07/18/2018 Agreement
DATE: July 31, 2018
TO: Sheryl Graham, Director
Social Services
FROM: Pamela G. Hancock, D.C.
SUBJECT: July 18th BOCC Meeting
Attached are three duplicate originals of Item C21, 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
for your
contract year 2018-2019 (07/01/2018- 06/30/2019) in the amount of $189,458.40,
handling.
Should you have any questions, please feel free to contact me at ext. 3550. Thank you.
cc: County Attorney
Finance
File
Contract Number KZ 1897
ALZHEIMER'S DISEASE INITIATIVE CONTRACT !NAL
5 2018 -2019 Fiscal Year a 1
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 performed 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 terms 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 perform 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 terms 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. P .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:
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KZ 1297
Program Title Year Funding Source CSFA# Fund Amounts
Alzheimer Disease 2018- General Revenue 65004 $189,458.40
Initiative 2019
TOTAL FUNDS CONTAINED IN THIS CONTRACT: $189,458.40
5. 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 determined by the Alliance and the availability of funds. Any renewal of a contract
shall be subject to mutual agreement, confirmed in writing, and subject to the same terms 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 #092815 -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, performed 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.
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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 terminate 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:i!elderaffairs. state.11.usidoea backgroundscreenins.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 termination, 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 termination, suspension or reduction in services that require the grievance process as described in
Appendix D, Department of Elder Affairs Programs and Services Handbook. The complaint procedures shall include
notification to all clients of the complaint procedure and include tracking the date, nature of the complaint and the
determination 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
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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 119.07(1), 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
doeapublicrecords @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 performance 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 form 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 immediately 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 performing 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.
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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
Information 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, termination 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 terms 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 norms set down by the Department, the Alliance will track performance 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 permit 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
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performance 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,
neglect or omission, action in bad faith, or violation of federal or state law by the Contractor, its agents, employees, or sub-
Contractors during the performance 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
of the Alliance.
15.1 Except to the extent permitted 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
determining 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 determination 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 term of this contract, the Contractor must maintain an insurance bond from a responsible commercial
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
determined by the insurance company and consistent with good business practices.
17. Confidentiality 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 Portability and Accountability 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 immediately 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
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services required to be performed 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 immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child,
aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number (1-800 -
96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon both the Contractor and its
employees.
20. Bankruptcy Notification
During the term of this contract, the Contractor shall immediately 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 Publicity
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 performed 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 commodities 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
programmatic monitoring to ensure contractual compliance, fiscal accountability, programmatic performance and
compliance with applicable state and federal laws and regulations. The Contractor shall monitor to ensure that time
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schedules are met, the budget and scope of work are accomplished within the specified time periods, and other
performance 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 performing any duties or functions within this contract have the
qualifications as specified in the DOEA Programs and Services Handbook
24. Service Cost Reports and Unit Cost Methodology Reports:
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, with the inclusion of a Unit Cost Methodology, in accordance with the Alliance's approved Reimbursement Rate
Review Policy, which is incorporated by reference.
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 performance rendered unless such costs and
performances are strictly in accordance with the terns 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 terms 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 terms and conditions of the contract, unless the bid specifications, purchase order, or this contract specify otherwise.
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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 691- 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_guide /).
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
applicable, and that administrative expenses do not exceed amounts budgeted in the Contractor's approved service
application.
The Contractor will certify that detailed documentation is available to support each item on the itemized invoice or
payment request for cost reimbursed expenses, fixed rate or deliverables contracts or agreements incorporating this
Contract by reference, including paid 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
in the laws and guiding circulars cited in this Contract, in the Reference Guide for State Expenditures, and any other laws
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.
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 immediately 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
performance 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 terminated 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 Policy
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.
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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 firm 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.
32. Public Entity Crime
Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a conviction for a
public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity;
may not submit a bid, proposal, or reply on a contract with a public entity for the construction or repair of a public building or
public work; may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or
perform work as a Contractor, supplier, 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 immediately. 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 summarizing 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, Copyrights, Royalties
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 performed 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.
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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 terms 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
performance 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 Form is hereby incorporated by reference and available at:
http:i'!www.mvt lorida.com /appsivbs /adoc!F7740 _PURI000,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 Form. However, if the conflicting terms or conditions in the
PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained in the PUR 1000 Form
shall take precedence.
38. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon the 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 Mlanazer, 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 performed 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 -
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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, I% 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, I% 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 1 Ith 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 Consequences of Non- Performance
If the Contractor fails to meet the minimum level of service or performance identified in this agreement, or that is customary for
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,
tendering only partial payments, and /or cancellation of contract and reacquiring services from an alternate source.
The Alliance will withhold or reduce payment if the Contractor fails to perform the deliverables to the satisfaction of the
Contract according to the requirements referenced in ATTACHMENT I, 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 performance criteria as
outlined in ATTACHMENT I, Section II of this contract.
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 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
ATTACHivIENTS 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) Performance Specifications as referenced in ATTACHMENT I, Section II, 2.6 of this contract — Failure to perform the
performance 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 perform arises out of causes that were
the responsibility of the Alliance.
41.2 No Waiver of Sovereign Immunity
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
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 terms 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 Majeure
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control, provided the
party experiencing the force majeure condition provides immediate written notification to the other party and takes all
reasonable efforts to cure the condition.
• Page 12 of 61
46. Severability Clause
The Parties agree that if a court of competent jurisdiction deems any tern 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.
49. Waiver
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
waiver of the Alliance's right thereafter to enforce those rights, nor will any single or partial exercise of any such right preclude
any other or further exercise thereof or the exercise of any other right.
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
deemed an event of default of the Contractor, and subject the contract to immediate, 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 1. 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) terminate 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 terminated by either party without cause upon no less than thirty
(30) calendar days' notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said
notice shall be delivered by U.S. Postal Service 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
termination, 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.
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54.2 Termination for Cause. The Alliance may terminate this contract if the Contractor fails to (I) deliver the product within
the time specified in the contract or any extension, (2) maintain adequate progress, thus endangering performance 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 termination 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 terminated. 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
determined 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 Signature
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 form
with an electronic signature must indicate the person and the person's capacity who electronically signed the document
on any non - electronic copy of the document.
