05/16/2001 Contract
CLERK OF THE CIRCUIT COURT
MONROE COUNTY
BRANCH OFFICE
MARATHON SUB COURTHOUSE
3117 OVERSEAS HIGHWAY
MARATHON, FLORIDA 33050
TEL. (305) 289-6027
FAX (305) 289-1745
MONROE COUNTY COURTHOUSE
500 WHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
FAX (305) 295-3663
BRANCH OFFICE
PLANTldION KEY
GOVERNMENT CENTER
88820 OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-7145
FAX (305) 852-7146
MEMORANDUM
DATE:
June 26, 2001
TO:
Louis Latorre, Director
Social Services Division
ATTN:
Tracy Threlkeld
In Home Services
Pamela G. Hanc~
Deputy Clerk '0
FROM:
At the May 16, 2001, Board of County Commissioners meeting the Board granted
approval and authorized execution of Standard Contract KG034 Community Care for Disabled
Adults for Fiscal year 7/1/01 through 6/30/02 between Florida Department of Children and
Families, and the Monroe County Board of County CommissionersIMonroe County Social
Services (Monroe County In Home Service Program, the Case Management Agency).
Enclosed are three duplicate originals of the above, executed on behalf of Monroe County,
for your handling. Please be sure to return the fully executed "Clerk's Original" as soon as
possible. Should you have any questions please feel free to contact our office.
Cc: County Administrator w/o document
County Attorney
Finanye
File /
1/1/01
CFDA No.
CLERK'S or;.INAL . Client I8l Non:Clieinlo-
Multi-District 0
FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
STANDARD CONTRACT
THIS CONTRACT is entered into between the Florida Department of Children and Families, hereinafter referred to as the
"department," and Monroe County In Home Services ...,J
I. THE PROVIDER AGREES:
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A. Attachment I
To provide services in accordance with the conditions specified in Attachment I.
B. Requirements of Section 287.058 F.S.
To provide units of deliverables, including reports, findings, and drafts, as specified in Attachment I, to be received and
accepted by the contract manager prior to payment. To comply with the criteria and the final date by which such criteria
must be met for completion of this contract as specified in Section III, Paragraph A. of this contract. To submit bills for
fees or other compensation for services or expenses in sufficient detail for a proper pre-audit and post-audit thereof,
Where applicable, to submit bills for any travel expenses in accordance with section 112.061, F,S, The department may,
if specified in Attachment I, establish rates lower than the maximum provided in section 112.061, F.S. To allo\i\( public
access to all documents, papers, letters, or other materials subject to the provisions of Chapter 119, F.S., made or
received by the provider in conjunction with this contract. It is expressly understood that the provider's refusal to comply
with this provision shall constitute an immediate breach of contract.
C. Governing Law
1. State of Florida Law
That this contract is executed and entered into in the State of Florida, and shall be construed, performed, and enforced in
all respects in accordance with the laws, rules, and regulations of the State of Florida, Each party shall perform its
obligations herein in accordance with the terms and conditions of the contract.
2. Federal Law
a. That if this contract contains federal funds, the provider shall comply with the provisions of 45 CFR, Part 74,
and/or 45 CFR, Part 92, and other applicable regulations as specified in Attachment I.
b. That if this contract contains federal funds and is over $100,000, the provider shall comply with all applicable
standards, orders, or regulations issued under section 306 of the Clean Air Act, as amended (42 U,S.C, 7401 et seq,),
section 508 of the Federal Water Pollution Control Act as amended (33 U.S,C, 1251 et seq,), Executive Order 11738, and
Environmental Protection Agency regulations (40 CFR, Part 30). The provider shall report any violations of the above to
the department.
c. That no federal funds received in connection with this contract may be used by the provider, or agent acting for
the provider, to influence legislation or appropriations pending before the Congress or any State legislature, If this
contract contains federal funding in excess of $100,000, the provider must, prior to contract execution, complete the
Certification Regarding Lobbying form, Attachment N/A , If a Disclosure of Lobbying Activities form, Standard Form
LLL, is required, it may be obtained from the contract manager, All disclosure forms as required by the Certification
Regarding Lobbying form must be completed and returned to the contract manager.
d. That unauthorized aliens shall not be employed, The department shall consider the employment of
unauthorized aliens a violation of section 274A(e) of the Immigration and Nationality Act (8 U,S,C, 1324 a). Such violation
shall be cause for unilateral cancellation of this contract by the department.
e. That if this contract contains $10,000 or more of federal funds, the provider shall comply with E~ecutive Order
11246, Equal Employment Opportunity, CjS amended by Executive Order 11375, and as supplemented in Department of
Labor regulation 41 CFR, Part 60. [45CFR, Part 92]
f. That if this contract contains federal funds and provides services to children up to age 18, the provider shall
comply with the Pro-Children Act of 1994 (20 U,S,C, 6083), Failure to comply with the provisions of the law may result in
the imposition of a civil monetary penalty of up to $1,000 for each violation and/or the imposition of an administrative
compliance order on the responsible entity. This clause is applicable to all approved subcontracts.
D. Audits, Records and Retention
1. To establish and maintain books, records, and documents (including electronic storage media) in accordance with
generally accepted accounting procedures and practices, which sufficiently and properly reflect all revenues and
expenditures of funds provided by the department under this contract.
2. To retain all client records, financial records, supporting documents, statistical records, and any other documents
(including electronic storage media) pertinent to this contract for a period of five (5) years after completion of the contract,
or.if an audit has been initiated and audit findings have not been resolved at the end of five (5) years, the records shall be
retained until resolution of the audit findings or any litigation which may be based on the terms of this contract.
CF Standard Contract, JF 01/2001 1 CONTRACT # KG034
1/1/01
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3. Upon demand, at no additional cost to the department, the provider will facilitate the duplication and transfer of any
records or documents during the required retention period in Section I, Paragraph 0.2,
4. To assure that these records shall be subject at all reasonable times to inspection, review, copying, or audit by
Federal, State, or other personnel duly authorized by the department.
5. At all reasonable times for as long as records are maintained, persons duly authorized by the department and
Federal auditors, pursuant to 45 CFR, Part 92.36(i)(10), shall be allowed full access to and the right to examine any of the
provider's contract and related records and documents, regardless of the form in which kept.
6. To provide a financial and compliance audit to the department as specified in Attachment ---1L and to ensure that
all related party transactions are disclosed to the auditor. .
7. To include these aforementioned audit and record keeping requirements in all approved subcontracts and
assignments,
E. Monitoring by the Department
To permit persons duly authorized by the department to inspect any records, papers, documents, facilities, goods, and
services of the provider which are relevant to this contract, and to interview any clients and employees and subcontractor
employees of the provider to assure the department of the satisfactory performance of the terms and conditions of this
contract. Following such evaluation, the department will deliver to the provider a written report of its findings and request
for development, by the provider, a corrective action plan, The provider hereby agrees to correct all noted deficiencies
identified by the department within the specified period of time set forth in the department approved corrective action plan,
F. Indemnification
NOTE: Paragraphs I.F,1. and 2, are not applicable to contracts executed between state agencies or subdivisions, as
defined in subsection 768.28(2), F,S,
1. To be liable for and indemnify, defend, and hold the department and all of its officers, agents, and employeE;!s
harmless from all claims, suits, judgments, or damages, including attorneys' fees and costs, arising out of any act, actions,
neglect, or omissions by the provider, its agents, or employees during the performance or operation of this contract or any
subsequent modifications thereof, whether direct or indirect, and whether to any person or tangible or intangible property,
2. That its inability to evaluate its liability or its evaluation of liability shall not excuse the provider's duty to defend and
to indemnify within seven (7) days after notice by the department by certified mail. After the highest appeal taken is
exhausted, only an adjudication or judgment specifically finding the provider not liable shall excuse performance of this
provision, The provider shall pay all costs and fees, including attorneys' fees related to these obligations and their
enforcement by the department. The department's failure to notify the provider of a claim shall not release the provider of
these duties, The provider shall not be liable for the sole negligent acts of the department.
G. Insurance
To provide adequate liability insurance coverage on a comprehensive basis and to hold such liability insurance at all times
during the existence of this contract and any renewal(s) and extension(s) of it. By execution of this contract, unless it is a
state agency or subdivision as defined by subsection 768,28(2), F.S" the provider accepts full responsibility for identifying
and determining the type(s) and extent of liability insurance necessary to provide reasonable financial protections for the
provider and the clients to be served under this contract. Upon the execution of this contract, the provider shall furnish the
department written verification supporting both the determination and existence of such insurance coverage. Such
coverage may be provided by a self-insurance program established and operating under the laws of the State of Florida,
The department reserves the right to require additional insurance as specified in Attachment I.
