Item C40
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date:
12-16-2009
Division: _County Administrator
Bulk Item: Yes X No
Department: Social Services/In-Home Services_
Staff Contact PersonlPhone #: Sheryl Graham/X451 0
AGENDA ITEM WORDING: Approval for the Older Americans Act (OAA) Contract AA-I029
between the Alliance for Aging, Inc. (Area Agency on Aging) and the Monroe County Board of County
Commissioners (Social Services/In-Home Services and Nutrition Programs) for fiscal year 1/1/10 to
12/31/10.
ITEM BACKGROUND: The approval of OAA Contract #AA-I029 will enable Monroe County to
continue providing In-Home and Nutritional Services to Monroe County's Elderly population under the
Older Americans Act Contract
PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to OAA Amendment 003 to
contract number AA-929 on 11-18-09.
CONTRACT/AGREEMENT CHANGES: N/A
STAFF RECOMMENDATIONS: Approval
TOTAL COST: $519,561.00
INDIRECT COST: -0- BUDGETED: Yes X-No
COST TO COUNTY: $0 (No Cash Match Required) SOURCE OF FUNDS: Grant
REVENUE PRODUCING: Yes
No X_ AMOUNT PER MONTH
Year
APPROVED BY: County Arty ----K- OMBIPurchasing ~Risk Management _X_
DOCUMENTA TION:
Included X
Not Required_
DISPOSITION:
AGENDA ITEM #
Revised 1/09
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date:
12-16-2009
Division: _County Administrator
Bulk Item: Yes X No
Department: Social Services/In-Home Services_
Staff Contact PersonlPhone #: Sheryl GrahamlX451 0
AGENDA ITI~M WORDING: Approval for the Older Americans Act (OAA) Contract AA-l 029
between the Alliance for Aging, Inc. (Area Agency on Aging) and the Monroe County Board of County
Commissioners (Social Services/In-Home Services and Nutrition Programs) for fiscal year 1/1/10 to
12/31/10.
ITEM BACKIGROUND: The approval of OAA Contract #AA-I029 will enable Monroe County to
continue provi(jing In-Home and Nutritional Services to Monroe County's Elderly population under the
Older Americans Act Contract
PREVIOUS IlELEV ANT BOCC ACTION: Prior approval granted to OAA Amendment 003 to
contract numb~~r AA-929 on 11-18-09.
CONTRACT/AGREEMENT CHANGES: N/.l~
STAFF RECC)MMENDA TIONS: Approval
TOTAL cos~r: $519,561.00
INDIRECT COST: _-O-_BUDGETED: Yes LNo
v-/
COST TO COUNTY: $0 (No Cash Match Required) SOURCE OF FUNDS: Grant
REVENUE PllODUCING: Yes No X AMOUNT PER MONTH < Year
nl"t ~
APPROVED BY: County Arty ~ T' '(/ urchasing ~Risk Management _X_
DOCUMENT~~TION: Included X Not Required
DISPOSITION: AGENDA ITEM #~
Revised 1/09
CONTRACT AA.1015
Page 1
THIS AGREEMENT is entered into between the Alliance for Aging, Inc., hereinafter referred to as the
"'l\lIiance" and "Monroe County Social Services.", hereinafter referred to as the "contractor." THIS
CONTRAC1~ IS SUBJECT TO FURTHER MODIFICATION IN ORDER TO INCORPORATE CERTAIN
PASS-THROUGH LANGUAGE REQUIRED BY THE STATE OF FLORIDA DEPARTMENT OF ELDER
.-\FFAIRS. A~LL SUBSEQUENT l\tlODIFICATIONS WILL BE MADE THROUGH AMENDl\tIENTS TO THIS
CONTRAC1~.
All attachments are an integral part of this agreement and incorporated by reference.
The Budget Summary by Title is as follows:
Title III B (CFDAlCSF A # 93.044): $ 109,569
Title C1 (CFDA/CSFA # 93.045): $ 142,600
Title C2 (CFDA/CSFA # 93.045): $ 210,832
Title III E (CFDAlCSFA # 93.052): $ 56,560
1. The /\l1iance 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 Maximum Maximum
Service(s) to be Provided Unit Rate Units of Dollars
Service
HOimemaker $34.29 1 , 734 $59,459
Personal Care $40.07 1 , 1 30 $45,274
Screening & Assessment IIIB $42.05 115 $4,836
Congregate Meals $9.56 14,677 $140,3 II
Nutrition Education C 1 $63.58 36 $2,289
Home Delivered Meals $6.13 34,269 $21 0,068
Nutrition Education C2 $63.67 12 $764
Facility Respite $10.34 5,470 $56,560
Total Contract $519,561
2. This agreement shall begin on January 1, 2010 or the date it has been signed by both parties,
whichever is earlier.
IN WITNESS; WHEREOF, the parties hereto have caused this amendment to be executed by their
undersigned officials as duly authorized.
PROVIDER:
Monroe County Social
Services.
ALLIANCE FOR AGING, INC.
SIGNED BY:
SIGNED BY:
NAME:
Max B. Rothman, JD, LL.M.
TITLE:
~yl vi;::\ IT Mllrphy
Mayor
NAME:
TITLE:
President & CEO
DATE:
12-16-2009
DATE:
MJi4il t: vv~JI'l ~ ~Y!'\ I, r !) ;;;';,":''1 ,
C'j; 'i 0\/ fp ,0. ~ I' . '.,,(J,-V I ""(
;- p~o~~;-;~l~~~' ~-; - ,
ASSISTANT (; ,_, 'J >J: ,. ';, ~ ~.I E Y L ,: / \, I
Oat9 '.~ ...----.-- ~
\"
" r
r~/
~
1/48
CONTRACT AA-1015
Page 2
1. Purpose of Contract
The purpose of this contract is to provide services in accordance with the terms and conditions specified in
this contract including all attachments and exhibits, which constitute the contract document.
2. Incorporation of Documents within the Contract
The contract will incorporate attachments, proposal(s), area plan(s), grant agreements, relevant Alliance
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 document(s) shall
prevail over inconsistent provisions in the Proposal(s) or other general materials not specific to this contract
document and identified attachments.
3. Term of Contract
This contract shall begin on January 1,2010 or on the date on which the contract has been signed by the last
party reqllired to sign it, whichever is later. It shall end at midnight, local time in Miami, Florida, on
December 31.2010.
4. Contract Amount
The Alliarlce agrees to pay for contracted services according to the terms and conditions of this contract
or the rate schedule, subject to the availability of funds. Any costs or services paid for under any other
contract or from any other source are not eligible for payment under this contract.
5. Renewals
By mutual agreement of the parties, the Alliance may renew the contract for a period not to exceed three
years, or the term of the original contract, whichever is longer. The renewal price, or method for
determinirlg a renewal price, is set forth in the bid, proposal, or reply. No other costs for the renewal may be
charged. }my renewal is subject to the same terms and conditions as the original contract and contingent
upon satisfactory performance evaluations by the Alliance and the availability of funds.
6. Complianc:e with Federal Law
6.1. If this contract contains federal funds the following shall apply:
The provicier shall comply with the provisions of 45 CFR 74 and/ or 45 CFR 92, and other applicable
regulations.
6.1.1. If this conltract contains federal funds and is over $100,000.00, the contractor shall comply with all
applicable standards, orders, or regulations issued under s. 306 of the Clean Air Act as amended (42
V.S.C. 7401, et seq.), s. 508 of the Federal Water Pollution Control Act as amended (33 D.S.C. 1251, et seq.),
Executive ()rder 11738, as amended, and where applicable Environmental Protection Agency
regulations 40 CFR 30. The contractor shall report any violations of the above to the Alliance.
6.1.2. The contractor, or agent acting for the contractor, may not use any federal funds received in
connection with this contract to influence legislation or appropriations pending before the Congress or
any State legislature. If this contract contains federal funding in excess of $100,000.00, the contractor must,
prior to contract execution, complete the Certification Regarding Lobbying form, AITACHMENT II All
disclosure forms as required by the Certification Regarding Lobbying form must be completed and
returned to the Contract Manager, prior to payment under this contract.
6.1.4. That if this contract contains $10,000.00 or more of federal funds, the contractor shall comply with
Executive Order 11246, Equal Employment Opportunity, as amended by Executive Order 11375 and
others, an.d as supplemented in Alliance of Labor regulation 41 CFR 60 and 45 CFR 92, if applicable.
2/48
CONTRACT AA-1015
6.1.5. That if tJhis contract contains federal funds and provides services to children up to age 18, the
contractor shall comply with the Pro-Children Act of 1994 (20 V.S.C. 6081).
Page 3
6.1.6. That a contract award with an amount expected to equal or exceed $25,000.00 and certain other contract
awards s]1all not be made to parties listed on the government-wide Excluded Parties List System, in
accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689,
"Debarment and Suspension." The Excluded Parties List System contains the names of parties debarred,
suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or
regulatory authority other than Executive Order 12549. The contractor will comply with these
provisiofls before doing business or entering into subcontracts receiving federal funds pursuant to this
contract. The contractor shall complete and sign A TIACHMENT V prior to the execution of this
contract.
6.2. The contractor shall not employ an unauthorized alien. The Alliance shall consider the employment of
unauthorized aliens a violation of the Immigration and Nationality Act (8 D.S.C. 1324 a) and the
Immigration Reform and Control Act of 1986 (8 D.S.C. 1101). Such violation shall be cause for
unilateral cancellation of this contract by the Alliance.
7. CompliaJ1Ce with State Law
7. 1. That this contract is executed and entered into in the State of Florida, and shall be construed, performed
and enforced in all respects in accordance with the Florida law, including Florida provisions for conflict of
laws.
7.2. Requirerrlents of the contract under state law:
7.2.1. The contractor will provide units of deliverables, including reports, findings, and drafts, as specified in
this contract, which the Contract Manager must receive and accept in writing prior to payment.
7.2.2. The contractor will submit bills for fees or other compensation for services or expenses in sufficient detail
for a proF,er pre-audit and post-audit.
7.2.3. If itemized payment for travel expenses is permitted in this contract, the contractor will submit bills
for any travel expenses in accordance Alliance for Aging travel reimbursement rates., or at such lower
rates as rrlay be provided in this contract.
7.2.4. The contractor will allow public access to all documents, papers, letters, or other public records
when recluired by the Alliance, made or received by the contractor in conjunction with this contract
except for those records which are made confidential or exempt by law. The contractor's refusal to
comply "'lith this provision shall constitute an immediate breach of contract for which the Alliance may
unilaterally terminate the contract.
7.3. If clients are to be transported under this contract, the contractor shall comply with tl1e provisions of
Chapter 427, F.S.,and Rule 41-2, F. A. C.
7.4. Subcontractors who are on the state's discriminatory vendor list as defined in s. 287.134, F.S., may
not transact business with the Alliance.
7.5. 111e contractor will not expend contract funds for the purpose of lobbying the legislature, judicial branch
or a state agency.
8. Grievance Procedures
3/48
CONTRACT AA-1015 Page 4
The contractor shall develop and implement grievance procedures to process and resolve client
dissatisfaction with or denial of service(s), and address complaints regarding the termination,
suspensiorl or reduction of services, as required for receipt of funds. These procedures, at a minimum,
should provide for notice of the grievance procedure and an opporhmity for review of the subcontractor's
determina1ion( s).
9. Audits, Inspections, Investigations. Public Records and Retention
9.1. To establish and maintain books, records and documents (including electronic storage media) sufficient to
reflect all in.come and expenditures of funds provided by the Alliance under this contract.
9.2. To retain all client records, financial records, supporting documents, statistical records, and any other
documents (including electronic storage media) pertinent to this contract for a period of six (6) years
after completion of the contract or longer when required by law. In the event an audit is required by this
contract, records shall be retained for a minimum period of six (6) years after the audit report is issued or
until resolution of any audit findings or litigation based on the terms of this contract, at no additional cost
to the Alliatlce.
9.3. Upon demalld, at no additional cost to the Alliance, the contractor will facilitate the duplication and transfer
of any records or documents during the required retention period in Paragraph 9.2.
9.4. To assure t11at the records described in Paragraph 9 shall be subject at all reasonable times to inspection,
review, cor-ying, or audit by Federal, State, or other personnel duly authorized by the Alliance.
9.5. At all reasoIlable times for as long as records are maintained, persons duly authorized by the Alliance and
Federal auclitors, pursuant to 45 CFR 92.36(i)(lO), shall be allowed full access to and the right to
examine arty of the contractor's contracts and related records and documents pertinent to this specific
contract, re~5ardless of the form in which kept.
