12/19/2018 Agreement •
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ALLIANCE FOR AGING,INC. Fully
STANDARD CONTRACT
OLDER AMERICANS ACT Executed
THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as the"Alliance,"and
Monroe County Board of County Commissioners, Social Services/In-Home Services, hereinafter referred to as the
"Provider", and collectively referred to as the"Parties." The term contractor for this purpose may designate a vendor,
sub-grantee or sub-recipient,the status to be further identified in ATTACHMENT II, Exhibit-2 as necessary.
WITNESSETH THAT:
WHEREAS, the Alliance has established through the Area Plan on Aging that it is in need of certain services as
described herein; and
WHEREAS, the Provider has demonstrated that it has the requisite expertise and ability to faithfully perform such
services as an independent contractor of the Alliance.
NOW THEREFORE, in consideration of the services to be performed and payments to be made,together with the
mutual covenants and conditions hereinafter set forth. the Parties agree as follows:
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this
contract including all attachments and exhibits, which constitute the contract document.
2. Definitions
ADL—Activities of Daily Living
APS—Adult Protective Services
ADA—Americans with Disabilities Act
Alliance—Area Agency on Aging
APCL—Assessed Priority Consumer List
CIRTS—Client Information and Registration Tracking System
DOEA—Department of Elder Affairs (The Department)
l&R— Information and Referral
IADL—Instrumental Activities of Daily Living
MOA—Memorandum of Agreement
ivlOU —Memorandum of Understanding
NSIP-Nutritional _SeryiQ ,�lncentive Program
OAA—Older Americans"Act
PSAs— Planning and Service Areas corresponding to Miami-Dade and Monroe Counties
SPA—Service Provider Application '
USDA—United States Department of Agriculture
Subcontractor—an entity that makes eli gibility determination
Vendor—provides services or products without eligibility determination
3. Incorporation of Documents within the Contract
The contract incorporates by reference attachments, proposal(s), solicitation(s), Provider's Service Provider
Application, and the current DOEA Programs and Services Handbook. Any and all contracts or agreements
executed between the Provider and the Alliance during the effective period of this contract shall be governed in
accordance with the applicable laws and statutes.
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4. Term of Contract
This contract shall begin on January 1,2019 or on the date on which the contract has been signed by the last party
required to sign it, whichever is later. It shall end at midnight, local time in Miami, Florida, on December 31,2019,
unless renewed or extended as provided herein.
5. 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$687,364.98 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.
6. Renewals
By mutual agreement of the parties, the Alliance may renew the contract for five additional one-year periods.
Contingent upon satisfactory performance evaluations by the Alliance and the availability of funds, any renewal is
subject to the same terms as the original contract, with the exception of establishing unit rates which is described
further in this section. The original contractual unit rates are set forth in the bid proposal and reply.
Requests to renegotiate the original contractual established rates are provided for in the Alliance's approved
Reimbursement Rate Review Policy, which is incorporated by reference.
This contract may be extended upon mutual agreement for one extension period not to exceed six months to ensure
continuity of service. Services provided under this extension will be paid for out of the succeeding agreement
amount.
7. Compliance with Federal Law
7.1 This contract contains federal funds. The following shall apply:
7.1.1. The Provider shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable
regulations.
7.1.2 If this contract contains federal funds and is over$100,000.00,the Provider shall comply with all
applicable standards. orders. or regulations issued under s. 306 of the Clean Air Act as amended (42
U.S.C. 7401, et seq.),s. 508 of the Federal Water Pollution Control Act as amended(33 U.S.C. 1251;et
seq.), Executive Order 11738, as amended, and where applicable Environmental Protection Agency
regulations 40 CFR 30. The contractor shall report any violations of the above to the Alliance.
7.1.3. The Provider, or agent acting for the Provider, may not use any federal funds received in connection
with this contract to influence legislation or appropriations pending before the Congress or any State
legislature. The Provider must complete all disclosure forms as required, specifically the Certification
of Assurances Attachment, which must be completed and returned with this signed contract.
7.1.4. In accordance with Appendix A to 2 CFR 215,the contractor shall comply with Executive Order 11246,
Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as
supplemented in Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.
7.1.5. A contract award with an amount expected to equal or exceed$25,000.00 and certain other contract
awards shall not be made to parties listed on the government-wide Excluded Parties List System, in
accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689,
"Debarment and Suspension." The Excluded Parties List System contains the names of parties
debarred,suspended, or otherwise excluded by agencies, as well as parties declared ineligible under
statutory or regulatory authority other than Executive Order 12549. The Provider shall comply with
these provisions before doing business or entering into subcontracts receiving federal funds pursuant to
this contract. The Provider shall complete and sign the Certification and Assurances Attachment prior
to execution of this contract.
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7.2. The Provider shall not employ an unauthorized alien. The Alliance shall consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act(8 U.S.C. 1324 a) and the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1101). Such violation shall be cause for unilateral cancellation of
this contract by the Alliance.
7.3. If the Provider is a non-profit provider and is subject to Internal Revenue Service(IRS)tax exempt
organization reporting requirements (filing a Form 990 or Form 990-N) and has its tax exempt status revoked
for failing to comply with the filing requirements of the 2006 Pension Protection Act or for any other reason,
the Provider must notify the Alliance in writing within thirty(30)days of receiving the IRS notice of
revocation.
7.4. The Provider shall comply with Title 2 CFR Part 175 regarding Trafficking in Persons.
7.5. Unless exempt under 2 CFR Part 170.110(b). the Provider shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR 170.
7.6. To comply with Presidential Executive Order 12989 and State of Florida Executive Order Number 11-116,
Provider agrees to utilize the U.S. Department of Homeland Security's E-verify system to verify the
employment of all new employees hired by Provider during the contract term. Provider shall include in related
subcontracts a requirement that subcontractors and/or vendors performing work or providing services pursuant
to the state contract utilize the E-verify system to verify employment of all new employees hired by the
subcontractor and/or vendor during the contract term. Providers meeting the terms and conditions of the E-
Verify System are deemed to be in compliance with this provision.
8. Compliance with State Law
8.1. 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.
8.2. The Provider shall comply with the requirements of s. 287.058, F.S. as amended.
8.2.1. The Provider shall provide units of deliverables, including reporting, findings, and drafts,as specified in
this contract, which the Contract Manager must receive and accept in writing prior to payment.
8.2.2. The Contractor shall comply. v ith the criteria and final date b} which such criteria must be islet
for completion of this contract as specified in ATTACHMENT I. Section III. Method of
Payment.
8.2.3. The Provider shall submit bills for fees or other compensation for services or expenses in sufficient
detail for a proper pre-audit and post-audit.
8.2.4. If itemized payment for travel expenses is permitted in this contract, the contractor will submit bills for
any travel expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in
this contract.
8.2.5. The Provider shall allow public access to all documents, papers, letters, or other public records as
defined in subsection 119.011(12), F.S., made or received by the contractor in conjunction with this
contract except for those records which are made confidential or exempt by law. The Provider's refusal
to comply with this provision shall constitute an immediate breach of contract for which the Alliance
for Aging, Inc. may unilaterally terminate the contract.
8.3. If clients are to be transported under this contract,the Provider shall comply with the provisions of Chapter
427, F.S.,and Rule 41-2, F. A. C.
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8.4. Subcontractors and/or vendors who are on the discriminatory vendor list may not transact business with any
public entity, in accordance with the provisions of s.287.134, F.S.
8.5. The Provider will comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the
expenditure of contract funds for the purpose of lobbying the legislature,judicial branch or a state agency.
8.6. In accordance with Section 287.135 F.S., any Contractor on the Scrutinized Companies with Activities in
Sudan List, the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or the
Scrutinized Companies that Boycott Israel List(Lists), created pursuant to Section 215.473 F.S. and
215.4725, F.S., or is engaged in a boycott of Israel, or is engaged in business operations in Cuba or Syria, is
ineligible to enter into or renew a contract with the Department for goods or services of$1,000,000 or more.
Pursuant to Section 287.135 F.S.,the Alliance may terminate this contract if the Provider is found to have
submitted a false certification of its status on the Lists or has been placed on the Lists or is engaged in a
boycott of Israel or has been engaged in business operations in Cuba or Syria. Further, the Provider is
subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of
false certification. The Provider shall complete and sign the Certifications and Assurances Attachment, prior
to the execution of this contract.
9. Background Screening
9.1: The Provider shall ensure that the requirements of s. 430.0402 and Chapter 435, F.S., as amended, are met
regarding background screening for all persons who meet the definition of a direct service provider and who
are not exempt from the Department's level 2 background screening pursuant to s. 430.0402(2)-(3), F.S.The
Provider must also comply with any applicable rules promulgated by the Department and the Agency for
Health Care Administration regarding implementation of s. 430.0402 and Chapter 435, F.S.
9.2. Further information concerning the procedures for background screening is found at
http://elderaffai rs.state.11.us/doealbackgroundscreeni nu.php
9.3. Background Screening Affidavit of Compliance-To demonstrate compliance with this contract,the Provider
shall submit ATTACHMENT D, Background Screening Affidavit of Compliance annually. by January 15th.
10. Grievance Procedures
The Provider shall comply with and ensure subcontractor and/or vendors compliance with the Minimum Guidelines
for Recipient Grievance Procedures, Appendix D, DOEA Programs and Services Handbook, to address complaints
regarding the termination, suspension or reduction of services, as required for receipt of funds.
10.1. Complaint Procedures
The Provider shall develop and implement complaint procedures and ensure that subcontractors and/or
vendors develop and implement complaint procedures to process and resolve client dissatisfaction with
services. Complaint procedures shall address the quality and timeliness of services, provider and direct service
worker complaints, or any other advice related to complaints other than termination, suspension or reduction
in services that require the grievance process as described in Appendix D, Department of Elder Affairs
Programs and Services Handbook. The complaint procedures shall include notification to all clients of the
complaint procedure and include tracking the date, nature of complaint, the determination of each complaint,
and the follow-up with the client to ensure satisfaction with the resolution
11. Public Records and Retention
11.1. By execution of this contract, Contractor agrees to all provisions of Chapter l 19, F.S., and any
other applicable law, and shall:
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11.1.1. Keep and maintain public records required by the Department to perform the contracted services.
l 1.1.2. Upon request from the Department's custodian of public records, provide the Department a copy
of the requested records or allow the records to be inspected or copied within a reasonable time
at a cost that does not exceed the cost provided in Chapter 1 19, F.S.,or as otherwise provided by
law.
1 1.1.3. Ensure that public records that are exempt. or confidential and exempt. from public records
disclosure requirements are not disclosed except as authorized by law for the duration of the
contract term and following completion ol'the contract if the Contractor does not transfer the
records to the Department.
11.1.4. Upon completion of the contract.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 Department. If the Contractor transfers all public records to the Department upon
completion of the contract. Contractor shall destroy any duplicate public records that are
exempt, or confidential and exempt. from public records disclosure requirements. lithe
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 Department in a format that is compatible with the
information technology systems of the Department.
11.2. The Alliance may unilaterally cancel this contract, notwithstanding any other provisions of this
contract, for refusal by the Contractor to comply with ATTACHMENT I of this contract by not allowing
public access to all documents. papers. letters, or other material made or received by the Contractor in
conjunction with this contract, unless the records are exempt, or confidential and exempt, from Section
24(a)of Article I of the State Constitution and Section 1.19.07(1), F.S.
[F 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 32399
850-414-2342
doeapublicrecords(a eldera ffairs.org
12. Audits, Inspections, Investigations,Public Records and Retention
12.1. The Provider shall establish and maintain books, records and documents (including electronic storage media)
sufficient to reflect all assets, obligations, unobligated balances, income, interest and expenditures of funds
provided by the Alliance under this contract. Provider shall adequately safeguard all such assets and assure
they are used solely for the purposes authorized under this contract. Whenever appropriate, financial
information should be related to performance and unit cost data.
12.2. The Provider shall retain all client records, financial records,supporting documents, statistical records, and
any other documents (including electronic storage media) pertinent to this contract for a period of six(6)years
after completion of the contract or longer when required by law. In the event an audit is required by this
contract, records shall be retained for a minimum period of six(6)years after the audit report is issued or until
resolution of any audit findings or litigation based on the terms of this contract, at no additional cost to the
Alliance.
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12.3. Upon demand, at no additional cost to the Alliance,the Provider will facilitate the duplication and transfer of
any records or documents during the required retention period in Paragraph 12.2.
12.4. The Provider shall assure that the records described in this section shall be subject at all reasonable times to
inspection, review, copying, or audit by Federal, State, or other personnel duly authorized by the Alliance.
12.5. At all reasonable times for as long as records are maintained, persons duly authorized by the Alliance, DOEA
and Federal auditors, pursuant to 45 CFR Part 75, shall be allowed full access to and the right to examine any
of the Provider's contracts and related records and documents pertinent to this specific contract, regardless of
the form in which kept.
12.6. The Provider shall provide a financial and compliance audit to the Alliance as specified in this contract and
ensure that all related third-party transactions are disclosed to the auditor.
12.7. The Provider shall comply and cooperate immediately with any inspections, reviews, investigations, or
audits deemed necessary by the office of the DOEA's Inspector General pursuant to s. 20.055, F.S. Provider
further agrees that it shall include in related subcontracts a requirement that subcontractors and/or
vendors performing work or providing services pursuant to this contract agree to cooperate with the
Alliance or Inspector General in any investigation ,audit, inspection ,review,or hearing pursuant to
Section 20.055(5), F.S. By execution of this contract the Provider understands and will comply with this
subsection.
13. Nondiscrimination-Civil Rights Compliance
13.1 The Provider shall execute assurances in ATTACHMENT VI that it will not discriminate against any person
in the provision of services or benefits under this contract or in employment because of age, race, religion,
color, disability, national origin, marital status or sex in compliance with state and federal law and regulations.
The Provider further assures that all contractors, subcontractors, vendors, sub-grantees,or others with whom it
arranges to provide services or benefits in connection with any of its programs and activities are not
discriminating against clients or employees because of age. race. religion. color. disability, national origin,
marital status or sex.
13.2 During,the term of this contract, the Provider shall complete and retain on file a timer complete and accurate
Civil Rights Compliance Checklist attached to this contract.
13.3 The Provider shall establish procedures pursuant to federal law to handle complaints of discrimination
involving services or benefits through this contract. These procedures will include notifying clients,
employees, and participants of the right to file a complaint with the appropriate federal or state entity.
13.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Provider, its successors,transferees, and assignees for
the period during which such assistance is provided. The Provider further assures that all subcontractors,
vendors, or others with whom it arranges to provide services or benefits to participants or employees in
connection with any of its programs and activities are not discriminating against those participants or
employees in violation of the above statutes, regulations, guidelines, and standards. In the event of failure to
comply,the Provider understands that the Alliance may, at its discretion, seek a court order requiring
compliance with the terms of this assurance or seek other appropriate judicial or administrative relief,
including but not limited to, termination of and denial of further assistance.
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14. Provision of Services
The Provider shall provide the services referred to in ATTACHMENT VII in the manner described in the DOEA
Programs & Services Handbook and the Provider's Service Provider Application (SPA). In the event of a conflict
between the Service Provider Application and this contract, the contract language prevails.
15. Monitoring by the Alliance
The Provider shall permit persons duly authorized by the Alliance to inspect and copy any records, papers,
documents, facilities, goods and services of the Provider which are relevant to this contract, and to interview any
clients, employees and subcontractor/vendor employees of the Provider to assure the Alliance of the satisfactory
performance of the terms and conditions of this contract. Following such review, the Alliance will deliver to the
Provider a written report of its findings, and where appropriate,the Provider shall develop a Corrective Action Plan
(CAP). The Provider hereby agrees to timely correct all deficiencies identified in the CAP.
16. Coordinated Monitoring with Other Agencies
If the Provider receives funding from one or more of the State of Florida human service agencies, in addition to
Alliance funding, then a joint monitoring visit including such other agencies may be scheduled. For the purposes of
this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human service agencies shall include the
Department of Children and Families, the Department of Health, the Agency for Persons with Disabilities,the
Department of Veterans Affairs, and the Department of Elder Affairs. Upon notification and the subsequent
scheduling of such a visit by the designated agency's lead administrative coordinator, the Provider shall comply and
cooperate with all monitors, inspectors, and/or investigators.
17. Indemnification
The Provider shall indemnify, save, defend, and hold harmless the Alliance and its agents and employees from any
and all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the
execution of this agreement or performance of the services provided for herein. It is understood and agreed that the
Provider is not required to indemnify the Alliance for claims, demands, actions or causes of action arising solely out
of the Alliance's negligence.
17.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph 1 5 is not applicable to
contracts executed between the Alliance and state agencies or subdivisions defined in s. 76828(21. F.S.
18. Insurance and Bonding
18.1 The Provider shall provide continuous adequate liability insurance coverage during the existence of this
contract and any renewal(s).and extension(s) of it. By execution of this contract, unless it is a state agency or
subdivision as defined by subsection 768.28(2), F.S.. the Provider accepts full responsibility for identifying
_ and determining the type(s)and extent of liability insurance necessary to provide reasonable financial
protections for the Provider and the clients to be served under this contract. The Alliance shall be included as
an additional insured on the provider's liability insurance policy or policies and a copy of the Certificate of
Insurance shall be provided annually or when any changes—occur. The limits of coverage under each policy
maintained by the Provider do not limit the Provider's liability and obligations under this contract.The
Provider shall ensure that the Alliance has copy of the most current written verification of insurance coverage
throughout the term of this contract. Such coverage may be provided by a self-insurance program established
and operating under the laws of the State of Florida.The Alliance reserves the right to require additional
insurance as specified in this contract.
18.2 Throughout the term of this agreement,the Provider shall maintain an insurance bond from a responsible
commercial insurance company covering all officers,directors,employees and agents of the Provider
authorized to handle funds received or disbursed under all agreements and/or contracts incorporating this
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contract by reference in an amount commensurate with the funds handled,the degree of risk as determined by
the insurance company and consistent with good business practices.
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19. Confidentiality of Information
The Provider shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally
authorized to give that consent or when authorized by law.
20. Health Insurance Portability and Accountability Act
Where applicable,the Provider shall comply with the Health Insurance Portability and Accountability Act(42 USC
1320d.),as well as all regulations promulgated thereunder(45 CFR 160, 162, and 164).
21. Incident Reporting
21.1 The Provider shall notify the Alliance immediately but no later than forty-eight(48) hours from the Provider's
awareness or discovery of conditions that may materially affect the Provider's, subcontractor's or vendor's
ability to perform the services required to be performed under any contract. Such notice shall be made orally
to the Contract Manager(by telephone) with an email to immediately follow.
21.2 The Provider shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll free telephone
number(1-800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon the
Provider, subcontractors, vendors, and their employees.
