The URL can be used to link to this page

Backup Documents 09/08/2015 Item #16D 3 16fJ , COMMUNITY AND HUMAN SERIVCES INTEROFFICE MEMORANDUM TO: Board Minutes and Records FROM: Lisa N. Carr, Grants Coordinator, CHC" DATE: September 8, 2015 RE: Agreements between Area Agency on Aging for Southwest Florida, Inc and Collier County: CCE 203.15, ADI 203.15 and HCE 203.15 Please find attached one (1) of each fully executed document that was approved by the BCC on the day listed below for recording in Minutes and Records. Feel free to contact me if you have any questions. BCC Approved on September 8,2015, Item 16D3 Thank you for your assistance. Jul;2015 to June 2016 CCE 203.15 FLORIDA,AGENCY ON AGING FOR SOUTHWEST INC. 1 6 03 COMMUNITY CARE FOR THE ELDERLY PROGRAM CONTRACT COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. (Agency) and Collier County Board of County Commissioners (Contractor), and collectively referred to as the "Parties." The term Contractor for this purpose may designate a Vendor, Subgrantee or Subrecipient. WITNESSETH THAT: WHEREAS,the Agency has determined that it is in need of certain services as described herein; and WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services as an independent Contractor of the Agency. NOW THEREFORE, in consideration of the services to be performed and payments to be made,together with the mutual covenants and conditions hereinafter set forth,the Parties agree as follows: 1. Purpose of Contract The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments, forms, exhibits and references incorporated,which constitute the contract document. 2. Incorporation of Documents within the Contract The contract will incorporate attachments,proposal(s),state plan(s),grant agreements,relevant Department handbooks, manuals or desk books and Master Contract number HM014,as an integral part of the contract,except to the extent that the contract explicitly provides to the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s)or other general materials not specific to this contract document and identified attachments. 3. Term of Contract This contract shall begin at twelve (12:00) A.M., Eastern Standard Time July 1, 2015 or on the date the contract has been signed by the last party required to sign it,whichever is later. It shall end at eleven fifty-nine(11:59)P.M.,Eastern Standard Time June 30,2016. 4. Contract Amount The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $747.745.00, or the rate schedule, subject to the availability of funds. Any costs or services paid for under any other contract or from any other source are not eligible for payment under this contract. 5. Renewals By mutual agreement of the Parties, in accordance with s. 287.058(1)(g), Florida Statutes, the Agency may renew the contract for a period not to exceed three years,or the term of the original contract,whichever is longer. The renewal price,or method for determining a renewal price,is set forth in the bid,proposal,or reply. No other costs for the renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and contingent upon satisfactory performance evaluations by the Agency and the availability of funds. 1 July 2015 to June 2016 16 03CCE 203.15 6. Official Pavee and Representatives(Names.Addresses.and Telephone Numbers): Collier County Housing,Human and Veteran The Contractor name, as shown on page 1 of this Services a. contract, and mailing address of the official payee to 3339 E Tamiami Trail, Building H whom the payment shall be made is: Naples, FL 34112 Kimberly Grant, Director b. The name of the contact person and street address where Collier County Housing Services Human and Veteran financial and administrative records are maintained is: 3339 E Tamiami Trail, Building H Naples,FL 34112 Kimberly Grant,Director The name, address, and telephone number of the Collier County Housing, Human and Veteran c' representative of the Contractor responsible for Services administration of the program under this contract is: 3339 E Tamiami Trail, Building H Naples,FL 34112 (239)252-2273 Tammy Rhoades,VP of Finance The section and location within the Agency where Area Agency on Aging for Southwest Florida, Inc. d. Requests for Payment and Receipt and Expenditure 15201 North Cleveland Avenue, Suite 1100 fnrms are to he mailed ic• North Fort Myers, FL 33903 Marianne Lorini,Executive Director e. The name, address, and telephone number of the Area Agency on Aging for Southwest Florida, Inc. Contract Manager for this contract is: 15201 North Cleveland Avenue, Suite 1100 North Fort Myers,FL 33903 239-652-6900 Upon change of representatives (names, addresses, telephone numbers) by either party, notice shall be provided in writing to the other party and the notification attached to the originals of this contract. 7. All Terms and Conditions Included: This contract and its Attachments, I, III, VI-X and any exhibits referenced in said attachments,together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications,representations or agreements, either written or verbal between the Parties. By signing this contract,the Parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF,the Parties hereto have caused this contract, to be executed by their undersigned officials as duly authorized. Contractor: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST COUNTY COMMISSIONERS FLORIDA,INC. lap1 SIGNED BY: ', SIGNED BY: /162-A14-1-^4— NAME. — NAME: Stephen Y Carnell NAME: MARIANNE G LORINI TITLE: Public Services Department Head TITLE: PRESIDEN)T/CEO DATE: DATE: ?/ y//` Federal Tax ID: 59-6000558 Fiscal Year Ending Date: 09/30 Approved as to form and legality C7 2 \-1-11 AssistantCa County Attorney CA 1 6 Li July 2015 to June 2016 3 CCE 203.15 INDEX OF ATTACHMENTS ATTACHMENT I.. . 4 ATTACHMENT III .14 ATTACHMENT VI ANNUAL BUDGET AND RATE SUMMARY 15 ATTACHMENT VII INVOICE REPORT SCHEDULE 16 ATTACHMENT VIII REQUEST FOR PAYMENT 17 ATTACHMENT IX RECEIPT AND EXPENDITURE REPORT 18 ATTACHMENT X COST REIMBURSEMENT SUMMARY ..19 *Attachments II,IV,and V are included by reference in the Master Contract HM014. 3 ,July 2015 to June 2016 1 6 3 CCE 203.15 ATTACHMENT I AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. COMMUNITY CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1. DEFINITIONS OF TERMS AND ACRONYMS 1.1.1 Contract Acronyms Area Agency on Aging(AAA) Adult Protective Services(APS) Adult Protective Services Referral Tracking Tool (ARTT) Corrective Action Plan(CAP) Community Care for the Disabled Adult(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Florida Department of Elder Affairs(DOEA) Florida Statutes(F.S.) Home Care for Disabled Adults(HCDA) Planning and Service Area(PSA) Summary of Programs and Services(SOPS) 1.1.2 Program Specific Terms Adult Protective Services Referral Tracking Tool: A system designed to track DCF APS referrals to AAAs and CCE Lead Agencies for victims of second party abuse, neglect, and exploitation who need home and community-based services as identified by APS staff. Aging Out: The condition of reaching 60 years of age and being transitioned from the DCF Services, CCDA or HCDA services to the Agency's community-based services. Area Plan: A plan developed by the area agency on aging outlining a comprehensive and coordinated service delivery system in its PSA in accordance with the Section 306 (42 U.S.C. 3026)of the Older Americans Act and Agency and/or Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the area agency on aging enters CCE specific data in the CIRTS. An update may also include other revisions to the Area Plan as instructed by the Agency and/or Department. Department of Elder Affairs Programs and Services Handbook: An official document of the State of Florida, DOEA. The Handbook includes program policies, procedures, and standards applicable to agencies which are recipients/providers of DOEA funded programs. An annual update is provided through a Notice of Instruction. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. 4 3 July 2015 to June 2016 16 0 CCE 203.15 Notice of Instruction (NOI): The Department's established method to communicate to the Agency and/or Contractor the requirement to perform a particular task or activity. NOIs are located on the Department's website at http://elderaffairs.state.fl.us/doea/nois.php. Program Highlights: Success stories, quotes, testimonials, or human-interest vignettes that are used in the Summary of Programs and Services to demonstrate how programs and services help elders, families, and caregivers. Summary of Programs and Services (SOPS): A document produced by the Department and updated yearly to provide the public and the Legislature with information about programs and services for Florida's elders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The primary purpose of the CCE Program is to prevent, decrease, or delay premature or inappropriate and expensive placement of elders in nursing homes and other institutions. 1.2.2 Community Care for the Elderly Mission Statement The CCE Program assists functionally impaired elderly persons in living as independently as possible in their own homes or in the homes of relatives or caregivers. The program provides a continuum of care through the development, expansion, reorganization, and coordination of multiple community-based services to assist elders to reside in the least restrictive environment suitable to their needs. 1.2.3 Authority The relevant authorities governing CCE Program are: (1) Rule 58C-1, Florida Administrative Code; (2) Sections 430.201 through 430.207, F.S.; and (3) The Catalog of State Financial Assistance(CSFA)Number 65.010. 1.2.4 Scope of Service The Contractor is responsible for the programmatic,fiscal,and operational management of CCE. The program services shall be provided in a manner consistent with and described in the Contractor's Request for Proposal, RFP, and the Agency's current area plan, and the current DOEA Programs and Services Handbook, which are hereby incorporated by reference. 1.2.5 Major Program Goals The major goals of the program are to preserve the independence of elders and prevent or delay more costly institutional care through a community care service system that provides case management and other in-home and community services as needed under the direction of a lead agency and provide a continuum of service alternatives that meet the diverse needs of functionally impaired elders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The CCE Program provides a continuum of services for functionally impaired elders. 1.3.2 Individual Eligibility In order to receive services under this contract, an applicant must: (1) Be at least 60 years of age; (2) Be functionally impaired as determined through the initial comprehensive assessment; and 5 July 2015 to June 2016 1bD3 CCE 203.15 (3) Not be dually enrolled in the CCE Program and a Medicaid capitated long-term care program. 1.3.2.1 Targeted Groups Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk of placement in an institution or who are abused, neglected or exploited. SECTION II: MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS To achieve the goals of the CCE Program, the Contractor shall perform, or ensure that its Subcontractors perform the following tasks: (1) Client Eligibility Determination; (2) Assessment and Prioritization of Service Delivery for New Clients; (3) Delivery of Services to Eligible Clients; and (4) Monitoring the performance of Subcontractors. 2.1.1 Client Eligibility Determination The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this ATTACHMENT I,Section 1.3. 2.1.1.1 DCF APS Low,Intermediate,and High Risk Referrals Risk Referrals For DCF APS Low, Intermediate, and High Risk Referrals for individuals who are enrolled in a Medicaid long-term care program at the time of referral to the Contractor or Subcontractor,the Contractor shall: (1) Ensure that the intake entity contacts the DCF APS protective investigator and notifies him/her that the referral was not accepted because the referred individual is enrolled in a Medicaid long-term care program; and (2) Ensure that the intake entity notes that the referred individual is enrolled in a Medicaid long-term care program in the ARTT as the reason for rejection. 2.1.2 Assessment and Prioritization of Service Delivery for New Clients The Contractor shall ensure the following criteria are used to prioritize new clients in the sequence below for service delivery. It is not the intent of the Agency to remove existing clients from services in order to serve new clients being assessed and prioritized for service delivery. (1) DCF APS High Risk individuals: The Contractor shall ensure that pursuant to Section 430.205(5)(a), Florida Statutes, those elderly persons who are determined by DCF APS to be victims of abuse, neglect, or exploitation who are in need of immediate services to prevent further harm, and are referred by APS, will be given primary consideration for receiving CCE services. As used in this subsection, "primary consideration" means that an assessment and services must commence within 72 hours after referral to the Agency or as established in accordance with Agency contracts by local protocols developed between Agency service Contractors and APS. • The Contractor shall follow guidelines for DCF APS High Risk referred individuals established in the APS Operations Manual, which is incorporated by reference. (2) Imminent Risk individuals: Individuals in the community whose mental or physical health condition has deteriorated to the degree that self-care is not possible, there is no capable caregiver, and nursing home placement is likely within a month or very likely within 3 months. 6 1 6 July 2015 to June 2016 3 CCE 203.15 (3) Aging Out individuals: Individuals receiving CCDA and HCDA services through the Department of Children and Families' Adult Services transitioning to community-based services provided through the Agency and/or Department when services are not currently available. (4) Service priority for individuals not included in (1), (2), and (3) above, regardless of referral source, will be determined through the Agency's functional assessment administered to each applicant, to the extent funding is available. The Contractor shall ensure that first priority is given to applicants at the higher levels of frailty and risk of nursing home placement. For individuals assessed at the same priority and risk of nursing home placement, priority will be given to applicants with the lesser ability to pay for services. 