9.6. To provide a financial and compliance audit to the Alliance as specified in this contract and in
ATIACHN[ENT III and to ensure that all related party transactions are disclosed to the auditor.
9.7. To comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed
necessary b:V the office of the Inspector General of the State of Florida.
10. Nondiscrirnination-Civil Rights Compliance
10.1. The contractor will execute assurances in A TI ACHMENT VI that it will not discriminate against any
person in the provision of services or benefits under this contract or in employment because of age, race,
religion, color, disability, national origin, marital status or sex in compliance with state and federal law
and regulations. The contractor further assures that all subcontractors, sub grantees, or others with whom
it arranges to provide services or benefits in connection with any of its programs and activities are not
discriminating against clients or employees because of age, race, religion, color, disability, national origin,
marital status or sex.
10.2. The contractor will retain, on file, during the term of this agreement a timely, complete and accurate
Civil Rights Compliance Checklist (A TIACHMENT B).
10.3 The contractor agrees to establish procedures pursuant to federal law to handle complaints of
discrimination involving services or benefits through this contract. These procedures s11all include
notifying clients, employees, and participants of the right to file a complaint with the appropriate federal or
state entity.
4/48
CONTRACT AA-1015 Page 5
10.4 If this contract contains federal funds, these assurances are a condition of continued receipt of or
benefit from federal financial assistance, and are binding upon the contractor, its successors, transferees,
and assigrLees for the period during which such assistance is provided. The contractor further assures that
all subcontractors, vendors, or others with whom it arranges to provide services or benefits to participants
or emplojrees in connection with any of its programs and activities are not discriminating against those
participants or employees in violation of the above statutes, regulations, guidelines, and standards. In the
event of failure to comply, the contractor rmderstands that the Alliance may, at its discretion, seek a court
order req"uiring compliance with the terms of this assurance or seek other appropriate judicial or
administrative relief, including but not limited tOt termination of and denial of further assistance.
11. Provision of Services
The contractor will provide services in the manner described in ATIACHNIENT I and as per the 2009
Florida Department of Elder Affairs Programs and Services Handbook or any revisions made thereafter.
12 Monitorin.g by the Alliance
The contractor will permit persons duly authorized by the Alliance to inspect and copy any records, papers,
documents, facilities, goods and services of the contractor which are relevant to this contract, and to
interview any clients, employees and subcontractor employees of the contractor to assure the Alliance of the
satisfactor:v performance of the terms and conditions of this contract. Following such review, the Alliance
will deliver to the contractor a written report of its findings and request for development, by the
contractor, of a corrective action plan where appropriate. The contractor hereby agrees to timely correct
all deficiellcies identified in the corrective action plan.
13. Indemnification
13.1 To the exteIlt allowed by law, each party shall be responsible for any acts, or omissions, of negligence
on the part of its employees, agents, contractors, and subcontractors and shall defend, indemnify and
hold the other party, its officers and employees, agents and contractors, harmless from all claims
demands, causes of action, losses, costs and expenses of whatever type - including investigation and
witness costs and expenses and attorneys' fees and costs - that arise out of or are attributable to such
actions or omissions.
14. Insurance and Bonding
14.1. To provide continuous adequate liability insurance coverage during the existence of this contract and any
renewal(s) and extension(s) of it. By execution of this contract, the contractor accepts full responsibility
for identifying and determining the type(s) and extent of liability insurance necessary to provide
reasonable financial protections for the contractor and the clients to be served rmder this contract. The
limits of coverage under each policy maintained by the contractor do not limit the contractor's liability and
obligations under this contract. The contractor shall ensure that the Alliance has the most current
written verification of insurance coverage throughout the term of this contract. The Alliance reserves the
right to recluire additional insurance as specified in this contract.
14.2. Throughol1t the term of this agreement, the contractor agrees to maintain an insurance bond from a
responsible commercial insurance company covering all officers, directors, employees and agents of the
contractor authorized to handle funds received or disbursed under all agreements and/ or contracts
incorporating this contract by reference in an amount commensurate with the funds handled, the
degree of risk as determined by the insurance company and consistent with good business practices.
15. Confidentiality of Information
The contractor shall not use or disclose any information concerning a recipient of services rmder this
contract for any purpose prohibited by state or federal law or regulations except with the written consent of
5/48
CONTRACT AA-1015 Page 6
a person legally authorized to give that consent or when authorized by law.
16. Health In.surance Portability and Accountability Act
Where apJplicable, the contractor vvill comply with the Health Insurance Portability and Accountability Act
(42 use 1320d.), as well as all regulations promulgated thereunder (45 CFR 160, 162, and 164).
17. Incident JReporting
17.1. The contractor shall notify the i\lliance immediately, but no later than forty-eight (48) hours
from, the contractor's awareness or discovery of conditions that may materially affect the
contractor or subcontractor's ability to perform the services required to be performed under this
contract.
17.2. To imme(iiately 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). This provision is binding upon both the contractor and its
employees.
18. Sponsors:hip and Publicity
18.1. The contractor shall, in publicizing, advertising, or describing the sponsorship of the program,
state: "Sponsored by (contract1or's name), the Alliance for Aging and the State of Florida,
Department of Elder Affairs." If the sponsorship reference is in written material, the words
"Alliance for Aging and State of Florida, Department of Elder Affairs" shall appear in at least
the same size letters or type as the name of the organization.
18.2. The contractor shall not use the words "The State of Florida, Department of Elder Affairs" or
" Alliance for Aging" to indicate sponsorship of a program otherwise financed, unless, specific
authorization has been obtainecl from the Alliance for Aging prior to use.
19. AssignmE~nts
19.1. The contractor shall not assign the rights and responsibilities under this Contract without the prior
written aIJproval of the Alliance, which shall not be unreasonably withheld. Any sublicense,
assignmerlt, or transfer otherwise occurring without prior written approval of the Alliance will
constitute a material breach of the contract.
19.2. This contract shall remain bin,ding upon the successors in interest of either the contractor or
the Alliarlce.
20. Subcontracts
20.1 The contractor is responsible for all work performed and for all commodities produced
pursuant to this contract, whether actually furnished by the contractor or its subcontractors.
Any subcontracts shall be evidenced by a written document and subject to any conditions of
approval the Alliance deems necessary. The contractor further agrees that the Alliance shall not
be liable to the subcontractor in' any way or for any reason. The contractor, at its expense, will
defend the Alliance against any such claims.
20.2. Upon paynlent by the Alliance, Contractor shall pay any subcontractors in accordance with the Local
Govemmellt Prompt Payment Act, F.S. 218.73. Any subcontractor balances not paid witllin the time
specified b:y the Local Government Prompt Payment Act shall be subject to interest ptlrSuant to F.S.
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CONTRACT AA-1015
Page 7
218.74
21. Independent Capacity of Contractor
It is the intent and understanding of the parties that the contractor, or any of its subcontractors, are
independ.ent contractors and are not employees of the Alliance and shall not hold themselves out
as emplo:yees or agents of the Alliance without specific authorization from the Alliance. It is the
further intent and understanding of the parties that the Alliance does not control the employment
practices of the contractor and shall not be liable for any wage and hour, employment
discrimirlation, or other labor and employment claims against the contractor or its
subcontractors. All deductions for social security, withholding taxes, income taxes, contributions
to unemF,loyment compensation funds and all necessary insurance for the contractor shall be the
sole responsibility of the contractor.
22. Payment
Payments '-"rill be made to the contractor pursuant to s. 215.422, F.S., as services are rendered and invoiced by the
contractor. rrhe Alliance's Contract Manager will have final approval of the invoice for payment, and will
approve the invoice for payment only if the contractor has met all terms and conditions of the contract, unless
the bid specifications, purchase order, or this contract specify otherwise. The approved invoice will be submitted
to the Alliance's finance section for budgetary approval and processing. Disputes arising over invoicing and
payments V\Till be resolved in accordance with the provisions of s. 215.422 F.S. The recipient is aware and accepts
that all units of service not reported after a maximum of ninety (90) days after the date of service will not be
honored and paid by the Alliance. These units will be considered forfeited.
23. Return of Funds
The contractor will return to the Alliance any overpayments due to unearned funds or funds disallowed
and any irlterest attributable to such funds pursuant to the terms and conditions of this contract that were
disbursed to the contractor by the Alliance. In the event that the contractor or its independent
auditor cliscovers that an overpayment has been made, the contractor shall repay said
overpaynClent immediately without prior notification from the Alliance. In the event that the
Alliance first discovers an overpayment has been made, the Contract Manager, on behalf of the
Alliance, will notify the contractor by letter of such findings. Should repayment not be made
forthwith, the contractor may be charged the rate of interest established under F.S.55.03, after
Alliance flotification or contractor discovery.
24. Data Integrity and Safeguarding Information
The contractor shall insure an appropriate level of data security for the information the contractor is
collecting or using in the performance of this contract. An appropriate level of security includes approving
and trackll1g all contractor employees that request system or information access and ensuring that
user access has been removed from all terminated employees. The contractor, among other
requirements, must anticipate and prepare for the loss of information processing capabilities.
All data and software must be routinely backed up to insure recovery from losses or outages of the
computer system. The security over the backed-up data is to be as stringent as the protection required of the
primary systems. The contractor shall insure all subcontractors maintain written procedures for
computer system back up and recovery. The contractor shall complete and sign ATTACHMENT
IV prior to the execution of this contract.
25. Conflict of Interest
The contractor will establish safeguards to prohibit employees, board members, management and
subcontractors from using their positions for a purpose that constitutes or presents tile appearance of
personal or organizational conflict of interest or personal gain. No employee, officer or agent of the
contractor or subcontractor shall participate in selection, or in the award of an agreement supported by State
or Federal funds if a conflict of interest, real or apparent, would be involved. Such a conflict would arise
vvhen: (a) the employee, officer or agent; (b) any member of his/her immediate family; (c) IUs or l1er partner,
or; (d) an organization which employs, or is about to employ, any of the above, has a financial or other
7/48
CONTRACT AA-1015 Page 8
interest in the firm selected for award. The contractor or subcontractor's officers,
employees or agents will neither solicit nor accept gratuities, favors or anything of monetary
value frolTI contractors, potential contractors, or parties to subcontracts. The contractor's board
members and management must disclose to the Alliance any relationship which may be, or may be
perceived to be, a conflict of interest within thirty (30) calendar days of an individual's original
appointrrlent or placement in that position, or if the individual is serving as an incumbent,
within tllirty (30) calendar days of the commencement of this contract. The contractor's
employees and subcontractors must make the same disclosures described above to the contractor's
board of clirectors. Compliance with this provision will be monitored.
26. Public Entity Crime
The follo,tVing restrictions are placed on the ability of persons convicted of public entity crimes to
transact btlsiness with the Alliance. A person or affiliate who has been placed on the convicted vendor list
following a conviction for a public entity crime may not may not be awarded or perform work as a
contractor)' supplier, subcontractor, or consultant under a contract with the Alliance.
27. Purchasine
To procure any recycled products or materials, which are the subject of or are required to carry out this contract, in
accordance with the provisions of s. 403.7065 and 287.045, F.S.
28. Patentsl COPyrightSI Royalties
If any discovery, invention or copyrightable material is developed or produced in the course of or as a result
of work or services performed under this contract, the contractor shall refer the discovery, invention or
material tC) the Alliance for Aging. Any and all patent rights or copyrights accruing under this contract
are hereby reserved to the Alliance for Aging.
29. EmergenCJ' Preparedness and Continuity of Operations
29.1. If the tas]ks to be performed pursuant to this contract, include the physical care and control of
clients, or the administration and coordination of services necessary for client health, safety or welfare,
the contractor shall, within thirty (30) calendar days of the execution of this contract, submit to the
Contract rv1anager verification of an emergency preparedness plan. In the event of an emergency, the
contractor shall notify the Alliance of emergency provisions.
29.2. In the eveJnt, a situation results in a cessation of services by a subcontractor, the contractor will retain
responsibility for performance under this contract and must follow procedures to ensure continuity of
operations without interruption.
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CONTRACT AA-1015
Page 9
30. Dispute Resolution
Any disptlte 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.
31. No WaiveJr of Sovereign Immunity
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to
which sovereign immunity may be applicable.
32, Venue
If any disF)ute arises out of this contract, the venue of such legal recourse will be Momoe County/ Florida.