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
governmental 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
governmental 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
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.,!''.,rC's i.. 1. E v €! #:3e 1'x. i897
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
committed or repeated violations of Department standards;
d. The Contractor has failed to continue the provision or expansion of services after the declaration of a
state of emergency; and /or
e. The Contractor has failed to adhere to the terms of this contract.
f. The Contractor consistently misses performance measure targets, or does not demonstrate to the
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
DOEA Programs and Services Handbook or efficiently managed program budgets.
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 immediate 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,
imposing a moratorium on Contractor action, imposing financial penalties for nonperformance, or
other administrative action
j. In making any determination under this provision the Alliance may rely upon the findings of another
state or federal agency, or other regulatory body. Any claims for damages for breach of any contract or
agreement incorporating this Contract by reference are exempt from administrative proceedings and
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 format 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 finding 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 Payee and Representatives:
The name, address, and telephone number of the representative for the Alliance for this contract is:
Max B. Rothman, JD, LL.MI. 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:
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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 /In - Home Services
whom 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 /In -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 /In -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
e The name, address, and telephone number of the Alliance for Aging, Inc.
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.
Page 16 of 61
Cone acs Nu ritil €i,' 1397
Monroe County Board of County
Commissioners, Social Services /In -Home
Contractor: Services
ALLIANCE FOR AGING, INC.
SIGNED BY: / / SIGNED BY A4. k7...�
NAME: (" NAME: MAX B. ROTHMAN, JD, LL.M.
TITLE: County . T
AND CEO
Actin Coun Administrator
TITLE: PRESIDENT ENT
DATE: 6p\a 1 \ro`O\ DATE: r - v . 2 ?`r` r;
Wr
r
SIGNED BY:
NAME. ' D i t t LE
TITLE:. MPNOX,
DATE: fig, '2-o i 7
G , � - Ati ! a y .. .
f is y: ..; TviN FJiA :'w/ , CLERK CD CO ,
oOra$ MOOT LO ,�,��nn • / � yl
DEPU CLERK n `-"1.:
�-, : ► co., cam,
MONROE COUNTY ATTORNEY
APFIROVED AS T TO:___
^
CYNTHIA L. HALL
ASSISTANT COUNTY ATTORNEY
Date G - . 01,:3- '01 -0 I
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
•
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ATTACHMENT I
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)
Community Care for Disabled Adults (CCDA)
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 Community Care for Disabled Adults (CCDA) 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 performance 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 701 B 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
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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 58D -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 programmatic, 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 -term 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 performance of its Sub - Contractors,
the following tasks:
2.1.1 Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine 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 community;
b. Individuals in nursing homes whose Medicare coverage is exhausted and may be diverted to the community;
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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
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:
a. Caregiver Training /Support;
b. Case Aide;
c. Case Management;
d. Counseling (Gerontological);
e. Counseling (Mental Health /Screening);
f. Education /Training;
g. Intake;
h. Model Day Care;
i. Respite (Facility- Based);
j. Respite (In- Home); and
k. Specialized Medical Equipment, Services, and Supplies.
Caregivers benefit from receiving training, respite and related support services to assist them 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 information
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 information 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 performed by MDCs. The Contractor shall submit 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 normal business hours. Normal business hours are defined as Monday through
Friday, 8:OOam to 5:OOpm.
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.
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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 format 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 performed 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
"Enforcement" clause of this agreement in ATTACHMENT I, Section 2.7, including delaying or withholding
payment until the problem is corrected.
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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.
d. Establish procedures for handling complaints concerning adverse actions such as termination,
suspension, or reduction in services, as per Section of of the Contract.
e. Conduct client satisfaction surveys to evaluate and improve service delivery.
f. Monitor and evaluate subcontractors and vendors for programmatic and fiscal compliance.
2.6.2 The performance 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
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 determined 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 terms 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 Improvement 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
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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 affirms 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 performance 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:
a. Desk reviews and analytical reviews;
b. Scheduled, unscheduled and follow -up on -site visits;
c. Client visits;
d. Review of independent auditor's reports;
e. Review of third -party documents and /or evaluation;
f. Review of progress reports;
g. Review of customer satisfaction surveys;
h. Agreed -upon procedures review by an external auditor or consultant;
i. Limited -scope reviews; and
j. Other procedures as deemed necessary.
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 forms 106Z and 105Z, included as
ATTACHMENTS IX and X. Duplication or replication of both forms via data processing equipment is permissible,
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.
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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 terminated, 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
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.
3.5.2 The Contractor must require subcontractors to run monthly CIRTS reports and verify client and service data in the
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
expenditure reports can be approved by the Contractor.
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
commensurate 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 meals) 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 term, 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 terms 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.
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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 Tess than.
$10,000 and not more than $100,000 for each such failure.:
(9\1\ \
Signature ate
SkIeN ( izAit K . l (6q i
Name of Autho ized Individual Application or Agreement Number
M t feces an 4y ((3OCC S Sit Mc s
a
Name and Address of Organization
9too Sir —fr f Sfee --�'
U.SQc+- 30
DOEA: Form 103
(Revised Nov 2002)
MONROE COUNTY ATTORNEY
AFPROVED.AS TS O
YNTHIA L. HALL
ASS1S OF COUNTY AT
D a t e _ _ - - - - r
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C. ... I. KZ 97
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT
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.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A -133, as revised, and Section 215.97, F.S., (see
"AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits by the 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
determining 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 frilly
disclosed in the audit report with reference to the Alliance for Aging, Inc. agreement involved. If not otherwise disclosed as
required by Section 3I0(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.
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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 o f
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 determining the state financial assistance expended in its fiscal year, the Contractor shall consider all sources
of state financial assistance, including state financial assistance received from the Alliance 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
the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as defined by
Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit
organizations), Rules of the Auditor General.
