Agenda 09/27/2016 Item #16D13 16.D.13
09/27/2016
EXECUTIVE SUMMARY
Recommendation to approve "after-the-fact" Amendments and Attestation Statements with Area
Agency on Aging for Southwest Florida, Inc. for the Community Care for the Elderly, Alzheimer's
Disease Initiative and Home Care for the Elderly programs and authorize Budget Amendments to
reflect the final FY 15/16 grant funding amount(Net Fiscal Impact$8,984.01).
OBJECTIVE: To provide uninterrupted support services to Collier County Services for Seniors' (CCSS)
elderly clients.
CONSIDERATIONS: The Community and Human Services Division's Services for Seniors program
has been providing support to Collier County's frail and elderly citizens for over thirty years through the
Community Care for the Elderly (CCE), Alzheimer's Disease Initiative (ADI), and Home Care for the
Elderly (HCE) grant programs. These grants are funded by the Florida Department of Elder Affairs
(DOEA) through the Area Agency on Aging of Southwest Florida, Inc. ("Agency"). These grant fund
services enable clients to remain in their homes and live with independence and dignity.
On September 8, 2015, the Board approved the current grant contracts with the Agency (Agenda item
16D3). The contracts have a one-year term, effective July 1, 2015 through June 30, 2016, with a three
year renewal option.
The purposed of these amendments are to amend CCE, ADI and HCE final allocations for the FY 2015-
2016 contract year. The Agency agrees to pay for contracted services in the amount of$747,137.95 for
the CCE program, $284,945.86 for the ADI program and $52,334.87 for the HCE program. The stated
amounts represent an overall increase in funding for each grant program. The budget adjustments reflect
fluctuations in the case workers' client load and client services that routinely result from the loss/addition
of clients and increase/decrease in client service needs. Reallocation and increases of funding will allow
Services for Seniors to provide case management and services based on current and projected program
needs. The effective dates of these amendments are June 30, 2016.
The following table provides a detailed breakdown of the increased award adjustment:
Program Project Current Revised Increase/ Local Match
Budget Budget (Decrease) Increase/(Decrease)*
Community Care for 33418 $744,435.00 $747,137.95 $2,702.95 $300.33
the Elderly(CCE)
Alzheimer's Disease 33420 $282,050.00 $284,945.86 $2,895.86 $0.00
Initiative Program
(ADI)
Home Care for the 33419 $35,894.00 $38,978.87 $3,084.87 $0.00
Elderly(HCE) Basic
Subsidy**
Total $1,062,379.00 $1,071,062.68 $8,683.68 $300.33
*10%Match is Award divided by .9, multiplied by .1,per grantor requirements, rounded to nearest dollar
*The HCE Basic Subsidy of$13,356.00 is to be retained by the grantor agency, and therefore is not
included within Collier County's budget.
This item is being presented after-the-fact because CCSS received the grant agreement on July 29, 2016
I Packet Pg.1040
16.D.13
09/27/2016
from the Agency with a request for a 30-day turnaround. The Agency routinely sends CCSS amendments
with an effective date prior to the date the documents are received. Pursuant to CMA 5330 and Resolution
No. 2010-122, the County Manager authorized Steve Carnell, Public Services Department Head, to sign
the amendment. These amendments are being presented for Board ratification. Collier County, as the
Lead Agency, is responsible to respond to seniors' needs and to manage the spending authority for the
Federal and State funded Services for Seniors programs.
FISCAL IMPACT: Budget amendments are required to recognize the actual grant revenue of
$1,071,062.68 for the SFY CCE, ADI, and HCE grant programs funded by the Florida Department of
Elder Affairs which reflects an increase of$8,683.68 in grant revenue and the required local match of
$300.33. Funding will reside in Human Services Grant Fund 707 Projects 33418 (CCE), 33420 (ADI),
33419 (HCE). Local match is available within Human Services Grant Fund(707)Reserves.
LEGAL CONSIDERATIONS: This is a standard form amendment provided by the Area Agency on
Aging for Southwest Florida, Inc. This item is approved for form and legality and requires a majority
vote. -JAB
GROWTH MANAGEMENT: There is no growth management impact associated with this action.
RECOMMENDATIONS: That the Board of County Commissioners approves the after-the-fact
Amendments and an Attestation Statements with Area Agency on Aging for Southwest Florida, Inc. for
the Community Care for the Elderly, Alzheimer's disease Initiative and Home Care for the Elderly grant
programs and authorizes budget amendments to reflect the final FY 2015/2016 grant funding amount.
Prepared by: Lisa N. Carr, Grants Coordinator, Community and Human Services Division
ATTACHMENT(S)
1. CCE 203.15.005 Final (PDF)
2.ADI 203.15.004 Final (PDF)
3.HCE 203.15.004 Final (PDF)
4. CCE Contract and Prior Amendments -203.15 (PDF)
5.ADI Contract and Prior Amendments - 203.15 (PDF)
6. HCE Contract and Prior Amendments - 205.15 (PDF)
Packet Pg. 1041 I
16.D.13
09/27/2016
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.D.13
Item Summary: Recommendation to approve "after-the-fact" Amendments and Attestation
Statements with Area Agency on Aging for Southwest Florida, Inc. for the Community Care for the
Elderly, Alzheimer's Disease Initiative and Home Care for the Elderly programs and authorize Budget
Amendments to reflect the final FY 15/16 grant funding amount(Net Fiscal Impact$8,984.01).
Meeting Date: 09/27/2016
Prepared by:
Title: Grants Coordinator—Community&Human Services
Name: Lisa Carr
09/02/2016 4:03 PM
Submitted by:
Title: Division Director- Cmnty&Human Svc—Public Services Department
Name: Kimberley Grant
09/02/2016 4:03 PM
Approved By:
Review:
Public Services Department Amanda O.Townsend Level 1 Sim.Reviewer 1-8 Completed 09/05/2016 10:55 AM
Community&Human Services Dora Carrillo Level 1 Sim.Reviewer 1-8 Completed 09/06/2016 11:09 AM
Public Services Department Kimberley Grant Level 1 Sim.Reviewer 1-8 Completed 09/06/2016 11:16 AM
Community&Human Services Kristi Sonntag Level 1 Sim.Reviewer 1-8 Completed 09/06/2016 5:50 PM
Community&Human Services Maggie Lopez Level 1 Sim. Reviewer 1-8 Completed 09/07/2016 8:31 AM
Public Services Department Hailey Margarita Alonso Level 1 Division Reviewer Completed 09/09/2016 3:56 PM
Public Services Department Steve Carnell Level 2 Division Administrator Review Completed 09/09/2016 4:21 PM
Grants Erica Robinson Level 2 Grants Review Completed 09/12/2016 2:36 PM
County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 09/13/2016 3:18 PM
County Attorneys Office Jeffrey A.Klatzkow Level 3 County Attorneys Office Review Completed 09/14/2016 10:28 AM
Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 09/14/2016 11:13 AM
Grants Therese Stanley Level 3 OMB 1st Reviewer 1-4 Completed 09/16/2016 4:23 PM
County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 09/18/2016 9:53 PM
Board of County Commissioners MaryJo Brock Meeting Pending 09/27/2016 9:00 AM
I Packet Pg. 1042
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Amendment 005 July 2015 to June 2016 CCE 203.15.005
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AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
COMMUNITY CARE FOR THE ELDERLY PROGRAM CONTRACT
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners("Contractor"), amends agreement CCE 203.15.