33. Entire COIltract
This contract contains all the terms and conditions agreed upon by the parties. No oral agreements or
representations shall be valid or binding upon the Alliance or the contractor unless expressly contained
herein or by a written amendment to this contract signed by both parties.
34. Force Majeure
Neither party shall be liable for any delays or failures in performance due to circumstances beyond its
control, p,rovided the party experiencing the force majeure condition provides immediate written
notification. to the other party and takes all reasonable efforts to cure the condition.
35. Severability Clause
The parties agree that if a court of competent jurisdiction deems any term or condition herein void or
unenforceable, the other provisions are severable to that void provision and shall remain in full force and
effect.
36. Condition Precedent to Contract: Appropriations
The parties agree that the Alliance's performance and obligation to pay under this contract is contingent
upon an alIDUal appropriation by the Legislature.
37. Additionll)eletion
The parties agree that the Alliance reserves the right to add or to delete any of the services required
under this contract when deemed to be in the State's best interest and reduced to a written amendment
signed by "both parties. The parties shall negotiate compensation for any additional services added.
38. W ai ver
The delay or failure by the Alliance to exercise or enforce any of its rights under this contract shall not
constitute or be deemed a waiver of the Alliance's right thereafter to enforce those rights, nor shall any
single or I,artial exercise of any such right preclude any other or further exercise thereof or the exercise of
any other right.
39. Complian4:e
TI1e contractor agrees to abide by all applicable current federal statutes, laws, rules and regulations as
well as aI)plicable current State statutes, laws, rules and regulations. The parties agree that failure of the
contractor to abide by these laws shall be deemed an event of default of the contractor, and subject the
contract to immediate, unilateral cancellation of the contract at the discretion of the Alliance.
40. Final Invoice
TI1e contractor shall submit the final invoice for payment to the Alliance as specified in Paragraph 3.3.4.
(date for final request for payment) of ATIACHNlENT 1. If the contractor fails to submit final request for
payment t)y the deadline, then all rights to payment may be forfeited and the Alliance may not honor any
requests sllbmitted after the aforesaid time period. Any payment due under the terms of this contract may
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CONTRACT AA-1015 Page 10
be withheld until all reports due from the contractor and necessary adjustments thereto have been
approved by the Alliance.
41. Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only when they l1ave 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
establisheld through the appropriations process and subsequently identified in the Alliance's operating
budget.
42. Termination
42.1. This contract may be terminated by either party without cause upon no less than thirty (30) calendar
days notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said
notice s]hall be delivered by U.S. Postal Service or any expedited delivery service that provides
verification of delivery or by hand delivery to the Contractor or the representative of the contractor
responsible for administration of the contract.
42.2. In the event funds for payment pursuant to this contract become unavailable, the Alliance
may terJminate this contract upon no less than twenty-four (24) hours notice in writing to the
contractor. Said notice shall be delivered by U.S. Postal Service or any expedited delivery service
that pro'vides verification of delivery or by hand delivery to the Contract Manager or the
represenltative of the contractor responsible for administration of the contract. The Alliance shall
be the fiJnal authority as to the availability and adequacy of funds. In the event of termination of
this contract, the contractor will be compensated for any work satisfactorily completed prior to
the date of termination.
42.3. This contract may be terminated for cause upon no less than twenty-four (24) hours notice in
writing to the contractor. If applicable, the Alliance may employ the default provisions in Rule
60A-1.006(3), F.A.C. Waiver of breach of any provisions of this contract shall not be deemed to be
a waiver of any other breach and shall not be construed to be a modification of the terms and
conditions of this contract. The provisions herein do not limit the Alliance's or the contractor's
rights to remedies at law or in equity.
42.4. Failure to have performed any contractual obligations with the Alliance in a manner
satisfactory to the Alliance will be a sufficient cause for termination. To be terminated as a
contractor under this provision, the contractor must have (1) previously failed to satisfactorily
perform in a contract with the Alliance, been notified by the Alliance of the unsatisfactory
performance and failed to correct the unsatisfactory performance to the satisfaction of the
Alliance; or (2) had a contract terminated by the Alliance for cause
43. All Terms and Conditions Included
This contract and its Attachments, I - X, A and B, and any exhibits referenced in said attachments, together
with any documents incorporated by reference, contain all the terms and conditions agreed upon by the
parties. TIAlere are no provisions, terms, conditions, or obligations other than those contained herein, and this
contract s:hall supersede all previous communications, representations or agreements, either written or
verbal between the parties.
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A TT ACHM"ENT
A TT ACHMEN1~ I
A TT ACHMEN1~ II
A TT A CHMEN1~ III
A TT ACHMEN1~ IV
A TT ACHMEN1~ V
A TT ACHMEN1~ VI
A TT ACHMEN1~ VII
A TT ACHMEN1~ VIII
A TT A CHMEN1"' IX - A
A TT A CHMEN1"' IX - B
A TT ACHMEN1' IX-C
A TT ACHMEN1' X
A TT ACHMEN1' A
A TT ACHMEN1' B
CONTRACT AA-1015
INDEX TO CONTRACT A TT ACHMENTS
A TT ACHMENT DESCRIPTION
STA TEMENT OF WORK
CE.RTIFICA TION REGARDING LOBBYING
FINANCIAL COMPLIANCE AUDIT ATTACHMENT
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
CERTIFICA TION REGARDING DEBARMENT, SUSPENSION,
INELIGIBILITY AND VOLUNTARY EXCLUSION
CONTRACTS / SUBCONTRACTS
ASSURANCES - NON-CONSTRUCTION PROGRAMS
BLANK
CONTRACT REPORT CALENDAR ADVANCE BASIS SCHEDULE
RECEIPTS AND EXPENDITURES - TITLE III ADMINISTRATION
RECEIPTS AND EXPENDITURES - TITLES IIIB, Cl, C2, Dl AND D2
RECEIPTS AND EXPENDITURES - TITLE IIIE
REQUEST FOR PAYMENT
DEPARTMENT OF ELDER AFFAIRS PROGRAMS & SERVICES
HANDBOOK (ON CD)
DEPARTMENT OF ELDER AFFAIRS CIVIL RIGHTS COMPLIANCE
CHECKLIST AND INSTRUCTIONS
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CONTRACT AA-1015
A TT ACHMENT I
ST A TEMENT OF WORK
OLDER AMERICANS ACT PROGRAM
SECTION I: SEFtVICES TO BE PROVIDED
1.1. DEFINITIONS OF TERMS AND ACRONYMS
1.1.1. CONTllACT ACRONYMS
Activities of Daily Living (ADL)
Adult f.rotective Services (APS)
Alliance of Information & Referral Systems (AIRS)
Americans with Disabilities Act (ADA)
Area A;gency on Aging (AAA)
Assessed Priority Consumer List (APCL)
Client Information and Registration Tracking System (CIRTS)
Florida Alliance of Information and Referral Services (FLAIRS)
Information and Referral (I&R)
InstruIIlental Activities of Daily Living (IADL)
Memorandum of Agreement (MOA)
Memorandum of Understanding (MOU)
Older P~mericans Act (OAA)
Plannin.g and Service Areas (PSAs)
Web-based Database System (WebDB)
1.1.2. PROGI~AM SPECIFIC TERMS
Area Plan: A plan developed by the area agency on aging outlining a comprehensive and
coordinated service delivery system in its planning and service area in accordance with the Section
306 (42 V.S.C. 3026) of the Older Americans Act and Alliance instructions.
Area Plan Update: A revision to the area plan wherein the area agency on aging enters OAA
specific data in the web-based database system (WebDB). An update may also include other
revisiorlS to the area plan as instructed by the Alliance.
Child: i\n individual who is not more than 18 years of age or an individual with disability.
Family Caregiver: An adult family member, or another individual, who is an informal provider
of in-home and community care to an older individual.
Frail: \A/hen an older individual is unable to perform at least two activities of daily living (ADL)
without substantial human assistance, including verbal reminding, physical cueing or
supervision; or due to cognitive or other mental impairment, requires substantial supervision
because the individual behaves in a manner that poses a serious health or safety hazard to the
individ'ual or to another individual.
GrandI)arent: A grandparent or step-grandparent of a child, or a relative of a child by blood,
marria~;e or adoption and who lives with the child; is the primary caregiver of the child because
the biological or adoptive parents are unable or unwilling to serve as the primary caregiver of
tIle child; and l1as a legal relationship to the child, such as legal custody or guardianship, or is
raising the child informally.
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1.2.
1.2.1.
1.3.
1.3.1.
1.3.2.
1.3.3.
1.3.4.
1.4.
1.4.1.
1.4.1.1.
CONTRACT AA-1015
ALLIAJNCE MISSION STATEMENT
The Alliance's mission is to foster an optimal quality of life for elder Floridians. The Alliance's
vision and shared values are to foster a social, economic and intellectual environment for all
ages, alld 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
Alliance's mission, vision, and program priorities.
Older J\mericans Act Program Mission Statement
The Older Americans Act (OAA) Program is a federal program that provides assistance to
older persons and caregivers and is the only federal supportive services program directed solely
toward improving the lives of older people. The program provides a framework for a partnership
among the different levels of government and the public and private sectors with a common
objective, improving the quality of life for all older individuals by helping them to remain
indepeIldent and productive.
GENEltAL DESCRIPTION
General Statement
The primary purpose of the OAA program is to foster the development and implementation of
comprehensive and coordinated systems to serve older individuals. The OAA program uses
these s:ystems to assist older individuals to attain and maintain maximum independence and
dignity in a home environment and allows for the capability of self-care with appropriate
supportive services.
Authority
The relevant references authority governing the OAA program are:
( I )Older Americans Act of 2006, as amended;
(2)Rule 58A-1, Florida Administrative Code; and
(3)Section 430.101, Florida Statutes.
Scope of Service
The COlltractor is responsible for the programmatic, fiscal, and operational management of the
Title IIIB, IIIC1 and 2, HID and HIE programs of the Older Americans Act within its designated
Planninlg and Service Areas (PSAs). The scope of service includes planning, coordinating and
assessillg the needs of older persons, and assuring the availability and quality of services. The
services shall be provided in a manner consistent with and described in the current contractor's
area plan update and the current Alliance Programs and Services Handbook, (A TT ACHMENT
A).
Major j)rogram Goals
The major goals of the OAA program are to improve the quality of life for older individuals,
preserv'e their independence and prevent or delay more costly institutional care. These goals are
achieved through the implementation of a comprehensive and coordinated service system that
provides a continuum of service alternatives that meet the diverse needs of elders and their
caregivers.
INDIVIDUALS TO BE SERVED
Eligibility (Title III Programs)
OAA Title III, General
Consunlers shall not be dually enrolled in an OAA program and a Medicaid capitated long-term
care program.
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CONTRACT AA-1015
1.4.1.2. OAA Title IIIB, Supportive Services
(1 )Indiv"iduals age 60 or older; and
(2)lnfor:mation and Referral/ Assistance services are provided to individuals regardless of age.
1.4.1.3. OAA Title IIIC1 and C2, Nutrition Services, General
General factors that s110uld be considered in establishing priority for Nutrition Services, both
Cl and C2, include those older persons who:
(l)Cannot afford to eat adequately;
(2)Lack the skills or knowledge to select and prepare nourishing and well-balanced meals;
(3)Have limited mobility which may impair their capacity to shop and cook for themselves; or
(4)Have a disabling illness or physical condition requiring nutritional support or have been
screene,d at a high nutritional risk.
1.4.1.3.1. OAA Title IIIC1, Congregate Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in
A TTAC:HMENT I, Paragraph 1.4.1.3., individuals must be mobile, not homebound and
physically, mentally and medically able to attend a congregate nutrition program. Individuals
eligible to receive congregate meals include:
(l)lndi\riduals age 60 or older; and
(2)Any spouse (regardless of age) who attends the dining center with his/her eligible spouse;
(3)Persons with a disability, regardless of age, who reside in a housing facility occupied
primarily by older individuals where congregate nutrition services are provided;
(4)DisalJled persons who reside at home with and accompany an eligible person to the dining
center; and
(S)Volunteers, regardless of age, who provide essential services on a regular basis during meal
hours.
