Item C32 C.32
J �� BOARD OF COUNTY COMMISSIONERS
County of Monroe ire �f �r�l � � Mayor Heather Carruthers,District 3
The Florida.Keys Mayor Pro Tem Michelle Coldiron,District 2
Craig Cates,District I
David Rice,District 4
Sylvia J.Murphy,District 5
County Commission Meeting
July 15, 2020
Agenda Item Number: C.32
Agenda Item Summary #7088
BULK ITEM: Yes DEPARTMENT: Social Services
TIME APPROXIMATE: STAFF CONTACT: Sheryl Graham (305) 292-4510
N/A
AGENDA ITEM WORDING: Approval of Alzheimer's Disease Initiative Program (ADI)
Contract KZ-2097 between the Alliance for Aging, Inc., and Monroe County Board of County
Commissioners/Monroe County Social Services In-Home Services for the contract year 2020-2021
(07/01/2020-06/30/2021) in the amount of$189,458.40.
ITEM BACKGROUND: Approval of the ADI contract enables Monroe County Social Services
In-Home Services Program to continue providing personal services (in-home respite, facility-based
respite, case management) to Monroe County's elderly population under the Alzheimer's Disease
Initiative Program.
PREVIOUS RELEVANT BOCC ACTION: BOCC approved amendment 4001 to contract 4 KZ-
1997 on 6/17/2020.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
EXECUTED STAMPED KZ 2097 ADI- (REV 7/6/20)
ADI amendment 001 back up
FINANCIAL IMPACT:
Effective Date: 07/01/2020
Expiration Date: 06/30/2021
Total Dollar Value of Contract: $170,367.24
Total Cost to County: 10% Cash Match
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Current Year Portion:
Budgeted:
Source of Funds: Grant
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: Yes If yes, amount: Approx: $8,000.00
Grant: Yes
County Match: 10% Cash Match
Insurance Required: No
Additional Details: Revenue produced is from client co-payments.
07/15/20 NEW COST CENTER ADDED $170,367.24
REVIEWED BY:
Sheryl Graham Completed 07/01/2020 11:45 AM
Pedro Mercado Completed 07/01/2020 11:58 AM
Purchasing Completed 07/01/2020 12:09 PM
Budget and Finance Completed 07/01/2020 12:19 PM
Maria Slavik Completed 07/01/2020 12:45 PM
Kathy Peters Completed 07/01/2020 12:52 PM
Board of County Commissioners Pending 07/15/2020 9:00 AM
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ALZHEIMER'S DISEASE INITIATIVE CONTRACT >
ORIGINAL
2020-2021 Fiscal Year
THIS CONTRACT is entered into between the Alliance for Aging Inc.,hereinafter referred to as the"Alliance"and Monroe County
Board of County Commissioners,Social Services/In-Home Services,hereinafter referred to as the"Contractor,"and collectively
referred to as the"parties."
Attachments 1,II,III,VI,VII,VIII,IX,X,A,13,C,E,and G are incorporated herein and made a part of this Contract.
WHEREAS,the Alliance has been designated as the Area Agency on Aging for Planning and Service Area I 1 encompassing Miami CD
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Dade and Monroe Counties;and
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WHEREAS, the Florida Department of Elder Affairs (the "Department") has entered into a Contract with the Alliance to fund
Alzheimer Initiative Contractors in Miami-Dade and Monroe Counties;and
NOW THEREFORE,in consideration of the services to be performed and payments to be made,together with the mutual covenants
and conditions set forth in this Contract,the Parties agree as follows:
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract
including all attachments and exhibits,which constitute the contract document.
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2. Incorporation of Documents within the Contract >
The contract will incorporate attachments, proposal(s), state plan(s),grant agreements, relevant Department of Elder Affairs
handbooks,manuals or desk books,as an integral part of the contract,except to the extent that the contract explicitly provides
to the contrary. In the event of conflict in language among any of the documents referenced above,the specific provisions and
requirements of the contract document(s)shall prevail over inconsistent provisions in the proposal(s)or other general materials
not specific to this contract document and identified attachments.
Incorporation of Reference Memoranda:
In accordance with Chapter 287 F.S.,amended,and Department of Financial Services'Chief Financial Officer
Memoranda,the following memoranda are hereby incorporated by reference:
(1)CFO Memo No.02: Release date,October 3,2012;
(2)CFO Memo No.06:Release date,June 27,20I2;
(3)CFO Memo No.01:Release date,July 26,2012;and
(4)CFO Memo No.04:Release date,June 30,2006
3. Term of Contract CL
a. Effective Date:
This contract shall begin at twelve(12:00)A.M., Eastern Standard Time on July 1,2020 or on the date the contract has
been signed by both parties,whichever is later. The contract will end on June 30,2021,or such earlier date as the contract
is terminated pursuant to paragraph 10 herein,except that the parties shall continue to perform those limited contract close- UJ
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out activities set forth in section 4.b.
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b. Delivery of services shall end at 11:59 P.M.,Eastern Standard Time on June 30,2021,or such earlier time as the contract
is terminated pursuant to paragraph 10 herein. Under no circumstances will the Alliance reimburse the provider for
services provided after June 30,2021 or any earlier termination date. No changes to funding allocations will be made after
June 30,2021. Only limited contract close-out activities are to be performed after June 30,2021 consisting of reporting,
invoicing and payment in July of 2021 to facilitate payment for services rendered by the provider under this contract as
stipulated in ATTACHMENT VIII.
4. Contract Amount
The Alliance agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to
exceed$170,367.24 subject to the availability of funds. Any costs or services paid for under any other contract or from any
other source are not eligible for payment under this contract.
4.1 Obligation to Pay
The Alliance's performance and obligation to pay under this contract is contingent upon an annual appropriation by the
Legislature to the Department and funding received by the Alliance under its contract with the Department.
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4.2 Source of Funds
The costs of services paid under any other contract or from any other source are not eligible for reimbursement under this
contract. The funds awarded to the Contractor pursuant to this contract are in the state grants and aids appropriations and
consists of the following:
Program Title Year Funding Source CSFA# Fund Amounts
Alzheimer Disease 2020-21 General Revenue 65004 $170,367.24
Initiative
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TOTAL FUNDS CONTAINED IN THIS CONTRACT: $170,367.24 N
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5. Renewals
The contract may be renewed on a yearly basis for no more than two additional years. Such renewals shall be contingent upon
satisfactory performance evaluations as determined by the Alliance and the availability of funds. Any renewal of a contract
shall be subject to mutual agreement,confirmed in writing, and subject to the same terms and conditions set forth in the initial
contract,with the exception of establishing unit rates which is described further in this section.The renewal price,or method for
determining a renewal price,is set forth in the bid,proposal,or reply.Requests to renegotiate the original contractual established r
rates are provided for in the Alliance's approved Reimbursement Rate Review Policy,which is incorporated by reference.
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The parties shall re-evaluate the contract's reimbursement rates on an annual basis pursuant to DOEA's Notice of Policy
Clarification: Service Cost Reports Notice #092815-1-PC-SCBS dated September 28th, 2015 and the approved Alliance's
Reimbursement Rate Review Policy.
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In the event that contracts cannot be executed prior to the July 1st start date, the Alliance may, at its discretion, extend this
Agreement upon written notice for up to 120 days to ensure continuity of service. Services provided under this extension will be
paid for out of the succeeding agreement amount. UJ
6. Compliance with State Law
6.1 This contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced in all
respects in accordance with the Florida law,including Florida provisions for conflict of laws.
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6.2 The Contractor shall comply with requirements of s.287.058,F.S.as amended.
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6.2.1 The Contractor shall provide units of deliverables, including various client services,and in some instances mayCL
include reports, findings, and drafts, as specified in this contract, which the Contract Manager must receive and
accept in writing prior to payment in accordance with s.215.971,F.S.(1)and(2). h®
6.2.2 The Contractor shall submit bills for fees or other compensation for services or expenses in sufficient detail for a
proper pre-audit and post-audit. UJ
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6.2.3 If itemized payment for travel expenses is permitted in this contract,the Contractor shall submit bills for any travel
expenses in accordance with s. 112.061,F.S.,or at such lower rates as may be provided in this contract.
6.2.4 The Contractor shall allow public access to all documents papers, letters, or other public records as defined in �
subsection 119.011(12),F.S.,made or received by the Contractor in conjunction with this contract except for those
records which are made confidential or exempt by law. The Contractor's refusal to comply with this provision will
constitute an immediate breach of contract for which the Alliance may unilaterally terminate the contract.
6.3 If clients are to be transported under this contract,the Contractor shall comply with the provisions of Chapter 427,F.S.,and
Rule 41-2,F.A.C.
6.4 The Contractor may not subcontract with any individuals or entities on the discriminatory vendor list because they may not
transact business with any public entity,in accordance with the provisions of s.287.134,F.S.
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6.5 The Contractor shall comply with the provisions of s. 11.062,F.S.,and s. 216.347,F.S.,which prohibit the expenditure of
contract funds far the purpose of lobbying the legislature,judicial branch or a state agency.
6.6 The Alliance and/or Department may terminate if the Contractor is found to have submitted a false certification as provided
under 287.135(5), F.S., has been placed on the Scrutinized Companies with Activities in Sudan List, the Scrutinized
Companies with Activities in the Iran Petroleum Energy Sector List(Lists),or the scrutinized companies that Boycott Israel
list,or if the Contractor has been engages in business operations in Cuba or Syria or is engaged in a boycott of Israel.Further,
the Contractor is subject to civil penalties,attorney's fees and costs and any costs for investigations that led to the finding of
false certification.
7. Background Screening
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7.1 The Contractor shall ensure that the requirements of s. 430.0402 and Chapter 435, F.S., as amended, are met regarding
background screening for all persons who meet the definition of a direct service provider and who are not exempt from the
Department's Level 2 background screening pursuant to s.430.0402(2)-(3),F.S.The Contractor must also comply with any
applicable rules promulgated by the Department and the Agency for Health Care Administration regarding implementation
of s. 430.0402 and Chapter 435, F.S. To demonstrate compliance with this provision, Contractor shall submit to the
Department, the Background Screening Affidavit of Compliance(Screening Form) upon thirty(30)days of execution of
this contract. Should the Alliance have a completed Screening Form on file for the Contractor,a new Screening Form will
be required every twelve(12)months.
7.2 Further information concerning the procedures for background screening is found at
http://eideraff,iirs.state fl usr'doea/backzroundscreeni uhp .2
8. Grievance and Complaint Procedures
8.1 Grievance Procedure cv
The Contractor shall comply with and ensure sub-Contractor compliance with the Minimum Guideline for Recipient
Grievance Procedures, Appendix D,Department of Elder Affairs Programs and Services Handbook,to address complaints
regarding the termination,suspension or reduction of services,as required for receipt of funds.
8.2 Complaint Procedures:
The Contractor shall develop and implement complaint procedures and ensure that sub-Contractors develop and implement
complaint procedures to process and resolve client dissatisfaction with services. Complaint procedures shall address the N
quality and timeliness of services,Contractor and direct service worker complaints,or any other advice related to complaints
other than termination,suspension or reduction in services that require the grievance process as described in Appendix D,
Department of Elder Affairs Programs and Services Handbook. The complaint procedures shall include notification to all
clients of the complaint procedure and include tracking the date, nature of the complaint and the determination of the CL
complaint on a complaint log.
9. Public Records and Retention:
9.1 The Contractor,subject to the terms of section 287.058(1)(c),Florida Statutes,and any other applicable legal and equitable
remedies,shall: h®
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a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to
perform the services.
b) Upon request from the Alliance or the Department,the Contractor will provide a copy of the request for records or allow E
the records to be inspected or copies within a reasonable time at a cost that does not exceed the cost provided in Chapter
119,Florida Statutes,or as otherwise provided by law.
c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are
not disclosed except as authorized by law.
d) Upon completion of the contract, or upon termination or expiration of any contract or agreement incorporating this
Master Contract by reference the Contractor will either transfer, at no cost to the Alliance all public records in
possession of the Contractor or will keep and maintain public records required by the Alliance or the Department. If
the Contractor transfers all public records to the Alliance upon completion of the contract,Contractor shall destroy any
duplicate public records that are exempt,or confidential and exempt,from public records disclosure requirements. If
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the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall meet all
applicable requirements for retaining public records.All records stored electronically must be provided to the Alliance
in a format that is compatible with the information technology systems of the Alliance.
9.2 The Alliance may unilaterally cancel this contract notwithstanding any other provisions of this Master Contract,for refusal
by the Contractor to comply with Section 8 of this Master Contract by not allowing public access to all documents,papers,
letters,or other material made or received by the Contractor in conjunction with the contract or agreement incorporating this
Master Contract by reference,unless the records are exempt,or confidential and exempt,from Section 24(a)of Article I of
the State Constitution and Section 119.07(1),Florida Statutes.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119,FLORIDA CN
STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS LN,
CONTRACT,CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT:
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Public Records Coordinator
Florida Department of Elder Affairs
4040 Esplanade Way
Tallahassee,Florida 32309
850-414-2342
doeapublicrecords@elderaffairs.org
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10. Audits,Inspections,Investigations•
10.1 The Contractor shall establish and maintain books, records, and documents (including electronic storage media) in
accordance with generally accepted accounting procedures and practices that sufficiently and properly reflect all revenues
and expenditures of funds provided by the Alliance under this contract. Contractor agrees to maintain records, including
paid invoices, payroll registers, travel vouchers,copy logs,postage logs, time sheets, etc., as supporting documentation
for Service Cost Reports and for administrative expenses itemized for reimbursement. This documentation will be made
available upon request for monitoring and auditing purposes. Whenever appropriate, financial information should be
related to performance and unit cost data.
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10.2 The Contractor shall retain all client records,financial records, supporting documents,statistical records,and any other cv
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. CL
10.3 Upon demand,at no additional cost to the Alliance,the Contractor shall facilitate the duplication and transfer of any records U)
or documents during the required retention period.
10.4 The Contractor shall assure that the records described in Paragraph 10 will be subject at all reasonable times to inspection,
review,copying,or audit by federal,state,or other personnel duly authorized by the Alliance.
10.5 At all reasonable times for as long as records are maintained,persons duly authorized by the Alliance and the Department, ;;
pursuant to 45 CFR ppart 75,will be allowed full access to and the right to examine any of the Contractor's contracts and m
related records and documents pertinent to this specific contract,regardless of the form in which kept.
10.6 The Contractor shall provide a financial and compliance audit to the Alliance as specified in this contract and in
ATTACHMENT III and ensure that all related third-party transactions are disclosed to the auditor.
10.7 The Contractor shall comply and cooperate immediately with any inspections, reviews, investigations,or audits deemed
necessary by the office of the Inspector General pursuant to s.20.055,F.S. Contractor further agrees that it shall include
in related subcontracts a requirement that subcontractors performing work or providing services pursuant to this contract
agree to cooperate with the Inspector General in any investigation,audit,inspection,review,or hearing pursuant to Section
20.005(5),F.S. By execution of this contract,Contractor understands and will comply with this subsection.
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10.8 The Contractor shall maintain and file with the Alliance such progress,fiscal and inventory and other reports as the Alliance
may require within the period of this contract.
10.9 The Contractor shall submit management,program, and client identifiable data,as specified by the Department and/or
the Alliance. The Contractor must record and submit program specific data in accordance with the Department's Client
Information Registration and Tracking System(CIRTS)Policy Guidelines,
11. Nondiscrimination-Civil Rights Compliance
11.1 The Contractor shall execute assurances in ATTACHMENT VI that it will not discriminate against any person in the
provision of services or benefits under this contract or in employment because of age, race, religion, color, disability,
national origin, marital status or sex in compliance with state and federal law and regulations. The Contractor further
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assures that all Contractors,sub-Contractors,sub-grantees,or others with whom it arranges to provide services or benefits
in connection with any of its programs and activities are not discriminating against clients or employees because of age,
race,religion,color,disability,national origin,marital status or sex.
11.2 During the term of this contract,the Contractor shall complete and retain on file a timely, complete and accurate Civil
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Rights Compliance Checklist(ATTACHMENT B).
11.3 The Contractor shall establish procedures pursuant to federal law to handle complaints of discrimination involving services '_✓
or benefits through this contract. These procedures will include notifying clients,employees,and participants of the right r
to file a complaint with the appropriate federal or state entity.
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11.4 These assurances are a condition of continued receipt of or benefit from financial assistance, and are binding upon the W
Contractor, its successors, transferees, and assignees for the period during which such assistance is provided. The
Contractor further assures that all sub-Contractors,vendors,or others with whom it arranges to provide services or benefits
to participants or employees in connection with any of its programs and activities are not discriminating against those C44
participants or employees in violation of the above statutes,regulations,guidelines,and standards. In the event of failure [
to comply,the Contractor understands that the Alliance may,at its discretion,seek a court order requiring compliance with
the terms of this assurance or seek other appropriate judicial or administrative relief, including but not limited to,
termination of and denial of further assistance. ;
12. Provision of Services
The Contractor shall provide services in the manner described in in ATTACHMENT I of this agreement and in the Service
Provider Application(SPA). In the event of a conflict between the Service Provider Application and this contract, the contract cv
language prevails.
