Item C8 BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date:.- 7/16/14 Division:, Social Services
Bulk Item: Yes X No Department: Social Services
Staff Contact Person: Sh 1 -4510
� 305�292
AGENDA ITEM WORDING: Ratification of the Community Care far the Elderly(CCE)Contract
#KC 1471 between the Alliance for Aging, Inc. (AAA)and Monroe County Board of County
Commissioners(Social Services/In Home Services)for the contract period of 7/l/14 to 6/30/15, in the
amount of$302,523.00.
ITEM BACKGROUND: Approval of the CCE contract will enable Monroe County In Home
Services to continue providing services to Monroe County's elderly Population under the Community
Care for the Elderly program.
PREVIOUS RELEVANT BOCC ACTION: Prior approval granted by the BOCC on 11/20/13 for
Amendment #001 to the Community Care for the Elderly Conft-dd (CCE) # KC1371, contract year
13/14.
CONTRACT/AGREEMENT CHANGES: None
STAFF RECOMMENDATIONS: Approval
TOTAL AMOUNT OF GRANT: $302,523.00
TOTAL COST: $30,252.30(cash) BUDGETED: Yes Na
COST TO COUNTY: $30,252.30(cas6) SOURCE OF FUNDS:Grant funds plus cash match dollars_
REVENUE PRODUCING: Yes X No— AMOUNT PER: MONTH1. -18-00 YEAR:J21.600
(client co-payments)
O�A/PurcEt',
APPROVED BY: County Atty.- hasing Risk Management
DOCUMENTATION: Included X Not Required_ To Follow
DISPOSITION: AGENDA ITEM#
Revised 8/06
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, Inc. Contract: KC 1471
Effective Date: 7/1/2014
Expiration Date: 06/30/2015
Contract Purpose/Description: Ratification of the Community Care for the Elderly(CCE)Contract#KC
1471 between the Alliance for Aging, Inc.(AAA)and Monroe County Board of County Commissioners
(Social Services/In Home Services)for the contract period of 7/1/14 to 6/30/15,in the amount of
$302,523.00.
Contract Manager: Sheryl Graham 2924510 Social Services/Stop I
(Name) (Ext.) (Department/Stop 4)
For SOCC meeting on 7/16/14 6,13011-1
Agenda Deadline: 7/l/2014
CONTRACT COSTS
Total Dollar Value of Contract: $302,523.00 Current Year Portion:$
Budgeted Yes No Account Codes:
Grant:$302,523.00
County Match:$30,252.30 (cash)
Additional Match:
Total Match$ 30,252.30 (cash) ADDITIONAL COSTS __-
Estimated Ongoing Costs: For:
I (Not included in"ar value above)
(e.g.mainknonm utilities
, salaries
CONTRACT REVIEW
Changes Date Out
,'Date 10 Needed
Division Director
Yes i] No rffr
'A. 21"
Risk Management
Yes 6 No r°I"
O.M,BJPurchasing Yes No
7Z�5
County Attorney Yes Nol,'4'
Comments:
OMB Form Revised 2/27/01 MCP#2
Contract Number KC 1471
A i i L
CONENIULAITY CARE FOR THE ELDERLY LEAD AGENCY CONTRACT
2014-2015 Fiscal Year
THIS CONTRACT is entered into between the Alliance for A(2iriL, Inc., hereinafter referred to as the "Alliance,- and
Z� -
Monroe County Board of Commissioners. hereinafter referred to as the **provider-," and collectively referred to as the
"pat-ties."
Attachments 1, 11, Ill, IV, V, VI, VII, VIII, IX, X, A, B, C, D, E. G and 11 are incorporated herein and made a part of this
Contract.
WHEREAS, the Alliance has been deli-natcd as the area agency on aging for Planning and Service Area I I
encompassing Miami-Dade and Monroe Counties, and
WHEREAS, the Florida Department of Elder Affairs (the "Department") has entered into a Contract with the Alliance to
fund community care service systems in Miami-Dade and Monroe Counties; and
WHEREAS, in accordance with Section 430.203, Florida Statutes, the Alliance has designated the provider as a Lead
-)r the Elderly("CCE") program;
agency for the C0111MUnity Care ft
NOW'THEREFORE, in consideration of the services to be perfornied and payments to be made, together with the
mutual covenants and conditions set forth in this Contract,the Parties agree as follows:
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this
contract including all attachments and exhibits, which constitute the contract document.
2. Incorporation of Documents within the Contract
The contract will incorporate attachments, proposal(s), state plan(s), grant agreements, relevant Department of
Elder Affairs handbooks, manuals or desk books, as an integral part of the contract, except to the extent that the
contract explicitly provides to the contrary. In the event of conflict in language among 4my of the docurnents
referenced above, the specific provisions and requirements of the Contract documents) shall prevail over
inconsistent provisions in the proposal(s) or other general materials not specific to this contract document and
identified attachments.
3. Term of Contract
Effective Date:
This contract shall begin on July 1, 2014 or on the date the contract has been signed by both parties, whichever is
later.
Delivery of services shall end at midnight, local time in Miami, FL on June 30, 2015. The Alliance will not
reimburse the provider for services provided after this date. I lowever, the parties recognize that they will need
to perform continued activities relating to reporting, invoicing and payment in .July of 2014 to facilitate payment
for services rendered by the provider under this contract through and including the contract expiration date of
July 15, 2015.
4.0 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 302,523 or the rate schedule, subject to the availability of funds. Any costs or services
for
pai
d r under any other contract or from any other Source are not eligible for payment under this contract,
1
4.1 Oblioation to Pay
The Alliance's performance and obligation to pay under this contract is contingent upon an
aullUal appropriation by the Legislature to the Department and funding received by the Alliance
under its contract with the Department.
4.2 Source of Funds
An eligible for
The costs ot'scrvices paid under any other cot act or from my other source are not elk
I
Contract Number KC 1471
reinibUrsC111CM Under this contract, The funds awarded to the provider pursuant to this contract
are in
the state grants arid aids appropriations and consists of'the followin":
Program 'Title Year Funding Source CSFA# Fund Amounts
Conlinutifty Care Gencral Revenue/Tobacco 65010— 5302,523
for the Elderly Settlement Trust Funds
,ro,rAl, FUNDS CON'I'AINED IN '1'111S CON'TRACT: 5302,523
S. Renewals
The contract may be renewed on a yearly basis for no more than four 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. 'The renewal price, or method for determining a renewal
price, is set forth in the bid, proposal, or reply. No other costs for the renewal may be charged.
6. Compliance with Federal Law
6.1 If this contract contains federal f1inds the following shall apply:
6.1.1 "The Provider shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations.
6.1.2 It' this contract contains federal funds and is over $100,000.00, the Provider shall comply with all applicable
standards, orders, or regulations issued under s. 306 of the Clean An-Act as amended (42 U.S.C. 7401, et seq.), s.
508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order It 738, as
amended, and where applicable Environmental Protection Agency regulations 40 CFR, 30. The Provider shall
report any violations of the above to the Alliance.
6.1.3 The Provider, or agent acting for the Provider, may not use any federal funds received in connection with this
contract to influence legislation or appropriations pending before the Congress or any state legislature. If this
contract contains federal funding in excess of $100,000.00, the Provider must, prior to contract execution,
complete the Certification Regarding Lobbying form, AYrAC11MEN'F 11. All disclosure forms as required by
the Certification Regarding Lobbying form must be completed and returned to the Contract Manager prior to
payment under this contract.
6.1.4 In accordance with Appendix A to 2 CFR 215, the Provider shall comply with Executive Order 11246, Equal
Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in Department
of Labor regulation 41 CFR 60 and 45 CFR 92, if'applicable.
6.1.5 If this contract contains federal funds and provides services to children up to age 18, the Provider shall comply
with the Pro-('I hildren Act of 1994 (20 U.S.C. 6081).
6.1.6 A contract award Nvith an amount expected to equal or exceed $25,000.00 and certain other contract awards will
not be made to parties listed on the government-wide Excluded Parties List System, in accordance with the OMB
ouidelines at 2 CFR 180 that implement Executive Orders 12549 arid 12689, -Debarment and Suspension.*' The
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Excluded Parties List System contains the names of parties debarred. Suspended, or otherwise excluded by
agencies, as well as parties declared incligibIC under statutory or regulatory authority other than I."XeCWIVC Order
12549. 'The Provider shall comply with these provisions before doing business or entering into subcontracts
receiving federal funds pursuant, to this contract. The Provider shall complete and sign A'I"FACHIMEM' V prior
to the execution ot'this contract.
6.2 'Tile Provider shall not employ an unauthorized alien. The Alliance will consider the employment of'
unauthorized aliens a Violation ol'the Immigration and Nationality Act (8 U.S.C. 1324a) and the Immigration
Rel'orin and Control Act of* 1986 (8 LJ.S,C. 1 101). Such violation will be Cause fOr unilateral cancellation of this
2
Contract Number KC 1471
contract by the Alliance.
6.3 Il'the Provider is a rion-profit provider and IS Subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N) and has its tax exempt Status revoked for failing to
L_
comply with the Cling rLqUiretricrits of' the 2006 pension Protection Act or for any other reason, the provider
must notify the Alliance in writing within thirty(30) days of receiving the IRS notice of revocation.
The Provider shall comply with Title 2 CFR Part 275 regarding Trafficking in Persons.
6.4 t,
Unless exempt under 2 CFR Part 170.1 10(b), the Provider shall comply with the reporting requirements of the
Transparency Act as expressed in 2 CFR 170.
7. Compliance with State 1.,aw
7.1 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.
7.2 The Provider shall comply with requirements of s. 287.058, F.S. as amended.
7.2.1 The Provider shall provide units of deliverables, including various client services, and in some instances may
include reports, findings, and drafts, as specified in this contract, which the Contract Manager must receive and
accept in writing prior to payment in accordance with s. 215.971, F.S. (1) and(2).
7.2.2 The Provider shall submit bills for fees or other compensation for services or expenses in sufficient detail for a
proper pre-audit and post-audit.
7.2.3 If'itemized payment for travel expenses is perrnitted in this contract, the Provider shall submit bills for any travel
expenses in accordance with s. 112.06 1, F.S., or at such lower rates as may be provided in this contract.
7.2.4 The Provider shall allow public access to all documents, papers, letters, or other public records as defined in
subsection 119.011(12), F.S., made or received by the Provider in conjunction with this contract except for those
records which are made confidential or exempt by law. The Provider's refusal to comply with this provision will
constitute all immediate breach of contract for which the Alliance may unilaterally terminate the contract.
7.3 If clients are to be transported under this contract, the Provider shall comply with the provisions of Chapter 427,
F.S., and Rule 41-2, F. A. C.
7.4 The provider 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.
7.5 The Provider shall comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the
expenditure of"contract funds for the purpose of lobbying the legislature,judicial branch or a state agency.
7.6 In accordance with s. 287.135 F.S., any Contractor on the Scrutinized Companies with Activities in Sudan List or
the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List (Lists), created pursuant to s.
215.473 F.S., is ineligible to enter into or renew a contract or agreement with the Department for goods or
services of'SI million or more. Pursuant to s. 287.135 F.S., the Department may tenninate this Contract and any
contract or agreement incorporating this Contract by reference if the Contractor is found to have submitted a false
certification of'its status on the Lists or has been placed on the Lists. Further, the Contractor Is subject to civil
penalties, attorney's fees and costs and any costs for investigations that led to the finding of` alse certification. If
any contract or agreement incorporating this Contract contains $1 million or more, the Contractor shall complete
and sign A-I"-l'ACIIMI,-.N'I* fl. Certification Regarding Scrutinized Companies Lists, prior to the execution of this
Contract.
8. Back(_Yround Screenin
The Provider shall ensure that, prior to providing services, all persons having access to vulnerable elders and
children, their living area, funds or personal property, or protected health Hif'ormatioti pertaining, to Such
IndividUalS, will pass a Lc\cl 11 criminal background screening in accordance with the requirements of' s.
430.0402 and ch. 435. F.S., as amended. These provisions apply to employees, Subcontractors, consultants, direct
service providers and VOILInteers. Consequently, any commitment for employment, purchase of services, or
volunteer program participation will he contingent upon the passing of a Level 11 background check. The
Contract Number KC 1471
background screening will include erriployrricrit history checks as provided in s. 435.03(1), F'.S., and both local
and national criminal record checks coordinated through law enforcement agencies.
8.1 For purposes of this section, the terra -direct service provider" means a person IS years of age or older who,
pursuant to a program to provide set-vices to the elderly, has direct, face-to-face contact with a client while
providing services to the client or has access to the client's living areas or to the client's funds or personal
property. This term includes coordi,tiators, managers, and supervisors of residential facilities and volunteers.
8.2 Background Screening Affidavit of Compliance - To demonstrate compliance with section 6 of this Master
Contract, the Contractor shall submit A'f rACHMENT G, Background Screening Affidavit of Compliance
annually, by January 15th.
8.3 Further Informatioll concerning the procedures for background screening is found at
littp://elderaffhirs.state.fl.us/doea/backgroundscreening.php.
9. Grievance and Complaint Procedures
9.1 Grievance Procedure
The Contractor shall comply with and ensure subcontractor compliance with the Minimum Guideline for
Recipient Grievance Procedures, Appendix D, Department of Elder Affairs Programs and Services Handbook, to
address complaints regarding the ten'rimation, suspension or reduction of services, as required for receipt of
funds.
9.2 Complaint Procedures:
The Contractor shall develop and implement complaint procedures and ensure that Subcontractors develop and
implement complaint procedures to process and resolve client dissatisfaction with services. Complaint
procedures shall address the quality and timeliness of services, provider and direct service worker complaints, or
any other advice related to complaints other than termination, suspension or reduction in services that require the
grievance process as described in Appendix D, Department of Elder Affairs Programs and Services Handbook.
The complaint procedures shall include notification to all clients of the complaint procedure and include
tracking the date, nature of the complaint and the determination of the complaint.
10. Audits, Inspections, Investiflations, Public Records and Retention
10.1 The provider shall establish and maintain books, records, and documents (including electronic storage media) in
accordance with generally accepted accounting procedures and practices that sufficiently and property reflect all
revenues and expenditures of funds provided by the Alliance under this contract. Provider agrees to maintain
records, including paid invoices, payroll registers, travel vouchers, copy logs, postage logs, tune sheets, etc., as
supporting documentation for service cost reports and for administrative expenses itemized for reimbursement.
This documentation will be made available upon request for monitoring and auditing purposes. Whenever
appropriate, financial information should be related to performance and unit cost data.
10.2 The Provider shall retain all client records, financial records, Supporting documents, statistical records, and ally
other documents (including electronic storage media) pertinent to this contract for a period of six (6) years after
completion of the contract or longer when required by law. In tile event an audit is required by this contract,
records shall be retained for a rinininurn period of six (6) years after the audit report is issued or until resolution
of any audit findings or litigation based on the terms of this contract, at no additional cost to the Alliance.
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10.3 [)'poll demand, at no additional cost to the Alliance, the Provider shall facilitate the duplication. and transfer of
any records or documents during the required retention period in Paragraph 10.2.
10.4 The Provider 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, tile
Department and federal auditors, pursuant to 45 CFR 92,36(1)(10), Nvill be allowed Full access to and the right to
exanuric any of the Provider's contracts and related records and documents pertincnt to this specific contract,
ret-,ardless of the 16rin in which kept.
10.6 The Provider shall provide a financial and compliance audit to the Alliance as specified in this contract and in
ATTACHMENT Ill and ensure that all related third-party transactions are disclosed to the auditor.
4
Contract Number KC 1471
10.7 The Provider 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.
10.8 The Provider shall maintain and file with the Alliance such progress, fiscal and inventory and other reports as the
Alliance inay require within the period of this contract.
10.9 The Provider shall submit management, program, and client identifiable data, as specified by the Department of
Elder Affairs anti or the Alliance. The provider must record and submit program specific data in accordance
with the Department's Client Information Registration and Tracking System (CIRTS) Policy Guidelines.
10.10 If, under any contract or agreement incorporating this Contract by reference, the Contractor is providing services
and is acting on behalf of the Department of Elder Aftairs or the Alliance for Aging, Inc. as provided under
section 119.011(2), Florida Statutes, the Contractor, subject to the terms of section 287.058(l)(c), Florida
Statutes, and any other applicable legal arid equitable remedies, shall:
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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) Provide the public with access to public records on the same terms and conditions that the Department of
Elder Affairs or the Alliance for Aging, Inc. would provide the records and at a cost that does not exceed the cost
provided in Chapter 119, Ilorida Statutes, or as otherwise provided by law,
c) Ensure that public records that are exempt or confidential arid exempt from public records disclosure
requirements are not disclosed except as authorized by law.
d) Meet all requirements for retaining public records and transfer, at no cost, to the Department of Elder Affairs
or the Alliance for Aging, Inc. all public records in possession of the Contractor upon termination or expiration
of any contract or agreement incorporating this Contract by reference and destroy any duplicate public records
that are exempt or confidential and exempt frorn public records disclosure requirements. All records stored
electronically must be provided to the Department of Elder Affairs or the Alliance for Aging, Inc. in a format
that is compatible with the information technology systems of the Department.
10-11 The Alliance for Aging, Inc. may unilaterally cancel this Master Contract, and any contract or agreement
incorporating this Contract by reference, notwithstanding any other provisions of this Contract, for refusal by
the Contractor to comply with Section 8 of this Contract by not allowing public access to all documents, papers,
letters., or other material made or received by the Contractor in conjunction with the contract or agreement
incorporating this Contract by reference, unless the records are exempt from Section 24(a)of Article I of the
State Constitution and Section 11 9.07(1), Florida Statutes.
11. Nondiscrimination-Civil Rialits Compliance
11.1 The Provider shall execute assurances in ATTACHMENT VI that it will not discriminate against any person in
the provision of services or benefits under this contract or in employment because of age, race, religion, color,
disability, national origin, marital status or sex in compliance with state and federal law and regulations, The
Provider further assures that all Providers. Subcontractors, subgrantees, or others with whom it arranges to
provide set-vices 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 Provider shall complete and retain on file a timely, complete and accurate
Civil Rights Compliance Checklist (ATTACHMENT B).