If the Contractor expends less than $750,000 in state financial assistance in its fiscal year (for fiscal years ending September 30,
2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not required. In the
event that the 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 -
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 691-
5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by agreement number
for each agreement with the Alliance for Aging, Inc. in effect during the audit period. Financial reporting packages required under
this part must be submitted within 45 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 OiVIB Circular A -133, as revised (the number of copies required by Sections .320
(d) (I) and (2), OMB Circular A -I33, 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
KZ . y'897
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(0, 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
governmental entities) or 10.650 (nonprofit and for - profit organizations). Rules of the Auditor General, as applicable.
Contractors, when submitting financial reporting packages to the Alliance for Aging, Inc. for audits done in accordance with OMB
Circular A -133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for - profit organizations), Rules of the
Auditor General, should indicate the date that the reporting package was delivered to the Contractor in correspondence
accompanying the reporting package.
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.
Page 29 of 61
<c f', _.,. k V.Z 18•37
ATTACHMENT III
EXHIBIT —1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO
THIS AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE
FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD $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 S189,458.40
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
Page 30 of 61
Co' , .,. < . ! , 19 7
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 I is met. Contractors who have been determined to be vendors are not subject to the audit requirements of OMB Circular
A -133, as revised, and /or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, 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 determined to be:
Vendor or exempt entity and not subject to OMB Circular A -133 and /or Section 215.97, F.S.
X Recipient /sub- recipient subject to OMB Circular A -133 and /or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part §200 and /or Section 215.97, F.S. For Federal awards, for - profit organizations
are exempt; for state financial assistance projects, public universities, community colleges, district school boards, branches
of state (Florida) government, and charter schools are exempt. Exempt organizations must comply with all compliance
requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient /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 691- .006(2), FAC [state
financial assistance] and Section _ .400 OMB Circular A -133 [federal awards].
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 determined 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 (Formerly OMB Circular A -87)*
OMB Circular A -102 — Administrative Requirements
OMB Circular A -I33 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON- PROFIT ORGANIZATIONS NI UST FOLLOW:
2 CFR Part 230 Cost Principles for Non -Profit Organizations (Formerly' OMB Circular A -122 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly 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 (Formerly Circular A -21 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A -1 10 — 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
I ZL I
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
THE REST OF THIS PAGE WAS LEFT BLANK INTENTIONALLY
Page 32 of 61
Coc,trna i er K7 R97
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the Contractor named in the contract or agreement to which this form is an
attachment, hereby certifies that:
(1) The Contractor and any sub - Contractors of services under this contract have financial management systems capable of
providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each grant -
funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for
all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award: The inability to
process information in accordance with these requirements could result in a return of grant 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 immediately make required corrections to
restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State, and
without interruption to the ongoing business of the state, time being of the essence.
(4) The Contractor and any sub - Contractor(s) of services under this contract warrant their policies and procedures include a disaster
plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity
compliance issues.
The. Contractor shall require that the language of this certification be included in all 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 (formerly OMB Circular A -110).
Monroe County Board of County Commissioners, Social Services /In -Home Services
1100 Sim. Street, 2 -257
Key We 33040
Lo \V1\:.0`R
Signature Date
c or
Title
Name of Auth ized Sig er
MONR C®UNTY ATTORNEY
(Revised June 2008) A r s• OS ROY,) AS TOA F M
YNTHHA L.. HALL
ASSIS TANT OUNTY ATTORNEY ®ate_____ --. �.
Page 33 of 61
C +`?'`.4+ "','.:..t Numb KZ i89
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 debarment, declared ineligible, or voluntarily excluded from participation in this transaction by
any federal department or agency.
(2) Where the prospective Contractor is unable to certify to any of the statements in this certification, such prospective
participant shall attach an explanation to this certification.
(*a.C)\
Signature Date
Acting County Administrator Monroe County Board of County Commissioners, Social
Title Services /In -Home Services
Agency /Organization
(Certification signature should be same as Contract signature.)
Instructions for Certification
I. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person,"
"primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out in the sections of
rules implementing Executive Order 12549. (2 CFR 180.5-180.1020, as supplemented by 2 CFR 376.10- 376.995). You
may contact the Contract Manager for assistance in obtaining a copy of those regulations.
2. This certification is a material representation of facts upon which reliance was placed when the parties entered into this
transaction. If it is later . determined that the 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 debarment.
3. The Provider will provide immediate written notice to the Contract Manager if at any time the Provider learns that its
certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The Provider
may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower
tier covered transaction may, but is not required to, check the Excluded Parties List System (EPLS).
4. The Provider will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -
Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for lower tier covered
transactions.
5. The Provider agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is
debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by
the federal government.
6. If the Provider knowingly enters into a lower tier covered transaction with a person who is suspended, debarred,
ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the
federal government, the Department may pursue available remedies, including suspension, and /or debarment.
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)
MONROE COUNTY ATTORNEY
AP" - OVED OAS T! F•
6 f
. . ,
0 NTHIA t... ALL
ASSISTANT COUNTY ATTORNEY
Date -- iiZ)/
Page 34 of 61
K7 .<.':;9
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. 74728-4763) 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. 1 1 1681 -1683, and 1685 - 1686), which prohibits discrimination on the
basis of sex: (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. - 794), which prohibits discrimination
on the basis of handicaps: (d) the Age Discrimination Act of 1975. as amended (42 U.S.C. 1 1 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; ( 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) i — 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. - - 290 dd -3 and 290 ee 3), as amended,
relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C.
3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statute(s) under which application for federal assistance is being made; and (j) the
requirements of any other nondiscrimination statute(s) which may apply to the application.
7. Will comply, or has already complied. with the requirements of Titles 11 and III of the uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1970 (P.L. 91 -646) which provide for fair and equitable treatment of persons displaced or
whose property is acquired as a result of federal or federally assisted programs. These requirements apply to all interests in real
property acquired for project purposes regardless of federal participation in purchases.
8. Will comply as applicable. with the provisions of the (latch Act (5 U.S.C. 1=1501 -1508 and 7324- 7328), which limit the
political activities of employees whose principal employment activities are funded in whole or in part with federal funds.