2.1.2.1 Referrals for Medicaid Waiver Services: (1) The Contractor must require Subcontractors,through the performance of the client assessment,to identify potential Medicaid eligible CCE clients and to refer these individuals for application for Medicaid Waiver services. (2) The Contractor must require individuals who have been identified as being potentially Medicaid Waiver eligible to apply for Medicaid Waiver services in order to receive CCE services. These individuals may only receive CCE services while the Medicaid Waiver eligibility determination is pending. If the client is found ineligible for Medicaid Waiver services for any reason other than failure to provide required documentation,then the individual may continue to receive CCE services. (3) The Contractor must advise individuals who have been identified as being potentially Medicaid Waiver eligible of the responsibility to apply for Medicaid Waiver services as a condition of receiving CCE services while the eligibility determination is being processed. 2.1.3 Delivery of Service to Eligible Clients The Contractor shall ensure the provision of a continuum of services that meet the diverse needs of functionally impaired elders. The Contractor shall ensure performance and reporting of the following services in accordance with the current DOEA Programs and Services Handbook, which is incorporated by reference. The services include the following categories: (1) Core Services; (2) Health Maintenance Services; and (3) Other Support Services. 2.1.3.1 Core Services for Programmatic Operation The Contractor shall ensure that core services include a variety of home-delivered services,day care services, and other basic services that are most needed to prevent unnecessary institutionalization. Core services,to be provided at the unit rate identified in the Area Plan, as updated, include the following: (1) Adult Day Care; (8) Housing Improvement; (2) Chore Services; (9) Legal Assistance; (3) Companionship; (10) Pest Control Services; (4) Escort; (11) Respite Services; (5) Financial Risk Reduction; (12) Shopping Assistance; and (6) Home Delivered Meals; (13) Transportation. (7) Homemaker; 7 July 2015 to June 2016 CCE 203.15 2.1.3.2 Health Maintenance Services 1 6 0 3 The Contractor shall ensure that health maintenance services are routine health services that are necessary to maintain the health of functionally impaired elders. These services are limited to medical therapeutic services, non-medical prevention services, personal care services, home health aide services, home nursing services, and emergency response systems. Typical services to be provided at the unit rate identified in the Area Plan, as updated, include the following: (1) Adult Day Health Care; (8) Nutrition Counseling; (2) Emergency Alert Response; (9) Occupational Therapy; (3) Gerontological Counseling; (10) Personal Care; (4) Health Support; (11) Physical Therapy; (5) Home Health Aide; (12) Skilled Nursing Services; (6) Medication Management; (13) Specialized Medical Equipment, (7) Mental Health Counseling/Screening; Services and Supplies; and (14) Speech Therapy. 2.1.3.3 Other Support Services The Contractor shall ensure that support services expand the continuum of care options to assist functionally impaired elders and their caregivers. Support services to be provided at the unit rate identified in the Area Plan as updated, include the following: (1) Caregiver Training/Support; (2) Case Aid; (3) Case Management; (4) Intake; (5) Material Aid; and (6) Other services,as approved by the Agency. 2.1.4 Use of Subcontractors If this contract involves the use of a Subcontractor or third party, then the Contractor shall not delay the implementation of its agreement with the Subcontractor. If any circumstances occur that may result in a delay for a period of 60 days or more of the initiation of the subcontract or in the performance of the Subcontractor, the Contractor shall notify the Agency's Contract Manager and the Agency's Chief Financial Officer in writing of such delay. The Contractor shall not permit a Subcontractor to perform services related to this agreement without having a binding Subcontractor agreement executed. In accordance with Section 23.1 of Master Contract,the Agency will not be responsible or liable for any obligations or claims resulting from such action. The Contractor shall submit a copy of all subcontracts to the Contract Manager within thirty days of the subcontract being executed. 2.1.5 Monitoring the Performance of Subcontractors The Contractor shall monitor,at least once per year,each of its Subcontractors,Subrecipients,Vendors,and/or Consultants paid from funds provided under this contract. The Contractor shall perform fiscal,administrative and programmatic monitoring to ensure contractual compliance, fiscal accountability, programmatic performance and compliance with applicable state and federal laws and regulations. The Contractor shall monitor to ensure that time schedules are met, the budget and scope of work are accomplished within the specified time periods, and other performance goals stated in this contract are achieved. 8 �rr�� July,2015 to June 2016 CCE 203.15 1 6 0 3 2.2 SERVICE TIMES 2.2.1 Service Times The Contractor shall ensure the availability of services listed in this contract at times appropriate to meet client service needs, at a minimum during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The Contractor shall ensure the provision of the services described in the contract in accordance with the current DOEA Programs and Services Handbook and the service tasks described in Section 2.1. ATTACHMENT VI lists the services that can be performed,the highest reimbursement unit rate,the method of payment, and the service unit type. Units of service will be paid pursuant to the rate established in the Area Plan as updated, as shown in ATTACHMENT VI, and approved by the Agency. 2.4 REPORTS The Contractor shall respond to additional routine and/or special requests for information and reports required by the Agency in a timely manner as determined by the Contract Manager. The Contractor shall establish reporting due dates for Subcontractors that permit the Contractor to meet the Agency's reporting requirements. 2.4.1 Area Plan Update and All Revisions Thereto The Agency is required to submit an annual Area Plan update wherein the Agency enters CCE-specific data in the CIRTS. The Contractor may also be required to submit revisions to the Area Plan as instructed by the Agency and/or Department. 2.4.2 CIRTS Reports The Contractor shall input CCE-specific data into CIRTS. To ensure CIRTS data accuracy, the Contractor shall use CIRTS-generated reports which include the following: (1) Client Reports; (2) Monitoring Reports; (3) Services Reports; (4) Miscellaneous Reports; (5) Fiscal Reports; (6) Aging and Disability Resource Center Reports; and (7) Outcome Measurement Reports. 2.4.4 Program Highlights The Contractor shall submit Program Highlights referencing specific events that occurred in SFY/FFY 2014- 2015 by September 04,2015. The Contractor shall provide a new success story,quote,testimonial,or human- interest vignette.The highlights shall be written for a general audience,with no acronyms or technical terms. For all agencies or organizations that are referenced in the highlight, the Contractor shall provide a brief description of their mission or role. The active tense shall be consistently used in the highlight narrative, in order to identify the specific individual or entity that performed the activity described in the highlight. The Contractor shall review and edit Program Highlights for clarity, readability, relevance, specificity, human interest,and grammar, prior to submitting them to the Agency. 9 July 2015 to June 2016 CCE 203.15 1 6 D 3 2.5 RECORDS AND DOCUMENTATION The Contractor shall ensure, on a monthly basis,that client and service information is properly collected and maintained within the CIRTS or any such system designated by the Agency and/or Department.Maintenance includes valid exports and backups of all data and systems according to Agency and/or Department standards and the DOEA Programs and Services Handbook. 2.5.1 Policies for Data and Software Backup Each Contractor and Subcontractor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of Contractor 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 Contractor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with Subcontractors. These policies and procedures shall be made available to the Agency,upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1) The Contractor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook. (2) The Contractor shall timely submit to the Agency all reports described in ATTACHMENT I, SECTION 2.4 REPORTS; (3) The Contractor shall timely submit to the Agency all information described in ATTACHMENT I, SECTION 2.5 RECORDS AND DOCUMENTATION. 2.7 CONTRACTOR'S FINANCIAL OBLIGATIONS 2.7.1 Matching,Level of Effort,and Earmarking Requirement The Contractor must provide a match of at least 10 percent of the cost for all CCE services. The match must be made in the form of cash and/or in-kind resources. At the end of the contract period, all CCE funds expended must be properly matched. State funds shall not be used to match another state-funded program. 2.7.2 Cost Sharing and Co-Payments The Agency must ensure Contractors establish annual co-payment goals. The Agency has the option to withhold a portion of the Contractor's request for payment if goals are not met according to the Agency and/or Department's co-payment guidelines, in accordance with the current DOEA Programs and Services Handbook, which is incorporated by reference. Co-payments include only the amounts assessed to consumers by Contractors or the amounts consumers opt to contribute in lieu of an assessed co- payment. The consumer's contribution must be equal to or greater than the assessed co-payment. Co- payments collected in the CCE Program can be used as part of the local match, as detailed above in Section 2.7.1. 2.8 AGENCY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The Agency will provide to the Contractor guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Contractor. 10 July 2015 to June 2016 1 6 it 3 CCE 203.15 2.8.2 Contract Monitoring The Agency will review and evaluate the performance of the Contractor under the terms of this contract. Monitoring shall be conducted through direct contact with the Contractor through telephone,in writing,or an on-site visit. The Agency's determination of acceptable performance shall be conclusive. The Contractor agrees to cooperate with the Agency in monitoring the progress of completion of the service tasks and deliverables. The Agency may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 General Statement of Method of Payment The method of payment for this contract includes advances and fixed rate for services. Payment may be authorized for all allowable expenditures to complete the tasks identified in the deliverables, as required by the agreement. The Contractor shall consolidate all requests for payment from Subcontractors and expenditure reports that support requests for payment and shall submit to the Agency on ATTACHMENT VIII, ATTACHMENT IX, and ATTACHMENT X. 3.1.1 Funding Distribution The Contractor agrees to distribute funds as detailed in the Area Plan update and the Annual Budget Summary, ATTACHMENT VI to this contract. Any changes in the total amounts of the funds identified on the Budget Summary form require a contract amendment. 3.2 ADVANCE PAYMENTS The Contractor may request up to two months of advances at the start of the contract period to cover program administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount of funds released to the Agency and the Department by the State of Florida ("budget release"). The Contractor shall provide the Contract Manager documentation justifying the need for an advance and describing how the funds will be distributed. The Contractor's requests for advances require the approval of the Contract Manager. If sufficient budget is available, the Agency will issue approved advance payments after July 1, 2015. 3.2.1 Advance Recoupment All advance payments made to the Contractor shall be returned to the Agency as follows: one—tenth of the advance payment received shall be reported as an advance recoupment on each request for payment, starting with report number five,in accordance with the Invoice Report Schedule,ATTACHMENT VII. The Contractor may temporarily place advanced funds in a FDIC insured interest bearing account. All interest earned on advanced funds must be returned to the Agency within 30 days or the end of each quarter of the contract period. 11 6 0 July 2015 to June 2016 I. 3 CCE 203.15 3.3 INVOICE SUBMITTAL AND REQUESTS FOR PAYMENT All Requests For Payment and Receipt and Expenditure Reports submitted to the Agency shall be submitted using ATTACHMENT VIII, ATTACHMENT IX and Cost Reimbursement Summary (ATTACHMENT X). The Contractor shall include documentation of services provided,unit of services,and the rates for the services provided in conformance with the requirements as described in this ATTACHMENT I and ATTACHMENT VI. 3.3.1 Payment Requests All payment requests shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests(when available)and invoices is ATTACHMENT VII. 3.3.2 Payment Withholding Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments thereto,including any disallowance not resolved as outlined in Section 26 of the Master Contract. 3.3.3 Date for Final Request For Budget Revisions Final requests for budget revisions or adjustments to contract funds based on expenditures for services, must be submitted to the Contract Manager no later than June 25, 2016. 