HomeMy WebLinkAboutItem C08#
Meeting Date: — 10/ 19/2011 Division: —CAD
Bulk Item: Yes _X_ No Department: —Social Services
Staff Contact /Phone #: —Sheryl Graham X45 10
AGENDA ITEM WORDING:
Approval of Amendment 003 to the Older Americans Act (OAA) Contract AA -I 129 between the
Alliance for Aging, Inc. and Monroe County Social Services.
ITEM BACKGROUND:
The purpose of this amendment is to reallocate the funds among the service categories under the
contract. The amounts for Congregate Screening and Screening and Assessment are reduced and the
amounts for Congregate Meals and Home Delivered Meals are increased, the result being more meals
can be provided for the clients of the Monroe County Nutrition Program.
PREVIOUS RELEVANT BOCC ACTION:
Prior approval granted to the Older Americans Act Contract #AA - 1129 on 12/15/2010
CONTRACT/AGREEMENT CHANGES:
C-1: Transfer of $4421 from Congregate Screening to Congregate Meals
C-2: Transfer of $2534.75 from Screening and Assessment to Home Delivered Meals
STAFF RECOMMENDATIONS:
Approval
TOTAL COST:$421,641.85 INDIRECT COST: BUDGETED: Yes X No
DIFFERENTIAL OF LOCAL PREFERENCE:
COST TO COUNTY: _$42,164 In -Kind Match SOURCE OF FUNDS: Grant Funded
(Older Americans Act)
REVENUE PRODUCING: Yes No X \AMOUNT PER MONTH Year
41
APPROVED BY: County Atty OMB/Pult&sing Risk Management
DOCUMENTATION:
Revised 7/09
Included Not Required
AGENDA ITEM #
CONTRACT SUMMARY
Contract with: Alliance for Aging, Inc.
Contract #AA -
1129
Effective Date:
I/l/2011
Expiration Date:
12/31/2011
Contract Purpose/Description:
Amendment 003 to the Older Americans
Act contract reallocates the funds among
service categories under the contract.
Contract Manager: - Sheryl Graham
4510
Social Services/ Stop #1
(Name)
(Ext.)
(Department/Stop #)
for BOCC meeting on 10/19/2011
Agenda Deadline: 10/04/2011
CONTRACT COSTS
Total Dollar Value of Contract: $ 421,641.85 Current Year Portion: $
Budgeted? Yes® NoF_1 Account Codes: 125-6153111-
Grant: $ 415,028 125-6153211-
County Match: $ 42,164 (In- 125-6153411-
Kind Match)
Estimated Ongoing Costs: $ /yr
(Not included in dollar value above)
ADDITIONAL COSTS
For:
CONTRACT REVIEW
Chang
D Wal Neede
Division Director Yes[] N
Risk Management i YesF_1 N
etc.
Date Out
O.M.B./Purel4ing %% 2LL YesEl No® tWk-4Uk�1— 1,5 )v
i
N
County Attorney Yesr_� NoM
- �41
I Comments:
DMB Forra Revised 2/27/01 MCP #2
Amendment 003 CONTRACT AA-1 129 Page I
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 reallocate the funds, modify the number of units and
services under contract
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 (CFDA/CSFA # 93.045): $ 210,831.90
Title III E (CFDA/CSFA # 93.052): $ 67,560.00
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 C 1
$9.56
14,632
$139,886.95
Congregate Screening C 1
$20.00
41
$820.00
Nutrition Counseling Cl
$47.50
40
$1,906.00
Nutrition Education C 1
$63.58
10
$637.00
Home Delivered Meals C2
$6.13
33,795
$207,163.65
Screening & Assessment C2
$25.00
132
$3,306.25
Nutrition Education C2
$63.67
5
$362.00
In 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 have caused this amendment to be executed by their
undersigned officials as duly authorized.
Monroe County Social
Services.
ALLIANCE FOR AGING, INC.
SIGNED BY: SIGNED BY:
ffrf"
January 2011
ALLIANCE FOR AGING, INC.
STANDARD CONTRACT
Contract AA-1129
OLDER AMERICANS ACT PROGRAM TITLE III
THIS CONTRACT is entered into between the Alliance for Aging. 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 III, 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 $420.992.00, 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 under this contract.
5. Renewals
By mutual agreement of the parties, in accordance with s. 287.0580 )(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.
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.
6.1.2 If this contract contains federal funds and is over S 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 II. 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. l 101). 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.
_2/71
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. 1 12.061, 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. Backiround Screenine
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(l), 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
su termination, spension 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 fonds provided by the AAA under this contract.
3/71
E
}uouzry2Ol| Contract AA-l)29
10.2 To retain all client records, hnunoh| rccoub, 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, n:cmndx ohu1( be retained
for u minimum period of six (6) years after the audit report is issued or ond| resolution of any audit findings or
I itication based on the terms of this contract, at no additional cost to the AAA.
10.3 Upon demand, at no additional cost mthe AAA. the contractor will facilitate the duplication and transfer of any
records uvdocuments during the required retention period io Paragraph 102.
10'4 Tnuoourc that the records described in Paragraph 10shoU be subject at all reasonable times Co io*pccduo, 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, 0JEA and
Federal auditors, pursuant oo45CIR 92.30(i)(1ULshall hcallowed full access u/and the right ooexamine any ofthe
contractor's contracts and related records and documents pertinent to this specific contract, oftbcfonn in
which kept.
regardless
10.6 To provide ufinancial and compliance audit to the AAA asspecified inthis 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.
81. Nondiscrimination -Civil Riahts Compliance
88,1 The contractor will execute um*unu/ues 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 o,iQin, marital status o,sex in compliance with state and federal law and regulations. The contractor further
assures that all cnotruutoo, subcontractors, oubunanteey, 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 udmc|y. complete and accurate Civil 6ligbLm
Compliance Checklist (ATTACHMENT B)'
11.3 The contractor ugnzcn 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 ofthe right to file ucomplaint with the appropriate federal o,state entity.
18.4 lythis contract contains federal h/nds, these assurances are acondition ofcontinued receipt oforbenefit from federal
financial xuaia|aucc, and are binding upon the contractor, its successors, /runahncu, and assignees for the period
during which such auu'ocuocc is provided. The contractor further assures /but all suboonrmcto,m, vendors, or others
with whom it arranges /o provide acn/icem or benefits to participants or employees in connection with any of its
programs and activities are not discriminating against those participants o, employees in violation of the above
statutes, regulations, guidelines, and m|undooju. In the event offailure to comply, the contractor understands that the
AAA may. at its discretion. seek mcourt order requiring compliance with ,he terms of this assurance or seek other
appropriate judicial or administrative relief, including but not limited to, termination of and denial of further
uaaiamoce.
12. Provision, of Services
The contractor will provide services in the manner described in ATTACHMENT 1.
4/7L
January 2011
Contract AA-1110
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 Monitoring 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 Bondint*
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.
I& 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).
5/71
IanUary 2011
Contract AA-1129
19. Incident Repo. rtinz
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 perform
the services required to be performed under this contract. Such notice shall be made orally to the contract manager (by
telephone) with an email to immediately follow.
19.2 To immediately report knowledge or reasonable suspicion of abuse. neglect, or exploitation of a child, aged person, of
disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number (1-800-96ABUSE). A
required by Chapters 39 and 415, F.S., this provision is binding upon both the contractor and its employees.
20. New Contract(s) Reportine
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.