22. Bankruptcy Notification
If, at any time during the term of this contract,the Provider, its assignees, subcontractors, vendors or affiliates files a
claim for bankruptcy,the Provider must immediately notify the Alliance. Within ten(10) days after notification,the
Provider must also provide the following information to the Alliance: (1)the date of filing of the bankruptcy
petition; (2)the case number; (3)the court name and the division in which the petition was filed(e. g.,Northern
District of Florida,Tallahassee Division); and, (4)the name, address,and telephone number of the bankruptcy
attorney.
23. Sponsorship and Publicity
23.1 As required by s. 286.25, F.S., if the Provider is a non-governmental organization which sponsors a program
financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in
publicizing, advertising, or describing the sponsorship of the program. state: "Sponsored by(Provider's
name),the State of Florida Department of Elder Affairs and the Alliance for Aging, Inc." If the sponsorship
reference is in written material, the words "State of Florida, Department of Elder Affairs" and"Alliance for
Aging, Inc."shall appear in at least the same size letters or type as the name of the organization.
23.2 The Provider shall not use the words"The State of Florida Department of Elder Affairs"or"Alliance for
Aging, Inc."to indicate sponsorship of a program otherwise financed, unless specific authorization has been
obtained by the Alliance prior to use.
24. Assignments
24.1 The Provider shall not assign the rights and responsibilities under this Contract without the prior written
approval of the Alliance, which shall not be unreasonably withheld.. 4ny sublicense, assignment, or transfer
otherwise occurring without prior written approval of the Alliance will constitute a material breach of the
contract.
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24.2 The Alliance shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or
obligations under this contract to another agency upon giving prior written notice to the Provider. In the event
the Alliance approves transfer of the Provider's obligations, the Provider remains responsible for all work
performed and all expenses incurred in connection with the contract.
24.3 This contract shall remain binding upon the successors in interest of either the Provider or the Alliance.
25. Subcontracts
25.1 The Provider is responsible for all work performed pursuant to this contract_attf the Service Provider
Application in response to the 2018 OAA RFP whether actually furnished by the provider or its
subcontractors and/or vendors. Any subcontracts shall be evidenced by a written document and subject to any
conditions of approval the Alliance for Aging deems necessary. The Provider must ensure that the Alliance
has a current list of all subcontractors and/or vendors. The Provider further agrees that the Alliance shall not
be liable to the subcontractor and/or vendor in any way or for any reason. The Provider, at its expense, shall
defend the Alliance against any such claims.
25.2 The Provider shall promptly pay any subcontractors and/or vendors upon receipt of payment from the
Alliance. Failure to make payments to any subcontractor and/or vendor in accordance with s. 287.0585, F.S.,
unless otherwise stated in the contract between the Provider and subcontractor and/or vendor,will result in a
penalty as provided by statute.
26. Independent Capacity of Provider
It is the intent and understanding of the Parties that the Provider, or any of its subcontractors and/or vendors, are
independent contractors and are not employees of the Alliance and shall not hold themselves out as employees or
agents of the Alliance without specific authorization from the Alliance. It is the further intent and understanding of
the Parties that the Alliance does not control the employment practices of the Provider and shall not be liable for any
wage and hour, employment discrimination, or other labor and employment claims against the Provider or its
subcontractors and/or vendors. All deductions for social security, withholding taxes, income taxes, contributions to
unemployment compensation hinds and all necessary insurance for the Provider shall be the sole responsibility of
the Provider.
27. Payment
27.1. Payments will be made to the Provider pursuant to s. 215.422, F.S., as services are rendered and invoiced by
the Provider. The Alliance will have final approval of the invoice for payment. and will approve the invoice
for payment only if the Provider has met all terms and conditions of the contract, unless the bid specifications,
purchase order, or this contract specify otherwise. The approved invoice will be submitted to the Alliance's
fiscal section for budgetary approval and processing. Disputes arising over invoicing and payments will be
resolved in accordance with the provisions of s. 215.422 F.S.
27.2.The Provider agrees to submit bills for fees or other compensation for services or expenses in sufficient detail
for a proper pre audit and post audit thereof. The contractor shall comply with the particular requirements
under the following laws and guidelines that are applicable to the contracts or agreements incorporating in this
Contract by reference: (a) paragraph(16)(b)of section 216.181, F.S., regarding advances; (b) Rule 69I-
40.103 F.A.C. pertaining to Restriction of Expenditures from state funds; and, (c)the Invoice Requirements of
the Reference Guide for State Expenditures from the Department of Financial Services at:
http://www.mvfloridacfo.com/aadir/reference guide/Reference Guide For State Expenditures.pdf
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The Provider will certify that detailed documentation is available to support each item on the itemized invoice
or payment request for cost reimbursed expenses, fixed rate or deliverables contracts or agreements
incorporating this Contract by reference, including paid subcontractor and/or vendor invoices, and will be
produced upon request by the Alliance. The Provider will further certify that reimbursement requests are only
for allowable expenses as defined in the laws and guiding circulars cited in Sections 4 of this Contract, in the
Reference Guide for State Expenditures, and any other laws or regulations, as applicable.
27.3. The Provider, its subcontractors and/or vendors shall provide units of deliverables, including reports, findings,
and drafts as specified in the contracts or agreements and attachments which incorporate this Contract to be
received and accepted by the Contract Manager prior to payment.
27.4. Payments will be made to the Provider based on a complete and correct invoice, invoices that are incomplete
or with incorrect total will not be processed and will be returned to the Provider for correction. Fiscal staff
will not be able to correct or make changes to the invoices. Returning invoices for corrections may result in
failure to receive payment for that month. Invoices shall be submitted timely as per ATTACHMENT VIII in
order to avoid any payment delays.
27.5. Each service performed shall be recorded as specified in the client information and registration tracking
system(CIRTS)guidelines. Supporting documentation of services provided must be adequate to permit fiscal
and programmatic evaluation, and ensure internal management.
28. Return of Funds
The Provider will 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 this contract that were disbursed to the
Provider by the Alliance. In the event that the Provider or its independent auditor discovers that an overpayment has
been made,the Provider shall repay said overpayment immediately without prior notification from the Alliance. In
the event that the Alliance first discovers an overpayment has been made,the Contract Manager, on behalf of the
Alliance,will notify the Provider by letter of such findings. Should repayment not be made forthwith,the Provider
will be charged at the lawful rate of interest on the outstanding balance pursuant to s. 55.03, F.S., after Alliance
notification or Provider discovery.
29. Data Integrity and Safeguarding Information
The Provider and its subcontractors and/or vendors shall insure an appropriate level of data security for the
information the Provider is collecting or using in the performance of this contract. An appropriate level of security
includes approving and tracking all Provider employees that request system or information access and ensuring that
user access has been removed from all terminated employees. The Provider, among other requirements,must
anticipate and prepare for the loss of information processing capabilities. All data and software shall be routinely
backed up to ensure recovery from losses or outages of the computer system. The security over the backed-up data
is to be as stringent as the protection required of the primary systems. The Provider shall ensure all subcontractors
and/or vendors maintain written procedures for computer system back-up and recovery. The Provider shall complete
and sign ATTACHMENT III prior to the execution of this contract.
30. Computer Use and Social Media Policy
The DOEA has implemented a new Social Media Policy, in addition to its Computer Use Policy, which applies to
all employees, contracted employees, consultants, OPS and volunteers, including all personnel affiliated with third
parties, such as, but not limited to, Area Agencies on Aging and vendors. Any entity that uses the DOEA's
computer resource systems must comply with the DOEA's policy regarding social media. Social Media includes,
but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, social networks like
MySpace, Facebook and Twitter, as well as content sharing networks such as Flickr and YouTube. This policy is
available on DOEA's website at: http://elderaffairs.state.fl.us/doealfinancial.php
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31. Conflict of Interest
The Provider shall establish safeguards to prohibit employees, board members, management and subcontractors
and/or vendors from using their positions for a purpose that constitutes or presents the appearance of personal or
organizational conflict of interest or personal gain. No employee, officer or agent of the Provider or subcontractor
and/or vendor shall participate in selection, or in the award of an agreement supported by State or Federal funds if a
conflict of interest, real or apparent, would be involved. Such a conflict would arise when: (a) the employee, officer
or agent; (b)any member of his/her immediate family; (c) his or her partner, or; (d) an organization which employs,
or is about to employ, any of the above, has a financial or other interest in the firm selected for award. The Provider
or any subcontractor's and/or vendor's officers, employees or agents will neither solicit nor accept gratuities, favors
or anything of monetary value from contractors, potential contractors, or parties to subcontracts. The Provider's
board members and management must disclose to the Alliance any relationship which may be, or may be perceived
to be, a conflict of interest within thirty(30) calendar days of an individual's original appointment or placement in
that position, or if the individual is serving as an incumbent, within thirty (30) calendar days of the commencement
of this contract. The Provider's employees and subcontractors and/or vendors must make the same disclosures
described above to the Provider's board of directors. Compliance with this provision will be monitored.
32. Public Entity Crime
Pursuant to s. 287.133, F.S., the following restrictions are placed on the ability of persons convicted of public entity
crimes to transact business with the Alliance. A person or affiliate who has been placed on the convicted vendor list
following a conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any
goods or services to a public entity; may not submit a bid, proposal,or reply on a contract with a public entity for
the construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of
real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor,
vendor, 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.
33. Emergency Preparedness and Continuity of Operations
33.1 If the tasks to be performed pursuant to this contract include the physical care and control of clients, or the
administration and coordination of services necessary for client health. safety or welfare. the Provider shall.
within thirty (30)calendar days of the execution of this contract, submit to the Contract Manager verification
of an emergency preparedness plan (Continuity of Operations Plan.) In the event of an emergency,the
Provider shall notify the Alliance of emergency provisions.
33.2 In the event a situation results in a cessation of services by a subcontractor and/or vendor, the Provider shall
retain responsibility for performance under this contract and must follow procedures to ensure continuity of
operations without interruptions.
33.3 Contractors offering nutrition services must have at least 3 days' worth of shelf stable meals or a pre-
approved three-day menu for emergency meals w ith reserved funds set aside to purchase the food items and at
least one back-up caterer who can provide meals immediately in the event of an emergency. Either option
must be made available immediately to clients in the event of an emergency to ensure continuity of meal
services without interruption and must be included in the Contractor's Continuity of Operations Plan(COOP).
34. Use of Contract Funds to Purchase Equipment
No funds under this contract will be used by the Provider to purchase equipment.
Equipment means: (a)an article of nonexpendable,tangible personal property having a useful life of more than one
year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the
organization for the financial statement purposes, or$5,000.00 [for federal funds], or(b); nonexpendable,tangible
personal property of a non-consumable nature with an acquisition cost of$1,000.00 or more per unit, and expected
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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].
35. The PUR 1000 Form is hereby incorporated by reference and available at:
http://www.mvflorida.com/apes/vbs/adoc/F77 ICt Pf IRi 000.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, lithe 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.
36. Use of State Funds to Purchase or Improve Real Property -
No funds under this contract will be used by the Provider to purchase or improve Real Property.
Any state funds provided for the purchase of or improvements to real property are contingent upon the Provider or
political 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.
37. Dispute Resolution •
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce the
decision to writing and serve a copy on the Provider.
38. Financial Consequences of Non-Performance •
38.1 If the Provider fails to meet the minimum level of service or performance identified in this agreement, or that
is customary for the industry, then the Alliance may apply financial consequences commensurate with the
deficiency as referenced in ATTACHMENT I, Sec. 3.5.2. Financial consequences may also include contract
suspension, refusing payment, withholding payments until deficiency is cured,tendering only partial
payments, and/or cancellation of contract and reacquiring services from an alternate source.
38.2 The Provider shall not be charged with financial consequences, when a failure to perform arises out of causes
that were the responsibility of the Alliance.
39. 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.
40. Venue
If any dispute arises out of this contract, the venue of such legal recourse will be Miami-Dade County, Florida.
41. Entire Contract
This contract contains all the terms and conditions agreed upon by the parties. No oral agreements or
representations shall be valid or binding upon the Alliance or the Provider unless expressly contained herein or by a
written amendment to this contract signed by both Parties.
42. 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.
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43. Severability Clause
The Parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable,
the other provisions are severable to that void provision and shall remain in full force and effect.
44. 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.
45. Addition/Deletion
The Parties agree that, notwithstanding the terms of the procurement documents and actions leading to this contract,
the Alliance reserves the right to add or to delete any of the services required under this contract when deemed to be
in the best interest of the elder population targeted by the Area Plan and reduced to a written amendment signed by
both Parties. The Parties shall negotiate compensation for any additional services added.
46. Waiver •
The delay or failure by the Alliance to exercise or enforce any of its rights under this contract shall not constitute or
be deemed a waiver of the Alliance's right thereafter to enforce those rights, nor shall any single or partial exercise
of any such right preclude any other or further exercise thereof or the exercise of any other right.
47. Compliance •
The Provider shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable
current State statutes, laws, rules and regulations. The Parties agree that failure of the Provider to abide by these
- laws shall be deemed an event of default of the Provider, and subject the contract to immediate, unilateral
cancellation of the contract at the discretion of the Alliance.
48. Final Invoice
The Provider shall submit the final invoice for payment to the Alliance as specified in section 3.4.7(date for final
request for payment) of ATTACHMENT I. If the Provider fails to submit final request for payment by the deadline,
then all rights to payment may be forfeited and the Alliance may not honor any requests submitted after the
aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from
the Provider and necessary adjustments thereto have been approved by the Alliance.
49. Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only \\hen they ha\e been reduced to \Nriting and duly
signed by both parties.
50. Suspension of Work:
The Alliance may in its sole discretion suspend any or all.activities under this Contract and any Contract or
agreement incorporating in this Contract, at any time, when in the best interests of the State to do so.The Alliance
shall provide the Provider written notice outlining the particulars of suspension. Examples of the reason for
suspension include, but are not limited to, budgetary constraints, declaration of emergency, or other such
circumstances. After receiving a suspension notice,the Provider shall comply with the notice and shall not accept
any purchase orders. Within ninety days, or any longer period agreed to by the Provider,the Alliance shall either(1)
issue a notice authorizing resumption of work, at which time activity shall resume, or(2)terminate the Contract or
purchase order. Suspension of work shall not entitle the Provider to any additional compensation.
51. Termination
51.1 This contract may be terminated by either party without cause upon no less than thirty (30)calendar days'
notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall
be delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or
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by hand delivery to the Contract Manager or the representative of the Provider responsible for administration
of the contract.
51.2 In the event funds for payment pursuant to this contract become unavailable, the Alliance may terminate this
contract upon no less than twenty-four(24) hours' notice in writing to the Provider. Said notice shall be
delivered by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by
hand delivery to the Contract Manager or the representative of the Provider responsible for administration of
the contract. The Alliance will be the final authority as to the availability and adequacy of funds. In the event
of termination of this contract,the Provider will be compensated for any work satisfactorily completed prior
to the date of termination.
51.3 Termination for Cause
This contract may be terminated for cause by the Alliance upon no less than twenty-four(24)hours' notice in
writing to the Provider. Waiver of breach of any provisions of this contract shall not be deemed to be a
waiver of any other breach and shall not be construed to be a modification of the terms and conditions of this
contract. The provisions herein do not limit the Alliance's or the Provider's rights to remedies at law or in
equity.
51.4 Failure to have performed any contractual obligations with the Alliance in a manner satisfactory to the
Alliance will be a sufficient cause for termination. To be terminated as a contractor under this provision,the
Provider must have(1) previously failed to satisfactorily perform in a contract with the Alliance, been notified
by the Alliance of the unsatisfactory performance and failed to correct the unsatisfactory performance to the
satisfaction of the Alliance; or(2)had a contract terminated by the Alliance for cause.
51.5. Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and
shall not be construed to be a modification of the terms and conditions of this contract. The provisions herein
do not limit the Alliance's right to remedies at law or to damages of a legal or equitable nature.
51.6. Upon termination of this contract,the Provider. its subcontractors and/or its vendors shall, at no cost to the
Alliance, transfer all public records in their procession to the Alliance and destroy any duplicate records that
are exempt, or confidential and exempt. from public records disclosure requirements. All records stored
electronically shall be provided to the Alliance in a format that is compatible with the information technology
systems of the Alliance.
52. Electronic Records and Signature
The Alliance authorizes, but does not require,the Provider to create and retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this Contract. A contractor that
creates and retains electronic records and uses electronic signatures to conduct transactions shall comply with the
requirements contained in the Uniform Electronic Transaction Act, s. 668.50, Fla. Stat. All electronic records must
be fully auditable; are subject to Florida's Public Records Law, ch. 119, Fla. Stat.; must comply with section 28,
Data Integrity and Safeguarding Information; must maintain all confidentiality, as applicable; and must be retained
and maintained by the Provider to the same extent as non-electronic records are retained and maintained as required
by this Contract.
52.1. The Alliance's authorization pursuant to this section does not authorize electronic transactions between the
Provider and the Alliance. The Provider is authorized to conduct electronic transactions with the Alliance only
upon further written consent by the Alliance.
•
52.2. Upon request by the Alliance,the Provider shall provide the Alliance or DOEA with non-electronic(paper)
copies of records.Non-electronic(paper)copies provided to the Alliance of any document that was originally
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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.
53. Special Provisions:
The Provider agrees to the following provisions:
53.1 Investigation of Criminal Allegations:
Any report that implies criminal intent on the part of the Provider or any subcontractors and/or vendors and
was referred to a governmental or investigatory agency must be sent to the Alliance. If the Provider has reason
to believe that the allegations will be referred to the State Attorney, a law enforcement agency, the United
States Attorney's office, or other governmental agency, the Provider shall notify the Alliance immediately. A
copy of all documents, reports, notes or other written material concerning the investigation, whether in the
possession of the Provider, its subcontractors, or vendors, must be sent to the Alliance's contract manager
with a summary of the investigation and allegations.
53.2 Volunteers:
The Provider shall ensure the use of trained volunteers in providing direct services delivered to older
individuals and individuals with disabilities needing such services. If possible, the Provider shall work in
coordination with organizations that have experience in providing training, placement, and stipends for
volunteers or participants(such as organizations carrying out federal service programs administered by the
Corporation for National and Community Service), in community service settings.
54. Enforcement:
54.1 In accordance with Section 430.04, F.S., the Alliance may, without taking any intermediate measures
available to it against this Contract rescind this Contract if the Alliance finds that: .