1.4.1.3.2. OAA Title IIIC2, Home Delivered Nutrition Services
In addition to meeting the general nutrition services eligibility requirements listed in
A TT A(:HMENT I, Paragraph 1.4.1.3., individuals must be homebound and physically, mentally
or medically unable to attend a congregate nutrition program. Individuals eligible to receive
home delivered meals include:
(l)lndi,riduals age 60 or older who are also frail and homebound by reason of illness, disability
or isolation;
(2)The spouse of a homebound eligible individual, regardless of age, if the provision of the
collateral meal supports maintaining the person at home;
(3)lndi\riduals with disabilities, regardless of age, who reside at home with eligible individuals
and are dependent on them for care; and
(4)Persons at nutritional risk who have physical, emotional or behavioral conditions, which
would lnake their presence at the congregate site inappropriate; and persons at nutritional
risk who are socially or otherwise isolated and unable to attend a congregate nutrition site.
1.4.1.4. OAA Title IIIE, Caregiver Support Services
( 1 )Family caregivers of individuals age 60 or older;
(2)Grandparents (age 55 or older) or older individuals (age 55 or older) who are relative
caregIvers;
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CONTRACT AA-1015
(3)Priority will be given to family caregivers who provide care for individuals with Alzheimer's
disease and related disorders with neurological and organic brain dysfunction and for
grandparents or older individuals who are relative caregivers who provide care for children with
severe {iisabilities; and
(4 )For respite and supplemental services, a family caregiver must be providing care for an older
individ'ual who meets the definition of the term "frail" in OAA, Section 102 Paragraph 22.
1.4.2.
Targete'd Groups
Preferen.ce shall be given to those with the greatest economic and social need, with particular attention to
low-income older individuals, including those that are low-income minorities, have limited English
proficiency, and older individuals residing in rural areas.
SECTION II - M.ANNER OF SERVICE PROVISION
2.1. SERVIC:E TASKS
In order to achieve the goals of the OAA program, the contractor shall ensure the following tasks
are performed:
(1 )ClierLt eligibility determination as listed in ATTACHMENT I, Paragraph 1.4;
(2)Targeting and screening of service delivery for new clients;
(3)Deli\Tery of services to eligible clients;
(4)Use of volunteers to expand the provision of available services; and
(5)Monitoring the performance of its contractors.
2.1.1. Targeting and Screening of Service Delivery for New Clients
The COIltractor shall develop and implement policies and procedures consistent with OAA
targetirLg and screening criteria.
2.1.2. Delivery of Services to Eligible Clients
The corltractor shall provide a continuum of services that meets the diverse needs of elders and
their caregivers. The contractor shall perform and report performance of the following services in
accordance with ATTACHMENT A. The services funded pursuant to this contract are in
accordance with the OAA, Title III, sections 321, 331, 336, 361 and 373 as follows:
( I )Section 321, Title IIIB Supportive Services;
(2)Section 331, Title IllCl Congregate Nutrition Services;
(3)Section 336, Title IIIC2 Home Delivered Nutrition Services;
(4)Section 373, Title IIIE Caregiver Support Services; and
(5)Sections 321 and 373 - Information and Referral/ Assistance Access Services (Elder Helplines)
2.1.2.1. Supportive Services
Supportive services include a variety of community-based and home-delivered services that
support the quality of life for older individuals by helping them remain independent and
productive. Services include the following:
(I )Adult Day Carel Adult Day Health Care;
(2)Care:giver Training/Support;
(3)Case Aid/Case Management;
(4 )Chore Services;
(5)Com'panionship;
(6)Courlseling (Gerontological and Mental Health);
( 7)Education/Training;
(8)Emergency Alert Response;
( 9)Escort;
( I O)Health Support;
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CONTRACT AA-1015
( II )Horne Health Aid;
( 12)Hornemaker;
(13)HotlSing Improvement;
(14 )Information;
( 15)Inta:ke;
(16)Interpreter /Translating;
( 17)Legal Assistance;
( IS)Material Aid;
(19)Occ'upational Therapy;
(20)Outreach;
(21 )Personal Care;
(22)Physical Therapy;
(23 )Recreation;
(24)Referral/ Assistance;
(25)Res]Jite Services;
(26)Screening/ Assessment;
(27)Sho]pping Assistance;
(2S)Skilled Nursing;
(29)Specialized Medical Equipment, Services and Supplies;
(30)Speech Therapy;
(31 )Telephone Reassurance; and
(32)TraIlsportation.
2.1.2.2.1. Congregate Nutrition Services
Nutrition services are provided in congregate settings and are designed to reduce hunger and
food inlsecurity, promote socialization and the health and well being of older individuals by
assisting them to gain access to nutrition and other disease prevention and health promotion
services. Services include:
( 1 )Congregate meals;
(2)Congregate meals screening;
(3)Nutrition education and nutrition counseling; and
(4)Outreach.
2.1.2.2.2. Home ]]elivered Nutrition Services
In-home nutrition services are provided to reduce hunger and food insecurity; promote
socialization and the health and well being of older individuals by assisting such individuals
to gairl access to nutrition and other disease prevention and health promotion services.
Services include:
( 1 )HOITle delivered meals;
(2)Nutrition education and counseling; and
(3)Outreach.
2.1.2.3. Caregiv'er Support Services Program
The Caregiver Support Services Program components are designated in the Client I11formation
and Registration Tracking System (CIRTS) as follows:
( I )Care~5iver Support Services (IIIE Program);
(2)Care~5iver Supplemental Services (IllES Program); and
(3)Grandparent Support Services (IIIEG Program)
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CONTRACT AA-1015
2.1.2.4. Caregi,rer Support Services (IIIE Program)
The following services are intended to provide direct help to caregivers, assist in the areas of
health, nutrition and financial literacy and assist caregivers in making de(l:isions and problem
solving related to their caregiving roles and responsibilities:
(1) Ad.ult Day Carel Adult Day Health Care;
(2) Caregiver Training/Support;
(3) Co.unseling (Gerontological and Mental Health);
Ed ucation / Training;
(4) Financial Risk Reduction (Assessment and
Maintenance) ;
(5) Information;
(6) Intake;
(7) Outreach; ,
(8) Referral/ Assistance;
(9) Respite; I
(10) Screening and a~sessment;
(11) Transportation.
2.1.2.5. Caregi\rer Support Supplemental Services (IllES Program): At least 10 percent, but no more
than 20 percent, of the total Title IIIE funds shall be used to provide supplemental support
services. The following services are provided to complement the care provided by caregivers.
( I )Chore Services;
(2)Housing Improvement;
(3)Legal Assistance;
(4 )Material Aid; and
(5)Specialized Medical Equipment, Services and Supplies.
2.1.2.6. Caregi\rer Support Grandparent Services (IIIEG Program): At least 5 percent, but no more
than 10 percent, of the total Title IIIE funds shall be used to provide support services to
grandparents and older individuals who are relative caregivers. Services for grandparents or
older individuals who are relative caregivers designed to help meet their car~giving obligations
include::
(I )Care!~iver Training/Support; (7) Outreach;
(2)Childl Day Care; (8) Referral/ Assistance
(3 )Couflseling (Gerontological and Mental Health); (9) Screening / Assessment;
(4)Education/Training; (10) Sitter; and
(5)Infor:mation (11) Transportation
(6)Legal Assistance
2.1.3. Monitoring the Performance of Subcontractors
The COlltractor shall conduct at least one monitoring per year of each subcontractor. The
contractor shall perform fiscal, administrative and programmatic IT,lonitoring of each
subcontractors to ensure contractual compliance, fiscal accountability, programmatic
perforrrlance, and compliance with applicable state and federal laws and regtllations.
2.2. SERVI<:E LOeA TION AND EQUIPMENT
2.2.1. SerViCE! Times
The COfLtractor shall ensure the provision of the services listed in the contract during normal
business hours unless other times are more appropriate to meet the performance requirements of
the contract, and it shall monitor its subcontractors to ensure tlley are available to provide
services during hours responsive to client needs and during those times which best meet the
needs of the relevant service community.
2.3. Equipmlent
2.3.1. Equipmerlt means: (a) an article of nonexpendable, tangible personal property having a useful life
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CONTRACT AA-1015
of more trlan one year and an acquisition cost which equals or exceeds the lesser of the
capitalization level established by the organization for the financial statement purposes, or
$5,000.00 [for federal funds], or (b); nonexpendable, tangible personal property of a
nonconsu:mable nature with an acquisition cost of $1,000.00 or more per unit, and expected useful
life of at least one year; and hardback bound books not circulated to students or the general public,
with a value or cost of $250.00 or more [for state funds].
2.3.2. Contractors and sub-contractors who are Institutions of Higher Education, Hospitals, and
Other Non-Profit Organizations shall have written property management standards in compliance
with 2 CF~R Part 215 Administrative Requirements (formerly OMB Circular A-I 10) that include: (a)
a property' list with all the elements identified in the circular; and, (b) a procedure for conducting a
physical inventory of equipment at least once every two years. The property records must be
maintained on file and shall be provided to the Alliance upon request.
2.3.3. The contractor's property management standards for equipment acquired with Federal funds and
federally-owned equipment shall include accurately maintained equipment records with the
following information:
( I ) A description of the equipment;
(2) Manufactllrer's serial number, model number, Federal stock number, national stock number,
or other i(ientification number;
(3) Source of the equipment, including the award number;
(4) Whether title vests in the contractor or the Federal Government;
(5) AcquisitioJn date (or date received, if the equipment was furnished by the Federal Government) and
cost;
(6) Information from which one can calculate the percentage of Federal participation in the cost of the
equipment (not applicable to equipment furnished by the Federal Government);
(7) Location a:nd condition of the equipment and the date the information was reported;
(8) Unit acquisition cost; and
(9) Ultimate disposition data, including date of disposal and sales price or the method used to determine
current fair market value where a contractor compensates the Federal awarding agency for its
share.
2.3.4. Equipment purchased with federal funds with an acquisition cost over $5,000.00 and equipment
purchased. with state funds with an acquisition cost over $1,000.00 that is specifically
identified in the area plan approved by the Alliance is part of the cost of carrying out the
activities and functions of the grant awards and Title (ownership) will vest in the contractor,
subject to the conditions of 2 CFR Part 215 Administrative Requirements (formerly OMB Circular
A-I 10), Subpart C, Paragraph 34. Equipment purchased under these thresholds is considered
supplies a:nd is not subject to property standards. Equipment purchased with funds identified in the
budget attachments to agreements covered by this contract, or identified in the sub-
agreements with sub-contractors (not included in a cost methodology), is subject to the
conditions of section 273, F. S. and 60A-1.0017, F. A. C. or Title 45 CFR Part 74.
2.3.5. The contractor shall not dispose of any equipment or materials provided by the Alliance, or
purcl1ased with funds provided tl1rough tl1is contract without first obtaining the approval of the
Alliance's Contract Manager. When disposing of property or equipment the contractor must
submit a vvritten request for disposition instructions to the respective Contract Manager. The
request sl10uld include a brief description of the property, purchase price, funding source,
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CONTRACT AA-1015
percentage of state or federal participation, acquisition date and condition of the property. The
request should also indicate the contractor's proposed disposition (i.e., transfer or donation to
another a~;ency that administers federal programs, offer the items for sale, destroy the items, etc.).
2.3.6. TIle AllianLce's Contract Manager will issue disposition instructions. If disposition instructions are
not received within 120 days of the written request for disposition, the contractor is authorized to
proceed as directed in 2 CFR Part 215 Administrative Requirements (formerly OMB Circular A-I
10).
2.3.7. Real property means land (including land improvements), buildings, structures and
appurtenances thereto, but excludes movable machinery and equipment. Real property may not
be purchased with state or federal funds through agreements covered under this contract without
the prior approval of the Alliance. Real property purchases from Older Americans Act funds are
subject to the provisions of Title 42, Chapter 35, Subchapter III, Part A., Sec. 3030b United States
Code (US<:). Real property purchases from state funds can only be made through a fixed capital
outlay grants and aids appropriation and therefore are subject to the provisions of s. 216.348, F. S.
2.3.8. Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted
and testecl prior to disposal to ensure no confidential information remains.
2.4. DELIV~ERABLES
2.4.1 Service Unit
The conltractor shall provide the services described in the contract in accordance with
A IT AC:HMENT A. The chart below lists the services that can be performed and the unit of
measurement.
