Item C29 C29
BOARD OF COUNTY COMMISSIONERS
COUNTY of MONROE Mayor Craig Cates,District 1
The Florida Keys Mayor Pro Tern Holly Merrill Raschein,District 5
Michelle Lincoln,District 2
James K.Scholl,District 3
m' David Rice,District 4
Board of County Commissioners Meeting
October 18, 2023
Agenda Item Number: C29
2023-1667
BULK ITEM: Yes DEPARTMENT: Social Services
TIME APPROXIMATE: STAFF CONTACT: Sheryl Graham
N/A
AGENDA ITEM WORDING: Ratification of American Rescue Plan contract RP-2129.3 between
the Alliance for Aging, Inc., (AAA) and Monroe County Board of County Commissioners/Monroe
County Social Services for a funding total of$16,704.30 for contract period 10/01/2023 - 09/30/2024.
ITEM BACKGROUND:
The primary purpose of the American Rescue Plan grant funding is to prevent,prepare for, and respond
to, the coronavirus disease-19 (COVID-19); including provide supportive services, nutrition services,
preventive health, and provide support services for family caregivers. Preference is given to older
individuals with the greatest economic need, older individuals with the greatest social need, and clients
who continue to practice social distancing due to concerns over COVID-19.
PREVIOUS RELEVANT BOCC ACTION:
BOCC approved Amendment#001 to ARP RP-2129.2 on 2/15/2023.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
arp contract rp 2129.3 .pdf
Alliance Amendment.pdf
FINANCIAL IMPACT:
Funding total $16,704.30
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RP-2129.3
ALLIANCE FOR AGING, INC.
STANDARD CONTRACT
American Rescue Plan
'THIS CONTRACT is entered into between the Alliance for Aging, Inc., hereinafter referred to as the "Alliance," and Monroe
County Board Of County Commissioners,Social Services/In-Home Set-vices,hereinafter referred to as the"Provider"',and
collectively referred to as the"Parties," The terrn Provider for this purpose may designate a vendor,sub-grantee or sub-recipient,the
status to be further identified in ATTACI IMENTIJ, Exhibit-2 as necessary.
WITNESSETIFITHAT:
WHEREAS,the Alliance has established through the Area Plan that it is in need of certain services as described herein; and
WHEREAS, the Provider has demonstrated that it has the requisite expertise and ability to faithfiffly pCrf01_1n such SCI-ViCLS as an
independent Provider of the Alliance.
NOWTUIEREFORE, in consideration of the services to be perforined and payments to be made,together with the nlUtUal covenants
and conditions hereinafter set forth,,the Parties agree as follows:
1. Purpose of Contract
The purpose of this contract is to provide set-vices in accordance with the ternis and conditions specified in this contract inchiding
all attachments and exhibits,which constitute the contract document.
2. Definitions
ADL—Activities of Daily Living
APS—Adult Protective Services
ADA—Americans with Disabilities Act
Alliance—Area Agency on Aging
A K1—Assessed Priority (_'onstinler I.,ist
('IRTS—Client Information and Registration Tracking System
DOEA—Department of Elder Affairs(The Department)
I&R -Infortnation and Referral
IADL—Instrumental Activities of Daily Living
MDD—Ma'or Disaster Declaration
MOA—MernorandUln of Agreement
NIOU—Memorandum of Understanding
PSAs—Planning and Sen(ice Areas corresponding to kliatni-Dade and Monroe Counties
SPA—Service Provider Application
USDA—United States Department of Agriculture
3. Incorporation of Documents within the Contract
The contract incorporates by reference attachments,proposal(s),solicitation(s),Provider's Service Provider Application,and the
current DOEA Programs and Services Handbook. Any and all contracts or agreements executed between the Provider and the
Alliance during the effective period of this contract shall be governed in accordance with the applicable laws and statutes.
4. Term of Contract
The contract shall begin at twelve(12:00)A.M.,Eastern Standard Tinie,on October 1,2023,or on the date the contract has been
signed by the last party required to sign it, whichever is later. It shall end at eleven fifty-nine (11:59) RM., Eastern Standard
Time,on September 30,2024.
S. Contract Amount
The Alliance agrees to pay for contracted services according to the terms and conditions of this contract in an allIOUnt not to
exceed$10,704.30 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 payinent under this contract.
6,. Renewals
By mutual agreement of the parties, the Alliance may renew the contract for two additional one-year periods. COnfitlgCot Upon
satisfactory performance evaluations by tile Alliance and the availability of funds,any renewal is subject to the sarne ternis as the
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original contract and any amendments,with the exception ofestablishing unit rates which is described further in this section. The
original contractual unit rates are set forth in the bid proposal and reply.
Requests to renegotiate the original contractual established rates are provided for in the Alliance's approved Reimbursement Rate
Review Policy, which is incorporated by reference.
This contract may be extended upon Mutual agreement for one extension period not to exceed six months to ensure continuity of
service. Services provided under this extension will be paid for out of the Succeeding agreement aniount.
7. Compliance with Federal Lam,
7.1 This contract contains federal funds. The following shall apply:
7.1.1. The Provider shall comply with the provisions of 45 CF`R 74 and/or 45, CFR 92,and other applicable regulations,
7.1.2 If'this contract contains federal fluids and is over $100,000.0�0, the Provider shall comply with all applicable
standards,orders,or regulations issued under s. 306 of the Clean Air Act as amended (42 U.S.C. 7401, et seq.), s.
508 of the Federal Water Pollution Control Act as amended (33 U.S.C, 125 1, et seq.), Executive Order 11738, as
amended,and where applicable Environmental Protection,Agency regulations 40 CFR 30. The Provider shall report
any,violations of the above to the Alliance,
7.1.3. The Provider, or agent acting for the Provider, may not use any fccleral funds received in connection with this
contract to influence legislation or appropriations pending before the Congress or any State legislature. 'file Provider
must complete all disclosure forms,as required,specifically the Certification of Assurances Attachment,which must
be completed and returned with this signed contract.
7.1.4. In accordance with Appendix A to 2 C'FR 215, the Provider shall comply with Executive Order 11246, Equal
Employment Opportunity, as amended by Executive Order 113 75 and others, and as supplemented in Department
of Labor regulation 41 CFR FR 60 and 45 CFR 92, if applicable.
7.1.5. A contract award with all aniount expected to equal, or exceed $25,000.00 and certain other contract awards shall
not be made to parties listed on the government-wide Excluded Parties List System, in accordance with the OMB
guidelines at 2 CFR 180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension." 'rhe
Excluded Parties List System contains the names of parties debarred,Suspended,or otherwise excluded by agencies,
as %vell as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549, The
Provider shall comply with these provisions, before doing business or entering into subcontracts receiving federal
funds pursuant to this contract. The Provider shall complete and sign the Certification and Assurances Attachment
prior to execution of this contract.
7.2. The Provider shall not employ an unauthorized alien. 'rFlie Alliance shall consider the employment Of unauthorized aliens
a violation ofthe Immigration and Nationality Act(8 U.S.C. 1124 a)and the Immigration Reform and Control Act of 1986
(8 U.S.C. 1 10 1). Such violation shall be cause for unilateral cancellation of this contract by the Alliance.
7.3. If the Provider is a non-profit Provider and is subject to Internal Revenue Service(IRS)tax exempt organization reporting
reqUirCruentS(filing a Form 990 or Form 990-N)and has its tax-exempt status revoked for failing to comply with the filing
requirements Of the 2006 Pension Protection Act or for any other reason, the Provider must notify the Alliance in writing
within thirty (30)days of receiving the IRS notice of revocation.
7.4. The Provider shall comply with Title 2 CFR Part 175 regarding Trafficking in Pei-sons.
7.5. Unless exempt under 2 CFR Part 170.11 O(b),the Provider shall comply with the reporting requirements of the Transparency
Act as expressed in 2 CFR 170.
7.6. To comply with presidential Executive Order 12989 and State of Florida Executive Order Number I 1-116,
Provider agrees to utilize the U.S. Department of FlonieIand Security's E-verify system to verify the employment of all
new ernployces hired by Provider chlrilIg the contract term. Provider shall include in related subcontracts a requirement
that subcontractors and/or vendors performing work or providing services Pursuant to the state contract utilize the E-verify
system to verify employment of all new employees hired by the subcontractor and/or vendor during the contract terill.
Providers meeting the terms and conditions of the E-Verify System are deemed to be in compliance with this provision.
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8. Compliance with State Law
8.1. 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 I'lorida law, including Florida provisions for conflict of laws,
8,2. The Provider shall comply with the reqUirenielits of s.287.058, Florida Statutes(F,S,)as amended.
8.2,1„ T lie Provider shall provide units of deliverables, including reporting, findings, and drafts, as specified in this
contract, which the Contract Manager must receive and accept in writing prior to payment.
8.2.2, Thc Provider slllRl c(.)111 11IN wv i1h the Criteria alld FilMl chlk'I)\ wN 1)ich Stich c6lcria must he in et I'Or coil I plet ion
cW th is contract as specified it i A I FACI I NJ kN I' I, Sect imi I 11. NIQthod of llaviiient.
8.2.3. The Provider shall submit bills for fees or other compensation for services or expenses ill sufficient detail for as
proper pre-audit and post-audit.
8,2.4. If itemized payment for travel expenses is permitted in this contract, the Provider Nvill submit bills for any travel
expenses in accordance with s. 1 12.06 1, F,S.,or at such lower rates as may be provided in this contract,
8.2.5. The Provider shall allow public access to all documents, papers, letters, or other public records as defined ill
subsection 119.011(]2), F.S, made or received by the Provider in conjunction with this contract except For those
records which are made confidential or exempt by law. The Provider's refusal to comply with this provision shall
constitute an immediate breach of contract for which the Alliance for Aging, Inc, may unilaterally tenilinate the
contract,
8.3. If clients are to be transported under this contract,the Provider shall comply,with the provisions of Chapter 427, F.S. and
Rule 4 1-2, Florida Administrative Code(F. A,C),
8.4. Stibcontractor5 and/or vendors who are on the discriminatory vendor list may not transact business with only public entity,
in accordance with the provisions ofs.287,134, F.S.
8.5, The Provider will comply with the provisions of s. 11.062, 1'.S, and s. 2 16,34 7, F.S., which prohibit the expenditure of
contract funds for the purpose of lobbying file legislature,judicial branch or a state agency,
8,6. In accordance with s. 287,135 F.S., any Provider on the Scrutinized Companies with Activities in Sudan List, the
Scrutinized Companies with Activities in the Iran Petroleum Eiiergy Sector List. or the Scrutinized Companies that
Boycott Israel I-Ast(Lists), created pursuant to s.215.473 F.S. and 215.4725, FS,or is engaged in a boycott of Israel,or
is engaged in business operations in Cuba or Syria, is ineligible to enter into or renew a contract with the Department for
goods or services of sl,000,000 or more. Pursuant to s. 287.135 F.S, the Alliance may terminate this contract if the
Provider is found to have submitted a false certification of its Status Oil the Lists or has been placed on the Lists or is
engaged in a boycott of Israel or has been engaged in business operations in Cuba or Syria.Further,the Provider is subject
to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification,
-File Provider shall complete and sign the Certifications and Assurances Attachment,prior to the execution of this contract.
9. Background Screening
9.1. The Provider shall comply with and ensure subcontractors are in compliance with the requirements of s. 430.0402 and
Chapter 435,F.S,as amended,are niet regarding background screening for all persons who meet the definition of a direct
service provider and who are not exempt from the Department's level 2 background screening pursuant to s. 430.0402(2)-
(3), F.S.Care
Provider must also comply with any applicable rules pi-OlnUlgated by the Department and the Agency for
Health Care Administration regarding implementation of s.430.0402 and Chapter 435, F,S.
9.2, Further information concerning the procedures for background screening is found at
.1c atl
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10. Grievance Procedures
The Provider shall comply with and erasure subcontractor and/or vendors coniplAnce whit the NAinitnurn Chdclehrics Or Recipient
Grievance Procedures, Appendix D, DOEA Programs and Services I Nndbook,to address complaints regarding the termination,
suspension or reduction of services,as required for receilit,of funds.
10A. Complaint Procedures
'Me Provider shall develop and implement complaint procedures and ensure that subcontractors and/or vendors develop
and implement complaint procedures to process and resoNe client dissatisfaction with services.Conlidaim procedures MW
Wdivo the qmWy said timeliness of services, provider and direct service worker complaints,or any other advice related
to complaints other than tenninatlion,suspension or rechiCti011 in services that require the grievance process as described in
Appendix D, Depa"mclu of Elder Affairs Progmins and Services Handbook. The complaint procedures shall include
notification to all clients of the complAnt procedure and include tracking the date, nature of complaint, be determination
of each complaint, and Q kTowap with the Client to ClISUre satisfaction with the resolution
IL Public Records and IUINHWn
I 1 1,tly execution of this cNumm Pmvider agrees to all PmOdmy of(TaWer 119, Lt. nd arqAmher applicable W
and shall
I I.I J Keep and makkn public records requhvd by the Deprtman h) per-Ruin the coianwted services.
1 1.1.2 Upon rec1tw hrom Ow Dopunnow's cumodhn ol'public records, provide a o:opy of the requested, rccords
or allow the words to be inspected or copied %Win a reawnabic We at a cost that does n(q CXCCeorl the,
cost provided in Chapter 1 '91 S n or as othem,isQ prc)vided by law.
1.13 Wwrc that pWAR rucmAs Olat are: ewnWL cw confideltal and eXcalpt- 1'1% ln I)('WiC records disclosure
tekluir-enlents are not disclosed ewept as aUfl10ri1Qd by' IMV for the (101'01i()n Of 1hC C0111raCt JQrj)j anal
lotlowilig Completion of the contract if Mu PmvWx does non lNuisIr the rccords to the AHQ=.
1 1,1.4 IlyinconiploionorthecoMrachthQ !Io eider Nydi either imnsict
Al pubbic mcods in p(asesshn of we Pnwkicr, or "ill keep and mahuain public mcm-ds rNuked by Me
lQuarnem. HIM Vw0dexuarlsOrs all public words to the Depannicratlpon comnpletion onhe connwo,
hunioicr shall de=) any duplicale public reco"Is that areexenipw tw wAkemkil and ux~, Ihml
I)LINic records diSC OSLWC i-CLILlirCink,"HIS. it' tile i'r(wider keeps and maintains public uecords upoll
completion orsecorlOwL the Proses ddershall meet all applicable requirenlellis public rQcords.
AH records storied CICCWonliC;dlr MLN hk2 prtwided to the Mcpatirntsm in of wmat that iscompalUe"Oh lh;p
hoommkon WCWONT, systems Orme lkpanrllom,
1 1 2 Vw AHAwe may rnnilmomdb; cwww this umvaa nmwWwa"Wgmy OMupwvijOnsofMk oay,n
the llrovidcr locomply "kh Al hVIINION1 I AThs contact by not aTmhTpAhca"os my! &wwwnK papers.
letters. or, other material ulach: or reecio,ed by tile Provider in COnpUflction evilh this COMrJCt. Unless the reCof(iS are
ewmy.m amnAndal andexerillu, Pat Seckm 2Ma)of Artick I of the Sraw C`onmh6on and s, I NMII , FS,
IF THE PROVIII)ER "AS CAI JEW140AS REGARI)ING TIM APPLICV11ON' OU CHAVIT',R 119, FLORIDA
SrQtJES, 10 KIE PROVIDER'S DUTV 10 PROVIDE PURIJC RE(DUDS RELAYING 11) THIS
(UNTRA(7,CDNTACT THE Cl STODIAN OF PUBLIC RECORDS AT:
POW Rcuwds (IoWnator.
Florida Department of Elder Nrfairs
4040 EspMnnde Way
Tullmhassee, MoNdu 32399
850-414-2342
y�nauaultrlrcaf°Eayycla it—Oderaft airs. u
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RP-2129-3
12 Audits, inspections, Investigations,Public Records and Retention
12.1 The Provider shall establish and maintain books, records and docurnents(including electronic storage media)
sufficient to reflect all assets,obligations, Ullobflgated balances, income, interest and expenditures of funds
provided by the Alliance under this contract. Provider shall adequately safeguard all such assets and assure they are used
solely for the purposes authorized Under this contract. Whenever appropriate. financial information should be related to
performance and unit cost data.
12.2 The Provider shall retain all client records, financial records, supporting dOCLUllentS, 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 all audit is required by this contract,records sliall be retained for
a minimum period of six(6,)years after the audit report is issued or until resolution ofany audit findings or litigation based
oil the terms of this contract,at no additional cost to tile Department or the Alliance.
12.1 Upon demand, at no additional cost to the Department or the Alliance, the Provider will facilitate the duplication and
transfer of any records or documents during the required retention period in Paragraph 12.2.
12.4. The Provider shall assure that the records described it] this section shall be subject at all reasonable times to inspection,
review, copying, or audit by federal, State,or other personnel duly authorized by tile Alliance,
12.5. At all reasonable times for as long as records are maintained,persons duly authorized by the Alliance,the Department and
Federal ati(lit0l'S,pUl'SUant to 45 CFR Part 75,shall be allowed full access to and the right to examine any of the Provider's
contracts and related records and documents pertinent to this specific contract, regardless of the form in which kept.
12,6. The Provider shall provide a financial and compliance audit to the Alliance as specified in this contract and ensure that all
related third-party transactions are disclosed to the auditor.
12.7. 'file Provider shall comply and cooperate immediately with any inspections, reviews, investigations, or audits deemed
necessary by tile office of the Department's Inspector General pursuant to s. 20.055, F.S. Provider further aw,.rocs thal it
SIUAII itICIMIC ill rclawd subcontracts a reqU�I-Qnlctlt th,31 subcontractors andA)r w w.,ndors wwork or pro%,iding
Service,; Pursuant to this Contract lgrcc (1)cooperate %w ith the Allial a,or lnspce:tor(lencral in any I i-nnvstif,atioil.alitfil-,
inspCetion, or hcarilw purskimit to s. 20,055(5), f: S. By
Q-Xccution ofdiis contrad tile Provider conveys that
it rrudt�rsl,ruras MId "ill C0111l)IV Wi0l 11liS SLJI)sL-Clioll.
13. Nondiscrimination-Civil Rights Compliance
13.1 The Provider shall execute assurances in ATTACHMENT VI that it will not discriminate against any person in the
provision of services or benefits tinder 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 Provider further assures
that all Providers,Subcontractors, vendors,sub-grantees,or others with whom it arranges to provide services or benefits ill
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.
13.2 During the term Of this contract,the Provider shall complete and retain on file a timely,complete,and accurate Civil Rights
Compliance Checklist,attached to this contract.
13.3 The Provider shall establish procedures pursuant to federal law to handle complaints of discrimination involving services
or benefits through this contract. These procedures will include notifying clients, employees,and participants of the right
to file a complaint with the appropriate federal or state entity.
1 3A 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 Provider, its Successors, transferees, and assignees for the period during
which such assistance is provided, The Provider farther assures that all subcontractors, vendors, or others with whom it
arranges to provide services or benefits to participants or employees in connection with any of its programs and activities
are not discriminating against those participants or employees in violation of the above statutes, regulations, guidelines,
and standards. in the event of failure to comply, the Provider understands that the Alliance may, at its discretion, seek a
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Court order requiring compliance with the terns of this assurance or seek other appropriate.judicial or administrative relief,
including but not limited to,termination of and denial of further assistance.
14. Provision of Services
The Provider shall provide the services referred to in ATTACHMENT VH in the manner described in the Department's Progranis
& Services Handbook and the Provider's Service Provider Application (SPA), In the event of a conflict between the Service
Provider Application and this contract, the contract language prevails.
15. Monitoring by the Alliance
I'he Provider shall permit persons duly authorized by the Alliance to inspect and copy any records,papers, documents, facilities,
goods and services of the Provider which are relevant to this contract, and to interview any clients, employees and
subcontractor/vendor employees of the Provider to assure tile Alliance of the satisfactory performance of the terms and conditions
of this contract. Following such review, the Alliance will deliver to the Provider a written report of its findings, and where
appropriate, tile Provider shall develop a Corrective Action Plan (CAP). The Provider hereby agrees to timely correct all
deficiencies identified in the C I A P.
16. Coordinated Monitoring with Other Agencies
If the Provider receives funding from one or more of the State of Florida human set-vice agencies, in addition to Alliance funding,
then ajoint monitoring visit including such other agencies may be scheduled. For the Purposes of this contract,and pursuant to s.
287.0575, F,S, as amended, Florida's human service agencies shall include the Department of Children and Families, tile
Department of I lealth,the Agency for Persons with Disabilities,the Department of Veterans Affairs,and the Department of Elder
Affairs. Upon notification and the subsequent scheduling of such a visit by the designated agency's lead administrative
coordinator, the Provider shall comply and cooperate with all monitors, inspectors,and/or investigators.
16.1 New Contract(s) Reporting:
The Provider shall notify the Alliance within ten(10)days of entering into a new contract with tiny other state human service
agency. The notification shall include the following inforniatiow (I',) contracting state agency and the applicable office or
program issuing the contract;(2)contract nanic and number;(3)contract start and end dates;(4)contract aniount;(5)contract
description and coniniodity or service; and(6)Contract Manager name and contact information,
17. Indemnification
The Provider shall indeninify, save, defend, and hold harmless the Department and the Alliance and its agents and employees
from any and all clainis, demands, actions, causes of action of whatever nature or character, arising out of or by reason of the
execution of this agreement or performance of the services provided for herein, It is understood and agreed that the Provider is
not required to indemnify the Alliance for claims, demands, actions or causes of action arising solely out of the Alliance's
negligence,.
18. Insurance and Bonding
18.1 The Provider shall provide continuous adecitmte liability insurance coverage during the existence of this contract and any
renewal(s) and extension(s) of it. By eXCCUti0a of this contract, unless it is a state agency or subdivision as defined by,
subsection 768.28(2), ES., the Provider accepts full responsibility for identifying and determining the type(s) and extent
of liability insurance necessary to provide reasonable financial protections for the Provider and the clients to be served
under this contract. The Alliance shall be included as an additional insured on the Provider's liability insurance policy,or
policies and a copy of the Certificate Of insurance shall be provided annually or when any changes —occur. The limits of
coverage under each policy maintained by the Provider do not limit the Provider's liability and obligations under this
contract.The Provider shall ensure that the Alliance has copy of the most current written verification of insurance coverage
throughout the term of this contract.Such coverage may be provided by a self-insu rance program established and operating
under the laws of the State of Florida. The Alliance reserves the right to require additional insurance as specified in this
contract.
18.2 Throughout the terin of this agreement, the Provider shall maintain an insurance bond from a responsible commercial
insurance company covering all officers, directors, employees and agents of the Provider authorized to handle funds
received or disbursed under all agreements anWor 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.
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19. Confidentiality of Information
The Provider shall not use or disclose any information concerning a recipient of services under this contract for any purpose
prohibited by state or federal law or regulations except with the written consent of a person legally authorized to give that consent
or when authorized by law.
20. Health Insurance Portability and Accountability Act
Where applicable, the Provider shall comply with the Health Insurance Portability and Accountability Act of 1996, Public Law
104-19 1.),as well as all regulations promulgated thereunder(45 CFR 160, 162,and 164).
21. Incident Reporting
21.1 The Provider shall notify the Alliance immediately but no later than forty-eight(48)hours from the Provider's awareness
or discovery of conditions that may materially affect the Provider's, subcontractor's, or vendor's ability to perform tile
services required to be performed under any contract. Such notice shall be made orally to the Contract Manager (by
telephone)with an ernail to immediately follow.
21.2 The Provider shall immediately report knowledge or reasonable suspicion of abuse,neglect,or exploitation ofa child,aged
person,or disabled adult to the Florida Abuse f lolline on the statewide toll-free telephone number(1-800-96ABUSE). As
required by Chapters 39 and 415, F.S, this provision is binding upon tile Provider, Subcontractors, vendors, and their
eniployees.
22. Bankruptcy Notification
If, at any time during the term of this contract, the Provider, its assignees, subcontractors, vendors or affiliates files a claim for
bankruptcy, the Provider must immediately notify the Alliance. Within tell (10) days after notification, the Provider must also
provide the following information to the Alliance: (I) the date of filing of the bankruptcy petition; (2)the case number; (3) the
court name and the division in which the petition was filed(e.g.,Northern District of Florida, Tallahassee Division); and(4)the
name,address,and telephone number of the bankruptcy attorney.
23. Sponsorship and Publicity
23.1 As required by s. 286.25, F,S., if the Provider is a non-governniental organization which sponsors a program financed
wholly or in part by state funds, including any funds obtained through this contract, it shall, in publicizing,advertising, or
describing the sponsorship of the program, state: "Sponsored by (Provider's name), the State of Florida Department of
Elder Affairs and the Alliance for Aging, Inc." If the sponsorship reference is in written material, the words "State of
Florida, Department of Elder Affairs" and"Alliance for Aging, Inc." shall appear in at least the same size letters or type
as the name of the organization,
23.2 The Provider shall not use the words"The State of Florida Department of Elder Affairs"or"Alliance for Aging, Inc,"to
indicate sponsorship of a program otherwise financed,unless specific authorization has been obtained by the Alliance prior
to use,
24. Assignments
24.1 The Provider shall not assign the rights and responsibilities under this contract without the prior written approval of the
Alliance,which shall not be Unreasonably withheld. Any sublicense,assignment,or transfer otherwise occurring without
prior written approval of the Alliance will constitute a material breach of the contract.
