HomeMy WebLinkAboutItem C06i i
1 i ♦Moul 131
y
Meeting Date: 10-19-2011
Bulk Item: Yes X No
Division: _County Administrator
Department: Social Services/In-Home Services
Staff Contact Person/Phone #: Sheryl Graham/X4510
AGENDA ITEM WORDING: Approval of Amendment 002 to the Older Americans Act (OAA)
Contract AA-1129 between the Alliance for Aging, Inc. (Area Agency on Aging) and the Monroe
County Board of County Commissioners (Social Services/In-Home Services) for fiscal year I/1/I I to
12/31/11.
ITEM BACKGROUND: Approval of Amendment 001 will increase the funding for said contract
due to the allocation of carry forward funds that remained leftover from the 2010 contract year.
The increases are not recurrent.
PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to the Older Americans Act
(OAA) Contract #AA -I 129 on 12-15-2010
CONTRACT/AGREEMENT CHANGES: Increases in the Older Americans Act (OAA) Contract
#AA-1129 is as follows: Title C 1 will be increased by $2,965.68 from $140,284.27 to $143,249.95.
Title C2 is increased by $2,638.18 from $208,193.72 to $210,831.90. Title 3E is increased by
$1,009.19 from $66,550.81 to $67,560.00.
STAFF RECOMMENDATIONS: Approval
TOTAL COST: $421,641.85
INDIRECT COST: _-0-_BUDGETED:
Yes X No
COST TO COUNTY: No Cash Match required. SOURCE OF FUNDS: Grant
Approx. $42,164.00 In -Kind Match
REVENUE PRODUCING: Yes..4 No X_ AMOUNT PER MONTH Year
APPROVED BY: County At X OMB/Purchasing X Risk Management X_
DOCUMENTATION: Included X Not Required
DISPOSITION:
Revised 1 /09
AGENDA ITEM #
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, Inc. Contract # Amendment #002 for
Contract #AA-1129
Effective Date: 1 / 1 /2011
Expiration Date: 12/31/2011
Contract Purpose/Description: Approval of Amendment #002 to the OAA Contract #AA-1129 will increase the
funding by $6,613.05 due to the allocation of carry forward funds that remained leftover from the 2010 contract
year.
Contract Manager: Sheryl Graham
(Name)
For BOCC meeting on 10/19/11
4510 Community Services/Stop I
(Ext.) (Department/Stop #)
CONTRACT COSTS
Deadline: 10/4/11
Total Dollar Value of Contract: (extension) $421,641.85 Current Year Portion: $_
Budgeted? Yes X No ❑ Account Codes: _-_- -
Grant: $415,028.00 125 - 615 11_-
County Match: $42,164.00 (In -Kind Match) 125-6153211_-
_ 125_-6153411_-_
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) (eg. Maintenance, utilities, janitorial, salaries
etc
CONTRACT REVIEW
Division Director
Date Ip
�-F
Changes
Needed nevi ver
Yes ❑ No CI
Date Out
Risk Management
' l j
Yes ❑ No 1"" -
O.M.B./Purchasing
A
Yes 1-1 No E
I
County Attorney
Yes LE No
l
Comments:
uivib corm Keviseci L/L"//ul iviuF #2
Amendment 002 CONTRACT AA-1129 Page 1
THIS AMENDMENT is entered into between the Alliance for Aging, Inc. hereinafter referred to as the
"Alliance", and Monroe County Social Services.
The purpose of this amendment is to increase funding by allocating Older Americans Act carry
forward funds that remained from the 2010 contract year. The increases by title are as follows: Title
C1 is increased by $ 2,965.68 from 140,284.27 to $143,249.95, Title C2 is increased by $2,638.18 from
$208,193.72 to $ 210,831.90 and Title IIIE is increased by $1,009.19 from $66,550.81 to $ 67,560.00.
These increases are not recurrent.
The Budget Summary by Title for the whole fiscal year (January 1-December 31, 2011) is as follows:
Title C1 (CFDA/CSFA # 93.045): $ 143,249.95
Title C2 (CFDAICSFA # 93.045): $ 210,831.90
Title III E (CFDA/CSFA # 93.052): $ 67,560.00
Increased services are in bold
The Alliance shall make payment to the provider for provision of services up to a maximum number of units of service
and at the rate(s) stated below:
Service(s) to be Provided
Service
Unit Rate
Maximum
Units of
Service
Maximum
Dollars
Congregate Meals C1
$9.56
14,170
$135,465.95
Congregate Screening C1
$20.00
1 262
$5,241.00
Nutrition Counseling C1
$47.50
40
$1,906.00
Nutrition Education C 1
$63.58
10
$637.00
Home Delivered Meals C2
$6.13
33,381
$204,628.90
Screening & Assessment C2
$25.00
233
$5,841.00
Nutrition Education C2
$63.67
5
$362.00
1n Home Respite 3E
$23.08
833
$19,230.00
Facility Respite 3E
$10.34
4,674
$48,330.00
Total Contract
$421,641.85
All provisions in the contract and any attachments thereto in conflict with this amendment shall be and
are hereby changed to conform with this amendment.
All provisions not in conflict with this amendment are still in effect and are to be performed at the level
specified in the contract are hereby amended to conform with this amendment.
This amendment and all its attachments are hereby made a part of the contract.
IN WITNESS WHEREOF, the parties hereto
undersigned officials as duly authorized.
PROVIDER:
SIGNED BY:
NAME:
TITLE:
Monroe County
Services.
Heather Carruthers
Am
:aused this amendment to be cuted by their
Z
ALLIANCE FOR AGING, INC.
f►/=161�i
TITLE:
President & CEO
10-19-2011
DATE: DATE:
January 2011
IN
Contract AA- 1129
ALLIANCE FOR AGING, INC.
STANDARD CONTRACT
OLDER AMERICANS ACT PROGRAM TITLE III
THIS CONTRACT is entered into between the Alliance for Axing, Inc.. hereinafter referred to as the "AAA," and Monroe
County Social Services. hereinafter referred to as the -Contractor", and collectively referred to as the -Parties." The term
contractor for this purpose may designate a vendor, subgrantee or subrecipient, the status to be further identified in
ATTACHMENT 111, Exhibit-2 as necessary.
WITNESSETH THAT:
WHEREAS, the AAA has established through the Area Plan on Aging that it is in need of certain services as described
herein; and
WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services
as an independent contractor of the AAA.
NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the mutual
covenants and conditions hereinafter set forth, the Parties agree as follows:
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in this
contract including all attachments and exhibits, which constitute the contract document.
1.1 Definitions
DOEA means the Florida Department of Elder Affairs.
AAA means the Alliance for Aging, Inc.
PSA means the Planning and Service Area corresponding to Miami -Dade and Monroe Counties.
2. Incorporation of Documents within the Contract
The contract will incorporate the provider's application in response to the 2009 OAA RFP, attachments, proposal(s),
state plan(s), grant agreements, relevant department handbooks, the Alliance for Aging Policies and Procedures
manuals or desk books, as an integral part of the contract, and except to the extent that the contract explicitly provides
to the contrary. In the event of conflict in language among any of the documents referenced above, the specific
provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the Proposal(s)
or other general materials not specific to this contract document and identified attachments.
3. Term of Contract
This contract shall begin on January 1, 2011 or on the date on which the contract has been signed by the last party
required to sign it, whichever is later. It shall end at midnight, local time in Miami, Florida, on December 31, 2011.
4. Contract Amount
The department agrees to pay for contracted services according to the terms and conditions of this contract in an
amount not to exceed $422_0,992.00, or the rate schedule, subject to the availability of funds. Any costs or services
paid for under any other contract or from any other Source are not eligible for payment Linder this contract.
5. Renewals
By mutual agreement of the parties, in accordance with s. 287.058(l)(f), F.S.. the AAA may renew the contract for a
period not to exceed three years. The renewal price, or method for determining a renewal price, is set forth in the bid,
proposal, or reply. No other costs for the renewal may be, charged. Any renewal is Subject to the same terms and
conditions as the original contract and contingent upon satisfactory performance evaluations by the AAA and the
availability of funds.
1/71
January 2011 Contract AA-1129
6. Compliance with Federal Law
6.1. If this contract contains federal funds the following shall apply:
6.1.1 The provider shall comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable regulations.
61.2 If this contract contains federal funds and is over $100,000.00, the contractor shall comply with all applicable
standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s. 508
of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251, et seq.), Executive Order 11738. as
amended, and where applicable Environmental Protection Agency regulations 40 CFR 30. The contractor shall report
any violations of the above to the AAA.
6.1.3 The contractor, or agent acting for the contractor, may not use any federal funds received in connection with this
contract to influence legislation or appropriations pending before the Congress or any State legislature. If this
contract contains federal funding in excess of $100,000.00, the contractor must, prior to contract execution, complete
the Certification Regarding Lobbying form, ATTACHMENT H. All disclosure forms as required by the
Certification Regarding Lobbying form must be completed and returned to the Contract Manager, prior to payment
under this contract.
6.1.4 That if this contract contains $10,000.00 or more of federal funds, the contractor shall comply with Executive Order
11246, Equal Employment Opportunity, as amended by Executive Order 11375 and others, and as supplemented in
Department of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.
6.1.5 That if this contract contains federal funds and provides services to children up to age 18, the contractor shall comply
with the Pro -Children Act of 1994 (20 U.S.C. 6081).
6.1.6 That a contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards shall
not be made to parties listed on the government -wide Excluded Parties List System, in accordance with the OMB
guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." The
Excluded Parties List System contains the names of parties debarred, suspended, or otherwise excluded by agencies,
as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. The
contractor will comply with these provisions before doing business or entering into subcontracts receiving federal
funds pursuant to this contract. The contractor shall complete and sign ATTACHMENT V prior to the execution of
this contract.
6.2 The contractor shall not employ an unauthorized alien. The AAA shall consider the employment of unauthorized
aliens a violation of the Immigration and Nationality Act (8 U.S.C. 1324 a) and the Immigration Reform and Control
Act of 1986 (8 U.S.C. 1101). Such violation shall be cause for unilateral cancellation of this contract by the AAA.
6.3 If the contractor is a non-profit provider and is subject to Internal Revenue Service (IRS) tax exempt organization
reporting requirements (filing a Form 990 or Form 990-N) and has its tax exempt status revoked for failing to comply
with the filing requirements of the 2006 Pension Protection Act or for any other reason, the contractor must notify the
AAA in writing within thirty (30) days of receiving the IRS notice of revocation.
7. Compliance with State Law
7.1 That this contract is executed and entered into in the State of Florida, and shall be construed, performed and enforced
in all respects in accordance with the Florida law, including Florida provisions for conflict of laws.
7.2 Requirements of s. 287.058, F.S. as amended.
January 2011 Contract AA-1129
7.2.1 The contractor will provide units of deliverables, including various client services, and in some instances may include
reports, findings, and drafts, as specified in this contract, which the Contract Manager must receive and accept in
writing prior to payment in accordance with s. 215.971, F.S. (1) and (2).
7.2.2 The contractor will submit bills for fees or other compensation for services or expenses in sufficient detail for a
proper pre -audit and post -audit.
7.2.3 If itemized payment for travel expenses is permitted in this contract, the contractor will submit bills for any travel
expenses in accordance with s. 112.061, F.S., or at such lower rates as may be provided in this contract.
7.2.4 The contractor will allow public access to all documents, papers, letters, or other public records as defined in
subsection 119.011(12), F.S., made or received by the contractor in conjunction with this contract except for those
records which are made confidential or exempt by law. The contractor's refusal to comply with this provision shall
constitute an immediate breach of contract for which the AAA may unilaterally terminate the contract.
7.3 If clients are to be transported under this contract, the contractor shall comply with the provisions of Chapter 427,
F.S., and Rule 41-2, F. A. C.
7.4 Subcontractors who are on the discriminatory vendor list may not transact business with any public entity, in
accordance with the provisions of s. 287.134, F.S.
7.5 The contractor will comply with the provisions of s. 11.062, F.S., and s. 216,347, F.S., which prohibit the expenditure
of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency.
8. Background Screening
The contractor shall ensure that, prior to providing services, all persons having access to vulnerable elders and
children, their living area, funds or personal property, or protected health information pertaining to such individuals,
shall pass a Level II criminal background screening in accordance with the requirements of s. 430.0402 and ch. 435,
F.S., as amended. These provisions shall apply to employees, subcontractors, consultants, direct service providers and
volunteers. Consequently, any commitment for employment, purchase of services, or volunteer program participation
shall be contingent upon the passing of a Level II background check. The background screening shall include
employment history checks as provided in s. 435.03(1), F.S., and both local and national criminal record checks
coordinated through law enforcement agencies.
8.1 For purposes of this section, the term "direct service provider" means a person 18 years of age or older who, pursuant
to a program to provide services to the elderly, has direct, face-to-face contact with a client while providing services
to the client or has access to the client's living areas or to the client's funds or personal property. This term includes
coordinators, managers, and supervisors of residential facilities and volunteers.
9. Grievance Procedures
The contractor shall develop and implement, and ensure that its subcontractors have established grievance procedures
to process and resolve client dissatisfaction with or denial of service(s), and address complaints regarding the
termination, suspension or reduction of services, as required for receipt of funds. These procedures, at a minimum,
should provide for notice of the grievance procedure and an opportunity for review of the subcontractor's
determination(s).
10. audits, Inspections. Investigations, Public Records and Retention
10.1 To establish and maintain books, records and documents (including electronic storage media) sufficient to reflect all
income and expenditures of funds provided by the AAA Linder this contract.
3171
.v
January 2011
Contract AA-1129
10.2 To retain all client records, financial records, supporting documents, statistical records, and any other documents
(including electronic storage media) pertinent to this contract for a period of six (6) years after completion of the
contract or longer when required by law. In the event an audit is required by this contract, records shall be retained
for a minimum period of six (6) years after the audit report is issued or until resolution of any audit findings or
litigation based on the terms of this contract, at no additional cost to the AAA.
10.3 Upon demand, at no additional cost to the AAA, the contractor will facilitate the duplication and transfer of any
records or documents during the required retention period in Paragraph 10.2.
10.4 To assure that the records described in Paragraph 10 shall be subject at all reasonable times to inspection, review,
copying, or audit by Federal, State, or other personnel duly authorized by the AAA.
10.5 At all reasonable times for as long as records are maintained, persons duly authorized by the AAA, DQEA and
Federal auditors, pursuant to 45 CFR 92.36(i)(10), shall be allowed full access to and the right to examine any of the
contractor's contracts and related records and documents pertinent to this specific contract, regardless of the form in
which kept.
10.6 To provide a financial and compliance audit to the AAA as specified in this contract and in ATTACHMENT III and
to ensure that all related party transactions are disclosed to the auditor.