9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. _ 1276a to 276a -7), the Copeland Act (40
U.S.C. 276c and 18 U.S.C. fl11874) and the Contract Work Hours and Safety Standards Act (40 U.S.C. rio 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
Page 35 of 61
Cor:ri %'.I..t Nur he i.L. 197
of 1973 (P.L. 93 -234) which requires recipients in a special flood hazard area to participate in the program and to purchase
flood insurance if the total cost of insurable construction and acquisition is $10,000 or more.
11. Will comply, with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental
quality control measures under the National Environmental Policy Act of 1969 (P.L. 91 -190) and Executive Order (EO) 11514;
(b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of
flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State
management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. ❑ ❑ 1451 et seq.); (f) conformity
of federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended
(42 U.S.C. ❑ 0 740 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.0 G' 0 172 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. 0470), EO 11593 (identification and protection of historic properties), and the Archaeological and
Iistoric Preservation Act of 1974 (16 U.S.C. ❑ 0 469a -1 et seq.).
14. Will comply with P.L. 93 -348 regarding the protection of human subjects involved in research, development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89 -544, as amended; 7 U.S.C. ❑ -2131 et seq.) pertaining
to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this
award of assistance.
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. ❑ 0 4801 et seq.), which prohibits the use of lead -
based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments
of 1996 and OMB Circular No. A -133, Audits of States, Local Governments, and Non - Profit Organizations.
18. Will comply with all applicable requirements of all other federal laws, executive orders, regulations and policies governing this
program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
Acting County Administrator
APPLICANT ORGANIZATION DATE SUBMITTED
Monroe County Board of County Commissioners, Social Services/In-
Home Services
MONROE COUNTY ATTORNEY
r PROVED AS To F
c t .
CYNTHIA L. HALL
ASSISTANT 9O0TY ATTORNEY
Page 36 of 61
•
•
Contract Number s.7 1 397
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 number of units of service and at the
rate(s) stated below:
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
Page 37 of 61
KZ 139
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 /l0 advance reconciliation April 10
12 April Expenditure Report + 1 /l0 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 l: 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 #5. 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.
Page 38 of 61
189 7
ATTACHMENT IX
REQUEST FOR PAYMENT
ALZHEIMERS DISEASE INITIATIVE PROGRAM
RECIPIENT NAME, ADDRESS, PHONE# and FEID# TYPE CC REPORT This Request Period
PSA #
A. PAYMENT REQUEST. Report#
Regular Supplemental Contract it
B. METHOD OF PAYMENT: Contract Period
Advance Reimbursement
CERTIFICATION: I herebycertifyto the best of mykno'rdedge that this request is complete and correct and conforms with the terns and the purposes of the above contract.
Prepared by Date. Approved by Date
( (
PART A: BUDGET SUMMARY Respite Model Day Care TOTAL
1. Approved Contract Amount 50 00 50 00 50.00
2. Previous Funds Received for Contract Pericd 50.00 50 00 50 00
3. Contract Bala ice (line 1 minus line 2) 50 00 50 00 50.00
4 Previous Funds Requested and Not Received for Contract Period 50 00 $0 00 50.00
5. Contract Balance (fine 3 **anus line 4) 50.00 50.00 50.00
PART B: CONTRACT FUNDS REQUEST
1. Anticipated Cash Needs (1st - 2nd me nth, Attach Justification) 50 00 50 00 50.00
2. Net E>penditures For Month ;0.90 50.00 50.00
(DOEAForm 105ZPart B Line 3)
3 TOTAL 50 00 50.00 50.00
PART C: NET FUNDS REQUESTED
1 Less Advance Applied 50 00 50.00 50.00
2. Contrad Funds are Hereby Requested for (Part B. Line 3 50 00 50 00 50 00
minus Part C. Line 1)
•
List of Services; Units1Rates provided • See attached report
DOEA FORM 106Z
Revised 5i4
Page 39 of 61
CO NI:: a Ct NUM be. r K7 [j'7
RECEIPT AND EXPENDITURE REPORT
ALZHEIMERS DISEASE INITIATIVE PROGRAM
PROVIDER NAME ADDRESS, PHONE # and FEI It.' Program FU nCling . THIS REPORT PERIOD:
[From To
Respite CONTRACT PERIOD..
Model Day Care .CONTRACT *
REPORT
'PSAll
CERTIFICATION: I certify to the best of my knowledge and belief that the report is complete and correct and a1 outra.ys
berm are tor per pmes set Torth in the contract.
P-repapitt ...1.y Dace- Amoved 0y Dale
PAR T A BUDGETED INCOklEi RECEIPTS I Approved 2 Actual Recerpts 3 INal Receipts. 4. Percent ot
Budged For This Report Year to Date Approved Bud
1 E/ate Fur-4s 50 00 30 00 SG 00 '.
. #01
2. Program Income 50.00 30 00 30.00 *DI VIO
3 Local Cash Match 50 00 30 00 30 00
4 SUI3TOTAL: CASH RECEIPTS
5 LOcal In-Kind Match
1 5 TOTAL RECEIPTS S0 00 3080 j 30 00 #DIVIO
•
PART B EXPENDITURES 1 Approved 2 Expend tires 3 Expenditures 4 Percent el,
Auds,e4 For ril, pep° a _ Year to Date ..._ A9pLattip111 . ,,..1
1. Administrative Services 50.00 38.00 30.00 #DIViOt
2 Service SubcontractOr(s) S0.00 30.00 30 00 tOlViI0 F
3 TOTAL EXPENDITURES 50.00 30 00 30 00 "DIVAO!
PART C OTHER REVENUE AND EXPENDITURES II Intefost 111 Aovance Recouped
I Program I ncome tPI ) 1 Earned on GP. Attvwce 5 5
1 AU PI (7..ollected YID 5 _ .‚i Return Advarr.e 3
1 r oi al ( n citie ±C4tier Earned 5
•
PART D CO-PAYMENTS
2 Total of Co-payinento cotiected
er Tracking Po ses onty )
.._ CURRENT tikiNTli YEAR-TO-DATE
3
5
5 — - -,
--,
DOE a rCitt!
