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Item C17 ~#-~ Louis LaTorre, Senior Director Social Services/tabt BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY MEETING DATE: 6/20-21/01 DIVISION: COMMUNITY SERVICES BULK ITEM: YES X NO DEPARTMENT: SOCIAL SERVICES AGENDA ITEM WORDING: Approval of Contract #KG 034 Community Care For Disabled Adults for Fiscal Year 7/1/01 thru 6/30/02 Between the Florida Department of Children and Families, and the Monroe County Board of County Commissioners/Monroe County Social Services (Monroe County In Home Service Program, The Case Management Agency). ITEM BACKGROUND: The approval of this new contract will ensure uninterrupted In Home Services for the Disabled Adults under 60 in Monroe County. PREVIOUS RELEVANT BOCC ACTION: None CONTRACT/AGREEMENT CHANGES: None. STAF.F llliCOMMENUATION: Approval TOTAL COST: $91,713.00 COST TO COUNTY: $12,500.00 CI~ V?0 Y'\(\..~J~ BUDGETED: YES~ NO REVENUE PRODUCING: YES NO~ AMT.PER MONTH YEAR APPROVED BY: COUNTY ATTYl OM~~ l RISK MANAGEMENT ---X \).R . DIVISION DIRECTOR APPROVAL: DOCUMENTATION: INCLUDED -X- I ~ (.., TO FOLLOWJ_ NOT REQUIRED_ AGENDA ITEM#:J:.C..Q DISPOSITION: Revised 2/27/0 I MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Florida Department of Children & Contract #KG 034 Families Effective Date: July 1,2001 Expiration Date: June 30, 2002 Contract Purpose/Description: Approval of this new contract will ensure uninterrupted In Home Services for the Disabled Adults under 60 in Monroe County. Contract Manager: LouisLaTorre 2~4573 (Name) r' (Ext.) For BOCC meeting on 6/20-21/01 Social Services/Stop 1 (Department/Stop #) Agenda Deadline: 6/6/01 Total Dollar Value of Contract: $91,713.00 Budgeted? Yes X No 0 Account Codes: Grant: $ 91,713.00 County Match: $ 12,500.00 ~ I';) %) Estimated Ongoing Costs: $ (Not included in dollar value above) CONTRACT COSTS Current Year Portion: $ /yr ADDITIONAL COSTS For: (eg. Maintenance. utilities. janitorial, salaries, etc) Division Director Risk Management ~u~ng County Attorney Comments: Date In fe/~/ol l' [111 0 ~ ~tt\\O\ 0(/((01 CONTRACT REVIEW . Changes D~. .~A./,).,,_ / Date Out Ye~~ed~o~/ ~,. C.lt/of Yes 0 No g/ vel. W t'^:)"~ ~,.l>t=C;(;,<~ 0 / ' I J~ \ :::: :;; J~~ ~;; OMB Form Revised 2/27/01 MCP #2 1/1/01 Client (8J Non,:'clie'n10- Multi-District 0 CFDA No. FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES STANDARD CONTRACT THIS CONTRACT is entered into between the Florida Department of Children and Families, hereinafter referred to as the "department," and Monroe County In Home Services hereinafter referred to as the "provider." I. THE PROVIDER AGREES: A. Attachment I To provide services in accordance with the conditions specified in Attachment I. B. Requirements of Section 287.058 F.S. To provide units of deliverables, including reports, findings, and drafts, as specified in Attachment I, to be received and accepted by the contract manager prior to payment. To comply with the criteria and the final date by which such criteria must be met for completion of this contract as specified in Section III, Paragraph A. of this contract. To submit bills for fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit thereof. Where applicable, to submit bills for any travel expenses in accordance with section 112,061, F.S, The department may, if specified in Attachment I, establish rates lower than the maximum provided in section 112.061, F.S. To allow public access to all documents, papers, letters, or other materials subject to the provisions of Chapter 119, F.S., made or received by the provider in conjunction with this contract. It is expressly understood that the provider's refusal to comply with this provision shall constitute an immediate breach of contract. C. Governing Law 1. State of Florida Law 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 laws, rules, and regulations of the State of Florida. Each party shall perform its obligations herein in accordance with the terms and conditions of the contract. 2. Federal Law a. That if this contract contains federal funds, the provider shall comply with the provisions of 45 CFR, Part 74, and/or 45 CFR, Part 92, and other applicable regulations as specified in Attachment I. b. That if this contract contains federal funds and is over $100,000, the provider shall comply with all applicable standards, orders, or regulations issued under section 306 of the Clean Air Act, as amended (42 U.S.C. 7401 et seq.), section 508 of the Federal Water Pollution Control Act as amended (33 U.S.C. 1251 et seq.), Executive Order 11738, and Environmental Protection Agency regulations (40 CFR, Part 30), The provider shall report any violations of the above to the department. c. That no federal funds received in connection with this contract may be used by the provider, or agent acting for the provider, to influence legislation or appropriations pending before the Congress or any State legislature, If this contract contains federal funding in excess of $100,000, the provider must, prior to contract execution, complete the Certification Regarding Lobbying form, Attachment N/A . If a Disclosure of Lobbying Activities form, Standard Form LLL, is required, it may be obtained from the contract manager. All disclosure forms as required by the Certification Regarding Lobbying form must be completed and returned to the contract manager. d. That unauthorized aliens shall not be employed, The department shall consider the employment of unauthorized aliens a violation of section 274A(e) of the Immigration and Nationality Act (8 U.S.C. 1324 a). Such violation shall be cause for unilateral cancellation of this contract by the department. e. That if this contract contains $10,000 or more of federal funds, the provider shall comply with E~ecutive Order 11246. Equal Employment Opportunity, as amended by Executive Order 11375, and as supplemented in Department of Labor regulation 41 CFR, Part 60, [45CFR, Part 92] f. That if this contract contains federal funds and provides services to children up to age 18. the provider shall comply with the Pro-Children Act of 1994 (20 U.s.C. 6083). Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity. This clause is applicable to all approved subcontracts. D. Audits, Records and Retention 1. To establish and maintain books, records, and documents (including electronic storage media) in accordance with generally accepted accounting procedures and practices, which sufficiently and properly reflect all revenues and expenditures of funds provided by the department under this contract. 2. To retain all client records, financial records, supporting documents, statistical records. and any other documents (including electronic storage media) pertinent to this contract for a period of five (5) years after completion of the contract. or.if an audit has been initiated and audit findings have not been resolved at the end of five (5) years, the records shall be retained until resolution of the audit findings or any litigation which may be based on the terms of this contract. CF Standard Contract. JF 01/2001 1 CONTRACT # KG034 1/1/01 3. Upon demand, at no additional cost to the department, the provider will facilitate the duplication and transfer of any records or documents during the required retention period in Section I, Paragraph 0.2. 4. To assure that these records shall be subject at all reasonable times to inspection, review, copying, or audit by Federal, State, or other personnel duly authorized by the department. 5. At all reasonable times for as long as records are maintained, persons duly authorized by the department and Federal auditors, pursuant to 45 CFR, Part 92.36(i)(10), shall be allowed full access to and the right to examine any of the provider's contract and related records and documents, regardless of the form in which kept. 6. To provide a financial and compliance audit to the department as specified in Attachment --1L and to ensure that all related party transactions are disclosed to the auditor, 7. To include these aforementioned audit and record keeping requirements in all approved subcontracts and assignments. E. Monitoring by the Department To permit persons duly authorized by the department to inspect any records, papers, documents, facilities, goods, and services of the provider which are relevant to this contract, and to interview any clients and employees and subcontractor employees of the provider to assure the department of the satisfactory performance of the terms and conditions of this contract. Following such evaluation, the department will deliver to the provider a written report of its findings and request for development, by the provider, a corrective action plan. The provider hereby agrees to correct all noted deficiencies identified by the department within the specified period of time set forth in the department approved corrective action plan, F. Indemnification NOTE: Paragraphs 1,F,1. and 2, are not applicable to contracts executed between state agencies or subdivisions, as defined in subsection 768,28(2), F.S. 1. To be liable for and indemnify, defend, and hold the department and all of its officers, agents, and employees harmless from all claims, suits, judgments, or damages, including attorneys' fees and costs, arising out of any act, actions, neglect, or omissions by the provider, its agents, or employees during the performance or operation of this contract or any subsequent modifications thereof, whether direct or indirect, and whether to any person or tangible or intangible property. 2. That its inability to evaluate its liability or its evaluation of liability shall not excuse the provider's duty to defend and to indemnify within seven (7) days after notice by the department by certified mail. After the highest appeal taken is exhausted, only an adjudication or judgment specifically finding the provider not liable shall excuse performance of this provision. The provider shall pay all costs and fees, including attorneys' fees related to these obligations and their enforcement by the department. The department's failure to notify the provider of a claim shall not release the provider of these duties. The provider shall not be liable for the sole negligent acts of the department. G. Insurance To provide adequate liability insurance coverage on a comprehensive basis and to hold such liability insurance at all times 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 provider accepts full responsibility for identifying and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the provider and the clients to be served under this contract. Upon the execution of this contract, the provider shall furnish the department written verification supporting both the determination and existence of such insurance coverage. Such coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida. The department reserves the right to require additional insurance as specified in Attachment I. H. Safeguarding Information Not to use or disclose any information concerning a recipient of services under this contract for any purpose not in conformity with state statutes and federal law or regulations (45 CFR, Part 205,50), except upon written consent of the recipient, or the responsible parent or guardian when authorized by law, I. Assignments and Subcontracts 1. To neither assign the responsibility for this contract to another party nor subcontract for any of the work contemplated under this contract without prior written approval of the department which shall not be unreasonably withheld. Any sublicense, assignment, or transfer otherwise occurring, without prior approval of the department, shall be null and void. 2. To be responsible for all work performed and all expenses incurred with the project. If the department permits the provider to subc<;>ntract all or part of the work contemplated under this contract, including entering into subcontracts with vendors for services and commodities, it is understood by the provider that all such subcontract arrangements shall be evidenced by a written document subject to prior review and comment by the department. Such review of the written subcontract document by the department will be limited to a determination of whether or not subcontracting is permissible and the .inclusion of applicable terms and conditions of this contract. The provider further agrees that the department shall not be hable to the subcontractor for any expenses or liabilities incurred under the subcontract and the provider shall ?e solely liable to the subcontractor for all expenses and liabilities incurred under the subcontract The provider, at Its expense, will defend the department against such claims. 2 CONTRACT # KG034 1/1/01 3. That the State of Florida shall at all times be entitled to assign or transfer its rights, duties, or obligations under this contract to another governmental agency in the State of Florida, upon giving prior written notice to the provider. In the event the State of Florida approves transfer of the provider'S obligations, the provider remains responsible for all work performed and all expenses incurred in connection with the contract. In addition, this contract shall bind the successors, assigns, and legal representatives of the provider and of any legal entity that succeeds to the obligations of the State of Florida. 4. To make payments to the subcontractor within seven (7) working days after receipt of full or partial payments from the department in accordance with section 287.0585, F,S., unless otherwise stated in the contract between the provider and subcontractor. Failure to pay within seven (7) working days will result in a penalty charged against the provider and paid to the subcontractor in the amount of one-half of one (1) percent of the amount due per day from the expiration of the period allowed herein for payment. Such penalty shall be in addition to actual payments owed and shall not exceed fifteen (15) percent of the outstanding balance due, J. Return of Funds To return to the department any overpayments due to unearned funds or funds disallowed pursuant to the terms of this contract that were disbursed to the provider by the department. In the event that the provider or its independent auditor discovers that an overpayment has been made, the provider shall repay said overpayment within 40 calendar days without prior notification from the department. In the event that the department first discovers an overpayment has been made, the contract manager, on behalf of the department, will notify the provider by letter of such findings. Should repayment not be made forthwith, the provider will be charged at the lawful rate of interest on the outstanding balance after department notification or provider discovery. K. Client Risk Prevention and Incident Reporting 1. That if services to clients will be provided under this contract, the provider and any subcontractors shall, in accordance with the client risk prevention system, report those reportable situations listed in CFOP 215-6 in the manner prescribed in CFOP 215-6 or district operating procedures. 2. To immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person, or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number (1-800-96ABUSE), As required by Chapters 39 and 415, F.S" this is binding upon both the provider and its employees. L. Purchasing 1. To purchase articles which are the subject of or are required to carry out this contract from Prison Rehabilitative Industries and Diversified Enterprises, Inc., (PRIDE) identified under Chapter 946, F.S" in the same manner and under the procedures set forth in subsections 946.515(2) and (4), F.S. For purposes of this contract, the provider shall be deemed to be substituted for the department insofar as dealings with PRIDE. This clause is not applicable to subcontractors unless otherwise required by law. An abbreviated list of products/services available from PRIQE may be obtained by contacting PRIDE, (850) 487-3774, 2. To procure any recycled products or materials which are the subject of or are required to carry out this contract, in accordance with the provisions of sections 403.7065, and 287.045, F.S, M. Civil Rights Requirements 1. Not to discriminate against any employee in the performance of this contract, or against any applicant for employment, because of age, race, creed, color, disability, national origin, or sex. The provider further assures that all contractors, subcontractors, subgrantees, or others with whom it arranges to provide services or benefits to participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees because of age, race, creed, color, disability, national origin, or sex, This is binding upon the provider employing fifteen (15) or more individuals, 2. To complete the Civil Rights Compliance Questionnaire, CF Forms 946 A and B, in accordance with HRSM 220-2. This is binding upon providers if services are directly provided to clients and if 15 or more individuals are employed. N. Independent Capacity of the Contractor 1. To be solely liable for the performance of all tasks contemplated by this contract which are not the exclusive responsibility of the department. 2. To act in the capacity of an independent contractor and not as an officer, employee of the State of Florida, except where the provider is a state agency. Neither the provider nor its agents, employees, subcontractors or assignees shall represen~ to others that it has the authority to bind the department unless specifically authorized in writing to do so. 3. ThiS contract does not create any right to state retirement, leave benefits or any other benefits of state employees as a result of performing the duties or obligations of this contract. 4. To take such actions as may be necessary to ensure that each subcontractor of the provider will be deemed to be an independent contractor and will not be considered or permitted to be an agent, servant, joint venturer, or partner of the State of Florida. 5. The department will not furnish services of support (e,g" office space, office supplies, telephone service, secretarial or clerical support) to the provider, or its subcontractor or assignee, unless justified by the provider and agreed to by the department in Attachment I. 6. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation funds, and all necessary insurance for the provider, the provider's officers, employees, agents, subcontractors, or assignees shall be the sole responsibility of the provider. 3 CONTRACT # KG034 1/1/01 O. Sponsorship As required by section 286.25, F.S., if the provider is a nongovernmental 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 (provider's name) and the State of Florida, Department of Children and Families." If the sponsorship reference is in written material, the words "State of Florida, Department of Children and Families" shall appear in the same size letters or type as the name of the organization. P. Final Invoice To submit the final invoice for payment to the department no more than -1L days after the contract ends or is terminated. If the provider fails to do so, all rights to payment are forfeited and the department will not honor any requests submitted after the aforesaid time period. Any payment due under the terms of this contract may be withheld until all reports due from the provider and necessary adjustments thereto have been approved by the department. Q. Use Of Funds For Lobbying Prohibited To comply with the provisions of sections 11.062 and 216.347, F.S" which prohibit the expenditure of contract funds for the purpose of lobbying the Legislature, judicial branch, or a state agency. R. Public Entity Crime Pursuant to section 287,133, F.S" the following restrictions are placed on the ability of persons convicted of public entity crimes to transact business with the department: When a person or affiliate has been placed on the convicted vendor list following a conviction for a public entity crime, he/she may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or the repair of a public building or public work, may not submit bids 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 section 287.017, F,S., for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. S. Patents, Copyrights, and Royalties 1. If any discovery or invention arises or is developed in the course or as a result of work or services performed under this contract, or in anyway connected herewith, the provider shall refer the discovery or invention to the department to be referred to the Department of State to determine whether patent protection will be sought in the name of the State of Florida. Any and all patent rights accruing under or in connection with the performance of this contract are hereby reserved to the State of Florida. 2. In the event that any books, manuals, films, or other copyrightable materials are produced, the provider shall notify the Department of State, Any and all copyrights accruing under or in connection with the performance under this contract are hereby reserved to the State of Florida. 3. The provider, without exception, shall indemnify and save harmless the State of Florida and its employees from liability of any nature or kind, including cost and expenses for or on account of any copyrighted, patented, or unpatented invention, process, or article manufactured by the provider. The provider has no liability when such claim is solely and exclusively due to the Department of State's alteration of the article. The State of Florida will provide prompt written notification of claim of copyright or patent infringement. Further, if such claim is made or is pending, the provider may, at its option and expense, procure for the Department of State, the right to continue use of, replace, or modify the article to render it non-infringing. If the provider uses any design, device, or materials covered by letters, patent, or copyright, it is mutually agreed and understood without exception that the bid prices shall include all royalties or costs arising from the use of such design, device, or materials in any way involved in the work. T. Construction or Renovation of Facilities Using State Funds That the department shall file a lien against any property that has been constructed or substantially renovated, in whole or in part, through the use of state funds. However, the department is not required to file a lien if the amount of state funds does not exceed $25,000 or 10 percent of the contract amount, whichever amount is less. As a condition of receipt of state funding for this purpose, the provider agrees that, if it disposes of the property before the department's lien interest is vacated, the provider will refund the proportionate share of the state's initial investment, as adjusted by depreciation. U. Security Obligations 1. To identify an appropriately skilled individual to function as its Data Security Officer. This Security Officer shall act as the liaison to the Department's Security Staff and will maintain an appropriate level of data security for the information the provider is collecting or using in the performance of this contract. This includes approving and tracking all provider employees that request system or information access and ensuring that user access has been removed from all terminated provider employees, 2. To furnish Security Awareness Training to its staff. 3. To ensure that all provider employees that have access to departmental information are provided a copy of CFOP 50-6 and sign the DCF Security Agreement form (CF114). A copy may be obtained from the contract manager. V. Accreditation That the department is committed to ensuring provision of the highest quality services to the persons we serve. Accordingly, the department has expectations that where accreditation is generally accepted nationwide as a clear indicator of quality service, the majority of our providers will either be accredited, have a plan to meet national accreditation standards, or will initiate one within a reasonable period of time. 4 CONTRACT # KG034 1/1/01 .... - .....- W. Agency for Workforce Innovation and Workforce Florida That it understands that the department, the Agency for Workforce Innovation, and Workforce Florida, Inc. have jointly implemented an initiative to empower recipients in the Temporary Assistance to Needy Families Program to enter and remain in gainful employment. The department encourages provider participation with the Agency for Workforce Innovation and Workforce Florida. II. THE DEPARTMENT AGREES: A. Contract Amount To pay for contracted services according to the conditions of Attachment I in an amount not to exceed S 91,713.00 , subject to the availability of funds. The State of Florida's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Legislature, Any costs or services paid for under any other contract or from any other source are not eligible for payment under this contract. B. Contract Payment Pursuant to section 215.422, F.S" the department has five (5) working days to inspect and approve goods and services, unless the bid specifications, purchase order, or this contract specifies otherwise, With the exception of payments to health care providers for hospital, medical, or other health care services, if payment is not available within 40 days, measured from the latter of the date a properly completed invoice is received by the department or the goods or services are received, inspected, and approved, a separate interest penalty set by the Comptroller pursuant to section 55.03, F.S., will be due and payable in addition to the invoice amount. To obtain the applicable interest rate, contact the district fiscal office/contract administrator. Payments to health care providers for hospital, medical, or other health care services, shall be made not more than 35 days from the date eligibility for payment is determined. Financial penalties will be calculated at the daily interest rate of .03333%. Invoices returned to a vendor due to preparation errors will result in a payment delay. Interest penalties less than one dollar will not be enforced unless the vendor requests payment. C. Vendor Ombudsman A Vendor Ombudsman has been established within the Department of Banking and Finance, The duties of this office are found in section 215.422 (7), F,S" which include disseminating information relative to the prompt payment of this state and assisting vendors in receiving their payments in a timely manner from a state agency, The Vendor Ombudsman may be contacted at (850) 410-9724 or 1-800-848-3792, the State of Florida Comptroller's Hotline, D. Notice Any notice, which is required under this contract, shall be in writing and sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery, to the designated address contained in this contract. III. THE PROVIDER AND DEPARTMENT MUTUALLY AGREE: A. Effective and Ending Dates This contract shall begin on parties, whichever is later. It shall end on , or on the date on which the contract has been signed by both June 30, 2002 July 1, 2001 B. Termination 1. This contract may be terminated by either party without cause, no less than thirty (30) calendar days notice in writing to the other party unless a lesser time is mutually agreed upon in writing. Said notice shall be delivered by any mailing service that provides verification of delivery or in person with proof of delivery. 2. In the event funds to finance this contract become unavailable, the department may terminate the contract upon no less than twenty-four (24) hours notice in writing to the provider. Said notice shall be sent by U.S. Postal Service or any expedited delivery service that provides verification of delivery, The department shall be the final authority as to the availability and adequacy of funds, In the event of termination of this contract, the provider will be compensated for any work satisfactorily completed. . 3., ,This contract may be terminated for the provider's non-performance upon no less than twenty-four (24) hours notice In writing to the provider. If applicable, the department may employ the default provisions in Chapter 60A-1 ,006(3), F.A.C, Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and shall not be construed to be,a modification of the terms of this contract. The provisions herein do not limit the department's right to remedies at law or In equity. 4. Failure to have performed any contractual obligations with the department in a manner satisfactory to the department will be a sufficient cause for termination. To be terminated as a provider under this provision, the provider must have: (1) previously failed to satisfactorily perform in a contract with the department, been notified by the department of the unsatisfactory performance, and failed to correct the unsatisfactory performance to the satisfaction of the department; or (2) had a contract terminated by the department for cause, 5 CONTRACT # KG034 1/1/01 C. Renegotiation or Modification Modifications of provisions of this contract shall only be valid when they ,have been red,uced to writing ~nd duly ~igned 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 department's operating budget. D. Official Payee and Representatives (Names, Addresses, and Telephone Numbers): 1. The provider name, as shown on page 1 of this 3. The name, address, and telephone number of the contract, and mailing address of the official payee to contract manager for the department for this contract is: whom the payment shall be made is: Monroe County In Home Services 5100 College Road Key WEst, FL 33040 Theresa Phelan Department of Children and Families 1111 12th Street, #301 Key West. FL 33040 305/292-6810 2. The name of the contact person and street address where financial and administrative records are maintained is: Oeloris Simpson Monroe County In ~ome Services Key WEst, FL 33040 4. The name, address, and telephone number of the representative of the provider responsible for administration of the program under this contract is: Deloris Simpson Monroe County In Home Services 5100 College Road, Key West, FL 33040 305 / 292-4589 5. 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. E. All Terms and Conditions Included This contract and its attachments, I and II and 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 verbal or written between the parties, If any term or provision of this contract is legally determined unlawful or unenforceable, the remainder of the contract shall remain in full force and effect and such term or provision shall be stricken, By signing this contract, the parties agree that they have read and agree to the entire contract, as described in Paragraph 1I1.E. above. IN WITNESS THEREOF, the parties hereto have caused this ~ page contract to be executed by their undersigned officials as duly authorized, PROVIDER: Monroe County In Home Services FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES SIGNED BY: NAME: TITLE: DATE: George Neugent Mayor STATE AGENCY 29 DIGIT SAMAS CODE: Federal EID # (or SSN): F596000749029 APPROVED AS TO FOR AND AL SUFFICI '''~'r'O\'-O 0.5 TO rm:::\i f" .. . ..... .~. .. t\:-;D) .G,~ sU:;l.;Y #.--;r.L1,~ ''',,;:.~scl / Provider Fiscal Year Ending Date:~ I -R 6 CONTRACT # KG034 VliUIILUUl Community Care for Disabled Adults/Fixed Price . - _ '. _ Adult Services Program A rr ACHMENT I A. Services to be Provided 1. Definition of Terms a. Contract Terms (1) Amendment - A document by which substantial changes are made to the terms of an executed contract. Changes requiring an amendment include, but are not limited to adjustments in costs, services, time period, and method of payment. The amendment is incorporated as part of the original contract. (2) Contract - A contract, for the purposes of this document, is a formal written agreement between the department and an individual or organization for the procurement of services. A contract consists of the Standard Contract, Program Specific Model Attachment I, (PSMAI) / Attachment I including special provisions where appropriate, plus any other attachments or exhibits deemed necessary. Per Chapter 287, Florida Statutes (F.S.), a contract must be signed by both parties prior to services being rendered. (3) Contract Manager - The department's employee responsible for enforcing the performance of contract terms and conditions. The contract manager is the department's primary point of contact through which all contracting information flows between the department and the provider. (4) Contract Term - The period of time beginning with the contract start date and ending with the contract end date. (5) Department - Florida Department of Children and Families, unless otherwise stated. (6) District - The Florida Department of Children and Families' territorial division pertaining to a geographical service area. (7) Exhibit - Information appended to an Attachment I or any other contract attachment. The use of the word "exhibit" avoids confusion and allows for clearer referencing. All exhibits to an Attachment I/PSMAI must be referenced in that Attachment I/PSMAI. (8) Federal Fiscal Year - An accounting period of twelve consecutive months starting on October 1 and ending on the last day of September. 3/21/2001 7 . PSMAI No. GA 07 Contract No. KG034 , 07/01/2001 3/21/2001 Community Care Tor Disabled Adults/Fixed Price . Adult Services Program (9) Fixed Price - Method of payment used when the service provided can be broken down into unit cost (e.g., hours, client days, etc.), or a fixed fee (e.g., payment based on delivery of a complete service). (10) Invoice - A completed and timely submitted document used by the provider to request payment from the department. (11) Match - A contribution, in cash or in kind, specified by the funding source to be used in conjunction with the donation of the funding source, and upon which receipt of that donation is contingent. (12) Method of Payment - This is the third section of an Attachment I/PSMAI. It specifies the total or maximum dollar amount of the contract, the manner in which contract costs will be displayed on invoices, the frequency with which invoices will be submitted to the department, and any special conditions pertaining to payment of contract invoices. (13) Provider - An organization or individual providing services or materials to the department in accordance with the terms of the contract. This term is also known as "contractor." (14) Provider Fiscal Year - An accounting period of twelve consecutive months. (15) Region - The Department of Children and Families' specified territory or geographical service area. (16) State Fiscal Year - An accounting period of twelve consecutive months starting on July 1 and ending on the last day of June. b. Program or Service Specific Terms A glossary of approved terms is contained in The Community Care for Disabled Adults Instructional Guide, Section 0, herein incorporated by reference and included in the contract manager's file. (1) Activities of Daily Living (ADL) - Basic activities performed in the course of daily living, such as dressing, bathing, grooming, eating, toileting, and ambulating around one's own home. (2) Client - Any person at least eighteen years old, but under sixty years of age, who has one or more permanent physical or mental limitations that restrict his ability to perform normal activities of daily living, and impede his capacity to live independently or with relatives or friends without the provision of community-based services. 8 . PSMAI No. GA 07 Contract No. KG034 . 07/01/2001 Community Care Tor Disabled Adults/Fixed Price. Adult Services Program (3) Medicaid Institutional Care Program (MICP) - A program that serves Medicaid recipients who are determined eligible for a nursing home level of care, which provides primary, acute, and long-term care services at capitated federally-matched rates. 2. General Description a. General Statement (1) The Community Care for Disabled Adults (CCDA) Program is designed to assist disabled adults, age eighteen through fifty-nine, in utilizing available community and personal resources to help them remain in their homes, and to prevent them from premature or inappropriate institutionalization. (2) Service providers will ensure that appropriate community-based services (including duration, frequency, and scope of care plan) are provided to clients in a manner developed to meet the client's changing needs. b. Authority Sections 410.601-606, F.S., Chapter 65C-2, Florida Administrative Code (F.A.C.), and the annual appropriations act, with any proviso language or instructions to the department, constitute the legal basis for services to be delivered through the CCDA. c. Scope of Service Services will be targeted toward eligible adults, age eighteen through fifty- nine, in the following Florida counties: Monroe. d. Major Program GoaJ The community-based services provided under this contract are designed to prevent unnecessary institutionalization of disabled adults. 3. Clients to be Served a. General Description Adults with disabilities, age eighteen through fifty-nine, who are no longer eligible to receive children's services, and are too young to qualify for community and home-based services for the elderly, may be served under the provisions of this contract. 3/21/2001 9. PSMAI No. GA 07 Contract No. KG034 . 07/01/2001 3/21/2001 Community Care-for Disabled Adults/Fixed Price' Adult Services Program b. Client Eligibility (1) Clients must have one or more permanent physical or mental limitations, that restrict the ability to perform normal activities of daily living, as determined through the initial functional assessment and medical documentation of disability. Determination of a disability must be established and evidenced in one of the following manners: (a) A client may present a check, awards letter, or other proof showing receipt of Social Security Disability, or some other disability payment (e.g., Worker's Compensation); or (b) A client may present a written statement from a licensed physician, licensed nurse practitioner, or mental health professional, which meets the district's criteria for evidence of a disability. This written statement must, at a minimum, include the client's diagnosis, prognosis, a broad explanation of level of functioning, and the interpretation of need for services based on identified functional barriers caused by the client's disabling condition. (2) Clients must have an individual income at or below the prevailing MICP eligibility standard in order to receive free CCDA services. Clients with incomes above the standard will be assessed for a share of the costs, or may be required to provide volunteer services in lieu of payment. (3) The total annual cost, estimated or actual, for an individual receiving CCDA services, shall not exceed the average annual general revenue portion of a Medicaid nursing home bed within the district area. c. Client Determination (1) Clients will be assessed for eligibility determination, and prioritized for services by district or provider case management staff, in accordance with subsection 410.604 (2), F.S. (2) The department will determine client eligibility for this program. The department's contract manager will make the final determination in the event of a dispute regarding client eligibility. (3) Clients must not be receiving comparable services from any other entity. In order to prevent duplication of services, client files must contain documentation verifying that all comparable community services and funding sources have been explored and exhausted. 10. PSMAI No. GA 07 Contract No. KG034 . 07/01/2001 Community Care for Disabled Adults/Fixed Price Adult Services Program d. Contract Limits The provider shall deliver services only to those persons who meet program eligibility criteria, and only to the extent that funds are available. B. Manner of Service Provision 1. Service Tasks a. Task List (1) This contract will provide the following CCDA services: (Services are marked accordingly: X) The Guide provides descriptions and minimum requirements for each service listed. DAdult Day Care X Case Management X Personal Care DHome Health Aide X Homemaker DHome Nursing Dlnterpreter DTransportation X Chore DRespite DEscort DEmergency Alert Response DGroup Activity Therapy X Home Delivered Meals DMedical Therapeutic Services DPhysical and Exams (2) Details of services to be provided under this contract and the negotiated parameters of those services: There are no additional negotiated details. b. Task Limits (1) Each district CCDA program shall include case management services and at least one other community service. (2) Respite care may be provided for up to 240 hours per client per calendar year, depending upon individual need. The service may be extended to 360 hours, as recommended by the case manager and approved by an immediate supervisor. Documentation of approval must be evident in the case narrative section of the case manager's file. 3/21/2001 11. PSMAI No. GA 07 Contract No. KG034 . 07/01/2001 Community Care for Disabled Adults/Fixed Price Adult Services Program (3) Personal Care Services will not substitute for the care usually provided by a registered nurse, licensed practical nurse, therapist, or home health aide. The personal care aide will not change sterile dressings, irrigate body cavities, administer medications, or perform other activities prohibited by Chapter 59A-8, F.A.C. (4) Homemaker Service time does not include time spent in transit to and from the client's place of residence except when providing shopping assistance, performing errands or other tasks on behalf of a client. (5) Several restrictions apply to persons providing Homemaker Service activities. Persons providing services must not: (a) engage in work that is not specified in the Homemaker assignment; (b) accept gifts from clients; (c) lend or borrow money or articles from clients; (d) handle client money, unless authorized in writing by a supervisor or case manager (as evident in the personnel file) and unless bonded or insured by the employer; (e) transport clients, unless authorized in writing by a supervisor or case manager. (6) The parameters of service delivery, by type of service, are detailed in the Guide. (7) District task limits, which exceed those in the Guide, and are distinctive to this contract, are listed here: There are no District specific task limits. 2. Staffing Requirements a. Staffing Levels (1) The provider will meet the minimum staffing requirements for each service, as specified in the Guide. (2) The provider will notify the department within thirty days whenever the provider is unable, or expects to be unable, to provide the required quality or quantity of service because of staff turnovers or shortages. 3/21/2001 12. PSMAI No. GA 07 Contract No. KG034 . 07/01/2001 Community Care for Disabled Adults/Fixed Price . Adult Services Program b. Professional Qualifications The provider will ensure that staff meets the professional qualifications for each service, as specified in the Guide. c. Staffing Changes The provider agrees to notify the department's contract manager within two working days if an administrative position (e.g., executive director) becomes vacant. Planned staffing changes that may affect service delivery, as stipulated in this contract, must be presented in writing to the contract manager for approval at least two weeks prior to the implementation of the change. d. Subcontractors The provider is responsible for the performance of its subcontractors. Copies of all performance monitoring reports shall be made available to the department. 3. Service Location & Equipment a. Service Delivery Location & Times (1) CCDA services may be delivered in the client's home or on-site at a facility, as negotiated by the department and the provider. (2) Facilities delivering on-site services to clients shall pass an annual inspection by the local environmental health and fire authorities. (3) Service providers will meet the minimum service location and time requirements as specified in the Guide. (4) Services for this contract will be delivered at the following location(s) and times: SERVICE LOCA TION TIME Case Management Client's Home As Needed Homemaker Client's Home As Needed Personal Care Client's Home As Needed Home Delivered Meals Client's Home As Needed Chore Client's Home As Needed 3/21/2001 13. PSMAI No. GA 07 Contract No. KG034 . 07/01/2001 3/21/2001 Community Care lor Disabled Adults/Fixed Price' Adult Services Program ~. .. _.- b. Changes in Location The department and the provider must negotiate location of service delivery and evidence of this negotiation must be included in either the provider's Application or in this Attachment I. Once the service delivery location is agreed upon, any proposed change must be presented in writing to the contract manager for approval, prior to implementation of that proposed change. In the event of an emergency, temporary changes in location may necessitate waiver of this designated standard by the district's program office. Such a waiver will take into consideration the continuity, safety, and welfare of the department's clients, and is at the department's sole discretion. c. Equipment (1) The equipment required to perform the contracted services must be negotiated by the department and the provider. To ensure uniformity, safety, and quality of service to clients, any requests for equipment change must be presented in writing to the contract manager for approval at least ten days prior to any proposed change. (2) The provider must inventory all equipment acquired under this contract annually. The inventory list must be made available within seven days upon receipt of written request by the contract manager. 4. Deliverables a. Service Units A service unit is an appropriate, distinct amount of given service, which may include, but is not limited to, an hour or quarter hour of direct service delivery; a meal; an episode of travel; or a twenty-four hour period of Emergency Alert Response maintenance, as defined in the Guide. b. Reports (1) Reporting requirements for this contract include, Exhibit A, Quarterlv Cumulative Summary Report. Districts will negotiate with the provider on specific submission requirement criteria for this report. (2) Providers of case management services agree to submit quarterly reports, which include management program data (e.g., client identifiable data) to the department, according to negotiated instructions provided by the districts. The quarterly reports are due according to the following schedule: 14, PSMAl No. GA 07 Contract No. KG034 07/01/2001 3/21/2001 Community Care for Disabled Adults/Fixed Price Adult Services Program Quarterly Cumulative Summary Report Due Date three month October 30 six month February 15 nine month April 30 twelve month August 15 (3) In the event of early termination of this contract, the provider will submit the final Cumulative Summary Report within 45 days after the contract is terminated. c. Records and Documentation (1) Case Management provider files shall contain the following: (a) a completed client assessment (not more than one year old) (b) a care plan (not more than one year old) (c) a release of information form (d) a copy of a completed Client Information System (CIS) form (e) documentation of the client's age, disability, and income (f) a copy of the referral/intake form (9) a case narrative. (2) Providers shall maintain information on each client served by this contract, which includes the following: (a) documentation of the client by name or unique identifier (b) current documentation of eligibility for services (c) number of service units provided (d) dates of service provision and delivery (e) information documenting the client's need to receive services (f) the number of service units provided 15. PSMAI No. GA 07 Contract No. KG034 · 07/01/2001 Community Care lor Disabled Adults/Fixed Price' -'. - _.- Adult Services Program (g) all other forms or records necessary for program operation and reporting, as set forth by the department. (3) Providers must ensure that all client records match the invoices submitted for payment. Records must track to each invoice for payment. (4) Providers must maintain documentation necessary to facilitate monitoring and evaluation by the department. (5) The case management provider must maintain documentation in the client's file that all existing funding sources have been explored and exhausted before using CCDA funding. 5. Performance Specifications a. Performance Measures (Outcomes and Outputs) (1) 100% of clients will not be placed in a nursing home. (2) 30 clients will be served through this contract. (3) 95% of clients will be satisfied with services based upon responses to the Department Client Satisfaction Survey. The provider will administer the Department Client Satisfaction Survey to a representative sample of clients in accordance with the table provided in section B.5.b. below. b. Standards Definitions (1) Clients - Eligible individuals who have met the eligibility criteria outline in section A.3.b. of this Attachment, and who have received case management or any of the other services funded through the CCDA program during the fiscal year evaluated. (2) Eligible Individuals - Clients who meet the eligibility criteria outlined in sectionA.3.b. of this attachment. (3) Nursing home - Any facility which provides nursing services as defined in Chapter 464 F.S., licensed in accordance with Ch. 400, F.S. (4) Outcomes - Quantitative indicators that can be used by the department to objectively measure a provider's performance toward a stated goal. (5) Outputs - Process measures of the quantity(s) of services delivered, clients served, or similar units completed. 3/21/2001 16. PSMAI No. GA 07 Contract No. KG034 I 07/01/2001 3/21/2001 Community Care for Disabled Adults/Fixed Price Adult Services Program (6) Performance Measures - Quantitative indicators, outcomes and outputs, that can be used by the department to objectively measure a provider's performance. (7) Placed - Assessment of an individual who is no longer able to remain in his present place of residence. (To place a client involves preparation for and follow up of moving a client into a more restrictive alternative living environment.) (8) Will be served - The eligible individuals who will receive case management or negotiated service under this contract. (9) The table below identifies the minimum number of clients for which completed surveys are required in order to report results for the provider's annual case load at the ninety percent (90%) confidence level, with a five percent (5%) error rate. Annual caseload shall mean all clients who reach a point in their service plans during the year containing a trigger point. Trigger points are the appropriate points in time or service that a client shall be given the Department Client Satisfaction Survey to complete, for example at recertification, six months after admission, case closure, or at some other point. The department will determine trigger points for each affected client group, and contract managers will provide the information to the provider. Sample Sizes for Contract Providers Fiscal Year 2001 - 2002 Number of Clients Served in the Required Minimum Sample Fiscal Year Less than 59 All Clients 59 - 74 58 75 - 100 73 101 - 150 97 151 - 200 115 201 - 250 130 251 - 300 143 301 - 350 153 351 - 500 176 501 - 750 199 751 - 1,000 213 1,001 - 1,500 229 1,501 - 2,000 238 2,001 and over 250 17. PSMAI No. GA 07 Contract No. KG034 , 07/01/2001 3/21/2001 Community Care lor Disabled Adults/Fixed Price' Adult Services Program Satisfaction shall be determined by calculating a percentage of client responses that "agree" or "strongly agree" to the survey question, "Overall, I am satisfied with the services that I received." c. Monitoring and Evaluation Methodology (1) All monitoring activity performed by the District will be in accordance with CFOP 75-8, Contract Monitoring. (a) By execution of this contract, the provider hereby acknowledges and agrees that its performance under the contract must meet the standards set forth above and will be bound by the conditions set forth below. If the provider fails to meet these standards, the department, at its exclusive option, may allow up to six months for the provider to achieve compliance with the standards. If the department affords the provider an opportunity to achieve compliance, and the provider fails to achieve compliance within the specified time frame, the department will terminate the contract in the absence of any extenuating or mitigating circumstances. The determination of the extenuating or mitigating circumstances is the exclusive determination of the department. (b) The Contract Performance Unit ("CPU") may elect to perform an on-site administrative and programmatic monitoring during the contract period. At a minimum, an annual desk monitoring will be performed which will be accomplished by a combination of the review(s) of reports or other documentation submitted by the provider, input from service recipients and others, and visits to the site of service delivery for programmatic review. (c) For on-site monitorings, a random discovery sample of open and closed files will be taken for review. This sample may be increased to a random statistical sample depending on the results of our review. The number of files reviewed will be contingent upon the population size of services rendered. To facilitate the sampling process, upon CPU request, the provider shall submit an universal events listing of all services provided under the contract prior to the monitoring visit. (d) A report outlining the department's findings during the on-site monitoring will be submitted to the provider within 30 days of concluding field work with an exit conference. The provider agrees to respond and submit a corrective action plan, if 18. PSMAI No. GA 07 Contract No. KG034 07/01/2001 Community Care for Disabled Adults/Fixed Price . Adult Services Program required, within 30 days of receiving the department's monitoring report. d. Performance Definitions There are no District specific performance definitions. 6. Provider Responsibilities a. Provider Unique Activities In addition to the staffing requirements in the approved application or program proposal, the provider will be required to use volunteers to the fullest extent feasible in the provision of services and program operations. The provider is required to train, supervise, and appropriately support all volunteers with insurance coverage. b. Coordination with Other Providers/Entities (1) The case management provider must coordinate, as necessary, with The Developmental Services Office of the Department of Children and Families, the Department of Education, The Department of Health, and the Florida Statewide Advocacy Council, to serve those clients who are eligible for services through two or more service delivery continuums. (2) All providers must comply with the local environmental health and fire authorities' annual inspections. 7. Departmental Responsibilities a. Department Obligations (1) The department will supply all new providers with a copy of the CCDA Proqram Manual (HRSM 140-8) and the Guide. (2) The department will provide CCDA technical assistance to the provider, relative to the negotiated terms of this contract and instructions for submission of required data. b. Department Determinations Should a dispute arise, the department will make the final determination as to whether or not the contract terms are being fulfilled according to the contract specifications. 3/21/2001 19. PSMAI No. GA 07 Contract No. KG034 07/01/2001 Community Care for Disabled Adults/Fixed Price Adult Services Program C. Method of Payment 1. Payment Clause a. This is a Fixed Price contract. The department shall pay the provider for the delivery of service units provided in accordance with the terms of this contract for a total dollar amount not to exceed $91,713.00, subject to the availability of funds. b. The department shall make payment to the provider for provision of services up to the maximum number of units of service at the rates shown below. Service Unit Rate Maximum Units Total/Department to be Delivered Case Management $44.498 / Hour 178 Hours Homemaker $26.631 / Hour 1056 Hours Personal Care $32.976/ Hour 639 Hours Home Delivered Meals $ 6.732 / Meal 4753 Meals Chore $33.859 I Hour 90 Hours c. The provider's dollar match for this contract is $10,190.00. Case management and transportation services may be exempt from match requirement at the discretion of each district. 2. Invoice Requirements The provider shall request payment through submission of a properly completed Invoice, Exhibit 8, within 15 days following the completion of all terms and conditions for the delivery of service under this contract. If the provider fails to do so, all right to payment is forfeited, and the department will not honor any requests submitted after the aforesaid time period. Payment due under this contract will be withheld until the department has approved the final product. Replication of the form via data processing equipment is permissible; replications must include all data elements included on the departmental form. 3. Supporting Documentation a. The provider shall submit to the contract manager an original Invoice, Exhibit 8, along with supporting documentation, for payment on a monthly basis. The due date for these invoices is the 15th day of the month following the month being reported. 3/21/2001 20. PSMAI No. GA 07 Contract No. KG034 , 07/01/2001 Community Care for Disabled Adults/Fixed Price Adult Services Program b. It is expressly understood by the provider that any payment due the provider under the terms of this contract may be withheld pending the receipt and approval by the department of all financial and program reports due from the provider as a part of this contract and any adjustments thereto. Requests for payment, which cannot be documented with supporting evidence, will be returned to the provider upon inspection by the department. c. The provider must maintain records documenting the total number of recipients and names (or unique identifiers) of recipients to whom services were provided and the dates the services were provided so that an audit trail documenting service provision can be maintained. 4. Medicaid Billing The department and the provider specifically agree and acknowledge that the Medicaid program is the payor of last resort and: a. in no event shall the provider bill the Medicaid program for services or expenses for Medicaid recipients for which the provider has already been paid by any other liable third party, and b. provider services covered under the Florida Medicaid program for Medicaid recipients may be billed to the Medicaid program by the provider, unless the provider is already being paid by any other liable third party, and c. authorized provider services to non-Medicaid recipients, or for non- Medicaid covered services, may only be billed to the department or any other non-Medicaid first or third party payor, and d. the provider shall identify and report Medicaid earning separate from all other fees, and e. Medicaid earnings cannot be used as local match, and f. the provider will ensure that Medicaid payments are accounted for in compliance with federal regulations, and g. in no event shall both Medicaid and the department be billed for the same service. 3/21/2001 21. PSMAI No. GA 07 Contract No. KG034 07/01/2001 Community Care lor Disabled Adults/Fixed Price' Adult Services Program D. Special Provisions 1. Fees a. The provider will collect fees for services provided according to Rule 65C-2.007, F.A.C. b. No fees shall be assessed other than those set by the department. Fees collected in compliance with the department directives will be disposed of in a manner prescribed by the department. 2. Florida Statewide Advocacy Council The provider agrees to allow properly identified members of the Florida Statewide Advocacy Council access to the facility or agency and the right to communicate with any client being served, as well as staff or volunteers who serve them in accordance with subsections 402.165(8) (a) & (b), F.S. Members of the Florida Statewide Advocacy Council shall be free to examine all records pertaining to any case unless legal prohibition exists to prevent disclosure of those records. 3. Transportation Disadvantaged The provider agrees to comply with the provisions of Chapter 427, F.S., Part I, Transportation Services, and Chapter 41-2, F.A.C., Commission for the Transportation Disadvantaged, if public funds provided under this contract will be used to transport clients. The provider agrees to comply with the provisions of CFOP 40-5 if public funds provided under this contract will be used to purchase vehicles which will be used to transport clients. 4. Medicaid Waiver Report The provider agrees to submit a monthly report of actual program expenditures billed through the Medicaid Waiver program no later than the 10th day following the end of the report period. This report will include expenditures billed by the provider and any other program subcontractor. 5. Non-expendable Property a. Non-expendable property is defined as tangible personal property of a non-consumable nature that has an acquisition value or cost of $1,000 or more per unit and an expected useful life of at least one year, and hardback bound books that are not circulated to students or the general public, the value or cost of which is $250 or more. Hardback books with a value or cost of $25 or more should be 3/21/2001 22, PSMAI No. GA 07 Contract No. KG034 . 07/01/2001 - . Community Care for Disabled Adults/Fixed Price Adult Services Program classified as an Other Capital Outlay expenditure only if they are circulated to students or to the general public. The provider will use Exhibit C to report all capital assets purchased through funding provided by the Department for prior and current year contract. b, All such property purchased under this contract shall be listed on the property records of the provider. Said listing shall include a description of the property, model number, manufacturer's number, manufacturer's serial number, funding source, information needed to calculate the federal and/or state share, date of acquisition, unit cost, property inventory number and information on the location, use and condition, transfer, replacement, or disposition of the property. c. All such property purchased under this contract shall be inventoried annually and an inventory report shall be submitted to the Department along with the final expenditure report. A report of non- . expendable property shall be submitted to the Department along with the expenditure report for the period in which it was purchased. d. Title (ownership) to all non-expendable property acquired with funds from this contract shall be vested in the Department upon completion or termination of the contract. e. At no time shall the provider dispose of non-expendable property purchased under this contract except with the permission of, and in accordance with, instructions from the Department. f. A formal contract amendment is required prior to the purchase of any item of non-expendable property not specifically listed in the approved contract budget. 6. Information Technology Resources. All contract providers must adhere to the Department's procedures and standards when purchasing Information Technology Resources (ITRs) as part of this contract. These resources will revert to the Department at the conclusion of the contract. ITRs are data processing hardware, software, service, supplies, maintenance, training, personnel, and facilities. The provider agrees to secure prior written approval through the contract manager from the District Management Systems Director for the purchase of any ITR. The provider will not be reimbursed for any purchase made prior to this written approval. 3/21/2001 23. PSMAI No. GA 07 Contract No. KG034 07/01/2001 - Community Care-for Disabled Adults/Fixed Price. - Adult Services Program 7. Morals Clause The provider understands that performance under this contract involves the expenditure of public funds from both the state and federal governments, and that the acceptance of such funds obligates the provider to perform its services in accordance with the very highest standards of ethical and moral conduct. Public funds may not be used for purposes of lobbying, or for political contributions, or for any expense related to such activities, pursuant to Section I R of the Standard Contract of this contract. The provider understands that the Department is a public agency which is mandated to conduct business in the sunshine, pursuant to Florida Law, and that all issues relating to the business of the Department and the provider are public record and subject to full disclosure. The provider understands that attempting to exercise undue influence on the Department and its employees to allow deviation or variance from the terms of this contract other than negotiated, publicly disclosed amendment, is prohibited by the State of Florida, pursuant to, Section III C of the Standard Contract. The provider's conduct is subject to all state and federal laws governing the conduct of entities engaged in the business of providing services to government. 8. Year 2000 Compliance Warranty (Existing Hardware and Software) The provider shall warrant that their existing hardware and software shall not experience abnormal ending and/or produce invalid or incorrect results in the operation of the business of the State after the turn of the century. In the event of any recognition, calculation, or indication of century problems related to the Year 2000, the provider shall warrant that they will make all code adjustments necessary at no cost to the State in order to ensure that the code and databases are "Year 2000 Compliant". The warranty shall be in effect until December 31, 2000 or one year after system reconfiguration, which ever is later. Year 2000 compliant: "Year 2000 compliance" means that information resources meet the following criteria and/or perform as described. a. Data structures (databases, data filed, etc.) provide 4-digit data century recognition. Example: "1996" provides "data century recognition", "96 does not. b. Stored data contains date century recognition, including (but not limited to) data stored in databases and hardware/device internal system dates. 3/21/2001 24. PSMAI No. GA 07 Contract No. KG034 , 07/01/2001 Community Care for Disabled Adults/Fixed Price Adult Services Program c. Calculations and program logic accommodate both same century and multi-century formulas and data values. Calculations and logic include (but are not limited) sort algorithms, calendar generations, event recognition, and all processing actions that use or produce data values. d. Interfaces (to and from other systems or organization) prevent non- compliant dates and data from entering or exiting any state system. e. . User interfaces-(i.e. screens, reports, etc.) accurately show 4-digit years (if critical to business functions). f. Year 2000 is correctly treated as a leap year within all calculation and calendar logic. 9. Year 2000 Compliance Warranty - (New Hardware and Software Purchases) For purposes of this Year 2000 warranty, the term "Product" shall include software, firmware, microcode, hardware and embedded chip technology. Provider warrants that the Product is Year 2000 Compliant. All versions of the Product offered by the provider and purchased by the State, for which provider is obligated to provide maintenance service are, and in the future, will be, Year 2000 Compliant. Year 2000 Compliant means the Product will include the ability to: consistently handle date information before, during, and after January 1, 2000, including accepting date input, providing date output, and processing dates; function before, during and after January 1, 2000, without the need for program changes caused by the advent of the new century; properly handle all date related information before and following Jan. 1, 2001, including but not limited to accurate and reliable performance in processing date and date related data, including calculating, comparing and sequencing; properly process any and all date calculations before, on and after the leap year date of February 29, 2000 and store and provide output of date information in ways that are unambiguous as to century. The duration of this warranty and the remedies available to the State for breach of this warranty shall be defined in, and subject to, the terms and limitations of any general warranty provisions of this contract, provided that notwithstanding any provision to the contrary in such warranty provision(s), or in the absence of any such warranty provision(s), defects in the Product with regard to Year 2000 Compliance, if any, will be corrected by provider at provider's cost within a timeframe mutually agreed upon with the State. Provider cannot be held responsible for errors resulting from devices or systems external to this contract which are 3/21/2001 25. PSMAI No. GA 07 Contract No. KG034 . 07/01/2001 Community Careior Disabled Adults/Fixed Price' - - -. - -- Adult Services Program permitted to directly access any database provided under this Agreement and overwrite Product date fields or from the users improper integration of non-Year 2000 Compliant systems. Nothing in this warranty shall be construed to limit any rights or remedies the State may otherwise have under this contract with respect to defects other than Year 2000 performance. 10. Year 2000 Remedy Clause In the event of any decrease in product functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating beyond the Millennium Date Change, Licensors and providers or Licensors products, agree 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 licensee, and without interruption to the ongoing business of the licensee, time being of the essence. 11. Resellers All products bid under this bid/contract will be Year 2000 compliant. Year 2000 Compliant means the Product will include the ability to: consistently handle date information before, during, and after January 1, 2000, including accepting date input, providing date output, and processing dates; function before, during and after January 1, 2000, without the need for program changes caused by the advent of the new century; properly handle all date related information before and following Jan. 1, 2001, including but not limited to accurate and reliable performance in processing date and date related data, including calculating, comparing and sequencing; properly process any and all date calculations before, on and after the leap year date of February 29, 2000 and store and provide output of date information in ways that are unambiguous as to century. Resellers may provide a "pass through warranty" from the manufacturer/software developer, which meets all the warranty requirements by the State, and which shall include all other warranties provided by the manufacturer or software developer. Reseller shall be responsible for warranty assurance, assistance, enforcement and any other actions or remediation, required to satisfy warranty requirements. 12. Incident Reporting The Provider is required to document all reportable incidents, as defined in the District 11 Uniform Incident Reporting Protocol for Incident Reporting and Client Risk Prevention For Critical and Non-Critical Incidents, which is incorporated herein by reference. 3/21/2001 26. PSMAI No. GA 07 Contract No. KG034 , 07/01/2001 . Community Care lor Disabled Adults/Fixed Price . Adult Services Program For each incident occurring during the administration of its program, the Provider must, within 24 hours of the incident, complete and submit the District's approved Incident Report to the respective department program incident report liaison. It is the Provider's responsibility to use the most current District 11 approved incident report for this purpose. A copy of the incident report must be placed in a central file marked "Incident Report" and in each client's file involved in the incident. Dissemination of the report within the department will be the responsibility of the department's program incident report liaison. Incidents that threaten the health, safety or welfare of any person or that place any person in imminent danger must be reported immediately to the department by telephonic contact. The information contained in the incident report is confidential. The dissemination, distribution or copying of the report is strictly prohibited, unless authorized by the Department. 13. Security Agreement The Provider agrees to submit to the Department Contract Manager an original signed Security Agreement Form CF-114 (Exhibit D) for all required personnel no later than thirty (30) days following the execution of this contract or thirty (30) days from date of employment. All personnel who require access to departmental information must sign the Security Agreement Form prior to receiving access to the information. 3/21/2001 27. PSMAI No. GA 07 Contract No.. KG034 7/2J2001 -Community Care for DisabledAClCllts -- Quarterly Cummulative Summary Reports Gtl~~i~~~~ Exhibit A Fiscal Year 2001-2002 Community Care for Disabled Adults Quarterly Summary Report Local Reporting Period: _3 Month 6 Month 9 Month 12 Month District: 11 B Name of Contract Manager: Phone Number: SC I. Expenditures (1) Total CCDA dollars: (2) Total expenditures this quarter: (3) Total expenditures spent to date: (4) Encumbrances *: (5) Balance: II. Report Prepared By: III. Phone Number: GA07 Contract No. KG034 ~ 0710112001 Community Care for Disabled Adults- - Adult Services Program DEPARTMENT OF CHILDREN AND FAMILIES Exhibit B OFFICE OF FAMILY SAFETY MONTHLY REQUEST FOR PAYMENT AND EXPENDITURE REPORT PROVIDER FED. 10 # NAME AND MAILING ADDRESS OF PAYEE: CONTRACT AMNT.:_ REIMBURSEMENT YTD.:_ CONTRACT BALANCE: DATE: CONTRACT#: PERIOD OF SERVICE PROVISION: NAME OF SERVICE UNITS/ AMOUNT PER UNIT/ TOTAL AMOUNT OR DESCRIPTION OF MATERIALS QUANTITY EPISODE DUE TOTAL TOTAL MATCH REQUIRED PAYMENT FOR CONTRACT: REQUESTED THIS MNTH. YTD. LOCAL CASH MATCH r\ FLORIDA DEPARTMENT OF LOCAL IN-KIND ~ CHILDREN TOTAL DEDUCTIONS ~ & FAMILIES REMAINING MATCH BALANCE SIGNITURE OF PREPARER APPROVED BY DATE COMPLETED TITLE .,F THIS INVOICE IS FOR A FIXED PRICE CONTRACT, THE REOUEST FOR PAYMENT WILL BE DETERMINED BY DIVIDINC THE LENCTH OF THE CONTRACT INTO THE CONTRACTED AMOUNT (EX..S12,QOO{ALLOCATION) DIVIDED BY 12 MONTHS (THE LENGTH OF THE CONTRACT1=S1.000 PAYMENT REQUEST) ON A COST REIMBURSEMENT CONTRACT THE PAYMENT REOUEST WILL BE THE MONTHLY REOUEST EXPENSE. CHILDREN AND FAMILIES USE ONLY DATE INV. RCD. APPROVED BY: DATE IORG EO OBJ DESC. AMNT. IOCA Contract Page No. 2.. '1 GA07 Contract No. KG034 ~ ~ ~ n (3 ;ri ~ ~ '" r >- ,;0>OVJ1J r ~~~g~!lJ~Q oC~n()>"1J~ >- ~~O~r-~ (5 -. (')cn~--. Z ~ [ ~ ~11~~~~g1~i ~'" - 0; il'j'" ~i~li~ ~.a:'l ~.~c.... ~~lag, iJ,::=a...: ~ ~ g,:f ~ .0' i In..g' a CD &~ ~"i!.a:~'''! ~~!~~~~[.g~~; it~1i ~~~~i~ g.~i~ ~~i~-< g' it ~ ; g n ~ ~ .. ~ Ii :: ii~.;:. ~ ~~ ::: ~ o 0 :;). " ~ ~ ~. '"' "1i .. 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R'\ ^~ 0 (t) < :C~ l1) .., -n ... ~ ~ :J -0 .... r-~ '"0 < 0 (t) ~~ 0 :J II> - ~~ 0 ... r- oO 0 - ....~ [-< '" ZQ 0. r '^ ::J 0 (Jl 0 ... ~- "0 "'T1 l1) -< ... c: N ::J 0 - 0 ;;r -" I III N C. 0 n 0 0 < N ~ III 0- :J 0 a. 0 ~-o 0 .... 0 0 ~ .... ::J 0 cc 0 0 :J < III - ... .... ~ III '" 0 01 - 0,< en III .... fJI - m X ::I: [Xl =i (") ~l('H rLDREN ~ & FAMILIES EillIBIT D SECURITY AGREEMENT FORM The Department of Children and Families has authorized you: Employee's Name/Organization to have access to sensitive data through the use of computer-related media (e.g., printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer crimes are a violation of the department's disciplinary standards and, in addition to departmental discipline, the commission of computer crimes may result in Federal and/or State felony criminal charges. . By my signature, I acknowledge that I have received, read and understand the Computer Related Crimes Act, Chapter 815, F.S. . By my signature, I acknowledge that I have received, read and understand Sections 7213, 7213A, and 7431 of the Internal Revenue Code, which provide civil and criminal penalties for unauthorized inspection or disclosure of Federal tax data. . By my signature, I acknowledge that it is the policy of the Department of Children and Families that under no circumstances shall any contract employee be allowed access to IRS tax information. I understand that a security violation may result in criminal prosecution according to the provisions of Federal and State statutes and may also result in disciplinary action against me according to the provisions in the Employee Handbook. The minimum department security requirements are: . Personal passwords are not to be disclosed. . Information is not to be obtained for my own or another person's personal use. Print Employee's Name Signature of Employee Date Print Supervisor's Name Signature of Supervisor Date CF 114, JF 0212001 ]A' Oistribution of Copies: Original. Personnel File/Contract File Copy. Security File Copy. Employee ........-1,."r' I ....:,.," v' -,. '-' ~ 5.01 :ShoT:. titl,e. - The provisions of this act shall be known and may b~ cited as the '.Florida Computer Crimes Act: (History: s, 1, ch. 78-92,) 5.02 Legislative Intenl - The Legislature finds and declares that: , . (1) Computer-related crime is a growing problem in government as well as In the pnvate sector. . (2) Computer-related crime occurs at great cost to the public since losses for each InCident of computer crime tend to be far greater than the 10 30ciated with each incident of other whi:e: collar crime. Sses (3) The opportunities for computer-related crimes in financial institutions, government programs, government records, and other business enterprises throu h ! introduction of fraudulent records into a computer system, the unauthonzed use of computer facilltl~s, the alteration or destruction of computeriz g d Jrmation or files. and the stealing of financial instruments, data, and other assets are great. . . . '. e (4) While various forms of computer crime mi<;lht possibly be the subject of cnmlnal charges based on other prOVIsions of law, it IS appropnate and desirable It a supplemental and additional statute be provided which proscnbes vanous forms of computer abuse, (History: s, 1, ch, 78-92.) 5,03 Definitions. - As used in this chapter, unless the context clearly indicates otherwise: (1) '.Intellectual property'. means data, including programs. (2) "Computer program'. means an ordered set of data representing coded instructions or statements that when executed by a computer cause the computer :Jrocess data. . (3) "Computer" means an internally programmed, automatic device that performs data processing, . . . (4) '.Computer software'. means a set of computer programs, procedures, and associated documentation concerned with the operation of a computer system, (5) "Computer system" means a set of related connected or unconnected, computer equipment, deVices, or computer software, (6) '.Computer network" means a set of relat~d, remotely connected devices and communication facilities including more than one computer system with Jability to transmit data among them through communication facilities, (7) "Computer system services'. means providing a computer system or computer net...,or,.; to pe~orm useful work. .. '" (8) "Property" means anything of value as defined in (Footnote 1] s, 812.011 and Includes, but IS not limited to, financial Instruments, Information, Including 'ctronically produced data and computer software and programs in either machine-readable or human-readable form, and any other tangible or Intangible item value. (9) '.Financial instrument" means any check, draft, money order, certificate of deposit, letter of credit, bill of exchange, credit card, or marketable security. (10) '.Access'. means to approach, instruct, communicate with, store data in, retrieve data from, or otherwise make use of any resources of a computer, -nputer system, or computer network, (History: s. 1, ch. 78-92.) ((Footnote 1] Note: Repealed by s. 16, ch. 77-342.) 5.04 Offenses against intel!ectual property; public records exemption. - . ,. , '" (1) Whoever Willfully, knOWingly, and without authorization modifies data, programs, or supporting documentation reSiding or eXisting Internal or external to a nputer, computer system, or computer network commits an offense against intellectual property, (2) Whoever willfully, knowingly, and without authorization destroys data, pregrams, or supporting documentation residing or existing internal or external to a nputer, computer system, or computer network commits an offense against intellectual property, (3) (a) Data, programs, or supporting documentation which is a trade secret as defir:ed in s, 812,0~1 which resides or exists internal or ex:ternalto a nputer, computer system, or computer network which is held by an agency as defined In chapter 119 IS confidential and exempt from the proVIsions of s. 3,07(1) and s, 24(a), Art. I of the State Constitution, (b) Whoever willfully, knowingly, and without authorization disclos~s or takes data, programs, or supporting documentation whichis a trade secret as ined in s, 812.0~ 1 or is confidential_i!! provided by law residing or existing internal or external to a computer, computer system, or computer netv-Iork commits offense against Intellectual property.':"~_ (4) (a) Except as otherwise provided -in this subsection, an offense against intellectual property is a felony of the third degree, punishable as provided in s. 5.082, s. 775.083, or s, 775.084. (b) If the offense is committed for the purpose of devising or executing any scheme or artifice to defraud or to obtain any property, then the offender is Ity of a felony of the second degree, punishable as provided in s. 775,082, s, 775,083, or s, 775.084. (History: s, 1, ch. 78-92; s, 1, ch. 94-100; s. 431, ch, 96-406.) 5,045 Trade secret information_ - The Legislature finds that it is a public necessity that trade secret information as defined in s. 812.081, and as provided for s. 815.04(3), be expressly made confidential and exempt from the public records law because it is a felony to disclose such records, Due to. the legal :;ertainty as to whether a public employee would be protected from a felony conviction if otherwise complying with chapter 119, and with s. 24(a), Art. I of the lte Constitution, it is imperative that a public records exemption be created, The Legislature in making disclosure of trade secrets a crime has clearly :ablished the impo~a.nce attached to trade secret protection. Disclosing trade secrets in an agency's possession would negatively impact the business ~rests of those providing an agency such trade secrets by damaging them in the marketplace, and those entities and individuals disclosing such trade secrets uld hesitate to cooperate with that agency, which would impair the effective and efficient administration of governmental functions. Thus, the public and private 'm in disclosing trade secrets significantly outweighs any public benefit derived from disclosure, and the public's ability to scrutinize and monitor agency action lOt diminished by nondisclosure of trade secrets, (History: s, 2, ch. 94-100.) (Note, Former s, 119.165) i.05 Offenses against computer equipment or supplies_ _ (1) (a) Whoever willfully, knowingly, and without authorizatio.n modifies equipment or supplies used or intended to be used in a computer, computer system, ::omputer network commits an offense againsfcomputer equipment or supplies. (b) 1. ~xcept as provided in this paragraph, an offense against computer equipment or supplies as pro.vided in paragraph (a) is a misdemeanor of the t degree, punishable as provided in s, 775,082 or s. 775,083. 2, If the offense is committed for the purpose of devising or executing any scheme or artifice to raud or to obtain any property, t~en the offender is guilty o.f a felony o.f the third degree, punishable as provided in s, 775.082, s. 775,083, or s. 775.084. . (2) (a) Whoever Willfully, knOWingly, and without authorization destro.ys, takes, injures, or damages equipment or supplies used o.r intended to be used In a nputer, computer system, or computer network; or whoever willfully, knowingly, and without authorization destroys, injures, or damages any computer, nputer system, or computernetv-;.ork commits an offense against computer equipment or supplies. (b) 1. Except as provl~ed I~ this paragraph, an offense against computer equipment or supplies as provided in paragraph (a) is a misdemeanor of the : degree, punlshaole as provided In s. 775.082 or s, 775.083, 2, If the damage to such computer equipment or supplies or to the computer, computer system, :omputer netv-;ork is greater than 5200 but less than S 1,000, then the offender is guilty of a felony of the third degree, punishable as provided in s. 775.082, s, ,.083, or s. 775..084. ,3. If the damage to such computer equipment or supplies or to the computer, computer system, or computer net'....ork is 51,000 ?r ater, or If there IS an Interruption or impairment of governmental operation or public communication, transportation, or supply of water, gas, or other publiC Vice, then tne offender IS guilty of a felcny of the second degree, punishable as pro.vided in s. 775.082, s. 775,083, or s. 775.084. (HistOry: s. 1, ch, 78-92; s. 192, ch. 91-224,) ;,06 Offenses against computer users. _ (1) Whoever willful~y, knowingly, and without authorization accesses or causes to be accessed any computer, computer system, or computer network; or )~ver Willfully, ,kno.wlngly, and without authorization denies or causes the denial of computer system services to an authorized user of such computer system IlceS, which, In whole or part, is owned by, under contract to, or operated for, on behalf of, or in conjunction with another commits an offense against 'puter users, (2) (a) Except as provided in this subsection, an offense against computer users is a felony of the third degree, punishable as provided in s. 775.082, s. 1.083, or s. 775,084. (b) If the offense is committed for the purposes of devising or executing any scheme or artifice to defraud or to obtain any property. then the offender is ty of a felony of the second degree, puniShable as provided in s. 775.082, s. 775.083, or s. 775,084. (History: s. 1, ch, 78-92.) ,.07 This chapter not exclusive. - The provisions of this chapter shall not be construed to preclude the applicability of any other provision of the criminal law l~S state which presently applies or may in the future apply to any transaction which violates this chapter, unless such provision is inconsistent with the terms liS chapter. (History: s, 1, ch. 78-92,) 14, JF 02/2001 , :CT10N 7213 - UNAUTHORIZED DISCLOSURE OF INFORMATION ) RETURNS AND RETURN INFORMATION - . (1) FEDERAL EMPLOYEES AND OTHER PERSONS - It shall be unlawful for any officer or employee of the Um~ed States .or any person :scribed in section 6103(n)(or an cr.:cer or employee of ~ny suc~ person),or any form,er officer or employe~. wlllfull.y to dIsclose to any :rson, except as authorized in this title, any return or return Information. [as defined I~ se~lon 6103(b)].Any vIolation of this paragraph shall be felony punishable upon conviction by a fine in any amount, not exceeding S5,000.or Imprisonment of ~ot more than 5 years,. or bo~~. together th the costs of prosecution, and if such offense is committed by any officer or employee of the Umted States, he shall. In addltlon to an her punishment be dismissed from office or discharged from employment upon conViction for such offense. y (2) STATE A~IO OTHER EMPLOYEES - It shall be unlaw:ul for a0Y person [not ?escri~ed in paragraph (1)] willfu.lly to disclose to any lrson, except as authorized in this title, any return or return Information [as defined In section 610?(b)] acqUired ~y hl,m or an?ther person lder subsection ((d),(i)(3)(B)(i),(1)(6),(7),(8),(9),(10),(12),(15)or (16)or (m)(2),(4L(5),(6),or (7)of section 6103.Any Violation of thiS paragraph lall be a felony punishable by a fine in any amount not exceeding S5,OOO,or Imprisonment of not more than 5 years, or both, together with the lSt of prosecution. (3) OTHER PERSONS - It shall be unlawful for any person to whom any return or return information [as. defined in section 6103(b)] is sclosed in an manner unauthorized by this title thereafter willfully to print or publish in. any manner not provlde~ by law any s.uch return or turn information. Any violation of this paragraph shall be a felony punishable by a fine In any amount not exceeding S5,000,or Imprisonment not more than 5 years, or both, together with the cost of prosecution. , , , (4) SOLICITATION - It shall be unlawful for any person willfully to offer any Item of matenal value In exchange for any return or return formation [as defined in 6103(b)] and to receive as a result of such solicitation any such return or return information. Any violation of this 3ragraph shall be a felony puniShable by a fine in any amount not exceeding S5,000,or imprisonment of not more than 5 years, or both, gether with the cost of prosecution. (5) SHAREHOLDERS - It shall be unlawful for any person to whom return or return information [as defined in 6103(b)] is disclosed Jrsuant to the provisions of 61 03((e)(1 )(D)(iii)willfully to disclose ~uch return or return information in any ~an~er not provided by law. Any olation of this paragraph shall be a felony punishable by a fine In any amount not exceeding SS,OOO,or Imprisonment of not more than 5 ~ars, or both, together with the cost of prosecution. ECTION 7213A - UNAUTHORIZED INSPECTION OF RETURNS OR RETURN INFORMATION I) PROHIBITIONS - (1) FEDERAL EMPLOYEES AND OTHER PERSONS -It shall be unlawful for- (A) any officer or employee of the United States, or (8) any person described in section 6103(n)or an officer willfully to inspect, except as authorized in this title, any return or return Iformation. (2) STATE AND OTHER EMf?);OYEES - It shall be unlawful'for any person [not described in paragraph(I)] willfully to.inspect, except as uthorized by this title, any returrrJinformation acquired by such person or another person under a provision of section 6103 referred to in ~ction 7213(a)(2). J) PENALTY - (1) IN GENERAL - Any violation of subsection (a)shall be punishable upon conviction by a fine in any amount not exceeding $1000,or nprisonment of not more than 1 year, or both, together with the costs of prosecution. (2) FEDERAL OFFICERS OR EMPLOYEES - An officer or employee of the United States who is convicted of any violation of subsection ~) shall, in addition to any other punishment, be dismissed from office or discharged from employment. ;) DEFINITIONS - For purposes of this section, the terms "inspect", "return", and "return information'. have respective meanings given such ~rms by section 6103(b). ECTION 7431 - CIVIL DAMAGES FOR UNAUTHORIZED DISCLOSURE OF RETURNS AND RETURN INFORMATION ~) IN GENERAL - (1) INSPECTION OR DISCLOSURE 8Y EMPLOYEE OF UNITED STATES - If any officer or employee of the United States knowingly, or y reason of negligence, in~pects or discloses any return or return information with respect to a taxpayer in violation of any provision of section 1 03,such taxpayer may bring a civil action for damages against the United States in a district court of the United States. (2) INSPECTION OR DISCLOSURE BY A PERSON WHO IS NOT AN EMPLOYEE OF THE UNITED STATES - If any person who is not n officer or employee of the United States knowingly, or by reason of negligence, inspects or discloses any return or return information with ~spect to a taxpayer in violation of any provision of section 6103,such taxpayer may bring a civil action for damages against such person in a istrict court of the United States, J) EXCEPTIONS - No liability shall arise under this section with respect to any inspection or disclosure - (1) which results from good faith, but erroneous, interpretation of section 6103,or (2) which is requested by the taxpayer. :) DAMAGES - In any action brought under subsection (a) ,upon a finding of liability on the part of the defendant, the defendant shall be liable J the plaintiff in an amount equal to the sum of- (1) the greater of- (A) S 1,000 for each act of unauthorized inspection or disclosure of a return or return information with respect to which such defendarit is lund liable, or (B) the sum of: (!) t.he actual damages sustained by the plaintiff as a result of such unauthorized inspection or disclosure, plus (II) Inthe case of a willful inspection or disclosure or an inspection or disclosure which is the result of gross negligence, punitive damages, plus (2) the cost of the action, j) PERIOD FOR BRINGING ACTION - Notwithstanding any other provision of law, an action to enforce any liability created under this section 1 y be brought. Without regard to the amount in controversy, at any time within 2 years after the date of discovery by the plaintiff of the nauthorized inspection or disclosure. F 114, JF 0212001 ATTACHMENT II FINANCIAL AND COMPLIANCE AUDIT This attachment is applicable if the provider is any state or local government entity, non-profit organization, or for-profit organization. For State or local government entities, a Single Audit performed by the Auditor General shall satisfy the requirements of this attachment. If the provider does not meet any of the requirements below, no audit is required by this