6l71
Jonuu/y2O|l Contract AA- 1l29
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 commodities produced pursuant on this contract and
the service provider application ioresponse to the 2009OAA RFP,whether actually furnished bythe contractor mits
subcontractors. Any subcontracts shall be evidenced by a written document and subject to any conditions of approval
the AAA deems necessary, The contractor further agrees that the AAA shall not be liable to the subcontractor in any
way n,for any reason, The contractor, zuits expense, will defend the AAA against any such claims.
24^2 The contractor shall promptly pay any subcontractors upon receipt of payment from the department or other
sponsoring agency. Failure to make payments to any subcontractor in accordance with a. 287.0585` F.S, unless
otherwise stated imthe contract between the contractor and subcontractor, will result in upenalty uo provided by
25. Independent Capacitv of Contractor
It is the intent and understanding of the parties that the contractor, or any of its auhcontrucnzm, are independent
contractors and are not employees of the AAA and shall not hold themselves out umemployees o,agents 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 xhu!| not he liable for any wage and houc,
employment discrimination, or other labor and employment claims against the contractor or its subcontractors. All
deductions for social security, withholding taxes, income taxes, contributions m unemployment compensation funds
and all necessary insurance for the contractor shall he the sole responsibility ofthe contractor.
26. Payment
Payments will be made to the contractor pursuant to a. 215.422, F.S,uuservices are rendered and invoiced by the
contractor. The AAA's Contract &8uouger will have final approval of the invoice for puyment, and will approve the
invoice for payment only if the contractor has met all terms and conditions of the contract, unless the hid
specificutions, purchase order, or this contract specify otherwise. The approved invoice will be submitted to the
AAA's dacu| section for budgetary approval and processing. Disputes arising over invoicing and payments will be
resolved inaccordance with the provisions ofm.2|5.422ES.
27. Return of Funds
The contractor will return to the AAA any overpayments due to unearned funds uvfunds disallowed and any interest
attributable to such funds pursuant to the terms and conditions of this contract that were disbursed omthe contractor by
the AAA. In the event that the contractor or its independent auditor discovers that an overpayment has been made,
the contractor shall repay said overpayment immediately without prior notification from the AAA. In the event that
the AAA first discovers an overpayment has been made, the Contract Manager, on behalf of the AAA, will notify the
contractor by letter Of Such findings. Should repayment not be made [orthvvith, the contractor will be charged at the
lawful rate of imu:n:oc no the outstanding balance pursuant to x. 55.03, E8, after AAA notification o, contractor
discovery.
%8. Data Intep-rity and Salleauardina Information
The contractor xuuu insure an appropriate |cnr\ of data security for the information ,he contractor is cu|iccdog or
using in the performance of this contract. An appropriate level of security includes approving and tracking all
contractor employees that request system or information access and ensuring that user access has been removed 6nm
all terminated employees. The contractor, among other requirements. must anticipate and prepare for the |u** of
information processing capabilities. All data and software mug be routinely backed up to insure recovery from |omwzs
or outages of the computer system. The security over the backed -Lip data is to be as stringent as the protection
required of the primary xyxucma. The contractor *hm|| ixouoc ai| subcontractors maintain written procedures for
computer symucm back up and recovery. The contractor sho/| complete and sign /kTTA.CHNIEN1[ IV prior to the
January 2011
29. Computer Use and Social Media Policy
Contract AA- 1129
30. Conflict of Interest
The contractor will establish safeguards to prohibit employees, board members, management and subcontractors from
using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of
interest or personal gain. No employee, officer or agent of the contractor or subcontractor shad participate in
selection, or in the award of an agreement supported by State or Federal- funds if a conflict of interest, real or
apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member of
his/her immediate family; (c) his or her partner, or; (d) an organization which employs, or is about to employ, any of
the above, has a financial or other interest in the firm selected for award. The contractor or subcontractor's officers,
employees or agents will neither solicit nor accept gratuities, favors or anything of monetary value from contractors,
potential contractors, or parties to subcontracts. The contractor's board members and management must disclose to
the AAA any relationship which may be, or may be perceived to be, a conflict of interest within thirty (30) calendar
days of an individual's original appointment or placement in that position, or if the individual is serving as an
incumbent, within thirty (30) calendar days of the commencement of this contract. The contractor's employees and
subcontractors must make the same disclosures described above to the contractor's board of directors. Compliance
with this provision will be monitored.
31. Public Entity Crime
Pursuant to s. 287.133, F.S., the following restrictions are placed on the ability of persons convicted of public entity
crimes to transact business with the AAA. A person or affiliate who has been placed on the convicted vendor list
following a conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any
goods or services to a public entity, may not submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of real
property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant
under a contract with any public entity; and may not transact business with any public entity in excess of the
threshold amount provided in s. 287.017, F.S., for CATEGORY TWO for a period of 36 months following the date of
being placed on the convicted vendor list.
32. Purchasing
32.1 To procure any recycled products or materials, which are the subject of or are required to cant' out this contract, in
accordance with the provisions of s. 403.7065, F.S.
33. Patents, Copyrights. Royalties
If any discovery, invention or copyrightable material is developed or produced in the course of or as a result of work
or services performed under this contract. the contractor shall refer the discovery, invention or material to the AAA to
be referred to the Department of State. Any and all patent rights or copyrights accruing under this contract are hereby
reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. 287,0571 (5) (k) I and 2 as
amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in the
contract.
33.1 If the primary purpose of this contract is the creation of intellectual property, the state shall retain an unencumbered
right to use such property, notwithstanding any agreement made pursuant to Paragraph 33.
34. Emergency Preparedness and Continuity of Operations
34.1 If the tasks to be performed pursuant to this contract, include the physical care and control of clients, or the
administration arid coordination of services necessary for client health. safety or welfare, the contractor shall, within
8/71
19
January 2011 Contract AA-1 I29
thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of in
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 Nan -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 Soverehm 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 IvIaieure
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
9I71
January 2011 Contract AA-1129
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 tinder 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
U.S. Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the
Contract Manager or the representative of the 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 U.S,
Postal Service or any expedited delivery service that provides verification of delivery or by hand delivery to the
Contract Manager or the representative of the 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 fnay 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-I,006(3). FA.C. Waiver of
I0/71
E
F
January 2011 Contract AA- 1129
breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and shall not he
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 Uraham, Director, Monroe County Social Services
b.
where financial and administrative records are
1100 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
1100 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 WETNESS 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.
S1
f`i
TITLE: Mayor
DATE:
12-15-2010
CURK
CIEQ'
AS
ALLIANCE FOR AGING, INC.