54.2 An intentional or negligent act of the Provider has materially affected the health,welfare, or safety of clients
served pursuant to any contract or agreement, or substantially and negatively affected the operation of services
covered under any contract or agreement;
54.3 The Provider lacks financial stability sufficient to meet contractual obligations or that contractual funds have
been misappropriated; •
54.4 The Provider has committed multiple or repeated violations of legal and regulatory standards, regardless of
whether such laws or regulations are enforced by the Alliance, or the Provider has committed or repeated
violations of Alliance standards:
54.5 The Provider has failed to continue the provision or expansion of services after the declaration of a state of
emergency; and/or
54.6 The Provider has failed to adhere to the terms of any contract or agreement incorporating in this Contract.
54.7 In the alternative,the Alliance may, at its sole discretion, in accordance with section 430.04,F.S.,take
immediate measures against the Provider, including: corrective action, unannounced special monitoring,
temporary assumption of the operation of one or more contractual services, placement of the Provider on
probationary status, imposing a moratorium on Provider action, imposing financial penalties for
nonperformance, or other administrative action pursuant to Chapter 120, F.S.
54.8 In making any determination under this provision the Alliance may rely upon the findings of another state or
federal agency, or other regulatory body. Any claims for damages for breach of any contract or agreement are
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exempt from administrative proceedings and shall be brought before the appropriate entity in the venue of
Miami-Dade County.
55. Training
The Provider will attend all required trainings and meetings schedule by the Alliance.
•
56. Official Payee and Representatives (Name,Address, and Telephone Numbers)
The name, address. and telephone number of the representative for the Alliance for this contract is:
Max B. Rothman, JD, LL.MM1. 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:
Monroe County Board of County Commissioners,
The Contractor name, as shown on page 1 of Social Services/In-Home Services
A this contract, and mailing address of the official 1100 Simonton Street,2"d Floor
payee to whom the payment shall be made is: Key West, FL 33040
305-292-4510
Sheryl Graham
The name of the contact person of the Monroe County Board of County Commissioners,
B Contractor and street address where financial Social Services/In-Home Services
and administrative records are maintained is: 1 100 Simonton Street,2"d Floor
Key West, FL 33040
305-292-4510
Sheryl Graham
The name, address, and telephone number of Monroe County Board of County Commissioners,
c the representative of the Provider responsible Social Services/In-Home Services
for administration of the program under this 1 100 Simonton Street,2"d Floor
contract is: - Key West, FL 33040
305-292-4510
Alliance for Aging., Inc.
The section and location within the AAA where Fiscal Department
d Requests for Payment and Receipt and 760 NW 107th Avenue, Suite 214
Expenditure forms are to be mailed is: Miami, Florida 33 1 72-3 1 55
305-670-6500
Contract Monitor
The name, address,and telephone number of Alliance for Aging, Inc.
e the Contract Manager for the AAA for this 760 NW 107th Avenue, Suite 214
contract is: Miami, Florida 33172-3155
305-670-6500
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party and the notification attached to the originals of this contract.
57.All Terms and Conditions Included
This contract and its ATTACHMENTS I, II, III,VI, VII, VIII, IX,X, B, D, F, G, and K and any exhibits referenced
in said attachments,together with any documents incorporated by reference, contain all the terms and conditions
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•
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 76-page contract, to be executed by their undersigned
officials as duly authorized.
MONROE COUN OARD OF COUNTY
COMMISSIONE S, OCIAL
SERVICES/IN- E SERV ES ALLIANCE FOR AGING, INC.
SIGNED Ivil
SIGNED BY: j � i
NANIE/! V i" I l,1 r NAME: MAX B. ROTHMAN, J E: L.M.
TITLE: \ I Ckl Di `
DATE: V C� J TITLE: PRESIDENT AND CEO
� l9l 1,01 Ls., DATE: /ri ,l q
(SEAL) � .M
P K, RP OE EOD A 0 NEY
A �:KEVlid CLERK ,,,�
BY. (A C l'�°
DENT,/CLERK PEDRO .MERCADO N�
`•��k4) ASSISTANT r! Y
Z 3/
Datea` _
A.
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Page 17 of 76
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INDEX TO CONTRACT ATTACHMENTS
ATTACHMENT ATTACHMENT DESCRIPTION PAGE
ATTACHMENT I STATEMENT OF WORK 19-34
ATTACHMENT II FINANCIAL COMPLIANCE AUDIT ATTACHMENT 35-37
ATTACHMENT II AUDIT REPLATIONSHIP DETERMINATION 38-39
EXHIBIT 1
ATTACHMENT II FEDERAL RESOURCES AWARDED PURSUANT TO THIS 40-41
EXHIBIT 2 AGREEMENT
ATTACHMENT III CERTIFICATIONS AND ASSURANCES 42-47
ATTACHMENT VI ASSURANCES—NON-CONSTRUCTION PROGRAMS 48-49
ATTACHMENT VII CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE 50
ATTACHMENT VIII OLDER AMERICANS ACT CONTRACT REPORT CALENDAR 51
ATTACHMENT IX REQUEST FOR PAYMENT 52
ATTACHMENT X, RECEIPTS AND EXPENDITURES, FOR ALL OAA TITLES 53
EXHIBIT 1
ATTACHMENT X, RECEIPTS AND EXPENDITURES, FOR NSIP 54
EXHIBIT 2
ATTACHMENT X, PROVIDER MONTHLY MEALS REPORT, FOR NSIP 55
EXHIBIT 3
ATTACHMENT B DEPARTMENT OF ELDER AFFAIRS' CIVIL RIGHTS COMPLIANCE 56-61
CHECKLIST AND INSTRUCTIONS
ATTACHMENT D BACKGROUND SCREENING—AFFIDAVIT OF COMPLIANCE 62
ATTACHMENT F BUSINESS ASSOCIATE AGREEMENT 63-69
ATTACHMENT G ADRC POLICY AND PROCEDURES FOR OUTSOURCED 70-74
FUNCTIONS
ATTACHMENT K INCONTINENCE SUPPLIES/NUTRITIONAL PRODUCTS LIST 75-76
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ATTACHMENT I
ALLIANCE FOR AGING, INC.
•
STATEMENT OF WORK
OLDER AMERICANS ACT
SECTION I: SERVICES TO BE PROVIDED
1.1 Alliance For Aging, Inc. Mission Statement
The Alliance mission is to promote and advocate for the optimal quality of life for older adults and their families.
1.2 Program Specific Terms
Area Plan: A plan developed by the area agency on aging outlining a comprehensive and coordinated service
delivery system in its planning and service area in accordance with the Section 306(42 U.S.C. 3026) of the
Older Americans Act and DOEA instructions.
Area Plan Update: A revision to the area plan wherein the Alliance enters OAA specific data in the Client
Information and Registration Tracking System(CIRTS). An update may also include other revisions to the area
plan as instructed by the DOEA.
Child: An individual who is not more than 18 years of age or an individual with disability.
Criteria: A standard which the Administration on Aging/Administration for Community Living set for the
Title IIID Program. AoA/ACL's standard criterion consists of three tiers: Minimal Criteria, Intermediate
Criteria, and Highest-Level Criteria.
•
Family Caregiver: An adult family member, or another individual, who is an informal provider of in-home and
community care to an older individual.
Frail: When an older individual is unable to perform at least two activities of daily living(ADLs)without
substantial human assistance. including verbal reminding. physical cueing or supervision: or due to cognitive or
other mental impairment, requires substantial supervision because the individual behaves in a manner that poses
a serious health or safety hazard to the individual or to another individual.
Grandparent: A grandparent or step-grandparent of a child. or a relative of a child by blood, marriage or
adoption and who lives with the child; is the primary caregiver of the child because the biological or adoptive
parents are unable or unwilling to serve as the primary caregiver of the child: and has a legal relationship to the
child, such as legal custody or guardianship, or is raising the child informally.
Living Healthy: Also known as CDSMP for the State of Florida.
1.3 General Description
1.3.1 General Statement
The OAA Program is a federal program initiative that provides assistance to older persons and caregivers and
is the only federal supportive services program directed solely toward improving the lives of older people.
The program provides a framework for a partnership among the different levels of government and the public
and private sectors with a common objective, improving the quality of life for all older individuals by helping
them to remain independent and productive. The primary purpose of the OAA program is to foster the
development and implementation of comprehensive and coordinated systems to serve older individuals. The
OAA program uses these systems to assist older individuals to attain and maintain maximum independence
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and dignity in a home environment and allows for the capability of self-care with appropriate supportive
services. _
The NSIP provides incentives for the effective delivery of nutritious meals to older individuals. NSIP
allows programs to increase the number and/or the quality of meals served. NSIP is a cash allotment or
commodity program that supplements funding or food used in meals served under the OAA. Florida
has opted for cash payments in lieu of donated foods.
1.3.2 Authority
All applicable federal laws, regulations, action transmittals, program instructions, review guides and
similar documentation related to the following:
a. Catalog of Federal Domestic Assistance No. 93.043, 93.044, 93.045. 93.052, and 93.053;
b. Older Americans Act of 1965, as amended 2016;
c. Older Americans Act of 1965. as amended 2016. Section 311 (42 U.S.C. §3030a);
d. 42 U.S.C. §303. 42 U.S.C. §604;
e. Rule 58A-1, Florida Administrathe Cock (FAC);
f. Section 430.101, Florida Statutes (F.S.): and
g. DOEA Programs and Services Handbook, •
http: /www.allianceforaging.org/providers/program-documents
1.3.3 Scope of Service
The Provider is responsible for coordinating and assessing the needs of older persons, and assuring the
availability of quality services. The services shall be provided in a manner consistent with, and described in,
both the current DOEA Programs and Services Handbook and the Provider's Service Provider Application(s)
submitted in response to the 2018 OAA RFP. If receiving NSIP funding, the provider shall use NSIP funding
to supplement funding for food used in meals served by OAA Nutrition Program Providers.
1.3.4 Major Program Goals
The major goals of the OAA program are to improve the quality of life for older individuals, preserve their
• independence and prevent or delay more costly institutional care. These goals are achieved through the
implementation of a comprehensive and coordinated service system that provides a continuum of service
alternatives that meet the diverse needs of elders and their caregivers.
1.3.5 Leadership and Advocacy
As a designated Focal Point, a provider is encouraged to provide coordination of services for older
individuals. The Provider must also provide community leadership on aging issues and serve as the advocate
and focal point for the elderly within the community in cooperation with agencies, organizations and
individuals participating in activities funded by the Alliance. Advocacy should include initiating positive
changes in public or private policies and attitudes towards older persons, taking action to improve, modify, or
eliminate situations which adversely impact on lives of older persons, or expressing support for older persons
and their interests. Advocacy activities may be broadly supportive of the general interests of older persons or
may involve specific activities on behalf of individuals.
1.4 Clients To Be Served
1.4.1 General Description
Preference shall be given to those with the greatest economic and social needs, with particular attention to
low-income older individuals, including those that are low-income minorities, have limited English
proficiency, and older individuals residing in rural areas.
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1.4.1.1 OAA Title III, General Client Eligibility
• Consumers shall not be dually enrolled in an OAA program and a Medicaid capitated long-term
care program, with the exception of consumers in need of OAA Legal Assistance services and OAA .
Congregate Nutrition Services, including transportation services to and from congregate meal sites.
•
1.4.1.2 NSIP
Meals served to an elderly individual, funded in whole or in part under Statewide Medicaid
Managed Care Long-Term Care, Home Care for the Elderly, Community.Care for the Elderly
Programs, or other means tested programs may not be included in the NSIP count. OAA-
funded congregate meals provided to SMMC LTC clients may be included in the NSIP count.
1.4.1.3 OAA Title IIIB, Supportive Services, Client Eligibility
(1) Individuals age 60 or older •
•
1.4.1.4 OAA Titles IIIC1 and iI1C2,Nutrition Services, Client Edibility
General factors that should be considered in establishing priority for nutrition services include those
older persons who meet the following:
(1) Cannot afford to eat adequately;
(2) Lack the skills or knowledge to select and prepare nourishing and well-balanced'meals;
(3) Have limited mobility which may impair their capacity to shop and cook for themselves; or
• (4) Have a disabling illness or physical condition requiring nutritional support or have been
screened at a high nutritional risk.
1.4.1.5 OAA Title MCI, Congregate Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in
ATTACHMENT I, Paragraph 1.4.1.3 individuals must be mobile, not homebound and physically,
mentally and medically able to attend a congregate nutrition program. Individuals eligible to
receive congregate meals include:
(1) Individuals age 60 or older; and
(2) Any spouse(regardless of age) who attends the dining center with his/her eligible spouse;
(3) Persons with a disability, regardless of age, who reside in a housing facility occupied primarily
by older individuals where congregate nutrition services are provided;
(4) Disabled persons who reside at home with and accompany an eligible person to the dining
center; and
(5) Volunteers, regardless of age, who provide essential services on a regular basis during meal
hours. y
1.4.1.6 OAA Title 111C2, Home Delivered Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in
ATTACHMENT I, Paragraph 1.4.1.3, individuals must be homebound and physically, mentally or
medically unable to attend a congregate nutrition program. Individuals eligible to receive home
delivered meals include the following:
(1). Individuals age 60 or older who are homebound by reason of illness, disability or isolation;
(2) The spouse of a homebound eligible individual, regardless of age, if the provision of the
• collateral meal supports maintaining the person at home;
(3) Individuals with disabilities, regardless of age, who reside at home with eligible individuals and
are dependent on them for care; and
(4) Persons at nutritional risk who have physical, emotional or behavioral conditions,which would
make their presence at the congregate site inappropriate; and persons at nutritional risk who are
socially or otherwise isolated and unable to attend a congregate nutrition site.
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1.4.1.7 OAA TITLE IUD.DISEASE PREVENTION AND HEALTI-► PROMOTION SERVICES
(1) Target individuals age sixty (60) or older; and
(2) Priority will be given to individuals residing in medically underservecl areas.
1.4.1.8 OAA Title IIIE, Caregiver Support Services, Client Eligibility
(1) Family caregivers of individuals age 60 or older;
(2) Grandparents(age 55 or older)or older individuals (age 55 or older)who are relative
caregivers;
(3) Priority will be given to family caregivers who provide care for individuals with Alzheimer's
disease and related disorders with neurological and organic brain dysfunction and for
grandparents or older individuals who are relative caregivers who provide care for children with
severe disabilities; and
(4) For respite and supplemental services, a family caregiver must be providing care for an older
individual who meets the definition of the term"frail" in OAA, as per ATTACHMENT I,
Section 1.2.
SECTION II—MANNER OF SERVICE PROVISION
2.1 Service Tasks
In order to achieve the goals of the OAA program, the Provider shall ensure the following tasks:
(1) Client Eligibility Determination: The Provider shall ensure that applicant data is evaluated to determine
eligibility prior to rendering services. Eligibility to become a client is based on meeting the requirements
described in this Contract.
(2) Targeting and Screening of Service Delivery for New Clients: The Provider shall develop and implement
policies and procedures consistent with OAA targeting and screening criteria.
(3) Program Services: The Provider shall ensure the provision of a continuum of services that meets the diverse
needs of elders and their caregivers. The Provider shall ensure the performance and report performance of
the following services are in accordance with the current DOEA Programs and Services Handbook.
(4) Program Eligibility Requirements
a. Eligibility Criteria
Entities must meet the follov'ing criteria to be eli`ible for program participation:
i. An agency that has received a grant under OAA Title III [OAA section 311(42 U.S.C.
3030a)]; and
ii. A nutrition service provider that serves meals and is under the jurisdiction. control.
management and audit authority of the Area Agency on Aging and the Florida
Department of Elder Affairs.
b. Provider's Nutrition Service Operations
The Contractor shall ensure the nutrition sere ice operations of the provider meet the requirements
of this contract, as well as any other applicable regulations and policies prescribed by the current
DOEA Programs and Services Handbook, the Department of Health and Human Services,
USDA, DOH and local health departments, DBPR, or any other agency designated to inspect
meal quality for the State.
c. Prescribed Nutritional Requirements
The Contractor shall ensure that each meal provided under this contract meets the following
criteria:
i. Complies with the current Dietary Guidelines for Americans, published by the Secretaries of
the Department of Health and Human Services and the Department of Agriculture; and
ii. Provides a minimum of 33 1/3 percent of the dietary reference intakes/adequate intakes for an
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age 70+female as established by the Food and Nutrition Board of the National Academy of
Sciences.
d. Food Origin and Commodities Requirements
Consistent with existing requirements of the NSIP. the Contractor and its service providers may
use NSIP cash to purchase foods of U.S. origin for their nutrition projects under Title Ill of the
OAA. NSIP funds must be used to expand meal services to older adults.
(5) Monitoring the performance of'its subcontractors and/or vendors
2.2 Use of Subcontractors and/or Vendors •
If this contract involves the use of a subcontractor and/or vendor. then the Provider shall not delay the
implementation of its agreement with the subcontractor or vendor. if any circumstance occurs that may result
in a delay for a period of sixty (60) days or more the initiation of the subcontract/vendor or the performance
of the subcontractor/vendor, the Provider shall notify the Alliance Contract Manager in writing of such delay.
The Provider shall not permit a subcontractor/vendor to perform services related to this contract without
having a binding subcontractor/vendor agreement executed. The Alliance will not be responsible or liable for
any obligations or claims resulting from such action.
2.2.1 Copies of Subcontracts/Vendors
The Provider shall submit a copy of all subcontracts and/or vendors to the Alliance Contract Manager
within thirty(30) clays of execution of each subcontract agreement.
2.2.2 Monitoring the Performance of S ubcontractors and/or Vendors
The Provider shall monitor, at least once per year, each of its subcontractors, sub-recipients, vendors,
and/or consultants paid from funds provided under this contract.
a. Subcontractors - The Provider 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 Provider shall monitor to
ensure that time schedules are met, the budget and scope of work are accomplished within the
specified time periods, and other performance goals stated in this contract are achieved.
b. Vendors —The Provider shall perform administrative and programmatic monitoring to ensure
contractual compliance. programmatic performance and compliance with applicable state and
federal laws and regulations. The Provider shall monitor to ensure that time schedules are met,
and the scope of work is accomplished within the specified time periods, and other performance
goals stated in this contract al'e achie%ed. i-h. Pro' modified fiscal
monitoring to include billing.'invoicing procedures and reconciliation to ensure fiscal
accountability.
2.2.3 The Provider shall ensure that all required client data for services provided by subcontractors and/or
vendors are entered in the CIRTS database per the Department's CIRTS Policy Guidelines. The data
must be entered into the CIRTS database before the Provider submits the Request for Payment and
Expenditure Reports to the Alliance. The Provider shall establish time frames with its subcontractors
and vendors to ensure compliance with due dates for the Requests for Payment and Expenditure
Reports to the Alliance.
2.3 Staffing Requirements
2.3.1 Staffing Levels
The Provider shall assign its own administrative and support staff as needed to perform the tasks,
responsibilities and duties under this contract and ensure that subcontractors and/or vendors dedicate
adequate staff accordingly.