3.3.4 Date for Final Request for Payment The final request for payment for expenditures is due to the Agency no later than July 25,2016. 3.4 DOCUMENTATION FOR PAYMENT The Contractor shall maintain documentation to support payment requests that shall be available to the Agency or authorized individuals, such as Department of Financial Services,upon request. 3.4.1 CIRTS Data Entries for Contractors The Agency must require Contractors to enter all required data for clients and services in the CIRTS database per the DOEA Programs and Services Handbook and the CIRTS User Manual — Aging Provider Network users (located in Documents on the CIRTS Enterprise Application Services). Contractors must enter this data into the CIRTS prior to submitting their requests for payment and expenditure reports to the Agency. The Agency shall establish deadlines for submission to assure compliance with due dates for the requests for payment and expenditure reports that Contractor must submit to the Agency. 3.4.2 Contractors' Monthly CIRTS Reports The Contractor must run monthly CIRTS reports and verify client and service data in the CIRTS is accurate. This report must be submitted to the Agency with the monthly request for payment and expenditure report and must be reviewed by the Agency before the Contractor's request for payment and expenditure reports can be approved by the Agency. 3.5 REMEDIES FOR NONCONFORMING SERVICES The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely, completely, and commensurate with required standards of quality. Such goods and/or services shall only be delivered to eligible program participants. If the Contractor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this contract. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this contract. The Contractor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and/or services. The Agency requires immediate notice of any significant and/or systemic infractions that compromise the quality,security or continuity of services to clients. 12 ,July 2015 to June 2016 1 6 J 3 CCE 203.15 3.6 FINANCIAL CONSEQUENCES Contractor shall ensure 100% of the deliverables and service tasks identified in this contract are performed pursuant to contract requirements. If at any time after an initial written notice of deficiency, Contractor is notified by the Agency's Contract Manager that it has failed to correctly, completely, or adequately perform the deliverables or service tasks, Contractor will have 10 days to issue a Corrective Action Plan ("CAP") to the Contract Manager that addresses the deficiencies and states how the deficiencies will be remedied within the specified time period. The Agency shall assess a Financial Consequence for Non- Compliance on the Contractor for each deficiency identified in the CAP which is not corrected pursuant to the CAP. The Agency will also assess a Financial Consequence for failure to timely submit a CAP. 3.6.1 Payment Deduction In the event Contractor fails to correct an identified deficiency within the timeline specified in the CAP, the Agency shall deduct, from the payment for the invoice of the following month, 1% of the monthly value of the contract for each day the deficiency is not corrected. If Contractor fails to timely submit a CAP plan, the Agency shall deduct 1% of the monthly value of the administrative funds in the contract for each day the CAP is overdue, beginning the 11th day after notification by the contract manager of the deficiency. The deduction will be made from the payment for the invoice of the following month. If, or to the extent, there is any conflict between this paragraph and paragraphs 39 and 39.1 of the Master contract, this paragraph shall have precedence 13 , July.2015 to June 2016 1 6 JJ 3 CCE 203.15 ATTACHMENT III 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT TOTAL FEDERAL AWARD COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: N/A 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: MATCHING RESOURCES FOR FEDERAL PROGRAMS PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT • TOTAL STATE AWARD $0 STATE FINANCIAL ASSISTANCE SUBJECT TO Sec.215.97,F.S. PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT Community Care for the Elderly General Revenue-Collier 65.010 $747,745.00 TOTAL AWARD $747,745.00 COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: STATE FINANCIAL ASSISTANCE Section 215.97,F.S. Chapter 69I-5, Fla.Admin. Code 14 , July 2015 to June 2016 1 6 D 3 CCE 203.15 ATTACHMENT VI ANNUAL BUDGET SUMMARY COMMUNITY CARE FOR THE ELDERLY PROGRAM for Collier County Board of County Commissioners CCE Services $747,745.00 RATE SUMMARY for Collier County Board of County Commissioners RATE SUMMARY Charlotte County Total Unit Cost Reimbursement Rate-90% Case Management $60.00 $54.00 Case Aide $33.88 $30.50 Adult Day Care $12.83 $11.55 Chore $23.33 $21.00 Enhanced Chore $30.33 $27.30 Companion $23.33 $21.00 Skilled Nursing $42.00 $37.80 EARS $ 1.31 $ 1.18 Homemaking $21.50 $19.35 Personal Care $25.67 $23.10 Respite-in-Home $25.67 $23.10 Home Improvement $ Cost Reimbursement 90% Cost Reimbursement Material Aid $ Cost Reimbursement 90% Cost Reimbursement Specialized Medical Equipment, Service& Supplies $ Cost Reimbursement 90% Cost Reimbursement Transportation $ Cost Reimbursement 90% Cost Reimbursement 15 July.2015 to June 2016 1 6 D 3 CCE 203.15 ATTACHMENT VII INVOICE REPORT SCHEDULE COMMUNITY CARE FOR THE ELDERLY Report Number Based On Submit to State on this Date 1 July Advance* July 1 2 August Advance* July 1 3 July Expenditure Report August 9 4 August Expenditure Report September 9 5 September Expenditure Report October 9 6 October Expenditure Report November 9 7 November Expenditure Report December 9 8 December Expenditure Report January 9 9 January Expenditure Report February 9 10 February Expenditure Report March 9 11 March Expenditure Report April 9 12 April Expenditure Report May 9 13 May Expenditure Report June 9 14 June Expenditure Report July 9 15 Final Expenditure Report July 25 16 Closeout Report August 1 Legend: * Advance based on projected cash need. Note # 1: Report#1 for Advance Basis Agreements cannot be submitted to the Area Agency on Aging for Southwest Florida, Inc. prior to July 1 or until the agreement with the Agency has been executed and a copy sent to the Area Agency on Aging for Southwest Florida, Inc. Actual submission of the vouchers to the Area Agency on Aging for Southwest Florida, Inc. is dependent on the accuracy of the expenditure report. Note # 2: All advance payments made to the Contractor shall be returned to the Agency as follows: one — tenth of the advance payment received shall be reported as an advance recoupment on each request for payment, starting with report number five. The adjustment shall be recorded in Part C, Line 1 of the report (ATTACHMENT IX). Report numbers 5 through 14 shall reflect an adjustment of one-tenth of the total advance amount on each of the reports, repaying advances issued the first two months of the agreement. The adjustment shall be recorded in Part C, 1 of the report(ATTACHMENT IX). Note #3: Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects funds due back to the Agency, payment is to accompany the report. 16 , July,2015 to June 2016 CCE 203.15 1 6 1:13TACHMENT VIII REQUEST FOR PAYMENT COMMUNITY CARE FOR THE ELDERLY RECIPIENT NAME,ADDRESS,PHONE#and FEID# TYPE OF PAYMENT: This Request Period: From: To:_ Regular Contract Period_ _ Contract* _ Advance _ Report# __ PSA It_ CERTIFICATION: I hereby certify to the best of my knowledge that this request or refund conforms with the terms and the purposes of the above contract. Prepared by:_ _ _ Date:___ Approved by: _ _ Date:_ PART A: BUDGET SUMMARY CCE Admin. CCE Services TOTAL 1.Approved Contract Amount $ 0.00 $ 0.00 $ 0.00 2.Previous Funds Received for Contract Period $ 0.00 $ 0.00 $ 0.00 3.Contract Balance pine 1 minus line 2) $ 0.00 $ 0.00 $ 0.00 4.Previous Funds Requested and Not Received for Contract Period $ 0.00 $ 0.00 $ 0.00 5.CONTRACT BALANCE(line 3 minus line 4) $ 0.00 $ 0.00 $ 0.00 PART B: CONTRACT FUNDS REQUEST 1.Anticipated Cash Need(1st-2nd months) $ 0.00 $ 0.00 $ 0.00 2.Net Expenditures For Month $ 0.00 $ 0.00 $ 0.00 (DOEA Form 1050,Part B,Line 4) 3.TOTAL $ 0.00 $ 0.00 $ 0.00 PART C: NET FUNDS REQUESTED 1.Less Advance Applied $ 0.00 $ 0.00 $ 0.00 2.TOTAL FUNDS REQUESTED(Part B Line 3,minus Part C Line 1) $ 0.00 $ 0.00 $ 0.00 List of Services/Units/Rates provided-See attached report. DOEA FORM 106C Revised 5/4/12 17 i July 2015 to June 2016 CCE 203.15 16D3 ATTACHMENT IX RECEIPT AND EXPENDITURE REPORT COMMUNITY CARE FOR THE ELDERLY PROVIDER NAME,ADDRESS,PHONE#and FEID# Program Funding: THIS REPORT PERIOD: From To CCE Admin. CONTRACT PERIOD: CCE Services CONTRACT# REPORT# PSA# CERTIFICATION: I certify to the best of my knowledge and belief that the report is complete and correct and all outlays herein are for purposes set forth in the contract. Prepared by: Date: Approved by: Date: PART :BUDGETED INCOME/ RECEIPTS 1.Approved 2.Actual Receipts 3.Total Receipts 4.Percent of Budget For This Report Year to Date Approved Budget 1. State Funds $0.00 $0.00 $0.00 #DIV/0! 2. Program Income $0.00 $0.00 $0.00 #DIV/0! 3. Local Cash Match $0.00 $0.00 $0.00 #DIV/0! 4. SUBTOTAL:CASH RECEIPTS 5. Local In-Kind Match 6. TOTAL RECEIPTS $0.00 $0.00 $0.00 #DIV/0! PART B:EXPENDITURES 1.Approved 2.Expenditures 3.Expenditures 4. Percent of Budget For This Report Year to Date Approved Budget 1.Administrative Services $0.00 $0.00 $0.00 #DIV/0! 2. Service Subcontractor(s) $0.00 $0.00 $0.00 #DIV/0! 3.Adult Protective Services $0.00 $0.00 $0.00 #DIV/0! 4. TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIV/0! PART C:OTHER REVENUE AND EXPENDITURES II. Interest: III.Advance Recouped I. Program Income(PI) 1. Earned on GR Advance$ $ 1. CCE: PI Collected YTD $ 2. Return of GR Advance $ (Includes fees collected) 3. Other Earned $ PART D:CO-PAYMENTS CURRENT MONTH YEAR-TO-DATE 1.Total of Co-payments assessed $ $ 2. Total of Co-payments collected $ $ (For Tracking Purposes only) DOEA FORM 105C Revised 5/25/2010 18 ' July 2015 to June 2016 1 6 13 3 CCE 203.15 ATTACHMENT X Cost Reimbursement Summary Contract# Report(Invoice) Number: Budget Number of Category Description units Service Date Amount o , ra E I _ L l TOTAL ADMINISTRATION $0.00 w TOTAL EXPENSES 19 Revised August 2007 1 6 0 3 Attestation Statement Agreement/Contract Number CCE 203.15 Amendment Number I, Stephen Y. Carvell ,attest that no changes or revisions have been made to the (Recipient/Contractor representative) content of the above referenced agreement/contract or amendment between the Area Agency on Aging for Southwest Florida and Public Services Department Head (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting,due to the differences in electronic data processing media,which has no affect on the agreement/contract content. Q/7,4 - ) �. / r) l Signature of Recipient Contract representative Date Approved as to form and legality Assistant County Attorney i 055 Revised August 2007 CAC?` July 2015 to June 2016 160 3 ADI 203.15 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. ALZHEIMER'S DISEASE INITIATIVE CONTRACT COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida,Inc. (Agency) and Collier County Board of County Commissioners(Contractor)and collectively referred to as the"Parties." WITNESSETH THAT: WHEREAS,the Agency has determined that it is in need of certain services as described herein; and WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services as an independent Contractor of the Agency. NOW THEREFORE, in consideration of the services to be performed and payments to be made,together with the mutual covenants and conditions hereinafter set forth,the Parties agree as follows: 1. Purpose of Contract: The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments, forms, exhibits and references incorporated, which constitute the contract document. 2. Incorporation of Documents within the Contract: The contract will incorporate attachments,proposal(s), state plan(s), grant agreements,relevant Department handbooks, manuals or desk books and Master Contract number HM014,as an integral part of the contract,except to the extent that the contract explicitly provides to the contrary. hi the event of conflict in language among any of the documents referenced above, the specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s)or other general materials not specific to this contract document and identified attachments. 3. Term of Contract: This contract shall begin at twelve (12:00) A.M., Eastern Standard Time July 1,2015 or on the date the contract has been signed by the last party required to sign it,whichever is later. It shall end at eleven fifty-nine(11:59)P.M.,Eastern Standard Time June 30,2016. 4. Contract Amount: The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed $236,025.00, or the rate schedule, subject to the availability of funds. Any costs or services paid for under any other contract or from any other source are not eligible for payment under this contract. 5. Renewals: By mutual agreement of the Parties, in accordance with s. 287.058(1)(g), F.S., the Agency may renew the contract for a period not to exceed three years, or the term of the original contract, whichever is longer. The renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other costs for the renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and contingent upon satisfactory performance evaluations by the Agency and the availability of funds. 