all new employees hired by Provider during the contract term. Provider shall include in related subcontracts a requirement that subcontractors performing work or providing services pursuant to the state contract utilize the E- verify system to verify employment of all new employees hired by the subcontractor during the contract term. Providers meeting the terms and conditions of the E- Verify System are deemed to be in compliance with this provision. 9. Compliance with State Law 9.1. This contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 9.2. The Provider shall comply with the requirements of s. 287.058, F.S. as amended. 9.2.1. The Provider shall provide units of deliverables, including various client services, and in some instances may include reports, findings, and drafts, as specified in this contract, which the Contract Manager must receive and accept in writing prior to payment in accordance with s.215.971, F.S. (1) and (2). 9.2.2. The Provider shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre -audit and post - audit. 9.2.3. If itemized payment for travel expenses is permitted in this contract, the contractor will submit bills for any travel expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this contract. 9.2.4. The Provider shall allow public access to all documents, papers, letters, or other public records as defined in subsection 119.011(12), F.S., made or received by the contractor in conjunction with this Page 3 of 70 AA -1829 contract except for those records which are made confidential or exempt by law. The Provider's refusal to comply with this provision shall constitute an immediate breach of contract for which the Alliance for Aging, Inc. may unilaterally terminate the contract. 9.3.. 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. 9.4. Subcontractors who are on the discriminatory vendor list may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S. 9.5. The Provider will comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of contract finds for the purpose of lobbying the legislature, judicial branch or a state agency. 9.6. In accordance with s. 287.135 F.S., any contractor on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created pursuant to s. 215.473 F.S., is ineligible to enter into or renew a contract funded through a DOEA contract for goods or services of $1 million or more. The Alliance may terminate this contract if the Provider is found to have submitted a false certification of its status on the Lists or has been placed on the Lists. Further, the Provider is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification. If this contract contains $1 million or more, the Provider shall complete and sign ATTACHMENT H, Certification Regarding Scrutinized Companies Lists, prior to the execution of this contract. 10. Background Screening 10.1. The Provider shall ensure that the requirements of s. 430.0402 and Chapter 435, F.S., as amended, are met regarding background screening for all persons who meet the definition of a direct service provider and who are not exempt from the Department's level 2 background screening pursuant to s. 430.0402(2) -(3), F.S. The Provider must also comply with any applicable rules promulgated by the Department and the Agency for Health Care Administration regarding implementation of s. 430.0402 and Chapter 435, F.S. 10.2. Further information concerning the procedures for background screening is found at http: //elderaffairs. state .fl.us /doea/back9roundscreeni nga[ip 10.3. Background Screening Affidavit of Compliance - To demonstrate compliance with this contract, the Provider shall submit ATTACHMENT D, Background Screening Affidavit of Compliance annually, by January 15th. 11. Grievance Procedures The Provider shall comply with and ensure subcontractor compliance with the Minimum Guidelines for Recipient Grievance Procedures, Appendix D, DOEA Programs and Services Handbook, to address complaints regarding the termination, suspension or reduction of services, as required for receipt of finds. 11.1. Complaint Procedures The Provider shall develop and implement complaint procedures and ensure that subcontractors develop and implement complaint procedures to process and resolve client dissatisfaction with services. Complaint procedures shall address the quality and timeliness of services, provider and direct service worker complaints, or any other advice related to complaints other than termination, suspension or reduction in services that require the grievance process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook. The complaint procedures shall include notification to all clients of the complaint procedure and include tracking the date, nature of complaint, and the determination of each complaint. Page 4 of 70 AA -1829 12. Audits, Inspections, Investigations, Public Records and Retention 12.1 The Provider shall establish and maintain books, records and documents (including electronic storage media) sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of fiords provided by the Alliance under this contract. Provider shall adequately safeguard all such assets and assure they are used solely for the purposes authorized under this contract. Whenever appropriate, financial information should be related to performance and unit cost data. 12.2 The Provider shall retain all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to this contract for a period of six (6) years after completion of the contract or longer when required by law. In the event an audit is required by this contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the Alliance. 12.3 Upon demand, at no additional cost to the Alliance, the Provider will facilitate the duplication and transfer of any records or documents during the required retention period in Paragraph 12.2. 12.4 The Provider shall assure that the records described in Paragraph 12.2 shall be subject at all reasonable times to inspection, review, copying, or audit by Federal, State, or other personnel duly authorized by the Alliance. 12.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Alliance, DOEA and Federal auditors, pursuant to 45 CFR 92.36(i)(10), shall be allowed full access to and the right to examine any of the Provider's contracts and related records and documents pertinent to this specific contract, regardless of the form in which kept. 12.6 The Provider shall provide a financial and compliance audit to the Alliance as specified in this contract and in ATTACHMENT III and to ensure that all related party transactions are disclosed to the auditor. 12.7 The Provider shall comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by the office of the DOEA's Inspector General pursuant to s. 20.055, F.S. 13. Nondiscrimination -Civil Rights Compliance 13.1 The Provider shall execute assurances in ATTACHMENT VI that it will not discriminate against any person in the provision of services or benefits under this contract or in employment because of age, race, religion, color, disability, national origin, marital status or sex in compliance with state and federal law and regulations. The Provider further assures that all contractors, subcontractors, sub- grantees, or others with whom it arranges to provide services or benefits in connection with any of its programs and activities are not discriminating against clients or employees because of age, race, religion, color, disability, national origin, marital status or sex. 13.2 During the term of this contract, the Provider shall complete and retain on file a timely, complete and accurate Civil Rights Compliance Checklist (ATTACHMENT B). 13.3 The Provider shall establish procedures pursuant to federal law to handle complaints of discrimination involving services or benefits through this contract. These procedures will include notifying clients, employees, and participants of the right to file a complaint with the appropriate federal or state entity. 13.4 If this contract contains federal fiords, these assurances are a condition of continued receipt of or benefit from federal financial assistance, and are binding upon the Provider, its successors, transferees, and assignees for the Page 5 of 70 AA -1829 period during which such assistance is provided. The Provider further assures that all subcontractors, vendors; or others with whom it arranges to provide services or benefits to participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in violation of the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the Provider understands that the Alliance may, at its discretion, seek a court order requiring compliance with the terms of this assurance or seek other appropriate judicial or administrative relief, including but not limited to, termination of and denial of further assistance. 14. Provision of Services The Provider shall provide the services referred to in ATTACHMENT VII in the manner described in the DOEA Programs & Services Handbook and the Provider's Service Provider Application (SPA). In the event of a conflict between the Service Provider Application and this contract, the contract language prevails. 15. Monitoring by the Alliance The Provider shall permit persons duly authorized by the Alliance to inspect and copy any records, papers, documents, facilities, goods and services of the Provider which are relevant to this contract, and to interview any clients, employees and subcontractor employees of the Provider to assure the Alliance of the satisfactory performance of the terms and conditions of this contract. Following such review, the Alliance will deliver to the Provider a written report of its findings and request for development, by the Provider, a corrective action plan where appropriate. The Provider hereby agrees to timely correct all deficiencies identified in the corrective action plan. 16. Coordinated Monitoring with Other Agencies If the Provider receives finding from one or more of the State of Florida human service agencies, in addition to Alliance finding, then a joint monitoring visit including such other agencies may be scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human service agencies shall include the Department of Children and Families, the Department of Health, the Agency for Persons with Disabilities, the Department of Veterans Affairs, and the Department of Elder Affairs. Upon notification and the subsequent scheduling of such a visit by the designated agency's lead administrative coordinator, the Provider shall comply and cooperate with all monitors, inspectors, and /or investigators. 17. Indemnification The Provider shall indemnify, save, defend, and hold harmless the Alliance and its agents and employees from any and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the execution of this agreement or performance of the services provided for herein. It is understood and agreed that the Provider is not required to indemnify the Alliance for claims, demands, actions or causes of action arising solely out of the Alliance's negligence. 17.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph 15 is not applicable to contracts executed between the Alliance and state agencies or subdivisions defined in s. 768.28(2), F.S. 18. Insurance and Bonding 18.1 The Provider shall provide continuous adequate liability insurance coverage during the existence of this contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a state agency or subdivision as defined by subsection 768.28(2), F.S., the Provider accepts frill responsibility for identifying and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the Provider and the clients to be served under this contract. The Alliance shall be included as an additional insured on the provider's liability insurance policy or policies and a copy of the Certificate of Insurance shall be provided annually or when any changes — occur. The limits of coverage under each policy maintained by the Provider do not limit the Provider's liability and obligations under this contract. The Provider shall ensure that Page 6 of 70 AA -1829 the Alliance has copy of the most current written verification of insurance coverage throughout the term of this contract. Such coverage may be provided by a self - insurance program established and operating under the laws of the State of Florida. The Alliance reserves the right to require additional insurance as specified in this contract. 18.2 Throughout the term of this agreement, the Provider shall maintain an insurance bond from a responsible commercial insurance company covering all officers, directors, employees and agents of the Provider authorized to handle fiends received or disbursed under all agreements and /or contracts incorporating this contract by reference in an amount commensurate with the finds handled, the degree of risk as determined by the insurance company and consistent with good business practices. 19. Confidentiality of Information The Provider shall not use or disclose any information concerning a recipient of services under this contract for any purpose prohibited by state or federal law or regulations except with the written consent of a person legally authorized to give that consent or when authorized by law. 20. Health Insurance Portability and Accountability Act Where applicable, the Provider shall comply with the Health Insurance Portability and Accountability Act (42 USC 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164). 21. Incident Reporting 21.1 The Provider shall notify the Alliance immediately but no later than forty -eight (48) hours from the Provider's awareness or discovery of conditions that may materially affect the Provider or Subcontractor's ability to perform the services required to be performed under any contract. Such notice shall be made orally to the Contract Manager (by telephone) with an email to immediately follow. 21.2 The Provider shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll free telephone number (1- 800- 96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the Provider, Subcontractors, and their employees. 22. Bankruptcy Notification If, at any time during the term of this contract, the Provider, its assignees, subcontractors or affiliates files a claim for bankruptcy, the Provider must immediately notify the Alliance. Within ten (10) days after notification, the Provider must also provide the following information to the Alliance: (1) the date of filing of the bankruptcy petition; (2) the case number; (3) the court name and the division in which the petition was filed (e. g., Northern District of Florida, Tallahassee Division); and, (4) the name, address, and telephone number of the bankruptcy attorney. 23. Sponsorship and Publicity 23.1 As required by s. 286.25, F.S., if the Provider is a non - governmental organization which sponsors a program financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by (Provider's name), the State of Florida Department of Elder Affairs and the Alliance for Aging, Inc." If the sponsorship reference is in written material, the words "State of Florida, Department of Elder Affairs" and "Alliance for Aging, Inc." shall appear in at least the same size letters or type as the name of the organization. Page 7 of 70 AA -1829 23.2 The Provider shall not use the words "The State of Florida Department of Elder Affairs" or "Alliance for Aging, Inc." to indicate sponsorship of a program otherwise financed, unless specific authorization has been obtained by the Alliance prior to use. 24. Assignments 24.1 The Provider shall not assign the rights and responsibilities under this Contract without the prior written approval of the Alliance, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring without prior written approval of the Alliance will constitute a material breach of the contract. 24.2 The Alliance shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or obligations under this contract to another agency upon giving prior written notice to the Provider. In the event the Alliance approves transfer of the Provider's obligations, the Provider remains responsible for all work performed and all expenses incurred in connection with the contract. 24.3 This contract shall remain binding upon the successors in interest of either the Provider or the Alliance. 25. Subcontracts 25.1 The Provider is responsible for all work performed pursuant to this contract and the Service Provider Application in response to the 2012 OAA RFP. Any subcontracts shall be evidenced by a written document and subject to any conditions of approval the Alliance for Aging deems necessary. The Provider further agrees that the Alliance shall not be liable to the subcontractor in any way or for any reason. The Provider, at its expense, shall defend the Alliance against any such claims. 25.2 The Provider shall promptly pay any subcontractors upon receipt of payment from the Alliance. Failure to make payments to any subcontractor in accordance with s. 287.0585, F.S., unless otherwise stated in the contract between the Provider and subcontractor, will result in a penalty as provided by statute. 26. Funding Obligations 26.1 The Alliance acknowledges its obligation to pay the Provider for the performance of the Provider's duties and responsibilities set forth in any contract or agreement incorporating in this agreement. 26.2 The Alliance shall not be liable to the Provider for costs incurred or performance rendered unless such costs and performances are in accordance with the terms and conditions of any contract or agreement executed between the parties, which incorporates this Contract, including but not limited to terms, governing the Provider's promised performance and unit rates and /or reimbursement capitations specified. 2 6. 3 The Alliance shall not be liable to the Provider for any expenditures which are not allowable costs as defined in the C.F.R., Title 45, Parts 74 and 92, as amended, or which expenditures have not been made in accordance with all applicable state and federal rules. 26.4 The Alliance shall not be liable to the Provider for expenditures made in violation of regulations promulgated under the Older Americans Act, as amended, or in violation of applicable state and federal laws, rules, or provisions of any contract or agreement incorporating in this Contract. Page 8 of 70 AA -1829 27. Independent Capacity of Provider It is the intent and understanding of the Parties that the Provider, or any of its subcontractors, are independent contractors and are not employees of the Alliance and shall not hold themselves out as employees or agents of the Alliance without specific authorization from the Alliance. It is the further intent and understanding of the Parties that the Alliance does not control the employment practices of the Provider and shall not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the Provider or its subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation finds and all necessary insurance for the Provider shall be the sole responsibility of the Provider. 