01/20/2021 Agreement 'lc Kevin Madok,
CPA
CC
a
Clerk of the Circuit Court&Comptroller—Monroe County, Florida
DATE Februarys, 2021
TO: Sheryl Graham, Director
Social Services
ATTN: Lourdes Francis, Administrator
FROM: Pamela G. Hanc 4 .c.
SUBJECT: January 20th BOCC Meeting
Attached is an electronic copy of die following item for your handling:
C29 Standard Contract No.AA-2129, Older Americans Act between die Alliance for
Aging, Inc., and the Monroe County Board of County Commissioners/Monroe County Social
Services/In-Horne Services and Nutrition Programs for the contract period of January I, 2021
through December 31, 2021 in die amount not to exceed $700,545.79.
Should you have any questions please feel free to contact me at (305) 292-3550.
cc: County Attorney
Finance
File
KEY WEST MARATHON PLANTATION KEY 500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 HighROTH BUILDING
Key West,Florida 33040 Marathon,Florida 33050i y 50 Plantation Key,,1F305-294-4641Plantation05- - 145 Florida 33070 05- - 14
305-289-6027 305-852-7145 Floridala 33070
305-852-7145
AA-2129
ALLIANCE FOR AGING, INC.
STANDARD CONTRACT
OLDER AMERICANS ACT
THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as the "Alliance,"and
Monroe County Board of Courity Contin iss loiters,Social Semices)ln-flonte Service , hereinafler referred to as the
"Provider",and collectively referred to as the "Parties." The term contractor For this purpose may designate as vendor,
sub-grantee or SUb-recipient,the status to be further identified in Arl-ACI-INIENT It, Exhibit-2 as necessary.
W ITN FSS ETH T HAT;
W11FREAS, [lie Alliance luLs established through the Area Plan on Aging that it is in need of certain serviceq. as
described herein.and
WHE,REAS,die Provider[las demonstrated that It has the I-CqUiSitC and ability to faithfully perform such
services as an independent contractor of the Alliance.
NOW THERLWORE, in consideration cif the services to be performed and payments to he tuadv%together with the
HILMMI covenants and conditions hereinafter set forth,the Parfiesogee as follows:
1. Purpose of Contract
"file purpose ofthis contract Is to provide swrvicos in accordance with the terms and conditions specified in this
contract including all attachments and exhibits, which constitute the contract document.
2. Definitious
AM, —Activities of Daily Living
AP S—Adult Protective Services
ADA —Americans with Disabilitie5 Act
Aliiance—Area Agency on Aging
APCI. —Assessed Priority Consurner lJst
CIRTS—Client, Inrortnation and Registration Tracking System
DOY-"A—Deparfinent of Elder Affairs(The Depatulient)
I&R—information and Referral
[AD[-—instrumental Activities ofDaily Living
MOM--Memorandum (-)f Agreement
MOU—PvlernorandUol of UIRICI-SWIlding
NSIP--Nutritional SCI-ViCCS ItWeotiVC I'VO"I'
baul
OAA—Older Americans Act
PSAs—Planning and Service Areas corresponding to Miarni-Dade and Monroe Counties
SPA®-Service Provider Application
USDA —United States Department of Agriculture
3, Incorporation of Documents within the Contract
The contract incorporates by reference attachme tits, proposal(s), solicilation(s), Provider's Service Provider
Application,and the current DOA Programs, and Services Handbut& Any and all contracts or agreements
c,,ccuwd between [lie Providerand the Alliance during the erl'wive period ofthis contrac(shall be governed in
I accord'tocc Willi Lhe applicable laws mid statutes.
4. Term of Contrad
This contract shall begin on jantrary 1,2021 or oil the date on which the contract has been signed by the last party
reqUired to sign it, \vhichever is latci% It shall end at midnight, local turic in Nliarni, 17 lorida,on December 31, 2021,
careless renc%ved or eNtended as provided herein.
Page 1 of 73
AA-2129
5. (7ontract Anictunt
The Alliance aorces to pay for contracted services according to the tersns and conditions of this contract in an
L anIOUnt u0t to exceed J700.,54- 5-79 subJect to the availability of funds. Any costs m-services paid for under an),
other contract or from air), other source are not eligible for payment Under(his contract.
6. Renewals
By mutual agreement of the parties, the Alliance may renew the contract for five additional one-year periods.
Contingent upon satisf-aclory, perforniance MilUati(MIS by the Atliance and the availability of funds, any renewal is
subject to the sarrie terms as the original contract, with the exception of establishing unit rates which is described
1,111-ther in this section. The original contractual unit rates are set forth in the bid proposal and reply.
Requests to renegotiate the original contractual established rates are provided for in the Alliance's approved
Reimbursement Rate Review Policy, which is incorporated by reference,
This contract may be. exterided upon mutual agreeirtent fior one extension period not to exceed six inoriths to ensure
continuity of'service. Services provided Under this extension will be paid for Out of the succeeding agreement
11111101111t.
7. Compliance with Federal Uw
7.t This contract contains federal funds. The fbilowing shall apply:
7,1.1, The 11rovider shall comply with thv provisions cal 5 ('11174 andlor 45 CFR 92,and other applicable
regulations.
T 1.2 Ifthis contract contains Icdcral funds and is over$100,000M, the Provider shall comply %vith all
appIlicable standards,ordcrs,4)r regulations issued tinder s, 306 of the Cleart An-Act as amended(42
U.S,C 740 t, et seq.), s, 508(if the Federal Water P'0111.160fl Control Act as aluended(33 U.Sk 125 1,et
sect,), I"xecutive Order 11738, as amcnded, and where applicable Environmental Protection Agency
regulations 40 CFR 30. The contractor shall repoa an e to the Alliance.y violations ofthe above'7.1.3, The Provider,or agent acting for the Provider, may not use any fiederal funds received in conlicction
with this contract to influence legislation or appropriations pending before the Congress or any State
legislature. The Provider niust complete all disclosure forms as required,specifically [lie Certification
ofAsSUrances Attachment, which must be completed and returned with this signed contract.
7.1.4. In accordance with Appendix A to 2 CFR 2[5,the contractor shall comply with EXCCUtiVC Order 11246,
Equal Ernploymeat 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,
T 1,5. A contract award with ain amount expected to equal or exceed $25,000.00 and certain other contract
awards shall not be rnw[e to porfies listed on the governnient-wide Excluded Parties List System, in
accordance Nvith the ONIB guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689,
"Debarment and Suspensiom" "I'liQ Excluded Parties List System contains the narnes of parties
debarred, suspended, or othQFWi5c`QXQ11,1ded b.V EI�encies, as well ms partics declared ineligible unider
statutory or regitikilory atuh,01"ily other than EXecl,16VC 0rdCV 12549 The 11rovidcr shall comply with
these provisions before doing business or entering into subconlracis rccciving federal fUTIL15 PUI'SlMllt 10
this contract. *['he Provider shall coniplete and sign the Ccrilification in(] Assurances Attachineril prior
to execution of this contract.
7.2. The Provider shall not employ an unauthorized alicti The Alliance shall consider the ciriploymorl of
unauthorized aliens a violation of the immigration and Nationality Act (8 U,S,C. 1324 it)and the Irnini,::,nition
Rerorni and Control Act of 1�)86(8 US,C_ I 101). Such violation rahaall be cause for unilateral cancellation of
this contract by the Alliance.
Page 2 of 73
AA-2129
7.1 If the Provider is a non-profit provider and is subject to Internal Revenue Sel-ViCC(IRS) tax exempt
organization reporting requirements (filing as Form 990 or Form 990-N)and has iila=wx exempt status revoked
For failing to comply with the 111ing 1'eqUil-CrIlentS or the 2006 pension Protection Act or for amy other reason,
the Provider most notify the Alliance in \vriting within thirty(30)days of receiving tlic IRS r1ofice of
reVocallOol
7A, Thu prcivider sh;,dl comply Nvith Title 2 CFR Part 175 regarding Trafficking in Persons,
7.5. Unless exempt under 2 CFR Part 170i1 t0i(b), the Provider shatl comply with the reporting requirements of the
Transparency Act m expressed it) 2 CI-'R 170.
T& To comply w1th Presidential Fxecutive Order 12939,and State of Florida Executive Order Number I I-I t6.
Provider agrees to utilize the U.S. Departinetit ofl-loincland Security's H-vcri(y system to verify the
eniployrnent o1all new,employees hired by Provider during the contract term. Provider shall include in related
Subcontracts a NqUirenient that subcontractors andlor vendors perfonning work or providing services pursuant
to (lie slate contract utilize the E-verity systen)to verify employment of all new eniployces hired by the
suhcontractor and/or vendor during the contract term. Providers meeting the terms and conditions orlhe I--
Veri(y� Sysicin arc deemed to be in compliance with this provision.
8. Compliance with State LaNy
8.1. This contract is exectited and cincred in(o in flic State of Florida,and shall be construed, performed and
enforced in all respects in accotdinco with the Florida law, including Florida provisions for conflict of laws,
8.2. The Provider shall couiply, witli the requirCHICII(S ofs. 287.05$, F , as anwnde&
8.2,1, The Provider shall provide Units of deliverables, inClUding reporting, findings,and drams. as specified in
ell
this contract, which the Contract Manager MUSE receive and accept in wriling prior to payment.
8,2.1 Hit: Contracior shal I coinpl\ ,with the Criteria, and 1'"LEMI (h1LC 1)), \,JdCh MICA Ct-iM-ki Mthl IN: MCI[
Itir Qompkmion nffliis controct a,, ,pv6J"wd it) A I'l ACI I M lWF 1, Scclion I I I, N10hod oV
PIynwnt,
8.2.3 The Provider shall submit bills ftn' fees or ollier compensation for services or expenws in sufficient
det.itil Im a proper pre-audit and post-audit.
8,14, Ifiteinized payment lot-iravel expenses is permitted in this contract, the cetntractor will stibinit bills For
any travel expenses in accor(lirince with 1. 1 19.06 1, F.S., or at such lower rates a-s may lie provided in
1111S contract.
825i "I'lic Provider sha[I allow public access to all documents, papers, letters,or other public records as
defined in subsection 11 9M 11(12), V S—made or received by the contractor in conjuoction with this
contract except for those records which are made corifidentialor exempt by law. 'The Provider's refusal
to compty with,this provision shall c;omtltutc an nnnic(liate breach ol'contract for which the Alliance
for Aging, Inci way unilaterally tern-driale the contract,
83. Irclients are to lie transported under this contract, the Provider shall comply with the provisions ol'Chapter
427, F,&, aud We 4 1-2, F. & C
8A Subcontractors and/or vendors who are oil the discriminatory vendor list may not transact NlSioeSS with any
public entity, in accordance with the provisions of s. 287,134, f's.
8.5, The Provider\-vi 11 comply with the provisions of s. 11.062, F.S.,and s. 2 16-347, F.S., which prohibit the
expenditure ot'contract ftinds for(lie purpose of lobbying the logislatUrC,judicial branch or it State agency.
Page 3 of 73
AA0129
&6, 1 u accordanvc wi I h SeVoli 28T135 FW any Con tractor on Me SUL.Winized, Conipanies with Act iv hies in
Sudan IN. Me Saw hind Coin ratnics %vRh Activities in rhe ban Petroleurm E-awrgy Sector L,ist, or do
Senn Kind (oni,pailies t[rat Boycott 1W List Qsts). crouleci ki Se,chon 2 15,473 FS, and
215A721 KS. or is one agcct in a i),.,)cot, or ivrei, or is ent"'..aged in husiliess olieralions in Cuba or Syria, is,
ineligible to enter into or rmvvv a contsact �%ith the Departinem for goods,or scr,vw(,s gal $I 0000)0 or rnme,
l-'urst,mint to Section 281135 W. dw Alliancc inay rerininaie this contract, ifflii.-Providm- is fiwoid to have
nWhad to Use cutineadon of A srauls on be Lists or has Nor oil die Lifts or is en,,,�aged 0 a
boyca.-At oflsrael or has been engaged ill bL['ih1CSS Ortl2rdflons in Cul")a or Syria. Further. the Provider is
sutdect tarrvH c penalde& attorney's lies W, costs and my Loss Ar investigations tlnll jecl lo 11W findimp of-,
like cert%athmi The Provider shall conipl.ete and sign Te Unifications and Assurances thaachnient. Pan-
to % ewcut On of ibis Qmwwo,
I L lie PmvWcr AM! compt with mid ma wv sWonvolors are irk compliance %%ith [Ile requirellierrts,ofs:
4301402 and Chapter 431 KS, as anierided, are nio rc-pradhM backgrourid s-erwri ing for al I persons who
ine,et the defini,tion of a direct savice provider ail %vho mr nw exmqip, rrt:)m flie 1)cpartment"S level 2
Nwl�grourtd screening rmusuant to v 43UMQ(1131 F& The Provider must visa corriply ;&hh any tap pHcable
mks prorritilgawd by the f)eparlinent arid be Agowy for Health C-arc Adi-junistratiiot
implerriernm5n of's. 4130.0-102 and Chapter s135-1-`.S.
12, FLIXIINCT ird6ritialion claiwankg Me pi-licladures Ar backgrlau.nd screening is round M
01 Bacisground Screening ikAidavir of Comliliance - To dernonstrarte cart rfliarice %vith tr'lis' Conga--act, flic Prl'i'vidor
x ha 11 s ub n i h i%I]'A(.,HN1[:Nl EN 1A c kgmu n d S c men i ng A it dax i I a f Ccl i n 1,-j l'i arse e a.,i o i i ual I i,, I'ly J ai1L-fears 15 k h
111 Gfivvarace Provedures
Ile Prodder Mull comply wAh and enskiry submadracror vendors cmqhance whh to Wrimurn Widehms,
Or Recipient Grievance 14welves, A ripardix 1), IBC. 15A PTOgranIS and Sem ices I landbook, to address cort)plai rits
regarding the larrunaiion, or reduction ofs,.,rviGcs, a5 re(Itured lor receipt of runds,
Ifl-I., Contplaint Procedlaivs
The Provider sh.all develorl,and roil:Wrins complai ru procedures arid eivsure diat ,ulicontrac tors arid,`or
vend,ors deveicipand inil.,flerricrit corriplaiial procedures to process and resolve L;lir,,,rjt disswistaction %vith
serviees. Cornpla,int procedures s1rall address the, quark, arid linielkwKs of services providl,er and dimo service
worker cornplahms, or any odwr advice rNawd to corriplainm oVer Wall rell-nimsiom sumervilan or redwtion
in semims that require the grievance process as descrilied ill Appendix 1), Doliartirlo'll gal I l(t•er A ff(d.rs
Pwgrams arid Service's liandbook. The complAu pmczdurc�shall, iricludc nadficalki to all alienis ol"the
co ri 11)[a a n P, proc ed u rc arid i 11 C I Ll LIC, t rac k ing do d at e, nahme a f camp 15 M, d w do vac h l;orin 0 A M,
and the follow-tilt WhAhe CHMU to ensure sar.,isfactiort with the resolutiorl
PubIrc F�vcoords artf.1 Roctiflori,
f 1 . ll'-s, oxt""cotion Ott. thk w1mvict. (VMrwhw dgwos h; PH pwwkhmis 410yoky 1 19, KY mhl an.,,�
oW jITHWo lam, am! shall:
I 1 1. 1 , lin, and n0mmin puhlic awds rcQrQ JI)o HL.jLfk)rlj'j Ill(-'
J A. 1-pon Nquat Amn the Deparniu2nt's custodian ofpn[W YMOV PlAnK OW 1kPM11HQHl J Uj-,
dio
a a annz iho; sties not exceed HJW COY PNLl%jL[o] in 1 14 F 4"Was ohm" ke pnn kwo hY
Page 4 of 73
W2129
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Rul % UING III fills ( 0% 1 it it K f MYhor, I I M, I, S 11 of)l v", ('01, H, �3h W lfl"( OW)`% ivy
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AuMls, I n m pvc i In n s, I a v eni Ii gvj It k)1.1 S, 1,1111,1 i C Revor ds a n III It vt C 1:1 t i 6�11
121. T'he Ps YO W A a H cc A H M i a w I m M n twin h no k k run r rl s u id,d oc a i irt--i i S MI;1 ud i ng cd couc m i v s i ara ge nured i a)
sulm6u1= kv re ect A am, Al Win, undd igavl 1.ad incorrre ii il�,,Ivs,,L ari,c] exivndom e-, o!ftrla ,,;
pro,ided h,v the AHianct: kukler rhk conuxt Prof id,t�x Ihall adequ,,.awI_`, L1,11 SLICII aSS,VI1--, Arld w��ture
W me sL'd, 11� fe➢r dw 1:-Po41Eiwov suokwizal %uslur this coinzact Mvenevor zWpmprrAc, Rnans t;,d
ind'"inaahmi NhDiihl bj-o, ri,-Liaed lot ju,,�Yhinmance and WE cint data,
112, TwAlmAN MmIl retain A clicirt nxords, lisianial woudk suppartingdocumov, MAMA rmoMm and
any odwr do"imunt (inchadirqu,cluctronic viorage rnmhM peninent to Wis cornrz;wt ai-wricitl of six yeal's
aRuvmuWv1Qn uFle cotma sir kmgvr "ten noryiNd h) law, In the event vvn Wit is requirml hy lhis
c o ro ra 0, rev Ord s s WN be m W hwd r 4 i ii, n ror k i-,,n Fic in A Is f 0 x 41 y cars aIle r �f�w a od i I re p,or1 5,, k t,i e 1,1, or tj n
msol;;Oon of any ault WhTs or IN,jon bmedun Hit kmms offflis kl"ntra,'J, a 'no ix%%l to th'a
A lWe
III Upm donouid at no-uW A Wd uum to the A lharwe. Ow PVMkkT Will W H i We
any rveords or LhWoUents Ming lt, roquircd rtilvuliorl period in 'Paragr�-Iph 1-1-2,
114, 11 w II ivuh SO assrue chit be records dayd hed in WS section shal 1 he suNveL ai al I reamulahk ;inies t(��
Me, or Ober C,,,UWj dj&� �Jnr
0§00AUL re Wss, copying. or audN by F edu al, Su k�% 1.he A I I i aric e-
Page 5 oF 73
AA-2129
125 A! all reasonable thries Rn as toil as records rue nukuhud., por,ti,a5,didy autIffiorizal In Me Wance, WEA
l'cukcrad arwdircprs, pRusuant to 0 CFR F%n 71 shall b allov,,, d FnH Facce�a"' R"ie frgh
of the PnMdcr's,,r-ovrac1,s wid relawil rucowdy irndl 'Ic)eunwn'rs per!.4r,en1 ro lins Wk: V01WACL regast'Ites, �of
We 6arm in %hich kqtr,
116, Hur POWWer shall provide 11 Kuld"I alml wnydimice amlh to To Alhance am specified in Sks c(murac! and
e1[.,undmialAdated4k1paxy
117 The Provider shaH caiml:dy amll mopomc to wwdiately will arli inspections. reviews, or
at.iditsdeemed necessary by to oRke of the lit EA's 101SPCISIOr GINTIol',01 p'tu-suiant tos',, 20M5, 1,"S, F'rovider
I H a 10 AyQoi i hot i I 1 4111 W0102 HI I Mk%i OKI=ads a rw,pKlVH1CH1 Itsa I StS K I 11;W 101; .110 i W
Ohl n, Inni njhq: "jwh " ljo, hidIn %,q% jVVN jwwwt w 1d, cwordwi wwo wo'."Viou "I& tl',-
WFIRWkS I 11,14WIt-I"!W &On, 11 .;has'. OhW =q I HqWH 11 , 10% 10" WIN WIH; YA"I AM
k :5 K 1 -"WUN AJ 01 th V / Wq=l OW 140 KKq WHWILHO AW %% d' —maN whi ON
UK'Tro, "
13. Rights
I T I I hv P"nj&r shall uNecule asmormwev KA I I.0 I lNAl'-.N"FVl that it will imm dinihimaw agaW any ivi'son
in we yal vion of SUOVS or hownis 4.1M10 in, collrr.'wi or in ernplct ,rnont l-,ccaine of ago item Wgion,
cohn, disabiht- num innal injow mark at St;l U% co S'V*, i 1, CORI ljhZunCC MW WIWC a",l Wnd WM imd wgul Whris-
1 he Provider fm ther ,tsnm- °s ftm all =1 rar:uns, NoWnwroclor& vendors stib-grarri i It, url wv�2 0,tth' IN Boom it
alvary, to pmy ide sowkes I w hvit0i is in c om w®r ion "h h any of i is 1progr""'ll re, "'Ind aci i v4ic'? oni"' 1-lol
cikcrhnoiakng agant chews or wzyms iYowc orrin ritcv. ir-eligkwl. c'('dor" 1"Ji'sahHuyz o"rip'n.
nuuKil mmus or sex.
1-2 D"llrill tile term ofthis cmuma Ow Puwidwa shall chumplarte and Min an OW a 'u, e o ILI I Q arid
(T it Rights ConiiplWiwe Cleckkv awwWd to AN cowmci
111 Hw PumWer dmH eqAWh pranwedhirv; pwswam Ni 111cral hum to Sale compttims of disknunnahn
wo'ol"" i""- ices or benefAs 10migh % c"mravl 11no pmwediven kid! include mmy AT
"'nvqflo"acv's' "rrl(l ol'i'lle r,ight w, nd,," a,k unmiaks %Ah Me aWrAlbate We al or mate emb
13A ff thin contract contains Wdewal funX We n,wames we a conTiOn of covivinta"'d oh"ir bencl'ir ficla"
MY finawhil assislance, and, are binding tqxqi ths lhoviclei% hs and assijgruees 01
Ow period AST mflkh mxh assisrance n jwnvidoul, I'lle ProYider Farlher asmaes Hmi all sithivisnuscumns,
oroflxrs Wh Wfimn it III purm,,,ide, ices tw benefits to parlicipanis or eniployees in
�'nlaw(hon kkith oil v -'ofh"'; pror;ri"Irns am',J sic livilrcy arc imm discriminating agadiso Tosu pats 6pints or
employ eas in Wation ut'S al,nvv xhahAvs, rcgulmions, gmidehnes. and staiMa"k, In rho cvwH of kdw-e it),
conWly, he Pnvvidcr undcr'sizirids ONo rho Ahkiawo may.at its discroM seek a coun orhy reqwn I n 4"
conqQ knee "Ill dw ternm of this thsunwwv m seek odivr apprurru-'ate judk if or adnirdwnahv iv Ficil
i m:h A it I b In not H nd red tip, 1,e rt N i i r i-i I ior i laino i ud ,I,-,,ir ia I of (l I rl hv a1 i'ma 1-1 cv,,
1 ProviOon of Services
I'he 111A,"svider "'hatl provide the ser;On refined w in W1 IOIC14NIF141 V11 irl the Trninlner in 11w L)CH-A
11opialirs & beii ices I landbook aml me h,cividur's S'ervke Prclvider Application(SPA), In Pre c-ven.1 ot'a ,onllic
�'Rte Sen-vlce laru..3vivIct Applictrion and Aw connaw.i. the Invnvact languagv pru%aik,
15. NloWliming by the )=nce
1 hV Plot idOr shall lei rmirl peBons dull,.I aulmoded by the A.Mmee to inspect srmi rkT) an) recordn, papers,,
dmuiricran Whin. goods and serk icos ofthc Pmvhkr m Vilich aN relww to 06 cm-ammmid hi Wicnim aq
Pape 6 of 73
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clients,employees and subcontractur/vendor employees ofthe Provider to assure the A I I iance ofthc satisfactory
performance of the ternis and conditions Of this Contract. 17011OWing SUch review,the Alliance w1h deliver to the
Provider as written report of its findings,and where appropriate, the Provider shall develop at Corrective Action Plan
(CAIII). The Provider hereby agrees to timely correct all deficiencies identified in the CAR
16. Coordinated Monitoring with Other Agencies
If the Provider receives funding frorn,one or snore, of'the State offlorida latraaaan Service agencies, in addition to
Alliance funding, that ajoint m0ni(Otil%visit illChldirn�Such olher agencies inay be scheduled. For the purposes of
this contract,and ptinsuant,to s. 287,0575, R&as,amended, Florida's human service agencies shall include the
Department of Children and I"amities,the Departniont of Health, the Agency for Persons %vith 1)isabilities, the
Department of Veterans Affairs, and the Department of Elder affairs. ()poll notification and (lie subse(litent
scheduling orsuch a visit by the designated agency's lead administrative coordinator,the f1rovidershall Comply and
cooperate with all monitors, inspectors, and/or investigators.
17, Intlernnification
The Provider shall indemnify, save. derend, and hold harniless the Alliance and its agents and employees from are
and all claims,demands, actions, CaLlSeS Of action of whatever nature or character,arising out of ear by reason of Elie
execulion ol'this at,,,roernQrn or perf6rutanw of this services provided for herein, It is understood and agreed chat the
provider is not required to irnIQrnni(y the Alliance for clairtis, demands,actlon5 at'caUScS otaction arising solely out
of the AlIiancc'5 negligence.
IT I Except to [lie extent peralitted by s, 768.28, I".S_ or other Florida law, Parag!raph 15 is not applicable to
Corlit"UtS CXMIted beiweert the Alliance and state agencies or subdivisions defined ill S. 768.28(2), F.S.
18. Insurance and Bonding
18,11 The Provider shall provide confillUOUS adequate liability insurance coverage during die existence oftfik,
contract and arty renewal(s)and extension(s) of it, By execution of this contract, unless it is as strata agency or
Subdivision as defined by subsection 76,8.28(2), FS, the Provider accepts full responsilfility for identifying
and determining the type(s)and extent of liability insurance necessary to provide reasonable financial
liroNctions for the Provider and the: clients to be served under this contract. The Alliance shall be included as
an additional insured on the provider's liability insurance policy or policies and as copy ofthe Cerrti
ificate of
Insuratitx shall be provided annually or when any changes—occur. 'ne limits of coverage taider each policy
maintained by the Provider do not limit the Provider's liability and obligations under this contract. The
Provider shall CI Sure that il'ie Alfianct! has copy ofthe most current written verification ofinstil'alice Coverage
througlIOUt [Ile term of this conlractt Such coverage may be provided by a self.insUraFICe program established
and operating trader the laws of the State of'Honda, 1"he Alliance reserves the right to require additional
insurance as specifted in this Contract,
18.2 Throughout the term of this agrecinent, the Provider shall niaintair an imurancv, bond from it responsible
commercial insurance company Covering all officer%dircclors, eiiiploy(ms aiid agents ol'thc Provider
authorized to handle funds received or disbursed cinder Gall agreenients and/or c(.-ailracl:i incorporating this
contract by reference in art atnoUrIt C011MMISUrate with the funds. handled, the degree orrisk as determined by
the insurance contpany and consistent with good business practices.
19. Confidentiality of Information
The Provider sliall not use or disclose arty ffif"Orniation concerning a recipient Of sel'ViCeq Under this contract for any
purpose prohibited by state or federal law or regulations except with the written coosont of a persoll legally
authorized to give that consent or when M11horized by law.
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20. Health Insurance Portability and Accountability Act
Where applicable, the Provider shall conlilly with tile Health Insurance, Portability and Accountability Act (42 USC
l320d.),,as well as all regulation,;Promulgated thereundcr(45 Cl-R, ICE{?, 162,and 164)�
21. Incident Reporting
21.1 The Provider shall notify the Alliance immediately bill no later than forty-eight(48)hours from the Provider's
awareness or discover-
y of conditions;that may materially affect the Providers, subcontractor's or vendor's
ability to perform the services required to be performed under any contract. Stich notice shall be made orally
to the Contract Manager(by telephone)with an ernail to immediately follow,
21.2 'file Provicier shall immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of
a child, aged Person, or disabled adult to the Florida Abuse Hotline on the statewide toll free telephone
nurither(1-800-96ABUSE). As rcquired by Olaptiors 31) and 415, F.S this provision is binding upon the
Provider,snbcontractors, vendors, and their eniployces.