`..e..'12011
. •
Page 40 of 61
•
ATTACHMENT A
Title: Department of Elder Affairs Programs & Services Handbook
Department of Elder Affairs Programs & Services Handbook
http://www.allianceloraging..org. (see Contractors /Program Documents) or
http:i.elderaffairs.state.fl _ us /doewnois.php (notices of instructions)
Page 41 of 61
•
:or : ) . -, I : rri b c, KZ 1897
ATTACHMENT B
STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE THIS
FORM.
I. Briefly describe the geographic area se ved by the program /facili and the type of service provided:
-Pine. - ii t- •2 Ii C I/ 1 • • t.. t. /iv_ • - ill
u/'i
are.. etrek-sid - Lp. ■ •�. .4_� T i'.s. .. � . _ ad
10 L r 5o . c ti \ i4'-is qra - Q.- e- nip '� - ='-` , (-14"/ f
2. POPULATION OF'AREA SERVED. Source of data: Censu 3 p Ik- .
Total # % White % Black % Hispanic % Other % Female
` 13 ,S lat . 3 5'.'1 (4 . Q. a, _ t
3. S (+ TAFF CURRENTLY EMPLOYED. Effective date:
T # % I e % la k % spanic % Other
% Female % Disabled
� d S 8
'73 ca---•
4. CLIENTS CURRENTLY ENROLLED OR REGISTERED. Effective date: 6 ' $
3 l
Total %White %Black % Ijisganic % Other % Female %Disabled % !Over 40
I ` 10O _. 5 10 0 / o ®
5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE.
Total # % White % Black % Hispanic % Other % Female % Disabled
S (0 O 'O n 0 ( 4-0 e,
PART 11: 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 kF,S NO
❑ N ❑
7. Compare the staff composition to the population. Is staff representative of the population?
If N/A or NO, explain. N/A yE,s 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 E
111 ,YIA 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 YE
❑ A 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 YE NO
❑ ❑
. 1 1 . 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
❑ ❑
Page 42 of 61
Contra<:t Number KZ .1.897
Revised August 20 I 0, Page I a 2
Page 43 of 61
... ....Tract. KZ .1897
12. Is the program /facility accessible to non - English speaking clients? If N/A or NO, explain. N/A YES NO
❑ 14 ❑
13. Are employees, applicants and participants informed of their protection against discrimination? If
YES, how? Verbal ❑ Written gPoster ❑ If N/A or NO, explain. N/A yE,S NO
❑ rgi, ❑
14. Give the number and current status of any discrimination complaints regarding services or
employment filed against the program/facility. N/A NUM ER
15. Is the program /facility physically accessible to mobility, hearing, and sight- impaired individuals? If
N/A or NO, explain. N/A �'ES NO NI
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
`� ❑
17. Is there an established grievance procedure that incorporates due process in the resolution of
complaints? If NO, explain. YES NO
N gl
18. Has a person been designated to coordinate Section 504 compliance activities? If NO, explain. YES NO
`
I ('• ❑
19. Do recruitment and notification materials advise applicants, employees and participants of
nondiscrimination on the basis of disability? If NO, explain. YES NO
20. Are auxiliary aids available to assure accessibility of services to hearing and sight- impaired
individuals? If NO, explain. V YES NO
PART IV: FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF S50,000.00 OR MORE.
21. Do you have a written affirmative action plan? If NO, explain. YES NO
lx ❑
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
rr 1 897
Revised August 2010, Page 2 of 2
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city or other locality. If the program /facility serves
a specific target population such as adolescents, describe the target population. Also, define the type of service
provided.
2. Enter the percent of the population served by race and sex. The population served includes persons in the
geographical area for which services are provided such as a city, county or other regional area. Population
statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census
containing Florida population statistics. Include the source of your population statistics. ( "Other" races include
Asian /Pacific Islanders and American Indian /Alaskan Natives.)
3. Enter the total number of full -time staff and their percent by race, sex and disability. Include the effective date of
your summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and
list their percent by race, sex and disability. Include the date that enrollment was counted.
5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no
advisory or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the
contract language for DOEA recipients and their sub - grantees, 45 CFR 80.4 (a).
7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their
availability in the population, the program /facility has the responsibility to determine the reasons for such
variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities
may exist when programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR
80.3 (b) (6).
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and . 4) and also
through on -site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a)
and 45 CFR 80.1 (b) (2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national
origin, religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be
applied uniformly and without regard to race, sex. color, national origin, religion, age or disability. Entrances,
waiting rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR
80.3 (b).
11. For in- patient services, residents must be assigned to rooms, wards, etc., without regard to race, color, national
origin or disability. Also, residents must not be asked whether they are willing to share 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
Page 45 of 61
i„'.1:' .. :a L.. Number KZ . S 9 ...:
policy or plan for service, such as a current list of names and telephone numbers of bilingual individuals who will
assist in the provision of services, 45 CFR 80.3 (a).
13. Programs /facilities must make information regarding the nondiscriminatory provisions of Title VI available to
their participants, beneficiaries or any other interested parties. This should include information on their right to
file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of
HHS. The information may be supplied verbally or in writing to every individual, or may be 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 Tight, 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).
1 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).
1 Continuing steps must be taken to notify employees and the public of the program /facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper
ads, and other appropriate written communication, 45 CFR 84.8 (a).
20. Programs /facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with
impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to,
interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be
used to provide equally effective services, 45 CFR 84.52 (d).
21. Programs /facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246, 41 CFR 60
and Title VI of the Civil Rights Act of 1961, as amended.
DOEA Form 101 -B, Revised August 2010
Page 46 of 61
s r;i c r. Numb 1K2...18 ) 7
ATTACHMENT C
ADRC OUTSOURCED FUNCTIONS
I. Under this Contract, the Contractor agrees to the following:
A. Perform 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 - Termination
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
B. Maintain wait lists in CIRTS in accordance with DOEA requirements.
C. Report number of client contacts to the Aging Resource Center.
D. Adhere to prioritization policy as set forth by the Department of Elder Affairs.
E. Update the agency Disaster Plan to incorporate ADRC outsourced functions.
F. Ensure against conflicts of interest and inappropriate self - referrals by referring consumers in need of
options counseling or long -term care services beyond the Contractor's scope of services to the Aging
Resource Center.