H. Safeguarding Information
Not to use or disclose any information concerning a recipient of services under this contract for any purpose not in
conformity with state statutes and federal law or regulations (45 CFR, Part 205.50), except upon written consent of the
recipient, or the responsible parent or guardian when authorized by law,
I. Assignments and Subcontracts
1. To neither assign the responsibility for this contract to another party nor subcontract for any of the work
contemplated under this contract without prior written approval of the department which shall not be unreasonably
withheld. Any sublicense, assignment, or transfer otherwise occurring, without prior approval of the department, shall be
null and void,
2. To be responsible for all work performed and all expenses incurred with the project. If the department permits the
provider to subcontract all or part of the work contemplated under this contract, including entering into subcontracts with
vendors for services and commodities, it is understood by the provider that all such subcontract arrangements shall be
evidenced by a written document subject to prior review and comment by the department. Such review of the written
subcontract document by the department will be limited to a determination of whether or not subcontracting is permissible
and the inclusion of applicable terms and conditions of this contract. The provider further agrees that the department shall
not be liable to the subcontractor for any expenses or liabilities incurred under the subcontract and the provider shall be
solely liable to the subcontractor for all expenses and liabilities incurred under the subcontract. The provider, at its
expense, will defend the department against such claims.
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CONTRACT # KG034
1/1/01
3. That the State of Florida shall at all times be entitled to assign or transfer its rights, duties, or obligations under this
contract to another governmental agency in the State of Florida, upon giving prior written notice to the provider. In the
event the State of Florida approves transfer of the provider's obligations, the provider remains responsible for all work
performed and all expenses incurred in connection with the contract. In addition, this contract shall bind the successors,
assigns, and legal representatives of the provider and of any legal entity that succeeds to the obligations of the State of
Florida,
4. To make payments to the subcontractor within seven (7) working days after receipt of full or partial payments from
the department in accordance with section 287.0585, F.S., unless otherwise stated in the contract between the provider
and subcontractor. Failure to pay within seven (7) working days will result in a penalty charged against the provider and
paid to the subcontractor in the amount of one-half of one (1) percent of the amount due per day from the expiration of the
period allowed herein for payment. Such penalty shall be in addition to actual payments owed and shall not exceed fifteen
(15) percent of the outstanding balance due.
J. Return of Funds
To return to the department any overpayments due to unearned funds or funds disallowed pursuant to the terms of this
contract that were disbursed to the provider by the department. In the event that the provider or its independent auditor
discovers that an overpayment has been made, the provider shall repay said overpayment within 40 calendar days
without prior notification from the department. In the event that the department first discovers an overpayment has been
made, the contract manager, on behalf of the department, will notify the provider by letter of such findings, Should
repayment not be made forthwith, the provider will be charged at the lawful rate of interest on the outstanding balance
after department notification or provider discovery,
K. Client Risk Prevention and Incident Reporting
1. That if services to clients will be provided under this contract, the provider and any subcontractors shall, in
accordance with the client risk prevention system, report those reportable situations listed in CFOP 215-6 in the manner
prescribed in CFOP 215-6 or district operating procedures. '
2. To immediately report knowledge or reasonable suspicion of abuse, neglect, or exploitation of a child, aged person,
or disabled adult to the Florida Abuse Hotline on the statewide toll-free telephone number (1-800-96ABUSE), As required
by Chapters 39 and 415, F.S" this is binding upon both the provider and its employees,
L. Purchasing
1. To purchase articles which are the subject of or are required to carry out this contract from Prison Rehabilitative
Industries and Diversified Enterprises, Inc" (PRIDE) identified under Chapter 946, F,S" in the same manner and under
the procedures set forth in subsections 946,515(2) and (4), F.S, For purposes of this contract, the provider shall be
deemed to be substituted for the department insofar as dealings with PRIDE. This clause is not applicable to
subcontractors unless otherwise required by law. An abbreviated list of products/services available from PRIQE may be
obtained by contacting PRIDE, (850) 487-3774.
2. To procure any recycled products or materials which are the subject of or are required to carry out this contract, in
accordance with the provisions of sections 403.7065, and 287.045, F.S,
M. Civil Rights Requirements
1. Not to discriminate against any employee in the performance of this contract, or against any applicant for
employment, because of age, race, creed, color, disability, national origin, or sex, The provider further assures that all
contractors, subcontractors, subgrantees, or others with whom it arranges to provide services or benefits to participants or
employees in connection with any of its programs and activities are not discriminating against those participants or
employees because of age, race, creed, color, disability, national origin, or sex. This is binding upon the provider
employing fifteen (15) or more individuals,
2. To complete the Civil Rights Compliance Questionnaire, CF Forms 946 A and B, in accordance with HRSM 220-2,
This is binding upon providers if services are directly provided to clients and if 15 or more individuals are employed,
N. Independent Capacity of the Contractor
1. To be solely liable for the performance of all tasks contemplated by this contract which are not the exclusive
responsibility of the department.
2. To act in the capacity of an independent contractor and not as an officer, employee of the State of Florida, except
where the provider is a state agency, Neither the provider nor its agents, employees, subcontractors or assignees shall
represent to others that it has the authority to bind the department unless specifically authorized in writing to do so,
3. This contract does not create any right to state retirement, leave benefits or any other benefits of state employees
as a result of performing the duties or obligations of this contract.
4. To take such actions as may be necessary to ensure that each subcontractor of the provider will be deemed to be
an independent contractor and will not be considered or permitted to be an agent, servant, joint venturer, or partner of the
State of Florida, .
5. The department will not furnish services of support (e,g" office space, office supplies, telephone service, secretarial
or clerical support) to the provider, or its subcontractor or assignee, unless justified by the provider and agreed to by the
department in Attachment I.
6. All deductions for social security, withholding taxes, income taxes, contributions to unemployment compensation
funds, and all necessary insurance for the provider, the provider's officers, employees, agents, subcontractors, or
assignees shall be the sole responsibility of the provider,
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CONTRACT # KG034
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O. Sponsorship
As required by section 286.25, F.S" if t.he provider is a no~governmental ~rganizatio~ which ~ponso~s. ~ program ~n.anced
wholly or in part by state funds, including any funds obtained through this contract, It shall, In publicIzing, advertising, or
describing the sponsorship of the program, state: "Sponsored by (provider's name) and the State of Florida, Department
of Children and Families." If the sponsorship reference is in written material, the words "State of Florida, Department of
Children and Families" shall appear in the same size letters or type as the name of the organization.
P. Final Invoice
To submit the final invoice for payment to the department no more than ~ days after the contract ends or is
terminated, If the provider fails to do so, all rights to payment are forfeited and the department will not honor any requests
submitted after the aforesaid time period, Any payment due under the terms of this contract may be withheld until all
reports due from the provider and necessary adjustments thereto have been approved by the department.
Q. Use Of Funds For Lobbying Prohibited
To comply with the provisions of sections 11.062 and 216,347, F.S" which prohibit the expenditure of contract funds for
the purpose of lobbying the Legislature, judicial branch, or a state agency,
R. Public Entity Crime
Pursuant to section 287,133, F.S., the following restrictions are placed on the ability of persons convicted of public entity
crimes to transact business with the department: When a person or affiliate has been placed on the convicted vendor list
following a conviction for a public entity crime, he/she may not submit a bid on a contract to provide any goods or services
to a public entity, may not submit a bid on a contract with a public entity for the construction or the repair of a public
building or public work, may not submit bids on leases of real property to a public entity, may not be awarded or perform
work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact
business with any public entity in excess of the threshold amount provided in section 287,017, F,S" for CATEGORY TWO
for a period of 36 months from the date of being placed on the convicted vendor list.
S. Patents, Copyrights, and Royalties
1. If any discovery or invention arises or is developed in the course or as a result of work or services performed under
this contract, or in anyway connected herewith, the provider shall refer the discovery or invention to the department to be
referred to the Department of State to determine whether patent protection will be sought in the name of the State of
Florida, Any and all patent rights accruing under or in connection with the performance of this contract are hereby
reserved to the State of Florida,
2. In the event that any books, manuals, films, or other copyrightable materials are produced, the provider shall notify
the Department of State. Any and all copyrights accruing under or in connection with the performance under this contract
are hereby reserved to the State of Florida.
3. The provider, without exception, shall indemnify and save harmless the State of Florida and its employees from
liability of any nature or kind, including cost and expenses for or on account of any copyrighted, patented, or unpatented
invention, process, or article manufactured by the provider. The provider has no liability when such claim is solely and
exclusively due to the Department of State's alteration of the article, The State of Florida will provide prompt written
notification of claim of copyright or patent infringement. Further, if such claim is made or is pending, the provider may, at
its option and expense, procure for the Department of State, the right to continue use of, replace, or modify the article to
render it non-infringing, If the provider uses any design, device, or materials covered by letters, patent, or copyright, it is
mutually agreed and understood without exception that the bid prices shall include all royalties or costs arising from the
use of such design, device, or materials in any way involved in the work.