The purpose of this amendment is to amend 4. Contract Amount with the final allocation for the 2015-2016 contract
year, and revise ATTACHMENT III and ATTACHMENT VIII.
Line denotes completion of above summary
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 $747,137.95,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.
This amendment shall be effective June 30, 2016. All provisions in the agreement and any attachments thereto in conflict
with this amendment shall be and are hereby changed to conform with this amendment
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
IN WITNESS WHEREOF, the parties hereto have caused this 3 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
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SIGNED BY: I.'' / ) % 1 SIGNED BY: t70.4A1,,WL9 i 32.(.f ,
NAME: Steve Carvell NAME: MARIANNE G LORIN I
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: Y/01/47 DATE: { 1x. ,14
Federal Tax ID: 59-6000-558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
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ATTACHMENT III a
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
$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 $ 747,137.95
TOTAL AWARD $ 747,137.95
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97,Fla. Stat.
. hapten 691-5,Fla. Admin.
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ATTACHMENT VIII °'
COMMUNITY CARE FOR THE ELDERLY PROGRAM
ANNUAL BUDGET SUMMARY
for
Collier County Board of County Commissioners,
Collier
CCE Services $747,137.95
RATE SUMMARY
for
Collier County Board of County Commissioners
Collier 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
Escort $21.66 $19.50
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
Other $ 2.22 $ 2.00
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
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Attestation Statement
Agreement/Contract Number CCE 203.15
Amendment Number 005
I, Steve Carnet! ,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
Collier County Board of County Commissioners .
(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.
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Signature of Reci Vent/Contractor representative Date
Approved as to form and legality
Assistant County Attorney
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Revised August 2007
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AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
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ALZHEIMER'S DISEASE INITIATIVE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners("Contractor"), amends agreement ADI 203.15.
The purpose of this amendment is to amend 4. Contract Amount with the final allocation for the 2015-2016 contract
year, and revise ATTACHMENT III and ATTACHMENT VIII.
Line denotes completion of above summary
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 $284,945.86, 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.
This amendment shall be effective June 30, 2016. All provisions in the agreement and any attachments thereto in conflict
with this amendment shall be and are hereby changed to conform with this amendment
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
IN WITNESS WHEREOF, the parties hereto have caused this 3 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
SIGNED BY: 1 C(//,/ t� ' . I G-1 �L -
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NAME: Steve Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: ill (2,0(6 DATE:
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Federal Tax ID: 59-6000-558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant County Attorney
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ATTACHMENT III a
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
$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 $ 284,945.86
TOTAL AWARD $ 284,945.86
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97, Fla. Stat.
hapten 69I-5,Fla.Admin.
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ATTACHMENT VIII 13-
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
ANNUAL BUDGET SUMMARY
for
Collier County Board of County Commissioners,
Collier
ALLOCATION TOTAL $ 284,495.86
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Attestation Statement
Agreement/Contract Number ADI 203.15
Amendment Number 004
1, Steve Carnet] ,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
Collier County Board of County Commissioners .
(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.
C1)(1177.
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Signatut of Red- ient/Contractor representative Date
Approved as to form and legality
Assistant County Attorney
Revised August 2007
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AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
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HOME CARE FOR THE ELDERLY PROGRAM a
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners("Contractor"), amends agreement HCE 203.15.
The purpose of this amendment is to amend 4. Contract Amount with the final allocation for the 2015-2016 contract
year, and revise ATTACHMENT III and ATTACHMENT VI.
Line denotes completion of above summary
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 $52,334.87, 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.
This amendment shall be effective June 30, 2016. All provisions in the agreement and any attachments thereto in conflict
with this amendment shall be and are hereby changed to conform with this amendment
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
IN WITNESS WHEREOF, the parties hereto have caused this 3 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
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SIGNED BY:, SIGNED BY: 0-' i. A. ,A,-
NAME: STEVE CARNELL NAME: MARIANNE G LORINI
TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO
DATE: DATE: 0P/c2.�` /6
Federal Tax ID: 9-60 0-558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant County Attorney 032 *LgI
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ATTACHMENT III a
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
$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 $ 52,334.87
TOTAL AWARD $ 52,334.87
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97, Fla. Stat.
'hapten 69I-5, Fla. Admin.
Code
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ATTACHMENT VI a I
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Collier County Board of County Commissioners
Collier
HCE Services $52,334.87
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Attestation Statement
Agreement/Contract Number HCE 203.15
Amendment Number 004
1, Steve 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
Collier County Board of County Commissioners
(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.
111
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Signature of Recipient/Contractor representative Date
Approved as to form and legality
Assistant County Attorney 095 oc\440
Revised August 2007
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AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
COMMUNITY CARE FOR THE ELDERLY PROGRAM CONTRACT a
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.
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6. Offi i<1 Payee 'Ind Ike wesentatives ldames. Addr,sses •
Collier County Housing, Ilunman and Veteran °,
The Contractor name, as shown on page 1 of this ID'
Services
a. contract, and mailing address of the official payee to '3339E Tamiami Trail, Building L1
whom the payment shall he made is: Naples, FL 34112 a.
KimberlyGrant, Director
The name of the contact person and street address where Collier County Housing, Human and Veteran
b. Services
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 I lousing, 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
t
Naples, FL 34112
(239) 252-2273
Tammy Rhoades, VP of Finance
The section and location within the Agency where Arca Agency on Aging for Southwest Florida, Inc.
d' Requests for Payment and Receipt and Expenditure 15201 North Cleveland Avenue, Suite 1 100
fnrm� arm to he 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, 1, 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 ACING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
SIGNED BY: /`�� �' � , ����� t�� �� � � //'
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NAME: Stephen Y Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: DATE:
r'-decal Tax ID: 59-6000558
seal Year Ending Date: 09/30 Approved as to form and legality
2r
Assistant County Attorney
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INDEX OF ATTACHMENTS a
ATTACHMENT I . 4 ;�
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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.
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ATTACHMENT a
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
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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.
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6 Notice of Instruction (NOT): The Department's established method to communicate to the Agency chfl
and/or Contractor the requirement to perform a particular task or activity. NOIs are located on the °,-
Department's website at http://clderaffairs.state.fl.us/doca/nois.php.
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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
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(3) Not be dually enrolled in the CCE Program and a Medicaid capitated long-term care program. a.
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.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 1,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.
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(3) Aging Out individuals: Individuals receiving CCDA and HCDA services through the Department of a
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;
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The Contractor shall ensure that health maintenance services are routine health services that are necessary to Y
maintain the health of functionally impaired elders. These services are limited to medical therapeutic services, o
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.L5 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.
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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 n.
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.
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2.5 RECORDS AND DOCUMENTATION
The Contractor shall ensure, on a monthly basis, that client and service information is properly collected and R
maintained within the CIRTS or any such system designated by the Agency and/or Department. Maintenance EL
includesvalid 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 Iocation. 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.