1 U � 1 July 2015 to June 2016 1 6 ® 3 ADI 203.15 6. Official Payee and Representatives(Names,Addresses,and Telephone Numbers): Collier County Housing, Human and Veteran The Contractor name, as shown on page 1 of this Services a. contract, and mailing address of the official payee to 3339 E Tamiami Trail, Building H whom the payment shall be made is: Naples, FL 34112 Kimberly Grant, Director b. The name of the contact person and street address where Collier County Housing, Human and Veteran financial and administrative records are maintained is: Services 3339 E Tamiami Trail, Building H Naples, FL 34112 Kimberly Grant,Director The name, address,and telephone number of the Collier County Housing, Human and Veteran c. representative of the Contractor responsible for Services administration of the program under this contract is: 3339 E Tamiami Trail, Building H Naples,FL 34112 (239)252-2273 Tammy Rhoades, VP of Finance d The section and location within the Agency where Area Agency on Aging for Southwest Florida, Inc. Requests for Payment and Receipt and Expenditure 15201 North Cleveland Avenue, Suite 1100 forms are to be mailed is: North Fort Myers, FL 33903 Marianne Lorini, Executive Director e. The name, address, and telephone number of the Area Agency on Aging for Southwest Florida, Inc. Contract Manager for this contract is: 15201 North Cleveland Avenue, Suite 1100 North Fort Myers,FL 33903 239-652-6900 Upon change of representatives(names,addresses,telephone numbers)by either party,notice shall be provided in writing to the other party and the notification attached to the originals of this contract. 7. All Terms and Conditions Included This contract and its Attachments I, III, VI—X, and K any exhibits referenced in said attachments,together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications,representations or agreements,either written or verbal between the Parties. By signing this contract,the Parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF,the Parties hereto have caused this contract to be executed by their undersigned officials as duly authorized. Contractor: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR COUNTY COMMISSIONERS SOUTHWEST FLORIDA,INC. ?NAME \ r0/4 SIGNED BY: i , I f SIGNED BY: -g3?-451--t—AA— NAME: : Stephen Y. Camel! NAME: MARIANNE G LORINI TITLE: Public Services Department Head I TITLE: PRESIDENT/CEO DATE: 7 la 1 c DATE: Federal Tax ID: 59-6000558 Fiscal Year Ending Date: 09/30 Approved as to form and legality �3`5 ^\ 2 Assistant County Attorney 's July 2015 to June 2016 1 6 D 3 ADI 203.15 INDEX OF ATTACHMENTS ATTACHMENT I 4 STATEMENT OF WORK ATTACHMENT III 13 FUNDING SUMMARY ATTACHMENT VI 14 INVOICE REPORT SCHEDULE ATTACHMENT VII 15 ANNUAL BUDGET SUMMARY ATTACHMENT VIII ....16 REQUEST FOR PAYMENT ATTACHMENT IX 17 RECEIPT AND EXPENDITURE REPORT ATTACHMENT X 18 COST REIMBURSEMENT SUMMARY ATTACHMENT K 19 SERVICE RATE REPORT *Attachments II,IV,and V are incorporated by reference in Master Contract HM014. 3 9;, 6 0 July 2015 to June 2016 1 3 ADI 203.15 ATTACHMENT I STATEMENT OF WORK ALZHEIMER'S DISEASE INITIATIVE PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITIONS OF CONTRACT TERMS AND ACRONYMS 1.1.1 Definitions of Acronyms Alzheimer's Disease(AD) Alzheimer's Disease Initiative(ADI) Activities of Daily Living(ADL) Assessed Priority Consumer List(APCL) Adult Protective Services(APS) Client Information and Registration Tracking System(CIRTS) Community Care for Disabled Adults(CCDA) Corrective Action Plan(CAP) Department of Elder Affairs—(DOEA)or Department Florida Statutes—(F.S.) Home Care For Disabled Adults(HCDA) Instrumental Activities of Daily Living(IADL) Memory Disorder Clinic (MDC) Planning and Service Area(PSA) Summary of Programs and Services (SOPS) United States Code—(U.S.C.) 1.1.2 Program Specific Terms Area Plan: A plan developed by the Agency outlining a comprehensive and coordinated service delivery system in the respective planning and service area, in accordance with the Section 306 of the Older Americans Act (42 U.S.C.3026)and Department instructions.The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the Agency enters ADI specific data into the CIRTS.An update may also include other revisions to the Area Plan as instructed by the Department. Department of Elder Affairs Programs and Services Handbook: An official document of the State of Florida, DOEA. The Handbook includes program policies, procedures, and standards applicable to agencies which are recipients/providers of DOEA funded programs. An annual update is provided through a Notice of Instruction. Functional Assessment: A comprehensive,systematic,and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. Memory Disorder Clinic: Research oriented programs created pursuant to Sections 430.502(1) and(2), F.S.,to provide diagnostic and referral services, conduct basic and service-related multidisciplinary research, and develop training materials and educational opportunities for lay and professional caregivers of individuals with AD. 4 July 2015 to June 2016 ADI 203.15 Model Day Care: A program of therapeutic, social and health activi cll 3 clients with memory disorders. Services and activities include,but are not limited to,active and quiet games,reminiscence,validation therapy,pet therapy,water therapy and other failure free activities appropriate to the client's level of functioning. Model day care centers will also provide training for health care and social service personnel in the care of persons having AD or related memory disorders. Notice of Instruction (NOI): The Department's established method to communicate to the Agency and/or Contractor the requirement to perform a particular task or activity. NOIs are located on the Department's website at http://elderaffairs.state.fl.us/doea/nois.php. Program Highlights: Success stories, quotes, testimonials, or human-interest vignettes that are used in the Summary of Programs and Services to include information that helps tell the story of how programs and services help elders, families,and caregivers. Summary of Programs and Services(SOPS): A document produced by the Department and updated yearly to provide the public and the Legislature with information about programs and services for Florida's elders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement The ADI Program provides a continuum of services addressing the special needs of individuals with AD,their families and caregivers. 1.2.1.1 Alzheimer's Disease Initiative Program Mission Statement The ADI Program ensures that persons afflicted with AD and other forms of dementia are given essential services to help them age in place in an elder-friendly environment with security, dignity, and purpose. The program also provides support to family members and caregivers of persons afflicted with AD. 1.2.2 Authority The relevant authority governing the Alzheimer's Disease Initiative Program are as follows: (1) Rule Chapter 58D-1, Florida Administrative Code; (2) Sections 430.501, 430.502,430.503,and 430.504,Florida Statutes; and (3) The Catalog of State Financial Assistance(CSFA)Number 65.004. 1.2.3 Scope of Service The Contractor is responsible for the programmatic, fiscal, and operational management of the ADI Program. The program services shall be provided in a manner consistent with the Contractor's Request for Proposal, RFP, and the Agency's current area plan and the current Department of Elder Affairs OEA Programs and Services Handbook,which are incorporated by reference. 1.2.4 Major Program Goal The major goal of the ADI Program is to provide services to meet the needs of caregivers and individuals with AD and related memory disorders. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The ADI Program addresses the special needs of individuals with AD and their caregivers. 1.3.2 Individual Eligibility Those individuals eligible to receive services under this contract must meet the following conditions: 5 1603 July 2015 to June 2016 ADI 203.15 (1) Be 18 years of age or older and have a diagnosis of AD or a related disorder,or be suspected of having AD or a related disorder; and (2) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Targeted Groups Priority for services under this contract will be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS To achieve the goals of the ADI Program, the Contractor shall perform or ensure that its Subcontractors perform the following tasks: (1) Client Eligibility Determination; (2) Assessment and Prioritization of Service Delivery for New Clients; (3) Delivery of Services to Eligible Clients; and (4) Monitoring the Performance of Subcontractors. 2.1.1. Client Eligibility Determination The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements described in this ATTACHMENT I, Section 1.3. 2.1.2 Assessment and Prioritization of Service Delivery for New Clients The Contractor shall ensure the following criteria are used to prioritize new clients for service delivery. It is not the intent of the Agency to remove existing clients from any services in order to serve new clients being assessed and prioritized for service delivery. (1) Imminent Risk individuals: Individuals in the community whose mental or physical health condition has deteriorated to the degree that self-care is not possible, there is no capable caregiver, and nursing home placement is likely within a month or very likely within three(3)months. (2) Service priority for individuals not included in (1) above, regardless of referral source, will be determined through the Agency's functional assessment administered to each applicant, to the extent funding is available. The Contractor shall ensure that first priority is given to applicants at the higher levels of frailty and risk of nursing home placement. 2.1.3 Delivery of Services to Eligible Clients The Contractor shall ensure the provision of a continuum of services addressing the diverse needs of individuals with AD and their caregivers. The Contractor shall ensure performance and reporting of the following services in accordance with the current DOEA Programs and Services Handbook, which is incorporated by reference. The services include the following categories: (1) Caregiver Training/Support; (2) Case Aide; (3) Case Management; 6 July 2015 to June 2016 1 6 0 3 ADI 203.15 (4) Counseling(Gerontological); (5) Counseling(Mental Health/Screening); (6) Education/Training; (7) Intake; (8) Model Day Care; (9) Respite(Facility-Based); (10) Respite(In-Home); and (11) Specialized Medical Equipment, Services,and Supplies. 2.1.3.1 Memory Disorder Clinics MDCs are required to provide four (4) hours of in-service training to all respite, in-facility respite and model day care centers in their designated service areas. In-service training topics may include physiological, behavioral and emotional aspects of AD and related diseases as well as caregiver techniques, coping strategies and information regarding Silver Alert. The Contractor shall collaborate with MDCs to assist in this effort and in the effort to carry out Silver Alert protocol activities. The Contractor shall respond to requests for evaluation information and statistical data concerning its consumers, based on information requirements of the MDCs and Brain Bank. 2.1.4 Use of Subcontractors If this contract involves the use of a Subcontractor or third party, then the Contractor shall not delay the implementation of its agreement with the Subcontractor. If any circumstances occur that may result in a delay for a period of 60 days or more of the initiation of the subcontract or in the performance of the Subcontractor, the Contractor shall notify the Agency's Contract Manager and the Agency's Chief Financial Officer in writing of such delay. The Contractor shall not permit a Subcontractor to perform services related to this agreement without having a binding Subcontractor agreement executed. In accordance with Section 23.1 of the Master Contract, the Agency will not be responsible or liable for any obligations or claims resulting from such action. The Contractor shall submit a copy of all subcontracts to the Contract Manager within thirty days of the subcontract being executed. 2.1.5 Monitoring the Performance of Subcontractors The Contractor shall monitor at least once per year each of its Subcontractors, Subrecipients, Vendors and/or Consultants paid from funds provided under this contract. The Contractor shall perform fiscal, administrative and programmatic monitoring to ensure contractual compliance, fiscal accountability, programmatic performance, and compliance with applicable state and federal laws and regulations. The Contractor shall monitor to ensure that time schedules are met, the budget and scope of work are accomplished within the specified time periods and other performance goals stated in this contract are achieved. 2.2 SERVICE TIMES The Contractor shall ensure the availability of services listed in this contract at times appropriate to meet client service needs, at a minimum during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m. to 5:00 p.m. 7 July 2015 to June 2016 ADI 203.15 1 6 0 3 2.3 DELIVERABLES 2.3.1 Service Unit The Contractor shall ensure the provision of the services described in the contract in accordance with the current DOEA Programs and Services Handbook and the service tasks described in Section 2.1. ATTACHMENT K list the services that can be performed, the highest reimbursement unit rate, the method of payment, and the service unit type. Units of service will be paid pursuant to the rate established in the Area Plan as updated, as shown in ATTACHMENT K,and approved by the Agency. 2.4 REPORTS The Contractor shall respond to additional routine and/or special requests for information and reports required by the Agency in a timely manner as determined by the Contract Manager. The Contractor shall establish reporting due dates for Subcontractors that permit the Contractor to meet the Agency's reporting requirements. 2.4.2 CIRTS The Contractor shall input ADI-specific data into CIRTS. To ensure CIRTS data accuracy, the Contractor shall use CIRTS-generated reports which include the following: (1) Client Reports; (2) Monitoring Reports; (3) Services Reports; (4) Miscellaneous Reports; (5) Fiscal Reports; (6) Aging and Disability Resource Center Reports; and (7) Outcome Measurement Reports. 2.4.4 Program Highlights The Contractor shall submit Program Highlights referencing specific events that occurred in SFY/FFY 2014- 2015 by September 4, 2015. The Contractor shall provide a new success story, quote, testimonial, or human- interest vignette. The highlights shall be written for a general audience, with no acronyms or technical terms. For all agencies or organizations that are referenced in the highlight, the Contractor shall provide a brief description of their mission or role.The active tense shall be consistently used in the highlight narrative, in order to identify the specific individual or entity that performed the activity described in the highlight. The Contractor shall review and edit Program Highlights for clarity, readability, relevance, specificity, human interest, and grammar, prior to submitting them to the Agency. 