G. Ensure that services provided are in the clients' best interest, are the most cost effective, of high quality,
and are responsive and appropriate to the assessed needs.
The Assessed Priority Consumer List (APCL) is maintained when services funded by the department are not available.
Contracted 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.
C'o n ;. € .. ,, . Number KZ . f. 9 V,
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 701S assessment.
Alternatively, if a 701 A(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 701 A(B) assessment, the ADRC Contracted Contractor will make a
determination 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 determines 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 information].
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.
Page 48 of 61
.S^ : ,.. Fz`.,i i<Z._S97
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 -1 -OVCS as applicable.
Page 49 of 61
;,,:i"ar ;..'!.1C. K.Z 1
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
determined by a CIRTS priority score.
Procedure:
1. ADRC Contracted Contractor will conduct annual reassessments based on DOEA Wait List Reassessment
Standards.
2. If there is no current 701A or B in CIRTS, the Contractor will conduct the annual reassessment (701S) 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
3. 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 Form 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.
5. 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.
6. 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 programmatic requirements.
Page 50 of 61
� r r + '7
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.
Page 51 of 61
? �..i ;'' i < 8597
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. J§ 164.502(e), I64.504(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.) J§ 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. §§ 164.303, 164.310, 164.312, and 164.316
(2009) and such sections shall apply to a business associate of a covered entity in the same manner that such
sections apply to the covered entity.
The parties therefore agree as follows:
2.0 Definitions. For purposes of this agreement, the following definitions apply:
2.1 Access. The ability or the means necessary to read, write, modify, or communicate data /information or otherwise
use any system resource.
3.2 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 (ePH1) 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.
Page 52 of 61
r `be KZ __S97
2.8 Confidentiality. The property that data or information is not made available or disclosed to unauthorized persons
or processes.
2.9 Electronic Protected Health Information.(ePHI) Health information as specified in 45 CFR §160.103(1)(i) or
(1)(ii), limited to the information created or received by Business Associate from or on behalf of Covered Entity.
2.10 HITECH. The Health Information Technology for Economic and Clinical Health Act (2009)
2.11 Information System. An interconnected set of information resources under the same direct management control
that shares common functionality. A system normally includes hardware, software, information, data, applications,
communications, and people.
2.12 Integrity. The property that data or information have not been altered or destroyed in an unauthorized manner.
2.13 Malicious software. Software, for example, a virus, designed to damage or disrupts a system.
2.14 Part 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.
2.31 Security incident. The attempted or successful unauthorized access, use, disclosure, modification, or destruction of
information or interference with system operations in an information system.
3.22 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 P1-11. Protected health information that is not secured through the use of technology or methodology
specified by the Secretary in guidance issued under 42 U.S.C. section 17932(h)(2).
2.26 All other terms used, but not otherwise defined, in this Agreement shall have the same meaning as those terms in
the Privacy Rule.
3.0. Obligations and Activities of Business Associate.
Page 53 of 61
Numb, K7 97
3.1 Business Associate agrees to not use or disclose PHI other than as permitted or required by this agreement or as
Required by Law.
3.2 Business Associate agrees to:
(a) Implement policies and procedures to prevent, detect, contain and correct Security violations in accordance
with 45 CFR § 164.306;
(b) Prevent use or disclosure of the PHI other than as provided for by this Agreement or as required by law;
(c) Reasonably and appropriately protect the confidentiality, integrity, and availability of the ePHI that the
Business Associate creates, receives, maintains, or transmits on behalf of the Covered Entity; and
(d) Comply with the Security Rule requirements including the Administrative Safeguards, Physical Safeguards,
Technical Safeguards, and policies and procedures and documentation requirements set forth in 45 CFR §§
164.308, 164.310, 164.312, and 164.316.
3.3 Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Business
Associate of a use or disclosure of PHI by Business Associate in violation of the requirements of this Agreement.
3.4 Business Associate agrees to promptly report to Covered Entity any use or disclosure of the PHI not provided for
by this Agreement of which it becomes aware. This includes any requests for inspection, copying or amendment of
such information and including any security incident involving PHI.
3.5 Business Associate agrees to notify Covered Entity without unreasonable delay of any security breach pertaining
to:
(a) Identification of any individual whose unsecured PHI has been, or is reasonably believed by the Business
Associate to have been, accessed, acquired, or disclosed during such security breach; and
(b) All information required for the Notice to the Secretary of HHS of Breach of Unsecured Protected Health
Information.
3.6 Business Associate agrees to ensure that any agent, including a subcontractor, to whom it provides PHI received
from, or created or received by Business Associate on behalf of Covered Entity, agrees to the same restrictions and
conditions that apply through this Agreement to Business Associate with respect to such information.
3.7 If Business Associate has PHI in a Designated Record Set:
(a) Business Associate agrees to provide access, at the request of Covered Entity during regular business hours,
to PHI in a Designated Record Set, to Covered Entity or, as directed by Covered Entity, to an individual in order to
meet the requirements under 45 CFR §164.524; and
(b) Business Associate agrees to make any amendment(s) to PHI in a Designated Record Set that the Covered
Entity directs or agrees to pursuant to 45 CFR § 164.526 at the request of Covered Entity or an Individual within 10
business days of receiving the request.
3.3 Business Associate agrees to make internal practices, books, and records, including policies and procedures and
PHI, relating to the use and disclosure of PHI received from, or created or received by Business Associate on
behalf of Covered Entity, available to the Covered Entity or to the Secretary upon request of either for purposes of
determining Covered Entity's compliance with the Privacy Rule.
3.9 Business Associate agrees to document such disclosures of PHI and information related to such disclosures as
would be required for Covered Entity to respond to a request by an individual for an accounting of disclosures of
PHI in accordance with 45 CFR § 164.528.