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CONTRACT AA-1015
SERVICE
UNIT OF SERVICE
Adult Day Carel Adult Day Health Interpreter /Translating
Care Legal Assistance
Caregiver Training/Support Medication Management
Case Aid/Case Management Mental Health
Child Day Care Counseling/Screeni11g
Chore Services Nutrition Counseling
Companionship Occupational Therapy
Congregate Meals Screening Personal Care
Counseling Services Physical Fitness Hour
Escort Physical Therapy Recreation
Financial Risk Reduction Services Respite Services
Health Support Screening/ Assessment
Home Health Aide Sitter
Homemaker Skilled Nursing Services
Housing Improvement Speech Therapy
Intake
Emergency Alert Response Day
EducatiorL/Training
Information
Material j\id
Medication Management
Nutrition Education
Outreach
Referral/ i\ssistance
Specialized Medical Equipment, Services and Supplies Episode
Telephone Reassurance
Escort
Shopping Assistance
Transportation One-Way Trip
Congregate and Home Delivered Meals Meal
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CONTRACT AA-1015
2.5 B~EPORTS
2.5.1 The contractor is responsible for responding in a timely fashion to additional routine and/or
special requests for information and reports required by the Alliance. The contractor must
establish due dates for any subcontractors that permit the contractor to meet the Alliance's
reporting requirements.
2.5.2. Service Costs Reports
The contractors shall submit to the Alliance semi-annual service cost reports, which reflect actual
costs of providing each service by program. This report provides information for planning and
negotiating unit rates.
2.5.3. Surplus/Deficit Report
The contractor will submit a consolidated surplus/ deficit report in a format provided by the
Alliance to the Alliance's Contract Manager by the 25th of each month. This report is for all
agreements and/ or contracts between the contractor and the Alliance. The report shall include
the following:
( I)A list of all subcontractors and their current status regarding surplus/ deficit;
(2)The contractor's detailed plan on how the surplus/ deficit spending exceeding the threshold
specified by the Alliance will be resolved;
(3)Recommendations to transfer funds to resolve surplus/ deficit spending;
(4 ) Input from the contractor's Board of Directors on resolution of spending issues, if applicable
(5)Number of clients currently on Assessed Priority Consumer List (APCL) that receive a priority
ranking score of 4 or 5.
2.5.4. Disease Prevention and Health Promotion Services Reports
The contractor shall submit detailed reports of health and wellness promotion, disease
prevention and self-management activities in accordance with the requirements of the Alliance.
2.5.5. OAA Annual Report
The contractor will provide the Alliance with the data needed to complete the Older American's
Act Annual Report.
2.6. RECORDS AND DOCUMENT AnON
'The contractor will ensure the collection and maintenance of client and service information on a
monthly basis from the CIRTS or any such system designated by the Alliance. Maintenance
includes valid exports and backups of all data and systems according to Alliance standards.
2.6.1. Each contractor and subcontractor, among other requirements, must anticipate and prepare for
the loss of information processing capabilities. The contractor shall maintain written policies and
.procedures for computer system backup and recovery and shall have the same requirement in
its contracts and/ or agreements with subcontractors. TI1ese policies and procedures shall be
made available to the Alliance upon request.
2.7. PERFORMANCE SPEOFICA nONS
2.7.1. Outcomes
q(1) TI1e contractor shall timely submit to t11e Alliance all reports described in
A IT ACHMENT I, Paragraph 2.5. REPORTS;
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CONTRACT AA-1015
(2) The contractor shall timely submit to the Alliance all information described in
A TT ACHMENT I, Paragraph 2.6. RECORDS AND DOCUMENT A nON;
(3) The contractor shall ensure services in this contract are in accordance with
A TIACHMENT A.
2.7.2. The performance of the contractor in providing the services described in this contract shall be
measured by the current Area Plan strategies for the following criteria:
(l)Percent of most frail elders who remain at home or in the community instead of going into a
l1ursing home;
(2)Percent of Adult Protective Services (APS) referrals who are in need of immediate services to
prevent further harm who are served within 72 hours;
(3)A verage monthly savings per consumer for home and community-based care versus
nursing home care for comparable client groups;
(4)Percent of elders assessed with high or moderate risk environments who improved their
environment score;
(5)Percent of new service recipients with high-risk nutrition scores whose nutritional status
improved;
(6)Percent of new service recipients whose ADL assessment score has been maintained or
improved;
(7)Percent of new service recipients whose IADL assessment score has been maintained or
improved;
(8)Percent of family and family-assisted caregivers who self-report they are very likely to provide
care;
(9)Percent of caregivers whose ability to continue to provide care is maintained or improved
after one year of service intervention (as determined by the caregiver and the assessor); and
(10)Percent of customers who are at imminent risk of nursing home placement who are served
with community based services.
2.7.3. Monitoring and Evaluation Methodology
The Alliance will review and evaluate the performance of the contractor under the terms of
this contract. Monitoring shall be conducted through direct contact with the contractor through
telephone, in writing, or an on-site visit. The Alliance's determination of acceptable performance
shall be conclusive. The contractor agrees to cooperate with the Alliance in monitoring the
progress of completion of the service tasks and deliverables.
2.8. CONTRACTOR'S FINANOAL OBLIGA nONS
2.8.1. Matching, Level of Effort, and Earmarking Requirements
The contractor will provide match of at least 10 percent of the federal administrative funds
received. The contractor's match will be made in the form of cash, general revenue
administrative funds and/ or in-kind resources. The contractor will assure, through a provision
in subcontracts, a match requirement of at least 10 percent of the cost for all services funded
through this contract except Title IIID. The subcontractor's match will be made in the form of
cash and/ or in-kind resources. Match must be reported by title each month. At the end
of the contract period, all OAA funds must be properly matched.
2.8.2. Consumer Contributions
(I)The contractor assures compliance with Section 315 of the Older Americans Act as
amended in 2006, in regard to consumer contributions;
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CONTRACT AA-1015
(2)\/oluntary contributions are not to be used for cost sharing or matching;
(3)Accumulated voluntary contributions are to be used prior to requesting federal
reinlbursement; and
(4)v'oluntary contributions are to be used only to expand services.
2.8.3. Use of Service Dollars
The contractor is expected to spend all federal, state and other funds provided by the
Alliance for the purpose specified in the contract. The contractor must manage the
service dollars in such a manner so as to avoid having a wait list and a surplus of funds
at t11e end of the contract period, for each program managed by the contractor. If the
Alliance determines that the contractor is not spending service funds accordingly, the
Alliance may transfer funds to other PSAs during the contract period and/ or adjust
subsequent funding allocations accordingly, as allowable under state and federal law.
2.9. AL]~IANCE RESPONSIBILITIES
2.9.1. Prol~ram Guidance and Technical Assistance
The Alliance 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 Alliance shall, at its own discretion, conduct monitoring concerning any aspect of
the contractor's performance of this contract.
SECTI01'1 III: METHOD OF PAYMENT
3.1. General Statement of Method of Payment
The method of payment for this contract includes advances, cost reimbursement for
administration costs, and fixed rate for services. The contractor shall ensure fixed rates
for services include only those costs that are in accordance with all applicable state and
federal statutes and regulations and are based on audited historical costs in instances
where an independent audit is required. The contractor shall consolidate all requests for
payment from subcontractors and expenditure reports that support requests for payment
and shall submit to the Alliance on forms 106A (A TT ACHMENT X), 105AA
(ATTACHMENT IX-A), 105AS (ATTACHMENT IX-B) and 105AE (ATTACHMENT
IXC).
3.2. Advance Payments
3.2.1. The contractor may request up to two months of advances at the start of the contract
period, if available, to cover program administrative and service costs. The payment of
an advance will be contingent upon the sufficiency and amount of funds released to the
Alliance by the State of Florida ("budget release"). The contractor shall provide the
Alliance's Contract Manager documentation justifying the need for an advance and
describing how the funds will be distributed.
3.2.2. The contractor's requests for advance require the approval of the Alliance's. If
sufficient budget is available, the Alliance will issue approved advance payments after
Jantlary I, 2010.
3.2.3. Requests for the third through the tvvelfth months shall be based on the submission of
actlLal monthly expenditure reports beginning with the first month of the contract. TI1e
schedule for submission of advance requests, if available is shown on A TT ACHMENT
23/48
3.2.4.
3.2.5.
3.3.
3.3.1.
3.3.2.
3.4.
3.4.1.
3.4.2.
CONTRACT AA-1015
VIII of this contract.
All advance payments made to the contractor shall be recouped in accordance with
the Reporting Schedule, ATTACHMENT VIII of this contract.
Interest earned on advances must be identified separately by source of funds, state or
federal. Contractors shall maintain advances of federal funds in interest bearing accounts
unless otherwise excepted in accordance with 45 CFR 74.22(k).
Invoice Submittal and Requests for Payment
All requests for payment and expenditure reports submitted to support requests for
payment shall be on DOEA forms l06A (ATTACHMENT X), l05AA (ATTACHMENT
IX-A), l05AS (ATTACHMENT IX-B) and l05AE (ATTACHMENT IX-C). Duplication or
replication of both forms via data processing equipment is permissible, provided all data
elements are in the same format as included on Alliance forms.
All payment requests shall be based on the submission of actual monthly expenditure
reports beginning with the first month of the contract. The schedule for submission
of advance requests (when available) and invoices is ATTACHMENT VIII to this
contract.
Any payment due by the Alliance under the terms of this contract may be withheld
pending the receipt and approval of all financial and programmatic reports due from the
contractor and any adjustments thereto, including any disallowance not resolved as
outlined in Paragraph 22 of this contract.
Documentation for Payment
The contractor shall maintain documentation to support payment requests that shall be
available to the Alliance or authorized individuals, such as Alliance of Financial Services,
upon request.
The contractor shall ensure subcontractors enter all required data per the Alliance's CIRTS
Policy Guidelines for clients and services in the CIRTS database. Data must be entered into
CIRTS before the subcontractors submit their request for payment and expenditure reports
to the contractor. The contractor shall establish time frames to assure compliance with due
dates for the requests for payment and expenditure reports to the Alliance.
The contractor will require subcontractors to run monthly CIRTS reports and verify that client
and service data in CIRTS is accurate. This report must be submitted to the contractor with the
monthly request for payment and expenditure report and must be reviewed by the contractor
before the subcontractor's request can be approved by the contractor.
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CONTRACT AA-1015
ATTACHMENT II
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS,
LOANS AND AGREEMENTS
The undersigned certifies/ to the best of his or her knowledge and belief/ that:
(I )No federal apIJropriated funds have been paid or will be paid/ by or on behalf of the undersigned/
to any person for influencing or attempting to influence an officer or employee of any state or federal
agency/ a member of congress/ an officer or employee of congress/ an employee of a member of congress/
or an officer or enlployee of the state legislator/ in connection with the awarding of any federal grant/ the
making of any fe<ieralloan/ the entering into of any cooperative agreement/ and the extension/
continuation/ renewat amendment, or modification of any federal contract, grant/ loan/ or cooperative
agreement.
(2)lf any funds otller 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 emplo)ree 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-Ll.JL/ "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3)The undersigned shall require that the language of this certification be included in the award documents
for all sub-awards at all tiers (including subcontracts/ sub-grants, and contracts under grants, loans and
cooperative agree:ments) and that all subcontractors shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction imposed by section 1352, Title 31/ U.S. Code. Any person who fails to file
the required certification shall be subject to a civil penalty of not less than $10,000.00 and not more than
$100,000.00 for each such failure.
Signature
Date
Name of Authorized Individual
Application or Agreement Number
Name and Address of Organization
[)()EA Form 103 (Revised Nov 2(02)
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CONTRACT AA-1015
A ITACHMENT III
FINANOAL AND COMPLIANCE AUDIT
TIle administratior\ of resources awarded by the Alliance to the provider may be subject to audits and/ or
monitoring by the i\lliance, as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section
215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by the
Alliance staff, limited scope audits as defined by OMB Circular A-133, as revised, and/ or other procedures. By
entering into this agreement, the provider agrees to comply and cooperate with any monitoring
procedures/processes deemed appropriate by the Alliance for Aging. In the event the Alliance for Aging
determines that a limited scope audit of the provider is appropriate, the provider agrees to comply with any
additional instructions provided by the Alliance to the provider regarding such audit. The provider further
agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by any
level of government.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB
Circular A-133, as revised.
In the event that tIle provider expends $500,000.00 or more in Federal awards during its fiscal year, the provider
must have a single or program-specific audit conducted in accordance with the provisions of OMB Circular A-
133, as revised. EX:HIBIT 1 to this agreement indicates Federal resources awarded through the Alliance by this
agreement. In determining the Federal awards expended in its fiscal year, the provider shall consider all sources of
Federal awards, including Federal resources received from the Alliance. The determination of amounts of Federal
awards expended should be in accordance with the guidelines established by OMB Circular A-133, as revised. An
audit of the provider conducted by the Auditor General in accordance with the provisions of OMB Circular A-133,
as revised, will meet the requirements of this part.