8 July 2015 to June 2016 ADI 203.15 D 3 2.5 RECORDS AND DOCUMENTATION 2.5.1 The Contractor shall ensure the collection and maintenance of client and service information on a monthly basis from the CIRTS or any such system designated by the Agency. Maintenance includes valid exports and backups of all data and systems according to Agency standards. 2.5.2 Policies for Data and Software Backup Each Contractor and Subcontractor, among other requirements, must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of Contractor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. A copy of the backed up data shall be stored in a secure, offsite location. The Contractor shall maintain written policies and procedures for computer system backup and recovery and shall have the same requirement in its contracts and/or agreements with Subcontractors. These policies and procedures shall be made available to the Agency upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1) The Contractor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook; (2) The Contractor shall timely submit to the Agency all reports described in ATTACHMENT I, SECTION 2.4,REPORTS.; and (3) The Contractor shall timely submit to the Agency all information described in ATTACHMENT I, SECTION 2.5,RECORDS AND DOCUMENTATION. 2.7 CONTRACTOR'S FINANCIAL OBLIGATIONS 2.7.1 Cost Sharing and Co-payments The Contractor must establish annual co-payment goals. The Agency has the option to withhold a portion of the Contractor's request for payment if goals are not met according to the Agency and the Department's co-payment guidelines, in accordance with the current DOEA Programs and Services Handbook, which is incorporated by reference. Co-payments include only the amounts assessed to consumers by the Contractor or the amounts consumers opt to contribute in lieu of an assessed co-payment. The consumer's contribution must be equal to or greater than the assessed co-payment. 2.8 AGENCY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The Agency will provide the Contractor with guidance and technical assistance as needed to ensure the successful fulfillment of the contract by the Contractor. 2.8.2 Contract Monitoring The Agency will review and evaluate the performance of the Contractor under the terms of this contract. Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, or an on-site visit. The Agency's determination of acceptable performance shall be conclusive. The Contractor 9 Cid\ 1 6 0 3 July 2015 to June 2016 ADI 203.15 agrees to cooperate with the Agency in monitoring the progress of completion of the service tasks and deliverables. The Agency may use, but is not limited to,one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled,unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 GENERAL STATEMENT OF METHOD OF PAYMENT The method of payment for this contract includes advances, and fixed rate for services. Payment may be authorized for all allowable expenditures to complete the tasks identified in the deliverables, as required by the agreement. The Contractor shall consolidate all requests for payment from Subcontractors and expenditure reports that support requests for payment to the Agency on ATTACHMENTS VIII, IX, and X. 3.1.1 Funding Distribution The Contractor agrees to distribute funds as detailed in the Area Plan update and the Budget Summary, ATTACHMENT VII to this contract. Any changes in the total amounts of funds identified on the Budget Summary require a contract amendment. 3.2 ADVANCE PAYMENTS The Contractor may request up to two months of advances at the start of the contract period to cover program administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount of funds released to the Agency by the State of Florida Department of Elder Affairs ("budget release"). The Contractor shall provide the Contract Manager documentation justifying the need for an advance and describing how the funds will be distributed. The Contractor's requests for advances require the approval of the Contract Manager. If sufficient budget is available,the Agency will issue approved advance payments after July 1, 2015. 3.2.1 Advance Recoupment All advance payments made to the Contractor shall be returned to the Agency as follows: one —tenth of the advance payment received shall be reported as an advance recoupment on each request for payment, starting with report number five, in accordance with the Invoice Report Schedule, ATTACHMENT VI to this contract. The Contractor may temporarily place advanced funds in a FDIC insured interest bearing account. All interest earned on advanced funds must be returned to the Agency within thirty (30) days of the end of each quarter of the contract period. 3.3 INVOICE SUBMITTAL AND REQUESTS FOR PAYMENT All Requests For Payment and Receipt and Expenditure Reports submitted to the Agency shall be submitted using ATTACHMENTS VIII, IX, and X. The Contractor shall include documentation of services provided,the units of services, and the rates for the services provided in conformance with the requirements as described in this Attachment I and Attachment K. 10 , July 2015 to June 2016 16 p 3 ADI 203.15 3.3.1 Payment Requests All Requests for Payment shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract.The schedule for submission of advance requests(if/when available)and invoices is ATTACHMENT VI. 3.3.2 Payment Withholding Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments thereto, including any disallowance not resolved as outlined in Section 26 of the Master Contract. 3.3.3 Date for Final Request for Budget Revisions Final requests for budget revisions or adjustments to contract funds based on expenditures for services provided, must be submitted to the Contract Manager and approved in writing no later than June 25, 2016. Email requests and/or approvals are considered acceptable. 3.3.4 Date for Final Request for Payment The final request for payment is due to the Agency no later than July 25, 2016. 3.4 DOCUMENTATION FOR PAYMENT The Contractor shall maintain documentation to support payment requests that shall be available to the Agency or authorized individuals, such as the Department of Financial Services, upon request. 3.4.1 CIRTS Data Entries for Contractors The Contractor must enter all required data for clients and services in the CIRTS database per the DOEA Programs and Services Handbook and the CIRTS User Manual — Aging Provider Network users (located in Documents on the CIRTS Enterprise Application Services). Contractors must enter this data into the CIRTS prior to submitting their requests for payment and expenditure reports to the Agency. The Agency shall establish deadlines for submission to assure compliance with due dates for the requests for payment and expenditure reports that Contractor must submit to the Agency. 3.4.2 Contractors' Monthly CIRTS Reports The Contractor must run monthly CIRTS reports and verify client and service data in CIRTS is accurate. This report must be submitted to the Agency with the monthly request for payment and expenditure report and must be reviewed by the Agency before the Contractor's request for payment and expenditure reports can be approved by the Agency. 3.5 REMEDIES-NONCONFORMING SERVICES The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services shall only be delivered to eligible program participants. If the Contractor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this contract. In addition, any nonconforming goods (including home delivered meals) and/or services not meeting such standards will not be reimbursed under this contract. The Contractor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and/or services. The Agency requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.6 FINANCIAL CONSEQUENCES Contractor shall ensure 100% of the deliverables and service tasks identified in this contract are performed pursuant to contract requirements. If at any time after an initial written notice of deficiency, Contractor is notified by the Agency's Contract Manager that it has failed to correctly, completely, or adequately perform the deliverables or service tasks, Contractor will have 10 days to issue a Corrective Action Plan ("CAP") to the Contract Manager that addresses the deficiencies and states how the deficiencies will be remedied within the 11 Cr7-1 )� • 1 603 July 2015 to June 2016 ADI 203.15 specified time period. The Agency shall assess a Financial Consequence for Non-Compliance on the Contractor for each deficiency identified in the CAP which is not corrected pursuant to the CAP. The Agency will also assess a Financial Consequence for failure to timely submit a CAP. 3.6.1 Payment Deduction In the event Contractor fails to correct an identified deficiency within the timeline specified in the CAP, the Agency shall deduct, from the payment for the invoice of the following month, one percent (1%) of the monthly value of the contract for each day the deficiency is not corrected. If Contractor fails to timely submit a CAP plan, the Agency shall deduct one percent (1%) of the monthly value of the administrative funds in the contract for each day the CAP is overdue, beginning the 1 lth day after notification by the contract manager of the deficiency. The deduction will be made from the payment for the invoice of the following month. If, or to the extent, there is any conflict between this paragraph and paragraphs 39 and 39.1 of the Master contract, this paragraph shall have precedence. 12 �,P , July 2015 to June 2016 1 6 3 ADI 203.15 ATTACHMENT III FUNDING SUMMARY 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT TOTAL FEDERAL AWARD COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: N/A 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: MATCHING RESOURCES FOR FEDERAL PROGRAMS PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT TOTAL STATE AWARD $0 STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97, F.S. PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT Alzheimer's Disease Initiative General Revenue/TSTF Collier 65004 $236,025.00 TOTAL AWARD $236,025.00 COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: STATE FINANCIAL ASSISTANCE Section 215.97,Fla. Stat. Chapter 69I-5, Fla. Admin. Code 13 July 2015 to June 2016 1 6 0 3 ADI 203.15 ATTACHMENT VI INVOICE REPORT SCHEDULE ALZHEIMER'S DISEASE INITIATIVE Report Number Based On Submit to State on This Date 1 July Advance* July 1 2 August Advance* July 1 3 July Expenditure Report August 9 4 August Expenditure Report September 9 5 September Expenditure Report October 9 6 October Expenditure Report November 9 7 November Expenditure Report December 9 8 December Expenditure Report January 9 9 January Expenditure Report February 9 10 February Expenditure Report March 9 11 March Expenditure Report April 9 12 April Expenditure Report May 9 13 May Expenditure Report June 9 14 June Expenditure Report July 9 15 Final Request for Payment July 25 16 Closeout Report August 1 Legend: * Advance based on projected cash need. Note# 1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency on Aging for Southwest Florida, Inc. prior to July 1 or until the contract with the Agency has been executed and a copy sent to Agency on Aging for Southwest Florida, Inc. Actual submission of the vouchers to Agency is dependent on the accuracy of the expenditure report. Note# 2: All advance payments made to the Contractor shall be returned to the Agency as follows: one—tenth of the advance payment received shall be reported as an advance recoupment on each request for payment, starting with report number five. The adjustment shall be recorded in Part C,Line 1 of the report(ATTACHMENT IX). Note# 3: Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects funds due back to the Agency, payment is to accompany the report. 14 1 603 July 2015 to June 2016 ADI 203.15 ATTACHMENT VII ANNUAL BUDGET SUMMARY ALZHEIMER'S DISEASE INITIATIVE PROGRAM for Collier County Board of County Commissioners Allocation Total $236,025.00 Total $236,025.00 15 1 6 0 July 2015 to June 2016 3 ADI 203.15 ATTACHMENT VIII REQUEST FOR PAYMENT ALZHEIMERS DISEASE INITIATIVE PROGRAM RECIPIENT NAME.ADDRESS.PHONE#and FEID# TYPE OF REPORT This Request Period PSA# A PAYMENT REQUEST: Report# Regular__ Supplemental Contract#_ B METHOD OF PAYMENT Contract Period Advance Reimbursement_ CERTECATION: I herebycertifyto the best of my knowledge that this request is complete and correct and conforms with the terms and the purposes of the above contract. Prepared by_ Date. Approved by. _Date:_ (1) (2) PART A BUDGET SUMMARY Respite Model Daycare TOTAL 1 Approved Contract Amount $0:00 $0.00 $0.00 2.Previous Funds Received for Contract Period $0:00 $0.00 $0.001 3.Contract Balance(tire 1 minus he 2) $0.00 $0 00 $0.00, 4.Previous Funds Requested and Not Received for Contract Period $0 00 $0.00 $0.00' 5.Contract Balance Vine 3 minus fire 4) $0.00 $0.00 $0.00'; PART B: CONTRACT FUNDS REQUEST 1 Anticipated Cash Needs(1st-2nd month,Attach Justification) $0.00 $0.00 $0.001 2 Net Eiqrenditure s For Month $0.00 $0.00 $0.00 (DOEA Form 105Z Part 8,Line 3) 3.TOTAL $0.00 $0.00 $0.00 PART C.NET FUNDS REQUESTED 1.Less Advance Applied $0.00 50 00 $0.00 2 Contract Funds are Hereby Requested for(Part B,Line 3 $0.00 $0.00 $0.00 minus Part C.Line 1) List of Services/Units/Rates provided-See attached report. DOEA FORM 106Z Paused 5.4'12 16 1 6 03 July 2015 to June 2016 ADI 203.15 ATTACHMENT IX RECEIPT AND EXPENDITURE REPORT ALZHEIMERS DISEASE INITIATIVE PROGRAM PROVIDER NAME,ADDRESS.PHONE#and FEID:Program Funding: THIS REPORT PERIOD: From To Respite CONTRACT PERIOD: Model Day Care CONTRACT# REPORT# PSA# CERTIFICATION: I certify to the best of my knowledge and belief that the report is complete and correct and all outlays herein are for purposes set forth in the contract. Prepared by: Date: Approved by: Date: PART A:BUDGETED INCOME!RECEIPTS 1.Approved 2.Actual Receipts 3.Total Receipts 4.Percent of Budget For This Report Year to Date Approved Budget 1.State Funds $0.00 $0.00 $0.00 - #DIVIO! 