13. Monitoring by the Alliance for AQiniz
The Alliance will perform administrative, fiscal, and programmatic monitoring of the Contractor to ensure contractual CL
compliance, fiscal accountability, programmatic performance, and compliance with applicable state and federal laws and
regulations. The Contractor shall permit persons duly authorized by the Alliance to inspect and copy any records, papers,
documents, facilities, goods, and services of the contractor which are relevant to this contract, and to interview any clients,
employees, and subcontracted employees of the Contractor to assure the alliance of satisfactory performance of the terms andLIJ
conditions of this contract. Following such review,the Alliance will provide a written report of its findings to the Contractor,
and where appropriate, the Contractor shall develop an Action Plan and/or a Corrective Action Plan (CAP). The Contractor
hereby agrees to correct all deficiencies identified in a timely manner as determined by the Alliance Contract Manager.
13.1 The Contractor will supply progress reports, including data reporting requirements as specified by the Alliance or the
Department to be used for monitoring progress or performance of the contractual services as specified in this contract.
Following the norms set down by the Department,the Alliance will track performance on a monthly basis. In addition to
monthly tracking,annual monitoring will include desk reviews and on-sight visits to review requested fiscal documents,
CIRTS,and research production reports and any other system or process designated by the Alliance. Examples of review
criteria are surplus/deficit, independent audits, internal controls, reimbursement requests, subcontract monitoring,
targeting,program eligibility,outcome measures,service provision to clients designated as"high risk"by the Department
of Children & Families, Adult Protective Services program, data integrity, co-payments, client satisfaction,
correspondence,and client file reviews.(see ATTACHMENT 1,Section 2.9.2)
13.2 The Contractor shall permit persons duly authorized by the Department or the Alliance to inspect and copy any records,
papers,documents,facilities,goods and services of the Contractor which are relevant to this contract,and to interview any
clients, employees, and sub-Contractor employees of the Contractor to be assure the Alliance of the satisfactory
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performance of the terms and conditions of this contract. Following such review,the Alliance will provide the Contractor
a written report of its findings. The Contractor hereby agrees to correct all deficiencies identified in a timely manner as
determined by the Contract Manager.
14. Coordinated Monitorine with Other Agencies
If the Contractor receives funding from one or more other State of Florida human service agencies,in addition to the Department
of Elder Affairs,then a joint monitoring visit including such other agencies may be scheduled.For the purposes of this contract,
and pursuant to s. 287.0575,F.S. as amended,Florida's human service agencies shall include the Department of Children and
Families, the Department of Health, the Agency for Persons with Disabilities, the Department of Veterans Affairs, and the
Department of Elder Affairs.Upon notification and the subsequent scheduling of such a visit by the designated agency's lead
administrative coordinator,the Contractor shall comply and cooperate with all monitors,inspectors,and/or investigators. CD
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15. Indemnification LO
The Contractor shall indemnify, defend, and hold harmless the Department and the Alliance and their officers, agents, and
employees from any claim, loss,damage,cost,charge,or expense whatever nature or character arising out of any acts,actions,
neglect or omission, action in bad faith, or violation of federal or state law by the Contractor, its agents, employees, or sub-
Contractors during the performance of this contract, whether direct or indirect, and whether to any person or property. It is o
understood and agreed that the Contractor is not required to indemnify the Alliance for claims arising out of the sole negligence
of the Alliance.
15.1 Except to the extent permitted by s.768.28,F.S.,or other Florida law,Paragraph 16 is not applicable to contracts executed r
between the Alliance and state agencies or subdivisions defined in s.768.28(2),F.S.
16. insurance and Bondin
16.1 The Contractor must provide continuous adequate liability insurance and worker's compensation insurance coverage,on
a comprehensive basis,and must hold such liability and worker's compensation insurances at all times during the effective
period of this contract and any renewal(s)or extension(s)of this contract.The Alliance shall be included as an additional i
insured on the Contractor's liability insurance policy or policies and a copy of the Certificate of Insurance shall be provided
annually or when any changes—occur.The Contractor accepts full responsibility for identifying and determining the type(s)
and extent of liability insurance necessary to provide reasonable financial protections for the Contractor and the clients to
be served under this contract. Upon execution of this contract,the Contractor shall furnish the Alliance written verification
supporting both the determination and existence of such insurance coverage. The limits of coverage under each policy
maintained by the Contractor do not limit the Contractor's liability and obligations under this contract. The Contractor
shall ensure that the Alliance has the most current written verification of insurance coverage throughout the term of this
contract.Such coverage may be provided by a self-insurance program established and operating under the laws of the State
of Florida.The Department and the Alliance reserve the right to require additional insurance where appropriate.
16.2 Throughout the term of this contract, the Contractor must maintain an insurance bond from a responsible commercial
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insurance company covering all officers, directors, employees and agents of the Contractor, authorized to handle funds
received or disbursed under this contract, in an amount commensurate with the funds handled, the degree of risk as
determined by the insurance company and consistent with good business practices.
17. Confidentiality of Information
The Contractor shall not use or disclose any information concerning a recipient of services under this contract for any purpose
prohibited by state or federal law or regulations except with the written consent of a person legally authorized to give that consent
or when authorized by law.
18. Health Insurance Portability and Accountability Act
Where applicable,the Contractor shall comply with the Health Insurance Portability and Accountability Act(42 USC 1320d.),
as well as all regulations promulgated thereunder(45 CFR 160, 162,and 164).
19. Incident Reporting
19.1 The Contractor shall notify the Alliance immediately but no later than forty-eight (48) hours from the Contractor's
awareness or discovery of conditions that may materially affect the Contractor or Subcontractor's ability to perform the
services required to be performed under this contract. Such notice shall be made orally to the Contract Manager (by
telephone)with an email to immediately follow.
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19.2 The Contractor shall immediately report knowledge or reasonable suspicion of abuse,neglect,or exploitation of a child,
aged person,or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number(1-800-96ABUSE).
As required by Chapters 39 and 415,F.S.,this provision is binding upon both the Contractor and its employees.
20. Bankruotcv Notification
During the term of this contract, the Contractor shall immediately notify the Alliance if the Contractor, its assignees, sub-
Contractors or affiliates file a claim for bankruptcy. Within ten(10)days after notification,the Contractor must also provide the
following information to the Alliance: (1) the date of filing of the bankruptcy petition;(2),the case number; (3)the court name
and the division in which the petition was filed (e.g., Northern District of Florida, Tallahassee Division); and, (4)the name, .�
address,and telephone number of the bankruptcy attorney.
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21. Sponsorship and Publicity
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21.1 Any nongovernmental organization which sponsors a program financed wholly or partially by state funds or funds obtained M
from a state agency shall,in publicizing,advertising,or describing the sponsorship of the program,state:"Sponsored by,
the State of Florida,Department of Elder Affairs and Alliance for Aging Inc."If the sponsorship reference is in written
material,the words"State of Florida,Department of Elder Affairs and the Alliance for Aging"shall appear in the same
size letters or type as the name of the organization (ref.: section 286.25,F. S.). This shall include, but is not limited to,
any correspondence or other writing,publication or broadcast that refers to such program.
21.2 The Contractor shall not use the words"State of Florida,Department of Elder Affairs"and/or"The Alliance for Aging,
Inc." to indicate sponsorship of a program otherwise financed unless specific authorization has been obtained by the T)
Alliance prior to use. >
22. Assignments
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22.1 The Contractor shall not assign its rights and responsibilities under this contract without the prior written approval of the [
Alliance.All contracts or agreements incorporating this Contract by reference shall remain binding upon the successors in
interest of either the Contractor or the Alliance for Aging,Inc.
22.2 No approval by the Alliance of any assignment or subcontract shall be deemed in any event or in any manner to provide
for the incurrence of any obligation of the Alliance in addition to the dollar amount agreed upon in this contract.
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22.3 The State of Florida is at all times entitled to assign or transfer,in whole or part,its rights,duties,or obligations under any cv
contract or agreement to another governmental agency in the State of Florida, upon giving prior written notice to the
Contractor. In the event the State of Florida approves transfer of the Contractor's obligations, the Contractor remains
responsible for all work performed and all expenses incurred in connection with the contract or agreement.
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23. Subcontracts:
23.1 The Contractor is responsible for all work performed and for all commodities produced pursuant to this contract,whether
actually furnished by the Contractor or its sub-Contractors. Any subcontracts shall be evidenced by a written agreementUJ
subject to all applicable terms and conditions of this contract. Alliance approval of the service application presented by
the Contractor shall constitute Alliance approval of the Contractor's proposed subcontracts if the subcontracts follow the UJ
service and funding information identified in the Contractor's service application. All other subcontracts proposed to be
funded under this contract must be approved in advance by the Alliance. The Contractor agrees that the Alliance shall not UJ
be liable to any sub-Contractor in any way or for any reason. The Contractor,at its expense,will indemnify and defend
the Alliance against any sub-Contractor claims.
23.2 The Contractor shall promptly pay any sub-Contractors. Failure to pay sub-Contractors pursuant to any subcontract or as
required by law may result in enforcement action under this contract.
23.3 The Contractor shall monitor,at least once per year,each of its Subcontractors,Subrecipients,Vendors,and/or Consultants
paid from funds provided under this contract. The Contractor shall perform fiscal, administrative, and programmatic
monitoring to ensure contractual compliance, fiscal accountability, programmatic performance and compliance with
applicable state and federal laws and regulations. The Contractor shall monitor to ensure that time schedules are met,the
budget and scope of work are accomplished within the specified time periods,and other performance goals sated in this
contract are achieved.
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23.4 The Contractor shall have a procurement policy that assures maximum free and open competition. Such procurement
policy must conform,as applicable, with Federal and State contracting and procurement regulations,as set forth in Title
45 Code of Federal Regulations(CFR)part 74-Sub-Part C,Ch.287.057 Florida Statutes(F.S.),U.S.Office of Management
and Budget(OMB)Circular 110,Florida Department of Management Services(DMS)Rule 60A-1,Florida Administrative
Code,and with the Department of Elder Affairs Program and Services Handbook 2012.
23.5 The Contractor shall dedicate the staff necessary to meet the obligations of this contract and ensure that subcontractors
dedicate adequate staff,accordingly.
23.6 The Contractor shall ensure that staff responsible for performing any duties or functions within this contract have the
qualifications as specified in the DOEA Programs and Services Handbook CD
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24. Service Cost Reports and Unit Cost Methodology Reports:
The Contractor shall submit Service Cost Reports to the Alliance annually,but no later than ninety(90)calendar days after the
contract year ends. The Service Cost Reports shall reflect actual costs of providing each service by program for the preceding
contract year. If the Contractor desires to renegotiate its reimbursement rates,the Contractor shall make a request in writing to
the Alliance,with the inclusion of a Unit Cost Methodology, in accordance with the Alliance's approved Reimbursement Rate
Review Policy,which is incorporated by reference.
25. Fundine Obligations:
25.1 The Alliance for Aging, Inc.acknowledges its obligation to pay the Contractor for the performance of the Contractor's
duties and responsibilities set forth in any contract or agreement incorporating this Contract by reference. T
25.2 The Alliance shall not be liable to the Contractor for costs incurred or performance rendered unless such costs and
performances are strictly in accordance with the terms of this contract, including but not limited to terms governing the a
Contractor's promised performance and unit rates and/or reimbursement capitations specified. c=
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25.3 The Alliance shal I not be liable to the Contractor for any expenditure which are not allowable costs as defined by applicable
federal or state law,or which expenditures have not been made in accordance with the terms of this contract or fiscal or
programmatic guidelines and requirements outlined by the current Department of Elder Affairs Programs and Services
Handbook.
25.4 The Alliance shall not be liable to the Contractor for expenditures made in violation of regulations promulgated under the
Older Americans Act, Department rules,Florida Statutes,or this contract.
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26. Independent Capacity of Contractor
It is the intent and understanding of the Parties that the Contractor, or any of its Subcontractors, are independent CL
Contractor's and are not employees of the Alliance and shall not hold themselves out as employees or agents of the Alliance
without specific authorization from the Alliance. It is the further intent and understanding of the Parties that the Alliance U)
does not control the employment practices of the Contractor and will not be liable for any wage and hour, employment
discrimination, or other labor and employment claims against the Contractor or its Subcontractors. All deductions for W
social security, withholding taxes, income taxes, contributions to unemployment compensation funds and all necessary
insurance for the Contractor are the sole responsibility of the Contractor.
27. Payment
Payments shalt be made to the Contractor for all completed and approved deliverables (units of service) as defined in
ATTACHMENT 1. Disputes arising over invoicing and payments will be resolved in accordance with the provisions of Section
215.422, F.S. A Vendor Ombudsman has been established with the Florida Department of Financial Services and may be
contacted at 800-342-2762.
27.1 Payments shall be made to the Contractor as services are rendered and invoiced by the Contractor. The Alliance will have
final approval of the invoice for payment,and will approve the invoice for payment only if the Contractor has met all terms
and conditions of the contract, unless the bid specifications, purchase order, or this contract specify otherwise. The
approved invoice will be submitted to the Alliance's fiscal department for budgetary approval and processing per
ATTACHMENT VIII,
27.2 Payment Documentation Required:
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The Contractor shall maintain documentation to support payment requests which shall be available to the Comptroller,the
Department,or the Alliance upon request. Invoices must be submitted in sufficient detail for a proper pre audit and post
audit thereof. The Contractor shall comply with all state and federal laws governing payments to be made under this
contract including,but not limited to the following:(a)paragraph(16)(b)of section 216.181,F. S.,regarding advances;
(b) Rule 69I-40.103 F.A.C. pertaining to Restriction of Expenditures from state funds; and (c) the Contract Payment
Requirements sub-section of section C of the Reference Guide for State Expenditures from the Department of Financial
Services(http://www.dbfstatc.fl.us/aadir/reference-guide/).
The Contractor shall maintain detailed documentation to support each item on the itemized invoice or payment request for
cost reimbursed expenses,including paid sub-Contractor invoices,and will be produced upon request by the Alliance.The
Contractor shall only request reimbursement for allowable expenses as defined in the laws and guiding circulars cited inCD
this agreement, in the Reference Guide for State Expenditures,and any other laws or regulations,as applicable, and that ,N
administrative expenses do not exceed amounts budgeted in the Contractor's approved service application.
The Contractor will certify that detailed documentation is available to support each item on the itemized invoice or payment M
request for cost reimbursed expenses,fixed rate or deliverables contracts or agreements incorporating this Contract by
reference,including paid Sub-Contractor invoices, and will be produced upon request by the Alliance or the Department.
The Contractor will further certify that reimbursement requests are only for allowable expenses as defined in the laws and
guiding circulars cited in this Contract,in the Reference Guide for State Expenditures,and any other laws or regulations,
as applicable,and that administrative expenses do not exceed amounts budgeted in the Contractor's approved budget as '✓
developed in accordance with and pursuant to section 306(a)of the Older Americans Act of 1965,as amended.
27.3 The Contractor and Sub-Contractors shall provide units of deliverables,including reports,findings,and drafts as specified N
in this contract to be received and accepted by the Contract Manager prior to payment. >
28. Return of Funds
The Contractor shall return to the Alliance any overpayments due to unearned funds or funds disallowed and any interest c=
attributable to such funds pursuant to the terms and conditions of any contract or agreement incorporating this Contract by
reference that were disbursed to the Contractor by the Alliance. In the event that the Contractor or its independent auditor
discovers that an overpayment has been made,the Contractor shall repay said overpayment immediately without prior notification
from the Alliance.In the event that the Alliance first discovers an overpayment has been made,the Contract Manager will notify
the Contractor in writing of such findings. Should repayment not be made forthwith,the Contractor shall be charged at the lawful
rate of interest on the outstanding balance pursuant to s.55.03,F.S.,after Alliance's notification or Contractor discovery.
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29. Data Integrity and Safeguarding Information
The Contractor shall ensure an appropriate level of data security for the information the Contractor is collecting or using in the
performance of this contract. An appropriate level of security includes approving and tracking all Contractor employees that
request system or information access and ensuring that user access has been removed from all terminated employees. The
Contractor,among other requirements,must anticipate and prepare for the loss of information processing capabilities. All data CL
and software must be routinely backed up to insure recovery from losses or outages of computer systems. The security over the
back-up data is to be as stringent as the protection required of the primary systems. The Contractor shall insure all sub-Contractors
maintain written procedures for computer system backup and recovery. The Contractor shall,prior to execution of this agreement,
complete the Data Integrity Certification form,ATTACHMENT II.