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co The Agency will review and evaluate the performance of the Contractor under the terms of this contract. a
Monitoring shall be conducted through direct contact with the Contractor through telephone, in writing, or an 5
on-site visit. The Agency's determination of acceptable performance shall be conclusive, The Contractor re
agrees to cooperate with the Agency in monitoring the progress of completion of the service tasks and 0-
deliverables,
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.
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3.3 INVOICE SUBMITTAL AND REQUESTS FOR PAYMENT a.
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.
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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 a
notified by the Agency's Contract Manager that it has failed to correctly, completely, or adequately a
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
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ATTACHMENT II_ a
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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 691-5,Fla. Admin. Code
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ATTACHMENT V a
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ANNUAL BUDGET SUMMARY
ii. �
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
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ATTACHMENT VI. °-
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INVOICE REPORT SCHEDULE a..
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
1 I 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
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ATTACHMENT VII a
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REQUEST FOR PAYMENT a
COMMUNITY CARE FOR THE ELDERLY
RECIPIENT NAME,ADDRESS,PHONE#and FEID# TYPE OF PAYMENT: This Request Period: From: _ To:____
RegularContract Period_ __
Contract#_----
Advance _ Report#_ __
PSA#
CERTIFICATION: I hereby certify to the best of my knovdedge that this request or refund conforms with the terms and the purposes of the above contract.
Prepared by: _ Date: Approved by: _ Date:_i_�_
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(line 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 105C,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 8 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
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ATTACHMENT r)
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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 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. 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/OI
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/01
2. Service Subcontractor(s) $0.00 $0.00 $0.00 #DIV/01
3.Adult Protective Services $0.00 $0.00 $0.00 #DIV/01
4. TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIV/O!
PART C:OTHER REVENUE AND EXPENDITURES II. Interest: III.Advance Recouped
I. Program Income(PI) 1. Earned on GR Advance$ $
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)
OOEA FORM 105C
Revised 5/25/2010
18
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Cost Reimbursement Summary
Contract#
Report(invoice) Number:
Budget
Category Number of
Description units Service Date Amount
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TOTAL ADMINISTRATION $0,00
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TOTAL EXPENSES $0.00.
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Attestation Statement
Agreement/Contract Number CCE 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.
( ,//711(
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Signature of iReciipiient/Contractbi representativett4 I Date
Approved as to form and legality
Assistant County Attorney i
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Revised August 2007
1110 6 .13.d
Amendment 001 July 2015 to June 2016 I CCE 203.1.,..,
AREA AGENCY ON AGING FOR SOUTHWEST A,INC.
COMMUNITY CARE FOR THE ELDERLY PROGRAM CONTRACT
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners("Contractor"),amends agreement CCE 203.15.
0
The purpose of this amendment is to amend 4. Contract Amount,increase the allocation by$41,690.00, 6. Official
Payee and Representatives Contractor Name correction, add Escort and Other Services, and revise ATTACHMENT IH o
and ATTACHMENT VI,ANNUAL BUDGET and RATE SUMMARY.
Line denotes completion of above summary
4. Contract Amount: it
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount
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not to exceed$789,435.00,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.
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6. Official Payee and Representatives(Names.Addresses.and Telephone Numbers): u
The Contractor name,as shown on page 1 of this Collier County Board of County Commissioners
Community and Human Services
a. contract, and mailing address of the official payee 3339 E Tamiami Trail,Building H
to whom the payment shall be made is: U„
Naples,FL 34112
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Kimberley Grant,Director
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Collier County Board of County Commissioners
b The name of the contact person and street address c/o Community and Human Services
where financial and administrative records are 3339 E Tamiami Trail,Building H cp
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maintained is: Naples,FL 34112 -Ea
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Kimberly Grant,Director E
The name,address, and telephone number of the Collier County Board of County Commissioners
c. representative of the Contractor responsible for c/o Community and Human Services 0
administration of the program under this contract 3339 E Tamiami Trail,Building H a`
is: Naples,FL 34112 a
(239)252-2273
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This amendment shall be effective August 06, 2015. All provisions in the agreement and any attachments thereto in v
conflict with this amendment shall be and are hereby changed to conform with this amendment
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All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the v
agreement.
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Amendment 001 July 2015 to June 2016 I CCE 203.1 16.D.13.d
T WITNESS WHEREOF, the parties hereto have caused this 4 page amendment to be executed by their officials there
.to duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMIVIISSIONERS FLORIDA,INC.
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SIGNED BY: .4 "•'v C/141 .
SIGNED BY: m 61.44414N" 5.0 G
NAME: Stephen Y. Carnell NAME: MARIANNE G LORINI
TITLE:Public Services Department Head TITLE: PRESIDENT/CEO
DATE: Cr _ ( - DATE: Pf 6/K cn
Federal Tax ID: 59-6000-558
Fiscal Year Ending Date: 09/30
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Amendment 041 * July 2015 to June 2016 CCE 203.1 16.D.13.d
ATTACHMENT III
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO
THIS CONTRACT CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
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TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES
AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: N/A
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2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS o
CONTRACT CONSIST OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
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STATE FINANCIAL ASSISTANCE SUBJECT TO Sec.215.97,F.S. a`
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT c
Community Care for the Elderly General Revenue -Collier 65.010 $ 789,435.00 6
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TOTAL AWARD $ 789,435.00 y
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: co
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STATE FINANCIAL ASSISTANCE
Section 215.97,Fla. Stat.
Chapter 69I-5,Fla. Admin.
Code
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Amendment 001. * July 2015 to June 2016 • CCE 203.1 16.D.13.d
ATTACHMENT VI
ANNUAL BUDGET SUMMARY
COMMUNITY CARE FOR THE ELDERLY PROGRAM
for
Collier County Board of County Commissioners o
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Collier 74-
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CCE Services $789,435.00 u-
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RATE SUMMARY
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Collier County Total Unit Cost Reimbursement Rate-90% N
Case Management $60.00 $54.00
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Case Aide $33.88 $30.50 c
Adult Day Care $12.83 $11.55 m
Chore $23.33 $21.00
Enhanced Chore $30.33 $27.30 d
Companion $23.33 $21.00 Q
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Escort $21.66 $19.50 9
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Skilled Nursing $42.00 $37.80 a.
EARS $ 1.31 $ 1.18 c
Homemaking $21.50 $19.35
Personal Care $25.67 $23.10 2
Respite-in-Home $25.67 $23.10 0
Other $ 2.22 $ 2.00 U
Home Improvement $ Cost Reimbursement 90% Cost Reimbursement v
Material Aid $ Cost Reimbursement 90% Cost Reimbursement U
Specialized Medical Equipment,
Service& Supplies $Cost Reimbursement 90% Cost Reimbursement E
Transportation $ Cost Reimbursement 90% Cost Reimbursement 0
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16.D.13.d
Revised August 2007
Attestation Statement
Agreement/Contract Number 203.15
Amendment Number 001
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I, Stephen Y. Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
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content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida andcn
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Public Services Department Head in
(Recipient/Contractor name) >-
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electronic data processing media,which has no affect on the agreement/contract content. rn
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Arrindment 002 July 2015 to June 2016 CCE 203.1 16.D.13.d
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
COMMUNITY CARE FOR THE ELDERLY PROGRAM CONTRACT
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
The purpose of this amendment is to amend contractual language in ATTACHMENT I.