2.Program Income $0.00 $0.00 $0.00 #DIVIO! 3.Local Cash Match $0.00 $0.00 $0.00 #DIVIO! 4.SUBTOTAL:CASH RECEIPTS 5.Local In-Kind Match 6.TOTAL RECEIPTS $0.00 $0.00 $0.00 #01VIOl PART B:EXPENDITURES 1.Approved 2.Expenditures 3.Expenditures 4.Percent of Budget For This Report Year to Date Approved Budget 1.Administrative Services $0.00 $0.00 $0.00 #131V101 2.Service Subcontractor(s) $0.00 $0.00 $0.00 #DIVIO! 3.TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIVIO! PART C:OTHER REVENUE AND EXPENDITURES II.Interest: III.Advance Recouped I.Program Income(PI) 1.Earned on GR Advance$ $ 1.ADI:PI Collected YTD $ 2.Return of GR Advance $ (Includes co-payments collected) 3.Other Earned $ PART D:CO-PAYMENTS CURRENT MONTH YEAR-TO-DATE 1.Total of Co payments assessed $_ 5_ 2.Total of Co-payments collected $ $ (For Tracking Purposes only) DOEA FORM 1OSZ Rerised 5t22512010 17 July 2015 to June 2016 16 0 3 ADI 203.15 ATTACHMENT X Cost Reimbursement Summary Contract# Report(invoice)Number: Budget Number of Category Description units Service Date Amount, 0 a N_ E Q TOTAL ADMINISTRATION $0.00 a m a C a) a x tu TOTAL EXPENSES $0.00 18 July 2015 to June 2016 3 AD!203.15 ATTACHMENT K SERVICE RATE REPORT HIGHEST METHOD OF DELIVERABLES REIMBURSEMENT UNIT RATE PAYMENTS Case Aide: Collier $33.88 Fixed Fee/Unit Rate Case Management: Collier $60.00 Fixed Fee/Unit Rate Respite In-Facility: Collier $12.83 Fixed Fee/Unit Rate Respite In-Home: Collier $25.67 Fixed Fee/Unit Rate Specialized Medical Equipment, Services and Supplies Cost Reimbursement 19 6 3 Revised August 2007 Attestation Statement Agreement/Contract Number ADI 203.15 Amendment Number I, Stephen Y. Carnell ,attest that no changes or revisions have been made to the (Recipient/Contractor representative) content of the above referenced agreement/contract or amendment between the Area Agency on Aging for Southwest Florida and Public Services Department Head (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting,due to the differences in electronic data processing media,which has no affect on the agreement/contract content. Signature of Recipient/ tractor representative Date Approved as to form and legality Assistant County Attorney Revised August 2007 CA© July 2015 to June 2016 16 El 3 HCE 203.15 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. HOME CARE FOR THE ELDERLY PROGRAM CONTRACT COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS THIS CONTRACT is entered into between the Area Agency on Aging for Southwest Florida, Inc. (Agency) and Collier County Board of County Commissioners (Contractor), and collectively referred to as the "Parties." The term Contractor for this purpose may designate a Vendor, Subgrantee or Subrecipient. WITNESSETH THAT: WHEREAS,the Agency has determined that it is in need of certain services as described herein; and WHEREAS, the Contractor has demonstrated that it has the requisite expertise and ability to faithfully perform such services as an independent Contractor of the Agency. NOW THEREFORE, in consideration of the services to be performed and payments to be made,together with the mutual covenants and conditions hereinafter set forth,the Parties agree as follows: 1. J urpose of Contract The purpose of this contract is to provide services in accordance with the terms and conditions specified in this contract including all attachments, forms, exhibits and references incorporated, which constitute the contract document. 2. Incorporation of Documents within the Contract The contract will incorporate attachments,proposal(s),state plan(s),grant agreements,relevant Department handbooks, manuals or desk books and Master Contract number HM014,as an integral part of the contract,except to the extent that the contract explicitly provides to the contrary. In the event of conflict in language among any of the documents referenced above, the specific provisions and requirements of the contract document(s) shall prevail over inconsistent provisions in the proposal(s)or other general materials not specific to this contract document and identified attachments. 3. Term of Contract This contract shall begin at twelve (12:00) A.M., Eastern Standard Time July 1,2015 or on the date the contract has been signed by the last party required to sign it,whichever is later. It shall end at eleven fifty-nine(11:59)P.M.,Eastern Standard Time June 30,2016. 4. Contract Amount The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed 549.250.00,or the rate schedule, subject to the availability of funds. Any costs or services paid for under any other contract or from any other source are not eligible for payment under this contract. 5. Renewals By mutual agreement of the Parties, in accordance with s. 287.058(1)(g), F.S.,the Agency may renew the contract for a period not to exceed three years, or the term of the original contract, whichever is longer. The renewal price, or method for determining a renewal price, is set forth in the bid, proposal, or reply. No other costs for the renewal may be charged. Any renewal is subject to the same terms and conditions as the original contract and contingent upon satisfactory performance evaluations by the Agency and the availability of funds. 1 July 2015 to June 2016 1 6 3 HCE 203.15 [Type here] 6. Official Payee and Representatives(Names.Addresses.and Telephone Numbers): Collier County Housing, Human and Veteran The Contractor name, as shown on page 1 of this Services contract, and mailing address of the official payee to 3339 E Tamiami Trail,Building H a. whom the payment shall be made is: Naples,FL 34112 Kimberly Grant,Director The name of the contact person and street address where Collier County Housing,Human and Veteran b' financial and administrative records are maintained is: Services 3339 E Tamiami Trail, Building H Naples, FL 34112 Kimberly Grant, Director The name, address, and telephone number of the Collier County Housing, Human and Veteran c' representative of the Contractor responsible for Services administration of the program under this contract is: 3339 E Tamiami Trail, Building H Naples, FL 34112 (239)252-2273 Tammy Rhoades,VP of Finance d The section and location within the Agency where Area Agency on Aging for Southwest Florida, Inc. Requests for Payment and Receipt and Expenditure 15201 North Cleveland Avenue, Suite 1100 forms are to be mailed is: North Fort Myers, FL 33903 Marianne Lorini,Executive Director e. The name, address, and telephone number of the Area Agency on Aging for Southwest Florida, Inc. Contract Manager for this contract is: 15201 North Cleveland Avenue, Suite 1100 North Fort Myers,FL 33903 239-652-6900 Upon change of representatives(names,addresses,telephone numbers)by either party,notice shall be provided in writing to the other party and the notification attached to the originals of this contract. 7. All Terms and Conditions Included: This contract and its Attachments, I, III,VI—X,and any exhibits referenced in said attachments,together with any documents incorporated by reference, contain all the terms and conditions agreed upon by the Parties. There are no provisions, terms, conditions, or obligations other than those contained herein, and this contract shall supersede all previous communications,representations or agreements, either written or verbal between the Parties. By signing this contract,the Parties agree that they have read and agree to the entire contract. IN WITNESS THEREOF,the Parties hereto have caused this contract,to be executed by their undersigned officials as duly authorized. Contractor: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR COUNTY COMMISSI I.'ERS SOUTHWEST FLORIDA,INC. N SIGNED BY: Oki JII/,.,A Ad SIGNED BY: SNAME: < < � Itt NAME: MARIANNE G LORINI ✓ . TITLE:_ '� _ �� !! 1 TITLE: PRESIDENT/CEO DATE: ` ` DATE: b ✓ I Federal Tax ID: 59-6000558 Fiscal Year Ending Date: 09/30 Approved as to :or►n anti legality 2 Assistant Count;?.Aittney July 2015 to June 2016 HCE 203.15 I 6' n 3 INDEX OF ATTACHMENTS ATTACHMENT I 4 ATTACHMENT III 13 ATTACHMENT VI HOME CARE FOR THE ELDERLY ANNUAL BUDGET AND RATE SUMMARY.... 14 ATTACHMENT VII HOME CARE FOR THE ELDERLY INVOICE REPORT SCHEDULE 15 ATTACHMENT VIII REQUEST FOR PAYMENT 16 ATTACHMENT IX RECEIPT AND EXPENDITURE REPORT 17 ATTACHMENT X COST REIMBURSEMENT SUMMARY .18 *Attachments II,IV,and V are included by reference in the Master Contract HM014. 3 July 2015 to June 2016 HCE 203.15 [Type here] ATTACHMENT I AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. HOME CARE FOR THE ELDERLY PROGRAM SECTION I: SERVICES TO BE PROVIDED 1.1 DEFINITION OF CON TRACT TERMS AND ACRONYMS 1.1.1 Definitions of Acronyms Corrective Action Plan (CAP) Community Care for Disabled Adults(CCDA) Community Care for the Elderly(CCE) Client Information and Registration Tracking System(CIRTS) Department of Children and Families(DCF) Florida Department of Elder Affairs(DOEA) Florida Statutes(F.S.) Home Care for Disabled Adults(HCDA) Home Care for the Elderly(HCE) Institutional Care Program(ICP) Planning and Service Area(PSA) Summary of Programs and Services(SOPS) 1.1.2 Program Specific Terms Aging Out: The condition of reaching 60 years of age and being transitioned from DCF Services, CCDA or HCDA services to the Agency's and/or Department's community-based services. Area Plan: A plan developed by the area agency on aging outlining a comprehensive and coordinated service delivery system in its PSA in accordance with the Section 306 (42 U.S.C. 3026) of the Older Americans Act and Department instructions. The Area Plan includes performance measures and unit rates per service offered per county. Area Plan Update: A revision to the Area Plan wherein the area agency on aging enters HCE program specific data in the CIRTS. An update may also include other revisions to the Area Plan as instructed by the Agency and/or Department. Department of Elder Affairs Programs and Services Handbook: An official document of DOEA. Handbook includes program policies, procedures, and standards applicable to agencies which are recipients/providers of DOEA funded programs. An annual update is provided through a Notice of Instruction. Functional Assessment: A comprehensive, systematic, and multidimensional review of a person's ability to remain independent and in the least restrictive living arrangement. Notice of Instruction(NOI): The Department's established method to communicate to the Agency and/or Contractor the requirement to perform a particular task or activity.NOIs are located on the Department's website at http://elderaffairs.state.fl.us/doea/nois.php. 4 July 2015 to June 2016 1 6 3 HCE 203.15 Summary of Programs and Services(SOPS): A document produced by the Department and updated yearly to provide the public and the Legislature with information about programs and services for Florida's elders. 1.2 GENERAL DESCRIPTION 1.2.1 General Statement Area Agencies on Aging may contract with CCE lead agencies or other case management entities for the provision of the HCE program. Approved caregivers receive a Basic Subsidy to reimburse some of their expenses each month for caring for the consumer and may receive a Special Subsidy for other necessary services and essential supplies. Caregivers may be approved for up to three HCE clients in their home. 1.2.2 Home Care for the Elderly Program Mission Statement The HCE Program supports family-style living arrangements, on a non-profit basis, as an alternative to nursing homes or other institutional care. Through the program,a caregiver for 3 or fewer elders,living in a private home, provides basic services of maintenance and supervision, as well as coordinating other necessary specialized services. 1.2.3 Authority The relevant authority governing the HCE program includes: (1) Rule Chapter 58H-1,Florida Administrative Code; (2) Sections 430.601, 430.602, 430.603, 430.604, 430.605, 430.606, 430.608, F.S.; and (3) The Catalog of State Financial Assistance (CSFA)Number 65.001. 1.2.4 Scope of Service The Contractor is responsible for the programmatic,fiscal and operational management of HCE.The program services shall be provided in a manner consistent with and described in the Contractor's Request for Proposal, RFP, and the Agency's current Area Plan as updated,and the current Department of Elder Affairs OEA Programs and Services Handbook,which are incorporated by reference. 1.2.5 Major Program Goals The major goals of the HCE program are to ensure that: (1) Basic Subsidy is provided to the caregiver of each client, and; (2) Special Subsidy is provided when essential to the well-being of the client. 1.3 INDIVIDUALS TO BE SERVED 1.3.1 General Eligibility The HCE program serves elders age 60 and older at risk of placement in a nursing home or other institutional settings who can remain in a family-style setting through the provision of subsidies. 1.3.2 Client Eligibility Clients eligible to receive services under this contract must: (1) Be 60 years of age or older; (2) Have income no greater than the ICP standard; (3) Meet the ICP asset limitation; 5 July 2015 to June 2016 1 6 fl 3 HCE 203.15 (4) Be at risk of nursinghome placement; (5) Have an approved adult caregiver living in the home with them who is willing and able to provide care or assist in arranging for care; and (6) Not be enrolled in a Medicaid capitated long-term care program. 1.3.3 Caregiver Eligibility Caregivers eligible to receive services under this contract must: (1) Be at least 18 years of age; (2) Be capable of providing a family-type living environment; (3) Be a relative or a friend who has been accepted by the client as a surrogate family, or is a responsible adult with whom the client has made an arrangement to provide home care services; (4) Be willing to accept responsibility for the social,physical,and emotional needs of the care recipient; (5) Be physically present and live in the home to provide supervision and to assist in arrangement of services for the client; (6) Maintain the residential dwelling free of conditions that pose an immediate threat to the life, safety, health and well-being of the home care client; and (7) Be without record of conviction of abuse, neglect or exploitation of another person. 