30. Computer Use and Social Media Policy c,
The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Policy, which
applies to all employees, contracted employees, consultants, OPS and volunteers, including all personnel affiliated with third
parties, such as, but not limited to, Area Agencies on Aging and vendors. Any entity that uses the Department's computer
resource systems must comply with the Department's policy regarding social media. Social Media includes, but is not limited to
blogs, podcasts, discussion forums, Wikis, RSS feeds,video sharing, social networks like MySpace, Facebook and Twitter,as
well as content sharing networks such as Flickr and YouTube. This policy is available on the Department's website at:
http://eideraffairs.state.fl.us/doea/financial.php.
31. Conflict of Interest
The Contractor shall establish safeguards to prohibit employees,board members,management and sub-Contractors from using
their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal
gain. No employee, officer or agent of the Contractor or sub-Contractor shall participate in selection, or in the award of an
agreement supported by state or federal funds if a conflict of interest,real or apparent,would be involved.Such a conflict would
arise when: (a)the employee, officer or agent; (b) any member of his/her immediate family; (c) his or her partner, or; (d)an
organization which employs, or is about to employ, any of the above, has a financial or other interest in the firm selected for
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award. The Contractor or sub-Contractor's officers, employees or agents will neither solicit nor accept gratuities, favors or
anything of monetary value from Contractors,potential Contractors,or parties to subcontracts. The Contractor's board members
and management must disclose to the Alliance any relationship which may be,or may be perceived to be, a conflict of interest
within thirty(30)calendar days of an individual's original appointment or placement in that position,or if the individual is serving
as an incumbent,within thirty(30)calendar days of the commencement of this contract. The Contractor's employees and sub-
Contractors must make the same disclosures described above to the Contractor's board of directors. Compliance with this
provision will be monitored.
32. Public Entity Crime
Pursuant to s. 287.133, F.S.,a person or affiliate who has been placed on the convicted vendor list following a conviction for a .�
public entity crime may not submit a bid,proposal,or reply on a contract to provide an P p P Y p y goods or services to a public entity;may CD
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 LO
work; may not submit bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform
work as a Contractor,supplier,sub-Contractor,or consultant under a contract with any public entity;and may not transact business
with any public entity in excess of the threshold amount provided in s.287.017,F.S.,for CATEGORY TWO for a period of 36
months following the date of being placed on the convicted vendor list.
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If the Contractor or any of its officers or directors is convicted of a public entity crime during the period of this agreement,the
Contractor shall notify the Alliance immediately.Non-compliance with this statute shall constitute a breach of this agreement.
33.Purchasins: r
33.1 The Contractor may purchase articles which are the subject of or are required to carry out any contract or agreement from y
Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946,F.S.,in the W
same manner and under the procedures set forth in subsections 946.515(2)and(4),F.S.For purposes of this the Contractor
shall be deemed to be substituted for the Alliance insofar as dealings with PRIDE. This clause is not applicable to CD
Subcontractors unless otherwise required by law.An abbreviated list of products/services available from PRIDE may be C44
obtained by contacting PRIDE,800-643-8459.
33.2 The Contractor may procure any recycled products or materials, which are the subject of or are required to carry this
contract in accordance with the provisions of s.403.7065,F.S.
33.3 The Contractor may purchase articles that are the subject of,or required to carry out,this contract from a nonprofit agency
for the Blind or for the Severely Handicapped that is qualified pursuant to Chapter 413,F.S., in the same manner and
under the same procedures set forth in s.413.036(1)and(2),F S.For purposes of this contract the Contractor shall
be deemed to be substituted for the Alliance insofar as dealings with such qualified nonprofit agency are concerned.
Additional information about the designated nonprofit agency and the products it offers is available at
http://www.respectofflorida.org.This clause is not applicable to Subcontractors unless otherwise required by taw.
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33.4 The Contractor shall provide a Certified Minority Business Expenditure(CMBE)Report summarizing the participation of
certified suppliers for the current reporting period and project date. The CMBE Report shall include the names,addresses,
and dollar amount of each certified participant,and a copy must be forwarded to the Alliance and must accompany each
invoice submitted to the Alliance. The Office of Supplier Diversity (850-487-0915)will assist in furnishing names of
qualified minorities. The Florida Department of Elder Affairs, Minority Coordinator (850-414-2t34) will assist with
questions and answers. t3
34. Patents,ConvriEhts.Royalties
If this contract is awarded state funding and if any discovery,invention or copyrightable material is developed,produced or for E
which ownership was purchased in the course of or as a result of work or services performed under this contract the Contractor
shall refer the discover
y, invention or material to the Alliance to be referred to the Department. Any and all patent rights or
copyrights accruing under this contract are hereby reserved to the State of Florida in accordance with Chapter 286,F.S.Pursuant
to s.287.0571 (5)(k),as amended,the only exceptions to this provision shall be those that are clearly expressed and reasonably
valued in this contract
34.1 If the primary purpose of this contract is the creation of intellectual property, the State of Florida shall retain an
unencumbered right to use such property,notwithstanding any agreement made pursuant to this section 33.
34.2 If this contract is awarded solely federal funding,the terms and conditions are governed by 2 CFR Part 200.315.
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35. Emerizencv Preparedness and Continuity of Operations
35.1 The Contractor shall, within thirty (30)calendar days of the execution of this contract, submit to the Contract Manager
verification of an emergency preparedness plan. In the event of an emergency,the Contractor shall notify the Alliance of
emergency provisions.
35.2 In the event a situation results in a cessation of services by a sub-Contractor,the Contractor shall retain responsibility for
performance under this contract and must follow procedures to ensure continuity of operations without interruption. CD
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36. Equipment
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36.1 Use of Contract Funds to Purchase Equipment
No funds under this contract will be used by the Contractor to purchase equipment.
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36.2 Equipment means: a an article of nonex endable,tangible personal roe having a useful life of more than one year
� ) p g� P property g
and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the organization for the
financial statement purposes,or$5,000.00[for federal funds],or(b);nonexpendable,tangible personal property of a non- `_✓
consumable nature with an acquisition cost of$1,000.00 or more per unit,and expected useful life of at least one year;and r
hardback bound books not circulated to students or the general public,with a value or cost of$250.00 or more[for state
funds]. N
37. PUR 1000 Form:
The PUR 1000 Form is hereby incorporated by reference and available at:
http:mi Ati.niyflorida coni/apps/vbs/adoe/F77.10 PUR 1000 Rdf
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In the event of any conflict between the PUR 1000 Form and any terms or conditions of any contract or agreement terms or
conditions the contract shall take precedence over the PUR 1000 Form. However, if the conflicting terms or conditions in the
PUR 1000 Form are required by any section of the Florida Statutes, the terms or conditions contained in the PUR 1000 Form ;
shall take precedence.
38. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon the Contractor or politicalCD
subdivision granting to the state a security interest in the property at least to the amount of state funds provided for at least 5 years
from the date of purchase or the completion of the improvements or as further required by law.
39. Dispute Resolution CL
Any dispute concerning performance of the contract shall be decided by the Contract Manager,who shall reduce the decision to
writing and serve a copy on the Contractor. h®
40.Corrective Action Plan
a) Contractor shall ensure 100%of the deliverables identified in ATTACHMENT 1, Section It—MANNER OF SERVICE
PROVISION are performed pursuant to contract requirements.
b) If at any time the Contractor is notified by the Alliance Contract Manager that it has failed to correctly, completely,or
adequately perform contract deliverables,the Contractor will have 15 days to submit a Corrective Action Plan("CAP")to
the Alliance Contract Manager that addresses the deficiencies and states how the deficiencies will be remedied within a
time period approved by the DOEA Contract Manager. The Alliance shall assess a Financial Consequence for Non-
Compliance on the Contractor for each deficiency identified in the CAP which is not corrected pursuant to the CAP. The
Alliance will also assess a Financial Consequence for failure to timely submit a CAP.
c) In the event Contractor fails to correct an identified deficiency within the approved time period specified in the CAP,the
Alliance shall deduct,from the payment for the invoice of the following month, 1%of the monthly value of the monthly
invoiced funds in the contract for each day the deficiency is not corrected. The Alliance shall also deduct,from the payment
for the invoice of the following month, 1%of the monthly value of the invoiced funds in the contract for each day the
Contractor fails to timely submit a CAP.
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d) If Contractor fails to timely submit a CAP,the Alliance shall deduct 1%of the monthly value of the invoiced funds in the
contract for each day the CAP is overdue,beginning the I ith day after notification by the Alliance Contract Manager of
the deficiency. The deduction will be made from the payment for the invoice of the following month.
41. Financial Consequences of Non-Performance
If the Contractor fails to meet the minimum level of service or performance identified in this agreement,or that is customary for
the industry, then the Alliance must apply financial consequences commensurate with the deficiency. Financial consequences
may include, but are not limited to, contract suspension, refusing payment, withholding payments until deficiency is cured,
tendering only partial payments,and/or cancellation of contract and reacquiring services from an alternate source.
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The Alliance will withhold or reduce payment if the Contractor fails to perform the deliverables to the satisfaction of the Contract
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according to the requirements referenced in ATTACHMENT I,Section I and Section II of this contract.The following financial
consequences will be imposed if the deliverables stated do not meet in part or in whole the performance criteria as outlined in
ATTACHMENT I,Section iI of this contract.
a) Delivery of services to eligible clients as referenced in ATTACHMENT I,Section I, 1.3 Section II, 2.1 of this contract
—Failure to ensure adherence to established assessment and prioritization criteria as evidenced in CIRTS reports will
result in a reduction of payment equal to the percentage of new clients served who did not meet the criteria,compared
to the total number of clients served.
b) Services and units of services as referenced in ATTACHMENT 1,Section II,2.2 of this contract—Failure to ensure the
provision of services in accordance with the current DOEA Programs and Services Handbook,and ATTACHMENTS T)
VII and K, and submission of required documentation will result in a 2%reduction of payment per business day any W
identified deficiency is not cured or satisfactorily addressed.
c) Performance Specifications as referenced in ATTACHMENT I,Section 11,2.6 of this contract—Failure to perform the
performance specifications and oversight of CCE Program operations will result in a 2% reduction of payment per
business day any identified deficiency in duties is not cured or satisfactorily addressed in accordance with
ATTACHMENT I,Section Il,3.6.3
d) Exceptions may be granted solely, in writing,by the DOEA contract manager.
41.1 The Contractor will not be charged with financial consequences,when a failure to perform arises out of causes that were
the responsibility of the Alliance.
41.2 No Waiver of Sovereign Immunity
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable. CL
43. Venue
If any dispute arises out of this contract,the venue of such legal recourse will be Miami-Dade County,Florida.
44. Entire Contract
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or representations shall be
valid or binding upon the Alliance or the Contractor unless expressly contained herein or by a written amendment to this contract
signed by both Parties.
45. Force Maieure
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control,provided the E
party experiencing the force majeure condition provides immediate written notification to the other party and takes all reasonable
efforts to cure the condition.
46. 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.
47. Condition Precedent to Contract: Appropriations
The Parties agree that the Alliance's performance and obligation to pay under this contract is contingent upon an annual
appropriation by the Legislature to the Department and a corresponding allocation under contract from the Department to the
Alliance.
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48. Addition/Deletion
The Parties agree that the Alliance reserves the right to add or to delete any of the services required under this contract when
deemed to be in the State of Florida's best interest and reduced to a written amendment signed by both Parties. The Parties shall
negotiate compensation for any additional services added.
49. Waiver
The delay or failure by the Alliance to exercise or enforce any of its rights under this contract will not constitute or be deemed a
waiver of the Alliance's right thereafter to enforce those rights,nor will any single or partial exercise of any such right preclude
any other or further exercise thereof or the exercise of any other right.
50. Compliance
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The Contractor shall abide by all applicable current federal statutes,laws,rules and regulations as well as applicable current state
statutes, laws, rules and regulations. The Parties agree that failure of the Contractor to abide by these laws shall be deemed an
event of default of the Contractor,and subject the contract to immediate, unilateral cancellation of the contract at the discretion
of the Alliance.
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52. Final Invoice
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The Contractor shall submit the final invoice for payment to the Alliance as specified in Paragraphs 3.4,3.4.1 and 3.4.2(date for
final request for payment)of ATTACHMENT I. If the Contractor fails to submit final request for payment by the deadline,then '✓
all rights to payment may be forfeited and the Alliance may not honor any requests submitted after the aforesaid time period.
Any payment due under the terms of this contract may be withheld until all reports due from the Contractor and necessary
adjustments thereto have been approved by the Alliance. v_r
52. Modifications
Modifications of provisions of this contract shall only be valid when they have been reduced to writing and duly
signed by both parties. The parties agree to renegotiate this contract if revisions of any applicable laws or _
regulations make changes in this contract necessary. The parties agree that no such modifications or changes will
be made to this contract after June 30,2021.
53. Suspension of Work:
The Alliance may in its sole discretion suspend any or all activities under this contract when in the Department of Elder Affairs
and the Alliance determination that it is in the best interests of State to do so.The Alliance shall provide the Contractor written r�
notice outlining the particulars of suspension.Examples of the reason for suspension include, but are not limited to, budgetary
constraints, declaration of emergency, or other such circumstances. After receiving a suspension notice, the Contractor shall
comply with the notice and shall not accept any purchase orders. Within ninety days, or any longer period agreed to by the
Contractor,the Alliance shall either(1)issue a notice authorizing resumption of work,at which time activity shall resume,or(2)
terminate the Contract or purchase order.Suspension of work shall not entitle the Contractor to any additional compensation. uJ
54. Termination
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54.1 Termination for Convenience. This contract may be terminated by either party without cause upon no less than thirty
(30)calendar days'notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice
shall be delivered by U.S. Postal Service with verification of delivery or any expedited delivery service that provides
verification of delivery or by hand delivery to the Contract Manager or the representative of the Contractor responsible for
administration of the contract. The Contractor shall not furnish any product after it receives the notice of termination,
except as necessary to complete the continued portion of the contract,if any.The Contractor shall not be entitled to recover
any cancellation charges or lost profits.
54.2 Termination for Cause.The Alliance may terminate this contract if the Contractor fails to(1)deliver the product within
the time specified in the contract or any extension,(2) maintain adequate progress,thus endangering performance of the
contract,(3)honor any term of the(4)abide by any statutory,regulatory,or licensing requirement,or(5)in the event funds
for payment become unavailable for this contract. The Alliance will be the final authority as to the availability and
adequacy of funds. In the event of termination of this contract, the Contractor will be compensated for any work
satisfactorily completed prior to the date of termination. Rule 60A- 1.006(3), F.A.C., governs the procedure and
consequences of default. The contractor shall continue work on any work not terminated. Except for defaults of
Subcontractors at any tier,the Contractor shall not be liable for any excess costs if the failure to perform the Contract arises
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from events completely beyond the control,and without the fault or negligence,of the Contractor.If the failure to perform
is caused by the default of a Subcontractor at any tier,and if the cause of the default is completely beyond the control of
both the Contractor and the Subcontractor,and without the fault or negligence of either,the Contractor shall not be liable
for any excess costs for failure to perform,unless the subcontracted products or services were obtainable from other sources
in sufficient time for the Contractor to meet the required delivery schedule. If,after termination, it is determined that the
Contractor was not in default,or that the default was excusable,the rights and obligations of the Parties shall be the same
as if the termination had been issued for the convenience of the Alliance. The rights and remedies of the Alliance in this
clause are in addition to any other rights and remedies provided by law or under the Contract.
54.3 Upon expiration or termination of this contract the Contractor and Subcontractors shall transfer all public records in its
possession to the Alliance and destroy any duplicate public records that are exempt or confidential and exempt from public
records, disclosure requirements at no cost to the Alliance. All electronically stored records shall be provided to the LO
Alliance in a format that is compatible with the Alliance's information technology system(s).
55. Successors
This contract shall remain binding upon the successors in interest of either the Alliance or the Contractor.
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56. Electronic Records and Signature
U
The Alliance authorizes,but does not require,the Contractor to create and retain electronic records and to use electronic signatures
to conduct transactions necessary to carry out the terms of this Contract.A Contractor that creates and retains electronic records W
and uses electronic signatures to conduct transactions shall comply with the requirements contained in the Uniform Electronic
Transaction Act,s. 668.50,Fla.Stat.All electronic records must be fully auditable;are subject to Florida's Public Records Law,
Ch. 119, and Fla. Stat.; must comply with Section 29, Data Integrity and Safeguarding Information; must maintain all T)
confidentiality,as applicable;and must be retained and maintained by the Contractor to the same extent as non-electronic records W
are retained and maintained as required by this Contract.
56.1 The Alliance's authorization pursuant to this section does not authorize electronic transactions between the Contractor and
the Alliance. The Contractor is authorized to conduct electronic transactions with the Alliance only upon further written
consent by the Alliance.