0
NOW THEREFORE,in consideration of the mutual covenants and obligations set forth herein,the receipt and
sufficiency of which are hereby acknowledged,the Parties agree to the following:
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1.ATTACHMENT I, Section 3.2 is hereby replaced.
3.2 ADVANCE PAYMENTS cn
The Contractor may request up to two months of advances at the start of the contract period, to cover program !",12administrative and service costs. The payment of an advance will be contingent upon the sufficiency and amount of 14
funds released to the Agency and the Department by the State of Florida ("budget release"). The Contractor shall LL
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 and if sufficient
budget is available,the Agency will issue approved advance payments after July 1,the beginning of the contract term.
The schedule for submission of advance requests(when available) is ATTACHMENT VII to this contract. cn
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2_ ATTACHMENT I, Section 3.3 is hereby replaced.
3.3 INVOICE SUBMITTAL AND REQUESTS FOR PAYMENTcu
All Requests for Payment and Receipt and Expenditure Reports submitted to the Agency shall be submitted using
ATTACHMENT VIII and ATTACHMENT IX, and shall be in in accordance with the Invoice Schedule ai
(ATTACHMENT VII). The Contractor shall include documentation of services provided, number of units of E
services, and the rates for the services provided in conformance with the requirements as described in this
ATTACHMENT I and ATTACHMENT VI. Each deliverable must be received and accepted by the Agency before
payment is made. 647.
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3. ATTACHMENT I,Section 3.3.1 is hereby deleted.
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This amendment shall be effective February 19, 2016. All provisions in the agreement and any attachments thereto in
conflict with this amendment shall be and are hereby changed to conform with this amendment U
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the v
agreement.
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This amendment and all of its attachments are hereby made a part of this agreement.
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Packet Pg. 1080 I
Amendment 002 40 July 2015 to June 2016 CCE 203.1 16.D.13.d
IN WITNESS WHEREOF, the parties hereto have caused this 2 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
SIGNED BY: 4 ! SIGNED BY: Yiai
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NAME: STEPHEN Y. CARNELL NAME: MARIANNE G LORINI a
TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO
DATE: March 21,2016 DATE: 3 / 9/)6
Federal Tax ID: 59-6000-558CD
Fiscal Year Ending Date: 09/30
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Revised August 2007
Attestation Statement
Agreement/Contract Number 203.15
Amendment Number 002 E
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I, Stephen Y.Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative) o
ii
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and to
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Public Services Department Head
(Recipient/Contractor name)
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The only exception to this statement would be for changes in page formatting,due to the differences in c
electronic data processing media,which has no affect on the agreement/contract content.
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J� t J March 21.2016 '
Signature of Recipient/ ontractor representative Date
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Approved as to form and legality
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Assistant County ey 4
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Revised August 2007
Packet Pg. 1082
16.D.13.d
Amendment 003 July 2015 to June 2016 CCE
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
COMMUNITY CARE FOR THE ELDERLY PROGRAM CONTRACT
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners("Contractor"),amends agreement CCE 203.15.
The purpose of this amendment is to amend 4. Contract Amount,decrease the allocation by$45,000.00,and revise
ATTACHMENT III and ATTACHMENT VIII,ANNUAL BUDGET and RATE SUMMARY. 7
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Line denotes completion of above summary
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount it
not to exceed $744,435.00, or the rate schedule, subject to the availability of funds. Any costs or services paid for cn
under any other contract or from any other source are not eligible for payment under this contract.
This amendment shall be effective May 24, 2016. All provisions in the agreement and any attachments thereto in conflict
with this amendment shall be and are hereby changed to conform with this amendment
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
agreement.
1.0
This amendment and all of its attachments are hereby made a part of this agreement.
r.
IN WITNESS WHEREOF, the parties hereto have caused this 3 page amendment to be executed by their officials there
unto duly authorized.
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Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC. a
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SIGNED BY: '41' � � (�' SIGNED BY:
NAME: STEPHEN Y. CARNELL NAME: MARIANNE G LORINI U
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TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO
DATE: June 6, 2016 DATE:
Federal Tax ID: 59-6000-558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant County Attornry )) \\\61 ,3
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I6.D.13.d
Amendment 003 July 2015 to June 2016 CCE
ATTACHMENT III
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO
THIS CONTRACT CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
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TOTAL FEDERAL AWARD
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COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES
AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: N/A
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2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS
CONTRACT CONSIST OF THE FOLLOWING:
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MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
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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 $ 744,435.00 °
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TOTAL AWARD $ 744,435.00 v
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COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED 1
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97,Fla. Stat.
Chapter 69I-5,Fla.Admin.
Code
2
Packet Pg. 1084
Amendment 003 July 2015 to June 2016 CCE 203.1 16.D.13.d J
ATTACHMENT VIII
COMMUNITY CARE FOR THE ELDERLY PROGRAM
ANNUAL BUDGET SUMMARY
for
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Collier County Board of County Commissioners, 7
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Collier f°
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CCE Services $744,435.00 vii
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RATE SUMMARY
for
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Collier County Board of County Commissioners
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Collier 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 E
Chore $23.33 $21.00
Enhanced Chore $30.33 $27.30
Companion $23.33 $21.00 °'
Escort $21.66 $19.50
Skilled Nursing $42.00 $37.80
EARS $ 1.31 $ 1.18
Homemaking $21.50 $19.35 0
Personal Care $25.67 $23.10
Respite-in-Home $25.67 $23.10
Other $ 2.22 $ 2.00
Home Improvement $Cost Reimbursement 90% Cost Reimbursement
Material Aid $ Cost Reimbursement 90% Cost Reimbursement E
Specialized Medical Equipment,
Service& Supplies $ Cost Reimbursement 90% Cost Reimbursement us
Transportation $ Cost Reimbursement 90% Cost Reimbursement
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Packet Pa. 1085
16.D.13.d
Revised August 2007
Attestation Statement
Agreement/Contract Number 203.15
Amendment Number 003 0
I, Stephen Y. Carnet! ,
,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
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content of the above referenced agreement/contract or amendment between the Area Agency on Aging forcn
Southwest Florida and co
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Public Services Department Head T'
(Recipient/Contractor name) >-
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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. °'
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June 6,2016
Signature of R cipient/Contractor representative Date aa)
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16.D.13.d
Amendment 004 CCE 203.15.004
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA
COMMUNITY CARE FOR THE ELDERLY PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
This AMENDMENT,entered into between the Area Agency on Aging for Southwest Florida hereinafter referred to
as the "Agency,"and Collier County Board of County Commissioners,hereinafter referred to as the"Contractor," -c-
collectively stated as the"Parties"which amends contract CCE 203.15. e
This amendment shall be effective July 1, 2016.
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RECITALS:
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WHEREAS, on August 4, 2015,the parties entered into the Standard Contract for social services to becn
provided to Collier County's frail and elderly seniors (hereinafter referred to as "Contract"); and
WHEREAS, on October 5, 2015,the parties entered into a First Amendment to the Contract; and �}i..