22. Bankruptcy Notification
It, at any time during the term of this contract, the Provider, its assignees, subco tit ractors, voridori or affiliates rlQs as
clahn for bankruptcy, the Provider ITILISt immediately notify tile Alliance, Within ten(10)days after ticxificotion,tile
Provider rtr(M also provide [lie Collowing intbritlation to the Alliance-(1)the date of filing of the bankrupley,
petition; (2) the case number;(3) the couil name and the division in which tile petition was riled(c. g., Northern
District ol'Florida, Tallaha-isee Division),, all(],(4) the name,address, and telephone aUmber of file bankrupley
atturricy.
23. Sponsorship aird Publicity
231 As required by s, 286 25,F S,, if tile Provider is a nort-goverrovental organization which sponsors at progran)
financed wholly or in part by state funds, including arty Rinds Obtained through this contract, it shall, in
publicizing,advertising,or describing the sponsorship of the program,state: "Sponsored by (Provider's
name), file State of Florida Department of Elder Affairs and the Alliance for Aging, Inc," If the sponsorship
reference is in written material, the words"State of Florida, Department of VI der Affairs"and "Alliance l6r
Aging, Inc."shall appear in at least the saine size le(ters or type as the naine of the organization.
2,3.2 The Provider shall not use the words "The State of Florida Department of 1,71der Affairs"or"Alliance for
Aging, Inc," to indicate sponsorship of a program othemvise financed, unless specific authomeation has been
obtained by the Alliance prior to use.
24. Assigmarents
24,1 J'he Provider shall (lot assign tile rights and responsibilitteS Linder this Contract without the prior written
approvail of lie Alliance, which shall not (-le till reasollably withheld. Any sublicense, its i�rirracnt,ear transfer
OdWrWiW OCCUVritIg WilhOW prior written approval of(he Al liance Nvkl COnStilLOC as nizterial breach of the
contract,
2,1.2 'file Alliance shall at all thnes, he entitled to as-sign Or transl"er, in whole or part. its rights,duties, or
obligations under this contract to another agency upon giving prior written notice to tile [Irovidei% In (lie event
the Alliance approves transfer of tile, Provider's obligations, the Provider remains responsible for 111 worn
perlbrined and all expenses incurred in connection with the conimcl.
2143 This contract shall remain bindilIg UpOn tile NUCCCSS01-5 in interest ofeillicr the Provider or the Alliance.
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2,5. Subcontracts
X I TR Provider is responsi bk Fin AI word per f'ornied pursumi to this contract and th,e Service Ptavider
Application in response to the 2t')l& ("),AA RFP %%hodlor"'I'etlially Curnished by the provider or., its
subcolumums aridior vendors- Arty sukontracts shall be evidenced by a written document and subject to all
conditions of approval the Alliance for Agino deeins necenary. IS PruVidUT must ensure that the Alliasnce
has as current lit of MI sukontractors andAtr vendOVI The 1'rovisdor Wher agrees that the AlHance shall not
be 1 AN W We subconiractor and1or vmAoHn my way or for any reasol 1, '['lie lbovw0r, at hs expmse, mial''I
Mml to Allbrice apinsi my such cbkis-
232 Ile floOder shall promptly liciy' any subcommoms mod/or vmd011 Upon reu 1 p of rmymonl W WC
AMance. Vadme to nmkc park nenis io any subcontractor and/or vendor in accordance with s- `y�7,0585, F'Is-
unless odwvwiso smwd in No coiaract bowmn 11-iv Provider aind SUbcontractor and/or vendor, n il I resO I in a
lieria,lv_y as provided li� staikatc,
26 Independent C..apacio, of Provider
It is the ituent anti Welstandirg of the Panks dim the ProddeL oriiiny of its subcontractors andfor vendors-, ase
independent ccouractors aml are nxv emliloyees of the Alliance arad sdiall not bWd Owniselves our as muNgves or
agants ofTe Alliance Whma qxdnc au.thorizati.ori froirk the, Allianco, It is dre Wher WA and undusW41 of
Ow Wes that[ to Al Hance does nor comrol We practices ortlie and shall not be liable For aq
m age und hour, employment discArninafion, or oilier lahr and emphynwrd clakin against the Provida or As
subcNamoors anWor vendors, All decluctions fior sociad seemi, whhholding taxes, Rome Me& contributions to
quicinployrnen, vorapensathn WAS mk aR necessary insurance f-or to Pawkkr shall be We sole relmnsibilkity of
[he 111-tivider.
27. I'laynlent
2TL Qrnm ns v it I lie inodc to To isovidor pursurou to s. 2 15,422. F-S.- as services, are rendered ,irld illvoiccd by
the r:,roviLter. 'rhe Allizince will We final approval orne wivoice for payruent. arld %011 approve To immko
for payruent only if Pro�vider hzis Inct all tcrriis toil coriltimn or We cmumn, urAns We hid stimilkwKs,
purchase ordeq or dais contractspecify otherwk,4, lie approved hivoicewill lie submhted to the AMance's
fiscal secticpri for budgelciry approval aid [Vocess4g. Disputes al-ising over invoicing and payni,eins wR1 he
resolved in accordance%vNh the provkimls of s. 2 11422 KS-
272. The Provixtei agrees to subrinit bills for fees or other compaxinon l'orserviecs or cxpenst-,s in sufficient detail
Rn to propu pre audit and pom audk WWI he cmvraww Shull croupy %,,-hit the particuJar requironerits
under the ibllmving laws and guidelhes On am appUmble to dw o ooltruOs or agreerilents, incorporating hi this
Coal rad by re thence (a) paragmph (10 1)of sec6on 2 16.18 1. F.S., rot,,,ardurg advanccs-, (b) Rule 691-
40,103 1:-,A (:', pertairling to Restricdon of Opendkwts frmn sue bulds; ant Q) Um InvAce ReqW rot ems of
the Rorornwe (Jukle Or Stale EximadRums froin the i3qartinmr: or Wncial Semius a-
The F'rovidcr will certUT duo dewiled docurnmvathn is available to support each Rom on the Annimd, ins oluc
or pa,�incra r6r COS! Tehrribursed, expenses, Fixed rare or dahverableq cotrtr'acls 01,
i 1-1 CC)r li 0 ra 1 i it",", I h is C o I I t nw 1" 1-c 1'C re n m. he rod 6 g pa i d S U 11&01111'aIc to r a i itl/o r vend L a r in vc)iC os, and 4%i 11 b,,,,
p r mtric e d upo ri reW w M by A e A H Inc e. T h e Pn),v i der av i 11, further ce rt i 1� that re i I ll 1)Ll rse I n el I t roq I I Ci t .tare (5111 y
Ar aRowabb expmag us dot nod hi We laws and gu%q cirultm c-ited ha Actims 4 o Nils Convact, bi the
Referetice Guido fbr talc itures. and, any other ktivs or regulations. as appi icatile.
.27-3- The Provider, its suliCoulrOdoors,andlor vendors VaH provi,de units of dtliverables, inCholitu;rel-Lj,orls, firldings,
and dmRs as. Specified in the eorlwadA or agrecrumMs and Mc lin-lents which incorporate [his Contr.-ict 1) be
recei ved and accepwd by Tv Commet prior ro payn-kent,
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27.4. Pkyrnerns will be madic to the Provider hased oil it cornplete and correct invoice, Invoices that are incorriplew
or with incorrect total kvil I riot be processed and will be returned to the Provider for correction, Fiscal staff
will not be able to correct or niake changes to tho invoices, RetUrning Invoices for corrections may resuh in
failure to receive payment for that month. hlWiCCS Shall he 914111ii4ted firnoly as per AT'I"ACHIMENT Vill in
order to avoid any payment delays,
27.5. Each service performed shall be recorded as specified in the client information and registradon tracking
system(CIRTS)guidelortes. Supporting(10CURICtitation of services provided must fie, adequate to perrinit liscal
and prograintualic evaluation, and ensure intermfl inanagenient.
2& Return of Funds
The Provider will return to(tic Alliance any overpayments due to Unearned funds or funds disallowed and any
interest attributable to such Rinds pursuarit to the terms and conditions of this contract that were disbursed to the
Provider by the Alliance. In the,event that the Provider or its independent auditor discovers that all overpayment has
been made, the Provider shall repay said overpayment inutiediately without prior notification, 11rorn the Alliance. In
the event that the Alliance first discovers act overpayniou has been made, the Contract Manager,on behall'ofthe
Alliance, will notify the Provider by letter Of SLIC11 findings. Should rcpayllront not be M."Ide forthwith,the Provider
will be charged al (lie lawful rate of interest on the outstanding balance pUrRiant tars, 55,03, F�S�,after Alliance
notification or Provider discovery.
29, Data Integrity,and Safeguarding Information
The Provider an(l its subcornractors and/or vericlors shall insure an appropriate level of data SCCUI-ity for the
information the Provider is collecting,or Using ill (11C performance of this contract. Ali appropriate level of security
in,cludus approving and tracking till Provider employees that request system or information access and ensuring,ilia(
user accc;;S, has heels rornoved from all terminated employees, The Provider,arriong other requiretnerits,MUSt
anticipate and prcl:)are tier the loss of information Processing capabilities, All data and sQfhvare shall be routinely;
hacked Lill tea 0A)SUrC ITCOVCry from losses or outages of the cotlipUter system. The security over the backed-Lip data
is to be as stringent as tire protection required of the primary systerrts The Provider shall ensure all subcontractors
and/or vendors maintain written procedures for computer systern back-up and recovery, *Fhe Provider shall complete
and sign ATTACI IM ENT IV prior to the execution of this contract.
30. Cornputei- Use and Social Media policy
1-he DO EA has inipletnerited a new Social, Media Policy, in addition to its Conipuler Use Policy, which applies to
'111 employees,contracted eiriployM,CODSUltant-S, OPS and volunteers, including all Personnel afliliated with third
parties,such as,but not limited to,Area Agencies on Aging and venclori. Any entity that uses the D0111"A's
computer resource systems must comply with the DOEA's policy regarding social media. Social Media includes,
but is not limiled to blogs, podcasts,discussion formus, Wikis, RSS feeds,video sharing,, social networks like
My Space, Facebook and *rwitter, as well as content sharing nelworks such as Flicki,and YOUTube. This policy is
available on DOU'A's "ebsiirc at,Lgq 1 1,10 L Is Alto 11
n counict or interiest
The Provider shall establish safegnards to prohibit employees, b,,)ard mernbiers, management and subconlractors
and(or vendors Crane using their position,,, for a purpose 1hal constitutes or presents the appearance of personal or,
organizational conflict of interest or personal gain, No employee,offIcer or agent of the Provider or subcontractor
and/or vendor shall participate in selection, or in the award or an agreement supported by Suite or fWeral funds ifa
conflict of interest,real Or apparent, would be involved. Such as conflict would arse when: (a)the ernployee, officel,
or agent, (b) any inenih,or of his/her hnniedialo l'arnily;(Q) his or her partner,or; (d)an organization which employs,
or is about To cruploy, any of the above, has at financial or other interest in the Grin selected lbr award. The Provider
or any subcontractor's and/or vendor's,offiecrs, employees or-agcru-,kvill neither solicit nor accept gratuities, favors
or anything of monetary value from contractors, potential contractors, or parties to subcontracts. The Provider's
board nierribers and nianav01ernent Must disclose to the Alhatice any relationship which inay tic,or rilay be perceived
Page 10 of 73
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to he, a conflict of interest within thirty(30)calendar,days of an individual's original appointment tor placcillent in
drat position,,or if the individual is serving as;in incurnbent, within thirty(30)calendar days or the cornincriccirient
of this contract. The Provider's employees and subcontractors and/or vendors must tijake tire same diSCIOSLAVS
described above to the Provider's board of directors. Compliance with this provision will be monitored,
32. Public Entity Crime
pursuant to s. 287.133, F.S., the following restrictions are placed on the ability of persons convicted ot'ptiblic entity
crimes to transact business with the Alliance. A person or affiliate who has been placed on the convicted vendor list
following to conviction for as ptiblic entity crime may not submit as bid, proposal, or reply oil as contract to provide any
goods or services W as public entity; May not submit as bid, proposal,or reply (in a Contract with as public entity for
the construction or repair of as p6lic building Or public work, May 110t Submit bids, propomis,or replies,oil leases of
real properLy to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor,
vendor, or C011SUltant Under a contract with ;Iny PLIbliC entity;and may not transact business with any Public entity ire
excess of the threshold arriount provided in s, 287M 7, F,S,, for CATEGORY TWO for a period of 36 loonths
following the date of being placed (in the convicted vendor list.
33. Emergency Prepai-edriess and Continuity of0perallions
33A I('tile tasks to be performed pUrstiant to this contract include the physical cease and control of clients,or the
admini5 mration and coordination of services necessary for client health,safety or well"are, (lie provider sliall,
within thirty (30)calendar days of the. execution of this contract, subinit to the Conlract Manager verification
of an virrergency preparedness plan(Continuity of Operations Plan,) In the event of an etnergency,tile
Provider shall notify the Alliance ofernergency provisions, The Continuity of Operations plan (COOP) nILISI
address C011frWity OfWrViCCS, Opecially for meld Providers, in weather and non-weallier-related ctriergencios,
312 In the CV0111 at 1,'ilU31i0ll restitts in a cessation of services by as subcontractor and/or vendor,the provider shall
retain responsibility for performance under this contract zinc] must follo",procedures to CIISLtre continuity of
operations without hltcrrupdorls�
33A Contractors offering nutrition services must have ao Alliance approved shelf'stable menu with at least 3 days'
worth of'shel fstable meals with reserved funds set aside to purchase the food items in order to ensure
continuity of services WithOUt interruptions Ill weatherand no-weather, related emergencies.
34. Use of Conti-act Funds to Pui-chase Equipment
No l'unds under this contract will be used by the Provider cc) purebase equipinenli
Equipment rrreans:(a)an article of nonexpendable, tangibic personal property having as useful life of]more than one
year and all acquisition cost which MILials or exceeds the lesser of"the capitalization levol established by the
orginl-raticm for the rinancial Statement purposes,01'S5.000M for federal funds', or(b); nonexpend able,tangible
personal property of as non-consuniable nature With all UqUiSitron cost of S1,000,00 or inure per unit, and expected
useful life of it least one year,and hardback bound books not circulated to students, or the gencral public, will'i as
value or cost of$250X0 or more [R)r state funds],
3S. Tire PUR 1001) Form is hereby incorporated by reference and available at:
I r 7 7 4 0 [1(1R[01, d j
In the event of any conflict between the PUR 1000 Form and any ternis or conditions ofari),contract Or agFeCInCnt
terms or conditions the contract sliall take precedence over the PUR 1000 Form, However, if the conflicting lerins or
conditions in the POR 1000 f"orn) HIV IV(JUired by any section of the Florida Statutes, the terms or conditions
contained in the PUR 1000 Form shall take preceticnce,
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36. Use of$tate Funds to Purchase or Improve Real Property
No Funds. orider this contract wi It be used by the Provider to purchase or improve Real Property.
Any state Cunds provided for[lie pi,irchasc of improvements to real property are contingent upon data Provider or
political subdivision granting to Vic state as security interest in (tic property at least to the amount of state funds
provided for at least 5 years from the date of purchaso of the couripletion of 1he improvements or as further required
by law,
37. Dispute Resolution
Any diSPLItC concerning performance ofthe contract shall lie decided by (lie Contract Manager. kvho shall redUco, 111C
decision to writing and serve at copy on the Provider.
38. Financial COusequences of Non-Performance
38,11 1 fthe Provider filtils to ricel Itic rl)inimuni level of'service or performance identified in this agreeMCF11, or that
is custornary for the industry, then the Alliance may apply firranciii consequences commerisurate,with the
deficiency as referenced in ATTACIAMENT 1, Sm 3-52 Financial consequences may also include contract
suspension, refrising paymeal, williholding payments tIntil d'el Icleficy is coned,tendering only Partial
payments, and/or cancellation of contract and reaccillurtrig services froul all alternate Source,
38,2 1 he Provider shall act be charged with financial conscquenco, when as failLire to perform aflSCS OW OfCaLlSeS
that were thee..responsibility oftlic Alliance.
399. No Waiver of Sovereign Immunity
Nolhing coo mined in this agreement is intended to serve as a waiver of sovereign irninnnity by any entity to which
sovereign immunity may be applicable.
40. Ventle
I rany diSlILItC al-i-SeS Oin OrdliS contract, the venue OfSLICII legal recourse will be Miami-C)ade County, Florida,
41. Entire Contract
This contract contains all the terms and conditions agreed Upon by the parties. No oral agreements or
representat lolls Shall be valid or binding upon the Alliance or the Provider unless expressly contained herein or by at
written amendment to this contract signed by both Nmics.
42. Force Majeure
The Parties will not be liable for any delays or failurcs in per0ormance Clue to circumstances beyond their control,
provided the party experiencing the force majeure condition provides immediate written notification to the other
parry and takes all reasonable efforts to CUM, the C011ditiorl.
43. Severability Clause
The Parities agree that ifa Court orcompetent jurisdiction dcem any torro cr Qondition hercin void or,unenforceable,
Ilse olhQr 111-civisions are Severable to that void provision and shall remain in full Rqce and effect.
44o Condition Precedent to Contrac(: Appropriations
Tile Parties agree that the Alliance's performance and obligation to,pay under this contract is contingent upon an
anart-31 appropriation by the LcgiSlaftrl-C.
45. Addition/Deletion
The Parties agree that, lit)Lwiflistandi rigy the terms offfic procureirtent documents and action-, leading tea this, contract,
the Alliance reserves the right to add or to delete any ofthe services required under this contract when deemed to be
in the best interest of the elder p0pl.11,11i011 (argewd by the Area Plan arld reduced to a written anwndinern sioncd by,
both Partim The Parties shall negotido1c:compensation for any additional services added.
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46. Waiver
The delay or rail ure by the A I I iance to exercise or enforce any of its rights under this contract shall not cot)sO I ute or
be deemed a waiver-of the Alliance's right thereaftor to enforce those rights, nor shall any single or partial exercise
of any Such right preclude any other or futilicrexercise thereoror the exercise of any other right.
47. Compliance
The Provider shall abide by all applicable current federal statutes, laws, rules and regulations as well its applicable
current Slate statutes, laws, rules and regulations, "The Parties agree(flat failure of1he Provider to abide by these
laws shall be deemed an event ofdefault of the Provider,and stitiject the contract to immodiate, unilateral
cancellation of tire contract a( the discretion of the Alliance.
48. Final Invoice
I-lie Provider shall subtnit the final invoice for payment to the Alliance ws specified in section 14,7 (date for final,
request for payment) of ATTAO-IMFNT I (Nile Provider Bails to,submit final request for payment by the deadline,
then all rights to payment may be forfeited and(lie Alliance inay taut honor any requests submitted after the
aforesaid time period. Any payment due,under tile terals of this contract may be withheld until,all reports due fIrOul
the Provider and necessary adjustnients thereto have been approved by the Alliance.
49. Retlegotiallions oar Modifications
Modifications of the provisions of this contract sliall be valid only vdien they have been reduced to writing,and duly
signed by both parties,
51). Suspension of Work:
`fl,e Afliance may in its sole discretion suspend any or all activities under this Contract and any Contract or
agreement ineorporating in this Contract, at any firne, when in the best interests of tire State it)do so. The A I li;ince
shall provide the provider written notice oullilling� tile particulars ofstispension, Examples of the reason for
Suspension Include, but are not linflied to, bL1dget0Fy constraints,declaration of emergency, or other such
circunistarices. After receiving as suspension notice, the Provider shall comply with the notice and shall riot accept
any purchase orders. Within ninety (lays,or any longer period agreed to by the Provider, the Alliance shall either(I
issue a notice authorizing reSLIolf)tiOn of Work, at which time RC1iVi(,N` StUill MR1111C,or(2) terminate the Contract or
purchase order. Suspension of work shall riot entille the Provider to any addidolial compensation.
51. Termination
5 1"I This contract rnav be terminated by either party %VithOL11 Cause ttlion no less than thirty(30)calendar days'
notice in writing to the other Party unless,a sooner time is mutually agreed upon in wrifing. Said notice shall
be delivered by U.S. Postal Service or any expedited delivory service that provides vertfitcation of delivery or
by hand delivery to the Contract Manager or the representative oaf the. Provider responsible for administration
o(the contract.
5L2 In the event funds for payment pursuant to this contract beconlC unavailable, the Alliance may terininate this
contract upon no less than twenty-four (24) hours' notice in writing to the Provider. Said rioticc shall be
delivered by U.S. postal Service or arly expedited delivery service that provides verific;,ition ofdolivery or by
hand delivery to the Contract Manager or tire representative of the Provider responsible for adrninistration (if
the ColitraLL Thc Alliance will be [lie final authority as to the availability and adocitiacy of fonds. In the evcm
oftermination ortlik,contract, the Providut will be compensated JZ)r any work satisfaculrily complewd Prior
to the date of terinination.
5 L3 Termination for CaLISC
This contract may be terminated for CaUNC by the Alliance upon no less than twenty-fbur(24) hours' notice in
wriling to (lie Provider. Waiver orbreach of any provisions ofthis contract shall not be deemcd to be a
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waiver of arty other breach and shall not be construed to be it modification(if tl"ie terms and conditions cif this
contract, The Provisions herein do not Hnnit the Alliance's or the Provider's rights to remedies at law or in
eel city.
5[A Failure to have performed any contractual obligations with the Alliance in a manner satisfactory to tile
Alliance will be as sufficient cause for termination. To be terininated as a contractor under this provision, the
Provider must have(1) previously failed to satisfactorily perform In a contract with the,Alhance, been notified
by the Alliance Of the LIR5atiSfhQ(0I-y performance and finiled to correct the unsatisfactory performance to the
satisCaction ot'llic Alliance',or(2) had as contract terminated by the Alliance f0rCaLISC,
5 L5, Waiver of[)reach of any provisions of this contract Shall not be deemed to be it vvaiver of any other breach and
shall not be construed to be a iriodifIcation 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 as legal or equitable nature.
51,6, Upon termination of this contract, the Provider, its subcontractors,and/or its vendom shal I, at no cost to the
Alliance, transfer all public records in their procession to the Alliance and destroy any duplicate records that
are exempt,or confidential and exenIpt, fi"ODI t)Ublic records diSCIOSLIN requirernews. Ail recouls siored
i4dwronically shall be provided to the Alliance in a forimat that, is compatible w%,itli the, inrorination technotogy
systems ofthe Alliance.
52. Electronic Records and Signiturc
The Alliatice authoriz.cs, but does not require, the Provider to create and,retain electronic records and to use
electronic signatures to conduct transactions necessary to carry out the terms of this Contract, A contractor that
creates and retains,electronic records and uses electronic Signatures to conduct transactious shall comply %vitli the
requiivincrus contained in the Uniform [-,'Iectronic Transaction Act, s.668.50, Flit, Slat, All electronic records, RILISI
be full),auditable, are subject to [Ioridas Public Records Law,ch. 119, Fla. Slat.; must comply with section 28,
Data Integrity aad Safeguarding Information,UILIM maintain all confidt,,ritiatity, as applicable; and Must lee retained
and maintained by the Provider to the same extent as non-cleco-onic records are retained and maintained as reqUoT(I
by this Contract.
511, The Alliance's authorization pursuant to this section does not authori7c electronic transactions bukveen the
Provider and the Alliance, The Provider is authorized to conduct c1cc(ronic transactions with the Alliance only
upon further written consent by the Alliance,
5 2,1 Upon reqUest by the A I Hance, the Provider shall provide the A lhance or DO EA with non-clec tron ic(paper)
copies or records, Non-clecironic (paper) copies provided to the Alliance of any d0CUoICIu that WAS 01-ig iritilly
in electronic form with an electronic signature inust indicate the person and the person's capacity who
olectronicaHy signv, d the document On any non-electronic copy of the dOCUIRUIL
51 Special Provision,,-
The Provider agrees to the ('61lovving provisioiis:
53.1 Investigation of Criminal Allcgafions�
Any report that implies crinflwfl intent on Ilic fnirt or the Provider Or any subcontractors and/or vendors and
was referred to a governmental or Investigatory agency roust be sent to the Alliance. Ifthe Provider has reason
to believe that the alleviations will be referred to the Suite Atiorney, as law enforcement aV,, ncy, the United
States Attorney's office, or other governmental agency, the Provider shall notify the Alliance immediately. A
copy ofall dOCA11110111S, reports, notes Or other written Inaterial concerning the investigation, whether in the
possession of the Provider, its subcontractors, or vendors, inust be sent to the Alliancc,'s contract manager
with at surninary ofthe investig,,,ifion and allogations.
Page 14 of 73
AA-2129
512 VOILIMM'S:
The Provider shall ensure the use of trained volunteers in providing direct services delivered to older
individuals and individuals with disabilities needing suctr services, 11"possible, the Provider shall wott ill
coordination with orginizations that have experience in providing training, placement,and stipends for
volunteers or participams(such as organizations C,11'ryi[Ig out 1ederal service programs administered by the
Corporation for National and COITIMUlIfty 'Service). in community service settings.
,4. Erriftyreement-
54.1 In accordance kvith Section 430,04, F,s,, the,Alliance way, without taking any interolediate uWaWros
availal,fle to it againsi this Contract rescind this Contract if the Alliance finds that:
54.2 An intentional or negligent act of the Provider has materially affected the health, w0farc, or,safety orelients
-served pursuant to any Contract or agreement, or substardially and negatively affected file operation of services
covered under any contract or agreement
543 Tho Provider lacks financial stability SUrlilCieut 10 ITUM contractUal obligations or ffiat coritractual funds have
been rmiKipproprlated;
54A The Provider has cornmitted multiple or repealed'violations of legal l-kad regulatory standards, regardless of
whether such taws or regulations are enforced by the Alliance, or the Provider has committed or repeated
violations or Alliance standards;
54,5 The Provider hw., fabled 10 COnlillUC the [IrOViSi()I)or expansion of'services after the of
andlor.
54A The Provider Imi failed to adhere to the terms of any contract or agrecurent incorporating ill this Contract,
54 7 In tire alternative,the Alliance may,at its sole discretion, ill accordance with section 80.04,F.S.-take
immediate measures against (lie Provider, including corrective action,unannourleed special monitoring,
temporary assumption of the operation ofone or inore contractual services, placement of the Provider oil
probationary status, imposing a rnoratorium on Provider action, irnposing financial penaltles far
nonperformance,or other adm inistrative action pursuant to Chapter 120, FS
54,8 In n-jaking any determination under this provision the Alliance may rely upon the findings of another state or
federal agency, or other regulaWry body. Any claims for damm ges for breach al'any contract or agrectnent are
exempt frolu adininistrativV proccedings and shal I be brought before Ole appr(.)priatc UlIfity ill the Verme Of
Mialfli-Dade Cotjnty,
55, Training
HIC llr,,rwider will lntorld all required irainings an(] ineelingrs schedulc by the Alliance.