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N r i 397
3.10 Business Associate agrees to provide to Covered Entity or an individual, upon request, information collected to
permit Covered Entity to respond to a request by an Individual for an accounting of disclosures of PHI in
accordance with 45 CFR § 164.528 and ARRA § 13404.
3.11 Business Associate specifically agrees to use security measures that reasonably and appropriately protect the
confidentiality, integrity, and availability of PHI in electronic or any other form, that it creates, receives, maintains,
or transmits on behalf of the Covered Entity.
3.12 Business Associate agrees to implement security measures to secure passwords used to access ePHI that it accesses,
maintains, or transmits as part of this Agreement from malicious software and other man -made and natural
vulnerabilities to assure the availability, integrity, and confidentiality of such information.
3.13 Business Associate agrees to implement security measures to safeguard ePHI that it accesses, maintains, or
transmits as part of this agreement from malicious software and other man -made and natural vulnerabilities to
assure the availability, integrity, and confidentiality of such information.
3.14 Business Associate agrees to comply with:
(a) ARRA § 13404 (Application of Knowledge Elements Associated with Contracts);
(b) ARRA § 13405 (Restrictions on Certain Disclosures and Sales of Health Information); and
(c) ARRA § 13406 (Conditions on Certain Contacts as Part of Health Care Operations).
4.0 Permitted Uses and Disclosures by Business Associate. Except as otherwise limited in this Agreement or any
related agreement, Business Associate may use or disclose PHI to perform functions, activities, or services for, or
on behalf of, Covered Entity as specified in any and all contracts with Covered Entity provided that such use or
disclosure would not violate the Privacy Rule if done by Covered Entity or the minimum 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 § 164.502(j)(1).
6.0 Obligations of Covered Entity.
6.1 Covered Entity shall notify Business Associate of any limitation(s) in its notice of privacy practices of Covered
Entity in accordance with 45 CFR § 164.520, to the extent that such limitation may affect Business Associate's
use or disclosure of PHI, by providing a copy of the most current Notice of Privacy Practices (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.alliancefora,in;.or,.
Page 55 of 61
KZ .1
6.2 Covered Entity shall notify Business Associate of any restriction to the use or disclosure of PHI that Covered
Entity has agreed to in accordance with 45 CFR § 164.522, to the extent that such restriction may affect
Business Associate's use or disclosure of PHI.
7.0 Permissible Requests by Covered Entity. Except for data aggregation or management and administrative
activities of Business Associate, Covered Entity shall not request Business Associate to use or disclose PHI in any
manner that would not be permissible under the Privacy Rule if done by Covered Entity.
8.0 Effective Date and Termination.
8.1 The Parties hereby agree that this agreement amends, restates and replaces any other Business Associate
Agreement currently in effect between Covered Entity and Business Associate and that the provisions of this
agreement shall be effective as follows:
(a) These Business Associate Agreement provisions, with the exception of the electronic security provisions
and the provisions mandated by ARRA, HITECH and Part I shall be effective upon the later of April 14, 2003, or
the effective date of the earliest contract entered into between Business Associate and Covered Entity that involves
the use of PHI;
(b) The electronic security provisions hereof shall be effective the later of April 21, 2005 or the effective date
of the earliest contract entered into between Business Associate and Covered Entity that involves the use of PHI;
and
(c) Provisions hereof mandated by ARRA, HITECH and /or Part I shall be effective the later of February 17,
2010 or the effective date of the earliest contract entered into between covered entity and business associate that
involves the use of PHI or ePHI.
8.2 Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business Associate, Covered
Entity shall either:
(a) Provide an opportunity for Business Associate to cure the breach or end the violation and terminate this
agreement if Business Associate does not cure the breach or end the violation within the time specified by Covered
Entity;
(b) Immediately terminate this agreement if Business Associate has breached a material term of this
Agreement and cure is not possible; or
(c) If neither termination nor cure is feasible, Covered Entity shall report the violation to the Secretary.
8.3 Effect of Termination. Except as provided in subparagraph (b) of this section, upon termination of this
agreement, for any reason, Business Associate shall return all PHI and ePHI received from Covered Entity, or
created or received by Business Associate on behalf of Covered Entity.
(a) This provision shall apply to PHI and ePHI that is in the possession of subcontractors or agents of Business
Associate. Business Associate shall retain no copies of the PHI and ePHI.
(b) In the event that Business Associate or Covered Entity determines that returning the PHI or ePHI is
infeasible, notification of the conditions that make return of PHI or ePHI infeasible shall be provided to the other
party. Business Associate shall extend the protections of this Agreement to such retained PHI and ePHI and limit
further uses and disclosures of such retained PHI and ePHI, for a minimum of six years and so long as Business
Associate maintains such PHI and ePHI, but no less than six (6) years after the termination of this agreement.
9.0 Regulatory References. A reference in this agreement to a section in the Privacy Rule or Security Rule means the
section then in effect or as may be amended in the future.
Page 56 of 61
i.,! . ._ . K17 s_,'S97
10.0 Amendment. The Parties agree to take such action as is necessary to amend this agreement from time to time as is
necessary for Covered Entity to comply with the requirements of the Privacy Rule, the Security Rule and the
Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104 -191.
11.0 Survival. Any term, condition, covenant or obligation which requires performance by either party hereto
subsequent to the termination of this agreement shall remain enforceable against such party subsequent to such
termination.
12.0 Interpretation. Any ambiguity in this agreement shall be resolved to permit Covered Entity to comply with the
Privacy Rule and Security Rule.
13.0 Incorporation by reference. Any future new requirement(s), changes or deletion(s) enacted in federal law which
create new or different obligations with respect to HIPAA privacy and /or security, shall be automatically
incorporated by reference to this Business Associate Agreement on the respective effective date(s).
14.0 Notices. All notices and communications required, necessary or desired to be given pursuant to this agreement,
including a change of address for purposes of such notices and communications, shall be in writing and delivered
personally to the other party or sent by express 24 -hour guaranteed courier or delivery service, or by certified mail
of the United States Postal Service, postage prepaid and return receipt requested, addressed to the other party as
follows (or to such other place as any party may by notice to the others specify):
To Covered Entity: Alliance for Aging, Inc.