24.2 The Alliance shall at all times be entitled to assign or transfer, in whole or part, its rights, duties,or obligations under this
contract to another agency upon giving prior written notice to the Provider. In the event the Alliance approves transfer of
the Provider's obligations,the Provider remains responsible for all work performed and all expenses incurred in connection
with the contract.
24.3 This contract shall remain binding upon the successors in interest of either the Provider or the Alliance.
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25. Subcontracts
25.1 The Provider is responsible for all work performed pursuant to this contract whether actually furnished by the Provider or
its subcontractors and/or vendors, Any subcontracts shall be evidenced by a written(10CLU'rient and Subject to ally conditions
ofapproval the Alli,ancedeerns necessary. The Provider must ensure that the Alliance has a current list of all subcontractors
and/or vendors, The Provider further agrees that the Alliance shall not be liable to the subcontractor and/or vendor in any
way or for any reason. The Provider,at its expense, shall defend the Alliance against any Such claims.
25.2 The Provider shall promptly pay all),subcontractors and/or vendors upon receipt of payment from tile Alliance. Failure to
make payments to ally subcontractor and/or vendor in accordance with s. 287.0585, F.S,., unless otherwise stated in the
contract between the Provider and subcontractor and/or vendor, will result in a penalty as provided by statute.
26. Independent Capacity of Provider
It is the intent and understanding of the Parties that the 11rovidcr, or any of its subcontractors and/or vendors, are independent
Providers and are not employees of the Alliance and shall not hold themselves out as employees or agents ofthe Alliance without
specific authorization from the Alliance. It is the further intent and understanding of the Parties that the Alliance does:lot Control
the employment practices of the Provider and sliall not be liable for any wage and hour, employment discrinlinatioi, or other
labor and employment clairns against the Provider or its subcontractors and/or vendors. All deductions for social security,
withholding taxes, income taxes,contributions to unemployment compensation fluids and all necessary insurance for the Provider
shall be the sole responsibility of the Provider.
27'. Paynient
27,1. Payments will be made to the Provider pursuant to s. 215.422, F.S., as services are tendered and invoiced by tile Provider.
Tile Alliance will have final approval of tile invoice for payment and will approve the invoice for payment only if the
Provider has niet all terms arid 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 fiscal section fbr budgetary approval arid
processing. Disputes arising over invoicing,and payments will be resolved in accordance with the provisions of s.2 15.422
F.S.
27.2. The Provider agrees to Submit bills for fees or other compensation for services or expenses ill sufficient detail for a proper
pre audit and post audit thereof. The Provider shall comply with the particular requirements under the following laws and
guidelines that are applicable to the contracts or agreements incorporating in this contract by reference: (a)paragraph(I 6�)
(b)ofs.216,181,F.S.,regarding advances;(b)Rule 69 40.103 F.A.C.pertaining to Restriction of Expenditures frorn state
funds;arid,(c)the Invoice Requirements of the Reference Guide for State Expenditures fi-orn tile Department of Financial
Services at:
%van 11oridacCo.com �oadh- IuMc Refcrence, (Juidc I of Slaw
The Provider will certify that detailed documentation is available to support each item our the itemized invoice or payment
request for cost reimbursed expenses, fixed rate or deliverables contracts or agreements incorporating this contract by
reference, including paid subcontractor and/or vendor invoices, and Nvill be produced Upon request by the Alliance, Tile
Provider will ftirther certify that reimbursement requests are only for allowable expenses as defined in the laws and guiding
circulars cited in Sections 4 of this contract, in the Reference Guide for State Expenditures, and any other laws or
regulations,as applicable.
27.3. 'File Provider, its subcontractors and/or vendors shall provide units of deliverables, including reports, findings, and drafts
as specified in the contracts or agreements and attachments which incorporate this contract to be received and accepted by
the Contract Manager prior to payment.
27.4. Payments will be made to tile Provider based oil a complete and correct invoice, invoices that are incomplete or with
incorrect total will not be processed and will be returned to the Provider for correction. Fiscal staff will not be able to
correct or make changes to the invoices. Returning invoices for corrections may result ill failure to receive payment for
that month. Invoices shall be submitted finely as per ATTACHMENT'VIll in order to avoid any payment delays.
27.5. Each service performed shall be recorded as specified in the client hiffirmation and registration tracking system (CIRTS)
guidelines. Supporting documentation of services provided must be adequate to permit fiscal and programmatic evaluation
and ellSUrC internal management.
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28. Return of Funds
The Provider will return to the Alliance any overpayments due to unearned funds or funds disallowed and any interest attributable
to such funds pursuant to the terms and conditions of this contract that were disbursed to the Provider by the Alliance. In the
event that the Provider or its independent auditor discovers that all overpayment has been made, the Provider shall repay said
overpayment immediately Without prior notification from the Alliance. Ili tile event that the Alliance first discovers all
overpayment has been made,the('ontract Manager,oil behalf of the Alliance, will notify tile Provider by letter of such findings.
Should repayment not be made forthwith, the Provider will be charged at the lawful rate of interest on the Outstanding balance
pursuant to s. 55,0,3, F.S.,after Alliance notification or Provider discovery.
29. Data Integrity and Safeguarding Information
'file Provider and its subcontractors and/or vendors shall insure an appropriate level of data security for tile information the
Provider is Collecting or Using in the performance of this contract. Ali appropriate level of security includes approving and
tracking III Provider employees that request system or information access and ensuring that user access has been rernoved from
all terminated employees. The Provider, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. All data and software shall be routinely backed up to ensure recovery !Torn 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
Provider shall ensure all Subcontractors andlor vendors maintain written procedures for computer system back-up and recovery.
The Provider shall complete and sign ATTACI-IMENT 111 prior to the execution of this contract.
30. Social Media and Personal Cell Phone use:
3OD,1 Inappropriate use of social media and personal cell phones may pose risks to DOEA's confidential and proprietary
information and may jeopardize compliance with legal obligations. By signing this contract, Provider agrees to the
following social media and personal Cell Phone use requirements.
30,2 Social Media Defined. Tile term Social Media and for personal cellular communication includes,, but is not limited to,
social networking websites,blogs,pocicasts,discussion forums,RSS feeds,video sharing,SMS(including Direct Messages
(DNIs), iMessages, text messages, etc.); social networks like Instagrani,TikTok, Snapchat,Google FlallgOUtS, WhatsApp,
Signal, Facebook, Pinterest, and Twitter; all(] content sharing networks Such as Flickr and YOUTUbe. This includes tile
transmission of social media through any cellular or online transmission via any electronic, internet, intranet, or other
wireless communication.
30.3 Application to any direct or incidental D�OEA or other state business, This contract applies to ally DOEA or other state
business conducted on any of the Provider's, Subcontractor's, or their employees' social media accounts or through
personal cellular communication.
30.4 Application to DOER,Alliance,and Providers Equipment. This contract applies regardless of whether the social media is
accessed using DOEA's IT facilities and equipment or equipment belonging to Provider,Subcontractor,or then-respective
employees.Equipment includes,but is not limited to,personal C0111PUters,cellular phones,personal digital assistants,smart
watches, or smart tablets.
30.5 Florida Government in tile Sunshine, Florida Public Records Law,and filPAA. Provider acknowledges that any DOER or
other state business conducted by social media or through personal cellular communication is subject to Florida's
Government in the Sunshine Law,Florida's Public Records Law(Chapter 119,Florida Statutes),and the Health Insurance
Portability and Accountability Act(HIPAA).Compliance with these laws and other applicable laws are further detailed in
the contract.
30,6 Any social media posts which include photos, videos, or names of clients, volunteers, staff, or other affiliates of DOER
may only be posted when authorized by law and when any required HIPAA authorizations and any other consents or
authorizations required pursuant to federal,or state law are oil file with the Provider's records.
31. Conflict of Interest
The Provider shalt establish safeguards to prohibit employees,board members,management and Subcontractors from using their
positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal
gain.
No employee, officer, or agent of the Provider or subcontractor shall participate in selection, or in tile award of an agreement
supported by state or federal funds if a conflict of interest, real or apparent, Would be involved. Such a conflict would arise
when: (a) the employee, officer, or agent; (b) any member of his/her immediate family; (c) his or her partner-' or (d) an
organization which employs, or is about to employ, any ofthe above, has a financial or other interest in the firm selected for
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award,Tile Provider or subcontractor's officers,employees or agents will neither solicit nor accept gratuities,favors or anything
of monetary value ftOul Providers, potential Providers, or parties to subcontracts.
Pursuant to Chapter 4,Section's of the Department of Elder Affairs Program and Services Handbook,no Provider may employ,
in any capacity, any member of its governing board of-any family member of a person oil tile board or family member of its
Executive Director,
The Providers' 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 appointment or placement in
that position, or if the individual is serving as an incumbent, within thirty (30) calendar days of the commencement of this
contract.The Providers'employees and subcontractors must make the same disclosures described above to the Providers'Board
of Directors. Compliance with this provision will be monitored,
32. Public Entity
Pursuant to s. 287.133, F,S., a person of-affiliate who has been placed on the convicted vendor list foilowing a conviction fora
public entity crime rilay not submit a bid,proposal,of-reply oil a contract to provide any goods of-services to a public entity; may
riot Submit a bid, proposal,or reply on a contract with a public entity for the construction or repair of a public building of-public
work;may not submit bids,proposals,of,replies oil leases of real property to a public entity; may not be awarded or perform work
as a Provider, supplier, sub-Provider, of-consultant under a contract with any public entity; all(] may not transact business with
any public entity in excess of tile threshold aniount provided in s. 287.0 17, F.S., for Category Two for a period of 36 months
following the date of being placed oil the convicted vendor list. If the Provider or any of its officers or directors is convicted of
a public entity crime during the period of this agreement, tile Provider shall notify the Alliance immediately, Non-compliance
with this statute shall constitute a breach of this agreement,
33. Emergency Preparedness and Continuity oDf Operations
The Provider shall,within thirty(30)calendar days of the execution Of this contract,submit to the Contract Manager verification
ofanenier_geticypr-eparediiessplaui. In the event of ern emergency,the Provider slial I notify the Alliance of emergency provisions,
hi the event asituation,results in a cessation of'services by asub-Provider,tile Provider shall retain responsibility forperforinance
under this contract and must f0110W procedures to ensure continuity of operations without interruption,
34. Purchasing:
34.1 'file Provider shall procure products and/or services required to perform this contract in accordance with s.413,036,F.S.
34.11 IT IS EXPRESSLY UNDERSTOOD AND AGREED THAT ANY ARTICLES THAT ARE THE SUBJECT
OF, OR REQUIRED -1-0 CARRY OUT, THIS CONTRACT SlIALL BE` PURCHASED FROM A NONPROFIT
AGENCY FOR THE BLIND OR THE SEVEREI.,Y HANDICAPPED THAT' IS QUALIFIF"D PURSUANT TO
CHAPTER 413, F.S., IN THE SAME MANNER AND UNDER THE SAME PROCEDURES SET FORTIJ IN S.
413.036(1) AND (2), F.S.; AND FOR PURPOSES OF THIS CONTRACr THE PERSON, FIRM, OR OTHER
BUSINESS ENTITY CARRYING OUT THE PROVISIONS OF THIS CONTRACT SHALL BE DEEMED TO BE
SUBSjFTLJTED FOR THE STATE AGENCY INSOFAR AS DEALINGS WITH SUCH QUALIFIED NONPROFIT
AGENCY ARE CONCERNED,
34.1.2 Pursuant to s. 413.036(l) and (4), F.S., the Provider shall not be required to procure a product or service from
RESPECT if, (a) the product or service is not available within a reasonable delivery time; (b)the Provider is required by
law to procure the product or service from any agency of the state,or(c) the Provider determines that the performance
specifications,price,or quality of the product or serve is not comparable to the Provider's requirements,
34.1.3 Additional information about the designated nonprofit agency and the products it offers is available at
3�4,2 The Provider may purchase articles which are the subject of of-are required to carry Out any contract or agreement from
Prison Rehabilitative Industries and Diversified Enterprises, file., (PRIDE) identified under Chapter 946, F.S.., in the
same manner and tinder the procedures set forth in Subsections 946.5 15(2)and(4),F.S. For purposes of this contract,the
Provider shall be deerned to be substituted for the Alliance insofar as dealings with PRIDE. This clause is not applicable
to Subcontractors unless otherwise required by law. Ali abbreviated list of products/services available from PRIDE may
be obtained at https://pride-etiterprises.oi-g/,
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34,2 The Provider shall procure any recycled products or materials, which are the Subject of or are required to carry this
contract in accordance with the provisions of s.401,706,5,F.S.
35. 'The PUR 1000 Form
I'lie PUR 1000 Form is hereby incorporated by reference and available at:
domduad 29,3 t 1777 IT'R 1000 (IQHCI'd � OMRICt
In the event of any conflict between the PUR 1000 Form and any, terms or conditions of any contract or agreement terms or
conditions the contract shall take precedence over the PUR 1000 Form, However, if the conflicting terms or conditions in the
PUR 1000 Form are required by any section ofthe Florida Statutes„the terms ear conditions contained in the PUR 1000 Form shall
take precedence.
36. Use of State Funds to Purchase or Improve Real Property
No funds under this contract will be used by the Provider to purchase or improve Real Propeny.
Any state funds provided for the purchase of or improvements to real property are contingent upon the Provider or political
subdivision granting to the state a security interest in the property at least to the amount of state funds provided for at least 5 years
from the date of purchase or the completion of the improvernents or as further required by law.
37. Patents.Comijahts,Rovalties,
37.I If this contract is awarded state funding and if any discovery, invention or copyrightable material is developed, produced
or for which ownership was purchased in the course of or as a result of work or services performed under this contract the
Provider shall refer the discovery,invention or material to the Alliance to be referred to the Department,Any and all patent
rights or copyrights accruing, under this contract are hereby reserved to the State of Florida in accordance with Chapter
286, F.S. Pursuant to s. 287,0571 (5)(k), as amended, the only exceptions to this provision shall be those that are clearly
expressed and reasonably valued in this contract.
37,2 If the primary purpose of this contract is the creation Of intellectual property, the State of Florida shall retain an
unencumbered right to use such property, notwithstanding any agreement Inade Pursuant to this Section 33,
37.3 If this contract is awarded solely federal funding,the terms and conditions are governed by 2 CFR Part 200.315 or 45 CF1k
§ 75.322,as applicable.
38. Dispute Resolution
Any dispute concerning performance of the contract shall be decided by the Alliance Contract Manager, who shall reduce the
decision to writing and serve a cop), on the Provider.
39. No Waiver of Sovereign limmunity
Nothing contained in this agreement is intended to serve as a waiver of sovereign immunity by any entity to which sovereign
immunity may be applicable.
40. Venue
If any dispute arises Out of this contract,the venue of such legal recourse will be Miarni-Dade County, Florida.
41. Entire Contract
'This contract contains all the terms and conditions agreed upon by the parties. No oral agreements or representations shall he
valid or binding upon the Alliance or the Provider unless expressly contained herein or by a written amendment to this contract
signed by both Parties.
42. Force Majeure
The Parties will not be liable for any delays or failures in performance due to circumstances beyond their control, provided the
party experiencing the force majeUrC Condition provides immediate written notification to the other party and takes all reasonable
efforts to cure the condition.
43. Severability CIaUSe
'Flie Parties agree that if a COL"-t Of competent jurisdiction deerns 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.
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44, Condition Precedent to Contract: Appropriations,
The Parties agree that the Alliance's Performance and obligation to pay tinder this contract is contingent upon an annual
appropriation by the Legislature.
45. Addition/Deletion
The Parties agree that,notwithstanding the terms of the procurement documents and actions leading to this contract,the Alliance
reserves the right to add or to delete any of the set-vices required Linder this contract when deemed to be in the best interest of the
elder population targeted by the Area Plan and reduced to,a written amendment signed by both Parties. The Parties shall negotiate
compensation for any additional services added.
46. Waiver
The delay or failure by the Alliance to exercise or enforce any of its rights tinder 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 partial exercise of any such right preclude
any other or further exercise thereof or the exercise of any other right.
47, Compliance
'file Provider shall abide by all applicable Current federal statutes, laws, rules and regulations as well as applicable current state
statutes, laws, rules and regulations, policies of the Alliance and the Department, and the terms of this Contract, The Pat-ties
agree that failure of the Provider to abide by these laws, rules, regulations, policies, and terms of this Contract shall be deemed
an event of defbult of the Provider and subject the Provider to disciplinary action including corrective action, unannounced
special monitoring, temporary assumption of the operation of one or more contractual services, placement of the Provider on
probationary status, imposing a moratorium on Provider action, imposing financial penalties for nonperformance or
noncompliance,or other administrative:action to immediate, unilateral contract cancellation at the discretion oftlic Alliance,
Ifthe Alliance finds that the Provider fails to abide by all applicable current federal and state Statutes, laws,rules and regulations,
as well as conditions of this Contract,the Alliance shall provide the Provider a Notice ofViolation which shall include a concise
statement of the specific violations of the Provider and the facts relied upon to establish the violation.
Upon receipt of the Notice of Violation,the Provider shall have twenty-one(2 1)days to respond to the Notice of Violation. The
Provider's response must include a statement of any disputed issues of material fact and a concise statement of the specific facts
the Provider contends warrant reversal or deviation from the Alliance's proposed action, including an explanation of how the
alleged Eacts relate to the specific rules, statutes,or contractual term.
Failure ofthe Provider to respond to the Notice ol'Violation within twenty-one(21)days shall be deemed a waiver of the rights
outlined above and the Alliance will proceed against the Provider by default.
The Alliance,upon receiving a timely filed response to a Notice of Violation,will forward the response and all accompanying
documentation to the Contract Manager to review and consider. The Contract Manager shall,within 30 days after the receipt of
the Provider's response,file an order which lays out the final determination of disciplinary action by the Alliance.
48. Final Invoice
The Provider shall Submit the final invoice for payment to the Alliance as specified in this contract. If the Provider fails to submit
final request for payment as specified in this contract,then all rights to payment may be forfeited and the Alliance may not honor
any requests submitted.Any payment due tinder the terms of this contract may be withheld until all reports due from the Provider
and necessary adjustments thereto have been approved by the Alliance.
49. Renegotiations or Modifications
Modifications of the provisions of this contract shall be valid only when they have been reduced to writing and duly signed by
both parties.
50.Suspension of Work:
The Alliance may in its sole discretion suspend any or all activities under this contract and any contractor agreement incorporating
in this contract, at any time, when in the best interests of the Alliance to do so. The Alliance shall provide the Provider written
notice outlining the particulars of suspension. Examples of the reason for suspension include,, but are not limited to, budgetary
constraints,declaration ofemergency,or other such circumstances.After receiving a suspension notice,the Provider shall comply
with the notice and shall not accept any purchase orders. Within ninety days, or any longer period agreed to by the Provider, the
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Alliance shall either(I) issue a notice authorizing resumption of work, at which time activity shall resume, or(2)terminate the
contract or purchase order. Suspension of'work shall not entitle the Provider to air), additional compensation.
51. Termination
51.1 Termination for Convenience. This contract may be terminated by either party without cause upon no less than thirty,(30)
calendar days' notice in writing to the other party unless a sooner time is mutually agreed upon in writing. Said notice
shall be delivered by U.S. Postal Service with verification of delivery or any expedited delivery service that provides
verification of delivery or by ]land delivery to the Alliance Contract Manager or the representative of the Provider
responsible for administration of the contract. The Provider shall not furnish any product after it receives the notice of
term ination, except as necessary to complete the continued portion of the contract, if'any, 'file Provider shall not be
entitled to recover any cancellation charges or lost profits. See notes on entail regarding this paragraph.
51.2 Termination for Cause.The Alliance may,terminate this Contract ifthe Provider fails to(I)deliver the product within the
time specified in the contract or any extension, (2) maintain adequate progress, thus endangering performance of the
contract, (3) honor any, term of the contract, (4) abide by any statutory requirement, regulatory requirement, licensing
requirement, or Department policy or (5) in the event funds for payment become: unavailable for this contract. 'file
Alliance will be the final authority as to the availability and adequacy Of funds, fit the event of termination of this contract,
the Provider will be compensated for any work satisfactorily completed prior to the date of termination. Rule 60A-
1.006(3), F.A.C.,governs the procedure and consequences of default. The Provider shall continue work on any work not
terminated. Except for defaults of subcontractors at any tier, the Provider shall not be liable for any excess costs if the
failure to perform the contract arises from events completely beyond the control, and Without the fault or negligence, of
the Provider. Ifthe failure to perform is caused by the default of a subcontractor at any,tier,and if the cause of the default
is completely beyond the control of both the Provider and the subcotWactor,and without the faLdt or negligence of either,
the Provider shall not be liable for any excess costs for failure to pet-form, unless the Subcontracted Products or services
were obtainable fi-orn other sources in sufficient time for the Provider to rneet the required delivery schedule. If, after
termination, it is determined that the Provider was not in default, or that the default was excusable, the rights and
obligations of the Parties shall be the same as ifthe termination had been issued for the convenience of the Alliance. The
rights and remedies ofthe Alliance in this clause are in addition to arty other rights and remedies provided by law or under
the contract.
51.3 Upon expiration or termination of this contract, tile Provider and subcontractors shall transfer all public records in its
possession to the Alliance and destroy any duplicate public records that are exempt or confidential and exempt from
public records,diSCIOSUre requirements at no cost to the Alliance. All electronically stored records shall be provided to
the Alliance in a format that is compatible with the Alliance's information technology systeni(s),
52. Successors
This contract shall remain binding upon the successors in interest of either the Alliance or the Provider,subject to the assignment
provisions in Section 22 above.
53. Electronic Records and Signature
53.1 The Alliance authorizes, but does not require, the Provider to create and retain electronic records and to use electronic
signatures to conduct transactions necessary to cartyr out the terms of this contract. A Provider that creates and retains
electronic records and uses electronic signatures to conduct transactions shall comply with the requirements contained in
the Uniform Electronic Transaction Act, s, 668,50, F.S., All electronic records must be fully auditable; are subject to
Florida's Public Records Law, Ch. 119,F.S,; I11LISt Comply with Section 29, Data Integrity and Safeguarding Information;
must maintain all confidentiality,as applicable,- and must be retained and maintained by the Provider to the same extent as
non-electronic records are retained and maintained as required by this contract.
53.2 The Alliance's authorization pursuant to,this section does not authorize electronic transactions between the Provider and
the Alliance. The Provider is authorized to conduct electronic transactions with the Alliance Only Upon Further written
consent by the Alliance.
533 Upon request by the Alliance,the Provider shall provide the Alliance or Department with non-electronic(paper)copies of
records. Non-electronic (paper) copies provided to the Alliance of any document that was originally in electronic form
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with an electronic signature must indicate the person and the person's capacity who electronically signed the document on
any non-clectronic copy of the document.
54. Special Provisions:
The Provider agrees to the following provisions:
54.1 Investigation of Criminal Allegations:
Any report that implies criminal intent on the part of the Provider or any subcontractors and/or vendors and was referred
to a governmental or investigatory agency must be sent to the Alliance. If the Provider has reason to believe that the
allegations will be referred to the State Attorney, a law enforcement agency, the United States Attorney's office,or other
governmental agency, the Provider shall notify the Alliance innnediatcly. A copy of all documents, reporls,notes or other
written material concerning the investigation, whether in tile possession of the Provider-, its subcontractors, Or vendors,
MUSt be sent to the Alliance's contract manager with a summary of the investigation and allegations.
542 Volunteers:
The Provider shall ensure the use of trained Volunteers in providing direct set-vices delivered to older individuals and
individuals with disabilities needing such services. If possible,the Provider shall work in coordination with organizations
that have experience in providing training, placement, and stipends for volunteers or participants (such as organizations
carrying out federal service programs administered by the Corporation for National and Community Service), in
community service settings.
54.3 Enforcement:
54,11 In accordance with section 430.04, F.S_the Alliance may,without taking any intermediate measures available to it
against this contract rescind this contract if the Alliance finds that:
543.2 An intentional or negligent act of the Provider has materially affected the health, welfare,or safety ofelients served
Pursuant to any contract or agreement, or substantially and negatively affected the operation of services covered
Under any contract or agreement;
54.3.3 The Provider lacks financial stability Sufficient to meet contracttW obligations or that contractual funds have been
in isappropriated;
54.3A '"file Provider has committed multiple or repeated violations of legal and regulatory standards,regardless of'whether
SLICII laws or regulations are enforced by the Alliance, or the Provider has committed or repeated violations of
Alliance standards;
54.3.5 The Provider has failed to continue the provision or expansion of set-vices after the declaration of a state of
emergency;and/or
54.3.6 The Provider has failed to adhere to the terms of any contract or agreement incorporating in this contract,
543.7 In the alternative,the Alliance may, at its sole discretion,take immediate measures against
rist the Provider, including
corrective action, unallOOLIn m
Ced Special monitoring, temporary assumption of the operation of one or more
contractual services, placement of the Provider on probationary status, imposing a moratorium oil Provider action,
imposing financial penalties for nonperformance,or other administrative action.