56.2 Upon request by the Alliance,the Contractor shall provide the Alliance or DOEA with non-electronic(paper)copies of
records. Non-electronic(paper) copies provided to the Alliance of any document that was originally in electronic form
with an electronic signature must indicate the person and the person's capacity who electronically signed the document on
any non-electronic copy of the document.
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57. Special Provisions
The Contractor agrees to the following provisions:
57.1 Investigation of Criminal Allegations: CL
Any report that implies criminal intent on the part of the Contractor or any sub-Contractors and referred to a governmental
or investigatory agency must be sent to the Alliance.If the Contractor has reason to believe that the allegations will be
referred to the State Attorney, a law enforcement agency, the United States Attorney's office, or other governmental
agency,the Contractor shall notify the contract manager.A copy of all documents,reports,notes or other written material
concerning the investigation,whether in the possession of the Contractor or Sub-Contractors,must be sent to the Alliance's
contract manager with a summary of the investigation and allegations.
57,2 Volunteers:
The Contractor shall ensure the use of trained volunteers in providing direct services delivered to older Individuals and
individuals with disabilities needing such services.If possible,the Contractor shall work in coordination with organizations
that have experience in providing training, placement, and stipends for volunteers or participants(such as organizations U
carrying out federal service programs administered by the Corporation for National and Community Service), in
community service settings.
57.3 Enforcement:
57.3.1 In accordance with Section 430.04,F.S.,the Alliance may,without taking any intermediate measures available
to it against the Contractor,rescind the Contractor's contract,if the Alliance finds that:
a. An intentional or negligent act of the Contractor has materially affected the health,welfare,or safety of
clients served pursuant to any contract or agreement incorporating this Contract by reference, or
substantially and negatively affected the operation of services covered under any contract or agreement;
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b. The Contractor lacks financial stability sufficient to meet contractual obligations or that contractual
funds have been misappropriated;
c. The Contractor has committed multiple or repeated violations of legal and regulatory standards,
regardless of whether such laws or regulations are enforced by the Alliance, or the Contractor has
committed or repeated violations of Department standards;
d. The Contractor has failed to continue the provision or expansion of services after the declaration of a
state of emergency;and/or
e. The Contractor has failed to adhere to the terns of this contract.
f. The Contractor consistently misses performance measure targets, or does not demonstrate to the
satisfaction of the Alliance that a program budget surplus/deficit problem is being addressed in order to
avoid closing out the contract year with a budget variance of more than two percent. CD
g. The Contractor has failed to properly determine client eligibility as defined in this contract and the
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DOEA Programs and Services Handbook or efficiently managed program budgets.
h. The Contractor has failed to implement and maintain an approved client grievance resolution procedure.
i. In the alternative, the Alliance may, at its sole discretion, take immediate measures against the
Contractor,including:corrective action,unannounced special monitoring,temporary assumption of the
operation of one or more contractual services, placement of the Contractor on probationary status,
imposing a moratorium on Contractor action,imposing financial penalties for nonperformance,or other
administrative action
j. In making any determination under this provision the Alliance may rely upon the findings of another
state or federal agency,or other regulatory body.Any claims for damages for breach of any contract or
agreement incorporating this Contract by reference are exempt from administrative proceedings and
shall be brought before the appropriate entity in the venue of Miami-Dade County. v_r
57.4 Use of Service Dollars:
The Contractor will optimize the use of contract funds by serving the maximum possible number of individuals with ^�
appropriate care plans with the services allowed by this contract. The Contractor will spend all funds provided by this
contract to provide such services.
57.5 Surplus/Deficit Report:
The Contractor will submit a consolidated surplus/deficit report by program in a format provided by the Alliance to the ;
Alliance's Contract Manager with the monthly request for payments according to the calendar on ATTACHMENT VIII.
57.6 Surplus Recapture: r�
In accordance with its surplus/deficit management policies,in order to maximize available funding and minimize the time
that potential clients must wait for services,the Alliance in its sole discretion can reduce funding awards if the Contractor
is not spending according to monthly plans and is projected to incur a surplus at the end of the year.
58. Official Payee and Revresentatives: CL
The name,address,and telephone number of the representative for the Alliance for this contract is:
Max B.Rothman,JD,LL.M.President and CEO
760 NW 107th Ave,Suite 214
Miami,Florida 33172
(305)670-6500,Ext.224
The name,address,and telephone number of the representative of the Contractor responsible for administration of the program under
this contract is:
The Contractor name, as shown on page I of this Monroe County Board of County Commissioners,Social
a. contract, and mailing address of the official payee to Services/In-Home Services
whom the payment shall be made is: 1100 Simonton Street,2-257
Key West,FL 33040
Sheryl Graham,Senior Director
b The name of the contact person and street address where Monroe County Board of County Commissioners,Social
financial and administrative records are maintained is: Services/In-Home Services
1100 Simonton Street,2-257
Key West FL 33040
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The name, address, and telephone number of the Sheryl Graham,Senior Director
C. representative of the Contractor responsible for Monroe County Board of County Commissioners,Social
administration of the program under this contract is: Services/In-Home Services
1100 Simonton Street,2-257
Key West,FL 33040
The section and location within the AAA where Requests Vice President for Finance
d. for Payment and Receipt and Expenditure forms are to be Alliance for Aging,Inc.
mailed is: 760 NW 107th Avenue,Suite214
Miami,Florida 33172-3155 CD
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Contract Monitor
Alliance for Aging,Inc.
e. The name, address, and telephone number of the 160 NW 107th Avenue,Suite 214
Contract Manager for the AAA for this contract is:
Miami,Florida 33172-3155
In the event different representatives are designated by either party after execution of this contract,notice of the name and address of
the new representative will be rendered in writing to the other party and said notification attached to originals of this contract. v_r
59. All Terms and Conditions Included
This contract and its Attachments I, II, III, VI, VII, VIII, IX, X, A, B, C, E, and G and any exhibits referenced in said
attachments,together with any documents incorporated by reference,contain all the terms and conditions agreed upon by the
Parties. There are no provisions,terms,conditions,or obligations other than those contained herein,and this contract shall
supersede all previous communications,representations or agreements,either written or verbal between the Parties.
By signing this contract,the Parties agree that they have read and agree to the entire contract.
IN WITNESS THEREOF,the Parties hereto have caused this contract,to be executed by their undersigned officials as duly authorized.
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Monroe County Board of County
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Commissioners,Social Services/In-
ALLIANCE FOR AGING,INC.
Home Services
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SIGNED BY: SIGNED BY:
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NAME:- NAME: MAX B.ROTHMAN,JD,LL.M.
TITLE:
" TITLE: PRESIDENT AND CEO
DATE:__ DATE:
-94
ROE COU ATTORh1E1l
P E
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PEORO J.twIERC
AMSSI
Date Z6
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INDEX TO ATTACHMENTS
Attachment I SERVICE PROVISIONS ALZHEIMER'S DISEASE INITIATIVE
Attachment If CERTIFICATIONS AND ASSURANCES
Attachment III FINANCIAL AND COMPLIANCE AUDIT
Attachment VI ASSURANCES NON CONSTRUCTION PROGRAMS
Attachment VII BUDGET SUMMARY
Attachment VIII INVOICE REPORT SCHEDULE N
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Attachment IX REQUEST FOR PAYMENT FORM
Attachment X RECEIPT AND EXPENDITURE REPORT
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Attachment A DOEA HANDBOOK
Attachment B CIVIL RIGHTS COMPLIANCE CHECKLIST
Attachment C REFERRAL PROTOCOL AGING AND DISABILITY RESOURCE CENTER(ADRC)—
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Attachment E BUSINESS ASSOCIATE AGREEMENT T)
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Attachment G BACKGROUND SCREENING AFFADAVIT OF COMPLIANCE
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ATTACHMENT
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
SECTION I.SERVICES TO BE PROVIDED
1.1. DEFINITIONS OF TERMS AND ACRONYMS
1.1.1 DEFINITIONS OF ACRONYMS
Alzheimer's Disease(AD)
Alzheimer's Disease Initiative(ADI)
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Activities of Daily Living(ADL)
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Assessed Priority Consumer List(APCL)
Adult Protective Services(APS)
Client Information and Registration Tracking System (CIRTS)
Community Care for Disabled Adults(CCDA)
Corrective Action Plan(CAP)
Department of Elder Affairs—(DOEA)or Department
Department of Elder Affairs Program and Services Handbook(DOEA HANDBOOK)
Home Care For Disabled Adults(HCDA)
Instrumental Activities of Daily Living(IADL)
Memory Disorder Clinic(MDC)
Planning and Service Area(PSA) .2
1.1.2 PROGRAM SPECIFIC TERMS
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Aging Out Clients: Individuals reaching 60 years of age who are being transitioned from the Department of Children and
Families Services Community Care for Disabled Adults(CCDA)or Home Care for Disabled Adults(HCDA)services to the
Department's community-based services.
Area Plan: A plan developed by the Alliance outlining a comprehensive and coordinated service delivery system in the
respective planning and service area,in accordance with the Section 306 of the Older Americans Act(42 U.S.C.3026)and
Department instructions.The Area Plan includes performance measures and unit rates per service offered per county.
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Area Plan Update: A revision to the Area Plan wherein the Alliance enters ADI specific data into the CIRTS. An update cv
may also include other revisions to the Area Plan as instructed by the Department.
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Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain CL
independent and in the least restrictive living arrangement. DOEA Form 701 B is used by case managers to conduct the
functional assessment. h®
Memory Disorder Clinic: Research oriented programs created pursuant to Sections 430.502(1) and (2), F.S., to provide
diagnostic and referral services,conduct basic and service-related multidisciplinary research,and develop training materials
and educational opportunities for lay and professional caregivers of individuals with AD.
1.2 GENERAL DESCRIPTION
1.2.1 General Statement
The primary purpose of the ADI program is to provide a continuum of services addressing the special needs of
individuals with AD,their families and caregivers.
1.2.2.Alzheimer's Disease Initiative Mission Statement
The ADI program ensures that persons afflicted with AD and other forms of dementia are given essential services to
help them age in place in an elder-friendly environment with security,dignity,and purpose.The program also provides
support to family members and caregivers of persons afflicted with AD.
1.2.3 Authority
The relevant authority governing ADI program are:
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a. Rule 5813-1,Florida Administrative Code
b. Sections 430.501 through 430.504,F.S.
c. The Catalog of State Financial Assistance(CSFA)Numbers are 65004 and 65002
1.2.4 Scope of Service and Eligible Individuals
The Contractor is responsible for the programmatic, fiscal, and operational management of the ADI program per this
contract. The program services shall be provided in a manner consistent with the Area Plan,as updated and the current
DOEA Handbook, which are incorporated by reference. The Contractor agrees to be bound by all subsequent
amendments and revisions to the DOEA Handbook, and the Contractor agrees to accept all such amendments and
revisions.
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1.3 Clients to be Served
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1.3.1 General Eligibility
The ADI Program addresses the special needs of individuals with AD or other related disorders and their caregivers. M
1.3.2 Individual Eligibility
Clients eligible to receive services under this contract must: U
a. Be 18 years of age or older and have a diagnosis of AD or a related disorder,or be suspected of having AD or a `✓
related disorder;and
b. Not be enrolled in a Medicaid capitated long-term care program.
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1.3.3 Targeted Groups >
Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk of
placement in an institution.
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SECTION 11. MANNER OF SERVICE PROVISION
2.0 CONDITIONS
All services under this contract will be provided in a manner consistent with the conditions set forth in the current Florida
Department of Elder Affairs Programs and Services Handbook.
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Client access to services,assessment and eligibility determination must conform to the protocols listed in ATTACHMENT
C.
2.1 SERVICE TASKS
To achieve the goals of the ADI program,the Contractor shall perform or ensure the performance of its Sub-Contractors, CL
the following tasks:
2.1.1 Client Eligibility Determination
The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is
based on meeting the requirements described in this ATTACHMENT 1,Section 1.3.
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2.1.2 Assessment and Prioritization of Service Delivery for New Clients
The Contractor shall ensure the following criteria are used to prioritize new clients for service delivery.It is not the
intent of the Department to remove existing clients from any services in order to serve new clients being assessed and
prioritized for service delivery.
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Priority Criteria for Service Delivery
a. Individuals in nursing homes under Medicaid who could be transferred to the community;
b. Individuals in nursing homes whose Medicare coverage is exhausted and may be diverted to the community;
c. Individuals in nursing homes that are closing and can be discharged to the community;
d. Individuals whose mental or physical health condition has deteriorated to the degree self-care is not possible,
there is no capable caregiver,and institutional placement will occur within 72 hours;and
e. For the purpose of transitioning individuals receiving CCDA and HCDA services through the Department of
Children and Families' Adult Services to community-based services provided through DOER when services
are not currently available,area agency on aging staff and lead agency case managers will ensure that"Aging
Out"individuals are prioritized for services only after APS High.Risk and Imminent Risk individuals.
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2.1.3 Priority Criteria for Service Delivery for Other Assessed Individuals
The assessment and provision of services should always consider the most cost effective means of service delivery.
Functional impairment will be determined through the Department's functional assessment form administered to
each applicant. The most frail individuals not prioritized as described in this attachment, Paragraph 2.1.2.1 will
receive services to the extent funding is available.
2.1.4 Delivery of Services to Eligible Clients:
The Contractor shall ensure the provision of a continuum of services addressing the diverse needs of individuals
with AD and their caregivers. The Contractor shall ensure services are performed in accordance with the current
Department of Elder Affairs Programs and Services Handbook.Services categories include:
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a. Caregiver Training/Support;
b. Case Aide; r"
c. Case Management;
d. Counseling(Gerontological);
e. Counseling(Mental Health/Screening);
f. Education/Training;
g. Respite(Facility-Based);
h. Respite(in-Home);and �--
i. Specialized Adult Day Care
j. Specialized Medical Equipment,Services,and Supplies.
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Caregivers benefit from receiving training,respite and related support services to assist them in caring for the ADI
client.
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2.2 SERVICE TIMES AND LOCATION
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Service Times:
The Contractor shall ensure the provision of the services listed in this contract is available at times appropriate to meet client
service needs at a minimum,during normal business hours.Normal business hours are defined as Monday through Friday,
8:00am to 5:00pm.
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Change in Locations:
The Contractor shall notify the alliance in writing a minimum of one week prior to making changes in location that will affect
the Alliance's ability to contact the Contractor by telephone,facsimile,or email.
2.3 Service Units CL
Services will be reported in units as described in the DOEA Handbook.
2.4 REPORTS
2.4.1 The Contractor shall submit Service Cost Reports to the Alliance annually no later than ninety(90)calendar days
after the Contractor Fiscal Year end. The Service Cost Reports shall reflect actual costs of providing each service
by program for the preceding contract year. If the Contractor desires to renegotiate its reimbursement rates, the
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Contractor shall make a request in writing to the Alliance in accordance with the Alliance's approved
Reimbursement Rate Review Policy,which is incorporated by reference.
2.4.2 Client Information and Registration Tracking System(CIRTS)Reports
The Contractor shall ensure timely input of AD[ specific data into CIRTS. To ensure CIRTS data accuracy,the
Contractor shall adhere to the Alliance's CIRTS Data Integrity Policy and use CIRTS-generated reports which
include the following:
a. Client Reports;
b. Monitoring Reports;
c. Service Reports;
d. Miscellaneous Reports;
e. Fiscal Reports;and
f. Outcome Measures Reports.
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2.4.3 The Contractor shall provide the Alliance with an expenditure plan by July 15 or two weeks after this contract has
been signed;a monthly update is due on the 15thst day of each following month.The expenditure plan and updates
must follow the fonnat provided by the Alliance.
2.4.4 The Contractor shall respond to surplus/deficit inquiries and will provide ad-hoc reports as requested by the
Alliance.
2.4.5 The Contractor shall submit Program Highlights referencing specific events that occurred in the contract year 2019-
2020 by September 15, 2020. The Contractor shall provide a new success story, quote, testimonial, or human-
interest vignette. The highlights shall be written for a general audience,with no acronyms or technical terms. For
all agencies or organizations that are referenced in the highlight,the Contractor shall provide a brief description of CD
their mission or role. The active tense shall be consistently used in the highlight narrative,in order to identify the
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specific individual or entity that performed the activity described in the highlight. The Contractor shall review and
edit Program Highlights for clarity, readability, relevance, specificity, human interest, and grammar, prior to
submitting them to the Alliance.
2.5 ELECTRONIC RECORDS AND DOCUMENTATION
The Contractor will ensure the collection and maintenance of client and service information on a monthly basis from the
Client Information and Registration Tracking System (CIRTS).Maintenance includes valid exports and backups of all data
and systems according to Alliance and Department standards.