In connection wit]h the audit requirements addressed in Part I, paragraph I, the provider shall fulfill the
requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised.
If the provider expends less than $500,000.00 in Federal awards in its fiscal year, an audit conducted in
accordance with t.rle provisions of OMB Circular A-133, as revised, is not required. In the event that the provider
expends less than $500,000.00 in Federal awards in its fiscal year and elects to have an audit conducted in
accordance with tlle provisions 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 must be paid from provider resources obtained from other than
Federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's
fiscal year. ComF,liance findings related to agreements with the Alliance shall be based on the agreement's
requirements, inCll.:Lding any rules, regulations, or statutes referenced in the agreement. The financial statements
sllall disclose whether or not the matching requirement was met for each applicable agreement. All questioned
costs and liabilities due to the Alliance shall be fully disclosed in the audit report with reference to the Alliance
agreement involvec!. If not otherwise disclosed as required by Section .310(b)(2) of OMB Circular A-133, as revised,
the schedule of expenditures of Federal awards sllall identify expenditures by agreement number for each
agreement with the Alliance in effect during the audit period. Financial reporting packages required under this
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CONTRACT AA-1015
part must be submitted within the earlier of 30 days after receipt of the audit report or 9 months after the end of the
provider's fiscal year end.
As an Alliance reqllirement the Statement of Functional Expenses need to be part of the Financial and Compliance
Audit Report.
PART II: STATE FUNDED
This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2)/ Florida Statutes.
In the event that the provider expends a total amount of state financial assistance equal to or in excess of
$500/000.00 in an:y fiscal year of such provider (for fiscal years ending September 30/ 2004 or thereafter),
the provider must have a State single or project-specific audit for such fiscal year in accordance with
Section 215.97/ Florida Statutes; applicable rules of the Alliance of Financial Services; and Chapters 10.550
(local governmerttal entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor
General. EXHIBI1" I to this agreement indicates state financial assistance awarded through the Alliance by
this agreement. Irt determining the state financial assistance expended in its fiscal year, the provider shall
consider all sources of state financial assistance, including state financial assistance received from the
Alliance, other state agencies, and other nonstate entities. State financial assistance does not include
Federal direct or pass-through awards and resources received by a nonstate entity for Federal program
matching requirelnents.
In connection witJh 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 215.97(2)/ Florida Statutes, and Chapter 10.550 (local
governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General.
If the provider expends less than $500/000.00 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 $500/000.00 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 condulcted in accordance with this part shall cover the entire organization for the
organization's fiscal year. Compliance findings related to agreements with the Alliance shall be based on
the agreement's requirements, including any applicable rules, regulations, or statutes. The financial
statements shall d.isclose whether or not the matching requirement was met for each applicable agreement.
All questioned costs and liabilities due to the Alliance shall be fully disclosed in the audit report with
reference to the l\lliance 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 Alliance in effect during the audit period. Financial
reporting packages required under this part must be submitted within 45 days after delivery of the audit
report, but no later than 12 months after the provider's fiscal year end for local governmental entities.
Non-profit or foro-profit organizations are required to be submitted within 45 days after delivery of the
audit report, but no later than 9 months after tl1e provider's fiscal year end. Notwithstanding the
applicability of t]1is portion, the Alliance retains all right and obligation to monitor and oversee the
performance of this agreement as outlined throughout this document and pursuant to law.
As an Alliance reql1irement the Statement of Functional Expenses need to be part of the Financial and Compliance
Audit Report.
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CONTRACT AA-1015
PART III: REPO~RT SUBMISSION
Copies of reportirlg packages for audits conducted in accordance with OMB Circular A-133, as revised, and
required by PARlr I of this agreement shall be submitted, when required by Section .320 (d), OMB Circular
A-133, as revised, by or on behalf of the provider directly to each of the following:
The Alliance for P\.ging, Inc. at the following address:
Alliance for Aging, Inc.
Attn: Carlos Lahitte
9500 South Dadeland Boulevard, Suite 400
Miami, FL 33156-2867
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CONTRACT AA-1015
A TT ACHMENT III
EXmBIT-2
PART I: AUDIT RELATIONSHIP DETERMINA nON
Providers who receive state or federal resources mayor may not be subject to the audit requirements of OMB
Circular A-133, as revised, and/ or Section 215.97/ Fla. Stat. Providers who are determined to be recipients or
subrecipients of fe(ieral awards and/ or state financial assistance may be subject to the audit requirements if the
audit threshold req.uirements set forth in Part I and/ or Part II of Exhibit 1 are met. Providers who have been
determined to be ,rendors are not subject to the audit requirements of OMB Circular A-133, as revised, and/ or
Section 215.97/ Fla. Stat. Regardless of whether the audit requirements are met, providers who have been
determined to be recipients or sub recipients of Federal awards and/ or state financial assistance, must comply
with applicable programmatic and fiscal compliance requirements.
In accordance with Sec. 210 of OMB Circular A-133 and/ or Rule 691-5.006, F AC, provider has been determined to
be:
_ Vendor or exempt entity and not subject to OMB Circular A-133 and/or Section 215.97, F.S.
..L Recipient/ subrecipient subject to OMB Circular A-133 and/ or Section 215.97/ F.S.
NOTE: If a provider is determined to be a recipient / subrecipient of federal and or state financial assistance and
l1as been approved by the Alliance to subcontract, they must comply with Section 215.97(7)/ F.S., and Rule 691-
.006(2)/ FAC [state financial assistance] and Section _ .400 OMB Circular A-133 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL A W AR~DS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive
Federal awards or state matching funds on Federal awards and who are determined to be a subrecipient, must
comply with the fo:Uowing fiscal laws, rules and regulations:
STATES, L()CAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB
Circlllar A-87)*
OMl3 Circular A-I02 - Administrative Requirements
OMl3 Circular A-133 - Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON-PRO]~T ORGANIZA nONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non-Profit Organizations (Formerly OMB Circular A-122 - Cost
Principles) *
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A-I 10 - Administrative
Reqllirements)
ReqtIirements)
OM13 Circular A-133 - Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCA TIC)NAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENTI MUST
FOLLOW:
2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A-21 - Cost
Principles) *
29/48
CONTRACT AA-1015
2 CF'R Part 215 Administrative Requirements (Formerly OMB Circular A-lID - Administrative
Reql1irements)
OMlB Circular A-133 - Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in
the OMB Circular A-133 Compliance Supplement, Appendix 1.
STATE FINANC:IAL ASSISTANCE. Providers who receive state financial assistance and who are
determined to be a recipient/ subrecipient, must comply with the following fiscal laws, rules and regulations:
Section 215.97, Fla. Stat.
Chapter 691-5, Fla. Admin. Code
State Projects Compliance Supplement
Reference C;uide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
30/48
CONTRACT AA.1015
ATTACHMENT IV
CERTIFICA TIOr~ REGARDING DATA INTEGRITY
COMPLIANCE I~OR AGREEMENTS, GRANTS, LOANS AND
COOPERA TIVE AGREEMENTS
The undersigned, an authorized representative of the contractor named in the contract or agreement to
which this form is an attachment, hereby certifies that:
( I )The contractor and any sub-contractors of services under this contract have financial management
systems capable of providing certain information, including: (1) accurate, current, and complete disclosure
of the financial results of each grant- funded project or program in accordance with the prescribed
reporting requirements; (2) the source and application of funds for all agreement supported activities;
and (3) the comJ:1arison of outlays with budgeted amounts for each award. The inability to process
information in accordance with these requirements could result in a return of grant funds that have not
been accounted for properly.
(2)Management Information Systems used by the contractor, sub-contractor(s), or any outside entity on
which the contractor is dependent for data that is to be reported, transmitted or calculated, have been
assessed and verified to be capable of processing data accurately, including year-date dependent
data. For those systems identified to be non-compliant, contractor(s) will take immediate action to
assure data integrity.
(3)If this contract includes the provision of hardware, software, firmware, microcode or imbedded
chip technology, the undersigned warrants that these products are capable of processing year-date
dependent data accurately. All versions of these products offered by the contractor (represented by the
undersigned) ancl purchased by the State will be verified for accuracy and integrity of data prior to
transfer.
In the event of any decrease in functionality related to time and date related codes and internal
subroutines t]1at impede the hardware or software programs from operating properly, the contractor
agrees to imLnediately make required corrections to restore hardware and software programs to the
same level of functionality as warranted herein, at no charge to the State, and without interruption to
the ongoing business of the state, time being of the essence.
(4) The contractor and any sub-contractor(s) of services under this contract warrant their policies and
procedures inlclude a disaster plan to provide for service delivery to continue in case of an
emergency including emergencies arising from data integrity compliance issues.
The contractor shall require that the language of this certification be included in all subagreements,
subgrants, and other agreements and that all sub-contractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by OMB Circulars A-I02 and 2 CFR Part 215 (formerly OMB Circular A-I 10).
Name and Address of Contractor
Signature
Title
Date
Name of Authorized Signer
(Revised June 2008)
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CONTRACT AA-1015
A TT ACHMENT V
c:ERTIFICA TION REGARDING DEBARMENT, SUSPENSION,
Il~ELIGIBILITY AND VOLUNTARY EXCLUSION FOR LOWER TIER
COVERED TRANSACTIONS
(1 )The prospective contractor certifies, by signing this certification, neither it nor its principals are
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded
from participation in this transaction by any federal Alliance or agency.
(2)Where the J)rOS1Jective contractor is unable to certify to any of the statements in this certification,
such prospective F)articipant shall attach an explanation to this certification.
Signature
Date
Title Agency /Organization
(Certification signature should be same as Contract signature.)
Instructions for Certification
I.The terms "covered transaction/" "debarred/" "suspended/" "ineligible/" "lower tier covered
transaction/" "person/" "primary covered transaction/" and "voluntarily excluded/If as used herein, have
the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-
180.1020/ as sllPplemented by 2 CFR 376.10-376.995). You may contact the Contract Manager for
assistance in obtaining a copy of those regulations.
2.This certification is a material representation of facts upon which reliance was placed when the
parties entered. into this transaction. If it is later determined that the contractor knowingly rendered an
erroneous certification, in addition to other remedies available to the federal government, the
Alliance 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 lealTIS that its certification was erroneous when submitted or has become erroneous by
reason of char\ged 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 tOt check the Excluded Parties List System (EPLS).
4.The contractor will include a "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion - Lower Tier Covered Transaction" in all its lower tier covered transactions and in
all solicitations for lower tier covered transactions.
5.Tl1e 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 a'uthorized by the federal government.
6.If the contractor knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to otller remedies available to the federal government, the Alliance may pursue available
remedies, incl.uding suspension, and/ or debarment.
7.The contractor may rely upon a certification of a prospective participant hi a lower tier covered
transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered
transaction, u:nless it knows that the certification is erroneous.
(Revised June 2(08)
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CONTRACT AA-1015
A TT ACHMENT VI
ASSURANCES-NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 45 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and
reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to the Office of Management and Budget. Paperwork Reduction
Project (0348-0043), W'ashington, DC 20503.
PLEASE DC) NOT RETURN YOUR COMPLETED FORM TO TIlE OFFICE OF MANAGEMENT AND
BUDGET, ~,END IT TO THE ADDRESS PROVIDED BY TIlE SPONSORING AGENCY.
Note: Certain of th~~se assurances may not be applicable to your project or program. If you have questions please
contact the awardirlg agency. Further, certain Federal awarding agencies may require applicants to certify to
additional assuran(:es. If such is the case, you will be notified.
I.Has the legal autllority to apply for Federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-Federal share of project cost) to ensure proper planning, management, and
completion of the project described in this application.
2.Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State,
through any authorized representative, access to and the right to examine all records, books, papers, or
documents related to the award; and will establish a proper accounting system in accordance with generally
accepted accountin,~ standards or agency directives.
3.Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or
presents the appearance of personal or organizational conflict of interest, or personal gain.
4.Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding
agency.
5.Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C.. 4728-4763) relating to prescribed
standards for merit systems for programs funded under one of the 19 statutes or regulations specified in
Appendix A of OP:M's Standards for a Merit System of Personnel Administration (5 C.F.R. 900/ Subpart F).