54.4 In making any determination Under this provision the Alliance may rely upon the findings of another state or federal agency,
or other regulatory body.Any claims for damages for breach of any contract or agreement are exempt from administrative
proceedings and shall be brought before the appropriate entity in the venue of Miami-Dade COLHAY,
54.5 Use of'Service Dollars:
The Provider will optimize the use Of Contract funds by sendrig tile MaXiML1111 possible Dumber of individuals with tile
services allowed by this contract. The Provider will spend all funds provided 1)),this contract to provide such services,
54,6. Surplus/Deficit Report:
The Provider will submit a consolidated surplus/deficit report in a format provided by the Alliance to tile Alliance's
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Contract Manager in conjunction with the required monthly billing submission. This report is for this contract between
the Provider and the Alliance. The report will include the following:
54.61 The Provider's detailed plan on how the surplus or deficit spending exceeding the I%threshold will be resolved;
54.6.2 Number of clients currently on the APCL,that receive a priority ranking score of four(4)or five(5);
54.6.3 Number of clients currently on the APCL designated as Imminent Risk,
54.6.4 Number of clients served and Aging and Disability Resource Center("ADRU)client
contacts,
In accordance with its surplus/deficit management policies, in order to maximize available funding and minimize
the time that potential clients must wait for services,the Alliance in its sole discretion can redUCe funding awards if
the Provider is not spending according to monthly plans and is projected to incur a surplus at the end of the year.
54.7 Training: The Provider will attend all required trainings and meetings schedule by the Alliance.
55. Contract NIanaV_e
The Alliance may substitute any,Alliance employee to serve as the Contract Manager
56. Official Payee and Representatives(lane,Address,and Telephone Numbers)
The name,address,and telephone number of the representative for the Alliance for this contract is:
Max B. Rothnian,JD, LLA/l. President and CE0
760 NW 107th Ave, Suite 214
Miami,Florida 33172
(305) 670-6500, lxt. 224
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I fie imme, address,and telePhoire number ofthe represelltative ofthe Provider responsible Ibr administration ol'the Taro rare under
this colilract is:
Monroe County Board of Comity Col-rililisslorlers,
The Provider name,as shown oil page I of this Social services/Ill-'l-foure Services
A contract, and mailing,address of the official 1100 Simonton strect,2111r Floor
payee to whon) the Payment shalf lie made is: Key West. Fl, 33040
305-292-45 l0
Sheryl Graham
The name Oftfic WrWlct Person of the Provider Monroe Courity Board of Cou"lly Commissioners,
13 and sti-Cet iddl-ess where financial and Social ServicesAn-Home Services
administrative records are maintained is: 1100 Silliciliton Street, 2`1 Floor
Key West, I'l, 33040,
305-292-45 10
Sheryt Graham
The name,address.and (ciqhonc number of Nlonroe CoullI3 130ardo1 County Commissioners,
C the replescrilative offlie Provider responsrhic Social Services/Iii-ilorne Services
For administration of the prop-,jill under this 1100 Sirliontoll Sirect, 2"' Floor
contract k: key \Vcst, I'l, 3.3040
305-292,-45 10
Alliance for Aging, lnc
Ill e section and locatiMl widlin the AAA where Fiscaf Department
d RC(ILIeSIS for Payment and Receipt and 760 NW 107th Avenue,Suite 2 14
lFXpellditure fim-nis are to be matted is: kliami, Florida 33 172-3 I 55
Contract Manager.
I'lle narne,address,and t0eplione number.of" All iance tbr Aging, Inc,
thv Contract Vlanager kw the AAA liar this 760 MV I 07th Avenue,Suite 214
contract is: Miami. Florida 33172-3155
305-670-6500
Upin,change o C represeritaii Ves I lianics.addresses, te lepholle numbers)by either party, notice sharp be prov tded in wvj i t ilig to tile
other parly and the nofificati(,rjj attachcd to the origillals,ofthis emilract,
57. All"Ferins 311111 C"OndiflOFIN filClUtle(l
This Contract and its Attachments uld any exhibits referenced in said attachments, together lvitil ally docullients incorporalcd by
reference, contain all file leij,is and conditions "I"greed upon by lite Parties, There are no provisions, terms, conditicnis, Or
obligations other than thow contained hovin, and t his contract shall supersede all i)rcvi(.)t6 commimicatiolls, re[mvsciltatiolls or
agreements,either Written or verbat betweeii (lie Pal ties.
13Y siDling this contraci,the Parties agree that they have read and agree it)the ctifire contract,
IN WITNESS "ITIERFOU', the Parties hereto have caused this contract, to be executed by their midersigned ol'ficiak as cludy
authorized.
,MONROF COUXIA'BOARD OF COUNTY
COMMISSIONERS, SOCIAL
Al LIANCE F'OR AGING, INC.
SIGNED BY:
SK NEI)BY:
NAM E
iltymaw I_e N A N4 fl': ki A X B� R OTI I NI A N, J U, 1,L,JM.,_. ..............
TFILL Ce-,)LLjft+ ArtirhiA5.i-sli r IF I'LL PREISI DENT AND CUO
D T AE� Oct3,2023
Z.
20_21,�Y_ DAT[
Page 16 of 72
SIGNED BY:
Ap",,t n,o tmw.0 1,a,w NAME:
dul"In"„Ut::,,
TITLE: MAYOR
DATE:
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INDEX TO CONTRACT ATTACHMENTS
ATTACHMENT ATTACHMENT DESCRIPTION
ATTACHMENT I STATEMENT OF WORK
ATTACHMENTII FINANCIAL COMPLIANCE AUDITATFACHMENT
ATTACHMENT II AUDIT REPLATIONSHIP DETERMINATION
EXHIBIT I
ATTACHMENT II FEDERAL RESOURCES AWARDED PURSUANT"TO THIS AGREEMENT
EXHIBIT�2
ATTACHMENT III CERTIFICATIONS AND ASSURANCES
ATTACHMENT vi ASSURANCES—NON-CONSTRUCTION PROGRAMS
ATTACHMENTVIt CONTRACTBUDGETSUMMARY BY SERVICFAND TITLE
ATTACIIMENTVIH AMERICAN RESCUE PLAN CONTRACT REPORT`CALENDAR
ATTACHMENT IX REQUEST FOR PAYMENT
ATTACHMENT X, RECEIPT AND UNIT COST REPORT FOR SUPPORT SERVICES(RP3B)
ATTACHMENT X, RECEIPT AND UNIT COST REPORT FOR NUTRITION SERVICES(RP3CI)
FXHIBIT2
ATTACHMENT X, RECEIPT AND UNIT COST REPORT FOR CAREGIVER SUPPORT
EXHIBIT 3 SERVICES (RP3C2)
ATTACHMENT X, RE("I EIPTAND UNIT COST REPORT FOR CAREGIVER SUPPORT
EXIIIBIT4 SFRVI(-['--S(RP3D)
ATTACHMENT X, RECEIPT AND UNIT COST REPORT FOR CAREGIVER SUPPORT
EXHIBIT5 SERVICES (RP3E)
ATTACHMENT XI ARP QUARTERLY REPORT
ATTACHMENT B DEPARTMENT OF ELDER AF'FAIRS' CIVIL RIGHTS COMPLIANCE
CHECKLIST AND INSTRUCTIONS
ATTACHMENT BACKGROUND SCREENING—AFFIDAVIT OF COMPLIANCE
ATTACHMENT BUSINESS ASSOCIATE AGREEMENT
ATTACHMENT ADRC POLICY AND PROCEDURES FOR OUTSOURCED I'UNCTIONS
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ATTACHMENT I
ALLIANCE FOR AGING,INC
STATEMENT OF WORK
American Rescue Plan
SECTION 1: SERVICES TO BE PROVIDED
1.1 Alliance for Aging,Inc. Mission Statement
The Alliance mission is to promote and advocate for the optimal quality of life for older adults and their farnihes.
1.2 Program Specific Te I-ills
Area Plan:A plan developed by the area agency on aging Outlining a comprehensive and coordinated set-vice delivery system
in its planning and set-vice area in accordance with the Section 306 (42 (J.S.C. 3026) of the Older Americans Act and
Department instructions.
(-,'hil(l: An individual who is not more than 18 years of age or an individual with disability,
Disaster Relief Services:Administration on Community Living(ACL)considers disasterreliefservices for older individuals
to,be any allowable
OAA services during the period covered by Florida's Major Disaster Declaration (MDD)that are provided to eligible older
individuals Or family caregivers as defined under the 0AA.
Family Caregiver: An adult family member,or another individual:,, who is an informal provider of in-home and community
care to an older individual.
Frail: When an older individual is unable to perform at least two Activities of Daily Living (ADLs) without substantial
human assistance.including verbal reminding,physical cueing or supervision;or due to cognitive or other-mental impairment,,
requires substantial supervision because the individual behaves in a manner that poses a serious health or Safety hazard to the
individual or to another individual.
Grandparent: A grandparent or step-grandparent ofa child,or a relative ofa child by blood,marriage or adoption and who
lives with the child; is the primary caregiver of the child because the biological or adoptive parents are unable or unwilling
to serve as the primary caregiver of the child; and has a legal relationship to the child, such as legal custody or guardianship,
or is raising the child informally.
Major Disaster Declaration: States may request and receive an MDD by the President under the Stafford Act. Florida's
request was approved in 2020,which permitted the Alliance and the Provider to use any portion of the funds made available
under contract for disaster relief for older individuals. Although the MDD ended on June 26, 2021 when the State's
emergency order ceased,these flexibilifies were allowed to continue in,contracts that were in place as the time the Emergency
Order was lifted. As many of the services and plans for American Rescue Plan (ARP) funding was submitted to the
Department prior to the Emergency Order being lifted,the flexibilities allowed during the MDD will be allowed in the ARP
contract.
1.3 General Description
1.3,1 General Statement
The primary purpose of the American Rescue Plan Program is to prevent, prepare for,and respond to C01_011aVit-Lls disease-lad
(COS ID-19); including supportive services,nutrition services,preventive health,and Support set-vices for family caregivers.
1.3.2 Authority
All applicable fcder,,fl Jajvs, regUlations, action transmittals, program instruclions, review guides <jjjtj similar
(10CLUIlentalion retorted to the
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a, ('aialoo of'l:cdcr,,d Domestic Assistance No. 93,04 3,044, 93.045. 9'.05-2, and 93.051,
OMer Americans Act of 1965, a,,amended 20 1 6�
c. American Rescue Pkin Act:
d 4) U.S.C. 247ck
c. 42 UJ,SX'. §303,42 tJ.S.C, §60-k
f. RLde SSA-L Fiorida Administrative Code (i A('):
0. Section 41,0 i 01, HOrid'Ll SkttLikCN' (F.S.); and
Z�
11. 00FA Prournms and Scrvice,, Handbook, which is herchy incorporated by I_Cf`crVnQe, to ilICILKIC LIM
SLO)SCLILICIlt re\isions therM',
..........
13.3 Scope of Service
The Provider is responsible for the programmatic,fiscal,and operational management of tile American Rescue Plan Program
within this contract,
13.4 Major Program Goals
The maJor goals of the American Rescue Plan Program are to prevent, prepare for, and respond to COVID-19- including
supportive services, nutrition services, preventive health, and support services for family caregivers. Efforts may include
COVID-19 vaccination Outreach, education, and associated services with helping older adults get vaccinations; and
services that address social isolation, including activities for investments in technological equipment.
13.5 Leadership and Advocacy
As a designated Focai Point, a provider is encouraged to provide coordination of services for older individuals, The
Provider Must also provide community leadership on aging issues and serve as the advocate and focal point for the elderly
within the C01111111,11lity in cooperation with agencies, organizations and individuals participating in activities funded by the
Alliance. Advocacy should include initiating Positive changes in public or private policies and attitudes towards older
persons, taking action to improve, modify, or eliminate situations which adversely impact on lives of older persons, or
expressing Support for older persons and their interests. Advocacy activities may be broadly supportive of the gerterai
interests ofolder persons or may involve specific activities on belialf ofindividuals.
1.4 Clients to Be Served
1.4.1 General Description
'rill ic American Rescue Plan Program gives preference to older individuals with greatest economic need and older individuals
with greatest social need (with particular attention to low-income older individuals, including low-income minority older
individuals,older individuals with limited English proficiency, and older individuals residing in rural areas),and clients vitro
are practicing social distancing due to the COVID-19 public emergency.
1.4.1.1 American Rescue Plan Program, General Client Eligibility
a. American Rescue Plan Program
ConSUIllet'S Shall, not be dually enrolled in an American Rescue Plan Program and a Medicaid capitated Long-Term
Care Program,except consumers in need of American Rescue Plan Legal Assistance services and American Rescue
Plan Congregate Nutrition Services, including transportation to and from congregate meal sites,
b, American Rescue Plan Program For Supportive Services under Title 111-13 of the Older Americans Act
L Individuals must be age sixty(60)or older; and
ii. I&R/Assistance services are provided to individuals regardless of age.
c. American Rescue plan Program for Nutrition Services Under Title III-CI and III-C2 of the Older Americans Act
General factors that shall be considered in establishing priority for the receipt of nutrition services include those
older persons who:
i. Cannot afford to eat adequately;
ii. Lack the skills or knowledge to select and prepare nourishing and well-balanced meals-,
iii. Have limited mobility which may impair their capacity to shop and cook for themselves;
iv. [lave a disabling illness or physical condition requiring nutritional Support;
v. Have been screened at a high nutritional risk; or
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vi. Are unable to obtain nutrition because the individual is practicing social distancing due to COVID-19.
d. American Rescue Plan Program for Congregate Nutrition Services under Title HImC I of the Older Americans Act
i, In addition to meeting the general nutrition services eligibility requirements listed in Section 1.4.1 c. above,
individuals eligible to receive nutrition services include the following:
(I) Individuals age sixty(60)or older;
(2) Any spouse (regardless of age) who resides at home with or attends the dining center with his/her
eligible spouse;
(3) Persons with a disability,regardless of age,who reside in H h0USiflg facility occupied primarily by older
individuals where congregate nutrition services are provided or home delivered meals are delivered,
(4) Disabled persons who,reside at home with or accompany an eligible person to the dining center;
(5) Volunteers,regardless of age, who reside at home with or provide essential set-vices on a regular basis
during meal hours;
(6) Persons at nutritional risk who have physical,emotional,or behavioral conditions which Would prevent
therm from obtaining nutrition;and
(7) Persons at nutritional risk who are socially or otherwise isolated and unable to obtain nutrition.
e. American Rescue Plan Program for Horne Delivered Nutrition Services Under Title Ill-C2 of the Odder Americans
Act
i. In addition to tweeting the general nutrition services eligibility requirements listed in Section 1.4.I.e. above,
individuals must be unable to attend a congregate nutrition program. Individuals eligible to receive home
delivered meals include the following:
(I) Individuals aged sixty (60)or older who are incapacitated because of illness, disability,or isolation;
(2) A home delivered meals recipient's spouse, regardless of age, if the provision of the collateral meal
supports maintaining the person at home;
(3) Individuals with disabilities,regardless of age,who reside at home with home delivered meals recipients
and are dependent on them lot-care,and;
(4) Persons at nutritional risk who have physical, emotional, or behavioral conditions which Would make
their presence at congregate nutrition sites inappropriate;
(5) Persons at nutritional risk who are socially or otherwise isolated, ilICIUding those who are self-isolating
at home due to COVID-19, and unable to attend a congregate nutrition site;or
(6) Individuals age 60 or older who are unable to prepare meals due to a lack of inadequacy of facilities,an
inability to shop,cook,or prepare meals safely, or a lack of appropriate knowledge or skill.
f. American Rescue Plan Program for Preventative Health Services Linder Title 111-D of the Older American Acts
i. Target individuals must be age sixty(60)or older; and
ii. Priority will be given to individuals residing in medically undcrserved areas.
g. American Rescue Plan Program for Family Caregiver Support Program LJnder Title 11141 of the Older Anierican,
Acts
i. Eligible individuals include:
(I) Family caregivers of individuals aged sixty(60)or older; and
(2) Grandparents[age fifty-five(55)or older]or older individuals[age fifty-five(55)or older]who are relative
caregivers.
ii. For respite and supplemental services, a farnily caregiver must be providing care lot-an older individual who
meets the definition of the term "frail"as defined above.
iii. 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 to grandparents or older individuals who are
relative caregivers who provide care for children with severe disabilities.
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SECTION 11—MANNER OF SERVICE PROVISION
2.1 Service Tasks
In order to achieve the goals of the American ReSCUe Plan Program,tile Provider shall ensure the following tasks:
I) Client Eligibility Determination: The Provider shall ensure that applicant data is evaluated annually to determine
eligibility prior to rendering services, Eligibility to become a client is based on nicefing the requirements described in
this contract.
(2) J'argeting and Screening of Service Delivery for New Clients: 'flie Provider shall develop and implement policies and
procedures consistent with American ReSCUC Plan Program targeting and screening criteria.
(3) Program Services: The Provider shall ensure the provision of a continuum of services that meets the diverse needs of
elders and their caregivers. The Provider shall ensure the performance and report performance of the following services
are in accordance with the current DOEA Programs and Services I landbook.
(4) Program Eligibility Requirements
Crkeria
1�111ities musi 111cel the ftfllokv im—, cl,Ilvria to he ehuilfle for progralli participatloll:
i. An aKwnc that has, reuel%rcd a urailt under American kescue Plan Program and
i i. A nutriticm service providcr that serves Illeals and is under tlw jurisdiction. control. ma mu
and 'ludit allihol'ity of the A lhd[We and the Dcparlmeiw
b. Provider's Nutrition Set-vice Operations
I lie Provider shall CIISLIN 01C 1111161i0tj "QIIviCo ralaorutierns oi' tile Prrrvralcr rJeCi tile recpdreillelltrs 01, this
contract', as avoll us any o1her applicaWc regulations es tions and polic� prescribed by tile curroW IX,W m
A Prour�ls
mid Services kilidbook, the Depaltm eilt of 110 1111l alld limmin ``sera leans, IJSDA, DOI I and local health
delmrtlrlentw, DBPR, or am otherauenc% designlUr'd to inspect meal quakiv 1,01.the State. HIC Provider nlust
auree to noli i 1'y lilk.A I I imicc o f,:ill ,S illilation ii Ispec6ons, Cspecialk those thhat 'llCkride tliti'h priority violmions
and provide n Copy of the l"ellort to the Alliance within 24 hours. Closures must he rqwried lillilledialel)
All 'r"IlhccrIltractvd food service veltdor"illust provide,I writtoi corrective action plan to the Nutrition Provider-
for am, hi-h priority or si'milicalit findings oil SallitaItjaail jjjsi)QCjj()IjS. 1,h, o,TCCtlVe ',Wd011 J)LIIIS IIII.I.St hC
approved 1)),the Providers RD and SUboi i(j:ed to the Alliance to ensure that deficiencies are remedied.
c, Prescribed Nutritional Requirements
The Provider shall ensure that each meal provided mider this contract meets the following criteria:
i. Complies with the current Dietary Guidelines for Americans, published by the Secretaries of the
Department ofHealth and Human Services and the Department of AgricultUrC.
ii. Provides a minimum of 33 1/3 percent ofthe dietary reference intakes/adequate intakes for an age 70+
female as established by the U'ood and Nutrition Board of the National academy of Sciences; and
iii. Is served from and approved Alliance Merin.
(5t Mcmitorim, the periormanoo of its suhcontraclors and or voidors,
(6)Comply with the Alliance's N11tritior) policies and procedures.
(7) Hic Alliance has comr,,Icted 1,oi techlloloy Services ii7t-OL1011 CLARIS' CMU� Pkl,"DW I. E'1111(). HUlALI'A,
and A6ELF.SS INNOVA'HON «is appheable, Where aIpproprialc, Provider shall mersee. ensure insialiation,
11116lit',ite 01C retLli'll k)l' Jlle CqIlipjljellt (if "Ipplicalfle). ,III(] comply with the use ot! these tcchnok)uy
service colltracB to support it) redticim�, Social kolation alld loneliflesN "Illd to support Uaregh,ers-
2.2 (Ise of Subcontractors and/or %lendors
ifthis Contract involves the use OfIl SLIhC0Ht1,iC1M-rand or veilclot% then tile Provider shall not delay 0w impic'mcill"16on of
its auxceiilent with the subcontractor or vendor, if zany Cil'CLIMSIMICC OC-CLUS 01,11 Imly rk:SLIlt ill as deki)� lol' <1 period oaf sixty,
(60) days or Illore tho hli6mion ofille subcontrad,;venclor or the perlormance ol, tile slibcollilaclot'vondor, d1c. Provider
sharp inmtik the; Alliance ColItIqlCt ManaL�er in wrilh)o of such dolav, The Provider shall neat permit a
to performs scrvicQs related to this C,)I)trdCL without 1111611g ',I hilldhig sLa1r)c(inti-actt)t-,'vendor ,t,wreeiiiolit eXwlted, Hic
Alliance will not he responsiWe or liable fear,any obligations or claillis NsLllthlQl frown SUCII action,
221 Copies Of Subcontracts/Vendors
,lr*l,, Provider !shall submit a copy of all subcontracts and/or vendors to the Alliance Contract Manager within
thirty (30) days of exeCUtiO11 of each subcontract agreement. Throughout the contract period, the Provider shall
immediately submit and changes to subcontractors to the Alliance Conti-act Manager.
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2.2.2 Monitoring the Performance of S Libcontractors and/or Vendors
The Provider shall monitor, at least once per year, each of its subcontractors, sub-recipients, vendors, and/or
consultants paid from funds provided under this contract.
a. Sub-recipients - The Provider shall perform fiscai, administrative, and programmatic monitoring to eIISLII'e
contractual compliance, fiscal accountability, programmatic performance and compliance with applicable
state and federal laws and regulations, The Provider shall monitor to ensure that time schedules are filet, the
budget and scope of work are accomplished within the specified time periods, and other- performance goals
stated in this contract are achieved.
1), Vendors — The Provider shall perform administrative and programmatic monitoring to ensure contractual
compliance,programmatic performance and compliance with applicable state and federal laws and regulations.
The Provider shall monitor to ensure that time schedules are met,and the scope ofwork is accomplished within
the specified time periods, and other performance goals stated in this contract are achieved. The Provider
shall Perform a modified fiscal monitoring to include billing/invoicing procedures and reconciliation to ensure
fiscal accountability and sustainability.
2 2.3 'rhe Provider shall ensure that all required client data for services provided by subcontractors and/or vendors are
entered in the CIRTS database per the Department's CIRTS Policy Guidelines. 'I"'he data niust be entered into the
CIRTS database before the Provider submits the Request for Payment and Expenditure Reports to the Alliance.
The Provider shall establish time frames with its SU be oil tractors and vendors to ensure compliance with chle dates
for the ReCILIeStS for Payment and Lxpenditure Reports to the Alliance.
2.3 Staffing Requirements
.3.1 staffing, Le vets
I lit: llrovidQr Shall "Issic'n its own admillisil"Itiv",and "upport stoffo filet led to perform flit, tasks, rvsponsibihlics
and dWiCS UIRILT this C0101',tU and ellsurc that SLIL10MIll"'tclors and or vendors de(IiCIIC
2.3.2 Professional Qualifications
'I lw Providershall ellsure that Ille staI(Yrespotlsihlo t,or pel'torilliwu and dittiv or funclions within this contract have
the quillificatiolis as specitled in the: DOFA Programs and Services I Lindbook.
2,33 Service Times
"I'lle Provider SINAI ellSLII-c the f)I-0\'iSi0rI of services listed in this Colltrud dUrill" IM flltl bIlSilICSS h0LII-S LIIIlCSS
01her IiIIICS are I)IM-C ¢ipltrerpriafe the 111cet file requirements oflhts Contract, "Ind it shall n1ollitor its
slubconlinadol's arld,m \vndors to ensure they, are available lo provide SCIA iCCS (ILII-iM! 110LII'S l-CSj)0llSi\C ter client
lleQds and during those (itilo", which, hest Ilwet the licc(Is ol'the rcleva-Int seI,\;Icv conlnlkllllty.
23A Use Of VOILIrneers to Expand the Provision of Available Services
The Provider shail, make use of trained volunteers in providing direct services delivered to older individuals and
individuals with disabilities needing SLICII SCI-ViCM If possible, the Provider shall work in coordination with
organizations that have experience in providing training, placement,and stipends for volunteers or participants(such as
organizations carrying OLA Federal service programs administered by the Corporation for National and Community
Service), ill C0111MUnity service settings.
2.4 Deliverables
I he 11fflo\vhIL" section provides the SpCCifiC LILIdWifiable iffliIS Of (1Cli\'CI'JblCS alld SOLJI•CC d0CLHIICII1',lti0II NCIlliNd 10
t"Vidence the collipletioll of the tasks SpQcit'ied in this Contract, 'I Ile Pro\i(.ICI- MUM sUbIflit nth required docullicniation in
the little and Illanner specilled 101'the IllillitIlLIM le"'Cls to Ile Inet. Fach deliverable must be accepted in kr riting
b\ (lic AMaiicLe Contract VlalWl-Cr based 011 the W(iLlircillents 1`61, cach deliverable the Pt'OVJLICr 144)1161', MI iI)VOiCC
I-hc Pirovidershafl eIISLIN[Ile PI-C)Visi011 01',10MOHLIUM ol'scl-N ices than Illocts the diverse needs ofeklers"Illd thcircarcuivers.
'I Ile ProOder :sharp ensure the pe rform Lill cc and reportill- of the f0llowim,, services in accordance With the CLIH-Cilt 60t'A
Prourams mid Services I landbook and this contract. DOCUMCM8601I OfSer\iCe deliN ery intiSt iflChl&a report C011STSWIrk, all`
file f0l10\ViIl-: number of clients SCI-VC(1. 11LIHIbel' Of Service, Units provided by service, and rate per scrvt I Ce unit with
Ct1lCLI1,'Iti0IIS that eqLlll the total invoice.1111oullt.