Attention: Max Rothman
760 NW 107 Avenue
Miami, Florida 33172
To Business Associate: Monroe County Board of County Commissioners, Social Services /In -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 permitted by law.
17.0 Successors. Any successor to Business Associate (whether by direct or indirect or by purchase, merger,
consolidation, or otherwise) is required to assume Business Associate's obligations under this agreement and agree
to perform them in the same manner and to the same extent that Business Associate would have been required to if
that succession had not taken place. This assumption by the successor of the Business Associate's obligations shall
be by written agreement satisfactory to Covered Entity.
18.0 Entire Agreement. This agreement constitutes the entire agreement of the parties relating to the subject matter of
this agreement and supersedes all other oral or written agreements or policies relating thereto, except that this
agreement does not limit the amendment of this agreement in accordance with section 10.0 of this agreement.
Covered Entity: Alliance for Aging, Inc.
B y: / / _il / Date:
(signati '
Page 57 of 61
C Number K2 . 7
Business Associate: Monroe County Board of County Commissioners, Social Services /In -Home Services
By: � /� / —// Date: to ZQ/ °18
(signature • c m ounty Administrator
/
b ty for
MONBOE COUN TT. /
AP' :VNETD::\ASNr, ,' H't-I- ASSISTANT /OOU�YT O��NE`P
Page 58 01 61
{„ont acr Nun KZ _ 897
ATTACHMENT F
Verification of Employment Status Certification C�a
As a condition of contracting with the Alliance for Aging, Inc., 1 °IDMtre,Wun gDc J$b C �
e
, hereby referred to as contractor, certifies the use of the U.S. Department of Homeland Security's E- verify system
to verify the employment eligibility of all new employees hired by Contractor during the contract term to perform
employment duties pursuant to this Agreement and (b) that any subcontracts include an express requirement that
subcontractors performing work or providing services pursuant to this Agreement utilize the E- verify system to verify the
employment eligibility of all new employees hired by the subcontractor during the contract term.
1:)\'a,A \
Signature Date
(Same as contract signature)
Acting County Administrator
Title
•
•
MONROE COUNTY ATTORNEY
AP O VED AS TO FOR
C NTH !A L. H LL
ASSISTANT COUNTY ATTORNEY
Date_ 7-- _
Page 59 of 61
•
Contract Number KZ 1897
ATTACHMENT G
:._ BACKGROUND SCREENING
ELDER. AFE.�t..IRS
i 3�•� ttt 7 ,sacia;
Aff of Compliance - Employer
AU HORitY: This form is required annually -of aB employers to oomph, with the o �• tion
rsg nrenrerds set farth m section 435.05(3), Florida Statutes_
The teen 'employee' means any person or entity required :by law to aorduct badgroiend *Melting,
indudiig hut oat limited to Area Agencies oa
, Ag Ag' glAgitrg (and Disability) Resource centers, head Agercirs,
• and Service Provide that: contract rbnect[y err mdnectly with the Depart of Eider Affairs (DOEA), and
any other person or entity which hires employees err his volunteers in service vrho meet the definition
afa direct service provider_ ee § §435 2,436.0402, Stat
A direct .se€ vice ;provider is as Perim 18 years of age or order who; pint to a,pragram to piavide
services to the elderly, has direct, face -to -face oarrtact: with a dient while providmrg.services to the dient
and has access to the dient'sliving area, find,, personal property, or personal idt.irtifrsrtion information - .. .
as defined in s. 817.568_ The term includes coordinators, managers, and supenriwrs of residential faci ltie
and volunteers_' § 430 04o2 (1)(b), Fla. slat..
At d ee duly g a prized repre9eritatiete of 1 1 O1�(�lP ::: cx n� C�•s
` r EmployerNarne .
l .
atated at I` o o. t rym t4-4-0 1
� � _
aa� 1 Key (�.Se�- F�. 33� '4-0 St xaet Address ... _ 3 //
G?''. to z4Ptmde
( r do hereby affirm carder penalty & perjury
Name of f4iresentativ
that the above named employer is in ®m p liance with the
�ay'e P provisions of Chapter and section
430.0402, Florida Statutes, ce in level 2
Bard g backgrDUridscreeinng.
J vifrbi8 40,
Signature of ' -:• entative. Date
STATE OF FLORIDA; COUNTY OF M FiltS te,
worn to (or affirmed) and 'subscribed me this2.:i a
day of ‘..)1.4. 11 .: - :: , Zt3 by
'LItp I 9( +T`�'r'r ` (Name of Representative) who es personally krinwn •
tome at oduc proofcsfidentificatian.
1 ;li ar t °�., NATALIE M. MADDOX
Notary aublit State of Floriea: f!�L�C ,
• - _ T issie it GG tDiiii FS s�� [�
� ' �Inrm� Notary
M o m:
o
Public
.....F�;.:: y:
''' a ,4.,1 thrnueh National Notary Assn.
•
thi S +t.nDer71t. 21117 - ssdm7t R 43S.fl313t, ES_
Fort, bleattaniieruaerta tLiz,fen iWtd un3scecri=.017
MIONROE COUNTY ATTORNEY •
PPR VEDAS •.ter FS9M:
1
Page 60of61
CYNTHIA L. HALL
:ASSISTANT COUNTY ATT0RNEY . •
Date .. _D /8
Ntinter KZ 1 97
ATTACHMENT If
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 List" or the "Scrutinized Companies with Activities in the Iran Petroleum Sector List (collectively, "the Lists ") is
ineligible for, and may not bid on, submit a proposal for, or enter into or renew a contract pursuant to which funding is
provided by the Department of Elder Affairs (Department) for goods or services of $1 million or more.
(2) The 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.
� . `)N D
Signature Date
(Same as contract signature)
Acting County Administrator .
Title
Of\rpe.l,Ov.M UC C- O G.(Y: — CAS
Company Name
II°INUNTY ATTORNEY
APP ' OUE CO `' S T010' :
C r NTH!A L.. HALL
ASSISTANT OU A TO ®Y
Date Page 61 of 61