56. Official Kiyee alid Representatives(Naroe, Address,and Telephone Numbers)
The name, address, and telephone number of the representative for the Alliance for this contract is:
Max B. Rofluman. JD, LL,M, President and CED
760 NW 107th Ave, SLJtC 214
Miami, r1orida 33172
(305) 670-6500, Ext. 224
Page 15 of 73
Ark- 129
The name, address,and relephone number of the reps-csentative ol"die Contractor responsible for administration of"the
prq!,faln Linder this contract is:
Monroe County Board of County Commissioners,
The Contractor name, as shown on page I of Social Services/In-I Ionic Services
A this contract,and mailing address or the official I tOO Simonton Street,2"l Floor
payee to whorn the payment shall be inade is: Key West, FL 33040
305-29245 10
Sheryl Graham
"I'lle liatile of the contact PCrSon of tile Monroe Count)' Board of County Commissioners,
B Contractor and street address where financial Social services/Iti-I[011ie Services
and administrative records are maintained is: 1100 Simonton Street, 2"Floor
Key West, FL 33040
305-292-4 5 10
Shervi Graham
The name,address, and telephone number of Monroe County Boar(i of Coulity Coln In i""',ioners,
C the i-cpresentalive ofthe Provider responsible Social Services/Irr-l-lotric Services
for administration of(hc Program miler`this 1 [00 Simonton Street, 2"" Floor
contract is; Key West, FE. 33040
305-292-4510
Alliance for Aging,, [tic.
flic secti('m and location within the AAA where Fiscal Deparlitlern
(I Requests for Payincut and Receipt and 760 NW I 07th Aventic, Suite 214
ExImidinil'C, fOLHIS rare to bC tMiNd is: Miami, Florida 33172-3155
305-670-61500
Contract Monitor
J'he riame,address,and telephone number of' Alliance 1'(.)r Aging, Inc,
e the Contract Manager for the AAA for this 760 NW 107th Avenue,Suite 214
contract is Miami, Florida 33 172-3 155
305-670-6500
Upon change of representatives(names.addresses,telephone riumbers') hty either Party, notice shall be provided in
writing to the otherparty and the notification attaclied to the originals of this, contract,
C,
57. All Terms and Oinditions InOtilded
This contract iuld it,, A1TACHMENTS 1, 11, 11L V1, VII, V111, IX, X, B, D, F, aird G and atly exhibits referenced in
said atiachrilents, together with any documents incol-Imrated by reference, contain al I the terms and conditions
agreed upoll by the Pal-fles. There are no Provisions,terms, conditions, or obligations other than those cc nlairied
liereirt, and this contract shall SOPULSCh till PreViOUS Communications, represetitatioris or agreements, either writtell
Or verhal between the 11,arlies.
Page 16 of 73
AA-2129
By signing This contract,the Pat-ties agree thal they hay e read and agree to the entire contract.
IN WHNESS THEREOF,ike Parties Iteretu have catised this 73-page contract, to he cxeculed to their undersigned
Officiahs,its duly utithorimd.
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS, SOCIAL
SERVICESAN-MI�13, rl V1110— ALLIAW'T,' FOR AGIN6, INC.
SIGNED BY. SIGNED Hy;k lumm 11j".20 V Q EST
e,
NAMU": NAME: MAX U, ROTHMAN,JD, LL.M.
TITLE: Ac-4i&+ ut� AAffi_ZkSlS"4e__,,TITLE.. PRESIDENT AND Cr-O
ul
DATF:. 12%)J��j 202 b DATE: Jan 4,2021
NACRE COUNW ATTOFINEY
A 11OVE�At FOFV4
PED
NTY ATTORWY
ASSI w
Date 1/4/21
Page 17 of 73
AA-2129
tNDFX '1'0 CONJ`RACTATTACHMENTS
ATTACHMENT ATTACHMENT DESCRIPTION PAGE
ATTACHNIENTI STATEMEN"I'OF WORK 19-34
ATTACHNIENT It FINANCIALCONIPLIANCE Are DITAI'VACHMENI" 35-37
ATTACIUNNY/ 1. "it At)1)1'[' R1,-']"I.,,A'I'IONS141P DETERMINATION 38-39
EXHIBIT I
ki"I'ACHMENT 11 FEDERAL RESOURCES AWARDFD PURSUANT'ro'n-us 40-41
EXHI1 IT2 AGREEMENT
A'1'FACFIMFNT1J1 CEIRI lla[(,,A HONS AND ASSURANCES 4.)-4 7
A'17ACHMENTVI ASSURANCI"S-NON-('ONSTRUCTION PROGRAMS 48-49
A77A("H M F,NT V I I CONTRACT ICI DGE'f"SUMMARY BY SrRVt,('F-. 50
A-1-TACI IIVIFNT Vt 11 OLEA"IR AMERICANS AC.TCONTRACT REPORT CALENDAR 51
A'17A C H I'M E NT I X REQUEST E-OR PAYNIFNT 52
A,rl'ACHtvIE"NTX, RECEIPTS AND EXPENDITURES, FOR ALL OAA 111"T's 53
EXHIBIT I
A17ACHMENT X, RECEIPTS AN[) FOR NSIP 54
EXHIBIT2
Al-FACHMI"N"I' X, PROVIDER MONTHLY MEALS REPORT, FOR NSIP 55
EXHIBIT 3
A-1-FACTIMENT B DEPARTMENT OF ELDER AFFAIRSCIVIL RIGHTS COMPLIANCE 56-61
Cllt'CKLISTANI') INSTRUCTIONS
AITACHMENI,D BACKGROUND SCREENING-A]-`FII)AVITOF COMI'LIANCL T 2
ATTACHNIFNT F DATA PRIVACY & SECUR"ITY BUSINESS ASSO(AATF 63-0
A 0 R I-VM B N'I'
All'ACHME.NT G ADRC POLICY AND P ROC f",DtJ R li,S FOR OUTSOUR(I"'D 69-73
FUNCTIONS
Page IS of 73
AA-212 9
A-1-TACHIMENT I
ALLIANCE FOR AGING, INC.
STATEMENT OF WORK
OLDER AMERICANS ACT
SECTION 1: SERVICES TO BE PROVIDED
t.1 Alliance foi-Aging, Inc. Mission Statement
The Alliance mission is to promote and advocate for the optimal qUaliLy 0iliCe rear UldCr adU115 and their fainilies,
1.2 Pro grain specirtererms,
Area Plan, A plan developed by the areaa agency Oil aging outlining as com p relic nsi ve and courdinatud service
delivery systerti in its pkinningand, service area in accordance with the Section 306 (42 U.S.C. 3026)ofthe
Older Arriericans Act and DOFA instructions,
Area Plait Update: A revision to the area plan wherein the Alliance enters OAA specific data in (lie Client
fnforniation.and Registration Tracking System(01117S) An update may also include other revisions to (lie area
plan as instructed by the DOEA.
Child: An individual who is not mure than 18 years of age or an illdiVi(4131 with disability.
Criteria- A standard which the Administration on AgingiAdministration ror Community Living set for the
Title 111D Program, AoA/A.CL's standard criterion consists of three tiers: Minimal Criteria, Interinediate
Criteria, and Highest-Level Criteria,
Family Fare
'aregiver: An adult faini(y uneniber,or another individUal, who is in informal provide orin-w w rie zir
COMITILIftity crate to an older irldivkhqlL
Frail: When an older individual is unable to perform at Icast two activities of daily living(ADL.S) without
substantial hurnan assisiance, including,verbal reminding. physical ctreing or supervision,or due to cognitive or
other ineinal impairment, requircssubsultilial supervision because the individUal behaves in a manner that poses
a serious health tir safety hazard to the individual or loanother individual,
Grandparent- A grandparent or step-grand Paren t ol'a child, or a relative ora child by blood, marriage or
adoptiori and who lives with the.child: is the primary caregiver or the child becamic the biological or adoptive
parents are Unable or unwitiling to serve as the priniary caregiver of the child; and has a legal relationship to the
child, such as legal custody Or guardianship,or is raknig the child inforitrally,
Living, Healthy: Also known as CDSMP ror the State offlorida.
1.3 General Description
1,11 Gencral Statement
The OAA Prm,,raoi is as rederal pro grain initiative that provides assistance to older persons and caregivers and
is the:0101V federal SUppQfliVC services program directed solely toward improving the lives of oldcr peoplc.
The prograrn provides a framework ("or as parinership anions the ditkrerit levels of government wid the public
and private sectors with as Common ol:Pjective, improving the quality of life for all older individuals by helping
them to renrain independent and productive, The priniary pUrj)ose of the OAA prograin is to foster the
developinent,ind iniplementation ul"comprehensive and coordinated systems to serve older individuals. The
OAA progratri ti.ws these systems to assist older irldividuals to attain and rnaintain MIXinlUrn independence
Page 19 of 73
AA1129
and dignity in a %ne envionmeni and allows fair the capability of'scl(`-Q�,�vr(,� %vidi appropriate suWortke
sea Res.
110 "NIP PrOl RU &VQ`Q%Vx AM OW WhKOW &h%VQ, 4HU160MN Wnk A, AdU hOk WK \KlP
Ohm, pmqrrimt ks hwano III.' HIA11AW dMar V WK053 id nio& ion ed, NKI V K J CY01 04 qHhqO Ar
cownNhq pnvrarn Lhal npidomin", Fumlin; w Giod mvd K nw.d, surned t-wWr dw OAA I lvakh�
Us ON& on On& Pq rnanin in Hem 01 &wuwd And-,
U2 Anhorhy
All zindko[dw Role& Im"ti wykdwi,nn. nvkvi tomqnkads, jungroon inartwi4on-, rat to" puidc, my!
10^01 to dw VMS A:
a. C vadog of 1 edvAd I MCSIM A&WHOw Nit 93MA 1 93 0 1 L 03111� QUAT and 0 ;MU:
h (Ali Anwricani Act 4 1065. as jHwndcd 2H 1 h:
Act of 1 96.� Us WW&Od 2"1 A. VSkIl I I I V I SA Yuhav,
C Ride SKA.L 1 10do Adminkinam a (ANQ ;IM4
11 Scoami 491 10 1 , 1-Kidw SwimeN I 10a. aml
q. IN)h A PRtani"s mW 'wry ica 1 lanchn,uf—
qg 2U"own Im
1.13 Stqv of SUNU
The Prodder k requnalle Q couddiating and assessing the needs ofolder personjus, aral ;ismv I mg we
availability (if quabiq sowkcy JbQ yoxices AwIl be pmviclled in as rnarma wnsiswro xvilh. and described iri
both (he current DOEA Programs and ScrOves Handbook and the Provider's Service ProVideT Application(s)
mbmAwdtrnpaBetwOeNABOAAI�1:1."- I fj-Q�xi ving NSI P finnding, the providej'-.'S,,11dll rise NSI 1:1 lnnnling
to sWplemo-n Rulding for food used in ineals sorved by 0AA Nuo,iflon Program Providers-
13A 100or Flo gram Goals
The ma,jor goals of to 0A A. prograni arc K; kip=Q Te qwli[y ail"life for older individmak, fireservc 0,vL!,ir
i ndcp;i:ndcni;c a.nd Prevent or de layniore costly inst Wknal cum, 'Fhesc, "Olds are eichieved, lhrot.qgh thu,
impkmotawkin ofa ce,nipdwnsive and coordinated qerlike s"wrn ko provides a cmulumn in"oNke
ahoval Vs That ineet the Nverse needs of elders and thai r c are gi vers,
I Advoczii:y
As 2 designaWd FW PUAL a pwljkr N emomayd to firovldc coordination orservices far older
individt.tals- The Pn,,widcr rnum also pro O I de communk) leadership o'll kstws and w. rve it,,the advocate
and focal pohri Air the w1do-ly vyid-tin file C011111iUllit)- ill COOPOrMloa %vilh orpunizatiunts and
in.dividuals participming, in aWhics. INded by Te AHInm. Advocacy MmuW Kludo initiating posifiiv-e
C1l,c'fl1VgC.S its [Mblie Or pdvMQ pulick and altithes towards older perqonq, Eitking ai;liun to irripmm nw41Q4 or.
chminare SmIaHms which on lives of'otder liers,ons, or expresing support for older persons
wid their hVerests- Advocacy activities may be hwadl) SUPPOn We Dkbe genintal Aimms of okkr pernons, or
nlay h wo We s pe I fi c ac I i v,i i i cs cm i bc[to I fo�fi n 4ti vid uzi I s
1 4 C I i en Its to Be Se i-v ed
I A�I General Descuiptimn
11 re tironce s ha H be gi vQ,n to ffi ose vv i I h Me great est owo nd c land so d a I need v it th paK c u Lar Sitar nt Axt t c)
lo%v inco,jne older indiGhials, including thoso that die 1mvincotre minmities, have finihed f"ngfikh
profidow, and tale er 400duals rnilng in rural nmas,
Page 20 of 73
AAQ129
LCIJ OAA Ti le TIL WnerM (Mem ETWbUity
Constaners shall nol be dually enadled in ,-in OAA pro grant ajj:jd as Mcclicaid
care prograrn, whh Ow enctsion af ecrnswuns W need ofOAA Legal Ass istan-ce serviceq and OAA
tier gregaze Naarilbn Service& hwFuding transportaticir"I Crvict to ,I]id frorn congregate, 1-neal sites�.
4112 NIP'
NOW; sNi W w an Aduly iHdk HkMK MCI 5 UMOMM OWL Wider Swia"i& %lodicah.]
M,'Im,lgk.`dt [ Mg- 1001 WVC. I k1HO (ire Or tho Hd°"r°rl"- ("i."I l'1,1 r)1!11 i% It'.!,1v 15--, '1 1-1�,, r�I°J r 1
llymnik ,wwhor memo kAwd pnynm" imq no h,.! inc-lud-�,d in lhi-,-\S1 Pcoma, (EVA ,
0 Q,.,I o m g N q a 0 n w a k p Nm 40d i o S N I k K: I I V o 6 m n n Kq be i n v 1 u ded sir L h a N S I I n 1,
W3 OAA We H 114. Supportive Service-s- Client [JigJbilil'y
LUA SSA A `fitle, !V(1, eo,id 1,[ICT MAW Scmice& CWH Ed kith y
General Cactors thit shouki be conAdwed in emabbsiVing ptio&y for outrifloo see icesfiaclude
older persons w1jo jj`jc(!t 11ric fojj,fjj�c h..g,-
[
1) Cannot al"Cord to cat adequr.ilcly;
(2) lAck the Wils or knm:v1odt-,,,c io scloci and prepare nouWng and wcll-bata,-)t,,Cd meals:
(3) thive limited mobilit �vhic[rj
I, rj,,.jp,ajj-their capacity to shop and cook W lh,nrtsclvcs; or
I Live as d[saWing My or phydcal smIlition requiring nutritional mtpporl or havc been
screened at as high nutritional ri�;k,
LAK OAA TH 1111C 1. Congregate NuMon Sorv%s
[11 addiliorl to Ineeling do gawral marition set-Wes ehohiky requirements listed in
AD AC:AMENT 1. Paragraph I A.1.3 individuals rimst be jnobilz. nol hcomebowid and NqMcallj,
iricntall� ;,ind medically able to attend a congregare iontrition tirogran-i- Individuals cfl-��ihh to
receive congregate meals include:
( 1) Individwils at f, % ol-o[ijer. 'and,
() .Arlo S pousc Qmga M I ess a f age) wh o attends d w d A Kg can C r ly j t I I Ij jy'll C r e I j g i b 3e S
(3) Persons xvith a disability, regardless ot-age, who reside in a faciljly oCCUPied PlirMaYNY
1� older individuals mfore cmigregate mahAn sw6ces am proWed.,
(1) 1)i sa h[cd—p CI'S orl.", who rosi(l at horl'ic, %vi th and acconi panv an eligibly: person to the di ning
center and
() Volt nteers. ro,,L;ardles,a,, v-110 provide essential services on a mg,ulnrba� is during Ineal
how's.,
LVA DA A ITHe H I C 1 H orne De I i v.,Ln-cd N,u(ri I i m Sc rvi ce,s
[n addlon to nieetkg Ow garaml nWri km smNkes SobiJhy requirenions Wd in
A'[TACT]MFr.',N'[' 1. Paragraph I A j indiOdual rnt.w be homebound and physicaHl muniaQ, (51'
rnedical[y unaMe to aRend a congrogaw nwrithn pmgmrn, Individuals eligible to rcc6vQ horric
dd be ad mza Is Kc lud e Te RM ow Ng!
(I ) hxl Widuals age 60r or (.4der who Iry hchnobound by la mson oft 11.,ness, d isabi I ity or isolaiimi-,
(2) The spome of a honwhound WOW MO&NAL rcgard[css of,age. H-the provisiorl oft he
i;ol[<,Ilcral 111cal Supports maintaining di c person m lutriw;
(3) InAkhmis "it disimbilifies, nCgnrd1nS LWAgC, who reside al home with eligible individHOIS and
are deqnden! = the Or care: and
(4) Persons at rudritioriakisk "to have phyMcd, ernotional or 1whaviotal conditions. Xvhich %IOLdd
make their PMsence at the ux,regate site inappropriate; and persons at WAWA rkk We; are
socially or otherwhe bBland mid unabb to attend a am.�grqaw riutritiont site.,
Page 21 of 73
A02129
LC IA OAA TIH 11111111 NO ASI VIRMYUK AVD I HAI I I I PROM I UN SI MI MS
III I I Target indivkkuds age sixy (60) or older and
() PHorhy = be ;Ken w, &WkW& residkg in wedicall) iniderscrvcd a rQa i s
1.4.1, OAA ,ritw IRE,Caregiver Support Savices,Client EligWy
(1) FaniRy caregivers of individuals age 60 or older;
(2) Grandpa renh Mg C 55 or older)or older individuals(age 55 or older) who are relative
caregivers;
(3) Priority m411 be given to Chunfly caregivers who provide care for individuals with Alzbeitner's
disease and relted dburrdas with netwoloocid arul organic brain dysfunction and for
lymnelparems or older individuals who are rehitive careigivers who provide care for children with
severe disabiliVes:and
fir rnpRe and supplemental services, a Willy caregiver InLISI be providing care for an older
individual who nieetsthedefinition of(lie tarn'frail"hi OAA, as per, TTAC1+11VIENTI,
Section 1.2.
SECTION 11—RVIANNER OF SERVICE PROVISION
L I Service Wks
In order to achieve to goals or we UAA Ixogram the PrOVidCr Shall CnSUre the following tasks:
(1) Clienil-digibilill-Wrininrahn: The fAvvidershall enstuchn applicwx dam isevaluMed annul, to
determine eligibility prior in rendering services. Hhobilly to beta me at cHent is based on rueeting the
requirements described in this(.ontnact.
(2) Targeting and Screening of Sw-vice I)OlvcQv for New Cli= 1Ire Provi&r Wmh devehop and implement
policies and procedunniccrnsistem with OAA cargoting art(] screening criteria,
(3) f1rograrn Services: The Provider shall orme to plrovi-sion of a continuum of services that newts the diverse
needs of elders and their caivgNery -llie Provider shall ensure the performance and report perf'ormalicc, of
(lie 6bilowing,services are in accordance with the CUrrent DO FA Programs and Services l4andhook,
(4) Progratn Eligibility Requirements
TWOlks rnuit uneell the HOW ing edwria to he 01L,4illle l"Orl)YOM'aill I)AftiCiinafl Lill:
i. An flim Iran; rucived a gntIll. CHIder OAA TWO H I Y)AA satimi A InG UM
310%)]i and
H, A 11MMAH1 sm We linwider Chart serves inculs alki is LaWer the.lnrrsdWtrt'I€t. conw&
nuni-agemcni m0milk authorij or he Area Agow) on Aging wiml Me Flodda
0q)arrinent oI'l`,Idvr AI'lain,
1), Provider's Nutrition Service Operations
I he (WINwhirsholl ensure the maritimi %mvi" opmalms or the provi(h r lllct�l tile
of this cmHract, as well as mq odwraIVIinfic iqnhakmns alul llolieic~ proscrihed 1:>r thecill-rent
1)(W.'A Programs aini Services 1-Imulhook, dw 1krimonewt (WIWAT and lWWarn Smi ium
USD& I')()]] WILI local licalth dLI)annienLy INIPH, ot niq n0wr WXWY dBIJI'Mild 10 inspect
nwal quMhy Or the Slaw, The (Tinnuckw nmm agme w mitil), the Alibi we oran-. %andion
insIvection, espo&Q We W Koh0c hQh prkwhy %01011101-Is arld 1°1l-0Vide a Qk)l)) ol'the report
iti the Allionee %N Rhin 21 howh. Cknuws must lie repolod immelaick AN sulwoolitmoed awd
soNke vendims nimi rinsvide a %N rklen convcOve actkmi pion Ki the Widdirn lhovilder f1w my
Idgh prbrity or sig=cmit finIngs m sanitatiors inspections. Ile convetivu anitni Qns n€ "i lie
approved by the Provider's RD and SUIN10ted to tlia Alliailcc W OMAN that dcnciencics ark"
ro"clod,
c. Prescribed Nutritional ReqUireollentS
The Wntractnor shall ensum that each rneal provided under this contract rnects the following
coal:
Page 22 of 73
AAQ129
I Canfdies e.Uh dw curro a I hmmT An&I ries f,�,ir Aineti,cans. �'�uh I i4am I lr"='�' the Seclet',iric-'s, 4,'If
Ow Apam Nay;tu a f I Ica Rh And I Nana n Service:s and the Dq)-rwtrrrera ord Ainnctill I ure,:
al Provides it mKimum of 3 3 03, Itorcen It K^f One .Jic.,tarp ml,-,nrc-rtu.� intakes Aide qua to intakes Vai I
age 70 Urn al, as estabhAud by Ow 11,od cmd NuvAbn Board Adw Shhowl AwWein3 of
Sciences; and
K I q s v r v A To mi ar xJ "1`Qp9'.riaoo AID jt n t�j t v 1"I I c It
t Kqao m hh cm nth y i"Q,nnow% oCOn NKHk kw 5munhor =1 m %oi ucc ImsWur- inn
I hU NSIMA! at I PHIA14M K-k I, &I N mini H ki- WN mord WH pPg�h JM&T I hk Ill OCT,
i A 1. 40 P 01111 Whr 110 MKI 10 MIVIO MCA ill% KS N! ON, r Shh",
Ninko"Ing the purk"OK"Ka Or K ;uIdAn ulkhm'
16) (Ail IW) vVith IN Uhhx-s Njutrr%, ly?ciw AN piWOMML",
or SoRmonmImA andlov \ uudm"%
I V I h %.d%a, I H 1 wo A" "0 n 0 0 1 d"V I h b h o, t h v t 41 L 01 1 h V 4 o I A, t 1 W
I I➢w Us wro,mon, h ph Kh: e, ir A, AQ 14 1 MA" It 311 %A!"o—OM, t" 5A A! 0 Q Wsnj�
to n 1" 0 ova A 01 "Wh "of KKtr H"qc WO 'wo="k o Hh! "h,,q-rA0 % 417 0": P,040UNY
IN yon %Cnja 00 KOW1 WON in A Vh MLO O"'AnSt \1 VYWO W MUKU1. Wk it VIN
K 14'"000 AM W! PUWK n Y&Anyn I 'r sp"L L, 1W 10HI wrl :cv, Omni Y, A% tZKOK"! Who&
WO IQ 0 11 NOW who,417ACK" NOW I VXHWHI CtUM .Je 1 1, A& Awa vAl mA Q n4pokopal. -A K&A Or
,HV% I&KC0041- 'A Llapk' U-SrHn' lhw ou It V inn[
The PrDViLQr shallsubnQ a copy of MI m5wor"mets an&or vem1iis to Ilie Allumt-O" Uonlracl N-1rint'Irger
"%iin atirty (30) days of uxmi.Okm 4W,wh srdwmwa agwemerH, I Swohno We corurao pert ml,
thu ProvWcr shaH Smalim0y ,ul-uuril �nnd i.lr,',ingos to tag Ilia Alhairacc
Nlanager"
20.2 %lorhurrhy; Me Pahrmame of S ',HJdt(),T VCrIdOrS
I lie Fr(ovider shw.ifl rnotKor, at least once Per year each of its sub unuractory yulyrocqniemi.
vloukwy andOr consuNaus pak! Swu Onds pm%Wed un&r Obs maturaq:1
,&,-revJvrcrns - The Provider In,,,r6orrri P'isca[ ad,'n'iirflNtra6%r,-, anli inc'riitc'�Firng
ccouphance, A"I "courinlOq4 progmumumic performance andi
corrWhorwe Wit apphuible state and Rderal h"s am! mgidatkin& The 14"Ada shall monitor tc-i
un%utv that We schadkies am own the Inn-1put arad ""Te of Wr,-"rk il"re %kidni"n al-le
and oTer jwi ka-maneu poidzi suvted in 11-as, are ach&vd,
Qndtu — The Provider shall adarnirpsuradve and PTOgrarnnmlk monihoring to ensime
cormt-sultial cmmplianno. progrimuns6i: purko-numce a1u.1 :ornphance "Ah aMAWMA Mae arn.1
Inwq and mgWakma, Aw 19ovidu Man mordtorho ter'BUIC fllAt are nle , aird
tho scope ofv"A k amumphOwd %hhh Me spcMd t4no p�t!ria, ds. anil othcr licr forrii al ice g,) Is
SIMOd in GS COMO are SIO&VA Tho 1%vider shd1l perl'britt a numdHiod Awl mor-ohng W,
Awknk WralVinvoicing limuduren =1 rcusitwWwrion to citsitre lisc�,Il and
Sustahnithi[hy,
rhe NO�'idl-'r s1rall ensure th't i al I ViOlf dua 6, so-Wes, proO ded by subol m rswuws an&cr
, u
,ire eiitined Ph Me Lq RTS database per the Deparinwidni 0 R FS PAN C Suldmir, I he daiiii
inuta he entered iino dw CI RI S d."'I(i'..iba", L bvtnam.' dic Provid,er subirkit,, ihc Roquoa 6w Pa"nom aud
I xpen&ure Reps= to Ifre AlJiaru:�' 1" h"," Providea JiOl establish Anic Frmnc% %vidi V VAL01araCION,
And ;cn&xri to enime coniph-arux '�,sjoh' due, dMes Go me Req'uesu'� Cop and
PaRe 23 of 73
AA O 12 9
2,3 Stiilfing Reqnirements
0— na 0, -"n d&rVMWXK 0 a K OTAMI OAQ 0 M QvJ > P ""O"H 1W W
"W MW UK! WRAO KHMOV la'10,001 11`4 1 MHVQ1 at I I Wn,"IFIM Is e d"ah"An'.