10.7 To comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary by
the office of the Inspector General pursuant to s. 20.055, F.S.
it. Nondiscrimination -Civil Rights Compliance
11.1 The contractor will execute assurances in ATTACHMENT VI that it will not discriminate against any person in the
provision of services or benefits under this contract or in employment because of age, race, religion, color, disability,
national origin, marital status or sex in compliance with state and federal law and regulations. The contractor further
assures that all contractors, subcontractors, subgrantees, or others with whom it arranges to provide services or
benefits in connection with any of its programs and activities are not discriminating against clients or employees
because of age, race, religion, color, disability, national origin, marital status or sex.
11.2 The contractor will retain, on file, during the term of this agreement a timely, complete and accurate Civil Rights
Compliance Checklist (ATTACHMENT B).
11.3 The contractor agrees to establish procedures pursuant to federal law to handle complaints of discrimination
involving services or benefits through this contract. These procedures shall include notifying clients, employees, and
participants of the right to file a complaint with the appropriate federal or state entity.
11.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from federal
financial assistance, and are binding upon the contractor, its successors, transferees, and assignees for the period
during which such assistance is provided. The contractor further assures that all subcontractors, vendors, or others
with whom it arranges to provide services or benefits to participants or employees in connection with any of its
programs and activities are not discriminating against those participants or employees in violation of the above
statutes, regulations, guidelines, and standards. In the event of failure to comply, the contractor understands that the
AAA may, at its discretion, seek a court order requiring compliance with the terms of this assurance or seek other
appropriate judicial or administrative relief, including but not limited to, termination of and denial of further
assistance.
12. Provision of Services
The contractor will provide services in the manner described in ATTACHMENT I.
4l71
January 2011 Contract AA-1129
13. Monitoring by the AAA
The contractor will permit persons duly authorized by the AAA to inspect and copy any records, papers, documents,
facilities, goods and services of the contractor which are relevant to this contract, and to interview any clients,
employees and subcontractor employees of the contractor to assure the AAA of the satisfactory performance of the
terms and conditions of this contract. Following such review, the AAA will deliver to the contractor a written report
of its findings and request for development, by the contractor, a corrective action plan where appropriate. The
contractor hereby agrees to timely correct all deficiencies identified in the corrective action plan.
14. Coordinated Monitoriny with Other Agencies
If the contractor receives funding from one or more of the State of Florida other human service agencies, in addition
to the Department of Elder Affairs, then a joint monitoring visit including such other agencies may be scheduled. For
the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human service agencies shall
include the Department of Children and Families, the Department of Health, the Agency for Persons with Disabilities,
the Department of Veterans Affairs, and the Department of Elder Affairs. Upon notification and the subsequent
scheduling of such a visit by the designated agency's lead administrative coordinator, the contractor shall comply and
cooperate with all monitors, inspectors, and/or investigators.
15. Indemnification
The contractor shall indemnify, save, defend, and hold harmless the AAA and its agents and employees from any and
all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the
execution of this agreement or performance of the services provided for herein. It is understood and agreed that the
provider is not required to indemnify the AAA for claims, demands, actions or causes of action arising solely out of
the AAA's negligence.
15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph 15 is not applicable to contracts
executed between the DOEA and state agencies or subdivisions defined in s. 768.28(2), F.S.
16. Insurance and Bonding
16.1 To provide continuous adequate liability insurance coverage during the existence of this contract and any renewal(s)
and extension(s) of it. By execution of this contract, unless it is a state agency or subdivision as defined by subsection
768.28(2), F.S., the contractor accepts full responsibility for identifying and determining the type(s) and extent of
liability insurance necessary to provide reasonable financial protections for the contractor and the clients to be served
under this contract. The limits of coverage under each policy maintained by the contractor do not limit the
contractor's liability and obligations under this contract. The contractor shall ensure that the AAA has the most
current written verification of insurance coverage throughout the term of this contract. Such coverage may be
provided by a self-insurance program established and operating under the laws of the State of Florida. The AAA
reserves the right to require additional insurance as specified in this contract.
16.2 Throughout the term of this agreement, the contractor agrees to maintain an insurance bond from a responsible
commercial insurance company covering all officers, directors, employees and agents of the contractor authorized to
handle funds received or disbursed under all agreements and/or contracts incorporating this contract by reference in
an amount commensurate with the funds handled, the degree of risk as determined by the insurance company and
consistent with good business practices.
17. Confidentiality of Information
The contractor shall not use or disclose any information concerning a recipient of services under this contract for any
purpose prohibited by state or federal law or regulations except with the written consent of a person legally
authorized to give that consent or when authorized by law.
18. Health Insurance Portability and Accountability Act
Where applicable, the contractor will comply with the Health Insurance Portability and Accountability .act (42 USC
1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164).
January 2011
19. Incident Reporting
Contract AA-1129
19.1 The contractor shall notify the AAA immediately, but no later than forty-eight (48) hours from, the contractor's
awareness or discovery of conditions that may materially affect the contractor or subcontractor's ability to perforrr
the services required to be performed under this contract. Such notice shall be made orally to the contract manager (by
telephone) with an email to immediately follow.
19.2 To immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or
disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number (1-800-96ABUSE). As
required by Chapters 39 and 415, F.S., this provision is binding upon both the contractor and its employees.
20. New Contract(s) Reporting
The contractor shall notify the AAA within ten (10) days of entering into a new contract with any of the remaining
four (4) state human service agencies. The notification shall include the following information: (1) contracting state
agency; (2) contract name and number; (3) contract start and end dates; (4) contract amount; (5) contract description
and commodity or service; and (6) contract manager name and number. In complying with this provision, and
pursuant to s. 287.0575, F.S. as amended, the contractor shall complete and provide the information in
ATTACHMENT D.
21. Bankruptcy Notification
If, at any time during the term of this contract, the contractor, its assignees, subcontractors or affiliates files a
claim for bankruptcy, the contractor must immediately notify the AAA Within ten (10) days after notification, the
contractor must also provide the following information to the AAA: (1) the date of filing of the bankruptcy
petition; (2) the case number; (3) the court name and the division in which the petition was filed (e. g., Northern
District of Florida, Tallahassee Division); and, (4) the name, address, and telephone number of the bankruptcy
attorney.
22. Sponsorship and Publicity
22.1 As required by s. 286.25, F.S., if the contractor is a non -governmental organization which sponsors a program
financed wholly or in part by state funds, including any funds obtained through this contract, it shall, in publicizing,
advertising, or describing the sponsorship of the program, state: "Sponsored by (contractor's name), The Alliance for
Aging, and the State of Florida, Department of Elder Affairs." If the sponsorship reference is in written material, the
words "Alliance for Aging" and "State of Florida, Department of Elder Affairs" shall appear in at least the same size
letters or type as the name of the organization.
22.2 The contractor shall not use the words "Alliance for Aging" or "The State of Florida, Department of Elder Affairs" to
indicate sponsorship of a program otherwise financed, unless, specific authorization has been obtained by the AAA
prior to use.
23. Assignments
23.1 The contractor shall not assign the rights and responsibilities under this Contract without the prior written approval of
the AAA, which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring
without prior written approval of the AAA will constitute a material breach of the contract.
23.2 The Alliance shall at all times be entitled to assign or transfer, in whole or part, its rights, duties, or obligations under
this contract to agency, upon giving prior written notice to the contractor. In the event the State of Florida approves
transfer of the Alliance's obligations, the contractor remains responsible for all work performed and all expenses
incurred in connection with the contract.
6/71
January 2011 Contract AA- L}29
23.3 This contract shall remain binding upon the successors in interest of either the contractor or the AAA.
24. Subcontracts
24.1 The contractor is responsible for all work performed and for all oomnnn`dkiey produced pursuant cothis contract and
the service provider application inresponse to the 2009 OAA RFP,whether actually furnished bvthe contractor orits
subcontractors. Any subcontracts ohuU bcevidenced byuwritten document and subject tounyc. udibonuofapproval
the �\/���deems necessary. The contractor further u�r��y,hu��b� ��f\�\ shall not |iob|��oib� subcontractor in any
way nrfor any reason. The contractor, utits expense, will defend the AAA against any such claims.
24.8 The contractor sbu| promptly pay any subcontractors upon receipt of payment from the department or ode/
sponsoring o�enoy. Failure to make payments to any Subcontractor in accordance with o. 287.0585. F.S., unless
udhenvimc stated iothe contract between the contractor and subcontractor, will result in a penalty as provided by
25. Independent Capacity of Contracto
It is the /oicnt and understanding of the parties that the oontruotor, or any of its subcontractors, are independent
contractors and are not employees o[the AAA and shall not hold themselves out ooemployees oragents ofthe AAA
without specific authorization from the AAA. It is the further intent and understanding of the parties that the AAA
does not control the employment practices of the contractor and shall not be !iub|c for any wage and hour,
cnop|oynneot diuchmninudon, or other labor and employment claims against the contractor or its subcontractors. All
deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds
and all necessary insurance for the contractor shall be the sole responsibility of the contractor.
26. Paymen
Payments will be made tothe contractor pursuant kzx. 215.422, F.S.,uaservices are rendered and invoiced by the
contractor. The AAA's Contract Manager will have final approval of the invoice for payment, and will approve the
invoice for payment only if the contractor has met all terms and conditions of the contract, unless the bid
spcciOoudnna` punobuxe order, or this contract specify otherwise. The approved invoice will be submitted to the
AAA's fiscal section for budgetary approval and processing. Disputes arising over invoicing and payments will be
resolved inaccordance with the provisions ofu.2}5422F.S.
27. Return of Funds
The contractor will return k)the AAA any overpayments due to unearned funds orfunds disallowed and any interest
attributable tmsuch funds pursuant to the terms and conditions of this contract that were disbursed to the contractor by
the AAA. In the event that the contractor or its independent auditor discovers that an overpayment has been ooude,
the contractor mba|| repay said overpayment immediately without prior notification from the AAA. In the event that
the AAA first discovers an overpayment has been made, the Contract Munugor, on behalf ofthe AAA, will notify the
contractor by letter of such findings. Should repayment not be made forthwith, the contractor will be charged ' the
|u*fu| cu(c of interest on the outstanding balance pursuant to s. 55.03, F.S.. after AAA notification or contractor
discovery.
28. Data Integrity and Safeguarding Information
The contractor emu| insure an appropriate level of data Security for the information the contractor is collecting or
using in the performance of this contract. An appropriate level of security includes approving and zcackin� all
� conaobzrcmp|oycesdhx1ocquenLsyyicmocinfonnucimnocoeoyandenau�ng that user access has been ccmnovcd[rnnn
all terminated employees. The contractor. among other rcguircmcnCu, moot anticipate and prepare for the loss of
information processing capabilities. All data and software must be routinely backed Lip to insure recovery from losses
or outages of the computer system. The security over the backed -up data is to be as stringent as the protection
required of the prinnmry mys|c/nm. The contractor shall insure all Subcontractors maintain written procedures for
computer system hack upand recovery. The contractor shall complete and sign /k1[l[ACHIM|EN1[ IV prior to the
execution of this contract.
0
E
January 2011
29. Computer Use and Social Media Policy
Contract AA- 1l29
30. Conflict of Interest
The contractor will establish safeguards to prohibit employees, board uennbeo, management and Subcontractors from
using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of
iubzvcmt or pccoonu| gain. No emp|oyec, officer or azcnL of the contractor or subcontractor shall participate in
se|eotion, or in the award of an agreement supported by State or Federal funds if conflict of interest, real or
apparent, would hcinvolved, Such aconflict would arise when: (u)the employee, officer ocagent; (b)any member of
his/her immediate family-, (o) his orher partner, or (d)auorganization which employs, orivabout to employ, any of
the uhovr, has u financial or other intcccuL in the [inn on|euhod for award. The contractor or subcontractor's of6cers,
employees or ogcuix will neither solicit nor accept grutuitieo, tovoco or anything of monetary value from contractors,
poCcndu| contractors, or parties to subcontracts. The contractor's board members and management must disclose to
the AAA any relationship which may he, or may be perceived to he, uconflict ofinterest within thirty (30)co|endor
days of an individua|`x original appointment or placement in that position, or if the individual is serving as an
inoumhent, within thirty (30) calendar days of the commencement of this contract. The contractor's employees and
subcontractors must make the munnc disclosures described above to the contractor's board ofdirectors. Compliance
with this provision will be monitored.
38. Public Entity Crime
Pursuant toa.2O7./33,F.5,the following restrictions are placed onthe ability ofpersons convicted ofpublic entity
crimes to transact business with the AAA. /\ person or affiliate who has been placed on the convicted vendor list
following uoonvktkon for public entity crime may not submit u hid, proposal, or reply on u contract to provide any
goods orservices toupublic entity, may not submit ubid, proposal, or reply onucontract with upublic entity for the
construction orrepair ofu public building or public work; may not submit bido, proposals, or replies on |cuxeu of real
property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant
undcr u contract with my public entity; and may not Lrunnuot business with any public entity in excess of the
threshold amount provided ino.2878|7.F.S..for CATEGORY TWO for aperiod of3hmonths following the date of
being placed onthe convicted vendor list.
32.8 To procure any recycled products or materials, which are the subject of or are required to carry out this contract, in
accordance with the provisions of s. 403.7065, F.S.
33. Patents, Copyrights, Royalties
If any discovery, invention oroopyrightab|e nnatcha| is developed or produced in the course of or as u result of work
or services performed under this contract, the contractor shall refer the diocovery, invention or mutcdu| to the AAA to
be referred to the Department ofState. Any and all patent rights or copyrights accruing under this contract are hereby
rcacr°cd to the 8/o/e of Florida in accordance with CbupiccZDb. F.S. Pursuant to x. 207.0571 (5) (k) | and 2 as
amended, the only exceptions /n this provimion mhu|| be those that are clearly expressed and ccusonuh|y valued in the
33.0 If the primary purpose of this contract is the creation of intellectual pmpc¢y, the state xhuU retain an unencumbered
right to use such property., notwithstanding any agreement made Pursuant to Paragraph 33.
34. Ernergenev Preparedness and Confirmitv of Operations
34.1 If the tasks to he performed Pursuant to this contract, include the physical care and om|m| of clients, or the
January 2011
Contract AA-1129
thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of an
emergency preparedness plan. In the event of an emergency, the contractor shall notify the AAA of emergency
provisions.
34.2 In the event, a situation results in a cessation of services by a subcontractor, the contractor will retain responsibility
for performance under this contract and must follow procedures to ensure continuity of operations without
interruption.
35. PUR 1000 Form
The PUR 1000 Form is hereby incorporated by reference. In the event of any conflict between the PUR 1000 Form
and any terms or conditions of this contract the terms or conditions of this contract shall take precedence over the
PUR 1000 Form. However, if the conflicting terms or conditions in the PUR 1000 Form are required by any section
of the Florida Statutes, the terms or conditions contained in the PUR 1000 Form shall take precedence.
36. Use of State Funds to Purchase or Improve Real Property
Any state funds provided for the purchase of or improvements to real property are contingent upon the contractor or
political subdivision granting to the state a security interest in the property at least to the amount of state funds
provided for at least 5 years from the date of purchase or the completion of the improvements or as further required
by law.
37. Dispute Resolution
Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce the
decision to writing and serve a copy on the contractor.
38. Financial Consequences of Non -Performance
If the contractor fails to meet the minimum level of service or performance identified in this agreement, or that is
customary for the industry, then the AAA must apply financial consequences commensurate with the deficiency.
Financial consequences may include but are not limited to contract suspension, refusing payment, withholding
payments until deficiency is cured, tendering only partial payments, and/or cancellation of contract and reacquiring
services from an alternate source.
38.1 The contractor shall not be charged with financial consequences, when a failure to perform arises out of causes that
were the responsibility of the AAA.
39. No Waiver of Sovereign Immunity
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which
sovereign immunity may be applicable.
40. Venue
If any dispute arises out of this contract, the venue of such legal recourse will be Miami -Dade County, Florida.
41. Entire Contract
This contract contains all the terms and conditions agreed upon by the parties. No oral agreements or representations
shall be valid or binding upon the AAA or the contractor unless expressly contained herein or by a written
amendment to this contract signed by both parties.
42. Force XIaieure
Neither party shall be liable for any delays or failures in performance due to circumstances beyond its control,
provided the party experiencing the force majeure condition provides immediate written notification to the other party
and takes all reasonable efforts to cure the condition.
43. Severability Clause
Um
Contract AA-1129
January 2011
The parties agree that if a court of competent jurisdiction deems any term or condition herein void or unenforceable,
the other provisions are severable to that void provision and shall remain in full force and effect.
44. Condition Precedent to Contract: Appropriations
The parties agree that the AAA's performance and obligation to pay under this contract is contingent upon an annual
appropriation by the Legislature to DOEA.
45. Addition/Deletion
The parties agree that the AAA reserves the right to add or to delete any of the services required under this contract
when deemed to be in the PSA's best interest and reduced to a written amendment signed by both parties. The parties
shall negotiate compensation for any additional services added.
46. Waiver
The delay or failure by the AAA to exercise or enforce any of its rights under this contract shall not constitute or be
deemed a waiver of the AAA's right thereafter to enforce those rights, nor shall any single or partial exercise of any
such right preclude any other or further exercise thereof or the exercise of any other right.
47. Compliance
The contractor agrees to abide by all applicable current federal statutes, laws, rules and regulations as well as
applicable current State statutes, laws, rules and regulations. The parties agree that failure of the contractor to abide
by these laws shall be deemed an event of default of the contractor, and subject the contract to immediate, unilateral
cancellation of the contract at the discretion of the AAA.
48. Final Invoice
The contractor shall submit the final invoice for payment to the AAA as specified in Paragraph 3.3.4. (date for final
request for payment) of ATTACHMENT I. If the contractor fails to submit final request for payment by the
deadline, then all rights to payment may be forfeited and the AAA may not honor any requests submitted after the
aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from
the contractor and necessary adjustments thereto have been approved by the AAA.
49. Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly
signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price
level increases and changes in the rate of payment when these have been established through the appropriations
process and subsequently identified in the AAA's operating budget.
50. Termination
50.1 This contract may be terminated by either party without cause upon no less than thirty (30) calendar days notice in
writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice shall be delivered by
L.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the
Contract Manager or the representative of the contractor responsible for administration of the contract.
50.2 In the event funds for payment pursuant to this contract become unavailable, the AAA may terminate this contract
upon no less than twenty-four (24) hours notice in writing to the contractor. Said notice shall be delivered by UJ S.
Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the
Contract Manager or the representative of the contractor responsible for administration of the contract. The AAA
shall be the final authority as to the availability and adequacy of funds. In the event of termination of this contract,
the contractor will be compensated for any work satisfactorily completed prior to the date of termination.
50.3 This contract may be terminated for cause upon no less than twenty-four (24) hours notice in writing to the
contractor. If applicable, the AAA may employ the default provisions in Rule 60A-1.006(3), F.A.C. Waiver of
10171
E
E
January 2011
Contract AA- 1129
11.11t%, o any provisions of this contract snail not be deemed to be a waiver of any other breach and shall not be
construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit the
AAA's or the contractor's rights to remedies at law or in equity.
50.4 Failure to have performed any contractual obligations with the AAA in a manner satisfactory to the AAA will be a
Sufficient cause for termination. To be terminated as a contractor under this provision, the contractor must have (I)
previously failed to satisfactorily perform in a contract with the AAA, been notified by the AAA of the unsatisfactory
performance and failed to correct the unsatisfactory performance to the satisfaction of the AAA; or (2) had a contract
terminated by the AAA for cause.
51. Official Payee and Representatives (Names, Addresses, and Telephone Numbers):
The contractor name, as shown on page I of this
Monroe County Board of County Commissioners Nutrition
a.
contract, and mailing address of the official payee to
and In -Home Services Programs
whom the payment shall be made is:
1100 Simonton Street Rm 2-257
Key West, FL 33040
The name of the contact person and street address
Sheryl Graham, Director , Monroe County Social Services
b.
where financial and administrative records are
I 100 Simonton Street, Rm. 2-257
maintained is:
Key West, FL 33040
305-292-4510
C.
The name, address, and telephone number of the
Sheryl Graham, Director. Monroe County Social Services
representative of the contractor responsible for
I 100 Simonton Street, Rm. 2-257
administration of the program under this contract is:
Key West, FL 33040
305-292-4510
d-
The section and location within the AAA where
Anthony Coombs, Associate Vice President
Requests for Payment and Receipt and Expenditure
760 NW 107th Avenue, Suite 201 and 214
forms are to be mailed is:
Miami, Florida 33172
e.
The name, address, and telephone number of the
AAA Contract Manager (MARIA SCOTTO)
Contract Manager for the AAA for this contract is:
Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in
writing to the other party and the notification attached to the originals of this contract.
11/71
Im
January 2011
Contract AA-1129
52. All Terms and Conditions Included
This contract and its Attachments, I — X, A, B, D, E and F, and any exhibits referenced in said attachments, together
with any documents incorporated by reference, contain all the terms and conditions agreed upon by the parties. There
are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede
all previous communications, representations or agreements, either written or verbal between the parties.
By signing this contract, the parties agree that they have read and agree to the entire contract.
IN WITNESS THEREOF, the parties hereto have caused this 63 page contract, to be executed by their undersigned officials as
duly authorized.
Contractor Monroe County Social Services.
S IGNE
Rwuw
TITLE: Mayor
DATE:-- 12-15-2010
N
,GE CIER<
ALLIANCE FOR AGING, INC.
SIGNED BY: --"ZZ' .
NAME: MAX B. ROTHMAN
TITLE: PRESIDENT AND CEO
DATE:
AS
—PEDRO J. lT"
ASSIST N�Y ATTO`NEY
12171
■
IN
January 2011
ATTACHMENT
ATTACHMENT I
ATTACHMENT 11
ATTACHMENT III
ATTACHMENT III
EXHIBIT I
ATTACHMENT III
EXHIBIT'.)
ATTACHMENT' IV
ATTACHMENT V
ATTACHMENT VI
ATTACHMENT V II
ATTACHMENT
V III
ATTACHMENT IX
ATTACHMENT X,
EXHIBIT 2
ATTACHMENT X,
EXHIBIT 3
ATTACHMENT A
ATTACHMENT B
ATTACHMENT F,
EXHIBIT I
ATTACHMENT F,
EXHIBIT 2
ATTACHMENT G
INDEX TO CONTRACT ATTACHMENTS
i
Contract AA-1129
PAGE
STATEMENT OF WORK
CERTIFICATION REGARDING LOBBYING
FINANCIAL COMPLIANCE AUDIT ATTACHMENT
FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT
AUDIT REPLATIONSHIP DETERMINATION
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
INELIGIBILITY AND VOLUNTARY EXCLUSION
CONTRACTS/SUBCONTRACTS
ASSURANCES — NON -CONSTRUCTION PROGRAMS
CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE
OLDER AMERICANS ACT CONTRACT REPORT CALENDAR
REQUEST FOR PAYMENT
RECEIPTS AND EXPENDITURES, TITLE IIIB, IIIC 1, AND IIIC2
RECEIPTS AND EXPENDITURES, TITLE IIIE
DEPARTMENT OF ELDER AFFAIRS' PROGRAMS & SERVICES
HANDBOOK (ON CD)
DEPARTMENT OF ELDER AFFAIRS' CIVIL, RIGHTS COMPLIANCE
CHECKLIST AND INSTRUCTIONS
DOEA COST ANALYSIS FOR NON -COMPETITIVELY PROCURED
CONTRACTS IN EXCESS OF CATEGORY II
INSTRUCTIONS: DOEA COST ANALYSIS FOR NON -COMPETITIVELY
PROCURED CONTRACTS IN EXCESS OF CATEGORY II
ARC POLICY AND PROCEDURES FOR OUTSOURCED FUNCTIONS
15-27
29
31-33
35
37
39
41
43-44
45
47
49
51
53
55
57-62
63
65
67-71
II
E
January 2011
Contract AA- 1129
14t / I
E
M
January 2011
ALLIANCE FOR AGING, INC.
STATEMENT OF WORK
OLDER AMERICANS ACT PROGRAM TITLE III
SECTION 1: SERVICES TO BE PROVIDED
1.1 DEFINITIONS OF TERMS AND ACRONYMS
1.1.1 CONTRACT ACRONYMS
ADL — Activities of Daily Living
APS — Adult Protective Services
AIRS — Alliance of Information & Referral Systems
ADA — Americans with Disabilities Act
AAA — Area Agency on Aging
APCL — Assessed Priority Consumer List
CIRTS — Client Information and Registration Tracking System
FLAIRS — Florida Alliance of Information and Referral Services
I&R — Information and Referral
IADL — Instrumental Activities of Daily Living
MOA — Memorandum of Agreement
MOU — Memorandum of Understanding
OAA —Older Americans Act
PSAs — Planning and Service Areas
WebDB — Web -based Database System
Contract AA- 1129
ATTACHMENT I
1.1.2 PROGRAM SPECIFIC TERMS
Area Plan: A plan developed by the area agency on aging outlining a comprehensive and coordinated service delivery
system in its planning and service area in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act
and department instructions.
Area Plan Update: A revision to the area plan wherein the area agency on aging enters OAA specific data in the
web -based database system (WebDB). An update may also include other revisions to the area plan as instructed by
the department.
Child: An individual who is not more than 18 years of age or an individual with disability.
Family Caregiver: An adult family member, or another individual, who is an informal provider of in -home and
community care to an older individual.
Frail: When an older individual is unable to perform at least two activities of daily living (ADL) without substantial
human assistance, including verbal reminding, physical cueing or supervision; or due to cognitive or other mental
impairment, requires substantial Supervision because the individual behaves in a manner that poses a serious health
or safety hazard to the individual or to another individual.
Grandparent: A grandparent or step -grandparent of a child, or a relative of a child by blood, marriage or adoption
and who lives with the child; is the primary caregiver of the child because the biological or adoptive parents are
unable or unwilling to serve as the primary caregiver of the child: and has a legal relationship to the child, such as
legal custody or guardianship, or is raising the child informally,
Z71 -
15/71
E
E
}auuary20|l
1.2
Contract AA-|}Z4
Alliance for Aging Mission
--'
The Alliance For Auring,Inc. mission idkzpromote and advocate for the optimal quality oflife for older adults and
their families.
1.2.1 DOEA IN8ismio�n8tmtemneot
The department's mission iuUzfoster aooptimal quality o[life for elder Floridians. The department's vision and
shared values are to foster a social, economic and intellectual environment for all ages, and especially those age 60
and older, wbroc all can enjoy Florida's unparalleled uoocoi|icu in order iothrive and prosper. Area agencies, |cud
agencies and local service providers as partners and stakeholders in Florida's aging services network are expected
tosupport the drpurtmenC'omission, vision, and program priorities.
8�.2 Older Americans Act Program TMisaion Statement
The Older Americans Act ({)AA)Program is [cdoru| program initiative that provides assistance hnolder persons
and caregivers and is the only fe&4 supportive services program directed solely toward impnoving the lives of
older people. The program provides u framework for u partnership urnnng the different |evc|a of government and
the public and private sectors with u common objective, improving the quality of life for all older individuals by
helping tbcno to remain independent and productive.
1^3 GENERAL DESCRIPTION
General Statement
The primary purpose of the OAA program is to foster the development and implementation of comprehensive and
coordinated systems k» serve older individuals. The [)/\Aprogram umrn these systems toassist older individuals to
uLtuiu and maintain maximum independence and dignity in u home environment and u||owo for the capability of
self -care with appropriate supportive services.
1.3.2 Authority
The relevant references authority governing the OAAprogram are:
(1) Older Americans Act of2U06.uaamended;
(2) Rule 5QA-|.Florida Administrative Code; and
(3) Section 430./0/,Florida Statutes.
1-3.2,8 Incorporation oyReference Memoranda
In accordance with Ch. 287 F.S, as amended and Department of Financial Services, Chief Financial Officer
Memoruoda, the following memoranda are provided for informational purposes and incorporated by reteu:ouz:
(1) CFO Memo No. U2:Release date, August 2O,20|O;
(2) CFO Memo No. O3:Release date, June 2g.2O|0;and
(3) CFO Memo No. OA: Release date, June 30.20|Q.
1.3.3 Scope uyService
The contractor is responsible for the activities }imbcd in this Appendix, Sections /ood U and Appendix {}, and ahu||
be delivered in keeping with the in Provider Service Application in ncnpnnye to the 2009 U/\/\ HlP. The services
shall be provided in u manner consistent with and described in the current Department of Elder Affairs Programs
and Services Handbook (ATTACHMENT A).
1^3'4 Ma&r Proeram Goals
The major goals of the ()AA program are to improve the quality of |i�� for older individuals, preserve their
independence and prevent or delay more costly institutional cone. These goals are achieved through the
implementation of comprehensive and coordinated service system that provides urondnuum of service alternatives
MW
January 2011 Contract A: �-1129
1.4 INDIVIDUALS TO BE SERVED
1.4.1 Eligibility (Title III Programs)
1.4.1.1 OAA Title III, General
Consumers shall not be dually enrolled in an OAA program and a Medicaid capitated long-term care program.
1.4.1.2 OAA Title II113, Supportive Services
(1) Individuals age 60 or older; and
(2) Information and Referral/Assistance services are provided to individuals regardless of age.
1.4.1.3 OAA Titles IIICI and C2, Nutrition Services, General
General factors that should be considered in establishing priority for Nutrition Services, both Cl and C2, include
those older persons who:
(1) Cannot afford to eat adequately;
(2) Lack the skills or knowledge to select and prepare nourishing and well-balanced meals;
(3) Have limited mobility which may impair their capacity to shop and cook for themselves; or
(4) Have a disabling illness or physical condition requiring nutritional support or have been screened at a high
nutritional risk.
1.4.1.3.1 OAA Title IIICI, Congregate Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in ATTACHMENT I,
Paragraph 1.4.1.3 individuals must be mobile, not homebound and physically, mentally and medically able to
attend a congregate nutrition program. Individuals eligible to receive congregate meals include:
(1) Individuals age 60 or older; and
(2) Any spouse (regardless of age) who attends the dining center with his/her eligible spouse;
(3) Persons with a disability, regardless of age, who reside in a housing facility occupied primarily by older
individuals where congregate nutrition services are provided;
(4) Disabled persons who reside at home with and accompany an eligible person to the dining center; and
(5) Volunteers, regardless of age, who provide essential services on a regular basis during meal hours.
1.4.1.3.2 OAA Title HIC2, Home Delivered Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in ATTACHMENT I,
Paragraph 1.4.1.3, individuals must be homebound and physically, mentally or medically unable to attend a
congregate nutrition program. Individuals eligible to receive home delivered meals include:
(1) Individuals age 60 or older who are homebound by reason of illness, disability or isolation;
(2) The spouse of a homebound eligible individual, regardless of age, if the provision of the collateral meal
supports maintaining the person at home;
(3) Individuals with disabilities, regardless of age, who reside at home with eligible individuals and are dependent
on them for care; and
(4) Persons at nutritional risk who have physical, emotional or behavioral conditions, which would make their
presence at the congregate site inappropriate; and persons at nutritional risk who are socially or otherwise
isolated and unable to attend a congregate nutrition site.
1.4.1.4 OAA Title IIIE, Caregiver Support Services
17/7 I
January 2011
Cnu([uct AA-ll24
(K) Family caregivers ofindividuals age d0nrolder;
(2) Grandparents (age 55 o,older) orolder individuals (age 55 or older) who are relative caregivers;
(3) Priority will be given to family caregivers who provide cure for individuals with Alzbeimec`a disease and
rcimicd disorders with neurological and organic brain dysfunction and for grandparents or older individuals
who are no|udrc caregivers who provide care for children with severe disabilities-, and
AU For respite and uuooeoxeokz| services, o family caregiver must be pnovidin� care for an older individualwho
meets the definition of the term "frail" in OAA, Section 102 Paragraph 22.
1.4.2 Targeted Groups
Pn:Krrcncr shall be given to those with the grcu1coL economic and social need. with particular attention to low-
income older individuals, including those that are low-income minorities, have limited English pnnhcionoy, and
older individuals residing inrural areas.
'
SECTION 88—MANNER OBrSERVICE PROVISION
2.1 SERVICE TASKS
{uorder |oachieve the goals of the OAA program, the contractor shall ensure the following tasks are performed:
(0 Client eligibility determination;
(2) Targeting and screening ofservice delivery for new clients;
(3) Delivery o[services toeligible clients;
(4) Use ofvolunteers toexpand the provision ofavailable services;
(5) Monitoring the performance ofits subcontractors; and
(#) Information and Referral/Assistance Access Services (Elder 8e|p|ineo).
2,8.8 Client Eligibility Determination us|ixtedinATTACHMENT 1,Paragraph 8.4.
2^8.2 Targeting and Screening of Service Delivery for New Clients
The contractor shall develop and implement policies and procedures consistent with ()AA targeting and screening
2.8.3 Delivery of Services to Eligible Clients
The contractor shall provide a continuum of services that meets the diverse needs of elders and their caregivers. The
contractor shall perform and report�dond
monc� of following services in accordance ATTACHMENT `"
u oc with ��������— A
The services funded pursuant tothis contract are in accordance with the ()f\A.Title 111, sections 32| 3313a373 as follows:
n.
(U) Section 32l.Title DIB Supportive Services;
(2) Section 33|,Title RIC|Congregate Nutrition Services;
(3) Section ]30.Title |IIC2Home Delivered Nutrition Services;
(4) Section J73.Title JTDBCaregiver Support Services; and
(5) Sections 321 and 373 — Information and Referral/Assistance Access Services (Elder Helplines)
l8/7l
January 2O\l �~
Contract AA- )l2g
2,1.3.1 Supportive Services
Supportive services include uvariety ofcommunity-based and home -delivered services that support the quality ot
life for older individuals by helping ibenu oomuiu independent and productive. Services include the following:
(1) Adult Day Care/Adult Day Health Cuoc� (8) l~e-u} Assistance,
(2) Caregiver Train ing/Suppnri; (9) Material Aid;
(3) CaocAid/[uxe Management; (10) Occupational Therapy;
(4) Chore Services; (UU) Outreach;
(5) Companionship; (12) Personal Care;
(6) Counseling (Gerontological and Mental (83) Physical Therapy;
Health);
(7) Education/Training; (14) Recreation;
(05) Emergency AlertResponse; (24) Referral/Assistance;
(16) Escort; (25) Respite Services;
(17) Health Support; (26) 3cccenina/Aooconnncot;
(XN) Home Health Aid; (27) Shopping Assistance;
(89) l{onncmukcr; (28) Skilled Nursing;
(20) Housing Improvement; (29) Specialized Medical Equipment, Services, and
21) Information; Supplies
(22) Intake; (30) Speech Therapy;
(23) Interpreter/Translating; (31) Telephone Reassurance; and
(32) Transportation
2^1.3,2 Congregate Nutrition Services
Nutrition services are provided in congregate settings and are designed to reduce hunger and food ioxecudty,
promote socialization and the hcu|dh and �|| being of older individuals by assisting them to gain uoocox to nutrition
'
and other disease prevention and health promotion services. Services include:
(X) Congregate meals;
(2) Congregate meals screening;
(3) Nutrition education and nutrition Counseling; and
NU Outreach.
2.1.3.3 Home Delivered Nutrition Services
In -home nutrition services are provided to reduce hunger and food insecurity; promote socialization and the health
and well bein- of older individuals by assisting such individuu|y to aoin access to nutrition and other disease
prevention and health promotion services. Services Include:
(1) Home delivered meals;
(2) Nutrition education and counseling; and
(3) Outreach.
2L1-3.4 Caregiver Support Services (HIE )
The following services are intended to provide direct help to caregivers. assist Io the areas of health, nutrition and
financial literacy and assist caregivers in making decisions and problem solving nz|akxl to their caregiving roles and
MW
January 2011
2.1.5
Contract AA- l|2V
Monitoring the Perf»rommmco*f Subcontractors
--'
The contractor shall conduct at least one monitoring per year of each subcontractor. The contractor shall perform
docoi administrative and programmatic monitoring of each subcontractors to euxunc contractual comp|iuoce. Oocu/
uccoun(abi|ity, programmatic performance, and compliance with applicable state and federal laws and nc�u|ations.
2L1.5.1 Use of Subcontractors
If this contract involves the use of a subcontractor or third purty, then the contractor ahuU not delay the
implementation of its a�rcemcuC with the subcontractor. {fany circumstances occur that may ncuu|t in a delay for u
period of0O days or more of the initiation of the subcontract or in the performance of the subcootructor, the
contractor uba|| notify the AAA's Contract Manager and the AAA's Chief Financial Officer in writing of oucb
The contractor yhuU not permit u subcontractor to perform services pchLed to this agreement without having u
binding subcontractor agreement executed. In accordance withParagraph 24.1 of the StandardStandardAgreement,Agreement,the
&/���will not bcresponsible orliable for any obligations orclaims resulting from such action. �
2.2 SERVICE LOCATION AND EQUIPMENT
2.2.1 Service Times
The contractor shall ensure the provision of the services listed in the contract during oornxz| business hours unless
other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its
subcontractors to couun: they are available to provide services during hours responsive to client needs and during
those times which best meet the needs ofthe relevant service community.
2.3 Equipment
2.3.1 Equipment means: (a) an article of nonexpendable, tangible personal property having o useful |ih: of more than one
year and an acquisition rouL which cguu|o or exceeds the |cmaer of the capitalization level established by the
organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); noncxpendub|e, tangible
personal property of a nonconsumable nature with an acquisition cost of $1,000.00 or more per unit, and expected
useful |ih: of at |cout one year; and hardback bound books not circulated to students or the general pub|ic, with a
value o,cost of $250.O0ormore [for state funds }.
2.3.2 Contractors and sub -contractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations yhuU have written property management standards in compliance with 2 CFR Part 215
Administrative Requirements (formerly OMB Cirru|acA-| 10) that include: (u) m property list with all the elements
identified in the circular; and, (b) u procedure for conducting a physical inventory of equipment at |canL once every
two years. The property records must be maintained on file and shall be provided to the AAA upon request.
2.3.3 The contractor's property management standards for equipment acquired with Federal funds and federally -owned
equipment shall include accurately maintained equipment records with the following information:
(N Adescription ofthe equipment;
(2) Manufacturer's serial number, model numhcr. Federal suck number, nuhnno| stock number, or other
identification number;
(3) Source ofthe equipment. inckudingdeawmrdnumbcr
(4) Whether title vests iuthe contractor mthe Federal Government;
(5) Acquisition date (or date received, if the equipment was furnished by the Federal Government) and cost,
(6) Uofbrnunkon born which one can calculate the percentage of Federal participation in the cost of the equipment
2)/7\
January 2011
(not applicable to equipment furnished by the Federal Government); Contract AA-1 I29
(7) Location and condition of the equipment and the date the information was reported,
(8) Unit acquisition cost; and
(9) Ultimate disposition data, including date of disposal and sales price or the method used to determine current
fair market value where a contractor compensates the Federal awarding agency for its share.
2.3.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased witl
state funds with an acquisition cost over $1,000.00 that is specifically identified in the area plan approved by DOErA
is part of the cost of carrying out the activities and functions of the grant awards and Title (ownership) will vest it
the contractor, subject to the conditions of 2 CFR Part 215 Administrative Requirements (formerly OMB Circular
A -I 10), Subpart C, Paragraph 34. Equipment purchased under these thresholds is considered supplies and is not
subject to property standards. Equipment purchased with funds identified in the budget attachments to agreements
covered by this contract, or identified in the sub -agreements with sub -contractors (not included in a cost
methodology), is subject to the conditions of Chapter 273, F. S. and 60A-1.0017, F. A. C. or Title 45 CFR Part 74.
2.3.5 The contractor shall not dispose of any equipment or materials provided by the AAA, or purchased with funds
provided through this contract without first obtaining the approval of the AAA's Contract Manager. When
disposing of property or equipment the contractor must submit a written request for disposition instructions to the
respective Contract Manager. The request should include a brief description of the property, purchase price,
funding source, percentage of state or federal participation, acquisition date and condition of the property. The
request should also indicate the contractor's proposed disposition (i.e., transfer or donation to another agency that
administers federal programs, offer the items for sale, destroy the items, etc.).
2.3.6 The AAA's Contract Manager will issue disposition instructions. If disposition instructions are not received within
120 days of the written request for disposition, the contractor is authorized to proceed as directed in 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A-110).
2.3.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered under this contract without the prior approval of the DOEA. Real property purchases
from Older Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III, Part A., Sec.
3030b United States Code (USC). Real property purchases from state funds can only be made through a fixed
capital outlay grants and aids appropriation and therefore are subject to the provisions of s. 216.348, F. S.
2.3.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior to
disposal to ensure no confidential information remains.
January 2011 Contract AA-1129
2.4 DELIVERABLES
2.4.1 Service Unit
The contractor shall provide the services described in the contract in accordance with ATTACHMENT A. The
chart below lists the services that can be performed and the unit of measurement.
Adult Day Care/Adult Day Health Care
Caregiver Training/Support
Case Aid/Case Management
Child Day Care
Chore Services
Companionship
Congregate Meals Screening
Counseling Services
Escort
Financial Risk Reduction Services
Health Support
Home Health Aide
Homemaker
Housing Improvement
Intake
Emergency Alert Response
Interpreter/rranslating
Legal Assistance
Medication Management
Mental Health Counseling/Screening
Nutrition Counseling
Occupational Therapy
Personal Care
Physical Therapy
Recreation
Respite Services
Screening/Assessment
Sitter
Skilled Nursing Services
Speech Therapy
Education/Training
Information
Material Aid
Nutrition Education
Outreach
Referral/Assistance
Specialized Medical Equipment, Services and Supplies
Telephone Reassurance
Escort
Shopping Assistance
Transportation
Congregate and Home Delivered Meals
Hour
Day
Episode
One -Way Trip
Meal
2.5 REPORTS
The contractor is responsible for responding in a timely fashion to additional routine and/or special requests for
information and reports required by the AAA.
2.5.1 Service Costs Reports
The contractors shall submit to the AAA semi-annual service cost reports, which reflect actual costs of providing
each service by program. This report provides information for planning and negotiating unit rates.
23/71
January 2011
Contract AA- 1129
2.5.2 Surplus/Deficit Report
The contractor will submit a consolidated surplus/deficit report in a format provided by the AAA to the AAA's
Contract Manager by the 15th of each month. This report is for all agreements and/or contracts between tht
contractor and the AAA. The report shall include the following:
(1) A list of all subcontractors and their current status regarding surplus/deficit;
(2) The contractor's detailed plan on how the surplus/deficit spending exceeding the threshold specified by the
AAA will be resolved;
(3) Recommendations to transfer funds to resolve surplus/deficit spending;
(4) Input from the contractor's Board of Directors on resolution of spending issues, if applicable
(5) Number of clients Currently on Assessed Priority Consumer List (APCL) that receive a priority ranking score
of 4 or 5; and
(6) Number of clients currently on the APCL designated as Imminent Risk.
(7) Number of contacts including walk-ins, calls, emails or faxes as related to outsourced ARC functions.
2.5.3 DOEA Cost Analysis For Non -Competitively Procured Contracts In Excess of Category II
In compliance with State of Florida Chief Financial Officer Memorandum No. 03 (released June 29, 2010), the
contractor will submit a completed DOEA Cost Analysis For Non -Competitively Procured Contracts In Excess of
Category II identified as Attachment F, Exhibit 1 within 30 days of contract execution. Instructions for completing
the form are identified as Attachment F, Exhibit 2.
2.6 RECORDS AND DOCUMENTATION
The contractor will ensure the accurate collection and maintenance of client and service information on a monthly
basis from the CIRTS or any such system designated by the AAA. Maintenance includes valid exports and backups
of all data and systems according to AAA standards.
2.6.1 Each contractor and subcontractor, among other requirements, must anticipate and prepare for the loss of
information processing capabilities. The contractor shall maintain written policies and procedures for computer
system backup and recovery and shall have the same requirement in its contracts and/or agreements with
subcontractors. These policies and procedures shall be made available to the AAA upon request.
2.7 PERFORMANCE SPECIFICATIONS
2.7.1 Outcomes
(1) The contractor shall timely submit to the AAA all reports described in ATTACHMENT I, Paragraph 2.5
REPORTS;
(2) The contractor shall timely submit to the AAA. all information described in ATTACHMENT 1, Paragraph
2.6 RECORDS AND DOCUMENTATION;
(3) The contractor shall ensure services in this contract are in accordance with ATTACHMENT A.
2.7.2 The performance of the contractor in providing the services described in this contract shall be measured by the
Current Area Plan strategies for the following criteria:
(1) Percent of most frail elders who remain at home or in the community instead of going into a nursing home;
(2) Percent of Adult Protective Services (APS) referrals who are in need of immediate services to prevent further
harm who are served within 72 hours;
24/71
N
N
January 2011
Cnukuo��-i|7o
�U n�ond�b savings per consumer kv home and i ----'- ' ^~-~
^^.~..�� ' ".su conunnun[y'�au�4 oorc nzcmu� nursing home care [n/
comparable client groups;
HA Percent of elders assessed with high or moderate risk environments who improved their environment score;
(5) Percent of new service recipients with high -risk nutrition scores whose nutritional status improved;
(#) Percent of new service recipients whose ADL assessment score has been maintained or improved;
(7) Pc/ccoi of new uocvioc recipients whose [AIJL auucmanzcot score has been maintained or improved;
(0) Percent mffamily and family -assisted caregivers who self -report they are very likely Loprovide care;
(9) Percent of caregivers vvbmmc ability to continue to provide oamp is maintained or improved after one year of
service intervention (am determined by the caregiver and the uoxcuuo,); and
(10)Penc«uL of customers who are at imminent risk of nursing home placement who are ucrrrd with community
based services.
(81) Any other outcome mrusun:m as |io|cd in the Provider's Service Application in response to the 2009 (}A}\ RFP.
2�3 Monitoring and Evaluation
The AAA will review and evaluate the performance of the contractor under the Lennu of this contract. Monitoring
shall be conducted through direct contact with the contractor through telephone, in writing, - n�, and/or on -site visit.
The AAA's determination of acceptable performance shall be conclusive. The contractor ugn:co to cooperate with
the A�� in moni�ocin��hcpro�rcsaofconnplctionofLbextrvicctuuksunddc|ivcrab|co.
�`
2.7.4 Remedies- Nonconforming Services
The contractor shall"" "^"v^c that all participants served under this agreement are eligible for the program, and that all
monthly and/or quarterly performance ocpoda and hnuooiul rroocdo are maintained for each reporting period and
submitted as stipulated in Paragraphs 1.4- 1.4.2 and 2.1 - 2,1,6.
Any nonconforming program aerviocu, performance reports or financial records not meeting the aforementioned
reguin:nxeu\u ohd| not he eligible for n:innhuocmenL under this program. The costs associated with enrolling,
training, reporting and/or managing the program shall be borne solely by the contractor. The AAA requires
immediate notice of any significant and/or systemic infractions that compromise
ixc the contractor's ability to provide
participant services, to achieve programmatic performance or to provide sound financial management of /h
program.
2.8 'g FINANCIAL OBLIGATIONS
2.8.1 Matching, Level of Effort,and Earmarking Requirements
The contractor will fulfill umatch requirement nfat � least |Opercent ofthe cost for all services funded throuuhthis
contract (i.e. 90 cents o[grant funds must be matched with |O cents from the contractor.) The Subcontractor's
/or`a
match will be made in the [oformofcash and/or in -kind resources. Match muy� b� reported by title each nn-''-^. At end ofthe contract period, all OAf\funds must beproperly matched. ~
2J8.2 Consumer Contributions
(X) The contractor assures compliance with Section 315 of the Older /\mcdcuna Act as amended in 2008. in
regard Uoconsumer contributions;
(2) Voluntary contributions are not |obcused for cost sharing ormatching;
(3) Accumulated voluntary contributions are to be used prior to requesting R:decm| reimbursement; and
(4) Voluntary contributions are to be used only to expand services,
2,8.3 Use of Service Dollars
The contractor is expected to spend all federal, state and other funds provided by the AAA for the purpose specified
25/71
January 2011
Contract AA- 11 29
in the contract. The contractor must manage the service dollars in such a manner so as to avoid having a wait lis
and a surplus of funds at the end of the contract period, for each program managed by the contractor. If the AAA
determines that the contractor is not spending service funds accordingly, the AAA may transfer funds to othe
providers during the contract period and/or adjust subsequent funding allocations accordingly, as allowable unde
state and federal law.
2.8.4 Title III Funds
The contractor assures compliance with Section 306 of the Older Americans Act, as amended in 2006, that fund:
received under Title III will not be used to pay any part of a cost (including an administrative cost) incurred by tht
contractor to maintain a contractual or commercial relationship that is not carried out to implement Title III.
29 AAA RESPONSIBILITIES
2.9.1 Program Guidance and Technical Assistance
The AAA will provide to the contractor guidance and technical assistance as needed to ensure the successful
fulfillment of the contract by the contractor.
2.9.2 Contract Monitoring
The AAA shall, at its own discretion, conduct monitoring concerning any aspect of the contractor's performance of
this contract.
SECTION III: METHOD OF PAYMENT
3.1 General Statement of Method of Payment
The method of payment for this contract includes advances, cost reimbursement for administration costs, and fixed
rate for services. The contractor shall ensure fixed rates for services include only those costs that are in accordance
with all applicable state and federal statutes and regulations and are based on audited historical costs in instances
where an independent audit is required. The contractor shall consolidate all requests for payment from
subcontractors and expenditure reports that support requests for payment and shall submit to the AAA on forms
106A (ATTACHMENT IX), 105AA (ATTACHMENT X-EXHIBIT 1), 105AS (ATTACHMENT X-EXHIBIT
2), and 105AE (ATTACHMENT X-EXHIBIT 3).
3.1.1 The contractor agrees to implement the distribution of funds as detailed in ATTACHMENT VII, Budget
Summary. An amendment is required to change any amount, unit cost, or number of units by service.
3.2 Advance Payments
3.2.1 The contractor may request up to two months of advances at the start of the contract period, if available, to cover
program administrative and service costs. The payment of an advance will be contingent upon the sufficiency and
amount of funds released to the AAA by the State of Florida ("budget release"). The contractor shall provide the
AAA's Contract Manager documentation justifying the need for an advance and describing how the funds will be
distributed.
3.2.2 The contractor's requests for advance require the approval of the AAA's Contract ?Manager. If sufficient budget is
available, the AAA. will issue approved advance payments after January 1, 2011.
3.2.3 Requests for the first through the twelfth months shall be based on the submission of actual monthly expenditure
reports beginning with the first month of the contract. The schedule for submission of advance requests, if available
is shown on ATTACHMENT VIII of this contract.
26/7 I
January 2011 Contract AA-1129
3.2.4 All advanced payments made to the contractor shall be recouped in accordance with the Reporting Schedule
ATTACHMENT VIII of this contract.
3.2.5 Interest earned on advances must be identified separately by source of funds, state or federal. Contractors shall
maintain advances of federal funds in interest bearing accounts unless otherwise excepted in accordance with 45
CFR 74.22(k). Earned interest must be returned to the AAA at the end of each quarter.
3.3 Invoice Submittal and Requests for Payment
All requests for payment and expenditure reports submitted to support requests for payment shall be on DOER
forms 106A (ATTACHMENT IX) , 105AA (ATTACHMENT X-EXHIBIT 1), 105AS (ATTACHMENT X-
EXHIBIT 2). and 105AE (ATTACHMENT X-EXHIBIT 3).
3.3.1 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with the
first month of the contract. The schedule for submission of advance requests (when available) and invoices is
ATTACHMENT VIII to this contract.
3.3.2 Any payment due by the AAA under the terms of this contract may be withheld pending the receipt and approval of
all financial and programmatic reports due from the contractor and any adjustments thereto, including any
disallowance not resolved as outlined in Paragraph 26 of this contract.
3.3.3 Payment may be authorized only for allowable expenditures, which are in accordance with the limits specified in
ATTACHMENT VII, Budget Summary. Any changes in the amounts of federal or general revenue funds
identified on the Budget Summary form require a contract amendment.
3.3.3.1 Monthly review of the Receipt and Expenditure Report and the Request for Payment Form by the Alliance
will focus on:
a. Line item comparison of year-to-date expenditures with the budget to monitor rate of
expenditures.
b. Allowable total reimbursement, on a service by service level, does not exceed
budgeted/contractual amount. (No unilateral modified spending authority.)
C. Validation of service units reported against CIRTS.
d. Validation of service units reported against the Area Plan on Aging, fiscal module contract
data housed in WebDB.
3.3.4 Date for Final Request for Payment
The final request for payment will be due to the AAA no later than March 1, 2012.
3.4 Documentation for Payment
The contractor shall maintain documentation to support payment requests that shall be available to the AAA or
authorized individuals, such as Department of Financial Services, upon request.
3.4.1 The contractor must enter all required data per the department's CIRTS Policy Guidelines for clients and services in
the CIRTS database. Data must be entered into CIRTS before the contractors submit their request for payment and
expenditure reports.
3.4.2 The contractor run monthly CIRTS reports and verify that client and service data in CIRTS is accurate. This report
must be submitted to the AAA with the monthly request for payment and expenditure report and must be reviewed
by the AAA before the contractor's request can be approved by the AAA.
27/71
IN
}UUUuryZ0|l
Contract AA- )|20
ATTACHMENT 11
CE
RTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
AGREEMENTS
The undersigned certifies, bathe best nfhis nrher knowledge and belief, that:
(l) No federal appropriated funds have been paid or will be puid, by or on behalf ofthe
undersigned, to any person forinUuenciog or attempting to influence an officer or cmp|myco of any state or fedenol agency, a oen~"c of congress, an
officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator,imcooncotiouwitbthca*modingufuoyfedcrm1grant.tbcmakingofaoyfederu||onu,rbe entering into ofany cooperative
agreement, and the extension, continuation, renewal, amendment, or modificationo[any federal contract, grant, loan, or
cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid orwill bepaid to any person for influencing or
attempting to influence an officer or employee of any agency, a nbecofco~ ,uuofOceroremp|oycco[c~^g^`um
'or an employee of member of congress in connection with this federal contract, grant, loan, or cooperative agreement,the undersigned sbu|| complete and submit Standard Fonn LLL,.)iuo|oourc
Form to Report Lobbying," in accordance
with its instructions.
(3) The undersigned xbu| require that the language of this certification be included in the xv/a,d documents for all sub -
awards a1all tiers (including subcontracts, ou and contracts under grants, loans and cooperative agreements) and
that all sub -contractors shall certify and disclose accordingly.
This certification is u material representation of fact upon which reliance was placed when this kuuxnotiou was made or
entered into. Submission of this certification is u prerequisite for making or entering into this transaction imposed by
section |352,Title 3|.0.3.Code. Any person who fails to file the required certification shall be subject to a civil penalty
of not less than $ 10,000.00 and not more than $ 100,000.00 for each Such failure.
Signature
Name of Authorized Individual
Name and Address of Organization
D0E&F"rm 103
Application or Agreement Number
Joou4zy20ll
Contract AA- l|24
ATTACHMENT III
F8��A��C&�kL AND C����LIA��CE AUDIT
The administration of resources awarded by the Department of Elder Affairs or the Alliance for Aging to the provider may be
Subject to audits and/or monitoring by the Department of Elder Affairs or the Alliance for Aging, as described in this section,
MONITORING
bnaddition Coreviews ofaudits conducted inaccordance with OMB Circular A-l3].aurevised,
--u"—nd�8cotioo2|5-47' F.S `
`(see
'AO)[T3"bc|on),monitoring,._--_�-- may inc|udc, but not bolimited to, on -site visits hvthe department ncn� ufstaff, limited
scope audits amdefined bvOMB Circular A- 133. as ncviucd. and/or other procedures. By-o—'iuho this agreement, /heprovidecugrceaLoconp|yuodonoperutewidbxoymoniLoriugprocedures/processes deemed appropriate bythe Depuruuo'to/
Elder Affairs or the Alliance for Aging. In the event the Department of Elder Affairs o, the /'—'~c for Aging determinestkuL u limited scope audit of the provider is appropriate, the provider agrees to comply with any additional instructions by the Department of Elder Affairs or the Alliance for Agi . ng to .the provider regarding such audit. The provider
further agrees to comply and cooperate with any inspections, reviews,goUn
audits deemed necessary by the Chief
Financial Officer (CFO) or Auditor General.
AUDITS
PART 1: FEDERALLY FUNDED
This part isapplicable ifthe provider inxState mlocal government orunon-profit organization as defined inOMB Circular
A-133, as revised,
In the cvcnt that the provider expends $500.000 or more in Federal awards during its Oucu| yc«uzz`the provider ymust have c a
single or program -specific audit conducted in accordance with the provisions of OMB Circular A-|33'as revised. l}fD3[T| tothis agreement indicates Federal resources awarded through the Department of Elder Affairs or the Alliance for Aging by
this agreement. In determining the Federal awards expended in its fiscal year, the provider xhx|| consider �s urceso[Fcdcru| awards, including Pedcn1| resources received from the Department ofElder Affairs or the Alliance for Aging. Thedetermination of amounts of Federal awunJu expended should be in accordance with the guidelines established by O«uCirru|u,/'|33.aartviucd. /uaudit ofthe provider conducted hythe Auditor General inaccordance with the provisions of
OMB Circular A- 133, as revised, will meet the requirements of this part.
In connection with the audit requirements addressed in Part 1, paragraph 1, the provider shall fulfill the requirements relative
to auditee responsibilities as provided in Subpart C of OMB Circular A- 133, as revised.
If the provider expends less than $500.000 in Federal xeurdm in its fiscal year, an audit conducted in accordance with the
provisions of OMB Circular A,\33. as revised, is not required. In the event that the provider expends |cms than $500.000 in
Federal awards inits fiscal year and elects k7have uuaudit conducted inaccordance with the provisions o[OMB Circular /\
133. as revised, the cost of the audit must be paid fromnwn'Fedccx| resources (i.c., the coat of such audit must be paid hn''/
`-
provider resources obtained bumother than Federal entitica.)
An audit conducted in accordance with this part obmU cover the entire organization for the oqganizutkom'o Uwoa| year,
Compliance findings related to agreements with the Department of Elder Affairs or the Alliance for
n� -� -A~
ing shal
l
be based oil agreement's ncguircneoto, including any nmics, regulations, or mtuiubcx referenced in the agreement. The financials|aicmenty shall disclose whether or not the matching .~@uirrocni was met for each xpp|/coo|c agreement.—U questionedros<s and liabilities doe to the Department of Elder Affairs or the Alliance /. Aging mb—�U be fully disclosed in the auditreport with reference to ,he Department ofElder Affairs or the Alliance h/ Aging agreement invo|vcd' not oUenmaedimoioncd as required by Section .3}0(b}(2) of OMB Circular =-|33` as rcvimcu` �hcyrucd |e of expenditures ofFedcrulawurdm shall identify expenditures by ognzu�o� number for each agreement with the Department ofE|de/c
'\8aicw or the
Alliance for Aging in effect during the audit period, Financial reporting packages required Linder this part must be submitted
within the earlier of 30 clays after receipt of the audit report or 9 months after the end of the provider's fiscal year end.
11
IM
January 2011
PART II: STATE FUNDED
Contract AA- 1129
This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2), Florida Statutes
In the event that the provider expends a total amount of state financial assistance equal to or in excess of S500,000 in any
fiscal year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider must have a State single
or project -specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the
Department of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for- profit
organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance awarded
through the Department of Elder Affairs or the Alliance for Aging by this agreement. In determining the state financial
assistance expended in its fiscal year, the provider shall consider all sources of state financial assistance, including state
financial assistance received from the Department of Elder Affairs or the Alliance for Aging, other state agencies, and other
nonstate entities. State financial assistance does not include Federal direct or pass -through awards and resources received by a
nonstate entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1; the provider shall ensure that the audit complies
with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as
defined by Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for -
profit organizations), Rules of the Auditor General.
If the provider expends less than $500,000 in state financial assistance in its fiscal year (for fiscal years ending September 30,
2004 or thereafter), an audit conducted in accordance with the provisions of Section 21597, Florida Statutes, is not required.
In the event that the provider expends less than $500,000 in state financial assistance in its fiscal year and elects to have an
audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit must be paid from
the nonstate entity's resources (i.e., the cost of such an audit must be paid from the provider resources obtained from other
than State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Department of Elder Affairs or the Alliance for Aging shall be based on
the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose
whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to
the Department of Elder Affairs or the Alliance for Aging shall be fully disclosed in the audit report with reference to the
Department of Elder Affairs or the Alliance for Aging agreement involved. If not otherwise disclosed as required by Rule
69I-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by
agreement number for each agreement with the Department of Elder Affairs or the Alliance for Aging in effect during the
audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the
audit report, but no later than 12 months after the provider's fiscal year end for local governmental entities. Non-profit or for -
profit organizations are required to be submitted within 45 days after delivery of the audit report, but no later than 9 months
after the provider's fiscal year end. Notwithstanding the applicability of this portion, the Department of Elder Affairs or the
Alliance for Aging retains all right and obligation to monitor and oversee the performance of this agreement as outlined
throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by
PART I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on
behalf of the provider directly to each of the following:
The Alliance for Aging, Inc.:
Alliance for Aging, Inc.
Attn: lloracio Soberon
760 NW 1071h Ave.
Miami, FL 33172
32I71
January 2011 Contract AA- 1129
The Federal Audit Clearinghouse designated in OMB Circular A- 133, as revised (the number of copies required by Sections
.320 (d)(1) and (2), OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at the
following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10h Street
Jeffersonville, IN 47132
Other Federal agencies and pass -through entities in accordance with Sections
revised.
M
.
.320 (e) and (f), OMB Circular A-133, as
rsuanL LO Sections _120i,r), 01vits Circular A-133, as revised, the provider shall submit a copy of the reporting package
I—
described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the
Department of Elder Affairs at each of the following addresses:
Department of Elder Affairs
Attn: Beverly Friedberg
4040 Esplanade Way Office 325B
Tallahassee, FL 32399-7000
Additionally, copies of financial reporting packages required by Part 11 of this agreement shall be submitted by or on behalf of
the provider directly to each of the following:
The Alliance for Aging, Inc. at each of the following addresses:
Alliance for Aging, Inc.
Attn: Horacio Soberon
760 NW 107 1h Ave.
Miami, FL 33172
The Department of Elder Affairs at each of the following addresses
Department of Elder Affairs
Attn: Beverly Friedberg
4040 Esplanade Way Office 325B
Tallahassee, FL 32399-7000
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 323994450
Any reports, management letter, or other information required to be Submitted to the Department of Elder Affairs pursuant to
1-1 1
this agreement shall be submitted timely in accordance with OMB Circular A-133, Florida Statutes. and Chapters 10.550
(local governmental entities) or 10,650 (nonprofit and for -profit organizations), Rules of the Auditor General, as applicable.
I
Providers, when submitting financial reporting packages to the Department of Elder Affairs for audits done in accordance
with OMB Circular A-133 or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for -profit
organizations), Rules of the Auditor General, should indicate the date that the reporting package was delivered to the provider
in correspondence accompanying the reporting package.
33/71
January 2011 Contract AA- 1129
PART IV: RECORD RETENTION
The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six
years from the date the audit report is issued, and shall allow the Department of Elder Affairs or its designee, the CFO or
Auditor General access to such records upon request. The provider shall ensure that audit working papers are made available
to the Department of Elder Affairs, or its designee, CFO, or Auditor General upon request for a period of six years from the
date the audit report is Issued, unless extended in writing by the Department of Elder Affairs.
January 2011 Contract AA- 1129
ATTACHMENT III
EXHIBIT I
I. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
Older Americans Act Administration
Title 11113 — Suppo t Services
U.S. Health and Human Services
93.044
so.00
Older Americans Act Administration
Title IfIC I — Congregate dealsU.S.
Health and Human Services
93.045
$142,600.00
Older Americans Act Administration
Title III C2 — Home Delivered Meals
U.S. Health and Human Services
93.045
$210.832.00
Older Americans Act Administration
Title III E — Caregiver Support Services
U.S. Health and Human Services
93.052
$67,560.00
TOTAL FEDERAL AWARD
$420,992.00
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO
THIS AGREEMENT ARE AS FOLLOWS:
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
AGREEMENT ARE AS FOLLOWS:
3
January 2011 Contract AA- 1129
ATTACHMENT III
PART 1: AUDIT RELATIONSHIP DETERMINATION EXHIBIT 2
Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A- 133, as revised.
and/or Section 215,97, Fla. Stat. Providers who are determined to be recipients or subrecipients, of federal awards and/or state financial
assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part 11 of Exhibit I are met.
Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A-133, as revised. and/or
Section 215,97. Fla. Stat. Regardless of whether the audit requirements are met, providers who have been determined to be recipients or
subrecipients of Federal awards and/or state financial assistance, must comply with applicable programmatic and fiscal compliance
requirements.
In accordance with Sec. 210 of OMB Circular A-133 and/or Rule 691-5.006, FAC, provider has been determined to be:
— Vendor or exempt entity and not subject to OMB Circular A- 133 and/or Section 215.97. F.S.
X_ Recipient/subrecipient subject to OMB Circular A- 133 and/or Section 215.97, F.S.
NOTE: If a provider is determined to be a recipient /subrecipient of federal and or state financial assistance and has been approved by the
department to subcontract, they must comply with Section 215.97(7), F.S., and Rule 691-.006(2), FAC [state financial assistance] and
Section .400 OMB Circular A- 133 [federal awards].
PART 11: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal awards or state
matching funds on Federal awards and who are determined to be a subrecipient, must comply with the following fiscal laws, rules and
regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A-87)*
OMB Circular A- 102 — Administrative Requirements
OMB Circular A- 133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non -Profit Organizations (Formerly OMB Circular A- 122 — Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A- 110 — Administrative Requirements)
Requirements)
OMB Circular A- 133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A-21 — Cost Principles)*
2 CFR Part 2115 Administrative Requirements (Formerly OMB Circular A- I 10 — Administrative Requirements)
OMB Circular A- 133 — Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the ONIIB Circular A-
133 Compliance Supplement, Appendix 1,
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a
recipient/subrecipient, rnUSt Comply with the following fiscal laws, rules and reoulations:
Section 2 15 .97, Fla. Star.
Chapter 691-5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
E
}uuuury2U1l
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
FOR AGREEMENTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENTS
Contract AA- |l24
ATTACHMENT IV
The anauthorized representative ofthe contractor named inthe contract magreement towhich this form imao
attachment, hereby certifies that:
(|) The contractor and any ofservices under this contract have financial management systems capable of
providing certain information, including: ()) accurate, current, and complete disclosure of the Mouocia| results of each
grant -funded projectorpnogrunmiouccnrdunocv/iLhChcpneacdhcdncportingroguincozentu;(2)Ulcmourocuodupp|ico1ionnf
funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The
inability toprocess information in accordance with ibcue requirements could result in u return of grant funds that have not
been accounted for properly.
(2) ManagementInfomation Systems used by the contractor, yui-contractor(s).many outside entity onwhich the contractor
independent for data that imto be reported, transmitted mcalculated, have been assessed and verified to becuo���
processing data accurately, including year -date dependent data. For those systems identified to be non -compliant,
contractor(s)will Luke immediate ocdontoassure data integrity.'
(3) If this contract includes the provision of hardware, snftwanc. Ornxvurc microcode or imbedded chip technology, the
undersigned warrants that these products are cunubk: of processing year -date dependent data accurately. All versions of
these products offered bythe contractor (represented by the undersigned) and purchased hythe State will be verified for
accuracy and integrity of data prior to transfer.
In the event of any dccoeuoc in functionality related to time and date related codes and internal subroutines that impede the
hardware or software programs from operating properly, the contractor agrees to immediately make required corrections to
restore bundwuvc and aofivvuo: programs to the auoue level of functionality an wununhcd hercin, at no ohurOc to the State,
and without interruption to the ongoing huxiueem of the state, time being of the essence.
(4) The contractor and any of services under this contract warrant their policies and proceduresinc|ude a
disaster p|uo to provide for service delivery to continue in cunc of an emergency including emergencies arising from data
integrity compliance issues.
The contractor shall require that the language ofthis certification beincluded inall o n/cnLn,suborunks,ondoLhnr
agreements and that all sub -contractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered
into. Submission of this certification is u prerequisite for making or entering into this (naouoohon imposed by 0&{8 Circulars
Name and Address o/Contractor
Si�anatyne Title —
---
Numeof Authorized Signer
■
January 2011
Contract AA- 1129
om
E
E
lauuacy7A|1
Contract AA- 1|74
ATTACHMENT V
CERTIFICATION REGARDING DEBAl�ENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(I) The prospective unutraokn certifies, by signing this ocrdhcu|bxn, neither it nor its principals are presently debarred,
suspended, for debarment, declared Ineligible, or voluntarily excluded
' from participation in tb�`
�o�cbmhvany �dode
partment �m oua�m�. -
(2) Where the prospective contractor in unable to certify to any of the statements in this ccoificotion, such prospective
participant shall attach an explanation to this certification.
(Certification signature mhou|dbeouu'camContract signature.)
Instructions for Certification
|. The terms ^corcuzd transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person,"
'pomucyunvcrcdUanaucbnn,"und"vn|untah1ycxc|uded,"oyuoedhcoeio,huvetbcneolings set out inthe sections
of rules implementing Executive Order 12549. (2 CFR /80.5-180.1020, as supplemented ' � 2 CFR 376|0-
376.995). You may contact the Contract Manager for assistance inobtaining ucopy o[those regulations.
2. This certification is material representation of facts upon which reliance was placed when the parties entered into
this transaction. If it is later determined that the contractor knowingly rendered an erroneous certificationin
addition to other remedies xvui|ub|c to the federal government, the department may pursue available ncumc`~'co
including suspension and/or drhornnenL -'
The contractor will provide immediate written notice Lnthe Contract Manager ifo1any time the contractor learns that
its certification was erroneous when submitted or has become erroneous by neuuou ofchanged circumstances. The
contractor may decide the method and frequency by which it determines the eligibility of its principals. Each
participant to a lower tier covered transaction may. but is not required to, check the Excluded Parties List System
(EPL3).
4. The contractor will include "Certification Regarding Debarment, Sunpcnaion, Ineligibility and Voluntary Exclusion
Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for lower tier
covered transactions.
51 The contractor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is
debarred, suspendod, dcnconincd ineligible u«voluntarily exc|udedfrom puoicipukm, unless otherwise authorized
bythe federal government.
h� If the contractor knowingly enters into a lower tier covered transaction with a person who is auopendeJ debarred,
ine|igih|e, or Voluntarily excluded from participation in this \runnuction, in addition Loother remedies uvui|' Nc |n �b~
-
federal governmcnt, the department may pursue available rumcdiem, including suspension, and/or debarment.
7. The contractor may rely upon a certification of pcumproiivc participant in n lower tier covered transaction that i| is
not debarred, suspended, ine|igib|e, or vu|uniad|y excluded from the covered rnznmaction, uo|cm* it know* that the
certification ioerroneous,
(xuvi,u�dJune zoO
E
(3
January 201 t
ASSURANCES —NON -CONSTRUCTION PROGRAMS
Contract AA- 1129
ATTACHMENT VI
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing
instructions, searching o, existing data sources. gathering and maintaining the data needed and completing and reviewing the collection of
1
information. Send comments regarding the burden estimate or any other aspect of this collection of information, I on, including suggestions for
reducing this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET,
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If you have questions please contact the
awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If
such is the case, you will be notified.
I. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds
sufficient to pay the non -Federal share of project cost) to ensure proper planning, management, and completion of the project described
in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a
proper accounting system in accordance with generally accepted accounting standards or agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of
personal or organizational conflict of interest, or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C..4728-4763) relating to prescribed standards for merit
systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit
System of Personnel Administration (5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights
Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education
Amendments of 1972, as amended (20 U.S.C.. 1681-1683. and 1685-1686), which prohibits discrimination on the basis of sex, (c)
Section 504 of the Rehabilitation Act of 1973. as amended (29 U.S.C..794), which prohibits discrimination on the basis of handicaps;
(d) the Age Discrimination Act of 1975, as amended (42 U.S.C.. 6101-6107), which prohibits discrimination on the basis of age-, (e) the
Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255). as amended, relating to nondiscrimination on the basis of drug abuse'. (f)
the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616). as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism-, (g). 523 and 527 of the Public Health Service Act of 1912 (42
U.S.C.. 290 dd-3 and 290 ee 3). as amended, relating to confidentiality of alcohol and drug abuse patient records, (h) Title VIII of the
Civil Rights Act of 1968 (42 U.S.C.. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing:
(i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being m:, ade; and (j)
the requirements of any other nondiscrimination statute(s) which may apply to the application,
7. Will comply, or has already complied, with the requirements of Titles 11 and III of the uniform Relocation Assistance and Real Property
Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is
acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property acquired for
project purposes regardless of Federal participation in purchases.
Z�
8. Will comply, as applicable, with the provisions of the Hatch Act (5 U.S,C. ' 1501-1508 and 7137-4-7328), which limit the political
activities of employees whose principal employment activities are funded in whole or in part with Federal funds.
9. Will comply. as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C., 276a to 276a-7). the Copeland Act (40 U.S.C. 276c
and 18 U.S.C., 874) and the Contract Work Hours and Safety Standards Act (40 U.S.C., 327-333), regardiniz, labor standards for
federally assisted construction SUbagreements.
43171
January 2011
Contract AA- 1129
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973
(P.L. 93-2134) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if
the total cost of insurable construction and acquisition is $10,000.00 or more. Z�'
I I. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality
control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514. (b) notification
of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in
floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program
developed under the Coastal Zone Management Act of 1972 (16 U.S.C., 1451 et seq.). (f) conformity of Federal actions to State (Clear
Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C.
7401 et seq.). (g) protection of
underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended. (P.L. 93-523), and (h) protection of
1_
endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C.. 1721 et seq.) related to protecting components or potential
components of the national wild and scenic rivers system,
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966. as amended
Z�
16 U.S.C.. 470). EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act
of 1974 (16 U.S.C., 469a- I et seq).
14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities
supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C.. 2131 et seq.) pertaining to the care,
handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance.
V
16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C., 4801 et seq.), which prohibits the use of lead- based paint
in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996
and OMB Circular No. A- 133, Audits of States, Local Governments, and Non -Profit Organizations.
18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this
program.
C�
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL I TITLE
APPLICANT ORGANIZATION I DATE SUBMITTED
44/71
January 2011
owl UZAMIN a ULU LINIM I ".M
Report Number Based On
I
January Advance*
2
February Advance*
3
January Expenditure Report
4
February Expenditure Report
5
March Expenditure Report
6
April Expenditure Report
7
May Expenditure Report
8
June Expenditure Report
9**
July Expenditure Report**
10**
August Expenditure Report**
11
September Expenditure Report
12
October Expenditure Report
13
November Expenditure Report
14
December Expenditure Report
15
Final Expenditure and Request for Payment
16
Close Out Report
Legend: Advance based on projected cash need.
** Recoupment of advance due with this report.
Contract AA- 1129
ATTACHMENT V111
Submit to AAA
On This Date
January I
January I
February 5
March 5
April 5
May 5
June 5
July 5
August 5
September 5
October 5
November 5
December 5
January 5
February 14
February 28
Note # 1: Report #1 for Advance Basis Agreements cannot be submitted to the Department of
Financial Services (DFS) prior to January I or until the agreement with the Department has
been executed and a copy sent to DFS. Actual submission of the vouchers to DFS is
dependent on the accuracy of the expenditure report.
Note # 2: All advance payments made to the contractor shall be returned to the Department by the
submission date of report #9. The adjustment shall be recorded in Part C, I of the report
(ATTACHMENT IX).
Note #3: Submission of expenditure reports may or may not generate a payment request. If final
expenditure report reflects funds due back to the Department, payment is to accompany the
report.
E
E
January 2011
L9141114MI
Contract AA- 1129
ATTACHMENT IX
PROVIDER NAME, ADDRESS, PHONE AND FED ID NUMBER
TYPE OF REPORT
THIS REQUEST PERIOD:
Advance
Report i* _
Reimbursement-
Agreement #: _
Agreement Period:
PSA:
CERTIFICATION: I hereby certify to the best of my knowledge that this request conforms with the terms and the purposes set forth in the above agreement.
Prepared By: Date: Approved By: Date:
PART A:
(2)
(3)
(4) -
(7)
BUDGET SUMMARY
ADMIN.
III B
111CI
IIIC2
Title IIIE
TOTAL
I. Approved
Agreement Amount.
0.00
0.00
0.00
0.00
0.00
0,00
2. Pre\Aous Funds
RECEIVED for
Agreement period.
0.00
0.00
0.00
0.00
0.00
0.00
3. Agreement Balance
0.00
0.00
0.00
0.00
0.00
0.00
4. Previous Funds
REQUESTED and
Not Received.
0.00
0,00
0.00
0.00
0.00
0.00
5. Agreement Balance
0.00
0.00
0.00
0.00
0.00
0.00
PART B:
FUNDS REQUESTED
1. 1st-2nd Months
Request Only
0.00
0.00
0.00
0.00
0.00
0.00
2. Net Expenditures
For Month
0.00
0.00
0.00
0.00
0-00
0.00
3. Additional
Cash Needs (Attach Doc.)
0,00
0.00
0.00
0.00
0.00
0.00
4, Total
0.00
0.00
0,00
0.00
0.00
0.00
PART C-
NET FUNDS REQUESTED:
1. Less: Over -Advance
0,00
0,00
0.00
0.00
0.00
0, 0C
2, Agreement Funds are
Hereby Requested For
0.00
0,00
0.00
0,00
0,00
000
DOER FOPM I C16A revised 5/10
Em
January 2011
Contract AA- 1129
ATTACHMENT X
EXHIBIT-2
RECEIPTS AND EXPENDITURE REPORT
OLDER AMERICAN ACT
PROVIDER NAME. ADDRESS, PHONE# AND FEID#
Program Funding Source:
THIS REPORT PERIOD
FROM: TO:
111E
CONTRACT
IIIC2
PERIOD:
CONTRACT#
REPORT#
IPSA*
CERTIFICATION I certify to the best of my knowledge and belief that this report
is complete and all outlays herein are for purposes set forth
in the contract.
Prepared by Date:-
Approved by
Date
PART A: BUDGETED INCOME/ RECEIPTS
1. Approved
2. Actual Receipts
3. Total Receipts
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
1. Federal Funds
$0.00
$0.00
$0.00
%
2, State Funds
$0.00
$0.00
$om
%
3. Program Income
$0.00
$0.00
$0.00
%
4. Local Cash Match (CCE, HCE and Other)
$0.00
$0.00
$0.00
%
5. SUBTOTAL: CASH RECEIPTS
$0.00
$0.00
$0.00
%
6. Local In -Kind Match
$0.00
$0.00
$0.00
%
7. TOTAL RECEIPTS
$0.00
$0.00
$0.00
%
PART B: EXPENDITURES
1. Approved
2. Expenditures
3. Expenditures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
I. Meals/ Meal Agreements
$0.00
$0.00
$0.00
%
2. Service Subcontractor
$0.00
$0.00
$0.00
%
3. Other
$0.00
$0.00
$0,00
%
4. Indirect Cost
$0.00
$0.00
$0.00
%
5. TOTAL EXPENDITURES
$0.00
$0.00
$0.00
%
PART C: OTHER EXPENDITURES
(For Tracking Purposes only)
1. Match
a. Other and In -Kind
$0.00
$0.00
$0,00
%
b, Local Match
$0.00
$om
$0.00
%
2, USDA Cash Received
$0.00
$0.00
$0.00
%
3. TOTAL OTHER
$0.00
$0.00
$om
PART D: OTHER REVENUE AND EXPENDITURES
2, Addition Cost AIternative Program I; -come
3. Interest
t. Program Income (PI)
a. Approved Budget
a. Earned on GR Advances
a. OAA Unbudgeted Pt Receipts YTD
Id. Received YTD $
b. Return of G R Advance
c. Expenditures $
c. Other Earned
DOEA FORM 105as revised iiiog
Is
January 2011
RECEIPTS AND EXPENDITURE REPORT
OLDER AMERICAN ACT
Contract AA- 1129
ATTACHMENT X
EXHIBIT 3
PROVIDER NAME. ADDRESS, PHONE# AND FElD# Program Funding Source THIS REPORT PERIOD
FROM: TO:
CONTRACT
Title III E PERIOD:
CONTRACT it
REPORT#
PIZA.
CERTIFICATION I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth
in the contract.
Prepared by Date Approved by Date
PART A: BUDGETED INCOME/ RECEIPTS
1, Approved
2. Actual Receipts
3. Total Receipts
4, Percent of
Budget
For This Report
Year to Date
Approved Budget
1. Federal Funds
$0.00
$0.00
$0.00
%
2. State Funds
$0.00
$0.00
S0.00
%
3. Program Income
$0.00
$0.00
$0.00
%
4. Local Cash Match
$0.00
$0.00
$0.00
%
5. SUBTOTAL: CASH RECEIPTS
$0.00
$0.00
$om
%
6. Local In -Kind Match
$0.00
$0.00
$0.00
-
%
7. TOTAL RECEIPTS
$0.00
$0.00
S0.00
%
PART B : EWENDITURES
1. Approved
2. Expenditures
3, Expenditures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
A :Direct Services
1. Personnel
$0.00
$0.00
$0.00
%
2. Travel
$0.00
$0.00
$0.00
%
3. Building Space
$0.00
$0.00
$0.00
%
4. Communication / Utilities
$0.00
$0.00
$000
%
5. Printing / Supplies
WOO
$0.00
$0�00
-
%
6. Equipment
$0.00
$0.00
$0.00
%
7. Other
S0.00
$0,00
$0.00
I,B
Agreement Services
8. Services Subcontracted
$0.00
$0.00
$om
%
9. TOTAL EXPENDITURES
$0.00
$0.00
$000
%
10. DEDUCTIONS
a. Total Local Match
$0.00
$0.00
$0 00
%
b. Program income Used
$0,00
$0,00
$0.00
%
c. TOTAL DEDUCTIONS
$0.00
$0.00
$om
.1.
11. NET EXPENDITURES
$0.00
$0,00
$0.00
%
PART C: EXPENDITURES ANALYSIS
2. Units of Services Year to Date
3. Number of People Served Year to Date
A. Expenditures by SerAces Year to Date:
1. Information......._...
Ww
2. Assistance__........._..,...
$Ow
3 Counseling. .. ..... S0-00
$0 00
4. Respite........_. $000
5, Supplemental Ser4ces., 59-00
0.00
6, TOTAL_r . I— .. ..... ... $0 00
Part 8 Line 11, column 3 should be equal to this total.
PART D GRANDPARENT SERVICES (reported by Federal Fiscal Year)
PFY FFY,_ FFY$
March $ Match $ Match $
DOEA FORM 105AE revised 12,08
E
January 2011
Department of Elder Affairs Programs & Services Handbook, provided on CD.
Also, available at the Department's Intranet site under, "Publications".
Contract AA- 1129
ATTACHMENT A
VON
January 2011
STATE OF FLORIDA nFIPARTMFNT OF FI nFR A;:;:AIR4Z
Contract AA- 1129
ATTACHMENT B
CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name
AAA/Contractor
imp ete y
Telephone
PART 1.
WTI 114 No 14 142KIP911B W 0 9 0 1 MOTT, 1:111:1 IN LOR K612 1 0 161;101
1. Briefly describe the geographic area served by the program/facility and the type of service provided:
2.
POPULATION OF AREA SERVED. Source of data:
[7Total
#
% White
% Black
% Hispanic
% Other
0% Female
3.
STAFF CURRENTLY EMPLOYED. Effective date:
-7 -T-./.
Total #
hite
I % Black
% Hispanic
Other
% Female
% Disabled
4.
CLIENTS CURRENTLY ENROLLED OR REGISTERED Effective date:
Total #
I % White
I % Black
I % Hispanic
% Female
% Disabled
% Over 40
5.
ADVISORY OR GOVERNING BOARD, IF APPLICABLE.
Total # I
% White I
% Black
I % Hispanic
% Other
% Female
% Disabled
PART 11. USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE.
6. Is an Assurance of Compliance on file with DOER? If NA or NO, explain.
NA YES NO
El ED E-1
7.
Compare the staff composition to the population. Is staff representative of the population?
If NA or NO, explain.
NA YES NO
F-1 F-1 El
8.
Compare the client composition to the population. Are race and sex characteristics representative
of the Population? If NA or NO, explain.
NA YES NO
7 7 El
9.
Are eligibility requirements for services applied to clients and applicants without regard to
race, color, national origin, sex, age, religion or disability? If NA or NO, explain.
NA YES NO
El 1:1 1-1
57/71
January 2011
Contract AA- t 129
10. Are all benefits, services and facilities available to applicants and participants in an equally effective manner regardless of
race, sex, color, age, national origin, religion or disability? If NA or NO, explain.
NA YES NO
❑ ❑ ❑
11. For in -patient services, are room assignments made without regard to race, color, national origin or disability? If NA or
NO, explain.
NA YES NO
❑ ❑ ❑
12. Is the program/facility accessible to non-English speaking clients? If NA or NO, explain.
13. Are employees, applicants and participants informed of their protection against discrimination?
If yes, how? Verbal ❑ Written ❑ Poster ❑ If NA or NO, explain.
14. Give the number and current status of any discrimination complaints regarding services or
employment filed against the program/facility.
15. Is the program/facility physically accessible to mobility, hearing, and sight -impaired individuals? If NA or
NO, explain.
ZFWZM��'*
PART 111. THE FOLLOWING QUESTIONS APPLY TO '• AND FACILITIES WITH 15 OR MORE •
16, Has a self -evaluation i•' conducted to i• any barriers to serving disabled individuals, and to make any
necessary modifications? If NO, explain.
IT Is there and established grievance procedure that incorporates due process in the resolution of
complaints? If NO, explain.
YES NO
9M
January 2011
0 El
18. Has a person been designated to coordinate Section 504 compliance activities? If NO, explain.
Contract AA- 1129
YES NO
❑ ❑
19. Do recruitment and notification materials advise applicants, employees and participants of
nondiscrimination on the basis of disability? If NO, explain.
20. Are auxiliary aids available to assure accessibility of services to hearing and sight impaired
individuals? If NO, explain.
YES NO
❑ ❑
FEME]
PART IV. FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000 OR MORE.
21. Do you have a written affirmative action plan? If NO, explain. YES NO
❑ ❑
om
January 2011
Contract AA- 1129
AAA USE ONLY
Reviewed By
In Compliance: YES ❑ NO* o
Program Office
*Notice of Corrective Action Sent
Date
Telephone
Response Due
On -Site r] Desk Review F,
Response Received
M
60/71
Joouury20l| Contract AA-ll?g
^TT�c*�swT�
INSTRUCTIONS F��8�THE CIVIL RIGHTS �����PLK������E CHECKLIST
lDescribe the geographic service area such as a diatriot, cnunCy, city or other locality. If the program/facility
serves aspecific /acgutpopulation such uaadolescents, describe the tar -et Population. Also, define the type uf
service provided.
2. Enter the percent of the population served by race and sex. The population served includes persons in the
gcogruobiou| area for which services are provided such as ucip/, county ocother regional area. Population
statistics can beobtained fnznmlocal oborubensnfonmo�ercc,libraries, orany puh|icudnnbnnnthe
'|o80Census
containing Florida population statistics. Include the source of your population statistics. ("Other" races include
Asian/Pacific Islanders and American Indian/Alaskan Nativey.)
3. Enter the k`kU number of full-time staff and their percent by race, ocn and dixabi|i Include the effective date of
your Summary.
4. Enter the total number of clients who are enrolled, registered or currently served by the program or facility, and
list their percent by race, sex and disability. Include the date that enrollment was counted.
5. Enter the total number o[advisory board noenoben and their percent by race, ycx, and disability. If there is no
advisory orgoverning board, leave this section blank.
6. Each recipient of federal financial assistance ouuaL have on file an assurance that the program will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually u standard part of the
contract language for Il[)EA recipients and their oub-grxntcem.45CFR8O4(u).
7. Is the race, sex, and national origin of the staff reflective of the gcnc,u| population? For cxunup|c, if 10% of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their. availability in
the population, the program/facility has the responsibility to determine the reasons for such variation and take whatever
action may benecessary Uncorrect any discrimination. Some legitimate disparities may exist when programs are
sanctioned to serve target populations such as elderly or disabled persons. 45 CFR
80.3(h)(6).
9. Dneligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on -site record analysis ofpersons who applied but were denied services o«employment, 45CFR80.3(u)
nnd45 CFRQO.| (b)(2).
10. Participants or clients must be provided services Such as medical, nursing and dental care, laboratory services,
physical and recreational tbcrapiea, Counseling and social services without regard tn ruce, mcx, cu|mr, na[ionwl origin,
religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record keeping must be applied
uniformly and vvirbouC regard to rucm, aex, cNmr, national ucigin, rcligioo, age or disability. Eninanceu, waiting
ronrua, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR
8O.3(b).
11. For i services, uubkenia onmi be assigned to roonno wards, etc` without regard to ruce, color, nsk/noJ
origin or disability. '\iao, residents must not be asked whether they are willing to share uccommodm(ions with
persons o[mdifferent race, color, national origin, ordisability. 45[FRS0] (u).
12. The program/facility and all services ruum| be accessible to participants and applicants. including those persons who
may riot speak English. In geographic areas where a significant population of non -En lishspeaking people live,
program accessibility muy include the employment ofbilingual a|mf[ [nother areas, iLiySufficient tohave upolicy
r
11
Janttary 2011 Contract AA- 1.129
or plan for service, such as a current List of names and telephone numbers of bilingual individuals who will assist in
the provision of services, 45 CFR 80.3 (a).
13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to their
participants, beneficiaries or any other interested parties. This should include information on their right to file a
complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS.
The information may be supplied verbally or in writing to every individual, or may be supplied through the use of
an equal opportunity policy poster displayed in a public area of the facility, 45 CFR 80.6 (d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis, e.g., race, color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g., services or employment, placement,
termination, etc. Indicate the civil rights law or policy alleged to have been violated along with the name and
address of the local, state or federal agency with whom the complaint has been filed. Indicate the current status, e.g.,
settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc.
15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes
designated parking areas, curb cuts or level approaches, ramps and adequate widths to entrances. The lobby,
public telephone, restroom facilities, water fountains, information and admissions offices should be accessible.
Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and
serving lines should be observed for accessibility. Elevators should be observed for door width, and Braille or
raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be
installed at an appropriate height for mobility impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance conduct a
self -evaluation to identify any accessibility barriers. Self -evaluation is a four step process:
With the assistance of a disabled individual/organization, evaluate current practices and policies which do not
comply with Section 504.
Modify policies and practices that do not meet Section 504 requirements.
Take remedial steps to eliminate any discrimination that has been identified.
Maintain self -evaluation on file. (This checklist may be used to satisfy this requirement if these four steps
have been followed.), 45 CFR 84.6.
17. Programs or facilities that employ 15 or more persons must adopt grievance procedures that incorporate
appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any
action prohibited by Section 504.45 CFR 84.7 (b).
18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts to
comply with Section 504.45 CFR 84.7 (a).
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper
ads, and other appropriate written communication, 45 CFR 84.8 (a).
20. ProgramslfaciIities that employ 15 or more persons must provide appropriate auxiliary aids to persons with
impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to,
interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be
used to provide equally effective services, (45 CFR 84.52 (d).
1. Programs/facilities with 50 or more employees and $50,000 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246. 41 CFR 60
and Title VI of the Civil Rights Act of 1964. as amended.
62/71
■
January 2011
PROGRAM:
TYPE OF SERVICE:
Contract AA- 1129
ATTACHMENT E
EXHIBIT I
DOEA Cost Analysis For Non -Competitively Procured Contracts
In Excess Of Category 11
CONTRACT PERIOD:
1
2
Column 3
Column 4
Column 5
(to be completed by the contractor)
(to be completed by the DOER
Contract Manager
Budget
Line Item
Amount
% Allocated
Allowable
Reasonable
Necessary
Category
Budget Category
to this
Agreement
a.
Salaries
b.
Fringe Benefits
OC.
Equipment
d.
Telephone & Utilities
N
e.
Travel
f.
Printing & Supplies
ag.
Other (Please list or attach details)
Q
h.
Allocated Cost/Overhead
TOTAL
Client Services (Attach
y
details)
v
TOTAL
CERTIFICATION (to be signed by DOEA Contract Manager)
I certify that the cost for each line item budget category has been evaluated and determined to be allowable, reasonable, and
necessary as required by Section 216.3475, Florida Statutes.
Name Title
Signature Date
63/71
January 2011 Contract AA- 11219
ATTACHMENT F
EXHIBIT 2
INSTRUCTIONS:
COST ANALYSIS FOR NON-COTNIPETIVELY PROCURED CONTRACTS
IN EXCESS OF CATEGORY 11
The purpose of the ATTACHMENT F, Exhibit 1, is to document that costs in non -competitively procured contracts in excess of
$35.000 are allowable, reasonable and necessary. This form is required to be submitted by the contractor to the contract manager
within 30 days of the contract execution date.
Upon receipt of the form, the DOEA contract manager will:
I. Evaluate each separate line item to determine whether the cost is allowable, reasonable and necessary.
a. To be allowable, a cost must be allowable pursuant to state and federal expenditure laws, rules and regulations and
authorized by the agreement between the state and the contractor.
b. To be reasonable, a cost must be evaluated to determine that the amount does not exceed what a prudent person would
incur given the specific circumstances.
c. To be necessary, a cost must be essential to the successful completion of the program.
d. Allocated costs/overhead should be evaluated to determine that the rate is reasonable.
2. Place the Cost Analysis far Non -Competitively Procured Agreements in Excess of Category II form in the official file for
this contract at the Department of Elder Affairs,
(1) In accordance with the following instructions, the contractor must complete COLUMNS 3, 4 AND 5 of the DOEA Cost
Analysis For Non -Competitively Procured Contracts In Excess Of Category 11 worksheet (ATTACHMENT F, EXHIBIT
I ) for the original contract and any amendment that affects the amount of compensation and/or the level of services
provided.
(2) Definition of Administrative Costs —
a. Salaries[Wages: Are the charges to directly hire someone and put them on payroll.
b. Fringe Benefits: Are the costs of health insurance, Social Security. Medicare, unemployment and other benefits paid
on behalf of each employee. If fringe benefits will be based on a specified percentage, rather than the actual cost of
fringe benefits, then the calculation for the fringe benefits amount must be shown.
c. Equipment: Equipment means an article of nonexpendable, tangible personal property generally having a useful life
of more than one year and an acquisition cost that equals or exceeds the lesser of the established capitalization level
of $5.000 (federal funds) or $ 1.000 or hardback bound books not circulated, with a value of $250.00 or more (state
funds).
d. Telephone and Utilities: Are items such as utilities and telephone service costs.
e. Travel: Are those that are necessary, reasonable and allowable for carrying out the project. Travel must be in
accordance with Section 1 12.061. Florida Statutes, which includes submission of the claim on the approved State
travel voucher or electronic means and at the authorized meal, per them and state mileage reimbursement rates.
f. Printing and Supplies: Are items such as office Supplies, postage, and printing.
g. Other Costs or Miscellaneous: Please explain/justify. Support documentation for other direct costs may include
copies of published rates, copies of expense vouchers, and/or invoices. Support documentation for other costs or fees
may Include Copies of published catalog prices, or copies of expense vouchers.
h. Allocated Costs or Overhead: The contractor should attach a copy of the computation schedule supporting the
allocated cost rate. Support documentation for allocated costs may be a federally -negotiated allocated cost rate
agreement. If the contractor does not have a rate agreement, ( I ) sufficient information should be attached indicating
how the rate used was determined and (2) if the rate was accepted and paid previously by either a federal agency or
agency of the State of Florida, documentation to that affect should be provided.
t3) Client Service costs should be documented via Area Agency on Aging Area Plans, Unit Cost information input into
Z__ Z�
WebDB, or some other form of documentation to Support the cost analysis.
(4) The allocation to the agreement will be calculated based on the cost by line Item cost divided by the total agreement
amount.
Em
January 2011 Contract AA- 1129
ATTACHMENT G
Alliance for Aging, Inc.
Aging Resource Center/Eider Helpline
Policy and Procedure for
Outsourced function - Screening
Objective: To ensure that a comprehensive list of clients in need of services is maintained in CIRTS by appropriate funding
source and that the ARC is thereby able to effectively gauge the level of elder service need in Miami -Dade and
Monroe Counties.
Policy: To obtain necessary information from clients in order to assist in determining level of need and eligibility for DOEA
funded services
Procedure:
I ARC Contracted Providers will collect information from callers and conduct a 701 A assessment. Alternatively, if a
701 B assessment already exists or is provided from another source (i.e. CARES) the information from the 701 B can
be utilized.
2. Based on the information provided via the 701A(B) assessment, the ARC Contracted Provider will make a
determination as to the services that the caller is in need of receiving (see Contract Amendment APCL).
The ARC Contracted Provider will determine the appropriate funding source(s) that provides the needed services
(see Contract Amendment APCL).
4. If the caller is in need of a service(s) that is not provided by the ARC Contracted Provider, the ARC Contracted
Provider will refer caller to the ARC Elder Helpline utilizing the ARC Referral Form and/or to an ARC Contracted
Provider that provides the needed service.
The caller will be provided with general information regarding the ARC as well as the ARC Elder Helpline contact
number.
6. The caller will be informed of the services and funding sources that they are being placed on the wait list for in
CIRTS.
ARC Contracted Provider will create a client record in CIRTS (if there is no existing record) and enter the services
needed for the caller by funding source and service. [If there is an existing record in CIRTS, the appropriate fields
will be updated].
If the ARC Contracted Provider determines that the caller may qualify for more than one funding Source, ARC
Contracted Provider is encouraged to enter the appropriate information under multiple
ple funding Sources. [If there is
an existing client record in CIRTS, the client record in CIRTS will be updated with appropriate information].
9. ARC Contracted Provider will inform caller that they will receive a follow-up call (or home visit in case of active
client) to check on their status based on DOEA Wait List Reassessment Standards and encourage caller to contact
the ARC Elder Helpline with any questions.
65/71
January 2011
Alliance for Aging, Inc.
Aging Resource Center/Elder Helpline
Policy and Procedure for
Outsourced function - Triage
Contract AA- 1129
Objective: To ensure that clients in need of DOEA funded services receive services based on the highest level of need, first, as
funding becomes available.
I
Policy: To assist clients in obtaining DOEA funded services as funding becomes available, based on level of need as
determined by a CIRTS priority score.
Procedure:
1. ARC Contracted Provider will conduct periodic follow-up calls (or home visit in case of active client) to check on
client status based on DOEA Wait List Reassessment Standards.
2. Based on the information provided via the 701A(B) assessment, the ARC Contracted Provider Will update the client
information in CIRTS specifically as it pertains to level of need for services by funding Source
The ARC Contracted Provider will ensure that the CIRTS prioritization score is accurately maintained, according to
DOEA Standards.
4. If the caller is in need of a service(s) that is not provided by the ARC Contracted Provider, the ARC Contracted
Provider will refer caller to the ARC Elder Helpline utilizing the ARC Referral Form and/or to an ARC Contracted
Provider that provides the needed service.
5. The caller will be informed of the services and funding sources that they remain on the wait list for and/or have been
removed from the wait list for.
6. ARC Contracted Provider will advise client of any change in their CIRTS priority score based on the updated
Zn
information.
7. ARC Contracted Provider will remind client of the ARC Elder Help Line contact number and to contact the ARC Elder
Help Line with any questions or concerns.
8. As funding becomes available, ARC Contracted Provider will run CIRTS Prioritization Report and activate clients
according to DOEA Standards (refer to ARC Client Activation Policies and Procedures). The Contracted Provider will
apply targeting criteria, as appropriate, to prioritized clients to ensure activations meet programmatic requirements.
67/71
M
E
January 2011
Alliance for Aging, Inc.
Aging Resource Center/Elder Helpline
Policy and Procedure for
Activation From Wait List — Clients/Services
Contract AA- 1129
Objective: To ensure that elders in need of DOEA funded services in Miami -Dade and Monroe Counties and on the CIRTS wait
list begin to receive services as funding becomes available.
Policy: ARC will work with ARC Contracted Providers to ensure that clients waiting for DOEA funded services begin to
receive those services as funding becomes available.
Procedure:
1. ARC Contracted Provider will activate clients on CIRTS wait list based on DOEA prioritization polices and funding
availability.
2. ARC Contracted Provider Will update CIRTS status by funding source and service for any services being activated for
the client using appropriate CIRTS codes.
3. Client may be left on wait list of a different funding source than the one being activated if ARC Contracted Provider
determines that it is appropriate.
4. Client may also be left on wait list in CIRTS if they are being activated by the ARC Contracted Provider under a
temporary non-DOEA funding source and ARC Contracted Provider determines that the clients need will persist after
the temporary funding source is exhausted.
5. ARC Contracted Provider will inform the client of any services/funding source that they are being activated for as well
as those services and funding sources that they will continue to be wait listed for.
6. ARC Contracted Provider will inform client to contact the ARC Elder Helpline if they have any questions or concerns
regarding the status of any of their services.
1-1
EM
January 2011
Alliance for Aging, Inc.
Aging Resource Center/Elder Helpline
Policy and Procedure for
Termination From Wait List — Clients/Services
Contract AA- 1129
Objective: To ensure that the comprehensive list of clients in need of services in CIRTS is appropriately maintained by funding
source and that the ARC is thereby able to effectively gauge the current level of elder service need in Miami -Dade
and Monroe Counties.
Policy: ARC will maintain an accurate and current list of clients in need of elder services in Miami -Dade and Monroe Counties
with the assistance of the ARC Contracted Providers.
Procedure:
1. ARC Contracted Provider will re -screen clients which the ARC Contracted Provider initially placed on the CIRTS wait
list for services based on DOER Reassessment Standards.
2 The re -screening may be in the form of a phone screening or a home visit depending on the clients status (i.e.
active/pending)
3. ARC Contracted Provider will determine if the client is no longer in need (or eligible) for any of the services they were
wait listed for.
4. ARC Contracted Provider will terminate the client from the wait list (entirely or by specific service) using the
appropriate CIRTS termination code for any services or funding source for which the client is determined to no longer
be eligible for or no longer in need of.
5. ARC Contracted Provider will inform the client of any services/funding source that they are being removed from the
wait list for.
6. ARC Contracted Provider will inform client of their ability to be re -added to the wait list if their level of need should
change.
7. ARC Contracted Provider will inform client to contact the ARC Elder Helpline if they have any questions or concerns
regarding their wait list status.
8. Reference DOER Notice of Instruction: Assessed Priority Consumer List#:062906-1 -I-OVCS as applicable.
71/71