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Item C24BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date-. 12-12-2012 Division: County Administrator Bulk Item-. Yes X No Department.- Social Services/In-Home Services Staff Contact Person/Pho- 0 ,#ei # Sheryl Graham/ 2,9 2 - 4516 AGEINDA ITEM WO"ING: Approval ot'Amendment 001 to the Community Living Program (CLP) Contract CLP- 1229 between the Alliance for Aging, Inc. (Area Agency on Aging for Miami - Dade and Monroe Counties) and the Monroe County Board of County Commissioners (Social Services/In-Home Services) for fiscal period 1/1/12 to 12/31/12. ITEM BACKGROUND4: Approval of Amendment 001 to CLP-1229 will de -obligate $11,968.84 as a result of a surplus at grants end. Lack of spending was due to not enough clients being able to meet the required criteria and therefore not able to qualify for this grant. ........................................... .......... ........... PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to Contract CLP-1229 on December 14, 2011. CONTRACT/AGREEMENT CHANGES: A de -obligation of $11,968.84 in funds. STAFF RECOMMENDATIONS: Approval TOTAL COST: 6"-- INDIRECT COST: _-0--BUDGETED: Yes X No COST TO COUNTY: SOURCE OF FUNDS: REVENUE PRODUCING: Yes No AMOUNT PER MONTH Year APPROVED BY: County Atty X OMB/Purchasing X Risk Management X DOCUMENTATION. Included X Not Required DISPOSITION: Revised 1/09 AGENDA ITEM # MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Estimated Ongoing Costs: $ (Not included in dollar value above) ................. ... . .. . . . . . . Division Director Risk Management O.M.B./Purchasing County Attorney Comments: CONTRACT SU1 MARY Con -tract with: Alliance For Aging, Inc. Amendment 001 Contract CLP- 1229 Effective Date: I/l/201.2 Expiration Date: 1-2/31/201.2 Contract Purpose/Description: Approval of Amendment 00 1 to the Community Living Program (CLP) Contract CLP-1229 will de -obligate $11,968.84 from the contract. This is due to not enough clients being able to meet the required criteria and therefore not able to qualify for this grant. Contract Manager.- Sheryl Grazha. 2?Z-451.0 Community Services/Stop I (Name) (Ext.) (Department/Stop #) x"-. - For BOCC meeting on. 12/12/12 Agenda Deadline* H/27/12 . .......... Total Dollar Value of Contract.- -t9- Budgeted? Yes X No Grant: $ -15�- County Match: -&- - - - Total ADDITIONAL COSTS /yr For: .............. deg. Maintenance, utilities, janitorial, salaries, etc) CONTRACT COSTS Current Year Portion: $ Account Codes: ................... .... ... CONTRACT REVIEW Changes Date In Needed Reviewer Yes 0 No 0 Yes E] No n Yes El No 0 Yes '0_1 No 0 MB Form Revised 2/27/01 MCP #2 Date Out Amendment 001 CONTRACT CLP-1229 Page 1 THIS AMENDMENT is entered into between the Alliance for Aging, Inc. hereinafter referred to as the "Alliance", and Monroe County Social Services. The purpose of this amendment is to deolbligate $11,96 .84 from OAA CLP IIIB The Budget Summary by Title for the whole fiscal year (January 1 -December 31, 2012) is as follows: PROGRA-M TITLE FUNDING SOURCE CFDA ATMOUNT Older Americans Act Administration Title 111B — Support Services U.S. Health and Human Services 93.044 $209.16 TOTAL FEDERAL AWARD $209.16 . . . .. ....................... .......... The Alliance shall make payment to the provider for provision of services up to a maximum number of units of service and at the rate(s) stated below. - Service(s) to be Provided Service Unit Rate Maximum Units of Service* Maximum Dollars* HOMEMAKER $22.04 TBD TBD PERSONAL CARE $25.87 TBD: TBD CASE MANAGEMENT $38.03 TBD TBD Total Contract $2,809.16 All provisions in the contract and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the contract are hereby amended to conform with this amendment. This amendment and all its attachments are hereby made a part of the contract. IN WITNESS WHEREOF, the parties hereto have caused this amendment to be executed by their undersigned officials as duly authorized. Monroe County Social Services. SIGNED BY: George regent NAME: Mayor TITLE. - DATE : ALLIANCE FOR AGING, INC. . 4 ____ 0 W1110.&I mow, Max B. Rothman, JD, L.L.M. NAME: President & CEO TITLE: DATE: Contract CLP- 1. ?2W9 ALLIANCE FOR AGING, INC. STANDARD CONTRACTOLDER AMERICANS ACT PROGRAM TITLE 111-11 COMMUNITY LIVING PROGRAM THIS CONTRACT is entered into between the Alliance for Inc. Auing hereinafter referred to as the "A"' *_n_ , AA and Monroe County Social Services hereinafter referred to as the "Contractor"', and collectively referred to as the -Parties," The term contractor for this purpose may designate a vendor, subgrantee or SUbrecipient, the status to be further identified ill z:1 ATTACHMENT 111, Exhibit-2 as necessary. WSS IT THAT. WHEREAS, the AAA has established through the Area Plan on Aging that it is in need of certain services as described herein; and WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services as an independent contractor of the AAA. NOW THEREFORE, in consideration of the services to be performed and payments to be made, together with the Mutual covenants and conditions hereinafter set forth, the Parties agree as follows: .0 Purpose of Contract The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments and exhibits, which constitute the contract document. Definitions DOER means the Florida Department of Elder Affairs. AAA means the Alliance for Aging, Inc, PSA means the Planning and Service Area corresponding to Miami -Dade and Monroe Counties. 2. Incorporation of Documents within the Contract The contract will incorporate the provider's application in response to the 201.0 Community Living Program Invitation to Negotiate (ITN), attachments, proposal(s), state plan(s), grant agreements, relevant department handbooks, manuals or desk books, as an integral part of the contract, 'except to the extent that the contract explicitly provides to the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions and requirements of the contract documents.) shall prevail over inconsistent provisions in the Proposal(s) or other general materials not specific to this contract dOCLIment and identified attachments. Z= 3. Term of Contract This ' contract shall begin on. JanLlqry. 1, 201? or on the date on which the contract has been signed by the last party required to sign it, whichever is later. It s hall end at midnight, local time in Bari, Florida, on December 31. 2011 4, Contract Amount The department agrees to pay for contracted services according to the terms and conditions of this contract in an '11TIOUnt not to exceed -S 14.778.00, or the rate schedule, subject to the availability Of funds. Any costs or service,,.; paid for under any other contract or from any other source are not eligible for payment Linder this contract. zn MW Renewals By MUtual agreement of the parties, in accordance with s. 287.058(l T). F,&the AAA rnay renew the contract for a period not to exceed three years, or the term of the oriormal contract, whichever is longer. The renewal price. or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other costs for the renewal may he charged, Any renewal iS Subject to the same terms and conditions as the or gins contract and contingent UP011 satisfm actory perforance evalUations by the AAA and the availability Of funds, Contract CL.P- 1 2.9 6. Coillj2hance with Federal Law .1. If this contract contains federal funds the following shall. apply: .1.1 The provider shah comply with the provisions of 45 CFR 74 and/or 45 CFR 92, and other applicable rea lations, 6.1.2 If this contract contains federal funds and is over $100,000.00, the contractor shall comply with all applicable standards, orders, or regulations issued under s. 306 of the Mean .Air Act as amended 42 L.S.C. 7401, et seq.), s. 08 of the Federal water Pollution Control. Fact as amended (33 U.S.C. l 2.51, et seq.), Executive order 11738, as amended, and where applicable Environmental Protection Agency regulations 40 CPR 30. The contractor shall report any violations of the above to the AAA. .1. The contractor, or agent acting for the contractor, may not use any federal funds received in connection with this contract to influence legislation or appropriations pending before the Congress or any State legislature. If this contract contains federal funding in excess of $100,0 0.00, the contractor must, prior to contract execution, complete the Certification Regarding Lobbying form, ATTACHMENT I1. All disclosure forms as required by the Certification Regarding Lobbying fora roust be completed and returned to the Contract Manager, prior to payment tinder this contract. 6.1.4 That if this contract contains $10,000.00 or more of federal funds, the contractor shall comply with Executive order 11246, Equal Employment opportunity, as amended by Executive order 1.1375 and others, and as SLIpplemented in Department of Labor regulation 41 CFR 60 and 45 CPR 92, if applicable. 6.1..,E That if this contract contains federal funds and provides services to children LIP to age 18, the contractor shall comply pY with the Pro -Children .Act of 1994 (20 U.S.C. 6081). 6.1.6 That a contract award with an amount expected to equal or exceed $25,000.00 and certain other contract awards shall not be made to parties listed on the government -wide Excluded Parties List System, in accordance with the OMB guidelines at 2 CPR 180 that implement executive orders 12549 and 12 89, `Debarment and Suspension." The Excluded Parties List System contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parities declared ineligible Linder statutory or regulatory authority other than Executive order 12549. The contractor will comply with these provisions before doing business or entering into subcontracts receiving federal funds pursuant to this contract. The contractor shall complete and sign ATTACHMENT V prior to the execution of this contract. 6.2 The contractor shall not employ an unauthorized alien. The .AAA shall consider the employment of unauthorized aliens a violation of the Immigration and Nationality Act 8 US.C, 1324 a and the Immigration Reform and Control Act of 198 8 L.S.C. 1 101 . Such violation shall be cause for unilateral cancellation of this contract by the AAA. .3 If the contractor is a non-profit provider and is subject to Internal Revenue ;Service (IRS) tax exempt organization reporting requirements :filing a Form 990 or Form 990-N and has its tax exempt status revoked for failing to comply with the filing requirements of the "2 0 Pension Protection Act or for any other reason., the contractor must notify the AAA in writing with -in thirty 0 days of receiving the IRS notice of revocation. 7. Compliance with State Law 7.1 That this contract is executed and entered into in the ,State of Florida, and shall be construed, perfor red and enforced n all respects n accordance with the Florida law, including Florida provisions for conflict of laws. 71 Requirements of s. 7,0 8, F.S. as tamended. w a Contract CLP- I ,9 7.2.1 The contractor will provide units of deliverables, 111Cluding various client services, and in some instances mav icl uc reports, findings, and drafts, as specified in this contract, which the Contract Cana(yper must receive and accept 1 writing prior to payment in accordance with s, 2 1. 5.97 1, F.S. and (2). 7,2.2 The contractor will submit bills for fees or other compensation for services or expenses n sufficient detail for proper pre -audit and post -audit. p ail 7.23 If itemized payment for travel expenses is permitted in this contract, the contractor will submit bills for any r travt expenses in accordance with s. 112.06 1, F.S., or at Such lower rates as nay be provided in this contract. 7.2.4 The contractor will allow public access to all documents, papers, letters, or other public records as defined l. subsection 119.01 i 12 p , F.S., made or received by the contractor in conjunction with this contract except for thos records which are made confidential or exempt by law. The contractor's refusal to comply with this provision shal constitute an immediate breach of contract for which the AAA may unilaterally terminate the contract. 7.3 If clients are to be transported under this contract, the contractor shall comply with the provisions of Chapter 427 F.S., and Rule 4 l -?, F. A. C. p p 7.4 Subcontractors who are on the discriminatory vendor list may not transact business with any public entity,it accordance with the provisions of s. 287.134, F.S. 7.5 The contractor will comply with the provisions of s. 11.062, F.S., and s. 216.347, F.S., which prohibit the exx endit � p p � rt of contract funds for the purpose of lobbying the legislature, judicial branch or a state agency. S. Background Scree ni n The contractor shall ensure that, prior to providing services, all persons having access to vulnerable elders any children, their living area, funds or personal property, or protected health information pertaining to such individuals, p g shall pass a Level II criminal background screening in accordance with the requirements of s. 430.0402 and ch. 435 F.S., as amended. These provisions shall apply to employees, subcontractors, consultants, direct service providers and volunteers. Consequently, any commitment for employment, purchase of services, or volunteer rain ro participation program p p shall be contingent upon the passing of a Level II background check. The screening background ,shall include � g employment history checks as provided in s. 435.03(1), F.S., and both local and national criminal record checks coordinated through law enforcement agencies. 8.1 For purposes of this section, the term "direct service provider" means a person 18 ears of acre or older who urs � . Y � , p � ant to a program to provide services to the elderly, has direct, face-to-face contact with a client while providing services p g to the client or has access to the clients living areas or to the client's funds or personal This term includes property. coordinators, managers, and Supervisors of residential facilities and volunteers. 9. ri*eyance Procedures _.. rrnirnninn.rwwr The contractor shall develop and implement, and ensure that its subcontractors have established grievance procedures p � g to process and resolve client dissatisfaction with or denial of services , and address com faints re ardin the termination. suspension or reduction of services, as required for receipt of funds. These procedures, at a111iniMUMI, should provide for notice of the grievance procedure and an opportunity for review of the subcontractor's de term nation . s . 0. A d is InspectionsInvestl atlons �t bl c Records and Retention 10.1 To establish and maintain books records and documents (includingMedia` sufficient to electronic � m tronic storage � ereflect ,,III income and expenditures of funds provided by the AAA under this contract® 3/86 ;F 'Y if Co tract C LP- 2L9 10.2 To retain all client records, financial records, supporting documents, statistical records, and any other doctrner (ncl.rding electronic storage media) pertinent to this contract for a period of six. 6 years after completion of tl: contract or longer when required by lam}. In. the event an audit is required by this contract,, records shall be retains for a min rnrrrn period of six 6 years after the audit report is issued or until resolution of any audit findings i itrgation based on the terms of this contractat no additional cost to the AAA. Z7 10.3 Upon demand, at no additional cost to the AAA, the contractor will facilitate the duplication and transfer of ail records or documents during the required retention period in Paragraph 10.2. 1.0.4 To ass ire that the records described in Paragraph l shall. be subject at all reasonable times to inspection., revie v copying, or audit by Federal, State, or other personnel duly authorized by the A.A.. 10,z At all. reasonable times for as long as records are maintained, persons dL11y authorized by the AAA, DOER an Federal auditors, pursuant to 45 CFR 2.36 i (I 0), shall be allowed full access to and the right to examine any of th contractor's contracts and related records and documents pertinent to this specific contract, regardless of the form i which kept. 10.6 To provide a financial and compliance audit to the AAA as specified in this contract and in ATTACHMENT III any to ensure that all related party transactions are disclosed to the auditor. 1.0.7 To comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed necessary d b, the office of the Inspector General pursuant to s. 20.055, F.S. 11. Nondiserlrninntion-Civil Ri its Comm Il nee lilt The contractor will execute assurances in ATTACHMENT VI that it will not discriminate against any person in tht provision of services or benefits under this contract or in employment because of age, race, religion, color, disability national origin, marital status or sex in compliance with state and federal law and regulations. The contractor fUrthei asSLIres that all contractors, subcontractors, subgrantees, or others with whom it arranges to provide services of benefits in connection with any of its programs and activities are not discriminating against clients or ern to ee,5 p Y because of age, race, religion, color, disability, national origin, marital status or sex. 11.2 The contractor will retain, on file, during the terra of this agreement a timely, complete and accurate Civil Rights, Compliance Checklist ((ATTACHMENT B). 11.3 The contractor agrees to establish procedures pursuant to federal law to handle complaints of discrimination involving services or benefits through this contract. These procedures shall include notifying clients, employees, and participants of the right to file a complaint with the appropriate federal or state entity. I.1.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or benefit from federal financial ass stkr ce, and are binding upon the contractor, its successors, transferees, and assignees for the period during which such assistance is provided, The contractor further assures that all subcontractors, vendors, or others with whom itrranges to prop ode sergices or benefits to participants or employees in connection with any of its programs and a�:t �ines are not discriminating against those participants or er ployees in violation of the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the contractor understands that the AAA may, at its discretion, seek a court order requiring compliance with the terms of this assurance or seep other appropriate judicial or administrative nini:strative relief, i clrlding but not limited to, termination of and denial Of further assistance. 12. Provision of Services r_ ire cor trzrctor will provide services in the aianner described in A'fTACH,N4ENT 1. Contract CLP- 1 ?129 0. N-10nitoring by the AAA The contractor will permit persons duly authorized by the AAA to inspect and copy any records, papers, dOCLIment: facilities, goods and services of the contractor which are relevant to this contract, and to interview any client', employees and Subcontractor employees of the contractor to assure the AAA of the satisfactory performance of 01 terms and conditions of this contract. Following such review, the AAA will deliver to the contractor a written repo of its findings and request for development, by the contractor, a corrective action plan where appropriate. R contractor hereby agrees to timely correct all deficiencies identified in the corrective action plan. 14, Coordinated Monitoring with Other Agencies if the contractor receives funding from one or more of the State of Florida other human service agencies, in additio to the Department of Elder Affairs, then a joint monitoring visit including such other agencies may be scheduled. Fc the purposes of this contract, and pursuant to s. 287.0575, F.S. as amended, Florida's human service agencies sha include the Department of Children and Families, the Department of Health, the Agency for Persons with Disabilities the Department of Veterans Affairs, and the Department of Elder Affairs. Upon notification and the subseqUer scheduling Of Such a visit by the designated agency's lead administrative coordinator, the contractor shall comply an cooperate with all monitors, inspectors, and/or investigators. 15. Indemnification The contractor shall indemnify, save, defend, and hold harmless the AAA and its agents and employees from any ani all claims, demands, actions, causes of action of whatever nature or character, arising out of or by reason of th. execution of this agreement or performance of the services provided for herein. It is understood and agreed that th! provider is not required to indemnify the AAA for claims, demands, actions or causes of action arising solely Out 0 the AAA's negligence. Z� 15.1 Except to the extent permitted by s. 768.28, F.S., or other Florida law, Paragraph 15 is not applicable to contract executed between the .DOER and state agencies or subdivisions defined in s. 768.28(2), F.S. 16, Insurance and Bonin 16.1 To provide continuous adequate liability insurance coverage during the existence of this contract and any renewals and extension(s) of it. By execution of this contract, unless it is a state agency or subdivision. as defined by subsectiol 768.28(2)., F.S., the contractor accepts full responsibility for identifying and determining the type(s) and extent o liability insurance necessary to provide reasonable financial protections for the contractor and the clients to be serve( under this contract. The limits of coverage under each policy maintained by the contractor do not limit tht contractor's liability and obligations Linder this contract. The contractor shall ensure that the AAA has the mos current written. verification of insurance coverage throughout the term of this contract. SLIch coverage may N provided by a self-insurance program established and operating under the laws of the State of Florida. The A-AA,� reserves the right to require additional insurance as specified in this contract. Z! I. Throughout the term of this agreement., the contractor agrees to maintain an insurance bond from a responsibIt commercial Insurance company covering all officers, directors, employees and agents of the contractor authorized tc handle funds received or disbursed Under all agreements and/or contracts incorporating this contract by reference If' t� Zn i an amount commensurate with the funds handled, the degree of risk as determined by the insurance company am - consistent with good business practices. 