"WqW00 Vim,
2,3,2' Qualid"icatOns
I ho PunhKshad ollmm One IN it rm)jqm,M hwpo&TnAny inj 100 ;q 1hponny, " Ahm dd,
,i"Inwl hivo iho qMhomhms j% qhnilknl 51 QW 1 UA 11"ykHm and Smin w, 1 kwuHn"?,
2 3.3 Sc ry i c c, Ti m u-s
I Ill: III'-,hIVr sk,lll C IfEC !A 0%1,JW, ol Ii%R%I 'Q Wil 01111011 ;IHMIQ HtqOIAI I"hirmV
I h"i N u H I a q I i A h 0 r I i 0 k,, 0 1 C I H I W I P I 1 1 111110 0 1 n n i I&; p o 5 o m y w c ro y n 0 H M N 4 0 A% 0 M n%:,!,
ml ii sholl moidbi N ylhoom now, md iq 10064, W C11,11rc Sho = mnlihk, 1- wk We vr% ivw,�
j1WHI, 10-04 1 VIP,OVA e IP , QH1 !kill, .1"d dMHW 0"",qHMA "hkh hod HI JO 14-4 ok to JNL
In 4 %AH, lock bow In"Imnlown
2, '1, 1 1,-,,.Vc 1"'d Vtdurrte,,..rs rc-j E.xparid dre 11misam W Uabble Seryice,,,
A hu, Provider shalhnAe aw or mahied voltum-ers in InoOdhig direct services delivaed to okki WhAkials
ado MAWS U hh dimmome"WeAng such Sav ices. I f'pctssibie, �,,rne M&W simbi k"wk in cooNimob-i
v ifli IN.11 Kirk„,expenowe in pmnfini�,,-, trainir'lg- am,,,J siq,,wi ds fca o,r
PaMbbyMnS(SLWh as organWalkom mr,ing ma Fedcud savice progmms shninkmd bly dw Cory"Aml
fi,a and 1"Orv1crev in e:0111HILH,Wdls scr-,"lee serr.ing�.
t h,, hdkoV ni", -rV:[bH Ps"mR, di c ru .-ilia' qmundIM mlis wq QAwcA&WA UN S-"HvW' &WH11WIVINUE
101010 h; C, ubwc the 00midalum 14 Hk LAK, "lRq il'40 ill 10% CNNrJCl, I h,' 11-0 J&I IHIPA dNnit �dj
r vm a o I �I I1Wl04?61,kM ill HIM QI 0 dMi HIMUWI I ICA Wd hNI 1110 1 IM MUH I P&I"!166 Hlr0 10%C I, !, he 111y.'L,
I =4 'Mondd- nluit In M111111y hx 10 Alham! (Amwol Alxidncr Kpad mi To ilyHOTWHN
h u t,,ik Ic tkdi%,(Fl;dAw ber qa zhu 110%9d-1 SHIMHN dH Wokc rafkskan Pot H4-11
I in: 14'" Wo Ind! vno", 1ho yo k pw a -qH"Umm 'umn mov, 101 PP OW!" T � 10-l-, stool, archim mW
jm"o n an W wroy IMP; % 1 1 on-, JA N i Low" on ;4', „I 00, w mum V In "madal"m W
-i;" ;�� A C"Cl, Q; 51 lKWAY 0 4jol! .: mid 4m,q -1 PC 1&hm,1j , vumbo"d cham a VAI n"mhm q -0110,1
U "- VnK V le d h; I lywo on,& ; m ;AV �Vnvk� L,d I mon ,0rG"k,n4 Eno! vmynd Too I Wi MqMk V WOL'0-"
Ilk; MOM UK provide the services ilesunhN In 0,1c. ,colmmm, Iri accordame 00 the ument IMMIA XTrarn mJ
ims orservict, %%m �pomsnanl to the rmesemaNinhed hi AJ I ACHIM] I I]
HW !="AW www",
2AJ AqVo 0 Wit S e r0mm (I I I B P rag ra in)
S upp orl i Ve se rV i e�n, i n c I u d v m vor r y o 1 00 WH H L Un 4 V-bO SU d MY JW M C A d j Vr',rk"!a I sc.ry I It,o s I I url s It 1)1:,j ml me
(JW`Ifi[I, tit fir� f(Pt'Older individuS b) holfirig thm rmniab md-cpendem fem-n.] 1,rrodmcrive.. Smices
hwhde we Rdlouing:
( I ) Adult Dal, Cire�
:21 Chou Sav on:
(1"I Cc inn,,. li on,-s 1 n['i-,
(4) Chume4bg
(7) Ilomenmkm
(S) Houding Impmemwal,
PaRe 24 of 73
AA-2129
(9) Legal Assistance
(t 0) Material Aid;
(l 1) Personal Care;
(12) Recreation,
(13) Screening and Assessment;
(14) �hopping Assislancu,
(15) Transportation; and
(16) Specialized I'vIedical F"quipmusnt, Services-,and Supplies
2.4.2. Congregate Nutrition,Services(111CI Program)
Nutrition services are provided in congregare settings and are dcsiped to m,luce hunger and rood
insecurity, promote socialization and the health and well-being of older individuak, by assisting them to
gpin access to nutrition and other disease prevention and health promotion services. ScrViCCS irICILIde
the rol loweing�
(1) Congregale meals;
(2) Congregate meals sucening,
(1) Nutrition CdLlCatiOn and nutrition counsoling,
2.4.3 [Ionic Delivered Nutritiori Services(11ICZ Prol!rram)
In-home nutrition services are I)rOVided W WdLlCe lltlngU aod food insecurity, promote socialization and
the health and well-being(if older individuals by assjstingsuch indiVid0iflS to gain access to nutrition
and other disease prevention and health PrO1110601)SCIViCM Services iflChide Ilie following:
0) I Ionic delivered meals:
(2) NUtritiOn education and counseling;
(3) ScreeningJAS5CSSJnC1kt,
2.4.d, Disease Prevention and Health promotion Services(1111) Program)
Evidence-Based Disease Prevention and Health promotion(E-:BDPI IP) service have been demonwated
through evaluation to be effective for improving the health, wellbeing or reducing disease,disability
and/or i qj tnry among older adu Its, and proven c fI`ec live with older ad u It[MI)LIlat ions. TlIcAULJ(�,flneS
F"13DI'1-11'services as inceling highest-level criteria. Only services that meet the highost-lovel Criteria
are allowed under the 1111) Vrograni. F;l3DPHV SCrViCeS InUst be delivered per the requirements of the
prograin alld CtISUre prognmn fidelity. U"vidence based programs include the following:
t A Matter of 11�,fl ance
(2) Chronic Disease Se 11-tv'iatrmaaletaacttt
(3) l3kibetes Self-Management Program
(11) Enhanced Fitness
(5) 1 tom etvIeds
Caregiver Support Services(I HE 11'rogram)
l,r,t,, following servicesaw intended to provide direct hetp to,caregivers,imist in the areas oflicalth,
marition and financial literacy and assist caregivers in making decisions and problem solving relater) to:t
their caregiving rates and responsibilities:
I Adult Day, Care,
Caregiver Traillillg/SUPI)Ort(Individual & Group),,
(3) Respitc Services-,
(4) Screening/Assessment-,
2.4,6. Caregiver Support Stipplemental Services (1HES Program)
The following services are provided to coniplemoit (lie care provided by caregivers:
C. 'Services,
Page 75 of 73
AA-2129
(2) HOUSing Improverrient;
(3) Material Aid, and
(4) Speeialized Medical Equipment, Servicus and SLIJIPIiC,5.
2A.7. Caregiver Support Grandparent Serviecs(IIIEG Program):
Services for grandparents or older individuals who are relative caregivers designed to help meet their
caregiving obligations include the following:
(I Legal Assistance;
2.5 Iteports
The Provider is responsible for responding in it fin=iety fikshion to additional routine aridlor special requests for
inforinadon.and report,,, required by the Alliance. 'Hiv Provider most establish due dates for any subcontractors
and/or vendors that permit the Provider to meet the Alliance's reporting requirements.
2.5.1 Service Cost Reports
The Provider shall submit Service Cost Reports to the Alliance annually, no laier thari 90 days afier
the provider Fiscal year end. The Service Cost Rq,wils shall reflect actual costs orproviding, cach
service for the preceding Provider fiscal year. I i'the Provider desires to renegotiate its relinburs'ement
rates, the Provider shall make as request in writing to the Alliance in accordance with the Alliance's
approved Reimbursement [late Review Policy, which is incorporated by reference.
2-5,2 Surplirs/Deficit Report
The Provider will respond to the consolidated Stirplus/Deficit report in a format provided by the
A Iliance to the A[liance's contract manager. Surplus/Deficit reports must be submitted with the
monthly request for payrncnls This report is loroll wrvices provided in this agreernent incorporating
in this Contract beLween the Providcr and Elie Alliance, The report will irickide the following:
I) A list of all Services and their currctit sitattis rt.Tarding surplus or deficit, and why they differ from
its original hudget projections,
(2) A detailed plan on tow,the surplus or deficit spendlag c\cce din g, the I% nionthly threshold wilt
be resolved. The plan 11111st itICILICIC SoMFIC bUdgCI 141111hOrs 14) reflect hOW the plan", ki
address the variance,
(3) NURIbCrof clients currently on the waidist (APCI-).
(4) NUniber of Unduplicated Client served.
245.3 Volunteer Activity Report
The Provider shall submit an arintial UnctUplicated report of volunteer hOUrS Oil the format provided by
the. Alhance. The dala collection period is trom Jamlilry I — December 3 1 for each calendar year.
The data submission date is live()working days fbHowhig,the clow of'tlie contract period,
15A CIRTS
Client Information and Registration Tracking System(CIRTS) Reports:
,rhe Y-`E-ovider shall input OAAaspccillic daut into CIRTS to ensure ORTS dala accuracy. 'rhe
Provider shall use CIRTS—cricrawd reports which include the following:
(1) Client Reports;
(2) Monitoring, Reports-,
(3) Services Reports', and
(4) Outcome Measures Reports,
(5) Fiscal Report-,
Page 26 of 73
AA-2129
25.5 Program lfij�,hfighvi
The Provider shal I SLINII if Prograrn I Ughl WK reflandy sN6 6c events that OCCLWred in preViOlLts
aminau year by Sepember 10"' of the current contract ycar, Tlle Provider shal I provide a nelx SUCCCS-S
Story. q no t L; testI ni o n i a L or htnn a m&W iTst v i gn et w The h igl I I i gh I s s ha I I be %v linen I 1:i I- a ge ne ral
audit nce. uTh no acmnyrns or Wchnkul tenris, I'm all agcIdes cw orgimi/alions lNinl are r�,15(,�u-enc,kl in
the highlighL the Provider shill I provic[c a b5f dwaiphon of dwir minkin Or MI DIQ 00NU leM
Mm 11 be condstendy uwd in Me hiWAYM nwiriattive, in Wer to WgntiQ Mis specitic individual or
erl(0), th"R pet-1,61-inod dw ackrv6' dwsc"Filmd irl 11r : JAw Providi r shall revhI �, rind C(,.Iit
Prog,rair,i Fla,�2hliuhls fOr claril , rclvv""tm n specincity, Knan humt, and grwrimm pi-Ar
iu" Owni R) ihe; Alliance-
146 (JuireviQ Ainth 0
110 1"M kyl Al iqhyl in mnxomh oak AV, w kno sonQq"YiuQ WKY I 1.10A 101`111 rvjwniq_,�
OnLo oswillkhed h% Wc ARAno Ito on"Y muq KRAw Aw 11,10" Vlr An makwt nuinher
and I, jw uF jum 440%on, or oak Kies: duo and hwmhw= bTd nm1',`11,-)�,.,r pon-IieiEa'was an
in LTL or aw0vWx i iYA WK qorviuo noed, idov&wd: and I wOr"I wul%ys w inAwnwilkv,
pr n I daL R o pi ins in ino ho u NO Uod h; j in no A I and [Xwem hwn- 31 or onah oca H I-ou t j va I% N n
nah dies raqudrcd It, hc con,yool YlInWIIIS Go the Pr Wr
l,'onsin""'t" " Kh VIO vmmh;T "Worwarch WK IIV , uUmnaA K On SoA ko Pon klar.
010whm f SPA) sUl"minok:d ill 111L: 'O I S ( )A % Rl
_71 fllcaldk mid NVVMIC Ls Repol,14;
I no 11"SK NAl mdvnk \hm= Vnwnrlummic Ifu1mins Nw I A3 I)Iq Ill Aen, icch. Hoc,
U&HWW ( tMWnO \101YAgO !%A 10,00 UH IAW 4,1''1L,RdshL-�'1 41 ilk Me 1,11'v-,
I ImIth am! " CARICIN (1111C IN C�`Cll 111011111 t'_ 14�'IICUUAN Sk"% nqhWWd Only a" %103 1:
No iwrship omit Ink u1slakx! as noAkd 0 alld I SI&A ioal Ph wakdo"ii Page-
a. in RH nvolun pRwkkd hi Wk, KwIld) PRTj nininalic Ropon "nlwi mawh 1.. lRA K dwin
aill-I (he Rx"line", 661 lln
K I lie 1hot kler shvil I rv% Ow paigrdni docurnmaKin W KI)SUK 1104 111"HOMIJIM k Walplele
,Uhl adeqwoot uppm Illy' iniNninhim repm-red mi We Munthl) NoyininmoN KINin:
1"6oi k, nuhmiuing a 11"Imni tar N, mt.' u, The llov` Ides ' ill Icl Ih,,, ro" ill Lie
of Me NNOTY PATMMI11110 ROP1111 Ond PRA kit Nk"0111,
inkiniviliml lcprdhr-_. dl,,' a,;, 11"'chh:'d
o Prognmi dnkmri5q,miIifioH vglarll inclu& all Me 010"Aw Kimon: Wyn-111 Shal of
I lyxl4 iw thwunhotminin &n"maniting e1`160, In ivoyd pdninipano,i
nth I rmnn"o;Q I J I I)PI I P norvivvy pro% QWd: CU ITCH I fACT I d0lr 11`01i LOU IVS! C0111 01'
PIR)3o.1OH1 hXQnW and Up K."wN r"p&vd by Tc Wv6l1c pnjumn
(I 111-o" shal I =WV ow; PnTrim J"Unhow"Okm hwhidaq 4 Si nin-In Ykno Ow Alw1holnul.":
II M i1h We IMW. Hank: 01 1 ImiqViHn. 1YU iruipam mai
RdUmAj 150 Akuordmko 1 nV Ins ma hichwe j spwc kw pwinWymH Omnmv-,.
WkIdn"MI Pnjm`!HH &WHMC7a,hi,Wt Hill',-.-. lab' +ih.:lllided " hh pwtvomo QmuwnN TUI
HlalChe-, 111L: H�.Ujlc, anid dkyns hi !no Mk=6IdV',1IR`0 1 1 S. :,,:I'a i'll 17, I't
qTnmed hj UhHwc (Ananw! Klmaqw. RequemN mima he lll�lde in arld, kal"r
Q. KWUP1111, HUM! " Id :iHd sign dlej name mi paTram QHAH sham in AhinUmca 1 o,-q.
AHoUnow IA, "Ah parQuipant nama, t� pvCd or vrhl,un in h, To saIne porym "M ncq ln,
uVaepted a, on poinktals IvAncs or k WlAde n "IQ thor km 11
HIM 0&1 Sign. TO himnie"o no, sWo h; lonw, ng dw J�,Illh:ij�San! a rwic on dlk_
h!± xhet� k iq myo"Mo 10 & so Aw 1(l h,,.' iniii"11c.,l] air,,,[
K Tho I%AAkr jhaN j hkk by aH pin I am, I ide I A, rolph Nnwn n R nd an nmil Q oh,a%v kk I A co,
W5 r I I i DP I 11, e V%OR A lh`,`(,,.c %-, i I j i nc:I irdtd i I i i I ic-" ?do MQ Pn Inm Hmak Renq, in Wk:
Page 27 of 73
=2129
yAwyInWHIN neCtkal "hen a pNjiqanl Ill, been jn0e%0j, 11010nal,tahou pollamnInj to Q
ohNonoWn "ill ho kept and pon KWd Wi to Allioulk--�: ut'lon
I ho IVP% KA, Ooh covitni KY M HwieQ Qua lot Wagce in 02 nmd ol an cnjoqohj ut,
an vx Awn I a Ruinmamc "We Ho pR"kkr in unlWo as mahwain an awact of Add A) on hv
I I�I Wl It' I., is o:-.0. HMHMHM or ntaymuno hNno the and co'
the "MoOln Ar Q: JiNLJ'L'6011 01 111,! AMMMV (4MWMI MMMHOC HW Seit&O nU% he
uriLL.ir th,N civil rim 11MOMM, inne U01% WAUCIA i, V,i:;Aoivd Awr die
proVowi lins OWN. sly. rin the Requent IN 10, nwm (a :'t d",k revk�'%'— !he
loo, -,(it rie '=,jffflr Od or dl,fll hi"� inhu J`.'e 1he
,T� I I h'-' '0 0111 li i
A Hianve HO,"t V die %%orkhhq,.
h 11 w P ro v id or v h A 11 c k I k i v or a!Q ot ul Ili.nvt i , giiarkviN u ki Q i Itvron10 i k
1 111)PIII UnA ky g 10 M W N h 0 S A W H be d Had i 1 i 11! iiI ate 1,1 11 V,Iti, 11 '�I'I ,:-v"
Uppaqw1w, am!, win kiwi '" I Ill)PI 11' nolA oC r cmm"'L,i"i), ;nl 1k I
1C% 'WhOl' tijndhf-14,��" Winerships &M ah, addroN, WAINi.q whi sinaiiiiing an
101 ',,r KIM= %eii ive� I hi, hvividev I'm i, m; Whed
10. AWCAUMICHI A 11SHMS 1110 OUMPAMS, C0%%'Tirl�l for
Allkirwo upon raqwsl ovkknvi; of
p:umwshipNLimvi1`0FHYM% WMIJ011 ruloni-anding. Koddee x0i K,
rquiRml to 601) 1AWk 01 101neaddl", ill dw I ac :'h month tlic
I IR n Or hhall ro% 0% and PIAM WC HPdXCW Is H&MMA,
2�b Rveords aand Documentation
1 W 10%AW n'arcow on nmkv a Q WhIo to A114"we w W w the I laimit man. Ya R Wor on, pa N) WhouttJ h v the
.�oicd "i ILTMIMa" Ill C" Imn'lcl nnot Mormimokuk I he 11ovidwr swill (nkstv the
Mookvi am! viyWown" oral! pi"pron-i relnkml jqG"nVwkq'j anj on
-k4iqtvHvd iq Hie N115mv alld W the 141"IMOH1, Jdai14,.'910101 inClUdON CHO C\MWk dMI hWhIn W All
&A,A s!dkl j"IM14; to I QviSHoo widard, I M! vimst he umthlc and Ki a sohLihic Winn h'% W,
11110wv wd orihe
2.6.1. CIR Daia Vkidni,kni.m(x,
The Prixvfdor will ensure The acciarziw eollechon and nmhvenaixe ot'diem and se'rvik:c- on
a MOWN himis froin t[to, CIRJ'S,or any such symern dOgnmed by the AlKwe. Mainionance
We ludes valid exporls and Mys or tall dWa and synonts accord i ng to A Hiance and DOEA
standmAs. The Pmvidor must Were to Ow Aikance C'IRTS Data Wagiri, PAWS & Fhvixduiv ,
hinoqmwated L, refetvne, in War to enmue davi mcuracy.
1(5,2 Dam, Integrity and Back.-up Procedures
Fho WON slulf nishirdri "Won pdwie, mhl lwmaKuwn 4w caripma";not hookup wRI
rouov or, and Jall ha%c tho cum 1VW6vOWnL of M ST111OV11MOM, lHdqw %Qn0n.Tho,�'
1xilicio, vuh! provedwy, shall la mado PvMdw h die Uhnne npon ivqn;,,,1,
2.7 Sjj,v(,jfi,catjf)jjs
1TI Oulcornes and Chupws Qddrnance Waswes)— At as mKirinurt, the Ptavider imist:
(1) Ensure the provisOn of Me scrOces described in Kk cimmam an in acciardanev wift to current
DOM MgmMs mid Services 111andbook and in the 'M.aniier ol"Service Provvision dc,Qrihod in
this cororav,
(2) 1'irricly and a(curtjilvdy ubnii! to !he Mflance all htf-ornimbn dese6bed W IN eta ni-am
Page 28 of 73,
AA-2129
(3) Develop,document,and follow strategies in the Service Provider Aj)plication(SPA)to support
the Department's performance outcome measures in the following criteria:
a) 66%of new set-vice recipients with high-risk IlUtritiffll SCOrCS Will itrIpr0VC their`
nutritional SWILIS,
c) 65%of tie",service recipients will maintain or improve their ADL's assessment score,
d) 62.3%ofne-v service recipients will, maintain or improve their IADL's assessment score,
e) 89% of family and Iarmly-assisted u are givers will self-report they are very likely to provide care.
17.2 Monitoringand Evaluation Methodology
The Alliance will review and evaluate the performance of the Provider under the lernis of this
contracL Monitoring shall be conducted through direct contact with,the Provider through telephone, in
writing,and/or art on-site visit. The AII'larice's determination of acceptable performance shall be
conclusive.The Provider agrees to cooperate witit the Alliance in monitoring the Progress of
completion ofthe service tasks and deliverables. The Alliatice may use,but is not limited to,one or
moro of the following methods for monitoring:
(1) Desk roviews and analytical reviews;
(2) Scheduled, un,,,,chcdule(L and follow-up on-site Vi5it-s',
(3) Client visits;
(4) Re view of independent aud i to r's reports;
(5) Review ofthird-party documents and/or ovaltlation,
(6) Review of progress reports,
(7) Review of custorner satiql7action Surveys;
(8) Agreed-upon procedures review by an external aUditor or consukaw,
(9) Urnited-scope reviews: and
(10) Other procedures as deemed, necessary,
2.73 Services
The Provider shall ensure that all participants served under this agreement aro eligible ror the
prograrn, and that it][ monthly and/or ClUarterly performance reports and financial records are
rnainlainod for each reporting period and submitted as stipulated in 2.4,2.5,2,61 and 2.7.
Any nonconromiinIz, prograrn services, purl'ormance reports or financial records not mecting the
require moms of this Coniraci shall not be eligible (6r reinibUrsenrent under this prograill, The costs
associated with hiring, training,mportingand/or nunaging the program shall be borne solely by tile
Provider- The Alliance roquires invinedialo notice orrany significant andlor systemic Infractions that
compromise the Provider's ability to provide participant services, to achieve programmatic
performance or to provideSOUrict firiaticial wartagoment of the program.
2.9 Contractor's Financial Obligations
2XI Mitching, Level ofEXfort,and Earmarking RCqUir0itelits
The Provi,det shall provide triatch of it least 10 percent of the federal administrative funds rccQived,The
Provider's match will be made in the form of cash, general revenue administrative funds, and/or in-kind
rQsoorccs. -rhe provider will assure, through as provision it) gubconcracts. a Inatch requirement oral least 10
percent of the cost liar services funded through this contract,except tier Title JIID�The Provider's match will
be wade in Ore k.,,irm ofcash and/or in-kind resources. The Provider shall report niatch by title each morith. At
the end of 111C Contract per tact, the Provider must properly match OALA fttnds,
2.9.2 COMLIMCrContribotions
COUISLInler contributions zire to be used under the following terms:
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I) 'FlieProvider assures compIiance wit It Sectioa 315 of the A as amended ill 2006, in regard to
consumer coritribilitions,
2) Voluntary C011tfibUti011$are not to be used for cost sharing or matching;
3) ACCUrnulated voluntary contributions ire to be used prior to requesting federal reiniburserrient; aild
4) Voluntary contribL160115 rare to be used only, to expand services,
2.83 Use of Service Dollars
The Provider is CNpceted to spend all federal, state and other funds provided by the Alliance for the purpose
speeiIled in the cooitract. The Provider raust manage (lie service dollars in such A manner so as to avoid
having,a wait list,a deficit,or a surplus of funds at the end of the contract period, for each progirarn, roanaged
by the Provider, program surpluses must be reported to the Alliance.
2,8A Surplus Recapture
Ill aCCOrd,111CC With its SUrpIUS/dCficit manageruent policies, in order to maximize available funding arld
minirinize the time thtat potential clients must Nvalt tot-services,the Alliance ill its sole discretion can reduce
Funding awards if the Provider is not spending according to monthly plans and is pro,jected to HICUr 3.SUrpIUS
tit the end o(lhe year.
2.8,5 'I'lic Providor agrees to use Rinds ams detailed ill the BLidgUt Summary, A"I"I'ACHIVIENT VIL Any changes in
the amounts of Federal or gencral NVOlUe funds identificd on ihC flUdg I I. ,Cl SLItufflary 6orm require it contract
amcndmeut. Providers must adhere to Alliance's Modified Spending Policy, incorporated by reference, whert
mquesting changes to the bUdget Summary Fortm
2,8.6 Title III Rinds
The Provider assures compliance with Section 306 of the Older Americans Act,as amended in 2006 that
Reads received under TiVe Ill will not be used 10 J)ay any part of a cost (including an administrative cost)
incnirred by the Provider to maintain a contractUal or continercial relationship that is not carried Out to
itriplernent f-itte 111,
2.9 ALLIANCE'S RESPONSIBILITIES:
2.9,1 Prograni ("Juidarice and Technical Assistance
The Alliance will provide R) the PrOVidCr gLlWVoCV and technicrit assistance as needed to ensure the SUCCOSSfUl
1111 I'll 11110ru OftIle COnLract by (lie Provider, '['lie Providers must attend all required training session and
IIWCtjllgi. 'T'IlC Support,or kick (flereol" shall not rolieve tliv Provider front full pert"ormance ofcontract
roquirellients.
SECTION Ill. METHOD OF PAYMENT
3.1 General Statentent of Method of Paynterit
The Method of Payment for this contract is as combirialion of fixed-fee/unit rate, cost rei Ill bursement, and advallced
payt ents.subject to the availability of funds. The Provider shall eVISLIRe include only those:costs that are in
accordance with all applicable state and f'ederal statutes and MgUlations and are based on laudited historical costs in
instances where ail independent audit is required. The Alliance will pay the Provider uporl satisfactory corripletion
of Tasks/Deliverables as specified in Section It, 1 I� 1, and 21.5, and in accordance with other terms and conditions
of,this contract,
12 Unit o(Service
3.2,1 I'ce,(:nit Raw
Provider must llm:t the millimmil Icwel W'pel-fillnilance slatod ill ille c:ontrak:t ill oldcr to recelvc payynlelu,
Page 30 of 73
AA-2129
ho nwat, ku I Wed Ica! it l, Wan A mH im, e\ned in A I I ACI I�I I,N I VI I.
l.,xd R-ok:,, fi,i NS,11'
Rnm ono q Or 1,4111 Wai we hall en nod ':,fi,po u[JI ol
SL,I-% ice to he, Unit or tic Unit Rau.
I nial a mid I i,ecd Y I
nlolll m:l., IlcIRAW/01 W- GUITMAW O\IX`lkIKHrzN. pxfl-o,� linlit" AH `0", !\1[.,'c'I
A K"L WilldnWICHIOn! Re Wicyi 11W vomwqy nmw Who: HW wood r\yTdKMV Hornw,
Wynin; "K6 Ow C44 imuldi 411w cx"nu. I Iw Mim A= monn mcat the mmilmuln lond in'
i"; in th."! Lonn ak,:l kt e
1 he NOW who iWICO, to Wrillye ITUYI, an dc,-IAiLd in flIC BIQW! SUH11111q. .11 1 At I f\H N I VH. h
this couium. An clanyon in Tc k4d ammmo ko Ow Wd, idovaillud on Aw Owlyi Sm"=3 kim
33 Advance I'ayinenis
w awnwid,er muy request up r,,o i�vo irionTs of ndvarwvs at the start of the contract period, if avai W, to
crm,cr pro,,,?,nain service co m The pyawni or an adwmce "T be contingeni ilion We Widency and
olnormi AM TWO(I k) the Allizance, 'Ibe Provider shall provide ths .AiHsawe documm"MAmjm6Qkqd,
'Me mod As on udvancc and describing hmv We Wnwill be dhuibwaL
33.2 'Me Prov Wer's reques is fo r advant-e roq W re the app w v a AW be A I I lanc e. 11"s u R"i c ient budgM is ama Rabl,e,
M C A H Anc 0 W i H is U.a MXO"d actv am 0 pq Umn N "I file r J z j n ttioxy L 2021. A d%,-a n ce 13 ay rn e n is �%,,i,11, 11 ot he
Noted A NNW=
-33,33 Requests, for Me first OrmMh dw WRh moors, WU be bosed (m We vahnission ofaclual inontho,
ex p MUIJ awe report" beg.i rtn i it g "h h dw n ml m mn h o f W c malso, ]]ic w jr�j,;C I t I le lot S t 1 bjyj i,S"'.i 0 a
,, of advance
nxNem if availkNe is shnkvn on VHl ofil-tiq conrrtto,
33,4 ,III adva,nced ps)w-lents made to Me Provider shaH he reamped in �.tccordance wiOi !he R el-iordng Schedirk
AT-FACH M[.-,N-[' V[I I of[his comr-elct.
3-3,5 It i I ere s I emm ed o n adw=e s ni t is t be i 62 n I i fli e d se pa rate]y by 8o ume of I n d% am e o r red cra L P w A d cl,shall
maintain advances of Admal Am& in WFOS! RUNg MOLIJIHS LHASS irrkerwko exonped in accurdlirac
with 45 CFR 74 2ykj fanned interest must be ixturried to WeA Hiance m:the end of each qumler.
14 Immide SW,l Hfall Srul Requests fbr Payntent
Par),vjenj be ti-i,;adc tjon We 6'mviders presemagon of an invoice. Follo%ving acceptance arid Lipproval, by Ole
alhomc of deliverablos shown on the Nvoilsm TV Provider shall, mairtlain documenimion to support payinew,
requems Wt W be amilah]e todlQ err aukotrized WAKi.clualy sal h as Me DcprrmmH of IFinartchl.
Servit�cs. upon request. S"pa-dy docurnonwHon c4'services provided imust be a,deqL,,jal:e to l.m.,nnit fiscal and
pmgmmmmic evaWahon and ensrwe internal marntgemeni,
'Me for and sub,.�aantc of each invoice qLdjndtKd b), the Provider shall be as JbIlows:
Page 31 of 73
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3.4.1 All requests for paynient and expenditure reports sub witted to suppoil requests for payment shall be on
harms 106(Kri-ACHMENT IX), 105(ATTACHIME NAr X-)bXI LIBIT 1), 117(ATTACI IMENT X-
EXHIBIT 2) and 118(ATTACHMEN'r X-EXHIBIT 3).