2.3.2 Professional Qualifications
The Provider shall ensure that the staff responsible for performing any duties or functions within this
contract have the qualifications as specified in the DOEA Programs and Services Handbook.
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2.3.3 Service Times
• The Provider shall ensure the provision of services listed in this contract during normal business
hours unless other times are more appropriate the meet the performance requirements of this contract,
and it shall monitor its subcontractors and/or vendors to ensure they are available to provide services
during hours responsive to client needs and during those times \Nhich best meet the needs of the
relevant service community.
2.3.4 Use of Volunteers to Expand the Provision of Available Services
The Provider shall make use of trained volunteers in providing direct services delivered to older individuals
and individuals with disabilities needing such services. If possible, the Provider shall work in coordination
with organizations that have experience in providing training, placement, and stipends for volunteers or
participants (such as organizations carrying out Federal service programs administered by the Corporation
for National and Community Service), in community service settings.
2.4 Deliverables
The following section provides the specific quantifiable units of deliverables and source documentation
required to evidence the completion of the tasks specified in this contract. The Provider must submit all
required documentation in the time and manner specified for the minimum performance levels to be met.
Each deliverable must be accepted in writing by the Alliance Contract Manager based on the requirements
for each deliverable before the Provider submits an invoice requesting payment.
The Provider shall ensure the provision of a continuum of services that meets the diverse needs of elders and
their caregivers. The Provider shall ensure the performance and reporting of the following services in
• accordance with the current DOEA Programs and Services Handbook and this contract. Documentation of
service delivery must include a report consisting of the following: number of clients served, number of service
units provided by service, and rate per service unit with calculations that equal the total invoice amount.
The Provider shall provide the services described in the contract in accordance with the current DOEA Program and
Services Handbook. Units of service will be paid pursuant to the rates established in ATTACHMENT VII and
ATTACHMENT K.
The services include the following categories•
2.4.1 Supportive Services (IIIB Program)
Supportive services include a 'ariety of community-based and home-delivered services that support the
quality of life for older individuals by helping them remain independent and productive. Services
include the following:
(1) Adult Day Care;
(2) Chore Services;
(3) Companionship;
(4) Counseling(Gerontological);
(5) Emergency Alert Response;
(6) Escort;
(7) Homemaker;
(8) Housing Improvement;
(9) Legal.Assistance ..
(10) Material Aid;
• (11) Personal Care;
(12) Recreation;
(13) Screening and Assessment;
(14) Shopping Assistance;
(15) Transportation; and
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(16) Specialized Medical Equipment, Services, and Supplies
2.4.2. Congregate Nutrition Services (IIICI Program)
Nutrition services are provided in congregate settings and are designed to reduce hunger and food
insecurity, promote socialization and the health and well-being of older individuals by assisting them to
gain access to nutrition and other disease prevention and health promotion services. Services include
the following:
(1) Congregate meals;
(2) Congregate meals screening;
(3) Nutrition education and nutrition counseling:
2.4.3 Home Delivered Nutrition Services (IIIC2 Program)
In-home nutrition services are provided to reduce hunger and food insecurity; promote socialization and
the health and well-being of older individuals by assisting such individuals to gain access to nutrition
and other disease prevention and health promotion services. Services include the following:
(1) Home delivered meals;
(2) Nutrition education and counseling;
(3) Screening/Assessment.
•
2.4.4. Disease Prevention and Health promotion Services(IIID Program)
Evidence-Based Disease Prevention and Health promotion(EBDPHP)service have been demonstrated
through evaluation to be effective for improving the health, wellbeing or reducing disease, disability
and/or injury among older adults, and proven effective with older adult populations. The ACL defines
EBDPHP services as meeting highest-level criteria. Only services that meet the highest-level criteria
are allowed under the IIID Program. EBDPHP services must be delivered per the requirements of the
program and ensure program fidelity. Evidence based programs include the following:
(1) A Matter of Balance
(2) Chronic Disease Self-Management
(3) Diabetes Self-Management Program
(4) Enhanced Fitness
(5) l-fomeMeds
2.4.5. Caregiver Support Services (IIIE Program)
The following services are intended to provide direct help to caregivers. assist in the areas of health.
nutrition and financial literacy and assist caregivers in making decisions and problem solving related to
their caregiving roles and responsibilities:
(1) Adult Day Care;
(2) Caregiver Training/Support(Individual & Group);
(3) Respite Services;
(4) Screening/Assessment;
2.4.6. Caregiver Support Supplemental Services (HIES Program)
The following services are provided to complement the care provided by caregivers:
(1) Chore Services;
(2) Housing Improvement;
(3) Material Aid; and
(4) Specialized Medical Equipment, Services and Supplies.
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•
2.4.7. Caregiver Support Grandparent Services (MEG Program):
Services for grandparents or older individuals who are relative caregivers designed to help meet their
caregiving obligations include the following:
(I) Legal Assistance;
2.5 Reports
The Provider is responsible for responding in a timely fashion to additional routine and/or special requests for
information and reports required by the Alliance. The Provider must establish due dates for any subcontractors
and/or vendors that permit the Provider to meet the Alliance's reporting requirements.
2.5.1 Service Cost Reports
The Provider shall submit Service Cost Reports to the Alliance annually, in conjunction with the
submission of the annual Independent Audit Report for the Provider fiscal year end. The Service Cost
Reports shall reflect actual costs of providing each service by program for the preceding Provider
fiscal year. If the Provider desires to renegotiate its reimbursement rates, the Provider shall make a
request in writing to the Alliance in accordance \Kith the Alliance's approved Reimbursement Rate
Review Policy,which is incorporated by reference.
2.5.2 Surplus/Deficit Report
The Provider will respond to the consolidated Surplus/Deficit report in a format provided by the
Alliance to the Alliance's contract manager. Surplus/Deficit reports must be submitted with the
monthly request for payment. This report is for all services provided in this agreement incorporating
in this Contract between the Provider and the Alliance. The report will include the following:
•
(1) A list of all Services and their current status regarding surplus or deficit, and why they differ from
its original budget projections.
(2) A detailed plan on how the surplus or deficit spending exceeding the 1% monthly threshold will
be resolved. The plan must include specific budget numbers to reflect how the Provider plans to
address the variance.
(3) Number of clients currently on the waitlist(APCL).
(4) Number of Unduplicated Client served.
2.5.3 Volunteer Activity Report
The Provider shall submit an annual unduplicated report of volunteer hours on the format provided by
the Alliance. The data collection period is from January 1 —December 31 for each calendar year.
The data submission date is five (5) working days following the close of the contract period.
• 2.5.4 CIRTS
Client Information and Registration Tracking System (CIRTS) Reports:
The Provider shall input OAA-specific data into CIRTS to ensure CIRTS data accuracy. The
Provider shall use CIRTS-generated reports which include the following:
(1) Client Reports;
(2) Monitoring Reports;
(3) Services Reports; and
(4) Outcome Measures Reports.
(5) Fiscal Reports
2.5.5 Program Highlights
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The Provider shall submit Program Highlights referencing specific events that occurred in previous
• contract year by September 10th of the current contract year. The Provider shall provide a new success
story, quote, testimonial, or human-interest vignette. The highlights shall be written for a general
audience, with no acronyms or technical terms. For all agencies.or organizations that are referenced in
the highlight,the Provider shall provide a brief description of their mission or role. The active tense
shall be consistently used in the highlight narrative, in order to identify the specific individual or
• entity that performed the activity described in the highlight. The Provider shall review and edit
Program Highlights for clarity, readability, relevance, specificity. human interest, and grammar, prior
to submitting them to the Alliance.
2.5.6 Outreach Activity
The Provider shall report on outreach activities at least semi-annually using a uniform reporting
format established by the Alliance.The format must include the following information: number
and type of provider events or activities: date and location: total number of participants at each
event or activity; individual service needs identified: and referral sources or information
provided. Reports must be submitted by June 30 and December 31 of each contract year. At a
minimum, the number of outreach activities required to be completed annually for the Provider
must be consistent with the number of outreach activities referenced in the Service Provider
Application (SPA) submitted in the 2018 OAA RFP.
2.�.7 Health and Wellness Reports•
The Provider shall submit Monthly' Programmatic Reports for EBDPHP services. The
• Alliance Contract Manager will provide an Excel spreadsheet with the following tabs:
Health and Wellness (one for each month); Success Story (reported only in May);
Partnership (one tab updated as needed); and a Statistical Breakdown Page.
a. Information provided in the Monthly Programmatic Report must match CIRTS data
and the Request for Payment.
b. The Provider shall review program documentation to ensure documentation is complete
and adequately supports the information reported on the Monthly Programmatic Report •
prior to submitting a Request for Payment. The Provider will attest to the review. in the
"comments" section of the Monthly Programmatic Report and provide relevant
information regarding the documentation as needed.
c. Program documentation shall include all the folloinc element,: Sign-in Sheet or
Attendance Log: flyers or documentation demonstrating efforts to recruit participants
and promote EBDPHP services provided: current facilitator certificates: copy of
program license (if applicable): and an., forms required by the specific program.
d. Provider shall ensure that program documentation includes a Sign-In Sheet or Attendance
Log with date,time, name of program, participant names. and name of program
facilitator(s). If the Attendance Log does not include a space for participant signatures.
additional program documentation must be included w ith participant signatures that
matches the participant names and dates in the Attendance Log. Exceptions may be
approved by Alliance Contract Manager. Requests must be made in writing and kept with
program documentation.
e. Participants must write and sign their name on program sign-in sheet or Attendance Log.
Attendance Logs with participant names typed or written in by the same person will not be
accepted as program documentation. If a participant refuses or is unable to write their own
name and sign, the instructor may sign by proxy for the participant with a note on the sign-
in sheet stating why it is necessary to do so (the note needs to be initialed and dated).
f. The Provider shall abide by all program fidelity requirements and annually observe delivery
of EBDPHP services. A note will be included in the Monthly Programmatic Report, in the
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comments section, when a program has been observed. Documentation pertaining to the
observation will be kept and provided to the Alliance upon request.
g. The Provider shall contact the Alliance Contract Manager in the event of an emergency or
an exigent circumstance where the provider is unable to maintain an aspect of fidelity of the
EBDPHP services (e.g., minimum or maximum number of participants) before the end of
the workshop. At the discretion of the Alliance Contract Manager, the service may be
reimbursed under this contract: however, if the fidelity infraction is discovered after the
program has finished. during the Request for Payment Process or a desk review, the
Provider may not be reimbursed for the workshop or shall be requested to reimburse the
Alliance the cost of the workshop.
h. The Provider shall collaborate and partner with organizations to extend the reach of
EBDPHP services. Partnerships shall be designed to stimulate innovation of new
approaches and activities in EBDPHP services. development of greater capacity, and
leverage other funding sources. Partnerships shall also address building and sustaining an
infrastructure for the dissemination of EBDPHP services. This includes, but is not limited
to, recruitment of trainers and participants. covering costs for licenses, and replicating
program fidelity.
i. The Contractor shall document, and provide to the Alliance upon request.evidence of
partnerships created formally through Memoranda of Agreement/Understanding. Provider will be
required to keep track of partnerships in the Monthly Programmatic Report. Each month the
Provider shall review and provide updates as necessary.
2.6 Records and Documentation
The Provider agrees to make available to Alliance and/or the Department staff and/or any party designated by the
Alliance and/or Department all contract related records and documentation. The Provider shall ensure the
collection and maintenance of all program related information and documentation on any such system
designated by the Alliance and/or the Department. Maintenance includes valid exports and backups of all
data and systems according to Department standards. Data must be usable and in a readable format by the
Alliance and/or the Department.
2.6.1. CIRTS Data Maintenance
The Provider will ensure the accurate collection and maintenance of client and service information on
a monthly basis from the CIRTS or any such system designated by the Alliance. Maintenance
includes valid exports and backups of all data and systems according to Alliance and DOEA
standards. The Provider must adhere to the Alliance CIRTS Data Integrity Policies & Procedures,
incorporated by reference, in order to ensure data accuracy.
2.6.2 Data Integrity and Back-up Procedures
The Provider shall maintain written policies and procedures for computer system backup and
recovery and shall have the same requirement of its subcontractors and/or vendors.These
policies and procedures shall he made available to the Alliance upon request.
2.7 Performance Specifications
2.7.1 Outcomes and Outputs (Performance Measures)—At a minimum,the Provider must:
(1) Ensure the provision of the services described in this contract are in accordance with the current
DOEA Programs and Services Handbook and in the Manner of Service Provision described in
this contract.
(2) Timely and accurately submit to the Alliance all information described in this contract.
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(3) Develop,document, and follow strategies in the Service Provider Application(SPA)to support
the Department's performance outcome measures in the following criteria:
a) 66% of new service recipients with high-risk nutrition scores will improve their
nutritional status.
c) 65% of new service recipients will maintain or improve their ADL's assessment score.
d) 62.3%of new service recipients will maintain or improve their IADL's assessment score.
e) 89% of family and family-assisted caregivers will self-report they are very likely to provide care.
2.7.2 Monitoring and Evaluation Methodology
The Alliance will review and evaluate the performance of the Provider under the terms of this
contract. Monitoring shall be conducted through direct contact with the Provider through telephone, in
writing, and/or an on-site visit. The Alliance's determination of acceptable performance shall be
conclusive. The Provider agrees to cooperate with the Alliance in monitoring the progress of
completion of the service tasks and deliverables. The Alliance may use, but is not limited to, one or
more of the following methods for monitoring:
(1) Desk reviews and analytical reviews;
(2) Scheduled, unscheduled, and follow-up on-site visits; •
(3) Client visits;
(4) Review of independent auditor's reports;
(5) Review of third-party documents and/or evaluation;
(6) Review of progress reports;
(7) Review of customer satisfaction surveys;
(8) Agreed-upon procedures review by an external auditor or consultant;
(9) Limited-scope reviews; and
(10) Other procedures as deemed necessary.
2.7.3 Remedies-Nonconforming Services
The Provider shall ensure that all participants served under this agreement are eligible for the
program_ and that all monthly and/or quarterly performance reports and financial records are
maintained for each reporting period and submitted as stipulated in 2.4,2.5,2.6, and 2.7.
Any nonconforming program sore,ices, performance reports or financial records not meeting the
requirements of this Contract shall not be eligible for reimbursement under this program. The costs
associated with hiring, traininz reporting and/or managing the program shall be borne solely by the
Provider. The Alliance requires immediate notice of any significant and/or systemic infractions that
compromise the Provider's ability to provide participant services, to achieve programmatic
performance or to provide sound financial management of the program.
2.8 Contractor's Financial Obligations
2.8.1 Matching, Level of Effort,and Earmarking Requirements
The Provider shall provide match of at least 10 percent of the federal administrative funds received. The
Provider's match will be made in the form of cash, general revenue administrative funds, and/or in-kind
resources. The Provider will assure,through a provision in subcontracts, a match requirement of at least 10
percent of the cost for services funded through this contract, except for Title IIID. The Provider's match will
be made in the form of cash and/or in-kind resources. The Provider shall report match by title each month. At
the end of the contract period, the Provider must properly match OAA funds.
2.8.2 Consumer Contributions
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Consumer contributions are to be used under the following terms:
1) The Provider assures compliance with Section 315 of the OAA as amended in 2006, in regard to
consumer contributions;
2) Voluntary contributions are not to be used for cost sharing or matching;
3) Accumulated voluntary contributions are to be used prior to requesting federal reimbursement; and
4) Voluntary contributions are to be used only to expand services.
2.8.3 Use of Service Dollars
The Provider is expected to spend all federal, state and other funds provided by the Alliance for the purpose
specified in the contract. The Provider must manage the service dollars in such a manner so as to avoid
having a wait list, a deficit, or a surplus of funds at the end of the contract period, for each program managed
by the Provider. Program surpluses must be reported to the Alliance.
2.8.4 Surplus Recapture
In accordance with its surplus/deficit management policies, in order to maximize available funding and
minimize the time that potential clients must wait for services, the Alliance in its sole discretion can reduce
funding awards if the Provider is not spending according to monthly plans and is projected to incur a surplus
at the end of the year.
2.8.5 The Provider agrees to use funds as detailed in the Budget Summary, ATTACHMENT VII. Any changes in
the amounts of federal or general revenue funds identified on the Budget Summary form require a contract
amendment. Providers must adhere to Alliance's Modified Spending Policy, incorporated by reference, when
requesting changes to the budget Summary Form.
2.8.6 Title III Funds
The Provider assures compliance with Section 306 of the Older Americans Act, as amended in 2006,that
funds received under Title III will not be used to pay any part of a cost(including an administrative cost)
incurred by the Provider to maintain a contractual or commercial relationship that is not carried out to
implement Title III.
2.9 ALLIANCE'S RESPONSIBILITIES:
2.9.1 Program Guidance and Technical Assistance
The Alliance Neill pro\ide to the Provider guidance and technical assistance as needed to ensure the successful
fulfillment of the contract by the Provider. The Providers must attend all required training,session and
meetings. The support, or lack thereof, shall not relieve the Provider from full performance of contract
requirements.
SECTION III: METHOD OF PAYMENT
3.1 General Statement of Method of Payment
The Method of Payment for this contract is a combination of fixed-fee/unit rate, cost reimbursement, and advanced
payments, subject to the availability of funds. The Provider shall ensure include only those costs that are in
accordance with all applicable state and federal statutes and regulations and are based on audited historical costs in
instances where an independent audit is required. The Alliance will pay the Provider upon satisfactory completion
of Tasks/Deliverables as specified in Section II, 2.1, 2., and 2.5, and in accordance with other terms and conditions
of this contract.
3.2 Unit of Service
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3.2.1 Fixed Fee/Unit Rate
Provider must meet the minimum level of performance stated in the contract in order to receive payment.
Payments for Fixed Fee/Unit Rates shall not exceed amounts established in ATTACHMENT VII.
3.2.2 Fixed Rates for NSIP Program
Payments for NSIP Fixed rate shall not exceed the unit rate of service identified below:
Service to be Provided Unit of Service 1 Unit Rate
Eligible Congregate and Home Delivered 1 unit= 1 meal $.72
3.2.3 Cost Reimbursement
Payment may be authorized only for allowable expenditures, per the limits specified in ATTACHMENT
VII and ATTACHMENT K,all Cost Reimbursement Requests for Payment must include the actual
Expenditure Reports beginning with the first month of the contract. The Provider must meet the
minimum level of performance stated in the contract to receive payment.
The Provider agrees to distribute funds as detailed in the Budget Summary, ATTACHMENT VII, to
this contract. Any changes in the total amounts of the funds identified on the Budget Summary form
require a contract amendment.