2.5.1 Timely Data Entry
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The Contractor must enter all required ADI data per the Department's CIRTS Policy Guidelines for consumers and �+
services in the CIRTS database. The data must be entered into CIRTS before the Contractor submits its request for >
payment and expenditure reports to the Alliance as per ATTACHMENT VIIl.
2.5.2 Data Accuracy
The Contractor will run monthly CIRTS reports and verify client and service data in CIRTS is accurate. This report
must be submitted to the Alliance with the monthly request for payment and expenditure report and must be
reviewed by the Alliance before the Contractor's request for payment and expenditure reports can be approved byUj
the Alliance.
2.5.3 Failure to Maintain CIRTS Database
Failure to ensure the collection and maintenance of the CIRTS data may result in the Alliance enacting the
"Enforcement" clause of this agreement in ATTACHMENT I, Section 2.7, including delaying or withholding N
payment until the problem is corrected.
2.5.4 Computer System Backup and Recovery
Each Contractor, among other requirements, must anticipate and prepare for the loss of information processingCL
capabilities. The routine backing up of data and software is required to recover from losses or outages of the er
computer system. Data and software essential to the continued operation of Contractor functions must be backed 1Z
up. The security controls over the backup resources shall be as stringent as the protection required of the primary
resources.A copy of the backed up data shall be stored in a secure,offsite location. The Contractor shall maintain
written policies and procedures for computer backup and recovery. These policies and procedures shall be made
available to the Alliance upon request.
2.6 PERFORMANCE SPECIFICATIONS Uj
2.6.1 Outcomes
a. The Contractor shall timely submit to the Alliance all reports described in ATTACHMENT I, SECTION
2.4:REPORTS;
b. The Contractor shall timely submit to the Alliance all information described in ATTACHMENT I,
SECTION 2.5:ELECTRONIC RECORDS AND DOCUMENTATION;
c. The Contractor shall ensure services in this contract are in accordance with the current DOEA Programs
and Services Handbook.
d. Establish procedures for handling complaints concerning adverse actions such as termination,suspension,
or reduction in services,as per Section of of the Contract.
e. Conduct client satisfaction surveys to evaluate and improve service delivery.
f. Monitor and evaluate subcontractors and vendors for programmatic and fiscal compliance.
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2.6.2 The performance of the Contractor in providing the services described in this contract shall be measured by the
current strategies for the following criteria:
a. Percent of elders assessed with high or moderate risk environments who improved their environment score;
b. Percent of new service recipients with high-risk nutrition scores whose nutritional status improved;
c. Percent of new service recipients whose ADL assessment score has been maintained or improved;
d. Percent of new service recipients whose IADL assessment score has been maintained or improved;
e. Percent of family and family-assisted caregivers who self-report they are likely to provide care;
f. Percent of caregivers whose ability to provide care is maintained or improved after one year of service
intervention(as determined by the caregiver and the assessor);
The Contractor's performance will be documented in the Alliance's annual monitoring report.
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2.7 Compliance and Enforcement
The Contractor shall comply with all the terms and conditions set-forth in this contract,the Service Contractor Application
and the most recent edition of the DOEA Programs and Services Handbook. The Contractor is also responsible to respond
to any fiscal or programmatic monitoring items/issues within the timeframe stipulated by the Alliance. Monitoring
Items/Issues may include Corrective Actions, Reportable Conditions or Quality Improvement Recommendations provided
by the Alliance. The Contractor is also responsible to provide timely response to any inquiry related to program expenditures
including,but not limited to,addressing program surplus or deficit and corresponding program spend-out plan.
Failure to meet any of the contractual requirements or compliance items mentioned above will result in the imposition of
sanctions and/or other enforcement actions by the Alliance as stipulated in Section 41.
2.8 Contractor's Financial Obligations >
Cost Sharing and Co-payments
The Contractor in conjunction with the Alliance shall establish an annual co-payment goal (amount to be collected from
clients). Using the method prescribed in the current Department of Elder Affairs Program and Services Handbook, the
Contractor shall project the annual co-payments to be collected from each active client in all income ranges prior to the start
of each fiscal year. The Contractor is required to meet at least 90 percent of the goal. Co-payments collected in the CCE
program can be used as part of the local match.
The Alliance For Aging Inc.will hold back 5%of the Contractor's contract amount.The amount held back shall be released
to the Contractor after 50%of the adjusted annual goal is collected,but no later than February 15th of the fiscal year. Hold
back amounts not earned by Contractors as of February 15th will be reallocated to other Contractors meeting or exceeding
50%of their annual goal,except when no Contractor agency is meeting or exceeding its annual goal,or when an agency that
is meeting or exceeding such goal affirms that it lacks the capacity to receive additional funds.
2.9 Alliance for Aging Responsibilities
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2.9.1 Program Guidance and Technical Assistance
The Alliance will provide to the Contractor guidance and technical assistance as needed to ensure the successful
fulfillment of the contract by the Contractor.
2.9.2 Contract Monitoring
The Alliance will review and evaluate the performance of the Contractor under the terms of this contract.Monitoring
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shall be conducted annually through direct contact with the Contractor through telephone, in writing,or an onsite
visit. The Alliance's determination of acceptable performance shall be conclusive. The Contractor agrees to LIJ
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: m
a. Desk reviews and analytical reviews: n3
b. Scheduled,unscheduled and follow-up on-site visits;
c. Client visits;
d. Review of independent auditor's reports;
e. Review of third-party documents and/or evaluation;
f. Review of progress reports;
g. Review of customer satisfaction surveys;
h. Agreed-upon procedures review by an external auditor or consultant;
i. Limited-scope reviews;and
j. Other procedures as deemed necessary.
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SECTION 111. METHOD OF PAYMENT
3.1 General Statement of Method of Payment
The method of payment for this contract includes advances,cost reimbursement for administration costs, as well as fixed
rate and cost reimbursement for services. Payment may be authorized for all allowable expenditures to complete the tasks
identified in the deliverables,in accordance with all applicable state and federal statutes and regulations, and are based on
audited historical costs in instances where an independent audit is required. All Contractor requests for payment and
expenditure reports submitted to support requests for payment shall be on Department forms 106Z and 105Z, included as -"
ATTACHMENTS IX, X, and XI. Duplication or replication of both forms via data processing equipment is permissible, CD
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provided all data elements are in the same format as included on department forms.
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3.1.1 Contractor invoices shall be submitted in accordance with ATTACHMENT VIII,except that invoices cannot be submitted
beyond the date for final invoicing,as stated in this contract.Invoices submitted late will not be honored.Exceptions to this
rule are at the discretion of the Alliance,on a case by case basis;such exceptions must be requested prior to the expiration
of the invoicing deadline.In making a determination of the exception the Alliance will consider whether the disruption to
the billing cycle was beyond the control of the Contractor,the frequency with which such exceptions are requested by the
Contractor,and whether the Alliance can request reimbursement at a late date from DOEA.Exceptions for invoicing late
after the closeout date will not be made.
3.2 Advance Payments:
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Non-profit Contractors may request a monthly advance for service costs for each of the first two months of the contract T)
period,based on anticipated cash needs.Detailed documentation justifying cash needs for advances must be submitted with >
the signed contract,approved by the Alliance,and maintained in the contract manager's file. All payment requests for the
third through the twelfth months shall be based on the submission of monthly actual expenditure reports beginning with the
first month of the contract. The schedule for submission of advance requests is ATTACHMENT VIII to this contract.
Reconciliation and recouping of advances made under this contract are to be completed by October. All advance payments
are subject to the availability of funds.
3.3 Advance funds may be temporarily invested by the Contractor in an FDIC insured interest bearing account. All interest ;
earned on contract fund advances must be returned to the Alliance within thirty (30)days of the end of the first quarter of
the contract period.
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3.4 Final Request for Payment: N
3.4.1 The Contractor must submit the final request for payment to the Alliance no later than July 31, 2021; if the
Contractor fails to do so,all right to payment is forfeited,and the Alliance will not honor any requests submitted
after the aforesaid time period. CL
3.4.2 If the contract is terminated prior to the contract end date of June 30, 2021,then the Contractor must submit the
final request for payment to the Alliance no more than 30 days after the contract is terminated,but no later than July
15, 2021. If the Contractor fails to do so, all right to payment is forfeited, and the Alliance will not honor any
requests submitted after the aforesaid time period.
3.5 Documentation for Payment
The Contractor will maintain documentation to support payment requests that shall be available to the Alliance or authorized
individuals,such as the Department of Financial Services,upon request.
3.5.l The Contractor must require subcontractors to enter all required data per the Department's CIRTS Policy Guidelines
for clients and services in the CIRTS database. The data must be entered into the CIRTS before the sub-Contractors
submit their request for payment and expenditure reports to the Contractor. The Contractor shall establish time
frames to assure compliance with due dates for the requests for payment and expenditure reports to the Alliance.
3.5.2 The Contractor must require subcontractors to run monthly CIRTS reports and verify client and service data in the
CIRTS is accurate. This report must be submitted to the Contractor with the monthly request for payment and
expenditure report and must be reviewed by the Contractor before the subcontractors' request for payment and
expenditure reports can be approved by the Contractor.
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3.6 Remedies for Nonconforming Services
The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely,completely and
commensurate with required standards of quality. Such goods and/or services will only be delivered to eligible program
participants.
3.6.1 If the Contractor fails to meet the prescribed quality standards for services,such services will not be reimbursed
under this contract. In addition,any nonconforming goods(including home delivered meals)and/or services not
meeting such standards will not be reimbursed under this contract. The Contractor's signature on the request for
payment form certifies maintenance of supporting documentation and acknowledgement that the Contractor shall
solely bear the costs associated with preparing or providing nonconforming goods and/or services. The Alliance a
requires immediate notice of an significant and/ors systemic infractions that compromise the quality,
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continuity of services to clients. LO
3.6.2 Financial Consequences of Surplus
Contractor shall ensure the provision of services to the projected number of clients in accordance with Alliance's
forecasts and within the contract amount.The Contractor shall ensure expenditure of 100%of the contract amount
budgeted for services to clients at the unit rates established in this contract.In the event the Contractor has a surplus
of 1%or more at the end of the contract term,the Alliance will reallocate 1%of the budget for the next year contract
term to other lead agencies found to be serving clients to the fullest extent of their allocated budgets.
3.6.3 The Alliance reserves the right to adjust the total award as well as the contracted unit rate to reflect Contractor costs
and utilization rates based on active clients enrolled in the program.
3.6.4 The Alliance may withhold payment under the terms of this contract, pending the receipt and approval by the W
Alliance of complete and accurate financial and programmatic reports due from the Contractor and any adjustments OL
thereto,including any disallowance not resolved. CD
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ATTACHMENT 11
CERTIFICATIONS AND ASSURANCES
The Alliance will not award this contract unless Contractor completes the CERTIFICATIONS AND ASSURANCES
contained in this Attachment. In performance of this contract,Contractor provides the following certifications and
assurances:
A. Debarment and Suspension Certification(29 CFR Part 95 and 2 CFR Part 200)
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B. Certification Regarding Lobbying(29 CFR Part 93 and 45 CFR Part 93)
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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.
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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.
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G. Certification Regarding Data Integrity Compliance for Agreements. Grants,Loans And Cooperative 0)
Agreements
H. Verification of Employment Status Certification
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I. Records and Documentation Lu
J. Certification Regarding Inspection of Public Records
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A. CERTIFICATION REGARDING DEBARMENT,SUSPENSION,AND OTHER RESPONSIBILITY
MATTERS-PRIMARY COVERED TRANSACTION.
The undersigned Contractor certifies to the best of its knowledge and belief,that it and its principals:
I. Are not presently debarred,suspended, proposed for debarment,declared ineligible, or voluntarily excluded
from covered transactions by a Federal department or agency;
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Have not within a three-year period preceding this Contract been convicted or had a civil judgment rendered
against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain, Lu
or performing a public(Federal, State,or local)transaction or contract under a public transaction; violation of Lu
Federal or State antitrust statutes or commission of embezzlement,theft, forgery,bribery,falsification or
destruction of records,making false statements, or receiving stolen property; m
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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B. CERTIFICATION REGARDING LOBBYING -Certification for Contracts,Grants,Loans,and
Cooperative Agreements.
The undersigned Contractor certifies,to the best of its knowledge 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 of a Member of
Congress in connection with the awarding of any 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,renewal, a
amendment or modification of any Federal contract,grant, loan or cooperative agreement. LO
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If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employees 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 31 U.S.C. 1352.Any person who fails to file the required certification shall be subject to a civil penalty of not
less than$10,000 and not more than$100,000 for each such failure.
C. NON DISCRIMINATION &EQUAL OPPORTUNITY ASSURANCE(29 CFR PART 37 AND 45 CFR
PART 80). As a condition of the Contract, Contractor assures that it will comply fully with the nondiscrimination
and equal opportunity provisions of the following laws:
1. Section 188 of the Workforce Investment Act of 1998(WIA), (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, cv
disability,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 e®
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 tl I e benefits of,or be otherwise
subjected to discrimination under any program or activity for which the Applicant receives Federal financial
assistance from the Alliance.
3. Section 504 of the Rehabilitation Act of 1973(Pub. L.93-112)as amended, and all requirements imposed 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 Alliance.
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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 be subjected to discrimination under any program
or activity for which the Applicant receives Federal financial assistance from the Alliance.
5. Title IX of the Educational 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 activity for which the Applicant receives Federal financial assistance from the Alliance. LO
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6. The American with Disabilities Act of 1990(Pub. L. 101-336), prohibits discrimination in all employment
practices, including,job application procedures, hiring,firing,advancement,compensation,training, and other
terns,conditions, and privileges of employment. It applies to recruitment,advertising,tenure, layoff, leave,
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fringe benefits, and all other employment-related activities,and; c,
Contractor also assures that it will comply with 29 CFR Part 37 and all other regulations implementing the laws �--
listed above. This assurance applies to Contractor's operation of the WIA Title I-financially assisted program or
activity,and to all agreements Contractor makes to carry out the WIA Title I-financially assisted program or
activity. Contractor understands that the Alliance, Department,and the United States have the right to seek judicial N
enforcement of the assurance.
D. CERTIFICATION REGARDING PUBLIC ENTITY CRIMES, SECTION 287.133,F.S. N
Contractor hereby certifies that neither it,nor any person or affiliate of Contractor, has been convicted of a Public
Entity Crime as defined in section 287.133,F.S.,nor placed on the convicted vendor list.
Contractor understands and agrees that it is required to inform DOEA immediately upon any change of
circumstances regarding this status.
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E. ASSOCIATION OF COMMUNITY ORGANIZATIONS FOR REFORM NOW (ACORN)
FUNDING RESTRICTIONS ASSURANCE(Pub.L. 111-117).
As a condition of the Contract,Contractor assures that it will comply fully with the federal funding restrictions LU
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pertaining to ACORN and its subsidiaries per the Consolidated Appropriations Act,20 10, Division E,Section 511
(Pub. L. I I1-117). The Continuing Appropriations Act,2011,Sections 101 and 103(Pub.L. 111-242),provides
that appropriations made under Pub. L. I I 1-117 are available under the conditions provided by Pub. L. 111-117.
The undersigned shall require that language of this assurance 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 shalt provide this assurance accordingly.
F. SCRUTINIZED COMPANIES LISTS CERTIFICATION, SECTION 287.135,F.S.
In accordance with section 287.135,F.S.,Contractor hereby certifies that it is not participating in a boycott of Israel.
If this Contract is in the amount of$1 million or more, in accordance with the requirements of section 287.135,F.S.,
Contractor hereby certifies that it 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.
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Contractor understands that pursuant to section 287.135,F.S.,the submission of a false certification may result in
the Alliance and/or Department terminating this contract and the submission of a false certification may subject the
Contractor to civil penalties,attorney's fees, and/or costs, including costs for investigations that led to the funding of
false certification..
If Contractor is unable to certify to any of the statements in this certification, Contractor shall attach an explanation
to this Contract.
G. CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,
GRANTS,LOANS AND COOPERATIVE AGREEMENTSLO
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1. The Contractor 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 agreement supported activities;and(3)the
comparison of outlays with budgeted amounts for each award.The inability to process information in
accordance with these requirements could result in a return of grant funds that have not been accounted for
properly.
2. Management Information Systems used by the Contractor, Subcontractors,or any outside entity on which the
Contractor is dependent for data that is to be reported,transmitted or calculated,have been assessed and verified N
to be capable of processing data accurately, including year-date dependent data. For those systems identified to W
be non-compliant,Contractors will take immediate action to assure data integrity.
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1. If this contract includes the provision of hardware,software, firmware,microcode or imbedded chip technology,
the undersigned warrants that these products are capable of processing year-date dependent data accurately.All
versions of these products offered by the Contractor(represented by the undersigned)and purchased by the state UI
will be verified for accuracy and integrity of data prior to transfer.
2. In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly,the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted
herein,at no charge to the state,and without interruption to the ongoing business of the state,time being of the
essence.
