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Item C21
C ounty of M onroe {r `° " rel BOARD OF COUNTY COMMISSIONERS n Mayor David Rice, District 4 The FlOnda Key y m 1 �� Mayor Pro Tem Sylvia J. Murphy, District 5 Danny L. Kolhage, District 1 George Neugent, District 2 Heather Carruthers, District 3 County Commission Meeting July 18, 2018 Agenda Item Number: C.21 Agenda Item Summary #4435 BULK ITEM: Yes DEPARTMENT: Social Services TIME APPROXIMATE: STAFF CONTACT: Sheryl Graham (305) 292 -4510 N/A AGENDA ITEM WORDING: Approval of Alzheimer's Disease Initiative Program (ADI) Contract KZ -1897 between the Alliance for Aging, Inc., and Monroe County Board of County Commissioners /Monroe County Social Services In -Home Services for the contract year 2018 -2019 (07/01/2018 - 06/30/2019) in the amount of $189,458.40. ITEM BACKGROUND: Approval of the ADI contract will enable Monroe County Social Services In -Home Services Program to continue providing personal services to Monroe County's elderly population under the Alzheimer's Disease Initiative Program. PREVIOUS RELEVANT BOCC ACTION: BOCC approval on 07/19/2017 of ADI Contract KZ- 1797 between the AAA and Monroe County BOCC; and BOCC approval on 01/17/2018 of Amendment 4001 to ADI Contract KZ -1797 between the AAA and Monroe County BOCC . CONTRACT /AGREEMENT CHANGES: None STAFF RECOMMENDATION: Approval DOCUMENTATION: ADI Contract BACKUP Monroe County 2018 -2019 ADI Contract ADI Additional BACKUP FINANCIAL IMPACT: Effective Date: 07/01/2018 Expiration Date: 06/30/2019 Total Dollar Value of Contract: $189,458.40 Total Cost to County: 10% Cash Match Current Year Portion: Budgeted: Source of Funds: Grant CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: Yes Grant: Yes County Match: 10% Cash Match Insurance Required: No If yes, amount: Approx: $8,000.00 Additional Details: Revenue produced is from client co- 07/19/17 NEW COST CENTER ADDED 125- 6153617 $164,647.80 REVIEWED BY: Sheryl Graham Completed 07/02/2018 3:28 PM Pedro Mercado Completed 07/02/2018 4:15 PM Budget and Finance Completed 07/02/2018 5:06 PM Maria Slavik Completed 07/03/2018 7:23 AM Kathy Peters Completed 07/03/2018 11:08 AM Board of County Commissioners Pending 07/18/2018 9:00 AM 11 R ,kjl This contract shall begin on July 1, 2017 or on the date the contract has been signed bN both parties. whichever is later. Delivery ofservices shall end at 11:59 PNI, local time in Miami, FL on June 30, 2018. The Alliance not reirnburse the provider lor sen ices pro% ided after this date. I lo�ke� er, the parties recouni/e that the% will need to perform continued activities relating to reporting. invoicing and pa%nient in Ally of 2017 to facilitate payment for services rendered by the provider Linder this contract. I IN P. IIRW."Ilml,2w, 0,11 111111 MI 01"1111,111 funds. Any costs or services paid for under any other contract or from any other SOLLrce are not eligible fol payment under this contract. I EM IM 0 I M1 MIM Mlmi M The A] liance's performance and obligation to pay under this contract is contingent upon an annual aWmm,priation with the Department, Source of Funds The costs of services paid tinder any other contract or from any other source are not eligible for reimbursement under this contract. The state grants and aids appropriations and consists of the following: Prograrn Title ::Funding Source Fund Amounts L Alzheimer Disease I Revenue yy Initiative The parties shall re-evaluate the contract's reimbursement rates on an annual basis pursuant to DOEA's Notice or Policy Clarification: Service Cost Reports Notice #092815-1-PC-SCBS dated September 28"', 2015 and the approved Alliance's Reimbursement Rate Review Policy, In the event that contracts cannot be executed prior to the July I" start date, the Alliance may, at its discretion, extend this Agreement upon written notice for LIP to 120 days to ensure continUitV of servic Services provided tinder this extension %% ill be paid I"or OLIE Or the succeeding agreement amount Z7 = I Comnliance with State Law 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 or laws. The Provider shall comply with requirements of s. 288058, F.S. as amended. 6.2.4 The Provider shall allow public access to all documents, papers, letters, or other public records as defined in subsection 119.011(12), F.S., made or received by the Provider in conjunction with this contract except for IN IN P. complaint on a complaint log. 9. Public Records and Retention: 9.1 The Provider, subject to the terms ol'section 287.058( 1 )(c), Florida Statutes, and any other applicable legal and equitable remedies, shall. a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to perform the services. b) Provide the public with access to public records on the same terms and conditions that the Department would provide the 119, Florida Statutes, or as otherwise provided by law. c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by la d) Meet all requirements ror retaining public records and transfer. at no cost. to the Alliance and the Department of Elder Afrairs all public records in possession ofthe Provider upon termination or expiration - ---------- a 10.2 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 years after completion of the contract or longer when required by ]a%%. In the event an audit is required by ihis contract. records shall be retained for a minimum period ofsix (6) �ears afterthe audit report is issued or until resolution of any audit findings or litigation based on the terms or this contract. at no additional cost to the Alliance, IN S 102 © Provider shall submit management, prograrn, and client identifiable data, as specified by the Departme ofd r Affairs »4 <« Alliance, The provider «w: »« and Submit program specific data in accordance with the Department's Client Information Registration and Tracking System (CIRTS) Policy Guidelines. I 10.10 The Alliance for Aging, Inc. may unilaterally cancel this Contract, and any contract or agreement incorporating this Contract by reference, notwithstanding any other provisions of this Contra«. \:» by the Provider to comply with Section 9 of this Contract by not allowing public ®° to all documents, papers, letters, or :® material made or received by the Provider in conjunction with the contract or agreement incoa» »2:222#» »« by rererence, © the records are exempt from Section 24(a) of Article I of the State Constitution and Section 1 19.07(l ), Florida Statutes. IN IN P. w IN P. N 22® AaakUMOLs IN P. 'E 4EGOIX4K �w go m mm Data 31. Conflict or interest H IN P. 32® Public Entits Crime IN ft, 33. Purchasing Procurement of Products or Materials with Recycled Content: Reusable materials and products shall be used where economically technically feasible. 34. Patents, CopyrightslRovallfies If this contract is awarded state runding and if any discovery, invention or copyrightable material is developed Droduced or for which jwgiliji wiWjjjjjjjj, 1D he gotirse of T AIIHIMC LU JI-C [ 0 the Department of State. Any and all patent rights or cop�rights accruing Linder this contract are hereby reserved to the State of Florida in accordance with Chapter 286, F,S 35. Emergency lire gBj2AggMMd Continuity of Operations W IN P. Provider shal I ensure 100% of the del iverables identified in AT'rACHM ENT 1. Section 11 - MANNER OF SERVICE PROVISION are performed Pursuant to contract requirements, c) In the event Provider fails to correct an identified deficiency «ithin tile approved firne period speciri in the CAP. the Alliance shall deduct. from the pa%vnent for the in%oice ofthe f6lloaing month. 1% the monthIN value of the monthk in%oiced funds in the contract for each cim the cleficienc� is n corrected. The Alliance shall also deed uct. firorn the payment fork invoice ofthe flolling inont I% of the monthly value ofthe invoiced funds in the contract 4:« ch day the Provider fails to : z. Submit a CAP. d) If Provider fails to timely submit a CAP. the Alliance shall deduct 1% of the monthly value Or the invoiced funds in the contract for each day the CAP is overdue, beginning the I I"' day after notification by the Alliance Contract Manager of a y e deficiency, Th:de »on will be made from the payment for the invoice of the following month. IN In HE 9X in In, 1. Delivery ofservices. to eligible clients as referenced in ATTACHMENT 1, Section 1, 1.3 Section 11, 2.1 of this contract 4;;� FailUre to ensure adherence to established assessment and prioritization criteria as evidenced in CIRTS reports will result in a reduction of payment equal to the percentage of new clients served who did not meet the criteria, compared to the total number of cl ients served. 2. Services and units of services as referenced in ATTACHMENT 1, Section 11, 2.2 of this contract - Failure to ensure the provision of services in accordance with the current DOEA Programs and Services Handbook, and ATTACHMENTS VII, and submission of required documentation will result in a 2% reduction of payment per business day any identified deficiency is not cured or satisfactorily addressed. I Perilormance Specifications as rellerenced in ATTACHMENT 1, Section 11, 2.6 orthis contract -- Failure to perform the perrori speci fications and oversight or CCE Program operations will result in a 2 reduction of payment per business day any identified deficiency in duties is not cured or satisfactorily addressed in accordance with ATTAC�MENT 1, Section 11, 3.6.3 k. Exceptions may be granted solely, in writing. by the DOEA contract manager. 45. Force,�� 10 The Parties k011 not be liable for anN delaNs or IhilUres in performance due to circurnstances beNond their control. provided the party experiencing the force majeure condition provides irnmediate written notification to the other party and takes all reasonable efforts to Cure the condition. Severability Clause The Parties agree that if a court of competent jurisdiction deems any to or condition herein void or unenforceable; the other provisions are severable to that void provision and shall remain in full force and IN R The Provider -shall suw»,» -» invoice 66r payment to the Alliance as specified in Paragraphs 3.4, 3.4.1 and 3.4.2 (date for Final request for payrnent) of ATTACHMENT 1. If the Provider fails to submit final request for payment by the deadline, then all rights to pa.%,ment may be forfeited and the Alliance may not honor any requests submitted after the aforesaid time period. Any payment due Linder the terms of this contract may be withheld until all reports due from the Provider and necessary adjustments thereto have been approved by the Alliance. 52. Mod !gent ns Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly signed b} both parties, W IN P. W IN ft, 56.1 :<e» ». authorization pursuant to this section does not electr authorize electronic transactions between t Provider and the Alliance. The Provider is authorize d to conduct oic n transactions with the Allian only upon Further written consent by the Alliance. I 56.2 Upo<« «« «£y2 . the Provider shall provide the Alliance or DOEA with non-electronic (paper) copies of records. Non-electronic (paper) cup`es pro-, kled it) thL Ahiafice ofan� document that ori"inalk in electronic fibrin with an electronic signatare must indicate the person and the person's capacitN %flio electronic igned the document on an� non-electronic cop� of the docurrient. 57. Special Provisions The Provider agrees to the following provisions: 57.1 Investigation of Criminal Allegations: Any report that implies criminal intent on the part of the Provider or any sub-providers and referred to a governmental or investigatory agency must be sent to the Alliance. If the Provider has reason to bive tha R, the allegatiA ns will be referred to the State Attorney, a law enforcement agency, the United States Attorney's office, or other goverrimental agency, the Provider shall notify the contract manager. A copy or all documents, reports, notes or other written inaterial concerning tile investigation, whether in the possession or the Provider or Sub-providers, must be sent to the Alliance's contrict manager with a summary or the investigation and allegations. re An intentional or negligent act ofthe Provider has material I) affected the health, welfare, or safety of clients served pursuant to any contract or agreement incorporating this Contract by reference, or substantially and negatively affected the operation of services covered Linder ally contract or agreement; `rhe Provider lacks financial stability sufficient to meet contractual obligations or that contractual Rends have been misappropriated; 'File provider consistently misses performance rneaSUre targets, or does not demonstrate to tile satisfaction of the Alliance that a prograin budget snrplus/delicit problem is being addressed in order to avoid Closing Out tile contract �ear with a budget variance ofrnore than t%%o percent. 57.3.2 In making any determination Linder this provision the Alliance maN relV upon the findings or another state or federal agency, or other regulatory bod,%. An-y claims for dama-es for breach of any contract or a reement incorporating this Contract by reference are exempt from administrative proceeding's and shall be brought before the appropriate entity in the venue of Miami-Dade COLInty, 57.3.3 in the alternati�e, the , kiliance rrw�.,. �at its -;ule discretion. in accordance ��ith section 430.o4. r.S., take immediate measures against the Provider. including correcti�e action. unannoUnced special monitoring. temporary assumption or the operation of' one or more contractLial services. placement of the Provider on probationary status, imposing a moratorium on Pro�ider action. imposing financial penalties for nonperformance, or other administrafl%,e action pursuant to Chapter 120. F.S. 57.4 Use of Service Dollars: The Provider will optimize the use of contract funds by serving the maximum possible number of individuals IN ft, 11M Ter exectluon of Trus contract, notice ofthe name and address of the new representative will be rendered in writing to the other party and said notification attached to triginals of this contract. W IN A . ............. - - - The - P v Provider d e r name' The Provider name, as slio%rn on page I of this Monr Monroe County Board of County Commissioners, Social a. co n tr a c n d and mailing n' �contract, and mailing address or the official p ayee Services/In-Home Services v2' "2�' w the P. to 0 m I e e I Jym n to whom the payment shall be made is: 1100 Simonton Street, 2-257 -2S 7 Ih Key West, FL 33040 - ------------ 'fire narne of the contact person and street address Shcr Graharn, Senior Director Di (or b. f re c ial d where financial and administrative records are Monroe County Board of County Commissioners, Social Monrc 'm ' si -5 dal m i t i e is. maintained is: Services/in-Home Services 1100 Simonton Street,, 2-2S7 Key West, Fl. 33040 The name, address, and telephone number of the C. representative of the Provider responsible for Shcr�l Graham, Senior Director Monroe County Board of County Commissioners, Social administration of the progrorn Linder this contract Services/in-Home Services is: 1100 Simonton Street, 2257 Key West, FL 33040 ............ The section and location within the AAA `Oere Vice President for Finance d- Requests for Payment and Receipt and 760 NW 107th Avenue, SL[ite214 Expenditure forms are to be mailed is: Miami, Florida 33172-3 155 Contract klonitor e. The name, address. and telephone nUmber of the A I I iance for Agi ng. I nc. Contract Manager for the AAA ror this contract is: 760 NW 107th Avenue, Suite 214 Miami, Florida 33172 -3155 Ter exectluon of Trus contract, notice ofthe name and address of the new representative will be rendered in writing to the other party and said notification attached to triginals of this contract. W IN A 59. All Ternis and Conditions Included This contract and its Attachments, I through X, A, B, C, E, F, G, and 1-1 and any exhibits rellerenced in said attachments, together with any documents incorporated by rellerence, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions. or obligations other than those contained herein, and this contract shall supersede all previous COMMUnications, representations or agreements, either written or verbal between the Ila By siunim this contract. the Parties aigee IN WITNESS THEREOF, the Parties hereto have caused this 66 page contract, to be executed by their Undersigned Monroe County Board of County Provider Commissioners, Social Se rvices/1 n -Horne Services SIGNED BY: ALLIANCE FOR AGING, INC. 4,102 NAME: A NME: MAX B. ROTHIM , JD, LL.M AN CL M_ TITLE: U akk� DATE:._.... 42�1. Z4A i . ..... ...... IN P. UM i Attachment I SERVICE PROVISIONS COMMUNITY CARE FOR THE ELDERLY Attachment II CERTIFICATION REGARDING LOBBYING CERTIFICATION CONTRACTS, TS, LOANS AND AGREEMENTS Attachment III FINANCIAL AND COMPLIANCE IT Attachment IV CERTIFICATION RE I TA INTEGRITY COMPLIANCE AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS Attachment V CERTIFICATION REGARDI E , SUSPENSION, INELIGIBILITY VOLUNTARY EXCLUSION LOWER TIER COVERED TRANSACTIONS Attachment VI ASSURANCES NON CONSTRUCTION PROGRAMS Attachment VII BUDGET SUMMARY Attachment Vlll INVOICE SCHEDULE Attachment IX REQUEST FOR PAYMENT FORM Attachment X RECEIPT AND EXPENDITURE REPORT Attachment Attachment B CIVIL RIGHTS COMPLIANCE CHECKLIST Attachment C REFERRAL PROTOCOL AGING AND DISABILITY S U C T ( ) — OUTSOURCED FUNCTIONS Attachment E BUSINESS ASSOCIATE AGREEMENT Attachment F VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION Attachment G BACKGROUND SCREENING AFFADAVIT OF COMPLIANCE Attachment H CERTIFICATION REGA I SCRUTINIZED COMPANIES LISTS z ATTACHMENT I ALZHEIMER'S DISEASE INITIATIVE PROGRAM Memory Disorder «ww. Research oriented programs created pursuant to Sections 430.502(l) and (2), F.S., to provide diagnostic and referral services, conduct basic and service-related ltidi musciplinary research. and develop training materials and educational opportunities for lay and professional careg of individuals %vith AD. givers Model Day Care: A program of therapeutic, social and health »<2»® specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet games, rei validation thera t S6 Water th r General Statement The primary purpose of the ADI pro-ram is to provide a continuum of services addressing the special 0 needs of individuals with AD, their fami lies and caregivers. RE Alzheimer's Disease Initiative Mission Statement The ADI program ensures that persons afflicted with AD and other forms O f dementia are given essential 1.2.2 services to help them age in place in an cider-friendly environment with security, dignity, and purpose, The program also provides support to family members and caregivers of persons afflicted with AD. 1.3.2 Individual Eligibility Those individuals eligible to receive services tinder this contract must rneet the following conditions: (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder. or be Suspected of having AD or a related disorder; and (2) Not be enrolled in a Medicaid capitated long-term care program, 1.3-2.1 Targeted Groups Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION I. MANNER OF SERVICE PROVISION 2® Conditions "] Services Linder this co current Florida Department of Elder Affairs Programs and Services Handbook. Client access to services, assessment and eligibilit% determination must conform to the protocols listed in ATTACHMENT C. 2.1 Service Tasks To achieve the goals of the AD[ program. the Provider shall perform or ensure the performance of its Sub- Providers, the following tasks: (1) Client elig ibility Detennination; (2) Assessment and Prioritization of Service Delivery for New Clients, (3) Delivem of Services to Fli-ible Clients: 2.1.1 Client Eligibility Determination IN ft, Priority Criteria for Service Delivery ( 1 ) IndividUalS in nursing homes under Medicaid who could be transferred to the community; 21 2.1.2.1 Priority Criteria for Service Delivery for Other Assessed Individuals 11he assessment uai — orovision of servicN.WMWW delivery. Functional impairment will be determined through the Department's functional assessment form administered to each applicant. The most rrail individuals not prioritized as described in this attachment, Paragraph 2.1.2.1 will receive services to the extent funding is available. 2.1.3 Delivery of Services to Eligible Cie n is® 'The Provider shall ensure the provision of a continuum Of services addressing the diverse needs of individuals with AD and their caregivers. The Provider shall ensure services are performed in accordance with the current Department sal' Elder Afflairs Prograrn and Services I land book, Services categories include: ( I ) Caregiver Training/Sap ort9 1,3-1 Nlemorr Disorder Clinics IN ft, IN 2.1.3.2 Model Day Care Programs 2.2 SERVICE TIMES AND LOCATION 2.2.1 Service TiT, , r, , r , ,es The Provider shall ensure the provision of the services listed in this contract is available at times appropriate to meet client service needs at a minimum, during normal business hours. Normal business hours «.m «x¥ as Monday through Friday, 8:00arn to 500pm, 33 Service Units Services will be IN P. IN 142 Client Information and Registration Tracking System (CIRTS) Reports The Provider shall ensure timely input ol'ADI specific data into CIRTS. To ensure CIRTS data accuracy, the Provider shall adhere to the Alliance's CIRTS Data Integrit) Policy and use CIRTS-generated reports which include the following: , -I a Client Reports; • Monitoring Reports; • Service Reports; • Miscellaneous Reports; • Fiscal Reports; and 71 Outcome Measures Reports. 2443 The provider shall provide the Alliance with an expenditure plan by July 1 5 or t%vo weeks after this contract has been signed; a monthly update is due on the 15th" day of each follov in month. The expenditure plan and updates must follow the format provided by the Alliance. 2. 4.4 The provider shall respond to surplus."deficit inquiries and will provide ad-hoc reports as requested by the Alliance. 2.i ELECTRONIC RECORDS AND DOCUNIE-NTATION The provider will ensure the collection and maintenance of client and service information on a monflik basis from the Client Information and llegistration Tracking S�stern (CIRTS). Maintenance includes valid exports and backups of all data and systems according to Alliance and Department standards. 2. 5. 