3.3 Advance Payments
3.3.1 The Provider may request up to two months of advances at the start of the contract period, if available,to
cover program service costs. The payment of an advance will be contingent upon the sufficiency and
amount of funds released to the Alliance. The Provider shall provide the Alliance documentation justifying
the need for an advance and describing how the funds will be distributed.
3.3.2 The Provider's requests for advance require the approval of the Alliance. If sufficient budget is available,
the Alliance will issue approved advance payments after January 1. 2019. Advance payments will not be
issued for NSIP.
3.3.3 Requests for the first through the twelfth months shall be based on the submission of actual monthly
expenditure reports beginning with the first month of the contract.The schedule for submission of advance
requests, if available is shown on ATTACHMENT VIII of this contract.
3.3.4 All advanced payments made to the Provider shall be recouped in accordance with the Reporting Schedule,
ATTACHMENT VIII of this contract.
3.3.5 Interest earned on advances must be identified separately by source of funds, state or federal. Providers shall
maintain advances of federal funds in interest bearing accounts unless otherwise exempted in accordance
with 45 CFR 74.22(k). Earned interest must be returned to the Alliance at the end of each quarter.
3.4 Invoice Submittal and Requests for Payment
Payment shall be made upon the Providers presentation of an invoice, following acceptance and approval by the
alliance of deliverables shown on the invoice. The Provider shall 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. Supporting documentation of services provided must be adequate to permit fiscal and
programmatic evaluation and ensure internal management.
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The form and substance of each invoice submitted by the Provider shall be as follows:
3.4.1 All requests for payment and expenditure reports submitted to support requests for payment shall be on
forms 106 (ATTACHMENT IX), 105 (ATTACHMENT X-EXHIBIT 1), 117(ATTACHMENT X-
EXHIBIT 2) and 118 (ATTACHMENT X-EXHIBIT 3).
(I) Form 106
(2) Form 105 is for all OAA Titles—Use one form per Title
(3) Form l 17 is for NSIP
(4) Form 118 is for NSIP
3.4.2 The Provider shall submit all payment requests based on the submission of the Provider's actual monthly
expenditure reports beginning with the first month of the contract. The schedule for submission of advance
requests(when available).and invoices is ATTACHMENT VIII to this contract.
3.4.3 Any payment due by the Alliance under the terms of this contract may be withheld pending the receipt and
approval of all financial and programmatic reports due from the Provider and any adjustments thereto.
3.4.4 The Alliance will authorize payment only for allowable expenditures, which are in accordance with the
limits specified in ATTACHMENT VII and ATTACHMENT K, Incontinence Supplies/Nutritional Product
Lists. •
3.4.5 Monthly review of the Receipt and Expenditure Report and the Request for Payment Form by the Alliance
will focus on:
(1) Line item comparison of year-to-date expenditures with the budget to monitor rate of expenditures;
(2) Allowable total reimbursement, on a service by service level,does not exceed budgeted/contractual
amount(No unilateral modified spending authority.);
(3) Validation of service units reported against CIRTS.
3.4.6 In order to properly manage the program budget,the Provider must submit invoices for payment no later
than the 6th day following the month in which the expense was incurred, not to exceed three (3)months after
the end of the month in which the expense was incurred. except that invoices cannot be submitted after
Close Out Report date. Invoices submitted late will require the approval of the Alliance's contract manager.
Late invoices will not be paid unless justification is submitted and approved in writing by the contract
manager.
3.4.7 Date for Final Request for Payment
The Provider shall submit the final request for payment to the Alliance by the date indicated on Attachment
VIII of this contract.
3.4.8 Payments will be made to the Provider based on a complete and correct invoice, invoices that are
incomplete or with incorrect total will not be processed and will be returned to the Provider for correction.
Fiscal staff will not be able to correct or make changes to the invoices. Returning. invoices for corrections
may result in failure to receive payment for that month. Invoices shall be submitted timely as per
ATTACHMENT VIII in order to avoid any payment delays.
3.4.9 The Provider must enter all required data following DOEA's CIRTS Policy Guidelines for clients and
services in the CIRTS database. Data must be entered into CIRTS before the Providers submit their request
for payment and expenditure reports.
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3.4.10 The Provider shall run monthly CIRTS reports and verify that client and service data in CIRTS is accurate.
This report must be submitted to the Alliance with the monthly request for payment and expenditure report
and must be reviewed by the Alliance before the Provider's request can be approved by the Alliance.
3.4.11 For Providers receiving funding for Material Aid services, Material Aid must be provided only when there
is no available alternative, e.g. another program funding source or community resource, that can accomplish
the service or supply the goods. Prior written approval shall be obtained in writing from the Alliance's
contract manager for purchases of$500.00 or more. Written approval must be submitted with the request
for payment.
3.5.Remedies for Nonconforming Services
The Provider shall ensure that all goods and/or services provided under this contract are delivered timely,
completely and commensurate with required standards of quality. Such goods and/or services will only be delivered
to eligible program participants.
lithe Provider fails to meet the prescribed quality standards for services, such services will not be reimbursed under
this contract. In addition, any nonconforming goods (including home delivered meals)and/or services not meeting
such standards will not be reimbursed under this contract. The Provider's signature on the request for payment form
certifies maintenance of supporting documentation and acknowledgement that the Provider shall solely bear the
costs associated with preparing or providing nonconforming goods and/or services. Payments may be withheld
and/or required to be reimbursed if standards are not upheld and/or if documentation does not support invoices
being processed or already paid. The Alliance requires immediate notice of any significant and/or systemic
infractions that compromise the quality, security or continuity of services to clients.
3.5.1. Corrective Action Plan
1. Contractor shall ensure 100%of the deliverables identified in ATTACHMENT I, Section II (Manner of
Service Provision)of this contract, are performed pursuant to contract requirements.
2. If at any time the Contractor is notified by the Alliance that it has failed to correctly, completely, or
adequately perform contract deliverables identified in ATTACHMENT I, Sec. II,the Contractor will have
10 business days to submit a Corrective Action Plan ("CAP") to the Alliance Contract Manager that
addresses the deficiencies and states how the deficiencies will be remedied within a time period approved
by the Alliance's Contract Manager. The Alliance shall assess a Financial Consequence for Non-
Compliance on the Contractor as referenced in ATTACHMENT I. Sec. 3.5.2. of this contract for each
deficiency identified in the CAP which is not corrected pursuant to the CAP. The Alliance shall also
assess a Financial Consequence for failure to timely submit a CAP.
3. lithe Contractor fails to correct an identified deficiency within the approved time period specified in the
CAP,the Alliance shall deduct the percentage established in ATTACHMENT I, Sec. 3.5.2. of this
contract, from the payment for the invoice of the following month.
4. If the Contractor fails to timely submit a CAP, the Alliance shall deduct the percentage established in
ATTACHMENT I, Section 3.5.2. of this contract for each day the CAP is overdue. The deduction will be
made from the payment for the invoice of the following month.
3.5.2. Financial Consequences of Non-Performance
The Alliance will withhold or reduce payment if the Contractor fails to perform the deliverables to the
satisfaction of the Contract according to the requirements referenced in ATTACHMENT I, 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 I and Section II
of this contract.
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1. Delivery of services to eligible clients as referenced in ATTACHMENT I, Section 1.4 and Section 2.1 of
this contract—Failure to comply with established assessment and prioritization criteria as evidenced in
CIRTS reports will result in a 2% reduction of payment per business day. The reduction of payment will.
begin on the first business day following the Alliance's notification to the Provider that the identified
deficiency was not cured or satisfactorily addressed in accordance with the Alliance approved CAP,
referenced in ATTACHMENT I, Sec. 3.5.1.
2. Services and units of services as referenced in ATTACHMENT I, Section II of this contract—Failure to
provide services in accordance ATTACHMENT I, Section 2.4, the current DOEA Programs and Services
Handbook, the services listed on ATTACHMENTS VII and K, and submission of required documentation
will result in a 2% reduction of payment per business day. The reduction of payment will begin the first
business day following the Alliance's notification to the Provider that the identified deficiency was not
cured or satisfactorily addressed in accordance with the Alliance approved CAP, referenced in
ATTACHMENT I, Sec. 3.5.1.
3. Administrative duties as referenced in ATTACHMENT I, Section II of this contract—Failure to perform
the performance specifications and oversight of operations will result in a 2% reduction of payment per
business day. The reduction of payment will begin the first business day following the Alliance's
notification to the Provider that the identified deficiency was not cured or satisfactorily addressed in
accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. 3.5.1.
4. Timely submission of a CAP—Failure to timely submit a CAP within 10 business days after notification
of the deficiency by the Alliance contract manager will result in a 2% reduction of payment per business
• day the CAP is not received. The reduction of payment will begin the first business day following the
Alliance's notification to the contractor that the identified deficiency was not cured or satisfactorily
addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT I, Sec. 3.5.1.
5. Exceptions may be granted solely, in writing, by the Alliance.
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ATTACHMENT II
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Alliance to the provider may be subject to audits and/or monitoring by the
Allianceand/orthe Department as described in this section.
I. MONITORING
In addition to reviews of audits conducted in accordance with 2 C F R Part 200 ( fo r m e r I y OMB Circular A-133, as
revised), and Section 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site
visits by the Alliance and/or the Department staff, limited scope audits as defined by 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. In the event the Alliance and/or the Department determines that a
limited scope audit of the Contractor is appropriate, the Contractor agrees to comply with any additional instructions provided by
the Alliance and/or the Department to the Contractor regarding such audit. The Contractor further agrees to comply
and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Alliance and/or the
Department.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular A-
133, as revised.
In the event that the Provider expends $750,000.00 or more in federal awards during its fiscal year, the Provider must have a
single or program-specific audit conducted in accordance with the provisions of 2 C F R Part 200. EXHIBIT 2 to this
agreement indicates federal resources awarded through the Alliance by this agreement. In determining the federal awards
expended in its fiscal year, the Provider shall consider all sources of Federal awards, including federal resources received
from the A I I i a n c e. The determination of amounts of Federal awards expended should be in accordance with the
guidelines established by 2 C F R Part 200. An audit of the Provider conducted by the Auditor General in accordance
with the provisions of 2 C F R Part 200, will meet the requirements of this part.
In connection with the audit requirements addressed in Part I,paragraph I,the Provider shall fulfill the requirements relative to
auditee responsibilities as provided in 2 C F R Part 200.508.
If the Provider expends less than $750,000.00 in federal awards in its fiscal year, an audit conducted in accordance with the
provisions of 2 C F R Part 200, is not required. In the event that the Provider expends less than$750,000.00 in federal
awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of 2 C F R Part 200, the
cost of the audit must be paid from non-federal resources (i.e., the cost of such audit must be paid from Provider resources
obtained from other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Alliance shall be based on the agreement's requirements, including any
rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not the
matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Alliance and/or
the Department shall be fully disclosed in the audit report with reference to the Alliance agreement involved. If not
otherwise disclosed as required by 2 C F R Part 2 0 0.5 1 0,the schedule of expenditures of federal awards shall identify
expenditures by agreement number for each agreement with the Alliance in effect during the audit period. Financial
reporting packages required under this part must be submitted within the earlier of 30 days after receipt of the audit report or
9 months after the end of the Provider's fiscal year end.
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PART II: STATE FUNDED
This part is applicable if the Provider is a non-state entity as defined by Section 215.97(2),F.S.
In the event that the Provider expends a total amount of state financial assistance equal to or in excess of$750,000.00 in any
fiscal year of such Provider (for fiscal years ending September 30. 2004 or thereafter), the Provider must have a State single or
project-specific audit for such fiscal year in accordance with Section 215.97. F.S.: applicable rules of the Department of Financial
Services: and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations). Rules of the Auditor
General. EXHIBIT 2 to this agreement indicates state financial assistance awarded through the Alliance by this agreement. In
determining the state financial assistance expended in its fiscal year. the Provider shall consider all sources of state financial
assistance, including state financial assistance received from the Alliance, other state agencies, and other non-state entities. State
financial assistance does not include Federal direct or pass-through awards and resources received by a non-state entity for Federal
program matching requirements.
In connection with the audit requirements addressed in Part II. paragraph I. the Provider shall ensure that the audit complies with the
requirements of Section 215.97(8), F.S. This includes submission of a financial reporting package as defined by Section 215.97(2).
F.S., and Chapter 10.550(local governmental entities) or 10.650(nonprofit and for-profit organizations). Rules of the Auditor General.
If the Provider expends less than$750,000.00 instate financial assistance in its fiscal year(for fiscal years ending September 30,2004
or thereafter), an audit conducted in accordance with the provisions of Section215.97, F.S., is not required. In the event that the
Provider expends less than$750,000.00 in state financial assistance in its fiscal year and elects to have an audit conducted in
accordance with the provisions of Section 215.97, F.S., the cost of the audit must be paid from the non-state entity's resources
(i.e.,the cost of such an audit must be paid from the Provider resources obtained from other than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Alliance shall be based on the agreement's requirements, including any
applicable rules, regulations,or statutes. The financial statements shall disclose whether or not the matching requirement was
met for each applicable agreement. All questioned costs and liabilities due to the Alliance shall be fully disclosed in the audit report
with reference to the Alliance agreement involved. If not otherwise disclosed as required by Rule 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 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 Pro v-i d e r'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 Provider's fiscal year end. Notwithstanding the applicability of this portion.the
Alliance retains all right and obligation to monitor and oversee the performance of this agreement as outlined throughout this
document and pursuant to law.
II. PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with 2 C F R Part 200, and required by PART I of this
agreement shall be submitted,when required by 2 C F R Part 2 0 0.5 12.by or on behalf o f the Provider directly to each of the
following:
•
The Alliance at each of the following addresses:
Alliance for Aging, Inc.
Attn: Fiscal Department
760 NW 107' Avenue
Suite 214
Miami, FL 33172
For fiscal year 2013 and earlier to the Federal Audit Clearinghouse designated in 2 CFR §200.36 at the following address:
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Federal Audit Clearinghouse
Bureau of the Census 1201
East 10"' Street
Jeffersonville. IN 47132
For fiscal year 2014 and later. pursuant to 2 CFR §200.512. the reporting package and the data collection form must be
submitted electronically to the Federal Audit Clearinghouse.
Pursuant to 2 CFR§200.512, all other Federal agencies, pass-through entities and others interested in a reporting package
and data collection form must obtain it by accessing the Federal Audit Clearinghouse.
The Provider shall submit a copy of any management letter issued by the auditor, to the Florida Department of Elder
Affairs at the following address:
Alliance for Aging,Inc.
Attn: Fiscal Department
760 NW 107°' Avenue
Suite 214
Miami, FL 33172
Additionally, copies of financial reporting packages required by this contract's Financial Compliance Audit Attachment,
Part II shall be submitted by or on behalf of the Provider directly to each of the following:
The Florida Department of Elder Affairs at the.following address:
Alliance for Aging,Inc.
Attn: Fiscal Department
760 NW 107th Avenue
Suite 214
Miami, FL 33172
The Auditor General's Office at the f:?lle,Ains= adore:.•
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 Department pursuant to this contract
shall be submitted timely in accordance with 2 CFR Part 200. Florida Statutes, and Chapters 10.550 (local governmental
entities)or 10.650(nonprofit and for-profit organizations). Rules of the Auditor General, as applicable.
Providers. when submitting financial reporting packages to the Department for audits done in accordance Nrith 2 CFR Part
200 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 Provider in correspondence accompanying
the reporting package.
PART IV: RECORD RETENTION
The Provider shall retain sufficient records demonstrating its compliance with the terms of this contract for a period of six
(6) years from the date the audit report is issued, and shall allow the Department or its designee, the CFO or Auditor
General access to such records upon request. The Provider shall ensure that audit working papers are made available to
the Alliance and/or the Department or its designee, CFO, or Auditor General upon request for a period of six (6) years
from the date the audit report is issued, unless extended in writing by the Department.
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ATTACHMENT II
FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT
EXHIBIT 1
PART 1: AUDIT RELATIONSHIP DETERMINATION
Providers who receive state or federal resources may or may not be subject to the audit requirements of 2 CFR Part§200.500,
and/or Section 215.97, Fla. Stat. Providers who are determined to be recipients or subrecipients 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. Providers who have been determined to be vendors are not subject to the and it requirements of 2 CFR
Part§200.38,and/or Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, Providers who have been
determined to be recipients or subrecipients of Federal awards and/or state financial assistance must comply with applicable
programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part §200 and/or Rule 691-5.006. FAC, Contractor has been determined to be:
Vendor not subjectto2 CFR Part§200.38 and/or Section 215.97,F.S.
X Recipient/subrecipient subject to 2 CFR Part §200.86 and §200.93 and/or Section 215.97, F.S.
Exempt organization not subject to 2 CFR Part §200 and/or Section 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public universities, community colleges, district school
boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must comply
with all compliance requirements set forth within the contract or award document.
NOTE: If a Provider is determined to be a recipient/subrecipient of federal and or state financial assistance and has been
approved by the Alliance to subcontract, they must comply with Section 215.97(7), F.S., and Rule 691-.5006, FAC [state
financial assistance] and 2 CFR Part §200.330 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal
awards, state maintenance of effort funds, or state matching funds on Federal awards and who are determined to be a
subrecipient must comply with the following fiscal laws. rules and regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part §200.416- Cost Principles*
2 CFR Part §200.201- Administrative Requirements**
2 CFR Part§200.500- Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part§200.400-.41 1-Cost Principles*
2 CFR Part §200.100-Administrative Requirements
2 CFR Part 5200.500-Audit Requirements Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST
FOLLOW:
2 CFR Part §200.418-Cost Principles*
2 CFR Part §200.100-Administrative Requirements
2 CFR Part §200.500-Audit Requirements Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
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*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the 2 CFR Part
§200.400(5)(c).
**For funding passed through U.S. Health and Human Services, 45 CFR 92; for funding passed through U.S. Department
of Education, 34 CFR 80.
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a
recipient/subrecipient must comply with the following fiscal laws.rules and regulations: -
Section 215.97, Fla. Stat.
Chapter 691-5, Fla. Admin. Code
State Projects Compliance Supplement Reference Guide
for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
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ATTACHMENT II
FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT
EXHIBIT 2-FUNDING SUMMARY
Note:Title 2 CFR §200.33 L as revised, and Section 215.97. F.S..require that information about Federal Programs and State Projects
included in ATTACHMENT II. Exhibit I be provided to the recipient. Information contained is a prediction of funding sources and
related amounts based on the contract budget.
I. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST
OF THE FOLLOWING:
•
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Older Americans Act U.S. Health and Human Services 93.044 -$1 18,528.01
Title IIIB—Support Services
Older Americans Act •
U.S. Health and Human Services 93.045 $160,861.87
Title IIIC 1 —Congregate Meals
Older Americans Act U.S. Health and Human Services 93.045 $228,496.00
Title IIIC2—Home Delivered Meals
Older Americans Act U.S. Health and Human Services 93.043
Title IIID
Older Americans Act
Title IIIE—Caregiver Support Services $116,059.96
Title IIIEG—Caregiver Support Services U.S. Health and Human Services 93.052 $0.00
Title III ES—Caregiver Support Services • $36,452.35
Older Americans Act U.S. Health and Human Services 93.053 $26,966.79
Nutrition Services Incentive Program
TOTAL FEDERAL AWARD $ 687,364.98
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO
THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200-Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. OMB
Circular A-133 -Audits of States,Local Governments, and Non-Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHING RESOUCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD,
STATE FINANCIAL ASSITANCE SUBJECT TO sec.215.97, F.S.
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL AWARD
•
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
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STATE FINANCIAL ASSISTANCE:
Section 215.97,F.S., Chapter 691-5, FL Admin Code, Reference Guide for State Expenditures, Other fiscal requirements set forth in
program laws,rules and regulations.
The Remainder of this page left Intentionally Blank
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ATTACHMENT III
CERTIFICATIONS AND ASSURANCES
DOEA will not award this Contract unless the Provider completes these CERTIFICATIONS AND
ASSURANCES in performance of this contract. The Provider provides the following certifications and
assurances:
A. Debarment and Suspension Certification (29 CFR Part 95 and 45 CFR Part 75)
B. Certification Regarding Lobbying (29 CFR Part 93 and 45 CFR Part 93)
C. Nondiscrimination & Equal Opportunity Assurance (29 CFR Part 37 and 45 CFR Part 80)
D. Certification Regarding Public Entity Crimes, section 287.133, F.S.
E. Association of Community Organizations for Reform Now (ACORN) Funding Restrictions
Assurance (Pub.L. 111-117). - -
F. Certification Regarding Scrutinized Companies Lists, section 287.135, F.S.
G. Certification Regarding Data Integrity Compliance For Contracts, Agreements, Grants,
Loans and Cooperative Agreements
H. Verification of Employment Status Certification
I. Records and Documentation
J. Certification Regarding Inspection of Public Records
A. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER
RESPONSIBILITY MATTERS - PRIMARY COVERED TRANSACTION.
The undersigned Provider certifies to the best of its knowledge and belief, that it and its principals:
1. Are not presently debarred, suspended, proposed for debarment. declared ineligible, or voluntarily
excluded from covered transactions b, a Federal department or agent`.:
2. Have not within a three-year period preceding this Contract been convicted or had acivil judgment
rendered against them for commission of fraud or a criminal offense in connection with obtaining.
attempting to obtain,or performing a public (Federal, State, or local) transaction or contract under a
public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft,
forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen
property;
3. Are not presently indicted or otherwise criminally or civilly charged by a government entity(Federal,
State or local) with commission of any of the offenses enumerated in paragraph A.2. of this certification;
and/or .
4. Have not within a three-year period preceding this application/proposal had one or more public
transactions (Federal, State, or local)terminated for cause of default.
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The undersigned shall require that language of this certification be included in the documents for all
subcontracts at all tiers (including subcontracts, vendors, sub-grants and contracts under grants. loans and
cooperative agreements) and that all sub recipients and contractors shall provide this certification
accordingly.
B. CERTIFICATION REGARDING LOBBYING - CERTIFICATION FOR CONTRACTS,.
GRANTS, LOANS, AND COOPERATIVE AGREEMENTS.
The undersigned Provider certifies, to the best of its know ledge and belief, that:
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 Congress. or an employee ofa
Member of Congress in connection with the awarding of anti Federal contract, the making of any Federal
grant,the making of any Federal loan, the entering into of any cooperative agreement , and the extension.
continuation. renew al, amendment or modification of any Federal contract, grant. loan or cooperative
agreement.
If any-funds other than Federal appropriated funds have been paid or will he 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 employee of a Member of Congress in connection with a Federal
contract, grant, loan, or cooperative agreement, the undersigned shall also complete and submit Standard
Form - LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions .
The undersigned shall require that language of this certification be included in the documents for all
subcontracts at all tiers(including subcontracts, sub-grants and contracts under grants, loans and cooperative
agreements) and that all sub- recipients and contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this Contract was
made or entered into. Submission of this certification is a prerequisite for making or entering into this
Contract imposed by 3! II.S.C. 1352. An) person who fails to file the required certification shall he
subject to a civil penalty of not less than $10,000 and not more than $100.000 for each such failure.
C. NON-DISCRIMINATION & EQUAL OPPORTUNITY ASSURANCE (29 CFR PART 37 AND 45
CFR PART 80). -As a condition of the Contract. Provider assures that it will comply fully with the
nondiscrimination and equal opportunit\ pro ti isions of the follow ing laws:
1. Section 188 of the.Workforce Investment Act of 1998TWIA), (Pub. L. 105-220) . which prohibits
discrimination against all individuals in the United States on the basis of race, color, religion , sex national
origin. age, disabilit), political affiliation, or belief, and against beneficiaries on the basis of either
citizenship/status as a lawfully admitted immigrant authorized to work in the United States or participation
in any WIA Title I-financially assisted program or activity.
2. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by
or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 80),to the
end that, in accordance with Title VI of that Act and the Regulation, no person in the United States shall,
on the ground of race, color, or national origin , be excluded from participation in, be denied the benefits
of, or be otherwise subjected to discrimination under any program or activity for which the Applicant
receives Federal financial assistance from the Department.
3. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-1 12) as amended, and all requirements imposed
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by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 84),to
the end that, in accordance with Section 504 of that Act. and the Regulation, no otherwise qualified
handicapped individual in the United States shall, solely by reason of his handicap, be excluded from
participation in, be denied the benefits of. or be subjected to discrimination under any program or activity
for which the Applicant receives Federal financial assistance from the Department.
4. The Age Discrimination Act of 1975 (Pub. L. 94-135). as amended. and all requirements imposed by or
pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part 91). to the end
that, in accordance with the Act and the Regulation, no person in the United States shall, on the basis of
age. be denied the benefits of be excluded from participation in, or he subjected to discrimination under
any program or activity for which the Applicant receives Federal financial assistance from the
Department.
5.Title IX of the Education Amendments of 1972 (Pub. L. 92-318). as amended. and all requirements
imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR Part
86), to the end that, in.accordance with Title IX and the Regulation. no person in the United States shall.
on the basis of sex. be excluded from participation in. be denied the benefits of. or be otherwise subjected
to discrimination under any education program or actiN,it) for which the Applicant receives Federal
financial assistance from the Department.
6.The American with Disabilities Act of 1990 (Pub. L. 101-336), which prohibits discrimination in all
employment practices, including job application procedures, hiring, firing,advancement,compensation,
• training,and other terms, conditions, and privileges of employment. It applies to recruitment, advertising,
tenure, layoff, leave,fringe benefits, and all other employment-related activities.
Providers also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the
laws listed above. This assurance applies to Provider's operation of the VIA Title I - financially assisted
program.or activity, and to all contracts, Provider makes to carry out the WI Title I - financially assisted
program or activity. Provider understands that DOEA and the United States have the right to seek judicial
enforcement of the assurance.
The undersigned shall require that language of this assurance be included in the documents for all
subcontracts at all tiers (including subcontracts. vendors, sub-grants and contracts under grants, loans and
cooperati e agreements) and that all sub recipients and contractors shall pros ide this assurance
accordingly.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES,SECTION 287.133, F.S.
Provider hereby certifies that neither it, nor any person or affiliate of Provider, has been convicted of a Public
Entity Crime as defined in section 287.1.33, F.S., nor placed on the convicted vendor list.
Provider understands and agrees that it is required to inform DOEA immediately upon any change of
circumstances regarding this status.
E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW(ACORN) FUNDING
RESTRICTIONS ASSURANCE(PUB. L. 111-117).
As a condition of the Contract, Provider assures that it will comply fully with the federal funding
restrictions pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act.2010.
Division E,Section 511 (Pub. L. 111-117). The Continuing Appropriations Act, 2011. Sections 101 and 103
(Pub. L. 1 1 1-24 2). provides that appropriations made under Pub. L. 1 1 1-1 17 are available under the
conditions provided by Pub. L. I 1 1-117.
The undersigned shall require that language of this assurance be included in the documents for all
Page 44 of 76
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subcontracts at all tiers (including subcontracts, vendors, sub-grants and contracts under grants, loans and
cooperative agreements) and that all sub recipients and contractors shall provide this assurance accordingly.
F. CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS,SECTION 287.135, F.S.
If this Contract is in the amount of$1 million or more. in accordance w ith the requirements of Section
287.135, F.S., Provider hereby certifies that it is not participating in a boycott of Israel, is not listed on
either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities
.in the Iran Petroleum Energy Sector List, and that it does not have business operations in Cuba or Syria.
Both lists are created pursuant to Section 2 15.473, F.S.
•
Provider understands that pursuant to Section 287.135, F.S., the submission of a false certification may
subject Providerto civil penalties. attorney's fees, and/or costs.
If Provideris unable to certify any of the statements in this certification, Provider shall attach an
explanation to this Contract.
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR CONTRACTS,
AGREEMENTS,GRANTS,LOANS AND COOPERATIVE AGREEMENTS
1. The Provider and any subcontractors of services under this contract have financial management
systems capable of providing certain information, including: (I)accurate, current, and complete
disclosure of the financial results of each grant-funded project or program in accordance with the
prescribed reporting requirements; (2) the source and application of funds for all contract 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 Provider, subcontractors, vendors, or any outside entity
on which the Provider is dependent for data that is to he 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, Provider 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 Provider(represented by the
undersigned) and purchased by the state will be verified for accuracy and integrity of data prior to
transfer.
4. 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 Provider
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. .
5. The Provider and any subcontractors and/or vendors 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.
Page 45 of 76
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H.VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
As a condition of contracting with the Florida Department of Elder Affairs, Provider 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 the Provider during the contract term to perform employment duties pursuant to
this contract and that any subcontracts include an express requirement that subcontractors and/or vendors
performing work or providing services pursuant to this Contract utilize the E-verify system to verify the
employment eligibility of all new employees hired by the subcontractor and/or vendor during the entire
contract term.
The Provider shall require that the language of this certification be included in all sub-agreements, sub-
grants, and other agreements/contracts and that all subcontractors and/or vendors 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 Circulars A-102 and 2 CFR Part 200. and 215 (formerly 0MB Circular A-1 10).
I. RECORDS AND DOCUMENTATION
The Provider agrees to make available to Department staff and/or any party designated by the Department
any and all contract related records and documentation. The Provider shall ensure the collection and
maintenance of all program related information and documentation on any such system designated by the
Department. Maintenance includes valid exports and backups of all data and systems according to
Department standards.
J. CERTIFICATION REGARDING INSPECTION OF PUBLIC RECORDS
1. In addition to the requirements of sections. 10.1, 10.2 of the Standard Contract, and 119.0701(3) and (4)
F.S., and any other applicable law. if civil action is commenced as contemplated by Section 1 19.0701(4),
F.S.. and the Department is named in the civil action. Provider agrees to indemnify and hold harmless the
Department for any costs incurred by the Department, and any attorneys' fees assessed.or awarded against
the Department from a Public Records Request made pursuant to Chapter 119, F.S.. concerning this
contract or ser,ices performed thereunder.
a. Notwithstanding Section 119.070 F.S.. or other Florida law. this section is not applicable to
• contracts executed between the Department and state agencies or subdivisions defined in
Section 768.28(2). F.S.
2. Section 119.01(3), F.S., states if public funds are expended by an agency in payment of dues or
membership contributions for any person, corporation,foundation, trust, association, group, or other
organization, all the financial. business, and membership records of such an entity which pertain to the
public agency(Florida Department of Elder Affairs) are public records. Section 119.07.F.S,states that
every person who has custody of such a public record shall permit the record to be inspected and copied by
any person desiring to do so, under reasonable circumstances.
Page 46 of 76
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Additionally, I certify this organization does_does not _provide for institutional memberships.
Provider's signature below attests that records pertaining to the dues or membership application by the Alliance
and the Department are available for inspection as stated above.
By execution of this contract, Provider must include these provisions in all related subcontract agreements (if
applicable).
By execution of this contract, Provider must include these provisions(A-J) in all related subcontract agreements (if
applicable). -
By signing below, Provider certifies the representations outlined in parts A through J above, are true and correct.
(•�
&r! I ,J/..4/ 1100 Simonton Street, 2" Floor
Signature and Title of authorized Representative Street Address
Monroe County Board of County Commissioners,
Social Services/In-Home Services Key West, FL 33040
Provider name Date City, State,Zip code
-. COI A 1"
/'
PEDRO J ERCADO
ASSISTANT — " '
•
(8
•
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ATTACHMENT VI
ASSURANCES—NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and
reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction
Project(0348-0043), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET,.
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have"questions, please contact the
awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such
is the case,you will be notified.
1. Has the legal authority to apply for Federal assistance, and the institutional. managerial and financial capability (including,
funds sufficient to pay the non-Federal share of project cost)to ensure proper planning, management, and completion of the
project described in this application.
2. Will give the awarding agency,the Comptroller General of the United States, and if appropriate, the State, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the award;
and will establish a proper accounting system in accordance with generally accepted accounting standards or agency
directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728-4763)relating to prescribed standards for
merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPNI'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 i964 (P.L. 88-352) Nr\hich prohibits discrimination on the basis of race, color or national origin; (b)
Title IX of the Education Amendments of 1972, as amended(20 U.S.C. 1681-1683, and 1685-1686), which prohibits
discrimination on the basis of sex: (c) Section 504 of the Rehabilitation Act of 1973. as amended (29 U.S.C. 794). which
prohibits discrimination on the basis of handicaps: (d)the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-
6107), which prohibits discrimination on the basis of age; (e)the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-
255). as amended, relating to nondiscrimination on the basis of drug abuse; (f)the Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment and Rehabilitation Act of 1970(P.L. 91-616), as amended, relating to nondiscrimination
on the basis of alcohol abuse or alcoholism; (g) 523 and 527 of the Public Health Service Act of 1912(42 U.S.C. 290 dd-3
and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h)Title VIII of the Civil
Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended. relating to nondiscrimination in the sale, rental or financing of
housing; (i)any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance
is being made; and(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 II and III of the uniform Relocation Assistance and
Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons
displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to
all interests in real property acquired for project purposes regardless of Federal participation in purchases.
8. Will comply, as applicable, with the provisions of the Hatch Act(5 U.S.C. 501-1508 and 7324-7328),which limit the
• political activities of employees whose principal employment activities are funded in whole or in part with Federal funds.
9. Will comply, as applicable, with the provisions of the Davis-Bacon Act(40 U.S.C. 276a to 276a-7),the Copeland Act(40
U.S.C. 276c and 18 U.S.C. 1 1874)and the Contract Work Hours and Safety Standards Act(40 U.S.C. 327-333),
regarding labor standards for federally assisted construction sub agreements.
Page 48 of 76
• AA-1929
10. Will comply, if applicable,with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection
Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to
purchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969(P.L. 91-190)and Executive
Order(EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO
1 1990; (d)evaluation of flood hazards in floodplains in accordance with EO 11988: (e) assurance of project consistency
with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C.
1451 et seq.); (f) conformity of Federal actions to State(Clear Air) Implementation Plans under Section 176(c)of the
Clear Air Act of 1955, as amended(42 U.S.C. 7401 et seq.); (g) protection of underground sources of drinking water
under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under
the Endangered Species Act of 1973,as amended, (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. 1721 et seq.) related to protecting components or
potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966,
as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and
Historic Preservation Act of 1974(16 U.S.C. 469a-1 et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research,development, and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966(P.L. 89-544,as amended, 7 U.S.C. 2131 et seq.) pertaining
to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by
this award of assistance.
16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. 4801 et seq.), which prohibits the use of lead-
based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and OMB Circular No. A-133, Audits of States, Local Governments, and Non-Profit Organizations.
18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing
this program.
SEGNA I L RE OF AL I I IORILED CER l IFYING OFFICIAL I ILL
•
/ //
APPLICANT ORGANIZATION DATE SUBMITTED
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS,
SOCIAL SERVICES/IN-HOME SERVICES I243120(8
M ROE COUNTY TTORNEY
PEDRO J. RCADO •
ASSISTANT CO
Page 49 of 76
•
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ATTACHMENT VII
CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE
CIRTS SUMMARY FOR THE AGENCY
Service Unit Maximum Maximum
Service to be Provided Rate Units of Dollars
Service
Chore IIIB $24.00 683 $16,384.82
Companionship IIIB $11.00 45 $500.00
Escort IIIB $50.00 10 $500.00
Shopping Assistance IIIB $13.00 38 $500.00
Homemaker IIIB $25.00 1,981 $49,513.33
Personal Care IIIB $26.00 1,904 $49,513.34
Screening&Assessment IIIB $25.00 65 $1,616.52
Congregate Meals C1 $9.00 17,099 $153,887.54
Congregate.Meals Emergency Shelf C1 $9.00 188 $1,690.00
Nutrition Screening&Assessment C1 $20.00 128 $2,568.52
Nutrition Counseling C1 $70.56 29 $2,040.83
Nutrition Education C1 $0.50 1,350 $674.98
Home Delivered Meals Frozen C2 $5.00 31,664 $158,319.00
Home Delivered Meals Hot C2 $6.53 9,472 $61,855.00
Emergency Home Delivered Meals $6.53 386 $2,520.00
Shelf C2
Screening&Assessment C2 $26.22 200 $5,250.00
Nutrition Counseling C2 $70.56 3 $190.00
Nutrition Education C2 $0.50 724 $362.00
Respite In-Home IIIE $22.00 897 $19,742.78
Respite In-Facility IIIE $10.50 1 6,604 $69,343.88
Caregiver Training&Support Group IIIE $81.75 87 $7,151.26
Caregiver Training &Support Ind. IIIE $75.00 241 $18,053.98
Screening&Assessment IIIE $25.00 71 $1,768.06
Chore IIIES $24.00 347 $8,335.14
Housing Improvement IIIES Cost Reimburs. $9,536.86
Material Aid IIIES Cost Reimburs. $9,536.86
Specialized Medical Equipment IIIES Cost Reimburs. $9.043.49
Eligible Congregate& Home Delivered $0.72 37,454 $26,966.79
Meals (NSIP)
Total Contract $687,364.98
Page 50 of 76
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ATTACHMENT VIII
OLDER AMERICANS ACT CONTRACT REPORT CALENDAR
ADVANCE BASIS CONTRACT
Report Number Based On Submit to Alliance
On This Date
1 January Advance* January 6
2 February Advance* January 6
3 January Expenditure Report February 6
4 February Expenditure Report March 6
5 March Expenditure Report April 6
6 April Expenditure Report May 6
7 May Expenditure Report June 6
8 June Expenditure Report July 6
9 July Expenditure Report August 6
10 August Expenditure Report September 6
11 September Expenditure Report October 6
12 October Expenditure Report November 6
13 November Expenditure Report December 6
14 December Expenditure Report January 6
15 Final Expenditure and Request for Payment February 15
16 Close Out Report February 29
•
Legend: * Advance based on projected cash need.