SIGNED By
i-'
NAME: MAX B. ROTHMAV
TITLE: PRESIDENT/ AND CEO
DATE:
; TjjbRNEY
12/71
January 2011 Contract AA- 1129
INDEX TO CONTRACT ATTACHMENTS
ATTACHMENT
ATTACHMENT DESCRIPTION
PAGE
ATTACHMENT I
STATEMENT OF WORK
15-27
ATTACHMENT 11
CERTIFICATION REGARDING LOBBYING
)g
ATTACHMENT III
FINANCIAL COMPLIANCE AUDIT ATTACHMENT
31-33
ATTACHMENT III
FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT
35
EXHIBIT I
ATTACHMENT III
AUDIT REPLATIONSHIP DETERMINATION
37
EXHIBIT 2
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
39
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION,
41
INELIGIBILITY AND VOLUNTARY EXCLUSION
CONTRACTS/SUBCONTRACTS
ATTACHMENT VI
ASSURANCES — NON -CONSTRUCTION PROGRAMS
43-44
ATTACHMENT VII
CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE
45
ATTACHMENT
OLDER AMERICANS ACT CONTRACT REPORT CALENDAR
47
Vill
ATTACHMENT IX
REQUEST FOR PAYMENT
49
ATTACHMENT X,
RECEIPTS AND EXPENDITURES, TITLE 11113, IIIC 1, AND IlIC2
51
EXHIBIT 2
ATTACHMENT X,
RECEIPTS AND EXPENDITURES, TITLE IIIE
53
EXHIBIT 3
ATTACHMENT A
DEPARTMENT OF ELDER AFFAIRS' PROGRAMS & SERVICES
55
HANDBOOK (ON CD)
ATTACHMENT B
DEPARTMENT OF ELDER AFFAIRS' CIVIL RIGHTS COMPLIANCE
57-62
CHECKLIST AND INSTRUCTIONS
ATTACHMENT F,
DOEA COST ANALYSIS FOR NON -COMPETITIVELY PROCURED
63
EXHIBIT I
CONTRACTS IN EXCESS OF CATEGORY 11
ATTACHMENT F,
INSTRUCTIONS: DOER COST ANALYSIS FOR NON -COMPETITIVELY
65
EXHIBIT 2
PROCURED CONTRACTS IN EXCESS OF CATEGORY 11
ATTACHMENT G
ARC POLICY AND PROCEDURES FOR OUTSOURCED FUNCTIONS
67-71
13/71
E
January 2011
14/71
I
Contract AA- 1129
January 2011
E
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.
15/71
January 2011 Contract AA-1129
1.2 Alliance for Aging Mission
The Alliance For Aging Inc. mission id to promote and advocate for the optimal quality of life for older adults and
their families.
1.2.1 DOEA Mission Statement
The department's mission is to foster an optimal quality of 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, where all can enjoy Florida's unparalleled amenities in order to thrive and prosper. Area agencies, lead
agencies and local service providers as partners and stakeholders in Florida's aging services network are expected
to support the department's mission, vision, and program priorities.
1.2.2 Older Americans Act Program Mission Statement
The Older Americans Act (OAA) Program is a federal program initiative that provides assistance to older persons
and caregivers and is the only federal supportive services program directed solely toward improving the lives of
older people. The program provides a framework for a partnership among the different levels of government and
the public and private sectors with a common objective, improving the quality of life for all older individuals by
helping them to remain independent and productive.
1.3 GENERAL DESCRIPTION
1.3.1 General Statement
The primary purpose of the OAA program is to foster the development and implementation of comprehensive and
coordinated systems to serve older individuals. The OAA program uses these systems to assist older individuals to
attain and maintain maximum independence and dignity in a home environment and allows for the capability of
self -care with appropriate supportive services.
1.3.2 Authority
The relevant references authority governing the OAA program are:
(1) Older Americans Act of 2006, as amended;
(2) Rule 58A-I, Florida Administrative Code; and
(3) Section 430.101, Florida Statutes.
1.3.2.1 Incorporation of Reference :Memoranda
In accordance with Ch. 287 F.S., as amended and Department of Financial Services', Chief Financial Officer
Memoranda, the following memoranda are provided for informational purposes and incorporated by reference:
(1) CFO Memo No. 02: Release date, August 20, 2010;
(2) CFO Memo No. 03: Release date, June 29, 2010; and
(3) CFO Memo No, 06: Release date, June 30, 2010.
1.3.3 Scope of Service
The contractor is responsible for the activities listed in this Appendix, Sections I and 1I and Appendix G, and shall
be delivered in keeping with the in Provider Service Application in response to the 2009 OAA RFP. The services
shall be provided in a manner consistent with and described in the current Department of Elder Affairs Programs
and Services Handbook (ATTACHMENT A).
1.3.4 Major Program Goals
The major goals of the OAA program are to improve the quality of life for older individuals, preserve their
independence and prevent or delay more costly institutional care. These goals are achieved through the
implementation of a comprehensive and coordinated service system that provides a continuum of service alternatives
that meet the diverse needs of elders and their caregivers.
EM
January 2011 Contract AA-1129
1.4 INDIVIDUALS TO BE SERVED
1.4.1 Eligibility (Title III Programs)
1.4.1.1 OAA Title 111, General
Consumers shall not be dually enrolled in an OAA program and a Medicaid eapitated long-term care program.
1.4.1.2 OAS. Title IIIB, 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 IHC2, 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 HIE, Caregiver Support Services
17/71
r
January 2011
(1)
(2)
(3)
(4)
19
11
Family caregivers of individuals age 60 or older; Contract AA- 127
Grandparents (age 55 or older) or older individuals (age 55 or alder) who are relative caregivers;
Priority will be given to family caregivers who provide care for individuals with Alzheimer's disease and
related disorders with neurological and organic brain dysfunction and for grandparents or older individuals
who are relative caregivers who provide care for children with severe disabilities; and
For respite and supplemental services, a family caregiver must be providing care for an older individual who
meets the definition of the term "frail" in OAA, Section 102 Paragraph 22.
1.4.2 Targeted Groups
Preference shall be given to those with the greatest economic and social need, with particular attention to low-
income older individuals, including those that are low-income minorities, have limited English proficiency, and
older individuals residing in rural areas.
SECTION II — MANNER OF SERVICE PROVISION
2.1 SERVICE TASKS
In order to achieve the goals of the OAA program, the contractor shall ensure the following tasks are performed:
(1) Client eligibility determination;
(2) Targeting and screening of service delivery for new clients;
(3) Delivery of services to eligible clients;
(4) Use of volunteers to expand the provision of available services;
(5) Monitoring the performance of its subcontractors; and
(6) Information and Referral/Assistance Access Services (Elder Helpl ines).
2.1.1 Client Eligibility Determination as listed in ATTACHMENT 1, Paragraph 1.4.
2.1.2 Targeting and Screening of Service Delivery for New Clients
The contractor shall develop and implement policies and procedures consistent with OAA targeting and screening
criteria.
2.1. 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 performance of the following services in accordance with ATTACHMENT A.
The services funded pursuant to this contract are in accordance with the OAA, Title III, sections 321, 331, 336, and
373 as follows:
(1) Section 321, Title IIIB Supportive Services;
(2) Section 331, Title IIIC I Congregate nutrition Services.
(3) Section 336, Title IIIC2 Home Delivered ?Nutrition Services;
(4) Section 373, Title IIIE Caregiver Support Services, and
(5) Sections 321 and 373 — Information and Referral/Assistance Access Services (Elder Helplines)
15171
]uouury2011
Contract AA-l|2P
2,1~3.1 Supportive Services
Supportive xcrviocu include u variety ofcwmmunity'haoed
and home -delivered services that support the quality o/
life for older individuals by helping them remain independent
and productive. Services include the following:
(1) Adult Day Care/Adult DuyBcu(�b(�amc� (0)
Legal Assistance,
(2) CamrgiverTruiniog/Support, (9)
Material Aid;
(3) Case Aid/Case Management; (10)
Occupational Therapy;
(4) Chore Services-, (81)
Outreach;
(5) Companionship; (12)
Personal Care;
(6) Counsel in- (Gerontological and Mental (13)
Physical Therapy;
Health);
(7) Education/Training; (14)
Recreation;
(15) EmergencyAlert Response; (24)
Referral/Assistance;
(16) Escort; (25)
Respite Services;
(17) Health Support: (26)
Sc/ecning/Amoemwment,
(KQ) Home Health Aid; (27)
Shopping Assistance;
(89) Homemaker; (28)
Skilled Nursing;
(20) Housing Improvement; (29)
Specialized Medical Equipment, Services, and
(21) Information;
Supplies
(22) Intake; (30)
Speech Therapy;
(23) Interpreter/Translating; (30
Telephone Reassurance; and
(32)
Transportation
2.1~3.2 Congregate Nutrition Services
Nutrition services are provided in congregate az'hnga and
are designed to reduce hunger and food insecudty,
`
promo�mociu|izudooand the health and well being ofolder individuals byuamisdng them togain access to nutrition
and other disease prevention and health promotion services.