1.7. onfidentialit of Information The contractor shall not use or disclose any information concerning a recipient of services Linder this contract for an�- purpose prohibited by state or federal law or regulations except with the written consent of a person legall-v "Rithorized to cOve that consent or when "ILIthorized by law. 1.8. Health Insurance Portabilltv and Accountabilitv Act 1 6 ON, M =: Contract CLP- I.?9 'where applicable, the contractor will comply with the Health Insurance Portability and AccOLintability / U Act. 4.� 1320d.). as well as all regulations promulgated thereunder 45 CFR 160, 162. and 164). 19. 1 nc dent Reporting t.. The contractor shall notify the AAA immediately, but no later than forty-eight 4 hours from y � ,the contract awareness or discovery of conditions that may materially affect the contractor or subcontractory to abilit . o perf the services required to be performed under this contract. Such notice shall be jade orallyto the contract a act r�ana�er telephone) with an email to immediately follow. 9.2 To immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, ,aged persor disabled adult to the Florida Abuse Hotline on the statewide toll -free telephone number . l -800-9 p 6ABUSE. required by Chapters 39 and 415, F.S., this provision is binding upon both the contractor and its employees. 20, New Contracts Reporting (IN/A The contractor shall notify the AAA within ten (i 0) days of entering into a new contract with an of y the rernai�� four 4 state human. service agencies. The notification shall include the followinginformation: i contracting ntractng s agency, 2) contract name and number! 3) contract start and end dates; (4) contract amount; contract des ri � � c pt and commodity or service; and 6) contract manager name and number. In complying with this provision, f pursuant to s. 287.0575, F.S. as amended, the contractor shall complete and provide the information ATTACHMENT D. 21, BankruptcyBaukruptcy Notification If, at any time during the term of this contract, the contractor, its assignees, Subcontractors or affiliates i ate! file-s a claim for bankruptcy, the contractor must immediately notify the AAA 'within ten i 0 days after notification, � y ton, the contractor must also provide the following information to the AAA: (1) the date of film of the bankruptcy petition; (2) the case number; (3 the court name and g p y the division in which the petition was filed (e. g., Northern District of Florida, Tallahassee .Division); and, (4) the name, address, and telephone number of the bankr � p pity attorney. 22. Sponsorship and P'nb iclt 22.1 As required by s. 2286.25, F.S., if the contractor is a non -governmental sponsors organization which s g p 5ors a progra financed wholly or in part by state funds, including any funds obtained through this contract it shalt in F c g s publ�c���n4 advertising, or describing the sponsorship of the program, state: "Sponsored b contractor's name Th y �, e Alliance fc Aging, and the State of Florida, Department of .Elder Affairs."' If the sponsorshipreference is in written material, er�al$ Ih words "Alliance for Aging" and "State of Florida, Department of Eider Affairs" shall appear in at least the sam e ame siz{ letters or type as the name of the organization. 22.2 The contractor shall not use the words "Alliance for Aging" or "The State of Florida, Department of p Eider Affairs" t( indicate sponsorship of a program otherwise financed, unless, specific authorization has been obtained by the A A prier to .use. 4 13. Assigments 23. t The contractor :shall not assign the rights and responsibilities under this Contract without the prior written c p rotten 6 �pprocl c.� the AAA, which shall not be Unreasonably rithheld. Any sublicense, ass'-nment, or transfer otherwis e occurri, withoUt prior written approwal of the AAA will constitute a material breech of the contract, The State of Florida shell at all times he entitled to as:sigyn or transfer, ill whole Or .art, it,.sr Heights duties. i t E. ti011s Utider this Contract to another go �ern� ntal agency the State f Florida. Upon.tvi g rior � °ritten . �w� �. dice to the 86 ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Contract CLP- 1229 contractor. In the event the State of Florida approves transfer of the contractors oblicrations, the contractor retTla responsible for all work. performed and all expenses incurred in connection with the contract. 23.3 This contract shall remain binding upon the successors in interest of either the contractor or the AAA. 24. Subcontracts '14. 1 The contractor is responsible for all work performed and for al.1 commodities produced pursuant to this contra 'AW whether actually furnished by the contractor or its subcontractors. Any subcontracts shall be evidenced by a writt document and subject to any conditions of approval the AAA deems necessary. The contractor further agrees that t AAA shall not be liable to the Subcontractor in any way or for any reason. The contractor, at its expense, will defe� the AAA against any Such claims. 24.2 The contractor shall promptly pay any Subcontractors upon receipt of payment from the department or oth sponsoring agency. Failure to make payments to any subcontractor in accordance with s. 287-0585, F.S., Unle Z:5 otherwise stated in the contract between the contractor and subcontractor, will result in a penalty as provided I statute. 25, Independent CapacilLof-Contractor It is the intent and understanding of the parties that the contractor, or any of its subcontractors, are indepen& contractors and are not employees of the AAA and shall not hold themselves out as employees or agents of the A.A. without specific authorization from the AAA. It is the further intent and understanding of the parties that the AA. doesnot control the employment practices of the contractor and shall not be liable for any wage and hOLI employment discrimination, or other labor and employment claims against the contractor or its subcontractors. A deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation rune and all necessary insurance for the contractor shall be the sole responsibility of the contractor. 26. Pay.ment Payments will be made to the contractor pursuant to s. 215.422, F.S., as services are rendered and invoiced by th contractor. The AAA's Contract ManaErer will have final approval of the invoice for payment, and will approve th invoice for payment only if the contractor has net all terms and conditions of the contract, unless the bi specifications, purchase order, or this contract specify otherwise. The approved invoice will be Submitted to th AAA's fiscal section for budgetary approval and processing. Disputes arising over invoicing and payments will b resolved in accordance with the provisions of s. 215.422 F.S. A Vendor ombudsman has been establ is"'hed within th Department of Financial Services and may be contacted at (850) 413-5665. 27. Return of Funds The contractor will return, to the AAA any overpayments due to unearned funds or funds disallowed and any interes attributable to Such funds pursuant to the terms and conditions of this contract that were disbursed to the contractor h, the AAA. In the event that the contractor or its independent auditor discovers that an overpayment has been made the contractor shall repay said overpayment immediately without prior notification from the AAA, In the event tha the AAA first discovers an overpayment has been made, the Contract Manager, on behalf of the AAA, will notify tint contractor by letter Of SLIch findings. Should repayment not be made forthwith, the contractor will be charged at Olt lawful rate of interest on the OLItstanding balance pursuant to As. '55,03. F.S., after AAA notification or con-tracto, discovery. W 28. Data Irate art and Safe Hardin Information The contractor shall. insure an appropriate level of data security for the information the contractor is collecting of using in the performance of this contract. An appropriate level of security includes approving .-rid mackincr all Z! contractor employees that request system or information access, and ensuring that user 'tccess has been removed froni ..111.1 terminated ernployees, The contractor, aniong other nll',qUtremtints, 111LISt -,inbcipate and preprefor the 1()ss of -17/86 sa Cot act CLP- 1.229 in -formation processing capabilities. All data and software must be routinely backed Lip to insure recovery from los., or outages of the computer system. The security over the he backed -Up data is to be, as stringent as the protect] of the primary systems. The contractor shall insure all Subcontractors maintain written procedures computer system back Lip and recovery. The contractor shall complete and sign ATTACHMENT IV prior to I execution of this contract. 19, Comj2uter Use and Social Media Policy The Department of Elder Affairs has implemented a new Social Media Policy, in addition to its Computer Use Poli( which applies to all employees, contracted employees, consultants, OPS and volunteers, including all person affiliated with third parties, such as, but not limited to, Area Agencies on in and vendors'. 'Any entity that LISCS t Z� Department's computer resource systems must comply with the Department's policy regarding social media. hoc Media includes, but is not limited to blogs, podcasts, discussion forums, Wikis, RSS feeds, video sharing, sac networks like Ty pace, Facebook and Twitter, as well as content sharing networks such as flickr and YOUTUI (ATTACHMENT E) 30. Conffl*ct of Interest The contractor will establish safeguards to prohibit employees, board members, management and subcontractors fro Using their positions for a purpose that constitutes or presents the appearance of perso�n'al or organizational conflict interest or personal gain. No employee, officer or agent of the contractor or subcontractor shall participate selection, or in the award of an agreement Supported by State or Federal funds if a conflict of interest, real apparent, would be involved. Such a conflict would arise when: (a) the employee, officer or agent; (b) any member his/her immediate family; (c) his or her partner, or; (d) an organization which employs, or is about to employ, any the above, has a financial or other interest in the firm. selected for award. The contractor or SUbcontractor's officer employees or agents will neither solicit nor accept gratuities, favors or anything of monetary value from contractor potential contractors, or parties to subcontracts. The contractor's board members and management must disclose 1 the AAA any relationship which may be, or may be perceived to be, a conflict of interest within thirty (30) calend,-, days of an individual's original appointment or placement in that position, or if the individual is serving as a incumbent, within thirty (30) calendar days of the commencement of this contract. The contractor's employees an Subcontractors must make the same disclosures described above to the contractor's board of directors. Comps Banc with this provision will be monitored. 31. Public Entitv Crime Pursuant to s. 287.133., F.S., the following restrictions are placed on the ability of persons convicted of public entit crimes to transact business with the AAA. A person. or affiliate who has been placed on the convicted vendor li.1, following a conviction for a pLiblic entity crime may not submit a bid, proposal, or reply on a contract to provide an, goods or services to a public entity, may not submit a bid, proposal, or reply on a contract with a public entity for the construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of rea property to a public entity; may not be awarded or perform work as a contractor, Supplier, subcontractor, or conSL11tan tinder a contract with any public entity; and may not transact business with any public entity llii excess of the threshold anl-OLInt provided in s. 2.87.01-7, F.S., for CATEGORY TWO for a period of 36 months following the date o being placed on the convicted vendor list. 32. Purchasim 32.1 To procure any recycled products or materials, which are the Subject of or are required to carry out this contrtact, 111 accordance with the provisions of s, 403.7065, F.S. 33. PatentsLopyrlghts,...Ro I -es aalf If any discovery, inve i rition. or copyri.ghtkable material is developed or produced in the course of or cas a reSUlt of work or services performed Under this contract, the contractor shall refer the discovery t invention or material to the AAA tO he referred to the Department of State, Any and all pate nt rights or cop°riahts accrUin Under this contract ' r 1erebv 8/8 6 A Contract CLP- I 2"A"29 reserved to the State of Florida in accordance with Chapter 286, F.S. Pursuant to s. -287-0571 (5) (k) I and I amended, the only exceptions to this provision shall be those that are clearly expressed and reasonably valued in t contract, 33.1 If the primary purpose of this contract is the creation of intellectual propertV. the State shall retain an Unencumber right to use such property, notwithstanding any agreement made pursuant to P'aragraph 33. 34. E,,mergEnc. y _Preparedness and Continuity of OpeLations 34.1 If the tasks to be performed pursuant to this contract, include the physical care and control of clients, or t- administration and coordination of services necessary for client health, safety or welfare, the contractor shall, with thirty (30) calendar days of the execution of this contract, submit to the Contract Manager verification of emergency preparedness plan. In the event of an emergency, the contractor shall notify the AAA of emergen( provisions. Z 34.2 In the event, a situation results in a cessation of services by a Subcontractor, the contractor will retain responsibili for performance under this contract and must follow procedures to ensure continuit of operations withol; interruption. y 35. PUR 1000 Form The PUR 1000 Form is hereby incorporated by reference. In the event of any conflict between the PUR 1000 Fori and any terms or conditions of this contract the terms or conditions of this contract shall take precedence over th PUR 1000 Form. However, if the conflicting terms or conditions in. the PUR 1000 Form are required by any sectio of the Florida Statutes, the terms or conditions contained in the PUR 1000 Form shall take precedence. 36. Use of State Funds to Purchase or Improve Real Pro art Any state funds provided for the purchase of or improvements to real property are contingent upon the contractor c political subdivision. granting to the state a Security interest in the property at least to the amount of state fund provided for at least 5 years from the date of purchase or the completion of the improvements or as further requirei by law. 37. Dispute Resolufion Any dispute concerning performance of the contract shall be decided by the Contract Manager, who shall reduce the decision to writing and serve a copy on the contractor. 38, Financial Constguences of Non -Performance If the contractor fails to meet the minimum level of service or performance identified in this agreement, or that Customary for the industry, then the AAA must apply financial consequences commensurate with the deficiency Financial consequences in I ay include but are not limited to contract Suspension, refusinp-r payment, withholding payments until deficiency is cured. tendering only partial payments, and/or cancellation of contract and reacquirinig, services frog an alternate source. 38.1 The contractor shall not be charged with financial consequences, when a failure to perform arises Out of causes that were the responsibility of the AAA. 39. No Waiver of Soverej -zn Immu"ItV Noth-inor contained In this agreement is intended to serve as a waiver of sovereigin inInlUnity by any ent, to which zn I C 1tv sovereign immunity may be, applicable. 40. Venue If any dl'SpUte arises OLA of this contract, the VellUe Of SLIch legal recOL11-Se will be Lecin COUnty, Florida, MR . ......... . Contract CLP- 1. 2-429 4.1. Entire Contract This contract contains all the terms and conditions agreed upon by the parties. No oral agreements or representaw shall be valid or binding upon the AAA or the contractor unless expressly contained herein or by a %rit amendment to this contract signed by both parties. 42. Force Nla* ..weure Neither party shall be liable for any delays or failures in performance due to circumstances be and its Conti W provided the party experiencing the force maJeUre condition provides immediate written notification to the other pa and takes all reasonable efforts to cure the condition. 43. Severabilly Clause The parties agree that if a court of competent 4� jurisdiction deems any term or condition herein void or unenforceab the other provisions are severable to that void provision and shall remain in full force and effect. 44, Condiftion Precedent to Contract: ApXrovriafions The parties agree that the AAA's performance and obligation to pay under this contract is contingent upon an annL appropriation by the Legislature to DOEA. 4.1A.1 5 Addition/Deletion The parties agree that the AAA reserves the right to add or to delete any of the services required under this contra when deemed to be in the PSAs best interest and reduced to a written amendment signed by both parties. The part shall negotiate compensation for any additional services added. 46, Waiver The delay or failure by the AAA to exercise or enforce any of its rights under this contract shall not constitute or deemed a waiver of the AAA's right thereafter to enforce those rights, nor shall any single or partial exercise of ar such right preclude any other or further exercise thereof or the exercise of any other right. 47. Loin lance The contractor agrees to abide by all applicable current federal statutes, laws, rules and regulations as well applicable Current State statutes', laws, rules and regulations. The parties agree that failure of the contractor to abid by these laws shall be deemed an event of default of the contractor, and subject the contract to immediate, unilater,,, cancellation of the contract at the discretion of the AAA. 48. Final Invoice The contractor shall submit the final invoice for payment to the AAA as specified in Paragraph 3.3.4. (date for fins request for payment) of ATTACHMENT I. If the contractor fails to submit final request for payment by th deadline, then all rights to payment may be forfeited and the AAA may not honor any requests Submitted after thi aforesaid time period. Any payment due under the terms of this contract mav be withheld until all reports due fror the contractor and necessary adjustments thereto have been approved by the AAA, 49. Roegofiafions or Modi flea fions Modifications of the provisions of this contract shall be valid. only when they have been reduced to writing and dull signed by both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect prict level increases and changes in the rate of payment when these have been established through the appropriation. Z� process and subsequently identified in the AAA"s operating budget. I_- 5 5 0a Terminaflon 5 '0 This contract may lie terminated by either party without cause 111pon no less than thirty (_,­),(y) calendar days 110tIOC11 its writing to the other party UtIleSS a sooner tIrTle -IS RlUtUally agreed UpOfl in writing, Sl� lid notice shall be delivered by I/ Contract CLP1229 U.S. postal Service or any expedited delivery service that provides Verification of delivery or by elhand del* Contract tanager or the representative of the contractor responsible for administration of the contract. iery to 50.2 In the event funds for payment pursuant to this contract become unavailable, the AAA may terminat e ate this cant upon no less than twenty-four 2.4 hours notice in writing to the contractor. Said notice shall be delivere d by IPostal Service or any expedited delivery sere ice that provides verification of delivery b hand delivery or� elegy to Contract Manager or the representative of the contractor responsible for administration of the contract. The A. shall be the final authority as to the availability and adequacy of funds. In the event of termination of this cantr the contractor will be compensated for any work satisfactorily completed prior to the date of termination. p p on. 50.3 This contract may be terminated for cause upon no less than twenty-four 24 hours notice in writing `. � to contractor. if applicable, the AAA may employ the default provisions in Rule 0A- l .00 3 F.A.C. Waiver breach of an ' ' i ' provisions of this contract shall not be deemed to be a waiver of any other breach and shall not construed to be a modification of the terms and conditions of this contract. The provisions herein do not limit � �t AAA's or the contractor's rights to remedies at law or in equity. 50.4 Failure to have performed any contractual obligations with the AAA in a manner satisfactory to the AAA will b, sufficient cause for termination. To be terminated as a contractor under this provision., the contractor must have previously failed to satisfactorily perform in a contract with the AAA, been notified b the AAA of the . � unsatisfact( performance and failed to correct the unsatisfactory performance to the satisfaction of the AAA; or 2 had a contra terminated by the AAA for cause. 