Note# 1: Report#1 for Advance Basis Agreements cannot be submitted to the Department of
Financial Services(DFS) prior to January 1 or until the agreement with the Alliance has
been executed and a copy sent to DFS. Actual submission of the vouchers to DFS is
dependent on the accuracy of the expenditure report.
Note#2: Report numbers 5 through 14 shall reflect an adjustment of one-tenth of the total advance
amount, on each of the reports, repaying advances issued the first two months of the
agreement. The adjustment shall be recorded in Part C, 1 of the report(ATTACHMENT
IX).
Note#3: 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 51 of 76
. .
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ATTACHMENT IX
REQUEST FOR PAYMENT
OLDER AMERICANS ACT/NSIP
1 13.F.3.3F FIEPC,R-
!PRCA,CFR sIAL!,-.40DRE:33.Ps-ONE 0 F'ECI'D`ILMBER Co,rar:
Connact Period.. .
i
1 ' Re=user-tont , Rescrt Pons,:
i
Resort 4
1
Ir,omeg
,CERTIFiCATION. I re!e!sy cerdO a the best of so know!edge that Ens regaest cantor-ns sib to terns and the purposes sot'orh r the atone o tntract.
!Pre.uered B'i hate aPprs,ed B., 3ate
PART A: ,,.' (I) (21 il) ,,,I) ' ;5) (6) (7) [ iS)
/ I !
3001G40 SLMARY ADMIN IIB i l':C1 i II(C2 RID DE NS!P 1 TO-AL
I I
!I Approvec I
Cortract Amount 0 00 0 0.01" 0.00 0 00 0 00 0 00 0 001' 0.00
•
, . .
2.Previous Funds .
RECEIVED'or ,,. ...-,..,...,„ as
Contract per od rtnr‘ C CO 0 001 ..",..
0 0 0_,,,,,,A 0:0 0 00 3 00' 000
8 ..P &'''''''''''.-iia #7.N.1 A '''' ''"A., P.' n
I
,
,Contract Bz!ance 11030 rrm.4w OR ek A ctTor'- ,, o on fi n co" 000 o nor 0 00
(Line!rrirus lute 2) 'E
''''. - ii]
4.Precious Funds
,
RECLEF-EC srd
; I' Not Received
15.Contract Balarce 0 00r 0 00r „oar 0 00 0 CO 0 00 dci0t: 000
itLine 3 mrus Hoe•!..:
PORT 13:
1 '
7014105 RE,ILE STEC)
. I ,
I I
1 Resuest L:ny 0.301 0 00: 000 0.t:0 000 • 0 00 ?eq. . 0.00
2.Ne!Experd,.0rs.
1.
For Mont, 0'.'0' 0 OC'" 0 33 3 00' 0 X' 0 no' o D.:" 0 oo
1
L I:,T,ta. 0:01 :'it: 0 Y) :0
0 J 20" 0.00' 3 0? oar:
1 1
[PORT C:
1 ,
I
' 1
NET FOODS REQUESTED
I
,'.Less'Over-Advance t)00 0 Or: 0 00 000 0 CO 0 00 0 00 , 000
2.Contract Funds are
Hereby Requested ,,. 030 000 000 000' 0 C0' 000 000' 0.00
1FSA all OAAFcnn 103.Dated November 2013 :
Page 52 of 76
•
• AA-1929
ATTACHMENT X
EXHIBIT-1
RECEIPTS&UNIT COST REPORT
OAA
PROVIDER NAME.ADDRESS.PHONE#and FEID# FUNDING SOURCE THIS REPORT PERIOD.
!OAA Ill-B FROM THUR
'OAA Ill-CI j
i OAA III-C2 i CONTRACT PERIOD.
OAA III-D
OAA III-E CONTRACT#.
REPORT#
PSA#1 1
CERTIFICATION I certify to the best of my krowledge and belief that:his repoit is complete and correc_acd all outlays hereir are for purposes set forth in
the contract. Further;I certify that the attached monthly and YTD service units:unduplicated clients'report is correct•
Prepared by.. Date — Approved by Date'
PART A: INCOME/RECEIPTS A. Approved Budget B. Actual Receipts C. Total Receipts D_ °%o of Approved
for this report Year to Date Budget
1.Federal Funds
2.State Funds
3.Program Income •
4.Local Match(IIIB.C1,C2 111E)
5.SUBTOTAL Cash Receipts
6.Local In-Kind match
7.TOTAL RECEIPTS
PART B 1: Billable Unit Cost Report PART B 2: Unduplicated Clients Served
(A) (B) _.. (C) (D)......... (E) ... (F) . .._(G) (A) (B)
Services Contract Billable Unit Rate Amount Earned Y-T-D Y-T-D Current Month Y-T-D
Amount Units This Period Billable Billable Undup Clients Undup Clients
Units Cost Served
•
Total
Part,C:Other Exp(For tracking purp.only) Budget B. Total-Current Month B Total-Year to Date
A. Total Local telatch
B. USDA Cash
C. Program Income Used:
D. Total
•
,PSA#11 OAA Form 106.Dated November 2018 -- -
Page 53 of 76
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ATTACHMENT X
EXHIBIT 2
REQUEST FOR REIMBURSEMENT
Nutrition Services Incentive Program
PROVIDER NAME,ADDRESS,PHONE#and FEID TYPE OF REPORT: THIS REQUEST PERIOD:
Payment Request: From To
Regular Final Report
Contract Period To
Contract
PSA» 1I
CERT FICATION: I hereby certify that to the best of my knowledge the information in this report is accurate and complete and that ail outlays reported herein.-ere for purposes
set forth in the contract documents.
Prepared by: Date: Approved by: Date
PART A: REIMBURSEMENT COMPUTATION YEAR TO DATE CURRENT MONTH
CONGREGATE HOME DELIVERED CONGREGATE HOME DELIVERED
1.Number of Meals Served 0 0 0 0
2.Line 1 Times S.72 cents per Meal S0 00 S0.00 S0.00 S0.00
Year To Date Total Meals 0 Current Month Total Meals 0
Year To Date Total Reimbursed $0.00 Total Reimbursement Requested $0.00
PART E. CONTRACT`lJh;ll.IA.R+
1. Approved Contract Amount S0.n0
2. Previous Reimbursements Requested _0.00
3. Contract Balance __. 0
4. Amount to be Reimbursed-This Report $0.00
5. Contract Balance 50.00
COEA Form 117
Page 54 of 76
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ATTACHMENT X
EXHIBIT 3
PSA/PROVIDER MONTHLY MEALS REPORT
1 'PSA Number 11
2 Provider Name
3 Month.of Report
4 Number of days served this month
•
5 The total number of meals, regardless of funding source, served to:
all persons 60 years of age or older and their spouses, regardless of age
volunteers, regardless of age,who provider services during meal hours on a Regular basis
handicapped or disable individuals residing in housing facilities occupied primarily elderly
elderly at which congregate meal services were provider during the month.
Provider Name Congregate Meals Home-Delivery Meals Total
•
0 0 0
6 TOTAL:
I certify that the above information is accurate and complete to the best of my knowledge.
Signature Title Date
DOEA FORM 118
Page 55 of 76
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•
ATTACHMENT B
STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS •
CIVIL RIGHTS •
COMPLIANCE
CHECKLIST
Program/Facility Name: Monroe County Board of County
Commissioners, Social Services/In-Home Services
County:Mo ro
Address 1100 Sl'ottb �l � � 1 ()As? Completed By 1<i M WI t S—Mat"
City, State, Zip Code Key Vresf- et. 3gp tt-U Date I t 1r�-1 t 1(a Telephon 3r5 9g_q.
PART I. \
READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH
WILL HELP YOU IN THE COMPLETION OF THIS FORM.
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
The . QxyFi re. F 6 o121 5Cjy e Rrc e (�, D pccI(i Mal. f 2,0 I'k.ile!S 1ort. GA
ciA e.Qd auar'c�1 v Sod11� u r(m n sl,c . S eA i cp.c -6 be pvt d o 4 cicKJ I-►fn�1
2. POPULATION OF AREA SERVED. Source of data:U5 Cu.1 uS Pa n:)C- j RSPJ t2
' o)tTl�#Ss o hit % Black % panic Other % Fe naIL
3. -STAFF CURRENTLY EMPLOYED. Effective date:
Total#Lf-g %White 618 % Black 5z_ % Hispanic (s-- % Other 9 73% Female I/ % Disabled
4. CLIENTS CURRENTLY ENROLLED OR REGISTERED Effective date: rrr---
Total#35 %White 6,9 %.% Black �3(% Hispanic % Other (( Female /o Disabled %Over60
boo
5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE.
Total# %Whiteoo % Black O O% Hispanic D % Other 660 Female 0% Disabled
PART II. USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE.
6. Is an Assurance of Compliance on file with DOEA? If NA or NO, explain. NA YES NO
X El
7. Compare the staff composition to the population. Is staff representative of the population?
If NA or NO, explain.
NA YES NO
❑ ►/ •❑
8. Are eligibility requirements for services applied to clients and applicants without regard to race, NA YE . NO
color, national origin, sex, age, religion or disability? If NA or NO, explain. ❑ Al ❑
Page 56 of 76
•
•
AA-1929
•
9. Are all benefits, services and facilities available to applicants and participants in a9 equally effective manner
regardless of race, sex, color, age, national origin, religion or disability? NA_YES✓ NO If NA or NO, explain.
10. For in-patient services, are room assignments made without regard to race, color, national origin or disability?
NAXE�S_NO_ If NA or NO, explain.
`Y/ f�!" frie...d.tht)
I\ e, o e� durl i n p c�'�2.�c
11. Is the program/facility accessible to non-English speaking clients? If NA or NO, explain.
\les
12. Are employees, applicants and participants informed of their protection against discrimination?
If yes, how? Verbal % Written 0, Poster K.If NA or NO, explain.
13. Give the number and current status of any discrimination complaints regarding services or
employment filed against the program/facility. 4
14. Is the progra facility physically accessible to mobility, hearing, and sight-impaired individuals?
NA_YE NO If NA or NO, explain.
PART III. THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES
15. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to
make any necessary modifications? If NO, explain. fe_s
16. Is there and established grievance procedure that incorporates due process in the resolution
of complaints?YES(NO_ If NO, explain.
Page 57 of 76
AA-1929
•
17. Has a person been designated to coordinate Section 504 compliance activities? YESX NO_ If NO, explain.
18. Do recruitment and notification materials advise applicants, employees and participants of
nondiscrimination on the basis of disability? If NO, explain.
\(es
19. Are auxiliary aids available to assure accessibility of services to hearing and sight impaired
individuals? YESKNO If NO, explain.
PART IV
FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF
$50,000 OR MORE.
20. Do you have a written affirmative action plan? YES K NO_ If NO, explain.
Page 58 of 76
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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 / /_
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
I. 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).
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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 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 tiled against the program/facility. Indicate the basis. e.g.,
race. color, creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or
employment, placement, termination. etc. indicate the civil rights law or policy alleged to have been
violated along with the name and address of the local, state or federal agency with whom the
complaint has been filed. Indicate the current status, e.g., settled, no reasonable cause found, failure
to conciliate, failure to cooperate, under review,etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility
includes designated parking areas, curb cuts or level approaches, ramps and adequate widths to
entrances. The lobby, public telephone, restroom facilities, water fountains, information and
admissions offices should be accessible. Door widths and traffic areas of administrative offices,
cafeterias,restrooms, recreation areas, counters and serving lines should be observed for
accessibility. Elevators should be observed for door width, and Braille or raised numbers.
Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be
installed at an appropriate height for mobility impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance
conduct a self-evaluation to identify any accessibility barriers. Self-evaluation is a four step
Page 60 of 76
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process:
With the assistance of a disabled individual/organization, evaluate current practices and policies
which do not comply with Section 504.
Modify policies and practices that do not meet Section 504 requirements.
Take remedial steps to eliminate any discrimination that has been identified.
Maintain self-evaluation on file.(This checklist may be used to satisfy this requirement if these
four steps have been followed.), 45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that
incorporate appropriate due process standards and provide for the prompt and equitable resolution of
complaints alleging any action prohibited by Section 504.45 CFR 84.7(b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to
coordinate efforts to comply with Section 504.45 CFR 84.7(a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy
of nondiscrimination on the basis of disability. This includes recruitment material, notices for
hearings, newspaper ads, and other appropriate written communication, 45 CFR 84.8 (a).
20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to
persons with impaired sensory, manual or speaking skills where necessary. Auxiliary aids may
include, but are not limited to, interpreters for hearing impaired individuals,taped or Braille
materials, or any alternative resources that can be used to provide equally effective services, (45
CFR 84.52 (d).
21. Programs/facilities with 50 or more employees and$50,000 in federal contracts must develop,
implement and maintain a written affirmative action compliance program in accordance with
Executive Order 11246. 41 CFR 60 and Title VI of the Civil Rights Act of 1964, as amended.
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•
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ATTACHMENT D
BACKGROUND SCREENING
EIDER AFFAIRS
Affidavit of Compliance - Employer
AUTHORITY:This form is required annually of all employers to comply with the attestation
requirements set forth in section 435.05(3),Florida Statutes.
The term 'employer' means any person or entity required by law to conduct background screening,
including but not limited to,Area Agencies on Aging/Aging and Disability)Resource Centers,Lead Agencies,
and service Providers that contract directly or indirectly with the Departnceet of Elder Affairs(DOEA],and
any other person or entity which hires employees or has volunteers in service who meet the definition •
of a direct service provider_see§§435_412,430.0402,Fla_Stat.
A direct service provider is'a person 18 years of age or older who,pursuant to a program to provide
services to the elderly,has direct,face-to-face contact with a client while providing services to the client
and has act-Pc to the client's living area,funds,personal property,or personal identrfcdtion information
as defined ins_817.568.The term includes coordinators,managers,and supervisors of residential factlitin;
and volunteers! §430_4402(1)(b},Fla.scat_
ATTESTATION:As the duly authorized representative of i1i) � (.��j tv`
l� 0
1 SS (-{��( �� Employer ct wire` r L
located at I 1 OOetnCryfess oIS r"N 67 1 _ a Q J t `_ StoleCity BSI 121FJe ?3c 4o
StreI, I, grdlI&,(n do hereby affirm under penalty of perjury
Name oaf epreserr tffve
that the above named employer is in compliance with the provisions of Chapter 435 and section
430.0402,FZ�a Statutes,regarding level 2 background screening.
• �� , 3(2-018
,Signs ure of epresentative Date
STATE OF FLORIDA,CUUNTY OF Mel/VW �Q' Q
Sworn to cr affirmed) and subscribed before me this VI' day of DarC, 11o'Gi- , 20 a, by
cep Iv'y I Ui t r1` Warne of Representative)who is personally known
to me or produced /rS as proof of identification.
Print,Type,rg Stamp Corroft ioned Name of l45ry Puttc Notary Public
6CEd Farm 233,AffidaN2 at Com:dance-Ern pw a,ErfedieeSeetember 21.2017 Se cticsn 435A30l,FS
Fumauaittreat:httn:Jfeick Tr..;,-dater re{ersopsnjd rwtn veenire.�.t[o
M O COU A R
P',OVED RM
Lindsey Ballard / /r
.7* NOTARY PUBLIC
-itif. - STATE OF FLORIDA ASS PEDR UNN ATTO E
= `:r.-' Commit FF994388
s 7/8/202D Page 62 of 76 Pate_. _____ ` (g
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ATTACHMENT F
Alliance for Aging, Inc.
Business Assoc ate Agreement
This Business Associate Agreement is dated )2, 3 f 2.0 (8 , 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.
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 providers who perform functions for the Covered Entity.
1.4 HIPAA requires the Covered Entity and the Business Associate to enter into a contract or agreement
containing specific requirements to protect the confidentiality and security of patients' PHI,as set forth in,
but not limited to the Code of Federal Regulations (C.F.R.), specifically 45 C.F.R. §§ 164.502(e),
164.504(e), 164.308(b), and 164.314(a-b) (as may apply) and contained in this agreement.
I.5 The Health Information Technology for Economic and Clinical Health Act(2009),the American Recovery
and Reinvestment Act(2009)and Part I—Improved Privacy Provisions and Security provisions located at
42 United States Code(U.S.C.) §§ 17931 and 17934(2010)require business associates of covered entities
to comply with the HIPAA Security Rule, as set forth in, but not limited to 45 C.F.R. Subpart C and such
sections shall apply to a business associate of a covered entity in the same manner that such sections apply
to the covered entity.
The parties therefore agree as follows:
2.0 Definitions. For purposes of this agreement. the following definitions apply:
2.I Catch-all definition. The following terms used in this Agreement shall have the same meaning as those
terms in the HIPAA Rules: Access, Administrative Safeguards. Authentication, Availability, Breach.
Confidentiality, Data Aggregation, Designated Record Set, Disclosure, Electronic Protected Health
Information (ePHI), Health Care Operations, Individual, Information System, Integrity, Malicious
Software, Minimum Necessary. Notice of Privacy Practices. Password, Physical Safeguards, Protected
Health Information (PHI), Required By Law, Secretary, Security Incident, Subcontractor, Technical
Safeguards, Unsecured Protected Health Information, and Use.
2.2 ARRA. The American Recovery and Reinvestment Act(2009)
•
2.3 Business Associate. "Business Associate" shall generally have the same meaning as the term"business
associate" at 45 CFR 160.103, and in reference to the party to this Agreement, Allapattah Community
Action, Inc.
2.4 Covered Entity. "Covered Entity"shall generally have the same meaning as the term"covered entity"at
45 CFR 160.103, and in reference to the party to this Agreement,shall mean Alliance for Aging, Inc.
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2.5 HIPAA Rules. "HIPAA Rules" shall mean the Privacy, Security, Breach Notification, and Enforcement
Rules at 45 CFR Parts 160 and 164.
2.6 HITECH. The Health Information Technology for Economic and Clinical Health Act(2009)
2.7 All other terms used, but not otherwise defined, in this Agreement shall have the same meaning as those
terms in the HIPAA Rules.
3.0. Obligations and Activities of Business Associate.
3.1 Business Associate agrees to not use or disclose PHI other than as permitted or required by this agreement
or as Required by Law.