Services include:
(1) Congregate meals;
(2) Congregate /ncai,screening;
(3) Nutrition education and nutrition Counseling; and
(4) Outreach.
2'1.3'3 Home Delivered Nutrition Services
In -home nutrition services are provided to reduce hunger and food inmccuri,y, promote socialization and the health
and well bein* of older individuals by assisting such individuals to �uin 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 CaregiverHopport Servicmm(UHE )
The OoUnvin@ services are intended to provide direct help to caregivers. maia in the areas of health, nutrition and
financial literacy and assist caregivers in making decisions and problem solving related to their caregiving roles and
|9/7\
E
January 2011
responsibilities:
(1) Adult Day Care/Adult Day Health Care;
(2) Caregiver Train ing/Support;
(3) Counseling (Gerontological and Mental Health);
(4) Education/Training;
(5) Financial Risk Reduction (Assessment and Maintenance);
(6) Information;
(7) Intake;
(8) Outreach;
(9) Referral/Assistance,
(10) Respite Services;
(11) Screen ing/Assessment; and
(12) Transportation.
N
Contract AA- 1129
2.1.3.5 Caregiver Support Supplemental Services (HIES Program): At least 10 percent, but no more than 20 percent,
of the total Title IIIE funds shall be used to provide supplemental support services. The following services are
provided to complement the care provided by caregivers.
(1) Chore Services;
(2) Housing Improvement;
(3) Legal Assistance,
(4) Material Aid-, and
(5) Specialized Medical Equipment, Services and Supplies.
2.1.3.6 Caregiver Support Grandparent Services (111EG Program): At least 5 percent, but no more than 10 percent, of
the total Title IIIE funds shall be used to provide support services to grandparents and older individuals who are
relative caregivers. Services for grandparents or older individuals who are relative caregivers designed to help meet
their caregiving obligations include:
(1) Caregiver Train ing/Support, (7) Outreach,
(2) Child Day Care; (8) Referral/Assistance*
(3) Counseling (Gerontological and Mental
Health);
(4) EducatioivTrainina--;
(5) Information;
(6) Legal Assistance;
(9) Screening/Assessment;
('10) Sitter; and
(11) Transportation
2.1.4 Use of Volunteers to Expand the Provision of Available Services
The contractor shall make use of trained volunteers in providing direct services delivered to older individuals and
individuals with disabilities needing such services. If possible, the contractor shall work in coordination with
organizations that have experience in providing training, placement, and stipends for volunteers or participants
as organizations carrying out Federal service programs administered by the Corporation for National and
Community Service), in community service settings.
20/71
January 2011
Contract AA-1129
2.1.5 :Monitoring the Performance of Subcontractors
The contractor shall conduct at least one monitoring per year of each subcontractor. The contractor shall perform
fiscal, administrative and programmatic monitoring of each subcontractors to ensure contractual compliance, fiscal
accountability, programmatic performance, and compliance with applicable state and federal laws and regulations.
2.1.5.1 Use of Subcontractors
If this contract involves the use of a subcontractor or third party, then the contractor shall not delay the
implementation of its agreement with the subcontractor. If any circumstances occur that may result in a delay for a
period of 60 days or more of the initiation of the subcontract or in the performance of the subcontractor, the
contractor shall notify the AAA's Contract Manager and the AAA's Chief Financial Officer in writing of such
delay.
The contractor shall not permit a subcontractor to perform services related to this agreement without having a
binding subcontractor agreement executed. In accordance with Paragraph 24.1 of the Standard Agreement, the
AAA will not be responsible or liable for any obligations or claims 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 normal business hours unless
other times are more appropriate to meet the performance requirements of the contract, and it shall monitor its
subcontractors to ensure they are available to provide services during hours responsive to client needs and during
those times which best meet the needs of the relevant service community.
2.3 Equipment
2.3.1 Equipment means: (a) an article of nonexpendable, tangible personal property having a useful life of more than one
year and an acquisition cost which equals or exceeds the lesser of the capitalization level established by the
organization for the financial statement purposes, or $5,000.00 [for federal funds], or (b); nonexpendable, tangible
personal property of a nonconsumable nature with an acquisition cost of $1,000.00 or more per unit, and expected
useful life of at least one year; and hardback bound books not circulated to students or the general public, with a
value or cost of $250.00 or more [for state funds].
2.3.2 Contractors and sub -contractors who are Institutions of Higher Education, Hospitals, and Other Non -Profit
Organizations shall have written property management standards in compliance with 2 CFR Part 215
Administrative Requirements (formerly OMB Circular A-1 10) that include: (a) a property list with all the elements
identified in the circular; and, (b) a procedure for conducting a physical inventory of equipment at least 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:
(1) A description of the equipment;
(2) Manufacturer's serial number, model number. Federal stock number, national stock number. or other
identification number;
(3) Source of the equipment, including the award number;
(4) Whether title vests in the contractor or the Federal Government;
(5) Acquisition date (or date received, if the equipment was furnished by the Federal Government) and cost;
(6) Information from which one can calculate the percentage of Federal participation in the cost of the equipment
21/71
��
Juuuury20|1
Contract AA- ll29
(not applicable oaequipment furnished bythe Federal Govcrnmenc);
(7) Location and condition of the equipment and the date the information was reported;
(8) Unit acquisition cost; and
(9) 0dmoCc disposition data, including date of disposal and au{eu price or the method used to determine cuocnt
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 $5.00O.O0and equipment purchased wid
state funds with unacquisition oos over Sf,00O.0Othat isspecifically identified iothe area plan approved byD{}EA
impart ofthe cost ofcarrying out the activities and functions of the grant awards and Title (ownership) will vest ir
the contractor, subject to the conditions of 2 CFR Part 215 Administrative Requirements (formerly OMB CirCUlal
&-|iO). Subpart C. Yuuugoapb 34. Equipment purchased under these thresholds is cnooidcncd supplies and is no|
subject to property standards. Equipment purchased with funds identified in the budget attachments to agreements
covered by this contmct, or identified in the sub -agreements with sub -contractors (not included in u cost
mcthodo|o8y).imsubject tnthe conditions ofChapter 27].F. S.undb0A-i.0O|7.F.A.C.orTit|c45 CER Pmrt74,
2.3.5 The contractor shall not dispose of any equipment g�����p�i��— �A�,m��dwi���
provided this contract without first obtaining the approval of the AAA's Contract Manager. Whendiypooin0 ofpnr �y or �h� contractor submit owritten request for disposition instructions to therespective Contract Manager. The request should include u brief descriptionof the property, purchase price,(unding source, percentage of state or federal participation, acquisition date and condition of the property,The/equcxt should also indicate the contractor's proposed disposition (i.e., transfer »'donation t»another agency that
administers federal programs, offer the items for sale, destroy thitems, etc.).