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3. The Contractor and any Subcontractors 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.
H. VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION
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As a condition of contracting with the Alliance,Contractor certifies the use of the U.S. Department of Homeland
Security's E-verify system to verify the employment eligibility of all new employees hired by Contractor during the
contract term to perform employment duties pursuant to this contract and that any subcontracts include an express
requirement that Subcontractors performing work or providing services pursuant to this Agreement utilize the E-
verify system to verify the employment eligibility of all new employees hired by the Subcontractor during the entire
contract term.
I. RECORDS AND DOCUMENTATION
The Contractor shall make available to the Alliance and the Department staff and/or any party designated
by the Alliance and the Department any and all contract related records and documentation. The
Contractor shall ensure the collection and maintenance of all program related information and
documentation on any such system designated by the Alliance and the Department. Maintenance includes
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accurate and current data, and 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 section 9 of this contract,and 119.0701(3)and(4)F.S.,and any other applicable
law,if a civil action is commenced as contemplated by Section 119.0701(4),F.S.,and the Alliance and/or Department
if Elder Affairs is named in the civil action,Contractor agrees to indemnify and hold harmless the Alliance and/or
Department for any costs incurred by the Alliance and/or Department;and any attorneys' fees assessed or awarded
against the Alliance and/or Department from a Public Records Request made pursuant to Chapter 119,F.S., cv
concerning this contract or services performed thereunder. cv
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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
The Contractor shall require that the language of this certification be included in all sub agreements,subgrants,and
other agreements and that all Subcontractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into.Submission of this certification is a prerequisite for making or entering into this transaction
imposed by OMB Circulars A-102 and 2 CFR Part 200(formerly OMB Circular A-110).
By sign' below,Contractor certifies the representations outlined in parts A through I above are true and correct. >
(Si ature and&iitle of uthorized Representative)
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ATTACHMENT Ill
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Alliance for Aging,Inc.to the Contractor may be subject to audits and/or monitoring
by the Alliance or the Florida Department of Elder Affairs,as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section 215.97, F.S., (see
"AUDITS"below),monitoring procedures may include,but not be limited to,on-site visits by the Department of Elder Affairs and
Alliance staff, limited scope audits as defined by OMB Circular A-133,as revised, and/or other procedures. By entering into this CD
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agreement, the Contractor agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by theLO
Alliance or the Department of Elder Affairs. In the event the Alliance for Aging, Inc. determines that a limited scope audit of the
Contractor is appropriate,the Contractor agrees to comply with any additional instructions provided by the Alliance for Aging,Inc.
to the Contractor regarding such audit. The Contractor further agrees to comply and cooperate with any inspections, reviews,
investigations,or audits deemed necessary by the Chief Financial Officer(CFO)or Auditor General.
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AUDITS
PART 1: FEDERALLY FUNDED
This part is applicable if the Contractor is a State or local government or a non-profit organization as defined in OMB Circular A-133,
as revised. N
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In the event that the Contractor expends$750,000 or more in federal awards during its fiscal year,the Contractor must have a single
or program-specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised. EXHIBIT 1 to this
agreement indicates federal resources awarded through the Department of Elder Affairs and the Alliance by this agreement. In
determining the federal awards expended in its fiscal year,the Contractor shall consider all sources of federal awards,including federal
resources received from the Alliance or the Department of Elder Affairs. The determination of amounts of federal awards expended
should be in accordance with the guidelines established by OMB Circular A-133,as revised. An audit of the Contractor conducted
by the Auditor General in accordance with the provisions of OMB Circular A-133,as revised,will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1, the Contractor shall fulfill the requirements relative to
auditee responsibilities as provided in Subpart C of OMB Circular A-133,as revised.
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If the Contractor expends less than$750,000 in federal awards in its fiscal year,an audit conducted in accordance with the provisions
of OMB Circular A-133,as revised,is not required. In the event that the Contractor expends less than$750,000 in federal awards in
its fiscal year and elects to have an audit conducted in accordance with the provisions of OMB Circular A-133,as revised,the cost of UJ
the audit must be paid from non-federal resources(i.e.,the cost of such audit must be paid from Contractor resources obtained from CL
other than federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance
findings related to agreements with the Alliance for Aging,Inc.shall be based on the agreement's requirements, including any rules, UJ
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regulations,or statutes referenced in the agreement.The financial statements shall disclose whether or not the matching requirement
was met for each applicable agreement. All questioned costs and liabilities due to the Alliance for Aging,Inc.shall be fully disclosed UJ
in the audit report with reference to the Alliance for Aging,Inc.agreement involved. If not otherwise disclosed as required by Section
310(b)(2)of OMB Circular A-133,as revised,the schedule of expenditures of federal awards shall identify expenditures by agreement
number for each agreement with the Alliance for Aging,Inc.in effect during the audit period. Financial reporting packages required
under this part must be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the
Contractor's fiscal year end.
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PART II:STATE FUNDED
This part is applicable if the Contractor is a non-state entity as defined by Section 215.97(2),Florida Statutes.
In the event that the Contractor expends a total amount of state financial assistance equal to or in excess of$750,000 in any fiscal year
of such Contractor (for fiscal years ending September 30, 2004 or thereafter), the Contractor must have a State single or project-
specific audit for such fiscal year in accordance with Section 215.97,Florida Statutes;applicable rules of the Department of Financial
Services; and Chapters 10.550(local governmental entities)or 10.650(nonprofit and for-profit organizations), Rules of the Auditor
General. EXHIBIT I to this agreement indicates state financial assistance awarded through the Alliance for Aging, Inc. by this
agreement. In determining the state financial assistance expended in its fiscal year,the Contractor shall consider all sources of state
financial assistance, including state financial assistance received from the Alliance for Aging, Inc., other state agencies, and other CD
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non-state entities. State financial assistance does not include federal direct or pass-through awards and resources received by a non— LO
state entity for federal program matching requirements.
In connection with the audit requirements addressed in Part II,paragraph l;the Contractor shall ensure that the audit complies with 2
the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as defined by
Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations),Rules of the Auditor General.
If the Contractor expends less than$750,000 in state financial assistance in its fiscal year(for fiscal years ending September 30,2004
or thereafter),an audit conducted in accordance with the provisions of Section 215.97,Florida Statutes,is not required. In the event r
that the Contractor expends less than$750,000 in state financial assistance in its fiscal year and elects to have an audit conducted in
accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit must be paid from the non-state entity's T
resources(i.e.,the cost of such an audit must be paid from the Contractor resources obtained from other than State entities). W
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance
findings related to agreements with the Alliance for Aging, Inc. shall be based on the agreement's requirements, including any
applicable rules,regulations,or statutes. The financial statements shall disclose whether or not the matching requirement was met for
each applicable agreement. All questioned costs and liabilities due to the Alliance for Aging,Inc.shall be fully disclosed in the audit
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report with reference to the Alliance for Aging, Inc. agreement involved. If not otherwise disclosed as required by Rule 69I-5.003,
Fla.Admin.Code,the schedule of expenditures of state financial assistance shall identify expenditures by agreement number for each ;
agreement with the Alliance for Aging,Inc. in effect during the audit period. Financial reporting packages required under this part
must be submitted within 45 days after delivery of the audit report,but no later than 12 months after the Contractor's fiscal year end
for local governmental entities. Non-profit or for-profit organizations are required to be submitted within 45 days after delivery of
the audit report,but no later than 9 months after the Contractor's fiscal year end. Notwithstanding the applicability of this portion,
the Alliance and the Department of Elder Affairs retain all right and obligation to monitor and oversee the performance of this
agreement as outlined throughout this document and pursuant to law.
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PART III: REPORT SUBMISSION CL
Copies of reporting packages for audits conducted in accordance with OMB Circular A-133,as revised,and required by PART I of
this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the
Contractor directly to each of the following:
The Alliance for Aging,Inc.at each of the following addresses:
Alliance for Aging,Inc.
Attn:Fiscal Monitor
760 NW 107h Ave.Suite 214 E
Miami,FL.33172-3155
The Federal Audit Clearinghouse designated in OMB Circular A-133,as revised(the number of copies required by Sections.320(d)
(1)and(2),OMB Circular A-133,as revised,should be submitted to the Federal Audit Clearinghouse),at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 101h Street
Jeffersonville,IN 47132
Other federal agencies and pass-through entities in accordance with Sections.320(e)and(f),OMB Circular A-133,as revised.
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Pursuant to Sections.320(f),OMB Circular A-133,as revised,the Contractor shall submit a copy of the reporting package described
in Section.320(c),OMB Circular A-133,as revised,and any management letter issued by the auditor,to the Alliance for Aging,Inc.
at each of the following addresses:
Alliance for Aging,Inc.
Attn: Fiscal Monitor
760 NW 107"Ave.Suite 214
Miami,FL.33172-31550
Additionally, copies of financial reporting packages required by Part II of this agreement shall be submitted by or on behalf of the
Contractor directly to each of the following: CD
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The Alliance for Aging,Inc.at each of the following addresses:
Alliance for Aging,Inc. U
Attn: Fiscal Monitor
760 NW 107"Ave.Suite 214
Miami,FL.33172-3155
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building,Room 574 Ch
111 West Madison Street
Tallahassee,Florida 32399-1450
Any reports, management letter, or other information required to be submitted to the Alliance for Aging, Inc. pursuant to this
agreement shall be submitted timely in accordance with OMB Circular A-133, Florida Statutes, and Chapters 10.550 (local
governmental entities)or 10.650(nonprofit and for-profit organizations),Rules of the Auditor General,as applicable.
Contractors,when submitting financial reporting packages to the Alliance for Aging, Inc.for audits done in accordance with OMB
Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the
Auditor General,should indicate the date that the reporting package was delivered to the Contractor in correspondence accompanying
the reporting package.
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PART IV: RECORD RETENTION
The Contractor shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six years
from the date the audit report is issued,and shall allow the Alliance for Aging,Inc.or its designee,the CFO or Auditor General Access CL
to such records upon request. The Contractor shall ensure that audit working papers are made available to the Alliance for Aging,
Inc.,or its designee,the Department or its designee,CFO,or Auditor General upon request for a period of six years from the date the
audit report is issued,unless extended in writing by the Alliance for Aging,Inc.
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ATTACHMENT III
EXHIBIT—1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
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TOTAL FEDERAL AWARD
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COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO
THIS AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE
FOLLOWING: T)
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT cv
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TOTAL STATE AWARD $o
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STATE FINANCIAL ASSISTANCE SUBJECT TO Sec.215.97,F.S. N
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Alzheimer's Disease Initiative Program General Revenue 65004 $170,367.24
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TOTAL AWARD $170,367.24
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COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
AGREEMENT ARE AS FOLLOWS:
State Financial Assistance
Section 215.97 F.S.
Chapter 691-5 Fla.Administrative Code
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ATTACHMENT III
EXHIBIT-2
PART I:AUDIT RELATIONSHIP DETERMINATION
Contractors who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A-133, as
revised,and/or Section 215.97,Fla. Stat. Contractors who are determined to be recipients or sub-recipients of federal awards and/or
state financial assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II
of Exhibit 1 is met. Contractors who have been determined to be vendors are not subject to the audit requirements of OMB Circular
A-133,as revised,and/or Section 215.97,Fla.Stat. Regardless of whether the audit requirements are met,Contractors who have been
determined to be recipients or sub-recipients of federal awards and/or state financial assistance must comply with applicable CD
programmatic and fiscal compliance requirements.
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In accordance with Sec.210 of OMB Circular A-133 and/or Rule 691-5.006,FAC,Contractor has been determined to be:
r.
Vendor or exempt entity and not subject to OMB Circular A-133 and/or Section 215.97,F.S.
X Recipient/sub-recipient subject to OMB Circular A-133 and/or Section 215.97,F.S.
Exempt organization not subject to 2 CFR Part§200 and/or Section 215.97,F.S. For Federal awards,for-profit organizations
are exempt;for state financial assistance projects,public universities,community colleges,district school boards,branches
of state(Florida)government,and charter schools are exempt. Exempt organizations must comply with all compliance
requirements set forth within the contract or award document.
NOTE: If a Contractor is determined to be a recipient/sub-recipient of federal and or state financial assistance and has been
approved by the Department to subcontract,they must comply with Section 215.97(7),F.S.,and Rule 691-.006(2),FAC[state M
financial assistance]and Section .400 OMB Circular A-133 [federal awards]. >
PART II: FISCAL COMPLIANCE REQUIREMENTS
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FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Contractors who receive federal awards N_
or state matching funds on federal awards and who are determined to be a sub-recipient must comply with the following fiscal laws,
rules and regulations: UJ
STATES,LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State,Local and Indian Tribal Governments(Formerly OMB Circular A-87)*
OMB Circular A-102—Administrative Requirements
OMB Circular A-133—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations UJ
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NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non-Profit Organizations(Formerly OMB Circular A-122—Cost Principles)*
2 CFR Part 215 Administrative Requirements(Formerly OMB Circular A-110—Administrative Requirements) UJ
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Requirements)
OMB Circular A-133—Audit Requirements
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Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations UJ
EDUCATIONAL INSTITUTIONS(EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)MUST FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB(Formerly Circular A-21—Cost Principles)*
2 CFR Part 215 Administrative Requirements(Formerly OMB Circular A-110—Administrative Requirements)
OMB Circular A-133—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
*Some federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular
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A-133 Compliance Supplement,Appendix 1.
STATE FINANCIAL ASSISTANCE. Contractors who receive state financial assistance and who are determined to be a
recipient/sub-recipient must comply with the following fiscal laws,rules and regulations:
Section 215.97,Fla.Stat.
Chapter 69I-5,Fla.Admin.Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
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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, ry
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. c®
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Note:Certain of these assurances may not be applicable to your project or program.If you have questions please contact the r
awarding agency.Further,certain federal awarding agencies may require applicants to certify to additional
assurances.If such is the case,you will be notified.
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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 .2
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
CD
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. r"
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. " `;;4728-4?63)relating to prescribed standards for
merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a '
Merit System of Personnel Administration(5 C.F.R.900,Subpart F).
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6. Will comply with all federal statutes relating to nondiscrimination.These include but are not limited to: (a)Title VI of the Civil
Rights Act of 1964(P.L.88-352)which prohibits discrimination on the basis of race,color or national origin;(b)Title IX of the
Ili
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. !; +194),which prohibits discrimination on
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the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits CL
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 UJ
confidentiality of alcohol and drug abuse patient records; (h)Title VIII of the Civil Rights Act of 1968 (42 U.S.C. ] 3601 et h®
seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination
provisions in the specific statute(s)under which application for federal assistance is being made;and 0)the requirements of any UJ
other nondiscrimination statute(s)which may apply to the application. UJ
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. `s' `: 1501-1508 and 7324-7328), which limit the
political activities of employees whose principal employment activities are funded in whole or in part with federal funds.
9. Will comply, as applicable,with the provisions of the Davis-Bacon Act(40 U.S.C. 276a to 276a-7),the Copeland Act(40
U.S.C.276c and 18 U.S.C. : ; .i 874)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 36 of 56
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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 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 H990; (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. 11451 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 a
U.S.C. '_ '':`.7401 et seq.);(g)protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, CD
N
as amended,(P.L.93-523);and (h)protection of endangered species under the Endangered Species Act of 1973,as amended,
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(P.L.93-205).
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12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. ;:'f: 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-l 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. v_s
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.
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16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. ,. A801 et seq.),which prohibits the use of lead-
based paint in construction or rehabilitation of residence structures. UJ
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.
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18. Will comply with all applicable requirements of all other federal laws,executive orders,regulations and policies governing this
program.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
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APPLICANT ORGANIZATION DATE SUBMITTED
Monroe County Board of County Commissioners,Social Services/In-
Home Services
O OE CO A Ol:aNEY
OVER �l�YRM
P J.MERCA
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2-
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ATTACHMENT VI[
IMER'S DISEASE INITIATIVE
BUDGET SUMMARY
The Alliance shall make payment to the Contractor for provision of services up to a maximum number of units of service and at the
rate(s)stated below:
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Maximum
Service Units of Maximum
Service to be Provided Unit Rate Service Dollars
Case Management 60.73 56 3,407.34
Case Aide 15.00 10 150.00
Facility Respite 10.96 11,127 121,948.43
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In Home Respite 24.22 1,612 39,034.47
Shopping Assistance 30.90 100 3,090.00
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Telephone Reassurance 27.37 100 2,737.00
Total $ 170,367.24
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ATTACHMENT VIII
L IMER'S DISEASE INITIATIVE
INVOICE REPORT SCHEDULE
Report Number Based On Submit to Alliance onCD
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this Date
1 July Advance* July 1
2 August Advance* July 1
3 July Expenditure Report August 10
4 August Expenditure Report September 10
5 September Expenditure Report+ 1/10 advance reconciliation October 10
6 October Expenditure Report+ 1/10 advance reconciliation November 10 U
7 November Expenditure Report+ 1/10 advance reconciliation December 10
8 December Expenditure Report+ 1/10 advance reconciliation January 10
9 January Expenditure Report+ 1/10 advance reconciliation February 10 r,
10 February Expenditure Report+ 1/10 advance reconciliation March 10
11 March Expenditure Report+ 1/10 advance reconciliation April 10
12 April Expenditure Report+ 1/10 advance reconciliation May 10 T)
13 May Expenditure Report+ 1/10 advance reconciliation June 10 W
14 June Expenditure Report+ 1/10 advance reconciliation July 10
15 Final Expenditure and closeout July 31
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Legend: * Advance based on projected cash need.
Note 1: All advance payments made to the Contractor shall be returned to the Alliance as follows:
One-tenth of the advance payment received shall be reported as an advance recoupment on each Request
for Payment, starting with report #5. The adjustment shall be recorded in Part C, Line I of the reportCD
(Attachment IX). N
Note 2:Submission of expenditure reports may or may not generate a payment request. If final expenditure
report reflects funds due back to the Alliance,payment is to accompany the report. CL
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C gt C't "'i,. i ,i._,r.. N '}.""}.,.f
ATTACHMENT IX
REQUEST FOR PAYMENT
Form 106
ADI
Provider Name,Address,Phone# Type Of Report
Contract#
Provider. Advance
Address: Contract Periotl
Telephone: Reimbursement ,,i', .?..u. `w? Report Period °ia a`>r „1„r f„a,tl.na., N
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REPORT#: LO
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CERTIFICATION:I hereby certify that this request or refund conforms with the terms of the above contract.
Q
Prepared By:Date Approved By:Date: U
ADI TOTAL
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BUDGET SUMMARY
0
Approved Contract Amount 0.00 0.00
Previous Month YTD Billed o.00 0.00
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Prior Month Ending Contract Balance 0,001 1 1 1 1 1 0.00 tg
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Current Month Amount Billed 0,00 0.00
Less Current Month Adv Payback ,,A ,,{j„ 0.00 0.00
Contracted Funds Requested for Month 0.00 0,00
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CO-PAYMENTS CURRENT MONTH YEAR-TO-DATE
Prior Mo.YTD
�iGnla�2's i�i:
F" Total of Co-payments assessed
Total of Co-payments collected$- 'rt �' "')' ` ') CL
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(for Tracking Purposes only)
PSA$11 ADI Farms.Revised October 2019
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C.32.a
,, t 1,
Attachment X
Pam 105
ADI
PROVIDER NAME,AO NS&PHONE,00 FUNDING SOURCE THBi BEPORi PERIOD:
0 ACH Contract R: 10
0
Contract Pa'od: 0
0
RePert PeNod 0
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REPORTd 0 CD
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allr]FICATION I certify to the beat of are knowledge and belief that this mportis complete and correct and all outlays herein are for purposes set forth N the connect.Further,I
ceftifythatthe attarAed monddy and YTDservice uniWundupgrated tlknYa'repntt b conoex. '`
Prepared by:Date:A Approved by'Data: �
9m
Pflor Mo.Receipts YTID
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INCOFAVIR EIMS A.Approved Budget B.Actual Total Billing C.Total Billing D,%of Approved
foe this report Year to Date Budget
State Funds Program $. $ $• gOIV/W
lame Cash Match :a.a ?s,§ wtllh;t n#V" }),i.S-
ROtVl01
SUBTOTAL-Cash Receipts local In,
S-
Rind mach P'
S-
TOTAL RECEIPTS $0.� $- 0
$0.00
BBlabie Unl taster, k) (D) M (q IG) UreduallntedC Bella Sewed
(A) (B) (A) (6)
Services Contract Billable Unit Rate Amount Eame d Y-T•D Y•T-D current Month Y-T-O
Amount units This Period Billable Billable Undup Clients Lingua Clientsto
Units Cost Served Served
Prior Pro unKs prla YMli
_..;`.1""nwr h�r{,�`Y+�' t' `'�k?^�,z,',+�%7,t��+'�re"z',',��}'�`,-sff to rr t,�rers�lF.S- 5- ,tuts`4&t`�s�'r,d','�,�sbt t�✓;Ju Irv�r�l�sT`�`l Aea��0�,S: ��r` c aA�'
'(�a`, �aW4 ;^'i'Inl;r�.';\hm.}iq
jr.wrx,'t a9`�2t3t;,lefi? /+4}i si lr�,r i`�c{Y
$— 7� �e� CD
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hs �
rpwl $-
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PSA #11 ADI Forms, Revised October 2019
Page 41 of 56
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C.32.a
N i,i of b e r KZ u>, )1
ATTACHMENT A
Title: Department of Elder Affairs Programs& Services Handbook
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Department of Elder Affairs Programs& Services Handbook
http:l/GV1,,,,w.alliaiiceforaaUtg.orl-*(see Contractors/Program Documents)or
http:llelderaffairs.state.tl.usldoealno is.Vhp(notices of instructions)
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Page 42 of 56
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C.32.a
ATTACHMENT B
STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS
PART I: READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU COMPLETE THIS
FORM.
1. Briefly desc 'be the geographic area served by the program/facility and the type of service provided:'T1rZe—
r-tom s s u, rGS. Z lr( lse.A Q« A +Zo uL— . l CJ r TPt
�144 4t' (Lix �
2. POPULATION OF AREA SERVED. Source of data:00'%tls 2tZI O �+~S cSEIS' t f 6XYl+
Total# %Whi e %Black %Hispanic %Other %Female CV
Za. Iq
3. S AFF CURRENTLY EMPLOYED.•Effective date: LO
To 1# %White °/ B+� %Hispanic %Other °%Female °l°Disabled j
4. CLIENTS CURRENTLY ENROLLED OR REGISTERED. Effective date: 2 Ct2-5
Total# °Al ice %Black %Hispanic %Other I %male %Disabled %Over 40
` jj O 2- 0 OC] Op
5. ADVISORY OR GOVERNING BOARD,IF APPLICABLE.
Total# %White %Black %Hispanic %Other %F male %Disabled
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PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. r
6. Is an Assurance of Compliance on file with DOEA? If N/A or NO,explain. N/A YES NO
❑ '9 ❑ inn
7. Compare the staff composition to the population. Is staff representative of the population? c®
If N/A or NO,explain. N/A YES NO
❑ ❑
8. Compare the client composition to the population. Are race and sex characteristics representative
of the population? If N/A or NO,explain. N/A YES NO
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❑ ❑ cv
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9. Are eligibility requirements for services applied to clients and applicants without regard to race,
color, F®
national origin,sex,age,religion or disability? If N/A or NO,explain. N/A YES NO
❑ ❑ W
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10. Are all benefits,services and facilities available to applicants and participants in an equally effective
manner regardless of race, sex, color, age, national origin, religion or disability? If N/A or NO,
explain. N❑ NO
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11. For in-patient services,are room assignments made without regard to race,color,national origin
or disability? If N/A or NO,explain. N/A YES NO
❑ ❑
Page 43 of 56
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C.32.a
12. Is the program/facility accessible to non-English speaking clients? If N/A or NO,explain. N/A YES NO
❑ ❑
13. Are employees, applicants and participants informed of their protection against discrimination? If
YES,how? Verbal 69 Written M Poster❑ If N/A or NO,explain. N/A YES NO
❑ 0 ❑
14. Give the number and current status of any discrimination complaints regarding services or
employment filed against the program/facility. N/A
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15. Is the program/facility physically accessible to mobility,hearing,and sight-impaired individuals? If
N/A or NO,explain. N/A YES NO
O ❑
PART III:THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES, W
16. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals,and to
make any necessary modifications? If NO,explain. YES NO
17. Is there an established grievance procedure that incorporates due process in the resolution of
complaints? If NO,explain. YES NO
18. Has a person been designated to coordinate Section 504 compliance activities? If NO,explain. YES NO
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19. Do recruitment and notification materials advise applicants, employees and ppparticipants of
nondiscrimination on the basis of disability? If NO,explain. YES NO
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20. Are auxiliary aids available to assure accessibility of services to hearing and sight-impaired U)
individuals? If NO,explain. YES NO
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PART IV:FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF$50,000.00 OR MORE.
21. Do you have a written affirmative action plan? If NO,explain. YES NO
K ❑
Reviewed By In Compliance: YES ❑ NO* ❑
Program Office *Notice of Corrective Action Sent l /_
Date Telephone Response Due
On-Site ❑ Desk Review ❑ Response Received
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Revised August 2010,Page 2 of 2
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
l. 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
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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 LO
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
0
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
M
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
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compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the c®
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 CD
programs are sanctioned to serve target populations such as elderly or disabled persons,45 CFR 80.3(b)(6).
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also CL
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). h®
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 E
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).
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ti,4 s s f
13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries or any other interested parties. This should include information on their right to file a
complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS.
The information may be supplied verbally or in writing to every individual,or may be supplied through the use of
an equal opportunity policy poster displayed in a public area of the facility,45 CFR 80.6(d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis,e.g.,race,color, _
creed,sex,age,national origin,disability,retaliation;the issues involved,e.g.,services or employment,placement,
termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and CD
address of the local,state or federal agency with whom the complaint has been filed. Indicate the current status, LO
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 U
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 W
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- T)
evaluation to identify any accessibility barriers. Self-evaluation is a four step process:
a. With the assistance of a disabled individual/organization,evaluate current practices and policies which do not
comply with Section 504. c®
b. Modify policies and practices that do not meet Section 504 requirements.
c. Take remedial steps to eliminate any discrimination that has been identified.
d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have
been followed.),45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action
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a)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).
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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).
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20. Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired U
sensory,manual or speaking skills where necessary. Auxiliary aids may include,but are not limited to,interpreters uj
for hearing impaired individuals,taped or Braille materials,or any alternative resources that can be used to provide
equally effective services,45 CFR 84.52(d).
21. Programs/facilities with 50 or more employees and $50,000.00 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246,41 CFR 60
and Title VI of the Civil Rights Act of 1964,as amended.
DOER Form 101-B,Revised August 2010
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2
ATTACHMENT C
REFERRAL PROTOCOL
Issue: Screening, Triage, and Referral for Activation under the Alzheimer's Disease Initiative (ADI)
Program.
Policy: Referrals will be made based on availability of funds, in accordance with prioritization
requirements. `V
Purpose: To ensure funding is spent expeditiously and consumers are given a choice of case managementLO
agencies,to the extent possible.
Procedure:
0
I. Roles and Responsibilities
A. Alliance for Aging 1 Aging and Disability Resource Center �--
• Reconciles overall program and ADI Agency specific spending levels on a monthly basis
to ensure the ADI Agency is operating within the funding allocations. N
• Screens consumers to link with appropriate resources and prioritize for DOEA-funded W
programs and services. _
• Releases cases for activation based upon Adi Agency Requests.
• Releases cases from the waiting list based on their prioritization score.
• Monitors compliance with service standards and outcome measures.
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• Reviews files per the File Review Policies and Procedures.
• Reviews data in CIRTS.
B. ADI Agency
• Requests and accepts referrals from the Aging and Disability Resource Center,to serve an
optimal caseload and to avoid surpluses or deficits in accordance with the Alliance
Surplus/Deficit Analysis policy.
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• Refers inquiries from consumers interested in services to the ADRC for Information and CL
Referral to community resources, Screening, Triage, and Long-Term Care Options
Counseling,as appropriate. U)
• Completes comprehensive assessments on new consumers and annual reassessment on
existing consumers and develops care plans and reviews care plans semi-annually.
• Authorizes service delivery and enters data into CIRTS.
e Bills in CIRTS as appropriate.
• Monitors care plans in an effort to keep costs down while sustaining the individuals in the
community.
II. Management of the Assessed Prioritized Consumer List(APCL).
A. As clients are referred to the ADRC,clients are provided information on community resources and
programs available including private pay options. Persons are directed to those resources most
capable of meeting the need they have expressed to ADRC staff. Cases presenting strong identifiers
that indicate the consumer might benefit from publicly funded long-term care services are screened,
entered into CIRTS,triaged and provided options counseling.
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1. Consumers applying for the Alzheimer's Disease Initiative (ADI)program will be
contacted by Intake Unit staff and screened using the statewide assessment form developed
by the Department of Elder Affairs for this purpose(Form 701 S). The 701 S will determine
their ranking on the appropriate waiting list(s)APCL status. .
2. The ADRC will reassess consumers on the waiting lists according to the 2018 Department
of Elder Affairs Programs and Services Handbook,or any revisions made thereafter.
B. HIPAA forms will be sent to the consumer as appropriate.
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A. ADI Clients
1. The Alliance Fiscal Department will monitor ADI Agency specific spending levels on a
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monthly basis to ensure each ADI Agency is operating within its—spending authority. In U
addition, the Alliance will analyze surplus/deficit projections, and share the information with
the ADI Agency to assist in their determination of slot availability. The ADI Agency will �--
request referrals directly from the ADRC.The Fiscal Department will be notified of the number
of new cases being referred to the ADI Agency for activation.
2. Upon receipt of the request for referrals from the ADI Agency, the ADRC Intake Unit N
Supervisor will run the Prioritized Risk Report to identify the consumers on the APCL to be
opened.
3. In response to the request for referrals,the ADRC Intake Unit Supervisor will refer wait listed
clients to the ADI Agency for activation, in accordance with prioritization requirements. The
Intake Unit will update the wait list enrollment using the appropriate code to terminate from
the APCL,for release to the ADI Agency(TAEL).
4. Upon receipt of the list of clients released from the waiting list,the ADI Agency will enter the
APPL enrollment, contact clients to offer program enrollment, and proceed with the process
for activation.The ADI Agency will enter subsequent enrollments into CIRTS to reflect client
status.
5. The Alliance will oversee the enrollment process to ensure referrals have timely outcomes in
CIRTS.
6. Choice(for Miami-Dade County only): In the event that unallocated funds become available
at the Alliance to allow for new client enrollments into ADI,the ADRC will contact consumers
from the waiting list to offer choice of ADI Agency. If the client is no longer interested in
receiving services,the next client on the list will be contacted.
a. Intake Unit Specialists will contact the client to obtain choice of Provider. The client
referral will then be sent to the ADI Agency selected by the client.
b. If after two attempts by phone the Intake Unit staff is unable to reach the consumer, a U
contact letter will be sent.
c. If there is still no contact made with the consumer after these attempts,the Intake Unit
will close CIRTS enrollments(TALO).
d. If the consumer later contacts the Elder Helpline,the consumer can be placed back on
the APCL if they so desire.
e. Upon receipt of referral, the ADI Agency will enter the APPL enrollment, and
subsequent enrollments to reflect client status. Contract amendments will follow in
accordance with the number of clients referred for activation.
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C.32.a
B. Statewide Medicaid Managed Care Long Term Care Program Clients
1. The Department of Elder Affairs will run the statewide APCL(Assessed Priority Consumer
List)report to review clients wait listed for the SMMCLTCP program.DOEA will provide
the ADRC with a list of individuals authorized for release from the APCL.
2. For clients identified as active in ADI and authorized for release from the SMMCLTCP
waiting list,the ADRC will be responsible for the SMMCLTCP application process. For
ADI active clients, the ADRC will notify the ADI Agency in order to waive the ADI co-
PayLO
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IV. Clients Changing ADI Agencies
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A. Frequency of Changes
1. Consumers may change ADI Agencies on a monthly basis if they so choose.
2. Consumers will need to request a change of ADI Agency by the first(Is')of the month in
order for the change to be in effect by the 16`h of that same month.
3. If the request is made after the first of the month,the change will take effect by the 161h of
the following month.
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i. Process for Changing
1. Requests to change case management agency must come from the client or their personal
representative to the ADRC/Elder Helpline. Requests made by a case management agency
will not be honored.
2. When requesting a change,the consumer will be asked by the ADRC staff person to share
his/her reasons for doing so; if they spoke with their case management agency about their
concerns; and if they would like to speak with someone else at that agency.
3. If the consumer chooses to call the agency, nothing will be done until the consumer calls
the ADRC back requesting a change.
4. If the consumer does not want to speak with the ADI Agency and wants to change, the cv
ADRC will initiate the transfer process. A verbal choice will be accepted and documented
in the REFER database.
5. The ADRC/Intake Unit will send a Transfer Form to the selected ADI Agency and to the
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current ADI Agency. Both ADI Agencies will work closely with the ADRC to ensure the
transfer process is completed by the 151 of the month, as long as the transfer request was
received at the ADRC by the first of that same month.
6. The ADRC Intake Unit will change the owner provider record in CIRTS to the new ADI Lu
Agency.
7. The current ADI Agency will terminate enrollment in CIRTS as of the 15' of the month
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when the transfer is to take place. The new ADI Agency will activate enrollment in CIRTS
as of the 16"'of the month when the transfer is to take place. Lu
8. Each ADI Agency will notify its respective vendors of the termination and/or activation of
services for the transferred client as appropriate.
9. Services will start on the 16`h of the month when the change becomes effective. o
Note: These ADRC policies and procedures are subject to change.Any modifications will be done through a
contract amendment.
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C.32.a
ATTACHMENT E
Alliance for Aging,Inc.
Business Associate Agreement
This Business Associate Agreement is dated 2_ 2 ,by the Alliance for Aging,Inc.("Covered Entity")
and Monroe County Board of County Commissi ner ,Social Services/In-Home Services,("Business Associate"),anot-
for-profit Florida corporation.
1.0 Background.
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1.1 Covered Entity has entered into one or more contracts or agreements with Business Associate that involves the use
of Protected Health Information(PHI).
1.2 Covered Entity, recognizes the requirements of the Health Insurance Portability and Accountability Act of 1996
(HIPAA)and has indicated its intent to comply in the County's Policies and Procedures.
1.3 HIPAA regulations establish specific conditions on when and how covered entities may share information with
contractors who perform functions for the Covered Entity.
1.4 HIPAA requires the Covered Entity and the Business Associate to enter into a contract or agreement containing
specific requirements to protect the confidentiality and security of patients'PHI,as set forth in,but not limited to the T+
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- W
b)(2010)(as may apply)and contained in this agreement.
1.5 The Health Information Technology for Economic and Clinical Health Act (2009), the American Recovery and
Reinvestment Act (2009) and Part I— Improved Privacy Provisions and Security provisions located at 42 United
States Code(U.S.C.)§§ 17931 and 17934(2010)require business associates of covered entities to comply with the
HIPAA Security Rule,as set forth in,but not limited to 45 C.F.R.§§ 164.308, 164.310, 164.312,and 164.316(2009)
and such sections shall apply to a business associate of a covered entity in the same manner that such sections apply ;
to the covered entity.
The parties therefore agree as follows:
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2.0 Definitions. For purposes of this agreement,the following definitions apply:
2.1 Access. The ability or the means necessary to read, write,modify,or communicate data/information or otherwise LIJ
use any system resource. CL
2.2 Administrative Safeguards. The administrative actions, and policies and procedures, to manage the selection,
development, implementation, and maintenance of security measures to protect electronic Protected Health
Information(ePHI)and to manage the conduct of the covered entity's workforce in relation to the protection of that
information.
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2.3 ARRA. The American Recovery and Reinvestment Act(2009)
2.4 Authentication. The corroboration that a person is the one claimed.
2.5 Availability. The property that data or information is accessible and useable upon demand by an authorized person.
2.6 Breach. The unauthorized acquisition,access,use,or disclosure of PHI which compromises the security or privacy
of such information.
2.7 Compromises the Security. Posing a significant risk of financial,reputational,or other harm to individuals.
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C.32.a
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2.8 Confidentiality. The property that data or information is not made available or disclosed to unauthorized persons
or processes.
2.9 Electronic Protected Health Information.(ePHI) Health information as specified in 45 CFR §160.103(1)(i) or
(1)(ii),limited to the information created or received by Business Associate from or on behalf of Covered Entity.
2.10 HITECH. The Health Information Technology for Economic and Clinical Health Act(2009)
2.11 Information System. An interconnected set of information resources under the same direct management control
that shares common functionality. A system normally includes hardware,software,information,data,applications, CD
communications,and people. cv
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2.12 Integrity. The property that data or information have not been altered or destroyed in an unauthorized manner.
es
2.13 Malicious software. Software,for example,a virus,designed to damage or disrupts a system.
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2.14 Part 1. Part 1—Improved Privacy Provisions and Security provisions located at 42 United States Code(U.S.C.) §§
17931 and 17934(2010).
2.15 Password. Confidential authentication information composed of a string of characters.
2.16 Physical Safeguards. The physical measures, policies, and procedures to protect a covered entity's electronic T
information systems and related buildings and equipment,from natural and environmental hazards,and unauthorized W
intrusion.
2.17 Privacy Rule. The Standards for Privacy of Individually Identifiable Health Information at 45 CFR Part 160 and
Part 164,subparts A and E.
2.18 Protected Health Information. (PHI) Health information as defined in 45 CFR §160.103, limited to the
information created or received by Business Associate from or on behalf of Covered Entity.
2.19 Required By Law.Has the same meaning as the term"required by law"in 45 CFR§ 164.103.
r.
2.20 Secretary.The Secretary of the Department of Health and Human Services or his or her designee. cv
2.21 Security incident.The attempted or successful unauthorized access,use,disclosure,modification,or destruction of
information or interference with system operations in an information system.
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2.22 Security or Security measures. All of the administrative, physical, and technical safeguards in an information
system.
2.23 Security Rule.The Security Standards for the protection of Electronic Protected Health Information at 45 CFR part
164,subpart C,and amendments thereto.
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2.24 Technical Safeguards. The technology and the policy and procedures for its use that protect electronic protected
health information and control access to it.
2.25 Unsecured PHI. Protected health information that is not secured through the use of technology or methodology
specified by the Secretary in guidance issued under 42 U.S.C.section 17932(h)(2).
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2.26 All other terms used,but not otherwise defined,in this Agreement shall have the same meaning as those terms in the
Privacy Rule.
3.0. Obligations and Activities of Business Associate.
3.I Business Associate agrees to not use or disclose PHI other than as permitted or required by this agreement or as
Required by Law.
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C.32.a
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 N
Business Associate creates,receives,maintains,or transmits on behalf of the Covered Entity;and CD
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(d) Comply with the Security Rule requirements including the Administrative Safeguards,Physical Safeguards,
Technical Safeguards,and policies and procedures and documentation requirements set forth in 45 CFR§§ 164.308,
164.310, 164.312,and 164.316.
3.3 Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Business
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Associate of a use or disclosure of PHI by Business Associate in violation of the requirements of this Agreement.
3.4 Business Associate agrees to promptly report to Covered Entity any use or disclosure of the PHI not provided for by `_✓
this Agreement of which it becomes aware.This includes any requests for inspection,copying or amendment of such r
information and including any security incident involving PHI.
3.5 Business Associate agrees to notify Covered Entity without unreasonable delay of any security breach pertaining to: >
(a) Identification of any individual whose unsecured PHI has been, or is reasonably believed by the Business
Associate to have been,accessed,acquired,or disclosed during such security breach;and
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(b) All information required for the Notice to the Secretary of HHS of Breach of Unsecured Protected Health
Information.
3.6 Business Associate agrees to ensure that any agent, including a subcontractor,to whom it provides PHI received
from,or created or received by Business Associate on behalf of Covered Entity,agrees to the same restrictions and
conditions that apply through this Agreement to Business Associate with respect to such information. r"
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3.7 If Business Associate has PHI in a Designated Record Set: cv
(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 CL
(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.
Page 52 of 56
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C.32.a
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3.11 Business Associate specifically agrees to use security measures that reasonably and appropriately protect the
confidentiality,integrity,and availability of PHI in electronic or any other form,that it creates,receives,maintains,
or transmits on behalf of the Covered Entity.
3.12 Business Associate agrees to implement security measures to secure passwords used to access ePHI that it accesses,
maintains, or transmits as part of this Agreement from malicious software and other man-made and natural
vulnerabilities to assure the availability,integrity,and confidentiality of such information.
3.13 Business Associate agrees to implement security measures to safeguard ePHi that it accesses,maintains,or transmits
as part of this agreement from malicious software and other man-made and natural vulnerabilities to assure the CD
availability,integrity,and confidentiality of such information. cv
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3.14 Business Associate agrees to comply with: ¢,
(a) ARRA§ 13404(Application of Knowledge Elements Associated with Contracts);
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(b) ARRA§ 13405(Restrictions on Certain Disclosures and Sales of Health Information);and U
(c) ARRA § 13406(Conditions on Certain Contacts as Part of Health Care Operations).
4.0 Permitted Uses and Disclosures by Business Associate. Except as otherwise limited in this Agreement or any
related agreement,Business Associate may use or disclose PHI to perform functions,activities,or services for,or on T+
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.
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5.0 Specific Use and Disclosure Provisions. �
5.1 Except as otherwise limited in this agreement or any related agreement, Business Associate may use PHI for the
proper management and administration of the Business Associate or to carry out the legal responsibilities of the
Business Associate.
5.2 Except as otherwise limited in this agreement or any related agreement,Business Associate may disclose PHI for the
proper management and administration of the Business Associate,provided that disclosures are Required By Law,
or Business Associate obtains reasonable assurances from the person to whom the information is disclosed that it
will remain confidential and used or further disclosed only as Required By Law or for the purpose for which it was
disclosed to the person,and the person notifies the Business Associate of any instances of which it is aware in whichuj
the confidentiality of the information has been breached. CL
5.3 Business Associate may use PHI to provide data aggregation services to Covered Entity as permitted by 45 CFR U)
§164.504(e)(2)(i)(B),only when specifically authorized by Covered Entity.
5.4 Business Associate may use PHI to report violations of law to appropriate Federal and State authorities, consistent
with 45 CFR§164.5020)(1).
1.0 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 M to this Agreement. Future Notices and/or modifications to the NPP shall be posted
on Covered Entity's website at www.alliancefbraging.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.
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C.32.a
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7.0 Permissible Requests by Covered Entity. Except for data aggregation or management and administrative activities
of Business Associate,Covered Entity shall not request Business Associate to use or disclose PHI in any manner that
would not be permissible under the Privacy Rule if done by Covered Entity.
8.0 Effective Date and Termination.
8.1 The Parties hereby agree that this agreement amends,restates and replaces any other Business Associate Agreement
currently in effect between Covered Entity and Business Associate and that the provisions of this agreement shall be
effective as follows:
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(a) These Business Associate Agreement provisions,with the exception of the electronic security provisions and
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the provisions mandated by ARRA, HITECH and Part I shall be effective upon the later of April 14,2003,or the
effective date of the earliest contract entered into between Business Associate and Covered Entity that involves the
use of PHI;
(b) The electronic security provisions hereof shall be effective the later of April 21,2005 or the effective date of
the earliest contract entered into between Business Associate and Covered Entity that involves the use of PHI;and
(c) Provisions hereof mandated by ARRA, HITECH and/or Part I shall be effective the later of February 17,
2010 or the effective date of the earliest contract entered into between covered entity and business associate that
involves the use of PHI or ePHI.
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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.
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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.
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(a) This provision shall apply to PHI and ePHI that is in the possession of subcontractors or agents of Business
Associate. Business Associate shall retain no copies of the PHI and ePHI.
(b) In the event that Business Associate or Covered Entity determines that returning the PHI or ePHI is infeasible,
notification of the conditions that make return of PHI or ePHI infeasible shall be provided to the other party. Business
Associate shall extend the protections of this Agreement to such retained PHI and ePHI and limit further uses and
disclosures of such retained PHI and ePHI,for a minimum of six years and so long as Business Associate maintains
such PHI and ePHI,but no less than six(6)years after the termination of this agreement.
9.0 Regulatory References. A reference in this agreement to a section in the Privacy Rule or Security Rule means the E
section then in effect or as may be amended in the future.
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10.0 Amendment. The Parties agree to take such action as is necessary to amend this agreement from time to time as is
necessary for Covered Entity to comply with the requirements of the Privacy Rule,the Security Rule and the Health
Insurance Portability and Accountability Act of 1996,Pub.L.No. 104-191.
11.0 Survival. Any term,condition,covenant or obligation which requires performance by either party hereto subsequent
to the termination of this agreement shall remain enforceable against such party subsequent to such termination.
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C.32.a
7
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 CD
of the United States Postal Service, postage prepaid and return receipt requested, addressed to the other party as i
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 _W
1100 Simonton Street,2-257 r
Key West,FL 33040
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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.
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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 1®
agreement does not limit the amendment of this agreement in accordance with section 10.0 of this agreement.
Covered Entity: Alliance for Aging,Inc.
By: Date:
(signature)
Business Associate: Monroe County Board of County Commissioners,Social Services/In-Home Services
By Date:
(s i g n atu rOXcTtng oun mt 1S or
ROE C RNEY
HO f► FOFVA
Page 55 of 56
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ATTACHMENT G
BACKGROUND SCREENING
F1 V,fit AFFAIRS% a
Affidavit 4f Compliance - Employer N
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AaLlTll ORr€Y:This form is required annually of all employers to comply with the attestation
regtdrements set forth in seefion 435.05(3),Florida Statutes-
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The tern 'employer' means entity required y
arty person ore r oo^ed b Iave to conduct backgroand screenft
mducift but not limited to,,area Agencies an Aging/Agft{and Disabil"Resource Centers,Lead
and service Providers that contract directly or indirectly with the Department of Elder Affairs(DOER),and
any other person or entity which hires employees or has volunteers in service who meet the defxr'-
of a direct service provider.See§§43S.02,430.04Q2,Fla.stat.
Y A directservice provider is a person 18 years of age or dicier who,pursuant to a program to provide 'N
services to the elderly,has drec%face to-face contact with a diem white p g services to the diem
and has access to the dimes living area,funds,personal propertYr or Personalidentification inform 0)
as defined in s.817.s6lL The term includes amdinators,managers,and supenisors of residential fadTdas;
and volunteers." §430 04D2(i)(b),Ra.Scat'.
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Aar€STA7m to
},/� �`,
pr ��1oy"M c, N-
�ti.L ' `7 .Ntd 's
Astlredu authorizedre representative
_ Employerrhtme
located at I{Oct C c7t ILLO PThis 5 C�iY ,Cy.
5traerAd res3 CityI State MP code
(?
i • M dos hereby affirm under penalty of perjury
AromeoflIepresentative C�
that the above named employer is in compliance with the provisions of Chapter 435 and section tV
430.040 , on Statutes,reWding level 2 background screening_
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ail �
Signatsu+e entative Date
STATE OF FLORIDA,COUNTY GF UL C
Savour to(or affirmed)and subscribed before me this ay of a �20P. by
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� i} f Nana of Represen j who is personally known
to me or produces_ as proof of iden' ion-
Lrrr � rA
F TM or sumpcamm&-i nen Name crrwcap pwbfc Notary Public
NOVA Fom233,Arftmk orCampimw-empwia,M*djveseptemaer21,Zi7 S33.t6I31,F5.
Form&Aiaftathita'lleJaio-aT irxatste.A.usre Sh msCMwieerdm
O co OP)V •• UNDSEY:172,092,4
P YE ►. ;.; MY COMMISSIO0088
EXPIRES:J
PEORO J. ERC P 56 of 56 ;,, Bon W Thru N�aty writers
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Packet Pg. 1289
AMENDMENT 001 CONTRACT KZ - 1997
Pa C.32.b
THIS AMENDMENT is entered into between the Alliance of Aging, Inc. hereinafter referred to as the
"Alliance", and Monroe County Board of County Commissioners,Social Services/In-Home Services, hereinafter
referred to as the "contractor" and collectively referred to as the "Parties."
The purpose of this amendment is to make the following changes to the existing ADI Contract for fiscal year
July 01,2019-June 30,2020.
Decrease Respite In-Facility by -$23,493.22
Adjust Services
and Rates in
Response to the
COVID-19 Crisis
-$23,493.22
This amendment changes the total ADI contract funding from: $189,458.40 to $165,965.18
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Service to be Provided Service Maximum Units of Service Maximum
rior increase/
Unit Rate Units (Decrease) Total Units Dollars
Case Management $ 60.73 144 (0) 144 $8,718.19
Respite In-Facility S 10.96 11,445 (3,373) 8,072 $88,467.53 U
Respite In-Home $ 24.22 21283 0 2,283 $55,302.11 0
Shopping Assistance CV ADI S 30.90 104 104 $3,213.60
Telephone Reassurance CV ADI S 27.37 375 375 $10,263.75
Total Contract Amount $ 165,965.18
All provisions in the contract and any attachments thereto in conflict with this amendment shall be and are
hereby changed to conform with this amendment.
All provisions not in conflict with this amendment are still in effect and are to be performed at the
level specified in the contract.
This amendment and all its attachments are hereby made a part of the contract.
IN WITNESS WHEREOF,the parties hereto have caused this Amendment to be executed by their undersigned
NROE COUNTY ATTORNEY
officials as duly authorized. � 9�taveo�s� /Faso
ACJSISTA UNTY=�FINEY
Monroe County Board of County Date `5/12/20 ALLIANCE FOR AGING, INC.
Commissioners, Social Services/
In-Home Services
SIGNED BY: SIGNED BY:
NAME: NAME: Max B. Rothman,JD, LL.M.
TITLE: TITLE: President&CEO
DATE: DATE:
Prepared on 4/29/2020 1 Packet Pg. 1290