11.3 The Provider shall establish procedures pursuant to federal law to handle complaints of discrimination involving
services or benefits through this contract. These procedures will include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
11.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from
federal financial assistance, and are binding upon the Provider, its successors, transt'crees, and assignees for the
period during which Such assistance is provided. The Provider further assures that all Subcontractors, vendors, or
others with whorn it arranges to provide services or benefits to participants or employees in connection with any
of its programs and activities are not discriminating aglainst those participants or employees in violation of the
above statutes, regulations, guidelines, and standards. fit the event of failure to comply, the Provider Understands
that the Alliance inav, at its discretion, seek a court order requiring compliance with the terms of this assurance
Contract Number KC 1471
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 Provider shall provide services in the manner described in in ATTACHMENT I ot'this agrectrient and in the
Service Provider Application (SPA). In the event of a conflict between the Service Provider application and this
contract, the contract language prevails.
13. Monitoring by the Alliance for A(_,in
The Alliance will perf'orili administrative and programmatic monitoring of the provider to ensure contractual
compliance, fiscal accountability, progrartirriatic perforrilance, and compliance with applicable state and federal
laws and regulations.
13.1 The provider will Supply progress reports, including data reporting requirements as specified by the Alliance or
the Department to be used for monitoring progress or performance of'the contractual services as specified in this
contract. Following the nouns set down by the Department , the Alliance will track performance on a monthly
basis, through desk reviews of available fiscal, 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.
13.2 The provider 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 provider which are relevant to this contract, and
to interview any clients, employees, and subcontractor employees of the provider to be assure the Alliance of the
satisfactory performance of the terms and conditions of this contract. Following such review, the Alliance will
deliver to the provider written report of its findings and request for development, by the provider, of
corrective action plan (CAP)where appropriate. 'File Contractor hereby agrees to correct all deficiencies
identified in the CAP in a timely matiner as determined by the Contract Manager.
13.3 Extraordinary Reporting
The provider shall notify the contract manager for the Alliance immediately, but no later than within 48 hours,
from the provider's awareness or discovery of conditions that may materially affect the provider's ability to
perform, such as problems, delays, or adverse conditions which may impair the provider's ability to meet the
objectives of this contract or that niay affect the health, safety or well-being of clients. The notice shall include a
brief summary of the problern(s), a statement of the action taken or contemplated, time frames for
implementation, and any assistance needed to resolve the situation.
Examples of reportable conditions may include:
• proposed client terminations
• provider financial concerns/difficulties
• non-payment or untimely payment reported by vendors
• service documentation problems
• agreement non-compliance
• service quality problems and consumer complaint trends
• I IIPAA violations
• Potential 1raud allcgations or accusations ot'malfeasance by board members. employees,
VOILIntecrs, or other associates
The Alliance shall investigate allegations rcgardin(z I'alsification of'client information, service records, payment
requests, and other related Hif'ori-riation. Substantiated allegations shall be reported to the Department's contract
manager and to law erilorcernent as appropriate.
In the went that a Situation results in the cessation of services by a subcontract, the provider retains the
6
Contract Number KC 1471
responsibility for performance of all services covered lay this contract and must ensure that clients continue
receiving services without interruption, e. t-
(T. exercising their emergency procurement procedures, temporary
assumption of the direct provision of services, etc.
14. Coordinated 'MonitorinLy with Other Agencies
If the Provider receives ftinding from one or more of the State of Florida other human service agencies, in
addition to the Department of* Elder AfTairs, then a Joint monitoring visit including Such other agencies may be
scheduled. For the purposes of this contract, arid 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 t(ycncy*s lead administrative
iod ii
coordinator, the Provider shall comply and cooperate with all monitors, inspectors, and/or investigators.
15. Indemnification
The provider shall indemnify, defend, and hold harmless the Department and the Alliance and their officers,
agents, and employees frorn 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
provider, its agents, employees, or subcontractors during the performance of this contract, whether direct or
indirect, and whether to any person or property. It is understood and agreed that the provider is not required to
indemnify the Alliance for claims arising out of the sole negligence of the Alliance.
The provider's obligation to indemnify, defend, and pay for the defense or, at the Department's and/or the
Alliance's option, to participate and associate with the Department and/ or the Alliance in the defense and trial of
any claim and any related settlement negotiations, shall be triggered by the Department's and/or Alliance's
L
notice of claim for indemnification to the provider.The provider's inability to evaluate liability or its evaluation of
liability shall not excuse the provider's duty to defend and indemnify the Department and or the Alliance, upon
notice by the Department and'or the Alliance. Notice shalt be given by registered or certified mail, return
receipt requested. Only an adjudication or judgment after the highest appeal is exhausted specifically finding the
Alliance solely negligent shall excuse performance of this provision by the provider. The provider shall pay all
costs and fees related to this obligation and its enforcement by the Department and/or the Alliance. The
Alliance's failure to notify the provider of a claim shall not release the provider of the above duty to defend and
indemnify.
15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph 15 is not applicable to contracts
executed between the Alliance and state agencies or subdivisions defined in s. 768.28(2), F.S.
16. Insurance and Bondin
16.1 The provider Must carry 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 rencwal(s) or extension(s) of this contract. The Alliance shall be
included as an additional insured on the provider's liability insurance policy or policies and a copy of the
Certificate of Insurance shall be provided annually or when any changes —occur. The provider accepts full
responsibility for identifying arid determining the type(s) and extent of liability i ide
I . insurance necessary to prov
reasonable financial protections for the provider and the clients to be served under this contract. Upon execution
of this contract, the provider 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 provider do
not limit the provider's liability and obligations under this contract. The provider shall ensure that the Alliance
has the most current written verification of insurance coverage throughout the term of this contract. The
Department and the Alliance reserve the right to require additional insurance where appropriate.
16.2 Throughout the term of this contract, the provider must maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the provider, authorized
to handle funds received or disbursed under this contract, in in amount commensurate kvitli the funds handled, the
degree of risk as determined by the insurance company and consistent with good business practices.
16.3 If the provider is a state aszeriCV 01- Subdivision as defined by section 768.28, F.S., the provider shall furnish, upon
�liability protection accordance :r request, written -verification o rdarice with section 76S."S, F.S. Nothing herein shall
7
Contract Number KC 1471
be construed to extend any party's liability beyond that provided in section 768.28, F.S. (See also
Indcri-inification,Clause.)
17. Confidentiality of Information
The Provider shall not use or disclose any information concerning a recipient of services under this contract for
any Purpose prohibited by state or federal law or regulations except with the written consent of person legally
authorized to ,i\,e that consent or when authorized by law'.
18. Health Insurance Portability and Accountability Act
Where applicable, the Provider shall comply with the Health Insurance Portability and Accountability Act (42
USC 1320d.), as well as all regulations promulgated thereunder(45 CFR 160, 162, and 164).
19. Incident Reportin
19.1 The Provider shall notify the Alliance immediately, but no later than forty-eight (48) hours from, the Provider's
awareness or discovery of conditions that may materially affect the Provider or subcontractor's ability to perform
the services required to be performed under this contract. Such notice shall be made orally to the Contract
Manager(by telephone) with an email to immediately follow.
19.2 T lie Provider shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a
child, aged person, or disabled adult to the Florida Abuse Hotline oil the statewide toll-free telephone number(I-
I
800-96ABUSE). As required by Chapters 39 and 415, F.S., this provision is binding upon both the Provider and
its employees.
20. Bankruptcy Notification
During the term of this contract, the Provider shall immediately notify the Alliance if the Provider, its assignees,
subcontractors or affiliates file a claim for bankruptcy. Within ten (10) days after notification, the Provider must
also provide the following information to the Alliance: (1) the date of filing of the bankruptcy petition, (2) the
case number, (3) the court name and the division in which the petition was filed (e.g., Northern District of
Florida,Tallahassee Division); and, (4)the name, address, and telephone number of the bankruptcy attorney.
21. Sponsorship and Publici",
21.1 Any nongovernmental organization which sponsors a program financed partially by state funds or funds obtained
from a state agency shall, in publicizing, advertising, or describing the sponsorship of the program, state:
"Sponsored by, the State of Florida, Department of Elder Affairs and Alliance for Aging Inc." If tire 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 provider shall riot use, the words -State of Florida, Department of Elder Afftairs"and/or "The Alliance for
Aging, Inc" to indicate sponsorship of a program otherwise financed unless specific authorization has been
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obtained by the Alliance prior to use.
22. Assignments
22.1 'The provider shall riot 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 A(,ina, file.
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22.2 No approval by the Alliance of any assignment or subcontract shall be deemed in any event or in any manner to
provide for the incurrence of any obligation of the Alliance in addition to the dollar amount agreed upon in this
contract.
22.3 The State of lorida is at all times entitled to assign or transfer, in whole or part, its rights, duties, or obligations
under any contract or agreement to another governmental agency in the State of Florida, upon gi
'iving prior
written notice to the Contractor. In the event the State of Florida approves transfer of the Contractor's
obligations, the C_'ontractor remains responsible for all work performed and all expenses Incurred in connection
with the contract or agreement.
(7ontract Number KC 1471
23. Subcontracts:
23.1 The Contractor is responsible for all work performed and for all con-ii-noditics produced pursuant to this
contract, whether actually furnished by the Contractor or its subcontractors. Any Subcontracts shall be
evidenced by a written agreement subject to all applicable terms and conditions of this contract. Alliance
approval of the service application presented by the provider shall constitute Alliance approval of the provider's
proposed subcontracts if the subcontracts follow the service and funding information identified in the
provider's service application. All other subcontracts proposed to be funded under this contract must be
I provider agrees that the alliance shall not be liable to any
approved in advance by the alliance. The pi
subcontractor in any way or for any reason. The lie provider, at its expense, will indemnify and defend the
Alliance against any subcontractor claims.
23.2 The provider shall promptly pay any subcontractors. Failure to pay subcontractors pursuant to any subcontract
or as required by law may result in enforcement action under this contract.
23.3 J'he provider maintains responsibility for the monitoring and performance of all subcontracts in accordance with
all applicable federal and state laws.
23.4 T lie 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 'rhe Contractor shall submit annually to the Alliance service cost reports, which reflect actual costs ot'providing
each service by program. This report provides information for planning and negotiating unit rates.
41
24. Independent Capacity of Provider
24.1 The provider will be acting in its independent capacity and not as an employee, agent or representative of the
Alliance or the Department. The provider shall not be deemed or construed to be an employee, agent or
representative of the Alliance or the Department for any purpose whatsoever. Nothing contained in this contract
is intended to, or shall be construed in any manner, as creating or establishing the relationship of
employer/employee between the parties.
24.2 The provider shall be responsible for completely supervising and directing the work Linder this contract whether
performed by the provider or by any subcontractor that it may utilize. The provider shall be responsible for all
subcontractors who perform work under this contract. The provider agrees that it is as fully responsible for the
acts and ornissions of its subcontractors and of persons employed by them as it is for the acts and omissions of its
own employees.
24.3 It is further understood that the Alliance does not control the employment practices of the provider and shall not
be liable for any wage and hour, employment discrimination, or other labor and employment claims against the
provider or its subcontractors. All deductions for social security, withholding taxes, income taxes, contributions
to unemployment compensation funds and all necessary insurance for the provider shall be the sole
responsibility ofthe provider.
25. Payment
25.1 Pavmcnts shall be made to the Provider as services are rendered and invoiced by the Provider. The Alliance's
Contract Manager will have final approval of the invoice for payment, and will approve the invoice for payment
only if the Provider has met all terms and conditions of the contract. unless the bid specifications, purchase order,
or this contract specify otherwise. The approved invoice will be submitted to the Alliance's finance section for
budgctary approval and processing.
25.2 Payment Documentation Require
The provider 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 provider shall comply with all state and federal laws goVernilh!
payments to be made under this contract including, but not limited to the following: (a) paragraph (16) (b) of
Contract Number KC 1471
section 216.181, F. S.. regarding advances; (b) Rule 691-40.103 U.A.C. pertaining to Restriction of Fxpenditurcs
froin state binds; and (c) the Contract payment Requirements sub-section of section C of the Reference Guide
for State L`xpenditurcs from the Department of, Financial Services
litto:'
The provider shall maintain detailed documentation to support each item on the itemized invoice or payment
request for cost reimbursed expenses, including paid subcontractor invoices, and will be produced upon request
by the Alliance. The provider shall only request reimbursement for allowable expenses as defined in the laws and
guiding circulars cited in this agreen-ietit, in the Reference Guide for State Expenditures, and any other laws or
lati re-u Ions, as applicable, and that administrative expenses do not exceed amounts budgeted in the provider's
approved service application.
The Contractor will certify that detailed. documentation is available to support each item on the itemized invoice
or payment request l*(--)r cost reimbursed expenses, fixed rate or deliverables contracts or agreements
incorporating this Contract by reference, including paid Subcontractor invoices, and will be produced upon
request by the Department. The Contractor will further certify that reimbursement requests are only for
allowable expenses as defined in the laws and guiding circulars cited in Sections 6 and 7 of 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 area plan as developed in accordance
with and pursuant to section 306(a) of the Older Americans Act of 1965, as arnended.
25.3 Limit on Funding ObIiLmtions
ne 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.
The Alliance shall not be liable to the provider 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 provider's promised performance and unit rates and/or reimbursement capitations specified.
The Alliance shalt not be liable to the provider for any expenditures which are riot allowable costs as defined by
applicable federal or state law, or which expenditures have not been made in accordance with the fiscal guidelines
and requirements outlined by the Department.
The Alliance shalt not be liable to the provider for expenditures made in violation of regulations, the Older
Americans Act, Department rules, Florida Statutes, or this contract.
26. Return of Funds
The Contractor shall return to the Alliance any overpayments due to unearned funds or funds disallowed and any
interest attributable to such funds pursuant to the terms and conditions of any contract or agreement incorporating
this Conti-act 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 all
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.
27. Data Integrity and Safeguarding Information.
The provider shall ensure an appropriate level of data security for the inforniation the provider is collecting or
using in the ped'on-nance of this contract. An appropriate level of security includes approving and tracking all
provider employees that request system or infortriation access and ensuring that user access has been removed
front all terminated employees. The provider, among other requirements, must anticipate and prepare for the loss
of infori-nation processing capabilities. All data and software Must be routinely backed ill) to insure recovery
front losses or Outages of computer systems. The Security over the back-up data is to be as stringent as the
protection required of the pnn-iary systems. The provider shall insure all subcontractors maintain written
procedures For COIIIPLItcr system back up and recovery. The provider shall , prior to execution of this agreement.
complete the Data Integrity Certification form. ATTACHINMENT iv.
Contract Number KC 1471
28. Computer Use and Social Media Policy
T
The Department of L' U
Ider 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 for-arris, Wikis. RSS feeds,
video sharing, social networks like MySpace, I'acebook and Twitter, as well as content shalling, networks such as
flicki- and YouTube (This policy is available on the Department's website at:
littp://el(leraffairs.state.fl.us/(Ioea/finaticial.php).
29. Conflict of Interest
The Provider shall establish safeguards to prohibit employees, board members, management and subcontractors
from using their positions for a purpose that constitutes or presents the appearance of personal or organizational
conflict of interest or personal gain. No employee, officer or agent of the Provider or subcontractor shall
participate in selection, or in the award of an agreement supported by state or federal funds if a, conflict of interest,
real or apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any
member of his/her immediate family; (c) his or her partner, or; (d) an organization which employs, or is about to
employ, any of the above, has a financial or other interest in the firm selected for awarcl. The Provider or
subcontractor's officers, employees or agents will neither solicit nor accept gratuities, favors or anything of
monetary value from contractors, potential contractors, or parties to subcontracts. The Provider's board members
and management must disclose to the Alliance any relationship which may be, or may be perceived to be, a
conflict of interest within thirty (30) calendar days of an individual's original appointment or placement in that
position, or if the individual is serving as an incumbent, within thirty ('30) calendar days of the commencement of
this contract. The Provider's employees and subcontractors must make the same disclosures described above to
the Provider's board of directors. Compliance with this provision will be monitored.
30. Public Entity Crime
Pursuant to s. 287.133, F.S., a person or affiliate who has been placed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or
services to a public entity, may not Submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of
real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, 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 IWO for a period of 36 months following
the date of being placed on the convicted vendor list.
The provider represents and warrants that the provider, its officers, directors, senior management, partners,
employees or agents have not been convicted of any public entity crimes within the last 36 months. If the provider
or any of its officers or directors is convicted of a public entity crime during the period of this agreement, the
provider shall notify the Alliance immediately. Non-compliance with this statute shall constitute a breach of this
agreement. The provider must ensure that it does not enter into with any subcontractor on the convicted vendors
list or otherwise prohibited from contracting for state Funds pursuant to section 287.133, F,S.
31. Pur
Procurement of'Products or Materials with Recycled Content.
Reusable materials and products shall be used where economically technically feasible.
32. Patents, Copvriahts, Royalties
If this contract is awarded state fundin- and if any discovery, invention or copyrightable material is developed,
produced or for which ownership was purchased in the Course of or as a result of work or services performed under
this contract, the provider shall refer the discovery, invention or material to the Alliance to be referred to the
Department of State. Any and all patent rights or copyrights accruing under this contract are hereby reserved to
the State of lorida in accordance with Chapter 286, F.S.
33. Enieraency Preparedness and Continuity of Operation
11
Contract Number KC 1471
33.1 The Provider shall, within thirty (30) calendar days of the execution of this contract, submit to the Contract
Manager verification of ail emergency preparedness plan. In the event of an emergency, the Provider shall notify
the Alliance of emergency provisions.
33.2 in the event a situation results in a cessation of services by a subcontractor, the Provider shall retain responsibility
for performance under this contract and must follow procedures to ensure continuity of operations without
interruption.
33.3 In preparation for the threat of an emergency event as defined in the State of Florida Comprehensive Emergency
Management Plan, the Department may exercise authority over an area agency or service provider agency to
implement preparedness activities to improve the safety of the elderly in the threatened area and to secure area
agency and service provider facilities to minimize the potential impact of the event. These actions will be within
the existing roles and responsibilities of the area agency and provider.
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33.4 In the event the President of the United States or Goverrior of the State of Florida declares a disaster or state of
emergency, the Department may exercise authority over an area agency or service provider agency to implement
emergency relief measures and/or activities.