6.Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title
VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or
national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C.. 1681-1683/ and 1685-
1686)/ which prohilbits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C..794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act
of 1975/ as amendeld (42 V.S.C.. 6101-6107)/ which prohibits discrimination on the basis of age; (e) the Drug Abuse
Office and Treatment Act of 1972 (P.L. 92-255)/ as amended, relating to nondiscrimination on the basis of drug
abuse; (f) the ComJ:trehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970
(P.L. 91-616)/ as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g). 523 and 527
of the Public Healttl Service Act of 1912 (42 U.S.C.. 290 dd-3 and 290 ee 3)/ as amended, relating to confidentiality of
alcohol and drug albuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C.. 3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination
provisions in the sp'ecific statute(s) under which application for Federal assistance is being made; and (1) the
requirements of an~1 other nondiscrimination statute(s) which may apply to the application.
7.Will comply, or has already complied, with the requirements of Titles II and III of the uniform Relocation
Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable
treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs.
These requirements apply to all interests in real property acquired for project purposes regardless of Federal
participation in purchases.
8.Will comply, as a1=)plicable, with the provisions of tl1e Hatch Act (5 D.S.C.. 1501-1508 and 7324-7328), which limit the
political activities of employees whose principal employment activities are funded in w110le or in part with Federal
funds.
9.Will comply, as alJplicable, with the provisions of the Davis-Bacon Act (40 U.S.C..276a to 276a-7), the Copeland
Act (40 V.S.C. 276c and 18 V.S.C. 874) and the Contract Work Hours and Safety Standards Act (40 V.S.C. 327-333),
regarding labor sta11dards for federally assisted construction subagreements.
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CONTRACT AA-1015
lO.Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to Pllrchase flood insurance if the total cost of insurable construction and acquisition is $10,000.00 or
more.
it.Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution
of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order (I~O) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of
wetlands pUrSUaIlt to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e)
assurance of proiect consistency with the approved State management program developed under the Coastal
Zone Managemellt Act of 1972 (16 U.S.C..1451 et seq.); (f) conformity of Federal actions to State (Clear Air)
Implementation f'lans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C..7401 et seq.);
(g) protection of tmderground sources of drinking water under the Safe Drinking Water Act of 1974, as
amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as
amended, (P.L. 93.-205).
12 Will comply \vith the Wild and Scenic Rivers Act of 1968 components of the national wild and scenic rivers
system. (16 U.S.C..1721 et seq.) related to protecting components or potential
13.Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation
Act of 1966, as amended (16 U.S.C..470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974 (16 U.S.C..469a-1 et seq.).
14.Will comply with P.L. 93-348 regarding the protection of human subiects involved in research, development,
and related activities supported by this award of assistance.
15.Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C..2131 et seq.)
pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other
activities supported by this award of assistance.
16.Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C..4801 et seq.), which prohibits the
use of lead- based paint in construction or rehabilitation of residence structures.
17.Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and OMB Circular No. A-133, Audits of States, Local Governments, and Non-Profit
Organizations.
18.Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and
policies governing this program.
SIGNATURE OF AUfHORIZED CERTIFYING OFFICIAL TITLE
APPLICANT ORGANIZATION DATE SUBWTIED
34/48
CONTRACT AA-1015
A TT ACHMENT VII
BLANK
35/48
Report
CONTRACT AA-1015
A TT ACHMENT VIII
CONTRACT REPORT CALENDAR ADVANCE BASIS CONTRACT
Based On
Submit to the Alliance on
this Date
Janua 1
Janua 1
Februar 5
March 5
A ril 5
Ma 5
une5
Jul 5
Au st 5
Se tember 5
October 5
November 5
December 5
Janua 5
Februa 14
Februar 28
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
ort
Legend: * Ad\rance based on projected cash need. ** Submission of expenditure reports mayor
may not ~enerate a payment request. If final expenditure report reflects funds due back to the
Alliance, a merlt is to accom an the re ort.
Note#l: Report #1 for Advance Basis Agreements cannot be submitted to the State Comptroller
prior to January 1 or until the agreement with the Alliance has been executed and a copy sent to
the Comptroller. Actual submission of the vouchers to the State Comptroller is dependent on the
accuracy of the expenditure report.
Note # 2: The last two months of the recipient's fiscal reports covering actual expenditures shall
reflect an adjustlnent repaying advances for the first two months of the agreement, if advances have not
been recou ed.
36/48
CONTRACT AA-l015
J an uary 2010
Contract #KA009 A TT ACHMENT IX-A
RECEIPTS AND EXPENDITURE
REPORT OLDER AMERICAN ACT
Program Flmding Source:
THIS REPORT PERIOD
FROM: TO:
CONTRACT PERIOD:
PROVIDER NAME, ADDRESS, PHONES AND FEID#
CONTRACT #
REPORT*
PSA#
CERTIHCA TION: 1 certifv to the best of my knowled~e and belief that this report is complete and all outlays herein are for purposes set forth
in the contract.
Prepared bv: Date: Approved bv: Date:
1. Approved Budget 2. Actual Receipts For 3. Total Receipts Year 4. Percent of
P ART A : BUDGETED INCOMEI RECEIPTS $0.00 This Report to Date Approved Budget
$0.00 $0.00
2. State Funds 50.00 $0.00 50.00 ' ()
3. Program Income $0.00 SO.OO SO.OO j{ )
-l. Cash Match (CCE, HCE and Other) $0.00 SO.OO SO.OO II
5. SUBTOTAL: CASH RECEIPTS $0.00 50.00 SO.OO /0
6. Local In-Kind Match 50.00 $0.00 $0.00 II
7. TOTAL RECEIPTS SO.OO 50.00 50.00 ()
1. Approved Budget 2. Expenditures For 3. Expenditures Year 4. Percent of
$0.00 This Report to Date Approved Budget
PART B: EXPENDITURES 1. $0.00 $0.00
2. Travel SO.OO $0.00 $0.00 (~~ )
3. TOTAL EXPENDITURES $0.00 $0.00 SO.OO
PART C : OTHER EXPENDITURES
(For tracking purposes only)
1. Match: CCE/GR HCE/GR
Other and In-Kind 2. Local Match
3. TOTAL
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
SO.OO
PART D: Other Revenue and Expenditures 1.
n. Addition Cost Alternative Program Income III. Interest 1. Earned on GR
a.OAA Unbudgeted PI Receipts YfD
S
2. Received YTD
3. Expenditures
:5
:5
2. Return of GR Advance S
3. Other Earned S
IX)EA FORM 105aa revised 10/08
37/48
CONTRACT AA-1015
January 2010
Contract #
r\. IT ACH!v1ENT IX-B
RECEIPTS AND EXPENDITURE REPORT OLDER AMERICAN ACT
PROVIDER NAME, ADDRESS, PHONES AND FEID# Program Funding Source: IIIB lliIS REPORT PERIOD
III C 1 FROM: TO:
IllC2 CONTRACT
pJ:;DTnn.
CONTRACT #
H.EPORTS
PSA#
CERTIRCATION: 1 certify to the best of my knowledge and belief that this report is complete and all outlays herein are for purposes :;et forth in
the contract.
Prepared bv: Date: /\pproved bv: Date:
PART A: BUDGETED INCOME! RECEIPTS 1. Approved Budget 2. Actual Receipts For 3. Total Receipts Year -l. Percent of
1. Federal Flmds $0.00 This Report to Date Approved Budget
$0.00 $0.00
? Strl tp Fnnn" ~o 00 <;0 00 soon "I
l. Prm!ram Income ~O.OO ~O.OO SO.OO "I
4. T .11,;:)1 C;l'\h Mat,h (CCF HCF ;:)nn ()thpr) so on ~o nn ~o 00 "I"
5. SUBTOTAL: CASH RECEIPTS SO.OO SO.OO $0.00 '~~ I
6. Local In-Kind Match 50.00 $0.00 $0.00
7. TOTAL RECEIPTS $0.00 $0.00 $0.00
PART B: EXPENDITURES 1. 1. Approved Budget 2. Expenditures For 3. Expenditures Year ~. Percent of
Meals / Meal Agreements $0.00 This Report to Date Approved Budget
$0.00 $0.00
2. Service Subcontractor SO.OO $0.00 $0.00 I Y.,
'1 ()thpr ~o 00 q;O 00 so 00 ( ~I,.
4. Indirect Cost $0.00 $0.00 $0.00 ,,,
5. TOTAL EXPENDITURES SO.OO SO.OO $0.00
PART C : OTHER EXPENDITURES (For 50.00 $0.00 50.00
Tracking Purposes only)
1. Match a. Other and In-Kind
h T .11,;:)1 M;:)trh SO 00 ~o no ~o on ! )/
2. USDA Cash Received SO.OO SO.OO SO.OO 11/
3. TOTAL OlliER 50.00 SO.OO $0.00 II )
PART D : OlliER REVENUE J\ND EXPENDITURES 1. 2. Addition Cost Alternative Program Income ~\Interest .1. Earned on GR
Program Income (PI) a. Approved Budqet $ Adv.1nces S
L1. 01\A Unbudgeted PI Receipts YTD S b. Received YTD S b. Return of GR Adva nee 5
c. Expenditures S c. Other Earned
S
38/48
January 21009
CONTRACT AA-1015
RECEIPTS AND EXPENDITURE REroRT OLDER AIv1ERICAN ACT ATTACHMENT IX-C
Contract #
PROVIDER NAME, ADDRESS, PHONES AND FEIDS THIS REPORT PERIOD
FROM: TO:
Program Funding Source: CONTRACT PERIOD:
CONTRACT S
REPORTS
PSAS
CERTIFICATION: 1 certify to the best of my knowledge and belief that this report is complete and all set forth
outlays in the contract
Prepared bv: Date: Approved bv: lerein are for purposes
1. Approved Budget 2. Actual Receipts For 3. Total Receipts Year 4. Percent of
PART A: BUDGETED INCOME/ RECEIPTS 50.00 This Report to Date Approved Budget
50.00 50.00
2. State Funds 50.00 50.00 50.00 ()
3. Program Income 50.00 50.00 50.00 () I
4. Local Cash Match 50.00 50.00 50.00 ()
5. SUBTOTAL: CASH RECEIPTS 50.00 50.00 50.00 ()
6. Local In-Kind Match 50.00 50.00 $0.00 "I
/0
7. TOTAL RECEIPTS SO.OO $0.00 $0.00 ()
PART B : EXPENDITURES 1. Approved Budget 2. Expenditures For 3. SO.OO 4. Percent of
A: Direct Services 1. $0.00 This Report Expenditures Approved Budget
Personnel $0.00 Year to Date
2. Travel 50.00 $0.00 $0.00 'Xl
3. Building Space $0.00 $0.00 $0.00 'Xl
4. Communication / Utilities $0.00 $0.00 $0.00 01
,c I
5. Printing / Supplies $0.00 $0.00 $0.00 'X)
6. Equipment 7. $0.00 $0.00 $0.00 %
Other $0.00 $0.00 $0.00 () 1
B : Agreement Services 8. 50.00 50.00 $0.00 "(
1 (I
Services Subcontracted
9. TOTAL EXPENDITUI~ES $0.00 $0.00 $0.00 "(
1 ()
50.00 50.00 $0.00
10. DEDUCTIONS a.
Total Local Match
b. Program Income Used 50.00 $0.00 $0.00 0/
1(/
c. TOTAL DEDUCTIONS 50.00 SO.OO $0.00 %
11. NET EXPEN DlTURES $0.00 $0.00 SO.OO 01
2. Units of Services Year to Date 3. Number of People Served Year to Date
PART C: EXPENDITURES ANALYSIS A. Expenditures by . . . . . . . . . . . . . . . . . . . . . . . . . . .. $0.00 .... .... ............... ..... 0.00
......................................... SO .00 .......................................... 0.00
Services Year to Date: ........................................... . 50.00 0.00
.......................................a...
1. Information..... ...... ... ....... .... ........ 50.00 ...............a.............................. 50.00 a..................a............................ Mtl
2. Assistance ................................... 50.00 .. .... ..... ......... ........ sO.oo .. ........ .. .. .... .... . .. ... . .... ... .. ........ . .. .. ( )()()
J. Cl1lmseling .......... ........ ................ SO.OO
4. Respite ................................ ......... SO.OO
5. Supplemental Services .. SO 00
(). T ( ) T I\. L ......................................... 50.00
Part B Line 11, column J should be equal to this total.
FFY S
PART D: CRANDPARENT SERVICES (reported by Federal Fiscal Year)
OOEA FORi\110SAE revL,;ed 10/08
39/48
CONTRACT AA-1015
January 2010
REQUEST FOR P A )'MENTOLDER AMERICANS ACT
Contract # A Tl'ACHMENT X
PROVIDER NA\1E, ADDRESS, PHOl\l~ MD FED ID ~ 'L:vffiER TYPE OF REPORT: THIS REQUEST PERIOD:
Adv.mce Reimbursement Report #
.-\greement #:
Agreement Period:
PSA:
CERTIFICATION: 1 hereby certify to the be ~t of my kno~ ledge that this request conforms with the terms .md the purposes set forth in the above agreement.