(1) Form 106
(2} Form 105 is for all OAA Titles—Use one form per Tide
(3) Forin H 7 is for NS1 F,
(4) Form 118 is for NSI 1-1
3A 2 The Provider shall submit all payment requests based on the submission of the Provider's actual monthly
expenditure reports beginning with the first month of the contract. The sclictlule for submission ofadvance
re(JUCSts(when available) and invoices is ATTACI WENT Vill I to this contract.
3.43 Any payntent due by tire Alliance UnderthC terms of this contract irtay be withheld pending the receipt and
approval ofall financial and programmatic reports due frorn the Provider and any adjustments thereto.
3A-4 The Alliance will authorize pay nicni (,)illy for allowable expenditures, which are in accordance with the
limits specified in ATTACHMI-W!' VIL
3A5 Violably review(if the Receipt and Expenditure Rport and Ille ReqUVS1 for Payment Form by the A 1141nce
will focus oil:
(1) Line item comparison of year-to-date expenditures with the budget 10 monitor rate of expenditures;
(2) Allowable total reirnburseinent,on a service by service level, does not exceed budgeted/contractuai
amorail (No unilateral mordified spending audiority.);
(3) Validation Of SVrvic,e units reported against C[RTS.
14.6 In order to properly manage the prograrn budget. the Provider MUSt Submit invoices for payment no later
than the 0"'(kty fidlolVing the month in which tire expense Was incurred. not to exceed three(3)months after
the end()('tire Month ill Which the expense%vas incurred, except that invoices cannot be subinilled after
Close Out Rupoirt dlate. Invoices Subinilled lare will require the approval of the Alliance's contract manager,
Late invoices will not be paid Uo1eSSjUStifiCa1i0l1 is subimited and approved in writing by the contract
lllallagel%
3.4 7 Date for Final Request for Paynient
'I'lle Provider shall submit the final rcLlUCM fair payment to the Alliance by the date indicated tart Allachroelit
V1 11 of this contract.
3A.8 Payments will be tnade to the Provider based on a coniplete and correct invoice, invoices that are
incomplete or with incorrect total will not be processed and will be returned to the Provider fiat,correction.
Fiscal staff will not be able to correct or make cliangoi to the invoices, RCtL)rllil)g ir)VOiCCS J`brCCrrrCCii0r1Pq
may result in rilikire to receive payment for that month. Invoices sliall be subinitted hirrely as per
ATTACI IMENT V111 in order to avoid aji.y pyntent delays.
14,9 The Provider must eater call required data following DOEA's CIRTS Policy Guidelines for clients and
services in the CtRTS databaw— Data must be entered into CIRTS before the Providers submit then' reqUCS1
G)r payur,ent and expenditure repro-ts.
3 A.1() '('he PrOVIdUl"Shall run monthly CIRTS reports and verify that client and service (latil in CIRTS is accurate.
This report must be SUbinilWd to (lie Alliance with the niorahly request lbr payrnent and expenditure report
and roust be reviewed by the Alliance before the Providers request can be approved by the Alliance.
1-4,11 1 or Providers receiving funding for Material Aid services, Material A it] must be pruvided oily when them)
is no available altern-ative, e.g. another-prograrri funding, sOUrce or coanininity 1-CSOLINQ, ihat can accornplish
Page 32 of 73
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the service or supply the goods. Prior written approval shall be obtained in writing From the Alljancc's
contract manager for purchases of$500,00 or more. Written approval must be submitted witti the request
For payment.
3.5,Remedies for Nouctinforming Services
Tlie Provider shall ensure tliat idl goods and/or services Provided Under this cortiract tire delivered timely
coinpletely and cornniensurate%vith ruquirt(I standards,of quality.Stich goods andlor services Nvill only be delivered
to eligible prograin Participants.
If the Provider fails to nice(,tile prescribed quality standards tier services, such services will not be reinibursed under
this,contract. In addition, any nonconforming goods (including home detivered meals)and/or services riot Inecting
such standards will riot be reimbursed tinder this contract. The Provider's signature on the request for payment form
certi Vies inaintenance Of Supporting documentation and acknowledgement that tile Provider shall solely bear the
costs amocialted Nvith prep-aring or providing nonconforming goods and/or services. Payinonts tilay be withheld
and/or required to be reimbursed 11'standards are riot upheld and/or if documentation does ]lot Support invoices
being processed or already paid, `-lie Alliance requires inimediate notice ol'any signilicant andflor systenlic
infractions that compromise the quality,security or continuity urservices to clients.
3_5,1, Corrective Action Plan
I. Contractor shall ensure 100%of the deliverabics idontillied in ATTACIVvIVNT 1, Section I I (Ivlinner of
Wrvicc Provision)of this contract, are perforinctl pursuant to contract rMILdruniews.
2. Ifat any fline the Contractor is notirted by the Alliance that it kis railed to correctly, completely, or
adequately Perform contract deliverables identified in A"J"TACHWNT 1,Soc. 11,the Contrac(cr tvill have
10 business days to submit a Corrective Action Plan,("CAP")to the Alliance Contract Manager that
addresses tile deficiencies and states how the deficiencies will be rernedled within a time period approved
by the Alliance's Contract Manager. The Alliance shall assess as Financial Consequence for Non-
Compliance on the Contractor as referenced in ATTACI IMENT L' Sec. 3.5.2. of this contract for each
deficiency identified in the CAP which is not corrected JILITSUZInt to the CAP. Tlie A]I iance sharp also
assess a Financial Consequence for fai[tire to I imely SUbtlift a CAP,
3. Ifthe Contractor tails to correct an identified deficiency within the approved time period specified in the
CAP the Alliance shall dekh[Ct the percentage established in ATTACHNIENT 1,Svc. 3J.2. of this
contract, frorn the payment for tile invoice of the following tnunth.
4, I f1ho Contractor faik if>tinjo.I k I b t 4 1 1 1 i t a CAP, tiro Alliance sliall deduct the pc rcelitage established in
ATFACI-IMI-NT 1. Section 3_5.1 of this contract for each day the CAP is overdue. 'file &d0diOn will 110
made from than pay inem for the invoice of tire following month,
3.5.2. Financial ConscqUCUCCS of\Non-Perforniance
The Alliance will withhold or reduce jM.VulCut if tile ("ontractor ktils to perfbi-in the deliverables to the
satisfaction of the Contract according to tile, req u irerne tits rcforenci�d it) ATTACHMENT 1, Section I And
Section 11 ofthis contract. The f'ollowing financial consequences will be hnpo ecl if the deliverables stated do
rz,
not meet in part or in whole the performance criteria as outlined in ATTACI ITYIENI 1, Section I and Section 11
ofthis contract,
1. Delivery ofservices to eligible clients as referenced in ATTACI INIENT 1, Section [A and Section 2.1 of
this contract—Failure to comply with established assessment and prioritization criteria as evidenced in
CIRTS reports will result in as Y./o reduction of Payment Per business day, Tile reduction of payment %v]l
begin on the first business day following the Alliance's notification to the Provider that the identified
deficiency was not cured 01'satisfactorily addressed in accordance with(lie Alliance approved CAP,
referenced in ATTACHMEN'T 1. Sec. 3.5.L
Page 33 of 73
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2. Services rand Unih.Of SCrViCC5 as referenced in A,r,rACI WENT 1, Section 11 of this contrict—Failure 1i)
provide services in accordance Al"I'ACHMENT 1,Section 2.4, the Current DOEA Progranis and Services
Handbook,the services listed on AT'rACHMENTS "III and K. and submission of required documentation
will result in a 2% reduction ol'paynictit per business day. The reduction ol'payrilent will begin the first
business day fiallowing the Alliance's notification to the Provider that the identified deficiency wris not
Cured or swisfactorik addressed in accordaricc with the Alliance approved CAP, referenced in
ATTACI IMENT 1, Scc� 3 1,
3. Administrative denies as referenced in ATTACHNIFINTI, Section 11 of this.contract—Failure to perforni,
the perl'orniance specifications and oversight ofoperations will result in a 2% rcduction of payment per
business day, The reduction of payment will begin the first business day following the Alliance's
notirication to the Provider that the identified deficiency was not cured or satisfactoHly addre�.sed in
accordance with (lie Alliance approved CAP, referenced it) ATTAC[INTENT 1, See, 3,5.1.
4. Tifflely SUbnIiSSiOn Ora CA 1-1,— F'ailury to timely,submit as CAP within 10 business days after notifica(ilon
Ofthc deficiency by the Alliance contract mana"_, r will result in as 2% reduction of payment per bUSirICSS
day the CAP is not received. The recloction O"payment will begin(lie first business day following the
Alliance's notification to the contractor thin the identif-tud deficiency was not Cured or satisfactorily
addressed in accordance with the Alliance approved CAP, referenced in ATTACHMENT 1, Scc. 3.5,1,
5. Exceptions may be granted solely, iii wrifing, by the Alhancc.
The Ren-minder of the Page. len,Intentionally I'llank
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AT TA C 1-11 M E NT 11
ATTACHNIENT If
FINANCIAL AND, COMPLIANCE A Drr
The administralion ofresources awarded by the Alliance tea the provider rnay besubject tortudits and/ornionitoring by tile
Alliance ant.1brifie Depaaatment as described in this section,
1. MONITORING
In addition to "views of audits conducted illaccordallce willi 2 CFR Part. 200 (fo rat erly OMB Circulari%-03, its
revised), and Section 215,97. F,S.,(see "AUIATS" below), it ortitoring in-ircedurel may include, but not be 14114ed to, on-site
visits by the AWanue and/or the Departni cot staff, I i in ited scope audits as doted [kNONlt3CircttlarAk133, as revised, and/or
officr procedures. By entering into this"greememit, (tic Contntuor agrccs to comply and cooperate wilh wry nionitoring
deenred appropriate by the Alliance, In the event the Alliance arid/or tire Departtrient determines that a
limited SCUIN HUldit of the C.brItizictor is appropriate, theConti-actoragrees to corriply with any additional instructions Provided by
the A I I i alive andfor the Department 1i) tire Contractor regarding, such audit, The Contractor Further agrecs to comply
-slid cooperate with any inspecfiuns, reviews, Investigations, or audits deerned necessary by the Alliance andlor the
Department.,
AUDITS
P'ART 1: Fl` OURALLY FUNI)ED
This parl Is applicable ifflieprovider is as Starcurtocal government car-anon-profit organization as defined in COMB Circular A-
13J. asmviscd,
In the event that the Provider expends $750,000,00 or more in federal awards during its fiscal year, the Provider niu.st have as
single or prograni-specific audit conducted in accordance with tit provisions of 2 C F R F irt 2 00. EXHIBIT 2 to thiz,
ai,rcerneni jadicatc% federal resotirces awarded through the Alliance by this agreement. ]it deternaining the federal awards
expended itt its fiscal year, the Provid er sliall consider -LItso irciLs of l7ederal awards,including fedcral resources received
frorn tile A I I ia a c The delernibiatioll of ornoturts of FederM awards expended should be in accordance witli the
guideinies,established by 2 C'FR Part 20 0 An audit of file Provider conducted by the Auditor General ill accordance
with the provisiuris of 2 C F R Pa rt 2 0(1, will nicer the re(joirenrents of this part.
In connection with tic audil requirements addrcssed in Part 1,Paragraph 1,the Provider shall Fulfill the requircnients rc)ative to
auditec responsibilities as Provided in 2 CF R pa r t 2 0 0.5 0 8 ,
if Providerexpends less than $750,000.00 it) federal awards ill Its fiscal year. air auditconducted in accordance with the
provisions of 2 C F R 11 a r 1; 2 00, is not required. in dic event that tile Provider cNperds less than S750,000.00 in federal
awards in its fiscal year and elects to have all audit conducted in accordance with the provisions of2 C F R P a rt 2 0 0, the
cost oftlic audit most be paid front cron-federal resources (ix- the cost all"such audit niust he Paid front Nwiderresources
obtained from other Illan federal entities.)
An audit conducted in accord ri lice with this parl shall cover the entire organization Ow the orgarsization's fiscal year,
Conipliance findings related lo,agreements with the AI Nance s[Inil be bowd (lii the agreen i ui it's rcquirciticrits, including any
rules, regulations, or"ittites referenced in the agrecruciw Tile Financial statcrilents shall disclose whellict, ear not llic
marching requirement was inct for cacti applicab)c agreerneric All questioned costs and liabilities ducto theAlhance andlor
dre Department sliall be fully disclosed in the iudic report Willi reference to rite Alliance agreement involved. Unot
otherwise disclosed as required by 2 C FR P a r L 2 0 0 J 1 0, tile selledule cif expenditures of federal awards shall idelifil'y
CXI)elldiftires by iigreenicat nurrkber for each agreement with the Alliance ineffect during the audit Period. Financial
reporting packages required under this palI MUST be submitted vilthin tile earlier of'30 days alter receipt orthe audil report or
ea incluths after rite end of(lie Provider's Fiscal),car end.
Page 35 of 73
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PARTH: STATE FUNDED
11iispart isapplicablc ifthe Ptuvider is anort-state entity as defined 1)),Section 2 15.97(21, F.&
III lite event that tile Provider expends at total arnomit of state financial assistance equal to or it% eNcess of$750,000,00 in any
fiscal wear of'such ProOder (for fiscal years ending Septentimr 30, 2004 or thereafter), the Vrovider must have at Stile single or
project specific audit for sudi fiscal year iii accordance with Section 2 15.97, I%S.: applicable rules of the Dcpartmeat of Financial
Ser%°icec and Chapters 10,550 (local go%xiinnental entities) or 10,650 (nonprofit and far-profit organizations). Rules of than AUditor
General. EXHIBIT 2 to this agreement indicates state firiall6il ar,;SiSn!llCO amrded through the A 11iince by this agrcernejit. Ill
detefiminino lite state financial assistance expended in its fiscal year. the Providcr shall consider all cpurces of state friancial
issislance, including state financial assistance rcceived from the Alliance,other state agencies, and other ron-slatt entities. State
firiancial assistance does not include Federal direct or pass-1hrough uWaRIS and resources received by at non-stair: critity Im Federal
program niatching requirements.
Inconnection with the audit requirements address d in Par 11,piragraph 1. lite Providcr shall ensure that the audit compiies with the
requiremcnis of Section 215.97(8), FS- ]-his includes submission of a finaricial reporting package as defiled by Section 215.1)7(2).
F.S., and Chapter 10.550(local governmental entities) or 10.650(noaprofit and for-profit organizations),Rules of'the Auditor General.
[I'the rhAlcrexpends less than S750,000M instate financial assimance in,its fiscal year(for Fiscal years end(ng Selmetribur 30,2004
or therealler),an aticht conducted in accordlwt e NOO)tile provisions ot'Scction2l 5,97, F S,, is not required. In t1mcmit that file
Provider expends less than $750DOOM in state finuncial assistance in its fiscal year and elects to have ar audit conducted in
accordance with (lie provisions of Section 715.97 Fs, the cost or the .audit uJUSt be ),luid f1`0111 the 91011-State entity's WSULirces
(ix,the cost of such tan audit must be Paid front the Provider resources obtained fi-om other than Stale entities),
An audit conducted in accordance witli this part shall cover the entire orgarrization for the urganizallun's fiscal year.
(701111A ia lice finding"rehiled to agreements witit lite Alliance shall be basses) on the agreement's reerytrircratettts,including tiny
opplicab[c rules, rcj,!U4uiO)ls,01 statutes. The financial statements shall disclose whether or not the matching requirement veas
inct fbi-cach applicable agreement. AH questioned cosisand liabililics shall be Fully disclosed in the audit report
with reference to;the Alliance ,igrecrocrit involved. Ifilot otherwise disclosed as required by Rule 69t-5M3, Ila, Admin. Code,the
scheduic ofexpendi,tures ofstate financial assistance sliail identify expend it tires by ngreentent innnbcr for each qrrcenicilt with
the A I fiancc in effect during the audit period. Financial mporting packattcs required under this part must be wbrilitted within
45 days afler delivery ol'the audit report,but-no later than 12 months after the Providers fiscal year end for local
governmental entities. Non-profit or for-profit organizations are required to be submitted within 45 days afier delivery ofthe
audit report, but no later than 9 months airter the Provider's fiscal year end. Notwithstanding theapplicability ofthis porlioll,the..
Alliance mairs rail right and obligation to monitor laid oversee the perrormance ofthis agreement as outlined throughout this
document aind pursuant to raw.
11, PAwr ill. REPORT 81IJKMISSION
Copiciot'repoiling packages firm-audits conducted in accordance with 2 (A"R Part 2M and required byPART'lofthis
agrement CFR Par( 200,5 1 2,byorcan behalfof-the Noviderdirec to each of the
followille:
A lie Atlimice ill each of lite Following addresses:
Alliance for Aging, lite,
Attn: Fiscal Department
760 NW 107" Avenue
Suite 214
I'Mami, FL 33172
For riscaif vQm- 20 13 and eFln liar to lite Fekimil Audit Ck:m'uw'h('1(lw de"'i'malcd in 2 (TR l ;It tile 1,oillm,kip Page 36 of 73
AX2129,
l4dend Audit (leuringhouse
Wean of the Cenmis 1301
Ensl III— 10 reut
JuWsouville. IN 47132
I% Oval yaw 20 1 A mKI Iawr. pu"umn NY 2 C-10 §NMI 11 dw rqwwing package am! Me to cdkc&n W" unum be
submitted elecunniewly to 11W %%hudit Clear ightmw
Pumumu to 2 Ult§21M.512.all other Federal agencies, posAhrou,h oaitic�.and others inlcicstcd in roportinv pacl�a-
and than colketkYn Amu mug Wo it by oeccising thc 1'ederal Audit
The llro ider shall whend a cqj 4 m, manogoncra leur isswd 1a3 WC allMkn. M Me 1105101 DePWIMICAlt WAldcl'
A Wks m to Rd Wng adly":
Alliame for AWn*1w
Altnt: F"i s c a I D e pa r t in e n t
760 N%V 1071 Omenue
SuRe 214
Miamh FL 33172
ikdditiormHy, eopies nf timamcial mporflo.,-, piiLlkagi:s required b) dil conm0s I WpHmwe A= Awwhnwul,
101 U WmH he mil nilwd A) or on hvUl'ofTe lHoWnJ6,1jo wh adw Ikdh"hiu�
I lie 11oridn Dep,Irlu lent oflTdorA[Tair,:� at the iddrcss:
Wame for AWny Inn,
AM: Fiscal Department
760 NVV 1071 Awenue
Suke 214
RISK.Ff. 33172
The AudWr Gcnoral',,i 011-sce al the 1o11()%N io!-� adldrcss,a
"itaw of,I'loridu Auditor Geriet-al
Clamic Pepper Building, Iloon)
5 74
111 LYcs( MmIkon Street
Florida 32399.1450
Ajla rcports, Inann"moQ11t kncr_or kaher WhowwGui mqWwd w be bail mitwd io dw 1hpaNmew pnommu to this awto act
WH he suhmilacd Ilrucolp acowthowe "Wi 2 CI:R Part 200, ['101-ida SUIUVICS. and Ch"WIT IM5M Elam O yWaMnaMil
mKivs)or 10 650 ownprWU and kwproIlt organinahm"n Rol"odtho Audkur(Knord. as applicabic,
P"ahler, "bon mtrnkhV Wbal MWMKP PaLkages to the Dqinnrucra NO Wils done K aCYAWAUM "At 2 (AW I%
TH)or(luqurb 100500owd pwerrunoitol Qnth4shw 10AM)wWW and;Aw-Koht oTwiind"Q RO"onho Andkor
Gownw swum Wome we&a1hra paQkay%%as dvhvcrvd h)Te Priwider in eonv4pondence acewimlyinq ia�--
the 10jxw6w,-, padat--e
PAWl' IV: UEC010) jnj()NI
1 he IY(Ividcr shall roArr suffUckra records dernonstnabg 05 compik"we "it dw wonn"400s ewitrao kw as"rid am\
;61 Ssun Kon Me dmc We m0h rVkwt is Qued. aid WH AN the Deputrucra tv K d"Inev Me (T0 or Auditor
Cienowd accos to such rocords tqkoi ropwst, 10 IlLwkkr shM unnsure KI amfil moMing papa, am nwdc maiLah1c so
We AHKmc WW We DeponYaw or its Wynee, (11h or Audiw Uncral upon retprem Ru a paWd of On 0) 5varq
Boni the date We aUdil FoJWO j',,' issovd.knflcss vNtendcd in �sritiap by the Dcpartnlc�IW
I I
Page 37 of 73
AA-2129
A"ACtIMENT11
FINANCIAL, AND COMPLIANCE AUDIT A,rrACHMENT
FXFIIKIT I
PART I: A(,IDI'I"RL,LoV[-IONS[IIPDE'I'ERNIINA'I'ION
Providers who receive state or federal resources irmy or ma�y not be subject to the audit reqnircincrits of'2 CFR Part §200.500,
ail(i/orSei(ioii2l5,97, 1-'Iii, Si,it- Ilrovi,cfersNylioiire(letQrtiiiiie(itt)bci-ecipients car SLibrecipictitsofi'cderaii.i�v,irdsajid/(ri,state
financial assistance rnay be subject to the auditrequircilacrits if the audit threshold requirements set forth in [,art I artcVor Part 11
offxhEbitlismet. Providers
Part §20038, an(Vor Section 215.97, Fla, Stat. R,egard[esi ofwlketllCf(11C audit requiremerrm arc met,Providmi who have been
determined to be recipients or subrecipicnts of Federal awards and/or state financial assistance"lost Comply with applicable
programmatic and fiscal compliance requirements,
In accordance with 2 CFR Part §200 and/or Rule 69 1-5.006, FAC, Co n tr a ctor fins been deternrined to be:
Vcndornotsubjcctcro 2CFR Part§200.38 and10 r Sect ion 215,97,F.Si
X Recipient/subrecipicilt subject to 2) CFR Part §200.86 and 200.93, andior Section 215.97, F,S'
Exempt organization itot subject to 2 CFR Part §200 and/or Section 2 15.97,r.S. For Federal awards, fi)r-profit
organizations are exernpl; for state fininicial, assistance projects, public universities,comillUnity colleges,districtschool
boards, branches of state (Florida) govertiniern, and charier schools are exetript. Exempt organizations must comply
with all Compliance requirconeirls set fol-111 within the contract or amard doconicia,
NOTE: If as provider is determined to be as recipienUsubrecipient of federal and or state financial assistance and has been
approved by the A I liance to subcontract, IfiCy FuLlSt COMPly With 'Section 215 97(7), and Rule 69k.5006,FAC [state
finaricial assistariccl and 2 CFR Part §200330[federal awards],
PART W FISCAL COMPLIANCE REQUIRLNIEN'rs
FE'DUAIAL AWA140S OR TAT E MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive. Federal
awards, state. maintenance of effort Funds, or slate matching funds oil Federal ayardsaiid who are dettniflned to be a
subrecipient moist comply with the following fiscal laws, rules and regthticms'
&rATES, LOCAL GOVERNME.NTS AND INDIAN TRIUS IMUST FOLLOW
2 0-1 Part §200A16- Cost Principles'
2 CFR Part §200.20 1- Adn'rinistrative Requirements "
2 CFR Part§200,500- Audit Requirements
Keference Guide for State Expenditures
Other fiscal rcqrin-cments set feirth in progrann laws, nrless, and reoulations
NON-PROI-1TORCANIZATIONS MUSTFOLLOW:
2 CFR Part§200.400i-,41 1-Cost Principles",
21 Cl-'['t, Part §'200J00-Adritinistrative Rcqu�'rcnlelns
2 (AT Part §200,500-Audit Rcquiremcnu; Reference Guide for State Expcnditures
Other fiscal requiremorte,set forth in program lanes, rnles and remilations
zP
EDUCATIONAL INSTITUTIONS (EVE' IF A PART OF STATE OR LOCAL GOVERNMENT) NIGS1"
FOLLOW:
2 ClAl Part §200A 18- Cost Principles"
2 CPR Part §200.100-Administrative Requirements,
2 CF'lt, Part §200,500 -Audit Requirements Reference Ouide ror StawExpendiun-cs
Other 11scal rcqUiMolerlh set forth in prugram laws,rules and regulations
Page 38 of 73
AA- '129
*Sonic Federal prograrnns may he exempted from conipliace with dic Cost Principles Ciruslars its noted in the 2 CFR Part
§200A00(5)(c),
"For funding passed through U.S. Health and Human Services, 45 CFR 92; for funding passed through U.S, Department
of Education, 34 CFR W
STATjE FINANCIAL ASSISTANCE, Providers who reevive state Financial assistance and who aredeterniined to be a
rceipient1subrecipiant must comply with the following fiSCd kVXS,rUleS anklregUjatj Ott.q:
Section 21597, Fla. Start.
Chapter 691-5,, Fla, Admin. Code
St, (1
�� �VtC Pr �WS COMplianCe SUpplenient Refe-reoce,(',juide
ror StateExim)(lituros
Other fiscal icquirements so (6rdi in program Jam,rules and regulations
D b
The Remainder of This Page Left Intentionoilly Blank
Page 39 of 73
AA-2129
ATTACHMENT 11
FINANCAAL, AND COMPLIANCt` AMAT ATTACIMENT
EX111I IT 2-FUNDINC SLIMMARV
_ND,Lg-,Tjtic 2 CFR §200,331,as re6,Qd, and Section 215,97, F,S,require that irtrormation Anut Federal Programs and Slate Projects
included in ATTACtUMU'NT 11, LJtibit I be pro videal ter llierecipient. Informationconwhied is as prediction of funding sources and
related arnounts based ou the contract budget,
1. F'EDERAL RE'SOURCES AWARDED 'ro'n-tc SUBRECIPIENTPURSUAN'r TO THIS CONTRACT CONSIST
OF THE FOLLOWING.
111110GRAM TITLE FUNDtNG SOURCV— CIFDA AMOUNT
Older Americans Act U,S, Hcalth and Human Services 933.044 S 11 6,064�54
Title 11.1.(3--Sup ort Smices
Older Arnericatis Act Health and Hurn-anservices 91045 S 161,593,30
Ti If C I I IC I —C0j1J"'!CL'2tC N1 Cals
Older Americans Act U,S. I lealthand VI timan Services 93,045 S231,707.61
Title 11IC2—Home Delivered Meals
Older Americans Act
Title If ID U S.Health and Human Services 9,3,043
Older Arriericaris Act
Title It IC—Caregiver Support Services U& Health and Human Services 910521 (3 U)$115,2 81,29
Title IIIEG—Caregk,er Support Services (I)ES)S36,107.78
Title III ES—CIrev
Older Americans Act US. Health and Human Sen,ices 91053 $39169115
Nutrition Services Incentivc Program
TOTA L,FEVE&I L A WARD $ 700,545.79
COMP11,11ANCE REQUI REM ENTS A1'PLICABLETOT1 ILFLDI-RAL RUSOURCES A WARDED PURSUANT To
Tl[IS CONTRACTARC AS rOLLOWS-
1,*ll�Dr,KA I�
2 CFR Part 200-Uniform Administrative Requirenricim, Cost Principles, and Audit Requirements for Federal Awards, 01vt B
Circular A-133 -AUditS Of SV'Ite5,Local Governments, and'Non-Profit Organizations
s"rA'1'1-.RFSO1. R('I'-',8 A WA RDED TOTHU', R lilt LNT PURSUANT TOTJ I IS CONTRACT CONSIST OF
'I'l W VOILLOWING:
MATCHINO RESOtX,t,",S FOR FCAU'RAL, PROGRAMS
PROGRAM TITIS' FUNDINO SOURCE' FDA ANNJOUNT
TOTA L STATE A W A 11 D
STATL FINANCIAL ASSITANCUSLULCA''I'O see, 215,97, 1,%S.
PROGRAM TVIJJ,' FU,N D I N1 G S 0 U RCL CVDA A%cl 0 tJ NT
TOTA L A WA R D
COMPLIAN(7L REQUIREMENTS APPLICABLE 'ro s-rATE RESOURCES AWARDED PURSUANT 1-0 THIS
CONTRACT ARF AS FOIJ,OWS:
Page 40 of 73
AA-21Z9
Scedun -715.97, F,S,, Cliapler 691-5, FL Admin Code, Reference(juide I'm Slate Expendilincs, 011ier Oscal requiremantswn forth in
program laws,rules and regulations,
The Remainder of this page left Intention lly° Blank
Page 41 of 73
AA-2129
ATTACHMENT 11.1
CEWFIFI&VVIONS AND ASSURARICKS
DOEA W ma ,wow, rd Ods Cimuvcl mdess We Wovidcr completes these CERTIFICATIONS AND
ASSURANCES WpnRwmarweoFTkcumnm. I he Wov Wer provides the ll-fl low ing certi t-
scations and
assurances:
A. lkbannaUand Sumsension.CergASpHon t9 CC It Parl 95and 45 (111 Mid 75)
B. CediRculnin ReMwding.,,Lubhwin&j29 (CFIZ Part 93 .,tnd 45 CFItPqrI 93)�
C. Nundiarhitinaijun At I Vial Onimnirtunih- Assurance (19 1301, INkt-I 37 anii'l 4i CF14 Pah-t Hit
IK 40rti Wdin" We gpHng 11flic INIRy (Wingh,calbon 281133, F.S.
E. zkssociatkm of Commu"Rv UY WOWS
Ass q rajte.c..1 Pub, 1- 111-1177),
cc hir CIAH1
[I. Vel-ifica(ion ol,V'rl [flovilivni, Status Cerlilfic on
1. WCOIXIN aswtiwl 1 o-i-i"ienlathini
X Certineakori 1�Cgardjlljg
' CIAIFIFICATION DKIIARAWNT, SUSI'VINSION" ;AND OTIJUIZ
ITESPONSIBILITY NIATFERS = PRIMARY (OVERED -FRANSACTION.
'City WIWAYMI Wovider cenHOs to iho hc,,[ ol'il; kno"WNe and We& thm it and its prirwQxds:
1. Are not prcsomy debarred. su5peand. pnIxacd kw dOmnuoit, dcclort,%i ineliLihle. Or VOIL111t,11JI)
exckuled W" COMB IM"WhOrIS 1-1) ZI FedCJ'LIl LwlL4I-(InQffl tW
2. 1 Qvc mo NOW a We ear period preceding this(IMIMCI h0-'II COTh k1t:d OrhAd J Civ il'jUd,'-TIIWnt
ITHdo-ed agobst Won ha commissini orhaud or a criminol Alfonso On annneckin 1%idl HAM"",
<u wlnllhn,w'! to ob(Anaw pxMrming at rnkk (FedCr'al. S(OLC- or IOCat) 0-ashU601) noder a
Imic mmsmon; wation or Qvii or SuRe ambrus! SLOURN OV COYMIsdon c&nIe/;knWnL thd .
Ilwyery. Where. Wkilickori or de,,,nIICtj0II orrecords. inaking We wimmoH4 tw rcucivhT soloi
lmqvrq,:
3, Area of prewnfl) indiclvd ors lhorl\iso criminally or 601; choyed by a pAvnnmxnI craity (I'MoK
mawkw hwal) "kh ounmkion orrmy ofibc ofQnNos enumermod in pavagraph A.2. AM& umincak"I:
4. 1 We m! "Ohd a Wc-ymur podod prcudinN dON appricadon,ropmal had one or nimv ImMlic
transacHons MOW. Sta w. ov local) lennimod hvr cause 4delhuh,
Page 42 of 73
AN2129
1 no UHddNQ',L,] ',hJh ro',ji.il-V OYU AIITU,120 0his (vililicalkni ho WeludW in We Wnumonti At or
fZ!,ZUa i In oll WN AnJudhij; Nubuw[WiN wmkm, Yboyints 2110.1 undrals Under grom. mr, alu.1
ckroporaii%c mid that all suh r,.xq%"x mhl 11,'W plo% A,: Ti, kvrhoco(kni
ounidinab , .
W CERTIFICA"riwi R1%AtzniN(; IAMB% INC - F(W ('()NTR"XCTS�
(,;w,vvrS, I.a,kows, jrqu
tha 1111111CI`Ai�iwd MUM cuMUN, hsthobc,; k4h, krHmixWevid VAX Wx
No I alond aMniviakid nurd, lynt: lwvn pjid or " ill ho Q! 1, or on Inn ,II unAvAqw! van.i,
pel'wwl for hn''hw1w11- 18EWWWqqhy u) WouclWean Onwo' qvinplqn- "Wonyso"'. Or on ClnpkI,Cv ON
in connowthm "Wilho iudNhnroQ1y Fedoml womwEvi, Hw nvkhT nFmo QWil
grant. We inoliny Vaq I o1nd haiin the 0111"hle HaO A ICA &VhqWWnkC J;T0QHunt uml Ow v%tolihon,
c011'Ithi'Hioll. ralle" ah amexh"nu x modiumS or am I Mann covinao. grow. knin or Q,hq)enYJv,,,
dylycluvol.
If an., WHO "WE"I. dinri I"ca.1k:rdl ApjRtqI1T.1Qd Rod, hu)a hown juki or WK In paid n my IwNon Or
4WOOW&P kW Wto"Pdop to hohnqWC an W6010 11 CMpkq 00 Ora", jpanal I \jWMhCv 01 (4yWrny oil
in!Wir or amplo)cc OF 05iygoss. kw nuisks,u ;Tj khornhu oll 1mgNo in admomun " Kh a I InWril
(1,11,11"11"'HI'l- .'n ant. A,HL or i:,vTvnW v upruniou, Kv uralersWilud shail JIM) 01"IdWISC ZHU! 0111111il SKUKKUY
Wq I Wnk"HW FOUn k, ROPOn InhfQ kp in WOnAWWO "Ah kS loAnAW601 In ,
I he mumnowd WH i"jnrc HEY Wpvq of M cortibuokm ho WhIded W to Awumems 5 w all
It KAO I UWL, M ..ell AM N I hKIIANC WhninldlktV SHh-QUOS :Hid W01HrWQWZ tinder,ran is, lomo viki
aW%MM,n11v) ,1€Q :hot A! vu- lVVYWS jod undlok tors 0jil ard a,,"Ct
Min, tnm 10i'a1 un is a 11H."Ie""E'll IqknewHiMm A 0101 quil %%viol relhVICC "k no p1YC,_:d -,% hc�?i lhis ('ow,['aI,J I� Y1
HVIN -T GUAM W MM I"Hill of 14, van blvdihm i, o I w=kpkbi a Ow HK On or wvorhq, into divi
( urNan im I wscd h, A 1 1 S ( . ! 132. A Q I wrovi "cW A S k, hic Uia roquirol kNUMMi lad 1 1)L;
Mijon to a on il penuh, W Hvq Us ih.ui S 1(MAXI zmd IR11 nhWC thIn S I 1H)JAMI hW AILT WWII QIHUK,
NON-DIM RL81 INA 1'10,N 00 FQL Al. (jjq,jMM:N VU1 ASSI WA WE i2v t im rk wr 37 AXD 45
(13. R%RT 8Q. -AN I tnnklb no of to (1mumv So W WqWN AM i I %! HI QVH I Wj 111H) "Ki the
III,It I I lI i I I",I[ion Ji I Is I k:,.p I ai op p ORLI H il°, faON, isiO I�,s 0 f O'ho I Ai,,IvI H�I;t la rL.",-,:
! , Svo i,10 1 X8 I If Hn "A Wk A)WC hn vomn I I. A(-f Ol, I -98 i W I"A.). 0'1 I h. I . I 0..s_`:0) 11 ic I I I in I I'll I'i I,
tq,-Ariu 01 hWh KIM in Mot )Oed SuivA on the havis ol`niu , co of r(2,I.ikoon -
or 1 0 11, J kal"w I,t"', po I i I iI,-;I I I.OVW a L or I Well a Us I a gains i hen ant WWI; Iva the WON .al Wha
i"vo,I I i (Is NV a I a" It Q ad n A QQd im in igi an I a I a Sui/W to "ot hit a l :1'Jt,c,I 'N;.,,It e:, of It I I!H:q-'I I I,On
I A I A k: id0wicM unk,:ad I oginni ow acl:i%ky ,
I I I I o V I f 1 l i C (, i I,,i I R,i I I I I IRF4 ( I I b I , 8 x-3 5 2 1. as tnoc n d"ed., i�-t d a�I rc� t,irkI,r,��2,'l k 1 1-11"1�,cr.] I I
Or pirmnuo, 10 IN R oglihohm "rHw 10ponnionz of I US and I Won Seiikv, A5 ( 1 it Part Not v dw
LAW thata to nci-aWwwo nAh I h1v \q or Ts In mid To WyKadinn nn panmin dw I Wal wows AnT
on do gnmmd Or no& cokm 4w makmEol oNKH . ho vs,churod WH portia"Micin in, hc Knied to ('dowfit,
X u he othcndnc mA'Qlad a) disarillIQ14SH 11ndOr wig prognm v ach% iq Or "Wh the Appliewil
receives kederal lbnntii'd wN.,is1ar'_,v fi-01-11 lhk_ D0_IjY`,,J'IJIHL'HI.
Page 43 of 73
AA-2129
L Set A on 504 of dw KhAdhom Am i At I Q 107; (IN alp. 1. 03 1 12) an omwthlad, nin! a H raphavmcmi hupsol
by Or IMUSMMI io Aw MC'q I 01tia :;a". I I Of I kWh A lov I I kHHnn So iWOY U IT 14" MK tip
1h.'al, mawemi;:"mic, -I%idi S�-,ckou ',04 of ihm Avi- and to RagcOm4w. mi wher"ke qmdd Wd,
ix'dil UhUd in the I nhal Simon shad. sold, 1" reASOH or his Wdionp. ke exchuJud Wn
pnrQipmKn in. ho delod Te 1 o1'4"6v Mn he mQWcwd h I LvIdOr n% 1`409nHn km' wcn%n"
I'N Vdlldl 1.h;2 .-%,[)PIQHi rccokn Fodond Finnubd Croirl h'ic
k 1% Ago [AsetjrnKLUjMj AQ1 or IQ75 i Pub L. 10-133t a milomkd and all nNinirmunw, impowd hy or
purmuni w On: Spilpi.kni vilho Dorvirnronl (010nith MY 1 luman Ka%kn 05 (TR NO 01 I. 01 to ond
ill "M Lho Awl Mid ihs Roginko0n, in; porsoir in Ow I Thwd Simon &A, on dic }lit sis (,dI
ke id.r.1n, d the how hi, Of, he ndwkd fivin nwitillmKOH kl, or 11"zil"k-r
JM prOj."!r'aui or ;ivd% Q Jhr "Idni dic Alldicam "wohas 10daml Mmid ossinHwv hum ih,,
1hopmonoo.
V 1 No IX ky Hl,- AIUMMUMN Of 1972 00h. 1 . 02-,11 ','N',d all 1`S,,1oH`QM0n1
IMOMY by X PUrMCHM at, KW RCYAXkM Or OW [ROMIMCM 011 hAdth !Md I WKIMIA SUIX&M 45 (1 R I'M-1
86L hi dw and Ann vs wowdowv "kh 1 40 1 X viol iho HO P011011 in tho I HiWd SM04 shalL
on Me had, oF sv. e o"AuRd Win poriMpmb"s iry Q &,AM his hdoohn -1 or ho Mau Q wd.Uoc�,wd
to unWr mp alwyaw paignpu vy acd% hy W Mori 1.1e Appliamp ivowne, I'adem!
linnehil IsAwnec 3E" W1 the Dq"uinnorfn
6 1 he Aninvan " hh IQ 01'a11 hie, A01 of 1 Qq0 C ITh I. 101-336 h0i pri d0his divehininmion in ad I
omplo% mons FUVICK, invUhig A MT14shm pR,,Tduro,, Why Why. coniponswaki,,
rfhq�' 'io'd oi,h""r kan, wontlition, ond phd lopt ol�nyh I nvent it opplio, hy roornkinew Min in
oninn In%OIL QnNc. irit(go Inn whi. 1111d ad I In!1Q- OMP0, M On 140110 1 &TV A
Pnl%Yen, Also AWSHYC" rhoi k ni Hi niql; "ith 211 Ul it I&N 37 xhl AI a jwr rc.'ullio ioll"
1j", Wd apon 1. 1 hi, A—WIATU wK, 01 110% 464 ov tel '-inntion 4 'Kh'- VI IA I nic I
11r ,,1L'6 k A) , HMI 10 A n 1 ckorn� Wo% MmAn e i Y, on-ij onilhe " 1A 1 5 0 1 nnalMly indood
ol dCtk,it--, taidarsUMN that DOI A mid ihe Unhad Simon Me ihe HpIn ios"k IH&da�
ol HIL, U"SUIT:MCC.
I no um4n0wd W11 raphv On SyllaMthiS WOMA1100 he hIhOMI Who dUCHOW111, AW all
NUM MIAMI; M 1111 AM I WhAdily MAU"MCK %Won. suh-q ani, and amw acts tmdxgram . WHS Wid
co"pk- °'ilk"., xkl M; Al udi roc iplenLs =1 drill finn Kle Go wmvnwo
UCUMinuh ,
It CHM F10MM REGARF)l NG VUHLK' ENTrry (umf:,'s, NEV110N 287 1334 F'„s'
I%n Rk- MYQ cer;kin that n0hiar I =an, perym 11 No lime or 1%001 Kim heon 0"n% pled OF it IThh'.
Ina, (Mo an dolk"I & voakwl 2X7. 13 3, VS. r- ed 011 cnr-d ' I ki.
MW un&T,wiM aM jqrvo, Mat it ii rwqthrod io Mrm 1A )FA immoMoly iWon mp Wye of
E, ASSUCIAMN OFCONTNIFNI'l Y 011CAmumom IVIR REM11M 210M 1MUM) FITIFYINC
gg
As a unhM A In o r Ow C'onmna. PAM Al a,H NS II V; A "i I H omq&y Bill!' " Kh To Wina! Rxluhn,.,:i
rVildolialls jwrkuung N;MORIN mul its xHh0dhwQn [or Me ("i"Hsoh'LIJIL-d A4:1, -1010,
it! k&Ml K SVVAOH &I I (PUK 1. 11 1 1 l7l. 1110 GMAnuk, Appnqwi;aknn Act 2DI K SeAm" 101 allj W"
1140Y 1._ 1 11 -24 2 L pnn ides On! dppnjm Skuh ankle joijay Tidy I , 11 1 . 1 17 aro avx1*0 midur To
nduron,� 13ro6dcd h� lluht 1- 1 11 -1 17.
Page 44 of 73
AW129,
t h,,: undh.'rsiollo:d ,holl rallro don bliquago of HS issurance he WIMA W to documoaq Fol 01
iWkwacs ut III Gers (including Wanwisq. %ondiwv, vuh-graps ond caurnuti umler urow WOW d1o'd
:HhJ MY] 0 suh Wpivqn arvi ovrluv=4 sW11 ppnhk this WAUTHWo DUAylinur,
11'O'nS Cal I I'UCl IN in We 1,3ilh1WH OF A in Wdw% a rlkwo hi ociawdsic,; QW, On nul A ruincin 0141101",
287.1 W KS.. 14 n%i'Ol horoh_% Cc[Wes that it K' Ihm. jWWWOMY in 0 hQn. MU Or IWAVI iv Mq Bled On
in the kin 11w1non Ivel p W"w I AL and Waal A kQ; not W o hwinan or)wwbn in ( Hh;A in Sy W.
liol!I 1 k.-, k4vg,- pu,uanl w "! I_-k. 1,73.- 1
Ila Wr unW-unds that pmAllvlm vo susini _'L�7. 13.". '�'. 1110 sutoni'joIl -N a Ivin vatinuali'll Iny
`'Ws ocr idel W 0% H puntio, monw,A Am, ardAq cov�
It ;Hy &K Wnwohnns hi Ohs owninwi,my 14"WrOwd, i13. oh mi
to hit_ I I
Q (TIMPU k FR)N REGARIM30; MIA INUAWFUY (WIPLIANCE HH? CITNTILU T4
.A'C kl�F!N1 1,"N't'In GRAN I'S, 1,A)ANS AND CWKWA FIVE A(d1H-'_N1,FN FS
I he Pn" ROY W my mTwonnW,hqs OV%or%jUS, iinder IV ampoui Inho Finan,iA InallUgOL110111
SWOK WOW A Prot idb up cul U I A; ink"Mali,'I',- i I kk`I Uldh'l "� [ i I aLWAIL12. CHITU19. JIM 0011020e
kin khan NJ w f A i an vin I ran I h M a ch IS CHIP III&d pns'1c'k_r or I!I I II I du I I"_a: %% i I I l I I"t-
pi excrKed xtyslinp Anydrnmew i 2) tho mrWO 110 JI I qWOM I W hill Q MI ct"Hrduo snpru or Wd
XON Ah": JHO c 3) the wmpoih,nn Momhq , "Ah ;Airl'alf-Ib An caah n"sid. I he WAGIM v
YQkW Wkallalinll ill aCok"AHWO ukh We iquianukan ambd w0t in a iewni 4panL bulds rM
by%v vq Win acomnqed Or pNqvvo ,
1 ",birmpomim 10hanathm Klmov, incd h; We WOW ;Hbk4qjUo,jo,VS vvikknA. or on, ouside wit
OH v,hWh dw Pr vvk I or I'_1110 1 Wl A ol' &0 It IV I, ki he rep"I vd, Iron,at tilt ol- c a And o I at, hox o noor,,�
nse,wed .in! varinod hi ho cnVOW off,rowwssing &I-a accir-alv1% , Kluding a,mr-dakr d4pi-ldsol dwa
I ,al" 1,11ONe tob,! nym complmn Pros IV, m iH Wo immahwo whon wi as quo dual
11 I h i c,n I vo o:I -n c h i d - 11 K; p n n In t d h m 0"m v. w H"a w. I to i"a tv, n A ;n arc d a o r i m h N:d d o ir
Wwwo IT,. OW k%in lair., 1h,"Il prodricr.sOre capahk-, of oll t"Il. 4.11,'
doperidcrn .wwmavh . AR %ar"un of Wow pwducs WOW 10 the I?o%ida (ruprownled Iq IN
mid rnarehasod bs We stmo v%ill he %vri Fial AT aw"riu% mvi mwqiiq of dya p5m to
4. In 1004,11HI A OIQ docrar,c in ISM1011ahl; WOW w G-o dnd date iviawd rnwle, awl knalmd
,1011MON10, ILLY SmAv 11w WW"uro or wortm xy qnqporns Kim oln-voilip pip,11, inc Provider
10 nolka RqHwwd vtorivyhow W"vaory hard"av and WS it program, to lK
SO HIC 10110 1 A' 4110 1 h11 I Uh I% IV "nMlHkXI I hWo, al 1k) dill l ho IIW wo am I M A haq Oman yd", Io
III k.. o"I I hu'i�Ics" 'I I I!Ik, 'u I'I o.% l It I C I5 tII"I..I't!-I C
5, 1 he IW Wr and any NUM7,til110101 N 11lVe.aat3a WMA A Ael ViWW" invier Wis cwnwi kv urnuo Wob
judicin 11"I ponoduns hichwo a JIL'I'vi to I)IV%I& Q S'nvoc don a! ky omhliras in Cno; or
0 H CM0,01U0 KW I W HV e13HVl`gWn6o?n Al in b Q'I Fr"I 11 da-T'a I I I l,_." ri IS col I I I d I Ir 1,-e
Page 45 of 73
A02129
11, VE I Z I F I CA T 10); 0 F F N I PI A)V A I F Ilk, fl, S,F A I'll. S UFA ZJ I FI CATUO N
An d ovidinw oF cinurdaing " hh An: I hwido, od 1 hQr AHOds, Pon Kin on na the mv ol
Ke t �K. I kyonhwi I OF I kvnehim I S"U A h 4 P oa I i A S) Stan 1 1.0 %CIJJ' Llic` i,,!1 I 1[1
in" cnvokq en hbod h) the looduor duribi the wirs,I in in us pnihm; QHPIQ 1=1 dMi e4 DUI Want lo
Oil L'Olardw Anvi Tan mv; vothom"racis hwhoo an oxplys; 10i.p6womu M "101 venow,'
PUrAWHAlly "ork tw ln%A 41ing gervOg pormani 0, Hii, ( tinawl toilza Ow k v wTiQ n,ceni k, %vr!Q the
Alylsq HIAn Uligild% OFUU ne',% hind h) the suhaomraclor wh]Aw wigh-c
MKIAW 10M.
I Me lhovkh, 001 reqnhe ihnn ihc Koh"mpc H ilk, CalAbSkUl Q il1VIUdJ in IW *1hJjVVW1nWfWv NHK
af1d oflicn, jH& LIMt :_II vKnumvictors vis! q %unIns Toll CCU Q L;MqIQQC
='UMPI, ,
I his c4nfhaalky7 i", o id rq'Irunivalion of Oct 415tm - hich wliona; "aN placed " On Wks nowmahnn
v_:Is n .,r 3"""Howd Ms. %Uhni soon Or this eel I dica I I"I IN 11 prutophoo hw or?hy �I Ora by Ka" Ad
unindokm imptund h) Orcular, Ad U2 and 2 (TH Pon M and 21 S i k5wholy 0\1 B (Twular V I IQ
L R1(1111 IS A 74 1) E)()(I N I F NT AT I()N
I has Pion My A pro-o U- in ukv =1 AMY a i Fk I min NIP All'a Hd I W U I 1�
an *Q Of vtodwo rdmol ivannIs mid AximionaML I'M IN,,k4i shnH unsum dw Macaun owl
11UTIP11 M I H IV Im,I i I I A qluo I k a I ;ORI do-cul))0 OiC:I,join 0,11 ,Arl% �,Adl :1� NiC I H n,
k pw n man N 5 womm we ii w h Was vQ A o\p irn A nd ha k qv o F AI dran in KI si,stem N way,01, w
Knaonon m,inalaivis.
T f IT T I F f H 0 N' R F(,,A,RD I N C i INSPF(ILJ()N OF lltljflJ('
III jodw 10100"Mos ul Nculk"I" 141 , 147 orwo Swindmy ( orri"ack,
1 T, ind oln whei IPJAWKII [013C AVA% d W001 KCMHIHW1W 'tit osomonjilml h, nou&oij I j9M7nIpW,_
I _,, , md ih;', I )apitriplon! in rhinwd in dw 6% H wonvil. lion idar nvivv% to arju�, 11.'Ad iw'snino,"i thi_
IXTIWOM A ani in incand lor the Quirunno. 1Hd 1111) 1MOMO) V QIS 1010%%0d or U"M,101 ajndnsi
Ihsin 0 INAS 11000rdA Roque'! Itni'de 11_a�attfflr '0
pumoo to nTnJoss poTwmed dowunkr.
qST"n 1 110701, 1 n.. orolkar r, lorkki 1,o45, this socthyi is jar applioulnIQ k%
CtUMCIS noclac'd ilto Dt_Ivinnieju wal slow ngoicius or vAdiv iskm% ddowd in
Scohm 708�9(?y J�Q,
2. Oman I It, U 11 3 r I S., saw, NpulAR tuid, mv cxpendal h) III MCI&% i H Dy% nwri, o C d tws or
in Q(nhorshQ) omt A I m a A,ns IV,r Ully p or am L co pi no Qn. h I U I Rh a it M. [rH 0,. ;,I sm)L�i�I It 0 H, ..i 1 0 111-,, in. odicr
0TYPI K/0 1 hnn W 1 A W H HXWkW gaol Ai Ila q and rwin lvr,h i p recoi d, 0 C h Hd I On CH li hirh pv rhdn ila I R
p U 13HC OgCHC) (FInnidn I k Imn men t in IT FAde r A,1111'ai rs) 1)(1 1)1 i U rt,.,v,�LL,.,. m 1 It) I",t" I"S, s nt,`n; i I I at
a v or, pv rain I in h ns o ust 0 r MW h U PWA 0 1`001'd 50 H Q n1i I 11be 100 Wd k 1 110 U KPCC 101 mi Id ckqsQ,I lv,,4
o i,I-it'l _I r,i 1,k m 1"I I,! 1, i r(:`k,I I n 1!c c
Page 46 of 73
AN2129
ANNionall), I cerrir� ON e"Vonimion M, dilvs not zrrovikk 1,61. in tittniottal
1'rovideVs hignaw huhAv atim At wirds pvrhdnbg twi Te Ilms or tnernl:xnrship applicalioi) by tit,, Alliance
and thu winion am avaiswe nw wixam to wtowli pww.
By ewcution 4this evimmo, Wo�idec must ill(AMIC IIICIC 11RIN'kiOnk in all I-VIaNd SUIX0111rilct agwonlenIN(it'
applivuble),
By execlith"i WIN emomet, IWYWa nwM hwludc these junvisions JAQ in all nklexl skillcontracl zq,-sweatews(JI'
aPIONIMI,
By SWAW hdo". Mwwa cemnes dw rViamwUmlims OuHhwd in pans A through .1 above,act: truc ,,md cortwi.
'r
A Z2 aft. loor 1100sun-gatonStrc ,
go r
ure nod Me of auttlorked Wilma to SW"I AdWaSs
Monroe Counly Heard of County
PAR--
-,U J
Provider Name Vale City,State,Zip code
�7NIROE GO 'Y ArMRNEY r 2 711
A WE FOPMA
CMAM T'Y
ASSIRYN ISITYOUTORNEY
Date It
Page 47 of 73
AA-ZI29
ATTACHMENT VI
ASSURANCF','�r—NON-('ONSTIIUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to avvi-mm: 45 minutes per response, including time for
0
reviewing instrLictions,searching existing data sources,gathering and maintaining the data needed and completing And
rev im i jig tile collection of in to rmation, Send comments regard i jig the harden estimate or any other aspect of this co I Jection of
information, illClLlding SlIggUstiotis for reducing this burden, to tile Office of Management and Budget. Paperwork RedUCV011
Project (03,18-0043), Washington, DC 20503.
PLEASE DO NOTREA'LIRN YOUR CONIPLETED FORNI TO'rfm OFFICE OF 10ANA0[1:MLNTAND BUDGET,
SEND IT TO T1 IE At DRFSS PROV([X-,',i) BYTHF SPONSORING AGENCY.
Note:Cermin of these assurances may not be -applicable to your project or program. If you havc, questions, please contact the
akvarding agency. FlArther,certain Federatawarding agencies may re(10ire applicants to certifv to additional assnrances. If such
is the crane,YOU will be notified.
I. Has the legal mttfion(y to apply J'or Federal assistance,and the instilkilional, managerial and financial capability (ineltiding
funds sufficient to pay, the non-Federal share of project cost)to ensurc proper planning,management,and completion oFtho
project described in this application.
ed St�'11CS., arl(I it, ate,thl-OLIgh My
1 Will give the awarding agency, the Comptroller General of the Unit appropriate, the Sr,
authorized reprosemative, access to and the right to examine al I records, hooks,papers.or docurilents related to the award,
,and will establish as properaccounting,system in accordance with gCtVrallyr XC��Ptcd aCCOURting standards air agericy
directives.
3. Will establish sareguards to prohibit employees fir0111 Using their positions 150r a plit-POSC that COIIStitLUCS or presents the
a In-
ppeat-mice of personal or or conflict ofinterest,or personal gai
4, Will initiate and complete the work wilhin (lie applicable time frame after reccipt of approval of-the awarding agency,
5, Will comply with the Intergovernmental, Persorinvi Act of- 1970(42 U,S.0 4728-1763)relating it) prescribed standards for
merit systerrjs bor programs funded Under(,)lie of 111C 19 SUitUtCS or regulations specified in Appendix A of 013M's Standards
fora Merit System of Personnel Administration (5 C1,'.R. 900, SUbpart F).
6. Will comply Nvith all Federal statLacs relating to nond iscrim inal ion. These include but are not limited to-(a)Thle V[ ofihe
Civil Rights Act oft 964(P.L 88-352) which prohibits discrimination oil tile basis of race,color or national origin-, (b)
Title tX of the Education Amendments of 1972,as amended (20 U.S.0 168 1-1683, and 1685-1686),which prohibits
discrimination on the basis of sex,i (c) Section 504 of the Rchabililacion Act of 1973, as amended (29 ()-S-C- 794), which
pr(flflbi(,,a discrimination on the basis of handicaps;(d) the Age DiSCH111inalion Act of 1975, as amended (422 U S.C. 610 1-
6107), which prohibits discrimination on the basis of age;(e)tile Drug Abosu Office and Treammit Act of 1972, (PJ- 92-
255), as amended, rulating to nondiscrimination on the basis of drug,abuse;(1) flan.}Comprehensive Alcohol AbLlse and
AIC,01104S[n and Rehabilitation Act of 1970(P,I..91-616), as amended, relating to nondiscrimination
on the hasis of alcohol abnse oralcoliolism; (g) 523 and 527 of the Public Health Service Act of 19[2 (42 U.S.C. 290 dd-3
and 290 cc 3), as amonded, rclating,to confidentiality ol'alcohol and drug,abuse piltient records;(11)Title VIII offlic Civil
Rights Act of 1968 (42 3601 sit seep.),as amended, relating to nondiscrimination in the sale, rental or financing of'
houqiag; (i)any other nondiscrimination provisions in they specific statute(S)Under which apptication for Federal assistance
is being made;and(j) the. requirements ofany other nondiscrimination statute(s) which may apply to the apphealioti.
7. Will comply,, or has already complied, with the requirements offittles 11 and Ill of the uniforal Relgivatifin Assistance and
React Property Acquisition Policics Act of 1970(111- 9 t-646) which provide for flair and equitable treatment ofpursoris
displaced or whose properly is acquired as;l result of Federal or federally assisted progranm Thew re(piircrrj(-:n1s apply to
D I
all interests in real property acquired for projJecl purposes regardless.of Federal participation in purchases,
8. W'ill comply, as applicable, wit!) the provisions ofthe Hatch Act(5 U.S.0 50[-1508 and 7324-7328),which limit the
political activities of employees whose,principal, employment activities are fended in whole, or in part %vith Federal 51nds.
9 Will comply, as applicable,with the provisions of the Davis-Bacon Act (40 U S.0 276a to 276a-7), the Cop0and Act(40
(-).S,(', 276c and 18 U.S.C. 874)and the Contract Work I-Imirs and Safety Standards Act(40 U S.C.327-333),
regarding labor standards For f6derally assisted construction snb agreements.
Page 48 of 73
AA-2129
M Will comply, il'applicabic, with flood insurance purcliaso roquircritents or Section 102(a)of the Flood Dim.sur 11rotection
Act of 1973 (Kl-.93-234) which requires recipients in it spccial flood hazard area to participate in the program and to
purchase flomt biNurance if the lotal cost of insurable construction and acquisition is $10,000.0pair more.
I I. Will Comply Willi envirorinlantal mandards which may be prescribed pursuant(o the following,(a) institution of
environmental quality control nivasUrCS,under the Nalional Imvironoicinal Policy Act of 1969(RL.91-190)and Executive
Order(1-0) 11514-,(h) n(ttification of violating facilities pursuant to EO 11738;(c)protection ol'wellands pursuarit to LO
111990,(d)evaluation of flood hazards in floodplains in accordaticc with E0 11988;(e)assurarice of project consistency
with the approved State management program developed under the Coastal Zonc I'vinnagertient Act or 1972(16 U.S.C.
1451 et scat.);(1)coritorrvity of Federal actions to State(Clear Air) linialcirientation Plans undcrSectioll 176(c)of the
Clear Air Act of1955„as amended(42 U&C, 740 1 ct scq,);(g)protection of undei,ground sources of'drinking water
under the Safe Drinking Witter Act of"1974,as amended,(Mr— 93-523):and (it)protection ofendangered Species Linder
the Endangered Sliocles Act of 1973v as arnended,(P.L. 93-205),
12 Will comply with ilic Mid and Scenic Rivm Act of 1968(16 U,S,C. 1721 et qccl.)rctated to protecting components or
Potential components oftlic-national Wild and scenic rivets system.
113. Will Imsist tile awarding agency in assuring compliance with Section 106 ol'the National I historic Pmervalim Act or 1%6,
as amended(16 U.S.C.470), FO If 593(idmification and protection,of historic properties), and file Archaeological and
I fistoric Preservalion Act uF 074 (16 tf,&C, 469a-1 ci seq.),
14. Will comply wish P.L.93-348 regarding the protection of hifloaar stab eels involve(] in research, developmesn,and related
activities supported by this award ot'asesiquiacc,
15, Will comply with the Labi.)ratory Animal Welfare A,ct of 1966(V L.89-544.ai aulcnded 7 U .C.2131 rat seq.) perlaining
to the care,handling,.and treatinent of warm blooded animals held (bir raw arch.(caching.or ollicr oclivitics supported by
this award of assistaum
16, Will comply with the Lead-Hased Paint Poisoning Prevention Act(42 U.S.C.4,801 at serf,),which prohibits the use of lead
teased paint In construction or rehabi I inition cal`residence structures.
17, Will cmise to bu purlurnied the millilvd fulancial and compliance audits in accordance with the Single Audit Act
Aritendmems of 1996 and OMB Circular No.A-133, Audits of States, Local Governments,arid Non-Prorit Organizations.
Is. Will comply with till applicable requirements of call other Fedcral laws,executive orders, rcgulalions and policies governing
this program,
SIONATL)It 1,`01-•A UrMORI/tA)C[,'14TtVYING(IFF[CfAl IIIU.
A
rKA
APPLICANT ORGANIZA HUN DA'rt-
MONROE(MUNTY BOARD OF COUNIN COMMISSIONERS.
SOCIAl- SERVICE'SiIN-1-10ME SERMCFS 0
NROE COL) ATTanNEY AOVE /tT op'14
0
Pen M
0
ASS -CC NTYY ATTO RN EY
Date, 1'i V l!t/2 I
Page 49 of 73
AA-2129
ATTACHMENTNIII
CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE
GIFTS SUMMARY FOR THE AGENCY
Service maximum
SA-m4mg to be 1arovi4ed Unit Rate Units of Ninhu"m Dollars
smice
Owe f I III S 24.00 656 $ 15,744,30
Conipanlonsh)I I 1B S 11.00 45 $ -189-60
F.scort 11113 1 16,67 2 91 $ 499,60
Homemaker 11113 S 25,00 1,,939 $ 48,184,26
Perwonat Care 11113 $ 26,00 Is865 $ 48,484.26
Su chin &,Assessment 11113 S 25.001 (i 1 1,582,92
Home Dcliverod Roca ls 1111l -S 5.00 20 $ 10,00
Tc1cphont Reassurance CV 11113 27.37 4 $ 10010
Slag ssistancc CV II[B 30.90 19 $ 5890
cong!CEIC mcab Cl 9.00 --"-17,131 S 154,194,94
,Cuq,gMitc Mc&MLTC C 1 $ U0
mea 6,Volunteer C t Mo
C.`mgspqo mm is(cl vmLc 1 $5.00 20-S 100.01
11m!tEcliq cop try Kaw IMCIAS CI $ 9,00 188 S 1,60MO
129 $ 2,580.20
R06 congre:,gatt;,Moa6,screctillig C I
N tit rition Com!squjg c 70,56 29 $ 2,050,11
S
Nutriuoa F'ducwion C I S 1.00 678 S 678,05
Home Delivered MeaL5 C1 S 5100 20 100.00
'I'de tome kcasstwanco CV CI S 27,37 41 $ 1,00.00
Show pl±E,AssEstanec CV(,'I s 3fl,90 3 $ 1.00100
Mint Delivered Meals-Fwen C2 $ MO 32,150 $ 160,748,94
Floone Defivered Nfcatq -I lot C2 S 6.53 9,582 1$ 62,571.67
i C2 S 6.53 386 2,520.00
Screenina and Ass"smem(2 5 26.22 203 5,310M
Nutrhion CounscL18 C2 — 70,56 3 $ 19 .
Nur,rhian Education C7 $ 1.i111 366 S 3W 19
Res rite[tj-jjCjnje ljjE $ 22.01) 891 S —19,610.32-
Respite Facifity WE 11150
6,560 S 68,878,64
Carcgixrcj-TrainingCrr I 11,r- $ 81.75 --87 7.103,28
Carcp,ivcr Tvairdpg Ind IllE $ 714141 239 S 17,932.95
Screc ' &Assessment ME $ 25.00 70 S 1,756,20
Chore IIIES $ 24.00 345 S 8.279.22
uutz�,Im ravuncm,HIES cost Rcimb S 9,472,87
Material Aid IIJES Cost Relmh $ 9.112188
Specialized Medical Eq!alpmcnt HIES Cost Ile imb 8,98181
'NSIP $ 0.72 5 j 7 39,691,25
TOTAL 700,545,79
Page 50 of 73
AA- 7
ATTACHMENT VIII
OLDER AMERICAN,$ A(T CONTRACT REPORT CALENDAR
ADVANCE BASIS CONTRACT
Report Number Raged On Submit to Alliance
O,n This Date
I January Advance* January 6
2 Februaq Advanc0 January 6
3 January Expenditure Report February 6
4 February Expenditure Report March 6
March E%pendinlre Report April
6 A pri I 1-NileRditUrc Report May.6
7 May Vxpefiditurq Report June 6
8 June l"'Apenditurc Report July 6
July Expenditure Report AUgUst 6
10 AU�L]St EXIVrIditUre. Report September 6
11 September Expenditure Report October 6
12 October Expenditure Report November 6
November Expenditure Report Dccer0er 6
14 December Expenditure Report 1anklary 6
t5 Final Expenditure and Request fbi,payment F'cbruary 15
16 Close Out Report FArtiary 28
Legetl& Advance basmi on proJeeted cash need.
Note # 1 : Report 0 1 for Advance Hasis Agreciticnis cannot be Rlbllli(ted 10 the Department of
Financial Services prior to January I Or Until the agreement Nvith (lie Alliance has
hoLn exceuted and as copy sent to DFS. Actual submission of the vouchers to IFS is
dependem on tile accuracy ofthe cxpenditure report.
Note 4 2: Report flUrribim 5 through 14 shall reflect an at(juslmont of one-lonth of the total advance
aniount, oil each oftlic reports, repaying advances issued flic 11irsi two morlills ofthe
agreement. The adjustment shali be recorded in 11iirt C, I or the report (AT"I'ACITMEN'r
I X).
Now M3- St3biiiissionoi'cxpenditLircrel)otlsj)iavot,iiiay rant geiieratealiaviiictili,c(ILic�t. Iffinal
uxpQnditure report reflects funds due back to tile Mizmcc paymont is, to ,,iceonipuny the
report.
Page 51 of 73
AA-2119
ATTACHMENT EX
REQUEST rOR PAYMENT
FORM 106
OLDER AMERICANS ACT I NSIP
PAKIWOrM NAM r,ADCAY_%S PH CVrF IL PC 0 1V MOM 13ER
Ls
'j 4"tVj,:A I f,tl;r,4 -1 V" tl�A t"I
1,mr
1110 cl,I i D TA L MUCIlUt SUMMARY
Xi ro f)md............... ....
T
-----------
............
Page 52 of 73
AA-2129
ATTACHMENT X
EXHIBIT-1
RELCIP I%L Wdf GrM I AIM0141
OAA 50hilv 140
PROVRA M MAW APON
MI-11—ftrol"I tu—mm
ObA
A IA 1 :1
AA
i
'PT,m
FOOS fW10, I—y 0,0 V 4', '—eh
1h.
i;Y L7,sW—,Rrcr i--sn il 7 U
WOTOTAL C,�;h
U,IM,
u t J r,I-A,1—.4
Al Xl I
P. v,t bw C "I
.............
MAZI ..............
...........
Page 53 of 73
AA�2129
Al"I'ACHNIENT X
EMBIT 2
RECEIPTS AND EXPENNTURC 900M
NSIP
PROWAR NAMP,AMIRESK,PHONF& PROGMA FuHwAe3 scukc L
0 P',RT. r,
ln +0g Jrt
Dmq,
EXPFNaffURE COMPUTATION �YtAR TO OATE
7— LIV04
Lt'
Fd-j MI, 4,1, T', ------- D 0 c 0
,QR
U
no 'im4�1 s t4ml% 0)
MID alE
..........
CONTRACT SUMMARY
Afr,.",-j 0,C-13
Al"M E�L'—' Ifion(�1p�s Reptv,
—77,=0,,
Page 54 of 73
AA-2129
ATTACIFIMENT X
EXH1.131T 3
PSNPROVIDER MONTHLY MEALS REPORT
PSA Number
Month of Report 0
Number of days served this month
Total number of meals, regardless of funding SOUrce, served to,
- all persons 60 years of age or older and their spouses, regardless of age
- volunteers, regardless of age, vvho provider services during meal hours on a Regular basis
- handicapped or disabled individuals residing in housing facilities occupied primarily by
elderly at which congregate meat services were provider during the n-ionth.
Provider Narne ..ion 2.regate Meals Home-Deli, erl, Meals Total
0 0
TOTAL: r7 01 01
WINMMIWWWNW� 0 1 1
I certify that the above information is aCCUrate and complete to the best of my kno,.vledge.
Signature: Title: Date-,
PSA$41! C')AA NSIP ForMS, Revised October 2019
Page 55 of 73
AA-ZI29
STATE OF FLORIDA.DEPARTMENT OF ELDER AFFAIRS
CIVIL RIGHTS
COMPLIANCE
CHECKLIST
T
Program/Facility Narne: Monroe County Board of County
Commissioners, Social Services/ln-Home Services County; KaAr _
Address', t" 0 Completed By t
City, State, ,dip Code V pDate t��j� : Telephone
PART t.
READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH
WILL HELD YOU IN THE COMPLETION OF THIS FORM.
1, Briefly describe the geogr phic area served by the prograrrrffacllity and Ilse type of service provided YT `� '�
op e
�,....�
+� d ( t [ 4
y
E 11M
.. POPULATION OF AREA SERVED. Sourceoldala,
cat I Y� it % a %N par is / Oth r f� Female
, STAFF CURRENTLY EMPLOYED, Effective date: t
Taal tf %White Black 1/4 Hispanic 1 %,Other %Female -A Disabled
4. CLIENTS CURRENTLY ENROLLED OFF REGISTERED Effective state
Trital -A Whit %Black % Hispanic %Other � "/�Female "°c Ui,al�Ied ,CrIIr 9
S. ADVISORY OR GOVERNING BOARD,IF APPLICABLE,
Taal t 101
White %Black %Hispanic %Other `lrf Female °fo Disabled
PIART IIa USE A SEPARATE MPPT OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE,
6. Is an Assurance of Compliance on file with DC!'i°A? It NA,or NO, explain. NA YES N
7, Compare the staff composition to the population, Is staff representative of the population?
If NA or NO, explain, NA YES \,J�ry
8, Are eligibility requirements forservices applied to clients and applicants without regard to rake, NA YES NO
color, national origin, sex, age, religion or disability?If NA or NO, explain.
Page 56of7
AA- .I29
9. Are all benefits, services and facilities available to applicants and participants in an equally effective juanner
regardless of race, sex,color, age, national origin, religion or disability? NA_YESJZ�O_If'NA or NO, explain.
10. For atient services,are room assignments made without regard to race, color, national origin or disability?
NA ;YPES_NO If NA or NO,explain.
__Vfe, An
11. Is the program/facility accessible to non-English speaking clients?If NA or NO,explain
12. Are employees, applicant d participapts informed of fieir protection against discrimination?
if yes, how? Verbal P Written V Poster E:"NA or NO,explain,
13. Give the number and current Status of any discrimination complaints regarding services or
employment Ned against the pro ram/facility.
14, Is the progra Ifacility physically accessible to mobifty, hearing, and sight-impaired individuals?
NA YES 7NO_ If NA or NO, explain,
PART ill. T14E FOLLOWING QUESTtONS APPLY TO PROGRAMS AND FACILITiES With 16 OR MORE EMPLOYEES
15. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to
make any necessary modifications? If NO, explain.
16. Is there and establish 6 grievance procedure that incorporates due process in the resolution
of complair 2NO—if NO, explain,
............
Page 57 of 73
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17, Has a person been designated to coordinate Section 504 compliance activities?YES /No_if NO, explain,
I& Do recruitment and notification materials advise applicants, employees and participants of
nondiscrimination on the basis of disability? If NO,explain,
19, Are auxiliary aids tillable to assure accessibility of services to hearing and sight Impaired
individualsaids
If NO, explain.
PART IV
FOR PROGRAMS OR FACILITIES WITH 60 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF
$50,0100 OR MORE,
20. Do you have a whiten affirmative action plan? YES. NO_ If NO, explain.
..............
Page 58 of 78
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Alliance USE ONLY
Reviewed By In Compliance.- YES NO*u
Program Office *Notice of Correcl veActiort Sent —I—/—
Date Response Due
On-Site Desk Review Q FRosponse Reopived f-1—
INSTRUCTIONS FOR THE CIVIL RIGRTS C'OMPLIANCE CHECKLIST
1, Describe tile geographic service area such as as district. Mfllty City Or other IOC-ditY, If the
specific target p0l)(AlationSUCh as adolescents, describe tile larger
popula-tiow Also, derino tile type of'service provided.
1 EllfffthC percent OrtfiC POIRIlation served by race and sex, The population served iFICILides persons
in the geographical area for which services are provided such ze,a city,county or other regional
area. POPLdation statistics,can be obtained from local chambers ofconimmc, libraries,of,arry
publication froin the 1980 Census containing, Florida population statistics. Include the source Of
your population statistics. ("Ottrer" races include Asian/Pacific Islanders and Amenicall
IndianWaskan Natives.)
1 Enter the total Miniber of full-time staff and their percent by race, sex and disability, Include the
effective dale of*your surnmary.
4. Filter the lotal number of clients who are enrolled, registered or currently, scived by the pro"'rillin or
U,
fircility, and list their percent by race, sex and disability, Includc 11w (late 1hat enrollment was
counted.
5, Enter,the total manber oladvisory board members and their Irercent by race,sex,aild disability. If
there is no advisory or goveming board, leave this section blank.
6i Each recipient of'fedurat rmanc4d IISSiMarlCe MUSt have on file air assurance that liar: program will be
conducted in compliance with all nondiscrimincirory provisions its required in 45 CFI� 80, This is
LisWllly as standard part of the contract language; flor 1)()f--',A recipients and their SL[b-�',rantees, 45 CFR
8 0.4 (a).
7, Is the race,sex,and national origin of tile staff,rc nective t,)raie general 110PUlation? "car example, W
10%of'the population is Hispanic. is there as comparable percentage of I*,,yanic sliifl'�
K Where there is a significant variation between the race,sex or ethnic composition oCtlic clients easel their
availability in the population,the prograill/lacility has the responsibility it) d0cn-nine lite reasons for
such variation and take whateveraction may be necessary to correct any discrimination-Some
legitimate disparities may exist Mien progamrs are sanctioned to serve target populations such as
elderly or disabled persoms,45 CFR,
80.3 4b)(6).
Page 59 of 73
AA-2129
9, I)o cli-ibilily requirernents unlawfully CXCIUde persons in protected groups from (tie provision of
services or ejriployrneiO Evidence of such may be indicated ill sLaff and client representation
(( riestions 3 and 4)and also through on-site record analysis of flursons. who applied bill were denied
services or eniployrnent,45 C17R 80.3 (a)and 4i CFR 80.1 (b) (2).
10, Participants or clients must be provided wrvicci, ,,rich as medical, nursing and dental care, laboratory
services,physical arid recreational therapies,counseling and social services without regard to race,
sex,color,national origin, religion,age or disability, Courtesy titles,appointment selledtiling,and
accuraey of record keeping runs( be applied uniformly and with(lut regar(l to race, sex,color, national
origin, religion,age or disability. Entrances, waiting rooms, reception areas,restroorns and other
Gicilifies must also be equally available to all clients, 45 CTR
80,3 (b).
11, For in-patient, services, residents mu5t be assigned to rooms, wards, etc., wVWIOLR regard to race,
color, national origin (ir disability, Also, residents RIU-St not be asked whether thcy are willing to
I
share accommodations with persom of a din rent race.color, nationat origin,or disability,45 CFR
803 (a).
12, The prograni/facility and all services Intist be accessible It.) participants and, applicants, including
those persons who may not speak English. In geographic areas where at significant population of
non-1:i,riglish speaking people live, program accessibility may include the employment Qfbiliripgual
staff". Ill other areas.it is sufficient to have as policy or plan 1"orservice, such as as current list oftiarnes,
and telephone numbers
of bilingrial individuals who will assist in tile provision(if scrviec,',",45 Cl-`I
80.3 (a).
t 3, fart,-)grains/facilities must make iril'onnation regarding the nondiscriminatory provisions ol"Fille VI
ava i la ble To their participarns, beneficiaries or any other interested parties- This should inclildc
infmination on their right to rile a.complaint ot'discrimination with either the Florida Department of
Eider Affairs or [tie [).S. Department of IIHS, The inibrillation may be SUppliCd verbally or in
%Vritiug,to eVery indiViClUal. OY iriay" be supplied thrOLLgh tile USC 01"all CLILN'd OpjJOrt till ity POliCY pOSrCr
disqflayed in R public area ofthe facility,45 CFR 80,6(d),
14. Report number of discrimination complaints filed against the prograrn/1'acility. Indicate the basis, e.g-
race, color, creed, sex,age, national origin,disability, retaliation; the issues involved, e.g.,services or
placement, termination,etc. Indicate the civil rights lawv or policy alleged to have been
violated along with the riarne and address of tile local, state or federal agency kvilh whom tile
complaint has been filed, lndic4ne the eurrern statirs,e.g,, settled, no reasonable caLISC l'okind, f"IdUre
to conciliate, failure to cooperate, kinder review, etc,
15, The prognam/r;,iciliLy roust be physicatty accessible to disabled individuals,. Physical accessibility
includes designated parking areas, mrb cut s or level approaches, ramps and adequate widdis to
entrances. The lobby, public telephone, restroorn facilities, water fountains, ilifol'IlIalion and
admissions Offices SlIOUld be acces%R)[e. Door widths and traffic areas ofactlinnistrative Offices,
cafeterias, ru-stroorris, recreation areas,counters and serving titles should be observed 1'(-)r
accessibility. Elevarors ShOUld be observed For door wi(ilh,and Braffle or raised ininibers.
SwrIchos and controls Cor light, hear, ventilation, fires alarms, arid other c.sserifials should be
installed at all appropriate height fOr Mobility hupairVd illdlVidl.lals.
16. Section 504 ofthe Rehabilitation Act of 1973 requires that a recipient of ederal 1-mancial assistance
conduct a SCIf-MILlati011 to idClltify' any, accessibility barriers, Self-evaluatilovi is, as lour` step
Page 60 of 73
AA-2129
process:
Cl With the assistance of a disabled itidividual/()r,,alli�atiOrl, by ilUate Current practices and policies
which do not comply with Section 504.
11t Modify policies and practices that do not rneet Section 504 reqUirCHICWS.
[_1 Take reirtedial steps to clituiriale my discrimination that has been identified,
L'I Maintainself-evaltiadon on file.('['his checklist may, be used to satisfy this requirement if these
foLir steps have been followed.), 45 CPR 84,6.
175 Pro ,rases or facilities that employ 15 or more ptxsons must adopt grievance procedures that
incorporate appropriate due process standards and provide for the prompt and equitable resolution of
cumplaints alleging any action prohibited by Section 504.45 CFR 843 (b).
I& Programs or t'ilcilities that employ 15 or more persons must dosignate at least one parson to
coordinate efforts Lo comply with Section 5O4.45 CPR 84,7 (a).
19, Continuing steps must be taken to notify employees aud the public of the prograni/facility's policy
of nondiscrimination on the basis(if disability. This includes recruitment material, notices for
hearings, newspaper ads, and other appropriate wducn,communication, 45 CM 8,1,8(it).
20. Prograrns/fac i lit les that oiiploy 15 or morc persons must provide appropriate auxiliary aids to
persons.with linpaired sensory, manual or speaking skills where necessary. Auxiliary aids stray
include, bnt are not limited to, interpreters for hearing unpaired individuals, taped or Braille
maturials,or any alternative resources that can be used to provide equal ly effective services,(45
CPR 84.52 (d),
2 1. Programs/faciticies \,\dtli 50 or more uniployees and$50,000 in federal contracts niust develop,
implement and inaintaiii a written aft-11-11"I'Itive action compliance program in accordance with
F,Necutivc Order 11246. 41 (TR 60 and Title Vl of the Civil Rights Act of 1964, as aniended.
Page 61 of 71
AA-2129:
An,ACHNIEN] D
BACKGROUND SCREENING
R A F FA Affidavit of Compliance - Employer
ywr%go 04mloy with", Aft"tatic"
rantM fath In suctJoil MAN31,M4141a SUM".
Ttw wo" 'o tit Pbver"nwmi " wwo or onw roi*od iiy In.*to corwtxt is oom gctvenav,
k;WtK0t'%INV nQ01IRMW10,04404&44VKk%Qo04J"C/ACft(au W IA"AginVidl,
mod struke Pia%idan Watwa.ract thirwayo f 1ad1VK1IVVMh 1110 MVWtWMyMt of0der Aftn(UMAJ,and
my adwr person of oftbtV whO hm wnpktraes ov Isms w0umtwj Is,wwo Mia tood the daRrimms
of a direct W*w PMVkNf $to J5 43004m,fit, Stec
A direst Rorke ProMer h 'a person It years of age or dder"o,pursuant to a progtram to psayw
WkM tO the 0141011Y.IAN*"r,NW-104we t watt a(4444 wM4 pro'Aftg Wv**S to Me d*0
ww:$has b"nu to tho cufart Wric w to,funth,powtatial"arty,tw I*rxmw kberofficaflon wonflation
ndtfwwd in 1.817-,6&yfir torm itwludk4 cowt*tatul,ota"goti,01W woorvisof%of MA"WWWas"
a"vdunloes3'j 410 G=flHb),Fla Star
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Srxw#tAW .0_ city 51100 ZIP C 0dr
k�: - —do,hemby affitm under p4nafty of parliwe
that ite above oarno,d vtTW4oVwf It to coryip4anto wdli OwR rxov%%ions of Owl tea 43S and section
430.0402,F
Ada urt�t5f'ttapt cativ at
STATt OF FLORIDA,COUNTY OF
Swam to,(or affusnad)and vubscribed Wore me this—ta—day
fNanw of %4 0 it pauspn4ily known
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62 of 73 T-R"�
A WN "S S I&A5 64 5 y AT RN
AA-2129
ATTACHMENT F
Alliance for Aging, Inc.
Data Priwaev and Security Busittesi Associate Agreement
This Business Associate Agreement("BA Agreement") is (hited -_j2-Vl t 0 2-0 , by the Alliance for Aging, laic.
("Alliance") and to County Board of County Commissioners, Acid Services/la-flame Services, C'Busiucis
Assirciate").a not-for-profit Florida corporation.
LO Hackm,ound.
I'l The Alliance has entered into one or more contracts oragreernents with Busincss Associate("Service Agrecincrie')
that involves tile use of protected Health Information(PI-1I).
L2 The Alliance, recognizes the requirements of the Health insurance portability and Accounlability Act of 1996
(Fliff"AA)and has indicated its intent to comply in the County's Policies and Procedures.
13 State and ferleral lav"-and regulationi nlay establish specific conditions on when and hov,,covered entities ritay share
information with Coll I racto rs who purrorin functions for tire Alliance and how that iril'urmadun must be Kept private
and secure, and how individual!; Riust be g1ven access to their m1brination. Such laws :and rules, to the extoll
applicable to Ille Service Agreement,will be referred to in this 13A Agreement as tire Conlidenliaality Llws.