3.2 Business Associate agrees to:
(a) Implement policies and procedures to prevent, detect, contain and correct Security violations in
accordance with 45 CFR § 164.306;
(b) Prevent use or disclosure of the PHI other than as provided for by this Agreement or as required by
law;
(c) Reasonably and appropriately protect the confidentiality, integrity, and availability of the ePHI that
the Business Associate creates, receives, maintains, or transmits on behalf of the Covered Entity; and
(d) Comply with the Security Rule requirements under Subpart C of 45 CFR Part 164, including the
Administrative Safeguards, Physical Safeguards, Technical Safeguards, and policies and procedures and
documentation requirements set forth in 45 CFR §§ 164.308, 164.310, 164.312, and 164.316.
3.3 Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to
Business Associate of a use or disclosure of PI11 by Business Associate in violation of the requirements
of this Agreement.
3.4 Business Associate agrees to promptly report to Covered Entity any use or disclosure of the PHI not
provided for by this Agreement of which it becomes aware. This includes any requests for inspection,
copying or amendment of such information and including any security incident involving PHI.
3.5 Business Associate agrees to notify Covered Entity without unreasonable delay, but not later than ten(10)
days following the discovery, of any security breach pertaining to:
(a) Identification of any individual whose unsecured PHI has been, or is reasonably believed by the
Business Associate to have been, accessed, acquired, or disclosed during such security breach; and
(b) All information required for the Notice to the Secretafy of HHS of Breach of Unsecured Protected
Health Information.
3.6 Business Associate agrees to ensure that any agent, including a subcontractor and/or vendor, 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:
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(a) Business Associate agrees to provide access, at the request of Covered Entity during regular
business hours,to PHI in a Designated Record Set,to Covered Entity or, as directed by Covered Entity,to
an individual in order to meet the requirements under 45 CFR §164.524; and
(b) Business Associate agrees to make any amendment(s) to PHI in a Designated Record Set that the
Covered Entity directs or agrees to pursuant to 45 CFR § 164.526 at the request of Covered Entity or an
Individual within 10 business days of receiving the request.
3.8 Business Associate agrees to make internal practices, books, and records, including policies and
procedures and PHI, relating to the use and disclosure of PHI received from, or created or received by
Business Associate on behalf of Covered Entity, available to the Covered Entity or to the Secretary upon
request of either for purposes of determining Covered Entity's compliance with the Privacy Rule.
•
3.9 Business Associate agrees to document such disclosures of PHI and information related to such disclosures
as would be required for Covered Entity to respond to a request by an individual for an accounting of
disclosures of PHI in accordance with 45 CFR § 164.528.
3.10 Business Associate agrees to provide to Covered Entity or an individual, upon request, •information
collected.to permit Covered Entity to respond to a request by an Individual for an accounting of disclosures
of PHI in accordance with 45 CFR § 164.528 and ARRA § 13404.
3.11 Business Associate specifically agrees to use security measures that reasonably and appropriately protect
the confidentiality, integrity, and availability of PHI in electronic or any other form, that it creates,
receives, maintains, or transmits on behalf of the Covered Entity.
3.12 Business Associate agrees to implement security measures to secure passwords used to access ePHI that
it accesses, maintains,or transmits as part of this Agreement from malicious software and other man-made .
and natural vulnerabilities to assure the availability, integrity, and confidentiality of such information.
3.13 Business Associate agrees to implement security measures to safeguard ePi-Ii 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 Know ledge Elements Associated 1,‘,ith 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).
3.15 To the extent Business Associate is to carry out one or more of Covered Entity's obligation(s) under the
Privacy Rule, Business Associate agrees to comply with the requirements of the Privacy Rule that apply
to Covered Entity in the performance of such obligation(s).
4.0 Permitted Uses and Disclosures by Business Associate. Except as otherwise limited in this Agreement
or any related agreement, Business Associate may use or disclose PHI as Required By Law, as well as to
perform functions, activities, or services for, or on behalf of, Covered Entity as specified in any and all
contracts with Covered Entity provided that such use or disclosure would not violate the Privacy Rule if
done by Covered Entity or the minimum necessary policies and procedures of the Covered Entity.
5.0 Specific Use and Disclosure Provisions.
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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.allianceforaging.org.
6.2 Covered Entity shall notify Business Associate of any restriction to the use or disclosure of PHI that
Covered Entity has agreed to in accordance with 45 CFR § 164.522,to the extent that such restriction may
affect Business Associate's use or disclosure of PHI.
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 and HITECH shall be effective upon the later of April
14,2003,or the effective date of the earliest contract entered into between Business Associate and Covered
Entity that involves the use of PHI;
(b) The electronic security provisions hereof shall be effective the later of April 21, 2005 or the
effective date of the earliest contract entered into between Business Associate and Covered Entity that
involves the use of PHI; and
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(c) Provisions hereof mandated by ARRA and HITECH shall be effective the later of February 17,
2010 or the effective date of the earliest contract entered into between covered entity and business associate
that involves the use of PHI or ePHI.
8 2 Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business Associate,
Covered Entity shall either:
(a) Provide an opportunity for Business Associate to cure the breach or end the violation and terminate
this agreement if Business Associate does not cure the breach or end the violation within the time specified.
by Covered Entity;
(b) Immediately terminate this agreement if Business Associate has breached a material term of this
Agreement and cure is not possible; or
(c) If neither termination nor cure is feasible,Covered Entity shall report the violation to the Secretary.
8.3 Effect of Termination. Except as provided in subparagraph (b) of this section, upon termination of this
agreement,for any reason, Business Associate shall return all PHI and ePHI received from Covered Entity,
or created or received by Business Associate on behalf of Covered Entity.
(a) This provision shall apply to PHI and ePHI that is in the possession of subcontractors or agents of
Business Associate. Business Associate shall retain no copies of the PHI and ePHI.
(b) In the event that Business Associate or Covered Entity determines that returning the PHI or ePHI
is infeasible, notification of the conditions that make return of PHI or ePHI infeasible shall be provided to
the other party. Business Associate shall:
1. Retain only that PHI which is necessary for Business Associate to continue its proper
management and administration or to carry out its legal responsibilities;
2. Return to Covered Entit\ (or, if agreed to by Covered Entity, destroy) the remaining- PHI that
the Business Associate still maintains in any form;
3. Continue to use appropriate safeguards and comply with Subpart C of 45 CFR Part 164 with
respect to the ePHI to prevent use or disclosure of the PHI, other than as provided for in this Section, for .
as long as Business Associate retains the PHI:
4. Not use or disclose the PHI retained by Business Associate other than for the purposes for which
such PHi IA as retained and subject to the same conditions set out at Section 5.0 "Specific Use and
Disclosure Provisions" which applied prior to the termination; and
5. Return to Covered Entity (or, if agreed to by Covered Entity, destroy) the PHI retained by
Business Associate when it is no longer needed by Business Associate for its proper management and
administration or to carry out its legal responsibilities.
The obligations of Business Associate under this Section shall survive the termination of this Agreement.
9.0 Regulatory References. A reference in this agreement to a section in the Privacy Rule or Security Rule
means the section then in effect or as may be amended in the future.
10.0 Amendment. The Parties agree to take such action as is necessary to amend this agreement from time to
time as is necessary for Covered Entity to comply with the requirements of the Privacy Rule,the Security
Rule and the Health Insurance Portability and Accountability Act of 1996, Pub. L.No. 104-191.
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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
1 100 Simonton Street, 2"d Floor
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.
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Covered Entity: Alliance for Aging, Inc.
By: Date: 1 f'4!g
(signatt
Business Associate: Monroe County Board of County Commissioners, Social Services/In-Home Services
By: Date: 121312008
(signature)
M OE COU A R EY
P ED
PEDRO .ME
ASSISTA MORN
Date J�,
Page 69 of 76
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ATTACHMENT G
Alliance for Aging, Inc.
Aging and Disability Resource Center/Elder Helpline
AGING AND DISABILITY RESOURCE CENTER(ADRC)—OUTSOURCED FUNCTIONS
If applicable, the provider agrees to the following:
A. Perform ADRC outsourced functions in accordance with the Alliance's policies and procedures.
i. Policies and Procedures for Outsourced Function-Screening
ii. Policies and Procedures for Outsourced Function-Triage
iii. Policies and Procedures for Activation from Waitlist-Client Services
iv. Policies and Procedures for Termination from Waitlist-Client Services
B. Maintain wait lists in CIRTS in accordance with DOEA requirements.
C. Adhere to prioritization and targeting policy as set forth in the DOEA Programs and Services
Handbook, as applicable.
D. Ensure the Provider's Disaster Plan reflects ADRC Outsourced Functions, annually or as needed
to incorporate ADRC outsourced functions.
E. Ensure against conflicts of interest and inappropriate self-referrals by referring consumers in need
of options counseling or long-term care services beyond the provider's scope of services to the
Aging and Disability Resource Center.
F. Ensure that services provided are in the clients' best interest, are the most cost effective, of high
quality, and are responsive and appropriate to the assessed needs.
The Assessed Priority Consumer List (APCL) is maintained when services funded by the department are not
available. Contracted Providers of registered services for Alzheimer's Disease Initiative (ADI). Local Services
Program (LSP), and Older Americans Act (OAA) maintain waiting lists in the CIRTS database for registered
services when funding is not available.
•
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Alliance for Aging, Inc.
Aging and Disability Resource Center/Elder Helpline
Policy and Procedure for Outsourced function—Screening
Creation Date: March 5, 2008
Revision Date: May 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:
I. ADRC Contracted Providers will collect information from callers and conduct a 701S assessment.
Alternatively, if a 701A(B)assessment already exists or is provided from another source(i.e. CARES)
the information from the 701 B can be utilized.
2. Based on the information provided via the 701A(B) assessment, the ADRC Contracted Provider will
make a determination as to the services that the caller is in need of receiving.
3. The ADRC Contracted Provider 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 Provider,the ADRC
Contracted Provider will refer caller to the ADRC Elder Helpline utilizing the ADRC Referral Form
and/or to an ADRC Contracted Provider that provides the needed service.
5. The caller will be provided with general information regarding the ADRC as well as the ADRC Elder
Helpline contact number.
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 Provider 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 Provider determines that the caller may qualify for more than one program for
which the provider is funded, ADRC Contracted Provider is encouraged to enter the appropriate
information under multiple funding sources. [If there is an existing client record in CIRTS, the client
record in CIRTS will be updated with appropriate information].
9. ADRC Contracted Provider 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 71 of 76
AA-1929
Alliance for Aging, Inc.
Aging and Disability Resource Center/Elder Helpline
Policy and Procedure for
Outsourced function - Triage
Creation Date: March 5, 2008
Revision Date: May 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 1. ADRC Contracted Provider will conduct annual reassessments based on DOEA Wait List Reassessment
Standards.
2. If there is no current 701A or B in CIRTS, the Provider will conduct the annual reassessment (701s) as
appropriate. Based on the information provided via the 701S/A(B) assessment, the ADRC Contracted
Provider will update the client information in CIRTS specifically as it pertains to level of need for services
by funding source.
3. The ADRC Contracted Provider will ensure that the CIRTS prioritization score is accurately maintained,
according to DOEA Standards. If a significant change has occurred prior to the annual re-screening, the
Contracted Provider must re-screen. Definitions and examples of significant change are documented in
the DOEA Programs & Services Manual Chapter 2.
4. If the caller is in need of a service(s) that is not provided b� the ADRC Contracted Prot ides, the ADRC
Contracted Provider will refer caller to the ADRC Elder Helpline utilizing the ADRC Referral Form and/or
to an ADRC Contracted Provider that provides the needed service. The caller will be informed of the
services and funding sources that the \Nait list for andjor have been removed from the wait list for.
5. ADRC Contracted Provider will remind client of the ADRC Elder Help Line contact number and to contact
the ADRC Elder Help Line with any questions or concerns.
6. As funding becomes available, ADRC Contracted Provider will run CIRTS Prioritization Report and
activate clients according to DOEA Standards(refer to ADRC Client Activation Policies and Procedures).
The Contracted Provider will apply targeting criteria, as appropriate, to prioritized clients to ensure
activations meet programmatic requirements.
•
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•
AA-1929
Alliance for Aging, Inc.
Aging and Disability Resource Center/Elder Helpline
Policy and Procedure for
Activation From Wait List—Clients/Services
Creation Date: March 5, 2008
Revision Date: 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 Providers to ensure that clients waiting for DOEA funded
services begin to receive those services as funding becomes available.
Procedure:
I. ADRC Contracted Provider will activate clients on CIRTS wait list based on DOEA prioritization polices
and funding availability.
2. ADRC Contracted Provider will update CIRTS status by 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 Provider determines that it is appropriate.
4. Client may also be left on wait list in CIRTS if they are being activated by the ADRC Contracted Provider
under a temporary non-DOEA funding source and ADRC Contracted Provider determines that the client's
need will persist after the temporary funding source is exhausted.
5. ADRC Contracted Provider will inform the client of any services/funding source that they are being
activated for as 1‘ell as those services and funding sources that the continue to be ti‘ait listed for.
6. ADRC Contracted Provider will inform client to contact the ADRC Elder Helpline if they have any
questions or concerns regarding the status of any of their services.
•
Page 73 of 76
•
AA-1929
Alliance for Aging, Inc.
Aging and Disability Resource Center/Elder Helpline
Policy and Procedure for
Termination From Wait List—Clients/Services
Creation Date: March 5, 2008
Revision Date: 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 Providers.
Procedure:
I. ADRC Contracted Provider will re-screen clients which the ADRC Contracted Provider initially placed
on the CIRTS wait list for services based on DOEA Reassessment Standards.
2. The re-screening may be in the form of a phone screening or a home visit depending on the clients status
(i.e. active/pending)
3. ADRC Contracted Provider will determine if the client is no longer in need (or eligible) for any of the
services they were wait-listed for.
4. ADRC Contracted Provider will terminate the client from the wait list (entirely or by specific service)
using the appropriate CIRTS termination code for any services or funding source for which the client is
determined to no longer be eligible for or no longer in need of.
5. ADRC Contracted Provider will inform the client of any services/funding source that they are being
removed from the gait list for.
6. ADRC Contracted Provider will inform client of their ability to be re-added to the wait list if their level of
need should change.
7. ADRC Contracted Provider will inform client to contact the ADRC Elder Helpline if they have any
questions or concerns regarding their wait list status.
8. Reference DOEA Notice of Instruction: Assessed Priority Consumer List#:062906-1-I-OVCS as
applicable.
•
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AA-1929
Incontinence Supplies/Nutritional Products List ATTACHMENT K
BILLING
CODE
CATEGORY i MODIFIER RATE/UNIT
I
1
Adult Diapers Regular Absorbency
Adult Size Brief/Diaper-Medium ,T4522 I $0.69
Adult Size Brief/Diaper-Large T4523 1 $0.80
Adult Size Brief/Diaper-X Large IT4524 1 $0.90
I
I
Adult Diapers Moderate Absorbency '
Adult Size Brief/Diaper-Small T4521 U2 $0.63
I
Adult Size Brief/Diaper-Medium T4522 'U2 $0.69i
Adult Size Brief/Diaper-Large IIT4523 i U2 $0.80!
Adult Size Brief/Diaper-XLarge T4524 U2 $0.90
Adult Size Brief/Diaper-XXLarge . T4543 U2 $1.52
Adult Size Brief/Diaper-XXX Large Bariatric T4543 'U2 $1.52
Adult Diapers Extra Absorbency
Adult Size Brief/Diaper-Small T4521 U3 $0.63 -
Adult Size Brief/Diaper-Medium T4522 U3 $0.69
Adult Size Brief/Diaper-Large T4523 U3 $0.80
Adult Size Brief/Diaper-X Large T4524 U3 $0.90
Adult Size Brief/Diaper-XX Large T4543 U3 $1.52
Adult Size Brief/Diaper-XXX Large Bariatric T4543 U3 $1.52
Pull Ups Regular Absorbency
Adult Size Pull-up- Small T4525 $0.78
Adult Size Pull-up-Medium T4526
$0.85
Adult Size Pull-up-Large IT4527 $0.94
Adult Size Pull-up-X Large IT4528 $1.02
I
Pull Ups Moderate Absorbency
Adult Size Pull-up- Small T4525 U2 $0.78
Adult Size Pull-up-Medium T4526 U2 $0.85
Adult Size Pull-up-Large 1T4527 I U2 $0.94
Adult Size Pull-up-X Large 'T4528 'U2 $1.02
Pull Ups Extra Absorbency
Adult Size Ex-Absorb Pull-up-Small T4525 U3 $0.78
Adult Size Ex-Absorb Pull-up-Medium T4526 U3 $0.85
Adult Size Ex-Absorb Pull-up-Large T4527 U3 $0.94
Adult Size Ex-Absorb Pull-up-X Large T4528 U3 $1.02
Adult Size Ex-Absorb Pull-up-XX Large T4528 U3 $1.02
Page 75 of 76
AA-1929
Incontinence Supplies/Nutritional Products List ATTACHMENT K
BILLING j
CODE 1
CATEGORY MODIFIER I RATE/UNIT'
Additional Disposable Incontinence Products I
Disposable Liner/Shield/Pad Small T4535 $0.44
Disposable Liner/Shield/Pad Medium IT4535 jU1 $0.44
Disposable Liner/Shield/Pad Large T4535 1U2 $0.44
Disposable Underpads Extra Absorb 23X36 'A4554 ,IU2 1 $0.34
Disposable Underpads 23X36 IA4554 I U2 $0.34
1 1
Disposable Underpads 30x30 ,A4554 IU2 1 $0.341
Incontinence Wipes A5120 1 $0.17'
Gloves non sterile(vinyl) powder free-box ,A4927 $4.00
Skin Sealants,Zinc Oxide S5199 $16.66
Nutritional Products
Ensure(24/cs) B4150 SC $0.62
Boost(27/cs) B4150 SC $0.62
Ensure High Protein (24/cs) B4150 SC $0.62
Boost High Protein (27/cs) B4150 SC $0.62
Jevity 1.2(24/cs) B4150 SC $0.62
Ensure Plus(24/cs) 1B4152 . SC $0.501
Boost Plus(27/cs) B4152 SC $0.50
Jevity 1.5(24/cs) B4152 SC $0.50
Boost Glucose(27/cs) B4154 SC $0.90
Glucerna(24/cs) B4154 ISC 1 $0.9011
Nepro(24/cs) ;B4154 SC 1 $0.90,
Bath Accessories
3 in 1 Bedside Commode • E0163 $71.78
Raised Toilet Seat with Arms E0244 $29.10
Tub,Stool/Chair with Back 1 E0245 $38.00
Transfer Bench IE0247• 1 $65.001
*Services must be provided in accordance to the DOEA Programs and Services Handbook. This service shall
only be provided, if it cannot be purchased through Medicare, Medicaid or other any other funding source. All
items shall have direct medical or remedial benefit to the client and be related to the client's medical
condition.
Page 76 of 76