T. Construction or Renovation of Facilities Using State Funds
That the department shall file a lien against any property that has been constructed or substantially renovated, in whole or
in part, through the use of state funds. However, the department is not required to file a lien if the amount of state funds
does not exceed $25,000 or 10 percent of the contract amount, whichever amount is less. As a condition of receipt of
state funding for this purpose, the provider agrees that, if it disposes of the property before the department's lien interest
is vacated, the provider will refund the proportionate share of the state's initial investment, as adjusted by depreciation.
U. Security Obligations
1. To identify an appropriately skilled individual to function as its Data Security Officer. This Security Officer shall act
as the liaison to the Department's Security Staff and will maintain an appropriate level of data security for the information
the provider is collecting or using in the performance of this contract. This includes approving and tracking all provider
employees that request system or information access and ensuring that user access has been removed from all
terminated provider employees,
2. To furnish Security Awareness Training to its staff,
3. To ensure that all provider employees that have access to departmental information are provided a copy of CFOP
50-6 and sign the DCF Security Agreement form (CF114), A copy may be obtained from the contract manager,
V. Accreditation
That the department is committed to ensuring provision of the highest quality services to the persons we serve,
Accordingly, the department has expectations that where accreditation is generally accepted nationwide as a clear
ihdicator of quality service, the majority of our providers will either be accredited, have a plan to meet nationaldaccreditation standards, or will initiate one within a reasonable period of time,
4 CONTRACT # KG034
1/1/01
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W. Agency for Workforce Innovation and Workforce Florida
That it understands that the department, the Agency for Workforce Innovation, and Workforce Florida, Inc. have jointly
implemented an initiative to empower recipients in the Temporary Assistance to Needy Families Program to enter and
remain in gainful employment. The department encourages provider participation with the Agency for Workforce
Innovation and Workforce Florida,
II. THE DEPARTMENT AGREES:
A. Contract Amount
To pay for contracted services according to the conditions of Attachment I in an amount not to exceed
$91.713.00 , subject to the availability of funds. The State of Florida's performance and obligation to pay under
this contract is contingent upon an annual appropriation by the Legislature, Any costs or services paid for under any other
contract or from any other source are not eligible for payment under this contract.
B. Contract Payment
Pursuant to section 215.422, F.S., the department has five (5) working days to inspect and approve goods and services,
unless the bid specifications, purchase order, or this contract specifies otherwise, With the exception of payments to
health care providers for hospital, medical, or other health care services, if payment is not available within 40 days,
measured from the latter of the date a properly completed invoice is received by the department or the goods or services
are received, inspected, and approved, a separate interest penalty set by the Comptroller pursuant to section 55.03, F,S"
will be due and payable in addition to the invoice amount. To obtain the applicable interest rate, contact the district fiscal
office/contract administrator, Payments to health care providers for hospital, medical, or other health care services, shall
be made not more than 35 days from the date eligibility for payment is determined. Financial penalties will be calculated
at the daily interest rate of .03333%. Invoices returned to a vendor due to preparation errors will result in a payment
delay. Interest penalties less than one dollar will not be enforced unless the vendor requests payment.
C. Vendor Ombudsman
A Vendor Ombudsman has been established within the Department of Banking and Finance, The duties of this office are
found in section 215.422 (7), F,S" which include disseminating information relative to the prompt payment of this state
and assisting vendors in receiving their payments in a timely manner from a state agency. The Vendor Ombudsman may
be contacted at (850) 410-9724 or 1-800-848-3792, the State of Florida Comptroller's Hotline,
D. Notice
Any notice, which is required under this contract, shall be in writing and sent by U.S, Postal Service or any expedited
delivery service that provides verification of delivery, to the designated address contained in this contract.
III. THE PROVIDER AND DEPARTMENT MUTUALLY AGREE:
A. Effective and Ending Dates
This contract shall begin on
parties, whichever is later. It shall end on
, or on the date on which the contract has been signed by both
June 30, 2002
July 1, 2001
B. Termination
1. This contract may be terminated by either party without cause, no less than thirty (30) calendar days notice in
writing to the other party unless a lesser time is mutually agreed upon in writing, Said notice shall be delivered by any
mailing service that provides verification of delivery or in person with proof of delivery.
2. In the event funds to finance this contract become unavailable, the department may terminate the contract upon no
less than twenty-four (24) hours notice in writing to the provider, Said notice shall be sent by U,S, Postal Service or any
expedited delivery service that provides verification of delivery, The department shall be the final authority as to the
availability and adequacy of funds, In the event of termination of this contract, the provider will be compensated for any
work satisfactorily completed,
3. This contract may be terminated for the provider's non-performance upon no less than twenty-four (24) hours notice
in writing to the provider. If applicable, the department may employ the default provisions in Chapter 60A-1,006(3), FAC,
Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and shall not
be construed to be a modification of the terms of this contract. The provisions herein do not limit the department's right to
remedies at law or in equity.
4. Failure to have performed any contractual obligations with the department in a manner satisfactory to the
department will be a sufficient cause for termination. To be terminated as a provider under this provision, the provider
must have: (1) previously failed to satisfactorily perform in a contract with the department, been notified by the
department of the unsatisfactory performance, and failed to correct the unsatisfactory performance to the satisfaction of
the department; or (2) had a contract terminated by the department for cause.
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CONTRACT # KG034
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C. Renegotiation or Modification
Modifications of provisions of this contract shall only be valid when they have been reduced to writing and duly signed by
both parties. The rate of payment and the total dollar amount may be adjusted retroactively to reflect price level increases
and changes in the rate of payment when these have been established through the appropriations process and
subsequently identified in the department's operating budget.
D. Official Payee and Representatives (Names, Addresses, and Telephone Numbers):
1. The provider name, as shown on page 1 of this 3. The name, address, and telephone number of the
contract, and mailing address of the official payee to contract manager for the department for this contract is:
whom the payment shall be made is: .
Monroe County In Home Services Theresa Phelan
5100 College Road Department of Children and Families
Key WEst, FL 33040 1111 12th Street, #301
Key West, FL 33040
305 / 292-6810
2. The name of the contact person and street address
where financial and administrative records are maintained
is:
Deloris Simpson
Monroe County In Home Services
Key WEst, FL 33040
4. The name, address, and telephone number of the
representative of the provider responsible for
administration of the program under this contract is:
Deloris Simpson
Monroe County In Home Services
5100 College Road, Key West, FL 33040
305 / 292-4589
5. Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided
in writing to the other party and the notification attached to the originals of this contract.
E. All Terms and Conditions Included
This contract and its attachments, I and II and
exhibits referenced in said attachments, together with any documents incorporated by reference, contain all the terms and
conditions agreed upon by the parties, There are no provisions, terms, conditions, or obligations other than those
contained herein, and this contract shall supersede all previous communications, representations, or agreements, either
verbal or written between the parties, If any term or provision of this contract is legally determined unlawful or
unenforceable, the remainder of the contract shall remain in full force and effect and such term or provision shall be
stricken.
By signing this contract, the parties agree that they have read and agree to the entire contract, as described in
Paragraph III.E. above.
IN WITNESS THEREOF, the parties hereto have caused this ~ page contract to be executed by their undersigned
officials as duly authorized,
PROVIDER:
Monroe County In Home Services
FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES
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Charles M. Auslander
NAME:
TITLE:
DATE:
George Neugent
Mayor
NAME:
TITLE:
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DATE:
District Administrator
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Provider Fiscal Year Ending Date:~ / ~
CONTRACT # KG034
07/01/2001
Commur Care for Disabled Adults/Fixed Price . - - -0 _ _._
Adult Services Program
ATTACHMENT I
A. Services to be Provided
1. Definition of Terms
a. Contract Terms
(1) Amendment - A document by which substantial changes are made to
the terms of an executed contract. Changes requiring an amendment
include, but are not limited to adjustments in costs, services, time period,
and method of payment. The amendment is incorporated as part of the
original contract.
(2) Contract - A contract, for the purposes of this document, is a formal
written agreement between the department and an individual or
organization for the procurement of services. A contract consists of the
Standard Contract, Program Specific Model Attachment I, (PSMAI) /
Attachment I including special provisions where appropriate, plus any
other attachments or exhibits deemed necessary. Per Chapter 287,
Florida Statutes (F.S.), a contract must be signed by both parties prior to
services being rendered.
(3) Contract Manager - The department's employee responsible for
enforcing the performance of contract terms and conditions. The contract
manager is the department's primary point of contact through which all
contracting information flows between the department and the provider.
(4) Contract Term - The period of time beginning with the contract start
date and ending with the contract end date.
(5) Department - Florida Department of Children and Families, unless
otherwise stated.