2.3\6 The AAA's Contract Manager will issue disposition instructions. Ddisposition 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 2|5
Administrative Requirements (formerly OMB Circular A-|}0).
2.3~7 Rcu| property means land (including land improvements), 6uiNinQy, structures and appurtenances thereto,but
excludes movable machinery and equipment. Real property may not be purchased with state or federal funds
through agreements covered Linder this contract without the prior uppmmvu| of the D8E/� �eu} property purchases
6nmOlder '�medcuna'�ctfunds are subject tothe provisions ofTitle 42.Chapter 35Su�^hup�c�[Dyu�/\/'u�c
303Oh Dnitcd 8mtex Codc (DSC) |�cul pvopc�y purchuucm bono sCu�e fu dm '| ~~ " �`" '
. n can only be made through u fixed
cxpbulouduygonmand aids appnmpriudo. and t/ '[orcurcwu�ectiod �pro-inioouo`o.2|0.34Q.F.S.
2.3.0 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior to
disposal toensure nnconfidential information remains.
22/7)
January 2011
2.4 DELIVERABLES
IN
Contract AA-1129
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/Translating
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
Referra I/Assi stance
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'!
Contract Manager by the 15th of each month. This report is for all agreements and/or contracts between the
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 11 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 ATTACHTNIENT 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
January 2011
(3)
19
Contract AA-1129
Average monthly savings per consumer for home and community -based care versus nursing home care fos
comparable client groups;
(4) Percent of elders assessed with high or moderate risk environments who improved their environment score,
(a) Percent of new service recipients with high -risk nutrition scores whose nutritional status improved;
(6) Percent of new service recipients whose ADL assessment score has been maintained or improved;
(17) Percent of new service recipients whose iADL assessment score has been maintained or improved;
(8)- Percent of family and family -assisted caregivers who self -report they are very likely to provide care,
(9) Percent of caregivers whose ability to continue to provide care is maintained or improved after one year of
service intervention (as determined by the caregiver and the assessor); and
00) Percent of customers who are at imminent risk of nursing home placement who are served with community
based services.
(11) Any other outcome measures as listed in the Provider's Service Application in response to the 2009 OAA RFP.
2.7.3 Monitoring and Evaluation Methodology
The AAA will review and evaluate the performance of the contractor under the terms of this contract. Monitoring
shall be conducted through direct contact with the contractor through telephone, in writing, and/or an on -site visit.
The AAA's determination of acceptable performance shall be conclusive. The contractor agrees to cooperate with
the AAA in monitoring the progress of completion of the service tasks and deliverables.
2.7.4 Remedies -Nonconforming Services
The contractor shall ensure that all participants served under this agreement are eligible for the program, and that all
monthly and/or quarterly performance reports and financial records are maintained for each reporting period and
submitted as stipulated in Paragraphs 1.4 - 1.4.2 and 2.1 - 2.1.6.
Any nonconforming program services, performance reports or financial records not meeting the aforementioned
requirements shall not be eligible for reimbursement 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 the contractor's ability to provide
participant services, to achieve programmatic performance or to provide sound financial management of the
program.
2.8 CONTRACTOR'S FINANCIAL OBLIGATIONS
2.8.1 Matching, Level of Effort, and Earmarking Requirements
The contractor will fulfill a match requirement of at least 10 percent of the cost for all services funded through this
contract (i.e. 90 cents of grant funds must be matched with 10 cents from the contractor.) The subcontractor's
match will be made in the form of cash and/or in -kind resources. Match must be reported by title each month. At
the end of the contract period, all OAA funds must be properly matched.
2.8.2 Consumer Contributions
(1) The contractor assures compliance with Section 315 of the Older Americans Act as amended in 2006, in
regard to consumer contributions;
(2) Voluntary contributions are not to be used for cost sharing or matching;
(3) Accumulated voluntary contributions are to be used prior to requesting federal reimbursement; and
(4) Voluntary contributions are to be used only to expand services.
2.8.3 Use of Service Dollars
The contractor is expected to spend all federal, state and other funds provided by the AAA for the purpose specified
25171
J= nua �011
a ry Contract AA-1129
in the contract. The contractor must manage the service dollars in such a manner so as to avoid having a wait li4
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 uncle
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 th(
contractor to maintain a contractual or commercial relationship that is not carried out to implement Title III.
29 AAA RESPONSIBILITIES
29.1 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 I05AE (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 beginnincr with the first month of the contract. The schedule for submission of advance requests, if available
is shown on ATTACHMENT Fill of this contract.
26/71
January 201 I
IE
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 -44
CFR 74.22(k). Earned interest must he 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 DOE.A
forms 106A (ATTACHMENT IX) , 105AA (ATTACHMENT X-EXHIBIT I), 105AS (ATTACHINIENT X-
EXHIBIT 2). and 105AE (ATTACHMENT X-EXHIBIT 3).
3.3.1 All payment requests shall he 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. (Into 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 he submitted to the AAA with the monthly request for payment and expenditure report and must he reviewed
by the AAA before the contractor's request can be approved by the AAA.
27/71
January 2011
a
E
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that:
Contract AA- 1129
ATTACHMENT 11
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an
officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator,
in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or
cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing of
attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress,
or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement,
the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance
with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all sub -
awards at all tiers (including subcontracts, sub -grants, and contracts under grants, loans and cooperative agreements) and
that all sub -contractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
section 1352, Title 31, U.S. 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
Date
Name of Authorized Individual Application or Agreement Number
Name and Address of Organization
DOEA Form 103
(Revised Nov 2002)
29171
January 2011 Contract AA- 1129
FINANCIAL AND COMPLIANCE AUDIT ATTACHMENT III
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
In addition to reviews of audits conducted in accordance with OMB Circular A- 133, as revised, and Section 215,97, F.S., (see
"AUDITS" below), monitoring procedures may include, but not be limited to, on -site visits by the department of staff, limited
scope audits as defined by OMB Circular A- 133, as revised, and/or other procedures. By entering into this agr
eement, the
provider agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Department of
Elder Affairs or the Alliance for Aging. In the event the Department of Elder Affairs or the Alliance for Aging determines
that a limited scope audit of the provider is appropriate, the provider agrees to comply with any additional instructions
provided by the Department of Elder Affairs or the Alliance for Aging to the provider regarding such audit. The provider
further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief
Financial Officer (CFO) or Auditor General.
PART 1: FEDERALLY FUNDED
This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular
A-133, as revised.
In the event that the provider expends $500,000 or more in Federal awards during its fiscal year, the provider must have a
single or program -specific audit conducted in accordance with the provisions of OMB Circular A- 133, as revised. EXHIBIT
I to this 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 shall consider all sources of
Federal awards, including Federal resources received from the Department of Elder Affa I rs or the Alliance for Aging. The
determination of amounts of Federal awards expended should be in accordance with the guidelines established by OMB
Circular A- 133, as revised. An audit of the provider conducted by the Auditor General in accordance with the provisions of
OMB CircularA-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 awards in its fiscal year, an audit conducted in accordance with the
provisions of OMB Circular A- 133, as revised, is not required. In the event that the provider expends less than $500,000 in
Federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions of OMB Circular A-
133, as revised, the cost of the audit must he paid from non -Federal resources (i.e., the cost of such audit must be paid from
provider resources obtained from other than Federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Department of Elder Affairs or the Alliance for Aging shall be based on
the agreement's requirements, including any rules, regulations, or statutes referenced in the agreement. The financial
statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned
costs and liabilities due to the 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 Section 310(b)(2) of OMB Circular A-133, as revised, the schedule of expenditures of Federal
awards shall identify expenditures by agreement number for each agreement with the Department of Elder Affairs 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 days after receipt of the audit report or 9 months after the end of the provider's fiscal year end.