1 Timely Data Entry I r-gilitugautol mom' for-grat.11", IN 1W, IN P. 2.9 ALLIANCE FOR AGING RESPONSIBILITIES K.9.1 Program Guidance and Technical Assistance IN ft, In 3.1 General Statement of Method of Paymenl The Alliance reserves the right to adjust (lie total award as well as the contracted unit rate to reflect provider costs and utilization rates based on active clients enrolled in the program. The Alliance may withhold payment tinder the ten of this contract, pending the receipt and approval by the Alliance 3.6.4 of complete and'accurate financial and programmatic reports due from the provider and any adjustments thereto. including any disallowance not resolved, MM IN P. ATTACHMENT 11 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS (3) The undersi"Aned shall rekjUire that the laugmage i� t! awards at all tiers (including subcontracts, SUb-grants, and contracts Linder grants, loans and cooperative agreements) and that all sub-providers shall certify and disclose accordinek. This certification is a material representation of fbct upon %%hich 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 it, U.S. Code. An� person who fails to tile the required certification shall be , ubject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Signature 1 �7t�it�rized =n i��idual Narne �o ....... .............. . . . . . ... Date LL Appl ication or Agreement Number Name and Address of Or, ni7ation )coo stmw+ba - 5Aweek Dmiel &—Q!5 33 mrA Vorm 103 (Re% ised No% 2002) NN IN P. ATTACHMENT III W PART 1: FEDERALLY FUNDED 'rhis, part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular A-] 33, as revised. In connection with the audit requirements addressed in Part 1, paragraph 1. tile provider shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C ol'OMB Circular A-[ 33. as revised. Irthe provider expends less than $750,000 in federal m�ards in its fiscal �ear. an audit conducted in accordance with the provisions of OMB Circular A-133, as revised, is not required. In the event that the provider expends less than $750,000 in federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of OMB Circular A-133. as revised. the cost Of the audit MUSt be paid from non-federal resources (i.e., the Cost Of Such audit must be paid from provider resources obtained from other than federal entities.) KE IN ft, 11 This part is applicable if the provider is a non-state entity as defined by Section 215.97(2), Florida StatUteS. ] The Alliance for Aging, Inc. at each ofthe following addresses: Alliance for Aging, Inc. Attn Fiscal Monitor 760 NW 107 1h Ave. 4"J miffm� 11 WillrPlat RE The Federal Audit Clearinghouse designated in OMB Circular A- 133, as revised (the number or copies required Sections .320 (d) (1) and (2), OMB Circular A-133, as revised, should be submitted to the Federal Au Clearinghouse), at the following address: I Federal it Clearinghouse Bureau or the Census 1201 East 10"' Street -Jeffersonville, IN 47132 Other federal agencies and pass-through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as revised. Additionally, copies of financial reporting packages required by Part 11 of this agreement shall be Submitted b) or behalf of the provider directiv to each of the following: i The Alliance for Aging, Inc. at each of the following addresses- Alliance for Aging, Inc. Attn: Fiscal Monitor 760 NW 107"' Ave. Suite 214 Miami, FL. 33172-3155 I I I West Madison Street Tallahassee, Florida 32399-1450 AnN reports, management letter, or other information required to be Submitted to the Alliance [or Aging. Inc. pUrSUa to this agreement shall be submitted drnel� in accordance �%ith O'VII3 CirCUlar A-13 Florida Statutes, and Chapt 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations). Rules of the Auditor General. applicable. Z� Providers, when submng financial reporting packages to the Alliance for Aging. Inc, for audits done in accordan with OMB Circular A-133 or Chapters 10.530 (local governmental entities) or 10.650 (nonprofit and for-pro organizations), Rules of the Auditor General. should indicate the date that the reporting package was delivered to t provider in correspondence accompanying the reportin package. I"ART IV: RECORD RETENTION IN P. M ATTACHMENT III ff i-IRN I FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: w"ItivrJOR"y t rVy Ew PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 9 L IR19011"Al 101 f COMPLIANCE REQUIREIVIENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS AGREENIENT ARE AS FOLLOWS: State Financial Assistance Section 215.97 F.S. Chapter 691-5 Fla. Administrative Code IN ft, 33 STATE FINANCI,6.LJxSS1ST-k1JCr S1f'f - ,.1KCT rit qm 114 07 v Q ATTACHMENT III EXHIBIT-2 FEDERAL AWARDS OR STATE MATCHING FUISIDS ON FEDERAL AWARDS. Providers who recei ®1 fed ards eral aw or ©° hi te matcng funds on redeal r ard was ankw o are de mi terned to be a su bre -cipient must comp with the following fiscal laws, rules and regulations: 1 34 IF& LVCAL GOVERNMENT) MUST FOLLOW: *Some federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular A- 133 Compliance Supplement, Appendix 1, STATE FINANCIAL ASSISTANCE. Providers who receive state Financial assistance and who are determined to be -a recipient/stib-recipient must comply with the Collowing fiscal laws, rules and regulations: M ATTACHMENT IV Z REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the Provider named in the contract or agreement to which this rorm is an attachment, hereby certifies that: IN P. This certification is a material representation Of fact upon ',Nhich reliance was placed when this transaction was made entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed OMB Circulars A- 1 02 and 2 CFR Part 2 15 (1 OMB Circular A- I 10). 1 Name of Athoriz�d Signer W01 M3ENMzlI= ATTACHMENT V *X411111111-3 LINE 1141 M I[I c 1 (1) The prospective provider certifies, by signing this certiFication, neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible. or voluntarily excluded from participation in this transaction by any federal department or agency. (2) Where the prospective provider is unable to certify to any of the statements in this certification, Such prospective participant shall attach an explanation to this certification. SignUtUre . ..... I ........... at Monroe County Board of County Commissionersi IN P. 111112MUMEM ASS URANCES—NON-CONSTRUCTION PROGRAMS ATTACHMENT V1 Note: Certain orthese assurances may not be applicable to your project or program. If you hive questions please contact the awarding agency. Further, certain rederal awarding agencies may require applicants to certify to additional assurances. If such is the case, you Ivill be notified, Has the legal authority to apply for federal assistance, and tile institutional, managerial and financial capability (including runds 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 Comptrofler General of the United States, and if appropriate, tile State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; anc' 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 tile appeara, nee of'personal or organizational con6ict or interest, o'r personal gain. 11111111111111MIJ initiate and complete the work within the annl*, 6 t 5 Will comply viiih the Intergovernmental Personnei Act of 1970 (42 U.S.0 4728-4763) relating to prescribed standards li merit systems ror programs funded tinder one of the 19 statutes or regulations speci tied in Appendix A ofOPM's Standard a Merit System of]"ersonnel Administration (5 C.F.R. 900, Subpart F). 5 f 7. 1 4 ill comply, or has already complied, %vith the requirements of 11 and Ill of [lie unifiorm Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L 91-646) which pro or Fair and equitable treatment of persons displaced or whose propertN is acquired as a result of federal or federall% assisled programs. These requirements apply to all interests in real property acquired for project purposes regardless oftederal participation i n purchases, -T,. Will conipl%, as applicable, %6th the provisions of the Haich Act (5 U.&C, 1501-1508 and 7324-7328), which limit the political ac�lvifies of employees whose principal emplo)ment activities are funded in %%hole or in part with federal funds. 9 Will comply. as applicable, with the provisions of the Davis-Bacon Act (40 US.C. 276a to 276a-7), the Copeland Act (4C U.S.C. 276c and 18 U.S.C. 874) and the Contrael Work Hours and Safety Standards Act (40 U.S.C. 327-333), regarding labor standards for federally assisted construction sub-agreements. IN ft, M W IN P. 16. Will Comply with the Lead-Based Paint Poisonin.- Prevention Act (42 U.S.0 480 l et seq.). which prohibits die use of lead- based paint in consiruction or rehabilitation of residence StrUCIUres, L - 'j i. 98. Will comply %r,Rh all applicable requirements of all other federal la%%s, executive orders, regulaflons and policies governing this program, MCAN %1I RI Of M THORI/i ID C1 RI I FYING (A-1 K I %� APN ICAN T'ORGAN 11 % f ION' 3111 Al CE stmt - 7 39 2.C11 ATTACHMENT V11 ALZHEIMER'S DISEASE INITIATIVE PROGRAM BUDGET SUMMARY The Alliance shall make payment to the provider for ejrovision of services U - 0, to a anA at e stated below: IN ft, IN ATTACHMENT Vill Report Number Based On Submit to Alliance on this Date I Ally Advance* Jul" 2 August Advance* July 1 3 July Expenditure Report August 10 4 August Expenditure Report September 10 5 September Expenditure Report 1110 advance reconciliation October , 6 October Expenditure Report 1/10 advance reconciliation November 1 7 November Expenditure Report + 1110 advance reconciliation December 10 8 December Expenditure Report + 1110 advance reconciliation January 10 9 January Expenditure Report + 1110 advance reconciliation February 10 10 February ExpenditUre Report + 1110 advance reconciliation March 10 I I March Expenditure Report + 1/10 advance reconciliation April 10 12 April Expenditure Report + 1110 advance reconciliation May 10 13 May Expenditure Report Ifl 0 advance reconciliation June 10 14 June Expenditure Report+ 1110 advance reconciliation July 10 15 Final Expenditure and closeout July 10 Legend: Advance based on projected cash need. Note 1: All advance pay ments made to the Provider shall be returned to the Alliance as rollows: One-ienth of the advance payment received shall be reported its an advance recoupment on each Request for Payment. starting with report #5. The adjustment shall be recorded in Part C, Line I of the report (Attachment IX). IN ft, Note 2: Submission or expenditure reports may or rna) not generate a pa�yrnent request, If li expenditure report reflects, funds due back to the Alliance. pa,� ment is to accompany [lie report. I ATTACHMENT IX REQUEST FOR PAYMENT ALZHEIMERS DISEASE INITIATIVE PROGRAI RETMAME ADDRESS, PHOMEN and FE ?# T`rPE CF R5 1A PAWENTREQUEST The Request Period . ............ PEA # Report # - -- – — ------------ - List of Seroces I Urits IRMes prmiled - See attached report. is Reg ar SupplenwiW 'an act Ic 8 METHOD OF PAWYIEUT Co. actPeriod Advance Remburserrierit CEng TFCATIUI t h.,ebycmfytit Nh. best cif mylitioWedge that fins rerniest ? s compete and crislad and wrfcrrn Wth the terra and the Purposes& the above contract Prepared b Date .... . ...... App oved by m..e . . ............. . ..... Owe PT BUDGET SJrv?AARY (2) 1 Approved CarvactAmoul $000 Soo 2 Prinhous F R�cwed for Cortract Penad $000 SON Soo 3 Contract Ea s (kne I minus Cane 2) SUN WOO Soo 4 Prey ousF"s Requested acrd rhatRecowed for ComactPerrA S000 S000 50 01 5 Contract Balance (kne 3 mnus line 4) $000 SON so al Par 8. CO? Furs REQLEST 1 Arocipated Cash flaeds(lst- 2W imnth. AftachJustficabon) $000 SOAC so 0C 2 fletE,�pendituresForNlorah 50 00 $000 so ac (E3 Forth 1052. Part 8. Lim 3) 3 TOTAL Saco $000 50 0C PARTC fETFLTJDSREQLESTEr) I Less Advance Applied S000 SON S000 Cortract Furls are H reby Reqtjevled far Pan B L re 1 y , 0 name Part C Une I Q. 00 List of Seroces I Urits IRMes prmiled - See attached report. is RECEIPTAND EXPENDITURE REPORT [:A:t]ti:r�h�mewX 4 - CASHRECEIPTS 5 Local I mK�nd U31cn 6 TOTALRECEIPTS Saw S000 $000 s[N PART 6 EXPENDITURES 1 Approved 2 Expenditures 3 Expenddures 4 Percent of —1 For Tho; Repon, YparloDale 1 Adminwtainie Ser4ices so 00 5000 $000 MV G 2 Service Subcoraraclor(s) S000 $0 $000 iQV 3 TOTAL EXPENDITURES S000 5000 S000 ODIVCM FARE OTHER REVENUE AND EXPENDITURES I fl Interest M1 Awance Fie k ouped I Isfegrarn Income (PI) 1 Brned on "R Act, S S I AC I P1 Collected YTC) S --- 1 2 Return &GR Advance 5 (I ndLdes CO payme r1tS Ca le Cfed) 3 CithetEained S I I PARTD CO-MMENTS I 'total of Co- payments a$SeSsed 2 Total of Co-paynienls collected (For Trabing Purposes crov . ..... . .. . ..... ... CURR&IT MONTH YEAR –� DATE S ... ... . .................. . ...... ............. ............... . ... .. S, S I im Title: Department of Elder Affairs Programs & Services 11andbook 0 IE ATTACHMENT A 7. Compare the staff composition to the population. Is staff representative of the poptalation? If NIA or NO, expIain. N !A YES ICI Compare the client composition to the population, Are race and sex characteristics representative of i h the population a' f N/r or N0, explain. N A YES NO f 4 I S .. PARTH: USEA SEPARATE S110ETOF PAPER FOR vxl J�xI4, tNA HONS RFQ1 IRING MORE SPACE. 6. Is an Assurance Of Compliance on file with DOEA? If NIIA or NO. explain. 7. Compare the staff composition to the population. Is staff representative of the poptalation? If NIA or NO, expIain. N !A YES ICI Compare the client composition to the population, Are race and sex characteristics representative of the population a' f N/r or N0, explain. N A YES NO . Are eligibil it requirements for services applied to clients and applicants v4ithoul regard to race, color, national origin. sex, age, religion or disaabilite ? WN A car O, explain. W Are all benefits scrsic and fa; as %ailable tsa applicaantr aid p rti6paani, is ail ea calk effective manner regardless, vat agt4ra. se\, Qo1or, aage, national aarm m rcli��i n o disaa ilitG': if - t or NO, I I. For in- patient services, are room aassir.- nmemats made bvitlaout regard to race. color, national €:ari Pin or disability:' If N or NO, explain, Revised Augmt 2()J O. page =rar2 a . IN i?, Is the pro rarnlfacifity accessible to non- English speaking clients? If° `A or NO, explain. N. A YES NO El 9 Cl 15. Is the program /Facility physically accessible to mobility, hearing, and sight - unpaired individuals? if N/A or Turd, explain, Nt'A YES NO P,MT III THE FC}[,LOIA INCA Qt ESTIONS A PLI 10 1'ROGI2 S tlS ,sND T IES 1! I`I'FI 1 OR MORE E MP1.01 FLI% M Has a self-evaluation been conducted to identify any barriers to serving.? disabled individuals, and to make any necessary modifications? IfNO, e.aplain, YES N 9 El 27. Is there an established grievance procedure that incorporates dtte process in the resolution of complaints? IfNO, explain. YES NO 19 D Revised August 1..)1 U, Page 2 n''2 M INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST IN P. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 1 0% of the population �is Hispanic, is there a comparable percentage of Hispanic staM Where there is a significant variation bemeen the race, sex or ethnic composition of the clients and their i S availability in the population, the program/ tbci I i ty has the responsibility to determine the reason \ \ \ \ var « be necess § discrimination, Some legitimate disparities rna) exist Wien progra oned to serve target populations such as elderly or disabled persons, 45C d< 80.3 4 ) (6). 1 T ProUrams or faci I ities 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. Proly rarns or facilities that emplo% 13 or more persons must designate at least one person to coordinlie eftlorts io conipl% s% nth Section 564.45 CHI 84.7 (a). 19. Continuing steps MUM be taken to notitN enIPIOWeS and the Public of the program/facilip"s poli o f nondiscrimination on the basis of disabUitv, 'rfiis includes recruitment material. notices ' f l or hearings. newspaper ads, and other appropriate %% ritten COMMUnication. 43 CFR 84.8 (a). 20. Progyrams/facilities that employ 15 or more persons rnust provide appropriate auxiliary aids to persons with impaired sensory, manuai 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"Tac il i ties with 50 or more employees and $50,000.00 in federal contracts must develop, implement and maintain a written affirmative action compliance program in accordance with Executive Order 1 1246, 41 CFR 60 and Title VI ol'the Civil Rights Act ot'l 964, as arnended. DOEA Funn 101-13, Re� M ATTACHMENT C I. Under this Contract, the provider agrees to the following: A. Perform ADRC outsourced functions in accordance with policies and procedures developed by the Alliance for 0 Aging. Refer to the following attachments: Attachment C EXHIBIT I. Policies and Procedures for OLKSOurced Function- Screening Attachment C EXHIBIT 2 Policies and Procedures for 01ASOUrced Function- Termination from Waitlist-Client Services Attachment C EXHIBIT 3. Policies and ProcedUMS forTriage iv. Attachment C EXHIBIT 4 Policies and Procedures four Activation from Waitlist- Client Services G. Ensure that services provided are in the clients' best interest, are the most co e ff ec ti %e , o l'bi g h quality, and are responsive and appropriate to the assessed needs, The Assessed Priority Consumer List (APCL) is maintained %%hen reU�� z OMIMI IWAM �& M Mffu= U IT7TFiA . Hornemaker (MOK). lVIodeI DaN Care ' Personal Care (PECA), FacilitN -Based Respite (RESF). 111-1 lome Respite (RESP). I 30 ATTACHMENT C Exhibit I Alliance for Aging, Inc. Agine & Disability Resource Center/ Pr 1I Policy and Procedure for - . I S, vwg I W Revision Date: May 201 7 Review Date: April 2014 Objective: 'ro enSUre that a comprehensive list ofclients in need of'services is maintained in CIRTS by ar 42m_nriate funding source and that ZIFI C� 14 in Miami-Dade and Monroe Counties. F'olicy: To obtain necessary inflorynation rrom clients in order to assist in determining level orneed and eligibilim L'or registered services runded thrOUgh ADL OAA, and LSP prograrns. N Procedure: I a Contracted Providers will collect Information fro m callers and conduct as 701S assessment. Alternatively, if a 701 AM as�essrnent already exist -i or is pro ided from another SOUrce (i.e. CARF-IS) the information from the 701 B can be utilized. Callef JZ2 111 Ilueu 51 recejvm���� The ADRC Contracted Provider %% ill determine the appropriate ffinding SOUrce(s) that provides the needed services. 6. he caller %%ill be infon-ted ol'tl ser%,'ces and tending sources, that then are being placed on the wail list for in CIRTS. zz� IN P. ADRC Contracted Provider will inform caller that they will receive an annual re-assessment based on DOEA Wait List Reassessment Slandards and encourage caller to contact the ADRC Elder Helpline with any questions, IN ft, ATTACHMENT C Exhibit 2 Alliance for Aging, Inc. ;P0 T Policy and Procedure for Termination From Wait List — Clients/Services 1 11 9M, Review Date: May 2017 V b i jective: To enSUre that the comprehensive list of clients in need of services in CIRTS is appropriately maintained by funding SOUrce and that the ADRC is thereby able to effiectivel gaUge the CUrrent level oFeldef service need in Miami-Dade and Monroe COUnfies. Policy: ADRC will maintain an [ICCUrate and current list of clients Monroe Counties with the assistance of the ADRC Contracted Providers, Procedure: I ADRC Contracted Provider will re-screen clients which the r4 C 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 states (i.e. active/pending) ADRC Contracted Provider will determine ifthe clielLiLLL�W 4. ADRC Contracted Provider %%ill terminate the client frorn the k%ait list (entirek or by specific service) Using the appropriate CIRTS termination code for anN services or funding sou'rce ro'r %%hich the clie is deten to no longer be eligible flar or no longe'r in need of'. ADRC Contracted Provider removed frorn the wait list for. 6. ADRC Contracted Provider will inform client of their ability to be re-added to the nail list if their level of need Should change. T ADRC Contracted Provider %% ill inform client to contact the a0 C Elder Helpfine iflhey have and questions or concerns regarding their gait list status. & Reference DOEA Notice ofinstruction: Assessed Priority Con stir ner List#:062906-1 -I-OVCS a applicable. IN ft, N ATI' ACIFINIENTC Exhibit 3 Alliance for Aging, Inc. Aging & Disability Resource Center/Elder Helpline Policy and Procedure for Revision Date.- May 2017 Review Date: April 2014 Objective- To ensure that clients in need or need, first, as funding becomes available. Policy: To assist clients in obtaining DOEA funded services as funding becomes available, based on level of need as determined by a CiRTs priority score. Procedure: I ADRC Contracted Provider will conduct annual reassessments based on DOEA Wait List Reassessment Standards. 2. If there is no CUrrent 701 A or B in CIRTS. the provider will conduct tile annual reassessment (701 S) as appropriate. Based on the information provided via tile 701 S "A(B) assessment, the ADRC Contracted Provider will update the client infort in URTS specifically as it pertains to level of need for services by funding source Tile ADRC Contracted Provider will ensure that the CIRTS prioritization score is accurately maintained, according to DOEA Standards. If a significant change has occurred prior to the annual re- screening. the Contracted Provider Must re-screen, Definitions. and examples of significant change are documented in the DOEA Programs & Services Manual Chapter 2. If the caller is in need ofa service(s) that is not proJcled b� the ADRC Contracted Provider, the ADRC Contracted Provider will jefer The caller will be informed of the services and flunding sources that tl°ey rernain on the wait list for andior have been removed from the %%ait list for. 5. ADRC Contracted Provider %%ill reff lind ciientol'the m XDRC El-der I lelp Line contact numberand to contact the AD RC Elder I lelp Line %% ith aw, questiom or concerns. As funding becomes available. ADRC Contracted Provider %� ill rUn CIRTS Prioritization Report and activate clients accordin Y to DOEA Standards (rerer to ADRC Client Activation Policies and L Procedures), The Contracted Provider will apply targeting criteria, as appropriate. to prioritized clients to ensUre activations meet programmatic requirements. IN P. M ATTACHMENT C Exhibit 4 Alliance for Aging, Inc. Aging & Disability Resource Center/Eider Helpline Policy and Procedure for 1A T - , , - : f , 4 UJUM ���Jq J" Review Date: May 2017 Objective: 'ro ensure that elders in need of DOEA % «d«xw ©® services in Miami-Dade and Monroe Counties and on »e »m wait list begin to receive services as funding becomes available, 0 Policy: ADRC will work with ADRC Contracted providers to ensure that clients waiting for DOEA fund services begin to receive those services as fiLinding becomes available, 1 Procedure: L ADRC Contracted Provider will activate clients on CIRTS wait list based on DOEA prioritization polices and funding availability. IN P. W ATTACHMENT E Alliance for Aging, Inc. Business Associate Agreement This Business Associate Agreement is dated by the Alliance for Aging, I ("Covered Entity") and Monroe County Board of County Commissioners, Social Services/in-Home SerVl ("Business Associate"), a not"for-prof it Florida corporation. c i LO Background. w 2.6 Breach. The Unauthorized acquisition, access, use, or diSCIOSUre of PH I which compromises the se or privacy of such information. 2.7 Compromises the Security. Posing a significant risk of Financial, repUtational, or other harm to individuals, 1,13 Malicious soft Sollware. for example, a N ii-Lis, designed to damage or disrupts a system- WA 125 Unsecured PHI. Protected health information that is not secured through the use of' technology or methodology specified by the Secretary in guidance issued under 42 U.S.C. section 17932(h)(2). 2.26 All other to used, but not otherwise defined, in this Agreement shall have the same meaning as those terns in the Privacy Rule, 11 Business Associate agrees to not use or disclose PHI other than as permitted or required by this agreement or as Required by Law. (a) Implement policies and procedures to prevent, detect contain and Correct Security violations in accordance with 45 CrR § 164306; (b) Prevent use or disclosure of the PHI other than as provided for by this Agreement or as required by law; FS11M11 MtW "I I " - I 1 1 1111 iilii� i i , i I M All infon required for the Notice to Me Seereltuy of 1-1W ref Breach 01 1 HV?L-111-ed NOIeC'Jecl Health hiliwinaflon ).6 Business Associate agrees to ensure that am agent. includin�, a subcontractor. to %Oom it provides PHI received from. or created or received by BL Associate =1 on behall'of Covered Entit , agrees to the Y sarne restrictions and conditions that apply through this Agreement to Business Associate �kitfi respect t* Such information. 3.7 IrBusiness 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 Covere Entity, to an individual in order to meet the requirements under 45 CFR § 164.524; and IN W (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 orreceiving 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 ofCovered 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. JJ I Business Associate specifically agrees to use security measures that reasonably and appropriately protect the confidentiality, integrity, and availability or Pill in electronic or any other form, that it creates, receives, maintains, or transmits on belialfof the Covered Entitv. 3.12 Business Associate agrees to implement Security measures to secure passwords used to access ePFII that it accesses, maintains, or transmits as part of this Agreement frorn malicious software and other man- made and natural Vulnerabilities to assure the av integrity, and confidentiality of' such information. 3.13 Business Associate agrees to implement security measures to safeguard ePHI that it accesses, maintains, or transmits as part of this agreement from malicious software and other man-made and natural Vulnerabilities to assure the availability, integrity, r. Of Such information. 3.14 Business Associate agrees to comply vith: (a) ARRA § 13404 (Application of Knowledge Elements Associated v�ith Contracts); (b) ARRA § 13405 (Restrictions on Certain Disclosures and Sales offlealth Infon and "c) ARRA § 1 3 N06 (Conditions on Certain Contacts as Part of I lealth Care Operation7a 4.0 Permitted Uses and Disclosures by Business Associate. 1.1"Acept as otherv�ise limited in this Agreeme or any related agreement, Business Associate may use or disclose PI-11 to perform functions. activities, services for, or on behalf of Covered Entity as specified in an) and all contracts with Covered Enti provided that Such use or disclosure Would not violate the Privac% RUle ifdone by Covered Entih or tl nunirrilurn neccssar% policies and pr(medUres, ofthic Co�ercd 1 5.0 Specific Use arid Disclosure Provisions. 5.1 Except as otherwise limited in this agreement or aw, related a reement. Business Associate rna) use PHI for the proper management and admini�tration of the Business Associate or to caff� 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 wi I] remain confidential and used or further disclosed only as Required By 59 IN ft, Law or for tile purpose for which it was disclosed to tile person. and the person notifies the Business Associate of any instances of which it is akva in which tile confidentiality of the inrormation has been breached, IN i.0 Erfective Date and Termination. 8,1 The Parties hereby agree that this agreement amends, restates and replaces any other Business Associal Agreement currently in effect between Covered Entity and BUSiness Associate and that tile provisions this agreement shall be effective as fbllo%�s: (a) These BUSiness Associate Agreement provisions, with the exception of tile electronic SeCUri provisions and tile provisions mandated by ARRA, HITECI-I and Part I shall be efrective upon the lat ol'April 14. 