WHEREAS, on March 29,2016, the parties entered into a Second Amendment to the Contract; and Q+
WHEREAS, on May 24, 2016, the parties Third Amendment to the Contract is pending execution; and
WHEREAS, Section 3 of the Contract provides that the agreement is to expire on June 30, 2016; and
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WHEREAS,the funding source for a successor agreement for senior services is not yet available to the
Agency from the Florida Department of Elder Affairs; c
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WHEREAS, the Parties are satisfied with the arrangement that they currently enjoy under the Contract so
that both parties wish to extend the Contract to August 30, 2016 while they await notification of funding of a
successor contract.
NOW, THEREFORE, in consideration of the foregoing Recitals, and other good and valuable consideration, the
receipt and sufficiency of which is hereby mutually acknowledged,the Parties agree as follows:
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1. The foregoing Recitals are true and correct and are incorporated by reference herein.
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2. Both parties agree to extend the contract to August 30,2016.
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3. All other provisions of the Contract are to remain in effect and are to be performed at the level
specified in the agreement.
SIGNATURE PAGE TO FOLLOW
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16.D.13.d
Amendment 004 CCE 203.15.004
IN WITNESS WHEREOF,the parties hereto have caused this Amendment to be executed by their
officials there unto duly authorized.
Collier County Board of County Area Agency on Aging for Southwest Florida,
Contractor: Commissioners Inc.
To"
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NAME: Stephen Y. Carrell NAME: Marianne G Lorini
TITLE: Public Services Department Head TITLE: President/CEO >-
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DATE: June 6,2016 DATE: //G,/6
Federal Tax ID: 59-6000588
.scal Year Ending Date: 09/30
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Attestation Statement
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• July 2015 to June 2016 ADI 203.1
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. a
ALZHEIMER'S DISEASE INITIATIVE CONTRACT a.
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. 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 $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.
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6. Official Payee and Representatives(Names,Addresses, and Telephone Numbers): tth
Collier County Housing, Human and Veteran °,
The Contractor name, as shown on page 1 of this +a'Services
a. 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 a-
Kimberly Grant, Director
h 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 341 12
(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 1 100
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 1 100
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, IlI, 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.
SIGNED BY: - 'R i � c �' i.,.,_./.� ,, ,' SIGNED BY:
S-`I{ ' ( /
NAME: Stephen Y. Cannell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head
TITLE: PRESIDENT/CEO
DATE: €I ( /' (1 DATE:
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30 Approved as to form and legality c
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INDEX OF ATTACHMENTS
ATTACHMENT I 4
STATEMENT OF WORK cts
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ATTACHMENT 111 .13
FUNDING SUMMARY
ATTACHMENT VI .14
INVOICE REPORT SCHEDULE
ATTACH.MENT 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.
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ATTACHMENT a..
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STATEMENT OF WORK R
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 C1RTS. 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 CIinic: 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.
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disorders. Services and activities include,but are not limited to,active and quiet games,reminiscence,validation m
therapy,pet therapy,water therapy and other failure free activities appropriate to the client's level of functioning. 6
Model day care centers will also provide training for health care and social service personnel in the care of a
persons having AD or related memory disorders.
Notice of Instruction (NO1:): 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 lirtp://elderaffairs.state.fl.us/(1oea/nois.12hp.
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.
L2.1.1 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.
'.3.2 Individual Eligibility
Those individuals eligible to receive services under this contract must meet the following conditions:
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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;
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cO (4) Counseling(Gerontological);
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(5) Counseling(Mental Health/Screening);
(6) Education/Training; a.
(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.
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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.
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2.5 RECORDS AND DOCUMENTATION .
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2.5.1 The Contractor shall ensure the collection and maintenance of client and service information on a monthly basis a
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
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6 agrees to cooperate with the Agency in monitoring the progress of completion of the service tasks and ch
deliverables. The Agency may use, but is not limited to, one or more of the following methods for monitoring: 13-
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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.
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3.3.1 Payment Requestsa.
• 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 tel
is ATTACHMENT VI. a
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
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July 2015 to June 2016 ADI 203.1
specified time period. The Agency shall assess a Financial Consequence for Non-Compliance on the a
Contractor for each deficiency identified in the CAP which is not corrected pursuant to the CAP. The Agency will Y
also assess a Financial Consequence for failure to timely submit a CAP.
O_
3.6.1 Payment Deduction
1
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 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
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July 2015 to June 2016 ADI 203.1
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ATTACHMENT H
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FUNDING SUMMARY
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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.
hapter 691-5, Fla. Admin. Code
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INVOICE REPORT SCHEDULE a
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 I 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
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ATTACHMENT VII 0-
ANNUAL
ANNUAL BUDGET SUMMARY a
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
for
Collier County Board of County Commissioners
Allocation Total $236,025.00
Total $236,025.00
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ATTACHMENT VIII
REQUEST FOR PAYMENT a
ALZHEIMERS DISEASE INITIATIVE PROGRAM
RECIPIENT NAME,ADDRESS.PHONE#and FEID# TYPE OF REPORT This Reque st Period_
PSA#
A.PAYMENT REQUEST: Report#
Regular Supplemental Contract#
B.METHOD OF PAYMENT: Contract Period
Advance Reimbursement
CERTIFICATION: thereby certifyto the best of my knowledge that this request is complete and correct and conforms with the terms and the purposes dine above contract.
Prepared by_ Date: Approved by Date:
(1) (2)
PARTA BUDGET SUMMARY Respite ModelDayCare 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(line 1 minus line 2) 00 00 SO 00 00.00
4.Previous Funds Requested and Not Received for Contract Period $0.00 $0.00 $0.00
6.Contract Balance(Noe 3 minus line 4) $0.00 $0.00 $0.00
PART S: CONTRACT FUNDS REQUEST
1 Anticipated Cash Needs(1 et 2nd month.Attach Justification) $0.00 $0.00 $0.00
2.Net Eroenditures For Month $0.00 $0.00 $0.00
(DOEAForm 105Z Part B,Line 3)
3.TOTAL $0 00 00.00 $0.00
PART C: NET FUNDS REQUESTED
1.Less Advance Applied $000 $0.00 $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
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RECEIPT AND EXPENDITURE REPORT
ALZHEIMERS DISEASE INITIATIVE PROGRAM
PROVIDER NAME,ADDRESS.PHONE#and FEI Dt 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/RECEI PTS 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 #D1VI0!
2.Program Income $0.00 $0.00 $0.00 #DIVIOl
3.Local Cash Match $0.00 $0.00 $0.00 r #DIV/DI
4.SUBTOTAL:CASH RECEIPTS
5.Local In-Kind Match
6.TOTALRECEIPTS $0.00 $0.00 $0.00 #DIV/OI
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 #DIV101
2.Service Subcontractor(s) $0.00 $0.00 $0.00 #DMO!