1-4 The parties wish to ensure that all individually identifiable health infortalition or other personal data used and
disclosed 1XII-Sitant tO the Service Agreeinem is kept secure and used and disclosed only In; permitted by 111C
Corifidcritiality Laws. The Health insurance Portability and Accountability Art of 1996 and its, implementing
regulationi("HIMA")and the Health for Economic and Clinical I lQuIth Act(2009)and its
implennenting rcgulatiolls,requirc busincss associates of covered entities to comply with the HIPAJk Security Rule,
as set forth in,but not limited to 4-5 C.F R, §§ 164,309, 164-110, 164,112.and t64.3 16(2009)rand such see ions shall
apply to as business associate of a cow'Cred malty in Ille saille 1111nutor thal such sections apply to the covcrcd critity,
Neither Alliance nor Busincss Associate admit that they are subject to these provisions,but nevertheless intend that
111-H,as defined below, will tic used by f3usinos Associaw only as cornemplawd by I llP AAA and the I 1111"CH Act
and as permitted by the Confiden6ality Laws,
The parties therefore at"rce as follows:
2.0 Definitions. Fflr purpose's of this BA Agreement,the followillg defillitiorisapply in addition to definitions clsovilerc
in the BA Agrectrient:
2.1 Access. The ability or the ineans necessary to read, vw-riw, rnodi(y, or conunaniuitc daWinformation or offie"viSc
use any system resourcc.
12 Administrative Safeguards, The administrative actions, and policies and procedures, to nianage the selection,
development, implementation, and maintenance of securky mensures to prolect elecironic Protceted Health
Information (01-11) and to manage the condtAcr of the entity's workforce in relation to the protection of that
information.
?a Aaatlaa ratieatt rpta. The corroboration flat as parson is the one clairoc&
2A Availability, The property'that dala or inrunna(ion Is acccssiblcaod uscabic upon dernand 6),an authorized person-
15 Breach, The urnlLI1h11l'jZCd Uqoisifion,lcccss,use,or djsOosure of Pf I I w1lich contlNoullses the sQcurity Or privacy
of Such ultbrination-
16 Confidentiality. The property that drita or information is not made available or disclosed to unauthorized personi
or processys.
Page 63 of 73
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23 Informatian System, An interconnected stm re5ources under the same direct manao,5emeril Confrol
that shires common runctionality. A system nortually includes hardware,sollware, information,data,applications,
C0111111URicatiuns,and people.
18 Integrity, The property that data or information have not been altered or desvoyed in an milauthorized marrim
-).g 'Aw alit ialas Sor"Vare. Sonwam for example,as virus,designed to damage(it divopti a system,
2,10 Passwor& Colifidential authentication illformation composed of.1 string of'Qharactcr%,
2,11 Phlysical StalIcTuards. The phyiical ivicasures,polioies,and procedures to prO(W mi entity's electronic information
systems,as well as its building authorized intrusion.
's and equipment,Crom natural and environmental hazards,and unauthorized
2,12 Privacy Rute 'File Standards for Privacy of it dividually lderniroablr Health Information at 45 CFR ["art 160 and
Part It ,subparts A and E
113 Protected Infor"Intiom (IIIU) Personal facts about individuals, including individually identifiable information as
defined in 45 CFR §160.103, medic if records sljt jlect to Section 456.057, Florida Statutes, hospital records subject
to 395.3025, Florida Statutes,customer records and persotial information protected tinder Section 50 1.171, Florida
Statute-,aud other personil dam, whedier'tit paper or electronic fbirm,subject to state or federal laws or regulations
11111i(illg OW or diSdOSUrc,or subject Iti contnactrial obligations of confideritiality, lintited to the information created
ar received by Business Associate from oron behalf'of Alliance.
2,14 Required by Law,Has,the sal-ne meaning as the teen"required by law"in 45 CFR# MAO,
2,15 Seeretury.The Secretary of"the Department of Heirlth and Hurnan Services or his or lier dmiymcc.
2.10 Security incident.The attempted 0N5UCCUSSfiLl1 unautborizcd access,use,disclosure,modification.or destruction of
intimnation or intcrlr rencc with system operation-,; in an inkArnation system,
117 Security or Secrtri(y measures, All (if'the adminktrative, physical, and technical safeguards in an iril'ormation
Systealz
2AS Security Rule. rhc security Standards for the protection orElectroniv Protvcwd f1calth lol4mlation at 45 CFR part
L64,Subpart C,and amendments Ilierelo.
2.19 Technieal Safeguards. The teellurolop'y anal the Policy and Ptocudurcs I'm its use that prowl ele"ronic protwed
healilt kfornialion and control access to it,
0 Unsecured I"I'll. Protected health inf:grin ation that is not scetired OUOU�Th OIQ use Of tQC11111010gy or 1110110(JOILrey
SpCCi Red by tire SWCIUFy- in l,11-11dance issued L111dur 42 fJ,S,C section 17932(li)(2).
121 All other terms used, bta not olhurwise tic(bird,in this 8A Acri-cerneut shall have the:same meaning as tliow terms
in the Privacy Rule,
3.0, Obligations and Activities of Business Assochite.
Rusitio-s Associale agrees to not rise or disclose PFJI other than as permitted or rt'qwired by this BA Agrucirient, the.
Service Agwericnit,or as Required by 1,ri%v,
3,2 Business Assmialt:a.g r k.mi t o
0) Implement policici and procedures to prevent,detect,contain and correct Security violations in accordance with
the Security Rutc�
(11) Prevent use or disclosure of the P111 other than as provided fior by this BA Agreement or as required by, law;
Page 64 of 73
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(c) Reasonably and appropriately protect the confide n tial ity, Vite.grity,and availability of the l"HI that the Buin'le"S
Associate creates,receives,maintains,or transmits on behalfol'the Alliance:and
(d) Comply with the Security Rule requirements including tile Administrative Safeguards, Physical Safc_guards,
Technical Safeguards, and policies and procedures and documentation requirements set forth in 45 CFR §§
164,308, 164,310, 1641121,and 1643W
13 Business Associate agrees to mitigate, to the c.xtent, practicable, any hurri)['61 effect that is known to Business
Associate ora use or diSOICISLIN of 111-111 by Business Associate M violation of tile requirements of Ellis 13A Agreement.
3A Business Associate agrees to promptly (xvithin 49 hours) report to Alliance any use or disclosure of tile PHI not
provided for by this BA Agreement of which.it becomes awiire, This inCILKICS ally I'MitICStS for inspection,copying
ur amendment ot'stich ird"ormation and including any security-incident involving PH],
B t i s i i ves s A 5socia I e agrees(o n o t i ry A(I ia i i cc wit Ito it t n n reaso s i ab I e(I e I a),o fany breach pert a ill i jig Bo:
(a) Identification of any individual whose onsecored 11111 lGis been, or is reasonably believed by tile Business
Associate to have been, Uctssvd'actillo-ccl.,or disclosed during such security brcach� and
(1,)) All information reii(ired For notices required 1-5Y Section 501,17l, Florida Slagmes, as well as tile PriVaGy Role
I
and Security Ride, Mid SUCII other information requested by tile Alliance,
16 Business Associzite agrees to ensure that any ri�ent, including a stibcontraclor, to wliorn it provides Pill rcccived
from,or created or received by Business Associate on behalf of'the Alliance. agrecs to the same, restrictions and
conditions that apply tbrough this BA Agreement and the Service Agreement to Flusiness Associate with respect to
Such
3,7
(a) Business Associate agrees to provide access, at the request of'thu Affinnec during regular business hours,to 111-11
to the Alliance or,as directed by Alliancc, to an individual in order to meet the requirements the Cortridentiality
1,1%m and
b) Business Associzate agrees to make ally airlendnient(s)to PI that the A Illanec directs or w7recs to at the request
of the A Malice within, t 0 business days of receiving the rcqtrest,
.1.8 Business Associate:agrees to make internal practices.books,and records,including policies and procedwes and 1-1111,
relating to the use and disclosure of Ill it received fi-nin,or created or received by Business Associate un behalf'of'(lic
A Ili aace,availlable to the Alliance or to relevant regulatory authorities,which may include the Secretary,upon request
ofthe A Itiance or the..Secretary far purpows of determining cniripl i-ance with applicable Coaridentiality Law's,
19 Busirim-,Associate on�rm to dOCIMIC111-SUCh disclosures MTH I and inforluation related to va(Ch disclosures is would
be required for the Alliance lo respond to a I-CCILlest by an inclividUal for an aCCOL111ting oli'disclostircs of PHI in
accordance with the Confidentiality Laws.
110 Business Associate a8rces to provide to tile AlIiMCC, Upon request, infiorartation collected to permit the Alliance to
respond to a request by an Individual for an accounting of disclosures of PHI in accordance with the Confldc-litiality
Lam,,q.
111 Business Associate specifically agl-M to USC 5CCUrity MUSLIMS that reasotiably and appropriately protect the
confidentiality,integrity,and availability of'PI-11 in electronic or any other f'ornt, that it creates,receives, maintams,
or transmits on hehalfof the Alhajim
112 Business Associate agrees to implement scckjrity measures it)wcure p.m.mords used to access, PI-11 that it accesses,.
0
maintains, or (ransmils as part of Ellis BA At reenwrn from malicious wflware and other 1111,111-Made and natural
vulnerabilities to assure the avaailability, intcgrio,,and confidentiality of'such inibi-radon.
3,13 Business Associate agrees to irop[CRical sccurity measures to safeguard PI-11 that it accems,maintaim,or transmits
all part of this BA At,,reement from malicious software and other mari-inade and natural vulnerabilities to assure the
availability, integrity, and confidential icy of such information.
Page 65 of 73
AA-2129
3,14 Business Associate agrees to comply with all other applicable Confidentiality Law-, including, but not limited io,
restrictions on the sale of PHI and ,in), obligatioas under the Confidentiality I.aws delegated by tile Alliance to
Business As%ociaie, including any obI igations under the Privacy Rule, and agrees to use and disclosc Only the
Z,
minklikull necessary PI 11 to fulfill its obligations under this BA Agreement and the Service Agreement-
4.0 Permitted Uses and Disclosures by Busineis Associatei
Except as otherwise Fmitcd in this Agreement car zany related agreement,Business Associate may uic or disclose P111
to perform Functions, activities, or services (ov,Or oil behalf of, Alliance as specified in ally and all Contracts with
Alliance provided that such use or disclosure would not violate(lie Privacy Rule ifdone by Alliance or die ininitatim
necessary policies and procedures oftlic All iancL.
1.0 Sperific Ilse and Disclosure Provisions.
5,11 Except as otherwise limited ill this DA Agreement, the Survice Agreement or any Confidenteility Laws, Business
Associate may use PHI for(tic proper nianageniern and administration ofthe Business Associate or to carry r out the
legal responsibilities of the Business Associate,
5.2 Uxcept as;otherwise limited in this BA Agreernent, the Service Agreement, or any Confidenliality Laws,Business
Associate may disclose PHI for the proper management and admini5tratiun of the Business Associate,provided diat
disclosures tare;Required By Law,or Business Associate obtains fcasoriable,assurances from tile person to whom lite
inl6miation is disclosed that it wvjlj remain confidential and used or fourth disclosed only as Required By Law or Ica-
the purpose ror which it was diSCIONCLI 10 tile IM-Stla,and 1hC person nolifics tfic Business Associate of any instances
ol'%vliicji it is aware in which the confidcritiality ofthe inforritailon has beell firroulted.
5,3 Business Associate May USC PIJI to provide data aggregation services to the Alliance as perruilled by the:
Confidentiality Laws,but only whev specifically authorized Ili writing by the Alliance,
6.0 Obligations of Allhince.
6.1 The Allianck shall notify Business Associate of ugly restriction to the use or disclosure of PHI to which the Alliance
has agmcd to the extent dial such restriction may affect Business Associate's use or disclosure of PILL
6.2 Permissible Requests by the Alliance. Except for data aggregation or maliagenient and idalinistrativc aciivities of
Business Associate, the Alliance shall not request that Business Associate use or discloso Pill in any niannvr that
would not be permissible under the Privacy Role if done by Alliance,
TO 1"ffertive Date and TO roll illat inn,
Tj The Parties hereby agree that this BA Agreenim its effective M Or tile dRIC Above and aracrids,restates and replaces
any other 0aisiness Associatc Agrecriacra currently in effect between the Alliance and business Msociate.
7,2 "IFerinklalitial for Catise. Cpon llic Alliance's knowledge Grit material breach by Business Amociare, the Alliance
May:
(a) Provide an opportunity for fiLlSiness Associate to care the, breach or end the violation mid terminate this
agreement if Business Assockite does newt cure the breach or end the violmion within the lism specified by the::
Allialim or
(b) Immediately terminate this BA and rita F also terminate the Service A
C- greement iftlusijies5 Associate
has breaclied as matcriaI term of this Agreement and curc is not possible.
73 Efftvt of Termination, Fxcept as provided in subparagraph(b)or this wclion,upon termination ofthes agrcurnent,
for ans,reason, Business Associate shall return anti Pt 11 received from the Alliance or created or received by Business
Associate on bchalfol'the Alliance,No,PHI shall hedestroved withow theexpress written pmatission of*the Alliance.
Page 66 of 73
AA-2129
(a) This provision shall apply to PHI that is In the possession of subcontractors or agents of Business Assoviatc,
Business Associate shall retain 110 copies orthe VI[L
(b) In the evoit that Business Associate or Alliance determines that returning the PHI is infeasible,notification of'
the conditions that make return of Pill infeasible shall Lie provided to(tic Afffliate. if the Affiliate agrees that
ternihiation is infeasiblo, Businuss Associate rna)" retain thC PHI, SUbjeCt 10 the fC(JUrrCruC11j5 of this 13A
Agreerflent. Business Associate shall extend the protectimis ofthis IAA Agreement to such retained P141 oral limit
further uses and disclosures of such rdained Pill (br long as Busiricss Assuuiatc snaintairts such PHI,
8.0 Regulatory References, A reference in this agreement to at section in the Privacy Rule or Security Rule or offier
Confidentiality Law tneans the section then in effect or as may be amended in the future.
9A Amendment. The Parties agree to take such action as is necessary(o amend this agrecincrtt from tinic to time as is
necessary for the Alkaticc to comply ww th the requirements ofthe Confidentiality Laws.
10.0 SlikViVal. tyray°terns.c taclitiora,ur trcrraatst ear et lif artiatrr wwftieh retguires pc.rftrrr7aartefcr by either party hereto sulasegaeart
to the termination of-fluis 13A ALY grecinent shall winaia criforceable against such party Subsequent to such terntinalioll.
I I A Interpretivitiou, Any as abiguily in this BA Agrecivent shall be resolved to permit the Alliance to comply kvidl the
Cunfidentiatity Laws.
110 Notices. All rioticesand communications required,itec"saryorilvs1red to be gpivvo pursuant to dik,(3A Agrcenteut,
including,a change of address fear purposes of such Itolices Ind ColounloiC81tiOnS, shall be ijr.j avriting and delivered
personally to the other party or sent by express 24-hou rg atirit n teed cauricr or delivery servim or by cellified tuail
of the United States Posuil Services, postage prepaid and return receipt rcqttestcd, addressed to lite other party as
follows(or to such other Iflace as lity party may by notice to ffic ollim specify Y
To the Mliiarrcc: Alliance fior Aging, trig:.
Attention: Max Rcthnian
760 W 1117 Avenue
Miami, Florida 33 172
To Business Associate: Monroe COL111ty Board of County Cominissioners, Social ServiceAri-Hotne
Services
110, Simonton Street,2"r F loor
Key West, FL 330,10
Any such notice shall be deemed delivered upon actual teccipt.
deti,ecry will be deemed to have OCCUrred on the date such delivery was aitempred.
13.0 Governing Law, The laws of the Yate offlorida,without giving effect to principles of confliGi ol'It vs� guyem all
matters arising under this 13A Agreement,
14.0 Severjtbility. If an),provision in this agrevinert is to any extent,the:remainder of this BA Agreement,
or application ofthat provision to any persons or cir-CUMM1111C.CS OOICT tiMn thecae as to which it is held urtenforceable,
will not be afficcted by that unenforceability and will be enforceable to the fullest extent permitted by Imv.
15,0 Any successor to business Associate (wilctIter by direct or indirect or by purchase, merger,
consolidation, or otherwise) is required to assunre Business Associme's obligations under this UA Agreennoit and
agreie to 1.)erform thern in the same manner and to the same extent that Busiress Associate kvould have beca required
to ifthat succession had not taken place, This assumption by the successor of the Business Associate's obfigations
shall lie by written agreement satisfactory to the Alliance.
Page 67 of 73
AA-2129
16.11, fatire Agreement. This BA Agmenicni,together with lit e Servicc Agrectocol,conswules the entire agreement of
the partics Muting to Ific stibj"t niancr o(thi.4 HA,Agreement mid supersedes all other oral or written agreements or
policies reputing INereto,except flim ihis agreement does out Iiink (lie amendment of this agrecuient in arcordance
with,section U of this BA Agreement,
AttlancororAgl , otc.
By: Date: 2�0
m at q/20
ir44
Business AgNoclate: Munroe County Board of County Commissionors,Social Services/In-Illonit Services
By plat: Jan 4,2021
NS0E COUNTY q ATMnNEY'AArA0V 1�
FORM
P D 0 IZ
, r%my
ASSIS NTY ATTORNEY
Dal 1/4/21
Page 68 of 73
AA-2129
ATI-AC I I M,EN'I'C'
Alliance for Aging, Inc.
Aging and Disability Resource Center/Elder Hetpline
AGINC AND DISABILITV RESOURCE CENTER(ADRC)—OUTSOURCED FUNCTIONS
I. If applicable, the provider agrees to the following-
A. Perform ADR C oulsourced functions in accordance wi(h the Alliance's policies and procedures.
i. Policies and Procedures for OWSOUrced Function-Screening
ii. Policies and Procedures 601-OWSOUrced FLInCtiOn-'FriaillrC
iii. Policies and Procedures for Activation from Waitlist- Client Services
iv, Policies and Procedures for Termination from Wartlist- Client Services
8. Maiwain w,,ut listi in CIRI'S in accordance with DOEA rC(jL1i1'G'n1ents.
C. Adhere it) prioriti/ation ant] tar('0(ing PoIiCr)' 'J'S �N
r, et rorth in (lie DOE A Programs and Scrvices
Handbook, as appheabic.
D, Ensure (lie Providers Disaster Plan reflects ADRC 0111SOLIMCd FkIndiOnS, 81111MIlly Or aS necded
to incorporate ADRC orimourced functions.
E. Ensure against conflicts cal`interest and inappropriate self-referrals by referring consunwrs in riml
ol'options counseling, or long-term care services beyond die proviaer's scope of services to the
Aging and Disability Resource Center,
F. f-,,risure that services provided are in the clients' best interest, are the triost cost effective, of hiph
r:1
quality, and are responsive -.in([appropriate to the assessed needs.
'I'lie Assessed Priority Consumer List (APCL) is maintained when services funded by the department are not
available, Contracted Providers of VQgiSLCrCd services for 1.,ocal Services Program (LSP) and Older Arriericans
Act (O M N AA) FISI H1111t3ill WRitini" JjSj,,j1 its at, xise for registered services when funding is not
site CIRTS kk it
available.
Page 69 of 73
AA-2129
Alliance ror Aging, Inc.
Aging and Disability Resourcc Center/Eldcr 11clitline
t.
11olicy and Procedure for Outsourced function—Screening
Creation Date: March 5, 2008
Revision Ditte: October 2019
Review Date, October 2019
Objective. To enSUre that a comprehensive list of clients in need of servic", is maktained In CWTIS by
appropriate funding source and that the ADR,C is thereby able to effectively gauge the level oCelder
service need in Miami-Dade and Munroe COUnties.
policy., To (Naill necessary ini-onniniort 1rom clients in order to assist in determining level (if need and
eligibility for register-cd services funded through OAA and LSP programs.
I. Providers Nvill collect hif6mratioll from catles", mid CorldLICt it 70 1 S assessment. Alternatively, if a
70 IA(B)assessment already exists or is provided from another Provider the information from tile 7011
can be utilized.
1 -['le Provider will determine the set-vices needed and (lie appropriate fiinding source(s) that provides
Ille needed services,
I I'die caller- is in need of as service(s) that is not provided by the Provider, (lie Provider will refer caller
to Clio ADRC Eider Flelpline, as well as,to other contracted Providers and community organizations.
m
3, The caller will be provided with general information regarding the ADRC as well tv, the ADRC Elder
11elpline oontact numbcr.
4, The caller will be inforined of services and funding sources that they are being placed on the wait
list for in CIRTS.
5. For rion-case managed programs, the Provider will creale as client record in CIRTS, (if there is no
existing rccord�and enter the services needed for the caller by funding source and service, [If there is
an existing record in CIRTS,the appropriate fields will he updAtted],
6, If the Provider determines that the caller may quaHl"), l'or alort:than came program ter`which the Provider
is fUnded, the Provider is encouraged to enter the appropriaatc information under multiple funding
SOL11'CeS, [I[there is an existing client record in CIRT`S® the client record in CWTS will be updated with
appropriate hillormation].
T The 111ovider will inform caller that they will receive all annual re-assessment based on DOLA Wail
List Remisessment Standards and encourage caller to contact the, ADRC I"Idcr He 1pline with any
ques1k,ins,
Page 70 of 73
AA-2129
Alliance for Aging, lite.
Aging salad Disability Resource Center/Elder 11cliatine
Policy and Procedure for
Outsourced function -Triage
Crication Date: March i, 2008
Revision Date: October 2019
Review Date: Octo[ier 2019
Objective: To enSLLfe that clients in need of DO FA funded services receive services biased cars the highest level of
need, first, as funding becomes available.
Policy: To assist Clients in obtaining DOEA ftinded services as fi.inding becomes available, based on level of,"
tired its determined by it ons priority score.
Procedure:
I.. ']"Ile Provider will coridticl manual reassessments bused on DOEA Wait List Reassesstlicill Standards.
2. If there is no Current 70 l A or B in Cl R"I'S, the Provider will conduct the annual reassessment (701 S) as
appropriate. Based on the inhirmation provided via the 701S/A(13) ;messment, the Provider MII update
tire Client information in CIRTS specifically as It pertaill",to level of need for services by funding source,
3, The Provider will ensure that the CIRTS prioritization score is accurately rnairaiiined. aaccordirlp,,to DOEA
Standards. If as significant change has occurred prior to the annual tv-screoning, the provider must re-
screen, Dertnitions and examples of-significant change are documented in the DOE'A Vrc)grams& Services
Manual Chapter 2,
4, [fthe caller is In need ufa scrvicc(s)that is not provided by the Provider, the Provider will refer caller to
the ADRC Elder flelpline, as well as, to other contracted Providers and community or- nizations. The
cll�i
caller will be infuirmed ofthe services and funding sources than the wait list for andlor have ticen removed
from the wait list for,
5. "file Pl.t)Vi(Jer ",ill reorlill(] Client orlhe ADRC Elder [Ielp Line contact nUmber and to contact tile ADRC
F-Ador Help Lille with atly(ILICStlorls Or c0fteCrils,
6, As frinding becomes available, ilic Provider will rull CIRTS Prioritizittiort Report and activate clients
accordIngto Policies and Procedures), The Contracted
Provider Nvill apply targeting criteria, as appropHate, to priorilited clicills to ensnare activations meet
programmatic rcqUirClI1cII'K
Page 71 of 73
AA-2129
Alliance for Aging, Inc.
Aging and Disability Resource Center/Elder Helpfine
Policy and Procedure for
Activation,from Wait List—Clients/Services
Creation Date: March 5,2008
Revision Date: October 2019
Review Date. October 2019
Objective: To 011SUre that ClJCfS in need ofDOVA Funded services in Miami-Dmle and Monroe ounties and on
(lie CIRTS wait list be-in to receive servic"as Brandin becomcsavailah[c.
Policy: ADRC will work with Providers to eniurc that clients,waiting liar DOFA fundcd services bogin to
receive those services as funding becomes available.
Procedure:
I. The Provider will activate clients ari CIRTS wait list based on DOEA jirioriti7.aliori polices and ruading
availabtlity.
I The Provider Will Update CIRTS status by funding source rind service (brany smices being activated for
the client using appropriate CIRIS codes,
3. Clieni mia), be left on wait list arty as difTerent 11inding source than the otte being activated if the Provider
delcauines ilml it is appropriaw
4. Chom may also be loll on wait list In CIRTS ifthey aura}boing activated f.,i),the 11nwidur undera temporary
mean-DOFA funding source an(] the Provider deterinincs that the cheril's raced will persist after the
temj)orary rUndino source k exhamq� ed.
S. The Provider will inform than,cliem ol'ariy servicesHunding source that they;are, lac trig aolvatckl floras well
as those services and funding sources that they will continue to be wall listed for.
6. The Provider will inl7orto client,to contact the ADRC Elder I lelplitie.if they have any qLICS[i(VIS or micerns
regarding vices.
the status ofany of theh ser
Page 72 of 73
AA-2129
Alliance for Aging, Inc.
Agittg and Disability Resource Center/Elder Helpline
Folicy and Procedure for
Termination from Wait List—C lien,t sl-Sery ices
Creation Date- March 5. 2008
Revision Date- October 2019
Review Date: October 2019
Objective: 'Fo ensure Ilml the comprehensive list of clients in need ofservices in CI S is appropriately
maintained by funding source and that the ADRC is thereby able to effectively gauge the current ]evel,
ofolder service need in Miaini-Dade and Monroe COLI[ItieS.
Policy: ADRC will maintair, an accorateand current list oCclients in need of elder services in Mianii-Dade
and Monroe Counties with thc assistance oftliQ ADRC Contracted Providers,
Procedure:
t. The Provider will re-screen client/i which the Provider initially placed on Ow CIRTS wait list for services
based on DOE A, Reassessment Standards.
2, ThL re-screciling ina), be in the forni of a phone screening or a home visit depending on (tic client's status
(Le. aclive!pcilding)
3. The 11rovider will determine ifIliv client is no longer in need(or eligible) for any of the services ffic),, were
ki-lail-lisled for.
4, The Provithn- will terminate the client lions the wait list (entirely or by SpCCiFIC SMiCe) Using she
appropriate CIRTS runnination code for any services or funding source for which the client is determilled
to riot longer lie eligible for or 11(i tollger in,need uf
-5 The Provider wHl inform dic client ofany scrViecs/kInding soktrcQ that they are being removed from the
wait list fior,
6 The Provider will infortn client of their ability to be re-added to the %vflt list W1,110ir lCV01 01-110cd ShOUld
change
7. 'I'lic Provider vv I I I i it Io rin c I i c nt to contact t lie A D R C E I de r I I e I p lit ile i IF if I V.Y have any q I 10,6 ol is or Corker n s
regarding their Wait list SIZIILIS.
8, Reti rciicc DOEA Programs and Services I landbook as applicable.
Page 73 of 73
Monroe AA-2129 Provider Signed 17 & 68
Final Audit Report 2021-01-04
Created: 2021-01-04
By: Stain Mcneese(mcneeses@allianceforaging.org)
Status® Signed
Transaction ID: CBJCHBCAABAAUvRDqXX!1 pedfVDwnq59Yju9MyR_GAAU
"Monroe AA-2129 Provider Signed 17 & 68" History
Document created by Stan Mcneese (mcneeses@allianceforaging.org)
2021.01-04-11:1 1.33 PM GMT-IP address: 18.204,.136.48
I Document availed to Max B. Rothman (rothmanm@allianceforaging.org)for signature
2021-01-04-11:12:51 PM GMT
Email viewed by Max B. Rothman (rothmanm@allianceforaging.org)
2021-01-04-11:19:33 PM GMT-IP address:76,109,240.37
Document e-signed by Max B, Rothman (rot hmanm@allianceforaging.org)
Signature Date:2021-01.04-11:20:29 PM GMT-Time Source:server-IP address:76,109,240.37
Agreement completed.
2021-01-04-11:20:29 PM GMT
Adobe Sign