51. official Payee and Representatives (Names, addresses, and Telephone Numbers): p The contractor name, as shown on page I of this Monroe County Board of Count Commissioners � a. contract, and mailing address of the official payee to �' Social Services/In-Home �ceslln borne Services Program whore the payment shall be .Wade is: I 100 Simonton Street Key West, FL 33040 The name of the contact person and street address Monroe County Clerk of the Courts b. where financial and administrative records are R Finance Department maintained is: 500 Whitehead Street Key West, FL 33040 The Warne, address, and telephone number of the c` Sherd Graham, Director of Social Services representative of the contractor responsible for 1100 Simonton Street ern.2 -25 administration of the program under this contract is: Key West, FL 33040 305-292-45 10 1 The section and. location within the A where Yvonne Account ant tent Specialist I Requests for Payment and Receipt and Expenditure forms are to be .nailed is., 760 N'� I07th avenue Suite 201 and 214 Miami., Florida 33I72 e. The name, address and telephone number of the Tamara adia-Milian, MSW Contract Manager for the AAA for this contract is: Comm Community D l Diversion Program Coordinator 7 F 60 S�� 'V F�'q�Sp�p h Avenue, Suite 4 j7 'yg Miami, Florida 33 172 p f Contract CLP- 1.2-)q All Terms and Conditions Ineltided This contract and its Attachments, I — X. A, B, E, F. G and H, and any exhibits referenced in said attachmei together with any documents incorporated by reference, contain all the terms and conditions agreed upon by parties. There are no provisions, terms, conditions, or oblig`` ations other than those contained herein, and this cotr Z� shall supersede all previous communications, representations or agreements, either written or verbal between parties. By signing this contract, the parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF, the parties hereto have caused this 63 pacre contract, to be executed by their undersigned officials duly authorized. Contractor. SIGNEDBY: NAME:------ . David Rice TITLE: Mayor DATE.- 12-14-2011 M "' CQUNr� '/: P 0 D A ALLIANCE FOR AGING, INC. SIGNED BY: NAME: MAX B. ROTH AN, JD, LL.-M. TITLE: PRESIDENT AND CEO -qF DATE: JA N 13 2 0 12 V C L��TYATTORNEY Date Contract CLP- I. "612 ATTACHMENT ATTACHMENT ATTACHMENT 11 ATTACHMENT 111, EXHIBIT I ATTACHMENT III., EXHIBIT 2 ATTACHMENT 1111, EXHIBIT 3 ATTACHMENT IV ATTACHMENT V ATTACHMENT VI ATTACHMENT VII ATTACHMENT Vill ATTACHMENT IX ATTACHMENT X, EXHIBIT I ATTACHMENT X, EXHIBIT 1. ATTACHMENT X, EXHIBIT 3 ATTACHMENT A ATTACHMENT B ATTACHMENT E ATTACHMENT F, EXHfBIT 1. ATTACHMENT F, EXHIBIT 2 ATTCHMENT G ATTACHMENT H INDEX TO CONTRACT ATTACHMENTS ATTACHMENT DESCRIPTION STATEMENT OF WORK CERTIFICATION REGARDING LOBBYING FINANCIAL COMPLIANCE AUDIT ATTACHMENT FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT AUDIT RELATIONSHIP DETERMINATION & FISCAL COMPLIANCE REQUIREMENTS CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION ASSURANCES - NON -CONSTRUCTION PROGRAMS OLDER AMERICANS ACT PROGRAM BUDGET SUMMARY OLDER AMERICANS ACT CONTRACT REPORT CALENDAR REQUEST FOR PAYMENT RECEIPTS AND EXPENDITURES, TITLE Ill ADMINISTRATION RECEIPTS AND EXPENDITURES, TITLE IlIB, IIIC 1, AND IIIC2 RECEMTS AND EXPENDITURES, TITLE IIIE DEPARTMENT OF ELDER AFFAIRS` PROGRAMS & SERVICES HANDBOOK (ON CD) DEPARTMENT OF ELDER AFFAIRS' CIVIL RIGHTS COMPLIANCE CHECKLIST AND INSTRUCTIONS DEPARTMENT OF ELDER AFFAIRS' COMPUTER USE AND SOCIAL MEDIA POLICY (ON CD) DOEA COST ANALYSIS FOR NON -COMPETITIVELY PROCURED CONTRACTS IN EXCESS OF CATEGORY 11 INSTRUCTIONS: DOEA COST ANALYSIS FOR NON -COMPETITIVELY PROCURED CONTRACTS IN EXCESS OF CATEGORY I CLP PROGRAMS PROTOCOLS SERVICE PROVIDER APPLICATION PAGE 15 - 2) 5 ]27 29-32 33 35 37 39 41.4"? 43 45 47 49-51 53-55 57-59 61. 63-68 69 71 `73 '75-84 8 ,5 - 9 6 1-3/86 Contract CLP- 121-9 Em Contract CLP- 1,229 ATTACHMENT I ALLIANCE FOR AGING, INC. STATEMENT OF WORK OLDER AMERICANS ACT PROGRAM TITLE 1.11 SECTION Tarr TO BE PROVIDED III DEFINITIONS OF TERMS AND ACRONYMS III CONTRACT ACRONYMS ADL — Activities of Daily Living ASPS — Adult Protective Services AIRS — Alliance of Information & Referral Systems ADA — Americans with Disabilities Act AAA — Area Agency on Aging APCL — Assessed Priority Consumer List CIRTS — Client Information and Registration Tracking System FLAIRS, — Florida Alliance of Information and Referral Services I & R — Information and Referral IADL — Instrumental Activities of Daily Living MOA — Memorandum of Agreement MOO — Memorandum of Understanding OAA —Older Americans Act PSAs — Planning and Service Areas WebDB — Web -based Database System 1.1.2 PROGRAM SPECIFIC TERMS ADI (Alzheimer's Disease Initiative) — Services targeted to individuals with Alzheimer's Disease or a similar memory disorder, including respite, assessment, caregiver training, and other community -based services. These services are funded through a specific state appropriation. ADRC or ARC (Aging and Disability Resource Centers or Aging Resource Centers) — The not -for -profit entit which is the single entry point for the aging service system. within each established region of the state. ASPS (Adult Protective Services) High Risk — The designation of an elder who needs immediate protection from further abuse, neglect or exploitation, which can be accomplished completely or in part through the provision of home and community -based services. Area Plaw A plan developed by the area agency on aging outlining a comprehensive and coordinated service deliver system in. its planning and service area in accordance with the Section 306 (422 U.S.C. 3026) of the Older Americans At and department instructions. Area Plan Update,, A revision to the area plan. wherein the area agency on aging enters OAA specific data in th web -based database system (WebDB). An Update may also include other revisions to the area plan as instrLICted b the department. Caregiver or Support Zn System — For this project, the caregiver or Support system -nore persons whom the V m is one or i elder can depend on to provide care or to organize the provision of needed care. Care Plan Review Team — For purposes of this project, a team of staff designated by the CLP staff, which reviews the cllent�s situation and makes recommendations concerning contination of services after the initial short term initial �t-iraiit-fLinded,�,-,ri.sis-resolvitig period. flowever in no case will services be continued on a loncy term basis Under this program. 1-5/86 Contract C LP- i CCE (Community Care for the Elderly) - Services offered to functionally impaired of -der persons to enable the live in the least restrictive environment,, including adult day care, consumable medical supplies, home delivered meals, homemaker, personal care, respite, and other community -based services. These services are funded throuc. specific state appropriation, 16_ CIRTS (Client Information and Registration Tracking System) - The database of the Department of Elder Affairs used by the aging network to manage client assessment data, register clients for services, plan client servi and maintain program waiting cr lists. Lead agency provider assessors also use CfRTS to evaluate client eligibility I Medicaid services and to develop recommendations for client placement. CDC (Cons mer Directed Care) - A service option that gives elders, or their representatives, the OPPOrtU11.1ty tc manage the alder's service delivery, including decisions about which services will be provided, by whom and hog Z� 9 often. With the assistance of a consultant, an elder develops a budget plan that identifies needed goods and servi( and authorizes the elder to hire workers, who may be family members or friends, and select vendors to help with i care needs. A fiscal/employer agent (F/EA) pays the workers and vendors according to the rates on the budget pl,, The F/EA also pays the required federal and state taxes and files the necessary tax forms. Community Living Program - "Community Living Program" is a grant to the state offlorida from the federal Administration on Aging. For persons meeting the project's functional and financial eligibility criteria, the grant provides crisis -resolving in -home services to address their immediate and temporary needs as they leave a h�o�spita rehabilitation center or after a short-term nursing home stay. Without these services, the person would be at hierh of either nursing home placement or continued stay in a nursing home. This program also manages consumer dire care services provided to veterans. Cost Sharing - Payment by an individual for a portion of the monthly cost of the services he/she receives, based the individual's income and assets, and determined by the total monthly cost of the planned services. Crisis -Resolving Services - Time -limited community -based services provided to address a client's immediate she term care needs. Possible services include, but are, not limited to: case management, personal care, homemaker, transportation, meals. For the purposes of this program, a crisis is an episode that has a high probability of creating a nursing home long term placement or a re -hospitalization. Examples Of Such crisis include caregiving situations, i.e. a caregiver hospitalization that would cause the nursing home placement of the care rec iptent; it also includes hospital/rehab discharges that have a high likelihood of recidivism or further patient deterioration where a permanent nursing home placement is a likely sequel. Financial Eligibility - To be financially eligible to receive services, other than assessment and referral, under this project, the individual must not be eligible for Medicaid under the Institutional Care Program (ICP) rules. Frail: When an. older individual is unable to perform at least two activities of daily living 7 (ADL) without substanti,� human assistance, Including verbal reminding, physical cueing or supervision; or due to coanitive or other mental i impairment, requires substantial supervision because the I ridividUal behaves in a manner th'a:t poses a seriOLls health safety hazard to the Individual or to another individual. Lead Agency —A Community Care for the Elderly (CCE) designated agency. Lead acrenc' in Z7� jes provide services Linde the CCE and A programs. In addition. lead agencies handle APS cases in accordance with a DOEA established protocol. Z7_ agencies Lead Service Provider- A provider of Older American Act Services that also provides case management under th � project. The Case manager from the service provider will follow-up with those roject I pparticipants referred by the CLP staff to facilitate the provision of services during the grant period and to he the grant period. 1p plan for the person's needs after Z:n 0AA 111B. HID, 111E (Older Americans Act Titles) - Title 11113 provides Supportive services to Isst elders to HN independently in their COMMUnity. Title 1111) provides disease -prevention and health ron o toil s ervices at senior Centers - ters orialtemative sites. Title HIE provides services through the National Family Caregiver Support Program to ass st families caring for fail older inembers, and to assist grandparents or older relati ives who are iCare Clivers for 4n 16/86 Contract CLP- 12"29 children who are under 19 or are disabled, Private Pay — Payment of the complete cost of services by an individual. with sufficient income and assets to be the financial standards for receipt of state or grant funded services. Referring Entity — An entity providing referrals to the single entry point. These include case management atlenc hospitals, rehabilitation centers, home health agencies, physician assisted home based programs, and nursin ':horn . W 9 Individuals referred should appear to meet the eligibility criteria for this project. Self -declared — For purposes of initial financial eligibility for the project, the individual's declaration of income I assets wil l not require verification. SEP (Single Entry Point) — The CLP staff for the area where the individual is recetv' is the single ent. I . I &I in services point into the aging service system. Spend down to Medicaid — The use of personal resources to pay for services prior to the individual"s resources being reduced to the level of Medicaid eligibility. Triage — The activity performed by CLP staff to prioritize an individual for service based on the criteria establish for publicly funded programs because he/she does not meet the eligibility criteria for this project, Veterans Administration Consumer Directed Care —A capitated consumer directed care program sponsored the Veterans Administration and operated through the Community Living Program. Also, see Consumer Direct Care definition above. 1.2 Alliance for Aging Mission The Alliance For Aging Inc. mission id to promote and advocate for the optimal quality of life for older adults and i their families. 1. DOEA Mission Statement The departments mission is to foster an optimal quality of life for elder Floridians, The department's vision and shared values are to foster a social, economic and intellectual environment for all ages, and especially those age 60 and older, where all can enjoy Florida's unparalleled amenities in order to thrive and prosper. Area agencies, lead agencies and local service providers as partners and stakeholders in Florida's aging services network are expected to support the department's mission, vision, and program priorities. Z:� 1 2.2 Older Americans Act Program. Mission Statement The Older Americans Act (OAA) Program is a federal program initiative that provides assistance to older person "Ind caregivers and is the only federal Supportive sere ices `:prograrn directed solely toward improving the lives c C older people. The program provides a framework for a partnership amoner the different levels of government ail 4n the public and private sectors with a common objective, improving the quality of life for all older individuals h helping them to remain independent and productive, IJ GENERAL DESCRIPTION General Statement The goals of Community Living Program Phase 11, for PSA I I are to reduce overall Medicaid long term Marc expenditUres, develop co -pay and financially Sustainable systems within the context of the Older Americans Ac network of AAA and providers, and to increase consumer choice and self -direction. i.3. FXtithority _Fhe relevant references aUthority �--Y(Wm elng the OAA program are; .F Zn 1) Older Annericans Act of as <,tniended� Contract CLP- 1. 9 2 Rule 58A 1, Florida Administrative Code; and 3 Section 430.101. Florida. Statutes. 1.3.2.1 Incorporation of Reference Memoranda In accordance with Ch. 287 F.S., as amended and Department of Financial. Services= .Chi ef Financial oft Memoranda. the following memoranda are provided for informational a oses and incorporated p � p d by 1 CFO Memo No. 02. release date, august 20, 0 l oe 2 CFO Memo No. 03: Release date, .dune 29, 20I D; and 3 CFO Memo No. o : Release date, June 30, 2010. 1.3.3 Scope of Service The contractor is responsible for providing services in accordance with the CLP Proararn P .�TT�.=I�IIIENT G and its response � � Protocols contained esponse to the 20 l o CLP program ITN contained in ATTACHMENT H. T services shall be provided in a manner consistent with and described in the current contractor's area plan an update a the current Department of Elder Affairs Programs and Services Handbook(ATTACHMENT 1.3.4 IMajnr Program Goals The goals of Community Living Program Phase 11, for PSA, l l are to reduce overall .Medicaid lo ng team care expenditures, develop co -pay and financially sustainable systems within the context of the older Am ericans Act network of AAA, and providers, and to increase consumer choice and self -direction. To achieve these goals PSA l l will focus its efforts in providing consumers with the means to resolve events th have been identified as "critical pathways'' to institutional long term care. Some of these "critic � al pathways„ Inc l Lac sudden caregiver bumout, depression, malnutrition/dehydration and lack of follow L proper p with home ar community based services following hospital/rehab discharges. PSA. l l will also manageaa Veterans .�drninistratic Consumer Directed Care. 1.4 INDIVIDUALS To BE SERVED 1..4.1 Eligibility Client Identification l . Individual is at least 60 years old. 2. Individual is a resident of Miami -Dade or Monroe Counties. 3. Financially unel igible for Medicaid and functionally unpaired. 4. Has Medicare or private health insurance. Individual is not receiving hospice services. Individual or care giver is in need of crisis resoling services and/or short term care. t avoid readmission to a hospital/rehab facility or a nursing home placement which could lead to spend down to Medi � ` Services , p c aid: Seri c �. s are .�t geared to resole a long term creed but to address C eritical short ter need that if left unresolvedwould otld precipitate a nursing home placement or re -hospitalization 1..4.1.1 OAA Title 111, General eral Consumers shall not be dually enrolled in an OAA program and a Medicaid c hated long-term care p � �. rm � are, program. Contract CLP- 1229 income older individuals, including those that are low-income minorities, have limited English proficiency, i older individuals residing in rural areas. 1_� SECTION 11 — MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS In order to achieve the goals of the OAA program, the contractor shall ensure that the protocols contained ATTACHMENT G and the response to the 2010 CLP program TiIcontained in ATTACHMENT H Zn 0 2.1-3.1 Supportive Services Supportive services include a variety of community -based and home -delivered services that SLIPPOrt the quality life for older individuals by helping them remain independent and productive. Services include the following: (1) Adult Day Care/Adult Day Health Care, (17) Legal Assistance- (2) Training/Support- Care Caregiver 9 1 (18) Material Aid; (3) Case Aid/Case Management; (10) Occupational Therapy; ly (4) Chore Services, (20) Outreach; (5) Companionship; (21) Personal Care-, (6) Counseling (Gerontological and Mental (22) Physical Therapy; Health); (7) Education/Training; (23) Recreation; (8) Emergency Alert Response; (24) Referral/Assistance; (9) Escort - If (25) Respite Services; (10) Health Support; (26) Screen i ng/Assessment; (11) Home Health Aid; (27) Shopping Assistance, (12) Homemaker; (28) Skilled Nursing; (13) Housing Improvement; (29) Specialized Medical Equipment, Services, and (14) Information, Supplies (153) Intake-, (30) Speech Therapy; (16) Interpreter/Translating; (31) Telephone Reassurance; and (32) Transportation. -1 ,44* 1.4 Use of Volunteers to Expand the Provision of Available Services The contractor shall make use of trained VOILInteers in providing direct services delivered to older individuals and individuals with disabilities needing such services. If possible, the contractor shall work in coordination with or�,Tanizatjons that have experience in providingZ:!� training. ply cement, and stipends for VOILInteers or participants (SLIch as organizations carrying OLIt Federal service programs administered by the Corporation for at 'Land COMM Unity Service). in COMMUnity service settings. 2. 1 ..5 IMonitoring the Performance of Subcontractors The contractor sha,11 conduct at least one monitoring per year of e--),1,Xh SUbcontractor, The contractor shall perform f1scal, administrative and proararnma �q (y 0 contractors tO e11SUre contraCtUal complicance. 111.scal Z!7tic monitorn f each suK_ 19/86 :C� w \? Contract CLP- 1229 accountability, programmatic performance, and compliance iance with applicable state and federal laws and regulations 1.50.1 Use of Subcontractors If this contract involves the use of a subcontractor or third party, then the contractor shall not delav t� implementation of its agreement with the subcontractor. If any circumstances occur that may result in a del, for Y y period of 60 days or more of the initiation of the subcontract or in the performance of the subcontractor, tl contractor shall notify the AAA's Contract Manager and the AAA's Chief Financial officer in writing of st C delay. The contractor shall not permit a. subcontractor to perform services .related to this agreement without having binding subcontractor agreement executed. In accordance with Paracyraph 24.1 of the Standard Agreement, th AAA will not be responsible or liable for any obligations or claims resulting from such action. .2 SERVICE LOCATION AND EQUIPMENT .2.1. Service Times The contractor shall ensure the provision of the services listed in the contract during normal business hours unles other times are more appropriate to meet the performance requirements of the contract, and it shall monitor it subcontractors to ensure they are available to provide services during hours responsive to client needs and durin4. those times which best meet the needs of the relevant service community. 2•3 Equipment 23.1 Equipment means: (a) an article of nonexpendable, tangible personal propertyhaving a useful life of more than g an one year and an. acquisition cost which equals or exceeds the lesser of the capitalization level established b tht organization for the financial statement purposes, or $ o0o.o for federal Y p p � deral funds, or b, none�pendable, tan�iblc personal property of a nonconsumable nature with an acquisition cost of $1,0W.00 or more r unit, and e� ectec per p useful life of at least one year; and hardback bound boobs not circulated to students or the general public, with value or cost of $.2So.00 or more for state funds . � p � � 2.3.2 Contractors and sub -contractors who are Institutions of Higher Education, Hospitals,- and other Non -Profit Protit Organizations shall have written property management standards in compliance with ? CFI. fart 2 � p 1 �. Administrative Requirements (formerly OMB Circular ,.-1 10) that include: (a) a property list with all the elements p � Y identified in the circular; and, b a procedure for conducting a physical inventoryf equipment at least once every oe q p two years. The property records must be maintained on file and shall be provided to the AAA upon request. p ~~.3.3 The contractor's property management standards for equipment acquired with Federal funds and federally -owned Y ned equipment shall include accurately maintained equipment records with the following information: 1 A description of the equipment; .2 Mail . facturer's serial flUmber. yodel number, Federal stock number, national stock umber or oth er identification number'. ( Source of the equipment, including the award number; Whether title vests in the contractor or the Federal Government; :.Acquisition date or date received, if the equipmer t was furnished by the .federal Government) and cost- _ 61 Information from which one can calculate the percentage of Federal pa iici ation in the cost of the equipment. p of applicable to eqUipInellt furnished ished by the Federal Goy=ernment Location. k,nd condition of the eq ip gent �and the date the information was re -ported.- Contract CLP- 12,19 (8) Unit acquisition cost, and (9) Ultimate disposition data, including date of disposal and sales price or the method used to determine CLIrreill fair market value where a contractor compensates the Federal awarding agency for its share. Z*_11� 23.4 Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment purchased wi state funds with an acquisition cost over $ 1 .000.00 that is specifically identified in the area plan approved by DOE is part of the cost of carrying out the activities and functions of the grant awards and Title (ownership) will vest the contractor, subject to the conditions of 2 CFR Part 2.15 Administrative Requirements (formerly OMB Circuli A-1 10.), Subpart C, Paragraph 34. Equipment purchased under these thresholds is considered SLIPplies and is P subject to property standards. Equipment purchased with funds identified in the budeet attachments to agreemen covered by this contract, or identified in the sub -agreements with sub -contractors knot included in a co methodology), is subject to the conditions of Chapter 273. F. S. and 60A- L00 17, F. A. C. or Title 45 CFR Part 74. 2.3.5 The contractor shall not dispose of any equipment or materials provided by the AAA, or purchased with funs provided through this contract without first obtaining the approval of the AAAs Contract Manager. Whe disposing of property or equipment the contractor must submit a written request for disposition instructions to th respective Contract Manager. The request should include a brief description of the property, purchase prict funding source, percentage of state or federal participation, acquisition date and condition of the property. Th request should also indicate the contractor's proposed disposition (i.e., transfer or donation to an -other agency thc- administers federal programs, offer the items for sale, destroy the items, etc.). 2.3.6 The AAA's Contract Manager will issue disposition instructions. If disposition instructions are not received withi, 12.0 days of the written request for disposition, the contractor is authorized to proceed as directed in 2 CFR Part ? I Administrative Requirements (formerly OMB Circular A.-1 lo). 2.3.7 Real property means land (including land improvements), buildings, structures and appurtenances thereto, bu excludes movable machinery and equipment. Real property may not be purchased with state or federal fund. through agreements covered under this contract without the prior approval of the DOEA. Real property pLirchase': from Older Americans Act funds are Subject to the provisions of Title 42, Chapter 35, Subchapter 111, Part A., Sec 3030b United States Code (USC). Real property purchases from state funds can only be made through a fixe( capital outlay grants and aids appropriation and therefore are subject to the provisions of s. 2.16.348, F. S. 2.3.8 Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted and tested prior t( Zn disposal to ensure no confidential information remains. Contract CLP- L22W9 2,4 DELIVERABLES 2.4. t Service Unl*t The contractor shall provide the services described in the contract in accordance with ATTACHTN,1ENTS A. G ar H. 2. AN REPORTS The contractor is responsible for responding in a timely fashion to additional routine and/or special requests 6 information and reports required by the AAA. 2.5.1 Service Costs Reports The contractors shall submit to the AAA semi-annual service cost reports, which reflect actual costs of providill each service by program. This report provides information for planning and negotiating unit rates. 2.6.1 Each contractor and subcontractor, among other requirements, MLISt anticipate and prepare for the loss c information processing capabilities. The contractor shall maintain written policies and procedures far COMPLItc system backup and recovery and shall have the same requirement in its contracts and/or agreements wit subcontractors. These policies and procedures shall be made available to the AAA upon request. 2.7 PERFORMANCE SPECIFICATIONS 2.7.1 Outcomes (1) The contractor shall timely submit to the AAA all reports described in ATTACHMENT 1, Paragraph 2..` REPORTS; (2) The contractor shall timely submit to the AAA all information described in ATTACHMENT 1, Paragrapt 2.6 RECORDS AND DOCUMENTATION; (3) The contractor shall ensure services in this contract are in accordance with ATTACHMENT A. 2.7-3 Monitoring and Evaluation Methodology The AAA will review and evaluate the performance of the contractor under the terms of this contract. Ion tarn shall be conducted through direct contact with the contractor through telephone, in writing, and/or an on -site visit, The AAA's determination of acceptable performance shall be conclusive. The contractor agrees to cooperate with the AAA in monitoring the progress of completion of the service tasks and deliverables. Z:� 11 It �".7.4 Remedies- Nonconformi my Services The contractor shall ensure that all participants served Under this agreement are eligible for the program, and that aII monthly and/or quarterly performance reports and financial records are maintained for each reporting period and W SUbmitted as stipulated in Paragraphs 1.4 - 1.4.2 and 2.1 - 2.1.6. Any nonconforming program services, performance reports or financial records not meeting the aforementioned requirements shall not be eligible for reimbursement tinder this program, The costs associated with enrollinc.T. training, reportina and/or managing the program shall be born Z111 zn Z_1� zn e solely by the contractor, The AAA require�s immediate notice of any significant and/or systemic infractions that compro�i the contractor's ability to provide I e mise Participant services, to achieve programmatic performance or ide sound financial aianagen I ient of the proorrarn. lt� to prov Z� 1 .W*8 CONTRACTOR'S FINANCIAL OBLIGATIONS Contract CLP- 1229 2.8.1 Matching, Level of Effort, and Earmarking Requirements The contractor will fulfill a match requirement of at least 10 percent of the cost for all services funded thrOLIgh th contract (i.e. 90 cents of grant funds must be matched with 10 cents from the contractor.) The subcontractor match will be made in the form of cash and/or in -kind resources. Match must be reported by title each mon-th the end of the contract period, all OAA funds must be properly matched. The provider must comply with the "vak added" provisions contained in Appendix. 2.8,2 Consumer Contributions (1) The contractor assures compliance with Section 315 of the Older Americans Act as amended in. 22006, in regard, to consumer contributions; (2) Voluntary contributions are not to be used for cost sharing or matching; (3) Accumulated VOILintary contributions are to be used prior to requesting federal reimbursement;• and (4) Voluntary contributions are to be used only to expand services. 2.83 Use of Service Dollars The contractor is expected to spend all federal, state and other funds provided by the AAA for the purpose specifie, in the contract. The contractor must manage the service dollars in such a manner so as to avoid having a wait fill ll and a surplus of funds at the end of the contract period, for each program managed by the contractor. If the AAA determines that the contractor is not spending service funds accordingly, the AAA may transfer funds to othe providers during the contract period andlor adjust subsequent funding allocations accordingly, as allowable Linde state and federal law, 2.8.4 Title III Funds The contractor assures compliance with Section 306 of the Older Americans Act, as amended in 2006, that fun& received under Title III will not be used to pay any part of a cost (including an administrative cost) incurred by the ' contractor to maintain a contractual or commercial relationship that is not carried Out to implement Title 111. 2.9 AAA RESPONSIBILITIES 2.9.1 Program Guidance and Technical Assistance The AAA will provide to the contractor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the contractor. 2.9.2 Contract Monitoring The AAA shall, at its own discretion, conduct monitoring concerning any aspect of the contractor's performance of this contract. SECTION III*- IMETHOD OF PAYMENT 3.1 General Statement of Method of Pavment The method of payment for this contract includes advances, cost reimbursement for administration costs, and fixed rate for services. The contractor shall ensure fixed rates for services include only those costs that are in. accordance with all applicable state and federal statutes and reRilations and are based on a I udited historical costs in instances t� where an independent audit is required. The contractor shall consolidate all requests for payment from subcontractors and expenditure reports that Support requests for payment and shall submit to the AAA on forms 106A (ATTACHMENT IX),, 105AA (ATTACHMENT X-EXHIBIT 1.), 105AS (ATTACHNMENT X-EXHIBIT I tend 105AE (ATTACHMENT X-EXHIBIT 3). 8 6 Contract CAP- 12-1129 The contractor agrees to Implement the distribution. of funds as detailed in ATTACHiNIENT V11, Budget Z"-� I Summary. An amendment is required to change the total amount of the contract, 3.2 Advance Payments 6F7 3,2.1 The contractor may request up to two months of advances at the start of the contract period, if available, to cover program administrative an itd service costs. The, payment of an advance will be contingent UpOn the sufficiency and .If amount of funds released to the AAA by the State of Florida ('"budget release"'). The contractor shall provide the Z:� AAA's Contract Manacrer documentation justifying the need for an advance and describin how the funds will be distributed. 9 3.2.2 The contractor's requests for advance require the approval of the AAA's Contract Manager. If sufficient budget is available.., the AAA will issue approved advance payments after January 1. 2012. 3,23 Requests for the first through the twelfth months shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests, if available is shown on ATTACHMENT Vill of this contract. 3.2.4 All advanced payments made to the contractor shall be recouped in accordance with the Reporting Schedule, ATTACHIMENT Vill of this contract. 3-2.5 Interest earned on advances must be identified separately by Source of funds, state or federal. Contractors shall maintain advances of federal funds in interest bearing accounts unless otherwise excepted in accordance with 4.5 CFR 74.22(k). Earned interest must be returned to the AAA at the end of each quarter. 3.3 Invoice Submittal and Requests for Payment All requests for payment and expenditure reports submitted to support requests for payment shall be on DOEA forms 1-06A (ATTACHMENT IX), 105AA (ATTACHMENT X-EXHIBIT 1), 105AS (ATTACHMENT X- EXHIBIT 2), and 105AE (ATTACHMENT X-EXHIBIT 3). 3-3,1 All payment requests shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests when available) and invoices Is ATTACHMENT Vill to this contract. 33-2 Any payment due by the AAA Linder the terms of this contract may be withheld pending the receipt and approval of all financial and programmatic reports due from the contractor and any adjustments thereto, including any disallowance not resolved as outlined in Paragraph 26 of this contract. 3.3.3 Payment may be authorized only for allowable expenditures, which are in accordance with the limits specified in .9 ATTACHMENT III, Budget Summary. Any changes in the amounts of federal or (Teneral revenue funds identified on the Budget Summary form require a contract amendment. i� 3.3.4 Date for Final Request for Payment The final request for payment will be due to the AAA no later than February 14, 20 13, 3.4 Documentation for Pavment The contractor shall maintain documentation to support payment re pp that shall be tavail able to the AAA or authorized individuals, Such as Department of Financial Services. upon request, 3.4, 1, The oftractormust enter all required data per the department's CIRTS Policy Guide11n%---,s f or ch ie Ices M. nts and sere ' .. ........ Contract CLP- 11-)9 the CIRTS database. Data must be entered into CIRTS before the contractors submit their request for payment it expenditure reports. 3-4,2 The contractor run monthly CIRTS reports and verify that client and service data in CIRTS is accurate. This report must be submitted to the AAA with the monthly request for payment and expenditUre report and must be reviewed by the AAA before the contractor's request can be approved by the AAA. Contract CLP- 1229 Contract CLP- ?9 ATTACHMENT 11 CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: �( No federal appropriated funds have been paid or will be paid, b or on behalf of the � undersigned, to and person for tiuencng or attempting to influence an officer or employee of anagency, state or federal a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee ployee of the state legislator, in connection with the awarding of any federal grant, the makingof an Federal. loan � ,the entering into of and cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contra ct, grant loan, or cooperative agreement, (2) If any funds other than federal appropriated funds have been aid or will be aid t p p o and person for influencing or attempting or an employeeto influence an officer or employee of and agency, amember ofcongress, an officer of a member of congress e or employee of congress, ss in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit standard F`orrnll f, "Disclosure losure . � Form to Report Lobbying, in accordance 'vvith its instructions. (3 ) The undersigned shall require that the language of this certification be included in the award documents for all sLib- awards at all tiers (including subcontracts, sub -grants, and contracts under rants loans and cooperative grants, ooperat�ve agreements) and that all sub -contractors shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was laced when . p en this transaction was made or entered into. Submission of this certification is a prerequisite for makinor or enteringinto thi section 13 5�, Title 3 , U.S. bode. ,An person who � s transaction imposed b}� y p fails to f le the required certification shall be subject to a civil enalt of not less than $ 10,000.00 and not more than $100,000.00 for each such failure. p � Signature David Rice Marne of Authorized Individual d Date Clip Contract #CLP- 1229 pp l ication or agreement Number AJonroe Coun y Board of COL111tV Commissioners, 1 100 Simonton Name and address of Organization g ,,k 'se Nov 2 0 02 Contract 'ALP- 1'6229 8 /8 6 Contract CLP- 1.,A229 ATTACHMENT 1.1 EXHIBIT FINANCIAL AND COMPLIANCE AUDIT The administration of resources awarded by the Department of Elder Affairs or the Alliance for ,Avi a R` n�, to the provider �a� subject to audits and/or monitoring by the Department of Elder ,affairs or the Alliance for Agin � a � • � sect' g as described this on. MONITORING n addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section .2 � 15.97. F.S., use "AUDITS"' below), monitoring procedures may include, but not be limited to, on -site visits bthe department partment of staff, l irn ate+ scope audits as defined by OMB Circular A- 133, as revised, and/or other procedures. Bentering into this gi � g s aD�epartrnent reernent, th provider agrees to comply and cooperate with. any monitoring procedures/processes deemed appropriate by the o Elder Affairs or the Alliance for Aging. In the event. the Department of Elder affairs or the Allianc e for Aging determine � that a limited scope audit of the provider is appropriate, the provider agrees to comply with an ' g p � additional instruction,' provided by the Department of Elder Affairs or the Alliance for aging to the provider regarding such p � g audit. The provide farther agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed ed necessary by the Ch ie, Financial officer (CFO) or Auditor General. AUDITS PAIN I: FEDERALLY FUNDED This part is applicable if the provider is a State or local government or a non-profit organization as defined p � e �ned in OMB Circular A-133, as revised. In the event that the provider expends $500,000 or more in Federal awards during its fiscal year, th e provider must have a single or program -specific audit conducted in accordance with the provisions of OMB Circular A- I33 as , revised. EXHIBIT I. to this agreement indicates Federal resources awarded through the Department of Elder affairs or the Alliance for Aging by this agreement. In determining the Federal awards expended in its fiscal provider , earthe ider shall �' p consider all sources of Federal awards, including Federal resources received from. the Department of Elder Affairs or the Alliance 1' ance for Aging. The determination of amounts of Federal awards expended should be in accordance with the guidelines establis hed by OMB Circular A-133, as revised. An audit of the provider conducted by the auditor General in accordance a ce with the provisions of OMB Circular A-1.33, as revised, will meet the requirements of this part. n connection with the audit requirements addressed in Part 1, paragraph 1, the provider shall fulfill the ` p e requirements relate to audi tee responsibilities as provided in Subpart C of OMB Circular A-133, as rev ised. f the provider expends less than $500,000 in Federal awards in its fiscal year, an audit conducte d . � accordance with the provisions of OM Circular A- 133, as revised, is not required. n the event that the provider expends less p pe than $500e000 in Federal awards in its fiscal year and elects to have an audit conducted in accordance with the provisions ors of OMB Circular A- 133, as revised, the cost of the audit must be paid from non -Federal resources (i.e., the cost of such audit gust be paid from provider resources obtained from other than Federal entities. An audit conducted in accordance with this part shall cover the entire organization for the or " �i �� � anzaton s fscal.�r. Compliance findings related to agreements with the Department of gilder affairs or the alliance for Aging -F f n �.. ushall be based on the aiireement" .s requirements, including any rules, regulations, or statutes referenced i the agree ent, The financial statements shall disclose whether or not the matching requirement was met for each applicable pp agreement. �all questioned costs and liabilities due to the Department of Elder affairs or the alliance for Aging shall he f llv disclosed in the audit report with reference to the Department of elder affairs or the Alliance for ;'� � Aging . ro F reetet involved. lei riot otherwise disclosed as required. by Section 310 b of OMB Cinf- lar A-133, as revised, the schedule of expenditures ( �C :� �. �t ��.d�r�r1 86 Contract CLP- L-22;wq awards shall identify expenditures by agreement number for each agreement with the Department of Elder Affairs or th Alliance for Aging in effect during the audit period. Financial reporting packages required under this part must be submittei zn� Zn within the earlier of 30 days after receipt of the audit report or 9 months after the end of the provider's fiscal year end. PART 11** STATE FUNDED This part is applicable if the provider is a nonstate entity as defined by Section 21-5.97(2). Florida Statutes In the event that the provider expends a total amount If of state financial assistance equal to or in excess of $500,000 in an, fiscal year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider must have a State singi.( or project -specific audit for such fiscal year in accordance with Section 21-5.97, Florida Statutes; applicable rules of tht Depanment of Financial Services; and Chapters 10,550 (local governmental entities) or 10.650 (nonprofit and for- prof"i organizations), Rules of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance awardet thrOLIgh the Department of Elder Affairs or the Alliance for Aging by this agreement. In determining the state �financia assistance expended in its fiscal year, the provider shall consider all sources of state financial assistance, including stag financial assistance received from the Department of Elder Affairs or the Alliance for Aoring other state agencies, and other nonstate entities. State financial assistance does not include Federal direct or pass-thrOLIgh awards and resources received by nonstate entity for Federal program matching requirements. 4=t:5 In connection with the audit requirements addressed in Part 11, paragraph 1; the provider shall. ensure that the audit complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as defined by Section 21.5.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for profit. organizations). Rules of the Auditor General. If the provider expends less than $500,000 in state financial assistance in its fiscal year (for fiscal years ending September 30, 2004 or thereafter), an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, is not required. In the event that the provider expends less than $500,000 in state financial assistance in its fiscal year and elects to have an audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit must be paid from the nonstate entity's resources (i.e., the cost of such an audit must be paid from the provider resources obtained from other than State entities). An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance findings related to agreements with the Department of Elder Affairs or the Alliance for Aging shall be based on the agreement's requirements, including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Department of Elder Affairs or the Alliance for Aging shall be fully disclosed in the audit report with reference to the Department of Elder Affairs or the Alliance for aging agreement involved. If not otherwise disclosed as required by Rule 691-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance shall identify expenditures by agreement number for each agreement with the Department of Elder Affairs or the Alliance for Aging in effect during the ' audit period. Financial reporting packages required tinder this part must be Submitted within 45 days after delivery of the audit report, but no later than 12 months after the provider's fiscal year end for local governmental entities. Non-profit or for profit. organizations are required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after the provider s fiscal year end. Notwithstanding the applicability of this"fportion, the Department of Elder Affairs or the Alliance for Aointy retains all riaht and obligation to monitor and oversee the performance of this aLyreement as OUtlined throughout this document and pursuant to law. PART 1111 REPORT SUB.MISSION Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by .PART I of this agreement shall be submitted, when required by Section .320 (d), OMB CirCLIlar A- 13,11, as revised, b behalf of the provider directly to each of the follow' y or on The Alliance for Aoincr, Inc.: ti� /8' 6 . . ....... ...... Contract CLP- 12'.29 Alliance for Aging, Inc. Attn#. Horacio Soberon 760 NW 1.07 1h Ave. Miami, FL 33172 The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised the number of copies required by Section .320 (d)(1) and (2.), OMB Circular A-133, as revised, should be submitted to the Federal Audit Clearinghouse), at th following address: Federal Audit Clearinghouse Bureau of the Census 1201 East 101h Street Jeffersonville, IN 47132 Other Federal agencies and pass -through entities in accordance with Sections .320 (e) and (f), OMB Circular A-1.33, a revised. Pursuant to Sections .320(f), OMB Circular A-133, as revised, the provider shall submit a copy of the reporting packagt described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to th( Department of Elder Affairs at each of the following addresses. - Department of Elder Affairs Attn: Beverly Friedberg 4040 Esplanade Way Office 325B Tallahassee, FL 32399-7000 Additionally, copies of financial reporting packages required by Part 11 of this agreement shall be Submitted by or on behalf of the provider directiv to each of the following: The Alliance for Aging, Inc. at each of the following addresses: Alliance for Aging, Inc. Attn-. Horacio Soberon 760 NW 107 1h Ave. Miami, FL 33172 The Department of Elder Affairs at each of the following addresses Department of Elder Affairs Attn.- Beverly Friedberg 4040 Esplanade Way Office 325B Tallahassee, FL 32399-7000 The Auditor General's Office at the following address, - State of Florida Auditor General Claude Pepper Building, Room .10574 I I I West Madison Street Tallahassee, Florida 3.2.399-14150 Any reports, management letter. or other information required to he submitted to the Department of Elder Affairs PUrSLK111t to this agreement shall be submitted timely in accordance with OMB Circular A-133. Florida Statutes, and Chapters 10,�50 (local ilovernmental entities) or 10.61.10 (nonprofit and for -profit oraanizations), Rules of the Auditor General,, as applicable, L_1� Z7 General,, Providers, when submitting fintancical. repomng pack -ages to the Department of Elder Affa_rs for aUdits done in accordance with OMB CirCL11ar A-J.:3.3 or Chapters 10, 5 5 0 (local governmental entities) or 10.650 (nonprofit "i-nd for -profit 3 1/86 Contract CLP- 1.229 onozanizations), RLIleS of the Auditor General, should indicate the date that the reporting package was delivered to the providt in correspondence accompany imy the re g packagge. Z� The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of si years fro in the, date the audit report is issued, and shall allow the Department of Elder Affairs or its designee, the CFO c ALidifor General. access to such records upon request. The provider shall ensure that audit working papers are made availabl to the Department of Elder Affairs, or its designee, CFO, or Auditor General upon request for a period of six years from th date the audit report is issued, unless extended in writing by the Department of -Elder Affairs. 186 Contract CLP- 1. ATTA-CH.IENT III EXHIBIT I. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: ...................................... PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT Older Americans Act Administration Title 111B — Support Services U.S. Health and Hum -an Services $14,7-78.00 TOTAL FEDERAL AWARD $14,778.00 COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT T THIS AGREEMENT ARE AS FOLLOWS: Contract CLP- 14142W9 ATTACHNI ENT EXHIBE PART 1: AUDIT RELATIONSHIP DETERMINATION Providers who receive state or federal resources may or may not be Subject to the audit requirements of OMB Circular A- 133. as revis and/or Section 215.9 Fla. Stat. Providers who are determined to be recipients or subrecipients of federal awards and state finaric assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part. 11 of Exhibit I are n- Providers who have been determined to be vendors are not subject to the aUdit requirements of OMB Circular A- 133, as revised. and Section 2. 1.5.97, Fla. Stat. Re(Tardless of whether the audit requirements are met. providers who have been determined to be recipients SUbrecipients of Federal awards and/or state financial assistance, must comply with applicable programmatic and fiscal compliar requirements. %W In accordance with Sec. 210 of OMB Circular A- 133 and/or Rule 691-5.006, FAC, provider has been determined to be: Vendor or exempt entity and not subject to OM-13 Circular A- 133 and/or Section 15,97, F.S. _.X Recipient/subrecipient subject to OMB Circular A- 133 and/or Section 21 5 j 5 .97, F. S. NOTE: If a provider is determined to be a recipient /SLibrecipient of federal and or state financial assistance and has been approved by the department to Subcontract, they must comply with Section 2 15.97(7), F.S.. and Rule 691-.006(2), FAC [state financial assistance] and Section — 400 ONIB Circular A- 133 [federal awards I. PART 11: FISCAL COMPLIANCE REQUIREMENTS FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal awards or sty matching funds on Federal awards and who are determined to be a subrecipient, must comply with the following fiscal laws, rules a] regulations: STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW: '? CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A-87)* OMB Circular A- 1.02 — Administrative Requirements OMB Circular A- 133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations NON-PROFIT ORGANIZATIONS MUST FOLLOW-: 2 CFR Part 230 Cost Principles for Non -Profit Organizations (Formerly OMB Circular A- 121 — Cost Principles)* CFR Part 215 Administrative Requirements (Formerly 0M13 Circular A- I. 10 — Administrative Requirements) Requirements) OMB Circular A- 133 — Audit Requirements Reference Guide for State Expenditures Other fiscal requirements set forth in program laws, rules and regulations EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW: 2 CF`R Part 2210 Cost Principles for Educational Institutions OMB (Formerly Circular A-2 I — Cost Principles)* '12 CFR Part 2) 15 Administrative Requirements (Formerly OMB Circular A- I I0 — Administrative Requirements) OMB Circular A- 133 — Audit Requirements Reference Guide for State Expenditures Other fiscal reqUirements set forth in proctram laws. rules and re(TUlations, t� it� *Some Federal Programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB CirC.Ldar 133 Compliance SUpplement, Appendix 1, STD rrE FINANCIAL ASSISTANCE. Providers who receive state Financial assistance and who are, determined to be recipient/SLibrecipient, Must C'OMPly with the following fiscal laws, rules and regulations: zn Section 15.97, Fla. Stat, Chapter 691-5, Fla. i-Virnin, Code State Projects Compliance SUPPICnIent deference('I'Llide fbr State Expenditures Other fiscal requirements set forth in wro.ul.rafn laws, rules cand reoulations ti 8. ... . . . .. .. . .. ....... . ... . .. . .. .. ... .. .. ..... . .. .... ... ... ... .. .... ...... . .... ..... . ... . . .. .. .... . ... .... .... .. .. ... ... . ... . .. . . .. . . . . .. ... .. . .. ..... ... ... . .. . .. .. . .. . . ... .. ..... ........ . ... ... ... ... .. . . . . .. . . . ... ........ . .. .... . .. . .... . . . .. . . .. ... .. ......... . ....... ....... ... . ......... ..... .. ..... ..... .... .... . .... . .. ...... . . .. .. ....... . .. ..... .... ... .. ...... .. .... .. . . . ... ..... .............. .. ..... ... . . ... .... ... . .... . .... . .... .. ..... . .... ....... . .. . .. .. .. . .. .... . ...... . ... ... ... . .. .... .. ... .... ....... .. .. . .. ......... . .......... .... .... . .......... . .. . .... .............. . . .. .. . . . . .. .. ............... ....... ... . .. . . ... . .... . . Contract CLP- 1229 ATTACHMENT IV CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS The undersigned, an authorized representative of the contractor named in the contract or agreement to which this form i attachment, hereby certifies that-, The contractor and any sub -contractors of services under this contract have financial management systems capabl providing certain information, including.- (1) accurate,, current, and complete disclosure of the financial results of grant -funded project or program in accordance with the prescribed reportinor requirements- (2) the sourc 1) e and applicatio funds for all agreement supported activities* and (3) the comparison of OUtl'a��'ys with budgeted amounts for each award. inability to process information in accordance with these requirements could re been accounted for properly. sult in a return of grant funds that have (21) Nlanagement Information Systems used by the contractor, sub -contractors or any outside entity on which the contrai is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be capably processing data accurately, including year -date dependent data. For those systems identified to be non -corn contractor(s) will take immediate action to assure data integrity. p (3) If this contract includes the provision of hardware, software, firmware., microcode or imbedded chip technology, Undersigned warrants that these products are capable ofrocess* inyear-date pg dependent data accurately. All versions these products offered by the contractor (represented by the undersigned) and purchased by the State will be verified accuracy and integrity of data prior to transfer. In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede i hardware or software programs from operating properly, the contractor agrees to immediately make required corrections restore hardware and software programs to the same level of functionality as warranted herein, at no charge to the eta and without interruption to the ongoing business of the state, ', time being of the essence. (4) The contractor and any sub -contractors) of services under this contract warrant their policies and procedures includc disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from dc- integrity compliance issues. The contractor shall require that the language of this certification be included in all subagreements, subgrants, and other agreements and that all sub -contractors shall certify compliance accordin(. fly Z:!� � ¢rh is certification is a material representation Of fact UP011 Which reliance was placed when this transaction was made or enter( into, Submission of this certification is a prerequisite for making or entering into this transaction imposed by 01\4B CIrCUla / I) 11 A- 102 and 1:2- CFR part ' (formerly ON Circular A-1 10). onroe County Board of COLInt-v. C0111inissi oners 1100 Simonton Street, K Name and Address of Contractor e �st �FL �33 0 �O 'Vla 'or sionatUre 1 7 -title Date Rice Name of Authored Sillner 5 � R. ek _red JUITle 2)t)0,9) Contract CLP- 1229 A7FTACHMENT V CERTIFICATION REGARDING DEBARIVIENT., SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS 1) The prospective contractor certifies, by signing this certification, neither it nor its principals are presently debarre suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in th transaction by any federal department or agency. Where the prospective contractor is unable to certify to any of the statements in this certification, such prospectiN participant shall attach an explanation to this certification. Signature Date Mayor Monroe County Board of County Commissioners Title agency/Organization (Certification signature should be same as Contract signature.) Instructions for Certification I The terms "covered transaction,," "debarred," "suspended," "Ineligible," "lower tier covered transaction it Itperson it ' 3? primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out in the section<, of rules implementing Executive Order 142549. (2 CFI. 180.5-180.1020, as supplemented by 2 CFR 376.10- 3 76.995). You may contact the Contract Manager for assistance in obtaining a copy of those regulations. This certification is a material representation of facts upon which reliance was placed when the parties entered intc I # this transaction. If it is later determined that the contractor knowingly rendered an erroneous certification 5 IF addition to other remedies available to the federal government, the department may pursue available remedies, including suspension and/or debarment. 3. The contractor will provide immediate written notice to the Contract Manager if at any time the contractor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The contractor may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may, but is not required to, check the Excluded Parties List System (EPLS). 4. The contractor will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for lower tier covered transactions. 51 The contractor agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government. 6If the contractor knowingly enters into a lower tier covered transaction with a person who is suspended. debarred, ineligible. or voluntarily excluded ® participation in this transaction, in addition to other remedies avail'able to the federal government'. the department may pursue available remedie s, it suspension. and/or debarment. The contractor may rely Upon a certification of a prospective participant in a lo�ver tier -overed transaction that it is not debarred., SLISpellded', inelig-ible., onn r voluntarily excluded from the covered transacfi'�' C e rt i f ication is erroneous. on., unless it knows that fhe Revised lune liA C Contract CLP- I 2429 ATTACHMENT .............. Public reporting burden for this collection of information is estimated to averatle 45 minutes . ... .- per response, including time for review instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions reducina this burden, to the Office of Management and Budget. Paperwork Reduction Project (0348-0043), Washington., DC 420503. .......... PLEASE DO NOT RETURN YOUR COMPLETED FORM TO - ------ THE 0- FFICE OF MANAGEMENT NT AND BUDGET, SEND IT TO THE ADDRESS PROVIDED -BY THE SPONSORING AGENCY. Note.- Certain of these assurances may not be applicable to your project or program,, If you have questions please contact I W awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. such is the case, you will be notified. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (includino, fur sufficient to pay the non -Federal share of project cost) to ensure proper planning, management, and completion. of the project descrit in this application, C� I Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any aUthoriz C� representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a Purpose that constitutes or presents the appearance personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1.970 (42 U.S.C. 4728-4763) relating to prescribed standards for me systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Me, System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These, include but are not limited to: (a) Title VI of the Civil Righ Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin- (b) Title IX of the EdUcati( Amendments of 1972, as amended ('20 U.S.C.. 1681-1683. and 1685-1686), which prohibits discrimination on the basis of sex: (� Section 504 of the Rehabilitation Act of 1973. as amended ('2_9 U.S.C.. 794), which prohibits discrimination on the basis of handicap (d) the Age Discrimination Act of 1975, as amended (42. U.S.C.. 6101-6107), which prohibits discrimination on the basis of age; (e) tf Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse'. ( the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 P.L. 91-616), as amend'e: relating to nondiscrimination on the basis of alcohol abuse or alcoholism- tn (g), 51-3 and 527 of the Public Health Service Act of 1912 1 U.S,C-290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title V111 of t� Civil Rights Act of 1968 (42 U.S.C. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housim 1) any other nondiscrimination provisions in the specific statUte(s) under which application for Federal assistance is being made; and the requirements of any other nondiscrimination statutes) which may apply to the application, 7, Will comply, or has already complied, with the requirements of Titles If and III of the uniform Relocation Assistance and Real Propert AcqUiSition Policies Act of 1970 (.P,L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property i acquired as a result of Federal or federally assisted programs, These requirements apply to all interests in real property acquired fc t� I project purposes regardless of Federal participation in purchases. 8, Will comply. as applicable, with the provisions (if the Hatch Act (5 U,S�C� 1501 - 1508 and _71124-7/311.8). which limit the pohtic�' i i W . ;ww activities (.,.)f employees whose principal employment activities are funded in whole or in. part with Federal funds. 9. Will comply, as applicable, With the 4 1 provisions of the Davis -Bacon Act (40 U,S,C. 276a to '2716a-Ti. the COpeland Act (40 U.S.C. -7 and N UaS,C, 1 874) and the Contract Work HOUrs Zind Safety Standards Act ('40 [T'S.C' I . ')�/-_133.), regarding labor standards to federally assisted. construction subai;7reernents, Z:� t Contract CLP- 1229 A;-W t 0. W i I I con pI y. if applicable, with flood insurance purchase requirements of Section 10 (a) of the Flo d Disaster Protection Act of I P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance the total cost of I ns urab le construction and acquisition is $ 10,000, 00 or more. I I . Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental qua. control measures Linder the National Environmental Policy Act of 1969 P.L. 91-190) and Executive Order (EO) 11514., (b) notificat of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management pro(Urr developed under the Coastal Zone Management Act of 1972 (16 U.S.C. 1.451 et seq.)-. (f) conformity of Federal actions to State (.Cl Air) Implementation Plans Linder Section 176(c) of the Clear Air Act of 1955. as amended (42 U.S.C. 7401 et seq. (g) protection underground sources of drinking water under the Safe Drinking Water Act of 1974. as amended, P.L. 93-523); and (h,) protection end -angered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205). 1 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C., 1721 et seq.) related to protecting components or poteni components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1.966, as amenc 1.6 U.S.C.. 470), EO I I D-93 identification and protection of historic properties), and the Archaeological and Historic Preservation of 1974 (16 U.S.C.. 469a- I et seq.). 14. Will comply with P.L. 933-348 regarding the protection of human subjects involved in research, development, and related activit Supported by this award of assistance. I.S. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C.' 2131 et seq.) pertaining to the ca handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C.y 4801 et seq.), which prohibits the use of lead- based pa in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 19 and OMB Circular No. A- 133, Audits of States, Local Governments, and Non -Profit Organizations. C__ 1 8s Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing t1- program, I"- SIGNATURE ©F AUTHORIZED CERTIFYING OFFICIAL TITLE APPLICANT ORGANIZATION DATE SUBMITTED . . ..... ...... ............... Contract CLP- 1219 ATTACHiNIENT VII BUDGET SUTNIMARY Maximum Service Unit Units of Maximum Service(s) to be Provided Rate Service* Dollars* HOMEMAKER $22.04 TBD TBD PERSONAL CARE $25.87 TBD TBD CASE MANAGEMENT $38.08 TBD TBD total Contract $14,778.00 .`'The number of units of service will be determined by the AAA authorizing individual care plans for each CLP program participant. The total contract aMOLint will not be exceeded. -,M Contract CLP- 1229 ATTACHMENT V111 CONTRACT REPORT CALENDAR ADVANCE BASIS CONTRACT Report Number Based On Submit to the Alliance On This Date I January Advance* January 1, 201'2 `7 February Advance* January 1, 'A20 12 3 January Expenditure Report February 5. 2012 4 February Expenditure Report March 5, 2012 March Expenditure Report April 5,, '4")..;012 6 April Expenditure Report May 5, 2012 7 May Expenditure Report June 5, 2012. 8 June Expenditure Report July 5, 2012 9 July Expenditure Report August 5, '2W012 10 August Expenditure Report September -5, 2012W .11 September Expenditure Report October 5, 2012 12 October Expenditure Report" November 5, 2012 13 November Expenditure Report December 5, 2012 14 DecemberExpenditure Report January 5, 2013 15 Final Expenditure and Request for Payment February 14, 2013 16 Closeout Report February 28, 'r.2013 Legend.- Advance based on projected cash need. Recoupment of advance due with this report. Note # I: Report #1 for Advance Basis Agreements cannot be submitted to the Department of Financial Services (DFS) prior to January I or until the agreement with the Department has been executed and a copy sent to DFS. Actual submission of the vouchers to IFS is dependent on the accuracy of the expenditure report. Note # 2: All advance payments made to the contractor shall be returned to the Department by the submission date of report #12. The adjustment shall be recorded in Part C, I of the report (ATTACHMENT IX). Note #3: Submission of expenditure reports may or mav not generate a payment request. If final 417n expenditure report reflects funds due back to the Department, payment is to accompany the report, Contract CLP-l22g ATTA-CHNLIENT IX REQUEST FOR PAYMENT OLDER AMERICANS ACT PRO\ACER NANIE, ADDFRESS, PHONE AND FED ID NW,41BER TYPE OF REPORT. THIS REQUEST PERIOD: Advance Report 4 Reimbursement Agreement # - ----- Agreement Perio& PSA CER-nFICATION: I hereby certify to the best of my knowledge that this request conforms with the terms and the purposes set forth in the abow agreement, Prepared By: Date: Approwd By: BUDGET SUMMARY ADMIN. [it B IIIC2 Title IIIE I. Approwd om RECEIVED for REMESTED and FUNDS REQUESTED Net Expenditures �2. .3. Additional PART C: NET FUNDS REQUESTED: 2. Agreement Funds are Contract CLP- 1.?")9 om�� ATTACH.NMENT EXHIBI] BLANK PAGE 44/86 Contract CLP- 12 2*9 RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT . .. ........... I ............. .. PROVIDPR NAME, ADDRESS, PHONE4 AND FEID# Program Funding Source THIS REPORT PERIOD IFROM: TO, CONTRACT Title III Admin. PERIOD: CONTRACT REPORT # PSA# CERTIFICATION . I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the contract. Prepared by : Date : --- ... Approved by : Date : PART A: BUDGETED INCOME/ RECEIPTS 1 Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0.00 $0.00 $0.00 2. State Funds $0.00 MOO $0.00 3. Program Income $0.00 $0.00 MOO 4. Cash Match (CCE, HCE and Other) $om $aoo $0,00 5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 6. Local In -Kind Match $0.00 MOO $0.00 7. TOTAL RECEIPT'S $0.00 $0.00 MOO PART B EXPELrTURES 1. Approved 2. Expenditures 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget 1. Administrative Services MOO $0,00 $0.00 2. Travel $0.00 $aoo $0.00 3. TOTAL EXPENDITURES MOO $0.00 $0.00 PART C : OTHER EXPENDITURES (For tracking purposes only) 1. Match: CCE / GR HCE / GR Other and In -Kind 2. Local Match 3, TOTA L PART D : Other Revenue and Expenditures 1. Program Income (Ply a.OAA Unbudgeted PI Receipts YTD . .... ..... . DOEA FORM 105aa revised 10�08 $0.00 $0.00 $0-00 $0-00 $0.00 $0.00 MOO MOO $0.00 $O-00 $0.00 'S0:00 $0.00 $0,00 $0.00 . ...................... . .. . I 11. Addition Cost Alternative Program Income 1111, Interest I. Approved Budget 1. Earned on GR Ad%ance 2, Received YTD $ 2 .2. Return of GR Advance 3. Expenditures $.,- 3. Other Earned mm, la . . ........ . . . . .. . . Contract CLP- 1-229 ATTACHMENT EXHIBIT 46/86 Contract CLP- 1229 BLANK PAGE 47786 Contract CLP- 1219 �AWW RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT PROVIDER NAME, ADDRESS. PHONEW AND FEID# Program Funding Source THIS REPORT PERIOD FROM; TO: IIIB 111C1 CONTRACT IIIC2 PERIOD: CONTRACT # REPORT# ........ ... <Z A if CERTIFICATION I certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes set forth in the contract. Prepared by Date Approved by Date PART A: BUDGETED INCOME/ RECEIPTS 1. Approved ... ....... . 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0,00 $0.00 $0.00 % 2. State Funds $0.00 $0.00 $a00 % 3. Program Income $a00 $0.00 $0.00 % 4. Local Cash Match (CCE, FICE and Other) $0.00 $0.00 $0.00 % 5. SUBTOTAL: CASH RECEIPTS $0.00 $0.00 $0.00 % & Local In -Kind Match $0.00 $0.00 $0.00 % 7. TOTAL RECEIPTS $0.00 $0,00 $0.00 % PART B : EXPENDITURES 1 Appro\ed 2. Expenditures .......... . . ............ - 3. Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget 1, Meals / Meal Agreements $0.00 $0.00 $0.00 % 2, SeNce Subcontractor $0.00 $0.00 $0.00 % 3. Other $0.00 $0,00 $0.00 0 yo 4. Indirect Cost $0.00 $a00 $0.00 % 5. TOTAL EXPENDITURES $000 $0.00 $0.00 % PART C: OTHER EXPENDITURES (For Tracking Purposes only) I. Match a, Other and In -Kind $0,00 $om $0,00 b. Local Match $0,00 $0,00 $0.00 2, USDA Cash Received $0.00 $0,00 $0,00 % 3, TO TAL 0-PHER $0.00 $0,00 $0,00 % PART D, OVER REVENUE AND EXPENDITURES .......... 2- Addition Cost Alternative Program income 3. interest 1. Program Income PI) a. Appro�d Budget a- Earned on GR Advances $ a, OAA Unbudgeted P1 Receipts YTD b. Recejd YTD b, Return of OR Advance ---------- c. Expenditums C. Other Earned DOEA FARM t.05a.s reused 1111"09 H= .. .. ..... ..... Contract CLP- l'?Ig A.W~ BLANK PAGE 49/86 ............. .... ...... ... . Contract CLP- I -?")g REMAINDER OF PAGE BLANK ATTACHMENT X EXHIBIT 3 W= Contract CLP- 1729 Contract LP- 1 �29 RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT PROVOER NAME, ADDRESS. PHONEPHONEO AND FEID40 Program Funding Source : THIS REPORT PERIOD FROM: TO - CONTRACT Title III E PERIOD: CONTRACT REPORT PSA CERTIFICATION ; € certify to the best of my knowledge and File# that this report is complete and all outlays herein are for purposes set forth in the cotract. Prepared by : Date : Approved by = date PART A: BUDGETED INCOME/ RECEIPTS 1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1. Federal Funds $0.00 $0.00 $0,00 % 2. State Funds W.,W $0.00 % 3. Program Income $0.00 $0.00 $0.00 % 4. Local Cash Match $0 00 $o w $0.00 % 5. SUBTOTAL: CASE NEWTS $0.00 $000 $0.00 % 8. Local In -Kind Match $03 00 $0.00 $0,00 % 7. TOTAL RECEIPTS $a00 $0.00 $0.00 % PART B : EXPENDITURES 1. Approved 2. Expenditures 3, Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget : A Direct Services 1. Personnel $0.00 $0.00 $0,00 °10 2. Travel $0.00 $0.00 $0.00 3, Building Space $0.00 Saw $0.00 % 4. Communication f Utilities $0,00 $0.00 $0.00 % 5. P dnting t Supplies $0.00 $0.00 $0.0o % 8. Equipment $0.00 $0.00 $0.00 % 7. Other $0.00 $0.00 $0.00 % B : Agreement Services 8. Services Subcontracted $0.00 $0.00 $©.o3 % 3. TOTAL EXPENDITURES $.00 $0.00 MOO % 10. DEDUCTIONS a. Total Leal Match $0.00 $0.00 $0.00 % b. Program Income Used $o.00 $0.00 $0.00 % c. TOTAL DEDUCTIONS $a00 $0.00 $0.00 % 11. NET EXPENDITURES $0.00 $0,00 MOO PART O ; EENDITURES ANALYSIS 2. Units of Services Year to Date 3. Number of People Ser+,ed Year to Date A. Expenditures by Services Year to Date: 1. Information.._,...... _-...-, $0.0c ........... am O 2, Assistance.,,,..... 10 ;4 . Counseling..................... 0.00 . , , _ . , . 4. Respite........... ..... _ ....... $0,00 ....... o_00 5. Supplemental Ser.4ces...,. $0 00 0. . A ...................... .00 . Part B Line 11, column 3 should be equal to this total. PART D _ GRANDPARENT SERViCiPo.S ireported by Federal Fiscal Year) Match t,OEA 01PM 055AE re sell 12; 08 Contract CLP- L,2LN Contract CLP- 121.29 ATTACHNIENT Department of Elder Affairs Programs & Services Handbook, provided on CD. Also, available at the Departinents Intranet site Linder, "Publications". .. .... ... . ....... . .. Contract CLP- 1229 ATTACHMEN STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS RIGHTS COMPLIANCE CHECKLIST . . . ........... - ........... ................................... . Monroe County Board of County� County: Monroe Program/Facty Name Commissioners AAA/Contractor 1100 Simonton Street Completed By Dotti Albur,� City, State, Zip Code Key West, FL 33040 Date 1-13-2012 Telephone 305-292-4510 PART 1. READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU IN THE COMPLETION OF THIS FORM. 1. Briefly describe the geographic area served by the program/facility and the type of service provided.- The entire Ploy; Keys (Monroe County, approximately 120 miles) which are considered rural with some urban characteristics. Monr County provides the following services., Home Delivered Meals, Congregate Meals, Case Management, Cho Homemaking, Personal Care, Facility Respite and In -Home Respite 2, POPULATION OF AREA SERVED, Source of data: 2010 Census from the U.S. Census Bureau .......... ............. 72.3% 19.6% 46.6% Total # 71165 White 5.7% Black Hispanic 2.0% Other Female 3. STAFF CURRENTLY EMPLOYED. Effective date: ........ . .. . .. ............ 70.0% 71.0% Total # 20 White 30.0% Black 1.5% Hispanic 0.0% Other Female 0% Disabled . . . ........... 1 4. CLIENTS CURRENTLY ENROLLED OR REGISTERED Effective date: ........................ 86.8% 160% 71 .0% 100% 100% Over Total # 1-64 White 12.2% Black Hispanic 1 .0% Other Female Disabled 40 5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE. . . .............. . - 100% Total# 5 White 0% Blank n0/m Hitznnnit- 0 0/,, r) f Hm r At'10L Celt V 0-11ek M..L.1—A PART Il, USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. & Is an Assurance of Compliance on file with DOEAR? If NA or NO, explain. NA YES NO E, 01 7 YES 7. Compare the staff composition to the population. Is staff repreesentative of the population? If NA or NO, explain, I 8, Compare the client composition to the population. Are race and sex characteristics representative of the, Population? If NA or NO, explain. NA YES NO 1:1 FE]", Ell YES IN A YES IN 0 a . . . . ....... Contract CLP- 1 "229 9. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national origin, sex, age, religion or disability? If NA or NO, explain. NA YES NO 1:1 0 71 YES 10. Are all benefits, services and facilities available to applicants and participants in an equally effective manner regardless of race, sex, color, age, national origin, religion or disability? If NA or NO, explain. the AAA reuuire- ell* NA YES NO E] E] ❑ NO a sthrough 11, For in -patient services, are room assignments made without regard to race, color, national origin or disability? if NA or NO, explain. We do not service any clients at in -patient. All services are provided to clients in their homes. NA YES NO 0 ❑ D N/A 12. Is the program/facility accessible to non-English speaking clients? If NA or NO, explain. YES 13. Are employees, applicants and participants informed of their protection against discrimination? If yes, how? Verbal D Written El Poster If NA or NO, explain. .............. YES — Verbal.- ritten (orientati -on) and Poster (ha fi-ging -up at job site 14. Give the number and current status of any discrimination complaints regarding services or employment filed against the program/facility. 0 15. Is the programf'facility physically accessible to mobility, hearing, and sight-impalred Individuals? If NA or NOf explain. %�e L0 = Y E S 56/86 Contract CLP- 1229 PART 111. 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 disabled individuals, and to make any necessary modifications? If NO, explain, YES 17. Is there and established grievance procedure that incorporates due process in the resolution of complaints? If NO, explain. YES NO F YES 18. Has a person been designated to coordinate Section 504 compliance activities? If NO, explain, YES NO L-j E YES 19. Do recruitment and notification materials advise applicants, employees and participants of nondiscrimination on the basis of disability? If NO, explain. YES 20, Are auxiliary aids available to assure accessibility of services to hearing and sight impaired individuals? If NO, explain, YES NO YES PART IV, FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $'50=0 OR MORE. 21 - Do you have a written affirmative action plan? If NO, explain. YES NO Ell E 0M Contract CLP- 1229 AAA USE ONLY Reviewed By Program Office Date Telephone On -Site 0 Desk Review 0 DOER Form 101 A Revised May 2008 Page 2 of 2 In Compliance: YES 11 *Notice of Corrective Action Sent Response Due Response Received NO* 0 gv Contract CLP- 1. 22.9 ATTACHMENT INSTRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST Describe the geographic service area Such as a district, county, city or other locality. If the progran-i/facility serves a specific target population such as adolescents, describe the target population.. Also, define the type of service provided. Enter the percent of the population served by race and sex. The population served includes persons in the geographical area for which services are provided such as a city, county or other regional area. Population 1W statistics can be obtained from local chambers of commerce. libraries, or any publication from the 1.980 Census containing Florida population statistics. Include the source of your population statistics. ("Other" races include Asian Pacific Islanders and American Indian/Alask-an Natives.) 3. Enter the total number of full-time staff and their percent by race, sex and disability, Include the effective date of your summary, 4. Enter the total number of clients who are enrolled, registered or Currently served by the program or facility,and I ist their percent by race, sex and disability. Include the date that enrollment was counted. 5. Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no advisory or governing board, leave this section blank. Z� 6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted in compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of the contract language for DOEA recipients and their sub -grantees, 45 CFR 80.4 (a). 7. Is the race, sex, and national origin of the staff reflective of the general population? For example, if 10% of the C� population is Hispanic, is there a comparable percentage of Hispanic staff? 8. Where there is a significant variation between the race, sex or ethnic composition of the clients and their availability in the population, the program facility has the responsibility to determine the reasons for such variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities ma exist when t", Y programs are sanctioned to serve target populations such as elderly or disabled persons, 45 CFR 80.3 (b) (6). 9. Do eligibility requirements unlawfully exclude persons in protected groups from the provision of services or e rn ploy rne nt'_.� Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also through on -site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3 (a) and 45 CFR 80.1 (b) (2). 10, Participants or clients must be provided services SLIch as medical, nursing and dental care, laboratory services, physical and recreational therapies, counseling and social. services without regard to race, sex, color, national origin, relia,ion, acre or disability, Courtesy titles, appointment schedulina and accuracy of record keeping must he k_� Z� t� .1 applied uniformly and without regard to race, sex, color, national origin, religion, age or disability, Entrances. waiting rooms, reception areas, restrooms and other facilities must also be equally available to all clients, 45 CFR 80-31 (b). For in -patient services, residents Must be assigned to rooms, wards, etc., with-OLIt regard to race, color., national origin or disabilltv, Also, residents MLISt not be asked whether they are willing to share accommodations with persons of a different race, color, national origin, or disability, 45 CFR 803 (.a). "['he proorani/facilltv and all services MUSt he accessible to participants It,indapplicants, 111CIUdIng those persons Z7 Who nitay, not speak Enollsh, In t!7c 71 i1phic areas where a significant population of non-English s saki people `9'86 el Contract CLP- 12 2W9 live, program accessibility may include the employment of bilingual staff. In other areas, it is sufficient to have a policy or plan for service, such as a current list of names and telephone numbers of bilingual Individuals who W zl� will assist in the provision of services, 45 CFR 80.3 (a). 13. Programs/facilities must make information regarding the nondiscriminatory provisions of Title VI available to Zl� Z�l their participants. beneficiaries or any other interested parties. This should include information on their right to Zn file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of HHS. The information may be supplied verbally or in writing to every individual, or may be Supplied through the use of an equal opportunity policy poster displayed in a public area of the facility. 45 CFR 80.6 (d). 14. Report number of discrimination. complaints filed against the program/facility. Indicate the basis, e.g., race, color, creed, sex, age, national origin, disability, retaliation- the issues involved, e.g., services or employment, placement, termination. etc. Indicate the civil rights law or policy alleged to have been violated along with the name and address of the local, state or federal agency with whom the complaint has been filed. Indicate the current status,, e.g., settled, no reasonable cause found, failure to conciliate, failure to cooperate, under review, etc. 15. The program/facility must be physically accessible to disabled individuals. Physical accessibility includes designated parking areas, curb Cuts or level approaches, ramps and adequate widths to entrances. The lobby, public telephone, restroom facilities, water fountains, information and admissions offices should be accessible. Door widths and traffic areas of administrative offices, cafeterias, restrooms, recreation areas, counters and serving lines should be observed for accessibility. Elevators should be observed for door width, and Braille or raised numbers. Switches and controls for light, heat, ventilation, fire alarms, and other essentials should be installed at an appropriate height for mobility impaired individuals. 16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance condLICt a self -evaluation to identify any accessibility barriers. Self -evaluation. is a four step process: With the assistance of a disabled individual/organization, evaluate current practices and policies which do not comply with Section 504. Modify policies and practices that do not meet Section 504 requirements. Take remedial steps to eliminate any discrimination that has been identified. Maintain self -evaluation on file. (This checklist may be used to satisfy this requirement if these four steps have been. followed.). 45 CFR 84.6. 17. Programs or facilities that employ 1.5 or more persons must adopt grievance procedures that incorporate appropriate due process standards and provide for the prompt and equitable resolution of complaints alleging any action prohibited by Section 504.45 CFR 84.7 (b). 18. Programs or facilities that employ 15 or more persons must designate at least one person to coordinate efforts Z:� to comply with Section 504.45 CFR 84.7 (a). 19� Continuing steps Must be taken to notify employees and the public of the program/facility's policy of nondiscrimination on the basis of disability. This includes recruitment material, notices for hearings, newspaper ads, and other appropriate written communication, 45 CFR 84.8 (a.). '10� Programs/facilities that employ 15 or more persons must provide appropriate auxiliary aids to persons with impaired sensory. nitanUaf or speaking skills where necessary. Auxiliary aids may include, but are not limited to, interpreters for hearlll(.Y impaired indiviIduals, t,iped or Braille materials, or any alternative resources that can be used to provide equally effective services, (45 C.FR 84.521 (d)v Programs1facilities with '0 or more ernpioyees and S'50.000 in. federal. contracts must develop implement and maintain a written affirroat tve, action. compliance program in ,ick-2-ordance with ExeCUUVe Order I 1, 41 CFR 60 and?Fide VI ofthe Civil Rights Act of 1964, as amended. ..... ..... . Ms Contract CLP- 1229 ATTACHMENT Department's COMPLIter Use Policy and its Social Media Policy, provided on CD. 61.185 Contract CLP- 1229 ATTACHNIENT F DOEA Cost Analysis For Non -Competitively Procured ContractA In Excess Of Category 11 1 EXHIBIT PROGRAM: CONTRACT PERIOD: TYPE OF SERVICE. 2 Column 3 . .. ....... Column 4 Column 5 7 . . . . . . . . ..... to be completed by the contractor) (tobcompleted by: the D.OEA.... Contract Manager:::..., Budget Line Item Amount % Allocated Allowable.�:.� Reasonable Necessary Category Budget Category to this Agreement a. . .......... ....... Salaries b. Fringe Benefits 0 C. Equipment . . . . ......... ... . . . .. .......... . d. Telephone & Utilities e. Travel f. E... Printing & Supplies 77 g. Other (Please list or attach details) ... ...... - .. .... .. h. Allocated Cost/Overhead . .......... TOTAL . . .. ............. Client Services (Attach ........ . .. ............. deta*ls• ) Q TOTAL CERTIFICATION (to besigned by DOEA Contract Manager)�. I certify that the cost for each line item budget. category. has been evaluated and determined to be allowable reasonable:, an( necessaryas required bySection: 216.3475,Florida Statutes.... . . . ................. . Name � .. . ............ ...... Title Date.. Signature. l Contract CLP- 1. 229 ATTACHMENT EXHIBIT INSTRUCTIONS: J CfOST ANALYSIS FOR NON-COMPETIVELY PROCURED CONTRACT*'i; IN EXCESS OF CATEGORY 11 The purpose of the ATTACHMENT F, Exhibit 1, is to document that costs in non -competitively procured contracts in excess of $35,000 are allowable, reasonable and necessary. This form is required to be submitted by the contractor to the contract manager within 30 days of the contract execution date. Upon receipt of the form, the DOEA contract manager will.- 1. Evaluate each separate line item to determine whether the cost is allowable, reasonable and necessary. a. To be allowable, a cost must be allowable pursuant to state and federal expenditure lags, rules and regulations and authorized by the agreement between the state and the contractor. b. To be reasonable, a cost must be evaluated to determine that the amount does not exceed what a prudent person would incur given the specific circumstances. c. To be necessary, a cost must be essential to the successful completion of the program. d. Allocated costs/overhead should be evaluated to determine that the rate is reasonable. 2. Place the Cost Analysis for Non -Competitively Procured Agreements in Excess of Category/1 form in the official file for this contract at the Department of Elder Affairs. (t) In accordance with the following instructions, the contractor must complete COLUMNS 3, 4 AND 5 of the DOEA Cost Analysis For lion -Competitively Procured Contracts In Excess of Category 11 worksheet (ATTACHMENT P, EXHIBIT 1) for the original contract and any amendment that affects the amount o compensation and/or the level of services provided. (2) Definition of Administrative Costs — a. Salaries/Wages: Are the charges to directly hire someone and put therm on payroll. b. Fringe Benefits: Are the costs of health insurance, Social Security, Medicare, unemployment and other benefits paid. on behalf of each employee. If fringe benefits will be based on a specified percentage, rather than the actual cost of fringe benefits, then the calculation for the fringe benefits amount must be shown. c. Equipment: Equipment means an article of nonexpendable, tangible personal property generally having a useful life of more than one year and an acquisition cost that equals or exceeds the lesser of the established capitalization level of $5,000 (federal funds) or $1,000 or hardback bound books not circulated, with a value of $250.00 or more (state funds). d. Telephone and Utilities: Are items such as utilities and telephone service costs. e. Travel: Are those that are necessary, reasonable and allowable for carrying out the project. Travel must be in accordance with Section 112.061, Florida Statutes, which includes submission of the claim on the approved State travel voucher or electronic means and at the authorized meal, per diem and state mileage reimbursement rates. f. Printing and Supplies: Are items such as office supplies, postage, and printing. g0 other costs or Miscellaneous.- Please explain/justify. Support documentation for other direct costs may include copies of published rates, copies of expense vouchers, and/or invoices. Support documentation for other costs or fees may include copies of published catalog prices, or copies of expense vouchers. h� Allocated costs or Overhead: The contractor should attach a copy of the computation schedule supporting the allocated cost rate. Support documentation for allocated costs may be a federally - negotiated allocated cost rate agreement. If the contractor does not have a rate agreement, ( sufficient information should be attached indicating how the rate used was determined and 2 if the rate was accepted and paid previously by either a federal agency or agency of the State of Florida, documentation to that affect should be provided. 3) Client Service costs should be documented via Area Agency on Aging Area Plans, Unit Cost information input into WebDB, o some other form o documentation to support the cost analysis. 4 The allocation to the agreement will be calculated based on the cost by line stern cost divided by the total agreement amount. Contract +ALP- 1.2_9 COiMMUNITY LIVING PROGRAM PROTOCOLS Program Overview The goals of Community Living program Phase 11, for PSA l 1 are to reduce overall Medicaid long term care expenditures, develop co -pay and financially sustainable systems within the context of the older Americans Act network of AAA and providers, and to increase consumer choice and self -direction. To achieve these goals PSA 1 I will focus its efforts in providing consumers with the means to resolve events tha have been identified as `critical pathways" to institutional long terms. care. Some of these critical pathways include sudden caregiver burnout, depression, malnutrition/dehydration and lacy of proper follow up with home and comm.unity based. services following hospital/rehab discharges. PSA I 1 will also manage a 'Veterans Administration Consumer Directed Care. In particular, PSA. 11 will provide short tern, cost effective, interventions, to individuals at high risk of nursing home placement or hospital re -admission, using a Holistic Social Work model utilizing a motivational empowerment case management approach focus on monitoring client follow-up in the community with medical needs, nutritional needs, mental health, home care needs, and recreational needs in order to reduce re -admission and nursing home placements. A► Case Manager will utilize an interdisciplinary managed team approach whose major role is to coordinate community based services to enable the client's independence and prevent premature or unnecessary institutionalization. The proposed model has three characteristics: Timely, short term sponsored interventions using older Americans Act services, intensive case management and, the possibility of long term continuation of services on a cost -shared basis at the consumer's choice. Acron ms and Derinit ons ADI Al heimer's Disease Initiative - Services targeted to individuals with Alzheimer's Disease or a similar en-iory disorder, including respite, assessment, caregiver training and other conMnity-based services, ADRC or ARC (Aging and Disability Resource Venters or Au.ing Resource Centers) --� The not -for -profit entit � which is the single entry point for the aging service s }stc -n within each established region of the state. APS (Adult Protective Services) High Risk - The designation of an elder who needs immediate protection from further abLISe, nealect or exploitation,, £hich can be accomplished conipletely or in part through the provision of home C ity-hase services. Contract CLP- 12.029 Caregiver or Support System — For this project, the caregiver or support system is one or more persons whom the 4:� elder can depend on to provide care or to organize the provision of needed care. Z� Care Plan - A comprehensive listing of all services, including Medicare, CCE. OAA, county, etc. that address the client's physical, mental, and home care needs to resolve the crisis condition(s), and accomplish the client"s personal goals. The Lead Service Provider would coordinate all services and evaluate their outcomes in conjunction Care Plan Review Team — For purposes of this project, a team of staff designated by the CLP staff, which reviewiS; the client's situation and makes recommendations concerning continuation of services after the initial short term grant -funded crisis -resolving period. However in no case will services be continued on a long term basis Linder this program. CCE (Community Care for the Elderly) — Services offered to functionally impaired older persons to enable them to live in the least restrictive environment, including adult day care, consumable medical supplies, home delivered meals, homemaker, personal care, respite, and other community -based services. CIRTS (Client Information and Registration Tracking System) — The database of the Department of Elder Affairs used by the aging network to manage client assessment data, register clients for services, plan client services and C) maintain program waiting lists. Lead agency provider assessors also use CIRTS to evaluate client eligibility for L-1 Medicaid services and to develop recommendations for client placement. CDC (Consumer Directed Care) — A service option that gives elders, or their representatives, the opportunity to manage the elder's service delivery,, including decisions about which services will be provided, by whom and how often. With the assistance of a consultant, an elder develops a budget plan that identifies needed goods and services 1 9 � cl� and authorizes the elder to hire workers, who may be family members or friends, and select vendors to help with dail.� care needs. A fiscal/employer agent (F/EA) pays the workers and vendors according to the rates on the budget plan. The F/EA also pays the required federal and state taxes and files the necessary tax. forms. Community Living Program — "Community Living program" is a grant to the state of Florida from the federal Z:� "I Zn 2:� Administration on Aoinu. For persons meeting the projects functional and financial eligibility criteria. the c-frant, Z�l Zn i=_ e Z� provides crisis -resolving in -home services to address their immediate and temporary needs as they leave a hospital or rehabilitation center or after a short-term nursing home stay. Without these services, the person would be at high risk 4_� of either nursing home placement or continued stav in a nursinatn_ home. This program also nianaues CO11SUmer directed Z:� Zn care services provided to veterans, Contract Clap`- 1,229 Cost Sharing — Payment by an individual for a portion of the monthly cost of the services he/she receives, based Z:� on the individual"s income and assets, and determined by the total monthly cost of the planned services. Cris is -Resolving Services — Time -limited community- based services provided to address a client's immediate short-term care needs. Possible services include, but are not limited to: case management, personal care, homemaker, transportation, meals. For the purposes of this program, a crisis is an. episode that has a high probability of creating a nursing home long term placement or a re -hospitalization. Examples of such crisis include caregiving situations'. i.e. a caregiver hospitalization that would cause the nursing home placement of the care recipient: it also includes hospital rehab discharges that have a high likelihood of recidivism or further patient deterioration where a pen-nanent nursing home placement is a likely sequel. Functional Eligibility — The priority rank of 4 or higher (priority score of > 40) is based on the 701A or 701B assessment tool; with an option for imminent risk designation in accordance, to the DOER policy. APS High Risk Referrals (priority rank 8) are not eligible. Financial Eligibility: * For a single person, the gross monthly income must be a minimum of $700 and a maximum of $4, 100. The assets, excluding primary residence and vehicle, must be valued at a minimum of $25,000 with a maximum cap of S 179,999. • For a couple, the mum 0 gross monthly income must be a minimum of $900 and a maxif $5,500. The assets, *11) 4- excluding primary residence and vehicle, Must be valued at a minimum of $25,000 with a maximum cap of $249,999. Imminent Risk - "In designating an individual imminent risk, the case manager must document in the client file how the client's situation meets all three of the criteria listed in the 3d) contract language.. 1. The client's mental or physical condition has deteriorated to the degree that self care is not possible, There is no capable caregiver, and zn 3. Institutional placement Will. OCCUr within 7"..). hours. Lead Agency Communitv Care for the Elderly (CCE) designated agency. Lead 1 agencies provide services Z7__ Linder the CCE and ADI programs. In addition lead agencies handle APS cases in accordance w'th a DOER I established protocol. Lead Service Provider —A provider of Older American Act Services that also provides case manacTement Under this project. The Case manager from the service provider will follow -tip with those prqlect participants referred bv 4[he CAP staff to facilitate the provision of services during the grant Period and to help Plan for the person. I s needs ft,--r the grant period. 6 Aw Contract CLP- 1229 OAS. 111B. 111D. 111E (Older Americans Act Titles) — Title 11113 provides supportive services to assist elders to IM independently in their community. Title 1111) provides disease -prevention and health -promotion services at senior centers or alternative sites. Title IIIE provides services through the National .Family Caregiver Support Program to assist families caring tn for frail older members, and to assist grand or older relatives who are caregivers for Z-1 children who are under 19 or are disabled. Private Pay — Payment of the complete cost of services by an individual with sufficient income and assets to be W over the financial standards for receipt of state or grant funded services. Refer -ring Entity — An entity providing referrals to the single entry point. These include case management agencies, hospitals, rehabilitation centers, home health agencies, physician assisted home based programs, and C� Z� nursing homes. Individuals referred should appear to meet the eligibility criteria for this project. Self -declared — For purposes of initial financial eligibility for the project, the individual's declaration of income and assets will not require verification. SEP (Single Entry Point) — The CLP staff for the area where the individual is receivinor serv*ces is the sinorle entry Z7� 1 1 C� point into the aging service system. Spend down to Medicaid — The use of personal resources to pay for services prior to the individual's resources being reduced to the level of Medicaid eligibility. Triage — The activity performed by CLP staff to prioritize an individual for service based on the criteria established for publicly funded programs because he/she does not meet the eligibility criteria for this project. Protocols Client Identification 1. The referring entity will use the following criteria to identify potentially appropriate project participants: Z:5 2. Individual is at least 60 years old. 3. Individual is a resident of Miami -Dade or Monroe Counties. 4. Financially and functionally eligible. Has Medicare or private health inSUrance. 6. Individual is not receiving hospice services. 7. Individual or caregiver Is in need of crisis resolving services and/or short term i."_,are, to 6 77 11 8 5 Contract CLP- L41'N avoid readmission to a hospital/rehab facility or a nursing home placement. 8. Not currently receiving any DOER sponsored services. Client Referral The referring entity will make client referrals to the single entry point (SEP). 1. Each referring entity will desi(2nate a Community Living Program contact to make referrals. Zn 4:� 41n 2. The SEP will designate an appointed staff to receive referrals. 3. At the referring entity, staff will complete the Referral Checklist and the designated Community Living Z:�% Program, contact will transmit the Referral to the SEP. o For individuals in a hospital or nursing home, the referral will be completed 24 to 48 hours prior to discharge, excluding weekends or holidays. Individuals in the community may be referred to the project during any time deemed to be in crisis or in need of short term intervention to avoid readmission and or nursing home placement. o SEP will work with the discharge planner, in the case of a facility discharge, to identify emergency services that wrap -around other benefits for which the client may be eligible, such as Medicare home health benefits, to authorize services prior to discharge and in -home assessment. o The SEP designated staff will confirm receipt of the referral to the referring entity and log in and assign the case for screening and intake on the date received. 4. To conclude the referral process from a hospital or nursing home, the referring entity will transmit a copy of the discharge summary to the SEP staff. Client Screening (Functional and Financial Eligibility) L Within'24 hours of receiving the referral, the SEP designated staff will determine client eligibility for * Z7� Z� project The SEP staff will conduct a CfRTS record check to determine if the Individual is cuiTently enrolled in CCE, ADI, or is a high risk A. -PS referral. If such is the case, the SEP staff will refer to the individuals case ni '� 4 fana�y,enien(-Y t aencv of record for follow up The lead agency will recommend crisis- resolving services 1 needed, to SLIpplewent the existing care plan. If the individual appears %-.!,1h11b1e for project participation. then the SEP staff will. aLlthorlze the lead ageicyto update the 701-B. 61 111� 8 8_5 Contract CLP- 1`2wli;wW9 If the client is not enrolled in CCE ADI, or any other case manaaed procyram., or is not a high risk APS 1� Z�- cl� referral and is in need of a short term care intervention, then the SEP designated staff will determine client eligibility for project participation. Screening must take place within 48 hours from the time the referral was received by the SEP. 3. Individuals scoring as priority levels 4 or 5 on the CLIP screen, that also meet self -declared income and asset criteria will be eligible for referral to the Lead Service Provider. Individuals that score less than a priority leve 4 will be eligible if there are demonstrable circumstances that put such individual at high risk of nursing home placement or re -hospitalization. These cases will be approved based on their particulars by the SEP on an exception basis. The SEP staff will notify the referring entity of the eligibility of the individual or, if applicable, the reasons for denyinor eligibility, in accordance to DOEA criteria. C4-� 4. If the individual does not appear eligible for project participation, then the SEP staff will triage the individual to the ARC/ADRC for follow-up Options counseling to provide assistance with referrals to other OA.A programs and services which may aid in their situation. I Lead Service Provider Responsibilities,0 Initial Client Assessment (701 B)-* * The Case manager (CM) will have contact, within 24 hrs of referral, with client and/or caregiver to introduce services and pro aam. The CM will reach out to individuals referred by the SEP to assess the situation. 6-1 9 The Case manager (CST) will provide information, including brochures and pamphlets regarding the project. The Case manager (CM) will begin discussing cost sharing, private pay, and consumer directed care service options should services be needed beyond the short term crisis resolving intervention. The financial worksheet will be completed. The Case Mana(yer will conduct the comprehensive assessment in the client"s home, or medical facility within 7 2. hours of referral using form. 7 0 1. B, in this latter instance, the CM will review the hospital discharcre z:-_ paperwork. The Lead Service Provider will enter data in CIRTS within the week of the assessment. The Case manai-yer (CM) will develop a care plan with. the client and or carealver/SUP &� zn . port system, based on the assessment, and will initiate in -lone crisis resolving services within 7? hours of receipt of referral. The Case manacter (CM) will Inform the client that the Department of Elder Affairs has contracted an Contract CLP- evaluator that will be calling to conduct a five-minute Survey about the quality and effectiveness of the services the client receives as part of the "Communitv Living Prograin programs. The case manager should assure the client that services will not be affected in any way whether the client participates or not in the survey or by how the client answers any of the questions. The case manager should report to the SEP staff if the client requests not to be surveyed. The Case manager (CM) will maintain a client file, including: care plan, financial worksheet, referral Z:� information, assessments, a summary of each contact with or on behalf of the client and caregiver, project forms, and any other related information collected on behalf of the client caregiver or required by the program, t� Z:� Enrollment Authorization. 0 The SEP staff will authorize enrollment of the individual in the project. * The SEP staff will refer the individual to the CLP lead agency provider for Case Management and crisis resolving services. If after initial enrollment the client is determined to be ineligible for financial reasons, the individual will continue to receive the services being provided tip to the crisis -resolving service period. o The CLP lead service provider will notify the SEP. o The SEP staff will contact the individual. o Transition will be made as possible to other appropriate programs. o The SEP staff will notify the CLP lead agency provider of the action to take regarding termination from the project. On-Going....Case Manqoregent .es pqns ib i I i ties: The Case manager (CM) will conduct on -going service coordination of home and community based services '111d hospital, nursina home or rehabilitation center if applicable. The Case manager will verify the information and coordinate services as needed. Client contact service is as follows: Throucy-hout the clZrant period, the Case manager (CM) will discuss the following with the client and caregiver issues t� 4_19 pertaining to the client's aiedical needs, 11LItritional needs, mental health needs, home care needs, recreational needsa Contract CLP- 122-9 Medication inanaaement issues: The Case manager will. encourage client and care giver to address Z� zn 4:� t7_ inedication management issues with primary physician. 2. Medical management.- The Case manager will review primary physician appointments and enCOLtrage client and family to maintain appointments accordingly. Encouracre client and care giver to follow -LIP With medical needs. 3. Nutrition management. -The Case manager (CMu ) will make referrals for nutrition conseling and meals Z:� programs, if needed. It will encourage client and caregiver to follow the instructions of the nutritionist conduct referrals as needed. 4. Mental Health.- The Case manager (CM) will monitor good mental health practice and encourage appropriate follow-up as needed for mental health need and conduct referrals and placement of services as needed. 5. Home Care needs: The Case manager (CM) will assess and monitor home care needs and conduct referrals and placement of services as needed 6. Recreational needs: The Case manager (CM) will assess and monitor recreational needs and encourage Z:� good recreational practices for both client and caregiver. CM will conduct referrals for services as needed. -The Case Manager will document the review in the client's case notes Satisfaction with services delivered during 45-day crisis resolvine, service period 2. What services is the client receiving? Are specific services adequately addressing the client's needs? Z:� 4. What are additional needs? How are those additional needs being addressed' Periodic Follow-up One week after initiating services, the Case manager will visit the client to ascertain services platined are being delivered and client needs are being met. _? -rwo weeks of service initiation,, the case manager will. conduct telephone contact with the client to determine if services are address in� the client � s needs. Four weeks after service initiation the case manac,,,er will. condLICt telephone contact with the client to determine if services are addressl1hy the chel-It's needs, Contract CLP- 1. 4. No less than 5 days prior to the end of project participation, the CLP Lead agency provider case manager will conduct a face to face contact with the client and, caregiver to review the care plan acid 4n llt� determine the individual's continued need of crisis -resolving services. The timing of this contact will C� be at the discretion of the Case manager prior to the discharge determination date. Termination of Services The Case manager will advise the SEP staff of the following: 9 o The crisis is resolved and the client may be terminated from the project. o The client is not stabilized and continues to need crisis resolving services. -Detail will be provided as to the recommended services, frequency and duration. o The crisis is resolved, but the client will need on -going in -home services. Detail will be provided as to the recommended services, frequency and duration. Also whether client is continuing with co -pays and consumer directed care. 0 Method of service, defive after crisis- resolving service vert*od ends a The client has an option of continuing to receive services in a traditional manner (agency ordered and delivered) continuing with a co -pay, subject to provider funding availability.(The share of cost is stated on the care plan.) 8 The client has an option of participating in consumer directed care (consumer determines service provision),, as a private pay client, however the provider will charge the consumer rates that are not higher than the lowest rates X � 9 t__; the provider receives from the Alliance. a The client can afford the cost of private pay services. Funding 0 bons. The SEP staff must ensure the avc-iflability of OAA dollars to serve individuals at high risk of nursing home W zn :n placement and spend down to Medicaid by implementing assessment and screening tools, as well as care planning and case managementforTitle IIIB funding. Title HID and Title IHE funds should be considered for the provision.provision.of services such as medication nianageinent and caregiver Support services. C� t� The Alzheinier's disease Demonstration Grant fun -ding shOUICI he coordinated as Cappropriate to expan.d services to C� clients in Mlanil-Dade COUnty. '-fhIs will InclUde IndividUals %elth Alzheimer's aisease or Relcated Disorders, who ai Contract CLP- 1'2"29 not eligible for Medicaid bUt are at imminent risk of nursina home placement and spend down, to remain in the community and avoid or delay nursinor home placement. zl CIRTS Data E Screening data for each. referral based on the CLP Screening tool or 701A or similar instrument will be entered into CIRTS. The Lead Service Provider will enter 701B assessment data promptly entered into CIRTS. All clients authorized for CLP services will be enrolled in CIRTS under the CLP program en-rollment code. For all services received by CLP clients, the case management agency will report the service units and unit cost data in CIRTS. Z:� W • All services will be reported as client specific, including non -registered OAA services. All services funded with CLP grant funds will be reported under the appropriate CLP service code. • All services funded with other program funds (OAA, CCE, etc.) will be reported using the appropriate program"s service code. ,,I jr �F 7 3 '8 _5 Contract CLP- 124'29 ATTACHNIENT H SERVICE PROVIDER APPLICATION Contract CLP- f229 INVITATION TO NEGOTIATE COMMUNITY LIVING PROGRAM OLDER AMERICANS ACT TITLE III-B SUBMITTED BY: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS SOCIAL SERVICES IN -HOME SERVICES PROGRAM SYLVIA J. MURPHY, MAYOR, MONROE COUNTY HISTORIC GATO BUILDING 1100 SIMONTON STREET RM. 2-257 KEY WEST, FL 33040 PHONE: (305) 292-4510 FAX: (305) 295-4359 75/85 Contract CLP- 1412�9 fMPLEMENTATION OF SERVICES STATEX4ENT OF READINESS L ec,V , Deputy County Administrator do hereby stipulate and I- Z77: D ceder ick agree that Monroe County Social Services,/In-Home Services is ready to implement the services mentioned in this Invitation to Negotiate (ITN) Date: 6/8 7 9 / , '� -)?g Contract CZ. P- CONUNfUNNITY LIVING PROGRAM — INVITATION TO NEGOTIATE Submitted by: Monroe County In -Home Services (MCIHS) Monroe County Board of County Commissioners Monroe County Social Services 1100 Simonton Street 2-257 Key West FL 33040 305-292-4510 (phone) Sylvia J. Murphy,. Mayor,, Monroe County — Chief Executive Officer Monroe County In -Home Services (MCIHS), a department within Monroe County Social Services (MCSS), is well-equipped to handle service interventions for the short-term hiorZ:�h risk individual. Due to our extensive reach throughout all of Monroe County, there are no areas that can -not be served. MCIHS is able to provide any manner of services throughout the entirety of Monroe County. For example, MCIHS already provides value-added services (via a number of non DOER sources) such as, case management, homemaking, personal care, in -home respite, facility -based respite, nutrition services for in -home and congregate clients, prescription assistance, pauper burials, transportation assistance, shelter, energy cost assistance, weatherization services, and many more. The funding for the Community Living Program will allow MOBS to provide the following short-term services to the ARC referred high -risk individuals: homemaking, personal care, and case management. MCIHS employs County staff, as well as subcontracted staff, that are strategically positioned throughout all areas of Monroe County. In addition to all of the aforementioned services which are considered value-added services, for the C0111-MUnity Living Program., we are able to per foun the followinv direct In -Home Services: Homemaking - which will allow clients to receive specific home management services such as gel eral housekeeping, laun.drv, assistance with btid(,1etin4g and pavino bills, shopping assistance, Contract C LP- 1. 2 21.9 eating, dressing, personal hygiene, and other significant activities of daily living. Case Management - Monroe County has qualified and experienced Case Manatzer's, Our Case Managers are able to assist clients in identifying physical. and emotional needs and problems through an interview and assessment process. Case Managers are able to discuss and develop a care plan for services for these short-term clients to remove them from being high risk. Our Case Managers are "gatekeepers" in the community care system and have vast knowledge in the different resources available in our community. Monroe County's Case Managers have many years of experience and are fully able to coordinate and link clients and caregivers with appropriate resources in the health care and delivery systems regardless of the agency or organization offering the services, to meet the client's needs. Case Managers are able to monitor t:� all services and referrals to ensure they are having a positive impact on the problems that have caused the client to become high risk. Respite Care -- as a value-added service — will provide relief or rest for a primary caregiver from the constant, continued supervision and care of a functionally impaired, high risk older person by providing care for the person in the home for a pre -determined period of time. Overall Coordination -Monroe County Case Managers are able to coordinate all community a Z= resources for high risk clients via a community care service that comprises health and community resources. As part of a government agency MCIHS has access to a myriad of social service prograrns available within our own offices, such as funding for prescription drugs and the others referenced on page 1. If a consumer needed medication and Could not afford it, MCSS WOUld be able to pay for that medication. This is Just one example of the nany val-Lie-added services that MCSS already has in place. Another example would be the Nlonroe County Disabilitv Council which is sponsored and staffed by the Monroe, COUnty Board Of COLInty V - - Contract CLP- 1 '1229 Commissioners (BOCC). The Social Services Department has long been the liaison for the BOCC with this advisory council. At present time one of our Case Manager Supervisors is Liaison and Secretary/Treasurer. The Council seeks to improve access, to, services for all W, - residents of our community. As a governmental agency, the BOCC provides additional funding to Social Services organizations (outside of the County structure) folio vines the counsel of the C Human Services Advisory Council (HSAB). The HSAB reviews applications and makes fun -ding recommendations for proort:�rams in the following service categories: primary and behavioral health care, core services, and quality of life services. The recommendations of HSAB are presented to the BOCC for approval. Once approved, the BOCC enters into contracts funding over 25 non -governmental, agencies that offer essential services for consumers. As Z:� contractors for the BOCC, these agencies are willing and able partners with the MCIHS Case Z:) Managers and Social Services staff to help meet the needs of consumers within the County. Monroe County Transit (MCA''), a program within the Social Services Department is a partner 4:� with In -Home Services providers. The ACT vehicle fleet is 100 percent accessible to the physically disabled and provides door-to-door transportation for anyone who is transportation disadvantaged throughout the entire length and breadth of the Keys. MCT coordinates closely Z-1 with the local COMMUnity Transportation Coordinator and Medicaid Transportation Coordinator the Guidance Care Center. All local transit providers are members of the Local Coordinating Board, including the City of Key West that provides bus routes in Key West and Stock Island .1 and the Lower Keys Shuttle that operates a fixed route from Marathon to Key West, Monroe County is an equal financial partner with the Cities of Key West and Marathon in the operation .1 of the Lower Kevs Shuttle. MCIHS Case Manaaers actively coordinate with available tran sport ation providers throttayhOUt the C01111nUpities of the Keys to ensrethat access to needed -79/8- N, Contract CLP- 12-29 services is available. Since MOBS is integrated into the Social Services department, Case Managers work closely with Community Support Services (CSS) for Consumable Supplies (value-added service). The Case Managers also work very closely with the health care providers in the Keys and CSS to provide a link to ensure individuals who are low income receive the supplies they need. This requires the involvement of local physicians, hospitals, physical therapy centers, etc. Further, Case Managers in Monroe County continuously monitor C� the quality, appropriateness, and cost of services that are delivered to consumers to ensm that the most appropriate and cost-effective service is being received. Referrals are often made for value-added services to the Helpline of the Florida Keys for clients who need Telephone Reassurance. This service is designed to allow staff to check on the consumer daily and if needed call to remind them to take their medication. Caregiver Support is also offered through Helpline and they hold support groups throughout the Florida Keys for any caregiver in need. Often caregivers are in crisis and this gives them an opportunity to discuss their situation and obtain some advice and assistance relative to their loved one. MCSS currently provides Homeless Prevention and Rapid Re -Housing Program (HPRP). This grant is Raided by the American Recovery and Reinvestment Act of 2009, through the Department of Homelessness/DCF and assists eligible Monroe County households with the prevention of homelessness. The intent of this funding is to help persons who can remain stably housed AFTER the teinporary housing assistance ends. It generally provides rent for 3 months or less. Like the Community LIvingy . ProuramHPRP is not a long-temi assistance program. MMSS also Program. zn operates the Weatherization Assistance Program (WAP). This grant through.DCA provides Energy RedLICin(7 Services to low income families to reduce energy cost, conserve ener(Tv, increase Z� Zt� znl co fort in the home and iniprove safety and health standards, Seine of the services that .r Em .... ... .... . ........... Contract CLP- 1 4129 are offered under this grant are threshold repairs, window and door replacement, insulation, and installation of smoke/fire/carbon monoxide detectors, etc, The Low Income Home Energy Assistance Program (LIHEAP is another service we are able to provide through the DCA. 4:�, This grant assists low income households to receive financial assistance in paying for the cooling 4:� and heating of their homes. As Visiting Nurse Association (VNA) currently sub -contracts with MCIHS for the provision of direct services to our clients, we have developed a close alliance with them and are able to make referrals to them for services outside of direct services. One of the services that we often refer to VNA for is Bereavement Counseling. Often consumers are very distraught after losing a loved one, such as a spouse, and are in dire need of professional services. VNA offers this service with licensed counselors free of charge. Along with VNA, Case Managers also refer for counseling services to the Guidance Care Center and the Care Center for Mental Health, Inc. (CCMI1 . These agencies have on staff a licensed mental health counselor (PhD), and a certified addiction professional (MSW . A wide range of Gerontological Counseling Services are also available to clients who are referred to these agencies. Z:� Service Coordination/Assessment, Coordination with the AAA - As Monroe County's Lead Agency for over the past three decades, MCIHS is able to ensure the coordination of services and is able to coordinate all aspects of the grant with the AAA. Monroe County has a close 11 relationship with the Aging Resource Center (ARC) and is able to receive and coordinate at, Z:� referrals for them. MCIHS are also able to work innovatively, since the Case Managers have a long-standing relationship with the local hospitals Discharge Z71e Planners. Staff are able to give �;_j these planners the ARC's contact information and they call the ARC when a high. risk consumer 'rom the hospital, �Fhrou(,YhMt M011r0C COU-11ty, these referrals will lead to SS CY '011hy to be released f ',_e I "I- - rrF Contract CL.P- 1229 intake and assessment. Intake and Assessment begins when a potential consumer, careaiver, family member, friend, neighbor, or public or private agency seeks assistance for an individual by contacting the Alliance for Aging's ARC. MCIHS employs ten staff members who have been trained and certified to take referrals and administer the DOEA Assessment Forms in accordance with the DOER Assessment Instructions (70 1 A, 70 f B, 70 1 C) Manual. Trainina and certification was completed for MCIHS staff by the AAA in Miami during August 2007 and August 2008 and staff continue to receive updated information and training as needed. MCIHS staff members conduct all assessments in accordance with the instructions for completion as indicated in the aforementioned training sessions and the DOER Assessment Instructions (701A, 701B, 701,C) Manual. The ARC determines when persons are approved for services from NICIHS and will send the referrals accordingly. After the referral is received, MCIHS conducts a home visit with the consumer in order to perform a comprehensive assessment (701B) and develop a care plan in accordance with the DOER. Referrals from the ARC for high risk individuals who are at imminent risk of institutional placement, such as individuals awaiting hospital or emergency room discharge, will be served immediately. Case Managers have the capability after administering the assessment (701B) to communicate with other agencies to ensure that all needs for the consumer are adequately addressed and keep the individual from staying high -risk. This is due to the fact that MCIHS enjoys a high level of coordination and commitment from community partners countywide. The success of MCIHS as well as the high level of countywide coordination and service linkage is due in a large part to the exceptional working relationship MOBS has maintained throughout the community for over three decades. Program Success and Reporting Reguirements and fa-miliarl" W i t h.....r e p o r t i n1v - M reqtiirements and service descriptions -As previously mentioned, NICIHS employs ten staff h Contract CLP- E2 29 members who have been trained and certified to administer the DOE A Assessment Forms in accordance with the DOER Assessment Instructions (701A, 701B, 701C) Manual. Two MCIHS administrative staff members are responsible for the upkeep and maintenance of the CIRTS data entry. Both staff members are full trained on the CIRTS application. While one clerical staff member serves as the primary CIRTS data entry worker, the other administrative staff member serves as a backup, thus ensuring that CIRTS data entry is completed timely. Monthly, quarterly, and annual reporting requirements are fulfilled by a full time Sr. Grants Coordinator employed by MOSS. The Sr. Grants Coordinator maintains a chart of reports including due dates, submission requirements, standards for completion, etc. Additionally, the Sr. Grants Coordinator reviews and coordinates all reporting with the Director of Social Services. This ensures that multiple staff members are aware of each report, progress being made on the report, when it is due, and what the requirements for completion are. The Sr. Grants Coordinator maintains electronic copies and printed copies of each report. Working papers and substantiating backup documentation are maintained in the printed copy files and stored in locked filing cabinets, inside locked offices,, in a secure building. Daily backups of electronic data Occur through routine Monroe County Technical Services operations. Since Monroe County implemented the position of Sr. Grants Coordinator, all reports have been submitted timely and accuracy and continuity has been ensured. Further, there is now one central person that the Alliance for Acrincr can contact if there are questions about reporting. Monroe County's staff is very familiar with the Service Descriptions as identified in the DOER Handbook issued July '02,010 as Monroe Co my being a CCE Lead Agency for the past 30 years. Agency A.0ditional Services/Resources at no charge to the Alliance for Aoinsy, - As previously I'll.elit.1 0 tied, MCIHS is a department within the MCSS. MOSS offers a wide array of service's to 83/85 .... ...... ...... ... .. ... .. Contract CLP- f.2,219 help Monroe County's citizens and MIDIS has full access to all services and funds. Some 4. these services include but are not limited to the services outlined under Overall Coordination starting on page.2. Self-sustaining pro ram when it is at the end of its pilot --Monroe County is certain it will be able to self -sustain the program when it is at the end of its pilot time allotment. All of the aforementioned services are able to be provided, on a limited basis, through our Case Managers, the MCSS, and all non DOEA funding. While some of these services are paid for with grants from DCF and DCA, many of these services are paid for through General Funds (County tax dollars) and is provided annually from Monroe County. Once the Community Living Proorrarn pilot ends our Case Managers will continue referring and coordinating services (as mentioned above) between the clients and other entities to provide the needed services for our citizens. Monroe County In -Home Services Technical Capacity_ to provide the 12roposed service intervention - MCIIIS Case Managers have the knowledge, educational background, ...... ....... .... experience, and skills to coordinate the most beneficial and least restrictive services and community resources for consumers throughout the community. Along with experience and training in the In -Home Services field, our Case Managers have many years and extensive 4 training in the Social Services field. Several of our Case Managers have worked for DCF or other uoverninacr -ental or private encies before working for Monroe County and have a Z� Zn back!YrOUnd and wide rancring knowledae services and procedures. With this knowledge, 1=1 C7 Zn C Monroe County Case Managers are proficient in helping individuals with Medicaid applications Z� Z:� along with assistinor them with their applications for Food Stamps on-line. Monroe C0L111tV'S Case Zn Z-7 _1 Mu ManatyMU111 ers have a miniOf 5 years experience in the Social Services field and as ch as '2_6 Z771 I years field experience. Alona with. the Case Man-acyers extensive experience, MCIHS has been a Z� tn - 84/85 Co fitract CLP- 12'29 CCU, lead aorencv for over 30 years and we have the knowledge and technical ability to submit all data and reportin(y into the CIRTS system, the knowledge of required reports, and the flexibility to handle requirements set forth by the .1 %_1 DOER and the Alliance for Aging. i� * Statement of Readiness — MORS is fully ready to implement services within the Community Living Program immediately. All of the services that we are proposing here are currently being performed by existing staff. We have the necessary infrastructure and financial resources necessary to begin serving referred clients immediately. C" Unit Rate — MCIHS has the commitment of the BOCC to meet the 10% cash match requirement as set forth in the ITN. In addition, MCIHS has the capacity to offer an additional 10 o in -kind match via our existing infrastructure (Office and conregate meal site space). The combination of these two sources of funds will equate to an overall .2.0% match. Value-added services are outlined and documented in this response, as well as the office and congregate meal site space which are documented on the Unit Cost Methodology. . . .. . ........ . . . ....... Contract CLP- 142.29 ATTACHMENT I Verification. of Employment Status Certification As a condition of contracting with the Alliance for Aging, Inc., Monroe County Social Services, hereby referred to as contractor, certifies the use of the U.S. Department of Homeland Security's E-verify system. to verify the employment eligibility of all new employees hired by Contractor during the contract term to perform employment dUties pursuant to this Agreement and (b) that any subcontracts include an express requirement that subcontractors performing work or providing services pursuant to this Agreement utilize the E-verify system to verify the employment eligibility of al_ newemployees hired by the subcontractor dUrinor the contract term. Z:) Signature (Same as contract signatUre) Title Company Name Date