3.TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIVi01
PART C:OTHER REVENUE AND EXPENDITURES IL.Interest: III.Advance Recouped
I. Program Income(PI) 1. Earned on GR Advance$
1.AD: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 $ $
2.Total of Co-payments collected
(For Tracking Purposes only)
OOEA FORM 10EZ
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512S12010
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ATTACHMENT 1 a
Cost Reimbursement Summary
Contract#
Report(invoice)Number:
Budget Number of
Category Description units Service Date Amount
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TOTAL ADMINISTRATION $0.00
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ATTACHMENT K
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SERVICE RATE REPORT a
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
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Attestation Statement a
Agreement/Contract Number ADI 203.15
Amendment Number
I, Stephen V. 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.
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Signature of Recipient/Contractor representative Date
Approved as to form and legality
Assistant County Attorney
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AmenJinent 001 411- July 2015 to June 2016 16.D.13.e
ADI 203.
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioner("Contractor"),amends agreement ADI 203.15.
The purpose of this amendment is to amend 4. Contract Amount,increase the allocation by$41,425.00,6. Official 0
Payee and Representatives Contractor Name correction, and revise ATTACHMENT III,FUNDING SUMMARY and 3
ATTACHMENT VII,ANNUAL BUDGET SUMMARY. °
Line denotes completion of above summary
4. Contract Amount: c
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount
not to exceed $277,450.00, or the rate schedule, subject to the availability of funds. Any costs or services paid for cc
under any other contract or from any other source are not eligible for payment under this contract.
6. Official Payee and Representatives(Names.Addresses.and Telephone Numbers);
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The Contractor name,as shown on page 1 of this Collier County Board of County Commissioners
p g Community and Human Services cei
a. contract, and mailing address of the official payee 3339 E Tamiami Trail,Building H
to whom the payment shall be made is: Naples,FL 34112 �n
Kimberley Grant,Director c
Collier County Board of County Commissioners N
b. The name of the contact person and street address c/o Community and Human Services
where financial and administrative records are 3339 E Tamiami Trail,Building H
maintained is: Naples,FL 34112 E
Kimberly Grant, Director m
The name, address,and telephone number of the Collier County Board of County Commissioners QE
c' representative of the Contractor responsible for c/o Community and Human Services
administration of the program under this contract 3339 E Tamiami Trail,Building H
is: Naples,FL 34112
(239)252-2273
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This amendment shall be effective August 04, 2015. All provisions in the agreement and any attachments thereto in ti
conflict with this amendment shall be and are hereby changed to conform with this amendment b
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All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the U
agreement.
This amendment and all of its attachments are hereby made a part of this agreement. E;
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•Amendment 001 July 2015 to June 2016 ` ADI 203.4
IN WITNESS WHEREOF, the parties hereto have caused this 4 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST =
COUNTY COMMISSIONERS FLORIDA,INC. g
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SIGNED BY: • e1 _ wigwam,SIGNED Bwigwam,
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NAME: Stephen Y. Carnell NAME: MARIANNE G LORINI
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TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: l - I S DATE: o 1015
Federal Tax ID: 59-6000-558
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Assistant County Attorney ,7
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Amendment 001 • July 2015 to June 2016 • 16.D.13.e
ADI 203. J.vu
ATTACHMENT III
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO
THIS CONTRACT CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
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TOTAL FEDERAL AWARD it
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES
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2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS M
CONTRACT CONSIST OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
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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 $ 277,450.00 Eis
TOTAL AWARD $ 277,450.00
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.
'ode
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Amendment 001 • July 2015 to June 2016 . 16.D.13.e
ADI 203. 3.UUI
ATTACHMENT VII
ANNUAL BUDGET SUMMARY
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
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ALLOCATION TOTAL $ 277,450
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Attestation Statement
Agreement/Contract Number 203.15
Amendment Number 001
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I, Stephen Y.Carnell ,attest that no changes or revisions have been made to the Q
(Recipient/Contractor representative) c
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content of the above referenced agreement/contract or amendment between the Area Agency on Aging for LY
Southwest Florida and
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Public Services Department Head n
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u_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.
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Amendment 002 July 2015 to June 2016 ADI 203. 16.1113.e
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners("Contractor"), amends agreement ADI 203.15.
The purpose of this amendment is to amend 4. Contract Amount, increase the allocation by $4,600.00, and revise
ATTACHMENT III and ATTACHMENT VIII,ANNUAL BUDGET SUMMARY.
Line denotes completion of above summary
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$282,050.00, or the rate schedule, subject to the availability of funds. Any costs or services paid foriZ
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under any other contract or from any other source are not eligible for payment under this contract.
cc
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This amendment shall be effective April 21, 2016. All provisions in the agreement and any attachments thereto in conflict n
with this amendment shall be and are hereby changed to conform with this amendment >-
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All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the c
agreement. Q,
This amendment and all of its attachments are hereby made a part of this agreement. LA
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IN WITNESS WHEREOF, the parties hereto have caused this 3 page amendment to be executed by their officials there ccv
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
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SIGNED BY: ' 9,. ) / / SIGNED BY: a
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NAME: STEPHEN Y. CARNELL NAME: MARIANNE G LORINI
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TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO v
DATE: May 26, 2016 DATE: `t
Federal Tax ID: 59-6000-558 a)
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Fiscal Year Ending Date: 09/30 _c
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Approved as to form and legality
Assistant County Attorney
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Amendment 002 July 2015 to June 2016 ADI 203. 16.D.13.e
ATTACHMENT III
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO
THIS CONTRACT CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
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0
0
0
7t-
TOTAL
TOTAL FEDERAL AWARD
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COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES
AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: N/A
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CONTRACT CONSIST OF THE FOLLOWING: o
MATCHING RESOURCES FOR FEDERAL PROGRAMS
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PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
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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 $ 282,050.00
TOTAL AWARD $ 282,050.00 c
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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
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Amendment 002 July 2015 to June 2016 ADI 203. 16.D.13.e
ATTACHMENT VIII
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
ANNUAL BUDGET SUMMARY
for0
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Collier County Board of County Commissioners,
Collier
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ALLOCATION TOTAL $ 282,050
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Attestation Statement
Agreement/Contract Number ADI 203.15
Amendment Number 002
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I, Stephen Y. Carnell
attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
713content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and CL
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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 LL
electronic data processing media,which has no affect on the agreement/contract content.
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MIN May 26, 2016
Signatu ie of Recip nt/Contractor representative Date to
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Amendment 003 ADI 203.15.003
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
This AMENDMENT,entered into between the Area Agency on Aging for Southwest Florida hereinafter referred to 2
as the"Agency,"and Collier County Board of County Commissioners,hereinafter referred to as the"Contractor," 11
collectively stated as the"Parties"which amends contract ADI 203.15.
This amendment shall be effective July 1,2016.
RECITALS: ce
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WHEREAS, on August 4, 2015,the parties entered into the Standard Contract for social services to be
provided to Collier County's frail and elderly seniors (hereinafter referred to as"Contract"); and
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WHEREAS, on October 5, 2015, the parties entered into a First Amendment to the Contract; and
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WHEREAS, on April 21, 2016, the parties Second Amendment to the Contract is pending execution; and
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WHEREAS, Section 3 of the Contract provides that the agreement is to expire on June 30, 2016; and N
WHEREAS, the funding source for a successor agreement for senior services is not yet available to the
Agency from the Florida Department of Elder Affairs;
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WHEREAS, the Parties are satisfied with the arrangement that they currently enjoy under the Contract so
that both parties wish to extend the Contract to August 30, 2016 while they await notification of funding of a
successor contract.
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NOW,THEREFORE, in consideration of the foregoing Recitals, and other good and valuable consideration,the 2
receipt and sufficiency of which is hereby mutually acknowledged,the Parties agree as follows:
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1. The foregoing Recitals are true and correct and are incorporated by reference herein. o
2. Both parties agree to extend the contract to August 30, 2016.
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3. All other provisions of the Contract are to remain in effect and are to be performed at the level
specified in the agreement.
SIGNATURE PAGE TO FOLLOW
IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be executed by their
officials there unto duly authorized.
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16.D.13.e
Amendment 003 ADI 203.15.003
Collier County Board of County
Contractor:
Commissioners Area Agency on Aging for Southwest Florida
h' / SIGNED
SIGNED BY:__. f! �u BY: C
NAME: STEPHEN Y. CARNELL NAME: Marianne G Lorini
To
TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: President/CEO
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DATE: June 6,2016 DATE: d//6//4e }
Federal Tax ID: 59-6000588
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Agreement/Contract Number ADI 203.15
Amendment Number 003 2
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cco AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. at.
HOME CARE FOR THE ELDERLY PROGRAM CONTRACT a
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 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.
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cd 6. flicial Payee and Representatives (Islamcs Adclresses and Tele h ne Numbs rsl
Collier County Housng, andVeteran
iHuman -Y
The Contractor name, as shown on page 1 of this
Services
contract, and mailing address of the official payee to a.
a. 3339 E Tamiami Trail, Building H
whom the payment shall be made is: Naples, FL 341 12
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
c The name, address, and telephone number of the Collier County Housing, Human and Veteran
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, 1, 111, 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 arc 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.
f-
SIGNED BY: / „��� 1 � SIGNED BY: `i) - ., w v.,„�.
�-� �
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NAME: ��,1,' (,/
C, NAME: MARIANNE G LORINI
TITLE:` fkl I srti - �'CC- .0 ('4 • KI j/ TITLE: PRESIDENT/CEO
DATE: H. DATE: (
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30 Approved as to ror,u arxu legality
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2 Assistant Countyq tey
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INDEX OF ATTACHMENTS a�
C.)a-
ATTACHMENT 1 .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 1I, IV,and V are included by reference in the Master Contract HM014.
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ATTACHMENT I I.-
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AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC. a
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 PIan 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. NOls are located on the Department's
website at http://elderaffairs.state.fl.us/doea/nois.php.
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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.
n.
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 EIder 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;
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(4) Be at risk of nursing home placement;
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(5) Have an approved adult caregiver living in the home with them who is willing and able to provide car y
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 I-ICE 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.
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(3) Service priority for individuals not included in (I) and (2) above, regardless of referral source, will
a.
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 6
levels of frailty and risk of nursing home placement. as
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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 I-lousing 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
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6 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 c
documented and needed services are planned, arranged and coordinated for the client and caregiver.
2.1.4 Use of Subcontractors a
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.I, 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.
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G 2.4.2 CIRTS Reports
The Contractor sha11 input HCE-specific data into CIRTS. To ensure CIRTS data accuracy, the Contractor a.
shall use CIRTS-generated reports which include the following:
(1) Client Reports; a
(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
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oSubsidy payments for each client and for the program must be maintained within the amount of program
co funding available,
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2.8 AGENCY RESPONSIBILITIES he
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2.8.1 Program Guidance anti 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.
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3.2.1 Advance Recoupment
r3 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 m
report number 5, in accordance with ATTACHMENT VII to this contract. The Contractor may temporarily t
place advanced funds into an FDIC insured interest bearing account. All interest earned on advanced funds a
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 I-ICE 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 I5th 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.
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0 3.4.3 Contractors' Monthly CIRTS Reports
co The Agency must require Contractors to run monthly CIRTS Reports and verify client and service data in a
the CIRTS is accurate. This report must be submitted to the Agency with the monthly request for payment and 1.5
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.
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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 he 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 I 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
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ATTACHMENT II to.
a.
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, FIa. Admin. Code
13
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ATTACHMENT VI a
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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
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ATTACHMENT VII a
HOME CARE FOR THE ELDERLY
INVOICE REPORT SCHEDULE a
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/I5) May 20
l 3 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 he 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
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ATTACHMENT VI a
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REQUEST FOR PAYMENT a
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 request is 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 $000
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 $0.00 $0.00
2.Net Expenditures For Month $0.00 $0.00 $0.00 $0.00
(DDEA 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
Ray.seo 5/4112
16
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`r° ATTACHMENT I` a
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RECEIPT AND EXPENDITURE REPORT
HOME CARE FOR THE ELDERLY PROGRAM
PROVIDER NAME,ADDRESS,PHONE#and FE/D# 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.Stale 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/O!
3.Service Subcontractors:Subsidy $0.00 $0.00 $0.00 #DIV/0!
a.Basic Subsidy $0,00 $0.00 $0.00 #D!V/0!
b.Special Subsidy $0.00 $0.00 $0.00 #DIV/0!
4.TOTAL EXPENDITURES $0.00 $0.00 $0.00 #DIVIOI
PART C OTHER REVENUE AND EXPENDITURES
I.Interest: II.Advance Recoupment
1.Earned on GR Advance$
2.Return of GR Advance $ 1.Advance Recouped $
3,Other Earned $
DOEA FORM 105H
{devised 5r20/2010
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ATTACHMENT )
Cost Reimbursement Summary
es
Contract#
Report(invoice)Number:
Budget Number of
Category Description units Service Date Amount
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TOTAL ADMINISTRATION $0.00
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TOTAL EXPENSES $0.00
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Attestation Statement
Agreement/Contract Number HCE 203.15
Amendment Number
1, Stephen Y.Came ,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.
Ci
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4.1)4 , //7)g
Signatu r"e`of Recipient/Contractorrepresentative Date
Approved as to form and legality
Assistant CountyAttorney
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Revised August 2007
Amendmert.!101 • HCE 2C 16.D.13.f
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. 2.44 {�
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HOME CARE FOR THE ELDERLY PROGRAM CONTRACT
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners ("Contractor"), amends agreement HCE 203.15.
0
The purpose of this amendment is to amend contractual language.
NOW THEREFORE, in consideration of the mutual covenants and obligations set forth herein, the receipt and sufficiency of Q
which are hereby acknowledged,the Parties agree to the following:
it
1. ATTACHMENT I,Section 2.1.3.1.1 is hereby replaced. cncn
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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 11:.
the Basic Subsidy. The Contractor shall ensure the Basic Subsidy is calculated in accordance with the M
current DOEA Programs and Services Handbook, Chapter 7, Section III, Item C.2., Basic Subsidy °'
Amount. --
Department of Elder Affairs Programs& Services Handbook may be found at the following link:
Http://elderaffairs.state.fl.us/doea/nois.php
(7)
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby
changed to conform to this Amendment.
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All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified Q
in the contract. o
This Amendment and all its attachments are hereby made part of the contract. c
IN WITNESS THEREOF, the Parties hereto have caused this 1 page amendment, to be executed by their
undersigned officials as duly authorized; and agree to abide by the terms,conditions and provisions of this HCE
contract as amended. This Amendment is effective on the last date the Amendment has been signed by both U
Parties.
Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY CO SSIONERS SOUTHWEST FLORIDA,INC. a=i
SIGNED BY: tr1 SIGNED BY: Atl— � I
NAME: STEPHEN Y. CARNELL NAME: MARIANNE G LORINI
TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO/
DATE: February 5, 2016 DATE: //a//c,
Federal Tax ID: 59-6000558
Approved as to form and legality
Fiscal Year Ending Date: 09/30
1
Mi)stant County ev
I Packet Pa. 1141
Revssed August 2007 16.D.13.f
Attestation Statement
Agreement/Contract Number: HCE 203.15
Amendment Number 001
0
0
0
I, Stephen Y Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
LL
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and cn
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Public Services Department Head �n
(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.
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Signature of Kecip lif/Uontractor representative Date cn
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Assistant County A o 'ey
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I Packet Pg. 1142
Amendment.002 S July 2015 to June 2016 . HCE 20 16.D.13.f
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
HOME CARE FOR THE ELDERLY PROGRAM CONTRACT
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners ("Contractor"), amends agreement HCE 203.15.
0
The purpose of this amendment is to amend contractual language in ATTACHMENT I.
NOW THEREFORE, in consideration of the mutual covenants and obligations set forth herein,the receipt and sufficiency =
of which are hereby acknowledged,the Parties agree to the following: u'
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1.ATTACHMENT I, Section 3.2 is hereby replaced. co
in
3.2 ADVANCE PAYMENTS >
The Contractor may request up to two months of advances at the start of the contract period, to cover program L''
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 F2
provide the Contract Manager documentation justifying the need for an advance and describing how the funds will be in
distributed. The Contractor's requests for advances require the approval of the Contract Manager and if sufficient budget �i
is available, the Agency will issue approved advance payments after July 1, the beginning of the contract term. The N
schedule for submission of advance requests(when available)is ATTACHMENT VII to this contract.
2. ATTACHMENT I, Section 3.3 is hereby replaced.
3.3 INVOICE SUBMITTAL AND REQUESTS FOR PAYMENT cp
All Requests for Payment and Receipt and Expenditure Reports submitted to the Agency shall be submitted using <
ATTACHMENT VIII, and ATTACHMENT IX, and shall be in in accordance with the Invoice Schedule
(ATTACHMENT VII). The Contractor shall include documentation of services provided, number of units of services,
and the rates for the services provided in conformance with the requirements as described in this ATTACHMENT I and 'c
ATTACHMENT VI. Each deliverable must be received and accepted by the Agency before payment is made. m
f4
3. ATTACHMENT I, Section 3.3.1 is hereby deleted.
This amendment shall be effective February 19, 2016. All provisions in the agreement and any attachments thereto in w
conflict with this amendment shall be and are hereby changed to conform with this amendment
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the
contract.
This Amendment and all its attachments are hereby made part of the contract.
1
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Packet Pg. 1143 I
Amendment.002 • July 2015 to June 2016 • HCE 2C 16.D.13.f
IN WITNESS THEREOF,the Parties hereto have caused this 1 page amendment,to be executed by their undersigned
--icials as duly authorized; and agree to abide by the teens, conditions and provisions of this HCE contract as
ended. This Amendment is effective on the last date the Amendment has been signed by both Parties.
Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY COMMIS. IONERS SOUTHWEST FLORIDA,INC.
fl,
„ A. SIGNED BY:��� ,..te- ve )C/ OZ
SIGNED BY: _Il �'�/
NAME: Stephen Y. Carnell NAME: MARIANNE G LORINI =
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO o
DATE: March 21. 2016 DATE: jp°06
Federal Tax ID: 59-6000558 i1
Fiscal Year Ending Date: 09/30 re
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• 16.D.13.f
Revised August 2007
Attestation Statement
Agreement/Contract Number: HCE 203.15
Amendment Number 002
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I, Stephen Y. Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
ii
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and t4
Public Services Department Head ,
(Recipient/Contractor name)
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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. M
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March 21, 2016tri
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16.D.13.f
Amendment 003 HCE 203.15.003
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA, INC.
HOME CARE FOR THE ELDERLY PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
This AMENDMENT,entered into between the Area Agency on Aging for Southwest Florida hereinafter referred to
as the "Agency„”and Collier County Board of County Commissioners,hereinafter referred to as the"Contractor,"
collectively stated as the"Parties"which amends contract HCE 203.15.
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This amendment shall be effective July 1, 2016.
RECITALS:
ct
WHEREAS, on August 17, 2015, the parties entered into the Standard Contract for social services to be
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provided to Collier County's frail and elderly seniors (hereinafter referred to as `Contract"); and
WHEREAS, on February 12, 2016, the parties entered into a First Amendment to the Contract; and u_
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WHEREAS. on March 29, 2016, the parties entered into a Second Amendment to the Contract; and. ca
WHEREAS, Section 3 of the Contract provides that the agreement is to expire on June 30, 2016;
and •
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WHEREAS, the funding source for a successor agreement for senior services is not yet available to the
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Agency from the Florida Department of Elder Affairs; E
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WHEREAS, the Parties are satisfied with the arrangement that they currently enjoy under the Contract so E
that both parties wish to extend the Contract to August 30, 2016 while they await notification of funding of a
successor contract.
NOW, THEREFORE, in consideration of the foregoing Recitals, and other good and valuable consideration, the m
receipt and sufficiency of which is hereby mutually acknowledged, the Parties agree as follows:
1. The foregoing Recitals are true and correct and are incorporated by reference herein.
2. Both parties agree to extend the contract to August 30, 2016. c.)
3. All other provisions of the Contract are to remain in effect and are to be performed at the level
specified in the agreement. c
SIGNATURE PAGE TO FOLLOW
1 GA"J
I Packet Pg.1146
16.D.13.f
Amendment 003 HCE 203.15.003
IN WITNESS WHEREOF, the parties hereto have caused this Amendment to he executed by their
officials there unto duly authorized.
Collier County Board of County
Contractor:
Commissioners Area Agency on Aging for Southwest Florida
SIGNED BY: I.i u / SIGNED
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NAME: Stephen Y. Carnell NAME: Marianne G LoriniCD
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TITLE: Public Services Department Head TITLE: President/CEO
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DATE: June 6, 2016 DATE: G/>b,/F
Federal Tax ID: 59-6000588
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Fiscal Year Ending Date: 09/30 N
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16.D.13.f
Revised August 2007
Attestation Statement
Agreement/Contract Number HCE 203.15
Amendment Number 003
a
I, Stephen Y.Carnell ,attest that no changes or revisions have been made to the c
(Recipient/Contractor representative) u_
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and `D
U,
Public Services Department Head >-
(Recipient/Contractor name) LL
The only exception to this statement would be for changes in page formatting,due to the differences in a)
electronic data processing media,which has no affect on the agreement/contract content.
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9toJune 6, 2016 Aer*difil
Signature of eci ient/Contractor representative Date
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Approved as to form and legality
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Assistant County Attorney 1\�.P v�
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Revised August 2007
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