"File Provider shall provide the services described in the contract in accordance lVith the current DOEA Prograrn and Services
Handbook. Units of service will be paid pursuant to the rates established in ATTACHMENT VII.
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Additional Stafford Act flexibilities may be allowed and are reflected on ATTACHNIETN VIL
The Servicos il)CJLILIe the I0110WiM_I Catolj(gieS:
2.4.1 American Rescue Plan too-Supportive Services under Title Ill-B of the Older Americans Act
Supportive services include a variety of community-based and home-delivered services that support the quality of
life for older individuals by helping thern remain independent and productive. Services include the following;
(1) Adult Day Care; (14) Personal Care;
(2) Caregiver Training& Support, (15) Pet Support Services;
(3) Chore& Chore(Enhanced), (1 Cr) Recreation;
(4) Companionship; (17) Respite Services(In-Horne& Facility)
(5) Counseling(Gerontological); (18) Screening and Assessment;
(6) Education/Training; (19) Shopping Assistance;
(7) Emergency Alert Response-, (20) Short Term Case Management
(8) Escort; (21) Specialized Medical Equipment,
(9) Healthcare Navigator; Services,and Supplies;
(1,0) Homemaker; (22) TCARE;
(11) Housing Improvement; (23) Technology,
(12) Legal Assistance; (24) Telephone Reassurance; and
(13) Material Aid;
2.4.2. American Rescue Plan for Congregate Nutrition Services cutler Title 111-Cl of the Older Americans Act
Nutrition services are designed to reduce hunger and food insecurity arid to promote socialization kind the health and
well-being of older individuals through access to nutrition and other disease prevention and health prornolion
services. Services include the following:
(I) Congregate meals;
(2) Congregate meals screening;
(3) Horne Delivered Meals;
(4) Nutrition education and nutrition counseling;
(5 t Shopping Assistance; and
(6) Telephone Reassurance,
2.4.3. American Rescue Plan for Home Delivered Nutrition Services antler Title III-C2 of the Older Americans Act
Nutrition services are designed to reduce hunger and food insecurity and to promote socialization and the health and
well-being of older individuals through access to nutrition and other disease prevention and health promotion
services. Services include the following:
(I) Horne Delivered Meals;
(2) Nutrition education
(3) Nutrition counseling;
(4) Screening and Assessment;
(5) Shopping Assistance;and
(6) Telephone Reassurance.
2.4.4. American Rescue Plan for Preventive Services under Title Ill 11-11)of the Older Americans Act
Evidence-Based Disease Prevention and Health Promotion (EBDPHP) services have been demonstrated through
evaluation to be effective for improving health and welibeing,or reducing disease, disability, and/or injury among
older adults. The ACL defines EBDPHP services as meeting highest-level criteria. Only services that meet the
highest-level criteria are allowable under the IFID Program. EBDPHP services must be delivered per the
requirements of the program and ensure program fidelity. EBDPHP services include the following:
(1) A Matter of Balance; (5) Enhance Fitness;
(2) Bingocise; (6) Healthcare Navigator;
(3) Chronic Disease Self-Management (7) HorneMeds;
Program; (8) Progranna,de ManeJo Personal de la
(4) Diabetes Self-Managernent Program; Diabetes;
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(9) Tai Chi/Tai Ji Quan Moving for Better (1 1) Telephone Reassurance;
Balance(Highest-Levcl); (12) Tomando(r 011 trol de su Salud-,
(10) Technology; (13) Un ASUnto de Equifibrio; and
2.4.5. Caregiver 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 decisions and problem solving related to their caregiving roles and
responsibilities:
(8) home Delivered Meals-,
(1) Adult Day Care; (9) Respite Services(In-Home&Facility);
(2) Caregiver Training/Support (10) Screening/,Assessment;
(Individual&Group); ('I I) Shopping Assistance;
(3) Caregiver Follow-up; (12) TCARE;
(4) Caring,for You, Caring for Me, (1 1) Technology;
(5) Counseling(Geronto logical); (14) Telephone Reassurance; and
(6) Education/Training; (15) Caregiver Support GrOLIPS
(7) Health Care Navigator,
2.4.6,, Caregiver Support Supplemental Services(IIIIES Program)
The following services are provided to complement the care provided by caregivers:
(1) Chore Services;
(2) Housing Improvement;
(1) Material Aid;and
(4) Specialized Medical Equipment, Services and Supplies.
2.4.7. Caregiver Support Grandparent Services(11 IEG Program):
Services for grandparents or older individuals who are relative caregivers designed to help meet their carcgiving
obligations include the following:
(I) Legal Assistance;
(2) Caregiver Training/Support;
(3) Caregiver Follow-up;
(4) Caregiver Support Groups;
(5) Caring for You,Caring for Me;
(6) Child Day Care;
(7) Counseling(Gerontological);
(8) Education/Training;
(9), health Care Navigator;
(10) Legal Assistance,,
(1 1) Pet Support Services;
(12) Screening& Assessment;
0 3) Sitter;
(14) Technology;
(15) Telephone Reassurance; and
(16) Transportation
2.5 Reports
The Provider is responsible for responding in a timely fashion to additional routine and/or special requests for information and
reports required by the Alliance. The Provider must establish due dates for any Subcontractors and/or vendors that permit the
Provider to meet the Alliance's reporting requirements,
2.5.1 Retrospective Unit Cost Methodology
The Provider shall Submit the Retrospective Unit Cost Methodology to the Alliance annually, no later than 90 days after
the provider Fiscal year end. The Retrospective Unit Cost Methodology shall reflect actual costs of providing each service
for the preceding Provider fiscal year. If the Provider desires to renegotiate its reimbursement rates, the Provider shall
make a request in writing to the Alliance in accordance with the Alliance's approved Reimbursement Rate Review Policy,
which is incorporated by reference.
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2,5.2 Surplus/Deficit Report
The Provider will respond to the consolidated Surplus/Deficit report in a format provided by the Alliance to the
Alliance's contract manager. Surplus/Defic:it reports must be submitted with the monthly request for payment. This
report is for all services provided in this agreement incorporating in this Contract between the Provider and the Alliance.
The report will include the following:
(1) A list of all Services and their current status regarding surplus or deficit,and wily they differ from its original budget
projecti oils.
(2) A detailed plan oil flow the surplus or deficit spending exceeding the 1% monthly threshold will be resolved. The
plan MUSt include specific budget nUrnbers to reflect]low the Provider plans to address the variance.
(3) NUrnber of clients CLU'rently on the waitlist(APCL),
(4) NUinber of Unduplicated Client served.
2.5.3 CIRTS
Client information and Registration'Fracking Systern IRTS) Reports:
The Provider shall input ARP-specific data into CIRTS or eCIRTS, depending on the instructions provided by tile
Alliance, to ensure CIRTS data accuracy. The Provider shall use CIRTS (or cCIRTS-generated reports which include
the following:
(I) Client Reports-,
(2) Monitoring Reports;
(3) Set-vices Reports; and
(4) Outcome Measures Reports.
(5) Fiscal Reports
2,5A Program Highlights
The Provider shall submit Prograrn Highlights referencing specific events that occurred Under this contract.The Provider
shall provide a new success story, quote, testimonial, or It tj in an-interest vignette. 'File highlights shall be written for a
general audience, with no acronyms or technical terms. For all agencies or organizations that are referenced ill the
highlight, the Provider shall provide a brief description of their mission or role. The active tense shall be consistently
used in tile highlight narrative, in order to identify the specific individual or entity that performed the activity described
in the highlight, The Provider shall review and edit Program Highlights f6r clarity, readability, relevance, specificity,
human interest, and grammar, prior to submitting them to the Alliance,
2.5,5 Health and Wellness Reports: Health and Wellness Reports:
The Provider shall Submit Monthly Programmatic Reports f6r EBDPFIP services oil the dates specified in Attachment
Vill. The Alliance Health), Aging staff will provide Provider with an Excel report template with entry tabs for: flealth
and Wellness Courses/Services offered including Attestations (cumulative), Partnerships (updated as needed), and
Success Stories(reported at least once each May).
(I) Information provided in the Monthly Programmatic Report must match CIRTS data and the Request for Payment.
(2) The Provider shall review, program documentation to ensure documentation is complete and adequately supports
the information reported oil the Monthly Programmatic Report prior to submitting a Request for payment. The
Provider will attest to the review in the "Comments" section of the Monthly Programmatic Report and provide
relevant information regarding the dUCLUDCritation as needed.
(3) Program documentation shall include all the following elements: Sign-In Sheets or Attendance Logs; flyers or
documentation demonstrating efforts to recruit participants and promote EBDPFIP services provided; current
facilitator certificates; copy ofprograrn license(if applicable); and any forms required by the specific program.
(4) Provider shall ensure that Sign-in Sheets or Attendance Logs accurately reflect dates, times, names of prograrns,
participant names, and narne(s) of program facilitator(s). If the Attendance Log does not include a space for
participant signatures, a Sign-In Sheet with signatures and dates must accompany it. Exceptions may be approved
by the Alliance Contract Manager. Requests, must be made to the Alliance in writing and kept with prograrn
documentation.
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(5) Participants must sign their name on program Sign-in Sheets or Attendance Logs. I fa participant is unable to sign
their name, the instructor may sign by proxy for the participant(including their own initials and date)with a note
oil the Sign-in Sheet explaining the need for the proxy.
(6) The Provider shall abide by all program fidelity requirements and annually observe delivery of EBDPHP services,
A note will be included in the Monthly 11rograinniatic Report, in the comments section,when a program has been
observed. Documentation pertaining to the observation will be kept and provided to file Alliance upon request.
(7) CDSME Workshop data Must be entered into the C'DSME Database,
(8) The Provider shall contact the Alliance Contract Manager in the event of an emergency or an exigent circumstance
where the provider is unable to ni,aintain all aspect of fidelity of the EBDP1 IP services(e.g.,mirrimurn or maximum
number of participants) before the end of the workshop. At the Alliance Healthy Aging staff, the service may be
reirnbursed under this contract;however,if the fidelity infraction is discovered afterthe program has finished,during
the Request for payment Process, or as a result of a desk review, the provider shall not be reimbursed for the
workshop or shall reirnburse the Alliance for the cost office workshop.
(9) The Provider shall collaborate and partner with organizations to extend the reach of EBDPl If',services.Partnerships
and collaborations may be developed with DOH, the Florida Department of Children and Families, USDA's
Nutrition Program, insurance companies, Centers for Disease Control and Prevention, Area Fleafth Education
Centers, local health Councils, public and private universities, federally qualified health clinics, county health
departments, and Florida's Age-Friendly COMITILInities. Partnerships shall be designed to stimulate innovation of
new approaches and activities In EBDP1lP services, develop greater capacity, and leverage other funding sources.
Partnerships shall also address building and sustaining all infrastructure for the dissemination of EBDPHP services.
This includes, but is not limited to, recruitment of trainers and participants, covering costs for licenses, and
replicating program fidelity.
I O)The Provider shall document, and provide to file Alliance upon request, evidence of partnerships created formally
(through Memoranda of Agt,eeiiietit,itJiiderstaiidiiig) or informally. The provider will be required to keep track of
partnerships in the Monthly Programmatic Report. Each month the Provider shall review this information and
provide updates to the Alliance as necessm-y.
2.5.6 ARP Quarterly Report
The Provider shall submit a Quarterly Repoli, in a format provided by the Alliance, as listed in ATTACHMENT X1, with
the invoice submitted each quarter. 'File Alliance contract manager will provide the Provider with an Excel ternplate with
tab,entries for each quarter. A quarter is defined as a calendar quarter.
2.6 Records and Documentation
lire Provider wrovs [o make a ,,aiLil:fle to Alliance and,or the Depirtillont staffaild,or�111y 1),Ltrtv designated by the Alfi„incc
and"'ol, I)epartment all contract rck]tCd IWOrd'; and de cunraantatiern. The ProOder Shall ensure the CoHectioll and
maiincilance of' all pro grain-related inforniatioll and docullicluillioll on ally such �;ystcni designated hN the AMance
an&or the Dopartinent. N/laill(CLI'MICC itlCklde, V,liid eXl)OTIS rIlld 1XICkL1111,01'aH data and sysicills accordin- to Dopartillolt
�alajid irds. Data must be usable arld ill a te"Idahk� format by 1he Alliance and;or the Dcparillivill,
2,6.1. CIRTS Data Maintenance
The Provider will ensure the accurate collection and maintenance of client and service inforniation oil a nionthly basis
fi-orri the ORTS or any such system designated by the Alliance. Maintenance includes valid exports and backups of all
data and systerns according to Alliance and DOEA standards. 'file Provider must adhere to the Alliance CIRTS Data
integrity Policies&Procedures, incorporated by reference, in order-to ensure data accuracy.
2.6.2 Data Integrity and Back-LIP Procedures
File Provider shall imiintain written policies and procedures for conil',mter system backup rarrai ShAl
have the Saille requirement of its slihContractors ilrld or velldors."J"hese Policies arid procedures Shall be amide
avaHable ik) the AllilMN L1l1011 1-eLJUQSt.
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2.7 Performance Specifications
2.7.1 Outcomes and Outputs(Performance Measures)—At a minimum,the Provider in List:
(1) Ensure the provision of the services described in this contract are in accordance with the current DOEA Programs
and Services Handbook and in the Manner of Service Provision described in this contract.
(2) Timely and accurately submit to the Alliance all information described in this contract.
(3) Develop, doCLUnCrit, and follow strategies in the Service Provider Application (SPA)to support the Department's
performance outcome measures in the following criteria:
a) 66%of new service recipients with high-risk nutrition scores will improve their nutritional status.
c) 65%of nekv service recipients will maintain or improve their ADL's assessment score.
d) 62.3%of new service recipients will maintain or improve their IADUs assessment score.
e) 89%of family and family-assisted caregivers will self-report they are very likely to provide care.
2.7.2 Monitoring and Evaluation Methodology
'File Alliance will review and evaluate the performance of the Provider Linder the terns of this contract. Monitoring shall
be conducted through direct contact with the Provider through telephone, in writing, and/or all oil-site visit. The
Alliance's determination of acceptable performance shall be conclusive. The Provider agrees to cooperate with the
Alliance in monitoring the progress of completion of the service tasks and deliverables.The Alliance may use,but is not
limited to,one or more of the following methods for monitoring:
(I) Desk reviews and analytical reviews;
(2) Scheduled,unscheduled,and f0lJOW-Up 011-SitC Visits;
(3) Client visits;
(4) Review of independent auditor's reports;
(5) Review of third-party documents and/or evaluation;
(6) Reviewe of progress reports;
(7) Review of customer satisfaction surveys;
(8) Agreed-upon procedures review by an external auditor or consultant.,
(9) Limitecimscope reviews;and
(10) Other procedures as deemed necessary.
2.7.3 Rernedies-Nonconforming Services
The Provider shall ensure that all participants served under this agreement are eligible for the program, arid that all
monthly and/or quarterly performance reports and financial records are maintained for each reporting period and
submitted as stipulated in 2.4, 2.5,2.6, and 2.7.
Any nonconforming program services, performance reports or financial records not meeting the requirenients of this
Conti-act shall not be eligible for reimbursement under this program. The costs associated with hiring,training,reporting
and/or managing the program shall be borne solely by the Provider. The Alliance requires immediate notice of any
significant and/or systemic infractions that compromise the Provider's ability to provide participant services,to achieve
programmatic performance or to provide sound financial management of the program.
2.8 Provider's Financial Obligations
2.8.1 COFISUrner Contributions
Consurner contributions are to be used under the following terms:
I) The Provider assures compliance with Section 315 of the OAA as amended in 2006, in regard to consumer
contributions;
2) Voluntary contributions are not to be used for cost sharing or matching;
3) Accumulated Voluntary contributions are to be used prior to requesting federal reimbursement„ and.
4) Voluntary contributions are to be used only to expand services,
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2.8.2 Use of Service Dollars
The Provider is expected to spend all federal,state and other funds provided by the Alliance for the purpose specified in
the contract. The Provider 111LISt inanag ge the service dollars in Such a manner so as,to avoid having a wait list,a deficit,
or a Surplus of funds at the end of the contract period, for each program managed by the Provider. Program surpluses
must be reported to the Alliance.
2.8.3 Surplus Recapture
In accordance with its surplus/deficit management policies, in order to maximize available funding and minimize the
time that potential clients must wait for services, the Alliance in its sole discretion call reduce funding awards if the
Provider is not spending according to monthly plans and is projected to incur a surplus at the end of the year.
2,8.4 The Provider agrees to use funds as detailed in file Budget Summary, ATTACHMENT Vill. Any changes, in the
aniOUntS of federal funds identified oil the Budget Summary for services within each title(Support Set-vices, Nutrition
Services Caregiver Support Set-vices) are allowed without contract amendment. Providers must adhere to Alliance's
Modified Spending Policy, allowed under this contract, incorporated by reference,
18.5 The Provider shall match at least ten percent(10%)of the federal service funds received. The Provider's match~mill be
made in the form of cash,and/or in-kind resources, except for services provided pursuant to Anieric,an Rescue Plan for
Preventive Services, under Title 111-D of the Older Americans Act. The Provider shall report match Funds by title cacti
month on the Receipts and Unit Cost Report identified in ATTACHMENT X, Exhibits 1,2, 3,and 5. At the end of the
contract period, the Provider intist properly match American Rescue Plan funds that require a match.
2.8.6 ARP Funds
-File Provider assures compliance with Section 306 of the Older Americans Act, as amended in 2006„that Funds received
under ARP will not be used to Pay any part of a cost (including, an administrative cost) incurred by the Provider to
maintain a contractual or commercial relationship that is not carried Out to implement ARP services.
2.9 ALLIANCE'S RESPONSIBILITIES.-
2.9.1 Program Guidance and Technical Assistance
The Alliance will provide to the Provider guidance and technical assistance as needed to ensure the SUCCeSSfill fulfillment
of file contract by the Provider. 'file Providers must attend all required training session and meetings. The support, or
lack thereof,shall not relieve the Provider from fall performance of contract requirements.
SECTION 111t]: METIIOD OF PAYMEN'll'
3.1 General Statement of Method of Payment
The Wthod of Payment for this contract is a combination of fixed fee/unit rate, cost reimbursement, and advance payments,
subject to the availability of funds and Provider performance.The Alliance will pay the Provider upon satisfactory conipletiori
of the Tasks/Deliverables,as specified in Section 11 and in accordance with other terms and conditions,ofthe contract.
3.1.1 Fixed Fee/Unit Rate
Payment for fixed Fee/Unit Rates shall not exceed amounts established in AT'I'ACHMENT V11, Per unit of service.
3.1.2 Cost Reimbursement
Payment may be authorized only for allowable expenditures, which are in accordance with the set-vices specified in
ATTACHMENT V11. All Cost Reimbursement Requests for Payment must include the Receipt and Expenditure
Report(ATTACHMENT X)beginning with the first month of the contract.
3.13 Advance Payments
The Provider may request tit) to two (2) months of advances at the start of the contract period to cover program
administrative and set-vice costs. The payment of an advance will be contingent upon the sufficiency and amount of
funds released to the Depatiment by the State of Florida("budget release"),The provider requests for advance payment
require the written approval of the Alliance and the Department's Contract Manager.For the first month's
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advance request,the Providershall provide the A I I iance Contract Manager docurrientationjustifying tile
need for all advance and describing flow the funds will be distributed. If the Provider is requesting two(2)months
of advances,documentation must be provided reflecting the cash needs of the Provider within the initial two(2)
months and should be supported through a cash-flow analysis or other information appropriate to demonstrate the
Contractor's financial need for the second month of advances. If sufficient budget is available, and the Alliance's
Contract Manager, in his or her sole discretion, has determined that there is a justified need for an, advance, the
Department may issue approved advance payments tip to 30 days after, but not prior to, amendment execution date,,
the Alliance and the Department may,issue approved advance payments after July I st of the contract year.All advance
payments will be reconciled and recouped from the third through the twelfth month. Reconciliation and recouping of
advances made under this contract are to be completed in accordance with ATTACI IMEN'r Vill.
3.1,4 Technology Administrative Flat Fee(TAFF)
Payments for Technology Administrative Flat Fee shall not exceed amounts established ill ATTACHMENT VII, per
technology,and must be billed and submitted oil the Technology Ach-ninistrafive Flatt Fee form (ATTACHMENT X,
Exhibit 6). Billing must be submitted c[Liring the month in which the technology was initiated for the client.
Documentation must be maintained ill client files to support this administrative billing,
3.2 Method of Invoice Payment
Payment shall be made upon the Provider's presentation of ail invoice subsequent to the acceptance and approval by,the Alliance
of the deliverables shown oil the invoice and payment has been received ftorn the Department.The form and substance of each
invoice submitted by the Provider shall be as follows:
3 12.1 Request payment on a nionthly basis for the units of services established in this contract, provided in conformance with
the requirements as described ill the DOEA Programs and Services Handbook, and at the rates established in
ATTACITNIE.,NT VII. Documentation of service delivery must include a report consisting of tile f(fllowing: number of
clients served,number of service units provided by service,and rate per service unit with calculations that equal the total
invoice amount.Any change to the total contract 11111OUnt requires a formal amendment.
3.2.2 'file Provider shall consolidate all subcontractors' Requests for Payment and Expenditure Reports that support Requests
for Payment and shall submit to tile Alliance using forms Request for payment (ATTACHMENT IX), Receipt and
Expenditure Reports(ATTACI fMENT X)for services.
3.2.3 All Requests for Payment shall be based oil the submission of monthly ExpenditUre Reports beginning with tile first
Illonth of' tile contract. The schedule for submission of advance requests and invoices is Invoice Schedule,
ATTACHMENT Vill.
3.2.4 In order to properly manage the program budget, the Provider Must submit invoices for payment no later than 90 days
after the end of the month in which the expense was incurred, except that invoices cannot be submitted after Close Out
Report date. Invoices submitted late will require the approval of the Alliance's Conti-act Manager, Late invoices will
not be paid unless justification is submitted and approved by the Contract Manager.
3 2.5 The Provider shall maintain documentation to Support payment requests which shall be available to the Alliance, the
Department,and the Department of Financial Services,or other authorized state and federal personnel Upon request,
3.2,6 All payments under the tennsofthis contract are contingent upon all annual appropriation by,the Legislature,and subject
to the availability of funds.
3.3 Payment Withholding
Any payment due by tile Alliance under the terms of this contract may be withheld pending the receipt and approval by the
Alliance of all financial and programmatic reports due From the Provider and any adjUStillClItS thereto, including any,
disallowance not resolved as outlined in this contract.
3.4 Final Invoice Instructions
Payments for Technology Administrative Flat Fee shall not exceed aniOUntS established in ATTACHMENT VII,per
technology,and must be billed and submitted oil the Technology Administrative Hatt Fee form(ATTACHMENT X, Exhibit
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6), Billing must be submitted during the month in which the technology was initiated for the client. Documentation must be
maintained in client files to supporl this administrative billing.
3.5 Providers' Monthly CIRTS Reports
The Provider must run monthly CIRTS reports and verify client and service data in the CIRTS is accurate. This report]trust
be submitted to the Alliance with the monthly request for payment and expenditure report and must be reviewed by the
Alliance before the Provider's request for payment and expenditure reports can be approved by the Alliance.
3.6 CIRTS Data Entries
The Provider must enter all required data for clients and services in the CIRTS database per the DOEA Programs and
Services Handbook and the CIRTS User Manual- Aging Provider Network users(located in Documents on the CIRTS
Enterprise Application Services). Providers must Cutff this data into the CIRTS prior to Submitting their requests for
payment and expenditure reports to the Alliance, The Provider shall establish deadlines for completing CIRTS data entry to
assure compliance with due dates for the requests fir payment and expenditure reports that must be submitted to the Alliance,
SEC'l'ION IV. SPECIAL PROVISIONS
4.1 Provider's Financial Obligations
4.1.1 Matching, Level of Effort, and Earmarking Requirements
The Provider shall match at least ten percent(10%)of the cost for services funded through this contract, except for
services provided pursuant to American Rescue Plan for Preventive Services under"hide 111-1)of the Older Arnericans
Act, The match will be made in the form of cash and/or in-kind resources.The Provider shall report jr-ratch funds by
title each month.At the end of the contract period,the Contractor must properly match, American ReSCLW Plan funds
that require a match.
4.1.2 C011SUnIff Contributions
C011SUIller contributions are to be used under the following,terms:
I),The Provider asSitres compliance with Section 3 15 of the OAA, as amended in 2020, regarding C011SUIrler
contributions;
2). Voluntary contributions are not to be Used for cost sharing or matching;
3). Voluntary contributions are to be used only to expand services; and
4) ACCUITILIlated voluntary contributions are to be used prior to requesting federal reirribUrsenlent.
(September 2021 —September 2024)KRP2 1
4.1.3. Use of Service Dollars and Management of the Assessed Priority Consumer List
The Provider is expected to spend all federal,state,and other funds provided by the Department for the purpose
specified in this,contract. For each program managed by the Provider,the Provider must manage the set-vice dollars in
Such a manner as to avoid having a wait list and a Surplus of funds at the end of the contract period. If the Alliance
determines that the Provider is not spending service funds accordingly,the Alliance may transfer funds to other
Providers during tile contract period and/or adjust subsequent funding allocations as allowable under state and federal
law.
4.1.4 American Rescue Plan Funds
The Provider assures compliance with Section 306 of tile OAA,as amended in 2020,and will not use funds received
under the American Rescue Plan to pay any part of Cost(illClUding all administrative cost)incurred by the Provider to
maintain a contractual or commercial relationship that is not carried out to implement Title 111.