28. Payment 28.1. Payments will be made to the Provider pursuant to s. 215.422, F.S., as services are rendered and invoiced by the Provider. The Alliance will have final approval of the invoice for payment, and will approve the invoice for payment only if the Provider has met all terms and conditions of the contract, unless the bid specifications, purchase order, or this contract specify otherwise. The approved invoice will be submitted to the Alliance's fiscal section for budgetary approval and processing. Disputes arising over invoicing. and payments will be resolved.in accordance with the provisions of s. 215.422 F.S. 28.2. The Provider agrees to submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre audit and post audit thereof. The contractor shall comply with the particular requirements under the following laws and guidelines that are applicable to the contracts or agreements incorporating in this Contract by reference: (a) paragraph (16) (b) of section 216.181, F.S., regarding advances; (b) Rule 69I- 40.103 F.A.C. pertaining to Restriction of Expenditures from state finds; and, (c) the Invoice Requirements of the Reference Guide for State Expenditures from the Department of Financial Services at: httu : / /www.myfloridacfo.com /aadir, /reference guide/Reference Guide For State Expenditures.pdf The Provider will certify that detailed documentation is available to support each item on the itemized invoice or payment request for cost reimbursed expenses, fixed rate or deliverables contracts or agreements incorporating this Contract by reference, including paid Subcontractor invoices, and will be produced upon request by the Alliance. The Provider will further certify that reimbursement requests are only for allowable expenses as defined in the laws and guiding circulars cited in Sections 4 of this Contract, in the Reference Guide for State Expenditures, and any other laws or regulations, as applicable. 28.3. The Provider and Subcontractors. shall provide units of deliverables, including reports, findings, and drafts as specified in the contracts or agreements and attaclunents which incorporate this Contract to be received and accepted by the Contract Manager prior to payment. 28.4. Payments will be made to the Provider based on a complete and correct invoice, invoices that are incomplete or with incorrect total will not be processed and will be returned to the Provider for correction. Fiscal staff will not be able to correct or make changes to the invoices. Returning invoices for corrections may result in failure to receive payment for that month. Invoices shall be submitted timely as per ATTACHMENT VIII in order to avoid any payment delays. 28.5. Each service performed shall be recorded as specified in the client information and registration tracking system (CIRTS) guidelines. Supporting documentation of services provided must be adequate to permit fiscal and programmatic evaluation, and ensure internal management. 29. Return of Funds The Provider will return to the Alliance any overpayments due to unearned finds or funds disallowed and any interest attributable to such finds pursuant to the terms and conditions of this contract that were disbursed to the Page 9 of 70 AA -1829 Provider by the Alliance. In the event that the Provider or its independent auditor discovers that an overpayment has been made, the Provider shall repay said overpayment immediately without prior notification from the Alliance. In the event that the Alliance first discovers an overpayment has been made, the Contract Manager, on behalf of the Alliance, will notify the Provider by letter of such findings. Should repayment not be made forthwith, the Provider will be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after Alliance notification or Provider discovery. 30. Data Integrity and Safeguarding Information The Provider and its subcontractors shall insure an appropriate level of data security for the information the Provider is collecting or using in the performance of this contract. An appropriate level of security includes approving and tracking all Provider employees that request system or information access and ensuring that user access has been removed from all terminated employees. The Provider, among other requirements, must anticipate and prepare for the loss of information processing capabilities. All data and software shall be routinely backed rrp to ensure recovery from losses or outages of the computer system. The security over the backed -up data is to be as stringent as the protection required of the primary systems. The Provider shall ensure all Subcontractors maintain written procedures for computer system back -up and recovery. The Provider shall complete and sign ATTACHMENT IV prior to the execution of this contract. 31. Computer Use and Social Media Policy The DOEA has implemented a new Social Media Policy, in addition to its Computer Use Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel affiliated with third parties, such as, but not limited to, Area Agencies on Aging and vendors. Any entity that uses the DOEA's computer resource systems must comply with the DOEA's policy regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as Flickr and YouTube (ATTACHMENT Q. This policy is available on the Department's website at: h� elcieraffairs .state.fl.us /doea/financiii phn 32. Conflict of Interest The Provider shall establish safeguards to prohibit employees, board members, management and subcontractors from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal gain. No employee, officer or agent of the Provider or subcontractor shall participate in selection, or in the award of an agreement supported by State or Federal funds if a conflict of interest, real or apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of his /her immediate family; (c) his or her partner, or; (d) an organization which employs, or is about to employ, any of the above, has a financial or other interest in the firm selected for award. The Provider or any subcontractor's officers, employees or agents will neither solicit nor accept gratuities, favors or anything of monetary value from contractors, potential contractors, or parties to subcontracts. The Provider's board members and management must disclose to the Alliance any relationship which may be, or may be perceived to be, a conflict of interest within thirty (30) calendar days of an individual's original appointment or placement in that position, or if the individual is serving as an incumbent, within thirty (30) calendar days of the commencement of this contract. The Provider's employees and subcontractors must make the same disclosures described above to the Provider's board of directors. Compliance with this provision will be monitored. 33. Public Entity Crime Pursuant to s. 287.133, F.S., the following restrictions are placed on the ability of persons convicted of public entity crimes to transact business with the Alliance. A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or Page 10 of 70 AA -1829 consultant under a contract with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 34. Emergency Preparedness and Continuity of Operations 34.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the administration and coordination of services necessary for client health, safety or welfare, the Provider shall, within thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of an emergency preparedness plan (Continuity of Operations Plan.) In the event of an emergency, the Provider shall notify the Alliance of emergency provisions. 34.2 In the event a situation results in a cessation of services by a Subcontractor, the Contractor shall retain responsibility for performance under this contract and must follow procedures to ensure continuity of operations without interruptions. 34.3 Contractors offering nutrition services must have at least 3 days' worth of shelf stable meals or a pre- approved three -day menu for emergency meals with reserved finds set aside to purchase the food items and at least one back -up caterer who can provide meals immediately in the event of an emergency. Either option must be made available immediately to clients in the event of an emergency to ensure continuity of meal services without interruption and must be included in the Contractor's Continuity of Operations Plan (COOP). 35. Use of Contract Funds to Purchase Equipment No finds under this contract will be used by the Provider to purchase equipment. Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable, tangible personal property of a non - consumable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful life of at least one year; and hardback bound books not circulated to students or the general public, with a value or cost of $250.00 or more [for state finds]. 36. The PUR 1000 Form is hereby incorporated by reference and available at: http: % /www.mvflorida.com /apps %vbs /adoc /F7740 PUR1000.pdf In the event of any conflict between the PUR 1000 Form and any terns or conditions of any contract or agreement terms or conditions the contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or conditions in the PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained in the PUR 1000 Form shall take precedence. 37. Use of State Funds to Purchase or Improve Real Property Any state finds provided for the purchase of or improvements to real property are contingent upon the Provider or political subdivision granting to the state a security interest in the property at least to the amount of state funds provided for at least 5 years fi - om the date of purchase or the completion of the improvements or as further required by law. 38. Dispute Resolution Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce the decision to writing and serve a copy on the Provider. 39. Financial Consequences of Non- Performance Page 11 of 70 AA -1829 39.1 If the Provider fails to meet the minimum level of service or performance identified in this agreement, or that is customary for the industry, then the Alliance may apply financial consequences commensurate with the deficiency as referenced in ATTACHMENT 1, Sec. 3.5.2. Financial consequences may also include contract suspension, refusing payment, withholding payments until deficiency is cured, tendering only partial payments, and /or cancellation of contract and reacquiring services from an alternate source. 39.2 The Provider shall not be charged with financial consequences, when a failure to perform arises out of causes that were the responsibility-of the Alliance. 40. No Waiver of Sovereign Immunity Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which sovereign immunity may be applicable. 41. Venue If any dispute arises out of this contract, the venue of such legal recourse will be Miami -Dade County, Florida. 42. Entire Contract This contract contains all the terms and conditions agreed upon by the parties. No oral agreements or representations shall be valid or binding upon the Alliance or the Provider unless expressly contained herein or by a written amendment to this contract signed by both Parties. 43. Force Majeure The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control, provided the party experiencing the force majeure condition provides immediate written notification to the other party and takes all reasonable efforts to cure the condition. 44. Severability Clause The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable, the other provisions are severable to that void provision and shall remain in frill force and effect. 45. Condition Precedent to Contract: Appropriations The Parties agree that the Alliance's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature. 46. Addition/Deletion The Parties agree that, notwithstanding the terms of the procurement documents and actions leading to this contract, the Alliance reserves the right to add or to delete any of the services required under this contract when deemed to be in the best interest of the elder population targeted by the Area Plan and reduced to a written amendment signed by both Parties. The Parties shall negotiate compensation for any additional services added. 47. Waiver The delay or failure by the Alliance to exercise or enforce any of its rights under this contract shall not constitute or be deemed a waiver of the Alliance's right thereafter to enforce those rights, nor shall any single or partial exercise of any such right preclude any other or further exercise thereof or the exercise of any other right. 48. Compliance The Provider shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable current State statutes, laws, rules and regulations. The Parties agree that failure of the Provider to abide by these Page 12 of 70 AA -1829 laws shall be deemed an event of default of the Provider, and subject the contract to immediate, unilateral cancellation of the contract at the discretion of the Alliance. 49. Final Invoice The Provider shall submit the final invoice for payment to the Alliance. as specified in section 3.3.6 (date for final request for payment) of ATTACHMENT I. If the Provider fails to submit final request for payment by the deadline, then all rights to payment may be forfeited and the Alliance may not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from the Provider and necessary adjustments thereto have been approved by the Alliance. 50. Renegotiations or Modifications Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly signed by both parties. 51. Suspension of Work: The Alliance may in its sole discretion suspend any or all activities under this Contract and any Contract or agreement incorporating in this Contract, at any time, when in the best interests of the State to do so. The Alliance shall provide the Provider written notice outlining the particulars of suspension. Examples of the reason for suspension include, but are not limited to, budgetary constraints, declaration of emergency, or other such circumstances. After receiving a suspension. notice, the Provider shall comply with the notice and shall not accept any purchase orders. Within ninety days, or any longer period agreed to by the Provider, the Alliance shall either (1) issue a notice authorizing resumption of work, at which time activity shall resume, or (2) terminate the Contract or purchase order. Suspension of work shall not entitle the Provider to any additional compensation. 52. Termination 50.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar days' notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the Contract Manager or the representative of the Provider responsible for administration of the contract. 50.2 In the event funds for payment pursuant to this contract become unavailable, the Alliance may terminate this contract upon no less than twenty -four (24) hours' notice in writing to the Provider. Said notice shall be delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the Contract Manager or the representative of the Provider responsible for administration of the contract. The Alliance will be the final authority as to the availability and adequacy of finds. In the event of termination of this contract, the Provider will be compensated for any work satisfactorily completed prior to the date of termination. 50.3 Termination for Cause This contract may be terminated for cause by the Alliance upon no less than twenty -four (24) hours' notice in writing to the Provider. Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the Alliance's or the Provider's rights to remedies at law or in equity. 50.4 Failure to have performed any contractual obligations with the Alliance in a manner satisfactory to the Alliance will.be a sufficient cause for termination. To be terminated as a contractor under this provision, the Provider Page 13 of 70 AA -1829 must have (1) previously failed to satisfactorily perform in a contract with the Alliance, been notified by the Alliance of the unsatisfactory performance and failed to correct the unsatisfactory performance to the satisfaction of the Alliance; or (2) had a contract terminated by the Alliance for cause. 50.5. Waiver of breach of any provisions of this contract shall not be deemed to be 'd waiver of any other breach and shall not be construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the Alliance's right to remedies at law or to damages of a legal or equitable nature. 53. Electronic Records and Signature The Alliance authorizes, but does not require, the Provider to create and retain electronic records and to use electronic signatures to conduct transactions necessary to carry out the terms of this Contract. A contractor that creates and retains electronic records and uses electronic signatures to conduct transactions shall comply with the requirements contained in the Uniform Electronic Transaction Act, s. 668.50, Fla. Stat. All electronic records must be fully a>.uditable; are subject to Florida's Public Records Law, ch. 119, Fla. Stat.; must comply with section 28, Data Integrity and Safeguarding Information;'must maintain all confidentiality, as applicable; and must be retained and maintained by the Provider to the same extent as non - electronic records are retained and maintained as required by this Contract. 53.1. The Alliance's authorization pursuant to this section does not authorize electronic transactions between the Provider and the Alliance. The Provider is authorized to conduct electronic transactions with the Alliance only upon further written consent by the Alliance. 53.2. Upon request by the Alliance, the Provider shall provide the Alliance or DOEA with non - electronic (paper) copies of records. Non - electronic (paper) copies provided to the Alliance of any document that was originally in electronic form with an electronic signature must indicate the person and the person's capacity who electronically signed the document on any non - electronic copy of the document. 54. Special Provisions: The Provider agrees to the following provisions: 54.1 Investigation of Criminal Allegations: Any report that implies criminal intent on the part of the Provider or any Subcontractors and referred to a governmental or investigatory agency must be sent to the Alliance. If the Provider has reason to believe that the allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney's office, or other governmental agency, the Provider shall notify the Alliance immediately. A copy of all documents, reports, notes or other written material concerning the investigation, whether in the possession of the Provider or Subcontractors, must be sent to the Alliance's contract manager with a summary of the investigation and allegations. 54.2 Volunteers: The Provider shall ensure the use of trained volunteers in providing direct services delivered to older individuals and individuals with disabilities needing such services. If possible, the Provider shall work in coordination with organizations that have experience in providing training, placement, and stipends for volunteers or participants (such as organizations carrying out federal service programs administered by the Corporation for National and Community Service), in community service settings. 