34. Equipment
34.1 Equipment means: (a) air article of nonexpendable, tangible personal property having a useful life of'more
than one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by
the organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); tionexpendable,
tangible personal property of a non-consumable nature with an acquisition cost of$1,000.00 or more per unit, and
expected useful life of at least one year; and hardback bound books not circulated to students or the general public,
with a value or cost of$250.00 or more [for state funds].
34.2 Contractors and Subcontractors who are Institutions of Higher Education, Hospitals, and Other Non-Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elernents identified in the circular; and, (b) a procedure for conducting a physical inventory of equipment at least
once every two years. (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on file and shall be provided to the Alliance upon request. The Contractor shall promptly
investigate, fully document and notify the Contract Manager of any loss, damage., or theft of equipment. The
Contractor shall provide the results of'
the investigation to the Contract Manager.
34.3 The Contractor's property management standards for equipment acquired with Federal funds and federally-
owned equipment shall include accurately maintained equipment records with the following information:
(I) A description of the equipment;
(2) Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number;
(3) Source of the equipment, including the award number;
(4) Whether title vests in the Contractor or the federal yovernment.
(5) Acquisition (late(or(late received, if the equipment was furnished by the federal government) and
cost:
(6) Information from which one call calculate the percentage of federal participation in the cost of the equipment
(riot applicable to equipment furnislied by tire federal ooverrinicrit):
(7) Location and condition of the equipment and the(late the nif'Orn-ration was reporle(t
(8) Unit acquisition cost. and
(9) Ulilturrate disposition data, Including date ot'disposal and sales price or the method used to determine
current fair market value where a Contractor compensates the federal awarding agency for its share.
12
Contract Number KC 1471
34.4 Equipment purchased with federal funds with an acquisition Cost over $5,000.00 and equipment purchased
with state funds with an acquisition cost over S1,000,00 that Is specifically identified in the area plan approved by
the Department is part of' the cost of carrying out the activities and functions of" the gyrant awards and Title
(ownership) will vest its the Contractor, subject to the conditions of 2 CFR part 215 Administrative Requirements
(formerly OMB Circular A-1 10), Subpart C, paragraph 34. l-quiprrient purchased under these thresholds is
considered supplies and is not subject to property standards. Equipment purchased With Funds identified in the
budget attachments to agreements covered by any contract or agreement incorporating this Contract by reference,
or
identified ied in the sub-agreements with Subcontractors (not included in a cost methodology), is subject to the
conditions of section 273, F. S. and 60A-I M 17, F. A. C. or Title 4-5 CFR Part 74.
35.5 The Contractor shall not dispose of any equipment or materials provided by the Alliarrice, or purchased with
funds provided through <rny contract or agreement incorporating this Contract without first obtaining the approval
of the Contract Manager. When disposing of property or equipment the Contractor must submit a written request
for disposition instructions to the respective Contract Manager. The request Should include a brief description of
the property, purchase price, funding source, percentage of state or federal participation, acquisition date and
condition of the property. The request should also indicate the Contractors proposed disposition (i.e., transfer or
donation to another agency that administers federal programs, offer the items for sate, destroy the items, etc.).
35.6 The Contract Manager will issue disposition instructions. If disposition instructions are not received within
120 days of the written request for disposition, the Contractor is authorized to proceed as directed in 2 CFR Part
215 Administrative Requirements (formerly OMB Circular A-I 10).
35. 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 Provider or
political subdivision granting to the state a security interest in the property at least to the amount of state funds
provided for at least 5 years frorn the date of purchase or the completion of the improvements or as further
required by law.
36. Dispute Resolution
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce
the decision to writing and serve a copy on the Provider.
37. Financial Consequences of Non-Performance
If the Provider fails to rneet, 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.
37.1 'Fhe Provider will not be charged with financial consequences, when a failure to perform arises out of causes that
were the responsibility of the ;�lliance.
38. No Waiver of Sovereign Immunity
Nothing contained in this agreement is intended to serve as a waiver of sovereig ign immunity by any entity to which
sovereign immunity may be applicable.
39. Venue
If any dispute arises out of this contract, the venue ot'such legal recourse will be Miami-Dade County, Florida.
39. Entire Contract
This contract contains all the terms and conditions agreed upon by the Parties. No oral agreements or
representations shall be valid or binding upon the Alliance or the Provider unless expressly contained herein or by
13
Contract Number KC 1471
a written amendment to this contract signed by both Parties.
40. Force NIAeure
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control.
provided the party experiencing the force 111ajeLrre condition provides immediate written notification to the other
party and takes all reasonable efforts to cure the condition.
41. 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.
42. Condition Precedent to Contract:Appropriations
The Parties agree that the Alliance's performance and obligation to pay Linder this contract is contingent upon an
annual appropriation by the Legislature to the Department and a corresponding allocation under contract from the
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Department to the Alliance.
43. Addition/Deletion
The Parties agree that the Alliance reserves the right to add or to delete any of the set-vices 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.
44. 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 ter 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.
45. Compliance
The Provider shall abide by all applicable current federal statutes, laws, rules and regulations as well as applicable
current state statutes, laws, rules and regulations. The Parties agree that failure of the Provider to abide by these
laws shall be deemed an event of default of the Provider, and subject the contract to immediate, unilateral
cancellation of the contract at the discretion of the Alliance.
46. Final Invoice
The Provider 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 ArrACHMENT I. If the Provider fails to submit final request for
payment by the deadline, then all rights to payment may be forfeited and the Alliance may not honor any requests
submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld until
all reports due from the Provider and necessary adjustments thereto have been approved by the Alliance.
47. Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only when they have been reduced to
writing and duly signed by both parties. The rate of payment and the total dollar amount may be
adjusted retroactively to reflect price level increases and changes in the rate of payment when these have
been established through the appropriations process and subsequently identified in the Alliance's
operating budget.
48. Termination
48.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar days notice
in writing, to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be
delivered by U'.S. Postal Service or any expedited deliver-y, service that provides verification of delivery or by
hand delivery to the Contract Manager or the representative of the Provider responsible for administration of the
contract.
48.2 in the event funds for pavnicrit pursuant to this contract become unavailable, the Alliance alay terminate this
contract upon no less than twenty-four(24) hours notice in writing to the Provider. Said notice shall be delivered
by U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery
14
Contract. Number KC 1471
to the (7 ontract Ivianager or the representative of the Provider responsible for administration of'the contract. The
Alliance will be the final authority as to the availability and adequacy of funds. In the event of terminationof this
contract, the Provider will be compensated for any work satisfactorily completed prior to the date of termination.
48.3 This contract may be terminated for cause upon no less than twenty four (24) hours' notice in writing to the
Provider. Waiver of breach of any provisions of this contract shall not be deemed to be I waiver of any other
breach and shall not be construed to be a modification of the terms and conditions of this contract. The
provisions hcrein do not limit the Alliance's or the Provider's rights to remedies at law or In equity.
48.4 Failure to have performed any contractual obligations with the Alliance in a manner satisfactory to the Alliance
will be a Sufficient cause for termination. To be terminated as a Provider under this provision, the Provider must
have (1) previously failed to satisfactorily perform in a contract with the Alliance, been notified by the Alliance
Of'the Unsatisfactory performance , placed by the Alliance under a corrective action plan and failcd to correct the
Unsatisfactory performance to the satisfaction of the Alliance as outlined it) the Corrective action plan; or(2) had a
contract tenninated by the Alliance for cause.
48.5 Waiver of breach of any provisions of this contract shall riot be deemed to be a waiver of any other breach,and
shall not be construed to be a modification of the terms and conditions of this contract. The provisions herein do
not limit the Alliance's right to remedies at law or to damages of a legal or equitable nature.
48.6 Suspension of Work:
If the Department of Elder Affairs deten-nines in its sole discretion suspend any or all activities under this
Contract and any Contract or agreement incorporating this Contract by reference, at any time, when in the best
interests of the State to do so, the Alliance will suspend the contractor's work. As the Department provides the
Alliance with written notice outlining the particulars of suspension, these reasons will be communicated to the
contractor by the Alliance. Examples of the reason for suspension include, but are not limited to, budgetary
constraints, declaration ot'emergency, or other such circumstances. After receiving a suspension notice, the
Contractor shall comply with (fie notice and shall not accept any purchase orders. Within ninety days, or any
longer period agreed to by the Contractor, the Alliance shall either(I) 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.
49. Successors
This contract shall remain binding upon the successors in interest of either the Alliance or the provider.
50 Electronic Records and Signature
The AAA authorizes, but does not require, the Contractor to create and retain electronic records and to
use electronic signatures to conduct transactions necessary to carry out the terms of this Contract. A
contractor that creates and retains electronic records and uses electronic signatures to conduct transactions
shall comply with the requirements contained in the Uiq'lbrin Electronic Ti-anstiction ,let, s. 668.50, Fla.
Stat. All electronic records must be fully auditable; are sub21ect to [�Iori(la'S Puhlic Records Luw, ch. 119.
Fla, Stat.-, must comply with section 28. Data Integrity and&i ' u(irding h!tbrine�aion, must maintain all
confidentiality, as applicable: and must be retained and maintained by the Contractor to the same extent
as non-electronic records are retained and maintained as required by this Contract.
50.1 The AAA's authorization pursuant to this section does not authorize electronic transactions between the
Contractor and the AAA. The Contractor is authorized to conduct electronic transactions with the
AAA only upon further written consent by the AAA.
50.2 Upon request by the AAA, the Contractor shall provide the AAA or DOEA with, non-electronic (paper)
copies of records. Non-electronic (paper) copies provided to the AAA of any document that was
originally in electronic tbrni with an electronic signature must indicate the person and the person's
capacity who electronically signed the document oil any non-electronic copy of the document.
51 Special Provisions
15
Contract Number b',C 1471
The Contractor agrees to the l'ollowing provisions:
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51.1 Invcstiulation of Criminal. Allegations:
Any report that implies criminal intent on the part of the Contractor or any Subcontractors and referred to
,a L, Alliance. the Contractor has reason to
governmental or investigatory agency must be sent to the Alli,nce. I
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 Subcontractors, must be sent to the Alliance's contract manager with a
summary of the investigation and allegations.
51.2 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
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in coordination with organizations that have experience in providing training, placement, and stipends for
volunteers or participants (such as organizations carrying out federal service programs administered by
the Corporation for National and Community Service), in community service settings.
51.3 Enforcement:
51.3.1 In accordance with Section 430.04, F.S., the Alliance may, without taking any intermediate
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measures available to it against the Conti-actor, rescind the Contractors designation as all area agency on
aging, if the Alliance finds that:
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51.3.2 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 anycontract
or agreement,
51.3.3 The Contractor lacks financial stability sufficient to meet contractual obligations or that
contractual funds have been misappropriated;
51.3.4 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
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has committed or repeated violations of Alliance standards;
51.3.5 The Contractor has failed to continue the provision or expansion of services after the declaration
of state of emergency-, and/for
1
51.3.6 The Contractor has failed to adhere to the terms of any contract or agreement incorporating this
Contract by reference.
51.3.7 In the alternative, the Alliance may, at its sole discretion, in accordance with section 430.04,
F.S., 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 pursuant to
Chapter 120. F.S.
513.8 In making any determination Under this provision the Alliance may rely upon the findings of
,mother state or federal agency, or other regulatory body. Any claims for damages for breach of
16
Contract Number KC 1471
ariv, contract or a(-1reenient incorporating this Contract by rel'crence are exempt from
administratke proceedin,,s and Shall be br()U('ht before the appropriate entity ill the VeliLle ()I*
Miami-Dade COLIIIIN
51. Official ll)avee and Representatives (Names. Addre,-,ses. and Telephone Numbers):
The name, address. and telephone number of the representative for the Alliance for this contract is:
I lax B. Rothman, JD, LL
Presi(lew wnl CEO
760 NW` 107t" Ave, Suite 214
Miami. Florida 33172
(305) 670-6500, Ext. 224
The name, address., and telephone number of the representative of the provider responsible for administration of
the program under this contract is:
The Contractor name, as shown on page I of this Monroe County Social Services
a. contract, and mailing address of the official payee to 1100 Simonton Street, Suite 2-257
whom the payment shall be made is: Key West, Florida 33040
The name of the contact person and street address Kim W. Wean,Compliance Manager
b. where financial and administrative records are 1100 Simonton Street, Suite 190
maintained is: Key West, Florida 33040
C The name, address, and telephone number of the Sheryl Graham, Sr, Director. Social Services
representative of the Contractor responsible for 1100 Simonton Street, Suite 2-257
administration of the program under this contract is: Key West, Florida 33040
D The section and location within the AAA where Associate Vice President Finance
iture 760 NW 107th Avenue, Suite214
Requests for Payment and Receipt and Expenditure Miami, Florida 33172-3 155
forms are to be mailed is:
Contract Mana-er
L Alliance for Aginz' Inc,name, address. and telephone number of the g�
760 NW 107th Avenue. Suite 2 144
Contract Maria-er for the AAA for this contract is:
Miami, Florida 33 172-3 155
I,Jpon change of representatives (names, addresses. telephone numbers) by either part\,, notice shall be pro\lded ill
I-ItIni-, to the other party and the notification attached to the orioin.,-ils of this contract.
.......... -------- ......... ..........
In the event different representatives are designated by either 1XII-I\ after execution Ofthis contract, notice. of'the name and
address of the nee\ representative will be rendered in writing to the other party and said notification attached to originals
of,this contract,
17
Contract Number KC 1471
51. All Terms and Conditions Included
I ills contract and its Attachments. I throw1h X. A. 13. C, D. E, and art% exhihits referenced in said anachmcnt>
together cy itlr arry d0CLlments irrcorporated by reference. contain all the terr7ls and canditions agreed upon by till
Parties. There are: rto prat isions, terms. conditions. or ohhgations other- than these contained herein. and this contra
shall supersede all preEiou.s C0111111 till icatiorrs. representations or agreements, either \�ritten or \erhal hemeen th,
Parties.
B siy�nirtg this contract, the Parties agree, that the` have read and agree to the entire contract.
IN WI I NI;SS I'HE EOI , the Parties hereto have caused this; 13 page contract, to he executed h\ their trndc:rsianed officials a
dul%' aUthorixed.
Contractor Monroe County Board of
Commissioners. ALLIANCE FORAGING, INC,.
"� �--�°"" SIGNED I3Y:
SIGNED BY . X
NAME: ROMAN GASTESI NAME: MAX B. ROTHMAN,JD, L.L,.M.
TITLE: C"OIJNI-Y ADMINISTRATOR TITLE: PRESIDENT AND CEO
DA'I"1: : 6 DATE;
e
cJ
d .
18
('011trac;t NUInbcr KC 147 1
INDEX TO ATTACHMENTS
Attachment I SERVICE PROVISIONS COMMUNITY CARE FOR THE ELDERLY
Attachment 11 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS,GRANTS,
LOANS AND AGREEMENTS
Attachment III FINANCIAL AND COMPLIANCE AUDIT
Attachment IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS,
GRANTS, LOANS AND COOPERATIVE AGREEMENTS
Attachment V CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
Attachment VI ASSURANCES NON CONSTRUCTION PROGRAMS
Attachment VII BUDGET SUMMARY
Attachment VIII INVOICE CONTRACT REPORT SCHEDULE
Attachment IX REQUEST FOR PAYMENT FORM
Attachment X RECEIPT AND EXPENDITURE REPORT
Attachment A DOEA HANDBOOK
Attachment B CIVIL RIGHTS COMPLIANCE CHECKLIST
Attachment C REFERRAL PROTOCOL AGING AND DISABILITY RESOURCE CENTER(ADRC)—
OUTSOURCED FUNCTIONS
Attachment D DOEA COMPUTER USE POLICY
Attachment E BUSINESS ASSOCIATE AGREEMENT
Attachment F E-VERIFY
Attachment G BACKGORUND SCREENING AFFIDAVIT OF COMPLIANCE
Attachment H CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
I()
Contract N'Uniher KC 1471
ATTACHMENT I
CO3MMUNITY CARE FOR THE ELDER,LY PROGRAM
SECTION I. SERVICES TO BE PROVIDED
1. Scope of Service and Eii<.Yil)le Individuals
1.1 The services to be provided are those dcscribcd in the provider's service provider application Submitted III
response to the 2011 CCE Lead Agency application arid as described in this contract.
1.2 The provider*s service provider application submitted in response to the 2011 CCE Lead Agency IZI',P, as well
as the ItFP itself is incorporated by reference in this contract between the Alliance and the provider and made a
part of this contract.
1.3 Individual Eligibility
In order to receive services under this contract, all applicant must:
(I) Be at least 60 years of age;
(2) Be functionally impaired as determined through the initial comprehensive assessment; and
(3) With the exception of APS high-risk referrals, consumers may not be dually enrolled in the CCE
program and a Medicaid capitated long-term care program.
(4) Eligible applicants must be screened, prioritized and referred to the provider by the Aging Resource
Center prior to enrollment.
SECTION 11. MANNER OF SERVICE PROVISION
2.0 Conditions
2.1 All services under this contract will be provided in a manner consistent with the conditions set forth in the
2012 Florida Department of Elder Affairs Programs and Services Handbook or any subsequent
revisions made to the Handbook and the provider's service provider application submitted in response to
the 2011 CCE Lead Agency RFP (SPA). In case of conflict between the SPA and the Handbook, the
handbook prevails.
2.1.1 Client access to services, assessment and eligibility determination must conform to the protocols listed in
ATTACHME,'NT C.
2.1.2 The provider will offer services based on clients' service plans,
2.2 Service Tasks
12.1 Delivery of Service to Eligible Clients
The provider shall provide a continuum of services that meets the diverse needs of functionally impaired elders.
The provider shall perform and report perforniance of the following services in accordance with the current
DOFIA ProL),rarns and Services I landbook. The services include the followill"categories:
(1) Core Seri ices;
(2) Health Maintenance Services; and
(3) Other Support Services.
1.11.1 Core Services
Core Set-,ices include a variety ot' home-delivered ;crvices, day care services, and other basic ser\ices that
�Ire most needed to Prevent unnecessary institutionalization. Core services Include the 1`01lowilIU:
(1) Adult Care: (3) Companionship:
0
Contra(J Number KC 1471
(2) (,'Ii(.)re Services. (4) Escort:
(5) Financial Risk Reduction: (10) Pest Control Services;
(6) Home Delivered :deals; (I I) Respite Services;.