4A.5 Use of Set-vice Dollars and management of Assessed Priority Consumer List:
The Provider is expected to spend all funds provided by the Alliance for the purpose specified in the contract.The
Provider must manage the service dollars in such a nianner,so as to avoid having a wait list and surplus of lulds at the
end of the contract period for each program managed by the Provider.
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4.2 Incident Reporting
T'lie Provider shall notify the Alliance immediately but It()later than forty-eight(48)hours from the Provider's awareness or
discovery of changes,related to a Provider authorized Proviso,that may materially affect the Provider's ability to perform the
set-vices required to be performed under this contract and in authorizing Proviso. Such notice shall be made orally to tile
Alliance Contract Manager(by telephone)with an email to immediately follow,illClUding the Provider's plan for provision of
the services authorized in Proviso.
4.3 Investigation of Criminal Allegations
Any report that implies criminal intent oil the part of the Provider or any Subcontractors and referred to a governmental or
investigatory agency must be sent to the Alliance which will in turn forward the information to the Department. If the
Alliance has reason to believe that the allegations will be referred to the State Attorney,a law enforcement agency, the United
States Attorney's office,or other governmental agency,the Alliance shall notify the Inspector General at the Department
immediately. A cop),of a]I documents, reports, notes or other written material concerning the investigation,whether in the
possession ofthe Provider or Subcontractors,must be sent to the Alliance which will in turn send the material to the
Department's Inspector General with a summary of the investigation and allegations.
4.4 Volunteers
The Provider shall ensure the Use of trained volunteers in providing direct services delivered to older individuals and
individuals with disabilities needing such set-vices. If possible,the Provider-shall work in coordination with organizations that
have experience in providing training, placement, and stipends for volunteers or participants(such as organization-,carrying
out federal service programs administered by the Corporation for National and oniniunity Service), in community service
settings.
The Provider shall submit an annual Unduplicated report of volunteer hours oil the formal provided by the Alliance, The data
collection period is from July I to RHIC 30 for each calendar year. "I'lie data submission date is 5 business days Billowing the
close of the contract period.
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ATTACHMENT It
ATTACIIMENTII
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Alliance to the provider may be subject to audits and/or monitoring by the
All imiceand/or the Depa-tinent as described in this section.
1. MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 20�0 (formerly OMB Circular A-133, as
revised), and s. 215.97, F.S., (see "AUDITS" below), monitoring procedures may include, but not be limited to, oil-site
visits by the Alliance and/or the Department staff, linlited 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 Nvith any monitoring
procedLH-Cs/processes deemed appropriate by the Alliance. In the event the Alliance and/or the Department determines that a
limited scope audit of the Provider is appropriate, the Provider agrees to comply with any additional instructions provided by
the Alliance and/or the Department to the Provider regarding such audit. file Provider further agrees to comply and
cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Alliance and/or the
Department.
A U D rrs
PART I: FEDERALLY FUNDED
This part is applicable if the provider is a State or local government or a non-profit organization as defined ill 0MB Circular A-133,
as revised.
In the event that the Provider expends$750,000.00 or more in federal awards during its fiscal year,the Provider must have a single
or program-specific audit conducted in accordance Nvith the provisions of C'FR Part 200. EXHIB l'i'2 to this agreement indicates
federal resources awNrarded through the Alliance by this agreement. In determining the fiederal akvards expended in its fiscal year, tile
Provider shall consider all sources of Federal awards, including federal resources received from the Alliance. The determination of
amounts of 1:-ederal awards expended should be in accordance with the guidelines established by 2 Cl,R Part 200. Ali audit oftlic
Provider conducted by the Auditor General in accordance with the provisions Of 2 CFR Part 200,wil I meet the requirements of this
part.
In connection with the audit requirements addressed in ['art 1, paragraph 1, the Provider shall fulfill the requirerrients relative to
auditee responsibilities is provided in 2 CFR Part 200.508.
If the Provider expends less than $750,000.00 in federal awards in its fiscal year, ail audit conducted in accordance with the
provisions oft CFR Part 200, is not required. I ii the event that the Provider expends less than$750,000.00 in federal awards in its
fiscal year and elects to have an audit conducted in accordance with the provisions of 2 CFR Part 200,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.)
Ali audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year. Compliance
findings related to agreements with the Alliance shall be based oil the agreement's requirements, including any rules,regulations,
or statutes referenced in the agreement. The financial statements shall disclose whether or not the matching requirement was met
for each applicable agreement. All questioned costs and liabilities due to the Alliance and/or the Department shall be fully
disclosed ill tile audit report with reference to the Alliance agreement involved. If not otherwise disclosed as required by 2 C'FR
Part 200.5 10,the schedule of expenditures of federal awards shall identify expenditures by agreement number for each agreement
with the Alliance in effect during the audit period. Financial reporting packages required under this pail 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.
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PART 11: STATE FUNDS D
This part is applicable ifthe Provider is a non-state entity as defined by s. 215.97(2), F.S.
In the event that tire Provider expends a total aniount of state financial assistance equal to or in excess of$750,000.00 in any fiscal
year of such Provider(for fiscal years ending September 30, 2004 or thereafter), the Provider must have a State single or project-
specific audit for such fiscal year in accordance with s, 2 15.97, F.S. applicable rules of the Department of Financial Services; and
Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General.
EXI-IIBfF 2 to this agreement indicates state financial assistance awarded through the Alliance by this agreement. In determining
the state financial assistance expended in its fiscal year,the Provider shaH consider all sources of state financial assistance,including,
state financial assistance received from the Alliance, other state agencies, and other non-state entities. State financial assistance
does not include FedcraI direct or pass-through awards and resources received by a non-state entity for Federal program matching
requirements,
In CollnUti011 With the audit rCCILdrements addressed in Part 11, paragraph 1, the Provider shall ensure that the audit complies with
the requirements of s. 215.97(8), F.S. This includes submission of a financial reporting package as defined by s. 215.97(2), F&,
and Chapter 10,550(local governmental entities,)or 10,650(rionprofit and for-profit organizations),Rules of the Auditor General.
If the Provider expends less than $750,000.00 in state financial assistance in its fiscal year(For fiscal years ending September 30,
20004 or thereafter), air audit conducted in accordance with the provisions of s, 215.97, F.S., is not required. Ill the event that the
Provider expends less than $750,000.00 in state financial assistance in its fiscal year and elects to have all audit conducted in
accordance with the provisions of s. 2 15.97, F.S,, the cost of the audit must be paid fironi the non-state entity's resources (i.e., the
cost of such air audit 11111st be paid from the Provider resources obtained from other than State entities),
Ali audit conducted in accordance with this part shall cover the entire orga
nization for the organization's fiscal year. Compliance
findings related to agreenictits with the Alliance shall be based oil the agreement's reqUirernents, including any applicable rules,
regulations,or statutes.'fhe financial statements shali disclose whether or not the matching requirement'was met for each applicable
agreement. All questioned costs and liabilities due to the Alliance shall be frilly disclosed in the audit report with reference to the
Alliance agreement involved. If riot otherwise disclosed as required by Rule 691-5.003,F.A.C.,the schedule of expenditures,ofstate
financial assistance shall identify CXpCllditUrcs by agi-cernent 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 rel)ort,
but-no later than 12 niontlis after the Provider's fiscal year end for local governmental entities.Non-profit or for-profit organizations
are required to be submitted within 45 days after delivery of the audit report,, but no later than 9 months after the Provider's fiscal
year end.Notwithstanding the applicability of this portion, the Alliance retains all right and obligation to monitor and oversee the
performance of this agreement as Outlined throughout this document and pursuant to law,
H. PART Ill: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with 2 CFR Part 200, and required by PART I of this agreement
sliaH be submitted, when required by 2 CFR Part 200.5 12, by or oil behalf of tile Provider directly to each of the following:
The Alliance at each of tile following addresses:
Alliance for Aging, Nc.
Attn- Fiscal Department
760 NW 107" Avenue
Suite 214
Miami, FL 33172
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For fiscal year 2014 arid later, Pursuant to 2 CFR §200.5 12, the reporting package and the data collection f6ril7 must be submitted
electronically to the Federal Audit Clearinghouse.
Pursuant to 2 CFR §200,5 12,all other Federal agencies,pass-through entities and others interested in a reporting package and data
collection forin must obtain it by,accessing the Federal Audit Clearinghouse.
The Provider shall submit a copy of any ilianagernent letter issued by the auditor, to the Florida Department of Elder Affairs at the
following address:
Alliance for Aging, Inc.
Attn: Fiscal Department
760 NW 107" Avenue
Suite 214
Miami, FI, 33172,
Additionally, copies of financial reporting packages required by this contract's Financial Compliance Audit Attachment, Part 11
shall be submitted by or on behalf of the Provider directly to each of the following:
The Florida Department of Elder Affairs at the following address:
Alliance for Aging,Inc.
Attn: Fiscal Department
760 NW 1071" Avenue
Sui,te 214
Miami, FI, 33172
The Audkor 60-101-al's 011-1ce at the foHm6nO address:
�7
State off,1orida Auditor General
Claude Pepper Buflding, Room
574 111 West Madison Strect
Tallahassee, Florida 32399-1,451)
Any reports, management letter,or other inforniation required to be submitted to the Department pursuant to this contract shall be
submitted timely in accordance with 2 CFR Part 200,Florida Statutes,and Chapters 10.550(local governmental entities)or 10.650
(nonprofit and for-profit organizations),Rules of the Auditor General, as applicable.
Providers, when submitting financial reporting packages to the Department for audits done in accordance with 2 CFR Part 200 or
Chapters 10.550 (local governmental entities) or 10.6�50 (nonprofit and for-profit organizations), Rules of the Auditor General,
should indicate the date that the repotting package was delivered to the Provider in correspondence accompanying the reporting
package.
PAWI IV RFUOIZD RETEWHON
The Provider shall retain sufficient records demonstrating its compliance with the terms,of this contract for a period ofsix(6)years
from the date the audit report is issued, and shall allow the Department or its designee,the CFO or Auditor General access to such
records upon request,The Provider shall ensure that audit working papers are made available to the Alliance and/or the Department
or its designee, CFO, or Auditor General upon request for a period of six (6) years from the date the audit report is issued, unless
extended in writing by the Depar-tinent.
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ATTACUIMENT11
FINANCIAL, AND COMPLIANCE AUDIT ATTACUIMENT
EXHIBIT I
PART I: AUDIT`RELATIONSHIP DETERMINATION
Providers who receive state or federal rCS0UJ-CeS may or may not be subject to the audit requirements of 2 CFR Part §200.500,and/or s,
215.97, F.S. Providers %vho are determined to be recipients OrSl.ibrecipients of federal awards and/or state financial assistance may be
SLJbject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part 11 of Exhibit I is met. Providers who
have been determined to be, vendors are not subject to the requirements of 2 CFR Part §200.38, and/or s. 215,97, F.S. Regardless of
whether the audit requirements are met, Providers who have been determined to be recipients or subrecipients of Federal awards and/or
state Financial assistance ITIUSt C0111ply with applicable programmatic and fiscal compliance requirements.
In accordance with 2 CFR Part §200 and/or Rule 691-5,006, FAC, Provider has been determined to be:
--- Vcridornot St.ibjectto2 CFR Part§200.38and/ors.215.97,F.S.
Recipient/subrecipient subject to 2 CTR Part §200.86 and §200.93 and/or s. 215.97, I-.S.
Exempt organization not subject to 2 CFR Part §200 and/or s. 215.97, F.S. For Federal awards, for-profit
organizations are exempt; for state financial assistance projects, public Lilliversities, community colleges, district school
boards, branches of state (Florida) government, and charter schools are exempt. Exempt organizations must comply
with all compliance requirements set forth within the contract or award document.
NOTE: If Provider is determined to be a recipiem/Ribrecipient of federal and or state financial assistance and has been approved
by the Alliance to SUI)COrrtract, they must comply with s, 215,97(7). F.S., and RLdc 691-.5006, FA("., [state financial assistance]
and 2 CFR Part §200.330 [federal awards],
PAR"I' ll: FISCAL COMPLIAN(.I I E REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal
awards, state maintenance of effort funds, or state matching funds; on 1ederal awards and who are determined to be a SUbrecipient
must comply with the tollowing fiscal laws, rules and regulations;
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW.
2 CFR Part §200.416- Cost Principles*
2 CFR Part §200,20 1- Administrative Requirernents",
2 CFR Part§200�,500- audit Requirements
Reference Guide for State ExpenditUITS
Other fiscal requirements set forth in program laws, rules and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part§200.400-.41 1-Cost Principles*
2 CFR Part §200.100-Administrative Requirements
2 CFR Part §200.500-Audit Requirements Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regUlations,
EDLJC,ATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT)MUST
FOLLOW:
2 CFR Part §200.418- Cost Principles*
2 CFR Part §200.100�-Administrative Requirements
2 CFR Part §200,500-Audit Requirements Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,i1fles and regulations
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*Some Federal programs may be exempted from cornpliance with the Cost Principles Circulars as noted inthe 2 CFR Part
§200A00(5)(c),
"For funding passed through U.S. Health and Human Services, 45 CFR 92; for funding passed through U.S. Department
of Education, 34 CFR 80.
STATE FINANCIAL ASSIS'FANCE. Providers who receive state financW assistance and who are determined to be a
recipient/subrecipient Must COMply with the following fiscal laws,rules and regulations:
Section 215.9�7, 1:,.S.
Chapter 691-5, Fla. Admin. Code
State Projects Compliance Supplement Reference (Alide
for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
The Remainder ofThis Page Left Intentionally Blank
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RP-2129.3
ATTAC"MENT II
FINANCIA1, AND COMPLIANCE AUDIT ATTACI-IMENT
EXHIBIT 2-FUNDING SUMMARY
Note: Title 2 CF'R §2003 3 1, as revised, and s. 215.97, F.S., require that information about Federal Programs and State Pro.jects
included in ATTACHMENT 11, Exhibit I be provided to the recipient. Information contained is a prediction of funding SOW-CeS
and related amounts based on the contract budget.
I!. FEDERAL RESOURCES AWARDED To THE SUTIRECIPIENTPURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
American Rescue Plan Administration U.S. Health and Human Services 91.043-044
American Rescue Plan for Supportive Services U.S. Health and Human Services 93.044 $9,704.30
Lincler'I"itle Ill-B of the Older Americans Act
American Rescue Plan for Congregate Meals U.S. Health and Human Services 93.045
under Title 111-C I of the Older Arnericans, Act
American Rescue Plan fbr Home Delivered Meals U.S. Health and Human Services 93,045
under Title III-C2 of the Older Americans Act
American Rescue Plan for Preventive Health under U.S. Health and Human Services 93,043
Title 111-1)of the Older Americans Act
American Rescue,Plan for Family Caregivers U.S. Health and Human Services 93,052 $7,000.00
under"I'itle 11 I-E of the Older Americans Act
TOTAL FEDERAL AWARD S 16,704.30
COMPLIANCE REQUIREMENTS APPLICABLE 'ro 'n ir," FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS.-
2 CTR Part 200-Uniform Administrative ReqL1irC111CutS, Cost Principles,and Audit Requirements for Federal Awards.OMB
Circular A-]33 -Audits of States, Local Governments, and Non-Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CON FRACTCONSISTOF
THE FOLLOWING:
MATCHING RESOUCES FOR FEDERAL., PROGRAMS
_PROGRAM TITLE FUNDING SOIJRC"E CFDA AMOUNT
-TOTAL STATE AWARD
STATE FINANCIAL ASSITANCE SUBJE"CT'll"O sec. 215.97, F.S.
-PROGRAM'TITLE FUNDING SOURCE CFDA AMOUNT
-TOTAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE, TO STATE RESOURCES AWARDED PURSUANT TO -I-HIS
CONTRACT ARE AS FOLLOWS:
STATEFINANL.IAL ASSISTANCE:
Section 215.97, F.S., Chapter 691-5, F.A.C., Reference Guide for State Expenditures, Other fiscal requirements set forth in
program laws, rules and regulations.
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RPQ129.3
ATTACHMENT III
CEWFIFICATIONS AND ASSURANCES
Ile Alliance %vHl neat award this COMISCI LIFIRSS the NOVideF c0l"Ifle1cs these 1"IFICAJIONS AND
ASSURANCES ni perforrnancQ ofthi4s Contract. I-i-le lll'()V ider provides flic 1`611orviwi certifications and USSUNIlICCS:
A. IDt 111tffljd Sus )mws
It UrifiWadon R"�W LO
urt 93
C, and 45 CFR Part mn
1).
F. Appyji kyof(Vn"n"nhvO "fjujizj
"lliolu LOL—Reform N—omUAKI)II X _N)_±u n(Lj!jjLRest!,L(Lt i()Il s sslar.af I L,v
G (VNWW"Kn ReZ_ D a taLj=KqL
_ jjjj! LO la t�j Ct hairLeLpenot G aints, oall 11 (
�LeLlricatiiorl or t-n!J_j
Rec""(1-S and—Doct,III ent ation
A. (AIRTIFICA VION REGARIMNG DEBARNIF�N-F, SUSPENSION, AND 0111ER
R L S PO N S I I i 11,FIN M A'J"FF:11 S - 11111 M A RY CO V E It F',1) 'I'R A N SA("i'll()N,
'Me umeNg"d Provid.cadfies to Ow hem Ws knm0mye mW UAL tot H nasal its Irvine tak:
I. Are not presently dOmm"L suspended, proposed aw debamwa decIawd Qli�_,ible,or volkufl�irfly excluded Wn
covered transactions by a fedc,ral departmQrn or agcncv:
I We not whihin at Knelov pehod precedIng this. Contact been awtvicted or Ud an civil jklgmml rodwed
rtu'aiust then) forconunission of fraud ora crimilill offense ill Connection with oblaining" "itwillpting to obtain,or
pupwinkig a public (Federal, State. or kwal) transaction or corlhwo under a public transactjon: violatic"I of
F"Oral or Sac amKvm statutes or cotrunimbun of thelft, foq!er . lrribcry. t"t1sific"Ition or
destructhn of records, nmkirtgo raise statements, or recck ing, stolcll propcfly�
I /Ve me presently kW&Wd or otlomise cQnWA1ynw civilly charged by a 9mvmment cWhy (Ademl. Maw of-
local) with Commission ofany ofthe offenses enumerated in pamgraph /Y! ofthk coWfictakm: andOr
4. Ilave not within an &Ncqww period preceding� this aalalalieantiaain lnrcapwnsnl had one or 1110re public transactions
OldefaL Stance, of- local) wralif-lated fear CaLlSe OfdWlUlt.
The undersigned shall require thsa Janguage ofthis cenilkadon he included ill the (JOCUrn(nuS fOr all SLI)COnlra(us at
alk 60, Owfuding subcofultmos, vendors, sub-grants and connacB under graniv Imns and mywmlive agwernents)
MId OW1 aU Sub rCCif)iCruSfll1d Contractors shall pro%ide this certification accordin(7'ly.
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B. CERTIFICATU)N REGYURDING [A)BBYING 44:111TIFICA'VION FOR CON'FRAC."I'S,(aRANJ'S,
WANS, A001) (00PERATIVE AGREENIENTS.
Ile undersigned Pmvklr certirics, to to hem or its knom ledge and hAW Tra:
No Federal appropriated funds have been paid or "IN be paW, by or on boialror we undersigned. to any poirsork for
Whoichig or mumMirig to influence an officer or wnpkqVc of(Wrigres" (W an employee of Member of Conz,:tres",
in connection %vuh [lie a%%arding ofany Federal conlract, [Ile making, ofany Federal ,,,rant, dic inalillu ofany ficdcr•al
loan, the cnwrhg into or my empuative agivommit and the extension. continnation, rcjjc% ,,d, alnendulcill or
modification of any Federal corilraci, grant, loall or coopQralive agreQ11lern,
If any kinds wher tan Faleml "propriated hands have been Paid or k011 he paid to an, person Rn influencing or
10 iarIUCHC,C all Officer or employee or any agency. a Member or Congress, an officer or cljjployec, of
0mgmsv or employee of as VvIernher of Cbriginess in colmockm with a lideml contract, grant. hran. or cok)peraNve
agreement. the undersyned shAl also corklllk:k: and SUlanit StaildM%J F011111 LLL, "Dr'SCIOSLHT 1:01131 to Report
Lobbying." in accordance whfi its instructions .
I he undersigned sUH rcQw that language orris cent ficatfork he hwlmkd in the docunwins lor call subcontracts at
all I iers(inc I lid i I sl lhcontraCtS,SUb-,Lu1n1S and sm"mos nn&rgmnIs. loarksand cm)permivc agreements)and that all
sub- recipients and conlroctors shall certify) arid disclose rrccordinu!Iy.
Ilk caWkWinn W a maw&! mmesenWhir orho upon which reliance vVas placed w0wri this Contract wN,as made
or entered huo. Suhnii!'Sion of this certificalion is a Prerequisite, for lnalchlg or 011(ering into this Contract imposed
by 31 US& 1352, An, pcBmi who faik to Me the rk:quircd certilkwhn Amil be subject to a cjv,jt penally orklo)t
kss tan S I OMOO and nor mow Own S I 00A)M) for each such Ware,
C. NON-DISCRIMIQUION & EQUAL OPPORTUNI'll Y ASStAMN(T (29 CFR PART 37 AND 45 CFR
PART 8W. As as corW him"WMe (�oniknk_ PRm Wa anums NMI N will compW Rilly %Oh Me norWisuKhation
and cqual opportunity proN isions ofthe follo%%ing la\vs:
I. Section 188 ofthe Worllorce Investment Ad (01998 (WIAA (Pula. L, 105-220h "Sch IWOks discrimhunion
a,gaillst all individuals in the UnNed Staws on the basis ofrace,color, wH,,,,ion, sex nafiowO origin. age, disability.
Ilohtical affiliation. or belief; and agaiina heriefichirks, on the basis of either dKeWilisnaus, as a la"Ally
adHlutCd orrarnisarnfl dUthori/ed to%%ork irk Me UnAd Ones or participation in any WIA I lk� W'inanciall s ki d
program or activity., y
2, l'itle VI ofthc(Avil Rights Act of 1954 Mull 1,880521 as amentled.wd all requircincrits unposed by or Pursuant,
10 the RCI-ILIlation ofthe DcImmmon oH RaM and I lumvin Services(45 UFR Part 80),to tire end that, in accordance
%vNh Title \1 orthat Act and the Regulation, no person in the United Fiats shall, on the ground ofmco color, or
national origin. be excluded froin Participation in, Ile don4d the helefits or, or he odler\kise skjbjccjed to
dNcdmhmtkn under any progran, or activity fear which the. Apykarn wc6ves 1Wral HunciM amWmwe Win
the Depariniclit.
3. S"Ark 504 ofthe Rchabiluation Ad or 1 W3 (1%h K, 93-1 12) as aniQ11LICCL and all reLlUireHICHtS hnpoSed [y 01-
piwsuant to the Regulation orthe Dermi-nnent orfKalth and IWIlmn Services(-15 CFR Park 84), to the end that, in
accordance ovith Secdon 504 orMat Act, and the Regulatikon, no other"nise qualified handicapped indkidual in the
Whed SWWs shall, soRV by reason of his handkq% he excluded Wi parHcosk6or; in he Wined to benefits or,
or be subjected to discrimination Under any PRTmm or ketivity for"Tich he Applicant receives liederal rhiancizil
assistance from the DcpaNmQrn,
4, Fhe Age 11scrimination Ad of M75 (Nb, R. 94135), as arnorded. and all requirements imposed by or PUNUMI
to the Regulation attic Dolmomon offleallhand I Imman Servims(45 CT R Part 91),to the end that, in accordance
Wh the A0 and the Regulation. no person in die Untied Mattes AW on Me hmk ory, be Wiled the be-nefits
of. be excluded hvni parlictmion in or he subjected to dkoln-Alation under any proprani or activity for 'which
the Applicats receives Federal financial assistance from (lie Department,
1 Ilk I X of Ow 14hicalkii Amolciments or 1972 (Pub. 1. 92-318, as amended. and A reclukemon impowd by
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RP-2129.3
or Imursuarit to the It ep I min n ol'the Depanincrit of I I eakh and I Oman Services ( 15 (: FR Part 86), to I he end that,
in accordance with FWc IX and the Regulation. no perwn in We Iftrited `Mattes shall, on the basis ()I' sex. be
CXCILided frorn parkyation in, he WId Me bmerhs of, or be odwrwke subjected to discrimination under an
c&wmkn p"Imin or acthity Jim"Tich We ApIflicam receives FQ�dcral financial assiaance-a 1'rom the Dcpanrncnt,
IT Ile Arnahan with Disabilities Act or la) o (Pula, I. 101036Y %0[ch prohibits discrimirmtkm in all empkli-Boni
prackes. inChKAng Q apoicathm riRwedurv, h4ing. lhing, advanconcrit, compensation. trainhig and odier,
tunns, conditions, and rwrivileps ofeniplcginent. Itapplics to recruitment.advcrtish)L,,, ICHLII-C. IIavc, fringe
benefits, and all rather cmpknmtcnVTAaWd activities.
Providers also '6sWVS too it Will colript %%kh 29 (TR Pan 37 aml Al other ryulwkwis hIplenwMing dw laws
listed above, This assurance apoks to Provid&s operation of the VVIA row I - firrancidly assisted propurn or
and to all contracts. Provider rmales tocarry out the WIA I ble I - 1"imneirdly ankwd proWam o"wiiwity.