55. Enforcement: Page 14 of 70 AA -1829 55.1 In accordance with Section 430.04, F.S., the Alliance may, without taking any intermediate measures available to it against this Contract rescind this Contract if the Alliance finds that: 55.2 An intentional or negligent act of the Provider has materially affected the health, welfare, or safety of clients served pursuant to any contract or agreement incorporating this Master Contract by reference, or substantially and negatively affected the.operation of services covered under any contract or agreement; 55.3 The Provider lacks financial stability sufficient to meet contractual obligations or that contractual finds have been misappropriated; 55.4 The Provider has committed multiple or repeated violations of legal and regulatory standards, regardless of whether such laws or regulations are enforced by the Alliance, or the Provider has committed or repeated violations of Alliance standards; 55.5 The Provider has failed to continue the provision or expansion of services after the declaration of a state of emergency; and /or 55.6 The Provider has failed to adhere to the terms of any contract or agreement incorporating in this Contract. 55.7 In the alternative, the Alliance may, at its sole discretion, in accordance with section 430.04,F.S., take immediate measures against the Provider, including: corrective action, unannounced special monitoring, temporary assumption of the operation of one or more contractual services, placement of the Provider on probationary status, imposing a moratorium on Provider action, imposing financial penalties for nonperformance, or other administrative action pursuant to Chapter 120, F.S. 55.8 In making any determination under this provision the Alliance may rely upon the findings of another state or federal agency, or other regulatory body. Any claims for damages for breach of any contract or agreement are exempt from administrative proceedings and shall be brought before the appropriate entity in the venue of Miami -Dade County. 56. Training The Provider will attend all required trainings and meetings schedule by the Alliance. Page 15 of 70 AA -1829 57. Official Payee and Representatives (Name, Address, and Telephone Numbers) The name, address, and telephone number of the representative for the Alliance for this contract is: Max B. Rothman, JD, LL.M. President and CEO 760 NW 107th Ave, Suite 214 Miami, Florida 33172 (305) 670 -6500, Ext. 224 The name, address, and telephone number of the representative of the Contractor responsible for administration of the program under this contract is: Page 16 of 70 The Contractor name, as shown on page 1 of this Monroe County Board of County Commissioners, A contract, and mailing address of the official Social Services /In -Home Services payee to whom the payment shall be made is: 1100 Simonton Street, 2 Key West, FL 33040 305- 292 -4510 Sheryl Graham The name of the contact person of the Monroe County Board of County Commissioners, B Contractor and street address where financial Social Services /In -Home Services and administrative records are maintained is: 1100 Simonton Street, Floor Key West, FL 330404 0 305- 292 -4510 Sheryl Graham The name, address, and telephone number of the Monroe County Board of County Commissioners, c representative of the Provider responsible for Social Services /In -Home Services administration of the program under this 1100 Simonton Street, 2 nd Floor contract is: Key West, FL 33040 305- 292 -4510 Alliance for Aging, Inc. The section and location within the AAA where Fiscal Department d Requests for Payment and Receipt and 760 NW 107th Avenue, Suite 214 Expenditure forms are to be mailed is: Miami, Florida 33 172 -3155 305- 670 -6500 Page 16 of 70 DEW 0` I AA -1829 Contract Monitor The name, address, and telephone number of the Alliance for Aging, Inc. Contract Manager for the AAA for this contract 760 NW 107th Avenue, Suite 214 is: Miami, Florida 33172 -3155 305- 670 -6500 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. 58. All Terms and Conditions Included This contract and its Attachments, I through X, A, B, C, D, E, F, G, H and any exhibits referenced in said attachments, together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terns, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. By signing this contract, the Parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF, the Parties hereto have caused this 71 page contract, to be executed by their undersigned officials as duly authorized. MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, SOCIAL SERVICESAN -HOME S // ERVICES SIGNED BY: NAME: ( - F4 4gwk TITLE:A`o kur-1 ^i ► LL n 1 f _R L DATE: I_� �(a ALLIANCE FOR AGING, INC. SIGNED BY NAME: MAX B. ROTHMA , LL.M. TITLE: PRESIDENT AND CEO DATE: DEC 2 9 2917 ® PEDRO J. ERCADQ`::__ :': = - ASSISTANT C SIGNED BY: `: ' 0-!" " Date NAME: David Rice ' TITLE: MAYOR Page 17 of 70 - K. CLERK DATE: 17, 2u r �{ r ` '_ DE CLERK AA -1829 INDEX TO CONTRACT ATTACHMENTS ATTACHMENT ATTACHMENT DESCRIPTION PAGE ATTACHMENT I STATEMENT OF WORK 19 -31 ATTACHMENT II CERTIFICATION REGARDING LOBBYING 32 ATTACHMENT III FINANCIAL COMPLIANCE AUDIT ATTACHMENT 33 -35 ATTACHMENT III EXHIBIT 1 AUDIT REPLATIONSHIP DETERMINATION 36 -37 ATTACHMENT III EXHIBIT 2 FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT 38 ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE 39 ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS /SUBCONTRACTS 40 ATTACHMENT VI ASSURANCES — NON - CONSTRUCTION PROGRAMS 41 -42 ATTACHMENT VII CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE 43 ATTACHMENT VIII OLDER AMERICANS ACT CONTRACT REPORT CALENDAR 44 ATTACHMENT IX REQUEST FOR PAYMENT 45 ATTACHMENT X, EXHIBIT 1 RECEIPTS AND EXPENDITURES, TITLE IIIB, IIICI, AND IIIC2 46 ATTACHMENT X, EXHIBIT 2 RECEIPTS AND EXPENDITURES, TITLE IIIE 47 ATTACHMENT A DEPARTMENT OF ELDER AFFAIRS' PROGRAMS & SERVICES HANDBOOK (ON Alliance FOR AGING, INC. INTERNET SITE) 48 ATTACHMENT B DEPARTMENT OF ELDER AFFAIRS' CIVIL RIGHTS COMPLIANCE CHECKLIST AND INSTRUCTIONS 49 -54 ATTACHMENT C DEPARTMENT'S COMPUTER USE POLICY AND ITS SOCIAL MEDIA POLICY, PROVIDED ON CD INSTRUCTIONS 55 ATTACHMENT D BACKGROUND SCREENING — AFFIDAVIT OF COMPLIANCE 56 ATTACHMENT E VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION 57 ATTACHMENT F BUSINESS ASSOCIATE AGREEMENT 58 -64 ATTACHMENT G ADRC POLICY AND PROCEDURES FOR OUTSOURCED FUNCTIONS 65 -69 ATTACHMENT H CERTIFICATION REGARDING SCRUTINIZED COMPANIES LIST 70 Page 18 of 70 AA -1829 Alliance FOR AGING, INC. STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE III SECTION I: SERVICES TO BE PROVIDED ATTACHMENT I 1.1 Alliance For Aging, Inc. Mission Statement The Alliance mission is to promote and advocate for the optimal quality of life for older adults and their families. 1.2 Program Specific Terms Area Plan: A plan developed by the area agency on aging outlining a comprehensive and coordinated service delivery system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and DOEA instructions. Area Plan Update: A revision to the area plan wherein the Alliance enters OAA specific data in the Client Information and Registration Tracking System (CIRTS). An update may also include other revisions to the area plan as instructed by the DOEA. Child: An individual who is not more than 18 years of age or an individual with disability. Family Caregiver: An adult family member, or another individual, who is an informal provider of in -home and community care to an older individual. Frail: When an older individual is unable to perform at least two activities of daily living (ADLs) without substantial human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or other mental impairment, requires substantial supervision because the individual behaves iri a manner that poses a serious health or safety hazard to the individual or to another individual. Grandparent: A grandparent or step - grandparent of a child, or a relative of a child by blood, marriage or adoption and who lives with the child; is the primary caregiver of the child because the biological or adoptive parents are unable or unwilling to serve as the primary caregiver of the child; and has a legal relationship to the child, such as legal custody or guardianship, or is raising the child informally. 1.3 General Description 1.3.1 General Statement The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and is the only federal supportive services program directed solely toward improving the lives of older people. The program provides a framework for a partnership among the different levels of government and the public and private sectors with a common objective, improving the quality of life for all older individuals by helping them to remain independent and productive. The primary purpose of the OAA program is to foster the development and implementation of comprehensive and coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to attain and maintain maximum independence and dignity in a home environment and allows for the capability of self -care with appropriate supportive services. . Page 19 of 70 AA -1829 1.3.2 Authority In accordance with Chapter 287 F.S., amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, October 3, 2012; (2) CFO Memo No. 07: Release date, June 27, 2012; (3) CFO memo No. 01: Release date, July 26, 2012; and (4) CFO Memo No. 06: Release date, June 30, 2010. 1.3.3 Scope of Service The Provider is responsible for coordinating and assessing the needs of older persons, and assuring the availability of quality services. The services shall be provided in a manner consistent with, and described in, both the current DOEA Programs and Services Handbook and the Provider's Service Provider Application(s) submitted in response to the 2012 OAA RFP. 1.3.4 Major Program Goals The major goals of the OAA program are to improve the quality of life for older individuals, preserve their independence and prevent or delay more costly institutional care. These goals are achieved through the implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives that meet the diverse needs of elders and their caregivers. 1.3.5 Leadership and Advocacy As a designated Focal Point, a provider is encouraged to provide coordination of services for older individuals. The Provider must also provide community leadership on aging issues and serve as the advocate and focal point for the elderly within the community in cooperation with agencies, organizations and individuals participating in activities funded by the Alliance. Advocacy should include initiating positive changes in public or private policies and attitudes towards older persons, taking action to improve, modify, or eliminate situations which adversely impact on lives of older persons, or expressing for older persons and their interests. Advocacy activities may be broadly supportive of the general interests of older persons or may involve specific activities on behalf of individuals." 1.4 Clients To Be Served 1.4.1 General Description Preference shall be given to those with the greatest economic and social needs, with particular attention to low - income older individuals, including those that are low- income minorities, have limited English proficiency, and older individuals residing in rural areas. 1.4.1.1 OAA Title I1I, General Client Eligibility Consumers shall not be dually enrolled in an OAA program and a Medicaid capitated long -term care program, with the exception of consumers in need of OAA Legal Assistance services. Individuals enrolled in SMNIC LTC may receive congregate meals if coordinated by the managed care plan and paid for by OAA funds, as per DOEA Notice of Instruction, NOTICE #: 032515- 2- PC -SCBS. Additionally, transportation funded through Title II113 can be provided to SMMC LTC enrollees attending congregate meal sites, in accordance with the Department's Programs and Services Handbook. 1.4.1.2 OAA Title IIIB, Supportive Services, Client Eligibility (1) Individuals age 60 or older Page 20 of 70 AA -1829 1.4.1.3 OAA Titles IIIC1 and IIIC2, Nutrition Services, Client Edibility General factors that should be considered in establishing priority for nutrition services include those older persons who meet the following: (1) Cannot afford to eat adequately; (2) Lack the skills or knowledge to select and .prepare nourishing and well - balanced meals; (3) Have limited mobility which may impair their capacity to shop and cook for themselves; or (4) Have a disabling illness or physical condition requiring nutritional support or have been screened at a high nutritional risk. 1.4.1.4 OAA Title IIIC1, Congregate Nutrition Services In addition to meeting the general nutrition services eligibility requirements listed in ATTACHMENT I, Paragraph 1.4.1.3 individuals must be mobile, not homebound and physically, mentally and medically able to attend a congregate nutrition program. Individuals eligible to receive congregate meals include: (1) Individuals age 60 or older; and (2) Any spouse (regardless of age) who attends the dining center with his /her eligible spouse; (3) Persons with a disability, regardless of age, who reside in a housing facility occupied primarily by older individuals where congregate nutrition services are provided; (4) Disabled persons who reside at home with and accompany an eligible person to the dining center; and (5) Volunteers, regardless of age, who provide essential services on a regular basis during meal hours. 1.4.1.5 OAA Title IIIC2, Home Delivered Nutrition Services In addition to meeting the general nutrition services eligibility requirements listed in ATTACHMENT I, Paragraph 1.4.1.3, individuals must be homebound and physically, mentally or medically unable to attend a congregate nutrition program. Individuals eligible to receive home delivered meals include the following: (1) Individuals age 60 or older who are homebound by reason of illness, disability or isolation; (2) The spouse of a homebound eligible individual, regardless of age, if the provision of the collateral meal supports maintaining the person at home; (3) Individuals with disabilities, regardless of age, who reside at home with eligible individuals and are dependent on them for care; and (4) Persons at nutritional risk who have physical, emotional or behavioral conditions, which would make their presence at the congregate site inappropriate; and persons at nutritional risk who are socially or otherwise isolated and unable to attend a congregate nutrition site. 1.4.1.6 OAA Title IIIE, Caregiver Support Services, Client Eligibility (1) Family caregivers of individuals age 60 or older; (2) Grandparents (age 55 or older) or older individuals (age 55 or older) who are relative caregivers; (3) Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction and for grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities; and (4) For respite and supplemental services, a family caregiver must be providing care for an older individual who meets the definition of the term "frail" in OAA, Section 102 Paragraph 22. Page 21 of 70 AA -1829 SECTION II — MANNER OF SERVICE PROVISION 2.1 Service Tasks In order to achieve the goals of the OAA program, the Provider shall ensure the following Service Tasks are performed at the level specified iri_ this contract. (1) Client Eligibility Determination: The Provider shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this Contract. (2) Targeting and Screening of Service Delivery for New Clients: The Provider shall develop and implement policies and procedures consistent with OAA targeting and screening criteria. (3) Delivery of Services to Eligible Clients: The Provider shall ensure the provision of a continuum of services that meets the diverse needs of elders and their caregivers. The Provider shall ensure the performance and report performance of the following services are in accordance with the current DOEA Programs and Services Handbook. The services funded pursuant to this contract are in accordance with the OAA, Title III, Section 321, 331, 336, 361, and 373 as follows: Section 321, Title I1I13 Supportive Services; Section 331, Title IIICI Congregate Nutrition Services; Section 336, Title IIIC2 Home Delivered Nutrition Services; Section 373, Title IIIE Caregiver Support Services; and (4) Use of volunteers to expand the provision of available services; (5) Monitoring the performance of its subcontractors; and (6) Document service delivery in accordance to the current DOEA Program and Services Handbook. 2. 1.1 Supportive Services (II113 Program) Supportive services include a variety of community -based and home - delivered services that support the quality of life for older individuals by helping them remain independent and productive. 2.1.1.1. Services include the following: (1) Adult Day Care /Adult Day Health Care; (2) Caregiver Training /Support; (3) Case Aid /Case Management; (4) Chore Services; (5) Companionship; (6) Counseling (Gerontological and Mental Health); (7) Education /Training; (8) Legal Assistance; (9) Material Aid; (10) Occupational Therapy; (1 1) Outreach; (12) Personal Care; (13) Physical Therapy; (14) Shopping Assistance; (15) Skilled Nursing; (16) Specialized Medical Equipment, Services, and Supplies; (17) Recreation; (18) Emergency Alert Response; (19) Escort; (20) Health Support; (2 1) Home Health Aid; Page 22 of 70 AA -1829 (22) Homemaker; (23) Housing Improvement; (24) Information; (25) Intake; (26) Interpreter /Translating; (27) Referral /Assistance; (28) Respite Services; (29) Screening/Assessment; (30) Speech Therapy; (3 1) Telephone Reassurance; and (32) Transportation Services authorized under this contract are listed on ATTACHMENT VII, Contract Budget Summary by Service and Title. 2.1.1.2. Congregate Nutrition Services (IIIC I Program) Nutrition services are provided in congregate settings and are designed to reduce hunger and food insecurity, promote socialization and the health and well -being of older individuals by assisting them to gain access to nutrition and other disease prevention and health promotion services. Services include the following: (1) Congregate meals; (2) Congregate meals screening; (3) Nutrition education and nutrition counseling; (4) Outreach. Services authorized under this contract are listed on ATTACHMENT VII, Contract Budget Summary by Service and Title. 2.1.1.3. Home Delivered Nutrition Services (IIIC2 Program) In -home nutrition services are provided to reduce hunger and food insecurity; promote socialization and the health and well -being of older individuals by assisting such individuals to gain access to nutrition and other disease prevention and health promotion services. Services include the following: (1) Home delivered meals; (2) Nutrition education and counseling; (3) Outreach; and (4) Screen ing/Assessment. Services authorized under this contract are listed on ATTACHMENT VII, Contract Budget Summary by Service and Title. 2.1.1.4. Caregiver Support Services (IIIE Program) The following services are intended to provide direct help to caregivers, assist in the areas of health, nutrition and financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and responsibilities: (1) Adult Day Care /Adult Day Health Care; (2) Caregiver Training /Support; (3) Counseling (Gerontological and Mental Health); _ (4) Education /Training; (5) Financial Risk Reduction (Assessment and Maintenance); (6) Information; (7) Intake; (8) Outreach; (9) Powerful Tools for Caregivers; Page 23 of 70 AA -1829 (10) Referral /Assistance; (11) Respite Services; (12) Screening/Assessment; (13) Stress - Busting Program for Family Caregivers; and (14) Transportation. Services authorized under this contract are listed on ATTACHMENT VII, Contract Budget Summary by Service and Title. 2.1.1.5. Caregiver Support Supplemental Services (IIIES Program): The following services are provided to complement the care provided by caregivers: (1) Chore Services; (2) Housing Improvement; (3) Material Aid; and (4) Specialized Medical Equipment, Services and Supplies. Services authorized under this contract are listed on ATTACHMENT VII, Contract Budget Summary by Service and Title. 2.1.1.6 Caregiver Support Grandparent Services (IIIEG Program): Services for grandparents or older individuals who are relative caregivers designed to help meet their caregiving obligations include the following: (1) Caregiver Training/Support; (2) Sitter. Services authorized under this contract are listed on ATTACHMENT VII, Contract Budget Summary by Service and Title. 2.1.2 Use of Volunteers to Expand the Provision of Available Services 2.1.2.1 Use of Volunteers to Expand the Provision of Available Services The Provider shall make use of trained volunteers in providing direct services delivered to older individuals and individuals with disabilities needing such services. If possible, the Provider shall work in coordination with organizations that have experience in providing training, placement, and stipends for volunteers or participants (such as organizations carrying out Federal service programs administered by the Corporation for National and Community Service), in community service settings. 2.1.2.2. The Contractor shall submit an annual unduplicated report of volunteer hours on the format provided by the Alliance. The data collection period is from January 1 — December 31 for each calendar year. The data submission date is 5 working days following the close of the contract period. 2.1.3. Monitoring the Performance of Subcontractors The Provider shall conduct at least one monitoring per year of each subcontractor and /or vendors paid from funds provided under this contract. The Provider shall perform fiscal, administrative and programmatic monitoring of each sub - contractor to ensure contractual compliance, fiscal accountability, programmatic performance, and compliance with applicable state and federal laws and regulations. 2.1.4. Subcontractor Outreach Reporting Requirements The Provider shall document its performance of outreach activities, by submitting a uniform reporting format provided by the Alliance that includes the following: number and type of provider events or activities; date and location; total number of participants at each event or activity; individual service needs identified; and referral sources or information provided. The Provider shall complete and submit this report on outreach Page 24 of 70 AA -1829 activities at least semi - annually. Reports must be submitted by June 30 and December 31 of each contract year. 2.2 .SERVICE LOCATION 2.2.1 Service Times The Provider shall ensure the provision of the services listed in the contract during normal business hours unless other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its subcontractors to ensure they are available to provide services during hours responsive to client needs and during those times which best meet the needs of the relevant service community. 2.3 DELIVERABLES 2.3.1 Services The Provider shall provide the services described in the contract in accordance with the current DOER Program and Services Handbook. Units of service will be paid pursuant to the rates established in ATTACHMENT VII. 2.4 REPORTS The Provider is responsible for responding in a timely fashion to additional routine and /or special requests for information and reports required by the Alliance. The Provider must establish due dates for any subcontractors that permit the Provider to meet the Alliance's reporting requirements. 2.4.1 Service Cost Reports The Provider shall submit Service Cost Reports to the Alliance annually, but no later than ninety (90) calendar days after the contract year ends. The Service Cost Reports shall reflect actual costs of providing each service by program for the preceding contract year. If the Provider desires to renegotiate its reimbursement rates, the Provider shall make a request in writing to the Alliance in accordance with the Alliance's approved Reimbursement Rate Review Policy, which is incorporated by reference. 2.4.2 Surplus /Deficit Report The Provider will respond to the consolidated Surplus /Deficit report in a format provided by the Alliance to the Alliance's contract manager. Surplus /Deficit reports must be submitted with the monthly request for payment. This report is for all services provided in this agreement incorporating in this Contract between the Provider and the Alliance. The report will include the following: (1) A list of all Services and their current status regarding surplus or deficit, and why they differ from its original budget projections. (2) A detailed plan on how the surplus or deficit spending exceeding the I% monthly threshold will be resolved. The plan must include specific budget numbers to reflect how the Provider plans to address the variance. (3) Number of clients currently on the waitlist (APCL). Page 25 of 70 AA -1829 2.5 CIRTS 2.5.1 Client Information and Registration Tracking System (CIRTS) Reports The Provider shall input OAA- specific data into CIRTS to ensure CIRTS data accuracy. The Provider shall use CIRTS - generated reports which include the following: (1) Client Reports; (2) Monitoring Reports; (3) Services Reports; and (4) Outcome Measures Reports. 2.5.2 Program Highlights The Provider shall submit Program Highlights referencing specific events that occurred in previous contract year by September 15 of the current contract year. The Provider shall provide a new success story, quote, testimonial, or human- interest vignette. The highlights shall be written for a general audience, with no acronyms or technical terms. For all agencies or organizations that are referenced in the highlight, the Provider shall provide a brief description of their mission or role. The active tense shall be consistently used in the highlight narrative, in order to identify the specific individual or entity that performed the activity described in the highlight. The Provider shall review and edit Program Highlights for clarity, readability, relevance, specificity, human interest, and grammar, prior to submitting them to the Alliance. 2.6 RECORDS AND DOCUMENTATION The Provider shall maintain documentation to support Request for Payment that shall be available to the Alliance or authorized individuals, such as DOEA and Department of Financial Services, upon request. 2.6.1. CIRTS Maintenance The Provider will ensure the accurate collection and maintenance of client and service information on a monthly basis from the CIRTS or any such system designated by the Alliance. Maintenance includes valid exports and backups of all data and systems according to Alliance and DOEA standards. The Provider must adhere to the Alliance CIRTS Data Integrity Policies & Procedures, incorporated by reference, in order to ensure data accuracy. 2.6.2 Data Integrity and Back -up Procedures The Provider shall anticipate and prepare for the loss of information processing capabilities. The routine backing up of.all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of contractor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite location. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes and Outputs (Performance Measures) — At a minimum, the Provider must: (1) Ensure the provision of the services described in this contract are in accordance with the current DOEA Programs and Services Handbook and in the Manner of Service Provision described in this contract. (2) Submit to the Alliance all information described in this contract. (3) Develop and document strategies in the Service Provider Application (SPA) to support the Department's performance outcome measures in the following criteria: Page 26 of 70 AA -1829 a) 79.3% of elders assessed with high or moderate risk environments will improve their environment score. b) 66% of new service recipients with high -risk nutrition scores will improve their nutritional status. c) 65% of new service recipients will maintain or improve their ADL assessment score. d) 62.3% of new service recipients will maintain or improve their IADL assessment score. e) 89% of family and family - assisted caregivers will self -report they are very likely to provide care. f) 90% of caregivers will maintain or improve their ability to provide care after one year of service intervention (as determined by the caregiver and the assessor). 2.7.2 Monitoring and Evaluation Methodology The Alliance will review and evaluate the performance of the Provider under the terms of this contract. Monitoring shall be conducted through direct contact with the Provider through telephone, in writing, and /or an on -site visit. The Alliance's determination of acceptable performance shall be conclusive. The Provider agrees to cooperate with the Alliance in monitoring the progress of completion of the service tasks and deliverables. The Alliance may use, but is not limited to, one or more of the following methods for monitoring: a) Desk reviews and analytical reviews; b) Scheduled, unscheduled, and follow -up on -site visits; c) Client visits; d) Review of independent auditor's reports; e) Review of third -party documents and /or evaluation; f) Review of progress reports; g) Review of customer satisfaction surveys; h) Agreed -upon procedures review by an external auditor or consultant; i) Limited -scope reviews; and j) Other procedures as deemed necessary. 2.7.3 Remedies - Nonconforming Services The Provider shall ensure that all participants served under this agreement are eligible for the program, and that all monthly and /or quarterly performance reports and financial records are maintained for each reporting period and submitted as stipulated in 2.4, 2.5, 2.6, and 2.7. Any nonconforming program services, performance reports or financial records not meeting the requirements of this Contract shall not be eligible for reimbursement under this program. The costs associated with hiring, training, reporting and /or managing the program shall be borne solely by the Provider. The Alliance requires immediate notice of any significant and /or systemic infractions that compromise the Provider's ability to provide participant services, to achieve programmatic performance or to provide sound financial management of the program. 2.8 CONTRACTOR'S FINANCIAL OBLIGATIONS 2.8.1 Matching, Level of Effort, and Earmarking Requirements The Provider shall provide match of at least 10 percent of the federal administrative funds received. The Provider's match will be made in the form of cash, general revenue administrative funds, and /or in -kind resources. The Provider will assure, through a provision in subcontracts, a match requirement of at least 10 percent of the cost for services funded through this contract. The Provider's match will be made in the form of cash and /or in -kind resources. The Provider shall report match by title each month. At the end of the contract period, the Provider must properly match OAA funds. 2.8.2 Consumer Contributions Consumer contributions are to be used under the following terms: Page 27 of 70 AA -1829 1) The Provider assures compliance with Section 315 of the OAA as amended in 2006, in regard to consumer contributions; 2) Voluntary contributions are not to be used for cost sharing or matching; 3) Accumulated voluntary contributions are to be used prior to requesting federal reimbursement; and 4) Voluntary contributions are to be used only to expand services. 2.8.3 Use of Service Dollars The Provider is expected to spend all federal, state and other fiends provided by the Alliance for the purpose specified in the contract. The Provider must manage the service dollars in such a manner so as to avoid having a wait list and a surplus of finds at the end of the contract period, for each program managed by the Provider. Program surpluses must be reported to the Alliance. 2.8.4 Surplus Recapture In accordance with its surplus /deficit management policies, in order to maximize available finding and minimize the time that potential clients must wait for services, the Alliance in its sole discretion can reduce finding awards if the Provider is not spending according to monthly plans and is projected to incur a surplus at the end of the year. 2.8.5 The Provider agrees to use funds as detailed in the Budget Summary, ATTACHMENT VII. Any changes in the amounts of federal or general revenue finds identified on the Budget Summary form require a contract amendment. Providers must adhere.to Alliance's Modified Spending Policy, incorporated by reference, when requesting changes to the budget Summary Form. 2.8.6 Title III Funds The Provider assures compliance with Section 306 of the Older Americans Act, as amended in 2006, that finds received under Title III will not be used to pay any part of a cost (including an administrative cost) incurred by the Provider to maintain a contractual or commercial relationship that is not carried out to implement Title III. 2.9 ALLIANCE'S RESPONSIBILITIES: 2.9.1 Program Guidance and Technical Assistance The Alliance will provide to the Provider guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Provider. The Providers must attend all required training session and meetings. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The Method of Payment for this contract is a combination of fixed- fee /unit rate, cost reimbursement, and advanced payments, subject to the availability of finds. The Provider shall ensure include only those costs that are in accordance with all applicable state and federal statutes and regulations and are based on audited historical costs in instances where an independent audit is required. 3.2 Advance Payments 3.2.1 The Provider may request up to two months of advances at the start of the contract period, if available, to cover program service costs. The payment of an advance will be contingent upon the sufficiency and amount of finds released to the Alliance. The Provider shall provide the Alliance documentation justifying the need for an advance and describing how the finds will be distributed. Page 28 of 70 AA -1829 3.2.2 The Provider's requests for advance require the approval of the Alliance. If sufficient budget is available, the Alliance will issue approved advance payments after January 1, 2018. 3.2.3 Requests for the first through the twelfth months shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests, if available is shown on ATTACHMENT VIII of this contract. 3.2.4 All advanced payments made to the Provider shall be recouped in accordance with the Reporting Schedule, ATTACHMENT VIII of this contract. 3.2.5 Interest earned on advances must be identified separately by source of funds, state or federal. Providers shall maintain advances of federal finds in interest bearing accounts unless otherwise exempted in accordance with 45 CFR 74.22(k). Earned interest must be returned to the Alliance at the end of each quarter. 3.3 Invoice Submittal and Requests for Payment 3.3.1 All requests for payment and expenditure reports submitted to support requests for payment shall be on DOEA forms 106A (ATTACHMENT IX), 105AS (ATTACHMENT X- EXHIBIT 1), and 105AE (ATTACHMENT X- EXHIBIT 2). 3.3.2 The Provider shall submit all payment requests based on the submission of the Provider's actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests (when available) and invoices is ATTACHMENT VIII to this contract. 3.3.3 Any payment due by the Alliance under the terms of this contract may be withheld pending the receipt and approval of all financial and programmatic reports due from the Provider and any adjustments thereto. 3.3.4 The Alliance will authorize payment only for allowable expenditures, which are in accordance with the limits specified in ATTACHMENT VII, Budget Summary. 3.3.5 Monthly review of the Receipt and Expenditure Report and the Request for Payment Form by the Alliance will focus on: (1) Line item comparison of year -to -date expenditures with the budget to monitor rate of expenditures; (2) Allowable total reimbursement, on a service by service level, does not exceed budgeted /contractual amount (No unilateral modified spending authority.); (3) Validation of service units reported against CIRTS. 3.3.6 In order to properly manage the program budget, the Provider must submit invoices for payment no later than 90 days after the end of the month in which the expense was incurred, except that invoices cannot be submitted after Close Out Report date. Invoices submitted late will require the approval of the Alliance's contract manager. Approvals must be requested prior to the invoicing deadline. Late invoices will not be paid unless justification is submitted and approved by the contract manager. 3.3.7 Date for Final Request for Payment The Provider shall submit the final request for payment to the Alliance no later than 45 days after the contract end date. Page 29 of 70 AA -1829 3.4 Documentation for Payment The Provider shall maintain documentation to support payment requests that shall be available to the Alliance or authorized individuals, such as Department of Financial Services, upon request. Supporting documentation of services provided must be adequate to permit fiscal and programmatic evaluation and ensure internal management. 3.4.1 Payments will be made to the Provider based on a complete and correct invoice, invoices that are incomplete or with incorrect total will not be processed and will be returned to the Provider for correction. Fiscal staff will not be able to correct or make changes to.the invoices. Returning invoices for corrections may result in failure to receive payment for that month. Invoices shall be submitted timely as per ATTACHMENT VIII in order to avoid any payment delays. 3.4.2 The Provider must enter all required data following DOEA's CIRTS Policy Guidelines for clients and services in the CIRTS database. Data must be entered into CIRTS before the Providers submit their request for payment and expenditure reports. 3.4.3 The Provider shall run monthly CIRTS reports and verify that client and service data in CIRTS is accurate. This report must be submitted to the Alliance with the monthly request for payment and expenditure report and must be reviewed by the Alliance before the Provider's request can be approved by the Alliance. 3.5. Remedies for Nonconforming Services The Provider shall ensure that all goods and /or services provided under this contract are delivered timely, completely and commensurate with required standards of quality. Such goods and /or services will only be delivered to eligible program participants. If the Provider fails to meet the prescribed quality standards for services, such services will not be reimbursed under this contract. In addition, any nonconforming goods (including home delivered meals) and /or services not meeting such standards will not be reimbursed under this contract. The Provider's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Provider shall solely bear the costs associated with preparing or providing nonconforming goods and /or services. The Alliance requires immediate notice of any significant and /or systemic infractions that compromise the quality, security or continuity of services to clients. 3.5.1. Corrective Action Plan 1. Contractor shall ensure 100% of the deliverables identified in ATTACHMENT 1, Section II (Manner of Service Provision) of this contract, are performed pursuant to contract requirements. If at any time the Contractor is notified by the Alliance that it has failed to correctly, completely, or adequately perform contract deliverables identified in ATTACHMENT I, Sec. II, the Contractor will have 10 days to submit a Corrective Action Plan ("CAP ") to the Alliance Contract Manager that addresses the deficiencies and states how the deficiencies will be remedied within a time period approved by the Alliance Contract Manager. The Alliance shall assess a Financial Consequence for Non - Compliance on the Contractor as referenced in ATTACHMENT I, Sec. 3.5.2. of this contract for each deficiency identified in the CAP which is not corrected pursuant to the CAP. The Alliance shall also assess a Financial Consequence for failure to timely submit a CAP. 3. If the Contractor fails to correct an identified deficiency within the approved time period specified in the CAP, the Alliance shall deduct the percentage established in ATTACHMENT I, Sec. 3.5.2. of this contract, from the payment for the invoice of the following month. Page 30 of 70 AA -1829 4. If the Contractor fails to timely submit a CAP, the Alliance shall deduct the percentage established in ATTACHMENT I, Sec. 11. 1. of this contract for each day the CAP is overdue. The deduction will be made from the payment for the invoice of the following month. 3.5.2. Financial Consequences of Non - Performance The Alliance will withhold or reduce payment if the Contractor fails to perform the deliverables to the satisfaction of the Contract according to the requirements referenced in ATTACHMENT I, Sec. I and Sec. II of this contract. The following financial consequences will be imposed if the deliverables stated do not meet in part or in whole the performance criteria as outlined in ATTACHMENT I, Sec. II of this contract. Delivery of services to eligible clients as referenced in ATTACHMENT I, Sec. 1.4 and Sec. 2.1 of this contract — Failure to comply with established assessment and prioritization criteria as evidenced in CIRTS reports will result in a 2% reduction of payment per business day. The reduction of payment will begin on the first business day following the Alliance's notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. 3.5.1. Services and units of services as referenced in ATTACHMENT I, Sec. II of this contract — Failure to provide services in accordance with the current DOEA Programs and Services Handbook, the service tasks described in section ATTACHMENTS VII and K, and submission of required documentation will result in a 2% reduction of payment per business day. The reduction of payment will begin the first business day following the Alliance's notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. 3.5.1. Administrative duties as referenced in ATTACHMENT I, Sec. 2.4, 2.5, 2.6, and 2.7 of this contract — Failure to perform the performance specifications and oversight of CCE Program operations will result in a 2% reduction of payment per business day. The reduction of payment will begin the first business day following the Alliance's notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. 3.5.1. 4. Timely submission of a CAP — Failure to timely submit a CAP within 10 business days after notification of the deficiency by the Alliance contract manager will result in a 2% reduction of payment per business day the CAP is not received. The reduction of payment will begin the first business day following the Alliance's notification to the contractor that the identified deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. 3.5.1. 5. Exceptions may be granted solely, in writing, by the Alliance. Page 31 of 70 AA -1829 ATTACHMENT II CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No federal appropriated finds have been paid or will be paid; by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any finds other than federal appropriated finds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub - awards at all tiers (including subcontracts, sub- grants, and contracts under grants, loans and cooperative agreements) and that all sub- contractors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000.00 and not more than $100,000.00 for each such failure. Signature Date ek cy+ � A- - i) aq Name of Auth rized Trillividual Contract Number Z cc-G Sc;C�aJ, 6?lj Name and Address of Org ization � t C 51;11 t5 s �- ,,_v �s FL . 3?cK DOEA Form 103 Page 32 of 70 AA -1829 ATTACHMENT III ATTACHMENT III FINANCIAL AND COMPLIANCE AUDIT The administration of resources awarded by the Alliance to the provider may be subject to audits and /or monitoring by the Alliance and/ortheDepartment as described in this section. I. MONITORING In addition to reviews of audits conducted in accordance with OMB Circular A -133, as revised, and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits by the Alliance and /or the Department staff, limited scope audits as defined by ONIB Circular A -133, as revised, and /or other procedures. By entering into this agreement, the Contractor agrees to comply and cooperate with any monitoring procedures /processes deemed appropriate by the Alliance. In the event the Alliance and /or the Department determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any additional instructions provided by the Alliance and /or the Department to the Contractor regarding such audit. The Contractor further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Alliance and /or the Department. AUDITS PART I: FEDERALLY FUNDED This part is applicable if the provider is a State or local government or a non - profit organization as defined in OMB Circular A- 133, as revised. In the event that the Contractor expends $750,000.00 or more in federal awards durin its fiscal year, the Contractor must have a single or program - specific audit conducted in accordance with the provisions of ONIB Circular A -133, as revised. EXHIBIT 2 to this agreement indicates federal resources awarded through the Alliance by this agreement. In determining the federal awards expended in its fiscal year, the Contractor shall consider all sources of Federal awards, including federal resources received from the A l l i a n c e . The determination of amounts of Federal awards expended should be in accordance with the guidelines established by OMB Circular A -133, as revised. An audit of the Contractor conducted by the Auditor General in accordance with the provisions of OMB Circular A -133, as revised, will meet the requirements of this part. In connection with the audit requirements addressed in Part 1, paragraph I, the Contractor shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A -133, as revised. If the Contractor expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with the provisions of OMB Circular A -133, as revised, is not required. In the event that the Contractor expends less than $750,000.00 in federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of OMB Circular A- 133, as revised, the cost of the audit must be paid from non - federal resources (i.e., the cost of such audit must be paid from Contractor resources obtained from other than federal entities.) An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Alliance shall be based on the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Alliance and /or the Department shall be fully disclosed in the audit report with reference to the Alliance agreement involved. If not otherwise disclosed as required by Section .310(b)(2) of OMB Circular A -133, as revised, the schedule of expenditures of federal awards shall identify expenditures by agreement number for each agreement with the Alliance in effect during the audit period. Financial reporting packages required under this part must be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor's fiscal year end. PART II: STATE FUNDED This part is applicable if the Contractor is a non -state entity as defined by Section 215.97(2), F.S Page 33 of 70 AA -1829 In the event that the contractor expends a total amount of state financial assistance equal to or in excess of $750,000.00 in any fiscal year of such Contractor (for fiscal years ending September 30, 2004 or thereafter), the Contractor must have a State single or project - specific audit for such fiscal year in accordance with Section 215.97, F.S.; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit organizations), Rules of the Auditor General. EXHIBIT 2 to this agreement indicates state financial assistance awarded through the A l l i a n c e by this agreement. In determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources of state financial assistance, including state financial assistance received from the Alliance, other state agencies, and other non -state entities. State financial assistance does not include Federal direct or pass- through awards and resources received by a non -state entity for Federal program matching requirements. Inconnection with the audit requirements addressed in Part II, paragraph I, the Contractor shall ensure that the audit complies with the requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as defined by Section 215.97(2), F.S., and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. If the Contractor expends less than $750,000.00 instate financial assistance in its fiscal year (for fiscal years ending September 30, 2004 or thereafter), an audit conducted in accordance with the provisions of Section215.97, F.S., is not required. In the event that the Contractor expends less than $750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the provisions of Section 215.97, F.S., the cost of the audit must be paid from the non -state entity's resources (i.e., the cost ofsuch an audit must be paid from the Contractor resources obtained from other than State entities). An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Alliance shall be based on the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Alliance shall be fully disclosed in the audit report with reference to the Alliance agreement involved. If not otherwise disclosed as required by Rule 69I- 5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the Alliance in effect during the audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the audit report, but -no later than 12 months after the Contractor's fiscal year end for local governmental entities. Non - profit or for - profit organizations are required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after the Contractor's fiscal year end. Notwithstanding the applicability ofthis portion, the Alliance retains all right and obligation to monitor and oversee the performance of this agreement as outlined throughout this document and pursuant to law. II. PART III: REPORT SUBMISSION Copies of reporting packages for audits conducted in accordance with ONIB Circular A -133, as revised, and required by PART I of this agreement shall be submitted, when required by Section .320 (d), ONIB Circular A -133, as revised, by or on behalf of the Contractor directly to each of the following: The Alliance at each of the following addresses: Alliance for Aging, Inc. Attn: Fiscal Department 760 NW 107` Avenue Suite 214 Miami, FL, 33172 The Federal Audit Clearinghouse designated in ONIB Circular A -133, as revised (the number of copies required by Sections .320 (d)(I) and (2), ON113 Circular A -133, as revised, should be submitted to the Federal Audit Clearinghouse), at the following address: Federal Audit Clearinghouse Bureau of the Census 1201 East 10 "' Street Jeffersonville, IN 47132 Page 34 of 70 AA -1829 Other Federal agencies and pass - through entities in accordance with Sections .320 (e) and (f), OMB Circular A -133, as revised. Pursuant to Sections .320(f), OMB Circular A -133, as revised, the provider shall submit a copy of the reporting package described in Section .320(c), OMB Circular A -133, as revised, and any management letter issued by the auditor, to the Alliance at each of the following addresses: Alliance for Aging, Inc. Attn: Fiscal Department 760 NW 107"' Avenue Suite 214 Miami, FL 33172 Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on behalf of the Contractor directly to each of the following: The Alliance at the following address: Alliance for Aging, Inc. Attn: Fiscal Department 760 NW 107` Avenue Suite 214 Miami, FL 33172 Any reports, management letter, or other information required to be submitted to the Alliance pursuant to this agreement shall be submitted timely in accordance with OMB Circular A -133, F.S., and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit organizations), Rules of the Auditor General, as applicable. Contractors, when submitting financial reporting packages to the A I l i a n c e for audits done in accordance with OMB Circular A -133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to the Contractor in correspondence accompanying the reporting package. III. PART IV: RECORD RETENTION The Contractor shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six (6) years from the date the audit report is issued, and shall allow the Alliance and the Department or its designee, the CFO or Auditor General Access to such records upon request. The Contractor shall ensure that audit working papers are made available to the Alliance and the Department, or its designee, CFO, or Auditor General upon request for a period of six (6) years from the date the audit report is issued, unless extended in writing by the Al I i an c e . Page 35 of 70 AA -1829. ATTACHMENT III FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT EXHIBIT 1 PART 1: AUDIT RELATIONSHIP DETERMINATION Contractors who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part §200.500, and /or Section 215.97, Fla. Stat. Contractors who are determined to be recipients orsubrecipients of federal awards and /or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and /or Part II of Exhibit I is met. Contractors who have been determined to be vendors are not subject to the and it requirements of2 CFR Part §200.38, and /or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, Contractors who have been determined to be recipients or subrecipients of Federal awards and /or state financial assistance must comply with applicable programmatic and fiscal compliance requirements. In accordance with 2 CFR Part §200 and /or Rule 691 - 5.006, FAC, Contractor has been determined to be: Vendor not subject to2 CFR Part §200.3 8 and /or Section 215.97, F.S. X Recipient /sub recipient subject to 2 CFR Part §200.86 and §200.93 and /or Section 215.97, F.S. Exempt organization not subject to 2 CFR Part §200 and /or Section 215.97, F.S. For Federal awards, for - profit organizations are exempt; for state financial assistance projects, public universities, community colleges, district school boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must comply with all compliance requirements set forth within the contract or award document. NOTE: If a Contractor is determined to be a recipient /subrecipient of federal and or state financial assistance and has been approved by the Alliance to subcontract, they must comply with Section 215.97(7), F.S., and Rule 691- .5006, FAC [state financial assistance] and 2 CFR Part §200.330 [federal awards]. PART II: FISCAL COMPLIANCE REQUIREMENTS FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive Federal awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a subrecipient must comply with the following fiscal laws, rules and regulations: STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW: 2 CFR Part §200.416- Cost Principles* 2 CFR Part §200.201- Administrative Requirements ** 2 CFR Part §200.500- Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations NON - PROFIT ORGANIZATIONS MUST FOLLOW: 2CFRPart §200.400- .411 -Cost Principles* 2 CFR Part §200.100 - Administrative Requirements 2 CFR Part §200.500- Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW: 2 CFR Part §200.418- Cost Principles* 2 CFR Part §200.100- Administrative Requirements 2 CFR Part §200.500 -Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, piles and regulations Page 36 of 70 AA -1829 *Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted inthe 2 CFR Part §200.400(5) (c). * *For funding passed through U.S. Health and Human Services, 45 CFR 92; for funding passed through U.S. Department of Education, 34 CFR 80. STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a recipient /subrecipient must comply with the following fiscal laws, rules and regulations: Section 215.97, Fla. Stat. Chapter 691 -5, Fla. Admin. Code State Projects Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations Page 37 of 70 AA -1829 ATTACHMENT III FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT EXHIBIT 2- FUNDING SUMMARY Note: Title 2 CFR § 200.331, As Revised, and Section 215.97(5), Florida Statutes, Require That Information About Federal Programs and State Projects Be Provided to the Recipient and Are Stated in the Financial and Compliance Audit Attachment and Exhibit 1. Financial and Compliance Audit Attachment, Exhibit 2- Funding Summary Provides Information Regarding the Funding Sources Applicable to This Contract, Contained Herein, Is APrediction of Funding Sources and Related Amounts Based on the Contract Budget. 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT Older Americans Act Administration U.S. Health and Human Services 93.044 $112,771.48 Title IIIB — Support Services Older Americans Act Administration U.S. Health and Human Services 93.045 $151,811.42 Title IIIC1 — Congregate Meals Older Americans Act Administration U.S. Health and Human Services 93.045 $228,495.60 Title III C2 — Home Delivered Meals Older Americans Act Arlministrution Title III E — Caregiver Support Services U.S. Health and Human Services 93.052 $103,386.71 Title III ES— Caregiver Support Services $32,472.36 TOTAL FEDERAL AWARD $628,937.57 COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: FEDERAL FUNDS: 2 CFR Part 200- Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. OMB Circular A -133, as amended- Audits of States, Local Governments, and Non-Profit Organizations 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: MATCHING RESOUCES FOR FEDERAL PROGRAMS PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT TOTAL STATE AWARD QTATR ATATAATrITAT ACCTTANCE S TRM TTO sac 215 97 F_C PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT TOTAL AWARD COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: STATE FINANCIAL ASSISTANCE: Section 215.97, F.S., Chapter 69I -5, FL Admin Code, Reference Guide for State Expenditures, Other fiscal requirements set forth in program laws, rules and regulations. Page 38 of 70 AA -1829 ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the contractor named in the contract or agreement to which this form is an attachment, hereby certifies that: (1) The contractor and any sub- contractors of services under this contract have financial management systems capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each grant - funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant fiends that have not been accounted for properly. (2) Management Information Systems used by the contractor, sub - contractor(s), or any outside entity on which the contractor is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be capable of processing data accurately, including year -date dependent data. For those systems identified to be non- compliant, contractor(s) will take immediate action to assure data integrity. (3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions of these products offered by the contractor (represented by the undersigned) and purchased by the State will be verified for accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the contractor agrees to immediately make required corrections to restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and without interruption to the ongoing business of the state, time being of the essence. (4) The contractor and any sub - contractor(s) of services under this contract warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues.+ The contractor shall require that the language of this certification be included in all subagreements, subgrants, and other agreements and that all sub- contractors shall certify compliance accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A -102 and 2 CFR Part 215 (formerly OMB Circular A -110). Monroe County Board of County Commissioners, Social Services /In -Home Services 1100 Simonton Street, 2 Floor Key We FL 33040 Z gizo a Signature Title I ^ Date Yy Y( rk l STS 07 f 2CV 082>w Name of Akithorizdd Signer (Revised June 2008) Page 39 of 70 AA -1829 ATTACHMENT V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS (1) The prospective contractor certifies, by signing this certification, neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. . (2) Where the prospective contractor is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this certification. tgrr wire Date 1 R 0n r'er-- � w4v 13 0cc Soc W :SUZ t c-CS Title Agency /Organization (Certification signature should be same as Contract signature.) Instructions for Certification 1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5- 180.1020, as supplemented by 2 CFR 376.10- 376.995). You may contact the Contract Manager for assistance in obtaining a copy of those regulations. 2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this transaction. If it is later determined that the contractor knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the department may pursue available remedies, including suspension and /or debarment. 3. The contractor will provide immediate written notice to the Contract Manager if at any time the contractor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The contractor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may, but is not required to, check the Excluded Parties List System (EPLS). 4. The contractor will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The contractor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the contractor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department may pursue available remedies, including suspension, and /or debarment. 7. The contractor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. (Revised June 2000) Page 40 of 70 AA -1829 ATTACHMENT VI ASSURANCES— NON - CONSTRUCTION PROGRAMS Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348- 0043), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET, SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non - Federal share of project cost) to ensure proper planning, management, and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728 -4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88 -352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972; as amended (20 U.S.C. 1681 -1683, and 1685- 1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101- 6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92- 255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91 -616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd -3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and 0) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Titles 11 and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91 -646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. 1501 -1508 and 7324 - 7328), which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. 276a to 276a -7), the Copeland Act (40 U.S.C. 276c and 18 U.S.C. _ 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. 327 -333), regarding labor standards for federally assisted construction subagreements. Page 41 of 70 AA -1829 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93 -234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. 1451 et seq.); (f) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93 -523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93 -205). 12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1721 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469a -1 et seq.). 14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89 -544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.), which prohibits the use of lead - based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A -133, Audits of States, Local Governments, and Non - Profit Organizations. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE 1 CR At� Cz ucy"� 4�d n A e 1 J 11 aiz r APPLICANT ORGANIZATION DATE SUBivI1TTED MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, SOCIAL SERVICES /IN -HOME SERVICES 1� 79I2-0 l� Page 42 of 70 AA -1829 CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE CIRTS SUMMARY FOR THE AGENCY ATTACHMENT VII Service to be Provided Service Unit Rate Maximum Units of Service Maximum Dollars No, of Clients Chore 1116 $25.00 624 $15,589.42 Homemaker IIIB $24.87 1,923 $47,822.00 Personal Care 1116 $29.00 1,649 $47,822.00 Screening & Assessment IIIB $26.22 59 $1,538.06 Congregate Meals C1 $9.25 15,873 $146,825.03 Congregate Meals Screening C1 $20.00 96 $1,925.00 Nutrition Counseling Ind. C1 $70.56 34 $2,424.39 Nutrition Education C1 $0.50 1,274 $637.00 Home Delivered Meals Frozen C2 $6.53 32,225 $210,427.84 Home Delivered Meals Hot C2 $6.53 1,872 $12,264.76 Nutrition Counseling Ind. C2 $70.56 3 $190.00 Nutrition Education C2 $0.50 724 $362.00 Screening & Assessment C2 $26.22 200 $5,251.00 In -Home Respite IIIE $22.98 765 $17,586.84 Respite In Facility IIIE $10.74 5,752 $61,771.59 Screening & Assessment IIIE $26.22 60 $1,575.00 Caregiver Training & Support — Grp. IIIE $100.90 71 $7,151.26 Caregiver Training & Support — Ind. IIIE $75.00 204 $15,302.02 Housing Improvement /Material Aid IIIES Cost Reimb $16,991.00 S Medical Equipment IIIES Cost Reimb $8,056.03 Chores IIIES $25.00 297 $7,425.33 Total Contract $628,937.57 Page 43 of 70 AA -1829 ATTACHMENT VIII OLDER AMERICANS ACT CONTRACT REPORT CALENDAR ADVANCE BASIS CONTRACT Report Number Based On Submit to Alliance On This Date 1 January Advance* January 1 2 February Advance* January 1 3 January Expenditure Report February 5 4 February Expenditure Report March 5 5 March Expenditure Report April 5 6 April Expenditure Report May 5 7 May Expenditure Report June 5 8 June Expenditure Report July 5 9 July Expenditure Report August 5 10 August Expenditure Report September 5 11 September Expenditure Report October 5 12 October Expenditure Report November 5 13 November Expenditure Report December 5 14 December Expenditure Report January 5 15 Final Expenditure and Request for Payment February 15 16 Close Out Report February 29 Legend: * Advance based on projected cash need. Note # 1: Report #I for Advance Basis Agreements cannot be submitted to the Department of Financial Services (DFS) prior to January 1 or until the agreement with the Alliance has been executed and a copy sent to DFS. Actual submission of the vouchers to DFS is dependent on the accuracy of the expenditure report. Note # 2: Report numbers 5 through 14 shall reflect an adjustment of one -tenth of the total advance amount, on each of the reports, repaying advances issued the first two months of the agreement. The adjustment shall be recorded in Part C, 1 of the report (ATTACHMENT IX). Note 93: Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects fiends due back to the Alliance payment is to accompany the report. Page 44 of 70 AA -1829 ATTACHMENT IX ....... ......... ......... . ........... E REQUST FOR PAYMENT ........... .. ...._. _.... . ....._. _._... OLDERAMERICANS A PROVIDER NAME, ADDRESS, PHONE AND FED ID NUMBER .. ........... ...._....... ......,..... ......._...._ ... ........_..... ......_ ......... .. ..._......... TYPE OF REPORT: .............. ...; ....._.. .......... ....................... THIS REQUEST PERIOD: _ _....._. ........... ... ........__. _.... ...... ...... Ad vance Report # .. ............. ............ ....... . _....... _ . _ ............... .__....... _... _......... ........._... _ .....;.......... ............ ...... .._....... Reimbursement ... ........ . .... _........ Agreement #: ........... . _ ........... ..................... ......... ... _.._....... ..... . ... . ....... ....._,.... ........... ...._......._. Agreement Period: PSA: CERTIFICATION I hereby certify to the best of my knowledge that thls request ,conforms with the terns and the purposes set, forth In the above agreement ...... ..._...... .. .... ... _ .. .. , ......... t; fo .. ......._..... .. ........ .. ... ............. ..... ......... .............. ................ ..,..... _..... ......,. ........... . ... ......... ............. .... ............ .....__.... _ .._ .............._. .... _. _......._....:...,.. ......_. ......_. ....... ................. ........... ................. Prepared,By. .. .............. ......._... ...._............ ..:..............._ ..__... ..'....._.... ..._.._.__... Appro�ed ................. .........,......._............. .....,........... ... ... _..._...._. ...,._......... Date: .Date: PART A _ .__... ... ��).. _ .( _ ( ( ( BUDGET SUMMARY ADMIN. ills MCI IIIC2 Title IIIE TOTAL I. Approved _Agreement_Amcunt_ , 0.00 0,00 0.00 0.00 0.00 0.00 2. Preuous Funds RECEIVED for Agreement period. 0.00 0.00 0.00 0.00 0.00 0.00 3. Agreement Balance 0.00 0.00 0.00 0.00 0.00 0.00 4. Premous Funds . _ ........... ....._._... ................. ____..._ ....... ........... . _....._ ...... _..........__._ .. ....... ................ .... REQUESTED and ... ....... _.. ............. .. . .............._.. .. ...... ........__............._.... _ ... .._ _...._... __. ...... ......... _ ..... ... .... _. _ ....., ............... ......_ .,..... Not Received. ._ ........................._ _ .._..._..... 0.00 ......_..._........ ..... ........ ...... 0.00 ................_... ..... .......... 0.00 .... ........... .. ._......._ ........................ 0.00 .. ...... 0.00 ........._..... ..... ..... ...... _ ......._ ......... _. ..... - .. ......... _........ ......_........ 0.00 ........ ... ........... .... ..... _.........._. . 5. Agreement Balance ................_ ....... 0.00 ...... ......_....._..._.. ... ... 0.00 ..... . . ......,....,... 0.00 __. _...... ........ 0.00 .. .. _ .. ... _. ... 0.00 .............. ...._........_ .... .. _ ........ 0.00 PART B: . .............. ......__. ......_....... ....__._.... ....................... ........... ...._....... ... _._ ........_..... ....._...._...., .FUNDS REQUESTED ..._ _.........._...... .... ... ..__....... ...._..__...... ................. ...... ... .................. ........... 1. 1st -2nd Months :. ............. .......... - ................ ... ............ _.........__................_ .... . ........... ............. _._ ...._..... .............. ............._. ._ _.._......__ .. _..,....._.. .............. _...__ _ .... .. ............ ..... . _...._.... ........_....._ ......._ ........... .. _,._......................._. Request Only_._ ...... ..........._ .... ..__....... 0.00 ............... 0.00 . _....... 0.00 __.._ 0.00 ... ............. ... 0.00 ._.._ _........__ ._.... .................. 0.00 .............. ............. . - _.... 2. Net Expenditures _...._..__. .._... ._ ........_ ........... ._ - __ .. ........._ .. _ .. __.. ._... .. .. ... _. ... __ .... .._.._.._... For Month 0 00 _ 0.00 0.00 - A . 00 0-00 0.00 .............. ...... ..... .._.... ........ _... 3. Additional ................ .. ..._ _..... __. ...... ........... ...... ... . ....... .... .... .. _. .._,...._ __ ..... ._ _ .. ._. .... ... ........... _.. _...... Cash Needs (Attach Doc) , _ 0.00 0.00 0.00 0 0.00 0.00 .......... .... ............ ......... ... ......... ... 4. Total ........... ..._....... 0.00 ..._,.... ... . 0.00 .........._ _. ...... 0.00 .... ... .. ... .. ........... 0.00 ........ .... 0.00 ...._ ..... ......... ..__... ... 0.00 PART C: ... ........ -.. . . ............ ............_.... ... .. .......... ................_. ......... _ ......_ . .. _..._. _.. .. NET FUNDS REQUESTED: ........_ ............... ....... .. .............. ... ........... _ .. _ ... ... _. _. ...................._.. ......,.. .. ........ _. _. .........._.. .... .. ... ....... _.__.......... ..... ... _........ ..._._._: 1. Less: Oyer- Advance 0.00 0.00 0.00 0.00 0.00 0.00 2 Agreement Funds are Hereby Requested For 0.00 0.00 0.00 0.00 0.00 0.00 DOEA FORM 109A revised 5/10 Page 45 of 70 AA -1829 ATTACHMENT XEXHIBIT -1 .. _ ..............._ . . _..... ... -.1.....- . ...... . _ ................ _...._..................__. ........ ........._........._. OLDER AMERICAN ACT PROVIDER NAME, ADDRESS, PHONE# AND FEID# Program Funding Source': THIS REPORT PERIOD FROM: TO: IIIB IIIC1 CONTRACT IIIC2 PERIOD: CONTRACT# REPORT# PSA# CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the contract. Prepared by : Date : Approved by : Date PARTA : BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0.00 $0.00 $0.00 % 2. State Funds $0.00 $0.00 $0.00 % 3. Program Income $0.00 $0.00 $0.00 % 4. Local Cash Match (CCE, HCE and Other) $0.00 $0.00 $0.00 % 5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 % 6. Local In -Kind Match $0.00 $0.00 $0.00 % 7. TOTAL RECEIPTS $0.00 $0.00 $0.00 % PART B : EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget 1. Meals / Meal Agreements $0.00 $0.00 $0.00 % 2. Service Subcontractor $0.00 $0.00 $0.00 % 3. Other $0.00 $0.00 $0.00 % 4. Indirect Cost $0.00 $0.00 $0.00 % 5. TOTAL EXPENDITURES $0.00 $0.00 $0.00 % PART C: OTHER EXPENDITURES (For Tracking Purposes only) 1. Match a. Other and In -Kind $0.00 $0.00 $0.00 % b. Local Match $0.00 $0.00 $0.00 % 2. USDA Cash Received $0.00 $0.00 $0.00 % 3. TOTAL OTHER $0.00 $0.00 $0.00 % PART D: OTHER REVENUE AND EXPENDITURES 2. Addition Cost Alternative Program Income 3. Interest 1. Program Income (PI) a. Approved Budget $ a. Earned on GR Advances $ a. OAA Unbudgeted PI Receipts YTD b. Received YTD $ b. Return of GR Advance $ C. Expenditures $ c. Other Earned $ DOEA FORM 105as revised 11/09 Page 46 of 70 AA -1829 ATTACHMENT X EXHIBIT 2 RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT s............ ....__..__... . _.. _.......... ..._...... ....- ......... ._ _._........ ............... ...........__. ..__...... PROVIDER NAME, ADDRESS, PHONE# AND FEID# Program Funding Source : THIS REPORT PERIOD FROM: TO: CONTRACT Title III E PERIOD: CONTRACT# REPORT# PSA# CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the contract. Prepared by : Date : Approved by : Date PART A : BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0.00 $0.00 $0.00 2. State Funds $0.00 $0.00 $0.00 % 3. Program Income $0.00 $0.00 $0.00 % 4. Local Cash Match $0.00 $0.00 $0.00 5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 % 6. Local In -Kind Match $0.00 $0.00 $0.00 % 7. TOTAL RECEIPTS $0.00 $0.00 $0.00 % PART B : EXPENDITURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget A: Direct Services 1. Personnel $0.00 $0.00 $0.00 % 2. Travel $0.00 $0.00 $0.00 3. Building Space $0.00 $0.00 $0.00 % 4. Communication / Utilities $0.00 $0.00 $0.00 % 5. Printing / Supplies $0.00 $0.00 $0.00 6. Equipment $0.00 '$0.00 $0.00 7. Other $0.00 $0.00 $0.00 B : Agreement Services 8. Services Subcontracted $0.00 $0.00 $0.00 % 9. TOTAL EXPENDITURES $0.00 $0.00 $0.00 % 10. DEDUCTIONS a. Total Local Match $0.00 $0.00 $0.00 % b. Program Income Used $0.00 $0.00 $0.00 % c. TOTAL DEDUCTIONS $0.00 $0.00 $0.00 % 11. NET EXPENDITURES $0.00 $0.00 $0.00 PART C : EXPENDITURES ANALYSIS 2. Units of Services Year to Date 3. Number of People Served Year to Date A. Expenditures by Services Year to Date: 1. Information ..................... $0.00 ........................ $0.00 .......................... 0.00 2. Assistance ..................... $0.00 ...................... $0$0_00 ............ ....I...... 0.00 3. Counseling ..................... 0.00 ........................ 0.00 .......................... 0.00 4. Respite ......................... $0.00 ........................ 0.00 .......................... 0.00 5. Supplemental Services..... $0_00 ....................... $0_00 .......................... 0.00 6. TOTAL .......................... 0.00 Part B Line 11. column 3 should be equal to this total. PART D : GRANDPARENT SERVICES (reported by Federal Fiscal Year) FFY $ FFY $ FFY $ Match $ Match $ Match $ DOEA FORM 105AE revised 12/08 Page 47 of 70 AA -1829 ATTACHMENT A Department of Elder Affairs Programs & Services Handbook, http: / /www.alliancefora ine.orJproviders /program- documents /2012 -doea- prams- services - handbook Page 48 of 70 AA -1829 ATTACHMENT B STATE OF FLORInA nFPARTMFMT r)F FI ni=p AFFAIRC CIVIL RIGHTS COMPLIANCE CHECKLIST Program /Facility Name: Monroe County Board of County Commissioners, Social Services /In -Home Services County: M,)YII Alliance /Provider Address 00 &M6t4��J Sf _ .7.7 Completed. By lyvl S _ Vrp- 1 City, State, Zip Code 1/Ve-S+ Fj 33 ©Lt o Date I-L 29 Zol I Telephone 305- 292 -y588 PART I. READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU IN THE COMPLETION OF THIS FORM. 1. Briefly describe the geographic area served by the program /facility and the type of service provided: 2. POPULATION OF AREA SERVED. Source of data: Sc-tS AM(V -, ae ` 3. STAFF CURRENTLY EMPLOYED. Effective date: Total #!�� % White % Black3�, % Hispanic+ % Other % F a e %Disabled 4. CLIENTS CURRENTLY ENROLLED OR REGISTERED Effective date: I Z t I"7 Total #. 2,. % W P t; 4p /o Other it % Black % H nic ° % F ; ale % Disabled % Over 40 �. 5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE. Total #� % W it O % Black % Hispanic % Other % Fe al % Disabled PART II. USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. 6. Is an Assurance of Compliance on file with DOEA? If NA or NO, explain. NA YES NO 7. Compare the staff composition to the population. Is staff representative of the population? If NA or NO, explain. NA YES NO ❑ 5< ❑ 8. Compare the client composition to the population. Are race and sex characteristics representative of the Population? If NA or NO, explain. NA YES NO ❑ X ❑ 9. Are eligibility requirements for services applied to clients and applicants without regard to race NA YES NO color, national origin, sex, age, religion or disability? If NA or NO, explain. ❑ [, ❑ AA -1829 10. Are all benefits, services and facilities available to applicants and participants in an equally effective manner regardless of race, sex, color, age, national origin, religion or disability? If NA or NO, explain. NA y YES NO F L ❑ 11. For in- patient services, are room assignments made without regard to race, color, national origin or disability? If NA or NO, explain. NA YES NO ❑ ❑ 12. Is the program /facility accessible to non - English speaking clients? If NA or NO, explain. A 'e, S 13. Are employees, applicants and participants informed of their protection against discrimination? If yes, how? Verbal �< Written A Poster NIf NA or NO, explain. 14. Give the number and current status of any discrimination complaints regarding services or employment filed against the program /facility. (� 15. Is the program /facility physically accessible to mobility, hearing, and sight- impaired individuals? If NA or NO, explain. NA YES NO PART III. THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES 16. Has a self - evaluation been conducted to identify any barriers to serving disabled individuals, and to make any necessary modifications? If NO, explain. Page 50 of 70 AA -1829 17. Is there and established grievance procedure that incorporates due process in the resolution of complaints? If NO, explain. YYEEjS NO �1 18. Has a person been designated to coordinate Section 504 compliance activities? If NO, explain. YES NO 19. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of disability? If NO, explain. \ IeS 20. Are auxiliary aids available to assure accessibility of services to hearing and sight impaired individuals? If NO, explain. YES NO X ❑ FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000 PART IV. OR MORE. 21. Do you have a written affirmative action plan? If NO, explain. YES '% NO ❑ Page 51 of 70 AA -1829 Alliance USE ONLY Reviewed By In Compliance: YES lam* Program Office *Notice of Corrective Action Sent Date Telephone Response Due _ /_ /_ On -Site Desk Review ❑ Response Received /_ /_ INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST 1. Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves a specific target population such as adolescents, describe the target population. Also, define the type of service provided. 2. Enter the percent of the population served by race and sex. The population served includes persons in the geographical area for which services are provided such as a city, county or other regional area. Population statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing Florida population statistics. Include the source of your population statistics. ( "Other" races include Asian/Pacific Islanders and American Indian/Alaskan Natives.) 3. Enter the total number of frill -time staff and their percent by race, sex and disability. Include the effective date of your summary. 4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list their percent by race, sex and disability. Include the date that enrollment was counted. 5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no advisory or governing board, leave this section blank. 6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the contract language for DOEA recipients and their sub- grantees, 45 CFR 80.4 (a). 7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the population is Hispanic, is there a comparable percentage of Hispanic staff? 8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability in the population, the program/facility has the responsibility to determine the reasons for such variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR C Page 52 of 70 AA -1829 80.3 (b) (6). 9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also through on -site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a) and 45 CFR 80.1 (b) (2). 10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services, physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin, religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied uniformly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR 80.3 (b). 11. For in- patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national origin or disability. Also, residents must not be asked whether they are willing to share accormnodations with persons of a different race, color, national origin, or disability, 45 CFR 80.3 (a). 12. The prograrn/facility and all services must be accessible to participants and applicants, including those persons who may not speak English. In geographic areas where a significant population of non - English speaking people live, program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will assist in the provision of services, 45 CFR 80.3 (a). 13. Programs /facilities must make information regarding the nondiscriminatory provisions of Title VI available to their participants, beneficiaries or any other interested parties. This should include information on their right to file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS. The information may be supplied verbally or in writing to every individual, or may be suppl ied through the use of an equal opportunity policy poster displayed in a public area of the facility, 45 CFR 80.6 (d). 14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color, creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement, termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address of the local, state or federal agency with whom the complaint has been filed. Indicate the current status, e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc. 15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed for accessibility. Elevators should be observed for door width, and Braille or raised numbers. Switches and controls for light, heat, ventilation, Page 53 of 70 AA -1829 fire alarms, and other essentials should be installed at an appropriate height for mobility impaired individuals. 16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self - evaluation to identify any accessibility barriers. Self - evaluation is a four step process: ❑ With the assistance of a disabled individual /organization, evaluate current practices and policies which do not comply with Section 504. ❑ Modify policies and practices that do not meet Section 504 requirements. ❑ Take remedial steps to eliminate any discrimination that has been identified. ❑ Maintain self - evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have been followed.), 45 CFR 84.6. 17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited by Section 504.45 CFR 84.7 (b). 18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to comply with Section 504.45 CFR 84.7 (a). 19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads, and other appropriate written communication, 45 CFR 84.8 (a). 20. Programs /facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be used to provide equally effective services, (45 CFR 84.52 (d). 21. Programs /facilities with 50 or more employees and $50,000 in federal contracts must develop, implement and maintain a written affirmative action compliance program in accordance with Executive Order 11246. 41 CFR 60 and Title VI of the Civil Rights Act of 1964, as amended. Page 54 of 70 AA -1829 ATTACHMENT C Department's Computer Use Policy and its Social Media Policy Available at the Department's website at http:// cIderaffairs .state.fl.us /doea/flnancial.plip Page 55 of 70 AA-1829 AUTHORITY. This form Is roquirod annually of all employers to comply with the attestatlon requirernmmts set 44arth in section 413S.OM2) F[Grtda Statutes. m The term �'employer" means any person or entity required by law to conduct barkg wand screening, including but not limited tn., Area Agencies on Aging Aging Resource Centers, Aging and Disabifity Resource Center, Lead Agendes, Long -Term Care Gmbvd Program,, Serving Healtin Insurance Needs of Elders Program, Service Providers, Diversion Providers, and anq other person or entity which Mires. CM.Ptayces or heel s Volunteers in service:: who nnim the definition. of a dilrock scryict provider, See 435.02, 430.04.02. Fla. RIM_ A direct service. proyIder Is, "i person 28 Ye es of aae or older who, pursuant to a proaram to. 0 roWe . seivicei to the elderly, has dlrect' contact vith a rRent while providing services to the dilent and has acres- to the clielnes living area, funds. personal property, or personal identification informa' flon as defined in s. 817-S68- The terni includes crjordinaWrs, managers, and zupen. of residential facilides, and volunteers." § 430.04FJA11(bi, Fla- Stat- ATTESTATION; Asth.eduiyauthoria ed representative of Mcocte L0Ll_A4 go c' Em. pfoyer Ajame locmd' at do hereby aff fm. under penalty of perjury that the above narned employer is In compliance with the provIslons of Chapter 4aS and section 430,04a-2 Flori totes, regarding level 2 bark ndscreen ing. pa te. STATE OF FLORIDA, CQUN_ryL OF ® n Co I iiiiiiii��illi III i U—Mrs.rVINVII 011111 !!11111111111111 111 1� i 1 3% 1 jjk - vorn to f or affirmed � and subscribed before me 2 -day 20j_ - by G ) r jiJarne of Represcmativel who is personally known to me or produced Z --- as proof of identification, &M 0 l C Notary Publl�i- Print, PMc, cT'Sftamp CarnmissianL-J Marna of r-outary Public DGNEA corm -Ernpklye ' err�_"00e A00 2012 5aWon 435,05(3�, IF,_`:. DAWN C. THOMAS i*: MY COMMISSION # FF 9547 EXPIRES: Ma 26, 2020 Bonded Thru NOWNY Public Underwr 0% G' j RI! R 5 HUN ATTACHMENT D "'11 I iiiiiiii��illi III i U—Mrs.rVINVII 011111 !!11111111111111 111 1� i 1 3% 1 jjk - vorn to f or affirmed � and subscribed before me 2 -day 20j_ - by G ) r jiJarne of Represcmativel who is personally known to me or produced Z --- as proof of identification, &M 0 l C Notary Publl�i- Print, PMc, cT'Sftamp CarnmissianL-J Marna of r-outary Public DGNEA corm -Ernpklye ' err�_"00e A00 2012 5aWon 435,05(3�, IF,_`:. DAWN C. THOMAS i*: MY COMMISSION # FF 9547 EXPIRES: Ma 26, 2020 Bonded Thru NOWNY Public Underwr AA -1829 ATTACHMENT E Verification of Employment Status Certification As a condition of contracting with the lliance for Aging, Inc., LL D F'S 4" C61-LK � C�GG C Vz m CO , hereby referred to as contractor, certifies the use of the U.S. Departi ent of Hoi eland Security's E- verify system to verify the employment eligibility of all new employees hired by Provider during the contract term to perform employment duties pursuant to this Agreement and (b) that any subcontracts include an express requirement that subcontractors performing work or providing services pursuant to this Agreement utilize the E- verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term. Signat re (Same as contract signature) Company Name PEDRO ASSISTANT C Date U Page 57 of 70 AA -1829 ATTACHMENT F Alliance for Aging, Inc. Business Associate Agreement. This Business Associate Agreement is dated f)JCO31Y 2-4,7011 , by the Alliance for Aging, Inc. ( "Covered Entity ") and Monroe County Board of County Commissioners, Social Services /In- Home Services, ( "Business Associate "), a not - for - profit Florida corporation. 1.0 Background. 1.1 Covered Entity has entered into one or more contracts or agreements with Business Associate that involves the use of Protected Health Information (PHI). 1.2 Covered Entity, recognizes the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and has indicated its intent to comply in the County's Policies and Procedures. 1.3 HIPAA regulations establish specific conditions on when and how covered entities may share information with contractors who perform functions for the Covered Entity. 1.4 HIPAA requires the Covered Entity and the Business Associate to enter into a contract or agreement containing specific requirements to protect the confidentiality and security of patients' PHI, as set forth in, but not limited to the Code of Federal Regulations (C.F.R.), specifically 45 C.F.R. §§ 164.502(e), 164.504(e), 164.308(b), and 164.314(a -b) (as may apply) and contained in this agreement. 1.5 The Health Information Technology for Economic and Clinical Health Act (2009), the American Recovery and Reinvestment Act (2009) and Part I — Improved Privacy Provisions and Security provisions located at 42 United States Code (U.S.C.) §§ 17931 and 17934 (2010) require business associates of covered entities to comply with the HIPAA Security Rule, as set forth in, but not limited to 45 C.F.R. Subpart C 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 Catch -all definition. The following terms used in this Agreement shall have the same meaning as those terms in the HIPAA Rules: Access, Administrative Safeguards, Authentication, Availability, Breach, Confidentiality, Data Aggregation, Designated Record Set, Disclosure, Electronic Protected Health Information (ePHI), Health Care Operations, Individual, 'Information System, Integrity, Malicious Software, Minimum Necessary, Notice of Privacy Practices, Password, Physical Safeguards, Protected Health Information (PHI), Required By Law, Secretary, Security Incident, Subcontractor, Technical Safeguards, Unsecured Protected Health Information, and Use. 2.2 ARRA. The American Recovery and Reinvestment Act (2009) 2.3 Business Associate. `Business Associate" shall generally have the same meaning as the term "business associate" at 45 CFR 160.103, and in reference to the party to this Agreement, Monroe County Board of County Commissioners, Social Services /In -Hoene Services. Page 58 of 70 AA -1829' 2.4 Covered Entity. "Covered Entity" shall generally have the same meaning as the term "covered entity" at 45 CFR 160.103, and in reference to the party to this Agreement, shall mean Alliance for Aging, Inc. 2.5 HIPAA Rules. " HIPAA Rules" shall mean the Privacy, Security, Breach Notification, and Enforcement Rules at 45 CFR Parts 160 and 164. 2.6 HITECH. The Health Information Technology for Economic and Clinical Health Act (2009) 2.7 All other terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in the HIPAA Rules. 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: (a) Implement policies and procedures to .prevent, detect, contain and correct Security violations in accordance with 45 CFR § 164.306; (b) Prevent use or disclosure of the PHI other than as provided for by this Agreement or as required by law; (c) Reasonably and appropriately protect the confidentiality, integrity, and availability of the ePHI that the Business Associate creates, receives, maintains, or transmits on behalf of the Covered Entity; and (d) Comply with the Security Rule requirements under Subpart C of 45 CFR Part 164, including the Administrative Safeguards, Physical Safeguards, Technical Safeguards, and policies and procedures and documentation requirements set forth in 45 CFR §§ 164.308, 164.310, 164.312, and 164.316. 3.3 Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Business Associate of a use or disclosure of PHI by Business Associate in violation of the requirements of this Agreement. 3.4 Business Associate agrees to promptly report to Covered Entity any use or disclosure of the PHI not provided for by this Agreement of which it becomes aware. This includes any requests for inspection, copying or amendment of such information and including any security incident involving PHI. 3.5 Business Associate agrees to notify Covered Entity without unreasonable delay, but not later than ten (10) days following the discovery, 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 Page 59 of 70 AA -1829 (b) All information required for the Notice to the Secretary of HHS of Breach of Unsecured Protected Health Information. 3.6 Business Associate agrees to ensure that any agent, including a subcontractor, to whom it provides PHI received from, or created or received by Business Associate on behalf of Covered Entity, agrees to the same restrictions and conditions that apply through this Agreement to Business Associate with respect to such information. 3.7 If Bus iness.Associate has PHI in a Designated Record Set: (a) Business Associate agrees to provide access, at the request of Covered Entity during regular business hours, to PHI in a Designated Record Set, to Covered Entity or, as directed by Covered Entity, to an individual in order to meet the requirements under 45 CFR § 164.524; and (b) Business Associate agrees to make any amendment(s) to PHI in a Designated Record Set that the Covered Entity directs or agrees to pursuant to 45 CFR § 164.526 at the request of Covered Entity or an Individual within 10 business days of receiving the request. 3.8 Business Associate agrees to make internal practices, books, and records, including policies and procedures and PHI, relating to the use and disclosure of PHI received from, or created or received by Business Associate on behalf of Covered Entity, available to the Covered Entity or to the Secretary upon request of either for purposes of determining Covered Entity's compliance with the Privacy Rule. 3.9 Business Associate agrees to document such disclosures of PHI and information related to such disclosures as would be required for Covered Entity to respond to a request by an individual for an accounting of disclosures of PHI in accordance with 45 CFR § 164.528. 3.10 Business Associate agrees to provide to Covered Entity or an individual, upon request, information collected to permit Covered Entity to respond to a request by an Individual for an accounting of disclosures of PHI in accordance with 45 CFR § 164.528 and ARRA § 13404. 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. U 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 Page 60 of 70 AA -1829 (c) ARRA § 13406 (Conditions on Certain Contacts as Part of Health Care Operations). 3.15 To the extent Business Associate is to carry out one or more of Covered Entity's obligation(s) under the Privacy Rule, Business Associate agrees to comply with the requirements of the Privacy Rule that apply to Covered Entity in the performance of such obligation(s). 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 as Required By Law, as well as to perform functions, activities, or services for, or on behalf of, Covered Entity as specified in any and all contracts with Covered Entity provided that such use or disclosure would not violate the Privacy Rule if done by Covered Entity or the minimum necessary policies and procedures of the Covered Entity. 5.0 Specific Use and Disclosure Provisions. 5.1 Except as otherwise limited in this agreement or any related agreement, Business Associate may use PHI for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate. 5.2 Except as otherwise limited in this agreement or any related agreement, Business Associate may disclose PHI for the proper management and administration of the Business Associate, provided that disclosures are Required By Law, or Business Associate obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as Required By Law or for the purpose for which it was disclosed to the person, and the person notifies the Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached. 5.3 Business Associate may use PHI to provide data aggregation services to Covered Entity as permitted by 45 CFR § 164.504(e)(2)(i)(B), only when specifically authorized by Covered Entity. 5.4 Business Associate may use PHI to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR § 164.5020)(1). 6.0 Obligations of Covered Entity. 6.1 Covered Entity shall notify Business Associate of any limitation(s) in its notice of privacy practices of Covered Entity in accordance with 45 CFR § 164.520, to the extent that such limitation may affect Business Associate's use or disclosure of PHI, by providing a copy of the most current Notice of Privacy Practices (NPP) to Business Associate as Attachment XI to this Agreement. Future Notices and /or modifications to the NPP shall be posted on Covered Entity's website at www.alliancefor 6.2 Covered Entity shall notify Business Associate of any restriction to the use or disclosure of PHI that Covered Entity has agreed to in accordance with 45 CFR § 164.522, to the extent that such restriction may affect Business Associate's use or disclosure of PHI. 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. Page 61 of 70 AA -1829 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 and HITECH 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 and HITECH shall be effective the later of February 17, 2010 or the effective date of the earliest contract entered into between covered entity and business associate that involves the use of PHI or ePHI. 8.2 Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business Associate, Covered Entity shall either: (a) Provide an opportunity for Business Associate to cure the breach or end the violation and terminate this agreement if Business Associate does not cure the breach or end the violation within the time specified by Covered Entity; (b) Immediately terminate this agreement if Business Associate has breached a material term of this Agreement and cure is not possible; or (c) If neither termination nor cure is feasible, Covered Entity shall report the violation to the Secretary. 8.3 Effect of Termination. Except as provided in subparagraph (b) of this section, upon termination of this agreement, for any reason, Business Associate shall return all PHI and ePHI received from Covered Entity, or created or received by Business Associate on behalf of Covered Entity. (a) This provision shall apply to PHI and ePHI that is in the possession of subcontractors or agents of Business Associate. Business Associate shall retain no copies of the PHI and ePHI. (b) In the event that Business Associate or Covered Entity determines that returning the PHI or ePHI is infeasible, notification of the conditions that make return of PHI or ePHI infeasible shall be provided to the other party. Business Associate shall: 1. Retain only that PHI which is necessary for Business Associate to continue its proper management and administration or to cant' out its legal responsibilities; 2. Return to Covered Entity (or, if agreed to by Covered Entity, destroy) the remaining PHI that the Business Associate still maintains in any form; Page 62 of 70 AA -1829 3. Continue to use appropriate safeguards and comply with Subpart C of 45 CFR Part 164 with respect to the ePHI to prevent use or disclosure of the PHI, other than as provided for in this Section, for as long as Business Associate retains the PHI; 4. Not use or disclose the PHI retained by Business Associate other than for the purposes for which such PHI was retained and subject to the same conditions set out at Section 5.0 "Specific Use and Disclosure Provisions" which applied prior to the termination; and 5. Return to Covered Entity (or, if agreed to by Covered Entity, destroy) the PHI retained by Business Associate when it is no longer needed by Business Associate for its proper management and administration or to carry out its legal responsibilities. The obligations of Business Associate under this Section shall survive the termination of this Agreement. 9.0 Regulatory References. A reference in this agreement to a section in the Privacy Rule or Security Rule means the section then in effect or as may be amended in the future. 10.0 Amendment. The Parties agree to take such action as is necessary to amend this agreement from time to time as is necessary for Covered Entity to comply with the requirements of the Privacy Rule, the Security Rule and the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104 -191. 11.0 Survival. Any term, condition, covenant or obligation which requires performance by either party hereto subsequent to the termination of this agreement shall remain enforceable against such party subsequent to such termination. 12.0 Interpretation. Any ambiguity in this agreement shall be resolved to permit Covered Entity to comply with the Privacy Rule and Security Rule. 13.0 Incorporation by reference. Any future new requirement(s), changes or deletion(s) enacted in federal law which create new or different obligations with respect to HIPAA privacy and /or security, shall be automatically incorporated by reference to this Business Associate Agreement on the respective effective date(s). 14.0 Notices. All notices and communications required, necessary or desired to be given pursuant to this agreement, including a change of address for purposes of such notices and communications, shall be in writing and delivered personally to the other party or sent by express 24 -hour guaranteed courier or delivery service, or by certified mail of the United States Postal Service, postage prepaid and return receipt requested, addressed to the other party as follows (or to such other place as any party may by notice to the others specify): To Covered Entity: Alliance for Aging, Inc. Attention: Max Rothman 760 NW 107 Avenue Miami, Florida 33172 To Business Associate: Monroe County Board of County Commissioners, Social Services /In -Horne Services 1100 Simonton Street, 2 nd Floor Key West, FL 33040 Page 63 of 70 DA 3 li a tS r � j �J AA -1829 Any such notice shall be deemed delivered upon actual receipt. If any notice cannot be delivered or delivery thereof is refused, delivery will be deemed to have occurred on the date such delivery was attempted. 15.0 Governing Law. The laws of the State of Florida, without giving effect to principles of conflict of laws, govern all matters arising under this agreement. 16.0 Severability. If any provision in this agreement is unenforceable to any extent, the remainder of this agreement, or application of that provision to any persons or circumstances other than those as to which it is held unenforceable, will not be affected by that unenforceability and will be enforceable to the fullest extent permitted by law. 17.0 Successors. Any successor to Business Associate (whether by direct or indirect or by purchase, merger, consolidation, or otherwise) is required to assume Business Associate's obligations under this agreement and agree to perform them in the same manner and to the same extent that Business Associate would have been required to if that succession had not taken place. This assumption by the successor of the Business Associate's obligations shall be by written agreement satisfactory to Covered Entity. 18.0 Entire Agreement. This agreement constitutes the entire agreement of the parties relating to the subject matter of this agreement and supersedes all other oral or written agreements or policies relating thereto, except that this agreement does not limit the amendment of this agreement in accordance with section 10.0 of this agreement. Covered Entity: Alliance for Aging, Inc. B Date: DEC 2 9 2017 (signature) Business Associate: Monroe County Board of County Commissioners, Social Services /In -Home Services By: Date: 12,12-9 (signatur0 COUNTY VED AS 7 ASSISTANT CO Date SIGNED BY: NAME: David Rice = A7`r ON CLERK TITLE: MAYOR Page 64 of 70 BX;: CLERK DATE: 4vww�u.L t? 7.0 ( T 1 AA -1829 ATTACHMENT G Alliance for Aging, Inc. Aging and Disability Resource Center /Elder Helpline AGING AND DISABILITY RESOURCE CENTER (ADRC) — OUTSOURCED FUNCTIONS I. If applicable, the provider agrees to the following: A. Perform ADRC outsourced functions in accordance with the Alliance's policies and procedures. i. Policies and Procedures for Outsourced Function - Screening ii. Policies and Procedures for Outsourced Function- Triage iii. Policies and Procedures for Activation from Waitlist- Client Services iv. Policies and Procedures for Termination from Waitlist- Client Services B. Maintain wait lists in CIRTS in accordance with DOEA requirements. C. Report number of client contacts to the Aging and Disability Resource Center. D. Adhere to prioritization policy as set forth by DOEA on a monthly basis. Reference DOEA Notice of Instruction: Assessed Priority Consumer List#: 062906-1 -I-OVCS as applicable. E. Ensure the agency's Disaster Plan reflects ADRC Outsourced Functions, annually or as needed to incorporate ADRC outsourced functions. F. Ensure against conflicts of interest and inappropriate self - referrals by referring consumers in need of options counseling or long -term care services beyond the provider's scope of services to the Aging and Disability Resource Center. G. Ensure that services provided are in the clients' best interest, are the most cost effective, of high quality, and are responsive and appropriate to the assessed needs. The Assessed Priority Consumer List (APCL) is maintained when services funded by the department are not available. Contracted providers of registered services for Alzheimer's Disease Initiative (ADI) and Older American's Act (OAA) maintain waiting lists in the CIRTS database for registered services when finding is not available. Registered Services for the above listed programs are as follows: Adult Day Care (ADC), Adult Day Health Care (ADHC), Chore (CHO), Escort (ESC), Home Delivered Meals (HDM), Home Health Aide (HHA), Homemaker (HMK), Model Day Care (MDC), Personal Care (PECA), Facility -Based Respite (RESF), In -Home Respite (RESP). Page 65 of 70 AA -1829 Alliance for Aging, Inc. Aging and Disability Resource Center /Elder Helpline Policy and Procedure for Outsourced function — Screening Creation Date: March 5, 2008 Revision Date: May 2012 Objective: To ensure that a comprehensive list of clients in need of services is maintained in CIRTS by appropriate funding source and that the ADRC is thereby able to effectively gauge the level of elder service need in Miami -Dade and Monroe Counties. Policy: To obtain necessary information from clients in order to assist in determining level of need and eligibility for DOEA funded services Procedure: 1. ADRC Contracted Providers will collect information from callers and conduct a 701A assessment. Alternatively, if a 701B assessment already exists or is provided from another source (i.e. CARES) the information from the 701B can be utilized. Based on the information provided via the 701A(B) assessment, the ADRC Contracted Provider will make a determination as to the services that the caller is in need of receiving. The ADRC Contracted Provider will determine the appropriate finding source(s) that provides the needed services. 4. If the caller is in need of a service(s) that is not provided by the ADRC Contracted Provider, the ADRC Contracted Provider will refer caller to the ADRC Elder Helpline utilizing the ADRC Referral Form and /or to an ADRC Contracted Provider that provides the needed service. 5. The caller will be provided with general information regarding the ADRC as well as the ADRC Elder Helpline contact number. The caller will be informed of the services and finding sources that they are being placed on the wait list for in CIRTS. ADRC Contracted Provider will create a client record in CIRTS (if there is no existing record) and enter the services needed for the caller by finding source and service. [If there is an existing record in CIRTS, the appropriate fields will be updated]. 8. If the ADRC Contracted Provider determines that the caller may qualify for more than one funding source. ADRC Contracted Provider is encouraged to enter the appropriate information under multiple funding sources. [If there is an existing client record in CIRTS, the client record in CIRTS will be updated with appropriate information]. ADRC Contracted Provider will inform caller that they will receive a follow -up call (or home visit in case of active client) to check on their status based on DOEA Wait List Reassessment Standards and encourage caller to contact the ADRC Elder Helpline with any questions. Page 66 of 70 AA -1829 Alliance for Aging, Inc. Aging and Disability Resource Center /Elder Helpline Policy and Procedure for Outsourced function - Triage Creation Date: March 5, 2008 Revision Date: May 2012 Objective: To ensure that clients in need of DOEA funded services receive services based on the highest level of need, first, as finding becomes available. Policy: To assist clients in obtaining DOEA funded services as finding becomes available, based on level of need as determined by a CIRTS priority score. Procedure: 1. ADRC Contracted Provider will conduct periodic follow -up calls (or horrie visit in case of active client) to check on client status based on DOEA Wait List Reassessment Standards. 2. Based on the infonnation provided via the 701A(B) assessment, the ADRC Contracted Provider Will update the client information in CIRTS specifically as it pertains to level of need for services by finding source. 3. The ADRC Contracted Provider will ensure that the CIRTS prioritization score is accurately maintained, according to DOEA Standards. 4. If the caller is in need of a service(s) that is not provided by the ADRC Contracted Provider, the ADRC Contracted Provider will refer caller to the ADRC Elder Helpline utilizing the ADRC Referral Form and /or to an ADRC Contracted Provider that provides the needed service. 5. The caller will be informed of the services and finding sources that they remain on the wait list for and /or have been removed from the wait list for. 6. ADRC Contracted Provider will advise client of any change in their CIRTS priority score based on the updated information. 7. ADRC Contracted Provider will remind client of the ADRC Elder Help Line contact number and to contact the ADRC Elder Help Line with any questions or concerns. S. As finding becomes available, ADRC Contracted Provider will run CIRTS Prioritization Report and activate clients according to DOEA Standards (refer to ADRC Client Activation Policies and Procedures). The Contracted Provider will apply targeting criteria, as appropriate, to prioritized clients to ensure activations meet programmatic requirements. Page 67 of 70 AA -1829 Alliance for Aging, Inc. Aging and Disability Resource Center /Elder Helpline Policy and Procedure for Activation From Wait List — Clients /Services Creation Date: March 5, 2008 Revision Date: May 2012 Objective: To ensure that elders in need of DOEA funded services in Miami -Dade and Monroe Counties . and on the CIRTS wait list begin to receive services as funding becomes available. Policy: ADRC will work with ADRC Contracted Providers to ensure that clients waiting for DOEA funded services begin to receive those services as funding becomes available. Procedure: 1. ADRC Contracted Provider will activate clients on CIRTS wait list based on DOEA prioritization polices and funding availability. 2. ADRC Contracted Provider will update CIRTS status by finding source and service for any services being activated for the client using appropriate CIRTS codes. 3. Client may be left on wait list of a different finding source than the one being activated if ADRC Contracted Provider determines that it is appropriate. 4. Client may also be left on wait list in CIRTS if they are being activated by the ADRC Contracted Provider under a temporary non -DOEA finding source and ADRC Contracted Provider determines that the clients' need will persist after the temporary finding source is exhausted. 5. ADRC Contracted Provider will inform the client of any services /funding source that they are being activated for as well as those services and Ending sources that they will continue to be wait listed for. 6. ADRC Contracted Provider will inform client to contact the ADRC Elder Helpline if they have any questions or concerns regarding the status of any of their services. Page 68 of 70 AA -1829 Alliance for Aging, Inc. Aging and Disability Resource Center /Elder Helpline Policy and Procedure for Termination From Wait List — Clients /Services Creation Date: March 5, 2008 Revision Date: May 2012 Objective: To ensure that the comprehensive list of clients in need of services in CIRTS is appropriately maintained by finding source and that the ADRC is thereby able to effectively gauge the current level of elder service need in Miami -Dade and Monroe Counties. Policy: ADRC will maintain an accurate and current list of clients in need of elder services in Miami- . Dade and Monroe Counties with the assistance of the ADRC Contracted Providers. Procedure: 1. ADRC Contracted Provider will re- screen clients which the ADRC Contracted Provider initially placed on the CIRTS wait list for services based on DOEA Reassessment Standards. 2. The re- screening may be in the form of a phone screening or a home visit depending on the clients status (i.e. active /pending) 3. ADRC Contracted Provider will determine if the client is no longer in need (or eligible) for any of the services they were wait - listed for. 4. ADRC Contracted Provider will terminate the client from the wait list (entirely or by specific service) using the appropriate CIRTS termination code for any services or finding source for which the client is determined to no longer be eligible for or no longer in need of. ADRC Contracted Provider will inform the client of any services /finding source that they are being removed from the wait list for. 6. ADRC Contracted Provider will inform client of their ability to be re -added to the wait list if their level of need should change. 7. ADRC Contracted Provider will inform client to contact the ADRC Elder Helpline if they have any questions or concerns regarding their wait list status. Reference DOEA Notice of Instruction: Assessed Priority Consumer List #:062906- 1- I -OVCS as applicable. Page 69 of 70 AA -1829 ATTACHMENT H CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS The undersigned, an authorized representative of the Provider named in the contract or agreement to which this form is an attachment, hereby certifies that: (1) The Provider understands that pursuant to s. 287.135 F.S., any company at the time of bidding or submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized Companies with Activities in Sudan List" or the "Scrutinized Companies with Activities in the Iran Petroleum Sector List (collectively, "the Lists ") is ineligible for, and may not bid on, submit a proposal for, or enter into or renew a contract pursuant to which funding is provided by the Department of Elder Affairs (Department) for goods or services of $1 million or more. (2) The Provider understands that, pursuant to s. 287.135 F.S., any company that submits a false certification is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification. (3) The Provider understands that the contract to which this form is an attachment may be terminated by the Alliance if the Provider submits a false certification or has been placed on the Lists. This certification, required by Florida law, is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction. Signatt e Date (Same as contract signature) Achia Cou n d YA tx i r T i tle n 1 �Yl C � l o u-A 4 _ Company Name Page 70 of 70