(I') Shopping and
(7) Homemaker; 13) Transportation
(8) Housing Improvement,
(9) Le(—Tal Assistance:
2.11.2 Health Maintenance Services
Health Maintenance Services are routine health services that are necessary to help maintain the health of
functionally impaired elders. The services are limited to medical therapeutic services, nori-medical
prevention servicLs, personal care services, home health aide services, home nursing services, and emergency
response systems. Typical services provided are the following:
I
(1) Adult Day Health Care, (8) Health Support,
(2) Emergency Alert Response, (9) [Ionic Health Aide;
(3) (jeronto logical Counseling; (10) Medication Management;
(4) Mental Health Counseling/Screening; (11) Physical Therapy
(5) Nutrition Counseling; (12) Skilled Nursing Services;
(6) Occupational Therapy; (13) Specialized Medical Equipment, Services
(7) Personal Care; and Supplies; and
(14) Speech Therapy.
2.2.1.3 Other Support Services
Support Services expand the continuum of care options to assist functionally impaired elders and their
caregivers. Support services include the following:
(1) Carcgiver'fraining/Support;
(2) Case Aid,
(3) Case Managenient',
(4) Intake,
(5) Material Aid, and
(6) Other.
2.2.2 Referrals for Medicaid Waiver Services
The provider shall identify potential Medicaid eligible CCE clients and refer these individuals for application
for Medicaid Waiver sery ices.
(1) Individuals who have been identified as being, potentially Medicaid Waiver eligible are required to appl",
I'or Medicaid Waiver services in order to receive CC F services and can only receive CE services while
the Medicaid Waiver eligibility determination is pending. If the client is found incligible fir Medicaid
\Vai%er services for any reason other than failure to provide I-C(IL11red documentation. then the indik'WLI 11
111,1% continue to rccelve ( ( I'. ices.
(2) III(IINKILMIS %kho have been Idelini-led as being potentially Medicaid Walker eligible must he advised (')I'
ilic responsibility to apply t'Or Medicaid Waiver scrkIccs as 3 Condition ofrecel%ing, (VF ervlces while
dic cll'�.ilbllity determination is bcin.g, processed.
-) I
Contract NUrriber KC 1471
2.3 SERVICE TENIES AND LOCATION
2.3.1 Service 'll'inies
The Provider shall ellSUre the pro%islon of the services, listed in tills c0liti"'Ict are available at times appropriate
to meet client service needs at a 1111111111uni, durill- normal 11LIS111CSS 1101.11-S, N01111al I)LISHICSS hours aH-CdCfir)Cd
as %loridav tlirouuh Friday. S:()(),iin to 5:00pni,
2.4 EQUIPM E-N-Y
2.4.1 I-_.
qUipinerit means: (a) an article of nonexpenclable, tangible personal property having a useful life of more than
one year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the
organization for the financial statement purposes, or S5,000.00 [for federal funds], or (b) nonexpendable,
tangible personal property of a nonconsumable nature with an acquisition cost of S 1,000.00 or more per unit,
and expected useful life of at least one year; and hardback bound books not circulated to students or the t-,encral
public, With a Value or cost of S250.00 or more [for state funds],
2.4.2 Providers and subcontractors who are Institutions of Higher Education, Hospitals, and Other Non-Profit
Organizations shall have written property management standards in compliance with 2 CPR Part 215
Administrative Requirements (formerly OMB Circular A-110) that include: (a) a property list with all the
elements identified in the circular; (b) a procedure for conducting a physical inventory of equipment at least once
every two years; (c) a control system to insure adequate safeguards to prevent loss, damage, or theft of the
equipment; and (d) maintenance procedures to keep the equipment in good condition. The property records must
be maintained on the and shall be provided to the Alliance upon request. Any loss, damage, or theft of
equipment shall be investigated and fully documented and the Provider shall promptly notify the Contract
Manager.
Z:�
2.4.2.1 'rhc Provider's property management standards for equipment acquired with federal funds and
federally owned equipment shall include accurately maintained equipment records with the following
information:
(1) A description of the equipment;
(2) Manufacturer's serial number, model number, federal stock number, national stock number, or other
identification number,
(3) Source of the equipment, including the award number.
(4) Whether title vests in the Provider or the federal government;
(5) Acquisition date (or date received, if the equipment was furnished by the federal government) and
Cost;
(6) information from which one can calculate the percentage of federal participation in the cost of' the
equipment (not applicable to equipment f'umished by the federal government),
(7) 1,ocation and condition of the equipment and the date the information was reported,
(8) Unit acquisition cost; and
(9) Ultimate disposition data, including (late of disposal and sales price or the method used to determine
current fair market Value where a Provider compensates the federal awarding agency for its share.
1.4.3 1~,q1,lipinCllt PLII-ChdSCd With federal funds With t111 ZICCILliSition cost over S5.000,00 and CCILUIN11CIlt Purchased
�%Itll state funds with all acquisition cost over S1,000.00 that is specifically identified in the ,,irea plan is part of'
the COSt of car2yldfu out the activities find functions of the grant awards and title (owIlerslllp) %\III %est in the
Pro%lder. subject to the conditions of 2 CTR I'Lirt 215 Adirlinist241tive RC(IUII-CI1ICIltS (t0l-IlleF1V ()MB Circular
A-I 10), Subpart C. paragraph 34. F(II-III)MCIlt pLIl-CIWScd under these thresholds is con SideNd and IS
not subject to property standards. Lquiplilent purchased with funds ideiallied In the hUdl-let attaChlllclltS tO
�iurcerncuts covered by this contract, or idCutitled in the Alb-agrecincritS With S'UhColltraCtOrS (not HICILIdCd in it
cost 111cillodolo'.!v), is subject to the conditions of section 273. F. S. and 60A-1.0017, 1'. A. C. or Title 4 CFR
Contract Number KC:' 1471
2.4.4 The Pro%ider shall not diSposc of a ay ecltaiprlrcIit or materials provided by the Alliance or purchased with funds
provided through this contract without first obttrining the approval of the Contract Manager. When disposin,.�
of property or equipment the Provider must submit rt dvrittc;rr recTuest for disposition instructions to the Contract
'\lan"w'er The request ;hOUld include a brief description of the property, I'nrrchase price.. funding Source,
percentage of state or federal participation, acquisition date and condition of'the property. The request should
also indicate the Provider's proposed disposition (e.g. transfer or donation to another agency that tadrninisters
federal pros-rains, offer the items for sale, destroy the items).
2.4.4.1 The Contract Manager will issue disposition instructions. If disposition instructions are not received within
120 days of'the written request for disposition, the Provider is authorized to proceed as directed in 2 C FR Part
215 Administrative Requirements (formerly OMB Circular A-1 10).
Any permanent storage devices (e.g. hard drives, removable storage media) must be refonnatted and tested
2.4.4.2 prior to disposal to ensure no confidential information remains.
2.4.4.3 The Provider must adhere to the Department of FIder Affairs procedures and standards when purchasing
Information Technology Resources (ITR) as part of any agreement(s) incorporating this contract by reference.
An ITR worksheet is required for any computer related item costing $1,000.00 or more, including data
processing hardware, software, services, supplies, maintenance, training, personnel and facilities. 'The
completed FI'R worksheet shall be maintained in the LAN administrator's file and must be provided to the
Department upon request. "I'lie Provider has the responsibility to require any subcontractors to comply with the
Department's ITR procedures.
2.5 REPORTS
2.5.1 The Provider shall respond to additional routine and/or special requests for information and reports required by
the Alliance in a timely manner as determined by the Contract Manager. The Provider shall establish due
dates for any subcontractors that permits the Provider to meet the Alliance's reporting requirements.
2.5.2 Client Information and Registration Tracking System (CIRTS) Reports
The Provider shall input CCh specific data into CIRTS to ensure CIRTS data accuracy
2.5.3 Service Costs Reports
The Provider shall submit to the Alliance annual service cost reports, which reflect actual costs of providing
each service by program. This report provides information for planning and negotiating Emit rates.
2.5.4 Surplus/Deficit Report
The Provider will submit a consolidated surplusldeticit report in a format provided by the Alliance to the
Contract Manager by the 15"' of each month. This report is for all agreements and/or contracts between tine
Provider and the Alliance. The report will include the hallowing:
(1) Current status regarding surplus or deficit:
("2) The Provider's detailed plan on how the surplus or deficit spending exceeding a two percent threshold
will be resolved;
(3) Recommendations to transfer funds to resolve surplu, deficit spending;
(4) Input froin the Provider's Board of Directors on resolution of spending issues. if applicable;
2.5.5 The provider can reallocate funding among services. as needed based on clients' needs.
2.5.6 File Alliance reserves the ri,glit to adjust the total a\t,Ird as well as the contracted unit rate to reflect prod ider
Co is and wiiiz rtloll rates based on active (lhcnts enrolled in the pri .*rani.
2.5.7 The Alliance may withhold payment under the tennis of this contract, pending the receipt and tipproyal by the
\]haiace of comptete and accurate financial and pro,ar<aminatic reports due from the provider and any
adjuStmcnts thereto. including any disallowarace not resolved.
Contract NUrnber KC 1.471
2.5.8 l lie provider- shalt provide the Alliance with arl expeluiittire plan by July 15 OI'two weeks after this contract
11aS been si`(tied; a inorrtlrly update is drie on the 21 day of each koIlowing month, l`lic expenditure plan and
updates must follow the format provided by the Alliance..
2.5.9 The provider shall respond to surplus deticit inquiries and ti�ill provide ad-hoc reports as requested by the
\lllance .
2.5.10 Surplus Recapture.
In accordance with its surplus'deficit management policies, in order to maximize available funding and mininnirc
the time that potential clients inust wait far services, the AAA in its sole discretion can reduce fundin4g awards itthe
Contractor is not spending according to monthly plans and is projected to incur a surplus at the end of the year.
2.6 ELECTRONIC RECORDS AND DOCUMENTATION
The provider 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 systerns according to Alliance and Department standards.
2.6.1 Timely Data Entry
The provider must enter all required 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 provider submits its request
for payment and expenditure reports to the Alliance. The Alliance shall establish time frames to assure
compliance with due dates for the requests for payment and expenditure reports to the Department.
2.6.2 Data .Accuracy
The provider 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 provider's request for payment and expenditure reports can be
approved by the Alliance.
2.6.3 Failure to Maintain CIRTS Database
Failure to ensure the collection and maintenance of the CIRTS data may result in the Alliance enacting the
` Enforcen-ient" clause of this agreement (see 2.5.2), including delaying or withholding payment until the
problem is corrected.
2.6.4 Computer System Backup and Recovery
Each provider, among other requirements, must anticipate and prepare for the loss of information processing
capabilities. The routine backing up of data and software is required to recover from losses or outages of the
computer system. Data and software essential to the continued operation of provider functions must be
backed up. The security controls over the backup resources shall be as stringent as the protection required of
the primary resources. It is recommended that a copy of the backed up data be stored in a secure, offsite
location. The provider shall maintain written policies and procedures for computer backup and recovery.
"These policies and procedures shall be made available to the Alliance upon request.
2.7.1 Outcomes
(1) the Provider shall timely submit to the Alliance all reports described in ATTACHMENT I, SEC7I'10N
2.5 REPORTS-,
(2) The Pro%ides shall timely submit to the Alliance t�rll information described in .ATTACIUMENT 1,
SEC"HON 2.6 RECORDS :AND DOCUMENTATION:
(3) 1 lie Prov ides shall ensure services in this contract arc in accordaIICe ��ith the current DOF'A Programs and
`services Ilandbook.
2.7.2 1lie pt'rfOrmance tit the Provider In providing the ser%Ices described In this contract shall be Measured l)v the
current Arca Plan strategies for the 161lowin,-, criteria:
24
Contract N'Llllll)Cl' KC 147 1
I) Percent of most frill elders who rcnialn nt home or in the community instead of going Into a nursing.;
horllc:
(2) Percent of .-\PS referrals \k ho are in need of' immediate services to present further harin who are served
within 72 hours:
(3) Average monthly savings per consumer for lionie and C011111111111ty-bascd care VCrSUS nursing home care
for comparable g1-01AP Clients:
(4) Percent of elders assessed with high or moderate risk environments who improved their environment
score:
-5) Percent of new service recipients with high-risk nutrition scores whose nutritional status improved,
(6) Percent ot'new service recipients whose ADL assessment score has been maintained or improved:
(7) percent of new service recipients whose IADL assessment score has been maintained or improved,
(8) percent of family and family-assisted caregivers who self-report they are likely to provide care:
(9) percent of caregivers whose ability to provide care is maintained or improved after one year of service
4-- 1
intervention (as determined by the caregiver arid the assessor);
(10) Average time in the CCE Program for Medicaid Waiver probable customers; and
(11) Percent Of Customers who are at imminent risk of mll-Sing home placement who are served with
community based services.
2.8. Compliance and Enforcement
2.8.1 The provider shall comply with all the terms and conditions set-forth in this contract, the CCE RFP pursuant to
which this contract was awarded, the Service Provider Application and the 2012 Department of Elder Affairs
Programs and Services Handbook. The provider is also responsible to respond to any fiscal or programmatic
monitoring iterns/issues within the timetrarne stipulated by the Alliance. Monitoring Items/Issues may include
Corrective Actions, Reportable Conditions or Quality Improvement Recommendations provided by the
Alliance. The provider 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.
2.8.2 Enforcement:
'File Alliance may take intermediate measures against the provider, including: corrective action, unannounced
special monitoring, temporary assumption of the operation of one or more programs. placement of the provider
probationary status, imposing a moratorium on provider action, imposing financial penalties for
nonperformance, or other appropriate action if the Alliance finds that:
• all intentional or negligent act of the provider has materially affected the health, welfare, or safety of
clients served pursuant to this contract, or substantially and negatively affected the operation of
services covered under this contract.
• the provider lacks financial stability sufficient to meet contractual obligations or that contractual
funds have been misappropriated.
• the provider has committed multiple or repeated violations of legaland re(-,ulatoi-v standards,
rcuarcitess of the criforccruent of'such laws or regulations.
• the provider has tailed to COWHILIC the. provision or expansion ot'services after the declaration ot'a
sate of elliel uencv.
• the provider has 1",lilcd to ,idhcre to the terms of'this corttrict-
• the provider consistently misses perfonl1,anCC nleaSLH'e t<H'�ZetS. Or(JOCS not dCn10r1Str,'1tC to tile
I -1c Allia -p1US dCfiCit problem is beiii1g, addressed in order
satisfaction of,0 rice that a prouram budget surplus
to avoid closim-, out the contract \,C.lr with a hUdILM %ZIMUICe 01'11101-e than two percent.
('ojltract N`uiiiher KC 1471
hi makitig, any detcrill",iti0ii Linder this provision the \Hlance inay rely upon tile j*ijld1jj,,; of another ;rate or
federal a'-'ency, or other reutilatory body.
SECTION Ill. METHOD OF MYMENT
3.1 General Statement of Method of Payment
The inethod or payment in this contract is based on a fixed unit rate for approved services. The provider must
ensure fixed unit rates Include only those costs kN hich are in accordance with all applicable state and federal
Statutes and 1-COUlatiOnS arid are based oil audited historical costs 'it instances where art independent audit is
required. All requests for payment and expenditure reports submitted to support requests for payment shall be
oil Department forms 106C and 105C, included as ATTACHMENTS IN and X. Duplication or replication of
both forms via data processing equipment is permissible, provided all data elements are in the same format as
included oil department forms.
3.1.1 provider invoices shall be Submitted, no later than 60 days after the end of the month on which the expense was
incurred, except that in\o1ces cannot be subt-ni tted beyond the date for final ittvcticing, as stated in this contract.
Invoices Submitted late will not paid. 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. Ili making a
deterrinnation of the exception the Alliance will consider whether the disruption to the billing cycle was beyond
the control of the provider, the frequency with which such exceptions are requested by the provider, and
whether the Alliance can request reimbursement at a late date from DOEA. Exceptions for invoicing late after
the closeout date will not be made.
3.2 Advance Payments
Non-profit providers may request a monthly advance for service costs for each of the first two trioriths of the
contract period, based oil 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
tile. 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 Vill to this contract. Reconciliation and recouping of advances made
tinder 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 provider in an insured interest bearing account. All interest
carried 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.
3.4 Final Request for Payment:
3.4.1 'File provider must Submit the tinal request for payment to the Alliance no later than July 17, 2014, if the
provider fails to do so. all right to payment is forfeited. and the Alliance will not horror any requests submitted
after the aforesaid time period. 30, '1014, then the provider must submit the
3.4.2 if the contract is terminated prior to the contract end date of.furne -
t'inal, request for payrnent to the Alliance no more than 45 clays at-'ter the contract is terminated, but no later than
,July 15, 2014. If the provider fails to (to 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
flue Contractor will maintain documentation to support payment requests that shall be available to tile
[)cpartnient Set-,ices, upon request.
3.5.1 I'lie Contractor MUSt 1*C(jL1i1'C ',UbColltnictors to cater all required data per the Departille"t's CHU'S P011cV
Git'delines for clients and scr%ices it, the ('IRTS datahase. HIC (1,1ta 111LISt be entered into the CIR I'S before the
subcontractors sLibinit their rcqLicst for tune fr�irneS tO assure compliance
inerti and expenditure reports to tile (:o)jltractor. I lie Contractor
shall
I c-c with due dates f0r the requests for payment and cxpc1ldl'tU1_e reports
to the I)Cpartirlcrlt.
Contract Number KC 1471
3.5.2 'I lie Contractor mast require subcomractors tc> run monthly C IR I'S reports and verify client and service data in
the C:'IR'I S is accurate. This report must be submitted to the Contractor with the monthly request for payment
and expenditure report and 1I1ust be reviewed by the Contractor before the subcotitractor"s request for payi7�c nt
and expenditure reports can be appro%ed by the Contractor.
3.6 Level of Effort, Co-pay and Cost Sharing
3.6.1 hatching, Level of Effort, and Earmarking Requirement
I.he provider will assure a match requirement of at least 10 percent of the cost for all CCE, services. The
match will be made in the form of"cash and/or iti-kind resources. At the end of the contract period, all C:'CE,
funds expended must be properly matched. State funds cannot be used to match another state-funded
program.
3.6.2 Cost Sharing and Co-payments
"The provider in conjunction with the.Nlliance shall establish an annual co-payment goal (amount to be
collected from clients). Using the method prescribed in the 2012 Department of Elder,affairs Program and
Services Handbook, the provider 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. i"he provider is required to meet at least 90 percent
of the goal Co-payments collected in the CCF program can be used as part of the local match.
The Alliance For Aging Inc. will hold back 5% of the provider's contract amount. The amount held back
shall be released to the provider 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 providers as of February 15th will be reallocated to
other providers meeting or exceeding 50%of their annual goal, except when no provider agency is meeting
or exceeding its annual goal, or when an agency that is meeting or exceeding such goal affirnis that it lacks
the capacity to receive additional funds.
3.6.3 This contract is for services provided beginning July 1, 2013 through June 30, 2014. However, the parties
recognize that they will need to perform continued activities relating to reporting, invoicing and payment in.
July of 2014 to facilitate payment for services rendered by the provider under this contract tln"ough and
including the contract expiration date of July 15. 2014. Services provided after.Tune 30, 2014 will not be
reimbursed under this contract.
SECTION IV Invoicing and Additional Reporting Requirements
4.1 If the Alliance has sanctioned the provider, while the sanctions are in effect, at the request of the Alliance,
the provider shall provide, on a monthly basis, the provider's financial statements that reflect the current, un-
audited revenues and the provider's cash position as well as any other financial and/or programmatic
documentation that may be requested by the(alliance.
4.2 If the provider is required to prepare a corrective action plan or respond to a Fiscal and/or Prourammatic
Nlonnoring finding, supporting documentation as requested by the Alliance shall be provided within the time
frame stipulated by the Alliance.
17
Contract Number K(- 1471
,kTT/kC1 INI E N TUD
CERTIFICATION REGARDING LOBBYING
CERTIFICATDON FOR CONTRACTS, GRANTS, LOANS AND
AGREEMENTS
'I'lle Lilldcrsigned ccrt1fie.,,, to the best offils or hcr knoMedge and belief, that:
(|) No federal appropriated funds have been paid or xU| be paid, by or on behalf ofthe undersigncd, to un% person for
inOuencingoruttempiingtoinUucnzeunoD5ccrorcmp|oyceo[unyutnxcurtedenz| ugcncy. umcmbcrofcononcss` an
officer or employee of congress. an emp|ovec of member *fcononrss, or an officer or employee of s|u[c
legislator, in connection with the unardingofany federal grant. the making ofany f�dcra| loan. !h� en|cring into of
any cooperative agreement. and the extension, conbnuuhon, renewal, amendment, or modification o[ onv federal
contract. orunt, loan, or cooperative agreement.
{2) If any funds other than federal appropriated funds have been paid orwill be paid tounyperson for inUocnuin001'
attempting to influence an officer or employee of any agency, a member of congress, an officer or employee o[
congress, or ail employee of a rnernber of congress in connection with this f'ederal contract. grant. loan, 01,cooperative
agreement, the undersigned shall complete and submit Standard Form-l-LL, "0isc|waumc Form to Report Lobbying,"
in accordance m/i(hits ina1ruodono.
(3) The undersigned sbu|| oc4uinc that the language of this certification be included in the award documents for all Sub-
awards utall hcm (inu|uding subcontracts, sub-grants, and contracts under grants, loans and oonpcm1ivc agreements)
and that all Subcontractors obu|| certify and disclose accordingly.
This certification is u material representation affbct upon which reliance was placed when this transaction wae made
or entered into. Submission of this certification ieuprerequisite for mukingmrentering into this transaction imposed
by section |]52, Title 3|` Q.S. Code. Any person who fails to file the required certification shall heou6icc(ooucivil
penalty of not less than $10,000 and not more than $100,000 for each Such failure.
-
Signature gD 4a
Name ufAuthorized Individual Application or Agreement Number ----
MONROE COUNTY BOCC-I 100 SIMONTON STREET, SUITE 190 KE'Y WIEST. FLORIDA 33040
Name and Address of Organization
|>nL\ Form |0}
(Kmiudunv2,O02>
Z8
Contract NUMlicr K(.-" 1471
ATTACHMENT III
FINANCIAL AND COMPLIANCE AUDIT
The administration Of I-CSOUrces awarded by the Alliance for A(nnll, Inc. to the provider 111,1V be subject to audits and,or
inonijorlm-, by the Alliance or the Florida Department of Elder Affairs, as described in this section.
MONITORING
In addition to reviews ofaudits conducted in accordance with OMB Circular A-I 33, as revised, and Section 215.97, I-',S.,
(see ALJDI'FS helo\v), monitoring procedures may Include, but not be limited to, on-site visits by the Department of
staff, limited scope audits as defined by OMB Circular A-133. as revised, an&'or other procedures. By entering into this
a-reement, the provider agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by
the Alliance or the Department of Elder Affairs. In the event the Alliance for Aging, [tic. determines that a limited scope
audit of the provider is appropriate, the provider agrees to comply with any, additional instructions provided by the
Alliance for Aging, Inc. to the provider regarding Such audit. The provider further agrees to comply and cooperate xvith
any inspections, reviews, investigations, or audits deemed necessary by the Chief Financial Officer (CFO) or Auditor
General.
AUDITS
PART 1: FEDERAL LN FUNDED
This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB
Circular A-133, as revised.
In the event that the provider expends $500,000 or more in federal awards during its fiscal year, the provider 111LISt have a
singl
e or program-specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised.
EXHIBIT I 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 provider 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 provider conducted by the Auditor General in accordance with the provisions
of(,.',)MB Circular A-133, as revised, will meet the requirements of this part.
In connection with the audit requirements addressed in Part 1, parag.r aph 1, the provider shall fulfill the requirements
relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised.
if the provider expends less than 5500,000 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 provider expends less than S500,000
in federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of ONII3
Circular A-I 33, as revised, the cost of the audit must be paid from non-federal resources (i.e., the cost of such audit must
be paid frorn provider resources obtained from other than federal entities.)
,\]I audit COTRILICted in accordance with this part shall cover the entire organization for the organization's fiscal -,,,car.
Compliance findings related to agreements with the Alliance for Aging, Inc. shall be based on the agreement's
requirements, including any rules. regulations, or statutes referenced in the agreement. fhe financial statements shall
disclose whether or not the matching requirement was met lor each applicable a,,zrcernent. All questioned costs and
liabilities due to the Alliance for Acing, Inc. shall be fully disclosed in the audit report with reference to the Alliance f'or
,\,_,Inu, Inc. aurcernent In%ok cd. It not otherwise disclosed as required by Section 31()(h)( of O%lB Circular A-I 33. as
1-c\ISC(i, the SCIM11,11C Of eXj_)cnditLII`e,, of Icderal akkardS shall idelltit' CXpC1IditLIres by agreement number for each
aLN-cement with the Alliance for hic. in effect during the audit period. Financial reporting packagcs rcClUired L111dCr
this [)art must be milinilited within the earlier of 30 days after rcccipt of the audit report or 9 months after the end of,the
prov lder*s fiscal .%,car end.
C0l1trt et Number KC 1471
XRT 11: S"I'.1,`I'I FIJN1)ED
Ellis part is applicable if tllc provider is t2 Ilk)nslate entity as (fetined by Section 215.97/(2). Florida Statutes.
In the C%,Crlt that the pro%'r(ler expends a total amount of state trrlaticlal ISsIStaIlCe equal t0 or ill excess of ` 500,000 ill any
fiscal year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider I11U5t Have a State
single or project-specific audit for such fiscal year in accordance with Section 215,97. Florida Statutes: applicable rules ol`
for-
the Department c:f` I inarlciai services; and (v'haptcrs 10,550 (local t�,overinnental entities) or 10,650 (nonprotit and for-
profit organizations).. Rules of` the .'auditor General. EXHIBIT to this agreement indicates state financial assistance
awarded 1.throupll the .'\lliance for Aging, Inc. by this agreement. In determining the state financial assistance expended ill
its fiscal year, the provider shall consider all sources of state financial assistance, including state financial assistance
received from,the Alliance for Aging, Inc... other state agencies, and other noristate entities. State financial assistance does
not include fedleral direct or pass-through awards and resources received by a nonstate entity for federal program matching,
requirements.
In connection with the audit requirements addressed in fart 11, paragraph 1, the provider shall ensure that the audit
complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting
package as defined by Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650
(nonprofit and for-profit organizations), Rules of the Auditor General.
If the provider expends less than .$500,000 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 riot
required. In the event that the provider expends less than $500,000 in state financial assistance in its fiscal year and elects
to have all audit conducted ill accordance with the provisions of Section 215.97, Florida Statutes, the cost of`tire audit
must be paid frorn the ndlnstate entity's resources (i.e., the cost of such an audit must be paid from the provider resources
obtained from other than State entities).
Ali audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Alliance for Aging, Inc. shall be based on the agreement's
requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or
not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the
Alliance for Aging, Inc. shall be fully disclosed in the audit report with reference to the Alliance for Aging, Inc.
agreement involved. If not otherwise disclosed as required by Rule 691-5.003, Fla. Admin. Code, the schedule of
expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the
Alliance for Aging, Inc. in effect during the audit period. Financial reporting packages required udder this part must be
submitted within 45 days after delivery of the audit report, but no later than 12 months after the provider'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 1`10 later than 9 months after the provider's fiscal year end. Notwithstanding the
applicability of this portion, the Alliance and the Department of Elder Affairs retain all right and obligation to monitor and
oversee the performance of this agreement as outlined throughout this document and pursuant to law.
PART Ill: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with (YMB Circular A-133, as revised, and required by
I'AR`I' I of this aureernent shall be submitted. when required by Section .320 (d), (Y%IB Circular A-133, as revised, by or
oil behalf of the provider(i.irect_Iv to each of the f(rllowirlg:
The .\Illance for Aging, Inc. at each of the f lllow ing,addresses:
.Aliance for Aging, Inc
Attn: Fiscal Manaocr
760 VNV 1071h .kve. Suite 214
Miami, FL. 33172-3155
1 he Federal .-yudit C:'learin2house dcsi�-,nated irr t %113 Circular .y-133. as revised ('the number of copses required by
�0
Contract Niumber KC 1471
Sections 320 (ol)(I ) and 2), ONIII Circular A-I 33. as revised, should be SUNI'litted to the Federal Audit ClCarlllUIIIOLISC), at
the 1`o)llo��,Ima address:
Federal Audit Clearinghouse
P,�
Bureau of the Census
1201 East IO'h Street
Jeffersonville, IN 47132
Other federal a,,encics and pass-thrOLI(Ol entities M accordance with Section,., .320 (e) and (f). (),vIB Circular A-133. as
revised.
PurSLIant to Sections .320(f), (YAB Circular A-133, as revised, the provider shall submit a copy of the reporting package
Z.-
described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, tcl the
Alliance for Aging, Inc. at each of the following addresses:
Alliance for Aging, Inc
Attn: Fiscal Manager
760 NW 107 1h Ave. Suite 214
Miami, FL.33172-31550
Additionally, copies of financial reporting packages required by Part 11 of this agreement shall be submitted by or on
behalf of the provider directs to each of the following:
The Alliance for Aging, Inc, at each of the following addresses:
Alliance for Aging, Inc
Attn: Fiscal Manager
760 NW 107'h Ave. Suite 214
Miami, FL.33172-3155
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
'Tallahassee, Florida 32399-1450
Any reports, management letter, or other information required to be submitted to the Alliance for Aging, Inc. pursuant to
this agreement shall be submitted timely in accordance with ONIB Circular A-133, Florida Statutes, and Chapters 10.5-0
(local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as
applicable.
Providers, when submitting financial reporting packages to the Alliance for ALYIng. Inc. for audits done in accordance kvith
OMB Circular A-133 or Chapters 10_550 (local go%crnmental entities) or 10,650 (nonprofit and Cor-profit organ izat lons
Rules of the Auditor General, should indicate the date that the reporting package was delivered to the provider in
correspondence accompanying the reporting package.
P,Awr rv: RECORD RETENTION
Hie pro\ides shall retain sufficient records demo list rat I I!(.! its Compliance with the tcrms of this Ligyrecinem t'Or a period of'
,ix vears from the date the. audit report is 1,,,sued, and shall, allow the Alliance tor Aunmu. Inc. or Its oicsignice, the CFO or
ALIditor GCIICY,'I1 �ICCCSS tO SUCh records Upon I-ColLICSt. I'lle pro\idCr elISLIN that audit \vorkilig papers are 111,1de
to the Alliance I'Or A,uill'a, hic.. or Its designee, the Department or its designee, CFO, Or ALIdItOr 6CIIeral upon
request 1,01, :i period of six cars from the date the audit report is Issued. unless extended in writing by the Alliance liar
111c..
Contract N'Llmher KC 1471
.vi-r..kci I NI ENT III
EXHIBIT- 1
1 1-f-DERAL Rf:S(:)(, RCTS A\V RDED 10 HIF Sl BREA,-I P I E',1-PI-RS[-A\f [(-)-F[I IS AG RE E\11,,T('0,S IS I (V I I if- FOLLOWI\16
----------- .......... .............................
PROGRA,'NITITLE FUNDING SOURCE CFDA ANIOUNT
...........
�.�i,o,—rAL-F—E-D--E-ki-AkL—.,k"��AR6
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 AGREENIENTCONSIST
OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRA,NITITLE FUNDING SOURCE CFDA AMOUNT
Ll O I'AL STATE AWARD so
STATE FINANCIAL ASSISTANCE SUBJECT TO See. 215.97, F.S.
P R 0 G kA—INV F iT-1,E 7"' FUNDING SOURCE
------------------- _CSFA_�_.___..,_�IOUN'r
Community Care for the Elderlv ProLyrarn General Revenue 650101 S301 513
---------------
—----------
I'OTAL AWARD S 0 2 5 3
-----------------------I-
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCESANVARDED PL'RSL.!,kN'l- 'I-O
'I'llIS AGREEMENT" ARE AS FOLLOWS:
C olltl-,Wt Nttt77ber KX 1471,
ATTACHMENT III
EXIIIBIT-2
PART L AUDIT REL,AT'IONSHIP DETEu'RM NATION
Providers \kilo receive Statc or federal resources may or may not be subject to the audit requirements of OMB Circular A-1 33, its
revised, and or Section 215.97, Fla, Stat. Providers who are determined to be recipients or Subrecipients of federal awards and.or state
financial assistance may he subject to the audit requnenents if the audit threshold requirements set forth in Part I artd.or Part 11 of
Exhibit 1 are meat. Providers %rho haye been determined to be vendors are not subject to the audit requirements of()MB Circular A-
1.33, as revised, and or Section 215,97, Fla. Stat. Rc4uardless of whether the audit requirements are met, providers Mio have been
determined to be recipients or Subrecipients of federal awards and or state financial assistance, must comply with applicable
provgratmnatic and fiscal compliance requirements,
In accordance with Sec. 210 of'O\MB Circular A-133 andior Rule 691-5.006, FAC,provider has been determined to be:
Vendor or exempt entity and not subject to ONIB Circular A-133 andor Section 2115.97. F.S.
Recipient.Subrecipient subject to 0%lB Circular A-133 and,or Section 215.97, F.S.
NOTE: If a provider is determined to be a recipient%subrecipient of federal and or state financial assistance and has been approved by
the Department to Subcontract, they must comply with Section 215.97(7), I-.S,.and Rule 69I-.006(2), FAC [state financial assistance]
and Section .400 OMB Circular A-133 [federal awards].
PART II: FISCAL. COMPLIANCE REQUIREMENTS
FEDERAL, AWARDS OR STATE NIA,rcIlING FUNDS ON FEDERAL AWARDS. Providers who receive federal awards or
state matching funds on federal awards and who are determined to be a subrecipient, must comply with the following Fiscal laws, rules
and regulations:
STATES,LOCAL GOVERNMENTS AND INDIAN TRIBES t'1US'r 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 la~+ws„rules and regulations
NON-PROFIT OR(.,,ANIZA,rIONS 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-1 10--Administrative Requirements)
Requirements)
OMB Circular A-133—Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS(EVEN IF A PART OF A STATE OR I..,OCAL GOVERNMENT) MUS"r
FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A-21 —Cost Principles)'*
2 CFR Part 215 Administrative Requirements{Formerly OMB Circular A-1 10--Administrative Requirements)
OMB Circular A-133 - audit Requirements
Reference Guide for State Expenditures
()then fiscal requirements Set forth in program law,. rules and regulations
"Some federal programs may he exempted from compliance, with the Cost Principles Circulars as noted in the OMB Circular
A-1 33 Compliance Supplement. Appendix 1,
STATE FINAMA L \SSISTANCE. Providers tvho receive state financial assistance and who are determined to be a
recipient subrecipient, must camp(\, v%ith the fk)llowinu fiscal Wks, rules and regulation,"':
`>cetion 213.Q>" Fla. Stat.
I. h:ipter Fla. Admin. (::ode
'State Projects Coillplialice Suppleme:tit
1tctc.rence (iutde f(}r State Expenditures
t)ther fiscal regturetuents set forth in program laws, rules and reErulati0nS
Contract N L I I I I ber K(' 1471
ATTACHMENT IN"
DATA FOR AGREI'MUN"I'S. GRANTS,
LOANS AND COOPERATIVE AGREEMENTS
The undersigned. an authorized representatike of the Contractor named in the contract of, aor I Is
cement to ��11 this;
,fit attachment, licrch% certifies that:
I Thc Contractor and any subcontractors of services Linder this contract have financial management s\stenis capable of
providing certain information, IIlCILIdiIlQ: (I) aCCUrate, current and complete disclosure of the financial result,., of each
grant-funded project or prograrn 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 w fill budgeted allIOLAIIIS
for each award. The Inability, to process information in accordance with these requirements could result in a return Of
gr
ant funds that have not been accounted for properly.
(21) Management information Systems used by the Contractor, SUbcontractor(s), or any Outside entity on which the
Contractor is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be
capable of processing data accurately, including year-date dependent data. For those systems identified to be non-
compliant, contractor(s) will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing year-date dependent data accurately. All versions
of these products offered by the Contractor (represented by the undersigned) and purchased by the State will be
verified f(-,)r accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that
impede the hardware or software programs from operating properly. the Contractor agrees to immediately make
required corrections to restore hardware and software programs to the same level of functionality as warranted herein,
at no charge to the State, and Without interruption to the ongoing business of the state, time being of the essence.
(4) The Contractor and any subcontractor(s) of services Linder this contract warrant their policies and procedures include a
disaster plan to provide for service delivery to continue in case of all emergency including eniergcricles arising from
data integrity compliance issues.
The Contractor shall require that the language of this certification be included in all subagreernents. SUbgrants,
and other agreements and that all subcontractors shall certify cornpliance accordingly.
*]'his certification is a material representation of fact upon which reliance was placed when this transaction was made of-
entered Into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
0%113 Circulars A-102 and 2 CFR Part 215 (fornierk 0.1013 Circular A-] 10).
Monroe COLL 11jtY\7jW�'/ Social Services-I 100 Simonton Street. Suite 2-2?7. Ke,� We,,;t. Fl. 13040
.................
\,unc an
7 County AdIll In istrator
V
Rolm in ja�,tc.sl
` 1cf,\3111e of A 11thof IZed I S,
11 _)4
Contract Number K(, 1471
ATTACHMENT V
CERTIFICATION REGARDING DEBA0NIIENT, S0SPENSION^ INELIGIBILITY AND
VOL0NTARYEXCL08ION FOR LOWER TIER COVEREDTRANSACT}ONS
(|) The prospective contractor certifies, by sTonin'o this certibcution, neither i/ nor its principals is presently
dcbarned, suspendu], proposed for debarment, declared indigiNe, or voluntarily excluded from participation in
this transaction b,uoy he |cru| department cvugcocy.
(2) VVbcn: the prospective contractor is unable to ccrtih/ to any of the statements in this certification. such
explanationpros ipant shall attach an |o this certification,
Signature Date
Roman Gantesi-CountyAdministrator ___.MonrocCounry B[XC(2Socia| Services
Title /\gencv/Orguoizadon
(Certification signature should hcuumeus Contract aignx/un:j
Instructions for Certification A
l. The terms "covered transaction," "debarred," "suspended," "ineligible." "lower tier covered transaction,"
"person," "primary covered Uonsautinn," and "Voluntarily excluded," as used herein, have the meanings set Out
in file sections of rules implementing Executive Order |2549. (2CFG |80.5-|00.|02O, un Supplemented hy2
CFR37O.|0-376.995). You may contact the Contract Manager for assistance in obtaining u copy mftbumc
n:gu|mhmoe.
2. This certification ismmaterial representation ofDctsupon which reliance was placed when the parties entered
into this transaction. If it is later determined that the Cmoiruc0zr knowingly rendered on erroneous ccrtificoiion,
in addition to other remedies available to the federal government, the Department may Pursue uvui|uh|c
remedies, including Suspension arid/or debarment.
3. The Contractor will provide immediate written notice to the Contract Manager it' at any time the Contractor
learns that its certification was erroneous when submitted or has become erroneous by nc4aon of* changed
circumstances. The Contractor may decide the metbnd and frequency bywhich i{ determines the e|igihi)ityof
its principals. Each participant to n lower tier covered transaction may. but is not required to, check the
Excluded Parties List Syytem (EPL5).
4. The Contractor will include "Certification Regarding Debarment, Suspension. |ndigibiU|y and Voluntary
Exclusion - LowcrTier[*rered Transaction- in all its lower tier covered transactions and in al mn|iuitaduny
k/r lower tier covered transactions.
5. The ConUnc1ora(urecs that it shuU not knowingly enter into any lower tier covered transaction nith u person
xho is debarred. suspended. determined ineligible orvo|uncari|yexcluded hnm participodon, unless *thcraIse
authorized by the federal government.
6. It' the Contractor knovingk cotca into u |mxer tier cnvcrcd transaction «hh u person xho is *uspmided.
debarred. ine|i(-,ib|c. or n01un1urU, cxc/udcd hvm participation in this transaction. in addition to o|her, remedies
a`oUub|e to ihe federal gorcrnmcn|. the Dcounmuu1 moy pursue uvui|uNc remedies. ixc|udinu suspcnsion.
and/ordehonneuL
7� The Contractor mm rc|y upon nccuificudoo of pnospcubvo pauicipun| in u |oner tier co%ercd |raouuudnn that
it is not dcboned, suspcoced. urvu|unturl|ycxc|udcd hvm \hccorcrcd transaction. unless it kno^s
that tile certification is erroneous.
.xu.au/mvzmm.
3�
Contract Number KC 1-471
ATTACHNIEN'r vi
,1SSL'R:kNC,'ES—N'ON-('ONS'I'RUC'I'ION PROGRAMS
Public reporting burden for this collection of iifforniation is estimated to average 45 minutes per response. includin- time for
i listruc t I oils, "earching, existing data sources. -atherin- and maintaining the data needed MILI completing and reviewing the
collection of information. Solid comments rcuarding the burden estimate or my other aspect of this collection Of illf'Orluat1011,
including sui-,,-estiotis for reducim-, this burden, to the Office of Mana-cment and Budget. Paperwork Reduction Project (0348-0043
Washilil-,ton, DC 20503.
PLEASE DO NOT RETURN YOL'R COMPLETED FOR.N1 TO THE OFFICE OF NIAN,,\,(;E.NIEN'F AND B('DGE-F,SENI)
IT TO THE ADDRESS PROVIDED 131'THE SPONSORING.AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the
awarding agency. Further, certain federal awarding agencies may require applicants to certify to additional assurances.
If such is tile case, you will be notified.
1, 1 las the legal authority to apply for federal assistance.and the institutional, managerial and financial capability(,including funds
sufficient to pay the non-federal share of project cost) to ensure proper planning, management, and completion of the project
described in this application
2. Will_give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records,books, papers, or documents related to the award; and will establish
a proper accounting system in accordance with generally accepted accounting standards or agency directives.
3. Will establish sateguards to prohibit employees frorn using their positions for a purpose that constitutes or presents the
Z,
appearance of personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728-4763) relating to prescribed standards for
merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards tbr a
Merit System of Personnel Administration(5 C.P.R. 900, Subpart F).
6, Will comply with all federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil
Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
F-.ducation Amendments of 1972. as amended (20 U.S.C. 1681-1683. and 1685-1686), which prohibits discrimination on the
basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended(29 U.S.C. 794), \vIlich prohibits discrimination on
the basis of handicaps: (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. 6101-6107), which prohibits
discrimination oil 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: (1) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and
Rehabilitation Act of 1970 (P.1- ()1-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism,
(-I-,) 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C, 290 dd-3 and 290 ee 3), as ,intended, relating to
confidentiality of alcohol and drui, abuse patient records. (it) Title Vill of the Civil Rights Act of 1968 (42 U.S.C. 3601 et
seq.). as amended, relating to nondiscrimination in the sale, rental or financing of housing-, (i) any other nondiscrimination
provisions in tile specific statute(,,) under which application for t'ederal assistance is being made: and (j) the requirements of any
other nondiscrimination statute(s) \kluch may apply to the application,
7, Will comply. or has already compiled, with the requirements of Titles 11 and III of the uniform Relocation Assistance and Real
Properly Acquisition Policies Act of 1()70 (1).[_ 91-646) which. provide for fair and equitable treatment ot'persons displaced or
\k hose property is acquired as a result of federal or federally assisted programs. 1These requirements apply to all interests in real
propertyacquired for project purposes regardless of federal participation in purchases.
8, �y ill comply. as applicable. % ith the pro%isions of the hatch Act (15 U-S,C'- 1501-1508 and 7324-7128), %%hich limit the
political actnities of emplc7tice;+ tis ta��se principal emplo4rraent actin hies are funcfed in whole or in part ��ith federal funds.
0. Will comply. \4ltll tile provisions of the Dais-Bacon Act (40 U S.( 17()tl to 176a-7), the (,ope1jud Act (40
U S'(- -1, -1-6C and I [',S.(-', 87 and the Contract Work Hours �llld Safety Standards Act (40 U S.C, 73.33). i�.l--a rd i i i i-,S
labor standards t'Or tcderalIN assisted COnStruCh011 sUh,11-11-eenlent",
10. Will conlpl.%, if �01i flood insurance purchase requirements of Section I 02(a) of tile Hood Disaster Protection Act Of,
,6
Contract NumbcrKC 1471
1973 (Pl, 9J-234) which requires recipients inaspecial Uom] hazard zreahparticipate in the pn�om and mpuohus* flood
insurance ifthc total cost ofinsurab|c construction and acquisition b 610.000ormoo.
| ) Will comply nith environmental standards which moy be prescribed pursuant to the foUoningy: (a) institution ofcnvironmcnta|
quoht! c000a| mcusurcs under the National Environmental Po|icy Act of' |q60 (Pl. P|'|gO) and Exocu1ivcUdcr(B}) 11514:
(b) nodMcadon ofvio|ming facilities pursuant /oB] | |738: (c) protection of wetlands Pursuant to Ed 11990: (d) cvu|uaoon nt
flood hozunls in 0uodp|ainy in accordance with EU 11988: (c) assurance of project cousiotency \ki1h the zpprorcd 5|me
munmL,cmrn/ pn&ram developed under tile Coastal Zone )vlunugcmrnt Act of' |q72 (|6U.S,C� 1451 ctscql: (0conhonni/yof'
federal actions to State (Clear Ain Implementation Plans Linder Section \76(do[the Clear Air Act n/ 1955. as umendcd (42
U.SI. 7101 c, sc4)�to) protection of underground Sources *fdrinking water Linder the Safe Drinking Water Act nf |g74, os
umcodcd. (Pl. 43'523)� and (h) protection of endangered Species under the Endangered Species Act of 1973. as amended, (P,L
93-285).
12. Will comply with che Wild and Scenic Rivers Act u[ !968 (16 Q,SI, 1721 c1so4] related m protecting components ur
potential components of the national wild and scenic rivers sys(cm.
13. Will assist the awarding ill assuring uompUoncewith Section |06ofhhcNational Historic Preservation Act of 1966. us
omendcd (|6 U.S.C. 470)` 6O 11593 (identification and protection of historic properties), and the Archaeological and Historic
Prcucrva1iun Act o[ |974 (l0D.G.C. 469u,| e/scql
14. Will comply with Pl, 93-348 regarding the protection of human subjects involved in research, development, arid related
activities supported hy this award ofassistance.
15. Will comply with the Laboratory Animal Welfare Act ofl966 (P.L89'544. aoamoodcd. 7U.S.C. 2131 c\scq] pertaining /u
the care. handling, and treatment ofwarm blooded animals bc\d for research, teaching, or other activities Supported by this award
of assistance.
16, Will comply with the Lead-Based Paint Poisoning Prevention Act (42 O.S.C. 4801 et oaqJ, v/6irh prohibits the use of lead-
based paint in construction ur rehabilitation ofresidence structures.
17. Will cause to6c performed the required financial arid compliance audits in accordance with the Single Audit Act Amendments of
|9g6 and OMB Circular No. 4-|33. Audits oy States, Loca| 0overnmenm. andNon-PonfitD,gaoizuions.
|#. Will comply with all applicable requirements ofall other federal laws, executive orders, regulations and policies governing this
program.
COUNTY ADV11NISTRATOR
ROMAN GAS I FS1
37
ColltraCt N'Llmher KC 1471
ATTACHNIEN'T
COMMUNITY CARE FOR THE ELDERLY PROGRAM
BUDGET SUNINIARY
'I'lie Alliance shall make Payment to the pro\ider for provision of services LIP to a MaXI'MUM 1111111ber Of LITAItS Ot'Service
and at the rates) stated below:
Service Maximum units Maximum
Service to be Provided
Unit Rate of Service l Dollars
----------
Case Aide $21.98 200 $4,396
Case Management $50.48 1,030 W Wm $S1,991
Chore $29.41 85 $2,500
Chore (Enhanced) $32.19 65 $2,092
-
Companionship $15.33 765
Homemaker __. -$22.06 4,101 $90,468
Home Improvement $50.00 10 $500
Personal-Care $28.67 3,614
Facility Respite $10.00 1,638 $16,380
In Home Respite $23.08 650� rvR $15,002
Specialized Medical Equipment $17.00 50 $850
Transportation $40.00 75 $3,000
I TOTAL FUNDS AND UNITS IN
THIS CONTRACT 202,523
Contract Number K(' 1471
ATTACHMENT X'111
COMMUNITY CARE FOR THE ELDERLY
INVOICE REPORT SCHEDULE
Report Number Based On Submit to State on this Date
I July Advance* July 1
2 August Advance* July 1
3 July Expenditure Report August 25
4 August Expenditure Report September 25
5 September Expenditure Report October 25
6 October Expenditure Report November 25
7 November Expenditure Report December 25
8 December Expenditure Report January 25
9 January Expenditure Report February 25
10 February Expenditure Report March 25
11 March Expenditure Report April 25
12 April Expenditure Report May 25
13 May Expenditure Report June 25
14 June Expenditure Report J Lily 25
15 Final Expenditure August 15
16 Closeout Report August 31
Legend: Advance based on projected cash need.
Contract Number KC 1471
ATTACIENIENT It
REQUEST FOR PAYMENT
COMMUNITY CARE FOR THE ELDERLY
RECIP�ENT NAVE ADDRESS PHONE9 and `E!D4 TYPE OF PAYMENT This Request Pr.rod From To__.......
Contract Period
Regular
Contract
Advance Repori
PSA#
CERTIFICATION I hereby certify to the best of my knowledge that this request or refund conforms with the terms and the purposes of the above contract.
Prepared Date Approved by Date
PART A BUDGET SUMMARY COE Admhn CCE Services TOTAL
1.Approved Contract Amount ......—-----
2.Previous Funds Received for Contract Period ......
3.Contract Balance
4,Previous Funds Requested and Not Received for Contract Period
5,CONTRACT BALANCE ----------
PART B CONTRACT FUNDS REQUEST
1 Anticipated Cash Need(1st-2nd months) —-----------
2 Net Expenditures For Month $--—----- $------------
(DOEA Form 105C,Part B,Line 4)
3 TOTAL $
PART C, NET FUNDS REQUESTED
I Less Advance Applied
2 TOTAL FUNDS REQUESTED(Part 6 13.minus Part C Line 1)
DOER FORM 106C
Revised 5;25,2010
40
Contn,ict N Limber KC 1471
ATT.,-kCIVNIENT X
RECEIPT AND EXPENDITURE REPORT
COMMUNITY CARE FOR THE ELDERLY
----------- -------
F....11 TO. ........... ...............
Adni- CONTRACT PERIOD
CONTRACT 0
REPORT ts
PSA4
cERrIFICATICN I '--'tifY r,1 IhO ocstcf—y k�m,-Iodqo and belief that these,ep<.W-co—plete anrs cc7)"ryGt and fall outl.y*
h(,yelf,;.area to, p—poses set forth in the i,owiact.
PART F3U0CETED INCOME / RECEIPTS 1 Alp,o,,jd 2 Act-al Receipts 3 Total Receipts 4 Po,cent of
puq I, rh,s Report Year to Date Apolo,ecl Bud(eL.
cj_
I state Funds $0,00 $0 co $000
2 P,oq,arn 111C01-he $0,00 $000 $0 00
13, Local C,1SJI $000 $000 $0 00 #o v 01
,I SUBT.OY.AL CASH RECEIPTS
5 Local 1,,-K,,,d Match
6, TOTAL RECEIPTS $0,00 $0,00 $000 #01V/W
PART B EXPENDITURES I Approved 2. Expenditures 3. Epf,.MditufoS 4 Percent of
Budc of For This Report year to Date Approved Bud_q2t
1,Adr—hs$trAtIv0 Sci—COS $000 $0,00 $0,00 oolvlo!
2, SO—Ice SubC00tn1Ct01(S) $0.00 $000 $0J)() #01V/01
3 Adult Protective Services $000 $0,00 $0,00 4DIV101
4, TOTAL EXPENDITURES $000 $000 $000 #DIV/01
PART C :OTHER REVENUE AND EXPENDI I'URES 11 Interest: Ill.Advance Recouped
I Prograrn Income(PI) 1. Earned on OR Advance
1 CCE` r,l cotiocted YTo 2. Return of OR Advance
fees collected) 3.Other Earned
PART 0 :CO-PAYMENTS CURRENT MONTH YEAR-10-DATE
1 Total of Co-payments assessed
2,Total of Co-payt,00tS c0lleCtOd ------
(For Trackrl§j Pulf,,O.OS 101Y)
41
Contract Number K(.--1 1471
,VFI',k C I IN I E NT ,k
Department of Elder Affairs Programs & Services Handbook, provided on CD.
Also, available at the Department's Intranet site under, "Publications".
42
Contract Number KC 1-171
A,rTACIINIENT
STATE OF FLORIDA DEPARTMENT OF ELDER AFFMRS
'\RTF READ THE \ITACHED I NSTRI CTIONS FOR I LLUSTRATIVE,I N'FORNIAT ION' \NHICII MIA,If ELPYOU COMPLETE THIS FORM.
-----------
2. ED Sc?urceo
I oral 11 ite
-----------
3. Effective date:
i Total I Wiam.ltte Mick 0111a Female DkahICL
------------------
4. CLIENITS CURRIHN'TTY FNROLLED OR REGIST ERED. Effective date:
Total Whitc "o Black Othel Female DiahQ �Tci 40
ffi.,pnic ( .0
L
0 ___1----------- ------
5. ADV❑ISORY OR GOVERNING BOARD, It: APPLICABI-F. 7
Blak Itivanic Other Female Disabled
C-I"
PART if.. LSE SEPARATE SHEEP OF PAPER FOR ANY EXPLANATION'S REQUIRING MORE SPACE.
6. Is an ',Nssurance ot'Compliance on file with DOEA'? If N('A or NO, explain. N,(A YES NO
7, Compare the staff composition to the population. Is staff representative of the population'?
If N/A or NO, explain. N�A YES NO
El ❑ 0
S. Compare the client composition to the population. Are race and sex characteristics representative of the
population'? If NA or NO, explain. NIA YES NO
9, Are eligibility requirements for services applied to clients and applicants without regard to race,color,
national origin.sex, age, religion or disability'? If N,,A or NO,explain. N/A YES NO
0"I
10. :kre all benefits, services and facilities available to applicants and participants in an equally effective
manner regardless of race, sex,color. age, national origin. religion or disability'? If N;A or NO, explain. N A YES NO
-—__------____—------—----------
.......... ........... ...........
t 1. For in-patient services.are room assignments made without regard to race, color, national origin
or disability'? It'N A or NO. explain. A 1'E S NO
............. ------ F
�j
4 3 2
Contract Number KC 1471
12. Is the prograni t'aci I It v accessible to non-Fn-I is I i speaking clients? If N Aor NO. explain. N A YE S No
13, Are employees. applicants and participants informed of their protection against discrimination'? If YES,
Verbal 7 Written ❑ Poster 7 If N A or NO, explain. N A YES NO
14, Give the number and Current status of any discrimination complaints regarding services or employment filed
a gainst the prograrrufacility. NiA NIJNIBER
F�
15. Is the program/facility physically accessible to mobility, hearing, and sight-impaired individuals'? If N/A or
NO, explain. N/A YES NO
❑ F]
PART III:THE FOLLOWING QVES HONS APPLY TO PROGRAMS AND FACILITIES WITH 15 ORNIORE EMPLOYEES.
16. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make
any necessary modifications'? If NO,explain. YES NO
17. Is there an established grievance procedure that incorporates due process in the resolution of complaints? If
NO,explain. YES NO
7� o
18. Has a person been designated to coordinate Section 504 compliance activities'? If NO,explain. YES NO
F�
19, Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination
on the basis of disability*! If NO, explain. YES NO
r"
LIN El
20. Are auxiliary aids available to assure accessibility of services to hearing and sight-impaired individuals'? If
No . explain. YES NO
PART IV: FOR PROCRAINIS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF S50.000.00 OR MORE.
21, Do you have a written affirmative action plan'? It'NO, explain. YES, N 0
ALLI A NCE USE ONLY
Reviewed By In Compliance: Y F,S NO* ❑
V
Prouram *Notice ofCorrecti\c Action Sent
I Tal",
Date Telephone RC1p0n1e Due
On-Site El IA Re,ww Response Recci�ed
ko I wd tj,-,u"t 21)1 pace 2 o C
44;0')
Contract NUmber KC 1471
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area such as a district, county, city or other locality. If't I ic prograin;faci I ity serves a
IfiC t21-1-let OpUlati011 SLICII Is adolescents, describe the tar et population. Also, define the type t,
Spec p �rl ype o ser%ic e
provided.
2. Fnter the percent of' the population served by race and sex. The Population served includes persons in the
,geographical area for which SCIA"ices 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 containill-
Florida population statistics. Include the source of your population statistics. ("Other" races Include AslariTacific
Islanders and American Indian,'Alaskan Natives.)
3. Fiiter the total number of full-time staff and their percent by race, sex and disability. Include the effective date Of Your
summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and list
their percent by race, sex and disability. Include the date that enrollment was Counted,
5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no advisory
or governing board, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted In
compliance with all nondiscriminatory provisions as required in 45 CFR 80, This is usually a standard part of the
contract language for DOER 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 IW/'o of the
I
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 prograinifficility has the responsibility to detenrime the reasons for such variation and take
whatever action may be necessary to correct any discrimination. Some legitimate disparities may exist when
programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR 80.3 (b) (6).
9. DO eligibility requirements unlawfully exclude persons in protected groups frond the provision of services, or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment. 45 CFR 80.3 (a) and
45 CFR 80.1 (b) (2).
10. participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
physical and recreational therapies, counseling and social services without regard to race, sex, color, national origin,
religion.. aue or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied
L lf'ormly and without regard to race, sex, color, national origin, religion, a� disability.
In gi e or Entrances, waitinu, rooms,
reception areas, rcstrooms and other facilities must also be equally available to all clients. 45 CFR SM) (b).
1. For iti-patient services, residents must be assigned to rooms. wards, etc., without regard to race, color, national origin
or disabilltv. Also, residents Must not be asked whether they are williniz, to share accommodations with persons of a
different race, color, national on-in, or disabilltv, 45 CFR SO. ) (,I).
12) I'lle program facility and all services Must be aCCCSSII)[C to j),IrtIcIj%IIIts and applicants, including, those persons %%ilo
may not speak Llnvlish- III !,cograplilc areas v0icre a sigllitllcallt population of non-English spcakingy people live,
program accessibility may include the cIlIpto%'InCIIt of bilingual staff. In other areas, it is sufficient to ha%c a policy or,
plan for scr%Ice, Such JS a CLiri-clit list of names and telephone 111.111111CI-S of hililh-11,1.11 Individuals %v ho will assist in tile
45 62
Contract xiuniher KC 1471
provision of services, 45 ( "R 50.3 (a).
l>. Programs facilitics must make information regarding the nondiscriminatory provisions Of Title VI alailablc to thCir
participants, berieticraries or any other interested parties. Flits should include information on their right to file a
Complaint of discrimination kvith. Gaither the Florida Department of 11der ,,�\ffairs or the (.J.s. Department of,lllls. I'll
information may be supplied verbally or in writing to every individual, or may be supplied through the use of'an equal
c)pportunity policy poster displayed in a public area of the facility, 47 (`l=R ,s0.6 (d).
14. Report number of discrimination complaints tiled against the pro4granvf:acility. Indicate the basis, e.g., race, color,
creed, sex, age., national ori'ain, disability, retaliation, the issues involved. e.g., services or employment, placement,
termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address
of the local, state or federal agency with whom the complaint has been tiled, Indicate the current status, e.4.. settled.
no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated
parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone,
restroom facilities, water fountains, information and admissions offices should be accessible. Door widths and traffic
areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed
for accessibility. Elevators should be observed for door width, and Braille or raised numbers. Switches and controls
for light, heat, ventilation„ fire alarms, and other essentials should be installed at an appropriate height for mobility
impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a self-
evaluation to identify any accessibility barriers. Self-evaluation is a four step process:
a. With the assistance of a disabled 1ndividuallorganization, evaluate current practices and policies which do not
comply with Section 504.
b. Modify policies and practices that do not meet Section 504 requirements.
c. "fake remedial steps to eliminate any discrimination that has been identified.
d. Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have
been followed.), 45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate appropriate
due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited
by Section 504.45 CFR 84.7 (b).
18, Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7 (a).
19, Continuing steps must be taken to notify employees and the public of the progranvftic ill ty"s policy of
nondiscrimination Oil the basis of disability. T his includes recruitment material, notices f(.)r hearings, newspaper ads,
and other appropriate written communication,45 CFR 84.8 (a),
N Programs,facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired
,cnsory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters for
hearing impaired individuals. taped or Braille materials, or any alternative resources that call be used to provide
equally effective sere ices, 45 CFR 84.52 (d).
Pro,-,rarils facilities with 50 or more emhfloyees and St}.tif)t).i40 in federril contracts must develop. Implement and
1ilaintairl a wriUcrl aitirrnatiee actiorl Compliance program in aceordanee with I-xeetttrve Order 11240, -;1 (TR tit:) and
f'itle VI of the(-,[v it 1'1,,-,fits Act of, 1904, trs amended.
4002
Contract NUmber KC 1471
DO I Fmm I H I-13, Rc�i,cd \LleU W
Lie �4
4 7 6 2
Contract Number KC 1471
Le
4S,02,
Contract Number KC 1471
.,VFTAC11N1EN'r c
REFERRAL PRo,rocol, NIONROE
Issue: Screening, 1'riage, and Ret'erral for.-\ctl%at Ion under the Cornmunitv (,`are t"or the Idderk, I Ionic Care for the
[Iderty.
11olicv: Referrals will be based on availability of funds, in accordance with prioritizWitioti regriirernents.
Purpose: To ensure funding is spent expeditiously and consumers are referred into programs for appropriate services.
Procedure for Monroe County:
I. Roles and Responsibilities
A. Alliance for Aging/ Aging and Disability Resource Center
• Reconciles overall program and Lead Agency specific spending levels on a monthly basis to ensure the
Lead Agency is operating within the funding allocation.
• Reviews the number of cases released for activation based on projected funding available.
• Screens consumers to link with appropriate resources and prioritize for DOER-funded programs and
services.
Recommends potential cases for activation based upon projected funding available by Lead Agency.
• Selects consumers from the waiting list based on their prioritization score.
• Refers consumers from the waiting list to the Lead Agency in Monroe County for activation, based on
availability of funds.
• Monitors compliance with service standards and outcome measures.
• Reviews care plans and files per the File Review Policies and Procedures.
• Reviews data in CIRTS.
13. Case Management 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 AAA CCEHCE Surplus/Deficit
Analysis policy.
• Refers inquiries from consumers interested in services to the ADRC t'()r Inforniation and Referral to
community resources, Screening, Triage, and [_ong-Tcrm Care Options Counseling, as appropriate.
ate.
-1 471
• The functions of Screening and Intake are outsourced to the Lead Aoencv. Screcrum, and Intake may
also be completed by the ADRC.
• Completes comprehensive assessments on new consumers and annual reassessment on cxIstII10
cMISLIIIICI'S and develops care plans and revie%vs care 1)1,111S SCIIII-,inmlally.
service delivery and enters data into CIRTS.
• Screens consumers for S',I,RA A`C cllglbllity. Bills in CIRTS as appropriate.
0 Monitors care plans in an ct't()rt to keel) costs down while SLIStaining the InL11%IdUalS In the C011111-11,1111tv.
4062
Contract N Limber KC 1471
11. Manauement of the Assessed Prioritized CoIISUIlier List (APCL).
A. Referrals to the ADR( are routed to the Information and Referral Specialists or Intake LJint staff depending oil the
type of referral. Clients are provided information Oil C01111111.111itv resources and programs a�ailable including private pay
options. Persons are directed to those resources most capable ofinecting the need they have expressed to :M)RC staff.
Cases presenting strong identifiers that Indicate the consumer might benefit from publicly funded long term care services
are screened, entered into IRTS, triaged and provided options counseling. In ?Monroe County, file functions of
Screening and Intake are OLItSOUrced to the Lead Agency. Screening and Intake may also be completed by the ADRC.
C7 t�
DOEA prioritization requirements will he adhered to by both entities, as follows:
I. APS I ligh Risk Referrals (See section 13) .
hirininent Risk cases will be prioritized for activation after APS High Risk Referrals have been served. If budgetary
L,
constraints prevent opening new cases, clients will be placed on the APCL ADRC staff will contact the client on a
monthly basis to determine if there has been a change in the client's situation.
3. All other CARES referrals will be screened and prioritized in accordance with DOEA requirements.
4. Aging Out consumers will be referred by DCF for prioritization and/or activation in the corresponding aged programr_1 :_1
managed by the Alliance, as appropriate(See section IV).
5. Consumers applying for the Community Care for the Elderly(CCE) and/or I Ionic Care for the Elderly(HCE)
programs will be contacted and screened using the statewide form developed assessment by the Department of Elder
Affairs for this purpose(Form 701 S). If a consumer is being served through a DOEA-funded agency which enters their
4:�
annual assessment into CIRTS, the Priority Score generated by that assessment will determine their ranking on the APCL
G. Consumers referred for inclusion under the Statewide Medicaid Managed Care Long'Term Care Program APCL will
be contacted and screened following the same procedure as the one described under Section 5.
7. Individuals who appear as potentially eligible for other types of public assistance will be referred to the Economic Self-
Sufficiency Unit at the Department of Children and Families.
S. All other referrals will be waitlisted and prioritized, during which time other community resources will be researched,
iricludim,), ' )fee for services providers. Consumers on the waiting lists will be reassessed according to the 2013
private p ay,
Department of Elder Affairs Programs and Services Handbook, or any revisions made thereafter.
B. IJIPAA forms will be sent to the consumer as appropriate.
Ill. Opening New Cases
A. CCF I ICE Clients
1. Thc Fiscal Department will monitor Lead Agency specific spending levels oil a inowilly basis to ensure each Lead
Agency is operating %�ithill Its 5j-)Cndin1-' 31.10101-itV. In addition, tile fiscal (lep"Irtillent «1111 analyze surplus deficit
projectiolls, Mld share the In fOrniat toll with the I Cj(i to as I I ,availability. The Leid
�jSt 11 their determination of , I
5062
C 0I It I-tWt N U III her KC 1471
.\12'ellcN" Will request referrals directly frorn the V)RC. The Fiscal Department will he notified of*the number ot'new cases
11CHIL, referred to the Lead Agency for activation.
2. I..'pon receipt of' the request for- referrals from the Lead \,gency, the ADR(.' Intake Unit 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 ,* DRC Intake Unit Supervisor will refer wait listed clients to the Lead
Agency for acti\Lit I io n accordance with prioritization, requirements. The Intake Unit will Update the wait list enrollment
using the appropriate code to terminate frorn the ,kPCL. Upon receipt of referral, the Lead Agency will enter the APPI,
enrollment. and Subsequent enrollments to reflect client status.
4. [..,'Pori receipt of list of clients released frorn the waiting list, the Lead Agency will enter the APPL enrollment, will
ontact clients to offer program enrollment, and will proceed with activation. The Lead Agency will enter Subsequent
enrollments into CIRTS to reflect client status.
5. In accordance with the DOEA Program & Services Handbook, consumers who were screened using Form 701 S and
received a priority
score or rank of 3, 4 or 5 with a CIRTS Enrollment Screen program status code set to -APCL- and subsequently assessed
using 701B and receive a new priority score or rank of I or 2 must be returned to the APCL to allow for prioritization of
other consumers on the APCL with priority score or
ranks of 3, 4 or 5,
The ADRC will oversee the enrollment process to ensure referrals have timely outcomes in CIRTS.
B. Statewide Medicaid Managed Care Long Term Care Program Clients
1. The Department of Elder Affairs will run the APCL (Assessed Priority Consumer List) report to review clients wait
listed f'or the SMMCLTCP . DOEA will provide the ADRC with a list of individuals authorized for release frorn the
APO-
2. For clients active in CCE or I ICE and authorized for release from the Medicaid Waiver waiting list, the ADRC will be
responsible for the application process. For CCE active clients the ADRC will notify the Lead Agency in order to waive
the co-pay.
C. APS Rct'errals
1. APS Low and Intermediate Risk referrals will be screened and prioritized by the ADRC for services as per the
DOE N-,'APS Mernoranduni of UnderstandinLy. Low and Intermediate Risk referrals are also offered information and
referral to additional community resources, including private pay as appropriate.
APS Ifi�-,h Risk Referrals are not waithsted. They are immediately referred for Service from DCF in ;Monroe County
to the Lead \gency. ARTT referrals will be forwarded directly the Lead A,-,encv. APS cases are to be served for a
Maxii-nuin ot'31 calendar days. 11'additional time IS justified, the case nianaucment agency will staff the case with the
.\11MIlce to obtain the extension needed.
1 62
Contract Number KC 1471.
3. Upon receipt ofthe -APS Iligh Risk referral. the Lead Agency will coordinate services to bcolin within the 7" hour
period mandated by statute. A coniprehcnsive assessment will be done %vithin 72 hours of the referral. Services required
under tile care plan will rcirialli in place for a
triaximurn (,)1'3 1 CILIVS, unless an cxtension has been granted.
4, The Lead Agency will enter ACTV enrollment under their provider number in CIRTS. In addition. service codes will
be entered by service date for all services provided. If a service(;) is not provided as required under the care plan, an
NDP code will need to be entered in CIRTS and the case notes under the client file Should document the reason for non-
deI0,cry of Such service(s).
IV. Aging Out Consumers:
A. All consumers-Aging ) consumers will be referred by DCF to the ADRC for enrollment into the corresponding aged
( "
program managed by the Alliance.
B. Consumers active in the CCDA and FICDA programs that are turning 60 and are eligible for CCE and/or HCE will be
opened in the corresponding aged program managed by the Alliance if funding is available. If funding is available. these
consumers will be made active. If handing is not available, they will be waitlisted for these programs but will be given
priority for activation once funding is available.
Note: These ADRC policies and procedures are subject to change. Any modifications will be done through a
contract amendment.
5`6 2
Contract Number KC 1471
ATTACHMENT 1)
Depannient's Computer Use Policy and its Social Media Policy, provided on CD.
53 61
Page 54
ATTACHMENT
Alliance for Aging, Inc.
Business Associate Agreement
This Business Associate Agreement is datedby the Alliance for Acling,
|nc.(''Covcred Entib/^) and M Business Associate^), o not-for-profit Florida
corporation, /
1.0 Background.
1"I Covered Entity has entered into one or more contracts or agreements with Business Associate
that involves the use of Protected Health Information (PH|).
1.2 Covered Endty, 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 ofpatients' PHI, as set forth
in, but not limited to the Code ofFederal Regulations (C.F.Rj. specifically 45C.F.R. §§ 184.502(e). 164.504(o).
184.308(b). and 184.314(a-b)(2010) (as may apply) and contained in this agreement.
1.5 The Health Information Technology for Economic and Clinical Health Act(2OOQ). the American
Recovery and Reinvestment Ac (2008) and Part | — Improved Privacy Provisions and Security provisions located
at42 United States Code (U.S.C.) §§ 17A31 and 17Q34 (2O1O) require business associates of covered entities bm
comply with the H|PAASeourity Ru|e, as set forth in, but not limited to45C.F,R. §§ 164308. 164.310. 164.312.
and 184.316 (2009)and such sections shall apply toa business associate ofacovered entity in the same manner
that such sections apply tothe covered entity.
The parties therefore agree as follows:
2.0 Definitions. For purposes of this agreement, the following definitions apply:
2.1 Access. The ability or the means necessary to read, wmi0e, modify, or communicate
data/information or otherwise use any system resource.
2,2 Administrative Safeguards. The administrative actions, and policies and prooedunem, to
manage the selection, development, implementation, and maintenance of security measures to protect electronic
Protected Health Information (ePH|) and to manage the conduct ufthe covered entity's workforce in relation to the
protection of that information.
2.3 ARRA. The American Recovery and Reinvestment Act (2009)
2.4 Authentication. The corroboration that a person im the one claimed.
25 /4voi|obi|ity. The property that data or information is accessible and useable upon demand by an
authorized person.
2�8 Breach, The unauthorized acquimhnn, anceee, use, or disclosure ofPHI which compromises the
security or privacy of such information,
27 Compromises the Security. Posing u significant risk of financial, reputahooai, or other harm to
individuals.
2.8 ConfidendaUty, The property that data *r information e riot made available or disclosed to
unauthorized persons nrprocesses.
54
Page 55
2�9 Electronic Protected Health |nfonnation.(aPH|) Health information aa specified in45CFFl
§1 60,103(l)(1) or(1)(ii), limited to the information created or received by Business Associate from or on behalf of
Covered Entity.
2.10 HITECH. The Health Information Technology for Economic and Clinical Health Act(2009)
2,11 Information System, An interconnected set of information resources under the same direct
management control that shares common functionality. A system normally includes hardware, software,
information, data, applications, communications, and people.
2.12 Integrity. The property that data or information have not been altered or destroyed in an
unauthorized manner.
2.13 Malicious software. Softwane, for example, a virus, designed to damage or disrupts a oysbann.
2.14 Part |. Pod | — |mprovedPhvocyProvisions and Security provisions located at42 United States
Code (U.S.Cj §§ 17831 and 17A34 (2O10),
2.15 Password. Confidential authentication information composed ofe string ofcharacters.
2.16 Physical Safeguards. The physical measures, po|icins, and procedures to protect covered
entity's electronic information systems and related buildings and equipment, from natural and environmental
hazards, and unauthorized intrusion.
2.17 Privacy Rule. The Standards for Privacy of Individually Identifiable Health Information at 45 CFR
Part 16O and Part 1G4. subparts A and E.
2.18 Protected Health Information. (PHU Health information as defined in45CFRG1SO.1O3. limited
to the information created or received by Business Associate from oron behalf of Covered Entity.
2.19 Required By Law. Has the same meaning as the term "required by law" in 45 CFR § 164.103.
2.20 Secretary. The Secretary of the Department of Health and Human Services or his or her
designee.
2.21 Security incident. The attempted or successful unauthorized access, use, disclosure,
modification, or destruction of information or interference with system operations in an information system.
2,22 Security or Security measures. All of the adminimtrodve, physical, and technical safeguards in
an information system.
2.23 Security Rule. The Security Standards for the protection of Electronic Protected Health
Information at45CFRpart 1G4. subpart C. and amendments thereto.
224 Technical Safeguards. The technology and the policy and procedures for its use that protect
electronic protected health information and control access toit.
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 under42 U.S.C, section 17932(h)(2).
2�26 All other terms used, but not otherwise defined, in this Agreement shall have the same meaning
aa those terms in the Privacy Rule.
10 Obligations and Activities of Business Associate.
3.1 Business Associate agrees to not use ordisclose PHI other than as permitted or required by this
agreement orao Required byLaw.
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Page 56
3.2 Business Associate agrees hz�
(a) Implement policies and procedures to prevent, detect, contain and correct Security
violations in accordance with 45 CFR § 1S4�3O&1
(b) Prevent use or disclosure of the PHI other than as provided for by this Agreement or as
required by law,
(o) Reasonably and appropriately protect the confidentiality, inbeghh/, and availability ofthe
ePH| that the Business Associate oreabye, naceivas, maintainm, or transmits on behalf of the Covered Entity; and
(d) Comply with the Security Rule requirements including the Administrative Sufeguerde.
Physical Safeguards, Technical Safeguards, and policies and procedures and documentation requirements set
forth in 45 CFR §§ 164�308. 164,310. 164.312. and 184.316.
3.3 Business Associate agrees to mihgata, to the extent prootioab|e, any harmful effect that is known
to Business Associate of a use or disclosure of PHI by Business Associate in violation of the requirements of this
Agreement.
34 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 inspaohon, copying
or amendment of such information and including any security incident involving PHI.
3.5 Business Associate agrees to notify Covered Entity without unreasonable delay of any security
breach pertaining to:
(a) |danhfioodnn of any individual whose unsecured PHI has been, or is reasonably believed
by the Business Associate to have been, accessed, acquired, or disclosed during such security breach; and
(b) All information required for the Notice to the Secretary of HHS of Breach of Unsecured
Protected Health Information.
16 Business Associate agrees to ensure that any agent, including a aubcontrootor, to whom it
provides PH I received from, or created or received by Business Associate on behalf of Covered Entity, agrees to
the same restrictions and conditions that apply through this Agreement to Business Associate with respect to such
information.
3.7 |f Business Associate has PHI in a Designated Record Get
(o) 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, an directed by Covered Endty, to
an individual in order to meet the requirements under 45 CFR §164.524; and
(b) Business Associate agrees to make any emandment(s) to PHI in Oaaignohad Record
Set that the Covered Entity directs or agrees to pursuant to 45 CFR § 164.526 at the request of Covered Entity or
on Individual within 10 business days of receiving the request.
38 Business Associate agrees to make internal praohcnm, booka, and reoorda, 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 nfCovered Enbty, 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.
19 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 on individual for on accounting of
disclosures of PHI in accordance with 45 CFR § 164,628
310 Business Associate agrees ko provide to Covered Entity oren iodividuu|, 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§ 184,528 and ARRA § 13404
56
Page 57
3.11 Business Associate specifically agrees to use security measures that reasonably and
appropriately protect the confidentiality, integrity, and availability ofPHI in electronic or any other form, that it
onaates, receivee, maintaina, or transmits on behalf ofthe Covered Entity.
3.12 Business Associate agrees to implement security measures to secure passwords used to access
ePH| that it accesaeo, maintaina, or transmits as part ofthis Agreement from malicious software and other man-
made and natural vulnerabilities to assure the availability, integrity, and confidentiality of such information,
313 Business Associate agrees to implement security measures to safeguard ePHI that it accesses,
maintains, or transmits as part of this agreement from malicious software and other man-made and natural
vulnerabilities to assure the availability, integrity, and confidentiality of such information.
3J4 Business Associate agrees ho comply with:
(u) ARRA § 13404 (Application of Knowledge Elements Associated with Contracts);
(b) ARRA § 13405 (Restrictions on Certain Disclosures and Sales of Health Information); and
(c) ARRA § 13406 (Conditions on Certain Contacts as Part of Health Care Operations).
48 Permitted Uses and Disclosures byBusiness Associate. Except as otherwise limited inthis
Agreement mr any related agreement, Business Associate may use ordisclose PHI to perform funohonm, acbvides,
or services for, or on behalf of, Covered Entity as specified in any and all contracts with Covered Entity provided
that such use or disclosure would not violate the Privacy Rule if done by Covered Entity or the minimum
necessary policies and procedures cf the Covered Entity.
5.0 Specific Use and Disclosure Provisions.
5.1 Except as otherwise limited in this agreement or any related agnoemen\. 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.
52 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, mr Business Associate obtains reasonable assurances from the person (owhom the
information is disclosed that it will remain confidential and used or further disclosed only as Required By Law or
for the purpose for which it was disclosed to the person, and the person notifies the Business Associate of any
instances of which it is aware in which the confidentiality of the information has been breached.
5�3 Business Associate may use PHI to provide data aggregation services 10 Covered Entity oo
permitted by 45 CFR§164.5O4(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 45CFR §184.5O2(j)(1).
0.0 Obligations of Covered Entity.
61 Covered Entity shall notify Business Associate of any limitation(s) in its notice of privacy practices
of Covered Entity in accordance with 45 CFR § 1G4.52O. tm the extent that such limitation may affect Business
Associate's use or disclosure of PHI, by providing m copy ofthe most current Notice of Privacy Practices (NPP) to
Business Associate aeAttachment X| to this Agreement, Future Notices and/or modifications N the NPP shall he
posted on Covered Entity's weboitoat .
6.2 Covered Entity shall notify Business Associate of any restriction to the use ordisclosure of PHI
that Covered Entity has agreed to in accordance with 45CFR § 184 522. to the extent that such restriction may
affect Business Associate's use or disclosure ofPHI.
70 Permissible Requests by Covered Entity. Except for data aggregation ormanagement and
administrative activities of Business Associate. Covered Entity shall riot 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,
�7
P8ge5S
8,0 Effective Date and Termination.
81 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 anfollows:
(a) These Business Associate Agreement provisions, with the exception of the electronic
security provisions and the provisions mandated byARRA. H|TECH and Part | 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 ofPHI:
(b) The electronic security provisions hereof ahoU 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 ofPHI; and
(o) Provisions hereof mandated byARRA. H|TECH and/or Part | 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 m,ePH|.
8,2 Termination for Cause Upon Covered Entity's knowledge ofo material breach byBusiness
Associate, Covered Entity shall either:
(o) 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 in not possible; or
(c) |f neither termination nor cure is feasible, Covered Entity shall report the violation tothe
Secretary.
83 Effect of Termination. Except as provided in subparagraph (b) of this sechnn, upon termination
of this agreement. for any reason, Business Associate shall return all PHI and ePH| received from Covered Endty,
or created or received by Business Associate on behalf ofCovered Entity.
(a) This provision shall apply to PHI and ePHI that is in the possession of subcontractors or
agents uf Business Associate. Business Associate shall retain no copies of the PHI and ePH|.
(b) }n the event that Business Associate orCovered Entity determines that returning the PHI
or ePH| is infeasib|e, notification of the conditions that make return of PHI or ePH| 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 ePH|, but no |eea than six (8) years after the termination of this
agreement.
9.0 Regulatory References. Areference in this agreement to a section in the Privacy Rule or
Security Rule means the section then in effect or as may be amended in the future.
10�D 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 1erm, condibon, covenant or obligation which requires performance by either party
hereto subsequent to the termination of this agreement shall remain enforceable against such party subsequent to
such termination.
12.0 Interpretation. Any amb{Auityin this agreement shall be resolved to permit Covered Entity to
comp|y with the Privacy Rule and Security Rule,
��
P3AB5v
13.0 Incorporation bvreference. Any future new nequirement(s). changes ordeAction(a) enacted in
federal law which oreeha new or different obligations with respect to H|PAAprivocy and/or security, shall be
automatically incorporated by reference to this Business Associate Agreement on the respective effective deto(s),
14,0 Notices, All notices and communications required, necessary or desired to be given pursuant to
this agreement, including a change of address for purposes of such notices and communications, shall be in
writing and delivered personally to the other party or sent by express 24-hour guaranteed courier or delivery
service, or by certified mail of the United States Postal Service, postage prepaid and return receipt requested,
addressed to the other party as follows (or to such other place as any party may by notice to the others specify):
To Covered Entity: Alliance for Aging, Inc.
Attention: Max Rothman
78ONVV1O7Avenue
K8iami, Florida 33172
To Business Associate-.
Any such notice shall be deemed delivered upon actual receipt. |f any notice cannot be delivered ordelivery
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 Smvermbi|itV. 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 bylaw.
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 bz perform them in the same manner and \o the same extent that Business Associate would have been
required toif that succession had not taken place. This assumption by the successor of the Business Associate's
obligations ohoU be by written agreement satisfactory to Covered Entity.
18.0 Entire Agreement. This agreement constitutes the entire agreement rf the parties relating bo the
subject matter ofthis agreement and supersedes all other oral or written agreements or policies relating thereto,
except that this agreement does not limit the amendment of this agreement in accordance with section 10.0 of this
agreement,
Covered E i
By� Date:
Business Associate: Mu^lpec�E COJO-�Ty
By: Date:
Page 60
ATTACHMENT F
Verification of Employrnent Status Certification
As a condition of contracting %vitli the Alliance for ikgino, Inc.,
otiJRo wktn &Y—C- 15060-1 hereby referred to as contractor. certifies the
use of the U.S. Department of Homeland Security's E-verify system to verify the crnplOVMent
eligibility of all new employees hired by Contractor during the contract term to perform employment
duties pursuant to this Agreement and (b) that any subcontracts include an express requirement that
subcontractors performing work or providing services pursuant to this Agreement utilize the E-verify
system to verify the employment eligibility of all new employees hired by the subcontractor during the
contract term.
Signature Date
(Sarne as contract signature)
C ky i r'J', og-
7 Title
OF cc)r-
Company Name
7-777
00
Page 61
%I 1AC1 INI L:\ I G
BACKGROUND SCREENING
I., L 1) L R
e 1:1--,\ I 1�s Affidavit of Compliance - Employer
�f A I E OP I L.uW0A
This luirm, Is irequted vinuaily of -At to comply with[tie aftestAIIJW
reyuareraacratx ,scvt tort h In Rocd a Slat tA a�- I
rh" ,-r I)l 'no'llis ,frq pef,,,R zx PnC,ty irqljul;'t I"j hw to kAlo-ind ,W lie"
h'.I,I'g. lq�'J('I ro, ".,,i Aci'm I c, )II vg, Ing 1 -otw e I e, '011 Of,11,0 ly
,I.I j I I f.I e fit I-I",t.,;Kl Ae'efl,w."I o of,It'I III' It 1, �e t,,I nih iie,o it iii,mm%e Pjf-,,r I..
wj eAwr lwf-,on of olft&",vrPair.r i'fv:
�f hA, ill -ef,+I, s';ho wx'0 jflN of a J11(,<t '".f 1,1, �J>-j t. Frei
r11(1 311,SC.at.
A I I I 7u,r,j,n 114 "t of ;ilof, r"It-al'ifil tfr I i�) jltovidf.
-r�1, -f 1'rerl,t'), �1;11 f,(Cintift 4�,rltl I dw,111 Dios 'Ing lo 1�,p�h'-f t
to Ilso krid",jivi"ol"'ll plofivir-0,ut lkj,0IIti(3tK0 o,%f mition
101ned If w. Ifl;'%& Pit, (anal kithak's .uufAf!I.jtuI%, 111.1rutre1%, .trial ur I,,,#JVrItA
ATTEVATION:
As the duly autil0riZed rep rose rtative of
Iruwated at
Ail Woee-
Jo hereby affirm under T,enhn,,of perjury
—v,
that t Iny f"r i5 irl -,,-,--ip ianizf'. frith *he! rcviOcrf�, �>!` (F,iptt�.r 435 and �mcfiarr
koovr, nir-irl i-mz
4,-10,0zoa.Florida Statute,�,rega(.A:ng levfrl Z balkgtoulid"fpeflirig.
Signat�.;re of Pepresentat�,we Date
A I E 0 P FLORIDA,C0?-NrY Ofr
*-)rn co fDr affirreed) and subscribed befclre me this jay of 2 0_ by
(tJarr4- -)f Re!prr,,,wWaflvr-)who -.per-roritkily ki-irwrif
to me-,.r prc)ducecl as proof of idemr ffcatian,
Page 62
ATTACHMENT H
CERTIFICATION REGARDING, SCRUTINIZED COMPANIES LISTS
The Lill dcrs 1-ned. all authorized rcprescntative of the Contractor named in the contract or ag-reement to which
this form is an attachment, hereby certifies that:
(I) The Contractor understands that pursuant to s. 287.135 FS., any company at the time of bidding, or
submitting a proposal for a new contract or renewal of all existing contract, that is on the "Scrutinized
Companies with Activities In Sudan List" or the "Scrutinized Companies with Activities in the Iran Petroleum
Sector List (collectively. *the Lists") is ineligible for, and may not bid oil, Submit a proposal for, or enter into
or renew a contract pursuant to which funding is provided by the Department of Elder Affairs (Department)
t'(.)r goods or services of S I million or more.
(2)'The Contractor understands that, pursuant to s. 1-87.1'15 F.S., any company that submits a false certification
is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of
false certification.
(3)The Contractor understands that the contract to which this form is an attachment may be terminated by the
AAA if the Contractor submits a false certification or has been placed on the Lists.
This certification, required by Florida law, is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction.
Signature Datd
(Same as contract signature)
-QQ�v
Title
XT:
Company Name
Amendment 001 CONTRACT KC 1371 Page 1
THIS AMENDMENT, entered into between the Alliance for Aging, Inc. hereinafter referred to as the
"Al'tiance", and Monroe County Board of Commissioners, Social Services/In-Home Services.
he purpose of this amendment is to modify Attachment 11 of the original contract to read:
A'I'TACKNIENT 11
COMMUNITY CARE FOR THE ELDERLY
INVOICE REPORT SCIIEDULE
Based On Submit to AAA
Report Number On 'I'his Date
July Advance* July t
August Advance* July 1
3 July Expenditure Report August 15
4 August Expenditure Report September t 5
September Expenditure Report October 15
October Expenditure Report November 15
7 November Expenditure Report December 15
8 December Expenditure Report January 15
9 January Expenditure Report February 15
10 February Expenditure Report March 15
I I March Expenditure Report April 15
12 April Expenditure Report May 15
13 May Expenditure Report June 15
14 June Expenditure Report July 15
15 Final Expenditure and Request for Payment July 25
16 Close Out Report August 15
Legend: Advance based on projected cash need.
Note # 1: Report #1 for Advance Basis Agreements cannot be submitted to the Department of Financial Services
(DFS) prior to July I or until the agreement with the AAA has been executed and a copy sent to DFS.
Actual submission of the vouchers to DFS is dependent on the accuracy of the expenditure report.
Note # 2: All advance payments made to the Contractor shall be returned to the AAA by the submission (late of
report #9.
Note -3: Subi-nission of expenditure reports may or rnaV not generate a payment request. If final expenditure
report reflects funds due back to the AAA payment is to accompany the report.
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 are hereby amended to conform with this amendment.
This amendment and all its attachments are hereby made a part of the contract. This amendment and
all its attachments are hereby made a part of the contract.
Amendment 001 CONTRACT KC 1371 Page 2
iN WITNESS WHEREOF, the parties hereto have caused this 1-page amendment to be executed by their
undersigned officials as duly authorized.
PROVIDER:
Monroe County Board of ALLIANCE FOR AGING, INC.
ommissioners, Social
rvices/I m ervices.
SIGNED B SIGNED BY: � ,
Sylvia ur y Ma B. Rothman, J LL.
NAME: ' eu e.n.t_ _ NAME:
President & CEO
TITLE: Mayor TITLE:
DATE: 11/2,0/2013 DATE:
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