Provider understands that the Dopartinent alrd die Wked Sham have die right to SCO'<J'AdiCidl
ammWICC.
MQ uWasyred MmH require that language of dOs asmin"we be inducled in the documents I'or all subcontracts wo
all das(includog subconmica"verwors. snygmnis MCI Ck)utN',ICtS Imuis and cojimative agwernents)
and Wt all sub wtOms and cmitracw shall Imovide this nymwwe a"oMkgly,
IX CERTWKWUMN 1HA; %HDING 1101011C ENTH) CRIMES,SECHON 287a133' FX
PinwWr hereby certifies that neither it, iuw ap person or anime ormm has ken convined of a 110lic I AQ
Crhuc ,is dclined in s, 287.133. U.S. mm ph"d on the.corIvIted vendor list.
Ff'ON ider understands and agmes OrM it is required in WrIn the Deriartinew iminedkocl; uqum any change of
circulastanca2s rQLIardinu this, status.
E, ASSO(IATU)N OF CWNUAIVNITY OR(�ANIIZATIONS FX)R REH)RM NOW I %( OWNJ� FVNIXIINC.'
REST18K71IONS, kSSIVANCI: (PI It. 1.. 1141 17).
As a condition of We (ontniot, Pnm WT ammuTs that it wHI comp —nllly' With the t'Cdo_dI fl.Ifldol4, rCStt•icti,011S
pertakiL ).p ki WMIN and Ns subsidiaries per the ConsMichated ApproKkhms Act. 30 10, Ili ish-ni Uh YkaW 51 l
(Pub, 1. 11 1-1 17A Ile ("oWhubg ApRoKhadons Act, 2011. SwAvIs 101 and 103) (Pub l'. 11 1-21 2). provides
that appropriations riladc under Poh, 1. 1 H 0 17 are availahk undo- Me Conditions rir0v'idQd by Pull. I_ J I I.-1 17.
The urdnoigud AW wqWw that language ollhis asstirmice be WOW in dw ciocurricras for aH suhowitraos at Mi
tic^rs(including subcontracts, %ardors. sukgranB and connects un,dcr grains fauns and cooperalive and
that all sub recipients slid conn-aciam shall provicle ON assurance amoon-ign,
1% CER'11FICkTION REGARDE'";SURIAINIZED(XM1PAN1ES IIASTS,SEXTION 28113X I� S.
If this ('oluracl is in the amount Of Sf Million Or 11101-C. in accOrCIMIce %%ith the requirenienis of s. 287.135, F.S..
Provider herd)) co-tifics ilia[ it is nor par-ticiputing N; at Njcotl of load. is not listed on either the SaWirdeed
(Iornpanies "Nh Activities K Sudan Lism dw Suiakked (Virriparies xvith ActivAies hi the Iran Petndeurri Wiergy
SCCUW ILL and that it does not have husless operations ill Cuba or Syna. Both list,, are Cl-ealed Pursuant to s,
215.473. V&
Pr0%ldCr UnderslancIN that pursuant to s. 28031 VS. the suhruission ofa Ike cWHIMW many m1ps PlawKerto
civil pelialtlQs' tuiorncy's fees, and"or costs.
Iff'rovido- is unable to ccitd ( any ofthe stawnlentw in 1114 cenHWK. PumW shall mmch an explanmion to this
CororacE
Q (TRAFICATION REGARDING DATA IN FEGRITY COMPLIAN(li FICM WNTWV113, AGREEMENTS,
GRANT%LMANS AND(DOPERNHIT AGREEMENTS
1. I'lle Provider "Ind any S(J)C0ua'dCtorS of SCJ'ViCCS Linda Ihis CMLmo have rinanchd managerricro s)strerms,
cNmbw or PMVWog co-Will inforrilaii0l), J d) accurate, Ctli'l'erit, and complete disclosure of the
Page 40 of 72
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rinanckd rowilts of each grack-funded project or program in accordance "Nh W ynctrilned rqvorting,
wWtimmems: (2) Mc sotwce and application of funds for all contract SUPIlOrtCLI and (3) HIQ
comparison of outlays "Oh bar Yetud atnmmas R)r each a"qvd.rhe in,,H),iiity to proees iniorn,ition it,
acCllrdaHCe NN nit these requircnrcrots coW result in a room of qnmt Funds that have not been accounted Wr
PnTedy.
2. Management InFormadon S)Merns used by the lowiden stAcor ow:tors. wcndms,, or any outside entity on
which the Provider is dependent for data that is to, he reported. transmined, or cdculmed. Tave been a"essed
and vailRd W be cap alite orprocessing dMa accwawb% hwWding yoar-daw dependent data. For those Systems
ideluilied (obc llon-cornpliant, Provider will take immediate action W usurc data integrity.
I IT INS contract includes the provision of hardware, "'okwarc" lil-riv'Nare, microcode or irnbcd(led chip
technology be undemOrred wrummIs Mat these products mv capable of'processing vear-dare deporldvilt data.
aaccuratCly. All versions of these products ol'fcred b% the Provicka. (rCl)rQse11flc(:I f))� the LHILICI'Si,�,IlCd) and
ptrchawb by to state "M In vxH%d Ar aTtumcy and integrity ofda[a Prior to transfer,
4. In the event orany decrease in finicaicqialiIy related to 6111C and date NkAted Code, and internal SU01-01-HineS
that inipede Me hardware or soh%yare, I)rO."ranis from Operating, properly, the Provider aurce." to initnediau"K,
nuke required corrections to rci4we hard"arc atul solh%ure programs U) the same level or runcOmadij as
"ananwd herch, at no charge to We sum, and "khow inwrmption to d1c,onuoinu business orthe State. tirlic
beim., of the essence.
5 1 he Provider arld any subconlraclors and or -vendors ofse"Wes under His cownw; "ansm MW policks and
procedures include a disaster plan to provide;For service delivery to conthute in cue ornn emoTeml—includkg,
ot-mergcncios arising flurn data Wwrit emnpliance issue's,
IL VER"ACATH)Pi OF ENIPIAWMENT STATUS (AR DIA(AITON
As a condWort oFamumcdng "Ah the l)epadment. PRniducenifius the INV OfIlle 11. ), I)eI),1VHnQH1 Offlonicland
Smud"I FoCK14 Sy stem Wvri(y Me emplopnow eliaihRy of all new C1nIpl0,\CcS hired by tile Pr0N,`idC1-
the comnact Wnrl to perlorin crnploymou duties pursuant 4) ON cuUmet and Hmi any suhartamos include an
express requirement that subcontractors and-or venAws pwRmnKg worp or pw0dWg savices purmtarm to Wis
Contract 111ili/c the [:-verity SyMC111 tO VCrify' tile CMIfloyincin cligjhihty of calf neck hired b, tile
subcontractor and'or vendor during the entire contract Icrin,
'I he llrow idershaH rupike that the langupe or His cenificarkm he hwhKkd in all sukpams and
other aercen-rcmKontracts and dNa all subamnactots andir vendows slull catify cotupliance w"ordirIgly.
Ilk certHkatOn is a trnatcAd represenialical of fact upon which rehance ,was Placed when this transaction was
made or entered into. submissW of this ccrtificssion is to prerequisite for making or emcHng imlo flans Wns;wdon
itnpowd by Ciradars Ad 02 and 2 (TR Part AM. and 2 15 (Rmnerl) ONIB (Kuhr /Y 110).
L R E CO 111)S A N D 1)0 Ct�[NI F,N FATII 0 N
The Provider agrees to nmke avAbble to We Alliance and Departinem MWT and eon any party designawd by the
AHAnce and Ikpartmet" any and MI coraract related inecotAs and docurnemunion 1% lhovider shall ensure the
wilection am! nmhAenMLC Of FM proprimn-rebted information and documentmOn on any such sIm"i designated
b; that Dqm0mers WhIC110111CC ilICILILIeS %dfid exports and backqrs ol',,,tll data and systems according) I Department
standards.
J. CTIRTIFTCATION REGARDING INSIPIEVTJ(: N OF PUBLIC RLCX)RDS
I. In addition to the requirements ot'seciAnz 11 K 102 of We SWurd ('ontract, and 1 1107(' "3) and (4) IRS, and
any other applicable law. ifa WvW action k commenced as contemplated by s, 1 19.00)1(4h KS.. and the Alliance or
the Dersartmmi is named in the civil action. Provider agrees to indemnHI and hoki harmless the Alliance atui the
Departmen I for any UNS hwwwd by the Alliance or the DqmnmmL and wV anways' fees assessed or mun-ded
a,--ainst the from a Public Records Bequest made pursuant to Chapter 119, [.S. conmrnh,.!
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this coluroct or ser0cQS perfornwd thcretaldcl%
2. Smion I 19.01(3L FS, mates W puldic Rmds we eywn&d by an agmey in payment of dues or mernhership
moibubms 6w any person. corpormAm. TumhOwn, nam, a"odation, group, or odier organization, all the
lhmckh buMness. and moribership records of mwh an emit; whkh pe"Mn to the POW agemy (Floddal
Depar-tawnt of Elder Arfairs) are pubW records. Section 119.07,1,,S� staves that VVery 1101-Sr;n WhO hens CLISIOd 01'
mwh a pWAW rccmd MH purnk the re"wd to he irvspewd and copied by any IM-SOu de il-ulcq, to do SO, Llader
N,aSOIMMe CirCUHlStanCCS.
Additiom0k. I cerflk this oi-L=anizaflon does chws nwill
pnwide Rw hmitmional rnwnlxNhlps.
lwovideWs silunatime beh" Wwms that records perlAning to dw dues or mernhersht appHnOW by the AHhmcc and
to mpaommi we avashic rcw wpmd I on as matal abnm
My execution uF this cmmmt Ito AN runt include kvw provisions it) M! related whommm aowmerms (H'
applicablc).
P;N, ewcution of, this colm"'Ict. Providei must niclude these pro%khms (Ad) in all rchwd subtonkm agreememls (it'
applic,able)
IN siunhw WON% Provider certilli2s the mpresenuaions outhned in Parts 'A tln'kaOVll pWe trUQ adakl correct.
1100 Simonton Street, 2`1 Flom
Signature and Title of autliorized Representative Street Address
[Monroe County Board of County Commissioners,
Social Services/In-Monte Services Key West, Fl, 33O�40
Provider Name Date City, State,Zip code
Page 42 of 72
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RP-2129.3
ATTACHMENT V1
ASSLJRANCES—NON-CONS'I'R(JC'FION 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), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED I:`ORMTO THE OFFICE Of"MANAGEMENTAND BUDGET,
SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program. If YOU have questions, please contact the
awarding agency. Further, certain Federal awarding agencies rnay require applicants to certify to additional assurances. [fsucli is
the case,you Nvill be notified.
1. Has the legal authority to apply for federal assistance, and the institutional, managerial and financial capability (including
funds sufficient to pay the non-Federal share of project cost)to ensure proper planning, rnanagenicnt,and completion of the
project described in this application.
2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the award;
and will establish a proper accounting system in accordance with generally accepted accounting standards or agency,
directives.
Will establish safeguar-ds 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 ofapproval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4729-4763) relating to prescribed standards for
merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of 01INTs Standards
for a Merit System of Personnel Administration(5 (l F.R. 900, Subpart F),
6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a)Title V1 ofthe
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 prohibits discrimination
on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C::`. 794), which prohibits
discrimination on the basis of handicaps;(d)the Age Discrimination Act of 1975„as amended(42 LJ.S.C.61.01-6 107),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; (ot the Comprehensive Alcohol Abuse and Alcoholism prevention,
Treatment and Rehabilitation Act of 1970 (P.L_ 91-6 16), as amended, relating to nondiscrimination on the basis of alcohol
abuse or alcoholism;(g)523 and 527 ofthe Public Health Service Act of 1912(42 U.S.C.290 dd-3and 290 ee 3),as amended,
relating to confidentiality of alcohol and drug abuse patient records-,(It)Title Vill of the Civil Rights Act of 1968 (42 U. S.C.
3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other
nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and (j)
the requirements of any other nondiscrimination statutes)which may apply to the application.
T Will comply, or has, already complied, with tile requirements of Titles 11 and III of the uniform Relocation Assistance and
Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons
displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all
interests in real property acquired for project purposes regardless of Federal participation in purchases.
8. Will comply,as applicable,with the provisions of the I latch Act(5 U.S,("11 50 1-1508 and 7324-7328),which limit the political
activities of employees whose principal employment activities are funded in whole or in part with Federal funds,
9. \Vill comply, as, applicable, with the provisions of the Davis-Bacon Act (40 U.S.C. 276a to 276a-7), the Copeland Act (40
U.S.C. 276c and 18 U.S.C, ''a874)and the Contract Work I lours and Safety Standards Act(40 U,S.C. 327-333), regarding
labor standards for federally assisted construction sub agreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection
Act of 1973(P.L 93-234)which requires recipients in a special flood hazard area to participate in the program and to,purchase
flood insurance if the total cost of insurable construction and acquisition is$10,000.00 or more,
11. Will comply with environmental standards which may be prescribed pursuant to the following:(a)institution ofenvironmental
quality control measures under the National Environmental Policy Act of 1969 (PA_ 91-190) and Executive Order (EO)
115 14; (b) notification of violating facilities pursuant to EO 11718,; (c) protection of wetlands pursuant to EO 11990; (d)
Page 43 of 72
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RP-21293
evaluation of flood hazards in floodplains in accordance with FO 11988, (e) assurance of project consistency with the
approved State management program developed Linder the Coastal Zone Management Act of 19,72 (16 U.S.C. 1451 et seq.);
(1) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 1 76(c) of the Clean. Air Act of
1955,as ainerided(42 U,S,C.7401 et seq.);(g)protection Of Underground SOLINCS,of drinking water under the Safe Drinking
Water Act of 1974, as amended,(P.L. 93-523); and (11)protection of endangered species Linder the Endangered Species Act
of 1973„ as amended, (P.L. 93-205).
12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C;. 1721 et seq.) related to protecting components or
potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of tile National Historic Preservation Act of 1966,
as amended (16 U.S,C, 470), ECG 11593 (identification and protection of historic properties), and the Archaeological and
Historic Preservation Act of 1974(16 U.S.C.469a-I et seq.).
14. Will comply with P.L. 93-348 regarding the protection of human subJects involved in research, development, and related
activities supported by this award,of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966(PL. 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 LLSk'. 4801 el seq.), which prohibits the use of lead-
based paint in construction or rehabilitation of residence StrUCtURTS,
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments
of 199�6 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.
SI(JNA"I"tAU OFAUTIIORIZI:l)CERTIFYIN6 OFFICIM, 11,11F.
,�XAIA ZA
AITIACAN] ORGANVATION DATE SUBMITITI)
MONROE COUNTY BOARD OFCOUNTY COMMISSIONERS,S a
SOCIAL, SERVICESIN-110ME SERVIC ES Page 44 of 72
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ATTACHMENTVII
CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE
CHITS SUMMARY FOR THE AGENCY
Service Unit Maximum Units of Maximum
Services to be Provided Rate Service Dollars
Chore 111B $24.00 5 $120.00
Companionship 111B, $11.00 5 $55.010
Escort IIIB $16.67 5 $83.35
Homemaker 111B $33.20 157 $5,20112
Personal Care IN $33.20 123 $4,071.66
Screening &Assess 111B $26,36 5 $131.80
Shopping Assistance 111B $13.00 1 $13,.00
Telephone Reassurance 111B $27.37 1 $27.37
Chore, I1IES $24.00 146 $3,500.00
Specialized Medical Equipment IIIES Cost R jmb $3,500.00
FOTAL $16,704.301
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ATTACHMENT Vill
ARP CONTRACT REPORT CALENDAR
ADVANCE BASIS CONTRACT
Report Number Based O1n Submit to Alliance
()n This Date
I October Advance* October 25
2 November Advance October 25
3 October Expenditure Report November 6
4 November Expenditure Report December 6
5 December Expenditure Report January 6
6 JarlUary Expenditure Report February 6
7 February Expenditure Report March 6
8 March Expenditure Report April 6
9 April Expenditure Report May 6
10, May Expenditure Report June 6
11 June Expenditure Report July 6
12 July Expenditure Report ALIgUst 6
13 August Expenditure Report September 6
14 September Expenditure Report October 6
15 Firia1 Expenditure and Close Out Report October ;1
Legend: Advance based on projected cash need.
Note 4 1: Report 0 1 for Advance Basis Agreements cannot be SUbmitted,to the Department prior to October 22
or until the agreement with the Alliance has been exeCUted.
Note it 2: Report numbers 5 through 14 shall reflect an a(tiLiStinent of one-tenth of the total advance amount, on
each of the reports, repaying advances issued the first month of the agreement.
Note#3 Submission of expenditure reports may or may not generate a payment reqUCSt. If final expenditure
report reflects funds due back to the Alliance,the Provider shall submit payment to accompany the
report.
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ATTACHMENT IX
REQUEST FOR PAYMENT
ARP -FORM106
AMERICAN RESCUE PLAN-CILDER ADULT'ACT FUNDING
TYPE OF REPORT:
PROVIDER NAME,ADDRESS,PHONE&FED ID NUMBER Advance Contract
Presider Name: Contract Penal:
Promder Address:
Reimbursement
Prouder Telephone
REPORT# T
CERT0CATION: I hereby cerbfy to the best of my knowledge that this request conforms with the terms and the purposes set forth in the abom contract.
Prepared By.______ Cabe: Approved Approved By Date:
BUDWTSU'MMARY RP313 RP3Cl RP3C2 RP3D RP3E % TOTAL
Approved Contract Amount 0100 000 0.00 0.00 000 000
Previous Month YTD Wiled 000 000
0.00
Prior Month Endq2 COQtraat Bolan- 0.00 000 0.00[ 0001 0.00 0.00
Current Month Amount Wiled 0.00 0,00 000 0.00 0.00 0.00
Less Current Month Arty Pa ack 0.00 000 000 000 0,00 opggp'
,/gg/
OrOG
Contracted Funds Re nested for this Month 0.0q 0.00 000 OZO 0.00
PSA#11 ARP Forms,Ray sed October 2021
Page 47 of 72
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RP-2129.3
ATTACHNIENTX
EXHIBIT I
RECEIPTS&UNIT COST REPORT
ARP SulsThtle 10B
...................
..........-
FRAV-WIB_NAMEADD „SS_FKQNE#and EUP-1 EUNQWG—SOURCE. RM REPORT PERIOD'
'D ARP 111-B x Report period 0
0
0
Ca 2ct P Hart,0
0 ...............
REPORTL_[0_]
...... --—--------------- ............. SA#11_
QfdLDEjQAUW I certify to the best of my knowledge and belief that this repel is complete and correct and all outlar herein are tar purposes set forth in
"contract.Further,I certify that the attached monW y and YTD service units Ruodupllicated clients'Tepart is correct.
Prepared by--_Dalo:__A_ Approved by' _____Date
INCOMEIRECEIPTS A Approved Budget B. Actual Total Billing C, Total Billing D %Of Approved
for this report Year to Date Budget Prior Mo.Receipts YTD
Federal Funds:r co ........... $ #Dlvioi
Cash Match(IOB,MCI,HIC2,IIIE) $
SUBTOTAL: Cash Recepts $
Lo,cal In-Kind match $0 DO $ - #0vil) [a
P
TOTAL RECEIPTS. 00 —L$ $ #01vt01
Billable Unit Cost Report Unduplicated'Clients Served
(A) (8) (D) (E) (F) A (A) (B)
Ser,aces Contract BdIable, Unit Rate Amount Earned Y-TD Y-T-D Current Month Y-T-D
Amount Units This Penod Billable Billable Undup Clients Jndup Clients
Units Cost 8ared Sanied Prior YM units-Prier YTD fl;
$
............
$........... $ ..........
..........
IERACV
.............
c�—-L-- ..—. L.. I - —_ ........... ....
....
MATE Rsimb $ . - $ -
HOIM Cost Rehab. $
.T.0.I----------------- ..........
FGA 411 ARP 1 US 316'Forms,October 2021
Page 48 of 72
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ATTACHMENT X
EXHIBIT 2
RECEIPTS&UNIT COST REPORT
ARP SublItle 1111011
k§m— )M%pHPNEN ands FEJD# fYNPjN9-5D MRCE THIS REPORT PERIOD:
0 ........ -
0 ..... .
....
Report Pengd
0 &A lIPC1
0Contract Period' 0
0
kEPO:R:T:#
PSA 911
ZERTIFICADgR II certify to the best ofmyknoVedge anTbeliefthat this report is complete and correct and all outlays herein are for purposes set forth in
the contract.Furfiterr I certify that the attached month Y and YTD s oNce unitslunduplicated thents'reporl is correct.
Prepared by: Date:— A Apprcnedby: _Date
INCOMEIRECOPTS A Approved Budget B Actual Total Willing C. Total Wiling D. %ofAjuproNed
Lot this report Year to Date— Budget PriorMo Receipts VTO
Federal Funds $ $ tholv/0!
Program Income $
Cash Match 011B,MCI,liIC2,INE) $
SUBTOTAL Cash Receipts $
Local In-Kind match ..........$(D—00 $ ADIV/01
TOTAL RECEIPTS $0,00
L$-- - r #DIVIDI
Billable UnIt Cost Report Undupileated Clients Served
(A) (8) (C) (D) (E) CO) (A) (9)
SeNces Contract Billable 'Unit Rate Amount Earned Y.T-D Y-T-D Current Month Y-T-D
Amount Units, Thus Period Billable Billable Undup Clients Jndup Clients
Units at Serwd Seated -Prior YMunfts PrivrYM$
$
EE $
$
$ T _
$
HDM $
SACV
Total
..........
PSA#11 ARP 105 X1 For- 0ctkber 2021
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ATTACHMENT X
EXHIBIT
RECEIPTS&UNIT COST REPORT
ARP SubTitle HIC2
..........
RRQYjDER NAMEAPDBEU PHPNUAnjfEID#
-SOURCE jj:[[S_R RIQ M
...........
0 ARP fll-C2 Ix Contract Parod lia
7-
Contract#
:R=EP=CR:T#=:TO
PSA#11
I ce"ify to the best ofnry knowlectge avid heliefthat ibis report is complete and carrecA and all outlays herein are fo�r ptaposas set fi Mn
theuDirilract Furlher,N ceMythaf the AN Oied movillifly amid Y1rL)service unimstundurlicated clerits'repart 115 correct
Prepared by A. toed by, ._rille
INCOMEIRECEIPTS A Alatrvtwfsd Budget Actual Total Stilling C. Tolal Billing D %of Approved!
for this report Year to Data Budget Prior Mo.Recent pts;YTD
Federal FUndS 9D1VJ01
Program Inccrffla
Cash Match lH113 IHCI HIC2 111E)
SUBTOTAL CastiRersi S S
Local it Kindmatch #DIVIO!
09 S
.10TAL RECEFTS SO CIO S S ODIV;01'
Biliable Unit Cost Report Unduplicated Clients' erved
(A) (6) (DD QE) (F) (Gb (A) (6)
SeNces Contract Biillabe Unit Rate Arnouit Earned YJ-D Y-TT) Current Monlin Y T-D
Arnount Units This Penadl Billai Hlilatle UndUip CO tints Jndl Clients
Units Coat Served Sere Priory-rDs
$
..........
$
.......... ..........
Tot al
PSAfll ARP l053C2F.,n. 0,,tobe,20211
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ATTACHMENT X
Exhibit 4
RECEIPTS&UNIT COST REPORT
ARP SubTitle HID
P�V I D M ME—A_DD R 9 EhQN51-and FEjIQV. EUND1N_QAQJJ.RGE RT Pr
0
..........
Co tract Period�10
0 ARP PI-D X
REPOR:T:#: 0=
QERTJELQ,81LQX I cerbly to the best of my knowledge and belief Pat this report is complete and correct and all outlays herein are for purposes set forth In
thecantract. Further,I cavity that the attached monthly and YTD s eNce uninlunduplicated chowls'nopurt is correct.
Preparedby Cats:— A Approved by: —Date
INCOMEIRECE]PTS A. A __pprovad Budget B. Acluai Total ElFifidn_g C. Total_B111lIng _D. %olAppround
or this I-P-It Year 10 Dale
Budget Prior Mo,Rele,lpts YTD
Federal Funds #DIVIOI
Program Income
SUBTOTAL: Cash Receipts $
TOTAL RECEIPTS —————————i_$0 00 $ #CIWOI
Wattle Unit Cost Report Unduplicated Clients Served
(A) (8) A (0) (E) (F) (G) JA) (8)
SeNces Contract Billable Unit Rate Amount Earned Y-T-D Y-T.D Current Month Y-T-D
Amount Units This Period Billable Bliable Undup Clients Jrdup Cients
Untlts Cost Served Served _Fr,_0rYTD.ni% Prior YTDS
$ $
$
$
s
........... ...........
$
TE RAC $ $
SACV $
PSA011ARP10530l'ours Octlher2021
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ATTACHMENT X
Exhibit 5
RECEIPTS&UNiT COST REPORT
ARP Suill IIIE
P-SQViD99 NAME,APPRM,-PHQN9#an FUNDING SOURCE TMIIS REPORT PER1M,
............... 'R—epo—rl Pe.n-a'W"""0 .......................................................................
Contra t Period:10
D
ARP I l-E+X Contract M lo
REPORTM �0
CERTIFICATION I cent lyto the best of my knowledge and belief that this report is complete and correct and all outlays herein are for purposes set forth in
the contract Further,I Curltat the attached monthly and YTD so Nce u l duplicated clionts'repol is correct
Prepared by: Data: A Approved by: _Date
INCOMEJRECEJPTS A. Approwd Budget B Actual Total Billing C. Total Billing D %of Approwd
for this report Year to Date Budget Prior Mo.Receipts YTO
Federal Funds $ $ #DIVID!
Program Income $
Cash Match(116,C1,C2,IIIE) $
SUBTOTAL. Cash Recesp(s 1 7--
Ll IrKind match $000 $
TOTAL RECEIPTS $0. $ [ #DIVIO!
Billable Unit Cost Report Unduplicated Clients Served
(A) (B) (C) (D) (E) (F) (G) (A) A
Seruices Contract Billable Unfit Rate Amount Earned Y-T-D Y-T-D Current Month Y-T-D
Amount Units This Pointed Billable Billable Undup Clients Jndup Clients
Units Cost Sel Served Priwymul Pfl*rYTD$
HDM S $
TERACV $ Is
SACV $ $
MATE Cost Reirre. $ $
HOIM cat Reimb. $
SCSM $ $
............--To[al
PSA#11 ARP 105 3E Forrm,Mtobv 21121
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ATTACHMENT X
Exhibit 6
Alliance for Aging, Inc.
American Resue Plan
Technology Service
Administrative Fee
Provider Name:
Billing Month and I i
Complete this form only during the month(s)that an initial alloted slot is initiailly filled
and submit it with monthly billing reports to be paid.
Tech no,logy Se rvi e,c Billed Amount per
Client Name eC1 RTS I D (Drop own Selection) Product
FALSE
FALSE
FALSE
FALSE
........... FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
FALSE
EOTAL.
The Serviec Adminstrative Flat Fee can be billed only once for each slot offered per Technology.
This Administrative Flat Rate Fee was designed to absorb any necessity to fil I a slot vacated by attrition.
Page 53 of 72
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ATTACHMENT M
American Rescue Plan(ARP)Quar erly Report-Quarter I
How do you plan to
How will these funds keep these activities
enhance or supplement What new services Describe how How will you be sustainable after
current OAA services, do you plan,on technology will be addressing mental Major goals and ARP funding is spent
Title practices? implementing? used, health? objectives through?
RP3B
RP3C1
RP3C2
RP30
RP3E
American Rescue Plan(ARP)Quarterly Report-Quarter
How do you plan to
How will these funds keep these activities
enhance or supplement What new services Describe how How will you be sustainable after
current OAA services, do you plan on technology will be addressing mental M ajorgoals and ARP funding is spent
Title practices? implementin a used, health? objectives through?'
RP38
RP3C1
RP3C2
RP3D
RP3E
American Rescue Plan(ARP)Quarterly Report w Quarter 3
How do you plan to
How will these funds keep these activities
enhance or supplement What new services Describe how How will you be sustainable after
current OAA services, do you pi'an on technology with be addressing mental Major goals and ARP funding is spent
Title practices? fimplernentingUused. health? objectives through?
RP3d
RP3C1
4
RP3C2
RP3D
RP3E
American Rescue Plan(ARP)Quarterly Report,Quarter 4
Flow do you plan to
How will these funds keep these activities
enhance orsupplement What new services Describe how How will you be sustainable after
current OAA services, do you plan on technology will be addressing mental Major goaIs and ARP funding is spent
Titlepractices? implementing? used. health? objectives throw h?
RP3B
RP3C1
RP3C2
RP3D
RP3E
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ATTACHMENT B
STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS
CIVIL RIGHTS
COMPLIANCE
CHECKLIST
Prograni/Facility Name: Monroe County Board of County
Commissioners„ Social Services/In-Home Services. COLUIty: mmonf
Address I,()() S,1(,Yj0n+un a,�. sLL&L 2 -2,�61-7 Completed By de Fra'rta's Lour -S
CitY, State, Zip Code Date 2
Ft, OH 0 ( ZjZ 1'eiephone(3()� .-t 1 j
P,%ICY 1.
READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH
WILL HELP YOU IN THE COMPLETION OF THIS FORM.
1, Briefly describe the geographic area served by the prograrn/facility and the type of set-vice provide,]: M�e-, en�"-1 Ec
E'wkda apt) - ift�k-,t 120 wAeI lorw and are-, cQf���d
17t"aA m -iL , erv�(.',es "-��X' � ii.-'d Air 'ief bd ' S 110vic
2, POPULATION OFARFIA SERVED. SOUNC ofdata: Ce-41 U jkjQQd AND edf,, e Skai ',-PLU
I ,
wIlnza Black �'6 I I'Spa 11 izc Other ,,, 11 1
6 1 '��"' '11c
05 �j " MiAt4
3 I`1'1:Cfi%'edatCJM1-0i3—
Lota 11/0white JC Hispanic Fcnl"de No Disabled
3(.1 LEI
4.
o1al 4 'N'female DisnHed
5) Other 7
.(qq '?
41
S. Af)VIS(:)RYO�R(',OVI?,RNIN(,i ]3(,)r1Rl,), LC"AIIPI.IC'AI31,f>.
FotaI 11 1061,While ph Black N)I lispanic ON Other isabled
PART IL USE SEPARATE,SHEF]TOU'PAPE'it FOR ANY EXPLANATIONS REQUIRINC' MORE SPACE-
Is an Assurance of Compliance on file Nvith the Department?If NA or NO, NA YFS NO
6. explain.
7, Compare the staff composition to the population. Is staff representative of the population? IfNA
or NO,explain.
M\ YFS NO
El YrEJ
8. Are eligibility requirements for services applied to clients and applicants without regard to race, color, NA YFS No
national origin, sex,age,religion or disability? If NA or NO,explain. El El
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9. Are all benefits.services and facilities available to applicants and pam I Cipants in an equalk efl�ctivc manner regardless of race,
sex, color. age,national origin,religion or disability'? NA_YF. 7NO-11 IfNA or NO,CXjIIaiD.
110, For in-patient set-vices,are room assignments made without regard to race,color,national origin or disability? NA/
YES NO If'NA or NO, explain,
y\ie. do nv�- ovoyf0e in DQLLt�j Se,rvC&S
I I. Is the program/facility`accessible to non-English speaking clients? IFNA or NO,explain.
12. Are employees,applicants , I participants .11`01'rned Oftl"10,4-protection against discrimination?
If yes, ho\0 Verb,,applicants
Poster M JfNA or NO, explain,
13. Give the number and Current status of any discrimination complaints regarding services or employment
filed against the program/facility,
14. Is the ograiii/facility physically accessible to mobility, hearing, and sight-impaired individuals'? NA
Y I
NO If NA or NO,explain.
PART III. THE FOLLOWING QUESTIONS APPINTO PROGRAMS AND FACILITIES wrm IS OR MORE EMPLOYEL'S
15. Has a self-evaluation been conducted to identify any barriers to serving disabled individuals,and to make any
necessary modifications? If NO, explain.
16. Is there an estab islaed grievance procedure that incorporates due process in the resolution of
complaints?YI
No_ If NO,explain.
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17. Has a person been designated to coordinate Section 504 compliance activities? YE'S'A0 If NO,explain.
18. Do recruitment and notification materials advise applicants, employees and participants of
nondiscrimination oil the basis of disability'? If NO, explain.
19. Are auxiliary aids available to assure accessibility of' services to hearing and sight impaired
individuals'? Yi,'S"O IfNO,explairl,
PART IV
FOR PROGRAMS Oil FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF
$50,000 OR MORE.
20. Do you have a written affirmative action plan? YES'V/NO,__., If NO,explain.
-----------
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Alliance USE ONLY
Reviewed By In Compliance: Yl:S C3 NO*0
Program Office *Notice o[Torrective Action Sent
Date ==Teleplione Response Dac
Oil-Site 0 Desk Review El Response Received
INSTRUCTIONS FOR,rHE CIVIL RIGHTS COMPLIANCE CHECKLIST
1. Describe the geographic service area Such as a district,county, city or other locality. If the pro.grarn/facility
serves a specific target population such as adolescents, describe the target population. Also,define the type
of service provided.
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 ofcornmerce, libraries,or any publication from the 1980 Census
containing Florida population statistics.Include the source ofyour population statistics.("Other"'races include
Asian/Pacific Islanders and American Indian./Alaskan Natives.)
i, Friter the total uUmber of full-time staff and their percent by race, sex and disability. Include the effective date
of Your summary.
4. L"niter the total number of clients who are enrolled, registered or currently served by the program or thcility,
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 hoard, leave this section blank.
6. Each recipient of federal financial assistance must have on file an assurance that the program will be conducted
in compliance with all nondiscriminatory provisions as required in 45 CFR 80. This is usually a standard part of
the contract language for Department recipients and their sub-grantees,45 CFR 80.4 (a).
7. ls the race, sex, and national origin of the staff reflective of the general Population? For example, if 10% 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 the Population, the prograrrill'acility has the responsibility to determine the reasons for SUCII
variation and take whatever action may be necessary to correct any discrimination. Some legitimate disparities
may exist when programs are sanctioned to serve tat-get populations Such as elderly or disabled persons, 45
CFR
803 (b)(6�).
9. Do eligibility requirements Unlawfully exclude persons in protected groups from the provision of services or
employment?Evidence Of SLICII 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 set-vices or employment, 45 CFR 80.3
(a)and 45 CFR 80.1 (b)(2).
10. Participants or clients must be provided services such as medical, nursing and dental care, laboratory services,
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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 illust
be applied unifori-rily and without regard to race,sex,color,national origin,religion, age or disability. Entrances,
waiting roonis,reception areas,restroorns and other facilities must also be equally available to all clients,45 CFR
80.3 (b).
It, 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 accommodations with
persons of a different race,color, national origin,or disability,45 CFR 80.3 (a).
12. The program/facility and all services must be accessible to participants and applicants, including those persons
who may not speak English. Ili geographic areas where a significant population of'rion-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. Program s/fac i H ties must make information regarding the nondiscriminatory provisions of'ritle V1 available to
their participants, beneficiaries or any other interested parties. This should il'ICILICIC information on their right to
file a complaint of discrimination with either the Florida Department of Elder Affairs or the U.S. Department of
I HIS.The inforination may be supplied verbally or in writing to every individual or may be supplied through the
use of an equal opportunity policy Poster displayed in a public area of the facility,45 CFR 80.6 (d).
14. Report number of discrimination complaints filed against the program/facility. Indicate the basis,e.g.,race,color,
creed, sex, age, national origin, disability, retaliation; the issues involved, e.g,, services or employment,
placement, termination, etc. Indicate the civil rights law or policy alleged to ]lave been violated along with the
name and address of the local,state or federal agency with whom the complaint has been filed.Indicate the current
status,e.g., settled,no reasonable cause found, Failure to conciliate, Failure to Cooperate, under review,etc.
15. The program/facility Must be physically accessible to disabled individuals. Physical accessibility includes
designated parking areas,Curb Cuts Or level approaches,ramps and adequate widths to entrances. The lobby,
public telephone, restroorn facilities, water fountains, inforination and admissions offices should be
accessible. Door widths and traffic areas of administrative offices, cafeterias, restroorns, 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 kin appropriate height for mobility impaired individuals.
16. Section 504 of the Rehabilitation Act of 1973 requires that a recipient offederal financial assistance conduct
a self-evaluation to identify any accessibility barriers. Self-evaluation is a four-step process:
With the assistance of a disabled individual/organisation, evaluate current practices and policies which do
not comply with Section 504.
Modify policies and practices that do not meet Section 50�4 requirements.
Take remedial steps to eliminate any discrimination that has been identified.
• N4aintain self-evaluation on file. ('['his 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 person 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 CF'R 84.7(b).
I& Programs or facilities that employ 15 or More persons must designate at least one person to coordinate efforts
to comply with Section 50�4.45 CFR 84.7(a),
19. Continuing steps must be taken to notify employees and the public of the program/facility's policy of
nondiscrimination oil the basis of disability.This includes recruitment material,notices for hearings,newspaper
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ads,and other appropriate written communication,45 CFR 84.8(a).
20, Programs/facilities that employ 15 Or more Persons IIILISt provide appropriate auxiliary aids to persons with
impaired sensory, maDUal or speaking skills where necessary. Auxiliary aids may include, but are not limited
to,interpreters for hearing impaired individuals,taped or Braille rnaterWs,or any alternative resources that can
be used to provide equally effective set-vices,(45 CFR 84.52(d),
21. Program s/Faci I i ties with 50 or more employees and $50,000 in federal contracts must develop, implement and
maintain a written affirmative action compliance program in accordance with Executive Order 11246. 41 CFR
60,and Title Vr of the Civil Rights Act of 1964,as amended.
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RP'-2129.3
ATTACHNIENTI)
DEPARTMENT OF ELDER AFFAIRS
BACKGROUND SCREENING
ATTESTATION OFCOMPLIANCE - EMPLOYER
A NTH ORrM ALL EMPLOYERS are rvqmired to annualh- submit this &rm attesting to
compliance with theprotisions of chapter 435 and section 4�0.0402 of the Florida StahAtes.
-------—-------11.---..---.--...-
The term"employer"ore-cars any person or entity required by law to conduct backpound-9sre4eninp, urcluding
Imi not minted to,Axea Agencies on Ag=4r Agmg and Ehsabthty Re7,mzce Centars,Lead Agencies,and Sen'ree
Rvvbders that coma-act directly or uidn"y vvith the Department of Elder Affain(DOEA),and any offiez pea sm
a' emfity Much huc-i employees or has voluzrteen in senrice who meet the defirution of a duvct sen-rce provuler-
See§§435 02,430 0402,Fla Stat..
A&rectservire provider is"a persou 18,years of age or older who,piti-mant to a progain to prmide senices to
the elderly,has direct„face-to-face confact with a chent while picniduig ser%ices to the client and has,accesa to
the client's hi,mg mead,fiuids,personal proper-ty,or perrocial idea fification nifortrisrhon as defined=s. 8 17-568.
The term also includes,but is not lizinted to, the,administratca ce a smiilarly irtled petson who is re4ponuble for
the day-tc-clay operations,of the lnuvidey:,the financial officez or sun darly titled pason who is re uble for the
fim-mrial operahmn of the provider, coo rdinaton, vianagers, and supenrisers of residentral tacih,fies:, and
volunteers,and aror other person seeking employment with a provider who is expected to,ow who5e responsibilities
n2ay require hiin cc hen to,pwvide penomal care cm!-services directly to clients ar hzn-e access to chent innds,
financlal matters,legal matters,personal property,or li-ving areas,"§430.0402(1)(ay,Fla, Star,(2023),
ATTESTATION
A I
As the duly aufliorized representative of (Aov,( u p -7a,41
(Name of Emplayer) I
Located at -2,511 kw V�Zr-4-,
Street address :it ',Slate, Zip Cbde,
Under penalty ofperjury,1,
04ne ofk4resenlative)
hereby swear or affinu that theabove-rianied emplover is in camphance with the provisions ofcha;iter
J 43355 almd sects epTti �4135,0.0402 of the Florida Statutes,regaiding,level 2 backgroimd screen
N,
aattti
. ...........
' esentatve Date
fR
................
DOEA For 23�5,Atmnu6ou of Cough-EmpWyer,Effective My 1,2023„F.S.
L,,.2LLAauU&3= "-
I
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ATTACHMENT F
Alliance for Aging, Inc.
Bnsiness Associate Agreement
This Business Associate Agreement is dated I 12-T I XL , by the Alliance for Aging, Inc, ("Covered Entity")
Cu u and Monroe County Board of County Commissi ner4,Social Services/In-l-lome Services,("Business Associate"), a not-
for-profit Florida corporation,
1.0 Background.
LI Covered L`ntity has entered into one or more contracts or agreements with Business Associate that involves the use of
Protected Health Information (Pill).
1.2 Covered Entity recognizes the requirements of the Health Insurance Portability and Accountability Act of 1996
(I-IIPAA)and has indicated its intent to comply in the County's Policies and Procedures.
1.3 HIPAA regulations establish specific conditions on when and how covered entities inay share information with
Providers who perform functions for the Covered Entity,
1.4 HJPAA requires. the Covered Entity and the Business Associate to enter into a contract or agreement containing
specific requirements to protect the confidentiality and security of patients' PHI,as set forth in,but not limited to the
Code of Federal Regulations (C.F.R.),specifically 45 C_F.R, §§ 164.502(c), 164.504(c), 164,308(b), and 164.3 14(a-
b)(20 10)(as may apply)and contained in this agreement.
1.5 The flealth, Information Technology for Economic and Clinical Health Act (2009), the American Recovery and
Reinvestment Act(2009)and Part I—improved Privacy Provisions and Security provisions located at 42 United States
Code Ode(U.S.C.)§§ 17911 and 17934(20 10) require business associates of'covered entities to comply with the I I IPAA
Security Rule,as set forth in,but not I iin ited to 45 CJ".R.§§ 164.308, 164.310, 1643 12,and 164.3,16(2009)and such
sections shall apply to a business associate of a covered entity in the same manner that such sections apply to tile
covered entity.
The Pat-ties therefore agree as follows:
10 Definitions. For Purposes of this agreement,the following definitions apply:
2A Access. The ability or the inearis necessary to read, write, modify,or conitnUilicate data/information or otherwise use
any system resource,
2.2 Administrative Safeguards. The administrative actions, and policies and procedures, to manage the selection,
development, implementation, and maintenance of security measures to protect electronic Protected Health
Information(ePHI) and to manage the conduct of the covered entity's workforce in relation to the protection of that
information.
2.3 ARRA. The American Recovery and Reinvestment Act(2009)
2A Authentication. The corroboration that a person is the one claimed.
2.5 Availability. The property that data or information is accessible and useable upon demand by an authorized person.
2,6 Breach. The Unauthorized acquisition, access, use, or disclosure of Pill which compromises the security or privacy
Of Such information,
2.7 Compromises the Security. Posing a significant risk of financial,reputational,or other harm to individuals,
2.8 Confidentiality, The property that data or information is not made available or disclosed to unauthorized persons or
processes.
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2,9 Electronic Protected Health I it to rotation (ePtI I). Health information as specified in 45 CFR§160.103(1)(j)or
(I)(N), limited to the information created or received by B Lis iness associate from or oil behalf of Covered Entity.
2.10 HITECIL The Health Information Technology for Economic and Clinical Health Act(2009)
2.11 Information Systern. An interconnected set of information resotu•ces Lluder the same direct niariagenient control
that shares common functionality, A system normally includes hardware,software, information,data,applications,
communications, and people.
2.12 Integrity. The property that data or information have not been altered or destroyed in an unauthorized manner.
2.13 Malicious software, Software, for example,a virus, designed to damage or disrupts a system.
2.14 Part 1. Part I—Improved Privacy Provisions and Security provisions located at 42 United States Code(U.S.C.) §§
17931 and 17934(2010).
115 Password. Confidential authentication information composed of a string of characters.
2.16 Physical Safeguards. The physical measures, policies, and procedures to protect a covered entity's electronic
information systenis and related buildings and equipment, from natural and environmental hazards, and
unauthorized intrusion.
2.17 Privacy Rule, The Standards for Privacy of Individually Identifiable Health Information at 45 CFR Pail 160 and
Part 164,subparts A and E.
118 Protected Health Information (Pill). Health information as defined in 45 CFR §160J03, limited to the
inl'orniation created or received by Business Associate from or on behalf of Covered Entity.
2.19 Required Bylaw. Has the same meaning as the term"required by law"in 45 CFR§ 164,103,
220 Secretary.The Secretary of the Department of Health and Human Services or his or her designee.
12 1 Security incident, `11 he attempted or successful unauthorized access, use, disclosure, modification, or destruction
of information or interference with system operations in an information system.
2.22 Security or Security measures. All of the administrative, physical, and technical safeguards in an information
system.
2.23 Security Rule. The Security Standards for the protection of Electronic Protected Health Information at 45 CFR part
16�4,SUbparl C,and amendments thereto.
2,24 Technical Safeguards, The technology and the policy and procedures f6r its use that protect electronic protected
health information and control access to it,
2,25 Unsecured PHI. Protected health information that is not secured through the use or technology or methodology
specified by the Secretary in guidance issued Under 42 U.S.C. section 17932(h)(2).
2.26 All other terms used, but not otherwise: defined, in this Agreement shall have the same meaning as those terms in
the Privacy Rule.
3.0. Obligations and Activities of Business Associate.
3.1 Business Associate agrees to not use or disclose PHI other than as permitted or required by this agreement or as
Required by I..,aw.
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3.2 Business Associate agrees to:
(a) Implement policies and procedures to prevent, detect, contain and correct Security violations in accordance
with 45 CFR § 164.306;
(b) Prevent use or disclosure of the PI It other than as provided for by this Agreement or as required by law;
(c) Reasonably and appropriately protect the confidentiality, integrity, and availability of the ePHI that the
Business Associate creates, receives, maintains,or transmits on behalf of the Covered Entity; and
(d) Comply With the Security Rule requirements including the Administrative Safeguards, Physical Safeguards,
Technical Safeguards, and policies and procedures and documentation requirements set forth in 45 CFR §§
164,308, 164.3 10, 164.112,and 164,316.
33 Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Business
Associate of a use or diSCIOSLHT Of PI-11 by Business Associate in violation of the requirements of this Agreement.
3.4 Business Associate agrees to promptly report to Covered Entity any use or disclosure of the PHI not provided for
by this Agreement of'which it becomes aware. This includes any requests for inspection, copying or amendment of
Such information and including any security incident involving PHL
3.5 Business Associate agrees to notify Covered Entity, without Unreasonable delay of any security breach pertaining
to:
(a) Identification of any individual whose unsecured PHI has been, or is reasonably believed by, the Business
Associate to have been,accessed,acquired,or disclosed(hiring such security breach; and
(b) All information required for the r,Volice to the Secretary q/'1111S ol'Breach (?f Unsecurct/ ProleclecilIcallh
Mfin-mation,
3.6 Business Associate agrees to ensure that any agent, including a subcontractor, to whom it provides PHI received
from, or created or received by Business Associate on behalf of Covered Entity,agrees to the sane restrictions and
conditions that apply through this Agreement to Business Associate with respect to such infonnation,
3.7 If Business Associate has 111-11 in a Designated Record Set:
(a) Business Associate agrees to provide access,at the request of'Covered Entity during regular business hours,to
PI-11 in a Designated Record Set,to Covered Entity,or,as directed by Covered Entity,to an individual in order
to meet the requirements under 45 CFR §164.524;and
(b) Business Associate agrees to make any amendments) to PHI in a Designated Record Set that the Covered
Entity directs or agrees to Pursuant to 45 CFR § 164.526 at the request of Covered Entity, or an Individual
within 10 business days of receiving the request,
3,8 Business Associate agrees to make internal practices, books, and records, including policies and procedures and
PHI,relating to the use and disclosure of PI.11 received from,or created or received by Business Associate on behalf
of Covered Entity, available to the Covered Entity or to the Secretary upon request of either party for purposes of
determining Covered Entity's compliance with the Privacy Rule.
3.9 Business Associate agrees to document such disclosures of PHI and information related to such disclosures as would
be required for Covered Entity to respond to a request by an individual for an accounting of disclosures of PI]I in
accordance with 45 CFR§ 164.528.
3.10 Business Associate agrees to provide to Covered Entity or an individual, upon request, information collected to
permit Covered Entity to respond to a request by an Individual for all accounting of disclosures of PHI in accordance
with 45 CFR § 164.528 and ARRA § 13)404.
II I Business Associate specifically agrees to use security measures that reasonably and appropriately protect the
coil fi dential ity, integrity,and availability of PHI in electronic or any other form,that it creates,receives,maintains,
or transmits oil behalf of the Covered Entity,
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112 Business Associate agrees to implement security measures to secure passwords used to access ePHl that it accesses,
maintains, or transmits as part of this Agreement from malicious software and other man-made and natural
Vulnerabilities to assure the availability, integrity, and confidentiality Of such information,
3.13 Business Associate agrees to implement security measures to safeguard ePI-11 that it accesses,maintains,or transmits
as part of this agreement from malicious software and other man-made and natural Vulnerabilities to assure the
availability,integrity, and confidentiality of such information,
3.14 Business Associate agrees to comply Nvith:
(a) A RRA § 13404 (Application of Knowledge Elements Associated with Contracts);
(b) ARRA § 13405(Restrictions on Certain Disclosures and Sales of Health Information);and
(c) A RRA § 13406(Conditions oil Certain Contacts as Part of Flealth Care Operations).
4.0 Permitted Uses and Disclosures by Business Associate, Except as othenvise limited in this Agreement or ally related
agreement, Business Associate may use or disclose PI-11 to perform functions, activities, or services for, or oil behalf of
Covered Entity as specified in any and all contracts with Covered Entity provided that such use or disclosure Would not
violate the Privacy Rule if done by Covered Entity or the minimum necessary policies and procedures of the Covered
Entity.
5.0 Specific Use and Diselosture Provisions.
5.1 Except as otherwise limited in this agreement or any related agreement, Business Associate may use PHI for the
proper management and administration of the Business Associate or to carry out the legal responsibilities of the
Business Associate,
52 Except as otherwise limited in this agreement or any related agreement, Business Associate may disclose PHI for.
the proper management and administration of the Business Associate, provided that disclosures are Required By
Law, or Business Associate obtains reasonable assurances from the person to whom the information is disclosed
that it will remain confidential and used or further disclosed only as Required By Law or for the purpose for which
it was disclosed to the person, and the person notifies the Business Associate of any instances of which it is aware
in which the confidentiality of the information has been breached,
5.3 Business Associate may use PHI to provide data aggregation services to Covered Entity as permitted by 45 CFR
§I 64.504(e)(2)(i)(B),, only when specifically authorized by Covered Entity.