(6) District - The Florida Department of Children and Families' territorial
division pertaining to a geographical service area.
(7) Exhibit - Information appended to an Attachment I or any other
contract attachment. The use of the word "exhibit" avoids confusion and
allows for clearer referencing. All exhibits to an Attachment I/PSMAI must
be referenced in that Attachment I/PSMAI.
(8) Federal Fiscal Year - An accounting period of twelve Consecutive
months starting on October 1 and ending on the last day of September.
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(9) Fixed Price - Method of payment used when the service provided can
be broken down into unit cost (e.g., hours, client days, etc.), or a fixed fee
(e.g., payment based on delivery of a complete service).
(10) Invoice - A completed and timely submitted document used by the
provider to request payment from the department.
(11) Match - A contribution, in cash or in kind, specified by the funding
source to be used in conjunction with the donation of the funding source,
and upon which receipt of that donation is contingent.
(12) Method of Payment - This is the third section of an Attachment
lIPS MAl. It specifies the total or maximum dollar amount of the contract,
the manner in which contract costs will be displayed on invoices, the
frequency with which invoices will be submitted to the department, and
any special conditions pertaining to payment of contract invoices.
(13) Provider - An organization or individual providing services or
materials to the department in accordance with the terms of the contract.
This term is also known as "contractor."
(14) Provider Fiscal Year - An accounting period of twelve consecutive
months.
(15) Region - The Department of Children and Families' specified
territory or geographical service area.
(16) State Fiscal Year - An accounting period of twelve consecutive
months starting on July 1 and ending on the last day of June.
b. Program or Service Specific Terms
A glossary of approved terms is contained in The Community Care for
Disabled Adults Instructional Guide, Section D, herein incorporated by
reference and included in the contract manager's file.
(1) Activities of Daily Living (ADL) - Basic activities performed in the
course of daily living, such as dressing, bathing, grooming, eating,
toileting, and ambulating around one's own home.
(2) Client - Any person at least eighteen years old, but under sixty years
of age, who has one or more permanent physical or mental limitations that
restrict his ability to perform normal activities of daily living, and impede
his capacity to live independently or with relatives or friends without the
provision of community-based services.
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(3) Medicaid Institutional Care Program (MICP) - A program that serves
Medicaid recipients who are determined eligible for a nursing home level
of care, which provides primary, acute, and long-term care services at
capitated federally-matched rates.
2. General Description
a. General Statement
(1) The Community Care for Disabled Adults (CCDA) Program is
designed to assist disabled adults, age eighteen through fifty-nine, in
utilizing available community and personal resources to help them remain
in their homes, and to prevent them from premature or inappropriate
institutionalization.
(2) Service providers will ensure that appropriate community-based
services (including duration, frequency, and scope of care plan) are
provided to clients in a manner developed to meet the client's changing
needs.
b. Authority
Sections 410.601-606, F.S., Chapter 65C-2, Florida Administrative Code
(F.A.C.), and the annual appropriations act, with any proviso language or
instructions to the department, constitute the legal basis for services to be
delivered through the CCDA.
c. Scope of Service
Services will be targeted toward eligible adults, age eighteen through fifty-
nine, in the following Florida counties: Monroe.
d. Major Program Goal
The community-based services provided under this contract are designed
to prevent unnecessary institutionalization of disabled adults.
3. Clients to be Served
a. General Description
Adults with disabilities, age eighteen through fifty-nine, who are no longer
eligible to receive children's services, and are too young to qualify for
community and home-based services for the elderly, may be served under
the provisions of this contract.
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b. Client Eligibility
(1) Clients must have one or more permanent physical or mental
limitations, that restrict the ability to perform normal activities of daily
living, as determined through the initial functional assessment and
medical documentation of disability. Determination of a disability must be
established and evidenced in one of the following manners:
(a) A client may present a check, awards letter, or other proof
showing receipt of Social Security Disability, or some other
disability payment (e.g., Worker's Compensation); or
(b) A client may present a written statement from a licensed
physician, licensed nurse practitioner, or mental health
professional, which meets the district's criteria for evidence of a
disability. This written statement must, at a minimum, include the
client's diagnosis, prognosis, a broad explanation of level of
functioning, and the interpretation of need for services based on
identified functional barriers caused by the client's disabling
condition.
(2) Clients must have an individual income at or below the prevailing
MICP eligibility standard in order to receive free CCDA services. Clients
with incomes above the standard will be assessed for a share of the
costs, or may be required to provide volunteer services in lieu of payment.
(3) The total annual cost, estimated or actual, for an individual receiving
CCDA services, shall not exceed the average annual general revenue
portion of a Medicaid nursing home bed within the district area.
c. Client Determination
(1) Clients will be assessed for eligibility determination, and prioritized for
services by district or provider case management staff, in accordance with
subsection 410.604 (2), F.S.
(2) The department will determine client eligibility for this program. The
department's contract manager will make the final determination in the
event of a dispute regarding client eligibility.
(3) Clients must not be receiving comparable services from any other
entity. In order to prevent duplication of services, client files must contain
documentation verifying that all comparable community services and
funding sources have been explored and exhausted.
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d. Contract Limits
The provider shall deliver services only to those persons who meet
program eligibility criteria, and only to the extent that funds are available.
B. Manner of Service Provision
1. Service Tasks
a. Task List
(1) This contract will provide the following CCDA services: (Services are
marked accordingly: X) The Guide provides descriptions and minimum
requirements for each service listed.
DAdult Day Care X Case
Management
X Personal Care DHome Health Aide
X Homemaker DHome Nursing
Dlnterpreter DTransportation
X Chore DRespite
DEscort
DEmergency Alert
Response
DGroup Activity
Therapy
X Home Delivered
Meals
DMedical Therapeutic
Services
DPhysical and
Exams
(2) Details of services to be provided under this contract and the
negotiated parameters of those services: There are no additional
negotiated details.
b. Task Limits
(1) Each district CCDA program shall include case management services
and at least one other community service.
(2) Respite care may be provided for up to 240 hours per client per
calendar year, depending upon individual need. The service may be
extended to 360 hours, as recommended by the case manager and
approved by an immediate supervisor. Documentation of approval must
be evident in the case narrative section of the case manager's file.
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(3) Personal Care Services will not substitute for the care usually
provided by a registered nurse, licensed practical nurse, therapist, or
home health aide. The personal care aide will not change sterile
dressings, irrigate body cavities, administer medications, or perform other
activities prohibited by Chapter 59A-8, F .A.C.
(4) Homemaker Service time does not include time spent in transit to and
from the client's place of residence except when providing shopping
assistance, performing errands or other tasks on behalf of a client.
(5) Several restrictions apply to persons providing Homemaker Service
activities. Persons providing services must not:
(a) engage in work that is not specified in the Homemaker
assignment;
(b) accept gifts from clients;
(c) lend or borrow money or articles from clients;
(d) handle client money, unless authorized in writing by a
supervisor or case manager (as evident in the personnel file) and
unless bonded or insured by the employer;
(e) transport clients, unless authorized in writing by a supervisor or
case manager.
(6) The parameters of service delivery, by type of service, are detailed in
the Guide.
(7) District task limits, which exceed those in the Guide, and are
distinctive to this contract, are listed here: There are no District
specific task limits.
2. Staffing Requirements
a. Staffing Levels
(1) The provider will meet the minimum staffing requirements for each
service, as specified in the Guide.
(2) The provider will notify the department within thirty days whenever the
provider is unable, or expects to be unable, to provide the required quality
or quantity of service because of staff turnovers or shortages.
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b. Professional Qualifications
The provider will ensure that staff meets the professional qualifications for
each service, as specified in the Guide.
c. Staffing Changes
The provider agrees to notify the department's contract manager within
two working days if an administrative position (e.g., executive director)
becomes vacant. Planned staffing changes that may affect service
delivery, as stipulated in this contract, must be presented in writing to the
contract manager for approval at least two weeks prior to the
implementation of the change,
d. Subcontractors
The provider is responsible for the performance of its subcontractors.
Copies of all performance monitoring reports shall be made available to
the department.
3. Service Location & Equipment
a. Service Delivery Location & Times
(1) CCDA services may be delivered in the client's home or on-site at a
facility, as negotiated by the department and the provider.
(2) Facilities delivering on-site services to clients shall pass an annual
inspection by the local environmental health and fire authorities.
(3) Service providers will meet the minimum service location and time
requirements as specified in the Guide.
(4) Services for this contract will be delivered at the following location(s)
and times:
SERVICE LOCATION TIME
Case Management Client's Home As Needed
Homemaker Client's Home As Needed
Personal Care Client's Home As Needed
Home Delivered Meals Client's Home As Needed
Chore Client's Home As Needed
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b. Changes in Location
The department and the provider must negotiate location of service
delivery and evidence of this negotiation must be included in either the
provider's Application or in this Attachment I. Once the service delivery
location is agreed upon, any proposed change must be presented in
writing to the contract manager for approval, prior to implementation of
that proposed change. In the event of an emergency, temporary changes
in location may necessitate waiver of this designated standard by the
district's program office. Such a waiver will take into consideration the
continuity, safety, and welfare of the department's clients, and is at the
department's sole discretion.
c. Equipment
(1) The equipment required to perform the contracted services must be
negotiated by the department and the provider. To ensure uniformity,
safety, and quality of service to clients, any requests for equipment
change must be presented in writing to the contract manager for approval
at least ten days prior to any proposed change.
(2) The provider must inventory all equipment acquired under this
contract annually. The inventory list must be made available within seven
days upon receipt of written request by the contract manager.
4. Deliverables
a. Service Units
A service unit is an appropriate, distinct amount of given service, which
may include, but is not limited to, an hour or quarter hour of direct service
delivery; a meal; an episode of travel; or a twenty-four hour period of
Emergency Alert Response maintenance, as defined in the Guide.
b. Reports
(1) Reporting requirements for this contract include, Exhibit A, Quarterly
Cumulative Summary Report. Districts will negotiate with the provider on
specific submission requirement criteria for this report.
(2) Providers of case management services agree to submit quarterly
reports, which include management program data (e.g., client identifiable
data) to the department, according to negotiated instructions provided by
the districts. The quarterly reports are due according to the following
schedule:
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Quarterly Cumulative Summary Report Due Date
three month October 30
six month February 15
nine month April 30
twelve month August 15
(3) In the event of early termination of this contract, the provider will
submit the final Cumulative Summary Report within 45 days after the
contract is terminated.
c. Records and Documentation
(1) Case Management provider files shall contain the following:
(a) a completed client assessment (not more than one year old)
(b) a care plan (not more than one year old)
(c) a release of information form
(d) a copy of a completed Client Information System (CIS) form
(e) documentation of the client's age, disability, and income
(f) a copy of the referral/intake form
(g) a case narrative.
(2) Providers shall maintain information on each client served by this
contract, which includes the following:
(a) documentation of the client by name or unique identifier
(b) current documentation of eligibility for services
(c) number of service units provided
(d) dates of service provision and delivery
(e) information documenting the client's need to receive services
(f) the number of service units provided
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(g) all other forms or records necessary for program operation and
reporting, as set forth by the department.
(3) Providers must ensure that all client records match the invoices
submitted for payment. Records must track to each invoice for payment.
(4) Providers must maintain documentation necessary to facilitate
monitoring and evaluation by the department.
(5) The case management provider must maintain documentation in the
client's file that all existing funding sources have been explored and
exhausted before using CCDA funding.
5. Performance Specifications
a. Performance Measures (Outcomes and Outputs)
(1) 100% of clients will not be placed in a nursing home.
(2) 30 clients will be served through this contract.
(3) 95% of clients will be satisfied with services based upon responses to
the Department Client Satisfaction Survey. The provider will administer
the Department Client Satisfaction Survey to a representative sample of
clients in accordance with the table provided in section B.5.b. below.
b. Standards Definitions
(1) Clients - Eligible individuals who have met the eligibility criteria outline
in section A.3.b. of this Attachment, and who have received case
management or any of the other services funded through the CCDA
program during the fiscal year evaluated.
(2) Eligible Individuals - Clients who meet the eligibility criteria outlined in
sectionA.3.b. of this attachment.
(3) Nursing home - Any facility which provides nursing services as
defined in Chapter 464 F.S., licensed in accordance with Ch. 400, F.S.
(4) Outcomes - Quantitative indicators that can be used by the
department to objectively measure a provider's performance toward a
stated goal.
(5) Outputs - Process measures of the quantity(s) of services delivered,
clients served, or similar units completed.
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(6) Performance Measures - Quantitative indicators, outcomes and
outputs, that can be used by the department to objectively measure a
provider's performance.
(7) Placed - Assessment of an individual who is no longer able to remain
in his present place of residence. (To place a client involves preparation
for and follow up of moving a client into a more restrictive alternative living
environment. )
(8) Will be served - The eligible individuals who will receive case
management or negotiated service under this contract.
(9) The table below identifies the minimum number of clients for which
completed surveys are required in order to report results for the provider's
annual case load at the ninety percent (90%) confidence level, with a five
percent (5%) error rate. Annual caseload shall mean all clients who reach
a point in their service plans during the year containing a trigger point.
Trigger points are the appropriate points in time or service that a client
shall be given the Department Client Satisfaction Survey to complete, for
example at recertification, six months after admission, case closure, or at
some other point. The department will determine trigger points for each
affected client group, and contract managers will provide the information
to the provider.
Sample Sizes for Contract Providers
Fiscal Year 2001 - 2002
Number of Clients Served in the Required Minimum Sample
Fiscal Year
Less than 59 All Clients
59 - 74 58
75 -100 73
1 01 - 150 97
151 - 200 115
201 - 250 130
251 - 300 143
301 - 350 153
351 - 500 176
501 - 750 199
751 - 1,000 213
1,001 - 1,500 229
1,501 - 2,000 238
2,001 and over 250
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Satisfaction shall be determined by calculating a percentage of client
responses that "agree" or "strongly agree" to the survey question,
"Overall, I am satisfied with the services that I received."
c. Monitoring and Evaluation Methodology
(1) All monitoring activity performed by the District will be in accordance
with CFOP 75-8, Contract Monitoring.
(a) By execution of this contract, the provider hereby acknowledges
and agrees that its performance under the contract must meet
the standards set forth above and will be bound by the
conditions set forth below. If the provider fails to meet these
standards, the department, at its exclusive option, may allow up
to six months for the provider to achieve compliance with the
standards. If the department affords the provider an opportunity
to achieve compliance, and the provider fails to achieve
compliance within the specified time frame, the department will
terminate the contract in the absence of any extenuating or
mitigating circumstances. The determination of the extenuating
or mitigating circumstances is the exclusive determination of the
department.
(b) The Contract Performance Unit ("CPU") may elect to perform an
on-site administrative and programmatic monitoring during the
contract period. At a minimum, an annual desk monitoring will
be performed which will be accomplished by a combination of
the review(s) of reports or other documentation submitted by
the provider, input from service recipients and others, and visits
to the site of service delivery for programmatic review.
(c) For on-site monitorings, a random discovery sample of open
and closed files will be taken for review. This sample may be
increased to a random statistical sample depending on the
results of our review. The number of files reviewed will be
contingent upon the population size of services rendered. To
facilitate the sampling process, upon CPU request, the provider
shall submit an universal events listing of all services provided
under the contract prior to the monitoring visit.
(d) A report outlining the department's findings during the on-site
monitoring will be submitted to the provider within 30 days of
concluding field work with an exit conference. The provider
agrees to respond and submit a corrective action plan, if
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required, within 30 days of receiving the department's
monitoring report.
d. Performance Definitions
There are no District specific performance definitions.
6. Provider Responsibilities
a. Provider Unique Activities
In addition to the staffing requirements in the approved application or
program proposal, the provider will be required to use volunteers to the
fullest extent feasible in the provision of services and program operations.
The provider is required to train, supervise, and appropriately support all
volunteers with insurance coverage.
b. Coordination with Other Providers/Entities
(1) The case management provider must coordinate, as necessary, with
The Developmental Services Office of the Department of Children and
Families, the Department of Education, The Department of Health, and
the Florida Statewide Advocacy Council, to serve those clients who are
eligible for services through two or more service delivery continuums.
(2) All providers must comply with the local environmental health and fire
authorities' annual inspections.
7. Departmental Responsibilities
a. Department Obligations
(1) The department will supply all new providers with a copy of the
CCDA Program Manual (HRSM 140-8) and the Guide.
(2) The department will provide CCDA technical assistance to the
provider, relative to the negotiated terms of this contract and instructions
for submission of required data.
b. Department Determinations
Should a dispute arise, the department will make the final determination
as to whether or not the contract terms are being fulfilled according to the
contract specifications.
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C. Method of Payment
1. Payment Clause
a. This is a Fixed Price contract. The department shall pay the provider
for the delivery of service units provided in accordance with the terms of
this contract for a total dollar amount not to exceed $91,713.00, subject to
the availability of funds.
b. The department shall make payment to the provider for provision of
services up to the maximum number of units of service at the rates shown
below.
Service Unit Rate Maximum Units
T otal/Department to be Delivered
Case Management $44.498 / Hour 178 Hours
Homemaker $26.631/ Hour 1056 Hours
Personal Care $32.976/ Hour 639 Hours
Home Delivered Meals $ 6.732 / Meal 4753 Meals
Chore $33.859/ Hour 90 Hours
c. The provider's dollar match for this contract is $10,190.00. Case
management and transportation services may be exempt from match
requirement at the discretion of each district.
2. Invoice Requirements
The provider shall request payment through submission of a properly completed
Invoice, Exhibit 8, within 15 days following the completion of all terms and
conditions for the delivery of service under this contract. If the provider fails to
do so, all right to payment is forfeited, and the department will not honor any
requests submitted after the aforesaid time period. Payment due under this
contract will be withheld until the department has approved the final product.
Replication of the form via data processing equipment is permissible; replications
must include all data elements included on the departmental form.
3. Supporting Documentation
a. The provider shall submit to the contract manager an original Invoice,
Exhibit 8, along with supporting documentation, for payment on a
monthly basis. The due date for these invoices is the 15th day of the
month following the month being reported.
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b. It is expressly understood by the provider that any payment due the
provider under the terms of this contract may be withheld pending the
receipt and approval by the department of all financial and program
reports due from the provider as a part of this contract and any
adjustments thereto. Requests for payment, which cannot be
documented with supporting evidence, will be returned to the provider
upon inspection by the department.
c. The provider must maintain records documenting the total number of
recipients and names (or unique identifiers) of recipients to whom services
were provided and the dates the services were provided so that an audit
trail documenting service provision can be maintained.
4. Medicaid Billing
The department and the provider specifically agree and acknowledge that the
Medicaid program is the payor of last resort and:
a. in no event shall the provider bill the Medicaid program for services or
expenses for Medicaid recipients for which the provider has already been
paid by any other liable third party, and
b. provider services covered under the Florida Medicaid program for
Medicaid recipients may be billed to the Medicaid program by the
provider, unless the provider is already being paid by any other liable
third party, and
c. authorized provider services to non-Medicaid recipients, or for non-
Medicaid covered services, may only be billed to the department or any
other non-Medicaid first or third party payor, and
d. the provider shall identify and report Medicaid earning separate from
all other fees, and
e. Medicaid earnings cannot be used as local match, and
f. the provider will ensure that Medicaid payments are accounted for in
compliance with federal regulations, and
g. in no event shall both Medicaid and the department be billed for the
same service.
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D. Special Provisions
1. Fees
a. The provider will collect fees for services provided according to Rule
65C-2.007, F.A.C.
b. No fees shall be assessed other than those set by the department.
Fees collected in compliance with the department directives will be
disposed of in a manner prescribed by the department.
2. Florida Statewide Advocacy Council
The provider agrees to allow properly identified members of the Florida
Statewide Advocacy Council access to the facility or agency and the right to
communicate with any client being served, as well as staff or volunteers who
serve them in accordance with subsections 402.165(8) (a) & (b), F.S. Members
of the Florida Statewide Advocacy Council shall be free to examine all records
pertaining to any case unless legal prohibition exists to prevent disclosure of
those records.
3. Transportation Disadvantaged
The provider agrees to comply with the provisions of Chapter 427, F.S., Part I,
Transportation Services, and Chapter 41-2, F.A.C., Commission for the
Transportation Disadvantaged, if public funds provided under this contract will be
used to transport clients. The provider agrees to comply with the provisions of
CFOP 40-5 if public funds provided under this contract will be used to purchase
vehicles which will be used to transport clients.
4. Medicaid Waiver Report
The provider agrees to submit a monthly report of actual program expenditures
billed through the Medicaid Waiver program no later than the 10lh day following
the end of the report period. This report will include expenditures billed by the
provider and any other program subcontractor.
5. Non-expendable Property
a. Non-expendable property is defined as tangible personal property
of a non-consumable nature that has an acquisition value or cost of
$1,000 or more per unit and an expected useful life of at least one
year, and hardback bound books that are not circulated to students
or the general public, the value or cost of which is $250 or more.
Hardback books with a value or cost of $25 or more should be
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classified as an Other Capital Outlay expenditure only if they are
circulated to students or to the general public. The provider will use
Exhibit C to report all capital assets purchased through funding
provided by the Department for prior and current year contract.
b. All such property purchased under this contract shall be listed on
the property records of the provider. Said listing shall include a
description of the property, model number, manufacturer's number,
manufacturer's serial number, funding source, information needed
to calculate the federal and/or state share, date of acquisition, unit
cost, property inventory number and information on the location,
use and condition, transfer, replacement, or disposition of the
property.
c. All such property purchased under this contract shall be inventoried
annually and an inventory report shall be submitted to the
Department along with the final expenditure report. A report of non- '
expendable property shall be submitted to the Department along
with the expenditure report for the period in which it was
purchased.
d. Title (ownership) to all non-expendable property acquired with
funds from this contract shall be vested in the Department upon
completion or termination of the contract.
e. At no time shall the provider dispose of non-expendable property
purchased under this contract except with the permission of, and in
accordance with, instructions from the Department.
f. A formal contract amendment is required prior to the purchase of
any item of non-expendable property not specifically listed in the
approved contract budget.
6. Information Technology Resources.
All contract providers must adhere to the Department's procedures and
standards when purchasing Information Technology Resources (ITRs) as
part of this contract. These resources will revert to the Department at the
conclusion of the contract. ITRs are data processing hardware, software,
service, supplies, maintenance, training, personnel, and facilities. The
provider agrees to secure prior written approval through the contract
manager from the District Management Systems Director for the purchase
of any ITR. The provider will not be reimbursed for any purchase made
prior to this written approval.
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7. Morals Clause
The provider understands that performance under this contract involves
the expenditure of public funds from both the state and federal
governments, and that the acceptance of such funds obligates the
provider to perform its services in accordance with the very highest
standards of ethical and moral conduct. Public funds may not be used for
purposes of lobbying, or for political contributions, or for any expense
related to such activities, pursuant to Section I R of the Standard Contract
of this contract. The provider understands that the Department is a public
agency which is mandated to conduct business in the sunshine, pursuant
to Florida Law, and that all issues relating to the business of the
Department and the provider are public record and subject to full
disclosure. The provider understands that attempting to exercise undue
influence on the Department and its employees to allow deviation or
variance from the terms of this contract other than negotiated, publicly
disclosed amendment, is prohibited by the State of Florida, pursuant to,
Section III C of the Standard Contract. The provider's conduct is subject
to all state and federal laws governing the conduct of entities engaged in
the business of providing services to government.
8. Year 2000 Compliance Warranty (Existing Hardware and Software)
The provider shall warrant that their existing hardware and software shall
not experience abnormal ending and/or produce invalid or incorrect
results in the operation of the business of the State after the turn of the
century. In the event of any recognition, calculation, or indication of
century problems related to the Year 2000, the provider shall warrant that
they will make all code adjustments necessary at no cost to the State in
order to ensure that the code and databases are "Year 2000 Compliant".
The warranty shall be in effect until December 31, 2000 or one year after
system reconfiguration, which ever is later.
Year 2000 compliant: "Year 2000 compliance" means that information
resources meet the following criteria and/or perform as described.
a. Data structures (databases, data filed, etc.) provide 4-digit data
century recognition. Example: "1996" provides "data century
recognition", "96 does not.
b. Stored data contains date century recognition, including (but not
limited to) data stored in databases and hardware/device internal
system dates.
3/21/2001
24.
PSMAI No. GA 07
Contract No. KG034
~ - .. ~ - ---
07/01/2001
Community Cart. . j Disabled Adults/Fixed Price
Adult Services Program
C.
Calculations and program logic accommodate both same century
and multi-century formulas and data values. Calculations and logic
include (but are not limited) sort algorithms, calendar generations,
event recognition, and all processing actions that use or produce
data values.
d.
Interfaces (to and from other systems or organization) prevent non-
compliant dates and data from entering or exiting any state system.
e.
User interfaces-(i.e. screens, reports, etc.) accurately show 4-digit
years (if critical to business functions).
f. Year 2000 is correctly treated as a leap year within all
calculation and calendar logic.
9. Year 2000 Compliance Warranty - (New Hardware and Software
Purchases)
For purposes of this Year 2000 warranty, the term "Product" shall include
software, firmware, microcode, hardware and embedded chip technology.
Provider warrants that the Product is Year 2000 Compliant. All versions
of the Product offered by the provider and purchased by the State, for
which provider is obligated to provide maintenance service are, and in the
future, will be, Year 2000 Compliant. Year 2000 Compliant means the
Product will include the ability to: consistently handle date information
before, during, and after January 1, 2000, including accepting date input,
providing date output, and processing dates; function before, during and
after January 1, 2000, without the need for program changes caused by
the advent of the new century; properly handle all date related information
before and following Jan. 1, 2001, including but not limited to accurate
and reliable performance in processing date and date related data,
including calculating, comparing and sequencing; properly process any
and all date calculations before, on and after the leap year date of
February 29, 2000 and store and provide output of date information in
ways that are unambiguous as to century.
The duration of this warranty and the remedies available to the State for
breach of this warranty shall be defined in, and subject to, the terms and
limitations of any general warranty provisions of this contract, provided
that notwithstanding any provision to the contrary in such warranty
provision(s), or in the absence of any such warranty provision(s), defects
in the Product with regard to Year 2000 Compliance, if any, will be
corrected by provider at provider's cost within a timeframe mutually
agreed upon with the State. Provider cannot be held responsible for
errors resulting from devices or systems external to this contract which are
3/21/2001
25,
PSMAI No. GA 07
Contract No. KG034
07/01/2001
Community Carl Disabled Adults/Fixed Price . - - -. - _.-
Adult Services Program
permitted to directly access any database provided under this Agreement
and overwrite Product date fields or from the users improper integration of
non-Year 2000 Compliant systems. Nothing in this warranty shall be
construed to limit any rights or remedies the State may otherwise have
under this contract with respect to defects other than Year 2000
performance.
10. Year 2000 Remedy Clause
In the event of any decrease in product functionality related to time and
date related codes and internal subroutines that impede the hardware or
software programs from operating beyond the Millennium Date Change,
Licensors and providers or Licensors products, agree to immediately
make required corrections to restore hardware and software programs to
the same level of functionality as warranted herein at no charge to the
licensee, and without interruption to the ongoing business of the licensee,
time being of the essence.
11. Resellers
All products bid under this bid/contract will be Year 2000 compliant. Year
2000 Compliant means the Product will include the ability to: consistently
handle date information before, during, and after January 1, 2000,
including accepting date input, providing date output, and processing
dates; function before, during and after January 1, 2000, without the need
for program changes caused by the advent of the new century; properly
handle all date related information before and following Jan. 1,2001,
including but not limited to accurate and reliable performance in
processing date and date related data, including calculating, comparing
and sequencing; properly process any and all date calculations before, on
and after the leap year date of February 29, 2000 and store and provide
output of date information in ways that are unambiguous as to century.
Resellers may provide a "pass through warranty" from the
manufacturer/software developer, which meets all the warranty
requirements by the State, and which shall include all other warranties
provided by the manufacturer or software developer. Reseller shall be
responsible for warranty assurance, assistance, enforcement and any
other actions or remediation, required to satisfy warranty requirements.
12. Incident Reporting
The Provider is required to document all reportable incidents, as defined
in the District 11 Uniform Incident Reporting Protocol for Incident
Reporting and Client Risk Prevention For Critical and Non-Critical
Incidents, which is incorporated herein by reference.
3/21/2001
26,
PSMAI No. GA 07
Contract No. KG034
07/01/2001
. Community Carl. ( Disabled Adults/Fixed Price'
Adult Services Program
.--..~----
For each incident occurring during the administration of its program, the
Provider must, within 24 hours of the incident, complete and submit the
District's approved Incident Report to the respective department program
incident report liaison. It is the Provider's responsibility to use the most
current District 11 approved incident report for this purpose. A copy of the
incident report must be placed in a central file marked "Incident Report"
and in each client's file involved in the incident. Dissemination of the
report within the department will be the responsibility of the department's
program incident report liaison.
Incidents that threaten the health, safety or welfare of any person or that
place any person in imminent danger must be reported immediately to the
department by telephonic contact.
The information contained in the incident report is confidential. The
dissemination, distribution or copying of the report is strictly prohibited,
unless authorized by the Department.
13. Security Agreement
The Provider agrees to submit to the Department Contract Manager an
original signed Security Agreement Form CF-114 (Exhibit D) for all
required personnel no later than thirty (30) days following the execution of
this contract or thirty (30) days from date of employment. All personnel
who require access to departmental information must sign the Security
Agreement Form prior to receiving access to the information.
3/21/2001
27,
PSMAI No. GA 07
Contract No. KG034
7/212001
.:>mmunity Care for Disabled Aaa1ts---
Quarterly Cummulative Summary Reports
f:;f!~f:~~~
Exhibit A
Fiscal Year 2001-2002
Community Care for Disabled Adults Quarterly Summary Report
Local
Reporting Period:
3 Month
6 Month
9 Month
12 Month
District: 11 B
Name of Contract Manager:
Phone Number: SC
I. Expenditures
(1) Total CCDA dollars:
(2) Total expenditures this quarter:
(3) Total expenditures spent to date:
(4) Encumbrances *:
(5) Balance:
II. Report Prepared By:
III. Phone Number:
GA07
Contract No. KG034
~
07/0112001
Community Care for Disabled Adults--
Adult Services Program
DEPARTMENT OF CHILDREN AND FAMILIES Exhibit B
OFFICE OF FAMILY SAFETY
MONTHLY REQUEST FOR PAYMENT AND EXPENDITURE REPORT
PROVIDER FED. ID #
NAME AND MAILING ADDRESS OF PAYEE:
CONTRACT AMNT.:_
REIMBURSEMENT YTD.:_
CONTRACT BALANCE:
DATE:
CONTRACT#:
PERIOD OF SERVICE PROVISION:
NAME OF SERVICE UN ITSI AMOUNT PER UNITI TOTAL AMOUNT
OR DESCRIPTION OF MATERIALS QUANTITY EPISODE DUE
TOTAL
TOTAL MATCH REQUIRED PAYMENT
FOR CONTRACT: REQUESTED
THIS MNTH, YTD,
LOCAL CASH MATCH r\ FLORIDA DEPARTMENT OF
LOCAL IN-KIND CH I LDREN
TOTAL DEDUCTIONS
REMAINING MATCH BALANCE ~ & FAMILIES
SIGNITURE OF PREPARER
APPROVED BY
DATE COMPLETED
TITLE
.IF THIS INVOICE IS FOR A FIXEO PRICE CONTRACT, THE REQUEST FOR PAYMENT WILL BE DETERMINEO
BY DIVIDING THE LENGTH OF THE CONTRACT INTO THE CONTRACTED AMOUNT (EX.-S12,OOO(ALLOCATION) DIVIDED BY
12 MONTHS [THE LENGTH OF THE CONTRACT)=Sl,OOO PAYMENT REQUEST) ON A COST REIMBURSEMENT CONTRACT
THE PAYMENT REQUEST WlU BE THE MONTHLY REQUEST EXPENSE.
CHILDREN AND FAMILIES USE ONLY
DATE INV, RCD.
APPROVED BY:
DATE
IORG
EO
OBJ
DESC,
AMNT.
IOCA
Contract Page No. 2. e;
GA07
Contract No. KG034
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---~----
~LCIH ILDREN
~ & FAMILIES
EXHIBIT D
SECURITY AGREEMENT FORM
The Department of Children and Families has authorized you:
Employee's Name/Organization
to have access to sensitive data through the use of computer-related media (e.g., printed reports,
microfiche, system inquiry, on-line update, or any magnetic media).
Computer crimes are a violation of the department's disciplinary standards and, in addition to
departmental discipline, the commission of computer crimes may result in Federal and/or State
felony criminal charges.
. By my signature, I acknowledge that I have received, read and understand the Computer
Related Crimes Act, Chapter 815, F.S.
. By my signature, I acknowledge that I have received, read and understand Sections 7213,
7213A, and 7431 of the Internal Revenue Code, which provide civil and criminal penalties
for unauthorized inspection or disclosure of Federal tax data.
. By my signature, I acknowledge that it is the policy of the Department of Children and
Families that under no circumstances shall any contract employee be allowed access
to IRS tax information.
I understand that a security violation may result in criminal prosecution according to the provisions
of Federal and State statutes and may also result in disciplinary action against me according to the
provisions in the Employee Handbook. The minimum department security requirements are:
. Personal passwords are not to be disclosed.
. Information is not to be obtained for my own or another person's personal use.
Print Employee's Name
Signature of Employee
Date
Print Supervisor's Name
Signature of Supervisor
Date
CF 114, JF 0212001
1,4
Distribution ot Copies: Original - Personnel File/Contract File
Copy - Security File
Copy - Employee
- - ". - ...--
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
This attachment is applicable if the provider is any state or local government entity,
non-profit organization, or for-profit organization. For State or local government entities,
a Single Audit performed by the Auditor General shall satisfy the requirements of this
attachment. If the provider does not meet any of the requirements below, no audit is
required by this attachment.
P ART I: FEDERAL AUDIT REQUIREMENTS
This part is applicable if the recipient is a State or local government or a non-profit
organization as defined in OMB Circular A-133, as revised.
In the event that the recipient expends $300,000 or more in Federal awards in its fiscal
year, the recipient must have a single or program-specific audit conducted in accordance
with the provisions of OMB Circular A-I33, as revised. In determining the Federal
awards expended in its fiscal year, the recipient shall consider all sources of Federal
awards. The determination of amounts of Federal awards expended should be in
accordance with guidelines established by OMB Circular A-I33, as revised. An audit of
the recipient conducted by the Auditor General in accordance with the provisions of OMB
Circular A-133, as revised, will meet the requirements of this part. In connection with the
audit requirements, the recipient shall fulfill the requirements relative to auditee
responsibilities as provided in Subpart C of OMB Circular A-133, as revised.
The reporting package shall include a schedule that discloses the amount of expenditures
by contract number for each contract with the department in effect during the audit
period. Compliance findings related to contracts with the department shall be based on
contract requirements including any rules, regulations, or statutes referenced in the
contract. The reporting package shall disclose whether or not the matching requirement
was met for each applicable contract. All questioned costs and amounts due to the
department shall be fully disclosed in the report with reference to the department contract
involved.
For recipients who are subject to both Part I and Part II below, the audit must also
address applicable State audit requirements.
CF 1120, JF 07/01
32-
PART II: STATE REQUIREMENTS
In the event the recipient expends a total amount of State financial assistance to carry out
state projects equal to or in excess of $300,000 in any fiscal year of such recipient, the
recipient must have a Single or project-specific audit for such fiscal year in accordance
with Section 215.97, Florida Statutes; applicable rules of the Executive Office of the
Governor and the Comptroller, and Chapter 10.550 (Local Government Entity Audits) or
10.650 ( State Single Audits: Nonprofit and For-Profit Organizations), Rules of the
Auditor General. In determining the State financial assistance expended in its fiscal year,
the recipient shall consider all sources of State financial assistance, including State funds
received from the Department of Children & Families, except that amounts received by a
nonstate entity for Federal program matching requirements shall be excluded from
consideration.
In connection with the audit requirements addressed in the preceding paragraph, the
recipient shall ensure that the audit complies with the requirements of Section 215.97(7),
Florida Statutes. This includes submission of a reporting package as defined by Section
215.97(2)(d), Florida Statutes, and the applicable Chapter 10.550 or 10.650, Rules of the
Auditor General.
The reporting package shall include a schedule that discloses the amount of expenditures
by contract number for each contract with the department in effect during the audit
period. Compliance findings related to contracts with the department shall be based on
contract requirements including any rules, regulations, or statutes referenced in the
contract. The reporting package shall disclose whether or not the matching requirement
was met for each applicable contract. All questioned costs and amounts due the
department shall be fully disclosed in the audit report with reference to the specific
contract involved.
P ART III: SUBMISSION OF REPORTS
For any of the above requirements, copies of the audit report and any management letter
by the independent auditors shall be submitted within 180 days after the end of the
provider's fiscal year or within 30 days of the recipient's receipt of the audit report,
whichever occurs first, directly to each of the following, unless otherwise required by.
Florida Statutes:
A. Contract manager for this contract
B. District office:
Contract Compliance Unit
Attention: Audit Review Analyst
40 I NW 2nd Avenue
Suite N-921
Miami, FL 33128
07/01101
'33
--".-...--
C. Copies ofreports for audits conducted in accordance with OMB Circular A-133, as
revised, and required by Part I of this agreement shall be submitted, when required by
Section .320( d), OMB Circular A-133, as revised, by or on behalf of the recipient directly
to the Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the
number of copies required by Sections .320(d)(I) and (2), OMB Circular A-133, as
revised, should be submitted to the Federal Auditing Clearinghouse), at the following
address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jefferson, IN 47132
and Other Federal agencies and pass-through entities in accordance with Sections .320(e)
and (t), OMB Circular A-133, as revised.
D. Copies of reporting packages required by Part II of this agreement shall be submitted by
or on behalf of the recipient directly to the Auditor General's Office at the following
address:
State of Florida Auditor General
Attn: Ted J. Sauerback
Room 574, Claude Pepper Building
111 West Madison Street
Tallahassee, Florida 32302-1450
PART IV: RECORD RETENTION
The provider shall ensure that audit working papers are made available to the department, or
its designee, upon request for a period of five years from the date the audit report is issued,
unless extended in writing by the department.
07/01101
"'f
5.
6.
.- -". - ---
Conflict of Interest Questionnaire
MONROE COUNTY IN HOME SERVICES
YES
NO
1.
Do you, your immediate family, or
business partner have financial or
other interest in any of the
potential bidders/entities listed?
x
2.
Have any gratuities, favors, or
anything of monetary value been
offered to you or accepted by you
from any of the potential bidders/
entities listed?
x
3.
Have you been employed by any of
the potential bidders/entities listed
within the Last 24 months?
x
4 .
Do you plan to obtain a financial
interest; i.e., stock, in any of the
potential bidders/entities listed?
x
Do you plan to seek or accept future
employment with any of the potential
bidders/entities listed?
x
Are there any other conditions which
may cause a conflict of interest?
x
If you answered "yesH to any of the above questions,
attach to this questionnaire a written explanation of your
answer.
I DECLARE ALL OF THE ABOVE QUESTIONS ARE
AND TO THE BEST OF MY KNOWLEDGE.
~~
ANSWERED TRUTHFULLY
:sIJ (61
Date
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRh~TS, GRANTS, LOANS AND COO. ..:RA TIVE
AGREEMENTS
Attachment J(j /11-
t603'f
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,
to any person for influencing or attempting to influence an officer or an employee of any agency,
a member of congress, an officer or employee of congress, or an employee of a member of
congress in connection with the awarding of any federal contract, the making of any federal
grant, the making of any federal loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment, or modification of any federal contract, grant,
loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person
for influencing or attempting to influence an officer or employee of any agency, a member of
congress, an officer or employee of congress, or an employee of a member of congress in
connection with this federal contract, grant, loan, or cooperative agreement, the undersigned
shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in
accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, subgrants, and contr~cts
under grants, loa~and cooperative agreements) and that all subrecipients shall certifY and
disclose according1y.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making
or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who
fails to file the required certification shall be subject to a civil penalty of not less than $10,000
and not more than $100,000 for each such failure.
~ [(-,e De-Q~d
-
b/z-%l
Signature
Date
b Uet, ( tI~t/c;{N( ( tAftLf&~
Name of Authorized Individual
fVll) N br;. UJ () NT t i'2;tJC--L-
lication or Contract Number
Name of Organization
Address of Organization
Page _
JF 03/96
"')ntract No. I( G-O ~ '-I
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION
- CONTRACTS/SUBCONTRACTS
-
This certification is required by the regulations implementing Executive Order 12549, Debarment
and Suspension, signed February 18, 1986. The guidelines were published in the May 29, 1987
Federal Register (52 Fed. Reg., pages 20360 - 20369).
INSTRUCTIONS
1. Each provider whose contracUsubcontract equals or exceeds $25,000 in federal monies must
sign this certification prior to execution of each contract/subcontract. Additionally, providers
who audit federal programs must also sign, regardless of the contract amount. Children &
Families cannot contract with these types of providers if they are debarred or suspended by
the federal government.
2. This certification is a material representation of fact upon which reliance is placed when this
contracUsubcontract is entered into. If it is later determined that the signer knowingly rendered
an erroneous certification, the Federal Government may pursue available remedies, including
suspension and/or debarment.
3. The provider shall provide immediate written notice to the contract manager at any time the
provider learns that its certification was erroneous when submitted or has become erroneous
by reason of changed circumstances.
4. The terms "debarred", "suspended", "in~Jigible", "person", "principal", and "voluntarily
excluded", as u~ in this certification, have the meanings set out in the Definitions"and
Coverage section~ of rules implementing Executive Order 12549. You may contacfthe
contract manager for assistance in obtaining a copy of those regulations.
5. The provider agrees by submitting this certification that, it shall not knowingly enter into any
subcontract with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this contract/subcontract unless authorized by the Federal
Government.
6. The provider further agrees by submitting this certification that it will require each subcontractor
of this contract/subcontract, whose payment will equal or exceed $25,000 in federal monies,
to submit a signed copy of this certification.
7. The Department of Children and Families may rely upon a certification of a
provider that it is not debarred, suspended, ineligible, or voluntarily excluded from
contracting/subcontracting unless it knows that the certification is erroneous.
8. This signed certification must be kept in the contract manager's contract file. Subcontractor's
certifications must be ke t at the contractor's business location.
(1) The prospective provider certifies, by signing this certification, that neither it nor its
principals is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this contracUsubcontract by any federal department
or agency.
(2) Wh~ t~e prospective provider is unable to certify to any of the statements in this
ce IcatIon, such p~ecti~er ':""0 attach ari.!'xplanation to this :rtification.
~nature ~
Name Ge..C)V'~ e If. Ne.c.c. '1~V) t Title
':::J 'J APPROVED A~ IU f-ORM