Prepared Bv: Date: Approved Bv: Dale:
PART A: d) ( 2) (3) ~ -1:) (5) (6) ( 7) Title (6 )
BLDGET SCMMARY ,\DMIN. IIIB meI IIIC2 IIIE
TOTAL
1. Approved Agreement () . ()() () .00 ().OO () . ()() ().oo () . ()() () .00 l).OO
Amount.
2. Previous Funds 0.00 ().OO (UX) 0.00 (UX) (),( X) o . 00 0.00
RECEIVED for
Agreement period.
3. Agreement Balance (UX) (WO (UX) 0.00 0.00 (UX) lUX) 0.00
-1:. Previous Funds ( UX) (UX) ().OO 0.00 O.(X) ().OO (WO 0.00
REQUESTED for
Agreement period.
S. Agreement (U X) ( UX) (UX) (UX) O.lX) ( UX) (UX) n.oo
Balance
PART B:
FlJNDS REQUESTED
l.lst-2nd Months (UX) ().oo O.lX) (UX) 0.00 (),( X) 0.00 0.00
Request Only
2. Net Expenditures o . 00 (UX) (UX) (UX) (UX) (),( X) () . 00 l).OO
For Month
3. Additional Cash Needs 0.00 () .00 O.(X) 0.00 O.(X) ().oo (l.( X ) 0.00
(Attach Doc.)
-1:.. Total O. ()O lUX) (UX) (UX) ( UX) 1),( X) () .00 0.00
PART C:
:\lET FlJNDS REQUESTED:
1. Less: Over-Advance () . O() O. ()O o . ()O ().(X) o.()O (UX) O. ()O 0.00
2. Agreement Funds are O.O() ().oo ().oo 0.00 (UX) ().oo () . ()O n.oo
Hereby Requested For
:3 DATE ST A~IP
IX)FAFCRM 1())Al'e\i<alOl/CJl
40/48
CONTRACT AA-1015
January 2010
Contract #
A TIACHMENT A
Department of Elder Affairs Programs & Services Handbook, provided
on CD. Also, available at the Alliance's Intranet site under,
"Pub lications" .
41/48
CONTRACT AA-1015
ATTACHMENT B
STATE OF FLORIDA ALLIANCE
CIVIL RIGHTS COMPLIANCE CHECKLIST
Program/Facility r~ame County I Contractor
Address Completed By
City, State, Zip Ccx:le Date IT elephone
PART I. READ THE A IT ACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH WILL HELP YOU IN
THE CC)MPLETION OF THIS FORM.
1. Briefly describe the geographic area served by the program/ facility and the type of service provided:
2. POPULATION C)F AREA SERVED. Source of data:
I T otal# ~Vhite % Black % Hispanic
3. Sf AFF CURRENTLY EMPLOYED. Effective date:
I Total# ~Vhite % Black % Hispanic % Other
4. CLIENTS CURRENTLY ENROLLED OR REGISTERED Effective date:
I Total# ~Vhite % Black % Hispanic % Other
5. ADVISORY OR CDVERNING BOARD, IF APPLICABLE.
I Total # ~ White % Black % Hispanic
~/o Other
0/0 Female
0/0 Female
0/0 Disabled
(Yo Female
(Yo Disabled
0/0 Over 40
0/0 Other
0/0 Female
<Yo Disabled
PART II. USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE.
6. Is an Assurance of Compliance on file with the Alliance? If NA or NO explain
NA YES NO
7. Compare the staff composition to the population. Is staff representative of the population? If NA or NO, explain.
NA YES NO
8. Compare the client composition to the population. Are race and sex characteristics representative of the Population? If
NA or NO, ex]plain.
NA YES NO
9. Are eligibility requirements for services applied to clients and applicants without regard to race, color,
national OrigirL, sex, age, religion or disability? If NA or NO, explain.
~A YES NO
42/48
CONTRACT AA-1015
10. Are all benefits, services and facilities available to applicants and participants in an equally effective manner regardless
of race, sex, cDlor, age, national origin, religion or disability? If NA or NO, explain.
\lA YES NO
11. For in-patient services, are room assignments made without regard to race, color, national origin or disability? If NA or
NO, explain.
:\JA YES NO
12. Is the program/ facility accessible to non-English speaking clients? If NA or NO, explain.
NA YES NO
13. Are employees, applicants and participants informed of their protection against discrimination? If yes,
how? Verbal. Written. Poster. If NA or NO, explain.
.
14. Give the number and current status of any discrimination complaints regarding services or
employment filed against the program/ facility.
15. Is the program/ facility physically accessible to mobility, hearing, and sight-impaired individuals? If NA or NO, explain.
NA YES NO
PART III. THE FOLLOWING QUESTIONS APPLY TO PROGRAMS AND FACILITIES WITH 15 OR MORE EMPLOYEES
16. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals, and to make
any necessary modifications? If NO, explain.
YESNO
. .
43/48
CON I HAC I AA-' Ul:'
17. Is there and established grievance procedure that incorporates due process in the resolution of
complaints? If 1'10, explain.
. .
YJ:;"S ~IO
18. Has a person been designated to coordinate Section 504 compliance activities? If NO, explain.
YES NO
o 0
19. Do recruitment and notification materials advise applicants, employees and participants of
nondiscrimina1ion on the basis of disability? If NO, explain.
.
YES NO
20. Are auxiliary aids available to assure accessibility of services to hearing and sight impaired
individuals? If NO, explain.
. .
YES NO
PART IV. FOR PRC)GRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF $50,000 OR
MORE.
21. Do you have a ,mitten affirmative action plan? If NO, explain.
) 15 :'-J)
DOEA USE ONLY
Reviewed By Incompliance: YES . NO* ·
Program Office *Notice of Corrective Action Sent / /
Date I Telephone Response Due / /
On-Site n Desk Review n Response Received / /
DOEA Form lOl-A, Revised May 2008 Page 2 of 2
44/48
CONTRACT AA-1015
45/48
CONTRACT AA-1015
A IT ACHMENT B
Ir~STRUCTIONS FOR THE CIVIL RIGHTS COMPLIANCE CHECKLIST
I.Describe the geographic service area such as a district, county/ city or other locality. If the program/ facility
serves a specific target population such as adolescents, describe the target population. Also, define the type of
service providedl.
2.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
statistics can be obtained from local chambers of commerce, libraries, or any publication from the 1980 Census
containing Florid.a population statistics. Include the source of your population statistics. ("Other" races include
Asian/Pacific Islanders and American Indian/ Alaskan 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 emolled, registered or currently served by the program or facility,
and list their percent by race, sex and disability. Include the date that enrollment was counted.
5.Enter the total number of advisory board members and their percent by race, sex, and disability. If there is no
advisory or governing board, leave this section blank.
6.Each recipient of federal financial assistance must have on file an assurance that the program will be
conducted in cOlnpliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a
standard part of the contract language for OOEA 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 100/0 of the
population is Hispanic, is there a comparable percentage of Hispanic staff?
8.Where there is a significant variation between the race, sex or ethnic composition of the clients and their
availability in tlle 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
may exist when 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
employment? Evidence of such may be indicated in staff and client representation (Questions 3 and 4) and also
through on-site record analysis of persons who applied but were denied services or employment, 45 CFR 80.3
(a) and45CFR80.1(b)(2).
IO.Participants or clients must be provided services such as medical, nursing and dental care, laboratory
services, physical and recreational therapies, counseling and social services without regard to race, sex, color,
national origin/ religion, age or disability. Courtesy titles, appointment scheduling and accuracy of record
keeping must be 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 80.3 (b).
II.For in-patient services, residents must be assigned to rooms, wards, etc., without regard to race, color,
national origin or disability. Also, residents must not be asked whether they are willing to share
accommodationLS with persons of a different race, color, national origin/ or disability, 45 CFR 80.3 (a).
46/48
CONTRACT AA-1015
12.The program/ facility and all services must be accessible to participants and applicants, including those
persons who may not speak English. In geographic areas where a significant population of non-English
speaking people 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 will assist in the provision of services, 45 CFR 80.3 (a).
13.Programs/ facilities must make information regarding the nondiscriminatory provisions of Title VI
available to their participants, beneficiaries or any other interested parties. This should include
information on their right to file a complaint of discrimination with either the Florida Alliance or the
U.S. Alliance 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 C:FR 80.6 (d).
14.Report num"ber 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, failulre to cooperate, under review, etc.
IS.The prograrn/ facility must be physically accessible to disabled individuals. Physical accessibility
includes desigllated 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.
l6.Section 504 of the Rehabilitation Act of 1973 requires that a recipient of federal financial assistance
conduct a self-evaluation to identify any accessibility barriers. Self-evaluation is a four step process:
-With tile assistance of a disabled individual/ organization, evaluate current practices and
policies which do not comply with Section 504.
-Modify' policies and practices that do not meet Section 504 requirements.
-Take remedial steps to eliminate any discrimination that has been identified.
-Maintain self-evaluation on file. (This checklist may be used to satisfy this requirement if these
four steps have been followed.), 45 CFR 84.6.
17.Programs or facilities that employ 15 or more persons must adopt grievance procedures that
incorporate appropriate due process standards and provide for the prompt and equitable resolution of
complaints alleging any action prohibited by Section 504.45 CFR 84.7 (b).
lS.Programs or facilities that employ 15 or more persons must designate at least one person to
coordinate efforts to comply with Section 504.45 CFR 84.7 (a).
19.Continuing steps must be taken to notify employees and the public of the program/ facility's policy
of nondiscrimination on the basis of disability. TI1is includes recruitment material, notices for hearings,
newspaper ads, and other appropriate \vritten communication, 45 CFR 84.8 (a).
20.Programs / facilities that employ 15 or more persons must provide appropriate auxiliary aids to
47/48
CONTRACT AA-1015
persons with irnpaired sensory, manual or speaking skills where necessary. Auxiliary aids may
include, but are not limited to, interpreters for hearing impaired individuals, taped or Braille
materials, or arlY alternative resources that can be used to provide equally effective services, (45 CFR
84.52 (d).
21.Programs/ facilities with 50 or more employees and $50,000 in federal contracts must develop,
implement ancl maintain a written affirmative action compliance program in accordance with
Executive Order 11246.41 CFR 60 and Title VI of the Civil Rights Act of 1964, as amended.
48/48
Amendment 003 CONTRACT AA-929 Page 1
THIS AMENDMENT is entered into between the Alliance for Aging, Inc. hereinafter referred
to as the "Alliance", and Monroe County Social Services.
The purpose of this amendment Is to Increase Title III B by $855.00, increase Title C1 by $
1,909.00, increase Title C2 by 1,085.00 and Increase Title IIIE by $1,822.00.
The breakdown by Title will be as following:
Title III B (CFDAlCSFA # 93.044): $ 110,424
Title C1 (CFDAlCSFA # 93.045): $ 144,509
Title C2 (CFDAlCSFA # 93.045): $ 211,917
Title III E (CFDAlCSFA # 93.052): $ 58,382
1. 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 Maximum Maximum
Service(s) to be Provided Unit Rate Units of Dollars
Service
]Homemaker $34.29 1 ,734 $59,459
]Personal Care $40.07 1,151 $46,129
Screening & Assessment rrrn $42.05 115 $4,836
lCongregate Meals $9.56 14,877 $142,220
:Nutrition Education Cl $63.58 36 $2,289
Home Delivered Meals $6.13 34,446 $211,153
:Nutrition Education C2 $63.67 12 $764
In Home Respite $ 23.08 1,300 $30,000
Facility Respite $10.34 2,745 $28,382
'Total Contract $525,232
2. This amendment shall begin on January 1, 2009 or the date it has been signed by both
parties, whichever is earlier.
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.
'-his amendment and all its attachments are hereby made a part of the contract.
IN WITNIESS WHEREOF, the parties hereto have caused this amendment to be executed by their
undersi~lned officials as duly authorized.
PROVICtER:
Monroe County Social
Services.
ALLIANCE FOR AGING, INC.
Max B. Rothman, JOt LL.M.
SIGNEl:t BY:
SIGNED BY:
NAME:
NAME:
President & CEO
Mayor
TITLE:
TITLE:
11-18-2009
DATE: