Item D07
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: 12-20-2006
Division: Community Services
Bulk Item: Yes l
No
Department: Social Services/In-Home Services
Staff Contact Person: Deloris Simpson
AGENDA ITEM WORDING: Approval of the Master Agreement #PE-729 for the period of January
1,2007 through December 31,2007, between the Alliance for Aging, Inc. (Area Agency on Aging for
Miami - Dade and Monroe Counties) and the Monroe County Board of County CommissionerslMonroe
County Social Services (In-Home Services ProgramlNutrition Program).
ITEM BACKGROUND: The approval of the Master Agreement will ensure the continuation of In-
Home Services and Nutrition Programs (with no disruption to the consumers) assure that both the
Alliance and Monroe County will be subject to the conditions set forth in all contracts between above
referenced parties and will allow either party to amend executed contracts covered under this Master
Agreement.
PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to Master Agreement PA-429 on
June 18,2004
CONTRACT/AGREEMENT CHANGES: N/A
STAFF RECOMMENDATIONS: Approval
TOTAL COST $ -0-
COST TO COUNTY: $ -0-
BUDGETED: Yes ----K- No
SOURCE OF FUNDS: N/A
REVENUE PRODUCING: Yes
No X
AMOUNTPERMONTH_ Year
APPROVED BY: County Atty -L OMB/Purchasing ~
Risk Management _ X_
DOCUMENTATION:
Included X
Not Required_
DISPOSITION:
AGENDA ITEM #
Revised 8/06
O,l!,~T.y ~o~~~~E
(305) 294-4641
BOARD OF COUNTY COMMISSIONERS
Mayor Charles "Sonny" McCoy, District 3
Mayor Pro Tern Dixie M. Spehar, District 1
George Neugent, District 2
David P. Rice, District 4
Glenn Patton, District 5
~1~1~fJ"~1
',-,' --- ,::\-
- .
-.. --.. ;'~1~
MEMORANDUM
TO:
Monroe County Board of County Commissioners
FROM:
Dee Simpson, Senior Administrator, In-Home Services Program
DATE:
11/13/2006
RE:
Agenda Item regarding Master Agreement PE- 729
This memorandum is in regards to Master Agreement PE-7Z9. This Agreement is between Monroe County Board
of County Commissioners/Social Services (In-Home Services/In-Home Services) and the Alliance for Aging, Inc.
(Area Agency on Aging for Miami - Dade and Monroe Counties).
The approval of this Agreement will allow:
1. For In-Home Services/Nutrition Programs to provide services according to the conditions specified in any
agreement(s) with the Alliance during the period this agreement is in effect.
Z. This agreement covers all services provided by In-Home Services/Nutrition Programs under contract
with the Alliance.
3. To provide services in compliance3 with the provisions of the Department Home and Community-Based
Services Handbook.
4. This agreement will allow either party to amend executed contracts between Monroe County and the
Alliance.
Thank you.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract with: Alliance For Aging, Inc. Contract #PE 729
Effective Date: January 1,2007
Expiration Date: December 31, 2007
Contract Purpose/Description: Approval of Contract #PE-729, Master Agreement, between the Alliance For
Aging, Inc. (Area Agency on Aging for Miami-Dade and Monroe Counties) and the Monroe County Board of
County CommissionerslMonroe County Social Services (Monroe County In Home Service Program/Monroe
County Nutrition Program). ~
~-
Contract Manager: Deloris impson 4589 Social Services/Stop 1
(Name) (Ext.) (Department/Stop #)
For BOCC meeting on 12/20/2006
A enda Deadline:
12/5/2006
Total Dollar Value of Contract: $ -0-
Budgeted? Yes No X Account Codes:
Grant: $ -0-
County Match: $ -0-
Estimated Ongoing Costs: $
(Not included in dollar value above)
CONTRACT COSTS
Current Year Portion: $
/yr
ADDITIONAL COSTS
For:
(eg. Maintenance, utilities, janitorial, salaries, etc)
CONTRACT REVIEW
:::~~ y]~
Yes t;> --r=- Y C7~
Yes c9 ~~
Division Director
Date In
1\ \ "L/-d 0 to
t I-JJcU~
II I ~ I o~
II/slob
Risk Mana~ment
~'t
E'C \\~
O.:i\113./Purcl1asing
County Attomey
Comments:
Date? ut
1%'7/0
/J~))4
l\~
1#6
OMB Form Revised 2/27/01 MCP #2
01/2007
Agreement PE-729
ALLIANCE FOR AGING INC.
MASTER AGREEMENT
THIS MASTER AGREEMENT is entered into between the Alliance for Aging Inc., hereinafter referred to
as the "Alliance," and the Monroe County Board of Commissioners, hereinafter referred to as the
"recipient."
All agreements executed between the recipient and the Alliance shall be subject to the conditions set
forth in this agreement for the duration of the agreement period(s). Any and all agreements executed
between the recipient and the Alliance during the effective period of this agreement will incorporate this
agreement by reference and shall be governed in accordance with the laws, statutes, and other
conditions set forth in this agreement. This Master Agreement is subject to change in order to
incorporate pass-through language required by the Depar tment of Elder Affairs.
The parties agree:
I. Recipient Agrees:
A. 1. To provide services according to the conditions specified in any agreement(s) with the
Alliance during the period this agreement is in effect.
2. This agreement covers all services provided by the recipient under contract with the
Alliance.
3. To provide services in compliance with the provisions of the Department Home and
Community-Based Services Handbook.
B. State and Federal Laws and Regulations:
The recipient shall:
1. Comply with the cost principles, administrative requirements, and other provisions of all
applicable state and federal laws and regulations including: sections 215.97 and 216.348,
F.S., Title 45, Code of Federal Regulations (CFR), Part 74, and/or 45 CFR, Part 92, andlor
48 CFR Part 31, and Office of Management and Budget (OMB) Circulars A-21 , A-87, A-102,
A-110, A-122, and A-133, whichever is applicable to the reci pient's organization.
2. Comply with all applicable standards, orders, or regulations issued pursuant to the Clean
Air Act [42 United States Code (U.S.C.) 7401 et seq.], the U.S. Department of Labor,
Occupational Safety and Health Administration (OSHA) code, Title 29 CFR, Part
1910.1030, and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251 et
seq.). The recipient shall report any violations of the above to the Alliance.
3. Prior to execution of this agreement, complete the Certification Regarding Lobbying form,
ATTACHMENT I, and the Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion Contracts/Subcontracts form, ATTACHMENT II. If a Disclosure of
Lobbying Activities form, Standard Form LLL, is required, it may be obtained from the
Alliance's contract manager, and all disclosure forms as required by the Certification
Regarding Lobbying form must be completed and returned to the Alliance with the signed
agreement.
1
01/2007
Agreement PE-729
4. Comply with section 112.061, F. S., and any policies of the Department of Elder Affairs
regarding any and all business travel pursuant to agreements covered by this agreement
(including use of the State Comptroller approved Reimbursement of Travel Expenses form,
or an equivalent form developed by the recipient), and comply with the provisions of
Chapter 119, F.S., allowing public access to all documents, papers, letters, or other
materials made or received by the recipient in conjunction with this agreement and any
agreements incorporating this agreement by reference.
5. Abuse Neglect and Exploitation Reporting: In compliance with Chapter 415, F.S., an
employee of the recipient who knows, or has reasonable cause to suspect, that a child,
aged person or disabled adult is or has been abused, neglected, or exploited, shall
immediately report such knowledge or suspicion to the State of Florida's central abuse
registry and tracking system on the statewide toll-free telephone number (1-800-96ABUSE).
6. Transportation Disadvantaged: If clients are to be transported under any agreements
incorporating this agreement, comply with the provisions of Chapter 427, F.S., and Rule 41-
2, Florida Administrative Code (F. A. C.).
7. Use of Funds For Lobbying Prohibited: Comply with the provisions of section 216.347,
F.S., Title 48 CFR, Part 31.205, or Title 45 CFR, Part 93, whichever is applicable, that
prohibit the expenditures of funds for the purpose of lobbying the Legislature, a judicial
branch or a state agency.
8. Safeguarding Information: Except as provided for auditing and monitoring purposes, not
to use or disclose any information concerning a consumer who receives services under
agreements incorporating this agreement by reference or subsequent agreements for any
purpose not in conformity with state and federal regulations, except upon written consent of
the consumer, or the consumer's authorized representative.
9. HIPAA Compliance: Comply with all requirements of the Health Insurance Portability Act
(HIPAA) of 1996, as applicable. The Alliance and the recipient recognize that each may be
a "Business Associate" of the other under the terms of HIPAA. As such and to the extent
said terms may be applicable, each agrees to the terms as written in ATTACHMENT VII.
10. Grievance and Appeal Procedures: Follow the Minimum Guidelines for Recipient
Grievance Procedures, ATTACHMENT V, for handling complaints from consumers who
complain service has been suspended, terminated or reduced. Recipients and
subrecipients will also establish their own complaint procedures for consumers who are
dissatisfied with or denied services that include, at minimum, notice of the right to complain
and to have their complaint reviewed.
It is expressly understood that substantial evidence of the recipient's refusal to comply with any
of the above provisions shall constitute a breach of this agreement.
2
01/2007
C. Civil Rights Certification:
Agreement PE-729
1. The recipient gives this assurance in consideration of and for the purpose of obtaining
federal grants, loans, contracts (except contracts of insurance or guaranty), property,
discounts, or other federal financial assistance to programs or activities receiving or
benefiting from federal financial assistance. The recipient shall comply with all federal,
state and local regulations, statutes and ordinances relating to nondiscrimination in
programs or activities receiving or benefiting from state, federal, or local financial
assistance, whichever apply. These include, but are not limited to: (a) Executive Order
11246, "Equal Employment Opportunity," as amended by E.O. 11375, "Amending
Executive Order 11246 Relating to Equal Employment Opportunity," and as supplemented
by regulations at Title 41 CFR, Part 60; (b) Title VI of the Civil Rights Act of 1964, as
amended, 42 U.S.C. 2000d et seq., which prohibits discrimination on the basis of race,
color, or national origin (c) Title IX of the Education Amendments of 1972, as amended, 20
U.S.C. 1681-1683, and 1685-1686 et seq., which prohibits discrimination on the basis of
sex in education programs; (d) Section 504 of the Rehabilitation Act of 1973, as amended,
29 U.S.C. 794, which prohibits discrimination on the basis of handicaps; (e) The Age
Discrimination Act of 1975, as amended, 42 U.S.C. 6101 et seq., which prohibits
discrimination on the basis of age and with any and all other applicable regulations,
guidelines, and standards as are now or may be lawfully adopted pursuant to the above
statutes or which may apply to agreements covered by this agreement.
2. The recipient agrees to complete the Civil Rights Compliance Questionnaire (DOEA forms
101 A and B), if services are provided to consumers and if fifteen (15) or more persons are
employed. For recipients employing less than 15 persons, the Alliance requests
completion of the Civil Rights Compliance Questionnaire.
3. The recipient shall establish procedures to handle complaints of discrimination involving
services or benefits through this agreement. These procedures shall include advising
clients, employees, and participants of the right to file a complaint, their right to appeal a
denial or exclusion from the services or benefits, and their right to a fair hearing as a result
of their complaint of discrimination. Complaints of discrimination involving services or
benefits through this agreement and may also be filed with the Secretary of the
Department of Elder Affairs or the appropriate federal or state agency.
4. The recipient agrees that compliance with these assurances are a condition of continued
receipt of or benefit from federal financial assistance, and that it is binding upon the
recipient, its successors, transferees, and assignees for the period during which such
assistance is provided. The recipient further assures that all subrecipients, 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 recipient understands that the Alliance
and/or Department of Elder Affairs may, at their discretion, seek a court order requiring
compliance with the terms of this assurance or seek other appropriate judicial or
administrative relief, including but not limited to, termination of and denial of further
assistance.
3
01/2007
Agreement PE-729
D. Payment Requirements
For all agreements covered by this agreement, the recipient agrees:
1. To submit bills for fees or other compensation for services or expenses in sufficient detail for
a proper pre audit and post audit thereof. The recipient shall comply with only the particular
requirements under the following laws and guidelines that are applicable to the agreements
covered under this agreement: (a) paragraph (16) (b) of section 216.181, F. S., regarding
advances; (b) paragraph 691-40.103 F.A.C. pertaining to Restriction of Expenditures from
state funds; and, (c) the Contract Payment Requirements sub-section of section C of the
Reference Guide for State Expenditures from the Department of Financial Services
http://www.dbf.state.fJ.us/aadir/reference_gUide/). The recipient certifies that detailed
documentation is available to support each item on the itemized invoice or payment request
for cost reimbursed expenses, including paid subcontractor invoices, and will be produced
upon request by the Alliance. The recipient further certifies that reimbursement requested is
only for allowable expenses as defined in the laws and guiding circulars cited in Section I,
paragraph B. 1 of this agreement, in the Reference Guide for State Expenditures, and any
other laws or regulations, as applicable, and that administrative expenses do not exceed
amounts budgeted in the recipient's approved service application.
2. Recipients and sub-recipients shall provide units of deliverables, including reports, findings, and
drafts as specified in the agreements and agreement attachments covered by this agreement, and
the service provider applications developed by the recipient (pursuant to section 306(a) of the Older
Americans Act), to be received and accepted by the contract manager prior to payment.
E. Withholdings and Other Benefits:
The recipient is responsible for Social Security and Income Tax withholdings.
F. Indemnification:
If the recipient is a state or local governmental entity, pursuant to section 768.28( 18) F.S., the
provisions of this section do not apply.
1. Recipient and all subrecipients agree to indemnify, defend, and hold harmless the
Department of Elder Affairs and the Alliance and their officers, agents, and employees from
any claim, loss, damage, cost, charge, or expense arising out of any acts, actions, neglect
or omission, action in bad faith, or violation of federal or state law by the recipient, its
agents, employees, or subrecipients during the performance of all agreements incorporating
this agreement by reference, whether direct or indirect, and whether to any person or
property to which the Department, the Alliance or said parties may be subject, except
neither recipient nor any of its subrecipients will be liable under this section for damages
arising out of injury or damage to persons or property directly caused or resulting from the
sole negligence of the Department, the Alliance or any of its officers, agents, or employees.
2. Recipient's obligation to indemnify, defend, and pay for the defense or, at the Department's
and lor the Alliance's option, to participate and associate with the Department and lor the
Alliance in the defense and trial of any claim and any related settlement negotiations, shall
be triggered by the Department's and I or Alliance's notice of claim for indemnification to
recipient. Recipient's inability to evaluate liability or its evaluation of liability shall not excuse
4
01/2007 Agreement PE-729
recipient's duty to defend and indemnify the Department and or the Alliance, upon notice by
the Department and I or the Alliance. Notice shall be given by registered or certified mail,
return receipt requested. Only an adjudication or judgment after the highest appeal is
exhausted specifically finding the Department and I or the Alliance solely negligent shall
excuse performance of this provision by recipients. Recipient shall pay all costs and fees
related to this obligation and its enforcement by the Department and / or the Alliance. The
Department's and I or the Alliance failure to notify the recipient or subrecipient of a claim
shall not release recipient of the above duty to defend.
3. It is the intent and understanding of the parties that the recipient, nor any of its
subrecipients, are employees either of the Department or the Alliance and shall not hold
themselves out as employees or agents of either agency without specific authorization from
them. It is the further intent and understanding of the parties that neither the Department
nor the Alliance control the employment practices of the recipient and shall not be liable for
any wage and hour, employment discrimination, or other labor and employment claims
against the recipient, or its subrecipient.
G. Insurance and Bonding:
1. To provide adequate liability insurance coverage on a comprehensive basis and to hold
such liability insurance at all times during the effective periOd of any and all agreements
incorporating this agreement by reference. The recipient accepts full responsibility for
identifying and determining the type(s) and extent of liability insurance necessary to provide
reasonable financial protections for the recipient and the clients to be served under
contracts incorporating this agreement by reference. Upon execution of each contract
covered under this agreement, the recipient shall furnish the Alliance written verification
supporting both the determination and existence of such insurance coverage. Such
coverage may be provided by a self-insurance program established and operating under
the laws of the State of Florida. The Department of Elder Affairs and the Alliance reserve
the right to require additi onal insurance where appropriate.
2. To furnish an insurance bond from a responsible commercial insurance company covering
all officers, directors, employees and agents of the recipient authorized to handle funds
received or disbursed under all agreements incorporating this agreement 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.
3. If the recipient is a state agency or subdivision as defined by section 768.28, F.S., the
recipient shall furnish, upon request, written verification of liability protection in accordance
with section 768.28, F.S. Nothing herein shall be construed to extend any party's liability
beyond that provided in section 768.28, F.S. (See also Indemnification clause.)
H. Purchasing:
1. Procurement of Products or Materials with Recycled Content
Any products or materials which are subject of, or are required to carry out any contracts under
this agreement shall be procured in accordance with the provisions of Section 403.7065 and
287.045, Florida Statutes.
5
01/2007
I. Sponsorship:
Agreement PE-729
1. Any nongovernmental organization which sponsors a program financed partially by state
funds or funds obtained from a state agency shall, in publicizing, advertising, or describing
the sponsorship of the program, state: "Sponsored by, the State of Florida, Department of
Elder Affairs and Alliance for Aging Inc." If the sponsorship reference is in written material,
the words "State of Florida, Department of Elder Affairs and the Alliance for Aging" shall
appear in the same size letters or type as the name of the organization (ref.: section 286.25,
F. S.). This shall include, but is not limited to, any correspondence or other writing,
publication or broadcast that refers to such program.
2. If the recipient is a governmental entity or political subdivision of the state, the Departm ent
and the Alliance request compliance with the conditions specified above.
3. The recipient shall not use the words "State of Florida, Department of Elder Affairs and the
Alliance for Aging, lnc" to indicate sponsorship of a program otherwise financed unless
specific authorization has been obtained by the Alliance prior to use.
J. Public Entity Crime - Applicable only to state agencies or political subdivisions of the
state:
Denial or revocation of the right to transact business with public entities.
In compliance with the legislature's intent to restrict the ability of persons convicted of public
entity crimes to transact business with the Department of Elder Affairs, or the Alliance, as the
pass through agent for the Department, pursuant to section 287.133, F.S.: is a condition of
receipt or benefit from state or federal funds and it is binding upon the recipient, its successors
and transferees during the period of this agreement. The recipient further assures that the
recipient, its officers, directors, senior management, partners, employees or agents have not
been convicted of any public entity crimes within the last 36 months. If the recipient or any of its
officers or directors is convicted of a public entity crime during the period of this agreement, the
recipient shall notify the Departm ent of Elder Affairs and the Alliance immediately. Non-
compliance with this statute shall constitute a breach of this agreement.
K. Employment:
If the recipient is a non-governmental organization, it is expressly understood and agreed the
recipient will not knowingly employ unauthorized alien workers. Such employment constitutes a
violation of the employment provisions as determined pursuant to the Immigration Nationality
Act (INA), Sec. 274A [8 U.S.C. s.1324a]. Violation of the employment provisions as determined
pursuant to section 274A shall be grounds for unilateral cancellation of any and all agreements
incorporating this agreement by reference.
L. Audits and Records:
The recipient agrees:
1. To maintain books, records, and documents (including electronic storage media) in
accordance with generally accepted accounting procedures and practices that suffiCiently
and properly reflect all revenues and expenditures of funds provided by the Alliance under
all contracts covered by this agreement. Recipient agrees to maintain records, including
paid invoices, payroll registers, travel vouchers, time sheets, etc., as supporting
6
01/2007 Agreement PE-729
documentation for service cost reports and for administrative expenses itemized for
reimbursement. This documentation will be made available upon request for monitoring and
auditing purposes.
2. To assure these records shall be subject at all reasonable times to inspection, review, audit,
copy, or removal from premises by state personnel and other personnel duly authorized by
the Alliance, the Department of Elder Affairs or by federal personnel, if applicable.
3. To maintain and file with the Alliance such progress, fiscal and inventory and other reports
as the Alliance may require within the period of this agreement. Such reporting
requirements must be reasonable given the scope and purpose of the agreements
incorporating this agreement by reference.
4. To submit management, program, and client identifiable data, as specified by the
Department of Elder Affairs and/or the Alliance. To record and submit program specific
data in accordance with Department of Elder Affairs Client Information Registration and
Tracking System (CIRTS) Policy Guidelines.
5. To provide a financial and compliance audit to the Alliance as specified in ATTACHMENT
III and to ensure all related party transactions are disclosed to the auditor.
6. To include these aforementioned audit and record keeping requirements, including
ATTACHMENT III, in all sub-agreements and assignments.
7. The recipient agrees to provide client information and statistical data for research and
evaluative purposes when requested by the Department of Elder Affairs and/or the Alliance.
8. To provide to the Alliance all fiscal information regarding services contracted pursuant to
this agreement using the application required by the Department of Elder Affairs.
M. Retention of Records:
1. To retain all client records, financial records, supporting documents, statistical records, and
any other documents (including electronic storage media) pertinent to each agreement
covered under this agreement for a period of at least five (5) years after termination of the
agreement(s), or if an audit has been initiated and audit findings have not been resolved at
the end of five (5) years, the records shall be retained at least until resolution of the audit
findings. These records may be subject to additional retention requirements set by Jaw.
2. Persons duly authorized by the Department of Elder Affairs, the Alliance or federal auditors,
pursuant to Title 45 CFR, Part 92.42(e), (1), and (2), shall have full access to and the right
to examine or duplicate any of said records and documents during said retention period or
as long as records are retained, whichever is later.
N. Monitoring and Incident Reporting:
1. The recipient will provide progress reports, including data reporting requirements as
specified by the Department of Elder Affairs to be used for monitoring progress or
performance of the contractual services as specified in the area plan submitted by the
Alliance to the Department as well as in the service application submitted by the recipient to
the Alliance. Following the norms set down by the Department of Elder Affairs, the Alliance
7
01/2007 Agreement PE-729
will establish performance standards for recipients with weights assigned to each standard.
Standards will be tracked monthly by Alliance staff through desk reviews of available fiscal,
CIRTS, and research production reports and any other system or process designated by
the Department. Examples of review criteria are surplus/deficit, independent audits, internal
controls, reimbursement requests, subrecipient monitoring, targeting, program eligibility,
outcome measures, service provision to clients designated as "high risk" by the Department
of Children & Families, Adult Protective Services program, data integrity, co-payments,
client satisfaction, correspondence, and client file reviews.
2. The Alliance will perform administrative and programmatic monitoring of the recipient to
ensure contractual compliance, fiscal accountability, programmatic performance, and
compliance with applicable state an d federal laws and regulations.
3. To permit persons duly authorized by the Department of Elder Affairs or the Alliance to
inspect any records, papers, documents, facilities, goods and services of the recipient
which are relevant to agreements incorporating this agreement by reference, or to the
mission and statutory authority of the Department of Elder Affairs or the Alliance, and to
interview any clients and employees of the recipient to be assured of satisfactory
performance of the terms and conditions of these agreement(s). Following such inspection
the Department of Elder Affairs or the Alliance will deliver to the recipient a list of its
concerns with regard to the manner in which said goods or services are being provided.
The recipient will rectify all noted deficiencies provided by the Department of Elder Affairs or
the Alliance within the time set forth, or provide either the Department of Elder Affairs or the
Alliance with a reasonable and acceptable justification for the recipient's failure to correct
the noted shortcomings. The Department of Elder Affairs or the Alliance shall determine
whether such failure is reasonable and acceptable. The recipient's failure to correct or
justify deficiencies within a reasonable time as specified by the Department of Elder Affairs
or the Alliance may result in either agency taking any of the actions identified in Section III.,
C., Enforcement, or deeming the recipient's failure to be a breach of this agreement.
4. Extraordinary Reporting: The recipient shall notify the contract manager for the Alliance
immediately, but no later than within 24 hours, from the recipient's awareness or discovery
of conditions that may materially affect the recipient's ability to perform, such as problems,
delays, or adverse conditions which may impair the recipient's ability to meet the objectives
of the agreements covered by this agreement. The notice shall include a brief summary of
the problem(s), a statement of the action taken or contemplated, time frames for
implementation, and any assi stance needed to resolve the situation. Examples of reportable
conditions may include:
· proposed consumer terminations
· recipient financial conce rns/difficulties
· non-payment or untimely payment reported by vendors
· service documentation problems
· agreement non-compliance
· service quality problems and consumer complaint trends
· HIPAA violations
The Alliance shall investigate allegations regarding falsification of client information, service
records, payment requests, and other rei ated information. Substantiated allegations sha II be
reported to the Department of Elder Affairs' contract manager.
8
01/2007 Agreement PE-729
In the event that a situation results in the cessation of services by a sub-recipient or vendor,
the recipient retains the responsibility for performance under agreements covered by this
agreement and must follow their own procedures to ensure that clients continue receiving
services without interruption, e. g. exercising their emergency procurement procedures,
temporary assumption of the direct provision of services, etc.
O. Assignments and Subcontracts:
1. Alliance's approval of the service application presented by the recipient shall constitute
Alliance's approval of the recipient sub agreements if the sub agreements follow the service
and funding information identified in the service application. No such approval by the
Alliance of any assignment or subcontract shall be deemed in any event or in any manner
to provide for the incurrence of any obligation of the Alliance in addition to the dollar amount
agreed upon in contracts covered by this agreement and the contracts incorporating it by
reference and to any conditions of approval the Alliance shall deem necessary.
2. For every transaction, the recipient must determine if the subcontractor is a vendor rather
than a subrecipient, as defined in OMS Circular A-133, subpart S, section .210, and in
section 215.97, F.S., and this determination must be documented in writing. When a
vendor relationship is identified, an agreement with all of the terms and conditions set forth
in this agreement is not required. However, a written agreement outlining the term of the
agreement, the goods being purchased or services to be performed, and conditions for
procurement, receipt and payment for goods and services. Compliance for vendors is
usually limited to these tasks unless the recipient chooses to pass down program
compliance to the vendor in the written agreement. The recipient is ultimately responsible
for assuring program compliance and performance, and any applicable conditions of this
agreement and the agreements covered by it.
P. Return of Funds:
1. To return to the Alliance any overpayments due to unearned funds or funds disallowed
pursuant to the terms of all agreements for which funds were disbursed to the recipient by
the Alliance.
a. The recipient shall return any overpayment to the Alliance within forty (40) calendar
days after either discovery by the recipient, or notification by the Alliance, of the
overpayment.
b. In the event the recipient or its independent auditor discovers an overpayment has been
made, the recipient shall repay said overpayment within forty (40) calendar days without
prior notification from the Alliance. In the event the Alliance first discovers an
overpayment has been made, the Alliance will notify the recipient by letter of such a
finding.
c. Overpayments due to unallowable or un-allocable expenses due to billing discrepancies
must be returned to the Alliance under the same terms and conditions as this section.
Information indicating recipient has been overpaid as a result of over-budgeting on the
unit cost methodology can be used by the Alliance to negotiate lower rates in
subsequent years. Continuous overpayment to recipients due to over budgeting may
result in a demand for repayment to the Alliance under the same terms and conditions
of this section. Repayment received by the Alliance shall be reported to the Department
9
01/2007
Agreement PE-729
of Elder Affairs and may be either re-allocated to other recipient(s) or returned to the
Department, at the Department's discretion.
Q. Data Integrity
Federal Grants Management require financial management systems for recipients of state and
federal funds to be capable of providing certain information, assuring accuracy and
accountability, in accord with prescribed reporting requirements. These reporting requirements
may require certain calculations or the provision of specified data to fully disclose the financial
results of each federally funded or state-sponsored program.
Accordingly, the recipient must, prior to execution of this agreement, complete the Data
Integrity Certification form. ATTACHMENT IV.
R. Conflict of Interest:
The recipient will maintain a written code of conduct governing the performance of its
employees, board members, management and sub-recipients, engaged in the award and
administration of contracts. No employee, officer or agent of the recipient or sub-recipient shall
participate in selection, or in the award or administration of a contract 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 of the
above, has a financial or other interest in the firm selected for award. The recipient or sub-
recipient's officers, employees or agents will neither solicit nor accept gratuities, favors or
anything of monetary value from contractors, potential contractors, or parties to sub-
agreements. The recipient's board members and management must disclose to the Alliance
any relationship which may be, or may be perceived to be, a conflict of interest within thirty (30)
days of an individual's original appointment or placement in that position, or if the individual is
serving as an incumbent, within thirty (30) days of the commencement of this agreement. The
recipient's employees and sub-recipients must make the same disclosures described above to
the recipient's board of directors. Compliance with this provision will be monitored.
S. Successors and Transferees:
Recipient must receive approval from the Alliance's contract manager prior to transferring or
assigning this agreement, or any agreements referencing this agreement, to another party or a
different organizational entity. Further, this agreement or any agreements referencing this
agreement are binding in their entirety on the recipient and its successors, assignees and
transferees.
II. The Alliance Agrees:
A. Payment:
Payments to vendors contracted by the Alliance shall be made in accord with the terms as
negotiated with the vendor(s).
10
01/2007
B. Vendor Ombudsman:
Agreement PE-729
Requests for Payment returned to a vendor or a recipient due to preparation errors will result in
a payment delay. Invoice payment requirements do not start until a properly completed invoice
and/or request for payment is provided to the department.
Recipients, subrecipients and vendors experiencing problems obtaining timely payment(s) from
the Alliance may contact the Department's contract manager at (850) 414-2000.
III. Agreement Term and Renewal
The recipient and the Alliance mutually agree:
A. Effective Date
1. This agreement shall begin on January 1. 2007 or on the date on which the agreement has
been signed by both parties, whichever is earlier, and shall end on December 31.2007.
2. All agreements executed between the Alliance and the recipient during the effective period of
this agreement shall reference this agreement by number, incorporating it therein, and shall be
governed by the conditions of this agreement and its successor( s) for the duration of the
contract period( s).
B. Enforcement:
1. The Alliance may take corrective action, including but not limited to termination,
unannounced special monitoring, temporary assumption of the operation of one or more
programs, placement of the recipient on probationary status, imposing a moratorium on
recipient action, or other administrative action if it finds that:
· an intentional or negligent act of the recipient has materially affected the health, welfare,
or safety of consumers served pursuant to this agreement, or substantially and
negatively affected the 0 peration of services covered under this agreement.
· the recipient lacks financial stability sufficient to meet contractual obligations or that
contractual funds have been misappropriated.
· the recipient has committed multiple or repeated violations of legal and regulatory
standards
· the recipient has failed to continue the provision or expansion of services after the
declaration of a state of emergency.
· the recipient has failed to adhere to the terms of this agreement or the terms of any
agreement(s) covered by this agreement and incorporating it by reference.
2. 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 claim for breach of this
agreement is exempt from administrative proceedings and shall be brought before the
appropriate entity in the venue of Mi ami Dade County. Before the Alliance formally rescinds
the designation of the recipient or initiates any intermediate measure, or either party
11
01/2007 Agreement PE-729
commences equitable or legal action of any sort, both parties agree to engage in informal
mediation through a meeting of each party's representative at a place and location
designated by the Alliance.
C. Termination:
1. Termination for Convenience
This agreement and any other agreements incorporating it by reference may be terminated
by either party upon no less than sixty (60) calendar days notice, without cause, unless a
lesser time is mutually agreed upon by both parties, in writing. Said notice shall be
delivered by certified mail, return receipt requested, or in person with proof of delivery. In
the event the recipient terminates an agreement at will, the recipient agrees to submit, at
the time it serves notice of the intent to terminate, a plan which identifies procedures to
ensure services for consumers pursuant to this agreement or any sub-agreement will not be
interrupted or suspended by the termination. In the event that an agreement between the
recipient and a sub-recipient is terminated, the recipient shall require the sub-recipient to
submit to the recipient and the Alliance, a similar plan ensuring services to consumers will
not be interrupted or suspended by the termination.
2. Termination Because of Lack of Funds
In the event funds to finance any agreement(s) under this agreement become unavailable,
the Alliance may terminate the affected agreement or agreements upon no less than
twenty-four (24) hours notice in writing to the recipient. Said notice shall be delivered by
certified mail, return receipt requested, or in person with proof of delivery. The Alliance
shall be the final authori ty as to the avail ability of funds.
3. Termination for Breach
Unless the breach is waived in writing by the Alliance, or if the recipient fails to cure the
breach within the time specified, the Alliance may, by written notice to the recipient,
terminate any and all of the agreement(s) incorporating this agreement by reference upon
no less than twenty-four (24) hours notice. Said notice shall be delivered by certified mail,
return receipt requested, or in person with proof of delivery. Waiver of breach of any
provisions of anyone contract covered by this agreement shall not be deemed to be a
waiver of any other breach and shall not be construed to be a modification of the terms of
other agreements covered under this agreement. The provisions herein do not limit the
Alliance's right to remedies at law or to damages of a legal or equitable nature.
D. Notice and Contact:
1. The name, address and telephone number of the Alliance's contact for this agreement are:
Pedro Jove
President/CE 0
9500 South Dadeland Boulevar d, Suite 400
Miami, FL 33156
Phone: (305) 670-6500, SC 455-6500
12
01/2007 Agreement PE-729
2. The name, address and telephone number of the recipient's contact for this agreement are:
Monroe County Board of Commissioners
Gato Building
1100 Simonton Street
Key West, FL 33040
Phone: (305) 292-4573 - Fax (305) 292-4517
3. The name of the contact person, street address and telephone number where financial and
administrative records are maintained are:
Debbie Barsell
Director of Community and Social Services
Gato Building
1100 Simonton Street
Key West, FL 33040
Phone: (305) 292-4573 - Fax (305) 292-4517
E. Renegotiation or Modification:
1. Modifications of provisions of this agreement and of any and all agreement(s) incorporating
this agreement by reference shall only be valid when they have been reduced to writing and
duly signed by both parties. The parties agree to renegotiate this agreement and any
affected agreements if revisions of any applicable laws or regulations make changes in this
agreement necessary.
2. The rate of payment and the total dollar amount may be adjusted retroactively for any
agreement(s) incorporating this Master Agreement by reference only when these have been
established through the appropriations process, or identified in the federal program.
IV. The Recipient Agrees to the following special provisions:
A. Property & Equipment
1. Equipment means: (a) an article of nonexpendable, tangible personal property having a
useful life of more than one year and an acquisition cost which equals or exceeds the lesser
of (a) the capitalization level established by the organization for the financial statement
purposes, or $5000 [for federal funds], or (b) nonexpendable, tangible personal property of
a non-consumable nature with an acquisition cost of $1000 or more per unit, and expected
useful life of at least one year; and hardback bound books not circulated to students or the
general public, with a value or cost of $250 or more [for state funds].
2. Recipients and sub-recipients who are Institutions of Higher Education, Hospitals, and
Other Non-Profit Organizations shall have written property management standards in
compliance with OMB Circular A-110 that include: (a) a property list with all the elements
identified in the circular; and, (b) A procedure for conducting a physical inventory of
equipment at least once every two years. The property records must be maintained on file
and shall be provided to the Alliance upon request.
3. Equipment purchased with federal funds with an acquisition cost over $5,000 and
equipment purchased with state funds with an acquisition cost over $1,000 that is
13
01/2007 Agreement PE-729
specifically identified in the recipient's service application approved by the Alliance is part of
the cost of carrying out the activities and functions of the grant awards and Title (ownership)
will vest in the recipient, subject to the conditions of OMS Circular A-110, Subpart C,
paragraph .34. Equipment purchased under these thresholds is considered supplies and is
not subject to property standards. Equipment purchased with funds identified in the budget
attachments to agreements covered by this agreement, or identified in agreements with
recipients (not included in a cost methodology), is subject to the conditions of section 273,
F. S. and 60A-1.0017, F. A. C. or Title 45 CFR part 74.
4. Real property means land (including land improvements), buildings, structures and
appurtenances thereto, but excludes movable machinery and equipment. Real property
may not be purchased with state or federal funds through agreements covered under this
agreement without the prior approval of the Alliance. Real property purchases from Older
Americans Act funds are subject to the provisions of Title 42, Chapter 35, Subchapter III,
Part A., and Sec. 3030b United States Code (USC). Real property purchases from state
funds can only be made through a fixed capital outlay grants and aids appropriation and
therefore are subject to the provisions of section 216.348, F. S.
5. Any permanent storage devices (e.g.: hard drives, removable storage media) must be
reformatted and tested prior to disposal to ensure no confide ntial information remains.
6. A budget amendment is required to be submitted and approved by the Alliance's contract
manager prior to the purchase of any item of nonexpendable property not specifically listed
in the approved budget.
7. Information Technology Resources
The recipient must adhere to the Department of Elder Affairs' procedures and standards
when purchasing Information Technology Resources (ITR) as part of any agreement(s)
incorporating this agreement by reference. An ITR worksheet is required for any computer
related item costing $1,000.00 or more, including data processing hardware, software,
services, supplies, maintenance, training, personnel and facilities. The completed ITR
worksheet shall be maintained in the Alliance for Aging's LAN administrator's file. The
Alliance has the responsibility to require any recipient to comply with the Department of
Elder Affairs ITR procedures.
B. Copyright Clause
The recipient may copyright any work that is subject to copyright and was developed, or for
which ownership was purchased, under any agreement(s) incorporating this agreement by
reference. The Department of Elder Affairs reserves a royalty-free, nonexclusive and
irrevocable right to reproduce, publish, or otherwise use the work for state and federal
purposes, and to authorize others to do so. Other rights of the Department and recipient are
described in Title 45 CFR, sec. 74.36, and section 286.021, F.S.
C. Investigation of Criminal Allegations
Any report that implies criminal intent on the part of this recipient or any subrecipient and
referred to a governmental or investigatory agency must be sent to the Department of Elder
Affairs via the Alliance. 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
14
01/2007 Agreement PE-729
governmental agency, the Alliance shall notify the Inspector General at the Department of Elder
Affairs immediately. A copy of all documents, reports, notes or other written material concerning
the investigation, whether in the possession of the Alliance or the recipient, must be sent to the
Department of Elder Affair's Inspector General with a summary of the investigation and
allegations.
D. Disaster
In preparation for the threat of an emergency event as defined in the State of Florida
Comprehensive Emergency Management Plan, the Department of Elder Affairs may exercise
authority over an area agency or service provider agency to implement preparedness activities
to improve the safety of the elderly in the threatened area and to secure area agency and
service provider facilities to minimize the potential impact of the event. These actions will be
within the existing roles and responsibilities of the area agency and its s ubrecipient.
In the event the President of the United States or Governor of the State of Florida declares a
disaster or state of emergency, the Department of Elder Affairs may exercise authority over an
area agency or service provider agency to implement emergency relief measures and/or
activities.
In either of these cases, only the Secretary, Deputy Secretary or his/her designee of the
Department of Elder Affairs shall have such authority to order the implementation of such
measures. All actions directed by the department under this section shall be for the purpose of
ensuring the health, safety and welfare of the elderly in the potential or actual disaster area.
E. Volunteers
The recipient will promote the use of volunteers as prescribed in section 306(a) (12), Older
Americans Act and section 430.07, F.S.
F. Business Hours
Recipients who are lead agencies, as defined in section 430.203(9), F.S. or who provide elder
helpline services pursuant to this agreement must also maintain minimum business hours from
8:00 AM until 5:00 PM, Monday through Friday, excluding national and state holidays.
G. Management Information Systems
For all program agreements incorporating this agreement by reference for which the collection
of client data in electronic format (CIRTS, for example) is required:
1. The Alliance shall employ a Local Area Network (LAN) Administrator who shall assure the
Alliance's compliance with the requirements of the "LAN Administrator Guidelines" adopted
by the Department. These "Guidelines" delineate the roles and responsibilities of the Local
Area Network Administrator. The Alliance shall assure any other support necessary for full
"LAN Administrator Guidelines" compliance, including reporting to the department the
operational status of their LAN and Wide Area Network (WAN) in accord with the frequency
and format directed in these "Guidelines".
2. The Alliance will ensure the collection and maintenance of consumer and service
information on a monthly basis from the Client Information Registration and Tracking
15
01/2007 Agreement PE-729
System (CIRTS) or any such system designated by the department. Maintenance includes
valid exports and backups of all data and systems according to department standards.
3. The recipient must enter all required data per the Department's CIRTS Policy Guidelines for
consumers and services in the CIRTS database. The data must be entered into the CIRT S
before the recipient submits their request for payment and expenditure reports to the
Alliance. The Alliance shall establish time frames to assure compliance with due dates for
the requests for payment and expenditu re reports to the Department.
4. The recipient will run monthly CIRTS reports and verify consumer and service data in the
CIRTS is accurate. This report must be submitted to the Alliance with the monthly request
for payment and expenditure report and must be reviewed by the Alliance before the
recipient's request for payment and expenditure reports can be approved by the Alliance.
5. Failure to ensure the collection and maintenance of the CIRTS data may result in the
Alliance enacting the "Enforcement" clause of this agreement (see Section III, C.), including
delaying or withholding payment until the problem is corrected.
6. Computer System Backup and Recovery
Each recipient, among other requirements, must anticipate and prepare for the loss of
information processing capabilities. The routine backing up of data and software is required
to recover from losses or outages of the computer system. Data and software essential to
the continued operation of recipient functions must be backed up. The security controls
over the backup resources shall be as stringent as the protection required of the primary
resources. It is recommended that a copy of the backed up data be stored in a secure,
offsite location. The recipient shall maintain written poliCies and procedures for computer
backup and recovery. These policies and procedures shall be made available to the
Alliance upon request.
H. Consumer Outcomes
1. The Alliance will develop consumer outcome measures consistent with those developed by
the Department of Elder Affairs.
2. As required by the legislature for performance-based program budgeting, the Department of
Elder Affairs will set targets for the performance of outcome measures. The Alliance is
responsible for achieving these targets and will incorporate them into sub agreements as
necessary.
I. Surplus/Deficit Report:
The Alliance will submit a consolidated surplus/deficit report in a format provided by the
Department to the Department's contract manager by the 25th of each month. This report is for
all agreements between the Alliance and the Department.
The report will include the following:
1. A list of all subcontractors and their current status regarding surplus or deficit;
16
01/2007
2.
Agreement PE-729
The Alliance's detailed plan on how the surplus or deficit spending exceeding the threshold
specified by the Department will be resolved;
3. Recommendations to transfer funds to resolve surplus/deficit spending, and;
4. Input from the recipient's Board of Directors on resolution of spending issues, if applicable.
17
01/2007
Agreement PE-729
IN WITNESS THEREOF, the parties hereto have caused this 39-page agreement to be executed by
their undersigned officials as duly authorized.
RECIPIENT:
ALLIANCE FOR AGIN G, INC.,
BOARD PRESIDENT OR
AUTHORIZED DESIGNEE
SIGNED
BY:
SIGNED
BY:
NAME:
NAME: PEDRO JOVE
TITLE:
TITLE: PRESIDENT/CEO
DATE:
DATE:
FEDERAL ID NUMBER: 59-6000749
RECIPIENT'S FISCAL YEAR ENDING DATE: 06/30
(Revised February 2004)
18
01/2007
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENT
Agreement PE-729
ATTACHMENT I
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,
to any person for influencing or attempting to influence an officer or employee of any state or
federal agency, a member of congress, an officer or employee of congress, an employee of a
member of congress, or an officer or employee of the state legislator, in connection with the
awarding of any federal grant, the making of any federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any federal
contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a member of
congress, an officer or employee of congress, or an employee of a member of congress in
connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall
complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance
with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under
grants, loans and cooperative agreements) and that all sub-recipients shall certify and disclose
accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file
the required certifi tion shall be subject to a civil penalty of not less than $10,000 and not more than
$100,000 for uch failure.
/10~-b
Date /
Deloris Simpson
Name of Authorized Individual
Application or Contract Number:
PE-729
Name and Address of Organization:
Monroe County Board
GATO Building
1100 Simonton Street
Key West, FL 33040
of Commissioners
DOEA Form 103
(Revised Nov 2002)
19
01/2007
Agreement PE-729
ATTACHMENT II
INSTRUCTIONS
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION CONTRACTS/SUBCONTRACTS
1. Each recipient of federal financial and non-financial assistance that equals or exceeds $100,000
in federal monies must sign this debarment certification prior to contract execution. Independent
auditors who audit federal programs regardless of the dollar amount are required to sign a
debarment certification form. Neither the Department of Elder Affairs nor its contract recipients
can contract with subrecipients if they are debarred or suspended by the federal government.
2. This certification is a material representation of fact upon which reliance is placed when this
agreement is entered into. If it is later determined that the signed knowingly rendered an
erroneous certification, the Federal Government may pursue available remedies, including
suspension and/or debarment.
3. The recipient shall provide immediate written notice to the contract manager at the Alliance any
time the recipient learns that its certification was erroneous when submitted or has become
erroneous by reason of changed circ umstances.
4. The terms "debarred," "suspended," "ineligible," "person," "principal," and "voluntarily excluded,"
as used in this certification, have the meanings set out in the Definitions and Coverage sections
of rules implementing Executive Order 12549 and 45 CFR (Code of Federal Regulations), Part
76. You may contact the contract manager for assistance in obtaining a copy of those
regulations.
5. The recipient further agrees by submitting this certification that, it shall not knowingly enter into
any subcontract with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this contract unless authorized by the Federal Government.
6. The recipient further agrees by submitting this certification that it will require each subrecipient of
agreements referencing this agreement whose payment will equal or exceed $100,000 in federal
monies, to submit a signed copy of this certification with each sub agreement.
7. The Department of Elder Affairs may rely upon a certification by a recipientlsubrecipient entity
that it is not debarred, suspended, ineligible, or voluntarily excluded from
contractinglsubcontracting unless the Department knows that the certification is erroneous.
8. The Alliance may rely upon a certification by a subrecipient entity that it is not debarred,
suspended, ineligible, or voluntarily excluded from contracting/subcontracting unless the Alliance
knows that the certification is erroneous.
9. The signed certifications of all subrecipients shall be kept on file with the Alliance.
DOEA FORM 112A
(Revised February 2004)
20
01/2007
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION CONTRACTS/SUBCONTRACTS
Agreement PE-729
This certification is required by the regulation implementing Executive Order 12549, Debarment and
Suspension, signed February 18, 1986. The guidelines were published in the May 29, 1987 Federal
Register (52 Fed. Reg., pages 20360-20369).
(1) The prospective recipient certifies, by signing this certification, that neither he nor his principals is
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from participation in contracting with the Department of Elder Affairs (or the Alliance for
Aging acting as its agent) by any federal department or agency.
(2) Where the prospective recipient is unable to certify to any of the statements in this certification,
such prospective recipient shall attach an explanation to this certification.
Signature: ~ A
Date: /0~/dt
Name and Title of Authorized Individual (Print or type):
Deloris Simpson
Senior Administrator
...
Name of Organization:
Monroe County Board of Commissioners
DOEA FORM 1128
(Revised April 2001)
21
01/2007
Agreement PE-729
ATTACHMENT III
Audit Attachment
The administration of funds awarded by the Department of Elder Affairs to the Alliance and to any
subrecipient, through agreements with the Alliance, may be subject to audits andlor monitoring by the
Department and other authorized state personnel or federal personnel as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMS Circular A-133 and section 215.97,
F.S., as revised (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-
site visits by department staff, limited scope audits as defined by OMS Circular A-133, as revised,
andlor other procedures. Sy entering into this agreement, the recipient agrees to comply and cooperate
with any monitoring procedureslprocesses deemed appropriate by the department. In the event the
department determines that a limited scope audit of the recipient is appropriate, the recipient agrees to
comply with any additional instructions provided by the Department to the recipient regarding such
audit. The recipient further agrees to comply and cooperate with any inspections, reviews,
investigations, or audits deemed necessary by the Comptroller, Auditor General or federal personnel.
OTHER REQUIREMENTS
If the recipient is a non-profit organization, the Oath of Not for Profit Status form (EXHISIT 2 of this
attachment) must be completed and returned to the Alliance with the signed contract.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the recipient or subrecipient is a State or local government or a non-profit
organization as defined in OMS Circular A-133, as revised.
1. In the event that the recipient expends $300,000 ($500,000 for fiscal years ending after December
31, 2003) or more in Federal awards in its fiscal year, the recipient must have a single or program-
specific audit conducted in accordance with the provisions of OMS Circular A-133, as revised.
Federal funds awarded through the Alliance by this agreement, if any, are indicated in section II. A.
of the contract(s) covered by this agreement. In determining the Federal awards expended in its
fiscal year, the recipient shall consider all sources of Federal awards, including Federal funds
received from or passed through the Alliance. The determination of amounts of Federal awards
expended should be in accordance with the guidelines established by OMS Circular A-133, as
revised. An audit of the recipient conducted by the Auditor General in accordance with the
provisions OMS Circular A-133, as revised, will meet the requirements of this part.
2. In connection with the audit requirements addressed in Part I, paragraph 1., the recipient shall fulfill
the requirements relative to auditee responsibilities as provided in Subpart C of OMS Circular A-
133, as revised.
3. If the recipient expends less than $300,000 ($500,000 for fiscal years ending after December 31,
2003) in Federal awards in its fiscal year, an audit conducted in accordance with the provisions of
OMS Circular A-133, as revised, is not required. In the event that the recipient expends less than
$300,000 ($500,000 for fiscal years ending after December 31, 2003) in Federal awards in its fiscal
22
01/2007 Agreement PE-729
year and elects to have an audit conducted in accordance with the provisions of OMS Circular A-
133, as revised, the cost of the audit must be paid from non-Federal funds (Le., the cost of such an
audit must be paid from recipient resources obtained from other than Federal entities).
4. Information regarding audit requirements contained in OMS Circular A-133 and section 215.97,
F.S., can be obtained from the following web-sites:
http://www . whitehouse.oov/omb/circulars/
and:
http://www.leO.state.f1.us/
PART II: STATE FUNDED
This part is applicable if the recipient is a non-s tate entity as defined by section 215.97 , F .S.
1. In the event that the recipient expends a total amount of State awards (Le., State financial
assistance provided to the recipient to carry out a State project) equal to or in excess of $300,000
in any fiscal year of such recipient, the recipient must have a State single or project-specific audit
for such fiscal year in accordance with section 215.97, F.S.; applicable rules of the Executive Office
of the Governor and the Comptroller, and Chapter 10.600, Rules of the Auditor General. State
grants and aids amounts awarded through the Alliance by this agreement are indicated in section
II. A. of the contract(s) of which this agreement is an attachment. In determining the State awards
expended in its fiscal year, the recipient shall consider all sources of State awards, including State
funds received from the Department of Elder Affairs through the Alliance for Aging, other state
agencies, and other non-state entities except that State awards received by a non-state entity for
Federal program matching requirements shall be excluded from consideration.
2. In connection with the audit requirements addressed in Part 1/, paragraph 2, the recipient shall
ensure that the audit complies with the requirements of section 215.97, F.S. This includes
submission of a reporting package as defined by section 215.97, F.S., and Chapter 10.550 (local
governmental entities) or 10.650 (nonprofit and for-profit organizations) Rules of the Auditor
General, to include an auditor's examination attestation report, management assertion report
(alternatively, management's assertion may be included in the management representation letter),
and a schedule of State financial assistance.
The auditor's examination attestation report must indicate whether management's assertion as to
compliance with the following requirements is fairly stated, in all material respects: activities
allowed or unallowed; allowable costslcost principles; matching (if applicable), and; reporting.
3. If the recipient expends less than $300,000 in State awards in its fiscal year, an audit conducted in
accordance with the provisions of section 215.97, F.S., is not required. In the event that the
recipient expends less than $300,000 in State awards in its fiscal year and elects to have an audit
conducted in accordance with the provisions of section 215.97, F.S., the cost of the audit must be
paid from non-State funds (Le., the cost of such an audit must be paid from the recipient's
resources obtained from other than State entities).
23
01/2007
PART III: REPORT SUBMISSION
Agreement PE-729
1. Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as
revised, and required by PART I of this attachment shall be submitted, when required by section
.320 (d), OMB Circular A-133, as revised, by or on behalf of the recipient directly to each of the
following within 45 days of receipt of the report but no later than nine (9) months of recipient's fiscal
year end:
A. The Alliance for Aging, Inc., at the following address:
Attn: Carlos L. Martinez, CPA
Chief Financial Officer
9500 South Dadeland Boulevar d, Suite 400
Miami, FL 33156
B. The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number
of copies required by sections .320 (d) (1) and (2), OMB Circular A-133, as revised, should
be submitted to the Federal Audit Clearinghouse), at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville, IN 47132
C. Other Federal agencies and pass-through entities in accordance with sections .320 (e) and
(f), OMB Circular A-133, as revised.
2. The recipient shall submit a copy of the reporting package described in section .320 (c), OMB
Circular A-133, as revised, and any management letters issued by the auditor, to the Alliance at
the following address within 45 days of receipt of the report but no later than nine (9) months of
recipient's fiscal year end:
Affiance for Aging, Inc.
Attn: Carlos L. Martinez, CPA
Chief Financial Officer
9500 South Dadeland Boulevar d, Suite 400
Miami, FL 33156
3. Copies of audits and reporting packages required by PART 1/ of this attachment shall be submitted
by or on behalf of the recipient directly to each of the fOllowing within 45 days of receipt of the
report but no later than nine (9) months of recipient's fiscal year end:
A. The Affiance for Aging, Inc. at the fol/owing address:
Attn: Carlos L. Martinez, CPA
Chief Financial Officer
9500 South Dadeland Boulevard, Suite 400
Miami, FL 33156
24
01/2007
Agreement PE-729
B. The Auditor General's Office at the following address:
State of Florida Auditor General
Room 574, Claude Pepper Building
111 West Madison Street
Tallahassee, Florida 32302-1450
4. Any reports, management letters, or other information required to be submitted to the Alliance
pursuant to this attachment shall be submitted timely in accordance with OMB Circular A-133,
section 215.97 F.S., and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and
for-profit organizations), Rules of the Auditor General, as applicable and should indicate the date
that the reporting package was delivered to the recipient in correspondence accompanying the
package.
5. Recipients, when submitting the financial reporting packages to the Alliance, should indicate the
date that the audit report was delivered to the recipient in correspondence accompanying the audit
report.
PART IV: RECORD RETENTION
The recipient shall retain sufficient records demonstrating its compliance with the terms of this
attachment for a minimum period of five (5) years from the date the audit report is issued or longer
if requested by the Alliance in writing, and shall allow the Alliance, the Department of Elder Affairs
or its authorized designee and the Comptroller or Auditor General access to such records upon
request. The recipient shall ensure that audit working papers are made available to the Alliance,
the Department of Elder Affairs or its designee, and the Comptroller or Auditor General upon
request, for a minimum period of five (5) years from the date the audit report is issued, or may
need to be longer if requested in writing by any of these age ncies. Alliance.
PART V: SPECIFIC REQUIREMENTS OF DEPARTMENT ADMINISTERED PROGRAMS
1. The Department of Elder Affairs requires a supplemental schedule of functional expenses be
prepared in a format provided by the department, which presents costs by service (as defined by
the department), including units of service delivered, for recipients or subrecipients expending state
or federal awards for services performed by their employees, contractors, and other payees who
receive payment from department-administered funds for units of service recorded in the
department's Client Registration and Tracking System (CIRTS). This supplemental schedule shall
be prepared using the same methodology as used in determining the contractual rates.
Government entities are excluded from this requirement.
2. If an audit is not required or performed, the head of the recipient entity or organization must provide
a written attestation, under penalty of perjury, that the recipient has complied with the allowable
cost provisions (congruent with the Reference Guide for State Expenditures and OMB Circular A-
122 or A-87, whichever is applicable). EXHIBIT 1 to this attachment provides an example
attestation document that should be used by the agency head or authorized signatory for contracts
to attest to compliance with these provisions.
3. Interest earned on federal funds or general revenue funds must be returned to the Alliance. A chart
is included in all contracts identifying the funding source(s), program titles, applicable CFDA or
CSFA numbers and the amount of funds granted.
25
01/2007
Agreement PE-729
4. Specific requirements for match, co-payments, and program income applicable to programs
administered by the Department are outlined in the following applicability chart. Brief definitions of
terms used in the chart are included.
(Revised February 2004)
26
()')
N
,....
I
W
a..
.S: a x en
(/)-oQ)Q)
~ Q) C:.2
'- E ~ 2:
2:lU-Q)
Q)Q)c:(/)
(/) .- Q)
Q)(/)-(/)
(/)lUC:lU
.. lU....Q)Q)
5; ~mg.C3
E g >''0 .S:
>. .- 0 c: 0
cv OlUlU::
Q. -.l= '0 lU
1. 'Oc:....Q)
c'3 Q) 0 lU >.
(/)O~_
::JQ)0r3
Q)E""'(/)
.QlU-g1i:
......., (J)._ Q)
~Q)t::m
E5r3tj
Q) (/).S:
(/)lU-
lU .... c:
~lUQ)
OQ)Q,
tj c: >. (/)
Q) .- _ '0
.... 0 0 c:
G) Q)-lUlU
t= C '0 .l=
r;;; '- Q) c: E ....
o C:(/)OlUlU
o lU::JO~Q)
I-.s c: '0 Q) C >-
0:: t= .- c: E .E ro
c(:; 'OlUlU'OO
J:... Q)_(/)Q)(/)
o 51 ]i 5 Q) 'C: Ii:
>- 0 00=Ci;.$
..J!:: Q: 5r ~ c: 0 S
'0 lU '- .... (/)
(/)o~
iii Q) 0) Q) '0 ~
oct .0 'E .2 EQ) c:
o >-lU2:
- lUQ)Q)lUQ)
..J E.Q(/)Q)5
0.
0.
c(
,....
o
o
~
..-
o
...
c
Q)
E
Q)
~
0>
<(
.
.
.s:;
o
..
cv
:E
-Q)
C:..c:
Q)-
e ....
Q),2
0.
o~
..-lU
_e..>
!G~
Q)'-
_C:
_::J
lU E
..c:E
o 0
me..>
E=
_lUen
(/) .... Q)
::J 0 0
E"'" .-
-2:
(/) (/) Q)
-o(/)
~o>-
.- Q) 1::
. e....c: Q)
0--0
Q)'--
....ow
.
~~
'c: :: E
-E,2~e!
~E~~g>
OOlU_....
_ue..>wQ..
'0
Q)
Ii:
.- '0
t:c:
~:5f
.S:
~~
r3~
I
~:g
..c:
....-
Q) ....
..c:o
-
'Q) ai
....
Q)2
.0:0
>.c:
lU Q)
E~
Q)
..c:o
0=
m.g
Eo.
.
o
-
-0
Q)
(/)
::J
Q).$
.oc:
>.Q)
lU E
E~
(/) 'S
c:0"
o Q)
+::L....
::J..c:
.00
'C: -
_lU
gE
0-
lU
2:'0
lU..s!
--
c: Q)
::J Q)
oE
>
.
>.
1::'0
Q) 0
Q,'C:
e Q)
0.0.
Q)o
.Qe!
--
(/) c:
::J 0
E 0
'OQ)
Q)5
-go
Q)'O
Q,c:
>< Q)
Q) Q)
~5
c:_
,2lU
w-g
e..>..c:
u,8
lU
roE
.
'0
Q)
(/)
::J(/)
Q)tj
.00
_0
Oc:
E.Q
lU-
o e!
-
(/).~
'Oc:
5'E
.....'0
Q) lU
.~~
(/) ....
Q).E
......c:
8,8
WlU
e..>E
e..>!G
.
0'0
e!ffi
c'O
o l;; ....
o w lU
Q)~Q)
E.E~
lU '0 r3
(/) Q) (/)
'E Ii:
Q) r3 Q)
..c: _
- lU
....-
c: 0 (/)
:':ux
C:Q)Q)
Q)EC:
Q,lUQ)
(/)Q)=
Q) (/) c:
.Q lU'-
>-....c
lU lU Q)
E~g.
.
~
8 E
wQ)~~e!
oE-Q)g>
J:OaJ2....
_J:"",wQ..
.S: a x
Q) .
(/) '0 c: (/)
Q) Q) Q)
o E Q).2
.~ lU = ~
~ Q) .S: (/)
Q)(/)-Q)
(/) lU c: (/)
lU....Q)lU
Q)lUQ,~
.... Q) (/) 0
g >-'0 .S:
.- 0 c: 0
OlUlU-
.....1--0.....
,oc....lU
Q)OlUQ)
(/)O~>-
::JQ)Oro
Q)E""'~
.QlU'Ol;::
- (/).~ Q)
(/) ....-
EE B ~
.
g>~ax
'1:: 0.... Q)
lU'-'" c:
Q)2:~Q)
.oQ)......c:
_(/)lU_
(/)Q)Q)c:
~ (/) (/).-
Q)lUlU_
c~""C:
.- 0 lU Q)
c:1::Q)Q,
lU .- >- (/)
1::20'0
.- lU I::
'O'O....lU
.$~c ....
.- ::J 0 E lU
(/) 0 lU Q)
g,'OQ)~>-
~ffiE.E~
_ lU (/)
Q)I::(/)'Ol;::
.Q::JQ)Q)
>- 0 ..c: '1:: .$
lUo-....lU
E ~ .S: r3 tj
.
(/)
...
Q) Q) Q)
E (/) >
-'Q) lU +:;
- Q)lU
c..c:(/)+:;
c( ..!:::! '- 'c:
-<(0-
0)
I::
'1::
lU
..c:
(/)
-
(/)
o
o
....
.E
'0
Q)
(/)
::J
Q)
.Q
-
o
I::
I::
lU
o
.d
Ci;"g
~lU
OEm
~lUQ)
-~>.
C:C_
8.Er3
Q) Jg
E-gQ)
m'E m
Q}lUtj
=ox
I:: .... Q)
.- 0 I::
c'OQ)
~Q)=
(/) E I::
lU'-
~Q)c
>-(/)~
lU lU (/)
E
r--
N
.
(/)
Q) E
_ olu
0. -.- ....
cnr32:g>
.,JOQ)....
--'000..
t5 .~
0') <( LO
N en T-
I'- c: ('t) c:en
I ctlc:O
W .0 0 +:;
a. C:'-:::J
...... Q) t5 ..c
c: E Q)'C:
Q) <( en 'E
E ....0'0
Q)Q)00
Q)"'Oo ....
;;'-NQ)
~'O_ E
.s::::.o~
:t::enc:
;:-0
~ 0
~E.9
.- "'0 '0
is. c: ....
g~~
o<(~
.
~ .!!! '0- E
"'O:t::ffie
c: .s::::. a. ..-
Q)o><E
0..- Q)
>< .s::::. ctl
Q);:o\";'
_0>
Q) "~'O e
..c"'OQ)Q.
- .2 ~ Q)
en.... .c
:::JQ)Q)_
E o...c c:-C
- .- Q)
Q)~t)~~
E-EE:::JQ)
8 0 en ~
c:0'O....C)
.- Q) c: 0
E .s::::. ctl - .!!!
-"'O~:t::
~g>Q)0.c
C)._ c: ~ 0
o .... .... .......-
....:::JctlE.s::::.
Q."'O Q)._ ;:
.
....
S
.c
o
-
ctl
E
'0
Q)
en
:::J
Q)
..c
-
o
c:
c:
ctl.c
o 0
en-
c: ctl
.2 E
-....
,go
. I:: C)
'E "e
o ctl
O.s::::.
~en
St)
c: 0
:::J 0
- ....
g.E
.
;,RctlLOen
u,~,....:t::
co <( '0 0>
- Q)c:
LO c;; Q)'I::
o<(~2
T- Q)en
1 -'C
10 . 0'-
COQ)'c:E
en->.'O
.- S ctl <a
~enE_
:::JOenO
~~Q)-
t: LO .... en
.E :::JO
-:t:: 0
-00 ~ -g Q)
~~Q).c
0._
;,R~-
....oenOe
.E T- -""- _ <a
.....c:-
.s::::. _0Q)0.
o 'C:Octl
_'OQ)....Q)
ctl Q) <(0) Q) ....
E u.. Q. <a
....
S
'0
Q)
en
:::J
Q) u)
..cE
-~
gg>
c: ....
ctlo.
0_
ctl
~Q;
c:"'O
.2~
....
~~
00
.
.
en
c:
I'- ctl E
0- 0 ctl
<3; .....1:: ....
O<3;Q)Q) 0>
~OO"'OEt5e
~ _ <{<(o.
o
'0
Q)
r.;:::
"- '0
tc:
Q).-
O..ll::
,
- .~
~~
<a ctl
00.
>.'
..c:g
.s::::.
....-
Q) ....
.cO
-
'Q) ai
....
Q)E
..c:.c
c:
>.Q)
ctlo.
E ><
Q)
.s::::. .2
0-
_ ..c
ctl :::J
EO.
.
00
C"l
'#.
o
.....
.!!!
-
c:
Q)
E
Q)
.!:::
:::J
0"
~
.c
o
-
ctl
E
en
-
c:
Q)
'i5..
'(3
~
.0
:::J
CJ)
.
01/2007
APPLICABILITY CHART DEFINITIONS
Agreement PE-729
AAA. Area Agency on Aging
Program Income. Program income means gross income earned by a recipient from activities which
are supported by a grant; i.e., when at least some of the cost of the activity is a direct cost of the grant
or indirect cost which helps match requirements of the grant. Program income includes contributions for
meals or other supportive services, proceeds from the sale of tangible personal property purchased for
the program, fees for the usage or rental of such property, and patent or copyright royalties for
materials developed through the program. Revenue generated from a particular activity of the
recipient/sub-recipient for which Department funds were used to cover at least half the cost is
considered program income. Note: Money donated (cash donation) without earmark to the project by
the donor should not be declared in an audit to be "program income"
Cash Donations. Cash donations are money donated without earmark to the project by the donor.
These donations, when used as match, cannot be earmarked for any specific expenditure but are to be
budgeted normal/y. Cash donations are not program income.
Match. When general revenue funded contracts require match, it may be either by cash, certified public
expenditure, or third-party in-kind. The non-federal share used to match OAA funds may be cash,
certified public expenditure, or third-party in-kind.
Co-payments. Fees assessed and collected according to a sliding scale based on the consumer's
income for CCE and ADI services.
In-kind Resources. In-kind resources must be identified in project records, necessary to project's
achievement, reasonable and in proportion to time used for project, claimed after use in the project and,
not included as contributions for other programs unless specifically allowed.
In-kind Contributions
In-kind contributions represent a value placed on non-cash contributions provided to the recipient of a
contract. In-kind contributions may consist of actual charges for real property and equipment, and the
value of goods and services that directly benefit and are identified with project activities. This may
include staff time contributed by state and local agencies not otherwise matched or supported by
federal funds.
29
01/2007
MANAGEMENT ATTESTATION LETTER
(To be completed at the end of recipient's fiscal year)
Agreement PE-729
ATTACHMENT 11/
EXHIBIT - 1
Contract or Agreement Number:
I,
(recipient's authorized representative)
, hereby attest under penalty 0 f perjury
that
(recipient agency name)
, based on the criteria
set forth in the Audit Attachment, PARTS I and II, that:
A. The above named recipient agency is not required to provide an audit report or reporting package
because [check applicab/e statement( s)]:
D the above-named entity has not expended $300,000 ($500,000 for fiscal years ending after
December 31, 2003) or more in total federal awards in its fiscal year and therefore is not
required to have a single or program-specific audit performed in accordance with OMB Circular
A-133, as revised, and/or;
D the above-named entity has not expended a total amount equal to or in excess of $300,000 in
state awards in its fiscal year and therefore is not required to have a State single or program-
specific audit in accordance with section 215.97, Florida Statutes.
B. The recipient has complied with the allowable cost provisions [congruent with State and Federal
law, generally accepted accounting principles, the Department of Financial Services' Reference Guide
for State Expenditures, and Office of Management and Budget (OMB) Circular A-122, A-11 0, or A-a7,
whichever is applicable].
By making this statement the recipient has considered not only funding or awards from the Alliance,
but all sources of Federal and State funding or awards.
Fiscal year ended (Month/day/year):
(Signature)
(Title)
(Date)
30
01/2007
Agreement PE-729
ATTACHMENT 11/
Exhibit - 2
Oath of Not for Profit Status
Contract or Agreement Number: PA 427
As an authorized representative for the Recipient identified herein, and in the above referenced
profit) organization as defined in section 501 (c)(3) of the Internal Revenue Code. If this non-
document(s), I do hereby swear under oath that this entity is currently a "not for profit" (non-
profit status changes for any reason during the life of the above referenced contract or
agreement, the Alliance for Aging will be notified in writing immediately.
Name of Recipient entity: Monroe County Board of Commissioners
A----/
/"'"
Printed name and Title of Authorized Representative
II II") /0 C:-
Oati of ctath
Deloris Simpson
Senior Administrator
(Revised February 2004)
31
01/2007
Agreement PE-729
ATTACHMENT IV
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
FOR CONTRACTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS
The undersigned, an authorized representative of the recipient named in the contract or
agreement to which this form is an attachment, hereby certifies that:
(1) The recipient and any sub-recipients of services under this contract have financial
management systems capable of providing certain information, including: (1) accurate,
current, and complete disclosure of the financial results of each grant-funded project or
program in accordance with the prescribed reporting requirements; (2) the source and
application of funds for all contract supported activities; and (3) the comparison of outlays
with budgeted amounts for each award. The inability to process information in accordance
with these requirements could result in a return of grant funds that have not been accounted
for properly.
(2) Management Information Systems used by the recipient, sub-recipient(s), or any outside
entity on which the recipient is dependent for data that is to be reported, transmitted or
calculated, have been assessed and verified to be capable of processing data accurately,
including year-date dependent data. For those systems identified to be non-compliant,
recipient(s) will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or
imbedded chip technology, the undersigned warrants that these products are capable of
processing year-date dependent data accurately. All versions of these products offered by
the recipient (represented by the undersigned) and purchased by the State will be verified
for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and
internal subroutines that impede the hardware or software programs from operating
properly, the recipient agrees to immediately make required corrections to restore hardware
and software programs to the same level of functionality as warranted herein, at no charge
to the State, and without interruption to the ongoing business of the state, time being of the
essence.
(4) The recipient and any sub-recipient( s) of services under this contract warrant their policies
and procedures include a disaster plan to provide for service delivery to continue in case of
an emergency including emergencies arising from data integrity compliance issues.
The recipient shall require that the language of this certification be included in all subcontracts,
sub grants, and other agreements and that all sub-contractors shall certify compliance
accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction w s made or entered into. Submission of this certification is a prerequisite for
making or: n ring into thi ransaction imposed by OMS Circulars A-102 and A-110.
Senior Administrator
Title
I~/;?i~~
Name of Authorized Signer:
Deloris Simpson
(Revised March 2004)
32
01/2007
Agreement PE-729
ATTACHMENT V
MINIMUM GUIDELINES FOR RECIPIENT GRIEVANCE PROCEDURES
APPLICABLE TO ALL ADVERSE ACTIONS DEEMED TERMINATIONS, SUSPENSIONS, OR
REDUCTIONS IN SERVICE
Medicaid Waiver clients have the right to request a fair hearing from the Department of Children
and Families (DCAF) Office of Appeal Hearings in addition to or as an alternative to these
procedures.
NOTICE TO THE RECIPIENT OF THE ADVERSE ACTON TO BE TAKEN AND
EXPLANATION OF THE GRIEVANCE PROCEDURES FOR REVIEWING THAT DECISION
· The recipient must be informed by the decision maker of the action, in writing, no less than
10 calendar* days prior to the date the adverse action will be taken.
(Prior notice is not applicable where the health or safety of the individual is endangered if
action is not taken immediately; however, notice must be made as soon thereafter as
practicable. )
· Services cannot be reduced or terminated, nor any adverse action taken during the 10 day
period.
· The Notice must contain:
a statement of what action is intended to be taken;
the reasons for the intended action;
an explanation of:
1) the individual's right to a grievance review if requested in writing and delivered within 10
calendar* days of the Notice postmark (assistance in writing, submitting and delivering
the request must be offered and available to the individual) ;
2) in Medicaid Waiver actions, the individual's right to request a fair hearing from DCAF;
3) the individual's right, after a grievance review, for further appeal;
4) the right to seek redress through the courts if applicable;
a statement that current benefits will continue if a grievance review is requested, and will
continue until a final decision is made regarding the adverse action; and a statement
that the individual may represent himselflherself or use legal counsel, a relative, a friend,
or other qualified representative in the requested revi ew proceedings.
· All records of the above activities must be preserved in the client's file.
GRIEVANCE REVIEW PROCEDURE UPON TIMELY RECEIPT OF A WRITTEN REQUEST
FOR REVIEW
· Within 7 calendar* days of the receipt of a request for review, the provider must
acknowledge receipt of the request by a written statement delivered to the requester. This
statement must also provide notice of:
the time and place scheduled for the review;
the designation of one or more impartial reviewers who have not been involved in the
decision at issue;
the opportunity to examine, at a reasonable time before the review, the individual's own
case record, and to a copy of such case record at no cost to the individual;
the opportunity to informally present argument, evidence, or witnesses without undue
interference at a reasonable tim e before or during the review;
33
01/2007
Agreement PE-729
a contact person for any accommodations required under the Americans with Disabilities
Act; and assistance, if needed, in order to attend the review; and the stopping of the
intended action until all appeals are exhausted.
· All grievance reviews must be conducted at a reasonable time, date and place by one or
more impartial reviewers who have not been directly invoived in the initial determination of
the action in question.
· The reviewer( s) must provide written notification to the requester, within 7 calendar* days
after the grievance review, stating:
the decision, the reasons therefore in detail;
the effect the decision has on current benefits, if favorable, or the circumstances regarding
continuation of current benefits until all appeals are exhausted;
the individual's right to appeal an adverse decision to the Alliance for Aging by written
request within 7 calendar* days, except in decisions involving the professional judgment of a
legal assistance provider;
the availability of assistance in writing, submitting and delivering the appeal to the
appropriate agency;
the opportunity to be represented by himself/herself or by legal counsel, a relative, a friend
or other qualified representative;
for legal assistance service appeals, the individual's right to file a grievance with the Florida
Bar regarding complaints related to the actual legal representation provided.
PROCEDURE FOR APPEALS OF A GRIEVANCE REVIEW DECISION UPON TIMELY
RECEIPT OF A WRITTEN APPEAL TO THE ALLIANCE FOR AGING - AREA AGENCY ON
AGING
· Within 7 calendar* days of the receipt of a notice of appeal of a grievance review decision,
the AAA must acknowledge receipt of the notice of appeal by a written statement delivered
to the appellant. This statement must also provide notice of:
the time and place scheduled for the appeal;
the designation of one or more impartial AAA officials who have not been involved in the
decision at issue;
the opportunity to examine at a reasonable time before the appeal the individual's own case
record to date, and to a copy of such case record at no cost to the individual;
the opportunity to informally present argument, evidence, or witnesses without undue
interference during the appeal;
assistance, if needed, in order to attend the appeal;
and the stopping of the intended action until all appeals are exhausted.
· All appeals of grievance reviews must be conducted at a reasonable time, date and place by
one or more impartial AAA officials who have not been directly involved in the initial
determination of the action in question.
· The designated AAA official(s) must provide written notification to the requester within 7
calendar* days after considering the grievance review appeal, stating:
the decision, and the reasons ther efore in detail;
the effect the decision has on current benefits, if favorable, or the circumstances regarding
continuation of current benefits until all appeals are exhausted;
the individual's right to appeal, if applicable.
· Except for Medicaid Waiver actions, the decision of the AAA shall be the final decision;
34
01/2007
Agreement PE-729
and the availability of assistance in requesting a fair hearing, including a notice regarding
accommodations as required by the ADA.
· All records of the above activities must be preserved and remain confidential. A copy of the
final decision must be placed in the client's fi Ie.
* In computing any period of time prescribed or allowed by these guidelines, the last day of the
period so computed shall be included unless it is a Saturday, Sunday, or legal holiday, in which
event the period shall run until the end of the next day which is neither a Saturday, Sunday, or
legal holiday.
35
01/2007
Agreement PE-729
INDICATORS MEASUREMENT INTERMEDIATE
Section 430.04 (2), F.S. MEASURES Section 430.04
(2), F .5.
Lacks financial stability · Failure within the same . Temporary assumption of
sufficient to meet contractual fiscal year in which due to operations and functions
obligations or that contractual pay short-term loans related to the problem
funds have been · Failure to transfer at the area within the agency
misappropriated appropriate time, due to . Placement on
lack of funds probationary status for a
0 Taxes withheld on specified period sufficient
the income of to address identified
employees problems
0 Employer and . Impose a time limited
employee moratorium on agency
contributions for . Reduce any advances for
federal social security the following year to 30
or any pension, days and exam ine
retirement, or benefit surpluses for
plan for an employee redistribution.
· Failure for one pay period to
pay, due to lack of funds
0 Wages and salaries
owed to em ployees
0 Retirement benefits
owed to former
employees
· An unreserved or total fund
balance or retained
earnings deficit for which
sufficient resources are not
available to cover the deficit
for 2 successive years
An intentional or negligent act . Intentional or Repeated . Impose a time limited
of the agency has materially violations of the moratorium on agency
affected the health, welfare, requirement to serve APS . Temporary assumption of
or safety of clients, or clients within 72 hours operations and functions
substantially and neg atively . Any other verifiable report related to the problem
affected the operation of an of such actions area within the agency
aging services program
INTERMEDIATE MEASURES
ATTACHMENT VI
36
01/2007
Agreement PE-729
Committed multiple or . Achievement levels from . Unannounced spe cial
repeated violations of legal monitoring reviews monitoring
and regulatory requirements . Any other verifiable report . Reduction in advances for
or Department standards of such actions following year and review
of surpluses for
redistribution
. Appropriate Corrective
action
37
01/2007
Agreement PE-729
INDICA TORS MEASUREMENT INTERMEDIATE
Section 430.04 (2), F.S. MEASURES Section 430.04
(2), F .S.
Failed to adhere to terms of . Achievement levels from . Placement on probationary
its contract with the monitoring reviews status for a specified
Department as passed . Adherence to Service periOd to address identified
through the Alliance Application problems
. Any other verifiable report . Financial penalties
of such action . Re-allotment of surplus
funds to other planning and
service areas
. Appropriate Corrective
action
Failed to implement and . Achievement levels from . Appropriate Corrective
maintain Departm ent monitoring reviews action
approved client grievance . Any other verifiable report
resolution procedure of such action
Failed to continue the . Achievement levels from . Temporary assumption of
provision or expansion of monitoring reviews agency operations and
services after the declaration . Any other verifiable report functions to im plement
of a state of emergency of such action emergency service plan
INTERMEDIATE MEASURES
ATTACHMENT VI (cont.)
38
01/2007
Agreement PE-729
Health Insurance Portability and Accountability Act (HIPAA) of 1996
Attachment VII
The Alliance and the recipient will comply with all requirements of the Health Insurance
Portability and Accountability Act (HIPAA) of 1996. The Alliance and the recipient recognize
that each is a "Business Associate" of the other under the terms of HIPAA. As such and in so
far as these apply, each agrees to the following:
(a) That neither party will use or disclose protected health information for any purpose other
than as authorized by law, by this contract, or by separate agreement between the parties.
(b) That each party will not use or disclose protected health information in a manner which
would be a prohibited use or disclosure if made by the other.
(c) That each party will maintain safeguards as necessary to ensure that the protected health
information is not used or disclosed except as provided by law, by this contract, or by
separate agreement between the parti es.
(d) That each party will report to the other any use or disclosure of the protected health
information of which it becomes aware that is not provided for by law, by this contract, or by
separate agreement between the parti es.
(e) That each party will ensure that any of its subcontractors or agents to whom it provides
protected health information received from the other agrees to the same restrictions and
conditions that apply to each other with respect to such information.
(f) That each party will follow an agreed upon process established to provide access to
protected health information to the subject of that information when the other has made any
material alteration to the information. This process will include how each party would
determine in advance how the other would know or could readily ascertain when a particular
individual's protected health information has been materially altered by the other and how it
could provide access to such information. This process will establish how each party would
provide access to protected health information to the subject of the information in
circumstances where the information is being held by the other.
(g) That each party will provide health information to the subject of the information in
accordance with the subject's right to access, inspect, copy, and amend their health
information.
(h) That each party will make available to the other its internal practices, books and records
relating to the use, disclosure, and tracking of disclosure of protected health information
received from the other or its agents for the purposes of enforcing compliance with HIP AA.
(i) That each party will assist the other in meeting its obligation to provide, at an individual's
request, an accounting of all uses and disclosures of personal health information which are
not related to treatment, payment, or operations within 60 days of the request of an
accounting.
U) That each party will incorporate any amendments or corrections to protected health
information when notified by the other that the information is inaccurate or incomplete.
39
01/2007
Agreement PE-729
(k) That at the termination of this contract, unless a new contract is agreed upon, each party will
return or destroy all protected health information received from the other that it still maintains
in any form.
(I) That either party may terminate this contract if it learns that the other has repeatedly violated
a term of this contract provision.
(m) That each party will disclose only the minimum amount of information necessary to
accomplish the permitted use of the protected health information. This minimum use
requirement does not apply to information provided for treatment or to disclosures required
by law.
(n) That each party will limit the use and disclosure of protected health information to the
minimum number of employees necessary by class of employee and type of information to
accomplish the permitted use of the inform ation.
(0) That each party will meet at least the minimum security requirements for the protection of
protected health information as required by HIP AA.
(p) That each party is bound by the terms of the "Notice of Practices" of the other with regard to
protected health information it receives from the other.
40
07/2004
TIDS MASTER AGREEMENT is entered into between the Alliance for Aging me., hereinafter referred to as
the "Alliance," and the Monroe County Board of Commissioners hereinafter referred to as the "recipient."
Agree~ent PA-429
ALLIANCE FOR AGING INC.
MASTER AGREEMENT
All agreemeots executed between the recipient and the Alliance shall be subject to the conditions set forth io this
agreement for tbe duration of the agreement period(s). Any and all agreements executed between the recipient
aod the Alliance during the effective period of this agreement will incorporate tlUs agreement by reference and
shall be govemed in accordance with the laws, slalutes, and other c?nditions set forth in this agreement.
The parties agree:
I. Recipient Agrees:
A. I. To provide services according to the conditions specified in any agreement(s) with the Alliance
during the period this agreement is in effect.
2. This agreement covers all services provided by the recipient under contract with the Alliance.
3. To prOvide services in compliance with the provisions of the Department Home and Community_
Based Services Handbook.
B. State and Federal Laws and Regulations:
The recipient shall:
1. Comply with the cost principles, administrative requirements, and other provisions of all applicable
state and federalla Ws and regulations including: sections 215.97 and 2 I 6.348, F. S., Title 45, Code of
Federal Regulations (CPR), Part 74, and/or 45 CFR, Part 92, and/or 48 CFR Part 31, and Office of
Management and Budget (OMB) Circulars A-21, A-87, A-102, A-110, A-122, and A-133, whichever
is applicable to the recipient's organization.
2. Comply with all applicable standards, orders, or regulations issued pursuant to the Clean Air Act
[42 United Slates Code (U.S.c.) 7401 et seq.), the U.S. Department ofLabor, Occnpational Safety
and Health Administration (OSHA) code, Title 29 CPR, Part 1910.1030, and the Federal Water
Pollution Control Act asamended (33 U.S. C. 125/ et seq.). The recipient shall report any violations
of the above to the Alliance.
3. Prior to execution of this agreement, complete the Certification Regarding Lobbying form,
A TT ACHMENT I, and the Certification Regarding Debarment, Suspension, meligibiIity and
V 0 lun tary Exclusion Contracts/Subcontracts form, A 17 A CHMENT II. If a Diselosure of
Lobbying Activities form, Standard Form LLL, is required, it may be oblained from the Alliance's
Contract manager, and all disclosure fonns as required by the Certification Regarding LobbYing
form must be completed and returned to the Alliance with the signed agreement.
1
07/2004
Agreement PA-429
4. Comply with section 112.061, F. S., and any policies of the Department of Elder Affairs regarding
any and all business travel pursuant to agreements covered by this agreement (including use of the
State Comptroller approved Reimbursement of Travel Expenses form, or an equivalent form
developed by the recipient), and comply with the provisions of Chapter 119, F.S., allowing public
access to all documents, papers, letters, or other materials made or received by the recipient in
conjunction with this agreement and any agreements incorporating this agreement by reference.
5. Abuse Neglect and Exploitation Reporting: In compliance with Chapter 415, F.S., an employee
of the recipient who knows, or has reasonable cause to suspect, that a child, aged person or disabled
adult is or has been abused, neglected, or exploited, shall immediately report such knowledge or
suspicion to the State of Florida's central abuse registry and tracking system on the statewide toll-
free telephone number (l-800-96ABUSE).
6. Transportation Disadvantaged: If clients are to be transported under any agreements
incorporating this agreement, comply with the provisions of Chapter 427, F.S., and Rule 41-2,
Florida Administrative Code (F. A. C.).
7. Use of Funds For Lobbying Prohibited: Comply with the provisions of section 216.347, F.S.,
Title 48 CFR, Part 31.205, or Title 45 CFR, Part 93, whichever is applicable, that prohibit the
expenditures of funds for the purpose of lobbying the Legislature, a judicial branch or a state
agency.
8. Safeguarding Information: Except as provided for auditing and monitoring purposes, not to use or
disclose any information conceming a consumer who receives services under agreements
incorporating this agreement by reference or subsequent agreements for any pUrpose not in
conformity with state and federal regulations, except upon written consent of the consumer, or the
consumer's authorized representative.
9. IllPAA Compliance: Comply with all requirements of the Health Insurance Portability Act
(HIP AA) of 1996, as applicable. The Alliance and the recipient recognize that each may be a
"Business Associate" of the other under the terms of HIP AA. As such and to the extent said terms
may be applicable, each agrees to the terms as written in ATTACHMENT YD.
10. Grievance and Appeal Procedures: Follow the Minimum Guidelines for Recipient Grievance
Procedures, A TT ACHMENT V, for handling complaints from consumers who complain service
has been suspended, terminated or reduced. Recipients and subrecipients will also establish their
own complaint procedures for consumers who are dissatisfied with or denied services that include,
at minimum, notice of the right to complain and to have their complaint reviewed.
It is expressly understood that substantial evidence of the recipient's refusal to comply with any of the
above provisions shall constitute a breach of this agreement.
2
07/2004
C. Civil Rights Certification:
Agreement PA-429
1. The recipient gives this assurance in consideration of and for the purpose of obtaining federal
grants, loans, contracts (except contracts of insurance or guaranty), property, discounts, or other
federal financial assistance to programs or activities receiving or benefiting from federal financial
assistance. The recipient shall comply with all federal, state and local regulations, statutes and
ordinances relating to nondiscrimination in programs or activities receiving or benefiting from
state, federal, or local financial assistance, whichever apply. These include, but are not limited to:
(a) Executive Order 11246, "Equal Employment Opportunity," as amended by E.O. 11375,
"Amending Executive Order 11246 Relating to Equal Employment Opportunity," and as
supplemented by regulations at Title 41 CFR, Part 60; (b) Title VI of the Civil Rights Act of 1964,
as amended, 42 D.S.c. 2000d et seq., which prohibits discrimination on the basis of race, color, or
national origin (c) Title IX of the Education Amendments of 1972, as amended, 20 D.S.C. 1681-
1683, and 1685-1686 et seq., which prohibits discrimination on the basis of sex in education
programs; (d) Section 504 of the Rehabilitation Act of 1973, as amended, 29 D.S.c. 794, which
prohibits discrimination on the basis of handicaps; (e) The Age Discrimination Act of 1975, as
amended, 42 D.S.c. 6101 et seq., which prohibits discrimination on the basis of age and with any
and all other applicable regulations, guidelines, and standards as are now or may be lawfully
adopted pursuant to the above statutes or which may apply to agreements covered by this
agreement.
2. The recipient agrees to complete the Civil Rights Compliance Questionnaire (DOEA forms 101 A
and B), if services are provided to consumers and if fifteen (15) or more persons are employed.
For recipients employing less than 15 persons, the Alliance requests completion of the Civil Rights
Compliance Questionnaire.
3. The recipient shall establish procedures to handle complaints of discrimination involving services
or benefits through this agreement. These procedures shall include advising clients, employees, and
participants of the right to file a complaint, their right to appeal a denial or exclusion from the
services or benefits, and their right to a fair hearing as a result of their complaint of discrimination.
Complaints of discrimination involving services or benefits through this agreement and may also
be filed with the Secretary of the Department of Elder Affairs or the appropriate federal or state
agency.
4. The recipient agrees that compliance with these assurances are a condition of continued receipt of
or benefit from federal financial assistance, and that it is binding upon the recipient, its successors,
transferees, and assignees for the period during which such assistance is provided. The recipient
further assures that all subrecipients, 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 recipient understands
that the Alliance and/or Department of Elder Affairs may, at their discretion, seek a court order
requiring compliance with the terms of this assurance or seek other appropriate judicial or
administrative relief, including but not limited to, termination of and denial of further assistance.
3
07/2004
Agreement PA-429
D. Payment Requirements
For all agreements covered by this agreement, the recipient agrees:
1. To submit bills for fees or other compensation for services or expenses in sufficient detail for a
proper pre audit and post audit thereof. The recipient shall comply with only the particular
requirements under the following laws and guidelines that are applicable to the agreements covered
under this agreement: (a) paragraph (16) (b) of section 216.181, F. S., regarding advances; (b)
paragraph 691-40.103 F.A.c. pertaining to Restriction of Expenditures from state funds; and, (c) the
Contract Payment Requirements sub-section of section C of the Reference Guide for State
Expenditures from the Department of Financial Services
http://www.dbf.state.flus/aadir/reference_guide/). The recipient certifies that detailed
documentation is available to support each item on the itemized invoice or payment request for cost
reimbursed expenses, including paid subcontractor invoices, and will be produced upon request by
the Alliance. The recipient further certifies that reimbursement requested is only for allowable
expenses as defined in the laws and guiding circulars cited in Section I, paragraph B. I of this
agreement, in the Reference Guide for State Expenditures, and any other laws or regulations, as
applicable, and that administrative expenses do not exceed amounts budgeted in the recipient's
approved service application.
2. Recipients and sub-recipients shall provide units of deliverables, including reports, findings, and
drafts as specified in the agreements and agreement attachments covered by this agreement, and the
service provider applications developed by the recipient (pursuant to section 306(a) of the Older
Americans Act), to be received and accepted by the contract manager prior to payment.
E. With holdings and Other Benefits:
The recipient is responsible for Social Security and Income Tax withholdings.
F. Indemnification:
If the recipient is a state or local govemmental entity, pursuant to section 768.28(18) F.S., the provisions
of this section do not apply.
1. Recipient and all subrecipients agree to indemnifY, defend, and hold harmless the Department of
Elder Affairs and the Alliance and their officers, agents, and employees from any claim, loss,
damage, cost, charge, or expense arising out of any acts, actions, neglect or omission, action in bad
faith, or violation of federal or state law by the recipient, its agents, employees, or subrecipients
during the performance of all agreements incorporating this agreement by reference, whether direct
or indirect, and whether to any person or property to which the Department, the Alliance or said
parties may be subject, except neither recipient nor any of its subrecipients will be liable under this
section for damages arising out of injury or damage to persons or property directly caused or
resulting from the sole negligence of the Department, the Alliance or any of its officers, agents, or
employees.
2. Recipient's obligation to indemnitY, defend, and pay for the defense or, at the Department's option,
to participate and associate with the Department in the defense and trial of any claim and any related
settlement negotiations, shall be triggered by the Department's notice of claim for indemnification
to recipient. Recipient's inability to evaluate liability or its evaluation of liability shall not excuse
recipient's duty to defend and indemnifY the Department, upon notice by the Department. Notice
4
07/2004 Agreement PA-429
shall be given by registered or certified mail, retum receipt requested. Only an adjudication or
judgment after the highest appeal is exhausted specifically finding the Department solely negligent
shall excuse performance of this provision by recipients. Recipient shall pay all costs and fees
related to this obligation and its enforcement by the Department. The Department's failure to notifY
the recipient or subrecipient of a claim shall not release recipient of the above duty to defend.
3. It is the intent and understanding of the parties that the recipient, nor any of its subrecipients, are
employees either of the Department or the Alliance and shall not hold themselves out as employees
or agents of either agency without specific authorization from them. It is the further intent and
understanding of the parties that neither the Department nor the Alliance control the employment
practices of the recipient and shall not be liable for any wage and hour, employment discrimination,
or other labor and employment claims against the recipient, or its subrecipient.
5
07/2 004
Agreemenc PA-429
G. Insurance and Bonding:
1. To provide adequate liability insurance coverage on a comprehensive basis and to hold such liability
insurance at all times during the effective period of any and all agreements incorporating this
agreement by reference. The recipient accepts full responsibility for identifYing and determining the
type(s) and extent of liability insurance necessary to provide reasonable financial protections for the
recipient and the clients to be served under contracts incorporating this agreement by reference.
Upon execution of each contract covered under this agreement, the recipient shall furnish the
Alliance written verification supporting both the determination and existence of such insurance
coverage. Such coverage may be provided by a self-insurance program established and operating
under the laws of the State of Florida. The Department of Elder Affairs and the Alliance reserve the
right to require additional insurance where appropriate.
2. To furnish an insurance bond from a responsible commercial insurance company covering all
officers, directors, employees and agents of the recipient authorized to handle funds received or
disbursed under all agreements incorporating this agreement 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.
3. If the recipient is a state agency or subdivision as defined by section 768.28, F.S., the recipient shall
fumish, upon request, written verification of liability protection in accordance with section 768.28,
F.S. Nothing herein shall be construed to extend any party's liability beyond that provided in
section 768.28, F.S. (See also Indenmification clause.)
H. Purchasing:
1. Procurement of Products or Materials with Recycled Content
Any products or materials which are subject of, or are required to carry out any contracts under this
agreement shall be procured in accordance with the provisions of Section 403.7065 and 287.045,
Florida Statutes.
I. Sponsorship:
1. Any nongovemmental organization which sponsors a program financed partially by state funds or
funds obtained from a state agency shall, in publicizing, advertising, or describing the sponsorship
of the program, state: "Sponsored by Monroe County Board of Commissioners, the State of Florida,
Department of Elder Affairs and Alliance for Aging Inc." If the sponsorship reference is in written
material, the words "State of Florida, Department of Elder Affairs and the Alliance for Aging" shall
appear in the same size letters or type as the name of the organization (ref.: section 286.25, F. S.).
This shall include, but is not limited to, any correspondence or other writing, publication or
broadcast that refers to such program.
2. If the recipient is a govemmental entity or political subdivision of the state, the Department and the
Alliance request compliance with the conditions specified above.
3. The recipient shall not use the words "State of Florida, Department of Elder Affairs and the
Alliance for Aging, Inc" to indicate sponsorship of a program otherwise financed unless specific
authorization has been obtained by the Alliance prior to use.
6
~ rIM
07/2004
Agreement PA-429
J. Public Entity Crime - Applicable only to state agencies or political subdivisions of the state:
Denial or revocation of the right to transact business with public entities.
In compliance with the legislature's intent to restrict the ability of persons convicted of public entity
crimes to transact business with the Department of Elder Affairs, or the Alliance, as the pass through
agent for the Department, pursuant to section 287.133, F.S.: is a condition of receipt or benefit from state
or federal funds and it is binding upon the recipient, its successors and transferees during the period of
this agreement. The recipient further assures that the recipient, its officers, directors, senior management,
partne~s, employees or agents have not been convicted of any public entity crimes within the last 36
months. If the recipient or any of its officers or directors is convicted of a public entity crime during the
period of this agreement, the recipient shall notify the Department of Elder Affairs and the Alliance
immediately. Non-compliance with this statute shall constitute a breach of this agreement.
K. Employment:
If the recipient is a non-governmental organization, it is expressly understood and agreed the recipient
will not knowingly employ unauthorized alien workers. Such employment constitutes a violation of the
employment provisions as determined pursuant to the Immigration Nationality Act (INA), Sec. 274A [8
U.S.c. s.1324a]. Violation of the employment provisions as determined pursuant to section 274A shall
be grounds for unilateral cancellation of any and all agreements incorporating this agreement by
reference.
L. Audits and Records:
The recipient agrees:
1. To maintain books, records, and documents (including electronic storage media) in accordance with
generally accepted accounting procedures and practices that sufficiently and properly reflect all
revenues and expenditures of funds provided by the Alliance under all contracts covered by this
agreement. Recipient agrees to maintain records, including paid invoices, payroll registers, travel
vouchers, copy logs, postage logs, time sheets, etc., as supporting documentation for service cost
reports and for administrative expenses itemized for reimbursement. This documentation will be
made available upon request for monitoring and auditing purposes.
2. To assure these records shall be subject at all reasonable times to inspection, review, audit, copy, or
removal from premises by state personnel and other personnel duly authorized by the Alliance, the
Department of Elder Affairs or by federal personnel, if applicable.
3. To maintain and file with the Alliance such progress, fiscal and inventory and other reports as the
Alliance may require within the period of this agreement. Such reporting requirements must be
reasonable given the scope and purpose of the agreements incorporating this agreement by
reference.
4. To submit management, program, and client identifiable data, as specified by the Department of
Elder Affairs and! or the Alliance. To record and submit program specific data in accordance with
Department of Elder Affairs Client Information Registration and Tracking System (CIRTS) Policy
Guidelines.
5. To provide a financial and compliance audit to the Alliance as specified in ATTACHMENT m
and to ensure aU related party transactions are disclosed to the auditor.
7
07/2004
Agreemeu~ PA-429
6. To include these aforementioned audit and record keeping requirements, including
A TT ACHMENT ill, in all sub-agreements and assignments.
7. The recipient agrees to provide client information and statistical data for research and evaluative
purposes when requested by the Department of Elder Affairs and/or the Alliance.
8. To provide to the Alliance all fiscal information regarding services contracted pursuant to this
agreement using the application required by the Department of Elder Affairs.
M. Retention of Records:
1. To retain all client records, financial records, supporting documents, statistical records, and any
other documents (including electronic storage media) pertinent to each agreement covered under
this agreement for a period of at least five (5) years after termination of the agreement(s), or if an
audit has been initiated and audit findings have not been resolved at the end of five (5) years, the
records shall be retained at least until resolution of the audit findings. These records may be subject
to additional retention requirements set by law.
2. Persons duly authorized by the Department of Elder Affairs, the Alliance or federal auditors,
pursuant to Title 45 CFR, Part 92.42(e), (1), and (2), shall have full access to and the right to
examine or duplicate any of said records and documents during said retention period or as long as
records are retained, whichever is later.
N. Monitoring and Incident Reporting:
I. The recipient will provide progress reports, including data reporting requirements as specified by
the Department of Elder Affairs to be used for monitoring progress or performance of the
contractual services as specified in the area plan submitted by the Alliance to the Department as
well as in the service application submitted by the recipient to the Alliance. Following the norms
set down by the Department of Elder Affairs, the Alliance will establish performance standards for
recipients with weights assigned to each standard. Standards will be tracked monthly by Alliance
staff through desk reviews of available fiscal, CIRTS, and research production reports and any other
system or process designated by the Department. Examples of review criteria are surplus/deficit,
independent audits, internal controls, reimbursement requests, subrecipient monitoring, targeting,
program eligibility, outcome measures, service provision to clients designated as "high risk" by the
Department of Children & Families, Adult Protective Services program, data integrity, co-
payments, client satisfaction, correspondence, and client file reviews.
2. The Alliance will perform administrative and programmatic monitoring of the recipient to ensure
contractual compliance, fiscal accountability, programmatic performance, and compliance with
applicable state and federal laws and regulations.
8
07/2004
Agreement PA-429
3. To permit persons duly authorized by the Department of Elder Affairs or the Alliance to inspect any
records, papers, documents, facilities, goods and services of the recipient which are relevant to
agreements incorporating this agreement by reference, or to the mission and statutory authority of
the Department of Elder Affairs or the Alliance, and to interview any clients and employees of the
recipient to be assured of satisfactory performance of the terms and conditions of these
agreement(s). Following such inspection the Department of Elder Affairs or the Alliance will
deliver to the recipient a list of its concerns with regard to the manner in which said goods or
services are being provided. The recipient will rectify all noted deficiencies provided py the
Department of Elder Affairs or the Alliance within the time set forth, or provide either the
Department of Elder Affairs or the Alliance with a reasonable and acceptable justification for the
recipient's failure to correct the noted shortcomings. The Department of Elder Affairs or the
Alliance shall determine whether such failure is reasonable and acceptable. The recipient's failure
to correct or justify deficiencies within a reasonable time as specified by the Department of Elder
Affairs or the Alliance may result in either agency taking any of the actions identified in Section
III., c., Enforcement, or deeming the recipient's failure to be a breach of this agreement.
4. Extraordinary Reporting: The recipient shall notify the contract manager for the Alliance
immediately, but no later than within 24 hours, from the recipient's awareness or discovery of
conditions that may materially affect the recipient's ability to perform, such as problems, delays, or
adverse conditions which may impair the recipient's ability to meet the objectives of the agreements
covered by this agreement. The notice shall include a brief summary of the problem( s), a statement
of the action taken or contemplated, time frames for implementation, and any assistance needed to
resolve the situation. Examples of reportable conditions may include:
· proposed consumer terminations
· recipient fmancial concerns/difficulties
· non-payment or untimely payment reported by vendors
· service documentation problems
· agreement non-compliance
· service quality problems and consumer complaint trends
The Alliance shall investigate allegations regarding falsification of client information, service
records, payment requests, and other related information. Substantiated allegations shall be reported
to the Department of Elder Affair's contract manager.
In the event that a situation results in the cessation of services by a sub-recipient or vendor, the
recipient retains the responsibility for performance under agreements covered by this agreement and
must follow their own procedures to ensure that clients continue receiving services without
interruption, e. g. exercising their emergency procurement procedures, temporary assumption of the
direct provision of services, etc.
O. Assignments and Subcontracts:
I. Alliance approval of the service application presented by the recipient shall constitute Alliance
approval of the recipient subagreements if the subagreements follow the service and funding
information identified in the service application. The recipient must submit all contracts for
services under the service application to the Alliance for prior approval when the proposed
subrecipient is a profit making organization. No such approval by the Alliance of any assignment
or subcontract shall be deemed in any event or in any manner to provide for the incurrence of any
obligation of the Alliance in addition to the dollar amount agreed upon in contracts covered by this
9
07/2004 Agreemen~ PA-429
agreement and the contracts incorporating it by reference and to any conditions of approval the
Alliance shall deem necessary.
2. For every transaction, the recipient must determine if the subcontractor is a vendor rather than a
subrecipient, as defined in OMB Circular A-l33, subpart B, section .210, and in section 215.97,
F.S., and this determination must be documented in writing. When a vendor relationship is
identified, an agreement with all of the terms and conditions set forth in this agreement is not
required. However, a written agreement outlining the term of the agreement, the goods being
purchased or services to be performed, and conditions for procurement, receipt and payment for
goods and services. Compliance for vendors is usually limited to these tasks unless the recipient
chooses to pass down program compliance to the vendor in the written agreement. The recipient is
ultimately responsible for assuring program compliance and performance, and any applicable
conditions of this agreement and the agreements covered by it.
P. Return of Funds:
1. To return to the Alliance any overpayments due to unearned funds or funds disallowed pursuant to
the terms of all agreements for which funds were disbursed to the recipient by the Alliance.
a. The recipient shall return any overpayment to the Alliance within forty (40) calendar days after
either discovery by the recipient, or notification by the Alliance, of the overpayment.
b. In the event the recipient or its independent auditor discovers an overpayment has been made,
the recipient shall repay said overpayment within forty (40) calendar days without prior
notification from the Alliance. In the event the Alliance first discovers an overpayment has
been made, the Alliance will notify the recipient by letter of such a finding.
c. Overpayments due to unallowable or un-allocable expenses due to billing discrepancies must be
returned to the Alliance under the same terms and conditions as this section. Information
indicating recipient has been overpaid as a result of over-budgeting on the unit cost
methodology can be used by the Alliance to negotiate lower fates in subsequent years.
Continuous overpayment to recipients due to over budgeting may result in a demand for
. repayment to the Alliance under the same terms and conditions of this section. Repayment
received by the Alliance shall be reported to the Department of Elder Affairs and may be either
re-allocated to other recipient(s) or returned to the Department, at the Department's discretion.
Q. Data Integrity
Federal Grants Management require financial management systems for recipients of state and federal
funds to be capable of providing certain information, assuring accuracy and accountability, in accord
with prescribed reporting requirements. These reporting requirements may require certain calculations
or the provision of specified data to fully disclose the financial results of each federally funded or state-
sponsored program.
Accordingly, the recipient must, prior to execution of this agreement, complete the Data Integrity
Certification form. ATTACHMENT VI.
R. Conflict of Interest:
The recipient will maintain a written code of conduct governing the performance of its employees,
board members, management and sub-recipients, engaged in the award and administration of contracts.
No employee, officer or agent of the recipient or sub-recipient shall participate in selection, or in the
10
07/2004 Agreement PA-429
award or administration of a contract 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 hislher immediate family; (c) his or her partner, or; (d) an organization which employs,
or is about to employ, any of the above, has a financial or other interest in the firm selected for award.
The recipient or sub-recipient's officers, employees or agents will neither solicit nor accept gratuities,
favors or anything of monetary value from contractors, potential contractors, or parties to sub-
agreements. The recipient's board members and management must disclose to the Alliance any
relationship which may be, or may be perceived to be, a conflict of interest within thirty (30) days of an
individual's original appointment or placement in that position, or if the individual is serving as an
incumbent, within thirty (30) days of the commencement of this agreement. The recipient's employees
and sub-recipients must make the same disclosures described above to the recipient's board of directors.
Compliance with this provision will be monitored.
S. Successors and Transferees:
Recipient must receive approval from the Alliance's contract manager prior to transferring or assigning
this agreement, or any agreements referencing this agreement, to another party or a different
organizational entity. Further, this agreement or any agreements referencing this agreement are binding
in their entirety on the recipient and its successors, assignees and transferees.
II. The Alliance Agrees:
A. Payment:
Unless otherwise stated in the agreements covered by this agreement between the Alliance and
recipient, payments made by the Alliance to the recipient must be within seven (7) working days after
receipt by the Alliance of full or partial payments from the Department of Elder Affairs. Payments to
vendors contracted by the Alliance shall be made in accord with the terms as negotiated with the
vendor(s). Failure to pay within these time frames may result in the Department of Elder Mfairs
applying intermediate measures against the Alliance as per Attachment VI.
B. Vendor Ombudsman:
Recipients who may be experiencing problems in obtaining timely payments(s) from the Department of
Elder Affairs may contact the Vendor Ombudsman within the Department of Banking and Finance at I
(800) 848-3792 or (850) 413-7269. Subrecipients and vendors experiencing problems obtaining timely
payment(s) from the Alliance may contact the Department's contract manager at (850) 414-2000.
11
07/2004
Agreement PA-429
ID. Agreement Term and Renewal
The recipient and the Alliance mutually agree:
A. Effective Date
1. This agreement shall begin on March 1, 2004 or on the date on which the agreement has been signed by
both parties, whichever is earlier, and shall end on December 31. 2006.
2. All agreements executed between the Alliance and the recipient during the effective period of this
agreement shall reference this agreement by number, incorporating it therein, and shall be governed by
the conditions of this agreement and its successor(s) for the duration of the contract period(s).
B. Enforcement:
1. The Department of Elder Mfairs, or the Alliance acting on its behalf may, in accordance with
section 430.04, F.S., take intermediate measures against the recipient, including: corrective action,
unannounced special monitoring, temporary assumption of the operation of one or more programs,
placement of the recipient on probationary status, imposing a moratorium on recipient action,
imposing financial penalties for nonperformance, or other administrative action pursuant to Chapter
120 F.S., if the Department of Elder Affairs or the Alliance acting on its behalf finds that:
· an intentional or negligent act of the recipient has materially affected the health, welfare, or
safety of consumers served pursuant to this agreement, or substantially and negatively affected
the operation of services covered under this agreement.
· the recipient lacks fmancial stability sufficient to meet contractual obligations or that
contractual funds have been misappropriated.
· the recipient has committed multiple or repeated violations of legal and regulatory standards,
regardless of whether such laws or regulations are enforced by the Department of Elder Mfairs
or the recipient has committed or repeated violations of Department standards.
· the recipient has failed to continue the provision or expansion of services after the declaration of
a state of emergency.
· the recipient has failed to adhere to the terms ofthis agreement or the terms of any agreement(s)
covered by this agreement and incorporating it by reference.
2. In making any determination under this provision the Department of Elder Affairs may rely upon
the findings of another state or federal agency, or other regulatory body. Any claim for breach of
this agreement is exempt from administrative proceedings and shall be brought before the
appropriate entity in the venue of Leon County. Before the Department of Elder Affairs formally
rescinds the designation of the recipient or initiates any intermediate measure, or either party
commences equitable or legal action of any sort, both parties agree to engage in informal mediation
through a meeting of each party's representative at a place and location designated by the
Department of Elder Affairs.
3. In making any determination under this provision for intermediate measures, the Department or the
Alliance acting on its behalf, will be guided by the measures and options as set forth in
12
07/2004 Agreement PA-429
ATTACHMENT VI. The purpose of the options set forth in ATTACHMENT VI is to give notice
to the recipient of the range of intermediate measures that would normally be imposed for violations
as set forth in this provision. This range of intermediate measures is based upon a single violation
of each provision listed. Multiple violations of the same provision will be grounds for enhancement
of intermediate measures. The Department or the Alliance acting on its behalf, is entitled to deviate
from the range of intermediate measures provided in A TT ACHMENT VI upon a showing of
circumstances presented to the Department and/or Alliance prior to the imposition of an
intermediate measure. Circumstances that may be considered for enhancement or reduction of
intermediate measures include, but are not limited to:
a. History of previous violations.
b. The magnitude and scope of the damage inflicted upon the general public.
c. The lack of danger to the public health, safety and welfare.
d. The degree of financial hardship incurred by the recipient as a result of the imposition of
intermediate measures.
e. Corrective action taken by the recipient.
f. Steps taken by the recipient to ensure the non-occurrence of similar violations in the future.
C. Termination:
1. Termination for Convenience
This agreement and any other agreements incorporating it by reference may be terminated by either
party upon no less than sixty (60) calendar days notice, without cause, unless a lesser time is
mutually agreed upon by both parties, in writing. Said notice shall be delivered by certified mail,
return receipt requested, or in person with proof of delivery. In the event the recipient terminates an
agreement at will, the recipient agrees to submit, at the time it serves notice of the intent to
terminate, a plan which identifies procedures to ensure services for consumers pursuant to this
agreement or any sub-agreement will not be interrupted or suspended by the termination. In the
event that an agreement between the recipient and a sub-recipient is terminated, the recipient shall
require the sub-recipient to submit to the recipient and the Alliance, a similar plan ensuring services
to consumers will not be interrupted or suspended by the termination.
2. Termination Because of Lack ofPunds
In the event funds to finance any agreement(s) under this agreement become unavailable, the
Alliance may terminate the affected agreement or agreements upon no less than twenty-four (24)
hours notice in writing to the recipient. Said notice shall be delivered by certified mail, return
receipt requested, or in person with proof of delivery. The Alliance shall be the final authority as to
the availability of funds.
13
07/2004
Agreement PA-429
3. Termination for Breach
Unless the breach is waived in writing by the Department of Elder Affairs and/or the Alliance as the
local agent for the Department, or if the recipient fails to cure the breach within the time specified,
the Department! Alliance may, by written notice to the recipient, terminate any and all of the
agreement(s) incorporating this agreement by reference upon no less than twenty-four (24) hours
notice. Said notice shall be delivered by certified mail, return receipt requested, or in person with
proof of delivery. If applicable, the Department of Elder Affairs may employ the default provisions
in section 60A-l.006(3), Florida Administrative Code. Waiver of breach of any provisions of any
one contract covered by this agreement shall not be deemed to be a waiver of any other breach and
shall not be construed to be a modification of the terms of other agreements covered under this
agreement. The provisions herein do not limit the Department's or the Alliance right to remedies at
law or to damages of a legal or equitable nature.
14
07/2004
Agreement PA-429
D. Notice and Contact:
1. The name, address and telephone number of the Alliance for this agreement is:
Steven Weisberg, M.S.
President/CEO
9500 South Dadeland Boulevard, Suite 400
Miami, FL 33156
Phone: (305) 670-6500, SC 455-6500
2. The name, address and telephone number of the recipient for this agreement is:
Monroe County Board of Commissioners
Gato Building
1100 Simonton Street
Key West, FL 33040
Phone: (305) 292-4573
3. The name of the contact person, street address and telephone number where financial and
administrative records are maintained:
Louis LaTorre
Gato Building
1100 Simonton Street
Key West, FL 33040
Phone: (305) 292-4573
E. Renegotiation or Modification:
1. Modifications of provisions of this agreement and of any and all agreement(s) incorporating this
agreement by reference shall only be valid when they have been reduced to writing and duly signed
by both parties. The parties agree to renegotiate this agreement and any affected agreements if
revisions of any applicable laws or regulations make changes in this agreement necessary.
2. The rate of payment and the total dollar amount may be adjusted retroactively for any agreement(s)
incorporating this Master Agreement by reference only when these have been established through
the appropriations process, or identified in the federal program.
IV. The Recipient Agrees to the following special provisions:
A. Property & Equipment
1. Equipment means: (a) an article of non expendable, tangible personal property having a useful life of
more than one year and an acquisition cost which equals or exceeds the lesser of (a) the
capitalization level established by the organization for the financial statement purposes, or $5000
[for federal funds], or (b) nonexpendable, tangible personal property of a nonconsumable nature
with an acquisition cost of $ I 000 or more per unit, and expected useful life of at least one year; and
hardback bound books not circulated to students or the general public, with a value or cost of $250
or more [for state funds].
15
07/;2004
Agreement PA-429
2. Recipients and sub-recipients who are Institutions of Higher Education, Hospitals, and Other Non-
Profit Organizations shall have written property management standards in compliance with OMB
Circular A-I 10 that include: (a) a property list with all the elements identified in the circular; and,
(b) A procedure for conducting a physical inventory of equipment at least once every two years. The
property records must be maintained on file and shall be provided to the Alliance upon request.
3. Equipment purchased with federal funds with an acquisition cost over $5,000 and equipment
purchased with state funds with an acquisition cost over $1,000 that is specifically identified in the
recipient's service application approved by the Alliance is part of the cost of carrying out the
activities and functions of the grant awards and Title (ownership) will vest in the recipient, subject
to the conditions of OMB Circular A-I 10, Subpart C, paragraph .34. Equipment purchased under
these thresholds is considered supplies and is not subject to property standards. Equipment
purchased with funds identified in the budget attachments to agreements covered by this agreement,
or identified in agreements with recipients (not included in a cost methodology), is subject to the
conditions of section 273, F. S. and 60A-I.OOI7, F. A. C. or Title 45 CFRpart 74.
4. Real property means land (including land improvements), buildings, structures and appurtenances
thereto, but excludes movable machinery and equipment. Real property may not be purchased with
state or federal funds through agreements covered under this agreement without the prior approval
of the Alliance. Real property purchases from Older Americans Act funds are subject to the
provisions of Title 42, Chapter 35, Subchapter Ill, Part A., Sec. 3030b United States Code (USC).
Real property purchases from state funds can only be made through a fixed capital outlay grants and
aids appropriation and therefore are subject to the provisions of section 216.348, F. S.
5. Any permanent storage devices (e.g.: hard drives, removable storage media) must be reformatted
and tested prior to disposal to ensure no confidential information remains.
6. A budget amendment is required to be submitted and approved by the Alliance's contract manager
prior to the purchase of any item of nonexpendable property not specifically listed in the approved
budget.
7. Information Technology Resources
The recipient must adhere to the Department of Elder Affairs' procedures and standards when
purchasing Information Technology Resources (ITR) as part of any agreement(s) incorporating this
agreement by reference. An ITR worksheet is required for any computer related item costing
$1,000.00 or more, including data processing hardware, software, services, supplies, maintenance,
training, personnel and facilities. The completed ITR worksheet shall be maintained in the Alliance
for Aging's LAN administrator's file. The Alliance has the responsibility to require any recipient to
comply with the Department of Elder Affairs' ITR procedures.
B. Copyright Clause
The recipient may copyright any work that is subject to copyright and was developed, or for which
ownership was purchased, under any agreement(s) incorporating this agreement by reference. The
Department of Elder Affairs reserves a royalty-free, nonexclusive and irrevocable right to reproduce,
publish, or otherwise use the work for state and federal purposes, and to authorize others to do so.
Other rights of the Department and recipient are described in Title 45 CFR, sec. 74.36, and section
286.02 I, F.S.
16
07/2004
Agreemeuc PA-429
C. Investigation of Criminal Allegations
Any report that implies criminal intent on the part of this recipient or any subrecipient and referred to a
governmental or investigatory agency must be sent to the Department of Elder Affairs via the Alliance.
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 of Elder Affairs immediately. A copy of all
documents, reports, notes or other written material concerning the investigation, whether in the
possession of the Alliance or the recipient, must be sent to the Department of Elder Affair's Inspector
General with a summary of the investigation and allegations.
D. Disaster
In preparation for the threat of an emergency event as defined in the State of Florida Comprehensive
Emergency Management Plan, the Department of Elder Affairs may exercise authority over an area
agency or service provider agency to implement preparedness activities to improve the safety of the
elderly in the threatened area and to secure area agency and service provider facilities to minimize the
potential impact of the event. These actions will be within the existing roles and responsibilities of the
area agency and its subrecipient.
In the event the President of the United States or Governor of the State of Florida declares a disaster or
state of emergency, the Department of Elder Affairs may exercise authority over an area agency or
service provider agency to implement emergency relief measures and/or activities.
In either of these cases, only the Secretary, Deputy Secretary or hislher designee of the Department of
Elder Affairs shall have such authority to order the implementation of such measures. All actions
directed by the department under this section shall be for the purpose of ensuring the health, safety and
welfare of the elderly in the potential or actual disaster area.
E. Volunteers
The recipient will promote the use of volunteers as prescribed in section 306(a) (12), Older Americans
Act and section 430.07, F.S.
F. Business Hours
Recipients who are lead agencies, as defined in section 430.203(9), F.S. or who provide elder helpline
services pursuant to this agreement must also maintain minimum business hours from 8:00 AM until
5 :00 PM, Monday through Friday, excluding national and state holidays.
17
07/2004
G. Management Information Systems
Agreement PA-429
For all program agreements incorporating this agreement by reference for which the collection of client
data in electronic format (CIRTS, for example) is required:
1. The Alliance shall employ a Local Area Network (LAN) Administrator who shall assure the
Alliance's compliance with the requirements of the "LAN Administrator Guidelines" adopted by the
Department. These "Guidelines" delineate the roles and responsibilities of the Local Area Network
Administrator. The Alliance shall assure any other support necessary for full "LAN Administrator
Guidelines" compliance, including reporting to the department the operational status of their LAN
and Wide Area Network (WAN) in accord with the frequency and format directed in these
"Guidelines".
2. The Alliance will ensure the collection and maintenance of consumer and service information on a
monthly basis from the Client Information Registration and Tracking System (CIRTS) or any such
system designated by the department. Maintenance includes valid exports and backups of all data
and systems according to department standards.
3. The recipient must enter all required data per the Department's CIRTS Policy Guidelines for
consumers and services in the CIRTS database. The data must be entered into the CIRTS before the
recipient submits their request for payment and expenditure reports to the Alliance. The Alliance
shall establish time frames to assure compliance with due dates for the requests for payment and
expenditure reports to the Department.
4. The recipient will run monthly CIRTS reports and verify consumer and service data in the CIRTS is
accurate. This report must be submitted to the Alliance with the monthly request for payment and
expenditure report and must be reviewed by the Alliance before the recipient's request for payment
and expenditure reports can be approved by the Alliance.
5. Failure to ensure the collection and maintenance of the CIRTS data may result in the Alliance
enacting the "Enforcement" clause of this agreement (see Section III, C.), including delaying or
withholding payment until the problem is corrected.
6. Computer System Backup and Recovery
Each recipient, among other requirements, must anticipate and prepare for the loss of information
processing capabilities. The routine backing up of data and software is required to recover from
losses or outages of the computer system. Data and software essential to the continued operation of
recipient functions must be backed up. The security controls over the backup resources shall be as
stringent as the protection required of the primary resources. It is recommended that a copy of the
backed up data be stored in a secure, offsite location. The recipient shall maintain written policies
and procedures for computer backup and recovery. These policies and procedures shall be made
available to the Alliance upon request.
18
07/2004
Agreement PA-429
H. Consumer Outcomes
1. The Alliance will develop consumer outcome measures consistent with those developed by the
Department of Elder Affairs.
2. As required by the legislature for performance-based program budgeting, the Department of Elder
Affairs will set targets for the performance of outcome measures. The Alliance is responsible for
achieving these targets and will incorporate them into sub agreements as necessary.
I. Surplus/Deficit Report:
The Alliance will submit a consolidated surplus/deficit report in a format provided by the Department to
the Department's contract manager by the 25th of each month. This report is for all agreements
between the Alliance and the Department.
The report will include the following:
I. A list of all subcontractors and their current status regarding surplus or deficit;
2. The Alliance's detailed plan on how the surplus or deficit spending exceeding the threshold
specified by the Department will be resolved;
3. Recommendations to transfer funds to resolve surplus/deficit spending, and;
4. Input from the recipient's Board of Directors on resolution of spending issues, if applicable.
19
07/2004
AgreemL_...t PA-429
IN WITNESS THEREOF, the parties hereto have caused this ~ page agreement to be executed by their
undersigned officials as duly authorized.
RECIPIENT: MONROE COUNTY BOARD.
OF COMMISSIONERS
ALLIANCE FOR AGING, INC.,
BOARD PRESIDENT OR
AUTHORIZED DESIGNEE
SIGNED
BY:
", .-: f
Y+./
I ( . _ +'. "+,,,"
SIGry-~~~
Bl(:. to')
,~/
__Il
NAME: Murray E. Nelson
NAME: STEVEN WEISBERG, M.S.
TITLE: Mayor/Chairman
TITLE: PRESIDENT/CEO
DATE:~
DATE: June 16, 2004
FEDERAL ID NUMBER: 59-6000749
RECIPIENT FISCAL YEAR ENDING DATE: 09/30
f84!AL)
Gg~
DE CLERK
'_c...,._~.."""'_
" '-',.,"'" c' ~~;,y
",~,;L ',l;! ,"- -, --',' ,) i '.,," -:
.~, r _ " .' -~ '''. '.J -, _ >. "
., "
'" ~-'-~'^-"~-'-- -,,-'
~;;..-cc:~ ,',': ;::)N .
~ &/01/0(/
I
(Revised MARCH 2004)
20
07/2004
Agreeme~~~ PA-429
ATTACHMENT I
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENT
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of any state or federal agency, a
member of congress, an officer or employee of congress, an employee of a member of congress, or an
officer or employee of the state legislator, in connection with the awarding of any federal grant, the
making of any federal loan, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative
agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a member of congress, an
officer or employee of congress, or an employee of a member of congress in connection with this federal
contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard
Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents
for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and
cooperative agreements) and that all sub-recipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction
imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be
subject to a . . penal not less than $10,000 and not more than $100,000 for each such failure.
'....~s:;D~
Date
l.. e J, J l~ "" ,,-fEr
Name of Authorized Individual
P A429
Application or Contract Number
Monroe County Board of Commissioners
Gato Building
1100 Simonton Street
Key West, FL 33040
Name and Address of Organization
DOE A Form 103
21
07/2004
(Revised Nov 2002)
Agreeme~_ PA-429
Page Intentionally Left Blank
22
07/2004
Agreement: PA-429
ATTACHMENT n
INSTRUCTIONS
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION CONTRACTS/SUBCONTRACTS
I. Each recipient of federal financial and non-financial assistance that equals or exceeds $100,000 in federal
monies must sign this debarment certification prior to contract execution. Independent auditors who
audit federal programs regardless of the dollar amount are required to sign a debarment certification
form. Neither the Department of Elder Affairs nor its contract recipients can contract with subrecipients
if they are debarred or suspended by the federal government.
2. This certification is a material representation of fact upon which reliance is placed when this agreement is
entered into. If it is later determined that the signed knowingly rendered an erroneous certification, the
Federal Government may pursue available remedies, including suspension and/or debarment.
3. The recipient shall provide immediate written notice to the contract manager at the Alliance any time the
recipient learns that its certification was erroneous when submitted or has become erroneous by reason of
changed circumstances.
4. The terms "debarred," "suspended," "ineligible," "person," "principal," and "voluntarily excluded," as used
in this certification, have the meanings set out in the Definitions and Coverage sections of rules
implementing Executive Order 12549 and 45 CFR (Code of Federal Regulations), Part 76. You may
contact the contract manager for assistance in obtaining a copy of those regulations.
5. The recipient further agrees by submitting this certification that, it shall not knowingly enter into any
subcontract with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from
participation in this contract unless authorized by the Federal Government.
6. The recipient further agrees by submitting this certification that it will require each subrecipient of
agreements referencing this agreement whose payment will equal or exceed $ I 00,000 in federal monies, to
submit a signed copy of this certification with each sub agreement.
7. The Department of Elder Affairs may rely upon a certification by a recipient/subrecipient entity that it is
not debarred, suspended, ineligible, or voluntarily excluded from contracting/subcontracting unless the
Department knows that the certification is erroneous.
8. The Alliance may rely upon a certification by a subrecipient entity that it is not debarred, suspended,
ineligible, or voluntarily excluded from contracting/subcontracting unless the Alliance knows that the
certification is erroneous.
9. The signed certifications of all subrecipients shall be kept on file with the Alliance.
DOEAFORM 112A
(Revised February 2004)
23
07/2004 Agreemel1-.. PA-429
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELlGffilLITY
AND VOLUNTARY EXCLUSION CONTRACTS/SUBCONTRACTS
This certification is required by the regulation implementing Executive Order 12549, Debarment and Suspension,
signed February 18, 1986. The guidelines were published in the May 29, 1987 Federal Register (52 Fed. Reg.,
pages 20360-20369).
(1) The prospective recipient certifies, by signing this certification, that neither he nor his principals is
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in contracting with the Department of Elder Affairs (or the Alliance for Aging acting as its
agent) by any federal department or agency.
(2) Where the prospective recipient is unable to certify to any of the statements in this certification, such
prospective recipient shall attach an explanation to this certification.
Signature
~~~
{
Date (p .,. ~.>: .::>-r
Louis LaTorre, Executive Director
Name and Title of Authorized Individual
(Prin t or type)
Monroe County Board of Commissioners
Name of Organization
DOEA FORM 112B
(Revised April 2001)
24
07/2()04
AgreerneL_ PA-429
ATTACHMENTm
Audit Attachment
The administration of funds awarded by the Department of Elder Affairs to the Alliance and to any subrecipient,
through agreements with the Alliance, may be subject to audits and/or monitoring by the Department and other
authorized state personnel or federal personnel as described in this section.
Monitoring:
In addition to reviews of audits conducted in accordance with OMB Circular A-133 and section 215.97, F.S., as
revised (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by
department staff, limited scope audits as defined by OMB Circular A-l33, as revised, and/or other procedures.
By entering into this agreement, the recipient agrees to comply and cooperate with any monitoring
procedures/processes deemed appropriate by the department. In the event the department determines that a
limited scope audit of the recipient is appropriate, the recipient agrees to comply with any additional instructions
provided by the Department to the recipient regarding such audit. The recipient further agrees to comply and
cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Comptroller, Auditor
General or federal personnel.
OTHER REQUIREMENTS
If the recipient is a non-profit organization, the Oath of Not for Profit Status form (EXHIBIT 2 of this
attachment) must be completed and returned to the Alliance with the signed contract.
Audits
PART I: FEDERALLY FUNDED
This part is applicable if the recipient or subrecipient is a State or local government or a non-profit organization
as defined in OMB Circular A-l33, as revised.
1. In the event that the recipient expends $300,000 ($500,000 for fiscal years ending after December 31, 2003)
or more in Federal awards in its fiscal year, the recipient must have a single or program-specific audit
conducted in accordance with the provisions of OMB .Circular A-I33, as revised. Federal funds awarded
through the Alliance by this agreement, if any, are indicated in section II. A. of the contract(s) covered by
this agreement. In determining the Federal awards expended in its fiscal year, the recipient shall consider all
sources of Federal awards, including Federal funds received from or passed through the Alliance. The
determination of amounts of Federal awards expended should be in accordance with the guidelines
established by OMB Circular A-I33, as revised. An audit of the recipient conducted by the Auditor General
in accordance with the provisions OMB Circular A-l33, as revised, will meet the requirements of this part.
2. In connection with the audit requirements addressed in Part I, paragraph 1., the recipient shall fulfill the
requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-l33, as
revised.
25
07/2004
AgreemeL_ PA-429
3. If the recipient expends less than $300,000 ($500,000 for fiscal years ending after December 31, 2003) in
Federal awards in its fiscal year, an audit conducted in accordance with the provisions of OMB Circular A-
133, as revised, is not required. In the event that the recipient expends less than $300,000 ($500,000 for
fiscal years ending after December 31, 2003) in Federal awards in its fiscal year and elects to have an audit
conducted in accordance with the provisions ofOMB Circular A-133, as revised, the cost of the audit must
be paid from non-Federal funds (i.e., the cost of such an audit must be paid from recipient resources
obtained from other than Federal entities).
4. Information regarding audit requirements contained in OMB Circular A-133 and section 215.97, F.S.,
can be obtained from the following web-sites:
http://www . whitehouse. gov /omb/ circulars/
and:
http://www.leg.state.f1.us/
PART II: STATE FUNDED
This part is applicable if the recipient is a non-state entity as defined by section 215.97, F.S.
1. In the event that the recipient expends a total amount of State awards (i.e., State financial assistance
provided to the recipient to carry out a State project) equal to or in excess of $300,000 in any fiscal year of
such recipient, the recipient must have a State single or project-specific audit for such fiscal year in
accordance with section 215.97, F.S.; applicable rules of the Executive Office of the Governor and the
Comptroller, and Chapter 10.600, Rules of the Auditor General. State grants and aids amounts awarded
through the Alliance by this agreement are indicated in section n. A. of the contract(s) of which this
agreement is an attachment. In determining the State awards expended in its fiscal year, the recipient shall
consider all sources of State awards, including State funds received from the Department of Elder Affairs
through the Alliance for Aging, other state agencies, and other nonstate entities except that State awards
received by a non-state entity for Federal program matching requirements shall be excluded from
consideration.
2. In connection with the audit requirements addressed in Part II, paragraph 2, the recipient shall ensure that
the audit complies with the requirements of section 215.97, F.S. This includes submission of a reporting
package as defined by section 215.97, F.S., and Chapter 10.550 (local governmental entities) or 10.650
(nonprofit and for-profit organizations) Rules of the Auditor General, to include an auditor's examination
attestation report, management assertion report (alternatively, management's assertion may be included in
the management representation letter), and a schedule of State fmancial assistance.
The auditor's examination attestation report must indicate whether management's assertion as to compliance
with the following requirements is fairly stated, in all material respects: activities allowed or unallowed;
allowable costs/cost principles; matching (if applicable), and; reporting.
3. If the recipient expends less than $300,000 in State awards in its fiscal year, an audit conducted in
accordance with the provisions of section 215.97, F.S., is not required. In the event that the recipient
expends less than $300,000 in State awards in its fiscal year and elects to have an audit conducted in
accordance with the provisions of section 215.97, F.S., the cost of the audit must be paid from non-State
funds (i.e., the cost of such an audit must be paid from the recipient's resources obtained from other than
State entities).
26
07/2004
AgreemeL PA-429
Page Intentionally Left Blank
27
07/2004
PART ID: REPORT SUBMISSION
Agreemen~ PA-429
1. Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and
required by PART I of this attachment shall be submitted, when required by section .320 (d), OMB Circular
A-l33, as revised, by or on behalf of the recipient directly to each of the following within 45 days of receipt
of the report but no later than nine (9) months of recipient's fiscal year end:
A. The Alliance for Aging, Inc., at the following address:
Attn: Carlos L. Martinez, CPA
Chief Financial Officer
9500 South Dadeland Boulevard, Suite 400
Miami, FL 33156
B. The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of
copies required by sections .320 (d) (1) and (2), OMB Circular A-l33, as revised, should be
submitted to the Federal Audit Clearinghouse), at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East lOth Street
Jeffersonville, IN 47132
C. Other Federal agencies and pass-through entities in accordance with sections .320 (e) and (f), OMB
Circular A-133, as revised.
2. The recipient shall submit a copy of the reporting package described in section .320 (c), OMB Circular A-
133, as revised, and any management letters issued by the auditor, to the Alliance at the following address
within 45 days of receipt of the report but no later than nine (9) months of recipient's fiscal year end:
Alliance for Aging, Inc.
Attn: Carlos L. Martinez, CPA
Chief Financial Officer
9500 South Dadeland Boulevard, Suite 400
Miami, FL 33156
3. Copies of audits and reporting packages required by PART II of this attachment shall be submitted by or on
behalf of the recipient directly to each of the following within 45 days of receipt of the report but no later
than nine (9) months of recipient's fiscal year end:
A. The Alliance for Aging, Inc. at the following address:
Attn: Carlos L. Martinez, CPA
Chief Financial Officer
9500 South Dadeland Boulevard, Suite 400
Miami, FL 33156
28
07/2004
AgreemeL PA-429
B. The Auditor General's Office at the following address:
State of Florida Auditor General
Room 574, Claude Pepper Building
1 I 1 West Madison Street
Tallahassee, Florida 32302-1450
4. Any reports, management letters, or other information required to be submitted to the Alliance pursuant to
this attachment shall be submitted timely in accordance with OMB Circular A-133, section 215.97 F.S., and
Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of
the Auditor General, as applicable and should indicate the date that the reporting package was delivered to
the recipient in correspondence accompanying the package.
5. Recipients, when submitting the financial reporting packages to the Alliance, should indicate the date that
the audit report was delivered to the recipient in correspondence accompanying the audit report.
PART IV: RECORD RETENTION
The recipient shall retain sufficient records demonstrating its compliance with the terms of this attachment
for a minimum period of five (5) years from the date the audit report is issued or longer if requested by the
Alliance in writing, and shall allow the Alliance, the Department of Elder Affairs or its authorized designee
and the Comptroller or Auditor General access to such records upon request. The recipient shall ensure that
audit working papers are made available to the Alliance, the Department of Elder Affairs or its designee,
and the Comptroller or Auditor General upon request, for a minimum period of five (5) years from the date
the audit report is issued, or may need to be longer if requested in writing by any of these agencies.
Alliance.
29
07/2 004 Agreemer!~ PA-429
PART V: SPECIFIC REQUIREMENTS OF DEPARTMENT ADMINISTERED PROGRAMS
1. The Department of Elder Affairs requires a supplemental schedule of functional expenses be prepared in a
fannat provided by the department, which presents costs by service (as defined by the department),
including units of service delivered, for recipients or subrecipients expending state or federal awards for
services performed by their employees, contractors, and other payees who receive payment from
department-administered funds for units of service recorded in the department's Client Registration and
Tracking System (CIRTS). This supplemental schedule shall be prepared using the same methodology as
used in determining the contractual rates. Government entities are excluded from this requirement.
2. If an audit is not required or performed, the head of the recipient entity or organization must provide a
written attestation, under penalty of perjury, that the recipient has complied with the allowable cost
provisions (congruent with the Reference Guide for State Expenditures and OMB Circular A-I22 or A-87,
whichever is applicable). EXHIBIT I to this attachment provides an example attestation document that
should be used by the agency head or authorized signatory for contracts to attest to compliance with these
prOVISIons.
3. Interest earned on federal funds or general revenue funds must be returned to the Alliance. A chart is
included in all contracts identifying the funding source(s), program titles, applicable CFDA or CSFA
numbers and the amount of funds granted.
4. Specific requirements for match, co-payments, and program income applicable to programs administered by
the Department are outlined in the following applicability chart. Brief definitions of terms used in the chart
are included.
(Revised February 2004)
30
-
c
Q)
E
>.
ns
Co
.
o
(.)
.S; 0 X uj
<1>
V)"'Oc~
~ <1> <1>'-
.- E L: c:
C:ca-<1>
<1> <1> C V)
V) .- <1>
<1>V)-V)
V) ca C CO
CO '- <1> <1>
<1> CO 9-0 '-
'- <1> v,
g >- "'0 .S;
.- u c 0
ocaca-
-'-"'0'-
"'Oc'-co
<1>8ca~
V) ~_
~<1>0~
<1> E..... V)
.0 "'O~
- m.~ <1>
V) '-_
~ <1> '- ca
E:5~(;)
.
Q)
E
o
CJ
I- .5
~ E
:::r: l!
OCD
r: e
_0-
...J
ai
<
o
::;
0-
0-
<
<1> v).s;
V)ca_
ca '- c
~ ca <1>
0<1>0.
(;)C>-V)
~ '0 u -g
<1>-caca
c"'O~
.- <1> c 'E '-
~~8~m
c "'0 <1> C >-
.- c E.E ca
"'0 ca ca "'0 0
~ c V).~ ~
V) ~ <1> t:: <1>
fr8~~E
"'0 ca .- '- V)
V)O",!-!
Q) 0) Q) "'0 x
.oCOQ)Q)
.C '- C C
iO'coC:'-Q)
E~~m:5
.
.c
CJ
-
ns
:e
-<1>
CL:
~-
'- '-
<1>.E
a.
o~
~CO
_0
~~
Q).-
_C
-~
ca E
L:E
o 0
roO
E=
_cauj
V) '- Q)
~ 0 ()
E ..-. .-
-c:
V) V) Q)
-8V)
C >.
.~ Q) L::
.9-:5 Q)
() "'0
Q).....-
,-ow
"'0
Q)
~
. - "'0
t::c
~~
.s;
~€
~~
I
>- "'0
.0 .!::
L:
'- -
Q) '-
L:O
-
. a:5 ai
'-
Q).3
.0:0
>-c
ca Q)
E~
<1>
{3 .S?
-.0
ca ~
Eo.
.
.
~~
.- -
C.... E
-E.E€~
~E~~g>
(.)oca_,-
_oowa..
o
-
"'0
Q)
V)
~
Q)i3
.oc
>-Q)
ca E
E.~
V) ~
cO"
o <1>
:+J'-
~L:
.00
Ero
C E
8-
i::'~
ca 0
--
C <1>
~ <1>
oE
>
.
>-
L::"'O
<1> 0
o..c
OQ)
i5..o.
<1>0
.o~
--
v)c
E8
"'OQ)
Q):5
-go
Q)"'O
o.c
~Q)
V) Q)
"'0:5
c_
~ ca
.....
w~
OL:
o.B
ca
roE
.
"'0
Q)
V)
~ V)
Q)cn
.08
Oc
c 0
c+::
~~
-
V).!a
"'OC
C'-
~ E
..... "'0
~ ca
.~~
V) '-
Q).E
'-L:
8.B
w~
OV)
Oca
.
'0"'0
~ ~
-
B'E
o ca 1:0
Q)~~
E--
ca "'0 ~
V) <1> V)
'E~
~co.$
-Oca
'- -
c 0 V)
=-ox
c <1> Q)
~Ec
V) CO Q)
<1>:5
~ V).S;
co_
>.'-C
ca CO Q)
E~g.
.
~
8 E
wQ)~€~
(.)E-Q)g>
J:o,-:g,-
_I.EWa..
.s; 0 x
Q) .
V) "'0 C V)
~ ~ Q) .~
.~ ca:5 c:
Q)Q)c~
V) '_
Q)V)_Q)
V) ca c V)
ca '- Q) co
Q)COo.~
t5 Q) V) 0
C >- "'0 .s;
'- 0 c 0
ocaCO-
- '- "'0 '-
"'OC'-CO
Q)8coQ)
V) ~>-
~Q)OCO
Q) E ..-. ~
.oco"'O~
- V).~ Q)
~Q)t::ro
E:5~(;)
.
0) V) '-x
.s; ~ 0 Q)
Co .- "'0 C
Q)~~Q)
.oV)"",L:
- ,,,-
V)Q)Q)c
~ V) V).-
Q)COCO_
c~'-c
.- 0 co Q)
cCQ)o.
.- >- V)
co
c.9O"'O
.- ca C
"'O~~CO
Q) (J) C '-
:!:~8'Eco
(J) co Q)
R "'0 Q) ~ >-
~~E.E~
_co (J)
Q)c(J)"'O~
.o~<1>Q)
>- 8 L: 'C .$
co -'-co
Eocco-
co._ () (J)
.
(J)
-'-
Q)
EQ)Q)
._ (J) >
:::- Q) co ~
~ L: Q)._
N(J):!:
-'- C
_<(0_
0)
c
'C
co
L:
(J)
-
(J)
8
'-
.E
"'0
Q)
V)
~
Q)
.0
-
o
C
c
~
.
'-"'0
ca C
~co
'O'E1:o
~co~
c~_
8.E ~
Q) ~
E~Q)
m.E 16
Q)~cn
:5 X
c'-Q)
.- 0 C
C"'OQ)
Q)Q)L:
a. -
(J)Ec
CO'-
~Q)'E
>-V)~
co co V)
E
rl
M
.
(J)
E
_ ~co
0- -.- '-
cn~c:g>
..JOQ),-
_...JrJ)Q.
..... c
U._
<(
lD
CIl ~ en
c ('l') c::
<tlCO
.~ O~
L.._ ='
Q)UD
E Q)';:::
<(CIlc:
L.OS
Q) 0 ....
"0 0 CJ)
ONE
'+-=,
.J::.oen
~CIlC::
~ C S
Q)
CIlEo
Q) ......
"- "0 -0
Cic....
EQ)ct!
8 E 0>
<(~
.
"OCIl -E
Q) "- -0
....._c::o
.....,.- ct! L.
C .J::. C. '+-
Q)uxE
a..- a>
x .J::. <tl
Q)~oL.
C ...... g>
Q) .- -0 L.
.0 "'8 m a.
en "C ::J 1?
:JQ)a>- .
E a...o c "0
- '- Q)
U...... <tl-
Q)<tlcnen~
E -cL. E::J :J Q)
o CIl c
U 8 Q)
C '0 L. 0>
.- Q) c:: 0 CIl
E.J::. co .--
-'OQ)~
~g>a>~.J::.
0>._ c:: L.a. U
o L. '- .-
L.:JCOE.J::.
a."O a> ._ ~
.
L.
J2
.J::.
U
-
<tl
E
~<tllDCIl
u,~I'-~
co <( "0 0>
'-'" Q)c
lD C B .C
o<(x.$
~ Q)CIl
I .-
lD . (5"~
COQ)'cE
CIl - :>."0
. - .!9 <tl ctl
..!J;!CIlE'+-
:JOCllO
E;;-:::Q).....
L.lDL.CIl
J2 -:E 8
~~I~
:{~~'+-
L.oCllOc
J2 ~ ->...... <tl
UCa.
-5 ~c~ctl
-"OQ)L.Q)
ctl Q) <(0) Q) L.
ELLa. ctl
.
L.
J2
"0
Q)
CIl
:J
Q) CIl
.oE
ctl
(5 L.
~e
~a.
ctl
CIl L.
"0 Q)
c"O
.2~
L.
~~
00
.
en
c::
~
;( L. "C
~Q)Q.) 0>
OO"OEue
_ <(:<(Q.
E
~
"0
(I)
CIl
:J
(I)
.0
.....
o
c
C
~.J::.
U
~C5
o E
:+:::iL-
Eo
'C 0>
c.~
o L.
u~
~CIl
ctl.....
_CIl
38
- L.
~J2
.
"0
Q)
l<=
"- "0
t::c
~~
I
- .~
~~
~ ctl
a.
I
:>'"0
.0 "~
.J::.
L. .....
Q) L.
.cO
-
'(ij (I)
L.
(1).3
.0:0
c
:>'Q)
ctl a.
E x
Q)
.c U
u=
-.0
ctl :J
Ea.
.
N
("')
~
o
o
~
.!a
-
c
(I)
E
~
'5
~
.c
u
-
ctl
E
CIl
.....
c
Q)
"a.
'0
Q)
L.
I
.0
:J
(j)
.
APPLICABILITY CHART DEFINITIONS
AAA. Area Agency on Aging
Program Income. Program income means gross income earned by a reclplent from activities which are
supported by a grant; i.e., when at least some of the cost of the activity is a direct cost of the grant or indirect cost
which helps match requirements of the grant. Program income includes contributions for meals or other
supportive services, proceeds from the sale of tangible personal property purchased for the program, fees for the
usage or rental of such property, and patent or copyright royalties for materials developed through the program.
Revenue generated from a particular activity of the recipient/sub-recipient for which Department funds were used
to cover at least half the cost is considered program income. Note: Money donated (cash donation) without
earmark to the project by the donor should not be declared in an audit to be "program income"
Cash Donations. Cash donations are money donated without earmark to the project by the donor. These
donations, when used as match, cannot be earmarked for any specific expenditure but are to be budgeted
normally. Cash donations are not program income.
Match. When general revenue funded contracts require match, it may be either by cash, certified public
expenditure, or third-party in-kind. The non-federal share used to match OAA funds may be cash, certified public
expenditure, or third-party in-kind.
Co-payments. Fees assessed and collected according to a sliding scale based on the consumer's income for CCE
and ADI services.
In-kind Resources. In-kind resources must be identified in project records, necessary to project's achievement,
reasonable and in proportion to time used for project, claimed after use in the project and, not included as
contributions for other programs unless specifically allowed.
In-kind contributions represent a value placed on noncash contributions provided to the recipient of a contract.
In-kind contributions may consist of actual charges for real property and equipment, and the value of goods and
services that directly benefit and are identified with project activities. This may include staff time contributed by
state and local agencies not otherwise matched or supported by federal funds.
33
MANAGEMENT ATTESTATION LETTER
(To be completed at the end of recipient's fiscal year)
ATTACHMENT m
EXIDBIT - 1
Contract or Agreement Number:
I,
(recipient's authorized representative)
, hereby attest under penalty of petjury
that
(recipient agency name)
, based on the criteria
set forth in the Audit Attachment, PARTS I and II, that:
A. The above named recipient agency is not required to provide an audit report or reporting package because
[check applicable statement(s)J:
o
o
the above-named entity has not expended $300,000 ($500,000 for fiscal years ending after December 31,
2003) or more in total federal awards in its fiscal year and therefore is not required to have a single or
program-specific audit performed in accordance in OMB Circular A-l33, as revised, and/or;
the above-named entity has not expended a total amount equal to or in excess of $300,000 in state awards
in its fiscal year and therefore is not required to have a State single or program-specific audit in
accordance with section 215.97, Florida Statutes.
B. The recipient has complied with the allowable cost provisions [congruent with State and Federal law,
generally accepted accounting principles, the Department of Financial Services' Reference Guide for State
Expenditures, and Office of Management and Budget (OMB) Circular A-122, A-IlO, or A-87, whichever is
applicable].
By making this statement the recipient has considered not only funding or awards from the Alliance, but all
sources of Federal and State funding or awards.
Fiscal year ended
(Month, day, year)
(Signature)
(Title)
(Date)
34
ATTACHMENT HI
Exhibit - 2
Oath of Not for Profit Status
Contract or Agreement Number: P A-429
As an authorized representative for the Recipient identified herein, and in the above referenced document(s), I do
hereby swear under oath that this entity is currently a "not for profit" (non-profit) organization as defined in
section 501 (c )(3) of the Internal Revenue Code. If this non-profit status changes for any reason during the life of
the above referenced contract or agreement, the Alliance for Aging will be notified in writing immediately.
Monroe County Board of Commissioners
Name of Recipient entity
'd?#
Signature of Authorized Representative
Louis LaTom..'
Printed name and Title of Authorized Representative
b"~~~~
Date of Oath
(Revised February 2004)
35
7/2004
r\greement P A-429
CERTIFICATION REGARDING DATA INTEGRITY COMPLIANCE
FOR CONTRACTS, GRANTS, LOANS AND
COOPERATIVE AGREEMENTS
ATTACHMENT IV
The undersigned, an authorized representative of the recipient named in the contract or agreement to which this
form is an attachment, hereby certifies that:
(1) The recipient and any sub-recipients of services under this contract have financial management systems
capable of providing certain information, including: (1) accurate, current, and complete disclosure of the
financial results of each grant-funded project or program in accordance with the prescribed reporting
requirements; (2) the source and application of funds for all contract supported activities; and (3) the
comparison of outlays with budgeted amounts for each award. The inability to process information in
accordance with these requirements could result in a return of grant funds that have not been accounted for
properly.
(2) Management Information Systems used by the recipient, sub-recipient(s), or any outside entity on which the
recipient is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified
to be capable of processing data accurately, including year-date dependent data. For those systems identified
to be non-compliant, recipient(s) will take immediate action to assure data integrity.
(3) If this contract includes the provision of hardware, software, firmware, microcode or imbedded chip
technology, the undersigned warrants that these products are capable of processing year-date dependent data
accurately. All versions of these products offered by the recipient (represented by the undersigned) and
purchased by the State will be verified for accuracy and integrity of data prior to transfer.
In the event of any decrease in functionality related to time and date related codes and internal subroutines
that impede the hardware or software programs from operating properly, the recipient agrees to immediately
make required corrections to restore hardware and software programs to the same level of functionality as
warranted herein, at no charge to the State, and without interruption to the ongoing business of the state, time
being of the essence.
(4) The recipient and any sub-recipient(s) of services under this contract warrant their policies and procedures
include a disaster plan to provide for service delivery to continue in case of an emergency including
emergencies arising from data integrity compliance issues.
The recipient shall require that the language of this certification be included in all subcontracts, subgrants, and
other agreements and that all sub-contractors shall certify compliance accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction
imposed by OMB Circulars A-I02 and A-I 10.
~I\.~L./-S~
Title
, .; .;2 )-:. 0 '1
Date
,...,....
Signature
"-..J.-J L4-JbI\.~~
Name of Authorized Signer
36
7/2004
(Revised February 2004)
Page Intentionally Left Blank
37
- ~greement P A-429
7/2004
~ _5feernent PA-429
ATTACHMENT V
MINIMUM GUIDELINES FOR RECIPIENT GRIEVANCE PROCEDURES
APPLICABLE TO ALL ADVERSE ACTIONS DEEMED TERMINATIONS, SUSPENSIONS, OR
REDUCTIONS IN SERVICE
Medicaid Waiver clients have the right to request a fair hearing from the Department of Children and Families
(DCAF) Office of Appeal Hearings in addition to or as an alternative to these procedures.
NOTICE TO THE RECIPIENT OF THE ADVERSE ACTON TO BE TAKEN AND EXPLANATION OF THE
GRIEVANCE PROCEDURES FOR REVIEWING THAT DECISION
· The recipient must be informed by the decision maker of the action, in writing, no less than 10 calendar* days
prior to the date the adverse action will be taken.
(Prior notice is not applicable where the health or safety of the individual is endangered if action is not taken
immediately; however, notice must be made as soon thereafter as practicable.)
· Services cannot be reduced or terminated, nor any adverse action taken during the 10 day period.
. The Notice must contain:
a statement of what action is intended to be taken;
the reasons for the intended action;
an explanation of:
1) the individual's right to a grievance review ifrequested in writing and delivered within 10 calendar* days
of the Notice postmark (assistance in writing, submitting and delivering the request must be offered and
available to the individual);
2) in Medicaid Waiver actions, the individual's right to request a fair hearing from DCAF;
3) the individual's right, after a grievance review, for further appeal;
4) the right to seek redress through the courts if applicable;
a statement that current benefits will continue if a grievance review is requested, and will continue until a
final decision is made regarding the adverse action; and a statement that the individual may represent
himselfi'herself or use legal counsel, a relative, a friend, or other qualified representative in the requested
review proceedings.
· All records of the above activities must be preserved in the client's file.
GRIEVANCE REVIEW PROCEDURE UPON TIMELY RECEIPT OF A WRITTEN REQUEST FOR REVIEW
· Within 7 calendar* days of the receipt of a request for review, the provider must acknowledge receipt of the
request by a written statement delivered to the requester. This statement must also provide notice of:
the time and place scheduled for the review;
the designation of one or more impartial reviewers who have not been involved in the decision at issue;
the opportunity to examine, at a reasonable time before the review, the individual's own case record, and to a
copy of such case record at no cost to the individual;
the opportunity to informally present argument, evidence, or witnesses without undue interference at a
reasonable time before or during the review;
a contact person for any accommodations required under the Americans with Disabilities Act; and assistance,
if needed, in order to attend the review; and the stopping of the intended action until all appeals are exhausted.
· All grievance reviews must be conducted at a reasonable time, date and place by one or more impartial
reviewers who have not been directly involved in the initial determination ofthc action in question.
38
712004 n.greement P A-429
. The reviewer(s) must provide written notification to the requester, within 7 calendar* days after the grievance
review, stating:
the decision, the reasons therefore in detail;
the effect the decision has on current benefits, if favorable, or the circumstances regarding continuation of
current benefits until all appeals are exhausted;
the individual's right to appeal an adverse decision to the Alliance for Aging by written request within 7
calendar* days, except in decisions involving the professional judgement of a legal assistance provider;
the availability of assistance in writing, submitting and delivering the appeal to the appropriate agency;
the opportunity to be represented by himseIfi'herself or by legal counsel, a relative, a friend or other qualified
representative;
for legal assistance service appeals, the individual's right to file a grievance with the Florida Bar regarding
complaints related to the actual legal representation provided.
PROCEDURE FOR APPEALS OF A GRIEVANCE REVIEW DECISION UPON TIMEL Y RECEIPT OF A
WRITTEN APPEAL TO THE ALLIANCE FOR AGING - AREA AGENCY ON AGING
. Within 7 calendar* days of the receipt of a notice of appeal of a grievance review decision, the AAA must
acknowledge receipt of the notice of appeal by a written statement delivered to the appellant. This statement
must also provide notice of:
the time and place scheduled for the appeal;
the designation of one or more impartial AAA officials who have not been involved in the decision at issue;
the opportunity to examine at a reasonable time before the appeal the individual's own case record to date,
and to a copy of such case record at no cost to the individual;
the opportunity to informally present argument, evidence, or witnesses without undue interference during the
appeal;
assistance, if needed, in order to attend the appeal;
and the stopping of the intended action until all appeals are exhausted.
. All appeals of grievance reviews must be conducted at a reasonable time, date and place by one or more
impartial AAA officials who have not been directly involved in the initial determination of the action in
question.
. The designated AAA official(s) must provide written notification to the requester within 7 calendar* days
after considering the grievance review appeal, stating:
the decision, and the reasons therefore in detail;
the effect the decision has on current benefits, if favorable, or the circumstances regarding continuation of
current benefits until all appeals are exhausted;
the individual's right to appeal, if applicable.
. Except for Medicaid Waiver actions, the decision of the AAA shall be the fmal decision;
and the availability of assistance in requesting a fair hearing, including a notice regarding accommodations as
required by the ADA.
. All records of the above activities must be preserved and remain confidential. A copy of the final decision
must be placed in the client's file.
* In computing any period of time prescribed or allowed by these guidelines, the last day of the period so
computed shall be included unless it is a Saturday, Sunday, or legal holiday, in which event the period shall run
until the end of the next day which is neither a Saturday, Sunday, or legal holiday.
39
712004
, ..greement P A-429
ATTACHMENT VI
INTERMEDIATE MEASURES
INDICATORS MEASUREMENT INTERMEDIATE
Section 430.04 (2), F .S. MEASURES Section 430.04
(2), F.S.
Lacks financial stability . Failure within the same . Temporary assumption of
sufficient to meet contractual fiscal year in which due to operations and functions
obligations or that contractual pay short-term loans related to the problem
funds have been . Failure to transfer at the area within the agency
misappropriated appropriate time, due to . Placement on
lack of funds probationary status for a
0 Taxes withheld on specified period sufficient
the income of to address identified
employees problems
0 Employer and . Impose a time limited
employee moratorium on agency
contributions for . Reduce any advances for
federal social security the following year to 30
or any pension, days and examine
retirement, or benefit surpluses for
plan for an employee redistribution.
. Failure for one pay period to
pay, due to lack of funds
0 Wages and salaries
owed to employees
0 Retirement benefits
owed to former
employees
. An unreserved or total fund
balance or retained
earnings deficit for which
sufficient resources are not
available to cover the deficit
for 2 successive years
An intentional or negligent act . Intentional or Repeated . Impose a time limited
of the agency has materially violations of the moratorium on agency
affected the health, welfare, requirement to serve APS . Temporary assumption of
or safety of clients, or clients within 72 hours operations and functions
substantially and negatively . Any other verifiable report related to the problem
affected the operation of an of such actions area within the agency
aging services program
Committed multiple or . Achievement levels from . Unannounced special
repeated violations of legal monitoring reviews monitoring
and regulatory requirements . Any other verifiable report . Reduction in advances for
or Department standards of such actions following year and review
of surpluses for
redistribution
. Appropriate Corrective
action
40
7/2004
Agreement PA-429
ATTACHMENT VI (cont.)
INTERMEDIATE MEASURES
INDICATORS MEASUREMENT INTERMEDIATE
Section 430.04 (2), F.S. MEASURES Section 430.04
(2), F .S.
Failed to adhere to terms of -Achievement levels from - Placement on probationary
its contract with the monitoring reviews status for a specified
Department as passed -Adherence to Service period to address identified
throug h the Alliance Application problems
-Any other verifiable report - Financial penalties
of such action - Re-allotment of surplus
funds to other planning and
service areas
- Appropriate Corrective
action
Failed to implement and -Achievement levels from - Appropriate Corrective
maintain Department monitoring reviews action
approved client grievance -Any other verifiable report
resolution procedure of such action
Failed to continue the -Achievement levels from - Temporary assumption of
provision or expansion of monitoring reviews agency operations and
services after the declaration -Any other verifiable report functions to implement
of a state of emergency of such action emergency service plan
41
7/2004
r\.greernent PA-429
Attachment VII
Health Insurance Portability and Accountability Act (HIP AA) of 1996
The Alliance and the recipient will comply with all requirements of the Health Insurance Portability and
Accountability Act (HIP AA) of 1996. The Alliance and the recipient recognize that each is a "Business
Associate" of the other under the terms ofHIPAA. As such and in so far as these apply, each agrees to the
following:
(a) That neither party will use or disclose protected health information for any purpose other than as authorized
by law, by this contract, or by separate agreement between the parties.
(b) That each party will not use or disclose protected health information in a manner which would be a prohibited
use or disclosure if made by the other.
(c) That each party will maintain safeguards as necessary to ensure that the protected health information is not
used or disclosed except as provided by law, by this contract, or by separate agreement between the parties.
(d) That each party will report to the other any use or disclosure of the protected health information of which it
becomes aware that is not provided for by law, by this contract, or by separate agreement between the
parties.
(e) That each party will ensure that any of its subcontractors or agents to whom it provides protected health
information received from the other agree to the same restrictions and conditions that apply to each other with
respect to such information.
(f) That each party will follow an agreed upon process established to provide access to protected health
information to the subject of that information when the other has made any material alteration to the
information. This process will include how each party would determine in advance how the other would
know or could readily ascertain when a particular individual's protected health information has been
materially altered by the other and how it could provide access to such information. This process will
establish how each party would provide access to protected health information to the subject of the
information in circumstances where the information is being held by the other.
(g) That each party will provide health information to the subject of the information in accordance with the
subject's right to access, inspect, copy, and amend their health information.
(h) That each party will make available to the other its internal practices, books and records relating to the use,
disclosure, and tracking of disclosure of protected health information received from the other or its agents for
the purposes of enforcing compliance with HIP AA.
(i) That each party will assist the other in meeting its obligation to provide, at an individual's request, an
accounting of all uses and disclosures of personal health information which are not related to treatment,
payment, or operations within 60 days of the request of an accounting.
(j) That each party will incorporate any amendments or corrections to protected health information when notified
by the other that the information is inaccurate or incomplete.
(k) That at the termination of this contract, unless a new contract is agreed upon, each party will return or destroy
all protected health information received from the other that it stilI maintains in any form.
(1) That either party may terminate this contract if it learns that the other has repeatedly violated a term of this
contract provision.
42
..r\.greement P A-429
7/2004
(m) That each party will disc lose only the minimum amount of information necessary to accomplish the pennitted
use of the protected health information. This minimum use requirement does not apply to information
provided for treatment or to disclosures required by law.
(n) That each party will limit the use and disc tosure of protected health information to the minimum number of
employees necessary by class of employee and type of information to accomplish the permitted use of the
information.
(0) That each party will meet at least the minimum security requirements for the protection of protected health
information as required by HIP AA.
(p) That each party is bound by the terms of tbe "Notice of Practices" of the other with regard to protected health
information it receives from the other.
43