1.3.4 Targeted Groups Priority for services provided under this contract shall be given to those eligible persons assessed to be at risk of placement in an institution. SECTION II: MANNER OF SERVICE PROVISION 2.1 SERVICE TASKS To achieve the goals of the HCE program,the Contractor shall perform or ensure that its Subcontractors perform the following tasks: (1) Client Eligibility Determination; (2) Assessment and Prioritization of Service Delivery for New Clients; (3) Delivery of Services to Eligible Clients; and (4) Monitoring the performance of its Subcontractors. 2.1.1. Client Eligibility Determination The Contractor shall ensure that applicant data is evaluated to determine eligibility. Eligibility to become a client is based on meeting the requirements in ATTACHMENT I, Section 1.3. 2.1.2 Assessment and Prioritization of Service Delivery for New Clients The Contractor shall ensure the following criteria are used to prioritize new clients for service delivery. It is not the intent of the Agency to remove existing clients from any services in order to serve new clients being assessed and prioritized for service delivery. (1) Imminent Risk individuals: Individuals in the community whose mental or physical health condition has deteriorated to the degree that self-care is not possible, there is no capable caregiver, and nursing home placement is likely within a month or very likely within 3 months. (2) Aging Out individuals: Individuals receiving CCDA and HCDA services through the Department of Children and Families' Adult Services transitioning to community-based services provided through the Agency and/or Department when services are not currently available. 6 July 2015 to June 2016 1 6 Ui 3 HCE 203.15 (3) Service priority for individuals not included in (1) and (2) above, regardless of referral source, will be determined through the Agency's functional assessment administered to each applicant, to the extent funding is available. The Contractor shall ensure that first priority is given to applicants at the higher levels of frailty and risk of nursing home placement. 2.1.3 Delivery of Services to Eligible Clients The Contractor shall ensure the provision of a continuum of services that meet the diverse needs of the functionally impaired elders and their caregivers. The Contractor shall ensure Basic Subsidy and Special Subsidy services are performed in accordance with the current Department of Elder Affairs Programs and Services Handbook. 2.1.3.1 Basic Subsidy The Basic Subsidy is a cash payment made to an approved caregiver each month to reimburse some expenses incurred in caring for the client.The Basic Subsidy is provided for support and maintenance of the care recipient, including housing, food, clothing, and medical costs not covered by Medicaid, Medicare or any other insurance. A Basic Subsidy shall be paid to approved caregivers when the client is in the home for any part of the month. If the client is hospitalized or in any other temporary institution for 30 days or less, the full Basic Subsidy shall be provided to the caregiver as if the client were in the home. 2.1.3.1.1 Calculating the Basic Subsidy The Basic Subsidy shall be based on the financial status of the client receiving care. In the event that both a husband and wife are clients, their combined financial status shall be used to determine the amount of the Basic Subsidy. The Contractor shall ensure the Basic Subsidy is calculated in accordance with the current DOEA Programs and Services Handbook. 2.1.3.2 Special Subsidy Services Though every eligible HCE client receives a Basic Subsidy, Special Subsidy payments are pre-authorized and are based on additional specialized medical or health care services, supplies or equipment needed to maintain the health and well-being of the individual elder. The Special Subsidy for additional medical support and special services is a cash payment to reimburse the costs of any other service or special care not covered by Medicaid, Medicare, or private insurance when these services are determined to be essential to maintain the well-being of the home care recipient. A Special Subsidy shall be paid to the approved caregivers when the client is in the home for any part of the month. Special Subsidy Services may be authorized through a vendor agreement. All Special Subsidy services must be performed in accordance with the Department of Elder Affairs Programs and Services Handbook. Special Subsidy services include: Service Unit of Service Adult Day Care Housing Improvement Hour Adult Day Health Care Occupational Caregiver Training/Support Therapy Other Chore Outreach Chore(Enhanced) Personal Care Counseling(Gerontological) Physical Counseling(Mental Therapy Health/Screening) Respite(Facility Based or In-Home) Home Health Aide Service Skilled Nursing Services Speech Homemaker Therapy Home Delivered Meals Meal Material Aid Episode Other Specialized Medical Equipment, Services and Supplies Transportation One-Way Trip 7 6 July 2015 to June 2016 , , 3 HCE 203.15 2.1.3.3 Access to and Coordination of Services The Contractor shall ensure,through case management and case aide services,that the HCE clients' needs are documented and needed services are planned, arranged and coordinated for the client and caregiver. 2.1.4 Use of Subcontractors If this contract involves the use of a Subcontractor or a third party, then the Contractor shall not delay the implementation of its agreement with the Subcontractor. If any circumstances occur that may result in a delay for a period of 60 days or more of the initiation of the subcontract or in the performance of the Subcontractor, the Contractor shall notify the Contract Manager and the Agency's Chief Financial Officer in writing of such delay. The Contractor shall not permit a Subcontractor to perform services related to this agreement without having a binding Subcontractor agreement executed. In accordance with Section 23.1 of the Master Contract, the Agency will not be responsible or liable for any obligations or claims resulting from such action. The Contractor shall submit a copy of all subcontracts to the Contract Manager within thirty days of the subcontract being executed. 2.1.5 Monitoring the Performance of Subcontractors The Contractor shall monitor at least once per year each of its Subcontractors, Subrecipients, Vendors and/or Consultants paid from funds provided under this contract. The Contractor shall perform fiscal, administrative and programmatic monitoring to ensure contractual compliance, fiscal accountability, programmatic performance, and compliance with applicable state and federal laws and regulations. The Contractor shall monitor to ensure that time schedules are met, the budget and scope of work are accomplished within the specified time periods, and other performance goals stated in this contract are achieved. 2.2 SERVICE TIMES 2.2.1 Service Times The Contractor shall ensure the availability of the services listed in this contract at times appropriate to meet client service needs, at a minimum, during normal business hours. Normal business hours are defined as Monday through Friday, 8:00 a.m.to 5:00 p.m. 2.3 DELIVERABLES 2.3.1 Service Unit The Contractor shall ensure the provision of the services described in the contract, and the service tasks described in Section 2.1, are in accordance with the current Department of Elder Affairs Programs and Services Handbook. ATTACHMENT VI lists the services that can be performed, the highest reimbursement unit rate, the method of payment, and the service unit type. Units of service will be paid pursuant to the rate established in the Area Plan as updated and shown in ATTACHMENT VI and approved by the Agency. 2.4 REPORTS The Contractor shall respond to additional routine and/or special requests for information and reports required by the Agency in a timely manner as determined by the Contract Manager. The Contractor shall establish reporting due dates for Subcontractors that permit the Contractor to meet the Agency's reporting requirements. 2.4.1 Area Plan Update and All Revisions Thereto The Agency is required to submit an annual Area Plan update wherein the Agency enters HCE-specific data in the CIRTS. The Contractor may also be required to submit revisions to the Area Plan as instructed by the Agency and/or Department. 8 July 2015 to June 2016 16 D3 HCE 203.15 2.4.2 CIRTS Reports The Contractor shall input HCE-specific data into CIRTS. To ensure CIRTS data accuracy, the Contractor shall use CIRTS-generated reports which include the following: (1) Client Reports; (2) Monitoring Reports; (3) Services Reports; (4) Miscellaneous Reports; (5) Fiscal Reports; (6) Aging and Disability Resource Center Reports; and (7) Outcome Measurement Reports. 2.4.3 Program Highlights The Contractor shall submit Program Highlights referencing specific events that occurred in SFY/FFY 2014- 2015 by September 04, 2015. The Contractor shall provide a new success story,quote,testimonial, or human- interest vignette. The highlights shall be written for a general audience, with no acronyms or technical terms. For all agencies or organizations that are referenced in the highlight,Contractor shall provide a brief description of their mission or role.The active tense shall be consistently used in the highlight narrative,in order to identify the specific individual or entity that performed the activity described in the highlight. The Contractor shall review and edit Program Highlights for clarity,readability,relevance,specificity,human interest,and grammar, prior to submitting them to the Agency. 2.5 RECORDS AND DOCUMENTATION The Contractor shall ensure the collection and maintenance of client and service information, on a monthly basis, from the CIRTS or any such system designated by the Agency. Maintenance includes valid exports and backups of all data and systems according to Agency standards. 2.5.1 Policies for Data and Software Backup The Contractor and each Subcontractor,among other requirements,must anticipate and prepare for the loss of information processing capabilities. The routine backing up of all data and software is required to recover from losses or outages of the computer system. Data and software essential to the continued operation of Contractor functions must be backed up. The security controls over the backup resources shall be as stringent as the protection required of the primary resources. A copy of the backed up data shall be stored in a secure, offsite location. The Contractor shall maintain written policies and procedures for computer system backup and recovery, and shall have the same requirement in its contracts and/or agreements with Subcontractors. These policies and procedures shall be made available to the Agency upon request. 2.6 PERFORMANCE SPECIFICATIONS 2.6.1 Outcomes (1) The Contractor shall ensure services provided under this contract are in accordance with the current DOEA Programs and Services Handbook; (2) The Contractor shall timely submit to the Agency all reports described in ATTACHMENT I, SECTION 2.4,REPORTS; and (3) The Contractor shall timely submit to the Agency all information described in ATTACHMENT I, SECTION 2.5,RECORDS AND DOCUMENTATION. 2.7 CONTRACTOR'S FINANCIAL OBLIGATIONS 9 �_. July 2015 to June 2016 () 0 3 HCE 203.15 Subsidy payments for each client and for the program must be maintained wi hin the amount of program funding available. 2.8 AGENCY RESPONSIBILITIES 2.8.1 Program Guidance and Technical Assistance The Agency will provide to the Contractor guidance and technical assistance, as needed, to ensure the successful fulfillment of the contract by the Contractor. 2.8.2 Contract Monitoring The Agency will review and evaluate the performance of the Contractor under the terms of this contract. Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, or an onsite visit. The Agency's determination of acceptable performance shall be conclusive. The Contractor agrees to cooperate with the Agency in monitoring the progress of completion of the service tasks and deliverables. The Agency may use, but is not limited to, one or more of the following methods for monitoring: (1) Desk reviews and analytical reviews; (2) Scheduled, unscheduled and follow-up on-site visits; (3) Client visits; (4) Review of independent auditor's reports; (5) Review of third-party documents and/or evaluation; (6) Review of progress reports; (7) Review of customer satisfaction surveys; (8) Agreed-upon procedures review by an external auditor or consultant; (9) Limited-scope reviews; and (10) Other procedures as deemed necessary. SECTION III: METHOD OF PAYMENT 3.1 GENERAL STATEMENT OF METHOD OF PAYMENT The method of payment for this contract includes advances and fixed rates for services. Payment may be authorized for all allowable expenditures to complete the tasks identified in the deliverables, as required by the agreement. The Contractor shall consolidate all requests for payment from Subcontractors and Expenditure Reports that support requests for payment and shall submit to the Agency on ATTACHMENT VIII, ATTACHMENT IX, and ATTACHMENT X. 3.1.1 Funding Distribution The Contractor agrees to distribute funds as detailed in the Area Plan update and ATTACHMENT VI. To request a budget line item change between the budget categories of Case Management and Subsidies, the Contractor must submit the request in writing with a revised contract budget and receive written approval from the Agency's Contract Manager. Any changes in the total amounts of the funds identified on the ATTACHMENT VI form require a contract amendment. 3.2 ADVANCE PAYMENTS The Contractor may request up to two months of advances at the start of the contract period to cover service costs. The payment of an advance will be contingent upon the sufficiency and amount of funds released to the Agency and/or Department by the State of Florida("budget release"). The Contractor shall provide the Contract Manager documentation justifying the need for an advance and describing how the funds will be distributed. The Contractor's requests for advances require the approval of the Contract Manager. If sufficient budget is available, the Agency will issue approved advance payments after July 1, 2015. 10 July 2015 to June 2016 ElHCE''203.15 3 3.2.1 Advance Recoupment 6 All advance payments made to the Contractor shall be returned to the Agency as follows: one-tenth of the advance payment received shall be reported as advance recoupment on each request for payment, starting with report number 5, in accordance with ATTACHMENT VII to this contract. The Contractor may temporarily place advanced funds into an FDIC insured interest bearing account. All interest earned on advanced funds must be returned to the Agency within 30 days of the end of each quarter of the contract period. 3.3 INVOICE SUBMITTAL AND REQUESTS FOR PAYMENT All Requests For Payment and Receipt and Expenditure Reports submitted to the Agency shall be submitted using ATTACHMENT VIII,ATTACHMENT IX and Cost Reimbursement Summary(ATTACHMENT X). The Contractor shall include documentation of services provided, unit of services,and the rates for the services provided in conformance with the requirements as described in this ATTACHMENT I. 3.3.1 Payment Requests All payment requests shall be based on the submission of actual monthly expenditure reports beginning with the first month of the contract. The schedule for submission of advance requests and invoices is ATTACHMENT VII to this contract. 3.3.2 Payment Withholding Any payment due by the Agency under the terms of this contract may be withheld pending the receipt and approval by the Agency of all financial and programmatic reports due from the Contractor and any adjustments thereto, including any disallowance not resolved as outlined in section 26 of Master Contract. 3.3.3 Date For Final Request For Budget Revisions Final requests for budget revisions or adjustments to contract funds based on expenditures for services, must be submitted to the Contract Manager no later than June 25, 2016. 3.3.4 Date for Final Request for Payment The final request for payment is due to the Agency no later than August 1, 2016. 3.4 DOCUMENTATION FOR PAYMENT The Contractor shall maintain documentation to support payment requests that shall be available to the Agency, or authorized individuals, such as Department of Financial Services,upon request. 3.4.1 HCE Subsidy Data Entries Schedule The Contractor must ensure all data for HCE subsidies are entered in the CIRTS by the 15th of each month. HCE subsidy data entered into the CIRTS by the 15th of the month will be for payments incurred between the 16th of the previous month and the 15th of the current month. Case management data entered into the CIRTS by the 9th of the month shall be for units of service provided during the previous month from the 1st and up to and including the last day of the previous month or case management units of service may be entered according to the Contractor schedule, in aggregate on the 31st or daily, weekly or monthly. The Contractor shall ensure data entry for HCE subsidies will cease on the 15th of the month and the CIRTS Monthly Service Utilization Report, by consumer and by worker identification is generated. The Contractor shall ensure the Monthly Utilization Report by consumer and by worker identification is verified, corrected, and certified no later than the 20th of the month in which the Report is generated. 3.4.2 CIRTS Data Entries for Contractors The Agency must require Contractors to enter all required data per the Agency's and/or Department's CIRTS Policy Guidelines for clients and services in the CIRTS database. The data must be entered into the CIRTS before the Contractors submit their request for payment and expenditure reports to the Agency. The Agency shall establish time frames to assure compliance with due dates for the requests for payment and expenditure reports to the Agency and/or Department along with copies of receipts/services over $150. 11 July 2015 to June 2016 1 6 ® 3 HCE 203.15 3.4.3 Contractors' Monthly CIRTS Reports The Agency must require Contractors to run monthly CIRTS Reports and verify client and service data in the CIRTS is accurate. This report must be submitted to the Agency with the monthly request for payment and expenditure report and must be reviewed by the Agency before the Contractor's request for payment and expenditure reports can be approved by the Agency. 3.5 REMEDIES FOR NONCONFORMING SERVICES The Contractor shall ensure that all goods and/or services provided under this contract are delivered timely, completely and commensurate with required standards of quality. Such goods and/or services shall only be delivered to eligible program participants. If the Contractor fails to meet the prescribed quality standards for services, such services will not be reimbursed under this contract. In addition, any nonconforming goods, including home delivered meals, and/or services not meeting such standards will not be reimbursed under this contract. The Contractor's signature on the request for payment form certifies maintenance of supporting documentation and acknowledgement that the Contractor shall solely bear the costs associated with preparing or providing nonconforming goods and/or services. The Agency requires immediate notice of any significant and/or systemic infractions that compromise the quality, security or continuity of services to clients. 3.6 FINANCIAL CONSEQUENCES Contractor shall ensure 100% of the deliverables and service tasks identified in this contract are performed pursuant to contract requirements. If at any time after an initial written notice of deficiency, Contractor is notified by the Agency's Contract Manager that it has failed to correctly, completely, or adequately perform the deliverables or service tasks, Contractor will have 10 days to issue a Corrective Action Plan ("CAP") to the Agency's Contract Manager that addresses the deficiencies and states how the deficiencies will be remedied within the specified time period. The Agency shall assess a Financial Consequence for Non-Compliance on the Contractor for each deficiency identified in the CAP which is not corrected pursuant to the CAP. The Agency will also assess a Financial Consequence for failure to timely submit a CAP. 3.6.1 Payment Deduction In the event Contractor fails to correct an identified deficiency within the timeline specified in the CAP, the Agency shall deduct, from the payment for the invoice of the following month, 1% of the monthly value of the contract for each day the deficiency is not corrected. If Contractor fails to timely submit a CAP plan, the Agency shall deduct 1% of the monthly value of the administrative funds in the contract for each day the CAP is overdue, beginning the 11th day after notification by the contract manager of the deficiency. The deduction will be made from the payment for the invoice of the following month. If, or to the extent, there is any conflict between this paragraph and paragraphs 39 and 39.1 of the Master contract,this paragraph shall have precedence. 12 July 2015 to June 2016 1 6 3 HCE 203.15 ATTACHMENT III 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT TOTAL FEDERAL AWARD COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: N/A 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE FOLLOWING: MATCHING RESOURCES FOR FEDERAL PROGRAMS PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT TOTAL STATE AWARD $0 STATE FINANCIAL ASSISTANCE SUBJECT TO Sec.215.97,F.S. PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT Home Care for the Elderly General Revenue-Collier 65.001 $49,250.00 TOTAL AWARD $49,250.00 COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: STATE FINANCIAL ASSISTANCE Section 215.97, Fla. Stat. Chapter 69I-5, Fla. Admin. Code 13 July 2015 to June 20161 6 Q3 HCE 203.15 Ai CHMENT VI HOME CARE FOR THE ELDERLY PROGRAM BUDGET SUMMARY Collier County Board of County Commissioners Collier HCE Case Management/Case Aide $ 3805.00 HCE Basic and Special Subsidies 45,445.00 Total $ 49,250.00 RATE SUMMARY Collier County Board of County Commissioners Collier SERVICES REIMBURSEMENT RATE Collier Case Management $60.00 Case Aide $33.88 14 July 2015 to June 2016 ® � HCE 203.15 ATTACHMENT VII HOME CARE FOR THE ELDERLY INVOICE REPORT SCHEDULE Report Number Based On Submit to Agency on this Date 1 July Advance* July 1 2 August Advance* July 1 Monthly Utilization Report (7/1-7/15) July 20 3 July Expenditure Reports (105 & 106) August 9 Monthly Utilization Report(7/16-8/15) August 20 4 August Expenditure Report (105 & 106) September 9 Monthly Utilization Report(8/16-9/15) September 20 5 September Expenditure Report (105 & 106) October 9 Monthly Utilization Report (9/16-10/15) October 20 6 October Expenditure Report(105 & 106) November 9 Monthly Utilization Report(10/16-11/15) November 20 7 November Expenditure Report (105 & 106) December 9 Monthly Utilization Report (11/16-12/15 December 20 8 December Expenditure Report (105 & 106) January 9 Monthly Utilization Report(12/16-1/15) January 20 9 January Expenditure Report (105 & 106) February 9 Monthly Utilization Report(1/16-2/15) February 20 10 February Expenditure Report (105 & 106) March 9 Monthly Utilization Report (2/16-3/15) March 20 11 March Expenditure Report(105 & 106) April 9 Monthly Utilization Report(3/16-4/15) April 20 12 April Expenditure Report(105 & 106) May 9 Monthly Utilization Report(4/16-5/15) May 20 13 May Expenditure Report (105 & 106) June 9 Monthly Utilization Report (5/16-6/15) June 20 14 June Expenditure Report (105 & 106) July 9 Monthly Utilization Report(6/15-6/30) July 20 15 Final Expenditure Report (105 & 106) August 1 16 Closeout Report (105 & 106) August 15 Legend: * Advance based on projected cash need. Note# 1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency on Aging for Southwest Florida, Inc.prior to July 1 or until the contract with the Agency has been executed and a copy sent to the Agency on Aging for Southwest Florida, Inc. Actual submission of the vouchers to the Agency is dependent on the of the expenditure report. Note # 2: All advance payments made to the Contractor shall be returned to the Agency as follows: one— tenth of the advance payment received shall be reported as an advance recoupment on each request for payment, starting with report number five. The adjustment shall be recorded in Part C, Line 1 of the report(ATTACHMENT IX). Note #3: Submission of expenditure reports may or may not generate a payment request. If final expenditure report reflects funds due back to the Agency, payment is to accompany the report. 15 July 2015 to June 2016 HCE 203.15 o Li 3 ATTACHMENT VIII REQUEST FOR PAYMENT HOME CARE FOR THE ELDERLY PROGRAM RECIPIENT NAME,ADDRESS,PHONE#and FEID# TYPE OF PAYMENT: This Request Period: From: To: Regular Contract Period Contract# Advance Report# PSA# CERTIFICATION: I hereby certify to the best of my knowledge that this requestis complete and correct and conforms with the terms and the purposes of the above contract. Prepared by: Date: Approved by: Date: PART A: BUDGET SUMMARY AAA Admin. Case Management Subsidies TOTAL 1.Approved Contract Amount $0.00 $0.00 $0.00 $0.00 2.Previous.Funds Received for Contract Period $0.00 $0.00 $0.00 $0.00 3.Contract Balance(line 1 minus line 2) $0.00 $0.00 $0.00 $0.00 4.Previous Funds Requested and Not Received for Contract Period $0.00 $0.00 $0.00 $0.00 5.CONTRACT BALANCE(line 3 minus line 4) $0.00 $0.00 $0.00 $0.00 PART B: CONTRACT FUNDS REQUEST 1.Anticipated Cash Need(1st-2nd months) $0.00 $0.00 50.00 $0.00 2.Net Expenditures For Month $0.00 $0.00 $0.00 $0.00 (DOEA Form 105H,Part B,Line 4) 3.TOTAL $0.00 $0 00 $0.00 $0.00 PART C: NET FUNDS REQUESTED 1.Less Advance Applied $0.00 $0.00 $0.00 $0.00 2.TOTAL FUNDS REQUESTED(Part B Line 3,minus Part C Line 1) $0.00 $0.00 $0.00 $0.00 List of Services/Units/Rates provided-See attached report. DOEA FORM 106H Revised 5/4/12 16 July 2015 to June 2016 1 b p 3 HCE 203.15 • ATTACHMENT IX RECEIPT AND EXPENDITURE REPORT HOME CARE FOR THE ELDERLY PROGRAM PROVIDER NAME,ADDRESS,PHONE#and FEID# Program Funding: THIS REPORT PERIOD: From To AAA Admin. CONTRACT PERIOD: Case Management CONTRACT# Subsidies: REPORT# Basic Special PSA# CERTIFICATION: I certify to the best of my knowledge and belief that the report is complete and correct and all outlays herein are for purposes set forth in the contract. Prepared by: Date: Approved by: Date: PART A: BUDGETED INCOME/ RECEIPTS 1.Approved 2.Actual Receipts 3.Total Receipts 4. Percent of Budget For This Report Year to Date Approved Budget 1.State Funds $0.00 $0.00 $0.00 #DIV/0! 2.TOTAL RECEIPTS $0.00 $0.00 $0.00 #DIV/0! PART B:EXPENDITURES 1.Approved 2.Expenditures 3. Expenditures 4.Percent of Budget For This Report Year to Date Approved Budget 1.AAA Program Administration $0.00 $0.00 $0.00 #DIV/0! 2.Service Subcontractors:Case Management $0.00 $0.00 $0.00 #DIV/0! 3.Service Subcontractors:Subsidy $0.00 $0.00 $0.00 #DIV/0! a.Basic Subsidy $0.00 $0.00 $0.00 #DIV/0! b.Special Subsidy $0.00 $0.00 $0.00 #DIV/0! 4.TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIV/0! PART C:OTHER REVENUE AND EXPENDITURES I.Interest: II.Advance Recoupment 1.Earned on GR Advance$ 2.Return of GR Advance $ 1.Advance Recouped $ 3.Other Earned $ DOEA FORM 105H. Revised 5/25/2010 17 July 2015 to June 2016 1 6 133 HCE 203.15 ATTACHMENT X Cost Reimbursement Summary Contract# Report(invoice)Number: Budget Number of Category Description units Service Date Amount c E 0 R . L I TOTAL ADMINISTRATION $0.00 0 aC a w TOTAL EXPENSES $0.00 18 Revised August 2007 1 6 0 3 Attestation Statement Agreement/Contract Number HCE 203.15 Amendment Number I, Stephen Y.Carnell ,attest that no changes or revisions have been made to the (Recipient/Contractor representative) content of the above referenced agreement/contract or amendment between the Area Agency on Aging for Southwest Florida and Public Services Department Head (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting,due to the differences in electronic data processing media,which has no affect on the agreement/contract content. CA J Date f7 hg(/ Signatu e of Reci int/Contractor representative Approved as to form and legality Assistant County Attorney �\`� Revised August 2007