31/71
January 2011
' two,
of
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 $500,000 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 1I, paragraph 1; the provider shall ensure that the audit complies
with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as
defined by Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for -
profit organizations), Rules of the Auditor General.
If the provider expends less than $500,000 in state financial assistance in its fiscal year (for fiscal years ending September 30,
2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is 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
691-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by
agreement number for each agreement with the 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: Horacio Soberon
760 NW 107`h Ave.
Miami, FL 33172
3 2I71
January 2011 Contract AA- 1119
The Federal Audit Clearinghouse designated in OMB Circular A- 133, as revised (the number of copies required by Sections
.320 (d)(1) and (2), OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at the
following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 101h Street
Jeffersonville, IN 47132
Other Federal agencies and pass -through entities in accordance with Sections .320 (e) and (f), OMB Circular A-133, as
revised.
Pursuant to Sections .320(fj, OMB Circular A-133, as revised, the provider shall submit a copy of the reporting package
described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the
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'h 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 32399-1450
Any reports, management letter, or other information required to be submitted to the Department of Elder Affairs pursuant to
this agreement shall be submitted timely in accordance with OMB Circular A- 133, Florida Statutes. and Chapters 10.550
(local governmental entities) or 10.650 (nonprofit and for -profit organizations), Rules of the Auditor General, as applicable.
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
oroanizations). 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
PART IV: RECORD RETENTION
Contract AA- 1129
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.
34/71
JanUary 2011 Contract AA- 1129
ATTACHMENT III
EXHIBIT t
I. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
PROGRAM TIT=LIE-FPUNDING
SOURCE
CFDA
AMOUNT
Older Americans Act Administration
Title 111B — Support Services
U.S. Health and Human Services
91044
$00) i
Older Americans Act Administration
Title 111C I —Congregate Nvleals
U.S. Health and Human Services
Human Services
93.045
$142.6000)
Older Americans Act Administration
Title III C2 — Home Delivered Meals
U.S. Health and Human Services
93.045
$210,83100
Older Americans Act Administration
---
Title III E — Caregiver Support Services
U.S. Health and Human Services
93.052
$67.5600)
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:
35/71
January 2011
E
E
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 he 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. Star. 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-'130 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-2 I - Cost Principles)*
2 CFR Part 215 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 ONIB Circular A-
133 Compliance Supplement, Appendix 1,
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to he a
recipient/subrecipient. must comply with the following fiscal laws, rules and regulations:
Section 215.97, Ha. 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
37/71
January2011 Contract AA-1129
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
FOR AGREEMENTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the contractor named in the contract or agreement to which this form is an
attachment, hereby certifies that:
(1) The contractor and any sub -contractors of services under this contract have financial management systems capable of
providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each
grant -funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of
funds for all agreement supported activities; and (3) the comparison of outlays with budgeted amounts for each award. The
inability to process information in accordance with these requirements could result in a return of grant funds that have not
been accounted for properly.
(2) Management Information Systems used by the contractor, sub-contractor(s), or any outside entity on which the contractor
is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be capable of
processing data accurately, including year -date dependent data. For those systems identified to be non -compliant,
contractor(s) will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the
undersigned warrants that these products are capable of processing year -date dependent data accurately. All versions of
these products offered by the contractor (represented by the undersigned) and purchased by the State will be verified for
accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the
hardware or software programs from operating properly, the contractor agrees to immediately make required corrections to
restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the State,
and without interruption to the ongoing business of the state, time being of the essence.
(4) The contractor and any sub -contractors) of services under this contract warrant their policies and procedures include a
disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data
integrity compliance issues.
The contractor shall require that the language of this certification be included in all subagreements, subgrants, and other
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 a prerequisite for making or entering into this transaction imposed by OMB Circulars
A-102 and 2 CFR Part 215 (formerly OMB Circular A -I 10).
Name and Address of Contractor
Signature Title Date
ame of Authorized Signer
s Re, i ed hine 20'{}s}
3g171
January 2011
Contract AA- 1129
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
I The prospective contractor certifies, by signing this certification, neither it nor its principals are presently debarred,
suspended, proposed for debarment, declared ineligible, or Voluntarily excluded from participation in this
transaction by any federal department or agency.
(2) Where the prospective contractor is unable to certify to any of the statements in this certification, such prospective
participant shall attach an explanation to this certification.
S ignature Date
Title Agency/Organization
(Certification signature should be same as Contract signature.)
Instructions for Certification
I. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person,"
"primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out in the sections
of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020, as supplemented by 2 CFR 376.10-
376.995). You may contact the Contract Manager for assistance in obtaining a copy of those regulations.
2. This certification is a 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 certification, in
addition to other remedies available to the federal government, the department may pursue available remedies,
including suspension and/or debarment.
3. The contractor will provide immediate written notice to the Contract Manager if at any time the contractor learns that
its certification was erroneous when submitted or has become erroneous by reason of changed 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
(EPLS).
4. The contractor will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion
- Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for lower tier
covered transactions.
5. The contractor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is
debarred, suspended, determined ineligible or Voluntarily excluded from participation, unless otherwise authorized
by the federal government.
6. If the contractor knowingly enters into a lower tier covered transaction with a person who is suspended, debarred,
ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the
federal government, the department may pursue available remedies, including suspension, and/or debarment.
T The contractor may rely upon a certification of a prospective participant in a lower tier covered transaction that it is
not debarred, -,uspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the
certification is erroneous.
Rv,. ised kine NY)
4 1/7 1
January 2011
K
11
ASSURANCES —NON -CONSTRUCTION PROGRAMS
Contract AA- 1129
ATTACHMENT V1
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information, including g sug
,,.,estions 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 1695-1686), 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;
(it) 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: (t)
the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616). as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g), 523 and 527 of the Public Health Service Act of 1912 (42
U.S.C.. 290 dd-3 and 290 ee 3). as amended, relating to confidentiality of alcohol and drug abuse patient records: (h) Title VIII of the
Civil Rights Act of 1968 (42 U.S.C.. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing;
(i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made, and (j)
the requirements of any other nondiscrimination statute(s) which may apply to the application,
7. Will comply, or has already complied, with the requirements of Titles 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.
Will comply. as applicable. with the provisions of the Hatch Act (5 U&C. ' 1501-1508 and 7324-7328), which limit the political
activities of employees whose principal employment activities are funded in whole or in part with Federal funds.
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. 276,L
and IS U.S.C,1874) and the Contract Work Hours and Safety Standards Act 00 U.S.C., 327-333). regarding labor standards for
federally assisted construction subagreements.
43171
January 2011 Contract AA- 1129
IQ Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973
(P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if
the total cost of insurable construction and acquisition is $ 1 0.0(X).00 or more. t
I L 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.)- W 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,740l et seq,). (g) protection of
Underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended. (P.L. 93-523); and (h) protection of
endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C._ 1721 et seq.) related to protecting components or potential
components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended
(16 U.S.C..470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act
of 1974 (16 U.S.C.. 469a- 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.
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.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL I TITLE
APPLICANT ORGANIZATION I DATE SUBMITTED
44/71
January 1-0 11
0 W, VU z XT4 0 5 11 1 L%1 Ll UK I
Report Number Based On
t
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- 11, 29
ATTACHMENT V111
Submit to AAA
On This Date
January t
January I
February 3
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.
47171
E
January 20 t I
E
Contract AA- 1129
I-V
REQUEST FOR PAYMENT
OLDER AMERICANS ACT
PROMIDER NAME, ADDRESS, PHCNE AND FED 10 NUMBER
TYPE OF REPORT
THS REQUEST PERIOD:
Advance
Report * -
Reimbursement-
Agreement # : _
Agreement Period:
PSA:
CERTIFICATION: I hereby certify to the best of my knowledge that this request conforms with the terms and thepurposesset forth in the above agreement.
Prepared By: Date: - Approved By: Date:
PART A:
BUDGET SUMMARY
ADMIN.
(2)
ilia
(3) (4) P
(6)
IfIci IIIC2 Title IIIE TOTAL
1. Approved
Agreement Amount.
0.00
0.00
0.00 0.00 0.00 0.00
2. Previous 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
11. 1st-2nd Months
Request Only
0.00
0.00
0,00
0.00
0.00 000
2, Net Expenditures
For Month
0.00
0.00
0.00
0.00
I
0.00 0,00
3. Additional
Cash Needs (Attach Doc.)
0,00
0,00
0.00
0.00
0.00 0 00
4, Total
PA
0,001
0,001
0.00
0.00
000 0.00
NET FUNDS REQUESTED:
1. Less: Over -Advance
000
0,00
000
0,00
0,00 0 00
2- Agreement Funds are
Hereoy Requested For
0�00
0.00
0,00
0.00
000 0 00
DOER RDPW 1r,6A - used 511,0
49/71
January 2011
Contract AA- 1129
ATTACHMENT X
EXHIBIT-2
PROVIDER NAME, ADDRESS, PHONE# AND FEIO*
Program Funding Source:
THIS REPORT PERIOD
FROM: TO;
CONTRACT
IIIC2
PERIOD:
CONTRACT*
REPORT#
CERTIFICATION I certify to the best of my knoWedge and telief 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 %Pon
Year to Date
Approved Budget
1, Federal Funds
$0,00
$0.00
$0,00
%
2, State Funds
$0,00
$0.00
$0.00
%
3. Program Income
$0.00
S0,00
som
%
4. Local Cash Match (CCE, HCE and Other)
$0.00
$aoo
$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
Som
%
PART B : EXPENDITURES
1. Approved
2. Expenditures
3. Expenditures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
1. 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 E)(PENDITURES
$om
$0.00
$0.00
%
PART C: OTHER EXPENDITURES
(For Tracking Purposes only)
1. Match
a. Other and In -Kind
$0.00
S0.00
$0,00
b. Local Match
$0.00
$om
$0,00
%
2. USDA Cash Received
$0,00
SO.00
S0.00
3, TOTAL OTHER
$0.00
$0,00
$0,00
PART OTHER REVENUE AND EXPENDITURES
2. Addition Cost Alternative Program Income
3, tj7t-ereSt
1, Program Income (PI)
a Approved Budget$
a, Earned on GR Advances $____
a. OAA Unbudgeted PI Receipts YTD
b- Received YTD
b. Return of GR Advance
$
c. Expenditures
c. Other Earned
DOEA FORM 11,15as revised f *, /r?9
51/71
January 2011
RECEIPTS AND EXPENDITURE REPORT
OLDER AMEMCAN ACT
Contract AA- 1129
ATTACHMENT X
EXHIBIT 3
PROVIDER NAME, ADDRESS, P40NE# AND FE104
Program Funding Source
THIS REPORT PERIOD
FROM: TO�
CONTRACT
Title M E
PERIOD:
CONTRACT 4
REPORT#
CERTIFICATION: I certify to the best of my knoMedge 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
WOO
%
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
S0-00
%
6. Local In -Kind Match
SOAX)
$0.00
$0.00
%
7. TOTAL RECEIPTS
$0.00
$0.00
$0.00
%
PART B: EXPENDITURES
I. Approved
2. Expenditures
3. Expenditures
4. Percent of
Budget
For This Report
Year to Date
Approved Budget
A: Direct Services
1. Personnel
$O.00
WOO
$0�00
%
2. Travel
$0.00
Saw
$0,00
-
*16
3- Building Space
$0.00
$0.00
50.00
%
4. Communication I Utilities
$000
$0.00
S0.00
%
5. Printing / Supplies
$0.00
$o_()o
$o, 00
6. Equipment
$0.00
S0.00
$0.00
--%
%
7. Other
$0.00
$0,00
$0.00
%
8 Agreement Services
8. Services Subcontracted
$0,00
$0.00
$0.00
%
9. TOTAL EXPENDITURES
WOO
S0.00
$0.00
%
10. DEDUCTIONS
a. Total Local Match
$0.00
S0.00
S0.00
%
b. Program Income Used
SO-00
$0.00
S0.00
c. TOTAL DEDUCTIONS
$0.00
$0.00
som
%
11. NET E)VEN07UR ES
$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 Services year to Date:
1. !nfcrrmatlon , , 30,00
$0,00
2- Assistance.- iF5O
1 1 1 S0100
70-0
3 r-ouri... $0,00
1 11 $000
0100
4, Respite..-.... 10-00
50,00
5, Supplemental Ser�ces,
$000
6, TOTAL........_.__.__.--.. $0100
Part 8 Line 11, column 3 snowd be equal to this total.
PART f3RANDPARENTSERVr-ESireMrteclbyFederajFiscal Teary
IFFY --- S - ------ FFY _ S,____ Fpy
Mlatch $ Match $ Match $
DOEA FORM 105AE e�Ased IZ�
53171
January 2011
19
N
Department of Elder Affairs Programs & Services Handbook, provided on CD.
Also, available at the Department's Intranet site under, "Publications".
55/71
Contract AA- 1129
ATTACHMENT A
January 2011
19
E
STATE OF FLORIDA nFPARTMFNT r)l: r-i nFR A1:;:AlQQ
Contract AA- 1129
ATTACHMENT B
CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility Name
County
AAA/Contractor
Address
Completed By
City, State, Zip Code
Date jTelephone
PART 1.
k"ej 114 q 04 IRWO11 I I I a 9: 14M910T, 1:1 IRA III IQ 011141;2 9 W I &MLOM
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:
Total #
I % White
I % Black
I % Hispanic
% Other
% Female
3.
STAFF CURRENTLY EMPLOYED. Effective date:
Total #
I % White
I % Black
I % Hispanic
% Other
% Female
% Disabled
4.
CLIENTS CURRENTLY ENROLLED OR REGISTERED Effective date:
Total #
% White
I % Black
I % Hispanic
% Other
% Female
% Disabled
% Over 401
5.
ADVISORY OR GOVERNING BOARD, IF APPLICABLE.
Total #
% White
% Black
% 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 DOEA? If NA or NO, explain.
F-1 NA YES F�NO
f-1
7.
Compare the staff composition to the population. Is staff representative of the population?
If NA or NO, explain.
NA YES NO
777
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 0 1:1
9. Are eligibility requirements for services applied to clients and applicants without regard to NA YES NO
race, color, national origin. sex, age. religion or disability? If NA or NO, explain. El 7 71
57/71
IE
January 2011
N
Contract AA- l|29
0. 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
� [� [� F
�� �� ��
11. For in'patientaemicea. are room assignments made without regard to race, color, national origin or disability? If N* 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 oftheir protection against discrimination?
Uyes, how? Verbal C Written C Poster 0 |/NAorNO, explain.
14. Give the number and current status o/ any discrimination complaints regarding oamioeo or
employment filed against the program/facility.
15. Is the Program/facility physically aoueoa)b|e to mobiUty, hoaring, and sight -impaired individuals? If NA or
NO, explain.
mxYES wo
M Fl =
PxeT|m. THE FOLLOWING QUESTIONS APPLY ToPROGRAMS AND pAc/uTrEaWITH 15oR MORE EMPLOYEES
16. Has a self -evaluation been conducted to identify any barriers tnserving disabled individuals. and tomake any
necessary modifications? If NO. explain.
17� /s there and established grievance procedure that incorporates duo process in the resolution of
complaints? /fNO, explain,
YES NO
January 20 t t
❑ [I
0 . I• # ss �*- - M,
Contract AA- 111-9
YES NO
H F-1
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
F-1 0
MW
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 0NO
F�
59171
January 2011
M
Contract AA- 1129
AAA USE ONLY
Reviewed By
In Compliance: YES ❑ NO* ❑
Program Office
*Notice of Corrective Action Sent
Date
Telephone
Response Due
On -Site 0 Desk Review ❑
Response Received
1#1111MIllift . I - M '.*- 6
60/71
57
]oouury20il `-
CoutrucC/\}\-}|2A
INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST xrrmo*MEmra
i. Describe the geographic service area such is a district, county, city or other locality, If the progmm/facility
serves xspecific target population such uyadolescents. describe the target population. Also, define the type of
service provided.
2. Enter the percent ofthe population served byrace and sex. The population served includes persons inthe
geographical area for which services are provided such mmucity, County o«other regional area.Population- stati
stics
containing Florida population statistics. Include the source of your population statistics. ("Other" races include
Asian/Pacific Islanders and American Indian/Alaskan 2Vutivey.)
Enter the total number of full-time staff and their percent by race, sex and disability. Include the effective date o[
your Summary.
4. Enter the total number o[clients who are enrolled, registered or currently served bythe program orfacility, and
list their percent by race, sex and disability. Include the date that enrollment was counted.
5. Enter the total number o[advisory board members and their percent by rxoc sex, and disability. If there is no
advisory or governing board, leave this section blank.
h. Each recipient of federal financial uuxiy{unce must have on fib on assurance that the pnogo/rn will be conducted in
compliance with all nondiscriminatory provisions as required in 45 CER 80. This is usually u standard part of the
contract language for DOEA recipients and their sub -grantees, 45 CFR 80.4 (a).
7. Is the race, scx, and national origin of the staff reflective of the general population'? For example. if 10% of the
population ioHispanic, inthere ucomparable percentage o[Hispanic ytuf?
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 mdetermine the reasons for such variation and take whatever
action may be necessary to correct any discrimination. Some legitimate disparities may exist when programs are
sanctioned to serve target populations such as elderly or disabled persons. 45 CFR
80.3 (h)(6)'
9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or
employment'? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on -site record analysis of persons who applied but were denied services or employment, 45 CFR803(u)
and 4jCFK80.| (h)(2).
|O. Participants orclients must be provided services such as mcdicu|, nursing and dental core. laboratory mopviccy
physical and recreational rbemupien, Counseling and mocid services without regard ,o race, ^mx co|or. national ' origin,
religion. age ordisability. (�ou�cxyhdes.appointment scheduling and ocounre
cord ` —
must
uniformly and wiwithoutrc�and/o race. sox, color. national origin. religion, age or disability. Entrances, waiting
roomm nz�nmnur�am n�mnoumuxndod� ur�i|ibcxmmudsmbccquuUymvuilahk:unoUc/kznu�45 CFR =
|{. For in -patient nerviccu residents must boassigned un rooms. wards, etc, without regard uorace, co|o:nationalx�onu/
origin or disability, Also, residents mug no, be asked whether they are willing to share accommodations with
persons m[udifferent race, color, national origin, ordisability, 45CFR 80.3(a).
12. The program/facility and all services must beaccessible mparticipants and applicants. inc|udinQthose persons who
may not speak English. /n geographic areas where u significant population of non-English speaking people live.
pvogommcccmmihihtymay include ,he employment o[bUingux| staff, Ioother areas. ixiysuUicient/ohave upolicy
6D7l
Im
January 2011 Contract AA- 1129
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 prograrriffacility. 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, restroorn 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 he taken to notify employees and the public of the progmm/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).
10.
Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with
impaired sensory, manual or speaking skills where necessary. Auxiliary aids may include, but are not limited to,
interpreters for hearing impaired individuals, taped or Braille materials, or any alternative resources that can be
used to provide equally effective services. (45 CFR 84,52 (d).
21. Programs/facilities with 50 or more employees and S50.000 in federal contracts must develop, implement and
Z7
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.
62171
January 2011 Contract AA-1129
ATTACHMENT F
EXHIBIT I
DOEA Cost Analysis For Non -Competitively Procured Contracts
In Excess Of Category 11
PROGRAM: CONTRACT PERIOD:
TYPE OF SERVICE:
1
2
Column 3
Column 4
Column 5
7t`
&"7 7
(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
-j
f.
Printing & Supplies
ag.
Other (Please iist or attach details)
K7
Allocated Cost/Overhead
TOTAL
Client Services (Attach
m
details)
v
TOTAL
N
N
CERTIFICATION (to be signed by DOER 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
6317 1
January 2011 Contract AA- 1129
ATTACHNIENT F
EXHIBIT 2
INSTRUCTIONS:
"A %i I'll kk
2i 116'. Ofivi
k '110KC a) 0 k1IM I KIAV4 V KIM# I
The purpose of the ATTACHMENT F, Exhibit 1, is to document that costs in non -competitively procured contracts in excess of
S35.0()0 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 Anorlysisfbr Non -Competitively Procured Agreements in Excess of Category Hform 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 H 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,(X)O (federal funds) or $ LWO 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 112.061, 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.
E 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 federal ly- 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 ('D 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.
(3) Client Service costs should be documented via Area At!encv on Aging Area Plans, Unit Cost information input into
WebD13, or some other form of documentation to support the cost analysis.
(4) 'Fhe allocation to the agreement will be calculated based on the cost by line item cost divided by the total agreement
amount.
64/71
January 2011
Alliance for Aging, Inc.
Aging Resource Center/Elder Helpline
Policy and Procedure for
Outsourced function - Screening
Contract AA- 1129
ATTACHMENT G
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.
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).
3. 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.
7. 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].
8. 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 funding sources. [If there is
an existing client record in CIRTS, the client record in CIRTS will he 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 Relpline
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.
Z�
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:
I. 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
3. 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
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
January 2011
E
E
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 DOER funded services in Miami -Dade and Monroe Counties and on the CIRTS wait
list beam to receive services as funding becomes available,
Policy: ARC will work with ARC Contracted Providers to ensure that clients waiting for DOER funded services begin to
receive those services as funding becomes available.
Procedure:
I . ARC Contracted Provider will activate clients on CIRTS wait list based on DOER 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 -DOER 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.
69/71
Jantlary 1-0 11
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 DOEA Reassessment Standards.
2. The re -screening maybe 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 DOEA Notice of Instruction: Assessed Priority Consumer List#:062906-1 -I-OVCS as applicable.
7 1/71