attachment. P ART I: FEDERAL AUDIT REQUIREMENTS This part is applicable if the recipient is a State or local government or a non-profit organization as defined in OMB Circular A-I33, as revised. In the event that the recipient expends $300,000 or more in Federal awards in its fiscal year, the recipient must have a single or program-specific audit conducted in accordance with the provisions of OMB Circular A-l33, as revised. In determining the Federal awards expended in its fiscal year, the recipient shall consider all sources of Federal awards. The determination of amounts of Federal awards expended should be in accordance with guidelines established by OMB Circular A-l33, as revised. An audit of the recipient conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as revised, will meet the requirements of this part. In connection with the audit requirements, the recipient shall fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-l33, as revised. The reporting package shall include a schedule that discloses the amount of expenditures by contract number for each contract with the department in effect during the audit period. Compliance findings related to contracts with the department shall be based on contract requirements including any rules, regulations, or statutes referenced in the contract. The reporting package shall disclose whether or not the matching requirement was met for each applicable contract. All questioned costs and amounts due to the department shall be fully disclosed in the report with reference to the department contract involved. For recipients who are subject to both Part I and Part II below, the audit must also address applicable State audit requirements. CF 1120, JF 07/01 32-- PART II: STATE REQUIREMENTS In the event the recipient expends a total amount of State financial assistance to carry out state projects equal to or in excess of $300,000 in any fiscal year of such recipient, the recipient must have a Single or project-specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the Executive Office of the Governor and the Comptroller, and Chapter 10.550 (Local Government Entity Audits) or 10.650 ( State Single Audits: Nonprofit and For-Profit Organizations), Rules of the Auditor General. In determining the State financial assistance expended in its fiscal year, the recipient shall consider all sources of State financial assistance, including State funds received from the Department of Children & Families, except that amounts received by a nonstate entity for Federal program matching requirements shall be excluded from consideration. In connection with the audit requirements addressed in the preceding paragraph, the recipient shall ensure that the audit complies with the requirements of Section 215.97(7), Florida Statutes. This includes submission of a reporting package as defined by Section 215.97(2)(d), Florida Statutes, and the applicable Chapter 10.550 or 10.650, Rules of the Auditor General. The reporting package shall include a schedule that discloses the amount of expenditures by contract number for each contract with the department in effect during the audit period. Compliance findings related to contracts with the department shall be based on contract requirements including any rules, regulations, or statutes referenced in the contract. The reporting package shall disclose whether or not the matching requirement was met for each applicable contract. All questioned costs and amounts due the department shall be fully disclosed in the audit report with reference to the specific contract involved. P ART III: SUBMISSION OF REPORTS For any of the above requirements, copies of the audit report and any management letter by the independent auditors shall be submitted within 180 days after the end of the provider's fiscal year or within 30 days of the recipient's receipt of the audit report, whichever occurs first, directly to each of the following, unless otherwise required by Florida Statutes: A. Contract manager for this contract B. District office: Contract Compliance Unit Attention: Audit Review Analyst 401 NW 2nd Avenue Suite N-921 Miami, FL 33128 07/01/01 "'33 C. Copies of reports for audits conducted in accordance with OMB Circular A-I33, as revised, and required by Part I of this agreement shall be submitted, when required by Section .320( d), OMB Circular A-I33, as revised, by or on behalf of the recipient directly to the Federal Audit Clearinghouse designated in OMB Circular A-I33, as revised (the number of copies required by Sections .320( d)( I) and (2), OMB Circular A-133, as revised, should be submitted to the Federal Auditing Clearinghouse), at the following address: Federal Audit Clearinghouse Bureau of the Census 1201 East 10th Street Jefferson, IN 47132 and Other Federal agencies and pass-through entities in accordance with Sections .320(e) and (f), OMB Circular A-133, as revised. D. Copies ofreporting packages required by Part II of this agreement shall be submitted by or on behalf of the recipient directly to the Auditor General's Office at the following address: State of Florida Auditor General Attn: Ted J. Sauerback Room 574, Claude Pepper Building 111 West Madison Street Tallahassee, Florida 32302-1450 PART IV: RECORD RETENTION The provider shall ensure that audit working papers are made available to the department, or its designee, upon request for a period of five years from the date the audit report is issued, unless extended in writing by the department. 07/01/01 '31 2. 5. - - . Conflict of Interest Questionnaire MONROE COUNTY IN HOME SERVICES YES NO 1. Do you, your immediate family, or business partner have financial or other interest in any of the potential bidders/entities listed? x Have any gratuities, favors, or anything of monetary value been offered to you or accepted by you from any of the potential bidders/ entities listed? x 3. Have you been employed by any of the potential bidders/entities listed within the Last 24 months? x 4. Do you plan to obtain a financial interest; i.e., stock, in any of the potential bidders/entities listed? x Do you plan to seek or accept future employment with any of the potential bidders/entities listed? x 6 . Are there any other conditions which may cause a conflict of interest? x If you answered "yes" to any of the above questions, attach to this questionnaire a written explanation of your answer. I DECLARE ALL OF THE ABOVE QUESTIONS ARE AND TO THE BEST OF MY KNOWLEDGE. ~~ ANSWERED TRUTHFULLY ;S(0/6l Date ' _10....-.. lII. J tJ 10MJ JUJ'i 1""\.L-\.....Jr~.LJro.__..........."'-____~~---_ r"\ l\."';' \.,,1 111 lc;.;. I\, CERTIPICATION FOR CONTRACTS, GRANTS, LOA~S AND COOPERATIVE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: (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 an 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 the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, 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 or 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 subawards at all tiers (in<.:luding subcontracts, subgrants, and contrCilcts under grants, loans~and cooperative agreements) and that all subrecipients shall certifY and disclose according1y.. 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 and not more than $100,000 for each such failure. Signature Date Name of Authorized Individual Application or Contract Number Name of Organization Address of Organization Page _ 03/96 Contract No. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION - . CONTRACTS/SUBCONTRACTS This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, signed February 18, 1986. The guidelines were published in the May 29, 1987 Federal Register (52 Fed. Reg., pages 20360 - 20369). I~STRUCTIONS 1. Each provider whose contract/subcontract equals or exceeds $25,000 in federal monies must sign this certification prior to execution of each contract/subcontract. Additionally, providers who audit federal programs must also sign, regardless of the contract amount. Children & Families cannot contract with these types of providers if they are debarred or suspended by the federal government. 2. This certification is a material representation of fact upon which reliance is placed when this contract/subcontract is entered into. If it is later determined that the signer knowingly rendered an erroneous certification, the Federal Government may pursue available remedies, including suspension and/or debarment. 3. The provider shall provide immediate written notice to the contract manager at any time the provider learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms "debarred", "suspended", "ineJigible", "person", "principal", and "voluntarily excluded", as u~ in this certification, have the meanings set out in the Definitions"and Coverage sections of rules implementing Executive Order 12549. You may contacfthe contract manager for assistance in obtaining a copy of those regulations. 5. The provider agrees by submitting this certification that, it shall not knowingly enter into any subcontract with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this contract/subcontract unless authorized by the Federal Government. 6. The provider further agrees by submitting this certification that it will require each subcontractor of this contract/subcontract, whose payment will equal or exceed $25,000 in federal monies, to submit a signed copy of this certification. 7. The Department of Children and Families may rely upon a certification of a provider that it is not debarred, suspended, ineligible, or voluntarily excluded from contracting/subcontracting unless it knows that the certification is erroneous. (1) The prospective provider certifies, by signing this certification, that neither it nor its principal.s is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this contract/subcontract by any federal department or agency. (2) Wh~!e t~e prospective provider is unable to certify to any of the statements in this certlTlcatlon, such prospective provider shall attach an explanation to this certification. Signature Date Name @j'lOAIDAOlPAKTMENTOF . " CHILDREN C;V "FAMILIES CIVIL RIGHTS COMPLIANCE CHECKLIST Program/FacililyName Monroe County Board of Count County Monroe Commissioners Social Servic n m Address District 1 1 5100 Colle e Rd.-PSB Win III City. State. Zip Code Deloris Date Ke West FL 33 4 READ THE REVERSE SIDE FOR IllUSTRATIVE INFORMATION WHICH Will HELP YOU IN COMPLETION OF THIS FORM. PART I. 1. Briefly describe the geographic area served by the program/facility and the type of service provided: All 0 f Monroe ~(')1]nty K,::>y T.."lrl)f"'I to Ke~' Wesot Providing Cace M:ln:lgement, Chore, IIomemaking, ~1eals d.l!d Pt::l. ::ovua.l Ca.l. t:: 2. POPULATION OF AREA SERVED. Total # % White % Female 3. 4. 5. NA o Yg' 0 7. Compare staff composition to the population. Are staff representative of the population? If NA or NO, explain. 8. Compare the client composition to the population. Are race and sex characteristics representative of the population? If NA or NO, explain, NA o Y&r 0 9. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national origin, sex, age, religion or handicap? If NA or NO, explain. NA o Y~ NO [0 D 10. Are all benefits, services and facilities available to applicants and participants in an equally effective manner regardless of race, sex, color, age, national origin, religion or handicap? If NA or NO, explain. NA D Yt 0 If NA or NO, f5 NA / YES ~ D NO D CF 946A. Jan 98 (Replaces Oct 96 adition which may be used) (Stock Number: 5740-00A-0946-0) Distribution of Copies: White - District Program Office Yellow - Facility Page 1 of 2 PART II. USE A SEPARATE SHEET OF PAPER FqR ANY EXPLANATIONS REQUIRING MORE SPACE. 12. Is \he Iprogram/facility accessible to non-English speaking clients? If NA or NO, explain. 0 YOJI 0 13. Are employees, applicants and participants informed of their protection against discrimination? If YES, how? Verbal _ Written _ Poster _ If NA or NO, explain. 14. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/facility, 15. Is the program/facility physically accessible to mobility, hearing and sight impaired individuals? If NA or NO, explain. o Y~ 0 NAj NUMBER o I I NA o yr 0 PART III. THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES. 16. Has a self-evaluation been conducted to identify any barriers to serving handicapped individuals, and to make any necessary modifications? If NO, explain. 17. Is there an established grievance procedure that incorporates due process into the resolution of complaints? If NO, explain. 18. Has a person been designated to coordinate Section 504 compliance activities? If NO, explain. 19. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of handicap? If NO, explain. 20. Are auxiliary aids available to assure accessibility of services to hearing and sight impaired individuals? If NO, explain. Y&Y [] Yg [] Y[1 [] Y~ NO o Y~ 0 PART IV. FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000 OR MORE. 21. Does the program/facility have a written affirmative action program? If NO, explain. t$~ YES o NO o DEPARTMENT OF CHILDREN AND FAMILIES USE ONLY Reviewed By In Compliance: YES 0 NO 0 Program Office *Notice of Corrective Action Sent ---.J ---.J_ Date I Telephone Response Due ~ _/---.J _ On-Site 0 Desk Review 0 Response Received _/_/- :F 9468, Jan 98 (Replace. Oct 96 edition which may be used) ~tock Number: 5740-008-0946-4) Page 2 of 2