54 Business Associate may use P111 to report violations of law to appropriate Federal and State authorities, consistent
with 45 CFR §164.5020)(1
6.0 Obligations of Covered Entity.
6.1 Covered Entity shall notify Business Associate of any limitation(s) in its notice of privacy practices of Covered
Entity in accordance with 45 CFR§ 164.520,to the extent that such limitation may affect Business Associate's use
or disclosure of PHI, by providing a copy of the most current Notice of PrivaCyr Practices (NPP) to Business
Associate. Future Notices and/or modifications to the NPP shall be posted on Covered Entity's website at
6.2 Covered Entity shall notify, Business Associate of any restriction to the use or disclosure Of PHI that Covered Entity
has agreed to in accordance with 45 CFR § 164.522, to the extent that Such restriction may affect Business
Associate's use or disclosure of Pill,
7.0 Permissible Requests by Covered Entity. Except for data aggregation or management and administrative activities of
Business Associate,Covered Entity shall not request Business Associate to use or disclose PHI in any manner that would
not be permissible Under the Privacy Rule if done by Covered Entity.
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8.0, Effective Date and Termination.
8.1 The Parties hereby agree that this agreement amends,restates and replaces any other Business Associate Agreement
currently in effect between Covered Entity and Business Associate and that the provisions of this agreement shall
be effective as follows:
(a) These Business Associate Agreement provisions, with the exception of the electronic security provisions and
the Provisions mandated by ARRA, HITECH and Part I shall be effective upon the later of April 14, 2003, or
the effective date of the earliest contract entered into between Business Associate and Covered Entity that
involves the use of PHI;
(b) Tile electronic security provisions hereof shall be effective the later of April 21, 2005 or the effective date of
the earliest contract entered into between Business Associate and Covered Entity that involves the use of PHI;
and
(c) Provisions hereof mandated by ARIA„ FliTECH and/or Part I shall be effective the later of ebrUary 17,2010
or the effective date of the earliest contract entered into between covered entity and business associate that
involves the use of 111-11 or el?Fil.
82 Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business Associate,Covered
Entity shall either;
(a) Provide all opportunity for Business Associate to Cure the breach or end the violation and terminate this
agreement if Business Associate does not cure the breach or end the violation Nvithin the tinle specified by
Covered Entity,
(b) Immediately terminate this agreement if Business Associate has breached a material term of'this Agreement
and Cure is not possible; or
(c) Ifneither termination nor cure is feasible,Covered Entity shall report the violation to the Secretary,
8.3 Effect ofTerunination. Except as provided in subparagraph(b)ofthis section, upon termination ofthis agreement,
for any reason,Business Associate shall return all PI If and ePHI received from Covered Entity or created or received
by Business Associate on behalf ol'Covered Entity,
(a) This provision shall apply to PI It mid ePI 11 that is in the possession of subcontractors or agents of Business
Associate, Business Associate shall retain no copies of the PHI and ePFIL
(b) In the event that Business Associate or Covered Entity determines that returning the Pill or ePTIl is infeasible,
notification of the conditions that make return of PI-11 or ePI-111 infeasible shall be provided to the other party.
Business Associate shall extend the protections of this Agreement to such retained PHI and ePHI and limit
further uses and disclosures of such retained PFII and ePlJl, for a minimum of six years and so long as Business
Associate maintains such PI-11 and el11-11,but no less than six(6)years after the termination of this agreement.
9.0 Regulatory References. A reference in this agreement to a section in the Privacy Rule or Security Rule means the
section then in effect or as may be amended in the future.
10.0 Amendment. The Parties agree to take such action as is necessary to amend this agreement from time to time as is
necessary for Covered Entity to comply with the requirements of the Privacy Rule, the Security Rule and the Health
Insurance Portability and Accountability Act of 1996,pub, L No. 104-191.
11.0 Survival. Any term,condition,covenant or obligation which requires performance by either party hereto subsequent to
the termination of this agreement shall remain enforceable against Such part),subsequent to such termination.
12.0 Interpretation, Any ambiguity in,this agreement shall be resolved to permit Covered Entity to comply with the Privacy
Rule and Security Rule.
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13.0 Incorporation 1)),reference, Any future new requirernent(s),cllanges ordeletion(i)enacted in lederal la%v which create
nov or different obligations with respect to HIPAA privacy and/or security, shall be autornaticafly incorporated by
relemice to this Business Associate Agreement oil tile respective effective datc(s).
I i.0 Notices, All notices and cornall Lill ications required, necessary or desired to be given pursuant to this agreement,
including ru change of address for purposes of such notices and communications. shall be in %vrifing mid delivered
personally to the other party or sent by express 24-how guaranteed courier or delivery service,,or by certilled mad of
the United States postal Service, postage Prepaid and return, receipt requested, addressed to the other party ais follows
(Or to such other place as any,parry may by,notice to file others specify
To Covered Fnfity: Alliance for Aging, tile,
Atmitiow Max Rothman
760 NW 107 Avenue
Miami, 11"lorida 3 1172
to Business Associate. Monroe County Board ofConntY Commissioners, social Services/111-1 folne Services
1100 Simonton Street, 2"" ]Floor,
Key West, FT 33040
Any such notIce shall be deemed delivered upon actual receilil. Ifany irotice cannot be delivered or delivery thereork-refused,
delivery will be deemed to have occurred oil the date such delivery was attempted,
15.O Governing Law. The la%vs of the State of l"loricla, \,%1jtlIOUt giving cfteet to principles of Conflict of laws, gmeril 'III
matters arisnit,under this agreement..
16,0 Severability. It'any provishm in this agreement is urvenAm,ceable to any extent, the remainder of this agircernent, or
application offirat provision to tarry persons or cirCLIMS1,111CCS otfi4Ar than those as to which it is field unenfbiveabie,wvill
not be aft"cded by that unenl6rceab,Llity and will be enfoiceable to the fullest extent permitted by law
17,C) Successors Any successor to Business Associate(wvIlether by direct or indirect or by purchase,nwl.wr,consolidation,
or otherwise)is required to assume Business Associate's obligations under this agreement and agree to perform thein ill
the same manner and to the same extent that Business Associate vwuld have been required to if that succession had not
taken place. 'I his assumption, by the successor of the Business Associate's obligations shall be by written agreement
satisfactoi-
y lo Covered Frarity.
18.0 Entire Agreemeut. "Uhis agwClfleln COJIStkUteS the entire agicement of the parties relating to tile SLIbjCCt 1jjatter()rdais
ag,recolein and supersedes all other orid or written agreements or policies relating ilierew, except that this agreentelit
does not Hiner the aineirdment of this agreement in accordance with section 10.0 ofthis,
Covered Entity, Alliance for Ag'ing,Inc.
Oct3,2023
fly: *700,��7777 771)1 7�-777" Dale�
..........
(signature)
Business Associate: Monroe County Board of olinty ('0111111 issioners,Social Sea-vices/In-Horme Services
By.
(signature)... ...... Date: a)"23
SIGNED BV:
NAME:
TITLE: MAVOR Page 67 of 72 uw,r,, or A,,om ,,,a Am,,,,
DATE:
Iq
04
RP-2129.3
ATTACHMENTC,
Alliance for Aging, Inc.
Aging and Disability Resource Center/Elder I lelpline
AGING AND DISABILITY RESOURCE CENTER (ADRC)—OUTSOURCED FUNCTIONS
If applicable, the provider agrees to the following:
A. Perform ADRC outsourced functions in accordance with the Alliance's policies and procedures,
i. Policies and Procedures for OWSOUrced FLinction-Screening
i i. Policies and Procedures for ClUtSOurced function-Triage
iii. Policies and Procedures for Activation from Waitlist- Client Set-vices
iv. Policies and procedures for Termination froin Waitlist- Client Services
B. Maintain wait lists in CIRTS in accordance with Department requirements.
C. Adhere to prioritization and targeting policy as set forth in the DOEA Programs and Services
Handbook, as applicable.
D. Ensure the Provider's Disaster Plan reflects ADRC Outsourced Functions, annually or as needed
to incorporate ADRC OLItSOLIrced functions.
E. EnSUIT against conflicts of interest and inappropriate self-referrals by referring consurners in need
of options counseling or long-term care set-vices beyond the provider's scope of services to the
Aging and Disability Resource Center.
F. Ensure that services provided are in the clients' best interest, are the most cost effective, of high
quality, and are responsive and appropriate to the assessed needs.
The Assessed Priority Consurner List (APCL) is maintained when set-vices ftinded by the Department are not
available, Contracted Providers of registered set-vices for Local Services Program (1,,SP) and Older Americans
Act (OAA) and ARP must maintain waiting lists in the CfRTS database for registered services When funding is
not available.
Page 68 of 72
LO
CN
RP-2129.3
Alliance for Aging, Inc.
Aging and Disability Resource Center/Eider Helpline
Policy and Procedure for Outsourced function—Screening
Creation Date: March 5, 2008
Revision Date: October 2019
Review Date: October 2019
Objective' TO e11SLJr(-' that a comprehensive list of clients in need of services is maintained in CIRTS by
appropriate funding source and that the ADRC is thereby able to effectively gauge the level of elder
service need in Mianii-Dade and Monroe Counties.
Policy: To obtain necessary information from clients in order to assist in determining level of need and
eligibility for registered services funded through OAA and I.SP and ARP programs,
Procedure:
I Providers will collect information from callers and conduct a 701S assessment. Alternatively, it' a
701 A(B)assessment already exists or is provided I"roni another Provider the information from the 70IB
can be utilized.
1 The Provider will determine the services needed and the appropriate funding SOUrCe(S) that provides
the needed services.
If the caller is in need of a service(s)that is not provided by the Provider, tile Provider will refer caller
to the ADRC Elder Helpline, as well as, to other contracted Providers and C01111TIL111ity organizations,.
3. The caller will be provided with general information regarding the ADRC as wcl] as the ADRC Eider
lielpline contact number.
4. '['he caller will be informed of the services and funding sources that they are being placed on the wait
list for in CIRTS.
5. For non-case managed programs, the Provider will create a client record in ('IRTS (it' there is no
existing record) and enter the services needed for the caller by funding source and service. [If there is
an existing record in CIRTS, the appropriate fields will be updated],
6. Ifthe Provider determines that the caller may qualify for more than one program for,,vhich the Provider
is funded, the Provider is encouraged to enter the appropriate information Linder MUltiple funding
sources. [Ifthere is an existing client record in CIRTS, the client record in CIRTS will be updated with
appropriate information].
7. The Provider will inform caller that they will receive an annual re-assessment based on Department
Wait List Reassessment Standards and encourage caller to contact the ADRC Eider Helpline with any
questions.
Page 69 of 72
W
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RP-21293
Alliance for Aging, Inc.
Aging and Disability Resource Center/Elder Helpline
Policy and Procedure for
Outsourced function -Triage
Creation Date: March 5, 20�08
Revision Date: October 201 9
Review Date: October 2019
Obliective. To ensure that clients in need of Department funded services receive services based on the highest
level of need, first, as funding becomes available.
Policy: To assist clients in obtaining Department funded services as funding becomes available, based on
level of need as determined by a CIRTS priority, score.
Procedure:
I, The Provider will conduct annual reassessments based on Department Wait List Reassessment Standards.
2. If there is 110 Current 701 A or B in CIRTS, the Provider will conduct the annual reassessment (70 1 s) as
appropriate. Based on the information provided via the 70IS/A(B), assessment, the Provider Will Update
the client information in CIRTS specifically as it pertains to level of need for services by funding SOUrce,
3. The Provider will cnsurc that the CIRTS prioritization score is accurately maintained, according to
Department Standards. If a significant change has occurred prior to the annual re-screening, the Provider
must re-screen. Definitions and examples of significant change are dOCLUnented in the DO[7.-,A Programs
& Services Manual Chapter 2.
4. If the caller is in need of a service(s)that is not provided by the Provider,the Provider will refer caller to
the ADRC Elder Flelpline, as well as, to other contracted Providers and COITIMUnity organizations, 'Fhe
caller will be informed of the set-vices and funding sources that the Wait list for and/or have been removed
frown the wait list for,
5. The Provider will remind client of the ADRC Elder I lelp Line contact number and to contact the ADRC
Elder Help Line with any, questions or concerns.
6. As funding becomes available, the Provider Nvill run CIRTS Prioritization Report and activate clients
according to Department Standards (refer to ADRC Client Activation Policies and Procedures). The
Contracted Provider will apply targeting criteria, as appropriate, to prioritized clients to ensure activations
meet programmatic requirements.
Page 70 of 72
I
CN
CV)
RP-21293
Alliance for Aging, [tic.
Aging and Disability Resource Center/Elder Helpline
Policy and Procedure for
Activation from Wait List—C lien ts/Ser,vices
Creation Date: March 5, 2008
Revision Date: October 2019
Review Date: October 20 19
Objective: To ensure that elders in need of Department funded set-vices in Miarni-Dade and Monroe Counties and
on the CIRTS wait list begin to receive services as funding becomes available.
Policy: ADRC will work Nvith Providers to ensure that clients waiting for Department funded services begin
to receive those services as funding becomes available.
Procedure:
1. The Provider will activate clients on CIRTS wait list based on Department prioritization Polices and
funding availability,
2. The Provider will update CIRTS status by funding SMArce and service for any services being activated for
the client using appropriate CIRTS codes,
3. Client may be left on Wait list of a different funding Source than the one being activated if the Provider
determines that it is appropriate.
4. Client may also be left on wait list in CIRTS if they are being activated by the Provider under a temporary
non-Department funding source and the Provider determines that the client's need will persist after the
temporary funding source is exhausted.
5. The Provider will inform the client of any services/funding source that they are being activated for as well
as those set-vices and funding sources that they Will Continue to, be wait listed for.
6. The Provider will inform client to contact the ADRC Elder Flelpline ifthey have any(JUestions or concerns
regarding the status of any of their services.
Page 71 of 72
00
CN
RP-2129.3
Alliance for Aging, Inc.
Aging and Disability .Resource Center/Elder flelpline
Policy and Procedure for
Termination from Wait List—Clients/Services
Creation Date: March 5, 2008
Revision Date: October 2019
Review Date: October 20,19
ObJective: To, ensure that the comprehensive list of clients in need of services in CIRTS is appropriately
maintained by funding Source and that the ADRC is thereby able to effectively gauge the Current level
of elder service need in Mianii-Dade and Monroe Counties.
Policy: ADRC will maintain an accurate and current list of clients in need ofelder services in Miarni-Dade
and Monroe Comities with the assistance of the ADRC Contracted Providers.
Procedure:
1, The Provider will re-screen clients which the Provider initially placed on the CIRTS wait list for services
based on Department Reassessment Standards.
2, The re-screening may be in the form of a phone screening or a horne visit depending on the client's status
(ix, active/pending)
1 The Provider will determine if the client is no longer in need (or eligible) for any of the services they were
wait-listed for,
4. The Provider will terminate the client from the wait list (entirely or by specific service) using the
appropriate CIRTS termination code For any services or Funding Source for which the client is determined
to no longer be eligible for or no longer in need of.
5, The Provider will inform the client of any services/funding Source that they are being removed from the
wait list for.
6. The Provider will inform client of their ability to be re-added to the wait list if their level of need Should
change.
7, The Provider will inform client to contact the ADRC Elder Helpline if they have any questions or concerns
regarding their wait list status,
8. Reference DOEA programs and Services I landbook as applicable.
Page 72 of 72
G,,I C°URr,
o: A Kevin Madok, CPA
W. ►�.: -
�° ........ � Clerk of the Circuit Court& Comptroller Monroe County, Florida
ryR°f COUN�1.
DATE: February 16, 2023
TO: Sheryl Graham, Director
Social Services
ATTN: Lourdes Francis, Administrator
Social Services
Kim Wilkes Wean, Sr. Administrator
Social Services
FROM: Liz Yongue, Deputy Clerk
SUBJECT: February 15th BOCC Meeting
The following item has been partially executed:
C26 1 st Amendment to American Rescue Plan Contract No. RP-2129.2 between the
Alliance for Aging, Inc. and Monroe County Board of County Commissioners/Monroe County
Social Services to increase grant funding by$89,775.43, bringing the contract total from
$142,333.49 to $232,108.92 for contract period October 1, 2022 through September 30, 2023.
Please send us the final version after it has been executed by Alliance for Aging, so we
can add it to the record. Should you have any questions please feel free to contact me at(305)
292-3550.
cc: County Attorney
Finance
File
KEY WEST MARATHON PLANTATION KEY
500 Whitehead Street 3117 Overseas Highway 88770 Overseas Highway
Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070
1329
AMENDMENT 001 CONTRACT RP-2129.2 Page 1
This Amendment entered into between the Alliance for Aging, Inc. (Alliance) and Monroe County
Board of County Commissioners,Social Services/In-Home Services(Provider),collectively referred
to as the "Parties" hereby amends contract RP-2129.2.
The purpose of this Amendment is to allocate additional funding to all subtitles, including a Technology
Administrative Flat Fee for providers that will be servicing Technology initiatives.
1. ATTACHMENT 1 Section 2.1 (7) is hereby replaced:
2.1(7) The Alliance has contracted for technology services through CLARIS, CARE PREDICT,
ELL.IQ, TRUALTA, and AGELESS INNOVATION as applicable. Where appropriate,
Provider shall oversee, ensure installation, follow up, facilitate the return of the equipment (if
applicable), and comply with the use of these technology service contracts to support in
reducing social isolation and loneliness and to support Caregivers.
2. ATTACHMENT 1 Section 3.1.4 is hereby added:
3.1 A Technology Administrative Flat Fee (TAFF)
Payments for Technology Administrative Flat Fee shall not exceed amounts established in
ATTACHMENT VII, per technology, and must be billed and submitted on the Technology
Administrative Flat Fee form (ATTACHMENT X, Exhibit 6). Billing must be submitted
during the month in which the technology was initiated for the client. Documentation must be
maintained in client files to support this administrative billing.
3. ATTACHMENT X, Exhibit 6, TECHNOLOGY ADMINISTRATIVE FLAT FEE is hereby added
4. ATTACHMENT II, Exhibit 2, FUNDING SUMMARY is hereby replaced
S. ATTACHMENT VII, CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE is hereby
replaced
1330
AMENDMENT 001 CONTRACT RP-2129.2 Page 2
All provisions in the contract and any attachments thereto in conflict with this amendment are hereby
changed to conform with this amendment.
All provisions not in conflict with this amendment are still in effect and are to be performed at the
level specified in the contract are hereby amended to conform with this amendment.
This amendment and all its attachments are hereby made a part of the contract.
IN WITNESS THEREOF,the Parties hereto have caused this contract, to be executed by their
undersigned officials as duly authorized.
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS,SOCIAL
SERVICES/IN-H E SERVICES
S ALLIANCE FOR AGING, INC.
0
00ew
og
B.R,A Im n ai i(I ob 1 2,023 13: 9-S I)
0
SIGNED 0� SIGNED BY: Max
NAME: CRAIG CATES, NAME: MAX B. ROTHMAN 1r)ALK.
TITLE: MAYOR TITLE: PRESIDENT AND CEO
DATE: DATE: Feb 17,2023
'A VIN MADOK, CLERK
Z
s Deputy Clerk
w.
Approved as to form and legal sufficiency
Monroe County Attorney's Office
Christina Cory,Assistant County Are omey
Date: 1/31/23
1331
AMENDMENT001 CONTRACT RP-2129.2 Page 3
ATTACHMENT X
Exhibit 6
Alliance for Aging,Inc.
American Resue Plan
Technology Service
Administrative Fee
Provider Name:
Billing Month and Year.1
Complete this form only during the month(s)that an alloted slot is init4w y f uKed
and submit it with monthly billing reports to be paid.
Technology Serviec Billed Amount per
___w;lit ............nt Name eCIRTS lor own Se Product
... .....................................-..........................
---------------
......................... ............... ...............
-------------
I—-----------------
mmea --I—-----------
-------------..... ....
............................
------------
................ ---- -----.................
....................................
........... .............. ........
................................. .............
................... ........................
...........................................
.......................
�TOTAL
The Serviec Adminstrative Flat Fee can be billed only once for each slot offered per Technology.
This Administrative Fiat Rate Fee was designed to absorb any necessity to fill a slot vacated by attrition,
1332
AMENDMENT001 CONTRACT RP-2129.2 Page 4
ATTACHMENT 11
FINANCIAL, AND COMPLIANCE AUDIT ATTACHMENT
EXHIBIT 2-FUNDING SUMMARY
Note:Title 2 CFR§ 200.331,as revised,and s.215.97,F.S., require that information about Federal Programs and State Projects
included in ATTACHMENT 11,Exhibit I be provided to the recipient. Information contained is a prediction of funding sources
and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECI PI ENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
American Rescue Plan Administration U.S.Health and Human Services 93.043-044 $10,800.00
American Rescue Plan for Supportive Services U.S. Health and Human Services 93.044 $21,570.17
under Title 111-13 of the Older Americans Act
American Rescue Plan for Congregate Meals U.S. Health and Human Services 93.045 $38,597.66
under Title 111-C I of the Older Americans Act
American Rescue Plan for Home Delivered Meals U S. Health and Human Services 93.045 $127,709.09
under Title III-C2 of the Older Americans Act
American Rescue Plan for Preventive Health under U.S. Health and Human Services 91043
Title 111-D of the Older Americans Act
American Rescue Plan for Family Caregivers U.S. Health and Human Services 93.052 $33,432.00
under Title III-E of the Older Americans Act
TOTAL FEDERAL AWARD S 232,108.92
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDSm
2 CFR Part 200-Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
OMB Circular A-]33 -Audits of States, Local Governments, and Non-Profit Organizations
2. STATE RESOURCES AWARDED TO'rHE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO sec.215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE:
Section 215.97, F.S., Chapter 691-5, F.A.C., Reference Guide for State Expenditures, Other fiscal requirements set forth in
program laws, rules and regulations.
1333
AMENDMENT001 CONTRACT RP-2129.2 Page 5
ATTACHMENT VIT
CONTRACT BUDGET SUMMARY BY SERVICE AND TITLE
CHITS SUMMARY FOR THE AGENCY
Service Unit Maximum Units of Maximum
Services to be Provided Rate Service Dollars
Chore 11113 $24.00 80 $1,920.00
Companionship 11113 $noo 10 $110.00
Escort 11113 $16.67 6 $100.02
Homemaker11113 $33.20 287 $9,528.40
Personal Care 11113 $33.20 287 $9,528.40
Screening&Assess 11113 $26.36 14 $370.35
Shopping Assistance 1118 $13.00 1 $13.00
Congregate Meals C1 $9.00 4,121 $37,091.06
Congregate Meals MLTC C1 $9.00 -
Emergency Congregate Meals C1 $9.00 40 $360.00
Congregate Meals Screening Cl $20.001 30 $600.00
Nutrition CounselingC1 $70.56 5 $352.80
Nutrition Education C1 $1.02 190 $193.80
Home Delivered Meals Frozen C2 $5.00 17,762 $88,811.15
Home Delivered Meals Hot C2 $6.53 5,280 $34,478.40
Emergency Home Delivered Meals C2 $6.53 180 $1,175.40
Nutrition Counseling C2 $70.56 4 $282.24
Nutrition Education C2 $1.02 180 $183.60
Screening&Assessment C2 $26.46 105 $2,778.30
Caregiver Training Grp 111E $81.75 11 $890.62
Caregive r Trai n i ng Ind I I I E $75.00 29 $2,208.52
Respite- Facility ME $10.50 800 $8,399.37
Respite- In-Home 111E $2193 112 $2,453.39
Screening&Assess ME $26.46 10 $253.28
Chore IIIES $24.00 183 $4,392.00
House Improve IIIES Cost Reimb $5,030.22
Material Aid IIIES Cost Reimb $5,030.23
Specialized Medical Equipment IIIES Cost Reimb $4,774.37
Tech Admin Flat Fee
-Care Predict(30 slots) $10,800.00
TOTAL $2.32,108.92
1334
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���I iiii� II iiii� iiii� mill iiii� 00111111111
Final Audit Report 2023-02-17
Created: 2023-02-17
By: Stan Mcneese(mcneeses@allianceforaging.org)
Status: Signed
Transaction ID: CBJCHBCAABAA9m-ty14aezWEJEL7LL6CeCtEThuVX_cp
"Monroe RP 2129.2 Amendment 001 - Provider signed" History
6.,.,. Document created by Stan Mcneese (mcneeses@allianceforaging.org)
2023-02-17-6:12:57 PM GMT-IP address:52.201.156.234
Document emailed to rothmanm@allianceforaging.org for signature
2023-02-17-6:13:38 PM GMT
Email viewed by rothmanm@allianceforaging.org
2023-02-17-6:18:45 PM GMT-IP address:73.245.17.80
rm Signer rothmanm@allianceforaging.org entered name at signing as Max B. Rothmman
2023-02-17-6:19:20 PM GMT-IP address:73.245.17.80
rim Document e-signed by Max B. Rothmman (rothmanm@allianceforaging.org)
Signature Date:2023-02-17-6:19:22 PM GMT-Time Source:server-IP address:73.245.17.80
Agreement completed.
2023-02-17-6:19:22 PM GMT
Adobe Acrobat Sign
1335