200 or the effective date o� die earliest contract entered into between Business Associa and Covered Entity that involves tile use of PHI: I (b) The electronic security provisions hereof shall be effective [lie later of April 21, 2005 or the effective date of the earliest contract entered into bet%keen Business Associate acid Covered Entity that involves tile use Of PI-11; and (c) Provisions hereor mandated b� ARRA, HiTECI I and/or Part I shall be effecdve die later Febi 17. 2010 or the effiectke da' I te ol'the earliest contract wered into bct%�eejj co%ered b entitN at], usiness associate that inNolves tile use 0l'PI 1 1 or OHL 8.2 Termination for Cause. Upon Covered Entiq's knoMedge of a material breach by Business Associate, Covered Entity shall either® (a) Provide an opporttmity for Business Associate to Cure tile breach or end tile violation and terminate this agreement if Business Associate does riot cure the breach or end the violation within tile time specified by Covered Entity; (b) Immediately terminate this agreement i r Business Associate has breached a material term of this Agreement and cure is not possible; or zi (c) It' neither termination nor cure is feasible, Covered Entity shall report the violation to the Secretary. 9,0 Regulatory Rererences. 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 EntitN to comply with the requirements of the Privacy RUle, the SeCUrq Rule and the Health Insurance Portability and AcCOUntability Act of1996, 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 shal I remain enforceable against such party Subsequent to such termination. M 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 ne%v reqUirement(s), changes or deletion(s) enacted in federal la%% which create new or different obligations with respect to I IIPAA privacy and/or security. shall be ataomaticall� incorporated by reference to this Business Associate Agr date(s). cernent on the respective effective To Covered Entity - Alliance flor Aging, Inc. Attention: iviax Rothman 7601V W 107 Avenue Miami, Florida 33172 To Business Associate: Monroe County Board of County Commissionersp Social Services/in-Home Services 1100 Simonton 2-257 Key West, FL 33040 IN M, f , 5.0 Governing Law. The laws of the State ofFlorida. without giving effect to principles ofconflict of laws, govern all matters arising tinder this agreement. 16,0 Severability. If any provision in this agreement is unenforceable to any extent, the remainder of this agreement, or application oFthat 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 Linder 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. I — 8.0 Entire Agreement. This agreement constitLiteS the entire wn - eement of the parties relating to tile subject matter of this agreement and SUpersedes all other oral or written agreements or policies relating thereto, exceot that this agreement does not lit the amendment of this agreement in accordance with section I U of this agreement. I Covered Entity: Alliance for Aging, Inc. ME MM= Date, Business Associate: Monroe County Board of County Commissioners, Social Services/In-Home Services By: Date: (si"nat = "*cTWgT6—unWWTm—fin—jsMT5—r fY 1 2 IN P. MN ATTACHMENT F Date IN P. 63 ATTACHNIENT 6 drV iwrson qf en1dy requireffil by Lvx to Eor%jL<w 1WCk8?oLpnj , ,jeengle, in inn but mici WNW to, Nva Aegricic-, 041 Agiry, eleng IRe wurce Ceinlvg% A,00f ant Vd bilgy Cenlipst, krall Agema w , iffma reli r Arr Omblalmman rilingirmu %Pvairig & lrntmcm r Welk of Mem, plati imvkx PmMeii%, NWItiffl Piinvidem 4ii?d aiirs niilvp jwfaran qwu rii v I ir h Cage, P Oil NIs VOruftlem In serviloL who rrvol ffie defintitoon nif j diii- wivike provikipf .ee §q 115-04 4130 D402, I'LL S111 A jilrerl m-fvirr pitti j. "aj i ]A VrAm ni ,Vr ot wiles . - Is , rnjv reliuk"m sin the elderly=, Kllmvi Lire jj> fj (cj V . , Oh a Clip 7jbili , piicr, vrc 1 1 h C lIr pl i arW has XUSOD the ClIent'S Imbigatea, lun&, PefSOMM PrOpefTy air peosofuf idejjjli ig ajffta ld� Diij as dellmd n S, 917-568. The leim Includes, coord IlL facildirl, and U-01ume"gl" 143 4AW(l)(h), 11,1 vak .11, arod wovivMN Uir itsojenUil A-YESTkI M,- . a As The di authorized representaCive of 5xisem s lacisled at 911-vidits _.+ 2-741 VOIJ 1 0-4 2:Z 4w I i SUTE OF FICIRMA, COUNIYOF "ell I A/ 7 I , V m k dt »Ml undersigned. an authorized M this form is an attachment, hereby certifies that: lfum-yuoml (1) The Contractor understands that pursuant to s. 287.135 FS. any company at the time of bidding or submitting a proposal for a new contract or renewal o \ \ f nract, 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 \\% >\ \> or ® »a ?e« Pursuant to which funding is provided by the Department of Elder Affairs (Department) for goods or services of$l ?§!: »r more. ie Contractor understands that, eUrAlant to q. 287.135 F.S sm c* I 11"MAKIR (3) The Contractor understands that the contract to whijil thij 0 1111- a IMSE certification or nas This certification. required by Florida la%v, is a matenjal repre. ol'fact upon wilich reliance was plac when this transaction was made or entered into. Submission of this certification is a prerequisite for making entering into this transaction. i ,— NUA:�- (/ Focx— 430 Company Name IN M 66 ALZHEIMER'S DISEASE INITIATIVE CONTRACT 2018 -2019 Fiscal Year 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 "Contractor," and collectively referred to as the "parties." Attachments I, II, III, IV, V, VI, VII, VIII, IX, X, A, B, C, E, F, G, and H are incorporated herein and made a part of this Contract. WHEREAS, the Alliance has been designated as the Area Agency on Aging for Planning and Service Area 11 encompassing Miami -Dade and Monroe Counties; and WHEREAS, the Florida Department of Elder Affairs (the "Department ") has entered into a Contract with the Alliance to fund Alzheimer Initiative Contractors in Miami -Dade and Monroe Counties; and NOW THEREFORE, in consideration of the services to be perfonned and payments to be made, together with the mutual covenants and conditions set forth in this Contract, the Parties agree as follows: 1. Purpose of Contract The purpose of this contract is to provide services in accordance with the teens and conditions specified in this contract including all attachments and exhibits, which constitute the contract document. 2. Incorporation of Documents within the Contract The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department of Elder Affairs handbooks, manuals or desk books, as an integral part of the contract, except to the extent that the contract explicitly provides to the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s) or other general materials not specific to this contract document and identified attachments. Incorporation of Reference Memoranda: In accordance with Chapter 287 F. S., amended, and Department of Financial Services' Chief Financial Officer Memoranda, the following memoranda are hereby incorporated by reference: (1) CFO Memo No. 02: Release date, October 3, 2012; (2) CFO Memo No. 06: Release date, June 27, 2012; (3) CFO Memo No. 01: Release date, July 26, 2012; and (4) CFO Memo No. 04: Release date, June 30, 2006 3. Term of Contract Effective Date: This contract shall begin on July 1, 2018 or on the date the contract has been signed by both parties, whichever is later Delivery of services shall end at 11:59 PM, local time in Miami, FL on June 30, 2019. The Alliance will not reimburse the Contractor for services provided after this date. However, the parties recognize that they will need to perfonn continued activities relating to reporting, invoicing and payment in July of 2019 to facilitate payment for services rendered by the Contractor under this contract. 4. Contract Amount The Alliance agrees to pay for contracted services according to the teens and conditions of this contract in an amount not to exceed $189,458.40, subject to the availability of funds. Any costs or services paid for under any other contract or from any other source are not eligible for payment under this contract. 4.1 Obligation to Pay The Alliance's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature to the Department and funding received by the Alliance under its contract with the Department. 4.2 Source of Funds The costs of services paid under any other contract or from any other source are not eligible for reimbursement under this contract. The funds awarded to the Contractor pursuant to this contract are in the state grants and aids appropriations and consists of the following: V Page 1 of 61 Program Title Year Funding Source CSFA# Fund Amounts Alzheimer Disease Initiative 2018- 2019 General Revenue 65004 $189,458.40 TOTAL FUNDS CONTAINED IN THIS CONTRACT: $189,458.40 Renewals The contract may be renewed on a yearly basis for no more than two additional years. Such renewals shall be contingent upon satisfactory performance evaluations as detennined by the Alliance and the availability of funds. Any renewal of a contract shall be subject to mutual agreement, conflnned in writing, and subject to the same terns and conditions set forth in the initial contract, with the exception of establishing unit rates which is described further in this section. The renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or 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 4092815- 1- PC -SCBS dated September 28th, 2015 and the approved Alliance's Reimbursement Rate Review Policy. In the event that contracts cannot be executed prior to the July 1st start date, the Alliance may, at its discretion, extend this Agreement upon written notice for up to 120 days to ensure continuity of service. Services provided under this extension will be paid for out of the succeeding agreement amount 6. Compliance with State Law 6.1 This contract is executed and entered into in the State of Florida, and shall be construed, perfonned and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of laws. 6.2 The Contractor shall comply with requirements of s. 287.058, F.S. as amended. 6.2.1 The Contractor 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). 6.2.2 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre -audit and post- audit. 6.2.3 If itemized payment for travel expenses is permitted in this contract, the Contractor shall submit bills for any travel expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this contract. 6.2.4 The Contractor 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 contract except for those records which are made confidential or exempt by law. The Contractor's refusal to comply with this provision will constitute an immediate breach of contract for which the Alliance may unilaterally terminate the contract. 6.3 If clients are to be transported under this contract, the Contractor shall comply with the provisions of Chapter 427, F.S., and Rule 41 -2, F. A. C. 6.4 The Contractor may not subcontract with any individuals or entities on the discriminatory vendor list because they may not transact business with any public entity, in accordance with the provisions of s. 287.134, F.S. 6.5 The Contractor shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the expenditure of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency. V Page 2 of 61 6.6 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 or agreement with the Department for goods or services of $1 million or more. Pursuant to s. 287.135 F.S., the Department may tenninate this Contract and any contract or agreement incorporating this Contract by reference if the Contractor is found to have submitted a false certification of its status on the Lists or has been placed on the Lists. Further, the Contractor is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification. If any contract or agreement incorporating this Contract contains $1 million or more, the Contractor shall complete and sign ATTACHMENT H, Certification Regarding Scrutinized Companies Lists, prior to the execution of this contract. 7. Background Screening 7.1 The Contractor 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 Contractor 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. To demonstrate compliance with this provision, Contractor shall submit to the Department, the Background Screening Affidavit of Compliance (Screening Form) upon thirty (30) days of execution of this contract. Should the Alliance have a completed Screening Form on file for the Contractor, a new Screening Form will be required every twelve (12) months. 7.2 Further information concerning the procedures for background screening is found at http: / /elderaffairs. state. fl .us /doea/back�4roundscreenin�4�php 8. Grievance and Complaint Procedures 8.1 Grievance Procedure The Contractor shall comply with and ensure sub - Contractor compliance with the Minimum Guideline for Recipient Grievance Procedures, Appendix D, Department of Elder Affairs Programs and Services Handbook, to address complaints regarding the tennination, suspension or reduction of services, as required for receipt of funds. 8.2 Complaint Procedures: The Contractor shall develop and implement complaint procedures and ensure that sub - Contractors develop and implement complaint procedures to process and resolve client dissatisfaction with services. Complaint procedures shall address the quality and timeliness of services, Contractor and direct service worker complaints, or any other advice related to complaints other than tennination, suspension or reduction in services that require the grievance process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook. The complaint procedures shall include notification to all clients of the complaint procedure and include tracking the date, nature of the complaint and the detennination of the complaint on a complaint log. 9. Public Records and Retention: 9.1 The Contractor, subject to the terms of section 287.058(1)(c), Florida Statutes, and any other applicable legal and equitable remedies, shall: a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to perform the services. b) Upon request from the Alliance or the Department, the Contractor will provide a copy of the request for records or allow the records to be inspected or copies within a reasonable time at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes, or as otherwise provided by law. c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. d) Upon completion of the contract, or upon termination or expiration of any contract or agreement incorporating this Master Contract by reference the Contractor will either transfer, at no cost to the Alliance all public records in possession of the Contractor or will keep and maintain public records required by the Alliance or the Department. If the Contractor transfers all public records to the Alliance upon completion of the contract, Contractor shall destroy any duplicate public records that are exempt, or confidential and exempt, from public records disclosure V Page 3 of 61 requirements. If the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the Alliance in a format that is compatible with the information technology systems of the Alliance. 9.2 The Alliance may unilaterally cancel this contract notwithstanding any other provisions of this Master Contract, for refusal by the Contractor to comply with Section 8 of this Master Contract by not allowing public access to all documents, papers, letters, or other material made or received by the Contractor in conjunction with the contract or agreement incorporating this Master Contract by reference, unless the records are exempt, or confidential and exempt, from Section 24(a) of Article I of the State Constitution and Section 11 9.07(l), Florida Statutes. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: Public Records Coordinator Florida Department of Elder Affairs 4040 Esplanade Way Tallahassee, Florida 32309 850 - 414 -2342 do eapublicreco rds @elderaffairs.org 10. Audits, Inspections, Investigations: 10.1 The Contractor shall establish and maintain books, records, and documents (including electronic storage media) in accordance with generally accepted accounting procedures and practices that sufficiently and properly reflect all revenues and expenditures of funds provided by the Alliance under this contract. Contractor agrees to maintain records, including paid invoices, payroll registers, travel vouchers, copy logs, postage logs, time sheets, etc., as supporting documentation for Service Cost Reports and for administrative expenses itemized for reimbursement. This documentation will be made available upon request for monitoring and auditing purposes. Whenever appropriate, financial information should be related to perfonnance and unit cost data. 10.2 The Contractor 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. 10.3 Upon demand, at no additional cost to the Alliance, the Contractor shall facilitate the duplication and transfer of any records or documents during the required retention period. 10.4 The Contractor shall assure that the records described in Paragraph 10 will be subject at all reasonable times to inspection, review, copying, or audit by federal, state, or other personnel duly authorized by the Alliance. 10.5 At all reasonable times for as long as records are maintained, persons duly authorized by the Alliance and the Department, pursuant to 45 CFR ppart 75, will be allowed full access to and the right to examine any of the Contractor's contracts and related records and documents pertinent to this specific contract, regardless of the foram in which kept. 10.6 The Contractor shall provide a financial and compliance audit to the Alliance as specified in this contract and in ATTACHMENT III and ensure that all related third -party transactions are disclosed to the auditor. 10.7 The Contractor shall comply and cooperate iiu with any inspections, reviews, investigations, or audits deemed necessary by the office of the Inspector General pursuant to s. 20.055, F.S. Contractor further agrees that it shall include in related subcontracts a requirement that subcontractors perfonming work or providing services pursuant to this contract agree to cooperate with the Inspector General in any investigation, audit, inspection, review, or hearing pursuant to Section 20.005(5), F.S. By execution of this contract, Contractor understands and will comply with this subsection. V Page 4 of 61 10.8 The Contractor shall maintain and file with the Alliance such progress, fiscal and inventory and other reports as the Alliance may require within the period of this contract. 10.9 The Contractor shall submit management, program, and client identifiable data, as specified by the Department and / or the Alliance. The Contractor must record and submit program specific data in accordance with the Department's Client Inforination Registration and Tracking System (CIRTS) Policy Guidelines. 11. Nondiscrimination -Civil Rights Compliance 11.1 The Contractor 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 Contractor further assures that all Contractors, sub - Contractors, 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. 11.2 During the term of this contract, the Contractor shall complete and retain on file a timely, complete and accurate Civil Rights Compliance Checklist (ATTACHMENT B). 11.3 The Contractor 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. 11.4 These assurances are a condition of continued receipt of or benefit from financial assistance, and are binding upon the Contractor, its successors, transferees, and assignees for the period during which such assistance is provided. The Contractor further assures that all sub - Contractors, 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 Contractor 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, tennination of and denial of further assistance. 12. Provision of Services The Contractor shall provide services in the manner described in in ATTACHMENT I of this agreement and in the Service Provider Application (SPA). In the event of a conflict between the Service Provider Application and this contract, the contract language prevails. 13. Monitoring by the Alliance for Aging The Alliance will perform administrative, fiscal, and programmatic monitoring of the Contractor to ensure contractual compliance, fiscal accountability, programmatic performance, and compliance with applicable state and federal laws and regulations. The Contractor shall permit persons duly authorized by the Alliance to inspect and copy any records, papers, documents, facilities, goods, and services of the contractor which are relevant to this contract, and to interview any clients, employees, and subcontracted employees of the Contractor to assure the alliance of satisfactory performance of the teens and conditions of this contract. Following such review, the Alliance will provide a written report of its findings to the Contractor, and where appropriate, the Contractor shall develop an Action Plan and /or a Corrective Action Plan (CAP). The Contractor hereby agrees to correct all deficiencies identified in a timely manner as determined by the Alliance Contract Manager. 13.1 The Contractor will supply progress reports, including data reporting requirements as specified by the Alliance or the Department to be used for monitoring progress or performance of the contractual services as specified in this contract. Following the nouns set down by the Department, the Alliance will track perfonnance on a monthly basis. In addition to monthly tracking, annual monitoring will include desk reviews and on -sight visits to review requested fiscal documents, CIRTS, and research production reports and any other system or process designated by the Alliance. Examples of review criteria are surplus /deficit, independent audits, internal controls, reimbursement requests, subcontract monitoring, targeting, program eligibility, outcome measures, service provision to clients designated as "high risk" by the Department of Children & Families, Adult Protective Services program, data integrity, co- payments, client satisfaction, correspondence, and client file reviews. (see ATTACHMENT I, Section 2.9.2) 13.2 The Contractor shall pen persons duly authorized by the Department or the Alliance to inspect and copy any records, papers, documents, facilities, goods and services of the Contractor which are relevant to this contract, and to interview any clients, employees, and sub - Contractor employees of the Contractor to be assure the Alliance of the satisfactory V Page 5 of 61 perfonnance of the terms and conditions of this contract. Following such review, the Alliance will provide the Contractor a written report of its findings. The Contractor hereby agrees to correct all deficiencies identified in a timely manner as determined by the Contract Manager. 14. Coordinated Monitoring with Other Agencies If the Contractor receives funding from one or more other State of Florida human service agencies, in addition to the Department of Elder Affairs, then a joint monitoring visit including such other agencies may be scheduled. For the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human 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 Contractor shall comply and cooperate with all monitors, inspectors, and /or investigators. 15. Indemnification The Contractor shall indemnify, defend, and hold harmless the Department and the Alliance and their officers, agents, and employees from any claim, loss, damage, cost, charge, or expense whatever nature or character arising out of any acts, actions, e, neglect or omission, action in bad faith, or violation of federal or state law by the Contractor, its agents, employees, or sub- C Contractors during the perfonmance of this contract, whether direct or indirect, and whether to any person or property. It is !' understood and agreed that the Contractor is not required to indemnify the Alliance for claims arising out of the sole negligence C 1,3 D of the Alliance. s L 15.1 Except to the extent pennitted by s. 768.28, F.S., or other Florida law, Paragraph 16 is not applicable to contracts executed between the Alliance and state agencies or subdivisions defined in s. 768.28(2), F.S. 16. Insurance and Bonding 16.1 The Contractor must provide continuous adequate liability insurance and worker's compensation insurance coverage, on a comprehensive basis, and must hold such liability and worker's compensation insurances at all times during the effective period of this contract and any renewal(s) or extension(s) of this contract. The Alliance shall be included as an additional insured on the Contractor's liability insurance policy or policies and a copy of the Certificate of Insurance shall be provided annually or when any changes — occur. The Contractor accepts full responsibility for identifying and detennining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the Contractor and the clients to be served under this contract. Upon execution of this contract, the Contractor shall furnish the Alliance written verification supporting both the detennination and existence of such insurance coverage. The limits of coverage under each policy maintained by the Contractor do not limit the Contractor's liability and obligations under this contract. The Contractor shall ensure that the Alliance has the most current written verification of insurance coverage throughout the term of this contract. Such coverage may be provided by a self - insurance program established and operating under the laws of the State of Florida. The Department and the Alliance reserve the right to require additional insurance where appropriate. 16.2 Throughout the tenor of this contract, the Contractor must maintain an insurance bond from a responsible coimmercial insurance company covering all officers, directors, employees and agents of the Contractor, authorized to handle funds received or disbursed under this contract, in an amount commensurate with the funds handled, the degree of risk as detennined by the insurance company and consistent with good business practices. 17. Confidentialitv of Information The Contractor 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. 18. Health Insurance Portabilitv and Accountabilitv Act Where applicable, the Contractor 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). 19. Incident Reporting 19.1 The Contractor shall notify the Alliance iimmediately but no later than forty-eight (48) hours from the Contractor's awareness or discovery of conditions that may materially affect the Contractor or Subcontractor's ability to perform the Page 6 of 61 services required to be perfonmed under this contract. Such notice shall be made orally to the Contract Manager (by telephone) with an email to immediately follow. 19.2 The Contractor shall ini nediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number (1-800 - 96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon both the Contractor and its employees. 20. Bankruptcy Notification During the tenn of this contract, the Contractor shall ininediately notify the Alliance if the Contractor, its assignees, sub - Contractors or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Contractor 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. 21. Sponsorship and Publicitv 21.1 Any nongovernmental organization which sponsors a program financed wholly or partially by state funds or funds obtained from a state agency shall, in publicizing, advertising, or describing the sponsorship of the program, state: "Sponsored by, the State of Florida, Department of Elder Affairs and Alliance for Aging Inc." If the sponsorship reference is in written material, the words "State of Florida, Department of Elder Affairs and the Alliance for Aging" shall appear in the same size letters or type as the name of the organization (ref.: section 286.25, F. S.). This shall include, but is not limited to, any correspondence or other writing, publication or broadcast that refers to such program. 21.2 The Contractor shall not use the words "State of Florida, Department of Elder Affairs" and/or "The Alliance for Aging, Inc." to indicate sponsorship of a program otherwise financed unless specific authorization has been obtained by the Alliance prior to use. 22. Assignments 22.1 The Contractor shall not assign its rights and responsibilities under this contract without the prior written approval of the Alliance. All contracts or agreements incorporating this Contract by reference shall remain binding upon the successors in interest of either the Contractor or the Alliance for Aging, Inc. 22.2 No approval by the Alliance of any assignment or subcontract shall be deemed in any event or in any manner to provide for the incurrence of any obligation of the Alliance in addition to the dollar amount agreed upon in this contract. 22.3 The State of Florida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or obligations under any contract or agreement to another governmental agency in the State of Florida, upon giving prior written notice to the Contractor. In the event the State of Florida approves transfer of the Contractor's obligations, the Contractor remains responsible for all work perfonmed and all expenses incurred in connection with the contract or agreement. 23. Subcontracts: 23.1 The Contractor is responsible for all work performed and for all coimmodities produced pursuant to this contract, whether actually furnished by the Contractor or its sub - Contractors. Any subcontracts shall be evidenced by a written agreement subject to all applicable terms and conditions of this contract. Alliance approval of the service application presented by the Contractor shall constitute Alliance approval of the Contractor's proposed subcontracts if the subcontracts follow the service and funding information identified in the Contractor's service application. All other subcontracts proposed to be funded under this contract must be approved in advance by the Alliance. The Contractor agrees that the Alliance shall not be liable to any sub - Contractor in any way or for any reason. The Contractor, at its expense, will indemnify and defend the Alliance against any sub - Contractor claims. 23.2 The Contractor shall promptly pay any sub - Contractors. Failure to pay sub - Contractors pursuant to any subcontract or as required by law may result in enforcement action under this contract. 23.3 The Contractor shall monitor, at least once per year, each of its Subcontractors, Subrecipients, Vendors, and /or Consultants paid from funds provided under this contract. The Contractor shall perform fiscal, administrative, and prograimmatic monitoring to ensure contractual compliance, fiscal accountability, prograimmatic perfonmance and compliance with applicable state and federal laws and regulations. The Contractor shall monitor to ensure that time V Page 7 of 61 schedules are met, the budget and scope of work are accomplished within the specified time periods, and other perfonnance goals sated in this contract are achieved. 23.4 The Contractor shall have a procurement policy that assures maximum free and open competition. Such procurement policy must conform, as applicable, with Federal and State contracting and procurement regulations, as set forth in Title 45 Code of Federal Regulations (CFR) part 74 - Sub -Part C, Ch.287.057 Florida Statutes (F.S.), U.S. Office of Management and Budget (OMB) Circular 110, Florida Department of Management Services (DMS) Rule 60A -1, Florida Administrative Code, and with the Department of Elder Affairs Program and Services Handbook 2012. 23.5 The Contractor shall dedicate the staff necessary to meet the obligations of this contract and ensure that subcontractors dedicate adequate staff, accordingly. 23.6 The Contractor shall ensure that staff responsible for perfonning any duties or functions within this contract have the qualifications as specified in the DOEA Programs and Services Handbook r� 24. Service Cost Reports and Unit Cost Methodologv Reports: CD CD The Contractor shall submit Service Cost Reports to the Alliance annually, but no later than ninety (90) calendar days after the C contract year ends. The Service Cost Reports shall reflect actual costs of providing each service by program for the preceding !' contract year. If the Contractor desires to renegotiate its reimbursement rates, the Contractor shall make a request in writing to C the Alliance, with the inclusion of a Unit Cost Methodology, in accordance with the Alliance's approved Reimbursement Rate t Review Policy, which is incorporated by reference. c 25. Funding Obligations: 25.1 The Alliance for Aging, Inc. acknowledges its obligation to pay the Contractor for the performance of the Contractor's < duties and responsibilities set forth in any contract or agreement incorporating this Contract by reference. 25.2 The Alliance shall not be liable to the Contractor for costs incurred or perfonnance rendered unless such costs and perfonnances are strictly in accordance with the terms of this contract, including but not limited to terms governing the Contractor's promised performance and unit rates and/or reimbursement capitations specified. 25.3 The Alliance shall not be liable to the Contractor for any expenditure which are not allowable costs as defined by applicable federal or state law, or which expenditures have not been made in accordance with the terns of this contract or fiscal or programmatic guidelines and requirements outlined by the current Department of Elder Affairs Programs and Services Handbook. 25.4 The Alliance shall not be liable to the Contractor for expenditures made in violation of regulations promulgated under the Older Americans Act, Department rules, Florida Statutes, or this contract. 26. Independent Capacity of Contractor It is the intent and understanding of the Parties that the Contractor, or any of its Subcontractors, are independent Contractor's 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 Contractor and will not be liable for any wage and hour, employment discrimination, or other labor and employment claims against the Contractor or its Subcontractors. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary insurance for the Contractor are the sole responsibility of the Contractor. 27. Payment Payments shall be made to the Contractor for all completed and approved deliverables (units of service) as defined in ATTACHMENT 1. Disputes arising over invoicing and payments will be resolved in accordance with the provisions of Section 215.422, F.S. A Vendor Ombudsman has been established with the Florida Department of Financial Services and may be contacted at 800 - 342 -2762. 27.1 Payments shall be made to the Contractor as services are rendered and invoiced by the Contractor. The Alliance will have final approval of the invoice for payment, and will approve the invoice for payment only if the Contractor has met all teens and conditions of the contract, unless the bid specifications, purchase order, or this contract specify otherwise. Page 8 of 61 The approved invoice will be submitted to the Alliance's fiscal department for budgetary approval and processing per ATTACHMENT VIII. 27.2 Payment Documentation Required: The Contractor shall maintain documentation to support payment requests which shall be available to the Comptroller, the Department, or the Alliance upon request. Invoices must be submitted in sufficient detail for a proper pre audit and post audit thereof. The Contractor shall comply with all state and federal laws governing payments to be made under this contract including, but not limited to the following: (a) paragraph (16) (b) of section 216.181, F. S., regarding advances; (b) Rule 69I- 40.103 F.A.C. pertaining to Restriction of Expenditures from state funds; and (c) the Contract Payment Requirements sub - section of section C of the Reference Guide for State Expenditures from the Department of Financial Services (http://www.dbf.state.fl.us/aadir/reference The Contractor shall maintain detailed documentation to support each item on the itemized invoice or payment request for cost reimbursed expenses, including paid sub - Contractor invoices, and will be produced upon request by the Alliance. The Contractor shall only request reimbursement for allowable expenses as defined in the laws and guiding circulars cited in this agreement, in the Reference Guide for State Expenditures, and any other laws or regulations, as e, applicable, and that administrative expenses do not exceed amounts budgeted in the Contractor's approved service application. C' CD The Contractor will certify that detailed documentation is available to support each item on the itemized invoice or 0 payment request for cost reimbursed expenses, fixed rate or deliverables contracts or agreements incorporating this Contract by reference, including paid Sub - Contractor invoices, and will be produced upon request by the Alliance or the Department. The Contractor will further certify that reimbursement requests are only for allowable expenses as defined U in the laws and guiding circulars cited in this Contract, in the Reference Guide for State Expenditures, and any other laws Q or regulations, as applicable, and that administrative expenses do not exceed amounts budgeted in the Contractor's -- approved budget as developed in accordance with and pursuant to section 306(a) of the Older Americans Act of 1965, as amended. L 27.3 The Contractor and Sub - Contractors shall provide units of deliverables, including reports, findings, and drafts as specified in this contract to be received and accepted by the Contract Manager prior to payment. 28. Return of Funds The Contractor shall return to the Alliance any overpayments due to unearned funds or funds disallowed and any interest attributable to such funds pursuant to the terms and conditions of any contract or agreement incorporating this Contract by reference that were disbursed to the Contractor by the Alliance. In the event that the Contractor or its independent auditor discovers that an overpayment has been made, the Contractor shall repay said overpayment iiurnediately without prior notification from the Alliance. In the event that the Alliance first discovers an overpayment has been made, the Contract Manager will notify the Contractor in writing of such findings. Should repayment not be made forthwith, the Contractor shall be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after Alliance's notification or Contractor discovery. 29. Data Integrity and Safeguarding Information. The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using in the perfonnance of this contract. An appropriate level of security includes approving and tracking all Contractor employees that request system or information access and ensuring that user access has been removed from all tenninated employees. The Contractor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. All data and software must be routinely backed up to insure recovery from losses or outages of computer systems. The security over the back -up data is to be as stringent as the protection required of the primary systems. The Contractor shall insure all sub - Contractors maintain written procedures for computer system backup and recovery. The Contractor shall, prior to execution of this agreement, complete the Data Integrity Certification form, ATTACHMENT IV. 30. Computer Use and Social Media Policv The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Policy, which applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel affiliated with third parties, such as, but not limited to, Area Agencies on Aging and vendors. Any entity that uses the Department's computer resource systems must comply with the Department's policy regarding social media. Social Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks like MySpace, Facebook and Twitter, as well as content sharing networks such as Flickr and YouTube. This policy is available on the Department's website at: http: / /elderaffairs.state.fl.us /doea/financial.php. Page 9 of 61 33. Purchasing: 33.1 The Contractor may purchase articles which are the subject of or are required to carry out any contract or agreement from Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S., in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of this the Contractor shall be deemed to be substituted for the Alliance insofar as dealings with PRIDE. This clause is not applicable to Subcontractors unless otherwise required by law. An abbreviated list of products /services available from PRIDE may be obtained by contacting PRIDE, 800 - 643 -8459. 33.2 The Contractor may procure any recycled products or materials, which are the subject of or are required to carry this contract in accordance with the provisions of s. 403.7065, F.S. 33.3 The Contractor may purchase articles that are the subject of, or required to carry out, this contract from a nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S., in the same manner and under the same procedures set forth in s. 413.036(1) and (2), F S. For purposes of this contract the Contractor shall be deemed to be substituted for the Alliance insofar as dealings with such qualified nonprofit agency are concerned. Additional information about the designated nonprofit agency and the products it offers is available at http: / /www.respectofflorida.org. This clause is not applicable to Subcontractors unless otherwise required by law. 33.4 The Contractor shall provide a Certified Minority Business Expenditure (CMBE) Report sunirnarizing the participation of certified suppliers for the current reporting period and project date. The CMBE Report shall include the names, addresses, and dollar amount of each certified participant, and a copy must be forwarded to the Alliance and must accompany each invoice submitted to the Alliance. The Office of Supplier Diversity (850- 487 -0915) will assist in furnishing names of qualified minorities. The Florida Department of Elder Affairs, Minority Coordinator (850 -414- 2134) will assist with questions and answers. 34. Patents, Couyrights, Rovalties If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed, produced or for which ownership was purchased in the course of or as a result of work or services perfonmed under this contract the Contractor shall refer the discovery, invention or material to the Alliance to be referred to the Department. Any and all patent rights or copyrights accruing under this contract are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Page 10 of 61 31. Conflict of Interest The Contractor shall establish safeguards to prohibit employees, board members, management and sub - Contractors 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 Contractor or sub - Contractor 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 fine selected for award. The Contractor or sub - Contractor'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 Contractor'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 Contractor's employees and sub - Contractors must make the same disclosures described above to the Contractor's board of directors. Compliance with this provision will be monitored. r� 32. Public Entitv Crime I CD Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction or repair of a public building or es public work; may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or U perform work as a Contractor, supplier, sub - Contractor, or consultant under a contract with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. If the Contractor or any of its officers or directors is convicted of a public entity crime during the period of this agreement, the -- Contractor shall notify the Alliance iimmediately. Non - compliance with this statute shall constitute a breach of this agreement. 33. Purchasing: 33.1 The Contractor may purchase articles which are the subject of or are required to carry out any contract or agreement from Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S., in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of this the Contractor shall be deemed to be substituted for the Alliance insofar as dealings with PRIDE. This clause is not applicable to Subcontractors unless otherwise required by law. An abbreviated list of products /services available from PRIDE may be obtained by contacting PRIDE, 800 - 643 -8459. 33.2 The Contractor may procure any recycled products or materials, which are the subject of or are required to carry this contract in accordance with the provisions of s. 403.7065, F.S. 33.3 The Contractor may purchase articles that are the subject of, or required to carry out, this contract from a nonprofit agency for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413, F.S., in the same manner and under the same procedures set forth in s. 413.036(1) and (2), F S. For purposes of this contract the Contractor shall be deemed to be substituted for the Alliance insofar as dealings with such qualified nonprofit agency are concerned. Additional information about the designated nonprofit agency and the products it offers is available at http: / /www.respectofflorida.org. This clause is not applicable to Subcontractors unless otherwise required by law. 33.4 The Contractor shall provide a Certified Minority Business Expenditure (CMBE) Report sunirnarizing the participation of certified suppliers for the current reporting period and project date. The CMBE Report shall include the names, addresses, and dollar amount of each certified participant, and a copy must be forwarded to the Alliance and must accompany each invoice submitted to the Alliance. The Office of Supplier Diversity (850- 487 -0915) will assist in furnishing names of qualified minorities. The Florida Department of Elder Affairs, Minority Coordinator (850 -414- 2134) will assist with questions and answers. 34. Patents, Couyrights, Rovalties If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed, produced or for which ownership was purchased in the course of or as a result of work or services perfonmed under this contract the Contractor shall refer the discovery, invention or material to the Alliance to be referred to the Department. Any and all patent rights or copyrights accruing under this contract are hereby reserved to the State of Florida in accordance with Chapter 286, F.S. Page 10 of 61 Pursuant to s. 287.0571 (5)(k), as amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in this contract 34.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an unencumbered right to use such property, notwithstanding any agreement made pursuant to this section 33. 34.2 If this contract is awarded solely federal funding, the teens and conditions are governed by 2 CFR Part 200.315. 35. Emergency Preparedness and Continuity of Operations 35.1 The Contractor shall, within thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of an emergency preparedness plan. In the event of an emergency, the Contractor shall notify the Alliance of emergency provisions. 35.2 In the event a situation results in a cessation of services by a sub - Contractor, the Contractor shall retain responsibility for perfonnance under this contract and must follow procedures to ensure continuity of operations without interruption. 36. Equipment 36.1 Use of Contract Funds to Purchase Equipment No funds under this contract will be used by the Contractor to purchase equipment. 36.2 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable, tangible personal property of a non - consumable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful life of at least one year; and hardback bound books not circulated to students or the general public, with a value or cost of $250.00 or more [for state funds]. 37. PUR 1000 Form: The PUR 1000 Fonn 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 terms or conditions of any contract or agreement terms or conditions the contract shall take precedence over the PUR 1000 Fonn. However, if the conflicting teens or conditions in the PUR 1000 Fonn are required by any section of the Florida Statutes, the teens or conditions contained in the PUR 1000 Fonn shall take precedence. 38. Use of State Funds to Purchase or Improve Real Propertv Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or political subdivision granting to the state a security interest in the property at least to the amount of state funds provided for at least 5 years from the date of purchase or the completion of the improvements or as further required by law. 39. 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 Contractor. 40. Corrective Action Plan a) Contractor shall ensure 100% of the deliverables identified in ATTACHMENT 1, Section II — MANNER OF SERVICE PROVISION are perfonned pursuant to contract requirements. b) If at any time the Contractor is notified by the Alliance Contract Manager that it has failed to correctly, completely, or adequately perform contract deliverables, the Contractor will have 15 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 DOEA Contract Manager. The Alliance shall assess a Financial Consequence for Non- Page 11 of 61 Compliance on the Contractor for each deficiency identified in the CAP which is not corrected pursuant to the CAP. The Alliance will also assess a Financial Consequence for failure to timely submit a CAP. c) In the event Contractor fails to correct an identified deficiency within the approved time period specified in the CAP, the Alliance shall deduct, from the payment for the invoice of the following month, 1% of the monthly value of the monthly invoiced funds in the contract for each day the deficiency is not corrected. The Alliance shall also deduct, from the payment for the invoice of the following month, 1% of the monthly value of the invoiced funds in the contract for each day the Contractor fails to timely submit a CAP. d) If Contractor fails to timely submit a CAP, the Alliance shall deduct 1% of the monthly value of the invoiced funds in the contract for each day the CAP is overdue, beginning the 11th day after notification by the Alliance Contract Manager of the deficiency. The deduction will be made from the payment for the invoice of the following month. 41. Financial Conseauences of Non - Performance If the Contractor fails to meet the minimum level of service or perfonnance identified in this agreement, or that is customary for r C the industry, then the Alliance must apply financial consequences commensurate with the deficiency. Financial consequences may include, but are not limited to, contract suspension, refusing payment, withholding payments until deficiency is cured, C' tendering only partial payments, and /or cancellation of contract and reacquiring services from an alternate source. CD The Alliance will withhold or reduce payment if the Contractor fails to perform the deliverables to the satisfaction of the u Contract according to the requirements referenced in ATTACHMENT I, Section I and Section II of this contract. The following financial consequences will be imposed if the deliverables stated do not meet in part or in whole the perfonnance criteria as U outlined in ATTACHMENT I, Section II of this contract. Q a) Delivery of services to eligible clients as referenced in ATTACHMENT I, Section I, 1.3 Section II, 2.1 of this contract — Failure to ensure adherence to established assessment and prioritization criteria as evidenced in CIRTS reports will result in a reduction of payment equal to the percentage of new clients served who did not meet the criteria, compared to the total number of clients served. b) Services and units of services as referenced in ATTACHMENT I, Section II, 2.2 of this contract — Failure to ensure the provision of services in accordance with the current DOEA Programs and Services Handbook, and ATTACHMENTS VII, and submission of required documentation will result in a 2% reduction of payment per business day any identified deficiency is not cured or satisfactorily addressed. c) Perfonmance Specifications as referenced in ATTACHMENT I, Section II, 2.6 of this contract — Failure to perfonm the perfonnance specifications and oversight of ADI Program operations will result in a 2% reduction of payment per business day any identified deficiency in duties is not cured or satisfactorily addressed in accordance with ATTACHMENT I, Section II, 3.6.3 d) Exceptions may be granted solely, in writing, by the DOEA contract manager. 41.1 The Contractor will not be charged with financial consequences, when a failure to perfonm arises out of causes that were the responsibility of the Alliance. 41.2 No Waiver of Sovereign hninunity Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which sovereign iiuinunity may be applicable. 43. Venue If any dispute arises out of this contract, the venue of such legal recourse will be Miami -Dade County, Florida. 44, Entire Contract This contract contains all the tenors and conditions agreed upon by the Parties. No oral agreements or representations shall be valid or binding upon the Alliance or the Contractor unless expressly contained herein or by a written amendment to this contract signed by both Parties. 45. Force Maieure The Parties will not be liable for any delays or failures in perfonmance due to circumstances beyond their control, provided the party experiencing the force majeure condition provides iimmediate written notification to the other party and takes all reasonable efforts to cure the condition. Page 12 of 61 46. Severabilitv Clause The Parties agree that if a court of competent jurisdiction deems any teen or condition herein void or unenforceable; the other provisions are severable to that void provision and shall remain in full force and effect. 47. Condition Precedent to Contract: Appropriations The Parties agree that the Alliance's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature to the Department and a corresponding allocation under contract from the Department to the Alliance. 48. Addition/Deletion The Parties agree that the Alliance reserves the right to add or to delete any of the services required under this contract when deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both Parties. The Parties shall negotiate compensation for any additional services added. r� 49. Waiver r CD The delay or failure by the Alliance to exercise or enforce any of its rights under this contract will not constitute or be deemed a e® waiver of the Alliance's right thereafter to enforce those rights, nor will any single or partial exercise of any such right preclude C—D any other or further exercise thereof or the exercise of any other right. CD U 50. Compliance The Contractor 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 Contractor to abide by these laws shall be U deemed an event of default of the Contractor, and subject the contract to iiuinediate, unilateral cancellation of the contract at the discretion of the Alliance. < 51. Final Invoice The Contractor shall submit the final invoice for payment to the Alliance as specified in Paragraphs 3.4, 3.4.1 and 3.4.2 (date for final request for payment) of ATTACHMENT L If the Contractor 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 Contractor and necessary adjustments thereto have been approved by the Alliance. 52. 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. 53. Suspension of Work: The Alliance may in its sole discretion suspend any or all activities under this contract when in the Department of Elder Affairs and the Alliance determination that it is in the best interests of State to do so. The Alliance shall provide the Contractor 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 Contractor shall comply with the notice and shall not accept any purchase orders. Within ninety days, or any longer period agreed to by the Contractor, the Alliance shall either (1) issue a notice authorizing resumption of work, at which time activity shall resume, or (2) terininate the Contract or purchase order. Suspension of work shall not entitle the Contractor to any additional compensation. 54. Termination 54.1 Termination for Convenience. This contract may be tenninated 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 with verification of delivery or any expedited delivery service that provides verification of delivery or by hand delivery to the Contract Manager or the representative of the Contractor responsible for administration of the contract. The Contractor shall not furnish any product after it receives the notice of tennination, except as necessary to complete the continued portion of the contract, if any. The Contractor shall not be entitled to recover any cancellation charges or lost profits. Page 13 of 61 54.2 Termination for Cause. The Alliance may terminate this contract if the Contractor fails to (1) deliver the product within the time specified in the contract or any extension, (2) maintain adequate progress, thus endangering perfonnance of the contract, (3) honor any term of the (4) abide by any statutory, regulatory, or licensing requirement, or (5) in the event funds for payment become unavailable for this contract. The Alliance will be the final authority as to the availability and adequacy of funds. In the event of tennination of this contract, the Contractor will be compensated for any work satisfactorily completed prior to the date of termination. Rule 60A- 1.006(3), F.A.C., governs the procedure and consequences of default. The contractor shall continue work on any work not tenninated. Except for defaults of Subcontractors at any tier, the Contractor shall not be liable for any excess costs if the failure to perform the Contract arises from events completely beyond the control, and without the fault or negligence, of the Contractor. If the failure to perform is caused by the default of a Subcontractor at any tier, and if the cause of the default is completely beyond the control of both the Contractor and the Subcontractor, and without the fault or negligence of either, the Contractor shall not be liable for any excess costs for failure to perform, unless the subcontracted products or services were obtainable from other sources in sufficient time for the Contractor to meet the required delivery schedule. If, after termination, it is detennined that the Contractor was not in default, or that the default was excusable, the rights and obligations of the Parties shall be the same as if the termination had been issued for the convenience of the Alliance. The rights and remedies of the Alliance in this clause are in addition to any other rights and remedies provided by law or under the Contract. 54.3 Upon expiration or termination of this contract the Contractor and Subcontractors shall transfer all public records in its possession to the Alliance and destroy any duplicate public records that are exempt or confidential and exempt from public records, disclosure requirements at no cost to the Alliance. All electronically stored records shall be provided to the Alliance in a format that is compatible with the Alliance's information technology system(s). 55. Successors This contract shall remain binding upon the successors in interest of either the Alliance or the Contractor. 56. Electronic Records and Sitnature The Alliance authorizes, but does not require, the Contractor 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 auditable; are subject to Florida's Public Records Law, Ch. 119, and Fla. Stat.; must comply with Section 29, Data Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained and maintained by the Contractor to the same extent as non- electronic records are retained and maintained as required by this Contract. 56.1 The Alliance's authorization pursuant to this section does not authorize electronic transactions between the Contractor and the Alliance. The Contractor is authorized to conduct electronic transactions with the Alliance only upon further written consent by the Alliance. 56.2 Upon request by the Alliance, the Contractor 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 foam with an electronic signature must indicate the person and the person's capacity who electronically signed the document on any non - electronic copy of the document. 57. Special Provisions The Contractor agrees to the following provisions: 57.1 Investigation of Criminal Allegations: Any report that implies criminal intent on the part of the Contractor or any sub - Contractors and referred to a goverm or investigatory agency must be sent to the Alliance. If the Contractor 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 goverm agency, the Contractor shall notify the contract manager. A copy of all documents, reports, notes or other written material concerning the investigation, whether in the possession of the Contractor or Sub - Contractors, must be sent to the Alliance's contract manager with a summary of the investigation and allegations. 57.2 Volunteers: The Contractor 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 Contractor shall work in coordination with organizations that have experience in providing training, placement, and stipends for volunteers or participants (such as V Page 14 of 61 organizations carrying out federal service programs administered by the Corporation for National and Community Service), in community service settings. 57.3 Enforcement: 57.3.1 In accordance with Section 430.04, F.S., the Alliance may, without taking any intermediate measures available to it against the Contractor, rescind the Contractor's contract, if the Alliance finds that: a. An intentional or negligent act of the Contractor has materially affected the health, welfare, or safety of clients served pursuant to any contract or agreement incorporating this Contract by reference, or substantially and negatively affected the operation of services covered under any contract or agreement; b. The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual funds have been misappropriated; c. The Contractor 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 Contractor has coiumitted or repeated violations of Department standards; e, d. The Contractor has failed to continue the provision or expansion of services after the declaration of a state of emergency; and /or C' e. The Contractor has failed to adhere to the terms of this contract. CD f The Contractor consistently misses perfonuance measure targets, or does not demonstrate to the t satisfaction of the Alliance that a program budget surplus /deficit problem is being addressed in order to avoid closing out the contract year with a budget variance of more than two percent. g. The Contractor has failed to properly determine client eligibility as defined in this contract and the U DOEA Programs and Services Handbook or efficiently managed program budgets. Q h. The Contractor has failed to implement and maintain an approved client grievance resolution procedure. i. In the alternative, the Alliance may, at its sole discretion, take iiniuediate measures against the Contractor, including: corrective action, unannounced special monitoring, temporary assumption of the operation of one or more contractual services, placement of the Contractor on probationary status, U imposing a moratorium on Contractor action, imposing financial penalties for nonperfonuance, or other administrative action Q j. In making any determination under this provision the Alliance may rely upon the findings of another Cs - state or federal agency, or other regulatory body. Any claims for damages for breach of any contract or e,4 agreement incorporating this Contract by reference are exempt from administrative proceedings and O shall be brought before the appropriate entity in the venue of Miami -Dade County. � 57.4 Use of Service Dollars: The Contractor will optimize the use of contract funds by serving the maximum possible number of individuals with appropriate care plans with the services allowed by this contract. The Contractor will spend all funds provided by this contract to provide such services. 57.5 Surplus /Deficit Report: The Contractor will submit a consolidated surplus /deficit report by program in a fonuat provided by the Alliance to the Alliance's Contract Manager with the monthly request for payments according to the calendar on ATTACHMENT VIII. 57.6 Surplus Recapture: In accordance with its surplus /deficit management policies, in order to maximize available funding and minimize the time that potential clients must wait for services, the Alliance in its sole discretion can reduce funding awards if the Contractor is not spending according to monthly plans and is projected to incur a surplus at the end of the year. 58. Official Pavee and Representatives 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 15 of 61 In the event different representatives are designated by either party after execution of this contract, notice of the name and address of the new representative will be rendered in writing to the other party and said notification attached to originals of this contract. 59. All Terms and Conditions Included This contract and its Attachments, I through X, A, B, C, E, F, G, and 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, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. By signing this contract, the Parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF, the Parties hereto have caused this 61 page contract, to be executed by their undersigned officials as duly authorized. V Page 16 of 61 The Contractor name, as shown on page 1 of this Monroe County Board of County Commissioners, Social a. contract, and mailing address of the official payee to Services /ln -Home Services whole the payment shall be made is: 1100 Simonton Street, 2 -257 Key West, FL 33040 The name of the contact person and street address Sheryl Graham, Senior Director b. where financial and administrative records are Monroe County Board of County Commissioners, Social maintained is: Services /ln -Home Services 1100 Simonton Street, 2 -257 Key West, FL 33040 The name, address, and telephone number of the Sheryl Graham, Senior Director C. representative of the Contractor responsible for Monroe County Board of County Commissioners, Social Services /ln -Home Services administration of the program under this contract is: 1100 Simonton Street, 2 -257 Key West, FL 33040 The section and location within the AAA where Vice President for Finance d. Requests for Payment and Receipt and Expenditure 760 NW 107th Avenue, Suite214 forms are to be mailed is: Miami, Florida 33172 -3155 Contract Monitor The name, address, and telephone number of the Alliance for Aging, Inc. e Contract Manager for the AAA for this contract is: 760 NW 107th Avenue, Suite 214 Miami, Florida 33172 -3155 In the event different representatives are designated by either party after execution of this contract, notice of the name and address of the new representative will be rendered in writing to the other party and said notification attached to originals of this contract. 59. All Terms and Conditions Included This contract and its Attachments, I through X, A, B, C, E, F, G, and 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, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications, representations or agreements, either written or verbal between the Parties. By signing this contract, the Parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF, the Parties hereto have caused this 61 page contract, to be executed by their undersigned officials as duly authorized. V Page 16 of 61 Monroe County Board of County Commissioners, Social Services /In -Home Contractor: Services ALLIANCE FOR AGING, INC. SIGNED BY: SIGNED BY: NAME: NAME: MAX B. ROTHMAN, JD, LL.M. TITLE: TITLE: PRESIDENT AND CEO r� DATE: DATE: CD 0, u L SIGNED BY: k NAME: TITLE: DATE: Page 17 of 61 INDEX TO ATTACHMENTS Attachment I SERVICE PROVISIONS ALZHEIMER'S DISEASE INITIATIVE Attachment II CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS Attachment III FINANCIAL AND COMPLIANCE AUDIT Attachment IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS Attachment V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS Attachment VI ASSURANCES NON CONSTRUCTION PROGRAMS Attachment VII BUDGET SUMMARY Attachment VIII INVOICE REPORT SCHEDULE Attachment IX REQUEST FOR PAYMENT FORM Attachment X RECEIPT AND EXPENDITURE REPORT Attachment A DOEA HANDBOOK Attachment B CIVIL RIGHTS COMPLIANCE CHECKLIST Attachment C REFERRAL PROTOCOL AGING AND DISABILITY RESOURCE CENTER (ADRC) — OUTSOURCED FUNCTIONS Attachment E BUSINESS ASSOCIATE AGREEMENT Attachment F VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION Attachment G BACKGROUND SCREENING AFFADAVIT OF COMPLIANCE Attachment H CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS Page 18 of 61 ATTACHMENT ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I. SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 DEFINITIONS OF ACRONYMS Alzheimer's Disease (AD) Alzheimer's Disease Initiative (ADI) Activities of Daily Living (ADL) Assessed Priority Consumer List (APCL) Adult Protective Services (APS) Client Information and Registration Tracking System (CIRTS) Coininunity Care for Disabled Adults (CODA) Corrective Action Plan (CAP) Department of Elder Affairs — (DOEA) or Department Department of Elder Affairs Program and Services Handbook (DOEA HANDBOOK) Home Care For Disabled Adults (HCDA) Instrumental Activities of Daily Living (IADL) Memory Disorder Clinic (MDC) Planning and Service Area (PSA) 1.1.2 PROGRAM SPECIFIC TERMS Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and Families Services Coinimunity Care for Disabled Adults (CODA) or Home Care for Disabled Adults (HCDA) services to the Department's community -based services. Area Plan: A plan developed by the Alliance outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C. 3026) and Department instructions. The Area Plan includes perfonmance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the Alliance enters ADI specific data into the CIRTS. An update may also include other revisions to the Area Plan as instructed by the Department. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. DOEA Form 701B is used by case managers to conduct the functional assessment. Memory Disorder Clinic: Research oriented programs created pursuant to Sections 430.502(1) and (2), F.S., to provide diagnostic and referral services, conduct basic and service- related multidisciplinary research, and develop training materials and educational opportunities for lay and professional caregivers of individuals with AD. Model Day Care: A program of therapeutic, social and health activities specific to clients with memory disorders. Services and activities include, but are not limited to, active and quiet games, reminiscence, validation therapy, pet therapy, water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the ADI program is to provide a continuum of services addressing the special needs of individuals with AD, their families and caregivers. 1.2.2. Alzheimer's Disease Initiative Mission Statement V Page 19 of 61 The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder - friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.3 Authority The relevant authority governing ADI program are: a. Rule 5813-1, Florida Administrative Code b. Sections 430.501 through 430.504, F.S. c. The Catalog of State Financial Assistance (CSFA) Numbers are 65004 and 65002 1.2.4 Scope of Service and Eligible Individuals The Contractor is responsible for the programinatic, fiscal, and operational management of the ADI program per this contract. The program services shall be provided in a manner consistent with the Area Plan, as updated and the current DOEA Handbook, which are incorporated by reference. The Contractor agrees to be bound by all subsequent amendments and revisions to the DOEA Handbook, and the Contractor agrees to accept all such amendments and revisions. 1.3 Clients to be Served 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD or other related disorders and their caregivers. 1.3.2 Individual Eligibility Clients eligible to receive services under this contract must: a. Be 18 years of age or older and have a diagnosis of AD or a related disorder, or be suspected of having AD or a related disorder; and b. Not be enrolled in a Medicaid capitated long -tenn care program. 1.3.3 Targeted Groups Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II. MANNER OF SERVICE PROVISION 2.0 CONDITIONS All services under this contract will be provided in a manner consistent with the conditions set forth in the current Florida Department of Elder Affairs Programs and Services Handbook. Client access to services, assessment and eligibility determination must conform to the protocols listed in ATTACHMENT C. 2.1 SERVICE TASKS To achieve the goals of the ADI program, the Contractor shall perform or ensure the perfonnance of its Sub - Contractors, the following tasks: 2.1.1 Client Eligibility Determination The Contractor shall ensure that applicant data is evaluated to detennine eligibility. Eligibility to become a client is based on meeting the requirements described in this ATTACHMENT I, Section 1.3. 2.1.2 Assessment and Prioritization of Service Delivery for New Clients The Contractor shall ensure the following criteria are used to prioritize new clients for service delivery. It is not the intent of the Department to remove existing clients from any services in order to serve new clients being assessed and prioritized for service delivery. Priority Criteria for Service Delivery a. Individuals in nursing homes under Medicaid who could be transferred to the cormnunity; b. Individuals in nursing homes whose Medicare coverage is exhausted and may be diverted to the cormnunity; V Page 20 of 61 c. Individuals in nursing homes that are closing and can be discharged to the community; d. Individuals whose mental or physical health condition has deteriorated to the degree self -care is not possible, there is no capable caregiver, and institutional placement will occur within 72 hours; and e. For the purpose of transitioning individuals receiving CCDA and HCDA services through the Department of Children and Families' Adult Services to community -based services provided through DOEA when services are not currently available, area agency on aging staff and lead agency case managers will ensure that "Aging Out" individuals are prioritized for services only after APS High Risk and Imminent Risk individuals. 2.1.3 Priority Criteria for Service Delivery for Other Assessed Individuals The assessment and provision of services should always consider the most cost effective means of service delivery. Functional impairment will be determined through the Department's functional assessment form administered to each applicant. The most frail individuals not prioritized as described in this attachment, Paragraph 2.1.2.1 will receive services to the extent funding is available. 2.1.4 Delivery of Services to Eligible Clients: The Contractor shall ensure the provision of a continuum of services addressing the diverse needs of individuals e, with AD and their caregivers. The Contractor shall ensure services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. Services categories include: C' r� CD a. Caregiver Training /Support; 0 b. Case Aide; �- c. Case Management; d. Counseling (Gerontological); e. Counseling (Mental Health/Screening); f Education/Traimng; -- g. Intake; h. Model Day Care; i. Respite (Facility- Based); j. Respite (In- Hoime); and k. Specialized Medical Equipment, Services, and Supplies. Caregivers benefit from receiving training, respite and related support services to assist therm in caring for the ADI client. 2.1.5 Memory Disorder Clinics MDCs are required to provide four (4) hours of in- service training to all respite, in- facility respite and model day care centers in their designated service areas. In- service training topics may include physiological, behavioral and emotional aspects of AD and related diseases as well as caregiver techniques, coping strategies and inforimation regarding Silver Alert. The Contractor shall collaborate with MDCs to assist in this effort and in the effort to carry out Silver Alert protocol activities. The Contractor shall respond to requests for evaluation inforimation and statistical data concerning its consumers, based on information requirements of the MDCs and Brain Bank. 2.1.6 Model Day Care Programs The Contractor will ensure Model Day Care Centers supported by this contract develop innovative therapies and interventions which can be shared with other ADI health and social services personnel via training. Model Day Care Centers supported by this contract must report to the Contractor all training activities provided to health care and social service personnel and caregivers, as well as serve as a natural laboratory for service related applied research perfonned by MDCs. The Contractor shall subunit an annual Model Day Care Center Training Report, to the Department by July 16, 2018, if applicable. 2.2 SERVICE TIMES AND LOCATION Service Times: The Contractor shall ensure the provision of the services listed in this contract is available at times appropriate to meet client service needs at a minimum, during nonnal business hours. Nonnal business hours are defined as Monday through Friday, 8:00ain to 5:00pm. Change in Locations: The Contractor shall notify the alliance in writing a minimum of one week prior to making changes in location that will affect the Alliance's ability to contact the Contractor by telephone, facsimile, or email. Page 21 of 61 2.3 Service Units Services will be reported in units as described in the DOEA Handbook. 2.4 REPORTS 2.4.1 The Contractor 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 Contractor desires to renegotiate its reimbursement rates, the Contractor 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 Client Information and Registration Tracking System (CIRTS) Reports The Contractor shall ensure timely input of ADI specific data into CIRTS. To ensure CIRTS data accuracy, the Contractor shall adhere to the Alliance's CIRTS Data Integrity Policy and use CIRTS- generated reports which include the following: a. Client Reports; b. Monitoring Reports; c. Service Reports; d. Miscellaneous Reports; e. Fiscal Reports; and f Outcome Measures Reports. 2.4.3 The Contractor shall provide the Alliance with an expenditure plan by July 15 or two weeks after this contract has been signed; a monthly update is due on the 15thst day of each following month. The expenditure plan and updates must follow the forinat provided by the Alliance. 2.4.4 The Contractor shall respond to surplus /deficit inquiries and will provide ad -hoc reports as requested by the Alliance. 2.4.5 The Contractor shall submit Program Highlights referencing specific events that occurred in SFY /FFY 2018 -2019 by September 15, 2019. The Contractor 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 Contractor 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 perfonned the activity described in the highlight. The Contractor shall review and edit Program Highlights for clarity, readability, relevance, specificity, human interest, and grammar, prior to submitting them to the Alliance. 2.5 ELECTRONIC RECORDS AND DOCUMENTATION The Contractor will ensure the collection and maintenance of client and service information on a monthly basis from the Client Information and Registration Tracking System (CIRTS). Maintenance includes valid exports and backups of all data and systems according to Alliance and Department standards. 2.5.1 Timely Data Entry The Contractor must enter all required ADI data per the Department's CIRTS Policy Guidelines for consumers and services in the CIRTS database. The data must be entered into CIRTS before the Contractor submits its request for payment and expenditure reports to the Alliance as per ATTACHMENT VIII. 2.5.2 Data Accuracy The Contractor will run monthly CIRTS reports and verify client and service data in CIRTS is accurate. This report must be submitted to the Alliance with the monthly request for payment and expenditure report and must be reviewed by the Alliance before the Contractor's request for payment and expenditure reports can be approved by the Alliance. 2.5.3 Failure to Maintain CIRTS Database Failure to ensure the collection and maintenance of the CIRTS data may result in the Alliance enacting the "Enforcemenf' clause of this agreement in ATTACHMENT I, Section 2.7, including delaying or withholding payment until the problem is corrected. V Page 22 of 61 2.5.4 Computer System Backup and Recovery Each Contractor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of 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. A copy of the backed up data shall be stored in a secure, offsite location. The Contractor shall maintain written policies and procedures for computer backup and recovery. These policies and procedures shall be made available to the Alliance upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes a. The Contractor shall timely submit to the Alliance all reports described in ATTACHMENT I, SECTION 2.4: REPORTS; b. The Contractor shall timely submit to the Alliance all information described in ATTACHMENT I, SECTION 2.5: ELECTRONIC RECORDS AND DOCUMENTATION; c. The Contractor shall ensure services in this contract are in accordance with the current DOEA Programs and Services Handbook. C' d. Establish procedures for handling complaints concerning adverse actions such as tennination, ~ suspension, or reduction in services, as per Section of of the Contract. 0 e. Conduct client satisfaction surveys to evaluate and improve service delivery. f Monitor and evaluate subcontractors and vendors for programmatic and fiscal compliance. U 2.6.2 The perfonnance of the Contractor in providing the services described in this contract shall be measured by the current strategies for the following criteria: < a. Percent of elders assessed with high or moderate risk environments who improved their environment 9 score; b. Percent of new service recipients with high -risk nutrition scores whose nutritional status improved; c. Percent of new service recipients whose ADL assessment score has been maintained or improved; d. Percent of new service recipients whose IADL assessment score has been maintained or improved; e. Percent of family and family- assisted caregivers who self -report they are likely to provide care; f Percent of caregivers whose ability to provide care is maintained or improved after one year of service intervention (as detennined by the caregiver and the assessor); The Contractor's performance will be documented in the Alliance's annual monitoring report. 2.7 Compliance and Enforcement The Contractor shall comply with all the teens and conditions set -forth in this contract, the Service Contractor Application and the most recent edition of the DOEA Programs and Services Handbook. The Contractor is also responsible to respond to any fiscal or programmatic monitoring items /issues within the timeframe stipulated by the Alliance. Monitoring Items/Issues may include Corrective Actions, Reportable Conditions or Quality hnprovement Recommendations provided by the Alliance. The Contractor is also responsible to provide timely response to any inquiry related to program expenditures including, but not limited to, addressing program surplus or deficit and corresponding program spend -out plan. Failure to meet any of the contractual requirements or compliance items mentioned above will result in the imposition of sanctions and/ or other enforcement actions by the Alliance as stipulated in Section 41. 2.8 Contractor's Financial Obligations Cost Sharing and Co- payments The Contractor in conjunction with the Alliance shall establish an annual co- payment goal (amount to be collected from clients). Using the method prescribed in the current Department of Elder Affairs Program and Services Handbook, the Contractor shall project the annual co- payments to be collected from each active client in all income ranges prior to the start of each fiscal year. The Contractor is required to meet at least 90 percent of the goal. Co- payments collected in the CCE program can be used as part of the local match. The Alliance For Aging Inc. will hold back 5% of the Contractor's contract amount. The amount held back shall be released to the Contractor after 50% of the adjusted annual goal is collected, but no later than February 15th of the fiscal year. Hold back amounts not earned by Contractors as of February 15th will be reallocated to other Contractors meeting or Page 23 of 61 exceeding 50% of their annual goal, except when no Contractor agency is meeting or exceeding its annual goal, or when an agency that is meeting or exceeding such goal affinns that it lacks the capacity to receive additional funds. 2.9 Alliance for Aging Responsibilities 2.9.1 Program Guidance and Technical Assistance The Alliance will provide to the Contractor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Contractor. 2.9.2 Contract Monitoring The Alliance will review and evaluate the perfonmance of the Contractor under the terms of this contract. Monitoring shall be conducted annually through direct contact with the Contractor through telephone, in writing, or an onsite visit. The Alliance's determination of acceptable performance shall be conclusive. The Contractor 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: � CD r a. Desk reviews and analytical reviews; e® b. Scheduled, unscheduled and follow -up on -site visits; C' c. Client visits; CD d. Review of independent auditor's reports; 0 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. SECTION III. METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this contract includes advances, cost reimbursement for administration costs, as well as fixed rate and cost reimbursement for services. Payment may be authorized for all allowable expenditures to complete the tasks identified in the deliverables, in accordance with all applicable state and federal statutes and regulations, and are based on audited historical costs in instances where an independent audit is required. All Contractor requests for payment and expenditure reports submitted to support requests for payment shall be on Department foams 106Z and 105Z, included as ATTACHMENTS IX and X. Duplication or replication of both foams via data processing equipment is pennissible, provided all data elements are in the same format as included on department forms. 3.1.1 Contractor invoices shall be submitted in accordance with ATTACHMENT VIII, except that invoices cannot be submitted beyond the date for final invoicing, as stated in this contract. Invoices submitted late will not be honored. Exceptions to this rule are at the discretion of the Alliance, on a case by case basis; such exceptions must be requested prior to the expiration of the invoicing deadline. In making a determination of the exception the Alliance will consider whether the disruption to the billing cycle was beyond the control of the Contractor, the frequency with which such exceptions are requested by the Contractor, and whether the Alliance can request reimbursement at a late date from DOEA. Exceptions for invoicing late after the closeout date will not be made. 3.2 Advance Payments: Non -profit Contractors may request a monthly advance for service costs for each of the first two months of the contract period, based on anticipated cash needs. Detailed documentation justifying cash needs for advances must be submitted with the signed contract, approved by the Alliance, and maintained in the contract manager's file. All payment requests for the third through the twelfth months shall be based on the submission of monthly actual expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests is ATTACHMENT VIII to this contract. Reconciliation and recouping of advances made under this contract are to be completed by October. All advance payments are subject to the availability of funds. 3.3 Advance funds may be temporarily invested by the Contractor in an FDIC insured interest bearing account. All interest earned on contract fund advances must be returned to the Alliance within thirty (30) days of the end of the first quarter of the contract period. Page 24 of 61 3.4 Final Request for Payment: 3.4.1 The Contractor must submit the final request for payment to the Alliance no later than July 15, 2019; if the Contractor fails to do so, all right to payment is forfeited, and the Alliance will not honor any requests submitted after the aforesaid time period. 3.4.2 If the contract is terminated prior to the contract end date of June 30, 2019, then the Contractor must submit the final request for payment to the Alliance no more than 45 days after the contract is tenninated, but no later than July 15, 2019. If the Contractor fails to do so, all right to payment is forfeited, and the Alliance will not honor any requests submitted after the aforesaid time period. 3.5 Documentation for Payment The Contractor will maintain documentation to support payment requests that shall be available to the Alliance or authorized individuals, such as the Department of Financial Services, upon request. 3.5.1 The Contractor must require subcontractors to enter all required data per the Department's CIRTS Policy Guidelines for clients and services in the CIRTS database. The data must be entered into the CIRTS before the e, sub - Contractors submit their request for payment and expenditure reports to the Contractor. The Contractor shall establish time frames to assure compliance with due dates for the requests for payment and expenditure reports to the Alliance. CD 3.5.2 The Contractor must require subcontractors to run monthly CIRTS reports and verify client and service data in the u CIRTS is accurate. This report must be submitted to the Contractor with the monthly request for payment and expenditure report and must be reviewed by the Contractor before the subcontractors' request for payment and U expenditure reports can be approved by the Contractor. Q 3.6 Remedies for Nonconforming Services The Contractor shall ensure that all goods and /or services provided under this contract are delivered timely, completely and connmensurate with required standards of quality. Such goods and /or services will only be delivered to eligible program participants. 3.6.1 If the Contractor 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 ineals) and /or services not meeting such standards will not be reimbursed under this contract. The Contractor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and /or services. The Alliance requires immediate notice of any significant and /or systemic infractions that compromise the quality, security or continuity of services to clients. 3.6.2 Financial Consequences of Surplus Contractor shall ensure the provision of services to the projected number of clients in accordance with Alliance's forecasts and within the contract amount. The Contractor shall ensure expenditure of 100% of the contract amount budgeted for services to clients at the unit rates established in this contract. In the event the Contractor has a surplus of 1% or more at the end of the contract tenor, the Alliance will reallocate 1% of the budget for the next year contract term to other lead agencies found to be serving clients to the fullest extent of their allocated budgets. 3.6.3 The Alliance reserves the right to adjust the total award as well as the contracted unit rate to reflect Contractor costs and utilization rates based on active clients enrolled in the program. 3.6.4 The Alliance may withhold payment under the tenors of this contract, pending the receipt and approval by the Alliance of complete and accurate financial and programmatic reports due from the Contractor and any adjustments thereto, including any disallowance not resolved. Page 25 of 61 ATTACHMENT II CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, 'Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub - awards at all tiers (including subcontracts, sub - grants, and contracts under grants, loans and cooperative agreements) and that all sub - 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 and not more than $100,000 for each such failure. Signature Name of Authorized Individual Name and Address of Organization DOEA Form 103 (Revised Nov 2002) Date Application or Agreement Number Page 26 of 61 V FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT III The administration of resources awarded by the Alliance for Aging, Inc. to the Contractor may be subject to audits and /or monitoring by the Alliance or the Florida Department of Elder Affairs, as described in this section. lu to] QIY1111N10Itl In addition to reviews of audits conducted in accordance with OMB Circular A -133, as revised, and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits by the Department of Elder Affairs and Alliance staff, limited scope audits as defined by OMB 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 or the Department of Elder Affairs. In the event the Alliance for Aging, Inc. determines that a limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any additional instructions provided by the Alliance for Aging, Inc. 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 Chief Financial Officer (CFO) or Auditor General. AUDITS PART I: FEDERALLY FUNDED This part is applicable if the Contractor 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 or more in federal awards during its fiscal year, the Contractor must have a single or program- specific audit conducted in accordance with the provisions of OMB Circular A -133, as revised. EXHIBIT 1 to this agreement indicates federal resources awarded through the Department of Elder Affairs and the Alliance by this agreement. In detennining the federal awards expended in its fiscal year, the Contractor shall consider all sources of federal awards, including federal resources received from the Alliance or the Department of Elder Affairs. The determination of amounts of federal awards expended should be in accordance with the guidelines established by OMB Circular A -133, as revised. An audit of the 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 I, paragraph 1, 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 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 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 for Aging, Inc. shall be based on the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Alliance for Aging, Inc. shall be fully disclosed in the audit report with reference to the Alliance for Aging, Inc. agreement involved. If not otherwise disclosed as required by Section 310(b) (2) of OMB Circular A -133, as revised, the schedule of expenditures of federal awards shall identify expenditures by agreement number for each agreement with the Alliance for Aging, Inc. in effect during the audit period. Financial reporting packages required under this part must be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the Contractor's fiscal year end. V Page 27 of 61 PART II: STATE FUNDED This part is applicable if the Contractor is a non -state entity as defined by Section 215.97(2), Florida Statutes. In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of $750,000 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, Florida Statutes; applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance awarded through the Alliance for Aging, Inc. by this agreement. In detennining 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 for Aging, Inc., 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. In connection with the audit requirements addressed in Part II, paragraph 1; the Contractor shall ensure that the audit complies with jZ the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as defined by e, Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General. C' CD If the Contractor expends less than $750,000 in state financial assistance in its fiscal year (for fiscal years ending September 30, 5 2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not required. In the event that the Contractor expends less than $750,000 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit must be paid from the non- U state entity's resources (i.e., the cost of such 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 for Aging, Inc. shall be based on the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Alliance for Aging, Inc. shall be fully disclosed in the audit report with reference to the Alliance for Aging, Inc. agreement involved. If not otherwise disclosed as required by Rule 69I- 5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the Alliance for Aging, Inc. in effect during the audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the audit report, but no later than 12 months after the 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 of this portion, the Alliance and the Department of Elder Affairs retain all right and obligation to monitor and oversee the performance of this agreement as outlined throughout this document and pursuant to law. PART III: REPORT SUBMISSION Copies of reporting packages for audits conducted in accordance with OMB Circular A -133, as revised, and required by PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A -133, as revised, by or on behalf of the Contractor directly to each of the following: The Alliance for Aging, Inc. at each of the following addresses: Alliance for Aging, Inc. Attn: Fiscal Monitor 760 NW 107`" Ave. Suite 214 Miami, FL. 33172 -3155 The Federal Audit Clearinghouse designated in OMB Circular A -133, as revised (the number of copies required by Sections .320 (d) (1) and (2), OMB Circular A -133, as revised, should be submitted to the Federal Audit Clearinghouse), at the following address: Federal Audit Clearinghouse Bureau of the Census 1201 East 10 Street Jeffersonville, IN 47132 Page 28 of 61 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 Contractor shall submit a copy of the reporting package described in Section .320(c), OMB Circular A -133, as revised, and any management letter issued by the auditor, to the Alliance for Aging, Inc. at each of the following addresses: Alliance for Aging, Inc. Attn: Fiscal Monitor 760 NW 107`" Ave. Suite 214 Miami, FL. 33172 -31550 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 for Aging, Inc. at each of the following addresses: Alliance for Aging, Inc. Attn: Fiscal Monitor 760 NW 107`" Ave. Suite 214 Miami, FL. 33172 -3155 The Auditor General's Office at the following address: State of Florida Auditor General Claude Pepper Building, Room 574 111 West Madison Street Tallahassee, Florida 32399 -1450 Any reports, management letter, or other information required to be submitted to the Alliance for Aging, Inc. pursuant to this agreement shall be submitted timely in accordance with OMB Circular A -133, Florida Statutes, and Chapters 10.550 (local goverm entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General, as applicable. Contractors, when submitting financial reporting packages to the Alliance for Aging, Inc. for audits done in accordance with OMB Circular A -133 or Chapters 10.550 (local goverm 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. PART IV: RECORD RETENTION The Contractor shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years from the date the audit report is issued, and shall allow the Alliance for Aging, Inc. or its designee, the CFO or Auditor General Access to such records upon request. The Contractor shall ensure that audit working papers are made available to the Alliance for Aging, Inc., or its designee, the Department or its designee, CFO, or Auditor General upon request for a period of six years from the date the audit report is issued, unless extended in writing by the Alliance for Aging, Inc. V Page 29 of 61 ATTACHMENT III EXHIBIT — 1 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: I PROGRAM TITLE I FUNDING SOURCE I CFDA I AMOUNT TOTAL FEDERAL AWARD COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: MATCHING RESOURCES FOR FEDERAL PROGRAMS I PROGRAM TITLE I FUNDING SOURCE I CFDA I AMOUNT TOTAL STATE AWARD 1 $0 STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97, F.S. PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT Alzheimer Disease Initiative General Revenue 65004 $189,458.40 TOTAL AWARD $189,458.40 COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: State Financial Assistance Section 215.97 F.S. Chapter 691 -5 Fla. Administrative Code V Page 30 of 61 ATTACHMENT III EXHIBIT -2 PART I: AUDIT RELATIONSHIP DETERMINATION Contractors who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A -133, as revised, and /or Section 215.97, Fla. Stat. Contractors who are determined to be recipients or sub - recipients of federal awards and /or state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and /or Part II of Exhibit 1 is met. Contractors who have been detennined to be vendors are not subject to the audit requirements of OMB Circular A -133, as revised, and /or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, Contractors who have been determined to be recipients or sub - recipients of federal awards and /or state financial assistance must comply with applicable programmatic and fiscal compliance requirements. In accordance with Sec. 210 of OMB Circular A -133 and /or Rule 691 - 5.006, FAC, Contractor has been detennined to be: Vendor or exempt entity and not subject to OMB Circular A -133 and /or Section 215.97, F.S. iz X Recipient/sub- recipient subject to OMB Circular A -133 and /or Section 215.97, F.S. e, Exempt organization not subject to 2 CFR Part §200 and /or Section 215.97, F.S. For Federal awards, for - profit organizations e® M are exempt; for state financial assistance projects, public universities, community colleges, district school boards, branches CD of state (Florida) government, and charter schools are exempt. Exempt organizations must comply with all compliance CD requirements set forth within the contract or award document. L NOTE: If a Contractor is determined to be a recipient /sub - recipient of federal and or state financial assistance and has been approved by the Department to subcontract, they must comply with Section 215.97(7), F.S., and Rule 69I- .006(2), FAC [state financial assistance] and Section .400 OMB Circular A -133 [federal awards]. — Q PART II: FISCAL COMPLIANCE REQUIREMENTS FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive federal awards or state matching funds on federal awards and who are detennined to be a sub - recipient must comply with the following fiscal laws, rules and regulations: STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW: 2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Fonnerly OMB Circular A -87)* OMB Circular A -102 — Administrative Requirements OMB Circular A -133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations NON - PROFIT ORGANIZATIONS MUST FOLLOW: 2 CFR Part 230 Cost Principles for Non - Profit Organizations (Fonnerly OMB Circular A -122 — Cost Principles)* 2 CFR Part 215 Administrative Requirements (Fonnerly OMB Circular A -110 — Administrative Requirements) Requirements) OMB Circular A -133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW: 2 CFR Part 220 Cost Principles for Educational Institutions OMB (Fonnerly Circular A -21 — Cost Principles)* 2 CFR Part 215 Administrative Requirements (Fonnerly OMB Circular A -110 — Administrative Requirements) OMB Circular A -133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations *Some federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Page 31 of 61 Circular A -133 Compliance Supplement, Appendix 1. STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a recipient/sub- recipient must comply with the following fiscal laws, rules and regulations: Section 215.97, Fla. Stat. Chapter 69I -5, Fla. Admin. Code State Projects Compliance Supplement Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations V THE REST OF THIS PAGE WAS LEFT BLANK INTENTIONALLY Page 32 of 61 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 inforination, 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 infonnation in accordance with these requirements could result in a return of grant funds that have not been accounted for properly. (2) Management Information Systems used by the 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 iimmediately 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 - Contractors) 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 sub - agreements, sub - grants, 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 (fonnerly OMB Circular A -110). Monroe County Board of County Commissioners, Social Services /In -Home Services 1100 Simonton Street, 2 -257 Key West, FL 33040 Signature Title Name of Authorized Signer (Revised June 2008) Date Page 33 of 61 V 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 is presently debarred, suspended, proposed for debannent, 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. Signature Title Date Monroe County Board of County Commissioners, Social Services /In -Home Services Agency /Organization (Certification signature should be same as Contract signature.) Instructions for Certification 1. The teens "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 detennined that the Provider knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the Department may pursue available remedies, including suspension and /or debannent. 3. The Provider will provide immediate written notice to the Contract Manager if at any time the Provider learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The Provider may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may, but is not required to, check the Excluded Parties List System (EPLS). 4. The Provider will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 5. The Provider agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, detennined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6. If the Provider knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the Department may pursue available remedies, including suspension, and /or debannent. 7. The Provider may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. (Revised June 2008) V Page 34 of 61 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. 11114728-4763) 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. 11111681-1683, 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. 1111 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) 1111 523 and 527 of the Public Health Service Act of 1912 (42 U.S. C. 1111 290 dd -3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. ❑ 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for federal assistance is being made; and 0) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91 -646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of federal participation in purchases. 8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S.C. 11111501-1508 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. 1111 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. 1111 327 -333), regarding labor standards for federally assisted construction sub - agreements. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act V Page 35 of 61 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 S10,000 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. 11111451 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. 11117401 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. 11111721 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. 11470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. ❑ 11469a -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. 11112131 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. 11114801 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 APPLICANT ORGANIZATION TITLE DATE SUBMITTED Monroe County Board of County Commissioners, Social Services /ln- Home Services V Page 36 of 61 ATTACHMENT VII ALZHEIMER'S DISEASE INITIATIVE PROGRAM BUDGET SUMMARY The Alliance shall make payment to the Contractor for provision of services up to a maximum nunber of units of service and at the rate(s) stated below: V Page 37 of 61 Service Maximum Maximum Service to be Provided Unit Rate Units of Dollars Service Case Management $50.51 173 $8,718.19 Respite In- Facility $10.70 11723 $125,438.10 Respite In -Home $24.03 2,301 $55,302.11 TOTAL $189,458.40 V Page 37 of 61 ATTACHMENT VIII ALZHEIMER'S DISEASE INITIATIVE INVOICE REPORT SCHEDULE Report Number Based On Submit to Alliance on this Date 1 July Advance* July 1 2 August Advance* July 1 3 July Expenditure Report August 10 4 August Expenditure Report September 10 5 September Expenditure Report + 1/10 advance reconciliation October 10 6 October Expenditure Report + 1/10 advance reconciliation November 10 7 November Expenditure Report + 1/10 advance reconciliation December 10 8 December Expenditure Report + 1/10 advance reconciliation January 10 9 January Expenditure Report + 1/10 advance reconciliation February 10 10 February Expenditure Report + 1/10 advance reconciliation March 10 11 March Expenditure Report + 1/10 advance reconciliation April 10 12 April Expenditure Report + 1/10 advance reconciliation May 10 13 May Expenditure Report + 1/10 advance reconciliation June 10 14 June Expenditure Report+ 1/10 advance reconciliation July 10 15 Final Expenditure and closeout July 10 Legend: * Advance based on projected cash need. Note 1: All advance payments made to the Contractor shall be returned to the Alliance as follows: One -tenth of the advance payment received shall be reported as an advance recoupment on each Request for Payment, starting with report 45. The adjustment shall be recorded in Part C, Line 1 of the report (Attachment IX). Note 2: Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects funds due back to the Alliance, payment is to accompany the report. V Page 38 of 61 ATTACHMENT IX REQUEST FOR PAYMENT ALZHEIMERS DISEASE INITIATIVE PROGRAM RECIPIENT NAMEADDRESS, PHONE# and FEID# TYPE OF REPORT. This Request Period PSA# A. PAVvIENT REQUEST Report # Regular Supplemental Contract # B METHOD OF PAdv1EI` Contract Period Advance Reimbursement CERTIFICATION I herelaycertifyto the best of my l-mowledge that this request is complete and correct and conforms with the terms and the purposes of the above contract. Prepared by._ Date Approved by. Date: f1} (21 PARTA BUDGET SUMMARY Respite Model Day Care TOTAL 1. Approved C o Wa ct Am o urd $0,00 $0 00 $0 00 2. Previous Funds Received for Contract Period $0,00 $0 00 $0 00 3, Contract Balance {line 1 minus line 2) $0,00 $0.00 $0.00 4. Previous Funds Requested and Not Received for Contract Period $0,00 $o 00 $o 00 5. Contract Balance (line 3 minus line 4) $0,00 $o 00 $o 00 PART B: CONTRACT FUNDS REQUEST 1. Anticipated Cash Needs (1st-2nd month.AttachJustification $0,00 $0 00 $0 00 2, Not E)penditures For Month $0,00 $0 00 $0 00 (DOEA Form 1052 Part B. Line 3) 3, TOTAL $0,00 $0.00 $0.00 PART C. NET FUNDS REQUESTED 1. Less Advance Applied $0,00 $0 00 $0 00 2, Contract Funds are Hereby Requested for (Part B. Line 3 $0,00 $0 00 $0 00 minus Part C. Line 1) List of Services Units/ Rates provided - See attached report. DOER FORM 1062 Page 39 of 61 RECEIPTAND EXPENDITURE REPORT - Fi-f L s+ o'n"c" T 'F I g 'n d - in g .................................................. — IC.fi --- D - -------------------------------------- - 1 F ion, T cr Ic"Ott"T'RA T PIRIC)CI NVJ do-11 0-Ay CIO N " kA(-"l' REK")k i PSAAi El R T I F I CAT I O'N 1 c edify I o the bes', crl my kr-owledge and b� i ef that the re-pQrt. is c, cimpive arvi curTect and al vs 0 1 L-1 I'l - 101 13e p C""n �s l'i o I ort h i rl rh� c n r I If a c FAR A BUL'Yk, f,", Ll I N(,',O PAL k L-C Ad 1`1'S i tcrulki�ceql&, 1, Pet ce-.1 I I G! yF,=-wwihvp [Li I 0' � — Q-1, I St a 1 0 V u rick" 50 ou I 0 110 2 Program lnp7Lwcj S0,00 solo i so I'D 41"D Vdi I 3 Loca6 Ga Whlalch SO 0o £+0 fh ('10 tUl VO I 4 SUBTO 7AL, CASH RECEIPTS t eir,4 hr Kit at Mwch 6 Tea I'At R E GEI r s so ou ono I V PART 8 EXPENDIT1,1RES I Appmved 2 ExpendZwe,= 3 Expendruines .4, PFf cern of Budgei- F-01 �hrs, klepoll� yeaf to bate� ryti d8u4o 1 A(IMMUStrall'.T. S01"WIC&S, s cl, ('10 S0,00 $CH00 ill D I v Al) 1 2 Wr 00 $0 OQ V),OQ 4V 1 V �T) 3 TOT ALEXPENDITUBES Ff IWO Sri 00 so 00 4D I Wl) PARTC r ,'I'THE,RREIVENUEA[�iDE.XPEtADITI.JRES 11 Intefest lit Advance RQc. oupticirl I Program 1 �Pl l 1 Eamod or! xGR AdvajKe S I AD 1 5- 2 RF hji i i ol G R Advwvxe Sp,, (111 clu(jes CC) p@yrl ccl l� cled 3 Cv erlarne S, PARI D CO-PAYMENTS CURRENT WtAl Ill Y EAJR - - (,'p - D AT 1. [it Ca pavillents coflec i,Fol rrac�jroj Purposq. s,n ) Page 40 of 61 ATTACHMENT A Title: Department of Elder Affairs Programs & Services Handbook r CD 04 CD r- Department of Elder Affairs Programs & Services Handbook 0 http: / /www.allianceforaging.org (see Contractors /Program Documents) or http:// elderaffairs .state.fl.its /doea /nois.phu (notices of instructions) U Page 41 of 61 r , STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS ATTACHMENT B PART L• READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE THIS FORM. 1. Briefly describe the geographic area served by the program/facility and the type of service provided: 2. POPULATION OF AREA SERVED. Source of data: Total # % White % Black % Hispanic % Other % Female 3. STAFF CURRENTLY EMPLOYED. Effective date: Total # % White % Black % Hispanic % Other % Female % Disabled N/A ❑ 4. CLIENTS CURRENTLY ENROLLED OR REGISTERED. Effective date: Total # % White % Black % Hispanic % Other % Female % Disabled %Over 40 5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE. Total # % White % Black % Hispanic % Other % Female % Disabled 8. PART IL• USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. 6. Is an Assurance of Compliance on file with DOEA? If N/A or NO, explain. N/A ❑ YES ❑ NO ❑ 7. Compare the staff composition to the population. Is staff representative of the population? If N/A or NO, explain. N/A ❑ YES ❑ NO ❑ 8. Compare the client composition to the population. Are race and sex characteristics representative of the population? If N/A or NO, explain. N/A ❑ YES ❑ NO ❑ 9. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national origin, sex, age, religion or disability? If N/A or NO, explain. N/A ❑ YES ❑ NO ❑ 10. Are all benefits, services and facilities available to applicants and participants in an equally effective manner regardless of race, sex, color, age, national origin, religion or disability? If N/A or NO, explain. N/A ❑ YES ❑ NO ❑ 11. For in- patient services, are room assignments made without regard to race, color, national origin or disability? If N/A or NO, explain. N/A ❑ YES ❑ NO ❑ V i Page 42 of 61 r, Revised August 2010, Page Iof 2 Page 43 of 61 r, 12. Is the program/facility accessible to non - English speaking clients? If N/A or NO, explain. N/A YES NO ❑ ❑ ❑ 13. Are employees, applicants and participants informed of their protection against discrimination? If YES, how? Verbal ❑ Written ❑ Poster ❑ If N/A or NO, explain. N/A YES NO ❑ ❑ ❑ 14. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/facility. N/A NUMBER El 15. Is the program/facility physically accessible to mobility, hearing, and sight - impaired individuals? If Program Office *Notice of Corrective Action Sent r CD Telephone N/A or NO, explain. N/A YES NO ❑ ❑ ❑ CD r� CD U 2 L PART III: THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. 16. Has a self - evaluation been conducted to identify any barriers to serving disabled individuals, and to make any necessary modifications? If NO, explain. YES NO ❑ ❑ Q u L 17. Is there an established grievance procedure that incorporates due process in the resolution of complaints? If NO, explain. YES NO ❑ ❑ CD 18. Hasa person been designated to coordinate Section 504 compliance activities? If NO, explain. YES NO r CD `I ❑ ❑ 19. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of disability? If NO, explain. YES NO U ❑ ❑ W 0 L c 0 20. Are auxiliary aids available to assure accessibility of services to hearing and sight - impaired individuals? If NO, explain. YES NO ❑ ❑ E u PART W: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000.00 OR MORE. 21. Do you have a written affirmative action plan? If NO, explain. YES NO ❑ ❑ ALLIANCE USE ONLY Reviewed By In Compliance: YES ❑ NO* ❑ Program Office *Notice of Corrective Action Sent Date Telephone Response Due On -Site ❑ Desk Review ❑ Response Received Page 44 of 61 r , Revised August 2010, Page 2 of 2 INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST Describe the geographic service area such as a district, county, city or other locality. If the program/facility serves a specific target population such as adolescents, describe the target population. Also, define the type of service provided. Enter the percent of the population served by race and sex. The population served includes persons in the geographical area for which services are provided such as a city, county or other regional area. Population statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census containing Florida population statistics. Include the source of your population statistics. ( "Other" races include Asian/Pacific Islanders and American Indian/Alaskan Natives.) Enter the total number of full -time staff and their percent by race, sex and disability. Include the effective date of your suns nary. 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. 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 detennine the reasons for such variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR 80.3 (b) (6). 9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also through on -site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a) and 45 CFR 80.1 (b) (2). 10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services, physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin, religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied unifonnly and without regard to race, sex, color, national origin, religion, age or disability. Entrances, waiting rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR 80.3 (b). 11. For in- patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national origin or disability. Also, residents must not be asked whether they are willing to share accommodations with persons of a different race, color, national origin, or disability, 45 CFR 80.3 (a). 12. The program/facility and all services must be accessible to participants and applicants, including those persons who may not speak English. In geographic areas where a significant population of non - English speaking people live, program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a V Page 45 of 61 r , 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. Prograins /facilities must make information regarding the nondiscriminatory provisions of Title VI available to their participants, beneficiaries or any other interested parties. This should include information on their right to file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS. The information may be supplied verbally or in writing to every individual, or may be supplied through the use of an equal opportunity policy poster displayed in a public area of the facility, 45 CFR 80.6 (d). 14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color, creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement, termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address of the local, state or federal agency with whom the complaint has been filed. Indicate the current status, e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc. 15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed for accessibility. Elevators should be observed for door width, and Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for mobility impaired individuals. 16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self - evaluation to identify any accessibility barriers. Self - evaluation is a four step process: a. With the assistance of a disabled individual/organization, evaluate current practices and policies which do not comply with Section 504. b. Modify policies and practices that do not meet Section 504 requirements. c. Take remedial steps to eliminate any discrimination that has been identified. d. Maintain self - evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have been followed.), 45 CFR 84.6. 17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited by Section 504.45 CFR 84.7 (b). 18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to comply with Section 504.45 CFR 84.7 (a). 19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads, and other appropriate written comimunication, 45 CFR 84.8 (a). 20. Prograims /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. Prograims /facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and Maintain a written affinnative action compliance program in accordance with Executive Order 11246, 41 CFR 60 and Title VI of the Civil Rights Act of 1964, as amended. DOEA Form 101 -B, Revised August 2010 V Page 46 of 61 r , ATTACHMENT C ADRC OUTSOURCED FUNCTIONS I. Under this Contract, the Contractor agrees to the following: A. Perfonn ADRC outsourced functions in accordance with policies and procedures developed by the Alliance for Aging. Refer to the following attachments: i. Attachment C EXHIBIT 1: Policies and Procedures for Outsourced Function- Screening ii. Attachment C EXHIBIT 2 Policies and Procedures for Outsourced Function- Tennination from Waitlist -Client Services iii. Attachment C EXHIBIT 3: Policies and Procedures for Triage iv. Attachment C EXHIBIT 4 Policies and Procedures for Activation from Waitlist- Client Services r CD B. Maintain wait lists in CIRTS in accordance with DOEA requirements. e® C. Report number of client contacts to the Aging Resource Center. CD D. Adhere to prioritization policy as set forth by the Department of Elder Affairs. C ° E. Update the agency Disaster Plan to incorporate ADRC outsourced functions. s F. Ensure against conflicts of interest and inappropriate self - referrals by referring consumers in need of Y options counseling or long -term care services beyond the Contractor's scope of services to the Aging Resource Center. U 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 Contractors of registered services for Alzheimer's Disease Initiative (ADI), Older American's Act (OAA), and Contracted Services (CS) Maintain waiting lists in the CIRTS database for registered services when funding is not available. Note: OAA3E is an exempt funding source for ADRC Wait List purposes. For services provided through OAA3E, no CIRTS client data entry is required. Registered Services for the above listed programs are as follows: Adult Day Care (ADC), Adult Day Health Care (ADHC), Chore (CHO), Escort (ESC), Home Health Aide (HHA), Homemaker (HMK), Model Day Care (MDC), Personal Care (PECA), Facility -Based Respite (RESF), In -Home Respite (RESP). Page 47 of 61 r , ATTACHMENT C Exhibit 1 Alliance for Aging, Inc. Aging & Disability Resource Center /Elder Helpline Policy and Procedure for Outsourced function - Screening Creation Date: March 5, 2008 Revision Date: May 2017 Review Date: April 2014 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 registered services funded through ADI, OAA, and LSP programs. Procedure: 1. ADRC Contracted Contractors will collect information from callers and conduct a 701 S assessment. Alternatively, if a 701A(B) assessment already exists or is provided from another source (i.e. CARES) the information from the 701B can be utilized. 2. Based on the information provided via the 701A(B) assessment, the ADRC Contracted Contractor will make a detennination as to the services that the caller is in need of receiving. 3. The ADRC Contracted Contractor will determine the appropriate funding 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 Contractor, the ADRC Contracted Contractor will refer caller to the ADRC Elder Helpline utilizing the ADRC Referral Form and /or to an ADRC Contracted Contractor 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. 6. The caller will be informed of the services and funding sources that they are being placed on the wait list for in CIRTS. 7. For non -case managed programs, the, ADRC Contracted Contractor will create a client record in CIRTS (if there is no existing record) and enter the services needed for the caller by funding source and service. [If there is an existing record in CIRTS, the appropriate fields will be updated]. 8. If the ADRC Contracted Contractor detennines that the caller may qualify for more than one program for which the Contractor is funded, ADRC Contracted Contractor 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 infonmation]. 9. ADRC Contracted Contractor will inform caller that they will receive an annual re- assessment based on DOEA Wait List Reassessment Standards and encourage caller to contact the ADRC Elder Helpline with any questions. V Page 48 of 61 r , ATTACHMENT C Exhibit 2 Alliance for Aging, Inc. Aging & Disability Resource Center /Elder Helpline Policy and Procedure for Termination From Wait List — Clients /Services Creation Date: March 5, 2008 Revision Date: February 2013 Review Date: May 2017 Objective: To ensure that the comprehensive list of clients in need of services in CIRTS is appropriately maintained by funding 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 Contractors. Procedure: 1. ADRC Contracted Contractor will re- screen clients which the ADRC Contracted Contractor 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 Contractor 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 Contractor will terminate the client from the wait list (entirely or by specific service) using the appropriate CIRTS termination code for any services or funding source for which the client is determined to no longer be eligible for or no longer in need of. 5. ADRC Contracted Contractor will inform the client of any services /funding source that they are being removed from the wait list for. 6. ADRC Contracted Contractor will inform client of their ability to be re -added to the wait list if their level of need should change. 7. ADRC Contracted Contractor will inform client to contact the ADRC Elder Helpline if they have any questions or concerns regarding their wait list status. 8. Reference DOEA Notice of Instruction: Assessed Priority Consumer List#:062906- 1- I -OVCS as applicable. V Page 49 of 61 r , ATTACHMENT C Exhibit 3 Alliance for Aging, Inc. Aging & Disability Resource Center /Elder Helpline Policy and Procedure for Outsourced function - Triage Creation Date: March 5, 2008 Revision Date: May 2017 Review Date: April 2014 Objective: To ensure that clients in need of DOEA funded services receive services based on the highest level of need, first, as funding becomes available. Policy: To assist clients in obtaining DOEA funded services as funding becomes available, based on level of need as detennined by a CIRTS priority score. Procedure: 1. ADRC Contracted Contractor will conduct annual reassessments based on DOEA Wait List Reassessment Standards. If there is no current 701A or B in CIRTS, the Contractor will conduct the annual reassessment (701 S) as appropriate. Based on the information provided via the 701 S /A(B) assessment, the ADRC Contracted Contractor will update the client information in CIRTS specifically as it pertains to level of need for services by funding source The ADRC Contracted Contractor will ensure that the CIRTS prioritization score is accurately maintained, according to DOEA Standards. If a significant change has occurred prior to the annual re- screening, the Contracted Contractor must re- screen. Definitions and examples of significant change are documented in the DOEA Programs & Services Manual Chapter 2. 4. If the caller is in need of a service(s) that is not provided by the ADRC Contracted Contractor, the ADRC Contracted Contractor will refer caller to the ADRC Elder Helpline utilizing the ADRC Referral Foram and /or to an ADRC Contracted Contractor that provides the needed service. The caller will be informed of the services and funding sources that they remain on the wait list for and /or have been removed from the wait list for. ADRC Contracted Contractor will remind client of the ADRC Elder Help Line contact number and to contact the ADRC Elder Help Line with any questions or concerns. As funding becomes available, ADRC Contracted Contractor will run CIRTS Prioritization Report and activate clients according to DOEA Standards (refer to ADRC Client Activation Policies and Procedures). The Contracted Contractor will apply targeting criteria, as appropriate, to prioritized clients to ensure activations meet prograimmatic requirements. V Page 50 of 61 r , ATTACHMENT C Exhibit 4 Alliance for Aging, Inc. Aging & Disability Resource Center /Elder Helpline Policy and Procedure for Activation From Wait List — Clients /Services Creation Date: March 5, 2008 Revision Date: February 2013 Review Date: May 2017 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 Contractors to ensure that clients waiting for DOEA funded services begin to receive those services as funding becomes available. Procedure: 1. ADRC Contracted Contractor will activate clients on CIRTS wait list based on DOEA prioritization polices and funding availability. 2. ADRC Contracted Contractor will update CIRTS status by funding 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 funding source than the one being activated if ADRC Contracted Contractor 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 Contractor under a temporary non -DOEA funding source and ADRC Contracted Contractor determines that the clients need will persist after the temporary funding source is exhausted. 5. ADRC Contracted Contractor will inform the client of any services /funding source that they are being activated for as well as those services and funding sources that they will continue to be wait listed for. 6. ADRC Contracted Contractor will inform client to contact the ADRC Elder Helpline if they have any questions or concerns regarding the status of any of their services. V Page 51 of 61 r , ATTACHMENT E Alliance for Aging, Inc. Business Associate Agreement This Business Associate Agreement is dated , 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)(2010) (as may apply) and contained in this agreement. 1.5 The Health Information Technology for Economic and Clinical Health Act (2009), the American Recovery and Reinvestment Act (2009) and Part I — Improved Privacy Provisions and Security provisions located at 42 United States Code (U.S.C.) §§ 17931 and 17934 (2010) require business associates of covered entities to comply with the HIPAA Security Rule, as set forth in, but not limited to 45 C.F.R. §§ 164.308, 164.310, 164.312, and 164.316 (2009) and such sections shall apply to a business associate of a covered entity in the same manner that such sections apply to the covered entity. The parties therefore agree as follows: 2.0 Definitions. For purposes of this agreement, the following definitions apply: 2.1 Access. The ability or the means necessary to read, write, modify, or communicate data/inforination or otherwise use any system resource. 2.2 Administrative Safeguards. The administrative actions, and policies and procedures, to manage the selection, development, implementation, and maintenance of security measures to protect electronic Protected Health Information (ePHI) and to manage the conduct of the covered entity's workforce in relation to the protection of that information. 2.3 ARRA. The American Recovery and Reinvestment Act (2009) 2.4 Authentication. The corroboration that a person is the one claimed. 2.5 Availability. The property that data or information is accessible and useable upon demand by an authorized person. 2.6 Breach. The unauthorized acquisition, access, use, or disclosure of PHI which compromises the security or privacy of such information. 2.7 Compromises the Security. Posing a significant risk of financial, reputational, or other harm to individuals. V Page 52 of 61 r , 2.8 Confidentiality. The property that data or information is not made available or disclosed to unauthorized persons or processes. 2.9 Electronic Protected Health Information.(ePHI) Health information as specified in 45 CFR §160.103(1)(i) or (1)(ii), limited to the information created or received by Business Associate from or on behalf of Covered Entity. 2.10 HITECH. The Health Information Technology for Economic and Clinical Health Act (2009) 2.11 Information System. An interconnected set of information resources under the same direct management control that shares coininon functionality. A system nonnally includes hardware, software, information, data, applications, coininunications, and people. 2.12 Integrity. The property that data or information have not been altered or destroyed in an unauthorized manner 2.13 Malicious software. Software, for example, a virus, designed to damage or disrupts a system. 2.14 Part I. Part I — Improved Privacy Provisions and Security provisions located at 42 United States Code (U.S.C.) §§ 17931 and 17934 (2010). 2.15 Password. Confidential authentication information composed of a string of characters. 2.16 Physical Safeguards. The physical measures, policies, and procedures to protect a covered entity's electronic information systems and related buildings and equipment, from natural and environmental hazards, and unauthorized intrusion. 2.17 Privacy Rule. The Standards for Privacy of Individually Identifiable Health Information at 45 CFR Part 160 and Part 164, subparts A and E. 2.18 Protected Health Information. (PHI) Health information as defined in 45 CFR §160.103, limited to the information created or received by Business Associate from or on behalf of Covered Entity. 2.19 Required By Law. Has the same meaning as the term "required by law" in 45 CFR § 164.103. 2.20 Secretary. The Secretary of the Department of Health and Human Services or his or her designee. 2.21 Security incident. The attempted or successful unauthorized access, use, disclosure, modification, or destruction of information or interference with system operations in an information system. 2.22 Security or Security measures. All of the administrative, physical, and technical safeguards in an information system. 2.23 Security Rule. The Security Standards for the protection of Electronic Protected Health Information at 45 CFR part 164, subpart C, and amendments thereto. 2.24 Technical Safeguards. The technology and the policy and procedures for its use that protect electronic protected health information and control access to it. 2.25 Unsecured PHI. Protected health information that is not secured through the use of technology or methodology specified by the Secretary in guidance issued under 42 U.S.C. section 17932(h)(2). 2.26 All other terms used, but not otherwise defined, in this Agreement shall have the same meaning as those teams in the Privacy Rule. 3.0. Obligations and Activities of Business Associate. V Page 53 of 61 r , 3.1 Business Associate agrees to not use or disclose PHI other than as penmitted 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 including the Administrative Safeguards, Physical Safeguards, Technical Safeguards, and policies and procedures and documentation requirements set forth in 45 CFR §§ 164.308, 164.310, 164.312, and 164.316. 3.3 Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Business Associate of a use or disclosure of PHI by Business Associate in violation of the requirements of this Agreement. 3.4 Business Associate agrees to promptly report to Covered Entity any use or disclosure of the PHI not provided for by this Agreement of which it becomes aware. This includes any requests for inspection, copying or amendment of such information and including any security incident involving PHI. 3.5 Business Associate agrees to notify Covered Entity without unreasonable delay of any security breach pertaining to: (a) Identification of any individual whose unsecured PHI has been, or is reasonably believed by the Business Associate to have been, accessed, acquired, or disclosed during such security breach; and (b) All information required for the Notice to the Secretary of HHS of Breach of Unsecured Protected Health Information. 3.6 Business Associate agrees to ensure that any agent, including a subcontractor, to whom it provides PHI received from, or created or received by Business Associate on behalf of Covered Entity, agrees to the same restrictions and conditions that apply through this Agreement to Business Associate with respect to such information. 3.7 If Business Associate has PHI in a Designated Record Set: (a) Business Associate agrees to provide access, at the request of Covered Entity during regular business hours, to PHI in a Designated Record Set, to Covered Entity or, as directed by Covered Entity, to an individual in order to meet the requirements under 45 CFR § 164.524; and (b) Business Associate agrees to make any aimendiment(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 detenmining 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. V Page 54 of 61 r , 3.10 Business Associate agrees to provide to Covered Entity or an individual, upon request, information collected to permit Covered Entity to respond to a request by an Individual for an accounting of disclosures of PHI in accordance with 45 CFR § 164.528 and ARRA § 13404. 3.11 Business Associate specifically agrees to use security measures that reasonably and appropriately protect the confidentiality, integrity, and availability of PHI in electronic or any other form, that it creates, receives, maintains, or transmits on behalf of the Covered Entity. 3.12 Business Associate agrees to implement security measures to secure passwords used to access ePHI that it accesses, maintains, or transmits as part of this Agreement from malicious software and other man-made and natural vulnerabilities to assure the availability, integrity, and confidentiality of such information. 3.13 Business Associate agrees to implement security measures to safeguard ePHI that it accesses, maintains, or transmits as part of this agreement from malicious software and other man-made and natural vulnerabilities to assure the availability, integrity, and confidentiality of such information. 3.14 Business Associate agrees to comply with: (a) ARRA § 13404 (Application of Knowledge Elements Associated with Contracts); (b) ARRA § 13405 (Restrictions on Certain Disclosures and Sales of Health Inforimation); and (c) ARRA § 13406 (Conditions on Certain Contacts as Part of Health Care Operations). 4.0 Permitted Uses and Disclosures by Business Associate. Except as otherwise limited in this Agreement or any related agreement, Business Associate may use or disclose PHI to perform functions, activities, or services for, or on behalf of, Covered Entity as specified in any and all contracts with Covered Entity provided that such use or disclosure would not violate the Privacy Rule if done by Covered Entity or the minimum necessary policies and procedures of the Covered Entity. 5.0 Specific Use and Disclosure Provisions. 5.1 Except as otherwise limited in this agreement or any related agreement, Business Associate may use PHI for the proper management and administration of the Business Associate or to carry out the legal responsibilities of the Business Associate. 5.2 Except as otherwise limited in this agreement or any related agreement, Business Associate may disclose PHI for the proper management and administration of the Business Associate, provided that disclosures are Required By Law, or Business Associate obtains reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as Required By Law or for the purpose for which it was disclosed to the person, and the person notifies the Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached. 5.3 Business Associate may use PHI to provide data aggregation services to Covered Entity as permitted by 45 CFR § 164.504(e)(2)(i)(B), only when specifically authorized by Covered Entity. 5.4 Business Associate may use PHI to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR §164.5020)(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.allianceforagingM V Page 55 of 61 r , 7.0 O 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. 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 pennissible under the Privacy Rule if done by Covered Entity. 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: 8.2 8.3 9.0 (a) These Business Associate Agreement provisions, with the exception of the electronic security provisions and the provisions mandated by ARRA, HITECH and Part I shall be effective upon the later of April 14, 2003, or the effective date of the earliest contract entered into between Business Associate and Covered Entity that involves the use of PHI; (b) The electronic security provisions hereof shall be effective the later of April 21, 2005 or the effective date of the earliest contract entered into between Business Associate and Covered Entity that involves the use of PHI; and (c) Provisions hereof mandated by ARRA, HITECH and /or Part I shall be effective the later of February 17, 2010 or the effective date of the earliest contract entered into between covered entity and business associate that involves the use of PHI or ePHI. 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) hmimediately terminate this agreement if Business Associate has breached a material tenor of this Agreement and cure is not possible; or (c) If neither tenmination nor cure is feasible, Covered Entity shall report the violation to the Secretary. Effect of Termination. Except as provided in subparagraph (b) of this section, upon tenmination of this agreement, for any reason, Business Associate shall return all PHI and ePHI received from Covered Entity, or created or received by Business Associate on behalf of Covered Entity. (a) This provision shall apply to PHI and ePHI that is in the possession of subcontractors or agents of Business Associate. Business Associate shall retain no copies of the PHI and ePHI. (b) In the event that Business Associate or Covered Entity determines that returning the PHI or ePHI is infeasible, notification of the conditions that make return of PHI or ePHI infeasible shall be provided to the other party. Business Associate shall extend the protections of this Agreement to such retained PHI and ePHI and limit further uses and disclosures of such retained PHI and ePHI, for a minimum of six years and so long as Business Associate maintains such PHI and ePHI, but no less than six (6) years after the termination of this agreement. 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. V Page 56 of 61 r , 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 ternination of this agreement shall remain enforceable against such party subsequent to such ternination. 12.0 Interpretation. Any ambiguity in this agreement shall be resolved to pen 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 -Home Services 1100 Simonton Street, 2 -257 Key West, FL 33040 Any such notice shall be deemed delivered upon actual receipt. If any notice cannot be delivered or delivery thereof is refused, delivery will be deemed to have occurred on the date such delivery was attempted. 15.0 Governing Law. The laws of the State of Florida, without giving effect to principles of conflict of laws, govern all matters arising under this agreement. 16.0 Severability. If any provision in this agreement is unenforceable to any extent, the remainder of this agreement, or application of that provision to any persons or circumstances other than those as to which it is held unenforceable, will not be affected by that unenforceability and will be enforceable to the fullest extent pernitted 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 perforn 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. am (signature) Date: V Page 57 of 61 r , Business Associate: Monroe County Board of County Commissioners, Social Services /In -Home Services 'I (signature) Date: Page 58 of 61 r , ATTACHMENT F Verification of Employment Status Certification As a condition of contracting with the Alliance for Aging, Inc., hereby referred to as contractor, certifies the use of the U.S. Department of Homeland Security's E- verify system to verify the employment eligibility of all new employees hired by Contractor during the contract terra 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 terra. Signature (Same as contract signature) Date Title V Page 59 of 61 ATTACHMENT G BACRGROIRDSCREEMAG FLI)FR AVVA ;71 Affidavit of Compliance - Employer AUTHORFTY: This form is required ainnuaft of all ernpici to comply with the attestation requirements set forth iin section 435-0613), Florida Statutes- )0- The term "employer' means •any person or entity required by law to conduct bac4T ' Tound screening- indWirigbutnot lirniftedta, Area Agencie.son, Aging/ AgingViand Disai Resource Centers, Lead Agencies and service Providers that contract directly or indirectly vArth the DepairtUMMI of EI&T Affairs (DoEA), and any other person or ef which hiresemployees or has volunteers in service who meet the definition of a direct service provider- -lee M 435-02, 430. x, Fla. Mt. )0 A direct service provider is 'a person is years of age or cider who, pursuant to a program to proMe services to the elderly, has direct„ face-to-face contact with a client while providing services to the client and has access to the cileniffs living area, ftnds, perscinal; property,, or personal identification information as defined ins. 817.315 ,9v The term micludesroordinattirs, managers, and supervisors of residential facilities; and vic4unteers.' § 430.&W2(1)(b), F13. Mt. ATTIESTATION: As the duly authorized representative of Err Pfoy- N'ff— located at stmerAddress 6 TY sture OP code I do here by affirmi under pena Ity of perjury Name GfRepre-zefltubve that the above named emooyer is in compliance with the provisions of Chapter 435 and section 430-0402, Ficwida Statutes.. regarding level 2 background screening.. Signature of Representative STATE OF FLORIDA, COUNTY OF [on Sworn to Jor affirmed) and subscribed before me this day of 20 ------- I (Naime of Representative) who is personally known to me or produced as proof of idea tification- Frfnt Tpe, err Stmimp Carnmizioned Name of Notary Public Notary Public aoEA FDr,-n z35, Arficinft at Campianm - Empli Erfetthm Smft nber 21, Z017 5'I4311JDN,31, F.S. Page 60 of 61 r , ATTACHMENT H CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is an attachment, hereby certifies that: (1) The Contractor understands that pursuant to s. 287.135 F.S., any company at the time of bidding or submitting a proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized Companies with Activities in Sudan Lisf' or the "Scrutinized Companies with Activities in the Iran Petroleum Sector List (collectively, "the Lists ") is ineligible for, and may not bid on, submit a proposal for, or enter into or renew a contract pursuant to which funding is provided by the Department of Elder Affairs (Department) for goods or services of $1 million or more. (2) The Contractor understands that, pursuant to s. 287.135 F.S., any company that submits a false certification is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification. (3) The Contractor understands that the contract to which this form is an attachment may be terminated by the Alliance for Aging, Inc. if the Contractor submits a false certification or has been placed on the Lists. This certification, required by Florida law, is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction. Signature (Same as contract signature) Title Company Name Date V Page 61 of 61 BULK ITEM: Yes DEPARTMENT: Social Services TIME APPROXIMATE: STAFF CONTACT: Sheryl Graham (305) 292-4510 N/A CD N AGENDA ITEM WORDING: Approval of Amendment #001 to Alzheimer's Disease Initiative M CD (ADI) Program Contract KZ-1797 between the Alliance for Aging, Inc., (AAA) and Monroe Count 9 y rl- CD BOCC/Social Services /In -home Services for the contract year 2017-2018 in the amount of $189,458.40. This amendment increases funding by $24, 810.60. 0 ITEM BACKGROUND: Approval of the ADI contract will enable Monroe County Social Services/In-home Services program to continue providing personal services to Monroe County's elderly population under the Alzheimer's Disease Initiative Program. PREVIOUS RELEVANT BOCC ACTION: BOCC approval on 7/19/2017 of ADI Contract KZ- 1797 between the AAA and Monroe County BOCC. 0 CONTRACT/AGREEMENT CHANGES: Funding Increase STAFF RECOMMENDATION: Approval E DOCUMENTATION: ADI Amendment #001 01 -02-1 < ADI BACKUP pt. 1 1-02-2018 ADI BACKUP pt. 2 1-02-2018 FINANCIAL IMPACT: Effective Date: 01/17/2018 Expiration Date: 06/30/2018 Total Dollar Value of Contract: $189,458.40 Total Cost to County: 10% cash match Current Year Portion: Budgeted: Source of Funds: Grant CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: Yes If yes, amount: $4,000.00 Grant: Yes CountyMatch: 10% Cash Match Insurance Required: No Krorilffro M4, =111121 01/17/18 NEW COST CENTER ADDED 125-6153617 FROKINIT Sheryl Graham Completed 12/19/2017 3:02 PM Pedro Mercado Completed 12/19/2017 3:19 PM Budget and Finance Completed 12/28/2017 9:31 AM Maria Slavik Completed 12/28/2017 9:49 AM Kathy Peters Completed 12/28/2017 9:50 AM Board of County Commissioners Completed 01/17/2018 9:00 AM C.21.c AMENDMENT001[7j -1797 ,NTRACT KZ THIS AMENDMENT is entered into between the Alliance of Aging, Inc. hereinafter referred to as tha "Alliance", and Monroe County Board of county Commissioners, Social Services/In-Home Sei s S'4, referred to as the "contractor" and collectively referred to as the "Parties," The purpose of this amendment is to make the following changes to the existing ADI Contract for fiscal year July 01, 2017 - June 30, 2018. These funds These funds are recurring. "UMMUM "M77&Z?ff Zm7ai'"M&W& Increase Case Management by: Increase Respite In-Facility by: Increase Respite In-Home by: Total Increase This amendmeTterai A-.t $1,141.69 $16,426.80 $7,242.11 $24,810.60 — $164,647.80 to $189,458.40 Service to be Provided Service Maximum Units of Service Maximum Increase / Unit Rate Prior Units (Decrease) Total Dollars Case Management 50.51 — 150 — 23 173 $8,718.19 Respite In- Facility V $ 10.70 - 10,188 1,535 11,723 $125,438.10. Respite In-Home $ 24.03 1,000 301 2,301 $55,302.111 Total Contract Amount 18�9,458_4�0 � All provisions in the contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the contract. This amendment and all its attachments are hereby made a part of the contract. IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be executed by their undersigned officials as duly authorized. mm�* T % SIGNED BY: ZM3 PFATIII� SIGNED BY: if FI - President & CEO F F B 011 7 2